med surg eaq
Which statement would the nurse provide to a client scheduled for an endoscopic sphincterotomy to remove a gallstone lodged in the common bile duct who asks the nurse about pain during the procedure? "All you'll need is an oral painkiller." "Epidural anesthesia usually is given." "You will get a local injection at the site." "An intravenous [IV] sedative usually is administered."
"An intravenous [IV] sedative usually is administered."
Which instruction about phenytoin will the nurse provide during discharge teaching to a client with epilepsy who is prescribed phenytoin for seizure control? "Antiseizure medications will probably be continued for life." "Phenytoin prevents any further occurrence of seizures." "This medication needs to be taken during periods of emotional stress." "Your antiseizure medication usually can be stopped after a year's absence of seizures."
"Antiseizure medications will probably be continued for life."
Which action would the nurse teach to a client with pulmonary tuberculosis who is prescribed a combination of rifampin and isoniazid? "Report any changes in vision." "Take the medicine with my meals." "Call my doctor immediately if my urine or tears turn red-orange." "Continue taking the medicine even after I feel better."
"Continue taking the medicine even after I feel better."
Which statement by the client receiving corticosteroids after a bilateral adrenalectomy indicates to the nurse that additional education is needed? "I need to have periodic tests of my blood for glucose." "I am glad that I only have to take the medication once a day." "I must take the medicine with meals." "I should tell my health care provider if I am overly restless or have trouble sleeping."
"I am glad that I only have to take the medication once a day." Usually, a larger dose is given at 8:00 AM and the second dose is given before 4:00 PM to mimic expected hormonal secretion and prevent insomnia. Having periodic blood tests for glucose is necessary because long-term administration of steroids leads to elevated blood glucose levels and possible steroid-induced diabetes. Oral corticosteroids should be taken with food or antacids to prevent gastric irritation and gastric hemorrhage. Neurological and emotional side effects, such as euphoria, mood swings, and sleeplessness, are expected.
Which advice will the nurse include when discussing postoperative medication therapy with a client admitted to the hospital for a subtotal thyroidectomy? "You will be taking iodine daily to increase the formation of thyroid hormone." "After your body adjusts to postsurgical status, you will be weaned off this medication." "The propylthiouracil that is prescribed will stimulate the secretion of thyroid-stimulating hormone." "If you develop palpitations, nervousness, or tremors, the dose of thyroid hormone may need to be decreased."
"If you develop palpitations, nervousness, or tremors, the dose of thyroid hormone may need to be decreased."
Which response would a nurse give to a client who asks "Why can't I take the insulin in pills instead of taking shots?" during a teaching session about insulin injections? "Insulin cannot be manufactured in pill form." "Insulin is destroyed by gastric juices, rendering it ineffective." "Your health care provider decides the route of administration." "Your health care provider will prescribe pills when you are ready."
"Insulin is destroyed by gastric juices, rendering it ineffective."
How would a nurse respond to the spouse of a client with an intracranial hemorrhage who asks the nurse, "Why aren't they administering an anticoagulant?"? "It is not advisable because bleeding will increase." "If necessary, it will be started to enhance circulation." "If necessary, it will be started to prevent pulmonary thrombosis." "It is inadvisable because it masks the effects of the hemorrhage."
"It is not advisable because bleeding will increase."
How will the nurse respond to a client with cancer experiencing severe nausea and vomiting from chemotherapy who wants to know if it is true that smoking marijuana will help? "Nurses are not allowed to discuss illegal substances with clients." "Marijuana is effective for nausea and vomiting if it is injected." "Marijuana is not proven to be effective in preventing chemotherapy-induced nausea and vomiting." "Some tetrahydrocannabinol (THC)-based medications that contain marijuana control chemotherapy-induced nausea and vomiting in some people."
"Some tetrahydrocannabinol (THC)-based medications that contain marijuana control chemotherapy-induced nausea and vomiting in some people."
How would the nurse respond to a female client receiving cortisone therapy for adrenal insufficiency who expresses concern that she is developing facial hair? "It is just another sign of adrenal insufficiency." "This side effect will disappear after therapy." "This is not important as long as you are feeling better." "The medication contains a hormone that causes male characteristics."
"The medication contains a hormone that causes male characteristics."
