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. Hypertension is not a common side effect of phenytoin. It is not typically associated with the medication.
B. Peripheral edema is not commonly linked to phenytoin use.
C. Gingival hyperplasia, or overgrowth of the gums, is a common side effect of phenytoin, particularly with long-term use.
D. Hematuria is not a typical side effect of phenytoin and may indicate a different medical issue.

A. Apply lubricating lotion to the areas. B. Refer the client for a skin lesion biopsy. C. Ask about recent international travel. D. Record the presence of senile lentigines.

Correct Answer is D

Explanation

A. Lubricating lotion may be helpful for dry skin but is not necessary for these lesions.
B. A biopsy is not typically required for benign lesions such as senile lentigines, unless there is suspicion of malignancy.
C. Recent international travel is unrelated to the development of senile lentigines.
D. Senile lentigines, also known as "liver spots" or "age spots," are common in older adults. They are benign lesions that result from sun exposure and aging. Recording their presence is appropriate for documentation, as they are generally not harmful.

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Naxlex Comprehensive Predictor Exams

To detect common untoward effects of phenytoin, the nurse should assess a client with a seizure disorder for which sign or symptom?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

While assessing a client who takes acetaminophen for chronic pain, the nurse observes that the client's skin looks yellow in color. Which action should the nurse take in response to this finding?

When systematically auscultating a client's anterior breath sounds, the nurse should begin by placing the stethoscope over which location?

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?

A client who is in shock is receiving a continuous IV infusion of a sympathomimetic dopamine. Which intervention should the nurse include in this client's plan of care?

In preparing to perform colostomy care, the nurse observes that a client's colostomy stoma has become a dark red to bluish color. Which action should the nurse implement?

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?

During the shift change report, the nurse is told that a client has a stage 2 pressure injury. Which ulcer appearance is most likely to be observed?

The home care nurse has identified the nursing problem, "risk for hopelessness" for a client who is terminally ill with a life expectancy of several days. Which instruction should the nurse provide to the client's spouse?