Nursing test 2 Clinical science 3100
The client comes to the emergency department with an anxiety attack. He or she tells the nurse he heard that there was another anthrax attack in the capitol and is concerned about running out of medications. What is the best response by the nurse?
"The Centers for Disease Control and Prevention (CDC) maintains a large stockpile of medications for us in case that occurs."
The client tells the nurse that she is concerned about terrorist activity and questions if everyone should be immunized against smallpox. What is the best response by the nurse?
"The vaccine has side effects, which are serious and could kill many people."
The nurse is teaching the importance of drugs for emergency preparedness to local firemen. The nurse determines that learning has occurred when the firemen make which statements?
"The vendor-managed inventory (VMI) package can reach any community within 24 to 36 hours." "The push package can reach any community within 12 hours of an attack." "Our country's drug stockpile is managed by the Centers for Disease Control and Prevention (CDC)."
The client confides in the nurse that he or she is drawn to complementary and alternative medicine because it promotes the "whole person." The client would like spirituality and prayer included in his or her plan of care. What is the best response by the nurse? A. "What exactly do you mean by spirituality and prayer?" B. "We will include spirituality in your plan. Would you like to say a prayer?" C. "We usually do not pray with clients; is there something you are worried about?" D. "I think your spiritual concerns are best left up to you and your minister."
"We will include spirituality in your plan. Would you like to say a prayer?"
The risk management department is using a root-cause analysis to improve a nursing unit's medication administration accuracy. What questions will be used to develop this tool?
"What kind of errors are occurring?" "What is the current medication administration accuracyrate?" "What do the nurses think can be done to prevent errors from continuing?" "What is the impact of changes made to improve accuracy?"
A healthcare provider has prescribed a chemotherapeutic drug for a client with cancer. This drug commonly causes loss of hair. The client asks the nurse, "Will all of my hair fall out?" What is the most therapeutic response by the nurse?
"Yes, that is one of the expected side effects of this medication."
Place these methods of communicating with a non-English speaking client in order of their desirability and usefulness.
1. Healthcare agency interpreter is present 2. Adult family member interprets 3. Child relative interprets 4. Nurse uses drawings and body language to communicate 5. No interpretation is attempted
Place these nursing activities in the correct order of the nursing process.
1. The nurse weighs the client 2. The nurse analyzes the data collected 3. The nurse writes an individualized nursing intervention 4. The nurse documents the time and route of the administered meds 5. The nurse changes the intervention if it doesn't work
The nurse preparing to transfer to a pediatric hospital would expect to administer medications to children from birth to age_______years.
16
The nurse who is writing a risk nursing diagnosis will write a______ part statement.
2
A woman who wishes to become pregnant is concerned about the drugs she must take in order to treat a serious medical condition. The nurse reviewing the drug list would be most concerned about which kind of drug?
A drug with a long half-life.
A client asks a nurse why herbal remedies are popular now. What is the nurse best response? A. They are being marketed very aggressively. B. They are more effective for treating bacterial infections. C. Most insurance policies cover them. D. Their popularity is decreasing, not increasing.
A. They are being marketed very aggressively.
When teaching the client about a new medication, the nurse should include which information?
Adverse effects that can be expected Which adverse effect to report to the healthcare provider The drug's therapeutic action
The nurse has several educational pamphlets for the client about medications the client is receiving. Prior to giving the client thesepamphlets, what is the most important assessment by the nurse?
Assess the client's reading level.
The nurse is reviewing the steps of the nursing process with a student. The nurse is aware that it is most important to be accurate in which portion of the nursing process?
Assessment
The client takes St. John's wort for depression but does not tell the healthcare provider. The provider prescribes an SSRI. The nurse should monitor for which of the following? A. Serum potassium of 6.0 B. Dizziness C. Serum glucose level of 340 D. Sedation
B. Dizziness
The healthcare provider has prescribed a nitroglycerine (Nitrodur) patch for the client. The nurse understands that which of the following is the best outcome for this client as it relates to use of the medication?
Client will demonstrate correct application of the patch prior to discharge
The African American client had a myocardial infarction and is receiving atorvastatin (Lipitor). The nurse assesses the client's diet to be very high in fat. What is the best plan by the nurse to improve the client's diet and reduce the risk for additional medications?
Discuss his diet with whomever prepares meals for his family.
A nursing student asks a nurse how pharmacotherapy in the older adult is different than a middle-aged adult. How would the nurserespond?
Drug absorption is slower due to increased gastric pH.
A nurse is reviewing medication records of older adults living in extended care. Which concepts about the pharmacotherapy of older adults should be considered?
Drug distribution is slowed in the older adult. First-pass metabolism is reduced in the older adult Changes in the kidney may result in decreased drug excretion
Which information is essential for the nurse to collect when reviewing aclient's medication list?
Drug names Dosage being taken Frequency of administration
A student nurse asks a nursing instructor which federal agency responsible for reviewing all medication errors reports. What is the nursing instructor's best response?
FDA's Division of Medication Error Prevention and Analysis(DMEPA
The nurse makes a medication error, but the client is not harmed. Theclient's family asks the nurse manager what is considered a medication error. How should the nurse manager respond?
Failure to follow healthcare provider's orders. Failure to give the right medication Failure to give a medication at the ordered time Failure to give the right dose of the medication
The nurse assesses an adverse effect of a medication that has been administered. Who should the nurse report this adverse effect to?
Food and Drug Administration's (FDA) MedWatch Website.
The nurse is conducting a holistic assessment of a client with alcoholism. What are the important questions the nurse would ask?
How is drinking alcohol viewed by your culture?" "Did you see your parents drinking alcohol when you were growing up?" "What blood relatives of yours are addicted to alcohol?"
