N 351 final

For productive cough the pt would take

guaifenesin (Robitussin, Mucinex)

Dig toxicity

hypokalemia, N/V, yellow light around objects

what area of the brain might have been effected if the pt is experiencing paresthesia after stroke?

parietal

AE of albuterol to treat severe asthma? tremors lethargy palpitations bronchoconstriction dec pulse rate

AC

. Which of the following drug groups are considered for the management of allergic rhinitis? SATA A. antihistamines B. anticholinergics C. mast cell stabilizers D. beta adrenergic blockers E. corticosteroids F. leukotriene modifiers

ACEF

What is colchicine used for?

Tx /prevention of acute gout attack

2. RN administering colchicine (Colycrys) to pt with acute gout, RN should monitor client for which adverse effect related to med? a. Liver failure b. Bleeding c. Kidney stones d. Hypercalcemia

B

Which diagnostic test would be MOST useful in eval of effectiveness of asthma tx? A. Chest X ray B. Pulmonary Fxn Test C. Serum eosinophil counts D. IgE levels

B

Which statement about a MDI with a spacer, which statement indicates the need for further teaching "I will wait for at least 1 min bw puffs" "I will shake whole unit vigorously 1 or 2 times" "I will hold my breath for at least 10 secs after each puff" "I will clean the spacer with warm water at least once a week"

B

pt is hospitalized with emphysema. RN recognizes importance of assessing for clinical indicators of hypoxia based on which condition associated? A. pleural effusion B. loss of aerating surface C. infectious obstruction D. respiratory muscle pralysis

B

What assessment data would indicate that COPD pt has developed polycythemia? Pallor dyspnea on exertion elevated Hgb dec hct

C

Which explanation would the nurse provide to a client with gastric ulcer disease who asks the RN why the health care provider has prescribed metronidazole? A. augment immune response B. potentiate effect of antacids C. treat helicobacter pylori infection D. recude HCl secretion

C

Which info would RN include in teaching plan for pt given sumatriptan for migraine HA? A. admin when HA is at peak B. admin by deep IM C. contraindicated in people with CAD D. injectable may be administered Q6 prn

C

when pt with COPD , which action by RN has highest priority? teach how to use inhalers discuss normal progression of disease ask whether pt wants to quit smoking explain pulmonary rehab program

C

18. Nurse is caring for 30 y/o pt with dx of COPD. Which of the following is most significant risk factor that has been attributed to the development of COPD in this patient? A. passive smoking B. increased age C. outdoor air pollution D. alpha1-antitrypsin deficiency

D. alpha 1 antitrypsin deficiency

Which type of hypersensitivity rxn would an RN doc when pt experiences wheal and flare rxn to skin test after mosquito bite? Type 1 Type 2 Type 3 Type 4

Type 1

guauifenesin contains ______ in the syrup, which is something _______ pts should be aware of

glucose; diabetic

RN is educated parents of a child put on oral iron therpay. Anticipatory guidance re which side effect would the nurse provide bloody stool orange urine greenish-black stool staining of mouth

greenish-black stool (Staining should not happen if straw is used)

0.45% NaCl is

hypotonic

famotidine

inhibits gastric acid secretion at H2 receptors

PAD pain

intermittent claudication, relieved with rest

Lopermadine has a _____ risk of addiction compared to other antidiarrheals

lower

buergers disease is most commonly seen in _________ (gender), ___________ than 45 years

men, less than

2. Pt developed expressive and receptive aphasia after stroke. Which of the following areas of the cerebrum might have been affected? SATA A. frontal B. parietal C. occipital D. temporal E. cerebellum

nswers: A. frontal = speech production D. temporal = language comprehension

A peds pt is given IV methylprednisolone. Which clinical manifestation requires immediate intervention during admin of initial dose? polyuria tinnitus drowsy hypoTN

polyuria

IgD

present in human cord blood, differentiates B cells

purpura

small BV leak under skin

MOA of glyburide

stimulate pancreas to produce insulin

IgA is present in

tears, saliva, and breast milk

pts with raynauds phenomenon should avoid _______

tobacco

buergers disease is strongly associated with _______

tobacco use

when do you take theophylline to be effective?

when it is prescribed

Do you forcibly shake DPI before use?

yes

which Ig can cause asthma and hay fever

IgE

Which Ig can cross the placenta?

