Term 2 Final Exam Review | Pharmacology & Medical Surgery (66 items) sereia

32. A nurse is providing education to a patient taking rifampin (an antimycobacterial) as a result of an exposure to TB. What side effects of this drug should the nurse include?

Body fluids to become red-orange

19. A nurse records the assessments of stasis dermatitis on an intake assessment for a patient with peripheral vascular disease (PVD). What is the best way to describe this finding?

Brownish skin disorientation on the lower legs

59. A 78-year-old retired teacher with a history of osteoporosis has fallen in her bathroom and sustained a subcapital femoral fracture. She is scheduled for an open reduction and internal fixation (ORIF) procedure in the morning. Which type of traction will most likely be implemented?

Buck

1. A nurse is reviewing a recent lab report for a client who has HIV. Which of the following lab values should the nurse report to the provider?

CD4 T-cell 140/mm3

3. What should a patient with HIV avoid to prevent bacillary angiomatosis?

Cats

55. An LPN is drawing blood from a patient for a variety of blood tests. What should be the HIGHEST priority nursing action as a part of the patient preparation?

Choose the correct blood tubes in which to collect the blood

64. A nurse at an extended care facility is instructing a class of assistive personnel (AP) about the use of assistive devices during client ambulation. Which of the following instructions should the nurse include about assisting clients who use a cane?

"When the client moves, he should move the cane forward first"

8. A nurse is preparing to administer gr 1⁄4 of a medication. Available is 50mg/mL. How many mL should the nurse administer per dose? (Do not round)

0.8 mL

10. A nurse is preparing to administer 3mg of medication. The amount available for injection is 5mg/2mL. How many mL should the nurse administer? (Round the answer to the nearest tenth)

1.2 mL

62. A nurse is caring for a client who has a fractured tibia as a result of a fall. The x-ray shows that the bone is splintered into several pieces around the shaft. The nurse should recognize this is a finding for which of the following types of fracture?

Comminuted

28. A nurse should anticipate that a patient taking Vasotec, an angiotensin-converting enzyme (ACE) inhibitor, should have which patient outcome to this drug?

Decreased blood pressure

46. A nurse is preparing to administer ear drops to a 2-year-old child. The nurse should pull the auricle in which of the following directions when installing the medication?

Down and backward

18. A patient asks what a transesophageal echocardiogram (TEE) is and what it is expected to do? What is the best explanation by the nurse?

Evaluates the efficiency of the valves

61. Which is true about a greenstick fracture?

Fracture is incomplete, and one side is bent

34. The nurse has a prescription to give a patient two puffs of albuterol and two puffs of the beclomethasone dipropionate by a metered-dose inhaler. How should the nurse administer these medications?

Give albuterol first and then the beclomethasone dipropionate

A patient who has sustained a hemorrhagic stroke is placed on a protocol of 60mg of calcium channel blocker (nimodipine) every 4 hours. The patient's pulse is 82 beats/min before the administration of the prescribed dose. Which action should the nurse implement?

Give the full dose as prescribed without further assessment

6. An obese African American male reports that he smokes. How should the nurse stage this patient's hypertension?

Grade B

25. Which action of ACE inhibitors results in effective treatment of heart failure?

Increased cardiac output

31. What should a nurse expect when assessing the CBC results of a patient with chronic bronchitis?

Increased red blood cells (RBC's)

2. A nurse is caring for a patient with HIV infection taking retrovir, a nucleoside antiviral that is a reverse transcriptase inhibitor. What should the nurse be especially observant of?

Jaundice

21. An LPN is assisting a patient being treated for PVD. The physician has prescribed Buerger-Allen exercises for him. What should the LPN tell the patient to do first?

Lie flat on his back and raise his legs above the level of his heart for 2 minutes or until they become very pale

60. The nurse is at the bedside completing an assessment on a patient who has a hip fracture. Which signs and symptoms are indicative of fat embolism?

