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3. Calcitonin (Miacalcin)
Rationale:
1) A nurse is caring for a client with The normal serum calcium level is 8.6
hyperparathyroidism and notes that the to 10.0 mg/dL. This client is experiencing
client's serum calcium level is 13 mg/dL. hypercalcemia. Calcium gluconate and
Which medication should the nurse pre- calcium chloride are medications used
pare to administer as prescribed to the for the treatment of tetany, which occurs
client? as a result of acute hypocalcemia. In hy-
1. Calcium chloride percalcemia, large doses of vitamin D
2. Calcium gluconate need to be avoided. Calcitonin, a thyroid
3. Calcitonin (Miacalcin) hormone, decreases the plasma calcium
4. Large doses of vitamin D level by inhibiting bone resorption and
lowering the serum calcium concentra-
tion.
4. Orange juice
2.) Oral iron supplements are prescribed
Rationale:
for a 6-year-old child with iron deficiency
Vitamin C increases the absorption of
anemia. The nurse instructs the mother
iron by the body. The mother should be
to administer the iron with which best
instructed to administer the medication
food item?
with a citrus fruit or a juice that is high
1. Milk
in vitamin C. Milk may affect absorption
2. Water
of the iron. Water will not assist in ab-
3. Apple juice
sorption. Orange juice contains a greater
4. Orange juice
amount of vitamin C than apple juice.
3.) Salicylic acid is prescribed for a client
1. Tinnitus
with a diagnosis of psoriasis. The nurse
Rationale:
monitors the client, knowing that which
Salicylic acid is absorbed readily through
of the following would indicate the pres-
the skin, and systemic toxicity (sali-
ence of systemic toxicity from this med-
cylism) can result. Symptoms include tin-
ication?
nitus, dizziness, hyperpnea, and psycho-
1. Tinnitus
logical disturbances. Constipation and
2. Diarrhea
diarrhea are not associated with sali-
3. Constipation
cylism.
4. Decreased respirations
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4.) The camp nurse asks the children
preparing to swim in the lake if they have
4. At least 30 minutes before exposure to
applied sunscreen. The nurse reminds
the sun
the children that chemical sunscreens
Rationale:
are most effective when applied:
Sunscreens are most effective when ap-
1. Immediately before swimming
plied at least 30 minutes before exposure
2. 15 minutes before exposure to the sun
to the sun so that they can penetrate the
3. Immediately before exposure to the
skin. All sunscreens should be reapplied
sun
after swimming or sweating.
4. At least 30 minutes before exposure
to the sun
5.) Mafenide acetate (Sulfamylon) is pre- 3. Informing the client that this is normal
scribed for the client with a burn injury. Rationale:
When applying the medication, the client Mafenide acetate is bacteriostatic for
complains of local discomfort and burn- gram-negative and gram-positive organ-
ing. Which of the following is the most isms and is used to treat burns to re-
appropriate nursing action? duce bacteria present in avascular tis-
1. Notifying the registered nurse sues. The client should be informed that
2. Discontinuing the medication the medication will cause local discom-
3. Informing the client that this is normal fort and burning and that this is a normal
4. Applying a thinner film than pre- reaction; therefore options 1, 2, and 4 are
scribed to the burn site incorrect
1.Hyperventilation
Rationale:
6.) The burn client is receiving treat- Mafenide acetate is a carbonic anhy-
ments of topical mafenide acetate (Sul- drase inhibitor and can suppress renal
famylon) to the site of injury. The nurse excretion of acid, thereby causing aci-
monitors the client, knowing that which dosis. Clients receiving this treatment
of the following indicates that a systemic should be monitored for signs of an
effect has occurred? acid-base imbalance (hyperventilation).
1.Hyperventilation If this occurs, the medication should be
2.Elevated blood pressure discontinued for 1 to 2 days. Options 3
3.Local pain at the burn site and 4 describe local rather than systemic
4.Local rash at the burn site effects. An elevated blood pressure may
be expected from the pain that occurs
with a burn injury.
