ATI Pharmacology Quizzes & Midterm Q1 - Lim WED A nurse is teaching for a client who is to begin taking Tamoxifen to treat breast cancer. The nurse should instruct the client to expect which of ... the following findings as an adverse effect of the medication? a. Hot flashes b. Insomnia c. Constipation d. Increased appetite, Patient with bladder cancer receiving Cisplatin medication what to expect e. Check the results of the client's most recent CBC A nurse is reviewing the CBC findings for a female client who is receiving combination chemotherapy for breast cancer. Which of the following findings should the nurse report to the provider? f. Hemoglobin of 10 g/L g. WBC count of 2,300/µl h. Platelets of 65,000/µl i. Serum creatinine level of 1.2 mg/dl Primary prevention for cancer j. Teach use of sun screen k. Yearly Papsmears 2. Recommend time for colon cancer at age 50 3. Patient concerned about the adverse effect of chemo 4. Patient dying of cancer wants to go home and die family can’t take care what should be recommended 5. Older adult client lives with family member comes in with bruises what should the nurse do first a. Document findings b. Give patient crisis hot-line number c. Report to supervisor 6. Thrombocytopenia nursing action 7. A client is receiving treatment for stage IV ovarian cancer and asks the nurse to discuss her prognosis. The client plans to have aggressive surgical, radiation, and chemotherapy treatments. Which of the following prognoses should the nurse discuss with the client? a. Guarded b. Poor c. Good d. Excellent 8. SATA 4/5 for palliative car a. Maintain quality of life b. Provides relief from symptoms c. Provides relief from pain d. reducing the severity of disease symptoms e. Support groups 9. What are expected lab values SATA 3 a. Decreased platelet count b. Decreased WBC c. Decreased erythrocytes d. Increased RBC e. Increased platelets 10. As adults age what decreases SATA 3 a. Eyes sight decreases b. Slower reflexes c. Lower systolic BP d. Muscle atrophy 11. Neutropenic precaution what restrictions should the nurse put in the patients plan of care 12. The nurse is caring for a client who is on morphine PRN for pain. The client is having difficulty breathing, the nurse decides to not administer the medication because she fears the client will die. What ethical principle is the nurse performing? 13. Bleeding gums what is nursing action a. Check platelet count b. Refer to dentist c. Use electric toothbrush 14. A patient with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. An important nursing intervention for the patient is to a. teach about the importance of nutrition during treatment. b. have the patient eat large meals when nausea is not present. c. administer prescribed antiemetics 1 hour before the treatments. d. offer dry crackers and carbonated fluids during chemotherapy. 15. Coming in or chemo what patient teaching 16. A nurse is caring for a client who is scheduled to receive external radiation to the neck for cancer of the larynx. During a pre-treatment exam, the nurse explains to the clients the most likely side effect would be a. Dyspnea b. Dysphagia c. Diarrhea 17. Expected side effect of chemo Alopecia 18. Most common adverse effect of chemo 19. Hair loss 20. A patient was alert and oriented upon arrival but suddenly became confused and disoriented what should the nurse do? 21. Patient will have peripheral neuropathy what are the expected findings? 22. Patient is receiving chemo via IV and reports burning and stinging what is the nursing action? 23. A nurse in a provider's clinic is assessing a client who has cancer and a prescription for methotrexate PO. Which of the following actions should the nurse take when the client reports bleeding gums? Q- 1 Joy WED 1. PPE what order to take off? a. gloves b. goggles c. gown d. mask 2. Thrombocytopenia (a lot of Qs) a. 10 min b. Administer oprelvekin to stimulate platelet production monitor platelet count 3. Expected side effect of chemo 4. Immunosuppressed patient at home 5. Neutropenia 6. Where to take bone marrow biopsy treatment other than iliac crest 7. Patient teaching to all age groups 8. To help with n/v, what to avoid 9. Before chemo avoid fluid intake by 10. Skin cancer melanoma? SATA a. Genetics b. UV c. Skin injury 11. What kind of isolation do you put on patient 12. Hand hygiene a. 4-5 ml of soap b. Hot water 13. What precaution for patient with bone marrow transplant a. Neutropenic/preventative a. contact 14. Patient afraid of pain from bone marrow transplant 15. Patient with low WBC count 16. Patient with low platelet counts 17. Patient with low platelet 18. A nurse is providing teaching to a client who has breast cancer about the adverse effects of chemotherapy. Which of the following client statements indicates an understanding of the teaching? 