pvn 106 exam 2 Ch 12,, 19 & 44

A client is diagnosed with myasthenia gravis, and the anticholinesterase medication pyridostigmine (Mestinon) is prescribed. When teaching the client about this medication, the nurse explains that the desired effect is to increase: 1.)Intestinal peristalsis 2.)Salivary and gastric secretions 3.)Contraction of skeletal muscles 4.)Secretion and discharge of tears

3.)Contraction of skeletal muscles

A client who has been taking ibuprofen (Advil) for rheumatoid arthritis asks the nurse if acetaminophen (Tylenol) can be substituted instead. An appropriate nursing response is: 1.)"Acetaminophen is the preferred treatment for rheumatoid arthritis." 2.)"Acetaminophen irritates the stomach more than ibuprofen does." 3.)"Ibuprofen is an anti-inflammatory and acetaminophen is not." 4.)"Both are antipyretics and have the same effect."

3.)"Ibuprofen is an anti-inflammatory and acetaminophen is not."

A client has received instructions to take 650 mg aspirin (ASA) every 6 hours as needed for arthritic pain. What should the nurse include in the client's medication teaching? (Select all that apply.) 1.)Take the aspirin with meals or a snack. 2.)Make an appointment with a dentist if bleeding gums develop. 3.)Do not chew enteric-coated tablets. 4.) Switch to Tylenol (acetaminophen) if tinnitus occurs. 5.) Report persistent abdominal pain.

1 .)Take the aspirin with meals or a snack. 3.)Do not chew enteric-coated tablets. 5.)Report persistent abdominal pain.

A client is receiving morphine sulfate (MS Contin) for severe metastatic bone pain. To prevent complications from a common, serious side effect of morphine, the nurse should: 1.)Monitor for diarrhea 2.)Observe for an opioid addiction 3.)Assess for altered breathing patterns 4.)Check for a decreased urinary output

3.)Assess for altered breathing patterns

After surgery for a ruptured appendix, a 12-year-old child is receiving morphine for pain control by way of a patient-controlled analgesia (PCA) infusion. A bolus of morphine can be delivered every 6 minutes. A parent will be staying with the child during the immediate postoperative period. What statement indicates to the nurse that the instructions about the PCA pump have been understood? 1.)"I'll make sure that she pushes the PCA button every 6 minutes." 2.)"She needs to push the PCA button whenever she needs pain medication." 3.)"I'll have to wake her up on a regular basis so she can push the PCA button." 4.)"I'll press the PCA button every 6 minutes so she gets enough pain medication while she's sleeping."

2.)"She needs to push the PCA button whenever she needs pain medication."

A nurse is caring for a client who reports urinary problems, and the health care provider prescribes a cholinergic medication. Which response is prevented that helps the nurse determine that the medication is effective? 1.)Bladder spasticity 2.)Bladder flaccidity 3.)Urinary tract calculi 4.)Urinary tract infections

2.)Bladder flaccidity

A client with arthritis is taking ibuprofen (Motrin), a nonsteroidal anti-inflammatory drug, and large doses of aspirin (ASA). The nurse teaches the client about the clinical manifestations of aspirin toxicity, including: 1.)Feelings of drowsiness 2.)Disturbances in hearing 3.)Intermittent constipation 4.)Metallic taste in the mouth

2.)Disturbances in hearing

Based on the client's reported pain level, the nurse administers 8 mg of the prescribed morphine. The medication is available in a 10 mg syringe. Wasting of the remaining 2 mg of morphine should be done by the nurse and a witness. It is most appropriate for the nurse to ask which member of the health care team to be the witness? 1.)Nursing supervisor 2.)Licensed practical nurse (LPN) 3.)Client's health care provider 4.)Designated nursing assistant

2.)Licensed practical nurse (LPN)

The nurse is caring for a client with arthritis. The client asks, "Can I take Tylenol instead of aspirin? Aspirin irritates my stomach." The nurse explains that acetaminophen (Tylenol): 1.)Lacks anticoagulant action 2.)Has the same action as aspirin 3.)Lacks an anti-inflammatory action 4.)Has more severe side effects than aspirin

3.)Lacks an anti-inflammatory action

Which relationship does the nurse consider reflective of the relationship of naloxone (Narcan) to morphine sulfate? 1.)Aspirin to warfarin (Coumadin) 2.)Amoxicillin (Amoxil) to systemic infection 3.)Protamine sulfate to parenteral heparin 4.)Enoxaparin (Lovenox) to dalteparin (Fragmin)

3.)Protamine sulfate to parenteral heparin

Acetylsalicylic acid (aspirin) is prescribed for a client with rheumatoid arthritis. The nurse understands that the major rationale for this treatment is: 1.)Reduction of fever 2.)Preservation of bone integrity 3.)Reduction of joint inflammation 4.)Prevention of flexion contractures

3.)Reduction of joint inflammation

A nurse is teaching an older adult client about managing chronic pain with acetaminophen (Tylenol). Which client statement indicates that the teaching is effective? 1.)"I need to limit my intake of acetaminophen to 650 mg a day." 2.)"I can take oxycodone with the acetaminophen if it is ineffective." 3.)"I should take an emetic if I accidentally overdose on the acetaminophen." 4.)"I have to be careful about which over-the-counter cold preparations I take when I have a cold."

