Nokea
A client has a new prescription for Morphine to manage post-operative pain. Which of the following assessments should the nurse perform first?
- A. Urine output
- B. Bowel sounds
- C. Pain level
- D. Respiratory rate
Correct Answer: D
Rationale: The nurse should prioritize assessing the client's respiratory rate first when administering Morphine due to the risk of respiratory depression, which is a life-threatening adverse effect of this medication. Monitoring the respiratory rate is crucial to detect any signs of respiratory distress early and take prompt action to ensure the client's safety. Assessing urine output, bowel sounds, and pain level are also important but not as critical as monitoring respiratory rate when initiating Morphine therapy.
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A client in the operating room received a dose of Succinylcholine. During the operation, the client suddenly develops rigidity, and their body temperature begins to rise. The healthcare provider should anticipate a prescription for which of the following medications?
- A. Neostigmine
- B. Naloxone
- C. Dantrolene
- D. Vecuronium
Correct Answer: C
Rationale: Muscle rigidity and a sudden rise in temperature are manifestations of malignant hyperthermia. Dantrolene acts on skeletal muscles to reduce metabolic activity and treat malignant hyperthermia effectively. Neostigmine (choice A) is used to reverse the effects of non-depolarizing neuromuscular blockers, not to treat malignant hyperthermia. Naloxone (choice B) is an opioid antagonist used for opioid overdose. Vecuronium (choice D) is a non-depolarizing neuromuscular blocker and is not used to treat malignant hyperthermia.
A healthcare professional is reviewing a client's medication history and notes a new prescription for Enalapril. The healthcare professional should monitor the client for which of the following as an adverse effect of this medication?
- A. Bradycardia
- B. Hyperkalemia
- C. Hypoglycemia
- D. Hypocalcemia
Correct Answer: B
Rationale: Enalapril, an ACE inhibitor, can cause hyperkalemia as an adverse effect due to decreased aldosterone levels, which leads to potassium retention. Monitoring potassium levels is essential to prevent potential complications associated with hyperkalemia. The other options, bradycardia, hypoglycemia, and hypocalcemia, are not typically associated with Enalapril use and are less likely to occur as adverse effects.
When educating a client with early Parkinson's disease about pramipexole, what adverse effect should the nurse advise the client to monitor for?
- A. Hallucinations
- B. Increased salivation
- C. Diarrhea
- D. Discoloration of urine
Correct Answer: A
Rationale: The correct answer is A: Hallucinations. Pramipexole can lead to hallucinations, especially within 9 months of starting the medication, and may necessitate discontinuation. Hallucinations are a serious adverse effect that the client should be aware of and report promptly to their healthcare provider for evaluation and management. Increased salivation (choice B), diarrhea (choice C), and discoloration of urine (choice D) are not common adverse effects associated with pramipexole and are not typically emphasized in client education for this medication.
A client has a new prescription for Clonidine. Which of the following adverse effects should the nurse monitor?
- A. Drowsiness
- B. Dry mouth
- C. Weight gain
- D. Insomnia
Correct Answer: B
Rationale: Dry mouth is a common adverse effect of Clonidine. Clonidine can reduce saliva production, leading to dry mouth. To alleviate this symptom, the client should be advised to increase fluid intake or use sugar-free gum or candy. Monitoring for dry mouth is important to prevent complications such as oral health issues. Drowsiness, weight gain, and insomnia are potential side effects of Clonidine but are less common compared to dry mouth. Therefore, the nurse should prioritize monitoring for dry mouth as it's a more prevalent adverse effect associated with this medication.
A client has a new prescription for Digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?
- A. Contact provider if heart rate is less than 60/min.
- B. Check pulse rate for 30 seconds and multiply the result by 2.
- C. Increase intake of sodium.
- D. Take with food if nausea occurs.
Correct Answer: A
Rationale: The correct instruction for a client prescribed Digoxin for heart failure is to contact the provider if the heart rate is less than 60/min. Digoxin can affect heart rate, and a heart rate below 60/min may indicate toxicity, requiring prompt medical attention. Checking the pulse rate accurately and seeking medical advice are essential components of safe medication management. Choices B, C, and D are incorrect. Choice B is related to checking the pulse rate but does not address the critical action of contacting the provider if it is below 60/min. Increasing intake of sodium (Choice C) is inappropriate as high sodium levels can worsen heart failure. Taking Digoxin with food if nausea occurs (Choice D) does not address a critical aspect of Digoxin administration related to heart rate monitoring.