NSG 123 Exam 3
The nurse knows the most serious complication of carotid artery disease is:
Stroke
The nurse correlates an increase in the secretion of which hormone with the release of thyrotropin-releasing hormone? A. T3 B. thyroxine C. TSH D. thyrocalcitonin
C
The nurse is gathering data from a male client who is suspected of having gonorrhea. Which of the following would the nurse most likely find? A. testicular pain B. purulent rectal discharge C. pain on urination D. skin rash
C
The nurse is instructing a client with acute asthma who is taking short-term corticosteroid therapy. The nurse should tell the client that steroids will have which expected outcome? A. promote bronchodilation B. act as expectorant C. anti-inflammatory effect D. prevent development of resp. infections
C
The nurse is teaching a client with COPD to assess for s/sx of right-sided heart failure. Which s/sx should be included in the teaching plan? A. clubbing of nail beds B. HTN C. peripheral edema D. increased appetite
C
The nurse should teach the client with asthma to avoid which of the most common precipitating factors of an acute asthma attack? A. occupational exposure to toxins B. Valsalva's maneuver C. exposure to cigarette smoke D. exercising in cold temperatures
C
The nurse teaching about COPD & right sided heart failure knows to include which s/sx in the teaching plan? A. clubbing of nail beds B. HTN C. peripheral edema D. increased appetite
C
The nurse who is administering Aspirin knows to monitor for which complication? A. tachycardia B. rhabdomyloysis C. thrombocytopenia D. HTN
C
The patient experiencing thyroid storm is ordered to receive beta-adrenergic agents. The nurse monitors for which therapeutic effect of these meds? A. increased RR B. increased appetite C. decreased HR D. decreased bowel sounds
C
What is the primary difference btw emphysema & chronic bronchitis? A. chronic bronchitis predominately affects the large airways B. emphysema predominately affect the large airways C. emphysema predominately affects the alveoli D. chronic bronchitis predominately affects the alveoli
C
When a client with COPD is recovering from an MI, is weak, and has an ineffective cough, the nurse knows to assess for: A. pleural effusion B. pulmonary edema C. atelectasis D. o2 toxicity
C
Which info should the nurse discuss with the client dx with reactive airway disease who is prescribed theophylline slow release? A. instruct client to take on empty stomach B. explain increased HR & irritability are expected side effects C. discuss need to avoid large amounts of caffeine-containing drinks D. tell client to double next dose if dose is missed
C
A 39 y/o woman with hx of smoking & OCP use is admitted with a venous thromboembolism & prescribed unfractioned heparin. What lab test should the nurse review to evaluate the expected effect of the heparin? A. platelets B. ACT C. INR D. aPTT
D
The client with the flu has been taking acetylcysteine. Which adverse effect should the nurse assess for? A. bronchospasm B. nausea C. fever D. drowsiness
A acetylcystein is a mucolytic
Which instruction should the nurse include in the discharge teaching plan for a client with asthma? SATA A. incorporate physical exercise as tolerated into daily routine B. monitor peak flow numbers after meals & at bedtime C. eliminate stressors in the work & home environment D. use melatonin to ensure uninterrupted sleep at night E. avoid smoke-filled rooms
A, E
Which is a priority goal for the client with COPD? A. maintaining functional ability B. minimizing chest pain C. increasing CO2 levels in blood D. treating infectious agents
A
Which person should the nurse identify as having the highest risk for AAA? A. 70 y/o male with high cholesterol & HTN B. 40 y/o female with obesity & metabolic syndrome C. 60 y/o male with renal insufficiency who is physically inactive D. 65 y/o female with hyperhomocysteinemia & substance abuse
A
Which prescription should the nurse implement first to client experiencing severe asthma attack? A. albuterol neb B. chest XRay C. ipratropium inhaler D. sputum culture
A
A 22 y/o has presented to her PCP for her scheduled pap smear. Abnormal results of this dx test may imply infection with: A. HPV B. chlamydia C. candida albicans D. trichomonas vaginalis
A
A 48 y/o woman tells the nurse, "I missed my period last month. Am I in menopause?". The nurse would respond that a woman is considered to be in menopause when: A. periods have stopped for 1 year B. periods have been irregular & light for 12 mo C. sx of vasomotor instability D. sx of decreased estrogen, such as dyspareunia
