NS 309 Final Exam Practice Questions and Answers

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The client is receiving vancomycin. A peak and trough level is ordered for the dose the nurse is administering. Which priority intervention should the nurse implement? A. Monitor the amino glycosid... e peak level B. Determine if the trough level has been drawn C. Ask the client if he has had any diarrhea D. Check the client's culture and sensitivity report - ANSWER B. Determine if the trough level has been drawn The client with type 2 diabetes is prescribed glyburide. Which statement indicates the client understands the medication teaching. A. "There are no side effects that I need to worry about." B. "This medication will make my muscles absorb insulin." C. "I should carry some hard candy when I go walking." D. "I must take my insulin injection every morning." - ANSWER C. "I should carry some hard candy when I go walking." The client glucose reading is 380 mg/dL. How many units should the nurse administer? GLUCOMETER READING // UNITS OF INSULIN <150= 0 151-250= 5 251-350= 8 351-450= 10 - ANSWER 10 Units of insulin The nurse administers 18 units of humulin N at 1630. Which priority intervention should the nurse implement? A. Monitor the client's hemoglobin A1C B. Make sure the client eats the evening meal C. Ensure that the client eats a snack D. Check the A1C blood glucometer reading - ANSWER B. Make sure the client eats the evening meal The nurse administering the following 1800 medications. Which medication should the nurse question before administering? A. The sliding-scale insulin to the client who has just been released to have the evening meal. B. Metformin to the client having a CT scan in the morning C. Protonix to the client diagnosed w/ peptic ulcer disease D. The antibiotic to the client who is one day post-op expiratory abdominal surgery - ANSWER B. Metformin to the client having a CT scan in the morning The nurse is administering insulin glargine to the client at 2200. The nurse asks the charge nurse to check the dosage. Which action should the charge nurse implement? A. Have the nurse notify the health care provider B. Ask the nurse why the insulin is being given late C. Instruct the nurse to complete a medication error form D. Check the MAR with the dosage in the syringe - ANSWER B. Ask the nurse why the insulin is being given late The nurse is preparing to administer Synthroid to a client. Which assessment data would indicate the client is receiving too much medication? A. Bradypnea and weight gain B. Irritability and tachycardia C. Lethargy and hypotension D. Normothermia and constipation - ANSWER B. Irritability and tachycardia The nurse administered an IV broad spectrum antibiotic scheduled every 6 hours to the client at 0800. At 1000 the culture and sensitivity prompted the HCP to change the IV antibiotic. When should the nurse administer the new medication? A. Administer the dose within one hour of the order B. Schedule the dose for the next day C. Check with the HCP to determine when to start D. Schedule the dose for 1400 - ANSWER C. Check with the HCP to determine when to start The HCP has ordered an intramuscular antibiotic. After reconstituting the medication the clinic nurse must administer 4.8 mL of the medication. Which action should the nurse implement first when administering this medication? A. Administer the medication in the gluteal muscle B. Divide the medication and give 2.4 mL in each hip C. Inform the HCP that this is toom uch medication D. Discard the medication in the sharps container - ANSWER B. Divide the medication and give 2.4 mL in each hip ** A client calls a clinic to renew prescription for insulin being administered subcutaneously via insulin pump. Which insulin type if prescribed by a physician, should the nurse question? A. Insulin lispro B. Insulin gluisine C. Insulin aspart D. Insulin glargine - ANSWER D. Insulin glargine Exenatide is prescribed for a client with type 2 diabetes in addition to a combination of metformin and glyburide. A. Teaching the client how to administer exenatide subcutaneously B. Discussing exenatide's action in reducing hemoglobin A1C and fasting plasma glucose levels C. Informing the client that exenatide helps to reduce body weight due to slower gastric emptying D. Discussing the signs and symptoms of hypoglycemia - ANSWER A. Teaching the client how to administer exenatide subcutaneously An unresponsive client with DM is admitted to an emergency department w/ a serum glucose level of 35 mg/dl. Which medication should a nurse plan to administer? A. Pramlintide B. Miglitol C. Glucagon D. Exenatide - ANSWER D. Exenatide A client is receiving levothyroxine for the treatment of hypothyroidism. Which serum