Nursing Elites

1. What types of medications should the healthcare provider expect to administer to a client during an acute respiratory distress episode?

• A. Vasodilators and hormones.
• B. Analgesics and sedatives.
• C. Anticoagulants and expectorants.
• D. Bronchodilators and steroids.

Correct answer: D

Rationale: During an acute respiratory distress episode, the priority is to widen air passages, increase air space, and reduce alveolar membrane inflammation. Therefore, the client would likely require bronchodilators to open up the airways and steroids to reduce inflammation. Vasodilators and hormones (Choice A) are not typically indicated in this situation. Analgesics and sedatives (Choice B) may be used for pain management and anxiety but are not primary treatments for respiratory distress. Anticoagulants and expectorants (Choice C) are not the main medications used during an acute respiratory distress episode and may not address the immediate needs of the client.

2. A 58-year-old client who has been post-menopausal for five years is concerned about the risk for osteoporosis because her mother has the condition. Which information should the nurse offer?

• A. Osteoporosis is a progressive genetic disease with no effective treatment.
• B. Calcium loss from bones can be slowed by increasing calcium intake and exercise.
• C. Estrogen replacement therapy should be started to prevent the progression of osteoporosis.
• D. Low-dose corticosteroid treatment effectively halts the course of osteoporosis.

Correct answer: B

Rationale: Post-menopausal females are at risk for osteoporosis due to the cessation of estrogen secretion. While genetics can play a role, osteoporosis is not solely a genetic disease. Increasing calcium intake, along with vitamin D supplementation and weight-bearing exercise, can help prevent further bone loss by slowing down calcium loss from bones. Estrogen replacement therapy is no longer recommended as a first-line treatment for osteoporosis due to associated risks. Corticosteroid treatment is not typically used as a primary treatment for osteoporosis.

3. The nurse is caring for a patient who is receiving an intravenous antibiotic. The nurse notes that the provider has ordered serum drug peak and trough levels. The nurse understands that these tests are necessary for which type of drugs?

• A. Drugs with a broad spectrum
• B. Drugs with a narrow spectrum
• C. Drugs with a broad therapeutic index
• D. Drugs with a narrow therapeutic index

Correct answer: D

Rationale: Medications with a narrow therapeutic index have a limited range between the therapeutic dose and a toxic dose. It is important to monitor these medications closely by evaluating regular serum peak and trough levels. Drugs with a narrow spectrum (Choice B) are antibiotics that target only a limited group of bacteria, not related to the need for peak and trough monitoring. Drugs with a broad spectrum (Choice A) cover a wide range of bacteria, but this characteristic does not determine the need for peak and trough monitoring. Drugs with a broad therapeutic index (Choice C) have a wide safety margin between therapeutic and toxic doses, so they typically do not require peak and trough level monitoring.

4. The nurse is preparing to administer intravenous gentamicin to an infant through an intermittent needle. The nurse notes that the infant has not had a wet diaper for several hours. The nurse will perform which action?

• A. Administer the medication and give the infant extra oral fluids.
• B. Contact the provider to request adding intravenous fluids when giving the medication.
• C. Give the medication and obtain a serum peak drug level 45 minutes after the dose.
• D. Hold the dose and contact the provider to request a serum trough drug level.

Correct answer: D

Rationale: In this scenario, the infant not having a wet diaper for several hours indicates a potential decrease in urine output, which can be a sign of nephrotoxicity related to gentamicin. The correct action for the nurse is to hold the dose and contact the provider to request a serum trough drug level. This is important to monitor the drug levels and ensure that they are not reaching toxic levels. Administering the medication without addressing the decreased urine output could potentially lead to further nephrotoxicity. Contacting the provider to add intravenous fluids or obtaining a serum peak drug level are not the most appropriate actions in this situation as the priority is to assess for potential nephrotoxicity and ensure patient safety.

5. A client who underwent surgery and experienced significant blood loss is being cared for by a nurse. Which findings by the nurse should prompt immediate action to prevent acute kidney injury? (Select all that apply.)

• A. Urine output of 100 mL in 4 hours
• B. Large amount of sediment in the urine
• C. A & B
• D. Amber, odorless urine

Correct answer: C

Rationale: The nurse must monitor for signs of acute kidney injury in a postoperative client who had major blood loss. Low urine output, presence of sediment in the urine, and low blood pressure should raise concerns and be reported to the healthcare provider promptly. Postoperatively, assessing urine characteristics is crucial. Sediment, hematuria, and urine output less than 0.5 mL/kg/hour for 3 to 4 hours should be reported. While a urine output of 100 mL in 4 hours is low, it should be compared to the recommended 0.5 mL/kg/hour over a longer period. Perfusion to the kidneys is a priority, hence the importance of addressing low blood pressure. Amber, odorless urine is considered normal and does not indicate an immediate concern for acute kidney injury, unlike low urine output and presence of sediment.

Similar Questions