NRSG 245 Exam 4

Which pain meds should Mr. G avoid because he has peptic ulcer disease? A.) NSAIDs B.) Ibuprofen C.) Aspirin D.) Tylenol

A B C

Anxiety when a patient thinks he or she cannot leave a room or situation is

Agoraphobia

Your patient is starting both Clarithromycin and Amoxicillin to treat H. pylori infection. You encourage your patient to have a variety of flavored beverages on hand because of these common side effects: A.) Headache and hypotension B.) Diarrhea and distorted taste C.) Hyperglycemia and nausea D.) Vomiting and tooth discoloration

B

The generic names of histamine 2 receptor antagonists share which common suffix and purpose: A.) -azoles; disrupt bacterial DNA synthesis B.) -lols; decrease heart rate & blood pressure C.) -tadines; block the burn before it starts D.) -pams; decrease anxiety

C

What type of drugs are used to destroy H. pylori? A.) Antacids B.) Antisecretory Agents C.) Antibiotics D.) Mucosal Protectents

C

Yesterday your patient had a BAC (blood alcohol concentration) of 0.27%. That's 27mL alcohol/100mL blood. He is on antibiotics to treat an H. pylori infection causing peptic ulcer disease. Which of these antibiotics needs to be held today? A.) Clarithromycin B.) Amoxicillin C.) Metronidazole D.) Tetracycline

C

You gave your patient Sucralfate at 0700. At what time would it be okay for him to start eating breakfast and to begin taking his other medications? A.) 0730 B.) 0800 C.) 0900 D.) 1000

C

Antacids are often seen in the check-out aisle next to candy, but there are serious dangers to overuse such as: A.) kidney stones B.) kidney failure C.) Increase risk for intestinal infections, such as C. diff D.) all of the above

D

Your patient is 6 years old and needs to be started on an antibiotic to treat an H. pylori infection causing her peptic ulcers. Which antibiotic will not be used? A.) Clarthithromycin B.) Pepto-Bismol C.) Amoxicillin D.) Tetracycline

D

Your patient is on Nardil, an MAOI, for depression. Which statement by the patient best indicates that medication education has been effective? a.) "I am eating three well balanced meals a day." b.) "I've been eating lots of avocados." c.) "I ordered cheese pizza instead of pepperoni pizza." d.) "At a family cookout I chose grilled chicken instead of the smoked salmon."

D - avoid foods that are smoked, aged, or cured to avoid hypertensive crisis

omeprazole (Prilosec) and esomeprazole (Nexium) are now sold OTC meaning that they have no serious adverse risks. True or False?

False

TCA's are reserved for patients who have not responded to first-line drugs because they?

They have more adverse effects

A nurse administers which medication to inhibit an enzyme that makes gastric acid in a patient who has a duodenal ulcer? Omeprazole [Prilosec] Famotidine [Pepcid] Misoprostol [Cytotec] Ranitidine [Zantac]

a

A patient comolaines of ED when taking paroxetine. What is the best response a. encourage patient to share concern with prescriber b. instruct patient to not take the med on weekends c. suggest the patient ask the prescriber to change prescription to bupropion d. withhold the drug

a

A patient is prescribed drug therapy including bismuth, metronidazole, tetracycline, omeprazole. The patient reveals to the nurse she doesn't like so many meds. The nursing should explain that its important for patient to take therapy as prescribed because failure to do so may lead to a. increased risk of resistance b. increased incidence of adverse effects c. increased risk of cancer d. increased incidence of nausea/diarrhea

a

A patient who has gastroesophageal reflux disease (GERD) is taking magnesium hydroxide (milk of magnesia). Which outcome should a nurse expect if the medication is achieving the desired therapeutic effect? Neutralized gastric acid Reduced stomach motility Increased barrier to pepsin Reduced duodenal pH

a

Inner ear hearing problems are associated with: a.) Loop diuretics b.) Thiazide diuretics c.) Potassium-sparing diuretics d.) Osmotic diuretics