laboratory results should lead a nurse to conclude that the client's dose is adequate? A. A glucose and free T4 B. Thyroid-stimulating horming (TSH) and T4 C. Potassium and sodium D. White blood cells and platelets - ANSWER B. Thyroid-stimulating horming (TSH) and T4 The order reads to give a client 300 units of penicillin every 8 hours. The nurse notes that the safe dose for the client is 1500 units daily. Which of the following interventions should the nurse perform? A. Hold the medication and contact the provider B. Hold the medication and contact the pharmacy C. Give the medication & contact pharmacy to send more D. Give the medication - ANSWER D. Give the medication The client diagnosed with type 2 diabetes has been prescribed an oral hypoglycemic medication, calls the clinic and reports yellowing around the sclera. Which intervention should the nurse implement? A. Check to see if the client is taking a cardiac glycoside B. Determine if the client has a history of alcohol use C. Ask the client if he or she has been exposed to someone with hepatitis D. Make an appointment for the client to come in to the clinic - ANSWER D. Make an appointment for the client to come in to the clinic A client is taking insulin glargine. The nurse should administer the medication at what time? A. Midday B. Prior to each meal C. At night D. Prior to the evening meal - ANSWER C. At night A client takes 20 units of NPH at 7 a.m.. The nurse knows to look for signs of hypoglycemia at what time? A. 3 p.m. B. 10 a.m. C. 8 a.m. D. 5 a.m. - ANSWER B. 10 a.m. When instructing a client who has been prescribed thyroid replacement medication, the nurse should teach the client to take the medication: A. in the evening B. after meals C. in the morning D. at bedtime - ANSWER C. in the morning A diabetic client is maintained on metformin. Which teaching should be included in the plan of care? A. increase the amount of carbohydrates in your diet B. allow six weeks for optimal effects C. report changes in urinary patterns D. use lotions to treat itching - ANSWER B. allow six weeks for optimal effects A client comes in to the clinic and is diagnosed with tuberculosis. The patient is to receive isoniazid (INH) and the nurse realizes that during therapy the patient must be assessed for signs of: A. glaucoma B. renal disease C. congestive heart failure D. hepatotoxicity - ANSWER D. hepatotoxicity A client is receiving gentamicin. Which of the following assessments would cause the nurse to discontinue use? A. photosensitivity B. seizure C. hearing loss D. tooth discoloration - ANSWER B. seizure Before administering the first dose of penicillin to a client, the client states "I develop a rash when I was a child when my mom gave me penicillin". What is the best action for the nurse to take? A. withhold the drug and notify the physician B. administer the dose as ordered and observe for a reaction C. administer the prn diphenhydramine before giving the first dose D. administer the drug IM - ANSWER A. withhold the drug and notify the physician The prescriber orders tetracycline for a three year old patient. The nurse would question this order because of which contraindication? A. loss of hearing B. elevated BP C. photosensitivity D. tooth discoloration - ANSWER D. tooth discoloration When reviewing the allergy history of a client, the nurse notes that the client is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics? A. sulfonamides B. tetracyclines C. imipenem-cilastatin D. cephalosporins - ANSWER D. cephalosporins 2 hours after taking a dose of Humulin R, a client complains of tremors, palpitations and tachycardia. Which nursing action is most appropriate for this client? A. Check pulse oximetry and administer oxygen B. Administer a baby aspirin and one sublingual nitroglycerin tablet C. Check blood glucose D. Check vital signs - ANSWER D. Check vital signs A nurse administers a usual morning dose of 4 units of regular insulin and 8 units of NPH at 7:30a.m. Which statements regarding the client's insulin are correct? A. The onset of the regular insulin will be 7:45 a.m. and the peak at 1:00 p.m. B. The onset of regular insulin will be at 8 a.m. and the peak will be at 10:00 a.m. C. The onset of the NPH insulin will be at 8 a.m. and the peak at 10 a.m. D. The onset of the NPH will be at 12:30 p.m. and the peak at 11:30 p.m. - ANSWER B. The onset of regular insulin will be at 8 a.m. and the peak will be at 10:00 a.m. *A home health nurse is planning the first home visit for a 60 year old client newly diagnosed with type 2 diabetes. The client has been instructed to take NPH in the morning and at supper time. Which interventions should be included in the client's care plan? A. Instruct the client to inspect the hands daily