Nokea
The hospitalized adult is having difficulty falling and staying asleep. The nurse consults standing orders, which have medications included in the table illustrated. Which hypnotic medication should the nurse administer to effectively help the client sleep soundly throughout the night?
- A. Zaleplon
- B. Triazolam
- C. Flurazepam
- D. Eszopiclone
Correct Answer: B
Rationale: Triazolam (Halcion) has a later peak and longer duration, helping the client fall and stay asleep longer.
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The nurse receives the HCP order to start TPN for the client who has a PICC. Into which type of catheter illustrated should the nurse plan to administer the TPN?
- A. TPN_1.PNG
- B. TPN_2.PNG
- C. TPN_3.PNG
- D. TPN_4.PNG
Correct Answer: B
Rationale: A: Illustration A is a central line that is percutaneously inserted into the jugular or subclavian vein and terminates in the central circulation. These are intended for short-term venous access. B: Illustration B is a PICC, which is inserted into the arm and terminates in the central circulation. A PICC is used when medications or solutions are too caustic to be peripherally administered or when therapy lasts more than 2 weeks. C: Illustration C is a tunneled catheter inserted into the upper chest wall and threaded through the cephalic vein; it terminates in the central circulation. D: Illustration D is an intra-aortic balloon pump catheter that is inserted into the femoral artery and positioned in the descending aortic arch. The balloon on the end inflates during diastole. It is not used for medication or fluid administration.
A dose of albuterol 5 mg by nebulization is prescribed for the pediatric client experiencing wheezing from an asthma episode. The medication vial contains 2.5 mg per 3 mL. How many milliliters of medication should the nurse prepare for administration by nebulization?
Correct Answer: 6
Rationale: Use a proportion formula: 2.5 mg : 3 mL :: 5 mg : X mL; multiply the outside values and then the inside values and solve for X; 2.5X = 15; X = 6 mL.
The client has been successful at controlling gastroesophageal reflux symptoms without prescription medications. Which OTC medication should the nurse explore whether the client is taking for symptom control?
- A. Aspirin once a day
- B. Famotidine
- C. Ibuprofen
- D. Desloratadine
Correct Answer: B
Rationale: A: Aspirin increases gastric acid secretion and may worsen symptoms. B: The nurse should explore whether the client is taking famotidine (Pepcid) for symptom control. Famotidine blocks histamine-2 receptors on parietal cells, thus decreasing gastric acid production. C: NSAIDs, such as ibuprofen (Motrin), do not reduce gastric acid. D: Desloratadine (Clarinex) blocks only histamine-1 receptors and is not effective against histamine-2 receptors.
The client taking glyburide 5 mg orally once daily presents in the ED with headache, flushing, nausea, and abdominal cramps. The client's fingerstick blood sugar result is 56 mg/dL. Which question is most important for the nurse to ask the client?
- A. How many grams of protein do you normally eat?
- B. What time did you eat your dinner last night?
- C. How often do you check your blood sugar level?
- D. What was your alcohol intake like this past week?
Correct Answer: D
Rationale: A: Carbohydrate intake, not protein, is more important to consider in diabetic clients in relation to blood sugar levels. B: Glyburide once daily dose is taken with breakfast, so asking the client about dinner is not consistent with drug administration. C: Asking the client frequency of checking blood sugar levels will not help determine the possible causes of the client's symptoms. D: Alcohol use while taking sulfonylureas such as glyburide (DiaBeta, Micronase) can cause a disulfiram-like reaction, manifested by abdominal cramps, nausea, headache, flushing, and hypoglycemia.
An allergic reaction is classified as what type of pharmacological effect?
- A. a therapeutic effect
- B. a side effect
- C. an adverse effect
- D. an incompatibility
Correct Answer: C
Rationale: An allergic reaction is considered an adverse effect, as it is unintended and requires treatment. A side effect is also undesired but is somewhat expected, and a side effect does not require intervention.