167 Exam 4***

The nurse is discussing management of symptoms of an upper respiratory tract infection. Which classes of medications are often used in treating the symptoms of upper respiratory tract infections? (Select all that apply.) 1 Antihistamines 2 Nasal decongestants 3 Antitussives 4 Expectorants 5 Antibiotics

1, 2, 3, 4

Which statement by a patient best demonstrates an understanding of the teaching on flunisolide (AeroBid)? "I will take two puffs to treat an acute asthma attack." "I will rinse my mouth with water after each use." "I will immediately stop taking my oral prednisone as soon as I start using the AeroBid." "I will not use my albuterol inhaler while I am taking AeroBid."

"I will rinse my mouth with water after each use"

Patient teaching regarding the use of antileukotriene drugs such as zafirlukast (Accolate) would include which statement? "Take the medication as soon as you begin wheezing." "It will take about 3 weeks before you notice a therapeutic effect." "This medication works by preventing the inflammation that causes your asthma attack." "Increase fiber and fluid in your diet to prevent the common side effect of constipation."

"This medication works by preventing the inflammation that causes your asthma attack."

The nurse should prepare which of the following medications for chemical cardioversion for a client in atrial fibrillation? 1. Amiodarone 2. Verapamil 3. Nifedipine 4. Lidocaine

1. Amiodarone

The nurse is providing care to a patient prescribed a nonselective adrenergic agonist bronchodilator. Which medical diagnosis on this patient's chart would alert the nurse to question this order? 1Coronary artery disease 2Chronic obstructive pulmonary disease (COPD) 3Hyperkalemia 4Premature labor

1 coronary artery disease

Discharge teaching to a patient receiving a beta-agonist bronchodilator should emphasize reporting which side effect? 1 Tachycardia 2 Nonproductive cough 3 Hypoglycemia 4 Sedation

1 tachycardia

After the nurse administers albuterol to a 24 year old client with symptoms of an acute athsma attack , which of the following outcomes is best? 1.) Relief of wheezing 2. ) Respiratory rate decreased from 34 to 22 3.) Dyspnea rating scale decreased from 9 to 6 4.) Oxygen saturation of 82%

1.) Relief of wheezing

When teaching a patient about antihypertensive drug therapy, which statements by the nurse are correct? (Select all that apply.) 1. "You need to have your blood pressure checked once a week and keep track of the readings." 2. "If you notice that the symptoms have gone away, you should be able to stop taking the drug." 3. "An exercise program may be helpful in treating hypertension, but let's check with your doctor first." 4. "If you experience severe side effects, stop the medicine and let us know at your next office visit." 5. "Most over-the-counter decongestants are compatible with antihypertensive drugs." 6. "Please continue taking the medication, even if you are feeling better."

1. "You need to have your blood pressure checked once a week and keep track of the readings." 3. "An exercise program may be helpful in treating hypertension, but let's check with your doctor first." 6. "Please continue taking the medication, even if you are feeling better."

A patient's blood pressure elevates to 270/150 mm Hg, and a hypertensive emergency is obvious. He is transferred to the intensive care unit and started on a sodium nitroprusside (Nipride) drip to be titrated per his response. With this medication, the nurse knows that the maximum dose of this drug should be infused for how long? 1. 10 minutes 2. 30 minutes 3. 1 hour 4. 24 hours

1. 10 minutes

The nurse should withhold the currently scheduled drug dose and consult with the prescriber after noting that a client with which health problem is receiving fluticasone aerosol? 1. Acquired immune deficiency syndrome (AIDS) 2, Asthma 3. Chronic obstructive pulmonary disease 4. Systemic lupus erythematosus

1. Acquired immune deficiency syndrome (AIDS)

Before a client receives metoprolol as treatment for hypertension, the nurse should ask the client about a history of which health problem? 1. Asthma 2. Seizures 3. Peripheral arterial disease 4. Myasthenia vis

