Pharm Quiz 2 Cards

Which action would the nurse include in the plan of care for a client undergoing a transsphenoidal hypophysectomy? Select all that apply. One, some, or all responses may be correct.

- Assessing for clear nasal drainage - Maintaining strict intake and output - Increasing daily dietary fiber intake - Elevating the head of the bed 30 degrees - Instructing on the use of an incentive spirometer

A client with terminal cancer is to receive 4 mg of hydromorphone intravenously (IV) every 4 hours as needed for severe breakthrough pain. It is supplied at 10 mg/mL. When the client complains of severe pain, how much solution of hydromorphone should the nurse administer? Record your answer using one decimal place and leading zero if applicable. ___ mL

0.4

A nurse is administering total parenteral nutrition (TPN) to a client who asks why the solution is yellow. What is the nurse's best response? 1 "Vitamin B complex makes it yellow." 2 "Preservatives in the solution change its color." 3 "I will have the pharmacist come to speak with you." 4 "There is no reason to be concerned because all TPN is yellow."

1

A primary health care provider prescribes 1000 mL total parenteral nutrition (TPN) to be infused over 12 hours via a central venous access device. What is most important for the nurse to obtain when preparing the equipment? 1 An infusion pump 2 A steady intravenous (IV) pole 3 An infusion set delivering 60 gtts/mL 4 A set of hemostats to be taped at the bedside

1

While awaiting surgery, a client with a long history of Crohn disease is receiving total parenteral nutrition (TPN) on an outpatient basis. The nurse teaches the client that TPN helps to prepare for surgery by which process? 1 Decreasing fecal bulk 2 Preventing bowel infection 3 Providing stimulation of secretions 4 Maintaining negative nitrogen balance

1 By decreasing fecal bulk and bowel stimulation, TPN provides rest for the bowel while the client awaits surgery. TPN does not prevent a bowel infection. TPN does not stimulate gastrointestinal secretions. TPN promotes positive nitrogen balance.

A client with a history of liver disease is found to have endometriosis. Which drug is contraindicated in this client? 1 Danazol 2 Celecoxib 3 Leuprolide 4 Ketoconazole

1 Danazol is a synthetic androgenic steroid that acts by suppressing secretion of follicle-stimulating hormone and luteinizing hormone. This results in decreased secretion of estrogen and progesterone and regression of endometrial tissue. It may result in decreased lipoprotein levels and an increase in low-density lipoprotein. It is contraindicated in clients with liver disease. Celecoxib, a nonsteroidal antiinflammatory drug, should be used with caution in liver disease. Leuprolide is a gonadotropin-releasing hormone (GnRH) agonist; it may be safe for use in clients with liver disease. Ketoconazole is a nonsteroidal antiinflammatory drug and should be used with caution in clients with liver disease.

A client with malabsorption syndrome is admitted to the hospital for medical intervention. A subclavian catheter is inserted, and the client is started on total parenteral nutrition (TPN). What should the nurse teach the client in order to prevent the most common complication of TPN? 1 Avoid disturbing the dressing or getting it wet. 2 Keep the head as still as possible whenever moving. 3 Regulate the flow rate on the infusion pump as necessary. 4 Monitor daily weights at the same time while wearing the same clothing.

1 Disturbing the dressing may expose the area to pathogens. Infection is the most common complication; sterile technique at the catheter insertion site must be maintained. Keeping the head still is not necessary; the catheter is sutured in place, and reasonable movement is permitted. The client should be taught to leave the infusion pump set at the rate prescribed by the healthcare provider and to call the nurse if the alarm rings. Excessive weight gain or loss is not a complication of total parenteral nutrition.

A client with a history of endometriosis has abdominal surgery to remove abdominal adhesions. What should this client's postoperative plan of care include? 1 Encouraging the client to ambulate in the hallway 2 Elevating the client's legs by gatching the bed 3 Helping the client dangle her legs over the side of the bed 4 Maintaining the client on bed rest until the dressings have been removed

1 Muscle contraction during ambulation improves venous return, which prevents venous stasis and thrombus formation. Gatching the bed and dangling the legs each place pressure on the popliteal spaces, limiting venous return and increasing the risk of thrombus formation. Bed rest is associated with venous stasis, which increases the risk of thrombus formation.

A 15-year-old adolescent is diagnosed with endometriosis. The client has severe, acute, and incapacitating symptoms. What would be the anticipated line of treatment? 1 Surgical intervention 2 NSAIDs during menstruation 3 OCP with low estrogen-to-progestin ratio 4 Continuous combined hormone therapy and NSAIDs

1 Surgical intervention is needed in adolescents with severe, acute, and incapacitating symptoms. NSAIDs can be used for symptomatic pain relief. Women having mild symptoms and desire for future pregnancy are treated with limited use of NSAIDs during menstruation. Women having mild symptoms and who can postpone pregnancy are treated with oral contraceptive pills that have low estrogen-to-progestin levels. In adolescents less than 16 years of age diagnosed with endometriosis, continuous combined hormone therapy and NSAIDs is the treatment option.

A pregnant woman who was admitted to the high-risk maternity unit for severe hyperemesis gravidarum is receiving total parenteral nutrition (TPN). Intralipids are not being administered. Which potential complication should the nurse monitor this client for? 1 Dehydration 2 Hypoglycemia 3 Allergic reaction 4 Diabetes insipidus

1 TPN is a hypertonic solution that pulls fluid from the interstitial compartment into the intravascular compartment, resulting in diuresis and dehydration. Because of its high glucose content, TPN may cause hyperglycemia, not hypoglycemia. Allergic reaction is unlikely; the administration of lipids is associated more commonly with allergic reactions. TPN may precipitate hyperglycemia (pseudo diabetes mellitus), not diabetes insipidus.

A client with endometriosis asks the nurse what side effects to expect from leuprolide. What should the nurse include in the response? 1 Weight gain 2 Increased libido 3 Frequent urination 4 Heavy menstrual bleeding

1 The nurse should teach the client that the side effects of leuprolide include edema, which causes an increase in weight. Leuprolide decreases libido. Frequent urination is not a side effect of leuprolide. Clients who take leuprolide do not experience menstrual periods because follicle-stimulating hormone and luteinizing hormone are suppressed.