19. A nurse is preparing a teaching plan for a client who has neutropenia as a result of radiation therapy for the treatment of lung cancer. Which of the following should the nurse plan to include in the teaching? 20. Infected iv site 21. What to do with patient for risk of skin breakdown a. best options are move patient with draw sheet b. use cornstarch to keep areas dry (has to be talcum powder) 22. Hospice care patient teaching 23. A nurse if caring for an older adult client who has a WBC of 2,000/mm^3 after three rounds of chemotherapy. Which of the following actions should the nurse take? Quiz 1 Joy SAT 1. SATA; Nurse is explaining nonpharmacologic interventions, what responses by the client indicates proper understanding? a. nonpharmacologic interventions may be used with pharmacotherapy b. nonpharmacologic intervention may be used adjunct with pharmacotherapy c. nonpharmacologic intervention has not made it to mainstream yet d. nurses do not value this method of nonpharmacologic 2. Elder comes in with bruises, what do do? a. report to supervisor 3. Alzheimer’s partner is having a difficult time, what finding indicates caretaker is fatigue/strained ? a. caretaker loses 20 lbs in 2 months b. putting locks on doors c. hiring a housekeeper d. redirecting alzheimer's patient when patient is frustrated 4. Laryngeal cancer 5. SATA risk factors for cancer a. Bloating b. change in bowel movement c. change in moles d. sore that doesn't heal e. coughing 6. Heavy long-term smoker develops laryngeal cancer, what is the first symptom that develops? 7. a. Clean dentures in cup b. cook fruit 8. Stem cell transplant; WBC is 2,000 a. Negative airflow room b. change water in flower vase c. humidifier 9. S/E radiation therapy a. Fatigue b. constipation 10. Mastectomy; Tamoxifen a. hot flashes b. constipation 11. Skin cancer a. put sunblock even in winter b. sitting outside for 10 minutes 12. Chemotherapy Question a. hair loss is a common including the eyelashes b. after chemotherapy hair will grow back nice and thick 13. Erythropoiesis treatment, which statements indicate that goals were met ?SATA a. RBC goes up b. epistaxis stops c. no shortness of breath on exertion d. patient reports being able to take enjoy a walk with family for the first time in a while- not sure about this one e. one more option 14. Not confused patient but confused patient after , what to do? a. Put them near the nursing station b. put the patient in restraints c. use sedation d. call family member to sit with them 15. Patient is going through chemotherapy; church member said “they are getting cancer because of their sins” what is an appropriate action for the nurse to take? a. with permission from pt, contact hospital minister b. “ “, contact church minister c. “ “, contact family member d. “ “, contact ethic committee 16. neuropathy induced by chemotherapy expected findings? a. tingling in extremities b. spasms of extremities c. weak muscles 17. SATA; Aging a. muscle atrophy b. slower reaction time c. small bladder capacity d. eyesight acuity e. hepatomegaly - not sure if this was an option 18. Patient reports fatigue months after ; 19. IV vesicant; Priority Question 20. pt has redness, dry, and scaly skin from radiation. what should pt do for skin? (stuck b/w these two) a. wash with regular soap b. apply hydrating lotion 21. cisplatin- nursing actions? a. check vital signs every 8 hours b. check CBC ?? - nephrotoxicity ! c. give 1000mL water every 12 hours 22. Angina; patient teaching regarding nitroglycerin? a. take sublingual every 15 minutes for 30 minutes b. it will relieve chest pain by dilating vessels 23. what should a nurse teach a patient to expect after a lobectomy? 24. Pt experiencing pain due to chemotherapy, what should the patient do to help relieve the pain? 25. Pt feels isolated and lonely and wants to resume normal daily activities after receiving chemotherapy. what action should the patient take? a. avoid crowds b. drink bottle of water only c. stay inside the house d. exercise (something weird and random can’t recall the last one) 26. Pt receiving radiation & mastectomy what is the adverse effect that the patient may receive? a. Alopecia b. Fatigue c. Diarrhea d. anorexia 1. Filgrastim / neupogen 2. For which patient would the nurse question an order for administration of filgrastim (Neupogen)? a. Patient with severe chronic neutropenia b. Patient undergoing bone marrow transplant c. d. Patient with cancer that has metastasized