A client taking paroxetine (Paxil) presents to the emergency room with agitation, increased sweating, and new auditory hallucinations.
What is the priority action?
Ask if the patient has started any new prescription or over-the-counter medications.
Administer an anti-anxiety medication to subdue and sedate the patient.
Place the patient in loose bilateral arm restraints.
Tell the patient that the voices they are hearing are not real.
The Correct Answer is A
This is because the patient may be experiencing serotonin toxicity, a potentially life- threatening condition caused by excessive levels of serotonin in the brain. Paroxetine (Paxil) is a selective serotonin reuptake inhibitor (SSRI) that increases serotonin levels, and some other medications or supplements may interact with it and cause serotonin toxicity. Some of the symptoms of serotonin toxicity include agitation, increased sweating, and hallucinations.
Choice B is wrong because administering an anti-anxiety medication may worsen serotonin toxicity, especially if the medication is also an SSRI or another serotonergic agent.
Choice C is wrong because placing the patient in loose bilateral arm restraints may increase the risk of injury or agitation, and does not address the underlying cause of the symptoms.
Choice D is wrong because telling the patient that the voices they are hearing are not real may not be helpful or reassuring, and may also increase the patient’s distress or confusion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Irrigating the tube with 30 mL of sterile saline as needed. This prescription should be questioned by the nurse because it may cause trauma to the kidney or dislodge the tube. The nurse should only irrigate the tube if ordered by the health care provider and with a smaller amount of fluid.
Choice A is wrong because monitoring the urine’s color and odor is an appropriate intervention for a client with a nephrostomy tube. The urine may be bloody or cloudy initially, but it should gradually clear.
Choice B is wrong because recording the intake and output every eight hours is also an appropriate intervention for a client with a nephrostomy tube. The nurse should measure and document the amount and characteristics of urine drainage and report any changes or abnormalities.
Choice D is wrong because measuring the vital signs every four hours during the day is a reasonable prescription for a client with a nephrostomy tube. The nurse should monitor the client for signs of infection, bleeding, or obstruction.
Correct Answer is B
Explanation
0.8.
To find the answer, you need to use the formula: Dose ordered / Dose available = Volume to administer
In this case, the dose ordered is 250,000 units and the dose available is 300,000 units/mL. So, you need to divide 250,000 by 300,000 and get 0.8333.
Then, you need to round it to one decimal place and get 0.8 mL. Choice A is wrong because it is too low.
If you administer 0.4 mL, you will give only 120,000 units of penicillin G benzathine, which is half of the prescribed dose.
Choice C is wrong because it is too high.
If you administer 1.2 mL, you will give 360,000 units of penicillin G benzathine, which is 44% more than the prescribed dose.
Choice D is wrong because it is also too high.
If you administer 1.6 mL, you will give 480,000 units of penicillin G benzathine, which is almost double the prescribed dose.
The normal range for penicillin G benzathine dosage depends on the type and severity of infection, but it is usually between 50,000 and 2.4 million units per injection.
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