Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is caring for a client who has breast cancer and reports pain 1 hr after administration of prescribed morphine 10 mg IV.
Which of the following medications should the nurse expect to administer?
A. Fentanyl transmucosal.
This is because fentanyl transmucosal is a fast-acting opioid that can be used for breakthrough pain in patients who are already receiving opioids for chronic pain. Breakthrough pain is a sudden and severe increase in pain that occurs despite the use of regular pain medication. Fentanyl transmucosal has a rapid onset of action (1-3 minutes) and a short duration of effect (1-2 hours), which makes it suitable for treating episodic pain.
B. Lidocaine patch.
Choice B. Lidocaine patch is wrong because lidocaine patch is a topical anesthetic that can be used for localized neuropathic pain, but not for acute or severe pain.
C. Morphine tablet.
Choice C. Morphine tablet is wrong because morphine tablet is a long-acting opioid that can be used for chronic pain, but not for breakthrough pain. Morphine tablet has a slow onset of action (30-60 minutes) and a long duration of effect (3-4 hours), which makes it unsuitable for treating episodic pain.
D. Naloxone IV.
Choice D. Naloxone IV is wrong because naloxone IV is an opioid antagonist that can reverse the effects of opioids, but not relieve pain. Naloxone IV can cause acute withdrawal symptoms in patients who are dependent on opioids.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Pharmacology 2019 Proctored Exam. Take the full exam now
Full Explanation
This is because fentanyl transmucosal is a fast-acting opioid that can be used for breakthrough pain in patients who are already receiving opioids for chronic pain. Breakthrough pain is a sudden and severe increase in pain that occurs despite the use of regular pain medication. Fentanyl transmucosal has a rapid onset of action (1-3 minutes) and a short duration of effect (1-2 hours), which makes it suitable for treating episodic pain.
Choice B. Lidocaine patch is wrong because lidocaine patch is a topical anesthetic that can be used for localized neuropathic pain, but not for acute or severe pain.
Choice C. Morphine tablet is wrong because morphine tablet is a long-acting opioid that can be used for chronic pain, but not for breakthrough pain. Morphine tablet has a slow onset of action (30-60 minutes) and a long duration of effect (3-4 hours), which makes it unsuitable for treating episodic pain.
Choice D. Naloxone IV is wrong because naloxone IV is an opioid antagonist that can reverse the effects of opioids, but not relieve pain.
Naloxone IV can cause
Similar Questions
A nurse accidentally administers the medication metformin instead of metoprolol to a client.
Which of the following actions should the nurse take?
A. Obtain the client’s HDL level.
Choice A is wrong because HDL (high-density lipoprotein) is a type of cholesterol that is not affected by metformin or metoprolol.
B. Monitor the client’s thyroid function levels.
Choice B is wrong because thyroid function levels are not affected by metformin or metoprolol.
C. Collect the client’s uric acid level.
Choice C is wrong because uric acid level is not affected by metformin or metoprolol. Uric acid is a waste product that can cause gout if it accumulates in the joints. Normal ranges for blood glucose are 70 to 130 mg/dL before meals and less than 180 mg/dL two hours after meals. Normal ranges for HDL are 40 to 60 mg/dL for men and 50 to 60 mg/dL for women. Normal ranges for thyroid function levels vary depending on the specific test, but generally they are between 0.4 and 4.0 mIU/L for TSH (thyroid-stimulating hormone), 4.5 to 11.2 mcg/dL for T4 (thyroxine), and 80 to 180 ng/dL for T3 (triiodothyronine). Normal ranges for uric acid are 3.4 to 7.0 mg/dL for men and 2.4 to 6.0 mg/dL for women.
D. Check the client’s glucose level.
Metformin is a medication used to lower blood glucose levels in people with type 2 diabetes. Metoprolol is a beta-blocker used to treat high blood pressure and heart problems. If the nurse accidentally gives metformin instead of metoprolol, the client may experience hypoglycemia (low blood sugar), which can cause symptoms such as sweating, shakiness, confusion, and loss of consciousness. Therefore, the nurse should check the client’s glucose level and treat hypoglycemia if needed.
Full Explanation
Metformin is a medication used to lower blood glucose levels in people with type 2 diabetes. Metoprolol is a beta-blocker used to treat high blood pressure and heart problems. If the nurse accidentally gives metformin instead of metoprolol, the client may experience hypoglycemia (low blood sugar), which can cause symptoms such as sweating, shakiness, confusion, and loss of consciousness. Therefore, the nurse should check the client’s glucose level and treat hypoglycemia if needed.
Choice A is wrong because HDL (high-density lipoprotein) is a type of cholesterol that is not affected by metformin or metoprolol.