1. Asthma

Because of a potential side effect of guaifenesin, the nurse at the outpatient clinic should provide which instruction to the client? 1. Consider using over the counter antiemetic 2. Report increased production of respiratory secretions 3. Follow medication with a sip of water 4. Take aspirin 625 mg for temperature elevation

1. Consider using an OTC antiemetic

A patient is taking guaifenesin (Humibid) as part of treatment for a sinus infection. Which instruction will the nurse include during patient teaching? 1. Force fluids to help loosen and liquefy secretions. 2. Report clear-colored sputum to the prescriber. 3. Avoid driving a car or operating heavy machinery because of the sedating effects. 4. Report symptoms that last longer than 2 days.

1. Force fluids to help loosen and liquefy secretions.

A client asks the nurse to explain why she is receiving lidocaine in her IV when her dentist uses it to numb her gums before a tooth filling. What information about lidocaine should the nurse include in a response? Select all that apply. 1. It regulates electrical activity in the heart. 2. It acts as a local anesthetic on nerve endings diac muscles. 3. It reduces irritability of the cardiac cells 4. It increases the heart rate. 5. It primarily treats dysrhythmias originating ventricles.

1. It regulates electrical activity in the heart. 3. It reduces irritability of the cardiac cells 5. It primarily treats dysrhythmias originating in the ventricles.

A client with a history of mild congestive heart failure (CHF) is receiving diltiazem for hypertension. The nurse should give priority to which of the following assessments? 1. Tachycardia and rebound hypertension 2. Weight loss and euphoria 3. Bradycardia and peripheral edema 4. Improved ability to perform activities of daily living (ADL)

3. Bradycardia and peripheral edema

The mother of a 6-year-old client with asthma reports using metaproterenol more frequently. The nurse is most likely to caution the parent about which set of adverse effects? 1. Nervousness and tachycardia 2. Lethargy and bradycardia 3. Decreased blood pressure and dizziness 4. Increased blood pressure and fatigue

1. Nervousness and tachycardia

A client with acute bronchitis is apprehensive because the flaps on the nonrebreather oxygen mask close during exhalation. The nurse should make which adjustment? 1. None, because the mask is functioning properly 2. Change client to a nasal cannula 3. Replace non rebreather mask with a new one 4. Call the respiratory therapist

1. None, because the mask is functioning properly

The nurse is providing instructions to a patient who has a new prescription for a corticosteroid metered-dose inhaler. Which statement by the patient indicates that further instruction is needed? (Select all that apply.) 1. "I will rinse my mouth with water after using the inhaler and then spit out the water." 2. "I will gargle after using the inhaler and then swallow." 3. "I will clean the plastic inhaler casing weekly by removing the canister and then washing the casing in warm soapy water. I will then let it dry before reassembling." 4. "I will use this inhaler for asthma attacks." 5. "I will continue to use this inhaler, even if I am feeling better." 6. "I will use a peak flow meter to measure my response to therapy."

2. "I will gargle after using the inhaler and then swallow." 4. "I will use this inhaler for asthma attacks."

The nurse is evaluating the effectiveness of client teaching about self administration of zafirlukast. Which statement by the client indicates that further instruction is needed? 1. "I will take the drug a few weeks before I expect to notice an improvement in symptoms" 2. "I will use this medication when I have the symptoms of an acute asthma attack" 3. "I will increase my fluid intake while I am taking this medication" 4. "I will plan to take my medicine one hour before meals"

2. "I will use this medication when I have the symptoms of an acute asthma attack"

When caring for a patient with angina, the nurse would question an order for a noncardioselective beta blocker in a patient with what coexisting medical diagnosis? 1. Hypertension 2. Atrial fibrillation 3. Bronchial asthma 4. Myocardial infarction

3. Bronchial asthma

A patient with a tracheostomy has difficulty removing excessive, thick mucus from the respiratory tract. The nurse expects that which drug will be ordered to aid in the removal of mucus? 1. guaifenesin (Humibid) 2. benzonatate (Tessalon Perles) 3. diphenhydramine (Benadryl) 4. dextromethorphan (Robitussin DM)

