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 B
Explanation
The correct answer is: B. Determine the acuity and number of casualties arriving at the facility.
Choice A rationale: Assisting in discharging stable clients to home is important but not the primary focus during the immediate response to a mass casualty event.
Choice B rationale: Determining the acuity and number of casualties arriving at the facility is crucial in a mass casualty event. This involves assessing the severity of injuries and prioritizing care based on urgency, ensuring that the most critical patients receive immediate attention.
Choice C rationale: Delegating tasks to emergency health care specialists is typically the responsibility of team leaders or incident command staff, not the medical-surgical unit nurses.
Choice D rationale: Providing informational updates to members of the media is generally managed by hospital administration or public relations staff, not by medical-surgical nurses.
Correct Answer is A
Explanation
Choice A rationale:
"This medication can increase your risk for sunburn." Ciprofloxacin, a fluoroquinolone antibiotic, can increase the risk of sunburn and photosensitivity reactions. Patients taking this medication should be advised to use sunscreen, wear protective clothing, and avoid excessive sun exposure to prevent sunburn.
Choice B rationale:
"Take an antacid if the medication causes gastrointestinal upset." Ciprofloxacin should not be taken with antacids or other products containing calcium, magnesium, aluminum, or iron, as these can interfere with its absorption. Therefore, advising the patient to take an antacid with ciprofloxacin is incorrect.
Choice C rationale:
"Restrict your daily fluid intake while taking this medication." There is no need to restrict fluid intake while taking ciprofloxacin. In fact, it is important for patients to stay well-hydrated to prevent potential side effects like crystalluria. Adequate fluid intake helps dilute the urine and reduce the risk of crystal formation.
Choice D rationale:
"Expect to experience diarrhea while taking this medication." Diarrhea can be a side effect of ciprofloxacin, but it is not something patients should necessarily expect. While gastrointestinal upset is a known side effect, not everyone who takes the medication will experience diarrhea. Patients should be advised to report any severe or persistent diarrhea to their healthcare provider.
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