to the spleen 3. The nurse is checking the laboratory results of a patient taking epoetin alfa (Procrit). Which finding requires immediate intervention? a. Hematocrit 38 b. Hemoglobin 14 c. Platelets 150,000 d. RBC count of 3.8 4. palliative care SATA: 5. neutropenia further teaching: 6. Neutropenia: client teaching 7. A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the nurse would indicate a need for further teaching? a. The patient ambulates several times a day in the room. b. The patient's visitors bring in some fresh peaches from home. c. The patient cleans with a warm washcloth after having a stool. d. The patient uses soap and shampoo to shower every other day. 8. UAP REQUIERES further teaching, client has pancytopenia? a. Assist the client with flossing after meals b. fluoride toothpaste on soft bristled brush c. backing soda to brush teeth When caring for a patient who is pancytopenia, which action by unlicensed assistive personnel (UAP) indicates a need for the nurse to intervention? d. The UAP assists the patient to use dental floss after eating. e. The UAP adds baking soda to the patient's saline oral rinses. f. The UAP puts fluoride toothpaste on the patient's toothbrush. g. The UAP has the patient rinse after meals with a saline solution. 9. home health nurse what would you assess in an elder adult? WHICH one is priority? a. dysphagia b. urinary hesitance 10. Client has been falling, what contributes to their falls? a. using non-slip bath mat b. using fitted shoes c. using a Benzodiazepam 11. client has a WBC count of 1.3, what should the nurse include in the plan of care? 12. The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Which laboratory result is most important to report to the health care provider? a. Hematocrit of 30% b. White blood cell (WBC) count of 2700 at risk for infection c. Platelets of 95,000/µL d. Hemoglobin of 10 g/L 13. Which of the following is recommended in a teaching for young and older adults? a. fecal occult test b. pap smear every 3 yeas starting at age 25 c. mammogram every year at age 45 14. Risk factors for cancers? SATA a. immunization b. sunscreen c. decrease carcinogens d. limit alcohol e. Genetic testing 15. SIADH. what finding would you report? a. 280 ml of urine in 8hr b. serum sodium level of 120 16. After change-of-shift report on the oncology unit, which patient should the nurse assess first? a. Patient who has a platelet count of 82,000/µL after chemotherapy b. Patient who has xerostomia after receiving head and neck radiation c. Patient who is neutropenic and has a temperature of 100.5° F (38.1° C) medical emergency d. Patient who is worried about getting the prescribed long-acting opioid on time 17. drug, IV 18. primary prevention? SATA 19. Nurse is caring for a client that has terminal cancer and tells the nurse that he wants to die at home. Nursing Intervention. 20. A multidisciplinary oncology team of physicians, nurses, and the social worker notes that a client who has been undergoing chemotherapy is now experiencing pancytopenia. When reviewing the laboratory data, which values support this diagnosis? Select all that apply. a. Decreased RBCs b. Decreased platelets c. Decreased white blood cells Quiz 2 Lim WED 1. Right sided heard failure SATA 4/6 a. Peripheral edema b. Hepatomegaly c. Muscle weakness d. JVD e. Cough f. Orthopnea 2. A client has a new prescription for transdermal nitroglycerin (Nitro-Dur) to treat angina pectoris. When talking with the patient about using this drug, the nurse should include which of the following instructions? (Select all that apply.) 3/5 a. Apply a new patch every morning b. Remove patch at night for 10-12 hour free period c. Apply to hairless site and rotate site daily d. Apply to dry area and cover with plastic wrap e. Apply when you have pain 3. Reduction of risk factors for CAD what indicates understanding of teaching SATA 3/5 a. b. Stop smoking c. Stop drinking d. Limit exercise e. Monitor weight 4. Thrombocytopenia SATA 4/5 a. Pad sharp edges b. Use a straight razor c. Avoid iv and injections/apply pressure for 10 min d. Closed toe shoes e. Lubricate the lips with water soluble lubricant 5. Teaching on nitroglycerin what should the nurse include? a. Can store in bathroom medicine cabinet b. Take 5 min after pain starts c. Take at night and after every meal 6. Nitroglycerin a. Call 911 after the pain is not relived within the first 5 min of the first does and take 2 more dose 5 min apart b. Call 911 then take the first dose c. Call 911 if the pain is not relived after the 5 doses 15 min apart 7. A nurse is reinforcing teaching with a client who has angina pectoris about starting therapy with nitroglycerin (Nitrostat). The nurse should remind to take the medication a. after each meal and at bedtime. b. q15 min during an acute attack. c. at first indication of chest pain. d. with 8 oz of water. 