NUR 414 quiz questions throughout semester

V tach interventions

-not appropriate for defibrillation (V fib is appropriate) -assess for carotid pulse -administer amioderone

A client is admitted to the emergency department with crushing chest pain. A diagnosis of acute coronary syndrome is suspected. The nurse expects that the client's initial treatment will include which medication?1Aspirin2Midazolam3Gabapentin4Alprazolam

1Aspirin

A patient with diabetes mellitus is admitted to the hospital with lower back pain. The patient's blood glucose is 563 mg/dL upon admission. Which assessment findings with the nurse most likely note with this blood glucose level?

1. Perspiration.2. Rapid, thready pulse.3. Respiratory depression.4. Tremor.

A nurse mixes a short-acting and an intermediate-acting insulin in the same syringe to administer to a client with diabetes. List the actions in the order the nurse should perform them.

1.Put air into the intermediate-acting insulin vial.2.Put air into the short-acting insulin vial.3.Withdraw the prescribed amount of short-acting insulin.4.Withdraw the prescribed amount of intermediate-acting insulin.

A 10-year-old girl with diabetes joins the school's soccer team. Her mother is unsure whether to tell the coach of her child's condition. The mother asks the school nurse for guidance. On what information should the nurse base the response?1Children with diabetes who participate in active sports can have episodes of hypoglycemia.2Children may have to leave athletic teams if school authorities learn that they have diabetes.3The school nurse will treat the child if clinical findings of hypoglycemia are recognized early.4The coach might violate confidentiality by discussing the child's condition with other faculty members.

1Children with diabetes who participate in active sports can have episodes of hypoglycemia.

A client with type 1 diabetes is diagnosed with diabetic ketoacidosis and initially treated with intravenous (IV) fluids followed by an IV bolus of regular insulin. The nurse anticipates that the health care provider will prescribe a continuous infusion of:1 Novolin L insulin.2 Novolin R insulin.3 Novolin N insulin.4 Novolin U insulin.

2.Regular insulin is the only insulin that is administered intravenously. Novolin L insulin cannot be administered intravenously. Novolin N insulin cannot be administered intravenously. Novolin U insulin cannot be administered intravenously.

A 40-year-old male is prescribed Metformin XL (Glucophage) to control his type 2 diabetes mellitus. Which statement made by this client indicates the need for further education?1"I will take the drug with food."2 "I must swallow my medication whole and not crush or chew it."3 "I will stop taking Metformin for 24 hours before and after having a test involving dye."4 "I will notify my doctor if I develop muscular or abdominal discomfort."

3.Metformin must be withheld for 48 hours before the use of iodinated contrast materials to prevent lactic acidosis. Metformin is restarted when kidney function has returned to normal. Metformin is taken with food to avoid adverse gastrointestinal effects. If crushed or chewed, Metformin XL will be released too rapidly and may lead to hypoglycemia. Muscular and abdominal discomfort is a potential sign of lactic acidosis and must be reported to the health care provider.

A client undergoes cardiac catheterization via the femoral artery. What is the most important nursing action after the procedure?1 Provide a bed cradle2 Check for a pulse deficit3 Elevate the head of the bed4 Assess the groin for bleeding

4 Assess the groin for bleeding

What should the nurse emphasize when teaching insulin self-administration to a 10-year-old child recently diagnosed with diabetes?a) Wash the hands before preparing the insulin injectionb) Shake the bottle of insulin thoroughly before drawing up the dosec) Alternate the sites of the insulin injections among the four extremitiesd) Rub the injection site briskly for half a minute after giving the injection

A Thorough hand washing is the best infection prevention We do want to alternate sites but the preferred sit for self administration of insulin is the abdomen

A patient is diagnosed with primary hypertension. When taking the patient's history, the healthcare provider anticipates the patient will report which of the following?A) "I have not noticed any significant changes in my health."B) Sometimes I get pain in my lower legs when I take my daily walk."C) "Every once in awhile I wake up at night covered in sweat."D) "I'm starting to get out of breath when I go up a flight of stairs."

