NSG 123 Exam 4 Infection/inflammation

Clients with indwelling catheters require catheter care and emptying the drainage bag at least every _____ hours.

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19. Which of the following instructions should the nurse give to the parents of an 8-year-old child with asthma who is being switched from parenteral steroid therapy to a daily dose of oral prednisone? A. "Have the child take the dose with meals to prevent gastric irritation." B. "Administer the dose before bedtime to minimize adverse effects." C. "Give the medication according to the child's response." D. "Make sure to give the pill intact to maintain the enteric coating."

A. "Have the child take the dose with meals to prevent gastric irritation."

24. A client is to be discharged on prednisone. Which of the following statements indicates that the client understands important concepts about the medication therapy? A. "I need to wear or carry identification that I am taking prednisone." B. "I need to take the medicine in divided doses at morning and bedtime." C. "I am to take 40 mg of prednisone for 2 months and then stop." D. "Prednisone will give me extra protection from colds and flu."

A. "I need to wear or carry identification that I am taking prednisone."

25. A patient has been taking prednisone for several weeks after experiencing a hypersensitivity reaction. To prevent adrenal insufficiency, the nurse should ensure that the patient knows to do which of the following? A. Slowly taper down the dose of prednisone, as ordered. B. Take the drug concurrently with levothyroxine (Synthroid). C. Gradually replace the prednisone with an OTC alternative. D. Take each dose of prednisone with a dose of calcium chloride.

A. Slowly taper down the dose of prednisone, as ordered.

6. The nurse is assessing the client's use of medications. Which of the following medications may cause a complication with the treatment plan of a client with diabetes? A. Steroids B. Angiotensin-converting enzyme (ACE) inhibitors C. Sulfonylureas D. Aspirin

A. Steroids

clinical manifestations of cholecystitis?

-bloated -belching -flatulence -N/V/D -constipated -URQ pain -shoulder pain -general pain

At risk populations for cholecystitis:

-fat -fair skinned -female -fertile -forties

S/S of worsening cholecystitis

-jaundice -dark urine -clay-colored stool

15. A client is asking about dietary modifications to counteract the long-term effects of prednisone. What is the most appropriate information for the nurse to give the client? A. "Increase your intake of polyunsaturated fats." B. "Increase your intake of calcium and vitamin D." C. "Increase your intake of complex carbohydrates." D. "Increase your intake of dietary sodium."

B. "Increase your intake of calcium and vitamin D."

2. A client being treated for rheumatoid arthritis has been prescribed a type of drug that is commonly used for joint inflammation. The nurse will administer an initial dose as an injection, and the client will continue taking an oral form of the medication. Which type of analgesic drug will the nurse administer? A. Narcotic B. Corticosteroid C. Opioid D. Antidepressant

B. Corticosteroid

18. A physician orders prednisone to control inflammation in a client with interstitial lung disease. During client teaching, the nurse stresses the importance of taking prednisone exactly as ordered and cautions against discontinuing the drug abruptly. A client who discontinues prednisone abruptly may experience: A. hyperglycemia and glycosuria. B. acute adrenocortical insufficiency. C. GI bleeding. D. restlessness and seizures.

B. acute adrenocortical insufficiency.

23. The nurse is conducting an admission history of a client admitted with a fracture. The nurse recognizes that which of the client's medications placed the client at risk for fractures? A. furosemide (Lasix) B. prednisone (Deltasone) C. metoprolol (Lopressor) D. digoxin (Lanoxin)

B. prednisone (Deltasone)

The following UA results would indicate a possible UTI;

Bacteria>100,000, RBC>5, WBC>10

10. A client newly diagnosed with ulcerative colitis who has been placed on steroids asks the nurse why steroids are prescribed. The nurse should tell the client? A. "Ulcerative colitis can be cured by the use of steroids." B. "Long-term use of steroids will prolong periods of remission." C. "Steroids are used in severe flare-ups because they can decrease the incidence of bleeding." D. "The side effects of steroids outweigh their benefits to clients with ulcerative colitis."

C. "Steroids are used in severe flare-ups because they can decrease the incidence of bleeding."

4. Patients who have received corticosteroids preoperatively are at risk for which type of insufficiency? A.Thyroid B.Parathyroid C. Adrenal D.Pituitary

C. Adrenal

13. The nurse is caring for a patient with diabetes who has an infection. The nurse creates a plan of care for the patient based on a knowledge of the hypothalamic-pituitary response to stress by including which of the following nursing interventions in the plan of care A. Increasing insulin dosage B. Measurement of intake/output C. Assessment for hyperglycemia D. Restriction of dietary protein

C. Assessment for hyperglycemia

7. A nurse should perform which intervention for a client with Cushing's syndrome? A. Offer clothing or bedding that's cool and comfortable. B. Explain the rationale for increasing salt and fluid intake in times of illness, increased stress, and very hot weather. C. Explain that the client's physical changes are a result of excessive corticosteroids. D. Suggest a high-carbohydrate, low-protein diet.

C. Explain that the client's physical changes are a result of excessive corticosteroids.

20. A client is ordered prednisone daily. Which statement best explains why the nurse should instruct the client to take this drug in the morning? A. Prednisone has a longer half-life with morning administration, making it more effective. B. Prednisone is best absorbed when taken on an empty stomach, first thing in the morning. C. Morning administration of prednisone mimics the body's natural corticosteroid secretion pattern. D. Taking the drug at the same time every day establishes a regular routine, reducing the risk of forgetting a dose.

