Block 3 pharm
The parents of a teething infant ask the nurse about over-the-counter (OCT) solutions to help minimize the pain. What assessment question has priority when preparing to provide suggestions?
"How old is your infant?"
The nurse is educating an adult client diagnosed with herpetic lesions of the throat about the prescribed 1% viscous lidocaine gargle and swallow. Which statement made by the client establishes the need for farther clarification
"I can eat immediately after I use the medication."
The nurse has been educating the client about the self-administration of phenytoin. Which statement by the client demonstrates an understanding of the medication?
"I should not change brands without checking with my health care provider."
The nurse has been educating the client about the self-administration of phenytoin. Which statement made by the client demonstrates an understanding of the medication?
"I'll make sure to take the drug with food."
A client sustained a severe laceration to the right thumb and index finger that will require local anesthetic to facilitate suturing. Which statement made by the client should prompt the nurse to provide further client health education?
"I'm feeling pretty queasy about getting stitches, so I'm glad they'l be knocking me out."
A client's medication regimen for the treatment of anxiety has been changed from a benzodiazepine. The client asks the nurse what likely prompted the health care provider to change the medication. What is the nurse's best response?
"Long-term use of benzodiazepines can result in dependency."
A client admitted to the surgical division after a mastectomy has a PCA pump and states being fearful about being overdosed on morphine. Which response is most appropriate when addressing the client's concern of being overmedicated?
"The device is preset, so you cannot receive more than you need"
The murse is preparing to administer prescribed to a client. How soon after administration does the nurse expect to diazepam observe onset intravenously of action?
1 to 5 minutes
The nurse is teaching a client about a procedure that includes application of topical lidocaine. How long would the nurse say it takes to achieve full pain relief following application?
20 to 60 minutes
Prior to elective hip replacement surgery, the nurse is explaining the basic characteristics of general anesthesia to the client. The nurse should perform this education in the understanding that general anesthesia is best described as what result?
A state of reversible unconsciousness
The nurse is caring for a client with a history of renal impairment in the postanesthesia care unit (PACU) after general anesthesia with isoflurane and vecuronium. The client has a weak and ineffective cough. Which assessments should the nurse perform to determine if recurarization has occurred? Select all that apply.
A. Assess for the ability to swallow and handle secretions. C. Ask the client to lift the head off the bod for 5 seconds to determine strength. E. Determine what the bilateral hand grasp strength is
The nurse administers epinephrine intravenously toa client diagnosed with beart block. In what order would the nurse predict the steps of signal transduction and intracellular events that occur when the beta-adrenergic receptors are stimulated? Drag the statements into the order.
A. Epinephrine binds to the beta receptor and initiates intercellular activity. B. Epinephrine-beta receptor complex activates G protein, which reacts with guanosine triphosphate. C. Activated G protein activates the enzyme adenyl cyclase. D. Increases in cyclic adenosine monophosphate (CAMP) occur. E. Cyclic adenosine monophosphate (CAMP) initiates intracellular activities, including an increase in atrioventricular conduction.
The nurse general prepares to receive a client after a cesarean section who received isoflurane during anesthesia. Based upon the drig's adverse effects, which measures would the nurse provide postoperatively? Select all that apply.
A. Provide warm blankets C. Administer prescribed antiemetic. D. Assess for increased bleeding. E. Monitor oxygenation and vitals frequently.
The murse has administered a parasympathomimetic medication to a client. What assessment findings would the nurse expect following administration? Sclect all that apply.
A. Pupils are constricted bilaterally. C. The client states, "I am able empty my bladder more easily E. Pulse before medication: 90 and after medication: 70.
The nurse is caring for a client who has been prescribed a nonopioid analgesic in addition to a narcotic analgesic. What effect will the nurse expect?
Additive effect
The nurse is assessing a client with a suspected diagnosis of acute benzodiarepine withdrawal, What assessment findings would support that diagnosis? Select all that apply.
Agitation, Palpitations
A client has been started on cyclobenzaprine. For the duration of treatment with cyclobenzaprine, the nurse should teach the client to eliminate what?
