Nokea
A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. Which of the following actions should the nurse take first?
- A. Obtain the client's blood pressure
- B. Contact the client's provider
- C. Inform the charge nurse
- D. Complete an incident report
Correct Answer: A
Rationale: The correct answer is A: Obtain the client's blood pressure. The nurse's first priority is to assess the client's current condition and potential adverse effects of atenolol. Atenolol is a beta-blocker that can lower blood pressure and heart rate. Obtaining the client's blood pressure will help determine if any immediate interventions are needed. Contacting the provider (B) can be done after assessing the client's condition. Informing the charge nurse (C) is important but not the first priority. Completing an incident report (D) is necessary but should follow immediate client assessment. Other choices are not relevant to the immediate safety and well-being of the client.
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Which of the following medications interacts with carbamazepine?
- A. Nicotine transdermal system
- B. Diphenhydramine
- C. Estrogen-progestin combination (Non-hormonal forms of contraception)
- D. Beclomethasone
Correct Answer: C
Rationale: The correct answer is C: Estrogen-progestin combination (Non-hormonal forms of contraception). Carbamazepine induces the metabolism of estrogen-based contraceptives, leading to decreased efficacy and potential contraceptive failure. This interaction can result in unintended pregnancies. Choices A, B, and D do not have significant interactions with carbamazepine.
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.
Which of the following findings should indicate to the nurse that a client with myasthenia gravis taking neostigmine is experiencing an adverse effect?
- A. Tachycardia
- B. Oliguria
- C. Xerostomia
- D. Miosis
Correct Answer: D
Rationale: The correct answer is D: Miosis. Neostigmine is a cholinesterase inhibitor used to treat myasthenia gravis. Miosis, or excessive constriction of the pupil, is a sign of cholinergic crisis which can occur due to neostigmine overdose. This adverse effect indicates excessive stimulation of the parasympathetic nervous system, leading to symptoms such as increased salivation, bronchoconstriction, and miosis. Tachycardia (A) is not typically associated with neostigmine use, oliguria (B) is not a common adverse effect, and xerostomia (C) is the opposite of the expected effect of increased salivation due to cholinergic stimulation.
Which of the following information should the nurse include in the teaching about medication reconciliation?
- A. The client's provider is required to complete medication reconciliation.
- B. Medication reconciliation at discharge is limited to the medications ordered at the time of discharge.
- C. A transition in care requires the nurse to conduct medication reconciliation.
- D. Medication reconciliation is limited to the names of the medications that the client is currently taking.
Correct Answer: C
Rationale: The correct answer is C: A transition in care requires the nurse to conduct medication reconciliation. This is because medication reconciliation is crucial during transitions of care to ensure safe and accurate medication management. The nurse plays a key role in reconciling medications to prevent errors and ensure continuity of care.
Incorrect choices:
A: The client's provider is required to complete medication reconciliation - Incorrect, as nurses are often responsible for medication reconciliation, not just the provider.
B: Medication reconciliation at discharge is limited to the medications ordered at the time of discharge - Incorrect, as reconciliation should encompass all medications the client is taking.
D: Medication reconciliation is limited to the names of the medications that the client is currently taking - Incorrect, as it should also include dosages, frequencies, and routes of administration.
Which of the following medications should the nurse plan to administer to a client who has heroin toxicity, is unresponsive, has pinpoint pupils, and a respiratory rate of 8/min?
- A. Methadone
- B. Naloxone
- C. Diazepam
- D. Bupropion
Correct Answer: B
Rationale: The correct answer is B: Naloxone. Naloxone is an opioid antagonist that reverses the effects of opioids like heroin. In this scenario, the client's symptoms of unresponsiveness, pinpoint pupils, and respiratory depression indicate opioid toxicity. Naloxone will competitively bind to opioid receptors, reversing respiratory depression and potentially restoring consciousness. Methadone (A) is used for opioid dependence but not acute toxicity. Diazepam (C) is a benzodiazepine and not indicated for opioid toxicity. Bupropion (D) is an antidepressant and not appropriate for this situation.