Exam 3
A 77-year-old man who has been diagnosed with an upper respiratory tract infection tells the nurse that he is allergic to penicillin. Which is the most appropriate response by the nurse? a. "Many people are allergic to penicillin." b. "This allergy is not of major concern because the drug is given so often." c. "What type of reaction did you have when you took penicillin?" d. "Drug allergies don't usually occur in older individuals due to built-up resistance to allergic reactions."
"What type of reaction did you have when you took penicillin?"
Albumin
-protein in blood; maintains the proper amount of water in the blood -3.5-5 g/dL -type of test: blood; urine
Convert 250 micrograms to milligrams. Be sure to depict the number correctly according to the guidelines for decimals and zeroes.
.25 mg
After receiving an intramuscular (IM) injection in the deltoid, a patient states, "My arm really hurts. It's burning and tingling where got my injection." What should the nurse do next? (Select all that apply.) 1. Assess the injection site. 2. Administer an oral medication for pain. 3. Notify the patient's health care provider of assessment findings. 4. Document assessment findings and related interventions the patient's medical record. 5. This is a normal finding, so nothing needs to be done. 6. Apply ice to the site for relief of burning pain.
1. Assess the injection site. Notify the patient's health care provider of assessment findings. 4. Document assessment findings and related interventions in the patient's medical record.
What is the removal of devitalized tissue from a wound called? 1. Debridement 2. Pressure distribution 3. Negative-pressure wound therapy 4. Sanitization
1. Debridement
Which skin-care measures are used to manage a patient who is experiencing fecal and/or urinary incontinence? (Select all that apply.) 1. Frequent position changes 2. Keeping the buttocks exposed to air at all times 3. Using a large absorbent diaper, changing when saturated 4. Using an incontinence cleaner 5. Applying a moisture barrier ointment
1. Frequent position changes 4. Using an incontinence cleaner 5. Applying moisture barrier ointment
After surgery the patient with a closed abdominal wound reports a sudden "pop" after coughing. When the nurse examines the surgical wound site, the sutures are open, and pieces of small bowel are noted at the bottom of the now-opened wound. Which are the priority nursing interventions? (Select all that apply.) 1. Notify the health care provider. 2. Allow the area to be exposed to air until all drainage has stopped. 3. Place several cold packs over the area, protecting the skin around the wound. 4. Cover the area with sterile, saline-soaked towels immediately. 5. Cover the area with sterile gauze and apply an abdominal binder.
1. Notify the health care provider. 4. Cover the area with sterile, saline-soaked towels immediately.
An older adult states that she cannot see her medication bottles clearly to determine when to take her prescription. What should the nurse do? (Select all that apply.) 1. Provide a dispensing system for each day of the week. 2. Provide larger, easier-to-read labels. 3. Tell the patient what is in each container. 4. Have a family caregiver administer the medication. 5. Use teach-back to ensure that the patient knows what medication to take and when.
1. Provide a dispensing system for each day of the week. 2. Provide larger, easier-to-read labels. 5. Use teach-back to ensure that the patient knows what medica- tion to take and when.
When is the application of a warm compress to an ankle muscle sprain indicated? (Select all that apply.) 1. To relieve edema 2. To reduce shivering 3. To improve blood flow to an injured part 4. To protect bony prominences from pressure injuries 5. To immobilize area
1. To relieve edema 3. To improve blood flow to an injured part
Which of the following are measures to reduce tissue damage from shear? (Select all that apply.) 1. Use a transfer device (e.g., transfer board) 2. Have head of bed elevated when transferring patient 3. Have head of bed flat when repositioning patient 4. Raise head of bed 60 degrees when patient positioned supine 5. Raise head of bed 30 degrees when patient positioned supine
1. Use a transfer device (e.g., transfer board) 3. Have head of bed flat when repositioning patient 5. Raise head of bed 30 degrees when patient positioned supine
The American Dental Association suggests that patients who are at risk for poor hygiene use the following interventions for oral care. (Select all that apply.) 1. Use antimicrobial toothpaste. 2. Brush teeth 4 times a day. 3. Use 0.12% chlorhexidine gluconate (CHG) oral rinses. 4. Use a soft toothbrush for oral care. 5. Avoid cleaning the gums and tongue.
