A nurse is caring for several clients who have mental health disorders at an assisted-living facility. Which of the following clients should the nurse determine needs to be seen by a provider immediately?

A client who is taking thioridazine and has daytime drowsiness

A client who is taking olanzapine and experiences dizziness when first standing up

A client who is taking clozapine, and has flu-like manifestations

A client who is taking chlorpromazine and reports vomiting twice

Answer and Explanation

The Correct Answer is C

A. Thioridazine and drowsiness
A common side effect, not urgent.

B. Olanzapine and dizziness
Orthostatic hypotension-monitor, but not emergent.

C. Clozapine and flu-like symptoms
Could indicate agranulocytosis, a life-threatening condition-requires immediate evaluation.

D. Chlorpromazine and vomiting
Requires monitoring, but not as urgent as option C.

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Correct Answer is D

Explanation

A. Diarrhea and requests clear liquids
This is non-urgent. The client is stable and can eat as tolerated.

B. Type 1 DM, fasting glucose of 150
A fasting glucose of 150 is slightly elevated but not a priority compared to potential neurovascular compromise.

C. Pneumonia with axillary temp of 38°C
Mild fever is expected with pneumonia; not an immediate concern.

D. Cast on leg with numbness/paresthesia
This may indicate compartment syndrome or impaired circulation and requires immediate assessment to prevent permanent damage.

A. Give naloxone 0.2 mg IV STAT B. Bag-valve-mask (BVM) ventilations C. Chest compressions D. Defibrillation E. Incentive spirometry F. Chest physiotherapy (CPT) G. Give 2 units of packed red blood cells (PRBCs) H. Obtain crash cart I. Correct electrolyte imbalance(s) J. Give morphine sulfate 2 mg IV x 1 STAT

Correct Answer is ["A","B","H"]

Explanation

A. Give naloxone 0.2 mg IV STAT
The client has received multiple opioids (fentanyl + morphine) and is now increasingly somnolent, minimally responsive, with shallow respirations and low oxygen saturation. These are classic signs of opioid-induced respiratory depression, and naloxone (an opioid antagonist) should be administered immediately.

B. Bag-valve-mask (BVM) ventilations
The client has shallow respirations and poor oxygenation (SpO₂ dropped to 92%) and is minimally responsive. BVM is essential to maintain oxygenation and ventilation while naloxone takes effect or if apnea develops.

C. Chest compressions
There is no indication of cardiac arrest. The client still has a pulse and blood pressure, though hypotensive.

D. Defibrillation
There is no mention of a shockable rhythm (e.g., V-fib or pulseless V-tach). Defibrillation is not indicated for respiratory depression or somnolence.

E. Incentive spirometry
The client is minimally responsive and unable to cooperate with incentive spirometry. This is used post-op for alert clients to prevent atelectasis, not for unconscious or sedated patients.

F. Chest physiotherapy (CPT)
Not appropriate for this case. CPT is used for mucus clearance in conditions like COPD or pneumonia, not for opioid-induced respiratory depression.

G. Give 2 units of packed red blood cells (PRBCs)
There is no sign of active bleeding or anemia. Hemoglobin was not reported to be low, and there are no signs of hemorrhagic shock.

H. Obtain crash cart
The client is decompensating rapidly - lethargy, hypotension, and respiratory depression could progress to respiratory or cardiac arrest. Having the crash cart ready ensures that resuscitation medications and defibrillation (if needed) are available without delay.

I. Correct electrolyte imbalance(s)
There is no data provided suggesting an electrolyte imbalance. This is not a priority in the setting of opioid overdose with respiratory compromise.

J. Give morphine sulfate 2 mg IV x 1 STAT
This would worsen the client’s condition by increasing opioid load in someone already experiencing opioid toxicity. It’s absolutely contraindicated.

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A nurse is caring for several clients who have mental health disorders at an assisted-living facility. Which of the following clients should the nurse determine needs to be seen by a provider immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing four clients on a medical-surgical unit. Which of the following clients should the nurse care for first?

Correct Answer is D

Explanation

A nurse is caring for a post-operative client in the post anesthesia care unit (PACU). Exhibits A nurse has assessed the postoperative client. Which of the following interventions are needed immediately? (Select All that Apply.)

Correct Answer is ["A","B","H"]

Explanation

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