A client's genetic testing reveals a change in CYP2A6. The nurse would plan which interventions based on this discovery?
Increased surveillance for the development of lung cancer. Planning additional time and interventions to help the client stop smoking.
A student nurse asks a nurse what is included in the Strategic National Stockpile (SNS). The nurse explains that the SNS includes which of the following supplies?
Intravenous administration equipment Antibiotics Life-support medications Chemical antidotes
A nurse is caring for a client following a bioterrorism attack. The client has experienced initial nausea and vomiting followed by weight loss and eventual thyroid cancer. What was the most likely causative agent?
Ionizing radiation
The nurse plans to teach a safety class to parents of toddlers about household exposure to medications. What should the nurse include?
Keep all medications locked up and stored out of reach of the toddler Call the Poison Control Center for guidance with any medication ingested
A community health nurse is preparing a teaching plan regarding medications and their potential adverse effects for a new parent class. The nurse should encourage parents to do which of the following?
Maintain a list of current medications for each child. Be aware of each child's medication allergies Know what the child's prescribed medication is for, how it should be administered, and when to expect the child to feel better Be aware that any leftover medication should be appropriately disposed of, not saved for future use
The nurse provides care for elderly clients in an assisted living facility. What does the nurse assess as a primary contributing factor for drug toxicity in the elderly?
Older adults are frequently dehydrated
A nurse is admitting a client to the emergency department who has overdosed on a benzodiazepine. The nurse should anticipate the healthcare provider will prescribe which of the following drugs?
Romazicon
The client was exposed to cutaneous anthrax 2 weeks ago. What will the nurse see when assessing the client's skin?
Small skin lesions and later, black scabs
A nurse is providing care to a client who wears bilateral hearing aids. Which nursing interventions are indicated?
Speak a bit slower than normal. Ensure that verbal and nonverbal communication is congruent. Allow extra time for communication.
A nurse has been asked to present health promotion information at a community clinic whose clients are primarily non-Hispanic Black women. After review of health disparity and inequality statistics the nurse chooses to include information about which disorders?
Stroke Coronary artery disease Diabetes Prenatal care
A nurse is preparing to administer medications to a pregnant client. Which classification of drugs would the nurse refuse to administer?
Teratogenic
A nurse is assessing a client recently admitted to the unit. The nurse understands that which assessment identifies the collection of objective data?
The client has a wound measured at 5 cm in length.
For which client would the nurse expect the healthcare provider to continue prescribed medications during pregnancy?
The client recently diagnosed with gonorrhea The client with a history of frequent asthma attacks The client with hypertension
The nurse is preparing a teaching plan for an older client who is taking multiple medications. Which principles should the nurse keep in mind during the planning phase?
The client should have all prescriptions filled at the same pharmacy The client should keep a list of all medications for easy accessibility Older clients often take multiple drugs which is a common cause of medication errors The client should be aware of each prescribed medication, thedose, and possible side effects
The nurse is beginning medication reconciliation for a newly admitted client. What should the nurse include in this list?
The client takes ibuprofen for an occasional headache. The client mixes a powdered form of vitamin C into his morning orange juice. The client applies essential oils to his forehead to help with his or her allergies The client takes a prescription medication for osteoporosis once a week.
A nurse is developing a care plan for a client. Which client outcome statements are correctly formatted?
The client will identify two adverse effects of enoxaprarin(Lovenox) prior to self-administering the drug. The client will verbalize the storage requirements for NPH insulin prior to discharge.
The nurse in the emergency department administers an adult dose of an antibiotic to a 3-month-old baby. As a result, the baby suffers permanent brain damage. What best describes the effect of this error on the healthcare facility?
The morale of the staff involved will be decreased.
The nurse is managing care for several clients at a diabetic treatment center. The nurse understands that which of the following is the priority nursing intervention?
To return the client to an optimum level of wellness while limiting adverse effects related to the client's medical diagnosis
A nursing instructor is teaching a nursing student about human DNA sequences. The student demonstrates understanding by making with of the following statements?
"Even though human genetic differences are small, significant differences can be seen with drug metabolism."
A client returns to the clinic for follow-up after taking a newly prescribed medication for a month. The nurse recognizes medication teaching was successful when the client makes which statement?
"I've been taking my medication on an empty stomach like the prescription label said to." "I take my medication first thing in the morning, just like you said." "I switched all my medications to one pharmacy like yousuggested.
The public health nurse notices that several clients in the hypertension clinic have poorly controlled hypertension, even though they have been prescribed appropriate antihypertensive drugs. Which question will best enable the nurse to assess these clients?
Can you afford the high blood pressure medication?"
A nursing instructor is teaching nursing students about the FDA Pregnancy Drug Categories. The instructor asks the students to what category a drug for which research has shown an adverse effect in animals but not in pregnant women would be categorized as. The instructor knows learning has occurred with which student response?
Category B
A client is admitted to the emergency department with suspected exposure to anthrax. The nurse anticipates the healthcare provider will prescribe which medication?
Ciprofloxacin.
The client has been exposed to anthrax. The nurse anticipates administering which of the following drugs?
Ciprofloxacin (Cipro) and doxycycline (Vibramycin).
What is the most significant role for nurses as defined by state nurse practice acts and by regulating bodies such as The Joint Commission?
Client teaching
The nurse is preparing for medication administration to a group of clients. What is the best overall outcome for the clients?
Clients will receive the best therapeutic outcome from the medications
The nurse in charge of a clinical study welcomes the participants in an open forum. One client is surprised that there are men and women from several ethnic groups. The nurse explains that in the past, ethnic variables were largely unknown or ignored for whatreasons?
