NU308 exam 4 questions

what is the therapeutic goal of heparin APTT therapy

1.5-2.5 x higher

cushing's syndrome vs cushing's disease

Long term corticosteroid therapy cause: syndrome Tumor that stimulates the adrenal gland to release too much: disease

A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make? a."Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level." b."I will call the provider to get a prescription for discontinuing the IV heparin today." c."Both heparin and warfarin work together to dissolve the clots." d."The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay."

a

The nurse is managing care for a patient with cirrhosis of the liver. The nurse teaches the patient about how to avoid injury that may result in bleeding. The patient asks the nurse why he is at risk to start bleeding. What is the best response by the nurse? a. because your liver is injured and cannot make clotting factors b. because your liver is breaking down you clotting factors too quickly c. because your liver is injured and unable to manufacture platelets d. because your liver thickens your blood so it is less likely to clot

a

a nurse is caring for a pt taking warfarin. which food should the nurse instruct the pt to avoid a. cabbage b. cantaloupe c. green beans

a

nurse is education on alendronate effervescent to treat osteoporosis a. sit upright or stand for at least 30 min after b. take this med with food c. take this med with OJ d. chew or suck on tablet

a

pt has DVT and has been on heparin for 5 days. the provider prescribes warfarin with heparin therapy. the pt asks why both are necessary. what should the nurse say a. warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level b. i will call the provider c. both heparin and warfarin work together to dissolve the clots d. IV heparin increases the effects of warfarin and decreases the length of your hospital stay

a

pt taking alteplase. nurse will monitor for which of the following adverse effects a. ecchymoses b. clotting of the pts IV site c. decreased PT/aPTT d. decreased INR

a

risk factors for osteoporosis. which med is a risk factor for osteoporosis a. thyroid hormones b. anticoagulants c.NSAIDS d. cardiac glycosides

a

which of the folloiwng is not dependent on vitamin K a. von willebrand factor b. factor 7 c. factor 9 d. prothrombin

a

the plan of care for a pt receiving Oprelvkin should include monitoring for which adverse effects a. fluid retention b. severe hypotension c. impaired liver function d. severe diarrhea

a careful with heart disease and renal disease pts

pt has hemophilia A and is schedule for wisdom teeth extractions. the nurse should anticipate that the pt will need which product a. recombinant factor b. packed RBCs c. prophylactic antibiotics d. fresh frozen plasma

a hemophilia is missing factor 8

education about iron deficiency anemia to the parents of a toddler. which of the following should the nurse recommend as a method of preventing iron deficiency anemia a. avoid a diet that consists primarily of milk b. administer fat soluble vitamins daily c. include fluoridated water in the toddler's diet d. limit intake of high protein foods

a milk is a poor source of iron

what pt education should be included with enoxaparin select all a. educate to give at home b. educate not to take OTC drugs without talking with a doctor first c. educate to observe for unexplained bleeding e. educate about the importance of drinking grapefruit juice daily

a, b, c

pt taking levothyroxine. what info should the nurse provide select all that apply a. it may take a few weeks for you to see the full fenefits b. do not start a fiver laxative without discussing with PCP c. take your calcium supplement at least 4 hours after d. take this med with your evening meal e. be sure to keep all of your follow-up appointments

a, b, c, e take in morning before breakfast

edcatuion for ferrous sulfate select all that apply a. take the tablets on an empty stomach if possible b. if liquified prep, dilute with water or juice and sip through a straw placed in the back of the mouth c. Crush or dissolve sustained release tablets d. take at bedtime e. increase fluid intake and fiber

a, b, e can stain teeth

The client receives alendronate (Fosamax) as treatment for osteoporosis. The nurse has completed medication education and evaluates learning has occurred when the client makes which statements? select all that apply a. i cannot lie down for 30 min after taking the med b. milk will help with absorption c. i should call the provider if i experience heartburn d. i must take this with a full glass of water e. this med can be taken with or without food

a, c, d

side effects of propylthiouracil include which of the following select all that apply a. leukopenia b. weight loss c. rash d. agranulocytosis e. tachycardia

a, c, d

the pt should report what s/s r/t methimazole select all that apply a. unexplained bruising b. anxiety c.decrease sense of taste d. weight loss e. intolerance to cold f. schedule periodic liver function tests