A 37-year-old client with endometriosis visits the women's health clinic because she has dysmenorrhea and dyspareunia. Which statement is the most accurate description of dysmenorrhea? 1 Pain with menses 2 Endometrial hyperplasia 3 Bleeding between menses 4 Heavy bleeding with menses

1 dyspareunia is pain with sex

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The nurse should assess for which complications? Select all that apply. 1 Infection 2 Hyperglycemia 3 ABO incompatibility 4 Electrolyte imbalance 5 Cardiac dysrhythmias

1 2 4

The health care provider prescribes a blood transfusion for a client with esophageal varices. Place the following nursing actions in the correct order.

1. Check the client's vital signs. 2. Establish intravenous (IV) access with IV normal saline. 3. Verify the blood product with another nurse against the client's identification (ID) bracelet. 4. Monitor the client's vital signs and status according to agency policy.

An intravenous (IV) antibiotic in 50 mL of 0.9% sodium chloride needs to be administered over 20 minutes. The nurse will set the infusion pump to deliver how many milliliters per hour? Record your answer using a whole number. ___ mL/h

150

A client is receiving total parenteral nutrition (TPN) through a central venous access device. The nurse discovers that the TPN bag is empty and the next bag has not been received yet from the pharmacy. What is the most appropriate action for the nurse to take? 1 Perform a finger stick glucose test and call the primary healthcare provider with the results. 2 Hang a bag of 10% dextrose at the ordered TPN rate and place an urgent request for the next TPN bag. 3 Discontinue the infusion and flush the IV line with saline solution until the next TPN bag is ready. 4 Hang a bag of 5% dextrose at a keep-open rate and notify the nurse manager of the occurrence.

2

A client who has a diagnosis of endometriosis is concerned about the side effect of hot flashes from her prescribed medications. Which medication should the nurse explain causes this side effect? 1 Estrogen 2 Leuprolide 3 Diclofenac 4 Ergonovine

2

A client arrives at the clinic with swollen, tender breasts and flulike symptoms. A diagnosis of mastitis is made. What does the nurse plan to do? 1 Help her wean the infant gradually. 2 Teach her to empty her breasts frequently. 3 Review breastfeeding techniques with her. 4 Send a sample of her milk to the laboratory for testing.

2 Emptying the breasts limits engorgement because engorgement causes pressure and tenderness in an already tender area. Breastfeeding should be continued; it is not only unnecessary but also unwise to remove the infant from breastfeeding. Suckling keeps the breasts empty, limits engorgement, and reduces pain. Learning is difficult when the client is in pain; reviewing breastfeeding techniques may be done eventually, after the client has some relief from pain. The milk culture may be negative because the infection may be limited to the connective tissue of the breast.

To begin the administration of total parenteral nutrition (TPN), a client has a right subclavian central venous access device inserted. Immediately after insertion of the catheter, what is the priority nursing action? 1 Obtain a chest x-ray to determine placement. 2 Auscultate the lungs to evaluate breath sounds. 3 Draw a blood sample to assess blood glucose level. 4 Assess the right upper extremity for neurologic deficits.

2 The most significant and life-threatening complication of insertion of a subclavian catheter is a pneumothorax because of the proximity of the subclavian vein and the apex of the upper lobe of the lung; a client's respiratory status always is the priority. Although a chest x-ray may be done before TPN is begun, it is not the priority immediately after insertion of the catheter. A baseline blood glucose level should be obtained before insertion of the catheter. After TPN is started, routine monitoring of blood glucose levels is important. Although assessing for a neurologic deficit should be done eventually, it is not the priority at this time.

A client with a history of malabsorption syndrome is admitted to the hospital for medical management. Total parenteral nutrition (TPN) has been prescribed. What action will the nurse take to prevent a major reaction to the TPN infusion? 1 Record the intake and output. 2 Administer the infusion slowly. 3 Change the site every 24 hours. 4 Check the vital signs every 4 hours.

2 Total parenteral nutrition should be infused at a slow, constant rate; this will prevent both hyperglycemia and cellular dehydration from too rapid infusion of a hypertonic solution. Recording intake and output is essential because of the danger of fluid overload; however, monitoring will not prevent the complication. Generally a major vein is selected for administration of total parenteral nutrition; the site is not changed every 24 hours. Monitoring vital signs may identify a complication such as infection; monitoring will not prevent a complication from occurring.

The nurse is obtaining a health history from a client with endometriosis. What consequences can occur as a result of this disorder? Select all that apply. 1 Menopause 2 Metrorrhagia 3 Impaired fertility 4 Bowel strictures 5 Voiding difficulties

2 3 4 5

A nurse is preparing to administer insulin to a client with diabetes. In which order should the nurse perform the actions associated with insulin administration? 1. Wipe the top of the insulin vial with an alcohol swab. 2. Wash hands with soap and water. 3. Rotate the vial of insulin between the palms of the hands. 4. Withdraw the correct amount of insulin from the inverted vial. 5. Instill air into the vial of insulin equal to the desired dose.

2. Wash hands with soap and water. 3. Rotate the vial of insulin between the palms of the hands. 1. Wipe the top of the insulin vial with an alcohol swab. 5. Instill air into the vial of insulin equal to the desired dose. 4. Withdraw the correct amount of insulin from the inverted vial.

Levofloxacin 750 mg intravenous piggyback (IVPB) is prescribed for a client with pneumonia. The dose is available in 150 mL of 5% dextrose and is to infuse over 90 minutes. The administration set has a drop factor of 15 drops per mL. At how many drops per minute should the nurse regulate the IVPB to infuse? Record your answer using a whole number. ___ gtt/minute

25

The nurse receives an order to prepare the solution for administering a cleansing enema to a 3-year-old child. Which is the volume of solution the nurse would prepare?

250 to 350 mL

The primary healthcare provider has prescribed 500 mg of cephalexin by mouth every 6 hours for 10 days for a client with mastitis. The primary healthcare provider has given the client 24 sample tablets of 250 mg apiece. How many days should this supply last? Record your answer using a whole number of days

3

Which microorganism causes maternal mastitis? 1 Escherichia coli 2 Group B streptococcus 3 Staphylococcus aureus 4 Chlamydia trachomatis

3

During the administration of total parenteral nutrition (TPN), an assessment of the client reveals a bounding pulse, distended jugular veins, dyspnea, and cough. What is the priority nursing intervention? 1 Restart the client's infusion at another site. 2 Slow the rate of the client's infusion of the TPN. 3 Interrupt the client's infusion and notify the healthcare provider. 4 Obtain the vital signs and continue monitoring the client's status.

3 The client is experiencing pulmonary edema because of a fluid volume excess. The high concentration of TPN precipitates a fluid shift from the interstitial compartment into the intravascular compartment. Fluid will continue to be infused, which will continue to increase the intravascular volume.

