AH- Exam 2 prepu questions
normal calcium range
8.6-10.2
A client with asthma is prescribed a short acting beta-adrenergic (SABA) for quick relief. Which of the following is the most likely drug to be prescribed?
Albuterol
Which statement is true about both lung transplant and bullectomy?
Both procedures improve the overall quality of life of a client with COPD.
The nurse is caring for a client in the hospital who has been taking an analgesic for pain related to a chronic illness and has developed a tolerance to the medication. What is the most appropriate action by the nurse?
Consult with the prescriber regarding the need for an increased dose of the drug and not to reduce the frequency of administration.
You are caring for a 72-year-old client who has been admitted to your unit for a fluid volume imbalance. You know which of the following is the most common fluid imbalance in older adults?
Dehydration
Which of the following is a common irritant that acts as a trigger of asthma?
Esophageal reflux
A client is to receive hypotonic IV solution in order to provide free water replacement. Which solution does the nurse anticipate administering?
Half-strength saline (0.45%) is hypotonic. Hypotonic solutions are used to replace cellular fluid because it is hypotonic compared with plasma. Another is to provide free water to excrete body wastes. At times, hypotonic sodium solutions are used to treat hypernatremia and other hyperosmolar conditions. Lactated Ringer solution and normal saline (0.9% NaCl) are isotonic. A solution that is 5% NaCl is hypertonic.
In which grade of COPD is the forced expiratory volume in 1 second (FEV1) greater than 80% predicted?
I
A nurse is teaching a client with emphysema how to perform pursed-lip breathing. The client asks the nurse to explain the purpose of this breathing technique. Which explanation should the nurse provide?
It helps prevent early airway collapse.
The client is prescribed albuterol 2 puffs as a metered-dose inhaler. Which action by the client demonstrates understanding of administration for this medication?
Positions the inhaler 2 finger widths away from the lips
A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first?
Pulse
Which route of medication administration should the nurse consider first after IV removal in a postoperative client with an NPO (nothing by mouth) order?
Rectal
A client involved in a motor vehicle crash suffered a blunt injury to the chest wall and was brought to the emergency department. The nurse assesses the client for which clinical manifestation that would indicate the presence of a pneumothorax?
Sucking sound at the site of injury
pneumothorax
absent breath sounds
traumatic pneumothorax
air escapes from laceration of lung itself
lung abccess
diet rich in protein and calories chronic infection is assoc with a catabolic state
A client with cancer is being treated on the oncology unit for bilateral breast cancer. The client is undergoing chemotherapy. The nurse notes the client's serum calcium concentration is 12.3 mg/dL (3.08 mmol/L). Given this laboratory finding, the nurse should suspect that the
malignancy is causing the electrolyte imbalance. most common causes of hypercalcemia are malignancies and hyperparathyroidism
Alcoholism
most common cause of hypomagnesemia
hyperkalemia
muscle weakness diarrhea paresthesia of the hands, feet, and tongue
sucking chest wound
traumatic pneumothorax
The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction that leads to the collapse of alveoli. This complication is known as
Atelectasis
A nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include:
diminished or absent breath sounds on the affected side.
A client is taking spironolactone to control hypertension. The client's serum potassium level is 6 mEq/L. What is the nurse's priority during assessment?
electrocardiogram (ECG) results
encouraging fluid intake with pneumonia
helps to break up the secretions turning would prevent atelectasis but stabilize secretions
third spacing
hypovolemia with the exception of weight loss
A client with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this client includes
implementing measures to clear pulmonary secretions.
hyponatremia
increased intracranial pressure muscle twitching focal weakness hemiparesis papilledema fall in bp nausea
decrease in serum osmolality
kidney failure
respiratory alkalosis
light headedness paresthesia
convulsions or coma might occur with a
low sodium 135
simple pneumothorax
rupture of a bleb or bronchopleural fistula compression of the heart --> fluid in pericardial sack
petechiae and acute chest pain
signs of pulmonary embolism
pleurisy
stabbing pain during respiratory movement (from pleural membranes rubbing together) pain intensified with deep breathing, coughing, sneezing usually only occurs on one side may be localized or radiate to the shoulder
flail chest
two or more ribs broken in two or more places paradoxical chest movement
given with tb to prevent peripheral neuropathy
vitamin B6
A clinic nurse assesses a client with diabetes who reports taking naproxen (Aleve) and the herb bilberry for osteoarthtitis. To assess for an adverse reaction between naproxen and bilberry, the nurse asks the client
"Do you bleed easily?" naprexon (NSAID) bilberry increases risk for bleeding
A client with chronic obstructive pulmonary disease (COPD) and cor pulmonale is being prepared for discharge. The nurse should provide which instruction?
