a nurse is implementing a plan of care for a client who has a wound infection which of the following actions should the nurse perform first
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Nursing Elites

ATI RN

ATI Pharmacology Proctored Exam 2023 Quizlet

1. When caring for a client with a wound infection, which action should the nurse perform first in the plan of care?

Correct answer: B

Rationale: The priority action when caring for a client with a wound infection is to obtain a wound specimen for culture before initiating antibiotic therapy. This step is crucial to identify the specific microorganism causing the infection, allowing for targeted antibiotic treatment. Reviewing WBC laboratory findings and applying a wound dressing are important steps, but obtaining a wound specimen for culture takes precedence as it guides appropriate antibiotic therapy by identifying the causative organism.

2. A client has a new prescription for Digoxin. Which of the following instructions should the nurse include?

Correct answer: B

Rationale: When a client is prescribed Digoxin, it is essential to monitor their heart rate before each dose. Changes such as a heart rate below 60 bpm should be reported to the healthcare provider promptly. This is crucial because Digoxin can affect heart rhythm, and monitoring the heart rate helps in identifying any potential issues early on.

3. Which of the following is not a side effect of Sympathoplegics (Clonidine)?

Correct answer: A

Rationale: The correct answer is A. Clonidine, a Sympathoplegic, typically causes hypotension rather than hypertension. The other side effects associated with Clonidine include dry oral cavity, lethargic behavior, and difficulty breathing, making them incorrect choices in this context.

4. What is the antidote for Heparin?

Correct answer: A

Rationale: The correct answer is A: Protamine sulfate. Heparin is an anticoagulant medication used to prevent blood clots. In cases of overdose or excessive bleeding due to Heparin, protamine sulfate is administered as the specific antidote. Protamine sulfate works by neutralizing Heparin's anticoagulant activity. Choices B, C, and D are incorrect. Narcan (Naloxone) is used to reverse opioid overdose, Romazicon (Flumazenil) is used to reverse benzodiazepine overdose, and Naloxone is also used to reverse opioid overdose but is not the antidote for Heparin.

5. A client with end-stage cancer receiving Morphine has been prescribed Methylnaltrexone. The client's daughter asks about the purpose of Methylnaltrexone. Which response should the nurse provide?

Correct answer: C

Rationale: Methylnaltrexone is an opioid antagonist used to treat severe constipation unresponsive to laxatives in opioid-dependent clients. It functions by blocking the mu opioid receptors in the gastrointestinal tract, helping alleviate constipation associated with opioid use. Choices A, B, and D are incorrect. Methylnaltrexone does not increase respirations, prevent dependence on Morphine, or work with Morphine to increase pain relief; its primary purpose is to relieve opioid-induced constipation.

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