Ch 12-15 Test 2
The nurse is teaching a patient who has iron-deficiency anemia about iron supplementation. Which statement by the patient indicates understanding of the teaching? a. "I may improve iron absorption by taking this with orange juice." b. "I should take iron tablets with an antacid to reduce gastrointestinal upset." c. "Nausea and vomiting are minor side effects and will decrease over time." d. "Taking iron with food will help to increase the amount absorbed."
a. "I may improve iron absorption by taking this with orange juice."
The nurse is teaching a patient about water-soluble vitamins. Which statement by the patient indicates understanding of the teaching? a. "Water-soluble vitamins are excreted in the urine." b. "Water-soluble vitamins are generally toxic." c. "Water-soluble vitamins are highly protein bound." d. "Water-soluble vitamins are usually metabolized in the liver."
a. "Water-soluble vitamins are excreted in the urine."
The nurse is caring for a patient who has a heart rate of 98 beats per minute and a blood pressure of 82/58 mm Hg. The patient is lethargic, is complaining of muscle weakness, and has had gastroenteritis for several days. Based on this patient's vital signs, which sodium value would the nurse expect? a. 126 mEq/L b. 140 mEq/L c. 145 mEq/L d. 158 mEq/L
a. 126 mEq/L
The nurse is caring for an adult with severe burns who weighs 60 kg. Prior to initiating total parenteral nutrition (TPN) therapy, the nurse reviews the orders. Which TPN order is correct for this patient? a. 3000 kcal, 120 g amino acids per day b. 2400 kcal, 50 g amino acids per day c. 1500 kcal, 100 g amino acids per day d. 3600 kcal, 150 g amino acids per day
a. 3000 kcal, 120 g amino acids per day
The nurse is preparing to administer an enteral feeding to a patient who receives 300 mL of Isocal over 30 minutes every 4 hours. The nurse checks the residual prior to initiating the feeding and notes a residual amount of 50 mL of formula. Which action will the nurse take next? a. Administer the feeding as ordered. b. Administer the feeding over 60 minutes. c. Hold the feeding and notify the patient's provider. d. Wait 1 hour and recheck the residual again.
a. Administer the feeding as ordered.
The nurse is caring for a patient who is being treated with total parenteral nutrition (TPN). The patient is experiencing chest pain, and the nurse observes shortness of breath and coughing along with cyanosis. The nurse understands that this patient is most likely experiencing which condition? a. Air embolism b. Pneumonia c. Pneumothorax d. Pulmonary edema
a. Air embolism
The nurse is caring for a patient whose provider has just ordered a switch from atenolol (Tenormin) to reserpine. When preparing the patient to take this medication, what will the nurse do? a. Ask about herbal supplements. b. Counsel that NSAIDs are safe to take with reserpine. c. Teach about potential side effects of mood elevation and euphoria. d. Tell the patient to expect immediate therapeutic effects.
a. Ask about herbal supplements.
A parent calls the nurse to report that a 5-year-old child has taken five children's vitamins. Which action will the nurse take first? a. Ask whether the vitamins contain iron. b. Reassure the parent that over-the-counter vitamins are not toxic. c. Recommend that the parent take the child to the emergency department (ED). d. Tell the parent to watch for tarry stools and report them immediately.
a. Ask whether the vitamins contain iron.
The nurse assumes care of a patient who has been receiving intermittent enteral feedings of 240 mL of Osmolite every 4 hours for the past 48 hours. The patient is in bed with the head of the bed elevated 60 degrees. The enteral tubing is intact, and the enteral pump is infusing at 320 mL per hour. The nurse notes 60 mL of solution left in the bag. The tubing is not labeled. What will the nurse do? a. Change and label the enteral tubing when this infusion is complete. b. Increase the infusion rate to 480 mL per hour to complete the infusion. c. Lower the head of the bed to 30 degrees. d. Stop the infusion and check for residual before resuming the infusion.
a. Change and label the enteral tubing when this infusion is complete.
