NSG 170 Test #4

"My sweat will turn orange from this medication."

A client with tuberculosis is started on rifampin. The nurse evaluates that the teaching about rifampin is effective when the client makes which statement? 1. "I need to drink a lot of fluid while I take this medication." 2. "My sweat will turn orange from this medication." 3. "I should have my hearing tested while I take this medication." 4. "Most people who take this medication develop a rash."

1.8 (Clients with hyperparathyroidism have decreased levels of phosphate ion in blood. The normal concentration of phosphate ion in blood ranges between 2.4 and 4.4 mg/dL. Client A has a serum phosphate ion concentration of 1.8 mg/dL, which is lower than the reference range. Therefore client A may have hyperparathyroidism. The serum phosphate concentrations of client B at 2.4 mg/dL, client C at 3.9 mg/dL, and client D at 4.2 mg/dL are all considered normal values)

After reviewing the reports of four clients, the nurse suspects hyperparathyroidism in one of the clients. Which client's finding supports the nurse's suspicion? Serum phosphate level (mg/dL): A. 1.8 B. 2.4 C. 3.9 D. 4.2

Calcineurin inhibitors (Calcineurin inhibitors such as cyclosporine act on T helper cells to prevent production and release of IL-2 and gamma interferon. This class of medications can cause adverse effects such as nephrotoxicity, lymphoma, hypertension, gingival hyperplasia, and hirsutism. Corticosteroids may cause peptic ulcer, osteoporosis, and hyperglycemia. Cytotoxic medications may cause bone marrow suppression, hypertension, diarrhea, and nausea. Monoclonal antibodies may cause pulmonary edema, hypersensitivity reactions, fever/chills, and chest pain. Test-Taking Tip: Read the question carefully before looking at the answers: (1) Determine what the question is really asking; look for key words; (2) Read each answer thoroughly and see if it completely covers the material asked by the question; (3) Narrow the choices by immediately eliminating answers you know are incorrect.)

Commonly used to treat clients needing immunosuppressant therapy, which medication classification has the potential long-term side effects of neurotoxicity, lymphoma, abnormal glucose control, and hypertension? 1. Corticosteroids 2. Cytotoxic medications 3. Monoclonal antibodies 4. Calcineurin inhibitors

Diagnosed during adolescence and young adulthood

The spouse of a 22-year-old client who is being tested for Hodgkin lymphoma tells the nurse, "Don't you think it is unlikely for someone like my spouse to have cancer?" Which information about Hodgkin lymphoma will the nurse use when responding? 1. More likely to affect women than men 2. Diagnosed during adolescence and young adulthood 3. Primarily a disease of older rather than younger adults 4. More common among populations of Asian heritage

Gastric ulcer, pain in bones, muscle weakness (The presence of such symptoms as a moon-shaped face and thin arms and legs indicates Cushing syndrome. In Cushing syndrome, the cortisol level rises resulting in gastric ulcer formation caused by increased hydrochloric acid secretion and decreased production of protective gastric mucus. Osteoporosis is common in Cushing syndrome; therefore bone pain is common. Clients may also feel muscle weakness. Clients with Cushing syndrome experience increased appetite and weight gain, therefore they display truncal obesity and a "buffalo hump.")

The nurse is assessing a client with a moon-shaped face and thin arms and legs. The nurse expects which other assessment findings? Select all that apply. One, some, or all responses may be correct. 1. Weight loss 2. Gastric ulcer 3. Pain in bones 4. Poor appetite 5. Muscle weakness

Azathiprine (When used with allopurinol, azathioprine may cause bone marrow suppression in children. Tacrolimus should be administered only after a careful assessment of a child's kidney functioning, history of past anaphylactic reactions, and availability of resuscitative equipment. The functioning level of various systems must be assessed before administering cyclosporine because this medication has a toxic effect on numerous organs. Baseline vital signs including weight should be assessed before administering muromonab-DC3 because of the potential risk for fluid retention.)

The nurse understands which immunosuppressant medication interacts with allopurinol and may cause bone marrow suppression in children? 1. Tacrolimus 2. Azathioprine 3. Cyclosporine 4. Muromonab-DC3

Cortisol, thyrotropin, growth hormone

Which hormone levels peak during a client's sleep? Select all that apply. One, some, or all responses may be correct. 1. Cortisol 2. Calcitonin 3. Thyrotropin 4. Progesterone 5. Growth hormone

A suction pump is used, Chronic ulcers are reduced by removing fluids from the wound (In negative pressure wound therapy, a suction pump is used to treat the wounds. This therapy can reduce chronic ulcers by removing fluids from the wound. Necrotizing infections are treated by hyperbaric oxygen therapy. Hyperbaric oxygen therapy is the administration of oxygen under high pressure. Electrical stimulation is the application of a low-voltage current to a wound area.)