a

Using a stepwise approach to managing asthma, a nurse teaches a patient who is at step 1 to use albuterol MDI [Proventil] at which of these times? a. Whenever needed (PRN) as a quick-relief agent b. Twice daily combined with an inhaled glucocorticoid c. Only with a long-acting beta2 agonist (LABA) d. If nighttime awakenings occur more than 2 days a week

a

What are current recommendations for use of inhaled glucocorticoids for persistent asthma a. administer daily even on days where there are no symptoms b. administer first when giving bronchodilators c. only use as a rescue drug for acute flares of wheezing d. only use on a regular basis if acute attacks occur every day because of adverse effects

a

What should be included in teaching the patient who revels they are self medicating to St. Johns wart a. tell all health care providers your using the drug b. research is proven the product as effect antidepressant drug for mild depression c. the substance is proven to be effective d. the substance is safe because its natural and not a drug

a

which lab result would be a reason for the nurse to consult the prescriber regarding administration of rabeprazole a. digoxin 2.5 b. INR 1 c. LDL 138mg d. WBC 10,000

a

The nurse should monitor for which adverse effect after administering hydrochlorothiazide [HydroDIURIL] and digoxin [Lanoxin] to a patient? Digoxin toxicity Decreased diuretic effect Dehydration Heart failure

a Digoxin levels have an inverse relationship with potassium levels. Because hydrochlorothiazide can lower potassium levels, combined use of hydrochlorothiazide and digoxin poses a risk for elevated digoxin levels and ensuing digoxin toxicity.

The nurse knows that diuretics mostly affect which function of the kidneys? a. Cleansing and maintenance of extracellular fluid volume b. Maintenance of acid-base balance c.Excretion of metabolic waste d. Elimination of foreign substances

a Most diuretics block sodium and chloride reabsorption, thus affecting the maintenance of extracellular fluid volume.

The nurse is caring for several patient who receive B-agonist inhalation treatments for asthma. After treatments are administered it is of greatest priority to reassess the patient who also has a history of which condition a. heart failure b. deep vein thrombosis c. gastroesophageal reflux d. Rhumatoid arthritis

a because if dosage is excessive, the crossover stimulation of beta one receptors can cause angina pectoris and tachydysrthymias.

A 36 year old women who is taking bismuth subsalicylate, tetracycline, and metronidazole experiences black colored stool. What is the priority nursing action a. completing an abdominal assessment b. consulting prescriber c. continuing nursing care, this isa harmless effect of bismuth d. teaching that tetracycline can discolor fetal teeth if patient gets pregnant

a because it could be internal bleeding

The nurse takes orthostatic BP readings before administering diuretics to a group of patients. It would be a priority to teach orthostatic BP precautions to a patient with which orthostatic blood pressure readings? A. 150/90 mm Hg lying; 125/70 mm Hg sitting. B. 140/82 mm Hg lying; 125/72 mm Hg sitting. C. 130/90 mm Hg lying; 118/78 mm Hg sitting. D. 116/70 mm Hg lying; 110/68 mm Hg sitting.

a because theres a 20 mmHG drop in systolic bp

Which lab result is of greatest concern if receiving nefazodone a. AST 356 IU b. BUN 22mg c. Sodium 146 d. WBC 11,000

a because they can cause hepatotoxicity

A patient with history of GAD has been admitted with COPD. Its priority to consul regarding continuation of which drug if the patient has been taking it at home? a. alprazolam b. busprione c. duloxetine d. paroxetine

a needs to be used with caution in people with pulmonary disorder

*the priority outcome when teaching a patient about phenelzine prescribed for panic disorder with depression is that the patient will state the a. actions needed to prevent constipation b. importance of avoiding aged cheese, meats, and fish c. importance of exercise d. possible adverse sexual effects

b

A 20 year old patient ha been prescribed spironolactone for primary polycystic ovary syndrome. Developmentally, what would be a priority nursing diagnosis? a. activity intolerance related to loss of Na b. Altered body image related to hirituism and deepening of voice c. decisional conflict related to treatment options d. fluid volume excess related to excessive salt intake

