final Flashcards
nitrofurantoin contraindication
when Cr is <30
terazosin administered when
at bedtime
Sodium polystyrene sulfonate
An osmotic laxative that evacuates potassium from the bowel
Expect diarrhea
Do not administer to patients with hypoactive bowel/paralytic ileus (can cause bowel necrosis)
epoietin alfa MOA and ed
rises Hgb.hct
will turn stool black
atorvastatin MOA
lowers LDL
gemfibrozil moa
lowers triglcycerides and inc HDL
most common med for drug allergy
penicillin
cephalosporin ed
no alcohol
what med used for MRSA
vancomycin
gentamycin ed
can cause nephrotixicty, ototoxicity
fluorquinolone AE
tendon rupture
how to check skin on dark person
check hands
when to assess pts in acute, long term or home care
acute is q 24, long term is weekly and home is every visit
how often to reposition patient
bed - 2 hours
chair - 1 hour
When admitting a patient with acute glomerulonephritis, it is most important that the nurse ask the patient about
a. recent sore throat and fever.
b. history of high blood pressure.
c. frequency of bladder infections.
d. family history of kidney stones.
a
A patient is admitted to the hospital with new onset nephrotic syndrome. Which assessment data will the nurse expect to find related to this illness?
a. Poor skin turgor
b. High urine ketones
c. Recent weight gain
d. Low blood pressure
c because edema
A patient’s renal calculus is analyzed as being very high in uric acid. To prevent recurrence of stones, the nurse teaches the patient to avoid eating
a. milk and dairy products.
b. legumes and dried fruits.
c. organ meats and sardines.
d. spinach, chocolate, and tea.
c - Organ meats and fish such as sardines increase purine levels
To prevent the recurrence of renal calculi, the nurse teaches the patient to:
a. use a filter to strain all urine.
b. avoid dietary sources of calcium.
c. drink diuretic fluids such as coffee.
d. have 2000 to 3000 mL of fluid a day.
d
A patient in the hospital has a history of functional urinary incontinence. Which nursing action will be included in the plan of care?
a. Place a bedside commode near the patient’s bed.
b. Demonstrate the use of the Credé maneuver to the patient.
c. Use an ultrasound scanner to check postvoiding residuals.
d. Teach the use of Kegel exercises to strengthen the pelvic floor.
a
When assessing the patient who has a lower urinary tract infection (UTI), the nurse will initially ask about
a. nausea.
b. flank pain.
c. poor urine output.
d. pain with urination.
d
Which assessment finding for a patient who has just been admitted with acute pyelonephritis is most important for the nurse to report to the health care provider?
a. Foul-smelling urine
b. Complaint of flank pain
c. Blood pressure 88/45 mm Hg
d. Temperature 100.1° F (57.8° C)
c- he low blood pressure indicates that urosepsis and septic shock may be occurring
A patient with renal calculi is hospitalized with gross hematuria and severe colicky left flank pain. Which nursing action will be of highest priority at this time?
a. Encourage oral fluid intake.
b. Administer prescribed analgesics.
c. Monitor temperature every 4 hours.
d. Give antiemetics as needed for nausea.
b
- The nurse teaches the female paitent who has frequent UTIs that she should
a. take tub baths with bubble bath
b.urinate before and after sexual intercourse
c.take prophylactic sufonamides for the rest of her life
d. restrict fluid intake to prevent the need for frequent voiding
b
4.One of the nruse’s most important roles in relation to acute poststreptococcal golmerulonephritis is to
a. promote early diagnosis and treatment of sore throats and skin lesions
b.encourage patients to obtain antibiotic therapy for upper respiratory tract infections
c.teach patients with APSGN that long term prophylactic antibiotic therapy is necessary to prevent recurrence
d.monitor patients for respiratory symptoms that indicate the disease is affecting the alveolar basement membrane
a
- A patient with ureterolithotomy returns from surgery with a nephrostomy tube in place. Postoperative nursing care of the patient includes:
a.encourage the patient to drink fruit juices and milk
b.encouraging fluids of at least 2-3 L/day after nausea has subsided
c. irrigating the nephrostomy tube with 10ml of NS solution as needed
d. notifying the physician if nephrostomy tube drainage is more than 30ml/hr
b
The patient with chronic kidney disease is considering whether to use peritoneal dialysis (PD) or hemodialysis (HD). What are advantages of PD when compared to HD (select all that apply)?
a. Less protein loss
b. Rapid fluid removal
c. Less cardiovascular stress
d. Decreased hyperlipidemia
e. Requires fewer dietary restrictions
ce
Priority Decision: During the immediate postoperative care of a recipient of a kidney transplant, what should the nurse expect to do?
a. Regulate fluid intake hourly based on urine output.
b. Monitor urine-tinged drainage on abdominal dressing.
c. Medicate the patient frequently for incisional flank pain.
d. Remove the urinary catheter to evaluate the ureteral implant
a
The home care nurse visits a 34-year-old woman receiving peritoneal dialysis. Which statement, if made by the patient, indicates a need for immediate follow-up by the nurse?