1. Use antimicrobial toothpaste. 3. Use 0.12% chlorhexidine gluconate (CHG) oral rinses. 4. Use a soft toothbrush for oral care.
sodium
135-145 mEq/L type of test: urine (24- hr)
A drug that delivers 300 mg has a half-life of 4 hours. How many milligrams of drug will remain in the body after 1 half-life?
150mg
The nurse is preparing to give an oral dose of acetaminophen (Tylenol) to a child who weighs 12 kg. The dose is 15 mg/ kg. How many milligrams will the nurse administer for this dose?
180mg
The nurse is preparing to administer 8 mg of a 10 mg dose of an intravenous narcotic. Which of the following statements made by the nurse best reflects an understanding of the appropriate manner to handle this situation? 1 I will sign out the narcotic before the end-of-shift count is completed. 2 I need to get another RN to witness the waste and sign the narcotic sheet. 3 Narcotics are expensive, so it makes sense to save the unused portion for the next time they need the drug. 4 I always make sure someone sees me place the unused portion on the narcotic in the sharps container.
2 I need to get another RN to witness the waste and sign the narcotic sheet.
The client receiving an intravenous infusion of morphine sulfate begins to experience respiratory depression and decreased urine output. This effect is described as: 1 Therapeutic 2 Toxic 3 Idiosyncratic 4 Allergic
2 Toxic
The student nurse is teaching a family member the importance of foot care for his or her mother, who has diabetes. Which safety pre- cautions are important for the family member to know to prevent infection? (Select all that apply.) 1. Cut nails frequently. 2. Assess skin for redness, abrasions, and open areas daily. 3. Soak feet in water at least 10 minutes before nail care. 4. Apply lotion to feet daily. 5. Clean between toes after bathing.
2. Assess skin for redness, abrasions, and open areas daily. 4. Apply lotion to feet daily. 5. Clean between toes after bathing.
It is important to take precautions to prevent medication errons A nurse is administering an oral tablet to a patient. Which of the following steps is the second check for accuracy in determining the patient is receiving the right medication? 1. Logging on to automated dispensing system (ADS) medicine from drawer or cart. 2. Before going to patient's room, comparing patient's name and name of medication on label of prepared drugs with MAR. 3. Selecting correct medication from ADS, unit-dose drawer, or stock supply and comparing name of medication on label with MAR or computer printout. 4. Comparing MAR or computer printout with names of medications on medication labels and patient name at bedside.
2. Before going to patient's room, comparing patient's name and name of medication on label of prepared drugs with MAR.
What is the proper position to use for an unresponsive patient during oral care to prevent aspiration? (Select all that apply.) 1. Prone position 2. Sims' position 3. Semi-Fowler's position with head to side 4. Trendelenburg position 5. Supine position
2. Sims' position 3. Semi-Fowler's position with head to side
The client has an order for 30 units of U-500 insulin. The nurse is using a U-100 syringe and will draw up and administer: 1.) 5 units 2.) 6 units 3.) 10 units 4.) 30 units
2.) 6 units
During the admission interview the client reports to the nurse that she is a little allergic to penicillin. Which of the following questions asked by the nurse is most likely to provide the most relevant information regarding the clients possible allergy to penicillin? 1 Who told you that you are allergic to penicillin? 2 What makes you think you are allergic to penicillin? 3 Can you describe what happens when you take penicillin? 4 What do you take for an infection since you are allergic to penicillin?
3 Can you describe what happens when you take penicillin?
While planning morning care, which of the following patients would have the highest priority to receive his or her bath first: 1. A patient who just returned to the nursing unit from a diagnostic test 2. A patient who prefers a bath in the evening when his wife visits and can help him 3. A patient who is experiencing frequent incontinent diarrheal stools and urine 4. A patient who has been awake all night because of pain 8/10
3. A patient who is experiencing frequent incontinent diarrheal stools and urine
Integrity of the oral mucosa depends on salivary secretion. Which of the following factors impairs salivary secretion? (Select all that apply.) 1. Use of cough drops 2. Immunosuppression 3. Radiation therapy 4. Dehydration 5. Presence of oral airway
3. Radiation therapy 4. Dehydration
When the nurse is assigned to a patient who has a reduced level of consciousness and requires mouth care, which physical e perform before the procedure? (Select all that apply.) 1. Oxygen saturation 2. Heart rate assessment 3. Respirations 4. Gag reflex 5. Response to painful stimulus
3. Respirations 4. Gag reflex
The nurse observes an adult Middle Eastern patient attempting to bathe himself with only his left hand. The nurse recognizes that this behavior likely relates to: 1. Obsessive-compulsive behavior. 2. Personal preferences. 3. The patient's cultural norm. 4.Controlling behaviors.