A client at the women's health clinic tells the nurse that she has endometriosis. What factors associated with endometriosis does the nurse anticipate the client will report? Select all that apply. 1 Insomnia 2 Ecchymosis 3 Rectal pressure 4 Abdominal pain 5 Skipped periods 6 Pelvic infections

3 4

Which gonadotropin-releasing hormone agonists are used to treat endometriosis? Select all that apply. 1 Trazodone 2 Diclofenac 3 Leuprolide 4 Isotretinoin 5 Nafarelin acetate

3 5 Leuprolide and nafarelin acetate are gonadotropin-releasing hormone (GnRH) agonists used to treat endometriosis. Trazodone is used in cases of erectile dysfunction. Diclofenac is a nonsteroidal antiinflammatory drug used to relieve pain in endometriosis. Isotretinoin is an oral agent that is effective against severe cystic acne.

Which degree of edema will result in a 6-mm deep indentation upon pressure application?

3+

A client is scheduled to receive an intravenous (IV) solution of lactated Ringer to run at 150 mL/hr. To deliver the solution, the nurse plans to use an administration set that delivers 15 gtt/mL. At how many drops per minute should the nurse set the IV to administer the prescribed amount of fluid? Record your answer using a whole number. ___ gtt/min.

38

An intravenous piggyback (IVPB) of cefazolin 500 mg in 50 mL of 5% dextrose in water is to be administered over a 20-minute period. The tubing has a drop factor of 15 drops/mL. At what rate per minute should the nurse regulate the infusion to run? Record your answer using a whole number. Do not include units in your answer. ______ gtt/min

38

A client is admitted to the hospital with a diagnosis of acute pancreatitis. The health care provider's prescriptions include nothing by mouth and total parenteral nutrition (TPN). The nurse explains that the TPN therapy provides what benefit? 1 Is the easiest method for administering needed nutrition 2 Is the safest method for meeting the client's nutritional requirements 3 Will satisfy the client's hunger without the discomfort associated with eating 4 Will meet the client's nutritional needs without causing the discomfort precipitated by eating

4

A client with a history of endometriosis gives birth to a healthy infant. She expresses concern that the problems associated with endometriosis will return now that her pregnancy is over. What is the best response by the nurse? 1 "Pregnancy usually cures the problem." 2 "Endometriosis usually causes early menopause." 3 "You may need a hysterectomy if the problems recur." 4 "Breast-feeding will delay the return of the endometriosis."

4 Lactation delays ovarian function during the postpartum period; therefore lactation will delay the return of endometriosis. Pregnancy temporarily suppresses ovarian function; the aberrant endometrial tissue is still present. Endometriosis may lead to sterility; it does not cause menopause. Conservative medical therapy will be used first; hysterectomy is a last resort.

What should the nurse include in the discharge instructions for a client who will be receiving total parenteral nutrition (TPN) at home? 1 Changing the TPN access device daily 2 Contacting and scheduling professionals to administer the TPN 3 Listing the schedule of the days the client is to receive the TPN 4 Administering the TPN while working around the client's normal activities

4 The less disruptive the procedure, the greater the acceptance by the client. Most often, total parenteral nutrition is set up to run daily during sleeping hours. Depending on the type of circulatory access used, it may not need to be changed for weeks. The client or a significant other can be taught the principles of administration.

At 10:00 AM the nurse hangs a 1000-mL bag of 5% dextrose in water (D 5W) with 20 mEq of potassium chloride to be administered at 80 mL/h. At noon the health care provider prescribes a stat infusion of an intravenous (IV) antibiotic of 100 mL to be administered via piggyback over 1 hour. How much longer than expected will it take the primary bag to empty if the nurse interrupts the primary infusion for infusion of the antibiotic?

60 minutes

One liter of 5% dextrose solution contains 50 grams of sugar. The nurse calculates that 3 L solution/day will supply approximately how many kilocalories?

600

A client who weighs 176 pounds (80 kg) is being immunosuppressed by daily maintenance doses of cyclosporine to prevent organ transplant rejection. The dose prescribed is 8 mg/kg each day. How many milligrams should the nurse plan to administer each day? Record your answer using a whole number. ___ mg

640

Which percentage of total body water is found in a premature newborn?

85%

Which assessment should the nurse obtain before administering digoxin to a client? A. Apical heart rate B. Radial pulse on the left side C. Radial pulse in both right and left arms D. Difference between apical and radial pulses

A. Apical heart rate

A client is scheduled to begin chemotherapy 2 weeks after surgery for colon cancer. What explanation does the nurse give to explain the delay following surgery? A. Chemotherapy interferes with cell growth and delays wound healing. B. Because chemotherapy causes vomiting, it endangers the integrity of the incisional area. C. Chemotherapy decreases red blood cell production, and the resultant anemia will add to postoperative fatigue. D. Chemotherapy increases edema in areas distal to the incision by blocking lymph channels with destroyed lymphocytes.

A. Chemotherapy interferes with cell growth and delays wound healing.

The nurse is monitoring a client who is having a third transfusion of packed red blood cells. Which of these may be evident if the client is experiencing a febrile transfusion reaction? Select all that apply. A. Chills B. Urticaria C. Hypotension D. Tachycardia E. Bronchospasm F. Sense of impending doom

A. Chills C. Hypotension D. Tachycardia

A client is diagnosed with acute kidney failure secondary to dehydration. An intravenous (IV) infusion of 50% glucose with regular insulin is prescribed. What does the nurse recognize as the primary purpose of the IV insulin for this client? A. Correct hyperkalemia B. Increase urinary output C. Prevent respiratory acidosis D. Increase serum calcium levels

A. Correct hyperkalemia

A client diagnosed with asthma has received a prescription for an inhaler. The nurse teaches the client how to determine when the inhaler is empty, instructing the client to do what? A. Count the number of doses taken. B. Taste the medication when sprayed into the air. C. Shake the canister. D. Place the canister in water to see if it floats.

A. Count the number of doses taken.

A client with anorexia nervosa is admitted to the critical care unit following a period of prolonged starvation. What signs or symptoms indicate to the nurse that the client may have hypokalemia? Select all that apply. A. Muscle weakness B. Metabolic alkalosis C. Cardiac dysrhythmias D. Respiratory rate of 24 or higher E. Serum potassium of 5.5 mEq/L (5.5 mmol/L)

A. Muscle weakness C. Cardiac dysrhythmias

A client with type 1 diabetes self-administers NPH insulin every morning at 8 am. The nurse evaluates that the client understands the action of the insulin when the client identifies which time range as the highest risk for hypoglycemia? A. Noon to 8 pm B. 8 pm to noon C. 9 am to 10 am D. 10 am to 11 am

A. Noon to 8 pm

A nurse teaches a client about warfarin. Which information is essential for the nurse to include in the education plan? A. Periodic blood testing is necessary. B. Foods do not affect the medication. C. Physical activities should be limited. D. Daily doses should not be interrupted.

