NMNC 4310 - Quiz 1-3 Combined
A 56-year-old, normally healthy patient at the clinic, is diagnosed with bacterial community-acquired pneumonia. Before treatment is prescribed, the nurse asks the patient about an allergy to: A) erythromycin B) amoxicillin C) sulfonamides D) cephalosporins
A
A nurse prepares an adult patient with a severe burn injury for a dressing change. The nurse knows that this is a painful procedure and wants to try providing music to help the patient relax. Which action is best for the nurse to take? A) Ask the patient about music preferences B) Ask the patient about music preferences C) Play music that does not have words D) Use music composed by Mozart
A
A patient receiving chemotherapy rings the call bell and reports the onset of nausea. The nurse should prepare an as-needed dose of which medication? A) Ondansteron B) Morphine Sulfate C) Dexamethasone D) Zolpidem
A
A patient with chronic pain who has been receiving morphine sulfate 20 mg IV over 24 hours is to be discharged home on oral sustained-release morphine (MS Contin) administered twice a day. What dosage of MS Contin will be needed for each dose to obtain an equianalgesic dose for the patient? (Morphine sulfate 10 mg IV is equianalgesic to morphine sulfate 30 mg orally.) A) MS Contin 30 mg/dose B) MS Contin 15 mg/dose C) MS Contin 120 mg/dose D) MS Contin 60 mg/dose
A
A patient with osteoarthritis has been taking ibuprofen 400mg every 8 hours. The patient states that the drug doesn't seem to work as well as it used to in controlling the pain. The most appropriate response to the patient is based on what knowledge? A) Another NSAID may be indicated because of individual variations in response to drug therapy. B) It may take several months for NSAIDS to reach its therapeutic levels in the blood and thus be effective. C) The patient may not be taking the drug correctly, so the nurse must assess the patient's knowledge base and provide teaching. D) If NSAIDS is not effective in controlling symptoms, systemic corticosteroids are the next line of drug therapy.
A
The major advantage of a Venturi mask is that it can: A) deliver a precise concentration of Oxygen B) deliver up to 80% oxygen C) provide continuous 100% humidity D) be used while a patient eats and sleeps
A
The nurse caring for a client with emphysema walks into the client's hospital room and finds the client sitting on the side of the bed while leaning on the overbed table. Which statement is accurate? A) "You are demonstrating the correct position to enhance breathing." B) "Please call the staff before leaning over the table as it is unsafe." C) "Next time sit upright instead of leaning over the table." D) "You need to recline in the bed-side chair to relax the diaphragm."
A
The nurse educator is explaining how to assess pain in infants to a group of new nurses. Which behaviors should be explained as the most consistent indicators of pain in infants? A) Facial Expressions and withdrawing B) Squirming and jerking C) Increased respirations D) Increased heart rate
A
The nurse is caring for a patient who had abdominal surgery yesterday and is receiving morphine through patient-controlled analgesia (PCA). What action by the nurse is a priority? A) Checking the respiratory rate B) Auscultating bowel sounds C) Evaluating for sacral redness D) Assessing for nausea
A
The nurse is conducting preoperative teaching with a client about the use of an incentive spirometer. The nurse should include which piece of information in discussions with the client? A) The best results are achieved when sitting up or with the head of the bed elevated 45 to 90 degrees B) After maximum inspiration, hold the breath for 15 seconds and exhale C) Inhale as rapidly as possible D) Keep a loose seal between the lips and the mouthpiece
A
Which action by the nurse will be most helpful to a patient who is expected to ambulate, deep breath, and cough on the first postoperative day? A) Administer prescribed analgesic medications before the activities B) Ask the patient to state two possible complications of immobility C) Schedule the activity to begin after the patient has taken a nap D) Encourage the patient to state the purpose of splinting the incision
A
While providing home care instructions to the mother of a child diagnosed with right lobar pneumonia, which intervention will the registered nurse (RN) instruct her to implement? Select all that apply. A) Encourage child to take deep breaths frequently B) Position the child on the right side frequently C) Administer acetaminophen as needed for increased fever D) Administer cough syrup if cough becomes too strong
A B C
A client has developed a hospital-acquired pneumonia. When preparing to administer cephalexin 500 mg, the nurse notices that the pharmacy sent cefazolin. What should the nurse do? Select all that apply. A) Request that cephalexin be sent promptly B) Contact the pharmacy and speak to a pharmacist C) Return the cefazolin to the pharmacy D) Verify the medication prescription as written by the healthcare provider (HCP) E) Administer the cefazolin
A B C D
