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A nurse is providing teaching for a client who has a new prescription for promethazine tablets. Which of the following client statements indicates an understanding of the teaching?
- A. This medication can cause diarrhea
- B. The medication can cause increased salivation
- C. This medication can cause pupil constriction
- D. The medication can cause drowsiness
Correct Answer: D
Rationale: The correct answer is D: "The medication can cause drowsiness." This is the correct answer because promethazine is known to have sedative effects and can cause drowsiness as a common side effect. This statement indicates that the client understands one of the primary side effects of the medication.
A: Incorrect. Promethazine typically does not cause diarrhea.
B: Incorrect. Promethazine does not commonly cause increased salivation.
C: Incorrect. Promethazine can cause pupil dilation rather than constriction.
Overall, choice D is the most appropriate as it aligns with the expected side effect profile of promethazine.
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A nurse is preparing to administer exenatide for a client who has type 2 diabetes mellitus. Which of the following routes of administration should nurse plan to use?
- A. Oral
- B. Intramuscular
- C. Subcutaneous
- D. Intravenous
Correct Answer: C
Rationale: The correct answer is C: Subcutaneous. Exenatide is typically administered subcutaneously because it is a peptide-based medication that needs to be absorbed slowly for optimal effects. Subcutaneous injections allow for a slow and steady release of the medication into the bloodstream, which helps in regulating blood sugar levels effectively. Oral administration is not suitable for exenatide as it would be broken down in the digestive system. Intramuscular and intravenous routes are not recommended for exenatide administration due to the risk of erratic absorption and potential adverse effects. Subcutaneous administration ensures a more predictable and consistent absorption rate, making it the most appropriate route for exenatide.
A nurse is caring for a client who is receiving diazepam as sedation for an endoscopy, Which of the following antidotes should the nurse have on hand during the procedure?
- A. Naloxone
- B. Atropine
- C. Flumazenil
- D. Neostigmine
Correct Answer: C
Rationale: The correct answer is C: Flumazenil. Flumazenil is the antidote for benzodiazepines like diazepam, used for sedation. It works by competitively inhibiting benzodiazepine binding, reversing sedative effects. Naloxone (A) is for opioid overdose, Atropine (B) for bradycardia, and Neostigmine (D) for reversing neuromuscular blockade. No other choices provided. In summary, Flumazenil is the appropriate antidote for benzodiazepine overdose, making it the correct choice in this scenario.
A nurse is reviewing the laboratory results of a client who has been taking warfarin for 3 months. Which of the following laboratory results Indicates that the medication has been effective?
- A. Hgb 14 g/dL
- B. WBC count 10,000/mm3
- C. INR 2.0
- D. Platelets 150,000/mm3
Correct Answer: C
Rationale: The correct answer is C: INR 2.0. INR (International Normalized Ratio) measures the effectiveness of warfarin in preventing blood clotting. A therapeutic range for INR in clients on warfarin is typically between 2.0 and 3.0. An INR of 2.0 indicates that the medication is within the desired range and is effectively anticoagulating the blood to prevent clot formation.
Choice A (Hgb 14 g/dL) is a normal hemoglobin level and does not directly reflect warfarin effectiveness. Choice B (WBC count 10,000/mm3) measures white blood cells and is not related to warfarin efficacy. Choice D (Platelets 150,000/mm3) is a normal platelet count and does not indicate the effectiveness of warfarin.
A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which of the following findings should the nurse identify as an adverse effect of TPN
- A. 2+ deep tendons reflexes
- B. Casual blood glucose 100 mg/dl
- C. Potassium 4.8 mEq/L
- D. 2+ peripheral pitting Edema
Correct Answer: D
Rationale: The correct answer is D: 2+ peripheral pitting Edema. This is due to fluid overload from TPN, leading to excessive fluid accumulation in peripheral tissues. Deep tendon reflexes (A) and normal blood glucose levels (B) are not typically adverse effects of TPN. Potassium within normal range (C) is a positive finding. Peripheral pitting edema (D) indicates fluid imbalance.
A nurse discovers that a client has been administered a higher dose of oxybutynin than the prescription indicates. The nurse should assess the client for which of the following adverse effects?
- A. Increased salivation
- B. Hyperthermia
- C. Urinary incontinence
- D. Bradycardia
Correct Answer: D
Rationale: Rationale for Correct Answer (D - Bradycardia): Excess oxybutynin can lead to anticholinergic effects, including decreased heart rate (bradycardia). This is due to the drug's action on muscarinic receptors in the heart. Assessing for bradycardia is crucial as it can indicate toxicity.
Summary of Incorrect Choices:
A: Increased salivation - Oxybutynin is an anticholinergic drug that typically causes dry mouth, not increased salivation.
B: Hyperthermia - Oxybutynin toxicity does not commonly lead to hyperthermia.
C: Urinary incontinence - Oxybutynin is used to treat urinary incontinence, so excess dose would not cause this adverse effect.
E, F, G: No further choices provided.