Nokea
A client who was prescribed increasing dosages of baclofen to relieve muscle spasms should have taken 80 mg daily in 4 divided doses but misunderstood and took 80 mg four times a day, resulting in an overdose and pronounced CNS depression. Which of the following treatments does the nurse anticipate?
- A. Administration of naloxone.
- B. Administration of atropine.
- C. Supportive care only.
- D. Administration of flumazenil.
Correct Answer: C
Rationale: Baclofen overdose causes CNS depression, treated with supportive care (C) like ventilation and monitoring. Naloxone (A), atropine (B), and flumazenil (D) are not antidotes for baclofen.
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The physician has made a diagnosis of 'shaken child' syndrome for a 13-month-old who was brought to the emergency room after a reported fall from his highchair. Which finding supports the diagnosis of 'shaken child' syndrome?
- A. Fracture of the clavicle
- B. Periorbital bruising
- C. Retinal hemorrhages
- D. Fracture of the humerus
Correct Answer: C
Rationale: Retinal hemorrhages are a hallmark of shaken baby syndrome due to the shearing forces from violent shaking causing bleeding in the retina.
The physician has ordered a low-residue diet for a client with Crohn's disease. Which food is not permitted in a low-residue diet?
- A. Mashed potatoes
- B. Smooth peanut butter
- C. Fried fish
- D. Rice
Correct Answer: C
Rationale: Fried fish is high in fat and residue, which can exacerbate symptoms in Crohn's disease; low-residue diets emphasize easily digestible foods.
The client is admitted to the chemical dependence unit with an order for continuous observation. The nurse is aware that the doctor has ordered continuous observation because:
- A. Hallucinogenic drugs create both stimulant and depressant effects.
- B. Hallucinogenic drugs induce a state of altered perception.
- C. Hallucinogenic drugs produce severe respiratory depression.
- D. Hallucinogenic drugs induce rapid physical dependence.
Correct Answer: B
Rationale: Continuous observation is needed due to the altered perception caused by hallucinogens, which can lead to unsafe behaviors.
The physician has ordered sublingual nitroglycerin for a client. Which of the following are contraindications for administration of sublingual or buccal medications? Select all that apply.
- A. Client is edentulous.
- B. Client has mild dementia.
- C. Mucous membranes are red and irritated.
- D. Client is dehydrated.
- E. Client has productive aphasia.
Correct Answer: C,D
Rationale: Red, irritated mucous membranes (C) and dehydration (D) impair sublingual absorption. Edentulous state (A), mild dementia (B), and aphasia (E) do not contraindicate sublingual administration.
The nurse is assisting in the care of a patient who is 2 days post-operative from a hemorrhoidectomy. The nurse would be correct in instructing the patient to:
- A. Avoid a high-fiber diet
- B. Continue to use ice packs
- C. Take a laxative daily to prevent constipation
- D. Use a sitz bath after each bowel movement
Correct Answer: D
Rationale: A sitz bath promotes healing and relieves pain after a hemorrhoidectomy by keeping the area clean and reducing inflammation.