HESI Review

Morphine sulfate is an opioid analgesic and can depress the central nervous system, which results in respiratory depression. A respiratory rate of ______ breaths per minute indicates respiratory depression, and the nurse should stop the medication immediately. Elevating the head of the client's bed ensures proper breathing.

8

The nurse is monitoring a client who is taking digoxin for adverse effects. Which findings are characteristic of digoxin toxicity? A. Tremors B. Diarrhea C. Irritability D. Blurred vision E. Nausea and vomiting

b, d, e

______ are harsh on the lining of the stomach and should be taken with meals. They are not given for fever. Liver function tests are not monitored when taking these.

NSAIDs

A client with diabetes is taking metoprolol (Lorpressor) for hypertension. Which of the following information should the nurse include in the teaching plan? Select all that apply: A. These tablets should be taken with food at the same time each day. B. Notify the healthcare provider if the pulse is below 80 beats per minute. C. Have a blood glucose drawn every 6 to 12 months during therapy. D. Use an appropriate decongestant if needed. E. Report any fainting spells to the health care provider.

a, e

A patient is complaining of pain rated "10" on a scale of 1 to 10. The nurse has several choices of pain medication to administer. Which order is the best for the nurse to administer at this time? A. Morphine sulfate 1 mg IV B. MS Contin 2 tablets PO C. Transdermal patch D. Tylenol suppository

a

The client with arthritis is self-medicating with aspirin. Which complication should the nurse discuss with the client? A. Tinnitus B. Diarrhea C. Tetany D. Paresthesia

a

The client with osteoarthritis is prescribed a nonsteroidal anti-inflammatory drug (NSAID). Which intervention should the nurse implement? A. Time the medication to be given with meals. B. Notify the HCP if abdominal striae develop. C. Do not administer if oral temperature is greater than 102 degrees Fahrenheit. D. Monitor the client's liver function tests.

a

The nurse is caring for a postpartum patient with severe afterbirth pains. The primary health care provider prescribes morphine sulfate (Astramorph). Which parameters should the nurse monitor in the patient? Select all that apply. A. Alertness B. Respirations C. Renal function D. Blood cell count E. Bowel activity

a, b, e

A client with heart failure is receiving digoxin intravenously. The effectiveness of the drug is best determined by assessing which of the following? A. Dilated coronary arteries B. Increased myocardial contractility C. Decreased cardiac arrythmias D. Decreased electrical conductivity of the heart

b

A terminally ill client in a hospice unit for several weeks is receiving a morphine drip. The dose is now above the typical recommended dosage. The client's spouse tells the nurse that the client is again uncomfortable and needs the morphine increased. The prescription states to titrate the morphine to comfort level. What should the nurse do? A. Add a placebo to the morphine to appease the spouse. B. Assess the client's pain before increasing the dose of morphine. C. Discuss with the spouse the risk for morphine addiction. D. Check the client's heart rate before increasing the morphine to the next level.

b

The nurse is monitoring a client who is taking propranolol. Which assessment finding indicates a potential adverse complication associated with this medication? A. The development of complaints of insomnia. B. The development of audible expiratory wheezes. C. A baseline blood pressure of 150/80 mm HG followed by a blood pressure of 138/72 mm Hg after 2 doses of the medication. D. A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of 72 beats/minute after 2 doses of the medication.

b

Which symptoms are serious adverse effects of beta blockers such as propranolol (Inderal)? A. Headache, hypertension, and blurred vision B. Wheezing, hypotension, and AV block C. Vomiting, dilated pupils, and papilledema D. Tinnitus, muscle weakness, and tachypnea

b

A ______-______ antibiotic is ordered until culture and sensitivity results are determined. Then, an antibiotic which will specifically target the infecting organism must be started immediately. Waiting could cause serious harm with the client possibly going into septic shock.