An elderly patient with chronic arthritis asks you for suggestions for pain relief and does not want to depend on pain medications. You advise the following possible measures: Choose all that apply. A) Guided Imagery B) Massage C) Heat/Cold Therapies D) Massage E) Music Therapy F) NSAIDS
A B C D E
Mr. S is a 65-year-old male who is admitted to the telemetry unit for treatment of pneumonia of the right middle lobe. His morning assessment reveals the following data: T: 100.4, Pulse: 110, RR: 24, B/P: 108/68, and O2 saturation 89% on room air. Which diagnostic studies does the nurse anticipate for this client? Choose all that apply. A) Chest x-ray B) Sputum culture C) Elevated WBC's > 10,000 D) EKG E) Decreased WBC's F) ABG's
A B C F
Which findings are significant data to gather from a client who has been diagnosed with pneumonia? Select all that apply. A) Quality of breath sounds B) Color of nail beds C) Presence of bowel sounds D) Occurrence of chest pain E) Amount of peripheral edema
A B D
Which findings indicate that a patient is developing status asthmaticus? (select all that apply) A) Extreme wheezing B) Lack of response to conventional treatment C) Positive sputum culture D) Unable to speak in complete sentences
A B D
The plan of care for the patient with chronic obstructive pulmonary disease (COPD) should include: (select all that apply) A) breathing exercises, such as pursed-lip breathing that focus on exhalation B) use of peak flow meter to monitor the progression of COPD C) exercise such as walking D) high flow rate of Oxygen administration
A C
The nurse develops a nursing care plan for a client at risk of having hospital-acquired pneumonia. Which factor(s) places this client at highest risk for developing hospital-acquired pneumonia? Select all that apply. A) A client with a decreased level of consciousness B) A client who did not receive the pneumococcal vaccine C) A client with dysphagia D) A client on a ventilator
A C D
The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which finding would the nurse expect to note on assessment of this client? Select all that apply. A) Decreased oxygen saturation with mild exercise B) A widened diaphragm noted on chest x-ray C) A low arterial PCO2 level D) A hyperinflated chest noted on the chest x-ray
A D
The nurse instructs a client to use the pursed-lip method of breathing and evaluates the teaching by asking the client about the purpose of this type of breathing. The nurse determines that the client understands if the client states that the primary purpose of pursed-lip breathing is to promote which outcome? A) Strengthen the diaphragm B) Promote oxygen intake C) Strengthen the intercostal muscles D) Promote carbon dioxide elimination
D
The nurse is caring for a patient with pneumonia. If a pleural effusion is developing, the nurse would expect which finding? A) Paradoxical respirations B) Barrel-shaped chest C) Hyperresonance on percussion D) Localized decreased breath sounds
D
The nurse is performing an admission assessment for a hospitalized client with a diagnosis of asthma. The nurse questions the admitting order for ipratropium bromide (Atrovent) because the client has a history of which condition? A) Peripheral edema B) Cushing disease C) Anticoagulation therapy D) Glaucoma
D
The nurse is preparing to administer Reslizumab as an IV infusion to a 75 kg patient suffering from COPD. The order states to administer 3mg/kg. Calculate the dose. How many mg will the patient receive? A) 536 mg B) 123 mg C) 75 mg D) 225 mg
D
You are providing teaching to a patient with chronic COPD on how to perform diaphragmatic breathing. This technique helps do the following: A) Increase the breathing rate to prevent hypoxemia B) Encourages the use of accessory muscles to help with breathing C) Decrease the use of the abdominal muscles D) Strengthen the diaphragm
D
Which finding is an expected outcome for an elderly client following treatment and recovering from bacterial pneumonia? A) a respiratory rate of 25 to 30 breaths/min B) the ability to perform activities of daily living without dyspnea C) a maximum loss of 5 to 10 lb. (2 to 5 kg) of body weight D) chest pain that is minimized by splinting the rib cage
B
Which of the following is NOT a treatment for chronic bronchitis or emphysema? A) Theophylline B) Metoprolol C) Albuterol D) Spirvia
B
The healthcare provider has prescribed penicillin for a client admitted to the hospital for treatment of pneumonia. Prior to administering the first dose of penicillin, the nurse should ask the client which of the following? A) "Do you have any cardiac history" B) "Do you have a history of seizures" C) "Have you had any recent infections" D) "Have you had a previous allergy to penicillin"
D
A 2-day post-operative right-below-knee amputation patient complains of right foot pain at an '8' on 0-10 pain scale. The nurse's most appropriate response would be to: A) Explain to the patient that the pain is 'not real' because the foot is not there B) Medicate the patient for pain, as ordered C) Encourage guided imagery D) Refer the patient to psychiatry
B
