N330 Quiz 4

A man weighs 165 lb. and is being treated for shock. The nurse is preparing dopamine hydropchloride infusion to start at 5 mcg/kg/min. The nurse has prepared the following to infuse: dopamine 400 mg in 250 mL D5W. Which of the following rates of infusion should the nurse choose? (Round to nearest whole number, include units).

14 ml/hr

The physician orders 0.5 mg of digoxin for a client with atrial fibrilliation. The pharmacy has 250-mcg tablets available. How many tablets will the nurse give? (Round to nearest whole number, include units).

2 tablets

The nurse is preparing to set up an intravenous infusion of normal saline 1,000 mL over a 6-hour period. The tubing drop factor is 10 gtt/mL. Which of the following rates of infusion should the nurse choose? (Round to nearest whole number, include units).

28 gtt/min

A client is to receive 35 mg/hr of intravenous aminophylline. The nurse mixes 350 mg of aminophylline in 500 mL D5W. At which of the following rates should the nurse infuse this solution? (Round to nearest whole number, include units in the answer).

50 m/hr

You have an order for furosemide (Lasix) 80 mg IV every morning. You have on hand Lasix 20 mg in 2 mL sterile water. How many milliliters should you prepare? (Round to nearest whole number, include units).

8 ml

Older adult patients are predisposed to develop fluid volume deficit for which reason? (Select all that apply). a. Decrease in proportion of body fluids b. Increased fat stores c. Alterations in thirst d. Diminished reflexes e. Decreased muscle mass

A, B, C, E

Which diet choice by the patient with an acute exacerbation of inflammatory bowel disease (IBD) indicates a need for more teaching? a. Oatmeal with cream b. Scrambled eggs c. White toast and jam d. Pancakes with syrup

a

Which group is at the greatest risk for osteoporosis? a. European American women b. Men c. Asian American women d. African American women

a

Which is a strategy for lowering risk for osteoporosis? a. Smoking cessation b. Increased age c. Low initial bone mass d. Diet low in calcium and vitamin D

a

Which clinical manifestations of inflammatory bowel disease does the nurse determine are common to both patients with ulcerative colitis (UC) and Crohn's disease (select all that apply.)? a. Bloody, diarrhea stools b. Cramping abdominal pain c. Restricted to rectum d. Strictures are common e. Lesions penetrate intestine

a, b

A 68-year-old woman recently diagnosed with hypertension has started taking furosemide 40 mg PO twice daily. During a clinic appointment, she reports new onset muscle weakness and abdominal cramping. Lab tests are performed. The nurse knows which of the following results is the best explanation for the symptsoms experienced by the client? a. Creatinine 1.5 mg/dL b. Potassium 3.0 mEq/L c. Fasting glucose 105 mg/dL d. Total calcium 10.0 mg/dL

b

A male client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of: a. Wearing an appliance pouch only at bedtime. b. Increasing fluid intake to prevent dehydration. c. Taking only enteric-coated medications. d. Consuming a low-protein, high-fiber diet.

b

The long-term care nurse is evaluating the effectiveness of protein supplements for an older resident who has a low serum total protein level. Which assessment finding indicates that the patient's condition has improved? a. Blood pressure 110/72 mm Hg b. Decreased peripheral edema c. Absence of skin tenting d. Hematocrit 28%

b

The nurse is performing a neurologic assessment for a patient. When assessing the accessory nerve, what action should the nurse take? a. Ask the patient to push the tongue to either side against resistance. b. Ask the patient to shrug the shoulders against resistance. c. Have the patient say "ah" while visualizing elevation of soft palate. d. Assess the gag reflex by stroking the posterior pharynx.

b

The nurse is performing an assessment for a patient with fatigue and shortness of breath. Auscultation of the heart reveals the presence of a murmur. What is this assessment finding indicative of? a. Friction between the heart and the myocardium b. Turbulent blood flow across a heart valve c. A deficit in heart conductivity that impairs normal contractility d. Increased viscosity of the patient's blood

b

The nurse is reviewing the lab work of a client admitted for chemotherapy treatment. For which of the following laboratory values should the nurse call the physician? a. BUN 5, creatinine 0.7 b. WBC 0, hemoglobin 2 c. Magnesium 2 d. Hemoglobin 9.5, WBC

b

When teaching a patient about dietary management of stage 1 hypertension, which instruction is most appropriate? a. Use calcium supplements. b. Restrict sodium intake. c. Increase protein intake. d. Increase water intake.

