Pharm Exam #1
A health care provider prescribes diuretic therapy to a client with nephrotic syndrome. The nurse suspects that the client is hyponatremic based on which assessment finding?
Tachycardia
anticoagulants
drugs that prevent formation of new clots and extension of clots already present; do not dissolve formed clots
antiplatelet drugs
drugs that prevent one or more steps in the prothrombotic activity of platelets
electrolytes
electrically charged particles found in body fluids and cells (e.g., sodium or potassium ions)
central adiposity
accumulation of abdominal fat, resulting in an increased waist circumference
The nurse is caring for a client suspected of having renal dysfunction. The presence of what substances in the client's urine would be considered pathological?
blood cells and protein
thrombus
blood clot
thrombolysis
breakdown or dissolution of blood clots
Interferons may be used to treat
chronic hepatitis C
cretinism
congenital hypothyroidism that occurs when a child is born with a poorly functioning or absent thyroid gland
A patient who is newly diagnosed with diabetes mellitus demonstrates extreme anxiety. The most appropriate intervention to decrease the patient's anxiety would be to do which of the following?
convey empathy, trust, and respect toward the patient
A woman receives a diagnosis of Cushing's disease. She has an excess of which of the following hormones?
corticotropin
A young woman, a graduate nurse, is scheduled to take the NCLEX examination in the morning. Which of the following hormones is released while she is asleep?
corticotropin
A woman is experiencing periods of increased anxiety and panic attack over her illness and that of her family members. Epinephrine and norepinephrine are released. What glucocorticoid is released by the adrenal cortex in response to stress?
cortisol
blood glucose meter
device that measures how much glucose is in the blood
The nurse is monitoring a patient newly diagnosed with type 2 diabetes mellitus taking repaglinide for complications. Which of the following, if exhibited by the patient, would indicate hypoglycemia and require immediate treatment?
diaphoresis
thrombolytics
drugs that dissolve blood clots
erythropoietin
hormone secreted by the kidneys that stimulates bone marrow production of red blood cells
releasing hormone
hormones produced by the hypothalamus to accelerate secretion of a major hormone of the pituitary gland; hypothalamus uses growth hormone-releasing hormone to communicate with the pituitary to release somatotropin; hypothalamus uses corticotropin-releasing hormone to communicate with the pituitary to release corticotropin; hypothalamus uses thyrotropin-releasing hormone to communicate with the pituitary to release thyrotropin; hypothalamus uses gonadotropin to communicate with the pituitary to release more gonadotropin
A young man has been diagnosed with type 2 diabetes and has been prescribed glyburide. Which statement suggests that the nurse should perform further health education?
"I'll plan to take my glyburide each night before I go to bed."
The nurse instructs a client on the use of prescribed B-vitamin supplements. Which client statement indicates that the teaching was effective?
"I'll take the niacin supplement at bedtime."
Ms. Ziem is prescribed filgrastim. The nurse provides education to Ms. Ziem about this therapy. Which statement would indicate the patient understood the teaching?
"I will avoid crowds and people with illnesses."
A client with heart failure is prescribed a loop diuretic. Which client statement indicates that teaching provided by the nurse about this medication was effective?
"I will change positions slowly if I feel dizzy."
The nurse determines teaching about warfarin is successful when the client makes what statement?
"I will check with my primary health care provider before taking any herbal supplements."
The nurse educates a client diagnosed with atrial fibrillation about the prescribed warfarin. Which client statements establish the need for further clarification?
"I will stop eating green leafy vegetables, broccoli, yogurt, or cheese."
A patient with type 2 diabetes begins taking sitagliptin for the management of blood glucose levels. Which statement by the patient indicates an understanding of this medication?
"I will take this medicine once a day.:
A client being prepared for discharge to home has been ordered several medications and daily tube feedings. What statement made by their caregiver demonstrates a need for further education regarding safe administration of both the medications and the feedings?
"I'll mix the medication into the formula when administering the drug."
What type of medication is heparin?
Anticoagulant
A patient is taking systemic corticosteroids. Which of the following nursing interventions is most important to implement?
Assess for signs and symptoms of adrenocortical excess.
The primary health care provider orders a 300-mg dose of clopidogrel for a client. The client then is to receive 75 mg/day. The nurse interprets the 300-mg dose to be which type of dose?
Loading dose
Which type of insulin does not have a peak?
Long-acting
What is true regarding type 2 diabetes?
Many patients do not know they have type 2 diabetes.
For what purpose would the nurse administer postoperative epoetin alfa to the client who is a Jehovah's Witness?
Reduce the need for allogenic blood transfusion
Which type of insulin can be given intravenously to patients who are critically ill?
Regular
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
What does a pH of 7.17, a CO2 of 75 mEq/L, and an HCO3 of 26 mEq/L indicate?
Respiratory acidosis
What is the expected outcome when the glomerular membrane is damaged?
The filtration of fluid from the blood into the kidney's nephron tubule is impaired
dependent edema
localized edema occurring in the feet and ankles in people who are ambulatory
Mrs. Conley, age 53, has had hypertension for 10 years and admits that she does not comply with her prescribed antihypertensive therapy. Recently, she has begun to experience shortness of breath and ankle swelling. A workup reveals the presence of chronic renal insufficiency. What classification of diuretic is the first drug of choice for the nurse practitioner to prescribe?
loop
neutropenia
low neutrophil count
A woman has received a diagnosis of Cushing's disease and is taking ketoconazole. Which of the following conditions affects the treatment plan?
migraine headaches with the administration of ergotamine
aldosterone
mineralocorticoid hormone secreted by the adrenal cortex to increase sodium reabsorption by the kidneys and indirectly regulate blood levels of potassium, sodium, and bicarbonate; also regulates pH, blood volume, and blood pressure
ceiling threshold
near-maximum response of a drug that is yielded by a certain dose
The nurse is administering filgrastim to a patient who has received a bone marrow transplant. Which laboratory parameter should the nurse monitor to determine if the drug is effective?
neutrophils
anuria
no urine output
immunocompetence
normal immune system function
You administer a single intramuscular (IM) injection of Vitamin K to each newborn in your nursery. What is the reason for the injection?
To prevent hemorrhagic disease
Why do loop diuretics need to be pushed slowly when administered via intravenous (IV) push?
To prevent ototoxicity
acromegaly
a chronic disease, resulting from excessive secretion of growth hormone (GH); characterized by an abnormal pattern of bone and connective tissue growth associated with an increased incidence of diabetes mellitus and hypertension
A patient is ordered potassium replacement for a potassium level of 3.2 mEq/dL. What is the best way to administer this medication?
Whole pill by mouth
Beta-carotene is found in what food?
Winter squash
A nurse administers chlorothiazide to a client with renal compromise. Which action should the nurse prioritize after noting the BUN level is rising?
Withhold the next dose of the drug.
The nurse is caring for four clients in a hospital setting. Which client will the nurse monitor most closely for signs of vitamin deficiencies?
a client being treated for cirrhosis of the liver
dwarfism
a condition marked by severely decreased linear growth and frequently severely delayed mental, emotional, dental, and sexual growth; some forms can be attributed to lack of growth hormone
Which one of the following findings in a nursing assessment of a newly admitted patient would be most likely to result in a vitamin deficiency?
a history of liver disease
A 48-year-old man visits his health care provider for his annual checkup. He is otherwise in good health, but assessment findings reveal the new onset of a slight increase in blood pressure and a total serum cholesterol of 240mg/dL. What can the nurse anticipate as the preferred treatment for this patient?
a low-lipid diet and an exercise program
A man is receiving mitotane for an inoperable adrenocortical carcinoma. He is admitted to the emergency department following an automobile accident. He is diaphoretic and unresponsive. He has a blood pressure of 80/30mmHg. What medication should the nurse anticipate administering?
a steroid
A patient is taking fludrocortisone acetate for adrenal insufficiency. Which of the following symptoms indicates that the patient is hypokalemic?
muscle weakness
euthyroid
normal thyroid gland functioning
thyroid storm
rare but severe complication characterized by extreme symptoms of hyperthyroidism; most likely to occur in patients with hyperthyroidism that has been inadequately treated, especially when stressful situations occur; also known as thyrotoxic crisis
The patient is to receive a bolus tube feeding and a medication per tube at 08:00. When should the medication be administered?
