Nokea
The client being treated for opiate dependence is receiving a buprenorphine/naloxone combination. The nurse understands that the reason for adding naloxone to the treatment with buprenorphine is for what effect?
- A. Prevent opiate intoxication should the client abuse an opiate.
- B. Replace essential nutrients due to malnutrition from drug abuse.
- C. Reduce the incidence of adverse reactions of the buprenorphine.
- D. Induce an adverse reaction if the client uses an opiate while on buprenorphine.
Correct Answer: A
Rationale: Naloxone in buprenorphine/naloxone (Suboxone) blocks opiate receptors, preventing intoxication if opiates are abused.
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The LPN receives a call from a mother caring for her eight-month-old infant. The mother describes that the child has a low-grade fever and has teeth breaking through the gums. Which of the following measures would be inappropriate to recommend to the mother?
- A. Allow the child to chew on a cooled teething ring.
- B. Massage the child's gums gently.
- C. Administer acetaminophen.
- D. Administer aspirin.
Correct Answer: D
Rationale: Aspirin should not be recommended as a pain medication for children due to the increased risk of Reye's syndrome.
The 8-year-old child with gastroenteritis is prescribed to receive 500 mL of lactated Ringer's (LR) solution over the next 10 hours. How many milliliters per hour should the nurse administer?
Correct Answer: 50
Rationale: 500 mL / 10 hr = 50 mL/hr
The nurse is assessing a client who has recently found out she is pregnant. Which of the following statements would be a priority for the nurse to follow up on?
- A. I am nervous about how painful labor will be.
- B. I need to review my finances and make sure I am prepared to care for a child.
- C. I hate this nausea that I've been having for a week.
- D. I am preparing myself to do this on my own because I do not have any family nearby. But I have always been very independent.
Correct Answer: D
Rationale: The nurse should follow up on the client's lack of support system. Even if there is no family in the area, there are supportive resources in the community that may help the client through the pregnancy and into motherhood. It is normal for the client to worry about labor, address financial concerns, and express displeasure from early pregnancy symptoms such as nausea.
The client taking carbamazepine XR for seizure control reports that pieces of the medication are being passed into the stool. Which action by the nurse is most important?
- A. Report this to the health care provider.
- B. Reassure the client that this is normal.
- C. Collect the stool for laboratory analysis.
- D. Document the findings in the medical record.
Correct Answer: B
Rationale: A: It is inappropriate to report an expected finding to the HCP. B: Carbamazepine XR (Tegretol XR) is a sustained-release medication with a coating that is not absorbed but is excreted in feces and may be visible in stool. The nurse should reassure the client that this is normal. C: Collecting the stool for laboratory analysis is not necessary because the coating is not absorbed but excreted in the stool. D: The nurse should document the client teaching but usually would not document the presence of the coating in the client's stool.
The 12-year-old weighing 50 kg is hospitalized with bacterial pneumonia and an upper respiratory tract infection. The nurse is reviewing the child's serum laboratory report illustrated. Based on the findings, which HCP order is most important for the nurse to question?
- A. Amikacin sulfate 375 mg IVPB q12h
- B. Guaifenesin 50-100 mg q4h prn for cough
- C. Dextrose 5% in 0.25 NaCl with 20 mEq/L KCl at 90 mL/hr
- D. Acetaminophen 325-650 mg q4-6h prn, not to exceed 3000 mg/24 hr
Correct Answer: A
Rationale: A: Amikacin (Amikin) is an aminoglycoside, which is nephrotoxic and should be questioned. The serum creatinine and BUN levels are elevated, suggesting decreased renal function. B: Guaifenesin (Robitussin) is used for cough. The dose is within the range for a child of 12 years. C: The serum osmolality is high, suggesting dehydration, and the potassium is low. D5 in 0.25 NaCl with 20 mEq/L at 90 mL/hr will treat the dehydration and hypokalemia. D: The acetaminophen (Tylenol) dose is within parameters, but it is concerning with the decreased renal function. Because acetaminophen is prn and amikacin is timed, the amikacin is more important to question.