Editing Pharmacology – RN Practice Questions (section)

==Question 15==
A client with severe preeclampsia is receiving an intravenous magnesium sulfate infusion. The nurse finds absent patellar deep tendon reflexes, a respiratory rate of 10, and urine output of 20 mL over the last hour. Which is the correct sequence of nursing actions?
# Increase the infusion rate, then notify the provider
# Stop the infusion, administer calcium gluconate as ordered, and notify the provider
# Administer naloxone, then stop the infusion
# Continue the infusion and recheck reflexes in one hour

'''Answer:''' 2 (B) Stop the infusion, administer calcium gluconate as ordered, and notify the provider.

''Rationale:'' Loss of deep tendon reflexes is the earliest reliable sign of magnesium toxicity, followed by respiratory depression, oliguria, and eventually cardiac arrest. Magnesium is renally cleared, so falling urine output accelerates accumulation. The nurse stops the infusion first, then gives the antidote, calcium gluconate, and notifies the provider. Option 1 worsens the toxicity. Option 3 is wrong because naloxone reverses opioids, not magnesium. Option 4 delays treatment of an evolving emergency.

[[Category:Pharmacology]]
[[Category:Registered Nurse (NCLEX-RN)]]
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