1. guaifenesin (Humibid)

What system assessment will the nurse monitor in a patient due to a known common side effect of traditional antihistamines? 1 Cardiac status 2 Neurologic status 3 Respiratory status 4 Gastrointestinal status

2 Neurologic status

The nurse receives lab values for a patient with a theophylline level of 14 mcg/mL. How does the nurse interpret this theophylline level? 1 Subtherapeutic 2 Therapeutic 3 Toxic 4 Life-threatening

2 Therapeutic

Loratadine (Claritin) has an advantage over traditional antihistamines such as diphenhydramine (Benadryl) in that loratadine has 1 less risk of cardiac arrhythmias. 2 less sedative effect. 3 increased bronchodilating effects. 4 less gastrointestinal upset.

2 less sedative effect.

A client hospitalized for heart failure is receiving digoxin IV push. The nurse obtains the following data on the client. Place the data in order from that of highest concern to least concern to the nurse. 1. Potassium (K+) level is 3.2 mEq/L 2. Apical pulse is 53 beats per minute 3. Client has been taking furosemide 20 mg daily for two days 4. Client enjoys orange juice with breakfast

2, 1, 3, 4

What statements best indicate to the nurse that the client understood instructions about self administration of salmeterol? Select all that apply 1. "I will use this medication every 6 hours." 2. "If my symptoms are not better within 20 minutes, I should notify my healthcare provider." 3. "Although it will remain regular, this medicine may decrease my heart rate." 4. "This drug is supposed to prevent an asthma attack, but is not good for treating one." 5. "I will take a dose of this medicine when I notice I am wheezing."

2. "If my symptoms are not better within 20 minutes, I should notify my healthcare provider." 4. "This drug is supposed to prevent an asthma attack, but is not good for treating one."

Which statement would be most appropriate during discharge teaching for a patient receiving transdermal clonidine (Catapres)? 1. "Your blood pressure should be checked by a physician at least once a year." 2. "The patch should be applied to a nonhairy site, and abrupt withdrawal should be avoided." 3. "Excessive exercise or prolonged standing is not a problem with clonidine as it can be with other antihypertensive drugs." 4. "If you are having difficulty with the common side effect of excessive drooling, notify your physician so your dosage can be adjusted."

2. "The patch should be applied to a nonhairy site, and abrupt withdrawal should be avoided."

The nurse provides discharge instructions to a client about the use of amiodarone. Which statement indicates that the client has the knowledge necessary for safe self-administration? 1. "As soon as my provider says I am stable on this medication, I will be able to enjoy the sun again." 2. "The side effects of this medication may not begin to show up for several weeks or even months after I start taking it." 3. "If my pulse drops below 100 beats per minute. I should call the primary care provider right away." 4. "If I miss a dose of medication I will take two pills the next day."

2. "The side effects of this medication may not begin to show up for several weeks or even months after I start taking it."

After a healthcare provider prescribed propranolol for a client with frequent premature ventricular contractions (PVCS), the nurse should include which of the following in the care plan? 1. Inform the client that breathing will be improved with exercise. 2. Measure heart rate daily before taking dose. 3. Monitor for clients increased resistance to infection 4. Observe for skin rashes, a rare side effect.

2. . Measure heart rate daily before taking dose.

