Exam Review
- The nurse is planning to administer sucralfate to a client with peptic ulcer disease. Which action should the nurse indude in this patient's plan of care?A)Administer sucralfate once a day, preferably at bedtime.B)Monitor for electrolyte imbalance.C)Assess for secondary Candida infection.D)Give sucralfate on an empty stomach.
- A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?A)Phosphate.B)PH.C)Calcium.D)Potassium.
- During a home visit, a client informs the nurse about feeling like the heart is skipping beats. When reviewing the client's record, the nurse notes that the client is taking hydrochlorothiazide. Based on these assessment data, the nurse plans to obtain a blood sample to check for which condition?A)Hypokalemia.B)HyponatremiaC)Hyperphosphatemia.D)Hypermagnesemia.
- A client is receiving IV vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the medication. Which collection times provide the best determination of these levels?A)Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.B)One hour after completion of the IV dose and one hour before the next administration of the medication.C)Two hours after completion of the IV dose and two hours before the next administration of the medication.D)Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication.
Exam Review
- A client is using the nasal spray hormone calcitonin to reduce bone loss from osteoporosis. To reduce rhinitis associated with administration of the nasal spray, the nurse should provide the client with which instruction?A)Alternate the use of each nostril when administering the nasal spray each day.B)Do not lie down within thirty minutes of use of the nasal spray.C)Use an nonsteroidal anti-inflammatory drug (NSAID) PRN to reduce any inflammation that may occur.D)Take an over-the-counter antihistamine with each dally dose of nasal spray.
- Prior to administration of the initial dose of the gastrointestinal (GI) agent misoprostol, which information should the nurse obtain from the patient?A)Taking an antiemetic medication.B)Allergy to aspirin.C)Currently pregnant.D)History of glaucoma.
- The nurse is caring for a client who has a finger stick blood glucose level of 130 mg/dL (7.21 mmol/L) Prior to administering the scheduled dose of acarbose, the nurse is informed that morning meal trays will be 30 minutes late. Which action should the nurse take? Reference Range: Glucose [74 to 106 mg/dl. (4.1 to 5.9 mmol/L)]A)Administer the medicationB)Notify the healthcare provider.C)Hold the medication until the meal trays arrive.D)Obtain another finger tick blood glucose level.
- An older female client comes to the clinic for a regular check-up. The client tells the nurse that she has increased her daily doses of acetaminophen for the past month to control joint pain. Based on this patient's comment, which previous laboratory results should the nurse compare with today's laboratory report?A)Determine if there is a decrease in serum potassium due to renal compromiseB)Expect to find an increase in today's activated partial thromboplastin time (APTT) as compared to last quarter's due to bleeding.C)Look at last quarter's hemoglobin and hematocrit, expecting an increase today due to dehydration.D)Look for an increase in today's lactic dehydrogenase (LDH) compared to the previous one to assess for possible liver damage.
Exam Review
- A client receives a prescription for methotrexate. Which information provided by the client requires additional instruction by the nurse?A)Obtain a platelet count weekly.B)Take the medication during pregnancy.C)Use folic acid to protect the liver.D)Store the medication at room temperature.
- Rivastigmine, a cholinesterase inhibitor, is prescribed for a female client with early stage Alzheimer's Disease. The client's daughter tells the nurse that she plans to start administering the drug when her mother's symptoms are no longer manageable, in hopes that her mother will not have to go to a nursing home. How should the nurse respond?A)Affirm the decision to use the medication when the symptoms start to worsen.B)Assess the patient's current mental status before deciding to support the decision.C)Confirm that the daughter is aware of the progressive nature of the disease.D)Explain that the drug should be used early in the course of the disease process.
- 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)Leave the patch in place and administer a PRN dose of sublingual nitroglycerin.B)Reassure the client that the patch will begin to take effect within a few minutes.C)Withhold further doses of nitroglycerin until contacting the healthcare provider.D)Obtain another transdermal patch and position it on the patient's left upper chest.
- 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)Withhold the medication until the client's breakfast tray is available on the unit.B)Consult with a pharmacist about scheduling the dose one hour after the client eats.C)Instruct the client that it is necessary to take nothing but water with the medication.D)Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low fat milk.
Exam Review
- Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium.A)Restlessness.B)Decreased appetite.C)Intolerance to cold.D)Constipation.
- Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dl (3.5 mmol/l) Which action should the nurse implement? Reference Range: Calcium 8.5 to 10.5 mg/dL (2.25 to 2.75 mmol/L)A)Administer both prescribed medications as scheduled.B)Hold the calcium carbonate, but administer the calcitriol as scheduled.C)Hold the calcitriol, but administer the calcium carbonate as scheduled.D)Hold both medications until contacting the healthcare provider.
