Obesity and Pharmacology Review- PREP U

A client being seen in the emergency department has labored respirations. Auscultation reveals inspiratory and expiratory wheezes. Oxygen saturation is 86%. The client was nonresponsive to an albuterol (Ventolin) inhaler and intravenous methylprednisolone (Solu-Medrol). The nurse administers the following prescribed treatment first: A. Oxygen therapy through a non-rebreather mask B. Intravenous magnesium sulfate C. Oral fluid of at least 2500 mL/day D. Normal saline 0.9% at 100 mL/hr intravenously

A. Oxygen therapy through a non-rebreather mask

The nurse observes that a client admitted with asthma is anxious, has audible wheezing, and is using the neck muscles when breathing. What actions would be appropriate? A. Position in high Fowler's position and administer an albuterol sulfate inhaler. B. Position in a semi-prone position and encourage deep breathing. C. Position in Fowler's position and administer oxygen. D. Position in orthopneic position and encourage the client to calm down.

A. Position in high Fowler's position and administer an albuterol sulfate inhaler.

A school nurse is assessing an obese 10-year-old child who wants to lose weight. Which of the following questions would be most important for the nurse to ask to develop a realistic plan of care? A. "At what age did you notice your weight starting to increase?" B. "What kinds of foods do your parents serve at meal times and for snacks?" C. "What is the significant medical history in your family?" D. "Do you have friends who can support you while you try to lose weight?"

B. "What kinds of foods do your parents serve at meal times and for snacks?"

A nurse caring for a patient who has had bariatric surgery is developing a teaching plan in anticipation of the patient's discharge. Which of the following is essential to include? A. Drink a minimum of 12 ounces of fluid with each meal. B. Eat several small meals daily spaced at equal intervals. C. Sit upright when eating and for 30 minutes afterward. D. Choose foods that are high in simple carbohydrates.

B. Eat several small meals daily spaced at equal intervals.

Which of the following dietary guidelines should be followed following bariatric surgery? Select all that apply. A. Eat and drink at the same time. B. Eat slowly. C. Eat three meals per day. D. Total meal size should be 1 cup. E. Include two protein snacks per day.

B. Eat slowly. C. Eat three meals per day. E. Include two protein snacks per day.

An older client with diabetes who has been maintained on metformin has been scheduled for a cardiac catheterization. The nurse should verify that the health care provider (HCP) has written a prescription to: A. limit the amount of protein in the diet prior to the cardiac catheterization. B. withhold the metformin prior to the cardiac catheterization. C. give the metformin before breakfast. D. administer the metformin with only a sip of water prior to the cardiac catheterization.

B. withhold the metformin prior to the cardiac catheterization.

A client with asthma who has wheezing and shortness of breath asks the nurse if it is all right to use the salmeterol inhaler during exercise. What is the nurse's best response? A. "Use the inhaler 5 minutes before you exercise to prevent the wheezing." B. "This inhaler is for allergic rhinitis, not asthma." C. "No, this drug is a maintenance drug, not a rescue inhaler." D. "Yes, use the inhaler immediately for these symptoms."

C. "No, this drug is a maintenance drug, not a rescue inhaler."

A patient comes to the bariatric clinic to obtain information about bariatric surgery. The nurse assesses the obese patient knowing that in addition to meeting the criterion of morbid obesity, a candidate for bariatric surgery must also demonstrate what? A. Insight into why past weight loss efforts failed B. Positive body image and high self-esteem C. Adequate understanding of required lifestyle changes D. Knowledge of the causes of obesity and its associated risks

C. Adequate understanding of required lifestyle changes

A nurse administers albuterol, as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect? A. Dilated and reactive pupils B. Heart rate of 100 beats/minute C. Respiratory rate of 22 breaths/minute D. Urine output of 40 ml/hour

C. Respiratory rate of 22 breaths/minute

Which of the following is included as a dietary guideline for a patient who has had bariatric surgery? A. Limit soda to 1 can per day. B. Eat four small meals a day. C. Restrict total meal size to less than 1 cup. D. Make sure to drink liquids while eating.

C. Restrict total meal size to less than 1 cup.

For a client with asthma, the health care provider (HCP) prescribes albuterol, two puffs twice a day via MDI, and beclomethasone, two puffs twice a day via MDI. The nurse should instruct the client to administer: A. beclomethasone inhaler first and follow with albuterol. B. albuterol on awakening and alternate the medications every 4 hours. C. albuterol first and follow with beclomethasone 2 times a day. D. medications 1 hour apart, 2 times a day.