b

A history of allergy to which substance is a contraindication to the use of ipratropium/albuterol [Combivent]? Mold Peanuts Penicillin Dairy products

b

A hospitalized patient has orders for budesonide and salmeterol, one inhalation every 12 hours and albuterol MDI, two puffs every 4 hours as needed. The patient has not required albuterol for the last 24 hours. When preparing to administer budesonide and salmeterol, the nurse notes audible wheezing and dyspnea. Which action by the nurse is correct? a. administer albuterol b. administer albuterol, wait 5 minutes, and then administer the salmetrol and then budesonide c. Administer salmeterol and then budesonide, and reassess in 15 min for the need for albuterol d. administer budesonide, wait 5 min, administer the salmeterol, and reassess in 15 minutes for the red for albuterol

b

A nurse assesses a male patient who has developed gynecomastia while receiving treatment for peptic ulcers. Which medication from the patient's history should the nurse recognize as a contributing factor? Amoxicillin [Amoxil] Cimetidine [Tagamet] Metronidazole [Flagyl] Omeprazole [Prilosec]

b

A nurse teaches a patient with chronic obstructive pulmonary disease (COPD) about the adverse effects of tiotropium [Spiriva]. Which behavior by the patient would indicate that the teaching has been effective? Combines tiotropium with an antacid. Sucks on hard candy as needed. Prevents constipation with a stool softener. Wears long sleeves and a wide-brim hat.

b

Instruction by the nurse regarding alcohol abstinence is essential when a patient will be discharged taking which medication? Tetracycline Metronidazole Bismuth subsalicylate Clarithromycin

b

Low potassium (K+) is termed: a.) hyponatremia b.) hypokalemia c.) hypernatremia d.) hyperkalemia

b

The nurse is reviewing lab result for patient whose drug regimen includes desvenlafaxine (SNRI), which result is priority to report a. eGFR - 75mL b. Human chorionic gonadotripin 900 c. Osteoarthritic changes in the spine d. sodium

b

To achieve therapeutic effectiveness, a nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule? Only in an emergency On a continuing, daily basis To abort an asthma attack 2 weeks on, 2 weeks off

b

When assessing a patient receiving an antidepressant, which questions is of greatest priority to ask: a. are you concerned about weight gain when you take meds b. are you having thoughts that you could harm yourself c. do you experience dizziness when you get up d. have you had any difficulty voiding

b

When the nurse administer sertraline to patient for social anxiety disorder, which outcome states therapy is achieved for desired effect a. patient goes on errands without experiencing palpitations, chest pain, dizziness, or fear of losing control b. patient presents teaching to nursing students c. patient rides in elevators with people without having panic attack d. patient touches people without fear of contamination

b

Which data is of greatest concern when patient is prescribed desipramine' a. patient reports yawngasm b. patient reports palpitations and racing heart c. patient reports they burn easily in sun d. patient reports use of polyethylene glycol weekly due to constipation

b

Which instruction should be included to a patient prescribed an MAOI about orthostatic bp a. avoid certain foods b. change position slowly d. drink two servings of caffeine daily d. stop taking drug if you feel dizzy

b

Which lab result should be reported if a diabetic patient is prescribed hydrochlorothiazide 50mg 1x per day and metformin/glyberide 50mg/2.5mg 2x per day? a. fasting blood glucose 90 b. A1c 8.2% c. Potassium 4mEq d. Sodium 136 mg/dL

b

Which over the counter med can counter act effects of diuretics a. acetaminophen b. IB profin c. Iron d. Multiple vitamins

b

You give your patient hydrochlorothiazide at 8am. What time do you predict the patient will next need to go to the bathroom? a.) 30min b.) 10am c.) 6pm d.) 8pm

b

What is a priority assessment when a patient is switched from a TCA antidepressant to an MAOI a. blood glucose b. blood pressure c.skin color d. skin hydration

