Exam Review
- A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? Reference Range: Hemoglobin (Hgb) [14 to 18 g/dL (8.7 to 11.2 mmol/L)]A)Takes concurrent iron therapy without adverse effects.B)Reports of increased energy levels and decreased fatigue.C)Hemoglobin level increased to 12 g/dl. (7.45 mmol/L).D)Food diary shows increased consumption of iron-rich foods.
- To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers?A)When using the discus, have the client breathe out rapidly into the mouthpiece.B)Offer the discus to the client for use during an acute asthma attack.C)Clients using the discus may experience decreased blood pressure.D)Explain that the client should not use the discus more than twice daily.
- The nurse administers naloxone to a client with opioid-induced respiratory depression. One hour later, nursing assessment reveals that the client has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unable to be aroused. Which action should the nurse implement?A)Initiate cardiopulmonary resuscitation (CPR).B)Prepare to assist with chest tube insertion.C)Determine Glasgow Coma Scale score.D)Administer a second dose of naloxone.
- The nurse is caring for a client receiving a prescription for sucralfate to treat a peptic ulcer. Which instruction should the nurse provide during discharge education?A)Continue with normal dose schedule after missing a dose.B)Administer an additional dose if a dose is missed.C)Take on an empty stomach at least 1 hour before meals.D)Schedule doses with each meal and at bedtime.
Exam Review
- A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history, the nurse determines that the client has been self-administering St. John's Wort, an herbal preparation, on the advice of a friend. Which information is most significant about this finding?A)Adding the herb can decrease the need for corticosteroids.B)The client probably used this herb to treat depression.C)Ingestion of St. John's Wort can reduce the client's intake of sodium.D)St. John's Wort can decrease plasma concentrations of cyclosporine.
- The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?A)Consult with a pharmacist about scheduling the dose one hour after the client eats.B)Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk.C)Withhold the medication until the client's breakfast tray is available on the unit.D)Instruct the client that it is necessary to take nothing but water with the medication.
- The nurse observes that a client has become lethargic 30 minutes after receiving an opioid injection for pain. Which vital sign should the nurse obtain first?A)Pulse rate.B)Blood pressure.C)Temperature.D)Respiratory rate.
- The nurse is administering sodium polystyrene sulfonate to a client in acute kidney injury (AKI). Which laboratory finding indicates that the medication has been effective? Reference Range: Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)] Hemoglobin [14 to 18 g/dL (140 to 180 g/L)] Potassium [3.5 to 5 mEq/L (3.5 to 5 mmol/L)] Ammonia [10 to 80 pg/dL (6 to 47 μmol/dL)]A)Serum ammonia level of 30 μg/dl. (17.62 μmol/dL).B)Hemoglobin level of 13.5 g/dL (135 g/L).C)Serum potassium level of 3.8 mEq/L (3.8 mmol/L).D)Serum glucose level of 120 mg/dL (6.7 mmol/L)
Exam Review
- A client with generalized anxiety disorder (GAD) receives a new prescription for lorazepam. Which statement provided by the client requires additional instruction by the nurse?A)Use relaxation techniques to reduce excessive anxiety.B)Avoid alcohol and other sedatives while taking the medication.C)Stop taking the medication if intended effect is not immediate.D)Move slowly from a sitting position to a standing position.
- A client is receiving orlistat as part of a weight management program. Which ongoing assessment should be included in the plan of care to determine the effectiveness of the medication?A)Body mass index (BMI).B)Dally calorie count.C)Depression screeningD)Serum protein levels.
- A client receives a prescription for penicillin 2 million units IM. The available vial is labeled, "600,000 units/2 mL." How many mL should the nurse administer? (Enter numeric value only.)
- A client has a new prescription for diclofenac, a nonsteroidal antiinflammatory drug (NSAID). Which information in the client's history is of greatest concern to the nurse in monitoring the client's response to this medication?A)Osteoarthritis.B)Chronic alcoholism.C)Type 2 diabetes mellitus.D)Migraine headaches.
