A nurse is monitoring a client who has a head injury and is receiving mannitol 25% via IV infusion. The nurse should identify which of the following as an adverse effect of the medication and report to the provider?

Glasgow coma scale rating of 15

Crackles on auscultation

Increase in urinary output

Intracranial pressure reading of 12mm

Answer and Explanation

The Correct Answer is B

A. Glasgow Coma Scale rating of 15: A Glasgow Coma Scale (GCS) rating of 15 is a positive sign indicating that the client is fully conscious and oriented. It is not an adverse effect of mannitol.
B. Crackles on auscultation: Crackles, also known as rales, can indicate fluid overload or pulmonary edema, which can be an adverse effect of mannitol. Mannitol can cause shifts of fluid, including into the lungs, leading to pulmonary edema.
C. Increase in urinary output: Mannitol is an osmotic diuretic, and an increase in urinary output is an expected and therapeutic effect of the medication. It is not considered an adverse effect.
D. Intracranial pressure reading of 12 mmHg: A decrease in intracranial pressure is a therapeutic effect of mannitol, and a reading of 12 mmHg is generally within a normal range. It is not considered an adverse effect.

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Correct Answer is D

Explanation

A. Obtain a prescription for an alternative antibiotic:
Clindamycin is generally safe for penicillin-allergic clients there is no need for an alternative antibiotic.
B. Administer the clindamycin using a desensitization schedule:
Using a desensitization schedule is a specialized procedure typically reserved for certain situations and performed in a controlled environment. It is not a standard approach for administering antibiotics, and in this case, obtaining an alternative antibiotic is a more appropriate and straightforward solution.
C. Premedicate the client with epinephrine before administering the antibiotic:
Premedicating with epinephrine is not a routine practice for preventing allergic reactions to antibiotics. While epinephrine may be used in severe allergic reactions, it's not a preemptive measure in this context. It's important to address the underlying issue by avoiding the allergen (penicillin class) and using an alternative antibiotic.
D. Give the client the prescribed dose of the clindamycin:
Clindamycin is generally safe for penicillin-allergic clients since it belongs to the lincosamide class and does not share the beta-lactam ring structure responsible for allergic reactions to penicillins.

A. "I should take this medication with 8 ounces of milk." B. I should take an antacid with this medication to prevent stomach upset." C. "I should notify my provider if my stools turn black" D. I should stay upright for at least 15 minutes after taking this medication

Correct Answer is C

Explanation

A. "I should take this medication with 8 ounces of milk." This statement is incorrect. Calcium-containing substances, such as milk, can interfere with the absorption of iron. It's generally recommended to take iron supplements on an empty stomach or with vitamin C-containing foods to enhance absorption.
B. "I should take an antacid with this medication to prevent stomach upset." This statement is also incorrect. Antacids can reduce the absorption of iron. It's advisable to take iron supplements separately from antacids to optimize absorption.
C. "I should notify my provider if my stools turn black." (Correct Answer) This statement is correct. Iron supplements can cause stools to appear black or dark green. This is a common and harmless side effect related to the change in the color of iron in the gastrointestinal tract. However, it's important for the client to notify the healthcare provider to rule out any potential bleeding issues.
D. "I should stay upright for at least 15 minutes after taking this medication." This statement is not specific to ferrous gluconate. However, it may be relevant for medications that can cause esophageal irritation or reflux. In the case of ferrous gluconate, the primary concern is optimizing absorption by taking it on an empty stomach or with vitamin C-containing foods.

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A nurse is monitoring a client who has a head injury and is receiving mannitol 25% via IV infusion. The nurse should identify which of the following as an adverse effect of the medication and report to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer clindamycin to a client who states she forgot to report to the provider that she is allergic to penicillin, Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is teaching a client who has a prescription for ferrous gluconate. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is C

Explanation

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