NUR3128 Exam 1

Order: Ibuprofen 10 mgs/kg/dose. Client weighs 49 pounds. Ibuprofen vial is labeled 100 mgs/5 mls. How many mls will you administer? Round to nearest whole number. Enter the numeric value only.

11

Order: Hydroxyzine 2 mgs/kg/dose every 6 hours. The client weighs 134 pounds. How many mgs will you administer? Enter the numeric value only.

121.8

Which of the following fasting blood glucose levels is indicative of Diabetes Mellitus? 126 mg/dl or greater 100 mg/dl or greater 86 mg/dl or greater 110 mg/dl or greater

126 mg/dl or greater

A nurse in the pre-operative setting is assessing a client who is about to receive spinal anesthesia. The client asks about how they will feel with this level of anesthesia. Which response from the nurse is correct? Select all that apply. "The injection involves placing a needle into the cerebral spinal fluid." "Dentists will use spinal anesthesia to numb the nerves prior to oral surgery." "Spinal anesthesia affects the nerve bundles near the surgical area." "This type of anesthesia affects large regions of the body, such as the lower abdomen and legs." "This method of anesthesia is most commonly used in the obstetrical department."

"The injection involves placing a needle into the cerebral spinal fluid." "This type of anesthesia affects large regions of the body, such as the lower abdomen and legs."

Which clinical problem can develop with high doses or prolonged use of hydrocortisone (Cortef)?

-Cushing's Syndrome

What would the nurse be concerned about if a client relays that they abruptly stopped taking their corticosteroid medication?

-Profound hypotension -Tachycardia

The healthcare provider orders an isotonic solution to run intravenously (IV). Which of the following solutions should the nurse anticipate delivering? 3% Sodium Chloride 0.9% Sodium Chloride 0.45% Sodium Chloride 5% Dextrose in Normal Saline

0.9% Sodium Chloride

The patient received lidocaine viscous before a gastroscopy was performed. Which event would be a priority for the nurse to assess during the postprocedural period? 1. Return of gag reflex 2. Ability to urinate 3. Leg pain 4. Ability to stand

1. Return of gag reflex

A patient has received succinylcholine (Anectine, Quelicin) along with the general anesthetic in surgery. Which abnormal finding in the recovery period should be reported immediately to the provider? 1. Temperature 38.9°C (102°F) 2. Heart rate 56 3. Blood pressure 92/58 4. Respiratory rate 15

1. Temperature 38.9°C (102°F)

The patient, who is scheduled to have a minor in-office surgical procedure, will receive nitrous oxide and expresses concern to the nurse that the procedure will hurt. Which would be the nurse's best response? 1. "You may feel pain during the procedure but you won't remember any of it." 2. "You will be unconscious the entire time and won't feel any pain." 3. "You will not feel any pain during the procedure because the drug blocks the pain signals." 4. "You will feel pain but you won't perceive it the same way; that's why it's called 'laughing gas.'"

3. "You will not feel any pain during the procedure because the drug blocks the pain signals."

What is the onset of action for regular insulin (Humulin R)? 15-20 minutes 20-30 minutes 30-60 minutes 10-15 minutes

30-60 minutes

levothyroxine (Synthroid) is ordered 1.6mcg/kg po daily. The client weighs 165 lbs. levothyroxine (Synthroid) is available in 30mcg tablets. How may tablets will the nurse administer?

4

A young patient requires suturing of a laceration to the right forearm, and the provider will use lidocaine (Xylocaine) with epinephrine as the local anesthetic prior to the procedure. Why is epinephrine included in the lidocaine for this patient? 1. It will increase vasodilation at the site of the laceration. 2. It will prevent hypotension. 3. It will ensure that infection risk is minimized post-suturing. 4. It will prolong anesthetic action at the site.

4. It will prolong anesthetic action at the site.

A patient is admitted to the postanesthesia recovery unit (PACU) after receiving ketamine (Ketalar) after his minor orthopedic surgery. What is the most appropriate nursing action in the recovery period for this patient? 1. Frequently orient the patient to time, place, and person. 2. Keep the patient in a bright environment so there is less drowsiness. 3. Frequently assess the patient for sensory deprivation. 4. Place the patient in a quiet area of the unit with low lights and away from excessive noise.

4. Place the patient in a quiet area of the unit with low lights and away from excessive noise.

During the administration of nitrous oxide, the patient develops anxiety, excitement, and combativeness. The nurse would anticipate that what change in the patient's anesthesia is needed? 1. The nitrous oxide dose will be increased. 2. Propofol (Diprivan) will be given along with the nitrous oxide. 3. Succinylcholine (Anectine) will be given to the patient. 4. The nitrous oxide dose will be decreased.

4. The nitrous oxide dose will be decreased.

Which of the following are clinical manifestations of Hypothyroidism Select all that apply

A - Bradycardia C - Cold intolerance B - Weight gain

Which assessment findings would cause the nurse to withhold the patient's regularly scheduled dose of levothyroxine (Synthroid)? A 1-kg (2-lb) weight gain A blood pressure reading of 90/62 mmHg A heart rate of 110 beats/minute A temperature of 37.9°C (100.2°F)

A heart rate of 110 beats/minute

5. The nurse monitors for which therapeutic effect as a result of the administration of pitressin (Vasopressin)? (Note: reference pharm text page 695) A. Decreased urine output B. Decreased blood pressure C. Decreased serum glucose D. Decreased thirst

A. Decreased urine output

For patients who have risk factors associated with development of Clostridium Difficile (C. Diff), the nurse should observe for which of the following findings? Select all that apply. Abdominal discomfort Worsening of constipation Fever Worsening of diarrhea Hyperglycemia

Abdominal discomfort Fever Worsening of diarrhea

In teaching a hypertensive client to avoid orthostatic hypotension, the nurse should emphasize which of the following instructions? Select all that apply. Avoid standing still for long periods. Arise slowly from the bed. Adjust times for medications as needed. Take cool baths. Avoid alcohol intake

Avoid standing still for long periods. Arise slowly from the bed.

Which of the following is an overwhelming compulsion that drives someone to take drugs repetitively? Addiction Tolerance Preference Withdrawl

Addiction

Following a surgical procedure, the patient states that he does not want to take narcotic analgesics for pain because he is afraid he will become addicted to the drug. What is the best response by the nurse to the patient's concerns? Dependence on narcotics is common among postoperative patients but can be managed successfully. Addiction to prescription drugs is rare when used as prescribed and according to medical protocol, such as for pain control. Older patients are more likely to become addicted. Addiction is rare if the patient has a high pain threshold.

Addiction to prescription drugs is rare when used as prescribed and according to medical protocol, such as for pain control.

Which of the following hormones are controlled by the pituitary gland? Select all that apply. Corticotropin releasing hormone (CRH) Glucocorticoids Adrenocorticotropic hormone (ACTH) Antidiuretic hormone (ADH) Thyroid stimulating hormone (TSH)

Adrenocorticotropic hormone (ACTH) Antidiuretic hormone (ADH) Thyroid stimulating hormone (TSH)

Which of the following is a nonmodifiable risk factor related to atherosclerosis? Type 2 Diabetes Exercise level Age Dietary preferences

Age

A 17-year-old confides to the nurse that he smokes marijuana but that "it isn't as bad as tobacco cigarettes; it's not addicting like nicotine!" Which statement would be an appropriate response by the nurse? Although marijuana may not be addicting in the same way that nicotine is, it damages lung tissue and may cause breathing problems and cancer. Marijuana is not approved for any use except under highly regulated conditions. Marijuana is four times as addicting as nicotine. The effects of marijuana are much more prolonged than nicotine because it stays in the body longer.

Although marijuana may not be addicting in the same way that nicotine is, it damages lung tissue and may cause breathing problems and cancer.

The anterior pituitary gland secretes which of the following hormones? Select all that apply

B - Growth Hormone C - Thyroid Stimulating Hormone E - Follicle Stimulating Hormone

1. Upon review of Ms. Andrews' admission clinical presentation. which clinical manifestations are most related to excessive growth hormone? A. Headache B. Enlarged hands C. Visual changes D. Nausea

B. Enlarged hands

2. Ms. Andrews is ordered to receive bromocriptine mesylate (Parlodel) for the treatment of her tumor. The nurse correlates which rationale for this medication? (Note: Reference Pharm text page 694) A. Decreases serum glucose levels B. Decreases water reabsorption in the kidneys C. Decreases secretion of growth hormone D. Decreases secretion of ADH

C. Decreases secretion of growth hormone

4. In providing care to Ms. Andrews after she undergoes a transsphenoidal hypophysectomy, the nurse prioritizes which Intervention? A. Maintaining the patient in a flat, supine position B. Instructing the patient to cough and deep breathe C. Monitoring for clear fluid drainage from the nose D. Limiting exposure to bright lights

C. Monitoring for clear fluid drainage from the nose

The nurse is assisting a patient with chronic adrenal insufficiency to plan for medication consistency while on a family vacation trip. He is taking hydrocortisone (Cortef) and fludrocortisones (Florinef) as replacement therapy. What essential detail does this patient need to remember to do? Take his blood pressure once or twice daily. Avoid crowded indoor areas to avoid infections. Have his vision checked before he leaves. Carry an oral and injectable form of both drugs with him on his trip.

Carry an oral and injectable form of both drugs with him on his trip

Which pathway of nerves stimulate muscarinic receptors? Sympathomimetic Adrenergic Sympathetic Cholinergic

Cholinergic

The patient with a history of alcohol abuse is admitted to the hospital. The nursing care plan includes assessment for symptoms of alcohol withdrawal. What symptoms will the nurse observe for? (Select all that apply.) Confusion Violent yawning Tremors Constricted pupils Hallucinations

Confusion Tremors Hallucinations

3. Which laboratory result does the nurse correlate with a diagnosis of Diabetes Insipidus (DI)? A. Serum osmolarity, 285 mOsm/kg B. Serum sodium, 132 rnEq/L C. Hematocrit 32% D. Urine specific gravity, 1.001

D. Urine specific gravity, 1.001

A nurse is preparing the teaching plan for a patient who will be discharged on methylprednisolone (Medrol Dosepak) after a significant response to poison ivy. The nurse will include instruction on reporting which adverse effects to the healthcare provider? (Select all that apply.) Tinnitus Edema Eye pain or visual changes Abdominal pain Dizziness upon standing

Edema Eye pain or visual changes Abdominal pain

Which is the most abundant cell in the body? Granulocytes Erythrocytes Platelets Agranulocytes

Erythrocytes

Which of the following types of anesthesia is know as being "put to sleep" in layman's terms? Conscious Sedation Regional Anesthesia General Anesthesia Local Anesthesia

General Anesthesia

A patient is being treated with methimazole (Tapazole) for hyperthyroidism, pending thyroidectomy. While the patient is taking this drug, what symptoms will the nurse teach the patient to report to the healthcare provider? Tinnitus, altered taste, thickened saliva Insomnia, nightmares, night sweats General weakness, muscle cramps, and dry skin Dry eyes, decreased blinking, reddened conjunctiva

General weakness, muscle cramps, and dry skin

Which of the following receptors are responsible for symptoms of allergic rhinitis? H1 receptors Nicotinic H2 receptors H3 receptors

H1 receptors

The patient states that she is going to quit smoking "cold turkey." The nurse teaches the patient to expect which of the following symptoms during withdrawal from nicotine? (Select all that apply.) Headaches Increased appetite Tremors Insomnia Increased heart rate and blood pressure

Headaches Increased appetite Insomnia

The nursing student understands that SIADH displays all of the following characteristics EXCEPT:

High sodium level

Which of the following is a key chemical mediator in allergic reactions? Prostaglandins Bradykinin Histamine Leukotrines

Histamine

Which of the following explains the influence of aging on the development of peripheral vascular disease? Decreased viscosity Increased resistance Increased viscosity Decreased resistance

Increased resistance

You are completing the pathophysiology section of your nursing plan of care worksheet for your assigned client in the clinical unit. What information about the pathophysiology of Pneumonia are you going to include in that section? The most common causative viral organism for hospital-acquired Pneumonia is Pseudomonas aeruginosa. The most common organism for hospital-acquired Pneumonia is COVID - 19. It is an inflammation of the lung parenchyma (functional lung tissue) resulting from a bacterial, viral, or fungal infection. It is an accumulation of fluid or air in the pleural space (between the visceral pleura and parietal pleura).

