N352 - Exam 3 Review Questions

A client who has the flu has been taking Mucomyst. Which adverse effect would the nurse assess for? 1. Bronchospasm. 2. Nausea. 3. Fever. 4. Drowsiness.

1

A nurse teaches a client about the effects of diphenhydramine (Benadryl), which has been prescribed as an antihistamine. The nurse determines that the client needs further instructions if the client states that he or she will: 1. Take the medication on an empty stomach. 2. Avoid using alcohol while taking this medication. 3. Use sugarless gum or candy to decrease dry mouth. 4. Avoid activities requiring mental alertness while taking this medication.

1

A patient is receiving an intravenous infusion of heparin to treat a pulmonary embolism. What laboratory value will the nurse monitor to evaluate treatment with this medication? 1. Activated partial thromboplastin time (aPTT) 2. Prothrombin time (PT) 3. Platelet count 4. Hemoglobin and hematocrit

1

A patient is scheduled to start taking sildenafil (Viagra) for erectile dysfunction. A nurse should recognize that the patient is at risk for developing an adverse cardiac event if the patient's history reveals which conditions? 1. Angina 2. Hypertension 3. Varicose veins 4. Prosthetic mitral valve

1

A patient is taking finasteride (Proscar) for benign prostatic hyperplasia (BPH). The nurse should explain that this medication does what? 1. Decreases the size of the prostate gland 2. Relaxes smooth muscle of the prostate gland 3. Reduces the risk of prostate cancer 4. Improves sexual performance during intercourse

1

The HCP prescribed Augmentin for a client who has a sinus cold. Which intervention should the nurse implement? 1. Discuss the med with the HCP because antibiotics do not help viral infections. 2. Teach the client to take all the antibiotics as ordered. 3. Encourage the client to seek a second opinion. 4. Ask the client if he is allergic to sulfa drugs or shellfish.

1

The nurse instructs a patient about using combination oral contraceptives for birth control. The nurse determines that teaching is successful if the patient makes which statement? 1. "I will utilize additional methods of birth control if I have to take antibiotics." 2. "Birth control pills do not have serious side effects." 3. "I can continue taking birth control before elective surgeries." 4. "I should take the pill with food to prevent an upset stomach."

1

The nurse is caring for a client who has diabetes mellitus Type II. Before administering metformin (Glucophage), the nurse should notify the prescriber about which laboratory value? 1. Creatinine (Cr) level of 2.1 mg/dL 2. Hemoglobin (Hgb) level of 9.5 gm/dL 3. Sodium (Na) level of 131 mEq/dL 4. Platelet count of 120,000/mm3

1

The nurse is caring for a patient with asthma. The nurse assess increased wheezes upon asuscultation after ambulation. The nurse administers an "as needed" dose of Albuterol (Proventil) via nebulizer treatment. After the treatment, the patient is resting quietly with an SaO2 of 94%. What is the next action by the nurse? 1. Auscultate bilateral lung fields. 2. Continue the ambulation. 3. Put the patient on oxygen by mask. 4. Repeat the nebulizer treatment.

1

The nurse is caring for a patient with diabetes mellitus who received six units of insulin lispro at 0800. The nurse should monitor the patient for signs of hypoglycemia at which of the following times? 1. 0830 to 1030 2. 1130 to 1330 3. 1430 to 1630 4. 1730 to 1930

1

The nurse is providing teaching for a patient receiving glipizide (Glucotrol). Which patient statement indicates understanding of this medication? 1. "I need to notify my doctor if I have episodes of shakiness and sweating." 2. "Since this is an oral diabetic control medication, I will never have hypoglycemia." 3. "I can eat whatever I wish as long as I take my medication daily as prescribed." 4. "I will not have to test my blood sugars at home because this medication will cure my diabetes."

1

Theophylline is prescribed for a client with bronchial asthma. The nurse provides dietary instruction to the client and should instruct the client to avoid consuming which item? 1. Ice tea 2. Lemonade 3. Orange juice 4. Tomato juice

1

Which patient would be at most risk for developing a venous thromboembolism (VTE) if a combination oral contraceptive was prescribed? 1. A 25-year-old patient who drinks 3 to 4 alcoholic drinks/day 2. A 45-year-old patient who has a family history of stroke 3. A 22-year-old patient who smokes 2 packs of cigarettes/day 4. A 29-year-old patient who has used birth control pills for 9 years

1

A nurse has an order to give a client salmeterol (Serevent Diskus), two puffs, and beclomethasone dipropionate (Qvar), two puffs, by MDI. The nurse administers the medication by giving the : 1. Qvar first and then the Serevent. 2. Serevent first and then the Qvar. 3. Alternating a single puff of each, beginning with the Serevent. 4. Alternating a single puff of each beginning with the Qvar.

