a nurse is caring for a client who is receiving morphine iv for pain management which of the following actions should the nurse take
Logo

Nursing Elites

ATI RN

ATI Pharmacology Proctored Exam 2023 Quizlet

1. A client is receiving Morphine IV for pain management. Which of the following actions should the nurse take?

Correct answer: A

Rationale: The correct action for the nurse is to monitor the client's respiratory rate every 15 minutes while on Morphine IV to promptly detect respiratory depression, a critical adverse effect associated with this medication. Respiratory depression is a common side effect of opioid medications like Morphine and can be life-threatening. Monitoring the respiratory rate frequently enables the nurse to identify early signs of respiratory compromise and intervene promptly. Monitoring other vital signs like blood pressure, oxygen saturation, or heart rate is important but not as crucial as monitoring respiratory rate when a client is on Morphine IV.

2. 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.

3. During an admission assessment for a client with severe Aspirin toxicity, which finding should the nurse expect?

Correct answer: D

Rationale: In severe Aspirin toxicity, respiratory depression is an anticipated finding due to the development of respiratory acidosis. Aspirin toxicity can lead to metabolic acidosis, causing the individual to hyperventilate initially to compensate. However, as the condition progresses, respiratory depression can occur, resulting in impaired gas exchange and respiratory acidosis.

4. A nurse is providing teaching for a male client who has Schizophrenia and is taking Risperidone. Which of the following instructions should the nurse include in the teaching?

Correct answer: B

Rationale: The correct answer is B: 'Notify the provider if you develop breast enlargement.' Gynecomastia (breast enlargement) and galactorrhea can occur due to an increase in prolactin levels while taking risperidone. The client should inform the provider if these manifestations occur. Choices A, C, and D are incorrect. Adding extra snacks to the diet to prevent weight loss is not a specific instruction related to risperidone. Seizures are not a common side effect of risperidone, so the statement about mild seizures is inaccurate. Risperidone is more likely to cause sexual side effects like erectile dysfunction rather than increasing libido, making choice D incorrect.

5. A client with Angina Pectoris asks the nurse about the next step if they take one tablet, wait 5 minutes, but still have Anginal pain. Which response should the nurse provide?

Correct answer: B

Rationale: If anginal pain persists after taking the first tablet and waiting 5 minutes, the priority step is to call emergency services (911) and then take a second sublingual tablet. Persistent pain could indicate a myocardial infarction, and immediate medical attention is crucial. Taking two more tablets at the same time (Choice A) can lead to excessive vasodilation and hypotension. Taking a sustained-release nitroglycerin capsule (Choice C) is not appropriate for immediate relief during an acute episode. Waiting another 5 minutes and then taking a second tablet (Choice D) is not advisable in this emergency situation where prompt action is necessary.

Similar Questions

A healthcare professional in a provider's office is reviewing the medical record of a client who is pregnant and is at her first prenatal visit. Which of the following immunizations may the healthcare professional administer safely to this client?
A client receiving chemotherapy with Methotrexate asks why Leucovorin is being given. Which of the following responses should the nurse use?
A client is receiving treatment with capecitabine. Which of the following findings should the nurse monitor?
A client has a new prescription for Calcitonin-salmon for Osteoporosis. Which of the following tests should the nurse tell the client to expect before beginning this medication?
A healthcare professional is teaching a client who has a new prescription for Clopidogrel. Which of the following laboratory values should the healthcare professional monitor to assess for potential adverse effects?

Access More Features

ATI RN Basic
$69.99/ 30 days

  • 5,000 Questions with answers
  • All ATI courses Coverage
  • 30 days access

ATI RN Premium
$149.99/ 90 days

  • 5,000 Questions with answers
  • All ATI courses Coverage
  • 30 days access

Other Courses