A nurse is reviewing a client's peak and trough levels of gentamicin. The peak should be 6 to 8 mcg/mL and the trough should be 0.5 to 1 mcg/mL. The client's peak is10 mcg/mL and his trough is 2.3 mcg/mL. Which of the following clinical manifestations should the nurse expect with these findings? (Select all that apply.)

Insomnia

Constipation

Xerostomia

Persistent headache

Tinnitus

Answer and Explanation

Correct Answer : D,E

D. Persistent headache can occur with elevated levels of gentamicin, as it may indicate neurotoxicity. Gentamicin can cause neurotoxic effects, including headaches, especially when levels are elevated.

E. Tinnitus (ringing in the ears) is a classic symptom of gentamicin toxicity. Elevated gentamicin levels can lead to ototoxicity, which manifests as tinnitus among other auditory symptoms.

A. Insomnia is not typically associated with elevated levels of gentamicin. Elevated gentamicin levels are not known to cause insomnia.

B. Constipation is not typically associated with elevated levels of gentamicin. Elevated gentamicin levels are not known to cause constipation.

C. Xerostomia (dry mouth) is not typically associated with elevated levels of gentamicin. Elevated gentamicin levels are not known to cause xerostomia.

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Correct Answer is A

Explanation

A. Cleansing the injection site is important to reduce the risk of infection.

B. Sterile gloves are not typically required for administering subcutaneous injections unless there is a specific indication, such as when dealing with a client who has a compromised immune system or if there is potential for exposure to bodily fluids.

C. Pinching the skin can help in creating a fold where the needle can be inserted. However, there is no standard recommendation on which hand should be used.

D. Subcutaneous injections are typically administered at a 45-degree or 90-degree angle to the client's skin, depending on the amount of subcutaneous tissue present.

A. most appropriate distal vein on the nondominant arm. B. most appropriate proximal vein available on either arm. C. antecubital vein of the patient's nondominant arm. D. antecubital vein of the patient's dominant arm.

Correct Answer is A

Explanation

A. Distal veins, such as those in the hand or forearm of the nondominant arm, are often preferred for initial IV placement. These veins are typically smaller but can be easier to access and cause less discomfort for the patient compared to more proximal veins.

B. Proximal veins, such as those in the upper arm (brachial or basilic veins), may be considered if distal veins are not accessible or suitable. However, proximal veins are larger and can be more difficult to cannulate, potentially causing more discomfort and increasing the risk of complications.

C. The antecubital veins, located in the bend of the elbow, are commonly used for venipuncture due to their accessibility and size. The antecubital vein of the nondominant arm is often preferred to minimize interference with the patient's daily activities and reduce the risk of complications associated with frequent use of the dominant arm.

D. While the antecubital vein of the dominant arm may also be accessible, it is generally recommended to preserve this area for procedures that require a higher level of dexterity and strength. Frequent venipuncture in the dominant arm can lead to discomfort and potential complications, such as phlebitis or thrombosis.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer a subcutaneous injection to a client. Which of the following actions should the nurse plan to take?

Correct Answer is A

Explanation

A nurse is mentoring a new nurse who is learning to start IVs. The nurse tells the new nurse that in case the patient needs subsequent venipuncture sites, the best place to initially start an IV is the:

Correct Answer is A

Explanation

A nurse is preparing an injection using a single dose glass ampule. Which of the following actions should the nurse take?

A nurse is reinforcing teaching with a client who has diabetes mellitus about using a glucometer to monitor her blood glucose. Which of the following actions should the nurse identify as an indication that the client understands the instructions?

A nurse is collecting data on a client who has circulatory overload. Which of the following findings should the nurse expect?

A nurse is reinforcing teaching with a client who has a duodenal ulcer and has a new prescription for sucralfate. Which of the following instructions should the nurse include?

A charge nurse is observing a nurse performing a Mantoux tuberculin skin test for a client. Which of the following actions should prompt the charge nurse to intervene?

A nurse observes a newly licensed nurse administer enoxaparin subcutaneously using a pre- filled syringe. Which of the following indicates appropriate medication administration?

A nurse is assisting with care of a client who has a prescription for 3,000 mL of intravenous fluids over the next 24 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number)

A nurse is assisting in the plan of care for a client who has hypernatremia. Which of the following IV solutions should the nurse plan to initiate?