A nurse is caring for a patient with a diagnosis of sepsis who is on a ventilator in the intensive care unit. To reduce the risk of developing a physiologic stress ulcer, the nurse should anticipate an order to administer which medication?
Methylprednisolone
Enoxaparin
Pantoprazole
Ibuprofen
The Correct Answer is C
A. Methylprednisolone is a corticosteroid used to reduce inflammation and suppress the immune system. While corticosteroids are sometimes used in critical care settings, they are not specifically used to prevent stress ulcers. In fact, corticosteroids can increase the risk of gastrointestinal bleeding and may require additional measures to protect the stomach lining.
B. Enoxaparin is a low molecular weight heparin (LMWH) used primarily for the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE). It works as an anticoagulant, preventing blood clots. While enoxaparin is important for preventing thromboembolic events in critically ill patients, it does not specifically address the prevention of stress ulcers.
C. Pantoprazole is a proton pump inhibitor (PPI) that reduces gastric acid production by inhibiting the proton pumps in the stomach lining. PPIs are commonly used to prevent and treat stress ulcers because they help decrease gastric acid secretion, thereby reducing the risk of ulcer formation and bleeding. This makes pantoprazole the appropriate medication to administer to prevent physiologic stress ulcers in a patient with sepsis on a ventilator.
D. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used for pain relief and inflammation. NSAIDs can actually increase the risk of gastrointestinal bleeding and ulceration, especially in critically ill patients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
This is the correct expected outcome if the test is positive for myasthenia gravis. Edrophonium works quickly to increase acetylcholine levels, leading to temporary improvement in muscle strength. In a patient with myasthenia gravis, administration of edrophonium typically results in a rapid improvement in symptoms like facial weakness and ptosis within 30 to 60 seconds, with the effects lasting for a few minutes. This brief improvement is indicative of a positive result for myasthenia gravis.
B.A Worsening symptoms after administration of edrophonium are not expected and could indicate an adverse reaction or incorrect diagnosis. In myasthenia gravis, edrophonium typically improves symptoms rather than worsening them.
C. No change in symptoms would be unexpected in the case of myasthenia gravis. If edrophonium is effective, there should be a noticeable improvement in symptoms. If there is no change, it might suggest a diagnosis other than myasthenia gravis or that the test is inconclusive.
D. This outcome is not expected. Edrophonium has a very short duration of action, typically relieving symptoms for only a few minutes. The effects do not last for 24 hours. A longer-lasting improvement might be observed with other treatments for myasthenia gravis, such as anticholinesterase medications like pyridostigmine, but not with edrophonium.
Correct Answer is C
Explanation
. Shellfish allergies are related to potential reactions to iodinated contrast media used in imaging studies, such as CT scans, rather than to spirometry. Spirometry does not involve contrast media or shellfish, so this question is not pertinent for this test.
B.A Metal implants are typically a concern for imaging tests like MRI, which involve strong magnetic fields. Spirometry, however, does not involve any imaging or use of magnetic fields, so metal implants do not affect spirometry results. Thus, this question is not relevant for spirometry preparation.
C. This is a relevant question for spirometry testing. Bronchodilators are medications used to open the airways and improve breathing. They can affect spirometry results if taken shortly before the test. For accurate assessment, the nurse needs to know if the client has used any bronchodilators, as they might need to adjust the testing protocol or account for the medication's effects on lung function.
D. Spirometry does not typically involve enclosed spaces that would trigger claustrophobia, as it is a breathing test usually performed with the client sitting comfortably in an open space. Claustrophobia is more relevant to imaging studies like MRIs or CT scans, where the client might be in a confined space.
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