Pharm Exam 2
A client is diagnosed with hypomagnesemia. Which nursing intervention would be appropriate? A. Instituting seizure precautions to prevent injury b. instruct the pt on the importance of preventing infection c. teaching the pt the importance of early ambulation d. avoid the use of tight tourniquet when drawing blood
A
A nurse inserts a nasogastric tube and notes immediate drainage of 1000 mL of fluid. Which of the following electrolytes is of greatest concern at this time? a. potassium b. magnesium c. calcium d. sodium
A
A nurse is caring for a client who has been taking diuretics on a long-term basis. A fluid volume deficit is suspected. Which finding would be noted in the client with this condition? a. increased urine specific gravity b. increased BP c. gurgling respirations d. decreased hematocrit
A
The nurse is caring for a client with renal failure. The lab results reveal a magnesium level of 3.6 mg/dL. Which of the following manifestations would the nurse expect the client to display? a. irritability b. hyperactive reflexes c. loss of deep tendon reflexes d. twitching
C
A pt is rx'd digoxin, the nurse anticipates the pt's dx is? a. heart failure b. HTN c. bradycardia d. angina
A
If a pt is taking a drug to tx hyperlipidemia. What will the nurse monitor for? a. hypoglycemia b. hepatoxity c. dysrhythmia d. ototoxicity
B
What adverse effect would the nurse monitor in the patient having norepinephrine infused for cardiogenic shock? a. Hypotension b. Weak pulse c. Dysrhythmia d. Severe shortness of breath
C
The nurse is caring for a pt receiving a diltiazem drip. What is the likely dx? a. a-fib b. ventricular tachycardia c. v-fib d. PVCs
A
Which follow-up lab is priority due to potential adverse effects for the patient taking atorvastatin? a. creatinine level b. high density lipid level c. CRP level d. alanine transaminase level (ALT)
D
Which medication does the nurse teach the patient to take only as prescribed due to overdosage adverse effects of tinnitus and bleeding? a. furosemide b. acetylcysteine c. acetylsalicylic acid (ASA) d. tissue plasminogen activator (tPa)
C
The intensive care nurse is caring for a patient who needs a heart transplant and has low cardiac output and severe peripheral edema. Which diuretic should the nurse administer to help achieve fluid balance in this patient? a. mannitol 0.25g/kg IV over 3 hrs b. furosemide 40mg IV push over 10 min c. furosemide 20mg po d. hctz 50mg po
B
Which medication does the nursing instructor teach that, when taken with nitroglycerin, can cause profound hypotension? a. calcium channel blockers b. angiotensin II receptor blockers c. phosphodiesterase-5 enzyme inhibitors d. angiotensin-converting enzyme inhibitors (ACE-inhibitors)
C
Which medication is appropriate to administer to a patient with a serum potassium level of 6.5 mEq/L? a. triametrene b. captopril c. furosemide d. spironolactone
C
Which serious side effect is most associated with taking an angiotensin-converting enzyme inhibitor (ACE-inhibitor)? a. visual disturbances b. hypokalemia c. leg muscle pain d. swelling of lips
D
A nurse is caring for a client receiving dextrose 5% in 0.9% sodium chloride IV at 150 mL/hr. Which of the following statements by the client should alert the nurse to suspect fluid overload? a. "I think my ankles are less swollen" b. " I feel a little short of breath" c. "I feel lightheaded" d. "The nurse's aid told me that my BP was 120/70"
B
A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following findings should the nurse recognize as a complication of this therapy? a. stomatitis b. polyuria c. aspiration d. diarrhea
B
A patient arrives at the emergency department with a hemoglobin of 6. The health care provider orders 2 units of packed red blood cells (PRBCs) to be infused each over 4 hours. The nurse starts the first unit of PRBCs and within the first 15 minutes, the patient begins to flush, redness to the face, and begins itching. Which type of infusion reaction is the patient exhibiting? a. Febrile reaction. b. Anaphylactic reaction. c. Circulatory overload. d. Hemolytic reaction.
