A nurse is assessing a client 15 minutes after administering morphine sulfate 2 mg via IV push. The nurse should identify which of the following findings as an adverse effect of the medication?

Sleepy, but arousing when her name is called.

Respiratory rate 8/min.

Pain level of 6 on a scale from 0 to 10.

Answer and Explanation

The Correct Answer is B

Choice A reason:

Being sleepy but arousing when her name is called is a common side effect of morphine, which is a potent opioid analgesic. Morphine can cause drowsiness and sedation, but this is not necessarily an adverse effect unless it progresses to a state where the patient cannot be easily aroused. Therefore, while this is a side effect, it is not as concerning as respiratory depression.

Choice B reason:

A respiratory rate of 8/min is an adverse effect of morphine. Opioids like morphine can depress the respiratory center in the brain, leading to a decreased respiratory rate. Normal respiratory rates for adults are typically between 12 and 20 breaths per minute. A rate of 8 breaths per minute indicates significant respiratory depression, which can be life-threatening and requires immediate intervention.

Choice C reason:

A pain level of 6 on a scale from 0 to 10 indicates that the morphine has not fully alleviated the client’s pain. While this is important to address, it is not an adverse effect of the medication. The primary concern with morphine administration is monitoring for serious side effects like respiratory depression.

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Correct Answer is A

Explanation

Choice A reason:

The statement “Provide bedtime rituals” is correct. Establishing a consistent bedtime routine can help toddlers feel more secure and relaxed, which can promote better sleep. Bedtime rituals might include reading a story, singing a lullaby, or having a warm bath before bed. These activities signal to the child that it is time to wind down and prepare for sleep.

Choice B reason:

The statement “Encourage play exercises in the evening” is incorrect. While physical activity is important for overall health, engaging in stimulating play exercises right before bedtime can make it harder for toddlers to settle down and fall asleep. It is better to encourage quiet, calming activities in the evening.

Choice C reason:

The statement “Explain the source of the toddler’s fears” is not the most effective approach for promoting sleep. While addressing fears is important, the explanation alone may not be sufficient to help the toddler feel secure enough to sleep. Providing comfort and reassurance through bedtime rituals is more effective in creating a sense of safety.

Choice D reason:

The statement “Turn off the room light” is partially correct but not the best standalone solution. While a dark environment can promote sleep, some toddlers may feel more secure with a nightlight. The focus should be on creating a calming and comfortable sleep environment, which includes but is not limited to adjusting the lighting.

A. Intention tremors B. Purple striations C. Hirsutism D. Hyperpigmentation

Correct Answer is D

Explanation

Choice A reason: Intention tremors are not typically associated with Addison’s disease. Intention tremors are more commonly seen in conditions affecting the cerebellum, such as multiple sclerosis or cerebellar ataxia.

Choice B reason: Purple striations (striae) are more commonly associated with Cushing’s syndrome, which is characterized by excessive cortisol levels. Addison’s disease, on the other hand, involves insufficient cortisol production.

Choice C reason: Hirsutism refers to excessive hair growth in women in areas where hair is normally minimal or absent. This condition is more commonly associated with polycystic ovary syndrome (PCOS) or other endocrine disorders, not Addison’s disease.

Choice D reason: Hyperpigmentation is a hallmark sign of Addison’s disease. It occurs due to increased production of melanocyte-stimulating hormone (MSH) as a byproduct of elevated adrenocorticotropic hormone (ACTH) levels. This leads to darkening of the skin, especially in areas exposed to friction, such as the elbows, knees, knuckles, and scars.

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A nurse is assessing a client 15 minutes after administering morphine sulfate 2 mg via IV push. The nurse should identify which of the following findings as an adverse effect of the medication?

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