A nurse is caring for a client who is postoperative following a procedure that required moderate sedation using midazolam. Which of the following should the nurse have on hand?

Protamine sulfate.

Acetylcysteine.

Flumazenil.

Naloxone.

Answer and Explanation

The Correct Answer is C

Choice A reason: Protamine sulfate reverses heparin, not midazolam, a benzodiazepine requiring flumazenil for reversal. Assuming protamine is needed risks ineffective response to oversedation, critical to avoid in ensuring rapid reversal and safety in clients post-moderate sedation with midazolam in surgical settings.

Choice B reason: Acetylcysteine treats acetaminophen overdose, not midazolam, reversed by flumazenil. Assuming acetylcysteine is appropriate risks delayed reversal of sedation, potentially causing respiratory depression, critical to prevent in ensuring safe recovery for clients post-moderate sedation with midazolam in postoperative care.

Choice C reason: Flumazenil reverses midazolam’s benzodiazepine effects, critical for managing oversedation or respiratory depression post-moderate sedation. Having it on hand ensures rapid response, essential for client safety, preventing complications, and supporting recovery in surgical settings using midazolam for procedural sedation.

Choice D reason: Naloxone reverses opioids, not midazolam, a benzodiazepine requiring flumazenil. Assuming naloxone is needed risks ineffective treatment of sedation, potentially prolonging respiratory risks, critical to avoid in ensuring proper reversal and safety in clients post-moderate sedation with midazolam.

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Correct Answer is A

Explanation

Choice A reason: Using an eight electric razor reduces bleeding risk in clients on warfarin, an anticoagulant that increases bleeding tendency, critical for safety. This instruction prevents cuts, essential for minimizing hemorrhage, supporting adherence, and ensuring safe daily activities in clients managing anticoagulation therapy.

Choice B reason: Milk products do not interact with warfarin; consistent vitamin K intake is key. Assuming milk avoidance is needed risks unnecessary dietary restriction, potentially affecting nutrition, critical to avoid in ensuring accurate dietary education for clients on warfarin therapy.

Choice C reason: Back pain is not a common warfarin side effect; bleeding is the primary concern. Assuming back pain is related risks misinforming the client, potentially causing unnecessary worry, critical to prevent in ensuring accurate education and safety for clients on anticoagulation therapy.

Choice D reason: Sunlight exposure does not significantly affect warfarin; photosensitivity is unrelated. Assuming sunlight avoidance is needed risks unnecessary lifestyle restrictions, critical to avoid in ensuring accurate teaching, focusing on bleeding precautions, and supporting safe warfarin use in clients requiring anticoagulation.

A. I will hang a pastel-colored mobile 24 inches above my baby’s crib. B. I can use a firm pillow to prop up the bottle when feeding my baby. C. I will avoid picking up my baby too often to keep from spoiling him. D. I will place a ticking clock nearby to soothe my baby throughout the day.

Correct Answer is D

Explanation

Choice A reason: A mobile 24 inches above the crib is too high for a 1-week-old’s vision (8-12 inches is ideal), indicating misunderstanding. A ticking clock is soothing. Assuming mobile placement is correct risks reduced stimulation, critical to avoid in supporting infant development and parental education.

Choice B reason: Propping a bottle with a pillow risks choking or aspiration in a 1-week-old; holding is required. A ticking clock is correct. Assuming propping is safe risks infant safety, critical to prevent in ensuring proper feeding practices and parental education for newborns.

Choice C reason: Avoiding frequent holding risks neglecting bonding and comfort needs in a 1-week-old; responsive care is essential. A ticking clock is soothing. Assuming avoidance is correct risks developmental issues, critical to avoid in supporting infant emotional health and parental caregiving education.

Choice D reason: Placing a ticking clock nearby mimics womb sounds, soothing a 1-week-old, promoting sleep and comfort. This understanding is critical for infant well-being, supporting parental caregiving, ensuring a calming environment, and fostering healthy development in the early newborn period at home.

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A nurse is caring for a client who is postoperative following a procedure that required moderate sedation using midazolam. Which of the following should the nurse have on hand?

Nursing Test Bank

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