Measles like rash over the neck, upper arms, chest, or abdomen

42. A nurse is reviewing the arterial blood gas (ABG) results of a client. The client's ABG's are: ph 7.5, PaCO2 40 mm Hg, HCO3 32mEq/L. Which of the following acid base conditions should the nurse identify the client is experiencing?

Metabolic alkalosis

5. In relation to risk for transmission of HIV, how is anal or vaginal sex with a condom classified as?

Moderate risk

43. Which action will the nurse take when a patient receiving morphine sulfate via percutaneous coronary angiopathy (PCA) has a shallow, irregular respiratory rate of 6 breaths/min?

Notify the health care provider and prepare to administer naloxone

37. The nurse administers atropine ordered per-op for surgery. Thirty minutes after administration, the client complains of a very dry mouth and has flushed, dry skin with an oral temperature of 101.5 F and an apical heart rate of 113. The most appropriate nursing action is for the nurse to:

Notify the physician

38. The nurse is caring for a client on the 3rd day following abdominal surgery and assesses the absence of bowel sounds, abdominal distention, and the client passing no flatus. These findings indicate the client is experiencing which of the following postoperative complications?

Paralytic ileus

48. A nurse is collecting data from a 65-year-old client who is postoperative from a below the knee amputation and whose residual limb is wrapped with an elastic bandage to shrink the stump. Which of the following findings should alert the nurse to a possible complication?

Pitting edema above the bandage

35. A nurse is reviewing the lab results of a patient who is taking warfarin to reduce the risk of stroke. The patient is 12 and the INR is 2. What is the nurse's BEST action?

Place the results in the chart

14. When there is a lack of insulin in the body, the blood becomes thick with glucose, causing an increase in osmolarity?

Polydipsia

24. A blood pressure of 135/87 mm Hg is considered to be?

Prehypertension

22. The patient tells the nurse that "Using this tube thing is a waste of time". The nurse explains that the specific purpose of using the incentive spirometer is to?

Promote lung expansion that prevents post op fever

16. A nurse records the finding of a normal sirius rhythm (NSR) when the P, Q, R, S, and T are all present in the electrocardiographic complex. What additional information should the nurse expect?

Rate of 82 seconds

52. A nurse recognizes that a patient diagnosed with COPD has a rising level of partial pressure of CO2 in arterial blood PACO2. How should the nurse interpret this assessment?

Respiratory acidosis

23. On what is the selection of an antimicrobial agent based?

Sensitivity of the microorganism to the drug

53. When a patient with type 2 diabetes says "Why in the world are they looking at my hemoglobin? I thought my problem was my blood sugar?" What should the nurse explain about the level of hemoglobin A1c?

Shows what glucose level has done during the past 120 days

45. A nurse in the outpatient clinic is collecting data from a client who has psoriasis. Which of the following findings should the nurse expect?

Silvery seales

39. What should a nurse expect of a patient's respirations caused by the failing blood pressure and impaired blood circulation during the refractory stage of shock?

Slow and shallow

33. A nurse gathering data on a client with a diagnosis of TB. The nurse should review the results of which diagnostic test to confirm this diagnosis?

Sputum culture

54. Which of the following are major complications of bone marrow and peripheral blood stem cell transplants?

a. Graft-versus-host disease b. Thrombocytopenia c. Infection

12. The friend states that the patient has diabetes and takes insulin. Which adrenergic symptoms of hypoglycemia might the nurse access?

a. Headache b. Tachycardia

50. A teaching plan for a patient with diabetes is focused on smoking cessation and the control of hypertension for the avoidance of microvascular complications. What are the examples of microvascular complications? (Select all that apply)

a. Macular degeneration b. End-stage renal disease

36. A nurse caring for a client who is prone to op nausea and vomiting. Which of the following drug classifications is commonly used preoperatively to decrease secretions and helps reduce the risk of emesis and aspiration during induction and maintenance of general anesthesia?

