module 4 practice questions

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Which of the following findings would be the most concerning for a client receiving infliximab? A. HR 92 B. Rash C. Fever D. Nausea

c

Which of the following adverse effects is not common to ACE inhibitors? A. Hypokalemia B. Dry Nonproductive cough C. Dizziness D. Hypotension

A -- Hyperkalemia is common with ACE inhibitors

A 65-year-old male patient is prescribed an ACE inhibitor for the treatment of hypertension. Which medication below is an ACE inhibitor? A. Metoprolol B. Benazepril C. Losartan D. Amlodipine

B Benazepril is an ACE Inhibitor. Remember ACE Inhibitors end in PRIL.

A patient is receiving glucocorticoids for the treatment of rheumatoid arthritis. The patient complains of having a headache. Which ordered medication should the nurse administer? A. Aspirin [Bayer] B. Acetaminophen [Tylenol] C. Ibuprofen [Advil] D. Naproxen sodium [Aleve]

B The risk of gastrointestinal irritation and ulceration for a patient taking glucocorticoids is increased by concurrent use of other medications, such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs).

A client drinks 5-6 beers a day and takes acetaminophen for pain relief. What should the nurse caution the patient to do? A. Limit the intake of acetaminophen to 2000 grams/day B. Take the acetaminophen with food to reduce the risk of liver damage C. Limit the intake of acetaminophen to 4000 grams/day D. Avoid taking any other pain reliever than acetaminophen

A

A client is prescribed metoprolol (Lopressor) to treat hypertension. It is important for the nurse to monitor the client for which condition? A. Bradycardia B. Hypertension C. Ankle edema D. Decreased respirations

A

Hypertension is referred to as the "silent killer" due to the amount of people that don't even know they have it. What medication is primarily prescribed to maintain a proper blood pressure? A. Metoprolol B. Carisoprolol C. Pravastatin D. Diazepam

A

In preparing to administer digoxin (Lanoxin) to a patient with heart failure, which finding would cause the nurse to withhold the medication? A. Pulse 52 B. Increased thirst C. Blood pressure 142/86 D. Urine output of 250 mL over the last 8 hours

A

The client is also taking a diuretic that decreases her potassium level. The nurse expects that a low potassium level (hypokalemia) could have what effect on the digoxin? A. Increase the serum digoxin sensitivity level B. Decrease the serum digoxin sensitivity level C. Not have any effect on the serum digoxin sensitivity level D. Cause a low average serum digoxin sensitivity level

A

When performing discharge instructions to a patient prescribed metoprolol (Lopressor), which statement by the nurse is correct? A. "If you take your pulse and it is less than 60 beats/min, hold your medicine and call your health care provider for instructions." B. "If you become dizzy, do not take your medication for 2 days and then restart on the third day." C. "This medication may make you fatigued; increasing caffeine in your diet may help alleviate this problem." D. "Increase your intake of green leafy vegetables to prevent bleeding problems that can be caused by this medication."

A

When teaching a patient who has been prescribed a daily dose of prednisone, the nurse knows that the patient will be told to take the medication at which time of the day to help reduce adrenal suppression? A. In the morning B. At lunchtime C. At diner time

A

Which client assessment would assist the nurse in evaluating therapeutic effects of a calcium channel blocker? A. Client states that she has no chest pain. B. Client states that the swelling in her feet is reduced. C. Client states the she does not feel dizzy. D. Client states that she feels stronger.

A

A nurse provides discharge instructions for a patient who is taking acetaminophen [Tylenol] after surgery. The nurse should instruct the patient to avoid which product while taking acetaminophen? A. Alcoholic drinks B. Leafy green foods C. Bananas D. Dairy products

A -Through several mechanisms, regular alcohol consumption while taking acetaminophen [Tylenol] increases the risk of liver injury when dosages are excessive. Therapeutic doses of acetaminophen [Tylenol] may be safe for patients who drink alcohol; however, the U.S. Food and Drug Administration (FDA) requires that acetaminophen [Tylenol] labels state an alcohol warning for patients who consume three or more drinks a day to consult their prescriber to determine whether acetaminophen [Tylenol] can be taken safely. It is not necessary to avoid leafy green foods, bananas, or dairy products when taking acetaminophen.

