Quiz customizer

The normal range for TSH is between

0.5 mU/l and 5.0 mU/l. A high TSH suggests your thyroid is underactive (hypothyroid) and not doing its job of producing enough thyroid hormone. A low TSH suggests your thyroid is overactive (hyperthyroid) and producing excess thyroid hormone.

Which signs/symptoms should the nurse monitor for when caring for a client diagnosed with bulimia nervosa? You answered this question Incorrectly 1. Increased thirst 2. Muscle cramps 3. Blurred vision 4. Tingling of lips 5. Constipation

2., 4., 5. Correct: The typical abnormalities associated with bulimia are hypokalemia and metabolic alkalosis because of the binging and purging process. This leads to muscle cramps, weakness, fatigue, constipation, and arrhythmias are all symptoms of this electrolyte and acid-base imbalance. Hypokalemia leads to metabolic alkalosis.

Urine osmolality

200-800 mOsm/kg

MMR is contraindicated in

A known allergy to gelatin

Putting client at risk for hypomagnesemia

Alcohol abuse

Kava Kava

Causes liver damage

ABGs (arterial blood gases) are drawn by lab important to document

Client was on 2L of oxygen by nasal cannula

full thickness burn priority

Fluid volume status

Intranasal desmopressin

How is diabetes insipidus treated?

elevated INR/prolonged PT

Inform primary health care provider,watch for signs of bleeding

Divide by minutes

Multiply by drop rate

The nurse is preparing to administer subcutaneous injection. Place an X over the correct syringe position for this injection

SQ injections are delivered at a 45 degree angle to get the medication into the subcutaneous tissue.

Ureters

The tubes that carry urine from the kidneys to the bladder.

Lisapro (Humalog)

With meals

epoetin alfa (Epogen, Procrit)

biosynthetic form of erythropoietin

human papillomavirus cause

cervical cancer

client is pale, clammy and tachycardic, which is evidence of

early shock

Oliguric

reduced urine volume

A nurse suspects that a client admitted to the emergency department is in diabetic ketoacidosis. What data would lead the nurse to this conclusion? 1. Dry mucous membranes 2. Fruity-smelling breath 3. Biot's respirations 4. Glycosuria 5. Client report of abdominal pain

1,2,4,5,

The clinic nurse suspects that a 5 year old has been physically abused. What would be the best way for the nurse to establish trust with this child? You answered this question Correctly 1. Using play therapy. 2. Asking the mother questions. 3. Hugging the child. 4. Conducting an in-depth interview with the child.

1. Correct: Establishing a trusting relationship with an abused child is extremely difficult. He or she may not even want to be touched. Play activities can provide a nonthreatening environment that may enhance the child's attempt to discuss painful issues.

The nurse is caring for a client taking digoxin. Which electrolyte imbalance should be of most concern? You answered this question Correctly 1. Hypokalemia 2. Hyponatremia 3. Hypomagnesemia 4. Hypocalcemia

1. Correct: The serum potassium level is monitored because the effect of digoxin is enhanced in the presence of hypokalemia and digoxin toxicity could occur.

What problem in the client with chronic renal failure would be prevented by receiving epoetin alfa? You answered this question Correctly 1. Anemia 2. Halitosis 3. Edema 4. Pain

1. Correct: Yes, the diseased kidney does not produce the hormone necessary for bone marrow stimulation to promote RBCs. Epoetin alfa stimulates erythropoiesis (production of RBC). 2. Incorrect: No affect in breath odor. 3. Incorrect: No affect in edema. 4. Incorrect: Does not help with pain.

Which signs and symptoms would indicate to the nurse that the client is having an anaphylactic response after receiving penicillin? You answered this question Correctly 1. Reports a scratchy throat 2. Faint expiratory wheeze on auscultation. 3. Client statement, "I feel like something is wrong." 4. Bounding radial pulse rate of 100/min 5. BP 100/70

1., 2. & 3. Correct: Swelling of face, mouth, throat, and a scratchy throat are indicative of an inflammatory response that could obstruct the airway. Wheezes and stridor are indicators of breathing difficulties seen with anaphylactic reaction. A sense that something bad is happening should serve as a warning that something bad is really going on. Suspect anaphylactic response. 4. Incorrect: The pulse rate would be increased, but the client would have a thready, weak pulse, not bounding. The pulse may also be irregular. 5. Incorrect: This blood pressure is not below 90 systolic which could indicate shock. Although on the low side, simply getting this BP reading does not tell you if perfusion is adequate. Once blood pressure decreases, other symptoms may appear such as dizziness, blurred vision and loss of bladder/bowel control.