a, c, e, f signs of hypothyroidism from overtreatment

The nurse plans to teach a class about Alzheimer's disease to a caregiver's support group. What will the best plan by the nurse include? Select all that apply. select all that apply a. depression and aggressive behavior are common b. glutamergic inhibitors are the most common class of drugs c. alzheimer's accounts for 50% of all dementias d. memory difficulties are early s/s e. chronic inflammation of brain may be a cause

a, d, e

then urse i scaring for a pt with diabetes insipidus. she would expect to find which of the following select all that apply a. increase urine output b. increase blood glucose c. pulmonary edema d. hyponatremia e. increase serum osmolality f. increased urine osmolality

a, e

A nurse is assessing a client who has Paget's disease of the bone. Which of the following findings should the nurse expect? (Select all that apply.) a. cranial enlargement b. skeletal pain c. abnormal gait d. cold extremities e. visual loss

a,b,c

alpha secrete what beta cells secrete what

alpha secretes glucagon beta secretes insulin

what drug interferes with thromboxin A2

aspirin

A nurse is assessing a client who has hypoparathyroidism. Which of the following findings should the nurse expect? a. flaccid muscles b. pt report numb hands c. negative Chvostek sign d. pt report of anorexia

b

A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin? a. hemoglobin b. prothrombin time (PT) c. bleeding time d. activated partial thromboplastin time (APTT)

b

A nurse is presenting discharge instructions to a client who has multiple sclerosis (MS). The client reports symptoms of diplopia, dysmetria, and sensory change. Which of the following nursing statements are appropriate? a. wear an eye patch on the right eye b. implement a schedule to include periods of rest c. engage in a vigorous exercise program d. plan to relax in a hot tub spa each day

b

A nurse is teaching a client who taking benztropine to treat Parkinson's disease. The nurse should instruct the client to report which of the following adverse effects? a. excess slaivation d. difficulty voiding c. diarrhea d. slow pulse

b

A nurse is teaching an older adult client who has osteoporosis about beginning a program of regular physical activity. Which of the following recommendations should the nurse make? a. high impact aerobics b. walking briskly c. riding a bike d. stretching exercises

b

The client receives hydroxychloroquine sulfate (Plaquenil). Which test does the nurse tell the client should be done on a regular basis? a. serum K b. eye exams c. serum glucose d. bp

b

a mom is wondering hoe her child dx wich type 1 DM developed te disease. the nurse explains which of the follow is the number 1 cause of type 1 DM a. genetic defect b. autoimmune disorder c. obesity and sedentary lifestyle d. unknown

b

a nurse is providing discharge teaching for a pt who is taking warfarin. which of teh following instructions should the nurse include in the teaching a. mild nosebleeds are common b. use an electric razor c. if a dose of the med is missed, double the next one d. increase fiber intake to reduce the adverse effect of constipation

b

a pt with hemophilia A may receive which of the following medications to treat their condition a. alteplase b. aminocaproic acid c. glycoprotein llb/lla inhibitor d. aspirin

b

pt on clopidogrel. you understand that this drug affects platelet aggregation by preventing the activation of which of the following a. plasminogen b. glycoprotein GP2b/3a c. thromboxane 2 d. prothrombin

b

pt receives radioactive iodine therapy. what ill the best evaluation by the nurse reveal a. the pt could safely become pregnant b. the pt will require thyroid replacement therapy c. the pt does not have to distance herself from others d. the pt will temporarily accomplish the euthyroid state

b

pt taking clopidogrel after a TIA. what is the desired therapeutic effect of this drug a. anti inflammatory and antipyretic b. reduce risk of a stroke from a blood clot c. analgesic and clot dissolving d. stop clots from becoming emboli

b

symptoms of gout are due to a. increase in excretion of uric acid b. buildup of uric acid in blood c. cartilage loss in joints d. decrease in uric acid in the blood

b

teaching pt at high risk for osteoporosis about diet changes to increase calcium level. which food should the nurse advise a. carrots b. broccoli c. cabbage d. potatoes

b

the nurse is caring for a pt reciveing heparin infusion. which of the following meds should the nurse have available to reverse heparin's effects a. vitamin K b. protamine sulfate c. acetylcysteine d. deferasirox

b

which of the following lab values should the nurse monitor for a therpeuti effeect o warfarin a. HgB b. PT c. bleeding time d. APTT