A patient is taking doxazosin mesylate (Cardura) 1 mg/day to treat hypertension. The nurse notes a blood pressure of 110/72 mm Hg and a heart rate of 92 beats per minute. The nurse will contact the provider to discuss which change to the drug regimen? a. Changing to a beta-adrenergic blocker b. Decreasing the drug dose c. Increasing the drug dose d. Adding a diuretic
a. Changing to a beta-adrenergic blocker
The nurse is caring for a patient who weighs 75 kg. The patient has intravenous (IV) fluids infusing at a rate of 50 mL/h and has consumed 100 mL of fluids orally in the past 24 hours. Which action will the nurse take? a. Contact the provider to ask about increasing the IV rate to 90 mL/h. b. Discuss with the provider the need to increase the IV rate to 150 mL/h. c. Encourage the patient to drink more water so the IV can be discontinued. d. Instruct the patient to drink 250 mL of water every 8 hours.
a. Contact the provider to ask about increasing the IV rate to 90 mL/h.
A female patient who has a history of heavy menstrual periods is experiencing shortness of breath with exertion, pallor, and fatigue. Her hemoglobin and hematocrit levels are both lower than normal, and her CBC reveals microcytic and hypochromic erythrocytes. What will the nurse do? a. Contact the provider to discuss an order for 600 mg of PO ferrous sulfate BID. b. Recommend an over-the-counter folic acid supplement of 400 mcg/day. c. Suggest an over-the-counter iron supplement of 325 mg/day. d. Tell her to consult a dietician about including iron-rich foods in her diet.
a. Contact the provider to discuss an order for 600 mg of PO ferrous sulfate BID.
The nurse is caring for a patient who is receiving oral potassium chloride supplements. The nurse notes that the patient has a heart rate of 120 beats per minute and has had a urine output of 200 mL in the past 12 hours. The patient reports abdominal cramping. Which action will the nurse take? a. Contact the provider to request an order for serum electrolytes. b. Encourage the patient to consume less fluids. c. Report symptoms of hyperchloremia to the provider. d. Request an order to increase the patient's potassium dose.
a. Contact the provider to request an order for serum electrolytes.
The nurse is caring for a patient who is receiving total parenteral nutrition (TPN). The nurse will carefully monitor this patient for which symptom(s)? a. Coughing and shortness of breath b. Decreased breath sounds c. Diarrhea d. Nausea and abdominal distension
a. Coughing and shortness of breath
The nurse is caring for a patient who is receiving isotonic intravenous (IV) fluids at an infusion rate of 125 mL/h. The nurse performs an assessment and notes a heart rate of 102 beats per minute, a blood pressure of 160/85 mm Hg, and crackles auscultated in both lungs. Which action will the nurse take? a. Decrease the IV fluid rate and notify the provider. b. Increase the IV fluid rate and notify the provider. c. Request an order for a colloidal IV solution. d. Request an order for a hypertonic IV solution.
a. Decrease the IV fluid rate and notify the provider.
The nurse is caring for a patient who will receive 10% calcium gluconate to treat a serum potassium level of 5.9 mEq/L. The nurse performs a drug history prior to beginning the infusion. Which drug taken by the patient would cause concern? a. Digitalis b. Hydrochlorothiazide c. Hydrocortisone d. Vitamin D
a. Digitalis
The nurse caring for a patient who is taking an adrenergic agent will expect which side effects? (Select all that apply.) a. Dilated pupils b. Increased heart rate c. Increase gastrointestinal motility d. Vasodilation e. Bronchospasm f. Relaxed uterine muscles
a. Dilated pupils b. Increased heart rate f. Relaxed uterine muscles
A patient is admitted with orthopnea, cough, pulmonary crackles, and peripheral edema. The patient's urine specific gravity is 1.002. The nurse will expect this patient's provider to order which treatment? a. Diuretics b. Colloidal IV fluids c. Hypertonic IV fluids d. Hypotonic IV fluids
a. Diuretics
The nurse assumes care for a patient who is being treated with enteral feeding. When performing the initial assessment, the nurse finds the patient supine and asleep. The nurse will perform which action? a. Elevate the head of the bed 30 degrees. b. Flush the tubing with water. c. Position the patient to the left side. d. Temporarily discontinue the infusion.
a. Elevate the head of the bed 30 degrees.
