Exit 2 Flashcards
- A nurse is reviewing a patient’s medication during shift change. Which of the following medications would be contraindicated if the patient were pregnant? Select all that apply:
A. Warfarin (Coumadin)
B. Finasteride (Propecia, Proscar)
C. Celecoxib (Celebrex)
D. Clonidine (Catapres)
E. Transdermal nicotine (Habitrol)
F. Clofazimine(Lamprene)
- Answers: A, and B.
Option A: Warfarin (Coumadin). Has a pregnancy category X and associated with central nervous system defects, spontaneous abortion, stillbirth, prematurity, hemorrhage, and ocular defects when given anytime during pregnancy and a fetal warfarin syndrome when given during the first trimester.
Option B: Finasteride (Propecia, Proscar). Also has a pregnancy category X which has a high risk of causing permanent damage to the fetus.
Option C: Celecoxib (Celebrex). Large doses cause birth defects in rabbits; not known if the effect on people is the same.
Option D: Clonidine (Catapres). Crosses the placenta but no adverse fetal effects have been observed.
Option E: Transdermal nicotine (Habitrol). Nicotine replacement products have been assigned to pregnancy category C (nicotine gum) and category D (transdermal patches, inhalers, and spray nicotine products).
Option F: Clofazimine (Lamprene). Clofazimine has been assigned to pregnancy category C.
- A nurse is reviewing a patient’s past medical history (PMH). The history indicates the patient has photosensitive reactions to medications. Which of the following drugs is associated with photosensitive reactions? Select all that apply:
A. Ciprofloxacin (Cipro)
B. Sulfonamide
C. Norfloxacin (Noroxin)
D. Sulfamethoxazole and Trimethoprim (Bactrim)
E. Isotretinoin (Accutane)
F. Nitro-Dur patch
- Answers: A, B, C, D, and E.
Photosensitivity is an extreme sensitivity to ultraviolet (UV) rays from the sun and other light sources. A type of photosensitivity called Phototoxic reactions are caused when medications in the body interact with UV rays from the sun. Antiinfectives are the most common cause of this type of reaction.
- A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following of the patient’s medication does not cause urine discoloration?
A. Sulfasalazine
B. Levodopa
C. Phenolphthalein
D. Aspirin
- Answer: D. Aspirin
Aspirin is not known to cause discoloration of the urine.
Option A: Sulfasalazine may discolor the urine or skin to an orange-yellow color.
Option B: Levodopa may discolor the urine, saliva, or sweat to a dark brown color.
Option C: Phenolphthalein can discolor the urine to a red color.
- You are responsible for reviewing the nursing unit’s refrigerator. Which of the following drug, if found inside the fridge, should be removed?
A. Nadolol (Corgard)
B. Opened (in-use) Humulin N injection
C. Urokinase (Kinlytic)
D. Epoetin alfa IV (Epogen)
- Answer: A. Corgard
Nadolol (Corgard) is stored at room temperature between 59 to 86 °F (15 and 30 °C) away from heat, moisture, and light. Do not store in the bathroom and keep bottle tightly closed.
Option B: Humulin N injection if unopened (not in use) is stored in the fridge and is used until the expiration date, or stored at room temperature and used within 31 days. If opened (in-use), store the vial in a refrigerator or at room temperature and use within 31 days. Store the injection pen at room temperature (do not refrigerate) and use within 14 days. Keep it in its original container protected from heat and light. Do not draw insulin from a vial into a syringe until you are ready to give an injection. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen.
Option C: Urokinase (Kinlytic) is refrigerated at 2–8°C.
Option D: Epoetin alfa IV (Epogen) vials should be stored at 2°C to 8°C (36°F to 46°F); Do not freeze. Do not shake. Protect from light.
- A 34-year-old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb?
A. IgA
B. IgD
C. IgE
D. IgG
- Answer: D. IgG
IgG is the only immunoglobulin that can cross the placental barrier.
Option A: IgA antibodies protect body surfaces that are exposed to outside foreign substances.
Option B: IgD antibodies are found in small amounts in the tissues that line the belly or chest.
Option C: IgE antibodies cause the body to react against foreign substances such as pollen, spores, animal dander.
- A second-year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most significant action that nursing student should take?
A. Immediately see a social worker.
B. Start prophylactic AZT treatment.
C. Start prophylactic Pentamidine treatment.
D. Seek counseling.
- Answer: B. Start prophylactic AZT treatment.
Azidothymidine (AZT) treatment is the most critical intervention. It is an antiretroviral medication used to prevent and treat HIV/AIDS by reducing the replication of the virus.
Options A and D: Other interventions mentioned are to be done later.
Option C: Pentamidine is an antimicrobial medication given to prevent and treat pneumocystis pneumonia.
- You are taking the history of a 14-year-old girl who has a (BMI) of 18. The girl reports inability to eat, induced vomiting and severe constipation. Which of the following would you most likely suspect?
A. Multiple sclerosis
B. Anorexia nervosa
C. Bulimia nervosa
D. Systemic sclerosis
- Answer: B. Anorexia nervosa
All of the clinical signs and symptoms point to a condition of anorexia nervosa. The key feature of anorexia nervosa is self-imposed starvation, resulting from a distorted body image and an intense, irrational fear of gaining weight, even when the patient is emaciated. Anorexia nervosa may include refusal to eat accompanied by compulsive exercising, self-induced vomiting, or laxative or diuretic abuse.
Option A: Multiple sclerosis (MS) is a demyelinating disease in which the insulating covers of the nerve cells in the brain and spinal cord are damaged.
