A client indicates to the nurse a pain level of 8 out of 10. The nurse notes the client has an order for morphine 4 mg IV Q 6 hr PRN for moderate to severe pain. The client's blood pressure is 80/54 mm Hg, respirations 10 breaths/min, and pulse 62 beats/min. Which action should the nurse take?

Tell the client he can no longer have any more pain medication

Notify the prescribing physician

Administer half the dose of morphine, 2 mg IV

Administer 4 mg of morphine IV as ordered

Answer and Explanation

The Correct Answer is B

A. Tell the client he can no longer have any more pain medication: This is not appropriate. The client’s severe pain needs to be managed, but the current vital signs suggest a need for careful evaluation before administration.
B. Notify the prescribing physician: This is the correct choice. The client's blood pressure and respiratory rate are significantly low, which could be exacerbated by morphine. The physician needs to be informed to reassess pain management and possibly adjust the treatment.
C. Administer half the dose of morphine, 2 mg IV: Given the client's low blood pressure and respiratory rate, any morphine administration could worsen these issues. Adjusting the dose without physician guidance is not appropriate.
D. Administer 4 mg of morphine IV as ordered: Administering the full dose without addressing the client’s low blood pressure and respiratory rate could lead to severe complications.

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Correct Answer is ["C","D"]

Explanation

A. The client who takes medications for occasional anxiety: Anxiety medications are not typically associated with metabolic acidosis.
B. The client admitted with a mild pleural effusion: A mild pleural effusion is more related to fluid accumulation and respiratory issues rather than metabolic acidosis.
C. The client who has had diarrhea for the past 48 hours: Prolonged diarrhea can lead to loss of bicarbonate, resulting in metabolic acidosis.
D. The client admitted with an acute renal injury: Acute renal injury impairs the kidneys' ability to excrete acids and can lead to metabolic acidosis.
E. The client admitted for treatment of asthmatic bronchitis: Asthmatic bronchitis typically involves respiratory issues rather than metabolic acidosis.

A. 10% dextrose in water B. 10% dextrose in 0.45% sodium chloride C. 0.9% sodium chloride D. 2.5% sodium chloride

Correct Answer is C

Explanation

A. 10% dextrose in water: This solution is used primarily for providing calories and is not suitable for volume replacement.
B. 10% dextrose in 0.45% sodium chloride: This solution combines dextrose and a hypotonic sodium chloride solution, which is not ideal for immediate volume replacement in severe bleeding cases.
C. 0.9% sodium chloride: This is the correct choice. Normal saline (0.9% sodium chloride) is an isotonic solution used for volume replacement, especially in cases of significant blood loss.
D. 2.5% sodium chloride: This is a hypotonic solution and would not be appropriate for volume replacement in severe bleeding as it does not adequately address the need for fluid resuscitation.

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A client indicates to the nurse a pain level of 8 out of 10. The nurse notes the client has an order for morphine 4 mg IV Q 6 hr PRN for moderate to severe pain. The client's blood pressure is 80/54 mm Hg, respirations 10 breaths/min, and pulse 62 beats/min. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse identifies that which of the following clients is at risk for developing metabolic acidosis? (Select All That Apply)

Correct Answer is ["C","D"]

Explanation

A 28-year-old client is admitted to the hospital with severe bleeding from a fractured femur. Which intravenous fluid should the nurse anticipate will be ordered for volume replacement?

Correct Answer is C

Explanation

A client with dry skin and mucous membranes is weak, has orthostatic blood pressure changes, and has decreased urine output. The serum osmolality is 290 mOsm/kg. What IV fluid should the nurse anticipate being prescribed for this client?

The nurse is educating a group of student nurses about the different types of anesthesia. The student demonstrates an understanding of the teaching when they state that a client would maintain a gag reflex with what anesthesia?

An unresponsive client was brought to the emergency room and had an arterial blood gas drawn. Ten minutes later, the laboratory calls with the following results: PaO2 74%, pH 7.22, PaCO2 85 mm Hg, and HCO3 23 mEq/L. The nurse interprets the results as indicating which imbalance?

A hospitalized client is receiving IV furosemide (Lasix) to treat stage 2 hypertension. Which assessment finding related to the medication requires prompt collaboration with the health care provider?

Which client response best supports the decision to discharge the client from the Post-Anesthesia Care Unit?

After having an intravenous (IV) line in place for 72 hours, a client complains of tenderness, burning, and swelling. Assessment of the IV site reveals a cord-like vein and a reddened streak. The nurse identifies that these findings indicate what complication?

A client with leukemia is expected to require chemotherapy for several months. Which type of IV line will best meet the client's needs?

A client with acute pain is prescribed a sustained-release opioid that is administered every 12 hours. After 6 hours, the client complains of increasing pain that is rated as 9/10. Which intervention by the nurse is most appropriate to address the client's pain?