Upon preparing to administer activated charcoal by mouth to treat a patient who took an overdose of aspirin and several unknown drugs, the nurse notes that the patient has become very somnolent and eyes open only to a noxious stimulus. Which action by the nurse is most appropriate at this point?

Correct Answer: A

Rationale: The patient's decreased level of consciousness (somnolence and only responding to noxious stimuli) indicates a potential deterioration in their condition, possibly due to the overdose. Activated charcoal is contraindicated in patients with an altered mental status due to the risk of aspiration. The nurse should immediately consult the nurse practitioner to reassess the patient's condition and determine the appropriate intervention, such as securing the airway or considering alternative treatments.

Correct Answer: C

Rationale: Ondansetron is a medication commonly used to prevent nausea and vomiting, particularly in patients receiving chemotherapy or undergoing surgery. Its mechanism of action involves blocking the effects of serotonin, specifically by antagonizing serotonin 5-HT3 receptors in the chemoreceptor trigger zone of the brain and the gastrointestinal tract. By inhibiting serotonin signaling, ondansetron helps to alleviate nausea and vomiting in affected individuals. This action is distinct from the other options provided, making option C the correct answer for the drug Ondansetron.

Correct Answer: C

Rationale: Pseudoephedrine, an oral decongestant, stimulates alpha-adrenergic receptors, potentially causing cardiovascular effects like dysrhythmias due to its sympathomimetic action. An irregular heart rate of 82 is a priority concern, signaling possible arrhythmia, which could escalate to serious cardiac events, requiring immediate reporting. A mild fever or elevated respiratory rate could relate to the underlying condition (e.g., infection) rather than the drug. Dry mouth is a common, benign side effect. The nurse focuses on the irregular pulse as it aligns with pseudoephedrine's known risk of dysrhythmias, especially in susceptible patients, making choice C the most urgent finding to address.

Correct Answer: A

Rationale: Nausea is one of the early manifestations of lithium toxicity. It is important to monitor for this symptom in patients taking lithium to detect toxicity early and prevent more serious complications. Hypotension and renal failure are more severe manifestations of lithium toxicity that occur at later stages. Muscle weakness is not typically associated with early lithium toxicity.

Correct Answer: C

Rationale: Thiopental, a barbiturate, persists 24 hours post-surgery. Physiologic metabolism is correct-its lipophilicity causes redistribution to fat, with slow hepatic metabolism, normal in the elderly. Hepatitis or insufficiency lacks evidence. Renal failure doesn't primarily clear it. Trauma (E) is unrelated. This reflects thiopental's pharmacokinetics, not pathology.