Question

The nurse is preparing to administer the prescribed betaxolol to a client with open-angle glaucoma. What finding should cause the nurse to hold the medication and contact the healthcare provider?

Answer 1

Correct Answers:

Heart rate 52 beats/minute

Rationale :

💁‍♂️Bradycardia is a known adverse effect of beta-blockers such as betaxolol, which can worsen in clients with already low heart rates.

📉Beta-adrenergic blockers reduce intraocular pressure by decreasing aqueous humor production, but they also have systemic effects on the cardiovascular system, especially heart rate.

⚠️A heart rate of 52 beats/minute is below normal and places the client at risk of symptomatic bradycardia or even heart block if the medication is administered.

📞The nurse should hold the medication and notify the provider, as cardiac status must be evaluated before continuing betaxolol therapy.

📌Core Message

Betaxolol should be held if the heart rate is too low due to its bradycardic effects, which can compromise cardiac output.

Answer 2

Correct Answers:

Muscle wasting

Rationale :

🦴Muscle wasting is a hallmark feature of Cushing syndrome, which is characterized by excess cortisol leading to protein catabolism.

💪The elevated glucocorticoids break down muscle tissue to generate glucose, contributing to muscle weakness and wasting.

📉While weight gain may occur due to fat redistribution, muscle wasting is a consistent feature because of protein degradation.

🧬Clients may also have thin skin, hyperglycemia, and central obesity, but the loss of muscle mass is particularly diagnostic.

📌Core Message

Cushing syndrome causes muscle wasting due to excessive cortisol-induced protein breakdown.

Answer 3

Correct Answers:

75

Rationale :

💁‍♂️To calculate: 150 mL ÷ 2 hr = 75 mL/hr, which is the correct infusion rate.

💧This ensures the fluconazole is administered safely within the ordered timeframe.

⏱️IV medications must be given over the prescribed duration to avoid toxicity or ineffectiveness.

🧂Fluconazole in 0.9% sodium chloride is commonly used for treating fungal infections.

📌Core Message

To safely administer IV fluconazole, calculate the correct mL/hr rate based on volume and duration.

Answer 4

Correct Answers:

Fluconazole

Rationale :

🦠Fluconazole is an antifungal, not an antibacterial, and is not effective against bacterial UTIs.

💊For a bacterial urinary tract infection, appropriate choices include antibiotics like ciprofloxacin and ceftriaxone.

⚠️Giving fluconazole would delay proper treatment and allow the infection to worsen.

💁‍♂️This order should be questioned immediately to prevent inappropriate therapy.

📌Core Message

Fluconazole is inappropriate for bacterial UTIs, as it targets fungal organisms, not bacteria.

Answer 5

Correct Answers:

Check the labels and expiration dates of the insulin vials.

Rationale :

🧴Verifying labels and expiration dates ensures medication safety and avoids administering contaminated or incorrect insulin.

📋This action is always done first before any preparation of mixed insulin.

💉Ensuring the right type and integrity of insulin prevents hypoglycemia or hyperglycemia.

🔍This is a standard safety protocol in insulin administration and should never be skipped.

📌Core Message

Always verify insulin labels and expiration before preparation to ensure safe administration.

Answer 6

Correct Answers:

Serum sodium 155 mEq/L

Rationale :

💧Diabetes insipidus (DI) causes water loss, not sodium loss, leading to hypernatremia.

🧂A serum sodium of 155 is elevated and reflects the concentrated extracellular fluid due to excessive diuresis.

🚽Clients with DI produce large volumes of dilute urine, causing fluid volume deficit and electrolyte imbalances.

📈The nurse should monitor for signs of dehydration and administer fluids and desmopressin as ordered.

📌Core Message

In diabetes insipidus, water loss causes hypernatremia, which is a key diagnostic lab finding.

Answer 7

Correct Answers:

Heart palpitations

Rationale :

⚠️Heart palpitations in Addison’s disease may signal hyperkalemia, a dangerous electrolyte imbalance.

🔴Adrenal insufficiency leads to decreased aldosterone, causing potassium retention and sodium loss.

💣This can lead to cardiac dysrhythmias, making cardiac monitoring critical.

🚨Heart symptoms should always be prioritized over generalized fatigue or weakness.

📌Core Message

In Addison’s disease, palpitations may reflect life-threatening hyperkalemia requiring immediate attention.

Answer 8

Correct Answers:

"Are you consistently exposed to loud noises?"
"Do you have a history of chronic otitis media?"
"Do you smoke or are you exposed to smoke?"

Rationale :

🔊Loud noise exposure is a well-established risk for sensorineural hearing loss.

🦻Chronic otitis media can cause conductive hearing impairment due to recurrent infections.

🚬Smoking or exposure to second-hand smoke affects microcirculation, which may impair hearing over time.

🚫Acetaminophen, insomnia, and flu vaccine status are not associated with hearing loss risk.

📌Core Message

Risk factors for hearing loss include noise exposure, recurrent ear infections, and smoke inhalation.

Answer 9

Correct Answers:

Serum creatinine 2.3 mg/dL

Rationale :

🧪Serum creatinine is the most reliable marker of renal function because it reflects glomerular filtration rate (GFR).

📉A level of 2.3 mg/dL is elevated and indicates impaired renal clearance.

💉BUN can be influenced by hydration status, diet, and medications, making it less specific.