prior to the feeding at 07:30
pegylation
process of modifying a protein drug by treatment with polyethylene glycol
Clopidogrel is indicated for which of the following?
reduction of myocardial infarction, stroke, and vascular death in patients with atherosclerosis
When considering the management of diabetic ketoacidosis (DKA), what type of insulin can be administered intravenously?
regular
Heparin is the anticoagulant of choice in acute __________ disorders.
thromboembolic
insulin pump
wearable delivery system for continuous subcutaneous insulin infusion; the insulin dosage is programmed into the pump, and the appropriate amount of insulin is injected through a needle into the adipose tissue
A patient receives intravenous (IV) furosemide 80mg for symptoms of severe heart failure. The nurse recognizes that administering the drug slowly by IV push reduces the likelihood of which of the following adverse effects of drug therapy?
ototoxicity
glucagon
pancreatic hormone that raises blood glucose levels by stimulating the liver to convert glycogen into glucose; it opposes insulin
glucose
sugar in the blood; major stimulus of insulin secretion
To monitor possible intermittent claudication, the nurse will assess for a thrombus lodging in what specific location?
the legs
A client asks the nurse, "Where is chloride primarily reabsorbed?" Which area will the nurse indicate when responding?
the loop of Henle
cortisol
the main glucocorticoid secreted as part of the body's response to stress
Hydrochlorothiazide is an example of a __________ diuretic.
thiazide
A patient reports a drug allergy to sulfonamides. Which diuretic drug class should the nurse question if ordered for the patient?
thiazides
The nurse is caring for a client who is taking insulin. The nurse suspects the client is experiencing hypoglycemia when the client displays what signs?
weakness, sweating, and decreased mentation.
Vitamin K (Mephyton) is the antidote to aspirin. (T/F)
False
What does a pH of 7.25, a CO2 of 56 mEq/L, and an HCO3 of 24 mEq/L indicate?
Respiratory acidosis
What does a pH of 7.48, a CO2 of 32 mEq/L, and an HCO3 of 22 mEq/L indicate?
Respiratory alkalosis
A patient with newly diagnosed type 1 diabetes is beginning daily insulin injections. The nurse is preparing to teach the patient about insulin injections. What should the nurse include in the teaching plan?
Rotate the insulin injection sites.
The nurse is caring for a critically ill client in the unit who has an IV dedicated to fluid and electrolyte replacement. To prevent imbalances and adverse reactions, what should the nurse closely monitor?
Serum electrolyte levels
A woman taking propylthiouracil develops a sore throat and fever. What does the nurse suspect is wrong with this woman?
She has agranulocytosis.
A woman is being treated with long-term corticosteroid therapy. Her husband has just received a diagnosis of terminal cancer. How is his diagnosis likely to affect her treatment?
She may need to have her dose of corticosteroid increased because of the stress.
A client with hypertension is diagnosed with type 2 diabetes. For which reason would the nurse closely monitor the client when giving glyburide with metoprolol?
Signs of hypoglycemia may be masked.
A client receiving potassium chloride has a blood pressure of 128/82, respirations of 18 per minute, and a heart rate of 80 beats per minute with irregularity. What should the nurse do to best manage this client?
Slow the infusion and notify the provider.
What is a major electrolyte in extracellular fluid that influences the distribution of water and maintains acid-base balance and nerve function?
Sodium
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
The nurse explains to a patient that asprin suppresses blood clotting by
decreasing platelet aggregation
A client with hypoparathyroidism needs to increase the intake of ergocalciferol. Which food item would the nurse encourage the client to select for breakfast?
scrambled eggs
myxedema coma
severe, life-threatening hypothyroidism
lancet
sharp instrument used to prick the finger for a blood test
A nurse is preparing to administer an insulin that is clear. Which insulin would the nurse likely administer?
short-acting insulin
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."
The nurse is caring for a client who has been newly diagnosed with cancer. The client tells the nurse, "I saw advertisements on epoetin alfa and I want to start taking it immediately so I don't get tired from chemotherapy." What is the nurse's best response?
"Epoetin alfa is only effective if you develop anemia from chemotherapy that is caused by low levels of erythropoietin."
A patient with type 2 diabetes calls the nurse to report the following symptoms: blood glucose of 378mg/dL, excessive urination, and feelings of becoming drowsier. To determine a possible diagnosis, which of the following questions is most important?
"Have there been any ketones in the urine?"
John Jones, a 47-year-old teacher, now takes cholestyramine, and the nurse teaches him about the medication and its use. The nurse should be concerned if, after the teaching session, Mr. Jones states
"I may need to supplement my intake of the fat-soluble vitamins A, D, E, and K"
How long does it take for warfarin to take effect?
3 to 4 days
Which intravenous (IV) solution is expected for a patient with cerebral edema?
3% saline
The normal serum value for potassium is
3.5-5.5 mEq/L.
A girl is taking somatropin. Her mother asks the nurse when her daughter will no longer need the medication. Which of the following is the nurse's best response?
It will be stopped when she has stopped growing.
A patient presents with a blood pressure of 162/88mmHg, heart rate of 100bpm, triglycerides of 378mg/dL, and HDL of 25mg/dL. Which of the following are characteristics of metabolic sydrome? (Select all that apply) A. blood pressure of 162/88mmHg B. heart rate of 100bpm C. triglycerides of 378mg/dL D. HDL of 25mg/dL
A, C, and D
A patient is on a heparin infusion. Which lab value is used to titrate this medication?
Activated partial thromboplastin clotting time (aPTT)
Which is not a cause of hypotension?
Activation of the sympathetic nervous system
The nurse is caring for a hospitalized client who has been diagnosed with sickle cell anemia. What action should the nurse perform to reduce the client's likelihood of a sickle cell crisis?
Adhere closely to standard precautions.
The nurse is preparing to administer IV diphenhydramine and IV prednisone to prevent infusion reactions prior to an infusion of packed red blood cells. What is the most appropriate action to take when administering these medications?
Administer at least 10 mL normal saline between these two drugs.
Aldosterone levels would be affected if which gland was dysfunctional?
Adrenal
The client reports taking niacin regularly to reduce triglyceride levels. What information related to niacin should the nurse include in the client's teaching plan?
After a dose of oral niacin, lie down for 30 minutes.
Which cells help secrete glucagon to raise blood glucose levels?
Alpha
The pharmacology instructor is talking about interferon. The instructor explains that agents such as interferons have more than one biologic function. What function is NOT associated with interferons?
Antibacterial
What classification of medications does warfarin fall under?
Anticoagulant
What does a hemoglobin A1C (HbA1c) measure?
Average blood glucose over 3 months
A nurse is assigned to administer glargine to a patient at a health care facility. What precaution should the nurse take when administering glargine?
Avoid mixing glargine with other insulin.
An elderly client has been ordered magnesium 483 mg daily orally. The student nurse is about to administer that dose when the nursing instructor questions it. The student states that the regular dose is 54 to 483 mg/day. Why did the instructor question this dose?
Because older adults may need a reduced dosage as a result of decreased renal function.
Where is insulin produced?
Beta cells of the Islets of Langerhans
Trace minerals in the body, though small in quantity, play large roles in its functioning. Trace minerals have been hard to study because of what factor?
Bioavailability varies within the context of the total diet
Which factors should be assessed prior to administering a loop diuretic? Select all that apply.
Blood pressure; Potassium level
A 60-year-old client experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The client has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect?
By inactivating clotting factors and thus stopping the coagulation cascade
The nurse is teaching a client about dietary concerns related to the administration of warfarin. The nurse determines the teaching session is successful when the client correctly points out that a consistent intake of which foods is necessary when using warfarin?
Green leafy vegetables
Prior to administering insulin, what needs to be checked?
Capillary blood glucose
What does amylase assist in digesting?
Carbohydrates
A nurse should take what steps prior to administering insulin glargine (Lantus) to a client? Select all that apply.
Check the expiration date on the vial. Check the health care provider's orders for the type and dosage of insulin. Remove all air bubbles from the syringe barrel.
A female client visits the health care provider's office after routine labs are drawn. The nurse notes that her A1C is 9. How does the nurse interpret this finding?
Client's average blood glucose is above normal.
Which medication is an example of an antiplatelet?
Clopidogrel
Which type of insulin has the fastest onset?
Lispro
What information should be included in the teaching of a client prescribed enteral nutrition? Select all that apply.
