When administering ceftriaxone sodium IV to a client before surgery, which assessment finding requires immediate intervention by the nurse?

Nausea.

Stridor.

Headache.

Pruritus.

Answer and Explanation

The Correct Answer is B

A) 40-year-old female with frequent vaginal infections: Simvastatin is a medication used primarily to manage cholesterol levels and reduce the risk of cardiovascular diseases. Frequent vaginal infections are not directly related to cholesterol levels or cardiovascular risk. Therefore, this client is unlikely to benefit from education about simvastatin.
B) A 50-year-old male with a history of angina: Simvastatin is a statin medication prescribed to lower cholesterol levels and reduce the risk of cardiovascular events, such as heart attacks and strokes. Since angina is a symptom of coronary artery disease, a condition often related to high cholesterol levels, this client would benefit from education about simvastatin, which can help manage cholesterol and potentially reduce cardiovascular risk.
C) An 18-year-old pregnant female with type 1 diabetes mellitus: Statins, including simvastatin, are generally contraindicated during pregnancy due to potential risks to the developing fetus. Additionally, this client’s primary condition of type 1 diabetes mellitus would not typically be managed with simvastatin alone. Therefore, this client is not the target for simvastatin education.
D) A 75-year-old male with bone cancer: While simvastatin is used for managing cholesterol and preventing cardiovascular events, bone cancer is not directly related to cholesterol levels. The primary focus for this client would be managing cancer-related symptoms and treatments rather than cholesterol levels. Thus, this client would not benefit from education about simvastatin.

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Correct Answer is A

Explanation

A) Coronary artery disease: It is crucial to assess for a history of coronary artery disease (CAD) before administering sumatriptan, as the medication is a serotonin receptor agonist that can cause vasoconstriction of coronary arteries. This can increase the risk of serious cardiovascular events, such as heart attack or stroke, particularly in clients with preexisting CAD.

B) Seasonal allergic rhinitis: While seasonal allergic rhinitis may be a concern for other medications due to potential allergic reactions or interactions, it is not directly related to the administration of sumatriptan. This condition does not pose a significant risk with the use of sumatriptan.

C) Type 2 diabetes mellitus: Although type 2 diabetes mellitus is an important consideration in the overall health management of a client, it is not the most critical condition to assess before administering sumatriptan. However, if the client has diabetes with associated complications like cardiovascular disease, this would increase concern for using sumatriptan.

D) Irritable bowel syndrome: Irritable bowel syndrome (IBS) is a gastrointestinal disorder that typically does not influence the decision to administer sumatriptan. While IBS may affect a client’s comfort or medication regimen, it does not present the same immediate risks as coronary artery disease when using sumatriptan.

A. Administer the scheduled dose. B. Discontinue the warfarin schedule. C. Withhold warfarin for 24 hours D. Obtain another INR analysis immediately.

Correct Answer is C

Explanation

A) Administer the scheduled dose: Administering the scheduled dose of warfarin when the INR is 5.0 is not appropriate because this INR level is significantly elevated, indicating a high risk of bleeding. Warfarin dosing should be adjusted based on INR levels to prevent complications such as excessive bleeding.
B) Discontinue the warfarin schedule: Completely discontinuing warfarin may not be necessary unless there are additional factors or signs of bleeding. It is essential to take appropriate action based on the INR level, but discontinuation should be guided by further evaluation and healthcare provider recommendations.
C) Withhold warfarin for 24 hours: Withholding the dose of warfarin is the correct action when faced with an elevated INR of 5.0. This intervention is crucial to prevent potential bleeding complications while waiting for further evaluation and guidance from the healthcare provider regarding additional management, such as administration of vitamin K or other reversal agents.

D) Obtain another INR analysis immediately: While obtaining another INR analysis can be helpful in monitoring trends, it is not the immediate priority if the INR is already 5.0. The primary action should be to withhold the dose and consult with the healthcare provider to determine the appropriate next steps for managing the elevated INR and ensuring patient safety.

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When administering ceftriaxone sodium IV to a client before surgery, which assessment finding requires immediate intervention by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client's history includes which problem?

Correct Answer is A

Explanation

The nurse is preparing to administer warfarin sodium 10 mg PO to a client whose international normalized ratio (INR) is 5.0. Which intervention should the nurse implement? Reference Range: International 1 normalized ratio (INR) [INR: 0.8 to 1.1]

Correct Answer is C

Explanation

A client receives a prescription for allopurinol. Which information provided by the client requires additional instruction by the nurse?

Which instruction should the nurse provide an unlicensed assistive personnel (UAP) who is assisting with the personal care of a client receiving clopidogrel?

The nurse is preparing client teaching materials on commonly used medications. Which client is most likely to benefit from a client education packet about simvastatin?

A patient with open-angle glaucoma asks the nurse how long the prescribed eye drops will need to be used. Which response made by the nurse is accurate?

A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client's history requires follow up by the nurse?

A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

A male client reports to the nurse that he is experiencing gastrointestinal (GI) distress from a high dose of a corticosteroid and is planning to stop taking the medication. In response to the client's statement, which nursing action is most important for the nurse to Implement?