NURS20025 Abrams Chapter 31-34, 41 Questions

What assessment finding in a patient with HF receiving furosemide would indicate an improvement in fluid volume status? A) absence of crackles on the auscultation of lungs B) complaints of proximal nocturnal dyspnea C) bounding radial pulse D) decrease in hematocrit

A) absence of crackles on the auscultation of lungs

A nurse is providing health education to a client recently been diagnosed with asthma and prescribed albuterol and ipratropium. Which of the client's statements suggests a need for clarification by the nurse? A. "I'll keep taking my medications until I'm not experiencing any more symptoms." B. "I'll make sure I don't take my inhalers more often than they've been prescribed." C. "I'm a heavy coffee drinker, but I know that I now know I need to cut down on this." D. "I'll try to make sure that I drink plenty of fluids each day."

A. "I'll keep taking my medications until I'm not experiencing any more symptoms."

With adequate hydration, what is the expected approximate, normal daily urine production of an adult? A. 2 L/d B. 3 L/d C. 1 L/d D. 0.5 L/d

A. 2 L/d

A client who began treatment for type 2 diabetes 8 months ago is now meeting with a diabetic nurse for a scheduled follow-up. How can the nurse beat assess the client's glycemic control since beginning treatment? A. Assess the most recent hemoglobin A1C levels. B. Dialogue with the client about implemented management strategies. C. Review and discuss the data contained in the client's written blood glucose log. D. Arrange to have the client's random blood glucose measured.

A. Assess the most recent hemoglobin A1C levels.

A nurse reviewing a client's morning blood work notes a theophylline level of 22.2 mcg/mL. What action should the nurse take? A. Contact the care provider and inform him or her that the client has toxic theophylline levels. B. Withhold the scheduled dose of theophylline pending the next day's blood work results. C. Inform the care provider that an increase in the client's dose of theophylline may be necessary. D. Administer the schedule dose of theophylline with as needed (PRN) dose of a bronchodilator.

A. Contact the care provider and inform him or her that the client has toxic theophylline levels.

When providing client education regarding food allergies, what statement made by the nurse would indicate a need for further education on the subject? A. Foods have an equal risk of causing an allergic response. B. Certain fruits and vegetables have been identified as allergens. C. Children allergic to milk or soy will often outgrow their allergy. D. Food allergies are often an immune response to the ingestion of a protein.

A. Foods have an equal risk of causing an allergic response.

What medical condition is likely to be exacerbated by the medication therapy associated with asthma? A. GERD B. cataracts C. urinary retention D. dermatitis

A. GERD

Where should the nurse initially direct a client who is interested in learning more about the management of asthma? A. Global Initiative for Asthma (GINA) B. National Association of Educational Pulmonologists C. Journal of Allergy and Clinical Immunology D. Centers for Disease Control Education Center

A. Global Initiative for Asthma (GINA)

What statement accurately describes an aspect of serum sickness? A. It is a delayed hypersensitivity reaction. B. It can develop in 1 to 2 days. C. Symptoms include sensitivity to light resulting in optic pain. D. Sensitization to the antigen will diminish the reaction.

A. It is a delayed hypersensitivity reaction.

A pregnant client asks if there is anything that she can do to prevent her baby from developing allergies. Which statement should underlie the nurse's response to the client? A. Parents should discuss the introduction of solid foods to their infants with the health care provider. B. There is no known preventive strategy to prevent against the development of food allergies. C. Breast-fed infants seldom ever develop food-triggered allergies. D. Food allergies generally result from an inadequate variety of food during the first year of life.

A. Parents should discuss the introduction of solid foods to their infants with the health care provider.

A woman begins using an albuterol inhaler and a beclomethasone inhaler for her asthma. She asks if it matter which inhaler she uses first. The best response by the nurse is which of the following? A. You should use the albuterol inhaler first followed in 5-10 minutes by the beclomethasone inhaler. B. You should use the beclomethasone inhaler first followed in 5-10 minutes by the albuterol inhaler. C. The order in which you use the inhalers doesn't matter D. You should not use the inhalers one right after the other.

A. You should use the albuterol inhaler first followed in 5-10 minutes by the beclomethasone inhaler.

A common mucolytic used to liquefy mucus in the respiratory tract that A. acetylcyseine B. ipratropium C. dextromethorphan D. pseudoephedrine

A. acetylcyseine

What pathology is present in a client diagnosed with chronic asthma even when they may appear symptom free? Select all that apply. A. airway inflammation D. damaged airway mucosa C. hypogastric secretions D. elevated temperature E. bradycardia

A. airway inflammation D. damaged airway mucosa

A client's report of nasal congestion, itching, sneezing, and watery drainage, including itching of the throat, eyes, and ears, are consistent with what situation? A. allergic rhinitis B. a histamine reaction C. a sinus infection D. anaphylaxis