8. A nurse on a medical unit is caring for a client who has angina pectoris and reports chest pain with a severity of 6 on a 0 to 10 scale. The nurse administers sublingual nitroglycerin (Nitrostat). After 5 min, the client states that his chest pain is now a 2. Which of the following actions should the nurse take? a. Obtain a 12 lead EKG b. Administer a second dose of Nitroglycerin c. Measure the client's blood pressure. d. Call rapid response team 9. The client with CAD asks nurse, “Why do I get chest pain?” The most appropriate response by the nurse is? a. “Chest pain is caused by decreased oxygen to the heart muscle.” b. radiates to the jaw and back 10. A nurse is reinforcing teaching for a client who is taking warfarin (Coumadin) about monitoring its therapeutic effect. The nurse should explain that the provider will use international normalized ratio (INR) because a. it also helps with adjusting heparin therapy, should the provider switch the client's medication. b. It is the only test available for anticoagulant therapy monitoring. c. the client will only need the test twice per month. d. It is standardized, so it eliminates the variations different laboratories report in prothrombin time. 11. lisinopril a. Swollen tongue b. Coughing c. Nausea 12. A Fib is at risk for a. Pulmonary embolism 13. Nursing delegation to a UAP a. Apply leads to a patient on telemetry monitor b. Teach c. Asses 14. Normal sinus rhythm on an ECG a. Inverted P wave b. PR wave .22 c. QRS .2 sec d. PR interval is 0.12-0.20 seconds e. QRS is 0.06-0.10 seconds 15. What is counter indicated for warfarin 16. Nurse is caring for a patient having cardiopulmonary arrest what would the nurse guess that the emergency response team would use if their rate returned to bradycardia a. atropine b. epinephrine c. Adenosine 17. Diltiazem (Cardizem) is ordered for a patient with newly diagnosed Prinzmetal's (variant) angina. When teaching the patient, the nurse will include the information that diltiazem will a. reduce heart palpitations b. decrease spasm of the coronary arteries c. increase the force of the heart contractions d. help prevent plaque from forming in the coronary arteries. 18. A nurse is caring for a client who is admitted to the hospital with CHF who has been taking digoxin (Lanoxin) 0.25 mg daily. The client refuses breakfast and reports nausea. Which of the following actions should the nurse perform first? a. Asses vitals b. Tell them to rest before breakfast c. Request a dietary consult 19. While admitting a client for a cardiac catheterization, the nurse asks the client about allergies. The client states, "I always get a rash when I eat shellfish." Which of the following is the priority nursing intervention? a. Notify the provider of the client's allergy b. Attach a wrist band indicating the client's allergy. c. Notify the dietary department of the client's allergy. d. Ask the client if any other foods cause such a reaction. 20. A client is telling the nurse in the clinic that he gets a headache after he takes sublingual nitroglycerin (Nitrostat). Which of the following should the nurse remind the client to do? a. Take a mild analgesic to prevent the headache b. Nothing can be done c. I will notify your provider and see if there is another medication we can have you take 21. Working at a cardiac clinic what patient requires attention immediately a. Patient with chronic hypertension whose blood pressure today is 172/98 mm Hg b. Patient with stable angina who’s pain have become more frequent lately c. Patient with familial hypercholesterolemia and a total cholesterol of 465 mg/dL d. Patient with type 2 diabetes whose current blood glucose level is 145 mg/dL 22. Which electrocardiographic (ECG) change is most important for the nurse to report to the health care provider when caring for a patient with chest pain? a. Inverted P wave b. Sinus tachycardia c. ST-segment elevation d. First-degree atrioventricular block 23. A client is requesting information regarding a serum troponin test. Which of the following is the nurse's best response? 