Nursing test 2 Clinical science 3100

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The client comes to the emergency department with an anxiety attack. He or she tells the nurse he heard that there was another anthrax attack in the capitol and is concerned about running out of medications. What is the best response by the​ nurse?

"The Centers for Disease Control and Prevention​ (CDC) maintains a large stockpile of medications for us in case that​ occurs."

The client tells the nurse that she is concerned about terrorist activity and questions if everyone should be immunized against smallpox. What is the best response by the​ nurse?

"The vaccine has side​ effects, which are serious and could kill many​ people."

The nurse is teaching the importance of drugs for emergency preparedness to local firemen. The nurse determines that learning has occurred when the firemen make which​ statements?

"The vendor-managed inventory​ (VMI) package can reach any community within 24 to 36​ hours." "The push package can reach any community within 12 hours of an​ attack." "Our country's drug stockpile is managed by the Centers for Disease Control and Prevention​ (CDC)."

The client confides in the nurse that he or she is drawn to complementary and alternative medicine because it promotes the​ "whole person." The client would like spirituality and prayer included in his or her plan of care. What is the best response by the​ nurse? A. ​"What exactly do you mean by spirituality and​ prayer?" B. ​"We will include spirituality in your plan. Would you like to say a​ prayer?" C. ​"We usually do not pray with​ clients; is there something you are worried​ about?" D. ​"I think your spiritual concerns are best left up to you and your​ minister."

"We will include spirituality in your plan. Would you like to say a​ prayer?"

The risk management department is using a​ root-cause analysis to improve a nursing​ unit's medication administration accuracy. What questions will be used to develop this​ tool?

"What kind of errors are​ occurring?" "What is the current medication administration accuracy​rate?" "What do the nurses think can be done to prevent errors from​ continuing?" ​"What is the impact of changes made to improve ​accuracy?"

A healthcare provider has prescribed a chemotherapeutic drug for a client with cancer. This drug commonly causes loss of hair. The client asks the​ nurse, "Will all of my hair fall​ out?" What is the most therapeutic response by the​ nurse?

"Yes, that is one of the expected side effects of this​ medication."

Place these methods of communicating with a​ non-English speaking client in order of their desirability and usefulness.

1. Healthcare agency interpreter is present 2. Adult family member interprets 3. Child relative interprets 4. Nurse uses drawings and body language to communicate 5. No interpretation is attempted

Place these nursing activities in the correct order of the nursing process.

1. The nurse weighs the client 2. The nurse analyzes the data collected 3. The nurse writes an individualized nursing intervention 4. The nurse documents the time and route of the administered meds 5. The nurse changes the intervention if it doesn't work

The nurse preparing to transfer to a pediatric hospital would expect to administer medications to children from birth to age_______years.

16

The nurse who is writing a risk nursing diagnosis will write a______ part statement.

2

A woman who wishes to become pregnant is concerned about the drugs she must take in order to treat a serious medical condition. The nurse reviewing the drug list would be most concerned about which kind of​ drug?

A drug with a long​ half-life.

A client asks a nurse why herbal remedies are popular now. What is the nurse best​ response? A. They are being marketed very aggressively. B. They are more effective for treating bacterial infections. C. Most insurance policies cover them. D. Their popularity is​ decreasing, not increasing.

A. They are being marketed very aggressively.

When teaching the client about a new​ medication, the nurse should include which​ information?

Adverse effects that can be expected Which adverse effect to report to the healthcare provider The​ drug's therapeutic action

The nurse has several educational pamphlets for the client about medications the client is receiving. Prior to giving the client these​pamphlets, what is the most important assessment by the​ nurse?

Assess the​ client's reading level.

The nurse is reviewing the steps of the nursing process with a student. The nurse is aware that it is most important to be accurate in which portion of the nursing​ process?

Assessment

The client takes St.​ John's wort for depression but does not tell the healthcare provider. The provider prescribes an SSRI. The nurse should monitor for which of the​ following? A. Serum potassium of 6.0 B. Dizziness C. Serum glucose level of 340 D. Sedation

B. Dizziness

The healthcare provider has prescribed a nitroglycerine​ (Nitrodur) patch for the client. The nurse understands that which of the following is the best outcome for this client as it relates to use of the​ medication?

Client will demonstrate correct application of the patch prior to discharge

The African American client had a myocardial infarction and is receiving atorvastatin​ (Lipitor). The nurse assesses the​ client's diet to be very high in fat. What is the best plan by the nurse to improve the​ client's diet and reduce the risk for additional​ medications?

Discuss his diet with whomever prepares meals for his family.

A nursing student asks a nurse how pharmacotherapy in the older adult is different than a​ middle-aged adult. How would the nurse​respond?

Drug absorption is slower due to increased gastric pH.

A nurse is reviewing medication records of older adults living in extended care. Which concepts about the pharmacotherapy of older adults should be​ considered?

Drug distribution is slowed in the older adult. ​First-pass metabolism is reduced in the older adult Changes in the kidney may result in decreased drug excretion

Which information is essential for the nurse to collect when reviewing a​client's medication​ list?

Drug names Dosage being taken Frequency of administration

A student nurse asks a nursing instructor which federal agency responsible for reviewing all medication errors reports. What is the nursing​ instructor's best​ response?

FDA's Division of Medication Error Prevention and Analysis​(DMEPA

The nurse makes a medication​ error, but the client is not harmed. The​client's family asks the nurse manager what is considered a medication error. How should the nurse manager​ respond?

Failure to follow healthcare​ provider's orders. Failure to give the right medication Failure to give a medication at the ordered time Failure to give the right dose of the medication

The nurse assesses an adverse effect of a medication that has been administered. Who should the nurse report this adverse effect​ to?

Food and Drug​ Administration's (FDA) MedWatch Website.

The nurse is conducting a holistic assessment of a client with alcoholism. What are the important questions the nurse would​ ask?

How is drinking alcohol viewed by your​ culture?" "Did you see your parents drinking alcohol when you were growing​ up?" "What blood relatives of yours are addicted to​ alcohol?"

