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Answer: C. Butorphanol (Stadol) Rationale: Butorphanol is a mixed agonist - antagonist used in labor - reduces respiratory depression.

A 26-year-old primigravida client is experiencing increasing discomfort and anxiety during the active phase of labor. She requests something for pain. Which analgesic should the nurse anticipate administering? A. Morphine sulfate B. Hydromorphone (Dilaudid) C. Butorphanol (Stadol) D. Codeine sulfate

Answer: C. Naloxone (Narcan) Rationale: Naloxone - antidote

A client in the intensive care unit was given an accidental overdose of morphine. He's unconscious and has slow, shallow respirations at a rate of 8 breaths/minute. What drug should be given? A. Disulfiram (Antabuse) B. Flumazenil (Romazicon) C. Naloxone (Narcan) D. Norepinephrine (Levophed)

Answer: D. has developed a tolerance to the opioid. Rationale: Long-term use of central nervous system drugs can lead to tolerance, which means that increased doses of the drug are needed to achieve the same effect. Clients being treated with opioids for chronic pain may require higher doses of the drug for effective pain relief. Dependency usually isn't an issue in treating terminally ill cancer patients. Lack of pain relief doesn't necessarily indicate dependency. The nurse can't conclude that the client has a poor self-image or feels resentful based on the information given.

A client is hospitalized with terminal cancer. For the past 3 weeks, he has been receiving morphine, 5 mg I.V., every 4 hours, and has experienced relief from pain. He now says pain is still present, even after receiving the drug. The nurse recognizes that this client: A. has become dependent to the opioid. B. resents that the nurse is healthy and he isn't. C. is seeking attention for himself because of disease. D. has developed a tolerance to the opioid.

Answer: A. Tinnitus Rationale: Clinical manifestation - Tinnitus

A client is suspected of having salicylate poisoning, what clinical manifestation should the nurse assess the client for? A. Tinnitus B. Diarrhea C. Constipation D. Photosensitivity

Answer: D. AST. 268 U/L ALT. 150 U/L Rationale: Liver enzymes

A client tells the nurse that acetaminophen is taken daily for the relief of generalized discomfort. Which laboratory value would indicate toxicity associated with the medication? A. Platelet count of 150,000 mm3 B. Sodium level of 140 mEq/L C. Prothrombin time of 12 seconds D. AST. 268 U/L ALT. 150 U/L

Answer: C. Have regular blood pressure monitoring. Rationale: NSAIDs taken with thiazide diuretics can cause reduced antihypertensive and diuretic effects, so blood pressure must be checked regularly and the client should be alert for signs of fluid retention. Although it's important for the nurse to encourage the client to stick to the therapeutic regimen, stressing the importance of regular blood pressure checks takes priority. Using naproxen with oral anticoagulants or corticosteroids (not diuretics) may increase the risk of GI bleeding. Using naproxen with other drugs has no effect on bowel pattern, so the client need not increase dietary fiber.

A client who is taking the NSAID naproxen (Naprosyn) for his osteoarthritis recently started taking a thiazide diuretic for moderate hypertension. Which instruction is the most important for the nurse to give to this client? A. Increase dietary fiber to avoid constipation B. Reduce potassium intake. C. Have regular blood pressure monitoring. D. Watch for GI bleeding.

Answer: D. Dopamine in the central nervous system is released and increased. Rationale: Amantadine is a dopaminergic agonist - Dopamine is released and increased. It is used to treat dyskinesias in patients with PD.

A client with Parkinson Disease is started on oral amantadine (Symmetrel). Which statement accurately describes the action of this medication? A. Acetylcholine in the myoneural junction is enhanced. B. Viral organisms that cause Parkinson disease are eliminated. C. Norepinephrine release is reduced within the periphery. D. Dopamine in the central nervous system is released and increased.

Answer: B. Notify the health care provider of the need to increase the dose. Rationale: Notify the healthcare provider of the need to increase the dose (tolerance).