A
A nurse will monitor for Trousseau's sign in the client with which of the following electrolyte abnormalities? a. hypochloremia c. hypocalcemia c. hypokalemia d. hyponatremia
B
A patient diagnosed with heart failure has a short run of ventricular tachycardia on the cardiac monitor one hour following intravenous furosemide. The nurse will anticipate which electrolyte replacement? a. potassium b. phosphorous c. sodium d. calcium
A
A patient has a 84% oxygen saturation despite attempts to deep breath and cough. The nurse also suctions the patient without improvement. The nurse reviews the prn medication list for orders. Which medication should the nurse use first? a. ipratropium b. beclomethasone c. montelukast d. cromolyn
A
Which medical problem would the nurse expect the healthcare provider to prescribe dopamine as the medication treatment of choice? a. thyroid storm episode b. malignant HTN c. anaphylactic reaction d. low cardiac output
D
A nurse is preparing to administer potassium chloride IV to a client with hypokalemia. Which of the following is an appropriate action by the nurse? a. implement cardiac monitoring b. monitor urine output to ensure at least 20 mL/hr c. determine acid-base imbalance prior to administration d. administer medication IV push
A
A patient is prescribed a methylxanthine class medication. Which findings reflects the medication has achieved the desired therapeutic effect? a. The patient reports decreased chest tightness and wheezing b. The patient reports being able to cough mucus up effectively c. The patient reports decreased anxiety and increased mood d. The patient reports increasing heart rate and respirations
A
A patient with asthma is experiencing an acute bronchospasm. Which medication is most appropriate during this emergent situation? a. albuterol b. ipratropium c. theophylline d. beclomethasone
A
A spouse brings her 70-year-old husband to the emergency room and states, "I don't know what has happened, but my husband has become increasingly confused this week and isn't eating well?" The nurse verifies the patient takes digoxin 0.25 mg and furosemide 40 mg, and a digoxin level from two weeks prior is 2.4 ng/mL. The nurse's next priority action is: a. Assess for further signs of digoxin toxicity. b. Place oxygen by nasal cannula at 4 L/min. c. Document findings as normal. d. Call the health care provider to lower the dose to 0.125 mg.
A
Adverse side effects include angioedema, first dose hypotension, rash a. captopril b. metoprolol c. losartan d. amlodipine
A
Class of drugs that improve HDL, LDL, and triglycerides? a. fibrates b. statins c. bile acid sequestants d. cholesterol absorption inhibitors
A
The healthcare provider recommends the patient with border-line hypercholesterolemia to consider intake of which over-the-counter vitamin? a. vitamin B3 b. Vitamin B6 c. Vitamin B9 d. vitamin B12
A
The nurse is caring for a patient on a ventilator following acute respiratory distress syndrome and is about to administer respiratory treatment of acetylcysteine. Which priority action will the nurse prepare to perform after administration of acetylcysteine? a. suctioning excess secretions b. turn, cough, and deep breathe the pt c. instruct the pt that the medication may cause bradycardia d. remove any acetaminophen from the medication admin record
A
The nurse is caring for a patient receiving a continuous IV heparin infusion. The activated partial thromboplastin time (aPTT) result is 1 ½ times greater than normal. Which action should the nurse take? a. Document finding and continue to monitor. b. Call for prothrombin PT to confirm. c. Discontinue the heparin infusion d. Perform a stool guaiac test.