A​ client's genetic testing reveals a change in CYP2A6. The nurse would plan which interventions based on this​ discovery?

Increased surveillance for the development of lung cancer. Planning additional time and interventions to help the client stop smoking.

A student nurse asks a nurse what is included in the Strategic National Stockpile​ (SNS). The nurse explains that the SNS includes which of the following​ supplies?

Intravenous administration equipment Antibiotics ​Life-support medications Chemical antidotes

A nurse is caring for a client following a bioterrorism attack. The client has experienced initial nausea and vomiting followed by weight loss and eventual thyroid cancer. What was the most likely causative​ agent?

Ionizing radiation

The nurse plans to teach a safety class to parents of toddlers about household exposure to medications. What should the nurse​ include?

Keep all medications locked up and stored out of reach of the toddler Call the Poison Control Center for guidance with any medication ingested

A community health nurse is preparing a teaching plan regarding medications and their potential adverse effects for a new parent class. The nurse should encourage parents to do which of the​ following?

Maintain a list of current medications for each child. Be aware of each​ child's medication allergies Know what the​ child's prescribed medication is​ for, how it should be​ administered, and when to expect the child to feel better Be aware that any leftover medication should be appropriately disposed​ of, not saved for future use

The nurse provides care for elderly clients in an assisted living facility. What does the nurse assess as a primary contributing factor for drug toxicity in the​ elderly?

Older adults are frequently dehydrated

A nurse is admitting a client to the emergency department who has overdosed on a benzodiazepine. The nurse should anticipate the healthcare provider will prescribe which of the following​ drugs?

Romazicon

The client was exposed to cutaneous anthrax 2 weeks ago. What will the nurse see when assessing the​ client's skin?

Small skin lesions and​ later, black scabs

A nurse is providing care to a client who wears bilateral hearing aids. Which nursing interventions are​ indicated?

Speak a bit slower than normal. Ensure that verbal and nonverbal communication is congruent. Allow extra time for communication.

A nurse has been asked to present health promotion information at a community clinic whose clients are primarily​ non-Hispanic Black women. After review of health disparity and inequality statistics the nurse chooses to include information about which​ disorders?

Stroke Coronary artery disease Diabetes Prenatal care

A nurse is preparing to administer medications to a pregnant client. Which classification of drugs would the nurse refuse to​ administer?

Teratogenic

A nurse is assessing a client recently admitted to the unit. The nurse understands that which assessment identifies the collection of objective ​data?

The client has a wound measured at 5 cm in length.

For which client would the nurse expect the healthcare provider to continue prescribed medications during​ pregnancy?

The client recently diagnosed with gonorrhea The client with a history of frequent asthma attacks The client with hypertension

The nurse is preparing a teaching plan for an older client who is taking multiple medications. Which principles should the nurse keep in mind during the planning​ phase?

The client should have all prescriptions filled at the same pharmacy The client should keep a list of all medications for easy accessibility Older clients often take multiple drugs which is a common cause of medication errors The client should be aware of each prescribed​ medication, the​dose, and possible side effects

The nurse is beginning medication reconciliation for a newly admitted client. What should the nurse include in this​ list?

The client takes ibuprofen for an occasional headache. The client mixes a powdered form of vitamin C into his morning orange juice. The client applies essential oils to his forehead to help with his or her allergies The client takes a prescription medication for osteoporosis once a week.

A nurse is developing a care plan for a client. Which client outcome statements are correctly​ formatted?

The client will identify two adverse effects of enoxaprarin​(Lovenox) prior to​ self-administering the drug. The client will verbalize the storage requirements for NPH insulin prior to discharge.

The nurse in the emergency department administers an adult dose of an antibiotic to a​ 3-month-old baby. As a​ result, the baby suffers permanent brain damage. What best describes the effect of this error on the healthcare​ facility?

The morale of the staff involved will be decreased.

The nurse is managing care for several clients at a diabetic treatment center. The nurse understands that which of the following is the priority nursing​ intervention?

To return the client to an optimum level of wellness while limiting adverse effects related to the​ client's medical diagnosis

A nursing instructor is teaching a nursing student about human DNA sequences. The student demonstrates understanding by making with of the following​ statements?

​"Even though human genetic differences are​ small, significant differences can be seen with drug​ metabolism."

A client returns to the clinic for​ follow-up after taking a newly prescribed medication for a month. The nurse recognizes medication teaching was successful when the client makes which​ statement?

​"I've been taking my medication on an empty stomach like the prescription label said​ to." "I take my medication first thing in the​ morning, just like you​ said." ​"I switched all my medications to one pharmacy like you​suggested.

The public health nurse notices that several clients in the hypertension clinic have poorly controlled​ hypertension, even though they have been prescribed appropriate antihypertensive drugs. Which question will best enable the nurse to assess these​ clients?

Can you afford the high blood pressure​ medication?"

A nursing instructor is teaching nursing students about the FDA Pregnancy Drug Categories. The instructor asks the students to what category a drug for which research has shown an adverse effect in animals but not in pregnant women would be categorized as. The instructor knows learning has occurred with which student​ response?

Category B

A client is admitted to the emergency department with suspected exposure to anthrax. The nurse anticipates the healthcare provider will prescribe which​ medication?

Ciprofloxacin.

The client has been exposed to anthrax. The nurse anticipates administering which of the following​ drugs?

Ciprofloxacin​ (Cipro) and doxycycline​ (Vibramycin).

What is the most significant role for nurses as defined by state nurse practice acts and by regulating bodies such as The Joint​ Commission?

Client teaching

The nurse is preparing for medication administration to a group of clients. What is the best overall outcome for the​ clients?

Clients will receive the best therapeutic outcome from the medications

The nurse in charge of a clinical study welcomes the participants in an open forum. One client is surprised that there are men and women from several ethnic groups. The nurse explains that in the​ past, ethnic variables were largely unknown or ignored for what​reasons?

