medsurg pp questions
The nurse reads in the patient's chart that the HCP is concerned about myelosuppression. Which lab results will the nurse closely monitor and report to the provider? (SATA) A. WBC count B. Serum potassium level C. Red blood cell count D. Platelet count E. Blood glucose level
a c d
A nurse is assessing a patient with a diagnosis of diabetes insipidus. For which signs of the DI should the nurse assess the patient? (select all that apply) A. Excessive thirst B. Increased blood glucose C. Dry mucous membranes D. Increased blood pressure E. Decreased serum osmolarity F. Decreased urine specific gravity
a c f
Which of the following statements regarding fluid and electrolytes are true? (Select all that apply.) A. Sodium is the most abundant intracellular cation. B. Most of the potassium in the body is found in the cells. C. Aldosterone causes retention of sodium and water. D. ACE Inhibitors prevent the release of renin in the kidneys as a response to decreased perfusion. E. As calcium levels increase, so do phosphorus levels.
b c
After surgical clipping of an aneurysm, the patient develops the syndrome of inappropriate antidiuretic hormone (SIADH). For which manifestations of excessive levels of antidiuretic hormone should the nurse assess the patient? (select all that apply) A. Polyuria B. Weight gain C. Hypotension D. Hyponatremia E. Decreased specific gravity
b d
Before a patient receives propranolol, which is a ______________ , as treatment for hypertension, the nurse should ask the patient about a history of which of the following? A. Bronchospasms B. Seizures C. Peripheral vascular disease D. Myasthenia gravis
beta blocker A
A patient with a low potassium is to receive an IV potassium infusion. The pharmacy sends a 250 mL bag of fluid with 40 mEq of potassium in it. The label reads "Infuse over 1 hour". What should the nurse do next? A. Obtain a pump and infuse the medication. B. Double-check the order prior to infusing. C. Contact pharmacy as there is a mixing and labeling error. D. Recalculate the dose so that it is safe for the patient.
c
A patient with acute heart failure with pulmonary edema has a b-natriuretic peptide (BNP) level greater than 1500. Which medication does the nurse anticipate the HCP will order? A. Captopril, an ACEI, orally B. Digoxin, a cardiac glycoside, IVP C. Dobutamine, a synthetic catecholamine, IV D. Metoprolol, a BB, orally
c
A patient with lymphoma reports severe facial swelling, tightness of the gown collar, and shortness of breath. Which complication does the nurse suspect?A. Tumor lysis syndrome B. Cancer-induced hypercalcemia C. Superior vena cava syndrome D. Congestive heart failure
c
The nurse assesses the patient with a diagnosis of thyroid storm. Which classic signs and symptoms associated with thyroid storm indicate the priority need for immediate nursing intervention? A. Polyuria, nausea, and headache B. Hypotension, translucent skin, and obesity C. Fever, tachycardia, and systolic hypertension D. Diaphoresis, flushing, and constipation
c
Vasopressin (Pitressin) is prescribed for a patient with diabetes insipidus and the patient asks the nurse about the purpose of the medication. The nurse responds, knowing that the action of the medication is: A. Decrease peristalsis B. Produce vasodilation C. Decrease urinary output D. Inhibit smooth muscle contraction
c
Why does the nurse wear a dosimeter when providing care to a patient receiving brachytherapy? A. Indicates special expertise in radiation therapy B. Protects the nurse from absorbing radiation C. Measures the nurse's exposure to radiation D. Ensures that the radiation dose is accurate
c
A patient has been having frequent liquid diarrhea for the last 24 hours. A stool sample was sent to the laboratory to confirm possible Clostridium difficile infection. The nurse should monitor the patient for which electrolyte imbalance? A. Hyperkalemia B. Hypokalemia C. Hyponatremia D. Hypocalcemia
b
A patient is admitted with a diagnosis of Cushing's Disease. The nurse reviews the results of the patient's laboratory studies for which manifestation of this disorder? A. Hypokalemia B. Hyperglycemia C. Decreased plasma cortisol levels D. Low white blood count
b
The nurse hears in report that the patient has cachexia. Which assessment does the nurse plan to perform? A. Ability to ambulate independently B. Appetite and nutritional intake C. Mental status and cognition D. Sensation and pules in extremities
b
What is the minimum amount of urine output per day needed to excrete toxic waste products? A. 200-300 mL B. 400-600 mL C. 500-1000 mL D. 1000-1500 mL
b
Which patient with cancer has the greatest risk for infection? A. Recently diagnosed with breast cancer B. Has leukemia with neutropenia C. Has lung cancer with a persistent cough D. Diagnosed with prostate cancer 3 years ago
b
•The patient diagnosed with COPD has morphine sulfate ordered. Which statement is the scientific rationale for prescribing this medication?A.Morphine will depress the respiratory drive. B.Morphine dilates the bronchi and improves breathing. C.Morphine is not addicting so it can be administered routinely. D.Morphine causes bronchoconstriction and decreased sputum.
