Nokea
The client experiencing an acute attack of gouty arthritis is prescribed colchicine 1 mg IV now and then 0.5 mg q6h. Colchicine 0.5 mg/mL in a 2-mL ampule is available. How many milliliters should the nurse administer for the initial dose?
Correct Answer: 2
Rationale: Use a proportion formula; multiply the extremes (outside values) and then the means (inside values), and solve for X. 0.5 mg: 1 mL :: 1 mg: X mL; 0.5X = 1; 1 / 0.5 = 2; X = 2 mL. Colchicine (Colcrys) interferes with the function of WBCs in initiating and perpetuating the inflammatory response to monosodium urate crystals.
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The LPN is admitting a client to the unit and the client has rapidly blinking eyes, stuck out tongue, and a distorted posture. Which of these medications is the patient most likely taking?
- A. Clozapine
- B. Fluoxetine
- C. Ondansetron
- D. Haloperidol
Correct Answer: D
Rationale: Haloperidol is a first-generation antipsychotic that blocks dopamine receptors and is most likely to cause extrapyramidal symptoms (EPS), such as tardive dyskinesia. Symptoms of tardive dyskinesia include rapid blinking, mouth movements, sticking out of the tongue, rapid body movements, and a distorted posture.
The Native American client is being assessed for emotional distress following a family crisis. In anticipating pharmacological treatment, the nurse understands that the Native American client would most likely do what?
- A. Use herbal remedies and other plant therapies with healing properties
- B. Attempt to manage emotional problems on his or her own to avoid shame
- C. Rely heavily on family for support during treatment for emotional distress
- D. Want a well-established relationship with an HCP before accepting treatment
Correct Answer: A
Rationale: Native American cultures often use herbal or plant remedies with healing properties.
Six months after starting disulfiram for treatment of alcoholism, the client has serum laboratory tests completed (see exhibit). Place an X on each serum laboratory result that the nurse should report immediately to the HCP.
- A. Potassium
- B. Albumin
- C. AST
- D. ALT
- E. Total bilirubin
- F. Alkanine Phosphatase
- G. RBCs
Correct Answer: B,C,DE,F
Rationale: Abnormal liver function tests (low albumin, elevated AST, ALT, total bilirubin, ALP) should be reported due to disulfiram's potential liver effects. [Image-based question; X on abnormal LFTs.]
The client undergoing detoxification from chronic alcohol abuse is to receive Phenobarbital 120 mg IM and promethazine 50 mg IM. Which explanation by the nurse about using this medication combination is correct?
- A. Promethazine will prevent a potential allergic reaction to the phenobarbital.
- B. Combining promethazine and phenobarbital will have a greater sedative effect.
- C. Promethazine will decrease the nausea from phenobarbital when it is given IM.
- D. Combining these reduces the sedative effects and prevents a ‘hangover' feeling.
Correct Answer: B
Rationale: Promethazine (Phenergan) potentiates the CNS depression of phenobarbital, producing a greater sedative effect.
The client with CP is taking dantrolene. The nurse evaluates that the medication is effective when noting that the client has an increase in which findings? Select all that apply.
- A. Muscle spasticity
- B. Urinary frequency
- C. Level of mobility
- D. Ability to maintain balance
- E. Level of alertness
Correct Answer: C,D
Rationale: A: Increased muscle spasticity indicates the medication is not effective. B: Common adverse effects include urinary frequency. C: Dantrolene acts directly on skeletal muscles to inhibit muscle contraction, improving mobility. D: Dantrolene acts directly on skeletal muscles to inhibit muscle contraction, improving the ability to maintain balance. E: Dantrolene does not increase alertness.