The nurse is caring for a newly admitted patient who has severe gastroenteritis. The patient's electrolytes reveal a serum sodium level of 140 mEq/L and a serum potassium level of 3.5 mEq/L. The nurse receives an order for intravenous 5% dextrose and normal saline with 20 mEq/L potassium chloride to infuse at 125 mL/h. Which action is necessary prior to administering this fluid? a. Evaluate the patient's urine output. b. Contact the provider to order arterial blood gases. c. Request an order for an initial potassium bolus. d. Suggest a diet low in sodium and potassium.
a. Evaluate the patient's urine output.
The nurse is performing an assessment on a patient brought to the emergency department for treatment for dehydration. The nurse assesses a respiratory rate of 26 breaths/minute, a heart rate of 110 beats/minute, a blood pressure of 86/50 mm Hg, and a temperature of 39.5° C. The patient becomes dizzy when transferred from the wheelchair to a bed. The nurse notes cool, clammy skin. Which diagnosis does the nurse suspect? a. Fluid volume deficit (FVD) b. Fluid volume excess (FVE) c. Mild extracellular fluid (ECF) deficit d. Renal failure
a. Fluid volume deficit (FVD)
The nurse is caring for a patient who has asthma and administers a selective beta2-adrenergic agonist to treat bronchospasm. The nurse which side effect? a. Increased blood glucose b. Increased blood pressure c. Increased heart rate d. Increased gastrointestinal (GI) motility
a. Increased blood glucose
A patient is suspected of having severe hypocalcemia. While waiting for the patient's serum electrolyte results, the nurse will assess for which symptoms? (Select all that apply.) a. Laryngeal spasms b. Fatigue c. Muscle weakness d. Nausea and vomiting e. Numbness of fingers f. Twitching of the mouth
a. Laryngeal spasms e. Numbness of fingers f. Twitching of the mouth
The nurse is preparing to administer enteral nutrition to a patient who has had a stroke and who cannot swallow. A family member asks why the patient is not receiving intravenous nutrition. What information will the nurse provide to the family member? a. Parenteral nutrition carries a higher risk of infection. b. Parenteral nutrition does not provide sufficient calories. c. Parenteral nutrition increases the risk of aspiration. d. Parenteral nutrition is hyper-osmolar and increases the risk of dehydration.
a. Parenteral nutrition carries a higher risk of infection.
A patient will begin taking albuterol (Proventil) to treat asthma. When teaching the patient about this drug, the nurse will make which recommendation? a. Report rapid or irregular heart rate. b. Drink 8 to 16 extra ounces of fluid each day. c. Monitor serum glucose daily. d. Take a calcium supplement.
a. Report rapid or irregular heart rate.
The nurse is teaching a patient how to use phenylephrine HCl (Neo-Synephrine) nasal spray to treat congestion from a viral upper respiratory infection. What instruction will the nurse give the patient? a. Stop using the medication after 3 days. b. Spray the medication into the nose while lying supine. c. Use frequently since systemic side effects do not occur. d. Use the medication with any other over-the-counter medications.
a. Stop using the medication after 3 days.
A patient asks the nurse about taking calcium supplements to avoid hypocalcemia. The nurse will suggest that the patient follow which instruction? a. Take a calcium and vitamin D combination supplement. b. Take calcium along with phosphorus to improve absorption. c. Take calcium with antacids to reduce stomach upset. d. Use aspirin instead of acetaminophen when taking calcium.
a. Take a calcium and vitamin D combination supplement.
The nurse is caring for a patient whose serum sodium level is 140 mEq/L and serum potassium level is 5.4 mEq/L. The nurse will contact the patient's provider to discuss an order for a. a low-potassium diet. b. intravenous sodium bicarbonate. c. Kayexalate and sorbitol. d. salt substitutes
a. a low-potassium diet.
