In checking the dose of intravenous ticarcillin disodium prescribed for an older client, the nurse notes that the 24 hour dosage is lower than the normal range. Which finding supports the need for this reduced dosage?

Reference range

Creatinine [0.6 to 1.2 mg/dL (53 to 106 μmol/L)]

White blood cells (WBC) [5,000 to 10,000/mm3 (5 to 10 x 109/L)]

White blood cell count of 8,000/mm3 (8 X 109/L).

Inelastic skin turgor.

Serum creatinine of 3.5 mg/dL (310 μmol/L).

Thin, fragile hand and arm veins.

Answer and Explanation

The Correct Answer is C

A. A white blood cell count of 8,000/mm³ is within the normal range and does not indicate a need for dosage adjustment.
B. Inelastic skin turgor may indicate dehydration or aging but does not directly affect drug dosage.
C. Elevated serum creatinine levels indicate impaired renal function, which necessitates a reduced dosage of medications excreted through the kidneys, such as ticarcillin disodium.
D. Thin, fragile veins are a concern for intravenous access but do not affect the medication dosage.

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Correct Answer is C

Explanation

A. The history of coronary artery bypass surgery is important but does not directly relate to the current symptoms.
B. A recent colonoscopy is not relevant to the client's current symptoms.
C. Long-term use of digoxin and furosemide is highly significant as these medications can lead to digoxin toxicity, especially in the context of dehydration or renal insufficiency. Symptoms like nausea, vomiting, and anorexia are classic signs of digoxin toxicity.
D. A history of depression is important but not immediately relevant to the current symptoms of nausea, vomiting, and anorexia.

A. Apply lubricating lotion to the areas. B. Refer the client for a skin lesion biopsy. C. Ask about recent international travel. D. Record the presence of senile lentigines.

Correct Answer is D

Explanation

A. Lubricating lotion may be helpful for dry skin but is not necessary for these lesions.
B. A biopsy is not typically required for benign lesions such as senile lentigines, unless there is suspicion of malignancy.
C. Recent international travel is unrelated to the development of senile lentigines.
D. Senile lentigines, also known as "liver spots" or "age spots," are common in older adults. They are benign lesions that result from sun exposure and aging. Recording their presence is appropriate for documentation, as they are generally not harmful.

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Naxlex Comprehensive Predictor Exams

An older adult client with heart failure comes to the emergency room because of nausea, vomiting, and anorexia. Based on the client's signs and symptoms, which data from the medical history has the most significance when planning this client's care?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

An older adult client reports noticing increased difficulty hearing over the past year. The client explains that words often sound garbled and the end of sentences are often missed. Which follow-up question is best for the nurse to ask?

The nurse is planning discharge teaching for a client with type 2 diabetes mellitus who has a new prescription for insulin glargine. Which action should the nurse plan to Include in the discharge teaching?

To detect common untoward effects of phenytoin, the nurse should assess a client with a seizure disorder for which sign or symptom?

A male client has been receiving the antibiotic gentamicin sulfate, IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin? Reference Range: White Blood Cell [5000 to 10,000/mm3 (5 to 10 x 109/L)]

When entering a client's room to assess vital signs, the nurse finds the client crying. After allowing the client to express feelings, which intervention should the nurse implement?

The nurse is preparing to administer lorazepam 1.5 mg IV to an anxious preoperative client. The medication is available in a 2 mg/mL vial. Which action should the nurse perform with the remainder of the medication?