The LPN is about to give 100 mg Lopressor (metoprolol) to a client. Before administering the drug, he takes the patient's vitals, which are as follows: Pulse: 58, Blood Pressure: 90/62, Respirations: 18/minute. What action should the LPN take?
- A. Give the client half the prescribed dose and report the findings to the RN on duty.
- B. Give the client double the dose and report the findings to the RN on duty.
- C. Administer the drug and report the findings to the RN on duty.
- D. Hold the drug and report the findings to the RN on duty.
Correct Answer: D
Rationale: Lopressor is given to treat hypertension, and a pulse of 58 and a blood pressure of 90/62 are considered low. To prevent the client from bottoming out, the drug should be held and the findings reported to the RN, who should consult with the attending physician. LPNs should never adjust client dosing, as that is outside of their scope of practice.
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The client is taking methylphenidate sustained-release tablets once daily for attention deficit disorder. The medication peaks in 4 to 7 hours and has a duration of 12 hours. At which time should the nurse instruct the client to take the prescribed dose of methylphenidate?
- A. At bedtime
- B. With the midday meal
- C. Six hours before bedtime
- D. Upon waking in the morning
Correct Answer: D
Rationale: Sustained-release methylphenidate (Ritalin) should be taken in the morning to avoid sleep interference.
The client has been prescribed clonidine for the unlabeled purpose of easing the discomfort associated with smoking cessation. Which body system should be the nurse's initial focus when completing the client's physical assessment?
- A. Neurological
- B. Cardiovascular
- C. Gastrointestinal
- D. Musculoskeletal
Correct Answer: B
Rationale: Clonidine (Catapres) can cause hypotension and bradycardia, making the cardiovascular system the initial focus.
The client is to receive a first dose of oral sulfamethoxazole 1 g every 12 hours for treatment of recurrent UTIs. Which information about the client should prompt the nurse to question the medication order?
- A. History of gastric ulcer
- B. Type 1 diabetes mellitus
- C. Urine positive for Escherichia coli
- D. Near-term pregnancy
Correct Answer: D
Rationale: A: History of gastric ulcer is not a contraindication for the use of sulfamethoxazole. B: Type 1 diabetes does not prevent the use of sulfamethoxazole. C: A positive urine culture would be an indication for using sulfamethoxazole. D: Sulfamethoxazole (Bactrim, Septra), a sulfonamide antibiotic, is a category D medication for near-term pregnancy. This means there is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., for a life-threatening illness or a serious disease for which safer medications cannot be used or are ineffective).
The nurse should teach a client in the Emergency Department, who has suffered an ankle sprain, to:
- A. Use cold applications to the sprain during the first 24-48 hours
- B. Expect disability to decrease within the first 24 hours of injury
- C. Expect pain to decrease within 3 hours after injury
- D. Begin progressive passive and active range of motion exercises immediately
Correct Answer: A
Rationale: Cold applications reduce edema and vasoconstriction in the first 24-48 hours of an ankle sprain. Pain and disability may increase initially, and exercises begin later per physician guidance.
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.
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