Review of Physiological Adaptation, Pharmacological Therapy, and Health As EAQ

Which part of the client's brain is primarily associated with life support and basic functions of the body? 1 Cerebrum 2 Brain stem 3 Cerebellum 4 Cerebral cortex

2 Brain stem The brainstem, which connects the brain to the CNS, is concerned primarily with life support and basic functions, such as breathing and movement. The cerebrum controls intelligence, creativity, and memory. The cerebellum is concerned with coordination of movement. The cerebral cortex is part of the cerebrum, which is involved with almost all of the higher functions of the brain.

What are the clinical manifestations of myocardial infarction in women? Select all that apply. 1 Anoxia 2 Indigestion 3 Unusual fatigue 4 Sleep disturbances 5 Tightness of the chest

2 Indigestion 3 Unusual fatigue 4 Sleep disturbances Indigestion, unusual fatigue, and sleep disturbances are clinical manifestations of myocardial infarction in women. Anoxia and tightness of the chest are clinical manifestations of angina pectoris, not myocardial infarction.

course crackles

Coarse crackles are series of long-duration, discontinuous, low-pitched sounds associated with pulmonary edema or pneumonia with severe congestion. They sound like air is blowing through a straw underwater and are caused by air passing through airways intermittently occluded by mucus, unstable bronchial walls, or folds of mucosa. Rhonchi are continuous rumbling, snoring, or rattling sounds that occur due to obstruction of large airways with secretions. Wheezes are continuous high-pitched squeaking or musical sounds that result from rapid vibration of bronchial walls. Pleural friction rubs are creaking or grating sounds caused by roughened, inflamed pleural surfaces rubbing together. They are associated with pleurisy, pneumonia, or a pulmonary infarct.

A client with a partial occlusion of the left common carotid artery is to be discharged while still receiving warfarin. Which clinical adverse effect should the nurse identify as a reason for the client to seek medical consultation? Select all that apply. 1 Presence of blood in urine (hematuria). 2 Bruising noted at various stages of healing. 3 Delayed clotting from minor cuts and scrapes. 4 Bleeding from gums when brushing teeth. 5 Vomiting coffee-ground emesis.

1 Presence of blood in urine (hematuria). 5 Vomiting coffee-ground emesis. Warfarin causes an increase in the prothrombin time and international normalized ratio (INR) level, leading to an increased risk for bleeding. Any abnormal or prolonged bleeding must be reported, because it may indicate an excessive level of the drug. Common side effects including bruising, delayed clotting and bleeding gums do not require immediate intervention. However, hematuria and hemoptysis are evidence of more serious bleeding and require immediate attention. Coffee-ground emesis is a sign of gastric bleeding. Even though the emesis is not bright red, it still requires immediate attention by a healthcare provider.

When caring for a client who has sustained a closed head injury, it is important that the nurse assess for which clinical indicator(s)? Select all that apply. 1 Slowing of the heart rate 2 Diminished carotid pulses 3 Bleeding from the oral cavity 4 Absence of deep tendon reflexes 5 Increased pulse pressure 6 Altered level of consciousness

1 Slowing of the heart rate 3 Bleeding from the oral cavity 5 Increased pulse pressure 6 Altered level of consciousness Increased intracranial pressure from bleeding into and swelling of tissues within the cranium results in a slowing of the heart rate, an increased pulse pressure (due to increasing systolic blood pressure with a sustained diastolic blood pressure), and an altered level of consciousness. Carotid circulation is not altered. Bleeding from the oral cavity can occur in this situation and should be assessed for the presence of cerebral spinal fluid (CSF). Spinal reflexes generally remain intact.

The nurse is creating a health promotion series for a local community. Which conditions should the nurse include in the program because they are the current leading causes of death in the United States? Select all that apply. 1 Stroke 2 Cancer 3 Diabetes 4 Accidents 5 Arthritis

1 Stroke 2 Cancer 3 Diabetes According to the Centers for Disease Control and Prevention (2016), the leading causes of death in the United States (US) included stroke, cancer, diabetes, and accidents. Heart disease, chronic lower respiratory diseases, Alzheimer's disease, influenza/pneumonia, and suicide are also included on the list. Arthritis is not a current leading cause of the death in the US, although it is a chronic disease that causes great suffering for client with the condition.

