ATI
A nurse is assessing a preschooler who has recurrent and persistent otitis media. When obtaining the child's history from her parent, which of the following questions should the nurse ask?
"Does anyone smoke around or in the same house as your child?" [Otitis media is an infection of the middle ear. Passive smoking promotes adherence of respiratory pathogens to the lining of the middle ear space. It also prolongs the inflammation and impedes drainage from the ear.]
A nurse is reinforcing teaching with a client who has a prescription for scopolamine patches for the treatment of motion sickness. Which of the following client statements should indicate to the nurse that the teaching has been effective? "I should apply this patch behind my ear" "This patch should be replaced every 7 days" "Before putting on my patch, I should wipe the area with an alcohol swab" "I can use a second patch if a single patch is not effective"
"I should apply this patch behind my ear"
Normal HbA1c levels
4-5.6%
Simvastatin
A serious adverse effect of this medication is muscle injury, which can progress to severe myositis. The client should report any unusual onset of muscle pain or tenderness to the provider immediately.
A nurse is reinforcing discharge teaching with a client who has heart failure and a prescription for digoxin 0.125 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching? A. "I will eat fruits and vegetables that have high potassium content every day." B. "I know that blurred vision is expected to happen while I'm taking digoxin." C. "I will measure my urine output each day and document it." D. "I will skip a dose of my digoxin if my resting heart rate is below 72 bpm."
A. "I will eat fruits and vegetables that have high potassium content every day." Hypokalemia is an adverse effect of diuretic therapy. Because the client is taking digoxin, it is important to maintain a potassium level between 3.5-5.0 mg/dL to avoid digoxin toxicity.
A. Candesartan (Atacand) is classified as what type of drug? B. What is the action of candesartan?
A. Angiotensin II Receptor Blocker B. ARBs block angiotensin II receptors on blood vessels causing dilation of arterioles and veins. ARBs also block angiotensin II receptors in the heart, preventing angiotensin II from inducing pathologic changes in cardiac structure. By blocking angiotensin II receptors in the adrenals, ARBs decrease the release of aldosterone and can thereby increase renal excretion of sodium and water.
A. Docusate sodium (Colace) is used for what? B. How long can it take it soften stools?
A. As a stool softener or laxative B. May take up to 3 days to soften stools
A nurse is caring for a client with diabetic ketoacidosis who has a prescription for an intravenous infusion of insulin. The nurse should document that which of the following types of insulin was administered intravenously to treat ketoacidosis? A. Regular insulin B. Insulin lispro C. Insulin aspart D. Insulin glargine
A. Regular insulin Treatment for diabetic ketoacidosis is directed at correcting hyperglycemia and acidosis. Therefore, the client's insulin levels are restored with an initial IV bolus of regular insulin followed by continuous infusion.
A nurse is providing teaching to a client who has a new prescription for lisinopril. Which of the following should the nurse include in the teaching as an adverse effect of lisinopril? A. Tongue swelling B. Low potassium level C. Runny nose D. Bruising
A. Tongue swelling Angioedema is a fatal response that occurs in 1% of clients who use an ACE inhibitor such as lisinopril.
A nurse is providing teaching for a client who has type 2 diabetes mellitus and a new prescription for metformin. Which of the following adverse effects of metformin should the nurse instruct the client to report to the provider? A. Weight gain B. Myalgia C. Hypoglycemia D. Severe constipation
B. Myalgia Myalgia (muscle pain), malaise, somnolence, and hyperventilation are manifestations of lactic acidosis, which is a severe adverse effect possible when taking metformin.
A nurse is planning to administer epoetin alfa to a client who has chronic kidney failure. Which of the following should the nurse plan to review prior to administration of this medication? Blood pressure Temperature Blood glucose levels Total protein level
Blood pressure
A nurse is teaching a client who has asthma about the proper use of an albuterol inhaler. Which of the following client statements indicates an understanding of the teaching? A. "I should rinse my mouth out right before I use the inhaler." B. "After the first puff, I will wait 10 seconds before taking the second puff." C. "I will shake the inhaler well right before I use it." D. "I will tilt my head forward while inhaling the medication."
C. "I will shake the inhaler well right before I use it." The nurse should instruct the client to shake the inhaler vigorously for 3 to 5 seconds, which will mix the medication within the inhaler evenly.
