The practical nurse (PN) is administering multiple medications to an older adult client. The client has been receiving all of the same medications for one week. Which assessment is most important for the PN to make?

Synergistic actions.

Cumulative effects.

Idiosyncratic responses.

Antagonistic reactions.

Answer and Explanation

The Correct Answer is B

A. Synergistic actions: Synergistic effects occur when two drugs enhance each other’s action, but they are not the primary concern after one week of stable medication use. While important to monitor, they are less critical than cumulative effects in older adults who have slower drug metabolism.
B. Cumulative effects: Cumulative effects are the most important to assess in an older adult because aging decreases liver and kidney function, slowing drug metabolism and excretion. This can lead to drug buildup in the body, increasing the risk of toxicity even when medications have been taken as prescribed.
C. Idiosyncratic responses: Idiosyncratic reactions are unpredictable and not dose-dependent. They are important but tend to occur early in therapy rather than after a week of consistent medication use, making them less of a focus at this stage.
D. Antagonistic reactions: Antagonistic reactions, where drugs block each other's effects, are possible but would generally present early during therapy. After a week of stable use without new drugs added, cumulative buildup remains the greater priority for safe ongoing care.

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Correct Answer is C

Explanation

A. The amount of fluid the client drank today: Although fluid intake affects weight, daily weights are intended to reflect overall fluid and nutritional changes over time, not just today's intake. Monitoring intake is important but not the most critical factor in conducting daily weights consistently.
B. When the client wants to be weighed: While respecting the client's preferences is important for cooperation, clinical accuracy requires consistency in timing and conditions, not simply weighing at the client's preferred time.
C. When the client was last weighed: Knowing when the client was last weighed ensures consistency and accuracy for monitoring trends. Daily weights should be taken at the same time each day, ideally in the morning before eating and after voiding, to accurately track fluid balance and body mass changes.
D. The amount of food the client ate today: Food intake affects weight slightly, but the purpose of daily weights is to detect significant changes, such as fluid retention or loss. Weighing under consistent conditions matters more than focusing on the day's food intake.

A. I am holding the digoxin because the client's heart rate is too low. B. The client is a 59-year-old male with hypertension and heart failure. He is currently taking furosemide and digoxin. C. Do you want to recheck the digoxin level to see if there is toxicity? I will monitor the client's heart rate, blood pressure, and perfusion with a continuous monitor until his heart rate returns to normal. D. Heart rate is 48 beats/minute, blood pressure is 109/76 mm Hg.

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

Explanation

SBAR Format:

Situation:
I am holding the digoxin because the client's heart rate is too low.

Background:
The client is a 59-year-old male with hypertension and heart failure. He is currently taking furosemide and digoxin.

Assessment:

Heart rate is 48 beats/minute, blood pressure is 109/76 mm Hg.

Recommendation:
Do you want to recheck the digoxin level to see if there is toxicity? I will monitor the client's heart rate, blood pressure, and perfusion with a continuous monitor until his heart rate returns to normal.

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The practical nurse (PN) is administering multiple medications to an older adult client. The client has been receiving all of the same medications for one week. Which assessment is most important for the PN to make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The practical nurse (PN) is implementing a nursing care plan that requires daily weights. Which factor is most important for the PN to consider regarding daily weights?

Correct Answer is C

Explanation

Exhibits The practical nurse (PN) calls the healthcare provider to notify them that the heart rate is too low to administer the digoxin. Place the nurse statements in Situation, Background, Assessment, Recommendation (SBAR) format. Each column must have at only one answer selected.

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

Explanation

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The practical nurse (PN) is administering multiple medications to an older adult client. The client has been receiving all of the same medications for one week. Which assessment is most important for the PN to make?

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After accepting employment in a state different from where a practical nurse (PN) is currently employed, it is most important for the PN to review which reference?

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