b - combing a TCA to and MAOI can cause hypertensive crisis

A 53 year old male was admitted to the ER in the middle of the night for a panic episode. He is highly anxious and short of breath. The doctor continued his home meds of clonazepam prn, lorazepam prn, & the SSRI sertraline(Zoloft). Which med will you offer him first? a.) clonazepam b.) lorazepam c.) sertraline

b - it has a fast onset

A patient was started on an SSRI 3 days ago for depression. She was discharged from your nursing unit this morning, but is now calling back to say she is feeling confused, restless, & has a fever of 101 degrees F. Which of the following is the best nursing intervention? a.) Determine if the patient has flulike symptoms. b.) Instruct patient to stop taking the medication. c.) Recommend to take the medication at night. d.) Explain that these are expected side effects.

b - stop taking because this is a sign of serotonin syndrome

The nurse is reviewing the prescriber's orders and notes that omeprazole [Prilosec] has been ordered for a patient admitted with acute coronary syndrome (ACS). The nurse should be concerned if this medication is combined with which medication noted on the patient's record? Aspirin 81 mg daily Clopidogrel [Plavix] 75 mg daily Heparin 5000 units subQ every 12 hours Metoprolol 50 mg every 8 hours

b For patients who lack risk factors for GI bleeding, combined use of clopidogrel with a PPI, such as omeprazole, may reduce the effects of clopidogrel without offering any real benefits and thus should be avoided. This is due to inhibition of CYP2C19, which converts the drug to its active form. Nothing in the question indicates that the patient is at risk for GI bleeding. The other options are not cause for concern

A nurse is admitting a patient who is schedule for outpatient surgery. The patient was instructed to take her levothyroxine with a sip of water before coming to the hospital in the morning. The patient reveals she was extremely anxious so she took a lorazepam,, but only with the same sip of water an hour ago. What is the priority action a. assessing for abuse of benzodiazepines b. determining if patient signed consents before coming to the hospital c. ensuring patient understands postoperative teaching d. notifying anesthesia of medication taken in the morning

b because if patient was intoxicated, they aren't able to give consent.

A 47 year old women who has been taking non steroidal anti inflammatory drug for rheumatoid arthritis and an oral contraceptive is prescribed misoprostol to treat GI distress relating to NSAID used. She informs the nurse she has stopped taking her oral contraceptives because she hasn't had a period for 2 months and thinks she could be in menopause. What should the nurse do a. administer all meds as ordered and consult prescriber for tests for menopause b. administer the NSAID and misoprostol, hold the contraceptive and inform prescriber c. administer all meds as ordered and inform prescriber the patient hasn't been taking the contraceptives d. hold the meds and consult prescriber for pregnancy test

c

A liter of water weights approx. 1 kg. A patient with heart failure who weights 176 lb. has been prescribed a loop diuretic with the goal of loss of 1000 mL of additional urine output in the next 24 hours. The next morning, if this goal is met, the nurse would expect the patient weight to be a. 170lb b. 172lb c. 174lb d. 175lb

c

A nurse should give which nonmedication instruction to a patient who has peptic ulcers? "Reduce your intake of caffeine-containing beverages, such as coffee and colas." "Take a nonsteroidal anti-inflammatory drug once a day to help with pain." "It would be better to eat five or six small meals a day instead of three larger ones." "An ulcer diet of bland foods with milk and cream products will speed healing."

c

A patient who has peptic ulcer disease and is receiving magnesium hydroxide (milk of magnesia) is experiencing an increased number of bowel movements. Which is the nurse's priority action? a. Ask the healthcare provider for a reduction in dose. b. Encourage the patient to increase dietary fiber. c. Administer the drug with an aluminum hydroxide antacid. d. Instruct the patient to keep an accurate stool count.

