Exam 2 Review Flashcards
Part of effects of corticosteroids: includes affects the mimic aldosterone: acts on kidneys so reabsorb more Na from renal tubules back into bloodstream and exchange for K and so have K loss
Can you explain potassium replacement for electrolyte imbalances on the corticosteroids adverse effects.. like why would they be low on potassium?
A diabetic client’s blood glucose level is 63 mg/dL. The nurse should prepare to administer which medication?
A.Glargine
B.Glucagon
C.Glipizide
D.Guaifenesin
Answer: B
Rationale: glucose elevating agent; hypoglycemic currently; glargine: long-acting; glipizide - oral: anti-diabetic; guaifenesin: expectorant
Which medication is an oral antidiabetic?
A.Aspart
B.Lispro
C.Glargine
D.Metformin
Answer: D
Rationale: 2 oral anti-diabetics: glipizide and metformin; glargine: long-acting
The nurse is caring for a client prescribed prednisone for several years. What test does the nurse anticipate the primary care provider to order?
A.Bone density scan (DEXA scan)
B.Computed tomography (CT) scan of the head
C.Heart ultrasound (echocardiogram)
D.Pulmonary function tests
Answer: A
Rationale: corticosteroid; long time: taking over long-term is development of Cushing’s syndrome: monitor for AE of med: things happen if on for long-term; risk for osteoporosis; order this because over long-term risk for osteoporosis and risk for bone fractures: looks at bone density; had untreated HTN could possible get to HF; could also be C but more on osteoporosis - recognize have HTN and avoid it; more avoidable than osteoporosis; all issues from corticosteroids if taken for long-term
The use of aspirin in children is limited due to the possibility of what disease?
A.Munchausen syndrome
B.Guillain-Barre Syndrome
C.Angelman syndrome
D.Reye syndrome
Answer: D
Rationale: basic definition
A nurse is caring for a client in the early stage of rheumatoid arthritis. The nurse would expect which medication to be used in the treatment of this client?
A.Acetaminophen
B.Fentanyl
C.Ibuprofen
D.Morphine
Answer: C
Rationale: early stage of inflammatory process = key; NSAIDS good on inflammatory disorders; later stages could be on opioid pain meds but in early stages start on NSAIDS - first line treatments
A client states, “I take acetaminophen four to five times daily when I’m at home.” Which laboratory test is the most relevant in evaluating the effect of this practice?
A.Complete blood count
B.Peak and trough
C.Liver enzymes
D.Creatinine and BUN
Answer: C
Rationale: too much toxic to liver; NSAIDS: GI problems (distress/bleeding) and kidney toxicity very common so would check creatinine and BUN
The nurse is caring for a postoperative client with a history of opioid abuse who has been prescribed a dose of naloxone. Which issue should the nurse be prepared to address?
A.The client may report less pain
B.The client may demonstrate signs of withdrawal
C.Double the standard dose of naloxone may be needed
D.The client will need high dose pain medications to control pain
Answer: B
Rationale: give naloxone giving because sig AE: sig sedation and resp depression - worried about ability breathe and oxygenate, combat AE but pain will return - withdrawn from pain med and pain will return; double the standard dose - right off bat give double standard dose which is not true - may give second if not show improvement need to see with first dose; high dose: need naloxone too much pain med and now prob is pain hard control because not get too much because needed rescue med because received too much pain med - OD for some reason and given naloxone - cannot cont give high amounts pain med - naloxone pain not well controlled because cannot put at risk for resp depression
When evaluating the plan of care for a client receiving opioid analgesics for pain management, the nurse considers the plan successful when what occurs? Select all that apply.
A.Client reports pain is reduced
B.Adequate ventilation is maintained
C.Client reports daily BM
D.Urine output is reduced
E.Client reports anorexia
F.Client sleeps all day
Answer: A, B, C
Rationale: what want to happen for client; want pain to be reduced; maintain ventilation because resp depression is big prob; constipation is an AE - daily BM not constipated and is preferred than constipation and interventions for that; Not want D, E, F to occur
What potential adverse reaction is most likely to develop during cefazolin therapy?
A.Gastrointestinal upset
B.Dry skin and pruritus
C.Drowsiness
D.Orthostatic hypotension
Answer: A
Rationale: is an antibiotic; general AE with AE and AE specific for cefazolin: GI upset: n/v/d - common can happen with many diff AE
The nurse is giving discharge instructions to a woman who has been prescribed amoxicillin. The nurse teaches the client that which symptom indicates the development of a superinfection and should be reported?
A.Nausea
B.Abdominal pain
C.Vaginal itching and discharge
D.Swelling and itching of the throat
Answer: C
Rationale: symptoms of vaginal yeast infection: looking for superinfection; swelling and itching of the throat: allergic rxn
A nurse is caring for an adult client diagnosed with bacterial sinusitis. The nurse has cautioned the client against taking prescribed oral erythromycin together with antacids. What is the basis of this instruction?
A.Antacids delay metabolism of the drug.
B.Antacids can exacerbate nausea and reflux.
C.Antacids cause a dangerous rise in gastric pH.
D.Antacids decrease the absorption of the drug.
Answer: D
A client is prescribed isoniazid for a diagnosis of tuberculosis (TB). Which adverse effect will result in discontinuation of the medication?
A.Weight gain
B.Jaundice
C.Fever
D.Arthralgia
Answer: B
Rationale: TB drugs and major AE and implications includes being toxic to liver - taken for long duration
When reviewing an older client’s most recent laboratory values, which finding may contraindicate the use of tetracycline?
A.creatinine of 2.8 mg/dL
B.potassium of 3.4 mEq/L
C.hemoglobin of 10.5 g/dL
D.leukocyte count of 11.6/mm3
Answer: A
Rationale: antibiotic; deals with toxicity/AE of tetracycline; creatinine best answer because indicates kidney injury/disease - elevated; K: 3.4 - not that low - only discussed electrolytes with sulfonamides; antibiotics not have much effect on Hgb - not cause bleeding; leukocyte count not prob with tetracycline count - elevated ok because giving antibiotic and supposed to have increased count
A 71-year-old client with a history of atrial fibrillation, chronic obstructive pulmonary disease, and type 2 diabetes has had an antihistamine prescribed. What assessment should the nurse prioritize?
A.Auscultation of apical heart rate and rhythm
B.Chest auscultation and assessment of respiratory rate
C.Q4h blood glucose checks
D.Assessment of orientation and level of consciousness
Answer: A
Rationale: problem with diseases, how med works, AE, contraindicated with drug, afib: arythmia - tachycardia, COPD: lung probs - prob with breathing, CO2, oxygenation, T2DM - hyperglycemia; relationship between antihistamine and probs with glucose - no; some antihistamines sedating but second-gen that less sedation - not specify type so cannot go that way; check auscultation and assessment of RR - anticholinergic activity - breathe better; has afib and has anticholinergic effects which causes tachycardia and affects heart rhythm; Antihistamines have been associated with prolongation of the QT interval, which can lead to potentially fatal cardiac arrhythmias. The client’s history of an arrhythmia heightens the importance of assessing cardiac function. Assessing the client’s blood glucose every four hours is likely beyond what is necessary. Respiratory assessment is necessary because of the client’s history of COPD, but antihistamines do not exacerbate this condition. Cognitive changes are not expected.