A home care nurse is visiting an 88-year-old man, who is taking acetaminophen for arthritic pain in his knees. Which of the following patient teaching statements is most appropriate to implement? A. "Acetaminophen will only relieve pain but not the inflammation from arthritis." B. "Acetaminophen is appropriate for the treatment of inflammation from arthritis." C. "Your primary health care provider should consider a prescription of Vicodin (acetaminophen/hydrocodone)." D. "The acetaminophen should be administered on an empty stomach."

A Acetaminophen does not have anti inflammatory properties

A nurse is admitting a toddler to the hospital after an acetaminophen overdose. Which of the following medications should the nurse anticipate administering to this client? A Acetylcysteine B Narcan C Flumazenil D Naltrexone

A Acetylcysteine is the antidote for acetaminophen. Narcan is the antidote for opioids. Flumazenil is the antidote for diazepam. Naltrexone is used to treat symptoms of alcohol and opiate withdrawal.)

Before administering celecoxib [Celebrex], it is most important for the nurse to assess the patient for a history of what? A. Allergy to sulfonamides B. History of hepatitis C C. Hypothyroidism D. Diabetes mellitus

A Celecoxib contains a sulfur molecule and therefore can precipitate an allergic reaction in patients allergic to sulfonamides. Accordingly, the drug should be avoided by patients with a sulfa allergy. The other conditions listed should be part of the nurse's assessment but are not the most important.

Which agent is most likely to cause serious respiratory depression as a potential adverse reaction? A. Morphine [Duramorph] B. Pentazocine [Talwin] C. Hydrocodone [Lortab] D. Nalmefene [Revex]

A Morphine is a strong opioid agonist and as such has the highest likelihood of causing respiratory depression. Pentazocine, a partial agonist, and hydrocodone, a moderate to strong agonist, may cause respiratory depression, but they do not do so as often or as seriously as morphine. Nalmefene, an opioid antagonist, would be used to reverse respiratory depression with opioids.

A postoperative patient has an epidural infusion of morphine sulfate [Astramorph]. The patient's respiratory rate declines to 8 breaths per minute. Which medication would the nurse anticipate administering? A. Naloxone [Narcan] B. Acetylcysteine [Mucomyst] C. Methylprednisolone [Solu-Medrol] D. Protamine sulfate

A Naloxone is a narcotic antagonist that can reverse the effects, both adverse and therapeutic, of opioid narcotic analgesics.

After surgery, a patient has morphine prescribed for postoperative pain. It is most important for the nurse to make which assessment? A.Respiratory rate B.Heart rate C.Pain level D.Constipation

A Rationale: Monitoring the respiratory rate in all patients who are receiving morphine is a priority. If the respiratory rate is 12 or fewer breaths per minute, the nurse should withhold the medication and notify the prescriber.

Which information does the nurse include for a patient taking tramadol (Ultram)? A) "Tramadol may cause constipation, so be sure to include sufficient roughage in your diet." B) "Have your liver enzymes monitored until you complete the medication." C) "Take tramadol as often as needed for pain relief." D) "Continue to take tramadol even if you are not experiencing pain or discomfort."

A Rationale: The nurse should inform the patient that tramadol may cause constipation and the patient should be taught what can be done to prevent it. Tramadol should be taken as prescribed only. Opiate agonists cause respiratory depression; taking tramadol as often as the patient wishes may cause significant respiratory depression. Pain medication should be used as long as needed but should not be taken if the individual is not experiencing pain. Tramadol does not have an effect on liver functioning.

When caring for a patient who is receiving morphine it is most important that the nurse regularly assess for which of the following?A. respiratory depression B. hyperactive bowel sounds C. frequent urination D. insomnia

A he nurse should recognize that airway, breathing, and circulation (ABCs) are priority considerations. Respiratory depression is the most important adverse effect to observe for in people taking an opioid such as morphine.Additionally, it is necessary to assess patients taking morphine for the presence of hypotension. Bowel sounds are likely to be hypoactive rather than hyperactive, urination is likely to be less frequent, and sleep is more likely than insomnia.