A. allergic rhinitis

Because of the risks of lactic acidosis, metformin is contraindicated in which of the following clients? A. an 82-year-old diagnosed with type 2 diabetes B. a 16-year-old with a diagnosis of anorexia nervosa C. a 50-year-old who has undergone surgery 2 weeks ago D. a 37-year-old woman who takes oral contraceptives

A. an 82-year-old diagnosed with type 2 diabetes

What outcome may be expected if allergic rhinitis is improperly treated? Select all that apply. A. asthma B. chronic fatigue C. insomnia D. sinusitis E. emphysema

A. asthma B. chronic fatigue C. insomnia D. sinusitis

A client has been admitted to the ED in status asthmaticus. The ED nurse should anticipate administering which of the following? A. beta2 agonists in high doses B. intravenous theophylline C. high doses of montelukast D. inhaled corticosteroids

A. beta2 agonists in high doses

A patient presents with a blood pressure of 162/88 mm Hg, heart rate of 100 bpm, triglycerides of 378 mg/dL, and HDL of 25 mg/dL. Which of the following are characteristics of metabolic syndrome? (Select all that apply.) A. blood pressure of 162/88 mm Hg B. heart rate of 100 bpm C. triglycerides of 378 mg/dL D. HDL of 25 mg/d

A. blood pressure of 162/88 mm Hg C. triglycerides of 378 mg/dL D. HDL of 25 mg/d

An allergy to sulfonamides would contraindicate the use of what diuretic? Select all that apply. A. chlorothiazide B. thiazide diuretics hydrochlorothiazide C. potassium-sparing diuretics spironolactone D. osmotic diuretics mannitol E. furosemide

A. chlorothiazide B. thiazide diuretics hydrochlorothiazide E. furosemide

In caring for a patient with nasal congestion, the nurse knows that adrenergic drugs are used as nasal decongestants to relieve symptoms by A. constricting arterioles and reducing blood flow to nasal mucosa B. stimulating air movement in the lungs C. stabilizing mast cells D. initiating the cough reflex

A. constricting arterioles and reducing blood flow to nasal mucosa

A patient who is newly diagnosed with diabetes mellitus demonstrates extreme anxiety. The most appropriate intervention to decrease the patient's anxiety would be to A. convey empathy, trust, and respect toward the patient B. administer an antianxiety medication C. ensure that the patient knows the correct medical terminology to understand what is going on D. ignore the signs and symptoms of anxiety so they will disappear more quickly

A. convey empathy, trust, and respect toward the patient

The stress response triggered by illness will result in the increase secretion of what hormone? Select all that apply. A. glucagon B. cortisol C. thyroxine D. growth

A. glucagon B. cortisol D. growth

The nurse notes that a patient's serum theophylline level is 25 mcg/mL and that a scheduled dose of the medication is due. The nurse should A. hold the scheduled dose, contact the health care provider, and assess the patient for signs of theophylline toxicity B. administer the dose as scheduled C. administer only half of the dose and repeat the theophylline level in 4 hours D. hold the dose until the next meal and administer at that time

A. hold the scheduled dose, contact the health care provider, and assess the patient for signs of theophylline toxicity

You are caring for a client taking insulin. You realize that the client is experiencing symptoms of hypoglycemia when he or she displays which of the following symptoms? The demonstration of what symptom would suggest that an insulin-dependent client is experiencing a hypoglycemic reaction? Select all that apply. A. increased pulse rate B. diaphoresis C. decreased respiratory rate D. decreased urinary output E. mental confusion F. weakness

A. increased pulse rate B. diaphoresis E. mental confusion F. weakness

Because of the action of antihistamines on target tissues, these drugs are effective in producing which of the following actions? (Check all that apply.) A. inhibiting vascular permeability B. reducing pruritus C. minimizing edema formation D. preventing histamine release

A. inhibiting vascular permeability B. reducing pruritus C. minimizing edema formation

What is considered a possible trigger for an asthma attack? Select all that apply. A. pollutants B. cigarette smoke C. allergens D. exercise E. warm weather

A. pollutants B. cigarette smoke C. allergens D. exercise

A man who is using a steroid inhaler complains of anorexia and discomfort when he eats. The nurse reports this to the care provider, and the patient receives a diagnosis or oropharyngeal candidiasis. It is possible to decrease this adverse effect by which of the following actions? (Check all the apply.) A. reducing the dose B. administering the drug more frequently C. rinsing the mouth after use D. using a spacer device

A. reducing the dose C. rinsing the mouth after use D. using a spacer device

What risk factor appears to contribute to the high death rate associated with asthma among the African American population? A. urban living B. low health literacy C. race D. genetics

A. urban living

A nurse is instructing a patient on dietary considerations while taking spironolactone (Aldactone). Which of the following statements made by the patient indicates that further teaching is necessary? A) "I should not eat foods high in potassium while taking this medication." B) "I should use a salt substitute instead of regular salt." C) "I should call my NP if I have any significant adverse effects from my meds." D) "I should not take large amounts of potassium chloride supplements."