A nurse is preparing to administer warfarin to a client who has a new onset of atrial fibrillation. The client asks the nurse, "What should this medication do?" Which of the following responses should the nurse make? A. "It helps your heart return to a normal rhythm." B. "It dissolves blood clots." C. "It can reduce your risk of having a stroke." D. "It helps to prevent bleeding in atrial fibrillation."
C. "It can reduce your risk of having a stroke." The nurse should identify that atrial fibrillation increases the client's risk of having a stroke due to clot formation in the atrium. Warfarin can prevent clot formation when used long-term, which will reduce the client's risk of having a stroke.
A nurse is reinforcing discharge teaching with a client who has venous thrombosis and a prescription for warfarin. Which of the following instructions should the nurse include in the teaching? Take ibuprofen as needed for headaches or other minor pains Carry a medical alert ID card Report to the laboratory weekly to have blood drawn for aPTT Increase intake of dark green vegetables
Carry a medical alert ID card
A nurse is caring for a client who is taking warfarin. Which of the following laboratory values should the nurse recognize as an effective response to the medication? A. Hct 45% B. Hgb 15 g/dL C. aPTT 35 seconds D. INR 3.0
D. INR 3.0 Warfarin is an anticoagulant that prevents thrombus formation in susceptible clients. The INR measures its effectiveness. For most clients taking warfarin, an INR of 3.0 indicates effective therapy.
A nurse is preparing to administer a sublingual nitroglycerin tablet to a client who is reporting chest pain. For which of the following adverse effects should the nurse monitor after giving this medication? Hypotension Myalgia Diarrhea Ototoxicity
Hypotension
A nurse is collecting data from a client who has hypothyroidism and takes levothyroxine. Which of the following findings indicates that the client is experiencing acute levothyroxine overdose? Bradycardia Cold intolerance Tremor Hypothermia
Tremor
Should acarbose be taken with food?
Yes. Acarbose inhibits an enzyme in the intestines that slows the digestion of carbohydrates and results in a lower postprandial increase of blood glucose levels.
adenosine drug class
antiarrhythmic
doxycylcine should be taken with or without food?
without food. food decreases the absorption of the medication so it should be taken on an empty stomach.
A nurse is planning care for a client who took an overdose of acetaminophen. Which of the following laboratory values should the nurse plan to monitor for adverse effects of the overdose? Hematocrit High-density lipoproteins (HDL) Pancreatic enzymes Liver enzymes
Liver enzymes
What medication is used to stop preterm labor?
Nifedipine- a tocolytic
A nurse is providing discharge teaching to a client who does not speak the same language as the nurse. The client's neighbor, who speaks the client's native language and the nurse's, arrives to drive the client home. Which of the following actions should the nurse take?
Obtain the services of an interpreter [Federal mandates require that a professional medical interpreter translate the client's health care information into the client's native language.]
what is tamoxifen used for?
an anti-estrogen medication used to treat cancer of the breast in both premenopausal and postmenopausal women. It is also used to prevent breast cancer in women who are at an increased risk.
imipenem drug class
antibiotic
indications of thyrotoxicosis (patient has taken too much levothyroxine)
chest pain, tachycardia, insomnia, tremors, hyperthermia, heat intolerance, and diaphoresis. The client should notify the provider if any of these manifestations are present.
A nurse is reinforcing teaching with a client who has primary adrenal insufficiency (Addison's disease) and a prescription for hydrocortisone. Which of the following statements should the nurse include in the teaching about this medication? "You may need to take a lower dosage when you are ill or experiencing stress" "Take this medication before going to bed because it will make you tired" "Carry a supply of pills and a single-use injectable preparation with you at all times" "You will need to stop this medication before routine procedures such as a colonoscopy"
"Carry a supply of pills and a single-use injectable preparation with you at all times"
A client at a routine prenatal care visit asks the nurse if it is common to develop vaginal yeast infections during pregnancy. Which of the following responses should the nurse make?
"The hormonal changes of pregnancy change the acidity of the vagina, making yeast infections more common." [This is an information-seeking question; therefore, the therapeutic response is an answer that provides the client with the information she requested.]
A nurse is reinforcing teaching with a client who has multiple sclerosis and a new prescription for baclofen PO. Which of the following pieces of information should the nurse include? "You should take the medication on an empty stomach to increase absorption" "You can stop taking the medication once your back spasms disappear" "You can expect to experience urinary frequency when you first start taking this medication" "You should change positions slowly while taking this medication"
"You should change positions slowly while taking this medication"
A nurse is providing teaching to a client who has come to the family planning clinic requesting an intrauterine device (IUD). Which of the following information should the nurse provide the client?
