Nokea
Neuroleptic malignant syndrome is suspected in a client who is prescribed an atypical antipsychotic medication. Which medication should the nurse prepare in anticipation of being prescribed to treat this adverse effect related to the use of this medication?
- A. Bromocriptine
- B. Protamine sulfate
- C. Enalapril maleate
- D. Phytonadione (vitamin K)
Correct Answer: A
Rationale: Bromocriptine is a dopamine pathway medication used in the treatment of neuroleptic malignant syndrome. Protamine sulfate is the antidote for heparin overdose. Vitamin K is the antidote for warfarin overdose. Enalapril maleate is an angiotensin-converting enzyme inhibitor and an antihypertensive that is used in the treatment of hypertension.
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A client with a history of cystitis is admitted to the hospital with a diagnosis of pyelonephritis. The nurse should assess the client for which of the following?
- A. Suprapubic pain.
- B. Dysuria.
- C. Urine retention.
- D. Costovertebral tenderness.
Correct Answer: D
Rationale: Costovertebral tenderness is a hallmark of pyelonephritis, indicating kidney involvement, unlike the other symptoms, which are more typical of cystitis.
The nurse is caring for a client with a history of peptic ulcer disease who is prescribed misoprostol (Cytotec). The nurse should instruct the client to take the medication:
- A. With meals to enhance absorption.
- B. On an empty stomach.
- C. At bedtime only.
- D. With an antacid.
Correct Answer: A
Rationale: Misoprostol should be taken with meals to reduce gastrointestinal side effects and protect the stomach lining.
A client with a history of rheumatoid arthritis is prescribed prednisone. The nurse should monitor the client for which of the following adverse effects? Select all that apply.
- A. Hyperglycemia.
- B. Osteoporosis.
- C. Weight gain.
- D. Hypertension.
- E. Hypokalemia.
Correct Answer: A, B, C, D, E
Rationale: Prednisone can cause hyperglycemia, osteoporosis, weight gain, hypertension, and hypokalemia.
A young adult has been bitten by a human and the skin on the forearm is broken. The client's last tetanus shot was about 8 years ago. The nurse should prepare the client to receive:
- A. An injection of tetanus toxoid.
- B. An application of a corticosteroid cream.
- C. Closure of the wound with sutures.
- D. Testing for tuberculosis.
Correct Answer: A
Rationale: A human bite with broken skin and a tetanus shot over 5 years ago warrants tetanus toxoid to prevent tetanus infection. The other options are not indicated for this scenario.
The nurse is caring for a client with a suspected tension pneumothorax. Which finding requires immediate action?
- A. Tracheal deviation
- B. Mild dyspnea
- C. Oxygen saturation of 92%
- D. Subcutaneous emphysema
Correct Answer: A
Rationale: Tracheal deviation is a life-threatening sign of tension pneumothorax, indicating mediastinal shift and requiring immediate decompression.