Nokea
Minutes after administering an intravenous dose of 10 mg of morphine, the nurse notes that the client's blood pressure has dropped from 122/83 mmHg to 88/67 mmHg, and the client's respirations are now 8/minute. Which nursing action is the most appropriate?
- A. Prepare for intubation
- B. Prepare to administer a dopamine infusion
- C. Administer naloxone
- D. Start an intravenous infusion of normal saline
Correct Answer: C
Rationale: Naloxone reverses opioid-induced respiratory depression and hypotension, which are evident here.
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The nurse is caring for a client diagnosed with Multiple Sclerosis (MS). The nurse should anticipate a prescription for which medication?
- A. Topiramate
- B. Risperidone
- C. Prazosin
- D. Baclofen
Correct Answer: D
Rationale: Baclofen is a muscle relaxant commonly prescribed for spasticity in Multiple Sclerosis. Topiramate is used for seizures or migraines, risperidone for psychiatric conditions, and prazosin for hypertension, none of which are primary treatments for MS.
The nurse is developing a plan of care for a client with advanced Alzheimer's disease. Which of the following should the nurse include?
- A. Assess the client's risk for falls
- B. Monitor the client for hyperorality
- C. Provide consistent caregivers
- D. Obtain a prescription for as-needed (PRN) diphenhydramine
- E. Foster a low-stimulation environment
- F. Offer limited choices
Correct Answer: A,B,C,E,F
Rationale: These interventions address safety, behavior, and comfort in advanced Alzheimer's disease.
The nurse is caring for a client who has been prescribed carbidopa-levodopa for Parkinson's disease. The nurse should instruct the client that this medication may cause Select all that apply.
- A. Urine to appear darker
- B. Hallucinations
- C. Dizziness upon standing
- D. Dry, non-productive cough
- E. Painful rash that spreads and blisters
Correct Answer: A,B,C
Rationale: Carbidopa-levodopa can cause darker urine (due to metabolism), hallucinations (a CNS side effect), and dizziness upon standing (orthostatic hypotension). Dry cough and rashes are not typical side effects.
The nurse is assessing a client taking prescribed lamotrigine. Which client finding requires immediate follow-up?
- A. Abnormal dreams
- B. Skin blistering
- C. Dyspepsia
- D. Xerostomia
Correct Answer: B
Rationale: Skin blistering is a serious adverse effect of lamotrigine, potentially indicating Stevens-Johnson syndrome or toxic epidermal necrolysis, both life-threatening conditions requiring immediate medical attention. Abnormal dreams, dyspepsia, and xerostomia are less severe side effects that do not typically require urgent follow-up.
The nurse is caring for a client newly prescribed ropinirole. The nurse understands that this medication is prescribed to treat which condition?
- A. Multiple Sclerosis
- B. Parkinson disease
- C. Schizophrenia
- D. Guillain-Barré syndrome
Correct Answer: B
Rationale: Ropinirole is a dopamine agonist used to treat Parkinson's disease by improving motor symptoms. It is not indicated for Multiple Sclerosis, Schizophrenia, or Guillain-Barré syndrome, which involve different pathophysiology and treatments.