BIOLOGY NUR2221 MODULE 8 - Pharmacology and Intravenous Therapies Exam | Download To Score An A

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MODULE 8 - Pharmacology and Intravenous Therapies Submission Details • Submission Date: 5/2/2021 • Submission Time: 10:03 PM • Points Awarded: 9405 • Points Missed: 396 • Number of Att... empts Allowed: 5 • Not Scored: 0 • Percentage: 95.96% • 1.ID: 21553033078 A client is receiving total parenteral nutrition (TPN) with fat emulsion (lipids) piggybacked to the TPN solution. For which signs of an adverse reaction to the fat emulsion should the nurse monitor the client? Select all that apply. A. Chest and back pain Correct B. Nausea and vomiting Correct C. Chills Correct D. Headache Correct E. Pallor F. Subnormal temperature Awarded 99.0 points out of 99.0 possible points. 2. ID: 21553033022 A nurse has just hung a transfusion of packed red blood cells and stayed with the client for the appropriate amount of time. Before leaving the room, the nurse tells the client that it is most important to immediately report which specific signs if it occurs? Select all that apply. A. Fatigue B. Tiredness C. Rash Correct D. Chills Correct E. Backache Correct Rationale: The nurse should instruct the client to report signs of a transfusion reaction, such as a backache, chills, itching, or rash, immediately. If a transfusion reaction occurs, the nurse would stop the transfusion immediately. Fatigue and tiredness are not specifically related to a transfusion reaction. Test-Taking Strategy: Note the strategic words “most important” and “immediately.” Eliminate the comparable or alike options (fatigue and tiredness). Review: the signs of a transfusion reaction Level of Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Nursing Process/Implementation Content Area: Blood Administration Giddens Concepts: Immunity, Perfusion HESI Concepts: Immunity, Perfusion Reference: Perry, A., Potter, P., & Ostendorf, W. (2014). Clinical nursing skills & techniques (8th ed., p. 749). St. Louis: Mosby. Awarded 99.0 points out of 99.0 possible points. 3. ID: 21553032642 Disulfiram is prescribed for a client. Which questions does the nurse make a priority of asking the client before administering this medication? Select all that apply. A. “Do you have a history of thyroid problems?” Correct B. “Do you have a history of cancer in your family?” C. “Do you have a history of diabetes insipidus?” D. “When was your last drink of alcohol?” Correct E. “When did you have your last full meal?” Awarded 99.0 points out of 99.0 possible points. 4. ID: 21553033015 A client who needs to receive a blood transfusion has experienced a pruritic rash during previous transfusions. The client asks the nurse whether it is safe to receive the transfusion. Which medication does the nurse anticipate will most likely be prescribed before the transfusion? A. Acetaminophen B. Diphenhydramine Correct C. Ibuprofen D. Acetylsalicylic acid Awarded 99.0 points out of 99.0 possible points. 5. ID: 21553033533 Zidovudine is prescribed for an adult client with HIV infection. The nurse should provide which instruction to the client about the medication? A. That the medication must be taken with milk B. That aspirin can be taken to treat headache C. To discontinue the medication if nausea occurs D. To space the doses evenly around the clock Correct Awarded 99.0 points out of 99.0 possible points. 6. ID: 21553033518 A client with a thoracic spinal cord injury is receiving dantrolene sodium. Which statement by the client indicates to the nurse that the client is experiencing an adverse effect of the medication? A. “I’m feeling really drowsy.” Correct B. “I urinate about the same amount as I always did.” C. “My legs are very relaxed.” D. “I can’t seem to get enough to eat.” Rationale: Drowsiness, diarrhea, and hepatotoxicity are the adverse effects of this muscle relaxant, which is used to treat the chronic spasticity seen with spinal cord injury. The drowsiness may interfere with the client’s rehabilitation. Relaxed legs are a desired effect. Some clients experience anorexia and urinary frequency. Test-Taking Strategy: Focus on the subject, an adverse effect of a medication. Relaxed legs are a desired effect, so eliminate this option. To select from the remaining options, recall that this medication is a muscle relaxant. This will direct you to the correct option. Review: the adverse effects of dantrolene sodium Level of Cognitive Ability: Evaluating Client Needs: Physiological Integrity Integrated Process: Nursing Process/Evaluation Content Area: Pharmacology Giddens Concepts: Clinical Judgment, Intracranial Regulation HESI Concepts: Clinical Decision Making-Clinical Judgment-Critical Thinking, Intracranial Regulation Reference: Rosenjack Burchum, Rosenthal (2016) p. 244 Awarded 99.0 points out of 99.0 possible points. 7. ID: 21553033578 A home care nurse has been assigned a client who has been discharged home with a prescription for total parenteral nutrition (TPN). Which parameters does the nurse plan to check at each visit as a means of identifying complications of the TPN therapy? Select all that apply. A. Weight Correct B. Glucose test Correct C. Temperature Correct D. Peripheral pulses E. Hemoglobin and hematocrit Awarded 99.0 points out of 99.0 possible points. 8. ID: 21553032611 Phenelzine sulfate is being administered to a client with depression. The client suddenly complains of a severe frontally radiating occipital headache, neck stiffness and soreness, and vomiting. On further assessment, the client exhibits signs of hypertensive crisis. Which medication should the nurse prepare to administer, anticipating that it will be prescribed as the antidote to treat phenelzine-induced hypertensive crisis? A. Protamine sulfate B. Phentolamine Correct C. Acetylcysteine D. Calcium gluconate Awarded 99.0 points out of 99.0 possible points. 9. ID: 21553033010 The health care provider prescribes 1000 mL of 5% dextrose in water to be infused over 8 hours. The drop factor is 15 gtt/mL. At how many drops per minute does the nurse set the flow rate? (Round to the nearest whole number). Correct Correct Responses 1. 31 .//assessment[9]/question[62]/question_correct_feedback/text() Awarded 99.0 points out of 99.0 possible points. 