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    Exam Review

    1. A nurse in a clinic is caring for a client.
      (Highlight — findings requiring follow-up are marked)

      A nurse in a clinic is caring for a client.

      Click to highlight the findings that require immediate follow-up as contraindications to the prescribed prescription. To deselect a finding click on the finding again.

      Body System

      Findings

      Vital Signs/General History
      • Temperature 36.4° C (97.6° F), oral
      • Heart rate 75/min
      • Respiratory rate 16/min
      • Blood pressure 100/74mm Hg
      • Oxygen saturation 99% on room air
      • Client is a vegetarian and takes a multivitamin daily
      • Client reports having three to four alcoholic beverages a couple times per week

      Integumentary
      • Skin color is consistent with genetic background. No rashes or lesions. The client varicose veins.

      Cardiovascular/ Respiratory
      • S1 S2 auscultated. No murmurs. All peripheral pulses 2+ Lung sounds clear bilaterally

      Gastrointestinal/Genitourinary
      • Abdomen soft, nontender. Normoactive bowel sounds in all 4 quadrants. Last bowel movement was 3 days ago. Voids four to five times a day. Urine is clear, yellow, and odourless. Last menstrual period was 3 months ago

      Neurologic/Musculoskeletal
      • Alert and oriented to person, place, and time. Client takes diazepam as needed for anxiety. Client has full range of motion and is able to maintain flexion against resistance in all four extremities
    2. A nurse in the emergency department is assisting in the care of a client.
      (Highlight — findings requiring follow-up are marked)

      A nurse in the emergency department is assisting in the care of a client.

      Click to highlight the findings that require immediate follow-up. To deselect a finding click on the finding again.

      Nurses Notes

      1630:

      Called to client's room by emergency call bell. Client is alert and oriented to person, place, and time. Client is short of breath, intercostal retractions visible. Wheezing auscultated throughout lung fields, Diffuse, raised rash present on trunk. Abdomen soft, nontender

      Vital Signs

      1630:

      Temperature 38.3°C (101°F)

      Heart rate 110/min

      Respiratory rate 30/min

      Blood pressure 90/55 mmHg

      Oxygen saturation 91% on room air

    3. A nurse is preparing to administer medications to a client through an enteral feeding tube. Which of the following interventions is appropriate?
      A)
      Add the medications to the enteral feeding bag.
      B)
      Check for gastric residual 15 min after administering the medications
      C)
      Keep the client's head elevated 15° while administering the medications.
      D)
      Flush the tube with 30 ml of water between each medication
    4. A nurse is collecting data from a client who reports nausea and has vomited clear emesis. Which of the following medications should the nurse administer?
      A)
      Mependine
      B)
      Diazepam
      C)
      Naloxone
      D)
      Promethazine
    Page 1 of 15

    Exam Review

    1. A nurse is caring for a client who has ulcerative colitis and is receiving sulfasalazine. Which of the following findings requires immediate intervention?
      A)
      Anorexia
      B)
      Arthralgia
      C)
      Nausea
      D)
      Wheezing
    2. A nurse in a clinic receives a telephone call from a client who has tuberculosis and was prescribed rifampin 3 days ago. The client reports, "My saliva and tears are red. What should I do?" Which of the following responses by the nurse is appropriate?
      A)
      "This is an expected adverse effect of the medication.”
      B)
      "Stop taking the medication. You are having an allergic reaction.
      C)
      "This condition will only last a couple of days."
      D)
      "Taking the medication with red meat will cause this adverse effect."
    3. A nurse is collecting data from a client before administering a hepatitis B immunization. The nurse should withhold the immunization if the client is allergic to which of the following substances?
      A)
      Baker's yeast
      B)
      Nuts
      C)
      Wheat
      D)
      Egg yolk
    4. A nurse is collecting data from a client who received diphenhydramine 1 hr ago after developing an allergic reaction to trimethoprim- sulfamethoxazole. Which of the following statements by the client should indicate to the nurse that the medication is effective?
      A)
      "My appetite is increased.”
      B)
      "I don't have a headache anymore."
      C)
      "My voice is no longer hoarse."
      D)
      "I am feeling more alert."
    Page 2 of 15

