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1 i will sign out the narcotic before the end of

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1I will sign out the narcotic before the end-of-shift count iscompleted.2I need to get another RN to witness the waste and sign thenarcotic sheet.3Narcotics are expensive, so it makes sense to save the unusedportion for the next time they need the drug.4I always make sure someone sees me place the unused portionon the narcotic in the sharps container.1Percodan orally2Lidocaine topically
ANS: 4Each route of medication administration has a different rate of absorption. When applyingmedications on the skin, absorption is slow because of the physical makeup of the skin.Medications placed on the mucous membranes and respiratory airways are quickly absorbedbecause these tissues contain many blood vessels. Because orally administered medications passthrough the gastrointestinal tract, the overall rate of absorption is usually slow. Intravenous (IV)injection produces the most rapid absorption because medications are immediately availablewhen they enter the systemic circulation.DIF: A REF: 689 OBJ: ComprehensionTOP: Nursing Process: PlanningMSC: NCLEX test plan designation: Physiological Integrity/Pharmacological & ParenteralTherapies33. A 78-year-old client with congestive heart failure (CHF) is reporting vascular pain in hislower legs and requests his oral narcotic analgesic. The nurse recognizes that the clients painrelief will be negatively affected primarily because of:ANS: 2Clients with congestive heart failure have impaired circulation, which impairs medicationdelivery to the intended site of action. Therefore the efficacy of medications in these clients isdelayed or altered. The other options reflect possible barriers, but they are not as directlyresponsible as is the hearts functional capacityDIF: C REF: 689 OBJ: AnalysisTOP: Nursing Process: PlanningMSC: NCLEX test plan designation: Physiological Integrity/Pharmacological & ParenteralTherapies34. The nurse is aware that which of the following clients is at greatest risk for developingmedication toxicity?3Demerol intramuscularly4Morphine sulfate intravenously1The clients age2The systemic effects of CHF3The route of administration4The status of the peripheral vessels1The 16-year-old anorexic
ANS: 4The degree to which medications bind to serum proteins such as albumin affects medicationdistribution. Older adults have a decrease in albumin levels in the bloodstream, probably causedby a change in liver function. The same is true for clients with liver disease or malnutrition.Because of the potential for more medication being unbound, some older adults are at risk for anincrease in medication activity or toxicity or both.DIF: C REF: 691 OBJ: AnalysisTOP: Nursing Process: AssessmentMSC: NCLEX test plan designation: Physiological Integrity/Pharmacological & ParenteralTherapies35. A 20-year-old diagnosed with Crohns disease is experiencing severe pain and is requestingthe prescribed morphine as often as it can be administered. The nurse is particularly concernedabout opioid toxicity because of:ANS: 2Toxic effects develop after prolonged intake of a medication or when a medication accumulatesin the blood because of impaired metabolism or excretion. For example, toxic levels ofmorphine, an opioid, cause severe respiratory depression and death. This clients gastrointestinalproblem puts her at particular risk. The remaining options, while not incorrect, are not the

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Term
Spring
Professor
AlfredoVela

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