b

Which of the following definitions best describes gastritis? a. Inflammation of a diverticulum. b. Inflammation of the gastric mucosa. c. Erosion of the gastric mucosa. d. Reflux of stomach acid into the esophagus.

b

Your patient is complaining of abdominal pain during assessment. What is your priority? a. Auscultate to determine changes in bowel sounds. b. Observe the contour of the abdomen. c. Percuss the abdomen to determine if fluid is present. d. Palpate the abdomen for a mass.

b

A 76-year-old man is brought into the ED by his spouse. The client's spouse tells the nurse he is confused, disoriented, and weak, and has not been eating well. For which of the following lab results should the nurse immediately notify the physician? a. Hemoglobin 12 g/dL b. Potassium 3.8 mEq/L c. Sodium 122 mEq/L d. Magnesium 1.9 mg/dL

c

A client with a musculoskeletal injury is instructed to increase dietary calcium. Which statement by the nurse is appropriate? a. Unanswered option "You need to increase the amount of phosphorus in your diet." b. "You need to increase the amount of non-citrus fruits in your diet." c. "You need to increase the amount of vitamin D in your diet." d. "You need to increase the amount of red meat in your diet."

c

A patient with multiple draining wounds is admitted for hypovolemia. Which assessment would be the most accurate way for the nurse to evaluate fluid balance? a. Daily weight b. Urine output c. Edema presence d. Skin turgor

a

After abdominal surgery, a patient with protein calorie malnutrition is receiving total parenteral nutrition (TPN). Which is the best indicator that the patient is receiving adequate nutrition? a. Surgical incision is healing normally. b. Blood glucose is less than 110 mg/dL. c. Fluid intake and output are balanced. d. Serum albumin level is 3.5 mg/dL.

a

Peptic ulcer disease may be caused by which of the following? a. Helicobacter pylori b. Staphylococcus aureus c. Candida albicans d. Clostridium difficile

a

The nurse determines a patient has experienced the beneficial effects of therapy with famotidine when which symptom is relieved? a. Epigastric pain b. Belching c. Difficulty swallowing d. Nausea

a

The nurse is caring for a male client with a diagnosis of chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency? a. Vitamin B12 b. Vitamin A c. Vitamin E d. Vitamin C

a

The nurse performs client teaching for a woman with osteoarthritis. The client asks what she can do to effectively decrease pain and stiffness in her joints before beginning her daily routine. The nurse should instruct the client to do which of the following? a. "Take a warm bath and rest for a few minutes." b. "Stretch all muscle groups." c. "Do range of motion exercises, then apply ointment to your joints." d. "Perform isometric exercises for 10 minutes."

a

Which common problem of the upper extremity results from entrapment of the median nerve at the wrist? a. Carpal tunnel syndrome b. Impingement syndrome c. Dupuytren's contracture d. Ganglion

a

The home health nurse cares for an alert and oriented older adult patient with a history of dehydration. Which instructions should the nurse give this patient related to fluid intake? a. "More fluids are needed if you feel thirsty." b. "Increase fluids if your mouth feels dry." c. "Drink more fluids in the late evening." d. "If you feel confused, you need more to drink."

b

The nurse is developing a plan of care for a patient with an abdominal mass and suspected bowel obstruction. Which factor in the patient's history does the nurse recognize as increasing the patient's risk for colorectal cancer? a. Use of herbs as dietary supplements b. History of colorectal polyps c. History of lactose intolerance d. Osteoarthritis

b

The nurse is educating a client with low back pain on proper lifting techniques. The nurse recognizes that the education was effective when the client a. reaches over the head with the arms fully extended. b. places the load close to the body. c. uses a narrow base of support. d. bends at the hips and tightens the abdominal muscles.

b

When entering the grocery store, a patient trips on the curb and sprains the right ankle. Which initial care is appropriate (select all that apply.)? a. Apply ice directly to the skin. b. Rest and elevate the ankle above the heart. c. Administer anti-inflammatory medication. d. Compress ankle using an elastic bandage. e. Apply heat to the ankle every 2 hours.

b, c, e

Which information will the nurse include when teaching a patient with acute low back pain (select all that apply)? a. Keep the knees straight when leaning forward to pick something up. b. Avoid activities that require twisting of the back or prolonged sitting. c. Use ibuprofen (Motrin, Advil) or acetaminophen (Tylenol) to relieve pain. d. Sleep in a prone position with the legs extended. e. Expect symptoms of acute low back pain to improve in a few weeks.