A. Periodic blood testing is necessary.

A client steps on a rusty nail, and the puncture site becomes swollen and painful. Tetanus immune globulin is prescribed. What does the nurse identify as an action of this drug? A. Provides antibodies B. Stimulates plasma cells C. Produces active immunity D. Facilitates long-lasting immunity

A. Provides antibodies

A client is admitted to the emergency department in the midst of persistent tonic-clonic seizures (status epilepticus). Diazepam is to be administered immediately. In addition to decreasing central neuronal activity, what other effect does the nurse anticipate? A. Relaxing peripheral muscles B. Slowing cardiac contractions C. Dilating tracheobronchial structures D. Providing amnesia of the convulsive episode

A. Relaxing peripheral muscles

Ten minutes after the initiation of a blood transfusion, a client reports lumbar pain. What is the next nursing action? A. Stop the transfusion. B. Obtain the vital signs. C. Assess the pain further. D. Increase the flow of normal saline.

A. Stop the transfusion.

Hydrocortisone is prescribed for a client with Addison disease. Before discharge, the nurse teaches the client about this medication. What did the nurse include as a therapeutic effect of the drug? A. Supports a better response to stress B. Promotes a decrease in blood pressure C. Decreases episodes of shortness of breath D. Controls an excessive loss of potassium from the body

A. Supports a better response to stress

A client with bleeding esophageal varices is to be treated via infusion of medication through an intravenous line. Which medication should the nurse anticipate will be prescribed? A. Vasopressin B. Neostigmine C. Lansoprazole D. Phytonadione

A. Vasopressin

Prednisone is prescribed for a client with an exacerbation of colitis. What does the nurse teach the client before administering the first dose?

Although the medication decreases intestinal inflammation, it will not cure the colitis. Prednisone inhibits phagocytosis and suppresses other clinical phenomena of inflammation; this is a symptomatic treatment that is not curative. The response usually is rapid. The drug suppresses the immune response and increases the potential for infection. Appetite is increased; weight gain may result from this or from fluid retention.

A client's cardiac monitor indicates multiple multifocal premature ventricular complexes (PVCs). The nurse expects that the treatment plan will include a prescription for which medication?

Amiodarone (Amiodarone has an antiarrhythmic action that stabilizes cell membranes of the heart, reducing cardiac excitability; it is used for acute ventricular dysrhythmias.)

A client is admitted to the hospital for medical management of acute pancreatitis. Which nursing action is most likely to reduce the pancreatic and gastric secretions of a client with pancreatitis?

Anticholinergic drugs block the neural impulses that stimulate pancreatic and gastric secretions; they inhibit the action of acetylcholine at postganglionic cholinergic nerve fibers.

What should the nurse suggest for a client with right ventricular failure?

Avoid emotionally stressful situations.

A client is waiting for a kidney transplant. What explanation should the nurse include when teaching the client about the transplant? A. "Production of urine will be delayed after surgery." B. "You will require immunosuppressive drugs daily for the rest of your life." C. "Symptoms of rejection include a decrease in temperature and blood pressure." D. "You will need to modify your program of work and recreation, including sports."

B. "You will require immunosuppressive drugs daily for the rest of your life."

A client with Hodgkin disease enters a remission period and remains symptom free for 6 months before a relapse occurs. The client is diagnosed at stage IV. What therapy option does the nurse expect to be implemented? A. Radiation therapy B. Combination chemotherapy C. Radiation with chemotherapy D. Surgical removal of the affected nodes

B. Combination chemotherapy

A client with postradiation enteritis is to continue receiving total parenteral nutrition (TPN) at home after discharge. What information should the nurse include in the client's teaching plan? A. Showing how to mix the nutritional solutions B. Demonstrating how to test capillary glucose levels C. Identifying the types of infusion pumps that can be used D. Checking for catheter placement by palpating the insertion site

B. Demonstrating how to test capillary glucose levels

A client with arthritis is taking large doses of aspirin. What symptom does the nurse include when teaching the client about the clinical manifestations of aspirin toxicity? A. Feelings of drowsiness B. Disturbances in hearing C. Intermittent constipation D. Metallic taste in the mouth

B. Disturbances in hearing

A health care provider prescribes psyllium 3.5 g twice a day for constipation. What is most important for the nurse to teach this client? A. Urine may be discolored. B. Each dose should be taken with a full glass of water. C. Use only when necessary because it can cause dependence. D. Daily use may inhibit the absorption of some fat-soluble vitamins.

B. Each dose should be taken with a full glass of water.

What should the nurse monitor when a client is receiving a platelet aggregation inhibitor such as clopidogrel? A. Nausea B. Epistaxis C. Chest pain D. Elevated temperature

B. Epistaxis

A client is admitted to the hospital with a diagnosis of an exacerbation of asthma. What should the nurse plan to do to best help this client? A. Determine the client's emotional state. B. Give prescribed drugs to promote bronchiolar dilation. C. Provide education about the impact of a family history. D. Encourage the client to use an incentive spirometer routinely.

B. Give prescribed drugs to promote bronchiolar dilation.

The nurse is caring for a client with type 1 diabetes. For which signs or symptoms of insulin-induced hypoglycemia should the nurse particularly be observant? Select all that apply. A. Excessive hunger B. Headache C. Diaphoresis D. Excessive thirst E. Deep respirations

B. Headache C. Diaphoresis

A healthcare provider informs a client that midazolam will be administered preoperatively. Later, the client asks the nurse why this medication is given. What primary reason should the nurse consider when formulating a response? A. Reduces pain B. Induces sedation C. Produces amnesia D. Limits oral secretions

B. Induces sedation

A nurse teaches a client about the dangers of using sodium bicarbonate regularly. What effect of sodium bicarbonate is the nurse trying to prevent? A. Gastric distention B. Metabolic alkalosis C. Chronic constipation D. Cardiac dysrhythmias

B. Metabolic alkalosis

What are the desired outcomes that the nurse expects when administering ibuprofen? Select all that apply A. Diuresis B. Pain relief C. Antipyresis D. Bronchodilation E. Anticoagulation F. Reduced inflammation

B. Pain relief C. Antipyresis F. Reduced inflammation

Dexamethasone has been prescribed for a client after a craniotomy for a brain tumor. When evaluating the effectiveness of the medication, the nurse expects what physiologic response? A. Reduced cell growth B. Reduced cerebral edema C. Increased renal reabsorption D. Increased response to sedation

B. Reduced cerebral edema

What should the nurse include in a teaching plan for a client taking calcium channel blockers such as nifedipine? Select all that apply. A. Reduce calcium intake. B. Report peripheral edema. C. Expect temporary hair loss. D. Avoid drinking grapefruit juice. E. Change to a standing position slowly.