Enteral nutrition contains with a mixture of fluid and nutrients. It requires the insertion of a feeding tube into the mouth, nose, or directly in the stomach. It can be safely prescribed for clients experiencing liver failure.
A client has chronic renal failure. As the disease progresses, the client is experiencing increasing shortness of breath, due to anemia. The nurse would anticipate which medication order?
Epoetin alfa
When explaining the underlying mechanisms associated with renal failure, which would be most important for the nurse to keep in mind?
Extensive kidney damage has usually occurred by the time the patient is symptomatic.
ADH from the anterior pituitary gland promotes reabsorption of water from the distal tubules and the collecting ducts of the kidney. (T/F)
False
A male client is excited because it is football season. He has season tickets and attends most games with his friends. At his latest appointment, the client's blood pressure is elevated. What does the nurse suspect is the cause?
He is consuming excessive salty foods at the games.
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
During ongoing assessment of clients receiving insulin detemir (Levemir), the nurse assesses the client for symptoms of hyperglycemia that include which of the following? Select all that apply:
Increased thirst; Increased urination; Increased hunger
__________ diuretics are the diuretics of choice when rapid effects are required and when renal function is impaired.
Loop
A nurse is caring for a client with diabetes mellitus who is receiving an oral antidiabetic drug. Which ongoing assessments should the nurse prioritize when caring for this client?
Observe the client for hypoglycemic episodes.
Which are clinical manifestations of diabetes?
Polyuria, polydipsia, polyphagia
A client who is prescribed digoxin is receiving electrolyte replacement therapy. The nurse would monitor the client for signs of digoxin toxicity if which electrolyte is administered?
Potassium
A client has been prescribed folic acid and vitamin B12 supplements to treat a deficiency. The nurse will identify what causative factor underlying the client's deficiency?
The client has an alcohol use disorder.
A 35-year-old client has begun the administration of glyburide for treatment of diabetes mellitus type 2. The nurse caring for this client provides education regarding this medication. Which statement would NOT be an appropriate instruction for this client?
The medication should have a fixed dose which cannot be manipulated.
The nurse is administering epoetin alfa (Epogen). Which administration technique would not be considered appropriate for the patient identified?
The nurse administers epoetin alfa (Epogen) via IM injection.
The nurse is administering intranasal desmopressin to a child. What does he or she need to do differently from administering this drug to an adult?
The nurse needs to blow in the tube to administer the medication.
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 nurse is completing an admission assessment. During a 24-hour diet recall, the client reports eating spinach, asparagus, and green beans for lunch and dinner. Which vitamin is the client most likely consuming?
Vitamin K
Vitamins are organic compounds that differ in function and availability. What statement best describes vitamins?
Vitamins are susceptible to destruction by factors such as heat, air, and light
__________ dosage is regulated according to the INR.
Warfarin
The nurse is preparing to start a peripheral IV for a client with orders for 2 units of packed red blood cells (PRBCs) to manage aplastic anemia. Which peripheral IV is most appropriate for this client?
a 20 gauge IV in the left radial vein
Which one of the following patients taking vitamin A supplements is of most concern to the nurse?
a 21-year-old woman who is pregnant
Mrs. Thomas, a 60-year-old woman with cancer who started on interferon alfa 2b today, calls the clinic and reports that she has been having fever, chills, fatigue, and muscle aches since she has returned home. For relief of these symptoms, the nurse reinforces and says that the patient should take
acetaminophen
The nurse is caring for a client with a fever and severe diarrhea in addition to thrombophlebitis. How will this client's condition impact the clotting process?
activation of plasminogen
A woman visits the clinic. She states that she has been satisfying her recent cravings for salt by eating large quantities of potato chips and other salty foods. She has been under a great deal of stress, and last week she received treatment for pneumonia. What do these symptoms suggest?
acute adrenal crisis
acute adrenal crisis (or addisonian crisis)
acute adrenocortical insufficiency
glucocorticoid
adrenal cortical hormone that protects the body against stress and affects protein and carbohydrate metabolism
Cushing's disease
adrenaocortical hyperfuction; may result from excessive corticotropin or primary adrenal tumor
A client with fluid restriction and edema needs to restrict the intake of sodium. Which food source would the nurse recommend that the client avoid ingesting?
canned vegetables
Most early symptoms of type 2 diabetes result from disordered __________ metabolism, which causes glucose to accumulate in the blood.
carbohydrate
corticotropin-releasing hormone or factor
causes release of corticotropin in response to stress and threatening stimuli; most often secreted during sleep
gonadotropin-releasing hormone
causes release of follicle-stimulating hormone and luteinizing hormone
adrenocortical insufficiency
decrease in adrenocortical function
A patient with chronic obstructive pulmonary disease is being administered a corticosteroid by nebulizer. What effect does the corticosteroid have?
decrease in mucus secretion
The primary focus for prevention and management of metabolic syndrome and its sequelae is
elevated high-density lipoprotein (HDL) cholesterol, depressed low-density lipoprotein (LDL) cholesterol, and low total cholesterol
plasmin
enzyme that breaks down the fibrin meshwork that stabilizes blood clots; also referred to as fibrinolysin
fibrinolysin
enzyme that breaks down the fibrin meshwork that stabilizes blood clots; also referred to as plasmin
A man has received a diagnosis of acromegaly. Which of the following symptoms can cause alterations in the man's psychosocial integrity?
erectile dysfunction
Which of the following psychosocial changes are most likely to occur with the adminstration of corticosteroids?
euphoria
edema
excessive accumulation of fluid in body tissues
hyperthyroidism
excessive secretion of thyroid hormone; usually involves an enlarged thyrod gland that has an increased number of cells and an increased rate of secretion
impaired fasting glucose
fasting blood glucose level between 100 and 125mg/dL; also referred to as prediabetes
Vitamins A, D, E, and K are __________ vitamins.
fat-soluble
The nurse is caring for a client with a history of class II congestive heart failure, receiving a continuous infusion of normal saline at a rate of 50 mL/hour. The nurse notes the client's weight has increased by 1.4 kilograms (3 pounds) since yesterday, and their blood pressure has slightly increased. The nurse notifies the provider about which likely complication?
fluid overload
thrombogenesis
formation of a blood clot
hematopoiesis
formation of blood cells
inhibiting hormone
hormones produced in the hypothalamus that control the release of other hormones by inhibition of their release; the main inhibiting hormone in the hypothalamus uses somatostatin in communication with the anterior pituitary to inhibit somatropin
The nurse is providing education to a 72-year-old client who has been discharged home on a diuretic. What should the nurse include in the discharge instructions?
how to properly weigh themselves at home
A man who is taking an oral hypoglycemic for management of his type 2 diabetes mellitus begins taking hydrochlorothiazide. The nurse should monitor for which of the following serum laboratory changes?
hyperglycemia
A patient diagnosed with Addison's disease is taking exogenous corticosteroids. The nurse should assess the patient for which of the following adverse effects?
hyperglycemia
Digoxin toxicity is related to diuretic-induced __________.
hypokalemia
The health care provider prescribes glyburide for a client who is a newly diagnosed type 2 diabetic. The nurse knows that this medication produces hypoglycemia by:
increasing insulin secretion from the pancreas.
IV infusion of __________ and dextrose will cause potassium to move from the blood into the cells.
insulin
Which of the following insulins cannot be administered in a continuous subcutaneous insulin infusion pump?
insulin glargine
A client's current condition requires rapid reduction of blood sugar levels. Which type of insulin will have the most rapid onset of action?
insulin lispro
A 59-year-old client is on warfarin therapy. On follow-up visits to the clinic, the nurse will assess the client's:
intake of vitamin K.
By what route will the nurse administer the antihemophilic agent to a client with hemophilia following a car accident?
intravenous (IV)
parenteral nutrition
intravenous provision of fluid and nutrients to a patient who is unable to ingest enough fluid and food due to a nonfunctional gastrointestinal tract
erythropoiesis
production of red blood cells
A patient with a diagnosis of hyperthyroidism has a blood pressure of 170/98mmHg. Which of the following medications might a physician prescribe to treat hypertension?
propranolol
The students are studying the male reproductive system. The instructor tells the students that in the male, the urethra leaves the urinary bladder and passes through the:
prostate gland.