A client with metastatic cancer who has been receiving fentanyl (Duragesic) for several weeks reports to the nurse that the medication is not effectively controlling the pain, which intervention should the nurse initiate? A. Instruct the client about the indications of opioid dependence. B. Notify the health care provider of the need to increase the dose. C. Monitor the client for symptoms of opioid withdrawal. D. Administer naloxone (Narcan) per PRN protocol for reversal.

Answer: B. The client is asleep and has a respiratory rate of 8 breaths/minute. Rationale: Normal RR 12-20. Priority concern - RR 8/minute

A nurse administering oxycodone (OxyContin) to a client should be most concerned about which finding? A. The client complains of dizziness when standing up. B. The client is asleep and has a respiratory rate of 8 breaths/minute. C. The client experiences nausea 15 minutes after taking the medication. D. The client states he's more tired than usual and takes a nap in the afternoon.

Answer: B. monitor the patient's heart rate Rationale: Atropine - safety and monitoring - VS - pt HR

A nurse administers Atropine to a patient before induction of anesthesia for a surgical procedure. When evaluating the effect of this medication, the nurse will: A. assess for excessive bronchial secretions B. monitor the patient's heart rate C. expect a reduction in the client's anxiety D. observe for muscle paralysis

Answer: A. Contact the provider to request an order for serum drug level Rationale: If medication therapy is not effective, it is important to measure serum drug levels of the medication to determine whether therapeutic levels have been reached and to help monitor patient compliance (phenytoin level therapeutic range is 10-20 mcg/mL) Patients should be asked at the beginning of therapy to keep a seizure frequency chart to help deepen their involvement in therapy; asking for historical information is not helpful. Until it is determined that the patient is not complying, the nurse should not reinforce the need to take the medication. Until the drug level is known, increasing the dose is not indicated.

A nurse is caring for a patient who has been taking phenytoin, an antiepileptic drug for several weeks. The nurse asks the patient if the therapy is effective. The patient reports little change in seizure frequency. What will the nurse do? A. Contact the provider to request an order for serum drug level B. Ask the patient to complete a seizure frequency chart for the past few weeks C. Request an order to increase the dose of the antiepileptic drug D. Reinforce the need to take the medications as prescribed

Answer: D. Bronchoconstriction Rationale: ABC's - Bronchoconstriction is the main concern. Confusion and memory impairment are symptoms of AD. GI side effects are secondary to Airway/Breathing.

A nurse is caring for an older adult patient who has Alzheimer's disease. The patient is taking a cholinesterase inhibitor drug. Which adverse effect of donepezil concerns the nurse? A. Diarrhea B. Confusion and memory impairment C. Nausea D. Bronchoconstriction

Answer: A. With adequate drug therapy, the disease progression may be halted. Rationale: Levodopa/carbidopa is the initial drug of choice to treat motor symptoms. Amantadine is the only drug recommended to treat dyskinesias. Anticholinergics treat the EPS side effects (drooling, sweating, tremors). Drug therapy does not stop the progression of the disease.

A nurse provides teaching for a patient who is newly diagnosed with Parkinson's disease, which statement by the patient indicates further education is needed? A. With adequate drug therapy, the disease progression may be halted. B. Amantadine may be prescribed to treat dyskinesias. C. Anticholinergics are often needed to control the extrapyramidal side effects of antiparkinsonian drugs. D. A dopamine agonist (levodopa/carbidopa) is used to improve motor function.

Answer: C. Unstable angina Rationale: Greater risk of thrombotic events. Monitor for signs/ symptoms of MI, chest pain.

A nurse should question an order for celecoxib written for a client with which condition? A. Arthritis of the hand B. Painful menses C. Unstable angina D. A sprained knee

Answer: C. If medication is begun early, permanent remission can be achieved. Rationale: Permanent remission is incorrect with the diagnosis of MS.

