PN Fundamental v2 hesi, Medical-Surgical Drugs EAQ

What effect of povidone-iodine does a nurse consider when using it on the client's skin before obtaining a specimen for a blood culture?

Eliminates surface bacteria that may contaminate the culture

Health promotion efforts with the chronically ill client should include interventions related to primary prevention. What should this include?

Encouraging daily physical exercise

A client is admitted to the hospital for a subtotal thyroidectomy. When discussing postoperative drug therapy with the client, what will the nurse include in the teaching?

Report palpitations, nervousness, tremors, or loss of weight that may indicate an overdose of thyroid hormone.

What should a nurse teach the client to do to avoid lipodystrophy when self-administering insulin therapy?

Rotate injection sites.

Tissue plasminogen activator (t-PA) is to be administered to a client in the emergency department. Which is the priority nursing assessment?

Signs of bleeding

An older client who is receiving chemotherapy for cancer has severe nausea and vomiting and becomes dehydrated. The client is admitted to the hospital for rehydration therapy. Which interventions have specific gerontologic implications the LPN must consider? Select all that apply

Assessment of skin turgor Administration of antiemetic drugs Replacement of fluid and electrolytes

Which nursing activities are examples of primary prevention? Select all that apply.

Assisting with immunization program Stopping smoking

A nurse administers a parenteral preparation of potassium slowly and cautiously to avoid which complication?

Avoid cardiac arrest

The nurse is caring for a client who is receiving azathioprine, cyclosporine, and prednisone before receiving a kidney transplant. What does the nurse identify as the purpose of these drugs?

Reduce antibody production

A client is diagnosed with pulmonary tuberculosis, and the healthcare provider prescribes a combination of rifampin and isoniazid. The nurse evaluates that the teaching regarding the drug is effective when the client reports which action as most important?

"Continue taking the medicine even after I feel better."

Immediately after a bilateral adrenalectomy a client is receiving corticosteroids that are to be continued after discharge from the hospital. Which statement by the client indicates to the nurse that additional education is needed?

"I am glad that I only have to take the medication once a day."

The client who takes furosemide and digoxin reports that everything looks yellow. How will the nurse respond?

"I will hold the medication until I consult with your healthcare provider."

During a teaching session about insulin injections, a client asks the nurse, "Why can't I take the insulin in pills instead of taking shots?" What is the nurse's best response?

"Insulin is destroyed by gastric juices, rendering it ineffective."

The spouse of a client with an intracranial hemorrhage asks the nurse, "Why aren't they administering an anticoagulant?" How will the nurse respond?

"It is not advisable because bleeding will increase."

The nurse is administering lactulose to a client with a history of cirrhosis of the liver. The client asks the nurse why this medication is needed because the client is not constipated. How will the nurse respond?

"This medication helps you lower the high ammonia level caused by your liver disease."

The LPN/LVN plans care for a client with a somatoform disorder based on the understanding that the disorder is:

An unconscious means of reducing stress

A visitor comes to the nursing station and tells the nurse that a client and his relative had a fight and that the client is now lying unconscious on the floor. What is the most important action the LPN/LVN needs to take? A Ask the client if he is okay.

Ask security to make sure the room is safe

A LPN/LVN is taking care of a client who has severe back pain as a result of a work injury. What nursing considerations should be made when determining the client's plan of care? Select all that apply.

Ask the client what is the client's acceptable level of pain. Administer the pain medications regularly around the clock

A client is receiving morphine sulfate for severe metastatic bone pain. What will the nurse do to assess for complications from a common serious side effect of morphine?

Assess for altered breathing patterns

A nurse is caring for a postoperative client who has a nasogastric (NG) tube set to low intermittent suction. The nurse recalls that the primary reason that an intravenous infusion of 5% dextrose with 0.45% sodium chloride and 20 mEq of potassium has been prescribed is to prevent which complication?

Electrolyte imbalance

A client is admitted for dehydration, and an intravenous (IV) infusion of normal saline is started at 125 mL/hour. One hour later, the client begins screaming, "I can't breathe!" How should the nurse respond?

Elevate the head of the client's bed and obtain vital signs.

A toddler screams and cries noisily after parental visits, disturbing all the other children. When the crying is particularly loud and prolonged, the LPN puts the crib in a separate room and closes the door. The toddler is left there until the crying ceases, a matter of 30 or 45 minutes. Legally, how should this behavior be interpreted?

