Exam 1
patient receiving chemotherapy develops tumor lysis syndrome. the patient has had arrhythmias during the current hospital admission. considering the situation, which of the following assessment findings would you report to the client's HCP immediately?
elevated serum potassium
for a client receiving the chemotheraptuic drug vincristine, which side or adverse effect should be reported to the physician?
paresthesia
for a patient who is receiving chemotherapy, which laboratory result is particular important?
white blood cell count
How do you make the MAXIMUM amount of ATP possible per glucose molecule?
with adequate oxygen levels and completing the electron transport chain
a nurse on an oncology unit is preparing to administer doxorubicin to the client who has cancer. prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication for which of the following reasons is this verification necessary?
excess amount of doxorubicin can lead to cardiomyopathy
a client is receiving a continuous infusion of. medication that is ionized- how might this medication cross a cell membrane
facilitated diffusion
you are caring for a client with a NJ tube. this tube was easy to flush this morning, but now you are having trouble flushing. which of the following interventions should you try FIRST to unclog the tube?
flush with tap water
which drug is going to easily move out of the capillary blood stream and bind to a receptor on the surface of a muscle cell
free drug in the bloodstream
in terms of energy sources, cells are going to first rely on ______ followed by ________
glucose; glycogen
You are administering potassium chloride tablets to a client in your care. Which of the following should be done immediately before administering this medication?
have the patient sit in High Fowler's position
The RN is administering medications to a patient with history of alcoholism and fatty liver disease. Which of the following medication orders should the nurse call into question
hepatotoxic antibiotic
Which of the following is a characteristic of necrosis
inflammation
you are caring for a patient who recently had bowel resection surgery requiring bowel rest post-operative. which of the following pieces of equipment are necessary tis tart this patient on TPN? SATA
infusion pump micron filter primary tubing central venous access device
a drug with a therapeutic index of 10
is after that a drug with a therapeutic index of 5
which of the following is an end byproduct of glycolysis in the absence of oxygen or if oxygen levels in the body are low?
lactic acid
You are a nurse talking to a nursing student about he consequences of hypoxia. Which statement by the nursing student indicates understanding of these consequences?
lactic acidosis
a nurse is caring for a client who has cancer and a new prescription for odansetron to treat chemotherapy-induced nausea. for which of the following side effects should the nurse monitor?
lethargy
a client is receiving PO medication that tis excreted through the billiary system. What is a problem with many medications excreted through bile?
medication has longer-lasting effects on the body because it is recirculated with bile
which of the following client statements indicates an understanding of idiopathic disease
my health condition has multiple contributing factors, such as genetic, environmental, and lifestyle choices
a nurse is planning care for a client who is being treated with chemotherapy and radiation for metastatic breast cancer and the client has neutropenia. the nurse should include which of the following restrictions in the patients plan of care?
no fresh flowers or potted plants in the room
A nurse is assessing a client with a casted leg for signs and symptoms of compartment syndrome. which of the following would be consistent with compartment syndrome?
paresthesia
4 patients are experiencing allergic reactions from new medications. Which patient should the nurse assess first?
patient complaining of difficulty swallowing
patients receiving chemotherapy are at risk for thrombocytopenia related to chemotherapy or the disease process itself. which actions are needed for patients who must be placed in bleeding precautions? SATA
patient should be provided with a soft tooth brush or oral sponge to clean teeth patient should use electric razor instead of a safety razor patient should avoid asprin and aspirin containing products
you are caring for a client who recently received an antibiotic for the first time. thirty minutes after administration the client cals you reporting dyspnea. you go to the client's room. which of the following is your first intervention
place client In high fowlers position
a nurse is caring for a client who has cancer and is receiving total parenteral nutrition. which of the following lab values indicates the treatment is effective?
potassium of 4.6
regarding the specific chemotherapy drugs mentioned in the last question, the client should be told to report_______ and _______ to the HCP immediately
shortness of breath and edema
Which of the following situations describes an adverse effect
simvastatin causing skeletal muscle rupture
which of the following cell types is responsible for vasoconstriction of arteries
smooth muscle in vessel walls
a PO medication has to be in what form so that it can be absorbed into the bloodstream?
solution
RN is caring for a patient who recently started receiving continuous infusion of an IV antibiotic. 15 minutes into that infusion, the patient starts complaining of feeling lightheadedness and a rash has developed on their chest and arms bilaterally. which of the following actions should the RN take first?
stop the infusion of the antibiotic
which of the following statements is TRUE regarding human cell and energy production?
the inside of the cell is more negative than the outside for a cell at rest
you are the nurse working with a nurse intern on an oncology unit, caring for a patient with endometrial cancer undergoing brachytherapy treatment. Which of the following actions by the nurse intern requires intervention?
the nurse intern is ambulating the client around the unit with a gait belt.
you are caring for a 9-month old infant requiring intramuscular injection. Which of the following sites is most appropriate?
vastus lateralis (outer thigh)
Which of the following drugs is going to be easily excreted by the kidneys
water-soluble vitamin C
a nurse is providing nutritional teaching to a client who has dumping syndrome following a hemi-colectomy. which of the following foods should the nurse instruct the client to avoid?
High carbohydrate
for the patient in the previous question, before TPN is started what organ function needs to be assessed?
Liver
Which of the following medications can be crushed or administration
Lorazepam; nothing enteric coated, LA., XR, or XL
a client on an oncology unit is receiving chemotherapy for gastric cancer. which of the following medications or interventions should be avoided during the nadir?
administering a drug that prevents blood clot formations
A client is discharged home on daily PO potassium chloride tablets. which statement by the client indicates that the client understand how to administer this medication
" I am going to sit upright in a chair for 30 minutes after I take this pill"
a nurse is providing teaching to a client who has breast cancer about the adverse effects of chemotherapy. which of the following client statements indicates an understanding of the teaching?