24. A nurse is reinforcing teaching for a client who has a new diagnosis of angina pectoris. The nurse should remind the client of which of the following information about anginal pain? a. The pain usually lasts more than 20 min. b. The pain often radiates to the jaw or the back. c. The pain persists with rest and organic nitrates. d. The exertion and anxiety can trigger the pain. 25. A nurse is caring for a client who has pericarditis and reports feeling a new onset of palpitations and shortness of breath. Which of the following assessments should indicate to the nurse that the client may have developed atrial fibrillation? a. Different blood pressure in the upper arms b. Different apical and radial pulses c. Differences between oral and axillary temperatures d. Differences in upper and lower lung sounds 26. A client asks a nurse, "Why am I taking nitroglycerin?" Which of the following is the best response by the nurse? a. "Nitroglycerin relieves nausea and prevents vomiting which could lead to aspiration." b. "Nitroglycerin decreases chest pain by dissolving blood clots that are occluding the arteries." c. "Nitroglycerin acts as a bronchodilator to open small airways and decrease shortness of breath." d. "Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart." Quiz 2 Joy WED NA Quiz 2 Joy SAT 1. a/e of simvastatin a. leg cramp b. increased BP 2. a change in ECG, what would you report/ concerning find? a. ST elevation 3. ballon valvular plasty - what to expect w/sheath? pt teaching a. leave it in there (acts as stent) b. will take out c. it will dissolve d. will take it out once you get better - probably this answer i. Review after class: Sheath will stay in until med administered wears off, then it will come out 4. Digoxin 5. Patient ed, what is troponin 6. A-fib, expected findings a. Bradycardia b. HPTN 7. Pt on warfarin (Coumadin) what med is contraindicated? a. VItamin K (antidote for warfarin, only give when warfarin is given too much) b. Furosemide c. vitamin A 8. SATA; electrical conductivity a. SA – AN b. bundle of his - p. fibers 9. Thrombocytopenia 10. MRI 11. P wave 12. Nitroglycerin 13. A-fib 14. Good cholesterol 15. Question- Don’t remember a. increased temperature b. increased HR c. increased BP 16. Gave patient opioid, you know it’s going to decrease pain what else will it help with? a. anxiety - NO! b. sleep c. decrease blood pressure 17. Food to recommend for patient w/HR a. bran cereal, skim milk, orange juice b. scrambled eggs, whole wheat toasted, prune juice 18. Risk factors of CAD, what indicates pt learned – a. “i will limit intake of fast food” b. “i will monitor weight gain” c. “i will stop drinking” d. “I will stop smoking” 19. lisinopril - what do you “consider?” 20. COPD patient teaching 21. Patient unable to breath, priority nursing intervention. (Patient had a disease, can’t recall). a. place in high fowler's position b. give 2 L oxygen 22. Lisinopril what A/E to teach patient about? (one question is right, but ATI lists both) a. dry cough b. face swelling Quiz 2 Lim FRI 1. Signs and Symptoms of left sided heart failure a. Displaced apical pulse b. S3 gallop c. Frothy sputum d. Pulmonary congestion 2. Patient is receiving coumadin, his PT/INR is 5.2, what do you give? 3. Thrombocytopenia (select all) a. Brush with a soft bristle toothbrush b. Avoid straining c. Avoid NSAIDs d. Use electric razor 4. Cardiac Cath (select all) a. Lie flat for 6 hours b. Monitor peripheral pulses c. Extended legs and hips 5. Cardiac enzyme what do the mean? 6. Most accurate lab for MI 7. A patient which with stable angina complains an increase in frequency of pain what does the nurse do first? 8. RN can delegate to UAP 9. A patient has A fib 10. Catopril side effect 11. Metropolol side effect 12. How to do know Lasix is effective in a patient with heart failure complaining of severe orthopnea? 13. Who would the nurse see first in a clinical setting? 14. Patient is on took one nitrate and is still complaining of chest pain.. What does the nurse do? 15. Digoxin 16. A patient calls the MD office complain of chest pain...Patient already took one nitrate..what should the nurse instruct patient to do? 17. Dilitazem what does it do? 18. What diuretic causes hyperkalemia and hyponatremia? 19. Digoxin 20. Left side sata 21. digoxin/ morphine 22. Thrombocytopenia sata a. 23. Digoxin 24. Metropolol Side effect 25. Irregular rate rhythm weak pulse- Quiz 3 Lim WED 1. Meter dose inhaler steps (know all the steps) a. bring the inhaler to your mouth, place it in your mouth b/w your teeth and close your mouth around it b. start to breathe in slowly 2-3 sec while press the top of your inhaler once and keep breathing in slowly until you have taken a full breath c. remove the inhaler from your mouth hold your breath for 10 seconds then breathe out slowly d. Wait one minute between each puff e. Rinse mouth after each dose to prevent thrush 2. A college health nurse interprets the pean expiratory flow rate for a student who has asthma and finds