A. “Drain time is faster if I rub my abdomen.”
B.”The fluid draining from the catheter is cloudy.”
C.”The drainage is bloody when I have my period.”
D.”I wash around the catheter with soap and water.”
b
Which patient should be taught preventive measures for CKD by the nurse because this patient is most likely to develop CKD?
A.A 50-year-old white female with hypertension
B.A 61-year-old Native American male with diabetes
C.A 40-year-old Hispanic female with cardiovascular disease
D.A 28-year-old African American female with a urinary tract infection
b
A patient with rheumatoid arthritis has been taking corticosteroids for 11 months. Which nursing action is most likely to detect early signs of infection in this patient?
a. Monitor white blood cell count.
b. Check the skin for areas of redness.
c. Check the temperature every 2 hours.
d. Ask about fatigue or feelings of malaise.
d
A patient arrives in the emergency department with a swollen ankle after an injury incurred while playing soccer. Which action by the nurse is most appropriate?
a. Elevate the ankle above heart level.
b. Apply a warm moist pack to the ankle.
c. Assess the ankle’s range of motion (ROM).
d. Assess whether the patient can bear weight on the affected ankle.
a
After receiving a change-of-shift report, which patient should the nurse assess first?
a. The patient who has multiple black wounds on the feet and ankles
b. The newly admitted patient with a stage IV pressure ulcer on the coccyx
c. The patient who has been receiving chemotherapy and has a temperature of 102° F
d. The patient who needs to be medicated with multiple analgesics before a scheduled dressing change
c
An older adult patient is transferred from the nursing home with a black wound on her heel. What immediate wound therapy does the nurse anticipate providing to this patient?
A) Dress it with an absorbent dressing for exudate.
B) Handle the wound gently and let it dry out to heal.
C) Debride the nonviable, eschar tissue to allow healing.
D) Use negative-pressure wound (vacuum) therapy to facilitate healing.
c
A patient has been provided with a compression dressing in an attempt to facilitate rapid healing of an ankle sprain. What is a priority nursing assessment?
A)Frequent examination of the character and quantity of exudate
B) Monitoring for signs and symptoms of local or systemic infections
C) Assessment of the patient’s circulation distal to the location of the dressing
D) Assessment of the range of motion of the ankle and the patient’s activity tolerance
c
To which patient should the nurse plan to administer round-the-clock antipyretic drugs?
A) A 76-yr-old patient with bacterial meningitis and a temperature of 104.2°F
B) An 82-yr-old patient after hip replacement surgery and a temperature of 100.4°F
C) A 14-yr-old patient with infectious mononucleosis and a temperature of 101.6°F
D) A 59-yr-old patient with an acute myocardial infarction and a temperature of 99.8°F
a
The nurse teaches a patient diagnosed with systemic lupus erythematosus (SLE) about plasmapheresis. What instructions about plasmapheresis should the nurse include in the teaching plan?
a. Plasmapheresis will eliminate eosinophils and basophils from blood.
b. Plasmapheresis will remove antibody-antigen complexes from circulation.
c. Plasmapheresis will prevent foreign antibodies from damaging various body tissues.
d. Plasmapheresis will decrease the damage to organs caused by attacking T lymphocytes.
b
The nurse is caring for a patient undergoing plasmapheresis. The nurse should assess the patient for which clinical manifestation?
a. Shortness of breath
b. High blood pressure
c. Transfusion reaction
d. Numbness and tingling
d
The nurse teaches a patient about drug therapy after a kidney transplant. Which statement by the patient would indicate a need for further instructions?
a. “After a couple of years, it is likely that I will be able to stop taking the cyclosporine.”
b. “If I develop an acute rejection episode, I will need to have other types of drugs given IV.”
c. “I need to be monitored closely because I have a greater chance of developing malignant tumors.”