A
The nurse is caring for a patient receiving sodium polystyrene sulfonate for hyperkalemia. After administration of the medication, what will the nurse monitor to assure the goal of treatment has been met? a. increased bowel movements b. decreased blood pressure c. decreased urine output d. increased PVCs
A
The nurse is preparing to infuse dextrose through a peripheral vein. The nurse knows which of the following is the maximum concentration of dextrose that should be infused through a peripheral vein? a. 10% b. more than 50% c. less than 5% d. 20%
A
The nurse is providing instructions to parents of a toddler who is prescribed digoxin for cardiac failure. The nurse will instruct parents on which manifestation is associated with digoxin toxicity? a. bradycardia b. weight gain c. fever d. hyperactivity
A
The nurse monitors the blood pressure of the patient taking which medication due to the risk of hypotension? a. Isosorbide b. Ipratropium c. Simvastatin d. Dopamine
A
What should the nurse teach a patient who is a farmer, who takes acetylsalicylic acid for stroke prevention therapy and reports to the clinic nurse that it sometimes takes a while to stop the bleeding for minor cuts on his arms while working? a. apply pressure with a clean cloth until the bleeding stops b. wrap anything that is available and apply as a tourniquet above the cut c. run warm water over the wound until bleeding stops d. apply kerlix wrapped tightly around the area for at least an hour
A
What should you teach the pt who receives a prescription for prazosin? a. take first dose at bedtime b. report cough c, take on empty stomach d. dry mouth should resolve in 2-4 weeks
A
Which IV fluid is used to administer blood products? a. 0.9% sodium chloride b. dextrose 5% in water c. dextrose 5% in 0.9% sodium chloride d. Lactated Ringers solution
A
Which assessment most indicates the patient is taking an antiplatelet, such as aspirin? a. Ecchymosis on the arms and hands b. Thrombosis in the lower extremity c. Blurred vision and bradycardia d. Headache and severe hypotension
A
Which is the priority information for the nurse to obtain from a patient presenting to the emergency department with substernal chest pain of 8/10, diaphoresis, and a room air oxygen of 90%? a. A thorough medication history b. Insurance coverage information c. Social history, including alcohol use d. Use of supplemental oxygen in the home
A
Which lab value is the most concerning for a pt receiving enoxaprin? a. platelets 99,000 b. Hgb 9.5 c. aPTT 1.5x the baseline d. WBC 12
A
Which laboratory result best indicates that lovastatin therapy has produced the most desired effect? a. HDL level of 95 b. LDL level of 125 c. total cholesterol level of 275 d. triglyceride level of 268
A
Which medication would the critical care nurse expect to be ordered for treatment of a patient in cardiogenic shock? a. norepinephrine b. isosorbide dinitrate c. B-adrenergic blockers d. HMG-CoA reductase inhibitors
A
Which patient will most likely receive apixaban therapy? a. a pt with atrial fibrillation for prevent of stroke or embolism b. a pt with ventricular fibrillation following a ST elevation myocardial infarction c. a pt with a hemorrhagic stroke given to prevent further brain damage d. a pt with supra ventricular tachycardia needing to be converted to sinus rhythm
A
Which route does the nurse expect the healthcare provider to prescribe for a patient with a potassium level of 3.4 mmol/L who is receiving furosemide 20 mg daily? a. PO b. SC c. IM d. IV
A
The nurse is caring for a patient who is prescribed hydrochlorothiazide for hypertension. Following administration of this medication, the nurse should anticipate what effect? a. increased BP related to increased cardiac output b. increased urine output related to diuretic effect c. elevated potassium d. mild agitation
B
The nurse is instructing a patient on using a metered dose inhaler and will include which instructions? Select all that apply. a. Hold the metered dose inhaler 1-2 inches from mouth or use a spacer. b. After inhalation, close your mouth and hold your breath 5-10 seconds. c. Take short quick breaths with each inhalation. d. Exhale deeply after inhalation of medication.
A, B
Which treatment(s) are considered standard medical treatment for a patient admitted with chest pain associated with myocardial infarction (MI)? Select all that apply. a. IV morphine b. IV nitroglycerin c. PO warfarin d. IV digoxin e. Nasal cannula O2
A, B
An outpatient comes to the clinic for 2 units of blood. In the first 10 minutes of the 1st unit, the patient's lung sounds have audible crackles, VS: HR 128, RR 48 dyspnea, O2 sat 85%, and jugular vein distention is assessed. Which of these interventions should be implemented as priority? Select all that apply. a. slow the infusion to run over 4 hrs max. b. raise HOB up 45 degrees and begin oxygen BNC at 2-4 L/M c. discontinue all IV fluids infusing with the blood d. report to HCP immediately e. stop the infusion immediately
A, B, C, D
The medical surgical unit nurse prepares a discharge teaching plan for a patient with a diagnosis of deep vein venous thrombosis (DVT) who is being discharged to home. The patient will remain on warfarin anticoagulant therapy. Which instructions will the nurse include on the teaching plan? Select all that apply. a. if taking trips, stop and walk every 2 hrs b. observe for red, pink or dark smoky color to the urine c. eat green veggies for vitamin A d. use a soft toothbrush to avoid causing bleeding to the gums e. the need to wear a medical identification alert bracelet
A, B, D
Which instructions about taking aspirin during an episode of angina given by the graduate nurse in the emergency department would cause the charge nurse to intervene? Select all that apply. a. swallow the whole tablet with a full glass of water b. place this medication under your tongue c. chew this medication thoroughly and completely d. take another pill in 5 min if the pain persists e. you will receive four 81mg ASA tablets to take at the same time.