A nurse caring for a client with chronic obstructive pulmonary disease (COPD) auscultates wheezes and diminished breath sounds. The wheezes and diminished breath sounds indicate that the client is experiencing which complication of COPD? A) The client is experiencing hypersaturation in oxygen B) The client is experiencing a bronchospasm C) The client has a complication of pneumonia D) the client is experiencing pulmonary emboli
B
A patient admitted with metastatic lung cancer is ordered to receive morphine sulfate for pain. Which side effect of this medication should the nurse try to prevent with oral intake and medication? A) Respiratory Depression B) Constipation C) Agitation D) Urinary Frequency
B
A patient is newly diagnosed with COPD due to chronic bronchitis. You're providing education to the patient about this disease process. Which statement by the patient indicates they understood your teaching about this condition? A) "If I stop smoking, it will cure my condition." B) "Complications from this condition can lead to pulmonary hypertension and right-sided heart failure." C) "My respiratory system is stimulated to breathe due to high carbon dioxide levels rather than low oxygen levels. D) "I'm at risk for low levels of red blood cells due to hypoxia and may require blood transfusions during acute illnesses."
B
A patient who had knee surgery received IV ketorolac 30 minutes ago and continues to complain of pain at a level of 7 (0-10 scale). Which action is most effective for the nurse to take at this time? A) Reassure the patient that postoperative pain is expected after knee surgery B) Administer the prescribed prn IV morphine sulfate C) Teach the patient that the effects of ketorolac typically last about 6 to 8 hours D) Notify the health care provider about the ongoing pain
B
A patient who has frequent migraines tell the nurse, "My life feels chaotic and out of my control. I could not manage if anything else happens." Which response should the nurse make initially? A) "Your previous coping resources can be helpful to you now." B) "Tell me more about how your life has been recently." C) "Guided imagery can be helpful in regaining control." D) "Regular exercise may get your mind off the pain."
B
A patient who has severe pain associated with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective? A) The patient uses the ordered opioid pain medication whenever the pain is greater than 5 (0-10 pain scale) B) The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs C) The patient states the non-opioid analgesics may be used when the maximal dose of the opioid is reached without adequate pain relief D) The patient agrees to take the medications by the IV route in order to improve analgesic effectiveness
B
A patient with severe COPD is having an episode of extreme shortness of breath and requests their inhaler. Which type of inhaler ordered by the physician would provide the FASTEST relief for the patient based on this particular situation? A) Salmeterol B) Albuterol C) Spiriva D) Symbicort
B
Prior to giving a requested pain medication to a patient, the nurse would: A) Assess vitals signs B) Assess their pain on a 0-10 pain scale C) Call the doctor D) Wait longer, the patient did not appear to be uncomfortable
B
The healthcare provider has ordered Prednisone 1.5mg/kg/day in 2 divided doses for a 97-pound patient. How many mg will the patient receive per dose? A) 66 mg B) 33 mg C) 15 mg D) 39 mg
B
The nurse is caring for a client with a diagnosis of chronic obstructive pulmonary disease (COPD). The nurse received a new order for a metered-dose inhaler (MDI) and immediately notifies the health care provider because of which important finding? A) Long-acting anticholinergic should be contraindicated in client with COPD B) The client has severe arthritis in both hands C) The client is a smoker D) The client has trouble hearing
B
The nurse is caring for a patient receiving morphine sulfate via PCA. Which patient assessment data demonstrates the most therapeutic effect of this medication? A) Pain rating 3/10, awake and alert, respirations 24 B) Pain rating 2/10, awake and alert, respirations 18 C) Pain rating 1/10, drowsy but arousable, respirations 16 D) Pain rating 2/10, drowsy but arousable, respirations 18
B
The nurse is instructing the client on the use of a beclomethasone (Vanceril) inhaler. Which statement by the client indicates that teaching is successful? A) I will inhale then blow out forcefully B) I will rinse my mouth following each scheduled dose C) I will hold my diabetic medication for 2 hours before and after the inhaler D) I will use the inhaler prior to sleep
B
The nurse is teaching a client about coughing and deep-breathing techniques to prevent postoperative complications. Which statement is most appropriate for the nurse to make to the client at this time as it relates to these techniques? A) "Close monitoring of your oxygen saturation will detect hypoxemia." B) "Use of the incentive spirometer will help prevent pneumonia." C) "Administration of intravenous fluids will prevent or treat fluid imbalance." D) "Early ambulation and administration of blood thinners will prevent pulmonary embolism."