d. “The drugs are given in combination because they inhibit different ways the kidney can be rejected.”
a
A patient is admitted to the hospital with acute rejection of a kidney transplant. Which intervention will the nurse prepare for this patient?
a. Administration of immunosuppressant medications
b. Insertion of an arteriovenous graft for hemodialysis
c. Placement of the patient on the transplant waiting list
d. A blood draw for human leukocyte antigen (HLA) matching
a
A patient who is receiving immunotherapy has just received an allergen injection. Which assessment finding is most important to communicate to the health care provider?
a. The patient’s IgG level is increased.
b. The injection site is red and swollen.
c. The patient’s allergy symptoms have not improved.
d. There is a 2-cm wheal at the site of the allergen injection.
d
The reason newborns are protected for the first 6 months of life from bacterial infection is because of the maternal transmission of:
A. IgG
B. IgA
C. IgM
D. IgE
a
In a type 1 hypersensitivity reaction, the primary immunologic disorder appears to be:
A. binding of IgG to an antigen on the cell surface
B. deposit of antigen-antibody complexes in small vessels
C. release of cytokines to interact with specific antigens
D. release of chemical mediators from IgE-bound mast cells and basophils
d
The nurse advises a friend who asks him to administer his allergy shots that:
A. it is illegal for nurses to administer injections outside of a medical setting
B. he is qualified to do it if the friend has epinephrine in an injectible syringe provided with his extract
C. avoiding the allergens is a much more effective way of controlling allergens, and allergy shots are not usually effective
D. immunotherapy should only be administered in a setting where emergency equipment and drugs are available
d
The most common cause of secondary immunodeficiencies is:
A. drugs
B. stress
C. malnutrition
D. human immunodeficiency virus
a
- Emerging and reemerging infections affect health care by (select all that apply)
a. reevaluating vaccine practices.
b. revealing antimicrobial resistance.
c. limiting antibiotics to those with life-threatening infection.
d. challenging researchers to discover new antimicrobial therapies.
abd
- During HIV infection
a. reverse transcriptase helps HIV fuse with the CD4+ T cell.
b. HIV RNA uses the CD4+ T cell’s mitochondria to replicate.
c. the immune system is impaired predominantly by the eventual widespread destruction of CD4+ T cells.
d. a long period of dormancy develops during which HIV cannot be found in the blood and there is little viral replication.
c
- A diagnosis of AIDS is made when an HIV-infected patient has
a. a CD4+ T cell count below 200/µL.
b. a high level of HIV in the blood and saliva.
c. lipodystrophy with metabolic abnormalities.
d. oral hairy leukoplakia, an infection caused by Epstein-Barr virus.
a
- HIV antiretroviral drugs are used to
a. cure acute HIV infection.
b. decrease viral RNA levels.
c. treat opportunistic diseases.
d. decrease pain and symptoms in terminal disease.
b
- Opportunistic diseases in HIV infection
a. are usually benign.
b. are generally slow to develop and progress.
c. occur in the presence of immunosuppression.
d. are curable with appropriate drug interventions
c
- What is the most appropriate nursing intervention to help an HIV-infected patient adhere to a treatment regimen?
a. “Set up” a drug pillbox for the patient every week.
b. Give the patient a video and a brochure to view and read at home.
c. Tell the patient that the side effects of the drugs are bad but that they go away after a while.
d. Assess the patient’s routines and find adherence cues that fit into the patient’s life circumstances.
d
- The nurse has experienced a recent increase in the incidence of hospital care-associated infections (HAIs) on the unit. Which nursing action should be prioritized in the response to this trend?
A. Use of gloves during patient contact
B. Frequent and thorough hand washing
C. Prophylactic, broad-spectrum antibiotics
D. Fitting and appropriate use of N95 masks
b
- The nurse teaches the staff ensuring that standard precautions should be used when providing care for which type of patient?
A. All patients regardless of diagnosis
B. Pediatric and gerontologic patients
C. Patients who are immunocompromised
D. Patients with a history of infectious diseases
a
- A pregnant woman who was tested and diagnosed with human immunodeficiency virus (HIV) infection is very upset. What should the nurse teach this patient about her baby’s risk of being born with HIV infection?
A. “The baby will probably be infected with HIV.”
B. “Only an abortion will keep your baby from having HIV.”
C. “Treatment with antiretroviral therapy will decrease the baby’s chance of HIV infection.”
D. “The duration and frequency of contact with the organism will determine if the baby gets HIV infection.”
c
- The nurse is providing postoperative care for a patient with human immunodeficiency virus (HIV) infection after an appendectomy. What type of precautions should the nurse observe to prevent the transmission of this disease?
