A nurse is caring for a client who received neostigmine 1 hr ago and is experiencing a muscarinic response.
Which of the following manifestations should the nurse expect?
Occipital headache.
Fever.
Excessive salivation.
Myoclonic seizure.
The Correct Answer is C
Neostigmine is an anticholinesterase inhibitor that indirectly stimulates both nicotinic and muscarinic receptors by interfering with the breakdown of acetylcholine.
Stimulation of muscarinic receptors can lead to increased salivation.
Choice A is wrong because an occipital headache is not a manifestation of a muscarinic response to neostigmine.
Choice B is wrong because fever is not a manifestation of a muscarinic response to neostigmine.
Choice D is wrong because a myoclonic seizure is not a manifestation of a muscarinic response to neostigmine.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
- A. Assist the client to a left lateral position.
- This is generally used for clients at risk of aspiration, and it's not indicated based on the lithium level.
- B. Implement fluid restrictions.
- Fluid restrictions are usually implemented when there is a risk of fluid overload or hyponatremia, and not in this case. In fact, dehydration can raise lithium levels to toxic levels, so proper hydration is important.
- C. Request a dosage increase from the provider.
- While 0.6 mEq/L is within the therapeutic range, some providers may want to see a level slightly higher for maintenance. So requesting a dosage increase from the provider is the correct action.
- D. Prepare the client for hemodialysis.
- Hemodialysis is used to remove lithium from the blood in cases of severe lithium toxicity, which is indicated by levels significantly higher than 1.5 mEq/L. This is not needed when the lithium level is 0.6 mEq/L.
Correct Answer is A
Explanation
This is because pioglitazone can cause fluid retention and edema.
Choice B is wrong because tinnitus (ringing in the ears) is not a common adverse effect of pioglitazone.
Choice C is wrong because insomnia (difficulty sleeping) is not a common adverse effect of pioglitazone.
Choice D is wrong because orthostatic hypotension (a drop in blood pressure when standing up) is not a common adverse effect of pioglitazone.
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