Exhibits

Which of the following 3 provider prescriptions does the nurse anticipate?

Regular insulin 20 units subcutaneously

Potassium chloride 20 mEq/L intravenous PRN potassium less than 5.0 mEq/L

Initiate cardiac monitoring

0.9% sodium chloride at 15 ml/kg/hr for 1 hr and then reduce to 10 ml/kg/hr

Regular insulin continuous intravenous infusion, titrate per diabetic ketoacidosis (DKA) protocol once potassium is greater than 3.3 mEq/L

Dextrose 5% in water (DSW) intravenous at 5 ml/kg/hr for 4 hr

Blood glucose checks every 4 hr

Insert indwelling urinary catheter

Answer and Explanation

Correct Answer : B,D,E

. Potassium chloride 20 mEq/L intravenous PRN potassium less than 5.0 mEq/L

The client's potassium level is slightly elevated at 5.5 mEq/L. Potassium replacement may be necessary if the level drops below 5.0 mEq/L, which is within the anticipated range for the nurse's actions.

D.0.9% sodium chloride at 15 ml/kg/hr for 1 hr and then reduce to 10 ml/kg/hr

This prescription addresses the need for fluid resuscitation to correct dehydration and electrolyte imbalances often seen in DKA. The client's initial blood pressure of 96/65 mm Hg suggests some degree of dehydration, further supporting the use of isotonic saline.

E.Regular insulin continuous infusion, titrate per diabetic ketoacidosis (DKA) protocol once potassium is greater than 3.3 mEq/L

This prescription aligns with the client's presentation of severe hyperglycemia (468 mg/dL) and acidosis (pH 7.30), indicating diabetic ketoacidosis (DKA). Insulin infusion is crucial for lowering blood glucose levels and correcting acidosis.

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Correct Answer is A

Explanation

A Sputum cultures for AFB are used to detect the presence of Mycobacterium tuberculosis, the bacteria causing TB. A negative result means that the sputum samples tested do not contain viable TB bacteria that can be transmitted to others. It indicates that the client's TB treatment has been effective in reducing the bacterial load to non-infectious levels.

B. The Quantiferon-TB Gold test is a blood test used to detect TB infection based on the immune response to TB antigens. A positive result indicates TB infection but does not differentiate between latent TB infection (not infectious) and active TB disease (potentially infectious).

C. The Mantoux tuberculin skin test (TST) is another test used to detect TB infection based on a delayed- type hypersensitivity reaction to TB antigens. An induration of less than 1 mm is considered negative and suggests that the client does not have a significant immune response to TB antigens, which could mean they are not infected with TB or the infection is not significant. This finding does not provide information on the client's infectiousness.

D. This indicates improvement in the client's symptoms, as coughing up blood-tinged sputum (hemoptysis) is a common symptom of active pulmonary TB. While improvement in symptoms is an important aspect of TB treatment, it does not directly indicate whether the client is no longer infectious. Infectiousness is primarily determined by microbiological tests such as sputum cultures for AFB.

A. "Your provider wouldn't prescribe this medication if it weren't necessary." B. "Most clients feel better after taking the antibiotic." C. "If you don't take this medication, you will feel worse." D. "I will tell your provider that you do not want to take this medication."

Correct Answer is D

Explanation

A While this statement is factual, it may come off as dismissive of the client’s concerns. The client may feel that their feelings and autonomy are not being respected. It's important to provide education but also to engage the client in a conversation about their concerns.

B. While this statement is intended to provide reassurance and encouragement, it may not be accurate for all clients or situations. It could also oversimplify the client's concerns and may not address the specific reasons for their reluctance to take the medication.

C. This response emphasizes the potential consequences of not adhering to the prescribed treatment plan. It highlights the importance of the medication in managing or treating the client's condition effectively. However, it may come across as threatening or coercive, which is not conducive to building a trusting and collaborative relationship with the client.

D. This is an appropriate response as it acknowledges the client’s autonomy and concern. It indicates that the nurse respects the client’s wishes and that the client will have the opportunity to discuss their concerns further with the provider. This fosters open communication and may lead to a better understanding of the necessity of the medication.

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Exhibits Which of the following 3 provider prescriptions does the nurse anticipate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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Exhibits

Which of the following 3 provider prescriptions does the nurse anticipate?