Which antipyretic medication may cause Reye syndrome in children? 1 Aspirin (Anacin) 2 Naproxen (Aleve) 3 Ibuprofen (Advil) 4 Dantrolene (Dantrium)

1 Aspirin (Anacin) Aspirin (Anacin) increases the risk of swelling in the brain and liver, which are the main symptoms of Reye syndrome in children. Therefore aspirin is not recommended in children. Drugs such as naproxen (Aleve) and ibuprofen (Advil) do not induce swelling in the brain and liver; therefore, these drugs may not cause Reye syndrome. Dantrolene (Dantrium) does not induce swelling in the brain and liver; instead, it decreases calcium levels during malignant hyperthermia conditions.

A child being treated with cardiac drugs developed vomiting, bradycardia, anorexia, and dysrhythmias. Which drug toxicity is responsible for these symptoms? 1 Digoxin 2 Nesiritide 3 Dobutamine 4 Spironolactone

1 Digoxin Digoxin helps improve pumping efficacy of the heart, but overdose can cause toxicity leading to nausea, vomiting, bradycardia, anorexia, and dysrhythmias. The side effects of nesiritide may include effects like headache, insomnia, and hypotension. Dobutamine does not cause nausea or vomiting but may cause hypertension and hypotension. Spironolactone may cause edema.Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple choice items. If you are uncertain about a question, eliminate the choices you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

A child who reports shortness of breath, wheezing, and coughing is found to have pulmonary edema and is prescribed furosemide. Which nursing interventions would be beneficial to the client? Select all that apply. 1 Administering the drug on an empty stomach 2 Checking the child's weight every day 3 Calculating the dose of drug as carefully as possible 4 Exposing the child to sunlight for increasing periods 5 Assessing the child regularly to help prevent electrolyte loss

2 Checking the child's weight every day 3 Calculating the dose of drug as carefully as possible 5 Assessing the child regularly to help prevent electrolyte loss The child's weight should be checked and recorded daily to aid in the assessment of therapeutic and adverse effects. Pediatric doses should be calculated carefully to prevent an accidental overdose. Pediatric clients are at greater risk of electrolyte loss; therefore, they require closer and more cautious assessment to help prevent hypertension and stroke. Furosemide may cause stomach upset if it is taken on an empty stomach; the child should be given the drug with food to help prevent gastric upset. A child taking diuretics should not be exposed to sunlight for long periods because this action may precipitate fluid volume loss and heatstroke.

The nurse is caring for a client with chronic pain who is on opioid treatment. The client has constipation, nausea, vomiting, level 3 sedation, respiratory rate of 8 breaths per minute, and pruritus. Which conditions of the client should the nurse consider as highest priority? Select all that apply. 1 Pruritus 2 Sedation 3 Constipation 4 Respiratory rate 5 Nausea and vomiting

2 Sedation 4 Respiratory rate Chronic use of opioids for pain may lead to constipation, nausea, vomiting, sedation, and respiratory distress. The client with a level 3 of sedation has frequent drowsiness, arousals, and episodes of sleep during conversation and needs immediate intervention. A respiratory rate of 8 breaths per minute leads to respiratory distress, which must be supported by adequate oxygenation. Pruritus can be resolved slowly because it is less life threatening. Constipation can be relieved by providing the client with stimulant laxative and a stool softener. Nausea and vomiting may be resolved by providing antiemetics to the client.

The X-ray report of a client indicates a reduction in the alveolar surface area. Which condition can be inferred from this finding? 1 Acinus 2 Atelectasis 3 Hemoptysis 4 Histoplasmosis

2 Atelectasis Atelectasis, a condition that involves alveolar collapse, may occur due to the absence of surfactants. This condition causes a reduction in the alveolar surface area, which in turn reduces the gas exchange. The structural unit consisting of a respiratory bronchiole, an alveolar duct, and an alveolar sac is known as an acinus. Histoplasmosis is a fungal disease caused by the inhalation of contaminated dust. Hemoptysis is blood in the sputum.