B) "I should use a salt substitute instead of regular salt."

Mrs. Conley, age 53, has had hypertension for 10 years and admits that she does not comply with her prescribed antihypertensive therapy. Recently, she has begun to experience SOB and ankle-swelling. A workup reveals the presence of chronic renal insufficiency. What classification of diuretic is the first drug of choice for the NP to prescribe? A) thiazide B) loop C) osmotic D) potassium-sparing

B) loop

A patient reports a drug allergy to sulfonamides. Which diuretic drug class should the nurse question if ordered for the patient? A) loop diuretics B) thiazides C) potassium-sparing diuretics D) osmotic diuretics

B) thiazides

A client reports having difficulty finding the OTC decongestant that he/she used in the past. What assessment question should the nurse ask to help address the client's concern? A. "Have you asked the pharmacist about a substitute medication?" B. "Did the medication contain pseudoephedrine?" C. "How long hasit been since you last needed to take a decongestant?" D. "Would you like your health care provider to prescribe something for congestion?"

B. "Did the medication contain pseudoephedrine?"

What statement made by a client suggests a need for further teaching on the risk factors associated with drug allergies? A. "The additives that are in drugs can also cause allergic reactions." B. "If you didn't have allergies as a child, you won't develop allergies later in life." C. "Virtually any drug may induce an immunologic response in a susceptible people." D. "All drugs have the potential to cause an allergic reaction."

B. "If you didn't have allergies as a child, you won't develop allergies later in life."

When providing health education to a client prescribed diphenhydramine, what information should the nurse convey to the client? A. "Some people find that this drug makes their muscles weak." B. "This drug is likely to make you feel drowsy." C. "This drug will likely make you urinate more than usual." D. "You might have a dry cough for a few hours after taking this drug."

B. "This drug is likely to make you feel drowsy."

The client is scheduled to get a breakfast tray at 0700. At what time should the client receive a prescribed dose of insulin lispro? A. 0620 B. 0645 C. 0600 D. 0700

B. 0645

The nurse should be aware that diuresis will peak how long after the furosemide is administered? A. 5 to 10 minutes B. 30 minutes C. 15 minutes D. 60 to 75 minutes

B. 30 minutes

A patient is taking NPH insulin once daily in the morning. What is the most likely time for a hypoglycemic reaction? A. 1 to 3 hours after administration B. 4 to 12 hours after administration C. 12 to 18 hours after administration D. 18 to 24 hours after administration

B. 4 to 12 hours after administration

What hospital procedure has the greatest potential to cause an anaphylactoid reaction? A. Administration of intravenous fluids rapidly B. Administration of contrast media for diagnostic tests C. Administration of low molecular weight heparin D. Administration of bronchodilators by nebulizer

B. Administration of contrast media for diagnostic tests

When teaching a patient about the proper use of metered dose inhalers, which of the following statements should be included? A. Make sure that you puff out air repeatedly after you inhale the medication. B. After you inhale the medication, hold the breath for approximately 10 seconds, and exhale slowly. C. After you inhale the medication, once repeat until you obtain relief. D. Rinse out your mouth before using the inhaler to decrease the development of a mouth infection.

B. After you inhale the medication, hold the breath for approximately 10 seconds, and exhale slowly.

What principle guide the nurse's response when a parent asks about the use of an antitussive to treat a 7-year-old's dry cough? A. Children should be administered antitussives based on body surface index, not age. B. Antitussives are not recommended for use in young children. C. Children should be administered antitussives based on weight, not age. D. Antitussives should only be used to treat productive coughs in children, not dry coughs.

B. Antitussives are not recommended for use in young children.

When teaching a patient who has recently received a diagnosis of diabetes how to self-administer short-acting and intermediate-acting insulin subcutaneously, which of the following instructions is correct? A. Understand that the order of drawing up the two insulins into the syringe does not matter. B. Draw the short-acting insulin into the syringe first, followed by the intermediate-acting insulin. C. Draw the intermediate-acting insulin into the syringe first, followed by the short-acting insulin. D. Give yourself two injections because mixing these insulins together is unsafe

B. Draw the short-acting insulin into the syringe first, followed by the intermediate-acting insulin.

What factor is consistent with a drug reaction? Select all that apply. A. It is limited to drugs that are based on organic compounds. B. It follows a previous exposure to the same or similar drug. C. It occurs after a moderate to large dose of the drug. D. It follows ingestion of a drug known to produce allergic reactions. E. It occurs approximately 7 to 10 days after initial exposure to the suspected drug.

B. It follows a previous exposure to the same or similar drug. D. It follows ingestion of a drug known to produce allergic reactions. E. It occurs approximately 7 to 10 days after initial exposure to the suspected drug.