Clinical trials failed to include ethnically diverse subjects. Clinical trials comprised mostly Caucasian males. Little attention was focused on identifying the different effects drugs had on various ethnic groups.

A client is a vegan vegetarian and does not eat any animal products. The healthcare provider has prescribed a medication contained in a gelatin capsule. The nurse understands that a gelatin capsule is made from animal products. Which nursing actions are​ indicated?

Collaborate with the prescriber to find an alternative medication. Your answer is correct. Check to see if the capsule can be opened for administration.

A client is diagnosed with cancer. The healthcare provider has recommended​ chemotherapy, which would likely save the​ client's life. The client tells the​ nurse, "This is punishment from God for sins I have​ committed; some women at my church say​ so."? With permission from the​ client, what would the nurse do​ first?

Contact the​ client's minister to discuss the​ client's perspective about cancer.

A Hispanic man has been diagnosed with​ attention-deficit/hyperactivity disorder​ (ADHD), and is taking methylphenidate​ (Ritalin). Even though the drug helps with focus and​ grades, the client will not go to the school office at noon for his medication. Which statement best describes the result of the​ nurse's evaluation?

The adolescent is embarrassed about having to take medicine at​ school; it is a social stigma.

The adolescent is supposed to go to the school nurse at​ 12:00 to receive his medication for​attention-deficit/ hyperactivity disorder​ (ADHD). He often does not go for the medication. What best describes the​ nurse's understanding of this​ situation?

The adolescent is embarrassed in front of his peers

A nurse is caring for a client that was exposed to radiation. The client asks the nurse what factors increase the amount of radiation that a person is exposed to. What should the nurse include in responding to the​ client's question?

The amount of exposure. The​ long-lasting effects. The amount of cellular death.

The nurse teaches a class about medication used during pregnancy to pregnant women. The nurse determines that additional instruction is required when a class participant makes which​response?

The baby can only be harmed by medications during the first​ trimester

A client has been admitted to the emergency department for treatment of poison ingestion. Gastric lavage and placement of activated charcoal has been prescribed. The nurse would withhold this treatment and collaborate with the prescriber if which instances​ occur?

The client becomes unconscious. The client discloses that lithium was the drug taken. Paramedics report that it has been 2 hours since the drug was taken.

A client presents with hypotension and bradycardia. The client indicates that one of her healthcare providers recently prescribed three new medications to her current list of 10 medications per day. Based on this​ information, which statement would be the most​ accurate?

The client is experiencing adverse reactions as a result of polypharmacy.

The healthcare provider has prescribed quetiapine​ (Seroquel) for the client with chronic auditory hallucinations. The client has stopped taking the medication. The nurse incorrectly uses the diagnosis of​ "noncompliance." In which situation would this diagnosis be​ appropriate?

The client made an informed decision not to take the medication

All of the clients listed have cancer and are receiving chemotherapy. Which client does the nurse evaluate as having the highest probability for a​ remission?

The client with a support group of cancer survivors

The nurse is assessing a newly admitted​ client's current medication. Which of the following is an example of objective​ data?

The nurse checks the prescription bottles the client has brought to the hospital

A nurse is preparing to administer a new drug that was just prescribed by the healthcare provider. The nurse recognizes that the wrong concentration of the drug was sent by pharmacy. What is the​ nurse's best​ response?

The nurse informs the​ client, documents the error as per hospital​ policy, and notifies the healthcare provider.

The nursing instructor teaches the student nurses about how medication errors can occur. What information will the nursing instructor include in the​ presentation?

The nurse miscalculates the medication dose The nurse does not check the​ client's identification band. The nurse misinterprets a healthcare​ provider's order The nurse administers the incorrect drug

An American Indian client has been admitted to the hospital for chemotherapy. At any given​ time, five family members are in the​ client's room. The nurse tells the client that according to hospital​ policy, only two visitors at a time are allowed. What does the best analysis by the nurse manager reveal about the​ nurse's action?

The nurse should have assessed the​ client's preferences about how many family members she wanted to be present.

The nurse recognizes that agency system checks are in place to decrease medication errors. Who commonly collaborates with the nurse on checking the accuracy of the medication prior to​ administration?

The pharmacist

A nurse is administering medications to a group of clients. Which situation is an example of a medication​ error?

The wrong dose of a medication is drawn up but is caught and corrected prior to administration

The pregnant client tells the nurse that her prescribed medication is not as effective as it was before her pregnancy. What is the best response by the​ nurse?

This is because your blood volume has​ increased

The nurse commits a medication error. The nurse documents the error in the​ client's record and completes the incident report. What does the nurse recognize as the primary reason for doing​ this?

To verify that the​ client's safety was protected

The nurse plans to administer medication to a preschool child. Which approach indicates the nurse has an understanding of growth and​ development?

Use a brief​ rationale, followed by quick administration of the medication

The nurse is on a committee to reduce medication errors in a large healthcare facility. What is a recommendation the nurse proposes that will most likely help to reduce medication​ errors?

Use​ automated, computerized cabinets on all nursing units.

A nurse is administering medications to a client. The client​ states, "I've never taken that yellow pill​ before". What should the nurse do​ first?

Verify the order and​ double-check the label

The nurse is teaching a support group for caretakers of older adult clients. The focus is medication compliance. The nurse determines that learning has occurred when the caregivers make which​ response?

We should use a medication management box so they​ won't forget to take​ it.

A nurse is teaching a community group about holistic medicine. Which information should the nurse include about Western​ medicine

Western medicine focuses on the cause of disease. Disease is often viewed as a malfunction in a specific body system. Western medicine may focus on disease treatment.

Medication reconciliation has been started for a newly admitted client. At which points would the nurses and others caring for this client check this​ list?

When initial admission orders are received When the client is transferred to a different unit within the hospital When the client is discharged

A nursing student asks a nurse how gender influences pharmacology. How should the nurse​ respond?

Women tend to seek medical care earlier than men do.

The toddler refuses to take his oral medication. What is the best suggestion to the mother from the nurse for ensuring the toddler receives his​ medication?