- A male client tells the home health nurse that he has started taking magnesium hydroxide and aluminum hydroxide to treat occasional heartburn. It is most important for the nurse to review the client's medical history regarding the presence of which disorder?A)Diabetes mellitus.B)Deep vein thrombosis.C)Renal disease.D)Chronic bronchitis.
- A patient with open-angle glaucoma asks the nurse how long the prescribed eye drops will need to be used. Which response made by the nurse is accurate?A)Until a smaller angle can be restored.B)For long-term control of normal eye pressure.C)For long-term control of pain and swelling.D)Until the excess pressure is reduced.
Exam Review
- An older adult client with pernicious anemia has been receiving daily injections of cyanocobalamin for two weeks and reports that the injections are painful. The nurse notes that the client's hematocrit is 43% (0.43 volume fraction). Which action should the nurse implement? Reference Range: Hematocrit (Hct) [37% to 47% (0.37 to 0.47 volume fraction)]A)Instruct the client that since the hematocrit remains low, the daily injections are still necessary.B)Notify the healthcare provider of the patient's hematocrit level so the frequency of injections can be reduced.C)Advise the client that the medication is having the desired effect, but daily injections will continue to be needed for life for this chronic condition.D)Offer to instruct the client in self-administration techniques to improve the client's sense of control over the painful daily injections.
- The nurse is preparing to administer warfarin sodium 10 mg PO to a client whose international normalized ratio (INR) is 5.0. Which intervention should the nurse implement? Reference Range: International 1 normalized ratio (INR) [INR: 0.8 to 1.1]A)Administer the scheduled dose.B)Discontinue the warfarin schedule.C)Withhold warfarin for 24 hoursD)Obtain another INR analysis immediately.
- A male client reports to the nurse that he is experiencing gastrointestinal (GI) distress from a high dose of a corticosteroid and is planning to stop taking the medication. In response to the client's statement, which nursing action is most important for the nurse to Implement?A)Assess the client for other indications of adverse effects of corticosteroid use.B)Advise the client that the medication should be stopped gradually rather than abruptly.C)Encourage the client to take the medication with food to decrease Gl distress.D)Review the client's dosing schedule to ensure he is taking the prescribed amount.
- A client is receiving morphine sulfate via a patient-controlled analgesia (PCA) pump postoperatively. Which assessment finding should prompt the nurse to administer a prescribed PRN dose of naloxone?A)Expresses that they cannot get enough air to breathe.B)Respiratory rate of 7 breaths/minute.C)Intercostal retractions and bilateral wheezing on auscultation.D)Pulse oximeter reading of 89% on room air.
Exam Review
- A patient with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in the patient's plan of care?A)Limit the intake of foods high in potassium.B)Cover your skin before going outside.C)Replace salt with a salt substitute.D)Monitor skin for excessive bruising.
- A male client with dementia is admitted to the emergency department (ED) because he accidentally self-administered several doses of diltiazem. Which intervention is most important for the nurse to implement?A)Frequently assess the patient's blood pressure.B)Observe the client for signs of gastric irritation.C)Monitor electrocardiogram (ECG) continuously.D)Assess for changes in level of consciousness.
- The nurse is administering the sixth IV dose of gentamicin to a client with extensive full thickness burns. Which assessment finding warrants further intervention? Reference Range: White Blood Cell [5000 to 10,000/mm3 (5 to 10 x 10 %/L)] Blood Urea Nitrogen [10 to 20 mg/dL (3.6 to 7.1 mmol/L)] Creatinine [0.5 to 1.1 mg/dL (44 to 97 µmol/L)]A)Serum creatinine level of 1.6 mg/l. (141 µmol), a blood urea nitrogen (BUN) of 20 mg/dL.(7.1 mmol/L)B)Reports a sore mouth and three episodes of diarrhea that began this morning.C)White blood count of 9,000/mm3 (9 x 109/L) and an oral temperature of 98.2° F (36.7° C) two hours ago.D)Urinary output of 400 ml of clear, amber colored urine in the past eight hours.
- A client who is a vegetarian has a new prescription for warfarin. The client reports eating leafy green vegetables every day. How should the nurse respond?A)Advise the client that the healthcare provider needs to be made aware of the current diet.B)Suggest that the client replace the leafy vegetables with a protein source such as nuts or beans.C)Confirm that the clients diet choices will help the medication be more effective in preventing blood clots.D)Commend the patient for a healthy lifestyle and encourage the client to continue current diet habits.