Exam Review
- A client with a fungal infection of the toenail reports to the nurse that the client has been applying an over-the-counter (OTC) triple antibiotic ointment to the infection daily for two weeks without any improvement. Which action should the nurse take?A)Instruct the client to obtain a prescription for oral terbinafine.B)Advise the client to obtain a prescription-strength formulation of the ointment.C)Reassure the client that treatment of fungus infected toenails often takes several months.D)Suggest that the client use the ointment twice a day to be more effective.
- The nurse is caring for a client who takes methotrexate for rheumatoid arthritis and receives a prescription for adalimumab. Which instructions should the nurse provide the client?A)Have a chest x-ray prior to your first dose.B)Obtain routine vaccinations as scheduled.C)Undergo annual eye examinations.D)Avoid crowds and people who are sick.
- The healthcare provider prescribes propylthiouracil (PTU) and Lugol's solution, a strong iodine solution, for a client with hyperthyroidism. How should the nurse schedule the administration of these medications?A)Give parental dose once every 24 hours.B)Offer both drugs together with a meal.C)Schedule both medications at bedtime.D)Administer Iodine one hour before PTU.
- A client who is taking furosemide reports experiencing leg cramps, a cough, feeling tired, and palpitations. Which action should the nurse take first?A)Place on cardiac monitoringB)Monitor intake and output.C)Apply warm compresses to legs.D)Raise the head of the bed.
Exam Review
- The home health nurse observes that a female client is using a topical preparation that contains echinacea to treat a canker sore. Her husband expresses concern regarding the effectiveness and safety of using herbs. How should the nurse respond?A)Topical echinacea is usually used to soothe burns and can cause damage to the skin.B)This product is essentially harmless but also is not very beneficial in treating skin infections.C)Echinacea seems to be useful in the treatment of some infections, such as canker sores.D)Many of the herbal preparations are helpful primarily because of their placebo effect.
- A client who is newly diagnosed with diabetes insipidus (DI) is receiving a synthetic vasopressin intravenously. Which side effect of vasopressin reported by the client should the nurse report to the healthcare provider?A)Polyuria.B)Low urine specific gravity.C)Polydipsia.D)Worsening headache.
- A client receives a prescription for allopurinol. Which information provided by the client requires additional instruction by the nurse?A)Double the dose if a dose is missed.B)Reduce caffeine and alcohol intake.C)Avoid taking on an empty stomach.D)Consume 2 liters of water daily.
- A client has a prescription for heparin 1,000 units IV STAT. Several pre-filled syringes of low molecular weight heparin are available in the client's medication drawer. Which action should the nurse implement?A)Advise the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately.B)Request a prescription to change the route of administration and use the available heparin.C)Calculate and administer the equivalent dose of the available low molecular weight heparin.D)Dilute the available heparin in 250 mL of normal saline solution prior to IV administration.
Exam Review
- Which action should the nurse implement to assess the effectiveness of amlodipine?A)Measure the client's blood pressure.B)Note the client's serum calcium levels.C)Monitor the client's serum electrolytes.D)Review the client's intake and output.
- A client with nasal congestion receives a prescription for phenylephrine 10 mg PO every 4 hours. Which client condition should the nurse report to the healthcare provider before administering the medication?A)Hypertension.B)Bronchitis.C)Edema.D)Diarrhea.
- Which intervention is most important for the nurse to implement for a client with type 2 diabetes mellitus (DM) who is receiving insulin lispro?A)Check blood glucose levels every six hours.B)Assess for hypoglycemia between meals.C)Provide meals at the same time this insulin is given.D)Keep an oral liquid or glucose source available.
- A female client starts a new prescription, oxybutynin, for symptoms of an overactive bladder. The client tells the nurse that she is training to run in a half-marathon. Which Instruction should the nurse emphasize?A)Wear padding to protect from bruising if a fall occurs.B)Avoid crowds to help prevent acquiring infections.C)Keep skin and eyes covered to protect from sun injury.D)Take measures to avoid dehydration and over-heating.