course point questions
A patient with a longstanding diagnosis of chronic renal failure has experienced a significant decline in urine output in recent days, prompting him to seek care at a local clinic. A nurse at the clinic has suggested to a colleague that the administration of a diuretic such as hydrochlorothiazide may improve the patient's urine output. How should the colleague best respond to this suggestion?
"Actually, patients with renal failure usually can't take hydrochlorothiazide."
The nurse is teaching a nursing student about anemia and knows that it is important to start by explaining the causes of anemia. Which statement is true about the cause of anemia?
"Anemia is a condition caused by reduced amounts of hemoglobin, causing less oxygen to be delivered to the tissues."
A client has been taking a urinary tract anti-infective for two days for treatment of a severe urinary tract infection. Today, the client calls the clinic reporting continued burning on urination. What is the nurse's best response?
"Burning on urination is a common side effect of these drugs. This may continue the entire time that you are on the medication."
A patient has been receiving intramuscular injections of hydroxocobalamin as treatment for pernicious anemia. Which statement by the patient indicates that he understands the therapy?
"I will need these injections monthly for the rest of my life."
A client diagnosed with iron deficiency anemia is learning about her prescribed iron supplement. Which additional information would the nurse include in the client's teaching plan?
"If constipation or diarrhea become severe, call your primary care provider."
A client prescribed epoetin alfa asks how the medication works. Which is the nurse's best response?
"Increases the release of cells to increase the hemoglobin and hematocrit levels."
Which instruction would be most appropriate for a client who is taking a diuretic?
"It's okay to take it with food."
After teaching a patient who is receiving ferrous sulfate about the drug therapy regimen, which patient statement indicates that the teaching was successful?
"My stools might turn dark or green."
Which client statement demonstrates an accurate understanding of the action of a prescribed anticoagulant?
"This medication will keep unnecessary clots from forming in my blood."
A 56-year-old woman will soon begin treatment of her overactive bladder with tolterodine (Detrol). What patient teaching should the nurse provide to this woman
"You might find that you get a dry mouth or a headache from this drug, but this does not mean it has to be discontinued."
A 56-year-old woman will soon begin treatment of her overactive bladder with tolterodine (Detrol). What patient teaching should the nurse provide to this woman?
"You might find that you get a dry mouth or a headache from this drug, but this does not mean it has to be discontinued."
The nurse is administering furosemide IV to a client. How soon after administration does the nurse expect diuretic effects to peak?
30 minutes
A client asks the nurse what dose of acetylsalicylic acid (aspirin) is needed for antiplatelet effects to prevent heart attacks. What dose is most appropriate to reduce platelet aggregation?
300-325 mg/d is the usual dosage to reduce risk of death or nonfatal MI in patients with a past history of MI or with angina.
Heparin therapy is prescribed to a client with deep vein thrombosis. Which client would be at greatest risk of bleeding from this therapy?
45 year old women w peptic ulcer disease
After teaching a group of students about anemias, the instructor determines that the teaching was effective when the students identify what as the critical issue?
Altered red blood cell production or deficient functioning of red blood cells
A client has been administered heparin to prevent thromboembolism development status postmyocardial infarction. The client develops heparin-induced thrombocytopenia. Which medication will be administered?
Argatroban 9 - thrombin inhibitor
The home care nurse is caring for a client who is self-administering epoetin. What assessment is most important for the nurse to complete during the visit?
Blood pressure
The client is a woman, 69 years of age, seen in the clinic for anemia and administration of epoetin alfa. Before giving the drug, the nurse takes a complete history and reviews the client's EMR, because the nurse knows that epoetin alfa is contraindicated for which conditions? (Select all that apply.)
Clients with uncontrolled hypertension Clients needing an emergency transfusion Clients with a hypersensitivity to human albumin
A patient is receiving oxybutynin for treatment of overactive bladder. The patient also takes haloperidol (Haldol) drug as an antipsychotic agent. What effect of interaction of these two drugs should the nurse observe in the patient?