A palliative care client is suffering from persistent diarrhea. What foods should the nurse suggest? 1. Applesauce 2. Rice 3. Bananas 4. Tea 5. Yogurt

1., 2., & 3. Correct: The BRAT diet is recommended for clients with persistent diarrhea. This diet consists of bananas, rice, applesauce, and toast. Rice and potatoes help to reduce diarrhea. Bananas will help replace potassium. Once the diarrhea subsides, the client can add easily digestible foods like eggs.

The client diagnosed with active tuberculosis has been prescribed isoniazid 300 mg by mouth every day. The nurse is reinforcing client education on the medication. Which client statements indicate an understanding of isoniazid? You answered this question Incorrectly 1. "I will notify my primary healthcare provider if my urine turns dark." 2. "My primary healthcare provider has prescribed B6 along with the isoniazid to prevent neuritis." 3. "I should avoid eating aged cheeses and smoked fish." 4. "I will eat foods such as tuna twice a week." 5. "I will rise slowly from lying to sitting, or sitting to standing."

1., 2., 3., & 5 Correct: Signs of hepatotoxicity from this medication include dark urine, jaundice, and clay-colored stool. Isoniazid- induced pyridoxine (Vitamin B6) depletion causes neurotoxic effects. Vitamin B6 supplementation of 10-50 mg usually accompanies isoniazid use. Aged cheeses and smoked fish are high in tyramine which may cause palpitations, flushing, and blood pressure elevation while taking isoniazid. Avoid these foods during treatment. Isoniazid should be taken on an empty stomach, one hour before or two hours after food. Some clients experience orthostatic hypotension while taking isoniazid, so caution against rapid positional changes. 4. Incorrect: Histamine containing foods such as tuna and yeast extracts may cause exaggerated drug response (H/A, hypotension, palpitations sweating, itching, flushing, diarrhea).

What potential contributing factors for stress urinary incontinence should a nurse collect data for in an elderly female client? You answered this question Incorrectly 1. Lack of estrogen 2. Rising abdominal pressure 3. Multiparous vaginal births 4. Spinal cord injury 5. Dementia

1., 2., 3., Correct: During pregnancy and childbirth, the sphincter and pelvic muscles stretch out and are weakened. Increased age, decreased estrogen, and a history of multiple vaginal births/pregnancies are contributing factors for stress incontinence.

A client who has been taking phenytoin for several years arrives to the clinic for follow-up care. During the nurse's history and physical of the client, which findings indicate a possible side effect to the phenytoin? You answered this question Incorrectly 1. Skin rash 2. Reports fatigue 3. Dyspnea on exertion 4. Pale conjunctiva 5. Heart rate 60/min

1., 2., 3.,& 4. Correct: An adverse effect of phenytoin is aplastic anemia. Phenytoin is an anticonvulsant. Aplastic anemia is a blood disorder where not enough new blood cells are produced in the bone marrow. The blood cells include red blood cells, white blood cells and platelets. The most common symptom of decreased RBC's is fatigue and dyspnea upon exertion because RBC's are responsible for oxygen transport throughout the body. A common sign/symptom of aplastic anemia is also skin rashes. Collectively, these are signs/symptoms of aplastic anemia caused by this medication. 5. Incorrect: This is a normal heart rate, and there is no concern for vital signs within normal limits.

The nurse is caring for a client hospitalized with dissociative amnesia. Which nursing interventions are appropriate for this client? You answered this question Incorrectly 1. Obtain client likes and dislikes from family members. 2. Expose the client with data regarding the forgotten past. 3. Expose client to stimuli that was a happy memory of the past. 4. Hypnotize the client to help restoration of memory. 5. Ensure client safety.

1., 3. & 5. Correct: Considering likes and dislikes may help the client to remember. Using information to expose the client to stimuli that were happy memories may help the client remember. The client's disorder may lead to inattention to safety. Think safety first! 2. Incorrect: Do not expose the client to data regarding the forgotten past. Clients who are exposed to painful information from which the amnesia is providing protection may decompensate even further into a psychotic state. Dissociative amnesia is marked by an inability to recall important personal information, often traumatic or stressful in nature.

What is the primary electrolyte that the nurse should be aware to monitor for in a client who is receiving an insulin infusion?

Potassium

Nursing Process

assessment, diagnosis, outcome identification, planning, implementation, evaluation

A side effect of administering divalproex

is drug-induced hepatitis. / ALT levels will increase

Memantine (Namenda)

Alzheimer's / When beginning this medication provide ambulatory assistance / If the client cannot swallow the capsule you sprinkle on applesauce

Divalproex (Depakote)

Anticonvulsant

The client has been taking divalproex for the management of bipolar disorder. The nurse should give priority to monitoring which laboratory test? You answered this question Correctly 1. Alanine aminotransferase (ALT) 2. Serum glucose 3. Serum creatinine 4. Serum electrolytes

1. Correct: ALT levels will increase primarily in liver damage/disorders. A side effect of administering divalproex is drug-induced hepatitis. 2. Incorrect: Divalproex is not expected to alter glucose metabolism. 3. Incorrect: Divalproex should not cause a change in renal function. 4. Incorrect: Divalproex should not interfere with electrolytes balance.

