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Questions 163

NCLEX-PN

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Question 1 of 5

The client is receiving a gentamicin IV. Which finding may indicate an adverse response to gentamicin?

Correct Answer: A

Rationale: Gentamicin is nephrotoxic; decreased urine output suggests kidney injury, a serious adverse effect. Other symptoms are not typically associated.

Question 2 of 5

In preparing medications for a client with a gastrostomy tube, the nurse should contact the health care provider before administering which of the following drugs through the tube?

Correct Answer: A

Rationale: Cardizem SR is a 'sustained-release' drug form. Sustained release (controlled-release, long-acting) drug formulations are designed to release the drug over an extended period of time. If crushed, as would be required for gastrostomy tube administration, sustained-release properties and blood levels of the drug will be altered. The provider must substitute another medication.

Question 3 of 5

The nurse walks into a client's room and finds the client lying still and silent on the floor. The nurse should first

Correct Answer: C

Rationale: Establish that the client is unresponsive. This is the first step in CPR to determine the need for further action.

Question 4 of 5

The clinic nurse is reinforcing teaching to a client who has been prescribed transdermal scopolamine to prevent motion sickness during an upcoming vacation on a cruise ship. Which of the following statements made by the nurse are appropriate? Select all that apply.

Correct Answer: B,C,D,E

Rationale: Appropriate scopolamine instructions include safe disposal , removing old patches , correct placement , and hand washing . Applying the patch only when moving is incorrect, as it should be applied hours before travel.

Question 5 of 5

A new graduate nurse is administering enoxaparin to a client. Which action indicates the need for further orientation by the nurse preceptor?

Correct Answer: B

Rationale: Ejecting the air bubble in an enoxaparin syringe is incorrect, as the bubble ensures complete dose delivery and prevents leakage. Other actions (A, C,
D) are correct for subcutaneous administration.

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