What should be the nurse's initial response when a client diagnosed with type 1 diabetes suddenly reports feeling weak, shaky, and dizzy? A. Have the client drink a 4oz glass of orange juice B. Perform a blood sugar analysis C. Administer 1 ampule of 50% dextrose intravenously (IV) D. Administer 10 units of regular insulin subcutaneously (sub-Q)

B. Perform a blood sugar analysis

What statement best describes how the common cold is effected by and managed using medication therapy? A. Herbal remedies containing zinc have demonstrated some ability to reduce the symptoms generally associated with a cold. B. The tendencies to overmedicate and use antibiotics inappropriately with the common cold are widespread and pose significant risk for complications and drug resistance. C. Colds may be difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired. D. Because of the way cold viruses are spread, antibiotics are the most important protective and curative measure.

B. The tendencies to overmedicate and use antibiotics inappropriately with the common cold are widespread and pose significant risk for complications and drug resistance.

The nurse is assessing a patient who has just begun taking glyburide. Which of the following is a therapeutic outcome for this patient? (Select all that apply.) A. a glycosylated hemoglobin (hemoglobin A1C) of 10% B. a decrease in polyuria C. a decrease in polyphagia D. a fasting blood glucose of 108 mg/d

B. a decrease in polyuria C. a decrease in polyphagia D. a fasting blood glucose of 108 mg/d

Cold remedies listed as "nondrowsy" or labeled as "daytime" formula do not contain A. a nasal decongestant B. a first-generation antihistamine C. a pain reliever D. any of the above

B. a first-generation antihistamine

The nurse receives an order to administer diphenhydramine. This medication is recommended for use in A. premature or full term infants B. adults to prevent allergic reactions C. children with chickenpox D. children with a flu like infection

B. adults to prevent allergic reactions

What situation would an indication for a prescription of a first-generation antihistamine? Select all that apply. A. pneumonia B. allergic rhinitis C. dermatitis D. motion sickness E. emphysema

B. allergic rhinitis C. dermatitis D. motion sickness

Which drug is commonly implicated in anaphylactic reactions? Select all that apply. A. acetaminophen B. aspirin C. cisplatin D. tetanus vaccine E. penicillin

B. aspirin C. cisplatin E. penicillin

Montelukast is effective in relieving the inflammation and bronchoconstriction associated with acute asthmatic attacks through which principal action? A. stabilizing mast cells B. blocking leukotriene receptors C. binding to immunoglobulin E (IgE) D. decreasing prostaglandin synthesis

B. blocking leukotriene receptors

A client presents with ascites, secondary to cirrhosis. Which mechanism is involved in the fluid shift that has occurred? A. decreased capillary permeability B. decreased plasma oncotic pressure C. increased capillary hydrostatic pressure D. increased capillary permeability

B. decreased plasma oncotic pressure

What intervention should be included in the care plan of a client experiencing excessive respiratory tract secretions? A. supplemental oxygen by nasal prongs B. deep breathing and coughing exercises C. administration of pseudoephedrine D. administration of guaifenesin

B. deep breathing and coughing exercises

The nurse is monitoring a patient newly diagnosed with type 2 diabetes mellitus taking repaglinide for complications. Which of the following, if exhibited by the patient, would indicate hypoglycemia and require immediate treatment? A. polyuria B. diaphoresis C. decreased heart rate D. hypertension

B. diaphoresis

A patient has asked for an antihistamine to relieve symptoms of an upper respiratory infection. The nurse explains that studies have demonstrated that for treatment of the common cold, antihistamines A. are effective in relieving cold symptoms B. do not relieve symptoms and are not recommended C. should be compounded with other products to be effective D. relieve nonallergenic symptoms only

B. do not relieve symptoms and are not recommended

First-generation antihistamines frequency cause what adverse effect? Select all that apply. A. diarrhea B. dry mouth C. urinary retention D. sense of euphoria E. blurred vision

B. dry mouth C. urinary retention E. blurred vision

"Water follows salt" is a maxim that can guide many aspects of nursing practice. To what mechanism within the pathophysiology of edema does this principle apply? A. decreased plasma oncotic pressure B. increased capillary hydrostatic pressure C. increased capillary permeability D. decreased capillary permeability

B. increased capillary hydrostatic pressure

The nurse should be aware that concomitant use of what drug is contraindicated during tiotropium therapy? A. theophylline B. ipratropium C. budesonide D. fluticasone

B. ipratropium

An elderly client, diagnosed with chronic obstructive pulmonary disease (COPD), is being considered for corticosteroid therapy. The nurse should anticipate that these drugs may be administered by what routes? Select all that apply. A. sublingual B. parenteral C. topical D. oral E. inhaled

B. parenteral D. oral

A 58-year-old woman with type 2 diabetes mellitus takes glyburide (DiaBeta) 5 mg by mouth daily, and this drug controls her diabetes well. However, recently, her fasting blood glucose has measured between 200 and 220 mg/dL. Which of the following medications may have been added to the patient's regimen? A. atenolol B. prednisone C. enalapril maleate D. levothyroxine sodium