The child had a right to remain in the room with the other children

A client who is receiving phenytoin to control a seizure disorder questions the nurse regarding this medication after discharge. How will the nurse respond?

"Antiseizure drugs will probably be continued for life."

What should the nurse monitor when a client is receiving a platelet aggregation inhibitor such as clopidogrel?

Epistaxis

A LPN is teaching an adolescent about type 1 diabetes and self- care. Which questions from the client indicate a need for additional teaching in the cognitive domain? Select all that apply

what is diabetes and can you tell me how to use the glucose meter

A client with rheumatoid arthritis has been given a prescription for acetylsalicylic acid. The client asks the nurse, "What kind of drug is acetylsalicylic acid?" The nurse recalls that this drug has which property?

Analgesic

The LPN is preparing discharge instructions for a client who has begun to demonstrate signs of early Alzheimer dementia. The client lives alone. The client's adult children live nearby. According to the prescribed medication regimen the client is to take medications six times throughout the day. What is the priority nursing intervention to assist the client with taking the medication?

Contact the primary health care provider and discuss the possibility of simplifying the medication regimen

The nurse is providing postoperative care to a client who had a submucosal resection (SMR) for a deviated septum. The LPN should monitor for what complication associated with this type of surgery?

Expectoration of blood

A LPN/LVN cares for a client that has been bitten by a large dog. A bite by a large dog can cause which type of trauma?

Crush injury

A client who is taking rifampin tells the nurse, "My urine looks orange." What action will the nurse take?

Explain this is expected.

What therapeutic effect does the nurse expect to identify when mannitol is administered parenterally to a client with cerebral edema?

Decreased intracranial pressure

A client is admitted to the intensive care unit with acute pulmonary edema. Which diuretic does the nurse anticipate will be prescribed?

Furosemide

The triage LPN in the emergency department receives four clients simultaneously. Which of the clients should the nurse determine can be treated last?

Older adult male with a partially amputated finger

Client expresses concern about being exposed to radiation therapy because it can cause cancer. What should the LPN emphasize when informing the client about exposure to radiation?

Only a small part of the body is irradiated

In what position should the LPN/LVN place a client recovering from general anesthesia?

Side-lying

A nurse is providing discharge instructions about digoxin. Which response should a nurse include as a reason for a client to withhold the digoxin?

Blurred vision

A healthcare provider prescribes furosemide for a client with hypervolemia. The nurse recalls that furosemide exerts its effects in what part of the renal system?

Loop of Henle

A nurse is preparing to teach a client to apply a nitroglycerin patch as prophylaxis for angina. Which instruction should the nurse include in the teaching plan?

Remove a previous patch before applying the next one.

The LPN/LVN assesses a client's pulse and documents the strength of the pulse as 3+. The nurse understands that this indicates the pulse is:

normal.

A health care provider has prescribed isoniazid (Laniazid) for a client. Which instruction should the LPN give the client about this medication?

Drinking alcohol daily can cause drug-induced hepatitis

A nurse reviews a list of medications that have been prescribed for a client. The nurse is aware that it is unsafe to administer which medication as an intravenous (IV) bolus?

Potassium Chloride

Alternative therapy measures have become increasingly accepted within the past decade, especially in the relief of pain. Which methods qualify as alternative therapies for pain? Select all that apply

Prayer Hypnosis Aromatherapy Guided imagery

Which relationship does the nurse consider reflective of the relationship of naloxone to morphine sulfate?

Protamine sulfate to heparin

Enoxaparin 40 mg subcutaneously daily is prescribed for a client who had abdominal surgery. The nurse explains that the medication is given for what purpose?

Provide prophylaxis against postoperative thrombus formation

When a client files a lawsuit against a LPN for malpractice, the client must prove that there is a link between the harm suffered and actions performed by the nurse that were negligent. This is known as:

Proximate cause

A client diagnosed with tuberculosis is taking isoniazid. To prevent a food and drug interaction, the nurse should advise the client to avoid which food item?

Red wine

A client with rheumatoid arthritis asks the nurse why it is necessary to inject hydrocortisone into the knee joint. What reason should the nurse include in a response to this question?

Reduce inflammation

After a basal cell carcinoma is removed by fulguration, a client is given a topical steroid to apply to the surgical site. The nurse evaluates that the teaching regarding steroids and skin lesions is effective when the client identifies which action as the primary purpose of the medication?