An adult patient is brought to the emergency department for treatment of an asthma exacerbation. The patient uses inhaled albuterol as needed to control wheezing. The nurse notes expiratory wheezing, tremors, restlessness, and a heart rate of 120 beats per minute. The nurse suspects that the patient has a. overused the albuterol. b. not been using albuterol. c. taken a beta-adrenergic blocker. d. taken a monoamine oxidase (MAO) inhibitor.
a. overused the albuterol.
A patient is diagnosed with anemia and asks the nurse why the provider has ordered vitamin B12 instead of iron. Which answer by the nurse is correct? a. "Vitamin B12 is given to improve your overall energy level." b. "Vitamin B12 is necessary for the development of red blood cells." c. "Vitamin B12 prevents excess iron loss to reduce demand." d. "Vitamin B12 will help you absorb iron more efficiently."
b. "Vitamin B12 is necessary for the development of red blood cells."
The provider calculates the enteral nutrition needs for a non-ambulatory patient and determines that the patient will need 300 mL of Ultracal every 4 hours. Which method of delivery will the nurse use to administer these feedings? a. 300 mL every 4 hours given via syringe as a 10-minute bolus b. 300 mL every 4 hours given via enteral pump as a 45-minute infusion c. 75 mL per hour via enteral pump as a continuous infusion d. 150 mL every 2 hours via gravity infusion
b. 300 mL every 4 hours given via enteral pump as a 45-minute infusion
The nurse is caring for a patient who will receive intravenous calcium gluconate. Which nursing actions are appropriate when giving this solution? (Select all that apply.) a. Administering through a central line b. Assessing for Trousseau and Chvostek signs c. Giving as a rapid intravenous bolus d. Mixing in a solution containing sodium bicarbonate e. Monitoring the patient's electrocardiogram (ECG) f. Reporting a serum calcium level of >2.5 mEq/L
b. Assessing for Trousseau and Chvostek signs e. Monitoring the patient's electrocardiogram (ECG) f. Reporting a serum calcium level of >2.5 mEq/L
The nurse is caring for a patient who is receiving total parenteral nutrition (TPN) and notes that the patient becomes dyspneic when transferring from the bed to a chair. The nurse auscultates rales in both lungs. Which action will the nurse take next? a. Ask the patient to perform the Valsalva maneuver. b. Decrease the TPN rate and request an order for a diuretic medication. c. Obtain an order for a chest radiograph and an antibiotic. d. Stop the TPN and request an order for intravenous isotonic dextrose.
b. Decrease the TPN rate and request an order for a diuretic medication.
The nurse is preparing to administer enteral nutrition to a patient. Which assessment finding would prompt the nurse to hold the nutrition and notify the patient's provider? a. Blood pressure of 90/60 mm Hg b. Decreased bowel sounds c. A productive cough d. A temperature of 37.8° C
b. Decreased bowel sounds
The nurse administers subcutaneous epinephrine to a patient who is experiencing an anaphylactic reaction. The nurse should expect to monitor the patient for which symptom? a. Bradycardia b. Decreased urine output c. Hypotension d. Nausea and vomiting
b. Decreased urine output
A patient is taking nicotinic acid (Niacin) to treat hyperlipidemia. The patient reports a flushing sensation along with gastrointestinal irritation. The nurse will perform which action? a. Contact the provider to discuss possible thromboembolism. b. Discuss decreasing the patient's dose of nicotinic acid with the provider. c. Reassure the patient that these effects will decrease over time. d. Suggest that the patient take niacin with a full glass of cool water.
b. Discuss decreasing the patient's dose of nicotinic acid with the provider.
A patient receiving total parenteral nutrition (TPN) begins having cough and dyspnea. The nurse auscultates rales and notes neck vein engorgement and weight gain. The nurse suspects that the patient is experiencing which condition? a. Air embolism b. Fluid overload c. Pneumonia d. Pneumothorax
b. Fluid overload
A patient asks the nurse about whether it is necessary to take vitamin supplements. The patient is a 26-year-old female who is contemplating pregnancy. The nurse will recommend which supplement? a. Calcium and vitamin D b. Folic acid (folate) c. Iron d. Vitamin C
b. Folic acid (folate)
The nurse is preparing to administer digoxin to a patient who is newly admitted to the intensive care unit. The nurse reviews the patient's admission electrolytes and notes a serum potassium level of 2.9 mEq/L. Which action by the nurse is correct? a. Administer the digoxin and monitor the patient's electrocardiogram closely. b. Hold the digoxin dose and notify the provider of the patient's lab values. c. Request an order for an intravenous bolus of potassium. d. Request an order for oral potassium supplements.
b. Hold the digoxin dose and notify the provider of the patient's lab values.
