The nurse admits a client with a diagnosis of stage 4 cancer. The client has a prescription to wear a subcutaneous morphine sulfate patch for pain. The client is short of breath and difficult to arouse.
While performing a head-to-toe assessment, the nurse discovers four patches on the client’s body. Which action should the nurse take first?
Remove the morphine patches.
Monitor blood pressure.
Apply oxygen face mask.
Administer a narcotic reversal drug.
The Correct Answer is A
The client’s symptoms of being short of breath and difficult to arouse may indicate an overdose of morphine. The nurse should immediately remove the patches to prevent further absorption of the drug. After removing the patches, the nurse should continue to assess the client’s condition and take further actions as needed, such as administering a narcotic reversal drug or providing oxygen.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The client's symptoms suggest liver dysfunction, which is a known adverse effect of albendazole. Albendazole is primarily metabolized in the liver, and its use can cause liver damage in some cases. Therefore, it is essential to review liver function test results to assess the severity of liver damage and to determine if the medication should be discontinued or the dosage should be adjusted.
The renal function panel (a) measures the levels of various substances, such as creatinine and blood urea nitrogen, in the blood to assess kidney function.
The thyroid function test (b) evaluates the levels of thyroid hormones in the blood to diagnose thyroid disorders.
The basic metabolic panel (c) includes several tests that assess the levels of electrolytes, glucose, and other substances in the blood to evaluate metabolic function. However, these lab tests are not directly related to the symptoms and adverse effects associated with albendazole use
Correct Answer is C
Explanation
Tamsulosin is an alpha-1 adrenergic receptor blocker that is commonly used to treat benign prostatic hyperplasia (BPH). One of the potential adverse reactions of tamsulosin is hypotension, which can be manifested as dizziness, lightheadedness, and fainting. Therefore, monitoring blood pressure is a crucial intervention for clients receiving tamsulosin.
Assessing urine output (option a) and performing a bladder scan (option b) may be appropriate interventions for clients with urinary retention or other urinary tract issues, but they are not specific to monitoring adverse reactions to tamsulosin.
Obtaining daily weights (option d) may be useful for monitoring fluid balance in some clients, but it is not directly related to adverse reactions to tamsulosin.
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