question

theophylline - bronchodilator

answer

Drug of choice for acute asthma

question

tetracycline hydrochloride

answer

broad spectrum antibiotic

question

For the pregnant patients who are having a dry labor, the best thing to tell them is:

answer

the amniotic sac may impede the progress of labor and is often ruptured artifically

question

For manic patients, you offer which types of food?

answer

Foods that are high in protein, carbohydrates, vitamin C, and fiber

question

Which action should the nurse instruct the client to complete first to establish a normal urinary pattern? 1. Urinate every two hours 2. Record each time the client urinates 3. Keep a record of daily fluid intake 4. Stay near a bathroom

answer

1. Urinate every two hours - client should start voiding every two hours and gradually progress to three to four hours 2. Record each time the client urinates - second thing to do 3. Keep a record of daily fluid intake - CORRECT: client needs to know how much and when fluid is ingested 4. Stay near a bathroom - appropriate but not the first thing to do

question

The nurse plans care for the client who had surgery for an ileal conduit 2 days ago. It is most important for the nurse to take which action? 1. Remove the appliance regularly, and clean the skin with antiseptic solution 2. Apply a close-fitting drainage bag to the stoma 3. Massage the skin around the stoma with an emollient 4. Expose the area around the stoma to air twice a day

answer

1. Remove the appliance regularly, and clean the skin with antiseptic solution - soap and water should be used to clean the skin, not an antiseptic solution 2. Apply a close-fitting drainage bag to the stoma - CORRECT: primary preventative measure to prevent urine from contacting the skin 3. Massage the skin around the stoma with an emollient - would hinder the application of the bag for urine collection 4. Expose the area around the stoma to air twice a day - unnecessary; would not help prevent skin breakdown

question

With spinal cord injury, which type of food do you give?

answer

-High-fiber, low-fat diet - This helps prevent the complication of constipation

question

Babies double their birth weight at:

answer

5 months

question

Babies at 8 months can:

answer

- Smile when parents walk into the room by 6 months of age - Cry around strangers at 6 months and increases until 9 months - Can say dada or mama with meaning at 10 months of age

question

The 11 month old baby is having trouble gaining weight after discharge from the hospital. Which action by the nurse is best? 1. Observe the child at mealtime 2. Inquire about the child's eating patterns 3. Weigh the baby each month 4. Attempt to feed the baby for the mother

answer

1. Observe the child at mealtime - CORRECT: assessment; will provide the most information 2. Inquire about the child's eating patterns - assessment; may or may not secure an accurate picture 3. Weigh the baby each month - assessment; weight should be obtained more often or on each visit 4. Attempt to feed the baby for the mother - implementation; need to assess before determining appropriate interventions

question

Hypoparathyroidism

answer

- Tetany is a major sign: numbness and tingling

question

Graves' disease diet to avoid:

answer

- Anything that stimulates metabolic rate: iced coffee, diet cola, hot tea

question

ciprofloxacin - antibiotic

answer

- Drink plenty of fluids - Avoid sun exposure - Avoid caffeine cause it might increase caffeine effects

question

The client is to receive regional anesthesia (spinal anesthesia) during surgery. Which finding is the most important nursing implication regarding this anesthesia? 1. Adequately hydrate the client 2. NPO client for at least 12 hours 3. Assess the client for any allergies to idoine preparations 4. Determine the specific gravity of the urine

answer

1. Adequately hydrate the client - CORRECT: implementation; important that the client be well hydrated to prevent hypotensive problems after the spinal anesthesia is initiated 2. NPO client for at least 12 hours - implementation; unnecessary for client to be NPO for 12 hours 3. Assess the client for any allergies to idoine preparations - assessment; unnecessary, as iodine dyes are not used 4. Determine the specific gravity of the urine - assessment; irrelevant to the procedure

question

Transsphenoidal hypophysectomy - removes tumor of the pituitary gland. YOU SHOULD WATCH OUT FOR WHAT?