A client has been receiving long-term prednisone therapy for treatment of RA. The chart indicates that the client has developed Cushing's syndrome. When preforming a physical assessment, the nurse would all of the following but A. Hypoglycemia B. Muscle weakness C. Glucosouria D. Buffalo hump

A you would see hyperglycemia

A patient is prescribed Metoprolol. Which statement by the patient requires the nurse to re-educate the patient on how to take the medication properly? A. "After I stop taking this medication I will let my physician know." B. "I take this medication with my breakfast every morning." C. "I will change positions slowly while I'm taking this medication." D. "While I'm taking this medication I will monitor my heart rate."

A. The patient should NOT just stop taking the medication. It must be tapered off over a period of time (usually about 2 weeks). This will prevent the development of rebound hypertension, myocardial ischemia, and angina.

What does the nurse identify as a possible adverse effect of long-term glucocorticoid therapy? (Select all that apply.) A. Adrenal insufficiency B. Osteoporosis C. Hypoglycemia D. Hyperkalemia E. Cataracts

ABE Adverse effects of long-term glucocorticoid therapy include adrenal insufficiency, osteoporosis, hyperglycemia, hypokalemia, and cataracts.

A 60-year-old female patient is taking oral Nifedipine (Procardia) for angina and HTN. This drug is classified as a: A. Loop Diuretic B. Calcium Channel Blocker C. Potassium Channel Blocker D. Ace Inhibitor

B

A client is prescribed celecoxib and warfarin. Which of the following would the nurse be most concerned? A. Renal toxicity B. Platelet levels C. Liver enzymes D. Dysrhythmias

B

A client reports that they have been on morphine for the past months. Which Medication would the nurse question the order? A. Promethazine B. Pentazocine C. Ibuprofen D. Diphenhydramine

B

A patient states they are experiencing an annoying, persistent dry cough that started once they begin taking an ACE Inhibitor. The patient is not experiencing any other signs and symptoms. As the nurse, your response is? A. Tell the patient to immediately stop taking the medication and seek medical treatment. B. Reassure the patient this is a harmless side effect of this medication and to not abruptly stop taking the medication. C. Recommend the patient start taking the medication at night to decrease the coughing. D. Reassure the patient that the cough will disappear within 6 months of taking the medication.

B

A post-op client received an IV infusion of morphine has a respiratory rate of 8bpm and is lethargic. Which medication would the nurse anticipate to administer? A. Methadone B. Narcan C. Flumazinil D. Acetylcysteine

B

During long-term corticosteroid therapy, the nurse will monitor the patient for Cushing's syndrome, which is manifested by A. Weight loss B. moon face C. hypotension D. thickened hair growth

B

In administering diltiazem (Cardizem) to a patient, the nurse assesses the patient for which therapeutic response? A. Increased cardiac contractility B. Decreased blood pressure C. Decreased urine output D. Increased heart rate

B

The client is taking rosuvastatin (Crestor). What severe skeletal muscle adverse reaction should the nurse observe for? A. Myasthenia gravis B. Rhabdomyolysis C. Dyskinesia D. Agranulocytosis

B

Which assessment finding in a client taking an Statin (HMG-CoA reductase inhibitor) will the nurse act on immediately? A. Decreased hemoglobin B. Elevated liver function tests C. Elevated HDL D. Elevated LDL

B

Which assessment finding will alert the nurse to possible toxic effects of amiodarone? A. Heart rate 100 beats per minute B. Crackles in the lungs C. Elevated blood urea nitrogen D. Decreased hemoglobin

B

A patient who has rheumatoid arthritis is scheduled to start taking celecoxib [Celebrex]. A nurse should recognize which factor from the patient's history as a contraindication to taking this medication? A. Hypothyroidism B. Recent heart bypass surgery C. Positive tuberculin skin test result D. Allergy to penicillin

B Celecoxib [Celebrex] should be avoided in patients who have undergone recent heart bypass surgery. Because it does not inhibit COX-1, platelet aggregation is not suppressed. It does inhibit COX-2 in blood vessels, which results in increased vasoconstriction. Unimpeded platelet aggregation and increased vasoconstriction pose a higher risk of thrombotic events in patients with certain cardiovascular risk factors. Hypothyroidism, a penicillin allergy, and a positive tuberculin skin test result are not contraindications to taking celecoxib [Celebrex].

