np2 final

What is the normal range for Serum Sodium?

135-145 mEq/L

What is the normal range for Serum Potassium?

3.5-5 mEq/L

A client's arterial blood gases are: pH 7.32, PaCO2 48mm Hg, and HCO3 25 mEq/L. A nurse should anticipate that an appropriate order for this client will be: A)Incentive spirometer to be uses hourly B)O2 via mask with a rebreather mask C)Antianxiety medication to slow respiratory rate D)Sodium bicarbonate IV to raise the pH

a (ABGs show respiratory acidosis (pH below 7.35 and CO2 above 45), which would be decreased with effective deep breathing.)

The nurse administered 3% saline to a patient with hyponatremia. Which one of these assessment data will require the most rapid response by the nurse? A)There are crackles audible throughout both lungs B)The patient's radial pulse is 105 bmp C)The blood pressure increases from 120/80 to 142/94 D)There is sediment and blood in the patient's urine

a (Crackles throughout both lungs suggest that the patient may be experiencing pulmonary edema, a life-threatening adverse effect of hypertonic solutions. The increased pulse rate and blood pressure and the appearance of the urine should also be reported, but they are not as dangerous as the presence of fluid in the alveoli. (Think ABCs!))

A patient in the cardiac unit is concerned about the risk factors associated with atherosclerosis. Which of the following are hereditary risk factors for developing atherosclerosis? A) Family history of heart disease B) Overweight C) Smoking D) Age

a (Family history of heart disease is an inherited risk factor that is not subject to lifestyle change. Having a first degree relative with heart disease has been shown to significantly increase risk.)

An elderly patient with pneumonia may appear with which of the following symptoms first? A)Altered mental status and dehydration B)Fever and chills C)Hemoptysis and dyspnea D)Pleuritic chest pain and cough

a (Fever, chills, hemoptysis, dyspnea, cough, and pleuritic chest pain are common symptoms of pneumonia, but elderly patients may first appear with only an altered mental status and dehydration due to a blunted immune response.)

Which of the following nursing diagnosis is a priority for a patient with gout? A)Pain B)Fatigue C)Risk for infection D)Risk for peripheral neurovascular dysfunction

a (Gouty arthritis is a metabolic disorder characterized by accumulation of uric acid crystals deposits, called tophi, in tissues especially in joints that results in an inflammatory response. It is caused by prolonged hyperuricemia due to problems in synthesizing purine or by poor excretion of uric acid by the kidneys. The immediate problem for patients suffering from gout is the acute pain experienced on affected joints such as the great toe, feet, ankles, or knees.)

The nurse teaches a patient with hypertension that uncontrolled hypertension may damage organs in the body primarily by which of the following mechanisms? A)Hypertension promotes atherosclerosis and damage to the walls of the arteries. B) Hypertension causes direct pressure on organs, resulting in necrosis and replacement of cells with scar tissue. C) Hypertension causes thickening of the capillary membranes, leading to hypoxia of organ systems. D) Hypertension increases blood viscosity, which contributes to intravascular coagulation and tissue necrosis distal to occlusions.

a (Hypertension is a major risk factor for the development of atherosclerosis by mechanisms not yet fully known. However, once atherosclerosis develops, it damages the walls of arteries and reduces circulation to target organs and tissues.)

Which drug is indicated for pain related to acute renal calculi? A)Narcotic analgesics B)Nonsteroidal anti-inflammatory drugs (NSAIDs) C)Muscle relaxants D)Salicylates

a (Narcotic analgesics are usually needed to relieve the severe pain of renal calculi. Muscle relaxants are typically used to treat skeletal muscle spasms. NSAIDs and salicylates are used for their anti-inflammatory and anti-pyretic properties and to treat less severe pain.)

The nurse is monitoring a patient admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The patient begins to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the most appropriate nursing intervention? A)Notify the HCP. B)Administer the prescribed pain medication. C)Call and ask the OR team to perform the surgery ASAP. D)Reposition the patient and apply a heating pad on the warm setting to the patient's abdomen.

a (On the basis of the s/s presented, the nurse should suspect peritonitis and notify the HCP. Administering pain med is not an appropriate intervention. Heat should never be applied to the abdomen of a patient with suspected appendicitis because of the risk of rupture. Scheduling surgical time is not within the scope of nursing practice, although the HCP probably would perform the surgery earlier than the prescheduled time.)

A nurse should evaluate the effects of Coumadin (Warfarin), used in the treatment of deep vein thrombosis, by looking at the results of which laboratory test? A) Prothrombin time (PT) B) Lee-White clotting time C) Partial thromboplastin time (PTT) D) Fibrinogen clotting time (FCT)

a (PT is the specific test to determine the effectiveness of Coumadin (Warfarin) therapy. PTT.......think heparin. (Ptt = Heparin))

The nurse is teaching a client with newly diagnosed emphysema how to manage the disease. The client asks how pursed-lip breathing helps the emphysema. The best response by the nurse is: A) It prevents the air sacs in lungs from trapping air B) It decreases the pressure in the airways C)The resistance on exhalation increases muscle strength in the diaphragm D) It helps slow the respiratory rate

a (Pursed-lip breathing is a technique used by individuals with COPD where patients exhale through pursed lips. This increases airway pressure, not decrease it.)

You are caring for a patient admitted with an exacerbation of asthma. After several treatments, the ABG results are pH 7.40, PaCO2 40 mmHg, HCO3 24 mEq/L, PaO2 92 mmHg, O2 Sat 99%. You interpret these results as which of the following? A)Within normal limits B)Slight metabolic acidosis C)Slight respiratory acidosis D)Slight respiratory alkalosis

a (Since the pt's results all fall within these normal ranges, the nurse can conclude that the patient's blood gas results are WNL.)

Upon a client's admission for extracapsular fracture of the left femur, how should a nurse expect the extremity to appear? A) Shorter than the other leg B) Internally rotated C) Blanched over the fracture site D) To have foot drop

a (The affected leg will be shorter and externally rotated.)

The nurse is preparing to insert a NGT into a 68 y/o patient with an abdominal mass, who is experiencing nausea & vomiting; a bowel obstruction is suspected. The patient asks the nurse why this is necessary. Which of the following responses is most appropriate? A)"The tube will help to drain the stomach contents and prevent further vomiting." B) "The tube will push past the area that is blocked, and thus help to stop the vomiting." C) "The tube is just a standard procedure before many types of surgery to the abdomen." D) "The tube will let us measure your stomach contents, so that we can plan what type of IV fluid replacement would be best."

a (The nasogastric tube is used to decompress the stomach by draining stomach contents, and thereby prevent further vomiting.)