answer

- Specific gravity of urine - lack of ADH from pituitary will cause diabetes insipidus and diuresis with very low specific gravity

question

A LPN/LVN contacts the nurse to say that they have shingles on their back. Which statement by the nurse is best? 1. You can't take care of clients for 14 days 2. Come to work as scheduled 3. You can't care for clients until the lesions are crusted 4. Please contact your health care provider

answer

1. You can't take care of clients for 14 days - staff with localized lesions can care for non-high-risk clients 2. Come to work as scheduled - CORRECT: able to care for non-high risk clients; cover lesions should not care for pregnant women, premature infants, or immunocompromised clients 3. You can't care for clients until the lesions are crusted - able to care for low risk clients if lesions are covered 4. Please contact your health care provider - passing the buck

question

With onset of labor in primipara, YOU SEE:

answer

- Gush of fluid run down the legs -> indicates rupture of membranes, symptom of labor - See blood in vaginal discharge -> common symptom of labor - Experience low backache

question

cytomegalovirus (CMV)

answer

- Follow standard precautions - Pregnant people should be aware because CMV is fetotoxic

question

The nurse encounters a client diagnosed with psychosis coming out of the room nude. Which response by the nurse is best? 1. Come with me. You need to get dressed. 2. Why are you coming into the hallway undressed? 3. Being naked in the hallway is inappropriate. Return to your room to get dressed. 4. Do I need to get a male nurse to help you get dressed?

answer

1. Come with me. You need to get dressed - inappropriate behavior must be explained to client 2. Why are you coming into the hallway undressed? - don't ask "why" questions 3. Being naked in the hallway is inappropriate. Return to your room to get dressed - CORRECT: identifies inappropriate behavior and tells client what change must take place 4. Do I need to get a male nurse to help you get dressed? - yes/no question

question

The client on suicide precautions asks for a razor to shave her legs. When the nurse tells the client that she must remain with the client, the client responds, "Don't you trust me?" Which response by the nurse is best? 1. It is against hospital policy to allow clients on suicide precautions to have razors unsupervised 2. I trust you, but your health care provider said a nurse has to watch you if you want to shave your legs 3. Wouldn't you rather wait until you are feeling better before you try to shave your legs? 4. You have been having thoughts about wanting to hurt yourself recently, so I'll stay with you

answer

1. It is against hospital policy to allow clients on suicide precautions to have razors unsupervised - true statement but not the most therapeutic 2. I trust you, but your health care provider said a nurse has to watch you if you want to shave your legs - passing the buck 3. Wouldn't you rather wait until you are feeling better before you try to shave your legs? - yes/no question 4. You have been having thoughts about wanting to hurt yourself recently, so I'll stay with you - CORRECT: provides client with factual information in a caring manner

question

phenytoin sodium

answer

- Can cause pink urine -> normal - A pregnancy risk category D

question

Transcutaneous electrical nerve stimulation (TENS)

answer

- NORMAL: gel is used; rotate sites; turn up the voltage until patients feel a prickly "pins and needles" sensation; turn up the voltage based on the relief of pain - ABNORMAL: twitching of extremities; electrodes are placed over, above, or below the painful area; apply the electrodes before turning the device on

question

aminophylline - bronchodilator Should withhold based on:

answer

- propranolol -> may decrease metabolism and lead to toxicity - ciprofloxacin -> quinolones may decrease hepatic clearance of aminophylline causing risk of toxicity - seizure medications -> contraindicated in clients with poorly controlled seizure disorder

question

iron supplement should be taken with

answer

Orange juice -> vitamin C facilitates absorption of iron

question

Normal ammonia level

answer

15 - 45 mcg/dL

question

After abdominal surgery, the client reports abdominal gas pain. It is most important for the nurse to take which action? SATA 1. Offer the client fresh fruits 2. Ambulate the client frequently 3. Teach the client how to splint the abdomen during activity 4. Position the client on her right side 5. Provide bisacodyl suppositories prn

answer

2. Ambulate the client frequently - ambulation promotes the return of peristalsis and facilitates expulsion of flatus 4. Position the client on her right side - positioning on the right side aids in the release of gas in the colon 5. Provide bisacodyl suppositories prn - bisacodyl suppositories stimulate peristalsis and expulsion of gas