A patient is in an urgent-care center with an acute asthma attack. The nurse expects that which medication will be used for initial treatment? 1. An anticholinergic such as ipratropium (Atrovent) 2. A short-acting beta2 agonist such as albuterol (Proventil) 3. A long-acting beta2 agonist such as salmeterol (Serevent) 4. A corticosteroid such as fluticasone (Flovent)

2. A short-acting beta2 agonist such as albuterol (Proventil)

A client on the inpatient unit is having an acute athsma attack. The nurse is most likely to administer which medication with an appropriate prescription? 1. Aminophylline 2. Albuterol 3. Cromolyn disodium 4. Salmetro

2. Albuterol

The nurse should question a prescription for epinephrine for the treatment of acute bronchitis when the client has what health problem? 1. Asthma 2. Coronary heart disease 3. Hypotension 4. Bradycardia

2. Coronary artery disease

A patient receiving intravenous nitroglycerin at 20 mcg/min complains of dizziness. Nursing assessment reveals a blood pressure of 85/40 mm Hg, heart rate of 110 beats/min, and respiratory rate of 16 breaths/min. What is the nurse's best action? 1. Assess the patient's lung sounds. 2. Decrease the intravenous nitroglycerin by 10 mcg/min. 3. Increase the intravenous nitroglycerin by 10 mcg/min. 4. Recheck the patient's vital signs in 1 hour.

2. Decrease the intravenous nitroglycerin by 10 mcg/min.

After assessing a client with chronic obstructive pulmonary disease (COPD) who is being treated with beclemethasone dipropionate via oral inhaler, which clinical manifestations should the nurse conclude are medication side effects? SATA 1. Excess salivation 2. Delayed healing 3. Oral fungal infection 4. Fluid retention with weight gain 5. Decreased respiratory rate

2. Delayed healing 3. Oral fungal infection

A client is admitted to the emergency department with an exacerbation of heart failure. Blood pressure is 116/86 mm/Hg and heart rate is 98 beats per minute The nurse ensures that which medication is available for immediate use once it is prescribed? 1. Atropine sulfate 2. Digoxin 3. Propranolol 4. Verapamil

2. Digoxin

What side effect of angiotensin-converting enzyme (ACE) inhibitors most often results in the provider changing the treatment plan to an angiotensin receptor blocker? 1. Orthostatic hypotension 2. Dry, nonproductive cough 3. Fatigue 4. Hypokalemia

2. Dry, nonproductive cough

A client with frequent premature ventricular contractions (PVCS) received a bolus of lidocaine 100 mg IV (1 mg/kg of body weight). The nurse should monitor the client for which of the following? 1. Signs/symptoms of systemic lupus erythematosus (SLE) 2. Electrocardiogram (ECG) changes and neurologic changes 3. Vital sign changes and blood dyscrasias 4. Visual changes (green halos around lights)

2. Electrocardiogram (ECG) changes and neurologic changes

Which are common side effects of nitroglycerin? (Select all that apply.) 1. Blurred vision 2. Flushing 3. Headache 4. Hypotension

2. Flushing 3. Headache 4. Hypotension

Under which circumstance should the nurse suspend intravenous administration of phenylephrine and consult with the healthcare provider? 1. After 3 days of continuous use 2. If client develops hypertension or tachycardia 3. If client develops a dry, irritated oral cavity 4. If client develops rebound congestion

2. If client develops hypertension or tachycardia

4 A client cannot remember the name of the anti-hypertensive medication that has been prescribed. Based on the presence of a dry, nonproductive cough, the nurse suspects that the client is most likely taking which antihypertensive drug? 1. Propranolol 2. Lisinopril 3. Nifedipine 4. Bumetanide

2. Lisinopril

6 A client taking atenolol for hypertension tells the nurse, "Since I have been taking that medicine I feel so tired." What is the most appropriate priority nursing concern? 1. Potential for reduced tolerance to activity 2. Reduced cardiac output 3. Inability to manage health maintenance 4. Inability to perform self-care

2. Reduced cardiac output

After initiating a continuous infusion of nitroglycerin intravenously, the nurse would use which data to conclude that the client is experiencing an unintended effect? Select all that apply. 1. Pulmonary capillary wedge pressure (PCWP) from 13 to 11 mmHg 2. Tachycardia 3. Heart rate (HR) falling from 96 to 78 4. Blood pressure (BP) falling from 130/80 to 9 5. Headache