10. ID: 21553033097 The first bag of total parenteral nutrition (TPN) solution has arrived on the clinical unit for a client beginning this nutritional therapy. The solution is to be infused by way of a central line. Which essential piece of equipment should the nurse obtain before hanging the solution? A. Electronic infusion device Correct B. Pulse oximeter C. Noninvasive blood pressure monitor D. Blood glucose meter Rationale: The nurse obtains an electronic infusion device before hanging a TPN solution. Because of the high glucose load, it is necessary to use an infusion device to ensure that the solution does not infuse too rapidly or fall too far behind. Because the client’s blood glucose is checked every 6 to 8 hours during administration of PN, a blood glucose meter will also be needed, but it is not essential before the solution is hung. A noninvasive blood pressure cuff is unnecessary for this procedure. Although oxygen saturation is important, in this situation, it is not the most important equipment to use at this time. Test-Taking Strategy: Note the strategic word “essential” and note the words “before hanging.” This tells you that the correct option identifies the item that is needed to start the infusion. Use your knowledge of the procedures for TPN administration to eliminate each of the incorrect options. Review: the procedures for initiating a TPN infusion Level of Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Total Parenteral Nutrition Giddens Concepts: Fluids and Electrolytes, Safety HESI Concepts: Fluid & Electrolyte, Safety Reference: Perry, A., Potter, P., & Ostendorf, W. (2014). Clinical nursing skills & techniques (8th ed., p. 805). St. Louis: Mosby. Awarded 99.0 points out of 99.0 possible points. 11. ID: 21553033530 A nurse is to administer a dose of digoxin to a client with atrial fibrillation and notes that the client has a potassium level of 4.6 mEq/L (4.6 mmol/L). The nurse determines which about the administration of the dose? A. Should be withheld and the health care provider notified B. Should be preceded with a dose of potassium C. Should be administered as prescribed Correct D. Should be withheld that day Awarded 99.0 points out of 99.0 possible points. 12. ID: 21553033557 A nurse is providing instruction to a client who is taking codeine sulfate for severe back pain. Which instruction should the nurse provide to the client? A. Maintain a high-fiber diet Correct B. Avoid all exercise to help prevent lightheadedness C. Avoid the use of stool softeners to help prevent diarrhea D. Decrease fluid intake Awarded 99.0 points out of 99.0 possible points. 13.ID: 21553033000 The health care provider’s prescription for an adult client reads, “Potassium chloride 15 mEq by mouth.” The label on the medication bottle reads, “20 mEq potassium chloride/15 mL.” How many milliliters of KCl does the nurse prepare to ensure administration of the correct dose of medication? (Round to the nearest whole number.) Correct Responses 1. 11 .//assessment[9]/question[60]/question_correct_feedback/text() Awarded 99.0 points out of 99.0 possible points. 14. ID: 21553033051 A nurse notes that the site of a client’s peripheral IV catheter is reddened, warm, painful, and slightly edematous in the area of the insertion site. After taking appropriate steps to care for the client, the nurse documents in the medical record that the client has experienced which problem? A. Phlebitis of the vein Correct B. Hypersensitivity to the IV solution C. Infiltration of the IV line D. An allergic reaction to the IV catheter material Awarded 99.0 points out of 99.0 possible points. 15. ID: 21553033031 The health care provider prescribes 1000 mL of normal saline 0.45% for infusion over 8 hours. The drop factor is 10 gtt/mL. At how many drops per minute does the nurse set the flow rate? (Round to the nearest whole number). Incorrect Correct Responses 1. 21 Awarded 0.0 points out of 99.0 possible points. The health care provider prescribes 2000 mL of 5% dextrose and normal saline 0.45% for infusion over 24 hours. The drop factor is 15 gtt/mL. At how many drops per minute does the nurse set the flow rate? (Round to the nearest whole number). 21 Correct Correct Responses 1. 21 Awarded 99.0 points out of 99.0 possible points. 17. ID: 21553032679 A nurse is preparing a plan of care for a client with a diagnosis of cancer who is receiving morphine sulfate for pain. Which action does the nurse identify as a priority in the plan of care for this client? A. Monitoring urine output B. Monitoring the client’s respiratory rate Correct C. Encouraging increased fluids D. Monitoring the client’s temperature Awarded 99.0 points out of 99.0 possible points. 18. ID: 21553033094 A nurse is monitoring a client who is receiving total parenteral nutrition (TPN). Which signs and symptoms causes the nurse to suspect that the client is experiencing hyperglycemia as a complication? A. Nausea, thirst, and increased urine output Correct B. Nausea, vomiting, and oliguria C. Sweating, chills, and decreased urine output D. Pallor, weak pulse, and anuria Awarded 99.0 points out of 99.0 possible points. 19. ID: 21553033503 A nurse is caring for a group of adult clients on an acute care nursing unit. Which clients does the nurse recognize as the most likely candidates for total parenteral nutrition (TPN)? Select all that apply. A. A client with a severe exacerbation of ulcerative colitis Correct B. A client with severe sepsis Correct C. A client with pancreatitis Correct D. A client with renal calculi E. A client who has undergone repair of a hiatal hernia Awarded 99.0 points out of 99.0 possible points. 20. ID: 21553032636 Fluoxetine hydrochloride is prescribed for a client, and the nurse provides instruction regarding the use of the medication. The nurse tells the client that it is best to take the medication at what time? A. Midafternoon, with an antacid B. With the evening meal C. In the morning Correct D. At lunchtime Awarded 99.0 points out of 99.0 possible points. 21. ID: 21553033084 A client receiving total parenteral nutrition (TPN) requires fat emulsion (lipids), which will be piggybacked to the TPN solution. On obtaining a bottle of fat emulsion, the nurse notes that fat globules are floating at the top of the solution. Which action should the nurse take? A. Shake the bottle vigorously B. Run the bottle under warm water until the globules disappear C. Request a new bottle from the pharmacy Correct D. Rotate the bottle gently back and forth to mix the globules 22. ID: 21553033569 The serum theophylline level of a client who is taking the medication (Theo-24) is 16 mcg/mL. On the basis of this result, the nurse should take which action initially? A. Call the health care provider immediately B. Document the normal value on the chart Correct C. Call the pharmacy to alert the pharmacist regarding the client’s theophylline level D. Call the rapid response team to help with the emergency Awarded 99.0 points out of 99.0 possible points. 