A patient who has asthma is diagnosed with hypertension. drug will be safe to give this patient? a. Pindolol (Visken) b. Metoprolol (Lopressor) c. Nadolol (Corgard) d. Propranolol (Inderal)
b. Metoprolol (Lopressor)
A patient reports taking megadoses of vitamin C to prevent upper respiratory infections. The nurse will perform which action? a. Monitor the patient for hyperglycemia. b. Notify the provider and discuss a gradual taper of vitamin C. c. Request an order for a CBC to assess the patient's hemoglobin. d. Tell the patient that studies have confirmed this use of vitamin C.
b. Notify the provider and discuss a gradual taper of vitamin C.
A patient who has been receiving continuous enteral nutrition has had several large, watery stools. The nurse will contact the provider to discuss which intervention? a. Administering antidiarrheal medications b. Slowing the rate of infusion c. Starting total parenteral nutrition d. Thickening the nutrition solution
b. Slowing the rate of infusion
The nurse is preparing a patient who will receive intermittent enteral nutrition at home with a hyper-osmolar solution. What information will the nurse include when teaching this patient? a. How to perform the Valsalva maneuver b. The need to consume extra fluids between feedings c. The need to decrease dietary fiber d. The need to remain supine during infusion of the enteral solution
b. The need to consume extra fluids between feedings
The nurse is caring for a patient who will begin taking atenolol (Tenormin). What information will the nurse include when teaching the patient about taking this medication? a. The drug must be taken twice daily. b. The patient must rise slowly from a chair or bed. c. The medication is safe to take during pregnancy. d. Use NSAIDs as needed for mild to moderate pain.
b. The patient must rise slowly from a chair or bed.
A young woman tells the nurse that she has a strong family history of osteoporosis and that she has been taking calcium supplements. Which vitamin will the nurse recommend as an adjunct to calcium supplementation? a. Vitamin A b. Vitamin D c. Vitamin E d. Vitamin K
b. Vitamin D
The nurse is administering intravenous fluids to a patient who is dehydrated. On the second day of care, the patient's weight is increased by 2.25 pounds. The nurse would expect that the patient's fluid intake has a. equaled urine output. b. exceeded urine output by 1 L. c. exceeded urine output by 2.5 L. d. exceeded urine output by 3 L.
b. exceeded urine output by 1 L.
The nurse is performing an admission assessment on a patient who has recently begun taking reserpine. The patient reports using St. John's wort. The nurse anticipates that the patient will have a. hypotension. b. hypertension. c. bradycardia. d. tachycardia.
b. hypertension.
The nurse is caring for a patient who is receiving total parenteral nutrition (TPN). The patient reports nausea, headache, and thirst. The nurse will contact the provider to discuss a. giving acetaminophen for headache pain. b. obtaining a serum glucose level. c. ordering an antiemetic to prevent vomiting. d. starting intravenous isotonic dextrose.
b. obtaining a serum glucose level.
The nurse is caring for a patient who is ordered to take nothing by mouth. The patient weighs 65 kg. What volume of intravenous fluid should this patient receive in 24 hours? a. 2225 mL b. 2400 mL c. 2520 mL d. 2640 mL
c. 2520 mL
The nurse is preparing to hang a new bag for a patient who is receiving total parenteral nutrition (TPN). During this procedure, the nurse will instruct the patient to take a deep breath and then perform which action? a. Exhale slowly and bear down. b. Exhale slowly to the count of 10. c. Hold the breath and bear down. d. Take several rapid, shallow breaths.
c. Hold the breath and bear down.
A patient will be discharged on beta blockers. Which skill is essential for the nurse to teach the patient's family? a. How to prepare a low-sodium diet b. Assessments to detect fluid retention c. How to monitor heart rate and blood pressure d. Early signs of changing level of consciousness
c. How to monitor heart rate and blood pressure
A patient's serum osmolality is 305 mOsm/kg. Which term describes this patient's body fluid osmolality? a. Iso-osmolar b. Hypo-osmolar c. Hyper-osmolar d. Isotonic
c. Hyper-osmolar
A patient who has been receiving total parenteral nutrition (TPN) for several days accidently removes the intravenous (IV) line. While waiting for the IV therapy nurse, the nurse caring for this patient will monitor for which complication? a. Air embolism b. Dehydration c. Hypoglycemia d. Infection
c. Hypoglycemia
A patient has a serum potassium level of 2.7 mEq/L. The patient's provider has determined that the patient will need 200 mEq of potassium to replace serum losses. How will the nurse caring for this patient expect to administer the potassium? a. As a single-dose 200 mEq oral tablet b. As an intravenous bolus over 15 to 20 minutes c. In an intravenous solution at a rate of 10 mEq/h d. In an intravenous solution at a rate of 45 mEq/h
c. In an intravenous solution at a rate of 10 mEq/h
A nurse is teaching a patient how to use phenylephrine (Neo-Synephrine) nasal spray. To avoid systemic absorption, the nurse teaches the patient to perform which action? a. Apply pressure to the nose after spraying. b. Administer the spray while in the supine position. c. Insert the spray while sitting up. d. Exhale deeply while injecting the nasal spray.
c. Insert the spray while sitting up.
The nurse is caring for a patient who has had severe vomiting. The patient's serum sodium level is 130 mEq/L. The nurse will expect the patient's provider to order which treatment? a. Diuretic therapy b. Intravenous hypertonic 5% saline c. Intravenous normal saline 0.9% d. Oral sodium supplements
c. Intravenous normal saline 0.9%
A patient who spends most of the time indoors has been taking megadoses of vitamin D and is worried about vitamin D toxicity. The nurse will tell this patient to report which sign that may indicate vitamin D toxicity? a. Blurred vision b. Darkening of the skin c. Nausea and vomiting d. Palpitations
c. Nausea and vomiting
The nurse is caring for a patient who has recently begun taking atenolol (Tenormin) to treat hypertension. The patient reports dizziness, nausea, vomiting, and decreased libido since beginning the medication. What will the nurse do? a. Hold the next dose until the provider can be notified of these side effects. b. Reassure the patient that these symptoms are common and not worrisome. c. Recommend that the patient discuss these effects with the provider. d. Suggest that the patient request a different beta-adrenergic blocker.
c. Recommend that the patient discuss these effects with the provider.
The nurse is caring for an elderly patient who has poor nutrition. The nurse notes cracked skin at the corners of the patient's mouth along with generalized scaly dermatitis. The nurse will contact the provider to discuss a possible deficiency of which vitamin? a. Nicotinic acid b. Pyridoxine c. Riboflavin d. Thiamine
c. Riboflavin
The provider has ordered Kayexalate and sorbitol to be administered to a patient. The nurse caring for this patient would expect which serum electrolyte values prior to administration of this therapy? a. Sodium 125 mEq/L and potassium 2.5 mEq/L b. Sodium 150 mEq/L and potassium 3.6 mEq/L c. Sodium 135 mEq/L and potassium 6.9 mEq/L d. Sodium 148 mEq/L and potassium 5.5 mEq/L
c. Sodium 135 mEq/L and potassium 6.9 mEq/L
The nurse is caring for a patient with severe burns who will begin receiving total parenteral nutrition (TPN). The patient asks why TPN is necessary. The nurse explains that TPN is used for which reason? a. To minimize pulmonary complications b. To prevent hyperglycemia and fluid overload c. To promote wound healing and maintain cell integrity d. To restore fluid and electrolyte imbalance
c. To promote wound healing and maintain cell integrity
The nurse is preparing to discontinue total parenteral nutrition (TPN) therapy for a patient who has been receiving TPN for several days. The nurse will contact the provider to discuss an order for a. antibiotics. b. intravenous insulin. c. isotonic dextrose. d. nasogastric feedings
c. isotonic dextrose.