Reduce inflammation at the surgical site

A nurse has administered sublingual nitroglycerin. Which parameter should the nurse use to determine the effectiveness of sublingual nitroglycerin?

Relief of anginal pain

A LPN/LVN is preparing a community health program for senior citizens. The nurse teaches the group that the physical findings that are typical in older people include:

An increase in body warmth and some swallowing difficulties if it has a better choice pls select

At 10 AM the nurse hangs a 1000-mL bag of D 5W with 20 mEq of potassium chloride to be administered at 80 mL/hr. At noon the healthcare provider prescribes a stat infusion of an intravenous (IV) antibiotic of 100 mL to be administered via piggyback over 1 hour. How much longer than expected will it take the primary bag to empty if the nurse interrupts the primary infusion to use the circulatory access for the secondary infusion of the antibiotic?

1 hour

To ensure the safety of a client who is receiving a continuous intravenous normal saline infusion, the LPN should change the administration set every

72 to 96 hours

A LPN is preparing to administer an ophthalmic medication to a client. What techniques should the nurse use for this procedure? Select all that apply.

A Clean the eyelid and eyelashes. . C Apply clean gloves before beginning of procedure. E Press on the nasolacrimal duct after instilling the solution.

A nurse receives a subpoena in a court case involving a child. The nurse is preparing to appear in court. In addition to the state Nurse Practice Act and the American Nursing Association (ANA) Code for Nurses, what else should the nurse review?

ANA Standards of Clinical Nursing Practice

A client who is obtunded has a blood pressure of 80/35 mm Hg after a blood transfusion. In an effort to support renal perfusion, the nurse administers dopamine at 2 mcg/kg/min as prescribed. What is the most relevant outcome indicating effectiveness of the medication for this client?

An increase in urinary output

A nurse is administering serum albumin intravenously to a client with ascites. In response to this therapy, what does the nurse expect to decrease?

Abdominal girth

A dying client is coping with feelings regarding impending death. The nurse bases care on the theory of death and dying by Kübler-Ross. During which stage of grieving should the LPN/LVN primarily use nonverbal interventions?

Acceptance

A client with type 1 diabetes mellitus has a finger stick glucose level of 258 mg/dL (14.3 mmol/L) at bedtime. A prescription for sliding-scale regular insulin exists. What should the nurse do?

Administer the insulin as prescribed

The LPN/LVN is preparing to administer eardrops to a client that has impacted cerumen. Before administering the drops, the nurse will assess the client for which contraindications? Select all that apply

Allergy to the medication Drainage from the ear canal Tympanic membrane rupture

The LPN/LVN recognizes that which are important components of a neurovascular assessment? Select all that apply.

B Capillary refill E Pulse and skin temperature F Movement and sensation

A LPN discusses the philosophy of Alcoholics Anonymous (AA) with the client who has a history of alcoholism. What need must self- help groups such as AA meet to be successful?

Belonging

A client with myasthenia gravis has been receiving neostigmine and asks about its action. What information about its action should the nurse consider when formulating a response?

Blocks the action of cholinesterase

What client response indicates to the nurse that a vasodilator medication is effective?

Blood pressure changes from 154/90 to 126/72 mm Hg

Following surgery, total parenteral nutrition is instituted via a central venous infusion. During the fourth hour of the infusion the client complains of nausea, fatigue, and a headache. The hourly urine output is twice the amount of the previous hour. After contacting the primary health care provider, what is the next action the nurse should take?

Check the serum glucose level.

A client is receiving doxorubicin as part of a chemotherapy protocol. The nurse should assess the client for which major life-threatening side effect of doxorubicin?

Cardiotoxicity

The LPN/LVN should instruct a client with an ileal conduit to empty the collection device frequently because a full urine collection bag may:

Cause the device to pull away from the skin

What should the nurse include in a teaching plan to help reduce the side effects associated with diltiazem?

Change slowly from sitting to standing.

A client residing in an assisted living facility is diagnosed with Parkinson disease, and the healthcare provider prescribes selegiline. What precaution will the nurse teach the client?

Change to a standing position slowly.

A client is receiving patient-controlled analgesia (PCA) after surgery. What does the nurse identify as the primary benefit with this type of therapy?