In developing a safe plan of care, the nurse recognizes that which of the following agents is the antidote for heparin?
protamine sulfate
insulin
protein hormone secreted by beta cells in the pancreas; facilitates glucose utilization my cells; absence of insulin results in diabetes mellitus
Insulin cannot be given orally because it is a protein that is destroyed by __________ enzymes in the GI tract.
proteolytic
The nurse is caring for a client who is going home on warfarin. What laboratory test will the nurse inform the client will be used to evaluate therapeutic effects of the drug?
prothrombin time (PT) and international normalized ratio (INR)
enteral nutrition
provision of fluid and nutrients to a functional gastrointestinal tract via a feeding tube in a patient who is unable to ingest enough fluid and food
A patient diagnosed with a thyroid condition is preparing for a laboratory draw. The nurse is reviewing the laboratory orders. Which laboratory data are necessary for this patient?
thyroid-stimulating hormone (TSH)
A patient has been treated for ventricular dysrhythmias with amiodarone. What is the patient at risk for developing?
thyroiditis
A 30-year-old woman is receiving treatment for acromegaly. Her health care provider has prescribed octreotide for subcutaneous administration three times per day. What is the most important information to teach the patient?
to rotate the sites of the injections and use the sites infrequently
A male client is to begin glyburide (DiaBeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the client's:
use of alcohol.
A man with acromegaly is planning a mission trip to Haiti to assist with rebuilding houses damaged in a recent earthquake. He is taking chloroquine to prevent malaria and octreotide for acromegaly. What is he at risk for developing?
ventricular dysrhythmia
goiter
visible enlargement of the thyroid gland
A woman takes large amounts of vitamins, which she buys over the counter without a prescription. The nurse should teach the patient that excess consumption of which one of the following could result in a toxic overdose?
vitamin A
In developing a safe plan of care, the nurse should recognize that the antidote for warfarin is
vitamin K
fat-soluble vitamins
vitamins that are accumulated and stored in the body when taken in excess
water-soluble vitamins
vitamins that are not stored in the body and are rapidly eliminated
The nurse administers vitamin K if a patient is bleeding from an overdose of which of the following?
warfarin
A man has not been able to decrease his low-density lipoprotein (LDL) cholesterol levels with lifestyle management, and his nurse practitioner has prescribed atorvastatin, a hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor. The nurse explains to him that atorvastatin is best administered
without regard for time of day
Which lab values should be considered when assessing the pancreas? Select all that apply.
Lipase; Amylase
What is true regarding insulin production in type 1 diabetes?
Little to no insulin is being produced.
Why would a patient be ordered neutral protamine Hagedorn (NPH) insulin?
To create a more balanced glucose level
Red blood cells (RBCs) are mainly composed of _________________, which enables the cells to carry oxygen to the cells in the body.
hemoglobin
A nurse is teaching a client about the prescribed potassium replacement therapy which the client will continue at home. After teaching the client about this therapy, the nurse determines that additional teaching is warranted when the client makes which statement?
"If I have trouble swallowing the drug, I can crush it."
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."
A patient is ordered subcutaneous heparin every 8 hours. When the patient asks what this medication is for, what is the nurse's best answer?
"It is to prevent you from developing a blood clot."
A female client presents to the health care provider's office for her yearly physical examination. When the nurse asks about her current drug regimen, she states that she self-administers megadoses of vitamin C to prevent cancer. Which statement is an appropriate response?
"Large doses of single vitamins do not prevent cancer."
The nurse has just administered oral niacin to a client. What is the most important instruction the nurse can give to this client at this time?
"Lie down for about 30 minutes, and then be careful when you sit and stand up."
The nurse provides dietary teaching to a client with a vitamin D deficiency. Which statement indicates to the nurse that teaching was effective?
"Milk is a good source of vitamin D."
Karen James, a 32-year-old accountant with type 1 diabetes mellitus, is taking gemfibrozil to reduce her serum triglyceride level. She asks why she could not take niacin, as her husband does. The nurse responds
"Niacin increases blood glucose levels and is not preferred for people with diabetes"
The nurse is caring for a client with a WBC of 700 cells/mm3. Which discharge instruction is most important for the nurse to share with this client?
"Stay out of crowded places such as grocery stores."
The nurse providing drug education to a client prescribed an immunostimulant will place priority on which statement to help assure expected outcomes?
"Take the medication exactly as prescribed."
A client with type 1 diabetes has been prescribed 12 units of regular insulin and 34 units of NPH insulin in the morning. How should the nurse explain why two different types of insulin are required to control the client's blood glucose?
"The different onsets and peaks of the two types provide better overall glucose control."
You are precepting a nursing student and together you are caring for a patient who is to receive interleukins. The student nurse asks you what happens physiologically when a patient receives interleukins. What would be your best response?
"The patient has increases in the number of natural killer cells."
A client admitted with a diagnosis of viral pneumonia asks the nurse to assist with the menu. What response should the nurse make to help the client consume foods that will support recovery?
"We need to find some food high in vitamin C like orange juice and strawberries."
A patient who received a copy of her genomic testing and is classed as a "poor metabolizer" of clopidogrel asks the nurse what it means. The nurse, understanding the variant response to CYP2C19, would be most correct in stating which of the following?
"You metabolize the medication different than some individuals and may not receive the same benefit from drug therapy."
The client is scheduled to get a breakfast tray at 07:00. At what time should the client receive a prescribed dose of insulin lispro?
06:45
What prescribed dosage for epoetin alfa would the nurse administer to a client without needing to clarify the order?
100 units/kg subcutaneously three times per week
A client is receiving hydrochlorothiazide. The nurse would expect this drug to begin acting within which time frame?
2 hours
The nurse is providing health promotion education to a client regarding proper hydration. What amount of fluid does the nurse indicate a typical adult needs daily to maintain sufficient hydration?
2 to 3 L
A client is receiving anticoagulant therapy and has an INR done. Which result would the nurse interpret as being therapeutic?
2.4
The nurse is preparing to initiate an order for 1,000 mL normal saline over 10 hours through an administration set with a drop factor of 15 drops/mL. What are the correct drops per minute at which to administer this fluid?
25 drops per minute
Insulin retains potency up to __________ days at room temperature.
28
The amount of fluid excreted as urine each day averages approximately less than how many liters?
2L
A patient is taking NPH insulin once daily in the morning. What is the most likely time for a hypoglycemic reaction?
4 to 12 hours after administration
A patient has been prescribed a daily dosage of 20 mg of torsemide for the treatment of acute pulmonary edema. The drug is available in the form of 10 mg tablets. How many tablets should the nurse get for the course of 4 days?
8
Which blood pressure reading is considered hypotensive?
86/42mmHg
A 2-year-old client weighing 32 lb (14.5 kg) is prescribed ferrous sulfate 6 mg/kg/d PO. How many milligrams will the nurse administer to the client per dose?
87
The client is learning to self-administer heparin daily. The home care nurse draws blood every 2 to 3 days to monitor the client's platelet levels. What platelet count would the nurse report to the health care provider as a critical laboratory result?
90,000
Heparin therapy is prescribed to a client with deep vein thrombosis. Which client would be at greatest risk of bleeding from this therapy?
A 45-year-old corporate executive with peptic ulcer disease
Which client would be the best candidate to receive alteplase recombinant therapy?
A 68-year-old male who has had an ischemic stroke that resulted in neurological deficits
Which of the following assessment findings are positive outcomes in a patient receiving warfarin for the management of pulmonary embolism? (Select all that apply.) A. report of absence of chest pain B. respiratory rate of 18/min with no use of accessory muscles C. absence of uncontrolled bleeding D. international normalized ratio serum level of 3.2 E. prothrombin time serum level of 18 seconds F. presence of hematuria
A, B, C, and E
Which of the following, if expressed by a patient taking interleukins, indicate that patient teaching was successful? (Select all that apply.) A. "I should store the medication in the refrigerator." B. "I should not use the medication if it is discolored." C. "I need to drink additional fluids while taking the medication." D. "I need to shake the medication to mix it well before taking." E. "I should not take the acetaminophen if I have a fever or headache." F. "Shortness of breath and edema are side effects that I will need to learn to live with."
A, B, C, and F
A nurse is instructing a patient on dietary considerations while taking spironolactone (Aldactone). Which of the following statements made by the patient indicates that teaching has been successful? (Select all that apply.) A. "I should not eat foods high in potassium while taking this medication." B. "I should use a salt substitute instead of regular salt." C. "I should call my nurse practitioner if I have any significant advverse effects from my medication." D. "I should not take large amounts of potassium chloride supplements."
