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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The use of atropine for treatment of symptomatic bradycardia is contraindicated for a client with which of the following conditions?
- A. Urinary incontinence
- B. Glaucoma
- C. Increased intracranial pressure
- D. Right sided heart failure
Correct Answer: B
Rationale: Glaucoma. Atropine is contraindicated in clients with angle-closure glaucoma because it can cause pupillary dilation with an increase in aqueous humor, leading to a resultant increase in optic pressure.
A client has been receiving dexamethasone (Decadron) for control of cerebral edema. Which of the following assessments would indicate that the treatment is effective?
- A. A positive Babinski's reflex
- B. Increased response to motor stimuli
- C. A widening pulse pressure
- D. Temperature of 37 degrees Celsius
Correct Answer: B
Rationale: Decadron is a corticosteroid that acts on the cell membrane to decrease inflammatory responses as well as stabilize the blood-brain barrier. Once Decadron reaches a therapeutic level, there should be a decrease in symptomatology with improvement in motor skills.
The elderly male client is admitted for acute severe diverticulitis. He has been taking Xanax, a benzodiazepine, for nervousness three (3) to four (4) times a day prn for six (6) years. Which intervention should the nurse implement first?
- A. Prepare to administer an intravenous antianxiety medication.
- B. Notify the HCP to obtain an order for the client's Xanax prn.
- C. Explain Xanax causes addiction and he should quit taking it.
- D. Assess for signs/symptoms of medication withdrawal.
Correct Answer: D
Rationale: Long-term Xanax use risks dependence; assessing withdrawal (e.g., agitation, seizures) is the priority during acute illness to guide safe management.
The provider has ordered daily high doses of aspirin for a client with rheumatoid arthritis. The nurse instructs the client to discontinue the medication and contact the provider if which of the following symptoms occur?
- A. Infection of the gums
- B. Diarrhea for more than one day
- C. Numbness in the lower extremities
- D. Ringing in the ears
Correct Answer: D
Rationale: Ringing in the ears. Aspirin stimulates the central nervous system which may result in ringing in the ears.
The nurse in the physician's office is instructing an adult about taking penicillin V potassium (Pen-Vee-K) qid. When should the nurse tell him to take the medicine?
- A. With meals and at bedtime
- B. Once a day at 10:00 a.m.
- C. On an empty stomach at six-hour intervals
- D. With orange juice at four-hour intervals
Correct Answer: C
Rationale: Penicillin V potassium should be taken on an empty stomach at six-hour intervals to optimize absorption.