Clinical trials failed to include ethnically diverse subjects. Clinical trials comprised mostly Caucasian males. Little attention was focused on identifying the different effects drugs had on various ethnic groups.
A client is a vegan vegetarian and does not eat any animal products. The healthcare provider has prescribed a medication contained in a gelatin capsule. The nurse understands that a gelatin capsule is made from animal products. Which nursing actions are indicated?
Collaborate with the prescriber to find an alternative medication. Your answer is correct. Check to see if the capsule can be opened for administration.
A client is diagnosed with cancer. The healthcare provider has recommended chemotherapy, which would likely save the client's life. The client tells the nurse, "This is punishment from God for sins I have committed; some women at my church say so."? With permission from the client, what would the nurse do first?
Contact the client's minister to discuss the client's perspective about cancer.
A Hispanic man has been diagnosed with attention-deficit/hyperactivity disorder (ADHD), and is taking methylphenidate (Ritalin). Even though the drug helps with focus and grades, the client will not go to the school office at noon for his medication. Which statement best describes the result of the nurse's evaluation?
The adolescent is embarrassed about having to take medicine at school; it is a social stigma.
The adolescent is supposed to go to the school nurse at 12:00 to receive his medication forattention-deficit/ hyperactivity disorder (ADHD). He often does not go for the medication. What best describes the nurse's understanding of this situation?
The adolescent is embarrassed in front of his peers
A nurse is caring for a client that was exposed to radiation. The client asks the nurse what factors increase the amount of radiation that a person is exposed to. What should the nurse include in responding to the client's question?
The amount of exposure. The long-lasting effects. The amount of cellular death.
The nurse teaches a class about medication used during pregnancy to pregnant women. The nurse determines that additional instruction is required when a class participant makes whichresponse?
The baby can only be harmed by medications during the first trimester
A client has been admitted to the emergency department for treatment of poison ingestion. Gastric lavage and placement of activated charcoal has been prescribed. The nurse would withhold this treatment and collaborate with the prescriber if which instances occur?
The client becomes unconscious. The client discloses that lithium was the drug taken. Paramedics report that it has been 2 hours since the drug was taken.
A client presents with hypotension and bradycardia. The client indicates that one of her healthcare providers recently prescribed three new medications to her current list of 10 medications per day. Based on this information, which statement would be the most accurate?
The client is experiencing adverse reactions as a result of polypharmacy.
The healthcare provider has prescribed quetiapine (Seroquel) for the client with chronic auditory hallucinations. The client has stopped taking the medication. The nurse incorrectly uses the diagnosis of "noncompliance." In which situation would this diagnosis be appropriate?
The client made an informed decision not to take the medication
All of the clients listed have cancer and are receiving chemotherapy. Which client does the nurse evaluate as having the highest probability for a remission?
The client with a support group of cancer survivors
The nurse is assessing a newly admitted client's current medication. Which of the following is an example of objective data?
The nurse checks the prescription bottles the client has brought to the hospital
A nurse is preparing to administer a new drug that was just prescribed by the healthcare provider. The nurse recognizes that the wrong concentration of the drug was sent by pharmacy. What is the nurse's best response?
The nurse informs the client, documents the error as per hospital policy, and notifies the healthcare provider.
The nursing instructor teaches the student nurses about how medication errors can occur. What information will the nursing instructor include in the presentation?
The nurse miscalculates the medication dose The nurse does not check the client's identification band. The nurse misinterprets a healthcare provider's order The nurse administers the incorrect drug
An American Indian client has been admitted to the hospital for chemotherapy. At any given time, five family members are in the client's room. The nurse tells the client that according to hospital policy, only two visitors at a time are allowed. What does the best analysis by the nurse manager reveal about the nurse's action?
The nurse should have assessed the client's preferences about how many family members she wanted to be present.
The nurse recognizes that agency system checks are in place to decrease medication errors. Who commonly collaborates with the nurse on checking the accuracy of the medication prior to administration?
The pharmacist
A nurse is administering medications to a group of clients. Which situation is an example of a medication error?
The wrong dose of a medication is drawn up but is caught and corrected prior to administration
The pregnant client tells the nurse that her prescribed medication is not as effective as it was before her pregnancy. What is the best response by the nurse?
This is because your blood volume has increased
The nurse commits a medication error. The nurse documents the error in the client's record and completes the incident report. What does the nurse recognize as the primary reason for doing this?
To verify that the client's safety was protected
The nurse plans to administer medication to a preschool child. Which approach indicates the nurse has an understanding of growth and development?
Use a brief rationale, followed by quick administration of the medication
The nurse is on a committee to reduce medication errors in a large healthcare facility. What is a recommendation the nurse proposes that will most likely help to reduce medication errors?
Use automated, computerized cabinets on all nursing units.
A nurse is administering medications to a client. The client states, "I've never taken that yellow pill before". What should the nurse do first?
Verify the order and double-check the label
The nurse is teaching a support group for caretakers of older adult clients. The focus is medication compliance. The nurse determines that learning has occurred when the caregivers make which response?
We should use a medication management box so they won't forget to take it.
A nurse is teaching a community group about holistic medicine. Which information should the nurse include about Western medicine
Western medicine focuses on the cause of disease. Disease is often viewed as a malfunction in a specific body system. Western medicine may focus on disease treatment.
Medication reconciliation has been started for a newly admitted client. At which points would the nurses and others caring for this client check this list?
When initial admission orders are received When the client is transferred to a different unit within the hospital When the client is discharged
A nursing student asks a nurse how gender influences pharmacology. How should the nurse respond?