c

A patient with left sided HF has been prescribed a loop diuretic. Which assessment most accurately reflects a therapeutic effect of this drug a. drop in systolic bp of 10mm Hg b. normal heart sounds c. clear lung sounds d. pulse 80 and regular

c

An 80-year-old patient with a history of renal insufficiency recently was started on cimetidine. Which assessment finding indicates that the patient may be experiencing an adverse effect of the medication? +3 pitting edema Pain with urination New onset of disorientation to time and place Heart rate changes from a baseline of 70 to 80 beats/min (bpm) to 110 to 120 bpm

c

If flunisolide and formoteral are both are both ordered to be administered at 9am how should they be administered a. flunisolide first then fromoteral 1 min later using a spacer for both drugs b. flunisolide first, using a spacer, then formoteral 3 min later c. formoteral first, using a spacer, then flunisolide 5 min later d. formoteral first then flunisolide 10 min later, using a spacer for both drugs

c

It is a priority to teach patients who have PUD the importance of... a. avoiding use of alcohol b. consuming more dairy products c. not using tobacco products d. using ibuprofen, not acetaminophen, for headaches

c

It is priority for nurse to question a patient about which home feature when prescribed a diuretic a. central air b. forced air furnace c. water softener d. well or city water

c

Spironolactone and Aldoctone are examples of what type of diurectics? a.) Loop b.) Thiazides c.) Potassium Sparing d.) Osmotic

c

The nurse is caring for patient diagnosed with panic disorder. Teaching should include what info a. avoid strenuous exercise because it increases anxiety b. drug therapy helps patient be more comfortable with situations and places they have been avoiding c. its important to maintain regular sleep habits d. symptoms last 1-2 hours

c

What is the primary site of action of thiazide diuretics in the kidneys? a.) proximal convoluted tubule b.) Loop of Henle c.) early distal convoluted tubule d.) collecting duct

c

When a patient who's recieving an antidepressant verbalizes suicide ideation, what is the priority action a. administer antidepressant b. ask patient why they feel that way c. notify prescriber d. provide a safe environment

c

When caring for a patient taking furosemide (Lasix) you should monitor blood lab values for: a.) hypertension b.) hypernatremia c.) hypokalemia d.) hypoglycemia

c

Which dietary alteration may facilitate recovery from ulcers a. avoiding caffeine b. eating bland foods c. six small meals per day d. frequent intake of milk

c

Which lab result if identified in a patient receiving fluoxetine and warfarin, be a priority to report a. AST 30 units b. creatinine 0.8mg c. INR 4.5 d. platelets 250,000

c

Which of the following statements is correct? a.) Diuretics reduce the volume of urine passed b.) Diuretics increase blood pressure c.) Diuretics reduce blood pressure d.) Diuretics increase the volume of fluid in circulation?

c

Which outcome should a nurse establish as a priority for a patient taking an oral glucocorticoid for long-term treatment of asthma? Increases the daily intake of vitamin D and calcium. Records daily peak expiratory flow rates. Supplements additional doses at times of stress. Uses alternate-day therapy to reduce adverse effects.

c

Which outcome would be of greatest priority for most asthma patients? a. avoiding pollution b. increasing exercise tolerance c. preventing airway inflammation d. stimulating release of eosinophils

c

A patient who has been diagnosed with HF and type 2 DM has been prescribed furosemide 20mg PO 1x per day. Based on the effect of furosemide on the patients type 2 DM, its important to assess patient for which symptoms? a. irritability, paresthesias, and muscle weakness b. diaphoresis, shakiness, tachycardia c. increased thirst, confusion dry/hot skin d. nausea, vomiting, diarrhea

c - sighs of hyperglycemia

A patient is prescribed furosemide. Which symptom is priority for the nurse to monitor that suggests possible excessive loss of potassium a. hunger/fatigue b. 4+ deep tendon reflexes c. muscle weakness/cramping d. tall, tented T waves on ECG

c - signs of hypokalemia

The nurse plans to closely monitor for which clinical manifestation after administering furosemide [Lasix]? Decreased pulse Decreased temperature Decreased blood pressure Decreased respiratory rate

c High-ceiling loop diuretics, such as furosemide, are the most effective diuretic agents. They produce more loss of fluid and electrolytes than any others. A sudden loss of fluid can result in decreased blood pressure. When blood pressure drops, the pulse probably will increase rather than decrease. Lasix should not affect respiration or temperature. The nurse should also closely monitor the patient's potassium level.