"Weigh yourself daily and report a gain of 2 lb in 1 day." COPD causes pulmonary hypertension, leading to right-sided heart failure or cor pulmonale. The resultant venous congestion causes dependent edema. A weight gain may further stress the respiratory system and worsen the client's condition.
in clients with heart failure liquid intake shouldn't exceed
1.5 L daily others: 2-3 L daily
tb Mantoux test
10 mm+ is significant
A nurse is caring for a client with status asthmaticus. Which medication should the nurse prepare to administer?
An inhaled beta2-adrenergic agonist
A client experiencing an asthmatic attack is prescribed methylprednisolone intravenously. What action should the nurse take?
Assesses fasting blood glucose levels
The patient with a chest tube is being transported to X-ray. Which complication may occur if the chest tube is clamped during transportation?
Clamping can result in a tension pneumothorax. The other options would not occur if the chest tube was clamped during transportation.
A client is being admitted to the medical-surgical unit for the treatment of an exacerbation of acute asthma. Which medication is contraindicated in the treatment of asthma exacerbations?
Cromolyn sodium
The diagnosis of pulmonary hypertension associated with chronic obstructive pulmonary disease (COPD) is suspected when which of the following is noted? Select all that apply.
Dyspnea and fatigue disproportionate to pulmonary function abnormalities Right ventricular enlargement Elevated plasma brain natriuretic peptide (BNP) Enlargement of central pulmonary arteries
A client diagnosed with asthma is preparing for discharge. The nurse is educating the client on the proper use of a peak flow meter. The nurse instructs the client to complete which action?
If coughing occurs during the procedure, repeat it.
A mediastinal shift occurs in which type of chest disorder?
Tension pneumothorax
tb must go on ing/ isonzizad as prophylaxis for
6-12 months
A junior-level nursing class has just finished learning about the management of clients with chronic pulmonary diseases. They learned that a new definition of COPD leaves only one disorder within its classification. Which of the following is that disorder?
Emphysema
When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems?
Hypercapnia, hypoventilation, and hypoxemia
An elderly client takes 40 mg of furosemide twice a day. Which electrolyte imbalance is the most serious adverse effect of diuretic use?
Hypokalemia (potassium level below 3.5 mEq/L) usually indicates a defict in total potassium stores. Potassium-losing diuretics, such as furosemide, can induce hypokalemia. Hyperkalemia refers to increased potassium levels. Loop diuretics can bring about lower sodium levels, not hypernatremia. Furosemide does not affect phosphorus levels.
A nurse is assessing a client with syndrome of inappropriate antidiuretic hormone. Which finding requires further action?
Jugular vein distention vascular fluid overload assoc with weight gain and fluid retention
Endorphins decrease pain perception and transmission
acetylcholine, serotonine, and substance P increase the transmission of pain
monitoring pain
assess with vital signs
bacterial pneumonia
dyspnea and wheezing retained secretions- dyspnea
acetaminophen increases risk for hepatoxicitiy
early symptoms include rash and pruitis
the more pain one has experienced in the past
often leads to a higher pain rating in the future they have more fear about pain ex: one with partial thickness burns coming in for abdominal pain--> will report abdominal pain as an 8 because past perceptions of pain effect current pain
A nurse is monitoring a client being evaluated who has a potassium level of 7 mEq/L (mmol/L). Which electrocardiogram changes will the client display?
peaked T waves
neuromuscular blockers (opioids and atracurium) signs and symptoms
predispose client to: venous thromboemboli (VTE) muscle atrophy skin breakdown foot drop
relapse of pneumonia
take antibiotics for the entire 10 days reposition frequently drink 51-101 oz per day