"Your risk of ectopic pregnancy increases with an IUD." [An IUD is a family planning device the provider inserts through the cervix into the uterus to prevent pregnancy. The IUD works by changing the lining of the uterus and fallopian tubes, making fertilization in the uterus more difficult. Consequently, an IUD increases the risk for ectopic pregnancy.]
INR expected range
2 to 3. This needs to be monitored with patients taking warfarin.
A nurse is providing discharge teaching for a client who has a new prescription for metoprolol. Which of the following instructions should the nurse include? (Select all that apply.) A. "Do not stop taking this medication abruptly." B. "Take the medication right before bedtime." C. "Avoid exposure to sunlight." D. "Count your radial pulse daily." E. "Change positions slowly."
A. "Do not stop taking this medication abruptly." D. "Count your radial pulse daily." E. "Change positions slowly." Clients who stop taking metoprolol abruptly increase their risk of angina, HTN, and MI. They should reduce their dose gradually over 1-2 weeks. Clients should count their HR daily and report if lower than 60bpm. Metoprolol can cause orthostatic hypotension.
A. Potassium Chloride (KCl) is prescribed when someone has hypo- or hyperkalemia? B. When is its use contraindicated?
A. Hypokalemia B. It is contraindicated when someone has renal disease, hyperkalemia, acute dehydration; and is used with caution when a client is pregnant, has cardiac disease, or is already prescribed a potassium-sparing diuretic.
A. Insulin Aspart (Novolog) is what kind of insulin? B. What is the biggest concern for adverse effects?
A. Rapid acting insulin B. Hypoglycemia! Additional info- Onset: 10-20 min Peak: 1-3 hrs Duration: 3-5 hrs Route: SQ, IV Administer: just before meals
A nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a client. Which of the following pieces of information should the nurse include in the teaching? A. Respiratory depression can occur 7 min after the morphine is administered. B. The morphine will peak in 10 min. C. Withhold the morphine if the client has a respiratory rate of <16/min. D. Administer the morphine over 2 min.
A. Respiratory depression can occur 7 min after the morphine is administered. Respiratory depression can occur within 7 minutes of the administration of IV bolus morphine. The nurse should monitor the client's respirations and have naloxone available to reverse the effects of the morphine.
A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports that she has been taking extra doses to promote weight loss. Which of the following findings should indicate to the nurse that the client is dehydrated? A. Urine specific gravity 1.035 B. Distended neck veins C. BUN 18 mg/dL D. Bounding radial pulses
A. Urine specific gravity 1.035 Oliguria, and an increased urine specific gravity greater than 1.030 is expected in a dehydrated client.
A nurse is preparing to administer timolol eye drops to a client who has primary open-angle glaucoma (POAG). Prior to administering the medication, the nurse should recognize that which of the following conditions in the client's medical history is a contraindication to receiving this medication? Hypertension Peripheral vision loss Asthma Increase intraocular pressure
Asthma
A nurse on a mental health unit is caring for a client who has depression. Which of the following actions should the nurse take to foster a therapeutic environment for this client?
Build trust with the client by sitting quietly with him [The nurse should build trust with the client to convey interest in the client's concerns. Offering self by sitting with the client and the use of silence are actions that promote trust which encourages the client to speak more openly about issues and concerns.]
A nurse is assessing a toddler who has AIDS. The nurse should identify which of the following findings as an indication of an opportunistic infection?
Candidiasis [Candidiasis, or oral thrush, results from the overgrowth of Candida albicans, an opportunistic fungus that commonly infects the oral cavity of clients who have immature or compromised immune systems. Candidiasis appears as a cheesy, white plaque that looks like milk curds on the buccal mucosa and tongue. Thrush is often the initial opportunistic infection in an HIV-positive child who is developing AIDS.]
A nurse is providing teaching to client who is scheduled to start taking hydrochlorothiazide for hypertension. The nurse instructs the client to eat foods that are rich in potassium. Which of the following statements by the client indicates an understanding of the teaching? A. "This medication will not work unless I have enough potassium." B. "Potassium will increase the therapeutic effect of my blood pressure medication." C. "Potassium will lower my blood pressure." D. "This medication can cause a loss of potassium."
