A nurse is administering naloxone to a client who has developed an adverse reaction to morphine.
The nurse should identify which of the following findings is a therapeutic effect of naloxone?

Decreased blood pressure.

Decreased nausea.

Increased respiratory rate.

Increased pain relief.

Answer and Explanation

The Correct Answer is C

A therapeutic effect of naloxone is the reversal of opioid-induced respiratory depression, which is one of the most dangerous complications of opioid overdose. Naloxone works by binding to opioid receptors, displacing opioids, and restoring normal respiratory drive. An increase in respiratory rate after administration indicates that naloxone is effective.

Choice A is wrong because decreased blood pressure is not a therapeutic effect of naloxone.

In fact, naloxone can cause hypertension (high blood pressure) as a side effect due to opioid withdrawal.

Choice B is wrong because decreased nausea is not a therapeutic effect of naloxone. Nausea is a common side effect of morphine, but naloxone does not affect it directly.

Naloxone can actually cause nausea and vomiting as a side effect due to opioid withdrawal.

Choice D is wrong because increased pain relief is not a therapeutic effect of naloxone.

Pain relief is a desired effect of morphine, but naloxone antagonizes it by blocking the opioid receptors.

Naloxone can cause pain and discomfort as a side effect due to opioid withdrawal.

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Correct Answer is D

Explanation

The most appropriate action for the nurse to take in this situation is:

d. Apply a warm, moist compress.

Here's why the other options are not recommended:

a. Initiate a new IV distal to the initial site:This is not the first course of action. While starting a new IV might be necessary eventually, it's crucial to address the issue at the current site first.
b. Slow the IV solution rate:Slowing the rate doesn't directly address the coolness and edema, which indicate potential infiltration or extravasation.
c. Maintain the extremity below the level of the heart:This action would actually worsen the edema by promoting fluid accumulation at the site.

Applying a warm, moist compress can help promote absorption of any leaked fluid and improve circulation at the site. However, it's important to remember that this is just one step in the process. The nurse should also:

Stop the IV infusion.
Assess the extent of the infiltration or extravasation.
Document the findings.
Elevate the affected extremity.
Consult with a physician for further instructions and potential treatment.

A. A client who has a referral for social services. B. A client who is transported to radiology. C. A client who is transferred to a step-down unit. D. A client who has a consultation for physical therapy.

Correct Answer is C

Explanation

Medication reconciliation is the process of creating the most accurate list possible of all medications a client is taking and comparing that list against the physician’s orders at every transition of care. A client who is transferred to a step-down unit is at risk of medication errors due to changes in the level of care and the prescribing providers. Therefore, medication reconciliation should be performed for this client to prevent adverse drug events.

Choice A is wrong because a referral for social services does not involve a change in the client’s medications or care setting.

Choice B is wrong because transport to radiology is a temporary and short-term movement that does not require medication reconciliation.

Choice D is wrong because a consultation for physical therapy does not affect the client’s medication regimen or orders.

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A nurse is administering naloxone to a client who has developed an adverse reaction to morphine. The nurse should identify which of the following findings is a therapeutic effect of naloxone?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client’s IV infusion site and notes that the site is cool and edematous. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is teaching a newly licensed nurse about medication reconciliation. The nurse should instruct the newly licensed nurse to perform medication reconciliation for which of the following clients?

Correct Answer is C

Explanation

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A nurse is administering naloxone to a client who has developed an adverse reaction to morphine.
The nurse should identify which of the following findings is a therapeutic effect of naloxone?