23. ID: 21553033575 Cyclophosphamide has been prescribed for a client with a diagnosis of breast cancer, and the nurse is providing instructions to the client. The nurse realizes the instructions have been effective if the client makes the statement she will change which aspect of care? A. To drink at least 2 glasses of orange juice every day B. To avoid salt while taking this medication C. To increase fluid intake to 2000 mL to 3000 mL/day Correct D. That it is best to take the medication with food Awarded 99.0 points out of 99.0 possible points. 24. ID: 21553033500 A client with a peripheral intravenous (IV) line in place has a new prescription for infusion of total parenteral nutrition (TPN), a solution containing 25% glucose. Which action should be taken by the nurse? A. Hanging the IV solution but setting the infusion at just half the prescribed rate B. Diluting the solution with sterile water to half-strength C. Hanging the IV solution as prescribed D. Questioning the health care provider about the prescription Correct Awarded 99.0 points out of 99.0 possible points. 25. ID: 21553032626 A client is receiving heparin sodium by way of continuous IV infusion. For which adverse effects of the therapy does the nurse assess the client? Select all that apply. A. Slowed pulse B. Bleeding from the gums Correct C. Tarry stools Correct D. Increased blood pressure E. Tinnitus Awarded 99.0 points out of 99.0 possible points. 26. ID: 21553033072 A nurse suspects that a client receiving total parenteral nutrition (TPN) through a central line has an air embolism. The nurse immediately places the client in which position? A. Left side with the head lower than the feet Correct B. Right side with the head lower than the feet C. Right side with the head higher than the feet D. Left side with the head higher than the feet Awarded 99.0 points out of 99.0 possible points. 27. ID: 21553032660 A client taking hydrochlorothiazide reports to the clinic for follow-up blood tests. For which side/adverse effect of the medication does the nurse monitor the client’s laboratory results? A. Hypokalemia Correct B. Hypernatremia C. Hypermagnesemia D. Hypocalcemia Awarded 99.0 points out of 99.0 possible points. 28. ID: 21553033560 A nurse is caring for a client with myasthenia gravis who is exhibiting signs of cholinergic crisis. Which medication does the nurse ensure is available to treat this crisis? A. Atropine sulfate Correct B. Acetylcysteine C. Pyridostigmine bromide D. Protamine sulfate Awarded 99.0 points out of 99.0 possible points 29. ID: 21553033512 A nurse is caring for a client who has been taking acetazolamide for glaucoma. Which, if documented in the assessment data, indicates to the nurse that the client may be experiencing an adverse effect of the medication? A. No change in peripheral vision B. Jaundice Correct C. Pupillary constriction in response to light D. Tinnitus Awarded 99.0 points out of 99.0 possible points. 30. ID: 21553033091 At 1600 the nurse checks a client’s total parenteral nutrition (TPN) infusion bag and notes that the solution is running at a rate of 100 mL/hr. The bag was hung the previous day at 1800. The nurse plans to change the infusion bag and tubing this evening at what time? A. 1800 Correct B. 1700 C. 2000 D. 2100 Awarded 99.0 points out of 99.0 possible points. 31. ID: 21553032623 A client has a prescription for short-term therapy with enoxaparin . The nurse explains to the client that this medication is being prescribed for which purpose? A. Prevent pain B. Relieve back spasms C. Reduce the risk of deep vein thrombosis Correct D. Increase the client’s energy level Awarded 99.0 points out of 99.0 possible points. 32. ID: 21553032682 A nurse is preparing a plan of care for a client who will be receiving meperidine hydrochloride. Which side/adverse effects does the nurse make a note of needing to be alert to in the plan of care? Select all that apply. A. Hypotension Correct B. Constipation Correct C. Respiratory depression Correct D. Bradycardia E. Urine retention Correct Awarded 99.0 points out of 99.0 possible points. 33. ID: 21553033066 A nurse answers a call bell and finds that the total parenteral nutrition (TPN) solution bag of an assigned client is empty. The new prescription was written for a new bag at the beginning of the shift, but it has not yet arrived from the pharmacy. Which action should the nurse take first? A. Call the pharmacy for further instructions B. Hang a solution of 5% dextrose in 0.9% sodium chloride C. Hang a solution of 10% dextrose in water Correct D. Call the health care provider Awarded 99.0 points out of 99.0 possible points. 34. ID: 21553033902 A nurse notes that the site of a client’s peripheral intravenous (IV) catheter is reddened, warm, painful, and slightly edematous near the insertion point of the catheter. On the basis of this assessment, the nurse should take which action first? A. Slow the rate of infusion B. Notify the health care provider C. Check for loose catheter connections D. Remove the IV catheter Correct Awarded 99.0 points out of 99.0 possible points. 35. ID: 21553033088 A nurse is changing the central line dressing of a client receiving total parenteral nutrition (TPN). The nurse notes moisture under the dressing covering the catheter insertion site. What should the nurse assess next? A. Tightness of the tubing connections Correct B. Time of the last dressing change C. Expiration date on the infusion bag D. Temperature Awarded 99.0 points out of 99.0 possible points. 36. ID: 21553032648 Methylergonovine intramuscularly is prescribed for a postpartum client. Before administering the medication, the nurse explains to the client that the medication will promote which effect? A. Decrease the strength of uterine contractions B. Maintain a normal blood pressure C. Prevent postpartum bleeding Correct D. Reduce lochial drainage Awarded 99.0 points out of 99.0 possible points. 37.ID: 21553032685 The health care provider’s prescription reads, “Phenytoin 0.1 g by mouth twice daily.” The medication label indicates that the bottle contains 100-mg capsules. How many capsules does the nurse prepare for administration of one dose? Correct Correct Responses 1. 1 .//assessment[9]/question[57]/question_correct_feedback/text() Awarded 99.0 points out of 99.0 possible points. 38. ID: 21553033025 Packed red blood cells have been prescribed for a client with low hemoglobin and hematocrit values. The nurse takes the client’s temperature orally before hanging the blood transfusion and notes that it is 100.0° F (37.7 C). What should the nurse do next? A. Call the health care provider Correct B. Begin the transfusion as prescribed C. Administer 2 tablets of acetaminophen and begin the transfusion D. Administer an antihistamine and begin the transfusion Awarded 99.0 points out of 99.0 possible points. 