The nurse is caring for a client who is preparing to undergo a total hysterectomy for stage 4 cervical cancer. The client is crying and states, "I want to have more children, and I am unsure if I should have the procedure." What is the nurse's best action? You answered this question Correctly 1. Allow the client to discuss her fears, and encourage her to talk more with her primary healthcare provider. 2. Discuss the fun things that she will be able to do after her surgery, and encourage her to make a list of positive things. 3. Explain to the client that her ovaries can be frozen for egg harvesting at a later time, and she can find a surrogate. 4. Advise the client to put off having the surgery until she is certain, and notify the surgeon of the decision.

1. Correct: This is likely anticipatory grieving and fear. Let the client talk and encourage her to talk again to the primary healthcare provider. The client needs reassurance that she is making the right decision.

Which is a therapeutic technique that can be utilized by the nurse for clients with anxiety disorders? You answered this question Incorrectly 1. Activity assignments 2. Careful monitoring 3. Goal setting 4. Relaxation techniques 5. Group activities

1., 2., 3. & 4. Correct: Therapeutic techniques that can be utilized by the nurse for clients with anxiety disorders include activity assignments, careful monitoring, goal setting, and relaxation techniques. Other therapeutic techniques include assisting clients to use "self-talk" to help deal with anxiety-provoking stressors. 5. Incorrect: Group activities may increase anxiety.

The client has been prescribed promethazine for reports of nausea. The nurse makes rounds to the client's room approximately one hour after the medication was administered. What can the nurse expect to find when seeing the client? You answered this question Incorrectly 1. Reports feeling sleeping 2. Reports dry mouth 3. Reports that the drug has already stopped working 4. Reports blurred vision 5. Reports feeling calm

1., 2., 4., & 5. Correct: Promethazine causes sedation in most people. The medication has anticholinergic effects. Blurred vision is one of the anticholinergic side effects that the client may have. The medication works also as an antianxiety agent. 3. Incorrect: The drug typically has lasting effects for 2 to 8 hours following administration.

How should a nurse prepare to administer a Measles, Mumps, Rubella (MMR) vaccination to a 6 year old child? You answered this question Incorrectly 1. 3 mL syringe with 23 gauge, 1" needle for IM injection 2. Use a 25 gauge, ¾" needle for subcutaneous (Sub-Q) injection. 3. Prime intranasal spray for administration. 4. Tuberculin (TB) syringe with 28 gauge, 3/8" needle for intradermal injection.

2. Correct: MMR is given Sub-Q. Subcutaneous injections are administered in the fat layer, underneath the skin. When administering SQ injections use a 23-25 gauge needle, needle length for infants (1- 12 months) is 5/8", children 12 months and older 5/8" - ¾".

An adolescent admitted with an exacerbation of ulcerative colitis has been scheduled for a colostomy. When the LPN enters the room with medications, the client is very distraught, indicating this surgery represents an end to all future plans. What response by the LPN is most appropriate? You answered this question Incorrectly 1. "It is going to be okay because we'll teach you everything." 2. "How do you feel this surgery is going to affect your life?" 3. "Don't worry; usually such a colostomy is only temporary." 4. "Is the bag or the smell your biggest concern right now?"

2. Correct: The LPN has posed an open-ended question focusing on the client's expressed fears while encouraging further verbalization of concerns. This therapeutic response is directly focused on the issue in the question.

A nurse is preparing to insert a nasogastric tube. As the nurse gathers supplies, the client begins to experience palpitations, trembling, nausea, shortness of breath and a feeling of losing control. What is the client most likely experiencing? You answered this question Correctly 1. Hyperventilation 2. Panic disorder 3. Somatization 4. Conversion disorder

2. Correct: These are all signs of panic disorder. Additional s/s include: sweating, feeling of choking, chest discomfort, abdominal distress, dizziness, lightheadedness, faintness, feelings of unreality or being detached from self, fear of losing control, fear of dying, Paresthesias, chills or hot flashes

The nurse overhears this client responding on the phone when their boss asks them to work an extra night shift. Which statement by the client demonstrates assertive communication? You answered this question Correctly 1. "I know you are joking! I have already worked an extra night shift." 2. "I do not want to work an extra night shift. I have already worked an extra shift this week." 3. "Umm, well, okay. I guess I will work an extra night shift." 4. "Okay, I'll work an extra night shift." Then they say to another client. "The nerve of my boss to ask me to work another extra shift."

2. Correct: This is an example of assertive communication, the best response. Assertiveness is asking for what one wants or acting to get what one wants in a way that respects the rights and feelings of other people.

