2026/ 2027 Update) Questions and Answers |
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Which client should the nurse identify as being at highest risk for complications
during the use of an opioid analgesic?
A young adult with inflammatory bowel disease.
Rationale:
The principal indication for opioid use is acute pain, and a client with
inflammatory bowel disease is at risk for toxic megacolon or paralytic ileus related
to slowed peristalsis, a side effect of morphine. Adverse effects of morphine do not
pose as great a risk for clients with diabetes or a fracture as for the client with
bowel disease.
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with
heart failure. Which intervention should the nurse implement prior to administering
the digoxin?
Assess the serum potassium level.
Rationale:
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in
persons receiving digoxin. The nurse should monitor the client's serum potassium
levels. Blood pressure and respiratory rate will not inform the nurse about potential
safety issues with digitalis.
,A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which
client teaching is most important for the nurse to provide?
Expected duration of flushing.
Rationale:
Flushing of the face and neck, lasting up to an hour, is a frequent reason for
discontinuing niacin.
Inclusion of this effect in client teaching may promote compliance in taking the
medication. While nutrition tips and managing pruritis are worthwhile instructions
to help clients minimize or cope with normal side effects associated with niacin
(Niaspan), flushing is intense and causes the most concern for the client.
An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse
knows that the purpose of this medication is to maintain a gastric pH of 3.5 or
above.
Rationale:
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above
which is necessary for pepsinogen inactivity.
,Which dosing schedule should the nurse teach the client to observe for a
controlled-release oxycodone prescription?
Every 12 hours.
Rationale:
A controlled-release oxycodone provides long-acting analgesia to relieve moderate
to severe pain, so a dosing schedule of every 12 hours provides the best around-
the-clock pain management. Controlled-release oxycodone is not prescribed for
breakthrough pain on a PRN or as needed schedule. Using a schedule of every 4 to
6 hours may jeopardize patient safety due to cumulative effects.
A client with osteoarthritis receives a new prescription for celecoxib (Celebrex)
orally for symptom management. The nurse notes the client is allergic to sulfa.
Which action is most important for the nurse to implement prior to administering
the first dose?
Notify the healthcare provider.
Rationale:
Celebrex contains a sulfur molecule, which can lead to an allergic reaction in
individuals who are sensitive to sulfonamides, so the healthcare provider should be
notified of the client's allergies.
, The nurse is assessing a client who is experiencing anaphylaxis from an insect
sting. Which prescription should the nurse prepare to administer this client?
Epinephrine.
Rationale:
Epinephrine is an adrenergic agent that stimulates beta receptors to increase cardiac
automaticity in cardiac arrest and relax bronchospasms in anaphylaxis. On the ither
hand, dopamine is a vasopressor used to treat clients with shock. Ephedrine causes
peripheral vasoconstriction and is used in the treatment of nasal congestion.
Diphenhydramine is an antihistamine decongestant used in the treatment of mild
allergic reactions and motion sickness. Epinephrine is the medication of choice in
treating anaphylaxis.
A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse
has completed discharge teaching regarding medication administration. Which
morning schedule would indicate to the nurse that the client teaching has been
effective?
Take medication, go for a 30 minute morning walk, then eat breakfast.
Rationale:
Alendronate (Fosamax) is best absorbed when taken thirty minutes before eating in
the morning. The client should also be advised to remain in an upright position for
at least thirty minutes after taking the medication to reduce the risk of esophageal
reflux and irritation.