Nokea
A postoperative client has a prescription for ketorolac 30mg IV q6h. Which response demonstrates that therapeutic levels of the medication have been achieved?
- A. Observe wound drainage for a change in appearance
- B. Assess the client's calves for inflammation
- C. Perform a pain assessment using a numeric scale
- D. Measure the client's intake and output
Correct Answer: C
Rationale: The correct response is to perform a pain assessment using a numeric scale. Ketorolac is an NSAID prescribed for pain relief. Monitoring pain levels is crucial to evaluate the therapeutic effectiveness of the medication. Pain assessment helps determine if the medication is providing adequate pain relief, indicating that therapeutic levels have been achieved.
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A client with a history of angina is prescribed amlodipine. The practical nurse (PN) should monitor the client for which adverse effect?
- A. Headache
- B. Peripheral edema
- C. Hyperglycemia
- D. Hypertension
Correct Answer: B
Rationale: Amlodipine, a calcium channel blocker, commonly causes peripheral edema as an adverse effect. This is due to its vasodilation effects on blood vessels, leading to fluid accumulation in the extremities. Monitoring for peripheral edema is crucial to assess the client's response to amlodipine and ensure timely intervention if needed.
A client who is obtunded arrives in the emergency center with a suspected drug overdose. Intravenous naloxone is given, but within a short period, the client's level of consciousness deteriorates. What action should the nurse take first?
- A. Initiate a second intravenous access site
- B. Prepare to initiate cardiopulmonary resuscitation
- C. Determine the results of the drug toxicity screen
- D. Administer an additional dose of naloxone
Correct Answer: D
Rationale: Administering an additional dose of naloxone should be the first action taken by the nurse in this scenario. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose. If the client's level of consciousness deteriorates after the initial dose, administering another dose can help further reverse the overdose effects and improve the client's condition. Once the additional naloxone dose is given, the nurse can then proceed to assess the client's response and consider other interventions as needed.
A client has been taking simvastatin for 3 days and calls the nurse at the clinic to report extreme muscle tenderness and pain. Which is the most appropriate action?
- A. Notify the health care provider.
- B. Review the medication with the client.
- C. Advise the client to avoid grapefruit juice.
- D. Remind the client to limit physical activity until evaluated by the health care provider.
Correct Answer: A
Rationale: Extreme muscle tenderness and pain in a client taking simvastatin could indicate rhabdomyolysis, a serious condition. Promptly notifying the health care provider is crucial to evaluate and manage this potential medical emergency. Reviewing the medication with the client may not address the urgency of the situation. Advising the client to avoid grapefruit juice is not directly related to the client's current symptoms. Reminding the client to limit physical activity until evaluated by the health care provider is not appropriate as the client's symptoms should be assessed by a professional first.
A client diagnosed with a herniated disc is prescribed hydrocodone/acetaminophen 10 mg/300 mg prn every 4 to 6 hours. As the practical nurse (PN) enters the client's room to administer the requested medication, the client is seen talking and laughing with visiting family. What action should the PN take?
- A. Hold the pain medication until after the visitors leave.
- B. Notify the healthcare provider of the client's drug-seeking behavior.
- C. Administer analgesia as requested by the client.
- D. Inform the client that the medication is not needed based on their behavior.
Correct Answer: C
Rationale: The correct action for the PN in this situation is to administer the analgesia as requested by the client. Pain management is based on the client's self-report of pain, which is the most reliable indicator of pain intensity. Analgesics should be given promptly when pain occurs and before it worsens. Following the administration of medication, the PN should discuss the situation with the charge nurse for further guidance or assessment.
A client with hypertension is prescribed doxazosin. The nurse should monitor for which potential side effect?
- A. Hypotension
- B. Hypertension
- C. Hyperglycemia
- D. Hypernatremia
Correct Answer: A
Rationale: The correct answer is A: Hypotension. Doxazosin is an alpha-blocker medication commonly used to treat hypertension. One of the potential side effects of doxazosin is causing a sudden drop in blood pressure, leading to hypotension. Therefore, the nurse should closely monitor the client for signs and symptoms of low blood pressure when initiating or adjusting the dose of doxazosin.