The nurse is administering a prescribed medication to neonatal client. Which factor is most likely to increase the risk for drug toxicity in this client?

The stomach acid has a lower pH level which results in increase absorption

The glomerular filtration rate (GFR) is increased causing rapid excretion

The liver enzyme system responsible for drug metabolism is not fully developed

The albumin levels are elevated due to rapid growth and protein binding is enhanced

Answer and Explanation

The Correct Answer is C

A) The stomach acid has a lower pH level which results in increased absorption: While it is true that neonates have a lower gastric pH, which could affect the absorption of certain medications, this factor does not directly increase the risk for drug toxicity. Lower pH may increase absorption for some drugs, but it is not as critical in neonates as the immaturity of other organs, such as the liver and kidneys, which are responsible for drug metabolism and excretion.

B) The glomerular filtration rate (GFR) is increased causing rapid excretion: In neonates, the glomerular filtration rate (GFR) is actually decreased, not increased. This leads to slower excretion of medications, which can increase the risk for drug toxicity, especially for drugs that rely on renal elimination. This decreased renal function can result in accumulation of the drug in the bloodstream, potentially leading to toxicity.

C) The liver enzyme system responsible for drug metabolism is not fully developed: The liver enzyme system in neonates is immature, which significantly impacts the metabolism of drugs. Enzymatic activity is critical for breaking down medications to their active or inactive forms. Due to the underdeveloped liver function, drugs may not be metabolized properly, leading to a longer half-life and an increased risk for drug toxicity. This is a key factor in the increased risk of toxicity in neonatal clients.

D) The albumin levels are elevated due to rapid growth and protein binding is enhanced: Neonates typically have lower albumin levels, not elevated levels. Albumin is crucial for binding medications, and lower levels in neonates can result in more free (unbound) drug circulating in the bloodstream, which can increase the risk of drug toxicity. Elevated albumin would theoretically reduce this risk, but this is not typically the case in neonates.

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Correct Answer is B

Explanation

This action reflects the planning phase of the nursing process, where the nurse sets measurable and achievable goals based on the client's assessment data.

Here’s how the other options fall into different phases:

A. Demonstrating how to perform a blood glucose test = Implementation (teaching/intervention).

C. Administering insulin = Implementation (carrying out an intervention).

D. Checking blood glucose level = Assessment (gathering data).

A. The nurse formulates a goal "The client will be from infection for the duration of the hospitalization." B. The nurse assesses the client’s white blood cell count C. The nurse administers the ordered oral antibiotics D. The nurse teaches the client the appropriate hand washing technique

Correct Answer is A

Explanation

A) The nurse formulates a goal "The client will be free from infection for the duration of the hospitalization": This action reflects the planning phase of the nursing process. The planning phase involves setting goals and determining the best interventions to achieve the desired outcomes for the client. In this case, the goal is to prevent infection, which is a specific, measurable outcome that can guide further interventions.

B) The nurse assesses the client's white blood cell count: Assessing the client's white blood cell count is an important step in data collection, which is part of the assessment phase of the nursing process. It helps the nurse gather information about the client's current health status but is not a planning activity. The nurse would use the information from the assessment phase to formulate goals and plan interventions.

C) The nurse administers the ordered oral antibiotics: Administering antibiotics is an action related to the implementation phase of the nursing process. The implementation phase involves carrying out the planned interventions. In this case, the administration of antibiotics is a direct action taken to address the risk for infection, but it is not the planning phase.

D) The nurse teaches the client the appropriate hand washing technique: Teaching hand hygiene is an important intervention, but it falls under the implementation phase of the nursing process. It involves educating the client to help prevent infection, which is an action taken based on the goals and plan developed earlier. While important, it’s not the planning phase itself.

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The nurse is administering a prescribed medication to neonatal client. Which factor is most likely to increase the risk for drug toxicity in this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse assesses the client and determines the client is at risk for unstable blood glucose. Which activity best reflects the planning phase of the nursing process?

Correct Answer is B

Explanation

A nurse assesses the client and determines the client is at risk for infection. Which activity best reflects the planning phase of the nursing process?

Correct Answer is A

Explanation

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