Nokea
A nurse is caring for a client who has breast cancer and reports pain. 1 hr after administration of prescribed morphine 10 mg IV. Which of the following medications should the nurse expect to administer?
- A. Naloxone IV
- B. Morphine tablet
- C. Lidocaine patch
- D. Fentanyl transmucosal
Correct Answer: D
Rationale: The correct answer is D: Fentanyl transmucosal. Fentanyl is a potent opioid used for severe pain, and transmucosal administration provides rapid relief. Naloxone (A) is an opioid antagonist used to reverse opioid overdose, not for pain management. Morphine tablet (B) is not indicated for immediate relief after IV morphine. Lidocaine patch (C) is used for localized pain, not post-IV opioid pain control. Therefore, fentanyl transmucosal (D) is the most appropriate choice for rapid pain relief in this scenario.
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Which of the following statements should the nurse include in the teaching about the new medication?
- A. You should take this medication with dairy products.
- B. This medication may cause constipation.
- C. It is common to experience headache or blurred vision while taking this medication.
- D. You should avoid the sun while taking this medication.
- E. You should use an alternate method of birth control while taking this medication.
Correct Answer: D
Rationale: The correct answer is D: You should avoid the sun while taking this medication. This is important because some medications can increase sensitivity to sunlight, leading to sunburn or skin reactions. Avoiding the sun can prevent these adverse effects.
A: You should not take this medication with dairy products as it may interfere with the absorption of the medication.
B: Constipation is a common side effect of some medications, but it is not specific to this particular medication.
C: Headache or blurred vision may occur with some medications, but it is not specific to this particular medication.
E: Using an alternate method of birth control may be necessary if the medication interferes with hormonal contraceptives, but this information is not provided in the question stem.
A nurse inadvertently administers 160 mg of valsartan PO to a client who was scheduled to receive 80 mg. Which of the following actions is the priority for the nurse to take?
- 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. This is the priority because an overdose of valsartan, a medication used to treat hypertension, can lead to a sudden drop in blood pressure. Orthostatic hypotension is a potential complication that can result from this overdose, and it requires immediate assessment and intervention to prevent further complications such as falls or decreased perfusion to vital organs. Monitoring urine output (B) is important for some medications but is not the priority in this case. Obtaining laboratory results (C) may be necessary in the long term but is not urgent in this situation. Checking for nasal congestion (D) is not relevant to the issue at hand.
A nurse is providing teaching to a client who has a new prescription for clozapine. Which of the following statements should the nurse include in the teaching?
- A. Diarrhea is a common adverse effect of this medication.
- B. Ringing in the ears is an expected adverse effect of this medication.
- C. Notify your provider if you develop a fever while taking this medication.
- D. You might experience weight loss while taking this medication.
Correct Answer: C
Rationale: The correct answer is C: Notify your provider if you develop a fever while taking this medication. This is important because clozapine can cause a serious condition called agranulocytosis, which can lead to a fever. The nurse should emphasize the significance of monitoring for fever and promptly notifying the healthcare provider. Choice A is incorrect because diarrhea is not a common adverse effect of clozapine. Choice B is incorrect as ringing in the ears is not an expected adverse effect. Choice D is incorrect because weight gain, not weight loss, is a common side effect of clozapine.
A nurse is preparing to administer 4,000 units of heparin subcutaneously to a client who has deep-vein thrombosis. Available is heparin 10,000 units/mL. How many mL of heparin should the nurse administer? (Round to the nearest tenth.)
Correct Answer: 0.4
Rationale: To calculate the mL of heparin to administer, use the formula: desired dose (4,000 units) ÷ concentration (10,000 units/mL) = X mL. 4,000 ÷ 10,000 = 0.4 mL. The correct answer is 0.4 mL because it accurately represents the calculated dose needed for the client. Other choices are incorrect as they do not align with the correct calculation.
A nurse is administering naloxone to a client who has developed an adverse reaction to morphine. The nurse should identify which of the following findings as a therapeutic effect of naloxone?
- A. Decreased nausea
- B. Increased pain relief
- C. Decreased blood pressure
- D. Increased respiratory rate
Correct Answer: D
Rationale: The correct answer is D: Increased respiratory rate. Naloxone is an opioid antagonist that works by blocking the effects of opioids, such as morphine. By administering naloxone to the client experiencing an adverse reaction to morphine, the nurse can reverse the respiratory depression caused by the morphine. This reversal leads to an increase in the client's respiratory rate, which is a therapeutic effect of naloxone in this situation.
Incorrect choices:
A: Decreased nausea - Naloxone does not directly address nausea.
B: Increased pain relief - Naloxone does not provide pain relief but reverses the effects of opioids.
C: Decreased blood pressure - Naloxone may lead to an increase in blood pressure due to its effects on reversing opioid-induced respiratory depression.