4.)"I have to be careful about which over-the-counter cold preparations I take when I have a cold."

A nurse is caring for a 15-year-old adolescent who was admitted to the hospital after taking an acetaminophen (Tylenol) overdose. The result of which diagnostic study is most important for the nurse to monitor at this time? 1.)Blood gas level 2.)Liver function tests 3.)Complete blood count 4.)Glycosylated hemoglobin

2.)Liver function tests

A nurse is caring for an older adult who is taking acetaminophen (Tylenol) for the relief of chronic pain. Which substance is most important for the nurse to determine if the client is taking because it intensifies the most serious adverse effect of acetaminophen? 1.)Alcohol 2.)Caffeine 3.)Saw palmetto 4.)St. John's wort

1.)Alcohol

A beta-blocker, atenolol (Tenormin), is prescribed for a client with moderate hypertension. What information should the nurse include when teaching the client about this medication? (Select all that apply.) 1.)Change positions slowly 2.)Take the medication before going to bed 3.)Count the pulse before taking the medication 4.)Mild weakness and fatigue are common side effects 5.)It is safe to take concurrent over-the-counter (OTC) medications

1.)Change positions slowly 3 .)Count the pulse before taking the medication 4.)Mild weakness and fatigue are common side effects

A client is receiving oxycodone (Oxycontin) postoperatively for pain. The health care provider's prescription indicates that the dose should be administered every three hours for eight doses. What should the nurse assess before administering each dose of oxycodone? 1.)Respiratory rate and level of consciousness 2.)Color, character, and amount of urine output 3.) Intravenous site and patency of the intravenous catheter 4.)Amount and character of drainage in the portable drainage system

1.)Respiratory rate and level of consciousness

A 5-month-old infant is admitted with a diagnosis of respiratory syncytial virus (RSV) infection. The infant's condition suddenly deteriorates and a dose of epinephrine is prescribed to relieve bronchospasm. For what side effect of the medication should the nurse assess the infant? 1.)Tachycardia 2.)Hypotension 3.)Respiratory arrest 4.)Central nervous system depression

1.)Tachycardia

A client with arthritis states that the prescribed aspirin (ASA) causes stomach irritation even when taken with food. The nurse should instruct the client to take the aspirin: 1.)An hour before a meal 2.)With a full glass of water 3.)With sodium bicarbonate 4.)At the same time as the other drugs

2.)With a full glass of water

A 14-year-old girl in whom scoliosis has been diagnosed undergoes spinal fusion. On the first postoperative day her face is red, she is rigid, and she is crying because she is in pain. She has prescriptions for morphine sulfate for severe pain and an acetaminophen-codeine compound for moderate pain. What information should influence the nurse's choice of analgesic? 1.)One dose of morphine may be given, but the drug should be restricted thereafter because it is addictive. 2.)Adolescents tend to exaggerate their discomfort, particularly when they are immobilized by surgery or injury. 3.)Spinal fusion causes considerable pain during the early postoperative days, and morphine is the more effective analgesic. 4.)The acetaminophen-codeine compound is preferred because morphine can cause respiratory depression or respiratory arrest.

3.)Spinal fusion causes considerable pain during the early postoperative days, and morphine is the more effective analgesic.

A client with myasthenia gravis who is taking a cholinesterase inhibitor is admitted to the emergency department in crisis. To distinguish between myasthenic crisis and cholinergic crisis, the nurse expects the health care provider to prescribe: 1.)Atropine sulfate 2.)Protamine sulfate 3.)Naloxone (Narcan) 4.)Edrophonium chloride (Tensilon)

4.)Edrophonium chloride (Tensilon)

Pyridostigmine (Mestinon) is prescribed for a client with myasthenia gravis. The primary reason that the nurse instructs the client to take pyridostigmine about one hour before meals is to: 1.)Limit the appetite 2.)Promote absorption 3.)Prevent gastric irritation 4.)Increase chewing strength

4.)Increase chewing strength

A client is experiencing diplopia, ptosis, and mild dysphagia. Myasthenia gravis is diagnosed and an anticholinergic medication is prescribed. The nurse is planning care with the client and spouse. What instruction is the priority? 1.)Eat foods that are pureed 2.)Perform range-of-motion exercises 3.)Recommend taking a stool softener daily 4.)Take the medication according to a specific schedule

4.)Take the medication according to a specific schedule

A client who has a long leg cast for a fractured bone is to be discharged from the emergency department. When discussing pain management, the nurse should advise the client to take the prescribed as needed oxycodone and acetaminophen (Percocet): 1.)Just as a last resort 2.)Before going to sleep 3.)As the pain becomes intense 4.)When the discomfort begins

4.)When the discomfort begins