b
Which data indicates to the nurse that simvastatin an HMG-COA reductase inhibitor is effective? A. BP is 132/80 B. Cholesterol is 180 mg/dL C. LDL is 180 mg/dL D. HDH is 30 mg/dL
b Cholesterol is 180 mg/dL Goal is less than 200. HDL (50 or higher) LDL less than 130. Triglycerides should be less than 200
A nurse in the PACU is caring for a client who just had a thyroidectomy. For which client response is it most important for the nurse to monitor? A. Urinary retention B. Signs of restlessness C. Decreased blood pressure D. Respiratory obstruction
d
A nurse is caring for a client who had a hypophysectomy. For which complication specific to this surgery should the nurse assess the client for early clinical manifestations? A. Urinary retention B. Respiratory distress C. Bleeding at the suture line D. Increased intracranial pressure
d
A patient with a diagnosis of left-sided heart failure tells the nurse that she has been taking hawthorn extract, an OTC medication, since the HCP told her she has heart problems. Which statement by the nurse is most appropriate? A. "You need to take garlic supplements with hawthorn for it to be effective." B. "You should stop taking the herb immediately as it can cause more problems." C. "This herb can cause bleeding if you take it with your other prescribed medications." D. "Some patients find that herb helpful but make sure you let your HCP know that you are taking it."
d
A potential cause of ectopic ADH secretion, causing SIADH is: A. Guillain-Barré syndrome. B. Heredity. C. Intracranial surgery D. Small cell carcinoma of the lung.
d
The nurse is discharging a patient diagnosed with COPD. Which discharge instructions should the nurse provide regarding the patient's prescription for prednisone, a glucocorticoid? A.Take all the prednisone as ordered until the prescription is completed. B.Take the prednisone on an empty stomach with a full glass of H2O. C.Stop taking the prednisone if a noticeable weight gain occurs. D.The medication should never be abruptly discontinued.
d
The nurse is scheduled to administer a dose of digoxin to an adult patient with atrial fibrillation. The patient has a potassium level of 4.3 mEq/L. The nurse should perform which nursing action? A. Withhold the dose for that day. B. Obtain an order for potassium before giving the digoxin. C. Withhold the dose and notify the prescriber. D. Administer the dose as ordered.
d
Which assessment data should the nurse obtain prior to administration of a calcium channel blocker? A. The serum calcium level. B. The patient's femoral pulse. C. The current telemetry reading. D. The patient's blood pressure.
d
Which medication should the nurse not administer? A. Lisinopril to a patient with a BP of 116/74 B. Carvedilol to a patient with a HR of 65 C. Verapamil to a patient with angina D. Furosemide to a patient with leg cramps
d
Which medication should the nurse question administering? A. Hydralazine to a patient with a BP of 169/96 B. Prazosin to a patient with a sodium of 137 mEq/L. C. Diltiazem to a patient with a glucose of 280 mg/dL. D. Furosemide to the patient with a serum potassium level of 3.1 mEq/L.