A) "I have not noticed any significant changes in my health."

The nurse cares for a client with atrial fibrillation and a rate of 123bpm. How does the heart rate affect cardiac output for this client?A. Ventricular filling time is decreasedB. Stroke Volume IncreasesC. Oxygen Demand decreasesD. Ventricular filling time increases

A. Ventricular filling time is decreased

Two hours after a cardiac catheterization that was accessed through the right femoral route, an adult client complains of numbness and pain in the right foot. What action should the nurse take first?Call the primary healthcare provider.Check the client's pedal pulses.Take the client's blood pressure.Recognize the response is expected.

Answer: Check the client's pedal pulses. Rationale:These symptoms are associated with compromised arterial perfusion. A thrombus is a complication of a femoral arterial cardiac catheterization and must be suspected in the absence of a pedal pulse in the extremity below the entry site. A circulatory assessment should be conducted first; the primary healthcare provider may or may not need to be notified immediately concerning the results of the assessment. Taking the client's blood pressure is unnecessary; the symptoms indicate a local peripheral problem, not a systemic or cardiac problem. These symptoms are not expected.

The nurse plans to teach a 7-year-old child with recently diagnosed type 1 diabetes how to give insulin injections. Which would be included in the first lesson?Select all that apply.One, some, or all responses may be correct.

At 7 years of age, a child is curious and ready to learn when a simple explanation is offered. At 7 years,children are able to manipulate objects and learn from doing. Children learn best when learning isinteractive; a return demonstration provides an opportunity for the nurse to evaluate what is learned. Thechild is too young to be given reading materials to take home; readiness for this is determined at futuremeetings as the child gets older and reading skills improve. The presence of friends will be too distracting.

A pt with HTN is being discharged on captopril and spironolactone. What priority discharge teaching should the RN include?A. Be sure to avoid eating grapefruit or drinking grapefruit juiceB. Be sure to avoid salt substitutes that contain potassium chlorideC. Take these medications with foodD. Be sure to include foods high in potassium

B. Be sure to avoid salt substitutes that contain potassium chloride

V fib interventions

CPR and defibrillation

the nurse reviews the health record of a client with coronary artery disease (cad). when assessing client risk, which elevated lab value is the most likely to cause the progression of cad?

Elevated LDL(LOSERS)

What feeding instruction should a nurse give the mother of a 2-month-old infant with the diagnosis of heart failure?

Feed slowly while allowing time for adequate periods of rest.

A client with type 1 diabetes is transported via ambulance to the emergency department of the hospital. The client has dry, hot, flushed skin and a fruity odor to the breath and is having Kussmaul respirations. Which complication does the nurse suspect that the client is experiencing?

Ketoacidosis Ketoacidosis occurs when insulin is lacking and carbohydrates cannot be used for energy; this increases the breakdown of protein and fat, causing deep, rapid respirations (Kussmaul respirations), decreased alertness, decreased circulatory volume, metabolic acidosis, and an acetone breath.

An 85-year-old client with a history of congestive heart failure is experiencing dyspnea with a respiratory rate of 32. Crackles are noted bilaterally. The client is in Sim's position, receiving oxygen at 2 L/min via nasal cannula. Which action would the nurse do first?1) Raise the client to high-Fowler position2) Obtain the apical pulse and blood pressure3) Call the primary health care provider immediately4) Monitor the pulse oximeter to ascertain the oxygen level

Raising the client to high-Fowler position will decrease orthopnea by using gravity to keep fluid in lower extremities, putting less stress on the heart. Obtaining a full set of vital signs would be the next priority after changing the client position. Calling the primary health care provider immediately would not be useful without having a full set of vital signs, which should include the oxygen saturation, which the health care provider would expect the nurse to provide.

A client is admitted to the coronary care unit with atrial fibrillation and a rapid ventricular response. The nurse prepares for cardioversion. What nursing action is essential to prevent the potential danger of inducing ventricular fibrillation during cardioversion?

