NURS 142 Exam 2 Modules 7&10 NCLEX
Which of the following are actions that can be taken to decrease drug resistance? (Select all that apply): a. Vaccination b. Specific antimicrobial agents c. Utilize experts d. Treat both infections and viruses with antibiotics e. Use vancomycin as a first line of defense f. Isolate the pathogen
All but (d) and (e) Viral infections should not be treated with antibiotics Vancomycin should be used as a last resort
A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by the nurse? a. "Inject this insulin with your first bite of food, because it is very fast acting." b. "The duration of action for this insulin is about 8 to 10 hours, so you'll need a snack." c. "This insulin needs to be mixed with regular insulin to enhance the effects." d. "To achieve tight glycemic control, this is the only type of insulin you'll need."
a. "Inject this insulin with your first bite of food, because it is very fast acting." Source: evolve.elsevier.com Ch 57
A HCP prescribes an antibiotic to be administered via IV piggyback Q12H. At what time should the nurse schedule a blood sample to be drawn to determine a trough level when the drug is administered at 1400? a. 0130 b. 0230 c. 1500 d. 2000
a. 0130 The blood level of an antibiotic is at its lowest level just before the next scheduled dose Source: Test Success 6th edition, p. 327
The nursing student is about to administer a IM injection and asks the instructor which size gauge they should use. The nurse responds: a. 22 gauge b. 27 gauge c. 28 gauge d. 29 gauge
a. 22 gauge IM injections should be administered using a wider 18-25 gauge needle
Diabetes Mellitus is BEST defined as: a. A chronic metabolic disorder marked by hyperglycemia b. An acute metabolic disorder marked by hypoglycemia c. Failure of the pancreas to produce insulin d. Insulin resistance, with inadequate insulin secretion to sustain normal metabolism
a. A chronic metabolic disorder marked by hyperglycemia c is a definition of Type I DM d is a definition of Type II DM
A nurse on a surgical unit routinely assesses patients' incisions as part of postoperative care. After surgery, when should the nurse be alert for clinical signs of wound infection? a. Between days 3 and 5 after surgery b. Between days 1 and 2 after surgery c. Within 24 hours after surgery d. 7 days after surgery
a. Between days 3 and 5 after surgery Microorganisms in a wound can precipitate and infection, which manifests itself in 3 to 5 days; erythema, pain, edema, chills, fever and purulent drainage indicate infection Source: Test Success 6th edition, p. 293
A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should include which of these outcomes related to the therapeutic effects of the medication? a. Blood glucose control for 24 hours b. Mealtime coverage of blood glucose c. Less frequent blood glucose monitoring d. Peak effect achieved in 2 to 4 hours
a. Blood glucose control for 24 hours Source: evolve.elsevier.com Ch 57
Before administering metformin [Glucophage], the nurse should notify the prescriber about which laboratory value? a. Creatinine (Cr) level of 2.1 mg/dL b. Hemoglobin (Hgb) level of 9.5 gm/dL c. Sodium (Na) level of 131 mEq/dL d. Platelet count of 120,000/mm3
a. Creatinine (Cr) level of 2.1 mg/dL Metformin can reach toxic levels in individuals with renal impairment, which is indicated by a rise in the serum creatinine level. The prescriber may have to be notified of the hemoglobin, sodium, and platelet values, but they would not affect the administration of metformin. Source: evolve.elsevier.com Ch 57
All of the following drugs weaken the bacterial cell wall, EXCEPT: a. Fluoroquinolones b. Penicillins c. Cephalosporins d. Glycopeptides
a. Fluoroquinolones These drugs disrupt DNA replication and cell division
Which of the following antimicrobial drugs is effective in treating gram-negative aerobes? a. Gentamicin b. Erythromycin c. Rifampin d. Ciproflaxin
a. Gentamicin Lehne, p.1002
What group of medications has the highest risk for a drug interaction with digoxin (Lanoxin)? a. Glucocorticoids b. Sulfonamides c. Antibiotics d. Antacids
a. Glucocorticoids Glucoccorticoids can precipitate hypokalmeia even if digoxin serum levels are in the therapeutic range of 0.5-2.0 ng/mL Source: Test Success 6th edition, p.326
A pt receiving chemo treatment experiences nausea and vomits during the procedure. This is best defined as which kind of infection? a. Iatrogenic b. Communicable c. Nosocomial d. Superinfection
a. Iatrogenic
