A nurse is caring for a client who is receiving morphine for pain. Which of the following findings indicates that the client is experiencing an adverse effect of the medication?
Hypertension
Lacrimation
Tachycardia
Urinary retention
The Correct Answer is D
Choice A Reason:
Hypertension (high blood pressure) is not a common adverse effect of morphine. Opioid medications are more likely to cause hypotension (low blood pressure).
Choice B Reason:
Lacrimation (excessive tearing) is not a typical adverse effect of morphine. Opioids can cause dry mouth and decreased tear production.
Choice C Reason:
Tachycardia (rapid heart rate) is not a common adverse effect of morphine. Morphine and other opioids are more likely to cause bradycardia (slow heart rate) or a decrease in heart rate.
Choice D Reason:
Urinary retention is an adverse effect associated with opioid medications like morphine. Opioids can cause relaxation of smooth muscles, including those in the urinary bladder, which can lead to difficulty or inability to urinate.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Prolonged PT/INR (prothrombin time/international normalized ratio) is not typically seen in pancreatitis. It may be indicative of liver dysfunction or issues with blood clotting.
Choice B Reason:
Elevated lipase levels are commonly seen in clients with pancreatitis. Lipase is an enzyme produced by the pancreas, and when there is inflammation or damage to the pancreas, such as in pancreatitis, it can lead to the release of lipase into the bloodstream. Therefore, an elevated lipase level is a typical laboratory finding in clients with pancreatitis.
Choice C Reason:
Elevated ammonia levels are not typically associated with pancreatitis. Elevated ammonia levels may be seen in clients with liver disease or other metabolic disorders.
Choice D Reason:
Decreased albumin levels are not typically associated with pancreatitis. Decreased albumin levels may be seen in clients with liver disease or malnutrition, but it is not a specific marker for pancreatitis.
Correct Answer is B
Explanation
Choice A Reason:
Documenting the administration of medications after all assigned clients have been medicated is generally a good practice but doesn't address medication safety directly.
Choice B Reason:
Checking the clients' allergy bands with each medication administration is correct. During a review of medication administration protocol, it is important to emphasize safety practices that help prevent medication errors and ensure the correct medication is administered to the right patient. Checking the clients' allergy bands with each medication administration is a crucial safety step to verify the patient's identity and confirm allergies. This practice helps prevent medication errors related to patient identification and allergies.
Choice C Reason:
Reading medication labels twice before administration is an important practice, but it's not specific to patient identification or allergy checking.
Choice D Reason:
Using one client identifier before administering medication is important, but it's just one aspect of ensuring patient identification. Checking allergy bands provides an additional layer of safety by confirming allergies, which can be crucial in preventing adverse reactions.
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