Final Semester 1

Which of the following are bactericidal antibiotics? Select all that apply A.) Sulfonamides B.) Penicillins C.) Cephalosporins D.) Carbapenems

A B C D All are bactericidal antibiotics

Which of the following ADLs does central vision loss impair? Select all that apply A.) Ability to see surroundings B.) Driving C.) Reading & Writing D.) Loss of night vision E.) Ability to recognize safety hazards

B C E

Which of these would you want to check to ensure the remodeling of a patients fractured bone won't be hindered? Select all that apply. A.) Nutrition B.) Hormones C.) Perfusion D.) Localized nerve damage

A B C Remodeling requires adequate nutrition, hormonal regulation, and blood supply Local nerve damage shouldn't hinder remodeling

When would the nurse question giving and opioid to a patient? Select all that apply. A.) Respiration below 12 B.) When they get dizzy standing up C.) When they are falling asleep while talking D.) The patient is un-arousable

A C D

Which of these may indicate an infant is having inadequate gas exchange? Select all that apply A.) Flaring of the nares B.) Chest wall contraction on expiration C.) Cyanosis around lips when sucking D.) Stopping several times while feeding

A C D Chest wall contractions would occur on inspiration not expiration

A patient receiving a yearly physical voices concerns about developing glaucoma. Which symptoms would the nurse identify as signs of glaucoma? Select all that apply A.) Headache or brow pain B.) Double Vision C.) Nausea and vomiting D.) Colored halos around lights E.) Sudden blurred vision with decreased light perception

A C D E

Where are beta 1 receptors usually found? Select all that apply A.) Heart B.) Lungs C.) Kidneys D.) GI Tract E.) Skeletal Muscle

A C Important to remember since drugs that affect beta 1 receptors will have an effect on heart and kidneys

What would you expect in someone with increased HCO3 levels? Select all that apply A.) Decreased pH B.) Increased pH C.) Kidneys retaining HCO3 D.) Kidneys excreting HCO3

B D HCO3 is directly proportional to pH HCO3 elevated = alkalosis HCO3 low = acidosis Acidosis: kidneys retain HCO3 Alkalosis: Kidneys excrete HCO3

A patient comes in with complaints of foggy vision accompanied with eye pain & headaches. What is most likely the cause? A.) Primary Angle-Closure Glaucoma B.) Glaucoma C.) Macular Degeneration D.) Primary open angle glaucoma

D

What are 3 serious side effects of opioids?

Low Respiration Hypotension/Orthostatic Hypotension CNS Sedation

A patient receiving ondansetron for the first time on your shift. Which of these symptoms should you be most worried about? Select all that apply. A.) Agitation B.) Dizziness C.) Muscle Rigidity D.) Hypertension E.) Headache F.) Abnormal heart rhythm

A C All of these could indicate serotonin syndrome D F Could indicate Torsades De Pointes

What are the early signs/symptoms of cataracts? Select all that apply A.) Blurred vision B.) Dizziness C.) Loss of appetite D.) Double Vision E.) Redness F.) Brow Pain

A D

What medicine should be avoided being used in older adults?

Meperidine

Fracture through the skin

Open fracture

Malpractice

Person must be a professional (professional negligence) EX: Failure to follow standard of care (not using fall prevention protocol, Failure to communicate important information, failure to document, failure to assess and monitor, inappropriate delegation

A patients lab came back showing their PaCO2 levels had increased. What else would you expect to find in the lab report and by observing the patient? Select all that apply A.) pH decreased B.) pH increased C.) Faster/Deeper breaths D.) Slower/Shallower breaths

A D CO2 and pH are inversely proportional CO2 goes up so pH goes down Faster/Deeper breaths would get rid of more CO2

A patient presents to the ER with hypotension and a previous diagnosis of hepatic dysfunction. Which ACE inhibitors, if prescribed, would the patient most likely receive? Select all that apply. A.) Captopril B.) Benazepril C.) Trandolapril D.) Lisinopril

A D They are the only two that are not prodrugs meaning they don't metabolize in the liver

The nurse is caring for a client who is on digoxin long term for AFIB. The physician orders verapamil to treat the clients high BP. Which of the following is priority for the nurse to initially monitor? A.) K+ levels B.) Digoxin Levels C.) Heart Rate D.) Cardiac Rhythm

B

What do bactericidal antibiotics do? A.) Prevent bacteria from multiplying B.) Kill bacteria C.) Increase blood pH D.) Decrease blood pH

B

Which drug is the newest Beta Blocker that also produces vasodilation and is promoted as causing less sexual dysfunction? A.) Propranolol B.) Nebivolol C.) Metoprolol D.) Clonidine

B

Which lab should the RN check prior to administering furosemide? A.) Sodium B.) Potassium C.) WBC D.) Platelets

B

A nurse sends a text message to the oncoming nurse to report that a patient refuses to take medication as ordered. What should the oncoming nurse do? Select all that apply. A.) Tell the nurse who sent the text, that the text is a HIPAA violation B.) Inform the nursing supervisor C.) Forward the text to the charge nurse D.) Thank the nurse for sending the info.