B. prednisone

A client reports experiencing severe nasal congestion since starting to use an OTC nasal decongestant spray a week ago. This symptomology most supports what possible medical condition? A. bronchitis B. rebound congestion C. a drug allergy D. sinusitis

B. rebound congestion

When considering the management of diabetic ketoacidosis (DKA), what type of insulin can be administered intravenously? A. lispro B. regular C. isophane insulin (NPH) D. insulin glargine

B. regular

Which of the following herbal prepatations appears to play a role in the defense mechanisms of the respiratory system in adults? A. echinacea B. vitamin C C. zinc gluconate D. valerian

B. vitamin C

A man who is taking an oral hypoglycemic for management of his type 2 DM begins taking hydrochlorothiazide. The nurse should monitor for which of the following serum lab changes? A) hypocalcemia B) hypercalcemia C) hyperglycemia D) hypernatremia

C) hyperglycemia

A client asks the nurse to explain the difference between "AM" and "PM" combination cold remedies. What would be the nurse's best response? A. Designations of "AM" and "PM" indicate the medication's manufacturer. B. "PM" formulas contain a decongestant but do not contain an antihistamine; "AM" formulas contain an antihistamine. C. "AM" formulas contain a nasal decongestant but do not contain an antihistamine; "PM" formulas contain an antihistamine. D. "AM" formulas contain a mucolytic, and "PM" formulas contain a steroidal preparation.

C. "AM" formulas contain a nasal decongestant but do not contain an antihistamine; "PM" formulas contain an antihistamine.

A client, recovering from a cold and is now experiencing a hacking cough, asks if taking an antihistamine would be helpful. What response demonstrates the nurse's understanding of the effective use of antihistamines? Select all that apply. A. "Antihistamines are recommended for your type of cough, but you must monitor for adverse effects." B. "Antihistamines are effective but only if you also increase your fluid intake." C. "Antihistamines are not recommended because they tend to worsen your cough." D. "Antihistamines are not recommended in your situation but an antibiotic may be useful." E. "Antihistamines are used for allergy-related cough."

C. "Antihistamines are not recommended because they tend to worsen your cough." E. "Antihistamines are used for allergy-related cough."

A patient with type 2 diabetes calls the nurse to report the following symptoms: blood glucose of 378 mg/dL, excessive urination, and feelings of becoming drowsier. To determine a possible diagnosis, which of the following questions is most important? A. "Has there been any change in diet?" B. "Has there been any fever?" C. "Have there been any ketones in the urine?" D. "Have you increased the amount of fluid intake?"

C. "Have there been any ketones in the urine?"

What statement would be appropriately included in the teaching concerning type 2 diabetes? A. "Until you need to start insulin injections, you do not have to check your blood sugar." B. "If you drink alcohol, it may be necessary for you to increase your oral antidiabetic medication." C. "Regular exercise makes your body better able to use the insulin it produces." D. "Clients with type 2 diabetes always progress to insulin injections if they do not follow dietary guidelines."

C. "Regular exercise makes your body better able to use the insulin it produces."

When should a client prescribed diphenhydramine take the medication to prevent motion sickness during a ferry boat ride? A. as soon as the ferry leaves the dock B. when the client boards the ferry C. 30 to 60 minutes before the ferry trip D. the night before the scheduled trip

C. 30 to 60 minutes before the ferry trip

A client, being evaluated for diabetes, asks how a blood glucose test is used to diagnose this disease. What is the nurse's best response? A. A fasting blood sugar result of 100 mg/dL or more on two separate occasions is diagnostic of diabetes. B. Two consecutive glycosylated hemoglobin (hemoglobin A1C) results of 6 or more are diagnostic of diabetes. C. A fasting blood sugar result of 126 mg/dL or more on two separate occasions is diagnostic of diabetes. D. A fasting blood dugar result of 100 mg/dL or more and an A1C of more than 6 on two separate occasions are diagnostic of diabetes.

C. A fasting blood sugar result of 126 mg/dL or more on two separate occasions is diagnostic of diabetes.

When providing health education to an adult who is taking an OTC combination cold and cough remedy, the nurse should encourage the client to implement what intervention to best assure medication safety? A. Administer the medication with an additional dose of acetaminophen to potentiate therapeutic effects. B. Start with a low dose, and gradually increase it until symptoms are relieved. C. Carefully read the label, and adhere to guidelines for use. D. Withhold the medication until a prescription is obtained from a physician.

C. Carefully read the label, and adhere to guidelines for use.

An older adult client has been prescribed an inhaled corticosteroid for the treatment of chronic obstructive pulmonary disease (COPD). Which action should the nurse perform to reduce a client's risk for developing oral candidiasis? A. Have the client gargle with normal saline prior to administering the drug. B. Encourage the resident not to deeply inhale the medication. C. Have the resident rinse his or her mouth after each dose of the drug. D. Administer prophylactic antifungal medications.