D. "This medication can cause a loss of potassium." Hydrochlorothiazide can result in hypokalemia caused by excessive potassium excretion from the kidneys. The client should supplement their diet with potassium-rich foods. Foods that are high in potassium include: bananas, raisins, baked potatoes, pumpkins, and milk.
A nurse is assessing a client who is receiving a continuous morphine IV infusion and finds the client's respiratory rate has decreased from 20/min to 12/min. Which of the following actions should the nurse take? A. Flush the IV line with saline B. Administer flumazenil C. Lower the head of the bed D. Slow the rate of the infusion
D. Slow the rate of the infusion The nurse should decrease the infusion rate to reduce the amount of morphine the client receives and limit the risk of respiratory depression.
A nurse is assisting with the care of a client who has atrial fibrillation and is scheduled for cardioversion. The nurse should anticipate a prescription from the provider for which of the following medications for this procedure? Amlodipine Diltiazem Nifedipine Lidocaine
Diltiazem
Amlodipine adverse effects
Flushing, dizziness, palpations, peripheral edema
A community health nurse is performing client triage while participating in a disaster drill. The nurse should recommend that which of the following clients receives treatment first?
Hemothorax [The nurse should apply the survival potential priority-setting framework. The nurse should reserve the use of this framework for mass casualty situations, when resources are scarce and he must allocate resources to save the greatest number of lives. While it might seem that the client least likely to survive should receive priority care, this is the client who is the lowest priority. The nurse should assign the highest priority to the client who has injuries that are severe but has the potential to survive with treatment. Therefore, the nurse should recommend that the client who has a hemothorax receive treatment first. A hemothorax is life-threatening, but with chest-tube insertion and stabilization the client is likely to survive.
infliximab
Immunosuppressive drug. It can treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, plaque psoriasis, and ulcerative colitis.
A nurse is reinforcing teaching about immunosuppressive medications with a client who had kidney transplant surgery. Which of the following adverse effects of these medications should the nurse include in the teaching? Increased urinary output Increased susceptibility to infection Increase hair loss Increased risk for autoimmune disorders
Increased susceptibility to infection
A nurse is caring for a client who takes a combination oral contraceptive (OC). Which of the following findings should indicate to the nurse that the client is experiencing a deficiency of estrogen in the OC? Mid-cycle breakthrough bleeding or spotting Breast tenderness Migraine headaches Nausea
Mid-cycle breakthrough bleeding or spotting
A nurse is teaching the parent of a child who has severe reactive airway disease about glucocorticoid therapy. The parent asks why her child has to inhale the medication instead of taking it orally. Which of the following information should the nurse provide the parent?
Oral glucocorticoids are more like to slow linear growth in children. (Chronic use of oral glucocorticoids in high doses by children can result in decreased linear growth. Inhaled glucocorticoids deliver the anti-inflammatory agent directly to the local target area (pts airways) resulting in an decreased risk for adrenal suppression).
The nurse is assessing a client who has been taking linezolid to treat a Staphylococcus aureus infection. Which of the following findings should the nurse report to the provider?
Paresthesias. Although these reactions are rare, some clients who take linezolid develop irreversible peripheral neuropathy and reversible optic neuropathy. The nurse should report this finding to the provider because it might warrant switching the client to another antibiotic.
What condition warrants a black box warning for candesartan?
Pregnancy
A nurse is assessing a client who has an abdominal aortic aneurysm (AAA). Which of the following findings should indicate to the nurse that the AAA is expanding?
Report of sudden, severe back pain [An aortic aneurysm is a weak spot in the wall of the aorta, the primary artery that carries blood from the heart to the head and extremities, that allows the aorta to expand and increase in diameter. Sudden and increasing lower abdominal and back pain indicates that the aneurysm is extending downward and pressing on the lumbar sacral nerve roots.]
A nurse is providing teaching to a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give the client?
Stop taking the herbal supplement while taking the medication. [Taking the antidepressant sertraline and the herbal supplement St. John's wort together puts the client at risk for serotonin syndrome.]
Propylthiouracil
This medication is used to treat hyperthyroidism during the first trimester of pregnancy because it does not cross the placental barrier well, posing little risk to the fetus.
True or False: an agreement must be signed by the patient before starting alosetron.
