Quiz 3 (part 1)

A client is taking aspirin (ASA) for arthritis. The nurse will advise the client to take the medication: 1. with a glass of milk. 2. with other medications. 3. with orange juice at bedtime. 4. on an empty stomach in the morning.

1

A patient is taking warfarin sodium. The nurse will reinforce teaching by telling the patient that he should watch for: 1. bleeding. 2. pain. 3. headache. 4. rash.

1

A young female patient is being treated for hypertension. The nurse would be most concerned if the patient became pregnant while taking which drug? 1. Enalapril (Vasotec) 2. Potassium supplement 3. Doxazosin (Cardura) 4. Hydrochlorothiazide (HCTZ)

1

Acetaminophen reduces fever by: 1. directly acting on the hypothalamus. 2. inhibiting prostaglandins. 3. blocking impulses to the brain. 4. affecting nerve fibers.

1

Colony-stimulating factors (CSFs) are named according to: 1. type of blood cell stimulated. 2. type of hormone secreted. 3. type of homeostatic control. 4. type of stem cell stimulated.

1

In monitoring clients receiving erythropoiesis-stimulating agents, it is most important for the nurse to monitor for: 1. thromboembolus. 2. TIA (transient ischemic attack). 3. MI (myocardial infarction). 4. stroke.

1

Laboratory studies related to heparin therapy include: 1. aPtt. 2. serum heparin studies. 3. complete blood studies. 4. sedimentation rate.

1

The client calls the nurse and is very frantic. "I think something is wrong! My stools are black, and they have never been this color before!" The client is receiving ferrous sulfate (Feosol). What is the best response by the nurse? 1. "This is an expected side effect of ferrous sulfate (Feosol); it is okay." 2. "This sounds serious; you may have started bleeding again." 3. "Do you have hemorrhoids? That could be the problem." 4. "I will speak with your doctor and call you right back."

1

The client had stomach cancer and a surgical removal of his stomach several years ago. The physician prescribed cyanocobalamin (Nascobal). The client stopped this drug several months ago. What will the nurse most likely assess in this client? 1. Memory loss, numbness in the limbs, and depression 2. A gradual decrease in red blood cell counts 3. Jaundice and tarry stools 4. Low hemoglobin and hematocrit counts

1

The client has been taking hydrocortisone (Cortef) for a month and abruptly stops it. What will the best assessment by the nurse include? 1. Fatigue and anorexia 2. Hyperglycemia and depression 3. Dilated pupils and auditory hallucinations 4. Tachycardia and weight gain

1

The client is receiving medication for the treatment of anemia. The nurse has taught the client about this drug and about anemia. The nurse evaluates that learning has occurred when the client makes which statement? 1. "My anemia could be caused by blood loss somewhere, but there are other causes too." 2. "My anemia was caused by drinking too many carbonated beverages with caffeine." 3. "There are many causes for anemia; mine was caused by heart failure and fluid overload." 4. "I think my anemia occurred when I started that vegetarian diet."

1

The client receives interferon alfa-2b (Intron-A) for treatment of Kaposi's sarcoma. Which question by the client would alert the nurse that additional assessment is necessary? 1. "I really feel sad; do I need to see a psychiatrist?" 2. "Is it safe to drink grapefruit juice with this medication?" 3. "Do I need to limit my fluids while on this medication?" 4. "Is it okay to use aspirin or ibuprofen products while on this medication?"

1

The client receives prednisone as treatment for his inflammatory disease. He has experienced great relief and asks the nurse if he can just keep taking this medication. What is the best response by the nurse? 1. "No, because this medication has serious adverse effects." 2. "No, your doctor said the best treatment for your illness is to alternate medications." 3. "No, your body would get used to it and it would lose its effectiveness." 4. "No, because your illness is in remission and you don't need medication now."

1

The male patient has been receiving propranolol (Inderal) for treatment of a dysrhythmia for 6 weeks. What is an important question for the nurse to ask the patient when assessing medication compliance? 1. "Have you noticed any changes in your sexual functioning?" 2. "Has your appetite increased or decreased?" 3. "Have you noticed any changes in your bowel function?" 4. "Have you noticed any difficulty in your ability to concentrate?"

1

The mechanism of action of colony-stimulating factors, such as filgrastim (Neupogen), is to: 1. increase neutrophil production. 2. supplement iron in the body. 3. replace vitamin B12 factor. 4. increase erythrocyte production.

1

The nurse has completed medication education with the patient who is receiving nitroglycerine (Nitrostat) as therapy for angina. The nurse determines that additional teaching is necessary when the patient makes which statement? 1. "I can keep taking tablets until the pain is gone, but I should not use more than five tablets." 2. "If my pain is not reduced 5 minutes after taking one tablet I should call EMS." 3. "I should take a tablet as soon as chest pain occurs.." 4. "I can take three tablets, one every 5 minutes."

1

The nurse is planning to teach a class on antianginal drugs to a group of patients who have experienced myocardial infarctions (MIs). The nurse includes which information in this class? 1. "These medications decrease how much oxygen your heart needs." 2. "These medications thin your blood so your heart receives more oxygen." 3. "These medications increase the amount of oxygen your heart receives." 4. "These medications increase oxygen to your heart by increasing nitric oxide production."

1

The nurse teaches clients with rheumatoid arthritis about the side effects of nonsteroidal anti-inflammatory drugs (NSAIDs). The nurse evaluates that education has been effective when the clients make which statement? 1. "Blood tests may be necessary to monitor for side effects of this drug." 2. "We must be careful about falling with this medication because it can cause drowsiness." 3. "We must take the medicine just as the doctor said to take it." 4. "We must be sure and keep all scheduled doctors' appointments."

1

The patient asks the nurse, "My doctor said I need cardioversion for my dysrhythmia. Why can't I just take medication?" What is the nurse's best response? 1. "Antidysrhythmic medications have many side effects; cardioversion is considered safer." 2. "Special diets are necessary with antidysrhythmic medications, and they are hard to follow." 3. "Antidysrhythmic medications don't really work very well for most dysrhythmias." 4. "There is a high risk of seizures when you take antidysrhythmic medications."

1

The patient is being discharged on an anticoagulant following a valve replacement. The nurse has completed medication education and determines that learning has occurred when the patient makes which statement? 1. "I should wear a MedicAlert bracelet that says I'm on an anticoagulant." 2. "I need to eat more protein while I am taking this medication." 3. "I can take enteric-coated aspirin but not plain aspirin for my arthritis." 4. "I must limit my intake of vitamin C while I'm on warfarin (Coumadin)."

1

The patient is recovering from hypovolemic shock. The nurse hangs a bag of normal human serum albumin (Albutein) and educates the patient about this fluid. The nurse evaluates that learning has occurred when the patient makes which statement? 1. "It is a protein that pulls water into my blood vessels." 2. "It is a protein that causes my kidneys to conserve fluid." 3. "It is a super-concentrated salt solution that helps me conserve body fluid." 4. "It is a liquid that has electrolytes in it to pull water into my blood vessels."

1

The patient receives an appropriate dose of warfarin (Coumadin), but the international normalized ratio (INR) is in the high range. The patient denies taking any aspirin products. What is the best assessment question to ask the patient at this time? 1. "Have you been eating much garlic?" 2. "Have you been eating a lot of salads and vegetables?" 3. "Have you been drinking too much milk?" 4. "Are you restricting your fluids too much?"

1

The patient receives verapamil (Calan). The patient tells the nurse that he is nervous about taking this medicine. What is the best response by the nurse? 1. "This medicine is safe, and most patients do very well with it." 2. "This medicine increases your blood pressure, but we will be monitoring that." 3. "This medicine has many side effects, but you should be okay." 4. "This medicine is a potassium channel blocker and is considered safe."

1

The patient receives warfarin (Coumadin). The nurse plans to teach the patient to avoid which foods that are served for lunch? 1. Tomato salad with kale and basil 2. Whole-wheat bread with margarine 3. Salt substitute 4. Fettuccine Alfredo

1

The patient says to the nurse, "My neighbor said my antidysrhythmic drug can actually cause me to have irregular heartbeats. How can this be?" What is the nurse's best answer? 1. "Your medication blocks the flow of the electrolytes in your heart, and this can cause irregular beats." 2. "It is better to discuss your medication concerns with a professional, not a lay person like your neighbor." 3. "You must take two baby aspirins every other day to avoid the irregular heartbeats." 4. "Your medication is not the problem; it is when you mix it with over-the-counter (OTC) drugs that you develop irregular beats."

1

The patient takes nitroglycerine (Nitrostat) for relief of occasional stable angina. The nurse would be most concerned about which statement made by the patient? 1. "I'm getting married tomorrow; I hope my erectile dysfunction isn't a problem." 2. "I'm going water skiing tomorrow; I hope my angina isn't a problem." 3. "I really don't like those little pills. I've heard about patches: can I try them?" 4. "My angina has been a little more frequent. Do I need a painkiller too?"

1

The patient with type 1 diabetes mellitus is receiving propranolol (Inderal). What is the best outcome for this patient? 1. The patient will maintain blood glucose within normal limits. 2. The patient will decrease the required number of calories/day. 3. The patient will maintain adequate peripheral circulation. 4. The patient will perform activities of daily living.

1

The physician has ordered cyclosporine (Sandimmune) for the client who has undergone a kidney transplant. What will the nurse's priority assessment of this client include? 1. Assessing for infection 2. Assessing for peripheral edema 3. Assessing airway clearance 4. Assessing cardiac output

1

The physician has ordered sargramostim (Leukine) intravenously for the client. What is a priority plan by the nurse prior to administering this drug? 1. Plan to monitor the client's ECG readings. 2. Plan to insert a Foley catheter and monitor urine output. 3. Plan to administer 10% oxygen during the infusion. 4. Plan to have a white blood cell (WBC) count drawn every 30 minutes.

