Nokea
The client with schizophrenia has a history of nonadherence to the prescribed medication regimen. Injectable antipsychotic agents are being considered for long-term use. Which medications, if prescribed by the HCP, should the nurse question? Select all that apply.
- A. Olanzapine
- B. Ziprasidone
- C. Aripiprazole
- D. Risperidone Consta
- E. Fluphenazine decanoate
Correct Answer: A,B,C
Rationale: Olanzapine and ziprasidone injections are for short-term use, and aripiprazole is not available in injectable form.
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Which of the following actions should the LPN perform for a client with an active digoxin IV order? Select all that apply. A. Monitor ECG rhythm throughout administration., B. Administer the medication over at least 5 minutes., C. Monitor respirations during administration., D. Monitor the client's pulse for 1 minute prior to administration., E. Assess the client's blood pressure.
- A. A, D
- B. A, B, D
- C. B, C
- D. A, D, E
Correct Answer: A
Rationale: The LPN should monitor the client's heart rate and ECG with digoxin administration. Digoxin should not be given if a client's pulse is less than 60 bpm. Measuring blood pressure and respiratory rate are not indicated with digoxin administration. Administering an IV medication is outside of the LPN's scope of practice.
New medications are prescribed for the client taking lithium. Which medication, if prescribed, should the nurse question with the HCP?
- A. Isosorbide dinitrate by mouth tid
- B. Prednisone 20 mg by mouth daily
- C. Furosemide 80 mg by mouth daily
- D. Insulin aspart 2 units subcut with meals
Correct Answer: C
Rationale: Furosemide (Lasix) is a loop diuretic that promotes sodium loss and lithium retention, increasing serum lithium levels and risk of toxicity.
In planning care for this client, the nurse should anticipate which of the following side effects to contribute to a sense of altered body image?
- A. cushingoid appearance
- B. alopecia
- C. temporary or permanent sterility
- D. pathologic fractures
Correct Answer: D
Rationale: Pathologic fractures are not common to the disease process. Its treatment through osteoporosis is a potential complication of steroid use. Hodgkin's disease most commonly affects young adults (males), is spread through lymphatic channels to contiguous nodes, and also might spread via the hematogenous route to extradal sites (GI, bone marrow, skin, and other organs). A working staging classification is performed for clinical use and care.
Which of these medications has the least risk of causing tinnitus?
- A. Aspirin
- B. Lasix
- C. Gentamicin
- D. Fluoxetine
Correct Answer: D
Rationale: Gentamicin, Lasix, and Aspirin are all ototoxic drugs that have a potential side effect of causing tinnitus, a ringing in the ear. Fluoxetine, an SSRI, is not typically associated with tinnitus.
The client taking lithium for bipolar disorder participated in a recreational game of basketball in the mental health unit gym. The client is now feeling nauseated and shaky, has blurred vision, and is finding it hard to stand. Considering this information, which action should be taken by the nurse?
- A. Instruct the client to sit and rest for a while in a cool place.
- B. Call the HCP to request an order for a STAT serum lithium level.
- C. Give the prn prescribed antiemetic with a large glass of cold water.
- D. Alert the emergency team for the client's impending cardiac arrest.
Correct Answer: B
Rationale: The client is showing signs of lithium (Lithane) toxicity, especially apparent after high levels of physical activity. The HCP should be notified for a STAT lithium level and corrective action.