Which response would the nurse provide to a client receiving digoxin who calls the clinic and complains of "yellow vision."? "This is related to your illness rather than to your medication." "This is an expected side effect; you will become accustomed to it over time." "This side effect is only temporary. You should continue the medication." "The medication may need to be discontinued. Come to the clinic this afternoon."
"The medication may need to be discontinued. Come to the clinic this afternoon."
A client is prescribed 4 mg of hydromorphone intravenously (IV) every 4 hours, as needed. Hydromorphone is supplied at 10 mg/mL. How many milliliters of hydromorphone will the nurse administer per dose? Record your answer using one decimal place and leading zero if applicable.
0.4
A health care provider prescribes 250 mg of a medication. The vial reads 500 mg/mL. How many milliliters of medication will the nurse administer? Record your answer using one decimal place and leading zero if applicable.
0.5
A client is to receive metoclopramide 15 mg orally before meals. The concentrated solution contains 10 mg/mL. How many milliliters of solution will the nurse administer? Record your answer using one decimal place.
1.5 mL
An intravenous (IV) antibiotic in 50 mL of 0.9% sodium chloride needs to be administered over 20 minutes. The nurse will set the infusion pump to deliver how many milliliters per hour? Record your answer using a whole number.
150 ml/h
The nurse needs to administer lidocaine HCl at 1.5 mg per minute. The medication is available as 500 mg in 100 mL of D 5W. The nurse will set the intravenous (IV) infusion pump to deliver how many milliliters per hour?
18 ml/h
Filgrastim 5 mcg/kg/day by injection is prescribed for a client who weighs 132 lb. The vial label reads filgrastim 300 mcg/mL. How many milliliters will the nurse administer? Record your answer using a whole number.
1ml
Colchicine 1200 mcg orally is prescribed for client with gout. Each tablet contains 0.6 mg. How many tablets will the nurse administer? Record your answer using a whole number.
2
Cyanocobalamin (vitamin B 12) 0.2 mg intramuscularly (IM) is prescribed for a client with pernicious anemia. Each vial of the medication contains 100 mcg/mL. How many milliliters will the nurse administer? Record your answer using a whole number.
2 mL
The nurse must administer streptomycin 1 g intramuscularly (IM) to a client. The vial contains 500 mg/mL. How much solution must the nurse administer? Record your answer using a whole number.
2 mL
Acyclovir 0.8 g by mouth is prescribed for a client with herpes zoster. The oral suspension contains 200 mg/5 mL. How many milliliters will the nurse administer? Record your answer using a whole number.
20 ml
The health care provider prescribes intravenous fluids to be infused at 100 mL/h. The intravenous tubing delivers 15 drops/milliliters. The nurse will infuse the solution at a flow rate of how many drops per minute? Record your answer using a whole number.
25 drops per min
A client has an intravenous (IV) solution of 5% dextrose in water (D 5W) 250 mL to which 100 mg of morphine is added. The health care provider prescribes 14 mg of morphine per hour for end-of-life palliative treatment of a client. At how many milliliters per hour will the nurse set the IV pump? Record your answer using a whole number.
35 mL
Metformin 2 g by mouth is prescribed for a client with type 2 diabetes. Each tablet contains 500 mg. How many tablets will the nurse administer? Record your answer using a whole number.
4
Ceftriaxone 2.5 g intravenous piggyback (IVPB) every 8 hours is prescribed. The pharmacy sends a vial labeled 5 grams per 10 mL. How many milliliters of ceftriaxone will the nurse add to the IVPB solution ? Record your answer using a whole number.
5 mL
The nurse prepares to administer oxybutynin 30 mg orally. Each tablet contains 5 mg. How many tablets will the nurse administer? Record your answer using a whole number.
6 tablets
At 10:00 AM the nurse hangs a 1000-mL bag of 5% dextrose in water (D 5W) with 20 mEq of potassium chloride to be administered at 80 mL/h. At noon the health care provider prescribes a stat infusion of an intravenous (IV) antibiotic of 100 mL to be administered via piggyback over 1 hour. How much longer than expected will it take the primary bag to empty if the nurse interrupts the primary infusion for infusion of the antibiotic? 15 minutes 30 minutes 45 minutes 60 minutes
60 minutes An infusion of 1000 mL at 80 mL should take 12.5 hours. Because the primary infusion is interrupted for an hour while the antibiotic is infused, the primary bag will run an hour longer than if it were running uninterrupted. Minutes that are less than an hour are incorrect calculations.
