Patho Exam 2
B
A client in septic shock is receiving norepinephrine as a continuous titratable infusion through a central venous access device. The nurse should: A Administer pain medication concurrently B Monitor blood pressure continuously C Evaluate arterial blood gases every hour D Monitor for signs of infection
C
4 clients are being prescribed tetracycline for a bacterial infection. For which patient should the nurse question this order? A Patient with a history of penicillin allergies B Patient with a history of abdominal cramping while taking PO tetracycline C Patient who recently went to their HCP and is 20 weeks pregnant D Patient who takes oral contraceptives
B
4 clients are taking Azithromycin in the hospital. Which patient needs IMMEDIATE intervention? A Client reporting new onset of hearing loss in one ear B Client reporting substernal chest pain C Client asking when he can get of here and have a cocktail D Client who is scheduled to take simvastatin in 4 hours
C
A 72-year-old client is prescribed ciprofloxacin for a urinary tract infection (UTI). The nurse instructs the client to notify the health care provider (HCP) immediately about which of the following? a. Ringing in the ears b. Orange-colored urine c. Pain in the Achilles tendon region d. Sunburn
B
A client being discharged from the hospital on Tobramycin should be told to report any changes in: A libido B balance C hair growth D taste
C
A client discharged home on trimethoprim (TMP)-sulfamethoxazole (SMZ) to treat a UTI is advised by the nurse: A "Contact us immediately if you have pain in your muscles or Achilles tendon" B "Contact us immediately if you feel your heart racing" C "Contact us immediately if you notice any new rashes or peeling skin" D "Contact us immediately if you upper body suddenly becomes flush"
a
A client in the emergency department is being discharged with a prescription for tetracycline. Which statement by the client would indicate a need for follow-up? A. I just took 2 home pregnancy tests before I came here and they were both positive teratogenic. b. I should take these medications with 5 glasses of water c. This medication may cause blood sugar abnormalities so I should check my blood sugar 4 x per day instead of 3 x per day d. I have to stop taking my anti-hypertensive pill while I am on this medication
a
A client is admitted to the hospital with an exaccerbation of myasthenia gravis. What are the appropriate nursing actions? Select all that apply. A Administer Acetylcholinesterase inhibitor AC B Encourage solid food consumption C Teach the importance of avoiding the annual flu vaccination D Anticipate administer opioids for muscle pain E Apply a topical cream to their malar face rash
D
A client is in the hospital receiving IV gentamicin to treat a serious gastrointestinal infection. Which are the BEST instructions to give this patient regarding the medication? a. If you start to lose you hearing while on this medication, don't worry, it will return in a few days b. If you experience a seizure, let me know as soon as possible c. This medication will cause crystals or uric acid to form in your kidneys; be sure to drink plenty of water to prevent this d. If you experience ringing in your ears, dizziness, or a headache, let me know as soon as possible
D
A client prescribed Metronidazole as an outpatient is being given discharge instructors by the nurse. Which of the following instructions is most appropriate? A "Go to the nearest urgent care if you start experiencing a metallic taste in your mouth." B "Increase consumption of foods that are high in Vitamin B6." C "Avoid sunlight as much as possible" D "Contact your HCP if you have new onset of feverl, sore throat, or a skin rash."