A hospitalized Native American elder is actively dying and is surrounded by a large group of family members. The client's spiritual beliefs include burning a tiny amount of incense while chanting softly. The roommate summons the nurse, complaining about the noise and the odor despite the fact the curtain is drawn between the beds. What is the most appropriate action by the nurse? You answered this question Correctly 1. Tell the client's family the noise and odor bothers the roommate. 2. Move the elder to a private room so family can continue ceremony. 3. Offer to move the roommate to another room in a quieter area. 4. Explain the client is dying and the family will soon be leaving.

3. CORRECT. The most appropriate action in this situation is to move the roommate to a quieter location, allowing the family and dying client privacy while also fulfilling the roommate's request.

A client who has had a stroke presents with lethargy, facial droop, and slurred speech. The client has a history of gastroesophageal reflux disease (GERD). From this history, what does the nurse recognize as an increased risk for this client? You answered this question Correctly 1. Diminished colonic motility 2. Esophageal hemorrhage 3. Aspiration pneumonia 4. Stress ulcers

3. Correct: Anyone who has had a stroke is at risk for aspiration, especially with a history of reflux disease. It is important to remember that the stomach is full of acid. When aspiration of this acid occurs, it causes irritation to the lung tissue. The client can develop a severe pneumonitis. That's what could kill the client, so this answer takes priority.

A client with a history of eczema has been admitted with cellulitis of the left forearm. Which admission order should the nurse question immediately? 1. Start IV of normal saline at 100 mL per hour. 2. Keep left arm elevated on pillow at all times. 3. Apply ice packs to affected area every shift. 4. Ibuprophen 800 mg po every 6 hours prn pain.

3. Correct: Cellulitis is a bacterial skin infection resulting in warm, redden and edematous tissue, sometimes accompanied by fever and chills. Swelling in the affected area impedes blood flow and increases pain. In order to decrease the edema, warm, moist compresses are used to stimulate circulation and speed reabsorption of the fluid within the tissue. This order should be questioned immediately.

What is the nurse's most important role in the care of the family when a client's death is imminent? You answered this question Correctly 1. Providing temporary relief of care giving duties to allow the family to rest. 2. Providing education regarding the symptoms the client will likely experience. 3. Coordinating a visiting schedule for the family that is approved by everyone. 4. Communicating news of the client's impending death to the family while they are together.

4. Correct: Communicating news of the client's impending death to the family while they are together. The nurse's most important role in the care of the family is compassionate communication. The family needs to be informed about the situation so that they are prepared for the client's death and can provide support to one another

Which medication should the nurse administer first after receiving the morning shift report? You answered this question Correctly 1. Levothyroxine to the client with hypothyroidism and a thyroid stimulating hormone (TSH) level of 2.8 mU/L 2. Amlodipine to the client with hypertension and a blood pressure of 150/86 3. Regular insulin sliding scale dose to the client with diabetes and a 210 blood glucose level. 4. Cefotaxime intravenous piggyback to the newly admitted client with a diagnosis of pneumonia and a white blood cell count (WBC) of 12,000mm3

4. Correct: The first dose of intravenous antibiotic medication is the priority since the WBCs are elevated and the antibiotic should be administered first. 1. Incorrect: The TSH is normal so the thyroid medication is not the priority. 2. Incorrect: Amlodipine is for high blood pressure and is important but the antibiotic is the priority. 3. Incorrect: It is important to administer the regular insulin but it is not priority over initiating the intravenous antibiotic medication.

The nurse enters the client's room to administer the morning dose of digoxin. Before administration, the nurse checks the client's apical pulse to find the rate to be 70. What should the nurse do? You answered this question Correctly 1. Hold the medication as the pulse rate is too low. 2. Wait 30 minutes and attempt to give the medication again. 3. Contact the primary healthcare provider. 4. Give the medication as prescribed.

4. Correct: The pulse rate is high enough to give the medication. A pulse rate of less than 60 would warrant holding the medication.

The primary healthcare provider prescribed diazepam 12.5 mg IM to a client. The pharmacy dispenses diazepam 5 mg/mL. How many mL will the nurse administer? Round answer using one decimal point. You answered this question Correctly Enter the answer for the question below.

5 mg : 1 mL = 12.5 mg : x mL 5 x = 12.5 x = 2.5

Donepezil (Aricept)

Alzheimer's / "This medication is used to treat confusion."

Levothyroxine dosage to high

Angina - palpitations

Acetaminophen overdose s/s

Jaundiced conjunctiva

Episiotomy care

Perineal care; fill a squeeze bottle with warm water and an ounce of povidone/iodine solution; lavage perineum with several squirts and blot dry instead of rubbing; avoid anal area

Fluoxetine (Prozac)

Regulate neurotransmitter called serotonin

Laryngospasms can occur with low Ca and is a medical emergency

TRUE: Laryngospasms can occur with low Ca and is a medical emergency

Nurse assign a private room

Temp of 100.5 or client postpartum more than 24 hours indication of infection should be kept separate

gluten free diet

This diet includes: Rice, corn, soy flour, fruit, veggies, meat, egg, milk.