2. Tachycardia 4. Blood pressure (BP) falling from 130/80 to 90/64 5. Headache

A A nurse assesses a 75-year-old client for side effects of verapamil. Which side effect would be of most concern regarding this client? 1. Hypertension 2. Angina 3. Skin rash 4. Constipation

4. Constipation

A client is receiving nitroglycerin by continuous intravenous (IV) drip to control chest pain and to increase myocardial tissue perfusion. The nurse prepares this medication by taking which action? 1. Using a solution that is covered by a plastic bag. 2. Using a special tube designed for the medication 3. Changing the bag every 2 hours because it is unstabe 4. Mixing the medication under a laminar flow hood

2. Using a special tube designed for the medication

The nurse is monitoring drug levels for a patient who is receiving theophylline. The most recent theophylline level was 13 mcg/mL, and the nurse evaluates this level to be 1. below the therapeutic level. 2. at a therapeutic level. 3. above the therapeutic level. 4. at a toxic level.

2. at a therapeutic level.

A patient is taking a xanthine derivative as part of treatment for chronic obstructive pulmonary disease. The nurse will monitor for adverse effects associated with the use of xanthine derivatives, such as 1. diarrhea. 2. palpitations. 3. bradycardia. 4. drowsiness

2. palpitations

Patient teaching regarding expectorants should instruct the patient to perform which action? 1 Restrict fluids to decrease mucus production. 2 Take the medication once a day only, usually at bedtime. 3 Increase fluid intake to decrease viscosity of secretions. 4 Increase fiber and fluid intake to prevent constipation

3 Increase fluid intake to decrease viscosity of secretions.

A patient using Afrin nasal spray complains of worsening cold symptoms and tells the nurse, "I don't understand why this is not working. I am using it almost every 3 hours!" The nurse's response is based on knowledge that 1 Afrin nasal spray is not an effective nasal decongestant. 2 the medication needs to be used every 30 minutes for maximum effectiveness. 3 the patient is suffering from rebound congestion related to excessive use of the Afrin nasal spray. 4 adrenergic decongestants should only be used prophylactically, not to treat acute congestion.

3 the patient is suffering from rebound congestion related to excessive use of the Afrin nasal spray.

The nurse is discussing use of antihistamines for allergic rhinitis. Which medications would be included in the list of H 1 antagonists used in the treatment of allergic rhinitis? (Select all that apply.) 1 ranitidine (Zantac) 2 nizatidine (Axid) 3 fexofenadine (Allegra) 4 loratadine (Claritin) 5 cetirizine (Zyrtec)

3, 4, 5

A client who recently began antihypertensive drug therapy states she needs to go to the pharmacy to buy an over-the-counter (OTC) product to treat a common cold. The home health nurse should provide which most helpful instruction first? 1. "Buy a generic brand of medicine because it is m cost effective and they act in similar a ways 2. "Do not purchase a product that contains aspirin 3. "Read the label carefully and avoid products with pseudoephedrine." 4. "Many of the common products are con you are taking medication

3. "Read the label carefully and avoid products with pseudoephedrine."

The client states, "I always put my nitroglycerin(NTG) patch in the same place so I do not forget to take it off." Which of the following is the best response by the nurse 1. "Change the patch every 24 hours." 2. "Take two acetaminophen tablets 30 minutes prs applying the patch." 3. "Rotate the NTG patch to a different area every day." 4. "After removing the patch, scrub area vigorously with soap and water."

3. "Rotate the NTG patch to a different area every day."

When teaching a patient who will be receiving antihistamines, the nurse will include which instructions? (Select all that apply.) 1. "Antihistamines are generally safe to take with over-the-counter medications." 2. "Take the medication on an empty stomach to maximize absorption of the drug." 3. "Take the medication with food to minimize gastrointestinal distress." 4. "Drink extra fluids if possible." 5. "Antihistamines may cause restlessness and disturbed sleep." 6. "Avoid activities that require alertness until you know how adverse effects are tolerated.