The nurse assesses a patient who takes ibuprofen [Advil] on a regular basis. Which finding does the nurse know is an adverse effect of ibuprofen [Advil] therapy? A. Hives B. Hematemesis C. Dysmenorrhea D. Jaundice

B Ibuprofen is a member of the nonaspirin first-generation nonsteroidal anti-inflammatory drugs (NSAIDs). Through inhibition of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), ibuprofen poses a risk for gastric ulceration and bleeding, which may lead to hematemesis. Ibuprofen is used to reduce inflammation, fever, and pain and therefore is effective in reducing dysmenorrhea (painful menstrual cramping). It is not known to cause hives or jaundice, which are signs of impaired liver function.

A patient reports having taken morphine for the past 6 months. Which medication, if ordered by the physician, should the nurse question? A.Promethazine [Phenergan] B.Pentazocine [Talwin] C.Methylnaltrexone [Relistor] D.Dextromethorphan [Delsym]

B Rationale: Pentazocine is an agonist-antagonist opioid. If pentazocine is given to a patient who is physically dependent on a pure opioid agonist such as morphine, withdrawal or abstinence syndrome will occur. Before an agonist-antagonist is administered, the patient should be slowly withdrawn from the opioid agonist. Promethazine is an antiemetic that may be given with opioids to reduce nausea and vomiting, but it may also result in increased constipation and urinary retention. Methylnaltrexone is a selective mu opioid antagonist indicated for opioid-induced constipation; the drug does not block opioid receptors in the CNS. Methylnaltrexone does not decrease analgesia and cannot precipitate opioid withdrawal. Dextromethorphan may increase analgesia and reduce tolerance to morphine.

The nurse is caring for a client with acute coronary syndrome (ACS) and atrial fibrillation who has a new prescription for metoprolol (Lopressor). Which monitoring is essential when administering the medication? A. ST segment B. Heart rate C. Troponin D. Myoglobin

B Rationale: The effects of metoprolol are to decrease heart rate, blood pressure, and myocardial oxygen demand. ST segment elevation is consistent with MI; it does not address monitoring of metoprolol. Elevation in troponin is consistent with a diagnosis of MI but does not address needed monitoring for metoprolol. Elevation in myoglobin is consistent with myocardial injury in ACS but does not address needed monitoring related to metoprolol.

ou're providing discharge instructions to a patient who will be taking a calcium channel blocker at home. Which statement by the patient demonstrates they did NOT understand the teaching instructions and needs re-education? A. "I will follow a low-fat and high-fiber diet." B. "I will limit my consumption of soft drinks and try to incorporate more healthy options, like grapefruit juice." C. "This medication can enlarge my gums so I will maintain good oral hygiene." D. "I will monitor my blood pressure regularly because this medication can cause low blood pressure."

B The patient should AVOID grapefruit juice while taking CCBs because this could lead to an increase in drug levels. The patient should follow a high-fiber diet due to constipation (especially with Verapamil). In addition, CCBs can enlarge the gums (gingival hyperplasia) and lower blood pressure.

You're providing discharge instructions to a patient that will be taking an ACE Inhibitor at home. Which statements by the patient demonstrate they understood your discharge instructions? Select all that apply: A. "If I feel unwell, it is okay that I miss a dose." B. "I will avoid using salt substitutes that contain potassium." C. "I will make sure I incorporate a high amount of potatoes, bananas, oranges, and tomatoes into my diet while taking this medication". D. "I will regularly check my blood pressure and pulse rate while taking this medication and report any significant changes to my doctor."