Women tend to seek medical care earlier than men do.
The toddler refuses to take his oral medication. What is the best suggestion to the mother from the nurse for ensuring the toddler receives his medication?
Crush the tablet and mix it with a small amount of jam.
Following a bioterrorism attack, the nurse finds that the victims are suffering from small, black lesions on their forearms. The nurse collaborates with the healthcare provider to treat exposure to which agent?
Cutaneous anthrax
The nurse is teaching a class on anthrax to a group of emergency response workers. The nurse plans to include which of the following?
Cutaneous anthrax is the most common form, but inhaled anthrax is the most lethal form.
A nursing instructor is planning to discuss the Dietary Supplement Health and Education Act (DSHEA) of 1994 with a group of nursing students. The instructor plans to include which of the following? A. It requires that herbal products undergo the same rigorous testing as drugs do under the FDA. B. It mandates that herbal product labels contain accurate information. C. It ensures that herbal products provide proof of their intended effects. D. It mandates that herbal product labels state that the products are not intended to diagnose, treat, cure, or prevent disease.
D. It mandates that herbal product labels state that the products are not intended to diagnose, treat, cure, or prevent disease.
The client takes several prescription medications and asks the nurse about using complementary and alternative medicine (CAM). What is the best reply by the nurse? A. "CAM is a good idea that you should discuss with your healthcare provider." B. "CAM has not been demonstrated to help with your kind of symptoms." C. "CAM might help, but you will still need your medications." D. "CAM is an approach that might reduce your need for medications."
D. "CAM is an approach that might reduce your need for medications."
The nurse has been teaching a client about herbal preparations and determines that additional teaching is required when the client makes which statement? A. "I need to be careful about where I store my herbal product." B. "I should check with you before using an herbal product." C. "Herbal preparations are available in solid and liquid forms." D. "Herbal products usually contain only one active ingredient."
D. "Herbal products usually contain only one active ingredient."
The client tells the nurse that he or she plans to take St. John's wort to treat his or her depression. What is the best response by the nurse? Select all that apply. A. "That should be fine as long as you are not suicidal." B. "St. John's wort is successfully used in Europe for minor depression." C. "It would be a good idea to try this before paying for a prescription medication." D. "It would be better to have a psychiatric assessment first." E. "Herbal preparations can interact with many other medications."
D. "It would be better to have a psychiatric assessment first." Your answer is correct. E. "Herbal preparations can interact with many other medications."
The nurse is teaching a class on dietary supplements. The nurse determines that learning has occurred when the patients make which statement? A. "The Food and Drug Administration (FDA) is not involved with the approval of the dietary supplement and cannot remove it from the market." B. "Dietary supplements must go through rigorous testing prior to being marketed by the manufacturer." C. "The manufacturer of the dietary supplement has the burden of proof for the safety of the supplement." D. "Products can make claims based on body structure and function like 'promotes healthy urinary tract.'"
D. "Products can make claims based on body structure and function like 'promotes healthy urinary tract.'"
A client with hypertension is receiving medication to lower his blood pressure. Which nursing action demonstrates the evaluation process related to medication administration?
Determining that goals were not met 3 days following medication administration
The nurse makes a medication error and a client dies. In court, the attorney for the family of the deceased client asks the nurse if she followed standards of care in administering the medication. How would the attorney phrase this question?
Did you do what another nurse would have done under similar circumstances?
A home health nurse's patient caseload is ethnically diverse. Which interventions show understanding of cultural variables?
Discussing cultural preferences for herbs and spices and possible alternatives when drug interactions are possible. Assessing the client's response to acupuncture for pain. Discussing the client's beliefs regarding treatment.
The Joint Commission documented that client education was deficient on several medical-surgical units of a local hospital. A nursing committee was formed to address this problem. What is the best intervention to improve client education?
Discussing medications each time they are administered to clients.
The nurse teaches a class to clients about how to help prevent medication errors when in the hospital. What is the most important question for the nurse to ask the clients?
Do you know the names of all the medications you take?
A nurse who is presenting community education states, "Drugs are among our most powerful weapons for emergencypreparedness." What additional statements, made by the nurse, would support this statement?
Drugs help us treat the diseases that could be caused by bioterrorism. "Without drugs, we might be quickly overwhelmed by a bioterrorist attack." "Drugs can be used in chemical or nuclear attacks."
The nurse teaching a pre-conception class would tell participants that they should be most careful about exposure to drugs during which stage of pregnancy?
Embryonic
The nurse understands that drug therapy is postponed until after pregnancy and lactation when possible. Which of the following acute and chronic conditions may be managed with drugs during pregnancy?
Epilepsy Sexually transmitted infections Gestational diabetes Hypertension
An adolescent client comes to the school nurse with complaints of vague abdominal pain. What statement by the student would help to confirm the nurse's suspicion that the adolescent has body image concerns?
Everyone makes a big deal about what I eat, so don't ask
A client's genetic testing indicates the presence of a genetic polymorphism of the CYP 450 enzyme. The nurse expects this difference to be one of which classifications?
Extensive Ultrarapid Poor
The nursing instructor teaches student nurses about the Food and Drug Administration (FDA) Pregnancy Categories. What should the nurse include?
Food and Drug Administration (FDA) Pregnancy categories provide a framework for safe use of drugs in pregnant women Food and Drug Administration (FDA) Pregnancy Category X has been associated with teratogenic effects
A nurse is teaching a group of student nurses. Which of the following best indicates an ethnic characteristic that can affectpharmacotherapy?
Genetic differences
A client asks the nurse why a medication prescribed by the provider "didn't do anything at all." Which statement by the nurse accurately describes how genetics influence drug action?
