Nokea
A client prescribed hydromorphone for severe pain has a decreased respiratory rate from 16 breaths per minute to 6. Which of the following medications should the nurse prepare to administer?
- A. Flumazenil
- B. Naloxone
- C. Activated charcoal
- D. Aluminum hydroxide
Correct Answer: B
Rationale: Naloxone is the correct answer as it is used to reverse opioid-induced respiratory depression. Hydromorphone is an opioid medication that can cause respiratory depression at high doses. Naloxone is an opioid antagonist that competes with opioids at receptor sites, reversing the effects of opioids like hydromorphone. Flumazenil (Choice A) is a benzodiazepine antagonist used for benzodiazepine overdose, not opioid overdose. Activated charcoal (Choice C) is used for toxin ingestion to prevent absorption in the gastrointestinal tract, but it is not indicated for opioid overdose. Aluminum hydroxide (Choice D) is an antacid and would not be the appropriate intervention for respiratory depression caused by opioid overdose.
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A healthcare provider has just administered a wrong medication to a client. Which of the following actions should the provider take next?
- A. No action is needed
- B. Report error to the provider
- C. Complete an institutional incident report
- D. Inform the client that the wrong medication was given
Correct Answer: B
Rationale: In the scenario where a wrong medication has been administered, it is crucial for the healthcare provider to report the error to the provider. This action is essential to ensure that the provider is informed promptly, corrective measures are taken, and the client's well-being is safeguarded. Choice A is incorrect as taking no action could lead to serious consequences and compromise patient safety. Choice C, while important, should come after reporting the error to the provider. Choice D is not the immediate priority as the provider should first focus on addressing the error internally.
A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication?
- A. Advise the client to take the medication once daily at bedtime
- B. This medication is for the acute management of asthma
- C. Avoid dairy products while taking this medication
- D. If the client forgets to take the medication for a few days, he should not double up on doses to catch up
Correct Answer: A
Rationale: The correct answer is to advise the client to take montelukast once daily at bedtime to maintain therapeutic effects. Choice B is incorrect because montelukast is not typically used for acute asthma management but for chronic treatment. Choice C is incorrect as there are no known interactions between montelukast and dairy products. Choice D is incorrect as it is not safe to double up on doses if the client forgets to take the medication; the missed dose should be skipped and the regular dosing schedule maintained.
A nurse is caring for a client prescribed enoxaparin for deep vein thrombosis prophylaxis. Which of the following client assessments requires immediate intervention?
- A. Platelet count of 95,000/mm³
- B. Blood pressure of 145/90 mmHg
- C. Heart rate of 95 beats per minute
- D. Pain at the injection site
Correct Answer: A
Rationale: A platelet count of 95,000/mm³ requires immediate intervention as it is low and increases the risk of bleeding, which is a potential complication of enoxaparin therapy. Low platelet counts can predispose the patient to hemorrhage, and administering anticoagulants like enoxaparin in such cases can further increase the bleeding risk. Monitoring platelet counts is crucial during anticoagulant therapy to prevent serious bleeding complications. The other options do not pose immediate risks related to enoxaparin therapy. A slightly elevated blood pressure, a heart rate of 95 beats per minute, and pain at the injection site are common findings that may not warrant immediate intervention in this context.
A nurse is caring for a client with hypothyroidism. Which of the following findings indicates that the client is experiencing an adverse effect from the prescribed levothyroxine?
- A. Tachycardia
- B. Bradycardia
- C. Weight loss
- D. Increased appetite
Correct Answer: A
Rationale: Tachycardia is the correct answer as it is an adverse effect of levothyroxine. Levothyroxine is a medication used to treat hypothyroidism by supplementing the body with thyroid hormone. Tachycardia, or a fast heart rate, can indicate an overdosage or increased sensitivity to levothyroxine. Bradycardia, slow heart rate, weight loss, and increased appetite are not typically associated with adverse effects of levothyroxine. Bradycardia may actually be a symptom of untreated hypothyroidism.
A 52-year-old client with a history of angina has been prescribed transdermal nitroglycerin. Which of the following adverse effects is not associated with this therapy?
- A. Tolerance
- B. Orthostatic hypotension
- C. Headache
- D. Productive cough
Correct Answer: D
Rationale: The correct answer is D: Productive cough. Nitroglycerin therapy can lead to adverse effects such as tolerance, orthostatic hypotension, and headache. However, it is not known to cause a productive cough. Tolerance may develop over time, requiring dose adjustments. Orthostatic hypotension can occur due to vasodilation effects, leading to a sudden drop in blood pressure when changing positions. Headache is a common side effect due to vasodilation of cranial blood vessels. Productive cough is not a recognized adverse effect associated with transdermal nitroglycerin therapy.