B and D It is very important a patient does not miss a dose of this medication (even if they are unwell) because this medication can cause rebound hypertension. Also, the patient should avoid salt substitutes with potassium and AVOID consuming foods high in potassium (like the foods in option C) because this medication causes the kidneys to retain potassium. The patient should monitor their blood pressure and pulse rate regularly and report any significant changes to their doctor.

The health care provider is planning to discontinue a client's beta blocker. What instruction should the nurse give the client regarding the beta blocker? A. The beta blocker should be abruptly stopped when another cardiac drug is prescribed. B. The beta blocker should NOT be abruptly stopped; the dose should be tapered down. C. The beta blocker dose should be maintained while taking another antianginal drug. D. Half the beta blocker dose should be taken for the next several weeks.

B stopping a beta blocker abruptly will cause rebound tachycardia

A nurse is caring for an older adult client who has a new prescription for digoxin and takes multiple other medications. concurrent use of which of the following medications places the client at risk for dig toxicity? A. Phenytoin (Dilantin) B. Verapamil (Calan) C. Warfarin (Coumadin) D. Aluminum hydroxide (Amphojel)

B taking digoxin with a CCB will cause risk for toxicity

A client with systemic lupus erythematosus is prescribed prednisone. It is most important for the nurse to monitor the client for which of the following? A. Hypotension B. Neck and back pain C. Elevated potassium levels D. Hypoglycemia

B. (osteoporosis)

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

BDE Toxicity can lead to life-threatening events and the nurse needs to monitor the client closely for signs of toxicity. Early signs of toxicity include: GI manifestations such as anorexia, nausea, vomiting, diarrhea. Subsequent manifestations include headache; visual disturbances such as diplopia, blurred vision, yellow-green halos, and photophobia; drowsiness; fatigue; and weakness. Cardiac rhythm abnormalities can also occur. The nurse also monitors the digoxin level. The optimal therapeutic range for digoxin is 0.5 to 0.8 ng/mL.

A 22 year old female has been prescribed Captopril (Capoten) for hypertention. What recommendation is likely to be given to the patient? A. Take this medication 4 hours after a meal, before bedtime. B. Take it at the same time as an iron supplement C. Take measures to prevent pregnancy D. It is important to exercise immediately after taking this medication

C

A client has been prescribed glucocorticoids. It is most important for the nurse to teach the client to do which following? A. increase their intake of dietary sodium B. Take antibiotics to prevent infection C. Never abruptly withdraw therapy D. Have an eye examination every year

C

A client is ordered methotrexate for the treatment of RA. Which of the following findings would be the most concerning? A. Dizziness B. Petechial rash C. Saturation 92% room air D. Blood pressure 112/69mmHg

C

A client states during a medical history that he takes several acetaminophen tabs throughout the day. The nurse teaches the client that the dosage should not exceed which amount? A. 1g/day B. 2g/day C. 4g/day D. 6g/day

C

A male patient with asthma tells the nurse that he is using his metered-dose inhaler of epinephrine more frequently than prescribed to control wheezing. The nurse is concerned because this behavior may result in A. drug tolerance B. heart failure C. drug toxicity D. diabetes mellitus

C

A patient is being assessed before a newly ordered antilipemic medication is given. Which condition would be a potential contraindication? A. Diabetes Insipidus B. Pulmonary fibrosis C. Liver Cirrhosis D. Myocardial Infarction

C

A patient is taking ibuprofen. The nurse understands that COX-1 and COX-2 inhibitors are different in that ibuprofen is more likely than celecoxib to cause which adverse effect? A. Fever B. Constipation C. Peptic ulcer disease D. Metallic taste when eating

C

The nurse suspects a patient is experiencing digoxin toxicity. Which of the following symptoms did the patient report to make the nurse suspicious of a toxic reaction? A. insatiable hunger B. constipation C. halo in vision field D. muscle cramping

C

When assessing a patient who has been taking amiodarone for 6 months, the nurse monitors for which potential adverse effect? A. Hyperglycemia B. Dysphagia C. Photophobia D. Urticaria

C

Which point will the nurse emphasize to a patient who is taking an antilipemic medication in the "statin" class? A. The drug needs to be taken on an empty stomach before meals B. A low-fat diet is not necessary while taking these medications. C. It is important to report muscle pain immediately. D. Improved cholesterol levels will be evident within 2 weeks.

