A nurse in the emergency department is caring for a client who accidentally doubled their last dose of diazepam.
After assessing the client, which of the following medications should the nurse plan to administer?
Disulfiram.
Flumazenil.
Naloxone.
Dantrolene.
The Correct Answer is B
Choice A rationale
Disulfiram is an aldehyde dehydrogenase inhibitor used in the treatment of chronic alcoholism. It works by blocking the metabolism of ethanol, leading to the accumulation of acetaldehyde, which produces unpleasant physical reactions when alcohol is consumed. It has no pharmacological effect on benzodiazepine overdose.
Choice B rationale
Flumazenil is a competitive benzodiazepine receptor antagonist that rapidly reverses the sedative and other central nervous system effects of benzodiazepine overdose. It acts by binding to the gamma-aminobutyric acid (GABA) receptor complex, thereby displacing benzodiazepines and restoring normal neurological function.
Choice C rationale
Naloxone is an opioid receptor antagonist primarily used to reverse opioid overdose. It competitively binds to opioid receptors, particularly mu receptors, thereby blocking the effects of opioid agonists and reversing respiratory depression and other opioid-induced central nervous system depression. It does not affect benzodiazepines.
Choice D rationale
Dantrolene is a direct-acting skeletal muscle relaxant primarily used in the treatment of malignant hyperthermia and spasticity. It works by interfering with calcium release from the sarcoplasmic reticulum in muscle cells, reducing muscle contraction. It has no role in reversing benzodiazepine overdose.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"B"},"G":{"answers":"A"}}
Explanation
- conditions. The client has dyspnea, tachycardia, and low oxygen saturation, suggesting acute illness or cardiovascular instability.
- Bumetanide, a loop diuretic, is contraindicated here as it may worsen hypovolemia and electrolyte imbalance. The client’s blood pressure is high but he is already showing signs of dehydration and electrolyte abnormalities (hypokalemia). Diuretics may exacerbate hypokalemia and hypotension later.
- Labetalol is anticipated for managing the acute hypertension (BP 160/98 mm Hg), especially with the client’s tachycardia and hypertensive urgency signs. It acts by blocking alpha and beta receptors to lower blood pressure safely.
- Oxygen is anticipated because the client’s oxygen saturation is 92% on room air with dyspnea and tachypnea; supplemental oxygen will improve tissue oxygenation and reduce hypoxia.
- Midodrine is contraindicated because it raises blood pressure via alpha-1 agonism; given the client’s elevated BP, it would worsen hypertension and increase cardiovascular risk.
- Calcium gluconate is contraindicated because the client’s calcium is within normal limits (10.3 mg/dL) and giving calcium unnecessarily can cause hypercalcemia or arrhythmias.
- Potassium supplementation is anticipated as the client has hypokalemia (2.8 mEq/L) on Day 2, which can cause arrhythmias and muscle weakness, requiring prompt correction.
Correct Answer is ["3"]
Explanation
Step 1 is: Convert client weight from pounds to kilograms. 165 Ib ÷ 2.2 Ib/kg = 75 kg.
Step 2 is: Calculate the total dose of verapamil needed. 0.1 mg/kg × 75 kg = 7.5 mg.
Step 3 is: Calculate the volume to administer in mL. 7.5 mg ÷ (2.5 mg/mL) = 3 mL. The nurse should administer 3 mL.
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