d
•A nurse instructs a patient is the proper use of an incentive spirometer. Which does the nurse use to determine that the patient is using the IS effectively? A. Cloudy sputum B. Shallow breathing C. Unilateral wheezing D. Productive cough
d
Which factors determine the type of therapy used to treat cancer?(select all that apply) A. Type and location of the cancer B. Overall health of the patient C. Whether the cancer has metastasized D. Family history and genetics
all
The patient with breast cancer has bone metastasis. Based on this information, the nurse knows to monitor the patient for: A. Increase in serum calcium level B. Decrease in blood glucose C. Increase in platelet count D. Decrease in serum calcium level
a
When caring for a male client with diabetesinsipidus, the nurse expects to administer: A. Vasopressin B. Furosemide C. Regular insulin D. 10% dextrose
a
A nurse is caring for a client who just had a thyroidectomy. For which client response should the nurse assess the client when concerned about an accidental removal of the parathyroid glands during surgery. 1. Tetany 2. Myxedema 3. Hypovolemic shock 4. Adrenocortical stimulation
1
A nurse is performing a respiratory assessment on a patient being treated for an asthma attack. The nurse determines that the patient's respiratory status is worsening if which of the following occurs? 1. Loud wheezing 2. Wheezing on expiration 3. Noticeably diminished breath sounds 4. Wheezing during inspiration and expiration
3
hospitalized patient is dyspneic and has been diagnosed with left tension pneumothorax by chest x-ray after insertion of a central venous catheter. Which of the following observed by the nurse indicates that the pneumothorax is rapidly worsening? 1. Hypertension 2. Flat neck veins 3. Pain with respiration 4. Tracheal deviation to the right
4
When taking the blood pressure of a patient who had a thyroidectomy, the nurse identifies that the patient is pale and has spasms of the hand. The nurse notifies the HCP. What level should the nurse anticipate, the HCP will order? A. Calcium B. Magnesium C. Bicarbonate D. Potassium chloride
a
Which changes on a patient's ECG reflect hyperkalemia? A. Tall peaked T waves B. Narrow QRS complex C. Tall P waves D. Normal PR interval
a
The patient who is being discharged after having been treated for an acute myocardial infarction (AMI) is prescribed lisinopril which is an ________________________. Which instruction should the nurse include when teaching about this medication? A. Monitor blood pressure weekly .B. Take on an empty stomach. C. Rise slowly from a lying down position. D. Take the medication only at night.
ACE c
the provider prescribes hydrochlorothiazide (HydroDIURIL) 25 mg PO each morning to manage the patient's hypertension. Which statement do you include when teaching the patient about this drug? A. "This is a loop diuretic that decreases sodium reabsorption." B. "Eat foods rich in potassium, such as bananas and orange juice." C. "A potassium supplement will be prescribed along with this drug." D. "HydroDIURIL is a potassium-sparing diuretic that helps prevent the loss of essential potassium."5
B
Which of the following should be included in the nursing assessment of a patient receiving digoxin? (Select all that apply) A. Assess the patient's carotid pulse for 1 minute. B. Check the patient's potassium level. C. Ask the patient if they are having any visual disturbances like seeing yellow halos around lights .D. Have the patient squeeze the nurse's fingers with each hand. E. Teach the patient to get up slowly from a sitting position.
B C
A nurse is assigned to care for a patient who will be starting therapy with amlodipine which is a ______________ for treatment of chronic stable angina. The nurse should include which appropriate information in the teaching plan? A. This drug has been used for relief of migraine headaches. B. Dizziness may occur if rising from a sitting position. C. Report urinary retention if it occurs. D. Call the prescriber if the respiratory rate slows
B CCB
A patient is diagnosed with hypertension. He asks what he can do to improve his health. Which points do you include in your teaching plan? (Select all that apply.) A. Limiting smoking and caffeine to moderate use B. Making lifestyle changes to control blood pressure C. Checking blood pressure only at the clinic to ensure accuracy D. Exercising and weight loss to decrease the need for BP medications E. Alternative therapies such as relaxation techniques to help decrease stress associated with hypertension
B D E
the patient with CAD is prescribed colestipol which is a _________________. Which intervention should the nurse implement when administering this medication?A. Administer the medication with fruit juice. B. Instruct the patient to decrease fiber intake when taking this medication. C. Monitor the cholesterol level weekly while on the medication. D. Assess the patient for upper-abdominal discomfort.