Alcohol
The nurse administers intravenous (IV) dopamine to a client diagnosed with shock. The nurse would predict which receptor subtypes to be activated resulting in a stimulatory response? Select all that apply.
Alpha 1, beta 1, beta 2
The murse administers intravenous (IV) norepinephrine to the client diagnosed with shock The nurse would predict which receptor subtypes to be activated resulting in a stimelatory response? Select all that apply.
Alpha1 Alpha2 Beta1
The nurse should question the health care provider's IV morphine prescription for which client?
An 88-year-old client with failure to thrive
A client diagnosed with a left temporal brain tumor reports an odor of ammonia just prior to experiencing rapid rhythmic jerking movements. What is the odor of ammonia classified as?
An aura prior to the seizure activity
A client is scheduled to undergo craniofacial surgery, a procedure that will necessitate the use of propofol. The operating room nurse should be aware that alternative modications will be absolutely necessary in order to produce what effect in the client?
Analgesia
How does vecuronium induce paralysis required for the facilitation of intubation and balanced anesthesia?
Antagonizing acetylcholine (ACh) receptors at neuromuscular junctions
A client who has been taking medication for a seizure disorder is asking the nurse about getting pregnant. Why is pregnancy discouraged in women who are being treated for seizure disorders?
Antiepilepsy drugs are teratogenic
A surgical client's balanced anesthesia includes the use of vecuronium. What nursing action should the operating room nurses prioritize?
Assessing and protecting the client's airway
A client has been administered lidocaine in anticipation of a bronchoscopy and lung biopsy. What change in status would the nurse recognize as a possible indication of hypersensitivity to lidocaine?
Audible wheeze
Oral lidocaine viscous has been prescribed for a client who has developed stomatitis. To minimize the client's chance of aspiration, the nurse should encourage what intervention?
Avoiding cating or drinking for I hour following the use of lidocaine viscous
The nurse is caring for a newly admitted client requiring long-term mechanical ventilation. Which measures would the nurse provide for safe and effective long-term administration of the newly prescribed propofol intravenous (IV) drip being titrated for moderate sedation? Select all that apply.
B. Assess for contraindications: pancreatitis, allergies to soy, or eggs C. Monitor and report elevations in triglycerides, creatine kinase, or lactic acid E. Determine the level of sedation before and after titrating the drug
The nurse prepares to administer a selective alphar-adrenergic antagonist medication to a client diagnosed with hypertension. What would the nurse consider to be side effects based upon the characteristics of the prescribed medication? Select all that apply.
Blood pressure lying 130/70, dizziness, reflex tachycardia
What amide local anesthetic is contraindicated for local infiltration during pregnancy?
Bupivacaine
The nurse educates client diagnosed with asthma concerning the prescribed selective beta:-adrenergic agonist inhaler. Which client statement indicates the need for further clarification?
C. "The medication will cause my heart rate to increase and will cause palpitations."
The nurse administers a nonopioid analgesic to a client. What is the most effective way for the nurse to evaluate the pain response following administration?
C. Using a pain scale, ask the client to describe the pain.
Which ion is required for neurotransmitter release from storage sites in the small sacs known as synaptic vesicles?
Calcium
A client is diagnosed with trigeminal neuralgia. What antiepileptic agent may be usad to treat this disorder?
Carbamazepine
Which muscle relaxant is contraindicated due to the client's history of porphyria?
Carisoprodol
The murse has administered gabapentin to a client. Following administration, the nurse should assess the client for what possible adverse effect?
Central nervous system (CNS) depression
Which system uses acetylcholine as a neurotransmitter?
Cholinergic
What aspect of a client's health is most likely to cause insommia?
Chronic pain
A nurse is teaching a client about the prescription for acetaminophen to be taken at home This medication consists of acetaminophen and what other likely drug that enhances the analgesic effect of acetaminophen?
Codeine
A hospital client's medication administration record specifies the parenteral administration of lidocaine before a tissue biopsy to be performed later in the day. What action shculd the nurse take in response to this prescription?