2

A patient with deep vein thrombosis is receiving an intravenous (IV) heparin infusion. He asks the nurse how this medication will help him. The nurse's response is accurately based on which concept? 1. Heparin prevents the activation of vitamin K and thus blocks synthesis of some clotting factors. 2. Heparin suppresses coagulation by helping antithrombin perform its natural functions. 3. Heparin works by converting plasminogen to plasmin, which in turn dissolves the clot matrix. 4. Heparin inhibits the enzyme responsible for platelet activation and aggregation within vessels.

2

Drug therapy with enoxaparin (Lovenox) must be closely monitored with activated partial thromboplastin times (aPTTs) lab tests. 1. True 2. False

2

During administration of alteplase (Activase), the patient's IV site starts to ooze blood around the catheter. Which action by the nurse is most appropriate? 1. Discontinue the infusion of alteplase. 2. Assess the patient's vital signs. 3. Apply direct pressure over the puncture site. 4. Administer aminocaproic acid (Amicar).

2

The nurse instructs a group of postmenopausal women about hormone therapy (HT). Which information should the nurse include in the teaching plan? 1. The most frequent adverse effect of HT is headache. 2. HT increases the risk of stroke and venous thromboembolism. 3. Blood levels of estrogen are more consistent with oral HT. 4. HT may cause a harmless yellow discoloration of the skin.

2

The nurse is caring for a patient who has asthma. The nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule? 1. Only in an emergency. 2. On a continuing, daily basis. 3. To abort an asthma attack. 4. 2 weeks on, 2 weeks off.

2

The patient reports to the clinic nurse that yesterday they forgot to take their daily dose of levothyroxine (Synthroid) so this morning they doubled their dose. What is the priority action by the nurse? 1. Obtain the anaphylaxis kit. 2. Check the apical heart rate. 3. Check the oral temperature. 4. Ask about recent weight loss.

2

A 72-year-old woman is taking an over-the-counter multivitamin that contains ginkgo. Her physician has recommended that she start taking low-dose aspirin therapy as part of her treatment for transient ischemic attacks (TIAs). The concern with taking these two drugs together is: 1. None. 2. Decreased action of the apirin due to the interaction with the gingko. 3. Increased risk of bleeding because of the gingko. 4. Antagonism of the action of the aspirin because of the multivitamins.

3

A 75-year-old man fell at home and hit his head against a table. His wife calls their daughter to find out what to do. She reports to her daughter that he does not have cuts or scratches but there is a small lump on his upper scalp. She does not see any blood. He is taking warfarin and an antidysrhythmic as part of his treatment for chronic atrial fibrillation. What is the main concern at this time? 1. Pressure should be applied to the lump for 3 to 5 minutes. 2. He will need to take two doses of warfarin tonight to prevent blood clotting. 3. He needs to be examined for possible internal bleeding from the fall. 4. As long as there is no bleeding, there is no concern.

3

A client asks for medication to "break up this thick mucus"? What should the nurse administer? 1. Antitussive. 2. Decongestive. 3. Mucolytic. 4. Antibiotic.

3

A client has a prescription to take quaifenesin (Mucinex). The nurse determines that the client understands the proper administration of this medication if the client states that he or she will: 1. Take an extra dose if fever develops. 2. Take the medication with meals only. 3. Take the tablet with a full glass of water. 4. Decrease the amount of daily fluid intake.

3

A patient has been prescribed sildenafil (Viagra) for erectile dysfunction. Which instruction should the nurse include in the teaching plan? 1. Take the medication on an empty stomach. 2. Drink plenty of fluids to prevent priapism. 3. Avoid taking nitroglycerin with this drug. 4. Constipation is a common adverse effect.

3

A patient is receiving an IV infusion of heparin and was started on warfarin therapy the night before. Which statement is true? 1. The patient is receiving a double dose of anticoagulants. 2. The heparin therapy was ineffective, so the warfarin was started. 3. The heparin provides anticoagulation until therapeutic levels of warfarin are reached. 4. The heparin and warfarin work together synergistically to provide anticoagulation.