B. Ensure that the client eats a bedtime snack C. Assess the client's ability to read small print D. Teach the client how to perform an A1C E. Instruct the client on storing pre-filled syringes in the refrigerator - ANSWER A. Instruct the client to inspect the hands daily B. Ensure that the client eats a bedtime snack D. Teach the client how to perform an A1C The client received 10 units of Humulin R at 0700. At 1030, the CNA tells the nurse the client has a headache and is really acting "funny". Which action should the nurse implement first? A. Instruct the assistant to obtain a blood glucose test B. Have the client drink 8 ounces of orange juice C. Prepare to administer one amp 50% dextrose D. Go to the client's room and assess the client for hypoglycemia - ANSWER D. Go to the client's room and assess the client for hypoglycemia *A person should not take amaryl, a sulfonylurea, if they are allergic to: A. penicillin B. sulfa C. insulin D. caffeine - ANSWER B. sulfa The nurse needs to monitor the client daily for superinfection. A super infection can be defined as an infection that: A. is resistant to the currently used antibiotic B. necessitates increased amount of antibiotic treatments C. occurs if antibiotic therapy is abruptly stopped D. develops when an antibiotic alter the normal bacteria flora - ANSWER D. develops when an antibiotic alter the normal bacteria flora The client will have an increased chance of developing nephrotoxicity if he takes Cefazolin along with: A. an antacid B. vitamin D C. dimenhydronate D. an aminoglycoside - ANSWER D. an aminoglycoside *Which lab result is indicative of an adverse effect of cephalosporins? A. increased potassium B. increased BUN & creatinin C. decreased AST & ALT D. elevated hemoglobin - ANSWER B. increased BUN & creatinin Rationale= Cephalosporins may cause kidney failure, nephrotoxicity *Which statement by the client indicates a need for more teaching about erythromycin? A. "If I notice any change in my hearing, I will call the doctor." B. "I will take erythromycin with orange juice." C. "I won't take the erythromycin with meals." D. "I won't crush the erythromycin tablets. I'll swallow them whole." - ANSWER B. "I will take erythromycin with orange juice." Rationale= Take macrolides on an empty stomach *Which of the following adverse effects should the client report to the physician while taking tetracycline? A. constipation B. hypertension C. tachycardia D. diarrhea - ANSWER D. diarrhea The client is receiving enoxaparin. Which anatomical site is recommended for administering this medication? A. in the anterolateral abdomen (love handles) B. in the deltoids, subcutaneously C. the abdominal wall 1 inch away from the umbilicus D. the vastus lateralis with a 23 gauge needle - ANSWER A. in the anterolateral abdomen (love handles) *The client is receiving enalapril. When would the nurse question administering this medication? A. The client is not receiving a potassium supplement B. The blood pressure for 2 consecutive readings is 110/70 C. The client complains of a persistent irritating cough D. The client's urinary output is 400 mL for the last 8 hours - ANSWER C. The client complains of a persistent irritating cough The nurse is providing medication information about warfarin to a client who is being discharged following heart valve replacement. Which of the following information would provide the best protection for the client? A. Use an electric razor and a soft toothbrush B. Follow up lab testing is required every 3 months C. If a dose is missed, take the missed dose with the next scheduled dose D. Take this medication upon arising in the morning on an empty stomach - ANSWER A. Use an electric razor and a soft toothbrush The client taking heparin has blood profusely from multiple sites. Which medication should the nurse give to the client? A. Urokinase B. Platelets C. Protamine sulfate D. Vitamin K - ANSWER C. Protamine sulfate Before administering morphine, which assessment is most important for the nurse to make? A. Apical pulse rate B. Blood pressure C. Respiratory rate D. Level of consciousness - ANSWER C. Respiratory rate A client is admitted with severe back pain and is requesting pain medication. During the assessment, the nurse notes that the client has been taking acetaminophen 650mg every 4 hours at home with minimal relief. Based on this information, which of the following PRN ordered drugs should the nurse consider administering? A. acetaminophen B. acetaminophen and oxycodone C. acetaminophen and hydrocodone D. ibuprofen - ANSWER A. acetaminophen A patient has prescriptions for 2 inhalers. One inhaler is a bronchodilator and the other is a corticosteroid. Which instruction regarding these inhalers should the nurse give