Genetic differences can result in significant differences in how each client's body handles the same medication." "Genetic differences can cause mutations in enzymes, changing the way they function. This can alter how the body metabolizes and excretes drugs." "Because of genetic differences, medication may accumulate to toxic levels in one client while in another client may be inactivated before it can have a therapeutic effect."
A nurse is reviewing safe medication administration with a student nurse. What should the nurse plan to include in the teaching?
Give medications within the time frame specified by hospital policy
A nurse is planning to teach a client about a new medication. What is the best teaching method?
Give the client oral and written drug information and instructions
A nurse manager is discussing medication errors with a group of nurses. Which statement by the nurses indicates the teaching waseffective?
Handwritten orders are more frequently associated with medication errors than are typed orders
The client is receiving an oral antibiotic as treatment for cellulitis of the lower extremity. The client's outcome is "Client will state a key point about antibiotic treatment for cellulitis." Which statement would the nurse evaluate as best indicating this outcome has been met?
I need to take all the pills even if my leg looks better
A nurse has provided discharge medication instructions to the parents of a child being released from the emergency department. The nurse evaluates that learning has occurred when the parents make which statements?
I should give this antibiotic as prescribed until the bottle is empty I will keep this medication in the refrigerator as the label directs This antibiotic should help to clear my child's infection
A nurse has admitted a new client to the unit. Which concepts should the nurse use when developing a nursing diagnosis?
Include the client in the identification of needs Consider the client's response to the current health problem
A nurse working in an obstetric practice should consider which fact when discussing medication use with pregnant clients?
Inhaled drugs may be absorbed to a greater extent
The nurse is administering medications to an older adult. Which laboratory tests are most important for the nurse to assess prior to the administration of medication?
Kidney and liver function tests
The nurse works for the Centers for Disease Control and Prevention (CDC). In planning for a bioterrorist attack, what will the best plan of the nurse include?
Learn the signs and symptoms of chemical and biological agents. Obtain a listing of health and law enforcement contacts. Obtain current knowledge of emergency management.
A nurse is planning a discussion of emergency preparedness with newly hired nurses. Which events would this nurse use as historical examples of terrorism?
Many people died as a result of sarin gas exposure in a Tokyo subway. Twenty-two confirmed or suspected cases of anthrax infection occurred as a result of the bacillus being sent through U.S. mail.
A nurse is preparing care for a newly admitted client with diabetes. Which information would be critical for the nurse to assess?
Medical history Current lab results Medication allergies Use of dietary supplements
A nurse on the medical-surgical unit is caring for several very ill clients. One client says, "I was supposed to get my medications an hour ago." The nurse recognizes that medication errors can have what impact?
Medication errors can potentially extend the client's length of hospital stay Medication errors can result in expensive legal costs to the facility. Medication errors can damage the facility's reputation Medication errors cause preventable deaths during hospitalizations
The clinic nurse will immediately alert the healthcare provider when which category X drugs are identified on the medication record of a recently diagnosed pregnant patient?
Methotrexate Isotretinoin (Accutane) Oral contraceptives
The client is receiving albuterol (Proventil) for treatment of bronchospasm related to asthma. What is the primary nursing intervention as it relates to this medication?
Monitor the client for relief of bronchospasms
Which nursing intervention would take priority following administration of a new medication?
Monitoring the client's respiratory status
The pregnant client plans to breastfeed her baby. She asks the nurse about the use of herbal products during breastfeeding. What is the best response by the nurse?
Most drugs can be transferred to the infant during breastfeeding, so this is not recommended
The nurse is planning care for a pregnant client prone to substance abuse. When the client states, "My baby isn't getting my drugs, I am," how does the nurse respond?
Most illicit drugs will cross the placenta and hurt the baby. Drugs may work longer in your baby Some drugs result in your baby not growing enough
The nurse preparing a teaching plan for a postpartum mother. The nurse plans to include which topics regarding breastfeeding?
Most medications are secreted into breast milk. Dietary supplements should be avoided. Herbal products are secreted into breast milk and have the potential to cause harm to the infant All tobacco products should be avoided
A nurse is teaching a student nurse about common treatments for victims of bioterrorism. The nurse tells the student that atropine would be most useful for a victim of bioterrorism exposed to which of the following?
Nerve gas
The nurse administers an evening medication to the client in the morning. What is the nurse's best initial course of action at this time?
Notify the healthcare provider about the error
Which statement about the nursing process is accurate?
Obtaining the outcomes is essential for goal attainment.
The nurse will administer medication to a school-age child. What is the best action by the nurse?
Offer the child a choice of beverage with which to take the medication
The nurse is caring for several clients. Which clients have a psychosocial history that may affect their outcome?
Older adult who recently suffered a stroke, has an unsteady gait, and lives in a two-story home Middle-aged client with Down syndrome living in a group home Recently divorced mother of three children with breast cancer
The nurse has been hired to work in the risk management office of a hospital. What situations would the nurse expect to be included in thisjob?
Participating in the investigation of a sentinel medication event Using the computer to track data Working with staff nurses to identify work flow problems Participating in a committee who will recommend changes to the policy and procedures regarding medication administration.
A client was exposed to ionizing radiation. The nurse plans to administer which of the following medications?
Potassium-iodine tablets.
A pregnant client suspected of drug abuse is admitted to the emergency department. The nurse plans to teach the client about which complications associated with drug use during pregnancy?
Preterm birth Low birth weight Birth defects
The nurse administers potassium iodide (KI) tablets to a client who has been exposed to radiation from a nuclear weapon. What is the rationale for administering potassium iodide (KI) to this client?