3. "Take the medication with food to minimize gastrointestinal distress." 4. "Drink extra fluids if possible." 6. "Avoid activities that require alertness until you know how adverse effects are tolerated."

3 A client takes oxtriphylline for chronic obstructive pulmonary disease (COPD). Which explanation by the nurse accurately represents the drug's characteristics? 1. "The medicine increases your heart rate to increase the release of oxygen." 2. The drug relaxes the lung tissue so that oxygen will pass across it easier." 3. "The medicine is used to dilate your airways and make it easier for you to breathe." 4. "The medicine thins the secretions in your lungs and makes it easier for you to cough."

3. "The medicine is used to dilate your airways and make it easier for you to breathe."

A patient is in the intensive care unit and receiving an infusion of milrinone (Primacor) for severe heart failure. The prescriber has written an order for an intravenous dose of furosemide (Lasix). How will the nurse give this drug? 1. Infuse the drug into the same intravenous line as the milrinone. 2. Stop the milrinone, flush the line, and then administer the furosemide. 3. Administer the furosemide in a separate intravenous line. 4. Notify the prescriber that the furosemide cannot be given at this time.

3. Administer the furosemide in a separate intravenous line.

The nurse has just administered a dose of hydralazine intravenously to a client. After the initial dose, which of the following assessments is the priority? 1. Cardiac rhythm 2. Oxygen saturation 3. Blood pressure 4. Respiratory rate

3. Blood pressure

Which goal is most likely to be included by the nurse in the care plan for a client who is taking zileuton? 1. Client will manage lethargy commonly associated with drug. 2. Client will manage constipation commonly associated with the drug 3. Client will manage headaches commonly associated with the drug. 4. Client will demonstrate ability to cope with the sign and symptoms of asthma.

3. Client will manage headaches commonly associated with the drug.

A healthcare provider prescribed theophylline 0.4 mg/kg every 6 hours for a client. Which client information should lead the nurse to consult with the prescriber? 1. Concurrent history of Cushing disease 2. History of narcolepsy 3. Concurrent diagnosis of hyperthyroidism 4. Current state of hypothermia

3. Concurrent diagnosis of hyperthyroidism

When giving dextromethorphan, the nurse understands that this drug suppresses the cough reflex by which mechanism of action? 1. Causing depression of the central nervous system 2. Anesthetizing the stretch receptors 3. Having direct action on the cough center 4. Decreasing the viscosity of the bronchial secretions

3. Having direct action on the cough center

The prescriber has changed the patient's medication regimen to include the leukotriene receptor antagonist montelukast (Singulair) to treat asthma. The nurse will emphasize which point about this medication? 1. The proper technique for inhalation must be followed. 2. The patient needs to keep it close by at all times to treat acute asthma attacks. 3. It needs to be taken every day on a continuous schedule, even if symptoms improve. 4. When the asthma symptoms improve, the dosage schedule can be tapered and eventually discontinued.

3. It needs to be taken every day on a continuous schedule, even if symptoms improve.

A patient is in the intensive care unit because of an acute myocardial infarction. He is experiencing severe ventricular dysrhythmias. The nurse will prepare to give which drug of choice for this dysrhythmia? 1. diltiazem (Cardizem) 2. verapamil (Calan) 3. amiodarone (Cordarone) 4. adenosine (Adenocard)

3. amiodarone (Cordarone)

A gardener needs a decongestant because of seasonal allergy problems and asks the nurse whether he should take an oral form or a nasal spray. The nurse's answer considers that one benefit of orally administered decongestants is 1. immediate onset. 2. a more potent effect. 3. lack of rebound congestion. 4. shorter duration.

3. lack of rebound congestion.

The nurse is scheduled to administer a dose of digoxin to an adult client with atrial fibrillation. The client has a potassium level of 4.3 mEq/L. The nurse qshould perform which of the following activities next? 1. Withhold dose only for that day, 2. Obtain prescription for dose of potassium before digoxin. 3. Withhold dose and notify prescriber. 4. Administer dose as prescribed.

