Pharm PrepU 25,27,28,54,55
A client comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow? Antitussives Decongestants Mucolytics Expectorants
Decongestants
A client is prescribed salmeterol. The nurse would expect this drug to be administered by which route? Subcutaneous Oral Intravenous Inhalation
Inhalation
The nurse has finished teaching a 15-year-old client how to use an inhaler to treat asthma. What statement by the client suggests an understanding of the teaching? "I need to shake the inhaler well before taking the medication." "I need to take three short, quick breaths to inhale the medication." "I need to wait at least 30 minutes after the first inhalation before taking a second." "I should take a deep breath, hold it while I administer the medication, and then exhale."
"I need to shake the inhaler well before taking the medication."
After teaching a group of parents about the use of over-the-counter cough and cold products with their children, which statement indicates the need for additional teaching? "We should use the cup that comes with the drug to measure it out." "We can use over-the-counter products for our 5-year-old but not for our 18-monthold." "We can use the adult brand, but we just have to decrease the amount." "We need to read the label carefully to see how often and how much to give."
"We can use the adult brand, but we just have to decrease the amount."
A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman's nurse provide? "This will likely relieve your muscle spasms but you'll probably develop a certain amount of dependence on the drug over time." "We'll need to closely monitor your blood sugar levels for the next week." "You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity." "There's a small risk that you might experience some hallucinations in the first few days that you begin taking this drug."
"You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity."
The nurse assesses the serum theophylline of a client. Which finding would the nurse identify as being therapeutic? 30 mcg/mL 25 mcg/mL 5 mcg/mL 15 mcg/mL
15 mcg/mL
A patient comes to the clinic for a botox injection around her eyes. While making an assessment, the nurse finds that the patient is taking polymyxin for an infection. What would the nurse do first? Document the polymyxin on the chart. Wash her hands. Prepare the patient for the injection. Notify the physician.
Notify the physician.
A nurse is caring for a patient who has been prescribed a nasal decongestant. Which of the following factors should the nurse assess before administering the drug? Auditory tests Blood pressure Motor coordination Vision
Blood pressure
The nurse is caring for a 59 year-old female client who was diagnosed with multiple sclerosis two years ago. In recent weeks, the client has developed increasing muscle spasticity and the care team is considering the use of dantrolene. What assessment question should the nurse prioritize? "Are you on hormone replacement therapy?" "Have you had a hysterectomy?" "At what age did you begin menopause?" "Have you ever been treated for fibromyalgia?"
"Are you on hormone replacement therapy?"
A client asks the nurse how long to use oxymetazoline (Afrin) nasal spray for nasal congestion. What is the nurse's best response? "Over-the-counter medications are safe for long-term use." "Consult with your primary care provider." "Use the medication until your symptoms are completely relieved." "Afrin can be used as long as nasal burning and stinging do not occur."
"Consult with your primary care provider."
The nurse is educating an older adult client diagnosed with rhinosinusitis in an outpatient clinic about the prescribed topical oxymetazoline. The client has a history of hypertension and coronary artery disease. Which statement made by the client establishes the need for further clarification? "The drug is used no longer than 3 days." "I can take over-the-counter pseudoephedrine, too." "I will blow my nose before using the nasal spray." "I will rinse the spray tip off after each use."
"I can take over-the-counter pseudoephedrine, too."
A nurse is teaching a 55-year-old client about fexofenadine prescribed to treat allergic symptoms. Which client statement suggests an understanding of this teaching? "I should avoid driving after taking this medication." "Taking this medication shouldn't stop me from having my after-dinner drink." "This medication has no serious side effects." "It's safe to take this medication with the nighttime sinus medication that I've been using."
"I should avoid driving after taking this medication."
The nurse is caring for a client with cystic fibrosis who is receiving dornase alfa by nebulizer to help thin secretions. What statement by the client indicates a need for further instruction? "This medication will loosen up the sticky mucus that is in my lungs." "I'm glad that this medication will address all of my symptoms." "I will try to cough after I receive this medication." "I will continue to use postural drainage and take my enzymes as ordered."
"I'm glad that this medication will address all of my symptoms."
