Nokea
The LPN is administering 0800 medications to clients on a medical floor. Which action by the LPN would warrant immediate intervention by the nurse?
- A. The LPN scores the medication to give the correct dose.
- B. The LPN checks the client's armband and birth date.
- C. The LPN administers sliding-scale insulin intramuscularly.
- D. The LPN is 30 minutes late hanging the IV antibiotic.
Correct Answer: C
Rationale: Sliding-scale insulin is given subcutaneously, not IM; this error warrants intervention to prevent improper absorption. Scoring, ID checks, or timing are less critical.
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A client is receiving erythromycin 500 mg IV every 6 hours to treat a pneumonia. Which of the following is the most common side effect of the medication?
- A. Blurred vision
- B. Nausea and vomiting
- C. Severe headache
- D. Insomnia
Correct Answer: B
Rationale: Nausea and vomiting. Nausea is a common side-effect of erythromycin in both oral and intravenous forms.
The client is receiving the angiotensin-converting enzyme (ACE) inhibitor enalapril (Vasotec). When would the nurse question administering this medication?
- A. The client is not receiving potassium supplements.
- B. The client complains of a persistent irritating cough.
- C. The blood pressure for two (2) consecutive readings is 110/70.
- D. The client's urinary output is 400 mL for the last eight (8) hours.
Correct Answer: B
Rationale: A persistent cough is a common ACE inhibitor side effect, warranting discontinuation or HCP evaluation. Potassium, BP, or urine output are less critical.
The client diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) is receiving the aminoglycoside antibiotic vancomycin. Peak and trough levels are ordered for the dose the nurse is administering. Which priority intervention should the nurse implement?
- A. Ask the client if he has had any diarrhea.
- B. Monitor the aminoglycoside peak level.
- C. Determine if the trough level has been drawn.
- D. Check the client's culture and sensitivity report.
Correct Answer: C
Rationale: Trough levels must be drawn before the next vancomycin dose to ensure therapeutic levels and avoid toxicity; this is the priority. Diarrhea, peak levels, or culture reports are secondary.
The client is diagnosed with tuberculosis and prescribed rifampin and isoniazid (INH), both antituberculosis medications. Which instruction is most important for the public health nurse to discuss with the client?
- A. The client will have to take the medications for nine (9) to 12 months.
- B. The client will have to stay in isolation as long as he or she is taking medications.
- C. Explain the client cannot eat any type of pork products while taking the medication.
- D. The urine may turn turquoise in color, but this is an expected occurrence and harmless.
Correct Answer: A
Rationale: TB treatment requires 9–12 months for cure, ensuring adherence is critical to prevent resistance, a public health priority. Isolation, pork, or urine color are incorrect or less urgent.
The employee health nurse is discussing hepatitis B vaccines with new employees. Which statement best describes the proper administration of the hepatitis B vaccine?
- A. The vaccine must be administered once a year.
- B. Two (2) mL of vaccine should be given in each hip.
- C. The vaccine is given in three (3) doses over a six (6)-month time period.
- D. The vaccine is administered intradermally into the deltoid muscle.
Correct Answer: C
Rationale: Hepatitis B vaccine is given in three IM doses (0, 1, 6 months), per CDC guidelines. Annual dosing, split doses, or intradermal routes are incorrect.