A patient who has type 2 diabetes mellitus asks the nurse about taking chromium supplements. The nurse will tell this patient that taking chromium a. can increase the risk for ketoacidosis. b. is not recommended for persons with diabetes. c. may cause hypoglycemia if taken in large doses. d. should be taken in doses greater than 200 mcg/day.
c. may cause hypoglycemia if taken in large doses.
The nurse dilutes an antibiotic before administering it through a patient's nasogastric tube. The patient asks why this is necessary. The nurse explains that diluting the antibiotic helps to a. improve absorption. b. improve hydration. c. prevent diarrhea. d. prevent emboli.
c. prevent diarrhea.
The nurse is teaching a patient who has a folic acid deficiency about treatment for this disorder. Which statement by the patient indicates understanding of the teaching? a. "Food sources of folic acid are better than synthetic folic acid products." b. "I should take megadoses of folic acid to compensate for the deficiency." c. "Most folic acid is stored in the liver." d. "Symptoms of folic acid deficiency often do not appear for months."
d. "Symptoms of folic acid deficiency often do not appear for months."
The patient has been started on a treatment regimen that includes atenolol (Tenormin) and complains to the nurse of feeling weak. Which is the best response from the nurse? a. "I will hold your next dose of the medication." b. "You may need an increase in your next dose of the medication." c. "This is an adverse reaction to the medication. I will stop the drug." d. "This is a side effect of the medication. I will notify your physician."
d. "This is a side effect of the medication. I will notify your physician."
A patient reports wanting to take vitamin A to prevent blindness. Which response by the nurse is correct? a. "Vitamin A can be taken prophylactically without serious adverse effects." b. "Vitamin A does not have any effects on vision." c. "Vitamin A is difficult to obtain through dietary intake alone." d. "Vitamin A is stored in the liver for up to 2 years, and toxicity can occur."
d. "Vitamin A is stored in the liver for up to 2 years, and toxicity can occur."
Which patient is most likely to be a candidate for total parenteral nutrition (TPN) rather than enteral nutrition? a. A patient who is comatose after having had a stroke b. A patient who has a fractured mandible following a motor vehicle accident c. A patient who has cerebral palsy and severe dysphagia d. A patient who is pregnant and has intractable hyperemesis gravidarum
d. A patient who is pregnant and has intractable hyperemesis gravidarum
The patient has been ordered to receive Sudafed to treat nasal congestion. The nurse performing an admission assessment learns that the patient has diabetes mellitus. What action is appropriate for the nurse to take? a. Administer the medication as ordered. b. Contact the provider to discuss a lower dose. c. Give the medication and monitor serum glucose closely. d. Hold the medication and contact the provider.
d. Hold the medication and contact the provider.
A patient is taking a thiazide diuretic and reports anorexia and fatigue. The nurse suspects which electrolyte imbalance in this patient? a. Hypercalcemia b. Hypocalcemia c. Hyperkalemia d. Hypokalemia
d. Hypokalemia
The nurse is caring for a patient who is receiving intravenous dopamine (Intropin). The nurse notes erythema and swelling at the IV insertion site. What is the nurse's initial action? a. Apply warm soaks to the area. b. Monitor the patient closely for hypertension. c. Obtain an order for an electrocardiogram. d. Notify the provider of a need for phentolamine mesylate (Regitine).
d. Notify the provider of a need for phentolamine mesylate (Regitine).
The nurse is caring for a newly admitted patient who will receive digoxin to treat a cardiac dysrhythmia. The patient takes hydrochlorothiazide (HydroDIURIL) and reports regular use of over-the-counter laxatives. Before administering the first dose of digoxin, the nurse will review the patient's electrolytes with careful attention to the levels of which electrolytes? a. Calcium and magnesium b. Sodium and calcium c. Potassium and chloride d. Potassium and magnesium
d. Potassium and magnesium
A patient reports having taken a large dose of ascorbic acid (vitamin C) and is experiencing diarrhea and gastrointestinal upset. The nurse will prepare to take which action? a. Administer activated charcoal. b. Administer sodium bicarbonate. c. Perform gastric lavage. d. Provide symptomatic care.
d. Provide symptomatic care.