A, B, D
Which medication combination should the nurse question? Select all that apply. a. atenolol and albuterol b. albuterol and ipratropium c. cimetidine and theophylline d. ipratropium and beclomethasone e. theophylline and metoprolol
A, C
The nurse is preparing an instructional discharge plan for a patient with polycystic kidney disease and teaching will include which of the following instructions? Select all that apply. a. take all meds as ordered such as ACE inhibitors for HTN and diuretics for edema b. limit fluid intake since renal failure is imminent c. maintain fluid intake of at least 2,500 mL per day d. know s/s of UTI e. discuss diet and nutrition
A, C, D
Which vitamin or mineral is involved with red blood cell production and is often given for various types of anemia? Select all that apply a. cobalamin b. vitamin K c. folic acid d. ferrous sulfate e. calcium
A, C, D
Which medication order should the nurse question for an asthma patient? Select all that apply. a. Atenolol b. Guaifenesin c. Montelukast d. Ipratropium e. Acetylcysteine
A, E
Which side effect(s) should the nurse educate the patient about when a patient is prescribed a cough suppressant with codeine? Select all that apply. a. constipation b. sun sensitivity c. insomnia d. heart palpitations e. orthostatic hypotension
A, E
Which teaching is accurate when instructing a patient about sublingual nitroglycerin if chest pain is experienced at home? Select all that apply. a. stop what you are doing and sit down b. first call 911, then take pills as instructed c. take the pill with a full glass of water d. simultaneously place 3 pills under the tongue e. store the pills in the dark colored, original container
A, E
A patient is taking the diuretic furosemide and is asking the nurse about foods with potassium content. Which statement by the patient indicates accurate understanding after nurse instructions? a. I will take furosemide along with my HTN medication b. I will eat foods like apricots, dates, citrus fruits, bananas, and drink orange juice c. I will limit calcium in my diet d. I will limit spinach since vitamin k will affect my other K
B
High doses constrict renal blood vessels resulting in increased heart rate and blood pressure. a. epinephrine b. dopamine c. dobutamine d. nitroprusside
B
Pt teaching for niacin? a. increases bleeding time b. take ASA 30 min prior c. increase fiber and fluids d. take a vitamin supplement
B
The nurse is caring for a patient in the telemetry unit who was prescribed spironolactone prior to experiencing cardiac symptoms. On admission, the patient is demonstrating ECG changes and is experiencing muscle weakness. A priority outcome for the patient is for resolution of which electrolyte imbalance? a. Hypokalemia b. Hyperkalemia c. Hypocalcemia d. Hypercalcemia
B
The nurse is caring for a patient who is prescribed hydrochlorothiazide for hypertension. Following administration of this medication, the nurse should anticipate what effect? a. Increased blood pressure related to increased cardiac output b. Increased urine output related to diuretic effect c. Elevated potassium d. Mild agitation
B
A patient in the intensive care unit is having active bleeding and the health care provider orders 4 units of PRBC's to be infused ASAP. The patient's hemoglobin has dropped to 5 gm/dL. As the nurse begins the first infusion, the patient begins audibly wheezing, breaks out in a rash/hives over the body, and has a blood pressure of 72/38. Which type of infusion reaction is the patient experiencing? a. Febrile reaction. b. Anaphylactic reaction. c. Circulatory overload. d. Hemolytic reaction.
B
A patient is suffering from an upper respiratory infection with congestion. Which medication helps thin mucus in the airway? a. Antihistamine b. Expectorant c. Cough suppressant d. Mast cell stabilizer
B
A 21-year-old college student is in the emergency room following an aspirin overdose. Which emergency procedure will the nurse anticipate performing? a. administer vitamin k IM stat for bleeding potential b. administer activated charcoal stat, if drug overdose occurred within 2 hrs c. administer protaminie sulfate stat, if already bleeding d. administer N-acetylcysteine stat, if liver function abnormal
B
A client is receiving total parenteral nutrition (TPN). The nurse understands the TPN solution is most likely which tonicity? a. colloidal b. hypertonic c. isotonic d. hypotonic
B
A patient in the clinic is prescribed hydrochlorothiazide and metoprolol for new onset of hypertension and states, "My allergies made me catch a cold but I took a decongestant advertised on the television." What instruction point should the nurse emphasize when teaching the patient about these medications? a. "Decongestants are permitted, but do not add aspirin." b. "Avoid taking over-the-counter decongestants since they might increase your blood pressure." c. "You should check your blood pressure first." d. "Decongestants are permitted, but should not be taken with antibiotics.
