A client indicates to the nurse a pain level of 8 out of 10. The nurse notes the client has an order for morphine 4 mg IV Q 6 hr PRN for moderate to severe pain. The client's blood pressure is 80/54 mm Hg, respirations 10 breaths/min, and pulse 62 beats/min. Which action should the nurse take?

Tell the client he can no longer have any more pain medication

Notify the prescribing physician

Administer half the dose of morphine, 2 mg IV

Administer 4 mg of morphine IV as ordered

Answer and Explanation

The Correct Answer is B

A. Tell the client he can no longer have any more pain medication: This is not appropriate. The client’s severe pain needs to be managed, but the current vital signs suggest a need for careful evaluation before administration.
B. Notify the prescribing physician: This is the correct choice. The client's blood pressure and respiratory rate are significantly low, which could be exacerbated by morphine. The physician needs to be informed to reassess pain management and possibly adjust the treatment.
C. Administer half the dose of morphine, 2 mg IV: Given the client's low blood pressure and respiratory rate, any morphine administration could worsen these issues. Adjusting the dose without physician guidance is not appropriate.
D. Administer 4 mg of morphine IV as ordered: Administering the full dose without addressing the client’s low blood pressure and respiratory rate could lead to severe complications.

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Correct Answer is C

Explanation

A. Serum glucose and a Complete Blood Count: While a complete blood count (CBC) is useful in assessing overall health, serum glucose is less relevant in the context of renal disease. The focus should be on kidney function rather than glucose levels.
B. Arterial blood gas and coagulation tests: Arterial blood gas (ABG) and coagulation tests may be important for other conditions, but they are not specifically targeted to evaluate renal function or related preoperative risks in renal disease.
C. Serum creatinine and a Basic Metabolic Panel: This is the correct choice as serum creatinine is a key marker of kidney function, and a Basic Metabolic Panel (BMP) provides information on electrolyte levels and overall metabolic status, which are crucial in evaluating the impact of renal disease on surgery.
D. Chest X-ray and cardiac enzymes: These tests are more relevant for evaluating cardiac function and lung status rather than directly assessing kidney function, which is the primary concern in the context of renal disease.

A. Teach the client a relaxation technique to use until the next dose is due. B. Obtain an order for an immediate-release opioid for breakthrough pain. C. Explain to the client that the medication being administered lasts for 12 hours. D. Assess the client's vital signs and administer the next dose of opioids early.

Correct Answer is B

Explanation

A. Teach the client a relaxation technique to use until the next dose is due: While relaxation techniques can be helpful in managing pain, they are not sufficient for severe pain rated 9/10. The client requires more immediate pharmacological intervention.
B. Obtain an order for an immediate-release opioid for breakthrough pain: This is the most appropriate action. Immediate-release opioids are specifically used to manage breakthrough pain in clients on sustained-release opioid therapy. It addresses the client's severe pain effectively and promptly.
C. Explain to the client that the medication being administered lasts for 12 hours: Simply explaining the duration of the medication does not address the client's current severe pain. Effective pain management requires action, not just education.
D. Assess the client's vital signs and administer the next dose of opioids early: Administering the next dose early can lead to inappropriate dosing schedules and potential overdose. It is important to follow the prescribed dosing regimen and manage breakthrough pain appropriately.

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A client indicates to the nurse a pain level of 8 out of 10. The nurse notes the client has an order for morphine 4 mg IV Q 6 hr PRN for moderate to severe pain. The client's blood pressure is 80/54 mm Hg, respirations 10 breaths/min, and pulse 62 beats/min. Which action should the nurse take?

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Naxlex Comprehensive Predictor Exams

During a preoperative review of systems, the client reveals a history of renal disease. This finding suggests the need for which relevant preoperative diagnostic tests?

Correct Answer is C

Explanation

A client with acute pain is prescribed a sustained-release opioid that is administered every 12 hours. After 6 hours, the client complains of increasing pain that is rated as 9/10. Which intervention by the nurse is most appropriate to address the client's pain?

Correct Answer is B

Explanation

The nurse identifies that which of the following clients is at risk for developing metabolic acidosis? (Select All That Apply)

The nurse is providing teaching to the client about the use of vitamins and supplements. The nurse would state that vitamin D has a major role in which process?

A client has been receiving IV potassium therapy. Upon further assessment, the nurse notes the site has become erythematous and edematous. Which action by the nurse is most appropriate?

The illustration reflects a client's upper extremity while the nurse obtains a manual blood pressure. Which electrolyte abnormality is the nurse most likely to see in the client's blood chemistry results?

A nurse reviews a client's laboratory report and notes that the client's serum phosphorus (phosphate) level is 1.8 mg/dL. Which condition most likely caused this serum phosphorus level?

The nurse is reviewing serum laboratory values for a client who is scheduled for surgery tomorrow. Which value requires the nurse to promptly notify the surgeon?

The nurse is caring for a client being treated for fluid volume excess. Which assessment finding indicates that treatment has been effective?

Which of the following assessment findings should alert the nurse that a client's IV has infiltrated? (Select All That Apply)