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A nurse is discussing adverse reactions to pain medications in older adult clients with a newly licensed nurse. Which of the following findings should the nurse include as risk factors for an adverse drug reaction? (SATA)
- A. Polypharmacy
- B. Increased rate of absorption
- C. Decreased percentage of body fat
- D. Multiple health problems
Correct Answer: A,C,D,E
Rationale: To determine risk factors for adverse drug reactions in older adults, consider the following:
A: Polypharmacy increases the likelihood of drug interactions and adverse effects.
C: Decreased body fat can affect drug distribution, leading to higher drug concentrations.
D: Multiple health problems may require multiple medications, increasing the risk of adverse reactions.
E: Age-related changes in liver and kidney function can affect drug metabolism and excretion.
Other choices are incorrect because increased rate of absorption does not necessarily increase risk and choices F and G were not provided.
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A nurse is teaching a client who has angina a new prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching?
- A. Discard any tablets you do not use every 6 months.
- B. Take one tablet each morning 30 minutes prior to eating.
- C. Keep the tablets at room temperature in their original glass bottle.
- D. Place the tablet between your cheek and gum to dissolve.
Correct Answer: C
Rationale: The correct answer is C: Keep the tablets at room temperature in their original glass bottle. Nitroglycerin tablets are sensitive to light, moisture, and heat. Storing them in their original glass bottle at room temperature helps maintain their potency. Discarding unused tablets every 6 months (choice A) is not necessary as long as they are stored properly. Taking a tablet each morning (choice B) is not recommended as nitroglycerin is usually taken as needed for angina attacks. Placing the tablet between cheek and gum (choice D) is not the correct administration route for sublingual nitroglycerin, as it should be placed under the tongue for rapid absorption.
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.
A nurse is preparing to administer the initial dose of penicillin G IM to a client. The nurse should monitor for which of the following as an indication of an allergic reaction following the injection?
- A. Urticaria
- B. Bradycardia
- C. Pallor
- D. Dyspepsia
Correct Answer: A
Rationale: The correct answer is A: Urticaria. Urticaria, or hives, is a classic sign of an allergic reaction. It presents as raised, red, itchy welts on the skin. This occurs due to histamine release in response to the allergen (penicillin in this case). Monitoring for urticaria is crucial as it indicates a potentially serious allergic reaction that may progress to anaphylaxis. Bradycardia (B), Pallor (C), and Dyspepsia (D) are not typically associated with allergic reactions to penicillin. Bradycardia is a slow heart rate, pallor is paleness of the skin, and dyspepsia is indigestion. These symptoms are more likely related to other conditions or side effects rather than an allergic reaction.
A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?
- A. Hypocalcemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypomagnesemia
Correct Answer: C
Rationale: The correct answer is C: Hyponatremia. When a client taking lithium starts a new exercise program, they may sweat more, leading to sodium loss. Hyponatremia is characterized by low sodium levels in the blood, which can be exacerbated by the diuretic effect of lithium. This can result in symptoms such as confusion, muscle cramps, weakness, and seizures. Assessing for hyponatremia is crucial to prevent complications.
Incorrect choices:
A: Hypocalcemia - Not directly related to lithium or exercise.
B: Hypokalemia - More commonly associated with diuretic use or excessive potassium loss.
D: Hypomagnesemia - More commonly seen in alcoholism or malnutrition.
A home health nurse is visiting a client who has heart failure and a prescription for furosemide. The nurse identifies that the client has gained 2.5 kg (5 lb.) since the last visit 2 days ago. Which of the following actions should the nurse take first?
- A. Encourage the client to dangle the legs while sitting in a chair
- B. Teach the client about foods low in sodium
- C. Determine medication adherence by the client
- D. Notify the provider of the client's weight gain
Correct Answer: D
Rationale: The correct answer is D: Notify the provider of the client's weight gain. This is the first action the nurse should take because sudden weight gain in a client with heart failure could indicate fluid retention, which may worsen the client's condition. By notifying the provider, the nurse can ensure timely intervention to adjust the medication or treatment plan. Encouraging leg dangling (A) may help with circulation but does not address the immediate concern of weight gain. Teaching about low-sodium foods (B) is important for long-term management but not the priority at this moment. Determining medication adherence (C) is important but should come after addressing the immediate weight gain issue.