Crush the tablet and mix it with a small amount of​ jam.

Following a bioterrorism​ attack, the nurse finds that the victims are suffering from​ small, black lesions on their forearms. The nurse collaborates with the healthcare provider to treat exposure to which​ agent?

Cutaneous anthrax

The nurse is teaching a class on anthrax to a group of emergency response workers. The nurse plans to include which of the​ following?

Cutaneous anthrax is the most common​ form, but inhaled anthrax is the most lethal form.

A nursing instructor is planning to discuss the Dietary Supplement Health and Education Act​ (DSHEA) of 1994 with a group of nursing students. The instructor plans to include which of the​ following? A. It requires that herbal products undergo the same rigorous testing as drugs do under the FDA. B. It mandates that herbal product labels contain accurate information. C. It ensures that herbal products provide proof of their intended effects. D. It mandates that herbal product labels state that the products are not intended to​ diagnose, treat,​ cure, or prevent disease.

D. It mandates that herbal product labels state that the products are not intended to​ diagnose, treat,​ cure, or prevent disease.

The client takes several prescription medications and asks the nurse about using complementary and alternative medicine​ (CAM). What is the best reply by the​ nurse? A. ​"CAM is a good idea that you should discuss with your healthcare​ provider." B. ​"CAM has not been demonstrated to help with your kind of​ symptoms." C. ​"CAM might​ help, but you will still need your​ medications." D. ​"CAM is an approach that might reduce your need for​ medications."

D. ​"CAM is an approach that might reduce your need for​ medications."

The nurse has been teaching a client about herbal preparations and determines that additional teaching is required when the client makes which​ statement? A. ​"I need to be careful about where I store my herbal​ product." B. ​"I should check with you before using an herbal​ product." C. ​"Herbal preparations are available in solid and liquid​ forms." D. ​"Herbal products usually contain only one active​ ingredient."

D. ​"Herbal products usually contain only one active​ ingredient."

The client tells the nurse that he or she plans to take St.​ John's wort to treat his or her depression. What is the best response by the​ nurse? Select all that apply. A. ​"That should be fine as long as you are not​ suicidal." B. ​"St. John's wort is successfully used in Europe for minor​ depression." C. ​"It would be a good idea to try this before paying for a prescription​ medication." D. ​"It would be better to have a psychiatric assessment​ first." E. ​"Herbal preparations can interact with many other​ medications."

D. ​"It would be better to have a psychiatric assessment​ first." Your answer is correct. E. ​"Herbal preparations can interact with many other​ medications."

The nurse is teaching a class on dietary supplements. The nurse determines that learning has occurred when the patients make which​ statement? A. ​"The Food and Drug Administration​ (FDA) is not involved with the approval of the dietary supplement and cannot remove it from the​ market." B. ​"Dietary supplements must go through rigorous testing prior to being marketed by the​ manufacturer." C. ​"The manufacturer of the dietary supplement has the burden of proof for the safety of the​ supplement." D. ​"Products can make claims based on body structure and function like​ 'promotes healthy urinary​ tract.'"

D. ​"Products can make claims based on body structure and function like​ 'promotes healthy urinary​ tract.'"

A client with hypertension is receiving medication to lower his blood pressure. Which nursing action demonstrates the evaluation process related to medication​ administration?

Determining that goals were not met 3 days following medication administration

The nurse makes a medication error and a client dies. In​ court, the attorney for the family of the deceased client asks the nurse if she followed standards of care in administering the medication. How would the attorney phrase this​ question?

Did you do what another nurse would have done under similar​ circumstances?

A home health​ nurse's patient caseload is ethnically diverse. Which interventions show understanding of cultural​ variables?

Discussing cultural preferences for herbs and spices and possible alternatives when drug interactions are possible. Assessing the​ client's response to acupuncture for pain. Discussing the​ client's beliefs regarding treatment.

The Joint Commission documented that client education was deficient on several​ medical-surgical units of a local hospital. A nursing committee was formed to address this problem. What is the best intervention to improve client​ education?

Discussing medications each time they are administered to clients.

The nurse teaches a class to clients about how to help prevent medication errors when in the hospital. What is the most important question for the nurse to ask the​ clients?

Do you know the names of all the medications you​ take?

A nurse who is presenting community education​ states, "Drugs are among our most powerful weapons for emergency​preparedness." What additional​ statements, made by the​ nurse, would support this​ statement?

Drugs help us treat the diseases that could be caused by​ bioterrorism. ​"Without drugs, we might be quickly overwhelmed by a bioterrorist​ attack." ​"Drugs can be used in chemical or nuclear​ attacks."

The nurse teaching a​ pre-conception class would tell participants that they should be most careful about exposure to drugs during which stage of​ pregnancy?

Embryonic

The nurse understands that drug therapy is postponed until after pregnancy and lactation when possible. Which of the following acute and chronic conditions may be managed with drugs during​ pregnancy?

Epilepsy Sexually transmitted infections Gestational diabetes Hypertension

An adolescent client comes to the school nurse with complaints of vague abdominal pain. What statement by the student would help to confirm the​ nurse's suspicion that the adolescent has body image​ concerns?

Everyone makes a big deal about what I​ eat, so​ don't ask

A​ client's genetic testing indicates the presence of a genetic polymorphism of the CYP 450 enzyme. The nurse expects this difference to be one of which​ classifications?

Extensive Ultrarapid Poor

The nursing instructor teaches student nurses about the Food and Drug Administration​ (FDA) Pregnancy Categories. What should the nurse​ include?

Food and Drug Administration​ (FDA) Pregnancy categories provide a framework for safe use of drugs in pregnant women Food and Drug Administration​ (FDA) Pregnancy Category X has been associated with teratogenic effects

A nurse is teaching a group of student nurses. Which of the following best indicates an ethnic characteristic that can affect​pharmacotherapy?

Genetic differences

A client asks the nurse why a medication prescribed by the provider​ "didn't do anything at​ all." Which statement by the nurse accurately describes how genetics influence drug​ action?