The nurse is preparing to administer iron dextran IM. Which injection site would be best for administration?

Ventrogluteal

diabetes insipidus (DI)

insufficient secretion of antidiuretic hormone (vasopressin)

Akathisia

restlessness

A client diagnosed Alzheimer's disease has been prescribed memantine. The nurse is reinforcing education about this medication. What points should the client know about this medication? You answered this question Incorrectly 1. When beginning this medication provide ambulatory assistance. 2. This medication is prescribed to help improve mild dementia. 3. This medication must be taken without food. 4. If a dose is missed, double the next dose. 5. If the client cannot swallow the capsule you sprinkle on applesauce.

1. & 5. Correct: This medication can cause dizziness, so safety precautions should be taught to the caregiver. Extended release caps should not be crushed, chewed, or divided. If the client cannot swallow it whole, it can be opened and sprinkled on a small amount of applesauce. 2. Incorrect: Memantine is used for moderate to severe dementia associated with Alzheimer's disease. 3. Incorrect: Memantine can be taken with or without food. 4. Incorrect: If the client misses a single dose of memantine, that client should not double up on the next dose. The next dose should be taken as scheduled.

What is the best information the nurse can provide when administering acetylsalicylic acid 81 mg to a client experiencing severe, crushing chest pain radiating up the left jaw? You answered this question Incorrectly 1. Chew the acetylsalicylic acid prior to swallowing. 2. Place the acetylsalicylic acid under the tongue so that it can dissolve. 3. Swallow the acetylsalicylic acid tablet. 4. Insert the acetylsalicylic acid between the cheek and gum for greater absorption.

1. Correct: Acetylsalicylic acid has been shown to decrease mortality and re-infarction rates after MI. The fastest way to get the aspirin into the circulatory system is to have the client chew the acetylsalicylic acid prior to swallowing. 2. Incorrect: Nitroglycerin is administered sublingual (SL) or buccal. Initially acetylsalicylic acid is administered by chewing the tablet or swallowing the tablet. 3. Incorrect: If a solid dose pill is prescribed, the pill should be chewed. Faster absorption is obtained from chewing, rather than swallowing acetylsalicylic acid. 4. Incorrect: Nitroglycerin is administered SL or buccal. Initially acetylsalicylic acid would be chewed to increase the absorption rate.

What interventions should the LPN/VN include when reinforcing teaching with a client on how to prevent and treat fungal infections of the feet? You answered this question Correctly 1. Apply cornstarch to the feet after bathing. 2. Put terbinafine hydrochloride cream 1% on affected areas twice a day for two weeks. 3. Wear socks at all times until infection has cleared up. 4. Wash feet daily with soap and water. 5. Wear shower sandals when showering in public places. 6. Wear shoes that allow the feet to breathe.

2., 4. 5, & 6. Correct: Athlete's foot is treated with topical antifungal in most cases. Severe cases may require oral drugs. The feet must be washed daily with soap and water and dried thoroughly since the fungus thrives in moist environments.Steps to prevent athlete's foot include wearing shower sandals in public showering areas and wearing shoes that allow the feet to breathe

The nurse is caring for an elderly client who is approaching death and expressing intense despair and anxiety. Based on Erikson's theory, the nurse recognizes that this client's despair and anxiety would most likely be based on what? You answered this question Correctly 1. An inappropriate desire for youthfulness and staying young. 2. The decision to never marry. 3. The lack of a sense of wholeness, purpose, and a life well lived. 4. The fear of experiencing a painful death

3. Correct: Older adults who view their lives as purposeful and full have an increased ability to view death as a meaningful part of life.

A renal transplant client has received discharge education. Which statement by the client indicates the need for follow up? 1. "I will need to notify my primary healthcare provider if I develop a fever." 2. "I need to check my BP daily and report an increased B/P." 3. "I will tell my primary healthcare provider if I become easily fatigued." 4. "I will be on steroids for 3 months, then I will not have to take them."

4. Correct: This statement indicates a need for further teaching. Doses of immunosupressive agents are often adjusted, but the client will be required to take some form of immunosuppressive therapy for the entire time that the client has the transplanted kidney.

Phenytoin (Dilantin)

Anticonvulsant 10-20

Benazepril (Lotensin)

Antihypertensive

Levothyroxine (Synthroid)

thyroid hormone

Protein will help to improve the functioning of the

immune system

A client hospitalized in the mental health unit asks if she can receive mail from her mother and sister. Which statement by the nurse indicates adequate understanding of client rights? You answered this question Correctly 1. "All clients can receive and send mail, but staff must check for hazards." 2. "Clients are not allowed to receive mail while hospitalized." 3. "Receiving mail from family is not encouraged on inpatient units." 4. "I will check with the nursing supervisor about this."