A, C, and D
In explaining the use of warfarin to a female patient, the nurse is correct in telling her which of the following regarding warfarin? (Select all that apply.) A. Warfarin is a vitamin K antagonist. B. Warfarin does not cross the placenta. C. Warfarin is used for long-term anticoagulation therapy. D. Warfarin is metabolized by the liver.
A, C, and D
The nurse practitioner adds cholestyramine to statin therapy in a patient with markedly elevated serum levels of LDL cholesterol. Which of the following if stated by the patient indicates that patient teaching has been successful? (Select all that apply.) A. "I need to mix the powder with water or other fluids before I take it." B. "I should wait 1 hour after I eat to take the medication." C. "I need to maintain good oral hygiene as the medication can damage my teeth." D. "If i notice an increased bleeding tendency, I need to notify the nurse practitioner." E. "I might have some GI effects, including constipation or abdominal pain."
A, C, and E
Water is a vital element for the human body. What is one of its functions?
Aids in digestion and absorption
The nurse is educating a patient about proper foot care. Which instruction does the nurse include in the teaching plan?
Always have a podiatrist cut toenails.
A patient with chronic renal failure receiving epoetin alfa will be having a total left hip arthroplasty. What supplementation should the patient receive prior to surgery?
An iron supplement
A client who began treatment for type 2 diabetes 8 months ago is now meeting with a diabetic nurse for a scheduled follow-up. How can the nurse best assess the client's glycemic control since beginning treatment?
Assess the most recent hemoglobin A1C levels.
A nurse is preparing to administer insulin glargine to a client. What precaution should the nurse take when administering this drug?
Avoid mixing glargine with other insulins.
The nurse is assessing a patient who has just begun taking glyburide. Which of the following is a therapeutic outcome for this patient? (Select all that apply.) A. a glycosylated hemoglobin (hemoglobin A1C) of 10% B. a decrease in polyuria C. a decrease in polyphagia D. a fasting blood glucose of 108mg/dL
B, C, and D
A man has a low level of adrenocorticotropic hormone and a high level of cortisol. What disease does he have?
Cushing's disease
Based on the action of pramlintide, which of the following is a primary nursing intervention?
Provide a meal immediately after the administration of the subcutaneous injection.
A patient has a sodium level of 124 mEq/dL. Which assessment finding is expected?
Confusion
A nurse is caring for a patient who is "nothing by mouth" (NPO) before surgery scheduled at 10:00am. He routinely receives 30 unites of Humulin 70/30 every morning at 7:00am. What is the appropriate nursing action in this situation?
Contact the physician for a presurgery insulin order.
A patient has a baseline blood pressure of 86/42 mm Hg and is resting comfortably in their room talking on their phone. Their current blood pressure is 84/42 mm Hg. What is the nurse's best course of action?
Continue to monitor the patient.
What is the difference between crystalloids and colloids?
Crystalloids are clear fluids, and colloids are thicker and more viscous.
A person with type 1 diabetes mellitus and hypertension has the following lipid profile: total serum cholesterol 288mg/dL, low-density lipoprotein (LDL) cholesteron 200mg/dL, high-density lipoprotein (HDL) cholesterol 48mg/dL, and triglycerides 200mg/dL. How would you evaluate the results of the lipid profile? (Select all that apply.) A. LDL cholesterol is elevated. B. HDL cholesterol is within normal limits. C. Triglyceride level is elevated. D. Total cholesterol is within normal limits.
D
Sulfonylureas lower blood glucose by decreasing secretion of insulin. (T/F)
False
A client is prescribed warfarin. The client also takes a diuretic for the treatment of cardiac problems. The nurse will monitor the client for which potential interaction?
Decreased effectiveness of the anticoagulant
As the nurse caring for a young child is diagnosed with type 1 diabetes (IDDM), you know that they become at high risk for what and you include assessment and management of this in their care plan?
Delayed growth and development
The nurse is caring for a client who had a postpartum hemorrhage 2 weeks ago that resulted in anemia. The client has called the clinic after passing dark stools, stating, "I looked this up online, and I'm worried I might have stomach or intestinal bleeding." What is the nurse's best initial action?
Determine if the client is taking iron supplements.
Which condition is not an indication for a loop diuretic?
Diabetes mellitus
A nurse is assessing a client receiving a continuous IV infusion. Which assessment finding(s) should the nurse prioritize? Select all that apply.
Distended neck veins; Rapid breathing
Which is a symptom of hypotension?
Dizziness
Katie, a 45-year-old patient with breast cancer, is currently undergoing chemotherapy. She is started on epoetin alfa secondary to decreased hemoglobin and hematocrit levels. What rule is important when administering epoetin alfa, after reconstituting it?
Do not shake the drug vigorously.
The nurse caring for a patient with diabetes mellitus has lipodystrophy of the abdomen. What should the nurse assess?
Does the patient rotate sites for giving each injection?
When teaching a patient who has recently received a diagnosis of diabetes how to self-administer short-acting and intermediate-acting insulin subcutaneously, which of the following instructions is correct?
Draw the short-acting insulin into the syringe first, followed by the intermediate-acting insulin.
What assessment finding does the nurse determine is a therapeutic outcome of administering filgrastim (Neupogen) to the patient?
Elevation of white blood cell count (WBC)
A nurse is caring for a client who is to receive IV potassium. Which action would be appropriate?
Ensure that potassium infuses in no less than 4 hours.
A client with a diagnosis of hypertension has been prescribed a regimen of ramipril and hydrochlorothiazide. In the nurse's most recent assessment, the client reports weakness and leg cramps. In addition to reporting this finding to the health care provider, the nurse will perform which action?
Ensure the client's potassium level is promptly evaluated.
What is the first intervention when working with a patient who is hypotensive?
Ensure the patient is safe.
Clients receiving potassium-sparing diuretics should be encouraged to use salt substitutes. (T/F)
False
Deferoxamine is an oral drug used to remove excess iron from storage in the body. (T/F)
False
During heparin therapy, the aPTT should be maintained at approximately 3.0 times the control or baseline value. (T/F)
False
Heparin is absorbed from the gastrointestinal (GI) tract. (T/F)
False
In pernicious anemia, the most appropriate route of administration for vitamin B12 is oral. (T/F)
False
Serum potassium levels and digoxin have no effects on each other. (T/F)
False
The nurse has finished administering medication through a percutaneous endoscopic gastrostomy tube. Which one of the following steps should the nurse take next?
Flush the tube with water and record the amount.
After teaching a group of nursing students about diuretics, the instructor determines that the teaching was successful when the group identifies which as a loop diuretic?
Furosemide
Which is an example of a loop diuretic?
Furosemide (Lasix)
A client taking an anticoagulant drug tells the nurse she is having bleeding in the gums and teeth. When reviewing client history, the client states she has decided to try an herbal remedy. Which of the following is most likely the cause of increased bleeding?
Ginger
A nurse has determined a client has developed a hypoglycemic reaction. Which interventions should the nurse perform if the client can adequately demonstrate swallowing and gag reflexes?
Give oral fluids or candy.
A man is brought to the emergency department. He is nonresponsive, and his blood glucose level is 32 mg/dL. Which would the nurse expect to be ordered?
Glucagon
A nurse is teaching a client about the insulin product which has been prescribed. The nurse determines the session is successful when the client correctly chooses which insulin they will be using that acts by lowering the blood glucose by increasing the activity of the beta cells in the pancreas? Select all that apply.
Glyburide; Glipizide
Which is the best indicator of overall diabetic control?
Glycosylated hemoglobin levels
While preparing a client for discharge, the nurse is teaching the client about the proper use of warfarin. Which food should the nurse tell the client to avoid consuming in excess?
Green leafy vegetables
A boy with type 1 diabetes mellitus receives a prescription for somatropin. How will this medication affect the boy's insulin needs?
His insulin needs will increase.
A client is receiving subcutaneous heparin 5,000 units every 8 hours. An activated thromboplastin time (aPTT) is drawn 1 hour before the 0800 dose. The results show that the aPTT is at 3.5 times the control value. What is the nurse's priority action?
Hold the dose and call the primary health care provider.
A nurse is preparing to administer spironolactone to a client. The nurse would question this order if which disorder is noted in the client's history?