39. ID: 21553033081 A nurse is preparing a client for the insertion of a central intravenous line into the subclavian vein by the health care provider. The nurse gathers the equipment, places it at the bedside, and prepares to assist the health care provider with the procedure. As further preparation for the procedure, the nurse places the client in which position? A. In a slight Trendelenburg position Correct B. In the prone position C. Flat on the left side D. In the supine position Awarded 99.0 points out of 99.0 possible points. 40. ID: 21553033539 A nurse is providing dietary instructions to a client taking spironolactone. The nurse realizes the teaching has been effective if the client selects which food items from the menu? Select all that apply. A. Bananas Incorrect B. Citrus fruits Incorrect C. Cereal Correct D. Rice Correct E. Carrots Correct Awarded 0.0 points out of 99.0 possible points. 41. ID: 21553033551 A home health nurse provides instructions to a client who is taking allopurinol for the treatment of gout. The nurse realizes the instructions have been effective if the client verbalizes the importance of which teaching point? A. Take the medication on an empty stomach 2 hours before meals B. Use an over-the-counter (OTC) antihistamine lotion if a rash develops C. Drink at least 8 glasses of fluid every day Correct D. Place an ice pack on the lips if they swell Awarded 99.0 points out of 99.0 possible points. 42. ID: 21553033593 A client with heart failure is being given furosemide and digoxin. The client calls the nurse and complains of anorexia and nausea. Which action should the nurse take first? A. Administer an antiemetic B. Discontinue the morning dose of furosemide C. Check the result of laboratory testing for potassium on the sample drawn 3 hours ago Correct D. Administer the daily dose of digoxin Awarded 99.0 points out of 99.0 possible points. 43. ID: 21553032614 A nurse is reading the medical record of a client receiving haloperidol. The nurse notes that the health care provider has documented that the client is experiencing signs of akathisia. On the basis of the health care provider’s note, which clinical manifestation would the nurse expect to find during assessment of the client? A. Puffing of the cheeks B. Motor restlessness Correct C. Protrusion of the tongue D. Puckering of the mouth Awarded 99.0 points out of 99.0 possible points. 44. ID: 21553033506 Warfarin sodium has been prescribed, and the nurse teaches the client about the medication. Which statement by the client indicates that further teaching is necessary? A. “I’ll use an electric shaver until the doctor stops the Coumadin prescription.” B. “I won’t play football anymore.” C. “I won’t take any over-the-counter medications except aspirin.” Correct D. “I’ll buy one of those medication alert tags that tells people I’m taking an anticoagulant.” Awarded 99.0 points out of 99.0 possible points. 45. ID: 21553033048 A nurse has a written prescription to remove an intravenous (IV) line. Which item should the nurse obtain from the unit supply area for use in applying pressure to the site after removing the IV catheter? A. Alcohol swab B. Adhesive bandage C. Sterile 2 × 2 gauze Correct D. Povidone-iodine (Betadine) swab 46. ID: 21553033527 A client with heart failure being discharged home will be taking furosemide. Which statement by the client indicates to the nurse that the teaching has been effective? A. “I’ll measure my urine output.” B. “I’ll take my pulse every day.” C. “I’ll weigh myself every day.” Correct D. “I’ll check my ankles every day for swelling.” Rationale: A client taking furosemide must be able to monitor fluid status throughout therapy. Weighing oneself each day is the easiest and most accurate way to accomplish this. Checking the ankles for swelling and measuring urine output are incorrect because of the difficulty of assessing fluid status accurately in these ways. Taking daily pulse is not necessary and unrelated to the administration of furosemide. Test-Taking Strategy: Note the strategic word, effective. In client teaching questions, try to select the option that would be the easiest and most effective for a nurse to teach and for the client to understand. Remember, if you teach a client to do something that is too complicated, compliance will be poor. Having the client weigh himself every day is the easiest and most accurate way to measure fluid status. Review: the measures with which to effectively identify a therapeutic response to furosemide. Level of Cognitive Ability: Evaluating Client Needs: Physiological Integrity Integrated Process: Nursing Process/Evaluation Content Area: Pharmacology Giddens Concepts: Patient Education, Fluids and Electrolytes HESI Concepts: Teaching and Learning-Patient Education, Fluid& Electrolyte Reference: Rosenjack Burchum, Rosenthal (2016) pp. 450-451 Awarded 99.0 points out of 99.0 possible points. 47. ID: 21553032645 Carbamazepine is prescribed for a client with trigeminal neuralgia. Which side/adverse effects does the nurse instruct the client to report to the health care provider? Select all that apply. A. Sore throat Correct B. Fever Correct C. Mouth sores Correct D. Headache E. Nausea Awarded 99.0 points out of 99.0 possible points. 48. ID: 21553033060 A client with schizophrenia has been taking an antipsychotic medication for 2 months. For which adverse effect should the nurse monitor the client closely? A. Pelvic thrusts B. Athetoid limbs C. Akathisia Correct D. Protruding tongue Rationale: Approximately 5 to 60 days after starting an antipsychotic medication, the client may exhibit the adverse effect of akathisia, manifested by motor restlessness (continually tapping a foot, rocking back and forth in a chair, or shifting weight from one foot to another). Pelvic thrusts, athetoid limbs, and a protruding tongue are effects that may occur after 6 to 24 months of an antipsychotic medication. Test Taking Strategy: Focus on the subject, an adverse effect of an antipsychotic medication. Knowledge regarding the adverse effects of antipsychotic medications is needed to answer this question. Noting the words “2 months” and recalling the adverse effects of these medications will assist in directing you to the correct option. Review: the effects of antipsychotic medications Level of Cognitive Ability: Analyzing Client Needs: Physiological Integrity Integrated Process: Nursing Process/Assessment Content Area: Pharmacology Giddens Concepts:Psychosis, Safety HESI Concepts: Cognition, Safety Reference: Varcarolis, E. (2013). Essentials of Psychiatric Mental Health Nursing: A communication approach to evidence-based care. (revised reprint)) (2nd ed. pp. 331, 326). St. Louis: Saunders. Awarded 99.0 points out of 99.0 possible points. 