One liter of 5% dextrose solution contains 50 grams of sugar. The nurse calculates that 3 L solution/day will supply approximately how many kilocalories? 400 600 800 1000
600
The health care provider prescribes 1000 mL of total parenteral nutrition (TPN) to be administered in 12 hours. Based on this prescription, how many milliliters of solution will be administered per hour? 83 mL/h 100 mL/h 108 mL/h 125 mL/h
83 mL/h
Which blood type must a person have to be a universal recipient? A B O AB
AB
Which action would the nurse expect in the plan of care of a client scheduled for an adrenalectomy? Provide a low-protein diet. Administer parenteral corticosteroids. Collect a preoperative 24-hour urine specimen. Withhold all medications 48 hours before surgery.
Administer parenteral corticosteroids.
Which action would be taken by the nurse caring for a client with type 1 diabetes mellitus who has a finger-stick glucose level of 258 mg/dL (14.3 mmol/L) at bedtime and a prescription for sliding-scale regular insulin? Call the health care provider. Encourage intake of fluids. Administer the insulin as prescribed. Give the client 4 ounces of orange juice.
Administer the insulin as prescribed. A value of 258 mg/dL (14.3 mmol/L) is above the expected range of 70 to 100 mg/dL (3.6-5.6 mmol/L); the nurse would administer the regular insulin as prescribed. Calling the health care provider is unnecessary; a prescription for insulin exists and should be implemented. Encouraging the intake of fluids is insufficient to lower a glucose level this high. Giving the client orange juice is contraindicated because this will increase the glucose level further. Orange juice, a complex carbohydrate, and a protein should be given if the glucose level is too low.
How can the nurse prevent vomiting in a client who reports feeling nauseated after cataract surgery? Administer the prescribed antiemetic medication. Provide some dry crackers for the client to eat. Explain that this is expected after surgery. Teach how to breathe deeply until the nausea subsides.
Administer the prescribed antiemetic medication.
Which element, if missing from a newly admitted client's medication administration record (MAR), makes the record incomplete? Height Allergies Vital signs Body weight
Allergies
Which contraindication would a nurse assess for when preparing to administer eardrops to a client who has impacted cerumen? Select all that apply. One, some, or all responses may be correct. Allergy to the medication Itching in the ear canal Evidence of a fungal infection Conductive hearing loss in the affected ear
Allergy to the medication
Which medication is used to treat Helicobacter pylori infection? Select all that apply. One, some, or all responses may be correct. Amoxicillin Tetracycline Pantoprazole Metronidazole Bismuth subsalicylate
Amoxicillin Tetracycline Pantoprazole Metronidazole Bismuth subsalicylate
Which property of acetylsalicylic acid would a nurse recall when administering to a client? Sedative Hypnotic Analgesic Antibiotic
Analgesic
Which explanation would the nurse provide to a client with gastric ulcer disease who asks the nurse why the health care provider has prescribed metronidazole? To augment the immune response To potentiate the effect of antacids To treat Helicobacter pylori infection To reduce hydrochloric acid secretion
Approximately two-thirds of clients with peptic ulcer disease are found to have Helicobacter pylori infecting the mucosa and interfering with its protective function. Antibiotics do not augment the immune response, potentiate the effect of antacids, or reduce hydrochloric acid secretion.
Which client response indicates to the nurse that a vasodilator medication is effective? Absence of adventitious breath sounds Increase in the daily amount of urine produced Pulse rate decreases from 110 to 75 beats/minute Blood pressure changes from 154/90 to 126/72 mm Hg
Blood pressure changes from 154/90 to 126/72 mm Hg
Which mineral deficiency would a nurse suspect in a client who reports tingling in the fingers and around the mouth and exhibits carpopedal spasm and tremors after a surgical thyroidectomy ? Potassium Calcium Magnesium Sodium
Calcium
Which complication would a nurse try to avoid by slowly administering a parenteral preparation of potassium? Metabolic acidosis Cardiac arrest Seizure activity Respiratory depression
Cardiac arrest
Which advice would the nurse include in a teaching plan to reduce the side effects of diltiazem? Lie down after meals. Avoid dairy products in diet. Take the medication with an antacid. Change slowly from sitting to standing.
