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A 19-year-old male client who has sustained a severe head injury is
intubated and placed on assisted mechanical ventilation. To facilitate
optimal ventilation and prevent the client from "fighting" the
ventilator, the health care provider administers pancuronium bromide
IV, with adjunctive opioid analgesia. What medication should be
immediately accessible for a potential complication with this drug?
A. Dantrolene sodium
B. Neostigmine bromide
C. Succinylcholine bromide
D. Epinephrine - ans -B. Neostigmine bromide
Neostigmine bromide and atropine sulfate, both anticholinergic drugs,
reverse the respiratory muscle paralysis caused by pancuronium
bromide. Options A, C, and D are not antagonists to pancuronium
bromide and would not be helpful in reversing the effects of the drug
compared with the use of anticholinergics.
A client with viral influenza is receiving vitamin C, 1000 mg PO daily,
and acetaminophen elixir, 650 mg PO every 4 hours PRN. The nurse
calls the health care provider to report that the client has developed
diarrhea. Which change in prescriptions should the nurse anticipate?
A. Change the acetaminophen to ibuprofen.
B. Change the elixir to an injectable route.
C. Decrease the dose of vitamin C.
,D. Begin treatment with an antibiotic. - ans -C. Decrease the dose of
vitamin C.
When providing nursing care for a client receiving pyridostigmine
bromide 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 often.
C. Monitor blood pressure each shift to screen for hypertension.
D. Administer most medications after meals to decrease
gastrointestinal irritation. - ans -B. Assess respiratory status and breath
sounds often.
A client with a dislocated shoulder is being prepared for a closed
manual reduction using conscious sedation. Which medication should
the nurse explain as a sedative used during the procedure?
A.Inhaled nitrous oxide
B.Midazolam IV
C.Ketamine IM
D.Fentanyl and droperidol IM - ans -B. Midazolam IV
A client is being discharged with a prescription for sulfasalazine to treat
ulcerative colitis. Which instruction should the nurse provide to this
client prior to discharge?
A. Maintain good oral hygiene.
B. Take the medication 30 minutes before a meal.
C. Discontinue use of the drug gradually.
D. Drink at least eight glasses of fluid a day. - ans -D. Drink at least eight
glasses of fluid a day.
,The health care provider prescribes carbamazepine for a child whose
tonic-clonic seizures have been poorly controlled. The nurse informs
the mother that the child must have blood tests every week. The
mother asks why so many blood tests are necessary. Which
complication is assessed through frequent laboratory testing that the
nurse should explain to this mother?
A. Nephrotoxicity
B. Ototoxicity
C. Myelosuppression
D.Hepatotoxicity - ans -C. Myelosuppression
Myelosuppression is the highest priority complication that can
potentially affect clients managed with carbamazepine therapy. The
client requires close monitoring for this condition by weekly laboratory
testing. Hepatic function may be altered, but this complication does not
have as great a potential for occurrence as option C. Options A and B
are not typical complications of carbamazepine therapy.
When developing a written nursing care plan for a client receiving
chemotherapy for treatment of cancer, the nurse writes, "Assess each
voiding for hematuria." The administration of which type of
chemotherapeutic agent would prompt the nurse to add this
intervention?
A. Vincristine
B. Bleomycin sulfate
C. Chlorambucil
D. Cyclophosphamide - ans -D. Cyclophosphamide
Hemorrhagic cystitis is the characteristic adverse reaction of
cyclophosphamide. Administration of options A, B, and C does not
typically cause hemorrhagic cystitis.
, A client is receiving oral griseofulvin for a persistent tinea corporis
infection. Which response by the client indicates an accurate
understanding of the drug teaching conducted by the nurse?
A. "I'll wear sunscreen whenever I mow the lawn."
B. "This is the worse bacterial infection I've ever had."
C. "I will need to take the medication for 7 days."
D. "My urine will probably turn brown due to this drug." - ans -A. "I'll
wear sunscreen whenever I mow the lawn."
Photosensitivity is a side effect of griseofulvin, so clients should be
cautioned to wear protective sunscreen during sun exposure. Options
B, C, and D are not accurate statements about side effects of this
medication.
A 6-year-old child is admitted to the emergency department with status
epilepticus. His parents report that his seizure disorder has been
managed with phenytoin, 50 mg PO bid, for the past year. Which drug
should the nurse plan to administer in the emergency department?
A. Phenytoin
B. Diazepam
C. Phenobarbital
D. Carbamazepine - ans -B. Diazepam
Diazepam is the drug of choice for treatment of status epilepticus.
Options A, C, and D are used for the long-term management of seizure
disorders but are not as useful in the emergency management of status
epilepticus.
A client who has trouble swallowing pills intermittently has been
prescribed venlafaxine (XR) for depression. The medication comes in