B. Report peripheral edema. D. Avoid drinking grapefruit juice. E. Change to a standing position slowly.

A nurse is assessing the adequacy of a client's intravenous fluid replacement therapy during the first 2 to 3 days after sustaining full-thickness burns to the trunk and right thigh. What assessment will provide the nurse with the most significant data? A. Weights every day B. Urinary output every hour C. Blood pressure every 15 minutes D. Extent of peripheral edema every 4 hours

B. Urinary output every hour

A client who has been taking ibuprofen for rheumatoid arthritis asks the nurse if acetaminophen can be substituted instead. What is the appropriate nursing response? A. "Acetaminophen is the preferred treatment for rheumatoid arthritis." B. "Acetaminophen irritates the stomach more than ibuprofen does." C. "Ibuprofen has antiinflammatory properties and acetaminophen does not." D. "Yes, both are antipyretics and have the same effect."

C. "Ibuprofen has antiinflammatory properties and acetaminophen does not."

A client is scheduled to receive phenytoin 100 mg orally at 6 PM but is having difficulty swallowing capsules. What method should the nurse use to help the client take the medication? A. Sprinkle the powder from the capsule into a cup of water. B. Insert a rectal suppository containing 100 mg of phenytoin. C. Administer 4 mL of phenytoin suspension containing 125 mg/5 mL. D. Obtain a change in the administration route to allow an intramuscular injection.

C. Administer 4 mL of phenytoin suspension containing 125 mg/5 mL.

The nurse administers 2 units of salt-poor albumin to a client with portal hypertension and ascites. What does the nurse explain to the client regarding the purpose of the albumin? A. It provides nutrients. B. It increases protein stores. C. Albumin elevates the circulating blood volume. D. Albumin temporarily diverts blood flow away from the liver.

C. Albumin elevates the circulating blood volume.

A client is admitted to the cardiac care unit with a myocardial infarction. The cardiac monitor reveals several runs of ventricular tachycardia. The nurse anticipates that the client will be receiving a prescription for which drug? A. Atropine B. Epinephrine C. Amiodarone D. Sodium bicarbonate

C. Amiodarone

A client has an anaphylactic reaction after receiving intravenous penicillin. What does the nurse conclude is the cause of this reaction? A. An acquired atopic sensitization occurred. B. There was passive immunity to the penicillin allergen. C. Antibodies to penicillin developed after a previous exposure. D. Potent antibodies were produced when the infusion was instituted.

C. Antibodies to penicillin developed after a previous exposure.

A client who has been taking digoxin for 20 years is hospitalized. The client exhibits signs of dehydration, and laboratory results identify the presence of hypokalemia. The nurse should monitor the client for which clinical finding indicating digoxin toxicity? A. Constipation B. Decreased urination C. Cardiac dysrhythmias D. Metallic taste in the mouth

C. Cardiac dysrhythmias

The nurse is caring for a client who is scheduled for an electrophysiology study (EPS) because of persistent ventricular tachycardia. Before the procedure the client is to receive a beta-blocker. What client's response during the procedure best indicates that the beta-blocker is working effectively? A. Decreased anxiety B. Reduced chest pain C. Decreased heart rate D. Increased blood pressure

C. Decreased heart rate

A client who was admitted with a diagnosis of acute lymphoblastic leukemia is receiving chemotherapy. Which assessment findings would alert the nurse to the possible development of thrombocytopenia? Select all that apply. A. Fever B. Diarrhea C. Headache D. Hematuria E. Ecchymosis

C. Headache D. Hematuria E. Ecchymosis

When obtaining a health history, the nurse is informed that a client has been taking digoxin. What therapeutic effect of digoxin does the nurse expect? A. Decreased cardiac output B. Decreased stroke volume of the heart C. Increased contractile force of the myocardium D. Increased electrical conduction through the atrioventricular (AV) node

C. Increased contractile force of the myocardium

The health care provider prescribes propylthiouracil (PTU) for a client with hyperthyroidism. What is an action of PTU that the nurse will include in teaching? A. Increases the uptake of iodine B. Causes the thyroid gland to atrophy C. Interferes with the synthesis of thyroid hormone D. Decreases the secretion of thyroid-stimulating hormone (TSH)

C. Interferes with the synthesis of thyroid hormone

While on a hike, a rusty nail pierces the sole of a client's foot and he is brought to the emergency department of a local hospital. Tetanus immune globulin is prescribed because the client does not know when the last tetanus immunization was received. What information will the nurse include when teaching the client about this drug? A. It will take about a week to become effective. B. Immune globulin provides lifelong passive immunity. C. It provides immediate, passive, short-term immunity. D. Immune globulins stimulate the production of antibodies.

C. It provides immediate, passive, short-term immunity.

A client has severe diarrhea, and the health care provider prescribes intravenous fluids, sodium bicarbonate, and an antidiarrheal medication. Which drug does the nurse expect the health care provider to prescribe? A. Psyllium B. Bisacodyl C. Loperamide D. Docusate sodium

C. Loperamide

A client reports frequently taking calcium carbonate. What effect should the nurse advise the client that this can have? A. Diarrhea B. Water retention C. Rebound hyperacidity D. Bone demineralization

C. Rebound hyperacidity

A nurse is administering a histamine H2 antagonist to a client who has extensive burns. The nurse explains to the client that this drug is given prophylactically during the first few weeks after extensive burns. What complication of burns will it prevent? A. Colitis B. Gastritis C. Stress ulcer D. Metabolic acidosis

C. Stress ulcer

A client with Addison disease is receiving cortisone therapy. What complications does the nurse expect if the client abruptly stops the medication? Select all that apply. A. Diplopia B. Dysphagia C. Tachypnea D. Bradycardia E. Hypotension

C. Tachypnea E. Hypotension

A nurse in the surgical intensive care unit is caring for a client with a large surgical incision. The nurse reviews a list of vitamins and expects that which medication may be prescribed because of its major role in wound healing? A. Vitamin A (retinol) B. Vitamin K (phytonadione) C. Vitamin C (ascorbic acid) D. Vitamin B12 (cyanocobalamin)

C. Vitamin C (ascorbic acid)

A nurse is caring for a client with the diagnosis of right ventricular failure. Which condition unrelated to cardiac disease is the major cause of right ventricular failure? Renal disease Hypovolemic shock Severe systemic infection Chronic obstructive pulmonary disease (COPD)

COPD

A pregnant client with severe preeclampsia is receiving intravenous magnesium sulfate. Which item would the nurse keep at the bedside in case of magnesium sulfate toxicity?