Anticholinergics

44. A patient with severe psoriasis who is to be treated with the systemic drug methotrexate sodium anxiously asks, "Is this cancer drug safe? Are there some side effects I need to know about?" What is the best response by the nurse?

"We use this drug to treat many kinds of patients with cancer. You will have periodic blood tests"

58. Assisted devices such as canes, crutches, and walkers are used for people who need to limit weight-bearing activities on joints. Which statement by a nurse best illustrates an understanding of the appropriate use of these devices?

"Canes provide minimal support and balance and are carried on the unaffected side"

26. The nurse is providing teaching to a patient with heart failure who has been prescribed nifedipine, a calcium channel blocker. Which statement by the nurse is accurate?

"This medication reduces the resistance your heart has to pump against"

30. Which intervention is most appropriate for emergency care of a pneumothorax?

Apply a vented dressing, sealed on three sides

7. A nurse is preparing to administer 225mg of medication. Available is 250mg/2.5mL. How many mL should the nurse administer? (Round to the nearest tenth)

2.3 mL

47. Before administering the client's medication, the nurse must identify the client. Which of the following methods of identification should the nurse use?

Ask the client's full name and date of birth

4. The following antiviral agents in combination with other retroviral agents are used to treat HIV 1 infection.

Atazanavir (Reyataz) Fosamprenavir (Lexiva)

41. A nurse administers nalbuphine, an opioid agonist-antagonist to a 78-year-old patient. The family is worried about the patient and thinks that this drug is too strong and will cause harm. What should the nurse assure the family regarding this drug?

Blocks the side effects observed in opioid agonists

13. A nurse is preparing to administer a client's daily dose of NPH insulin at 0730. The nurse should expect this type of insulin to peak within which of the following time frames after administration?

6 to 10 hours

9. The nurse is to administer 0.2g of medication. On hand is a 15mg/0.5mL vial. How many mL should the nurse calculate? (Round to the nearest tenth)

6.7 mL

49. A nurse is caring for multiple patients with above the knee amputations, which patient would the nurse assess first?

A patient that complains of phantom limb pain

56. The nurse is caring for a group of patients. Which patient has most likely experienced cell mediated immunity?

A patient who has rejected a transplanted kidney

63. A nurse is assisting in the care of a client who is 2 hours postoperative following a wedge resection of the left lung and has a chest tube to suction. Which of the following is the priority finding the nurse should report to the provider?

Abdomen is distended

57. The nurse is teaching a patient about the immune system. Which is the best explanation of acquired immunity?

Activated only when needed

17. A 29-year-old patient is to receive cardioversion for dysrhythmia. What should the nurse instruct the patient to expect?

Administration of a short-acting sedative

20. Which of the following is an invasive diagnostic procedure used to assess the vascular system?

Angiography

65. A nurse is caring for a client who states "I am not going to take my medication anymore". Which of the following responses should the nurse make?

Tell me more about this decision"

15. What is a normal age-related change in older adults that makes them susceptible to cardiovascular disease?

The heart takes longer to respond to stress

51. A patient has a diagnosis of type 1 diabetes mellitus. What is the main characterization of type 1 diabetes mellitus?

There is an absence of endogenous insulin

27. What medication obtained in a patient's history will lessen the effects of warfarin (coumadin)?

Yaz (drospirenone/estradiol) as an oral contraceptive

40. A patient has entered the progressive stage of shock. What should a nurse be assessing a patient in the progressive stage of shock expected to find?

a. Deep respirations b. Decreased blood pressure

11. What are functional causes of hypoglycemia?

a. Dumping syndrome b. Addison disease c. Prolonged muscular exercis

66. The RN reviews the result of the ABGs with the LPN, and tells the LPN that the client is experiencing respiratory acidosis. The LPN should expect to note which lab result to report?

pH 7.35, PCO2 60 mm Hg