IgG

Which antidiarrheal med would RN anticipate administering to a client with severe diarrhea who is prescribed IV fluids, Na bicarb, and an antidiarrheal? Psyllium Bisacodyl Loperamide Docusate Sodium

Loperamide

Which lab for chronic bronchitis pt would RN report to PCP immediately PaO2 of 75 PaCO2 48 HCT 52% leukocytes 16000 mm^3 (16x10^()

D-indicates infection

Client comes in with PUD, which comlication would RN monitor for A. B. hemorrhage

B

NPH onset

1.5 hrs

NPH duration

12-18 hrs

sucralfate admin

30 mins before or after antacid 1 hr before/2 hr after meal

A client receiving chemotherapy develops bone marrow suppression. The nurse will monitor for which thrombocytopenic effect? Select all that apply. One, some, or all responses may be correct. fatigue pale skin DVT dizziness melena purpura emboli hematuria

EFH

List priority actions in ED for ischemic stroke mx within 1 hour

. MD evaluation 2. Blood sugar 3. IV access 4. Lab draw - coagulation profiles 5. Initiate code stroke 6. Time of last well known 7. NIH stroke assessment 8. Non-contrast CT evaluation to see if ischemic or hemorrhagic

NPH peak

4-12 hrs

1. RN instructor teaching about sumatriptan. Instructor would want to include: Contraindicated in clients with... a. CAD b. Diabetes mellitus c. Asthma d. Kidney stones

A

1. Rn understands that the correct MOA for aliskeren (Tekturna), a. Decreases renin activity thereby inhibiting the conversion of angiotensinogen to angiotensin 1 b. Inhibits calcium ion influx across the cardiac and smooth muscles c. Inhibits angiotensin 1 from being converted to angiotensin 2 d. Blocks angiotensin 2 effects at receptor sites

A

7. RN teaching pt about side effects of Flexeril which should nurse include? a. Dry mouth, constipation, urinary retention, tachy b. Hypercalcemia, hepatotoxicity c. Insomnia and psychosis d. Hallucinations and delusions

A

Which vitamin deficiency may occur if cholestyramine, an anion exchange resin, to treat a clients persistent diarrhea is needed long term? A. retinol (Vitamin A) B. ribflavin (Vitamin B2) C. Thiamine (Vitamin B12) D. Pyridoxine (Vitamin B6)

A, because Cholestyramine is a fat binding agent so it binds and interferes with all the fat-soluble vitamins

Which instructions will the nurse include in the teaching plan for a client with hyperlipidemia who is being discharged with a Cholestyramine perscription? A. "Increase your intake of fiber and fluid" B. "take med before bed" C. "check pulse before taking medication" D "contact HCP if skin turns yellow"

A, prevents common AE of constipation

8. Which of the following patients require dose monitoring while recovering corticosteroid therapy? SATA A. pt with history of diabetes B. pt who had colon resection one week ago C. pt with history of GERD D. pt with history of peptic ulcer disease E. pt with history of H. pylori

A. bc steroids increase BG B. bc risk for infection at the surgical site and steroids interfere with wound healing (be especially careful with IV steroid and pt with wounds) D. bc steroids decrease protective mucosa

5. Pt has been prescribed Primaxin (imipenem-cilastatin for a LRT infection. Which symptoms would the RN recognize as an adverse effect? SATA a. Urine output less than 30mL/hr b. Protein in urine c. Severe pain and swelling at heel with inability to bend foot down d. Teeth with brown color e. Urine is brown color