3. The patient's cultural norm.
A client is nauseated, has been vomiting for several hours, and needs to receive an antiemetic (anti-nausea) medication. The nurse recognizes that which of the following is accurate? 1.) An enteric-coated medication should be given. 2.) Medication will not be absorbed as easily because of the nausea. 3.) A parenteral route is the route of choice. 4.) A rectal suppository must be administered.
3.) A parenteral route is the route of choice.
potassium
3.5-5.0 mEq/L test: blood major cation with the cell
A patient is to receive medications through a small-bore nasogastric feeding. Which nursing actions are appropriate? (Select all that apply.) 1. Verifying tube placement after medications are given 2 Mixing all medications together to give all at once 3.Using an enteral tube syringe to administer medications 4.) Flushing tube with 30 to 60 mL of water after the last dose of medication 5. Checking for gastric residual before giving the medications 6 Keeping the head of the bed elevated 30 to 60 minutes after medications are given
3.Using an enteral tube syringe to administer medications 4.) Flushing tube with 30 to 60 mL of water after the last dose of medication 5. Checking for gastric residual before giving the medications 6 Keeping the head the bed elevated 30 to 60 minutes after the medications are given
The nurse is to administer several medications to the client via the N/G tube. The nurses first action is to: 1 Add the medication to the tube feeding being given 2 Crush all tablets and capsules before administration 3 Administer all of the medications mixed together 4 Check for placement of the nasogastric tube
4 Check for placement of the nasogastric tube
Which of the following describes a hydrocolloid dressing? 1. A seaweed derivative that is highly absorptive 2. Premoistened gauze placed over a granulating wound 3. A debriding enzyme that is used to remove necrotic tissue 4. A dressing that forms a gel that interacts with the wound surface
4. A dressing that forms a gel that interacts with the wound surface
When repositioning an immobile patient, the nurse notices redness over the hip bone. What is indicated when a reddened area blanches on fingertip touch? 1. A local skin infection requiring antibiotics 2. Sensitive skin that requires special bed linen 3. stage 3 pressure injury needing the appropriate dressing 4. Blanching hyperemia, indicating the attempt by the body to overcome the ischemic episode
4. Blanching hyperemia, indicating the attempt by the body to overcome the ischemic episode
cholride
98-106 mEq/L test: blood
The nurse recognizes which of the following clients as being at greatest risk for anaphylactic shock? 1 A 69-year-old client receiving an antibiotic for a respiratory tract infection 2 A 45-year-old prescribed a decongestant as needed for seasonal allergies 3 A 50-year-old client prescribed a therapeutic dose of an antihypertensive medication 4 A 26-year-old receiving intravenous steroids for the initial flare-up of rheumatoid arthritis
A 69-year-old client receiving an antibiotic for a respiratory tract infection
When administering an alpha-adrenergic drug for hypertension, it is most important for the nurse to assess the patient for the development of what response? A. Hypotension B. Hyperkalemia C. Oliguria D. Respiratory distress
A. Hypotension
To minimize the risk for injury to the oral mucosa, a client ordered a buccally administered medication is instructed to: 1 Alternate cheeks with each subsequent dose 2 Swallow the medication with a full glass of liquid 3 Chew the medication thoroughly before swallowing 4 Avoid allowing the medication to dissolve on the tongue
Alternate cheeks with each subsequent dose
Protein
An organic compound that is made of one or more chains of amino acids and that is a principal component of all cells -6.4-8.3g/dL -type of test: blood;urine
. On beginning the administration of 500 mg of aztreonam IV to a client with a urinary tract infection, the client complains of difficulty breathing. The nurse quickly identifies this as a symptom of a(n): 1 Therapeutic effect 2 Anaphylactic reaction 3 Idiosyncratic reaction 4 Medication interaction
Anaphylactic reaction
Plateau
Blood serum concentration of medication reached and maintained after repeated fixed doses
The nurse is preparing a care plan for a patient who has been newly diagnosed with type 2 diabetes mellitus. Which of these reflect the correct order of the steps of the nursing process? a. Assessment, planning, human needs statement, implementation, evaluation b. Evaluation, assessment, human needs statement, planning, implementation c. Human needs statement, assessment, planning, implementation, evaluation d. Assessment, human needs statement, planning, implementation, evaluation
Assessment, human needs statement, planning, implementation, evaluation
To best prevent a systemic effect from a topically applied medication patch, the nurse must: 1 Alternate application sites regularly 2 Avoid applying the medication to broken skin 3 Monitor the client for signs of an irritating rash 4 Remove residual medication with mild soap and water
Avoid applying the medication to broken skin
Which statement about ARBS does the nurse identify as being true? A Hyperkalemia is more likely to occur than when using ACE inhibitors. B. Cough is more likely to occur than when using ACE inhibitors. C. Chest pain is a common adverse effect. D. Overdose is usually manifested by hypertension and bradycardia.
