A nurse is caring for a client in the emergency department. Which action should the nurse take based on the client’s medication administration record at 1130?
Administer Albuterol nebulizer 2.5 mg stat.
Administer Methylprednisolone 50 mg IV stat.
Reassess the client’s vital signs before administering medications.
Notify the provider if the client has worsening symptoms after administration.
The Correct Answer is C
Choice A rationale
Administering Albuterol nebulizer 2.5 mg stat is appropriate for acute bronchospasm. Albuterol is a beta-agonist that relaxes airway smooth muscles, improving oxygenation. It is only administered when clinically indicated.
Choice B rationale
Methylprednisolone 50 mg IV is used for severe inflammation. It suppresses immune responses and reduces cytokine activity, but it does not directly address acute symptoms needing immediate intervention.
Choice C rationale
Reassessing vital signs ensures the patient’s stability before administering medications. This is vital in emergencies to evaluate therapy needs and prevent further clinical deterioration.
Choice D rationale
Notifying the provider about worsening symptoms after administration ensures timely interventions. However, preemptive measures, like reassessing stability, take priority before escalation.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Exercising close to bedtime increases adrenaline and body temperature, which interfere with sleep initiation. Studies recommend ceasing vigorous activity at least 3-4 hours before bedtime to optimize sleep quality.
Choice B rationale
Reducing fluid intake before bed minimizes nocturia, a common sleep disturbance. This aligns with promoting uninterrupted sleep and improving overall sleep hygiene and quality for individuals with insomnia.
Choice C rationale
Taking daytime naps, especially longer than 30 minutes, disrupts circadian rhythms and sleep drive, contributing to difficulty initiating and maintaining sleep during regular hours.
Choice D rationale
Eating a large meal before bedtime delays gastric emptying and may cause discomfort or reflux, both of which interfere with falling asleep. Light snacks are recommended if needed, but not heavy meals.
Correct Answer is A
Explanation
Choice A rationale
Sterile water prevents contamination and maintains the client’s safety during administration, reducing the risk of introducing pathogens. It ensures proper medication dissolution for smooth NG tube flow.
Choice B rationale
Mixing medications together increases the risk of drug interactions, altering pharmacokinetics or pharmacodynamics, potentially causing side effects. It is unsafe for administering via an NG tube without compatibility checks.
Choice C rationale
Sublingual medications are designed for absorption through oral mucosa, bypassing first-pass metabolism. Crushing alters this route, reducing effectiveness. They should not be crushed or administered via NG tube.
Choice D rationale
Flushing with only 5 mL of saline is insufficient to clear residue, risking medication clogging. Standard practice suggests using at least 15-30 mL to ensure patency and avoid tube obstruction.
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