to the patient? A. The corticosteroid should be taken first B. The bronchodilator should be taken first C. The two drugs should be taken 2 hours apart D. The order of administration does not matter with these 2 drugs - ANSWER B. The bronchodilator should be taken first A client with asthma has pronounced wheezing upon auscultation. What is the nurse's priority action? A. Have the client cough and deep breathe B. Prepare to administer a nebulizer beta-2 adrenergic agonist C. Prepare to intubate the client D. Have the client lay on his or her right side - ANSWER B. Prepare to administer a nebulizer beta-2 adrenergic agonist A nurse is to administer 40mg of furosemide to a client in heart failure. The prefilled syringe reads 100mg/mL. In order to give the correct dose, the nurse should administer how many mL to the client? - ANSWER 0.4 mL D/H 40mg/(100 mg/mL) = 0.4 mL *A client diagnosed with DM is on an insulin infusion drip. The insulin bag indicates there are 100 units of insulin in 1,000mL of normal saline. Based on the client's blood glucose readings, the client should receive 1.5 units per hour. To ensure that the client receives 1.5 units/hour, the nurse should set the pump at how many mL per hour? - ANSWER A client has eaten 45 grams of carbohydrates. The client is to receive 2 units of insulin subcutaneous for each carb choice. 1 carb choice= 15 carbs. How many units of insulin should the client receive? - ANSWER 45/15= 3 x 2= 6 units of insulin The health care provider orders 1,500 mL of normal saline to be given over 10 hours. How many mL/hour should the nurse program on the pump? - ANSWER 1,500 mL/10 hours= 150 mL/hour The physician has ordered 1.5 grams of cefazolin sodium. The client asks you how many mg that is equal to. The answer you would tell the client is? - ANSWER 1,500 mg *Infuse meropenem 1g/100mL D5W over 20 minutes. What flow rate should be set on the pump? - ANSWER 100mL/20min= 5ml/1min Kanamycin 200mg/IM. Dose available: Add 2.3 mL sterile water to make kanamycin 1g/3mL. How many mL should the nurse give? - ANSWER 0.6 mL 200mg x 3mL= 600 mg/mL (600 mg/mL)/1,000 mg= 0.6 mL Heparin 800 units subcutaneously bid. Dose available: Heparin 5,000 units/mL - ANSWER 0.16 mL (800 units x 1 mL)/5,000 units= 0.16 mL A nurse receives an order to administer metoprolol 50mg po bid. What action should the nurse take? - ANSWER administer the medication as ordered A nurse is observing a nursing student apply a clonidine transdermal patch to a client diagnosed with hypertension. Which action requires the nurse to intervene? - ANSWER The student applies the patch, rubbing the patch against the skin and then securing it in place A nurse receives the following medication orders while caring for multiple clients. Which medication should the nurse plan to administer first? - ANSWER Nitroglycerin 0.4mg sublingually stat for the client experiencing chest pain A client refuses to take a medication, despite the nurse implementing measures to control side effects. What is the next action the nurse should take? - ANSWER Report the information to the client's healthcare provider and request a different medication A mother calls the clinic to determine how much cough medication she should administer to her child. THe bottle states to give 5 mL using the dropper provided. The mother wants to use a teaspoon because the dropper is not available. The nurse should tell the mother to administer how many teaspoons? - ANSWER 1 teaspoon A nurse checking newly written orders determines that which orders require the nurse to contact the physician to clarify the order? - ANSWER - Aspirin 325mg orally qd - MS 4mg IV q 1 hr prn - Heparin 5,000 u subcutaneously bid A client experiences extravasation at the site where DOPAMINE HYDROCHLORIDE is infused. The infusion is stopped. What action should the nurse take next? - ANSWER The IV site should be treated with PHENTOLAMINE The student nurse is administering digoxin. The client's vital signs include a pulse rate of 55 and BP of 112/70. What would the student's priority action be? - ANSWER Hold the medication and notify the healthcare provider *The client was given nitroglycerin for chest pain. On assessment for the BP, the client states "I have a headache". The client's BP is 100.65. What action should the nurse take. - ANSWER Document the blood pressure *Which of the following should the nurse include in teaching about taking sublingual nitroglycerin? - ANSWER Take the tablet before exercise to prevent angina, replace the tablet on a yearly basis The provider orders a diabetic client to start on propanolol. The nurse knows that teaching was effective when the client states which of the following? - ANSWER Propanolol can increase the risk of hypoglycemia