Nokea
Which of the following medications is a serotonin antagonist that might be used to relieve nausea and vomiting?
- A. metoclopramide (Reglan)
- B. onedansetron (Zofran)
- C. hydroxyzine (Vistaril)
- D. prochlorperazine (Compazine)
Correct Answer: B
Rationale: Zofran is a serotonin antagonist that can be used to relieve nausea and vomiting. The other medications can be used for nausea and vomiting, but they have different mechanisms of action.
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The HCP prescribes risperidone to manage the hallucinations of the client diagnosed with paranoid schizophrenia. Which client statements reflect a need for further education regarding the medication's side effects? Select all that apply.
- A. Diarrhea may be a problem for me.
- B. I'll most likely develop high blood pressure.
- C. Being too nervous is a side effect of my medicine.
- D. I will need to watch what I eat so I won't gain weight.
- E. Getting up too quickly when I'm sitting can make me dizzy.
- F. I will need to be careful driving because this can make me drowsy.
Correct Answer: A,B
Rationale: Constipation, not diarrhea, and hypotension, not hypertension, are side effects of risperidone, indicating a need for further education.
When administering intravenous electrolyte solution, the nurse should take which of the following precautions?
- A. Infuse hypertonic solutions rapidly.
- B. Mix no more than 80 mEq of potassium per liter of fluid.
- C. Prevent infiltration of calcium, which causes tissue necrosis and sloughing.
- D. As appropriate, reevaluate the client's digitalis dosage. He might need an increased dosage because IV calcium diminishes digitalis's action.
Correct Answer: C
Rationale: Preventing tissue infiltration is important to avoid tissue necrosis. Choice A is incorrect because hypertonic solutions should be infused cautiously and checked with the RN if there is a concern. Choice B is incorrect because potassium, mixed in the pharmacy per physician order, is mixed at a concentration no higher than 60 mEq/L.
Which of the following is not considered one of the main mechanisms of Type II Diabetes treatment?
- A. Medications
- B. Nutrition
- C. Increased activity
- D. Continuous Insulin
Correct Answer: D
Rationale: Insulin is not required in continuous treatment for every Type II diabetic, as many can manage with lifestyle changes and oral medications.
The LPN is taking care of a 176-pound client who has recently been diagnosed with diabetes. The primary healthcare provider has written an order for Lantus (insulin glargine injection) 100 units/mL, using weight-based dosing of 0.2 units/kg per day. The LPN should prepare ___ units for administration.
- A. 12
- B. 35
- C. 16
- D. 9
Correct Answer: C
Rationale: To find the answer, you must convert 176 pounds to kilograms. 2.2 pounds = 1 kg. You must divide 176 by 2.2, which equals 80 kg. The client is 80 kg, and they should receive 0.2 units for every kilogram they weigh, so 80 × 0.2 = 16 units.
The 12-year-old weighing 50 kg is hospitalized with bacterial pneumonia and an upper respiratory tract infection. The nurse is reviewing the child's serum laboratory report illustrated. Based on the findings, which HCP order is most important for the nurse to question?
- A. Amikacin sulfate 375 mg IVPB q12h
- B. Guaifenesin 50-100 mg q4h prn for cough
- C. Dextrose 5% in 0.25 NaCl with 20 mEq/L KCl at 90 mL/hr
- D. Acetaminophen 325-650 mg q4-6h prn, not to exceed 3000 mg/24 hr
Correct Answer: A
Rationale: A: Amikacin (Amikin) is an aminoglycoside, which is nephrotoxic and should be questioned. The serum creatinine and BUN levels are elevated, suggesting decreased renal function. B: Guaifenesin (Robitussin) is used for cough. The dose is within the range for a child of 12 years. C: The serum osmolality is high, suggesting dehydration, and the potassium is low. D5 in 0.25 NaCl with 20 mEq/L at 90 mL/hr will treat the dehydration and hypokalemia. D: The acetaminophen (Tylenol) dose is within parameters, but it is concerning with the decreased renal function. Because acetaminophen is prn and amikacin is timed, the amikacin is more important to question.