b

planning education for a pt taking epoetin a. eating raw fruits and veggies must be avoided b. the frequent rest period should be taken to avoid excessive fatigue c. skin and mucous membranes should be protected from trauma d. exposure to direct sunlight minimize with sunscreen

b a would be for pts with low WBC c would be for pts with low platelets

pt with hypothyroidism is treated with levothyroxine. what will the best plan by the nurse include for med education a. assess for decreased appetite b. assess for altered sleep pattern c. monitor daily temp d. assess weekly serum blood levels

b can take up to 6 weeks for therapeutic effect

the best monitor for effects from filgrastim will be a. Hgb and Hct b. WBC and ANC count c. serum electrolytes d. RBC count

b filgrastim increases WBC production (ANC is neutrophil count)

which of the folloinw education should the nurse include with clopidogrel a. take this with food b. stop 5 days prior to surgery c. take this med 3x a day d. expect to have black colored stool

b prevent excessive bleeding, hemorrhage black stool is adverse effect

a nurse is doing a physical assessment with a pt with early osteoarthritis. which should the nurse expect a. symmetric joints affected b. pain worsens with activity c. weight loss d. ulnar deviation

b symmetric is RA, weight loss and anorexia, and ulnar deviation is RA

The nurse teaches a class about muscle movement to a group of patients who have neuromuscular disorders. What will the best plan of the nurse include? select all that apply a. body movement depends on an intact spinal cord b. body movement depends on proper functioning of muscles c. body movement depends on intact nerves d. body movement depends on proper endocrine functioning e. body movement depends on LOC

b, c

A patient reports having "arthritis." The nurse would determine that the patient's arthritis is rheumatoid arthritis if which findings are reported by history? select all that apply a. joint pain b. frequent fever c. pulmonary disease d. pericarditis e. inflammation in joints

b, c, d

diabetes insipidus will have which of the following findings select all that apply a. increased urine specific gravity b. increased serum Na c. decreased urine osmolality d. increased serum osmolality ed. decreased urine output

b, c, d

pt taking prednisone for rash treatment. what other regiments could the nurse suggest to achieve the smallest adverse effects select all that apply a. start with a small dose and work up to desired dose b. administer larger dose for a few days than gradually decrease c. use a topical application d. administer the doses IM e. give oral meds every other day

b, c, d

which of the following therapeutic drug classifications will either decrease the formation of clots or promote the removal of existing clots a. hemostatic b. antiplatelet c. thrombolytic d. anticoagulant

b, c, d

the nurse understands that there are adverse effects when pts take steroids for a long period of time which of the following? select all a. weight loss b. increased SI c. develop peptic ulcers d. cataract development e. muscle wasting f. increase serum glucose

b, c, d, e, f

which of the following adverse effects should the pt report to the provider while taking alendronate select all that apply a. tinnitus b. jaw pain c. blurred vision d. drowsiness e. dysphagia

b, c, e

pt taking cyanocobalamin injections. which of the following statements demonstrates an understnding of the teaching select all that apply a. i need to be careful to aovid infections b. i will neeed to take this drug for the rest of my life c. i should increase my intake of food that contain vitamin B12 d. take the liquird prep through a straw e. I may be able to switch over to nasal spsrays once my B12 levels are normal

b, e

long term adverse effects with corticosteroid therapy

behavioral changes, eye changes, immune response, metabolic changes, myopathy, osteoporosis, peptic ulcers

A child has rickets and is being treated at the clinic. In addition to taking vitamin D as prescribed, what is the best information the nurse can provide? a. avoid dairy products while taking vitamin D b. be sure to take brand name c. spend at least 20 in per day in sunlight d. take it on an empty stomach

c

A nurse is caring for a client who has a new prescription for ferrous sulfate tablets twice daily for iron-deficiency anemia. The client asks the nurse why the provider instructed that she take the ferrous sulfate between meals. Which of the following responses should the nurse make? a. taking this med between meals will help you avoid becoming constipated b. taking the med with food increases risk of esophagitis c. taking the med between meals will help you absorb the med more efficiently d. the med can cause nausea if taken with food

c

A nurse is caring for a client who has osteoporosis and takes a daily calcium supplement. Which of the following adverse effects of calcium should the nurse suspect when the client reports having flank pain? a. hepatitis b. hip fracture c. renal stones d. pancreatitis