You receive a physician's order to change a patient's IV from D5½ NS with 40 mEq KCl/L to D5NS with 20 mEq KCl/L. Which set of laboratory values would best support this IV order change? A) Sodium 136 mEq/L, potassium 4.5 mEq/L B) Sodium 145 mEq/L, potassium 4.8 mEq/L C) Sodium 135 mEq/L, potassium 3.6 mEq/L D) Sodium 144 mEq/L, potassium 3.7 mEq/L

a (The normal range for serum sodium is 135 to 145 mEq/L, whereas the normal range for serum potassium is 3.5 to 5.0 mEq/L. The change in the IV order decreases the amount of potassium and increases the amount of sodium. Therefore, for this order to be appropriate, the potassium level must be near the high end and the sodium level near the low end of their respective ranges.)

The nurse in the emergency department receives arterial blood gas results for four recently admitted patients with obstructive pulmonary disease. Which patient will require the most rapid action by the nurse? A) 20-year-old with ABG results: pH 7.28, PaCO2 60mm Hg, and PaO2 58 mm Hg B) 32-year-old with ABG results: pH 7.50, PaCO2 30 mm Hg, and PaO2 65 mm Hg C) 40-year-old with ABG results: pH 7.34, PaCO2 33 mm Hg, and PaO2 80 mm Hg D) 64-year-old with ABG results: pH 7.31, PaCO2 58 mm Hg, and PaO2 64 mm Hg

a (The pH, PaCO2, and PaO2 indicate that the patient has severe uncompensated respiratory acidosis and hypoxemia. Rapid action will be required to prevent increasing hypoxemia and correct acidosis. The other patients also should be assessed as quickly as possible, but do not require interventions as quickly as the 20-year old.)

The nurse is caring for a 76 y/o man who has undergone left knee arthroplasty with prosthetic replacement of the knee joint to relieve the pain of severe osteoarthritis. Postoperatively, the nurse expects which of the following will be included in the care of the affected leg? A)Progressive leg exercises to obtain 90 degree flexion B)Early ambulation with full weight bearing on the left leg C)Bed rest for 3 days with the left leg immobilized in extension D)Immobilization of the left knee in 30 degree flexion for 2 weeks to prevent dislocation

a (The patient is encouraged to engage in progressive leg exercises until 90 degree flexion is possible. Because this is painful after surgery, the patient requires good pain management and often the use of an continuous passive motion (CPM) machine.)

A 40 y/o male client has been hospitalized with peptic ulcer disease. He is being treated with a histamine receptor antagonist (cimetidine), antacids, and diet. The nurse doing discharge planning will teach him that the action of cimetidine is to: A) Reduce gastric acid output B) Protect the ulcer surface C) Inhibit the production of hydrochloric acid (HCl) D) Inhibit vagus nerve stimulation

a (These drugs inhibit action of histamine on the H2 receptors of parietal cells, thus reducing gastric acid output.)

The nurse provides home care instructions to a patient with systemic lupus erythematosus and tells the patient about methods to manage fatigue. Which statement by the patient indicated a need for further instruction? A)I should take hot baths because they are relaxing B)I should sit whenever possible to conserve my energy C)I should avoid long periods of rest because it causes joint stiffness D)I should do some exercises, such as walking, when I am not fatigued

a (To help reduce fatigue in a patient with SLE, the nurse should instruct the patient to sit whenever possible, avoid hot baths (because they exacerbate fatigue), schedule moderate low-impact exercises when not fatigued, and maintain a balanced diet. This patient is instructed to avoid long period of rest because it promotes joint stiffness.)

Foods allowed in the diet of gout patient include: A)Cheese B)Beef C)Sardines D)Liver

a (Uric acid is formed from metabolism of purine. To prevent further formation/accumulation of uric acid, the patient must be advised to stay on a low purine diet. Educate patient to avoid: sweet breads, yeast, heart, herring, sardines, anchovies, shellfish, heavy alcohol intake; Avoid excess weight gain; An alkaline ash diet increases the pH of urine to discourage precipitation of uric acid and enhance the action of drugs such as probenecid (Benemid).)

The nurse is planning to teach a patient with GERD about substances to avoid. Which items should the nurse include on this list? (Select all that apply.) A)Coffee B)Chocolate C)Peppermint D)Nonfat milk E)Fried chicken F)Scrambled eggs

a, b, c, e (Foods that decrease lower esophageal sphincter (LES) pressure and irritate the esophagus will increase reflux and exacerbate the symptoms of GERD and therefore should be avoided. Aggravating substance include chocolate, coffee, fried or fatty foods, peppermint, carbonated drinks and alcohol. Answers D & F do not promote this effect.)

Claudication is a well-known effect of peripheral vascular disease. Which of the following facts about claudication are correct? (Select all that apply.) A)It results when oxygen demand is greater than oxygen supply. B)It is characterized by pain that often occurs during rest. C)It is a result of tissue hypoxia. D)It is characterized by cramping and weakness.

a, c, d (Claudication describes the pain experienced by a patient with peripheral vascular disease when O2 demands in the leg muscles exceeds the O2 supply. This most often occurs during activity when demand increases in muscle tissue. The tissue becomes hypoxic, causing cramping, weakness and discomfort.)

The nurse is preparing a list of discharge instructions for a client who has been hospitalized for TB. Which instructions should be included on the list? (Select all that apply.) A)Activities should be resumed gradually. B)Avoid contact with other individuals, except family members, for at least 6 months. C)A sputum culture is needed q2-4 weeks once medication therapy is initiated. D)Respiratory isolation is not necessary because family members already have been exposed. E)Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags. F)When one sputum culture is negative, the client is no longer considered infectious and usually can return to former employment.

a, c, d, e (The nurse should provide the pt/family with information about TB and allay concerns about the contagious aspect of the infection. Instruct the client to follow the med regimen exactly as prescribed and always have a supply of the medication on hand. Advise the client of the side effects of the med and ways of minimizing them to ensure compliance. Reassure them that after 2-3 weeks of med therapy, it is unlikely that the client will infect anyone. Inform pt that activities should be resumed gradually; the need for adequate nutrition; well balanced diet rich in iron, protein, Vit C (promotes healing; prevents recurrence of infection). Inform pt/family that isolation is not necessary as family members have already been exposed. Educate about hand-washing and cover mouth/nose when sneezing/coughing. Sputum culture is needed q2-4 weeks once med therapy is initiated. When results of 3 sputum cultures are negative, the pt is no longer considered infectious and can usually return to former employment.)