Client is able to self-administer pain-relieving drugs as necessary

The health care provider prescribes an oral hypoglycemic for the patient with type 2 diabetes. What will the nurse need to consider when developing the teaching plan?

Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control.

A client comes to the clinic complaining of a productive cough with copious yellow sputum, fever, and chills for the past two days. The first thing the LPN/LVN should do when caring for this client is to:

Collect a sputum specimen

A client who is receiving multiple medications for a myocardial infarction complains of severe nausea, and the client's heartbeat is irregular and slow. The nurse determines that these signs and symptoms are toxic effects of what drug?

Digoxin

While awaiting surgery, a client with a long history of Crohn disease is receiving total parenteral nutrition (TPN) on an outpatient basis. The nurse teaches the client that TPN helps to prepare for surgery by which process?

Decreasing fecal bulk

A client has been diagnosed as brain dead. The LPN/LVN understands that this means that the client has

Deep tendon reflexes only and no independent breathing

A client reaches the point of acceptance during the stages of dying. What response should the LPN/LVN expect the client to exhibit?

Detachment

What clinical indicators should the LPN/LVN expect a client with hyperkalemia to exhibit? Select all that apply

Diarrhea Weakness Dysrhythmias

An 85-year-old client has just been admitted to a nursing home. When designing a plan of care for this older adult the nurse recalls what expected sensory losses associated with aging? Select all that apply

Diminished sensation of pain Impaired hearing of high-frequency sounds

What type of interview is most appropriate when a LPN/LVN admits a client to a clinic?

Directive

A nurse is caring for a client who is receiving an intravenous (IV) infusion. What should the nurse do first if the IV infusion infiltrates?

Discontinue the infusion.

A client with arthritis is taking large doses of aspirin. What symptom does the nurse include when teaching the client about the clinical manifestations of aspirin toxicity?

Disturbances in hearing

A client with stage III Hodgkin disease is started on ABVD therapy, a multiple-drug regimen. The client asks why so many drugs need to be given all at once. Which is the best response by the nurse?

Each drug destroys the cancer cell at a different time in the cell cycle.

A client is undergoing diagnostic testing to determine if the client has myasthenia gravis. The nurse understands that the test that is most specific for determining the presence of this disease is what?

Edrophonium chloride test

A client with Hodgkin disease is placed on an ABVD combination chemotherapy regimen. Because doxorubicin is part of this therapy, what education will the nurse provide about this drug?

Expect urine to turn red for a few days after taking this drug.

When being interviewed for a position as a registered professional LPN, the applicant is asked to identify an example of an intentional tort. What is the appropriate response?

False imprisonment

Twenty-four hours after a cesarean birth, a client elects to sign herself and her baby out of the hospital. Staff members are unable to contact her health care provider. The client arrives at the nursery and asks that her infant be given to her to take home. What is the most appropriate nursing action?

Give the infant to the client and instruct her regarding the infant's care.

The spouse of a comatose client who has severe internal bleeding refuses to allow transfusions of whole blood because they are Jehovah's Witnesses. The client does not have a Durable Power of Attorney for Healthcare. What action should the LPN/LVN take?

Give the spouse a treatment refusal form to sign and notify the health care provider that a court order now can be sought

A LPN is caring for a client with an impaired immune system. Which blood protein associated with the immune system is important for the nurse to consider?

Globulin

A client is receiving combination chemotherapy for treatment of metastatic carcinoma. For which systemic side effect should the nurse monitor the client?

Leukopenia

To minimize the side effects of the vincristine (Oncovin) that a client is receiving, what does the LPN/LVN expect the dietary plan to include?

High in fluids

A client is receiving furosemide to relieve edema. The nurse should monitor the client for which response to the medication?

Hypokalemia

A client is admitted to the hospital for an adrenalectomy. The nurse is providing postoperative care before the client's replacement steroid therapy is regulated fully. The nurse should monitor the client for which complication?

Hypotension

What should the LPN/LVN consider when obtaining an informed consent from a 17-year-old adolescent?

If the client is allowed to give consent

A client with diabetes who is receiving long-term corticosteroid therapy is admitted to the hospital with leg ulcers. What increased risk does the nurse consider when assessing this client?

Inadequate wound healing

Which age-related change should the LPN/LVN consider when formulating a plan of care for an older adult? Select all that apply

Increased sensitivity to glare Diminished sensation of pain

A client with hyperthyroidism is to receive methimazole. What instructions does the nurse provide?