Change slowly from sitting to standing.
Place the following nursing actions in the correct order for a client with esophageal varices prescribed a blood transfusion. 1. Check the client's vital signs. 2. Verify the blood product with another nurse against the client's identification (ID) bracelet. 3. Establish intravenous (IV) access with IV normal saline. 4. Monitor the client's vital signs and status according to agency policy.
Check the client's vital signs. Establish intravenous (IV) access with IV normal saline. Verify the blood product with another nurse against the client's identification (ID) bracelet. Monitor the client's vital signs and status according to agency policy.
Which benefit would be provided by administering patient-controlled analgesia (PCA) to a client after surgery? Select all that apply. One, some, or all responses may be correct. Client is able to self-administer pain-relieving medications as necessary Amount of medication received is determined entirely by the client Decreases client dependency Relieves the nurse of monitoring the client Increases client sense of autonomy
Client is able to self-administer pain-relieving medications as necessary Decreases client dependency Increases client sense of autonomy
Which goal is the priority for a client with asthma who has a prescription for an inhaled bronchodilator? Is able to obtain pulse oximeter readings Demonstrates use of a metered-dose inhaler Knows the health care provider's office hours Can identify triggers that may cause wheezing
Clients with asthma use metered-dose inhalers to administer medications prophylactically or during times of an asthma attack; this is an important skill to have. Home management typically includes self-monitoring of the peak expiratory flow rate rather than pulse oximetry. Although knowing the health care provider's office hours is important, it is not the priority; during a persistent asthma attack that does not respond to planned interventions, the client should go to the emergency department of the local hospital or call 911 for assistance. Although it is important to be able to identify triggers that may cause wheezing, knowing these cannot prevent all wheezing; therefore, being able to abort wheezing with a bronchodilator is the greater priority.
Which finding would lead the nurse to recheck the blood glucose level of a diabetic client before administering a mealtime insulin dose? Select all that apply. One, some, or all responses may be correct. Confusion Drowsiness Diaphoresis Nervousness Heart rate 110 beats/min
Confusion Drowsiness Diaphoresis Nervousness Heart rate 110 beats/min
Which clinical finding leads the nurse to conclude that an IV has infiltrated rather than caused inflammation? Pain Coolness Localized swelling Cessation in flow of solution
Coolness
Which response indicates that a beta blocker prescribed for persistent ventricular tachycardia is working effectively? Decreased anxiety Reduced chest pain Decreased heart rate Increased blood pressure
Decreased heart rate
Which medication would a nurse suspect is the cause of severe nausea and a heartbeat that is irregular and slow in a client who takes multiple medications? Digoxin Captopril Furosemide Morphine sulfate
Digoxin
Which symptom would the nurse include when teaching a client with arthritis who takes large doses of aspirin about the clinical manifestations of aspirin toxicity? Feelings of drowsiness Disturbances in hearing Intermittent constipation Metallic taste in the mouth
Disturbances in hearing
Which statement explains why are so many drugs are necessary for a client with stage III Hodgkin's disease who is started on a multiple-drug regimen of doxorubicin, bleomycin, vinblastine, and dacarbazine? Using smaller doses of several drugs reduces the likelihood of serious side effects. Each drug destroys the cancer cell at a different time in the cell cycle. Several drugs are used to destroy cells that are not susceptible to radiation therapy. Because there are stages of Hodgkin's disease, if one drug is ineffective, another will work.
Each drug destroys the cancer cell at a different time in the cell cycle.
How would the nurse respond to a client admitted for dehydration who has an intravenous (IV) infusion of normal saline is started at 125 mL/h and one hour later begins screaming, "I can't breathe!"? Discontinue the IV and notify the health care provider. Elevate the head of the client's bed and obtain vital signs. Assess the client for allergies and change the IV to an intermittent lock. Contact the health care provider to request a prescription for a sedative.
Elevate the head of the client's bed and obtain vital signs.
Why would lactulose be prescribed for a client with a history of cirrhosis of the liver? The desire to drink alcohol is decreased. Diarrhea is controlled and prevented. Elevated ammonia levels are lowered. Abdominal distension secondary to ascites is decreased.
Elevated ammonia levels are lowered.