c

A nurse is caring for an antepartum client who has iron-deficiency anemia. When teaching the client about nutrition, the nurse should emphasize the need for an increased intake of which of the following foods? a. whole grain bread b. fresh fruit c. red meat and organ meat d. milk and cheese

c

A nurse is teaching a client who has a new diagnosis of hyperparathyroidism. The nurse should include in the teaching that the client is at risk for which of the following complications? a. impaired skin integrity b. fluid retention c. pathologic fractures d. dysphagia

c

Heat sensitivity, spasticity, and visual impairment are symptoms most likely associated with which disorder? a. Parkinson's b. Alzheimer's c. MS d. amyotrophic lateral sclerosis

c

The client takes a bisphosphonate for osteoporosis. Which assessment is best in determining the effectiveness of the medication? a. normal serum Ca levels b. absence of fractures c. bone density scan d. absence of bone pain

c

The patient is diagnosed with Parkinson's disease. The patient's wife asks the nurse how taking medicine will help her husband. What is the best response by the nurse? a. the medications will help prevent muscle wasting b. the meds will boost his appetite and energy c. the meds will help you husbands to eat and walk d. the meds will balance serotonin and acetylcholine

c

The patient receives donepezil (Aricept) as a treatment for Alzheimer's disease. Which laboratory test(s) will the nurse primarily assess? a. serum amylase levels b. CBC c. liver function test d. pulmonary function test

c

a nurse is caring for a pt who has thrombophlebitis and is reciving heparin by IV. the pt asks the nurse how long it will take for the heparin to dissolve the clot. which of the following responses should the nurse give a. it usually takes hepatin 2-3 days to reach a therapeutic blood level b. a pharmacist is the person to answer that question c. heparin does not dissolve clots, it stops new clots from forming d. the oral med you will take after will dissolve the clot

c

aspirin causes anticoagulant effects by inhibiting which of the following a. plasminogen b. prothrombin c. thromboxane 2 d. glycoprotein llb

c

pt has devleoped agranulocytosis from taking propylthiouracil to treat hyperthyroidism. the nurse knows that this pt is at risk for which condition a. excessive bleeding b. ecchymosis c. infection d. hyperglycemia

c

the nurse is caring for a pt who is taking Oprelvekin. the nurse will monitor which of the following labs to evaluate effectiveness of medication a. total WBC count b. absolute neutrophil count c. platelet count d. hemoglobin

c

the nurse is instrucing a group of pts about which of the following is a trigger for the formation of vitamin D a. calcium b. vitamin A depletion c. exposure to sunlight d. weight bearing exercise

c

the nurse would monitor a pt with pernicious anemia for which of the following s/s a. dark stool b. bradycardia c. numb or tingling extremities d. flushing

c

which change is a common adverse effect of cyclobenzaprine a. alopecia b. tongue swelling c. drowsiness d. hypotension

c

which finding is a s/s of Cushing's syndrome a. hypoglycemia b. increased bone mass c. fat deposits on neck and face d. increased wound healing

c

which med prescribed to prevent osteoporosis. a. levothyroxine b. calcitonin c. raloxifene d. allopurinol

c

which health promotion should thenurse recommend as possible prevention for osteoporosis a. increase Na intake b. have a bone-density scan each year c. engage in weight bearing exercise regularly d. drink a cup of coffee

c bone scans do not prevent

which of the following spinal deformities should the nurse expect to find a. lordosis b. ankylosis c. kyphosis d. scoliosis

c forward, stooping posture, loss of height with age

pt has osteoporosis and takes a daily Ca supplement. which of the following adverse effects of calcium should the nurse suspect when the client report of flank pain a. hepatitis b. hip fx c. renal stones d. pancreatitis

c increase water intake

education for methimazole a. you may feel your heart beating fast b. call the clinic if you are having trouble sleeping c. it is important to schedule periodic liver function tests d. you may experience a weight loss while taking this med

c looking for signs of hypothyroid

a pt with DVT is taking heparin infusion and will be started on warfarin soon. what lab test will provide the nurse with info about its therapeutic effects a. PT b. INT c. APTT d. platelet count