The nurse is caring for a patient with heart failure who needs a diuretic. Which agent is likely to be chosen, because it has been shown to greatly reduce mortality in patients with heart failure? Furosemide [Lasix] Hydrochlorothiazide [HydroDIURIL] Spironolactone [Aldactone] Mannitol [Osmitrol]

c Spironolactone is a potassium-sparing diuretic used to treat both hypertension and edema. It is a preferred drug in heart failure, because it has been shown to have a cardioprotective effect, reducing mortality in patients with heart failure.

Which assessment finding in a patient who is prescribed a beta 2 adrenergic agonist would be a reason for the nurse to consult the prescriber a. BP 140/90 mm HG b. Fasting blood glucose 165 c. Unexplained fainting d. unexplained tremor

c because B2 adrenergic agonists can cause activation of beta 1 receptors in the heart stimulating b1 can cause tachycardia leading to fainting

A patient who has asthma has had peak expiratory flow rates at approximately 70% of his personal best despite regular and as-needed use of drugs. What are current treatment recommendations for this patient a. continue the regularly prescribed treatment b. use a regular inhaler and continue regularly prescribed treatment c. monitor PEF more frequently and consult the prescriber for possible treatment changes d. seek immediate medical attention

c because a PEF between 60-80% means it's not controlled well

In an emergency department, the nurse is caring for a patient who has asthma and takes omalizumab in an ED. Which symptom would warrant immediate priority care? a. fever b. headache c. perioral edema d. severe pharyngitis

c because malignancy and anaphylaxis where the most severe adverse effects of this drug. And c is a symptom of anaphylaxis

The nurse has revived report on patient who have recently prescribed antidepressant meds and are experiencing the following effects. Which patient is of highest priority for nurse a. amitriptyline-sleepiness and constipation b. fluoxetine-nausea/diarrhea c. tranylcypromine - headache/vomiting d. venlafaxine - anorexia/sweating

c because these are signs of a hypertensive crisis in MAOI

A patient has been taking citalopram (Celexa), an SSRI, for the past 6 months and is complaining of sexual problems. The doctor prescribes another antidepressant to take with the citalopram. Which antidepressant would this be? a.) Trazodone b.) venlafaxine (Effexor) c.) bupropion Wellbutrin d.) fluoxetine (Prozac)

c it goes well with SSRI

It would be great priority to report which condition to prescriber of bupropion a. anemia b. diabetes mellitus c. epilepsy d. glaucoma

c patient shouldn't take bupropion if they have seizures because that is one of the most serious effects of the drug

A child with moderate asthma is distressed because she has just learned that she is allergic to the family dog. Which intervention would most effectively address the physical and psycuholosocial needs of the child. a. advise the family there are no interventions b. advise family to increase the dose of the childs asthma drugs when the dog is around c. advise the family to take the dog to the local shelter d. advise the family to treat the dog to stay out out of bedrooms and off of furniture

d

A patient is admitted to the emergency department with acute severe exacerbation of asthma. Which drug should the nurse anticipate will be included in the treatment plan? Oral theophylline [Elixophyllin] Subcutaneous omalizumab [Xolair] Inhaled mometasone furoate [Asmanex] High-dose albuterol [Proventil] via nebulizer treatment

d

A patient prescribed an antidepressant 1 week ago says, "I really don't think this medication is helping me." Which nursing response is most appropriate? a.) "Are you feeling suicidal?" b.) "Are you having side effects?" c.) "You need to schedule a clinic appointment so we can discuss this more." d.) "It takes about 3 weeks for your medication to work."