so I should check my blood sugar more often Which action is a priority for the nurse who has a client on IV heparin? - ANSWER Attach the IV heparin to an infusion pump The client taking heparin is bleeding profusely from multiple sites. Which medication should the nurse give to the client? - ANSWER Protamine sulfate The nurse has provided education about warfarin sodium to a client. The nurse knows further instruction is needed when the client states which of the following? - ANSWER If I miss a daily dose of warfarin sodium, I can take 2 tablets the next day. THe client requests pain medication for a headache while receiving his heparin. The healthcare provider has ordered aspirin 650mg po q4h for pain. The nurse should do which of the following? - ANSWER Call the healthcare provider for a different pain reliever Nursing interventions during initial therapy with ACE-inhibitors must include= - ANSWER monitoring blood presure The nurse administering metoprolol. Prior to giving this medication for the first time, the nurse would question which of the following? - ANSWER a history of asthma The nurse administering lisinopril po. The nurse understands that the right assessment for this drug would include which of the following? - ANSWER Pulse, BP immediately prior to administration, BP 1 hour after administration *Which type of drug interaction occurs when one drug increases the other's effect, causing a total effect greater than the sum of the drug's separate effects? - ANSWER Synergistic interaction A nursing responsibility for a client receiving an antihypertensive medication is to= - ANSWER teach the client to stand up to sit up slowly A nurse is assessing a client who is taking atorvastatin. Which manifestations should the nurse ask about? - ANSWER Muscle pain and weakness *Which points should the nurse plan to include when teaching a client receiving a thiazide diuretic? - ANSWER - Report side effects such as muscle cramps, nausea, or a skin rash - Keep appointments for lab monitoring - Include fruits such as melons and bananas in the diet Oral terbutaline is prescribed for a client with bronchitis. Which comobidity should prompt a nurse to monitor the client closely following administration of this medication. - ANSWER Hypertension A patient has prescriptions for 2 inhalers. One inhaler is a bronchodilator and the other is a corticosteroid. Which instruction regarding these inhalers should the nurse give to the patient? - ANSWER The bronchodilator should be taken first The nurse is providing instructions to a patient who has a new prescription for a corticosteroid metered-dose inhaler. Which instructions are appropriate? Select all that apply. - ANSWER - Rinse your mouth with water after using the inhaler and spit out the water - Clean the plastic inhaler casing weekly by removing the canister, washing in warm soapy water, and reassembling when dry - Continue using the inhaler even if you are feeling better - Use a peak flow meter to measure your response to therapy When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects? - ANSWER Oral candidiasis and dry mouth *When evaluating a patient's use of a metered dose inhaler, the nurse notes that the patient is unable to coordinate the activation of the inhaler with her breathing. What intervention would be most appropriate t this time? - ANSWER Obtain a spacer device A patient is in an urgent-care center with an acute asthma attack. The nurse expects that which medication will be used for initial treatment. - ANSWER A beta 2 agonist such as albuterol A major nursing responsibility in relation to drug therapy is to= - ANSWER teach the clients about the medications they take A patient has been receiving IV doses of the antihypertensive drug propanolol 1mg q12h. The provider has now ordered 20mg po qid and d/c the IV dose. The nurse notes that the higher oral dose indicates less drug effectiveness via the oral route because of= - ANSWER hepatic first pass phenomenon The nurse has orders to administer 0.5mg epinephrine subcutaneously. The medication is supplied in a vial for injection that contains 5 mg/mL. How much should the nurse give subcutaneously? - ANSWER 0.1 mL The order reads digoxin 0.375 mg once daily by mouth. The bottle reads digoxin 0.25 mg per tablet. How much should the nurse administer? - ANSWER 1.5 tablet Enoxaparin sodium 25 mg SC q 12 hours is ordered. The label reads 30 mg/0.3 mL. How much should the nurse administer? - ANSWER 0.25 mL An adult is on continuous IV heparin therapy for thrombophlebitis. The IV contains 15,000 units of heparin in 500 mL. If the IV is running at 20 mL/hr, how many units per hour is the client receiving? - ANSWER 600 units The healthcare provider orders metoprolol 75 mg IV stat. Dose