The nurse is making a home visit to a 70 y/o client with emphysema. The nurse would call the physician if which of the following was present? A) Increased anterior-posterior diameter of the chest B)More frequent cough with change in the character of secretions C) Pursed-lip breathing D) O2 sats at 89%

b (A new cough producing yellow secretions may indicate a superimposed infection and predispose the client to respiratory failure.)

You are admitting a patient with complaints of abdominal pain with nausea and vomiting. A bowel obstruction is suspected. You assess this patient for which of the following anticipated primary acid/base imbalances if the obstruction is high in the intestines? A)Metabolic Acidosis B)Metabolic Alkalosis C)Respiratory Acidosis D)Respiratory Alkalosis

b (Because gastric secretions are rich in hydrochloric acid, the patient, who is vomiting, will lose a significant amount of gastric acid and be at an increased risk for metabolic alkalosis.)

A client with peptic ulcer disease tells the nurse that he has black stools, which he has not reported to his physician. Based on this information, which nursing diagnosis would be appropriate for this client? A)Ineffective coping related to fear of diagnosis of chronic illness B) Deficient knowledge related to unfamiliarity with significant signs and symptoms C) Constipation related to decreased gastric motility D) Imbalanced nutrition: Less than body requirements due to gastric bleeding

b (Black, tarry stools are an important warning sign of bleeding in peptic ulcer disease. Digested blood in the stomach causes it to be black. The odor of the stool is very stinky. Clients with peptic ulcer disease should be instructed to report the incidence of black stools promptly to their physician.)

The nurse considers which of the following to be the priority item in discharge teaching for a patient who has chronic bronchitis? A)Fluid restriction B)Smoking cessation C)Avoidance of crowds D)Side effects of drug therapy

b (Cigarette smoking is the primary etiology of chronic bronchitis so cessation is the priority for the patient.)

Which of the following complications does the nurse suspect when a patient has a fracture of the femur and is now experiencing respiratory distress? A)Sepsis B)Fat embolism C)Bleeding D)Shock

b (Fat embolism is a common complication of fracture of the long bones, like fracture of the femur. Yellow marrow is released into the circulation and reaches the pulmonary circulation. Acute respiratory distress syndrome may occur.)

The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-tube has drained 750ml of green-brown drainage. Which nursing intervention is most appropriate? A) Notify the physician B) Document the findings C) Irrigate the T-tube D) Clamp the T-tube

b (Following cholecystectomy, drainage from the T-tube is initially bloody and then turns to green-brown. The drainage is measured as output. The amount of expected drainage will range from 500 to 1000 ml per day. The nurse would document the output.)

Which of the following foods should not be included in the diet of a patient with diverticulitis? A)Rice and steamed chicken B)Tomato and cucumber C)Pasta and orange slices D)Roasted turkey and spaghetti

b (Foods with seeds like tomato and cucumber should be avoided by the patient with diverticulitis because the seeds may be trapped in the outpouchings.)

The nurse is caring for a pt admitted with a history of HTN. The patient's medication history includes hydrochlorothiazide (Hydrodiuril) daily for the past 10 years. Which of the following parameters would indicate the optimal intended effect of this drug therapy? A)Weight loss of 2 lb. B)Blood pressure 128/86 C)Absence of ankle edema D)Output of 600 ml per shift

b (Hydrochlorothiazide may be used alone as monotherapy to manage HTN or in combination with other meds if not effective alone. After the first few weeks of therapy, the diuretic effect diminishes, but the anti-HTN effect remains. Since the patient has been taking this medication for 10 years, the most direct measurement of its intended effect would be the blood pressure.)

A client is to receive gavage feeding through a nasogastric (NG) tube. Which of the following actions should be instituted to prevent complications? A) Flush with 20mL of air B) Place client in high Fowler's position C) Advance tube 1 cm D) Plug the air vent during feeding

b (Keeping the client in a high Fowler's position minimizes the risk of aspiration.)

Your patients morning laboratory results reveal a serum potassium level of 2.9 mEq/L. Which of the following classification of medications should you withhold until consulting with the physician? A) Antibiotics B) Loop diuretics C) Bronchodilators D) Antihypertensives

b (Loop diuretics are contraindicated during episodes of hypokalemia because these medications cause the kidneys to excrete sodium and potassium. Thus administration of this type of medication at this time would worsen the hypokalemia, putting the patient at risk for dysrhythmias. The prescribing physician should be consulted for potassium replacement therapy, and the drug should be withheld until the potassium has returned to normal range.)

A patient is complaining of low back pain that radiates down the left posterior thigh. The nurse should ask the patient if the pain is worsened or aggravated by which factor? A)Bed rest B)Bending or lifting C)Application of heat D)Ibuprofen (Motrin IB)

b (Low back pain that radiates into one leg (sciatica) is consistent with herniated lumbar disk. The nurse assesses the client to see whether the pain is aggravated by events that increase intraspinal pressure, such as bending, lifting, sneezing and coughing, or by lifting the leg straight up while supine (straight leg-raising test). Bed rest, heat (or sometimes ice), and NSAIDs usually relieve back pain.)

The nurse would be alerted to the occurrence of malignant hyperthermia when the patient demonstrates A) Hypocapnia B) Muscle rigidity C) Decreased body temperature D) Confusion upon arousal from anesthesia

b (Malignant hyperthermia is a metabolic disease characterized by hyperthermia with rigidity of skeletal muscles occurring as a result of exposure to certain anesthetic agents in susceptible patients. Hypoxemia, hypercapnia, and dysrhythmias may also be seen with this disorder.)

Which type of medication is most commonly used to treat RA? A)Glucocorticoids B)NSAIDs C)Antimalarial drugs D)Gold salts

b (NSAIDs are the first choice meds to treat RA. It's main action is to inhibit the inflammatory action of the mediators of inflammation; arachidonic acid and prostaglandins, etc. work to stop the disease process. It also provides pain relief. However, it does not correct existing damage or bone deformity. Meds used to treat RA include: Salicylates ASA-Aspirin (Anti-inflammatory and analgesic))

Patients with chronic illnesses are more likely to get pneumonia when which of the following is present? A)Dehydration B)Group living C)Malnutrition D)Severe periodontal disease

b (Patients with chronic illnesses generally have poor immune systems. Often, residing in group living situations increases the chance of disease transmission.)