Genetic differences can result in significant differences in how each​ client's body handles the same​ medication." ​"Genetic differences can cause mutations in​ enzymes, changing the way they function. This can alter how the body metabolizes and excretes​ drugs." "Because of genetic​ differences, medication may accumulate to toxic levels in one client while in another client may be inactivated before it can have a therapeutic​ effect."

A nurse is reviewing safe medication administration with a student nurse. What should the nurse plan to include in the​ teaching?

Give medications within the time frame specified by hospital policy

A nurse is planning to teach a client about a new medication. What is the best teaching​ method?

Give the client oral and written drug information and instructions

A nurse manager is discussing medication errors with a group of nurses. Which statement by the nurses indicates the teaching was​effective?

Handwritten orders are more frequently associated with medication errors than are typed orders

The client is receiving an oral antibiotic as treatment for cellulitis of the lower extremity. The​ client's outcome is​ "Client will state a key point about antibiotic treatment for​ cellulitis." Which statement would the nurse evaluate as best indicating this outcome has been​ met?

I need to take all the pills even if my leg looks​ better

A nurse has provided discharge medication instructions to the parents of a child being released from the emergency department. The nurse evaluates that learning has occurred when the parents make which​ statements?

I should give this antibiotic as prescribed until the bottle is​ empty I will keep this medication in the refrigerator as the label​ directs This antibiotic should help to clear my​ child's infection

A nurse has admitted a new client to the unit. Which concepts should the nurse use when developing a nursing​ diagnosis?

Include the client in the identification of needs Consider the​ client's response to the current health problem

A nurse working in an obstetric practice should consider which fact when discussing medication use with pregnant​ clients?

Inhaled drugs may be absorbed to a greater extent

The nurse is administering medications to an older adult. Which laboratory tests are most important for the nurse to assess prior to the administration of​ medication?

Kidney and liver function tests

The nurse works for the Centers for Disease Control and Prevention​ (CDC). In planning for a bioterrorist​ attack, what will the best plan of the nurse​ include?

Learn the signs and symptoms of chemical and biological agents. Obtain a listing of health and law enforcement contacts. Obtain current knowledge of emergency management.

A nurse is planning a discussion of emergency preparedness with newly hired nurses. Which events would this nurse use as historical examples of​ terrorism?

Many people died as a result of sarin gas exposure in a Tokyo subway. ​Twenty-two confirmed or suspected cases of anthrax infection occurred as a result of the bacillus being sent through U.S. mail.

A nurse is preparing care for a newly admitted client with diabetes. Which information would be critical for the nurse to​ assess?

Medical history Current lab results Medication allergies Use of dietary supplements

A nurse on the​ medical-surgical unit is caring for several very ill clients. One client​ says, "I was supposed to get my medications an hour​ ago." The nurse recognizes that medication errors can have what​ impact?

Medication errors can potentially extend the​ client's length of hospital stay Medication errors can result in expensive legal costs to the facility. Medication errors can damage the​ facility's reputation Medication errors cause preventable deaths during hospitalizations

The clinic nurse will immediately alert the healthcare provider when which category X drugs are identified on the medication record of a recently diagnosed pregnant​ patient?

Methotrexate Isotretinoin​ (Accutane) Oral contraceptives

The client is receiving albuterol​ (Proventil) for treatment of bronchospasm related to asthma. What is the primary nursing intervention as it relates to this​ medication?

Monitor the client for relief of bronchospasms

Which nursing intervention would take priority following administration of a new​ medication?

Monitoring the​ client's respiratory status

The pregnant client plans to breastfeed her baby. She asks the nurse about the use of herbal products during breastfeeding. What is the best response by the​ nurse?

Most drugs can be transferred to the infant during​ breastfeeding, so this is not​ recommended

The nurse is planning care for a pregnant client prone to substance abuse. When the client​ states, "My baby​ isn't getting my​ drugs, I​ am," how does the nurse​ respond?

Most illicit drugs will cross the placenta and hurt the​ baby. ​Drugs may work longer in your​ baby Some drugs result in your baby not growing​ enough

The nurse preparing a teaching plan for a postpartum mother. The nurse plans to include which topics regarding​ breastfeeding?

Most medications are secreted into breast milk. Dietary supplements should be avoided. Herbal products are secreted into breast milk and have the potential to cause harm to the infant All tobacco products should be avoided

A nurse is teaching a student nurse about common treatments for victims of bioterrorism. The nurse tells the student that atropine would be most useful for a victim of bioterrorism exposed to which of the​ following?

Nerve gas

The nurse administers an evening medication to the client in the morning. What is the​ nurse's best initial course of action at this​ time?

Notify the healthcare provider about the error

Which statement about the nursing process is​ accurate?

Obtaining the outcomes is essential for goal attainment.

The nurse will administer medication to a​ school-age child. What is the best action by the​ nurse?

Offer the child a choice of beverage with which to take the medication

The nurse is caring for several clients. Which clients have a psychosocial history that may affect their​ outcome?

Older adult who recently suffered a​ stroke, has an unsteady​ gait, and lives in a​ two-story home Middle-aged client with Down syndrome living in a group home Recently divorced mother of three children with breast cancer

The nurse has been hired to work in the risk management office of a hospital. What situations would the nurse expect to be included in this​job?

Participating in the investigation of a sentinel medication event Using the computer to track data Working with staff nurses to identify work flow problems Participating in a committee who will recommend changes to the policy and procedures regarding medication administration.

A client was exposed to ionizing radiation. The nurse plans to administer which of the following​ medications?

Potassium-iodine tablets.

A pregnant client suspected of drug abuse is admitted to the emergency department. The nurse plans to teach the client about which complications associated with drug use during​ pregnancy?

Preterm birth Low birth weight Birth defects

The nurse administers potassium iodide​ (KI) tablets to a client who has been exposed to radiation from a nuclear weapon. What is the rationale for administering potassium iodide​ (KI) to this​ client?

