Nokea
Which of the following medications should the nurse plan to administer to a client with myasthenia gravis who is in a cholinergic crisis?
- A. Potassium Iodide
- B. Glucagon
- C. Atropine
- D. Protamine
Correct Answer: C
Rationale: Rationale:
C: Atropine is the correct answer because it is an anticholinergic medication that can counteract the excess acetylcholine causing cholinergic crisis in myasthenia gravis.
Incorrect choices:
A: Potassium Iodide is used for thyroid conditions, not for myasthenia gravis crises.
B: Glucagon is used for hypoglycemia, not for myasthenia gravis crises.
D: Protamine is used to reverse the effects of heparin, not for myasthenia gravis crises.
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Which of the following findings is the best indication that morphine has been effective?
- A. The client's vital signs are within normal limits
- B. The client has not requested additional medication
- C. The client is sitting comfortably with eyes closed
- D. The client rates pain as 3 on a scale from 0 to 10
Correct Answer: D
Rationale: The correct answer is D because the client rating pain as 3 on a scale from 0 to 10 indicates that the morphine has effectively reduced their pain. This is a direct measure of the drug's efficacy. Choice A is not a specific indicator of pain relief. Choice B could mean the client is tolerating the pain, not necessarily that the medication is effective. Choice C is subjective and doesn't provide concrete evidence of pain relief.
Which of the following medications interacts with carbamazepine?
- A. Nicotine transdermal system
- B. Diphenhydramine
- C. Estrogen-progestin combination (Non-hormonal forms of contraception)
- D. Beclomethasone
Correct Answer: C
Rationale: The correct answer is C: Estrogen-progestin combination (Non-hormonal forms of contraception). Carbamazepine induces the metabolism of estrogen-based contraceptives, leading to decreased efficacy and potential contraceptive failure. This interaction can result in unintended pregnancies. Choices A, B, and D do not have significant interactions with carbamazepine.
How many mL/h should the nurse set the IV infusion pump to deliver half the total volume of lactated Ringer's (4,080 mL) in the first 8 hours?
- A. 200 mL/h
- B. 225 mL/h
- C. 250 mL/h
- D. 255 mL/h
- E. 275 mL/h
Correct Answer: D
Rationale: The correct answer is D: 255 mL/h. To deliver half of 4,080 mL in 8 hours, you need to administer 2,040 mL in 8 hours. To calculate the infusion rate, divide the total volume by the total time: 2,040 mL ÷ 8 hours = 255 mL/h. This rate ensures half of the total volume is infused within the specified time frame.
Choice A (200 mL/h) is too slow, as it would not deliver half the volume in 8 hours. Choices B, C, and E exceed the required rate and would deliver more than half the volume in 8 hours.
Which of the following over-the-counter medications should the nurse identify that the client should discontinue when starting lithium?
- A. Aspirin
- B. Ibuprofen
- C. Famotidine
- D. Bisacodyl
Correct Answer: B
Rationale: The correct answer is B: Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase lithium levels and lead to toxicity. NSAIDs compete with lithium for renal excretion, resulting in higher lithium levels. Aspirin (choice A) is not typically contraindicated with lithium. Famotidine (choice C) and Bisacodyl (choice D) do not have significant interactions with lithium.
A nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramidWhich of the following actions should the nurse take first?
- A. Report the incident to the charge nurse.
- B. Notify the provider.
- C. Check the client's blood glucose.
- D. Fill out an incident report.
Correct Answer: C
Rationale: The correct answer is C: Check the client's blood glucose. This is the first action the nurse should take because metformin is used to treat diabetes and can lower blood sugar levels. Checking the client's blood glucose will help assess if the client is experiencing hypoglycemia due to the medication error. Reporting the incident to the charge nurse (A) and filling out an incident report (D) are important steps, but assessing the client's immediate condition takes priority. Notifying the provider (B) can be done after ensuring the client's safety. The other options are not relevant to addressing the immediate concern of potential hypoglycemia.