A client complains of gnawing epigastric pain for a few hours after meals. At times, when the pain is severe, vomiting occurs. Specific tests are indicated to rule out: A) Cancer of the stomach B) Peptic ulcer disease C) Chronic gastritis D) Pylorospasm

b (Peptic ulcer disease is characteristically gnawing epigastric pain that may radiate to the back. Vomiting usually reflects pyloric spasm from muscular spasm or obstruction. Cancer would not evidence pain or vomiting unless the pylorus was obstructed.)

The nurse is teaching a patient with chronic bronchitis how to do pursed-lip breathing. What is the rationale for this type of exercise? A) Provides more time for gas exchange. B) Increases airway pressure. C) Increases the oxygen concentration. D) Stimulates coughing.

b (Pursed-lip breathing is a technique that uses the mild resistance of partially closed lips to prolong exhalation and to increase pressure, causing a delay of the airway's dynamic compression and minimizing the effects of airway trapping. Pursed-lip breathing doesn't provide more time for air exchange, increase the oxygen concentration, or stimulate coughing.)

Which of the following best describes the method of action of medications, such as ranitidine (Zantac), which are used in the treatment of peptic ulcer disease? A) Neutralize acid B) Reduce acid secretions C) Stimulate gastrin release D) Protect the mucosal barrier

b (Ranitidine is a histamine-2 receptor antagonist that reduces acid secretion by inhibiting gastrin secretion.)

Which assessment finding should the nurse expect for a patient who has been diagnosed with RA? A)An asymmetrical pattern of affected joints B)A positive rheumatoid factor titer C)The presence of Heberden's nodes D)A positive anti-nuclear antibody titer

b (S/S: begins as fatigue, musculoskeletal pain, low grade fever, lack of appetite and weight loss. They must be present for at least 6 weeks and must be present at the same time to establish a diagnosis. Morning stiffness lasts at least 1 hr. Other s/s include symmetric joint swelling of 3 or more joints, positive rheumatoid factor titer and rheumatoid nodules.)

Which of the following should the nurse include when giving health teachings to a patient with GERD? A)Lie down after meals. B)Sleep with the head of bed elevated. C)Eat high carbohydrate diet. D)Eat low protein diet.

b (The HOB should be elevated during sleep to prevent gastroesophageal reflux.)

The nurse is working on a surgical floor and is preparing to receive a postoperative patient from the post anesthesia unit. Which of the following should be the nurse's initial action upon the patient's arrival? A) Assess the patient's pain. B) Assess the patient's vital signs. C) Check the rate of the IV infusion. D) Check the physician's postoperative orders.

b (The highest priority action by the nurse is to assess the physiologic stability of the patient. This is in part accomplished by taking the patient's vital signs. The other actions can then take place in rapid sequence.)

The nurse identifies a nursing Diagnosis of pain r/t muscle spasms for a 45 y/o patient who has low back pain from herniated lumbar disk. Which of the following would be an appropriate nursing intervention to treat this problem? A)Provide gentle range of motion to the lower extremities B)Elevate the head of bed 20 degrees and flex the knees C)Place the bed in reverse Trendelenburg with the feet firmly against the footboard D)Place a small pillow under the pt's upper back to gently flex the lumbar spine

b (The nurse should elevate the HOB 20 degrees and flex the knees to avoid extension of the spine and increasing the pain. The slight flexion provided by this position is often comfortable for patient's with herniated lumbar disks.)

A patient with varicose veins has been prescribed compression stockings. How should the nurse teach the patient to use these? A)"As much as possible, try to keep your stockings on 24 hours a day." B)"While you're still lying in bed in the morning, put on your stockings." C)"Dangle your feet at your bedside for 5 minutes before putting on your stockings." D)"Your stockings will be most effective if you can remove them for a few minutes several times a day."

b (The patient with varicose veins should apply stocking in bed, before rising in the morning. Stockings should not be worn 24 hours a day; additionally, they should not be removed several times daily. Dangling at the bedside prior to application is likely to decrease their effectiveness.)

An 82 y/o man has been admitted with benign prostatic hyperplasia. Which of the following is most appropriate to include in the nursing plan of care? A) Limit fluid intake to no more than 1500 mL/day B) Leave a light on in the bathroom during the night C) Pad the patient's bed to accommodate overflow incontinence D) Ask the patient to use a urinal so that all urine can be measured

b (The patient's age and diagnosis indicate a likelihood of nocturia, so leaving the light on in the bathroom is appropriate. Fluids should be encouraged because dehydration is more common in older patients. The information in the question does not indicate that the measurement of the patient's output is necessary or that the patient has overflow incontinence.)

During recovery from anesthesia in the post anesthesia care unit (PACU), a patient's vital signs are blood pressure 118/72, pulse 76, respirations 12, and SpO2 91%. The patient is sleepy but awakens easily. Which action should the nurse take at this time? A) Place the patient in a side-lying position B) Encourage the patient to take deep breaths C) Prepare to transfer the patient from the PACU D) Increase the rate of the postoperative IV fluids

b (The patient's borderline SpO2 and sleepiness indicate hypoventilation. The nurse should remind the patient to take deep breaths. Placing the patient in a lateral position is needed when the patient first arrives in the PACU and is unconscious. The stable BP and pulse indicate that no changes in fluid intake are required. The patient is not fully awake and has a low SpO2; initiating a transfer from the PACU is not appropriate.)

A 54 y/o patient with acute osteomyelitis asks the nurse how this problem will be treated. Which of the following responses by the nurse is most appropriate? A) "Oral antibiotics are often required for several months." B) "Intravenous antibiotics are usually required for several weeks." C) "Surgery is almost always necessary to remove the dead tissue that is likely to be present."D) "Drainage of the foot and instillation of antibiotics into the affected area is the usual therapy."

b (The standard treatment for acute osteomyelitis consists of several weeks of intravenous antibiotic therapy. This is because bone is denser and less vascular than other tissues, and it takes time for the antibiotic therapy to eradicate all of the microorganisms.)

Unless contraindicated by the surgical procedure, which of the following positions is preferred for the unconscious patient immediately postoperative? A) Supine B) Lateral C) Semi-Fowler's D) High-Fowler's

b (Unless contraindicated by the surgical procedure, the unconscious patient is positioned in a lateral "recovery" position. This recovery position keeps the airway open and reduces the risk of aspiration. Once conscious, the patient is usually returned to a supine position with the head of the bed elevated.)