All of the following are true statements regarding Metformin, EXCEPT: a. It should be used carefully on its own as it may cause severe hypoglycemia b. The most common side effects are GI disturbances c. It is well suited for pts who tend to skip meals d. It is not metabolized
a. It should be used carefully on its own as it may cause severe hypoglycemia Metformin does not drop blood glucose levels. Lehne, p 684 Rationale for (d): Metformin is slowly absorbed from the small intestine. It is not metabolized; it is excreted unchanged by the kidneys; in the event of renal impairment, Metformin can accumulate to toxic levels
Typically __________ is started immediately after the diagnoses of Type 2 diabetes. a. Metformin b. Pramlinitide c. Nateglinide d. Glimepiride
a. Metformin Metformin (a Biguanide) decreases glucose production by the liver and increases tissue response to insulin
One of your pts is receiving Gentamicin. What is the most important assessment that should be done on the pt? a. Peak and Trough b. Reaction to medication c. Heart dysrhythmias d. Tooth discoloration
a. Peak and Trough
The nurse identifies which statements about penicillins as true? (Select all that apply.) a. Penicillins are the safest antibiotics available. b. The principal adverse effect of penicillins is allergic reaction. c. A patient who is allergic to penicillin always has a cross-allergy to cephalosporins. d. A patient who is allergic to penicillin is also allergic to vancomycin, erythromycin, and clindamycin. e. Penicillins are normally eliminated rapidly by the kidneys but can accumulate to harmful levels if renal function is severely impaired.
a. Penicillins are the safest antibiotics available. b. The principal adverse effect of penicillins is allergic reaction. e. Penicillins are normally eliminated rapidly by the kidneys but can accumulate to harmful levels if renal function is severely impaired. Source: evolve.elsevier.com Ch 84
When ceftriaxone is administered intravenously, it is most important for the nurse to avoid mixing it with what? a. Ringer's lactate b. Normal saline c. Sterile water d. D5 0.45% NS
a. Ringer's lactate Mixing ceftriaxone with calcium causes precipitates to form. Ringer's lactate contains calcium; therefore it should not be mixed with ceftriaxone. It is safe to mix normal saline, sterile water, and D5 0.45% NS with ceftriaxone. Source: evolve.elsevier.com Ch 85
A nurse should teach a patient to observe for which side effects when taking ampicillin? a. Skin rash and loose stools b. Reddened tongue and gums c. Digit numbness and tingling d. Bruising and petechiae
a. Skin rash and loose stools Ampicillin's most common side effects are rash and diarrhea; both reactions occur more frequently with ampicillin than with any other penicillin. Reddened tongue and gums, digit numbness and tingling, and bruising and petechiae are not associated side effects of ampicillin. Source: evolve.elsevier.com Ch 84
A nurse is caring for patients with a variety of wounds. What type of wounds heal by primary intention? Select all that apply. a. Surgical incision b. Excoriation c. Deep burn d. Paper cut e. Abrasion
a. Surgical incision d. paper cut Source: Test success 6th edition, p. 295
The nurse should question an order for glucocorticoids in the treatment of a patient with what? a. Systemic fungal infection b. Diabetes mellitus c. Myasthenia gravis d. Glaucoma
a. Systemic fungal infection Glucocorticoids are contraindicated in the treatment of a patient with a systemic fungal infection or in patients receiving live vaccines. Glucocorticoids should be used with caution in patients with diabetes mellitus, myasthenia gravis, and glaucoma. Source: evolve.elsevier.com Ch 72
A nurse irrigates the wound of a pt on contact precautions. What should the nurse do FIRST to remove PPE when leaving the pt's room? a. Untie the gown at the waist b. Untie the gown at the neck c. Remove the gloves d. Remove the mask
a. Untie the gown at the waist The waist is considered contaminated and should be untied with a gloved hand. Gloves should be removed next Then the neck of the gown should be untied Finally, the mask is removed by only touching the ties Source: Test Success 6th edition, p. 303
Red man syndrome is an undesirable effect most associated with which of the following antimicrobials? a. Vancomycin b. Gentamycin c. Ampicillin d. Levofloxacin
a. Vancomycin
A wound that proceeds through an orderly and timely reparative process that results in sustained restoration of anatomical and functional integrity best describes: a. acute wound b. chronic wound c. tertiary wound d. secondary wound
a. acute wound