AB

What pathophys changes in the lungs occur with emphysema? SATA A. Collapse of alveolar walls B. trapping of air in distal lung structures C. inc in pulmonary artery pressures D. inc in surface area for gas exchange E movement of fluid from capillaries into alveoli

ABC

Digoxin is prescribed for a client with heart failure. The nurse will assess for which clinical manifestation that indicates digoxin toxicity? Select all that apply. One, some, or all responses may be correct. confusion HA N V yellow vision dizziness irregular pulse inc urine output dec RR

ABCDEFG

Which factor would RN ID as precipitating hyponatremia? A. wound drainage B. diuretic therpay C. GI suction D. parenteral infusion of 0.9% NaCl E. inappropriate ADH secretion

ABCE

A client with hypertension is prescribed an angiotensin II receptor blocker (ARB). Which instruction will the nurse provide about this medication? Select all that apply. One, some, or all responses may be correct.

ACDFG

24. Which of the following are the advantages of a dry powder inhaler (DPI)? SATA A. more drug is delivered to the lungs B. DPI is used as a rescue inhaler C. DPI should be stored in the fridge between doses D. use of a spacer is not necessary E. less hand-mouth coordination is required

ADE

7. An older adult client with a history of COPD and CHF has begun Prednisone therapy. The nurse should prioritize which assessment during his care? SATA A. daily weights B. level of consciousness C. dyspnea D. blood pressure E. extremity edema

ADE

Which med requires the pt sit upright for 30 mins after taking?

Alendronate (prevent ulcer)

11. A client is being treated with corticosteroids for chronic adrenocortical insufficiency. When should the client be instructed to take the medication? A. between 6am and 9am B. at 12pm C. between 1pm and 2pm D. at night

Answer: A. between 6am and 9am Rationale: bc cortisol levels are highest in the morning

6. Which is priory for pt on Selegiline? A. blood pressure B. blood sugar C. LFTs D. thyroid test

Answer: A. blood pressure

11. Pt diagnosed with AD refuses meds. Which is preferred? A. donezepil patch B. rivastigmine patch C. magenta patch D. namzeric patch

Answer: B. Rivastigmine = only one available in patch form

8. Clinical manifestations of AD caused by deficit in which of the brains neurotransmitters? A. dopamine B. norepinephrine C. acetylcholine D. GABA

Answer: C. acetylcholine

3. A client asks the nurse about using dextromethorphan to relieve a cough. Wha type of cough would the nurse explain is best treated with this drug? A. occasional productive cough B. caught that is associated with an allergy C. cough that occurs when the client is exposed to airborne irritants D. a dry, nonproductive cough

Answer: D. a dry, non-productive cough

5. Which of the following meds is the drug of choice to manage off-time episodes of PD? A. Selegiline B. Ropinirole C. Amantadine hydrochloride D. Apomorphine hydrochloride

Answer: D. apomorphine hydrochloride

10. An adult client is admitted to the ED after a car accident. Assessment confirms that the client is unconscious with s/s of cerebral edema. What corticosteroid is most likely to be administered to manage the client's condition? A. prednisone B. hydrocortisone C. methylprednisolone D. dexamethasone

Answer: D. dexamethasone Rationale: it is the only steroid that can cross the BBB to remove fluid from cerebrum Note: also given for anticipatory nausea (chemo-induced nausea)

9. Nurse teaching pt about Donezepil (Aricept) for mx of AD. which is priority problem? A. risk for bleeding B. risk for hyperbole is C. risk for constipation D. risk for falls

Answer: D. risk for injury bc falls risk related to CNS depression so admin meds at bedtime

15. Nurse is teaching pt about benefits of inhalation drug therapy. Which of the following are true? SATA A. enhances therapeutic action B. minimizes systemic effects C. increases systemic effects D. rapid relief of acute attacks E. decreases need for other medications

Answers: A. enhances therapeutic action B. minimizes systemic effects D. rapid relief of acute attacks

4. Pt exhibiting classic s/s of hemorrhagic stroke. What reports form the pt would be indicator of this type of stroke? SATA A. exploding headache B. tinnitus C. nuchal rigidity D. vomiting E. double vision