When auscultating breath sounds in the client with an acute asthma episode, the nurse uses which of the following to guide interpretation of severity of findings? A)Severity of airway obstruction is associated with intensity of wheezing. B) Wheezing may be absent with severe airway obstruction. C)Unilateral wheezing indicates asthma as the origin for respiratory distress. D) Breath sounds are prolonged on expiration.

b (Wheezing is a common finding during an acute asthma episode; however, the wheezing is not a consistent predictor of the severity of the attack.)

A woman has been recently diagnosed with systemic lupus and shares with the nurse, "I am thinking about getting pregnant, but I don't know how I will be able to tolerate a pregnancy because I have lupus." Which of the following responses by the nurse is BEST? A)Most women find that they feel better when they are pregnant B)How long have you been in remission? C)Women with lupus frequently have slightly longer gestations D)It is best to become pregnant within the first 6 months of diagnosis

b (Women should be in remission for at least 5 months prior to conceiving. Maternal morbidity and mortality are increased with lupus. Gestation is not affected by SLE. It is recommended that a woman wait 2 years following diagnosis before conceiving.)

Which of the following intraoperative nursing responsibilities would be performed by the scrub nurse? (Select all that apply.) A) Documenting intraoperative care B) Keeping track of irrigation solutions for monitoring of blood loss C) Passing instruments and supplies to the surgeon by anticipating his or her needs D) Coordinating the flow and activities of members of the surgical team in the surgical suite E) Performing the count of sponges, needles, and instruments used during the surgical procedure

b, c, e (Both the scrub nurse and circulating nurse will participate in the counting of surgical sponges, needles and instruments, whereas passing instruments to the surgeon is the exclusive responsibility of the scrub nurse. The circulating nurse takes primary responsibility for the coordination of the surgical suite and documentation.)

Which person is at the highest risk for development of erectile dysfunction? A)A 35 y/o CEO of a company with a huge debt. B)A 40 y/o smoker who drinks socially. C)A 60 y/o man with a 15-year history of uncontrolled diabetes. D)A 55 y/o man with diet-controlled hypertension.

c (According to the NIH Consensus Development Panel on Impotence, ED is the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse. Risk factors for the development of ED include HTN, hyperlipidemia, cigarette smoking, diabetes mellitus, and pelvic irradiation. The 60 y/o patient with a 15-year history of uncontrolled diabetes is at the highest risk for the development of ED.)

After undergoing a transurethral resection of the prostate (TURP) to treat BPH, a patient is returned to the room with continuous bladder irrigation in place. One day later, the patient reports bladder pain. What should the nurse do first? A)Increase the irrigation flow rate B)Notify the doctor immediately C)Assess the irrigation catheter for patency and drainage D)Administer meperidine (Demerol) as prescribed

c (Although postop pain is expected, the nurse should ensure that other factors, such as an obstructed irrigation catheter, aren't the cause of the pain. After assessing catheter patency, the nurse should administer an analgesic such as meperidine as prescribed. Increasing the irrigation flow rate may worsen the pain. Notifying the doctor isn't necessary unless the pain is severe or unrelieved by the prescribed medication.)

Which of the following preoperative patients likely faces the greatest risk of bleeding as a result of their medication? A) A woman who takes metoprolol (Lopressor) for the treatment of hypertension B) A man whose type 1 diabetes is controlled with insulin injections four times daily C) A man who is taking clopidogrel (Plavix) after the placement of a coronary artery stent D) A man who recently started taking finasteride (Proscar) for the treatment of benign prostatic hyperplasia

c (Any drug that inhibits platelet aggregation, such as clopidogrel (Plavix), represents a bleeding risk. Insulin, metoprolol (Lopressor), and finasteride (Proscar) are less likely to contribute to a risk for bleeding.)

The nurse is caring for a patient admitted with emphysema, angina, and hypertension. Before administering the prescribed daily dose of atenolol 100 mg PO, the nurse assesses the patient carefully. Which of the following adverse effects is this patient at risk for given the patient's health history? A) Hypocapnia B) Tachycardia C) Bronchospasm D) Nausea and vomiting

c (Atenolol is a cardioselective β1-adrenergic blocker that reduces blood pressure and could affect the β2-receptors in the lungs with larger doses or with drug accumulation. Although the risk of bronchospasm is less with cardioselective β-blockers than nonselective β-blockers, atenolol should be used cautiously in patients with COPD.)

Which of the following is the primary reason for accurately recording the patient's current medications during a preoperative assessment? A)Some medications may alter the patient's perceptions about surgery. B) Many anesthetics alter renal and hepatic function, causing toxicity of other drugs. C) Some medications may interact with anesthetics, altering the potency and effect of the drugs. D) Routine medications are withheld the day of surgery, requiring dosage and schedule adjustments after surgery.

c (Drug interactions may occur between prescribed medications and anesthetic agents used during surgery. For this reason, it is important to take a careful medication history and check that they have been communicated to the anesthesia care provider.)

The nurse is caring for a patient with osteoarthritis who is about to undergo total left knee arthroplasty. The nurse assesses the patient carefully to be sure that there is not evidence of which of the following in the preoperative period? A)Pain B)Left knee stiffness C)Left knee infection D)Left knee instability

c (It is critical that the patient be free of infection before a TKA. An infection in the joint could lead to even greater pain and joint instability, requiring extensive surgery. For this reason, the nurse monitors the patient for signs of infection, such as redness, swelling, fever and elevated WBC.)

The nurse is admitting a patient who complains of a new onset of lower back pain. To differentiate between the pain of lumbar herniated disk and lower back pain from other causes, which of the following would be the best question for the nurse to ask the patient? A) "Is the pain worse in the morning or in the evening?" B) "Is the pain sharp and stabbing, or burning and aching?" C) "Does the pain radiate down the buttock or into the leg?" D) "Is the pain totally relieved by analgesics, such as acetaminophen (Tylenol)?"

c (Lower back pain associated with herniated lumbar disk is accompanied by radiation along the sciatic nerve and can be described commonly as traveling through the buttock, to the posterior thigh, or down the leg. This is because the herniated disk causes compression on spinal nerves as they exit the spinal column. The other questions asked by the nurse does not elicit this data.)