B C

Which drugs are nonselective beta blockers? A.) Atenolol B.) Propranolol C.) Sotalol D.) Timolol E.) Metoprolol

B C D

Where are beta 2 receptors usually found? Select all that apply A.) Heart B.) Lungs C.) GI System D.) Vascular smooth muscle E.) Skeletal Muscle F.) Ciliary body of eye

B C D E F

You are floated to work on a nursing unit where you are given an assignment that is beyond your capability. Which is the best nursing action to take first? 1. Call the nursing supervisor to discuss the situation. 2. Discuss the problem with a colleague. 3. Leave the nursing unit and go home. 4. Say nothing and begin your work.

1

Which of the following statements indicate that the new nursing graduate understands ways to remain involved professionally? (Select all that apply.) 1.) "I am thinking about joining the health committee at my church." 2.) "I need to read newspapers, watch news broadcasts, and search the Internet for information related to health." 3.) "I will join nursing committees at the hospital after I have completed orientation and better understand the issues affecting nursing." 4.) "Nurses do not have very much voice in legislation in Washington, DC, because of the nursing shortage." 5.) "I will go back to school as soon as I finish orientation."

1 2 3

Which of these are risk factors for BPH? (Select all that apply) 1.) Aging 2.) Estrogens 3.) Androgen supplements 4.) Increased dihydrotestosterone (DHT) 5.) Obesity 6.) Diabetes Mellitus 7.) Testosterone Supplements 8.) Decreased dihydrotestosterone (DHT) 9.) Increased physical activity

1 3 4 5 6 7 Estrogens are at higher levels in females not men Increased DHT is associated with BPH Decreased Physical activity is associated with BPH

Which statement made by the client diagnosed with BPH would be the most emergent for the RN to notify the health care provider about? 1.) "I have difficulty urinating sometimes and have to strain." 2.) "It burns when I urinate" 3.) "I can't urinate no matter how hard I try" 4.) "I am urinating more frequently"

3 In some men the prostate becomes so large that it blocks off the flow of urine causing "acute urinary retention". This problem requires emergent care.

Normal HCO3 values

22-26 mEq/L

A home health nurse notices significant bruising on a 2-year-old patient's head, arms, abdomen, and legs. The patient's mother describes the patient's frequent falls. What is the best nursing action for the home health nurse to take? 1.) Document her findings and treat the patient. 2.) Instruct the mother on safe handling of a 2-year-old child. 3.) Contact a child abuse hotline. 4.) Discuss this story with a colleague.

3

A man who is homeless enters the emergency department seeking health care. The health care provider indicates that the patient needs to be transferred to the city hospital for care before assessing the patient. This action is most likely a violation of which of the following laws? 1.) Health Insurance Portability and Accountability Act (HIPAA) 2.) Americans with Disabilities Act (ADA) 3.) Patient Self-Determination Act (PSDA) 4.) Emergency Medical Treatment and Active Labor Act (EMTALA)

4

Tamsulosin has which general action? A.) Relaxes the prostate B.) Dilates the blood vessels C.) Depresses the CNS D.) Increases serotonin levels

A

What do bacteriostatic antibiotics do? A.) Prevent bacteria from multiplying B.) Kill bacteria C.) Increase blood pH D.) Decrease blood pH

A

What should the nurse check prior to administering sotalol? A.) Heart rate, rhythm, BP B.) BP, Respirations C.) Apical Pulse, Digoxin levels D.) K+ levels, pulse E.) Pain, BP

A

Which drug is an Alpha2 agonist and has been used in coordination with opioid withdrawal? Select all that apply. A.) Clonidine B.) Captopril C.) Tamsulosin D.) Doxazosin

A

Which medial disorder puts you at an increased risk for ototoxicity? A.) Decreased kidney function B.) Urinary Retention C.) Heart Failure D.) Diabetes

A

Which statement made by the client indicates understanding of post-operative teaching after a myringotomy? A.) "I will avoid drinking through a straw for 2-3 weeks" B.) "I will change my ear dressing every 48 hours" C.) "Excessive drainage is common and doesn't need reported" D.) "I will need to request a refund for my plane ticket for a flight that is 4 weeks away"

A

Which drug would you know to be an Alpha 1 blocker? Select all that apply. A.) Doxazosin B.) Clonidine C.) Methyldopa D.) Captopril

A Alpha 1 blockers typically end in "osin"

Where do selective Beta Blockers target? Select all that apply A.) Heart B.) Kidneys C.) Lungs D.) Eyes E.) Vascular muscle

A B

What is the best way to avoid malpractice? Select all that apply. A.) Follow evidence-based standards of care B.) Deliver care compentently C.) Communicate with other health care providers D.) Documenting by exception

A B C

A patient comes in who is diagnosed with asthma, HF, and aplastic anemia. What are these impairments of relating to gas exchange? Select all that apply. A.) Ventilation B.) Perfusion C.) Transportation D.) Acid-Base balance

A B C D

Which of these are primary preventions of postoperative pulmonary complications? Select all that apply A.) Deep breath/cough every 2 hours B.) Administer anticoagulant SubQ C.) Intermittent compression devices D.) Encouraging ambulation as soon as possible

A B C D

Which of these drugs are vasodilators? Select all that apply A.) Minoxidil B.) Diazoxide C.) Hydralazine D.) Nitroprusside

A B C D

A patient is in skeletal traction and has a plaster cast due to a fractured femur. The patient experiences decreased sensation and a cold feeling in the toes of the affected leg. The nurse observes that the patient's toes have become pale and cold but forgets to document this because one of the nurse's other patients experienced cardiac arrest at the same time. Two days later the patient in skeletal traction has an elevated temperature, and he is prepared for surgery to amputate the leg below the knee. Which of the following statements regarding a breach of duty apply to this situation? (Select all that apply.) A.) Failure to document a change in assessment data B.) Failure to provide discharge instructions C.) Failure to provide patient education about cast care. D.) Failure to use proper medical equipment ordered for patient monitoring E.) Failure to notify a health care provider about a change in the patient's condition

A E

Which of the following actions, if performed by a RN, could result in criminal and administrative law sanctions against the nurse? Select all that apply. A.) Reviewing the EHR of a family member who is a patient in the same hospital on a different unit. B.) Refusing to provide health care information to a patients child. C.) Reporting Suspected abuse and neglect of children D.) Completing an occurrence report on the unit. E.) Applying physical restraints without a written order.

A E

Which ACE inhibitor would most likely be administered to a patient who is critically ill and never has taken them before? Select any that apply A.) Captopril B.) Lisinopril C.) Trandolapril D.) Benazepril

A.) Captopril Captopril has the shortest half-life so if complications arise they would be short lived

Which labs should the RN be most concerned with? Select all that apply A.) 55 year old male: PSA- 4.0 B.) 75 year old male: PSA- 6.0 C.) 30 year old female: BUN- 38 D.) 20 year old female: Serum Creatinine- 1.5

A.) Normal for 50-60 is 2.5-3.5. (Could indicate prostate cancer.) C.) Normal BUN is 7-20 (May indicate bladder or kidney dysfunction) D.) Normal Serum Creatinine is 0.9-1.3 (May indicate bladder/kidney dysfunction) B.) This one is fine. Normal for >70 is 0.0-6.5

When should the nurse administer ondansetron? Select all that apply A.) Before Chemo B.) During Chemo C.) Before Pain Medication D.) With pain Medication

A.) Should always give before chemo B.) Can give during chemo if client gets sick C.) D.) Can give before or with pain meds

What considerations would you educate your patient post-op vitrectomy? Select all that apply A.) Leave patch on for 24 hours without removal B.) Instruct to report any sudden acute pain C.) Encourage non-strenuous activities like reading D.) Instruct to avoid straining with bowel movements E.) Follow physicians orders on head positioning to promote reattachment

B D E

A patient has been admitted and you see he is prescribed Tamsulosin. What diagnosis might the patient have? Select all that apply A.) Hypertension B.) Benign Prostatic Hyperplasia (BPH) C.) Impotence D.) Kidney Stones

B C BPH could have been the original diagnosis and impotence could be a side effect from the drug Hypertension isn't treated with tamsulosin Females are typically prescribed tamsulosin for kidney stones

A client recovering from deep, partial-thickness burns develops chills, fever, flank pain, and mailaise. Which prescribed diagnostic test would the nurse expect to confirm a tentative urinary tract diagnosis? A.) Cystoscopy and bilirubio level B.) Specific gravity and pH of the urine C.) Urinalysis and urine culture and sensitivity D.) Creatine clearance and albumin/globulin (A/G) ratio

C

A nurse received bedside report at the change of shift with the night-shift nurse and the patient. The nursing student assigned to the patient asks to review the patient's medical record. The nurse lists patients' medical diagnoses on the message boards in the patients' rooms. Later in the day the nurse discusses the plan of care for a patient who is dying with the patient's family. Which of these actions describes a violation of the Health Insurance Portability and Accountability Act (HIPAA)? A.) Discussing patient conditions at the bedside at the change of shift B.) Allowing the nursing student to review the assigned patient's chart before providing care during the clinical experience C.) Posting medical information about the patient on a message board in the patient's room D.) Releasing patient information regarding terminal illness to family when the patient has given permission for information to be shared

C

Crackles heard in the lungs indicate what? A.) Inflamed bronchi B.) Mucus in the Bronchi C.) Fluid in the Alveoli D.) Anaphylaxis

C

When would the nurse question administering an opioid to a nonverbal adult patient? A.) Respiration at 20 B.) Respiration at 15 C.) Respiration at 11 D.) Respiration at 13

C

Which complication is the nurse's main priority during the early postoperative period after a subtotal thyroidectomy? A.) Hemmorhage B.) Thyrotoxic Crisis C.) Airway Obstruction D.) Hypocalcemic Tetany

C

Which of the following should the RN monitor in the client taking gabapentin? A.) EKG Changes B.) Sudden, Severe Hypertension C.) Neurological Status D.) WBC Counts

C

Why is nutrition a concern for someone who is diagnosed with Cystic Fibrosis? Select all that apply. A.) They need foods high in fat B.) They need bigger servings so they don't tire themselves C.) They need smaller servings so they don't tire themselves D.) They need high-calorie, high protein foods

C D

A woman has severe life-threatening injuries, is unresponsive, and is hemorrhaging following a car accident. The health care provider ordered two units of packed red blood cells to treat the woman's anemia. The woman's husband refuses to allow the nurse to give his wife the blood for religious reasons. What is the nurse's responsibility? A.) Obtain a court order to give the blood B.) Convince the husband to allow the nurse to give the blood C.) Call security and have the husband removed from the hospital D.) Gather more info about the wife's preferences and determine whether the husband is her power of attorney for health care

D

ACE inhibitors typically have which suffix? A.) "osin" B.) "tan" C.) "pine" D.) "pril"

D

During infusion, a child reports nausea and vomits. What is the priority nursing action? A.) Flush the line and continue chemo therapy. B.) Stop the chemo C.) Administer ondansetron D.) Stop the chemo, flush the line and administer ondansetron

D

Fracture straight across the bone

Transverse

Strengthens bones

Vitamins

What drug given through IV has an advantage over IV Beta Blockers and Calcium Channel Blockers? A.) Lisinopril B.) Captopril C.) Benazepril D.) Enalapril

D Enalapril because it does not require cardiac monitoring

A patient prescribed docusate sodium calls the next day asking why he still hasn't had a bowel movement. What might the nurse tell him? A.) Take it with 4 oz of water B.) Eat more food with it C.) Don't dilute it when you take it again D.) It may take 3 days for it to start working

D Giving it with more food would decrease absorption You should take it with 8 oz of water Diluting it shouldn't affect it

Which patients digoxin level would concern the nurse the most? A.) 0.5 B.) 2.0 C.) 0.8 D.) 2.5

D Normal digoxin levels are 0.5-2.0

Identify the characteristics of primary open angle glaucoma. Select 3 that apply A.) Halos around light B.) Sudden eye pain radiating to the face C.) Foggy Vision over time D.) Peripheral vision loss E.) Brow Pain

A C D

Which drugs are selective beta blockers? Select all that apply A.) Atenolol B.) Propranolol C.) Esmolol D.) Sotalol E.) Metoprolol

A C E

What are some symptoms of otitis media? Select all that apply (3) A.) Pain B.) Drainage C.) Redness/Swelling D.) Tinnitus E.) Reduced Conductive Hearing

A D E

Intervention for hypoxia

Administer Oxygen

Normal PaCO2 levels adult/children

Adult: 35-45 mmHg Children <2: 26-41 mmHg

Normal Adult/Newborn PaO2?

Adult: 80-100 mmHg Newborn: 60-70 mmHg

What is normal SaO2 for an adult and newborn?

