Nokea
The LPN is admitting a client to the unit and the client has rapidly blinking eyes, stuck out tongue, and a distorted posture. Which of these medications is the patient most likely taking?
- A. Clozapine
- B. Fluoxetine
- C. Ondansetron
- D. Haloperidol
Correct Answer: D
Rationale: Haloperidol is a first-generation antipsychotic that blocks dopamine receptors and is most likely to cause extrapyramidal symptoms (EPS), such as tardive dyskinesia. Symptoms of tardive dyskinesia include rapid blinking, mouth movements, sticking out of the tongue, rapid body movements, and a distorted posture.
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Which of the following are included in the Rights of Medication Administration? Select all that apply. A. right dose, B. right time, C. right explanation, D. right client, E. right route
- A. B, C, D, E
- B. A, B, D, E
- C. A, B, D
- D. B, C, E
Correct Answer: B
Rationale: The Rights of Medication Administration include right client, right drug, right dose, right route, and right time. An additional right that is sometimes included is right documentation.
A client receiving drug therapy with furosemide and digitalis requires careful observation and care. In planning care for this client, the nurse should recognize that which of the following electrolyte imbalances is most likely to occur?
- A. hyperkalemia
- B. hypernatremia
- C. hypokalemia
- D. hypomagnesemia
Correct Answer: C
Rationale: Furosemide, a diuretic, commonly causes potassium loss, leading to hypokalemia, which can potentiate digitalis toxicity, requiring close monitoring.
The nurse is storing vaccines for future use. What should the nurse do so they are properly stored? Select all that apply.
- A. Place all vaccines in a temperature-controlled refrigerator.
- B. Complete periodic checks of the expiration date on the vaccines.
- C. Place bulk supplies of vaccines in a temperature-controlled freezer.
- D. Avoid storing vaccines on the shelf in the door of the refrigerator.
- E. Do not store food or beverage in the same refrigerator or freezer as the vaccines.
Correct Answer: B,D,E,F
Rationale: A: Not all vaccines are refrigerated; some vaccines will be inactivated by refrigeration and freezing. B: Periodic checking for expiration dates is necessary to ensure that outdated vaccines are not administered. C: Not all bulk supplies should be placed in a freezer; some vaccines are inactivated by freezing. D: When refrigeration is required, a main shelf inside the refrigerator is best because a shelf in the door will have frequent temperature changes that will alter the potency of the vaccine. E: Storing food and beverage in the same unit may result in frequent opening of the unit, leading to greater chance of temperature instability and light exposure. Contamination may also result. F: Aluminum foil or packaging can be used to protect light-sensitive vaccines.
The 12-year-old weighing 50 kg is hospitalized with bacterial pneumonia and an upper respiratory tract infection. The nurse is reviewing the child's serum laboratory report illustrated. Based on the findings, which HCP order is most important for the nurse to question?
- A. Amikacin sulfate 375 mg IVPB q12h
- B. Guaifenesin 50-100 mg q4h prn for cough
- C. Dextrose 5% in 0.25 NaCl with 20 mEq/L KCl at 90 mL/hr
- D. Acetaminophen 325-650 mg q4-6h prn, not to exceed 3000 mg/24 hr
Correct Answer: A
Rationale: A: Amikacin (Amikin) is an aminoglycoside, which is nephrotoxic and should be questioned. The serum creatinine and BUN levels are elevated, suggesting decreased renal function. B: Guaifenesin (Robitussin) is used for cough. The dose is within the range for a child of 12 years. C: The serum osmolality is high, suggesting dehydration, and the potassium is low. D5 in 0.25 NaCl with 20 mEq/L at 90 mL/hr will treat the dehydration and hypokalemia. D: The acetaminophen (Tylenol) dose is within parameters, but it is concerning with the decreased renal function. Because acetaminophen is prn and amikacin is timed, the amikacin is more important to question.
What is pica?
- A. dependency on alcohol
- B. increased iron in the diet
- C. the sickle cell trait
- D. eating ice
Correct Answer: D
Rationale: Pica represents the ingestion of nonfood substances that leads to a clinical iron deficiency and might actually be the first sign of a problem. Clients eat a wide range of nonfood items, including ice, clay, dirt, and paste.