Exhibits

Review H and P, nurse's notes, laboratory results, flow sheet, and orders.

Click to mark whether the assessment finding represents a therapeutic result of the sodium bicarbonate administered, a non-therapeutic side-effect, or an unrelated finding.

Heart rate 77 bpm

400 mL Urine Output

Bicarbonate 22 mEq/L (22 mmol/L)

Blood pressure 113/72 mmHg

pH 7.35

Sodium 152 mEq/L (152 mmol/L)

Capillary refill 2 seconds

Answer and Explanation

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

Heart rate 77 bpm: Unrelated finding

400 mL Urine Output: Therapeutic result (indicating improved renal function)

Bicarbonate 22 mEq/L (22 mmol/L): Therapeutic result (indicating correction of acid-base imbalance)

Blood pressure 113/72 mmHg: Unrelated finding (within normal range)

pH 7.35: Therapeutic result (indicating improvement in acid-base balance)

Sodium 152 mEq/L (152 mmol/L): Therapeutic result (indicating improved electrolyte balance)

Capillary refill 2 seconds: Therapeutic result (indicating improved perfusion)

Nursing Test Bank

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Correct Answer is B

Explanation

A. Lorazepam:

Lorazepam is a benzodiazepine used for its anxiolytic and sedative effects. It is not known to cause AKI. Monitoring for sedation and respiratory depression may be necessary, but this is unrelated to kidney function.

The client the nurse should closely monitor for the development of acute kidney injury (AKI) when administering medications is:

B. Vancomycin.

Explanation: Vancomycin, an antibiotic commonly used to treat bacterial infections, has the potential to cause nephrotoxicity (kidney damage), especially when given in high doses or over a prolonged period. Therefore, clients receiving vancomycin should be closely monitored for signs of AKI, including changes in urine output, serum creatinine levels, and other renal function indicators.

C. Sucralfate:

Sucralfate is a medication used to treat and prevent gastrointestinal ulcers. It is not typically associated with AKI. Monitoring for gastrointestinal side effects is more relevant when administering sucralfate.

D. Digoxin:

Digoxin is a medication used to treat heart conditions. While it can affect renal function, it is not a primary cause of AKI. Monitoring serum digoxin levels and assessing for signs of digoxin toxicity are important when administering digoxin, but it is not the primary concern for AKI.

A. Unusual Irritability. B. Diarrhea. C. Nausea D. Involuntary movements

Correct Answer is D

Explanation

A) Unusual irritability: While irritability can be a side effect of metoclopramide, it is not as concerning as tardive dyskinesia. It's important to monitor and report any unusual irritability, but it's not the most critical side effect.

B) Diarrhea: Diarrhea is a common side effect of metoclopramide but is generally less concerning than tardive dyskinesia. It can often be managed with dietary adjustments or other medications.

C) Nausea: Nausea is the very symptom metoclopramide is prescribed to treat. If the client is still experiencing nausea despite taking metoclopramide, this might indicate the need for a different anti-nausea medication, but it's not the most important adverse effect to report.

D.Involutary movements: The most important adverse effect for the nurse to report when a client with chemotherapy-induced nausea is taking metoclopramide is D) Involuntary movements.

Explanation:

Metoclopramide is a medication often used to relieve nausea and vomiting, especially in cases like chemotherapy-induced nausea. However, it can have a side effect known as "tardive dyskinesia," which involves involuntary movements, typically of the face and tongue. Tardive dyskinesia is a serious and potentially irreversible side effect of metoclopramide.

In summary, involuntary movements (tardive dyskinesia) are the most critical side effect to report when a client is taking metoclopramide. This side effect needs prompt attention as it can be irreversible if not addressed.

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Laboratory Test	Result	reference range
Serum Creatinine	1 mg/dl (88.4 μmol/L)	0.5-1.1 mg/dL (44-97 μmol/L)
BUN	9 mg/dl. (3.2 mmol/L)	10-20 mg/dl. (3.6-7.1 mmol/L)
Sodium	136 mEq/L (136 mmol/L)	136 to 145 mEq/L (136 to 145 mmol/L)
Potassium	6.1 mEq/L (6.1 mmol/L)	3.5 to 5 mEq/L (3.5 to 5 mmol/L)

Exhibits Review H and P, nurse's notes, laboratory results, flow sheet, and orders. Click to mark whether the assessment finding represents a therapeutic result of the sodium bicarbonate administered, a non-therapeutic side-effect, or an unrelated finding.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When administering medications to a group of clients, which client should the nurse closely monitor for development of acute kidney injury (AKI)?

Correct Answer is B

Explanation

A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to repart?

Correct Answer is D

Explanation

The nurse is planning to administer the antiulcer gastrointestinal (GI) agent sucralfate to a client with peptic ulcer disease. Which action should the nurse include in this client's plan of care?

The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?

The nurse is administering the muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement?

The nurse administers naloxone to a client with opioid-induced respiratory depression. One hour later, nursing assessment reveals that the client has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unable to be aroused. Which action should the nurse implement?

Exhibits Review H and P, nurse's notes, laboratory results, flow sheet, and orders. Click to mark whether the assessment finding represents a therapeutic result of the sodium bicarbonate administered, a non-therapeutic side-effect, or an unrelated finding.

After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent oily stools and flatus. Which action should the nurse take?

A client taking atorvastatin develops an increased serum creatine phosphokinase (CK) level. The nurse should assess the client for the onset of which problem?

Exhibits

Review H and P, nurse's notes, laboratory results, flow sheet, and orders.

Click to mark whether the assessment finding represents a therapeutic result of the sodium bicarbonate administered, a non-therapeutic side-effect, or an unrelated finding.