C. albuterol first and follow with beclomethasone 2 times a day.

At 11 p.m., a client is admitted to the emergency department. He has a respiratory rate of 44 breaths/minute. He's anxious, and wheezes are audible. The client is immediately given oxygen by face mask and methylprednisolone I.V. At 11:30 p.m., the client's arterial blood oxygen saturation is 86%, and he's still wheezing. The nurse should plan to administer: A. alprazolam. B. morphine. C. albuterol. D. propranolol.

C. albuterol.

A physician orders a beta2 adrenergic-agonist agent (bronchodilator) that is short-acting and administered only by inhaler. The nurse knows this would probably be A. Atrovent B. Foradil C. Isuprel D. Albuterol

D. Albuterol

A nurse is teaching a patient with asthma about Azmacort, an inhaled corticosteroid. Which adverse effects should the nurse be sure to address in patient teaching? A. Fatigue and decreased level of consciousness B. Dyspnea and increased respiratory secretions C. Nausea and vomiting D. Cough and oral thrush

D. Cough and oral thrush

Which of the following disorders, which is linked to obesity, is on the rise in the United States? A. Congestive heart failure B. Prostate cancer C. Asthma D. Diabetes

D. Diabetes

A client has intermittent asthma attacks. Which of the following therapies does the nurse teach the client to use at home when experiencing an asthma attack? A. Inhaled cromolyn sodium (Intal) B. Oxygen therapy C. Oral theophylline (Theo-Dur) D. Inhaled albuterol (Ventolin)

D. Inhaled albuterol (Ventolin)

Which of the following problems is associated with obesity, heavy snoring, and shallow breathing? A. Hypersomnia B. Narcolepsy C. Hyperpnea D. Sleep apnea

D. Sleep apnea

A nurse who provides care in a campus medical clinic is performing an assessment of a 21-year-old student who has presented for care. After assessment, the nurse determines that the patient has a BMI of 45. What does this indicate? A. The patient is mildly obese. B. The patient is overweight. C. The patient is a normal weight. D. The patient is extremely obese.

D. The patient is extremely obese.

To reduce the risk of developing type 2 diabetes mellitus the nurse should instruct the client to: A. obtain a high-cholesterol diet. B. stop cigarette smoking. C. prevent hypertension. D. maintain weight in normal limits.

D. maintain weight in normal limits

The nurse is caring for a patient after bariatric surgery who experiences symptoms of gastric outlet obstruction. Which of the following are contraindicated? A. Surgical revision B. Endoscopic procedure C. Balloon dilation D. NG tube

D. NG tube

A patient is learning about his new diagnosis of asthma with the asthma nurse. What medication has the ability to prevent the onset of acute asthma exacerbations? A. Montelukast (Singulair) B. Albuterol sulfate (Ventolin) C. Epinephrine D. Diphenhydramine (Benadryl)

A. Montelukast (Singulair)

A client is experiencing an acute asthmatic attack. Prior to treatment with levalbuterol, respirations were 40 breaths per minute, pulse 132 beats per minute, oxygen saturation 86% on room air, and with audible wheezing. Which findings indicate achievement of the desired outcome of asthma treatment? A. pulse 96 bpm and SpO2 92% on room air B. decreased peak expiratory flow (PEF) rate C. wheezing inaudible with diminished breath sounds D. inspiratory cycle twice as long as the expiratory cycle

A. pulse 96 bpm and SpO2 92% on room air

A child is being discharged with albuterol nebulizer treatments. The nurse should instruct the parents to watch for: A. tachycardia. B. urine retention. C. constipation. D. bradypnea.

A. tachycardia.

When a client reports being allergic to amoxicillin even though the medication administration record and armband do not indicate medication allergies, the nurse should: A. withhold the amoxicillin. B. call the family to verify the client's statement. C. administer another, similarly acting antibiotic. D. administer the prescribed medication.

A. withhold the amoxicillin.

Which of the following medications are classified as leukotriene modifiers (inhibitors)? Select all that apply. A. Zileuton (Zyflo) B. Zafirlukast (Accolate) C. Tiotropium (Spiriva) D. Montelukast (Singulair) E. Ipratropium HFA (Atrovent)

A. Zileuton (Zyflo) B. Zafirlukast (Accolate) D. Montelukast (Singulair)

A physician orders albuterol for a client with newly diagnosed asthma. When teaching the client about this drug, the nurse should explain that it may cause: A. nervousness. B. nasal congestion. C. lethargy. D. hyperkalemia.

