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The LPN has been asked to help a client taking Risperdal with activities of daily living in the morning. Which of these tasks is most likely to be potentially impacted by this medication?
- A. eating breakfast
- B. drinking fluids
- C. getting out of bed to use the bathroom
- D. brushing teeth
Correct Answer: C
Rationale: Risperdal can cause orthostatic hypotension, so, to prevent a fall, care should be taken when changing positions.
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When caring for pediatric clients, the nurse should pay special attention to the psychosocial development stages credited to ?
- A. Robert Peck
- B. Erik Erikson
- C. Sigmund Freud
- D. Jean Piaget
Correct Answer: B
Rationale: Erik Erikson is credited with the psychosocial development theory and eight stages. The nurse should take these stages into account when caring for pediatric clients to assess their development. Jean Piaget is responsible for cognitive development. Sigmund Freud is responsible for psychosexual development. Robert Peck is responsible for aging theory.
The client diagnosed with BPD is taking Olanzapine. The nurse evaluates that Olanzapine is effective when observing a reduction in which behaviors? Select all that apply.
- A. Levels of anxiety
- B. The use of splitting
- C. Thoughts of paranoia
- D. Feelings of depression
- E. Expression of hostility
Correct Answer: A,C,E
Rationale: With BPD, reductions in anxiety, paranoia, and hostility indicate olanzapine (Zyprexa) is effective.
The nurse prepares to administer naloxone 0.4 mg IV to the client experiencing respiratory depression. Naloxone is supplied in a 1-mg/mL vial. How many milliliters should the nurse administer?
Correct Answer: 0.4
Rationale: Use a proportion formula to calculate the correct amount. Multiply the extremes and then the means and solve for X. 1 mg: 1 mL :: 0.4 mg: X mL; X = 0.4 mL. The nurse should administer 0.4 mL of naloxone (Narcan).
Which of the following is true when administering a nasal spray medication?
- A. The client should blow their nose gently before the medication is administered.
- B. The medication should be sprayed in front of the nose.
- C. The medication should be administered as the patient exhales.
- D. The client should lay flat when the medication is administered.
Correct Answer: A
Rationale: The client should blow their nose gently before the medication is administered. This is to clear the nasal passages to allow the medication to be properly administered. When administering the medication, the client should sit upright, insert the applicator into the designated nostril, and spray the medication as the patient inhales.
The nurse notes from the child's MAR illustrated that the child is to receive the first dose of a newly prescribed medication at 0800 hours. The drug reference book recommends an initial pediatric dose of lamotrigine of 0.6 mg/kg/day in two divided doses for the first 2 weeks. Which action by the nurse is most appropriate?
- A. Administer the medication as written on the MAR.
- B. Telephone the health care provider to question the dose.
- C. Ask the parent if this is the dose the child had been taking.
- D. Consult the pharmacist to verify whether the dose is correct.
Correct Answer: B
Rationale: A: Although the medication is written on the MAR, an error still exists in the dose, and the medication should not be administered. B: The nurse should notify the HCP. The child weighs 30 kg; the recommended initial daily dose of lamotrigine (Lamictal) for this child would be 18 mg (0.6 x 30 = 18 mg). If given 18 mg bid, the child would receive a daily dose of 36 mg, twice the recommended initial pediatric dose. C: The child has a new-onset seizure disorder; it is unlikely that the child was taking this medication prior to hospitalization. D: Consulting the pharmacist is unnecessary; the nurse still needs to seek clarification from the HCP.