A patient has been newly diagnosed with multiple sclerosis (MS) and the nurse provides teaching about the medications for the disease, which statement by the patient indicates a need for further teaching? A. I may need to take additional drugs at times of acute relapse. B. I will need to take medication indefinitely. C. If medication is begun early, permanent remission can be achieved. D. Some symptoms may need to be managed with symptom-specific drugs.

Answer: C. this is a normal occurrence related to entacapone (Comtan) Rationale: Reassure patient that this is a normal occurrence related to entacapone.

A patient has been taking entacapone (Comtan) to treat on-off phenomenon and expresses concern over brownish-orange urine, the nurse's response is based on the knowledge that: A. the patient may be developing hepatic failure B. brownish-orange urine signifies a lack of fluid intake C. this is a normal occurrence related to entacapone (Comtan) D. the patient may be developing renal failure

Answer: C. Stay with the patient until this self-limiting episode passes Rationale: Expected adverse effects of glatiramer acetate. Stay with the patient until this self-limiting episode passes.

A patient has received an initial dose of glatiramer acetate (Copaxone) for relapsing-remitting multiple sclerosis. The nurse noted the patient appears flushed, anxious, and has urticaria. The patient reports palpitations, chest pain, and a feeling of laryngeal constriction. What will the nurse do? A. Prepare to provide cardiorespiratory support B. Obtain an order for epinephrine to treat a hypersensitivity reaction C. Stay with the patient until this self-limiting episode passes D. Report a possible cardiotoxic episode to the provider

Answer: D. This drug significantly slows the progression of the disease Rationale: Cholinesterase inhibitors produce modest improvements in cognition, behavior and function and may slightly delay disease progression; they do not have a major impact on delaying progression of the disease. GI symptoms are common side effects. Drugs that block cholinergic receptors, including antihistamines can reduce therapeutic effects and should be avoided. Cholinesterase inhibitors prevent breakdown of acetylcholine

A patient will begin taking a cholinesterase inhibitor for early Alzheimer's disease. The nurse is teaching the patient's spouse about the medication. Which statement by the spouse indicates a need for further teaching? A. This drug prevents the breakdown of acetylcholine B. People taking this drug should not take antihistamines C. Gastrointestinal symptoms are common with this medication D. This drug significantly slows the progression of the disease

Answer: C. I will take Diphenhydramine (Benadryl) for any itching caused by a local reaction to the patch. Rationale: Benadryl is an antihistamine, and even though it is not classified as a muscarinic antagonist, it has anticholinergic effects. Giving it with a muscarinic antagonist greatly enhances these effects, so it should not be used. Muscarinic antagonists cause dry mouth, and patient should be taught to use sugar-free gum or candies to help with this. Muscarinic antagonists can cause constipation and laxatives may be used. Medication applied topically can be transferred to others who come in contact with the skin, so the site should be covered

A patient will begin using a transdermal preparation of a muscarinic antagonist, Oxybutynin (Ditropan XL) for overactive bladder. The nurse teaches the patient what to do if side effects occur. Which statement by the patient indicates the need for further teaching? A. I should keep the site covered to prevent other people from getting the medicine. B. I can use sugar free gum for dry mouth. C. I will take Diphenhydramine (Benadryl) for any itching caused by a local reaction to the patch. D. I may need laxatives for constipation.

Answer: C. An increased dose of phenytoin Rationale: The patient's phenytoin level is low; the therapeutic range is 10-20 mcg/mL. An increase in phenytoin dose is necessary. Extended release phenytoin is absorbed more slowly and would not increase this patient's serum phenytoin level.