C
A client tests positive for influenza A. Which piece of equipment must the nurse use when entering the room? A Goggles B Gown C simple face mask D N95 respirator
D
A client with C. diff colitis has a basic metabolic panel (BMP) drawn this morning. Which lab value do you find most concerning? A Creatinine of 1.1 B Sodium of 133 C Magnesium of 1.7 D Potassium of 2.4 E Bicarbonate of 25
B
A clinic nurse is performing a physical assessment on a client who has systemic lupus erythematosus (SLE). Which of the following findings should the nurse expect? A A grey-colored, papular rash across the trunk and back B A dry, red rash across the bridge of the nose and on the cheeks C Pitting edema of the hands and fingers D Subcutaneous nodules on the ulnar side of the arm
C
A mother is breast-feeding her newborn after discharge from the hospital. Which antibodies to you expect to be abundant in this infant's body? A IgE B IgM C IgA D IgG
D
A nurse is admitting a child who has leukemia. Which of the following clients should the nurse place in the same room with this child? A A child reporting nuchal rigidity and fever B A child with rheumatic fever following Strep throat C A child with cystic fibrosis and productive, yellow sputum D A child with chronic kidney disease and anemia
D
A nurse is admitting a client who has a wound infected with vancomycin-resistant enterococci (VRE). Which of the following types of precautions should the nurse plan to initiate? A Droplet B Airborne C Neutropenic D Contact
a
A nurse is admitting a client who has active tuberculosis to a room on a medical-surgical unit. Which of the following room assignments should the nurse make for the client? A A room that vents air directly to the outside environment B A room with a nonsurgical client C A room close to the nurse's station D A room with a client receiving methotrexate and cyclosporine
B
A nurse is assessing a client who has a suspected diagnosis of Guillain-Barré syndrome (GBS). Which of the following questions should the nurse ask the client? A "Do you have a history of alcohol use?" B "Have you had a recent gastrointestinal infection?" C "Have you traveled to South America recently?" D "Have you taken NSAIDs in the past week?"
C
A nurse is assessing a client who has systemic lupus erythematosus (SLE). Which of the following findings is the highest priority for the nurse to report to the provider? A Client report of feelings of depression B Dry, raised rash on the face C Presence of +4 peripheral edema D Joint pain in hands and knees
B
A nurse is assessing a client who has systemic lupus erythematosus and is taking hydroxychloroquine. The nurse should report which of the following adverse effects to the provider immediately? A Diarrhea B Blurred vision C Pruritus D Fatigue
C
A nurse is assessing a client who is 2 weeks postoperative following a kidney transplant. Which of the following manifestations should the nurse identify as possible organ rejection? A Temperature 97.0° F ( 36.1° C) B Insomnia C Oliguria D Weight loss
D
A nurse is caring for a client who has HIV-1 infection and is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication? a. Cardiac dysrhythmia b. Metabolic alkalosis c. Renal failure d. Low hemoglobin counts
C
A nurse is caring for a client who has a new diagnosis of myasthenia gravis. For which of the following signs or symptoms should the nurse monitor? A Increased intracranial pressure B Confusion C Weakness D Increased urine output
B
A nurse is caring for a client who has herpes zoster. Which of the following findings should the nurse expect? a. Different-sized papules in the genital area b. Painful lesions following a nerve pathway c. Multiple papules located on the client's back d. Patches scattered across the torso
B
A nurse is caring for a client who has streptococcal pneumonia and a prescription for penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports that the IV site itches and that he feels dizzy and short of breath. Which of the following actions should the nurse take first? A Call the HCP B Stop the infusion C Elevate the head of the bed D Auscultate the client's breath sounds
D
A nurse is caring for a client who is hospitalized with active pulmonary tuberculosis and is started on Ethambutol. The nurse should understand that which of the following should be monitored? A Urine output B Cardiac rhythm C Skin coloration D Visual acuity
C
A nurse is caring for a client who is to start taking cyclosporine following a kidney transplant. The nurse should instruct the client that which of the following foods can have an adverse interaction with this medication? A Aged cheese B Orange juice C Grapefruit juice D Smoked salmon
A
A nurse is preparing to administer Amoxicillin to a patient. Which of the following known allergies found in the patient's medical record would cause the nurse to hold the dose and contact the HCP? A Allergy to Cephalosporins B Allergy to Vancomycin C Allergy to Rifampin D Allergy to Sulfonamides
C
A nurse is reviewing the lab findings for a female client who is receiving combination chemotherapy for breast cancer. Which of the following findings should the nurse report to the provider? A Hemoglobin of 12 B Platelet count of 175,000 C White blood cell count 2,300 D Potassium of 4.7
B
A nurse is talking with a client who has to come to the clinic for HIV testing. The nurse should explain that, after the laboratory has the enzyme-linked immunosorbent assay (ELISA) results, it will use which of the following tests to confirm the diagnosis? a. Rapid HIV test b. Western blot analysis c. Viral load d. CD4 count
D
A nurse is teaching a client who has a urinary tract infection (UTI) and is taking ciprofloxacin. Which of the following instructions should the nurse give to the client? A "If the medicine causes any upset stomach, take an antacid at the same time." B "Limit your daily fluid intake while taking this medication." C "Get plenty of sunlight exposure while taking this medication as it inhibits Vitamin D synthesis" D "You should report any tendon discomfort you experience while taking this medication to your HCP."
