The nurse is administering ibuprofen (Advil) to an older patient. Which assessment data causes the nurse to hold the medication?

Patient reports pain on 4/10 scale in right shoulder

Patient experiences respiratory depression after administration of an opioid medication.

Patient reports last bowel movement was 2 days ago.

Patient reports past medical history of gastric ulcer.

Answer and Explanation

The Correct Answer is D

Choice A reason: Pain of 4/10 indicates a need for analgesia, and ibuprofen is appropriate for mild to moderate pain. This does not warrant holding the medication, as it aligns with the drug’s therapeutic purpose.

Choice B reason: Respiratory depression from opioids is unrelated to ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID). While concerning, it does not contraindicate ibuprofen administration, though it requires separate intervention for opioid toxicity.

Choice C reason: A bowel movement 2 days ago suggests mild constipation, not a contraindication for ibuprofen. While NSAIDs can cause gastrointestinal irritation, this finding alone does not justify holding the medication without further symptoms.

Choice D reason: A history of gastric ulcer is a contraindication for ibuprofen, an NSAID that inhibits prostaglandins, reducing gastric mucosal protection. This increases the risk of ulcer reactivation or bleeding, necessitating withholding the medication.

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Correct Answer is A

Explanation

Choice A reason: Morphine-induced respiratory depression (RR 10, O2 Sat 85%) and hypotension (BP 88/42) indicate opioid overdose. Naloxone reverses opioid effects, while Fowler’s position and oxygen improve ventilation and oxygenation, addressing life-threatening symptoms as the priority.

Choice B reason: High Fowler’s position aids breathing but does not address morphine’s opioid effects causing respiratory depression and hypoxia. Alone, it is insufficient to reverse the underlying cause or stabilize the patient’s critical vital signs.

Choice C reason: Applying oxygen via nasal cannula improves oxygenation but does not reverse morphine’s central nervous system depression causing hypoventilation. It is a supportive measure, not the priority compared to naloxone administration.

Choice D reason: Flumazenil reverses benzodiazepines, not opioids like morphine. Administering it is inappropriate and ineffective for this scenario, and while oxygen is helpful, it is secondary to reversing the opioid overdose with naloxone.

A. The patient will not interrupt the procedure by asking to go to the bathroom. B. To check the patency after abdominal surgery. C. Anesthetics can decrease bladder contractility and cause urinary retention. D. The patient may void uncontrollably during the procedure.

Correct Answer is C

Explanation

Choice A reason: Preventing bathroom interruptions is not the primary rationale. While convenient, indwelling catheters are used for clinical reasons like monitoring or preventing complications. This rationale overlooks the physiological effects of surgery and anesthesia, which are more critical for catheter use in abdominal procedures.

Choice B reason: Checking patency post-surgery is not the primary reason for intraoperative catheter placement. While catheters monitor urine output, the main goal is to manage bladder function during and immediately after surgery, when anesthesia and surgical manipulation increase retention risks, not just patency.

Choice C reason: Anesthetics, especially general or spinal, reduce detrusor muscle contractility, impairing bladder emptying. This increases urinary retention risk during and post-surgery. An indwelling catheter ensures continuous drainage, preventing bladder overdistention, discomfort, or complications like urinary tract infections or bladder injury.

Choice D reason: Uncontrolled voiding during surgery is unlikely under anesthesia, which suppresses bladder reflexes. While catheters prevent intraoperative bladder filling, the primary concern is retention from anesthetic effects, not involuntary voiding, making this rationale less accurate for catheter use.

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The nurse is administering ibuprofen (Advil) to an older patient. Which assessment data causes the nurse to hold the medication?

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

The patient is having lower abdominal surgery and the nurse inserts an indwelling catheter. What is the rationale for the nurse’s action?

Correct Answer is C

Explanation

A patient who had a motor vehicle crash 2 days ago is experiencing pain and is receiving patient-controlled analgesia (PCA). Which assessment finding indicates effective pain management with the PCA?

A nurse is providing discharge teaching to a client who will be performing intermittent self-catheterization. Which of the following instructions should the nurse include?

A nurse is caring for a patient who recently had abdominal surgery and is experiencing severe pain. The patient’s blood pressure is 110/60 mmHg, and heart rate is 60 beats/min. Additionally, the patient does not appear to be in any distress. Which response by the nurse is most therapeutic?

A patient is receiving opioids for pain. Which bowel assessment is a priority?

A nurse is caring for a client who is incontinent of bowel and bladder. Which of the following actions should the nurse take?

A nurse is caring for a client who has a new diagnosis of urolithiasis. Which of the following should the nurse identify as an associated risk factor?

The nurse is planning care for a group of patients. Which task will the nurse assign to the nursing assistive personnel?

Which task could the RN delegate to the unlicensed assistive personnel (UAP)?