1.
The nurse is administering 0900 medications to the following patients. To which patients would the nurse question administering the medication?
Correct Answer
B. The patient receiving a beta blocker, who has a blood pressure of 110/70.
Explanation
Beta blockers are medications that lower blood pressure, so administering them to a patient with already low blood pressure (hypotension) could potentially worsen the condition and lead to complications like dizziness, fainting, or even shock. Therefore, the nurse should question administering the beta blocker in this scenario.
2.
The patient with a head injury is ordered a CT scan of the head with contrast dye. Which intervention should the nurse include when discussing the procedure?
Correct Answer
B. Inform the client an intravenous line will be started prior to the procedure.
Explanation
The nurse should inform the patient that an intravenous line will be started prior to the procedure because contrast dye is typically administered intravenously during a CT scan. This allows for better visualization of the head structures and can help identify any abnormalities or injuries. Starting an intravenous line beforehand ensures that the contrast dye can be quickly and easily administered during the procedure. It also allows for the administration of any necessary medications or fluids before, during, or after the scan.
3.
The obstetric clinic nurse is discussing folic acid, a vitamin, with a patient who is trying to conceive. Which information should the nurse discuss with the patient when taking this medication?
Correct Answer
A. This medication will help prevent spina bifida in the unborn child.
Explanation
The nurse should discuss with the client that taking folic acid medication will help prevent spina bifida in the unborn child.
4.
The client is experiencing ventricular tachycardia and has a weak, thread apical pulse. Which medication should the nurse prepare to administer to the client?
Correct Answer
B. Lidocaine, an antidysrhythmic, intravenous push.
Explanation
Lidocaine is the correct medication to administer in this situation because it is an antidysrhythmic. Ventricular tachycardia is a potentially life-threatening arrhythmia that can lead to cardiac arrest. Lidocaine helps to stabilize the heart rhythm and prevent further dysrhythmias. The weak, thread apical pulse suggests that the client's heart is not effectively pumping blood, and lidocaine can help to restore a more normal rhythm and improve cardiac output. Epinephrine is typically used in cardiac arrest situations, while atropine is used for bradycardia. Digoxin is not typically used for ventricular dysrhythmias.
5.
The client who has had abdominal surgery has an IV of Ringer lactate infusion at 100 mL/hour. The nurse is hanging a new bag of fluid at which rate should the nurse set the pump to infuse the Ringer’s lactate?
Correct Answer
A. 100 ML
Explanation
The nurse should set the pump to infuse the Ringer's lactate at a rate of 100 mL/hour. This is because the question states that the IV is already infusing at a rate of 100 mL/hour, and the nurse is hanging a new bag of fluid. Therefore, the pump should continue to be set at the same rate to maintain a consistent infusion of Ringer's lactate.
6.
The client admitted for an acute exacerbation of reactive airway disease is receiving intravenous aminophylline. The client’s serum theophylline level is 18 ug/mL. Which action should the nurse implement first?
Correct Answer
A. Continue to monitor the aminopHylline drip.
Explanation
The correct answer is to continue monitoring the aminophylline drip. This is because the client's serum theophylline level is within the therapeutic range (10-20 ug/mL). Monitoring the drip ensures that the medication is being administered properly and that the client's condition is being adequately managed. Assessing for nausea and restlessness, discontinuing the drip, or notifying the healthcare provider would be appropriate actions if the theophylline level was outside of the therapeutic range or if the client was experiencing adverse effects.
7.
The nurse is administering 0800 medications. Which medication would the nurse question?
Correct Answer
C. Furosemide (Lasix), a loop diuretic, to a 56-year-old male with a potassium level of 3.0mEq/L.
Explanation
The nurse would question administering Furosemide (Lasix) to a 56-year-old male with a potassium level of 3.0mEq/L(low levels) because Furosemide is a loop diuretic that can cause potassium loss. With a low potassium level already present, giving Furosemide could further decrease the potassium level and potentially lead to complications.
8.
