Nokea
The client has the following arterial blood gases: pH 7.19, Paco2 33, Pao2 95, and HCO3 19. Which medication would the nurse prepare to administer based on the results?
- A. Intravenous sodium bicarbonate.
- B. Oxygen via nasal cannula.
- C. Epinephrine intravenous push.
- D. Magnesium hydroxide orally.
Correct Answer: A
Rationale: Metabolic acidosis (low pH, low HCO3) requires sodium bicarbonate to correct pH. Oxygen, epinephrine, or antacids are inappropriate.
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A post-operative client has a prescription for acetaminophen with codeine. What should the nurse recognize as a primary effect of this combination?
- A. Enhanced pain relief
- B. Minimized side effects
- C. Prevention of drug tolerance
- D. Increased onset of action
Correct Answer: A
Rationale: Enhanced pain relief. Combination of analgesics with different mechanisms of action can afford greater pain relief.
The client diagnosed with essential hypertension calls the clinic and tells the nurse she needs something for the flu. Which information should the nurse tell the client?
- A. OTC medications for the flu should not be taken because of your hypertension.
- B. If OTC medications do not relieve symptoms within three (3) days, contact the HCP.
- C. Tell the client to ask the pharmacist to recommend an OTC medication for the flu.
- D. Make an appointment for the client to receive the influenza vaccine.
Correct Answer: B
Rationale: OTC flu medications (e.g., decongestants) may raise BP but can be used cautiously; persistent symptoms warrant HCP contact. Total avoidance, pharmacist reliance, or vaccines are less appropriate.
A client confides in the RN that a friend has told her the medication she takes for depression, Wellbutrin, was taken off the market because it caused seizures. What is an appropriate response by the nurse?
- A. Ask your friend about the source of this information.'
- B. Omit the next doses until you talk with the doctor.'
- C. There were problems, but the recommended dose is changed.'
- D. Your health care provider knows the best drug for your condition.'
Correct Answer: C
Rationale: Wellbutrin was introduced in the U.S. in 1985 and then withdrawn because of the occurrence of seizures in some patients taking the drug. The drug was reintroduced in 1989 with specific recommendations regarding dose ranges to limit the occurrence of seizures. The risk of seizure appears to be strongly associated with dose.
The male client is self-medicating with the H-2 antagonist cimetidine (Tagamet). Which complication can occur while taking this medication?
- A. Melena.
- B. Gynecomastia.
- C. Pyrosis.
- D. Eructation.
Correct Answer: B
Rationale: Cimetidine can cause gynecomastia due to antiandrogen effects, especially in males. Melena, pyrosis, or eructation are unrelated.
The health care provider has written 'Morphine sulfate 2 mgs IV every 3-4 hours prn for pain' on the chart of a child weighing 22 lb. (10 kg). What is the nurse's initial action?
- A. Check with the pharmacist
- B. Hold the medication and contact the provider
- C. Administer the prescribed dose as ordered
- D. Give the dose every 6-8 hours
Correct Answer: B
Rationale: Hold the medication and contact the provider. The usual pediatric dose of morphine is 0.1 mg/kg every 3 to 4 hours. At 10 kg, this child typically should receive 1.0 mg every 3 to 4 hours.