1. Correct: Clients are allowed to send and receive mail. Mail must be checked for hazards to protect the client and the safety of others on the unit.

The nurse is caring for a client diagnosed with chronic renal failure who has been taking Epoetin alfa for 2 months. What should the nurse monitor for pertaining to Epoetin alfa during the client's clinic visit? You answered this question Incorrectly 1. Hypertension 2. Halitosis 3. Hemoptysis 4. Oliguia 5. Dependent edema

1., 3., & 5. Correct: Epoetin alfa can cause or worsen high blood pressure, induce rapid weight gain, and swelling of feet and hands . Clients may experience coughing up of blood as a result of a rapid increase number of RBCs.

The nurse is working with a client who is experiencing urinary incontinence. What alterations in diet could improve urinary function? 1. Encourage the client to drink cranberry juice to acidify the urine. 2. Encourage the client to drink caffeine containing beverages in the evening. 3. Ask the client to limit or eliminate artificial sweeteners in the diet. 4. Ask the client to limit intake of caffeine to no more than 2 cups of coffee per day. 5. Suggest that the client limit or eliminate alcoholic drinks in the diet.

1., 3., 4. & 5. Correct. Increasing acidity of urine may help to reduce the risk of repeated urinary tract infections. Artificial sweeteners may irritate the bladder, thus increasing incontinent episodes. Caffeine containing beverages may serve as a bladder irritant, thus contributing to incontinence. Alcohol containing drinks may also increase the likelihood of urinary incontinence.

A positive Chvostek's sign is an indication of hypocalcemia, so the client should be assessed for the subjective symptoms of hypocalcemia, such as numbness or tingling of the hands (B) or feet. (A and C) are unrelated assessment data. (D) is contraindicated because the client is hypocalcemic and needs additional dietary calcium.

Hypokalemia

A client arrives by ambulance after being thrown from a horse. The client is pale, clammy and tachycardic with bruising over left upper abdominal quadrant. The nurse is aware what prescription by the primary healthcare provider takes priority? 1. Obtain blood for type and cross match. 2. Administer hydromorphone IV for pain. 3. Increase Lactated Ringers to 150 mL/hour. 4. Send client to radiology for stat CAT scan.

1: Excellent! The rupture of an internal organ can quickly lead to death without medical or surgical intervention. The vascular spaces are losing volume into the abdominal cavity, which leads to shock. This client will need large amounts of blood before, during, and after surgery; therefore, the process of typing and cross matching should be initiated immediately.

The client, who recently started college, tells the nurse, "I am having trouble studying for my tests. Every time I try to study, my mind begins to wander." What is the nurse's best response? You answered this question Correctly 1. "Stop making excuses and make a study schedule you will follow." 2. "I wouldn't worry. You are smart enough to pass college." 3. "You are having difficulty concentrating?" 4. "What do you mean you can't study?"

3. Correct: The correct answer demonstrates the therapeutic communication technique of "restating". The main idea is to let the client know whether or not an expressed statement has been understood and gives him or her the chance to continue or clarify if necessary

After obtaining vital signs, which prescribed medication should the nurse hold when caring for a client on the cardiac unit? Exhibit You answered this question Correctly 1. Rosuvastatin 2. Enalapril 3. Digoxin 4. Clopidogrel T - 98 ° (36.7°) P - 74 R - 20 BP - 88/50

2. Correct: Enalapril is an angiotensin converting enzyme (ACE) inhibitor. An ACE inhibitor will lower the client's blood pressure. The blood pressure in the stem's exhibit is low. Lowering the client's blood pressure more could have a negative effect on the client's condition. 1. Incorrect: Rosuvastatin is a lipid lowering medication. The client's blood pressure has no bearing on whether or not to administer the medication. 3. Incorrect: Digoxin is an antiarrhythmic/inotropic agent. It will slow the heart rate and increase the force of myocardial contraction. This action could actually increase the blood pressure. 4. Incorrect: Clopidogrel is an antiplatelet agent. The client's blood pressure would not have a bearing on whether or not to administer the medication.

The client with bi-polar disorder is parading around the common areas of the psychiatric unit in a sexually suggestive manner. The client then sits on the lap of one of the young male clients. What should the nurse do? You answered this question Correctly 1. Tell the client that the behavior is inappropriate. 2. Accompany the client to the TV room on the unit. 3. Allow the male client to handle the situation. 4. Continue with the unit routine.

2. Correct: This behavior must be interrupted, as the rights of other clients are being jeopardized. The other clients are being exploited by the manic client. Stop the behavior by going with them to another area. Many people with bipolar disorder don't recognize the extreme changes in their moods and the effects these changes have on their lives and others. You must stop them and remove them from the situation.

