Patient Data

Exhibits

Mark whether the assessment finding represents a therapeutic result of the lactulose administered, a nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.

Large, liquid stool

Abdomen soft and flat

Blood pressure 120/68 mm Hg

Drowsiness

Heart rate 62 beats/minute

Pain rating of 2 on a 0 to 10

Cramping

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"C"},"D":{"answers":"B"},"E":{"answers":"C"},"F":{"answers":"C"},"G":{"answers":"B"}}

Large, liquid stool: Lactulose is prescribed to treat constipation by drawing water into the bowel and promoting a bowel movement. A large, liquid stool indicates that the medication has effectively relieved the client's postoperative constipation.

Abdomen soft and flat: Before receiving lactulose, the client had a distended abdomen. A soft, flat abdomen afterward shows that bowel motility improved and gas or stool buildup has decreased, reflecting therapeutic action.

Blood pressure 120/68 mm Hg: Lactulose does not significantly affect blood pressure. A normal blood pressure reading is a positive finding but is unrelated to the expected outcomes or side effects of lactulose therapy.

Drowsiness: Drowsiness is not an intended or expected effect of lactulose. It may result from opioid use (morphine) rather than the lactulose itself, but since it impacts the client's alertness, it is considered a nontherapeutic side effect here.

Heart rate 62 beats/minute: Lactulose has no direct pharmacologic impact on heart rate. A heart rate of 62 beats per minute is within acceptable limits for many adults and is unrelated to the administration of lactulose.

Pain rating of 2 on a 0 to 10 scale: Pain control relates to the administration of morphine and other analgesics, not to lactulose. Therefore, a lower pain score reflects effective analgesia but is not linked to lactulose therapy.

Cramping: Cramping can occur with lactulose because it increases bowel motility and draws fluid into the intestines. Although mild cramping is expected, it is still classified as a nontherapeutic side effect because it can cause client discomfort.

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Correct Answer is A

Explanation

A. Observe bowel movement pattern and take a stool softener: Morphine commonly causes constipation due to reduced gastrointestinal motility. Recognizing this and taking preventive measures like a stool softener indicates a good understanding of how to manage one of the most frequent and bothersome side effects of opioid therapy.

B. Do not drink grapefruit juice after taking morphine: Grapefruit juice significantly interacts with certain medications, particularly those metabolized by CYP3A4 enzymes, but it has minimal clinical effect on morphine metabolism. This instruction is not relevant for morphine use.

C. Watch for signs of agitation and record any insomnia: While these symptoms can occasionally occur, they are not typical or expected side effects of morphine. More common effects include sedation, respiratory depression, and constipation.

D. Take the benzodiazepine at the same time of taking the morphine: Combining morphine with benzodiazepines increases the risk of severe sedation, respiratory depression, and overdose. Co-administration should be carefully managed and typically avoided unless specifically directed by the healthcare provider.

A. Consult with a pharmacist about scheduling the dose one hour after the client eats. B. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low fat milk. C. Withhold the medication until the client's breakfast tray is available on the unit. D. Instruct the client that it is necessary to take nothing but water with the medication.

Correct Answer is D

Explanation

A. Consult with a pharmacist about scheduling the dose one hour after the client eats: Risedronate must be taken on an empty stomach with water for proper absorption. Taking it after eating would severely reduce its effectiveness, making pharmacist consultation unnecessary at this point.

B. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low fat milk: Milk contains calcium, which can bind to risedronate and interfere with its absorption. Providing milk at the time of administration would make the medication much less effective in treating osteoporosis.

C. Withhold the medication until the client's breakfast tray is available on the unit: Administering risedronate with or immediately after food would impair absorption. Delaying the dose until after breakfast would not meet the medication's requirements for maximum efficacy.

D. Instruct the client that it is necessary to take nothing but water with the medication: Risedronate should be taken with a full glass of plain water while fasting to ensure proper absorption. After administration, the client should also remain upright for at least 30 minutes to reduce gastrointestinal irritation.

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Patient Data Exhibits Mark whether the assessment finding represents a therapeutic result of the lactulose administered, a nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing discharge instructions for a client with metastatic cancer who is prescribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

Correct Answer is A

Explanation

The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?

Correct Answer is D

Explanation

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Patient Data

Exhibits

Mark whether the assessment finding represents a therapeutic result of the lactulose administered, a nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.