b, c, e

A patient is receiving a 3% saline continuous IV infusion for hyponatremia. Which assessment data will require the most rapid response by the nurse? a. The patient's radial pulse is 105 beats/min. b. The blood pressure increases from 120/80 to 142/94 mm Hg. c. There are crackles throughout both lung fields. d. There is sediment and blood in the patient's urine.

c

A patient that had been admitted 3 days ago with an upper GI bleed, coffee ground emesis, positive for occult blood in the stool, and Hgb of 6.7 is preparing to be discharged. Which of the following discharge medications should the nurse question? a. Famotidine 20 mg b. Pantoprazole 40 mg c. Aspirin 325 mg d. Ondansetron 8 mg

c

A patient who has been vomiting for several days from an unknown cause is admitted to the hospital. The nurse anticipates collaborative care to include a. administration of parenteral antiemetics b. oral administration of broth and tea c. IV replacement of fluid and electrolytes d. insertion of a nasigastric tube to suction

c

The nurse identifies that which patient is at highest risk for developing colon cancer? a. A 52-yr-old man who has followed a vegetarian diet for 24 years b. A 28-yr-old man who has a body mass index of 27 kg/m2 c. A 32-yr-old woman with a 12-year history of ulcerative colitis d. A 58-yr-old woman taking prescribed estrogen replacement therapy

c

The nurse is assessing an elderly client for risk of falls. Which of the following should the nurse collect? a. Psychosocial history b. The facility's environmental safety plan c. Gait, balance, and visual impairment information d. The facility's restraint policy

c

The nurse is caring for a client with a hip fracture. The physician orders the client to start taking a bisphosphonate. Which medication would the nurse document as given? a. Raloxifene b. Denosumab c. Alendronate d. Teriparatide

c

The nurse will plan to teach a patient with Crohn's disease who has megaloblastic anemia about the need for a. iron dextran infusions b. routine blood transfusions. c. oral ferrous sulfate tablets. d. cobalamin (B12) supplements.

d

The patient receiving chemotherapy rings the call bell and reports the onset of nausea. The nurse should prepare an as-needed dose of which medication? a. Dexamethasone b. Morphine sulfate c. Zolpidem d. Ondansetron

d

The results of a patient's recent endoscopy indicate the presence of peptic ulcer disease (PUD). Which teaching point should the nurse provide to the patient based on this new diagnosis? a. "Many people find that a minced or pureed diet eases their symptoms of PUD." b. "You'll need to drink at least two to three glasses of milk daily." c. "Taking medication will allow you to keep your present diet while minimizing symptoms." d. "It would be beneficial for you to eliminate drinking alcohol."

d

Jerod is experiencing an acute episode of ulcerative colitis. Which is the priority for this patient? a. Monitor for increased serum glucose level from steroid therapy. b. Restrict the dietary intake of foods high in potassium. c. Replace lost fluid and sodium. d. Note any change in the color and consistency of stools.

c

Nurse Hannah is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: a. Alcohol abuse and a history of acute renal failure. b. A history of hemorrhoids and smoking. c. Alcohol abuse and smoking. d. A sedentary lifestyle and smoking.

c

Regina is a 46 y.o. woman with ulcerative colitis. You expect her stools to look like: a. Firm and well-formed b. Watery and frothy c. Bloody and mucous d. Alternating constipation and diarrhea

c

When teaching a client how to prevent low back pain as a result of lifting, the nurse should instruct the client to: a. bend the knees and loosen the abdominal muscles. b. use a narrow base of support. c. avoid overreaching. d. place the load away from the body.

c

Which action should the nurse take first when a patient complains of acute chest pain and dyspnea soon after insertion of a centrally inserted IV catheter? a. Give prescribed PRN morphine sulfate IV. b. Notify the health care provider. c. Auscultate the patient's breath sounds. d. Offer reassurance to the patient.

c

Pain control with peptic ulcer disease includes which of the following (select all that apply)? a. Eating meals when desired. b. Taking laxatives regularly c. Promoting physical and emotional rest. d. Administering medications that decrease gastric acidity. e. Identifying stressful situations.

c, d, e

A patient receives 3% NaCl solution for correction of hyponatremia. Which assessment is most important for the nurse to monitor for while the patient is receiving this infusion? a. Peripheral pulses b. Peripheral edema c. Urinary output d. Lung sounds

d

A patient with a history of chronic hypertension is being evaluated in the emergency department for a blood pressure of 200/140 mm Hg. Which patient assessment question is the priority? a. Does the patient need to urinate? b. Is the patient taking antiseizure medications as prescribed? c. Is the patient pregnant? d. Does the patient have a headache or confusion?