Contact the prescriber because administration should be performed by a health care provider or nurse anesthetist.
A client receiving morphine sulfate 5 mg IV every 4 hours for the past several days now states that the pain is not being relieved as well as it was in the past. What is the reason for this development?
D. A tolerance to morphine
During surgery to repair a ruptured Achilles tendon, the client develops severe muscle contractions and a dramatic rise in body temperature. Which medication will be administered?
Dantrolene sodium
Which medication will inhibit the release of calcium in skeletal muscle cells to minimize the development of muscle contractions?
Dantrolene sodium
In addition to relieving agitation and anxicty, what is a rationale for using benzodiazepines in the treatment of a critically ill client?
Decreased cardiac workload
When in postanesthetic recovery, the nurse should assess for what adverse effect when ketamine is included in a surgical client's balanced anesthesia?
Delirium and agitation
What medication may be administered intravenously (IV) to assist in reducing status epilepticus seizure activity?
Diazepam
A nurse has noted that a newly admitted client has been taking ramelteon for the past several weeks. The nurse is justified in suspecting that this client was experiencing what peablem prior to starting this drug?
Difficulty falling asleep at night
A client is administered the opioid antagonist naloxone for respiratory depression and a state of unresponsiveness. How does naloxone work?
Displacement
5. A client has been diagnosed with Parkinson's discase. The client's spasticity is relane of 138 decrease in what neurotransmitter?
Dopamine
The murse is caring for a client who is receiving cyclobenzaprine for relief of muscle spasms. What adverse effect should the nurse assess for?
Drowsiness
nurse administrates an opioid medication to a client. For what side effect should the nurse assess?
Drowsiness
A client reports being prescribed a bypnotic for the treatment of chronic insomnia. What drug does the nurse suspect the client is taking?
Eszopiclone
child suffers from absence seizures. What is the drug of choice for absence seizures?
Ethosuximide
An older adult client diagnosed with generalized anxiety disorder is preseribed a benzodiazepine. The nurse caring for the client knows to inclade what intervention in the client's care plan?
Falls risk assessment
The anesthesiologist has informed the operating room nurse that opioids will be used to supplement anesthesia for a client undergoing a partial mastectomy. What opioid is most likely to be utilized?
Fentanyl
The nurse is caring for a client suspected of experiencing benzodiazepine toxicity. Which medication does the nurse expect the health care provider to prescribe?
Flumazenil
30-year-old client has been ordered meperidine 100 mg IM every 4 hours for 2 days after fractured femur. What action should the nurse take?
Give the medication as ordered.
The nurse is providing education to a client who has been prescribed dantrolene. What serious adverse effect should the nurse mention during teaching?
Hepatitis
The nurse is providing education to a client who has been prescribed tizanidine. What adverse effect should the nurse mention during teaching?
Hypotension
An adult client who is currently undergoing rhinoplasty has developed the characteristic signs and symptoms of malignant hyperthermia. The operating room nunse should anticipate what intervention?
IV administration of dantrolene sodium
The nurse is assessing a client who has received procaine. What finding would suggest to the nurse the possibility of an adverse effect?
Increased Heart rate
The etiology of anxiety involves which physiologic process?
Increased activation of the autonomic nervous system
The nurse administers prescribed naloxone to a client. Following admimistration, the murse should assess for what potential adverse effect?
Increased blood pressure
The nurse prepares to administer a selective alpha-adrenergic agonist medication to a client diagnosed with shock. What would the nurse consider to be therapeutic or desired effects based upon the characteristies of the prescribed medication? Select all that apply.
Increased blood pressure and cardiac output
Which outcomes should the nurse consider to be side effects of a selective cholinergic agonist based upon the characteristics of the preseribed medication? Sclect all that apply.
Increased drooling, Abdominal cramping, Blood pressure 88/50 mm
client's chronic venous ulcer on the lower lateral surface of the leg requires incision and debridement (1& D). The nurse should anticipate that lidocaine will be administered by which route?