A client is admitted after overdose with acetaminophen. What medication would the nurse expect to be administered? Darbepoetin alfa Acetylcysteine Daptomycin Oxymetazoline hydrochloride
Acetylcysteine
A client has been prescribed baclofen and will be taking the drug on an outpatient basis. The client asks the nurse if it is still okay to drink wine with meals or end the day with a "nightcap." What is the nurse's best response? "You're not permitted to drink alcohol while you're taking baclofen." "The combination of baclofen and alcohol could depress your nervous system to a dangerous level." "If you combine baclofen and alcohol you could suffer a severe allergic-type reaction." "It's best to keep your alcohol intake to a low level when you're taking muscle relaxants."
"The combination of baclofen and alcohol could depress your nervous system to a dangerous level."
A client is prescribed salmeterol as treatment for exercise-induced asthma. The nurse would instruct the client to use the inhaler at which time? Right before and after exercising Immediately after beginning to exercise 30 minutes before engaging in exercise Midway during the exercise routine
30 minutes before engaging in exercise
In which situation would the neuromuscular junction (NMJ) blocker vecuronium be contraindicated? A 6-year-old boy is scheduled for a hernia repair. A 78-year-old man is scheduled for electroshock therapy. A 1-day-old premature girl needs mechanical ventilation. A 53-year-old woman requires emergency intubation.
A 1-day-old premature girl needs mechanical ventilation. The NMJ blocker vecuronium is commonly used for short surgical procedures, intubation, and mechanical ventilation. Use of this drug should be avoided, however, with neonates and premature infants.
A 13-year-old patient is scheduled to receive pancuronium (Pavulon). Which healthcare provider should administer the medication? A surgical resident A CRNA trained to use NMJ blockers An RN who works in ICU An EMT with military training
A CRNA trained to use NMJ blockers
Which assessment finding indicates that a neuromuscular junction (NMJ) blocking agent is effective? Patient reports no pain Absent reflexes Hyperkalemia Hypocalcemia
Absent reflexes
After reviewing information about drugs used to treat lower respiratory system conditions, a group of nursing students demonstrate understanding of the information when they identify which as an example of a short-acting beta-2 agonist (SABA)? Formoterol Albuterol Salmeterol Arformoterol
Albuterol Long-acting beta-2 agonists may increase the risk of asthma-related death. ICSs are contraindicated in clients with hypersensitivity to the corticosteroids, acute bronchospasm, status asthmaticus, or other acute episodes of asthma and can cause throat irritation, hoarseness, upper respiratory tract infection, and fungal infections of the mouth and throat. SABA bronchodilators are drugs used to relieve bronchospasm associated with respiratory disorders, such as bronchial asthma, chronic bronchitis, and emphysema but can cause tachycardia, palpations, arrhythmias, hypertension, nervousness, anxiety, and insomnia. The mast cell stabilizer is contraindicated in clients with known hypersensitivity to the drugs and during attacks of acute asthma, because they may worsen bronchospasm during the acute asthma attack. A mast cell stabilizer is used cautiously during pregnancy (pregnancy category B) and lactation and in clients with impaired renal or hepatic function.
Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication? Albuterol causes relaxation of the bronchial smooth muscles. Albuterol blocks the stimulation of the beta-2 receptors. Albuterol causes stimulation of the bronchial tissue. Albuterol decreases vital capacity.
Albuterol causes relaxation of the bronchial smooth muscles.
The perioperative nurse is caring for a client who is undergoing abdominal surgery with the inclusion of succinylcholine in the client's anesthesia. The anesthesiologist tells the team that the client is exhibiting signs and symptoms suggestive of malignant hyperthermia. What is the nurse's best action? Prepare to administer acetylcysteine IV Administer naloxone IV as per facility protocol Anticipate IV administration of dantrolene Initiate resuscitation
Anticipate IV administration of dantrolene
An older adult client with shingles is experiencing intractable pain in her trunk and back, and has been prescribed topical lidocaine to augment the pain control regimen. What is the nurse's most appropriate action when administering this medication? Monitor closely for signs and symptoms of heart block. Apply moderate heat after applying the gel. Teach the client to expect pain relief in 60 to 75 minutes. Apply the gel approximately 1/8 inch (3 mm) thick.
Apply the gel approximately 1/8 inch (3 mm) thick.
