Exam Review

A client with open-angle glaucoma is using pilocarpine ophthalmic solution, a miotic agent. Which action should the nurse at the eye clinic include in evaluating the effectiveness of the medication?
A)
Check amount of drainage from each eye.
B)
Use Snellen chart to assess visual acuity.
C)
Review eye pressure measurements.
D)
Palpate eyelids for decreased swelling.
Exhibits The nurse is discussing the client's pain management with a student nurse. Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided. Morphine is a(n) ▾ pure opioid agonistand it activates ▾ Mureceptors and is used to relieve▾ Acute postoperative pain.
Dropdown 1:
Option 1: Non opioid analgesic
Option 2: Partial opioid agonist
Option 3: pure opioid agonist
Dropdown 2:
Option 1: Mu
Option 2: Dopamine
Option 3: muscarinic
Dropdown 3:
Option 1: Chronic neuropathic pain
Option 2: Mild inflammatory pain
Option 3: Acute postoperative pain
Exhibits Which actions should the nurse take to assure safety during morphine administration? Select all that apply.
(SATA)
A)
Ask the client about other medications she takes.
B)
Suction the client to clear the airway.
C)
Take an initial respiratory rate.
D)
Have a manual resuscitation bag at the bedside.
E)
Perform a 12-lead electrocardiogram.
F)
Restrain the client with soft restraints.
Exhibits Which other medications would the nurse expect the surgeon to prescribe along with morphine? Select all that apply.
(SATA)
A)
Naloxone
B)
Propofol
C)
Ibuprofen
D)
Docusate sodium
E)
Senna
F)
Methadone

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Exam Review

Exhibits The charge nurse places a fall precautions sign on the client's door. Which side effects of morphine could contribute to this client's fall risk? Select all that apply
(SATA)
A)
Orthostatic hypotension
B)
Sedation
C)
Seizures
D)
itching
E)
Nausea
F)
Urinary retention
G)
Euphoria
Exhibits Which should the nurse do immediately? Select all that apply.
(SATA)
A)
Provide rescue breaths with a manual ventilation bag
B)
Print an electrocardiogram strip
C)
Call for rapid response
D)
Give naloxone 2 mg intravenous push
E)
Perform chest compressions
F)
Apply oxygen via nasal cannula

Exhibits For each statement, click to indicate whether the statements by the student nurse indicate understanding or no understanding of naloxone. Each row must have one option selected.

	Understanding	No Understanding
"When given IV, naloxone starts working immediately and can last several hours."		✓
"If the first dose does not work, you can give as many doses as needed to reverse respiratory depression."	✓
"Naloxone will not affect the client's level of pain."		✓
"You can give naloxone intravenously, intramuscularly, or subcutaneously."	✓
"Naloxone works best on pure agonist opioids."	✓

A client receives a new prescription for somatropin. Which information provided by the client indicates a need for further education by the nurse?
A)
Administer the medication subcutaneously.
B)
Rotate injection sites to minimize discomfort.
C)
Discard the medication if the solution is cloudy.
D)
Store unused vials at room temperature.

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Exam Review

A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mm Hg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?
A)
Obtain another transdermal patch and position it on the client's left upper chest.
B)
Withhold further doses of nitroglycerin until contacting the healthcare provider.
C)
Reassure the client that the patch will begin to take effect within a few minutes.
D)
Leave the patch in place and administer a PRN dose of sublingual nitroglycerin.
The nurse is preparing to administer alendronate to a client with osteoporosis. Which laboratory value indicates that the nurse should withhold the medication and contact the healthcare provider? Reference Range: Total Calcium 19 to 10.5 mg/dL (2.3 to 2.6 mmol/L)] Sodium [136 to 145 mEq/L (136 to 145 mmol/L)] Potassium [3.5 to 5 mEq/L (3.5 to 5 mmol/L)] Magnesium [1.3 to 2.1 mEq/L (0.65 to 1.05 mmol/L)]
A)
Magnesium 2.4 mEq/L (2.4 mmol/L).
B)
Sodium 132 mEq/L (132 mmol/L).
C)
Calcium 13.0 mg/dL (3.3 mmol/L).
D)
Potassium 5.2 mEq/L (5.2 mmol/L).
A client receives a new prescription for levothyroxine. Which statement made by the client indicates to the nurse that education was effective?
A)
Administer levothyroxine at bed time.
B)
Take medication on an empty stomach.
C)
Avoid the use of iron supplements.
D)
Consume foods that are high in iodine.
A client has a prescription for clopidogrel bisulfate 75 mg by mouth daily at 0900. In which situation should the nurse hold this medication?
A)
The client's platelet level is high.
B)
Breakfast has not been eaten.
C)
Elective surgery is scheduled in two hours.
D)
An abdominal sonogram is scheduled.

