A nurse is caring for a client who has a history of cardiac arrhythmias and is taking verapamil. For which of the following reasons should the nurse consult the pharmacist?

To assess compatibility of the verapamil with newly ordered medications

To request a change in the dosage of the verapamil

To verify the frequency of administration of the verapamil

To report the client's refusal to take the verapamil

Answer and Explanation

The Correct Answer is A

A.   To assess compatibility of the verapamil with newly ordered medications: Verapamil is a calcium channel blocker used to treat hypertension, angina, and arrhythmias. It has potential interactions with many other medications due to its effects on cardiac conduction and blood
pressure. Therefore, consulting the pharmacist is important to assess compatibility and potential drug interactions when new medications are prescribed.
B.   To request a change in the dosage of the verapamil: Changing the dosage of verapamil may require a healthcare provider's order rather than consultation with a pharmacist.
C.   To verify the frequency of administration of the verapamil: The frequency of administration of verapamil is typically determined by the healthcare provider and documented in the prescription. The pharmacist's role may involve dispensing the medication as prescribed but not verifying the frequency unless there are discrepancies.
D.   To report the client's refusal to take the verapamil: Reporting the client's refusal to take the medication should be communicated to the healthcare provider for further assessment and
intervention. The pharmacist's role is primarily related to medication dispensing and ensuring appropriate use rather than addressing client refusals.

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Correct Answer is B

Explanation

A. Hyperactive bowel sounds: Muscarinic agonist poisoning typically results in increased gastrointestinal motility and hyperactive bowel sounds. Atropine, an anticholinergic medication, works by blocking muscarinic receptors and reducing gastrointestinal motility. Therefore, the presence of hyperactive bowel sounds may indicate ongoing muscarinic stimulation and inadequate treatment with atropine.
B. Heart rate 90/min: Atropine is an anticholinergic medication that increases heart rate by blocking the parasympathetic effects of acetylcholine on the heart. Bradycardia is a common manifestation of muscarinic agonist poisoning, and an increase in heart rate following atropine administration indicates reversal of this effect and effective treatment.
C. Blood pressure 90/50 mm Hg: Atropine administration may result in transient hypertension due to its effect on increasing heart rate and cardiac output. Hypotension is a common
manifestation of muscarinic agonist poisoning, and an increase in blood pressure following atropine administration may indicate improvement in cardiovascular function. Therefore, a blood pressure of 90/50 mm Hg may not necessarily indicate effective treatment with atropine.
D. Increased salivation: Muscarinic agonist poisoning typically results in excessive salivation (sialorrhea) due to stimulation of muscarinic receptors in the salivary glands. Atropine administration works by blocking these muscarinic receptors and reducing salivation. Therefore, increased salivation would indicate ongoing muscarinic stimulation and inadequate treatment with atropine.

A. Inject air into the NPH vial. B. Withdraw the regular insulin from the vial. C. Inject air into the regular insulin vial. D. Withdraw the NPH insulin from the vial. E. None F. None

Correct Answer is A

Explanation

A. The correct order is

wipe off tops of insulin vials with alcohol sponge.
draw back amount of air into the syringe that equals total dose.
inject air equal to NPH dose into NPH vial. ...
air equal to regular dose into regular vial.
invert regular insulin bottle and withdraw regular insulin dose.
without adding more air into NPH vial, carefully withdraw NPH dose

B. Withdraw the regular insulin from the vial: This step should occur after injecting air into the regular insulin vial. The nurse should draw up the regular insulin before drawing up the NPH
insulin.

C. Inject air into the regular insulin vial: Inject air into the regular insulin vial is not thecorrect first step to avoid contamination of the clear insulin with cloudy insulin..
D. Withdraw the NPH insulin from the vial: This step should occur after withdrawing the regular insulin. The nurse should draw up the NPH insulin after drawing up the regular insulin to ensure the correct sequence and dosage.

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A nurse is caring for a client who has a history of cardiac arrhythmias and is taking verapamil. For which of the following reasons should the nurse consult the pharmacist?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has muscarinic agonist poisoning. Following administration of atropine, which of the following findings should indicate to the nurse that the treatment has been effective?

Correct Answer is B

Explanation

A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to a client who has diabetes mellitus. Which of the following actions should the nurse take first?

Correct Answer is A

Explanation

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