Answers: A. exploding headache d/t bleeding and increased ICP C. nuchal rigidity = neck stiffness D. vomiting d/t increased ICP

2. Nurse teaching pt diagnosed with PD about cogentin (Beztropin). Which of the following statements of the nurse are correct? SATA A. Medication is given to reduce drooling B. Med is given to reduce bradykinesia C. You need to void before taking this med D. You need to ask provider to reduce the dosage in the winter E. Med can cause bradycardia

Answers: A. medication is given to reduce drooling (anticholinergic) C. you need to void before taking this med because it is an anticholinergic = urinary retention (also tachycardia, dry mouth, constipation, decreased sweating, increased temperature)

10. Which of the following clinical manifestations are expected in pt with PD? SATA A. shuffling gait B. resting tremor C. intentional tremor D. bradykinesia E. mask-like facial expression

Answers: A. shuffling gait B. resting tremor D. bradykinesia E. mask-like facial expression

26. The nurse is teaching a pt about montelukast (Singulair). Which statement by the pt would indicate that the nurse's teaching was effective? SATA A. I will take a dose as soon as I feel short of breath B. I need to report any mood changes immediately C. this is the priority med for preventing exercise-induced asthma D. I am prone to get oral candidiasis with the use of this medication

Answers: B. mood changes C. exercise-induced asthma

16. Which of the following drug groups can be administered to manage exercise induced asthma? SATA A. can think group B. short-acting beta adrenergics C. corticosteroids D. short-acting anti-cholingerics E. leukotriene modifiers F. mast cell stabilizers

Answers: B. short-acting beta adrenergics D. short-acting anti-cholinergics E. leukotriene modifiers

Which IV fluid is a hypertonic solution? A. Ringer solution B. 5% dextrose in water C. LR solution D. 5% dextrose in normal saline

D Ringer and LR are isotonic 5% dextrose in water is slightly hypotonic

1. The use of pseudophedrine would most likely to be contraindicated in which client? A. A woman who is breastfeeding B. A man with a history of severe hypertension C. A man with a dx of COPD D. A woman who has cellulitis

B Rationale: pseudophedrine (Sudafed) = alpha 1 adrenergic agonist = vasoconstriction This med is used as a nasal decongestant by shrinking nasal mucous membranes & increasing drainage of sinus secretions

Which med would the RN question when reviewing the home med list for a pt admitted with PUD? A. Iron B. Ibuprofen C. Famotidine D. Acetaminophen

B (Aspirin and NSAIDS inc risk of gastric bleeding)

When monitoring for a client with hyponatremia which would be significant? A. thirst B. seizures C. erythema D. confusion E. constipation

B, C

Which assessment findings indicate to the nurse that a client with COPD who is receiving O2 is retaining CO2 SATA A Anxiety B drowsy C irregular pulse D. mental confusion E. Inc respirations

BCD

7. Which pts are candidates for tPA after CT scan confirmation of ischemic stroke? SATA A. CT result indicates hemorrhagic stroke B. Time of onset of stroke is 7 hours C. Platelet >100,000/mm^3 D. BP 200/120mmHg E. Pt had surgery for aneurysm past month F. Pt had transient ischemic attack G. Pt has not received heparin for past 48 hours

C G Choice A = no tPA for hemorrhagic stroke Choice B = time should be < 3 hours Choice D = BP should be < 185/110 Choice E = no brain surgery within past month Choice F = transient would mean no clot seen on CT scan

A client with OA reports experiencing painful back muscle spasms. Which med would the RN admin? A. Tramadol B. hyaluronate C. Diclofenac epolamine patch D. cyclobanzaprine hydrochloride

D (muscle relaxant used to relieve painful muscle spasms)

Which client would Rn suspect for Type 4 hypersensitive rxn? A B C D

D, type 4 is mediated by T cells, not antibodies. it causes erythema and edema within 24-48 hrs