1

The physician has prescribed epoetin alfa (Epogen) for the client. What is the priority assessment by the nurse? 1. The client's blood pressure 2. The client's report of a headache, indicating a stroke 3. The client's ability to use the proper injection techniques for self-administration 4. The client's hemoglobin and hematocrit levels

1

Which antidysrhythmic agent also dilates coronary arteries and is frequently used to treat angina? 1. Verapamil (Calan) 2. Amiodarone (Cordarone) 3. Procainamide (Pronestyl) 4. Lidocaine (Xylocaine)

1

Which drug would be indicated for treating ventricular tachycardia? 1. Lidocaine (Xylocaine) 2. Verapamil (Calan) 3. Diltiazem (Cardizem) 4. Atropine (Atropair)

1

Which finding is a sign or symptom of inflammation? 1. Redness 2. Cyanosis 3. Dizziness 4. Cold skin

1

Which is the most serious adverse effect associated with milrinone (Primacor)? 1. Ventricular dysrhythmia 2. Nausea 3. Headache 4. Atrial dysrhythmia

1

Which medication would be of most help to increase myocardial contractility in a patient with heart failure? 1. Digoxin (Lanoxin) 2. Lisinopril (Prinivil) 3. Carvedilol (Coreg) 4. Furosemide (Lasix)

1

Which of the following would the nurse identify as a component of the specific immune response? 1. Lymphocytes 2. Phagocytes 3. Epithelial lining of the skin 4. Gastrointestinal membrane

1

Which patient who has had a myocardial infarction would be a candidate for reteplase (Retavase) therapy? 1. 54-year-old female with type 2 diabetes 2. 45-year-old female with a 2-week-old cranial artery repair 3. 62-year-old with a recent hemorrhagic stroke 4. 70-year-old male with active GI bleed

1

Which symptom is most likely to be related to angina as opposed to a myocardial infarction? 1. Chest pain relieved by one sublingual nitroglycerin 2. Chest pain that radiates to the patient's back 3. Chest pain that occurred while the patient was eating breakfast 4. Chest pain accompanied by shortness of breath

1

Which vital sign is of greatest concern to the nurse prior to administering digoxin (Lanoxin)? 1. Heart rate 2. Temperature 3. Blood pressure 4. Respiratory rate

1

A 19-year-old athlete is admitted to the emergency department in hypertensive crisis. It is determined that this patient has been "blood doping" to prepare for a championship game. How does the nurse explain this practice to the patient's parents? 1. "Having additional red blood cells may put an athlete at an advantage as more oxygen is available for cells." 2. "This process may include transfusion of blood products." 3. "Some athletes take epoetin alfa to increase their competitive edge." 4. "Blood doping helps to increase white blood cells that help to repair tissue damage." 5. "The injection of blood deep into muscles is thought to improve their strength."

1, 2, 3

A patient comes into the emergency department with systemic manifestations of anaphylaxis caused by a wasp sting. For which health problems would the nurse be concerned prior to administering epinephrine? 1. Premature ventricular contractions 2. Hypertension 3. Hyperthyroidism 4. Pheochromocytoma 5. Hypotension

1, 2, 3

A patient has been prescribed a second 10-day course of a corticosteroid. The nurse should provide which medication education? 1. "Make certain you do weight-bearing exercises at least three times each week." 2. "Weigh yourself every day." 3. "Let us know if you development a fever." 4. "Monitor the color of your urine." 5. "If you feel jittery or anxious, discontinue the medication."

1, 2, 3

A patient who has been taking medication for a month for an atrial dysrhythmia returns to the clinic for a checkup. Which statements indicate the nurse should plan extra time with the patient for additional teaching? 1. "Since I can't drink coffee anymore, I have started drinking diet cola in the mornings." 2. "I have found that a glass of wine after work and one with dinner helps me to relax from my stressful job." 3. "We have celebrated several birthdays since I saw you last. I love chocolate birthday cake." 4. "I have really worked at stopping my smoking since I was last here." 5. "My friends and I have found several restaurants in our area that offer good, low-fat meals."

1, 2, 3

The client experienced a sports-related injury to his leg. During the morning assessment, what signs of inflammation will the nurse most likely assess? 1. Swelling 2. Pain 3. Warmth 4. Pallor 5. Pitting edema

1, 2, 3

The nurse is caring for a patient who is being treated pharmacologically for the symptoms of heart failure. What would be included in the nurse's role of pharmacologic management of this patient? 1. Teaching the patient how to space medications to decrease adverse effects 2. Teaching the patient the long-term benefits of beta blockers 3. Continually monitoring the patient during IV infusions 4. Decreasing medication dosages when the patient complains of adverse effects 5. Changing a medication that is no longer working to decrease the patient's symptoms

1, 2, 3

The nurse is concerned that a patient receiving dobutamine (Dobutrex) is experiencing adverse effects from the medication. What did the nurse assess in the patient? 1. Palpitations 2. Drop in blood pressure 3. Cold extremities 4. Headache 5. Blurred vision

1, 2, 3

The nurse is directed to prepare norepinephrine for administration to a patient. For which health problems is this medication indicated? 1. Acute shock 2. Cardiac arrest 3. Septic shock 4. Hypovolemic shock 5. Cardiogenic shock

1, 2, 3

The nurse is educating a patient diagnosed with heart failure (HF). The nurse knows that instruction regarding compensatory mechanisms has been effective when the patient states, 1. "My heart enlarged in order to compensate for the effects of heart failure." 2. "My nervous system kicks in to compensate for the effects of heart failure." 3. "My body will decrease blood flow to other organs in order to compensate for heart failure." 4. "My body will increase urine output in order to compensate for the effects of heart failure." 5. "My body will produce anti-inflammatory agents to compensate for heart failure."

1, 2, 3

The paramedics are transporting to the emergency department a patient who is experiencing shock. What will the nurse prepare in anticipation of the patient's arrival? 1. Cardiac monitor 2. Pulse oximeter 3. Oxygen 4. Whole blood 5. Dextran 40

1, 2, 3

The physician orders pentoxifylline (Trental) for the patient with peripheral vascular disease. The nurse has completed medication education and determines that learning has occurred when the patient makes which statement(s)? 1. "It makes my red blood cells (RBCs) squishy so they can go into the little blood vessels." 2. "It decreases my platelets so my blood is less likely to clot." 3. "It decreases the "stickiness" of my blood." 4. "It changes how my liver makes clotting factors." 5. "It destroys clotting factors."

1, 2, 3

The patient has been recently diagnosed with hypertension with a sustained blood pressure of 144/90 mmHg. The patient is concerned about effects on the body. What effects of hypertension on the body will the nurse include in her education of this patient? 1. Kidney damage 2. Stroke 3. Liver failure 4. Heart failure 5. Blindness

1, 2, 4, 5

A patient has been prescribed nitroglycerin ointment for transdermal application. The nurse should teach the patient to hold the medication and contact the prescriber if which situations occur? 1. Dyspnea 2. Cough with frothy sputum 3. Headache 4. Fever 5. Confusion

1, 2, 5

A clinic nurse is developing a teaching handout for patients who are prescribed warfarin (Coumadin) therapy. Which statement should be included in this information? 1. "Tell your dentist you are taking warfarin prior to any procedures." 2. "Report to the lab for testing of activated partial thromboplastin time (APTT)." 3. "Avoid strenuous activities." 4. "Place ice at the injection site if stinging or burning occurs." 5. "Take nonsteroidal anti-inflammatories (NSAIDs) for minor pain relief."

1, 3

A patient asks which conditions will cause his heart to need more oxygen. The nurse answers with which statements? 1. "Increasing physical activity." 2. "Watching a television show." 3. "Emotional stress." 4. "Eating a meal." 5. "Listening to music."

1, 3

A patient has had great difficulty controlling hypertension with standard drug therapy. She says, "My neighbor couldn't get her blood pressure down until the doctor started her on hydralazine (Apresoline). Which response, by the nurse, is indicated? 1. "Because you had rheumatic fever that damaged your heart, this is not a good drug for you." 2. "Your neighbor must be over age 70." 3. "Your lupus diagnosis keeps us from using that drug." 4. "You should not use that drug because you have rheumatoid arthritis." 5. "We try to avoid using hydralazine (Apresoline) because it causes constant coughing."

1, 3

The nurse is providing information for a patient who will self-administer a twice-daily antidysrhythmic medication at home. The nurse would provide additional education if the patient makes which statement? 1. "If I get the flu, I should stop taking the medication until my fever goes down." 2. "I should take my doses as close to 12 hours apart as I can." 3. "If I forget a dose of medication I should take two pills for the next dose." 4. "If I can't take the medication for a couple of days because I am sick, I should call the clinic for advice." 5. "I should get my prescription refilled before I am completely out of medicine."

1, 3

The nurse is writing a care plan for a patient who has been started on an antiarrhythmic drug for complaints of chest pain and palpitations. The patient says, "I can't do what I once did. I just do not have any energy." Which nursing diagnoses would the nurse likely include in this care plan? 1. Decreased Cardiac Output 2. Ineffective Breathing Pattern 3. Activity Intolerance 4. Ineffective Individual Coping 5. Impaired Gas Exchange

1, 3

A patient is prescribed an additional once-daily antidysrhythmic drug to control persistent atrial fibrillation. What instructions should the nurse provide for this patient? 1. "Take your first dose of this new medication before you go to bed tonight." 2. "Do not eat or drink anything for 2 hours after taking the new medication." 3. "Before you get out of bed in the morning, sit up on the side of the bed for a few minutes." 4. "Plan to return to the clinic to have your electrolytes checked in 2 weeks." 5. "Contact the clinic if you notice any loss of hair from your head."

1, 3, 4

A patient was seen in the emergency department after sustaining a fractured leg and multiple abrasions in a bicycle accident. Eight hours after discharge the patient is admitted in anaphylactic shock. The nurse would suspect which drugs prescribed for the initial injury as implicated in this reaction? 1. A cephalosporin antibiotic 2. A topical antibiotic for use on abrasions 3. An NSAID for minor pain 4. An opioid analgesic for more severe pain 5. Normal saline wash for abrasions

1, 3, 4

A patient has been treated for mild phlebitis. Which discharge teaching should the nurse provide? 1. "You should stop smoking." 2. "Do not travel by air." 3. "Increase your fluid intake." 4. "When you travel, stop frequently and walk around." 5. "Adopt a low-fat diet."

1, 3, 4, 5

The nurse is teaching a class to clients who have recently undergone transplant surgery and are taking immunosuppressant drugs. The nurse evaluates that learning has occurred when the clients make which statements? 1. "We must immediately report hair loss to the physician." 2. "We must wear a protective mask when going out in public." 3. "We must avoid exposure to individuals who have infections." 4. "We must practice reliable contraception." 5. "We must avoid eating raw fruits and vegetables."

1, 3, 4, 5

A nurse has been assigned to provide care for a patient who has class IV heart failure. Which nursing interventions are indicated? 1. Assist nursing support personnel with the patient's bed bath. 2. Accompany the patient on a walk to the courtyard. 3. Monitor that the patient's position is changed every 2 hours. 4. Take vital signs before and after physical therapy weight-bearing exercises. 5. Assist the patient with meals as indicated.

1, 3, 5

A patient reports the following symptoms. Which symptoms would the nurse evaluate as probable unstable angina? 1. "My chest has started hurting even if I am just watching television." 2. "My chest starts hurting if I climb one set of stairs." 3. "My attacks of chest pain are coming more frequently now." 4. "The pain is intense and moves up into my neck." 5. "The pain is worse than it used to be."