Calcium gluconate

On the second day after surgery, a client reports pain in the right calf. What should the nurse do first?

Calf pain may be a sign of thrombophlebitis, which can lead to pulmonary embolism. A postoperative client with pain in the calf should be confined to bed immediately and the health care provider notified.

When a client who is taking a diuretic has been instructed to eat foods high in potassium, which fruit would the nurse suggest?

Cantaloupe

A nurse identifies premature ventricular complexes (PVCs) on a client's cardiac monitor. What does the nurse conclude that these complexes are a sign of?

Cardiac irritability

Which finding during peritoneal dialysis would the nurse act on as a sign of infection?

Cloudy return of dialysate

A client who takes high-dose aspirin for arthritis has an acute episode of right ventricular heart failure. The healthcare provider prescribes furosemide and lowers the client's usual dosage of aspirin. The client asks the nurse the reason for the lower dose. On what principle does the nurse base a response? Aspirin accelerates metabolism of furosemide and decreases the diuretic effect. Incorrect Aspirin in large doses after an acute stress episode increases the bleeding potential. Competition for renal excretion sites by the drugs causes increased serum levels of aspirin. Use of furosemide and aspirin concomitantly increases formation of uric acid crystals in the nephron.

Competition for renal excretion sites by the drugs causes increased serum levels of aspirin. Because furosemide and aspirin compete for the same renal excretory sites, salicylate toxicity may occur even with lower dosages.

What should the nurse expect when assessing a client with pleural effusion?

Compression of the lung by fluid that accumulates at its base reduces expansion and air exchange. Crackles or rhonchi at the posterior of the lungs are not associated with pleural effusion. If tracheal deviation occurs, it is away from the affected side. Dullness is produced on percussion of the affected area.

A female client whose ECG exhibits multiple premature ventricular complexes is prescribed oral disopyramide. Which side effects should the nurse include when teaching the client about this drug?

Constipation Dry mouth

The nurse assesses a client's intravenous (IV) site. Which clinical finding leads the nurse to conclude that the IV has infiltrated, rather than caused inflammation?

Coolness

Thick mucous gland secretions, elevated sweat electrolytes, meconium ileus, and difficulty maintaining and gaining weight are associated with which autosomal recessive disorder?

Cystic fibrosis

A client is admitted to the hospital for medical management of acute pancreatitis. Which nursing action is most likely to reduce the pancreatic and gastric secretions of a client with pancreatitis? A. Encouraging clear liquids B. Obtaining a prescription for morphine C. Assisting the client into a semi-Fowler position D. Administering prescribed anticholinergic medication

D. Administering prescribed anticholinergic medication

A nurse prepares to administer intravenous (IV) albumin to a client with ascites. What effect does the nurse anticipate? A. Ascites and blood ammonia levels will decrease. B. Decreased capillary perfusion and blood pressure. C. Venous stasis and blood urea nitrogen level will increase. D. As extravascular fluid decreases, the hematocrit will decrease.

D. As extravascular fluid decreases, the hematocrit will decrease.

A health care provider prescribes famotidine for a client with dyspepsia. What is important to include about this medication in a teaching program for this client? A. Lowers the stress level B. Neutralizes gastric acidity C. Reduces gastrointestinal peristalsis D. Decreases secretions in the stomach

D. Decreases secretions in the stomach

A nurse is caring for a client who is receiving serum albumin. What indicates that the albumin is effective? A. Improved clotting of blood B. Formation of red blood cells C. Activation of white blood cells (WBCs) D. Effective cardiac output

D. Effective cardiac output

A healthcare provider prescribes simvastatin 20 mg daily for elevated cholesterol and triglyceride levels for a female client. Which is most important for the nurse to teach when the client initially takes the medication? A. Take the medication with breakfast. B. Have liver function tests every 6 months. C. Wear sunscreen to prevent photosensitivity reactions. D. Inform the healthcare provider if the client wishes to become pregnant.

D. Inform the healthcare provider if the client wishes to become pregnant.

The nurse is caring for a client who is experiencing side effects from high doses of methotrexate. Leucovorin calcium is prescribed and is to be administered immediately after the infusion of methotrexate. What is the best indicator that leucovorin calcium is effective? A. Increased energy B. Decreased nausea C. Decreased white blood cell (WBC) level D. Methotrexate level less than 0.05 micromole

D. Methotrexate level less than 0.05 micromole

A client has increased intracranial pressure resulting from a traumatic brain injury. Assessment findings indicate that the client is unconscious with vital signs of pulse 60 beats/min, respirations 16 breaths/min, and blood pressure 142/64 mm Hg. The nurse reviews the treatment plan and questions which prescription? A. Mannitol B. Dexamethasone C. Chlorpromazine D. Morphine

D. Morphine

A client using fentanyl transdermal patches for pain management in late-stage cancer dies. What should the hospice nurse who is caring for this client do about the patch? A. Tell the family to remove and dispose of the patch. B. Leave the patch in place for the mortician to remove. C. Have the family return the patch to the pharmacy for disposal. D. Remove and dispose of the patch in an appropriate receptacle.

D. Remove and dispose of the patch in an appropriate receptacle.

What will the nurse include when developing a teaching plan for a client receiving digoxin for left ventricular failure? A. Sleep flat in bed B. Follow a low-potassium diet C. Take the pulse three times a day D. Rest periodically throughout the day

D. Rest periodically throughout the day

A client with esophageal cancer is to receive total parenteral nutrition. A right subclavian catheter is inserted. What is the primary reason total parenteral nutrition is infused through a central line rather than a peripheral line? A. It prevents the development of infection. B. There is less chance of this infusion infiltrating. C. It is more convenient so clients can use their hands. D. The large amount of blood helps dilute the concentrated solution.

