Pharm 2. chapter 55
The nurse observes a client's uric acid level of 9.3 mg/dL. When teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest?
A low-purine diet
A patient is given theophylline to treat acute asthma symptoms. Which of the following foods should the patient avoid?
Chocolate
A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following?
Cigarette smoking
As the nurse comes from morning report, the nurse is instructed to use a bladder scanner on a client following a client's attempt at urination. The client is able to void 300 mL. The client denies any pain on urination. The nurse scans 250 mL of remaining urine in the bladder. Which entry is most correct when documenting the intervention?
Client voided 300 mL with 250 mL residual volume
A nurse is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following?
Coffee
The client's theophylline levels are increased. The nurse questions the client about his intake of which of the following?
Coffee
The nurse is caring for a client who is receiving IV theophylline for treatment of severe bronchospasm. The nurse will ensure that which item on the client's food tray will be held while the client is receiving theophylline?
Coffee
The nurse is encouraging the client with recurrent urinary tract infections to increase his fluid intake to 8 large glasses of fluids daily. The client states he frequently drinks water and all of the following. Which of the following would the nurse discourage for this client?
Coffee in the morning
A group of students are reviewing the various drugs that affect inflammation. The students demonstrate understanding when they identify which agent as a mast cell stabilizer?
Cromolyn
The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective?
"My urine will be eliminated through a stoma."
A client presents at the clinic with complaints of urinary retention. What question should the nurse ask to obtain additional information about the client's complaint?
"When did you last urinate?"
A client undergoes extracorporeal shock wave lithotripsy. Before discharge, the nurse should provide which instruction?
"Increase your fluid intake to 2 to 3 L per day."
Which statement by a client who is prescribed triamcinolone indicates the need for additional teaching?
"I should see some results in about 3 to 4 days."
The nurse assesses the serum theophylline of a patient. Which finding would the nurse identify as being therapeutic?
15 mcg/mL
A client is using an inhaled bronchodilator as treatment for exercise-induced asthma. The nurse would instruct the client to use the inhaler at which time?
15 minutes before engaging in exercise
The nurse instructs a patient who is using albuterol for exercise-induced bronchospasm to use the inhaler at which time?
15 minutes prior to exercising
A client is receiving theophylline intravenously. The nurse reviews the results of his serum drug levels and notifies the physician for which result?
25 mcg/mL
The nurse is participating in a bladder retraining program for a patient who had an indwelling catheter for 2 weeks. The nurse knows that, during this process, straight catheterization, after catheter-free intervals, can be discontinued when residual urine is:
<100 mL
The nurse is educating a female patient with a UTI on the pharmacologic regimen for treatment. What is important for the nurse to instruct the patient to do?
Take the antibiotic for 3 days as prescribed.
A nurse is teaching a female client with a history of multiple urinary tract infections (UTIs). Which statement indicates the client understands the teaching about preventing UTIs?
"I should take at least 1,000 mg of vitamin C each day."
A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis?
Acute pain
A child is prescribed an inhaled corticosteroid agent to decrease respiratory inflammation related to exposure to an animal. The patient's parent administers high doses of the therapy after 2 days of administration. What is the patient at risk for?
Adrenal insufficiency
A male client presents with symptoms of bronchospasm that occurred during a birthday party for his grandson. What medication would the nurse expect the physician to give him?
Albuterol
During the summer, a female client experiences increased periods of acute symptoms of her asthma. The physician increases the dose frequency of which of her medications?
Albuterol
Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?
Albuterol causes relaxation of the bronchial smooth muscles.
The asthmatic client is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order?
Albuterol first, wait five minutes and then follow with flunisolide
The nurse is employed in an urologist office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence?
Anticholinergic
The patient has been diagnosed with urge incontinence. What classification of medication does the nurse expect the patient will be placed on to help alleviate the symptoms?
Anticholinergic agents
A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program?
Assessing present voiding patterns
Which of the following would a nurse identify as a surfactant?
Beractant
A patient is experiencing an acute asthma attack. What is the first-line therapy for relief of an acute asthma attack?
