NCLEX Med & select all questions

The nurse is teaching a client who will be discharged with a prescription for warfarin (Coumadin). The nurse should include which statement in discharge teaching?

Avoid aspirin while taking warfarin.

A client with known coronary artery disease reports intermittent chest pain, usually on exertion. The physician diagnoses angina pectoris and prescribes sublingual nitroglycerin to treat acute angina episodes. When teaching the client about nitroglycerin administration, the nurse should provide which instruction?

Be sure to take safety precautions because nitroglycerin may cause orthostatic hypotension

The physician prescribes pentoxifylline (Trental), 400 mg by mouth three times daily with meals, for a client with intermittent claudication and a history of adult-onset diabetes mellitus. The nurse knows that pentoxifylline is a:

Blood viscosity-reducing agent.

Before discharge, which instruction should the nurse give to a client receiving digoxin (Lanoxin)?

Call the physician if you have a rapid heart rate.

A client who complained of chest pain received sublingual nitroglycerin (Nitrostat). Which statement by the client indicates that this drug is producing its therapeutic effect?

My chest pain is decreasing.

A postoperative client is receiving heparin after developing thrombophlebitis. The nurse monitors the client carefully for adverse effects of heparin, especially bleeding. If the client starts to exhibit signs of excessive bleeding, the nurse should expect to administer an antidote that's specific to heparin. Which agent fits this description?

Protamine sulfate

After experiencing a transient ischemic attack (TIA), a client is prescribed aspirin, 325 mg by mouth daily. The nurse should teach the client that this medication has been prescribed to:

Reduce platelet agglutination

The physician has ordered digoxin for a client with pulmonary edema. The nurse knows that digoxin has a direct and beneficial effect on myocardial contraction in the failing heart. This effect:

Slows the conduction of impulses through the atrioventricular (AV) node

Considering a client's atrial fibrillation, the nurse must administer digoxin (Lanoxin) with caution because it

Stimulates the parasympathetic division of the autonomic nervous system, increasing vagal tone

A client develops atrial fibrillation after an acute myocardial infarction. The physician prescribes digoxin (Lanoxin), 0.125 mg I.M. daily. The nurse clarifies the order with the physician because I.M. administration of digoxin leads to:

an increased serum creatine kinase (CK) level.

A client with chronic arterial occlusive disease undergoes percutaneous transluminal coronary angioplasty (PTCA) for mechanical dilation of the right femoral artery. After the procedure, the client will require long-term administration of:

aspirin

To avoid a falsely elevated serum digoxin level, the nurse should wait how long after administering oral digoxin (Lanoxin) to draw a blood sample?

at least 8 hours

The licensed practical nurse discovers a client with a pulse rate of 40 beats/minute. His blood pressure is 80/50 mm Hg and he complains of dizziness. Which medication would the registered nurse use to treat the client's bradycardia?

atropine

A client is receiving nitroglycerin ointment (Nitrol) to treat angina pectoris. The nurse evaluates the therapeutic effectiveness of this drug by assessing the client's response and checking for adverse effects. Which vital sign is most likely to reflect an adverse effect of nitroglycerin?

blood pressure

The nurse is caring for a client who's on ritodrine (Yutopar) therapy to halt premature labor. What condition indicates an adverse reaction to ritodrine therapy?

crackles

The nurse is caring for a client with left-sided heart failure. To reduce fluid volume excess, the nurse can anticipate using:

diuretics

Before administering digoxin (Lanoxin) to a client, a nurse reviews information about the drug. She learns that after digoxin is metabolized, the body eliminates remaining digoxin as unchanged drug by way of the:

kidneys

The labor and delivery unit has 10 clients in varying stages of labor. Staffing for the upcoming shift consists of four registered nurses (RNs) and one licensed practical nurse (LPN). Which client care assignment is best? The stable clients in the early stages of labor should be assigned to the LPN. "Which of the following nutritional instructions should the nurse provide to a 32-year-old primigravida?

" 1. Caloric intake should be increased 300 cal/day. 2. Protein intake should be increased by more than 30 g/day. 5. Intake of all minerals, especially iron, should be increased. "

A client admitted with preterm labor is prescribed magnesium sulfate to halt contractions. The nurse should monitor the client for which adverse reactions to the drug?