4 Administer dose as prescribed

What is the role of corticosteroids in the treatment of acute respiratory disorders? 1 They stimulate the immune system. 2 They directly dilate the bronchi. 3 They increase gas exchange in the alveoli. 4 They decrease inflammation.

4 They decrease inflammation.

Which statement should the nurse include when teaching a client about loratadine? 1. "This medication may make you feel nervous" 2. "It will take this medication a few hours before it becomes effective" 3. "This medication will help in an acute asthma attack" 4. "Be sure to take this medication on an empty stomach"

4. "Be sure to take this medication on an empty stomach"

A client receiving theophylline asks the nurse why a specific item was removed from the food tray. Which response is most appropriate? 1. "Peas contain a chemical that can reduce the effects of the drug" 2. "Brown beans are high in protein and can increase the effects of the drug" 3. "Milk is high in calcium and increases the cardiac rate ." 4. "Coffee contains caffeine, which can increase the drug level more quickly."

4. "Coffee contains caffeine, which can increase the drug level more quickly"

A homebound client who has a history of asthma and was recently started on cromolyn sodium has a 3-week-old newborn at home. The case manager would give which priority instruction to the home health aide? 1. "Teach the client to pace activities of daily living (ADL) 2. "Encourage the client to wear a mask when mowing thelawn 3. "Recommend that the client avoid individuals with upper respiratory infections" 4. "Report if breastfeeding is observed during your visit

4. "Report if breastfeeding is observed during your visit

1. The nurse should monitor a client beginning drug therapy with sotalol for which life-threatening manifestations of an adverse drug reaction? 1. Increase in systolic blood pressure and fatigue 2. Report of blurry vision and the appearance of halos 3. Bluish discoloration of the skin 4. Bradycardia and dyspnea

4. Bradycardia and dyspnea

After administering promethazine 12.5 mg intravenously to an 80-year-old client for nausea, the nurse should provide which instruction to unlicensed assistive personnel (UAP)? 1. Provide client with non skid slippers for ambulation 2. Teach client how to use emergency cord in the bathroom. 3. Place a chair next to client's bed to reduce potential falls. 4. Instruct client to remain in bed with top half rails up.

4. Instruct client to remain in bed with top half rails up.

The nurse should select which of the following as the most appropriate nursing concern for a client who is receiving oxymetazoline? 1. Reduced gas exchange 2. Chronic pain 3. Alterations in tissue integrity 4. Interrupted sleep pattern

4. Interrupted sleep pattern

What action is often recommended to help reduce tolerance to transdermal nitroglycerin therapy? 1. Omit a dose once a week. 2. Leave the patch on for 2 days at a time. 3. Cut the patch in half for 1 week until the tolerance subsides. 4. Remove the patch at bedtime, and then apply a new one in the morning.

4. Remove the patch at bedtime, and then apply a new one in the morning.

Because a client with chronic obstructive pulmonary disease (COPD) had been taking triamcinolone acetamide 8 mg by mouth (four times daily) at home and is currently receiving dexamethasone 4 mg intravenously every 4 hours in the hospital, the nurse should anticipate which of the following in relation to these two medications? 1. Increase in the dose of triamcinolone 2. Scheduling the drugs so they peak at different times 3. Increase in symptoms with administration of the two drugs 4. Smaller dose of triamcinolone and/or dexamethasone

4. Smaller dose of triamcinolone and/or dexamethasone

The nurse has prepared nitroprusside 50 mg in 250 mL of 5% dextrose in water. The client is to receive 1.5 mg/min. What rate should the nurse set the infusion to administer per minute? Record your answer, Rounding to one decimal place.

7.5. desired/have x quantity. 1.5/50 * 250mL= 7.5

A client receiving ephedrine nose drops PRN complains of wakefulness. What action should the nurse take to minimize the client's insomnia? A.Administer the dose a few hours before bedtime. B.Offer the client a sedative with the bedtime dose. C.Provide warm milk when administering the bedtime dose. D.Reduce environmental stimuli by closing the client's door.