" I will call my doctor if I notice any unusually heavy menstrual bleeding"
A client 32 weeks pregnant is currently taking a medication that Is tabled as category X. Which of the following statements but eh client indicates the client understands what drug category means?
" this medication is contraindicated for pregnant individuals"
you are the RN working with a nursing student on a med-surg unit. Which of the following statements, if made by the student to a patient, should you help correct?
"Blood is 50% Red blood cells and 50% white blood cells"
How would you write an order for a medication to be given by mouth, twice per day, as needed?
PO BID PRN
what is an example of a waste product of energy production even with adequate oxygen levels in the body?
Carbon dioxide
Which of the following is an example of passive diffusion
a lipid soluble drug crossing the blood brain barrier
a client receiving an IVP medication asks you, their nurse, how the drug they are receiving will move through their body to get to where it will have its therapeutic effects. What is the most appropriate response?
"The drug will use the bloodstream to move to these cells where it has its effects"
Which of the following statements by the patient with T1D indicates that the patient correctly understands the pathopyshiology of the disease
"the beta cells in my pancreas do not function/work and therefore make no insulin"
a client with a history of aging asks why his nitroglycerin tablets should be administered sublingually. Which response by the nurse demonstrates understanding of this route of admin?
"there is a large vessel sublingually which allows for rapid drug absorption into bloodstream"
You are taking care of a patient in hospital reporting concerns regarding ongoing constipation after receiving multiple doses of hydroporphone. Which of the following is the most appropriate nursing responses to the patient's concerns?
"we could try and address the consitpation by discussing with the HCP adding a stool softener to your daily medications"
transcribe this medication order into the appropriate abbreviation: 10mg Oxycodone, by mouth, every 8 hours, as needed for severe pain
10mg Oxycodone PO TID PRN for severe pain
Which of the following is true regarding selective permeability and cell membranes?
3 sodium move out of cell and 2 potassium move in through active transport pumps
Which of the following cell transport mechanisms require ATP
Active transport
Which of the following are considerations for a patient receiving TPN? SATA
Always infuse with micron filter to trap air and particles in TPN Patient must have a Central Venous access device to infuse TPN
Which of the following prescription orders should the nurse call into question? SATA
Cefepime 1g IVPB Q.D for surgical prophylaxis Quetiapine 100 mg PO QHS
You are the nurse caring for a patient who has been receiving multiple doses of hydromorphine while recovering from bilateral arthroplasty of the knees. Which of the following responses by the patient indicates that the hydromorphine is having the intended therapeutic effect on TARGETED cells
Patient reporting 10/10 pain rating previously now has a 3/10 pain rating
a nurse caring for a client who has cancer and takes scheduled PO morphine for pain relieve. the nurse goes to administer the next scheduled dose of morphine, and the client is unresponsive with a RR of 8. Which of the following medications would be indicated for this situation?
Naloxone
while a patient is on TPN which of the following orders do you anticipate receiving from the HCP related to potential complications of receiving TPN?
Q6H blood glucose checks
An RN is providing a patient with education regarding different controlled substance schedules. Which of the following schedules has the highest potential for abuse
Schedule 1
The nurse is preparing to administer morphine to a patient with post-operative pain. Which other medication should the nurse anticipate administering to address a universal complication of this medicine?
Stool softener
a nurse is reviewing the CBC (complete blood count) findings for a client who is receiving combination chemotherapy for cancer. Which of the following findings should the nurse report to the provider?
WBC 2300/ MM 3
you have just received morning hand-off report from the night shift nurse and it is currently 7 am. which patient is your priority to assess and care for this morning? a patient scheduled for an exploratory laparotomy this morning a patient who reports breakthrough pain since their last dose of pain medication a patient who developed tumor lysis syndrome at 6 am a patient who is nauseous and asking for a PRN dose of metoclopramide
a patient who developed tumor lysis syndrome at 6 am
where would you find the top of a CVC
above the right atrium in the superior vena cava
which of the following assessment findings suggest the client is a candidate for receiving TPN?
absent bowel sounds in all 4 quadrants
You are the nurse caring for a patient who is showing signs and symptoms of hypoglycemia and has a blood sugar of 31 mg/dl. The patient is obtunded. Which of the following is the most appropriate intervention at this time?
administer IM glucagon
a nurse caring for a client who has bone marrow suppression after receiving chemotherapy. the nurse should monitor the client for which of the following?
bleeding from the gyms
The nurse would teach a patient receiving doxorubicin and paclitaxel that these medications can cause ______ toxicity
cardiac
you are about to give a patient receiving chemotherapy a dose of schedules metoclopramide. Which of the following findings would cause you to hold this medication?
client exhibits constant lip smacking
which of the following patients is not an ideal candidate for Tamoxifen
client with a history of pulmonary embolisms
you are taking care of a patient who was recently started on a medication to treat lymphoma. The patient came to your urgent care today reporting that since starting this medication a month ago, the client has noted unexplained increased blood pressure, pitting edema of the hands and feet, and impaired wound healing. what medication do you anticipate this patient was started on last month?
dexamethasone
A client with T1D is experiencing an episode of hypoglycemia after accidentally self-administering too much SQ insulin. What signs or symptoms of hypoglycemia would the nurse anticipate assessing?
diaphoresis
You are caring for a client suspected of acute renal failure. Which of the following is a sign or symptom that supports this diagnosis?
elevated serum creatinine