49. ID: 21553032676 A client who has been taking lisinopril complains to the nurse of a persistent dry cough. What should the nurse tell the client? A. This is a side effect of therapy Correct B. He needs to have his blood counts checked C. A chest x-ray is required because the cough is a sign of heart failure D. He probably has an upper respiratory infection Awarded 99.0 points out of 99.0 possible points. 50. ID: 21553033521 A pregnant client is receiving magnesium sulfate for the management of preeclampsia. Which assessment finding indicates to the nurse that the client is experiencing magnesium toxicity? A. Proteinuria of +3 B. Sudden drop in fetal heart rate Correct C. Presence of deep tendon reflexes D. Serum magnesium level of 2.5 mEq/L (1.25 mmol/L) Awarded 99.0 points out of 99.0 possible points. 50. ID: 21553033521 A pregnant client is receiving magnesium sulfate for the management of preeclampsia. Which assessment finding indicates to the nurse that the client is experiencing magnesium toxicity? A. Proteinuria of +3 B. Sudden drop in fetal heart rate Correct C. Presence of deep tendon reflexes D. Serum magnesium level of 2.5 mEq/L (1.25 mmol/L) Awarded 99.0 points out of 99.0 possible points. 50. ID: 21553033521 A pregnant client is receiving magnesium sulfate for the management of preeclampsia. Which assessment finding indicates to the nurse that the client is experiencing magnesium toxicity? A. Proteinuria of +3 B. Sudden drop in fetal heart rate Correct C. Presence of deep tendon reflexes D. Serum magnesium level of 2.5 mEq/L (1.25 mmol/L) Awarded 99.0 points out of 99.0 possible points. 52. ID: 21553033057 A client with schizophrenia who has been taking an antipsychotic medication calls the clinic nurse and says, “I need to cancel my appointment with the psychiatrist again, because I still have this awful sore throat. It’s so bad that my mouth has a sore.” How does the nurse respond to the client? A. “Do you remember when you started this medication? Your psychiatrist told you how important it is to keep your appointments with him.” B. “I think you need to come in for blood work today, because this may be an adverse effect of your medicine.” Correct C. “You probably have a simple flu, but it might help if you gargle with some antiseptic mouthwash every 2 hours or so and drink plenty of water.” D. “I wouldn’t be upset. It happens when you aren’t drinking enough water.” Awarded 99.0 points out of 99.0 possible points. 53. ID: 21553021385 A client is taking a folic acid supplement. Which laboratory parameter does the nurse use to evaluate the effectiveness of this therapy? Select all that apply. A. Hematocrit Correct B. Blood glucose C. Alkaline phosphatase D. Hemoglobin Correct E. Magnesium Awarded 99.0 points out of 99.0 possible points. 54. ID: 21553032620 Metoprolol has been prescribed for a client with hypertension. For which common side effects of the medication does the nurse monitor the client? Select all that apply. A. Weakness Correct B. Erectile dysfunction Correct C. Nightmares D. Dry eyes E. Fatigue Correct Awarded 99.0 points out of 99.0 possible points. 55. ID: 21553033599 A nurse hangs a 500-mL bag of intravenous (IV) fluid for an assigned client. One hour later the client complains of chest tightness, is dyspneic and apprehensive, and has an irregular pulse. The IV bag has 100 mL remaining. Which action should the nurse take first? A. Remove the IV B. Slow the rate of infusion C. Shut off the IV infusion Correct D. Sit the client up in bed Awarded 99.0 points out of 99.0 possible points. 56. ID: 21553033045 A client has just undergone insertion of a central venous catheter by the health care provider at the bedside. Which result would the nurse be sure to check before initiating infusion of the IV solution that the health care provider has prescribed? A. Portable chest x-ray Correct B. Serum osmolality C. Serum electrolytes D. Intake and output record Awarded 99.0 points out of 99.0 possible points. 57. ID: 21553032617 A client with HIV infection has been started on therapy with zidovudine. The nurse tells the client to report to the laboratory in 3 months for testing to detect adverse effects of the therapy. Which laboratory test is most important to monitor for this client? A. Complete blood count (CBC) Correct B. Blood urea nitrogen (BUN) C. Creatinine D. Serum potassium Awarded 99.0 points out of 99.0 possible points. 58. ID: 21553033524 A client who has undergone adrenalectomy is prescribed prednisone. Which finding indicates that the client is experiencing an adverse effect of the medication? A. Hypoglycemia B. Dry mouth C. Hypotension D. Tarry stools Correct Awarded 99.0 points out of 99.0 possible points. 59. ID: 21553032651 A nurse is providing instructions to a client regarding quinapril hydrochloride. The nurse should teach the client to implement which measure? A. To discontinue the medication if nausea occurs B. To take the medication with meals C. To rise slowly from a lying to a sitting position Correct D. That a therapeutic effect will be felt immediately Awarded 99.0 points out of 99.0 possible points. 60.ID: 21553032663 A nurse has taught a client taking a methylxanthine bronchodilator, theophylline, about beverages that must be avoided. Which beverage choices by the client indicate to the nurse that the client needs further education? Select all that apply. A. Coffee Correct B. Chocolate milk Correct C. Orange juice D. Cocoa Correct E. Lemonade Awarded 99.0 points out of 99.0 possible points. 61. ID: 21553021396 A nurse is caring for a client with histoplasmosis who is receiving intravenous amphotericin B . Which is the most critical observation for the nurse to make while the medication is being administered? A. Check the client’s neurological status B. Monitor the client’s urine output Correct C. Check the client’s blood glucose level D. Monitor the client for hypothermia Awarded 99.0 points out of 99.0 possible points. 62. ID: 21553032605 Betaxolol eye drops have been prescribed for the treatment of a client’s glaucoma. The nurse tells the client to return to the clinic for follow-up for which purpose? A. To give a sample for urinalysis B. For measurement of blood pressure and apical pulse Correct C. To have weight checked D. To have the blood glucose level checked Awarded 99.0 points out of 99.0 possible points. 63. ID: 21553021399 A client who is taking bupropion in an attempt to stop smoking tells a nurse that he has been doubling the daily dose to make it easier to resist smoking. The nurse warns the client that doubling the daily dosage is dangerous. Of which adverse effect of the medication does the nurse warn the client? A. Insomnia B. Weight gain C. Seizures Correct D. Orthostatic hypotension Awarded 99.0 points out of 99.0 possible points. 