A
A client is prescribed metaproterenol via MDI, 2 puffs every 4 hrs. The nurse instructs the client to report which adverse effect? A. irregular heartbeat B. constipation C. pedal edema D. decreased HR
A
A key aspect of teaching for the patient on an anticoagulant therapy includes which instructions? A. monitor for and report any signs of bleeding B. do not take acetaminophen for a HA C. decrease dietary intake of foods containing Vit K D. arrange to have blood drawn routinely to check drug levels
A
A nurse is admitting a 68 y/o preop patient with a suspected AAA. The med hx reveals pt has been taking Warfarin daily. Based on the hx and the pt admitting dx, the nurse should prepare to admin which med? A. Vit K B. cobalamin C. heparin sodium D. protamine sulfate
A
A nurse is providing teaching to a client who is starting simvastatin. Which of the following information should the nurse include in the teaching? A. take in the evening B. change position slowly when rising from a chair C. maintain steady intake of leafy green veggies D. consume no more than 1 L/day of fluid
A
A nurse is teaching a client who has a new script for beclomethasone. Which of the following instructions should the nurse include? A. rinse mouth after each use B. limit fluid intake while taking med C. increase intake of Vit B12 while taking med D. take medication as needed
A
A nurse is teaching a client who has a script for long-term use of oral prednisone for tx of chronic asthma. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of the medication? A. weight gain B. nervousness C. bradycardia D. constipation
A
The nurse correlates an increase in which lab value to the dx of primary hyperthyroidism? A. T4 B. TSH C. serum Ca D. serum iodine
A
The nurse correlates which clinical manifestation to the pathophysiology of hypothyroidism? A. cold intolerance B. weight loss C. insomnia D. diarrhea
A
The nurse educates a client prescribed ezetimibe (Zetia) to report which to the provider? A. muscle pain & weakness B. insomnia C. increased appetite D. HA
A
The nurse is reviewing home meds for a client starting clopidogrel (Plavix). Which medication needs to be reviewed for potential drug interactions? A. ibuprofen 200mg prn for HAs B. docusate sodium 100 mg PO Qday C. insulin lispro (Humalog0 sliding scale SQ with meals D. metoprolol 25 mg PO Qday
A
When developing a discharge plan with a client with COPD, what info should the nurse include in the plan? People with COPD: A. develop respiratory infections easily B. usually maintain their current status C. require less supplemental O2 D. show permanent improvement
A
Which assessment data indicates the client with reactive airway disease has "good" control with the medication regimen? A. client's peak expiratory flow rate (PEFR) is greater than 80% of their personal best B. lung sounds are clear bilaterally, both posterior & anterior C. only had 3 acute exacerbations of asthma in the past month D. monthly serum theophylline level is 18 E. taking medications as directed by HCP
A
Which info should the nurse teach the client who is prescribed a glucocorticoid inhaler? A. gargle after each admin B. use inhaler on prn basis C. encourage not to use spacer when using inhaler D. check their forced expiratory volume daily
A
The client with the flu is prescribed OTC cough suppressant dextromethorphan. Which info should the nurse teach regarding this med? A. take every 4-8 hrs as needed for cough B. med can cause addiction if taken for too long C. do not drive or operate machinery while taking drug D. do not take beta blocker when taking this med
A dextromethorphan does not cause drowsiness- that is codeine/hydrocodone only
The client dx with flu is prescribed cough medicine hydrocodone. Which info should the nurse teach the client about the medication? A. monitor bowel movements for constipation B. it is fine to operate or drive machinery while taking C. plan for rest periods as medication usually causes insomnia D. explain med is more effective when taken with a mucolytic
A opioids slow peristalsis
The nurse recognizes non-modifiable risk factors for atherosclerosis include: SATA A. family hx B. age C. smoking D. diet
A, B
The nurse caring for a client with order for heparin sodium 5000 units subq Q12. The nurse will: SATA A. check the CBC prior to admin B. admin med in the abd tissue C. wait 10 sec before withdrawing needle D. massage abd after injection
