Chapter 55: Adult and Pediatric Emergency Drugs

Chapter 55: Adult and Pediatric Emergency Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient who is experiencing chest pain and shortness of breath is brought to the emergency department. The nurse assesses a heart rate of 98 beats per minute, bilateral lung crackles, and an oxygen saturation of 93%. What drug will the nurse expect to administer initially to this patient?

a.	Albuterol
b.	Aspirin
c.	Nitroglycerin
d.	Oxygen

 

 

ANS:   D

The patient has signs of pulmonary edema, which can cause chest pain, crackles, and shortness of breath along with compensatory tachycardia and low oxygen saturations. The initial drug of choice is oxygen, which can minimize chest pain and open up the alveoli. The other drugs are given for specific underlying causes and may be necessary after the patient is evaluated further.

 

DIF:    Cognitive Level: Applying (Application)                              REF:    p. 814

TOP:    Nursing Process: Nursing Intervention

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A patient with suspected myocardial infarction is seen in the emergency department. The nurse is preparing to administer 325 mg of aspirin. The nurse will perform which action?

a.	Administer an enteric-coated tablet.
b.	Ask the patient to chew the tablet.
c.	Give the tablet with a small sip of water.
d.	Place the tablet under the patient’s tongue.

 

 

ANS:   B

To speed the absorption of aspirin, in a cardiac emergency, the patient should chew the tablet when given. An enteric-coated tablet will slow the absorption. Giving the aspirin with water or sublingually will slow the absorption rate.

 

DIF:    Cognitive Level: Applying (Application)                              REF:    p. 815

TOP:    Nursing Process: Nursing Intervention

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. A patient with angina has been given 0.4 mg of nitroglycerin SL. The patient reports continued chest pain 5 min later. The nurse assesses a heart rate of 84 beats per minute and a blood pressure of 88/68 mm Hg. The nurse will take which action?

a.	Administer 0.4 mg of nitroglycerin SL.
b.	Administer 0.3 mg of nitroglycerin SL.
c.	Give nitroglycerin by translingual spray.
d.	Notify the provider of the patient’s vital signs.

 

 

ANS:   D

Nitroglycerin should be held if the patient has a systolic blood pressure less than 90 mm Hg. The nurse should notify the provider.

 

DIF:    Cognitive Level: Applying (Application)                              REF:    p. 815

TOP:    Nursing Process: Nursing Intervention

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A patient with congestive heart failure and pulmonary edema is experiencing chest pain. The patient has an order for morphine sulfate IV 4 mg every 5–30 min PRN until chest pain is relieved. The last dose of 4 mg was 15 min prior, and the patient is complaining of chest pain and exhibiting increased work of breathing. The nurse notes a heart rate of 82 beats per minute, a respiratory rate of 18 breaths per minute, and a blood pressure of 135/88 mm Hg. What will the nurse do next?

a.	Administer morphine sulfate IV 4 mg over 1–5 min.
b.	Administer naloxone (Narcan) to reverse respiratory depression.
c.	Request an order for morphine sulfate IV 2 mg over 1–5 min.
d.	Hold the next dose and notify the provider of the patient’s symptoms.

 

 

ANS:   A

Morphine acts to relieve pain, dilate venous vessels, and decrease the workload on the heart to treat acute cardiogenic pulmonary edema and can relieve the dyspnea caused by this condition. The nurse should administer 4 mg since the patient’s pain has not abated. Respiratory depression would be characterized by a decreased respiratory rate.

 

DIF:    Cognitive Level: Applying (Application)                              REF:    p. 815

TOP:    Nursing Process: Assessment/Nursing Intervention

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies