Pharmacology

The nurse is preparing to discharge a patient who is receiving acebutolol HCl. Which instruction will the nurse include in the medication teaching plan for this patient? a. "If you take your pulse and it is less than 60, hold your medicine and call your health care provider for instructions." b. "If you become dizzy, do not take your medication for 2 days and then restart on the third day." c. "This medication may make you fatigued; increasing caffeine in your diet may help alleviate this problem." d. "Increase intake of green leafy vegetables to prevent bleeding problems that can be caused by this medication."

"If you take your pulse and it is less than 60, hold your medicine and call your health care provider for instructions." Acebutolol HCl, a beta blocker, has negative chronotropic effects and could cause symptomatic bradycardia and/or heart block. The health care provider should be consulted before acebutolol is administered to a patient with bradycardia (heart rate less than 60 beats/min).

Based on the condition of the patient, an intravenous fluid that is hypotonic will be ordered. Which intravenous fluid is most likely to be ordered by the health care provider? a. 5% dextrose and normal saline (D5NS) b. 5% dextrose and lactated Ringer (D5LR) c. 0.33% NaCl d. Normal saline

0.33% NaCl Of the fluids listed, the only one that is hypotonic is 0.33% NaCl. Normal saline is isotonic; both D5NS and D5LR are considered to be hypertonic solutions.

Which solution below is NOT a hypertonic solution? A. 5% Dextrose in 0.9% Saline B. 5% Saline C. 5% Dextrose in Lactated Ringer's D. 0.33% saline (1/3 NS)

0.33% saline (1/3 NS)

The doctor orders an isotonic fluid for a patient. Which of the following is not an isotonic fluid? A. 0.9% Normal Saline B. Lactated Ringer's C. 0.45% Saline D. 5% Dextrose in 0.225% saline

0.45% Saline

A patient comes to the emergency department with symptomatic bradycardia. The nurse prepares to administer which dose of atropine intravenously? 1.25 mg 0.3 mg 2 mg 0.5 mg

0.5 mg The recommended dose of atropine to treat symptomatic bradycardia is 0.5 to 1 mg.

A patient is being admitted with dehydration due to nausea and vomiting. Which fluid would you expect the patient to be started on? A. 5% Dextrose in 0.9% Saline B. 0.33% saline C. 0.225% saline D. 0.9% Normal Saline

0.9% Normal Saline

A patient gained 4.4 lb (2 kg), and it has been determined that the weight gain is caused by fluid retention. The nurse correctly estimates that the weight gain may be equivalent to approximately how much fluid? a. 1 L b. 2 L c. 6 L d. 8 L

2 L

A patient with cerebral edema would most likely be order what type of solution? A. 3% Saline B. 0.9% Normal Saline C. Lactated Ringer's D. 0.225% Normal Saline

3% Saline. A patient with cerebral edema would be ordered a HYPERTONIC solution to decrease brain swelling. The solution would remove water from the brain cells back into the intravascular system to be excreted. 3% Saline is the only hypertonic option.

A patient is to receive dopamine 5 mcg/kg/min. The patient weighs 176 pounds. An infusion of dopamine 400 mg in 500 mL of D5W is available. The nurse will infuse this drug at a rate of how many milliliters per hour? ____________mL/h

30 The patient's weight of 176 lb is converted to kg by dividing by 2.2: 176 ÷ 2.2 = 80 kg. 5 mcg/kg × 80 kg = 400 mcg, or 0.4 mg/min. 0.4 mg/min ÷ 400 mg/500 mL = 0.5 mL/min; 0.5 mL/min × 60 min = 30 mL/h.

Based on the condition of the patient, an intravenous fluid that is hypertonic will be ordered. Which intravenous fluid is most likely to be ordered by the health care provider? a. 0.33% NaCl b. 5% dextrose and normal saline c. Normal saline d. 2.5% dextrose and water

5% dextrose and normal saline Of the fluids listed, the only one that is hypertonic is 5% dextrose and normal saline. Normal saline is isotonic, and both 2.5% dextrose and water and 0.33% NaCl are considered to be hypotonic.

The health care provider orders a hypertonic crystalloid IV solution for a 70-year-old patient. Which solution will the nurse hang? a. Lactated Ringer's b. 0.45% sodium chloride (NaCl) c. 0.9% sodium chloride (NaCl) d. 5% dextrose in 0.9% sodium chloride (NaCl)

5% dextrose in 0.9% sodium chloride (NaCl)

Which statement accurately describes the total body water (TBW) composition compared to weight? A. 6 kilogram (13.2 lb) 2-month-old neonate is 75% to 80% water. B. 60 kilogram 70-year-old is 75% water. C. 3 kg 2-week-old is 95% water. D. 70 kilogram (154 lb) 40-year-old man is 40% wate

6 kilogram (13.2 lb) 2-month-old neonate is 75% to 80% water. The TBW of a 70 kg (154 lb) man is approximately 60% (40 L). This percentage varies with age, sex, and percentage of body fat. Neonates are 75% to 80% water, whereas older adults are 45% to 55% water. Women tend to have less body water than men due to the effects of hormones and higher amount of adipose tissue, which contains very little water.

Which vitamins are considered fat soluble? (Select all that apply.) Select all that apply. D E B A C

D, E, A

Which of the following is not a hypertonic fluid? A. 3% Saline B. D5W C. 10% Dextrose in Water (D10W) D. 5% Dextrose in Lactated Ringer's

D5W

The nurse monitors a patient prescribed dicyclomine for which therapeutic effect? Decrease in urinary frequency Increase in blood pressure Decrease in GI motility Increase in heart rate

Decrease in GI motility Dicyclomine is an antispasmodic cholinergic blocker used to decrease GI motility in patients with functional GI disorders such as irritable bowel syndrome.

A patient receiving a unit of red blood cells suddenly develops shortness of breath, chills, and fever. What will the nurse do first? a. Reassure the patient that this is an expected reaction. b. Notify the health care provider while a peer monitors the blood transfusion. c. Decrease the infusion rate and reassess the patient in 15 min. d. Discontinue the infusion.

Discontinue the infusion These are signs and symptoms of a blood transfusion reaction that could escalate to anaphylaxis; therefore, the blood transfusion should be stopped immediately.

Isotonic fluids cause shifting of water from the extracellular space to the intracellular space. True False

FALSE. HYPOTONIC fluids cause shifting of water from the extracellular space to the intracellular space (not isotonic)

The nurse assesses a patient's laboratory results and finds a decreased white blood cell count as well as evidence of anemia. The nurse suspects that a vitamin deficiency is the source of the change in lab values. Based on the results, the patient is most likely to be experiencing a deficiency of which vitamin? Vitamin B1 Vitamin A Vitamin B6 Folic acid

Folic acid Folic acid deficiency is characterized by decreased white blood cell count, decreased clotting factors, anemia, intestinal disturbances, as well as depression.

The nurse is instructing a group of patients about nutrition. The nurse is discussing vitamin deficiencies in this week's class. A patient asks if a B12 deficiency is a significant problem. The nurse explains that a B12 deficiency can result in which symptom? Gastrointestinal disorders Loss of appetite Dermatitis Blurred vision

Gastrointestinal disorders Vitamin B12 deficiency is known to produce symptoms such as gastrointestinal disorders, poor growth, and anemia. Dermatitis is symptomatic of a deficiency of vitamin B6; loss of appetite is symptomatic of vitamin B1 deficiency; blurred vision is symptomatic of deficiency of vitamin B2.

Which finding would indicate to the nurse that a medication has activated beta2 receptors? Increased saliva production Hyperglycemia Bronchiolar constriction Uterine contractions

Hyperglycemia When beta2 receptors are stimulated, the nurse will observe dilation of bronchioles; gastrointestinal and uterine relaxation; increases in blood glucose through glycogenolysis in the liver, and increases in blood flow in skeletal muscles.

A nurse is preparing to administer a beta blocker to a patient. The nurse recognizes that beta blockers are used to treat which conditions? (Select all that apply.) Sinus bradycardia Hypertension Chronic obstructive pulmonary disease (COPD) Cardiogenic shock Angina pectoris Congestive heart failure (CHF)

Hypertension Angina pectoris Congestive heart failure (CHF)

What type of fluid would a patient with severe hyponatremia most likely be started on? A. Hypotonic B. Hypertonic C. Isotonic D. Colloid

Hypertonic

_________solutions cause cell dehydration and help increase fluid in the extracellular space. A. Hypotonic B. Osmosis C. Isotonic D. Hypertonic

Hypertonic

Three days after a patient's total colectomy and ileostomy, he has a nasogastric tube for continuous suction and a Foley catheter for continuous drainage. The night nurse reports a high output from the ileostomy. The patient's pulse is irregular, and he reports leg weakness. Based on this situation, the nurse would correctly suspect what type of imbalance? a. Hypokalemia b. Hyperkalemia c. Hyponatremia d. Hypercalcemia

Hypokalemia

When the cell presents with the same concentration on the inside and outside with no shifting of fluids this is called? A. Hypotonic B. Hypertonic C. Isotonic D. Osmosis

Isotonic

A patient is receiving intravenous (IV) potassium supplements. What is the most important nursing implication when administering this drug? a. It is administered via a central vascular access device. b. It is diluted with IV fluids and delivered by infusion pump. c. IV potassium must be chilled before administration. d. IV potassium preparations should not contain preservatives.

It is diluted with IV fluids and delivered by infusion pump.

Which adverse reaction will the nurse monitor for in a patient taking bethanechol for treatment of urinary retention? Tachycardia Constipation Hypertension Muscle weakness

Muscle weakness Adverse reactions to bethanechol include abdominal cramps, diarrhea, orthostatic hypotension, bradycardia, and muscle weakness.

The nurse is caring for a patient who is taking ascorbic acid (vitamin C). The nurse plans to monitor the patient for which adverse effect of ascorbic acid? Excessive bleeding tendencies Seizure activity Nausea, vomiting, heartburn Frequent constipation

Nausea, vomiting, heartburn Adverse effects of ascorbic acid (vitamin C) include nausea and vomiting, headache, heartburn, and the development of kidney stones.

The patient is ordered an isotonic intravenous fluid. Which intravenous fluid is most likely to be ordered by the health care provider? a. 5% dextrose and lactated Ringer (D5LR) b. 0.33% NaCl c. Normal saline d. 5% dextrose and normal saline (D5NS)

Normal Saline Of the fluids listed, the only one that is isotonic is normal saline. Both D5NS and D5LR are considered to be hypertonic solutions; 0.33% NaCl is considered to be hypotonic.

The nurse is preparing to administer a transfusion of a blood product. What is the most appropriate intravenous fluid to hang as a maintenance infusion? a. Lactated Ringer b. 5% dextrose and water c. Ringer solution d. Normal saline

Normal Saline Of the intravenous solutions listed, the only one that is compatible with blood products is normal saline.

The patient is receiving a bolus feeding through a gastrostomy tube and develops diarrhea. What is a priority nursing intervention? Slow the bolus feedings. Call the health care provider. Finish the bolus and continue to monitor the patient. Stop the feeding and administer an antispasmodic.

Slow the bolus feedings. Diarrhea can be caused by rapid administration of feeding, high caloric solutions, malnutrition, gastrointestinal bacteria, and drugs. Diarrhea can usually be managed or corrected by decreasing the feeding flow rate, and as diarrhea lessens, the feeding flow rate can be gradually increased.

Which electrolyte is the major cation of extracellular fluid? Sodium Chloride Potassium Phosphorous

Sodium

The patient is receiving enteral feedings through a gastrostomy tube at a rate of 100 mL/h. The nurse assesses residual volume as 80 mL. What is the nurse's priorty intervention? a. Assess the patient's bowel sounds. b. Discard the residual volume and continue to monitor the feeding. c. Decrease the feeding to 80 mL/h for the next hour. d. Stop the feeding for 1 h and reassess.

Stop the feeding for 1 h and reassess. The residual volume should not be greater than 50% of the hourly rate. This indicates that the feeding is not absorbing. The feeding should be stopped for an hour, and then the residual volume should be reassessed.

The nurse finds that the patient's enteral feeding is infusing at 150 mL/h instead of the ordered rate of 50 mL/h. What is the nurse's priority action? a. Stop the infusion and check the patient. b. Notify the health care provider of the error. c. Call the pharmacy to stop the next bag. d. Complete an incident report.

Stop the infusion and check the patient Although all of the actions should be completed at some point, the highest priority is the patient's safety. Thus, the infusion should be stopped, the patient's condition assessed, and the rate then clarified.

A patient is receiving 10 mEq of potassium chloride in 100 mL of normal saline intravenously (IV) to infuse over 1 hour via infusion pump. The patient has a 22-gauge peripheral IV in his right forearm and reports pain at the insertion site; the nurse notes that the site is reddened, warm, and tender to the touch. Which action would the nurse take? a. Aspirate and check for blood return, and then slow the IV rate. b. Discontinue the IV, and then have a central line inserted. c. Stop the infusion, and discontinue the IV immediately. d. Apply warm compresses to the IV site and elevate extremity.

Stop the infusion, and discontinue the IV immediately.

The nurse assesses the peripheral intravenous infusion site of a patient receiving intravenous dopamine and suspects extravasation. What is the nurse's primary action? Stop the infusion. Elevate the patient's extremity. Apply a cold pad to the site. Pull the IV immediately.

Stop the infusion.

The health care provider has ordered 5% dextrose in water as a maintenance fluid for the patient. The nurse is assessing the patient at the beginning of the shift and observes the fluid hanging to be 50% dextrose in water (D50W). Which is the priority nursing action? a. Notify the health care provider of the error. b. Stop the infusion. c. Complete an incident report. d. Find out which nurse hung the D50W.

Stop the infusion. The patient's safety is always the primary concern; the fluid should be stopped and the correct fluid hung before other measures are taken such as notifying the health care provider.

D5W solutions are sometimes considered a hypotonic solution as well as an isotonic solution because after the body metabolizes the dextrose the solution acts as a hypotonic solution. True False

TRUE. D5W is classified as a ISOTONIC fluid BUT after adminstration the body metabolizes the dextrose and the fluid left over is a hypotonic solution.

The nurse administered donepezil to a patient. Which finding indicates that the medication has a therapeutic effect? The patient has urinated. The patient is relaxed. The patient has increased cognition. The patient is awake.

The patient has increased cognition Donepezil is used to treat Alzheimer disease, a disorder of decreased acetylcholine levels in the brain. It can increase cognition..

Which assessment most assists the nurse in determining if bethanechol has had a therapeutic effect? Muscular assessment Neurologic assessment Gastric assessment Urinary assessment

Urinary assessment This medication increases the tone of the detrusor muscle and causes the patient to void.

The patient arrives at a local health clinic complaining of dry skin and not being able to see well in dim light. The nurse suspects that the patient is experiencing a vitamin deficiency. Based on the symptoms, the patient is most likely to be experiencing a deficiency of which vitamin? Folic acid Vitamin A Vitamin B6 Vitamin B1

Vitamin A Vitamin A deficiency is characterized by symptoms of dry skin and night blindness as well as poor tooth development.

The nurse is caring for an older adult patient who arrives at the health clinic complaining of fatigue, lack of appetite, and changes in his vision. The nurse suspects that the symptoms may be related to a vitamin deficiency. Based on the symptoms, the patient is most likely to be experiencing a deficiency of which vitamin? Vitamin B1 Vitamin B2 Vitamin B6 Vitamin B12

Vitamin B1 Vitamin B1 deficiency is characterized by sensory disturbances, retarded growth, fatigue, and anorexia.

The patient arrives at the health clinic complaining of experiencing numbness in his extremities. He also tells the nurse that the rash on his nose will not go away despite use of many home remedies. The nurse suspects that the patient is deficient in which vitamin? Vitamin B2 Vitamin B1 Vitamin B12 Vitamin B6

Vitamin B12 Evidence of a vitamin B2 deficiency includes visual defects such as blurred vision and photophobia, cheilosis, rash on nose, and numbness of the extremities.

The nurse is caring for a patient who has been experiencing convulsions. The patient's laboratory results also show evidence of anemia. The nurse suspects that the patient may be experiencing a deficiency of which vitamin? Vitamin B1 Folic acid Vitamin A Vitamin B6

Vitamin B6 Vitamin B6 deficiency is characterized by neuritis, convulsions, dermatitis, anemia, and lymphopenia.

The nurse assesses a patient receiving an adrenergic (sympathomimetic) agent. Which finding will be of greatest concern to the nurse? a. Heart rate of 95 beats per minute and strong peripheral pulses. b. Increased peripheral pulses and increased heart rate. c. Weak peripheral pulses and decreased heart rate. d. Stable blood pressure and increased cardiac output.

Weak peripheral pulses and decreased heart rate. Adrenergic agents stimulate the sympathetic nervous system, which increases heart rate (positive chronotropic effect), contractility (positive inotropic effect), and conductivity (positive dromotropic effect). The nurse would be most concerned that the pulses remain weak and heart rate decreased after receiving this drug, as the therapeutic effect is not being achieved.

A patient has hypernatremia. Which components are appropriate to include in the nursing teaching plan of care? (Select all that apply.) a. Instruct patient on seizure precautions. b. Keep appointments for laboratory tests. c. A sign of hypernatremia is muscle cramps. d. Explain the meaning of fluid restriction. e. Instruct patient on how to read food labels.

a. Instruct patient on seizure precautions. b. Keep appointments for laboratory tests. e. Instruct patient on how to read food labels.

A patient is receiving fluid replacement. The nurse's health teaching with this patient includes which suggestions? (Select all that apply.) a. Measure patient's weight every morning. b. Know that thirst means a mild fluid deficit. c. Monitor fluid intake and fluid output daily. d. Avoid using calcium & chloride supplements. e. Review patient's daily electrolyte labs for changes.

a. Measure patient's weight every morning. b. Know that thirst means a mild fluid deficit. c. Monitor fluid intake and fluid output daily. e. Review patient's daily electrolyte labs for changes.

What is the priority nursing intervention when administering intravenous potassium replacement to the patient? a. Administer the medication using an infusion device. b. Teach the patient and family the signs and symptoms of hypokalemia. c. Administer potassium as a bolus over 10 min. Apply heat to the site of intravenous administration.

Administer the medication using an infusion device Too rapid infusion of potassium can cause cardiac dysrhythmias; an intravenous infusion device must always be used. Potassium should not be bolused or pushed. Heat will not aid the infusion. Unless the patient is prone to constant hypokalemia, teaching the signs and symptoms is not a priority.

The patient undergoing catheter placement for total parenteral nutrition experiences coughing, shortness of breath, chest pain, and cyanosis. Which complication does the nurse suspect the patient is experiencing? Infection Pneumothorax Aspiration pneumonia Air embolism

Air embolism

The nurse would be correct in identifying which outcome as the most serious complication of tube feedings? Bowel perforation Dehydration Constipation Aspiration pneumonia

Aspiration pneumonia Aspiration pneumonitis is one of the most serious and potentially life-threatening complications of tube feedings. Bowel perforation is a complication of placement, not feeding. Dehydration and diarrhea are expected side effects.

The patient receiving enteral feedings has poor skin turgor, and urinary output is 40 mL/h. What is the nurse's first intervention? Assess fluid intake. Monitor hemoglobin and hematocrit. Call the health care provider. Assess blood pressure.

Assess fluid intake. Dehydration can occur if the patient does not receive a sufficient amount of fluid with or between feedings.

The nurse is assessing a patient who follows a vegan diet. What assessment is the priority for the nurse to make? Assess for bleeding disorders. Assess for vitamin B12 deficiency. Assess for vitamin A deficiency. Assess for impaired elimination.

Assess for vitamin B12 deficiency. Vegans may be at risk for pernicious anemia, and the levels of vitamin B12 should be assessed.

A patient with cardiac decompensation is receiving dobutamine as a continuous infusion. The patient's blood pressure has increased from 100/80 mm Hg to 130/90 mm Hg. What is the nurse's priority action? Assess hourly blood pressure readings. Assess I&O and decrease IV fluids. Assess ECG and slow the infusion. Assess respiratory rate and measure ABGs.

Assess hourly blood pressure readings. The major therapeutic effect of dobutamine is to increase cardiac output. Cardiac output is reflected in the patient's heart rate, blood pressure, and urine output. An increase in blood pressure is the expected therapeutic effect.

The nurse is administering hypertonic saline solution to treat a patient with severe hyponatremia. Which is the priority nursing intervention? a. Monitor temperature. b. Assess skin for flushing and assess increased thirst. c. Administer antiemetic for vomiting. d. Monitor urinary output.