A, B, C
The nurse instructs the woman taking OCPs to report which possible side effects? SATA A. abd pain B. weight gain C, HA D. eye or visual problems E. speech disturbances
A, C, D, E
The client dx with emphysema is admitted to surgical unit for a cholecystectomy. What postop interventions should the nurse implement? SATA A. have pt turn, cough, breathe deeply every 2 hrs B. admin O2 at 4L C. assess surgical dressing every 4 hrs D. medicate frequently with morphine 15mg IV push E. use incentive spirometer every 4 hrs
A, C, E
A nurse is teaching client about antihistamines. Which info should the nurse include in teaching plan? SATA A. operating machinery & driving may be dangerous when taking med B. continue taking even if nasal infection develops C. effect is not felt until days after D. do not use alcohol with medication E. increase fluid intake to 2000 ml/day
A, D, E
What are adverse effects of using diphenhydramine for allergic rhinitis? SATA A. dry mouth B. nonproductive cough C. skin rash D. drowsiness E. urinary hesitation
A, D, E
The nurse admins theophylline to a client. When evaluating effectiveness, what is expected outcome? A. suppression of client's respiratory infection B. decrease in bronchial secretions C. less difficulty breathing D. thinning of tenacious, purulent sputum
C
A 67 y/o man with peripheral artery disease is seen in primary care clinic. Which sx reported by the pt would indicate that the he is experiencing intermittent claudication? A. complains of chest pain with strenuous activity B. says muscle leg pain occurs with continued exercise C. has numbness & tingling of all his toes and both feet D. states feet become red if he puts them in dependent position
B
A client with COPD is experiencing dyspnea & has low PaO2 level. The nurse plans to admin oxygen as prescribed. Which statement is true concerning oxygen admin to client with COPD? A. high O2 concentrations will cause coughing and dyspnea B. high O2 concentrations may inhibit the hypoxic stimulus to breath C. increased O2 use will cause client to become more dependent on the oxygen D. admin of O2 is contraindicated in clients using bronchodilators
B
A nurse is caring for a client who has been taking phenylephrine nasal drops for the past 10 days for sinusitis. The nurse should assess the client for which of the following manifestations as an adverse effect of the medication? A. sedation B. nasal congestion C. productive cough D. constipation
B
A nurse is providing instructions to a client who has a new script for albuterol PO. Which of the following should the nurse include? A. can take this med to abort an acute asthma attack B. tremors are an adverse effect C. prolonged use of this med can cause hyperglycemia D. the med can slow skeletal growth rate
B
A nurse is providing instructions to a client who has new script for albuterol and beclomethasone inhalers for asthma control. Which of the following instructions should the nurse include in teachings? A. take albuterol at same time each day B. admin the albuterol inhaler prior to using the beclomethasone inhaler C. use beclomethasone if experiencing an acute episode D. avoid shaking the beclomethasobe before use
B
A nurse is teaching a client about the use if fluticasone to treat perennial rhinitis. Which of the following statements indicates an understanding of the teaching? A. I should use spray every 4 hrs while awake B. it can take as long as 3 weeks before the medication takes a maximum effect C. this med can also be used to treat motion sickness D. I can use this medication when my nasal passages are blocked
B
A patient admitted to hospital with dx of AAA. Which s/sx would suggest it has ruptured? A. sudden SOB & hemoptysis B. sudden severe back pain & bruising along his flank C. gradually increasing substernal chest pain and diaphoresis D. sudden patchy blue mottling on feet & toes and rest pain
B
At which developmental stage is death seen as a punishment? A. toddlers (1-3) B. preschool age (3-5) C. school age (6-12) D. teens
B
Emphysema is described by which of the following statements? A. chronic dilation of the bronchus or bronchi B. destruction of the walls of over-distended alveoli C. presence of cough & sputum for at least a total of 2-3 mo in 2 yrs D. disease that results in outcome of reversible airflow obstruction
B
The nurse correlates a positive Chvostek sign to hyposecretion of which hormone? A. T4 B. thyrocalcitonin C. PTH D. T3
C