A. nervousness.

A client with asthma has been prescribed beclomethasone via metered-dose inhaler. To determine if the client has been rinsing the mouth after each use of the inhaler, the nurse should inspect the client's mouth for: A. oral candidiasis. B. ulceration C. gingival hyperplasia. D. dental caries.

A. oral candidiasis.

Which of the following medications is considered a glitazone? A. Actos B. Glucovance C. Glucophase D. Glucophage

A. Actos

The health care provider has prescribed penicillin for a client admitted to the hospital for treatment of pneumonia. Prior to administering the first dose of penicillin, the nurse should ask the client: A. "Have you had any recent infections?" B. "Do you have a history of seizures?" C. "Do you have any cardiac history?" D. "Have you had a previous allergy to penicillin?"

D. "Have you had a previous allergy to penicillin?"

An adult client with type 2 diabetes is taking metformin 1,000 mg two times every day. After the nurse provides instructions regarding the interaction of alcohol and metformin, the nurse evaluates that the client understands the instructions when the client says: A. "Adverse effects I should watch for are feeling excessively energetic, unusual muscle stiffness, low back pain, and a rapid heartbeat." B. "If I feel bloated, I should call my health care provider." C. "If my health care provider approves, I may drink alcohol with my metformin." D. "If I know I will be having alcohol, I must not take metformin; I could develop lactic acidosis."

D. "If I know I will be having alcohol, I must not take metformin; I could develop lactic acidosis."

A patient has just been diagnosed with type 2 diabetes. The physician has prescribed an oral antidiabetic agent that will inhibit the production of glucose by the liver and thereby aid in the control of blood glucose. What type of oral antidiabetic agent did the physician prescribe for this patient? A. A thiazolidinedione B. An alpha glucosidase inhibitor C. A sulfonylurea D. A biguanide

D. A biguanide

The nurse is instructing the client on insulin administration. The client is performing a return demonstration for preparing the insulin. The client's morning dose of insulin is 10 units of regular and 22 units of NPH. The nurse checks the dose accuracy with the client. The nurse determines that the client has prepared the correct dose when the syringe reads how many units? Record your answer using a whole number.

32

A 10-year-old client with asthma is prescribed 2 mg of albuterol syrup four times per day. The syrup comes in a dosage strength of 2 mg/5 mL. How many milliliters of syrup should the nurse administer? Record your answer using a whole number.

5

A client is admitted with a diagnosis of diabetic ketoacidosis. An insulin drip is initiated with 50 units of insulin in 100 ml of normal saline solution administered via an infusion pump set at 10 ml/hour. The nurse determines that the client is receiving how many units of insulin each hour? Record your answer using a whole number.

5

Following are statements regarding medications taken by a patient diagnosed with COPD. Choose which statements correctly match the drug name to the drug category. Select all that apply. A. Albuterol is a bronchodilator. B. Decadron is an antibiotic. C. Bactrim is a bronchodilator. D. Prednisone is a corticosteroid. E. Ciprofloxacin is an antibiotic.

A. Albuterol is a bronchodilator. D. Prednisone is a corticosteroid. E. Ciprofloxacin is an antibiotic.

A patient who had bariatric surgery complains of diarrhea. The nurse recommends which of the following dietary changes? A. Increased fiber B. Increased protein C. Decreased carbohydrates D. Decreased fat

A. Increased fiber

Which of the following categories of oral antidiabetic agents exert their primary action by directly stimulating the pancreas to secrete insulin? A. Sulfonylureas B. Thiazolidinediones C. Alpha glucosidase inhibitors D. Biguanides

A. Sulfonylureas

As a nurse completes the admission assessment of a client admitted for gastric bypass surgery, the client states, "Finally! I'll be thin and able to eat without much concern." Which statement by the nurse would be most appropriate? A. "How do you feel recovery will be after surgery?" B. "Can you tell me your best understanding of the procedure?" C. "I can tell you are ready to sign the consent form and get this done." D. "You must be excited for that."

B. "Can you tell me your best understanding of the procedure?"

A 7-year-old client with type 1 diabetes is sick with the flu. What is the most important information for the nurse to convey regarding diabetes management during illness? A. Increase intake of fluids high in carbohydrate to prevent diarrhea. B. Blood glucose needs to be checked more frequently during illness. C. Children require less insulin when they are sick with the flu. D. Urine ketones should be checked every other day during illness.

B. Blood glucose needs to be checked more frequently during illness.

The physician orders 250 mg of a drug. The drug vial reads 500 mg/ml. How much of the drug should the nurse give? A. 1 ml B. 2 ml C. ½ ml D. ¼ ml

C. ½ ml