The unit physicians have ordered MRI tests for four clients. For which client would the nurse decline to make test arrangements without further discussion with the physician? The client who:

Correct Answer: C

Rationale: The correct answer is C because a client who has had a total knee replacement may have metal implants, which can interfere with the MRI imaging and pose a safety risk. The nurse should decline to make test arrangements without further discussion with the physician to ensure the safety and appropriateness of the test. Choice A (breastfeeding) is not a contraindication for an MRI, as it is safe for breastfeeding mothers. Choice B (allergic to iodine) is also not a reason to decline an MRI, as contrast agents without iodine can be used. Choice D (neuroleptic medication) may affect the MRI results, but it is not a reason to decline the test outright without further discussion with the physician.

Correct Answer: D

Rationale: The correct answer is D: Diarrhea. Procainamide is known to have gastrointestinal side effects, including diarrhea. This adverse effect is important to monitor as it can lead to dehydration and electrolyte imbalances. Bradycardia (A) is not a common side effect of procainamide. Shortened QT interval (B) is not an adverse effect associated with procainamide. Dyspnea (C) is also not a common side effect of procainamide. Monitoring for diarrhea is crucial to prevent complications and ensure patient safety.

Correct Answer: D

Rationale: The correct answer is D: Palpitations. Topically applied adrenergic nasal decongestants can be absorbed systemically, leading to increased sympathetic activity. This can manifest as palpitations due to excessive stimulation of the heart. Heartburn (A) is not a systemic effect of adrenergic nasal decongestants. Bradycardia (B) is unlikely as these drugs typically cause tachycardia. Drowsiness (C) is more commonly associated with antihistamines, not adrenergic decongestants.

Correct Answer: A

Rationale: The correct answer is A: Pretty fast absorption. Sublingual route involves placing the drug under the tongue for direct absorption into the bloodstream through the highly vascular sublingual mucosa. This bypasses the first-pass metabolism in the liver, leading to faster onset of action compared to oral administration. Choice B is incorrect because sublingual administration avoids exposure to gastric secretion. Choice C is incorrect as sublingual administration bypasses liver metabolism. Choice D is incorrect as the variety of doses does not specifically relate to the sublingual route.

Correct Answer: C

Rationale: The correct term for a gradual decrease in responsiveness to a drug over days or weeks is "tolerance." Tolerance occurs due to the body adjusting to the drug's effects, requiring higher doses for the same response. Refractoriness refers to a lack of response, not a reduced response. Cumulative effect refers to increased drug effects with repeated doses. Tachyphylaxis is a rapid decrease in responsiveness, not a gradual one. Therefore, "tolerance" is the best fit for the described scenario.