available is 50 mg/mL. How much should the nurse administer? - ANSWER 1.5 mL Physician order: Heparin 800 units SC bid. Available: 5,000 units/mL. How much should the nurse administer? - ANSWER 0.16 mL Physician order: Verapamil HCl 7.5 mg IVP. Available: Verapamil HCl 2.5 mg/mL - ANSWER 3 mL Physician order: 0.125 mg po qd Available: Digoxin 0.25 mg tablets - ANSWER 0.5 tablet 6 rights of medication administration - ANSWER 1. Patient 2. Dose 3. Route 4. Time 5. Medication 6. Education What is wrong with the following order? "Labetalol 100 mg qd" - ANSWER No route included, abbreviations A post-op client states that they are worried that they will become addicted to painkillers so they will wait for the pain to become intense before taking the meperidine. The nurse's best response would be which of the following? - ANSWER Meperidine will be most effective if you take it before your pain becomes severe. This will decrease your needing excessive amounts Before administering morphine, which assessment is most important for the nurse to make? - ANSWER Respiratory rate Which adverse effect would the nurse not expect to observe in a client receiving a narcotic analgesic? - ANSWER Hypoglycemia Expect= Urine retention, hypotension, constipation Which of the following assessments by the nurse indicates an adverse effect of naloxone? - ANSWER Tremors The nurse should teach clients to watch for which common adverse effect of phenytoin? - ANSWER Gingival hyperplasia The drug of choice for an active seizure is which of the following? - ANSWER Diazepam Which of the following interventions should the nurse stress while a client is on lithium therapy? - ANSWER Do not restrict sodium *Which statement indicates a need for more teaching by the nurse concerning fluoxetine therapy? - ANSWER I will use calamine lotion if I get a skin rash Which of the following effects of atropine sulfate would the nurse expect a client to exhibit? - ANSWER Dry mouth *Which statement indicates that the client needs more teaching concerning the use of atropine sulfate? - ANSWER I will eat low-residue foods to prevent diarrhea A client with metastatic colon cancer has been prescribed hydromorphone po/prn to help manage pain. The nurse knows that the rectal route of administration is contraindicated when which of the following is present? - ANSWER Neutropenia= Low levels of neutrophils *A client is admitted with severe back pain and is requesting pain medication. During the assessment, the nurse notes that the client has been taking acetaminophen 650mg q4h at home with minimal relief. Based on this information, which of the following PRN ordered drugs should the nurse consider administering? - ANSWER Ibuprofen A boy is prescribed amphetamine and dextroamphetamine for ADHD. The nurse explains that the client should be alert for which of the following adverse drug effect? - ANSWER Depression A client regurns to the clinic after being started on allopurinol 200mg po qd. The nurse reviews information about the medication with the client. Which of the following statements by the client indicates that teaching was effective? - ANSWER I should drink at least8 glasses of water qd Phenytoin has been ordered 4 times a day for the client. Prior to administering the second dose, the nurse notes that the client appears lethargic, has nystagmus and dilantin level of 30. Which of the following is priority for the nurse to do? - ANSWER Withhold the phenytoin due to signs of toxicity The nurse reviews medication information with a client who has been prescribed sertraline daily. Which of the following statements by the client indicates a need for further instruction? - ANSWER If these pills don't work in 2 weeks, I will stop taking them The nurse is caring for an elderly client who is 8 hours postop hip replacement and is reporting incisional pain. Which intervention is priority for this client? - ANSWER Initiate pain medication at lowest dose *The client with arthritis is self-medicating with aspirin, an NSAID. Which complication should the nurse discuss with the client? - ANSWER Tinnitus The client received naloxone following colonoscopy. Which action by the nurse has the highest priority? - ANSWER Assess the client q 15-30 minutes The client dx w/ epilepsy is being discharged from the hospital w/ rx for phenytoin. Which discharge instructions should the nurse discuss with the client? - ANSWER Client should see a dentist at least q 6 months *The client w/ osteoarthritis is prescribed an NSAID. Which interventions should the nurse implement? - ANSWER Time the medication to be given with meals. The client with epilepsy is prescribed carbamazapine. Which discharge instruction [Show More]

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