1, 3, 5

Following a massive myocardial infarction, the patient develops cardiogenic shock. The patient's family asks the nurse what the patient's chances of survival are. What information does the nurse consider when formulating a response to these concerns? 1. Cardiogenic shock is the major reason people die after having an MI. 2. Even though many people develop cardiogenic shock, the majority survive without residual effects. 3. Cardiogenic shock is the most lethal type of shock. 4. As long as the patient does not develop septic shock, survival is probable. 5. Cardiogenic shock results from pump failure.

1, 3, 5

A child has leukemia and is immunosuppressed due to chemotherapy. The mother frantically calls the clinic to say that her child was exposed to varicella (chickenpox). What does the best plan by the nurse include? 1. The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin if he develops chickenpox. 2. The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin. 3. The child should be brought to the clinic immediately to receive a vaccination for chickenpox. 4. The child should be kept away from other children to avoid further exposure to varicella.

2

A mother brings her child to the clinic for his last diphtheria-pertussis-tetanus (DPT) immunization. The mother tells the nurse that the child developed a red rash after the previous diphtheria-pertussis-tetanus (DPT) immunization. What does the best action by the nurse include? 1. Administer only a pertussis-tetanus immunization. 2. Withhold this immunization and contact the physician. 3. Tell the mother to give the child acetaminophen (Tylenol) if another rash develops. 4. Administer diphenhydramine (Benadryl) prior to the diphtheria-pertussis-tetanus (DPT) immunization.

2

A mother comes to the clinic and tells the nurse, "I don't want my child to have any vaccinations. I have heard they cause diseases." What is the best response by the nurse? 1. "Vaccinations are safe; there is no reason to worry." 2. "Vaccinations have some risks, but the benefits outweigh the risks." 3. "People worry too much about vaccinations." 4. "Vaccinations are required by law; you really don't have a choice."

2

A person with a heart rate of 170 bpm and a normal QRS duration would most likely be experiencing a: 1. tachydysrhythmia originating from the bundle branches. 2. tachydysrhythmia originating from the atria. 3. tachydysrhythmia originating from the ventricles. 4. tachydysrhythmia originating from the Purkinje fibers.

2

An adult female client is beginning her series of hepatitis B immunizations. What does the best teaching by the nurse include? 1. "Contact your physician if you develop pain at the injection site, mild fever, or soreness." 2. "Practice reliable birth control for 3 months after the administration of the vaccinations." 3. "Immediately report any signs of bleeding such as hematuria, or bleeding from the gums." 4. "Avoid crowded areas where you might be exposed to an infectious disease."

2

Anticoagulants are used to: 1. increase the number of platelets. 2. prevent the formation of blood clots. 3. shorten the prothrombin time. 4. dissolve blood clots.

2

Changes in which level would be sensed by baroreceptors and relayed to the vasomotor center? 1. Oxygenation 2. Blood pressure 3. Carbon dioxide 4. Blood pH

2

Following a myocardial infarction, elevations in which cardiac marker would be seen first and are cardiac tissue-specific? 1. White blood cells 2. Troponin I 3. Myoglobin 4. Creatine kinase

2

In a person with a sinus rhythm, the primary purpose of the AV node is to: 1. pace the heart at 40-60 bpm. 2. delay the impulse from the SA node. 3. pace the heart at 60-100 bpm. 4. enhance the impulse from the SA node.

2

Lisinopril (Prinivil) is often used to treat heart failure because it lowers blood volume. Which statement best explains how lisinopril lowers blood volume? 1. It has an antagonistic effect on angiotensin-converting enzyme. 2. It lowers aldosterone secretion, a hormone that increases sodium reabsorption. 3. It causes hypernatremia and increased renal tubule permeability, resulting in a diuretic effect. 4. It causes a diuretic effect by lowering the amount of sodium lost in the urine.

2

The client complains of constipation while receiving ferrous sulfate (Feosol). What is the best plan by the nurse to assist the client in resolving this common side effect? 1. Plan to teach the client about which laxatives are the safest to use. 2. Plan to teach the client to increase fluids and high-fiber foods in the diet. 3. Plan to teach the client to self-administer Fleets enemas. 4. Plan to teach the client to increase exercise.

2

The client has chronic alcoholism. He asks the nurse why his doctor put him on folic acid (Folvite) since he promised the doctor that he would stop drinking. What is the best response by the nurse? 1. "You should ask your doctor since you promised him that you would not drink anymore." 2. "You have been drinking instead of eating, and alcohol interferes with folate metabolism in your liver." 3. "You need folic acid to make up for the vitamin B12 deficiency that was caused by your alcoholism." 4. "You need folic acid because you have not been compliant with taking your vitamins and attending Alcoholics Anonymous (AA) meetings."

2

The client is pregnant and has been told by her physician that she needs cyanocobalamin (Nascobal). She asks the nurse, "Will this hurt my baby?" What is the best response by the nurse? 1. "No, this medication will not hurt your baby as long as you take it with ascorbic acid." 2. "No, this is safe as long as long as you take it in pill form; it is a Pregnancy Category A drug, which means it is safe for your baby." 3. "No, this medication will not hurt your baby as long as you take the pills only in the third trimester." 4. "No, this is safe in either pill or injectable form; it is a Pregnancy Category A drug which means it is safe for your baby."

2

The client is receiving chemotherapy for cancer. The physician has prescribed oprelvekin (Neumega). The nurse has completed medication education and evaluates it as effective when the client makes which statement? 1. "This medication will help my chemotherapy work better." 2. "This medication will help increase my platelet count." 3. "This medication will help me regain the weight I have lost." 4. "This medication will help increase my red blood cell count."

2

The client receives a nonsteroidal anti-inflammatory drug (NSAID) for treatment of arthritis. What is a priority for the nurse to include when doing medication education? 1. "Constipation is common; include roughage in your diet." 2. "Drink at least eight glasses of water a day." 3. "Take your medication with food." 4. "Take your medication on an empty stomach."

2

The client receives cyclosporine (Neoral). The nurse completes medication education and evaluates that learning has occurred when the client makes which statement? 1. "I must check my blood pressure; it can run low with this medication." 2. "I cannot have grapefruit while I am on this medication." 3. "Mealtimes will have no effect on when I take this medication." 4. "I might have an increased urine output with this medication."

2

The client receives epoetin alfa (Epogen) subcutaneously, and says to the nurse, "My doctor said I have anemia. Are there little red blood cells in that shot?" What are the best responses by the nurse? 1. "No, we do not give blood for anemia anymore." 2. "No, this medication stimulates your body to make red blood cells." 3. " Yes, this small amount of red blood cells will stimulate your bone marrow to produce more cells in the kidney." 4. "No, this medication promotes clotting so you will not lose even more red blood cells."

2

The client receives filgrastim (Neupogen). He asks the nurse, "That is such a funny name; where do you suppose it comes from?" What is the best response by the nurse? 1. "It comes from the interleukins it stimulates; this one stimulates neuocytes." 2. "It comes from the blood cell it stimulates; this one stimulates neutrophils." 3. "It comes from the stem cells it stimulates, such as filgrastims." 4. "It is a complicated process; the drug companies are secretive about it."

2

The client receives interferon alfa-2b (Intron-A). The client tells the nurse that he gets very sleepy and thirsty every time he takes the medication. What is the best assessment question for the nurse to ask? 1. "Are you consuming at least eight glasses of water daily?" 2. "Are you including beverages with alcohol in your diet?" 3. "Have you had any flu symptoms lately?" 4. "How much time have you spent out in the sun?"

2

The major difference between B cell lymphocytes and T cell lymphocytes is that: 1. T cells produce clones. 2. B cells produce antibodies. 3. T cells produce antibodies. 4. B cells produce clones.

2

The most important food for a patient taking anticoagulants to avoid is: 1. citrus fruits. 2. garlic. 3. honey. 4. meat.

2

The nurse conducts group education for clients with seasonal allergies and teaches about the role of histamine. The nurse evaluates that the education has been effective when the clients make which statement? 1. "Histamine is inhibited by nonsteroidal anti-inflammatory drugs (NSAIDs). 2. "Histamine dilates the vessels in the nose, so it is congested and stuffy." 3. "Histamine constricts vessels, causing capillaries to become more permeable." 4. "Histamine is primarily stored in phagocyte cells in the skin."

2

The nurse has completed medication education with the patient who is receiving atenolol (Tenormin). The nurse determines that teaching is effective when the patient makes which statement? 1. "I must avoid grapefruit juice when I take this medicine." 2. "I must call my doctor if I want to stop this medicine." 3. "I must check my pulse before taking the medicine and call the doctor if it is less than 50." 4. "I must take this medicine with food so it will be properly absorbed."

2

The nurse is providing care to a patient who has experienced several episodes of angina. What is the primary desired outcome for this patient? 1. The patient will experience relief of chest pain with anticoagulant therapy. 2. The patient will experience relief of chest pain with nitrate therapy. 3. The patient will experience relief of chest pain with aspirin therapy. 4. The patient will experience relief of chest pain with therapeutic lifestyle changes.

2

The nurse manages care for clients who have had organ transplants. What is the best information for the nurse to include when teaching the clients about body defenses? 1. Nonspecific body defense is effective primarily against bacteria. 2. Specific body defense usually only acts against a single organism. 3. Specific body defense includes the complement system. 4. Nonspecific body defense is also known as the immune response.

2

The nurse plans to teach a class on acetaminophen (Tylenol) to mothers with young children. What will the best plan by the nurse include? 1. "It is best to give your child acetaminophen (Tylenol) with a high-carbohydrate meal." 2. "Read the labels of all over-the-counter (OTC) medications for the amount of acetaminophen (Tylenol) in them." 3. "Acetaminophen (Tylenol) will only need to be given once a day because it is long-lasting." 4. "It is okay to substitute a baby aspirin for acetaminophen (Tylenol) if you run out of acetaminophen (Tylenol)."

2

The patient has a history of cardiac disease and receives digoxin (Lanoxin). The nurse determines that education about dietary needs with this medication has been effective when the patient makes which selection for lunch? 1. Cottage cheese, peach salad, and blueberry pie 2. Baked fish, sweet potatoes, and banana pudding 3. Green bean soup, whole-wheat bread, and an apple 4. Hamburger, French fries, and chocolate chip cookies

2

The patient has heart failure and receives digoxin (Lanoxin). Prior to discharge, what will the best teaching plan by the nurse include? 1. "Report development of a metallic taste in the mouth." 2. "Report mental changes such as depression." 3. "Stop the medication if your pulse is irregular." 4. "If you miss a dose, take two doses."

2

The patient in the emergency department experienced an acute myocardial infarction (MI) 8 hours ago. The nurse is administering reteplase (Retavase) intravenously (IV). The patient asks the nurse what is being done. What is the best response by the nurse? 1. "This medicine is widening the arteries in your heart so they can get more oxygen." 2. "This medication is dissolving the clot that is causing your heart attack." 3. "This medicine is thinning your blood so more clots will not develop." 4. No response is indicated; the patient is past the time frame where thrombolytic therapy is effective.