C
A nurse is teaching a client who is taking metronidazole. Which of the following sense alterations should the nurse include as an side effect of metronidazole? A Olfactory changes B Vertigo C Metallic taste D Tinnitus
C
A nurse is teaching the parent of an 8-year-old who had a febrile seizure about management of future fevers. Which instruction is appropriate to include in the teaching? A Given the child frequent cold baths to control fever B If the child develops another seizure, wait 15 minutes and then call 911 C Give acetaminophen or ibuprofen every 6 hours to control fever D Place ice packs under the arms and around the groin for fever control
D
A nurse manager is providing an educational program on antibiotic sensitivity to bacterial infections. The nurse should include in the teaching that vancomycin is indicated for which of the following infections? A Klebsiella B Candida C Herpes zoster D Methicillin-resistant Staphylococcus aureus
A B D E
A parent calls the nurse telehealth triage line with concerns about an allergic reaction to something a child ate. Which symptoms should the nurse instruct the parent to assess for to determine if the child is having an anaphylactic reaction? Select all that apply A Wheezing B Diffuse urticaria C Fever D Lightheadedness E Dyspnea
C
A patient with SLE is admitted to the hospital for evaluation and management of acute joint inflammation. Which information obtained in the admission laboratory testing concerns you most? A Positive antinuclear antibody test result B Thrombocyte count of 147,000 C Elevated creatinine and BUN D Hemoglobin count of 11.7
C
A patient with a history of liver transplantation has been receiving cyclosporine, prednisone, and mycophenolate for over a year. Which finding is most concerning? A Gums that bleed easily when brushing teeth B A blood glucose of 162mg/dL C A nontender lump above the clavicle D 1+ pitting edema in the feet and ankles
B
A pregnant nurse should NOT take care of which of the following clients? A Client with MRSA infection B Client with toxoplasmosis C Client with bacterial pneumonia D Client with a viral upper respiratory infection
D
A toddler is exposed to a sibling who has varicella zoster and contracts the disease. When exposed to another toddler at school months later, the toddler does not develop clinical indicators of the disease. What type of immunity is being described? A Artificially acquired passive immunity B Artificially acquired active immunity C Naturally acquired passive immunity D Naturally acquired active immunity
B
Adam has been in your ICU for 4 weeks on multiple different IV antibiotics to treat his peritonities. You have been taking care of him for the past few days and are noticing increased amounts of watery diarrhea in his colostomy bag. What laboratory test would be most appropriate to perform at this time to guide his care? A urine culture and sensitivity B C. diff testing of his stool C nasal swab for MRSA D White blood cell count
B
Adam has received numerous liters of IVF, and his MAP is current 52 mm Hg. Which interventions should the nurse anticipate implementing next? A Change the IVF from 0.9% NaCl to 5% Dextrose B Anticipate starting a Norepinephrine infusion titrated to a MAP of 65 C Give an IM injection of Epinephrine D Place Adam in a prone position to promote oxygenation
C D
Adam is diagnosed with C. diff colitis secondary to prolonged antibiotic use. Which antibiotics below would be appropriate to treat this infection? Select all that apply. A PO Penicillin B IV Vancomycin C IV Metronidazole D PO Vancomycin E IV Cefepime
C
Adam is started on Clindamycin. Which of the following organ functions needs to be monitored closely? A Liver B Cardiac C Renal D Respiratory
B
An 18 yo college student with an exacerbation of lupus has been receiving prednisone 20mg daily for 4 days while in the hospital (prescription to end after the 4th day). Which medical order should you question? A Discontinue prednisone after the 4th day B taper down the prednisone doses before discontinuing C Check the patient's blood glucose ACHS D Administer ibuprofen 600 mg PO PRN for mild pain
D
An LPN, under your supervision, is providing nursing care for a client with Guillain-Barre Syndrome. What observation should you instruct the LPN to report immediately? A Reports of numbness and tingling in the hands B Reports paresthesia in bilateral feet C Rapid heart rate of 102 bpm D Shallow respirations and decreased breath sounds