3

A patient is taking estrogen daily. Which instruction by the nurse should be included to reduce the risk of a cardiovascular event such as stroke or myocardial infarction? 1. Reduce aerobic activities. 2. Increase dietary intake of trans fat. 3. Stop smoking. 4. Take the medication with food.

3

Montelukast (Singulair) is prescribed for a client who has bronchial asthma. Which lab test does the nurse expect to be prescribed before the administration of this medication? 1. Platelet count 2. Neutrophil count 3. Liver function tests 4. Complete blood count (CBC)

3

The child with an acute asthma attack is prescribed a 7-day course of the systemic corticosteroid prednisolone. The mother asks the nurse, "Doesn't this medication cause serious side effects?" Which statement is the best response? 1. "Yes, this medication does have serious side effects, but your child needs the medication." 2. "The doctor would not have ordered a medication that has serious side effects.? 3. "A short-term course of steroids should not cause serious side effects." 4. "There may be serious consequences if your child does not take the medication."

3

The nurse cares for a patient receiving an intravenous heparin infusion. Which medications would the nurse administer as an antidote if the patient develops uncontrolled bleeding? 1. Ferrous sulfate 2. Atropine sulfate 3. Protamine sulfate 4. Magnesium sulfate

3

The nurse is caring for a patient with asthma who is scheduled to start taking a glucocorticoid medication with a metered-dose inhaler (MDI). The nurse should give the patient which instruction about correct use of the inhaler? 1. "After you inhale the medication once, repeat until you obtain symptomatic relief." 2. "Wait no longer than 30 seconds after the first puff before taking the second one." 3. "Use a spacer with the inhaler and rinse your mouth after each dose administration." 4. "Breathe in through the nose and hold for 2 seconds just before activating the inhaler."

3

The nurse is providing education to a 35 year old woman who is being prescribed oral contraceptives. Which risk factor would increase the risk of thromboembolic phenomena (Blood clots) arising from Oral Contraceptives use in this patient? 1. Alcohol consumption. 2. Asthma. 3. Smoking. 4. Noncompliance.

3

Which instruction about clopidogrel (Plavix) should be included in the discharge teaching for a patient who has received a coronary stent? 1. "Constipation is a common side effect of clopidogrel, so take a stool softener daily." 2. "Do not worry if you see blood in your urine or black stools, this is a common side effect." 3. "Check with your healthcare provider before taking any over-the-counter medications for gastric acidity." 4. "Keep the amounts of foods containing vitamin K, such as mayonnaise, canola and soybean oil, and green, leafy vegetables, consistent in your diet."

3

Which of the following should the nurse include in the teaching plan for a patient who has hyperthyroidism and is being treated with Iodine-131? 1. "A single dose of the Iodine-131 is sufficient." 2. "Body secretions will be radioactive for one week." 3. "Report an increase in temperature and pulse rate." 4. "Your symptoms should subside in 1 to 2 weeks."

3

Which patients may need an increased dose of warfarin (Coumadin) to have the same anticoagulant effect? 1. A patient taking acetaminophen (Tylenol) for back pain 2. A patient taking cimetidine (Tagamet) to prevent gastric ulcers 3. A patient taking oral contraceptives to prevent pregnancy 4. A patient taking prednisone (Deltasone) for rheumatoid arthritis

3

A client diagnosed with hypertension develops a cold. What should the nurse teach? 1. Use OTC meds that do not produce drowsiness. 2. OTC meds will not be as effective as prescription. 3. OTC meds are more expensive than prescription. 4. Do not take OTC meds unless approved by the HCP.

4

A patient is prescribed insulin glargine (Lantus). Which statement should the nurse include in the discharge instructions? 1. The insulin will have a cloudy appearance in the vial and the vial should be gently rotated before use. 2. The insulin should be injected twice daily before breakfast and before the evening meal. 3. The patient should mix Lantus with the regular- short duration acting insulin. 4. The patient will have less risk of hypoglycemia reactions with this insulin.

4

A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse explains that normal insulin has which action in the body? 1. It stimulates the pancreas to reabsorb glucose. 2. It promotes the synthesis of amino acids into glucose. 3. It stimulates the liver to convert glycogen to glucose. 4. It promotes the passage of glucose into cells for energy.

4