The nurse is administering morning medication to the patient in a medical ward. Which medication should the nurse administer first?
Correct Answer
A. Regular insulin sliding scale to an elderly client diagnosed with Type 1 diabetes mellitus.
Explanation
The nurse should administer the regular insulin sliding scale to the elderly client diagnosed with Type 1 diabetes mellitus first because insulin is necessary for controlling blood sugar levels in diabetic patients. Failure to administer insulin promptly can lead to hyperglycemia and potential complications such as diabetic ketoacidosis. Therefore, it is crucial to prioritize the administration of insulin to ensure proper management of the client's diabetes.
9.
Which intervention should the nurse implement when administering the biologic response modifier filgrastim (Neupogen) subcutaneously?
Correct Answer
C. Discard any unused portion of the vial after withdrawing the correct dose.
Explanation
It is important to discard any unused portion of the vial after withdrawing the correct dose of filgrastim (Neupogen) because it is a biologic medication that can easily become contaminated if not handled properly. This reduces the risk of infection or other complications for the patient.
10.
The client experienced a full-thickness burn to 45% of the body including the chest area. The HCP ordered fluid resuscitation. Which data indicates the fluid resuscitation has been effective?
Correct Answer
C. The client’s blood pressure is 110/70.
Explanation
The client's blood pressure being 110/70 indicates that the fluid resuscitation has been effective. A full-thickness burn can lead to significant fluid loss and hypovolemia, which can cause a decrease in blood pressure. By restoring the fluid volume, the blood pressure returns to a normal range, indicating that the fluid resuscitation has been successful in restoring the client's fluid balance.
11.
The charge nurse on an orthopedic unit is transcribing orders for a client diagnosed with back pain. Which HCP order should the charge nurse question?
Correct Answer
A. MorpHine sulfate, a narcotic analgesic, Q 4 hours ATC.
Explanation
The charge nurse should question the order for morphine sulfate, a narcotic analgesic, Q 4 hours ATC. This is because "ATC" stands for "around the clock," which means the medication should be given regularly and not as needed. However, the client is diagnosed with back pain, which typically requires pain medication to be administered on an as-needed basis. Therefore, the order for morphine sulfate should be questioned and clarified with the healthcare provider.
12.
The nurse is administering medications to clients in an orthopedic unit. Which medication should the nurse question?
Correct Answer
B. MorpHine, an opioid analgesic, to a client with a “2” back pain on the pain scale.
Explanation
The nurse should question administering morphine, an opioid analgesic, to a client with a "2" back pain on the pain scale because opioids are typically reserved for moderate to severe pain. A pain level of "2" suggests mild pain, which can usually be managed with non-opioid analgesics such as ibuprofen or muscle relaxants like methocarbamol. Administering morphine for mild pain may be unnecessary and can increase the risk of adverse effects associated with opioids.
13.
Which is the scientific rationale for prescribing decongestants for a client with a cold?
Correct Answer
A. Decongestants vasoconstricts the blood vessels, reducing nasal inflammation.
Explanation
Decongestants vasoconstricts the blood vessels, reducing nasal inflammation. When a person has a cold, the blood vessels in the nasal passages become dilated, leading to nasal congestion and inflammation. Decongestants work by constricting these blood vessels, reducing the swelling and congestion in the nasal passages, and providing relief from symptoms such as stuffy nose. This is the scientific rationale for prescribing decongestants for a client with a cold.
14.
The nurse is caring for clients on the telemetry unit. Which medication should the nurse administer first?
Correct Answer
B. The marcotice morpHine IVP to the client who has pleuritic chest pain that is a “7” on a 1-10 pain scale.
Explanation
The nurse should administer the marcotice morphine IVP to the client who has pleuritic chest pain that is a “7” on a 1-10 pain scale. Pain management is a priority in this situation, as the client is experiencing moderate to severe pain. Morphine is an appropriate medication to relieve chest pain. The other options, such as digoxin, lidocaine, and lisinopril, are not indicated for immediate pain relief and can be administered at a later time.