B
The nurse is caring for a patient with complaints of blurred vision, halos, and anorexia. The nurse determines which of the following medications as a cause for the blurred vision, visual halos, and anorexia? a. Propranolol b. Digoxin c. Glipizide d. Phenelzine
B
The nurse is instructing the patient on use of the beclomethasone inhaler. Which statement by the patient indicates that teaching is successful? a. "I will hold my diabetic medication for two hours before and after the inhaler." b. "I will rinse my mouth following each scheduled dose." c. "I will use the inhaler prior to sleep." d. "I will inhale then blow out forcefully."
B
The nurse is providing discharge instructions for a patient who experienced a myocardial infarction. The discharge instruction includes administration of nitroglycerin for chest pain. Which statement by the patient indicates understanding of instructions on taking nitroglycerin? a. "I will take 2 nitroglycerin tablets 15 minutes apart, and if I do not have any relief I will contact my health provider." b. "I will place 1 tablet under my tongue 5 minutes apart for up to 3 times, and if I do not have any relief I will seek emergency care immediately. c. "I will take 3-4 nitroglycerin tablets every 5 minutes until the chest pain subsides." d. "I will take 1 tablet and lay down for an hour."
B
What lab finding is of biggest concern for a pt taking spirolactolone? a. Sodium 135 b. Potassium 5.0 c. glucose 190 d. calcium 9.5
B
What lab should be monitored for a pt on a heparin drip? a. PT b. PTT c. LFT d. H&H
B
What should you teach the pt who receives a prescription for amlodipine? a. report cough b. change positions slowly c. avoid potassium-rich foods d. take first dose at bedtime
B
Which assessment finding of a patient on tissue plasminogen activator (tPa) would the nurse report immediately? a. scant bleeding around the IV site b. decreased level of consciousness c. increased urinary output of 80 ml/hr d. serum potassium level of 4.9 mEq/L
B
Which assessment would the nurse perform before administration of atenolol? a. review aPTT levels b. palpate radial pulse rate c. monitor for hypokalemia d. assess for presence of bleeding
B
Which common side effect does the nurse caution the patient about when starting a new bile-acid sequestrant for hypercholesterolemia? a. bleeding b. diarrhea c. leg pain d. facial flushing
B
Which education from the nurse is most appropriate for a patient newly prescribed warfarin home therapy for a recent deep vein thrombosis? a. Encouragement of daily folic acid supplementation b. Explaining the need for periodic blood testing c. Teaching to count their own pulse before the medication d. Reporting toxicity symptoms of visual disturbances
B
Which is a medically benign side effect of sublingual nitroglycerin tablets? a. Increasing chest pain b. Headache pain of 6/10 c. BP of 84/58 mm Hg d. Hbg 8, Hct 30%
B
Which laboratory values would the nurse monitor for a patient receiving IV heparin? a. Prothrombin time (PT) b. Activated partial thromboplastin time (aPTT) c. International ration (INR) d. Potassium (K+)
B
Which medication does the nurse anticipate being prescribed for a patient following an uncomplicated femur bone reduction surgery for prevention of DVT? a. Intravenous heparin b. Subcutaneous enoxaparin c. Intravenous alteplase d. Oral digoxin preparation
B
Which patient report is most concerning to the nurse in a patient who has been taking rosuvastatin for 6 weeks? a. nausea and drowsiness b. HA and muscle pain c. decreasing LDL and increasing HDL d. insomnia and abd cramping
B
The nurse is caring for a patient with heart failure who is receiving a prescribed angiotensin-converting enzyme inhibitor (ACE inhibitor). The patient is asking how the drug works for heart failure. What will the nurse include in teaching the patient about this medication? Select all that apply. a. The ACE inhibitor reduces fluid volume b. The ACE inhibitor relaxes blood vessels and lowers blood pressure c. The ACE inhibitor reduces workload on the heart d. The ACE inhibitor decreases pulmonary venous pressure. e. The ACE inhibitor prevents vasoconstriction and secretion of aldosterone.
