A client who has had recent cardiac surgery develops pericarditis and complains of level 6 (0 to 10 scale) chest pain with deep breathing. Which of these ordered PRN medications will be the most appropriate for the nurse to administer?
Oral acetaminophen (Tylenol) 650 mg
IV morphine sulfate 6 mg
Fentanyl 2 mcg IV
Oral ibuprofen 800 mg
The Correct Answer is B
A. Oral acetaminophen is suitable for mild pain but may not provide sufficient relief for moderate to severe pain (level 6).
B. IV morphine sulfate is appropriate for moderate to severe acute pain, provides rapid relief, and also reduces the sympathetic response associated with severe chest pain, making it the best choice in this scenario.
C. Fentanyl is potent but the dose listed (2 mcg) is very low and may not provide effective pain relief for level 6 pain.
D. Oral ibuprofen may help with inflammation-related pain but has a slower onset than IV morphine and may not provide immediate relief for acute, moderate chest pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Nitroprusside is a potent vasodilator used to treat hypertensive emergencies, but it is not the first step in managing a drug-induced BP increase from dopamine.
B. Amiodarone is an antiarrhythmic; a bolus is not indicated for hypertension caused by dopamine.
C. Discontinuing dopamine entirely may cause hypotension again; the appropriate action is to titrate the dose according to the order.
D. The order allows titration of dopamine to maintain the target BP (100/70). The client’s BP is now excessively high, indicating the dopamine dose is too strong. The nurse should decrease the infusion rate and monitor BP closely, notifying the physician of the response.
Correct Answer is A
Explanation
A. The cornerstone of ACS management is to prevent further ischemia by ensuring that myocardial oxygen supply meets the heart’s demand. This goal guides all interventions, including oxygen therapy, medications, and revascularization strategies.
B. While regulating heart rate and contractility helps optimize cardiac output, it is a secondary objective that supports the primary goal of oxygen balance.
C. Enhancing myocardial muscle strength is not immediately achievable in ACS and is not the primary focus of acute care.
D. Minimizing myocardial energy consumption is supportive but does not directly address the critical issue of ischemia prevention.
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