Prevent thyroid cancer

During​ evaluation, the​ nurse, client, and healthcare provider determine that the goals of antibiotic therapy have not been met. What actions are​indicated?

Review the dosage of the medication Consider checking serum drug levels Consider prolonging therapy Consider using a different antibiotic

The client has been exposed to a nerve agent. For which symptoms will the nurse most likely​ assess?

Salivation and involuntary urination.

The nurse is preparing medications for a group of clients. Another nurse begins telling the nurse about her recent engagement. What is the best action by the first​ nurse?

Tell the second nurse that the conversation is distracting and she must stop talking while medications are being prepared.

The nurse is preparing an educational plan for parents about how to protect their children if a bioterrorist attack occurs. What is the best information to​ include?

"Follow the Centers for Disease Control and Prevention​ (CDC) guidelines for​ immunizations."

The nurse conducts a seminar in a local community center on how citizens can be affected by radiation from a nuclear attack. The nurse determines that the education is effective when the clients make which​ statement?

"I am at risk to develop leukemia as a result of radiation​ exposure."

The nurse manager would determine that a nurse understands culturally sensitive care if which statements are​ made?

"I have been helping my client understand how to choose foods from our diet​ menu." ​"I am concerned because my client needs sterile dressing changes but has no running water at​ home." ​"My client and I worked out a way to get her medications delivered to her at​ home."

The nurse is providing education about warfarin​ (Coumadin) to a patient of Asian ancestry. The nurse determines that learning has occurred when the client makes which​ statement?

"I may need less medication than someone from a different ethnic​ group."

The nurse uses a newly admitted​ client's armband barcode to identify the client prior to administering medications. The nurse should use at least________ other means of identifying this client.

2

A nurse working in the emergency department is told that the smallpox virus was aerosolized at a parade attended by thousands of people. The nurse explains to the student nurse that the vaccine for this virus provides a high level of protection if given within days of exposure.

3

A series of category E medication errors have occurred on a hospital unit. When discussing this trend with the nursing​staff, the risk manager would list which characteristics of a category E​ error?

A client was harmed No interventions to sustain life were required as a result of the error

Which client would be most likely to seek complementary and alternative therapies as a treatment​ modality? Select all that apply. A. A​ 48-year-old male who wants to boost his immune system. B. A​ 22-year-old male athlete who is preparing for the Olympics. C. A​ 50-year-old female going through menopause. D. A​ 58-year-old male with prostate problems. E. None of these clients would be wise to seek these therapies.

A. A​ 48-year-old male who wants to boost his immune system. Your answer is correct. B. A​ 22-year-old male athlete who is preparing for the Olympics. Your answer is correct. C. A​ 50-year-old female going through menopause. Your answer is correct. D. A​ 58-year-old male with prostate problems.

A client asks a nurse what the common complications are due to​ drug-herbal interactions. How would the nurse​ respond? A. Blood coagulation B. Vision loss C. Urine output D. Hair growth

A. Blood coagulation

The client asks if there are any supplements that would help improve or preserve his memory. Which supplements would the nurse​ discuss? Select all that apply. A. Carnitine B. Coenzyme Q10 C. Glucosamine D. DHEA E. Selenium

A. Carnitine D. DHEA

A client with inflammatory arthritis asks about adding an​ anti-inflammatory herb to the medication regimen to decrease the use of prescription drugs. The nurse suggests the client discuss the efficacy of which herbs with the healthcare​ provider? Select all that apply. A. Evening primrose B. St.​ John's wort C. Ginger D. Ginseng E. Bilberry

A. Evening primrose B. St.​ John's wort C. Ginger

A client with a family history of heart disease asks the nurse to recommend herbs that decrease the risk for heart disease. The nurse suggests the client discuss which herbs with the healthcare​ provider? Select all that apply. A. Flaxseed B. Green tea C. Soy D. Milk thistle E. Acai

A. Flaxseed B. Green tea C. Soy

A client who is considering taking a dietary supplement recommended by the nurse asks how to determine if the supplement is safe. The nurse explains that the Dietary Supplement and Nonprescription Drug Consumer Protection Act of 2007 requires that companies marketing herbal and dietary supplements do which of the​ following? Select all that apply. A. Include their contact information on the label so consumers can report adverse effects. B. Notify the Food and Drug Administration​ (FDA) within 15 days of receiving a report of an adverse effect C. Keep records of adverse effects for at least 6 years and make these records available for inspection by the Food and Drug Administration​ (FDA). D. Demonstrate product effectiveness prior to release of the product to the public. E. State which conditions the product is intended to cure or prevent.

A. Include their contact information on the label so consumers can report adverse effects. B. Notify the Food and Drug Administration​ (FDA) within 15 days of receiving a report of an adverse effect. C. Keep records of adverse effects for at least 6 years and make these records available for inspection by the Food and Drug Administration​ (FDA).

A postmenopausal client with a history of stroke is told she cannot take female hormones because of the risk for future thromboembolic events. The client asks about nonpharmacologic ways to manage her symptoms. Which herbs does the nurse suggest as​ alternatives? select all that apply A. Soy B. Black cohosh C. Evening primrose D. Saw palmetto E. Acai

A. Soy B. Black cohosh C. Evening primrose

The client is being treated for a cardiac dysrhythmia with amiodarone​ (Cordarone). The client has elevated liver function tests​ (LFTs). Which assessment finding would the nurse suspect as contributing to the elevated​ LFTs? A. The client was taking Echinacea to treat cold symptoms. B. The client was taking​ Kava-Kava for anxiety. C. The client was taking gingko biloba for memory problems. D. The client was taking St.​ John's wort for depression.

