The nurse assumes care of a patient in the post-anesthesia care unit (PACU). The patient had abdominal surgery and is receiving intravenous morphine sulfate for pain. The patient is asleep and has not voided since prior to surgery. The nurse assesses a respiratory rate of 10 breaths per minute and notes hypoactive bowel sounds. The nurse will contact the surgeon primarily to report which condition?

Correct Answer: B

Rationale: The most critical condition that the nurse should report to the surgeon in this scenario is respiratory depression. Respiratory depression is a potential side effect of opioid medications such as morphine sulfate. It is characterized by a decreased respiratory rate, which in this case, is 10 breaths per minute, indicating inadequate ventilation. Respiratory depression can lead to hypoxia and respiratory arrest if not promptly addressed. The nurse should prioritize notifying the surgeon to ensure immediate intervention and appropriate monitoring to prevent further complications for the patient. While the other conditions (paralytic ileus, somnolence, and urinary retention) are also relevant to the patient's care, respiratory depression poses the most immediate threat to the patient's safety and requires urgent attention.

Correct Answer: A

Rationale: Long half-life drugs (e.g., diazepam) linger, risking fetal exposure post-conception, a pharmacokinetic worry for serious conditions. No active metabolites reduce risk. High protein-binding limits free drug, less concern. As-needed use minimizes exposure. Long half-life heightens teratogenic potential, critical in planning.

Correct Answer: B

Rationale: The nurse monitors the aPTT to check the effectiveness of heparin therapy in preventing and treating blood clots. Heparin acts by inhibiting the clotting cascade, specifically by enhancing the activity of antithrombin III, which inactivates clotting factors such as thrombin and factor Xa. The aPTT measures the intrinsic pathway of the clotting cascade, which is affected by heparin therapy. By monitoring the patient's aPTT levels, the nurse can ensure that the patient is within the therapeutic range for heparin therapy to be effective in preventing further clot formation. Monitoring bleeding times, PT/INR, or vitamin K levels is not typically done to assess heparin therapy effectiveness.

Correct Answer: C

Rationale: A loading dose achieves therapeutic levels quickly for drugs with long half-lives or urgent needs. Clozapine's slow titration avoids agranulocytosis, not rapid loading. Zolmitriptan, for acute migraine, acts fast without loading due to short half-life. Amiodarone, with a half-life of weeks, uses loading doses (e.g., 800-1600 mg/day) to rapidly control arrhythmias, rational for urgent onset. Levodopa's short half-life and titration in Parkinson's don't require loading. Doxazosin, for hypertension, starts low to avoid first-dose hypotension. Amiodarone's pharmacokinetics and arrhythmia urgency make loading advised, balancing efficacy and toxicity risks.

Correct Answer: D

Rationale: Salmeterol improves asthma as a long-acting β2-agonist , relaxing bronchial smooth muscle for 12 hours. β1 agonism (A, C) affects the heart. β1 antagonism or β2 antagonism (E) worsen asthma. Salmeterol's specificity enhances control.