When assessing patients in the preoperative area, the nurse knows that which patient is at a higher risk for an altered response to anesthesia

The 21-year-old patient who has never had surgery before

The 40-year-old patient who is to have a kidney stone removed

The 82-year-old patient who is to have gallbladder removal

The 35-year-old patient who stopped smoking 8 years ago

Answer and Explanation

The Correct Answer is C

A.   The 21-year-old patient who has never had surgery before: While lack of previous surgery experience may contribute to anxiety, it doesn't inherently increase the risk of altered response to anesthesia.
B.   The 40-year-old patient who is to have kidney stone removed: While the type of surgery may influence anesthesia considerations, being 40 years old alone doesn't significantly increase the risk of altered response to anesthesia.
C.   The 82-year-old patient who is to have gallbladder removal: Advanced age is a significant risk factor for altered response to anesthesia due to age-related changes in physiology, metabolism, and drug clearance.
D.   The 35-year-old patient who stopped smoking 8 years ago: While smoking history can impact anesthesia considerations, stopping smoking 8 years ago likely reduces the associated risks compared to current smokers.

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Correct Answer is A

Explanation

A. The drug level is at a toxic level, and the dosage needs to be reduced. Phenytoin has a narrow therapeutic range, and levels above 20 mcg/mL are considered to be in the toxic range.
Symptoms of phenytoin toxicity can include nystagmus, ataxia, slurred speech, and confusion. Therefore, if a patient's phenytoin level is 23 mcg/mL, the nurse should be concerned about potential toxicity and consult with the healthcare provider to adjust the dosage.
B. The patient's seizures should be under control if she is also taking a second antiepileptic drug.

While combination therapy with multiple antiepileptic drugs can help control seizures, a phenytoin level of 23 mcg/mL is still concerning for toxicity and requires intervention.
C. The patient is at risk for seizures because the drug level is not at a therapeutic level. A phenytoin level of 23 mcg/mL is actually above the therapeutic range and is more indicative of toxicity rather than subtherapeutic levels.

D. The patient's seizures should be under control because this is a therapeutic drug level. A phenytoin level of 23 mcg/mL is not within the therapeutic range but rather in the toxic range, so the patient may experience symptoms of toxicity rather than having adequate seizure control.

A. The patient's respiratory rate B. The appearance of the incision C. The date of the patient's last bowel movement D. The patient's pulse rate

Correct Answer is A

Explanation

A. The patient's respiratory rate: Morphine sulfate is an opioid analgesic that can cause

respiratory depression as a side effect. Therefore, assessing the patient's respiratory rate is crucial before administering the medication to ensure it is within normal limits.
B. The appearance of the incision: While assessing the incision is important for overall surgical site assessment, it's not directly related to the administration of morphine sulfate.
C. The date of the patient's last bowel movement: Bowel movements may be impacted by anesthesia and surgery, but they are not directly relevant to assessing the safety of administering morphine sulfate.
D. The patient's pulse rate: Pulse rate is important for overall assessment of the patient's

condition but may not directly indicate the need for or safety of administering morphine sulfate.

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When assessing patients in the preoperative area, the nurse knows that which patient is at a higher risk for an altered response to anesthesia

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During a routine appointment, a patient with a history of seizures is found to have a phenytoin level of 23 mcg/mL. What concern will the nurse have, if any?

Correct Answer is A

Explanation

A patient had abdominal surgery this morning. The patient is groggy but complaining of severe pain around the incision. What is the most important assessment data to consider before the nurse administers a dose of morphine sulfate to the patient?

Correct Answer is A

Explanation

The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor (MAOI). Which food choice would indicate the need for additional teaching?

A patient has had an overdose of an intravenous cholinergic drug. The nurse expects to administer which drug as an antidote?

While being intubated, a client with a head injury experienced bradycardia. Atropine was consequently administered. What assessment should be postponed until all atropine is excreted and no longer exerting an effect?

A patient has been taking lithium for 1 year, and the most recent lithium level is 0.9 mEq/L. Which statement about the laboratory result is correct?

When monitoring a patient who is taking a cholinergic drug, the nurse will watch for which cardiovascular effect?

The nurse is caring for a client experiencing sympathetic nervous system stimulation. What assessment finding supports this diagnosis? Select all that apply. (Select All that Apply.)

A nurse is preparing to administer meperidine 35 mg IM to a client every 6 hr PRN for pain. Available is meperidine injection 75 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)