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7.) Isotretinoin is prescribed for a client 2. Triglyceride level
with severe acne. Before the administra- Rationale:
tion of this medication, the nurse antic- Isotretinoin can elevate triglyceride lev-
ipates that which laboratory test will be els. Blood triglyceride levels should be
prescribed? measured before treatment and period-
1. Platelet count ically thereafter until the effect on the
2. Triglyceride level triglycerides has been evaluated. Op-
3. Complete blood count tions 1, 3, and 4 do not need to be mon-
4. White blood cell count itored specifically during this treatment.
8.) A client with severe acne is seen in 1. Vitamin A
the clinic and the health care provider Rationale:
(HCP) prescribes isotretinoin. The nurse Isotretinoin is a metabolite of vitamin A
reviews the client's medication record and can produce generalized intensifica-
and would contact the (HCP) if the client tion of isotretinoin toxicity. Because of the
is taking which medication? potential for increased toxicity, vitamin
1. Vitamin A A supplements should be discontinued
2. Digoxin (Lanoxin) before isotretinoin therapy. Options 2, 3,
3. Furosemide (Lasix) and 4 are not contraindicated with the
4. Phenytoin (Dilantin) use of isotretinoin.
9.) The nurse is applying a topical cor-
ticosteroid to a client with eczema. The 2. Axilla
nurse would monitor for the potential Rationale:
for increased systemic absorption of the Topical corticosteroids can be absorbed
medication if the medication were being into the systemic circulation. Absorption
applied to which of the following body is higher from regions where the skin is
areas? especially permeable (scalp, axilla, face,
1. Back eyelids, neck, perineum, genitalia), and
2. Axilla lower from regions in which permeability
3. Soles of the feet is poor (back, palms, soles).
4. Palms of the hands
10.) The clinic nurse is performing an
1. Acne
admission assessment on a client. The
Rationale:
nurse notes that the client is taking aze-
Azelaic acid is a topical medication used
laic acid (Azelex). Because of the med-
to treat mild to moderate acne. The
ication prescription, the nurse would sus-
acid appears to work by suppressing
pect that the client is being treated for:
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1. Acne the growth of Propionibacterium acnes
2. Eczema and decreasing the proliferation of ker-
3. Hair loss atinocytes. Options 2, 3, and 4 are incor-
4. Herpes simplex rect.
11.) The health care provider has pre-
scribed silver sulfadiazine (Silvadene)
for the client with a partial-thickness
burn, which has cultured positive for
3. "The medication will permanently stain
gram-negative bacteria. The nurse is re-
my skin."
inforcing information to the client about
Rationale:
the medication. Which statement made
Silver sulfadiazine (Silvadene) is an an-
by the client indicates a lack of under-
tibacterial that has a broad spectrum of
standing about the treatments?
activity against gram-negative bacteria,
1. "The medication is an antibacterial."
gram-positive bacteria, and yeast. It is
2. "The medication will help heal the
applied directly to the wound to assist in
burn."
healing. It does not stain the skin.
3. "The medication will permanently
stain my skin."
4. "The medication should be applied
directly to the wound."
12.) A nurse is caring for a client who is
1. Notify the registered nurse.
receiving an intravenous (IV) infusion of
Rationale:
an antineoplastic medication. During the
When antineoplastic medications
infusion, the client complains of pain at
(Chemotheraputic Agents) are adminis-
the insertion site. During an inspection
tered via IV, great care must be taken
of the site, the nurse notes redness and
to prevent the medication from escaping
swelling and that the rate of infusion of
into the tissues surrounding the injection
the medication has slowed. The nurse
site, because pain, tissue damage, and
should take which appropriate action?
necrosis can result. The nurse monitors
1. Notify the registered nurse.
for signs of extravasation, such as red-
2. Administer pain medication to reduce
ness or swelling at the insertion site and
the discomfort.
a decreased infusion rate. If extravasa-
3. Apply ice and maintain the infusion
tion occurs, the registered nurse needs
rate, as prescribed.
to be notified; he or she will then contact
4. Elevate the extremity of the IV site,
the health care provider.
and slow the infusion.
13.) The client with squamous cell
carcinoma of the larynx is receiving