Injection
A perioperative nurse explaining the process of general anesthesia in anticipation of the adult client's imminent bowel resection. When describing the phase of induction, the nurse should explain that this is usually achieved by what means?
Intravenous (V) administration of anesthetics
The nurse is providing education to a client who will receive spinal anesthesia prior to a scheduled bunionectomy. What information should the urse include about administration?
It will be injected into the cerebrospinal fluid.
A child is administered a benzodiazepine. How will the child's dose differ from an adult's dose?
It will be lower.
A client has been administered an opioid. For what effect should the nurse regularly assess?
Level of consciousness (LOC)
client with impaired liver function is suffering from a seizure disorder, which is noted to consist of partial seizures. Which medication might the health care provider prescribe to avoid risks associated with impaired liver function?
Levetiracetam
When administering benzodiazepines, which medication should be considerod the drug of choice?
Lorazepam
The nurse is caring for a client newly admitted for chronic opioid abuse. What modicationxoes the nurse expect to be prescribed to the client
Methadone
A client is scheduled to undergo a bronchoscopy for the investigation of a bronchial mass. What benzodiazepine should the clinic nurse anticipate administering for conscious sedation?
Midazolam
The nurse is developing a care plan for a child diagnosed with night temrors who is prescribed diazepam. The nurse should include monitoring for development of what disorder in the care plan?
Mood disorders
client is in the end of life and has developed increased respiratory secretions and labored breathing. The health care provider will order which medication to decrease these symptoms?
Morphine sulfate
BLM: A client has a decrease in calcium. Which receptor will be stimulated to increase the intracellular concentration of calcium?
Muscarinic
A client has a decreased heart rate. Which receptor will activate the potassium channels to increase the cardiac output and rate?
Muscarinic 2
The nurse administers an anticholinergic medication to a client. The nurse would peodict which receptor subtypes to be blocked? Select all that apply.
Muscarinic, Nicotinic
The murse caring for a postanesthesia client notes a respiratory rate of 6 breaths'min. What drug should administered?
Naloxone
During ambulation after surgery, the skeletal muscle produces contraction. What receptor is located in motor nerves and skeletal muscle?
Nicotinic
The pathophysiology of pain begins with a signal from what source?
Nociceptors
The nurse is caring for a client in the postanesthesia care unit (PACU) after general anesthesia with isoflurane. The in client suddenly develops BP s8 50, HR 110, RR 28 shallow, T 102°F (39°C), SaO; 88%, mottling of skin and profase diaphoresis, and spasms of bilateral masseters. Which action should the nurse implement first?
Notify anesthesia immediately for evaluation and prescriptions including intravenous dantrolene sodium.
The nurse is caring for a young adult client in the emergency department (ED) requiring rapid sequence induction and placement on mechanical ventilation. The client has no known allergies; takes no medications, over-the-counter (OTC) drugs, herbals, or alcohol; and has no history of chronic conditions. The nurse administered the prescribed intravenous (IV) succinylcholine. Which best action would the nurse take when the client remains paralyzed 30 minutes after the intubation?
Notify the emergency department health care provider.
What effect will dehydration and a decreased albumin level have on a client's prescribed dose of severe phenytoin?
Potentially cause a toxie serum level
A client diagnosed with insomnia pr prescribed flurazepam. This medication has a longer half-life than han 24 24 hours. hours. Which Which contributes to the long half-life of this modication and other benzodiazepines?
Presence of active metabolites
How does spinal procaine achieve anesthesia?
Preventing the influx of sodium into nerve cells
A client who suffered a laceration while doing woodwork will have the wound treated under local anesthesia achieved using lidocaine and epinephrine. The nurse who will assist with the procedure should recognize that epinephrine performs what function in this situation?
Prolonging the effects of lidocaine
8. The nurse is preparing to administer an adrenergic medication to a client. What instructions will the nurse include in client teaching related to the drug's actions on the body? Select all that apply.
Recommend that the client wear sunglasses. B. Instruct the client to increase fluid intake.
A client has been prescribed a fentanyl patch for chronic pain. What client teaching should the nurse provide to the client and family upon discharge?