Hyperkalemia
Upon assessment, a patient has Trousseau and Chvostek signs. Which electrolyte abnormality does this indicate?
Hypocalcemia
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
A patient is ordered furosemide. What is a potential complication of this medication?
Hypotension
A health care provider orders intravenous magnesium sulfate to control convulsions in a pregnant client. When will the preparation take effect?
Immediately following administration
The nurse is assessing a client for risk factors associated with type 2 diabetes. Which findings would the nurse prioritize? Select all that apply.
Impaired glucose tolerance; Obesity; History of gestational diabetes
The pharmacology class learns that epoetin alfa is an immunosuppressant drug that is designed to have what expected outcome?
Increased RBC count
A health care provider has prescribed a loop diuretic for a client with hypertension. The client also has diabetes mellitus. What condition should the nurse monitor for in this client after administering the prescribed drug?
Increased blood glucose levels
When describing the effects of incretins on blood glucose control to a group of students, which would an instructor include?
Increases insulin release
When administering insulin, what would be most appropriate?
Insert the needle at a 45-degree angle for injection.
A nurse at a health care facility is assigned to administer insulin to the patient. Which intervention should the nurse perform before administering each insulin dose?
Inspect the previous injection site for inflammation.
The nurse has just admitted a client to the unit who is newly diagnosed with Kaposi's sarcoma. The health care provider has order an IV infusion of an interferon. What drug has the provider ordered?
Interferon alfa-2b
What lab value should be monitored for a patient on warfarin?
International normalized ratio (INR)
What should be avoided when a patient is on warfarin?
Intramuscular (IM) injections
A male client is self-administering epoetin in the home. The nurse encourages him to include what supplements as part of his daily medication regimen?
Iron
A boy has contracted a rash caused by poison ivy over a large portion of his arms and legs following a camping trip. His health care provider has prescribed oral prednisone, which is to be administered in a taperint dose over the next 10 days. What effect does the medication have on the rash?
It decreases the accumulation of neutrophils and macrophages at the site, thus reducing inflammation.
A patient has just been told that her cancer has metastasized to the right kidney. An interferon has been prescribed to treat this metastasis. The patient asks why the interferon is ordered. What is the nurse's best response?
It has been shown to inhibit tumor growth.
How does warfarin work?
It suppresses vitamin K and "thins" the blood.
A cancer patient asks the nurse why he is being given a corticosteroid before his chemotherapy. Which of the following is the nurse's best response?
It will prevent nausea and vomiting that occur with chemotherapy.
Adequate intake of vitamin B12 is necessary for cell metabolism, nutrient absorption, and normal development of red blood cells and nerve cells. Which of the following foods are natural sources of this vitamin?
Meat, Fish, Cheese
__________ anemias occur with deficiency of folic acid or vitamin B12.
Megaloblastic
A nurse has administered ammonium chloride to a client as prescribed. Which assessment finding will the nurse prioritize?
Metabolic acidosis
What does a pH of 7.14, a CO2 of 36 mEq/L, and an HCO3 of 9 mEq/L indicate?
Metabolic acidosis
What does a pH of 7.50, a CO2 of 41 mEq/L, and an HCO3 of 42 mEq/L indicate?
Metabolic alkalosis
Which intervention should be implemented for patients on any medications that increase the risk of bleeding?
Monitor for dark stools.
A client with renal impairment is in need of a diuretic. Because of the renal problem, potassium-sparing diuretics are contraindicated but may be used if there is no other option. If they are used at all, what nursing intervention would be most important for this client?
Monitoring of serum electrolytes, creatinine, and BUN
After teaching a group of students about the renal system, the instructor determines that the teaching was successful when the students state:
Most fluid that is filtered by the kidneys is returned to the body.
How should intravenous (IV) heparin be administered?
On a pump with guardrails
A client is receiving hydrochlorothiazide. 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
A 21-year-old woman is taking levothyroxine for hypothyroidism. She has recently become sexually active and would like to take an oral contraceptive. Which of the following aspects of patient teaching is most accurate?
Oral contraceptive agents result in diminished levothyroxine levels due to inactivation.
The nurse is caring for a client who is receiving an iron supplement for treatment of anemia. What food/liquid will the nurse offer the client to take with the iron that will increase the iron's absorption?
Orange juice
The nurse monitoring a client receiving insulin glulisine notices the client has become confused, diaphoretic, and nauseated. The nurse checks the client's blood glucose and it is 60 mg/dL (3.33 mmol/L). Which can a nurse give to treat a client with a hypoglycemic episode? (Select all that apply.)
Orange or other fruit juice; Glucose tablets; Hard candy
The nurse monitoring a client receiving insulin glulisine notices the client has become confused, diaphoretic, and nauseated; and has a blood glucose of 60 mg/dL. Which emergent treatment would the nurse most likely give? Select all that apply.
Orange or other fruit juice; Glucose tablets; Hard candy
A client diagnosed with type 1 diabetes suddenly reports feeling weak, shaky, and dizzy. What should be the nurse's initial response?
Perform a blood sugar analysis.
A 69-year-old client, who has been prescribed a daily diuretic, is admitted to critical care with a cardiac arrhythmia. Which electrolyte should be monitored due to its' effect on heart rate and excretion or retention during diuretic therapy?
Potassium
Many people throughout the world are practicing vegetarians. Their diet is rich in fruits and vegetables so it is also likely to be rich in:
Potassium
The pharmacology instructor is discussing the differences among the various diuretic agents. Which would the instructor cite as a difference between spironolactone and hydrochlorothiazide?
Potassium losses are greater with hydrochlorothiazide than with spironolactone.
A client with hypertension has been prescribed spironolactone. The client's previous diuretic, furosemide, has been discontinued. The nurse should explain what benefit of this change?
Potassium losses are lower with spironolactone than with furosemide.
Which factor is an absolute contraindication to receiving a thrombolytic?
Pregnancy
A male client is receiving heparin by continuous intravenous infusion. The nurse will instruct the client and family members to report what should it occur?
Presence of blood in urine or stools
The pharmacology instructor is discussing heparin with the students. How would the instructor explain the action of heparin?
Promotes the inactivation of clotting factors
How does propranolol control symptoms of hyperthyroidism?
Propranolol impedes the beta-adrenergic receptors in various organs.
A client exhibits signs and symptoms of heparin overdose. The nurse would anticipate administering:
Protamine sulfate
What is the antidote for heparin?
Protamine sulfate
__________ edema is a life-threatening condition that occurs with circulatory overload or acute heart failure.
Pulmonary
A client is to receive enoxaparin. The nurse would administer this drug by which route?
Subcutaneous injection
A nurse is preparing an in-service presentation for a group of staff members on diabetes. Which would the nurse include as the primary delivery system for insulin?
Subcutaneous injection
An adult client has told the nurse that vitamin supplements should be avoided because "natural foods are the only good source of vitamins." What information about synthetic vitamins should be the basis of the nurse's response? Select all that apply.
Synthetic vitamins are less expensive than some natural sources. Natural and synthetic sources of vitamins are equivalent in function.
A patient asks the nurse when the daily dose of levothyroxine should be taken. Which of the following instructions is most appropriate to teach the patient?
Take it before breakfast on an empty stomach.
A patient is taking ketoconazole for the treatment of Cushing's disease. When providing patient teaching, which of the following is most important?
Take the medication with juice or an acidic beverage.
A client began taking hydrochlorothiazide 1 week ago and is reporting occasional dizziness when standing up quickly from sitting or lying. What is the nurse's best action?
Teach the client about the blood pressure effects of the medication and relevant safety measures.
A stable daily dose of warfarin is reached when which parameter is achieved?
The PT and INR are within their therapeutic ranges, and the dose does not cause bleeding.
A patient is on a heparin infusion. How does the nurse know if the medication is infusing at a therapeutic rate?
The activated partial thromboplastin clotting time (aPTT) is 1.5 to 2.5 times the normal time.
The patient has pernicious anemia. Why does the nurse administer vitamin B12 by the intramuscular route?
The drug is not absorbed if taken orally.
The pancreas has both endocrine and exocrine functions. Which statement is true?
The exocrine function assists in secreting digestive enzymes.
A patient is prescribed a loop diuretic. What will happen to the potassium level when this medication is administered?
The potassium level will decrease.
The nurse is caring for a 34-week preterm infant and knows that preterm infants need proportionately more vitamins than term infants, for what reason?