d

A patient's TPN bag is nearly empty, and a new bag has not arrived yet from the pharmacy. Which intervention by the nurse is appropriate? a. Decrease the PN infusion rate to 10 mL/hr until a new bag arrives. b. Flush the peripheral line with saline until a new PN bag is available. c. Monitor the patient's capillary blood glucose every 6 hours. d. Infuse 5% dextrose in water until a new PN bag is delivered.

d

After an exploratory laparotomy, a patient on a clear liquid diet reports severe gas pains and abdominal distention. Which action by the nurse is most appropriate? a. Administer an as-needed dose of IV morphine sulfate. b. Return the patient to NPO status. c. Place cool compresses on the abdomen. d. Encourage the patient to ambulate as ordered.

d

Ondansetron is prescribed for a patient with cancer chemotherapy-induced vomiting. The nurse understands that this drug a. Is a derivative of cannabis and has potential for abuse b. Has a strong antihistamine effect that provides sedation and induces sleep c. Is used only when other therapies are ineffective because of side effects of anxiety and hallucinations d. Relieves vomiting centrally by action in the vomiting center and peripherally by promoting gastric emptying

d

The nurse is caring for a hospitalized female client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician? a. Hypotension b. A hemoglobin level of 12 mg/dL c. Bloody diarrhea d. Rebound tenderness

d

The nurse is preparing to administer famotidine to a postoperative patient with a colostomy. The patient states they do not have heartburn. What response by the nurse would be the most appropriate? a. "The stress of surgery is likely to cause stomach bleeding if you do not receive it." b. "It will prevent the heartburn that occurs as a side effect of general anesthesia." c. "It will prevent air from accumulating in the stomach, causing gas pains." d. "It will reduce the amount of acid in the stomach."

d

The nurse is reviewing the record of a female client with Crohn's disease. Which stool characteristics should the nurse expect to note documented in the client's record? a. Constipation alternating with diarrhea b. Stools constantly oozing from the rectum c. Chronic constipation d. Diarrhea

d

A patient calls the clinic to report a new onset of severe diarrhea. The nurse anticipates that the patient will need to a. have blood cultures drawn. b. collect a stool specimen. c. prepare for colonoscopy. d. schedule a barium enema.

b

A patient with new-onset confusion and hyponatremia is being admitted. When making room assignments, the charge nurse should take which action? a. Place the patient in a room nearest to the water fountain. b. Assign the patient to a room near the nurse's station. c. Place the patient on telemetry to monitor for peaked T waves. d. Assign the patient to a semi-private room.

b

An older patient receiving iso-osmolar continuous tube feedings develops restlessness, agitation, and weakness. Which laboratory result should the nurse report to the health care provider immediately? a. K+ 3.4 mEq/L (3.4 mmol/L) b. Na+ 154 mEq/L (154 mmol/L) c. PO4-3 4.8 mg/dL (1.55 mmol/L) d. Ca+2 7.8 mg/dL (1.95 mmol/L)

b

Crohn's disease can be described as a chronic relapsing disease. Which of the following areas in the GI system may be involved with this disease? a. Only the sigmoid area. b. The small intestine and colon; affecting the entire thickness of the bowel. c. The entire length of the large colon. d. The entire large colon through the layers of mucosa and submucosa.

b

Stephanie, a 28 y.o. accident victim, requires TPN. The rationale for TPN is to provide: a. Tube feedings for nutritional supplementation. b. Complete nutrition by the I.V. route. c. Necessary fluids and electrolytes to the body. d. Dietary supplementation with liquid protein given between meals.

b

Two nurses are preparing to lift a client up on bed. Which of the following should the nurses do to help avoid injuring their backs? a. Lift with the back, not with the legs b. Lower the head of the bed to about 30 degrees, if the client can tolerate it c. Bend from the waist d. Make certain the bed is in a reasonably high position

d

Which aspect should a nurse include in the teaching plan for a client with osteomalacia? a. Avoid dairy products b. Avoid any activity or exercise c. Avoid green, leafy vegetables d. Include calcium, phosphorus, and vitamin D supplements

d

Which of the following substances is most likely to cause gastritis? a. Enteric-coated aspirin b. Bicarbonate of soda, or baking soda c. Milk d. Nonsteroidal anti-inflammatory drugs

d