Nokea
The nurse is administering a.m. medications. Which medication should the nurse administer first?
- A. The daily digoxin to the client diagnosed with congestive heart failure.
- B. The loop diuretic to the client with a serum potassium level of 3.1 mEq/L.
- C. The mucosal barrier Carafate to the client diagnosed with peptic ulcer disease.
- D. Solu-Medrol IVP to a client diagnosed with chronic lung disease.
Correct Answer: C
Rationale: Carafate (sucralfate) forms a protective barrier and must be given on an empty stomach, 30–60 minutes before other meds, to be effective for PUD.
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Which observation, if reported by a client, is most suggestive of an adverse reaction to gentamicin?
- A. A WBC of 8000
- B. Ringing in the ears
- C. Itching
- D. Nasal stuffiness
Correct Answer: B
Rationale: Gentamicin is ototoxic. Ringing in the ears suggests possible damage to the eighth cranial nerve, the auditory nerve. A WBC of 8000 is normal.
Which laboratory test should the nurse monitor for the client receiving the intravenous steroid Solu-Medrol?
- A. Potassium level.
- B. Sputum culture and sensitivity.
- C. Glucose level.
- D. Arterial blood gases.
Correct Answer: C
Rationale: Solu-Medrol (methylprednisolone) can cause hyperglycemia, requiring glucose monitoring, especially IV. Potassium, sputum, or ABGs are less directly affected.
A client is scheduled for an intravenous pyelogram (IVP). After the contrast material is injected, which of the following client reactions should be reported immediately?
- A. Feeling warm
- B. Face flushing
- C. Salty taste
- D. Hives
Correct Answer: D
Rationale: Hives. This is a sign of anaphylaxis and should be reported immediately. The other reactions are considered normal and the client should be informed that they may occur.
The client in the intensive care department is receiving 2 mcg/kg/min of dopamine, an inotropic vasopressor. Which intervention should the nurse include in the plan of care?
- A. Monitor the client's blood pressure every two (2) hours.
- B. Assess the client's peripheral pulses every shift.
- C. Use a urometer to assess hourly output.
- D. Ensure the IV tubing is not exposed to the light.
Correct Answer: C
Rationale: Dopamine affects renal perfusion; hourly urine output via urometer monitors efficacy and prevents toxicity. BP, pulses, or light exposure are less critical.
An adult is hospitalized for an acute attack of gout. Which medication should the nurse expect to administer?
- A. Morphine
- B. Colchicine
- C. Allopurinol
- D. Acetaminophen
Correct Answer: B
Rationale: Colchicine is used to treat acute gout attacks by reducing inflammation, unlike allopurinol, which prevents attacks.