The nurse is preparing a blood transfusion for a client with renal failure. Why does anemia often complicate renal failure? 1 Increase in blood pressure 2 Decrease in erythropoietin 3 Increase in serum phosphate levels 4 Decrease in serum sodium concentration

2 Decrease in erythropoietin The hormone erythropoietin, produced by the kidneys, stimulates the bone marrow to produce red blood cells. In renal failure there is a deficiency of erythropoietin that often results in the client developing anemia. Therefore the nurse is instructed to administer blood. In renal failure, increased blood pressure is due to impairment of renal vasodilator factors and is not treated by administration of blood. Phosphate is retained in the body during renal failure, causing binding of calcium leading to done demineralization, not anemia. Increase in urinary sodium concentration and decrease in serum sodium concentration trigger the release of renin from the juxtaglomerular cells.

A registered nurse teaches a nursing student about the physiologic changes that occur during pregnancy and their impact on drug disposition and dosing. Which statement of the nursing student indicates the need for further education? 1 Drug elimination is increased. 2 The hepatic metabolism of a drug is decreased. 3 The intestinal transit time of a drug is increased. 4 The absorption of a drug through the gastrointestinal tract is increased.

2 The hepatic metabolism of a drug is decreased. The hepatic metabolism of the drugs is increased in pregnancy, which increases the drug response. Elimination of the drugs is increased because the renal blood flow doubles in the third trimester. The intestinal transit time of drugs increases because the motility of the bowel decreases in pregnancy. This action also leads to an increase in the drug's gastrointestinal absorption.

Which statement regarding erythropoietin is true? 1 Erythropoietin is released by the pancreas. 2 An erythropoietin deficiency causes diabetes. 3 An erythropoietin deficiency is associated with renal failure. 4 Erythropoietin is released only when there is adequate blood flow.

3 An erythropoietin deficiency is associated with renal failure. Erythropoietin is produced by the kidneys; its deficiency occurs in renal failure. Erythropoietin is released by the kidneys, not the pancreas. Erythropoietin deficiency causes anemia. Erythropoietin is secreted in response to hypoxia, which results in decreased oxygenated blood flow to the tissues.

Which pharmacokinetic condition of a drug may result in a high intensity and long duration of response? 1 When both absorption and elimination are rapid 2 When both absorption and elimination are delayed 3 When absorption is rapid but elimination is delayed 4 When absorption is delayed but elimination is rapid

3 When absorption is rapid but elimination is delayed Pharmacokinetic factors determine the concentration of a drug at its sites of action. When the drug's absorption is rapid and elimination is delayed, the concentration of the drug at the site of action is high. This action increases the intensity and duration of the drug response. When both the absorption and elimination rates are rapid, the concentration of drug at the site of action is lesser. This in turn decreases the duration of the drug response. In contrast, when both the absorption and elimination of the drug are delayed, the intensity of the drug's effect is also decreased. When absorption is delayed but elimination is rapid, the duration and intensity of the drug are decreased because the concentration of the drug at the site of action is low.

The nurse is assessing a pediatric client diagnosed with chronic renal failure exhibiting alterations in growth patterns. When educating the client's parents about the child's growth, which statement is accurate? 1 "Your child's poor growth is most likely caused by sustained alkalosis." 2 "The hypotension associated with your child's diagnosis is causing poor growth." 3 "Your child's poor growth is most likely caused by the carbohydrate restrictions." 4 "Resistance to growth hormone associated with your child's diagnosis is causing poor growth."

4 "Resistance to growth hormone associated with your child's diagnosis is causing poor growth." Poor growth that occurs in children who are diagnosed with chronic renal failure is often due to tissue resistance to growth hormone. Other reasons for poor growth include sustained acidosis, hypertension, and protein restrictions.

A registered nurse is examining the medical reports of different clients. Which client may need immediate assessment? 1 A client who is scheduled for a bronchoscopy 2 A client who is scheduled for a thoracentesis 3 A client with pleural effusion and decreased breath sounds 4 A client with acute asthma and 85% oxygen saturation

4 A client with acute asthma and 85% oxygen saturation A client with acute asthma may have low peripheral arterial oxygen saturation. Pulse oximetry results less than 86% requires immediate assessment and treatment. Scheduled bronchoscopies and thoracenteses do not require immediate action. Pleural effusions with decreased breath sounds are an issue, but this condition does not require immediate assessment.

What does a nurse need to do during the third accuracy check before administering ear drops in a 5-year-old child? 1 Prepare the medication 2 Perform hand hygiene 3 Teach the parents about medication 4 Check the label of medication at child's bedside

4 Check the label of medication at child's bedside The nurse needs to check the medication label against the medication administration record during the third accuracy check at child's bedside. The nurse prepares the medication and performs hand hygiene before the first and second accuracy checks. The nurse teaches the parents about the medication after the third accuracy check.