The nurse has been working with an attractive teenage girl regarding appropriate nutrition. Which statement by the teenager would support a disturbed body image? You answered this question Incorrectly 1. "I am happy my weight is within normal limits. " 2. "I can never exercise enough to lose those saddle bags." 3. "I can always work a little harder on school work and hobbies." 4. "I try to eat only two meals a day to keep my weight down." 5. "I have been trying to include more fruits and vegetables in my diet."

2., 3. & 4. Correct: Compulsive exercising may indicate an eating disorder or a risk for developing one. Perfectionism in school, sports, and hobbies may indicate low self-esteem, which is reflected in eating disorders. Compulsive adherence to routines for weight loss or control may indicate a risk for developing an eating disorder.

The nurse is caring for a client with body dysmorphic disorder. The client tells the nurse, "My ugly ears make everyone sick!" Which defense mechanism is this client utilizing? You answered this question Incorrectly 1. Sublimation 2. Somatization 3. Symbolism 4. Projection 5. Conversion

3. & 4. Correct: Symbolism and projection are the correct answers. Symbolism is the unconscious process by which one object or idea comes to represent another. The client's ears symbolize everything distasteful and unacceptable to her/him. Projection is the unconscious process by which an individual attributes one's own intolerable wishes, emotions, or motivations to another person. The client states that others are horrified by the ears, but actually the client is horrified by them. 1. Incorrect: Sublimation is the unconscious process of substituting acceptable impulses for unacceptable ones. Sublimation is not shown in this scenario. 2. Incorrect: Somatization has significant functional impairment as recurrent medical symptoms appear, but no physical cause can be identified. This is not shown in this scenario. 5. Incorrect: Conversion is marked by deficits in voluntary motor or sensory function. Conversion is not shown in this scenario.

The nurse is caring for a client who is taking an antipsychotic medication for the treatment of schizophrenia. The nurse is told in report that the client has akathisia, as a side effect of their antipsychotic medication. What symptom should the nurse expect this client to have? You answered this question Correctly 1. Upward gaze of the eyes. 2. Involuntary movement of the tongue. 3. Reports of restlessness. 4. Lack of movement or slowed movement

3. Correct: Reports of restlessness, inability to sit still, and nervous energy indicate akathisia. These symptoms respond poorly to treatment. If possible, the dose of the medication may be reduced. 1. Incorrect: Upward gaze of the eyes indicates dystonia, a possible adverse reaction to the antipsychotic medications. 2. Incorrect: Tardive dyskinesia has the symptoms of involuntary movement of the tongue, chewing movements of the mouth, and lip smacking. These symptoms may be irreversible. 4. Incorrect: Slowed movement refers to the side effect of bradykinesia. Lack of movement is referred to as akinesia.

Which response by the nurse is appropriate when admitting a 5 year old child who is crying and hugging a stuffed animal? You answered this question Incorrectly 1. "Hello, I am your nurse. I am going to show you to your room." 2. "Don't cry. Let's go to the playroom where you can meet other children." 3. "You are upset. I see you have your stuffed animal." 4. "Can I hold your stuffed animal? Then, would you like to put your stuffed animal in the bed?"

3. Correct: These statements acknowledge the child's feelings and changes focus. 1. Incorrect: This response does not acknowledge the child's feelings. 2. Incorrect: This response does not alleviate fear. 4. Incorrect: Closed-ended questions are not helpful in getting a child to express fear.

A client admitted to the psychiatric unit after a suicide attempt is placed on suicide precautions. Which nursing interventions would be appropriate? You answered this question Incorrectly 1. Assign the client to a private room away from nurses station. 2. Make rounds to assess the client at regular intervals. 3. Secure a promise that the client will seek out staff when feeling suicidal. 4. Closely supervise the client during meals. 5. Ask the client to sign a no harm contract.

3., 4. & 5. Correct: Remove harmful objects from the client's access, such as sharp objects, straps, belts, ties, glass items, and alcohol. Close supervision is necessary during meals. Increased feelings of self-worth may be experienced when the client feels accepted unconditionally regardless of thoughts or behavior.

The family of an elderly client are concerned about emotional well-being since the loss of the spouse two years ago. What alternative therapy could the nurse recommend for this client? You answered this question Correctly 1. Massage 2. Bioelectromagnetics 3. Accupressure 4. Animal-assisted therapy

4. Correct: Animal-assisted therapy is the use of specifically selected animals as a treatment modality in health and human service settings. It has been shown to be a successful intervention for people with a variety of physical or psychological conditions. The contributions companion animals make to the emotional well-being of people include providing unconditional love and opportunities for affection; achievement of trust, responsibility, and empathy toward others; a reason to get up in the morning, and a source of reassurance.