Assess skin for flushing and assess increased thirst. Flushed skin and increased thirst are signs and symptoms of hypernatremia.

Which is the priority intervention when the nurse is assessing a patient with a potassium level of 3.2 mEq/L? a. Start IV fluids. b. Administer Kayexalate. c. Apply oxygen. d. Attach telemetry leads for monitoring.

Attach telemetry leads for monitoring.

A nurse is monitoring a patient receiving atropine. Which finding requires immediate nursing action? Dilated pupils Heart rate of 60 beats/min Nasal congestion Blood pressure of 90/40 mm Hg

Blood pressure of 90/40 mm Hg Atropine is an anticholinergic agent that blocks the effects of the parasympathetic nervous system, producing sympathetic nervous system effects. Adverse reactions include nasal congestion, tachycardia, hypotension, pupillary dilation, abdominal distention, and palpitations. This blood pressure is low enough that action is required.

The nurse assesses a patient with hyperparathyroidism and notes that the patient is to receive a vitamin D supplement. What is the priority nursing assessment? Clotting factors Hemoglobin and hematocrit Urinary output Calcium levels

Calcium Levels Vitamin D is contraindicated with hypercalcemia, a clinical manifestation of hyperparathyroidism.

The nurse is caring for a patient diagnosed with heart failure and chronic obstructive pulmonary disease (COPD). The patient is ordered a nonselective beta blocker. What is the nurse's primary intervention? a. Call the health care provider to request a different medication. b. Maintain the patient on intake and output. c. Assess the heart rate before administration. d. Make sure the patient is on telemetry monitoring.

Call the health care provider to request a different medication. Nonselective beta blockers are used to treat supraventricular dysrhythmias secondary to their negative chronotropic effects (decreasing heart rate). They may exacerbate heart failure and COPD. The patient could receive a selective beta blocker instead. The nurse should make the health care provider aware of the patient's history of respiratory disease.

Which of the following actions if taken by a nursing student should alert the nurse that additional instruction is needed with regard to enteral feeding administration? a. Perform patient identification prior to starting therapy. b. Head of bed is elevated between 30 to 45 degrees based on patient's comfort position. c. Check gastric residual immediately following feeding. d. Auscultated bowel sounds prior to starting therapy.

Check gastric residual immediately following feeding. Checking for residual should be done prior to tube feedings and then 3 to 6 hours following a feeding.

The nurse is reviewing a patient's medication history and notes that the patient is taking vitamin K. What is the priority for the nurse to assess? Confusion Seizure activity Coagulation studies Diarrhea

Coagulation studies Vitamin K is an essential nutrient for the synthesis of clotting factors. It is also the antidote for warfarin, an oral anticoagulant. The administration of vitamin K enhances the coagulation process, thus minimizing a patient's risk for excessive bleeding.

The patient has been ordered to receive a unit of packed red blood cells. What is the priority nursing action prior to initiating the infusion of the blood product? a. Verify that a large bore IV is in place. b. Verify that the permit for infusion was witnessed. c. Collect the blood product from the blood bank. d. Confirm the identity of the patient.

Confirm the identity of the patient. Although all of the actions listed are important, the highest priority is confirmation of the identity of the patient. Failure to do this is a major safety violation.

The health care provider has written an order for a critically ill patient to receive enteral feedings. The nurse anticipates that the provider will order which administration mode? Intermittent infusion Continous feeding Bolus Cyclic

Continous feeding For critically ill patients, the healthcare provider will order continous feedings by infusion pump. The other feeding modes would not provide sufficient nutritional benefit to the patient.

Given each of the following actions, the nurse should recognize which action has the highest priority for a patient admitted with glaucoma? Teach the patient to wear glasses at all times. Teach patient to avoid bending at the waist. Administer pilocarpine as prescribed. Administer atropine as prescribed.

Administer pilocarpine as prescribed. Pilocarpine is a direct-acting cholinergic drug that constricts the pupils of the eyes, thus opening the canal of Schlemm to promote drainage of aqueous humor (fluid). This drug is used to treat glaucoma by relieving fluid (intraocular) pressure in the eye. Patients with glaucoma should not take atropine as it can increase intraocular pressure. Teaching related to wearing glasses and patient positioning at this time are not the priority.