A. Droplet precautions
B. Contact precautions
C. Airborne precautions
D. Standard precautions
d
- The nurse is monitoring the effectiveness of antiretroviral therapy (ART) for a patient with acquired immunodeficiency syndrome (AIDS). What laboratory study result indicates the medications are effective?
A. Increased viral load
B. Decreased neutrophil count
C. Increased CD4+ T cell count
D. Decreased white blood cell count
c
- A patient has acquired immunodeficiency syndrome (AIDS) and the viral load is reported as undetectable. What patient teaching should be provided by the nurse related to this laboratory study result?
A. The patient has the virus present and can transmit the infection to others.
B. The patient is not able to transmit the virus to others through sexual contact.
C. The patient will be prescribed lower doses of antiretroviral medications for 2 months.
D. The syndrome has been cured, and the patient will be able to discontinue all medications.
a
what type of rxn is latex
1 and IV
Which statement by a nurse to a patient newly diagnosed w/ type 2 diabetes is correct?
a) Insulin is not used to control blood glucose in patient w/ type 2 diabetes
b) Complications of type 2 diabetes are less serious than those of type 1 diabetes
c) Changes in diet and exercise may control blood glucose levels in type 2 diabetes
d) Type 2 diabetes is usually diagnosed when the patient is admitted w/ hyperglycemic coma
c
A 48 y/o male patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL. The nurse will plan to teach the patient about
a) self-monitoring of blood glucose
b) using low doses of regular insulin
c) lifestyle changes to lower blood glucose
d) effects of oral hypoglycemic medications
c
In order to assist an older diabetic patient to engage in moderate daily exercise, which action is most important for the nurse to take?
a) Determine what type of activities the patient enjoys
b) Remind the patient that exercise will improve self-esteem
c) Teach the patient about the effects of exercise on glucose level
d) Give the patient a list of activities that are moderate in intensity
a
An unresponsive patient w/ type 2 diabetes is brought to the ED and diagnosed w/ hyperosmolar hyperglycemia syndrome (HHS). The nurse will anticipate the need to
a) give a bolus of 50% dextrose
b) insert a large-bore IV catheter
c) initiate oxygen by nasal cannula
d) administer glargine (Lantus) insulin
b
After change-of-shift report, which patient should the nurse assess first?
a) 19 y/o w/ type 1 diabetes who has an A1C of 12%
b) 23 y/o w/ type 1 diabetes who has a blood glucose of 40 mg/dL
c) 40 y/o who is pregnancy and whose oral glucose tolerance test is 202 mg/dL
d) 50 y/o who uses exenatide (Byetta) and is complaining of acute abdominal pain
b
6 ss of SIADH
Results in reabsorption of water into the circulation
Fluid retention
Serum hypoosmolality
Dilutional hyponatremia
Hypochloremia
Concentrated urine
positioning for SIADH patient
HOB flat
SIADH vs DI
- The nurse determines that additional instruction is needed for a patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH) when the patient makes which statement?
a. “I need to shop for foods low in sodium and avoid adding salt to food.”
b. “I should weigh myself daily and report any sudden weight loss or gain.”
c. “I need to limit my fluid intake to no more than 1 quart of liquids a day.”
d. “I should eat foods high in potassium because diuretics cause potassium loss.”
a - they need Na
- A 62-yr-old patient with hyperthyroidism is to be treated with radioactive iodine (RAI). The nurse instructs the patient
a. about radioactive precautions to take with all body secretions.
b. that symptoms of hyperthyroidism should be relieved in about a week.
c. that symptoms of hypothyroidism may occur as the RAI therapy takes effect.
d. to discontinue the antithyroid medications taken before the radioactive therapy.
c
- Which nursing assessment of a 70-yr-old patient is most important to make during initiation of thyroid replacement with levothyroxine (Synthroid)?
a. Fluid balance
b. Apical pulse rate
c. Nutritional intake
d. Orientation and alertness
b
- Which finding for a patient who has hypothyroidism and hypertension indicates that the nurse should contact the health care provider before administering levothyroxine (Synthroid)?
a. Increased thyroxine (T4) level
b. Blood pressure 112/62 mm Hg
c. Distant and difficult to hear heart sounds
d. Elevated thyroid stimulating hormone level
a
addisons vs cushings labs