A nurse is providing discharge teaching to a patient with peripheral vascular disease. Which of the following information should be included in the teaching? A) Walk barefoot whenever possible B) Use a heating pad to keep feet warm C) Avoid crossing the legs D) Use antibacterial ointment to treat skin lesions at risk of infection

c (Patients with peripheral vascular disease should avoid crossing the legs because this can impede blood flow. Walking barefoot and the use of a heating pad places the patient at risk for injury. Patient should report skin lesions to their HCP.)

Which of the following organisms most commonly causes community-acquired pneumonia in adults? A)Haemophilus influenza B)Klebsiella pneumoniae C)Streptococcus pneumoniae D)Staphylococcus aureus

c (Pneumococcal or S. pneumonia, caused by S. pneumoniae, is the most common cause of community-acquired pneumonia. H. influenza is the most common cause of infection in children. Klebsiella species is the most common gram-negative organism found in hospital settings. Staph. Aureus is the most common cause of hospital-acquired pneumonia.)

A client is to take one daily dose of ranitidine (Zantac) at home to treat her peptic ulcer. The nurse knows that the client understands proper drug administration of ranitidine when she says that she will take the drug at which of the following times? A) Before meals B) With meals C) At bedtime D) When pain occurs

c (Ranitidine blocks secretion of hydrochloric acid. Clients who take only one daily dose of ranitidine are usually advised to take it at bedtime to inhibit nocturnal secretion of acid. Clients who take the drug twice a day are advised to take it in the morning and at bedtime.)

Of the options below, which one is NOT a symptom of BPH? A)Urinary incontinence B)Difficulty urinating C)Intestinal pain D)Sexual dysfunction

c (Recent studies suggest that there is a correlation between lower urinary tract symptoms and sexual dysfunction in aging patients. In fact, the severity of urinary symptoms and the degree of sexual dysfunction are strongly correlated, independent of age. In particular, community-based studies have found that a significant number of patients with symptomatic BPH have sexual dysfunction.)

When assessing a patient's surgical dressing on the first postoperative day, the nurse notes new, bright-red drainage about 5 cm in diameter. In response to this finding, the nurse should do which of the following? A) Recheck in 1 hour for increased drainage. B) Notify the surgeon of a potential hemorrhage. C) Assess the patient's blood pressure and heart rate. D) Remove the dressing and assess the surgical incision.

c (The first action by the nurse is to gather additional assessment data to form a more complete clinical picture. The nurse can then report the findings as a whole.)

The nurse understands that teaching has been effective when the patient verbalizes the following regarding influenza vaccinations: A)"Since the vaccine is the live virus, I can expect to be ill for 4-7 days after receiving my shot." B)"Influenza vaccines are a cure for the flu." C)"The vaccine is an inactivated virus, but may cause some mild cold-like symptoms." D)"If I have already had the vaccine last year, it is not recommended that I get it again this year."

c (The flu vaccine is recommended annually to protect individuals against the flu virus. Because the vaccine is not a live virus, individuals will not contract the virus and its ill effects. Though the virus itself has been destroyed, some parts of the protein shell remain intact, the body is able to recognize these proteins as a foreign body and create antibodies to protect the individual from it. Because the body is creating a defense, the individual may develop very mild cold-like symptoms.)

A patient is admitted to the nursing unit with a diagnosis of right renal calculus. He has a Foley catheter and IV of 1000 mL of 0.9% NS infusing at 150 mL/hr. Which of the following assessment findings warrants immediate reporting by the nurse? A)Flank pain that radiates to the lower abdomen B)Nausea that is controlled with prescribed medication C)No urine output for 2 hours D)Pt reports feeling "sweaty"

c (The lack of urine output may indicate obstruction and warrants immediate reporting by the nurse. Nausea, flank pain that radiates to the abdomen, and sweating are all common occurrences associated with a renal calculus.)

The nurse has reviewed proper body mechanics with a 45 y/o patient with a history of low back pain caused by a herniated lumbar disk. Which of the following statements made by the patient indicates a need for further teaching? A)I should sleep on my side or back with my hips and knees bent. B)I should exercise at least 15 minutes every morning and evening. C)I should pick up items by leaning forward without bending my knees. D)I should try to keep one foot on a stool whenever I have to stand for a period of time.

c (The patient should avoid leaning forward without bending the knees. Bending the knees helps to prevent lower back strain and is part of proper body mechanics when lifting.)

A nurse teaches a patient about the use of a respiratory inhaler. Which action by the patient indicates a need for further teaching? A)Removes the cap and shakes the inhaler well before use. B)Presses the canister down with his fingers as he breathes in. C)Inhales the mist and quickly exhales. D)Waits 1-2 minutes between puffs if more than one puff has been prescribed.

c (The patient should be instructed to hold his/her breath at least 10-15 seconds before exhaling the mist.)

A patient with pyelonephritis is being discharged from the hospital, and the nurse provides instructions on how to prevent recurrence. The nurse determines the patient understands the information if the patient states an intention to: A)Increase fluids for 2 days if signs and symptoms of a urinary tract infection develop B)Take the prescribed antibiotics until all symptoms subside C)Return to the physician's office for scheduled follow-up urine cultures D)Decrease fluid intake if frequent urination occurs

c (The patient with pyelonephritis should take the full course of antibiotics and return to the HCP's office for follow-up urine cultures if so instructed. The patient should learn the s/s of a urinary tract infection, and report them immediately if they occur. The patient should also drink 3 L of fluid per day.)

A patient with pneumonia develops dyspnea with a respiratory rate of 32 bpm and difficulty expelling his secretions. The nurse auscultates his lung fields and hears bronchial sounds in the left lower lobe. The nurse determines that the patient requires which of the following treatments first? A)Antibiotics B)Bed rest C)Oxygen D)Nutritional intake

c (The pt is having difficulty breathing and is probably becoming hypoxic. As an emergency measure, the nurse can provide O2 without waiting for a doctor's order. Antibiotics may be warranted, but this isn't an RN's decision. The patient should be maintained on bedrest if he is dyspneic to minimize his O2 demands, but providing additional O2 will deal more immediately with his problem. The patient will need nutritional support, but while dyspneic, he may be unable to spare the energy needed to eat and at the same time maintain adequate oxygenation.)

