08 Oct Aspirin could be detrimental in which of these situations?

Aspirin could be detrimental in which of these situations? (Select all that apply.)

 

 Client is also pregnant

 

 Client also has rheumatoid arthritis

 

 Client is a child with a fever

 

 Client also takes anticoagulants

 

 Client also has a peptic ulcer

 

Question 2The nurse is preparing to administer lithium to a client with bipolar disorder whose lithium level is 2.0 mEq/L. What symptoms might the nurse expect to see? (Select all that apply.)

 

 Pacing

 

 Slurred speech

 

 Drooling

 

 Unsteady gate

 

 Hunger

 

 Irregular heart rate

 

Question 3Sumatriptan is ordered for an elderly client experiencing a migraine. The nurse understands that triptans are contraindicated in which condition?

 

 Chronic lung disease

 

 Irritable bowel syndrome

 

 Cerebrovascular insufficiency

 

 Narcotic dependency

 

Question 4A client with persistent pain due to cancer is brought to the emergency department by his spouse. Upon assessment, the nurse notes pinpoint pupils and a respiratory rate of 6 breaths per minute. The nurse should immediately prepare for administration of which medication?

 

 Naloxone

 

 Flumazenil

 

 Methamphetamine

 

 Acetylcysteine

 

Question 5A client who started an antidepressant 1 week ago tells his nurse, “I really don’t think this medication is helping me.” Which response by the nurse would be most appropriate?

 

 “It can take weeks for antidepressants to work. How are you doing?”

 

 “Why do you think the medication is not helping you?”

 

 “What were you hoping would happen?”

 

 “You need to come to the clinic so we can discuss this.”

 

Question 6A client taking amitriptyline complains of having blurred vision and dry mouth, and he states that he hasn’t had a bowel movement in 3 days, whereas he normally has one daily. His vital signs are temperature 97.6° F, pulse 90/minute, blood pressure 130/79 mm Hg, and respirations 20/minute. Based on this assessment, the nurse should suspect which of the following causes?

 

 Medication incompatibilities

 

 Dehydration

 

 Anticholinergic effects

 

 Sympatholytic effects

 

Question 7The nurse reads that the half-life or morphine is roughly 3 hours. How would the nurse use this information to decide if it is safe to give morphine every 3 hours as needed for pain?

 

 The half-life of morphine shortens over time as the liver becomes familiar with the drug.

 

 The half-life of morphine would be longer in hepatic insufficiency. The drug would accumulate.

 

 The half-life of morphine shouldn’t be an issue here. Pain alone should determine the interval.

 

 The half-life for morphine shortens in states of dependence. It will be needed more often.

 

Question 8The client has been prescribed an atypical antipsychotic. Which laboratory finding should the nurse watch closely, since it may be altered by this medication?

 

 The client’s white blood cell count

 

 The client’s albumin level

 

 The client’s arterial blood gases

 

 The client’s thyroid level

 

Question 9A friend of a nurse who is being treated for anxiety with a selective serotonin reuptake inhibitor wants to know why sertraline is better for controlling anxiety than a benzodiazepine. Which of the following is the nurse’s best response?

 

 “Sertraline is better for the control of physical symptoms of anxiety than a benzodiazepine.”

 

 “Sertraline is better for reducing cognitive symptoms of anxiety than a benzodiazepine.”

 

 “Sertraline provides a more rapid and durable response to the uncomfortable anxiety symptoms.”

 

 “Benzodiazepines currently have no role in the treatment of anxiety.”

 

Question 10A client who has been taking haloperidol is now to complaining of severe muscle spasms of the neck and back. Based on these manifestations, which of these prn prescriptions could the nurse offer to help stop the symptoms?

 

 Acetaminophen

 

 Diphenhydramine

 

 Lorazepam

 

 Ibuprofen

 

Question 11A client taking paroxetine for post-traumatic stress disorder calls the clinic complaining of confusion, restlessness and fever. What should the nurse reply?

 

 Have the client talk to their provider before taking any more paroxitine. These are signs of serotonin toxicity.

 

 Have the client submit a urine specimen. The client is at risk for drug induced urine retention and urinary tract infection.

 

 Tell the client to seek a haloperidol prescription from an urgent care doctor.

 

 Explain to the client that these are expected antidepressant side effects that will subside with time.

 

Question 12A client who was involved in a motor vehicle accident comes into the emergency room distraught and complaining of leg pain. Knowing that the client is experiencing a stress response to trauma, what signs or symptoms would the nurse expect to see?

 

 Elevated pulse and respirations

 

 Pupil constriction

 

 Hyperactive bowel sounds

 

 A decrease in serum glucose

 

Question 13Which of these effects of opiate analgesics should be considered when formulating a client care plan? (Select all that apply.)

 

 Fever reduction

 

 Cough suppression

 

 Constipation

 

 Fall risk

 

 Inflammation reduction

 

Question 14What should the nurse do after giving a young man hydromorphone for a migraine headache?

 

 Provide a restful, dimly lit environment.

 

 Offer him something to eat.

 

 Explain the risks of hydromorphone.

 

 Awaken him to assess his pain level.

 

Question 15A client is returning to the clinic for follow-up related to elevated liver enzymes. Which of the following medications on the client’s medication list would concern the nurse the most?

 

 Ibubrofen three times a day

 

 Vitamin C prn for cold symptoms

 

 Acetaminophen as needed for pain

 

 Daily antihistamines

 

Question 16A client experiencing loss of libido wants to know why he was started on a selective serotonin reuptake inhibitor (SSRI) rather than one of the other types of anti-depressants?” Which response would be most appropriate?

 

 “I can’t begin to guess what your doctor was thinking. You need to ask him.”

 

 “It is the probably the only medication that your insurance will pay for.”

 

 “Medications like citalopram work much faster than the other medications”

 

 “SSRIs have fewer side effects than other antidepressants. Should I mention the concern to your provider?”

 

Question 17Which adjustment in pain medication may be needed for an elderly client with elevated liver enzymes due to anticonvulsant therapy?

 

 The medication should be crushed to facilitate more rapid metabolism.

 

 A higher dose should be used with the same time schedule due to elevated liver enzymes.

 

 The time between doses should be expanded to allow for metabolism in hepatic dysfunction.

 

 The time between doses should be shortened. Elevated liver enzymes will speed metabolism.

 

Question 18A nurse is providing client education about the use of a fentanyl transdermal delivery system. Which of these statements would indicate accurate understanding of self-care expectations?

 

 Always apply the patch to the same spot on your skin

 

 Change the patch every 72 hours

 

 Massage the patch whenever pain occurs

 

 Driving is safe when using this form of narcotic

 

Question 19An elderly client is being assessed for repeated falls. Which of their medicines increases that risk? (Select all that apply.)

 

 Pregabalin for nerve pain

 

 Triazolam for sleep

 

 Acetaminophen for back pain

 

 Capsaicin cream for local control of back pain

 

 Oxycodone for back pain

 

Question 20A depressed client is being started on a monoamine oxidase inhibitor (MAOI). Which statement shows understanding of the needed self-care precautions?

 

 “I can have pizza as long as there is no sausage on it.”

 

 “I can’t drink alcohol, but caffeinated drinks and hot chocolate are fine.”

 

 “When I go to cookouts this summer I should eat chicken instead of hotdogs.”

 

 “This medication causes memory problems, but I can take ginseng to help with that

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