Nokea
The nurse instructs the client who is taking gentamicin to monitor factors related to renal function. The nurse determines that the client needs additional instruction when he makes which of the following statements?
- A. I should call you if I notice that I'm not urinating as much.'
- B. I should call you if my urine looks dark or unusual.'
- C. I should call you if my legs swell or I notice my skin looks puffy around my eyes.'
- D. I should call you if I have a fever.'
Correct Answer: D
Rationale: Gentamicin can cause nephrotoxicity, so monitoring for decreased urine output, dark urine, or edema (swelling) is appropriate. Fever is not directly related to renal function, indicating a need for further instruction.
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Which of the following is an adverse effect of vancomycin (Vancocin) and needs to be reported promptly?
- A. Vertigo.
- B. Tinnitus.
- C. Muscle stiffness.
- D. Ataxia.
Correct Answer: B
Rationale: Tinnitus is a sign of ototoxicity, a serious adverse effect of vancomycin that requires prompt reporting to prevent permanent hearing damage.
A client with a history of heart failure is prescribed eplerenone (Inspra). The nurse should monitor the client for which of the following side effects?
- A. Hyperkalemia.
- B. Hypoglycemia.
- C. Weight gain.
- D. Hypertension.
Correct Answer: A
Rationale: Eplerenone, a potassium-sparing diuretic, can cause hyperkalemia, requiring monitoring of potassium levels.
The nurse reviewing the electrocardiogram (ECG) rhythm strip of a client with a history of a myocardial infarction (MI) notes that the PR intervals are 0.16 seconds. The nurse should arrive at which interpretation of this assessment data?
- A. A normal finding
- B. An abnormal finding
- C. An impending reinfarction
- D. First-degree atrioventricular (AV) block
Correct Answer: A
Rationale: The PR interval represents the time it takes for the cardiac impulse to spread from the atria to the ventricles. The PR interval range is 0.12 to 0.2 seconds. Therefore, the finding is normal. The remaining options all indicate an abnormal finding, so they are not appropriate responses.
Select the opioid classification that is accurately coupled with an example of it AND a side effect or adverse reaction to it.
- A. Opioid Agonist: Dilaudid: Constipation
- B. Opioid Agonist: Naloxone: Constipation
- C. Opioid Antagonist: Dilaudid: Anaphylaxis
- D. Opioid Antagonist: OxyContin: Anaphylaxis
Correct Answer: A
Rationale: Dilaudid (hydromorphone) is an opioid agonist, and constipation is a common side effect due to opioid effects on the gastrointestinal tract.
The nurse is teaching a client with a new diagnosis of epilepsy about self-care. Which of the following instructions should be included?
- A. Avoid swimming alone.
- B. Take medications at bedtime only.
- C. Limit fluid intake to prevent seizures.
- D. Wear loose-fitting clothing.
Correct Answer: A
Rationale: Avoiding swimming alone prevents drowning during a seizure, a key safety measure.