Option C: On the other hand, bulimia nervosa features binge eating followed by a feeling of guilt, humiliation, and self-deprecation. These feelings cause the patient to engage in self-induced vomiting, use of laxatives or diuretics.
Option D: Systemic sclerosis or systemic scleroderma is an autoimmune disease of the connective tissue.
- A 24-year-old female is admitted to the ER for confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Based on the presenting signs and symptoms, which of the following would you most likely suspect?
A. Diverticulosis
B. Hypercalcemia
C. Hypocalcemia
D. Irritable bowel syndrome
- Answer: B. Hypercalcemia
Hypercalcemia can cause polyuria, severe abdominal pain, and confusion.
Option A: Diverticulosis is a condition that develops when pouches (diverticula) form in the wall of the large intestine; most people don’t have symptoms.
Option C: Hypocalcemia is low calcium levels in the blood; it is asymptomatic in mild forms but can cause paresthesia, tetany, muscle cramps, and carpopedal spasms in severe hypocalcemia.
Option D: Irritable bowel syndrome is a widespread condition involving recurrent abdominal pain and diarrhea or constipation, often associated with stress, depression, anxiety, or previous intestinal infection.
- Rhogam is most often used to treat____ mothers that have a ____ infant.
A. RH positive, RH positive
B. RH positive, RH negative
C. RH negative, RH positive
D. RH negative, RH negative
- Answer: C. RH negative, RH positive
Rhogam prevents the production of anti-RH antibodies in the mother that has a Rh-positive fetus.
- A new mother has some questions about phenylketonuria (PKU). Which of the following statements made by a nurse is not correct regarding PKU?
A. A Guthrie test can check the necessary lab values.
B. The urine has a high concentration of phenylpyruvic acid
C. Mental deficits are often present with PKU.
D. The effects of PKU are reversible.
- Answer: D. The effects of PKU are reversible.
Phenylketonuria (PKU) is an inherited disorder that increases the levels of phenylalanine (a building block of proteins) in the blood. If PKU is not treated, phenylalanine can build up to harmful levels in the body, causing intellectual disability and other serious health problems. The signs and symptoms of PKU vary from mild to severe. The most severe form of this disorder is known as classic PKU. Infants with classic PKU appear normal until they are a few months old. Without treatment, these children develop a permanent intellectual disability. Seizures, delayed development, behavioral problems, and psychiatric disorders are also common. Untreated individuals may have a musty or mouse-like odor as a side effect of excess phenylalanine in the body. Children with classic PKU tend to have lighter skin and hair than unaffected family members and are also likely to have skin disorders such as eczema. The effects of PKU stay with the infant throughout their life (via Genetic Home Reference).
- A patient has taken an overdose of aspirin. Which of the following should a nurse most closely monitor for during acute management of this patient?
A. Onset of pulmonary edema
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Parkinson’s disease type symptoms
- Answer: A. Onset of pulmonary edema
Aspirin overdose can lead to metabolic acidosis and cause pulmonary edema development.
Early symptoms of aspirin poisoning also include tinnitus, hyperventilation, vomiting, dehydration, and fever. Late signs include drowsiness, bizarre behavior, unsteady walking, and coma. Abnormal breathing caused by aspirin poisoning is usually rapid and deep.
Pulmonary edema may be related to an increase in permeability within the capillaries of the lung leading to “protein leakage” and transudation of fluid in both renal and pulmonary tissues. The alteration in renal tubule permeability may lead to a change in colloid osmotic pressure and thus facilitate pulmonary edema (via Medscape).
- A 50-year-old blind and deaf patient have been admitted to your floor. As the charge nurse, your primary responsibility for this patient is?
A. Let others know about the patient’s deficits.
B. Communicate with your supervisor your patient safety concerns.
C. Continuously update the patient on the social environment.
D. Provide a secure environment for the patient.
- Answer: D. Provide a secure environment for the patient.
This patient’s safety is your primary concern.
- A patient is getting discharged from a skilled nursing facility (SNF). The patient has a history of severe COPD and PVD. The patient is primarily concerned about his ability to breathe easily. Which of the following would be the best instruction for this patient?
A. Deep breathing techniques to increase oxygen levels.
B. Cough regularly and deeply to clear airway passages.
C. Cough following bronchodilator utilization.
D. Decrease CO2 levels by increased oxygen take output during meals.
- Answer: C. Cough following bronchodilator utilization
The bronchodilator will allow a more productive cough.
- A nurse is caring for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present?
A. Slow pulse rate
B. Weight gain
C. Decreased systolic pressure
D. Irregular WBC lab values
- Answer: B. Weight gain
Weight gain due to fluid accumulation is associated with heart failure and congenital heart defects.
- A mother has recently been informed that her child has Down’s syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down’s syndrome?
A. Simian crease
B. Brachycephaly
C. Oily skin
D. Hypotonicity
- Answer: C. Oily skin
The skin would be dry and not oily.
- A client with myocardial infarction is receiving tissue plasminogen activator, alteplase (Activase, tPA). While on the therapy, the nurse plans to prioritize which of the following?
A. Observe for neurological changes.
B. Monitor for any signs of renal failure.
C. Check the food diary.
D. Observe for signs of bleeding.
- Answer: D. Observe for signs of bleeding.
Bleeding is the priority concern for a client taking thrombolytic medication.
Options A and B: Are monitored but are not the primary concern.
Option C: is not related to the use of medication.
