Exhibits

Review H and P, nurse's notes, laboratory values, flow sheet, and prescriptions.

Click to mark whether the assessment finding represents a therapeutic result of the mannitol administered, a non-therapeutic side effect, or an unrelated finding. Each row must have one option selected.

Peripheral edema

Potassium 2.9

Urine output 280 ml

Heart rate 79

Intracranial pressure 11mmHg

Oxygen saturation

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"C"},"E":{"answers":"A"},"F":{"answers":"C"}}

1. Peripheral edema: Non-therapeutic side effect

- Mannitol is an osmotic diuretic that can cause fluid shifts leading to peripheral edema, which is an unintended side effect.

2. Potassium 2.9: Non-therapeutic side effect

- Hypokalemia (low potassium) is a potential side effect of mannitol due to increased urinary excretion of electrolytes.

3. Urine output 280 mL: Therapeutic result

- Mannitol increases urine output as it promotes diuresis, which is the intended therapeutic effect.

4. Heart rate 79: Unrelated finding

- The heart rate of 79 beats/minute is within normal limits and is not directly related to the administration of mannitol.

5. Intracranial pressure 11 mmHg: Therapeutic result

- The decrease in intracranial pressure from 24 mmHg to 11 mmHg is a desired therapeutic outcome of mannitol, as it helps reduce cerebral edema.

6. Oxygen saturation: Unrelated finding

- The oxygen saturation of 99% is within normal limits and is not directly related to the administration of mannitol.

Nursing Test Bank

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Free Nursing Study Resources

Correct Answer is ["A","C","D","E","F","H"]

Explanation

A. (The dose of insulin drawn up in the syringe): Ensures the correct dosage is being administered, which is critical to avoid under- or overdosing.
B. The site for the insulin administration is not typically double-checked with another nurse, as they are part of the nurse's standard assessment and practice.
C. (The type of insulin to be administered): Confirms that the correct insulin type (e.g., insulin lispro) is being given, as administering the wrong type could lead to improper glucose control.
D. (The sliding scale insulin lispro prescription): Verifies the correct sliding scale dosing, ensuring it matches the client's current blood glucose level.
E. (The insulin concentration): Ensures the insulin concentration is appropriate and aligns with the prescribed dose.
F. (The insulin vial for color and clarity): Confirms that the insulin is not compromised; any discoloration or cloudiness could indicate that the insulin is not safe to use.
H. (The expiration date on the insulin vial): Ensures the insulin is within its expiration date and effective.
G. The history and physical with the diabetes diagnosis listed are not typically double-checked with another nurse, as they are part of the nurse's standard assessment and practice.

A. Hold the dose of IV pantoprazole until the client has finished eating breakfast. B. Provide a PRN dose of antacid along with the scheduled medications. C. Instruct the client to take the dose of sucralfate PO while eating breakfast. D. Administer both of the medications before breakfast as scheduled.

Correct Answer is D

Explanation

A. Pantoprazole should be given before breakfast to inhibit gastric acid secretion; delaying it until after breakfast would reduce its effectiveness.
B. Administering an antacid alongside sucralfate may interfere with the absorption of sucralfate.
C. Sucralfate should be taken on an empty stomach before meals to form a protective barrier on the ulcer site, not while eating.
D. Both pantoprazole and sucralfate are scheduled to be administered before breakfast to maximize their effectiveness in reducing gastric acid and protecting the ulcer site.

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Exhibits Review H and P, nurse's notes, laboratory values, flow sheet, and prescriptions. Click to mark whether the assessment finding represents a therapeutic result of the mannitol administered, a non-therapeutic side effect, or an unrelated finding. Each row must have one option selected.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Exhibits The nurse prepares to give 2 units of insulin lispro. Which should the nurse double check with a second nurse? Select all that apply.

Correct Answer is ["A","C","D","E","F","H"]

Explanation

A client with peptic ulcer disease is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0730. The client reports experiencing heartburn when the nurse brings the scheduled medications. Which action should the nurse take?

Correct Answer is D

Explanation

Exhibits Review H and P, nurse's notes, laboratory results, flow sheet, and prescriptions. Click to mark whether the assessment finding represents a therapeutic result of the minoxidil administered, a non-therapeutic side-effect, or an unrelated finding. Each row must have one option selected.

A client with chronic asthma receives a prescription for montelukast, a leukotriene modifier. Which statement by the client indicates to the nurse that medication teaching was effective?

A client who is receiving pregabalin for fibromyalgia complains of tremors in the hands. Which action should the nurse implement?

Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?

The nurse is caring for a client with atrial fibrillation who receives a prescription for warfarin. The international normalized ratio (INR) is 2.8. Which action should the nurse take?

Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client's history includes which problem?

Exhibits

Review H and P, nurse's notes, laboratory values, flow sheet, and prescriptions.

Click to mark whether the assessment finding represents a therapeutic result of the mannitol administered, a non-therapeutic side effect, or an unrelated finding. Each row must have one option selected.