A healthcare professional is preparing to administer IV Dantrolene to a client who has developed Malignant Hyperthermia during surgery. Which of the following actions should the healthcare professional take?
- A. Dilute the medication with sterile water and administer it rapidly.
- B. Store the medication in a refrigerator until use.
- C. Administer the medication through a large-bore IV catheter.
- D. Administer the medication via an infusion pump over 60 minutes.
Correct Answer: C
Rationale: Dantrolene should be administered through a large-bore IV catheter because it is highly irritating to tissues and can cause vein irritation or thrombophlebitis if administered through a small vein. Using a large-bore IV catheter helps to minimize the risk of tissue damage and ensures proper and safe administration of the medication in emergency situations like Malignant Hyperthermia. Choices A, B, and D are incorrect because diluting the medication with sterile water and administering it rapidly can lead to tissue damage, storing the medication in a refrigerator is not necessary, and administering the medication via an infusion pump over 60 minutes is not appropriate in emergency situations like Malignant Hyperthermia where rapid administration is crucial.
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Which one of the following antipsychotics has been shown to be a partial agonist at the dopamine D2 receptor?
- A. Aripiprazole
- B. Clozapine
- C. Haloperidol
- D. Risperidone
Correct Answer: A
Rationale: Aripiprazole, a third-generation antipsychotic, acts as a partial agonist at D2 receptors, stabilizing dopamine activity: it activates receptors in low-dopamine states (e.g., negative symptoms) and competes with excess dopamine (e.g., psychosis), reducing side effects like EPS. Clozapine, a second-generation drug, has weak D2 affinity, targeting 5HT2 and other receptors. Haloperidol, a first-generation antipsychotic, is a D2 antagonist. Risperidone and thioridazine block D2 fully, not partially. Aripiprazole's unique partial agonism, confirmed by pharmacological data, balances efficacy and tolerability, distinguishing it in schizophrenia treatment.
A client is prescribed levothyroxine for hypothyroidism. Which of the following findings should indicate to the nurse that the medication is effective?
- A. Decreased heart rate
- B. Increased energy levels
- C. Weight loss
- D. Improved mental clarity
Correct Answer: B
Rationale: Increased energy levels are a key indicator of the effectiveness of levothyroxine in treating hypothyroidism. Levothyroxine works to regulate thyroid hormone levels, which can lead to improved energy levels as the body's metabolism is restored. While the other options may also improve with treatment, increased energy levels directly reflect the correction of the thyroid hormone imbalance. Decreased heart rate can be an indicator of overmedication, weight loss can be attributed to increased metabolism but may not directly reflect the effectiveness of levothyroxine, and improved mental clarity is a more general cognitive improvement that may not directly relate to thyroid function.
A client with osteoporosis has a new prescription for alendronate. Which of the following instructions should the nurse provide?
- A. Take the medication with a meal.
- B. Remain upright for at least 30 minutes after taking the medication.
- C. Take the medication with a glass of juice.
- D. Take the medication with milk or food.
Correct Answer: B
Rationale: The correct instruction for a client taking alendronate is to remain upright for at least 30 minutes after administration. This is essential to prevent esophageal irritation and ensure the medication reaches the stomach properly. Remaining upright reduces the risk of side effects such as esophagitis. Choices A, C, and D are incorrect as alendronate should not be taken with a meal, juice, milk, or food to optimize its absorption and effectiveness.
A client with breast cancer is being taught about Tamoxifen. Which of the following adverse effects of tamoxifen should the client be informed about?
- A. Irregular heart rhythm
- B. Abnormal uterine bleeding
- C. Yellowing of the sclera or dark-colored urine
- D. Difficulty swallowing
Correct Answer: B
Rationale: Abnormal uterine bleeding is a known adverse effect of tamoxifen. It is important to educate the client about this side effect as those taking tamoxifen are at an increased risk for endometrial cancer. Any abnormal uterine bleeding should be promptly reported and evaluated by healthcare providers to ensure timely management and monitoring. The other options, such as irregular heart rhythm, yellowing of the sclera or dark-colored urine, and difficulty swallowing, are not typically associated with tamoxifen use and are not commonly reported adverse effects. Therefore, they are not the priority adverse effects to inform the client about.
When educating a client starting a new prescription for metoprolol, which instruction should the nurse include?
- A. Check your pulse before taking the medication.
- B. Take the medication with food to increase absorption.
- C. Avoid sudden changes in position.
- D. Monitor your blood pressure regularly.
Correct Answer: C
Rationale: The correct instruction for a client starting metoprolol is to avoid sudden changes in position. Metoprolol can cause dizziness due to its blood pressure-lowering effects, increasing the risk of falls and injury. Instructing the client to change positions slowly helps prevent orthostatic hypotension and related adverse events. Checking the pulse before taking the medication (Choice A) is not typically necessary for metoprolol. Taking the medication with food (Choice B) is not required for absorption and can be taken with or without food. Monitoring blood pressure regularly (Choice D) is essential for clients taking metoprolol, but avoiding sudden changes in position is more critical to prevent dizziness and falls.