Patient Data

Exhibits

Mark whether the assessment finding represents a therapeutic result of the lactulose administered, a nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.

Large, liquid stool

Abdomen soft and flat

Blood pressure 120/68 mm Hg

Drowsiness

Heart rate 62 beats/minute

Pain rating of 2 on a 0 to 10

Cramping

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"C"},"D":{"answers":"B"},"E":{"answers":"C"},"F":{"answers":"C"},"G":{"answers":"B"}}

Large, liquid stool: Lactulose is prescribed to treat constipation by drawing water into the bowel and promoting a bowel movement. A large, liquid stool indicates that the medication has effectively relieved the client's postoperative constipation.

Abdomen soft and flat: Before receiving lactulose, the client had a distended abdomen. A soft, flat abdomen afterward shows that bowel motility improved and gas or stool buildup has decreased, reflecting therapeutic action.

Blood pressure 120/68 mm Hg: Lactulose does not significantly affect blood pressure. A normal blood pressure reading is a positive finding but is unrelated to the expected outcomes or side effects of lactulose therapy.

Drowsiness: Drowsiness is not an intended or expected effect of lactulose. It may result from opioid use (morphine) rather than the lactulose itself, but since it impacts the client's alertness, it is considered a nontherapeutic side effect here.

Heart rate 62 beats/minute: Lactulose has no direct pharmacologic impact on heart rate. A heart rate of 62 beats per minute is within acceptable limits for many adults and is unrelated to the administration of lactulose.

Pain rating of 2 on a 0 to 10 scale: Pain control relates to the administration of morphine and other analgesics, not to lactulose. Therefore, a lower pain score reflects effective analgesia but is not linked to lactulose therapy.

Cramping: Cramping can occur with lactulose because it increases bowel motility and draws fluid into the intestines. Although mild cramping is expected, it is still classified as a nontherapeutic side effect because it can cause client discomfort.

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Correct Answer is A

Explanation

A. Acetaminophen: Acetaminophen is metabolized by the liver, and excessive or chronic use can lead to hepatotoxicity, which presents with signs such as jaundice. Observing jaundice in a client taking acetaminophen requires prompt notification of the healthcare provider to assess for potential liver damage.

B. Prednisone: Prednisone can have many systemic effects, including fluid retention and immune suppression, but it is not typically associated with liver toxicity or jaundice as a primary adverse effect.

C. Captopril: Captopril is used to manage hypertension and can cause renal dysfunction, but it is not commonly linked to liver dysfunction or jaundice. Liver-related side effects are rare with ACE inhibitors.

D. Omeprazole: Omeprazole is a proton pump inhibitor used for gastroesophageal reflux and has minimal hepatic side effects. It is not commonly associated with jaundice in clinical practice.

A. Notify the healthcare provider. B. Administer the medication. C. Hold the medication until the meal trays arrive. D. Obtain another finger stick blood glucose level.

Correct Answer is C

Explanation

A. Notify the healthcare provider: Notification of the healthcare provider is not immediately necessary just because of a meal delay. The nurse can manage the situation appropriately by adjusting the medication timing to ensure patient safety without requiring immediate provider involvement.

B. Administer the medication: Acarbose should be taken with the first bite of food to effectively delay carbohydrate absorption. Administering it without food available increases the risk of hypoglycemia, especially since the glucose level is already slightly elevated but within a manageable range.

C. Hold the medication until the meal trays arrive: Acarbose must be taken with the first mouthful of food to match the timing of glucose absorption. Holding the medication until the meal arrives ensures optimal therapeutic effect and prevents unnecessary hypoglycemia.

D. Obtain another finger stick blood glucose level: Rechecking the blood glucose is unnecessary at this time. The primary concern is coordinating the medication with food intake, not monitoring glucose trends over a short 30-minute delay.

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Patient Data Exhibits Mark whether the assessment finding represents a therapeutic result of the lactulose administered, a nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

Correct Answer is C

Explanation

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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

Patient Data

Exhibits

Mark whether the assessment finding represents a therapeutic result of the lactulose administered, a nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.