A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic solution.
Which of the following findings should indicate to the nurse that the treatment is effective?

Improved cognition.

Cardiac arrhythmias absent.

Decreased vomiting.

Absent Chvostek’s sign.

Answer and Explanation

The Correct Answer is A

Hyponatremia is a condition where the sodium level in the blood is too low, which can cause confusion, lethargy, seizures, and coma. A hypertonic solution is a fluid that has a higher concentration of solutes than the blood, which can help raise the sodium level and reduce the brain swelling caused by hyponatremia. Therefore, improved cognition indicates that the treatment is effective.

Choice B. Cardiac arrhythmias absent.

Cardiac arrhythmias are not a common symptom of hyponatremia unless it is severe or rapid in onset.

Therefore, their absence does not necessarily indicate that the treatment is effective.

Choice C. Decreased vomiting.

Vomiting can be a cause or a consequence of hyponatremia, depending on the underlying condition.

Decreased vomiting may indicate that the patient is less nauseated, but it does not reflect the sodium level or the brain status.

Choice D. Absent Chvostek’s sign.

Chvostek’s sign is a facial twitching that occurs when tapping on the cheek, which indicates hypocalcemia (low calcium level).

It is not related to hyponatremia or hypertonic solution.

Normal ranges for sodium are 135 to 145 mEq/L and for calcium are 8.5 to 10.5 mg/dL.

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Correct Answer is ["A","B"]

Explanation

Fluticasone is an inhaled steroid that prevents the symptoms of asthma by decreasing inflammation in the airways. It is not used to treat a sudden asthma attack.

Some additional information to explain why the other choices are wrong are:

Choice C is wrong because soaking the inhaler in water after use can damage the device and affect its performance.

Choice D is wrong because fluticasone is not a rescue inhaler that can be used as needed for shortness of breath.It is a controller inhaler that should be used regularly as prescribed by the doctor.

Choice E is wrong because shaking the device prior to administration is not necessary for a fluticasone metered-dose inhaler (MDI).However, it is recommended for fluticasone inhalation powder (Flovent Diskus). Some normal ranges that may be applicable are:

The usual dose of fluticasone MDI for adults and children 12 years and older is 55 to 232 mcg twice a day.The usual dose of fluticasone MDI for children 4 to 11 years old is 30 mcg twice a day. The maximum dose of fluticasone MDI for adults and children 12 years and older is 1000 mcg twice a day.

A. The client had chemotherapy 12 hr before the medication was administered. B. The medication vial sat at room temperature for 2 hr before it was administered. C. The client’s absolute neutrophil count was 2,500/mm3 before the medication was administered. D. The nurse flushed the client’s IV line with dextrose 5% in water before and after the medication was administered.

Correct Answer is D

Explanation

The correct answer is d

Choice A reason:

Administering filgrastim 12 hours after chemotherapy does not typically require an incident report. Filgrastim is often given at least 24 hours after chemotherapy to avoid the risk of increasing the toxicity of the chemotherapy agents. While the timing is closer than recommended, it does not necessarily constitute an error unless specific instructions for the timing were provided by the prescribing physician.

Choice B reason:

The medication vial sitting at room temperature for 2 hours before administration does not require an incident report. Filgrastim can be left out at room temperature for up to 24 hours before use. This is within the safe handling guidelines for the medication.

Choice C reason:

An absolute neutrophil count (ANC) of 2,500/mm³ is within the normal range, which is typically 1,500-8,000/mm³. Filgrastim is used to increase neutrophil counts in patients with low ANC due to chemotherapy. Since the ANC was not low before administration, this would not necessitate an incident report, although it may prompt a review of the necessity of the medication.

Choice D reason:

Flushing the client's IV line with dextrose 5% in water before and after the medication was administered is not the standard procedure and could potentially lead to medication errors or adverse effects. Filgrastim should be diluted in glucose 5% in water for intravenous infusion, but not used to flush the line. This deviation from the standard protocol is what necessitates an incident report.

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A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic solution. Which of the following findings should indicate to the nurse that the treatment is effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a guardian of a school-age child who has a new prescription for a fluticasone metered-dose inhaler. Which of the following information should the nurse include in the teaching? (Select all that apply)

Correct Answer is ["A","B"]

Explanation

A nurse recently administered filgrastim intravenously to a client who has cancer and is receiving cytotoxic chemotherapy. For which of the following data, discovered after the medication was administered, should the nurse file an incident report?

Correct Answer is D

Explanation

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A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic solution.
Which of the following findings should indicate to the nurse that the treatment is effective?