" 3. Respiratory rate less than 12 breaths/minute 4. Extreme muscle weakness Palpitations 6. Hot flashes"

(select all) "The nurse is teaching a pregnant client about exercises that may be helpful during pregnancy. Which points should the nurse include in her instruction?

"1. Pelvic rocking may help relieve lower back pain. 2. Abdominal breathing lifts the abdominal wall off of the uterus. 3. Kegel exercises help improve vaginal contractility and bladder control.

A client is evaluated for hypertension. The physician prescribes atenolol (Tenormin), 50 mg by mouth daily. Atenolol should have which therapeutic effect on the client?

Decreased cardiac output and systolic and diastolic blood pressure

A client with a history of atrial arrhythmia is receiving propranolol (Inderal), 10 mg by mouth three times per day. The nurse knows that propranolol inhibits the action of sympathomimetics at beta1-receptor sites. Where are these sites mainly located?

Heart

A hospitalized client experiences digoxin- (Lanoxin-) induced premature ventricular contractions (PVCs). Which type of effect do such contractions represent?

Latrogenic

The nurse is teaching a client how to take nitroglycerin (Nitrostat) to treat angina pectoris. The client verbalizes an understanding of the need to take up to three sublingual nitroglycerin tablets at 5-minute intervals, if necessary, and to notify the physician immediately if chest pain doesn't subside within 15 minutes. The nurse informs the client that nitroglycerin may cause

headache, hypotension, dizziness, and flushing

"During a prenatal screening of a client with diabetes, the nurse should keep in mind that the client is at increased risk for which complications?

1. Still birth 3. Pregnancy-induced hypertension 5. Spontaneous abortion

The nurse is explaining the use of transdermal nitroglycerin (Transderm-Nitro), which is to be applied twice daily. The client demonstrates understanding when he states:

My wife should be careful not to touch the patch with her fingers if she helps me

The nurse reviews a client's medication history before administering a cholinergic blocking agent. Which of the following drugs may have delayed absorption because of the adverse effects of a cholinergic blocking agent?

Nitroglycerin (Nitrostat)

"A client is scheduled for amniocentesis. What should the nurse do to prepare the client for the procedure?

" 1. Ask the client to void. 4. Assess fetal heart rate. 6. Monitor maternal vital signs. "

A client is receiving terbutaline (Brethine) to stop preterm labor. The physician plans to discharge the client in the morning with a terbutaline infusion pump. Which instruction should the nurse include when teaching the client about the drug?

"3. ""Assess the insertion site for signs of infection.""

A client with hyperemesis gravidarum is on a clear liquid diet. Which foods would be appropriate for the nurse to serve?

"3. Tea and gelatin 4. Ginger ale and apple juice 5. Cranberry juice and chicken broth "

A client is admitted to the facility in preterm labor. To halt her uterine contractions, the nurse expects the physician to prescribe:

"4. terbutaline (Brethine).

(SELECT ALL THAT APPLY) The nurse is preparing a teaching plan for a client who recently underwent surgery for insertion of a permanent pacemaker. Which instructions should the nurse include in the teaching plan?

(1) Check heart rate for 1 minute daily (4) Report redness, swelling, or discharge at insertion site. (6) Avoid magnetic resonance imaging (MRI) diagnostic studies.

"(SELECT ALL THAT APPLY) Which of the following signs and symptoms should the nurse expect to find in a client with angina?

(1) Chest tightness (3) Chest pressure (4) Jaw pain

(SELECT ALL THAT APPLY) A client is prescribed furosemide (Lasix) to manage his heart failure. What laboratory values should be monitored while the client receives this medication?

(1) Complete blood count and (2) Serum potassium

(SELECT ALL THAT APPLY) The nurse is caring for a client who just underwent cardiac catheterization through a femoral access site. Which nursing interventions should the nurse include in the care plan for the next 8 hours?

(1) Maintain pressure over the femoral access site. (3) Check the dressing and access site for bleeding. (5) Keep the extremity straight.

(SELECT ALL THAT APPLY) The nurse advises a client recovering from a myocardial infarction to decrease his fat and sodium intake. Which foods should the nurse instruct the client to avoid?