64. ID: 21553033019 At 1300, the nurse is documenting the receipt of a unit of packed blood cells at the hospital blood bank. The nurse calculates that the transfusion must be started by which time? A. 1315 B. 1345 C. 1400 D. 1330 Correct Awarded 99.0 points out of 99.0 possible points. 65. ID: 21553032690 The health care provider’s prescription reads, “Clindamycin phosphate 0.3 g in 50 mL NS, to be administered IV over 30 minutes.” The medication label reads, “Clindamycin phosphate 150 mg/mL.” How many milliliters of medication does the nurse prepare to ensure that the correct dose is administered? Correct Correct Responses 1. 2 .//assessment[9]/question[58]/question_correct_feedback/text() Awarded 99.0 points out of 99.0 possible points. 66. ID: 21553033554 A nurse is preparing a plan of care for a pregnant client who will be given oxytocin to induce labor. Which occurrence does the nurse include in the plan of care as a reason for immediate discontinuation of the oxytocin infusion? A. Uterine hyperstimulation Correct B. Uterine atony C. Severe drowsiness D. Early decelerations of the fetal heart rate 67. ID: 21553032672 A client has been given a prescription to begin using nitroglycerin transdermal patches for the management of angina pectoris. What should the nurse tell the client about the medication? A. Place the patch in the area of a skin fold to promote adherence B. If the patch becomes dislodged, do not reapply and wait until the next day to apply a new patch. C. Apply the patch at the same time each day and leave it in place for 12 to 16 hours as directed Correct D. Alternate daily dose times between the morning and the evening to prevent the development of tolerance to the medication Awarded 99.0 points out of 99.0 possible points. 68. ID: 21553033069 A nurse is making initial rounds on a group of assigned clients. Which client should the nurse see first? A. A client receiving total parenteral nutrition (TPN) at a rate of 50 mL/hr for the last 24 hours B. A client receiving TPN at a rate of 50 mL/hr whose temp was 99° F (37.2°C) on the previous shift C. A client whose TPN solution was decreased to a rate of 25 mL/hr who is now complaining of weakness, headache, and sweating Correct D. A client receiving TPN at a rate of 100 mL/hr who has complained of needing frequent trips to the bathroom to void Awarded 99.0 points out of 99.0 possible points. 69. ID: 21553033566 A client with tuberculosis is being started on isoniazid and the nurse stresses the importance of returning to the clinic for follow-up blood testing. The nurse realizes the client understands the instructions if the client verbalizes the need to return to the clinic for which blood test? A. Red blood cell count B. Liver enzymes Correct C. Blood urea nitrogen D. Serum creatinine Awarded 99.0 points out of 99.0 possible points. 70. ID: 21553033054 The client rings the call bell and complains of pain at the site of an IV infusion. The nurse assesses the site and determines that phlebitis has developed. Which actions should the nurse take? Select all that apply. A. Starting a new IV line in a proximal portion of the same vein B. Applying warm, moist compresses to the IV site Correct C. Removing the IV catheter at that site Correct D. Notifying the health care provider about the finding Correct E. Encouraging the client to scrub the site while in the shower Awarded 99.0 points out of 99.0 possible points. 71. ID: 21553033036 A client has a prescription for a unit of packed red blood cells (RBCs). Which IV solution should the nurse obtain to hang with the blood product at the client’s bedside? A. Lactated Ringer’s solution (LR) B. 5% dextrose in 0.9% sodium chloride C. 0.9% sodium chloride Correct D. 5% dextrose in water in 0.45% sodium chloride Awarded 99.0 points out of 99.0 possible points. 72. ID: 21553033542 A nurse is monitoring a client who is receiving a continuous intravenous infusion of morphine sulfate. Which finding should cause the nurse to contact the health care provider? A. Temperature of 97.6° F (36.4°C) B. Blood pressure of 100/60 mm Hg C. Respiratory rate of 10 breaths/min Correct D. Urine output of 30 mL/hr Awarded 99.0 points out of 99.0 possible points. 73. ID: 21553032695 The health care provider prescribes 1000 mL of 5% dextrose in water, to be infused over 24 hours. The drop factor is 60 gtt/mL. At how many drops per minute does the nurse set the flow rate? (Round to the nearest whole number). Correct Responses 1. 42 .//assessment[9]/question[59]/question_correct_feedback/text() Awarded 99.0 points out of 99.0 possible points. 74. ID: 21553033028 A nurse discontinues an infusion of a unit of blood after the client experiences a transfusion reaction. Once the incident has been documented appropriately, where does the nurse send the blood transfusion bag? A. Risk management B. Microbiology laboratory C. Infection-control department D. Blood bank Correct Awarded 99.0 points out of 99.0 possible points. 75. ID: 21553033563 Baclofen is prescribed for a client with a spinal cord injury who is experiencing muscle spasms. While providing instructions to the client, which side effect does the nurse tell the client is possible? A. Increased appetite B. Increased salivation C. Photosensitivity D. Nasal congestion Correct Rationale: Common side effects of baclofen include drowsiness, dizziness, weakness, and nausea. Occasional side effects include headache, paresthesia of the hands and feet, constipation or diarrhea, anorexia, hypotension, confusion, and nasal congestion. Paradoxical central nervous system excitement and restlessness may occur, along with slurred speech, tremor, dry mouth, nocturia, and erectile dysfunction. Photosensitivity is not a side effect of this medication. Test-Taking Strategy: Eliminate increased appetite and increased salivation because they are comparable or alike options. To select from the remaining options it is necessary to know that nasal congestion can occur. Review: the side effects of baclofen Level of Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Teaching and Learning Content Area: Pharmacology Giddens Concepts: Patient Education, Safety HESI Concepts: Teaching and Learning-Patient Education, Safety Reference: Hodgson, B., & Kizior, R. (2015). Saunders nursing drug handbook 2015. (pp. 116-117) St. Louis: Saunders. Awarded 99.0 points out of 99.0 possible points. 