🔍Monitoring creatinine helps determine progression or improvement in kidney injury.

📌Core Message

Serum creatinine is the best indicator of renal function due to its specificity to GFR and kidney health.

Answer 10

Correct Answers:

Administer 1 ampule of 50% dextrose intravenously as prescribed.

Rationale :

💉A blood glucose of 38 mg/dL is critically low and requires immediate intervention with IV dextrose to reverse neuroglycopenia in an unconscious patient.

🛌Since the client is unresponsive, oral or buccal glucose routes are unsafe due to aspiration risk.

🧠D50 (50% dextrose) provides rapid glucose delivery directly into the bloodstream, essential for restoring cerebral glucose.

🚨Prompt action can prevent seizures, coma, or death associated with severe hypoglycemia.

📌Core Message

In unconscious hypoglycemia, the nurse must immediately administer IV dextrose to restore brain glucose levels safely.

1 :
The nurse is preparing to administer the prescribed betaxolol to a client with open-angle glaucoma. What finding should cause the nurse to hold the medication and contact the healthcare provider?

2 :
What finding should the nurse identify as consistent with Cushing syndrome?

3 :
A nurse is preparing to administer fluconazole 400 mg via intravenous (IV) infusion over 2 hours. Available is fluconazole 400 mg in 150 ml. 0.9% sodium chloride (NaCl). At what rate will the nurse set the infusion?1 mL/hr (if needed, round the answer to the nearest whole number.)

4 :
The nurse caring for a client admitted with a bacterial urinary tract infection receives orders from the healthcare provider. The nurse should question the healthcare provider's order for which medication?

5 :
A nurse is preparing to mix Neutral Protamine Hagedorn (NPH) insulin and regular insulin in the same syringe for administration to a client with type 1 diabetes. Which action should the nurse take first?

6 :
What laboratory finding should the nurse expect when caring for a client with diabetes insipidus?

7 :
The nurse is caring for a client newly diagnosed with Addison's disease. Which finding should the nurse prioritize?

8 :
The clinic nurse is interviewing a client to determine their risk factors for hearing loss. What question(s) should the nurse ask the client? Select all that apply.

9 :
A nurse caring for a client with acute kidney injury is evaluating the client's laboratory values. Which laboratory result is the best indicator of renal function?

10 :
The nurse cares for a client who presents to the emergency department unconscious with a blood glucose of 38 mg/dL. What action should the nurse take?

1 : The nurse is preparing to administer the prescribed betaxolol to a client with open-angle glaucoma. What finding should cause the nurse to hold the medication and contact the healthcare provider?

2 : What finding should the nurse identify as consistent with Cushing syndrome?

3 : A nurse is preparing to administer fluconazole 400 mg via intravenous (IV) infusion over 2 hours. Available is fluconazole 400 mg in 150 ml. 0.9% sodium chloride (NaCl). At what rate will the nurse set the infusion?1 mL/hr (if needed, round the answer to the nearest whole number.)

4 : The nurse caring for a client admitted with a bacterial urinary tract infection receives orders from the healthcare provider. The nurse should question the healthcare provider's order for which medication?

5 : A nurse is preparing to mix Neutral Protamine Hagedorn (NPH) insulin and regular insulin in the same syringe for administration to a client with type 1 diabetes. Which action should the nurse take first?

6 : What laboratory finding should the nurse expect when caring for a client with diabetes insipidus?

7 : The nurse is caring for a client newly diagnosed with Addison's disease. Which finding should the nurse prioritize?

8 : The clinic nurse is interviewing a client to determine their risk factors for hearing loss. What question(s) should the nurse ask the client? Select all that apply.

9 : A nurse caring for a client with acute kidney injury is evaluating the client's laboratory values. Which laboratory result is the best indicator of renal function?

10 : The nurse cares for a client who presents to the emergency department unconscious with a blood glucose of 38 mg/dL. What action should the nurse take?

1 :
The nurse is preparing to administer the prescribed betaxolol to a client with open-angle glaucoma. What finding should cause the nurse to hold the medication and contact the healthcare provider?

2 :
What finding should the nurse identify as consistent with Cushing syndrome?

3 :
A nurse is preparing to administer fluconazole 400 mg via intravenous (IV) infusion over 2 hours. Available is fluconazole 400 mg in 150 ml. 0.9% sodium chloride (NaCl). At what rate will the nurse set the infusion?1 mL/hr (if needed, round the answer to the nearest whole number.)

4 :
The nurse caring for a client admitted with a bacterial urinary tract infection receives orders from the healthcare provider. The nurse should question the healthcare provider's order for which medication?

5 :
A nurse is preparing to mix Neutral Protamine Hagedorn (NPH) insulin and regular insulin in the same syringe for administration to a client with type 1 diabetes. Which action should the nurse take first?

6 :
What laboratory finding should the nurse expect when caring for a client with diabetes insipidus?

7 :
The nurse is caring for a client newly diagnosed with Addison's disease. Which finding should the nurse prioritize?

8 :
The clinic nurse is interviewing a client to determine their risk factors for hearing loss. What question(s) should the nurse ask the client? Select all that apply.

9 :
A nurse caring for a client with acute kidney injury is evaluating the client's laboratory values. Which laboratory result is the best indicator of renal function?

10 :
The nurse cares for a client who presents to the emergency department unconscious with a blood glucose of 38 mg/dL. What action should the nurse take?