Nokea
A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension. and dyspneWhich of the following medications should the nurse administer first?
- A. Diphenhydramine
- B. Albuterol inhaler
- C. Epinephrine
- D. Prednisone
Correct Answer: C
Rationale: The correct answer is C: Epinephrine. Epinephrine is the first-line treatment for anaphylaxis, which can present with symptoms such as anxiety, hypotension, and dyspnea following administration of a medication like cefazolin. Epinephrine acts quickly to reverse the severe allergic reaction by constricting blood vessels, increasing blood pressure, and opening up the airways to improve breathing. Diphenhydramine (A) is an antihistamine that can be used as an adjunct therapy but is not the first choice in an acute anaphylactic reaction. Albuterol inhaler (B) is used for bronchodilation in asthma, not for managing anaphylaxis. Prednisone (D) is a corticosteroid that may be used later in the treatment process to prevent a late-phase reaction but is not the initial treatment for anaphylaxis.
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A nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has hyperkalemiWhich of the following actions should the nurse plan to take?
- A. Hold the client's other oral medications for 1 hour post-administration.
- B. Inform the client that this medication can turn stool a light tan color.
- C. Keep the client's solution in the refrigerator for up to 72 hours.
- D. Monitor the client for constipation.
Correct Answer: D
Rationale: The correct answer is D: Monitor the client for constipation. Sodium polystyrene sulfonate is a medication used to treat hyperkalemia by binding excess potassium in the intestines for elimination. Constipation is a common side effect, as the medication can cause a decrease in bowel motility. The nurse should monitor the client for signs of constipation, such as abdominal discomfort, decreased frequency of bowel movements, or difficulty passing stools. This is essential to prevent complications such as bowel obstruction. Holding the client's other oral medications, informing about stool color changes, or refrigerating the solution are not relevant actions for administering sodium polystyrene sulfonate.
Which of the following medications puts the client at risk for developing hearing loss?
- A. Rifampin
- B. Ciprofloxacin
- C. Penicillin G
- D. Gentamicin
Correct Answer: D
Rationale: The correct answer is D: Gentamicin. Gentamicin is an aminoglycoside antibiotic known to cause ototoxicity, leading to hearing loss. It can damage the hair cells in the inner ear, affecting hearing. Rifampin (A), Ciprofloxacin (B), and Penicillin G (C) are not associated with ototoxicity. Gentamicin should be used cautiously to prevent hearing loss.
Which of the following medications for pain relief can be taken concurrently with enoxaparin?
- A. Ibuprofen
- B. Naproxen sodium
- C. Acetaminophen
- D. Aspirin
Correct Answer: C
Rationale: Correct Answer: C (Acetaminophen)
Rationale:
1. Acetaminophen is a non-steroidal anti-inflammatory drug (NSAID) that does not affect platelet function.
2. Enoxaparin is an anticoagulant that works by inhibiting blood clot formation.
3. Taking acetaminophen with enoxaparin does not increase the risk of bleeding.
4. Choices A, B, and D (Ibuprofen, Naproxen sodium, Aspirin) are NSAIDs that can increase the risk of bleeding when taken with enoxaparin.
A nurse is teaching a client about cyclobenzaprinWhich of the following client statements should indicate to the nurse that the teaching is effective?
- A. I will have increased saliva production.
- B. I will continue taking the medication until the rash disappears.
- C. I will taper off the medication before discontinuing it.
- D. I will report any urinary incontinence.
Correct Answer: C
Rationale: The correct answer is C: "I will taper off the medication before discontinuing it." This indicates effective teaching because cyclobenzaprine should not be abruptly stopped to prevent withdrawal symptoms. Tapering off gradually helps the body adjust. Saliva production (A) is not a typical side effect. Continuing until rash disappears (B) is incorrect as it may not be related to the medication. Reporting urinary incontinence (D) is important but not related to proper medication use.
Which of the following actions is the priority for the nurse to take after inadvertently administering 160 mg of valsartan PO to a client who was scheduled to receive 80 mg?
- A. Evaluate the client for orthostatic hypotension
- B. Monitor the client's urine output
- C. Obtain the client's laboratory results
- D. Check the client for nasal congestion
Correct Answer: A
Rationale: The correct answer is A: Evaluate the client for orthostatic hypotension. After administering a double dose of Valsartan, the priority is to assess the client for potential adverse effects such as a sudden drop in blood pressure, which can lead to orthostatic hypotension. This is crucial to prevent any harm to the client. Monitoring urine output (B) may be important but is not the immediate priority. Obtaining laboratory results (C) would not provide immediate information on the client's current condition. Checking for nasal congestion (D) is irrelevant to the situation.