C. Chest pain is a common adverse effect.
A priority for the nurse in the administration of oral medications and prevention of aspiration is: 1 Checking for a gag reflex 2 Allowing the client to self-administer 3 Assessing the ability to cough 4 Using straws and extra water for administration
Checking for a gag reflex
The nurse prepares to administer a prn pain medication by IM injection. The client refuses the injection stating that I dont like shots. The best reaction by the nurse is to: 1 Contact the physician for pain medication to be given by a different route 2 Instruct the client that he or she needs to be brave and take the shot 3 Contact the nursing supervisor to talk with the client 4 Inform the client that the injection is the only route that the pain medication is ordered
Contact the physician for pain medication to be given by a different route
The number of people with hypertension in the United States is estimated to be A. 10 million. B. 25 million. C. 50 million. D. 70 million.
D. 70 million.
A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension. Which drug will most likely be ordered for this patient? A. Clonidine B. Prazosin C. Diltiazem D. Captopril
D. Captopril
A patient with diabetes has a new prescription for the ACE inhibitor lisinopril. She questions this order because her physician has never told her that she has hypertension. What is the best explanation for this order? A The doctor knows best. B. The patient is confused. C. This medication has cardioprotective properties. D. This medication has a protective effect on the kidneys for patients with diabetes.
D. This medication has a protective effect on the kidneys for patients with diabetes.
The nurse is administering an injection at the ventrogluteal site. On aspiration, the nurse notices that there is blood in the syringe. The nurse should: 1 Inject the medication 2 Pull the needle back slightly and inject the medication 3 Move the skin to the side and inject the medication slowly 4 Discontinue the injection and prepare the medication again
Discontinue the injection and prepare the medication again
In the event of a medication error, the nurses first responsibility is to: 1 Contact the physician 2 Fill out an incident report 3 Notify their supervisor 4 Ensure the clients safety
Ensure the clients safety
Research has shown that the primary reason nurses make medication errors is related to: 1 The complexity of making accurate drug calculations 2 Events that distract the nurse during the administration process 3 The presence of multiple drugs with similar generic and trade names 4 Heavy client assignments that require massive medication administrations
Events that distract the nurse during the administration process
Stage 3
Full-thickness loss of skin, in which adipose (fat) visible in the ulcer and granulation tissue and epibole (rolled wound edges) are often present. Slough and/or eschar may be visible. The depth of tissue damage varies by anatomical location; areas of significant adiposity can develop deep wounds. Undermining and tunneling may occur. Fascia, muscle, tendon, ligament, cartilage, and/ or bone are not exposed. If slough or eschar obscures the extent of tissue loss, this is an Unstageable Pressure Injury.
Stage 4
Full-thickness skin and tissue loss with exposed or directly palpable fascia, muscle, tendon, liga- ment, cartilage, or bone in the ulcer. Slough and/ or eschar may be visible. Epibole (rolled edges), undermining, and/or tunneling often occurs. Depth varies by anatomical location. If slough or eschar obscures the extent of tissue loss, this is an Unstageable Pressure Injury.
Policies for the proper storage and distribution of narcotics within a health care organization are written by: 1 Federal government 2 State government 3 Local governmental bodies 4 Health care organization
Health care organization
A client is observed swallowing a chewable form of aspirin. Which of the following statements made by the nurse shows the best understanding of the educational reinforcement needed by this client? 1 This aspirin is designed to be chewed, not swallowed. 2 This aspirin will not give you the desired effects if its swallowed. 3 I realize that you usually swallow aspirin, but this form only works if its chewed. 4 I can see if your health care provider will order your aspirin in a form that can be swallowed.