broad-spectrum

A client is receiving metoprolol (Lopressor SR). Which assessment is the most important for the nurse to obtain? A. Temperature B. Lung sounds C. Blood pressure D. Urinary output

c

A patient with a history of hypertension, coronary artery disease, and diabetes mellitus is prescribed Propranolol. You have provided the patient with education about this new medication. Which statement by the patient indicates that your teaching was effective? A. I will take this every AM with grapefruit juice B. If I miss a dose, it is important that I double the next dose to prevent potential side effects C. It is important the I monitor my blood glucose very closely while taking this medication D. I will immediately stop taking this medication if I experience cold hands or feet.

c

The client diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) is receiving the aminoglycoside antibiotic vancomycin. Peak and trough levels are ordered for the dose the nurse is administering. Which priority intervention should the nurse implement? A. Ask the client if he has had any diarrhea. B. Monitor the aminoglycoside peak level. C. Determine if the trough level has been drawn. D. Check the client's culture and sensitivity report.

c

The male client with a chronic urinary tract infection is prescribed trimethoprim-sulfamethoxazole (Bactrim). Which statement indicates the client needs more teaching? A. "I will drink six to eight glasses of water a day." B. "I will need to take this medication forever." C. "I can stop taking this medication if there is no more burning." D. "I may get diarrhea with this medication."

c

The nurse finds the respiratory rate is 8 breaths per minute in a client who is on intravenous morphine sulfate. What should the nurse do immediately in this situation? A. Measure other vital signs. B. Elevate the head of the client's bed. C. Stop administering the medication. D. Report to the primary healthcare provider.

c

A ______ UTI will require antibiotics on a daily basis to keep the bacteria count under control. Discontinuing the antibiotic if symptoms resolve could contribute to antibiotic resistance. The client should increase fluid intake to help flush the bacteria through the kidneys and bladder.

chronic

Clients on ______ therapy should avoid sunlight because the medication increases sensitivity to sun and could result in sunburn

ciprofloxacin

Most antacids contain aluminum or magnesium, which interferes with the absorption of ______, a drug used to treat UTI's.

ciprofloxacin

The nurse administered an IV broad-spectrum antibiotic scheduled every six hours to the client with a systemic infection at 0800. At 1000, the culture and sensitivity prompted the HCP to change the IV antibiotic. When transcribing the new antibiotic order, when would the initial dose be administered? A. Schedule the dose for 1400. B. Schedule the dose for the next day. C. Check with the HCP to determine when to start. D. Administer the dose within one hour of the order.

d

Which instruction should the nurse give a client who is on oral extended-release ciprofloxacin therapy for urinary tract infection? A. Chew the medication along with food B. Take a walk in morning sunlight C. Stop the drug after symptoms subside D. Refrain from taking the tablet immediately after an antacid

d

The client should be instructed to swallow the ______-______ tablet and not chew it because chewing it negates the action of the drug.

extended-release

When a drug is administered ______, it does not need to be absorbed because it is placed directly into general circulation and will have an immediate effect to decrease pain.

intravenously

______ suppresses the central nervous system; therefore, it may reduce alertness. Monitor alertness to ensure the patient's safety. This medication also reduces the responsiveness of respiratory centers in the brain, which may cause respiratory distress. Opioid drugs also decrease peristalsis of the gastrointestinal tract and cause constipation in patients, so monitoring bowel activity is essential.

morphine

The ______ level is not drawn until one hour after the medication has been infused

peak

The ______ rate is the significant vital sign to be monitored; morphine depresses the central nervous system, specifically the ______ center in the brain.

respiratory

Diarrhea is a sign of a ______, which occurs when the antibiotic kills the good flora in the bowel. It occurs when a person is being treated for one infection and gets different infection.

superinfection

______, ringing in the ears, is a sign of aspirin toxicity and needs to be reported to the HCP.

tinnitus

Over time clients receiving morphine develop ______ and require increasing doses to relieve pain, thus requiring continuing reassessments

tolerance

The ______ level must be drawn prior to administering the dose of the medication; therefore, it is the priority intervention.

trough