Patient Data

Exhibits

Review H and P, and nurse’s note. Identify from the choices below which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.

Answer and Explanation

The Correct Answer is []

Potential Condition: Methemoglobinemia

Methemoglobinemia is a condition in which the hemoglobin in the blood is unable to bind oxygen effectively, resulting in tissue hypoxia. It can be caused by exposure to certain drugs or chemicals, such as nitrates, benzocaine, or dapsone. Some symptoms of methemoglobinemia include cyanosis, headache, fatigue, dyspnea, and tachycardia. In severe cases, it can lead to seizures, coma, and death.

Actions to Take:

Draw blood for a complete blood count
administer methylene blue

A complete blood count (CBC) can help diagnose methemoglobinemia by measuring the level of methemoglobin in the blood. A normal level is less than 1%, while a level above 15% can cause symptoms. A level above 30% can be life-threatening. Methylene blue is a medication that can reduce methemoglobin back to normal hemoglobin and restore oxygen delivery to the tissues. It is given intravenously at a dose of 1-2 mg/kg over 5 minutes.

Parameters to Monitor:

Methemoglobin level
heart rate and rhythm

The methemoglobin level is the most important parameter to monitor in methemoglobinemia, as it indicates the severity of the condition and the response to treatment. The goal is to lower the level below 10% or until symptoms resolve. The heart rate and rhythm are also important to monitor, as methemoglobinemia can cause tachycardia and dysrhythmias due to hypoxia and acidosis. The goal is to maintain a normal sinus rhythm and a heart rate within the normal range for the client’s age and condition.

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Correct Answer is C

Explanation

Choice A reason: Beef tips with gravy are not a dietary choice that should be avoided by a client taking phenelzine, which is a monoamine oxidase inhibitor (MAOI) that treats depression. Beef tips with gravy do not contain tyramine, which is a substance that can interact with MAOIs and cause a hypertensive crisis.

Choice B reason: Deep-fried shrimp are not a dietary choice that should be avoided by a client taking phenelzine, which is a monoamine oxidase inhibitor (MAOI) that treats depression. Deep-fried shrimp do not contain tyramine, which is a substance that can interact with MAOIs and cause a hypertensive crisis.

Choice C reason: Pepperoni pizza is a dietary choice that should be avoided by a client taking phenelzine, which is a monoamine oxidase inhibitor (MAOI) that treats depression. Pepperoni pizza contains tyramine, which is a substance that can interact with MAOIs and cause a hypertensive crisis. Tyramine is found in aged, fermented, cured, smoked, or pickled foods, such as cheese, salami, sauerkraut, soy sauce, beer, and wine.

Choice D reason: Pan-seared catfish is not a dietary choice that should be avoided by a client taking phenelzine, which is a monoamine oxidase inhibitor (MAOI) that treats depression. Pan-seared catfish does not contain tyramine, which is a substance that can interact with MAOIs and cause a hypertensive crisis.

A. Eliminate use of nonsteroidal anti-inflammatory drugs (NSAIDs). B. Monitor blood glucose levels daily. C. Notify healthcare provider prior to dental procedures. D. Avoid consuming all foods that contain iodine.

Correct Answer is A

Explanation

Choice A reason: Eliminating use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, is an instruction that the nurse should provide to the client who is taking lithium carbonate, which is a medication that stabilizes mood and prevents manic episodes. NSAIDs can increase the blood levels of lithium and cause toxicity, which can manifest as nausea, vomiting, tremors, confusion, or seizures.

Choice B reason: Monitoring blood glucose levels daily is not an instruction that the nurse should provide to the client who is taking lithium carbonate, which is a medication that does not affect the blood sugar levels or the risk of diabetes. Blood glucose levels may be important for the general health of the client, but they are not related to lithium therapy.

Choice C reason: Notifying healthcare provider prior to dental procedures is not an instruction that the nurse should provide to the client who is taking lithium carbonate, which is a medication that does not interact with local anesthetics or antibiotics that may be used during dental procedures. However, the client should inform the dentist about their medical history and medications, as a precaution.

Choice D reason: Avoiding consuming all foods that contain iodine is not an instruction that the nurse should provide to the client who is taking lithium carbonate, which is a medication that does not interfere with the thyroid function or the metabolism of iodine. Iodine is an essential nutrient that is found in many foods, such as seafood, dairy products, eggs, and iodized salt. Avoiding iodine can cause deficiency and lead to goiter or hypothyroidism.

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Patient Data Exhibits Review H and P, and nurse’s note. Identify from the choices below which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.

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Naxlex Comprehensive Predictor Exams

A client with bulimia and depression who is taking phenelzine 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. Which dietary choices should the nurse instruct the client to avoid?

Correct Answer is C

Explanation

A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate. Which instruction should the nurse provide to the client?

Correct Answer is A

Explanation

A client who is taking an oral dose of a tetracycline reports gastrointestinal (GI) upset. Which snack should the nurse instruct the client to take with the tetracycline?

Patient Data Exhibits The charge nurse places a fall precautions sign on the client's door. What side effects of morphine could contribute to this client's fall risk? Select all that apply.

The nurse is administering sevelamer during lunch to a client with chronic kidney disease (CKD). The client asks the nurse to bring the medication later. The nurse should describe which action of sevelamer as an explanation for taking it with meals?

A female client with mild depression reports to the nurse recently starting St. John's wort. Which information provided by the client requires further instruction?

Patient Data Exhibits What actions should the nurse take to ensure safety during morphine administration? Select all that apply.

Patient Data Exhibits Review H and P, and nurse’s note. Identify from the choices below which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.

A client with a cold is taking the antitussive medication benzonatate. Which assessment information indicates to the nurse that the medication is effective?

Patient Data

Exhibits

Review H and P, and nurse’s note. Identify from the choices below which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.