1. Right Answer: C
Explanation: Only an unbound drug can be distributed to active receptor sites. Therefore, the more of a drug that is bound to protein, the less it is available for the desired drug effect. Choice 1 is incorrect because less drug is available if it is bound to protein. Choice 2 is incorrect because distribution to receptor sites is irrelevant if the drug, which is bound to protein, cannot bind with a receptor site. Choice 4 is incorrect because metabolism is not increased. The liver first has to remove the drug from the protein molecule before metabolism can occur. The protein is then free to return to circulation and be used again. Pharmacological Therapies
2. Right Answer: B
Explanation: A client with an infection needs both antibiotics as soon a possible. However, the pH of ampicillin is 810, and the pH of gentamicin is 35.5 (making them incompatible when given together). Flushing well between drugs is necessary. Choice 3 is incorrect because the PN determines the correct steps and consults with the pharmacist and the physician as necessary. Choice 4 is incorrect because delaying the second medication by several hours slows the treatment of the clients infection. Pharmacological Therapies
3. Right Answer: A
Explanation: They have a high energy-to-fluid-volume ratio. Fat emulsions are formulated in 10%, 20%, and 30% solutions and supply 1.1, 2, and 3 kilocalories respectively for each milliliter. A milliliter of 5% dextrose only supplies 0.17 kilocalories. Choices 2, 3, and 4 are incorrect because fat emulsions are essentially pH neutral and isotonic. Pharmacological Therapies
4. Right Answer: B
Explanation: The nurse should positively reinforce each expression of feelings. Psychosocial Integrity
5. Right Answer: C
Explanation: The nurse can raise the clients self-esteem by communicating confidence the client can participate in actively finding solutions to the problem. The nurse also conveys the client is a worthwhile person by listening and accepting the clients feelings and praising the client for seeking assistance. Psychosocial Integrity
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