In checking the dose of intravenous ticarcillin disodium prescribed for an older client, the nurse notes that the 24 hour dosage is lower than the normal range. Which finding supports the need for this reduced dosage?

Reference range

Creatinine [0.6 to 1.2 mg/dL (53 to 106 μmol/L)]

White blood cells (WBC) [5,000 to 10,000/mm3 (5 to 10 x 109/L)]

White blood cell count of 8,000/mm3 (8 X 109/L).

Inelastic skin turgor.

Serum creatinine of 3.5 mg/dL (310 μmol/L).

Thin, fragile hand and arm veins.

Answer and Explanation

The Correct Answer is C

A. A white blood cell count of 8,000/mm³ is within the normal range and does not indicate a need for dosage adjustment.
B. Inelastic skin turgor may indicate dehydration or aging but does not directly affect drug dosage.
C. Elevated serum creatinine levels indicate impaired renal function, which necessitates a reduced dosage of medications excreted through the kidneys, such as ticarcillin disodium.
D. Thin, fragile veins are a concern for intravenous access but do not affect the medication dosage.

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Correct Answer is C

Explanation

A. Applying pressure proximal to the IV site is not appropriate and could cause further complications.
B. Assessing the radial pulse is important but is not the immediate response to the occlusion alarm.
C. Straightening the arm can help relieve a positional occlusion, which is a common cause of such alarms.
D. Elevating the arm may help with venous return but is not a first-line action for addressing the occlusion alarm.

A. Discuss with the client that there may be a need for additional sleep if the feeling of fatigue is present the next day. B. Encourage the client to obtain a prescription for a benzodiazepine antagonist. C. Instruct the client that it is important to reduce the dose of the medication gradually. D. Advise the client to stop taking the medication immediately.

Correct Answer is C

Explanation

A. While additional sleep may be helpful, it does not address the root cause of the hangover effect from temazepam.
B. A benzodiazepine antagonist is typically used in cases of overdose, not for managing next-day drowsiness.
C. Temazepam is a benzodiazepine, and sudden discontinuation can lead to withdrawal symptoms. The nurse should advise the client to taper off the medication gradually under medical supervision to prevent withdrawal symptoms and minimize the "hangover" effect.
D. Stopping the medication abruptly can lead to withdrawal symptoms and is not recommended.

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Naxlex Comprehensive Predictor Exams

A client has an IV solution infusing through a catheter inserted in the right antecubital area. The infusion pump is alarming and indicates an occlusion. Which action should the nurse take?

Correct Answer is C

Explanation

A client taking temazepam informs the nurse of plans to quit taking the medication due to feelings of "hungover" the next day. Which action should the nurse implement?

Correct Answer is C

Explanation

The nurse is preparing a bladder irrigation for an adult client who has a long-term indwelling urinary catheter. The urine is cloudy with fibrin clots and sediment. Which intervention should the nurse implement?

The nurse is planning discharge teaching for a client with type 2 diabetes mellitus who has a new prescription for insulin glargine. Which action should the nurse plan to Include in the discharge teaching?

A client with heart failure reports increased shortness of breath. The nurse administered furosemide 20 mg IV 60 minutes ago. Which action is most important for the nurse to implement?

The nurse is caring for a client who is taking the mood stabilizer divalproex sodium. Which laboratory value is most important for the nurse to monitor?

An older adult client reports noticing increased difficulty hearing over the past year. The client explains that words often sound garbled and the end of sentences are often missed. Which follow-up question is best for the nurse to ask?

A client with myasthenia gravis receives a new prescription for pyridostigmine. Which information should the nurse obtain to prior to administering the medication?

After receiving large doses of chlorpromazine for two weeks, a client begins to develop spasms of the neck and back. Which action should the nurse take?