that the student is in the yellow zone of his asthma action plan. The nurse should base her actions on which of the following information? SATA a. The student should use his quick-relief inhaler (albuterol) b. The student's asthma is not well controlled c. The student's peak flow is 50-80% of his best peak flow d. The nurse should obtain a second expiratory flow rate. e. The student needs to go to the hospital, the nurse should obtain a second expiratory flow rate 3. The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications? a. Carvedilol b. Fluticasone c. Captopril d. Isosorbide dinitrate 4. A young adult patient who denies any history of smoking is seen in the clinic with a new diagnosis of chronic obstructive pulmonary disease (COPD). It is most appropriate for the nurse to teach the patient about a. α1-antitrypsin testing b. use of the nicotine patch c. continuous pulse oximetry d. effects of leukotriene modifiers. 5. The emergency department nurse is evaluating the effectiveness of therapy for a patient who has received treatment during an asthma attack. Which assessment finding is the best indicator that the therapy has been effective? a. No wheezes are audible. b. Oxygen saturation is >90%. c. Accessory muscle use has decreased. d. Respiratory rate is 16 breaths/minute 6. A patient is scheduled for pulmonary function testing. Which action should the nurse take to prepare the patient for this procedure? a. Give the rescue medication immediately before testing. b. Administer oral corticosteroids 2 hours before the procedure. c. Withhold bronchodilators for 4 to 6 hours before the examination. d. Ensure that the patient has been NPO for several hours before the test. 7. A client has begun therapy with theophylline. The nurse should plan to teach the client to limit the intake of which items while taking this medication? a. coffee, cola, and chocolate b. oysters, lobster, and shrimp c. melons, oranges, and pineapple d. cottage cheese, cream cheese, and dairy creamers 8. A nurse is caring for a patient who has COPD. The patient tells the nurse, "I can feel the congestion in my lungs, and I certainly cough a lot, but I can't seem to bring anything up". Which of the following actions should the nurse take to help this patient with tenacious bronchial secretions? a. Maintaining a semi-Fowlers position as often as possible b. Administering O2 via nasal cannula @ 2L/min c. Helping the patient select a low-salt diet d. Encouraging the patient to drink 2-3L water daily 9. A client is newly diagnosed with asthma and needs information regarding possible asthma triggers. The nurse is preparing to teach the client to prevent asthma triggers. What information is appropriate for the nurse to educate the client to avoid? a. Stay away from triggers 10. A nurse is caring for a client who has asthma and is taking fluticasone. The nurse should monitor the client for which of the following adverse effects? a. Hypertension b. Oropharyngeal candidiasis c. hyperglycemia d. Adrenocortical dysfunction 11. A patient with chronic obstructive pulmonary disease (COPD) has a nursing diagnosis of imbalanced nutrition: less than body requirements. An appropriate intervention for this problem is to a. "I will lie on my stomach to practice abdominal breathing every day." b. "I will avoid getting a flu shot." c. "I will inhale slowly through pursed lips to help me breathe better." d. "I will follow a daily diet high in calories and protein." 12. A nurse is providing discharge teaching to a patient who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the patient indicates an understanding of teaching? a. If my breathing begins to feel tight, I will use the cromolyn immediately. b. I will be sure to take the albuterol before taking the cromolyn. c. I will use both medications immediately after exercising. d. I will administer the medications 10 minutes apart. 13. When assessing a patient for hypoxemia during an asthma attack, which of the following manifestations should the nurse expect? a. Nausea b. Dysphagia c. Agitation d. Hypotension 14. A patient with COPD has a nursing diagnosis of impaired breathing pattern related to anxiety. Which nursing action is most appropriate to include in the plan of care? a. Titrate oxygen to keep saturation at least 90%. b. Discuss a high-protein, high-calorie diet with the patient. c. Suggest the use of over-the-counter sedative medications. d. Teach the patient how to effectively use pursed lip breathing. 