A patient with a seizure disorder is admitted to the hospital and has a partial convulsive episode shortly after arriving on the unit. The patient has been taking phenytoin (Dilantin) 100 mg three times daily for several years. The patient's phenytoin level is 5.6 mcg/mL. The nurse contacts the health care provider to report the level and the seizure. What will the nurse expect the provider to order? A. Extended-release phenytoin B. Discontinue phenytoin C. An increased dose of phenytoin D. Add another anti-seizure medication

Answer: C. Baclofen (Lioresal) Rationale: Baclofen is used to treat muscle spasticity associated with MS, spinal cord injury, and CP. It is a Centrally Acting Muscle Relaxer for Spasticity. It does not reduce muscle strength, so it will not exacerbate this patient's muscle weakness. Dantrolene would not be a good option for this patient, although it can help with muscle spasm, it causes muscle weakness. Cyclophosphamide (Cytoxan) is a chemotherapeutic agent used in MS along with steroids to shorten length of attack. Benztropine (Cogentin) an anticholinergic is used to control drug-induced extrapyramidal side effects of Parkinson's.

A patient with multiple sclerosis has severe muscle spasticity and muscle weakness. The nurse is correct to anticipate that which medication will be ordered? A. Dantrolene (Dantrium) B. Cyclophosphamide (Cytoxan) C. Baclofen (Lioresal) D. Benztropine (Cogentin)

Answer: 1.5 Rationale: 0.4 mL x 0.6mg = 1.5 mL

A physician orders naloxone 0.6mg IV push for a client. The vial has a concentration of 0.4 mg/ml. How many milliliters of naloxone should the client receive per dose? Record your answer using one decimal place.

Answer: C. Risk for injury related to prolonged bleeding time, inhibition of platelet Rationale: The nursing diagnosis addresses all the interactions that pose a threat to the client taking both these drugs. Bleeding time is prolonged and not decreased when both drugs are used. Thrombocytosis does not occur with either of these drugs. Platelet aggregation is inhibited and not increased when both drugs are used.

An appropriate nursing diagnosis for clients who are taking NSAIDs and anticoagulants would be which of the following? A. Potential for injury related to GI toxicity and decrease in bleeding time. B. Risk for injury related to thrombocytosis prolonged prothrombin time. C. Risk for injury related to prolonged bleeding time, inhibition of platelet aggregation, and increased risk of GI bleeding. D. Altered protection related to GI bleeding and increasing platelet aggregation.

Answer: B. assess the client's pain level. Rationale: Assess and document pain level.

Before administering a dose of pain medication, a nurse should always: A. have emergency resuscitation equipment available. B. assess the client's pain level. C. give the client something to eat. D. reposition the client.

Answer: B. Withdrawal symptoms Rationale: Opioid dependence when given a mixed agonist/antagonist can precipitate withdrawal.

Before patient patient administering the mixed opioid agonist-antagonist pentazocine, the nurse asks the if he has used opioids. Administering a mixed opioid agonist-antagonist to a dependent on opioid agonists may cause which reaction? A. Hypersensitivity reaction B. Withdrawal symptoms C. Constipation D. Urinary incontinence

Answer: B. Decreased respiratory rate Rationale: Isoflurane causes respiratory depression and hypotension. Malignant hyperthermia occurs in genetically predisposed patients; the use of succinylcholine with halothane may produce malignant hyperthermia.

The patient has received isoflurane [Forane] as a general anesthetic. What should the nurse closely observe the patient for during the immediate postoperative period? A. Elevated blood pressure B. Decreased respiratory rate C. Malignant hyperthermia D. Increased heart rate

Answer: A. Drowsiness Rationale: CNS effects are expected adverse effects.

Cyclobenzaprine (Fexmid) is prescribed for a client for muscle spasms and the nurse is reviewing the client's response. What adverse effect does the nurse expect with the administration of this medication? A. Drowsiness B. Increased GI motility C. Increased salivation D. Muscle spasms

Answer: 13.8

Dopamine has been ordered at 4mcg/kg/min using a 400mg/250mL D5W solution. The patient weighs 92 kg. Calculate the ml/hr flow rate (Record your answer using one decimal place.).

Answer: A. A benzodiazepine will be given intravenously to calm the client Rationale: Surgery increases anxiety in patients and a benzodiazepine med may be given to calm the client.

