Nokea
The nurse administers risperidone to the client experiencing hallucinations. Which physiological disorder should the nurse assess for considering the risk of developing this disorder as a side effect of risperidone?
- A. Asthma
- B. Hypertension
- C. Crohn's disease
- D. Diabetes mellitus
Correct Answer: D
Rationale: Risperidone (Risperdal) increases the risk of diabetes, especially in the first few months of therapy.
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A 20-year-old obese female client is preparing to have gastric bypass surgery for weight loss. She says to the nurse, 'I need this surgery because nothing else I have done has helped me to lose weight.' Which response by the nurse is most appropriate?
- A. If you eat less, you can save some money.'
- B. Exercise is a healthier way to lose weight.'
- C. You should try the Atkins diet first.'
- D. I respect your decision to choose surgery.'
Correct Answer: D
Rationale: This statement is most appropriate, as it shows respect and empathy. The other statements are both insensitive and unprofessional.
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 nurse is initiating an IV infusion of lactated Ringer's (LR) for the client in shock. What is the purpose of LR for this client?
- A. Increase fluid volume and urinary output
- B. Draw water from the cells into the blood vessels
- C. Provide dextrose and nutrients to prevent cellular death
- D. Replace potassium and magnesium for cardiac stabilization
Correct Answer: A
Rationale: A: LR is an isotonic crystalloid solution containing multiple electrolytes in approximately the same concentration as plasma. It enters the cells from the blood, provides fluids, and increases urinary output. B: A hypertonic solution draws fluid from the cells into the vascular compartment; LR is isotonic. C: LR alone does not contain dextrose. Formulations with dextrose are available. D: Magnesium is not a component of LR.
While the nurse is completing the assessment of the child with Reye's syndrome, the parent states that multiple OTC medications were given before hospitalization to treat the child's influenza symptoms. Which medication stated by the parent is most important for the nurse to report to the HCP?
- A. Acetaminophen
- B. Bismuth subsalicylate
- C. Pseudoephedrine
- D. Diphenhydramine
Correct Answer: B
Rationale: A: Acetaminophen (Tylenol) is an aspirin-free analgesic and antipyretic. B: Although the etiology of Reye's syndrome is unknown, the condition typically occurs after a viral illness, such as influenza, and is associated with aspirin (acetylsalicylic acid) use during the illness. Bismuth subsalicylate (Pepto-Bismol) contains aspirin. C: Pseudoephedrine (Sudafed) is an allergy and/or cold remedy used for nasal drying and decongestion. This does not contain aspirin. D: Diphenhydramine (Benadryl) is an antihistamine. This does not contain aspirin.
The nurse completes teaching the client who has PD about taking benztropine. Which statements made by the client indicate that teaching is effective? Select all that apply.
- A. I plan to crush the tablets so that they are easier to swallow.
- B. I should refrain from taking over-the-counter medications.
- C. Once my symptoms improve, I can stop taking benztropine.
- D. Benztropine can cause drooling and excessive secretions.
- E. I should avoid driving until I know how benztropine affects me.
Correct Answer: A,B,E
Rationale: A: Benztropine (Cogentin) may be crushed; this statement indicates teaching is effective. B: Many OTC medications contain alcohol. Alcohol should be avoided because it is another CNS depressant, and additive drowsiness can occur. This statement indicates teaching is effective. C: Benztropine should not be abruptly discontinued; symptoms will recur, and it may precipitate parkinsonian crisis. D: Benztropine is an anticholinergic that will cause a dry mouth, not drooling and increased secretions. E: Because benztropine (Cogentin) is a CNS depressant, driving should be avoided until the effects of the medication are known. This statement indicates teaching is effective.