After an older client receives treatment for drug toxicity, the healthcare provider prescribes a 24-hour creatinine clearance test. Prior to starting the urine collection, the nurse notes that the client's serum creatinine is 0.3 mg/dL (22.9 μmol/L). Which action should the nurse implement?
Creatinine [Reference Range: 0.5 to 1.1 mg/dL (44 to 97 μmol/L)]

Initiate the urine collection as prescribed.

Evaluate the client's serum BUN level.

Notify the healthcare provider of the results.

Assess the client for signs of hypokalemia.

Answer and Explanation

The Correct Answer is C

Choice A rationale: Initiating the urine collection without reporting the low serum creatinine is inappropriate. A value of 0.3 mg/dL is below the reference range and may indicate significant muscle wasting or severe malnutrition.

Choice B rationale: Evaluating the BUN level provides information about hydration and renal perfusion, but it does not address the immediate clinical significance of an abnormally low creatinine level in an older adult client.

Choice C rationale: The nurse must notify the provider because a creatinine level of 0.3 mg/dL is abnormally low. In older adults, this often reflects low muscle mass, which significantly impacts how drug dosages are calculated.

Choice D rationale: Assessing for hypokalemia is not directly indicated by a low creatinine level. While electrolyte monitoring is important in drug toxicity, it is not the priority action linked to this specific lab finding.

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Correct Answer is C

Explanation

A. This task is beyond the scope of practice for a UAP. Calling the pharmacy to obtain medications requires clinical judgment and understanding of medication administration, which is the responsibility of licensed nursing personnel. B. This task requires assessment skills, which are beyond the scope of practice for a UAP. Determining a client's need for assistance with mobility requires clinical judgment. C. This task is appropriate to delegate to a UAP. It involves transporting an item from one location to another, which does not require clinical judgment or assessment. D. This task requires assessment skills and clinical judgment, which are beyond the scope of practice for a UAP. Evaluating a client's urinary catheter involves assessing for patency and signs of complications, which should be done by a licensed nurse.

Correct Answer is ["1.4"]

Explanation

Calculate the total dosage required: 44 mcg/kg * 65 kg = 2860 mcg. Convert mcg to mg: 2860 mcg ÷ 1000 = 2.86 mg.

Divide by concentration: 2.86 mg ÷ 2 mg/mL = 1.43 mL.

Considering the vial contains 2 mg/mL, the nurse should administer around 1.43 mL, which can be rounded to 1.4 mL.

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Naxlex Comprehensive Predictor Exams

Which instruction should the nurse delegate to an unlicensed assistive personnel (UAP)?

Correct Answer is C

Explanation

Correct Answer is ["1.4"]

Explanation

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