True. Alosetron has potentially fatal adverse effects associated with constipation and bowel obstruction. The FDA has allowed alosetron to be placed on the market only if clients sign and adhere to a risk management program, which includes signing a client-provider agreement before starting alosetron.
timolol contraindication
asthma is a contraindication to receiving timolol. Timolol is a beta-blocker that can cause blocking of the beta2-receptors, causing bronchospasm. A client who has a history of asthma is a candidate for an alternate medication to treat this condition such as betaxolol.
Which of the following findings should indicate to the nurse the client is experiencing an adverse effect of desmopressin?
headaches are an indicator of the adverse effect of water intoxication, which can occur as a result of taking desmopressin. This medication causes fluid retention and places the client at risk of water intoxication.
methimazole
the preferred medication in the second and third trimesters of pregnancy to treat hyperthyroidism.
A nurse is reinforcing teaching with a client who has postmenopausal osteoporosis and a new prescription for intranasal calcitonin-salmon. Which of the following statements by the client indicates an understanding of the teaching? "I will administer a spray into each nostril daily" "I should expect nasal bleeding for the first week" "I will need to depress the side arms initially to active the pump" "I should expect to take this medication for a short-term course of treatment"
"I will need to depress the side arms initially to active the pump"
A nurse is providing teaching to a school-age child who has just had a fiberglass cast application following lower extremity fracture. Which of the following instructions should the nurse give the child and his parents about care during the first 48 hours?
"Keep the cast above the level of your heart." [Immediately following the injury, and for at least the first 48 hours, the child should keep the affected limb above the level of the heart to help prevent edema and pain and to promote venous return.]
A nurse is reinforcing teaching with a client who has a prescription for doxycycline for the treatment of a Helicobacter pylori infection. Which of the following instructions should the nurse include in the teaching? "Take this medication with meals to decrease gastrointestinal upset" "Continue this medication if you become pregnant" "Wear protective clothing while in the sun" "Expect to have severe diarrhea while taking this medication"
"Wear protective clothing while in the sun"
serum phenytoin level range
10 to 20 mcg/mL
HbA1c level of someone with diabetes
6% and higher
sumatriptan adverse effect
A client who takes sumatriptan can develop sensations of chest pressure and heavy arms. The nurse should monitor the client; if the chest pressure continues, the nurse should notify the provider. About 50% of clients who take sumatriptan experience chest pressure and heaviness of the arms that are transient and resolve.
what should you assess for while administering adenosine?
Assess for dyspnea during administration, it can occur due to bronchoconstriction. Since adenosine has a short half-life of about 10 seconds, this effect should be short-lived.
A school nurse is caring for a child who is experiencing an acute asthma attack. Which of the following medications should the nurse plan to administer to the child? A. Zafirlukast B. Budesonide C. Montelukast D. Albuterol
D. Albuterol This is considered a rescue medication due to its rapid onset of action. Albuterol is a beta-adrenergic agonist that promotes bronchodilation and suppresses histamine release in the lungs.
Statins
a class of lipid-lowering medications that reduce illness and mortality in those who are at high risk of cardiovascular disease
A nurse is caring for a client who had a myocardial infarction 2 hours ago and is receiving alteplase. Which of the following findings should the nurse identify as an adverse effect of receiving this medication? A. Bleeding B. Increased clot formation C. Shortness of breath D. Blockage of the central venous catheter
A. Bleeding Severe bleeding can occur as a result of the alteplase-plasminogen complex, which catalyzes the conversion of other plasminogen molecules that digest fibrin clots. This action of the medication can contribute to hemorrhage.
A nurse is preparing to administer amlodipine to a client who has hypertension. The nurse should plan to monitor the client for which of the following adverse effects of the medication? (Select all that apply.) A. Dizziness B. Pale appearance C. Palpitations D. Abdominal pain E. Peripheral edema
A. Dizziness C. Palpitations E. Peripheral edema The nurse should advise the client to avoid activities that require alertness until the effect of the medication is known and to notify the provider if any of these adverse effects occur.
A nurse is assessing a client who has heart failure and is taking daily furosemide. The client's pulse is weak and irregular. The nurse should identify these symptoms as indicative of which electrolyte imbalance? A. Hypokalemia B. Hypophosphatemia C. Hypercalcemia D. Hypermagnesemia
A. Hypokalemia Furosemide can cause loss of potassium. Manifestations of hypokalemia include shallow respirations, muscle weakness, and lethargy.
A nurse is facilitating a group discussion with preschool teachers about child abuse. Which of the following data should the nurse use as a common example of a suggestive finding?