For a client with asthma, the HCP prescribes albuterol (2 puffs 2x/day via metered-dose inhaler) and beclomethasone (2 puffs 2x/day via MDI). How should the nurse instruct client to admin these drugs? A. take the meds 1 hr apart, 2x/day B. take albuterol first and follow with beclomethasone 2x/day C. take albuterol on awakening and alternated the meds every 4 hrs D. take the beclomethasone inhaler first and follow with albuterol
B
The client dx with CAD is prescribed atorvastatin. Which statement by the client warrants the nurse to notify HCP? A. I really havent changed my diet but I am taking my med every day B. I am feeling pretty good except I am having muscle pain all over my body C. I am swimming at the local pool about 3x/week for 30 min D. I am taking this med first thing in morning with bowl of oatmeal
B
The client on strict bedrest is prescribed subq heparin. Which data indicates the medication is effective? A. clients current PT=22, INR=2.4, PTT=70 B. calves are normal size, normal skin color, nontender C. client performs active ROM exercises every 4 hours D. varicose veins have reduced in size and appearance
B
The client who has been using oxymetazoline nasal spray for several weeks reports to the nurse that the spray no longer seems to work to clear the nasal passages. Which info should the nurse teach? A. increase the amount of sprays used until desired effect has been reached B. this type of med can cause rebound congestion if used too long C. alternate oxymetazoline with saline spray every 2 hrs D. place oxymetazoline nasal spray in vaporizer at night for best results
B
The nurse recognizes that which patient is at greatest risk for hypothyroidism? A. 19 y/o male B. 35 y/o female C. 45 y/o male D. 80 y/o female
B
The patient at highest risk for venous thromboembolism is: A. 62 y/o male with spider veins who is having arthroscopic knee surgery B. 32 y/o woman who smokes, takes OCPs and is planning trip to Europe C. 26 y/o woman who is 3 days postpartum & received maintenance IV fluids for 12 hrs during labor D. An active 72 y/o man at home recovering from transurethral resection of the prostate for benign prostatic hyperplasia
B
The woman using a diaphragm correctly would tell the nurse that the diaphragm: A. does not require use of spermicidal cream or jelly B. should be left in place for at least 6 hrs after intercourse C. is removed immediately after intercourse for douching D. if effective for up to 48 hrs if positioned properly
B
When preparing to admin cholestyramine (Questran) to a client with hyperlipidemia, the nurse knows to: A. admin after dinner B. mix with juice C. admin with morning meds D. keep the client NPO after midnight
B
Which data indicates to the nurse that simvastatin is effective? A. BP 132/80 B. cholesterol level 180 C. LDL 180 D. HDL 35
B
Which is the most important risk factor for development of COPD? A. occupational exposure B. cigarette smoking C. air pollution D. genetic
B
The client with chronic reactive airway disease is taking montelukast (Singular). Which statement by the client warrants intervention by the nurse? A. I have been having a lot of HAs lately B. I have started taking an aspirin every day C. I keep med on very high shelf D. I must protect this medication from extreme temperatures
B Singular is a leukotreine receptor inhibitor & interacts with Warfarin, aspirin, theophylline. HA is a common side effect so does not need an intervention
The nurse is preparing to admin Warfarin. The clients INR is 5.9. Which intervention should the nurse implement? A. discontinue IV bag immediately B. prepare to admin Vit K C. Notify HCP to increase the dose D. admin med as ordered
B Warfarin is admin orally, not IV. Therapeutic range of INR is 2-3 so need to admin antidote which is Vit K
The client with a cholesterol level of 320 is taking ezetimibe. What statement indicates client needs additional teaching? A. this med helps decrease absorption of cholesterol in my intestines B. I cannot take this with any other cholesterol-lowering meds C. I need to eat a low fat, low cholesterol diet even when taking med D. It will take a few months for my cholesterol level to get down to normal levels
B Zetia is used together with statins to help lower cholesterol in clients who cannot control cholesterol levels with statins alone
A nurse is caring for a client who is experiencing an acute asthma attack. Which of the following indicates respiratory status is declining? SATA A. O2 95% B. Wheezing C. retraction of sternal muscles D. pink mucous membranes E. tachycardia
B, C, E