C. Have the resident rinse his or her mouth after each dose of the drug.

A patient with newly diagnosed type 1 diabetes is beginning daily insulin injections. The nurse is preparing to teach the patient about insulin injections. What should the nurse include in the teaching plan? A. Understand that ketones in the urine indicate the need for a decrease in the number of units of insulin. B. Administer the insulin at the same time every day regardless of meals. C. Rotate the insulin injection sites. D. Increase the insulin dosage just prior to exercise

C. Rotate the insulin injection sites.

What factor allows for substance exchange to occur freely through the walls of the renal convoluted tubules? A. The extensively porous nature of the tubules. B. The presence of natural holes in the tubular walls. C. The tubules have a large surface area. D. The presence of numerous tubules.

C. The tubules have a large surface area.

What are second-generation H1 receptor antagonists less likely to cause central nervous system (CNS) depression? Select all that apply. A. They block the reuptake of serotonin. B. They have a mild inotropic effect. C. They are selective for peripheral H1 receptors. D. They stimulate the release of catecholamines. E. They do not cross the blood-brain barrier.

C. They are selective for peripheral H1 receptors. E. They do not cross the blood-brain barrier.

Why would potassium-sparing diuretics be contraindicated for clients experiencing renal failure? A. They promote excretion of potassium. B. They may cause rebound edema. C. They may cause hyperkalemia. D. They are the strongest form of diuretics.

C. They may cause hyperkalemia.

The substances released from mast cells are responsible for what physiological response? Select all that apply. A. myalgia B. decreased capillary permeability C. bronchoconstriction D. inflammatoin E. smooth muscle dilation

C. bronchoconstriction D. inflammatoin

What medication should be prescribed to minimize the risk associated with a blood transfusion for a client with a history of a previous transfusion reaction? A. cetirizine B. clemastine C. diphenhydramine D. epinephrine

C. diphenhydramine

The nurse working in the emergency department anticipates an order of a severe allergic reaction with anaphylaxis, knowing that the drug of choice for severe allergic reactions with anaphylaxis is A. diphenhydramine B. cimetidine C. epinephrine D. loratadine

C. epinephrine

A man with type 2 diabetes mellitus has a blood glucose of more than 500 mg/dL. He is complaining of excessive urination, extreme thirst, and weakness, and he also notes recent weight loss. The nurse would expect to find which diagnosis in his chart? A. hypoglycemia B. diabetic ketoacidosis C. hyperglycemic hyperosmolar nonketotic syndrome D. hypothyroidism

C. hyperglycemic hyperosmolar nonketotic syndrome

Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine? A. ineffective breathing pattern B. risk for infection C. ineffective airway clearance D. impaired tissue perfusion

C. ineffective airway clearance

As the nurse caring for a patient with nasal congestion who is using the OTC decongestant oxymetazoline, the nurse counsels the patient that this medication should only be used for the time recommended on the package and no longer because excessive use may produce A. copious lower respiratory tract secretions B. ringing in the ears C. rebound nasal congestion D. a suppressed cough reflex

C. rebound nasal congestion

Adrenergics are a category of bronchodilators used in the treatment of asthma and chronic obstructive pulmonary disease (COPD). In what conditions is cautious use of these drugs recommended? Select all that apply. A. hypothyroidism B. renal failure C. seizure disorders D. hypertension E. diabetes mellitus

C. seizure disorders D. hypertension E. diabetes mellitus

A patient with type 2 diabetes begins taking sitagliptin for the management of blood glucose levels. Which statement by the patient indicates an understanding of this medication? A. "I will take two doses in the morning if my blood sugar is high." B. "By taking this medication, I am able to eat more." C. "Now that I am taking this medication, I don't have to exercise anymore." D. "I will take this medicine once a day."

D. "I will take this medicine once a day."

Nasal decongestants would be contraindicated for which client? A. A client with a history of controlled hypertension B. A client with a pulse rate of 58 beats per minute C. A client with a history of diet-controlled diabetes mellitus D. A client with a history of coronary artery disease

D. A client with a history of coronary artery disease

A client with a long-standing diagnosis of heart failure has been taking HCTZ for several weeks. The client states that she has been experiencing moderate diuresis, but she and her care provider agree that increased diuresis would be of benefit. However, the care provider has explained that the client is likely near the ceiling threshold of this drug. What is the main implication when a client prescribed HCTZ is told they are, "nearing the drug's ceiling threshold"? A. Increased use of HCTZ will exacerbate, rather than alleviate, her heart failure B. A higher dose of HCTZ will reduce the client's ability to produce concentrated urine C. Increased use of HCTZ will have a paradoxical effect of reducing diuresis D. A higher dose of HCTZ will not result in increased diuresis

D. A higher dose of HCTZ will not result in increased diuresis

The nurse is educating a patient about proper foot care. Which instruction does the nurse include in the teaching plan? A. Always use a pumice stone on callused areas of the feet. B. Use a heavy moisturizing cream on the feet at all times. C. Wash feet in cold water only. D. Always have a podiatrist cut toenails.

