Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
The nurse notices that an order for intravenous gentamicin for a newly admitted client is half of the normal dose usually ordered for an adult. Before calling the provider for confirmation of the order, the nurse reviews the client's history to check for which preexisting condition that could have prompted the adjustment to the normal dose?
A. Antibiotic resistance
Antibiotic resistance is not a reason to adjust the dose of gentamicin.
B. Renal disease
Gentamicin is primarily excreted by the kidneys. In the presence of renal disease, the dose may need to be adjusted to prevent toxicity.
C. Liver disease
Liver disease does not directly impact the metabolism or excretion of gentamicin, so it is not typically a factor in dose adjustment.
D. Interpatient variation
Interpatient variation alone may not prompt a specific dose adjustment; individual patient factors, especially renal function, are crucial in determining gentamicin dosage.
This question is an excerpt from Nurse Dive's nursing test bank - Ramsussen Section 4 Module 11. Pharmocology For Professional Nursing Proctored Exam. Take the full exam now
Full Explanation
A) Antibiotic resistance is not a reason to adjust the dose of gentamicin.
B) Gentamicin is primarily excreted by the kidneys. In the presence of renal disease, the dose may need to be adjusted to prevent toxicity.
C) Liver disease does not directly impact the metabolism or excretion of gentamicin, so it is not typically a factor in dose adjustment.
D) Interpatient variation alone may not prompt a specific dose adjustment; individual patient factors, especially renal function, are crucial in determining gentamicin dosage.
Similar Questions
A client has been prescribed 81 mg of enteric coated aspirin every morning. Which of these statements by the client warrants further education?
A. "I should chew this medication thoroughly."
This statement warrants further education because enteric-coated aspirin is specifically designed to be absorbed in the small intestine and should not be chewed. Chewing the enteric coated aspirin can interfere with its protective coating and may lead to stomach irritation.
B. "I can take this with food to avoid stomach irritation."
This statement is correct. Taking the aspirin with food can help minimize stomach irritation.
C. "I can give this low-dose aspirin to my five-year-old if he has a fever."
This statement warrants further education. Aspirin, even in low doses, should not be given to young children without consulting a healthcare provider due to the risk of Reye's syndrome.
D. "I should expect ringing in my ears, as this is normal."
This statement warrants further education. Ringing in the ears (tinnitus) is not a normal side effect of aspirin, and persistent symptoms should be reported to the healthcare provider. e. This statement is correct. Black, tarry stools can indicate gastrointestinal bleeding, and the healthcare provider should be notified promptly.
E. "If I have black, tarry stools, I should call my provider."
This statement is correct. Black, tarry stools can indicate gastrointestinal bleeding, and the healthcare provider should be notified promptly.
Full Explanation
a. This statement warrants further education because enteric-coated aspirin is specifically designed to be absorbed in the small intestine and should not be chewed. Chewing the enteric coated aspirin can interfere with its protective coating and may lead to stomach irritation.
b. This statement is correct. Taking the aspirin with food can help minimize stomach irritation.
c. This statement warrants further education. Aspirin, even in low doses, should not be given to young children without consulting a healthcare provider due to the risk of Reye's syndrome.
d. This statement warrants further education. Ringing in the ears (tinnitus) is not a normal side effect of aspirin, and persistent symptoms should be reported to the healthcare provider.
e. This statement is correct. Black, tarry stools can indicate gastrointestinal bleeding, and the healthcare provider should be notified promptly.
A nurse is performing a preoperative drug history on a client who is admitted to the hospital for surgery. To evaluate the risk of hemorrhage, the nurse will ask the client about antiplatelet and anticoagulant medications as well as which dietary supplement?
A. St. John's Wort
St. John's Wort is not typically associated with an increased risk of bleeding.
B. Coenzyme Q-10
Coenzyme Q-10 is not known to have significant anticoagulant or antiplatelet effects.
C. Ginkgo biloba
Ginkgo biloba is a dietary supplement that may increase the risk of bleeding, and its use should be assessed preoperatively.
D. Ma Huang
Ma Huang (ephedra) is associated with cardiovascular stimulation rather than anticoagulant effects.
Full Explanation
A) St. John's Wort is not typically associated with an increased risk of bleeding.
B) Coenzyme Q-10 is not known to have significant anticoagulant or antiplatelet effects.
C) Ginkgo biloba is a dietary supplement that may increase the risk of bleeding, and its use should be assessed preoperatively.
D) Ma Huang (ephedra) is associated with cardiovascular stimulation rather than anticoagulant effects.
A client taking warfarin presents with bruises, dark tarry stools, and an international normalized ratio (INR) of 4.3. What is the nurse's action?
A. Explain to the client the nurse may ask the provider to order a test for leukemia.
The symptoms described (bruises, dark tarry stools, elevated INR) are indicative of warfarin overdose or excessive anticoagulation, not leukemia.
B. Hold the warfarin and consult the provider regarding the next steps.
This is the correct answer because holding the warfarin is necessary to prevent further bleeding complications, and consulting the provider is essential for guidance on the next steps.
C. Give an ampule of Vitamin K, then call the physician to report client status.
Giving Vitamin K may be necessary in cases of severe bleeding due to warfarin, but it is not the initial action. Consulting the provider is the priority.
D. Give the warfarin with a dark green salad and check the next stool for blood.
Giving warfarin with a dark green salad may exacerbate the situation and increase the risk of bleeding. Checking the next stool for blood does not address the immediate issue of anticoagulation excess.
Full Explanation
a. The symptoms described (bruises, dark tarry stools, elevated INR) are indicative of warfarin overdose or excessive anticoagulation, not leukemia.
b. This is the correct answer because holding the warfarin is necessary to prevent further bleeding complications, and consulting the provider is essential for guidance on the next steps.
c. Giving Vitamin K may be necessary in cases of severe bleeding due to warfarin, but it is not the initial action. Consulting the provider is the priority.
d. Giving warfarin with a dark green salad may exacerbate the situation and increase the risk of bleeding. Checking the next stool for blood does not address the immediate issue of anticoagulation excess.