A nurse is monitoring a client who takes aspirin daily. The nurse should identify which of the following manifestations as adverse effects of aspirin? SATA A. HTN B. coffee ground emesis C. tinnitus D. paresthesias of extremities E. nausea
B, C, E
A client is experiencing an acute asthmatic attack. Prior to tx with levalbuterol, VS were RR 40, HR 132, O2 86% on RA. Which finding indicates achievement of the desired outcome of asthma tx? A. decreased PEF rate B. wheezing inaudible with diminished breath sounds C. HR 96, O2 92% on RA D. inspiratory cycle twice as long as the expiratory cycle
C
A client with acute asthma is prescribed short-term corticosteroid therapy. Which is the expected outcome? A. promote bronchodilation B. act as expectorant C. have anti-inflammatory effect D. prevent development of resp distress
C
A nurse is assessing a client with COPD. Which finding requires immediate intervention? A. distant heart sounds B. diminished lung sounds C. inability to speak D. pursed-lip breathing
C
A nurse is assessing a client with chronic emphysema. Which finding requires immediate intervention? A. pursed-lip breathing & prolonged expiration B. circumoral cyanosis C. crackles auscultated posteriorly halfway up left lung D. appearance of barrel chest
C
A nurse is caring for a client who is receiving heparin by continuous IV infusion. The client begins vomiting blood. After the heparin has been stopped, which of the following meds should the nurse prepare to admin? A. Vit K B. atropine C. protamine D. calcium gluconate
C
A nurse is collecting data from a client who is taking gemfibrozil. Which of the following assessment findings should the nurse identify as an adverse effect of this medication? A. mental status changes B. tremor C. jaundice D. pneumonia
C
A nurse is completing a nursing hx for a client who takes simvastatin. The nurse should identify which of the following disorders as a contraindication to adding ezetimibe to the client's medications? A. hx of severe constipation B. hx of HTN C. active Hepatits C D. type 2 diabetes
C
A nurse is explaining to a student nurse that lifestyle choices often can be both a risk factor and cause of ED. The nurse knows that the student understands the explanation when stating which lifestyle choices as causes of ED? A. stress, anxiety, low self-esteem B. injury to penis, COPD, Diabetes C. smoking, alcohol use, overweight, not exercising D. low testosterone, hypothyroidism
C
A nurse is performing client education about atorvastatin (Lipitor). The nurse knows the client needs further instruction when they state "I will": A. take the medication at same time each day B. notify my doctor if I have muscle pain C. take the medication with grapefruit juice D. notify my doctor if i have abd pain
C
A nurse is teaching a client who has a new script for dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this med? A. diarrhea B. anxiety C. sedation D. palpitations
C
A patient with asthma presents with which sx? A. cough, elevated BP B. decreased RR, fatigue C. increased RR, wheezes D. increased sputum, decreased RR
C
A patient with ineffective endocarditis develops sudden left leg pain with pallor, paresthesia and loss of peripheral pulses. The nurse's initial action should be to: A. elevate leg to promote venous return B. start anticoagulant therapy with IV heparin C. notify physician of the change in peripheral perfusion D. place bed in reverse trendelenburg to promote perfusion
C
The client dx with CAD is instructed to take 81mg of aspirin. Which statement best describes the scientific rationale for prescribing this med? A. medication will help thin client's blood B. daily aspirin will decrease incidence of angina C. medication will prevent platelet aggregation D. baby aspirin will not cause gastric distree
C
The client is prescribed albuterol metered-dose inhaler. Which behavior indicates teaching is effective? A. client holds breath for 5 sec & then exhales forcefully B. client states canister is full when lying on top of water C. client exhales & then squeezes canister as next inspiration occurs D. client connects O2 tubing to inhaler before administering dose
C
A client with hx of asthma admitted to ED. Client is dyspneic, RR 35, nasal flaring, and use of accessory muscle. Auscultation of lung sounds reveals greatly diminished breath sounds. What should nurse do first? A. initiate O2 as prescribed and reassess in 10 min B. draw blood for ABGs C. encourage client to relax & breathe slowly through the mouth D. admin bronchodilators as prescribed