A- frequently drowsy, arousable, drifts off to sleep during conversations (15 resp/min) B- slightly drowsy, easily aroused (24 resp/min) C- awake and alert (32 resp/min) D- minimal response to verbal/physical stimulation (10 resp/min) The nurse is assessing four clients in the postanesthesia care unit (PCU) who are on opioid treatment. Which client does the nurse expect will benefit from an immediate treatment with naloxone? 1 Client A 2 Client B 3 Client C 4 Client D

4 Client D Client D with severe sedation due to opioids has minimal response to verbal and physical stimulation; this client requires immediate treatment with naloxone to reverse effects of opioids. Client A with level 3 of sedation and respiratory rate of 15 breaths per minute should take acetaminophen to stabilize the condition. Client B who is slightly drowsy and easily aroused with a respiratory rate of 24 breaths per minute has level 2 of sedation, which does not require any intervention. Client C who is awake and alert with respiratory rate of 32 breaths per minute is normal.

Which statement is true about the absorption of drugs in pediatrics? 1 Gastric emptying time is delayed in early infancy, which affects absorption. 2 Drug absorption following intramuscular injection is rapid in the neonate. 3 Gastric acidity reaches adult values in 1 year of age, which affects absorption. 4 Infants are at increased risk for toxicity through transdermal administration due to thinner skin increasing absorption.

4 Infants are at increased risk for toxicity through transdermal administration due to thinner skin increasing absorption. Blood flow to the skin is higher in infants because they have thinner skin, so drug absorption is rapid through transdermal administration. This causes increased risk of toxicity. Gastric emptying time is prolonged and irregular in early infancy, enhancing absorption. Drug absorption through intramuscular injection is slow and erratic. Although lower gastric acidity does affect absorption, gastric acidity in children doesn't reach adult values until 2 years of age.

An infant with cardiopulmonary disease who displays signs and symptoms of bronchiolitis and pneumonia was admitted to the hospital. What condition is the infant likely to have? 1 Poliomyelitis 2 Pneumococcal infection 3 Meningococcal infection 4 Respiratory syncytial virus infection

4 Respiratory syncytial virus infection Respiratory syncytial virus infections are the most common cause for hospitalization of infants younger than 1 year of age; this disease especially affects premature infants and infants with cardiopulmonary disease. Poliomyelitis is caused by the poliovirus. Streptococcus pneumonia infections cause meningitis, sepsis, pneumonia, and otitis media. Neisseria meningitidis causes meningitis.

While assessing the vital signs of an elderly alcoholic client with symptoms of cardiovascular collapse, the nurse notes that the client's skin is warm. What other findings does the nurse expect to observe? Select all that apply. 1 Body temperature of 84.2 °F 2 Body temperature of 100.6 °F 3 Blood pressure of 100/62 mmHg 4 Respiratory rate of 12 breaths/minute 5 Respiratory rate of 16 breaths/minute

1 Body temperature of 84.2 °F 3 Blood pressure of 100/62 mmHg 4 Respiratory rate of 12 breaths/minute Alcohol acts as a vasodilator in the body; therefore, it causes dilation of surface blood vessels and results in hypothermia due to loss of body heat. However, the skin of the alcoholic client gives a false sensation of warmth, even while the client shows symptoms of hypothermia. Therefore the nurse finds the body temperature of the client is less than 86 °F. Cardiovascular collapse can result in clients with severe hypothermia. During severe hypothermic conditions, the blood pressure of the client decreases. Hypothermia lowers the respiratory rate; therefore, the client may have a respiratory rate of 12 breaths/minute. As the client does not have hyperthermia, he or she does not have a body temperature of 100.6 °F. The normal respiratory rate for elderly clients is in the range of 12 to 18 breaths per minute. Individuals with hypothermia may not have a normal respiratory rate of 16 breaths/minute.

Which complications should the nurse assess a toddler-age client for after receiving a gastric lavage in the treatment of an accident overdose? Select all that apply. 1 Hypoxia 2 Diarrhea 3 Aspiration 4 Clay-colored stools 5 Gastric perforation

1 Hypoxia 3 Aspiration 5 Gastric perforation Complications associated with gastric lavage include hypoxia, aspiration, and gastric perforation. Diarrhea and clay-colored stools are not complications associated with a gastric lavage.

