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A patient was admitted to the emergency department with a pulse oximeter reading of 85% after a successful prehospital resuscitation from cardiac arrest due to an asthma attack. What is the most important initial drug to administer as ordered?
- A. Epinephrine
- B. Sodium bicarbonate
- C. Albuterol
- D. Oxygen
Correct Answer: D
Rationale: Oxygen is the most important initial intervention for a patient with a low pulse oximeter reading (85%) to correct hypoxia and prevent further complications. While epinephrine (A) and albuterol (C) are used to treat asthma, oxygen is the priority to address the immediate hypoxia. Sodium bicarbonate (B) is not indicated unless there is severe metabolic acidosis.
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A nurse is completing discharge teaching for a client who has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions?
- A. "I will clean the site with an alcohol swab before I apply the patch."
- B. "I will rotate the application sites weekly."
- C. "I will apply the patch to an area of skin with no hair."
- D. "I will place the new patch on the site of the old patch.
Correct Answer: B
Rationale: Rotating the application sites of transdermal patches is important to prevent skin irritation and enhance absorption efficiency. This practice helps to minimize skin irritation and allows the skin to recover between applications. By rotating the sites weekly, the client can ensure optimal medication delivery and reduce the risk of skin reactions at any specific application site. This indicates that the client understands the importance of proper patch placement and skin care.
The adolescent is supposed to go to the school nurse at 12:00 to receive his medication for attention-deficit hyperactivity disorder (ADHD). He often does not go for the medication. What best describes the nurse's understanding of this situation?
- A. The adolescent is embarrassed in front of his peers
- B. The adolescent does not understand the need for the medication
- C. The adolescent forgets that he is supposed to take the medication
- D. The adolescent has made a conscious decision not to take the medication
Correct Answer: A
Rationale: Adolescents prioritize peer image-skipping ADHD meds (e.g., Ritalin) at school likely stems from embarrassment, a developmental trait. Lack of understanding or forgetting is possible but less likely with routine. Conscious refusal needs evidence (e.g., verbal rejection). Embarrassment fits social sensitivity, guiding intervention.
A client has a new prescription for Atenolol. Which of the following statements should be included by the healthcare provider?
- A. Take the medication with a high-fat meal.
- B. Monitor your heart rate before taking the medication.
- C. Expect a persistent cough.
- D. Avoid foods high in fiber.
Correct Answer: B
Rationale: When a client is prescribed Atenolol, a beta-blocker, they should monitor their heart rate before taking the medication. It is crucial because if the heart rate is below 60 bpm, the client needs to contact their healthcare provider for further guidance and evaluation. Choices A, C, and D are incorrect. Atenolol does not need to be taken with a high-fat meal, does not typically cause a persistent cough, and there is no need to avoid foods high in fiber when taking this medication.
Pregnancy advise is given in what Part of the MIMS:
- A. Preg. Cat.
- B. pre and post prandial advice ;
- C. drug category;
- D. abbreviations
Correct Answer: A
Rationale: Pregnancy advice is typically provided under the "Preg. Cat." section in the MIMS (Monthly Index of Medical Specialities) guide or database. This section specifically categorizes medications based on their safety profiles during pregnancy, providing healthcare professionals with essential information to make informed decisions regarding drug use in pregnant patients. It includes details on pregnancy categories that classify drugs according to their potential risks during pregnancy, guiding healthcare providers on the appropriateness of prescribing certain medications to pregnant individuals. Therefore, for pregnancy-related advice in the context of medication safety, referring to the "Preg. Cat." section in the MIMS is the most relevant source of information.
The nurse notes in the patient™s medication orders that the patient will be taking ibutilide (Corvert). Based on this finding, the nurse interprets that the patient has which disorder?
- A. Ventricular ectopy
- B. Atrial fibrillation
- C. Supraventricular tachycardia
- D. Bradycardia
Correct Answer: B
Rationale: Ibutilide (Corvert) is a class III antiarrhythmic medication primarily used for the treatment of atrial fibrillation and atrial flutter. It works by prolonging the action potential duration and refractory period of atrial tissue. Therefore, when a nurse notes that a patient will be taking ibutilide, it indicates that the patient likely has atrial fibrillation, a common arrhythmia characterized by rapid, irregular electrical activity in the atria of the heart.