2

The patient is being treated for angina. He asks the nurse if angina is the same thing as having a heart attack. What is the best response by the nurse? 1. "They have some things in common, for example, severe emotional distress and panic can accompany both angina and myocardial infarction." 2. "Angina means heart muscle is not getting enough oxygen, while heart attack, or myocardial infarction, means part of your heart has died." 3. "Actually, it depends on what type of angina you mean; there are several types." 4. "They are basically the same."

2

The patient receives enalapril (Vasotec) as treatment for heart failure. What is the best nursing assessment following the initial administration of this drug? 1. Assess the patient for ototoxicity. 2. Assess the patient's blood pressure. 3. Assess the patient for an irregular pulse. 4. Assess the patient for a serious rash.

2

The patient receives enoxaparin (Lovenox) postoperatively. The nurse teaches the patient about this medication and evaluates that learning has occurred when he makes which statement? 1. "It inhibits the synthesis of prostaglandins." 2. "It increases the time it takes for me to form a clot." 3. "It dissolves small clots so I won't have a stroke." 4. "It increases the flexibility of my blood cells."

2

The patient receives heparin. During the morning assessment of the patient, the nurse notes that the patient's blood pressure and red blood cell (RBC) count are low. There is no evidence of bleeding on the bed linen or the patient's gown. What will the best assessment of this patient reveal? 1. The patient is dehydrated. 2. The patient may be bleeding internally. 3. The patient's activated partial thromboplastin time (aPTT) is too low. 4. The patient has probably formed some clots.

2

The patient receives hydrochlorothiazide (Microzide). He tells the nurse he is urinating a lot and questions how this drug affects his blood pressure. What is the best response by the nurse? 1. "Hydrochlorothiazide (Microzide) enhances kidney function causing you to urinate more and that decreases your blood pressure." 2. "Hydrochlorothiazide (Microzide) decreases the fluid in your bloodstream and this lowers your blood pressure." 3. "Hydrochlorothiazide (Microzide) dilates your blood vessels so you urinate more and your blood pressure decreases." 4. "Hydrochlorothiazide (Microzide) increases your heart rate; this pumps blood faster to your kidneys so you urinate more and your blood pressure decreases."

2

The patient receives reteplase (Retavase) intravenously (IV). The nurse assesses the patient for orientation and level of consciousness. The patient's wife asks the nurse why this is being done. What does the nurse indicate as the reason for the assessment? 1. The medication can alter fluid balance; this affects orientation and level of consciousness. 2. The medication can cause bleeding in the brain; this affects orientation and level of consciousness. 3. The medication causes hypoglycemia; this affects orientation and level of consciousness. 4. The medication decreases oxygen to the brain; this decreases orientation and level of consciousness.

2

The patient will be receiving dopamine (Intropin). What equipment will the nurse prioritize prior to infusion of this drug? 1. Oxygen cannula 2. Intravenous (IV) pump 3. Pulse oximeter 4. Sequential compression devices

2

The patient will receive an IV infusion of milrinone (Primacor) as treatment for acute heart failure. What is the priority plan by the nurse? 1. Plan to monitor for atrial fibrillation. 2. Plan to monitor the ECG continuously. 3. Plan to take vital signs every 15 minutes. 4. Plan to monitor for hypertension.

2

The patient with hypertension is receiving nifedipine (Procardia XL). The nurse determines that the patient needs additional medication education when the patient selects which menu for breakfast? 1. Whole-wheat pancakes with syrup, and bacon, oatmeal, and orange juice 2. Eggs, whole-wheat toast with butter, cereal, milk, and grapefruit juice 3. Eggs and sausage, a biscuit with margarine, coffee with cream, and cranberry juice 4. Egg and cheese omelet, tea with sugar and lemon, hash brown potatoes, and prune juice

2

The physician has ordered amiodarone (Cordarone). Prior to starting this medication, the nurse would alert the physician to which laboratory result? 1. Sodium 140 mEq/L 2. Potassium 3.1 mEq/L 3. Potassium 4.9 mEq/L 4. International normalized ratio (INR) of 12 seconds

2

The physician has prescribed epinephrine (Adrenalin) for an older adult patient. What is an important nursing assessment prior to administration of this drug? 1. A history of type 1 diabetes mellitus 2. A history of narrow angle glaucoma 3. A history of dizziness 4. A history of human immunodeficiency virus (HIV) infection

2

The physician orders acetaminophen (Tylenol) four time a day for a client with arthritis. The nurse would plan to validate which other order with the physician? 1. Heparin 5000 units subcutaneously every 8 hours 2. Warfarin (Coumadin) 2 mg orally every day 3. Penicillin G benzathine (Bicillin LA) 2.4 million units IM one time 4. Paroxetine (Paxil) 37.5 mg orally every day

2

The physician orders enoxaparin (Lovenox) for the postoperative patient. What is the best administration technique by the nurse? 1. Administer the medication in the upper arm, subcutaneously. 2. Administer the medication in the abdomen, subcutaneously. 3. Administer the medication via slow intravenous (IV) push in the patient's intravenous (IV) line. 4. Ask the patient where she would like the injection and administer it subcutaneously.

2

The process of fibrinolysis is to: 1. stop blood flow. 2. remove a blood clot. 3. promote enzymes. 4. increase blood flow.

2

What is a priority nursing intervention for a patient who has just begun antihypertensive treatment with enalapril (Vasotec)? 1. Monitor the patient for headaches. 2. Take the patient's blood pressure. 3. Order a sodium-restricted diet for the patient. 4. Review the patient's lab results for hypokalemia.

2

Which drug is the primary agent for paroxysmal supraventricular tachycardia (PSVT)? 1. Flecainide (Tambocor) 2. Adenosine (Adenocard) 3. Lidocaine (Xylocaine) 4. Procainamide (Pronestyl)

2

Which lists include the three factors that make up blood pressure? 1. Blood volume, heart rate, and stroke volume 2. Cardiac output, blood volume, and peripheral vascular resistance 3. Age, weight, and race 4. Body mass index, diet, and genetics

2

Which statement best explains what happens to cardiac output when the heart rate gets extremely high? 1. Cardiac output is not generally affected by rapid heart rates. 2. Cardiac output lowers when the rapid rate doesn't allow enough time for complete filling of the heart chambers. 3. Cardiac output will continue to increase as long as the heart rate continues to increase. 4. Cardiac output will increase until the heart rate reaches 150 bpm, at which time it will no longer be affected.

2

Which statement is accurate in regard to secondary hypertension? 1. There is no known cause. 2. It can result from chronic renal impairment. 3. It is also known as idiopathic. 4. It accounts for 90% of all hypertensive cases.

2

A laboratory test used to best measure the effectiveness of warfarin sodium therapy is known as: 1. complete blood count. 2. platelet count. 3. aPtt. 4. international normalized ratio (INR).

4

A mother calls the clinic and tells the nurse that her 4-month-old baby has a fever. The mother asks if she can use the liquid acetaminophen (Tylenol) that is used for her 10-year-old child. What is the best response by the nurse? 1. "Infants should not have acetaminophen (Tylenol) because it damages the liver." 2. "It is best if the pediatrician is called; he can be asked this question." 3. "It is fine to use the same medicine for both children." 4. "Infant drops should be used for the baby; they are different from liquid medicine."

4

A mother tells the nurse, "I am so concerned about my child. He may not have adequate immunity to chickenpox." What is the best response by the nurse? 1. "You don't have to worry as long as your child has received all of his vaccinations." 2. "We can give your child another booster if you would like." 3. "There really is no way to know if your child will develop chickenpox." 4. "We can draw a titer to determine if there is adequate immunity."

4

A patient has been prescribed ferrous sulfate (Feosol). What should the nurse teach the patient about taking this medication? 1. Take this medication with milk. 2. It is okay to take this medication along with your other medications, such as calcium. 3. Take this medication with orange juice. 4. Take this medication with water.

4

A patient with cardiogenic shock would exhibit which symptom? 1. Bradycardia 2. Low temperature 3. Restlessness and anxiety 4. Tachycardia and low blood pressure

4

A woman brings her husband to the emergency department and tells the nurse that her husband just had a stroke. The physician verifies a thrombotic stroke occurred and plans to use alteplase (Activase). What priority assessment question will the nurse ask the wife? 1. "What other medications does your husband take?" 2. "Does your husband have hypertension?" 3. "What other medical illnesses does your husband have?" 4. "What time did your husband have the stroke?"

4

Histamine release produces which response? 1. Bronchodilation 2. Vasoconstriction 3. Diarrhea 4. Vasodilation

4

Hypovolemic shock is different from neurogenic shock in that it relates to: 1. an infectious process. 2. a brain or spinal cord trauma. 3. inadequate cardiac output. 4. volume depletion.

4

The client receives an immunosuppressant medication. What is the priority information for the nurse to teach the client about this medication? 1. The client should get adequate exercise. 2. The client should drink plenty of fluids. 3. The client should eat plenty of fruits and vegetables. 4. The client should avoid crowds.

4

The client receives chemotherapy as therapy for cancer. The physician orders epoetin alfa (Procrit) subcutaneously. The client asks the nurse if this drug is also chemotherapy. What is the best response by the nurse? 1. "No, but it works with your chemotherapy to make it more effective." 2. "No, this drug helps to counteract the nausea and vomiting caused by your chemotherapy." 3. "No, it will stimulate your immune system to help you battle the cancer." 4. "No, this drug will help prevent anemia that can be caused by your chemotherapy."

4

The mechanism of action of norepinephrine is to: 1. cause increased blood flow. 2. increase heart rate. 3. decrease cardiac output. 4. produce vasoconstriction.

4

The myocardium receives blood via coronary arteries that attach to: 1. the aortic arch. 2. the superior vena cava. 3. the pulmonary vein. 4. the base of the aorta.

4

The nurse is aware that the mechanism of action of anticoagulant drugs is to: 1. alter plasma membrane and platelets. 2. convert plasminogen to plasmin. 3. prevent fibrin from dissolving. 4. inhibit clotting factors to prevent clot formation.

4

The nurse is managing care for a group of patients receiving antidysrhythmic medication. Which assessment data will the nurse discuss with the prescriber as adverse effects of these medications? 1. Depression, irritability, fatigue, and nausea 2. Anorexia, insomnia, confusion, and 2+ pitting peripheral edema 3. Low-grade fever, diaphoresis, weakness, and dry mucous membranes 4. Palpitations, chest pain, weakness, and fatigue

4

The nurse is managing care for a patient with a DVT (deep vein thrombosis) of the right calf. The patient receives heparin intravenously (IV). What is the priority outcome for this patient? 1. The patient will comply with dietary restrictions. 2. The patient will keep the right leg elevated on two pillows. 3. The patient will not disturb the intravenous infusion. 4. The patient will not experience bleeding.

