1) A nurse is planning care for a ptwho isreceiving Mannitol via continuousIV infusion. The nurse shouldmonitorthe ptfor which ofthe following adverse effects.

-Weight loss

Mannitol is an osmotic diuretic used to promote diuresis, decrease intracranial pressure, and improve renal function. An expected therapeutic effect of mannitol is

weight loss resulting from diuresis.

-Increased intraocular pressure

An indication forthe use ofmannitol isincreased intraocular pressure. Mannitol decreasesthe intraocular pressure by creating an osmotic gradient between the

intraocular fluid and the plasma.

-Auditory hallucinations

Mannitol hasseveral neurologic adverse effects, including increased intracranial pressure,seizures, confusion, and headaches.However, it does not cause auditory

hallucinations.

-Bibasilar crackles = CORRECT ANSWER

Mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema. Therefore,the nurse should recognize lung crackles as an indicator of a potential

complication and stop the infusion.

2) A nurse is planning to teach about inhalant medicationsto a pt who has a new diagnosis of exercise induced asthma. Which ofthe following medicationsshould the nurse

plan to instruct the pt to use prior to physical activity?

-Cromolyn = CORRECT ANSWER

Cromolyn sodium stabilizes mast cells, which inhibit the release of histamine and otherinflammatorymediators. The clientshould use cromolyn 10 to 15 min before

planning to exercise to prevent bronchospasms.

-Beclomethasone

Beclomethasone is a prophylactic glucocorticoid inhalant medication thatsuppressesthe inflammatory and humoral immune responses. Beclomethasone should be

administered with a fixed schedule, not for PRN use before physical exercise.

-Budesonide

Budesonide is a glucocorticoid medication used to treat asthma as a long-term inhaled agent. This medication is administered by inhalation twice daily, not prior to

physical activity.

-Tiotropium

Tiotropium is an anticholinergic medication that decreasesmucus production and produces bronchodilation. Tiotropium is used for maintenance therapy of

bronchospasms and has a duration of 24 hr.

3) A nurse is caring for a pt who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medications?

-Vitamin K

Vitamin K is used to treat increased warfarin serum levels, indicated by elevated levels of PT/INR.

-Acetylcysteine= CORRECT ANSWER

Acetylcysteine is a specific antidote for acetaminophen toxicity. It can prevent severe injury when given orally or by IV infusion within 8 to 10 hr.

-Benztropine

Benztropine is an anticholinergic medication used to treat adverse effects of Parkinson's disease by reducing rigidity and tremors.

-Physostigmine

Physostigmine is an effective antidote for antimuscarinic poisoning from medicationssuch as atropine,scopolamine,some antihistamines, phenothiazines, and

tricyclic antidepressants. It has no effect on acetaminophen toxicity.

4) A nurse is assessing a clientwho isreceiving Epoetin alfa to treat anemia. Which ofthe following findingsshould the nursemonitor?

-Paresthesia

Epoetin alfa stimulatesthe bone marrow to increase production ofred blood cells. Adverse effectsinclude neurologicalmanifestationssuch asseizures, headache,

and dizziness. However, epoetin alfa does not cause paresthesia.

-Increased blood pressure = CORRECT ANSWER

The therapeutic effect of epoetin alfa is an increase in hematocrit levels, which can result in an increase in a client's blood pressure. If the client's hematocrit level

rises too rapidly, hypertension and seizures can result. The nurse should monitor the client's blood pressure and ensure hypertension is controlled prior to

administering the medication.

-Fever

Adverse effects of epoetin alfa include neurological manifestations such as coldness and sweating. However, it does not cause fever.