I realize that you usually swallow aspirin, but this form only works if its chewed.
. The nurse is administering morphine sulfate to a client for pain. The order has been written so that the nurse can chose from several routes of administration. The nurse knows that the morphine sulfate be most rapidly absorbed by which of the following routes? 1 Oral 2 IV 3 IM 4 Rectal
IV
During the medication administration process, it is important that the nurse remembers which guideline? a. When in doubt about a drug, ask a colleague about it before giving the drug. b. Ask what the patient knows about the drug before giving it. c. When giving a new drug, be sure to read about it after giving it. d. If a patient expresses a concern about a drug, stop, listen, and investigate the concerns.
If patient expresses a concern about a drug, stop, listen, and investigate the concerns.
The nurse prepares to administer a table to a client who has difficulty swallowing pills. The nurse decides to crush the tablet and mix it with food. The nurse should mix the crushed medication: 1 In a large amount of food to mask the taste 2 With the clients favorite food 3 With grapefruit juice 4 In a very small amount of food
In a very small amount of food
Stage 1
Intact skin with a localizcd area of nonblanchable erythema, which may appear differently in darkly pigmented skin. Presence of blanchable erythema or changes in sensation, temperature, or firmness may precede visual changes. Color changes do not include purple or maroon discoloration; these may indicate deep tissue pressure injury.
Trough
Minimum blood serum concentration of medication reached just before the next scheduled dose
the nurse is caring for a client who is experiencing severe pain and is insistent about getting some relief quickly. Which of the following prescriptions is most likely to produce the quickest pain relief? 1 Percodan orally 2 Lidocaine topically 3 Demerol intramuscularly 4 Morphine sulfate intravenously
Morphine sulfate intravenously
Stage 2
Partial-thickness loss of skin with exposed dermis. The wound bed is viable, pink or red, moist, and may also present as an intact or ruptured serum- filled blister. Adipose (fat) is not visible, and deeper tissues are not visible. Granulation tissue, slough, and eschar are not present. These injuries commonly result from adverse microclimate and shear in the skin over the pelvis and shear in the heel. This stage should not be used to describe moisture-associated skin damage (MASD), includ- ing incontinence-associated dermatitis (IAD), intertriginous dermatitis (ITD), medical adhesive- related skin injury (MARSI), or traumatic wounds (skin tears, burns, abrasions).
During the admission interview a client shares with the nurse that she is allergic to latex. The nurses immediate response is to: 1 Place an allergic to latex sticker on the clients Kardex 2 Verbally notify the staff of the clients allergy to latex 3 Notify the clients health care provider of the clients allergy to latex 4 Place an identification bracelet on the client that identifies the latex allergy
Place an identification bracelet on the client that identifies the latex allergy
The nurse is preparing to administer an injection to a preschool-age child. Which approaches are appropriate for this age group? (Select all that apply.) a. Explain to the child in advance about the injection. b. Provide a brief, concrete explanation about injection. c. Encourage participation in the procedure. d. Make use of magical thinking. e. Provide comfort measures after the injection.
Provide a brief, concrete explanation about the injection. d. Make use of magical thinking. e. Provide comfort measures after the injection.
Which of the following is an indication for a binder to be placed around a surgical patient with a new abdominal wound? (Select all that apply.) 1. Collection of wound drainage 2. Providing support to abdominal tissues when coughing or walking 3. Reduction of abdominal swelling 4. Reduction of stress on the abdominal incision 5. Stimulation of peristalsis (return of bowel function) from direct pressure
Providing support to abdominal tissues when coughing or walking 4. Reduction of stress on the abdominal incision
The nurse is aware that which of the following clients is at greatest risk for developing medication toxicity? 1 The 16-year-old anorexic 2 The 35-year-old with liver cancer 3 The 45-year-old chronic alcoholic 4 The 73-year-old diagnosed with hepatitis B
The 73-year-old diagnosed with hepatitis B
A 20-year-old diagnosed with Crohns disease is experiencing severe pain and is requesting the prescribed morphine as often as it can be administered. The nurse is particularly concerned about opioid toxicity because of: 1 The clients frequent requests for the narcotic 2 The clients compromised bowel absorption 3 The drugs seeming inability to control the clients pain 4 The drugs ability to produce marked respiratory depression
The clients compromised bowel absorption
The nurse assigns ancillary personnel the task of giving a client a pre-procedure enema. Which of the following statements made by the personnel requires immediate follow-up by the nurse? 1 I use all of the soap provided in the kit. 2 The soapy water just came right back out. 3 An enema is intended to clean out the rectum. 4 The client was able to hold the enema for 5 minutes.