4

The nurse is taking the initial history of a patient admitted to the hospital for hypertension. The physician has ordered a beta-adrenergic blocker. Which statement by the patient does the nurse recognize as most significant? 1. "I don't handle stress well; I have a lot of diarrhea." 2. "When I have a migraine headache, I need to have the room darkened." 3. "My father died of a heart attack when he was 48-years-old." 4. "I have always had problems with my asthma."

4

The nurse is teaching a class on how red blood cell formation is regulated by the body to a group of clients who have AIDS. The nurse evaluates that learning has occurred when the clients make which statements? 1. "Red blood cell formation is regulated through chemicals called colony-stimulating factors that come from white blood cells." 2. "Red blood cell formation is regulated through messages from the hormone, secretin, which is located in the kidney." 3. "Red blood cell formation is regulated through specific liver enzymes and a process called hemochromatosis." 4. "Red blood cell formation is regulated through messages from the hormone erythropoietin."

4

The nurse teaches the patient about lisinopril (Prinivil) and evaluates that additional teaching is required when the patient makes which statement? 1. "I will monitor my blood pressure until my next appointment." 2. "I will avoid using salt substitutes for seasoning." 3. "It takes a while for this medication to take effect." 4. "I don't need to worry about having blood tests done."

4

The nursing instructor is teaching student nurses about humoral and cell-mediated immune responses. What does the best teaching plan include? 1. Helper T cells are an important part of humoral immunity. 2. Humoral immunity refers to immune responses where targets are attacked by immune cells. 3. B lymphocytes are an important part of cell-mediated immunity. 4. Humoral immunity refers to immune responses that are mediated by antibodies.

4

The patient has been recently diagnosed with hypertension. Assessment data include: Wt: 200 pounds Ht: 5' 4" Diet: Mostly starches Alcohol intake: 3 beers/week Stressors: Works 60 hours/week In planning care with this patient, what is the priority outcome? 1. Patient will eliminate alcohol from the diet. 2. Patient will decrease stress by limiting work to 40 hours/week. 3. Patient will balance diet according to the food pyramid. 4. Patient will achieve and maintain optimum weight.

4

The patient is receiving human serum albumin (Albuminar) as treatment for shock. What is a priority assessment by the nurse? 1. Auscultate breath sounds for hyper-resonance. 2. Auscultate for an absence of breath sounds in the lower lobes. 3. Auscultate breath sounds for inspiratory stridor. 4. Auscultate breath sounds for crackles.

4

The patient receives warfarin (Coumadin). The nurse notes that the patient's morning international normalized ratio (INR) is 7-. What are the priority nursing interventions at this time? 1. Hold the next dose of warfarin (Coumadin) and repeat the international normalized ratio (INR). 2. Administer protamine sulfate and hold the next dose of warfarin (Coumadin). 3. Hold the next dose of warfarin (Coumadin) and contact the physician. 4. Administer vitamin K and hold the next dose of warfarin (Coumadin).

4

The patient says to the nurse, "My doctor said I can't have fried chicken anymore because I have heart disease. I've eaten it all my life and am fine except for some indigestion lately." What is the best response by the nurse? 1. "Did your doctor mention exercise? That is the most important lifestyle change to slow the progression of your heart disease." 2. "Your indigestion is an indication that your body cannot tolerate fatty foods; this causes an increased workload for your heart." 3. "Fried chicken is actually okay, but you must be very careful with the type of fat that you fry the chicken in." 4. "Your indigestion could actually be chest pain caused by narrowed coronary arteries; you will need a low-fat diet."

4

The patient who is prescribed furosemide (Lasix) and digoxin (Lanoxin) reports using an over-the-counter antacid for recurrent heartburn. The nurse would assess for which result? 1. Hyponatremia 2. Hypermagnesemia 3. Increased effectiveness of furosemide (Lanoxin) 4. Decreased effectiveness of digoxin (Lanoxin)

4

The patient with hypertension has experienced heart failure. The nurse notes that the patient is receiving nifedipine (Procardia). What is a priority assessment for the nurse? 1. Review recent lab results for hypokalemia. 2. Assess urinary output. 3. Assess level of orientation. 4. Auscultate breath sounds for crackles.

4

The primary pharmacologic goal in treating patients experiencing stable angina is to: 1. increase venous blood flow to the right atrium. 2. eliminate blockages by using thrombolytics. 3. establish a regular exercise program and diet plan. 4. increase cardiac oxygen supply and reduce cardiac oxygen demand.

4

Thrombolytic drugs are used to: 1. convert plasmin to plasminogen. 2. prevent the liver from making fibrin. 3. prevent a thrombus from forming. 4. lyse a thrombus.

4

What is the most likely reason that atherosclerotic plaque would be responsible for producing a myocardial infarction? 1. Atherosclerotic plaque builds up on the endocardium, preventing blood from leaving the atriums. 2. Atherosclerotic plaque results in a narrowing of 50% of the coronary arteries. 3. Atherosclerotic plaque impairs the ability of coronary arteries to constrict and dilate. 4. Atherosclerotic plaque causes a blockage that prevents blood from reaching the myocardium.

4

What would be the expected first treatment of shock? 1. Start an intravenous line. 2. Assess level of consciousness. 3. Take the blood pressure. 4. Maintain the airway.

4

Which adverse effect is shared among all antidysrhythmic drugs? 1. Edema 2. Impotence 3. Photosensitivity 4. Prodysrhythmic effects

4

Which drug is indicated for the prevention of blood clots? 1. Captopril (Capoten) 2. Reteplase (Retavase) 3. Morphine 4. Abciximab (ReoPro)

4

Which drugs reduce the heart's demand for oxygen by lowering heart rate? 1. Anticoagulants and beta-adrenergic blockers 2. Calcium channel blockers and anticoagulants 3. Organic nitrates and calcium channel blockers 4. Beta-adrenergic blockers and calcium channel blockers

4

Which individual listed below would be at the greatest risk for developing heart disease? 1. 35-year-old with diabetes mellitus and prehypertension 2. 75-year-old with Parkinson's disease and normal blood pressure 3. 52-year-old with osteoporosis and stage 1 hypertension 4. 68-year-old with stage 2 hypertension and recent myocardial infarction

4

Which laboratory test would be the priority for a patient with hypertension who takes a thiazide diuretic? 1. Magnesium 2. Calcium 3. Chloride 4. Potassium

4

Which situation would lead to an increase in cardiac output? 1. Reduced cardiac contractility 2. Hypovolemia 3. Peripheral vascular resistance 4. Increase in preload

4

Which statement is accurate regarding the use of beta-adrenergic blockers for use in patients with heart failure? 1. Higher doses are used initially until optimal vital signs are achieved. 2. Dosage changes are done on a daily basis for the first 2 weeks. 3. This drug class does not have an effect on the bronchioles of the lungs. 4. They are generally used in combination with other heart-failure drugs.

4

The nurse is managing care for a patient with cirrhosis of the liver. The nurse teaches the patient about how to avoid injury that may result in bleeding. The patient asks the nurse why he is at risk to start bleeding. What is the best response by the nurse? 1. "Because your liver is injured and unable to manufacture platelets." 2. "Because your liver thickens your blood so it is less likely to clot." 3. "Because your liver is injured and cannot make clotting factors." 4. "Because your liver is breaking down your clotting factors too quickly."

3

The nurse is preparing to administer nitroglycerine via the intravenous route. What must the nurse plan to do prior to administering this medication? 1. Use gloves to prevent self-administration. 2. Instruct the patient to avoid moving the arm in which the medication is infusing. 3. Cover the intravenous (IV) bottle to decrease light exposure. 4. Darken the room to decrease light exposure.

3

The nurse is teaching a class on rhythm abnormalities to patients who have experienced dysrhythmias. Which information would the nurse include in this teaching? 1. "Dysrhythmias cause serious electrolyte imbalances; this results in heart block." 2. "Dysrhythmias are the result of long-standing, uncontrolled hypertension." 3. "Dysrhythmias interrupt the normal electrical pathways in the heart so it can't beat properly." 4. "Dysrhythmias alter the blood flow through the heart and cause it to stop beating."

3

The nurse is teaching the patient about lifestyle modifications to help manage the patient's hypertension. The nurse determines that teaching has been effective when the patient makes which statement? 1. "I need to get started on my medications right away." 2. "My father had hypertension, did nothing, and lived to be 90-years-old." 3. "I know I need to give up my cigarettes and alcohol." 4. "I won't be able to run in the marathon race anymore."

3

The nurse plans care for an older adult receiving nonsteroidal anti-inflammatory drug (NSAID) therapy. What is the best outcome for this client as it relates to side effects of nonsteroidal anti-inflammatory drugs (NSAIDs)? 1. The client will refrain from taking other medications with the nonsteroidal anti-inflammatory drug (NSAID). 2. The client will avoid the use of caffeine while taking the nonsteroidal anti-inflammatory drug (NSAID). 3. The client will report any bleeding or bruising while taking the nonsteroidal anti-inflammatory drug (NSAID). 4. The client will report any mood changes while taking the nonsteroidal anti-inflammatory drug (NSAID).

3

The nurse teaches a class on iron-deficiency anemia to a group of pregnant clients. The nurse evaluates that additional learning is needed when the clients make which statement? 1. "Most iron in our bodies is stored on hemoglobin in the red blood cell." 2. "Transferrin is a protein that transports iron to places in our bodies where it is needed." 3. "We need extra iron because when our red blood cells die, all their iron is excreted from the body." 4. "The most common cause of nutritional anemia is iron deficiency."

3

The nurse teaches a group of clients with arthritis about the use of ibuprofen (Motrin), emphasizing the maximum daily amount. The nurse evaluates that education has been most effective when the clients make which statement? 1. "We cannot take over 4000 mg/day." 2. "We cannot take over 3600 mg/day." 3. "We cannot take over 3200 mg/day." 4. "We cannot take over 3000 mg/day."

3

The nurse volunteers at a senior citizen center. The nurse assesses which senior citizen as having the greatest risk of developing heart failure? 1. A 50-year-old African American female who smokes 2. A 75-year-old Caucasian male who is overweight 3. A 69-year-old African American male with hypertension 4. A 52-year-old Caucasian female with asthma

3

The nursing instructor is teaching student nurses about the process of hemostasis after an injury. What does the nursing instructor include as the initial event in this process? 1. Platelets become sticky. 2. Plasma proteins convert to active forms. 3. The vessel spasms. 4. Von Willebrand's factor is activated.

3

The patient comes to the emergency department after suffering a bilateral traumatic amputation of his lower extremities. The physician orders normal serum albumin (Albuminar). The patient goes into shock. What will the best nursing assessment of this patient reveal? 1. B/P: 140/90 mmHg, P: 46, weak and irregular, R: 24, and shallow. 2. B/P: 50/0 mmHg, P: 126, weak and thready, R: 14, and shallow. 3. B/P: 80/20 mmHg, P: 122, weak and thready, R: 28, and shallow. 4. B/P: 130/88 mmHg, P: 90, bounding, R: 32, and shallow.

