Practice (mistakes) makes perfect!!

The nurse auscultates the lung sounds of a client with shortness of breath. Then the nurse notifies the HCP about the adventitious sound heard. which medication prescription should the nurse anticipate 1. Bumetanide 2.Methylprednisolone

1. Bumetanide ( coarse crackles are present when fluid or mucus collects in the lower respiratory tract eg. pulmonary edema. loop diuretics treat pulmonary edema. )

a nurse is reinforcing teaching with a client who has systemic lupus erythematosus & a new prescription for oral glucocorticoid therapy. Which of the following client statements indicates an understanding of the teaching? 1. I should take a calcium supplement while on this medication. 2. I have to complete regular liver function studies while I am taking this medication.

1. I should take a calcium supplement while on this medication. ( An adverse effect of systemic glucocorticoid therapy is osteoporosis)

an unaccompanied 16 year old female comes to the emergency department with severe abdominal pain & vomiting. the client has a temp. of 102.2 & a pulse of 120/min & is lethargic. the client's parents are out of town, & no guardians can be reached. how should this client's care be handled? 1. administer care until the parents or guardians can be reached. 2. perform a pregnancy test to see if the client qualifies as an emancipated minor.

1. administer care until the parents or guardians can be reached. (an unaccompanied minor should be treated if the medical condition is an emergency.)

the client has been diagnosed with acute pericarditis. ? potential intervention. select all that apply. 1. administer colchicine 2. administer nitroglycerin 3.maintain supine positioning 4.administer high-dose aspirin 5.encourage frequent use of an incentive spirometer

1. administer colchicine 4.administer high-dose aspirin

a nurse is reinforcing teaching with a female client who has a new prescription for pravastatin to treat hyperlipidemia. which of the following pieces of information should the nurse include in the teaching? 1. pravastatin can be taken with grapefruit juice. 2. pravastatin can be continued during pregnancy. 3.pravastatin should be taken with the morning meal.

1. pravastatin can be taken with grapefruit juice.(unlike other statins, such as lovastatin, simvastatin, is not affected by CYP3A4 inhibitors) (3.taking it in the evening is recommended)

vaginal delivery resulted in a stillborn infant. ? actions by the nurse is the most important 1.be available to the client to listen to expression of grief 2.check client's perineal pad frequently for excess bleeding

1.be available to the client to listen to expression of grief

a nurse is reinforcing teaching about the adverse effects of baclofen with a client who has multiple sclerosis with spasms. Which of the following statements should the nurse identify as an indication that the client understands the information? 1. adverse effects include urinary frequency 2. I should not stop taking this medication suddenly

2. I should not stop taking this medication suddenly (adverse effects associated with abrupt withdrawal of baclofen such as visual hallucinations, seizures. (1. it can cause urinary retention.)

the Lpn is caring for clients in the GYN clinic. A client reports an off-white vaginal discharge with a curdlike appearance & vulvar itching. The Lpn observe the discharge & vulvular erythema. It would be most important for the Lpn to ask which questions? 1.Are you sexually active? 2.what kind of birth control do you use?

2.what kind of birth control do you use? (oral contraceptives predispose individuals to candidiasis) (candidiasis NOT usually sexually transmitted)

the client's chest tube is reinserted & connected to a new water seal drainage system. which of the following observations require follow up with the health care provider? select all that apply 1. diminished breath sounds on the right side of the chest 2. pleuritic chest pain on deep inspiration 3. 150 ml sanguineous output 1 hour after chest tube reinsertion 4. continuous bubbling in the water seal chamber

3. 150 ml sanguineous output 1 hour after chest tube reinsertion (indicate possible hemorrhage from the stab wound or a complication of chest tube reinsertion eg lung rupture) 4. continuous bubbling in the water seal chamber (1.expected finding until the affected lung reexpands. 2.tension pneumothorax & chest tubes cause pleuritic pain)

A nurse is assisting with the admission of a client who has atrial fibrillation with a HR 155/min. The nurse should anticipate a prescribed from the provider for which of the following? 1. Vasopressin 2.Atropine 3.Diltjazem

3.Diltjazem ( is an antiarrhythmic agent that reduces the ventricular rate in atrial fibrillation ) (1. is a vasopressor agen that is administered to treat cardiac arrest & asystole. 2. is an antiarrhythmic agent that is administered to accelerate the HR to treat sinus bradycardia & heart block.)

the Lpn is observing that a client's radial pulse is now 56 beats per minute. It was 72 beats per minute 4 hours ago. what is the most appropriate action for the Lpn to take? 1.Check the oxygen saturation level 2.begin oxygen at 2 L/ minute by nasal cannula. 3.obtain the client BP.

