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Question 1 of 5

The nurse has attended a staff education program about narcissistic personality disorder (NPD). The nurse should understand that clients with NPD

Correct Answer: A

Rationale: Clients with NPD typically have a fragile self-esteem masked by grandiosity and may fear abandonment . Hallucinations are not characteristic, magical thinking aligns more with schizotypal personality disorder, and acute anxiety is less specific.

Question 2 of 5

Diltiazem (Cardizem) 90 mg qid is prescribed for an adult who has angina. Which statement by the client indicates a need for further instruction?

Correct Answer: C

Rationale: Diltiazem is not typically withheld based on heart rate alone unless specified; this indicates a need for clarification on administration instructions.

Question 3 of 5

The nurse is collecting data from a client who delivered a full-term newborn vaginally 12 hours ago after prolonged labor. Which of the following findings would be essential to follow up?

Correct Answer: A

Rationale: Foul-smelling lochia suggests possible endometritis or infection, requiring immediate follow-up. External hemorrhoids and mild temperature elevation are common postpartum findings, and discomfort during fundal massage is expected unless accompanied by other concerning signs.

Question 4 of 5

The nurse is caring for a client who has a prescription for clarithromycin 7.5 mg/kg/day PO in 2 divided doses. The client weighs 78 lb. How many mL should the nurse administer for each dose? Record your answer using 1 decimal place.

Correct Answer: 7.5 mL/dose

Rationale: Client weight: 78 lb ÷ 2.2 = 35.45 kg. Dose: 7.5 mg/kg/day × 35.45 kg = 265.875 mg/day ÷ 2 doses = 132.9375 mg/dose. Clarithromycin is typically 250 mg/5 mL. Thus, 132.9375 mg × (5 mL/250 mg) = 2.65875 mL ≈ 2.7 mL/dose.

Question 5 of 5

The client has been receiving garamycin 65 mg IVPB every 8 hours for the past 6 days. Which lab result indicates an adverse reaction to the medication?

Correct Answer: D

Rationale: Garamycin (gentamicin) is an aminoglycoside antibiotic that can cause nephrotoxicity. A serum creatinine level of 2.0 mg/dL is elevated (normal range is approximately 0.6-1.2 mg/dL), indicating potential kidney damage, an adverse reaction. Answers A, B, and C represent normal or unrelated lab values.

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