Nokea
The nurse is preparing to administer 37.5 mg of meperidine (Demerol) IM to a client who is having pain. The medication comes in a 50-mg/mL vial. Which action should the nurse implement?
- A. Notify the pharmacist to bring the correct vial.
- B. Have another nurse verify wastage of medication.
- C. Administer one (1) mL of medication to the client.
- D. Request the HCP to increase the client's dose.
Correct Answer: B
Rationale: Dose: 37.5 mg / 50 mg/mL = 0.75 mL. Wasting 0.25 mL requires verification by another nurse, per narcotic protocols.
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A client confides in the RN that a friend has told her the medication she takes for depression, Wellbutrin, was taken off the market because it caused seizures. What is an appropriate response by the nurse?
- A. Ask your friend about the source of this information.'
- B. Omit the next doses until you talk with the doctor.'
- C. There were problems, but the recommended dose is changed.'
- D. Your health care provider knows the best drug for your condition.'
Correct Answer: C
Rationale: Wellbutrin was introduced in the U.S. in 1985 and then withdrawn because of the occurrence of seizures in some patients taking the drug. The drug was reintroduced in 1989 with specific recommendations regarding dose ranges to limit the occurrence of seizures. The risk of seizure appears to be strongly associated with dose.
A post-operative client has a prescription for acetaminophen with codeine. What should the nurse recognize as a primary effect of this combination?
- A. Enhanced pain relief
- B. Minimized side effects
- C. Prevention of drug tolerance
- D. Increased onset of action
Correct Answer: A
Rationale: Enhanced pain relief. Combination of analgesics with different mechanisms of action can afford greater pain relief.
The client has the following arterial blood gases: pH 7.19, Paco2 33, Pao2 95, and HCO3 19. Which medication would the nurse prepare to administer based on the results?
- A. Intravenous sodium bicarbonate.
- B. Oxygen via nasal cannula.
- C. Epinephrine intravenous push.
- D. Magnesium hydroxide orally.
Correct Answer: A
Rationale: Metabolic acidosis (low pH, low HCO3) requires sodium bicarbonate to correct pH. Oxygen, epinephrine, or antacids are inappropriate.
The clinic nurse is teaching an adult male who has AIDS. He is receiving zidovudine. Which statement he makes indicates that he understands the medication regimen?
- A. If I get a sore throat and it is hard to swallow my capsules, I can empty the capsule into applesauce.
- B. I am hopeful that this drug will get rid of this awful disease.
- C. I understand I might need a transfusion.
- D. I should take acetaminophen (Tylenol), not aspirin, if I get a fever.
Correct Answer: D
Rationale: Zidovudine can cause bone marrow suppression; acetaminophen is safer than aspirin, which increases bleeding risk.
The male client is self-medicating with the H-2 antagonist cimetidine (Tagamet). Which complication can occur while taking this medication?
- A. Melena.
- B. Gynecomastia.
- C. Pyrosis.
- D. Eructation.
Correct Answer: B
Rationale: Cimetidine can cause gynecomastia due to antiandrogen effects, especially in males. Melena, pyrosis, or eructation are unrelated.