Exam Review

A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the nurse implement?
A)
Measure the client's vital signs.
B)
Obtain a fingerstick blood glucose.
C)
Perform a neurological exam.
D)
Administer glucagon intramuscularly.
A client receives a new prescription for montelukast. Which information should the nurse include in the client's teaching?
A)
The medication will prophylactically limit the inflammatory response to allergens.
B)
The medication will contract the smooth muscles located in the respiratory tract.
C)
Montelukast will increase the production of mucus in the lungs.
D)
Montelukast will help repair damaged tissue in the base of the lungs.
Patient Data Exhibits Review history. Which 2 drugs would be the most appropriate to give the client now?
(SATA)
A)
Budesonide via metered dose inhaler
B)
Salmeterol via nebulizer
C)
Levalbuterol inhaler
D)
Fexofenadine orally
E)
Racemic epinephrine via nebulizer
F)
Albuterol via nebulizer
Patient Data 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 ▾ beta adrenergic agonist that decreases ▾ bronchospasm.
Dropdown 1:
Option 1: Cholinergic antagonist
Option 2: beta adrenergic agonist
Option 3: Beta adrenergic blocker
Dropdown 2:
Option 1: bronchospasm
Option 2: inflammation
Option 3: blood pressure

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Exam Review

Patient Data. Exhibits Review history, nurses' notes, and prescriptions.
(Highlight — findings requiring follow-up are marked)
Patient Data.

Exhibits

Review history, nurses' notes, and prescriptions.

Click to specify which aspects of the 0930 focused assessment indicate adverse reactions to albuterol.

0930

Albuterol given as prescribed via nebulizer. Following the treatment, decreased wheezes noted. The client's hands are trembling and is reporting a headache. Heart rate 129 beats/minute, respirations 20 breaths/minute, blood pressure 125/72 mm Hg, oxygen saturation 99% on room air.
Patient Data. 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.
(SATA)
A)
Glucocorticoids
B)
Angiotensin-converting enzyme (ACE) inhibitor
C)
Loop diuretic
D)
Long acting beta agonists
E)
Antiproliferative agents
F)
Biologics
Patient Data. Exhibits The nurse prepares the client for discharge and educates him on his new prescription. Which possible side effect(s) of fluticasone should the nurse advise the client about? Select all that apply.
(SATA)
A)
Dry mouth
B)
Dehydration
C)
Oral candidiasis
D)
Hyperglycemia
E)
Adrenal suppression
F)
Hyperkalemia
G)
Hypoxia

Patient Data. Exhibits Click to specify whether the client statements following asthma management education indicate understanding or no understanding. Each row must have one option selected.

	Understanding	No Understanding
“The inhaled fluticasone that I was prescribed carries just as much risk as an oral steroid."		✓
"I can decrease my risk of asthma attacks if 1 reduce my exposure to allergens in my home."	✓
"Even with asthma, I can maintain normal activity levels."	✓
"If this treatment plan does not work, there are other drugs and combinations of drugs that I can get from my doctor to manage my asthma."	✓
"I should keep track of my peak expiratory flow to see how well I am managing my asthma."	✓
"I should discontinue using albuterol after I fill my prescription for fluticasone.		✓

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Exam Review

The spouse of a client diagnosed with Parkinson's disease calls the clinic and tells the nurse the client is having involuntary jerky movements of the legs and arms and is confused. Which action should the clinic nurse implement first?
A)
Request that the client's spouse bring the client to the clinic as soon as possible.
B)
Advise the client's spouse to call an ambulance to take the client to the emergency department (ED)
C)
Ask the client's spouse to list all medications the client is currently taking
D)
Determine how long the client has been diagnosed with Parkinson's disease.
The nurse is preparing to administer the client's morning dose of digoxin. Which action should the nurse take prior to administering the digoxin?
A)
Verify that the urine output exceeds 30 mL per hour.
B)
Listen to the heart at the left 5th intercostal space.
C)
Obtain a left radial pulse rate for a full 30 seconds.
D)
Check the client for signs of orthostatic hypotension.
A client with chronic lower back pain has been taking ibuprofen PO twice a day for several months. Which assessment is most important for the nurse to complete?
A)
Evaluate ongoing sleep patterns.
B)
Palpate volume of pedal pulses.
C)
Determine presence of abdominal pain.
D)
Assess back pain using numeric scale.
A client with bipolar disorder is receiving valproic acid 1,000 mg PO at bedtime. Prior to administering the medication, the nurse notes that the client's morning valproic acid level was 142 mcg/ml (984.63 mcmol/L). Which action should the nurse implement? Reference Range: Valproic Acid [50 to 100 mcg/mL (350 to 700 mcmol/L)]
A)
Give the dose the following morning.
B)
Notify the healthcare provider.
C)
Determine time the specimen was collected.
D)
Review liver function test findings.