Adult: 95%-100% Newborn: 40%-90%

Which medications may reduce sexual desire/response? Select all that apply A.) Antihypertensives B.) Antacids C.) Antidepressants D.) Antipsychotics E.) Anticonvulsants F.) Diuretics G.) Narcotics

All of the listed drugs are correct

Post op intervention for hip fracture

Ambulation Day 1

A mother asks the nurse why it seems her sons arms and legs seem to be growing but his head and chest haven't changed any noticeably. Which would be the best answer for the nurse to give? A.) The axial skeleton is shorter than the appendicular skeleton B.) His arms and legs are disproportionately shorter than his head/chest C.) They aren't growing at different rates, it just seems like that because bones are decompressing after birth D.) More bones in the arms and legs fuse together than in the head and chest

B

A nurse is planning care for a patient going to surgery. Who is responsible for informing the patient about the surgery along with possible risks, complications, and benefits? A.) Family Member B.) Surgeon C.) Nurse D.) Nurse Manager

B

During respiratory auscultation you hear wheezing/strider during expiration and inspiration. What does this indicate? A.) Dilated Bronchi B.) Narrowed bronchi C.) Atelectasis D.) Pneumonia

B

Which of these side effects of metoclopramide need to be reported immediately? Select all that apply A.) Sedation B.) Fatigue C.) Excessive Blinking D.) Lip Smacking E.) Restlessness

C D Could indicate Tardive Dyskinesia

Fracture classification

Complete and Incomplete

Hearing rhonchi when performing respiratory auscultation indicated what? A.) Narrowed Bronchi B.) Fluid in the Alveoli C.) Dilated Bronchi D.) Mucus or Secretions in Bronchi

D

The Rn should observe which of the following in the client taking tamsulosin? A.) Bowel Patterns B.) Bilateral Pulses C.) Level of consciousness D.) Urinary Patterns

D

The nurse is caring for a client who is 1 day postoperative for a left hip fracture repair. Which clinical finding would the nurse assess further? A.) Pain at the surgical site B.) Small amount of serosanguinous drainage C.) Decreased range of motion to the left extremity D.) Sudden shortness of breath.

D

What is normal ABG pH? A.) 7.15-7.5 B.) 7.2-7.45 C.) 7.5-8.0 D.) 7.35-7.45

D

Which factor may affect the accuracy of oxygen saturation obtained using pulse oximetry? A.) Fever B.) Obesity C.) Hypertension D.) Nail Thickening

D

Which of the following are signs of digoxin toxicity? A.) Hypotension, bradycardia, hyperkalemia, constipation B.) Fatigue, tachycardia, hypokalemia, diarrhea C.) Hallucinations, hypertension, hyponatremia, abdominal pain D.) Hypokalemia, blurred vision, fatigue, nausea

D

Which point is most important for the RN to reinforce with the client taking clopidogrel? A.) You will need to avoid foods high in K+ to prevent complications B.) You will need to have your PT/INR checked weekly taking this med C.) You will only need to take this med for 2 weeks then stop it D.) You will take longer to stop bleeding while taking this med

D

What should the nurse do first and most importantly before administering any antihypertensive drug? A.) Check RBC count B.) Check for end-organ damage C.) Examine the fundus of the patients eye D.) Check BP

D Monitoring for end-organ failure is done but it isn't the primary focus directly before administering The provider exams the fundus of the eye, not the nurse RBC counts are not a primary concern

A 7 year old male comes into the ED when he started experiencing wheezing, coughing, dyspnea, and tightness in his chest. He said it started in the middle of his baseball game. You remember it was windy on your way to work. What do you first suspect is wrong? A.) Anaphylaxis B.) Allergies C.) Hypertension D.) Asthma

D More prevalent in male children 5-9 Exercise and airborne allergens on the windy day probably enhanced it.

The nurse is caring for a client who just started taking benazepril. The client reports generalized itching and a tingle in his throat approximately 1 hour after receiving the first dose of medication. What is the nurses priority action? A.) Notify the physician the client is having an allergic reaction B.) Tell them it is a common side effect and will go away C.) Discontinue the medication and list it as an allergy on charting D.) Notify physician and document the findings E.) Maintain clients airway and call for assistance

E

True or False ? The RN should push the clients PCA button

False

Cracks in the bone

Fissures

What is a post op intervention for a hip fracture?

Float the heels

A woman gave birth to twins at 37 weeks after experiencing 2 miscarriages over the last 3 years, at 20 weeks each. What is her GTPAL score

G: 3 T: 1 P: 2 A: 0 L: 2

Side effect of celecoxib

GI upset

Fracture when bone bends and partially breaks

Greenstick fracture

Negligence

Poor care that leads to physical harm of the patient. Anyone is subject to being accused of negligence.

Nutritional needs post fracture

Protein, Vitamin B, and C

RICE

Rest Ice Compression Elevation

People over 60 years old will most like have what?

Some degree of arthritis

Fracture when one or both halves are twisted

Spiral fracture