A 78-year-old patient is in the recovery room after having a lengthy surgery on his hip. As he is gradually awakening, he requests pain medication. Within 10 minutes after receiving a dose of morphine sulfate, he is very lethargic and his respirations are shallow, with a rate of 7 breaths/minute. The nurse prepares for which priority action at this time?

Assessment of the patient's pain level

Close observation of signs of opioid tolerance

Immediate intubation and artificial ventilation

Administration of naloxone

Answer and Explanation

The Correct Answer is D

A.   Assessment of the patient's pain level: While pain assessment is important, the patient's lethargy and shallow respirations indicate a potential opioid overdose, which takes priority.
B.   Close observation of signs of opioid tolerance: The patient's symptoms are indicative of opioid overdose, not tolerance.
C.   Immediate intubation and artificial ventilation: While respiratory support may eventually be necessary if the patient's condition deteriorates further, administering naloxone to reverse the opioid effects is the initial priority.
D.   Administration of naloxone: Naloxone is an opioid antagonist used to reverse opioid overdose by blocking opioid receptors, which can rapidly restore normal respiratory function and
consciousness in patients experiencing opioid-induced respiratory depression.

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Correct Answer is D

Explanation

A. Fever: Fever is not a common adverse effect of haloperidol.

B. Intractable hiccups: While hiccups can occur as a side effect of some medications, they are not a commonly reported adverse effect of haloperidol.
C. Excessive salivation: Excessive salivation is not a typical adverse effect of haloperidol.

D. Extrapyramidal symptoms: Haloperidol, as a first-generation antipsychotic, is known to cause extrapyramidal symptoms such as dystonia, akathisia, parkinsonism, and tardive dyskinesia. Monitoring for these adverse effects is essential during treatment with haloperidol.

A. (Select All that Apply.) B. Attention deficit hyperactivity disorder (ADHD) C. Panic attacks D. Narcolepsy E. Neonatal apnea

Correct Answer is ["A","C","E"]

Explanation

A. Attention deficit hyperactivity disorder (ADHD) - Correct. CNS stimulants like

methylphenidate and amphetamine derivatives are commonly used to treat ADHD by improving attention, focus, and impulse control.

B. Panic attacks - Incorrect. CNS stimulants are not typically used to treat panic attacks.

Medications such as benzodiazepines or selective serotonin reuptake inhibitors (SSRIs) are more commonly used for panic disorder.

C. Narcolepsy - Correct. CNS stimulants are used to treat narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and sudden attacks of sleep.

D. Neonatal apnea - Incorrect. CNS stimulants are not indicated for neonatal apnea.

Management of neonatal apnea usually involves supportive measures, respiratory support, and caffeine citrate as a respiratory stimulant.

E. Obesity - Correct. CNS stimulants like phentermine are sometimes used as adjuncts to diet and exercise for short-term management of obesity

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has schizophrenia and is taking haloperidol. The nurse should monitor for which of the following adverse effects of haloperidol?

Correct Answer is D

Explanation

The nurse is reviewing the use of central nervous system stimulants. Which of these are indications for this class of drugs? (Select all that apply.)

Correct Answer is ["A","C","E"]

Explanation

A patient has been taking donepezil for 2 weeks as part of the treatment for early stages of Alzheimer's disease. Her daughter calls the prescriber's office and is upset because "Mother has not improved one bit!" Which response by the nurse is appropriate?

A patient in a rehabilitation center is beginning to experience opioid withdrawal symptoms. The nurse expects to administer which drug as part of the treatment?

The nurse has given medication instructions to a patient receiving phenytoin. Which statement by the patient indicates that the patient has an adequate understanding of the instructions?

A patient has been given a prescription for levodopa-carbidopa for a new diagnosis of Parkinson's disease. The patient asks the nurse, "Why are there two drugs in this pill?" The nurse's best response reflects which fact?

A patient has had an overdose of an intravenous cholinergic drug. The nurse expects to administer which drug as an antidote?

A nurse is preparing to administer amantadine 150 mg PO every 12 hr. Available is amantadine 50 mg/5 mL syrup. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Before administering a client's prescribed nonselective adrenergic blocker, what should the nurse assess?

The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor (MAOI). Which food choice would indicate the need for additional teaching?