test 2 PREP U
The nurse is preparing a client with multiple sclerosis (MS) for discharge from the hospital to home. The nurse should tell the client:
"Keep active, use stress reduction strategies, and avoid fatigue."
upon review of a clients phenytoin levels, a nurse notes a value of 16 mcg/ml what should the nurse do next
(10-20 is normal)
The nurse understands that several physiologic changes are related to normal aging. Which change is the least affected by the pharmacokinetic process process during aging?
*Absorption* Explanation: Although absorption seems to be the least affected pharmacokinetic process during aging, several physiologic changes related to absorption affect drug therapy.
A *76-year-old* patient is brought into the clinic via wheelchair by a family member. The patient has *end-stage renal disease, hypertension, diabetes mellitus, and two prior myocardial infarctions*. What category of elderly is this patient considered?
*Frail elderly* Explanation: Some older adults are not independent and are in poor or compromised health. These are the *frail elderly, a term that describes all people older than 65 years who have one or more debilitating conditions.* Being frail and elderly places a person at higher risk for developing serious adverse drug effects.
Which of the following substances would most likely *inhibit the cytochrome P450* enzyme system?
*Ketoconazole* is an example of a drug that inhibits the activity of the cytochrome P450 enzyme system. *Nicotine, alcohol, and glucocorticoids, such as cortisone, increase* the activity of this enzyme system.
Which of the following drug types have been discovered but not "adopted" by any drug company?
*Orphan drugs* have been discovered but are not financially viable and therefore have not been "adopted" by any drug company.
For what reason is the *creatinine level* alone *not a good indicator of renal function* in the *older adult*?
*There is a decline in overall muscle mass, which produces a lower creatinine level.* The normal range is maintained because *creatinine production declines* in the older patient as *muscle mass decreases*; therefore,* less creatinine overall* exists in the older adult to be filtered. *should not be interpreted as an indication of normal renal function in elderly patients.*
The elderly client has been *noncompliant with taking a prescribed medication*. The nurse next asks the client
*What is the reason you have not taken the medication?"* Explanation: The nurse seeks the reason the client is noncompliant. This question is *open-ended*, provides the most information, and now allows the nurse to better intervene with the client. The other questions are close-ended and nontherapeutic
An elderly client has taken flurazepam (Dalmane) for sleep and has experienced signs of a *paradoxical reaction*. The nurse
*implements fall prevention strategies* Explanation: Signs of a paradoxical reaction to a benzodiazepine would include restlessness and inability to fall alseep. The nurse would implement fall prevention strategies. *A paradoxical reaction is not a common reaction.* The nurse does not administer a different medication to induce sleep while the effects of flurazepam is still active. No data support the nursing diagnosis of Ineffective coping.
at an obstetrics and gynecology physicians office, a nurse and nursing student discuss the prioritization of returning client phone messages. which of the following clients would be a priority to call
34 weeks blurred vision 36 anxious 30 weeks morning sickness
after completing assessment rounds, which client should the nurse discuss with the health care provider first
A client with hepatitis whose pulse was 84 and regular and is now 118 and irregular.
the nurse beginning the shift is planning care for 6 clients on the post partum unit. three of the clients have immediate needs and 3 of the clients are listed as stable. for the best utilization of time and client safety the nurse should make rounds on which client first
A mother who had a spontaneous vaginal delivery and received methlergonovine maleate (Methergine)
A client with stage II Alzheimer's disease is admitted to the short stay unit after cardiac catheterization that involved a femoral puncture. The client is reminded to keep his leg straight. A knee immobilizer is applied, but the client repeatedly attempts to remove it. The nurse is responsible for three other clients who underwent cardiac catheterization. What's the best step the nurse can take
Ask the staffing coordinator to assign a nursing assistant to sit with the client.
Which of the following Food and Drug Administration (FDA) pregnancy categories indicates that animal studies on the drug have shown adverse fetal effects, but there are no adequate studies in humans?
Category C drugs are those in which animal studies have shown adverse fetal effects, but there are no adequate studies in humans.
a nurse is relieving the triage nurse in labor and birthing unit who is going to lunch. the report indicates that there are 3 clients having their vital sign assessed and a fourth client on her way to the unit from the emergency department in which order of priority from first to last should the nurse manage these clients
First, the nurse should assess the client from the emergency department who is screaming because she may be anywhere along the labor continuum and her status will be unknown until she has a vaginal exam to determine cervical effacement and dilation. The nurse should next assess the client with right lower quadrant pain as she may be experiencing an ectopic pregnancy or appendicitis and may need further evaluation by the health care provider. The client with clear vesicles and brown vaginal discharge is experiencing a molar pregnancy and will need to have a D&C to evacuate the vesicles; this condition will not jeopardize the life of the mother if no intervention occurs within an hour. The client who is at term without fetal movement is a priority from an emotional concern if there is no heart beat when she is evaluated, but the physical status of the fetus with no fetal movement for 2 days will not change if not seen within the next half hour and the nurse can see this client last. The emotional care for this client will be extensive if there is a diagnosis of fetal demise and the nurse should plan the time to be available to support this client as needed.
