A nurse is monitoring a client who has a head injury and is receiving mannitol 25% via IV infusion. The nurse should identify which of the following as an adverse effect of the medication and report to the provider?

Glasgow coma scale rating of 15

Crackles on auscultation

Increase in urinary output

Intracranial pressure reading of 12mm

Answer and Explanation

The Correct Answer is B

A. Glasgow Coma Scale rating of 15: A Glasgow Coma Scale (GCS) rating of 15 is a positive sign indicating that the client is fully conscious and oriented. It is not an adverse effect of mannitol.
B. Crackles on auscultation: Crackles, also known as rales, can indicate fluid overload or pulmonary edema, which can be an adverse effect of mannitol. Mannitol can cause shifts of fluid, including into the lungs, leading to pulmonary edema.
C. Increase in urinary output: Mannitol is an osmotic diuretic, and an increase in urinary output is an expected and therapeutic effect of the medication. It is not considered an adverse effect.
D. Intracranial pressure reading of 12 mmHg: A decrease in intracranial pressure is a therapeutic effect of mannitol, and a reading of 12 mmHg is generally within a normal range. It is not considered an adverse effect.

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Correct Answer is A

Explanation

A. Urticaria (hives): Urticaria is a manifestation of an allergic reaction, which can occur during a transfusion reaction. If the client develops urticaria, it suggests an allergic response, and epinephrine may be administered to manage severe allergic reactions.
B. Distended jugular vein: Distended jugular veins may be associated with fluid overload or cardiovascular issues, but it is not a typical indication for administering epinephrine during a blood transfusion reaction.
C. Bounding pulse: A bounding pulse may be associated with increased cardiac output but is not typically an indication for epinephrine administration during a blood transfusion reaction.
D. Confusion: Confusion is a neurological symptom and is not a typical indication for administering epinephrine during a blood transfusion reaction. Neurological symptoms may suggest other complications that need appropriate interventions.

A. Simvastatin 40 mg PO at bedtime B. Morphine 4 mg IV every 4 hr PRN for pain C. Levothyroxine 100 mcg PO every morning D. Acetaminophen 500 mg every 4 hr PRN for fever

Correct Answer is B

Explanation

A. Simvastatin 40 mg PO at bedtime: This prescription is clear and specifies the medication (Simvastatin), the dose (40 mg), route (PO – oral), and timing (at bedtime). There is no need for clarification.
B. Morphine 4 mg IV every 4 hr PRN for pain: The need for clarification arises here because "PRN" (pro re nata) means "as needed," and prescribing an IV medication on an as-needed basis might need further clarification regarding the specific indications and circumstances for administering the medication.
C. Levothyroxine 100 mcg PO every morning: This prescription is clear and specifies the medication (Levothyroxine), the dose (100 mcg), route (PO – oral), and timing (every morning). There is no need for clarification.
D. Acetaminophen 500 mg every 4 hr PRN for fever: Similar to option B, there might be a need for clarification regarding the specific indications and circumstances for administering acetaminophen on an as-needed basis. However, in many cases, PRN for fever is reasonable, so it may not be as critical as in the case of an IV pain medication.

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A nurse is monitoring a client who has a head injury and is receiving mannitol 25% via IV infusion. The nurse should identify which of the following as an adverse effect of the medication and report to the provider?

Nursing Test Bank

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Correct Answer is A

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Correct Answer is B

Explanation

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