Nokea
The nurse is caring for several patients who are receiving antibiotics. Which order will the nurse question?
- A. Azithromycin (Zithromax) 500 mg IV in 500 mL of fluid
- B. Azithromycin (Zithromax) 500 mg PO once daily
- C. Erythromycin 300 mg IM QID
- D. Erythromycin 300 mg PO QID
Correct Answer: C
Rationale: The nurse should question the order for Erythromycin 300 mg IM QID. Erythromycin and other macrolides should not be given intramuscularly because they cause painful tissue irritation. Options A and B are correct routes for Azithromycin, either intravenously or orally. Option D is a correct route for Erythromycin, which is orally.
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A client expresses difficulty voiding in public places. How should the nurse respond?
- A. Offer to turn on the faucet in the bathroom to help stimulate urination.
- B. Suggest a prescription for a diuretic to increase urine output.
- C. Propose moving to a room with a private bathroom to enhance comfort.
- D. Close the curtain to provide maximum privacy.
Correct Answer: D
Rationale: The nurse should prioritize the client's privacy when addressing issues related to voiding discomfort in public places. Closing the curtain in the current room would offer immediate privacy and support the client's needs. Turning on the faucet is not an evidence-based intervention for voiding difficulties. Prescribing a diuretic is not appropriate without further assessment. While moving to a room with a private bathroom might be ideal, it may not be immediately feasible, making ensuring privacy in the current setting the most appropriate action.
After an endotracheal tube is placed in a client who experienced sudden onset of respiratory distress, what should the nurse do?
- A. Secure the tube in place with tape
- B. Order a chest x-ray for the client
- C. Document the depth of tube insertion
- D. Auscultate both lungs for breath sounds
Correct Answer: D
Rationale: After endotracheal tube insertion, the nurse should auscultate both lungs for the presence of breath sounds. This step helps confirm proper tube placement and adequate ventilation. Auscultation of breath sounds is crucial to ensure that the tube is correctly positioned in the trachea and not in the esophagus. While securing the tube with tape is important, it is not the immediate priority after insertion. Ordering a chest x-ray may be necessary but is not the first action to take immediately post-intubation. Documenting the depth of tube insertion is important but ensuring proper ventilation through auscultation takes precedence.
The nurse is teaching the main principles of hemodialysis to a client with chronic kidney disease. Which statement by the client indicates a need for further teaching by the nurse?
- A. My sodium level changes due to the movement from the blood into the dialysate.
- B. Dialysis works by the movement of wastes from higher to lower concentration.
- C. Extra fluid can be pulled from the blood by osmosis.
- D. The dialysate is similar to blood but without any toxins.
Correct Answer: B
Rationale: The correct answer is B because dialysis works by the movement of solutes from an area of higher concentration to an area of lower concentration, which is known as diffusion. The other statements are accurate: A correctly describes the movement of sodium during hemodialysis, C explains the removal of excess fluid by osmosis, and D highlights the purpose of the dialysate in removing toxins from the blood.
A client with a diagnosis of hypothermia is being admitted to the hospital by a nurse. Which of the following signs does the nurse anticipate that this client will exhibit?
- A. Increased heart rate and increased blood pressure
- B. Increased heart rate and decreased blood pressure
- C. Decreased heart rate and increased blood pressure
- D. Decreased heart rate and decreased blood pressure
Correct Answer: D
Rationale: Hypothermia decreases the heart rate and blood pressure due to reduced metabolic needs of the body. With lower metabolic demands, the heart's workload decreases, leading to reductions in both heart rate and blood pressure. Choices A, B, and C are incorrect because hypothermia typically results in a decrease in heart rate and blood pressure, not an increase.
The patient has a heart rate of 98 beats per minute and a blood pressure of 82/58 mm Hg, is lethargic, complaining of muscle weakness, and has had gastroenteritis for several days. Based on these findings, which sodium value would the nurse expect?
- A. 126 mEq/L
- B. 140 mEq/L
- C. 145 mEq/L
- D. 158 mEq/L
Correct Answer: A
Rationale: The patient's presentation of tachycardia, hypotension, lethargy, muscle weakness, and gastroenteritis suggests hyponatremia. Hyponatremia is characterized by a serum sodium level below the normal range of 135-145 mEq/L. A serum sodium level of 126 mEq/L falls significantly below this range, indicating hyponatremia. Choice B (140 mEq/L) and Choice C (145 mEq/L) are within the normal range for serum sodium levels and would not explain the patient's symptoms. Choice D (158 mEq/L) is above the normal range and would indicate hypernatremia, which is not consistent with the patient's presentation.