A nurse is caring for a client who has a contusion of the brainstem and reports thirst. The client's urinary output was 4,000 mL over the past 24 hours. The nurse should anticipate a prescription for which of the following intravenous (IV) medications?
Epinephrine
Furosemide
Nitroprusside
Desmopressin
The Correct Answer is D
Choice A reason: Epinephrine is primarily used in emergency situations for its vasoconstrictive and bronchodilatory effects, particularly in cases of anaphylaxis or cardiac arrest. It is not typically used to manage symptoms associated with brainstem contusions or to regulate urinary output.
Choice B reason: Furosemide is a loop diuretic commonly prescribed to reduce fluid retention in conditions such as heart failure or renal disease. Given that the client has already produced a large volume of urine (4,000 mL in 24 hours, which is above the normal range of 800 to 2,000 milliliters per day), administering furosemide would not be appropriate as it would likely exacerbate the excessive urinary output.
Choice C reason: Nitroprusside is a potent vasodilator used to treat acute hypertensive crises. It has no role in the management of thirst or regulation of urinary output and is not indicated for the treatment of brainstem contusions.
Choice D reason: Desmopressin is a synthetic analogue of the naturally occurring antidiuretic hormone vasopressin. It is used to treat conditions characterized by excessive urination, such as diabetes insipidus, and to manage polyuria and polydipsia (excessive thirst) following head trauma or surgery in the pituitary region. In the context of a brainstem contusion with a reported high urinary output, desmopressin would be the appropriate medication to prescribe to reduce urine volume and address the client's thirst.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: This statement does not indicate a need for further instruction. It is recommended to wait at least 30 minutes after taking alendronate before taking other medications to ensure proper absorption of the drug.
Choice B reason: This statement indicates a need for further instruction. Alendronate should be taken with plain water, not milk. Milk and other dairy products can interfere with the absorption of alendronate due to their calcium content.
Choice C reason: This statement does not indicate a need for further instruction. Patients are advised to remain upright for at least 30 minutes after taking alendronate to prevent esophageal irritation or ulceration.
Choice D reason: This statement does not indicate a need for further instruction. Periodic bone density tests are a standard part of monitoring the effectiveness of osteoporosis treatment.
Correct Answer is A
Explanation
Choice A reason: Checking the pulse distal to the graft is essential to ensure that the graft is patent and that there is adequate blood flow to the distal extremity. A palpable pulse indicates that the graft is functioning properly and not occluded. The absence of a pulse could signify a serious complication, such as thrombosis or stenosis, which requires immediate attention.
Choice B reason: Keeping the left forearm below the level of the heart is not recommended as it can increase venous pressure and swelling, potentially compromising graft function. The extremity should be kept at or above heart level to promote venous return and reduce the risk of edema.
Choice C reason: Collecting blood specimens from the graft is generally avoided to prevent damage to the graft. Blood draws can be performed from other sites to protect the integrity of the graft.
Choice D reason: Splinting the left forearm is not a standard postoperative care measure for an arteriovenous graft. While protecting the graft from injury is important, immobilization with a splint is not necessary and can impede mobility and circulation.

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