Beta2-adrenergic agonist
A nurse is conducting a health history on a patient who is seeing her health care provider for symptoms consistent with a UTI. The nurse understands that the most common route of infection is which of the following?
By ascending infection (transurethral)
The most common presenting objective symptoms of a urinary tract infection in older adults, especially in those with dementia, include?
Change in cognitive functioning
The nurse working with a patient after an ileal conduit notices that the pouching system is leaking small amounts of urine. The appropriate nursing intervention is which of the following?
Change wafer and pouch.
Urinary tract infections increase with age and disability. The nurse is aware that the elderly often fail to exhibit the typical symptoms of a UTI. Therefore, a urine culture and sensitivity should be obtained. What bacteria would the nurse expect to find to help confirm the diagnosis of a UTI?
Escherichia coli
Which of the following is a cause of a calcium renal stone?
Excessive intake of vitamin D
The nurse is conducting a community education program on UTIs. The nurse determines that the participants understand the teaching when they identify which of the following as a contributing factor for UTIs in older adults?
Immunocompromise
Which of the following is a factor contributing to UTI in older adults?
Immunocompromise
The nurse is assisting in the development of a protocol for bladder retraining following removal of an indwelling catheter. Which of the following should the nurse include?
Implementing a 2- to 3-hour voiding schedule
A client who smokes is receiving theophylline orally. Because of his history of smoking, the nurse expects the health care provider to do what with the theophylline dosing?
Increase
Patients with urolithiasis need to be encouraged to:
Increase their fluid intake so that they can excrete 2.5 to 4 liters every day.
A nurse is caring for a client with acute pyelonephritis. Which nursing intervention is the most important?
Increasing fluid intake to 3 L/day
You are acting as the triage nurse in the emergency department when a 42-year-old patient with asthma presents for treatment. The patient's respiratory rate is 40 breaths per minute. Based on this objective data, what is the correct nursing diagnosis for this patient?
Ineffective breathing pattern
A nurse is administering levalbuterol to a client. The nurse would administer this drug by which route?
Inhalation
A patient is prescribed salmeterol. The nurse would expect this drug to be administered by which route?
Inhalation
The treatment of choice for a spinal cord-injured patient with impaired bladder emptying would include which of the following?
Intermittent self-catheterization
A nurse who is taking care of a patient with a spinal cord injury documents the frequency of reflex incontinence. The nurse understands that this is most likely due to:
Loss of motor control of the detrusor muscle.
Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?
Low purine
A patient undergoes surgery for removing a malignant tumor, followed by a urinary diversion procedure. The nurse's postoperative plan of care should include which of the following?
Maintain skin and stomal integrity.
Which of the following is used to treat acute air flow obstruction? (Choose one)
Metaproterenol (Alupent)
An 8-year-old child with an acute asthmatic attack is receiving metaproterenol via nebulizer. Which of the following would be most appropriate?
Mix the drug with saline.
A patient has had surgery to create an ileal conduit for urinary diversion. What is a priority intervention by the nurse in the postoperative phase of care?
Monitor urine output hourly and report output less than 30 mL/hr.
A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation?
Need to urinate after engaging in sexual intercourse
A client with COPD takes theophylline. The nurse identifies that the client is still experiencing severe dyspnea. Upon review of labs, the theophylline level remains nontherapeutic. The nurse evaluates the client for which of the following drugs that may cause decreased theophylline levels?
Nicotine
Which of the following is the most common symptom of bladder cancer?
Painless gross hematuria
Ms. Simpson, age 72 years, is being seen in the clinic with a suspected bladder tumor. These tumors occur more frequently in men than women and usually affect clients 50 years of age and older. Use of tobacco products is the leading cause of bladder cancer. You are asking Ms. Simpson about symptoms that she has had that brought her to the clinic. What is the most common first symptom of a malignant tumor of the bladder?
Painless hematuria
Which finding is an early indicator of bladder cancer?
Painless hematuria
A 64-year-old man is seeing his urologist for an annual check-up, post prostatectomy. The health care provider is concerned with the symptom he finds because it is considered diagnostic for bladder cancer. Which of the following signs/symptoms is diagnostic for bladder cancer?