C

A client with metastatic cancer who has been receiving fentanyl (Duragesic) for several weeks reports to the nurse that the medication is not effectively controlling the pain. Which intervention should the nurse initiate? A. Instruct the client about the indications of opioid dependence. B. Monitor the client for symptoms of opioid withdrawal. C. Notify the health care provider of the need to increase the dose. D. Administer naloxone (Narcan) per PRN protocol for reversal.

C Rationale- Because of prolonged use, the patient is developing tolerance to the medication and an increase in dosage may be in order. -Instructing the client about opioid tolerance, while you could argue beneficial, will not help to alleviate pain. -The other options are not appropriate

A man is receiving patient-controlling analgesia (PCA) and his family questions why his pain medication is being given in this manner. The nurse is most correct in explaining that the main advantage of PCA is that it A. requires less nursing time B. causes fewer adverse effects C. relieves pain more effectively D. can be used long term

C Administering narcotics through a patient-controlledanalgesia (PCA) pump allows the patient to manage his orher pain medication. This method provides more effectivepain relief.

A nurse administers naloxone [Narcan] to a postoperative patient experiencing respiratory sedation. What undesirable effect would the nurse anticipate after giving this medication? A. Drowsiness B. Tics and tremors C. Increased pain D. Nausea and vomiting

C Naloxone reverses the effects of narcotics. Although the patient's respiratory status will improve after administration of naloxone, the pain will be more acute.

Your patient is taking an ACE Inhibitor to manage blood pressure. Which finding below requires immediate nursing action? A. Urinary output is 190 mL within the past 4 hours. B. Patient has a persistent, dry cough. C. EKG shows tall, peaked t-waves. D. Patient has a negative Chvostek's sign.

C This EKG finding demonstrates hyperkalemia. Remember ACE Inhibitors can cause a high potassium level because the kidneys will keep potassium, but excrete water and sodium (so it has a diuretic effect too).

When teaching a patient who is receiving allopurinol, what should the nurse encourage the patient to do? A. Eat more meat. B. Increase vitamin C intake C. Have annual eye examinations D. Take medication 2 hours before meals.

C- long term use can lead to cataracts

Captopril (Capoten) has been ordered for a client. The nurse teaches the client that ACE inhibitors have which common side effects? A. Nausea and vomiting B. Dizziness and headaches C. Upset stomach D. Constant, irritating cough

D

Nonaspirin NSAIDs differ from aspirin in all but which way? A. They cause reversible inhibition of COX, so their effects decline as soon as their blood levels decline B. They can suppress platelet aggregation, but they are not used to prevent MI and stroke C. They can increase the risk of MI and stroke and therefore should be used in the lowest effective dosage for the shortest possible time. D. They are safe to use in children with chickenpox or influenza

D

The nurse monitors the patient receiving an ACE inhibitor for which adverse effect? A. Rebound hypertension B. Diminished pulses C. Hyperglycemia D. Hyperkalemia

D

a 68 y/o male is experiencing severe hypotension after receiving IV nitroglycerin. What is the most probable cause for this reaction? A. pt is having a MI B. the pt has a high potassium level C. the pt routinely exercises, but has not be active in over a week D. the pt failed to report that he is on Viagra

D

A patient arrives at the emergency department complaining of back pain. He reports taking at least 3 acetaminophen tablets every three hours for the past week without relief. Which of the following symptoms suggests acetaminophen toxicity? A. Tinnitus. B. Diarrhea. C. Hypertension. D. Hepatic damage.

D Acetaminophen in even modestly large doses can cause serious liver damage that may result in death. Immediate evaluation of liver function is indicated with consideration of N-acetylcysteine administration as an antidote. Tinnitus is associated with ASPIRIN overdose, not acetaminophen. Diarrhea and hypertension are not associated with acetaminophen.

