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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 - CORRECT ANSWER--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. - CORRECT ANSWER--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. -
CORRECT ANSWER--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 - CORRECT ANSWER--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. - CORRECT ANSWER--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 - CORRECT ANSWER--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 - CORRECT ANSWER--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." - CORRECT ANSWER--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 - CORRECT ANSWER--B. Diazepam