Decreased effect of the antipsychotic drug
A nurse is seeing a client who has been prescribed phenazopyridine in combination with an antibacterial medication to treat a urinary tract infection. What is important for the nurse to tell the client about this treatment?
Do not take this medication for more than two days
A 69-year-old client has been diagnosed with malignant melanoma. The care team has collaborated with the client and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the client may develop which adverse effect?
Flulike symptoms
A client prescribed both an ACE inhibitor and a beta-blocker for the treatment of hypertension has been consistently obtaining blood pressure readings in the vicinity of 145/90 mm Hg. As a result, the client's primary health care provider has prescribed furosemide. What order would be most consistent with this client's health needs?
Furosemide 40 mg PO BID
Which drug is most effective in reducing most major types of dyslipidemia in patients at risk or who have already developed CAD?
HMG-CoA reductase inhibitors
A nurse is providing care to a client who has elevated levels of low-density lipoprotein (LDL). A review of the client's history reveals a sedentary lifestyle and a history of being overweight. The nurse understands that this combination of factors places the client at risk for which condition?
Heart disease
A 91-year-old client, who is being prepared for discharge, has been prescribed the diuretic spironolactone. While teaching the client about the drug, what major adverse effect should the nurse be sure to mention?
Hyperkalemia
A client who has been taking hydrochlorothiazide arrives at the clinic for his 1-month follow-up appointment. The client tells the nurse that he feels weaker since he began taking the drug. What should the nurse consider as a possible cause of these symptoms?
Hypokalemia
The pharmacology class learns that epoetin alfa is an immunosuppressant drug that is designed to have what expected outcome?
Increased RBC count
Which lipid level would the nurse interpret as being high?
LDL level of 190 mg/dL would be considered high
The nurse is caring for a client who takes fluvastatin . Which laboratory value should be assessed regularly in this client?
LFT
To effectively prevent or manage metabolic syndrome, what should the desired blood lipid profile include? (Select all that apply.)
Low triglycerides High HDL cholesterol Low LDL cholesterol
Adverse effects of epoetin and darbepoetin include increased risks of what condition?
Myocardial infarction
Which nursing observation is an appropriate outcome to indicate effective anti-infective therapy for a urinary tract infection?
Negative urinalysis
A 3-year-old has a history of recurrent urinary tract infections (UTI). Which practice implemented by the parents for the child indicates an understanding of preventive measures regarding these infections?
No use of bubble bath liquids or salts
cholesterol levels
Normal HDL should be greater than 40 mg/dl, LDL should be less than 100 mg/dl, and total cholesterol should be less than 200 mg/dl.
The pharmacology instructor is discussing heparin with the students. How would the instructor explain the action of heparin?
Promotes the inactivation of clotting factors
For which disorder would treatment with an anti-infective be appropriate?
Pyelonephritis
What should the nurse review about an antihyperlipidemic medication with the client when completing discharge counseling? (Select all that apply.)
Reason for taking the prescribed drug Drug name Correct dose Frequency of administration Dosage form
The nurse is caring for a patient with chronic kidney disease who is receiving epoetin alfa. Which assessment finding would be of greatest concern for the nurse?
Reports of calf pain on dorsiflexion of the foot
A client with iron deficiency anemia has begun taking daily supplements of oral ferrous sulfate. The nurse should add what nursing diagnosis to the nursing care plan?
Risk for constipation related to use of iron supplements
Which nursing diagnosis is highest priority for a patient with history of urinary urgency who is taking oxybutynin (Ditropan)?
Risk for impaired urinary elimination
A client is to receive enoxaparin. The nurse would administer this drug by which route?
SUBQ LMWH- given sub q at 90 degrees
A male client has cirrhosis and is receiving diuretic therapy. The nurse knows that what drug will help prevent metabolic alkalosis or hypokalemia in this client?