3

The patient comes to the emergency department with a blood pressure of 200/120 mmHg. The physician orders hydralazine (Apresoline) IV. What will the nurse's priority assessment include? 1. Hypotension and bradycardia 2. Hypotension and hyperthermia 3. Hypotension and tachycardia 4. Hypotension and tachypnea

3

The patient comes to the emergency department with a severe allergic reaction to peanuts and is in serious respiratory distress. The patient's spouse tells the nurse that the patient has a known hypersensitivity to epinephrine (Adrenalin). What is the best response by the nurse? 1. "I will let the physician know about this immediately; we will need to choose an alternative medication." 2. "I'm not sure what we can use then. Do you know what has been used before with this allergic response?" 3. "This is a life-threatening situation; a prior hypersensitivity is not an absolute contraindication." 4. "This is a problem; we will need to use IV diphenhydramine (Benadryl)."

3

The patient has experienced hypovolemic shock as a result of severe burns. The physician orders a low dose of dopamine (Intropin). What is the best evaluation by the nurse? 1. Vasoconstriction and increased blood pressure 2. Stabilization of fluid loss 3. Urinary output of at least 50 mL/hour 4. Increased cardiac output

3

The patient is receiving norepinephrine (Levophed). When monitoring the patient's blood pressure, the nurse notes a pressure of 230/120 mmHg. What is the priority nursing action? 1. Assess the patient for signs/symptoms of a stroke. 2. Notify the physician. 3. Slow the rate of the infusion 4. Increase the infusion.

3

The patient is receiving normal serum albumin (Albuminar). What will be a priority outcome with this patient? 1. The patient will be afebrile. 2. The patient will be free of a rash. 3. The patient will experience adequate breathing patterns. 4. The patient will remain alert and oriented.

3

The patient is receiving procainamide hydrochloride (Pronestyl) for treatment of a dysrhythmia. What is the best patient outcome for medication compliance? 1. The patient will take his medication with food. 2. The patient will take his medication on an empty stomach. 3. The patient will take his medication as directed, even if he is feeling well. 4. The patient will monitor his pulse and hold his medication if his pulse is less than 60.

3

The patient receives amiodarone (Cordarone). The nurse would be concerned about which additional medication that a consulting physician prescribed? 1. Oxycodone (OxyContin) 2. Omeprazole (Prilosec) 3. Digoxin (Lanoxin) 4. Fluoxetine (Prozac)

3

The patient receives digoxin (Lanoxin). Which assessment findings would indicate adverse effects to this medication? 1. Tachycardia and hypotension 2. Blurred vision and tachycardia 3. Anorexia and nausea 4. Anorexia and constipation

3

The patient receives verapamil (Calan). The patient asks the nurse if it is okay to take herbal supplements with this medicine. What is the best response by the nurse? 1. "Using herbal supplements may increase your blood pressure too much." 2. "Herbal supplements are okay as long as you take calcium salts with them." 3. "Using herbal supplements may lower your blood pressure too much." 4. "Most herbal supplements are okay, but you should avoid St. John's wort."

3

The process for regulating hematopoiesis occurs via: 1. white bone marrow. 2. hematopoietic stem cell. 3. hormones. 4. essential vitamins and nutrients.

3

Which finding is a common adverse effect of anti-inflammatory drugs, such as ibuprofen? 1. Diarrhea 2. Palpitations 3. Heartburn 4. Hypotension

3

The patient has hypertension and asks the nurse how this can lead to heart failure. What is the best response by the nurse? 1. "Hypertension causes resistance in your blood vessels, or afterload; your heart works harder, and weakens." 2. "Hypertension limits the ability of your heart to stretch before emptying, or afterload; your heart works harder, and weakens." 3. "Hypertension causes resistance in your aorta, or afterload; your heart works harder and weakens." 4. "Hypertension limits the amount of blood entering your left ventricle, or afterload; your heart works harder, and weakens."

1

The patient is receiving diltiazem (Cardizem) and wants to know why he developed a headache after taking the medication. What is the best response by the nurse? 1. "Diltiazem (Cardizem) causes the blood vessels in your brain to widen, giving you the headache." 2. "Diltiazem (Cardizem) increases prostaglandin synthesis, giving you the headache." 3. "Diltiazem (Cardizem) releases Substance P, activating pain receptors in your brain and giving you the headache." 4. "Diltiazem (Cardizem) causes the blood vessels in your brain to narrow, giving you the headache."

1

The patient receives captopril (Capoten) as treatment for heart failure. Which adverse effect will the nurse plan to report to the physician? 1. The patient develops a cough. 2. The patient develops diarrhea. 3. The patient develops dehydration. 4. The patient develops facial flushing.

1

The physician orders dopamine (Intropin) intravenous (IV) for the patient in shock. What is a priority plan of the nurse with regard to administration of this drug? 1. Have phentolamine (Regitine) available in the room. 2. Have naltrexone (Revia) available in the room. 3. Have epinephrine (Adrenalin) available in the room. 4. Have flumazenil (Romazicon) available in the room.

1

Which interventions would be indicated and take highest priority for a 30-year-old female with a BMI of 20 who smokes and has a blood pressure of 137/88? 1. Smoking-cessation program 2. Diuretic therapy 3. Weight-loss program 4. Stress management

1

The nurse is concerned that a patient is developing right heart failure. What did the nurse assess in this patient? 1. Ankle edema 2. Enlarged liver 3. Displaced apical heart rate 4. Shortness of breath 5. Cough

1, 2, 3

A patient is brought to the emergency department in hypertensive crisis. The nurse plans care to protect which bodily systems that are most implicated in compensating for this crisis? 1. Cardiac 2. Respiratory 3. Integumentary 4. Gastrointestinal 5. Renal

1, 5

The patient is in shock with a blood pressure of 60/20 mmHg. The physician orders dobutamine intravenously (IV). The family is quite anxious and asks what "that liquid" is for. What is the best response of the nurse? 1. "This drug is a vasopressor and helps the heart beat more effectively, which will increase blood pressure." 2. "Vasopressor drugs act on the renin-angiotension system and thus increase blood pressure." 3. "This drug is a vasopressor and will help stabilize blood pressure by making the blood vessels smaller." 4. "It is called a vasopressor and will help increase blood flow to peripheral muscles."

3

The patient is receiving doxazosin (Cardura) for hypertension. He asks the nurse how the medication works. What is the nurse's best response? 1. "It works by causing your kidneys to excrete more urine." 2. "It works by making your heart work more efficiently." 3. "It works by making your blood vessels expand." 4. "It works by decreasing the release of your stress hormones."

3

The patient is receiving hydrochlorothiazide (Microzide) as well as digoxin (Lanoxin). Which lab result would the nurse recognize as most significant? 1. ALT level of 35 units/L 2. Sodium level of 140 mEq/L 3. Potassium level of 2.9 mEq/L 4. BUN level of 20 mg/dl

3

The patient takes insulin for diabetes mellitus. The physician orders metoprolol (Lopressor) for hypertension. After medication teaching, the nurse determines that learning has occurred when the patient makes which statement? 1. "I might not need to check my blood sugars as often with metoprolol (Lopressor)." 2. "I might be able to change from insulin to a pill with metoprolol (Lopressor)." 3. "I might need less insulin when I take metoprolol (Lopressor)." 4. "I might need more insulin when I take metoprolol (Lopressor)."

3

The physician orders metoprolol (Toprol-XL) for several patients. The nurse will most closely monitor the effects of this drug on which patient? 1. The patient with an apical pulse rate of 100 2. The patient with compensated heart failure 3. The patient with chronic bronchitis 4. The patient with a history of migraines

3

The young patient has a history of multiple allergies, and the physician prescribed epinephrine (EpiPen) for prevention of anaphylactic shock. The patient's mother says to the nurse, "I thought shock was about heart failure." What is the best response by the nurse? 1. "There are many kinds of shock: heart failure, nervous system damage, loss of blood, and respiratory failure." 2. "Allergic response is the most fatal type of shock; other types involve loss of blood, heart failure, and liver failure." 3. "There are many kinds of shock that also include infection, nervous system damage, and loss of blood." 4. "Heart failure is the most serious kind of shock; others include infection, kidney failure, and loss of blood."

3

Which adverse effect is common for patients taking topical nitroglycerin paste? 1. Rash 2. Shortness of breath 3. Headache 4. Ventricular tachycardia

3

Which statement is accurate regarding the physiological changes associated with heart failure? 1. Blood backs up into the lungs due to right ventricular hypertrophy. 2. The walls of the heart shrink, leading to lower cardiac output. 3. Cardiac remodeling occurs after prolonged ventricular hypertrophy. 4. Blood pressure increases, resulting in lowered afterload.

3

A patient presents with an intermittent fever of unknown origin. The nurse reviews the patient's medication history and identifies which medications that may be implicated in fever? 1. Paroxetine (Paxil) 2. Chlorpromazine (Thorazine) 3. Vitamin E 4. Metformin (Glucophage) 5. Furosemide (Lasix)

1, 2

A patient reports that he has been taking aspirin to treat the muscle pain that results from his new walking routine. The nurse would be concerned about this treatment plan if the patient has which history? 1. Myocardial infarction at age 61 2. Helicobacter pylori infection treatment last month 3. No influenza vaccine in last 2 years 4. Mild hypertension 5. History of migraine headaches

1, 2

The nurse is caring for a patient recently diagnosed with hypertension. The patient asks what medications may be used to treat the condition. The nurse begins by discussing the primary antihypertensive agents, which include: 1. thiazide diuretics. 2. angiotensin-II receptor blockers (ARBs). 3. beta-adrenergic antagonists. 4. direct-acting vasodilators. 5. peripheral adrenergic antagonists.

1, 2

The nurse is caring for an African American male who has just been diagnosed with hypertension and mild heart failure. The nurse anticipates that this patient will be started on which medications? 1. A combination drug like hydralazine and isosorbide dinitrate 2. A calcium channel blocker like nifedipine (Adalat) 3. An ACE inhibitor like enalapril (Vasotec) 4. A beta-adrenergic antagonist like atenolol (Tenormin) 5. An angiotensin-II receptor blocker like clonidine (Catapres)

1, 2

A client presents with a rash and is prescribed an over-the-counter ointment for treatment. The client says, "I thought I would need a shot or an expensive prescription." How should the nurse respond? 1. "Medications that go on your skin don't usually have as many side effects." 2. "Mild rashes often respond well to topical ointments." 3. "Many of the products used on the skin are available over-the-counter." 4. "You should try to discover what caused your rash." 5. "Prescription ointments are usually better at healing."