A client with a foreign body embedded in her hand requires local anesthesia for removal. What drug would be most appropriate? Methohexital Propofol Benzocaine Enflurane
Benzocaine
Which of the following would a nurse identify as a surfactant? Theophylline Zileuton Cromolyn Beractant
Beractant
Chronic obstructive pulmonary disease (COPD) encompasses which of the following? Select all that apply: Pulmonary embolism Chronic bronchitis Pneumonia Asthma Pulmonary hypertension
Chronic bronchitis Asthma
A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following? Hyperthyroidism Gastrointestinal upset Cigarette smoking Alcohol intake
Cigarette smoking
The nurse is providing education to a client who has been prescribed an antiasthmatic drug. The nurse should instruct the client to avoid excessive intake of what beverage? Grapefruit juice Acai juice Green tea Coffee
Coffee
Which statement accurately describes the pharmacodynamics of nondepolarizing neuromuscular junction (NMJ) blocking agents? Are lipophilic and cross the blood-brain barrier Compete with acetylcholine for receptor sites Cause potassium to enter skeletal muscle cells Are excreted unchanged by the kidneys
Compete with acetylcholine for receptor sites Nondepolarizing NMJ blocking agents block acetylcholine receptors so muscle stimulation will not occur. They are metabolized in the serum by plasma cholinesterases, which are manufactured by the liver. The metabolites are mostly excreted by the kidneys in the urine and are hydrophilic, so they do not easily cross the blood-brain barrier. Hyperkalemia may result from the drug action forcing potassium from the muscle cells.
The nurse is assisting in the care of a client during surgery. The nurse will be prepared to administer which drug if the client develops malignant hyperthermia? Toradol Dantrolene sodium Diazepam Acetaminophen
Dantrolene sodium
A client has been admitted to the unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the client is taking baclofen. Which outcome would the nurse expect to be associated with use of this medication? Reduction in the appearance of new lesions in magnetic resonance imaging (MRI) studies Increased muscle strength Decreased muscle spasms Decreased severity and duration of exacerbations
Decreased muscle spasms
The nurse is caring for a client with a history of renal impairment in the postanesthesia care unit (PACU) after general anesthesia with isoflurane and vecuronium. The client has a weak and ineffective cough. Which assessment should the nurse perform to determine if recurarization has occurred? Select all that apply. Determine what the bilateral hand grasp strength is. Assess for the ability to swallow and handle secretions. Examine the medical record if neostigmine was administered. Ask to lift the head off bed for 5 seconds to determine strength. Analyze the last recorded renal profile to determine renal status.
Determine what the bilateral hand grasp strength is. Assess for the ability to swallow and handle secretions. Ask to lift the head off bed for 5 seconds to determine strength
A 45-year-old female client is being seen in the health care provider's office for a dry, hacking cough that is keeping her up at night. The provider prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan? Dextromethorphan works on the receptors in the throat to prevent a cough. Dextromethorphan works by relaxing the smooth muscles in the bronchioles. Dextromethorphan works in the medulla to suppress the cough reflex. Dextromethorphan works by inhibiting allergen response.
Dextromethorphan works in the medulla to suppress the cough reflex.
A nurse administers carisoprodol to a client for the treatment of an acute musculoskeletal condition. The nurse would be alert for which adverse effect after administering the drug? Insomnia Constipation Anxiety Drowsiness
Drowsiness
The nurse is caring for a client who is receiving cyclobenzaprine for relief of muscle spasms. What adverse effect should the nurse assess for? Insomnia Drowsiness Muscle spasms Urinary incontinence
Drowsiness
When developing a teaching plan for a client who is to receive carisoprodol, which sign or symptom would the nurse include as the most common adverse reaction? Hypertension Drowsiness Tachycardia Dyspnea
Drowsiness
When developing a teaching plan for a client who is to receive carisoprodol, which sign or symptom would the nurse include as the most common adverse reaction? Tachycardia Dyspnea Hypertension Drowsiness
Drowsiness
A man with no significant medical history is being prepared for outpatient surgery under general anesthesia. As part of the preparation for surgery, the anesthesiologist administers atropine, a anticholinergic agent. What is the purpose of administering this medication at this time? Decrease anxiety. Dry up secretions in the respiratory tract. Sedate the client. Relax the muscles.
Dry up secretions in the respiratory tract.
What is the most important nursing action when a client is admitted to the postanesthesia recovery unit (PACU)? Position the client on his side to prevent aspiration of vomitus. Administer pain medication. Check the client's pulse and blood pressure. Ensure the client has adequate respirations.
Ensure the client has adequate respirations.
