The PMHNP is seeing clients at an inpatient substance abuse facility. She is called to assist a 42-year-old patient suspected of benzodiazepine overdose who has not responded to 3 mg of flumazenil (Romazicon) administered intravenously (IV). The most appropriate intervention at this time would be to:
Immediately administer another 3-mg dose of flumazenil IV.
Wait 5 minutes and administer a 1-mg dose of flumazenil IV.
Wait 20 minutes and administer another 3 mg of flumazenil.
Do not administer another dose of flumazenil.
The Correct Answer is D
Choice A reason: Administering another 3 mg of flumazenil immediately after a failed response to the initial dose is not recommended due to the risk of precipitating seizures, especially in patients with chronic benzodiazepine use or co-ingestion of pro-convulsant substances. Flumazenil has a narrow therapeutic window and should be titrated cautiously.
Choice B reason: Although smaller incremental doses of flumazenil (e.g., 0.2–1 mg) may be used in some protocols, repeated dosing after a cumulative 3 mg without response is generally discouraged. The risk of adverse effects, particularly seizures, increases with higher cumulative doses.
Choice C reason: Waiting 20 minutes and administering another 3 mg would exceed the recommended maximum cumulative dose of flumazenil, which is typically 3–5 mg. This approach increases the risk of serious complications and is not supported by clinical guidelines.
Choice D reason: If a patient does not respond to a total of 3 mg of flumazenil, further administration is not advised. The lack of response suggests that the cause of altered mental status may not be due to benzodiazepines alone or that the patient has developed tolerance. Supportive care and airway management should be prioritized.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: "Legislate, execute, and judge" refers to the three branches of government and their functions, not the phases of health policy development. This framework is constitutional, not specific to health policy.
Choice B reason: "Plan, Do, Study, Act" is a quality improvement cycle used in healthcare settings to test and implement changes in clinical practice. It is not a framework for health policy development.
Choice C reason: The health policy process typically follows three core phases: formulation (developing policy proposals), implementation (putting policies into action), and evaluation (assessing the effectiveness and impact of the policy). This model is widely accepted in public health and policy literature.
Choice D reason: "Understand, design, and structure change" is a vague and non-standard framework. It does not reflect the established phases used in health policy analysis and development.
Correct Answer is C
Explanation
Choice A reason: Pearson’s r correlation measures the strength and direction of a linear relationship between two variables. It does not quantify the likelihood of an event.
Choice B reason: The p-value indicates the probability of obtaining the observed results assuming the null hypothesis is true. While it reflects statistical significance, it is not the general term for likelihood.
Choice C reason: Probability is the statistical concept that describes the likelihood of an event occurring. It is foundational to inferential statistics and underpins many statistical tests.
Choice D reason: ANOVA tests for differences among group means but does not directly measure the likelihood of an event. It uses probability concepts but is not itself a measure of probability.
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