B
The nurse has given instructions on pursed-lip breathing to a client with COPD. Which statement by the client would indicate effective teaching? A) " I should inhale through my mouth very deeply" B) "I should make inhalation twice as long as exhalation" C) I should tighten my abdominal muscles with inhalation" D) "I should tighten my abdominal muscles with exhalation"
D
A patient is admitted to the emergency department with a severe exacerbation of asthma. Which finding is of most concern to the nurse? A) Presence of inspiratory and expiratory wheezing B) PaCO2 of 47 mmHg C) Unable to speak and sweating profusely D) Peak expiratory flow rate at 60% of personal best
C
A patient is unable to take oral steroids for their COPD exacerbation. The healthcare provider has ordered 150 mg of Hydrocortisone IV. The medication dispensing machine has Hydrocortisone 250 mg/mL. Calculate the mL the nurse will administer. How many mL will the nurse administer to the patient? A) 8.2 mL B) 1.2 mL C) 0.6 mL D) 0.3 mL
C
The nurse is assigned to care for a patient who has anxiety and an exacerbation of asthma. What is the primary reason for the nurse to carefully inspect the chest wall of this patient? A) Monitor the patient for bilateral chest expansion B) Allow time to calm the patient C) Evaluate the use of intercostal muscles D) Observe for signs of diaphoresis
C
The patient is suffering from community acquired pneumonia. The healthcare provider has ordered 500 mg/250 mL of Azithromycin IV piggyback to infuse over 90 minutes. Calculate the mL/hr the nurse will administer the medication on the IV pump. A) 154 mL/hr B) 90 mL/hr C) 167 mL/hr D) 200 mL/hr
C
Which assessment finding in a client with COPD indicates to the nurse that the client's respiratory problem is chronic? A) Productive cough B) Generalized cyanosis C) Clubbing in fingers D) Wheezing on exhalation
C
Which question asked by the nurse will give the most information about the patient's metastatic bone cancer pain? A) "How long have you had this pain?" B) "How often do you take pain medication?" C) "How would you describe your pain?" D) "How much medication do you take for the pain?"
C
A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition? A) Pulse rate of 90 beats per minute B) Warm, dry skin C) Respirations of 18 breaths per minute D) Decreased wheezing
D
A nurse instructs a COPD client to use the pursed-lip method of breathing and evaluates the teaching by asking that client about the purpose of this type of breathing. The nurse determines that the client understands if the client states that the primary purpose of pursed-lip breathing is to promote which outcome? A) Strengthen the diaphragm B) Strengthen the intercostal muscles C) Promote oxygen intake D) Promote carbon dioxide elimination
D
A patient who has good control for chronic pain using a fentanyl patch (Duragesic) patch reports rapid onset pain at a level 9 (0-10 scale) and requests "something for pain that will work quickly." How will the nurse document the type of pain reported by this patient? A) Somatic pain B) Neuropathic pain C) Referred pain D) Breakthrough pain
D
A patient with metastatic cancer of the colon experiences severe vomiting after each administration of chemotherapy. Which action, if taken by the nurse, is appropriate? A) Offer dry crackers and carbonated fluids during chemotherapy B) Give the patient a glass of a citrus fruit beverage during treatments C) Have the patient eat large meals when nausea is not present D) Administer prescribed antiemetics 1 hour before the treatments
D
True or False. Morphine may be given to a patient with COPD who is complaining of chest discomfort with coughing.
False
True or false? Patients with emphysema experience hypoventilation as a compensatory mechanism to help increase oxygen levels and decrease carbon dioxide levels in the body.
False
