Nursing Elites

1. A client diagnosed with a herniated disc is prescribed hydrocodone/acetaminophen 10 mg/300 mg prn every 4 to 6 hours. As the practical nurse (PN) enters the client's room to administer the requested medication, the client is seen talking and laughing with visiting family. What action should the PN take?

• A. Hold the pain medication until after the visitors leave.
• B. Notify the healthcare provider of the client's drug-seeking behavior.
• C. Administer analgesia as requested by the client.
• D. Inform the client that the medication is not needed based on their behavior.

Correct answer: C

Rationale: The correct action for the PN in this situation is to administer the analgesia as requested by the client. Pain management is based on the client's self-report of pain, which is the most reliable indicator of pain intensity. Analgesics should be given promptly when pain occurs and before it worsens. Following the administration of medication, the PN should discuss the situation with the charge nurse for further guidance or assessment.

2. The healthcare provider has administered albuterol as an inhaled medication. The healthcare provider should monitor the client for which possible adverse reaction?

• A. Enuresis
• B. Lethargy
• C. Depression
• D. Tachycardia

Correct answer: D

Rationale: Albuterol is a bronchodilator in the adrenergic category. Its actions and adverse effects are similar to adrenaline or epinephrine. The healthcare provider should monitor the client for tachycardia, which is a common adverse effect of albuterol due to its stimulant effect on beta-2 receptors. Enuresis, or night bed-wetting, is not an adverse effect associated with albuterol. Additionally, the client should be monitored for anxiety as a potential adverse effect, not lethargy or depression, which are not typically associated with albuterol administration.

3. Which assessment finding requires nursing intervention prior to the administration of medication?

• A. Apical pulse heard best at the pulmonic site
• B. Irregular apical pulse rhythm
• C. Presence of a systolic heart murmur
• D. Apical pulse rate of 50 beats/minute

Correct answer: D

Rationale: An apical pulse rate of 50 beats/minute indicates bradycardia, a heart rate below the normal range, which requires immediate nursing intervention before administering medication to address the potential impact of the bradycardia on the patient's overall condition.

4. A client with an exacerbation of asthma is prescribed albuterol. The nurse should assess the client for which common side effect of this medication?

• A. Tremors
• B. Nausea and vomiting
• C. Insomnia
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Tremors. Albuterol, a beta-agonist medication commonly used to treat asthma exacerbations, can lead to tremors as a side effect. Tremors result from the stimulation of beta-2 receptors in muscles, particularly in the hands. Nausea and vomiting (Choice B) are generally not common side effects of albuterol. Insomnia (Choice C) is less likely to occur with albuterol, as it is a stimulant and can cause alertness rather than sleep disturbances. Dry mouth (Choice D) is not a typical side effect associated with albuterol use.

5. A client with severe depression is prescribed sertraline. Which statement by the client indicates the need for further teaching?

• A. I can stop taking this medication once I feel better.
• B. It may take 1 to 4 weeks to notice improvement in symptoms.
• C. I should avoid alcohol while taking this medication.
• D. I should take this medication in the morning with food.

Correct answer: A

Rationale: The correct answer is A. Clients should not stop taking sertraline abruptly once they feel better without consulting their healthcare provider. It is important to complete the full course of treatment as prescribed to prevent a relapse of symptoms. Stopping the medication suddenly can lead to withdrawal symptoms and may worsen the condition. Choice B is correct because sertraline may take 1 to 4 weeks to show noticeable improvement in symptoms. Choice C is correct as alcohol should be avoided while taking sertraline due to the increased risk of side effects. Choice D is also correct as taking sertraline in the morning with food can help reduce gastrointestinal side effects.

Similar Questions