A- yellow B- brown C- unclear or hazy D- pink-red to orange The nurse is reviewing the cerebrospinal fluid (CSF) laboratory findings of four neurologically compromised clients. Which client does the nurse suspect to have had a previous meningeal hemorrhage? 1 Client A 2 Client B 3 Client C 4 Client D

2 Client B The brown color of the CSF indicates the client has had a meningeal hemorrhage. A yellow color of the CSF is due to the hemolysis of the red blood cells (RBC) that leads to increased production of bilirubin. An unclear or hazy appearance of the CSF indicates an elevated white blood cell count. A pink-red to orange color indicates the presence of RBCs.

Which clinical manifestation can a client experience during a fat embolism syndrome (FES)? 1 Nausea 2 Dyspnea 3 Orthopnea 4 Paresthesia

2 Dyspnea FES is clinically manifested by dyspnea because of low levels of arterial oxygen. Nausea and orthopnea are not seen in FES. However, tachypnea, headache, and lethargy are seen in clients with FES. Paresthesia occurs with compartment syndrome.

A fib

Image 4 shows a wavy baseline with atrial electrical activity and an irregular ventricular rhythm which indicates atrial fibrillation. Image 1 shows normal sinus rhythm in which both atrial and ventricular rhythms are essentially regular. There is one P wave before each QRS complex, and all the P waves are of a consistent morphology or shape. Image 2 shows sinus tachycardia. Image 3 shows sinus bradycardia.

Vesicular breath sounds

Vesicular breath sounds are normal, low-pitched rustling sounds heard over peripheral lung fields. Fine crackles are popping, discontinuous sounds caused by air moving into previously deflated airways. Coarse crackles are lower-pitched, rattling sounds caused by fluid or secretions in large airways. These are abnormal breath sounds associated with bronchitis or pneumonia. Bronchial breath sounds are normal, harsh, hollow, tubular, blowing sounds heard over the trachea and larynx.

wheezes

Wheezes are continuous high-pitched squeaking or musical sounds that result from rapid vibration of bronchial walls. They are associated with bronchospasms or airway obstruction. Pleural friction rubs are creaking or grating sounds caused by roughened, inflamed pleural surfaces rubbing together. They are associated with pleurisy, pneumonia, or a pulmonary infarct. Vesicular breath sounds are normal, low-pitched rustling sounds heard over peripheral lung fields. Bronchial breath sounds are normal, harsh, hollow, tubular, blowing sounds heard over the trachea and larynx.

The nurse is teaching the mother of a 3-year-old child about techniques to promote medicine adherence. What instructions should the nurse include in the teaching? Select all that apply. 1 Choose the proper dosage form. 2 Compensate for spilled or spit-out medicine by overdosing. 3 Complete the prescribed dose. 4 Use calibrated spoons for measuring liquid formulations. 5 Improve palatability of the drug by mixing it with food or juice.

1 Choose the proper dosage form. 3 Complete the prescribed dose. 4 Use calibrated spoons for measuring liquid formulations. Selecting a convenient and proper dosage form helps a family achieve treatment adherence. Some infections and diseases may resolve before the duration of the course, but the prescribed course should be completed for the maximum therapeutic effect. Use of calibrated spoons or measuring cylinders to administer liquid medications helps achieve accurate dosage. Infants may spill or spit out the medicine leading to an inaccurate dose; in order to compensate the spilled drug, the mother should estimate and administer the missed amount, rather than overdosing. Mixing the drug with food or juice may make the drug palatable but should only be done when allowed or recommended by the primary healthcare provider.

A registered nurse teaches a nursing student about the care to be taken in clients receiving lithium. Which statements made by the nursing student indicates a need for correction? Select all that apply. 1 "I will advise a client to strictly adhere to the dosage regimen." 2 "I will advise a pregnant client to use the drug with caution during first trimester." 3 "I will verify the plasma levels of T3, T4, and TSH levels before initiating therapy." 4 "I will verify the plasma lithium levels every two to three days during lithium therapy." 5 "I will instruct the client to restrict sodium intake while co-administering lithium and diuretics."