d

Diuretics are used in the management of a.) hypertension b.) edema c.) diabetes d.) both a & b

d

Hyper secretion of gastric acid is the etiology of a. duodenal ulcers b. gastric ulcers c. peptic ulcers d. Zollinger-Ellison syndrome

d

Its most important for the nurse to teach patient prescribed trazodone to do what a. drink at least 2500ml per day b. increase fluid and fiber in diet to prevent constipation c. report any symptoms of UTI d. seek medical care if erection doesn't subside in 4 hours

d

The most common known cause of peptic ulcer disease is: A.) Heartburn B.) NSAID overuse C.) Gastric Tumors D.) H. pylori

d

The nurse caring for a patient taking furosemide [Lasix] is reviewing the patient's most recent laboratory results, which are: sodium, 136 mEq/L; potassium, 3.2 mEq/L; chloride, 100 mEq/L; blood urea nitrogen, 15 mg/dL. What is the nurse's best action? Administer Lasix as ordered. Place the patient on a cardiac monitor. Begin a 24-hour urine collection. Hold the Lasix and notify the physician.

d

Which action would be of greatest priority when patient experiences five watery stools in 24 hours when prescribed a PPI a. consult prescribed for an order for stool for ova/parasite b. encourage oral intake of 2000mL of fluids for 24 hours c. place patient in isolation d. wash hands with soap and water after caring for the patient

d

Which symptom suggests that a child with asthma is not rinsing his or her mouth after using a glucocorticoid inhaler a. enlarged tonsils b. gray membrane in the throat c. persistent cough d. which patches in mouth

d

A patient is taking oral theophylline for maintenance therapy of stable asthma. A nurse instructs the patient to avoid using which substance to prevent a complication? Echinacea Cimetidine [Tagamet] Sunscreen products Caffeine

d Theophylline is a methylxanthine that provides benefits through bronchodilation. It is used to reduce the frequency and severity of asthma attacks, especially those occurring at night. Caffeine also is a methylxanthine, and its pharmacologic actions may intensify the adverse effects of theophylline on the central nervous system (CNS) and heart. Sources of caffeine should be avoided.

A 42 year old patient with asthma is admitted for surgery. Which information would be of greatest priority for the nurse to share with the anesthesiologist a. the patient experiences an asthma attack whenever exposed to tobacco smoke b. the patient has degenerative joint disease of the knees c. the patient uses albuterol MDI, two puffs every 4 hours as needed d. the patient was recently changed from long term oral methlprednisolone to inhaled beclomethasone

d because after withdrawal of oral glucocorticoids, several months are required to recover from adrenocortical function.

It is of greatest priority to teach strategies to maintain adequate bone mass if an asthmatic patient is prescribed which drug a. flunisolide MDI b. fluticasone-salmeterol DPI c. Nebulized levalbuterol d. prednisolone oral tablets

d because inhaled promote less bone loss than normal

The nurse is reviewing the lab values for a patient who's prescribed lithium carbonate for bipolar disorder and furosemide for HF> which result is concerning. a. Cl 100mEq b. Mg 1.8 mEq c. K 4.1 mEq d. Sodium 128 mEq

d because low Na can lead to lithium toxicity

The nursery sees that a neonate whose mother has been taking sertraline for depression during pregnancy is tremulous and irritable, when assessment finding you note the neonate is crying. What would be most concerning a. difficulting calming b. fixed extremities c. pulse 148 bpm d. flaring nostrils, grunting

d because sign of hypertension in neonate

Patient compliance with antidepressant therapy is most likely increased if the nurse explains a. possible drug interactions b. reason for limiting number of units of drug supplied with each prescription c. seriousness of adverse effects d. expected timing of the therapeutic response

d because they take a while to work

It would be a priority for the nurse to report that a patient with panic attacks and depression has admitted to attempting suicide in the past if they were prescribed which drug a. clomipramine b. clonazepam c. fluoxetine d. imipramine

d overdose with TCA is lethal

An adolescent patient with asthma has controlled her asthma using a drug regimen that includes theophylline. Which new behavior would be of greatest priority to report to the prescriber a. joining the soccer team b. occasionally skipping school when not ill c. becoming sexually active d. smoking marijuana

d smoking accelerates metabolism/and decreases 1/2 life

Overdose of TCA's can cause

death because of effects on the heart

Chronic, uncontrollable, excessive worrying

generalized anxiety disorder

The most common symptoms of depression: (2)

lack of interest or pleasure depressed mood