Which of the following interventions should the nurse include in the plan of care for a client who has hypertension and is to start taking metoprolol?
- A. Weigh the client weekly
- B. Determine apical pulse prior to administering
- C. Administer the medication 30 minutes before breakfast
- D. Monitor the client for jaundice
Correct Answer: B
Rationale: The correct answer is B: Determine apical pulse prior to administering. Metoprolol is a beta-blocker that can lower heart rate. By assessing the apical pulse before administering, the nurse can ensure the heart rate is within the safe range for medication administration. Weighing the client weekly (A) is not directly related to metoprolol therapy. Administering the medication 30 minutes before breakfast (C) is not specific timing for metoprolol. Monitoring for jaundice (D) is not a common side effect of metoprolol.
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Which of the following medications should the nurse plan to administer to a client who has heroin toxicity, is unresponsive, has pinpoint pupils, and a respiratory rate of 8/min?
- A. Methadone
- B. Naloxone
- C. Diazepam
- D. Bupropion
Correct Answer: B
Rationale: The correct answer is B: Naloxone. Naloxone is an opioid antagonist that reverses the effects of opioids like heroin. In this scenario, the client's symptoms of unresponsiveness, pinpoint pupils, and respiratory depression indicate opioid toxicity. Naloxone will competitively bind to opioid receptors, reversing respiratory depression and potentially restoring consciousness. Methadone (A) is used for opioid dependence but not acute toxicity. Diazepam (C) is a benzodiazepine and not indicated for opioid toxicity. Bupropion (D) is an antidepressant and not appropriate for this situation.
A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. Which of the following actions should the nurse take first?
- A. Obtain the client's blood pressure
- B. Contact the client's provider
- C. Inform the charge nurse
- D. Complete an incident report
Correct Answer: A
Rationale: The correct answer is A: Obtain the client's blood pressure. The nurse's first priority is to assess the client's current condition and potential adverse effects of atenolol. Atenolol is a beta-blocker that can lower blood pressure and heart rate. Obtaining the client's blood pressure will help determine if any immediate interventions are needed. Contacting the provider (B) can be done after assessing the client's condition. Informing the charge nurse (C) is important but not the first priority. Completing an incident report (D) is necessary but should follow immediate client assessment. Other choices are not relevant to the immediate safety and well-being of the client.
Which of the following medication prescriptions should the nurse identify as being complete?
- A. Tetracycline 200 mg PO
- B. Epoetin alfa 150 units/kg three times weekly
- C. Digoxin 0.25 mg PO daily
- D. Cimetidine PO twice daily
Correct Answer: C
Rationale: The correct answer is C, Digoxin 0.25 mg PO daily. This prescription is complete because it includes the name of the medication (Digoxin), the dosage (0.25 mg), the route (PO), and the frequency (daily). The dosage is specified, and clear instructions are given for administration.
Choice A is incomplete as it lacks frequency information. Choice B is incomplete as it lacks the frequency and route of administration. Choice D is incomplete as it lacks the medication name and dosage information. Choices E, F, and G are not provided.
Which of the following actions of sucralfate should the nurse include in the teaching for a client who is to start a new prescription for sucralfate for peptic ulcer disease?
- A. Decreases stomach acid secretion
- B. Neutralizes acids in the stomach
- C. Forms a protective barrier over ulcers
- D. Treats ulcers by eradicating H. pylori
Correct Answer: C
Rationale: The correct answer is C: Forms a protective barrier over ulcers. Sucralfate works by forming a protective barrier over ulcers in the stomach and small intestine, providing a physical barrier to prevent further damage from stomach acid. This action helps promote healing of the ulcers. Choices A, B, and D are incorrect because sucralfate does not decrease stomach acid secretion, neutralize acids in the stomach, or treat ulcers by eradicating H. pylori bacteria. It is important for the nurse to educate the client on the mechanism of action of sucralfate to ensure understanding and adherence to the treatment plan.
Which of the following findings should the nurse document as a manifestation of pseudoparkinsonism in a client taking haloperidol?
- A. Serpentine limb movement
- B. Shuffling gait
- C. Nonreactive pupils
- D. Smacking lips
Correct Answer: B
Rationale: The correct answer is B: Shuffling gait. Pseudoparkinsonism is a side effect of antipsychotic medications like haloperidol, characterized by symptoms resembling Parkinson's disease. A shuffling gait, where the client takes small steps with feet barely leaving the floor, is a classic manifestation. Serpentine limb movement (A) is not typically associated with pseudoparkinsonism. Nonreactive pupils (C) can be a sign of anticholinergic toxicity, not pseudoparkinsonism. Smacking lips (D) is more indicative of tardive dyskinesia, another side effect of antipsychotics.