During induction of anesthesia. the nurse notes the client becomes anxious and resists the treatment. The nurse concludes what intervention is needed? A. A benzodiazepine will be given intravenously to calm the client B. The surgery will need to be rescheduled C. The client must be put in restraints D. Anesthesia must be discontinued

Answer: B. Urinary retention Rationale: Bethanechol is a direct-acting cholinergic agonist that stimulates the cholinergic receptors on the smooth muscle of the bladder, leading to bladder contraction and emptying. Used for urinary retention.

During postoperative teaching the nurse explains that the client is receiving bethanechol (Urecholine) to treat: A. Respiratory atelectasis B. Urinary retention C. Postoperative hypotension D. Postoperative ischemic colitis

Answer: B. Increased GI motility Rationale: Cholinergic effects mimic the parasympathetic nervous system (of rest and digest) as opposed to the sympathetic nervous system (fight or flight). Increasing GI motility helps the body digest. Urinary retention, mydriasis, and decreased secretion from sweat glands are sympathetic nervous system responses (anticholinergic)

The nurse explains to the student nurse that cholinergic (muscarinic agonist) drugs may affect the patient by causing: A. Urinary retention B. Increased GI motility C. Mydriasis D. Decreased secretion from sweat glands

Answer: C. Diarrhea Rationale: Anticholinergic effects block the effects of the parasympathetic nervous system, producing sympathetic nervous system effects. The effect on the GI system would be to decrease GI motility, not increase it (diarrhea).

Side effects that the nurse will monitor for a patient taking Atropine include all of the following except: A. Mydriasis B. Urinary retention C. Diarrhea D. Dry mouth

Answer: B. The patient has a history of a recent acute myocardial infarction. Rationale: Triptans can cause vasoconstriction and coronary vasospasm. These drugs should not be administered to patients with coronary artery disease, current symptoms of angina, or uncontrolled hypertension.

The health care provider is considering the use of sumatriptan (Imitrex) for a patient with migraine headaches. Which information obtained by the nurse is most important to report to the health care provider? A. The patient has had migraine headaches for 30 years. B. The patient has a history of a recent acute myocardial infarction. C. The patient has at least 1 to 2 cups of coffee daily. D. The patient has been taking topiramate (Topamax) for 2 months.

Answer: B. An improvement of the weakness Rationale: An improvement in the weakness indicates myasthenia crisis. An edrophonium injection makes the client in a cholinergic crisis temporarily worse. Muscle spasms are not associated with this test.

The health care provider prepares to identify whether a client is having a cholinergic or myasthenic crisis, an injection of edrophonium (Tensilon Test) is administered. Which finding by the nurse indicates that the client is in myasthenic crisis? A. A decrease of muscle spasms B. An improvement of the weakness C. A temporary worsening of the condition D. Complaints of muscle spasms

Answer: D. Develops a sore throat. Rationale: Blood dyscrasias (aplastic anemia, leukopenia, anemia, and thrombocytopenia) can be an adverse effect of carbamazepine (Tegretol). Flu Like symptoms, such as pallor, fatigue, sore throat, and fever, are indications of such dyscrasias. Gingival hyperplasia is a side effect of phenytoin (Dilantin), not carbamazepine (Tegretol).

The health care provider prescribes the anticonvulsant carbamazepine (Tegretol) for an adolescent client with a seizure disorder. The nurse should instruct the client to notify the health care provider if which condition occurs A. Experiences dizziness. B. Experiences dry mouth. C. Develops gingival hyperplasia. D. Develops a sore throat.

Answer: B. increase availability of acetylcholine Rationale: Prescribed to patients with Alzheimer's Disease to increase levels and availability of acetylcholine in the brain by blocking its breakdown.

The nurse administering the cholinesterase inhibitor donepezil (Aricept) to a patient understands that the expected therapeutic action of this drug is to A. relieve anxiety and restless behavior B. increase availability of acetylcholine C. help control associated urinary incontinence D. block the effects of acetylcholine at the presynaptic neurons

Answer: B. Atropine Rationale: Atropine is the antidote for Bethanechol.