Arm cast for a spiral fracture of the forearm [Spiral fractures occur from twisting of an extremity. In most instances, spiral fractures of the arm result from an abusive injury.]
A nurse is caring for a client who has congestive heart failure and is taking digoxin. The client reports nausea and refuses to eat breakfast. Which of the following actions should the nurse take first? A. Encourage the client to eat the toast on the breakfast tray B. Administer an antiemetic C. Inform the client's provider D. Check the client's apical pulse
D. Check the client's apical pulse Nausea, anorexia, fatigue, visual effects, and cardiac dysrhythmias are possible findings in digoxin toxicity. Assessing the client first will provide the nurse with the knowledge to make an appropriate decision.
A nurse on a pediatric unit is planning care for a preschooler who will be having a surgical procedure in the morning. The child has been crying despite his parent's presence at his bedside. The nurse should add engaging the child in therapeutic play to the care plan because it offers which of the following benefits?
Allows the child to manipulate toy medical equipment [A major function of play therapy is making potentially unmanageable situations manageable through symbolic representation, which provides children with opportunities to learn to cope. A preschooler does not have the language development to express his fear of the unfamiliar medical equipment in the hospital. The nurse encourages the child to touch the equipment to decrease the child's fear and intimidation in a safe environment using age-appropriate vocabulary. The use of toys enables children to transfer anxieties, fears, fantasies, and guilt to objects rather than people.]
A nurse is teaching about the adverse effects of morphine with a client who has acute pain. Which of the following statements should the nurse include in the teaching? A. "You might notice that you see better in dim areas." B. "You should increase your fluid intake." C. "You should expect to have excessive urination." D. "You might experience difficulty sleeping."
B. "You should increase your fluid intake." The nurse should inform the client that an adverse effect of morphine is constipation. Increasing oral fluids promotes motility of the bowel.
A nurse is reviewing the medical record of a client who is receiving hydrochlorothiazide (HCTZ). The nurse should expect to find an improvement in which of the following conditions as a result of this medication? A. Gouty arthritis B. Dehydration C. Diabetes insipidus D. Hypokalemia
C. Diabetes insipidus A thiazide diuretic such as HCTZ is administered to treat diabetes insipidus. Diabetes insipidus is a condition in which there is an overproduction of urine. In the case of diabetes insipidus thiazides reduce urine production by 30% to 50%. Thiazide diuretics reduce total body sodium by an initial natriuresis, resulting in decreased extracellular fluid volume and reduced glomerular filtration rate. These changes cause increased fluid reabsorption in the proximal renal tubule and reduce urine output.
A nurse is assessing a client who is receiving morphine via a PCA pump following a cesarean birth. Which of the following findings should the nurse report to the provider? A. Respiratory rate 14/min B. Temperature 37.8'C (100'F) C. Dizziness upon rising D. Urine output 20 mL/hr
D. Urine output 20 mL/hr Opioid analgesics such as morphine can cause urinary retention. The client should have a urinary output of at least 30 mL/hr. The nurse should report this finding to the provider.
A nurse is reviewing the laboratory report for a client who has chronic kidney disease (CKD). The nurse finds the following laboratory test results: potassium 6.8 mEq/L, calcium 7.4 mg/dL, hemoglobin 10.2 g/dL, and phosphate 4.8 mg/dL. Which of the following findings is the priority for the nurse to report to the provider?
Hyperkalemia [The nurse should apply the urgent versus nonurgent priority-setting framework when caring for this client. Using this framework, the nurse should consider urgent needs the priority need because they pose more of a threat to the client. The nurse may also need to use Maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent. Therefore, hyperkalemia, which can cause life-threatening cardiac dysrhythmias, is the priority for the nurse to report to the provider.
A nurse is caring for a client who is receiving IV ampicillin and develops urticaria and dyspnea. Which of the following actions should the nurse take first?
Stop the medication infusion [The greatest risk to the client is an allergic reaction that can progress to anaphylaxis. The nurse should stop the infusion immediately to halt further exposure of the client to the allergen.]
The nurse should expect the provider to prescribe methotrexate at which of the following times? (time frame)
The nurse should identify that current guidelines recommend starting a disease-modifying antirheumatic drug (DMARD) such as methotrexate WITHIN 3 MONTHS OF DIAGNOSIS of rheumatoid arthritis to prevent or delay joint degeneration.