Prolonged glucocorticoid use causes which of the following: a. adrenal insufficiency b. hepatatoxicity c. ototoxicity d. nephrotoxicity
a. adrenal insufficiency Lehne, p. 876
The nurse has an order from the doctor to pack a pt's wound. The first step in packing a wound is to: a. assess its size, depth and shape b. not pack the wound too tight c. make sure the type of material used to pack the wound is appropriate d. describe the steps of the procedure to the pt
a. assess its size, depth and shape Potter and Perry, p. 1204
Which of the following is true of Microangiopathy? a. It only affects those with Diabetes Mellitus b. It can affect anyone c. It affects the arteries and the veins d. It can cause peripheral vascular disease (PVD)
a. it only affects those with Diabetes Mellitus The rest of the options all apply to Macroangiopathy
When assessing the skin of a 70 y/o Caucasian male for signs of pressure ulcer formation, you find the skin on the bottom of the heels to be blanched. Blanching occurs when: a. the normal red tones are absent b. color remains unchanged when pressure is applied c. the normal red tones are present d. the localized area of the skin is purple/blue
a. the normal red tones are absent options (c) and (d) are characteristics of dark skin with impaired integrity Potter and Perry, p. 1178 Box 48-2
Which instructions should a nurse provide to a patient who is to start taking amoxicillin/clavulanate [Augmentin]? a. "Take Augmentin once per day and only at bedtime." b. "Augmentin may be taken with food or meals." c. "Avoid taking Augmentin with grapefruit juice." d. "Use a minimal amount of liquid to swallow the Augmentin."
b. "Augmentin may be taken with food or meals." Source: evolve.elsevier.com Ch 84
Which instruction should a nurse include in the discharge teaching for a patient who is to start taking tetracycline? a. "You may stop taking the pills when you begin to feel better." b. "Use sunscreen and protective clothing when outdoors." c. "You'll have to come back to the clinic for weekly blood work." d. "Take the medication with yogurt or milk so you won't have nausea."
b. "Use sunscreen and protective clothing when outdoors." Tetracyclines are bacteriostatic antibiotics; photosensitivity and severe sunburn are common adverse effects. Source: evolve.elsevier.com Ch 86
The nurse is preparing to administer potassium chloride, 20 mEq in 100 ml solution over 2 hours. The IV tubing has a drip rate of 15 gtt// ml. What is the drip rate? a. 10 gtt/minute b. 13 gtt/minute c. 15 gtt/minute d. 20 gtt/minute
b. 13 gtt/minute 100 ml/120 minutes x 15 gtt/ml = 12.5 gtt/minute A half drip is impossible, so rounded up, the answer becomes 13 gtt/minute
Which generation of the cephalosporins have increased action on gram negative bugs? a. Ceftriazone b. Cefuroxime c. Cephalexin d. Cefepime
b. Cefuroxime 2nd generation
A pt has complaints of diarrhea, gastroparesis, anorexia, decreased libido and urinary retention. Based off of these findings, your pt likely has: a. Microangiopathy b. Diabetic Neuropathy c. UTI d. Macroangiopathy
b. Diabetic Neuropathy
A pt is going to see their doctor to see if they may have diabetes. The doctor wants to run some tests and tells the pt not to eat anything for 12 hours before their appointment. The pt is most likely going to take which of the following tests? a. Random plasma glucose test (RPG) b. Fasting Plasma Glucose (FPG) c. Oral Glucose Tolerance Test (OGTT) d. A1c (HbA1c)
b. Fasting Plasma Glucose (FPG)
A nurse is caring for a pt with an infection. For which MOST common response to infection should the nurse assess the pt? a. Anorexia b. Fever c. Headache d. Dehydration
b. Fever Fever is the mot common response of the hypothalamus (thermoregulatory center) to pyrogens that are released when phagocytic cells respond to the presence of pathogens Source: Test Success 6th edition, p. 303
Which antimicrobrial drug can put you at increased risk of tendon rupture? a. Cyclic Lipopeptides b. Fluroquinolones c. Ketolides d. Aminoglycosides
b. Fluroquinolones
A pt is receiving prednisone, a glucocorticoid. For what response should the nurse monitor the pt's electrolytes? a. Hypokalemia and hyponatremia b. Hypokalemia and hypernatremia c. Hyperkalemia and hyponatremia d. Hyperkalemia and hypernatremia
b. Hypokalemia and hypernatremia Prednisone, a glucocorticoid, has significant water-and sodium-retaining (mineralocorticoid) activities. As sodium is retained, potassium is depleted Source: Test Success 6th edition, p.325
A nurse is teaching a pt about how to prevent infection. Which of the following BEST increases a pt's defense against microorganisms? a. Covering a cough b. Maintaining intact skin c. Changing bed linen daily d. Using an antiseptic mouthwash