a
A patient with a history of left-sided heart failure is receiving diltiazem which is a __________________. The nurse should give priority to which of the following assessments? A. Tachycardia and rebound hypertension B. Weight loss and euphoria C. Bradycardia and peripheral edema D. Increased ability to perform ADLs
CCB c
A patient receiving bisphosphonate therapy should receive instructions on symptoms of hypocalcemia. Which of these symptoms should be included in the teaching?(SATA) A. Lethargy B. Irritability C. Muscle cramps D. Elated mood
a b c
For a patient undergoing external radiation therapy, what do the nurse's instructions include? (SATA) A. Do not remove the markings. B. Do not apply thick layers of lotions or ointments .C. Avoid direct skin exposure to sunlight for up to a year D. Use mild soap and water on the affected skin. E. Gently rub treated areas to stimulate circulation.
a b c d
A nurse has just administered a dose of hydralazine which is a _________________, intravenously to a patient. After the initial dose, which of the following assessments is the priority? A. Cardiac rhythm B. Oxygen saturation C. Blood pressure D. Respiratory rate
Vasodilator C
A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant with her medications. This fact increased her risk for injury related to what factor? A. Bone demineralization B. Exhaustion C. Edema and dry skin D. Tetany
a
A nurse is monitoring for clinical manifestations of infection in a patient with a diagnosis of Addison disease. Which body mechanism related to infectious processes does the nurse conclude is impaired as a result of this disease? A. Stress response B. Electrolyte balance C. Metabolic processes D. Respiratory function
a
A patient shows a positive Trousseau's sign. Which treatment will the nurse prepare to give the patient? A. IV calcium B. PO calcium C. IV potassium chloride D. PO potassium chloride
a
A patient with a recent history of thyroidectomy reports muscle twitching and spasms with tingling in the lips, nose, and ears. The nurse suspects which electrolyte imbalance? A. Hypocalcemia B. Hypercalcemia C. Hyponatremia D. Hypomagnesemia
a
A positive Chvostek's sign indicates what? A. Hypocalcemia B. Hyponatremia C. Hypokalemia D. Hypermagnesemia
a
Hormone levels indicating primary hyperthyroidism would include: A. Low TSH, elevated T3, T4. B. Low TSH, normal T3, T4. C. High TSH, elevated T3, T4. D. High TSH, low T3, T4.
a
The nurse is admitting a 56-year-old patient with exacerbation of COPD to the hospital and questions the patient as to whether he has received previous immunization for pneumococcal pneumonia. The patient states that he received the vaccine 6 years ago. Which of the following is essential to include in the plan of care during the patient's admission? A. Offer revaccination B. No further nursing action is needed C. Document the previous immunization on the patient record. D. Explain to the patient that he can only be vaccinated during the fall months.
a
The nurse notes a patient receiving chemotherapy is also receiving filgrastim. Which nursing intervention is related to the rationale for receiving filgrastim?A. Teaching the patient and family about hand hygiene B. Administering the filgrastim prior to chemo to prevent N/V C. Teaching the patient and family about signs of bleeding such as excess bruising D. Assess the patient for fatigue and teach them to plan for rest
a
The nurse is administering the combo medication Tenoretic (chlorthalidone and atenolol), a thiazide diuretic and a beta blocker, to a patient diagnosed with hypertension. Which interventions should the nurse implement? (Select all that apply) A. Do not administer if BP less than 90/60. B. Do not administer if HR less than 60. C. Teach the patient about orthostatic hypotension. D. Monitor the patient's oral intake and urinary output.
all
What impact does phosphorus have in the body? (Select all that apply.) A. Adds strength/density to bones and teeth B. Activates vitamins and minerals C. Helps with energy production D. Assists in the formation of ATP E. Assists in cell growth and metabolism
all
The electrolyte magnesium is responsible for which functions? (Select all that apply.) A. Increased bone density B. Carbohydrate metabolism C. Contraction of skeletal muscle D. Used by enzymes to synthesize DNA E. Formation of ATP63
all
