Nokea
The nurse is administering the following 1800 medications. Which medication should the nurse question before administering?
- A. The sliding-scale insulin to the client who has just been released to have the evening meal.
- B. The antibiotic to the client who is one (1) day postoperative exploratory abdominal surgery.
- C. Metformin (Glucophage), a biguanide, to the client having a CT scan with contrast dye in the morning.
- D. Protonix, a proton pump inhibitor, to the client diagnosed with peptic ulcer disease.
Correct Answer: C
Rationale: Metformin must be held before contrast dye due to lactic acidosis risk if renal function is impaired; other medications are appropriate.
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A woman is two months pregnant when her 5-year-old child develops rubella. What is most likely to be given to her?
- A. Immune serum globulin
- B. MMR
- C. RhoGam
- D. Rubella antitoxin
Correct Answer: A
Rationale: Immune serum globulin may be given to reduce the risk of rubella infection in the pregnant woman, protecting the fetus.
The client is receiving thrombolytic therapy for a diagnosed myocardial infarction (MI). Which assessment data indicate the therapy is successful?
- A. The client's ST segment is becoming more depressed.
- B. The client is exhibiting reperfusion dysrhythmias.
- C. The client's cardiac isoenzyme CK-MB is not elevated.
- D. The D-dimer is negative at two (2) hours post-MI.
Correct Answer: B
Rationale: Reperfusion dysrhythmias (e.g., PVCs) indicate restored coronary flow, a sign of thrombolytic success. ST depression, normal CK-MB, or D-dimer are not specific.
A 60-year-old client has been hospitalized for deep vein thrombosis. The client is to be discharged on warfarin (Coumadin) 5 mg PO daily. Which statement that the client makes indicates the best understanding of the medication routine?
- A. I will take aspirin for my arthritis.
- B. I love to eat spinach salads.
- C. I will get a blood test next week.
- D. I made an appointment to have my teeth pulled.
Correct Answer: C
Rationale: Warfarin requires regular INR monitoring via blood tests to ensure therapeutic anticoagulation levels.
The nurse administered an IV broad-spectrum antibiotic scheduled every six (6) hours to the client with a systemic infection at 0800. At 1000, the culture and sensitivity prompted the HCP to change the IV antibiotic. When transcribing the new antibiotic order, when would the initial dose be administered?
- A. Schedule the dose for 1400.
- B. Schedule the dose for the next day.
- C. Check with the HCP to determine when to start.
- D. Administer the dose within one (1) hour of the order.
Correct Answer: D
Rationale: New antibiotic orders for active infections require prompt administration (within 1 hour) to maintain therapeutic levels, per sepsis guidelines.
A 13-month-old child is admitted to the emergency room with salicylate poisoning. Her mother found her beside the empty bottle of adult aspirin. She says there were 'about 10' aspirin left in the bottle. What manifestations would the nurse most expect to see in the child?
- A. Bradypnea and pallor
- B. Hyperventilation and hyperpyrexia
- C. Subnormal temperature and bleeding
- D. Melena and bradycardia
Correct Answer: B
Rationale: Salicylate poisoning causes metabolic acidosis, leading to hyperventilation, and stimulates the CNS, causing fever (hyperpyrexia).