# Drag each urgent medication situation to the rescue or reversal pathway the nurse should anticipate first. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=568375&lang=en > language: en > subject: Medication Administration > category: PPT ## Question Drag each urgent medication situation to the rescue or reversal pathway the nurse should anticipate first. **1.** Client with respiratory rate 6/min, pinpoint pupils, and unresponsiveness after fentanyl administration Select a category IV dextrose pathway Opioid antagonist pathway Dabigatran reversal pathway Vitamin K antagonist reversal pathway **2.** Client with recurrent respiratory depression 45 minutes after initial naloxone reversal for opioid toxicity Select a category IV dextrose pathway Opioid antagonist pathway Dabigatran reversal pathway Vitamin K antagonist reversal pathway **3.** Client with dabigatran therapy and life-threatening gastrointestinal bleeding Select a category IV dextrose pathway Opioid antagonist pathway Dabigatran reversal pathway Vitamin K antagonist reversal pathway **4.** Client with dabigatran therapy requiring emergency surgery within 2 hours Select a category IV dextrose pathway Opioid antagonist pathway Dabigatran reversal pathway Vitamin K antagonist reversal pathway **5.** Client with warfarin therapy and major gastrointestinal bleeding with INR 4.8 Select a category IV dextrose pathway Opioid antagonist pathway Dabigatran reversal pathway Vitamin K antagonist reversal pathway **6.** Client with warfarin therapy and acute intracranial hemorrhage on CT scan Select a category IV dextrose pathway Opioid antagonist pathway Dabigatran reversal pathway Vitamin K antagonist reversal pathway **7.** Client with blood glucose 32 mg/dL, altered consciousness, and a patent IV line Select a category IV dextrose pathway Opioid antagonist pathway Dabigatran reversal pathway Vitamin K antagonist reversal pathway ## Explanation Naloxone reverses opioid-induced respiratory depression, but respiratory support and repeat dosing or surveillance may be needed because an opioid can outlast naloxone. Idarucizumab is the specific reversal agent for dabigatran in life-threatening or uncontrolled bleeding or urgent procedures. Major warfarin-related bleeding requires prescribed vitamin K antagonist reversal, commonly vitamin K plus four-factor prothrombin complex concentrate. Severe hypoglycemia with unsafe swallowing requires IV dextrose when access is available or glucagon when it is not. ## In-depth explanation Quick answer The correct matches are: client with respiratory depression after fentanyl and pinpoint pupils → opioid antagonist pathway; client with recurrent respiratory depression after initial reversal → opioid antagonist pathway; client with dabigatran and life-threatening bleeding → dabigatran reversal pathway; client with dabigatran needing urgent surgery → dabigatran reversal pathway; client with warfarin and major GI bleeding → vitamin K antagonist reversal pathway; client with warfarin and intracranial hemorrhage → vitamin K antagonist reversal pathway; client with severe hypoglycemia and IV access → IV dextrose pathway. Why this is correct Each situation is matched to the specific rescue or reversal pathway that addresses the underlying drug effect or deficiency. Opioid-induced respiratory depression requires an opioid antagonist. Dabigatran bleeding requires idarucizumab. Warfarin-related major bleeding requires vitamin K and prothrombin complex concentrate. Severe hypoglycemia with IV access requires IV dextrose. Clinical picture In urgent medication complications, the nurse must rapidly identify the offending agent and the appropriate reversal or rescue therapy. Airway, breathing, and circulation are always prioritized, but specific antidotes or reversal agents are critical to prevent deterioration. Memory hook Think 'opioid → naloxone', 'dabigatran → idarucizumab', 'warfarin → vitamin K + PCC', 'hypoglycemia → dextrose/glucagon'. NCLEX decision rule Match the clinical threat to the specific reversal agent or rescue therapy indicated for the drug or condition. Why the alternatives are wrong Incorrect matches would delay appropriate reversal, potentially causing harm. For example, giving naloxone for dabigatran bleeding would not reverse anticoagulation, and giving vitamin K for opioid toxicity would not reverse respiratory depression. Sources 1NCSBN 2026 NCLEX-RN Test Plan 2DailyMed: naloxone hydrochloride injection 3DailyMed: idarucizumab 4FDA: Kcentra indication 5DailyMed: glucagon for severe hypoglycemia ## Clinical scenario Medication rescue pathways Three clients have a time-critical medication complication. Match the drug exposure and clinical threat to the specific rescue pathway. Airway, breathing, circulation, emergency support, and local protocols remain concurrent priorities. ## Key concepts - **Naloxone** — Opioid antagonist that reverses respiratory depression and sedation from opioid overdose. - **Idarucizumab** — Monoclonal antibody fragment that specifically reverses dabigatran anticoagulation. - **Vitamin K antagonist reversal** — Treatment for warfarin-related major bleeding, typically vitamin K plus four-factor prothrombin complex concentrate. ## Related questions - [Before giving a scheduled dose of digoxin, the nurse obtains an apical pulse of 54/min in …](https://mymerci.kr/pages/nclex_q.php?qn_id=374883&lang=en) - [An older adult taking digoxin reports nausea, poor appetite, and yellow-green halos. The a…](https://mymerci.kr/pages/nclex_q.php?qn_id=374884&lang=en) - [A client with diabetes who uses insulin and takes propranolol reports sudden sweating and …](https://mymerci.kr/pages/nclex_q.php?qn_id=374893&lang=en) - [A client with bronchial asthma and current wheezing has a first dose of propranolol prescr…](https://mymerci.kr/pages/nclex_q.php?qn_id=374894&lang=en) - [Which response by the nurse is most appropriate?](https://mymerci.kr/pages/nclex_q.php?qn_id=374901&lang=en) - [Before administering spironolactone, the nurse notes a potassium level of 5.8 mEq/L and ne…](https://mymerci.kr/pages/nclex_q.php?qn_id=374902&lang=en) - [A client taking lisinopril develops sudden swelling of the lips and tongue with hoarseness…](https://mymerci.kr/pages/nclex_q.php?qn_id=374903&lang=en) - [A client taking losartan for hypertension reports a positive home pregnancy test. Which in…](https://mymerci.kr/pages/nclex_q.php?qn_id=374904&lang=en) ## Read in another language - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=568375&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=568375&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=568375&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=568375&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=568375&lang=vi) --- More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en) _For study reference only. Always follow current clinical guidelines and your institution’s protocols._