b. Maintaining intact skin The skin is a barrier to pathogens and, if pierced or broken, serves as a portal of entry Source: Test Success 6th edition, p. 302
A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse expect the patient to have if the medication is achieving the desired therapeutic effect? a. Inhibition of carbohydrate digestion b. Promotion of insulin secretion c. Decreased insulin resistance d. Inhibition of ketone formation
b. Promotion of insulin secretion Source: evolve.elsevier.com Ch 57
All of the following are true of autolytic debridement, EXCEPT: a. Requires moist wound free of infection b. Requires extensive technical skill c. Requires adequate nutrition and circulation d. Painless
b. Requires extensive technical skill Autolytic debridement requires limited technical skill
The development of a new infection as a result of the elimination of normal flora by an antibiotic is referred to as what? a. Resistant infection b. Superinfection c. Nosocomial infection d. Allergic reaction
b. Superinfection Source: evolve.elsevier.com Ch 83
Your pt has been prescribed Erythromycin (E-mycin) for pneumonia. Which of the following instructions would you want to insure you included in the discharge plan? a. Take the medication on an empty stomach b. Take the medication with meals c. Avoid milk while taking this medication d. Notify your physician if you notice ringing in your ears, as this may be a sign of ototoxicity
b. Take the medication with meals Macrolides have a SE of GI upset
The nurse knows that there is an increased risk of ototoxicity in a patient receiving an aminoglycoside if which level is high? a. Concentration b. Trough c. Peak d. Dose
b. Trough When trough levels remain elevated, aminoglycosides are unable to diffuse out of inner ear cells, thus exposing the cells to the medication for an extended time. Prolonged exposure (ie, high trough levels), rather than brief exposure to high levels, underlies cellular injury. Source: evolve.elsevier.com Ch 87
The inflammatory phase is prolonged if too little inflammation occurs and if too much inflammation occurs. Too much inflammation prolongs the healing process because: a. it suppresses the immune system b. arriving cells compete for available nutrients c. it expends too much energy d. the increased metabolic energy requirements cause weight loss
b. arriving cells compete for available nutrients Potter and Perry, p. 1182
Pt's with Diabetes Mellitus are at increased risk of infection due to all of the following, EXCEPT: a. increased blood glucose levels b. decreased immune function c. impaired inflammatory process d. delayed detection
b. decreased immune function
The principle use of hydrogen peroxide is: a. protection of central venous catheters b. disinfection and sterilization of instruments c. preoperative preparation of the skin d. sterile storage of instruments and supplies
b. disinfection and sterilization of instruments Lehne, p.1178
Which of the following debridement methods requires a prescription? a. autolytic b. enzymatic c. mechanical d. surgical
b. enzymatic
The results of your pt's Glycosylated Hemoglobin (HbA1C) tests have come back. The results show that the HbA1C is 5.6 and you inform your pt that they: a. need to see a diabetic specialist as they fall into the pre-diabetes range b. have nothing to worry about, their HbA1C is within normal limits c. have diabetes d. with diet and exercise, will be able to decrease their HbA1C so it is within normal limits
b. have nothing to worry about, their HbA1C is within normal limits <5.7 Non-Diabetic Range 5.7-6.4 Pre-Diabetes ≥6.5 Diabetes
All of the following corticosteroids are intermediate acting EXCEPT: a. methylprednisolone b. hydrocortisone c. prednisone d. triamcinolone
b. hydrocortisone this is a short acting corticosteroid Lehne, p. 870
A wound has healed by granulation tissue formation, wound contraction and epithelialization. Which wound classification does this implication for healing fall under?: a. Partial-Thickness b. secondary c. primary d. tertiary
b. secondary Potter and Perry, p. 1180 Table 48-1
Your pt is four days post-op from abdominal surgery and has recently vomited. Because of this, the abdominal suture has become dehiscenced, which means: a. there has been a protrusion of visceral organs through the wound layers b. there is partial separation of wound layers c. the edges of the wound appear inflammed d. there is a localized collection of blood underneath the tissues.