question

The client receives 2 mg lorezapan IV prior to a transurethral resection of the prostate (TURP). 5 minutes after the administration of the medication, the client has to void. The nurse should take which action? 1. Accompany the client to the bathroom 2. Obtain a urinal for the client to use 3. Assist the client to a bedside commode 4. Obtain an order to catheterize the client

answer

1. Accompany the client to the bathroom - after a preoperative medication is administered, the client should stay in bed due to lightheadedness or dizziness 2. Obtain a urinal for the client to use - CORRECT: necessary for client safety 3. Assist the client to a bedside commode - should stay in bed after getting preoperative medication because of possible orthostatic hypotension 4. Obtain an order to catheterize the client - unnecessary invasive procedure

question

The nurse cares for the client recovering from lower bowel surgery. The nurse determines that teaching is successful if the client selects which menu? 1. Milk, green beans, whole-wheat bread 2. Creamed chicken soup, broccoli, pudding 3. Baked chicken, buttered rice, plain gelatin 4. Cabbage salad, fried chicken, applesauce

answer

3. Baked chicken, buttered rice, plain gelatin - low-residue diet will leave a relatively small amount of residue, or indigestible material, in the colon; all meats, fish, and poultry must be broiled or baked

question

The primipara is admitted in early labor, with her ruptured membranes. Which assessment by the nurse is MOST important? 1. Determine the pH of the amniotic fluid 2. Evaluate the mother's blood pressure 3. Check the monitor for decelerations 4. Assess for a prolapsed cord

answer

1. Determine the pH of the amniotic fluid - amniotic fluid is important to check to differentiate it from urine; pH will be acidic if it is urine 2. Evaluate the mother's blood pressure - mother's blood pressure is not affected by rupture of the membranes 3. Check the monitor for decelerations - nurse should look for variable decelerations if cord is prolapsed 4. Assess for a prolapsed cord - CORRECT: initial assessment is to check for a prolapsed cord

question

Phantom limb pain

answer

Staying active will help decrease the episodes of pain

question

Estrogen therapy

answer

- COMMON: weight change, libido change, eye dryness - SHOULD: monthly self-breast exam and stop smoking

question

The adolescent is seen in the emergency room for an overdose of acetylsalicylic acid. Which action will take the nurse take? SATA 1. Determine when the client took the aspirin 2. Administer protamine sulfate 3. Administer vitamin K 4. Obtain an arterial blood gas 5. Obtain client's temperature

answer

1. Determine when the client took the aspirin - charcoal, if given within two hours, will absorb particles of salicylate 4. Obtain an arterial blood gas - severe acid/base disturbance can occur so ABGs will be needed 5. Obtain client's temperature - hyperthermia is a sign of overdose, monitoring temperature is an correct action

question

Withdrawing from pain is a sign of:

answer

Deterioration in client's condition; health care provider should be notified

question

flurazepam hydrochloride - benzo

answer

Medication that produces dependence should be a last resort; used only if other nursing measures and antidepressant medications have not worked and the client is exhausted

question

Pacemaker

answer

- Any time the pulse rate drops below the preset rate on the pacemaker, the pacer is malfunctioning - The pulse should be maintained at a minimal rate set on the pacemaker

question

Haemophilus influenzae meningitis

answer

- Droplet precautions - Minimize the likelihood of seizures - Fluid restriction to prevent increased intracranial pressure

question

Subclavian triple lumen catheter

answer

- Patients should be supine to produces dilation of neck and shoulder vessels

question

Failure to Thrive

answer

- Best assessment is weight and height

question

sulindac - NSAIDs

answer

- SHOULD REPORT: ecchymosis of extremities; vomiting red streaked fluid; flank pain (nephrotoxicity)

question

Cocaine abuse

answer

- insomnia -> cocaine stimulates with current users insomnia occurs - rhinorrhea -> associated with cocaine use by inhalation; nose is most common route for administration - tachycardia -> cardiac stimulant - euphoria

question

T tube in place

answer

- SHOULD and NORMAL FINDING: take shower; check the tube once a day; green drainage; light lifting at 5 weeks - SHOULD NOT: swim frequently

question

Myasthenia gravis

answer

- Avoid alcohol - Avoid large crowded places - Should stay calm because emotional extremes can cause exacerbation - Avoid heat - Spread activities out instead of clustering them in one time - Drink thicker liquid, not thin

question

atropine sulfate

answer

- Client should hold pressure on the inner canthus for one minute - holding pressure on the inner canthus decreases the amount of medication absorbed systemically

question

phenelzine sulfate - MAOI

answer

- Avoid tyramine - Medication is an MAO inhibitor; hypertensive crisis may be precipitated by foods containing tyramine; clients should be taught to report problems associated with hypertension - Takes two weeks to be effective - Cold medications with pseudoephedrine are contraindicated

question

Children can set their own pace for development

answer

.