A. Administer the dose a few hours before bedtime

A nurse is caring for a patient who is taking a angiotensin-converting enzyme inhibitor and develops a dry, uncomfortable, nonproductive cough that has persisted for several weeks. What is the nurse's priority action? A.Call the health care provider to switch the medication. B.Tell the patient that the cough will subside in a few days. C.Assess the patient for other symptoms of upper respiratory infection. D.Instruct the patient to take antitussive medication until the symptoms subside

A. Call the health care provider to switch the medication.

The nurse is reviewing a client's medication orders for PRN medications that can be given to a patient who has bronchitis with a productive cough. Which drug will the nurse choose? A.An antitussive B.An expectorant C.An antihistamine D.A decongestant

B. An expectorant

The nurse knows that an antitussive cough medication would be the best choice for which client? A.A client with a productive cough. B.A client with chronic paranasal sinusitis. C.A client who has had recent abdominal surgery. D.A client who has influenza.

C. A client who has had recent abdominal surgery

Which patient receiving losartan needs to be monitored closely while receiving this therapy? A.A patient with constipation B.A patient with a heart rate of 90 beats/minute C.A patient with an elevated creatinine level D.A patient with a potassium level of 3.4 mEq/L

C. A patient with an elevated creatinine level

The nurse assesses a patient's pulse before administering digoxin and notes a rate that is slower than 50 beats/minute. What is the priority intervention by the nurse? A.Administer an adrenergic drug B.Reduce the dose to half the prescribed dose C.Withhold the dose and notify the primary health care provider D.Administer the drug and notify the primary health care provider

C. Withhold the dose and notify the primary health care provider

The mother of a 6-year-old client with asthma reports using metaproterenolmore frequently. The nurse is most likely to caution the parent about which set of adverse effects? A.Increased blood pressure and fatigue B.Decreased blood pressure and dizziness C.Nervousness and tachycardia D.Lethargy and bradycardia

C. nervousness and tachycardia

A patient reports chest pain while performing daily activities and is prescribed metoprolol and verapamil. What assessment is a priority when caring for this patient? A.Assess enzymes every 8 hours. B.Assess electrocardiogram daily. C.Assess lung sounds after medication is administered. D.Assess pulse before administration of medications.

D. Assess pulse before administration of medications.

A homebound client who has a history of asthma and was recently started on cromolynsodium has a 3-week-old newborn at home. The case manager would give priority instruction to the home health aide? A."Teach the client to pace activities of daily living." B."Encourage the client to wear a mask when mowing the lawn" C."Recommend that the client avoid individuals with upper respiratory infections." D."Report if breastfeeding is observed during your visit."

D. "report if breast feeding is observed during your visit."

The nurse assesses a patient who is using topical nitroglycerine for angina. The patient has a rash on the chest where the medication was applied. What is the best action by the nurse. A.Stop the medication B.Assess the patient's diet C.Administer an antihistamine D.Change the area of administration

D. change the area of administration

A patient is in the intensive care unit because of an acute myocardial infarction. He is experiencing severe ventricular dysrhythmias. The nurse will prepare to give which drug of choice for this dysrhythmia? A. Diltiazem (Cardizem) B. Verapamil (Calan) C. Amiodarone (Cordarone) D. Adenosine (Adenocard)

c. amiodarone

A client receives a prescription for theophylline (Theo-Dur) PO to be initiated in the morning. The nurse determines that a theophylline level drawn yesterday was 15 mcg/ml. Based on this information, what should the nurse tell the nurse on the next shift about initiating the new prescription? A.Hold the theophylline dose and notify the healthcare provider. B.Start the client on a half-dose of theophylline PO. C.The theophylline dose can be initiated as planned. D.The client is not ready to wean from IV to PO dosages.

c. the theophylline dose can be initiated as planned.

Nitrates relieve angina pain by reducing preload, which is

the blood volume within the heart