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The client is prescribed varenicline for smoking cessation. The nurse concludes that varenicline is being prescribed primarily for its antagonistic effect. Which statement describes this effect?
- A. Gets readily absorbed into the bloodstream for rapid effectiveness
- B. Demonstrates a high degree of attractiveness for a specific receptor
- C. Blocks receptors in the brain that produce the pleasurable effects of smoking
- D. Stimulates receptors stimulated by smoking, producing similar pleasurable effects.
Correct Answer: C
Rationale: Varenicline (Chantix) functions as an antagonist, blocking receptors to reduce the pleasurable effects of smoking.
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The nurse is providing teaching to the client receiving a thiazide diuretic. Which points should the nurse plan to include? Select all that apply.
- A. Take the radial pulse before setting up the medication.
- B. Include fruits such as melons and bananas in the diet.
- C. Report side effects such as muscle cramps, nausea, or a skin rash.
- D. Take the last dose at bedtime when fluids are at the highest level.
- E. Avoid high-fat foods; thiazide diuretics increase cholesterol levels.
Correct Answer: B,C,E
Rationale: A: It is unnecessary for the client to monitor the pulse prior to taking thiazide diuretics. B: Thiazide diuretics can cause hypokalemia, and potassium-rich foods can help maintain potassium levels. C: Muscle cramps are a sign of possible medication side effects of hypokalemia and hypocalcemia. Nausea and rash are also medication side effects. D: A diuretic taken at bedtime can cause nocturia and loss of sleep. The usual timing of the last daily dose of a diuretic is at suppertime. E: Thiazide diuretics can increase serum cholesterol, LDL, and triglyceride levels, so teaching the client to avoid high-fat foods will help maintain cholesterol levels.
The nurse is preparing to administer morphine sulfate IV to the child in severe pain. The child has an IV infusion of D5W at 50 mL/hr through a PICC. Which intervention is best when administering the medication?
- A. Disconnect the infusion, inject 3 mL of normal saline, and give the morphine sulfate undiluted.
- B. Question the prescribed medication because morphine sulfate cannot be given through a PICC line.
- C. Give the morphine sulfate undiluted into the existing IV tubing's medication port closest to the child.
- D. Dilute the morphine sulfate with 5 mL of NS and give over 5 minutes into the IV tubing port closest to the child.
Correct Answer: D
Rationale: A: Unnecessary IV disconnections increase the risk for infection. Morphine sulfate is compatible with D5W. B: Morphine sulfate can be administered into a PICC access device. C: Administering undiluted morphine sulfate to a child increases the risk of adverse effects. D: The nurse should dilute the morphine sulfate before administration to prevent too-rapid administration and adverse effects. A single dose should be given over 4 to 5 minutes.
The nurse is caring for a client who has recently started using a PCA pump for pain management. Which of the following statements indicates a need for additional education.
- A. I will continue to report my pain score during assessments.
- B. I understand that there is a maximum dose in an hour that I can receive regardless of how many times I press the button.
- C. I think this new PCA pump is going to finally get rid of my back pain.
- D. I have more control of when and how much medication I receive.
Correct Answer: C
Rationale: The nurse should assess the client for reasonable versus unreasonable expectations of pain management when using a PCA pump. The patient should not expect the pain to go away completely.
The client admitted to the ED has drowsiness, clammy skin, and slow, shallow breathing. A friend states that the client took multiple oxycodone tablets. Which medication should the nurse plan to administer to this client?
- A. Naloxone
- B. Disulfiram
- C. Flumazenil
- D. Acetylcysteine
Correct Answer: A
Rationale: Naloxone (Narcan) reverses CNS and respiratory depression due to opioid overdose.
An LPN is taking care of an elderly client who experiences the effects of Sundowner's Syndrome almost every evening. Which of these interventions implemented by the nurse would be the most helpful?
- A. Place a nightlight in the client's room.
- B. Administer the PRN sedative prescribed by the attending physician.
- C. Remind the client the things and people they are seeing are not real and that they are safe.
- D. Turn on the TV or radio to a station the client enjoys.
Correct Answer: A
Rationale: A nightlight will help reorient the client to his or her surroundings in the evening and nighttime hours. It is best not to challenge the reality of a client experiencing Sundowner's Syndrome, and sedatives may make the effects of the syndrome worse. Every effort should be made to keep the client's room calm, quiet, and peaceful, so noise should be kept to a minimum.