A client is admitted to the emergency department with inspiratory stridor and air hunger. When anticipating treatment, the nurse will prepare which medication for administration? Cromolyn Ipratropium bromide Pseudoephedrine Epinephrine
Epinephrine
An older adult client has been prescribed an inhaled corticosteroid for the treatment of chronic obstructive pulmonary disease. When administering the drug, what action should the nurse perform to reduce the client's risk for developing oral candidiasis? Administer prophylactic antifungal medications. Have the client gargle with normal saline prior to administering the drug. Have the resident rinse his or her mouth after each dose of the drug. Encourage the resident not to deeply inhale the medication.
Have the resident rinse his or her mouth after each dose of the drug.
What is the chemical mediator released in immune and inflammatory response to allergic reactions? Histamine Epinephrine Norepinephrine Mast cells
Histamine
A nurse is providing health education to a client recently diagnosed with asthma and prescribed albuterol and ipratropium. Which of the client's statements suggests a need for clarification by the nurse? I'll keep taking my medications until I'm not experiencing any more symptoms." "I'll try to make sure that I drink plenty of fluids each day." "I'm a heavy coffee drinker, but I know that I now know I need to cut down on this." "I'll make sure I don't take my inhalers more often than they've been prescribed."
I'll keep taking my medications until I'm not experiencing any more symptoms."
An adult client who is currently undergoing rhinoplasty has developed the characteristic signs and symptoms of malignant hyperthermia. The operating room nurse should anticipate what intervention? IV administration of dantrolene sodium IV administration of naloxone Hemodialysis Tracheal intubation
IV administration of dantrolene sodium
A student asks the physiology instructor what causes loss of muscle function, or paralysis. What would the instructor respond? If ACh cannot react with the α-adrenergic receptors If the anticholinergic muscle receptor cannot be activated paralysis, or loss of muscle function, occurs If the β-adrenergic muscle receptor cannot be activated paralysis, or loss of muscle function, occurs If ACh cannot react with the cholinergic muscle receptor to allow new stimulation muscle contraction, muscle paralysis, or loss of muscle function, occurs
If ACh cannot react with the cholinergic muscle receptor to allow new stimulation muscle contraction, muscle paralysis, or loss of muscle function, occurs If Ach cannot react with the cholinergic muscle receptor or if the muscle cells cannot repolarize to allow new stimulation and muscle contraction, muscle paralysis, or loss of muscle function, occurs.
A nurse is preparing a presentation for a local elementary school parent group about over-the-counter cold medications and their use in children. Which would be most appropriate to include? (Select all that apply.) Using household measuring devices for dosage measurements Importance of reading the label for ingredients and dosage Using adult formulation with smaller doses Need to follow the directions for how often to give the drug Avoidance of use in children under age 2
Importance of reading the label for ingredients and dosage Need to follow the directions for how often to give the drug Avoidance of use in children under age 2
The nurse is reviewing a client's morning blood work and notes a theophylline level of 22.2 mcg/mL (123.21 µmol/L). What action should the nurse take? Inform the health care provider that an increase in the client's dose of theophylline may be necessary. Administer the scheduled dose of theophylline with as needed (PRN) dose of a bronchodilator. Withhold the scheduled dose of theophylline pending the next day's blood work results. Inform the health care provider that the client has toxic theophylline levels.
Inform the health care provider that the client has toxic theophylline levels.
When teaching a client about his prescribed asthma therapy, the nurse understands that which medications may increase the risk of asthma-related death? Mast cell stabilizers Inhaled corticosteroids (ICSs) Short-acting beta agonists (SABAs) Long-acting beta-2 agonists
Long-acting beta-2 agonists
A 30-year-old client is to receive tetracaine via spinal anesthesia for an abdominal procedure. What should the nurse do to prevent side effects of this type of anesthesia? Attach Venodyne boots. Insert a Foley catheter. Monitor the vital signs every 2 hours. Maintain the client in a supine position following the procedure.
Maintain the client in a supine position following the procedure.
