A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching?

“Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose."

"Plan to self-administer this medication for the next 6 months."

"Lie down for 1 hour after administering the medication."

"Administer the medication into one nostril once per week."

Answer and Explanation

The Correct Answer is D

A.   “Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose": This statement is not necessary for the administration of nasal cyanocobalamin. Nasal decongestants are not routinely recommended before administering nasal medications.
B.   "Plan to self-administer this medication for the next 6 months": While the duration of treatment for pernicious anemia may vary, specifying a timeframe of 6 months for self- administration is not appropriate without considering individualized treatment plans.

C.   "Lie down for 1 hour after administering the medication": There is no need for the client to lie down after administering nasal cyanocobalamin. This instruction is not necessary and may not be practical.
D.   "Administer the medication into one nostril once per week": This is the correct instruction for administering nasal cyanocobalamin. It is typically given once weekly into one nostril. This
method provides a convenient and effective route for vitamin B12 supplementation in clients with pernicious anemia.

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Correct Answer is D

Explanation

A. Ringing in the ears (tinnitus) is not a common adverse effect of midazolam.

B. Urinary retention is not a common adverse effect of midazolam.

C. Midazolam typically causes decreased blood pressure, not increased blood pressure.

D. Respiratory depression is a potential adverse effect of midazolam, particularly when administered in higher doses or in combination with other central nervous system depressants.

A. Hyperactive bowel sounds B. Heart rate 90/min C. Blood pressure 90/50 mm Hg D. Increased salivation

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.

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A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is administering midazolam to a client who is undergoing an endoscopic procedure. The nurse should monitor the client for which of the following as an adverse effect of the medication?

Correct Answer is D

Explanation

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

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