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Exam Review

A client with symptoms of influenza that started the previous day, asks the clinic nurse about taking oseltamivir to treat the infection. Which response should the nurse provide?
A)
Refer the client to the healthcare provider at the clinic to obtain a medication prescription.
B)
Explain to the client that antibiotics are not useful in treating viral infections such as influenza.
C)
Instruct the client that over-the-counter medications are sufficient to manage influenza symptoms.
D)
Advise the client that once symptoms occur it is too late to receive an influenza vaccination.
Which assessment finding indicates to the nurse that the prescription bethanechol is effective for a client diagnosed with urinary retention?
A)
Absence of xerostomia.
B)
No terminal urinary dribbling.
C)
Denies stress incontinence.
D)
Urinary output equals intake.
The nurse is caring for a client with type 2 diabetes mellitus who is taking liraglutide. Which problem(s) in the client's history may increase the risk for development of pancreatitis? Select all that apply.
A)
Chronic alcohol use.
B)
Pancreatitis.
C)
High triglyceride levels.
D)
Moderate daily alcohol use.
E)
Gallstones.
The nurse mixes diphenhydramine 25 mg in a 100 mL bag of normal saline, which is to be administered over 30 minutes. The IV pump should be set to administer how many mL/hour? (Enter numeric value only.)

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Exam Review

A young male athlete tells the nurse that he is concerned because his testicles seem to be shrinking. Which question is most important for the nurse to ask this client?
A)
Do you use any type of herbal supplements?
B)
How many hours a day do you spend exercising?
C)
Are you taking any type of anabolic steroids?
D)
Do you perform regular testicular self examinations?
The nurse is teaching a client with type 1 diabetes mellitus about the onset, peak, and duration of a new prescription for glargine insulin. If the insulin is self administered at 0800, when is the client most likely to experience hypoglycemia?
A)
No peak occurs.
B)
Shortly after midnight.
C)
Midmorning.
D)
Midafternoon.
A client with muscle spasticity receives a prescription for baclofen. Which information provided by the client requires additional instruction by the nurse?
A)
Take medication with meals.
B)
Use a stool softener as needed.
C)
Discontinue when spasms cease.
D)
Avoid the ingestion of alcohol.
The nurse is planning to administer sucralfate to a client with peptic ulcer disease. Which action should the nurse include in this client's plan of care?
A)
Give sucralfate on an empty stomach.
B)
Administer sucralfate once a day, preferably at bedtime.
C)
Assess for secondary Candida infection.
D)
Monitor for electrolyte imbalance.

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Exam Review

Exhibits Which 2 drugs would be the most appropriate to give the client now?
A)
Albuterol via nebulizer
B)
Racemic epinephrine via nebulizer
C)
Budesonide via metered dose inhaler
D)
Fexofenadine orally
E)
Levalbuterol inhaler
F)
Salmeterol via nebulizer
Exhibits Review history, nurses notes, and prescriptions. Choose the most likely options for the information missing from the statement by selecting from the lists of options provided. Albuterol is a dropdownthat decreasesdropdown.
Exhibits Review history, nurses' notes, and prescriptions. Which other medications might be helpful for this client in his management of asthma? Select all that apply.
A)
Angiotensin-converting enzyme (ACE) inhibitor
B)
Loop diuretic
C)
Glucocorticoids
D)
Long acting beta agonists
E)
Biologics
F)
Antiproliferative agents
Exhibits The nurse prepares the client for discharge and educates him on his new prescription. Which possible side effects of fluticasone should the nurse advise the client about? Select all that apply.
A)
Hyperglycemia
B)
Oral candidiasis
C)
Hyperkalemia
D)
Dry mouth
E)
Dehydration
F)
Hypoxia
G)
Adrenal suppression

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