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A geriatric patient received a narcotic analgesic before leaving the post-anesthesia care unit to return to the regular unit. What is the priority nursing action for the nurse receiving the patient on the regular unit?
- A. Administer a non-steroidal anti-inflammatory drug.
- B. Put side rails up and place bed in the lowest position.
- C. Encourage fluids.
- D. Create a restful dark environment.
Correct Answer: B
Rationale: The correct answer is B: Put side rails up and place bed in the lowest position. This is the priority nursing action as the geriatric patient who received a narcotic analgesic may experience drowsiness or confusion, increasing the risk of falls. By putting up the side rails and lowering the bed, the nurse is ensuring the patient's safety and preventing falls. Administering a non-steroidal anti-inflammatory drug (choice A) is not the priority as the patient's safety should be addressed first. Encouraging fluids (choice C) and creating a restful dark environment (choice D) are important but not as crucial as ensuring the patient's immediate safety.
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A 70-year-old patient has just received a drug that can cause sedation. What would be the priority nursing diagnosis for this patient?
- A. Deficient Knowledge, unfamiliar with drug therapy.
- B. Ineffective health maintenance, need for medication.
- C. Risk for injury, related to adverse effect of the drug.
- D. Noncompliance, cost of the drug.
Correct Answer: C
Rationale: The correct answer is C: Risk for injury, related to adverse effect of the drug. This is the priority nursing diagnosis because the patient, being 70 years old and receiving a sedating drug, is at an increased risk for falls and other injuries due to sedation. It is crucial for the nurse to monitor the patient closely for signs of sedation and take appropriate measures to prevent potential harm.
Choice A (Deficient Knowledge) is not the priority as the immediate concern is the risk of injury. Choice B (Ineffective health maintenance) focuses on the need for medication, not the potential risk of injury. Choice D (Noncompliance) is not relevant in this situation as it pertains to the cost of the drug, not the immediate safety of the patient.
A student asked the pharmacology instructor to describe the function of a cholinergic agonist. What would be the instructor's reply?
- A. Cholinergic agonist decreases the activity of gamma-aminobutyric acid (GABA) receptor sites throughout the body.
- B. Cholinergic agonist decreases the activity of norepinephrine throughout the body.
- C. Cholinergic agonist increases the activity of dopamine receptor sites throughout the brain and spinal cord.
- D. Cholinergic agonist increases the activity of acetylcholine receptor sites throughout the body.
Correct Answer: D
Rationale: The correct answer is D: Cholinergic agonist increases the activity of acetylcholine receptor sites throughout the body. A cholinergic agonist is a drug that mimics the action of acetylcholine, the neurotransmitter that binds to and activates cholinergic receptors. By increasing the activity of acetylcholine receptor sites, a cholinergic agonist enhances cholinergic neurotransmission, leading to various physiological responses.
Incorrect choices:
A: Cholinergic agonists do not affect gamma-aminobutyric acid (GABA) receptor sites.
B: Cholinergic agonists do not affect norepinephrine activity.
C: Cholinergic agonists do not affect dopamine receptor sites.
In summary, the correct answer is D because cholinergic agonists specifically target and enhance the activity of acetylcholine receptor sites, leading to increased cholinergic neurotransmission.
The nurse teaches the patient receiving propranolol (Inderal) at home for management of ventricular arrhythmias to monitor what parameter?
- A. Weekly pulse.
- B. Daily fluid intake.
- C. Daily blood pressure.
- D. Weekly weight.
Correct Answer: C
Rationale: The correct answer is C: Daily blood pressure. Monitoring daily blood pressure is crucial for a patient taking propranolol for ventricular arrhythmias as it helps assess the effectiveness of the medication in controlling the arrhythmias and ensuring the patient's safety. Changes in blood pressure can indicate potential side effects or worsening of the condition. Monitoring pulse alone (choice A) may not provide a comprehensive picture of the cardiac status. Daily fluid intake (choice B) and weekly weight (choice D) are not specific parameters for monitoring the effects of propranolol on ventricular arrhythmias.
The nurse receives an order for a triptan for a patient diagnosed with a cluster headache. What drug should be indicated for this purpose?
- A. Sumatriptan (Imitrex).
- B. Naratriptan (Amerge).
- C. Frovatriptan (Frova).
- D. Almotriptan (Axert).
Correct Answer: A
Rationale: The correct answer is A: Sumatriptan (Imitrex). Sumatriptan is the drug of choice for treating cluster headaches due to its rapid onset of action and high efficacy in relieving symptoms. It works by constricting blood vessels in the brain and blocking pain pathways. Naratriptan, Frovatriptan, and Almotriptan are also triptans but are not as effective or fast-acting as Sumatriptan for cluster headaches. Therefore, they are not the ideal choice. Summarily, Sumatriptan is the preferred option for managing cluster headaches due to its quick and potent action compared to other triptans.
A patient exhibits ptosis of both eyes and the provider orders edrophonium (Tensilon). The nurse notes immediate improvement of the ptosis. The nurse understands that this patient most likely has which disorder?
- A. Myasthenia gravis.
- B. Cerebral palsy.
- C. Multiple sclerosis.
- D. Muscle spasm.
Correct Answer: A
Rationale: The correct answer is A: Myasthenia gravis. Edrophonium is a reversible acetylcholinesterase inhibitor that improves muscle strength in patients with myasthenia gravis due to its ability to increase acetylcholine levels at the neuromuscular junction. The immediate improvement of ptosis after administration of edrophonium suggests a diagnosis of myasthenia gravis, a disorder characterized by muscle weakness and fatigability. Cerebral palsy (B) is a non-progressive neurological disorder not typically associated with ptosis and not responsive to edrophonium. Multiple sclerosis (C) is an autoimmune demyelinating disorder that does not typically present with ptosis. Muscle spasm (D) does not explain the ptosis and would not improve with edrophonium.