B, C
The nurse is teaching a pt about vitamins and minerals. the nurse recognizes that the teaching has been effective when the pt identifies which of the following as fat-soluble? SATA a. vitamin C b. vitamin A c. Vitamin E d. Iron e. vitamin B1
B, C
Which describes the function(s) of nitroglycerin during a myocardial infarction? Select all that apply. a. Increases preload b. Decrease afterload c. Produces vasodilation d. Decreases catecholamines e. Produces peripheral constriction
B, C
Which would indicate effectiveness of treatment with dopamine in a patient with kidney failure related to decreased renal perfusion due to decreased cardiac output? Select all that apply. a. Increasing creatinine b. Increasing blood pressure c. Increasing urinary output d. Increasing bronchodilation e. Increasing ALT and AST (liver)
B, C
The nurse is preparing for discharge instructions for a patient who experienced a recent myocardial infarction (MI). One of the new medications the patient will have upon discharge is clopidogrel. The nurse should develop an instructional plan which includes which information? Select all that apply. a. take with food b. report episodes of prolonged bleeding c. clopidogrel's action helps prevent platelets from sticking together and forming clots d. take med at the same time daily e. limit alcohol use
B, C, D
A nurse caring for a pt receiving TPN. Which of the following are priority interventions for this pt? SATA a. measure gastric residual b. monitor electrolyte levels weekly c. assess pt's gag reflex d. check glucose levels every 6 hrs
B, D
A patient has a new prescription captopril following a clinic visit. What should the nurse include in teaching about the drug? Select all that apply. a. Take the medication with meals b. Report any cough that develops. c. Report to the clinic for weekly blood serum labs. d. Check blood pressure prior to dose, log findings, and report changes. e. Do not drink grapefruit juice while taking captopril.
B, D
A patient who weighs 91 kg is diagnosed with iron-deficiency anemia and will require injection of iron dextran. How will the nurse prepare and inject the ordered medication? Select all that apply. a. the nurse will draw up the medication, use a 25g needle and inject at a 45 degree angle b. the nurse will draw up the medication, use a 2-in needle, and inject at a 90 degree angle c. pull skin laterally toward the injection site, injection and withdraw and massage d. pull skin laterally away from the injection site, inject, wait 10 sec, withdraw, and do not massage e. inject into the deltoid muscle to avoid tissue trauma
B, D
A patient with a diagnosis of congestive heart failure is receiving digoxin 0.25 mg daily. The nurse determines that the medication is achieving the desired goal because of which findings? a. Increased heart rate. b. Increased blood pressure. c. Increased urine output. d. Decreased myocardial contractility.
C
Administered fast push IV a. procainamide b. diltiazem c. adenosine d. amiodarone
C
Adverse effects of captopril? a. reflex tachycardia b. dry eyes c. cough d. cyanide toxicity
C
Class of antihypertensives ending in -"olol" a. ACE inhibitors b. ARBs C. Beta Blockers D. Calcium Channel blockers
C
Contraindication for receiving alteplase? a. acute MI b. DVT c. hemorrhagic stroke d. PE
C
A patient experiencing bronchospasms receives an albuterol treatment. Afterward, the patient tells the nurse, "I don't want that medicine again! It makes me feel like my heart is running away!" What is the most appropriate response by the nurse? a. I will note in your chart that you are allergic to albuterol b. I have never had that happen before with this medication c. increased heart rate is expected but it will get better in a few min d. cardiac dysrhythmias is expected, sinus rhythm will return shortly
C
A client is ordered to receive hypotonic IV solution to provide free water replacement. Which of the following solutions will the nurse anticipate administering? a. Lactated Ringers solution b. 0.9% sodium chloride c. 0.45% sodium chloride d. 5% dextrose with 0.45% sodium chloride
C
Nurse is preparing to administer alteplase for pt with PE. What is the appropriate intervention? a. administer alteplase within 8 hrs b. give IM enoxaparin with aleteplase c. hold pressure to any puncture site for 30 min d. administer aminocaproic acid before starting alteplase
C
The nurse is administering calcium gluconate to a patient experiencing laryngeal spasms and exhibiting a positive Chvostek sign. Which condition is most likely related to these symptoms and the need for immediate IV calcium gluconate? a. hypothyroidism b. hyperthyroidism c. hypoparathyroidism d. hyperparathyroidism
C
The nurse is caring for a client in the intensive care unit (ICU) following a saltwater near-drowning event. The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen, dry tongue; flushed skin; and peripheral edema. The nurse anticipates which of the following serum sodium values? a. 135 mEg/L b. 145 mEq/L c. 155 mEq/L d. 125 mEq/L
C
The nurse is caring for a patient with a new diagnosis of hypertension. The patient also has a history of type 2 diabetes and microalbuminuria. Which drug therapy will the nurse anticipate for the patient? a. Nefedipine b. clonidine c. captopril d. verapamil
C
The nurse is processing the physician's orders and recognizes that the client is to receive normal saline to keep vein open (KVO). The nurse is aware that normal saline solution is categorized as which of the following? a. hypotonic solution b. hypertonic solution c. isotonic solution d. colloidal solution
C
The nurse is starting a patient's 3rd unit of PRBCs. The patient begins complaining of severe back pain, becomes apprehensive, and VS: T 100.9F, P 126, RR 28, BP 80/54. Which intervention should the nurse perform as priority? a. Administer tylenol and benadryl and continue the infusion. b. Slow the infusion because the patient is in circulatory overload. c. Stop the infusion because the patient is having a hemolytic reaction. d. Stop the infusion because the patient is having an anaphylactic reaction.
