When administering medications to a group of clients, which client should the nurse closely monitor for the development of acute kidney injury (AKI)?

Correct Answer: D

Rationale: In the context of pharmacology and the risk of acute kidney injury (AKI), it is crucial for nurses to understand the nephrotoxic potential of certain medications. In this scenario, the correct answer is D) Vancomycin. Vancomycin is known to be nephrotoxic and can cause AKI, especially when given in high doses or for prolonged periods. Lorazepam (A) is a benzodiazepine used for its anxiolytic properties and is not associated with AKI. Sucralfate (B) is a medication used to treat ulcers by forming a protective barrier in the stomach and is not typically linked to AKI. Digoxin (C) is a cardiac glycoside used to treat heart conditions and does not have a direct nephrotoxic effect. Educationally, understanding the nephrotoxic potential of medications is vital for nurses to provide safe care to clients. It is essential to closely monitor clients receiving nephrotoxic drugs like Vancomycin for signs and symptoms of AKI, such as decreased urine output, edema, and changes in lab values like elevated serum creatinine levels. This knowledge helps nurses prevent, recognize, and manage potential complications, ensuring optimal patient outcomes.

Correct Answer: B

Rationale: The correct answer is B) Hold one nostril closed while spraying the other nostril. This technique is used when administering nasal sprays to ensure that the medication is delivered directly into the nasal passage and not lost in the air. By closing one nostril, the spray is directed into the open nostril, maximizing its effectiveness. Option A) Angle the tip of the inhaler upwards while spraying is incorrect because for nasal sprays, the tip should be angled slightly downwards to ensure proper delivery into the nasal passage. Option C) Avoid shaking the inhaler immediately before using is incorrect as shaking inhalers that contain suspensions helps to ensure even distribution of the medication, which is essential for consistent dosing. Option D) Use the inhaler when first awakening in the morning is incorrect because the timing of inhaler use is specific to individual medications and conditions. It is essential to follow the prescribed schedule provided by the healthcare provider for optimal therapeutic effect. In an educational context, it is crucial to teach clients the correct administration techniques for medications to ensure their safety and efficacy. Proper technique not only improves treatment outcomes but also reduces the risk of side effects and complications. By understanding and practicing correct administration methods, clients can better manage their health conditions and achieve the desired therapeutic effects of their medications.

Correct Answer: C

Rationale: In pharmacology, evaluating the effectiveness of a medication like metaproterenol involves understanding its intended therapeutic outcomes. Metaproterenol is a bronchodilator used to treat conditions like asthma and chronic obstructive pulmonary disease (COPD). The correct answer is C) Decreased wheezing upon auscultation because metaproterenol works by relaxing the muscles in the airways, leading to improved airflow and decreased wheezing sounds during breathing assessments. This indicates that the medication is effectively dilating the airways and improving respiratory function. Option A) Increased heart rate and blood pressure is incorrect because metaproterenol is a beta-2 adrenergic agonist that primarily acts on the lungs, not the heart or blood vessels. Option B) Decreased white blood cell count is not a relevant measure of metaproterenol's effectiveness in treating respiratory conditions. Option D) Decreased respiratory rate is also not the most appropriate indicator of metaproterenol's effectiveness, as the medication's goal is to improve breathing efficiency without necessarily affecting the respiratory rate. Educationally, this question highlights the importance of understanding the pharmacological mechanisms of drugs and how they relate to specific therapeutic outcomes. It emphasizes the need for healthcare providers to assess the effectiveness of medications based on targeted physiological responses in the context of specific patient conditions. This knowledge is crucial for safe and effective medication administration and patient care in clinical practice.

Correct Answer: D

Rationale: Administering iodine one hour before PTU is crucial to ensure proper absorption and effectiveness of PTU. This timing helps optimize the therapeutic benefits of PTU by allowing it to be absorbed efficiently without interference from iodine, ultimately leading to better treatment outcomes for the patient.

Correct Answer: D

Rationale: In hepatic encephalopathy, the goal of lactulose therapy is to reduce blood ammonia levels by promoting its excretion in the stool. Therefore, monitoring serum electrolytes and ammonia levels is crucial to assess the effectiveness of lactulose in lowering ammonia levels and improving the client's condition.