A nurse should recognize the signs of deep vein thrombosis (DVT) if a patient reports: (select all that apply) A)Leg feeling cool with no pain B)Numbness of legs with diaphoresis C)Sudden swelling of one leg with dependent edema D)Dizziness and blurred vision E)Pain behind the knee with dorsiflexion

c, e (Answer A is incorrect—the problem in DVT causes phlebitis, which is characterized by warmth, redness and pain. Answer B is incorrect—the problem in DVT is circulatory, not neurological. Answer C is correct—a clot in a leg vein will affect venous return causing swelling and edema. Answer D is incorrect—the problem in DVT is in the leg, not the eyes. Answer E is correct—pain with dorsiflexion (positive Homan's sign) may be present with DVT but should not be considered the only indicator.)

To prevent the recurrence of renal calculi, the nurse teaches the patient to: A) Use a filter to strain all urine B) Avoid dietary sources of calcium C) Drink diuretic fluids such as coffee D) Have 2000 to 3000 mL of fluid a day

d (A fluid intake of 2000 to 3000 mL of fluid daily is recommended to help flush out minerals before stones can form. Avoidance of calcium is not usually recommended for patients with renal calculi. Coffee tends to increase stone recurrence. There is no need for a patient to strain all urine routinely after a stone has passed, and this will not prevent stones.)

A client is taking an antacid for treatment of a peptic ulcer. Which of the following statements best indicates that the client understands how to correctly take the antacid? A)"I should take my antacid before I take my other medications." B) "I need to decrease my intake of fluids so that I don't dilute the effects of my antacid." C) "My antacid will be most effective if I take it whenever I experience stomach pains." D) "It is best for me to take my antacid 1 to 3 hours after meals."

d (Antacids are most effective if taken 1 to 3 hours after meals and at bedtime. When an antacid is taken on an empty stomach, the duration of the drug's action is greatly decreased. Taking antacids 1 to 3 hours after a meal lengthens the duration of action, thus increasing the therapeutic action of the drug. Antacids should be administered about 2 hours after other medications to decrease the chance of drug interactions. It is not necessary to decrease fluid intake when taking antacids.)

In reviewing medication instructions with a patient being discharged on antihypertensive medications, which of the following statements would be most appropriate for the nurse to make when discussing atenolol (Tenormin)? A)"A fast heart rate is a side effect to watch for while taking atenolol." B) "Stop the drug and notify your doctor if you experience any nausea or vomiting." C) "Because this drug may affect the lungs in large doses, it may also help your breathing." D) "Make position changes slowly, especially when going from a lying down to a standing position."

d (Atenolol is a β1-adrenergic blocker and antihypertensive agent that can cause orthostatic hypotension. For this reason, the patient should be instructed to rise slowly, especially when moving from a recumbent to a standing position.)

In a patient with emphysema, the initiative to breathe is triggered by: A)High PaCO2 levels B)Low PaCO2 levels C)High PaO2 levels D)Low PaO2 levels

d (Because of long-standing hypercapnia, low PaO2 levels trigger breathing in a patient with emphysema. In a patient with a normal respiratory drive, increased PaCO2 levels trigger the initiative to breathe.)

The patient with an un-displaced mid-shaft fracture of the left tibia was placed in a long leg cast after experiencing a car accident. Overnight the patient returned to the ER and is now complaining of unrelenting severe pain and feeling as if the toes are asleep. When the cast is removed and the patient still complains of severe pain, the nurse suspects that the patient is experiencing which of the following conditions? A)Fat embolism B)Pressure ulcer under cast C)Infection D)Compartment syndrome

d (Compartment Syndrome is a complication in which swelling of the muscle fascia cuts off circulation and must be relieved through a fasciotomy.)

A client being treated for chronic cholecystitis should be given which of the following instructions? A) Increase rest B) Avoid antacids C) Increase protein in diet D) Use anticholinergics as prescribed

d (Conservative therapy for chronic cholecystitis includes weight reduction by increasing physical activity, a low-fat diet, antacid use to treat dyspepsia, and anticholinergic use to relax smooth muscles and reduce ductal tone and spasm, thereby reducing pain.)

The nurse notes that the patient with a cast has a diminished distal pulse. Which of the following is the most appropriate nursing action? A)Check the patient's vital signs B)Get a Doppler and check for distal pulse C)Elevate the affected feet D)Notify the physician

d (Diminished distal pulse in an extremity with a cast indicates that the cast is too tight. This leads to circulatory impairment. Therefore, the physician should be notified. Bivalve or splitting of the cast will be done by the physician to prevent necrosis and gangrene formation.)

The nurse is caring for a 68 y/o patient admitted with abdominal pain, nausea, and vomiting. The patient has an abdominal mass and a bowel obstruction is suspected. The nurse auscultating the abdomen listens for which of the following types of bowel sounds that are consistent with the patient's clinical picture? A) Low pitched and rumbling above the area of obstructionB) High pitched and hypoactive below the area of obstructionC) Low pitched and hyperactive below the area of obstructionD) High pitched and hyperactive above the area of obstruction

d (Early in intestinal obstruction, the patient's bowel sounds are hyperactive and high pitched, sometimes referred to as "tinkling" above the level of the obstruction. This occurs because peristaltic action increases to "push past" the area of obstruction. As the obstruction becomes complete, bowel sounds decrease and finally become absent.)

The nurse is caring for a client with right middle lobe pneumonia. The nurse should perform which of following interventions to mobilize secretions? A) Administer antibiotics as ordered B) Limit fluids to prevent heart failure from developing as a complication C) Place client in a prone position to increase alveolar expansion D) Assist client to use incentive spirometer hourly

d (Helping clients deep breathe or use the incentive spirometer promotes maximum lung expansion.)

The nurse is caring for a patient who has had an above-the-knee amputation 2 days ago. The residual limb was wrapped with an elastic compression bandage, which has come off. Which immediate action should the nurse take? A)Apply ice to the site. B)Call the HCP. C)Apply a dry sterile dressing and elevate it on one pillow. D)Rewrap the residual limb with an elastic compression bandage.

d (If a patient with an amputation has a cast or elastic compression bandage that slips off, the nurse must wrap the residual limb immediately with another elastic compression bandage. Otherwise, excessive edema will form rapidly, which could cause a significant delay in rehabilitation. If the client had a cast that slipped off, the nurse would have to call the HCP so that a new one could be applied. Elevation on one pillow is not going to impede the development of edema greatly once compression is released. Ice would be of limited value in controlling edema from this cause. If the HCP were called, the prescription likely would be to reapply the compression dressing anyway.)