2 "I will advise a pregnant client to use the drug with caution during first trimester." 5 "I will instruct the client to restrict sodium intake while co-administering lithium and diuretics." Lithium should be avoided during the first trimester of pregnancy, and it should be used with caution during the remainder of the pregnancy. Sodium deficiency can cause lithium to accumulate. Diuretics promote sodium excretion, so the client should make necessary dietary changes to maintain the required sodium intake, but he or she should not restrict the intake. Rigid adherence to the prescribed regimen is important because any deviations in dosage size and timing can cause toxicity. Plasma levels of T3, T4, and TSH should be measured before treatment and yearly thereafter. Plasma levels should be measured every two to three days during initial therapy and every three to six months during maintenance to avoid toxicity.

Which anatomic changes result in thermodysregulation in elderly people? Select all that apply. 1 Increased metabolic rate 2 Increased shivering response 3 Decreased circulation of blood 4 Decreased number of sweat glands 5 Decreased vasoconstrictive response

3 Decreased circulation of blood 4 Decreased number of sweat glands 5 Decreased vasoconstrictive response As aging occurs, body temperature tends to fluctuate because of the body's decreased ability to regulate its temperature. These fluctuations in temperature occur because of decreased blood circulation, decreased number and efficiency of the sweat glands, and decreased vasoconstrictive response. Increased metabolic rate and shivering response do not result in thermodysregulation; they contribute to fluctuations in the body temperature.

Which information is important to obtain during the nursing assessment of a female who is taking oral contraceptives? Select all that apply. 1 Family stability and socioeconomic status 2 Maternal history for estimated gestation 3 History of vascular or thromboembolic disorder 4 Drug interactions leading to a decreased effect of oral contraceptives 5 Prescription of a medication that may have its therapeutic effects decreased if taken with oral contraceptives

3 History of vascular or thromboembolic disorder 4 Drug interactions leading to a decreased effect of oral contraceptives 5 Prescription of a medication that may have its therapeutic effects decreased if taken with oral contraceptives A history of vascular or thromboembolic disorders may increase the risk of complications with estrogen therapy. Drug interactions should be monitored and reduced. Drug interactions may decrease the therapeutic effects of concurrent drugs or oral contraceptives. An assessment of family stability and socioeconomic status is inappropriate. An assessment of maternal history for estimated gestation is irrelevant in oral contraceptive therapy.

The nurse is teaching the parents of an epileptic child about disease management. Which statement made by the parent indicates effective learning? Select all that apply. 1 "My child should take carbamazepine before meals." 2 "I should administer valproic acid along with milk." 3 "I should stop giving phenytoin if any skin rash develops." 4 "I should shake the suspension dosage forms before administering them to the child." 5 "I should maintain a record to measure the symptoms of epilepsy before and after administration of drug."

3 "I should stop giving phenytoin if any skin rash develops." 4 "I should shake the suspension dosage forms before administering them to the child." 5 "I should maintain a record to measure the symptoms of epilepsy before and after administration of drug." With regard to disease management for an epileptic child, phenytoin may cause a hypersensitivity reaction leading to rashes. In such cases, phenytoin should be stopped, and the prescriber should be informed. All suspension dosage forms are shaken before administration; shaking allows uniform distribution of the drug throughout the solvent. Maintaining a record helps the healthcare team evaluate and alter the possible outcomes of treatment if needed. Carbamazepine should be taken with meals, rather than before, to reduce gastrointestinal distress. Valproic acid should not be administered with milk since it irritates the gastric mucosa.

A client has a synchronous pacemaker inserted. The nurse observes spikes on the monitor at a regular rate that are not followed by myocardial activity. What conclusion should the nurse make about the pacemaker based on this data? 1 Loss of battery power 2 Functioning as expected 3 Failure to stimulate the heart 4 Ignoring the client's heartbeat

3 Failure to stimulate the heart If pacemaker spikes are present, the pacemaker is firing appropriately, but the lack of resulting QRS complexes indicates that it is not stimulating or "capturing" the heart. Loss of battery power is indicated by a slowing or irregular heart rate. Each pacemaker spike should be followed by a QRS complex. A fixed or asynchronous pacemaker is designed to work independently of the client's intrinsic rhythm.