Which effect of povidone-iodine would the nurse consider when using it on the client's skin before obtaining a specimen for a blood culture? Avoids drying the skin Preferred to alcohol swabs because it doesn't create false-positive blood alcohol results Eliminates surface bacteria that may contaminate the culture Provides a cooling agent to diminish the feeling from the puncture wound
Eliminates surface bacteria that may contaminate the culture
Which adverse effect would a nurse monitor for in a client taking clopidogrel? Nausea Epistaxis Chest pain Elevated temperature
Epistaxis
Which assessment finding indicates an improvement when the nurse is evaluating the results of treatment with erythropoietin? 2+ pedal pulses Decreased pallor Decreased jaundice 2+ deep tendon reflexes
Erythropoietin stimulates red blood cell production, thereby decreasing the pallor that accompanies anemia. It would not have an appreciable effect on pulses or deep tendon reflexes. It would not have a role in alleviating jaundice.
Which advice will the nurse provide about doxorubicin to a client with Hodgkin's disease? Cease taking any medication that contains vitamin D. Keep the doxorubicin in a dark place protected from light. Expect urine to turn red for a few days after taking this medication. Take the doxorubicin on an empty stomach with large amounts of fluids.
Expect urine to turn red for a few days after taking this medication.
Which action would the nurse take in a client who takes rifampin who tells the nurse, "My urine looks orange."? Explain that this is expected. Check the liver enzymes. Ask the provider to order a urinalysis. Ask what foods were eaten.
Explain that this is expected.
Which food would the nurse instruct a client taking diltiazem to avoid? Alcohol Grapefruit juice Cheddar cheese Summer sausage
Grapefruit juice
Which action would the nurse perform first when a health care provider prescribes milrinone for a client with congestive heart failure? Administer the loading dose over 10 minutes. Monitor the electrocardiogram (ECG) continuously for dysrhythmias during infusion. Assess the heart rate and blood pressure continuously during infusion. Have the prescription, dosage calculations, and pump settings checked by a second nurse.
Have the prescription, dosage calculations, and pump settings checked by a second nurse. Accidental overdose can cause death. Another nurse would verify accuracy of the prescription, dose, and pump settings to prevent harm to the client. Although administering the loading dose over 10 minutes is an appropriate intervention, it is not the first thing the nurse would do. Although monitoring for dysrhythmias is important because they are common with this medication and may be life threatening, it is not the first thing the nurse would do. Although taking the vital signs continuously during the infusion is important because the dose needs are slowed or discontinued if the blood pressure decreases excessively, it is not the first thing the nurse would do.
Which mechanism of action explains how hydrochlorothiazide increases urine output? Increases the excretion of sodium Increases the glomerular filtration rate Decreases the reabsorption of potassium Increases renal perfusion
Hydrochlorothiazide inhibits sodium reabsorption in the nephrons, causing increased excretion of sodium, which increases urine excretion. The glomerular filtration rate is not affected. The loss of potassium is a side effect, not the mechanism of action. Renal perfusion is not affected.
Which adverse effect would a nurse monitor for when caring for a client receiving furosemide to relieve edema? Hypernatremia Elevated blood urea nitrogen Hypokalemia Increase in the urine specific gravity
Hypokalemia
In which category of fluids would the nurse classify an intravenous solution of 0.45% sodium chloride? Isotonic Isomeric Hypotonic Hypertonic
Hypotonic
Which information would the nurse provide to a client with hyperthyroidism receiving methimazole? Initial improvement will take several weeks. Few side effects are associated with this medication. This medication may be taken at any time during the day. Large loading doses are used initially to normalize thyroid function.
Initial improvement will take several weeks
Which topic will the nurse include in the discharge teaching of a client who has had a total gastrectomy? Daily use of a stool softener Injections of vitamin B 12 for life Monthly injections of iron dextran Replacement of pancreatic enzymes
Injections of vitamin B 12 for life
Which part of the renal system does furosemide exerts its effects? Distal tubule Collecting duct Glomerulus of the nephron Loop of Henle
Loop of Henle
Which therapy is indicated for a client admitted to the hospital after general paresis develops as a complication of syphilis? Penicillin therapy Major tranquilizers Behavior modification Electroconvulsive therapy
Massive doses of penicillin may limit central nervous system damage if treatment is started before neural deterioration from syphilis occurs. Tranquilizers are used to modify behavior, not to treat general paresis. Behavior, not paresis, is treated with behavior modification. Electroconvulsive therapy is used to treat certain psychiatric disorders.