C
The nurse on the medical surgical unit is providing discharge instructions for a patient diagnosed with hypertension and cardiovascular disease. Which important diet instructions is priority for the patient who will be discharged with amlodipine? a. take amlodipine with a low fat meal b. be careful with too much sodium in the diet c. if taken at breakfast, so not consume grapefruit d. take with bananas to aid in maintaining potassium
C
What is the antidote for warfarin? a. calcium gluconate b. protamine sulfate c. vitamin K d. aminocaproic acid
C
Which assessment finding is of the greatest concern for the pt receiving IV dubotamine? a. BP 96/60 b. oriented, but drowsy c. urine output 20 ml/hr d. HR 105
C
Which best indicates effective nitroglycerin therapy in a patient admitted with a myocardial infarction awaiting transport to the cath lab? a. increased troponin levels b. increased BP c. decreased chest pain d. decreased HA
C
Which condition is most often treated with both digoxin and warfarin? a. Ventricular fibrillation b. Supraventricular tachycardia c. Atrial fibrillation d. Sinus tachycardia
C
Which is the best explanation from the nurse about how dopamine functions in the body? a. dopamine decreases cardiac output through stimulation of beta receptors b. dopamine causes cardiac stimulation in cardiac arrest and is used for bronchodilation c. digoxin is used to treat acute kidney failure caused by low cardiac output d. digoxin causes myocardial vasodilation and decreases afterload and preload
C
Which patient laboratory findings will most likely result in an immediate prescription from the healthcare provider for intervention? (see serum lab results below) Serum lab results: Sodium 136 mmol/L Calcium 9.0 mg/dL Magnesium 1.0 mg/dL Potassium 3.5 Hematocrit 40% Creatinine 1.2 mg/dL a. sodium level b. calcium level c. magnesium level d. potassium level
C
Which patient would absolutely not be able to receive alteplase for the stroke symptoms they are experiencing? a. Recently taking a phosphodiesterase inhibitor b. Home medication of a chewable baby aspirin daily c. A head injury associated with the stroke symptoms d. Computer tomography results indicating ischemia
C
A nurse is assessing a client's IV site. Which of the following findings indicate phlebitis? (Select all that apply.) a. cool, pale skin b. tachycardia c. palpable, hard mass above the insertion site d. pain at the IV site e. tingling sensation below the insertion site
C, D
A patient has been on digoxin therapy for 3 months. In addition to digoxin levels, the nurse will monitor which other serum levels? Select all that apply. a. glucose b. creatinine kinase c. potassium d. magnesium e. creatinine
C, D
What are the therapeutic uses of acetylcysteine? Select all that apply. a. Decreases inflammation during an acute asthma attack b. Protects the liver when contrast is used during a heart catheterization c. Used as an antidote for acetaminophen overdose d. Helps thin thick mucus associated with cystic fibrosis e. Reverses risk of bleeding in acetylsalicylic acid overdose
C, D
A patient is admitted to the intensive care unit with thrombocytopenia. The patient's platelet count is 120,000 μl. The health care provider ordered 5 bags of platelets to be infused on this patient. How long should the nurse infuse each bag of platelets? a. 5-10 min b. 10-20 min c. 20-30 min d. 30-60 min
D
A patient who has been taking theophylline for 6 months has a theophylline level of 25 mcg/mL. Which action is appropriate for the nurse? a. monitor pt for bronchospasm and hypoglycemia b. give the prescribed theophylline and continue monitoring the pt c. check with the provider to obtain an increased dosage of theophylline d. hold admin of theophylline and contact HCP
D
A pt reports yellow halos around objects and nausea. These are signs of toxicity of what? a. amlodipine b. diltiazem c. nitroprusside d. digoxin