76. ID: 21553032608 Risperidone is prescribed for a client with a diagnosis of schizophrenia. Which laboratory study does the nurse expect to see among the health care provider’s prescriptions? A. Red blood cell count B. Creatinine level Correct C. Platelet count Incorrect D. Sedimentation rate Awarded 0.0 points out of 99.0 possible points. 77. ID: 21553032654 A nurse is developing a plan of care for a client, hospitalized with heart failure, who has a history of Parkinson disease and is taking benztropine mesylate daily. Which intervention does the nurse identify as a priority in the plan? A. Placing the client in a right side-lying position B. Monitoring intake and output Correct C. Monitoring the client’s pupillary response D. Checking the client’s hemoglobin level daily Awarded 99.0 points out of 99.0 possible points. 78. ID: 21553033596 A nurse discontinues an infusion of a unit of packed red blood cells (RBCs) because the client is experiencing a transfusion reaction. After discontinuing the transfusion, which action should the nurse take next? A. Contact the health care provider Correct B. Remove the IV catheter C. Obtain a culture of the tip of the catheter device removed from the client D. Change the solution to 5% dextrose in water Awarded 99.0 points out of 99.0 possible points. 79. ID: 21553021393 A client with rheumatoid arthritis is taking high doses of acetylsalicylic acid. While assessing the client for aspirin toxicity, which question should the nurse ask the client? A. “Do you have any ringing in the ears?” Correct B. “Are you constipated?” C. “Do you have any double vision?” D. “Are you having any diarrhea?” Awarded 99.0 points out of 99.0 possible points. 80. ID: 21553032657 A nurse has taught a client who is taking lithium carbonate about the medication. The nurse determines that the client needs additional teaching if the client makes which comment to the nurse? A. It is important to decrease fluid intake while taking the medication to avoid nausea Correct B. The medication should be taken with meals C. The lithium blood levels must be monitored very closely D. The health care provider must be called if excessive diarrhea, vomiting, or diaphoresis occurs Awarded 99.0 points out of 99.0 possible points. 81. ID: 21553033509 A nurse instructs a client with hypothyroidism about the dosage, method of administration, and side effects of levothyroxine sodium. Which statement by the client indicates an understanding of the nurse’s instructions? A. “If I feel nervous or have tremors, I should only take half the dose.” B. “I can expect diarrhea, insomnia, and excessive sweating.” C. “I need to report any episodes of palpitations, chest pain, or dyspnea.” Correct D. “I should take the medication in the evening.” Awarded 99.0 points out of 99.0 possible points. 82. ID: 21553032630 A nurse provides instructions to a client who will be taking furosemide. Which statement by the client indicates to the nurse that the client needs additional instruction? A. “This medication will make me urinate.” B. “I need to maintain my fluid intake.” C. “I need to sit or stand up slowly.” D. “I should expect to have ringing in my ears.” Correct Awarded 99.0 points out of 99.0 possible points. 83. ID: 21553033063 A young female client with schizophrenia says to the nurse, “Since I started on olanzapine last year, I’m doing well in school and all, but I’ve gained so much weight, and it’s really bothering me. What can I do about this?” Which response by the nurse would be therapeutic? A. “Weight gain can be a side effect of the medication, so you need to watch your diet and exercise. How much weight have you gained?” Correct B. “Well, I think you’re overreacting. Today people think they should be skinny- minnies, even though it’s not healthy.” C. “I want you to stop taking this medication immediately, and I’m calling the doctor, because this is a very serious side effect and you may need dialysis.” D. “That medication isn’t any more likely to cause weight gain than the others you’re taking. Perhaps we could go over your diet and exercise habits.” Rationale: Olanzapine is an antipsychotic agent that causes weight gain, a disadvantage of the medication. Weight gain, especially in a young woman, for whom it may have an especially serious affect on self-image, may lead to noncompliance with the medication regimen. “That medication isn’t any more likely to cause weight gain than the others you’re taking” offers incorrect information. “I think you’re overreacting” minimizes the client’s complaints. “I want you to stop taking this medication immediately” gives incorrect information and is presented in an unprofessional style. Test Taking Strategy: Use therapeutic communication techniques. Eliminate the option that states the client’s medication does not cause weight gain any more than others do first, because this medication can cause weight gain. Next eliminate the option in which the nurse tells the client to stop taking this medication immediately, because it is also inaccurate and could cause anxiety for the client. To select from the remaining options, eliminate the one in which the nurse states the client is overreacting, because this minimizes the client’s complaints. Review: the effects of olanzapine Level of Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Communication and Documentation Content Area: Pharmacology Giddens Concepts: Communication, Psychosis HESI Concepts: Cognition, Communication Reference: Rosenjack Burchum, Rosenthal (2016) pp. 336-338 Awarded 99.0 points out of 99.0 possible points. 84. ID: 21553033536 A nurse is caring for a client with a diagnosis of chronic kidney disease who is receiving dialysis. Epoetin alfa, to be administered subcutaneously, has been prescribed, and the nurse is drawing the medication from a single-use vial. What should the nurse do to prepare the medication? A. Mix the medication with 0.1 mL of heparin before administration to prevent clotting B. Shake the vial before drawing up the medication C. Draw up the medication and discard the unused portion Correct D. Obtain the medication from the medication freezer and allow it to thaw Awarded 99.0 points out of 99.0 possible points. 85. ID: 21553033545 Erythromycin is prescribed for a client with a respiratory tract infection. The nurse provides instructions to the client regarding the administration of the oral medication and tells the client that it is best to take the medication in which way? A. On an empty stomach Correct B. At bedtime, with a snack C. With a meal D. With juice Awarded 99.0 points out of 99.0 possible points. 