Nokea
The client is receiving atropine, an anticholinergic, to minimize the side effects of routine medications. Which intervention will help the client tolerate this medication?
- A. Teach the client about orthostatic hypotension.
- B. Instruct the client to eat a low-residue diet.
- C. Encourage the client to chew sugarless gum.
- D. Discuss the importance of daily isometric exercises.
Correct Answer: C
Rationale: Atropine causes dry mouth; sugarless gum stimulates saliva, improving tolerance. Hypotension, diet, or exercises are unrelated.
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The nurse is instructing a client with moderate persistent asthma on the proper method for using MDIs (multi-dose inhalers). Which medication should be administered first?
- A. Steroid
- B. Anticholinergic
- C. Mast cell stabilizer
- D. Beta agonist
Correct Answer: D
Rationale: Beta agonist. The beta-agonist drugs help to relieve bronchospasm by relaxing the smooth muscle of the airway. These drugs should be taken first so that other medications can reach the lungs.
The nurse is monitoring a client receiving a thrombolytic agent, alteplase (Activase tissue plasminogen activator), for treatment of a myocardial infarction. What outcome indicates the client is receiving adequate therapy within the first hours of treatment?
- A. Absence of a dysrhythmia (or arrhythmia)
- B. Blood pressure reduction
- C. Cardiac enzymes are within normal limits
- D. Return of ST segment to baseline on ECG
Correct Answer: D
Rationale: Return of ST segment to baseline on ECG. Improved perfusion should result from this medication, along with the reduction of ST segment elevation.
The client on bedrest is receiving enoxaparin (Lovenox), a low molecular weight heparin. Which anatomical site is recommended for administering this medication?
- A. The abdominal wall one (1) inch away from the umbilicus.
- B. The vastus lateralis with a 23-gauge needle.
- C. In the deltoid area subcutaneously.
- D. In the anterolateral abdomen.
Correct Answer: D
Rationale: Enoxaparin is injected subcutaneously in the anterolateral abdomen for optimal absorption and minimal bruising, per manufacturer guidelines.
The client received Narcan, a narcotic antagonist, following a colonoscopy. Which action by the nurse has the highest priority?
- A. Document the occurrence in the nurse's notes.
- B. Prepare to administer narcotic medication IV.
- C. Administer oxygen via nasal cannula.
- D. Assess the client every 15 to 30 minutes.
Correct Answer: D
Rationale: Narcan reverses opioids but has a short half-life; frequent assessment (15–30 min) monitors for re-sedation or respiratory depression, the priority.
A 48-year-old man is in the emergency room. He has crushing substernal pain and is diaphoretic, apprehensive, and ashen gray in color. The cardiac monitor shows runs of premature ventricular contractions. Which drug is most likely to be given to this client?
- A. Lidocaine
- B. Verapamil
- C. Digitalis
- D. Nitroglycerin
Correct Answer: A
Rationale: Lidocaine is used to treat ventricular arrhythmias, such as premature ventricular contractions, in acute coronary syndrome.