A. The client was taking Echinacea to treat cold symptoms.

A nurse is planning to teach a client about the relationship of complementary and alternative therapies to pharmacology What should the nurse​ include? A. They can reduce client medication needs. B. They serve as competitors and should not be promoted. C. They have​ little-to-no value in disease prevention and treatment. D. They are more effective than medication use

A. They can reduce client medication needs.

A client experiencing occasional minor digestive problems asks the nurse about herbal therapy. What is the best response by the​ nurse? Select all that apply. A. Wheat grass B. Green tea C. Ginger D. Grape seed E. Stevia

A. Wheat grass Your answer is correct. B. Green tea Your answer is correct. C. Ginger

The client​ says, "I am convinced that the​ mind-body interventions I am using are improving my​ health." The nurse would ask additional questions about which complementary and alternative therapies that belong to this​ category? Select all that apply. A. Yoga B. Massage C. Dance D. Herbal therapies E. Biofeedback

A. Yoga B. Massage C. Dance E. Biofeedback

The older adult asks the nurse how dietary supplements will help support health. What is the best response by the​ nurse? A. ​"Fish oil will help to enhance your brain​ function." B. ​"Soy isoflavone will help prevent​ Alzheimer's disease." C. ​"Dietary supplements will help support and maintain​ hydration." D. ​"Chromium will help you achieve and maintain optimum​ weight."

A. ​"Fish oil will help to enhance your brain​ function."

Clients at a senior citizen center have asked the nurse to do a presentation on herbal preparations. Which statement would be included in the best plan by the​ nurse? A. ​"Herbal preparations actually are​ drugs; you must be careful with​ them." B. ​"Herbal preparations can be dangerous if you are allergic to​ them." C. ​"As long as the herbal preparation has been tested in the clinical​ setting, it is​ safe." D. ​"Herbal preparations are safe as long as you carefully read the​ label."

A. ​"Herbal preparations actually are​ drugs; you must be careful with​ them."

The nurse is teaching clients in a senior center about complementary and alternative therapies. Which statement by a client indicates understanding of the information the nurse has​ presented? Select all that apply. A. ​"I see now that​ 'natural' doesn't really mean​ 'safe,' and I should ask my healthcare provider about any supplements I want to​ take." Your answer is correct. B. ​"I didn't realize some herbal supplements may be just as strong as a prescription drug. I will need to discuss any supplements I want to try with my​ doctor." Your answer is correct. C. ​"I understand now that when I choose to use a natural product over a prescription​ medication, I could be delaying my​ recovery." Your answer is correct. D. ​"It's good to know that herbs contain ingredients that are as powerful as a prescribed medication and are an option for safe and effective​ therapy." E. ​"It's good to know that herbs contain ingredients that are as powerful as a prescribed medication and are an option forsafe and effective​ therapy."

A. ​"I see now that​ 'natural' doesn't really mean​ 'safe,' and I should ask my healthcare provider about any supplements I want to​ take." B. ​"I didn't realize some herbal supplements may be just as strong as a prescription drug. I will need to discuss any supplements I want to try with my​ doctor." C. ​"I understand now that when I choose to use a natural product over a prescription​ medication, I could be delaying my​ recovery."

A nurse is caring for a client admitted to the emergency department following a drug overdose. The nurse anticipates which of the following prescriptions to enhance removal of the poison from the​ client?

Administering activated charcoal. Changing the pH of urine. Preparing the client for enemas. Inserting a nasogastric tube.

A nurse is preparing to administer medications to a​ school-age child. What would the nurse​ do?

Allow the child to make decisions regarding how medications are taken

The African American client has panic​ attacks, is​ suicidal, and is on an inclient psychiatric unit. The healthcare professional prescribes sertraline​ (Zoloft) and clonazepam​ (Klonopin). The client refuses the drugs. The client also requests to have herbs and African objects in his room to​ "remove the​ curse." What is the priority action by the​ nurse?

Allow the request as long as the herbs and objects do not pose a safety risk for the client or other clients

The patient is from an Arab culture and is in labor and delivery. Her husband insists he must stay with her and will not allow her to receive any analgesia during the experience. What is the best action by the​ nurse?

Allow this request and be available in the event the request changes.

The nurse is working hard to prevent medication errors. What interventions will assist the nurse in preventing most​ errors?

Always check the​ client's identification band prior to administration of medications Open all of the medications immediately prior to administration. Tell healthcare providers that verbal orders will not be accepted.

The nurse was very busy and unfamiliar with a new​ medication, but administered it anyway. Later the nurse looked up the medication. How does the nurse manager evaluate this​ behavior?

An error could have occurred because the nurse was unfamiliar with the medication

The nursing supervisor tells a nurse that the medication error the nurse made yesterday has been determined to be a sentinel event. What should the nurse expect to​ occur?

An immediate investigation will occur. nterventions to prevent the error from occurring again will quickly be put in place. A​ root-cause analysis will be performed.

Which patient statements would the nurse evaluate as negatively affecting access to​ healthcare?

An older adult​ says, "If I tell my doctor that I fall​ frequently, I might have to go to a nursing​ home." The​ client's new insurance plan requires a​ $10 copay for office visits. A client asks to be discharged before noon as he has a​ 3-hour drive home.

A nurse is planning a presentation regarding anthrax. What should the nurse​ include?

Anthrax can spread easily. There are three basic types of anthrax.

A student nurse asks a nurse what items are found within the Strategic National Stockpile​ (SNS). What is the​ nurse's best​ response?

Antibiotics

The client is receiving a​ beta-blocker medication. The nurse has done medication education and provided the client with printed information to take home. During the next​ appointment, the nurse notes that the client is not taking the medication properly. What is a therapeutic assessment question to ask this​ client?

Are you able to read and comprehend the printed​ information?"

The nurse assesses the client with diabetes mellitus prior to administering medications. Which questions are important to ask the​ client?

Are you allergic to any​medications? Are you taking any herbal or​ over-the-counter (OTC)​medications? Will you please tell me about the kind of diet you​ follow? What other medications are you currently​ taking?

A nurse is caring for a client who has been exposed to a nerve agent. Which antidote will the nurse plan to​ administer?

Atropine

A nurse is teaching a student nurse about the active ingredients of herbal medicines. Which of the following indicates that teaching was​ effective? A. Are found only in the rhizome. B. Can be found in all parts of the herb. C. Are found only in the stems and leaves. D. Are found only in the root system.