The nurse finds that a client has reduced urinary output. Which condition would the nurse document in the client's medical record? 1 Anuria 2 Dysuria 3 Oliguria 4 Nocturia

3 Oliguria A reduced urinary output of less than 400 mL in a 24-hour interval is called oliguria. Anuria is the absence of urination. Painful or difficult urination is called dysuria. Frequent urination at night is called nocturia.

Which drug may cause tooth and bone anomalies as a teratogenic effect? 1 Alcohol 2 Estrogen 3 Tetracycline 4 Valproic acid

3 Tetracycline Tetracycline causes tooth and bone anomalies in fetuses when it is given to the mother during pregnancy. Alcohol causes fetal alcohol syndrome. Estrogen causes congenital defects of the female reproductive organs. Valproic acid causes neural tube defects.

A nurse educates a mother about the proper administration of oral medication to her 4-year-old child. What statement made by the mother indicates effective learning? 1 "I should administer the medication with a cup or spoon." 2 "I should mix the medicine in a large amount of food." 3 "I should avoid giving a straw to my child to take pills." 4 "I should use a disposable oral syringe to prepare liquid doses."

4 "I should use a disposable oral syringe to prepare liquid doses." The mother should use a plastic, disposable oral syringe to prepare accurate liquid doses, especially those less than 10 mL. The mother should not give medicine through a cup, spoon, or dropper because of the risk of inaccurate measurements. The mother should refrain from mixing the medicine in a large amount of the child's food because the child may refuse to eat such a large quantity. The mother can use straws for her child to swallow pills.

The nurse is administering medication through an implanted port. What nursing safety priority should the nurse follow in this scenario? 1 The nurse should use barrel syringes to flush any central line. 2 The nurse should use 20 mL of sterile saline to flush the port after drawing blood. 3 The nurse should use 10 mL of sterile saline to flush the port before and after medication administration. 4 The nurse should withhold the drug until patency and adequate noncoring needle placement of the port are established.

4 The nurse should withhold the drug until patency and adequate noncoring needle placement of the port are established. When administering medication through implanted ports, the nurse should withhold the drug until patency and adequate noncoring needle placement of the port are established. In case of a peripherally inserted central catheter (PICC), the nurse should use barrel syringes to flush any central line. The nurse should use 20 mL of sterile saline to flush the port after drawing blood as a nursing safety priority in case of PICC. The nurse should use 10 mL of sterile saline to flush the PICC before after and medication administration.

The nurse recalls that the events of heat production through the endocrine system occur in what order? 1. Release of thyroxine from the thyroid gland 2. Stimulation of the anterior pituitary gland 3. Release of thyroid-stimulating hormone (TSH) 4. Release of epinephrine from activated adrenal medulla 5. Increase in metabolic rate, stimulation of glycolysis, and vasoconstriction 6. Hypothalamus secretes thyrotropin-releasing hormone

6. Hypothalamus secretes thyrotropin-releasing hormone 2. Stimulation of the anterior pituitary gland 3. Release of thyroid-stimulating hormone (TSH) 1. Release of thyroxine from the thyroid gland 4. Release of epinephrine from activated adrenal medulla 5. Increase in metabolic rate, stimulation of glycolysis, and vasoconstriction When a drop in the body temperature occurs, the hypothalamus receives the information from thermoreceptors in the body. Then the hypothalamus secretes thyrotropin-releasing hormone, which in turn stimulates the anterior pituitary gland to release thyroid-stimulating hormone (TSH). This TSH in turn triggers the thyroid gland to release thyroxine. The thyroxine activates the adrenal medulla to release epinephrine. This epinephrine increases the metabolic rate, stimulates the process of glycolysis, and causes vasoconstriction, thus increasing heat production in the body.

Pleural friction rubs

Pleural friction rubs are creaking or grating sounds caused by roughened, inflamed pleural surfaces rubbing together. They are associated with pleurisy, pneumonia, or a pulmonary infarct and can be heard during inspiration, expiration, or both. Rhonchi are continuous rumbling, snoring, or rattling sounds that occur due to obstruction of large airways with secretions. Fine crackles are a series of short-duration, discontinuous, high-pitched sounds caused by rapid equalization of gas pressure when collapsed alveoli or terminal bronchioles suddenly snap open. They are heard just before the end of inspiration. Coarse crackles are series of long-duration, discontinuous, low-pitched sounds associated with pulmonary edema or pneumonia with severe congestion. They sound like air is blowing through a straw underwater.