15.
The nurse is administering digoxin (Lanoxin) 0.25 mg intravenous push medication to the client. Which intervention should the nurse implement?
Correct Answer
B. Check the client’s potassium level.
Explanation
The nurse should check the client's potassium level before administering digoxin because low potassium levels can increase the risk of digoxin toxicity. Digoxin works by increasing the force of contraction of the heart, and low potassium levels can enhance this effect, leading to cardiac dysrhythmias. Therefore, it is important to assess the client's potassium level to ensure it is within the therapeutic range before giving the medication. This intervention helps to prevent potential harm to the client.
16.
To which client would the nurse expect the health-care provider to prescribe chlordiazepoxide (Librium), a benzodiazepine?
Correct Answer
D. A client addicted to alcohol.
Explanation
Chlordiazepoxide (Librium) is a benzodiazepine commonly used to manage alcohol withdrawal symptoms. It helps reduce anxiety, tremors, and seizures associated with alcohol withdrawal. Therefore, it is expected that the health-care provider would prescribe chlordiazepoxide to a client addicted to alcohol.
17.
The client is discussing wanting to quit smoking cigarettes with the clinic nurse. Which intervention is most successful in helping the client to quit smoking cigarettes?
Correct Answer
C. Instruct the client to use varenicline (Chantix), a smoking cessation medication.
Explanation
Using varenicline (Chantix), a smoking cessation medication, is the most successful intervention in helping the client quit smoking cigarettes. Varenicline is specifically designed to help individuals quit smoking by reducing the cravings and withdrawal symptoms associated with nicotine addiction. It works by blocking the effects of nicotine on the brain and reducing the pleasurable sensations from smoking. Thus, instructing the client to use varenicline can greatly increase their chances of successfully quitting smoking.
18.
For which client with a head injury would the nurse not administer the osmotic diuretic mannitol (Osmitrol)?
Correct Answer
C. The 68-year-old client, who has congestive heart failure.
Explanation
Mannitol is an osmotic diuretic used to reduce intracranial pressure in patients with head injuries. However, it is contraindicated in patients with congestive heart failure (CHF) due to the risk of fluid overload, which can exacerbate CHF symptoms. Mannitol increases fluid excretion by the kidneys, which can lead to a shift of fluid from the intracellular space into the plasma, potentially worsening heart failure. The conditions mentioned for the other clients do not typically contraindicate the use of mannitol for head injury.
19.
The client receiving telemetry is exhibiting supraventricular tachycardia. Which antidysrhythmic medication should the nurse administer?
Correct Answer
C. Adenosine
Explanation
Adenosine is the correct antidysrhythmic medication to administer for a client exhibiting supraventricular tachycardia. Adenosine works by slowing down the electrical conduction in the heart, which can help restore a normal heart rhythm. It is often used as a first-line treatment for supraventricular tachycardia because of its effectiveness and rapid onset of action. Lidocaine is typically used for ventricular dysrhythmias, while atropine is used for bradycardia. Epinephrine is used for cardiac arrest or severe bradycardia.
20.
Walter, a teenage patient is admitted to the hospital because of an acetaminophen (Tylenol) overdose. Overdoses of acetaminophen can precipitate life-threatening abnormalities in which of the following organs?
Correct Answer
B. Liver
Explanation
Acetaminophen overdose can cause liver toxicity. The liver is responsible for metabolizing acetaminophen, and when taken in excessive amounts, it can overwhelm the liver's ability to process it. This can lead to liver damage and potentially life-threatening abnormalities.
21.
A contraindication for topical corticosteroid usage in a male patient with atopic dermatitis (eczema) is:
Correct Answer
B. Viral infection.
Explanation
Topical corticosteroids are commonly used to treat atopic dermatitis (eczema), but they should not be used if the patient has a viral infection. This is because corticosteroids can suppress the immune system, making it harder for the body to fight off viral infections. Using corticosteroids during a viral infection can potentially worsen the infection and delay the healing process. Therefore, it is important to avoid using topical corticosteroids in patients with viral infections.
