A client who received Prochlorperazine 4 hours ago reports spasms of his face. The nurse should anticipate a prescription for which of the following medications?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Diphenhydramine. The client's presentation of facial spasms after receiving Prochlorperazine indicates a possible extrapyramidal side effect, specifically acute dystonia. Diphenhydramine, an antihistamine with anticholinergic properties, is commonly used to manage these types of extrapyramidal symptoms. Option A) Fomepizole is used in the treatment of ethylene glycol or methanol poisoning and is not relevant to the client's current symptoms. Option B) Naloxone is a medication used to reverse opioid overdose, which is unrelated to the client's facial spasms. Option C) Phytonadione is vitamin K, used to reverse the effects of excessive anticoagulation, which is not indicated in this case. Educationally, understanding the side effects of medications and appropriate interventions is crucial for safe and effective nursing practice. Recognizing and managing adverse drug reactions promptly can prevent complications and improve patient outcomes. This question highlights the importance of pharmacological knowledge and critical thinking skills in nursing care.

Correct Answer: C

Rationale: In the context of a client with Preeclampsia receiving Magnesium Sulfate IV, the nurse should report a urinary output of 24 mL/hr to the provider. This finding is concerning because magnesium sulfate is excreted by the kidneys, and a decrease in urinary output may indicate magnesium toxicity, which can lead to serious complications such as respiratory depression and cardiac arrest. Option A (2+ deep tendon reflexes) is an expected finding in a client receiving magnesium sulfate, as it is used to prevent seizures by acting as a CNS depressant. Option B (2+ pedal edema) is a common symptom of preeclampsia and is not directly related to magnesium sulfate administration. Option D (respirations 12/min) is within the normal range and not a concerning finding in this context. Educationally, this question highlights the importance of monitoring clients receiving magnesium sulfate closely, particularly their urinary output, to prevent complications associated with magnesium toxicity. It also emphasizes the nurse's role in recognizing and reporting abnormal findings promptly to ensure patient safety.

Correct Answer: D

Rationale: In the case of a client with a new diagnosis of Fibromyalgia, the nurse should anticipate the prescription of Duloxetine (Option D). Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that is commonly used in the management of fibromyalgia due to its ability to modulate both neurotransmitters. This medication helps alleviate pain, improve mood, and reduce fatigue associated with fibromyalgia. Regarding the other options: - Option A: Colchicine is primarily used to treat gout by reducing inflammation. It is not indicated for fibromyalgia. - Option B: Hydroxychloroquine is commonly used to treat autoimmune conditions like lupus and rheumatoid arthritis. It is not a first-line treatment for fibromyalgia. - Option C: Auranofin is a disease-modifying antirheumatic drug (DMARD) used in the treatment of rheumatoid arthritis. It is not a typical medication prescribed for fibromyalgia. Educationally, understanding the rationale behind the choice of Duloxetine for fibromyalgia not only reinforces pharmacological knowledge but also highlights the importance of selecting medications based on their mechanisms of action and indications. This knowledge is crucial for nurses to provide safe and effective care to clients with fibromyalgia and other similar conditions.

Correct Answer: A

Rationale: In the case of a toddler admitted to the hospital after an Acetaminophen overdose, the nurse should anticipate administering Acetylcysteine. Acetylcysteine is the antidote for Acetaminophen overdose as it helps to replenish glutathione, a key antioxidant in the liver that gets depleted during Acetaminophen metabolism, thus preventing liver damage. Option B, Pegfilgrastim, is a medication used to stimulate the production of white blood cells in patients undergoing chemotherapy to prevent infections. This medication is not indicated for Acetaminophen overdose. Option C, Misoprostol, is a medication used to prevent stomach ulcers in patients taking nonsteroidal anti-inflammatory drugs (NSAIDs). It is not the appropriate treatment for Acetaminophen overdose. Option D, Naltrexone, is a medication used to treat opioid and alcohol dependence by blocking the effects of opioids or alcohol in the brain. It is not indicated for Acetaminophen overdose. In an educational context, it is crucial for nurses and healthcare providers to be familiar with antidotes and appropriate treatments for medication overdoses to ensure prompt and effective patient care. Understanding the mechanisms of action and indications of medications is essential in providing safe and competent nursing care.

Correct Answer: C

Rationale: In this scenario, the correct response is C) The medication will relieve your mother's constipation. The rationale behind this is that Methylnaltrexone is a peripherally acting mu-opioid receptor antagonist that is specifically used to treat opioid-induced constipation without affecting the central nervous system's analgesic effects of opioids like Morphine. By blocking the mu-opioid receptors in the gut, Methylnaltrexone helps to alleviate the constipation side effect caused by opioids without interfering with the pain relief provided by Morphine. Option A is incorrect because Methylnaltrexone does not increase respiration, as it is not centrally acting like traditional opioid antagonists such as Naloxone. Option B is incorrect because Methylnaltrexone does not prevent dependence on Morphine; its primary purpose is to address constipation. Option D is incorrect because while Methylnaltrexone does work in conjunction with Morphine, it does not directly increase pain relief but rather targets constipation. In an educational context, it is crucial for nurses to understand the rationale for using adjunct medications like Methylnaltrexone in managing side effects of opioid therapy. This knowledge enables healthcare providers to provide comprehensive care while minimizing adverse effects for patients with conditions like end-stage cancer.