The nurse assesses the client taking bethanechol and documents profuse salivation, tearing, visual disturbances, bronchospasm, diarrhea, and bradycardia. What drug should be given? A. Physostigmine B. Atropine C. Pancuronium D. Pilocarpine

Answer: C. Good oral hygiene is needed to prevent gingival hyperplasia Rationale: Typical anti-seizure medication instructions include taking the prescribed daily dosage to keep the blood level of the medication constant and having a sample drawn for serum medication level determination before taking the morning dose. The client is taught not to stop the medication abruptly, to avoid alcohol, to check with HCP before taking OTC meds, to avoid activities in which alertness and coordination are required until medication effects are known, to provide good oral hygiene, and to obtain regular dental care (risk of gingival hyperplasia). The client should also wear a medic alert bracelet.

The nurse has given medication instructions to a client receiving phenytoin. Which statement indicates that the client has an adequate understanding of the instructions? A. The medication dose may be self-adjusted, depending on the side effects B. Alcohol is not contraindicated while taking this medication C. Good oral hygiene is needed to prevent gingival hyperplasia D. The morning dose of the medication should be taken before a serum medication level is drawn

Answer: B. Acetylcysteine Rationale: Acetylcysteine is the antidote

The nurse is caring for a client who has been taking acetaminophen, and acetaminophen overdose is suspected. Which antidote should the nurse prepare for administration if prescribed? A. Fludarabine B. Acetylcysteine C. Auranofin D. Pentostatin

Answer: D. Assess the patient for malignant hyperthermia Rationale: Malignant hyperthermia occurs in genetically predisposed patients; the use of succinylcholine with halothane may produce malignant hyperthermia.

The nurse is caring for a patient who is receiving succinylcholine with halothane. Which action by the nurse is most appropriate? A. Keep a written record of the dispensing of this drug B. Make the environment quiet to prevent delirium C. Discard any unused solution within 6 hours D. Assess the patient for malignant hyperthermia

Answer: A. Complete blood count Rationale: When monitoring a patient receiving interferon, the nurse should watch for potential adverse reactions of hepatotoxicity (alkaline phosphatase) and myelosuppression (complete blood counts). The blood urea nitrogen and CC value is an indicator of renal function, which is not affected by interferon beta-1a. The hemoglobin A1c test is a weighted average of the glucose level over the past several months. Glucose levels are not affected by interferon beta-1a. Immunoglobulin G levels might be assessed when making the diagnosis, but they are not used to monitor for adverse effects of interferon.

The nurse is caring for a patient with Multiple Sclerosis who is receiving interferon beta-1a (Rebif) by subcutaneous injection. Which laboratory test should be performed regularly in this patient to monitor for a potential adverse effect? A. Complete blood count B. Creatinine clearance C. HemoglobinA1C D. Blood urea nitrogen

Answer: B. as an alternative to general anesthesia. Rationale: Local anesthesia can be used as an alternative to general anesthesia. Usually preferred to general anesthetics for surgery in elderly or debilitated patients or in patients with disorders that affect respiratory function

The nurse is caring for an older aged adult receiving a local anesthetic. The nurse understands that a local anesthetic can be used: A. to produce dissociative anesthesia. B. as an alternative to general anesthesia. C. for induction of general anesthesia. D. for maintenance of general anesthesia.

Answer: C. Avoid the use of alcohol Rationale: Baclofen is a skeletal muscle relaxant. The client should be cautioned against the use of alcohol and other CNS depressants because baclofen potentiates the depressant activity of these agents. Constipation rather than diarrhea as a side effects. Restriction of fluids is not necessary, but the client should be warned that urinary retention can occur. Fatigue is related to a CNS effect that is most intense during the early phase of therapy and diminishes with continued medication use. The client does not need to notify the HCP about fatigue.