When counseling a client in ways to prevent cholecystitis, which of the following guidelines is most important? A) Eat a low-protein diet B) Eat a low-fat, low-cholesterol diet C) Limit exercise to 10 minutes/day D) Keep weight proportionate to height

d (Obesity is a known cause of gallstones, and maintaining a recommended weight will help protect against gallstones. Excessive dietary intake of cholesterol is associated with the development of gallstones in many people. Dietary protein isn't implicated in cholecystitis. Liquid protein and low-calorie diets (with rapid weight loss of more than 5 lb. [2.3kg] per week) are implicated as the cause of some cases of cholecystitis. Regular exercise (30 minutes/three times a week) may help reduce weight and improve fat metabolism. Reducing stress may reduce bile production, which may also indirectly decrease the chances of developing cholecystitis.)

A patient has just experienced intraoperative vomiting. The nurse should consequently anticipate the use of which of the following medications? A) Midazolam (Versed) B) Fentanyl (Sublimaze) C) Meperidine (Demerol) D) Ondansetron (Zofran)

d (Ondansetron (Zofran) is an antiemetic, whereas midazolam (Versed) is a benzodiazepine, fentanyl (Sublimaze) and meperidine (Demerol) are opioid analgesics.)

When assessing a pt admitted with nausea and vomting, which of the following findings supports the nursing diagnosis of deficient fluid volume? A)Polyuria B)Decreased pulse C)Difficulty breathing D)General restlessness

d (Restlessness is an early cerebral sign that dehydration has progressed to the point where an intracellular fluid shift is occurring. If the dehydration is left untreated, cerebral signs could progress to confusion and later coma.)

A 42 y/o pt is scheduled for extracorporeal shock wave lithotripsy (ESWL). Which of the following statements by the patient demonstrates correct understanding of the procedure? A)"I will be fully awake during the procedure." B)"Lithotripsy will reduce my chances of a stone recurrence." C)"I will report any bruising that occurs to my doctor." D)"Straining my urine following the procedure is important."

d (Straining the urine will allow for analysis of the stone.)

A patient is admitted to the hospital with a diagnosis of BPH. He is scheduled for a TURP. It would be inappropriate to include which of the following points in the preoperative teaching? A)TURP is a common operation for severe BPH B)Explain the purpose and function of a 3-way irrigation system C)Expect blood urine, which will clear as healing takes place D)He will be pain free

d (Surgical interventions involve an experience of pain for the patient which can come in varying degrees. Telling the patient that he will be pain free is giving him false reassurance.)

A client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the mid-epigastric area along with a rigid, board-like abdomen. These clinical manifestations most likely indicate which of the following? A) An intestinal obstruction has developed B) Additional ulcers have developed C) The esophagus has become inflamed D) The ulcer has perforated

d (The body reacts to perforation of an ulcer by immobilizing the area as much as possible. This results in board-like muscle rigidity, usually with extreme pain. Perforation is a medical emergency requiring immediate surgical intervention because peritonitis develops quickly after perforation. An intestinal obstruction would not cause mid-epigastric pain. Esophageal inflammation or the development of additional ulcers would not cause a rigid, board-like abdomen.)

The nurse has conducted discharge teaching with a client diagnosed with tuberculosis, who has been receiving medication for 1.5 weeks. The nurse determines that the teaching has been effective when the client states: A)"I need to continue drug therapy for 2 months." B)"I can't shop at the mall for the next 6 months." C)"I can return to work if a sputum culture comes back negative." D)"I should not be contagious after 2-3 weeks of medication therapy."

d (The client is continued on medication therapy for 6-12 months, depending on the situation. The client generally is considered noncontagious after 2-3 weeks of medication therapy. The client is instructed to wear a mask if there will be exposure to crowds until the medication is effective in preventing transmission. The client is allowed to return to work when the results of 3 sputum cultures are negative.)

The nurse is caring for a 75 y/o woman who underwent left total knee arthroplasty and has a new order to be "up in chair today before noon." Which of the following actions would the nurse take to protect the knee joint while carrying out the order? A)Administer a dose of prescribed analgesic before completing the order B)Ask PT for a walker to limit weight bearing while getting out of bed C)Keep the CPM machine in place while lifting the patient from bed to chair. D)Put on a knee immobilizer before moving the patient out of bed and keep the surgical leg elevated while sitting.

d (The nurse should apply a knee immobilizer for stability before assisting the patient to get out of bed. This is a standard measure to protect the knee during movement following surgery.)

A 67 y/o patient hospitalized with osteomyelitis has an order for bedrest (with bathroom privileges) with the affected foot elevated on two pillows. The nurse would place highest priority on which of the following interventions? A) Ambulate the patient to the bathroom every 2 hours. B) Ask the patient about preferred activities to relieve boredom. C) Allow the patient to dangle legs at the bedside every 2 to 4 hours. D) Perform frequent position changes and range-of-motion exercises.

d (The patient is at risk for atelectasis of the lungs and for contractures because of prescribed bed rest. For this reason, the nurse should change the patient's position frequently to promote lung expansion and perform range-of-motion exercises to prevent contractures.)

Which data obtained by the nurse who is caring for a patient with rheumatoid arthritis should be reported immediately to the physician? A) The patient's temperature is 99.4° F. B) Both wrists are stiff, warm, and painful. C) The grip strength is decreased bilaterally. D) One joint on the left hand is hot and swollen.

d (The redness, swelling, and warmth associated with RA are typically bilateral. Redness, heat, and swelling in one isolated joint may indicate an infection, requiring immediate initiation of antibiotic therapy. The other data are typical of RA.)

Which information will the nurse include when teaching the patient with asthma about the prescribed medications? A)Utilize the inhaled corticosteroid when shortness of breath occurs B) Inhale slowly and deeply when using the dry-powder inhaler C) Hold your breath for 5 seconds after using the bronchodilator inhaler D) Tremors are an expected side effect of rapidly acting bronchodilators

d (Tremors are a common side effect of short-acting B2-adrenergic (SABA) medications and not a reason to avoid using SABA inhalers. Inhaled corticosteroids do not act rapidly to reduce dyspnea. Rapid inhalation is needed when using a DPI. The patient should hold their breath for 10 seconds after using inhalers.)

What is the normal range for ABGs? pH = PaCO2 = PaHCO3 = PaO2 = O2 Sats =

pH = 7.35 - 7.45 PaCO2 = 35 - 45 mmHg PaHCO3 = 22 - 26 mEq/L PaO2 = > 80% mmHg O2 Sats = 95 - 100%