The health care provider orders a hypertonic crystalloid IV solution for a 70-year-old patient. Which solution will the nurse hang?

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Question 1 of 5

The health care provider orders a hypertonic crystalloid IV solution for a 70-year-old patient. Which solution will the nurse hang?

Correct Answer: D

Rationale: A hypertonic solution has a higher solute concentration than plasma, drawing fluid into the intravascular space. 5% dextrose in 0.9% sodium chloride (D) is hypertonic. Lactated Ringer's (A) and 0.45% sodium chloride (B) are hypotonic, while 0.9% sodium chloride (C) is isotonic. Hypertonic solutions are used to treat severe hyponatremia or cerebral edema but must be administered cautiously to avoid fluid overload.

Question 2 of 5

A female patient needs a whole blood transfusion. In order for transfusion services (the blood bank) to prepare the correct product a sample of the patient's blood must be obtained for:

Correct Answer: B

Rationale: A blood type and crossmatch are essential before a whole blood transfusion to ensure compatibility between the donor and recipient. This process involves determining the patient's blood type (ABO and Rh) and testing for antibodies that could cause a transfusion reaction. A complete blood count and differential are not required for transfusion preparation. Blood culture and sensitivity are used to diagnose infections, not for transfusion compatibility. Therefore, blood type and crossmatch are the correct steps.

Question 3 of 5

Which of the following drugs blocks reuptake of 5-hydroxytryptamine (serotonin)?

Correct Answer: D

Rationale: Serotonin reuptake blockade increases synaptic levels. Buspirone, a 5-HT1A agonist, treats anxiety without reuptake effects. Pizotifen, a serotonin antagonist, prevents migraines. Granisetron, a 5-HT3 antagonist, controls nausea. Paroxetine, an SSRI, potently inhibits serotonin reuptake, elevating mood in depression. Sumatriptan activates 5-HT1 receptors. Paroxetine's mechanism is central to its antidepressant efficacy, distinguishing it from receptor modulators.

Question 4 of 5

Regarding biotransformation, which of the following is true:

Correct Answer: B

Rationale: Ethanol competes with methanol metabolism, not enhances it, increasing toxicity, so that's false. Grapefruit juice inhibits CYP3A4, reducing cyclosporin metabolism, raising levels, a true statement critical for transplant patients. Phenytoin induces, not inhibits, theophylline metabolism, lowering levels. Rifampicin induces, not inhibits, oral contraceptive metabolism, reducing efficacy. Griseofulvin induces warfarin metabolism, not inhibits. Grapefruit juice's effect is a classic drug-food interaction, necessitating dose adjustments or avoidance.

Question 5 of 5

Which assessment should the nurse prioritize for a client receiving total parenteral nutrition (TPN)?

Correct Answer: A

Rationale: When a client receives total parenteral nutrition (TPN), monitoring blood glucose levels is critical due to the high glucose content in TPN solutions, which can lead to hyperglycemia. This condition arises because TPN delivers concentrated nutrients directly into the bloodstream, bypassing the digestive system, and the body may struggle to regulate sugar levels effectively without proper insulin response. Potassium levels, while important in overall electrolyte balance, are less immediately impacted by TPN compared to glucose, as potassium imbalances typically develop over time rather than acutely from TPN initiation. Mental status assessments are valuable for neurological conditions but lack direct relevance to TPN's metabolic effects. Similarly, blood pressure monitoring is essential for cardiovascular health but isn't the primary concern with TPN, as it doesn't directly influence hypertension or hypotension in the same way glucose dysregulation does. The focus on glucose stems from its rapid impact on the client's metabolic state, making it the priority assessment to prevent complications like hyperglycemia, which can escalate to severe outcomes if unaddressed. Regular monitoring ensures timely intervention, aligning with TPN's nutritional goals.

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