Nokea
The nurse is performing a medication reconciliation for a client taking prescribed phenytoin. Which medication should the nurse question with the physician while the client is taking phenytoin?
- A. Thiamine
- B. Prazosin
- C. Warfarin
- D. Acyclovir
Correct Answer: C
Rationale: Phenytoin induces liver enzymes, which can decrease warfarin's effectiveness, increasing the risk of clotting. Thiamine, prazosin, and acyclovir have no significant interactions with phenytoin.
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The primary healthcare provider (PHCP) is preparing to intubate a client. The PHCP prescribes succinylcholine. The nurse understands that this medication is intended to
- A. Sedate the client during the procedure
- B. Decrease oral and airway secretions
- C. Increase heart rate in case of a vagal response
- D. Cause skeletal muscle paralysis
Correct Answer: D
Rationale: Succinylcholine is a depolarizing neuromuscular blocker used to cause skeletal muscle paralysis, facilitating intubation. It does not sedate, reduce secretions, or increase heart rate.
Select the three (3) prescriptions/orders the nurse should anticipate for this client
- A. Computed tomography scan of the brain
- B. Capillary blood glucose
- C. Lumbar puncture
- D. Arterial blood gas (ABG)
- E. Heparin by continuous IV infusion
- F. Nothing by mouth (NPO) status
- G. 500 mL of 0.9% saline
Correct Answer: A,B,F
Rationale: CT scan, CBG, and NPO status are critical for suspected stroke to assess brain injury, rule out hypoglycemia, and prepare for possible thrombolytics.
Minutes after administering an intravenous dose of 10 mg of morphine, the nurse notes that the client's blood pressure has dropped from 122/83 mmHg to 88/67 mmHg, and the client's respirations are now 8/minute. Which nursing action is the most appropriate?
- A. Prepare for intubation
- B. Prepare to administer a dopamine infusion
- C. Administer naloxone
- D. Start an intravenous infusion of normal saline
Correct Answer: C
Rationale: Naloxone reverses opioid-induced respiratory depression and hypotension, which are evident here.
The nurse is caring for a client following cervical spinal surgery. Which of the following assessments would require follow-up?
- A. Active range of motion in both arms
- B. Scant drainage on the dressing
- C. Difficulty swallowing liquids
- D. Soreness at the operative site
Correct Answer: C
Rationale: Difficulty swallowing (dysphagia) post-cervical spinal surgery could indicate complications like nerve damage or swelling, requiring immediate follow-up.
The nurse is teaching a group of students about contributing factors for delirium. The nurse is correct in identifying that delirium can be caused by:
- A. Fever
- B. Alzheimer's disease
- C. Hypoglycemia
- D. Vascular disease
- E. Infection
Correct Answer: A,C,E
Rationale: Fever, hypoglycemia, and infection are reversible causes of delirium, unlike Alzheimer's, which causes dementia.