In reviewing admission orders for a patient with a myocardial infarction, the nurse would question an order for which medication?A. Aspirin B. Morphine C. Butorphanol D. Pentazocine

D Pentazocine increases cardiac work. Accordingly, a pure agonist (e.g., morphine) is preferred to pentazocine for relieving pain in patients with myocardial infarction. Morphine is the opioid of choice for decreasing the pain of myocardial infarction. With careful control of dosage, morphine can reduce discomfort without causing excessive respiratory depression and adverse cardiovascular effects. In addition, by lowering blood pressure, morphine can decrease cardiac work. If excessive hypotension or respiratory depression occurs, it can be reversed with naloxone. Because pentazocine and butorphanol increase cardiac work and oxygen demand, these agonist-antagonist opioids should generally be avoided.

A postoperative patient who received an intravenous infusion of morphine has a respiratory rate of 8 breaths per minute and is lethargic. Which as-needed medication should the nurse administer to the patient? A.Methadone [Dolophine] B.Nalbuphine [Nubain] C.Tramadol [Ultram] D.Naloxone [Narcan]

D Rationale: After surgery, naloxone may be used to reverse the excessive respiratory and central nervous system depression that can be caused by opioids.

The nurse is monitoring a client during IV nitroglycerin infusion. Which assessment finding will cause the nurse to take action? A. Blood pressure 110/90 mm Hg B. Flushing C. Headache D. Chest pain

D The client should not continue to have chest pain while on IV nitroglycerin. This would prompt the nurse to intervene. Blood pressure of 110/90 mm Hg is not cause for concern and is expected with nitroglycerin. Headache and flushing are common side effects of nitroglycerin.

A nurse instructs the parent of a child with influenza that which medication or medications may be used safely to reduce fever? A. Ibuprofen [Advil] B. Naproxen [Aleve] C. Aspirin [Bayer] D. Acetaminophen [Tylenol] E. Indomethacin [Indocin]

D The use of NSAIDs, which include ibuprofen [Advil], naproxen [Aleve], indomethacin [Indocin], and especially aspirin [Bayer], by children with influenza or chickenpox may precipitate Reye's syndrome. This is a potentially fatal multisystem organ disease. Acetaminophen [Tylenol] may be used safely to reduce fever in children with influenza.

The teaching plan for a patient receiving hydralazine should include which of the following points? A. Returning for monthly urinalysis (U/A) testing B. Including citrus fruits, melons, and vegetables in the diet C. Decreasing potassium-rich food in the diet D. Rising slowing to standing from a lying or sitting position

D orthostatic hypotension

The nurse is assessing the client for possible evidence of digitalis toxicity. The nurse acknowledges that which is included in the signs and symptoms for digitalis toxicity? A. Pulse (heart) rate of 100 beats/min B. Pulse of 72 with an irregular rate C. Pulse greater than 60 beats/min and irregular rate D. Pulse below 60 beats/min and irregular rate

D- Digoxin controls heart rate. too much-will cause the heart rate to lower below the normal

A nurse instructs a patient to discontinue the scheduled use of high-dose aspirin before undergoing which procedures? (Select all that apply.) A. Routine dental cleaning B. Removal of a skin mole C. Cataract surgery D. Cholecystectomy E. Hysterectomy

DE Aspirin promotes bleeding by causing irreversible suppression of platelet aggregation. High-dose aspirin should be discontinued 1 week before elective surgery (cholecystectomy, hysterectomy). There is no need to stop aspirin before procedures with a low risk of bleeding, such as dental cleaning or dermatologic or cataract surgery.

Which property of aspirin does acetaminophen (Tylenol) lack? A) Antipyretic B) Antinausea C) Analgesic D) Antiinflammatory

Rationale: Aspirin has antiinflammatory properties, whereas acetaminophen does not. Both medications have analgesic properties. Both medications have antipyretic properties. Neither medication has antinausea properties.


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