b. there is a partial separation of wound layers Potter and Perry, p. 1184
The RN has recently administered Novolin R subcutaneously to their diabetic pt. When should the RN expect this drug to peak? a. 15-30 min b. 30-60 min c. 2-5 hours d. 5-10 hours
c. 2-5 hours
The RN has just administered Insulin glulisine (Apidra) to his pt. Knowing that this drug has a short duration and is rapid acting, he should expect to see the drug last for: a. 1-3 hours b. 30min-2 hours c. 3-6 hours d. 4-14 hours
c. 3-6 hours
An antimicrobial medication that has selective toxicity has which characteristic? a. Ability to transfer DNA coding b. Ability to suppress bacterial resistance c. Ability to avoid injuring host cells d. Ability to act against a specific microbe
c. Ability to avoid injuring host cells Source: evolve.elsevier.com Ch 83
When providing patient teaching for oral sulfonamide therapy, the nurse should instruct the patient to take the sulfonamide in what way? a. At mealtime, when food is available b. With soy or nonmilk products c. Between meals with a full cup of water d. On awakening before breakfast
c. Between meals with a full cup of water Oral sulfonamides should be taken on an empty stomach and with a full glass of water. To minimize the risk of renal damage, adults should maintain a daily urine output of 1200 mL. Sulfonamides should not be taken with soy or nonmilk products or food or before breakfast without liquids. Source: evolve.elsevier.com Ch 88
A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which action should the nurse take? a. Take the patient's blood pressure. b. Give the patient's PRN dose of insulin. c. Check the patient's capillary blood sugar. d. Advise the patient to lie down with the legs elevated.
c. Check the patient's capillary blood sugar Source: evolve.elsevier.com Ch 57
What intervention is unique to a Hemovac of Jackson-Pratt drain, one that is different from a T-tube or an indwelling catheter? a. Assess characteristics of the effluent b. Maintain patency of the conduit c. Ensure negative pressure d. Measure output
c. Ensure negative pressure Portable wound drainage systems work by continuous low pressure as long as the suction bladder is less than half full; T tubes and indwelling urinary catheters work via gravity Source: Test Success 6th edition, p. 293
When administering prednisone to a patient, the nurse will do what? a. Administer the prednisone in the evening to coincide with the natural secretion pattern of the adrenal cortex. b. Instruct the patient to stop taking the prednisone immediately if diarrhea develops. c. Ensure that meals are at bedside so that administration with food reduces gastric irritation. d. Avoid intravenous delivery to prevent adverse effects.
c. Ensure that meals are at bedside so that administration with food reduces gastric irritation. Source: evolve.elsevier.com Ch 72
A nurse initiates contact precautions for a pt with a wound infection. What should the nurse do to best help the pt cope with the psychological aspects of these precautions? a. Draw a smiley face on the mask b. Don gloves when providing direct care c. Explain the importance of contact precautions d. Wear a gown only when direct contact is expected
c. Explain the importance of contact precautions Option (a) is creepy Option (b) does not address psychological needs Option (d) does not address psychological needs and a gown must be worn at all times in the room Source: Test Success 6th edition, p. 302
Which of the following antibiotics is contraindicated in pt's diagnosed with Myasthenia Gravis? a. Cephalosporins b. Tetracyclines c. Fluoroquinolones d. Sulfonamides
c. Fluoroquinolones These drugs have a side effect of tendon rupture
Vancomycin belongs to which class of antibiotics? a. Cephalosporins b. Macrolides c. Glycopeptides d. Sulfonamides
c. Glycopeptides
A nurse monitors a patient who is receiving an aminoglycoside (gentamicin) for symptoms of vestibular damage. Which finding should the nurse expect the patient to have first? a. Unsteadiness b. Vertigo c. Headache d. Dizziness
c. Headache Gentamicin causes irreversible ototoxicity, which results in both impaired hearing and disruption of balance. Headache is the first sign of impending vestibular damage (balance) and may last 1 to 2 days. Unsteadiness, vertigo, and dizziness appear after headache. Source: evolve.elsevier.com Ch 87
After assessing a 7 year old boy his mother informs you that he was born with PKU. Knowing which drug is contraindicated with use in PKU, you know NOT to give which of the following: a. Dicloxacillin b. Sulfamethoxazole c. Linezolid d. Getamycin
c. Linezolid
A patient is receiving vancomycin [Vancocin]. The nurse identifies what as the most common toxic effect of vancomycin therapy? a. Ototoxicity b. Hepatotoxicity c. Renal toxicity d. Cardiac toxicity