Prevent thyroid cancer
During evaluation, the nurse, client, and healthcare provider determine that the goals of antibiotic therapy have not been met. What actions areindicated?
Review the dosage of the medication Consider checking serum drug levels Consider prolonging therapy Consider using a different antibiotic
The client has been exposed to a nerve agent. For which symptoms will the nurse most likely assess?
Salivation and involuntary urination.
The nurse is preparing medications for a group of clients. Another nurse begins telling the nurse about her recent engagement. What is the best action by the first nurse?
Tell the second nurse that the conversation is distracting and she must stop talking while medications are being prepared.
The nurse is preparing an educational plan for parents about how to protect their children if a bioterrorist attack occurs. What is the best information to include?
"Follow the Centers for Disease Control and Prevention (CDC) guidelines for immunizations."
The nurse conducts a seminar in a local community center on how citizens can be affected by radiation from a nuclear attack. The nurse determines that the education is effective when the clients make which statement?
"I am at risk to develop leukemia as a result of radiation exposure."
The nurse manager would determine that a nurse understands culturally sensitive care if which statements are made?
"I have been helping my client understand how to choose foods from our diet menu." "I am concerned because my client needs sterile dressing changes but has no running water at home." "My client and I worked out a way to get her medications delivered to her at home."
The nurse is providing education about warfarin (Coumadin) to a patient of Asian ancestry. The nurse determines that learning has occurred when the client makes which statement?
"I may need less medication than someone from a different ethnic group."
The nurse uses a newly admitted client's armband barcode to identify the client prior to administering medications. The nurse should use at least________ other means of identifying this client.
2
A nurse working in the emergency department is told that the smallpox virus was aerosolized at a parade attended by thousands of people. The nurse explains to the student nurse that the vaccine for this virus provides a high level of protection if given within days of exposure.
3
A series of category E medication errors have occurred on a hospital unit. When discussing this trend with the nursingstaff, the risk manager would list which characteristics of a category E error?
A client was harmed No interventions to sustain life were required as a result of the error
Which client would be most likely to seek complementary and alternative therapies as a treatment modality? Select all that apply. A. A 48-year-old male who wants to boost his immune system. B. A 22-year-old male athlete who is preparing for the Olympics. C. A 50-year-old female going through menopause. D. A 58-year-old male with prostate problems. E. None of these clients would be wise to seek these therapies.
A. A 48-year-old male who wants to boost his immune system. Your answer is correct. B. A 22-year-old male athlete who is preparing for the Olympics. Your answer is correct. C. A 50-year-old female going through menopause. Your answer is correct. D. A 58-year-old male with prostate problems.
A client asks a nurse what the common complications are due to drug-herbal interactions. How would the nurse respond? A. Blood coagulation B. Vision loss C. Urine output D. Hair growth
A. Blood coagulation
The client asks if there are any supplements that would help improve or preserve his memory. Which supplements would the nurse discuss? Select all that apply. A. Carnitine B. Coenzyme Q10 C. Glucosamine D. DHEA E. Selenium
A. Carnitine D. DHEA
A client with inflammatory arthritis asks about adding an anti-inflammatory herb to the medication regimen to decrease the use of prescription drugs. The nurse suggests the client discuss the efficacy of which herbs with the healthcare provider? Select all that apply. A. Evening primrose B. St. John's wort C. Ginger D. Ginseng E. Bilberry
A. Evening primrose B. St. John's wort C. Ginger
A client with a family history of heart disease asks the nurse to recommend herbs that decrease the risk for heart disease. The nurse suggests the client discuss which herbs with the healthcare provider? Select all that apply. A. Flaxseed B. Green tea C. Soy D. Milk thistle E. Acai
A. Flaxseed B. Green tea C. Soy
A client who is considering taking a dietary supplement recommended by the nurse asks how to determine if the supplement is safe. The nurse explains that the Dietary Supplement and Nonprescription Drug Consumer Protection Act of 2007 requires that companies marketing herbal and dietary supplements do which of the following? Select all that apply. A. Include their contact information on the label so consumers can report adverse effects. B. Notify the Food and Drug Administration (FDA) within 15 days of receiving a report of an adverse effect C. Keep records of adverse effects for at least 6 years and make these records available for inspection by the Food and Drug Administration (FDA). D. Demonstrate product effectiveness prior to release of the product to the public. E. State which conditions the product is intended to cure or prevent.
A. Include their contact information on the label so consumers can report adverse effects. B. Notify the Food and Drug Administration (FDA) within 15 days of receiving a report of an adverse effect. C. Keep records of adverse effects for at least 6 years and make these records available for inspection by the Food and Drug Administration (FDA).
A postmenopausal client with a history of stroke is told she cannot take female hormones because of the risk for future thromboembolic events. The client asks about nonpharmacologic ways to manage her symptoms. Which herbs does the nurse suggest as alternatives? select all that apply A. Soy B. Black cohosh C. Evening primrose D. Saw palmetto E. Acai
A. Soy B. Black cohosh C. Evening primrose
The client is being treated for a cardiac dysrhythmia with amiodarone (Cordarone). The client has elevated liver function tests (LFTs). Which assessment finding would the nurse suspect as contributing to the elevated LFTs? A. The client was taking Echinacea to treat cold symptoms. B. The client was taking Kava-Kava for anxiety. C. The client was taking gingko biloba for memory problems. D. The client was taking St. John's wort for depression.
