Adult Med-Surge Practice

A nurse is providing teaching to a client with hypertension and type 1 diabetes mellitus who has a new prescription for metoprolol. Which of the following statements by the client indicates an understanding of the teaching? A. "I might have difficulty recognizing when my blood sugar is low." B. "I will have a lower risk of developing an infection while I take this medication." C. "I should be concerned about losing excess weight while I take this medication." D. "I could have more problems with high blood sugar while taking this medication."

A. "I might have difficulty recognizing when my blood sugar is low." Because metoprolol decreases the heart rate, this common manifestation of hypoglycemia can be masked, and hypoglycemia might become more difficult to recognize.

A nurse has administered a medication to a client. Which of the following circumstances should the nurse identify as a medication error that resulted from a performance deficit by the nurse? A. A medication safety coordinator was not present. B. A verbal prescription was transcribed incorrectly. C. A medication with a similar name was dispensed instead of the correct medication. D. An intramuscular injection was given instead of a subcutaneous injection.

D. An intramuscular injection was given instead of a subcutaneous injection.

A nurse is teaching a client who has osteoporosis about a new prescription for risedronate. Which of the following client statements indicates an understanding of the teaching? A. "I will take this medication with a full cup of water." B. "I will lie down after I take this medication." C. "I will take this medication with food." D. "I will take this medication at bedtime."

A. "I will take this medication with a full cup of water." The nurse should instruct the client that risedronate should be taken with at least 180 to 240 mL (6 to 8 oz) of water.

A nurse is preparing a discharge teaching plan for a 6-year-old client with asthma who has several prescription medications using metered-dose inhalers (MDIs). Which of the following interventions should the nurse include in the plan? A. Add a spacer to each MDI B. Instruct the child to inhale more rapidly than usual when using an MDI C. Ask the provider to change the child's medications from inhaled to oral formulations D. Administer oxygen by facemask along with the MDI

A. Add a spacer to each MDI MDIs are difficult to use correctly; even when properly used, only a portion of the medication is delivered to the lungs. A spacer applied to an MDI can make up for a lack of hand-lung coordination by increasing the amount of medication delivered to the lungs.

A nurse is assessing a client who is taking varenicline for smoking cessation. Which of the following findings is the nurse's priority? A. Mood changes B. Nausea C. Altered sense of taste D. Skin rash

A. Mood changes The nurse should use Maslow's hierarchy of needs, the ABC priority-setting framework, and/or nursing knowledge to identify which risk poses the greatest threat to the client. The greatest risk to the client is the development of neuropsychiatric effects that can progress to depression and suicide.

A nurse is caring for a client with asthma who has been taking an inhaled glucocorticoid and long-acting beta2-agonist combination dry-powdered inhaler (DPI) for maintenance therapy. The nurse should identify that which of the following is a disadvantage of this medication? A. Restricted dosage flexibility B. Complicated delivery device C. Serious systemic effects D. Limited efficacy over time

A. Restricted dosage flexibility The nurse should identify that a disadvantage of an inhaled glucocorticoid and a long-acting beta2-agonist being combined is that the dosages of these medications are fixed, so the dose cannot be adjusted.

A nurse is preparing to administer the influenza vaccine to a client. Which of the following allergies should the nurse identify as a contraindication to the client receiving this vaccine? A. Gelatin B. Chicken eggs C. Neomycin D. Prednisone

B. Chicken eggs The nurse should identify that an allergy to chicken eggs is a contraindication to receiving the influenza vaccine. Clients who have this allergy can experience angioedema and severe respiratory distress if this vaccine is administered.

A nurse is admitting a client who has unstable angina. Which of the following medications should the nurse anticipate administering to the client? A. Epinephrine B. Nitroglycerin C. Lidocaine D. Atropine

B. Nitroglycerin The nurse should anticipate administering nitroglycerin to a client who has unstable angina. This medication acts by relaxing or preventing spasms in the coronary arteries along with dilating the arteries, which increases oxygenation and blood flow.

A nurse is monitoring a client who has diabetes insipidus and was administered desmopressin. Which of the following findings should indicate to the nurse the client is experiencing an adverse effect of this medication? A. Thirst B. Nocturia C. Headache D. Heart palpitation

C. Headache Headaches are an indicator of the adverse effect of water intoxication, which can occur as a result of taking desmopressin. This medication causes fluid retention and places the client at risk of water intoxication.

A nurse is reviewing the medication administration record of a client who is receiving an opioid medication for pain. Which of the following prescriptions should the nurse clarify with the provider? A. Metoprolol B. Ondansetron C. Lorazepam D. Naloxone

C. Lorazepam The nurse should identify that lorazepam can cause central nervous system depression, which can result in increased respiratory depression and sedation when administered with an opioid. The nurse should clarify the prescription with the provider.