Which potential side effect of docusate sodium would a nurse include in discharge teaching of a client who had repair of an inguinal hernia? Rectal bleeding Fecal impaction Nausea and vomiting Mild abdominal cramping
Mild abdominal cramping
Which medication for treatment of gastroesophageal reflux disease would be contraindicated in the pregnant client? Ranitidine Misoprostol Esomeprazole Calcium carbonate
Misoprostol is contraindicated in pregnancy because it can cause uterine contractions, expelling the developing fetus. Ranitidine, esomeprazole, and calcium carbonate are not contraindicated during pregnancy.
Which information will the nurse share about alopecia characteristics to a client who is to receive chemotherapy after surgery for cancer? Usually rare Not permanent Frequently prolonged Usually preventable
Not permanent
Which action will the nurse take in a client hospitalized for uncontrolled hypertension and chest pain on a daily diuretic for 2 days whose potassium level this morning is 2.7 mEq/L (2.7 mmol/L)? Send another blood sample to the laboratory to retest the serum potassium level. Notify the health care provider that the potassium level is above normal. Notify the health care provider that the potassium level is below normal. No action is required because the potassium level is within normal limits.
Notify the health care provider that the potassium level is below normal.
Which effect has resulted in the avoidance of tetracycline use in children under 8 years old? Birth defects Allergic responses Severe nausea and vomiting Permanent tooth discoloration
Permanent tooth discoloration Tetracycline use in children under the age of 8 years has been discontinued because it causes permanent tooth discoloration. Birth defects, allergic responses, and severe nausea and vomiting are not prevalent reasons for the discontinuation of tetracycline medications in children under 8 years old.
Which medication is unsafe to administer as an intravenous (IV) bolus? Saline flush Potassium chloride Naloxone Adenosine
Potassium chloride given as an IV bolus can cause cardiac arrest. It must be diluted and infused slowly through an IV infusion pump. Saline flush, naloxone, and adenosine are appropriate to be given as an IV bolus undiluted.
Which relationship reflects the relationship of naloxone to morphine sulfate? Aspirin to warfarin Amoxicillin to infection Enoxaparin to dalteparin Protamine sulfate to heparin
Protamine sulfate to heparin
Which action would the nurse take after contacting the primary health care provider of a post-surgical client complaining of nausea, fatigue, and a headache during the fourth hour of the infusion of total parenteral nutrition (TPN) instituted via a central venous infusion who has an hourly urine output that is twice the amount of the previous hour? Check the serum glucose level. Obtain an oxygen saturation level. Administer a prescribed analgesic. Elevate the head of the bed.
Rapid administration can cause glucose overload, leading to osmotic diuresis and dehydration. There is no indication of hypoxia. The client's headache should disappear with oral fluid replacement; analgesics are not indicated. There is no reason to elevate the head of the bed.
Which medication action would the nurse identify as the purpose of azathioprine, cyclosporine, and prednisone given before receiving a kidney transplant? Stimulate leukocytosis Provide passive immunity Prevent iatrogenic infection Reduce antibody production
Reduce antibody production
Which outcome would the nurse use to determine the effectiveness of sublingual nitroglycerin? Relief of anginal pain Improved cardiac output Decreased blood pressure Ease in respiratory effort
Relief of anginal pain
Which rationale would the nurse give to explain the purpose of administering an opioid analgesic via epidural catheter when providing postoperative teaching? Facilitates oxygen use Relieves abdominal pain Decreases anxiety and restlessness Dilates coronary and peripheral blood vessels
Relieves abdominal pain
Which instruction would the nurse include in a teaching plan for nitroglycerin patches? "Apply the patch on a distal extremity." "Remove a previous patch before applying the next one." "Massage the area gently after applying the patch to the skin." "Apply a warm compress to the site before attaching the patch."
Removing the previous patch before applying the next patch ensures that the client receives just the prescribed dose. Ideally, a patch should be removed after 12 to 14 hours to avoid the development of tolerance. The patch should be rotated among hair-free and scar-free sites; acceptable sites include the chest, upper abdomen, proximal anterior thigh, or upper arm. The patch should be gently pressed against the skin to ensure adherence; it should not be massaged. Applying a warm compress to the site before attaching the patch is unnecessary and can result in excessive absorption of the medication.