Spironolactone
Which is an appropriate intervention for a side effect of a urinary antispasmodic medication?
Suck on ice or hard candy to treat dry mouth
Which symptom, if assessed after the administration of epoetin alfa (Epogen), would be cause for alarm?
The patient displays weakness on one side of the body.
A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective?
The patient's hemoglobin level is 11 g/dL
A client prescribed epoetin alfa requests changing the medication from the subcutaneous to the oral route. Which statement should the nurse use to formulate a response to this request?
This drug is destroyed by acids found in the stomach.
After teaching a group of students about metabolic syndrome, the instructor determines that the teaching was successful when the students identify which characteristic?
Triglyceride level above 150 mg/dl
The component of the red blood cell that is not recycled is bilirubin.
True
The patient is being prescribed epoetin alfa for the treatment of anemia related to the renal failure. The patient also has a history of diabetes mellitus, uncontrolled hypertension, osteoarthritis, and hypothyroidism. Which of these conditions should the nurse bring to the physician's attention prior to administering the medication?
Uncontrolled hypertension
A nursing instructor is teaching students about the myelin sheath of the central nervous system (CNS). The nurse knows that teaching has been effective when a student identifies which vitamin as necessary for the formation of the myelin sheath in the CNS?
Vitamin B12
A client, diagnosed with chronic renal failure, has begun experiencing increasing shortness of breath. The nurse suspects that the client is experiencing symptoms associated with which resulting condition?
anemia lack of oxygen
A client taking warfarin after open heart surgery reports pain in both knees that began this week. The nurse notes bruises on both knees. Based on the effects of the medications and the report of pain, what should the nurse suspect is the cause of the pain?
bleeding
In addition to being synthesized in the liver and intestine, from where are blood lipids derived?
diet
Which would lead a nurse to suspect that a client most likely has pyelonephritis?
flank pain
Which diuretic will most likely be the initial drug of choice when a client demonstrates dyspnea related to pulmonary edema?
furosemide
Which genetic clinical condition will likely, over the course of the client's lifetime, require the pharmaceutical introduction of clotting factors to assure the client's safety?
hemophilia
A client has developed the formation of clots and has bruising. It is determined that there is a depletion of the client's coagulation factors and widespread bleeding. Which medication will be administered?
heparin
The nurse is caring for a client who is receiving epoetin alfa. What adjunct treatment will the nurse expect the health care provider to order for this client?
iron supplement
A client is receiving warfarin. The nurse would expect to administer this drug by which route?
oral
A client is to receive clopidogrel. The nurse would expect to administer this agent by which route?
oral
The nurse is administering a urinary tract drug that exerts a topical analgesic effect on the lining of the urinary tract. Which drug would the nurse likely administer?
phenazopyridine
The pharmacology instructor is discussing heparin with the students. How would the instructor explain the action of heparin?
promotes the inactivation of clotting factors
A client accidentally ingested extra doses of warfarin at home and now presents with an elevated INR and bleeding. Which medication will the nurse prepare as prescribed to administer along with vitamin K?
prothrombin complex concentrate
A client with a urinary tract infection (UTI) has a new prescription for nitrofurantoin. The nurse would question this order if the client has a history of:
renal dysfunction.
The client has been taking rosuvastatin for hyperlipidemia. The client now presents with severe weakness and states barely being able to move the extremities. The nurse suspects the client has which?
rhabdomyolysis.
What substance is reabsorbed in the ascending limb of the loop of Henle?
sodium
A 73-year-old client receiving warfarin (Coumadin) has blood in the urinary drainage bag this morning. After reporting these observations to the health care provider, the nurse will expect to administer what substance?
vitamin K
The nurse is caring for a 73-year-old client receiving warfarin. When the nurse performs the initial shift assessment, the nurse observes blood in the client's urinary drainage bag. After reporting the observation to the physician, which substance will the nurse likely administer?
vitamin K