D
Class of antihypertensives ending in -"pine" a. nitrates b. ACE inhibitor c. Beta blockers d. calcium channel blockers
D
Decreases absorption of fat-soluble vitamins a. niacin b. ezetimibe c. atorvastatin d. cholestyramine
D
The nurse correctly explains to the patient that which medication lowers the blood pressure by relaxing blood vessels? a. losartan b. lovastatin c. cantopril d. nifedipine
D
The nurse is caring for a patient who has a new order for heparin therapy. Which nursing assessment data is priority to evaluate prior to beginning heparin therapy? a. Serum blood glucose b. Serum potassium and sodium levels c. Heart rate and blood pressure d. Activated partial thromboplastin time
D
The nurse is caring for a patient who has right-sided heart failure, and is scheduled to receive the second dose of bumetanide. Prior to administration of the drug, assessment of the patient reveals a marked decrease from 4+ to 1+ ankle edema, neck distention is less than earlier, and the patient lost 3 pounds in 24 hours. What action should the nurse take? a. Hold the bumetanide b. Give the bumetanide early c. Notify the physician d. Give the scheduled dose
D
The nurse is reviewing a client's morning laboratory results. Which of these results is of greatest concern? a. serum potassium 5.1 mEq/L b. serum calcium 10.6 mg/dl c. serum sodium 134 mEq/L d. serum magnesium 0.8 mEq/L
D
The nurse is reviewing the patient's theophylline blood level during a followup visit. Which level, in mcg/mL, is within the therapeutic range for theophylline? a. 1.2 b. 3.5 c. 8.3 d. 10.6
D
The nurse receives an order form the health care provider which is described as: "Digoxin .125 mg P.O. once daily." To prevent a dosage error, how should the nurse transcribe this order onto the medication administration record? a. digoxin .1250mg P.O once daily b. digoxin .125 mg P.O once daily c. digoxin 0.1250 mg P.O once daily d. digoxin 0.125 mg P.O once daily.
D
What lab should be monitored for a pt taking warfarin? a. PTT b. LFT c. creatinine d. PT
D
Which education is essential for the nurse to give the patient to help facilitate the goal of treatment of guaifenesin? a. consume foods like chocolate and colas before taking guaifenesin b. take this before your heart cauterization to reduce kidney effects c. this is the drug of choice for patients with cystic fibrosis d. drink at least 2000 mL of water with this medication
D
Which is the most accurate response by the registered nurse when the nursing student inquires why beta blockers are administered during a myocardial infarction? a. beta blockers help dilate coronary blood vessels, thereby increasing cardiac output b. beta blockers relax smooth muscle, thereby decreasing workload of the heart c. beta blockers decrease fluid in the circulatory stem, thereby decreasing preload d. beta blockers decrease catecholamines, thereby decreasing oxygen demands
D
Which medication causes adverse effects include dry mouth, drowsiness, and rebound HTN if stopped abruptly? a. losartan b. verapamil c. terazosin d. clonidine
D
Which of the following is an anti platelet? a. rivaroxaban b. alteplase c. warfarin d. ASA
D
Which statement by the nurse properly explains the action of clopidogrel to a nursing student about a patient taking this medication after stent placement? a. "Clopidogrel is the antidote for heparin treatment." b. "Clopidogrel is used to eliminate existing clots." c. "Clopidogrel is prescribed for prevention of erythrocytosis" d. "Clopidogrel is given for prevention of platelet aggregation"
D
Before administering oral hydrochlorothiazide (HCTZ), what must the nurse assess for safe medication administration? Select all that apply. a. intracranial pressure b. HCTZ blood levels c. Hgb & Hct levels d. potassium level e. blood pressure
D, E