c. Renal toxicity The most common toxic effect of vancomycin [Vancocin] therapy is renal toxicity. Although ototoxicity may occur, it is rare. The liver and heart are not affected when vancomycin is used. Source: evolve.elsevier.com Ch 85
All of the following drugs are inhibitors of cell wall synthesis EXCEPT: a. Penicillin b. Cephalosporin c. Tetracycline d. Vancomycin
c. Tetracycline This drug is a bacteriostatic inhibitor of protein synthesis Lehne, p.1003
What is the main function of Thiazolidinediones? a. They inhibit slow digestion of starches b. They help your pancreas make more insulin c. They help body cells use insulin better d. They help the liver make extra sugar when it's needed
c. They help body cells use insulin better
All of the following can cause hyperglycemia, EXCEPT: a. Eating too much b. Illness c. Too much insulin d. Car accident
c. Too much insulin Hyperglycemia can result from too LITTLE insulin A stressful event (such as a car accident or hospitalization) can cause hyperglycemia--taken from lecture notes
On assessing your patient's sacral pressure ulcer, you note that the tissue over the sacrum is dark, hard, and adherent to the wound edge. What is the correct stage for this patient's pressure ulcer? a. Stage II b. Stage IV c. Unstageable d. Suspected deep tissue damage
c. Unstageable Potter and Perry, Ch 48
This type of antibiotic is reserved for those who are allergic to penicillin. The most troublesome side effect is Red Man Syndrome. Which of the following drug fits this description? a. Dicloxacillin (Dycill) b. Gentamycin (Garamycin) c. Vancomycin (Vancocin) d. Doxycline (Vibramycin)
c. Vancomycin (Vancocin)
Before the RN administers her pt's insulin, HumuLIN R, the nurse needs to ensure that her pt: a. eats their next meal within 5-15 minutes b. takes the insulin with a meal c. eats their next meal within 30-40 minutes d. has already had their meal and it has been 10-30 minutes
c. eats their next meal within 30-40 minutes
A stage III pressure ulcer is best described as: a. having sucbcutaneous fat and muscle exposed b. bone and tendon are likely visible c. full-thickness tissue loss d. partial-thickness tissue loss
c. full-thickness tissue lost A stage III pressure ulcer will NOT have bone, tendon or muscle exposed A partial-thickness tissue loss is a stage II pressure ulcer Potter and Perry, p. 1179
The MAIN function of insulin is to: a. raise blood glucose levels b. help utilize sugar as energy c. help get glucose inside of cells d. stimulate hepatic production of glucose
c. help get glucose inside of cells
A pt has been prescribed telithromycin (Ketek). Which of the following side effects is most common with this drug? a. ototoxicity b. nephrotoxicity c. hepatotoxicity d. photosensitivity
c. hepatotoxicity Lehne 1044
Which of the following is an abnormal finding when assessing a primary intention wound?: a. Drainage present on day two post-op b. inflammation on day four post-op c. no epithelialization of wound edges by day 5 d. no healing ridge by day 8
c. no epithelialization of wound edges by day 5 epithelialization of wound edges should occur by day 3 a. drainage present MORE than 3 days is abnormal b. inlammation INCREASED in first 3-5 days is abnormal d. no healing ridge by day 9 would be abnormal Potter and Perry, p. 1190
When treating inflammatory and allergic disorders with glucocorticoids, the goal is to: a. keep the dosage as low as possible b. suppress rejection of organ transplant c. suppress signs and symptoms to an acceptable level d. eliminate signs and symptoms
c. suppress signs and symptoms to an acceptable level Lehne, p. 878
Which of the following is a disadvantage of surgical debridement?: a. slowest method b. it's non-selective c. surface bacteria may be introduced into the body d. it can not be used on infected wounds
c. surface bacteria may be introduced into the body Surgical Debridement is Fast Selective CAN be used on infected wounds
A wound that is contaminated and requires observation for signs of inflammation would fit into which wound classification?: a. chronic b. secondary c. tertiary d. primary
c. tertiary Potter and Perry, p. 1180 Table 48-1
Your pt's lab work has come back with the following information: • Fasting glucose 114 mg/dL • Post-prandial glucose 152 mg/dL • A1C 5.9% This pt should be notified that: a. they have diabetes b. their lab work came back normal; they do not have diabetes c. they are pre-diabetic, but with diet and exercise can decrease these values d. their lab work came back normal but they need to exercise more and watch their caloric intake as they are close to falling into the pre-diabetes range.