Their growth rate is faster.
The health care provider indicates that a client experiencing renal failure is not a candidate for therapy with potassium-sparing diuretics. How will the nurse respond when the client's family member asks why this is the case?
They may cause hyperkalemia.
How do anticoagulants work?
Thin the blood to prevent clots and stop clots from getting bigger.
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.
__________ is considered a second-line drug for clients who cannot take aspirin.
Ticlopidine
A person with a fasting blood glucose level between 100 and 125 mg/dL is said to have prediabetes. (T/F)
True
Dosage of LMWHs should be reduced in clients with severe renal impairment. (T/F)
True
Hypokalemia increases the risk of digoxin toxicity. (T/F)
True
Insulin is the only effective drug treatment for type 1 diabetes. (T/F)
True
Mild hyperglycemia is considered safer for the client during the perioperative stage than hypoglycemia. (T/F)
True
Regular insulin (insulin injection) is the insulin of choice for DKA. (T/F)
True
Spironolactone effects occur slowly and may take several days before the therapeutic effects are seen. (T/F)
True
The normal serum potassium level is 3.5 to 5.0 mEq/L. (T/F)
True
Thiamine deficiency may lead to Wernicke's encephalopathy. (T/F)
True
Thrombogenesis may be lifesaving when it occurs as a response to hemorrhage. (T/F)
True
Vitamin A may be given IM if GI absorption is severely impaired or ocular symptoms are severe. (T/F)
True
Where is the pancreas located?
Upper left quadrant of the abdomen
The nurse is teaching a young female about the prescribed anticoagulant. The nurse determines the session is successful when the client correctly indicates they will apply which recommendation?
Use a reliable contraceptive.
A male client is prescribed interferon. What is his probable diagnosis?
Viral hepatitis
Which substances are moved from the glomerulus into the tubule due to hydrostatic pressure?
Water
A nurse has an order to administer heparin. Before initiating this therapy, a priority nursing assessment will be the client's:
aPTT.
dyslipidemia
abnormal lipid levels in the blood; associated with atherosclerosis and its many pathophysiologic effects (e.g., myocardial ischemia and infarction, stroke, peripheral arterial occlusive disease)
A 36-year-old woman has been taking atorvastatin 20mg PO daily for 6 months to treat mild dyslipidemia. At a clinic appointment, she tells the nurse she is 6 weeks pregnant. The nurse counsels the patient that it is likely that her midwife will counsel her
about discontinuing the drug during pregnancy
What assessment finding in a patient with heart failure receiving furosemide would indicate an improvement in fluid volume status?
absence of crackles on auscultation of lungs
ascites
accumulation of fluid in the abdominal cavity
A child is taking long-term systemic corticosteroids. What factor influences the child's diminished growth?
altered DNA synthesis
When administering long-term systemic corticosteroid medications, which of the following dosing schedules is recommended?
alternate-day therapy
The nurse should teach a patient to avoid large amounts of potassium-containing foods or a potassium supplement if the patient is taking which one of the following drugs for control of blood pressure?
an angiotensin-converting enzyme inhibitor
megaloblastic anemia
anemia characterized by the presence in the blood of megaloblasts (large, abnormal blood cells) associated with vitamin B12 deficiency
corticotropin
anterior pituitary hormone obtained from animal pituitary glands; also referred to as adrenocorticotropic hormone; this hormone may be used as a diagnostic test to differentiate primary adrenal insufficiency from secondary adrenal insufficiency caused by inadequate pituitary secretion of corticotropin
Graves' disease
antibody-mediated autoimmune disease resulting in hyperthyroidism; the most common cause of hyperthyroidism
A man has sustained burns over 80% of his body in a boating accident. Which of the following hormones is released to raise the arterial blood pressure?
antidiuretic hormone
Protamine sulfate is a(n) __________ for standard heparin and LMWHs.
antidote
A client with acute coronary syndrome is prescribed clopidogrel. Which additional medication will the nurse expect to be prescribed for this client?
aspirin
A 62-year-old woman has a reduced thyroid-stimulating hormone level of 0.07 microunit/L and a normal T3 and T4. Which of the following symptoms is she at risk for developing?
atrial fibrillation
A patient is receiving prednisone 10mg orally every day to reduce symptoms of Chrohn's disease. Which of the following effects is associated with daily administration of prednisone?
atrophy of the adrenal cortex
What food should the nurse encourage a patient taking Lasik to consume to prevent a low potassium (K+) level?
bananas
A client has been receiving regular doses of epoetin alfa for several weeks, and the home care nurse has been monitoring the client's condition closely. When taking the client's vital signs, the nurse should pay particular attention to what assessment datum?
blood pressure
blood glucose level
blood sugar level in the body
Which of the following adverse effects should the nurse discuss with a patient receiving filgrastin?
bone pain
essential thrombocythemia
chronic blood disorder characterized by the overproduction of platelets by megakaryocytes in the absence of another cause
diabetes mellitus
chronic disease characterized by disordered metabolism of carbohydrates, fats, and protein, and hyperglycemia, due to a deficiency in the amount on action of insulin; the three main forms of diabetes are type 1, type 2, and gestational diabetes
While reviewing a client's the record, the nurse sees that the client received a dose of interferon alpha-2b? For what disorder does the nurse suspect the client was being treated?
chronic hepatitis C
metabolic syndrome
cluster of several cardiovascular risk factors linked with obesity; increased waist circumference, elevated triglycerides, reduced high-density lipoprotein in cholesterol, elevated blood pressure, and elevated fasting glucose
thyroiditis
common cause of primary hypothyroidism; an autoimmune disorder characterized by inflammation of the thyroid gland
cholesterol
component of cell membrane that is produced and processed in the liver; a fat essential for the formation of steroid hormones that is produced in cells and taken in by dietary sources
Addisonian crisis
condition that mimics hypovolemic and septic shock; also known as adrenocortical insufficiency
An infant has diminished growth and development with a very slow pulse and below-normal temperature. Based on the symptoms, what disorder is suspected?
cretinism
hypothyroidism
diminished secretion of thyroid hormone; occurs when disease or destruction of thyroid gland tissue causes inadequate production of thyroid hormones
immunostimulants
drugs that stimulate immune function to fight infection and disease
chelating agents
drugs used to treat metal poisoning (e.g., from iron, lead, or mercury) that bind to the toxic metal, decrease binding of the metal within the body, and promote elimination of the metal
A patient with DKA is admitted to the hospital. Which of the following does the nurse expect to see?
elevated blood glucose and decreased plasma bicarbonate
A woman receives a prescription of hydrocortisone for adrenal insufficiency. It is necessary to report which of the following conditions to the primary health care provider?
fever
The nurse is caring for a patient who is undergoing chemotherapy for cancer. The physicial orders filgrastim. The nurse explains to the patient that an expected outcome after the administration of filgrastim is
fewer infections
gluconeogenesis
formation of glucose from noncarbohydrate sources such as fats and amino acids
antidiuretic hormone
functions to regulate water balance; also known as vasopressin; this hormone is secreted when body fluids become concentrated and when blood volume is low
Which diuretic will most likely be the initial drug of choice when a client demonstrates dyspnea related to pulmonary edema?
furosemide
Which medication, being taken regularly by a client, may create a need for oral potassium supplementation?
furosemide
A client with heart failure has developed acute shortness of breath and pulmonary edema. The nurse will prepare for administration of what medication and via what route?
furosemide IV
anasarca
generalized massive edema
In the kidneys, insulin is filtered by the __________ and reabsorbed by the tubules, which also degrade it.
glomeruli
The __________ is a network of capillaries that receives blood from the renal artery.
glomerulus
hyperkalemia
greater than normal amount of potassium in the blood
The home care nurse is visiting with a patient who has a diagnosis of hypothyroidism. The patient is being treated with levothyroxine. The assessment of the patient reveals the following findings: an audible S3, crackles in the lower lobes, edema of the lower extremities, and a heart rate of 120 beats/min. What does the nurse suspect the patient has developed?
heart failure
What should the nurse assess prior to the administration of levothyroxine?
heart rate
The nurse improves client compliance with the drug regimen of epoetin alfa through what intervention?
helping the client set up a reminder system for days when the drug is to be administered
During recovery from a gastrointestinal bleed, a client has been prescribed an iron preparation. Prior to beginning therapy, what assessment should the nurse prioritize?
hematocrit and hemoglobin
A man is admitted to the emergency department. He is hypotensive with nausea, vomiting, and muscle weakness. He has been taking enoxaparin 40mg subcutaneously daily for the past 2 weeks. It is suspected that he has developed which of the following disorders?
hemorrhage of the adrenal cortex
A single IM dose of vitamin K is given to infants to prevent __________ disease of newborns.
hemorrhagic
The nurse is caring for a pediatric client who needs anticoagulation therapy. What drug will the nurse anticipate being prescribed for this client?
heparin
The nurse is caring for a 76-year-old client who is receiving IV heparin 5000 units q4h. At the initiation of therapy, the client's control activated thromboplastin time (aPTT) was found to be 35 seconds. One hour prior to the next scheduled dose, aPTT is determined to be 92 seconds. Based on this result, the nurse will:
hold the dose and contact the provider.