A nurse is preparing to administer digoxin to a client. Which of the following findings should the nurse identify as a contraindication to the client receiving this medication? A. Blood pressure 180/70 mmHg B. Oxygen saturation rate 94% C. Heart rate 51/min D. Respiratory rate 21/min
C. Heart rate 51/min The nurse should identify that if the client's heart rate is less than 60/min, the medication should be withheld, and the provider should be notified.
what is ankylosing spondylitis and what medication is used to treat it?
a form of arthritis that primarily affects the spine, causing severe, chronic pain and discomfort. Infliximab is a TNF medication that can limit the progression of arthritis and decrease inflammation.
A nurse is teaching a client how to use an albuterol metered dose inhaler. After removing the cap from the inhaler and shaking the canister, identify the sequence of instructions the nurse should give the client. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)
1. The client should hold the mouthpiece 2-4 cm (1-2 in) from his mouth 2. Tilt his head back slightly, and then open his mouth 3. Next, he should depress the medication canister while taking a deep breath to facilitate delivery of the medication through the airway 4. After holding his breath for 10 seconds, the client should resume his usual breathing pattern.
Due to staffing shortages, a nurse manager floats a medical-surgical nurse to the pediatric unit. The nurse has limited experience with children. Which of the following actions should the nurse manager take?
Assign a unit nurse to act as a resource to act as a resource for the medical-surgical nurse. [Assigning a nurse who usually works on the pediatric unit to work with the medical-surgical nurse will provide consistent support]
A nurse is caring for a client who has been taking metformin for 6 months. Which of the following finding should the nurse identify as an expected therapeutic effect of the medication? A. Decreased vitamin B12 levels B. Decreased blood glucose level C. Abdominal bloating and diarrhea D. Decreased LDL level
B. Decreased blood glucose level Metformin is a non-insulin medication with the expected therapeutic effect of a decrease in blood glucose levels.
A nurse is conducting a home visit for an older adult client who has diabetes mellitus and takes regular insulin subcutaneously before each meal. The client appears disoriented and weak and has slurred speech. Which of the following conditions should the nurse consider first when responding to these manifestations? A. Dementia B. Hypoglycemia C. Infection D. Transient ischemic attack
B. Hypoglycemia Evidence-based practice indicates the nurse should first check the client for hypoglycemia by drawing a blood glucose level.
A nurse is caring for a client who has a pseudomonas infection and a new prescription for ticarcillin-clavulanate. Which of the following should the nurse collect before administering this medication? Indications of superinfection Peak and trough medication levels Baseline BUN and creatinine History of allergy to aminoglycoside antibiotics
Baseline BUN and creatinine
A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching? A. "Take hydrochlorothiazide as needed for edema." B. "Check your weight once each week." C. "Take hydrochlorothiazide in the morning." D. "Take hydrochlorothiazide on an empty stomach."
C. "Take hydrochlorothiazide in the morning." The client should take in the morning to allow for diuresis during the day and to prevent nocturia.
A nurse is caring for a client who takes warfarin 2.5 mg PO daily and has an INR of 6.2. The nurse should anticipate a prescription from the provider for which of the following medications? A. Protamine sulfate B. Fondaparinux C. Vitamin K D. Bivalirudin
C. Vitamin K The nurse should anticipate the provider to prescribe vitamin K for a client who has an INR of 6.2. Vitamin K antagonizes warfarin's actions, which can reverse warfarin-induced inhibition of clotting factor synthesis.
A nurse is caring for a client and realizes after administering the 0900 medications that she gave digoxin 0.25 mg PO to the client instead of the prescribed dose of digoxin 0.125 mg PO. Which of the following actions should the nurse take first? Notify the provider Contact the nursing supervisor Check the client's apical pulse Complete and incident report
Check the client's apical pulse
A nurse is reviewing the laboratory reports of a client who has been taking warfarin for atrial fibrillation. Which of the following results should the nurse report to the provider immediately? A. PT 18 seconds B. Platelet count 160,000/mm^3 C. Hct 43% D. INR 5.5
D. INR 5.5 A client who is taking warfarin for the treatment of atrial fibrillation is expected to have an INR in the range of 2 to 3. A level of 5.5 is considered a critical value and places the client at risk of bleeding.
A nurse is reviewing the morning laboratory results of an infant who is receiving digoxin and furosemide for the treatment of HF. Which of the following findings should the nurse report to the provider? A. Sodium 140 mEq/L B. Calcium 10.2 mg/dL C. Chloride 100 mEq/L D. Potassium 3.2 mEq/L
D. Potassium 3.2 mEq/L The nurse should identify this is below the expected range for an infant (4.1 mEq/L-5.3 mEq/L). This is also low for expected range for an adult (3.5 mEq/L-5.0 mEq/L).