A nurse assessing a postoperative patient who received a neuromuscular blocking (NMJ) agent during the procedure notes extreme muscle rigidity, pyrexia, and acidosis. What family history predisposed the patient to this event? Pulmonary hypertension Breast cancer Malignant hyperthermia Coronary artery disease
Malignant hyperthermia
An operating room nurse is assisting the anesthesiologist in the preparation of an intravenous dose of dantrolene. What emergent issue most likely prompted the need to give the patient dantrolene? Cerebrovascular accident Uncontrolled hypertension Malignant hyperthermia Myocardial ischemia
Malignant hyperthermia
The students are studying for an exam in pharmacology. They know several local anesthetics have been covered along with other forms. Which medication can they anticipate as being local anesthetics on the exam? Select all that apply. Marcaine Inapsine xylocaine Vistaril Novocain
Marcaine xylocaine Novocain
The nurse is preparing a patient for an endoscopic procedure that will use a nondepolarizing neuromuscular junction (NMJ) blocking agent. Which condition in the patient's history will require a change in anesthetic medication? Hypothyroidism Myasthenia gravis Osteoarthritis Peptic ulcer disease
Myasthenia gravis
A 40-year-old female client with myasthenia gravis has been prescribed dantrolene. The nurse has taught the client about the risks of liver toxicity associated with the medication and should teach the client to self-monitor for what early indications? Nosebleeds or bleeding gums Nausea and loss of appetite Weight gain and ankle edema Flank pain and abdominal distention
Nausea and loss of appetite
Which is classified as a decongestant? Levocetirizine (Xyzal) Azelastine (Astelin) Dextromethorphan (Delsym) Oxymetazoline (Afrin)
Oxymetazoline (Afrin)
Which agent would the nurse instruct a client to use orally? Pseudoephedrine Tetrahydrozoline Xylometazoline Phenylephrine
Pseudoephedrine
In ophthalmology, anticholinergic drugs are used because they produce which effect? Pupil dilation Sedation Decreased lacrimal secretions Pupil constriction
Pupil dilation
What is an adverse reaction commonly experienced by people taking nasal decongestants? Rash Diarrhea Rebound congestion Headache
Rebound congestion
A male client routinely takes baclofen as a skeletal muscle relaxant for a neuromuscular disorder. His last lab results indicate that he is experiencing renal insufficiency. Based on these data, what would the nurse expect the health care provider to do? Titer the dose Increase the dose Reduce the dose Maintain the current dose
Reduce the dose
A gerontological nurse has encouraged a group of caregivers who work with older adults to avoid administering first-generation H1 receptor antagonists to their clients. The nurse's cautionary message is an acknowledgment of what possible nursing diagnosis? Risk for falls related to sedation Risk for impaired skin integrity related to urticaria Risk for infection related to adverse effects of antihistamines Risk for deficient fluid volume related to diuresis
Risk for falls related to sedation First-generation antihistamines cause drowsiness and impaired cognition that can result in falls. These drugs are not known to cause diuresis, impaired skin integrity, or infection.
When does a client with spinal cord injury-associated spasticity require treatment for this condition? Orthopedic procedures are indicated. Pain is present in all affected extremities. Safety, mobility, and activities of daily living are impaired. Ambulation is possible only with an assistive device.
Safety, mobility, and activities of daily living are impaired.
The 35-year-old client has presented to the OB ward for her third delivery by cesarean section. The nurse who is caring for this client prepares for which type of anesthesia? Spinal General Local infiltrate Topical
Spinal
A client scheduled for surgery is to have a nondepolarizing neuromuscular junction (NMJ) blocker as adjunctive anesthesia. The nurse will have cause for concern about prolonged paralysis if the client has been taking what medication? Acetaminophen with codeine Levothyroxine Streptomycin Propranolol
Streptomycin Combining nondepolarizing NMJ blockers with aminoglycosides can result in prolonged paralysis, and this combination should be avoided. This interaction does not occur with barbiturate anesthetics, cephalosporins, or aminophyllin
Which neuromuscular blocking agent would a nurse expect to have the shortest duration of action? Rocuronium Vecuronium Atracurium Succinylcholine
Succinylcholine
The client is about to undergo surgery. The circulating nurse knows that methohexital is used for which purposes? Select all that apply. Analgesia during a surgical procedure Supplement to other anesthetics Depress the central nervous system to produce hypnosis Induction of anesthesia Long surgical procedures
Supplement to other anesthetics Depress the central nervous system to produce hypnosis Induction of anesthesia
An instructor is describing topical decongestants as belonging to which class? Antihistamines Adrenergic antagonists Sympathomimetics Anticholinergics
Sympathomimetics
The nurse is providing education to a client who has been prescribed albuterol. What adverse reaction should the nurse discuss during teaching? Tachycardia Hypotension Diarrhea Polydipsia
Tachycardia
The administration of local anesthetics will cause of loss of sensation of varying functions as the dosage is increased. Place the following sensations in the order that they fade away first when local anesthesia is given. Touch Temperature Proprioception (position sense) Skeletal muscle tone
Temperature Touch Proprioception (position sense) Skeletal muscle tone
A nurse caring for a client in the hospital is being discharged today with a prescription for benzonatate (Tessalon Perles) 200 mg one capsule 3 times daily. What would the nurse tell the client about this prescription during discharge counseling? (Select all that apply.) The client should drink plenty fluids. Benzonatate capsules should be sucked on like a lozenge. Consumption of alcohol is okay while taking benzonatate. Benzonatate can cause GI upset and sedation. Benzonatate can be taken more frequently than prescribed if needed.