The nurse is preparing discharge instructions for a client receiving baclofen. What instruction should be included in the teaching plan? A. Restrict fluid intake B. Notify the health care provider if fatigue occurs C. Avoid the use of alcohol D. Stop the medication if diarrhea occurs

Answer: C. Maximally reducing seizure activity while minimizing side effects of medication therapy Rationale: Maximally reducing seizure activity while minimizing side effects of medication therapy.

The nurse is teaching a patient newly diagnosed with a seizure disorder, the nurse correctly states the goal of pharmacologic therapy as: A. Eradicating all seizure activity and then weaning off medication once the patient is seizure free for 3 months B. Maximizing drug dosages to control seizure activity C. Maximally reducing seizure activity while minimizing side effects of medication therapy D. Reducing seizure occurrence to one per week

Answer: C. Decrease in urinary frequency Rationale: Darifenacin (Enablex) is prescribed for overactive bladder. Therapeutic effect is a decrease in urinary frequency.

The nurse monitors a patient taking Darifenacin (Enablex), a muscarinic antagonist for which therapeutic effect? A. Decrease in gastrointestinal motility B. Increase in blood pressure C. Decrease in urinary frequency D. Increase in heart rate

Answer: D. This is called the on-off phenomenon. Your health care provider can change your medication regimen slightly to help diminish this effect. Rationale: The helpful effects wear off after about 2 years of treatment, so alternative treatment approaches will be needed. This is known as the "on-off phenomenon."

The patient with Parkinson's disease who has been positively responding to carbidopa-levodopa (Sinemet) suddenly develops a relapse of symptoms. Which explanation by the nurse is appropriate? A. This is an atypical response. Unfortunately, there are no other options of drug therapy to give you. B. You have obviously developed resistance to your current medication and will have to be switched to another drug. C. You just need to keep taking your medication and these effects will go away. D. This is called the on-off phenomenon. Your health care provider can change your medication regimen slightly to help diminish this effect.

Answer: A. malignant hyperthermia Rationale: Dantrolene is indicated for the treatment of Malignant Hyperthermia

The patient's chart notes the administration of dantrolene (Dantrium) immediately postoperatively. The nurse suspects that the patient experienced A. malignant hyperthermia B. respiratory arrest C. a tonic-clonic seizure D. delirium tremens

Answer: D. Codeine is very constipating Rationale: Codeine causes constipation. It odes not cause diarrhea or more sedation than other opiates. Codeine is an antitussive - in lower doses.

When administering codeine to a patient, the nurse should be aware that A. Codeine produces more sedation than other opiates B. Codeine causes diarrhea so the client must take an additional medication C. Codeine is an antitussive in higher doses D. Codeine is very constipating

Answer: B. Assess respiratory status and breath sounds. Rationale: The client should be assessed often for signs of respiratory complications. The client with myasthenia gravis is at greatest risk for life-threatening respiratory complications because of the weakness of the diaphragm and ancillary respiratory muscles caused by the disease process. Paralysis of the respiratory muscles can be fatal. Cholinergic agents used to reduce muscle weakness can also cause hypersalivation, increased respiratory secretions, and possible bronchoconstriction. The other options reflect helpful interventions, they do not have the priority of assessing respiratory status in caring for the client with myasthenia gravis.

When providing nursing care for a client receiving Neostigmine (Bloxiverz) for Myasthenia Gravis, which nursing intervention has the highest priority? A. Monitor the client frequently for urinary retention. B. Assess respiratory status and breath sounds. C. Monitor blood pressure each shift to screen for hypertension. D. Administer most medications after meals to decrease gastrointestinal irritation.

Answer: A. An 85 year old man with benign prostate hyperplasia Rationale: An 85 year old man with benign prostate hyperplasia (Atropine causes urinary retention to worsen in clients with BPH).

Which factor in the client's history would cause the nurse to question a medication order for Atropine? A. An 85 year old man with benign prostate hyperplasia B. A 42 year old woman with a history of drug abuse C. An 18 year old man with IBS D. A 22 year old woman on the 2nd day of her menstrual cycle


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