The nurse is caring for a client with a diagnosis of major depression. The client began taking a selective serotonin reuptake inhibitor (SSRI) three days ago. The client says, "I am just not feeling well. My medicine is not working." Which reply by the nurse indicates adequate understanding of treatment? You answered this question Correctly 1. "I agree, your medication is not working." 2. "Your treatment may have to be changed." 3. "Most SSRIs take about 5 days to work." 4. "You should reach the desired effect in 1-3 weeks."

4. Correct: Therapeutic effect is usually reached in one to three weeks, or longer. Encourage the client to continue taking the medication as prescribed. Provide supportive care and reassurance during this time

The nurse has been talking with a depressed client at an outpatient clinic. When asked how the client feels to live alone, the client simply stares straight ahead. How should the nurse respond? You answered this question Correctly 1. Ask, "Why won't you answer me?" 2. Leave the client alone for awhile. 3. Tell a joke to lighten the mood. 4. Use therapeutic silence.

4. Correct: Use of silence allows the client time to think over what he or she wants to say and gives the client a chance to collect thoughts.

The nurse is preparing to give a client's prescribed ampicillin dose. How many mL will the nurse give to the client? Answer to the first decimal place. Answer with numbers and decimal only.

Answer: 0.8 Rationale: Prescription: Ampicillin 200 mg IM every 8 hours Available: Ampicillin 1 gm/ vial Step 1: Convert grams to mg (1 gram = 1000 mg). The vial also says that there are 250 mg/mL The instructions say to add 3.4 mL sterile water for injection to the vial. Volume yields 4 mL (250 mg/mL) Step 2: Think, 250 mg is in 1 mL, so 200 mg will in less than 1 mL but more than ½ mL. Step 3: D/H x Q = X 200/250 x 1 mL = 4/5 x 1 = 4/5 or 0.8 mL NOTE: This insert tells you that 200 mg is in 0.8 mL in the bottom left corner but it is always good to do your own math to double check the dose!

The nurse is preparing to give a client's prescribed levothyroxine dose. How many tablets will the nurse give to the client? Answer with numbers only.

Answer: 2 Rationale: Prescription: Levothyroxine 0.05 mg by mouth every morning. Available: Levothyroxine 0.025 mg per tablet Think, 1 tablet is 0.025 mg and you need to give 0.05 or twice the amount that is available. Remember the formula: D/H x Q = X 0.05mg/0.025 mg x 1 tablet = 0.05/0.025 = 2 tablets

Foods to avoid 3 days prior to guaiac test

Raw broccoli ,red meats, cantaloupe, radish

Homan's sign

is often used in the diagnosis of deep venous thrombosis of the leg. A positive Homans's sign (calf pain at dorsiflexion of the foot) is thought to be associated with the presence of thrombosis.

Anuric

is nonpassage of urine, in practice is defined as passage of less than 100 milliliters of urine in a day. Anuria is often caused by failure in the function of kidneys. It may also occur because of some severe obstruction like kidney stones or tumours.

Glycopyrrolate (Robinul)

quaternary anticholinergic agent used for treatment of peptic ulcers-- less likely to cross BBB

lupus

when immune system attacks tissues causing redness, pain, swelling, and damage

When providing instructions, the nurse asks the client to repeat the techniques for crutch walking. The nurse is aware that further action is needed when the client makes which statement? 1. "The elbows should be flexed at 10 degrees." 2. "I should not lean on the crutches with my armpit." 3. "When going upstairs, my non-surgical leg goes up first." 4. "Both crutches are held in one hand when sitting down".

1. Correct: The nurse is looking for an incorrect statement from the client. This statement indicates the client will need further instruction prior to discharge. When using crutches, the client's elbows should be flexed at 30 degrees

Which medication does the nurse expect will help decrease tremors in a client diagnosed with hyperthyroidism? You answered this question Correctly 1. Steroids 2. Anticonvulsants 3. Beta blockers 4. Iodine compounds

3. Correct: Beta blockers help anxiety and tremors. Beta blockers reduce the effects of adrenaline in the body and help decrease anxiety. In times of stress and emergency the adrenal gland produces adrenaline that acts on various organs in the body to enable us to deal with the situation. For example, the heart beats faster due to adrenaline. In order for adrenaline to be able to do this, various organs have beta receptors to accept the adrenaline and use it to behave differently in times of stress. Beta blockers block these receptors. They stop various organs in the body from accepting adrenaline. Taking them means the heart does less work generally and doesn't get over-worked in times of stress. One of the main symptoms of anxiety is a speeding heart which is part of the fight-or-flight response. In times of danger our body produces adrenaline to stop the heart from beating faster makes us feel calmer. Taking beta blockers for anxiety also makes us feel less shaky. The energy boost to our muscles (from the increased supply of blood and oxygen) which makes us feel 'jittery' and 'on-edge' doesn't happen without a fast heartbeat.