Nokea
The client diagnosed with multiple sclerosis (MS) is receiving Lioresal (baclofen), a muscle relaxant. Which information should the nurse teach the client/family?
- A. The importance of tapering off medication when discontinuing medication.
- B. Baclofen may cause diarrhea, so the client should take antidiarrheal medication.
- C. The client should not be allowed to drive alone while taking this medication.
- D. The need for follow-up visits to obtain a monthly white blood cell count.
Correct Answer: A
Rationale: Baclofen requires tapering to prevent withdrawal symptoms, like seizures, per FDA warnings. Diarrhea, driving, or WBC counts are not primary concerns.
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The client is diagnosed with pernicious anemia. Which health-care provider order should the nurse anticipate in treating this condition?
- A. Subcutaneous iron dextran.
- B. Intramuscular vitamin B12.
- C. Intravenous folic acid.
- D. Oral thiamine medication.
Correct Answer: B
Rationale: Pernicious anemia results from B12 deficiency; IM B12 is standard treatment due to absorption issues. Iron, folic acid, or thiamine do not address the primary cause.
A client is ordered atropine to be administered preoperatively. Which physiological effect should the nurse monitor for?
- A. Elevate blood pressure
- B. Drying up of secretions
- C. Reduce heart rate
- D. Enhance sedation
Correct Answer: B
Rationale: Drying up of secretions. Atropine dries secretions which may get in the way during the operative procedure.
To which client would the nurse question administering the osmotic diuretic mannitol (Osmitrol)?
- A. The client with 4+ pitting pedal edema.
- B. The client with decorticate posturing.
- C. The client with widening pulse pressure.
- D. The client with a positive doll's eye test.
Correct Answer: C
Rationale: Widening pulse pressure suggests increased intracranial pressure, a contraindication for mannitol due to potential brain herniation. Edema or neurological signs are indications.
The nurse is administering diltiazem (Cardizem) to a client. Prior to administration, it is important for the nurse to assess which parameter?
- A. Temperature
- B. Blood pressure
- C. Vision
- D. Bowel sounds
Correct Answer: B
Rationale: Blood pressure. Diltiazem (Cardizem) is a calcium channel blocker that causes systemic vasodilation resulting in decreased blood pressure.
The elderly client is admitted to the emergency department from a long-term care facility. The client has multiple ecchymotic areas on the body. The client is receiving digoxin, a cardiac glycoside; Lasix, a loop diuretic; Coumadin, an anticoagulant; and Xanax, an antianxiety medication. Which order should the nurse request from the health-care provider?
- A. A STAT serum potassium level.
- B. An order to admit to the hospital for observation.
- C. An order to administer Valium intravenous push.
- D. A STAT international normalized ratio (INR).
Correct Answer: D
Rationale: Ecchymosis with Coumadin suggests bleeding risk; STAT INR assesses anticoagulation status, guiding reversal if needed. Potassium, admission, or Valium are less urgent.