NUR 2407 Module 3 Quiz Remediation

NUR 2407 Module 3 Quiz Remediation Module 3 Quiz Remediation Original score 75% 5. A client who has been taking haloperidol (Haldol), a traditional antipsychotic, is now to complaining of severe muscle spasms of the neck and back. Based on these manifestations, which of these prn prescriptions could the nurse offer to help stop the symptoms? Selected Answer: Ativan Options: Benadryl (diphenhydramine) – Correct answer because what is being described is acute dystonia. In this case, Benadryl is the correct choice because of its anticholinergic effects. (ATI Book, page 110) Motrin (ibuprofen) – In the case of neuroleptic malignant syndrome, acetaminophen or aspirin are options for treatment of toxicity but not in the case of acute dystonia and ibuprofen is not the preferred NSAID in either case. (ATI Book page 110, 111) Ativan (lorazepam) – incorrect because what is being described is acute dystonia. IN the case of akathisia, this would be a an option. (ATI Book, page 111) APAP (acetaminophen) – This is advisable in the case of neuroleptic malignant syndrome, not acute dystonia. (ATI Book, page 111) 6. A client who started an antidepressant 1 week ago tells his nurse, "I really don't think this medication is helping me." Which response by the nurse would be most appropriate? Selected Answer: Why do you think the medication is not helping you? Options: Why do you think the medication is not helping you? – This is a more appropriate question at a minimum of 6-8 weeks of being on the medication as some meds can take 2-3 months before patients see full effects of the med. (ATI Book, page 93) What were you hoping would happen? – This is inappropriate as the goals of being on an antidepressant would have already been discussed at the time of the appointment when the patient was prescribed the med. (ATI Book Chapter 8) You need to come to the clinic so we can discuss this. – Incorrect because it is unnecessary for the patient to make a trip to the office for something which only requires phone discussion. Additionally, some medications can cause an increase in anxiety symptoms which would make driving contraindicated for the patient. (ATI Book, page 91) It can take weeks for antidepressants to work. How are you doing? – Correct – This is the most correct answer as it explains the length of time it takes for the medication to start working and also asks the client how they are doing currently in the interim until the med does start to work. It is an open ended question which leads to open discussion and determination of any adverse side effects which might be occurring. (Health Assessment and ATI Book, page 93) 8. A client with persistent pain due to cancer is brought to the emergency department by his spouse. Upon assessment, the nurse notes pinpoint pupils and a respiratory rate of 6 breaths per minute. The nurse should immediately prepare for administration of which medication? Selected answer: Flumazenil (Romazicon) Options: Naloxone (Narcan) – Correct – It is most likely the patient, due to their cancer treatment, is using opioid meds. (Pharm Book, page 372) Flumazenil (Romazicon) – Incorrect – The use of benzos in cancer patients is less common than the use of opioid meds. Methamphetamine (Deoxysyn) – Incorrect - Methamphetamine would not be given as this would lead to further CNS depression and toxicity. (ATI Book - Chapter 42) Acetylcysteine (Mucomyst) – Contraindicated in the use of some chemo drugs as it can increase the risk of toxicity and with others increases the risk of bleeding. Also contraindicated in patients with decreased respiratory sufficiency which could be likely depending upon the type of cancer and/or treatment. (Nurse Drug Book and ATI Book Chapter 42). 15. The client has been prescribed clozapine (Clozaril), an atypical antipsychotic. Which laboratory finding should the nurse watch closely, since it may be altered by this medication? Selected answer: The client’s arterial blood gases Options: The client’s thyroid level – Incorrect because though the drug can cause an increase to glucose, cholesterol and triglycerides, it is not known to affect the thyroid (Nurse Drug Book – clozapine) The client’s WBC count – Correct – Drug can cause decrease in WBC counts. (Nurse Drug Book – clozapine) The client’s albumin level – Albumin level is not one of the notable levels to monitor while clients are on this drug. (Nurse Drug Book – clozapine) The client’s arterial blood gases – The drug is not known to have a direct effect on blood gas levels. (Nurse Drug Book – clozapine) 18. What should the nurse due after giving a young man Dilaudid (hydromorphone) for migraine? Selected answer: Awaken him to assess his pain level. Options: Awaken him to assess his pain level. – Incorrect as it is most helpful for the patient to be allowed to rest quietly. (Pham Book, pages 374 – 377) Explain the risks of Dilaudid (after giving it) – Incorrect as the risks should always be discussed prior to the giving of any medication if the patient is able to understand/is awake/responsive. (Pham Book, pages 374 – 377) Offer him something to eat. – Incorrect as migraines are known to also involve stomach upset. (Pham Book, pages 374 – 377) Provide a restful, dimly lit environment. – Correct as this will promote the rest required for the migraine to subside more quickly. (Pham Book, pages 374 – 377)