The nurse dispensing medications to clients knows that medications have various names. *Which of the following is the medication name most physicians use to prescribe drugs?*
Generic name Explanation: The generic name is assigned by the medication's first manufacturer. If more than one company makes the same medication, it will have the same generic name, but different trade names. For this reason, many physicians order medications using only the generic name.
the nurse is caring for a child with a head injury place the following assessments in order of priority
LOC motor vitals DECREASED URINE OUTPUT
a nurse in the gynecologic surgery unit observes a respiratory therapist take medication cup with pills that was sitting in the medication room what course of action should the nurse take
Report the situation to the nursing supervisor.
When describing the characteristics of the client who comes into the health care system today, which of the following would apply?
The use of a complex array of OTC and alternative therapies
several pregnant clients are waiting to be seen in ob unit what client should nurse see first
a client 32 week gestation who has preeclampsia, protein in urine 3+
the nurse has received a change of shift report the nurse should assess which client first
blood alcohol level
the client performs self peritoneal dialysis, what should the nurse teach the client about preventing peritonitis. select all that apply
broad spectrum antibiotics characterized by cloudy antibiotics may be added peritonitis is most common
as the nurse enters the room of a newly admitted primigravida client diagnosed with severe preeclampsia the client begins to experience a seizure, the nurse should do which in order of priority from first to last
call for help maintain airway turn client ROM
a nurse manager is making morning assessment for the nursing team which duties can be assigned to the nursing assistant
changing linen transferring total IO repo a client
the nurse is assisting with bone marrow aspiration and bone marrow biopsy place the tasks in order in which the nurse should preform them
consent position clean ice
a charge nurse is completing client assignment on a neurologic unit. one full time nurse from the unit, two floating nurse, one agency nurse are present for the shift. the charge nurse should assign the units full time nurse to care for the client who
craniotomy hemorrhage
A staff nurse on a pediatric unit has a four-client assignment. Which child should the nurse assess first? a) A 7-year-old child whose mother is waiting for discharge instructions b) A 9-year-old child with a broken leg who wants help moving from the bed to the chair c) An 8-year-old child admitted from the postanesthesia care unit who's complaining of pain d) A 10-year-old child with asthma whose oxygen saturation levels are dropping d) A 10-year-old child with asthma whose oxygen saturation levels are dropping
d) A 10-year-old child with asthma whose oxygen saturation levels are dropping d) A 10-year-old child with asthma whose oxygen saturation levels are dropping
a nurse suspects that a coworker is self administering illegal drugs during work hours what is the first action a nurse should take
notify nurse manager and document the situation
the nurse is caring for a client scheduled for surgery who on the morning of the scheduled operation states that he/she wants to cancel it. what would be the best response by the nurse
explore reasons
hydralazine instead of hyrdoxazine
inservice.... change appearance label
8 farm workers are admitted to the emergency department after they were splashed with a couple of chemicals at work 30 minutes ago they have watery itchy eyes slight cough diaphoresis constricted pupils are conscious and oriented. their clothes are wet which action should the nurse do first
isolation
a client is brought to the emergency department with a abdominal trauma following an automobile accident, the vitals signs are as follows heart rate 132 rr 28 bp 84/58
iv .9
rick skipped one.... DUMBAzz
rick is a dumbazz
the client with benign prostatic hypertrophy is being transferred from emergency department to a surgery unit. most important info to pass on to nurse
the client was catheterized, urine appeared cloudy
pharmacokinetics
the study of the time course of drug absorption, distribution, metabo- lism, and excretion
the nurse is assigning clients for the evening shift which clients are appropriate for the nurse to assign to LPN to provide client care
ulcerative colitis inguinal hernia repair
Which of the following represents a pharmacokinetic phase? Select all that apply. You selected: • Absorption • Distribution • Metabolism Incorrect Correct response:
• Absorption • Distribution • Metabolism • Excretion The *pharmacokinetic phases* are absorption, distribution, metabolism, and excretion. *The acronym A.D.M.E.* is a helpful way to remember to pharmacokinetic phases.