86. ID: 21553033590 The health care provider (HCP)prescribes the administration of total parenteral nutrition (TPN), to be started at a rate of 50 mL/hr by way of infusion pump through an established subclavian central line. After the first 2 hours of the TPN infusion, the client suddenly complains of difficulty breathing and chest pain. The nurse should take which immediate action? A. Obtain blood for culture B. Obtain a sample for blood glucose testing C. Obtain an electrocardiogram (ECG) D. Clamp the TPN infusion line Correct Awarded 99.0 points out of 99.0 possible points. 87. ID: 21553033005 The health care provider prescribes an intramuscular dose of 200,000 units of penicillin G benzathine for an adult client. The label on the 10-mL ampule sent from the pharmacy reads, “Penicillin G benzathine, 300,000 units/mL.” How many milliliters of medication does the nurse prepares to ensure administration of the correct dose? (Round to the nearest tenth.) Incorrect Correct Responses 1. 0.7 IN.//assessment[9]/question[61]/question_correct_feedback/text() Awarded 0.0 points out of 99.0 possible points. 88. ID: 21553033042 A nurse has obtained a unit of blood from the blood bank and properly checked the blood bag with another nurse. Which parameter should the nurse assess just before hanging the transfusion? A. Vital signs Correct B. Urine output over the last 24 hours C. Skin color D. Latest platelet count Awarded 99.0 points out of 99.0 possible points. 89. ID: 21553033075 The nurse is preparing to change the solution bag and intravenous tubing of a client receiving total parenteral nutrition (TPN) through a left subclavian central venous line. Which essential action does the nurse ask the client to perform just before switching the tubing? A. Turn the head to the left B. Exhale slowly and evenly C. Take a deep breath and hold it Correct D. Turn the head to the right Awarded 99.0 points out of 99.0 possible points. 90. ID: 21553033515 The emergency department staff prepares for the arrival of a child who has ingested a bottle of acetaminophen. Which medication does the nurse ensure is available? A. Protamine sulfate B. Pancreatin C. Phytonadione D. Acetylcysteine Correct Awarded 99.0 points out of 99.0 possible points. 91. ID: 21553032602 Intravenous tobramycin sulfate is prescribed for a client with a respiratory tract infection. For which of the following symptoms, indicative of an adverse effect, does the nurse monitor the client? A. Hypotension B. Nausea C. Vomiting D. Vertigo Correct Awarded 99.0 points out of 99.0 possible points. 92. ID: 21553033039 A nurse has just received a prescription to transfuse a unit of packed red blood cells for an assigned client. For how long does the nurse plan to stay with the client after the unit of blood is hung? A. 60 minutes B. 45 minutes C. 5 minutes D. 15 minutes Correct Awarded 99.0 points out of 99.0 possible points. 93. ID: 21553032669 A client with newly diagnosed angina pectoris has taken 2 sublingual nitroglycerin tablets for chest pain. The chest pain is relieved, but the client complains of a headache. What should the nurse tell the client? A. This may be an allergic reaction to the nitroglycerin, and the health care provider must be notified B. This is an expected side effect of the nitroglycerin, and the client can relieve it by taking acetaminophen Correct C. Headache indicates medication tolerance, and the dosage must be increased D. This is an indication that the medication should not be used again Awarded 99.0 points out of 99.0 possible points. 94. ID: 21553033548 A client taking metronidazole for the treatment of trichomoniasis vaginalis calls the clinic nurse to express concern because her urine has turned dark in color. The nurse should provide which information to the client? A. To report to the clinic to see the health care provider B. To increase her fluid intake C. That darkening of the urine is a harmless side effect Correct D. To discontinue the medication Awarded 99.0 points out of 99.0 possible points. 95. ID: 21553033572 A client is receiving intravenous bleomycin sulfate. During administration of the chemotherapy, nursing assessment is the priority? A. Heart rate B. Level of consciousness C. Lung sounds Correct D. Peripheral pulses 96. ID: 21553032639 A nurse is assessing a client who is being hospitalized with a diagnosis of pneumonia. The client’s husband tells the nurse that the client is taking donepezil hydrochloride. The nurse should ask the husband about the client’s history of which disorder? A. Dementia Correct B. Posttraumatic stress disorder C. Seizure disorder D. Diabetes mellitus Rationale: Donepezil hydrochloride is a cholinergic agent that is used in the treatment of mild to moderate dementia of the Alzheimer type. It enhances cholinergic function by increasing the concentration of acetylcholine, slowing the progression of Alzheimer disease. The disorders in the other options are not treated with this medication. Test-Taking Strategy: Focus on the subject, the indicastions for using donepezil hydrochloride. Knowledge regarding the use of donepezil hydrochloride is necessary to answer this question. It is necessary to know that this medication is used in the treatment of mild to moderate dementia of the Alzheimer type. Review: donepezil hydrochloride. Level of Cognitive Ability: Analyzing Client Needs: Physiological Integrity Integrated Process: Nursing Process/Assessment Content Area: Pharmacology Giddens Concepts: Develoment, Cognition HESI Concepts: Cognition, Developmental Reference: Hodgson, B., & Kizior, R. (2015). Saunders nursing drug handbook 2015. (p. 387) St. Louis: Saunders. Awarded 99.0 points out of 99.0 possible points. 97. ID: 21553032666 A client has been taking metoprolol. Which finding indicates to the nurse that the medication is effective? A. The client has wheezes in the lower lobes of the lungs. B. The client’s ankles are swollen. C. The client’s blood pressure has decreased. Correct D. The client’s weight has increased. Awarded 99.0 points out of 99.0 possible points. 98. ID: 21553032633 A nurse is teaching a client how to mix regular and NPH insulin in the same syringe. The nurse should provide the client with which information about the insulin? A. Draw the regular insulin into the syringe first Correct B. Remove all of the air from the bottle before mixing the two types C. Shake the NPH insulin bottle before mixing the two types D. Keep insulin refrigerated at all times Awarded 99.0 points out of 99.0 possible points. 99. ID: 21553033581 A nurse is assessing a peripheral intravenous (IV) site and notes blanching, coolness, and edema at the insertion site. What should the nurse do first? A. Remove the IV Correct B. Measure the area of infiltration C. Check for blood return D. Apply a warm compress Awarded 99.0 points out of 99.0 possible points. [Show More]

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