Remove the patch every 3 days.
Which measures would the nurse provide for safe and effective drug administration when applying a 5% lidocaine patch to an adult client?
Remove the previous patch with clean gloves; fold it on itself and dispose of it, Cleanse and dry the skin, and inspect for redness or rash where the previous patch was applied, Apply the new patch to intact skin at the most painful site
A client experiencing cancer pain is receiving morphine every 2 hours. What assessment should the nurse teach family members to make while caring for this client at home?
Respiratory depression
A client will undergo an endoscopy with conscious sedation using midazolam. The nurse who is participating in this procedure should monitor the client closely for which sign of adverse reaction?
Respiratory depression
client in intensive care has been prescribed both lorazepam and hydromorphone. The nurse should prioritize what assessments for the client?
Respiratory rate and oxygen saturation
A client has becen administered flumazenil because of the toxic effects of benzodiazepines. The client should be observed for acute benzodiazepine withdrawal symptoms. Which sign or symptom is indicative of acute benzodiazepine withdrawal?
Seizures
The clients care plan specifies the use of proemptive analgesia. This approach to pain control client's will care involve plan what specifies nursing intervention?
Simultaneous use of analgesics from different drug classes
The nurse is scheduled to administer pancuronium, a neuromuscular-blocking medication, to a client receiving mechanical ventilation. The nurse would prodict which receptor sabtype(s) to be activated resulting in a stimulatory response?
Specifically nicotinic M receptors
A client prescribed phenytoin for a seizure disorder has recently run out of medication and has not obtained a refill. What is the client at risk for developing?
Status epilepticus
The client suddenly develops numbness, tingling of the face, tinnitus, and restlessness after receiving a nerve block with bupivacaine. Which action would the murse implement first?
Stop the infusion of bupivacaine.
A client is experiencing stimulation of receptors in the parasympathetic nervous system, What symptom does the nurse assess in this client?
Sweating
A client has been prescribed a benzodiazepine daily for the treatment of an anxiety disorder. In order to minimize the chances of withdrawal symptoms, the nurse knows to include what precaution in client teaching?
Tapering the dose of drug over a prolonged period of time
The nurse is caring for an older adult client who has been newly diagnosed with insomnia. What medication does the nurse expect the health care provider to prescribe?
Temazepam
How will the addition of nitrous oxide or IV anesthetics affect the minimum alveolar concentration (MAC) of isoflurane?
The MAC will decrease.
The nurse is providing education to a client who has been prescribed naltrexone. What effect should the nurse teach the client to expect if an opiod is taken?
The absence of usual physiologic effects
Three days after discontinuing diazepam with medical guidance, an older adult client continues to demonstrate impaired memory and confusion. The murse should consider what possible explanation for the client's current status?
The adverse effects of benzodiazepines can persist for several days after stopping the drug
The murse is assessing a client who received a local anesthetic 5 minutes ago. What assessment finding would the nurse interpret as possible evidence that the client has developed local anesthetic systemic toxicity(LAST)?
The client client has become intensely anxious and agitated.
The nurse reads that total intravenous anesthesia (TIVA) is indicated for a client to undergo a surgical repair of a meniscus. What is the most likely rationale for this interventiion?
The client has previously experienced severe postoperative nausea and vomiting
client has becen receiving morphine sulfate for the treatment of postoperative pain. The nurse assesses that the client is profusely sweating but is afebrile. What does this finding indicate to the nurse?
The client may have developed a tolerance and dependance to the morphine.
The anesthetist administers vecuronium to a client prior to thyroidectomy. What is the purpose of the medication?
To ensure that the client does not move during surgery
The nurse is caring for a client with premedication data as follows blood pressure (BP) 88/40 mure mm Hg. heart rate (HR) 45, respiratory rate (RR) 12, glucose 70 mg dl, cardiac output (CO) 3.8 L/min (normal range 4-6 Limin). The nurse would predict which assessment findings after administering a sympathomimetic to the client?
ВР 100/60, Glucose 150 mg dl. (8.32 mmol/L) , RR 20
