A nurse is assisting with the care of a client.
The nurse is reinforcing teaching for the client and their family about potential adverse effects of the client's prescribed medications.
For each potential adverse effect, click to specify if the effect is. consistent with agranulocytosis, neuroleptic malignant syndrome, or. serotonin syndrome.
Each finding may support more than 1 disease process.
Sore throat
Disorientation
Blood pressure changes
Tachycardia
High fever
Agranulocytosis
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B,C"},"C":{"answers":"B,C"},"D":{"answers":"B,C"},"E":{"answers":"B,C"},"F":{"answers":"A"}}
Condition |
Definition |
Causes |
Symptoms |
Treatment |
Agranulocytosis |
A severe and potentially life-threatening reduction in the number of white blood cells (neutrophils) that fight infection. |
Can be caused by some antipsychotic medications, such as clozapine, olanzapine, and quetiapine. |
Sore throat, fever, chills, mouth ulcers, infections, bleeding, and fatigue. |
Discontinuation of the offending medication, antibiotics, antifungals, and granulocyte colony-stimulating factor (G-CSF) injections to stimulate the bone marrow to produce more white blood cells. |
Neuroleptic Malignant Syndrome (NMS) |
A rare but serious reaction to antipsychotic medications, especially the older ones, such as haloperidol, fluphenazine, and chlorpromazine. |
Can be triggered by high doses, rapid dose changes, or switching of antipsychotic medications. |
High fever, muscle rigidity, altered mental status, autonomic instability (blood pressure changes, tachycardia, sweating, etc.), and elevated creatine kinase levels. |
Discontinuation of the offending medication, supportive care, cooling measures, hydration, and medications such as dantrolene, bromocriptine, or amantadine to counteract the effects of dopamine blockade. |
Serotonin Syndrome |
A potentially life-threatening condition caused by excessive levels of serotonin in the brain. |
Can be caused by taking too much of a serotonin-enhancing medication, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), or other drugs that affect serotonin levels, such as tramadol, linezolid, or St. John’s wort. Can also be caused by combining two or more serotonin-enhancing medications. |
Agitation, confusion, disorientation, anxiety, hallucinations, muscle spasms, tremors, shivering, hyperreflexia, incoordination, diarrhea, nausea, vomiting, blood pressure changes, tachycardia, and hyperthermia. |
Discontinuation of the offending medication(s), supportive care, hydration, and medications such as benzodiazepines, cyproheptadine, or serotonin antagonists to reduce serotonin levels. |
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
The correct answers are C and D.
Choice A reason: Preferred bath time is a personal preference and comfort-related aspect of patient care. While it is important for overall patient satisfaction and care planning, it is not critical information for a change-of-shift report following a total knee arthroscopy. The focus in such reports is typically on clinical status, immediate care needs, and potential complications.
Choice B reason: Admission vital signs are the initial measurements taken upon the patient’s admission to the healthcare facility. These are baseline values that can be referenced later to note any significant changes. However, for a change-of-shift report, especially 2 days postoperative, the most current vital signs and any changes since surgery are more pertinent than the admission values.
Choice C reason: The time of the last pain medication is crucial information for a change-of-shift report. Pain management is a key aspect of postoperative care, particularly after procedures like total knee arthroscopy. Knowing when the last dose was administered helps the incoming nurse manage the patient’s pain effectively and anticipate when the next dose is due.
Choice D reason: The steps required for dressing change are essential to include in the change-of-shift report. Proper wound care and dressing changes are vital to prevent infection and ensure proper healing after surgery. Detailed instructions on the dressing change process help maintain consistency in care between different caregivers.
Correct Answer is B
Explanation
Choice A rationale:
Uncapped sharps being put in a puncture-resistant container (choice A) is a safe and appropriate practice for the disposal of sharp objects, such as needles. This choice demonstrates adherence to infection control principles and minimizes the risk of accidental needlestick injuries.
Choice B rationale:
Soiled linens being placed on the floor (choice B) is not a safe or acceptable practice. Placing soiled linens on the floor can lead to contamination of the environment and pose a risk of spreading infection. Proper linen disposal protocols should be followed, which may include using designated linen hampers or containers.
Choice C rationale:
Waste containers being lined with single bags (choice C) is a standard practice for waste disposal. Using single bags makes it easier to handle and dispose of waste materials safely. It is a recommended infection control measure.
Choice D rationale:
Dampened cloths being used for dusting the area (choice D) is generally a safe practice for cleaning and dusting surfaces. Dampened cloths can help prevent the spread of dust and allergens. However, it's essential to ensure that the cloths are cleaned and disinfected regularly to prevent bacterial growth.
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