Nokea
The HCP prescribes risperidone to manage the hallucinations of the client diagnosed with paranoid schizophrenia. Which client statements reflect a need for further education regarding the medication's side effects? Select all that apply.
- A. Diarrhea may be a problem for me.
- B. I'll most likely develop high blood pressure.
- C. Being too nervous is a side effect of my medicine.
- D. I will need to watch what I eat so I won't gain weight.
- E. Getting up too quickly when I'm sitting can make me dizzy.
- F. I will need to be careful driving because this can make me drowsy.
Correct Answer: A,B
Rationale: Constipation, not diarrhea, and hypotension, not hypertension, are side effects of risperidone, indicating a need for further education.
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Two hours after administering iron dextran, the nurse is drawing the client's blood sample for a laboratory test. Which intervention should the nurse implement when noting that the client's blood has a brownish hue?
- A. Document the serum color.
- B. Draw blood from another site.
- C. Immediately notify the HCP.
- D. Discard the sample of blood.
Correct Answer: A
Rationale: A: The nurse should document the finding of the blood's brownish hue; iron dextran (Dexferrum) may impart a brownish hue to blood drawn within four hours after administration. B: Drawing blood from another site is unnecessary because iron dextran imparts the brown-colored serum, and the color will be unchanged even if blood is drawn at another site. C: Notifying the HCP is unnecessary because the brown-colored serum is a normal finding after iron dextran administration. D: The blood sample should not be discarded because the brown-colored serum is a normal finding after iron dextran administration and will not affect laboratory analysis.
The nurse is teaching the client newly started on propranolol for acute situational anxiety disorder. In addition to treating the client's anxiety, the nurse should inform the client that propranolol's use is effective in treating which associated problem?
- A. Bradycardia
- B. Hand tremors
- C. Muscle spasms
- D. Hypertensive crisis
Correct Answer: B
Rationale: Propranolol (Inderal), a beta blocker, has been shown to be effective in ameliorating the somatic symptoms of anxiety such as hand tremor.
The HCP prescribed a dose of acetaminophen according to weight recommendations for the child weighing 48 lb. The package insert states that the recommended dose is 15 mg per kg. What dose should the nurse administer?
Correct Answer: 327
Rationale: First change 48 lb into kilograms (48 / 2.2 = 21.8 kg). Next determine the dose (21.8 kg x 15 = 327 mg). The child should receive 327 mg of acetaminophen (Tylenol).
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.
An LPN is tasked with checking the narcotic count on a medical surgical unit. Which statement by the LPN requires further investigation?
- A. I need a witness when I waste the leftover narcotics in the client's PCA pump.
- B. I am going to check the facility's policy for how to dispose of this controlled substance.
- C. I left the narcotics box unlocked after confirming the beginning of shift count was correct.
- D. The end of shift narcotics count is incorrect and needs to be reported.
Correct Answer: C
Rationale: Narcotics should be locked and kept in a secure place during the shift.