The client should drink plenty fluids. Benzonatate can cause GI upset and sedation.
A 37-year-old client has received procaine hydrochloride (Novocain) in the mouth for a dental procedure. How would the nurse evaluate that the outcome of reduced pain related to a dental procedure has been met? The client's facial expressions are calm and relaxed. The client has not vomited or reported symptoms of nausea. The client reports no pain in the lower extremities. The client demonstrates reduced fear and anxiety.
The client's facial expressions are calm and relaxed.
A male client presents to the health care provider's office for his annual visit. When questioned about over-the-counter medication use, he states that he uses echinacea to prevent colds. What statement is true about echinacea? He is healthier because he uses the echinacea. Echinacea is the OTC drug of choice for prevention of viral infections. To be effective, echinacea must be taken daily regardless of symptoms. There is limited or no support for the use of echinacea to prevent or treat symptoms of the common cold.
There is limited or no support for the use of echinacea to prevent or treat symptoms of the common cold.
A client is being assessed by the home care nurse for the appropriate use of a metered-dose inhaler. Instructions concerning which intervention will assist a client in the proper use of the device? Using a spacer Administrating corticosteroid first Exhaling immediately after administration Pushing fluids
Using a spacer
A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident. He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor: prothrombin time and partial thromboplastin time. urine specific gravity. follicle-stimulating hormone levels. alanine aminotransferase and total bilirubin levels.
alanine aminotransferase and total bilirubin levels.
A surgical client has developed malignant hyperthermia. Which medication can be used to treat this health emergency? carisoprodol metaxalone dantrolene methocarbamol
dantrolene
A surgical client has developed malignant hyperthermia. Which medication can be used to treat this health emergency? dantrolene metaxalone carisoprodol methocarbamol
dantrolene
Which condition would contraindicate the use of oxymetazoline? hypertension nasal congestion skin rash cough
hypertension
A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to rebound bronchoconstriction. community-acquired pneumonia. severe anticholinergic effects. permanent liver damage.
rebound bronchoconstriction.
A nurse is providing health teaching to a newly diagnosed asthmatic client. The client has been prescribed theophylline. The nurse should encourage this client to stop: using insulin. exercising. smoking cigarettes. taking anti-inflammatory drugs.
smoking cigarettes.
A patient who has suffered a crushing injury to his thumb and two fingers in an accident at a factory is relieved to be administered a local anesthetic prior to treatment. The drugs that were administered decrease the permeability of the nerve cell membrane to: glucose. bicarbonate. sodium. phosphorus.
sodium.
Muscle spasms are thought to arise from the flood of sensory impulses coming to the spinal cord from an injured area. True False
true
Spinal reflexes are the simplest nerve pathways that monitor movement and posture. False True
true
A patient recovering from a procedure that involved succinylcholine reports muscle soreness and asks the nurse for an explanation. What will the nurse tell the patient? "Hypothermia caused you to strain muscles by shivering." "Hypoxic muscles build up lactic acid, which causes pain." "Muscle pain is the result of positioning on the treatment table."
"The drug triggers receptors to cause prolonged muscle contraction."
A male client presents to the health care provider's office with reports of inability to breathe freely. When the nurse reviews his use of over-the-counter medications, it is discovered that the client routinely uses nasal spray three times a day for 1 year. The nurse knows that what may be causing this client's continuous nasal congestion? Damage of the nasal concha Burning of the nares secondary to chronic use of nasal sprays Rebound nasal swelling Chronic nasal polyps
Rebound nasal swelling
A female patient has expressed anxiety to the nurse surrounding the thought of being awake but unable to move or express pain during surgery. The patient states that she recently saw a movie that addressed this phenomenon and that she is consequently fearful about her impending surgery. How should the nurse reassure this patient? "When you're unable to move because of the drugs that you're given, you're also unable to feel pain." "Actually, the same drugs that make you unconscious are the ones that keep you from moving." "The whole surgical team will be monitoring you very closely throughout the procedure to make sure that things like this don't happen." "We will teach you signals to use in the unlikely event that you wake up during your surgery."
