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Methylphenidate hydrochloride is prescribed for the child with ADHD. The nurse should teach the parents to administer the medication in which way?
- A. Whenever the child exhibits inattention behaviors
- B. Whenever the child exhibits hyperactive behaviors
- C. With a snack before bed to calm the child for sleep
- D. During or after meals if the medication decreases appetite
Correct Answer: D
Rationale: A: Methylphenidate is usually given twice daily at or before breakfast and at noon, not whenever inattention behaviors occur. B: Methylphenidate is usually given twice daily at or before breakfast and at noon, not whenever hyperactive behaviors occur. C: The last dose of the medication should be given before 6 p.m. to prevent insomnia. D: A side effect of methylphenidate hydrochloride (Ritalin) is anorexia. It should be given during or immediately after breakfast and lunch to prevent a decreased intake.
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The child, admitted to the ED, is experiencing nausea and vomiting, salivation, respiratory muscle weakness, and depressed reflexes an hour after exposure to pesticides. Which medications should the nurse anticipate administering to the child?
- A. Atropine and flumazenil
- B. Atropine and pralidoxime
- C. Epinephrine and naloxone
- D. Epinephrine and digoxin immune Fab
Correct Answer: B
Rationale: A: Flumazenil (Romazicon) antagonizes the effects of benzodiazepines on the CNS, such as sedation, impaired recall, and psychomotor impairment. B: An organophosphate base in pesticides causes acetylcholine to accumulate at neuromuscular junctions. Atropine (Atropine), an anticholinergic medication, and pralidoxime chloride (Protopam), a cholinesterase reactivator, are effective antidotes to reverse the symptoms. C: Epinephrine (EpiPen) is an alpha- and beta-adrenergic agonist and cardiac stimulant that strengthens myocardial contractions, increases systolic BP, increases cardiac rate and output, and constricts bronchial arterioles, inhibiting histamine release. Naloxone (Narcan) is a narcotic antagonist that reverses the effects of opiates. D: Digoxin immune Fab (Digibind) is the antidote for digoxin and digitoxin, which acts by complexing with circulating digoxin or digitoxin, preventing the drug from binding at receptor sites.
The nurse is reviewing the client's medication list illustrated, prepared by the client's daughter. The nurse is most concerned about which finding?
- A. Some medication doses are missing.
- B. Some administration routes are missing.
- C. Some medications are being duplicated.
- D. Some medications have drug-drug interactions.
Correct Answer: C
Rationale: A: Missing doses of medication is important to address; however, duplicate medications should be addressed first. B: It is important to address the administration routes, but the duplication of medications is the priority to address. C: Hydrochlorothiazide + captopril (Capozide) is a combination product. The nurse should first determine if the client is taking the combination product along with the individual products due to the potential for overdosing. The client may be clear regarding the dose and the route but may not realize that two medications were replaced with one combination product. D: Drug-drug interactions are important to address and should be addressed, but the duplicate medications are the priority.
The nurse is caring for a female client who has recently been diagnosed with cancer and will soon begin chemotherapy. Which of these statements would require additional follow-up and education?
- A. I will be most susceptible to an infection between 7 and 12 days after chemotherapy.
- B. I should try to get my annual teeth cleaning in before beginning chemotherapy.
- C. I should wait until all my hair falls out to purchase a wig.
- D. I should try to drink 8-10 glasses of water a day.
Correct Answer: C
Rationale: This client is at risk for altered body image secondary to the hair loss from chemotherapy. A wig can be helpful in coping with this, and the client should shop for a wig before his or her hair falls out so that he or she can better match his or her color and style. The remaining statements are accurate.
Which of the following would likely not be a barrier to learning?
- A. a client who took Ambien an hour ago
- B. a bipolar client currently in a manic phase
- C. a client who states they are not interested
- D. a client with dysphagia
Correct Answer: D
Rationale: Dysphagia may be a barrier to communication but not to learning. Barriers to learning include an altered mental status, taking sedative medications, and lack of motivation to learn.
The client with CRF receives a sodium polystyrene sulfonate enema. Which finding indicates that the medication is achieving the desired therapeutic effect?
- A. Returns of dark-colored stool
- B. Able to retain solution for 1 hour
- C. Verbalizes relief of constipation
- D. Serum potassium level 4.0 mEq/L
Correct Answer: D
Rationale: A: Although sodium polystyrene sulfonate may be administered as an enema and stool may return, the purpose of the medication is to lower serum potassium levels and not to empty the bowel. B: The client should be encouraged to retain the enema solution for as long as possible so that sodium ions can be exchanged for potassium ions in the intestine, but its retention for this length of time does not indicate its effectiveness in lowering the serum potassium level. C: The client may be constipated prior to receiving the enema, but this is not the purpose of a sodium polystyrene sulfonate enema. D: Sodium polystyrene sulfonate exchanges sodium ions for potassium ions in the intestine and is administered when the client has hyperkalemia. A normal serum potassium level of 4.0 mEq/L indicates that the medication is achieving its desired therapeutic effect.