It is an inflammation of the lung parenchyma (functional lung tissue) resulting from a bacterial, viral, or fungal infection.

What is considered the "functional unit of the kidney"? Calyces Lobe Renal pelvis Nephron

Nephron

Which is NOT a concern regarding renal function for the pediatric client? Number of nephrons decrease due to renal vascular and perfusion changes. Decreased ability to remove excess water and solutes. Decreased concentrating ability. Narrow margin for fluid and electrolyte balance.

Number of nephrons decrease due to renal vascular and perfusion changes.

A patient will be started on desmopressin (DDAVP) for treatment of diabetes insipidus. Which instruction should the nurse include in the teaching plan? Drink plenty of fluids, especially those high in calcium. Avoid close contact with children or pregnant women for 1 week after administration of the drug. Obtain and record your weight daily. Wear a mask if around children and pregnant women.

Obtain and record your weight daily.

What is the difference between physical and psychologic dependence? Physical dependence is the adaptation of the body to a substance over time such that when the substance is withdrawn, withdrawal symptoms will result. Psychologic dependence is the overwhelming desire to continue using a substance after it is stopped or withdrawn but without physical withdrawal symptoms occurring. Physical and psychologic dependence are terms that are used interchangeably. In both cases, physical withdrawal symptoms will result if the substance is withdrawn from use. They occur together: psychologic dependence is the first type of dependence to occur with a substance, followed by physical dependence. Psychologic dependence develops when the brain adapts over time to the use of the substance. Physical dependence is the active seeking of a substance associated with a desire to continue using the substance.

Physical dependence is the adaptation of the body to a substance over time such that when the substance is withdrawn, withdrawal symptoms will result. Psychologic dependence is the overwhelming desire to continue using a substance after it is stopped or withdrawn but without physical withdrawal symptoms occurring.

Which of the following are common signs of Tuberculosis? Select all that apply. Productive cough that becomes more frequent Fatigue, lethargy Night Sweats Hypertension Weight loss, anorexia

Productive cough that becomes more frequent Fatigue, lethargy Night Sweats Weight loss, anorexia

Which conduction channel is blocked after administration of a local anesthetic? Calcium Magnesium Potassium Sodium

Sodium

In which stage of general anesthesia do the skeletal muscles become paralyzed? Stage 1 Stage 2 Stage 3 Stage 4

Stage 3

Place the anatomical regions of the genitourinary system in order from the kidney to the ureter. Glomerulus Ascending Loop of Henle Medullary Collecting Tubule Descending Loop of Henle Proximal Convoluted Tubule Distal Convoluted Tubule

Step 1: Glomerulus Step 2 Proximal Convoluted Tubule Step 3 Descending Loop of Henle Step 4 Ascending Loop of Henle Step 5 Distal Convoluted Tubule Step 6 Medullary Collecting Tubule

Match the steps of Hemostasis in order. Vessel Spasm Vessel Injury Insoluble fibrin strands form and coagulate Platelets adhere to injury site and aggregate to form plug

Step 1: Vessel Injury Step 2: Vessel Spasm Step 3: Platelets adhere to injury site and aggregate to form plug Step 4: Insoluble fibrin strands form and coagulate

What client teaching point is is correct regarding levothyroxine (Synthroid)?

Take this medication in the morning.

The nurse is talking with the parents of a child who will receive somatropin (Nutropin) about the drug therapy. Which important detail will the nurse include in the teaching for these parents? The drug must be given by injection. The drug must be given regularly throughout adolescence and young adulthood to achieve desired effects. If the drug therapy is given throughout adolescence, it could add 6 (15 cm) to 8 inches (20 cm) to the child's height. Daily laboratory monitoring will be required during the first weeks of therapy.

The drug must be given by injection.

