LVN LEVEL II prep u questions

A client with a urinary tract infection is prescribed co- trimoxazole (trimethoprim-sulfamethoxazole). The nurse should provide which medication instruction?

"Drink at least eight 8-oz glasses of fluid daily." Explanation: When receiving a sulfonamide such as co-trimoxazole, the client should drink at least eight 8-oz glasses of fluid daily to maintain a urine output of at least 1,500 ml/day. Otherwise, inadequate urine output may lead to crystalluria or tubular deposits. For maximum absorption, the client should take this drug at least 1 hour before or 2 hours after meals. No evidence indicates that antacids interfere with the effects of sulfonamides. To prevent a photosensitivity reaction, the client should avoid direct sunlight during co- trimoxazole therapy.

streptomycin

an antibiotic produced by the actinomycete Streptomyces griseus and used to treat tuberculosis adverse effect- decreased hearing acuity

Colles' fracture

the break of the distal end of the radius at the epiphysis often occurs when the pt has attempted to break his/her fall fracture of the distal radius at the wrist

The nurse is caring for a client who underwent internal fixation of the right hip. Before administering the client's warfarin (Coumadin), the nurse checks the laboratory report for the client's International Normalized Ratio (INR) results. Which of the following indicates the therapeutic range for this client?

2.0 to 3.0 Explanation: Recent guidelines recommend an INR of 2.0 to 3.0 for clients without mechanical prosthetic heart valves who are receiving warfarin therapy. For clients with mechanical prosthetic heart valves, an INR of 2.5 to 3.5 is suggested. An INR below 2.0 is subtherapeutic with warfarin therapy. An INR above 3.0 in a client without a prosthetic valve indicates the need to reduce the warfarin dose

A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF?

Blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl Explanation: The normal BUN level ranges 8 to 23 mg/dl; the normal serum creatinine level ranges from 0.7 to 1.5 mg/dl. The test results in option 3 are elevated, which reflects CRF and the kidneys' decreased ability to remove nonprotein nitrogen waste from the blood. CRF causes decreased pH and increased hydrogen ions — not vice versa. CRF also increases serum levels of potassium, magnesium, and phosphorous, and decreases serum levels of calcium. A uric acid analysis of 3.5 mg/dl falls within the normal range of 2.7 to 7.7 mg/dl; PSP excretion of 75% also falls with the normal range of 60% to 75%.

A client is treated in the emergency department for a Colles' fracture sustained during a fall. What is a Colles' fracture?

Fracture of the distal radius Explanation: Colles' fracture is a fracture of the distal radius, such as from a fall on an outstretched hand. It's most common in women. Colles' fracture doesn't refer to a fracture of the olecranon, humerus, or carpal scaphoid.

myxedema coma

Life threatening complication of hypothyroidism due to persistently low thyroid hormone levels. May be triggered by sedatives, infection, or other stress on the body. Signs and symptoms include hypothermia, respiratory depression, hypoventilation, bradycardia, hypotension, cardiovascular collapse, decreased LOC, and coma. Treatment includes respiratory and cardiac support, IV thyroid hormone replacement, IV fluids and electrolytes. life-threatening condition associated with advanced myxedema, with profound hypothermia, bradycardia, and electrolyte imbalance.

A client has the following arterial blood gas values: pH, 7.30; PaO2, 89 mm Hg; PaCO2, 50 mm Hg; and HCO3-, 26 mEq/L. Based on these values, the nurse should suspect which condition?

Respiratory acidosis Explanation: This client has a below-normal (acidic) blood pH value and an above-normal partial pressure of arterial carbon dioxide (PaCO2) value, indicating respiratory acidosis. In respiratory alkalosis, the pH value is above normal and the PaCO2 value is below normal. In metabolic acidosis, the pH and bicarbonate (HCO3-) values are below normal. In metabolic alkalosis, the pH and HCO3- values are above normal.

trimoxazole

Sulfamethoxazole/Trimethoprim Treats or prevents infections. This medicine is a "sulfa drug" (sulfonamide)

`A client admitted with deep vein thrombosis of the left leg is prescribed bed rest. The client complains that she's unable to void in the bedpan. Which action should the nurse take?

When the client has the urge to void, assist her to a sitting position on the bedpan. Explanation: The nurse should assist the client to a sitting position on the bedpan when the client has the urge to void. The sitting position is the natural position assumed to void, and assisting her to this position may enable her to void on the bedpan. An indwelling urinary catheter isn't indicated at this time; inserting one unnecessarily places the client at risk for infection. The client isn't incontinent so there's no need to place incontinence pads on the client's bed. Obtaining a bedside commode for the client to use violates the bed rest order.

The nurse prepares to measure a client's blood pressure. What is the correct procedure for measuring blood pressure?

Wrapping the cuff around the limb, with the uninflated bladder covering about three-fourths of the limb circumference Explanation: When measuring blood pressure, the nurse should place the cuff 1" (2.5 cm) above the brachial pulse and then wrap the cuff around the client's arm or leg with the bladder uninflated; the bladder should cover approximately three-fourths (not one-fourth) of the limb circumference. Bladder size is chosen according to the size of the extremity.

Hashimoto's thyroiditis

an autoimmune disease in which the body's own antibodies attack and destroy the cells of the thyroid gland The most common cause of hypothyroidism.

A client is undergoing a diagnostic workup for suspected testicular cancer. When obtaining the client's history, the nurse checks for known risk factors for this type of cancer. Testicular cancer has been linked to:

cryptorchidism. Explanation: Cryptorchidism (failure of one or both testes to descend into the scrotum) appears to play a role in testicular cancer, even when corrected surgically.

An incoherent client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, the nurse prepares to take emergency action to prevent the potential complication of:

myxedema coma. Explanation: Severe hypothyroidism may result in myxedema coma, in which a drastic drop in the metabolic rate causes decreased vital signs, hypoventilation (possibly leading to respiratory acidosis), and nonpitting edema. Thyroid storm is an acute complication of hyperthyroidism. Cretinism is a form of hypothyroidism that occurs in infants. Hashimoto's thyroiditis is a common chronic inflammatory disease of the thyroid gland in which autoimmune factors play a prominent role.