The soapy water just came right back out.
A 78-year-old client with congestive heart failure (CHF) is reporting vascular pain in his lower legs and requests his oral narcotic analgesic. The nurse recognizes that the clients pain relief will be negatively affected primarily because of: 1 The clients age 2 The systemic effects of CHF 3 The route of administration 4 The status of the peripheral vessels
The systemic effects of CHF
When caring for an older adult Chinese patient, the nurse recognizes which of these cultural issues that may influence the care of this patient? a. Chest x-rays are seen as a break in the soul's integrity. b. Hospital diets are interpreted as being healing and healthful. c. The use of herbal products may be an important practice for this patient. d. Being hospitalized is a source of peace and socialization for this culture.
The use of herbal products may be an important practice for this patient.
Duration
Time during which medication is present in concentration great enough to produce a response
Onset
Time it takes after a medication is administered for it to produce a response
Peak
Time it takes for medication to reach its highest effective concentration
A 3-year-old child is to receive an iron preparation orally. The nurse should: 1 Use a straw 2 Administer the medication by injection 3 Mix the medication in water 4 Ask the pharmacy to send up a pill for the child to swallow
Use a straw
The nurse has taken a verbal order for a narcotic medication to be given to a client experiencing severe pain related to metastatic cancer of the bone. The nurses initial action regarding the order is to: 1 Prepare the medication for administration to the client 2 Properly sign for the narcotic analgesic in the narcotic records 3 Notify the client that a verbal order for a narcotic pain medication has been received 4 Write and then sign the complete order in the appropriate location in the clients chart
Write and then sign the complete order in the appropriate location in the clients chart
The nurse is reviewing new medication orders that have been written for a newly admitted patient. The nurse will need to clarify which orders? (Select all that apply.) a. metformin (Glucophage) 1000 mg PO twice a day b. sitagliptin (Januvia) 50 mg daily c. simvastatin (Zocor) 20 mg PO every evening d. irbesartan (Avapro) 300 mg PO once a day e. docusate (Colace) as needed for constipation
b. sitagliptin (Januvia) 50 mg daily e. docusate (Colace) as needed for constipation
The nurse is administering medications. Examples of high-alert medications include: (Select all that apply.) a. Chemotherapeutic agents b. Antibiotics c. Opiates d. Antithrombotics e. potassium chloride for injection
a. Chemotherapeutic agents c. Opiates d. Antithrombotics e. potassium chloride for injection
When evaluating polymorphism and medication administration, the nurse considers which factors? (Select all that apply.) a. Nutritional status b. Drug route c. Genetic factors d. Cultural beliefs e. Patient's age
a. Nutritional status c. Genetic factors d. Cultural beliefs e. Patient's age
The nurse is reviewing the various forms of topical medications. Which of these are considered topical medications? (Select all that apply.) a. Rectal ointment for hemorrhoids b. Eye drops for inflammation c. Sublingual tablet for chest pain d. Inhaled medication for asthma e. Intradermal injection for tuberculosis testing
a. Rectal ointment for hemorrhoids b. Eye drops for inflammation d. Inhaled medication for asthma
A patient of Japanese descent says that members of her family often have "strong reactions" after taking certain medications, but her white friends have no problems with the same dosages of the same drugs. The nurse recognizes that, because of this trait, which statement applies? a. She may need lower dosages of the medications prescribed. b. She may need higher dosages of the medications prescribed. c. She should not receive these medications because of potential problems with metabolism. d. These situations vary greatly, and her accounts may not indicate a valid cause for concern.
a. She may need lower dosages of the medications prescribed.