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Exam Review

The nurse administers acetylcysteine to a client with thick mucous and a nonproductive cough. To evaluate the effectiveness of the medication, which question should the nurse ask the client?
A)
"What color is the mucous?"
B)
"Are you experiencing any pain when you cough?"
C)
"How much phlegm are you coughing up?"
D)
"Are you still coughing?"
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)
Consume foods that are high in iodine.
D)
Avoid the use of iron supplements.
Patient Data. Exhibits Click to mark whether the assessment finding represents a therapeutic result of the minoxidil administered a, nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.
A)
Dizziness while sitting up
B)
Pain rated at 1 on a 0 to 10 scale
C)
Blood glucose 218 mg/dL (12.1 mmol/L)
D)
Urine output 600 mL
E)
Heart rate 99 beats/minute
F)
Mouth dryness
G)
Blood pressure 162/111 mm Hg
Which client's laboratory value should the nurse review prior to administering the initial dose of a statin medication?
A)
Serum electrolytes.
B)
Capillary blood glucose.
C)
Complete blood count.
D)
Serum liver enzymes.

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Exam Review

A client receives a prescription for IV famotidine. Which finding indicates to the nurse the medication is effective?
A)
Loss of 3 pounds (1.36 kg) in a month.
B)
Decreased in nighttime awakenings.
C)
Reduced epigastric pain.
D)
Positive stool antigen test.
A female client who started chemotherapy three days ago for breast cancer (BRCA) calls the clinic reporting that she is so upset she cannot sleep. The client has several PRN medications available. Which drug should the nurse instruct her to take?
A)
Ondansetron 8 mg PO three times a day PRN.
B)
Oxycodone, acetylsalicylic acid one tablet PO every 4 hours PRN.
C)
Lorazepam 2 mg PO bedtime.
D)
Acetaminophen, diphenhydramine 2 capsules bedtime.
The nurse is planning the home health care of a client who is receiving a mydriatic medication. Which environment is best for this client?
A)
A quiet, restful environment.
B)
Cool, humidified air.
C)
A warm room temperature.
D)
A dimly lit room.
A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?
A)
Nausea.
B)
Involuntary movements.
C)
Diarrhea.
D)
Unusual irritability.

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Exam Review

After months of receiving opioids for chronic pain, a male client is admitted with abdominal distension and pain, reporting that he has not had a bowel movement in two weeks. Which should the nurse do first?
A)
Provide fiber-rich dietary supplements.
B)
Assess for a fecal impaction.
C)
Encourage regular ambulation.
D)
Discuss taking less pain medication.
Which instruction should the nurse include in the teaching plan for a client who is taking the diuretic spironolactone?
A)
Avoid caffeine and smoking.
B)
Increase your consumption of bananas and oranges.
C)
Call the healthcare provider if you develop gynecomastia.
D)
Take the medication in the morning.
The nurse is preparing to administer diphenhydramine HCL, to a client with allergic rhinitis. Which desired effect describes the rationale for administering this medication?
A)
Histamine-1 antagonists cause the nasal mucosa to shrink.
B)
This classification of drugs decreases gastric acid production.
C)
These medications decrease upper airway inflammation.
D)
Antihistamines decrease nasopharyngeal secretions.
Which intervention is most important for the nurse to implement for a client with type 2 diabetes melitus (DM) who is receiving insulin lispro?
A)
Provide meals at the same time this insulin is given.
B)
Check blood glucose levels every six hours.
C)
Keep an oral liquid or glucose source available.
D)
Assess for hypoglycemia between meals.

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