question

asymptomatic diverticular disease

answer

- Avoid seeds containing food - Eat high-fiber content or diet high in cellulose and hemicellulose types of fiber (found in wheat bran and whole-wheat bread)

question

To-Keep Open

answer

IV fluid runs at a slow rate to keep the vein open

question

Incentive spirometer

answer

- Should promote lung expansion by encouraging maximal inspirations - Breath should not exceed 10/minute to 12/minute - Should hold breath at end of maximal inspiration

question

For a child vomiting multiple times, offer:

answer

Clear liquids first and if tolerated then full liquids (ice cream, pudding, orange juice)

question

Tepid sponge bath

answer

Used to clean newborns; reduce fever and rash in children; care for ill adults and the elderly

question

Bell's Palsy - sudden weakness in the muscles on one half of the face (kind of like stroke)

answer

Most important to use artifical tears -> paralysis of the eye allows the cornea to dry; patch can be used to keep the eyelid closed to prevent damage; drops and/or ointments are used to reduce chance of corneal damage

question

Peripheral Artery Disease (PAD)

answer

- Should ambulate until pain begins, then rest, and then resume walking - Don't smoke

question

Sigmoid colostomy

answer

- Don't need to irrigate more than once a day or even two-three days, if at all

question

Enema

answer

- Temp should be higher than body temp - The irrigation should be held 12-18 inches

question

Cystic Fibrosis - an inherited life threatening disorder that damages the lungs and digestive systme

answer

- Uncommon to see thick, yellow mucus (pneumonia) - Expected to see mucus production with postural drainage

question

chlordiazepoxide

answer

Antianxiety medication -> effective substitute for alcohol withdrawal

question

Ferrous sulfate

answer

- Should not be given with coffee -> impair iron absorption - Give it with orange juice

question

AVOID KNEE GATCH

answer

.

question

Vaginal itching

answer

- Avoid yogurt and dairy products -> disrupt vaginal pH - AVOID: Douching would disrupt vaginal pH - Do not wash frequently -> would cause dryness and increase itching in the area - Wear underwear that is lined with a cotton crotch -> more absorbent; allows for beter circulation of air to body; dampness aggravates itching - Refrained from sexual intercourse for a week - Take medication until all gone

question

hydrochlorothirazide and dexamethasone

answer

- Need to increase intake of potassium-rich foods because of potassium loss from medications

question

When irrigating client's ear

answer

- Warm the irrigant because water that is too cool can elicit dizziness when it comes into contact with the tympanic membrane

question

Steroids taken at night

answer

- Can cause sleeplessness

question

cyclophosphamide - chemotherapy

answer

- Patients develop alopecia (loss of hair)

question

Vena cava syndrome

answer

Occurs in the supine position -> BP drops -> treat it by positioning the patients on the left side

question

Colonscopy

answer

- Patients are NPO and did bowel prep -> must check fluid and electrolyte imbalances

question

The nurse performs health screening at a shelter for the homeless. Which observation most likely indicates the need for teaching about personal hygiene? 1. Fruity breath odor 2. Foul-smelling stools 3. Vaginal itching 4. Red, swollen gums

answer

1. Fruity breath odor - indicates the possibility of diabetic acidosis 2. Foul-smelling stools - may be a result of poor fat absorption 3. Vaginal itching - could be the result of antibiotic therapyand subsequent yeast infection 4. Red, swollen gums - CORRECT: red, swollen gums can indicate pyorrhea, which is caused by improper cleaning and poor mouth hyigene

question

Knee-chest

answer

Treatment for cyanotic spells, enhances systemic venous return, dilates right ventricle, decreases the obstruction

question

Fever over 103F (39.4 C) in first 48 hours after DTaP is a valid contraindication for pertussis vaccine

answer

.

