Patient Data

Which other medications would the nurse expect the surgeon to prescribe along with morphine? Select all that apply.

Propofol

Methadone

Docusate sodium

Ibuprofen

Naloxone

Senna

Answer and Explanation

Correct Answer : C,D,E,F

A. Propofol: Propofol is a powerful sedative used mainly for anesthesia or sedation during mechanical ventilation. It is not appropriate or expected for routine postoperative pain management with morphine on a surgical floor.

B. Methadone: Methadone is another opioid used for chronic pain management or opioid dependency, not typically prescribed alongside morphine for acute postoperative pain because combining opioids increases the risk of respiratory depression.

C. Docusate sodium: Docusate sodium is a stool softener often prescribed with opioids like morphine to prevent constipation, a common opioid side effect. Promoting bowel movements is an important preventative measure in postoperative patients.

D. Ibuprofen: Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), may be prescribed to provide additional pain relief through a different mechanism and reduce inflammation. This combination allows lower opioid doses, improving pain management while minimizing opioid side effects.

E. Naloxone: Naloxone is an opioid antagonist kept available as a safety measure in case of opioid-induced respiratory depression. Having naloxone ordered and readily accessible is a critical precaution during opioid therapy.

F. Senna: Senna is a stimulant laxative that can be prescribed along with docusate to prevent or treat opioid-induced constipation by actively stimulating bowel movements, making it a commonly expected medication alongside opioids.

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Correct Answer is A

Explanation

A. Take the medication during pregnancy: Methotrexate is highly teratogenic and absolutely contraindicated during pregnancy because it can cause severe fetal malformations or death. Clients must be instructed to avoid pregnancy while on methotrexate and for some time after discontinuing the drug, making this a critical point requiring immediate correction.

B. Use folic acid to protect the liver: Methotrexate interferes with folate metabolism, and folic acid supplementation is recommended to reduce some side effects such as liver toxicity, mucositis, and bone marrow suppression. This statement reflects appropriate understanding of supportive care during methotrexate therapy.

C. Store the medication at room temperature: Methotrexate should be stored at room temperature away from light and moisture, consistent with safe medication handling practices. This information is accurate and does not require additional instruction.

D. Obtain a platelet count weekly: Methotrexate can cause bone marrow suppression, increasing the risk of thrombocytopenia. Regular monitoring of blood counts, including platelets, is standard practice to detect toxicity early, so this action is appropriate and understood correctly.

A. Print an electrocardiogram strip B. Call for rapid response C. Perform chest compressions D. Apply oxygen via nasal cannula E. Give naloxone 2 mg intravenous push F. Provide rescue breaths with a manual ventilation bag

Correct Answer is ["B","E","F"]

Explanation

A. Print an electrocardiogram strip: While cardiac monitoring is important, printing an ECG strip does not immediately address the critical issue of respiratory depression and unresponsiveness. Priority actions must focus on airway and breathing first.

B. Call for rapid response: The client is critically unstable with severe respiratory depression and unresponsiveness, meeting criteria for a rapid response or even a code blue if the situation deteriorates further. Immediate expert team support is crucial.

C. Perform chest compressions: Chest compressions are only indicated if the client is pulseless. In this case, the client has a heart rate of 92 beats/minute, meaning compressions are not appropriate at this moment.

D. Apply oxygen via nasal cannula: A nasal cannula would not deliver high enough oxygen concentrations for someone with a respiratory rate of 5 breaths/minute and oxygen saturation of 54%. Higher oxygen delivery methods and ventilatory support are urgently needed.

E. Give naloxone 2 mg intravenous push: Naloxone is indicated immediately to reverse opioid-induced respiratory depression. Giving the prescribed naloxone IV push can rapidly counteract the morphine overdose and improve the client’s respiratory effort.

F. Provide rescue breaths with a manual ventilation bag: Because the client’s respirations are critically low, rescue breathing with a manual resuscitation bag is necessary to maintain oxygenation and ventilation until naloxone takes effect or more advanced airway management is available.

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Patient Data Which other medications would the nurse expect the surgeon to prescribe along with morphine? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client receives a prescription for methotrexate. Which information provided by the client requires additional instruction by the nurse?

Correct Answer is A

Explanation

Patient Data Which should the nurse do immediately? Select all that apply.

Correct Answer is ["B","E","F"]

Explanation

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?

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A client with symptoms of influenza that started the previous day asks the clinic nurse about taking oseltamivir to treat the infection. Which response should the nurse provide?

A client who uses transdermal contraceptive, calls to the clinic because she forgot to apply a new patch three days ago. Which instruction should the nurse provide to the client?

A client who experiences migraine headaches reports having fewer headaches since using the herbal remedy feverfew. Which information is most important for the nurse to include in a teaching plan for this client?

A client with open-angle glaucoma is using pilocarpine opthalmic solution, a miotic agent. Which action should the nurse at the eye clinic include in evaluating the effectiveness of the medication?

Patient Data

Which other medications would the nurse expect the surgeon to prescribe along with morphine? Select all that apply.