The healthcare provider prescribes morphine 2 mg IV for a client who reports a pain level of 7 on a 0 to 10 scale. Prior to administering the first dose, the nurse should review the electronic medical record for which condition?

Gout.

Diabetes.

Hypertension.

Asthma.

Answer and Explanation

The Correct Answer is D

A. Gout is a metabolic condition caused by elevated uric acid levels leading to crystal formation in joints, which results in pain and inflammation. Although gout may affect mobility and pain management strategies, it does not directly interact with opioids like morphine, nor does it pose an immediate risk when administering morphine intravenously. The nurse does not need to prioritize gout in the pre-administration assessment for IV morphine.

B. Diabetes mellitus involves impaired glucose regulation. While monitoring blood glucose is important when managing any client’s overall care, morphine does not directly alter blood glucose levels or exacerbate diabetes acutely. Standard precautions such as ongoing glucose monitoring and reviewing antidiabetic medications are sufficient; this condition does not require withholding or altering morphine administration.

C. Hypertension (high blood pressure) requires monitoring because opioids can cause mild vasodilation and hypotension. However, this effect is typically gradual and dose-dependent, and morphine at a standard 2 mg IV dose is unlikely to cause a dangerous drop in blood pressure in a stable hypertensive client. While the nurse should monitor vital signs, hypertension alone is not a contraindication or urgent concern prior to the first dose of morphine.

D. Asthma is the condition that requires the most careful assessment before administering morphine. Morphine can trigger histamine release, which may lead to bronchospasm and exacerbate airway obstruction. Additionally, opioids can cause respiratory depression, reducing the drive to breathe and potentially worsening hypoxia in clients with compromised pulmonary function. Before giving morphine, the nurse must review the client’s asthma history, assess current respiratory status (including rate, effort, and oxygen saturation), and be prepared to intervene if bronchospasm or respiratory compromise occurs. This assessment ensures the safe administration of morphine and prevents life-threatening complications in clients with reactive airway disease.

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Correct Answer is D

Explanation

A. Anticipating and monitoring for hypothermia is not a primary concern after a thyroidectomy. While vital signs should be monitored, hypothermia is not a common complication of thyroid surgery, so this intervention is not the most important at this stage.

B. Preparing to administer radioactive iodine treatments is unnecessary immediately post-thyroidectomy. Radioactive iodine is typically used in the treatment of hyperthyroidism or thyroid cancer at later stages, not as an immediate postoperative intervention.

C. Resuming antithyroid drug therapy is not indicated after a thyroidectomy because the surgical removal of thyroid tissue eliminates or significantly reduces thyroid hormone production. Postoperative care focuses on monitoring for complications rather than continuing antithyroid medications.

D. Maintaining a semi-Fowler position is the most important intervention. Elevating the head of the bed helps reduce swelling, promotes airway patency, and decreases tension on the surgical site. Airway compromise is a major postoperative risk due to edema or hematoma formation, and positioning is a critical component of preventing respiratory complications in the immediate 12-hour postoperative period.

A. Blood pressure control. B. Temperature maintenance. C. Prophylactic antiepileptic initiation. D. Glucose stabilization.

Correct Answer is A

Explanation

A. Blood pressure control is the most critical component in the management of a client with a subarachnoid hemorrhage, particularly when a cerebral aneurysm is present. Elevated blood pressure increases the risk of aneurysm rupture or rebleeding, which can lead to catastrophic neurological deterioration. Maintaining blood pressure within a safe range helps reduce intracranial pressure and prevents further bleeding, directly impacting patient outcomes.

B. Temperature maintenance is important for overall neurological recovery, as hyperthermia can increase cerebral metabolism and worsen neurological injury. However, it is secondary to the immediate need for blood pressure control in preventing aneurysm rupture or rebleeding.

C. Prophylactic antiepileptic medications may be considered for some patients, especially those with seizures or high risk of seizures, but routine prophylactic initiation is not the primary focus of SAH management and does not address the most urgent risk of rebleeding.

D. Glucose stabilization is important for critically ill patients to prevent secondary brain injury from hyperglycemia, but it is supportive care and not the key intervention in SAH management.

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The healthcare provider prescribes morphine 2 mg IV for a client who reports a pain level of 7 on a 0 to 10 scale. Prior to administering the first dose, the nurse should review the electronic medical record for which condition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which intervention is most important for the nurse to include in the plan of care for a client who is 12 hours post-thyroidectomy?

Correct Answer is D

Explanation

The nurse is caring for a client with a subarachnoid hemorrhage (SAH) complicated by a cerebral aneurysm. Which component of care is key to SAH management?

Correct Answer is A

Explanation

The charge nurse is making assignments for one practical nurse (PN) and three registered nurses (RN) who are caring for neurologically compromised clients. Which client with which change in status is best to assign to the PN?

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