D. The large amount of blood helps dilute the concentrated solution.

A client who has a long leg cast for a fractured bone is to be discharged from the emergency department. When discussing pain management, when does the nurse advise the client to take the prescribed as-needed oxycodone? A. Just as a last resort B. Before going to sleep C. As the pain becomes intense D. When the discomfort begins

D. When the discomfort begins

The nurse is caring for a client who is scheduled for an electrophysiology study (EPS) because of persistent ventricular tachycardia. Before the procedure the client is to receive a beta-blocker. What client's response during the procedure best indicates that the beta-blocker is working effectively? Decreased anxiety Reduced chest pain Decreased heart rate Increased blood pressure

Decreased HR

Which is the action of an antidiuretic hormone (ADH)?

Decreases water loss in urine

A nurse is caring for a client with a diagnosis of right ventricular heart failure. The nurse expects what assessment findings associated with right-sided heart failure? Select all that apply. Dependent edema Swollen hands and fingers Collapsed neck veins Right upper quadrant discomfort Oliguria

Dependent edema Swollen hands and fingers Right upper quadrant discomfort

A client receiving combination chemotherapy for treatment of metastatic carcinoma asks the nurse in the clinic why more than one type of drug is necessary. Which concept is most important to teach the client in relation to why drug cocktails are more effective than a single drug in cancer therapy?

Different drugs destroy cells at different stages of their replication; rapidly dividing cells not destroyed by one drug may be destroyed by another drug during a different stage of cell replication.

Which relationship between a client's burned body surface area and fluid loss would the nurse consider when evaluating fluid loss in a client with burns?

Directly proportional

A client with left ventricular heart failure is taking digoxin 0.25 mg daily. What changes does the nurse expect to find if this medication is therapeutically effective?

Diuresis Decreased HR Decreased edema

Which action would the nurse include in the plan of care for a client admitted with heart failure who has gained 20 pounds in 3 weeks? Select all that apply. One, some, or all responses may be correct.

Duiretics Low-salt diet Daily weight checks Fluid restriction Intake and output Oxygen administration

A thallium scan is scheduled for a client who had a myocardial infarction. The nurse explains that the reason the scan has been prescribed is to:

Establish the viability of myocardial muscle

The nurse is caring for a client who is having diarrhea. Which client data would the nurse closely monitor to prevent an adverse outcome?

Fluid and electrolyte balance

A client with supraventricular tachycardia (SVT) has a heart rate of 170 beats per minute. Following treatment with diltiazem hydrochloride, what assessment indicates to the nurse that the diltiazem hydrochloride is effective?

HR of 110 beats per minute. Diltiazem hydrochloride's purpose is to slow down the heart rate. SVT has a heart rate of 150 to 250 beats per minute. A heart rate of 110 indicates that the diltiazem hydrochloride is having the desired effect. Hypotension is a side effect of diltiazem hydrochloride, not a desired effect

The nurse would assess for which electrolyte imbalance during the first 48 hours after a client has sustained a thermal injury?

Hyperkalemia and hyponatremia

A client is receiving furosemide to relieve edema. The nurse will monitor the client for which adverse effect?

Hypokalemia

A nurse in the coronary care unit (CCU) identifies ventricular fibrillation on a client's cardiac monitor. What intervention is the priority?

Immediate defibrillation

The nurse is caring for a client with acute renal failure. The most serious complication for this client is

Infection is responsible for one third of the traumatic or surgically induced deaths of clients with acute renal failure, as well as for medically induced acute renal failure. Resistance is reduced in clients with kidneys that fail because of decreased phagocytosis, which makes them susceptible to microorganisms. Anemia occurs often with acute renal failure, but it is not the most serious complication and should be treated in relation to the client's adaptations; erythropoietin and iron supplements usually are prescribed. Weight loss is not life threatening. Platelet dysfunction occurs because of decreased cell surface adhesiveness, but it is not as serious as an infection.

A client experiences crushing chest pain and is brought to the emergency department. When assessing the electrocardiogram (ECG) tracing, the nurse concludes that the client is experiencing premature ventricular complexes (PVCs). Which abnormalities of the ECG support this conclusion?

Irregular rhythm, absence of a P wave, and wide and distorted QRS

Which part of the kidney produces the hormone bradykinin?

Juxtaglomerular cells of the arterioles

Which element excessively accumulates in the blood to precipitate the signs and symptoms associated with a diabetic coma?

Ketones as a result of rapid fat breakdown, causing acidosis

A client with a history of hypertension and left ventricular failure arrives for a scheduled clinic appointment and tells the nurse, "My feet are killing me. These shoes got so tight." What is the nurse's best initial action?

Listen to the client's breath sounds.

In which components of the nephron unit does furosemide decrease fluid reabsorption? Select all that apply. One, some, or all responses may be correct.

Loop of Henle Distal tubules Proximal tubules

A client takes furosemide and digoxin for heart failure. Why would the nurse advise the client to drink a glass of orange juice every day?

Maintaining potassium levels

A client hospitalized for uncontrolled hypertension and chest pain was started on a daily diuretic 2 days ago upon admission, with prescriptions for a daily basic metabolic panel. The client's potassium level this morning is 2.7 mEq/L (2.7 mmol/L). Which action will the nurse take next?

Notify the health care provider that the potassium level is below normal.

The nurse is caring for a client with severe burns and determines that the client is at risk for hypovolemic shock. Which physiological finding supports the nurse's conclusion?

Plasma proteins moving out of the intravascular compartment

A nurse is caring for a postoperative client who has diabetes. Which is the most common cause of diabetic ketoacidosis that the nurse needs to consider when caring for this client?

Presence of infection

The nurse is interpreting an electrocardiogram rhythm. What part of the electrical pattern represents ventricular contraction?

QRS Interval

What will the nurse include when developing a teaching plan for a client receiving digoxin for left ventricular failure? Sleep flat in bed Follow a low-potassium diet Take the pulse three times a day Rest periodically throughout the day

Rest periodically throughout the day. *The client needs potassium. A low-potassium diet when the client is taking digoxin predisposes the client to toxicity and dangerous dysrhythmias. *

The nurse assesses bilateral +4 peripheral edema while assessing a client with heart failure and peripheral vascular disease. Which is the pathophysiological reason for the excessive edema?

Shift of fluid into the interstitial spaces

Which dietary restriction will the nurse expect to be included in the plan for a client with left ventricular failure?

Sodium

A client is scheduled for an adrenalectomy. The nurse expects that the plan of care will include

Steroid therapy usually is given intravenously or intramuscularly preoperatively and continued intraoperatively to prepare for the acute adrenal insufficiency that follows surgery.