Painless, gross hematuria
While reviewing a client's history, an allergy to which of the following would alert the nurse to a possible problem with the use of ipratropium?
Peanuts
The nurse is caring for a postoperative client who has a Kock pouch. Nursing assessment findings reveal abdominal pain, absence of bowel sounds, fever, tachycardia, and tachypnea. The nurse suspects which of the following?
Peritonitis
Which of the following medications maybe ordered to relieve discomfort associated with a urinary tract infection?
Phenazopyridine (Pyridium)
Which of the following is a characteristic of a normal stoma?
Pink color
Which of the following terms is used to refer to inflammation of the renal pelvis?
Pyelonephritis
A female patient visits her primary health care provider with a complaint of frequency of urination and incontinence when she sneezes. The health care provider suspects the patient is experiencing cystitis. The nurse knows that this is most likely due to which of the following?
Reflux of urine from the urethra into the bladder
Sympathomimetics have which of the following effects on the body?
Relaxation of bladder wall
The nurse is teaching a client how to prevent Candida infections. Which of the following would the nurse include in the instructions?
Rinse mouth with water after each use.
Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis?
Risk for infection
When describing the action of mast cell stabilizers, which of the following would the nurse include as being inhibited?
Slow-reacting substance of anaphylaxis
Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing?
Stress
A patient is started on albuterol (Proventil). What reaction should the patient be instructed on?
Tachycardia will occur.
After teaching a group of students about inhaled steroids, the instructor determines that the teaching was successful when the students state which of the following?
The drugs are not for use during an acute attack.
The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action, made by the nursing assistant, would require instruction?
The nursing assistant places the drainage bag on the client's abdomen for transport.
The nurse is caring for a client with recurrent urinary tract infections. Which of the following body structures would the nurse instruct as the most frequent cause of women's urinary tract infections?
The urethra
A client was using nicotine patch to stop smoking when he was started on theophylline for emphysema. He has successfully stop smoking and has stopped using his nicotine patch. Which of following would be warranted? (Choose one)
Theophylline dose should be decreased
Cromolyn should not be used during an acute asthmatic attack.
True
Leukotriene receptor antagonists are administered orally.
True
A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate I can't control it, and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?
Urge
The nurse advises a patient with renal stones to avoid eating shellfish, asparagus, and organ meats. She emphasizes these foods because she knows that his renal stones are composed of which of the following substances?
Uric acid
The nurse is caring for a client who is describing urinary symptoms of needing to go to the bathroom with little notice. When the nurse is documenting these symptoms, which medical term will the nurse document?
Urinary urgency
A patient is being assessed by the home care nurse on the administration of the inhalers. Which of the following will assist in proper administration of the inhaler?
Use of a spacer
The nurse who provides teaching to the female patient regarding prevention of recurrent urinary tract infections includes which of the following statements?
Void immediately after sexual intercourse
The nurse recognizes that urinalysis results that most likely indicate a urinary tract infection include:
WBC 50
A nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial assessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patient
has a high coffee intake.
Bladder retraining following removal of an indwelling catheter begins with
instructing the patient to follow a 2 to 3 hour timed voiding schedule.
A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to
rebound bronchoconstriction.
A 5-year-old boy is brought to the ED with an asthma exacerbation, including wheezing (a high-pitched, whistling sound caused by turbulent airflow through an obstructed airway). Those who have asthma chronically present with what signs, even when they may appear symptom free? Select all that apply.
• Airway inflammation • Damaged airway mucosa
A major goal when caring for a catheterized patient is to prevent infection. Select all the nursing actions that apply.
• Empty the collection bag at least every 8 hours to reduce bacterial growth. • Suspend the drainage bag off the floor. • Wash the perineal area with soap and water at least twice daily.
One of the potential problems for the client with a urinary diversion is disturbed body image related to change in appearance and function. The expected outcome is that the client will accept the altered appearance and perform self-care. Which of the following are activities that would help in achieving that expected outcome? Select all that apply.
• Reassure the client that nursing staff will provide care until he or she is ready. • Discuss change in function and let the client know what to expect when recovery from surgery is complete. • Help the client gain independence by reinforcing that self-care is quite manageable and providing time for practice.