A nurse is caring for a client who is receiving bleomycin IV to treat lymphoma. Which of the following assessments is the nurse's priority?
Pulmonary function [The nurse should apply the safety and risk reduction priority-setting framework. This framework assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the one posing the greatest threat is the highest priority. The nurse should use Maslow's Hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which risk poses the greatest threat to the client. Bleomycin can cause severe lung injury, including pneumonitis and pulmonary fibrosis, and it affects a significant percentage of clients receiving this medication; therefore, pulmonary function is the priority assessment.]
acarbose adverse effects
The most common adverse effects of acarbose, an alpha-glucosidase inhibitor, are gastrointestinal. They include diarrhea, abdominal distention and cramping, and flatulence.
Ergotamine (used for)
Used to treat migraine headaches by blocking alpha-adrenergic receptors in the cranial peripheral vascular smooth muscle, which causes vasoconstriction of dilated cerebral blood vessels.
A nurse is providing teaching to a client who has hypertension and type 1 diabetes mellitus and a new prescription for metoprolol. Which of the following statements by the client indicates an understanding of the teaching? A. "I might have trouble recognizing when my blood sugar is low." B. "I will have a lower risk of developing infection." C. "I should be concerned about losing excess weight." D. "I could have more problems with high blood pressure."
A. "I might have trouble recognizing when my blood sugar is low." Metoprolol is a beta adrenergic-blocker. Because it decreases the HR, this common manifestation of hypoglycemia may be difficult to recognize. The client should be taught to recognize other hypoglycemia symptoms such as hunger, nausea, and sweating.
A nurse is developing a plan of care for a client who has gastroesophageal reflux disease (GERD). The nurse should plan to monitor the client for which of the following complications?
Aspiration [Aspiration is a common complication of GERD, which results when the esophageal sphincter malfunctions, allowing gastric acid and undigested food to back up into the esophagus. This places the client at risk for aspiration. GERD causes effortless, uncontrolled regurgitation whether the client is in an upright position or reclining. The most common results of regurgitation are heartburn and indigestion; however, aspiration is also possible. Therefore, the nurse should monitor the client for crackles in the lung fields, which is an indication of aspiration.]
A nurse is reviewing the medication history of a client who has mild intermittent asthma. The nurse should anticipate a prescription for which of the following inhalers for the client? A. Ipatropium B. Albuterol sulfate C. Tiotropium D. Budesonide
B. Albuterol sulfate Albuterol sulfate is a short-acting beta2-agnoist that activates beta2 receptors in the smooth muscle of the lung, allowing the client's airway and lungs to dilate, thereby relieving bronchospasm and allowing the client to breathe.
A nurse is providing discharge teaching to a client who has venous thrombosis and a prescription for warfarin. Which of the following instructions should the nurse include in the teaching? A. Take ibuprofen as needed for headaches or other minor pains B. Carry a medical alert ID card C. Report to the laboratory weekly to have blood drawn for aPTT D. Increase intake of dark green vegetables
B. Carry a medical alert ID card A client who is taking warfarin is at increased risk for bleeding. In the case of an emergency, any medical personnel must be aware of the client's medication history.
A nurse is reinforcing teaching with an assistive personnel (AP) about dietary restrictions for a client who is taking phenelzine to treat depression. The AP's selection of which of the following foods for the client's lunch indicates an understanding of the instructions? Bologna on wheat bread Chicken salad Cheddar cheese and crackers Pizza with pepperoni
Chicken salad
A nurse is reinforcing teaching about glucocorticoid therapy with the parent of a child who has severe reactive airway disease. The parent asks why her child has to inhale the medication instead of taking it orally. Which of the following pieces of information should the nurse provide the parent? Inhaled glucocorticoids are less likely to cause thrush Oral glucocorticoids are hazardous during times of stress Oral glucocorticoids are more likely to slow linear growth in children Inhaled glucocorticoids are more effective for acute bronchospasm
Oral glucocorticoids are more likely to slow linear growth in children
epoetin alfa adverse effects
The nurse should instruct the client to report hypertension. Other adverse effects can include headaches, seizures, heart failure, and thromboembolic events related to increased hemoglobin levels.
