Nokea
A nurse is assessing a client who is taking an osmotic laxative. Which of the following findings should the nurse identify as an indication of fluid volume deficit?
- A. Nausea
- B. Weight gain
- C. Headache
- D. Oliguria
Correct Answer: D
Rationale: The correct answer is D: Oliguria. Osmotic laxatives, such as lactulose or polyethylene glycol, work by drawing water into the colon to soften the stool. If a client on osmotic laxatives is experiencing oliguria (decreased urine output), it can be a sign of fluid volume deficit due to the body trying to conserve water. Nausea (A) is a common side effect of osmotic laxatives but not a specific indicator of fluid volume deficit. Weight gain (B) is not associated with fluid volume deficit. Headache (C) can be caused by various factors and is not a specific sign of fluid volume deficit.
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A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to a client who has diabetes mellitus. Which of the following actions should the nurse take first?
- A. Withdraw the regular insulin from the vial
- B. Withdraw the NPH insulin from the vial
- C. Inject air into the NPH vial
- D. Inject air into the regular insulin vial
Correct Answer: C
Rationale: The correct answer is C: Inject air into the NPH vial. This step is crucial to prevent creating a vacuum in the vial when withdrawing the NPH insulin, ensuring accurate dosage measurement. Injecting air into the NPH vial equalizes pressure, making it easier to withdraw the correct amount of insulin without causing air bubbles.
Choice A is incorrect as withdrawing regular insulin first may lead to air being drawn into the syringe when withdrawing NPH insulin. Choice B is incorrect because withdrawing NPH insulin first without equalizing pressure may cause difficulty in drawing the correct amount of insulin. Choice D is incorrect as injecting air into the regular insulin vial before withdrawing NPH insulin is unnecessary and may introduce air bubbles into the syringe.
A nurse is discussing adverse reactions to pain medications in older adult clients with a newly licensed nurse. Which of the following findings should the nurse include as risk factors for an adverse drug reaction? (SATA)
- A. Polypharmacy
- B. Increased rate of absorption
- C. Decreased percentage of body fat
- D. Multiple health problems
Correct Answer: A,C,D,E
Rationale: To determine risk factors for adverse drug reactions in older adults, consider the following:
A: Polypharmacy increases the likelihood of drug interactions and adverse effects.
C: Decreased body fat can affect drug distribution, leading to higher drug concentrations.
D: Multiple health problems may require multiple medications, increasing the risk of adverse reactions.
E: Age-related changes in liver and kidney function can affect drug metabolism and excretion.
Other choices are incorrect because increased rate of absorption does not necessarily increase risk and choices F and G were not provided.
A nurse is caring for a client who has a new diagnosis of benign prostate hypertrophy and a prescription for doxazosin. The client tells the nurse, 'I do not take this medication. I would prefer a natural therapy.' Which of the following supplements should the nurse suggest the client discuss with the provider?
- A. Black cohosh
- B. Garlic
- C. Feverfew
- D. Saw palmetto
Correct Answer: D
Rationale: The correct answer is D: Saw palmetto. Saw palmetto is commonly used as a natural remedy for benign prostate hypertrophy due to its potential benefits in reducing symptoms. It works by decreasing inflammation and promoting the shrinkage of the prostate gland. The nurse should suggest discussing saw palmetto with the provider as it aligns with the client's preference for natural therapy.
Choice A: Black cohosh is not typically used for prostate issues but rather for menopausal symptoms in women.
Choice B: Garlic is not specifically indicated for benign prostate hypertrophy and is more commonly known for its cardiovascular benefits.
Choice C: Feverfew is primarily used for migraine headaches and has no direct association with prostate health.
In summary, saw palmetto is the most appropriate supplement to suggest as it targets the client's condition effectively compared to the other options provided.
A nurse inadvertently administers 160 mg of valsartan PO to a client who was scheduled to receive 80 mg. Which of the following actions is the priority for the nurse to take?
- A. Evaluate the client for orthostatic hypotension.
- B. Monitor the client's urine output.
- C. Obtain the client's laboratory results.
- D. Check the client for nasal congestion.
Correct Answer: A
Rationale: The correct answer is A: Evaluate the client for orthostatic hypotension. This is the priority because an overdose of valsartan, a medication used to treat hypertension, can lead to a sudden drop in blood pressure. Orthostatic hypotension is a potential complication that can result from this overdose, and it requires immediate assessment and intervention to prevent further complications such as falls or decreased perfusion to vital organs. Monitoring urine output (B) is important for some medications but is not the priority in this case. Obtaining laboratory results (C) may be necessary in the long term but is not urgent in this situation. Checking for nasal congestion (D) is not relevant to the issue at hand.
A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following predisposes this client to developing digoxin toxicity?
- A. Taking a high ceiling diuretic
- B. Having a 10-year history of COPD
- C. Having a prolapsed mitral valve
- D. Taking an HMG CoA reductase inhibitor
Correct Answer: A
Rationale: The correct answer is A: Taking a high ceiling diuretic. High ceiling diuretics, such as furosemide, can lead to hypokalemia, which increases the risk of digoxin toxicity. Digoxin competes with potassium for binding sites on the Na+/K+-ATPase pump in the heart, so low potassium levels can lead to an increased concentration of digoxin in the body, predisposing the client to toxicity. Choices B, C, and D are incorrect as they do not directly impact digoxin levels or toxicity. A history of COPD (B) or a prolapsed mitral valve (C) do not specifically predispose a client to digoxin toxicity. Taking an HMG CoA reductase inhibitor (D) does not interact directly with digoxin.