A. The client was taking Echinacea to treat cold symptoms.
A nurse is planning to teach a client about the relationship of complementary and alternative therapies to pharmacology What should the nurse include? A. They can reduce client medication needs. B. They serve as competitors and should not be promoted. C. They have little-to-no value in disease prevention and treatment. D. They are more effective than medication use
A. They can reduce client medication needs.
A client experiencing occasional minor digestive problems asks the nurse about herbal therapy. What is the best response by the nurse? Select all that apply. A. Wheat grass B. Green tea C. Ginger D. Grape seed E. Stevia
A. Wheat grass Your answer is correct. B. Green tea Your answer is correct. C. Ginger
The client says, "I am convinced that the mind-body interventions I am using are improving my health." The nurse would ask additional questions about which complementary and alternative therapies that belong to this category? Select all that apply. A. Yoga B. Massage C. Dance D. Herbal therapies E. Biofeedback
A. Yoga B. Massage C. Dance E. Biofeedback
The older adult asks the nurse how dietary supplements will help support health. What is the best response by the nurse? A. "Fish oil will help to enhance your brain function." B. "Soy isoflavone will help prevent Alzheimer's disease." C. "Dietary supplements will help support and maintain hydration." D. "Chromium will help you achieve and maintain optimum weight."
A. "Fish oil will help to enhance your brain function."
Clients at a senior citizen center have asked the nurse to do a presentation on herbal preparations. Which statement would be included in the best plan by the nurse? A. "Herbal preparations actually are drugs; you must be careful with them." B. "Herbal preparations can be dangerous if you are allergic to them." C. "As long as the herbal preparation has been tested in the clinical setting, it is safe." D. "Herbal preparations are safe as long as you carefully read the label."
A. "Herbal preparations actually are drugs; you must be careful with them."
The nurse is teaching clients in a senior center about complementary and alternative therapies. Which statement by a client indicates understanding of the information the nurse has presented? Select all that apply. A. "I see now that 'natural' doesn't really mean 'safe,' and I should ask my healthcare provider about any supplements I want to take." Your answer is correct. B. "I didn't realize some herbal supplements may be just as strong as a prescription drug. I will need to discuss any supplements I want to try with my doctor." Your answer is correct. C. "I understand now that when I choose to use a natural product over a prescription medication, I could be delaying my recovery." Your answer is correct. D. "It's good to know that herbs contain ingredients that are as powerful as a prescribed medication and are an option for safe and effective therapy." E. "It's good to know that herbs contain ingredients that are as powerful as a prescribed medication and are an option forsafe and effective therapy."
A. "I see now that 'natural' doesn't really mean 'safe,' and I should ask my healthcare provider about any supplements I want to take." B. "I didn't realize some herbal supplements may be just as strong as a prescription drug. I will need to discuss any supplements I want to try with my doctor." C. "I understand now that when I choose to use a natural product over a prescription medication, I could be delaying my recovery."
A nurse is caring for a client admitted to the emergency department following a drug overdose. The nurse anticipates which of the following prescriptions to enhance removal of the poison from the client?
Administering activated charcoal. Changing the pH of urine. Preparing the client for enemas. Inserting a nasogastric tube.
A nurse is preparing to administer medications to a school-age child. What would the nurse do?
Allow the child to make decisions regarding how medications are taken
The African American client has panic attacks, is suicidal, and is on an inclient psychiatric unit. The healthcare professional prescribes sertraline (Zoloft) and clonazepam (Klonopin). The client refuses the drugs. The client also requests to have herbs and African objects in his room to "remove the curse." What is the priority action by the nurse?
Allow the request as long as the herbs and objects do not pose a safety risk for the client or other clients
The patient is from an Arab culture and is in labor and delivery. Her husband insists he must stay with her and will not allow her to receive any analgesia during the experience. What is the best action by the nurse?
Allow this request and be available in the event the request changes.
The nurse is working hard to prevent medication errors. What interventions will assist the nurse in preventing most errors?
Always check the client's identification band prior to administration of medications Open all of the medications immediately prior to administration. Tell healthcare providers that verbal orders will not be accepted.
The nurse was very busy and unfamiliar with a new medication, but administered it anyway. Later the nurse looked up the medication. How does the nurse manager evaluate this behavior?
An error could have occurred because the nurse was unfamiliar with the medication
The nursing supervisor tells a nurse that the medication error the nurse made yesterday has been determined to be a sentinel event. What should the nurse expect to occur?
An immediate investigation will occur. nterventions to prevent the error from occurring again will quickly be put in place. A root-cause analysis will be performed.
Which patient statements would the nurse evaluate as negatively affecting access to healthcare?
An older adult says, "If I tell my doctor that I fall frequently, I might have to go to a nursing home." The client's new insurance plan requires a $10 copay for office visits. A client asks to be discharged before noon as he has a 3-hour drive home.
A nurse is planning a presentation regarding anthrax. What should the nurse include?
Anthrax can spread easily. There are three basic types of anthrax.
A student nurse asks a nurse what items are found within the Strategic National Stockpile (SNS). What is the nurse's best response?
Antibiotics
The client is receiving a beta-blocker medication. The nurse has done medication education and provided the client with printed information to take home. During the next appointment, the nurse notes that the client is not taking the medication properly. What is a therapeutic assessment question to ask this client?
Are you able to read and comprehend the printed information?"
The nurse assesses the client with diabetes mellitus prior to administering medications. Which questions are important to ask the client?
Are you allergic to anymedications? Are you taking any herbal or over-the-counter (OTC)medications? Will you please tell me about the kind of diet you follow? What other medications are you currently taking?
A nurse is caring for a client who has been exposed to a nerve agent. Which antidote will the nurse plan to administer?
Atropine
A nurse is teaching a student nurse about the active ingredients of herbal medicines. Which of the following indicates that teaching was effective? A. Are found only in the rhizome. B. Can be found in all parts of the herb. C. Are found only in the stems and leaves. D. Are found only in the root system.
