Nokea
Which of the following findings should the nurse report to the provider as an adverse effect of gentamicin?
- A. Constipation
- B. Tinnitus
- C. Hypoglycemia
- D. Joint pain
Correct Answer: B
Rationale: The correct answer is B: Tinnitus. Gentamicin is an aminoglycoside antibiotic known to cause ototoxicity, including tinnitus. Tinnitus is characterized by ringing or buzzing in the ears and can be an early sign of auditory nerve damage. This adverse effect should be reported to the provider promptly to prevent further hearing loss.
A: Constipation is not a typical adverse effect of gentamicin.
C: Hypoglycemia is not a known adverse effect of gentamicin.
D: Joint pain is not commonly associated with gentamicin use.
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How many mL/h should the nurse set the IV infusion pump to deliver half the total volume of lactated Ringer's (4,080 mL) in the first 8 hours?
- A. 200 mL/h
- B. 225 mL/h
- C. 250 mL/h
- D. 255 mL/h
- E. 275 mL/h
Correct Answer: D
Rationale: The correct answer is D: 255 mL/h. To deliver half of 4,080 mL in 8 hours, you need to administer 2,040 mL in 8 hours. To calculate the infusion rate, divide the total volume by the total time: 2,040 mL ÷ 8 hours = 255 mL/h. This rate ensures half of the total volume is infused within the specified time frame.
Choice A (200 mL/h) is too slow, as it would not deliver half the volume in 8 hours. Choices B, C, and E exceed the required rate and would deliver more than half the volume in 8 hours.
Which of the following findings should indicate to the nurse that a client with myasthenia gravis taking neostigmine is experiencing an adverse effect?
- A. Tachycardia
- B. Oliguria
- C. Xerostomia
- D. Miosis
Correct Answer: D
Rationale: The correct answer is D: Miosis. Neostigmine is a cholinesterase inhibitor used to treat myasthenia gravis. Miosis, or excessive constriction of the pupil, is a sign of cholinergic crisis which can occur due to neostigmine overdose. This adverse effect indicates excessive stimulation of the parasympathetic nervous system, leading to symptoms such as increased salivation, bronchoconstriction, and miosis. Tachycardia (A) is not typically associated with neostigmine use, oliguria (B) is not a common adverse effect, and xerostomia (C) is the opposite of the expected effect of increased salivation due to cholinergic stimulation.
Which of the following information should the nurse include in the teaching about medication reconciliation?
- A. The client's provider is required to complete medication reconciliation.
- B. Medication reconciliation at discharge is limited to the medications ordered at the time of discharge.
- C. A transition in care requires the nurse to conduct medication reconciliation.
- D. Medication reconciliation is limited to the names of the medications that the client is currently taking.
Correct Answer: C
Rationale: The correct answer is C: A transition in care requires the nurse to conduct medication reconciliation. This is because medication reconciliation is crucial during transitions of care to ensure safe and accurate medication management. The nurse plays a key role in reconciling medications to prevent errors and ensure continuity of care.
Incorrect choices:
A: The client's provider is required to complete medication reconciliation - Incorrect, as nurses are often responsible for medication reconciliation, not just the provider.
B: Medication reconciliation at discharge is limited to the medications ordered at the time of discharge - Incorrect, as reconciliation should encompass all medications the client is taking.
D: Medication reconciliation is limited to the names of the medications that the client is currently taking - Incorrect, as it should also include dosages, frequencies, and routes of administration.
A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspneWhich of the following medications should the nurse administer first?
- A. Diphenhydramine
- B. Albuterol inhaler
- C. Epinephrine
- D. Prednisone
Correct Answer: C
Rationale: The correct answer is C: Epinephrine. When a client exhibits symptoms of anxiety, hypotension, and dyspnea after receiving cefazolin IV, it indicates a severe allergic reaction/anaphylaxis. Epinephrine is the first-line medication for anaphylaxis as it acts quickly to reverse the symptoms by constricting blood vessels, increasing blood pressure, and opening airways. Diphenhydramine (A) is an antihistamine that can be given as a second-line treatment. Albuterol inhaler (B) is used for bronchospasm but is not the first choice in anaphylaxis. Prednisone (D) is a corticosteroid that may be used later for inflammation but is not the initial treatment for anaphylaxis.
Which of the following findings should the nurse document as a manifestation of pseudoparkinsonism in a client taking haloperidol?
- A. Serpentine limb movement
- B. Shuffling gait
- C. Nonreactive pupils
- D. Smacking lips
Correct Answer: B
Rationale: The correct answer is B: Shuffling gait. Pseudoparkinsonism is a side effect of antipsychotic medications like haloperidol, characterized by symptoms resembling Parkinson's disease. A shuffling gait, where the client takes small steps with feet barely leaving the floor, is a classic manifestation. Serpentine limb movement (A) is not typically associated with pseudoparkinsonism. Nonreactive pupils (C) can be a sign of anticholinergic toxicity, not pseudoparkinsonism. Smacking lips (D) is more indicative of tardive dyskinesia, another side effect of antipsychotics.