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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.
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 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.
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
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.
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 capsule form. What should
the nurse include in the discharge teaching plan for this client?
A. Capsule contents can be sprinkled on pudding or applesauce.
B. Chew the medication thoroughly to enhance absorption.