UWorld NCLEX RN EXAM SOLVED
CORRECTLY TO SCORE A+!!!!
A client undergoing endotracheal intubation received IV sedation and succinylcholine.
Shortly after respiratory status has been stabilized, the client flushed and profusely
diaphoretic and has a rigid jaw. Which medication should the nurse prepare to
administer? Click the exhibit button for more information.
Exhibit: Vital signs
Temperature 105 F
Blood pressure 140/90 mm Hg
Heart rate 150/min
Respirations 28/min
O2 saturation 98%
- IM epinephrine
- IV atropine
- IV dantrolene
- IV glucagon CORRECT ANSWERS IV dantrolene
- Malignant hyperthermia is a rare and life-threatening condition precipitated by certain
medications used for anesthesia, including inhaled anesthetics and succinylcholine.
- Skeletal muscles become unable to control calcium levels, leading to a hypermetabolic
state manifested by contracture and increased temperature.
- Early sings of MH include tachypnea, tachycardia, and a rigid jaw or generalized
rigidity.
- As the condition progresses, the client develops a high fever
- Muscle tissue is broken down, leading to hyperkalemia, cardiac dysrhythmias, and
myoglobinuria.
MH requires emergent treatment with IV dantrolene to reverse the process by slowing
metabolism.
- Succinylcholine should be discontinued.
- Other interventions include applying cooling blankets to reduce temperature and
treating high potassium levels.
Inhaled anethetics CORRECT ANSWERS - desflurane
- Isoflurane
- halothane
Succinylcholine CORRECT ANSWERS A paralytic used adjunctively for intubation and
general anesthesia.
IM epinephrine CORRECT ANSWERS Administered for cardiac arrest, anaphylactic
reactions, or severe asthma attacks
IV atropine CORRECT ANSWERS An anticholinergic agent, used to treat bradycardia.
IV glucagon CORRECT ANSWERS Given IM, subq, or IV for severe hypoglycemia.
, - IV glucose is preferred due to its immediate effect, however, if it is unavailable,
glucagon can be given to stimulate glycogenolysis in the liver
The nurse is managing the care of a client diagnosed with chronic anxiety. Which
behavior demonstrates to the nurse that the client possesses resilience?
1. Avoids anxiety-producing situations.
2. Is able to identify anxiety-inducing triggers
3. Practices stress reduction techniques daily
4. Relies on anxiolytic medication to manage symptoms CORRECT ANSWERS
Practices stress reduction techniques daily.
- Resilient people readily deal with the stress they face by using interventions such as
deep breathing, meditation, thought interruption, and muscle relaxation.
The nurse reviews the laboratory results for 4 assigned clients. Which result is most
important for the nurse to report to the primary health care provider?
- Client with atrial fibrillation receiving warfarin for 7 days with an International
Normalized Ratio (INR) of 1.3
- Client with chronic bronchitis who has a hematocrit of 56& and hemoglobin of 19 g/dL
- Client with Clostridium difficile infections who has a white blood cell count of
15.000/mm3
- Client with sepsis receiving gentamycin who has a creatinine of 0.6 mg/dL CORRECT
ANSWERS Client with atrial fibrillation receiving warfarin for 7 days with an International
Normalized Ratio (INR) of 1.3
- The therapeutic INR level for a client receiving warfarin to treat atrial fibrillation is 2-3.
- The subtherapeutic INR of 1.3 is the most important result to report to the health care
provider as the client is at increased risk for a stroke and dose adjustment is needed
A client at 35 weeks gestation is admitted to the labor and delivery unit for severe pre-
eclampsia. She is started on IV magnesium sulfate for seizure prophylaxis. Which of the
following signs indicated that the client had developed magnesium sulfate toxicity?
Select all that apply.
- 0/4 patellar reflex
- Blood pressure of 156/84 mm Hg
- Client voiding 600 mL in 8 hours
- Respirations of 10/min
- Serum magnesium level of 8.0 mEq/L CORRECT ANSWERS - 0/4 patellar reflex
- Respirations 10/min
- Serum magnesium level of 8.0 mEq/L
- Therapeutic magnesium levels: 4-7 mEq/L
- Mag toxicity: >7
IV magnesium sulfate (seizure eclampsia prophylaxis) CORRECT ANSWERS - Loading
dose of 4-6 g
- followed by maintenance dose of 1-2 g/hr
- therapeutic level: 4-7 mEq/L
CORRECTLY TO SCORE A+!!!!