D
An adult patient comes to their HCP with a rhinorrhea, non-productive cough, swollen cervical lymph nodes, but is afebrile. The HCP rules out any bacterial cause of illness. Which medication is the patient likely going to be encouraged to take to address this illness? a. Acyclovir b. Nystatin c. Amoxicillin d. Dextromethorphan
C
An older adult patient with dementia who is bedbound is frequently incontinent of stool. What microorganism do you suspect as the cause of the patient's recurrent urinary tract infections? A Infleunza Type A B C. diff C E. Coli D Klebsiella
C
During inflammation, which substance naturally produce by the body causes pain? A histamine B bradykinin C prostaglandins D lactic acid
D
For a patient in septic shock, which of the following would you expect to see? A apical pulse of less than 60 bpm B Respiratory rate of 4 breaths/min C Pupils dilated and unequal in size D Systolic blood pressure of less than 90 mm Hg
C
For a patient like Adam who is in shock, which of the following is the most important goal of nursing care? A Manage hypervolemia B Manage increased cardiac output C Manage inadequate tissue perfusion D Manage vasoconstriction of capillaries
D
Four clients are seen by the emergency department nurse. Which client is a priority for treatment and definitive care? A Client receiving radiation therapy with a 6 cm laceration that is not actively bleeding B New parent who is crying and overwhelmed but denies suicidal ideation C Client with purulent drainage and crusted eyelids with no visual impairement D 7-day-old fussy infant with a rectal temperature of 100.6F (38.1C) and 6 wet diapers today
B
Multiple clients present to the emergency department. Which client should the triage nurse prioritize for diagnostic testing and definitive care? A 25 yo drug user with right arm swelling and redness reporting fever B 30 yo kidney transplant patient reporting generalized aching and a low-grade fever C 70 yo with diverticulosis reporting left lower quadrant pain and fever D 75 yo client with knee replacement reporting fever and a swollen knee
C
Patient receiving their 3rd dose of Vancomycin as a hospital inpatient calls you into their room reporting face and upper body erythema. What is your next most appropriate action? A Provide the patient with a cold compress B Conduct a focused integumentary assessment C Verify that you Vancomycin is infusing at the correct rate D Call the Rapid Response Team and anticipate intubating the patient
A C D
Prednisone is going to...(select all that apply) A suppress inflammation B promote B cell formation C supress the immune system D promote glucose formation/release into bloodstream
a
The first class of immunoglobulin secreted after an antigen is encountered in the body is called...: A. IgM B. IgG C. IgE D. IgA
C
The home care nurse is preparing to visit a client who has undergone renal transplantation. The nurse develops a plan of care that includes monitoring the client for signs of acute graft rejection. The nurse documents in the plan to assess the client for which signs of acute graft rejection? A Fever, hypotension, and polyuria B Hypertension, polyuria, and thirst C Fever, hypertension, and graft tenderness D Hypotension, graft tenderness, and hypothermia
c
The nurse is caring for a client diagnosed with Guillain-Barré syndrome (GBS) after a recent gastrointestinal (GI) illness. Monitoring for which of the following is a nursing care priority for this client? A Facial flushing and diaphoresis B Hypoactive bowel sounds C Inability to lift head or cough D Warm, tender, swollen leg
D
The nurse is caring for a client receiving IVPB erythromycin. Which client data obtained by the nurse should be reported to the health care provider (HCP) prior to administering any additional doses? A. Decreased white blood cell (WBC) count B. Oral temperature of 101.4F C. Became nauseated and vomited once D. Reports feeling a "fluttering" in his chest and a racing heartbeat
C
The nurse receives a hand-off report from the night shift nurse. Which client should the nurse assess first? A Client with anemia who began receiving 1 unit of packed red blood cells 1 hour ago B Client with a hemoglobin of 7 who needs an IVPB of ferrous sulfate C Client with seizure activity who received lorazepam 20 minutes ago D Client with suspected leukemia scheduled for a bone marrow biopsy in 1 hour