c. they are pre-diabetic, but with diet and exercise can decrease these values
In terms of treating Type 2 diabetes, which of the following is true of Amylin mimetics? a. they have a minor effect on decreasing glucagon absorption b. they have a major effect on increasing glucagon secretion c. they have a major effect on decreasing glucagon secretion d. they have a minor effect on decreasing glucose absorption
c. they have a major effect on decreasing glucagon secretion
The nurse is preparing to administer vancomycin, 500 mg IV over 60 minutes. The solution is 250 ml and the IV tubing has a drip factor of 15 gtt/ml. What is the drip rate? a. 25 gtt/minute b. 51 gtt/minute c. 60 gtt/minute d. 63 gtt/minute
d. 63 gtt/minute 250 ml/60 minutes x 15 gtt/ml = 62.5 gtt/minute. This is rounded up to 63 gtt/minute
Which of the following describes a hydrocolloid dressing? a. A seaweed derivative that is highly absorptive b. Premoistened gauze placed over a granulating wound c. A debriding enzyme that is used to remove necrotic tissue d. A dressing that forms a gel that interacts with the wound surface
d. A dressing that forms a gel that interacts with the wound surface Potter and Perry, Ch 48
Which of the following is NOT a modifiable risk factor of Diabetes Mellitus? a. Physical inactivity b. Abnormal lipid metabolism c. Hyperglycemia d. Aging
d. Aging Aging is non-modifiable
All of the following are contraindicated in wound cleaning EXCEPT: a. Povidone-iodine (Betadine) b. Chlorhexadine (Hibiclens) c. Sodium hypochlorite (Dakin's solution) d. Alginates
d. Alginates a, b and c are all considered cytotoxic and kill new tissue
Which type of insulin would be used to stop the liver from making extra sugar when it is not needed? a. Alpha-Glucosidase b. Amylin mimetic c. Sulfonylureas d. Biguanides
d. Biguanides
What actions break the chain of infection from a portal of exit from a reservoir? Select all that apply. a. Washing the hands b. Disposing of soiled linen c. Disinfecting used equipment d. Covering the mouth when coughing e. Avoiding breastfeeding when HIV positive
d. Covering the mouth when coughing e. Avoiding breastfeeding when HIV positive Source: Test Success 6th edition, p. 302
A nurse assessing a patient who is 12 years old should associate which complication with the patient's receiving tetracycline as a younger child? a. Delay in long bone growth b. Early onset of puberty c. Severe face and body acne d. Discoloration of the teeth
d. Discoloration of the teeth Tetracycline is contraindicated in children younger than 8 years of age, because it binds to calcium in developing teeth, resulting in permanent discoloration of the teeth. Source: evolve.elsevier.com Ch 86
All of the following hormones counter the effects of insulin, EXCEPT: a. Glucagon b. Epinephrine c. Growth hormone d. Glycogen
d. Glycogen Glycogen is not a hormone All of the following are hormones that counter the effects of insulin Glucagon Epinephrine Growth Hormones and CORTISOL
Metronidazole is a type of antimicrobial drug that does which of the following: a. Suppresses viral replication b. Disrupts cell membrane c. Inhibits protein synthesis d. Interferes with synthesis of bacterial DNA and RNA
d. Interferes with synthesis of bacterial DNA and RNA Lehne, p.1003
All of the following are true statements regarding penicillin, EXCEPT: a. It weakens the cell wall b. It inactivates aminoglycosides c. It has an effect against gram positive bacteria d. It is most commonly used on pt's with UTI's
d. It is most commonly used on pt's with UTI's
Which antibiotic would be contraindicated in a child with PKU? a. Gentamicin (Garamycin) b. Ampicillin (Omnipen) c. Levofloxacin (Levaquin) d. Linezolid (Zyvox)
d. Linezolid (Zyvox) Oxazolidinones contain phenolketonuria. People with PKU do not have the enzyme to break down phenylalanine.