Choice B is wrong because thyroid function levels are not affected by metformin or metoprolol.
Choice C is wrong because uric acid level is not affected by metformin or metoprolol.
Uric acid is a waste product that can cause gout if it accumulates in the joints. Normal ranges for blood glucose are 70 to 130 mg/dL before meals and less than 180 mg/dL two hours after meals.
Normal ranges for HDL are 40 to 60 mg/dL for men and 50 to 60 mg/dL for women.
Normal ranges for thyroid function levels vary depending on the specific test, but generally they are between 0.4 and 4.0 mIU/L for TSH (thyroid-stimulating hormone), 4.5 to 11.2 mcg/dL for T4 (thyroxine), and 80 to 180 ng/dL for T3 (triiodothyronine).
Normal ranges for uric acid are 3.4 to 7.0 mg/dL for men and 2.4 to 6.0 mg/dL for women.
A nurse is providing teaching to a client who has a new prescription for theophylline, a sustained-release capsule.
Which of the following statements by the client indicates an understanding of the teaching?
A. “I may sprinkle the medication in applesauce.”.
Choice A is wrong because the client should not sprinkle the medication in applesauce or any other food. Theophylline is a sustained-release capsule that should be swallowed whole and not crushed or chewed.
B. “I can take my medication in the morning with my coffee.”.
Choice B is wrong because the client should avoid caffeine while on this medication, as it can increase the side effects of theophylline, such as nausea, vomiting, headache, and irregular heart rate.
C. “I should limit my fluid intake while on this medication.”.
Choice C is wrong because the client should not limit fluid intake while on this medication, unless instructed by the doctor. Fluid intake helps prevent dehydration and kidney problems that can affect theophylline levels in the blood.
D. “I will need to have blood levels drawn.”.
The client will need to have blood levels drawn to monitor the therapeutic and toxic levels of theophylline, a bronchodilator that is used to treat symptoms of asthma and other lung conditions. The normal range of theophylline in the blood is 10 to 20 mcg/mL.
Full Explanation
The client will need to have blood levels drawn to monitor the therapeutic and toxic levels of theophylline, a bronchodilator that is used to treat symptoms of asthma and other lung conditions. The normal range of theophylline in the blood is 10 to 20 mcg/mL.
Choice A is wrong because the client should not sprinkle the medication in applesauce or any other food. Theophylline is a sustained-release capsule that should be swallowed whole and not crushed or chewed.
Choice B is wrong because the client should avoid caffeine while on this medication, as it can increase the side effects of theophylline, such as nausea, vomiting, headache, and irregular heart rate.
Choice C is wrong because the client should not limit fluid intake while on this medication unless instructed by the doctor.
Fluid intake helps prevent dehydration and kidney problems that can affect theophylline levels in the blood.
A nurse is caring for a client who is taking lithium and reports starting a new exercise program.
The nurse should assess the client for which of the following electrolyte imbalances?
A. Hypomagnesemia.
Choice A is wrong because hypomagnesemia is not a common side effect of lithium or exercise.
B. Hypocalcemia.
Choice B is wrong because hypocalcemia is not a common side effect of lithium or exercise.
C. Hyponatremia.
Lithium can cause hyponatremia by increasing the secretion of antidiuretic hormone and reducing the renal clearance of sodium.
D. Hypokalemia.
Choice D is wrong because hypokalemia is not a common side effect of lithium or exercise. However, lithium can interact with some diuretics that can cause hypokalemia, so the client should avoid taking these drugs without consulting their doctor. Normal ranges for electrolytes are: Sodium: 135-145 mmol/L Magnesium: 0.7-1.1 mmol/L Calcium: 2.1-2.6 mmol/L Potassium: 3.5-5.0 mmol/L
Full Explanation
Lithium can cause hyponatremia by increasing the secretion of antidiuretic hormone and reducing the renal clearance of sodium.
Strenuous exercise can also cause hyponatremia by increasing sweat loss and fluid intake. Therefore, a client who is taking lithium and starting a new exercise program is at risk of developing hyponatremia.
Choice A is wrong because hypomagnesemia is not a common side effect of lithium or exercise.
Choice B is wrong because hypocalcemia is not a common side effect of lithium or exercise.
Choice D is wrong because hypokalemia is not a common side effect of lithium or exercise.
However, lithium can interact with some diuretics that can cause hypokalemia, so the client should avoid taking these drugs without consulting their doctor. Normal ranges for electrolytes are:
Sodium: 135-145 mmol/L
Magnesium: 0.7-1.1 mmol/L
Calcium: 2.1-2.6 mmol/L
Potassium: 3.5-5.0 mmol/L