D
The nurse receives report for clients on the neurology floor. Which client is important for the nurse to assess first? A Client with multiple sclerosis and bladder incontinence last night B Client with Guillain-Barre syndrome who has "0" deep tendon patellar reflexes C Client with Parkinson's disease who is drooling D Client with dementia who has new onset of confusion and agitation
C
The triage nurse has one isolation room left in the emergency department. Which priority client should be assigned to this room? A. Child with impetigo who has been on antibiotics for 3 days B. Child with leg rash secondary to poison ivy exposure C. Child suspected of influenza A with a productive cough D .Child with chickenpox for the past 14 days; lesions are crusted over and dry
a
Vaccination is an example of which type of immunity?: A. Artificially acquired active immunity B. Artificially acquired passive immunity C. Naturally acquired active immunity D. Naturally acquired passive immunity
B
Which antibody is predominant in an allergic reaction that involves large quantities of histamine release? A. IgD B. IgE C. IgA D. IgM
A B D E F G H
Which of the following are signs and symptoms of liver failure? Select all that apply A Steatorrhea B Jaundice C Decreased liver enzymes D Nausea and vomiting E Pruritus F Abdominal pain G Petechiae H Confusion
D
Which of the following is NOT an element of the innate immune system? A Macrophages B Natural Killer cells C Epithelial cells of the skin D T lymphocytes
C
Which of the following is necessary for the rapid secondary immune response we see following vaccinations? A Helper T cells encountering the antigen for the first time B Inflammation at the injection site promoting phagocytosis C Memory B cells responding immediately to antigen D Antibody production that peaks after 2-3 weeks
C
Which of the following should be AVOIDED for a patient with bacterial meningitis? A Institute droplet precautions B Assess neuro status and cranial nerves frequently C Allow as many visitors as possible to prevent depression D Notify HCP of severe hypertension, widened pulse pressure, and bradycardia
A
Which of the following snacks should be avoided in a patient with hepatic encephalopathy? A High-protein B High-fat C High-carbohydrate D High-fiber
C
Which of the following statements is true regarding adaptive immunity? A Cytotoxic T cells promote opsonization of Helper T Cells B Macrophages produce antibodies in response to antigens C Helper T cells activate B cells to produce antibodies D B lymphocytes differentiate into plasma B cells and T cells
a
Which of the following statements regarding adaptive immunity is true? A. Adaptive immunity either directly destroys a foreign antigen or it produces antibodies against the antigen B. B cells either become memory B cells or complement-secreting B cells C. Memory B cells recall antigens as foreign invaders, and they slowly begin producing antibodies after re-exposure D. When adaptive immunity cannot control a bacterial infection then innate immunity is activated
B
Which of the following statements regarding pyrogens and fever is MOST accurate?: A. Pyrogens mature in the bone marrow and are constantly patroling the bloodstream B. Fever is beneficial to the immune system, as long as it is not extreme (> 105F) C. Pyrogens cause body temperature to rise, which causes bacteria to proliferate/multiply in the body D. Pyrogens have their effect on the Anterior Pituitary
D
Which of the following vaccination orders should the nurse question? a. Administer influenza B vaccination to a child with a penicillin allergy b. Administer an injectable influenza A vaccine to an infant c. Administer a tetanus vaccination to an adolescent who is currently taking antibiotics d. Administer measles-mumps-rubella (MMR) vaccine to a child with CD4 count of 100
B
You assess a client with lupus who is considering methotrexate for treatment. Which patient information is most important to communicate to the HCP? A Patient has concerns about the safety of the drug B Patient has been trying to get pregnant C Patient takes a daily multivitamin D Patient says that she has taken methotrexate in the past