Which condition would the nurse monitor for in the client on aminoglycoside therapy and skeletal muscle relaxants? Stroke Respiratory arrest Myocardial infarction Abdominal discomfort
Respiratory arrest
Which adverse effect will the nurse assess for when caring for a client taking morphine sulfate for severe metastatic bone pain? Diarrhea Addiction Respiratory depression Diuresis
Respiratory depression
Which mechanism of action would the nurse identify for levodopa therapy prescribed to a client diagnosed with Parkinson disease? Blocks the effects of acetylcholine Increases the production of dopamine Restores the dopamine levels in the brain Promotes the production of acetylcholine
Restores the dopamine levels in the brain
Which advice will the nurse give the client to avoid lipodystrophy when self-administering insulin therapy? Exercise regularly. Rotate injection sites. Use the Z-track technique. Vigorously massage the injection site.
Rotate injection sites.
Which condition would the nurse identify as the likely cause of profound weakness and nervousness in a client that became confused shortly after self-administering the morning dose of 10 units of regular insulin and 25 units of NPH insulin after a light breakfast with no additional intake in the 3 hours since that time? Hyperglycemia Hyperinsulinemia Hypoglycemia Hypoinsulinemia
Severe hypoglycemia is a finding in diabetic clients who take insulin and miss a meal. Signs and symptoms of hypoglycemia are nervousness, weakness, confusion, and disorientation. Hyperglycemia is rare in clients who are on insulin therapy and decrease their intake. Hyperinsulinemia is a condition where an excess of insulin is produced by the pancreas in response to conditions such as insulin resistance or insulinomas. Hypoinsulinemia refers to abnormally low levels of insulin in the blood.
Which assessment is the nurse's priority before beginning an infusion of tissue plasminogen activator (t-PA) to a client in the emergency department? Vital signs Electrocardiogram (ECG) monitoring Signs of bleeding Level of chest pain
Signs of bleeding
Which action will the nurse take during administration of blood products to ensure the client's safety? Stay with client during first 15 minutes of infusion. Flush packed red blood cells with 5% dextrose and 0.45% normal saline. Remove the intravenous catheter if a blood transfusion reaction occurs. Administer the red blood cells through a percutaneously inserted central catheter line with a 20-gauge needle.
Stay with client during first 15 minutes of infusion.
Which mechanism of action explains how glyburide decreases serum glucose levels? Stimulates the pancreas to produce insulin Accelerates the liver's release of stored glycogen Increases glucose transport across the cell membrane Decreases absorption of glucose from the gastrointestinal system
Stimulates the pancreas to produce insulin
Which action will a nurse take first when caring for a client reporting chest pain, difficulty breathing, and feeling cold twenty minutes after an infusion of packed red blood cells begins? Stop the transfusion. Notify the health care provider. Provide several warm blankets. Assess vital signs.
Stop the transfusion.
Which technique will the nurse teach a client who has a prescription for a sublingual nitroglycerin tablet? Place the pill inside the cheek and let it dissolve. Place the pill under the tongue and let it dissolve. Chew the pill thoroughly and then swallow it. Swallow the pill with a full glass of water.
Sublingual medication is placed under the tongue and is quickly absorbed through the mucous membranes into blood. The buccal route requires placing medication between the cheek and gums. Chewing the pill and then swallowing it may be done for oral administration of some large pills, but not with the sublingual route of administration. Taking the pill with water is required with the oral route of administration of medication, but not with sublingual. In addition, a full glass of water may be an excessive amount of fluid to swallow one pill.
Which statement will the nurse need to consider when developing the teaching plan for a client with type 2 diabetes prescribed an oral hypoglycemic medication? Oral hypoglycemics work by decreasing absorption of carbohydrates. Oral hypoglycemics work by stimulating the pancreas to produce insulin. Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control. Serious adverse effects are not a problem for oral hypoglycemics.
Taking a tablet may give the client a false sense that the disease is under control, and this can lead to dietary indiscretions. Some oral hypoglycemics work by stimulating the pancreas to produce insulin, others work by decreasing carbohydrate absorption, and others work in a variety of other ways; therefore teaching should be specific to the medication prescribed. Oral hypoglycemic medications can have serious adverse effects.