C. Morning administration of prednisone mimics the body's natural corticosteroid secretion pattern.

12. Which of the following indicates that the client with Addison's disease is receiving too much glucocorticoid replacement? A. Dizziness. B. Anorexia. C. Rapid weight gain. D. Poor skin turgor.

C. Rapid weight gain.

3. The nurse teaches the patient that corticosteroids will be used to treat his brain tumor for which reason? A. Prevent extension of the tumor B. Facilitate regeneration of neurons C. Reduce cerebral edema D. Identify precise location of the tumor

C. Reduce cerebral edema

22. When teaching the client who is receiving long-term prednisone therapy, the nurse should recommend? A. Eat foods that are low in potassium B. Take over-the-counter drugs as needed. C. Take the prednisone with food. D. Exercise three to four times a week.

C. Take the prednisone with food.

1. A nurse is teaching a client with adrenal insufficiency about corticosteroids. Which statement by the client indicates a need for additional teaching? A. "I will see my ophthalmologist regularly for a check-up." B. "I will avoid friends and family members who are sick." C. "I will eat lots of chicken and dairy products." D. "I may stop taking this medication when I feel better."

D. "I may stop taking this medication when I feel better."

9. An elderly client on steroids has secondary diabetes and chronic kidney disease (CKD) and takes insulin. The client has had episodes of hypoglycemia. The nurse should: A. Continue to monitor the client's blood glucose values. B. Restrict ambulation so there will be less of a chance for hypoglycemia. C. Contact the dietician to request that one additional serving of protein be added to each meal. D. Contact the physician and recommend that the doses of insulin be evaluated.

D. Contact the physician and recommend that the doses of insulin be evaluated.

8. The nurse is conducting an admission history and physical examination of a patient with a history of contact dermatitis. The nurse assesses if the patient utilizes which of the following medication classifications? A. Antifungals B. Antivirals C. Saline irrigations D. Corticosteroids

D. Corticosteroids

17. A client diagnosed with systemic lupus erythematosus comes to the emergency department with severe back pain. She reports that she first felt pain after manually opening her garage door and that she is taking prednisone daily. What adverse effect of long-term corticosteroid therapy is most likely responsible for the pain? A. Hypertension B. Muscle wasting C. Truncal obesity D. Osteoporosis

D. Osteoporosis

21. Which topic is most important to include in the teaching plan for a client newly diagnosed with Addison's disease who will be taking corticosteroids? A. How to decrease the dose of the corticosteroids when the client experiences stress. B. The need to adjust the steroid dose based on dietary intake and exercise. C. To notify the health care provider when the blood pressure is suddenly high. D. The importance of watching for signs of hyperglycemia.

D. The importance of watching for signs of hyperglycemia.

5. Which factor in a client's history indicates she's at risk for candidiasis? A. Greater than the age of 45 B. Use of spermicidal jelly C. Menopause D. Use of corticosteroids

D. Use of corticosteroids

16. A client takes prednisone, as ordered, for rheumatoid arthritis. During follow-up visits, the nurse should assess the client for common adverse reactions to this drug, such as: A. tetany and tremors. B. anorexia and weight loss C. abdominal cramps and diarrhea. D. fluid retention and weight gain

D. fluid retention and weight gain

The organism most frequently associated with UIT is ________________ ________.

Escherichia coli

s/s of a UTI

Low grade temp dysuria, frequency, urgency, fatigue, dark- foul smelling urine, and burning when voiding

When caring for a client with appendicitis, the nurse knows that maintaining.....

NPO status until surgery is determined, minimizing activity that could aggravate pain, placing client in a semi fowlers - fowlers position to decrease pain...sometimes lying with legs drawn up also helps, administering antibiotics as ordered

nd fungus) as well as aspiration Assessing a client with pneumonia, the nurse would expect:

adventitious breath sounds, Cough with/without sputum, Fever, Chills, SOB, Rapid-shallow breathing, Sharp/stabbing chest pain (worsens with cough and deep breathing, Loss of appetite, Low energy, fatigue, Nausea/Vomiting in young children, Confusion in elderly

A common initial symptom of UTI is ____________ _________ ________________.

burning upon urination

A common objective symptom of UTI in the elderly is change in ______________ _________________.

cognitive function

Clients admitted to the hospital with influenza should be placed on _____________ isolation

droplet

S/S of influenza

fever, chills, aches, dry cough, headache, fatigue/malaise, sore throat, clear nasal drainage, tachycardia, N/V/D

The nurse recognizes that a client with pneumonia who has bedrest ordered short term is done to reduce the cellular need for______________.

oxygen

ERCP puts the patient at risk for ______________.

pancreatitis

A ruptured appendix could lead to ______________.

peritonitis

Common complication of influenza is _________________.

pneumonia

When a client who is being evaluated for possible appendicitis experiences sudden relief after vomiting, the nurse should immediately notify Dr. /Affiliate as this is a sign of possible _____________.

rupture

In acute appendicitis, the nurse would expect to find...

sharp pain in the right lower quadrant, rebound tenderness (this refers to pain upon removal of pressure rather than application of pressure to the abdomen) in the right lower quadrant, N/V, low grade fever, loss of appetite, pain that worsens with coughing, walking, and other jarring movements.

Acalculous cholecystitis

sludge

calculous cholecystitis

stones

When visiting a client with influenza in the hospital, the nurse needs to educate all visitors that a _________ _____ should be applied prior to entering the room

surgical mask

One of the best ways to manage influenza is to receive the flu ________ every fall

vaccine