Nokea
The nurse is administering sodium polystyrene sulfonate to a client with acute kidney injury (AKI). Which laboratory finding indicates that the medication has been effective?
- A. Serum potassium level of 3.8 mEq/L (3.8 mmol/L)
- B. Hemoglobin level of 13.5 g/dL (135 g/L).
- C. Serum glucose level of 120 mg/dL (6.7 mmol/L)
- D. Serum ammonia level of 30 Mcg/dL (17.62 Mermol/L)
Correct Answer: A
Rationale: Sodium polystyrene sulfonate treats hyperkalemia by exchanging sodium for potassium. A potassium level of 3.8 mEq/L (A) indicates effectiveness (normal range: 3.5-5.0 mEq/L). Hemoglobin (B), glucose (C), and ammonia (D) are unrelated to its action.
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A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first?
- A. Determine when the last dose was administered.
- B. Review the history for past use of recreational drugs.
- C. Ask the client to rate the current level of pain using a pain scale.
- D. Encourage the client to use diversional thoughts to manage pain.
Correct Answer: C
Rationale: Assessing the client’s pain level using a pain scale (C) is the first step to quantify pain and guide appropriate dosing. Determining the last dose (A) and reviewing drug history (B) are secondary. Diversional thoughts (D) are a non-pharmacological adjunct, not the priority.
An adult patient at an outpatient clinic has been prescribed the antibiotic tetracycline HCI. What should the nurse include in the patient’s teaching plan?
- A. Consume with milk or antacids to prevent gastrointestinal irritation.
- B. Protect your skin from sunlight while on this medication.
- C. Enhance gastrointestinal absorption by taking with orange juice.
- D. Return to the clinic weekly for serum drug level checks.
Correct Answer: B
Rationale: Tetracycline causes photosensitivity, increasing sunburn risk, so sun protection (B) is essential. Milk/antacids (A) reduce absorption by chelating tetracycline. Orange juice (C) contains calcium, impairing absorption. Weekly drug level checks (D) are not required for tetracycline.
The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. What information is most important for the nurse to obtain?
- A. Family history of mental illness.
- B. Weight change in the last month.
- C. Liver function laboratory results.
- D. Recent use of other antidepressants.
Correct Answer: C
Rationale: Duloxetine is metabolized by the liver, and impaired liver function can increase toxicity risk. Liver function tests (C) are critical before starting. Family history (A), weight changes (B), and other antidepressants (D) are relevant but secondary to liver safety.
Before administering the evening dose of carbamazepine, the nurse notes that the patient’s morning carbamazepine level was 84 mcg/mL. What action should the nurse take?
- A. Notify the healthcare provider of the carbamazepine level.
- B. Administer the carbamazepine as prescribed.
- C. Withhold this dose of the carbamazepine.
- D. Assess the patient for side effects of carbamazepine.
Correct Answer: A
Rationale: Carbamazepine’s therapeutic range is 4-12 mcg/mL; 84 mcg/mL (A) indicates toxicity risk, requiring provider notification. Administering (B) or withholding (C) without consultation is unsafe. Assessing side effects (D) is secondary to reporting.
When administering medications to a group of patients, which patient should the nurse closely monitor for the development of acute kidney injury (AKI)?
- A. Patient on Vancomycin.
- B. Patient on Sucralfate.
- C. Patient on Lorazepam.
- D. Patient on Digoxin.
Correct Answer: A
Rationale: Vancomycin (A) is nephrotoxic and requires monitoring for AKI, especially with high doses or prolonged use. Sucralfate (B) protects the stomach, not kidneys. Lorazepam (C) and digoxin (D) have minimal renal toxicity risks.