_______fluids remove water from the extracellular space into the intracellular space. A. Hypotonic B. Hypertonic C. Isotonic D. Colloids

Hypotonic

Which condition below could lead to cell lysis, if not properly monitored? A. Isotonicity B. Hypertonicity C. Hypotonicity D. None of the options are correct

Hypotonicity

Which is a priority nursing diagnosis for a patient receiving an anticholinergic (parasympatholytic) medication? a. Impaired gas exchange related to thickened respiratory secretions b. Knowledge deficit related to pharmacologic regimen c. Urinary retention related to loss of bladder tone d. Risk for injury related to excessive CNS stimulation

Impaired gas exchange related to thickened respiratory secretions Although all of these nursing diagnoses are appropriate, the priority is determined by remembering the ABCs. Anticholinergic drugs decrease respiratory secretions, which could lead to mucous plugs and resultant impaired gas exchange.

Which finding would indicate to the nurse that a medication has activated alpha1 receptors? Increase in blood pressure Increased saliva production Pupillary constriction Bradycardia

Increase in blood pressure When alpha1 receptors are stimulated, the nurse will see increases in force of heart contraction; vasoconstriction increases blood pressure; mydriasis (dilation of pupils) occurs; secretion in salivary glands decreases; urinary bladder relaxation and urinary sphincter contraction increases.

Which patient below would NOT be a candidate for a hypotonic solution? A. Patient with increased intracranial pressure B. Patient with Diabetic Ketoacidosis C. Patient experiencing Hyperosmolar Hyperglycemia D. All of the options are correct

Patient with increased intracranial pressure

In which patient clinical finding(s) would the nurse question the use of bethanechol? (Select all that apply.) Select all that apply. Peptic ulcer disease Enlarged prostate Bradycardia Urinary retention Asthma

Peptic ulcer disease Bradycardia Urinary retention Asthma

Which is the highest priority nursing intervention for a patient who is starting on metoprolol? Respiratory rate Urinary retention Peripheral pulses Lung sounds

Peripheral pulses

The nurse is assessing a patient receiving enteral feedings. Which finding should alert the nurse to a potential complication? a. Persistent coughing by the patient b. Residual checks for the past 24 hours have been within normal range. c. Bowel sounds slightly hypoactive in all 4 quadrants. d. Patient prefers to sit up in bed.

Persistent coughing by the patient A potential complication of tube feedings is that of aspiration pneumonia. The fact that patient has persistent coughing is of concern. Residual checks within range is a normal finding. Patient's preference to sit up is noted with out signficance. Bowel sounds being slightly hypoactive would need to be monitored but it at this time it is not significant.

The health care provider has indicated that the patient requires an elemental enteral feeding preparation. The nurse understands that elemental feedings are used in treating which type of patient? Patient with renal disease. Patient who is hypertensive. Post gastrointestinal surgical intervention Diabetic patient with a hemoglobin A1c level of 10%

Post gastrointestinal surgical intervention Elemental feedings contain macronutrients that are hydrolized to increase absorption and are available in different energy and protein densities. They are typically used in the treatment of patients with impaired gastronintestinal or pancreatic dysfunction. Specialty formulas would be indicated for patients who are diabetic or who have renal disease. There is no specific formula type seletion for patients who have hypertension.

Which electrolyte is the major ion of the intracellular space? Sodium Potassium Chloride Phosphorous

Potassium

The nurse is caring for a patient receiving total parenteral nutrition (TPN). Which interventions will the nurse include in the patient's plan of care? (Select all that apply.) . Protect the solution from exposure to light at all times. . Monitor blood glucose levels per protocol. . Keep TPN solution that is not in use at room temperature. . Accelerate the rate of infusion to keep the infusion on time as needed. . Monitor the patient for changes in temperature. . Monitor intake and output.

Protect the solution from exposure to light at all times. Monitor blood glucose levels per protocol. Monitor the patient for changes in temperature. .Monitor intake and output.

When administering a hypertonic solution the nurse should closely watch for? A. Signs of dehydration B. Pulmonary Edema C. Fluid volume deficient D. Increased Lactate level

Pulmonary edema