D. Always have a podiatrist cut toenails.

A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon? A. Antitussives liquefy bronchial secretions while expectorants assist in the expectoration of those secretions. B. Antitussives kill cold viruses while expectorants liquefy bronchial secretions. C. Both drug types loosen bronchial secretions for ease of removal. D. Antitussives suppress coughing while expectorants loosen bronchial secretions.

D. Antitussives suppress coughing while expectorants loosen bronchial secretions.

A 6-year-old client, with a history of asthma, presents at the primary care office with an elevated temperature, bilateral ear pain, and irritability. What instructions should the nurse convey to the parents regarding the use of antipyretics and analgesics? A. Administer half the recommended dose for the first 2 days. B. Avoid administering any analgesic if the fever is less than 102 degrees F. C. Administer only nonsteroidal anti-inflammatory drugs (NSAIDs) for fever and discomfort. D. Avoid administering acetaminophen for fever and discomfort.

D. Avoid administering acetaminophen for fever and discomfort.

A nurse is caring for a patient who is "nothing by mouth" (NPO) before surgery scheduled at 10:00 AM. He routinely receives 30 units of Humulin 70/30 every morning at 7:00 AM. What is the appropriate nursing action in this situation? A. Administer 30 units of Humulin 70/30 subcutaneously. B. Hold the insulin because the patient is NPO. C. Give the patient a light breakfast and administer the insulin as ordered. D. Contact the physician for a presurgery insulin order

D. Contact the physician for a presurgery insulin order

The nurse caring for a patient with diabetes mellitus has lipodystrophy of the abdomen. What should the nurse assess? A. Does the patient administer the injection at a 45-degree angle? B. Does the patient aspirate for blood prior to giving the injection? C. Does the patient pinch the skin appropriately? D. Does the patient rotate sites for giving each injection?

D. Does the patient rotate sites for giving each injection?

A 50-year-old client is unsure whether his or her symptoms are attributable to a cold or to allergies, so he/she is taking pseudoephedrine as well as an antihistamine. This combination of drugs creates a risk for what adverse effect? A. Respiratory depression B. Hepatotoxicity C. Acute kidney injury D. Hypertension

D. Hypertension

When a 53-year-old client presents with ascites, secondary to cirrhosis, a low-dose combination diuretic therapy is prescribed. When the client's urine output fails to increase, what would be the expected action related to the diuretic dosage? A. Decrease the dose. B. Increase the dose. C. Discontinue the diuretics. D. Leave the dose the same.

D. Leave the dose the same.

A client has refused a scheduled dose of metformin, stating that he/she is worried about inducing hypoglycemia because his/her blood glucose level is currently 6 mg/dL. The nurse should convey what teaching points to the client? A. If the client has been taking metformin for more than 3 to 4 weeks, there is no risk for hypoglycemia. B. Hypoglycemia is only a risk in clients with type 1 diabetes. C. Overuse of metformin creates a risk for hyperglycemia, not hypoglycemia. D. Metformin does not cause hypoglycemia.

D. Metformin does not cause hypoglycemia.

A client prescribed metformin is scheduled to undergo diagnostic testing with the administration of parenteral radiographic contrast media containing iodine. What fact should direct the nurse's plan of care for this client? A. The metformin will be temporarily substituted for with insulin, to address the risk of potential kidney failure. B. The client will be prescribed an extra dose of metformin to address the contrast material's effect on the body. C. The client needs to be encouraged to drink 1 to 2 L of water to flush the contrast media out of the kidneys. D. Metformin should be discontinued at least 48 hours before and after diagnostic tests that use contrast medias.

D. Metformin should be discontinued at least 48 hours before and after diagnostic tests that use contrast medias.

Based on the action of pramlintide, which of the following is a primary nursing intervention? A. Administer glucagon during the peak of action. B. Assess blood sugar at 2.4 hours after medication administration. C. Assess respiratory status for the onset of an upper respiratory infection. D. Provide a meal immediately after the administration of the subcutaneous injection.

D. Provide a meal immediately after the administration of the subcutaneous injection.

A client was diagnosed with type 2 diabetes several months ago and has presented for a scheduled follow-up appointment. Which state behavior most clearly indicates that the client has established effective health maintenance? A. The client tells the nurse that he/she has gone on a diet. B. The client can describe the differences between type 1 and type 2 diabetes. C. The client exercises two to three times per week. D. The client frequently checks his/her blood glucose levels.