The nurse is reviewing data collected from a medication history. Which of these data are considered objective data? (Select all that apply.) a. White blood cell count 22,000 mm b. Blood pressure 150/94 mm Hg c. Patient rates pain as an "8" on a 10-point scale d. Patient's wife reports that the patient has been very sleepy during the day e. Patient's weight is 68 kg
a. White blood cell count 22,000 mm b. Blood pressure 150/94 mm Hg e. Patient's weight is 68 kg
these statement describes a phase of pharmacokinetics. Put the statements in order, with 1 indicating the phase that occurs first and 4 indicating the phase that occurs last. a. Enzymes in the liver transform the drug into an inactive metabolite. b. Drug metabolites are secreted through passive glomerular filtration into the renal tubules. C. A drug binds to the plasma protein albumin and circulates through the body. d. A drug moves from the intestinal lumen into the mesenteric blood system.
a=3 b=4 c=2 d=1
The nurse is reviewing the four clinical phases of investigational drug studies. Place the four phases in the correct order of occurrence. a. Studies that are voluntarily conducted by pharmaceutical companies to obtain more information about the therapeutic and adverse effects of a drug. b. Studies that involve small numbers of volunteers who have the disease or ailment that the drug is designed to diagnose or treat. c. Studies that involve small numbers of healthy subjects who do not have the disease or ailment that the drug is intended to treat. d. Studies that involve large numbers of patients who have the disease that the drug is intended to treat; these studies establish the drug's clinical effectiveness, safety, and dosage range.
a=4 b=2 c=1 d=3
The nurse is performing medication reconciliation during a patient's admission assessment. Which question by the nurse reflects medication reconciliation? a. "Do you have any medication allergies?" b. "Do you have a list of all the medications, including over- the-counter, you are currently taking?" c. "Do you need take anything to help you to sleep at night?" d. "What pharmacies do you use when you fill your prescriptions?"
b. "Do you have list of all the medications, including the-counter, you are currently taking?"
The nurse keeps in mind that which measures are used to reduce the risk of medication errors? (Select all that apply.) a. When questioning a drug order, keep in mind that the prescriber is correct. b. Avoid abbreviations and acronyms. s c. Use two patient identifiers before giving medications. d. Always double-check the many drugs with and look-alike names because of the high risk e. If the drug route has not been specified, the oral route.
b. Avoid abbreviations and acronyms. s Use two patient identifiers before giving medications. I Always double-check the many drugs with sound-alike and look-alike names because of the high risk of error.
An elderly woman took a prescription medicine to help her to sleep; however, she felt restless all night and did not sleep at all. The nurse recognizes that this woman has experienced which type of reaction or effect? a. Allergic reaction b. Idiosyncratic reaction c. Mutagenic effect d. Synergistic effect
b. Idiosyncratic reaction
A patient who has hypertension is now taking a daily beta blocker. Which term best describes this type of therapy? a. Palliative therapy b. Maintenance therapy c. Supportive therapy d. Supplemental therapy
b. Maintenance therapy
A patient is being counseled for possible participation in a clinical trial for a new medication. After the patient meets with the physician, the nurse is asked to obtain the patient's signature on the consent forms. The nurse knows that this "informed consent" indicates which of these? a. Once therapy has begun, the patient cannot withdraw from the clinical trial. b. The patient has been informed of all potential hazards and benefits of the therapy. C. The patient has received only the information that will help to make the clinical trial a success. d. No matter what happens, the patient will not be able to sue the researchers for damages.
b. The patient has been informed of all potential hazards and benefits of the therapy.
The nurse is compiling a drug history for a patient. Which questions from the nurse will obtain the most information from the patient? (Select all that apply.) a. "Do you use sleeping pills to get to sleep?" b. "Do you have a family history of heart disease?" c. "When you have pain, what do you do to relieve it?" d. did you have the mumps as a child?" " e. "Tell me about what happened when you had the allergic reaction to penicillin." f. "What herbal products or over-the-counter medications do you use?"
c."when you have pain, what do you use to relieve it?" e."tell me about what happened when you had the allergic reaction to penicillin?" f."What herbal products or over-the-counter medications do you use?"
An 82-year-old patient is admitted to the hospital after an episode of confusion at home. The nurse is assessing the current medications he is taking at home. Which method is the best way to assess his home medications? a. Ask the patient what medications he takes at home. b. Ask the patient's wife what medications he takes at home. c. Ask the patient's wife to bring his medications to the hospital in their original containers. d. Contact the patient's pharmacy for a list of the patient's current medications.
c. Ask the patient's wife to bring his medications to the hospital in their original containers.