D
A nurse is caring for a client 2 hr after admission. The client has an O2 of 91%, exhibits audible wheezes, and is using accessory muscles when breathing. Which of the following classes of meds should the nurse expect to administer? A. antibiotic B. beta blocker C. antiviral D. beta 2 agonist
D
A nurse is teaching a client with genital herpes. Education for this client should include explanation of: A. why the disease is transmittable only when viable lesions are present B. the need for use of petroleum products C. option of disregarding safe-sex practices now that he's already infected D. importance of informing his partners of the disease
D
A nurse tells a woman who is trying to conceive to check her cervical mucus for changes. A few days before ovulation the cervical mucus is: A. cloudy & tacky B. scant & thick C. thin & white D. clear & slippery
D
After teaching a group of students about STIs, the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment? A. syphilis B. gonorrhea C. chlamydia D. genital herpes
D
The 28 y/o client with chronic reactive airway disease is taking monteulkast sodium (Singular). Which statement indicates teaching was effective? A. I will not drink coffee, tea, or any type of cola drinks B. I will take this med at beginning of asthma attack C. It is OK to take this med if I am trying to get pregnant D. I should not decrease the dose or suddenly stop taking
D
The elderly client dx with CAD has been taking aspirin daily for more than a year. Which data warrants notifying the HCP? A. lost 5 lbs in last month B. trouble hearing low tones C. reports having funny taste in mouth D. has hard, dark, tarry stools
D
The nurse is assessing the respiratory status of a client experiencing an exacerbation of COPD secondary to an URI. Which findings are expected? A. normal breath sounds B. prolonged inspiration C. normal chest movement D. coarse crackles and rhonci
D
The nurse is discharging a client dx with COPD. Which instructions should nurse provide regarding script for prednisone? A. take all as ordered until script is empty B. take on empty stomach with full glass of water C. stop taking if noticable weight gain occurs D. do not abruptly stop taking medication
D
The nurse is educating a client with new script for warfarin (Caumadin). The nurse knows client needs further instruction when they state "I": A. will have my PT/INR drawn daily B. will notify my provider if I experience bleeding C. will limit my intake of green leafy veggies D. don't need to have my blood drawn b/c my blood levels were therapeutic
D
The nurse is evaluating effectiveness of teaching plan for client recovering from upper resp tract infection. Which is expected outcome? A. maintain fluid intake of 800 mL every 24 hrs B. have temp below 100 C. cough productively w/o chest discomfort D. experience less nasal obstruction & discharge
D
The nurse is instructing the client with COPD to do pursed-lip breathing. What is the expected outcome of this exercise? A. improved O2 intake B. deeper diaphragmatic breathing C. stronger intercostal muscles D. better elimination of CO2
D
When instructing clients on how to decrease risk of developing COPD, the nurse should emphasize which instruction? A. participate regularly in aerobic exercise B. maintain high protein diet C. avoid exposure to people with known respiratory infections D. abstain from cigarette smoking
D
Which diet would be most appropriate for a client with COPD? A. low fat, low cholesterol B. bland, soft diet C. low sodium D. high cal, high protein
D
Which medical tx is recommended for the client dx with mild intermittent asthma? A. combination of long-term control medication plus quick-relief medication B. routine glucocorticoid inhaler & sustained relief theophylline C. daily inhalation of oral glucocorticoid & daily neb treatments D. mild intermittent asthma treated on a PRN basis and no long-term control medication is needed
D
Which statement indicates that the client with COPD understands the care plan? A. plans to avoid direct contact with family & friends B. can state actions to reduce pain C. will use oxygen via nasal cannula at 5 L D. agrees to call HCP if dyspnea on exertion increases
D
The nurse should admin enoxaparin (Lovenox) for platelets <100,000 & Hct < 30 True or False
False
A client prescribed Warfarn (Caumadin) should limit their dietary intake of:
Vit K (green leafy veggies)
The nurse knows the major side effect of any anticoagulant is:
bleeding