B. Can be found in all parts of the herb.
A nurse is caring for a client being treated for seizures. The nurse would be most concerned if the client is also taking which herbal product? A. Ginger B. Ginkgo C. Goldenseal D. Feverfew
B. Ginkgo
A pregnant client asks the nurse about changing from her prescription antidepressant medication to St. John's wort because it is natural. What is the best response by the nurse? A. "No, herbal preparations are just not safe to take during pregnancy." B. "St. John's wort is a drug, and this should be discussed with your healthcare provider." C. "Yes, you can change, but let your doctor know at your next appointment." D. "It should be okay because your baby has been exposed to an antidepressant."
B. "St. John's wort is a drug, and this should be discussed with your healthcare provider."
The nurse plans to teach clients about the difference between herbal preparations and prescription medications. Which statement describes the best plan by the nurse? A. "Herbs, like prescription drugs, usually only contain one active ingredient." B. "The active ingredients in an herb, unlike prescription drugs, may be present in just one part or many parts." C. "Most herbs, like prescription drugs, are standardized and regulated by the Food and Drug Administration (FDA)." D. "Herbs are considered to be safer than prescription medications as they are natural."
B. "The active ingredients in an herb, unlike prescription drugs, may be present in just one part or many parts."
The nurse prepares to teach clients about the safety and efficacy of herbal preparations. Which statement would be included in the best plan by the nurse? A. "Herbal preparations have to meet the same safety and efficacy standards as prescription and over-the-counter (OTC) drugs." B. "The manufacturer does not have to prove the safety or efficacy of the herbal preparation." C. "Herbal preparations must be tested for safety and efficacy prior to marketing." D. "The label on the herbal preparation is required by the Dietary Supplement Health and Education Act (DSHEA) to be accurate."
B. "The manufacturer does not have to prove the safety or efficacy of the herbal preparation."
The nurse is doing a holistic assessment on a client prior to starting antihypertensive medication. What should the nurse include in theassessment?
Blood pressure Mood Level of education Belief in a higher power
The client uses Ginkgo biloba to enhance memory functioning but has not told the nurse about this herb. The healthcare provider orders warfarin (Coumadin) for this client. Which findings may the nurse find upon assessment? A. A blood glucose of 56. B. Headache, dizziness, sweating, and agitation. C. Petechiae and bleeding from the gums. D. An international normalized ratio (INR) of 3.0.
C. Petechiae and bleeding from the gums.
A student nurse asks a nurse how specialty supplements differ from herbal products. What is the nurse's best response? A. Specialty supplements must be prescribed. B. Specialty supplements are generally targeted for more general conditions. C. Specialty supplements can come from animal sources. D. Herbal products are more specific in their actions.
C. Specialty supplements can come from animal sources
The client tells the nurse that he or she has been taking herbal preparations to boost his or her immune system functioning. He or she does not know the names of the preparations. What is the best assessment question for the nurse to ask? A. "Would you please ask your wife or husband to discuss this with me during her next visit?" B. "Would you please ask your wife or husband to call the hospital pharmacist with the names?" C. "Would you please have your wife or husband bring the bottles to the hospital?" D. "Would you please tell your doctor about the herbs during the next visit?"
C. "Would you please have your wife or husband bring the bottles to the hospital?"
A new nurse on the orthopedic floor makes a medication error. Which statements by the nurse manager foster a safe environment in which nurses will report medication errors?
many of us have made a medication error in our careers. The most important issue is to identify why the error occurred I know you could not feel any worse than you already do. We need to discuss how this error happened and how we can prevent it from happening again It's really good that your client is OK and did not suffer any harmful effects of this error. We should discuss why this error occurred and how it can be prevented in the future Because you are a new nurse, we should sit down and discuss the procedure you followed to see what you could have done to prevent this error
The nursing instructor is teaching student nurses about the use of viruses in a bioterrorism attack. The nurse determines that learning has occurred when the students make which statement?
"A bioterrorist attack with viruses is a real threat to Americans."
The nurse in the emergency department is caring for several clients from diverse cultures. Which statement shows the nurse's ability to provide culturally competent care?
"I understand your religion prohibits blood transfusions. Would you consider nonblood alternatives?" "I just want to make sure you and your spouse understand the risks as you consider the options." "I don't really understand why you are afraid to take the medication. Do you have any questions I can answer to alleviate yourfear?"
The client is admitted to the hospital with sepsis following an elective abortion. The healthcare provider orders antibiotics that the client refuses stating, "I don't deserve them". What is the best response by the nurse?
"You have a serious infection and really need the drug."
The nurse is reviewing the steps of the nursing process with a student. The nurse knows that the student understands the teaching when the student correctly lists which of the following as the correct order of the nursingprocess?
Assessment, establish nursing diagnosis, planning, interventions, evaluation
The nurse follows the nursing process when conducting medication education about insulin. What will the nurse ask the client to evaluate theclient's knowledge of insulin?
Can you tell me four points you remember about how to take yourinsulin?
A nurse administering medications to a variety of patients on a medical-surgical floor recognizes that which clients may need additional education about medication adherence?
Fifty-year-old recently remarried male taking antihypertensive medication Thirty-four-year-old female with family history of blood clots taking an estrogen oral contraceptive Thirty-eight-year-old male recently started on an antidepressant Twenty-eight-year-old female started on acne medication known to cause male-patterned hair growth
A small nuclear weapon has been detonated in a nearby city. Which immediate symptoms of radiation sickness will the nurse assess in clients who have been exposed?
Nausea, vomiting, and diarrhea.
