A nurse in the emergency department is caring for a client who is suspected to be in a cholinergic crisis. Which of the following factors should the nurse identify as a possible cause?

High purine diet

High protein diet

Not exercising enough

Taking too much of the prescribed medication

Answer and Explanation

The Correct Answer is D

Choice A reason: A high purine diet is more commonly associated with gout and hyperuricemia, not cholinergic crisis.

Choice B reason: A high protein diet is not directly related to cholinergic crisis. The crisis is related to medication levels rather than dietary factors.

Choice C reason: Not exercising enough is not a direct cause of cholinergic crisis. Physical activity levels do not impact the balance of acetylcholine in the body in this context.

Choice D reason: A cholinergic crisis occurs due to excessive accumulation of acetylcholine, often from taking too much of prescribed anticholinesterase medications. This can lead to overstimulation of the neuromuscular junction and symptoms such as muscle weakness and respiratory distress.

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Correct Answer is B

Explanation

Choice A reason: Verifying the conductive gel pads is important but should be done before the command "CLEAR!" is given.

Choice B reason: Stepping away from the bed and ensuring others have done the same is crucial for safety. It prevents accidental electrical shock to anyone touching the patient or bed during defibrillation.

Choice C reason: Shutting off the intravenous infusion is not necessary during defibrillation. It does not pose a safety risk in this context.

Choice D reason: Shutting off the mechanical ventilator is not necessary during defibrillation and could compromise the patient's ventilation status.

A. A patient with a new-onset of confusion and restlessness. B. A patient who reports dizziness after receiving captopril (Capoten). C. A patient who requires oxygen via nasal cannula with saturations of 97%. D. A patient who has received digoxin and has a blood pressure (BP) of 100/56.

Correct Answer is A

Explanation

Choice A reason: A patient with a new-onset of confusion and restlessness is a priority because these symptoms could indicate a serious condition such as hypoxia, electrolyte imbalance, or a neurological event like a stroke. These changes in mental status need to be evaluated immediately to prevent further complications.

Choice B reason: Dizziness after receiving captopril (Capoten) can be a side effect of the medication due to its blood pressure-lowering effects. While it should be monitored, it is not as urgent as the new-onset confusion and restlessness seen in another patient.

Choice C reason: A patient requiring oxygen via nasal cannula with saturations of 97% is stable as the oxygen saturation is within normal limits. This patient does not need to be prioritized over others with more acute symptoms.

Choice D reason: A patient who has received digoxin and has a blood pressure of 100/56 should be monitored, especially for signs of digoxin toxicity. However, this situation is not as critical as the new-onset confusion and restlessness in another patient.

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A nurse in the emergency department is caring for a client who is suspected to be in a cholinergic crisis. Which of the following factors should the nurse identify as a possible cause?

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