Which property would the nurse understands that the medication is being primarily used primarily for when aspirin is prescribed on a regular schedule for a client with rheumatoid arthritis? Analgesic Antipyretic Anti-inflammatory Antiplatelet
The anti-inflammatory action of aspirin reduces joint inflammation. It can relieve pain and prevent abnormal clotting; however, although these effects can be beneficial, these are not the primary reasons that it is prescribed for rheumatoid arthritis. Aspirin reduces fever, but this is not the rationale for prescribing it for clients with rheumatoid arthritis.
For which circumstance would the nurse use the Z-track technique to administer a medication? A large volume of medication needs to be administered. The medication is irritating to subcutaneous tissue and skin. A depot medication is prescribed. The medication is lipophilic.
The medication is irritating to subcutaneous tissue and skin.
Within which period of time would a nurse advise the client to anticipate pain relief will begin when nitroglycerin sublingual tablets are prescribed for a client with the diagnosis of angina? 1 to 3 minutes 4 to 5 seconds 30 to 45 seconds 10 to 15 minutes
The onset of action of sublingual nitroglycerin tablets is rapid (1-3 minutes); duration of action is 30 to 60 minutes. If nitroglycerin is administered intravenously, the onset of action is immediate, and the duration is 3 to 5 minutes. It takes longer than 30 to 45 seconds for sublingual nitroglycerin tablets to have a therapeutic effect. Sustained-release nitroglycerin tablets start to act in 20 to 45 minutes, and the duration of action is 3 to 8 hours.
Which clinical indicator would the nurse monitor to determine if the client's simvastatin is effective? Heart rate Triglycerides Blood pressure International normalized ratio (INR)
Therapeutic effects of simvastatin include decreased levels of serum triglycerides, low-density lipoprotein (LDL), and cholesterol. Heart rate and blood pressure are not related to simvastatin. INR is not related to simvastatin; it is a measure used to evaluate blood coagulation.
For which purpose would a nurse advise a client with chloroquine-resistant malaria to take oral quinine immediately after meals? To delay its absorption To minimize gastric irritation To reduce its antidysrhythmic action To decrease stimulation of the appetite
To minimize gastric irritation
For which purpose would enoxaparin 40 mg subcutaneously daily be prescribed for a client who had abdominal surgery? To control postoperative fever To provide a constant source of mild analgesia To limit the postsurgical inflammatory response To provide prophylaxis against postoperative thrombus formation
To provide prophylaxis against postoperative thrombus formation Enoxaparin, a low-molecular-weight heparin, prevents the conversion of fibrinogen to fibrin and of prothrombin to thrombin by enhancing the inhibitory effects of antithrombin III. Enoxaparin is not an antipyretic. Enoxaparin is not an analgesic. Enoxaparin is not an anti-inflammatory medication.
Which issue related to antibiotic use is an increased risk for the older adult? Allergy Toxicity Resistance Superinfection
Toxicity The older adult is at increased risk for toxicity related to antibiotic use because of reduced metabolism and excretion of medications. Allergy, resistance, and superinfection are a risk for all antibiotic recipients but not an increased risk in the older adult population.
Which symptom will the nurse include as a reason to withhold the medication when teaching a client about digoxin therapy? Fatigue Yellow vision Persistent hiccups Increased urinary output
Yellow vision Digoxin toxicity is a common and dangerous effect. Visual disturbances, most notably yellow vision, may be evidence of digoxin toxicity. Fatigue is not a toxic effect of digoxin. Persistent hiccups are not related to digoxin toxicity. An increased urinary output is not a sign of digoxin toxicity; it may be a sign of a therapeutic response to the medication and an improved cardiac output.
Which reason would the nurse include in a response to a client with rheumatoid arthritis who asks the nurse why it is necessary to inject hydrocortisone into the knee joint? Lubricates the joint Reduces inflammation Provides physiotherapy Prevents ankylosis of the joint
b
Which client problem would the nurse expect to decrease in response to the administration of serum albumin intravenously to a client with ascites? Confusion Urinary output Abdominal girth Serum ammonia level
decrease in abdominal girth
Which food item will a client diagnosed with tuberculosis and taking isoniazid be advised to avoid to prevent a food and medication interaction?
red wine