While teaching a 76-year-old patient about the adverse effects of his medications, the nurse encourages him to keep a journal of the adverse effects he experiences. This intervention is important for the older adult patient because of which alterations in pharmacokinetics? a. Increased renal excretion of protein-bound drugs b. More alkaline gastric pH, resulting in more adverse effects c. Decreased blood flow to the liver, resulting in altered metabolism d. Less adipose tissue to store fat-soluble drugs
c. Decreased blood flow to the liver, resulting in altered metabolism
The nurse is reviewing factors that influence pharmacokinetics in the neonatal patient. Which factors puts the neonatal patient at risk with regard to drug therapy? (Select all that apply.) a. Higher gastric pH b. Increased peristalsis in the GI tract c. Immature renal function d. Reduced first-pass elimination in the liver e. Decreased protein-binding of medications
c. Immature renal function d. Reduced first-pass elimination in the liver e. Decreased protein-binding of medications
The nurse is caring for a patient with cirrhosis or hepatitis, and recognizes that abnormalities in which phase of pharmacokinetics may occur in this patient? a. Absorption b. Distribution c. Metabolism d. Excretion
c. Metabolism
A pregnant patient who is at 32 weeks' gestation has a cold and calls the office to ask about taking an over-the-counter medication that is rated as pregnancy category A. Which answer by the nurse is correct? a. "This drug causes problems in the human fetus, so you should not take this medication." b. "This drug may cause problems in the human fetus, but nothing has been proven in clinical trials. It is best not to it take this medication." c. "This drug has not caused problems in animals, but no testing has been done in humans. It is probably safe to take." d. "Studies indicate that there is no risk to the human fetus, so it is okay to take this medication as directed if you need to"
d. "Studies indicate that there is no risk to the human fetus, so it is okay to take this medication as directed if it you need to"
When the nurse is reviewing a list of medications taken by an 88-year-old patient, the patient says, "I get dizzy when I stand up." She also states that she has nearly fainted "a time or two" in the afternoons. Her systolic blood pressure drops 15 points when she stands up. Which type of medication may be responsible for these effects? a. Nonsteroidal antiinflammatory drugs (NSAIDS) b. Cardiac glycosides c. Anticoagulants d. Antihypertensives
d. Antihypertensives
A patient has been diagnosed with late-stage cancer. After consulting with his family, he tells the nurse, "I would like to try to live long enough to see my granddaughter graduate 3 months, but after that I don't want any extra treatments." This patient is demonstrating which of these? a. Veracity b. Beneficence c. Maleficence d. Autonomy
d. Autonomy
The nurse is giving medications to a patient in heart failure. The intravenous route is chosen instead of the intramuscular route. What physical function does the nurse recognize as the most influential when deciding to use the intravenous route of drug administration? a. Altered biliary function b. Increased glomerular filtration c. Reduced liver metabolism d. Diminished circulation
d. Diminished circulation
If a student nurse realizes that he or she has made a drug error, the instructor should remind the student of which concept? a. The student bears no legal responsibility when giving medications. b. The major legal responsibility lies with the health care institution at which the student is placed for clinical experience. c. The major legal responsibility for drug errors lies with the faculty members. d. Once the student has committed a medication error, his or her responsibility is to the patient and to being honest and accountable.
d. Once the student has committed a medication error, his or her responsibility is to the patient and being honest and accountable.
A new drug has been approved for use, and the drug manufacturer has made it available for sale. During the first 6 months, the FDA receives reports of severe adverse effects that were not discovered during the testing and considers withdrawing the drug. This illustrates which phase of investigational drug studies? a. Phase 1 b. Phase II c. Phase III d. Phase IV
d. Phase IV
The physiologic differences in the pediatric patient compared with the adult patient affect the amount of drug needed to produce a therapeutic effect. The nurse is aware that one of the main differences is that infants have which of these factors? a. Increased protein in circulation b. Fat composition lower than 0.001% c. More muscular body composition d. Water composition of approximately 75%
d. Water composition of approximately 75%
The nurse is reviewing medication orders. Which digoxin dose is written correctly? a. digoxin .25 mg b. digoxin .250 mg c. digoxin 0.250 mg d. digoxin 0.25 mg
d. digoxin 0.25 mg
A patient's medical record includes an order that reads as follows: "Atenolol 25 mg once daily at 0900." Which action by the nurse is correct? a. The nurse does not give the drug. b. The nurse gives the drug orally. c. The nurse gives the drug intravenously. d. The nurse contacts the prescriber to clarify the dosage route.
d. the nurse contacts the prescriber to clarify the dosage route