22.
Mandy, a patient, called the clinic today because he is taking atorvastatin (Lipitor) to treat his high cholesterol and is having pain in both of his legs. You instruct him to:
Correct Answer
C. Stop taking the drug and come to the clinic to be seen today.
Explanation
The correct answer is to stop taking the drug and come to the clinic to be seen today. This is because the patient is experiencing pain in both of his legs, which could be a symptom of a serious side effect of atorvastatin. It is important for the patient to be evaluated by a healthcare professional as soon as possible to determine the cause of the leg pain and adjust the treatment plan if necessary.
23.
Which of the following adverse effects is associated with levothyroxine (Synthroid) therapy?
Correct Answer
A. Tachycardia
Explanation
Levothyroxine (Synthroid) is a synthetic form of the thyroid hormone used to treat hypothyroidism. One of the adverse effects associated with levothyroxine therapy is tachycardia, which refers to a rapid heart rate. This can occur because levothyroxine increases the metabolic rate, leading to an increased demand for oxygen and nutrients, which in turn leads to an increased heart rate. Other adverse effects of levothyroxine therapy may include palpitations, chest pain, and arrhythmias.
24.
Which of the following adverse effects is specific to the biguanide diabetic drug metformin (Glucophage) therapy?
Correct Answer
C. Lactic acidosis
Explanation
Metformin, a biguanide diabetic drug, is known to have the specific adverse effect of lactic acidosis. Lactic acidosis occurs when there is an accumulation of lactic acid in the blood. This can be a serious condition and can lead to symptoms such as weakness, fatigue, muscle pain, and difficulty breathing. It is important to monitor for signs of lactic acidosis while taking metformin, especially in individuals with kidney or liver problems, as they may be at a higher risk. Hypoglycemia, GI distress, and somnolence are potential adverse effects of other diabetic drugs, but lactic acidosis is specific to metformin.
25.
Mr. Robin, a newly admitted patient, has a seizure disorder, which is being treated with medication. Which of the following drugs would the nurse question if ordered for him?
Correct Answer
B. Amitriptyline (Elavil), 10 mg QID
Explanation
The nurse would question the order for Amitriptyline (Elavil), 10 mg QID, because it is an antidepressant medication and not typically used to treat seizure disorders. The other options, Phenobarbital, Aspirin, and Phenytoin, are commonly used to treat seizure disorders and would be appropriate for Mr. Robin.
26.
A nurse is preparing the client’s morning NpH insulin dose and notices a clumpy precipitate inside the insulin vial. The nurse should:
Correct Answer
C. Draw the dose from a new vial
Explanation
When a nurse notices a clumpy precipitate inside an insulin vial, it indicates that the insulin has degraded or is no longer effective. Drawing up and administering the dose from this vial could result in an inaccurate dose or ineffective treatment. Shaking the vial may not effectively disperse the clumps and could potentially damage the insulin. Warming the bottle under running water is not recommended as it could alter the effectiveness of the insulin. Therefore, the best course of action is to draw the dose from a new vial to ensure the client receives the appropriate medication.
27.
A client who is taking famotidine (Pepcid) asks the home care nurse what would be the best medication to take for a headache. The nurse tells the client that it would be best to take:
Correct Answer
C. AcetaminopHen (Tylenol)
Explanation
Acetaminophen (Tylenol) would be the best medication to take for a headache while taking famotidine (Pepcid). This is because acetaminophen is less likely to interact with famotidine compared to aspirin, ibuprofen, or naproxen. Famotidine belongs to a class of medications called H2 blockers, which reduce stomach acid production. Aspirin, ibuprofen, and naproxen are nonsteroidal anti-inflammatory drugs (NSAIDs) that can increase the risk of stomach irritation and bleeding when taken with famotidine. Acetaminophen, on the other hand, is not an NSAID and is generally considered safe to take with famotidine.