12. A client has questioned why the prescribed corticosteroids can not be discontinued as soon as relief of symptoms has occurred. The nurse should explain the rationale for the client's regimen based on which statement? A. the serum half-life of many corticosteroids can exceed 3 months B. corticosteroids are sequestrated in hepatocytes and released over several weeks C. the HPA axis does not normally resume full function for several months D. abrupt cessation of corticosteroid therapy can cause nephrotoxicity Answer:

C. the HPA axis does not normally resume full function for several months

. Pt diagnosed with metabolic alkalosis from continuous, profuse vomiting which abnormal electrolyte findings would nurse anticipate? SATA a. K+=5.9 b. Ca=11.1 c. K+ = 2.8 d. Ca = 7.8

CD

4. RN teaching pt about baclofen that has been prescribed for painful muscle spasms. What would the RN include in their teaching a. Drug can cause high Ca levels called hypercalcemia b. To prevent GI disturbances, pt must sit upright for 30 mins after taking med c. Frequent LFTs will be requiredbc drug is hepatotoxic d. Do not stop taking it abruptly, the dose must be tapered down fbefore discontinuing

D

7. RN has experience in admin of TriCor wo pts to red triglyceride and inc HDL. RN understands it is contraindicated with? A pt with... a. Fasting BG of 100 b. HR of 104 c. BP of 129/90 d. BUN of 52 and Cr of 4.2

D

When the home health nurse is caring for a client with chronic occlusive arterial disease, which finding will be of most concern? A. Pedal pulses not palpable B. decreased sensation in both feet C. thick and yellow toenails bilaterally D. pale and dry-appearing ulcer on great toe

D

which MOA would a nurse recall when caring for a client prescribed bisacodyl for constipation A. producing bulk B. softening feces C. lubricating feces D. stimulating peristalsis

D

Which information would the nurse provide to a client taking dulaglutide? A. give with insulin B. admin med only C. works w/o exercise D. perform self-injection weekly

D non-insulin injection; admin Qwk, not with insulin. It is not oral, and it work with modified diet and exercise

cor pulmonale

R ventricular failure caused by pulmonary HTN

9. Nurse preparing teaching for pt to receive tPA after CT confirmation. Is teaching required or not? We will monitor your liver function before and after therapy Medication is given to dissolve the clot formed inside your brain We will monitor your coagulation profile before and after the therapy (platelets, aPTT, INR) Medication is given to control the bleeding inside your brain - not required bc tPA is for ischemic not hemorrhagic You need to take this medication with food - not required bc taken IV or intra-arterial, not PO Head CT will be repeated after 24 hours of administration of this medication to check therapeutic effectiveness

Required: Medication is given to dissolve the clot formed inside your brain We will monitor your coagulation profile before and after the therapy (platelets, aPTT, INR) Head CT will be repeated after 24 hours of administration of this medication to check therapeutic effectiveness Not Required: You need to take this medication with food - not required bc taken IV or intra-arterial, not PO Medication is given to control the bleeding inside your brain - not required bc tPA is for ischemic not hemorrhagic We will monitor your liver function before and after therapy

9: The nurse is preparing a teaching plan for a pt who is on long-term steroid therapy. For each of the listed teaching statements, which is required or not required? • you need to take prompt treatment for common cold • you need to take this medication with food • you need to take this medication on an empty stomach • you need to check your blood sugar on a regular basis • you need to check urine output

Required: • you need to take prompt treatment for common cold • you need to take this medication with food • you need to check your blood sugar on a regular basis Not required: • you need to take this medication on an empty stomach • you need to check urine output

acetylcysteine

breaks mucoprotein bonds, decreasing mucous viscosity

pt presenting with an acute asthma attack is being assessed in ED. Client's spouse reports pt currently is undergoing treatment for URI. RN would understand that the client most likely has which type of asthma? A. allergic B. emotional C. Extrinsic D. Intrinsic

d

melena

dark tarry feces

Allopurinol MOA

decreases the production of uric acid