Patient Data

Exhibits

Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided.

According to the information gathered in the nurse's assessment, the nurse should prepare to give the client
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and
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Answer and Explanation

The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Oral carbohydrates: The client is not currently hypoglycemic; in fact, the blood glucose is elevated at 279 mg/dL. Oral carbohydrates are typically given to treat low blood glucose, not high glucose. Administering carbohydrates here would worsen hyperglycemia.

Insulin lispro: The client’s blood glucose is significantly elevated and requires correction. Insulin lispro is a rapid-acting insulin designed to lower high blood glucose quickly, making it the correct medication to administer while monitoring closely for improvement.

Insulin glargine: Although the client is prescribed insulin glargine once daily, she has already received her dose earlier this morning before surgery. Giving another dose now would risk insulin stacking and dangerous hypoglycemia later, so it is not safe to administer at this point.

A bolus of IV fluids: The client is showing signs of early dehydration — thirst and low urine output — likely due to hyperglycemia-induced osmotic diuresis. Administering a bolus of IV fluids will help restore circulating volume, prevent further dehydration, and support tissue perfusion.

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Correct Answer is B

Explanation

A. Document the client's refusal of the medication at this time: While documentation is necessary if a medication is refused, the priority is to educate the client first. The nurse should explain the proper timing of sucralfate to promote understanding and adherence rather than simply accepting refusal.

B. Explain the need to take the medication at least 1 hour before meals: Sucralfate acts by forming a protective barrier over ulcerated mucosa and must be taken on an empty stomach for maximum effectiveness. Administering it one hour before meals ensures the stomach lining is properly coated before food intake.

C. Allow the client to take the medication up to 1 hour after breakfast: Taking sucralfate after a meal diminishes its ability to bind effectively to the mucosa. Food interferes with its action, so post-meal dosing is inappropriate for achieving therapeutic benefit.

D. Instruct the client to take it when the meal tray is delivered: Taking sucralfate at mealtime is too late for optimal therapeutic effect. At that point, gastric contents may interfere with its binding to ulcerated areas, reducing its protective action.

A. Excessive bruising. B. Muscle tenderness.. C. Nausea and vomiting. D. Peripheral edema.

Correct Answer is B

Explanation

A. Excessive bruising: While statins can rarely affect platelet function, leading to bruising, this is not commonly associated with elevated creatine kinase (CK) levels. Bruising is more indicative of coagulation issues rather than muscle injury.

B. Muscle tenderness: Elevated CK levels in a client taking atorvastatin suggest muscle injury, such as myopathy or rhabdomyolysis. Muscle tenderness, pain, or weakness are hallmark symptoms of these conditions. Prompt assessment is crucial, as continued statin use in the presence of muscle damage can lead to serious complications, including kidney failure .

C. Nausea and vomiting: These symptoms are nonspecific and can result from various causes. While they may occur in rhabdomyolysis, they are not primary indicators and should be considered in the broader clinical context.

D. Peripheral edema: Swelling in the extremities is not a typical sign of statin-induced muscle injury. It is more commonly associated with cardiac, renal, or hepatic conditions.

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Patient Data Exhibits Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided. According to the information gathered in the nurse's assessment, the nurse should prepare to give the client dropdown and dropdown

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is administering sucralfate to a client with stomatitis secondary to chemotherapy. The client wants to take the medication after breakfast. How should the nurse respond?

Correct Answer is B

Explanation

A client taking atorvastatin develops an increased serum creatine phosphokinase (CK) level. The nurse should assess the client for the onset of which problem?

Correct Answer is B

Explanation

When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. Which action should the nurse take?

The healthcare provider (HCP) prescribes pantoprazole for a client who experienced partial and full thickness burns. The client is questioning the nurse if this medication is necessary. Which action(s) should the nurse implement? Select all that apply.

After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent oily stools and flatus. Which action should the nurse take?

After receiving the third dose of a new oral anticoagulant prescription, an older adult client develops bleeding and tender gums and has many new bruises. Which action(s) should the nurse implement? Select all that apply.

Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?Reference Range:Calcium [8.5 to 10.5 mg/dL (2.25 to 2.75 mmol/L]

The nurse is administering the muscle relaxant baclofen PO to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement?

Azithromycin is prescribed for a client with Chlamydia trachomatis. In providing client teaching about the medication, the nurse should emphasize the importance of reporting the onset of which symptom to the healthcare provider (HCP)?

Patient Data

Exhibits

Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided.

According to the information gathered in the nurse's assessment, the nurse should prepare to give the client
dropdown
and
dropdown