question

Impetigo

answer

- Complication: periorbital edema -> indicative of postreptococcal glomerulonephritis

question

Buerger's disease

answer

- Inflammation and thrombosis in small and medium-sized blood vessels, typically in the legs and leading to gangrene. It has been associated with smoking. - Should inspect toes and fingers

question

levothyroxine

answer

- When you see patients who develop nervousness or difficulty sleeping, know that these are overdosage of hormone

question

meperidine

answer

narcotic - treat pain

question

hydroxyzine

answer

antihistamine - treat anxiety, nausea, vomiting, skin rash

question

Intravenous Pyelogram

answer

- Do not feel fluttery sensation - Does not cause spasms and shooting pain in the back - May experience a hot feeling and skin feel flushed because of dye injection - Does not feel light headed or desire to cough - Increase fluid intake to flush out the medium - Must complete the bowel prep for good visualization of the kidney

question

The nurse prepares to examine the client's thyroid gland. Which statement, if made by the nurse, is best? 1. Would you like a Band Aid? 2. Here is a glass of water 3. I will be using this tape measure 4. Please use this specimen cup

answer

2. Here is a glass of water - drinking water facilitates swallowing during examination of thyroid

question

Which nursing action is MOST appropriate when an infant is admitted for fever, poor feeding, irritability, and a bulging fontanel? 1. Perform neurological checks every four hours 2. Place the client on droplet precautions 3. Monitor the client's urine output closely 4. Encourage fluid intake

answer

2. Place the client on droplet precautions - implementation; classic signs of meningitis; client should be isolated from other clients

question

Analgesics in transition phase

answer

Should not be given in transition phase

question

Babinski reflex

answer

Disappears at 1 year of age

question

Extrusion reflex - sucking reflex

answer

Disappears between 3 and 4 months of age

question

The client with sudden onset of venous thromboembolism (VTE) is started on IV unfractionated heparin. Which order should the nurse question? 1. Warm, moist packs to the affected leg 2. Elevate the foot of the bed 6 inches 3. Complete bedrest for 5 days 4. Elastic stockings on unaffected leg

answer

1. Warm, moist packs to the affected leg - appropriate therapy 2. Elevate the foot of the bed 6 inches - appropriate therapy 3. Complete bedrest for 5 days - CORRECT: on bedrest only until heparin started 4. Elastic stockings on unaffected leg - appropriate therapy

question

The nurse determines which diversional activity is most appropriate for a 10 year old client recovering from a sickle cell crisis? 1. Walking in the hall 20 minutes twice a day 2. Watching the cartoon channel all day 3. Collecting pictures from magazines 4. Putting together large-pieced wooden puzzles

answer

1. Walking in the hall 20 minutes twice a day - will not conserve her much-needed energy 2. Watching the cartoon channel all day - an isolating activity 3. Collecting pictures from magazines - CORRECT: collecting is an activity that is important to school-aged children 4. Putting together large-pieced wooden puzzles - appropriate for preschool-aged children

question

Radium implant

answer

- Applicator should be checked every 8 hours - On low-residue diet to decrease bowel movements -> prevents the dislodge of radium implant - On strict bedrest - Increase fluid intake - Conserve energy -> fatigue is a major side effect - Take anti-nausea medication -> nausea is a side effect of internal radiation

question

hyperemesis gravidarum - a severe type of nausea during pregnancy

answer

- Parenteral hydration -> rehydrate patients - I and O to evaluate the status of hydration - Weight check - Bed rest

question

naproxen - NSAIDs

answer

Increases the risk of GI bleeding

question

fluoxetine - SSRIs

answer

Increase the risk of GI bleeding

question

metoclopramide hydrochloride

answer

Stimulates motility of upper gastrointestinal tract, contraindicated with possible hemorrhage of gastrointestinal tract; used to treat nausea of chemotherapy

question

haloperidol

answer

Effective in reducing assaultive behavior associated with severe anxiety

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