A patient is being treated for shock after a motor vehicle accident. The provider orders 6% dextran 75 to be given intravenously. The nurse should expect which outcome as the result of this infusion? a. Decreased urine output b. Improved blood oxygenation c. Increased interstitial fluid d. Stabilization of heart rate and blood pressure
d. Stabilization of heart rate and blood pressure
A patient who is being treated for dehydration is receiving 5% dextrose and 0.45% normal saline with 20 mEq/L potassium chloride at a rate of 125 mL/h. The nurse assuming care for the patient reviews the patient's serum electrolytes and notes a serum sodium level of 140 mEq/L and a serum potassium level of 3.6 mEq/L. The patient had a urine output of 250 mL during the last 12-hour shift. Which action will the nurse take? a. Contact the patient's provider to discuss increasing the potassium chloride to 40 mEq/L. b. Continue the intravenous fluids as ordered and reassess the patient frequently. c. Notify the provider and discuss increasing the rate of fluids to 200 mL/h. d. Stop the intravenous fluids and notify the provider of the assessment findings.
d. Stop the intravenous fluids and notify the provider of the assessment findings.
The nurse is caring for a patient who has a history of chronic alcohol abuse. The patient is confused and exhibits nystagmus and blurred vision. Which vitamin will the nurse expect to administer to this patient? a. Nicotinic acid b. Pyridoxine c. Riboflavin d. Thiamine
d. Thiamine
A patient is admitted after experiencing vomiting and diarrhea for several days. The provider orders intravenous lactated Ringer's solution. The nurse understands that this fluid is given for which purpose? a. To increase interstitial and intracellular hydration b. To maintain plasma volume over time c. To pull water from the interstitial space into the extracellular fluid d. To replace water and electrolytes
d. To replace water and electrolytes
A patient who will begin taking an antibiotic reports taking several vitamin supplements every day. Which vitamin or mineral will the nurse counsel the patient about during antibiotic therapy? a. Selenium b. Vitamin A c. Vitamin C d. Zinc
d. Zinc
A patient who has Raynaud's disease will begin taking an alpha-adrenergic blocker. The patient asks the nurse how the drug works to treat symptoms. The nurse explains that alpha-adrenergic blockers treat Raynaud's disease by causing a. decreased peripheral vascular resistance. b. orthostatic hypotension. c. reflex tachycardia. d. vasodilation.
d. vasodilation.
A child is brought to the emergency department after ingesting a grandparent's warfarin (Coumadin) tablets. The nurse will anticipate administering which form of vitamin K? a. K1 (phytonadione) b. K2 (menaquinone) c. K3 (menadione) d. K4 (menadiol)
a. K1 (phytonadione)
Patients with which conditions would benefit from enteral feedings? (Select all that apply.) a. Burns of face, chest, and neck b. Cerebral palsy with severe dysphagia c. Crohn disease d. Facial fractures e. Gluten enteropathy f. Stroke
b. Cerebral palsy with severe dysphagia d. Facial fractures f. Stroke
Supplementation with which fat-soluble vitamin should a patient discuss with a provider before having surgery? a. Vitamin A b. Vitamin D c. Vitamin E d. Vitamin K
c. Vitamin E
The nurse is caring for a child who receives all nutrition parenterally. The nurse will be alert for signs of a deficiency of which mineral in this child? a. Chromium b. Copper c. Iron d. Zinc
d. Zinc
A patient with cirrhosis is noted to have low serum albumin levels. The patient is to receive 200 mL of albumin in 30 minutes. The drop factor for the IV set is 15 gtt/mL. The nurse correctly adjusts the IV rate to what rate?
100 gtt/min (200 mL 15 gtt/mL) ÷ 30 min = 100 gtt/min.
