question archive Q1) The nurse working on a high-acuity medical-surgical unit is prioritizing care for four clients who were just admitted

Q1) The nurse working on a high-acuity medical-surgical unit is prioritizing care for four clients who were just admitted

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Q1) The nurse working on a high-acuity medical-surgical unit is prioritizing care for four clients who were just admitted. Which client should the nurse assess FIRST?

(a) The NPO client with a blood glucose level of 80 mg/Dl who just received 20 units of insulin lispro – correct answer

(b) The client with a pulse of 62 beats/min, about to receive digoxin

(c) The client with a blood pressure of 136/92 mm Hg. Who complains of having a headache

(d) The client with an allergy to penicillin who is receiving an infusion of vancomycin

 

 

Q19) What should the nurse include in a client’s discharge teaching when going home with a prescription for digoxin-0.125 mg by mouth once daily? Check the answer again.

(a) Take the digoxin at bedtime

(b) You must be able to check your pulse

(c) Don’t take digoxin if your heart rate exceeds 90 beats per minute

(d) Eat a diet high in bran fiber and calcium

 

Q23) Which of these findings from a client taking steroids should the nurse report immediately?

(a) Temperature of 100.2 degrees Fahrenheit – correct answer

(b) glucose 128 mg/dL

(c) heart rate of 92 beats per minute

(d) blood pressure of 144/68 mm Hg

 

Q29) A client will begin taking fexofenadine for hay fever. The nurse teaching this client will tell the client which of the following?

(a) Fexofenadine should be taken with food to prevent gastrointestinal symptoms

(b) The medication may be taken once or twice daily

(c) Tolerance to sedation will occur in a few weeks

(d) With renal impairment, this drug should be taken every other day

 

Q33) The nurse is schedule to administer insulin lispro per sliding scale before meal. The serum blood glucose reading before lunch is 280 mg/Dl. Given the following sliding scale, how much Humalog insulin should be given before lunch? (select all that apply)

(a) If below 60, notify the provider

(b) If 60 - 124, no coverage

(c) If 125 - 150 give two unit

(d) If 151 -200, give four unit

(e) If 201 -250, give six unit

(f) If 251 -300, give eight unit

(g) If over 300 notify the provider

 

Q34) A client with type one diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned?

(a) Propranolol increases insulin requirements because of receptors blocking

(b) The beta-blocker can mask the symptoms of hypoglycemia – correct answer

(c) The beta-blocker can cause insulin resistance

(d) Using the two agents together increases the risk of ketoacidosis

 

Q41) A client is taking oral itraconazole for a systemic fungal infection. The nurse reviews the medication record and notes that the client is also taking cimetidine for reflux disease which action should the nurse take?

(a) Administer the cimetidine one hour before the itraconazole

(b) Administer the cimetidine at least two hours after the itraconazole – correct answer but confirm

(c) Confer with the prescriber about a potentially hazardous interaction

(d) Don’t give the cimetidine to a client receiving itraconazole

 

 

Q39) What should a nurse advice a client on spironolactone regarding necessary self-care?

(a) Continue taking this medication even if you feel well

(b) Avoid salt substitutes – correct answer

(c) Add as many fruits and vegetables to your diet as possible

(d) Check your pulse before taking this medication

 

Q54) Which of these statements best describes the concept of half-life?

(a) It is the time it takes for half of the medication to be metabolized for elimination of the medication.

(b) It is the time it takes for half of the medicinal effect effects to be achieved

(c) It is the time it takes for half of the medication to be distributed to receptors

(d) The term refers to the shelf life of the drug

Q58) A client who has had abdominal surgery has been receiving morphine sulfate via client-controlled- analgesia. The nurse assesses the client and notes that the client’s pupils are constricted and the client is drowsy and lethargic. Th client’s heart rate is 84 beats/min, their respiratory rate is 10 beats per minute, and their blood pressure is 90/50 mm Hg. What is the nurse’s best action?

(a) Encourage the client to turn over and cough and take deep breaths

(b) Discuss possible oplate dependence with the client’s provider

(c) Note the effectiveness of the analgesia in the client’s chart

(d) Prepare to administer naloxone and provide ventilatory support

Q60) Which of these findings would cause the nurse to hold the administration of oral metoprolol

(a) Heart rate of 92 beats per minute

(b) Respiratory rate of 26 breath per minute

(c) Blood pressure of 92/44 mmHg

(d) Oxygen saturation level of 95% on room air

Q71) A client with chronic gout has been taking colchicine for several months and is admitted for acute gout pain. The prescriber plans to begin therapy with probenecid. What will the nurse do?

(a) Give the medication as ordered and observe the client for gastrointestinal side effect

(b) Request an order to lower the dose of the colchicine

(c) Restrict the client’s fluid intake to minimize the risk of renal injury

(d) Suggest delaying probenecid therapy until the acute episode has subsided

(e) Suggest delaying probenecid therapy until the acute episode has subsided

 

Q74) The nurse is caring for a client receiving intravenous acyclovir. To prevent nephrotoxicity. What is the nurse’s best action?

(a) Hydrate the client during the infusion and after the infusion

(b) Increase the client’s intake of foods rich in vitamin C.

(c) Monitor urinary output every 30 minute

(d) Provide a low-protein diet for one day

(e) Provide a low-protein diet for one day before and two days after the acyclovir infusion

 

Q76) A nurse is teaching a client who has taken glucocorticoids for over a year about glucocorticoid withdrawal. Which statement by the client indicates a need for further teaching?

