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The physician has ordered that a serum trough level be drawn for a medication. Which of the following is the correct time to draw blood for a trough level?
- A. At the midpoint in time between two scheduled doses of the drug.
- B. At the time the drug peaks.
- C. Immediately after a scheduled dose is administered.
- D. Immediately before a scheduled dose is due.
Correct Answer: D
Rationale: A trough level is drawn immediately before a scheduled dose (D) to measure the lowest drug concentration in the blood. Other times (A, B, C) do not reflect the trough level.
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The nurse caring for a client scheduled for an angiogram should prepare the client for the procedure by telling him to expect:
- A. Dizziness as the dye is injected
- B. Nausea and vomiting after the procedure is completed
- C. A decreased heart rate for several hours after the procedure is completed
- D. A warm sensation as the dye is injected
Correct Answer: D
Rationale: A warm sensation is commonly experienced during an angiogram due to the injection of contrast dye.
The nurse is teaching the mother of a child with cystic fibrosis how to do chest percussion. The nurse should tell the mother to:
- A. Use the heel of her hand during percussion
- B. Change the child's position every 20 minutes during percussion sessions
- C. Do percussion after the child eats and at bedtime
- D. Use cupped hands during percussion
Correct Answer: D
Rationale: Cupped hands during chest percussion create a vibration that helps loosen mucus in cystic fibrosis without causing injury.
The newly licensed nurse has been asked to perform a procedure that he feels unqualified to perform. The nurse's best response at this time is to:
- A. Attempt to perform the procedure
- B. Refuse to perform the procedure and give a reason for the refusal
- C. Request to observe a similar procedure and then attempt to complete the procedure
- D. Agree to perform the procedure if the client is willing
Correct Answer: B
Rationale: Refusing and explaining the lack of qualification ensures patient safety and adheres to ethical standards.
A client with a history of chronic obstructive pulmonary disease (COPD) is admitted with an acute exacerbation. The nurse notes that the client has a respiratory rate of 28 breaths per minute, is using accessory muscles, and has oxygen saturation of 88% on 2 L/min of oxygen via nasal cannula. Which of the following actions should the nurse take FIRST?
- A. Increase the oxygen flow to 4 L/min.
- B. Administer a bronchodilator as ordered.
- C. Place the client in a high Fowler’s position.
- D. Obtain an arterial blood gas (ABG) sample.
Correct Answer: C
Rationale: positioning in high Fowler’s facilitates breathing and improves oxygenation immediately; other actions may follow based on further assessment
The nurse notes variable decelerations on the fetal monitor strip. The most appropriate initial action would be to:
- A. Notify her.Concurrent doctor
- B. Increase the rate of IV fluid
- C. Reposition the client
- D. Readjust the monitor
Correct Answer: C
Rationale: Repositioning the client can relieve umbilical cord compression, the common cause of variable decelerations.