Which statement is correct regarding negative pressure wound therapy? Select all that apply. One, some, or all responses may be correct. 1. A suction pump is used. 2. Necrotizing infections are treated. 3. Oxygen is administered under high pressure. 4. A low-voltage current is applied to a wound area. 5. Chronic ulcers are reduced by removing fluids from the wound.

Negative pressure wound therapy

Which technology would the nurse use to reduce chronic ulcers by removing fluids from the wound? 1. Electrical stimulation 2. Topical growth factors 3. Hyperbaric oxygen therapy 4. Negative pressure wound therapy

Rubella, varicella, swordfish, phenytoin (Teratogens are noxious materials such as viruses, chemicals, and drugs that pass from mother to child during pregnancy that can affect fetal growth and development. Rubella, varicella, swordfish (due to high mercury content), and phenytoin are all teratogens that the nurse would educate pregnant clients to avoid. Acetaminophen is not a teratogen.)

Which teratogens affecting fetal growth and development would the nurse include in a teaching session for pregnant clients? Select all that apply. One, some, or all responses may be correct. 1. Rubella 2.Varicella 3. Swordfish 4. Phenytoin 5.Acetaminophen

Intravenous (IV) therapy (IV ensures a rapid, well-controlled technique for electrolyte (chloride) replacement. There is no assurance that adequate chloride will be ingested and absorbed. Oral electrolyte solution is not a rapid or well-controlled method for correcting electrolyte deficiencies. TPN is not necessary at this time, although it may be used eventually.)

A client with an acute episode of ulcerative colitis is admitted to the hospital. When reviewing the client's laboratory results, the nurse identifies that the client's serum chloride level is decreased. Which method is the most efficient way to correct this problem? 1. Low-residue diet 2. Intravenous (IV) therapy 3. Oral electrolyte solution 4. Total parenteral nutrition (TPN)

Obtain baseline vital signs before beginning blood administration (Baseline vital sign assessment is needed to have a basis for comparison should the client develop complications during administration. Dextrose solution will cause lysis of the red blood cells (RBCs); saline must be used. Warming the blood to body temperature may cause clotting and hemolysis. Blood samples may be drawn after, not before, a transfusion, but this is not routinely done. Test-Taking Tip: Never leave a question unanswered. Even if answering is no more than an educated guess on your part, go ahead and mark an answer. You might be right, but if you leave it blank, you will certainly be wrong and lose precious points.)

A health care provider prescribes one unit of whole blood for a client. Which action is important when administering blood? 1. Warm the blood to body temperature to prevent chilling the client. 2. Obtain baseline vital signs before beginning blood administration. 3. Draw a blood sample from the client before each unit is transfused. 4. Maintain patency of the intravenous catheter with dextrose solution.

Sore throat (A sore throat is indicative of a respiratory tract infection, which may be the first clinical sign of bone marrow suppression, which can be life-threatening. Nausea is an expected side effect of doxorubicin, but it is not life-threatening. Hair loss is not a side effect of doxorubicin but, regardless, is not life-threatening. Constipation is an expected side effect of doxorubicin, but it is not life-threatening.)

A client is receiving chemotherapy with doxorubicin. Which development will the nurse teach the client to report immediately? 1. Nausea 2. Sore throat 3. Loss of hair 4. Constipation

Rotating the sites for each injection (The allergen extract should always be administered in an extremity away from a joint so that a tourniquet can be applied for a severe reaction. The injection sites should be rotated for each injection to prevent skin damage. Current evidenced-based practice states nurses would not aspirate for blood before administering the subcutaneous injection because the subcutaneous tissues do not contain vessels large enough to affect the client. Systemic reactions may occur immediately. The nurse would observe the client for 20 minutes after receiving the injection .Test-Taking Tip: Understand the nurse is injecting allergen. The nursing intervention should result in the positive outcome towards the health of the client.)

A client who experiences severe anaphylactic reactions to insect venom arrives to begin allergen therapy. Which action would the nurse use when administering the allergen? 1. Rotating the sites for each injection 2. Aspirating for blood before giving the injection 3. Injecting in an extremity close to a joint 4. Observing the client for 5 minutes after an injection

High osmolarity of the feedings (The increased osmolarity (concentration) of many formulas draws fluid into the intestinal tract, which can cause diarrhea; such feedings may need to be diluted initially until the client develops tolerance or is changed to a more iso-osmolar strength formula. Formulas frequently have reduced fiber content. Bacterial contamination is not a factor if the manufacturer's recommendations are followed. Inappropriate positioning may increase the risk for aspiration, but it would not cause diarrhea.)

A client receiving hypertonic tube feedings experiences diarrhea. The nurse suspects that the diarrhea is related to which causative factor? 1. Increased fiber intake 2. Bacterial contamination 3. Inappropriate positioning 4. High osmolarity of the feedings