3.obtain the client BP. (cardiac output & blood pressure decrease, decreasing blood flow to the brain & other vital organs & increasing the risk of organ damage)

the new nurse is reinforcing teaching for a client who is scheduled for electroconvulsive therapy (ECT). which of the following statement by the new nurse would require the charge nurse to intervene? 1. be sure to take your valproic acid prior to the procedure. 2.you should avoid eating 8 hours prior to the procedure.

1. be sure to take your valproic acid prior to the procedure.( prior to the procedure, the client receives a general anesthetic & muscle relaxant to prevent uncontrolled seizure activity. Valproic acid is an anticonvulsant drug & inhibit the therapeutic effect of ECT )

the nurse working in a gastrointestinal clinic is reviewing the list of clients. which client should the nurse see first? 1. client reporting constipation since having a barium enema 3 days ago 2.client with ulcerative colitis reporting 2-3 loose, bloody stools per day for the past 2 days.

1. client reporting constipation since having a barium enema 3 days ago ( barium is a contrast medium that aides in the visualization of tumors. retention of barium can cause bowel obstruction, resulting in severe complication such as bowel perforation & peritonitis) (2.expected finding in clients with ulcerative colitis)

the staff nurse caring for a client with a history of substance use disorder. " my client constantly requests more oxycodone elixir. I gave a cup of cherry flavored syrup and told the client it was oxycodone, because it wasn't time for another dose" which action by the charge nurse is the priority at this time. 1. instruct the nurse to notify the health care provider about the lack of pain relief. 2. follow institutional protocol for filing an incident or variance report.

1. instruct the nurse to notify the health care provider about the lack of pain relief.

the nurse is reinforcing teaching to the caregiver of a client with a new prescription for risperidone. which statement indicates that the caregiver needs further instructions? 1. it is normal for the client to become shaky and restless when agitated. 2. I will not worry if the client sleeps more often while taking this medication.

1. it is normal for the client to become shaky and restless when agitated.

a nurse is reviewing the medical records of a client who is scheduled for induction of labor & has a prescription for misoprostol. Which of the following conditions should the nurse identify as a contraindication to administering this medication? 1. past cesarean delivery 2. preeclampisa

1. past cesarean delivery (misoprostol is used for cervical ripening & induction of labor. It causes a higher incidence of uterine tachysystole. -risk of uterine rupture)

the Lpn is caring for a client who had a thyroidectomy 12 hours ago for treatment of Graves disease. The Lpn would be most concerned if which were observed? 1.the client spontaneously flexes the wrist when the BP cuff is inflated during BP measurement. 2.the client becomes drowsy and reports a sore throat.

1.the client spontaneously flexes the wrist when the BP cuff is inflated during BP measurement. ( carpal spasms indicate hypocalcemia ) (2.expected outcome after surgery)

the nurse is reinforcing self-care & medication teaching for a client diagnosed with vaginal candidiasis who has been prescribed miconazole vaginal cream. which statement by the client indicate that further teaching is needed? 1. i should choose loose fitting cotton underwear instead of nylon undergarments. 2.I'll refrain from having sex until my partner is also tested & treated for the infection

2.I'll refrain from having sex until my partner is also tested & treated for the infection (unnecessary with C albicans infection because it is not commonly transmitted through sex contact)

for which client is most important for the nurse to reinforce teaching regarding ways t prevent the spread of the condition? 1.client with oral candidiasis 2.client with tinea corporis

2.client with tinea corporis (ringworm is a fungal infection of the skin often transmitted from one person to another or from an infected animal to human)

the nurse is caring for a client with non-Hodgkin lymphoma who is starting chemotherapy. which of the following findings should alert the nurse that the client is developing the potential complication of tumor lysis syndrome? 1. generalized edema & hyponatremia 2.hyperkalemia & hyperuricemia

2.hyperkalemia & hyperuricemia ( client with TLS develop significant imbalances of serum electrolytes & metabolites)

a newly admitted client with a history of seizures suddenly says to the Lpn, "I hear drums." which should the Lpn do first? 1.continue to question the client about the drum sound 2.insert an oral airway in the client

2.insert an oral airway in the client ( many adult clients experience unusual sensory perceptions before the onset of a seizure. an oral airway prevents the client from biting cheek or tongue during a seizure)

a client recovering from a laparoscopic laser cholecystectomy says to the Lpn, "I hate the thought of eating a low-fat diet for the rest of my life." which response by the Lpn is most appropriate? 1. what do you think is so bad about following a low fat diet 2.it may not be necessary for you to follow a low-fat diet for that long 3.at least you will be alive & not suffering that pain