B. Can be found in all parts of the herb.

A nurse is caring for a client being treated for seizures. The nurse would be most concerned if the client is also taking which herbal​ product? A. Ginger B. Ginkgo C. Goldenseal D. Feverfew

B. Ginkgo

A pregnant client asks the nurse about changing from her prescription antidepressant medication to St.​ John's wort because it is natural. What is the best response by the​ nurse? A. ​"No, herbal preparations are just not safe to take during​ pregnancy." B. ​"St. John's wort is a​ drug, and this should be discussed with your healthcare​ provider." C. ​"Yes, you can​ change, but let your doctor know at your next​ appointment." D. ​"It should be okay because your baby has been exposed to an​ antidepressant."

B. ​"St. John's wort is a​ drug, and this should be discussed with your healthcare​ provider."

The nurse plans to teach clients about the difference between herbal preparations and prescription medications. Which statement describes the best plan by the​ nurse? A. ​"Herbs, like prescription​ drugs, usually only contain one active​ ingredient." B. ​"The active ingredients in an​ herb, unlike prescription​ drugs, may be present in just one part or many​ parts." C. ​"Most herbs, like prescription​ drugs, are standardized and regulated by the Food and Drug Administration​ (FDA)." D. ​"Herbs are considered to be safer than prescription medications as they are​ natural."

B. ​"The active ingredients in an​ herb, unlike prescription​ drugs, may be present in just one part or many​ parts."

The nurse prepares to teach clients about the safety and efficacy of herbal preparations. Which statement would be included in the best plan by the​ nurse? A. ​"Herbal preparations have to meet the same safety and efficacy standards as prescription and​ over-the-counter (OTC)​ drugs." B. ​"The manufacturer does not have to prove the safety or efficacy of the herbal​ preparation." C. ​"Herbal preparations must be tested for safety and efficacy prior to​ marketing." D. ​"The label on the herbal preparation is required by the Dietary Supplement Health and Education Act​ (DSHEA) to be​ accurate."

B. ​"The manufacturer does not have to prove the safety or efficacy of the herbal​ preparation."

The nurse is doing a holistic assessment on a client prior to starting antihypertensive medication. What should the nurse include in the​assessment?

Blood pressure Mood Level of education Belief in a higher power

The client uses Ginkgo biloba to enhance memory functioning but has not told the nurse about this herb. The healthcare provider orders warfarin​ (Coumadin) for this client. Which findings may the nurse find upon​ assessment? A. A blood glucose of 56. B. ​Headache, dizziness,​ sweating, and agitation. C. Petechiae and bleeding from the gums. D. An international normalized ratio​ (INR) of 3.0.

C. Petechiae and bleeding from the gums.

A student nurse asks a nurse how specialty supplements differ from herbal products. What is the​ nurse's best​ response? A. Specialty supplements must be prescribed. B. Specialty supplements are generally targeted for more general conditions. C. Specialty supplements can come from animal sources. D. Herbal products are more specific in their actions.

C. Specialty supplements can come from animal sources

The client tells the nurse that he or she has been taking herbal preparations to boost his or her immune system functioning. He or she does not know the names of the preparations. What is the best assessment question for the nurse to​ ask? A. ​"Would you please ask your wife or husband to discuss this with me during her next​ visit?" B. ​"Would you please ask your wife or husband to call the hospital pharmacist with the​ names?" C. ​"Would you please have your wife or husband bring the bottles to the​ hospital?" D. ​"Would you please tell your doctor about the herbs during the next​ visit?"

C. ​"Would you please have your wife or husband bring the bottles to the​ hospital?"

A new nurse on the orthopedic floor makes a medication error. Which statements by the nurse manager foster a safe environment in which nurses will report medication​ errors?

many of us have made a medication error in our careers. The most important issue is to identify why the error​ occurred I know you could not feel any worse than you already do. We need to discuss how this error happened and how we can prevent it from happening​ again It's really good that your client is OK and did not suffer any harmful effects of this error. We should discuss why this error occurred and how it can be prevented in the​ future Because you are a new​ nurse, we should sit down and discuss the procedure you followed to see what you could have done to prevent this​ error

The nursing instructor is teaching student nurses about the use of viruses in a bioterrorism attack. The nurse determines that learning has occurred when the students make which​ statement?

​"A bioterrorist attack with viruses is a real threat to​ Americans."

The nurse in the emergency department is caring for several clients from diverse cultures. Which statement shows the​ nurse's ability to provide culturally competent​ care?

​"I understand your religion prohibits blood transfusions. Would you consider nonblood​ alternatives?" ​"I just want to make sure you and your spouse understand the risks as you consider the​ options." "I don't really understand why you are afraid to take the medication. Do you have any questions I can answer to alleviate your​fear?"

The client is admitted to the hospital with sepsis following an elective abortion. The healthcare provider orders antibiotics that the client refuses​ stating, "I​ don't deserve​ them". What is the best response by the​ nurse?

​"You have a serious infection and really need the​ drug."

The nurse is reviewing the steps of the nursing process with a student. The nurse knows that the student understands the teaching when the student correctly lists which of the following as the correct order of the nursing​process?

​Assessment, establish nursing​ diagnosis, planning,​ interventions, evaluation

The nurse follows the nursing process when conducting medication education about insulin. What will the nurse ask the client to evaluate the​client's knowledge of​ insulin?

​Can you tell me four points you remember about how to take your​insulin?

A nurse administering medications to a variety of patients on a​ medical-surgical floor recognizes that which clients may need additional education about medication​ adherence?

​Fifty-year-old recently remarried male taking antihypertensive medication Thirty-four-year-old female with family history of blood clots taking an estrogen oral contraceptive Thirty-eight-year-old male recently started on an antidepressant Twenty-eight-year-old female started on acne medication known to cause​ male-patterned hair growth

A small nuclear weapon has been detonated in a nearby city. Which immediate symptoms of radiation sickness will the nurse assess in clients who have been​ exposed?

​Nausea, vomiting, and diarrhea.


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