The nurse prepares to administer benztropine to the patient with Parkinson's Disease. The nurse holds the dose and notifies the physician based on which assessment finding?
A respiratory rate of 14
A pulse of 102
Blood pressure of 88/60 mmHg
A temperature of 100.2°F
The Correct Answer is C
A. A respiratory rate of 14
A respiratory rate of 14 is within the normal range and is not typically a reason to hold benztropine. Respiratory depression is not a common side effect of this medication.
B. A pulse of 102
A pulse rate of 102 is also within the normal range, and changes in heart rate are generally not a prominent side effect of benztropine. This finding alone is not a typical reason to hold the medication.
C. Blood pressure of 88/60 mmHg
This is the correct choice. Anticholinergic medications, like benztropine, can cause side effects such as a decrease in blood pressure. A blood pressure of 88/60 mmHg may be a concern, and the nurse should hold the dose and notify the physician.
D. A temperature of 100.2°F
An elevated temperature of 100.2°F is not a direct contraindication to benztropine administration. Fever is not a typical side effect of this medication, so an increased temperature alone is not a reason to hold the dose.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["540"]
Explanation
The client consumes three different types of fluids during the day: milk, juice, and soup. The amount of each fluid is measured in different units: cups, ounces, and bowls. To record the client's intake in milliliters (mL), we need to convert these units using the following conversion factors:
- 1 cup = 240 mL
- 1 ounce = 30 mL
- 1 bowl = 150 mL
Using these conversion factors, we can calculate the client's intake in mL as follows:
- Milk: 1 cup x 240 mL/cup = 240 mL
- Juice: 4 oz. x 30 mL/oz. = 120 mL
- Soup: 6 oz. x 30 mL/oz. = 180 mL
The total intake in mL is the sum of these three values:
- Total intake = 240 mL + 120 mL + 180 mL = 540 mL
Therefore, the client's intake in mL is 540 mL.
Correct Answer is ["C","D"]
Explanation
A. Administer morphine 1-2 mg IV
Administering morphine is not a preventive measure for spinal headaches. It may be considered for pain relief if the patient experiences discomfort after the effects of spinal anesthesia wear off.
B. Ambulate the client as soon as she gets feelings back
Ambulating the patient too soon after spinal anesthesia is generally not recommended. Staying in bed initially helps prevent complications like spinal headaches.
C. Increase fluid intake
Adequate hydration is important after spinal anesthesia to help maintain cerebrospinal fluid volume. Increasing fluid intake can reduce the risk of developing a spinal headache.
D. Encourage the patient to stay flat in bed
Remaining in a flat or slightly elevated position helps minimize cerebrospinal fluid leakage from the puncture site, reducing the likelihood of developing a spinal headache. This position is typically recommended for a specific duration after spinal anesthesia.
E. Position the client in high Fowler's position
Placing the patient in high Fowler's position (sitting upright) may increase the risk of cerebrospinal fluid leakage, potentially leading to a spinal headache. This position is not recommended for preventing spinal headaches after spinal anesthesia.
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