1, 2, 3, 4

Prior to administering dopamine, the nurse reviews a patient's current medication history. For which medications would dopamine cause a drug-drug interaction? 1. MAO inhibitor 2. Phenytoin 3. Beta blocker 4. Digoxin 5. Aspirin

1, 2, 3, 4

A client's blood work shows an anemia that was not present at the last clinic visit 6 months ago. Which questions should the nurse ask this client? 1. "Have you had a significant dietary change in the last 6 months?" 2. "Do you handle chemicals in your new job?" 3. "Have your stools changed in appearance?" 4. "Have you been eating more carbohydrates than usual?" 5. "Are your menstrual periods heavier than normal for you?"

1, 2, 3, 5

The nurse is caring for a patient being treated pharmacologically for heart failure. Which laboratory values is the nurse careful to monitor during treatment? 1. Potassium levels 2. BUN 3. Creatinine 4. Liver function tests 5. Serum drug levels

1, 2, 3, 5

The nurse is caring for a patient who has been diagnosed with heart failure. The nurse knows that which conditions may have contributed to the development of heart failure in this patient? 1. Uncontrolled hypertension 2. Coronary artery disease (CAD) 3. Diabetes (DM) 4. HIV 5. Mitral stenosis

1, 2, 3, 5

The nurse is explaining inflammation to a patient who has Crohn's disease. Which information should the nurse provide? 1. When cells are damaged nearby vessels get bigger. 2. The vessels in the area allow fluids to escape. 3. Inflammation produces pus. 4. Inflammation causes bleeding and inability to clot. 5. Inflammation causes pain.

1, 2, 3, 5

A client has been treated with an erythropoiesis-stimulating factor. Which client assessment would the nurse interpret as indicating the goal of this treatment has been reached? 1. The client's hemoglobin values have risen. 2. The client reports less shortness of breath on exertion. 3. The client has not had an episode of epistaxis in over 3 weeks. 4. The client reports enjoying a walk with family for the first time in months. 5. The client has not had a fever since treatment began.

1, 2, 4

A patient has been prescribed a short course of high dose aspirin. The nurse would educate the patient to monitor for which findings associated with salicylism? 1. Tinnitus 2. Excessive sweating 3. Cold chills 4. Headache 5. Bloating

1, 2, 4

The nurse and a home health patient have established this expected outcome: "The patient will be free from adverse effects of administration of verapamil (Calan)." Which finding indicates this outcome has not been met? 1. The patient complains of headache at each visit by the nurse. 2. The patient has 3+ edema in the ankles and feet. 3. The patient says, "Everything I eat tastes like metal." 4. The patient says, "I got so dizzy yesterday that I had to lie down for a while." 5. The patient's face is flushed.

1, 2, 4

The nurse is caring for a patient who is recovering from a myocardial infarction (MI). The nurse anticipates that the patient will be prescribed which medications in order to reduce post-MI mortality? 1. Aspirin 2. Beta blockers 3. Narcotic analgesics 4. ACE inhibitors 5. Antidysrhythmics

1, 2, 4

The nurse is caring for a patient with heart failure. Which assessment findings indicate the patient is currently experiencing class 2 heart failure? 1. Fatigue with physical activity 2. Palpitations with physical activity 3. No symptoms with physical activity 4. Dyspnea with physical activity 5. Angina at rest

1, 2, 4

The nurse is planning care for a patient receiving enoxaparin (Lovenox). Which interventions should be included? 1. Teach the patient or family to give subcutaneous injections at home. 2. Monitor for development of deep vein thrombosis. 3. Monitor multiple lab tests. 4. Teach the patient signs of excessive bleeding. 5. Schedule administration times right before breakfast and the evening meal.

1, 2, 4

The nurse works in a summer camp for children. One of the children says she was bitten by several wasps. The nurse plans to inject the child with epinephrine (EpiPen) if which symptoms are present? 1. The child's skin feels cold and clammy. 2. The child is thirsty. 3. The child's skin feels warm and dry. 4. The child is restless and confused. 5. The child is hyperactive and hyperverbal.

1, 2, 4

A client is scheduled to have chemotherapy Thursday at 9 a.m. Filgrastim (Neupogen) has also been ordered. The nurse should plan which dosing time for the Neupogen? 1. No later than 9 a.m. on Wednesday 2. At the time of the chemotherapy infusion 3. Immediately following the chemotherapy 4. No earlier than 9 a.m. Friday 5. Immediately before the chemotherapy

1, 4

A patient says, "Since I started taking metoprolol (Lopressor), I have been having problems having sex. I think I am going to stop taking it." What nursing responses are indicated? 1. "Sexual dysfunction is a common problem with this drug." 2. "Perhaps it would be better if you took atenolol (Tenormin)." 3. "I cannot stop you from discontinuing the drug." 4. "Stopping the drug all at once may make your blood pressure get higher." 5. "Try taking the drug early in the morning."

1, 4

Which client statement would the nurse evaluate as indicating the goal of treatment with an anti-inflammatory drug has been met? 1. "My fever went away yesterday." 2. "I've not been coughing up so much phlegm." 3. "The skin over my knee is red and hot to the touch." 4. "The pain in my shoulder is much relieved." 5. "My rash is spreading."

1, 4

A client has just been prescribed ibuprofen for a mild ankle sprain. Which health history information should alert the nurse to question this prescription? 1. The client has asthma. 2. The client had a similar ankle strain a year ago. 3. The client reports getting a rash when eating strawberries. 4. The client is allergic to aspirin. 5. The client reports having a peptic ulcer 6 months ago.

1, 4, 5

A patient presents with anaphylaxis to the penicillin prescribed for an ear infection. The nurse plans immediate care for the patient based on which goals? 1. Normalization of blood pressure 2. Reduction of blood volume 3. Identification of other allergies 4. Reduction of inflammatory response 5. Provision of basic life support

1, 4, 5

The patient has a deep vein thrombosis (DVT) and is admitted for initial heparin therapy. Which orders would the nurse want to validate with the physician? 1. Heparin 1000 units intravenous (IV) every 6 hours 2. Tylenol as needed (PRN) for headaches 3. Obtaining a daily weight on the patient 4. Advil as needed (PRN) for headaches 5. Low vitamin K diet

1, 4, 5

The nurse is conducting an education class about myocardial blood supply for patients with coronary artery disease (CAD). The nurse determines that learning has occurred when the patients make which statements. 1. "The heart has right and left arteries that arise from the aorta." 2. "The coronary arteries carry blood away from the heart to the right atrium." 3. "The heart receives its oxygen through the blood that fills it." 4. "Coronary arteries primarily carry blood to the left ventricle." 5. "The right and left arteries have smaller branches that go around the heart."

1, 5

A patient has been prescribed nifedipine (Adalat CC) as treatment for hypertension. The nurse would evaluate medication instruction as effective if the patient makes which statements? 1. "If I drink alcohol while taking this medication, I will get very sick to my stomach." 2. "I should stop taking my melatonin sleep medication." 3. "I should no longer drink grapefruit juice." 4. "I should no longer drink sports drinks with caffeine in them." 5. "I should stop taking my vitamin C supplement."

2, 3

A patient who had an anaphylactic reaction has been successfully treated with epinephrine. The nurse anticipates administering which other drugs? 1. Antibiotics 2. Antihistamines 3. Corticosteroids 4. Vasopressors 5. Vasodilators

2, 3

A patient who is in hypertensive crisis will be given the calcium channel blocker clevidipine (Cleviprex). The nurse should prepare for which interventions? 1. Monitoring bowel sounds 2. Administering the drug intravenously 3. Continuous blood pressure monitoring 4. Crushing caplets for administration 5. Infusing normal saline at 125 mL/hr

2, 3

Following treatment with epinephrine, the patient reports the following symptoms. The nurse would be most concerned about which report? 1. "I feel jittery." 2. "My heart is skipping beats." 3. "I have a pounding headache." 4. "I am so dizzy." 5. "That really hurt when you gave me that med."

2, 3

The nurse is conducting the initial group education session for patients who have hypertension. What is the most important information to include? 1. Blood pressures tend to decrease as people age, due to decreased blood volume. 2. The aorta has sensors that help regulate blood pressure. 3. Anger can result in hypertension. 4. The vasomotor center, located in the limbic system of the brain, helps regulate blood pressure. 5. Hypertension is diagnosed when the blood pressure is greater than 145/95 mmHg.

2, 3

The nurse is teaching a patient about the pharmacological management of angina. The nurse plans to include which points in the patient teaching? 1. The medications increase the heart rate. 2. The medications dilate the veins so that the heart receives less blood. 3. The medications cause the heart to contract with less force. 4. The medications increase blood pressure. 5. The medications increase the ability of the body to produce red blood cells

2, 3

The patient tells the nurse, "My doctor says I have atrial fibrillation. Is this serious and how is it treated?" What are the best responses by the nurse? 1. "This condition is best treated with what we call antidysrhythmic drugs." 2. "This is very common; your doctor will discuss the best treatment with you." 3. "Depending on your symptoms, your doctor may use an electrical shock." 4. "This is quite serious; did your doctor mention a heart transplant?" 5. "It is very serious, even more serious than a ventricular dysrhythmia."

2, 3

The nurse is teaching a class on immunizations for women with newborn infants. The nurse evaluates that learning has occurred when the women make which statements? 1. "The immunizations are more effective if they are given closer together." 2. "Our babies might have a mild fever and be fussy for a few days." 3. "If our babies develop a fever, we must call the doctor immediately." 4. "We can give acetaminophen (Tylenol) if our babies have a mild fever." 5. "If our babies develop a mild fever, it means an allergic reaction."

2, 4

A client presents with severe inflammation of the knee. The physician prescribes a corticosteroid and asks the client to return to the office in 10 days for follow-up. How does the nurse explain these instructions? 1. "We need to check to see if this is the correct treatment." 2. "We need to re-examine the knee after a few days of treatment." 3. "Corticosteroids should only be taken for 1 to 3 weeks." 4. "You may be able to change to an NSAID at that visit." 5. "You may need a 3-month prescription for a stronger corticosteroid at that time."

2, 3, 4

A patient has been started on clopidogrel (Plavix) after a myocardial infarction and stent placement. How should the nurse explain the action of this medication to the patient? 1. "Plavix will dissolve any clots that might form in your stent." 2. "Plavix will make the platelets in your blood less sticky." 3. "Plavix will change the way your platelets work their entire lives." 4. "Plavix decreases your blood's ability to clot." 5. "Plavix works just like the heparin you have been on in the hospital."