(1) Pepperoni Pizza (3) Bacon (4) Cheese (6) Soft Drinks

(SELECT ALL THAT APPLY) The nurse is admitting a client with substernal chest pain. Which diagnostic tests does the nurse anticipate the client will receive to confirm or rule out a diagnosis of myocardial infarction (MI)?

(2) Serum troponin (3) Serum myoglobin

(SELECT ALL THAT APPLY) A client is diagnosed with myocardial infarction. Which data collection findings indicate that the client has developed left-sided heart failure?

(3) Orthopnea (4) Cough (6) Crackles

(SELECT ALL THAT APPLY) A client is receiving heparin I.V. for the treatment of thrombophlebitis. Which laboratory value should the nurse monitor throughout heparin therapy?

(3) Partial thromboplastin time (PTT) (5) Platelet count

The nurse is providing instruction to a woman who is 18 weeks pregnant. Which findings are expected at this time?

1. Fundal height of approximately 18 cm 2. Quickening "

A client with pregnancy-induced hypertension (PIH) receives magnesium sulfate, 4 g in 50% solution I.V. over 20 minutes. What is the purpose of administering magnesium sulfate to this client?

2. To prevent seizures

After receiving large doses of an ovulatory stimulant such as menotropins (Pergonal), a client comes in for her office visit. Data collection reveals the following findings: Weight gain of 6 lb (3 kg), ascites, and pedal edema. These findings indicate that the client is:

2. demonstrating signs of hyperstimulation syndrome.

"The nurse is caring for a 16-year-old pregnant client who is taking an iron supplement. Which instruction should the nurse include when teaching the adolescent about ferrous sulfate?

3. Avoid taking the supplement with milk. 4. Avoid taking the supplement with antacids. 5. Avoid chewing the extended-release form of the drug"

Which drug will the physician probably order to treat a pregnant client who is experiencing morning sickness?

4. Phosphorated carbohydrate solution (Emetrol)

A client with high blood pressure is receiving an antihypertensive drug. The nurse knows that antihypertensive drugs commonly cause fatigue and dizziness, especially on rising. When developing a client teaching plan to minimize orthostatic hypotension, the nurse should include which instruction?

Flex your calf muscles, avoid alcohol, and change positions slowly.

A client is admitted to the acute care facility for treatment of heart failure. The nurse expects the physician to prescribe which drug?

Furosemide (Lasix)

When a client is started on oral or I.V. diltiazem (Cardizem), the nurse should monitor for which adverse reaction?

Heart failure

The physician prescribes several drugs for a client with hemorrhagic stroke. Which drug order should the nurse question?

Heparin sodium

The physician prescribes digoxin (Lanoxin) for a client with heart failure. During digoxin therapy, which electrolyte imbalance may predispose the client to digoxin toxicity?

Hypokalemia

A client experiences orthostatic hypotension while receiving furosemide (Lasix) to treat hypertension. How should the nurse intervene

Instruct the client to flex the calf muscles and then sit up for several minutes before standing

The nurse is teaching a client who receives nitrates for the relief of chest pain. Which of the following instructions should the nurse emphasize?

Lie down or sit in a chair for 5 to 10 minutes after taking the drug.

A male client is receiving digoxin (Lanoxin) and furosemide (Lasix) to treat heart failure. He complains of feeling weak and having muscle cramps. His apical pulse is 76 beats/minute; respirations, 16 breaths/minute; and blood pressure, 148/86 mm Hg. What action should the nurse take?

Look at the chart for his last potassium level and contact the physician.

The nurse administers furosemide (Lasix) to treat a client with heart failure. Which adverse effect must the nurse watch for most carefully?

Low serum potassium level

A client is experiencing an acute myocardial infarction (MI) and I.V. morphine is prescribed. Morphine is given because it

Lowers resistance, reduces cardiac workload, and decreases myocardial oxygen demand

A client is receiving captopril (Capoten) for heart failure. Which finding indicates that the medication isn't producing the desired treatment outcome and requires the nurse to notify the physician?

Peripheral edema

A client is admitted to the cardiac unit with a diagnosis of heart failure. The physician prescribes furosemide (Lasix) and digoxin (Lanoxin) to manage the condition. Which laboratory value should be monitored during hospitalization?

Potassium