Page 2093 - Saunders Comprehensive Review For NCLEX-RN

in the ears) is the most frequent effect noted with intoxication. Hyperventilation may
occur, because salicylate stimulates the respiratory center. Fever may result, because
salicylate interferes with the metabolic pathways coupling oxygen consumption and
heat production. Options 2, 3, and 4 are not associated specifically with toxicity.
Test-Taking Strategy: Focus on the subject, acetylsalicylic acid intoxication.
Options 2 and 3 relate to gastrointestinal symptoms, are comparable or alike, and
are eliminated first. From the remaining options, you must know that tinnitus
occurs.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Pharmacology: Pain Medications: Nonopioid analgesics
Health Problem: Adult Health: Neurological: Pain
Priority Concepts: Clinical Judgment; Safety
Reference: Lilley et al. (2017), pp. 696-697.

730. Answer: 3

Rationale: Carbamazepine, classified as an antiseizure medication, is used to treat
nerve pain. Adverse effects of carbamazepine appear as blood dyscrasias, including
aplastic anemia, agranulocytosis, thrombocytopenia, and leukopenia; cardiovascular
disturbances, including thrombophlebitis and dysrhythmias; and dermatological
effects. The low white blood cell count reflects agranulocytosis. The laboratory
values in options 1, 2, and 4 are normal values.
Test-Taking Strategy: Focus on the subject, an adverse effect of carbamazepine. If
you are familiar with normal laboratory values, you will note that the only option
that indicates an abnormal value is the correct option.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Analysis
Content Area: Pharmacology: Neurological Medications: Antiseizure
Health Problem: Adult Health: Neurological: Pain
Priority Concepts: Clinical Judgment; Cellular Regulation
Reference: Hodgson, Kizior (2018), p. 186.

731. Answer: 2

Rationale: While the client is taking codeine, the nurse would monitor vital signs
and assess for hypotension. The nurse also should increase fluid intake, palpate the
bladder for urinary retention, auscultate bowel sounds, and monitor the pattern of
daily bowel activity and stool consistency, because the medication causes
constipation. The nurse should monitor respiratory status and initiate deep
breathing and coughing exercises. In addition, the nurse monitors the effectiveness
of the pain medication.
Test-Taking Strategy: Focus on the subject, a specific nursing consideration
related to codeine. Eliminate options 1, 3, and 4 because they are comparable or
alike. In addition, relate codeine with constipation.

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