All are risk factors that compromise the healing process EXCEPT: a. Inadequate blood supply b. Conditions of poor oxygen delivery c. Diabetes mellitus d. NSAID's
d. NSAIDS's
Before applying povidone-iodine [Betadine] to a patient's skin, it is most important for the nurse to ask the patient about allergies to what? a. Penicillin b. Bees c. Latex d. Seafood
d. Seafood Seafood can be rich in iodine; therefore, a patient who is allergic to seafood has a high risk of being allergic to povidone-iodine. Penicillin, bees, and latex are not associated with allergies to povidone-iodine. Source: evolve.elsevier.com Ch 96
Which of the following antibiotics inhibit the synthesis of folic acid? a. Linezolid (Zyvox) b. Metronidazole (Flagyl) c. Tetracyclines d. Sulfonamides
d. Sulfonamides
All of the following statements are true regarding Sulfonylureas, EXCEPT: a. They work by promoting insulin release b. They help your pancreas make extra insulin c. They are only to be used to treat Type 2 diabetes d. The major side effects are weight loss and hyperglycemia
d. The major side effects are weight loss and hyperglycemia The major side effect of Sulfonylureas are weight GAIN and HYPOglycmeia
A patient with a chronic illness is on daily glucocorticoids. He is brought to the hospital following a severe motor vehicle accident. He is wearing a medical alert bracelet stating his home medications. Noting that the patient takes glucocorticoids daily, the nurse knows which of the following to be true? a. The patient will need lower doses of glucocorticoids following the trauma. b. The patient will have to stop all glucocorticoids immediately. c. The patient will need the same dose of glucocorticoids he used at home. d. The patient will need higher doses of glucocorticoids following a trauma.
d. The patient will need higher doses of glucocorticoids following a trauma. During times of stress, the adrenal glands normally secrete large amounts of glucocorticoids. If the stress is sufficiently severe (eg, trauma, surgery), these glucocorticoids are essential for supporting life. Accordingly, because of adrenal suppression, it is imperative that patients receiving long-term glucocorticoid therapy be given increased doses at times of stress. Source: evolve.elsevier.com Ch 72
A microbe acquires antibiotic resistance by which means? a. Development of medication resistance in the host b. Overriding of the minimum bactericidal concentration c. Incorrect dosing, which contributes to ribosome mutations d. Transfer of DNA coding to other bacteria
d. Transfer of DNA coding to other bacteria Source: evolve.elsevier.com Ch 83
When obtaining a wound culture to determine the presence of a wound infection, from where should the specimen be taken? a. Necrotic tissue b. Wound drainage c. Drainage on the dressing d. Wound after it has first been cleaned with normal saline
d. Wound after it has first been cleaned with normal saline Potter and Perry, Ch 48
Wound exudate should describe all of the following in a wound assessment EXCEPT: a. color b. odor c. amount d. induration
d. induration Wound exudate should describe the : amount color consistency odor Potter and Perry, p. 1180
All of the following are true of Humulin N, EXCEPT: a. the onset is 1-4 hours b. It can be administered SubQ ONLY c. the medication needs to be rolled before administered d. the peak is 1-4 hours
d. the peak is 1-4 hours is NOT true the peak is actually 4-14 hours
What effects do Insulin Secretagogues Incretins have on the pancreas when treating Type 2 diabetes? a. they have a minor effect on increasing insulin secretion b. they have a major effect on decreasing insulin secretion c. they have a minor effect on decreasing insulin secretion d. they have a major effect on increasing insulin secretion
d. they have a major effect on increasing insulin secretion
The son of your pt overheard another nurse saying that his father was admitted into the hospital with a pressure ulcer that was the result of shear force. When he asks you what this means, you explain that shear force is: a. the force of two surfaces moving across one another b. mechanical force exerted when skin is dragged across a coarse surface c. sliding movement of muscle and bone while the skin and subcutaneous tissue are stationary d. when the skin and subcutaneous layers adhere to the surface of the bed, and the layers of muscle and bone slide in the direction of body movement.
d. when the skin and subcutaneous layers adhere to the surface of the bed, and the layers of muscle and bone slide in the direction of body movement Potter and Perry, p. 1178