D. The client frequently checks his/her blood glucose levels.

A 68 year old man who has been well controlled on theophylline for 2 years complains of insomnia, nervousness, nausea and vomiting, tachycardia. He originally thought the nervousness was due to his recent smoking cessation. He had smoked one pack per day for 10 years. The nurse practitioner assess the patient and tells him that he is likely experiencing theophylline toxicity. A serum theophulline level confirms diagnosis. What is the best explanation for the theophylline toxicity in this patient? A. Because of his age, the patient is likely having renal insufficiency B. The patient is not taking the medication as prescribed C. A concurrent medication is altering the metabolism of theophylline D. The metabolism of theophlline has decreased with the recent smoking cessation.

D. The metabolism of theophlline has decreased with the recent smoking cessation.

Meglitinides should be administered at what time? A. 30 minutes before the meal B. 1 hour before the meal C. 1 hour after the meal D. Within only a few minutes before eating a meal

D. Within only a few minutes before eating a meal

The nurse's assessment should prioritize what system when caring for a client who has just been admitted for an overdose of pseudoephedrine? A. Renal B. Gastrointestinal C. Neurological D. Cardiovascular

D. cardiovascular

Upon visit to a primary care physician's office, your client presents with a 14 lb weight gain since his or her visit 3 weeks ago. His or her lower extremities are quite swollen, and his or her facial features are puffy. By what mechanism should the prescribed diuretic decrease the client's onboard fluid? A. serum sodium depletion B. increase capillary permeability C. increased venous hydrostatic pressure D. decreasing plasma volume

D. decreasing plasma volume

When providing care for older adults who are taking furosemide on a regular basis, the nurse should prioritize assessments that are relevant to what health problem? A. hypernatremia B. urinary retention C. dysrhythmias D. dehydration

D. dehydration

In explaining options for antihistamine medications to a patient, second generation H1 antagonists differ from first generation H1 antagonists in that they A. cause greater central nervous system sedation B. are available only by prescription C. are less expensive D. do not cross the blood brain barrier

D. do not cross the blood brain barrier

A patient with DKA is admitted to the hospital. Which of the following does the nurse expect to see? A. increased pH and increased heart rate B. increased respiratory rate and decrease in urine output C. elevated potassium and increase in blood pressure D. elevated blood glucose and decreased plasma bicarbonate

D. elevated blood glucose and decreased plasma bicarbonate

A patient who has just arrived at the emergency department may be suffering from diabetic ketoacidosis. Which of the following would confirm the diagnosis? A. elevated serum potassium B. increased respiratory rate C. increased pH D. elevated blood glucose level and low plasma bicarbonate level

D. elevated blood glucose level and low plasma bicarbonate level

Which diuretic will most likely be the initial drug of choice when a client demonstrates dyspnea related to pulmonary edema? A. spironolactone B. mannitol C. hydrocholorothiazide D. furosemide

D. furosemide

Which of the following insulins cannot be administered in a continuous subcutaneous insulin infusion pump? A. regular insulin B. insulin aspart C. insulin glulisine D. insulin glargin

D. insulin glargin

A client's current condition requires rapid reduction of blood sugar levels. Which of the following types of insulin will have the most rapid onset of action? A. Humulin 70/30 B. isophane (NPH) C. Humulin R D. insulin lispro

D. insulin lispro

Rosiglitazone is being considered for the treatment of diabetes in an adult male client. Before the initiation of rosiglitazone therapy, the nurse should review what laboratory work recently drawn? A. platelet count B. D-dimer C. dreatinine D. liver enzymes

D. liver enzymes

A patient with type 2 diabetes is scheduled to have a cardiac catheterization in 1 week, and the nurse makes a preprocedure phone call. The nurse instructs the patient to stop taking which medication 2 days before the procedure? A. sitagliptin B. insulin C. glyburide D. metformin

D. metformin

A patient receives IV furosemide 80 mg for symptoms of severe heart failure. The nurse recognizes that administering the drug slowly by IV push reduces the likelihood of which of the following adverse effects of drug therapy? A. hyponatremia B. hypokalemia C. fluid volume deficit D. ototoxicity

D. ototoxicity

An adult client with multiple chronic health problems has been prescribed furosemide in the management of hypertension. When reviewing this client's current medication administration record, what drug should signal the nurse to a potentially increased risk of hypokalemia? A. ibuprofen B. vitamin D C. calcium carbonate D. prednisone

D. prednisone

What substance is reabsorbed in the ascending limb of the loop of Henle? A. water B. amino acids C. glucose D. sodium

D. sodium

According to the National Asthma Education and Prevention Program (NAEPP) Expert Panel Guidelines, a client prescribed a short-acting beta2 agonist may take this medication how often during an acute exacerbation of asthmatic symptoms? A. every 5 minutes to a maximum of three doses B. hourly, with no more than six doses in a 24-hour period C. every 30 seconds until symptoms subside D. up to three treatments at 20-minute intervals

D. up to three treatments at 20-minute intervals