c warfarin would be a & b

pt with hyperthyroidism. the nurse teaches the pt to avoid which food selection a. high calorie b. caffeine free soda c. soy sauce d. milk products

c will need high calories due to weight loss soy can interact with absorption of thyroid meds (soy sauce, soy milk)

a nurse is administering heparin. which of the following action should the nurse plan to take a. use a 22 gauge needle b. use a 1-in needle c. inject the medication into the abdomen above the iliac crest d. massage the injection site after administration

c will use 3/8 in, 25 gauge needle

The nurse would plan to most closely observe which patients for the development of liver toxicity after dantrolene (Dantrium) is initiated. select all that apply a. A 60-year-old man with pneumonia. b. An 18-year-old who injured his leg playing soccer. c. A 49-year-old woman who has a history of esophagitis. d. A 38-year-old woman who has type 2 diabetes e. A 26-year-old woman who has an ostomy

c, d

the posterior pituitary is responsible for secreting which of the following hormones select all that apply a. corticotropin releasing hormone b. ACTH c. ADH d. oxytocin e. thyroid stimulating hormone

c, d

A nurse is monitoring a client who is receiving epoetin alfa for adverse effects. The nurse should identify which of the following findings as an adverse effect of this medication? select all that apply a. edema b. blurred vision c. headache d. hypertension e. thrombosis f. leukocytosis

c, d, e

The nurse is administering a glucocorticoid. The nurse knows that all of the following may be effects of glucocorticoids, EXCEPT? select all that apply a. suppression of the immune system b. possible development of cushing syndrome c. decreased blood glucose d. increase breakdown of protein e. increase of the matrix in bones

c, e

A nurse is caring for a client who the provider suspects might have pernicious anemia. The nurse should expect the provider to prescribe which of the following diagnostic tests? a. sweat test b. haptoglobin c. antinuclear antibodies d. Schilling test

d

A nurse is planning care for a client who has pernicious anemia. Which of the following interventions should the nurse plan to implement? a. Vitamin B6 supplement b. blood transfusion c. iron supplement d. Vitamin B12 injections

d

A nurse is providing teaching to the family of a client who has Parkinson's disease. Which of the following information should the nurse include in the teaching? a. a leave the TV on b. speak loudly to the pt c. limit pt physical activity d. provide pt supervision

d

The client receives alendronate (Fosamax) as treatment for osteoporosis. Which symptoms, caused by an adverse effect of the medication, does the nurse teach should be reported to the physician? a. ringing ears b. hot dry skin c. vision changes and photophobia d. muscle spasms and facial twitching

d

The patient is started on a medication to treat a neuromuscular disorder. What does the nurse teach as the primary therapeutic goal of the medication? a. to stop muscle spasms b. to improve pts appearance c. to promote exercise in pt d. to allow the pt increased independence

d

the nurse would find which assessment on a pt taking hydrocortisone a. hypotension b. weight loss c. hypothermia d. hypertension

d

the process of fibrinolysis is to a. increase blood flow b. promote enzymes c. stop blood flow d. remove blood clot

d

A patient is diagnosed with multiple sclerosis. What symptoms will the nurse most likely assess in this patient? Select all that apply. a. slow shuffling gait b. progressive chorea c. atrophy of hands and legs d. muscel weakness e. difficulty maintaining balance

d, e

a pt with vitamin B12 deficiency will most likely have what other deficiency

folate deficiency

what assessment dat best indicated the pts is adhering to DM type 1 treatment the best?

hemoglobin A1C

what organ produces our clotting factors?

liver

morphology of pernicious anemia and folate-deficiency anemia

macrocytic-normochromic large, abnormally shaped with normal hemoglobin concentration

Morphology of iron deficiency anemia

microcytic-hypochromic small, abnormally shaped with decreased hemoglobin concentration

what are the 2 types of corticosteroids released from the adrenal cortex

mineralcorticoids and glucocorticoids

morphology of aplastic anemia, hemorrhagic anemia, sickle-cell, and hemolytic anemia

normocytic-normochromic destruction or depletion of normal erythroblasts or mature RBCs

what lab test would you check with enoxaparin sodium administration

platelet count because it can cause thrombocytopenia

a pt taking antineoplastics will have what bleeding disorder and show what s/s

thrombocytopenia from bone marrow suppression will show excessive bleeding (cannot clot)