Twenty minutes after an infusion of packed red blood cells begins, the client complains of chest pain, difficulty breathing, and feeling cold. Which is the first action the nurse will take?

Stop the tranfusion.

The nurse is caring for a client who has had frequent premature ventricular complexes (PVCs) and monitors the client closely for ventricular fibrillation. The nurse recalls that the risk for ventricular fibrillation is greatest during which phase of the cardiac cycle?

T wave

A client who is receiving chemotherapy for lung cancer has nausea and vomiting because of the therapy. The client wants to know if it is true that smoking marijuana will help. What is the nurse's best response

THC, an ingredient in marijuana, acts as an antiemetic in some people and can be absorbed through the gastrointestinal tract or inhaled. THC-based medications, dronabinol (Marinol) and nabilone (Cesamet), are available by prescription to control nausea and vomiting resulting from cancer chemotherapy. The statement, "Smoking marijuana is not legal in any state," does not answer the client's question and is inaccurate. Marijuana is not injected. THC is an effective antiemetic for some clients.

A client has an open reduction and internal fixation (ORIF) of a fractured hip. The nurse monitors this client for signs and symptoms of a fat embolism. Which client assessment finding reflects this complication?

Tachycardia occurs because of an impaired gas exchange; petechiae are caused by occlusion of small vessels within the skin.

A client is diagnosed with acute kidney failure secondary to dehydration. An intravenous (IV) infusion of 50% glucose with regular insulin is prescribed. The nurse concludes that the primary purpose of the IV insulin for this client is to:

The 50% glucose and regular insulin infusion treats the hyperkalemia associated with kidney failure; it moves potassium from the intravascular compartment into the intracellular compartment. Insulin will not increase urinary output. Insulin is not a treatment for respiratory acidosis. Insulin and glucose do not increase serum calcium levels.

After teaching a family member how to administer subcutaneous enoxaparin sodium, how should a nurse evaluate the effectiveness of the training?

The best way to evaluate the effectiveness of the teaching is to observe the family member administering the medication to the client. The family member may be able to perform a subcutaneous injection on a manikin but fear hurting the family member. Knowing the side effects of enoxaparin sodium is important, but it does not provide any information as to the family member's ability to administer the medication. The family member may be able to verbalize all the steps but fear puncturing the skin with the needle.

The nurse is caring for a client with deep partial-thickness burns who is receiving a low dosage of an opioid for pain management. The preferred mode of medication administration for this client is:

The intravenous route provides for the quickest onset of action of the opioid

Nitroglycerin sublingual tablets are prescribed for a client with the diagnosis of angina. The client asks the nurse how long it should take for the chest pain to subside after nitroglycerin is taken. What should the nurse tell the client

The onset of action of sublingual nitroglycerin tablets is rapid (1 to 3 minutes); duration of action is 30 to 60 minutes. If nitroglycerin is administered intravenously, the onset of action is immediate, and the duration is 3 to 5 minutes. It takes longer than 30 to 45 seconds for sublingual nitroglycerin tablets to have a therapeutic effect. Sustained-release nitroglycerin tablets start to act in 20 to 45 minutes, and the duration of action is 3 to 8 hours.

A client is on a cardiac monitor. The monitor begins to alarm showing ventricular tachycardia. What should the nurse do first?

The treatment of ventricular tachycardia depends on the presence of a pulse. Therefore, checking for a pulse is the first priority for the nurse.

While providing care for a client with a second-degree left ankle sprain, the nurse raises the injured part above heart level. Which statement provides the reason behind this nursing intervention?

To prevent further edema

A nurse is assessing a client with the diagnosis of osteoporosis. What part of the client's body should the nurse assess to identify osteoporotic changes?

Vertebral column. Compression fractures of the vertebrae are the most common fractures in clients with osteoporosis; a gradual collapse of vertebrae may be asymptomatic and observed as kyphosis.

A child who has a history of a 5-lb (2.3 kg) weight gain in 1 week and periorbital edema is admitted with a diagnosis of acute glomerulonephritis. How can the nurse obtain the most accurate information on the status of the child's edema?

Weighing daily

Aspirin is prescribed on a regular schedule for a client with rheumatoid arthritis. The nurse understands that the drug is being used primarily for which of its properties?

anti inflammatory. The antiinflammatory action of aspirin reduces joint inflammation. Aspirin reduces fever, but this is not the rationale for prescribing it for clients with rheumatoid arthritis. Aspirin does not preserve bone integrity. Flexion contractures are prevented by exercise, not aspirin

Where should the nurse expect the first heart sound (S1) to be the loudest when auscultating a client's heart?

apex

Which interview technique is the nurse using when asking a client to score the pain on a scale from 0 to 10?

closed ended questioning. Asking a client to score pain on a scale of 0 to 10 is a type of closed-ended question. These types of questions specify the cause of the problem or the client's experience of the illness. Asking whether anything else is bothering the client is an example of probing. A response by the nurse such as "All right," or "Go on," when a client says something is called back channeling. This interview technique encourages a client to provide more details. The nurse asks open-ended, nonspecific questions such as "What brought you to the hospital today?" to elicit the client's side of story. Such questions are related to the client's health history and can strengthen the nurse-client relationship

What is the priority goal for a client with asthma who is being discharged from the hospital with prescriptions for inhaled bronchodilators? <p>What is the <b>priority</b> goal for a client with asthma who is being discharged from the hospital with prescriptions for inhaled bronchodilators?</p> Is able to obtain pulse oximeter readings Demonstrates use of a metered-dose inhaler Knows the healthcare provider's office hours Can identify the foods that may cause wheezing

demonstrates use of a metered-dose inhaler. Clients with asthma use metered-dose inhalers to administer medications prophylactically or during times of an asthma attack; this is an important skill to have before discharge. Pulse oximetry is rarely conducted in the home; home management usually includes self-monitoring of the peak expiratory flow rate. Although knowing the healthcare provider's office hours is important, it is not the priority; during a persistent asthma attack that does not respond to planned interventions, the client should go to the emergency department of the local hospital or call 911 for assistance. Not all asthma is associated with food allergies.

A client is admitted to the hospital with a diagnosis of emphysema and dyspnea. The nurse should encourage the client to assume what position?

orthopneic

A nurse is caring for a client who just had a thyroidectomy. For which client response should the nurse assess the client when concerned about an accidental removal of the parathyroid glands during surgery?

tetany