15. A patient with an acute exacerbation of COPD has the following ABG analysis: pH 7.32, PaO2 48 mm Hg, PaCO2 55 mm Hg, and SaO2 86%. The nurse recognizes these values as evidence of a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis 16. The client arrives in the emergency department experiencing difficulty breathing. Which assessment finding requires immediate action by the nurse? a. Use of accessory muscles to breathe b. Respiratory rate of 26 c. Pulse oximetry reading of 91% d. Peak expiratory flow rate of 240 L/minute 17. A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide? SATA a. Reins mouth after administration b. Use a spacer c. Do not use this for an acute attack d. Use on a regular schedule rather than as needed e. Take with food 18. A patient with chronic obstructive pulmonary disease (COPD) has poor gas exchange. Which action by the nurse would be most appropriate? a. Have the patient rest in bed with the head elevated to 15 to 20 degrees. b. Ask the patient to rest in bed in a high-Fowler's position with the knees flexed. c. Place the patient in the Trendelenburg position with several pillows behind the head. d. Encourage the patient to sit up at the bedside in a chair and lean slightly forward. 19. A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects? a. Adrenocortical insufficiency b. Hyperglycemia c. Severe dehydration d. Rebound pulmonary congestion 20. A nurse is evaluating teaching on a client who has a new prescription for montelukast to treat asthma. Which of the following statements by the client indicates an understanding of the teaching? Thrown out! a. take 2 hours before exercise b. Take at the same time in the morning c. mix the granules with 20oz of water d. administer at the onset of wheezing 21. A nurse is teaching the parents of a child who is to start using a metered-dose inhaler (MDI) to treat asthma. Which of the following information should the nurse include in the teaching? a. "The spacer increases the amount of medication delivered to the oropharynx." b. "The spacer increases the amount of medication delivered to the lungs." c. "Inhale rapidly using the spacer with the MDI." d. "Cover exhalation slots of the spacer with lips when inhaling." 22. Client is in 5L of oxygen nurse action? a. Apply petroleum jelly to nares to moisturize mucosa membrane b. secure the tube at head of bead c. remove cannula during meals d. attach humidifier above flow rate 23. COPD ? a. Maintain an O2 saturation of at least 85% ? b. Titrate O2 to maintain 90% c. Give 6L O2 d. Increase O2 from 2L 24. COPD can lead to what a. Respiratory failure b. Lung cancer c. Pneumothorax d. Hemothorax 25. The nurse reviews the medication administration record (MAR) for a patient having an acute asthma attack. Which medication should the nurse administer first? a. Albuterol (Ventolin) 2.5 mg per nebulizer b. Methylprednisolone (Solu-Medrol) 60 mg IV c. Salmeterol (Serevent) 50 mcg per dry-powder inhaler (DPI) d. Triamcinolone (Azmacort) 2 puffs per metered-dose inhaler (MDI) Quiz 3 Joy WED 1. Shallow 9 breath per minute a. respiratory acidosis? 2. How to use inhaler (drag and put in order) a. Inhale and exhale b. Place mouth on mouth piece c. Inhale d. Hold breath e. Pursed lip f. Wait 60 seconds before next puff 3. Theophylline 4. Chest X-ray 5. Expectorant 6. Phlebitis 7. Kid acute asthma attack 8. N/C 9. Presentation to prevent COPD 10. COPD 11. Digoxin/ Lasix 12. Pursed lip breathing 13. N95 14. Inhaler 15. Nurse's priority 16. Needs further teaching 17. Steroid 18. Call MD Quiz 3 Joy SAT Q3 - J. SAT 1. A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide? a. take the medication with meals b. rinse the mouth after administration i. Rationale: MDI can allow fungal overgrowth in the mouth. Rising the mouth after administration can lessen the likelihood of this complication. 2. A nurse is providing discharge instructions to a client who has asthma and is about to start taking theo. the nurse should tell the client that this medication might cause which of the adverse effects? 3. A nurse is providing discharge instructions to a client who has asthma and a new prescription for montelukast. THe nurse should instruct the client to report which of the following a/e to the provider? a. palpitations b. blurred vision c. diarrhea d. depression i. Rationale: psych s/e include: depression, behavior changes, hallucinations, and suicide ideation. Nurse should tell the patient to report any of these changes. A change in medication may be prescribed. 