Nokea
Which of the following findings should indicate to the nurse that a client with myasthenia gravis taking neostigmine is experiencing an adverse effect?
- A. Tachycardia
- B. Oliguria
- C. Xerostomia
- D. Miosis
Correct Answer: D
Rationale: The correct answer is D: Miosis. Neostigmine is a cholinesterase inhibitor used to treat myasthenia gravis. Miosis, or excessive constriction of the pupil, is a sign of cholinergic crisis which can occur due to neostigmine overdose. This adverse effect indicates excessive stimulation of the parasympathetic nervous system, leading to symptoms such as increased salivation, bronchoconstriction, and miosis. Tachycardia (A) is not typically associated with neostigmine use, oliguria (B) is not a common adverse effect, and xerostomia (C) is the opposite of the expected effect of increased salivation due to cholinergic stimulation.
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Which of the following findings should the nurse report to the provider as an adverse effect of gentamicin?
- A. Constipation
- B. Tinnitus
- C. Hypoglycemia
- D. Joint pain
Correct Answer: B
Rationale: The correct answer is B: Tinnitus. Gentamicin is an aminoglycoside antibiotic known to cause ototoxicity, including tinnitus. Tinnitus is characterized by ringing or buzzing in the ears and can be an early sign of auditory nerve damage. This adverse effect should be reported to the provider promptly to prevent further hearing loss.
A: Constipation is not a typical adverse effect of gentamicin.
C: Hypoglycemia is not a known adverse effect of gentamicin.
D: Joint pain is not commonly associated with gentamicin use.
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.
How many mL/h should the nurse set the IV infusion pump to deliver half the total volume of lactated Ringer's (4,080 mL) in the first 8 hours?
- A. 200 mL/h
- B. 225 mL/h
- C. 250 mL/h
- D. 255 mL/h
- E. 275 mL/h
Correct Answer: D
Rationale: The correct answer is D: 255 mL/h. To deliver half of 4,080 mL in 8 hours, you need to administer 2,040 mL in 8 hours. To calculate the infusion rate, divide the total volume by the total time: 2,040 mL ÷ 8 hours = 255 mL/h. This rate ensures half of the total volume is infused within the specified time frame.
Choice A (200 mL/h) is too slow, as it would not deliver half the volume in 8 hours. Choices B, C, and E exceed the required rate and would deliver more than half the volume in 8 hours.
How many mg should the nurse administer per dose to a child weighing 44 lbs if the prescribed dose is 15 mg/kg every 12 hours?
- A. 150 mg
- B. 200 mg
- C. 300 mg
- D. 350 mg
- E. 400 mg
Correct Answer: C
Rationale: To calculate the correct dose, we first convert the child's weight from pounds to kilograms (44 lbs ÷ 2.2 = 20 kg). Then, we multiply the weight by the prescribed dose (20 kg x 15 mg/kg = 300 mg). Therefore, the nurse should administer 300 mg per dose. Choice A is too low, choices B and D are higher than the correct answer, and choice E is significantly higher, exceeding the calculated dose.
Which of the following medications should the nurse anticipate administering to a client who has taken a large amount of diazepam?
- A. Ondansetron
- B. Magnesium Sulphate
- C. Flumazenil
- D. Protamine Sulphate
Correct Answer: C
Rationale: The correct answer is C: Flumazenil. Flumazenil is a benzodiazepine receptor antagonist used to reverse the effects of benzodiazepine overdose, such as diazepam. It competes with benzodiazepines at the receptor site, reversing their sedative and hypnotic effects. Ondansetron (A) is an antiemetic, Magnesium Sulphate (B) is used for various conditions like pre-eclampsia, Protamine Sulphate (D) is used to reverse heparin anticoagulation. Flumazenil is the most appropriate choice for reversing the effects of diazepam overdose.