"The whole surgical team will be monitoring you very closely throughout the procedure to make sure that things like this don't happen."
Prior to elective hip replacement surgery, the nurse is explaining the basic characteristics of general anesthesia to the client. The nurse should perform this education in the understanding that general anesthesia is best described as what result? A state of reversible unconsciousness A nonreversible, temporary state of unresponsiveness A stage N3 non-rapid eye movement sleep A stage N2 non-rapid eye movement sleep
A state of reversible unconsciousness
The client has been diagnosed with asthma and is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order? Flunisolide followed immediately by albuterol Flunisolide first, wait five minutes and then follow with albuterol Albuterol first, wait five minutes and then follow with flunisolide Albuterol followed immediately by flunisolide
Albuterol first, wait five minutes and then follow with flunisolide Albuterol is a a broncho dilator so it should be given first with 5 min to open the airways, then the corticosteroid can be administered.
A surgical client's balanced anesthesia includes the use of vecuronium. What nursing action should the operating room nurses prioritize? Protecting the client's skin integrity Monitoring the client for signs of increased level of consciousness Assessing and protecting the client's airway Monitoring the client's deep tendon reflexes
Assessing and protecting the client's airway
The nurse is working in collaboration with a nurse anesthetist to assess a preoperative client. When addressing the client's risk for malignant hyperthermia as a result of neuromuscular junction blockers, what assessment should be prioritized? Assessing for a history of febrile seizures in childhood Assessing for a family history of malignant hyperthermia Assessing the client's allergy status Assessing for any history of cytochrome P450 dysfunction
Assessing for a family history of malignant hyperthermia
What is one of the registered nurse's primary roles in the administration of general anesthetic? Administering intravenous anesthetics as prescribed Determining the client's most appropriate medication Administering inhaled anesthetics as prescribed Assessing the client's status during recovery from anesthetic
Assessing the client's status during recovery from anesthetic
A client who is scheduled for a diagnostic procedure has learned that the procedure will take place with a neuromuscular junction blocker rather than with a general anesthetic. The nurse should describe what benefit of this approach? Enhanced long-term control of neuromuscular spasticity Fewer effects of central nervous system depression Completion of procedures in a community setting Absence of pain during the procedure
Fewer effects of central nervous system depression
The student asks the physiology instructor where the motor neuron communicates with a skeletal muscle fiber. What would the instructor respond? Synapse Neuromuscular junction Afferent junction Synaptic cleft
Neuromuscular junction
The nurse is preparing to admit a client who has received conscious sedation. What is the most important area to assess when the client returns from the procedure using this type of anesthesia? Blood pressure Respirations Temperature Pulse
Respirations
A 6-year-old child has been brought to the emergency department in apparent status asthmaticus. The care team recognizes the need to intubate the client, who is inconsolably agitated. The nurse should anticipate a STAT prescription for what medication? Pancuronium Rocuronium Atracurium Succinylcholine
Succinylcholine
A nurse is monitoring a client closely for malignant hyperthermia because the client received which NMJ blocker? Pancuronium Succinylcholine Vecuronium Atracurium
Succinylcholine
A patient that has a history of glaucoma is to receive a NMJ blocker. Which agent would the nurse identify as being most problematic for this patient? Pancuronium Vecuronium Succinylcholine Rocuronium
Succinylcholine
For which assessment finding will the nurse intervene first when providing postoperative care to a patient who returned to the nursing unit 2 hours after receiving succinylcholine? Pulse 90 beats per minute Muscle weakness Temperature 40 degrees C (104 degrees F) Generalized muscle pain
Temperature 40 degrees C (104 degrees F)
The operating room nurse is taking a male patient into the OR when the patient informs the operating nurse that his grandmother spiked a 104°F temperature in the operating room and nearly died 15 years ago. The nurse knows that the anesthetist is planning to use a volatile liquid as part of the anesthetic. What relevance is this information regarding the patient? The patient may be at risk for hypothermia. The patient may be nervous. The grandmother's surgery has no relevance to the patient's surgery. The patient may be at risk for developing malignant hyperthermia.
The patient may be at risk for developing malignant hyperthermia.