4. A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects? a. hyperglycemia b. adrenocortical insufficiency i. Rationale: abrupt withdrawal can lead to syndrome of adrenal insufficiency c. severe dehydration d. rebound pulmonary congestion i. Rationale: it is an a/e of prednisone BUT rebound should not occur with withdrawal of prednisone 5. Patient with COPD, nurse is percussing over the right tenth rib and hears a dull sound. What a. liver a. over the heart 6. A nurse is assessing a client for hypoxemia, during an asthma attack. Which of the following manifestations should the nurse expect? a. agitation i. Rationale: The nurse should expect agitation due to neurological changes from poor oxygen exchange. b. hypotension c. nausea d. tachycardia 7. The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the providers orders and recognizes that clarification is needed for which of the following medications? a. Carvedilol i. Rationale: This is a medication that blocks beta-2 receptors (same as propanolol), which are contraindicated in clients with asthma. b. Fluticasone c. Captopril 8. A nurse is admitting a client who is having an exacerbation of his asthma. When reviewing the providers orders, the nurse recognizes that clarification is needed for which of the following medications? a. propranolol i. This medication blocks beta-2 receptors, contraindicated in clients with asthma. b. theophylline c. montelukast d. prednisone 9. A nurse in an urgent care center is caring for a client who is having an acute asthma exacerbation. Priority? a. initiate O2 therapy b. provide immediate rest for the client c. High Fowler's d. administer nebulized beta-adrenergic i. Rationale: ABC’s, greatest risk is airway obstruction. Beta-adrenergic medications act as bronchodilators. MOA: relax bronchiolar smooth muscle and is the initial priority intervention when client has an acute asthma exacerbation. 10. a patient does something about their asthma plan and is in the yellow zone, what does this indicate to the nurse? a. their asthma is not well controlled b. the nurse should obtain a second expiratory flow rate c. they need to use their quick relief inhaler d. they are breathing at 50-80% of their peak e. the student needs to go to the hospital 11. A nurse in an emergency department is caring for a child who is experiencing an acute asthma attack. Which of the following medications should the nurse expect to administer first? a. Fluticasone b. Budesonide c. Montelukast d. Albuterol 12. A nurse is assessing a client who has asthma. Which of the following areas should the nurse evaluate as the most reliable indicator of central cyanosis. a. soles of the feet b. conjunctiva c. oral mucosa d. ear lobes 13. A nurse is caring for a client who has COPD. The client tells the nurse “I can feel the congestion in my lungs, and I certainly cough a lot, but I can’t seem to bring anything up.” Which of the following actions should the nurse take to help this client with tenacious bronchial secretions? a. Position the client in high fowlers b. administer 02 via nasal cannula at 2 L/min c. Help the patient with a low salt diet d. Encourage the client to drink 2-3 L of water daily 14. A patient is diagnosed with nutrition imbalance: less than body requirements. What should the nurse suggest? a. high calorie, high protein snacks in between meals and before bedtime. b. more fruits c. wider variety of vegetables d. more whole grain 15. a smoking patient asks, “Why do i need to stop smoking? My lungs are already damaged.” what is the best response by the nurse. a. “You should enjoy the time left.” b. “If you stop smoking, your symptoms may be less severe.” c. “If you stop smoking, your lungs will get better pretty quickly.” d. “If you stop smoking, your COPD will not get worse as fast.” 16. A nurse on a medical-surgical unit is performing an admission assessment of a client who has COPD with emphysema. The client reports tha he hass a frequent productive cough and is short of breath. The nurse should anticipate which of the following assessment findings for this client? a. Respiratory alkalosis b. Increased anteroposterior diameter of the chest c. Decreased oxygen saturation d. petechiae on chest 17. A client is planning to perform nasotracheal suction for a client who has COPD and an artificial airway. Which of the following actions should the nurse take? a. Limit the pass to 25 seconds: nurse should limit the pass to 5-10 secs to prevent trauma to the respiratory mucosa and minimize risk of hypoxemia. b. Preoxygenate the client with 100% oxygen for up to 3 mins. c. Apply suction to the catheter when advancing it into the trachea. 18. What should the nurse instruct the patient before a pulmonary function test is performed? a. hold bronchodilators 6-12 hrs before procedure b. Remove all jewelry c. Ask if they are allergic to iodine. Quiz 3 Lim FRI [Show More]
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