Nokea
The nurse is preparing to administer the first dose of an antibiotic to a patient admitted for a urinary tract infection. Which action is most important prior to administering the antibiotic?
- A. Administering a small test dose to determine if hypersensitivity exists
- B. Having epinephrine available in case of a severe hypersensitivity reaction
- C. Monitoring baseline vital signs, including temperature and blood pressure
- D. Obtaining a specimen for culture and sensitivity
Correct Answer: D
Rationale: The most crucial action before administering an antibiotic for a urinary tract infection is to obtain a specimen for culture and sensitivity. This ensures the accurate identification of the causative organism and helps determine the most effective antibiotic therapy. Administering a test dose to detect hypersensitivity is usually reserved for cases with a strong suspicion of allergy to a needed antibiotic. Keeping epinephrine available is important when there is a significant risk of a severe allergic reaction. Monitoring baseline vital signs is essential during antibiotic therapy but is not the top priority before administering the first dose.
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A client who has just undergone bronchoscopy was returned to the nursing unit 1 hour ago. With which assessment finding is the nurse most concerned?
- A. Oxygen saturation of 97%
- B. Equal breath sounds in both lungs
- C. Absence of cough and gag reflexes
- D. Respiratory rate of 20 breaths/min
Correct Answer: C
Rationale: The correct answer is C. The absence of cough and gag reflexes is the most concerning finding for the nurse because it indicates a lack of protective airway reflexes, putting the client at risk of aspiration. Oxygen saturation of 97% is within the normal range and indicates adequate oxygenation. Equal breath sounds in both lungs are a positive finding, indicating no significant abnormalities. A respiratory rate of 20 breaths/min is also within the normal range and does not raise immediate concerns. Therefore, the absence of cough and gag reflexes poses the highest risk to the client's airway safety.
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.
A client with autosomal dominant polycystic kidney disease (ADPKD) asks, "Will my children develop this disease?" How should the nurse respond?
- A. No genetic link is known, so your children are not at increased risk.
- B. Your sons will develop this disease because it has a sex-linked gene.
- C. Only if both you and your spouse are carriers of this disease.
- D. Each of your children has a 50% risk of having ADPKD.
Correct Answer: D
Rationale: Children whose parent has the autosomal dominant form of PKD have a 50% chance of inheriting the gene that causes the disease. ADPKD is transmitted as an autosomal dominant trait and therefore is not gender-specific. Both parents do not need to have this disorder. Choice A is incorrect because ADPKD has a known genetic link and a definitive mode of inheritance. Choice B is incorrect as ADPKD is not sex-linked but autosomal dominant. Choice C is incorrect because ADPKD follows an autosomal dominant inheritance pattern and does not require both parents to be carriers for the child to inherit the disease.
A nurse reviews a female client's laboratory results. Which result from the client's urinalysis should the nurse recognize as abnormal?
- A. pH 5.6
- B. Ketone bodies present
- C. Specific gravity of 1.020
- D. Clear and yellow color
Correct Answer: B
Rationale: The correct answer is B: Ketone bodies present. Ketone bodies in urine indicate abnormal metabolism, specifically the incomplete breakdown of fatty acids. Normally, there should be no ketones present in urine. Ketone bodies are produced when the body uses fat sources instead of glucose for cellular energy. A pH range between 4.6 and 8, a specific gravity between 1.005 and 1.030, and clear yellow color in urine are considered normal findings for a female client's urinalysis. Therefore, options A, C, and D are within normal ranges and not indicative of abnormal results in the urinalysis.
A client has a long history of hypertension. Which category of medication would the nurse expect to be ordered to avoid chronic kidney disease (CKD)?
- A. Antibiotic
- B. Histamine blocker
- C. Bronchodilator
- D. Angiotensin-converting enzyme (ACE) inhibitor
Correct Answer: D
Rationale: The correct answer is D, Angiotensin-converting enzyme (ACE) inhibitor. ACE inhibitors inhibit the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. By blocking this conversion, ACE inhibitors promote vasodilation and improve perfusion to the kidneys. Additionally, ACE inhibitors block the breakdown of bradykinin and prostaglandin, further contributing to vasodilation. They also lead to increased renin and decreased aldosterone levels. These effects help in reducing blood pressure and protecting the kidneys in clients with hypertension. Antibiotics are used to fight infections, histamine blockers reduce inflammation, and bronchodilators widen the bronchi, none of which address the underlying processes involved in slowing the progression of chronic kidney disease (CKD) in hypertensive clients.