A nurse is collecting data from a client who received IV morphine for postoperative pain. The nurse should identify that which of the following findings indicates a therapeutic response to the medication?
The client's blood pressure has been reduced.
The client exhibits diaphoresis.
The client is grimacing.
The client has an elevated heart rate.
The Correct Answer is A
A. This is the correct answer. Reduction in blood pressure is a common therapeutic response to morphine administration. Morphine acts as a vasodilator, which can lead to decreased blood pressure.
B. Diaphoresis, or sweating, is not necessarily a therapeutic response to morphine. It may indicate other physiological responses or side effects.
C. Grimacing suggests pain or discomfort, which is not a therapeutic response but rather an indication that the pain relief from morphine may not be sufficient.
D. An elevated heart rate is not typically a therapeutic response to morphine and may indicate pain, anxiety, or other factors.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Correct. Viral pneumonia can be highly contagious, so placing the client in a private room can help prevent the spread of the infection to other patients.
B. Incorrect. Azithromycin is an antibiotic typically used for bacterial infections and would not be indicated for viral pneumonia.
C. Incorrect. Pneumococcal immunization is effective for preventing bacterial pneumonia caused by Streptococcus pneumoniae but is not indicated for viral pneumonia.
D. Incorrect. Limiting fluid intake to 1 L per day is not appropriate for a client with viral pneumonia, as adequate hydration is important for supporting the body's immune response and preventing dehydration.
Correct Answer is C
Explanation
A. Suggest the family persuade the client to take the medication: This option involves coercion, which is not ethically appropriate. Clients have the right to refuse medication, and persuasion from family members should not be used to override this right.
B. Recommend that the medication be delivered intramuscularly: Administering medication against a client's will through an invasive route like intramuscular injection is not appropriate and may constitute assault.
C. Remind the newly licensed nurse that the client has a right to refuse medication: This response upholds the client's autonomy and right to refuse treatment. Nurses must respect a client's decision to decline medication, provided they are competent to make that decision.
D. Suggest the newly licensed nurse contact the pharmacy to inquire about compatible foods: This response does not address the ethical issue of respecting the client's autonomy and right to refuse medication.
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