A nurse is caring for a client who has a contusion of the brainstem and reports thirst. The client's urinary output was 4,000 mL over the past 24 hours. The nurse should anticipate a prescription for which of the following intravenous (IV) medications?

Epinephrine

Furosemide

Nitroprusside

Desmopressin

Answer and Explanation

The Correct Answer is D

Choice A reason: Epinephrine is primarily used in emergency situations for its vasoconstrictive and bronchodilatory effects, particularly in cases of anaphylaxis or cardiac arrest. It is not typically used to manage symptoms associated with brainstem contusions or to regulate urinary output.

Choice B reason: Furosemide is a loop diuretic commonly prescribed to reduce fluid retention in conditions such as heart failure or renal disease. Given that the client has already produced a large volume of urine (4,000 mL in 24 hours, which is above the normal range of 800 to 2,000 milliliters per day), administering furosemide would not be appropriate as it would likely exacerbate the excessive urinary output.

Choice C reason: Nitroprusside is a potent vasodilator used to treat acute hypertensive crises. It has no role in the management of thirst or regulation of urinary output and is not indicated for the treatment of brainstem contusions.

Choice D reason: Desmopressin is a synthetic analogue of the naturally occurring antidiuretic hormone vasopressin. It is used to treat conditions characterized by excessive urination, such as diabetes insipidus, and to manage polyuria and polydipsia (excessive thirst) following head trauma or surgery in the pituitary region. In the context of a brainstem contusion with a reported high urinary output, desmopressin would be the appropriate medication to prescribe to reduce urine volume and address the client's thirst.

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Correct Answer is B

Explanation

Choice A reason : Desmopressin is a medication used to treat conditions like diabetes insipidus and certain cases of hemophilia, not allergic reactions such as hives and urticaria.

Choice B reason: Diphenhydramine is an antihistamine that is commonly used to treat allergic reactions, including hives and urticaria. It works by blocking the action of histamine, a substance in the body that causes allergic symptoms.

Choice C reason: Spironolactone is a diuretic and is not used to treat allergic reactions. It is typically prescribed for conditions like heart failure, hypertension, and certain hormonal disorders.

Choice D reason: Metoclopramide is a medication used to treat nausea and gastroparesis, not allergic reactions.

A. A client who has diabetes mellitus and is presenting with acute ketoacidosis. B. An older adult client who was admitted with aspiration pneumonia. C. A client who has a compound fracture of the right femur. D. A client who reports having fever, night sweats, and cough for 2 days.

Correct Answer is D

Explanation

Choice A reason: A client with diabetes mellitus presenting with acute ketoacidosis does not necessarily require a private room unless there are other infection control concerns. Acute ketoacidosis is a metabolic complication of diabetes that can be managed in a general ward setting with appropriate medical care and monitoring.

Choice B reason: An older adult client admitted with aspiration pneumonia would benefit from a private room if the pneumonia is caused by an infectious agent that requires droplet or airborne precautions. However, aspiration pneumonia is often a result of inhaling food, stomach acid, or saliva into the lungs, and not always infectious.

Choice C reason: A client with a compound fracture of the right femur would require a private room if there is an associated risk of infection due to the open nature of the injury. However, standard precautions and wound care can often be managed in a semi-private or general ward setting unless there are specific infection control issues.

Choice D reason: A client reporting fever, night sweats, and cough for 2 days may be exhibiting symptoms of a communicable disease such as tuberculosis. This client would require a private room with airborne precautions to prevent the spread of infection to other patients and healthcare workers.

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A nurse is caring for a client who has a contusion of the brainstem and reports thirst. The client's urinary output was 4,000 mL over the past 24 hours. The nurse should anticipate a prescription for which of the following intravenous (IV) medications?

Nursing Test Bank

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