Mental Health & Neurotransmitters
A patient taking sertraline reports agitation, sweating, and tremors. What should the nurse suspect?
Serotonin syndrome. (Rationale: Excess serotonin → hyperreflexia, agitation, fever.)
Normal PaCO₂ range?
35–45 mm Hg. (Rationale: Below = respiratory alkalosis; above = acidosis.)
Which inhaler provides quick relief during an asthma attack?
Albuterol. (Rationale: Short-acting beta₂ agonist.)
What is the normal cardiac output range?
4–8 L/min. (Rationale: Reflects heart’s pumping efficiency.)
Hold digoxin if the apical pulse is below __ bpm.
60 bpm. (Rationale: Prevent bradycardia/toxicity.)
Teaching for a client starting fluoxetine?
“It may take several weeks to feel better.” (Rationale: SSRIs need time for receptor sensitivity changes.)
pH 7.50, PaCO₂ 30 — what’s the imbalance?
Respiratory alkalosis. (Rationale: High pH, low CO₂ = hyperventilation.)
Teaching for fluticasone inhaler?
Rinse mouth after use. (Rationale: Prevent oral candidiasis.)
Which patient finding indicates poor perfusion?
Cold extremities and confusion. (Rationale: Low oxygen delivery to tissues.)
What adverse effect of ACE inhibitors should be reported immediately?
Swelling of lips or tongue. (Rationale: Angioedema = emergency.)
Which statement shows correct understanding of lorazepam use?
“I should avoid driving or alcohol while taking this.” (Rationale: CNS depressant → sedation.)
A COPD patient’s ABG shows pH 7.31, PaCO₂ 60. Nursing priority?
Encourage pursed-lip breathing. (Rationale: Helps eliminate CO₂ and improve oxygenation.)
Which adverse effect requires intervention for ipratropium?
Urinary retention. (Rationale: Anticholinergic effect.)
A post-MI client develops crackles and dyspnea. What complication should the nurse suspect?
Left-sided heart failure. (Rationale: Left ventricle backs up into lungs.)
Priority assessment before administering beta-blockers?
Heart rate and blood pressure. (Rationale: Prevent bradycardia and hypotension.)
A client on lithium has coarse tremor, vomiting, and confusion. What’s the nurse’s first action?
Hold the dose and notify the provider. (Rationale: Classic signs of lithium toxicity.)
The nurse notes SpO₂ 85% after bronchodilator use. What’s the first step?
Assess breath sounds and airway patency. (Rationale: Check for bronchospasm or airway collapse.)
A patient using acetylcysteine reports shortness of breath. Priority action?
Stop treatment and notify provider. (Rationale: Possible bronchospasm.)
Which ECG change is most consistent with hyperkalemia?
Peaked T waves. (Rationale: Indicates elevated potassium.)
Teaching for nitroglycerin tablets?
Store in dark container, take 1 every 5 minutes up to 3 doses. (Rationale: Light-sensitive and dosing-limited.)
Select all that apply — nursing considerations for MAOIs.
Avoid tyramine foods, monitor BP, teach risk of hypertensive crisis. (Rationale: Tyramine triggers crisis.)
Select all that apply — causes of impaired gas exchange.
Pneumonia, pulmonary edema, COPD. (Rationale: All interfere with alveolar-capillary diffusion.)
Select all that apply — correct metered-dose inhaler (MDI) use.
Shake before use, inhale slowly, hold breath 10 seconds. (Rationale: Ensures full medication delivery.)
Select all that apply — nursing priorities for decreased cardiac output.
Monitor urine output, assess mental status, maintain oxygen therapy. (Rationale: Organ perfusion indicators.)
Select all that apply — signs of digoxin toxicity.
Nausea, bradycardia, yellow vision. (Rationale: Cardiac glycoside toxicity.)