The patient states that she has been increasing the amount and frequency of the antianxiety drug she is using because "it just isn't working like it did before." What effect does this indicate? Immunity Resistance Tolerance Addiction

Tolerance

Blood pressure within systemic circulation is highest in which location? venules capillaries arteries aorta

aorta

What is the primary role of intrinsic factor? Vitamin B12 metabolism Stimulation of the production of erythrocytes Enhance carbon dioxide capacity Vitamin B6 rejuvenation

Vitamin B12 metabolism

Which of the following points are correct about the drug propofol (Diprivan)? Select all that apply a. Has almost an immediate onset of action b. Is used effectively for conscious sedation c. Emergence from anesthesia is rapid d. Few adverse effects occur during recovery e. Has an antiemetic effect that can prevent nausea and vomiting

a. Has almost an immediate onset of action b. Is used effectively for conscious sedation c. Emergence from anesthesia is rapid d. Few adverse effects occur during recovery e. Has an antiemetic effect that can prevent nausea and vomiting

Which of the following statements are correct about the drug isoflurane (Forane)? Select all that apply a. It produces a potent level of surgical anesthesia that is rapid in onset. b. It provides excellent muscle relaxation. c. Mild nausea and vomiting and tremor are common adverse effects. d. It produces dose dependent respiratory depression and lowers blood pressure. e. Malignant hyperthermia with elevated temperature have been reported.

a. It produces a potent level of surgical anesthesia that is rapid in onset. b. It provides excellent muscle relaxation. c. Mild nausea and vomiting and tremor are common adverse effects. d. It produces dose dependent respiratory depression and lowers blood pressure. e. Malignant hyperthermia with elevated temperature have been reported.

What is the pharmacologic class of the drug lidocaine (Xylocaine)? Review What is the pharmacologic class of the drug lidocaine (Xylocaine)? a. sodium channel blocker; amide b.sodium channel blocker; ester c. potassium channel blocker; amide d. potassium channel blocker; ester

a. sodium channel blocker; amide

The client presents to the ER with wheezing, coughing, and decreased breath sounds throughout the pulmonary structures. Which drug should the nurse anticipate administering? beclomethasone (Qvar) nebulizer montelukast (Singulair) tablet albuterol (Ventolin) nebulizer fluticasone (Flonase) inhaler

albuterol (Ventolin) nebulizer

Which is the best definition of the term psychological dependence? a. The body adapts to repeated use of the substance by altering normal physiology b. The overwhelming desire to continue drug-seeking behavior despite obvious negative consequences c. An overwhelming compulsion that drives someone to take drugs repetitively. d. A biological condition that occurs when the body adapts to a substance after repeated administration

b. The overwhelming desire to continue drug-seeking behavior despite obvious negative consequences

Which is the best definition of the term addiction? a. The body adapts to repeated use of the substance by altering normal physiology b. The overwhelming desire to continue drug-seeking behavior despite obvious negative consequences c. An overwhelming compulsion that drives someone to take drugs repetitively. d. A biological condition that occurs when the body adapts to a substance after repeated administration

c. An overwhelming compulsion that drives someone to take drugs repetitively.

Which of the following are expected adverse effects of the drug succinylcholine (Anectine)? Choose two (2) answers. a. Skeletal muscle paralysis b. Paralysis of the diaphragm c. Bradycardia d. Respiratory depression

c. Bradycardia d. Respiratory depression

How does the drug nitrous oxide contribute to anesthesia? a. It produces complete loss of consciousness. b. It causes profound relaxation of skeletal muscles c. It induces surgical anesthesia (stage 3). d. It produces full analgesia.

d. It produces full analgesia.

Which of the following is the prototype drug for disease-modifying anti-rheumatic drugs (DMRDs)? Interferon alfa-2b (Intron-A) allopurinol (Zyloprim) cyclosporine (Neoral) hydroxychloroquine (Plaquenil)

hydroxychloroquine (Plaquenil)

Which of the following lab values is the most alarming? pCO2 45 pH 7.28 Potassium 4.2 mEq/L Sodium 140 mEq/L

pH 7.28