Initial improvement will take several weeks.

A LPN is reviewing studies to answer a clinical question as part of an evidence-based practice project. The study design determines the level of evidence. Place each methodology in order from the most reliable to the least reliable

Meta-analysis

A client is to have mafenide (Sulfamylon) cream applied to burned areas. For which serious side effect of mafenide therapy should the LPN/LVN monitor this client?

Metabolic acidosis

A client reports fatigue and dyspnea and appears pale. The LPN/ LVN questions the client about medications currently being taken. In light of the symptoms, which medication causes the nurse to be most concerned?

Methyldopa (Aldomet)

A postoperative client says to the nurse, "My neighbor, I mean the person in the next room, sings all night and keeps me awake." The neighboring client has dementia and is awaiting transfer to a nursing home. How can the LPN/LVN best handle this situation?

Move the neighboring client to a room at the end of the hall

Place each step of the nursing process in the order that it should be used.

Obtain client's nursing history. Correct State client's nursing needs. Correct Identify goals for care. Correct Develop a plan of care. Correct Implement nursing interventions.

A nurse is reviewing a plan of care for a client who was admitted with dehydration as a result of prolonged watery diarrhea. Which prescription should the LPN/LVN question

Parenteral albumin (Albuminar)

A client is admitted to the hospital after general paresis develops as a complication of syphilis. Which therapy should the nurse anticipate will most likely be prescribed for this client?

Penicillin therapy

A client asks about the purpose of a pulse oximeter. The LPN/LVN explains that it is used to measure the:

Percentage of hemoglobin-carrying oxygen

A client has an order for a sublingual nitroglycerin tablet. The nurse should teach the client to use what technique when self-administering this medication?

Place the pill under the tongue and let it dissolve.

The provider prescribes one unit of packed red blood cells to be administered to a client. To ensure the client's safety, which measure should the nurse take during administration of blood products?

Stay with client during first 15 minutes of infusion.

A client newly diagnosed with type 2 diabetes is receiving glyburide and asks the nurse how this drug works. What mechanism of action does the nurse provide?

Stimulates the pancreas to produce insulin

A client develops a maculopapular rash on the upper extremities and audible wheezing during the administration of intravenous vancomycin. To ensure the client's safety, which action would the nurse carry out first?

Stop infusion

A client with a hemoglobin level of 6.2 g/dL (62 mmol/L) is receiving packed red blood cells. Twenty minutes after the infusion starts, the client complains of chest pain, difficulty breathing, and feeling cold. What is the first action the nurse should take?

Stop the transfusion.

A LPN is caring for a client diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) in the urine. The health care provider orders an indwelling urinary catheter to be inserted. Which precaution should the nurse take during this procedure?

Surgical asepsis

A client who was exposed to hepatitis A asks why an injection of gamma globulin is needed. Before responding, what should the LPN consider about how gamma globulin provides passive immunity?

The antigen is neutralized by the antibodies that it supplies

During the initial physical assessment of a newly admitted client with a pressure ulcer, a LPN observes that the client's skin is dry and scaly. The nurse applies emollients and reinforces the dressing on the pressure ulcer. Legally, were the nurse's actions adequate?

The nurse provided supportive nursing care for the well-being of the client.

Following a surgery on the neck, the client asks the LPN why the head of the bed is up so high. The LPN should tell the client that the high-Fowler position is preferred for what reason?

To reduce edema at the operative site

A client with gastric ulcer disease asks the nurse why the health care provider has prescribed metronidazole. What purpose does the nurse provide?

To treat Helicobacter pylori infection

A client is receiving albuterol (Proventil) to relieve severe asthma. For which clinical indicators should the LPN monitor the client? Select all that apply.

Tremors and palpations

A nurse concludes that the simvastatin being administered to a client is effective. A decrease in what clinical finding supports this conclusion?

Triglycerides

A LPN/LVN who is working on a medical-surgical unit receives a phone call requesting information about a client who has undergone surgery. The nurse observes that the client requested a do not publish (DNP) order on any information regarding condition or presence in the hospital. What is the best response by the LPN/LVN?

We have no record of that client on our unit. Thank you for calling."

The LPN/LVN expects a client with an elevated temperature to exhibit what indicators of pyrexia? Select all that apply

flushed face and increase pluse rate