2.it may not be necessary for you to follow a low-fat diet for that long(fat restriction is usually lifted as the client tolerates fat; biliary ducts dilate sufficiently to accommodate bile volume that was held by the gallbladder)(1.does not respond directly to the client 3.nontherapeutic and judgmental)

the nurse accidentally administered orally dissolving mirtazapine through a client's percutaneous endoscopic gastrostomy tube instead of the prescribed sublingual route. After assessing the client for adverse reactions, what is the nurse's priority action ? 1.inform the nurse manager about the error. 2.notify the prescribing health care provider

2.notify the prescribing health care provider (medication errors are events that may lead to client harm)

a client begins to breathe very rapidly. which action by the Lpn would be the most appropriate? 1.measure the client's BP & pulse 2.obtain the client's oxygen saturation level

2.obtain the client's oxygen saturation level (1.initial data collection should be directed at respiratory data)

the nurse is reviewing the medical history of a client who has sustained a right tibia/fibula fracture form the fall. the nurse identifies which finding as most likely to hinder healing? 1.family history of osteoporosis. 2.peripheral arterial disease

2.peripheral arterial disease ( decreased perfusion to the extremities. the bone is not supplied with the oxygen and nutrients required for healing)

The nurse administers ondansetron to a hospitalized client. Which statement would indicate the ondasetron was effective? 1. my diarrhea has decreased 2.the nausea is a lot better

2.the nausea is a lot better

1 day old client diagnosed with intrauterine growth retardation has a high-pitched shrill cry & appears restless & irritable. The Lpn also observes fist-sucking behavior. Base on this data, which action should the Lpn take first ? 1.gently massage the client's back every 2 hours. 2.tightly swaddle the client in a flexed position. 3.schedule feeding times every 3 to 4 hours.

2.tightly swaddle the client in a flexed position. (promotes client's comfort and security.)(1.may result in overstimulation;3.small frequent feedings are preferable)

the clinic nurse is caring for a 76 year old client who has heart failure & is experiencing sudden weight gain & orthopnea. Which question would be the most beneficial for the nurse to ask at this time? 1. do you check your HR before taking your medication? 2.when are you taking each of your medication?

2.when are you taking each of your medication? (sucralfate should be taken at least 2 hours after digoxin administration, because taking these medications at the same time can result in decrease digoxin absorption)

the nurse suspects the client is experiencing cardiac tamponade & measure the client's BP. which finding does the nurse expect? 1.decrease in systolic BP during inspiration 2.difference in BP between the upper & lower extremities

1.decrease in systolic BP during inspiration

the nurse understands that which factor increase a client's risk for experiencing atypical symptoms of myocardial infarction? 1.female sex 2.history of smoking

1.female sex ( client with atypical presentation have associated symptoms with NO ischemic chest pain. older adult and/or clients of the female sex are at greater risk for atypical presentation during an MI. )term-9

the experienced nurse on a medical surgical unit is supervising a new nurse who is caring for a client with constipation. which action by the new nurse would cause the experienced nurse to intervene? 1.request coffee to be included with breakfast trays 2.leave the client alone during restroom use

1.request coffee to be included with breakfast trays (the client should avoid caffeinated beverage because they promote diuresis, which may lead to dehydration and worsening of constipation.)

the Lpn is caring for a pediatric client in a leg cast for treatment for a right ankle fracture. It is most important for the Lpn to reinforce which activity after discharge? 1.the client performs isometric exercises of the right leg 2.the parent elevates the right leg on several pillows

1.the client performs isometric exercises of the right leg (contraction of muscle without moving joint; promotes venous return and circulation, prevents thrombi; quadriceps setting and gluteal setting) (2.unneccessary)

the nurse is caring for a client with darkly pigmented skin who has immune thrombocytopenia. which locations are best to monitor for the presence of petechiae? 1.palms of the hands & soles of the feet 2.nail beds of the fingers & toes 3.buccal mucosa & conjunctivae of the eyes

3.buccal mucosa & conjunctivae of the eyes

prescribed phenytoin 100mg PO qid for the client. prior to administering the second dose, the LPN/LVN observes that the client appears lethargic & has nystagmus and slurred speech. In addition to notifying the supervising RN, the Lpn should do which of the following ? A.withhold the phenytoin due to signs of an allergic reaction B.withhold the phenytoin because the client shows signs of toxicity

B.withhold the phenytoin because the client shows signs of toxicity