A client experiencing an acute dystonic reaction presents with a laryngeal spasm. Which treatment should the nurse prepare?

Intravenous administration of benztropine.

Oral administration of divalproex.

Intravenous administration of isotonic crystalloid fluid.

Oral administration of lorazepam.

Answer and Explanation

The Correct Answer is A

A)   Correct - Acute dystonic reactions are involuntary muscle spasms caused by certain medications, including antipsychotic drugs. These reactions can sometimes affect the muscles of the face and neck, including the larynx. Benztropine is an anticholinergic medication commonly used to treat acute dystonic reactions. It works by blocking certain neurotransmitters that contribute to muscle spasms, helping to relieve the symptoms.

B)   Incorrect - Divalproex is an anticonvulsant medication primarily used to treat epilepsy and bipolar disorder. It is not the appropriate treatment for acute dystonic reactions. These reactions are usually caused by certain antipsychotic medications and are characterized by sudden and involuntary muscle contractions. Divalproex does not have the specific mechanism of action needed to alleviate the symptoms of acute dystonic reactions.
C)   Incorrect - Isotonic crystalloid fluids are used for various purposes, such as fluid resuscitation, maintaining hydration, and balancing electrolytes. However, they are not a treatment for acute dystonic reactions. These reactions are neurological and musculoskeletal in nature and require medications with specific anticholinergic properties, like benztropine, to address the underlying issue.
D)   Incorrect - Lorazepam is a benzodiazepine commonly used for anxiety, sedation, and seizure control. While it can have a relaxing effect on muscles, it is not the first-line treatment for acute dystonic reactions. Anticholinergic medications like benztropine are more appropriate because they directly counteract the neurotransmitter imbalances that lead to muscle spasms in these reactions.

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Correct Answer is ["B","C","D"]

Explanation

Client's pain rating on a scale of 1 to 10: This information helps assess the client's current pain level and determine the need for pain medication.

Time of the last administration of pain medication: This is important to avoid overdosing or administering pain medication too frequently. It helps ensure that pain medication is given at the appropriate time intervals.

Effectiveness of the last pain medication administered: Understanding whether the previous dose provided relief or not helps guide the choice of the next medication or dosage.

The other options are not directly related to the immediate decision of administering pain medication:

Height and weight of the client prior to admission may be part of the client's medical history but are not typically required information just before administering pain medication.

A history of pain medication use during the past year is important information but may be already documented in the client's medical records and not necessary to obtain immediately before administration.

A. A primigravida whose perineal pain has worsened one hour after being medicated. B. A multigravida whose peri-pad is 1/4 saturated with lochia rubra after one hour. C. A multigravida complaining of strong afterbirth pains when breastfeeding. D. A primigravida who passed a small clot when she sat up on the edge of the bed.

Correct Answer is A

Explanation

This client should be reassessed by the RN prior to transfer, as worsening perineal pain may indicate a hematoma, infection, or inadequate pain management. The RN should inspect the perineum, check the vital signs, and evaluate the eﬀectiveness of the medication.

The other options are not correct because:

B. A multigravida whose peri-pad is 1/4 saturated with lochia rubra after one hour does not need to be reassessed by the RN, as this is a normal finding for a client two hours post-birth. Lochia rubra is a red-colored vaginal discharge that contains blood and debris from the placental site, and it usually lasts for 3 to 4 days after delivery. A peri-pad that is 1/4 saturated after one hour is within the expected range of blood loss.

C. A multigravida complaining of strong afterbirth pains when breastfeeding does not need to be reassessed by the RN, as this is a normal finding for a client two hours post-birth. Afterbirth pains are cramps caused by uterine contractions that help shrink the uterus and prevent bleeding. They are more common and intense in multiparous women and during breastfeeding, as oxytocin is released and stimulates contractions.

D. A primigravida who passed a small clot when she sat up on the edge of the bed does not need to be reassessed by the RN, as this is a normal finding for a client two hours post-birth. Small clots may form in the uterus or vagina due to pooling of blood during rest or anesthesia, and they are usually expelled when changing position or ambulating. As long as the clot is smaller than a plum and there is no excessive bleeding or pain, it is not a cause for concern.

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A client experiencing an acute dystonic reaction presents with a laryngeal spasm. Which treatment should the nurse prepare?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Prior to administering pain medication to an adult postoperative client, what information should the practical nurse (PN) obtain? (Select all that apply.)

Correct Answer is ["B","C","D"]

Explanation

After completing post anesthesia recovery assessments, the registered nurse (RN) asks the practical nurse (PN) to transfer four clients, each two hours post-birth, to the postpartum unit. Which client should the PN ask the RN to reassess prior to transfer?

Correct Answer is A

Explanation

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Before administering an antibiotic that can cause nephrotoxicity, which laboratory value is most important for the practical nurse (PN) to review?

A client is receiving mesalamine 800 mg by mouth three times a day. Which assessment should the nurse perform to assess the effectiveness of the medication?

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