    Exam Review

    1. A nurse is collecting data from a client who has a new prescription for nitrofurantoin to treat a urinary tract infection. The nurse should monitor the client for which of the following adverse effects?
      A)
      Tinnitus
      B)
      Abdominal cramping
      C)
      Stevens-Johnson syndrome
      D)
      Insomnia
    2. A nurse in a provider's office is collecting data from a client who continues to have a migraine headache after taking sumatriptan orally 2 hr ago. Which of the following findings is the priority for the nurse to report?
      A)
      Tingling sensation
      B)
      Hypertension
      C)
      Dizziness
      D)
      Flushing
    3. A nurse is preparing to administer erythromycin PO to a client who has an infection. The nurse checks the client's medical record and notes that the client has a severe allergy to penicillin. Which of the following actions should the nurse take?
      A)
      Request a different medication from the provider
      B)
      Administer the medication to the client.
      C)
      Premedicate the client with diphenhydramine.
      D)
      Request a different route of administration from the provider.
    4. A nurse is caring for a client who is experiencing acute alcohol withdrawal. The nurse should anticipate administering which of the following medications to the client to facilitate the withdrawal process?
      A)
      Varenicline.
      B)
      Clonidine.
      C)
      Methadone.
      D)
      Diazepam.
    Page 3 of 15

    Exam Review

    1. A nurse is reinforcing teaching with a client who has angina and a new prescription of nitroglycerin sublingual. Which of the following statements by the client indicates an understanding of the teaching?
      A)
      "If my pain is not relieved in 20 minutes, I will take a second tablet."
      B)
      "I will keep my tablets on a shelf in the bathroom."
      C)
      "I should be sure to swallow the tablet whole."
      D)
      “If my mouth is dry, I will take a sip of water before I take the tablet.”
    2. A nurse is caring for a client who is receiving heparin therapy. If the client requires a reversal of the effects of heparin, which of the following medications should the nurse expect the provider to prescribe?
      A)
      Atropine
      B)
      Vitamin K
      C)
      Vitamin B12
      D)
      Protamine
    3. A nurse is collecting a medication history from the parent of a preschooler who comes to the clinic for routine immunizations. For which of the following findings should the nurse withhold the varicella immunization?
      A)
      An allergy to eggs.
      B)
      Receiving treatment for leukemia.
      C)
      A pregnant parent.
      D)
      Taking acetaminophen for mild discomfort.
    4. A nurse is reinforcing teaching about fluticasone topical lotion with the parent of a 9-month-old infant who has atopic dermatitis on the wrist. Which of the following instructions should the nurse include?
      A)
      "Place a thick layer of the medication on open areas.”
      B)
      “Rub the medication until it disappears.”
      C)
      "Cover the area with an occlusive dressing.”
      D)
      "Apply the medication to your infant's entire arm.”
    Page 4 of 15

    Exam Review

    1. A nurse is preparing to administer phenobarbital 3 mg/kg/day PO in two divided doses to a client who weighs 145 lb. The amount available is phenobarbital 100 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
    2. A nurse is caring for a client who has Graves' disease and is to start therapy with propylthiouracil. The nurse should expect which of the following outcomes?
      A)
      Increased blood pressure.
      B)
      Decreased WBC count.
      C)
      Increased Hct.
      D)
      Decreased heart rate.
    3. . A nurse is caring for a client who is taking alendronate to treat osteoporosis. The nurse should monitor for which of the following adverse effects?
      A)
      Drowsiness
      B)
      Dyskinesia
      C)
      Musculoskeletal pain
      D)
      Weight gain
    4. A nurse is reinforcing teaching with a client who has schizophrenia and a new prescription for haloperidol. The nurse should instruct the client to avoid taking which of the following medications?
      A)
      Diphenhydramine
      B)
      Docusate sodium
      C)
      Ibuprofen
      D)
      Glucosamine
    Page 5 of 15

    Exam Review

    1. A nurse is administering phenytoin to a client. The nurse should monitor for which of the following adverse effects?
      A)
      Tinnitus
      B)
      Bleeding gums
      C)
      Jaundice
      D)
      Deep vein thrombosis
    2. A nurse is reinforcing teaching with a client who has COPD and has been taking long-term high doses of prednisone. Which of the following instructions should the nurse include in the teaching?
      A)
      Limit potassium-containing foods in your diet.
      B)
      Withhold prednisone for 48 hours prior to receiving contrast dye.
      C)
      Take prednisone on an empty stomach.
      D)
      Measure your blood glucose levels periodically.
    3. A nurse is caring for a client who is receiving filgrastim. The nurse should monitor the client for which of the following adverse effects?
      A)
      Hypertension
      B)
      Fluid retention
      C)
      Bone pain
      D)
      Hypokalemia
    4. A nurse is collecting data from a client who has gout and is taking allopurinol. Which of the following adverse effects should the nurse identify as the priority to report to the provider?
      A)
      Rash
      B)
      Diarrhea
      C)
      Nausea
      D)
      Metallic taste in mouth
    Page 6 of 15