(a) I should reduce the dose by half each day until I stop taking the drug – correct answer

(b) I will need to have cortisol levels monitored during the withdrawal process

(c) The withdrawal schedule may take several months

(d) If I have surgery, I may need to resume taking the drug.

 

Q79) A nurse is teaching a group of nursing students about administering medication to older adult clients. Which statement by a student indicate a need for further teaching?

(a) Alteration in hepatic function requires more frequent drug dosing – correct answer

(b) Changes in gastrointestinal function in older adult clients lead to lower serum drug levels

(c) Adverse drug reactions in older adult clients are related to altered renal function

(d) Nonadherence for medications among older adult clients is due to the cost of medications

 

Q85) A client who is pregnant has a history recurrent genital herpes virus. The client ask the nurse what will be done to suppress an outbreak when she is near term. What is the nurse’s best response?

(a) Antiviral medications are not safe during pregnancy

(b) Intravenous antiviral agents will be used if an outbreak occurs

(c) Oral acyclovir must be used to control outbreaks – correct answer

(d) Topical acyclovir must be used to control outbreaks

Q88) A nurse is preparing discharge teaching for a client who will be going home on warfarin. Which of these client statements indicate the need for further instruction?

(a) I should avoid alcohol and herbal remedies while I am taking warfarin

(b) I should be consistent with my intake of leafy greens because they reverse warfarin effects

(c) I should stop taking my warfarin if I get bruises or black stools –

(d) I should have my bleeding time checked when I am taking antibiotics

Q98) A client has had emergency surgery for a ruptured appendix. Before surgery, the client was taking dexamethasone for three years. Since the client was on this medication before surgery, the nurse would be most concerned about which complication in the recovery phase?

(a) Bradycardia

(b) Post-operative blood clots

(c) Pre-surgical dehydration

(d) Impaired wound healing

 

Q99) A male client tells the nurse he awakens once or twice each night to void and has difficulty starting his stream of urine. He describes these symptoms as “annoying”. The client’s provider examines him and notes that the prostate is moderately enlarge. The client is sexually active and tells the nurse that he does not want to take any medication that will interfere with sexual function. The nurse anticipates the provider will order which of the following?

(a) Doxazosin – correct answer

(b) Finasteride

(c) Silodosin

(d) A transurethral prostatectomy

 

Q14) The nurse working on

a high

-

acuity medical

-

surgical unit is prioritizing care for four clients who

were just admitted. Which client should the nurse assess FIRST?

 

(a)

 

The NPO client with a blood glucose level of

80 mg/Dl who just received 20 units of insulin

lispro

 

 

correct answer

 

(b)

 

The client with a pulse of 62 beats/min, about to receive digoxin

 

(c)

 

The client with a blood pressure of 136/92 mm Hg. Who complains of having a headache

 

(d)

 

The client with an allergy to penicillin who is receiving an infusion of

vancomycin

 

 

 

Q19) What should the nurse include in

 

a

client

’s

 

discharge teaching when going home with a

presc

ription for digoxin

-

0.125 mg by mouth once

daily?

 

 

Check the answer again.

 

(a)

 

Take the digoxin at bedtime

 

(b)

 

You must be able to check your pulse

 

(c)

 

Don’t take digoxin if your heart rate exceeds 90 beats per minute

 

(d)

 

Eat a diet high in bran fiber and calcium

 

 

 

Q23)

Which of these findings from a client taking steroids should the nurse report immediat

ely?

 

(a)

 

Temperature of 100.2 degrees Fahrenheit

 

correct answer

 

(b)

 

glucose 128 mg/dL

 

(c)

 

heart rate of 92 beats per minute

 

(d)

 

blood pressure of 144/68 mm Hg

 

 

Q29) A client will begin taking fexofenadine for hay fever. The nurse teaching this client will tell the

client which of the following

?

 

(a)

 

Fexofenadine should be taken with food to prevent gastrointestinal symptoms

 

(b)

 

The medication may be taken once or twice daily

 

 

(c)

 

Tolerance to sedation will occur in a few weeks

 

(d)

 

With renal impairment, this

drug should be taken every other day

 

 

Q14) The nurse working on a high-acuity medical-surgical unit is prioritizing care for four clients who

were just admitted. Which client should the nurse assess FIRST?

(a) The NPO client with a blood glucose level of 80 mg/Dl who just received 20 units of insulin

lispro – correct answer

(b) The client with a pulse of 62 beats/min, about to receive digoxin

(c) The client with a blood pressure of 136/92 mm Hg. Who complains of having a headache

(d) The client with an allergy to penicillin who is receiving an infusion of vancomycin

 

 

Q19) What should the nurse include in a client’s discharge teaching when going home with a

prescription for digoxin-0.125 mg by mouth once daily? Check the answer again.

(a) Take the digoxin at bedtime

(b) You must be able to check your pulse

(c) Don’t take digoxin if your heart rate exceeds 90 beats per minute

(d) Eat a diet high in bran fiber and calcium

 

Q23) Which of these findings from a client taking steroids should the nurse report immediately?

(a) Temperature of 100.2 degrees Fahrenheit – correct answer

(b) glucose 128 mg/dL

(c) heart rate of 92 beats per minute

(d) blood pressure of 144/68 mm Hg

 

Q29) A client will begin taking fexofenadine for hay fever. The nurse teaching this client will tell the

client which of the following?

(a) Fexofenadine should be taken with food to prevent gastrointestinal symptoms

(b) The medication may be taken once or twice daily

(c) Tolerance to sedation will occur in a few weeks

(d) With renal impairment, this drug should be taken every other day

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