A client undergoing endotracheal intubation received IV sedation and succinylcholine.
Shortly after respiratory status has been stabilized, the client flushed and profusely
diaphoretic and has a rigid jaw. Which medication should the nurse prepare to
administer? Click the exhibit button for more information.
Exhibit: Vital signs
Temperature 105 F
Blood pressure 140/90 mm Hg
Heart rate 150/min
Respirations 28/min
O2 saturation 98%
- IM epinephrine
- IV atropine
- IV dantrolene
- IV glucagon CORRECT ANSWERS IV dantrolene
- Malignant hyperthermia is a rare and life-threatening condition precipitated by certain
medications used for anesthesia, including inhaled anesthetics and succinylcholine.
- Skeletal muscles become unable to control calcium levels, leading to a hypermetabolic
state manifested by contracture and increased temperature.
- Early sings of MH include tachypnea, tachycardia, and a rigid jaw or generalized
rigidity.
- As the condition progresses, the client develops a high fever
- Muscle tissue is broken down, leading to hyperkalemia, cardiac dysrhythmias, and
myoglobinuria.
MH requires emergent treatment with IV dantrolene to reverse the process by slowing
metabolism.
- Succinylcholine should be discontinued.
- Other interventions include applying cooling blankets to reduce temperature and
treating high potassium levels.
Inhaled anethetics CORRECT ANSWERS - desflurane
- Isoflurane
- halothane
Succinylcholine CORRECT ANSWERS A paralytic used adjunctively for intubation and
general anesthesia.
IM epinephrine CORRECT ANSWERS Administered for cardiac arrest, anaphylactic
reactions, or severe asthma attacks
IV atropine CORRECT ANSWERS An anticholinergic agent, used to treat bradycardia.
IV glucagon CORRECT ANSWERS Given IM, subq, or IV for severe hypoglycemia.
, - IV glucose is preferred due to its immediate effect, however, if it is unavailable,
glucagon can be given to stimulate glycogenolysis in the liver
The nurse is managing the care of a client diagnosed with chronic anxiety. Which
behavior demonstrates to the nurse that the client possesses resilience?
1. Avoids anxiety-producing situations.
2. Is able to identify anxiety-inducing triggers
3. Practices stress reduction techniques daily
4. Relies on anxiolytic medication to manage symptoms CORRECT ANSWERS
Practices stress reduction techniques daily.
- Resilient people readily deal with the stress they face by using interventions such as
deep breathing, meditation, thought interruption, and muscle relaxation.
The nurse reviews the laboratory results for 4 assigned clients. Which result is most
important for the nurse to report to the primary health care provider?
- Client with atrial fibrillation receiving warfarin for 7 days with an International
Normalized Ratio (INR) of 1.3
- Client with chronic bronchitis who has a hematocrit of 56& and hemoglobin of 19 g/dL
- Client with Clostridium difficile infections who has a white blood cell count of
15.000/mm3
- Client with sepsis receiving gentamycin who has a creatinine of 0.6 mg/dL CORRECT
ANSWERS Client with atrial fibrillation receiving warfarin for 7 days with an International
Normalized Ratio (INR) of 1.3
- The therapeutic INR level for a client receiving warfarin to treat atrial fibrillation is 2-3.
- The subtherapeutic INR of 1.3 is the most important result to report to the health care
provider as the client is at increased risk for a stroke and dose adjustment is needed
A client at 35 weeks gestation is admitted to the labor and delivery unit for severe pre-
eclampsia. She is started on IV magnesium sulfate for seizure prophylaxis. Which of the
following signs indicated that the client had developed magnesium sulfate toxicity?
Select all that apply.
- 0/4 patellar reflex
- Blood pressure of 156/84 mm Hg
- Client voiding 600 mL in 8 hours
- Respirations of 10/min
- Serum magnesium level of 8.0 mEq/L CORRECT ANSWERS - 0/4 patellar reflex
- Respirations 10/min
- Serum magnesium level of 8.0 mEq/L
- Therapeutic magnesium levels: 4-7 mEq/L
- Mag toxicity: >7
IV magnesium sulfate (seizure eclampsia prophylaxis) CORRECT ANSWERS - Loading
dose of 4-6 g
- followed by maintenance dose of 1-2 g/hr
- therapeutic level: 4-7 mEq/L