2, 3, 4

The nurse is managing care for clients who will receive ibuprofen (Advil) for long-term therapy. What are the primary laboratory tests the nurse will assess prior to initiation of therapy? 1. Electrolytes 2. Hemoglobin and hematocrit 3. Bleeding times 4. Liver function tests 5. Serum amylase

2, 3, 4

The nurse is preparing to teach a patient therapeutic lifestyle changes that can decrease the risk of coronary artery disease. The nurse plans to include which topics in the teaching? 1. Eliminating the consumption of alcohol 2. Eliminating foods high in cholesterol and saturated fats 3. Maintaining blood pressure within normal levels 4. Exercising and maintaining a healthy weight 5. Decreasing the number of cigarettes smoked

2, 3, 4

The nurse is teaching a patient how to self-administer an erythropoiesis-stimulating drug. Which instruction should the nurse include? 1. "Shake the vial to mix the contents before use." 2. "Draw up what is needed and discard the rest of the vial." 3. "Place your stock of medication in your refrigerator." 4. "Hold the vial in your hand a few minutes before drawing up the medication." 5. "Give the medication deeply into a muscle.

2, 3, 4

The patient tells the nurse, "This educational video you gave me shows normal electrical conduction through the heart, but I still don't understand it. Can you explain it to me?" What are the nurse's best responses? 1. "Conduction through the bundle of His is the slowest in the heart." 2. "Conduction begins in the sinoatrial (SA) node and travels to the atrioventricular (AV) node." 3. "Conduction continues through the bundle branches to the Purkinje fibers." 4. "Conduction travels from the atrioventricular (AV) node through the bundle of His." 5. "The sinoatrial (SA) node is located in the left atrium."

2, 3, 4

The nurse is reviewing the health history for a patient who may be a candidate for thrombolytic therapy for the treatment of an MI. The nurse knows that therapy is contraindicated in which circumstances? 1. Menses 2. A history of intracranial hemorrhage 3. Hemophilia 4. Liver disease 5. Peptic ulcer disease

2, 3, 4, 5

A patient has been taking a potassium channel blocker for 4 weeks. Which statements would indicate to the nurse that additional time for teaching about the medication should be planned? 1. "I got some sunglasses like you said. Do you like them?" 2. "Do you have any idea what this rash on my neck and arm is?" 3. "I must be getting cataracts. I can't see anything anymore." 4. "I wear sunscreen whenever I am outdoors." 5. "I think that medicine is making my hair gray."

2, 3, 5

A patient says, "Ever since I changed jobs I just don't feel as good. I think my heart medicine is not working." What nursing assessment questions are priority? 1. "How well are you sleeping?" 2. "How did your new job change your work schedule?" 3. "How did your new job change your insurance coverage?" 4. "How has your job change affected your home life?" 5. "In what way do you not feel as well?"

2, 3, 5

A patient has been prescribed transdermal nitroglycerin patches. What medication education should the nurse provide? 1. Place the patch on the upper arm or leg. 2. Rotate sites of application. 3. Remove the patch for an hour each day. 4. Cleanse the skin under the patch after removal. 5. Triple wrap the patch in plastic wrap for disposal.

2, 4

The nurse is educating a patient whose blood pressure is 140/90 mmHg on ways to lower blood pressure and avoid hypertension. Which lifestyle choices may eliminate the need for pharmacotherapy in this patient? 1. Increasing intake of wine 2. Restricting salt intake 3. Increasing intake of red meat 4. Increasing activity 5. Stopping smoking

2, 4, 5

A client is to receive darbepoetin alfa (Aranesp) adjunctive medication during chemotherapy. The client says, "Not another drug. Why do I need this one?" How should the nurse respond? 1. "I know you are tired of drugs, but this is just one more." 2. "This drug will help you grow red blood cells." 3. "This drug will help keep you from getting infections." 4. "This is an erythropoiesis-stimulating factor." 5. "This drug will help you get more oxygen around to your tissues so you feel better."

2, 5

A patient has been treated with epinephrine. Which laboratory results could have been affected by this treatment? 1. Digoxin level is elevated. 2. Potassium level is low. 3. Calcium level is high. 4. Sodium level is low. 5. Blood glucose is high.

2, 5

For the last 3 months, the nurse has been working with a group of patients who have been using nonpharmacological methods to try to manage their hypertension. The nurse anticipates that which patients will require the addition of a pharmacological intervention? 1. A 30-year-old female whose blood pressure is 138/88 mmHg who is otherwise healthy. 2. A 61-year-old man whose blood pressure is 144/90 mmHg who also has type 2 diabetes. 3. A 56-year-old woman whose blood pressure is 135/84 who also has Cushing's disease. 4. A 65-year-old man whose blood pressure is 148/88 mmHg who is otherwise healthy. 5. A 61-year-old woman whose blood pressure is 153/92 mmHg who is otherwise healthy.

2, 5

A client is placed on aspirin. A toxic reaction to this medication that the nurse will teach the client to report is: 1. blurred vision. 2. muscle cramps. 3. tinnitus. 4. joint pain.

3

A newly licensed nurse abruptly discontinues the intravenous (IV) norepinephrine (Levophed) once it has infused into the patient. What is the priority action of the more experienced nurse? 1. Obtain an oxygen saturation reading with a pulse oximeter. 2. Notify the physician. 3. Assess the patient's blood pressure. 4. Administer oxygen via a rebreather mask.

3

After the client begins taking glucocorticoid medications, the nurse would observe for adverse effects of: 1. hypoglycemia. 2. hypotension. 3. bruising. 4. weight loss.

3

Colloids differ from crystalloids in that: 1. they contain electrolytes. 2. they readily leave the blood and enter cells. 3. they are too large to cross membranes. 4. they promote urine output.

3

Depolarization occurs when which two electrolytes rush into the cell? 1. Sodium and potassium 2. Calcium and magnesium 3. Calcium and sodium 4. Chloride and potassium

3

Per classification of anemias, the morphology for pernicious anemia or folate-deficiency anemia results in: 1. hematocytic-hematochromic erythrocytes. 2. microcytic-hypochromic erythrocytes. 3. macrocytic-normochromic erythrocytes. 4. normocytic-normochromic erythrocytes.

3

The client has experienced a sports-related injury. He asks the nurse how long it will take for him to respond to treatment. What is the best response by the nurse? 1. "With proper care, it will take about a month for symptoms to resolve." 2. "It will depend on your response to the medications." 3. "It will take about a week and a half for symptoms to resolve." 4. "The inflammatory process is too complex to predict a time frame for healing."

3

The nurse completed medication education with the patient who receives hydrochlorothiazide (Microzide). The nurse determines that teaching has been effective when the patient makes which statement? 1. "I really need to avoid grapefruit juice when I take this medication." 2. "I need to avoid salt substitutes and potassium-rich foods." 3. "I take my medication early in the morning." 4. "If I develop a cough, I should call my doctor."

3

The nurse completes medication education with a patient who receives propranolol (Inderal). The nurse evaluates the education as effective when the patient makes which statement? 1. "I must take my pulse every day and call my doctor if it is higher than 100." 2. "I must call my doctor if my anxiety increases and I start worrying again." 3. "I must take my pulse every day and call my doctor if it is less than 60." 4. "I must call my doctor if I lose more than three pounds a week."

3

The nurse has been teaching a class on dysrhythmias to a group of patients with this disorder. The nurse determines that teaching has been effective when a patient makes which statement? 1. "Our sodium, potassium, and magnesium levels must be okay for our hearts to have an electrical impulse." 2. "Potassium is the most important electrolyte when it comes to the electrical impulse in our hearts." 3. "Our sodium, potassium, and calcium levels must be okay for our hearts to have an electrical impulse." 4. "Enhancing potassium and sodium is how our medications will work to prevent dysrhythmias."

3

The nurse in the emergency department frequently sees clients who have overdosed on acetaminophen (Tylenol). Which client is at highest risk for developing hemolysis? 1. A Native American client 2. A Jewish client 3. An African American client 4. A Caucasian client

3

The nurse is aware that the drug that will most likely be used in the treatment of warfarin sodium overdose is: 1. aspirin. 2. heparin. 3. vitamin K. 4. protamine sulfate.

3

The nurse knows that the basic strategies of antianginal therapy are: 1. decreased oxygen consumption of the brain. 2. increased myocardial contractility. 3. increased blood flow to the peripheral blood vessels. 4. increased blood flow to the myocardium. 5. decreased myocardial oxygen demand.

4, 5

A nurse is preparing to administer ferrous sulfate IM to a client with anemia. What should the nurse consider when giving this injection? 1. Give the injection in the deltoid muscle. 2. Iron is best absorbed if given subcutaneously. 3. Iron is irritating to the tissues. 4. The z-track method should be used. 5. Iron preparations should be administered through a needle gauge 16 or larger.

3, 4

A patient is being treated for a thromboembolic disorder. If the goal is to prevent clot formation, the nurse anticipates the patient will be treated with which classification of drug? 1. Hemostatics 2. Thrombolytics 3. Anticoagulants 4. Antiplatelet agents 5. Clotting factor concentrates

3, 4

The nurse is providing discharge teaching regarding anticoagulant therapy. Which statements by the patient would the nurse evaluate as indicating the need for further instruction? 1. "I'll ask for an electric razor for my birthday next week." 2. "I guess my trip to the amusement park is off for now." 3. "I won't be able to cook anymore." 4. "I'll get one of those new electric toothbrushes with the firm bristles." 5. "I should make an appointment for a B12 injection monthly."

3, 4, 5

A hospitalized patient has been started on enalapril (Vasotec). The nurse would hold this drug and discuss which findings with the prescriber? 1. Cough 2. Light-headedness on ambulation 3. Swelling around the eyes 4. Sneezing 5. Difficulty swallowing

3, 5

The patient comes to the emergency department complaining of coughing and difficulty breathing. The patient's diagnosis is heart failure. He asks the nurse how difficulty breathing could be a heart problem. What is the best response by the nurse? 1. "The right side of your heart has weakened and blood has entered your lungs." 2. "The right side of your heart has enlarged and cannot effectively pump blood." 3. "What you have is called congestive heart failure." 4. "The left side of your heart is weak and pumps blood too quickly." 5. "The left side of your heart has weakened and blood has entered your lungs."

3, 5

The nurse teaches the patient about digoxin (Lanoxin) toxicity and determines that learning has occurred when the patient makes which statements? 1. "I should limit my fluids while taking this medication." 2. "It is okay to keep taking my ginseng." 3. "If I have nausea, it means I must stop the medication." 4. "I can drink orange juice every morning." 5. "I must check my pulse and not take the medication if it is less than 60."

4, 5

A patient is being treated for an iron overdose after taking a bottle of over-the-counter multiple vitamins with iron. Which information will the nurse provide to the family about treatment of this overdose? 1. "The antidote for iron overdose is a folic acid." 2. "The antidote is given via a retention enema." 3. "We will know that the antidote is working when the patient's urine turns a bluish color." 4. "Success of this medication depends on the patient having good kidney function." 5. "Iron overdose is extremely dangerous."

4, 5