When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug is used to treat:
hyperglycemia.
A man with type 2 diabetes mellitus has a blood glucose of more than 500mg/dL. He is complaining of excessive urination, extreme thirst, and weakness, and he also notes recent weight loss. The nurse would expect to find which diagnosis in his chart?
hyperglycemic hyperosmolar nonketotic syndrome
The administration of fludrocortisone is necessary in which of the following conditions?
hypernatremia
A health care provider is considering ordering hydrochlorothiazide for a client. This drug must be used cautiously, if at all, if the client has a history of:
hypersensitivity to sulfonamides.
Which one of the following mineral/electrolyte imbalances increases the chances of digoxin toxicity?
hypokalemia
A patient is taking fluticasone 440mcg inhaled two times per day. The patient is being seen in the pulmonary clinic and says, "I have been very congested and it has been hard to breathe, so for the past 10 days, I have been using my inhaler four times per day." The nurse should assess the patient for which of the following systemic adverse effects?
hypothalamic-pituitary-adrenal (HPA) suppression
myxedema
hypothyroidism that occurs after early childhood, more often in women than in men
heparin-induced thrombocytopenia (HIT)
immune-mediated adverse effect that leads to thrombogenesis resulting in a decrease in platelet count associated with heparin administration in patients with detectable HIT antibodies
malabsorption
impaired absorption of nutrients by the gastrointestinal tract
plasminogen
inactive protein found in many body tissues and fluids
immunodeficiency
inadequate or impaired immune function
adrenocortical excess
increase in adrenocortical function
An adult has decreased growth hormone. Which of the following signs or symptoms is the patient likely to develop?
increased cholesterol
A patient is admitted to the emergency department in anaphylactic shock following numerous bee stings. The prescriber orders parenteral administration of corticosteroids. What effect is expected from the administration of these agents?
increased or restored cardiovascular responsiveness
The expected outcome of administering epoetin alfa or darbepoetin alfa to a patient with chronic kidney disease is
increased red blood cell production
A patient who has just arrived at the emergency department may be suffering from diabetic ketoacidosis. Which of the following would confirm the diagnosis?
increased respiratory rate
biologic response modifiers
intrinsic and extrinsic substances in the body that enhance the body's response to infection; for example, interferons, monoclonal antibodies, interleukin-2, and types of colony-stimulating factors
The nurse who is administering epoetin alfa knows that most patients who take epoetin alfa or darbepoetin alfa also need to take
iron
A nurse is educating grandparents about child safety. Which of the following prevents precocious puberty?
keeping estrogen cream out of a child's reach
megavitamins
large doses of vitamins in excess of the recommended dietary allowance
hypokalemia
less than normal amount of potassium in the blood
steroid
lipid-soluble hormone produced by the gonadal organs or the adrenal cortex
Untreated iron accumulation from blood transfusions can lead to heart and __________ failure.
liver
Rosiglitazone is being considered for the treatment of diabetes in an adult client. Before the initiation of rosiglitazone therapy, the nurse should review what laboratory work recently drawn?
liver enzymes
Insulin and glucose __________ serum potassium levels by driving potassium into the cells.
lower
The nurse is caring for a client with increased intracranial pressure. Which diuretic would the nurse anticipate being prescribed for this client?
mannitol
Teaching for a patient who is being started on an iron supplement should include information that the preparation
may cause stools to be dark green or black
ketoacidosis
metabolic acidosis due to accumulation of ketone bodies formed by the breakdown of fatty acids and amino acids for energy in the absence of insulin
A patient with type 2 diabetes is scheduled to have a cardiac catheterization in 1 week, and the nurse makes a preprocedure phone call. The nurse instructs the patient to stop taking which medication 2 days before the procedure?
metformin
The nurse is reviewing the laboratory results of a hospitalized patient receiving intravenous heparin therapy for pulmonary embolism. The activated partial thromboplastin time (aPTT) is 38 seconds (control 28 seconds). The nurse should
notify the health care provider that the aPTT is low and anticipate orders to increase the dose
embolus
object that migrates through the circulation until it lodges in a blood vessel, causing occlusion; may be a thrombus, fat, air, amniotic fluid, a bit of tissue, or bacterial debris
The nurse is caring for a client with a cardiac condition. Which assessment finding indicates to the nurse that the client may have an increased level of potassium?
peaked T waves on electrocardiogram
Thrombolytic agents stimulate conversion of plasminogen to __________.
plasmin
Two weeks ago, a 4-year-old girl fell from a backyard swing and hit her head. Her mother states her potty-trained daughter has been wetting the bed for the past 3 nights. What do you suspect the bedwetting is related to?
possible diabetes insipidus
A 58-year-old woman with type 2 diabetes mellitus takes glyburide (DiaBeta) 5mg by mouth daily, and this drug controls her diabetes well. However, recently, her fasting glucose has measured between 200 and 220mg/dL. Which of the following medications may have been added to the patient's regimen?
prednisone
An adult client with multiple chronic health problems has been prescribed furosemide in the management of hypertension. When reviewing this client's current medication administration record, what drug should signal the nurse to a potentially increased risk of hypokalemia?
prednisone
A liver transplant patient is receiving corticosteroids. These drugs are important to the care of this patient because they
prevent tissue rejection
By what means does warfarin achieve the desired anticoagulant effects?
preventing synthesis of clotting factors in the liver
hemostasis
prevention or stoppage of blood loss from an injured blood vessel and is the process that maintains the integrity of the vascular compartment
Addison's disease
primary adrenocortical insufficiency with inadequate production of cortisol and aldosterone
The nurse is caring for a postoperative client whose diabetes has been well controlled on acarbose. The client is not allowed to take anything orally following complications of abdominal surgery and is receiving high-glucose total parenteral nutrition via a central IV line. What medication can the nurse administer intravenously to control the client's blood glucose level?
regular insulin
thyroid-stimulating hormone (thyrotropin)
regulates secretion of thyroid hormones
Patients with chronic kidney disease benefit from epoetin alfa because the drug
replaces erythropoietin no longer produced in the proximal tubules of the kidney
When assessing a patient for therapeutic effects of iron therapy, the nurse would check the result of which laboratory study?
reticulocyte count
cytokines
small proteins released by cells that specifically affect cell-to-cell communication; these include colony-stimulating factors, interleukins, and interferons
A patient has just received desmopressin. Which electrolyte is most important to assess?
sodium
What substance is reabsorbed in the ascending limb of the loop of Henle?
sodium
lipoproteins
specific proteins in plasma that transport blood lipids; contain cholesterol, phospholipid, and triglyceride bound to protein; they vary in density and amounts of lipid and protein
A nurse is planning to teach a patient about dietary sources of vitamin K. The nurse teaches that foods containing vitamin K include which of the following?
spinach, brussels sprouts, and broccoli
A nurse should question the use of an oral potassium preparation with which one of the following drugs?
spironolactone
corticosteroid
steroid hormone produced by the adrenal cortex; examples include androgens, glucocorticoids, and mineralocorticoids
mineralocorticoid
steroid hormone released by teh adrenal cortex to promote sodium and water retention and potassium excretion
growth hormone
stimulates the growth of body tissues; regulates cell division and protein synthesis required for normal growth and promotes an increase in cell size and number, including growth of muscle cells and lengthening of bone
immunosuppression
suppression of the immune system
negative feedback mechanism
when the output of a system affects the stimulus for the system (e.g., hormone secretion produces an effect that shuts off the stimulus for further hormone secretion)