Synchronizer switch is in the "on" position

A client who is taking an oral hypoglycemic daily for type 2 diabetes develops the flu and is concerned about the need for special care. What should the nurse advise the client?

Take the oral medication, drink fluids, and monitor capillary glucose levels.

The nurse instructs the client admitted for an acute exacerbation of chronic obstructive pulmonary disease (COPD) about the importance of assessing for right-sided heart failure after discharge. What does the nurse instruct the client to assess for

Weight gain. The most common signs and symptoms of right-sided heart failure are hepatomegaly, weight gain, jugular vein distention, and peripheral edema. Clients with right-sided heart failure often have decreased appetites. Clubbing is indicative of hypoxemia. Hypertension is associated with left-sided heart failure.

the nurse cares for a client with type 2 diabetes dependent on insulin. the nurse finds the client shaky, light-headed, and weak with a blood sugar of 61 mg/dL. Which intervention is the best choice for this client?

provide a 1/2 cup of fruit juice PO

A 13-year-old-child with type 1 diabetes is receiving 15 units of Novolin R insulin and 20 units of Novolin N insulin at 7 am each day. At what time should the nurse anticipate a hypoglycemic reaction from the Novolin N to occur?

in the afternoon

A nurse, caring for a client with uncontrolled diabetes, suspects that a client is experiencing hypoglycemia in response to insulin administration. What clinical manifestations lead the nurse to this conclusion? Select all that apply.A) headacheB) confusionC) extreme thirstD) profuse sweatingE) increased urination

A) headache, B) confusion, D) profuse sweating WHY? Neurologic responses occur when there is an insufficient supply of glucose to the brain, thus causing clinical manifestations such as headache and confusion. Profuse sweating is a classic sign of hypoglycemia. This is triggered by lack of glucose to the nerve cells. Thirst (polydipsia) is a classic symptom of hyperglycemia. Increased urination (polyuria) is a classic sign of hyperglycemia.

a client is admitted with heart failure. which lab value supports this diagnosis

BNP-over 100

A client with a coronary occlusion is experiencing chest pain and distress. What is the primary reason that the nurse should administer oxygen to this client?A. Prevent dyspneaB. Prevent cyanosisC. Increase oxygen concentration to heart cellsD. Increase oxygen tension in the circulating blood

C. Increase oxygen concentration to heart cellsAdministration of oxygen increases the transalveolar oxygenngradient, which improves the efficiency of the cardiopulmonary system; this increases the oxygen supply to the heart. Increased oxygen to the heart cells will improve cardiac output, which may or may not prevent dyspnea. Pallor, not cyanosis, is usually associated with MI. Although administrating oxygen will increase oxygen tension in the circulating blood, it is not specific to heart cells, which are hypoxic when there is a MI.

A 12-year-old child with type 2 diabetes is scheduled for abdominal surgery. Which factors are most important for the nurse to consider during the postoperative period?(Select all that apply)Infection will likely occur at the surgical site.Ketoacidosis frequently occurs later in the postoperative period.The blood glucose level will increase because of the stress of surgery.Urine test results are the most useful gauge of diabetic control after surgery.Diabetic control is usually maintained with insulin after surgery.

The blood glucose level will increase because of the stress of surgery. Diabetic control is usually maintained with insulin after surgery. RationaleThe stress of surgery causes the release of epinephrine and glucocorticoids, which increase the blood glucose level. Most individuals with type 2 diabetes who control their diabetes through diet and exercise require insulin during the recovery period. Although the child with diabetes is at risk for infection, surgical aseptic technique should prevent infection. Ketoacidosis is associated with type 1, not type 2, diabetes. Urine test results are affected by many variables and therefore are not reliable indicators of the blood glucose level.

An ECG is prescribed for a client who reports chest pain. What early finding does the nurse expect on the lead over the infarcted area?A. Flattened T wavesB. Absence of P wavesC. Elevated ST segmentsD. Disappearance of Q waves

C. Elevated ST segments