Which client does the nurse recognize to have the greatest risk of an adverse reaction if prescribed potassium Penicillin G?

55-year-old woman with coronary artery disease

21-year-old college senior who is being treated for Streptococcus

23-year-old woman who recently delivered and has mastitis

65-year-old man with dehydration .

Answer and Explanation

The Correct Answer is D

Choice A rationale

55-year-old woman with coronary artery disease. While patients with coronary artery disease often have multiple comorbidities and may be on medications that could interact with Penicillin G, there is no specific increased risk of adverse reactions to Penicillin G in this population.

Choice B rationale

21-year-old college senior who is being treated for Streptococcus. Penicillin G is often used to treat Streptococcus infections. There is no specific increased risk of adverse reactions in this population unless the patient has a known allergy to penicillins.

Choice C rationale

23-year-old woman who recently delivered and has mastitis. Penicillin G can be used to treat mastitis, an infection of the breast tissue that results in breast pain, swelling, warmth, and redness. There is no specific increased risk of adverse reactions in this population unless the patient has a known allergy to penicillins.

Choice D rationale

65-year-old man with dehydration. Dehydration can affect kidney function, and Penicillin G is excreted by the kidneys. Therefore, patients with dehydration or any other condition that reduces kidney function are at a higher risk of adverse reactions to Penicillin G3.

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Correct Answer is A

Explanation

Choice A rationale

Fluid Volume Excess (FVE), or hypervolemia, refers to an isotonic expansion of the ECF due to an increase in total body sodium content and an increase in total body water. This fluid overload usually occurs from compromised regulatory mechanisms for sodium and water as seen commonly in heart failure (CHF), kidney failure, and liver failure. The key signs of hypervolemia include weight gain and swelling. One of the defining characteristics of FVE is an increase in urine specific gravity. Therefore, a urine specific gravity of 1.012 can validate the problem of Fluid Volume Excess for a patient.

Choice B rationale

+4 Pedal pulses indicate a very bounding and strong pulse, which is not directly related to Fluid Volume Excess. While it might be observed in some cases due to increased blood volume and pressure, it is not a specific or primary indicator of this condition.

Choice C rationale

A respiratory rate of 20/minute is within the normal range for an adult (12-20 breaths per minute) and does not specifically indicate Fluid Volume Excess. While respiratory changes can occur with severe or prolonged Fluid Volume Excess, a normal respiratory rate does not validate this diagnosis.

Choice D rationale

A potassium level of 3.8 mEq/L is within the normal range (3.5-5.0 mEq/L) and does not specifically indicate Fluid Volume Excess. While electrolyte imbalances can occur with Fluid Volume Excess, a normal potassium level does not validate this diagnosis.

A. Hold the warfarin until the next day’s dose and notify the laboratory. B. Administer the daily dose of warfarin and notify the healthcare provider so tomorrow’s dose can be adjusted. C. Administer the daily dose of warfarin as these are the expected side effects of the medication. D. Hold the warfarin until the healthcare provider is notified of the assessment findings.

Correct Answer is D

Explanation

Choice A rationale

While holding the warfarin and notifying the laboratory could be appropriate actions in some situations, they would not address the immediate concern of the large, new ecchymotic areas on the client’s extremities.

Choice B rationale

Administering the daily dose of warfarin and notifying the healthcare provider for a dose adjustment the next day could potentially exacerbate the bleeding risk, given the presence of the large, new ecchymotic areas.

Choice C rationale

Large, new ecchymotic areas are not expected side effects of warfarin. They could indicate a serious problem such as excessive anticoagulation.

Choice D rationale

The presence of large, new ecchymotic areas could indicate excessive anticoagulation, which is a serious complication of warfarin therapy. Therefore, holding the warfarin and notifying the healthcare provider of the assessment findings would be the most appropriate initial action.

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Which client does the nurse recognize to have the greatest risk of an adverse reaction if prescribed potassium Penicillin G?

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse identifies the problem of Fluid Volume Excess for a patient. Which assessment finding validates this problem?

Correct Answer is A

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

The nurse is preparing to administer a client’s warfarin sodium 5 mg PO at 1900. Upon entering the client’s room, the nurse finds several large, new ecchymotic areas on the client’s extremities. What should be the nurse’s initial action?

Correct Answer is D

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

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