Final Exam: Sherpath Qs

Question 1

A patient with diabetes who is also taking beta-blockers exhibits the following: BP of 130/75, HR 80, Resp 18, tremors, irritability, and diaphoresis. Which action would the nurse take first?

Answer 1

Obtain a blood glucose level

Question 2

When auscultating the lungs of a patient receiving albuterol the nurse hears little improvement of wheezing. Which questions would the nurse ask the patient to determine drug efficacy? (4)

Answer 2

• “how often are you using your inhaler?”
• “do you have any pressure in your chest?”
• “have you experienced any numbness in your fingers or toes?”
• “are you taking any OTC medications?”

Question 3

Which action is the priority for the nurse when providing care to a patient prescribed carbidopa-levodopa for treatment of PD?

a. assessing for dry mouth
b. monitoring for constipation
c. assessing patient’s urine
d. monitoring WBC count

Answer 3

D. monitoring WBC count (adverse reaction of agranulocytosis)

Question 4

A patient with a hx of which condition would be at an increased risk for adverse effects after the administration of beta-blockers?

a. wrist injury
b. diabetes mellitus
c. hyperactivity disorder
d. myocardial infarction

Answer 4

B. diabetes mellitus (beta-blockers mask tachycardia which occurs during hypoglycemic shock)

Question 5

Which patient can safely receive metoprolol?

a. a patient with sinus bradycardia
b. a patient with AV block
c. a patient with acute HF
d. a patient with elevated serum renin levels

Answer 5

D. a patient with elevated serum renin levels (metoprolol is used for HTN to decrease blood pressure)

Question 6

The current use of which medication listed in the patient’s chart would be a concern to the nurse after receiving a prescription for an antithyroid drug?

a. antidiabetics
b. antihistamines
c. anticoagulants
d. beta lactam-antibiotics

Answer 6

C. anticoagulants

Question 7

Which action is a priority for a nurse who is caring for a patient receiving digoxin and furosemide and reports seeing yellow halos around lights?

Answer 7

Assess patient for symptoms of digoxin toxicity

Question 8

The nurse assesses a patient who receiving nitroglycerin for the treatment of angina and notes that the patient reports dizziness, syncope, and a headache. Which conclusion will the nurse make regarding the patient’s response to the drug?

Answer 8

Symptoms are the result of drug side effects

Question 9

Which action is the priority when providing care to a patient who is prescribed carbidopa-levodopa for the treatment of PD?

a. assisting the patient out of bed
b. ensuring the patient has low-protein foods
c. educating the patient and family that urine may be dark in color
d. providing a support group

Answer 9

A. assisting the patient out of bed (side effect: OH)

Question 10

Which parameters are important for a nurse to monitor when titrating nitroglycerin in a patient? (2)

Answer 10

• presence of chest pain

- continuous BP

Question 11

Which statement made by a patient prescribed carbidopa-levodopa reflects an understanding of the use of the drug combination?

Answer 11

“When I get up in the morning, I should get out of bed very slowly.”

Question 12

Which antiemetic can cause false pregnancy tests?

Answer 12

Promethazine HCl

Question 13

A patient is taking clomiphene citrate to increase ovulation to become pregnant. The nurse educates the patient on which potential side effect?

a. breast tenderness
b. nausea
c. vomiting
d. multiple gestations

Answer 13

D. multiple gestations

Question 14

What is the action of ibuprofen that causes it to relieve pain?

Answer 14

It blocks the action of cyclooxygenase (COX)

Question 15

Which assessment is a priority for a nurse administering diphenhydramine to a patient who is taking narcotics for chronic pain?

a. visual assessment
b. blood pressure
c. respiratory rate
d. urinary output

Answer 15

C. respiratory rate

Question 16

Which category of diuretics is contraindicated in patients who are taking ACE inhibitors?

Answer 16

Potassium-sparing diuretics (spironolactone)

Question 17

For patients taking ibuprofen for arthritis, it is important to assess for?

Answer 17

Peripheral edema, especially in the morning

Question 18

The nurse is caring for a patient who had just begun levothyroxine therapy. Which assessment is a priority for the nurse to address?

a. dehydration
b. irritability
c. heart rate
d. blood pressure

Answer 18

B. irritability

Question 19

Which concomitant drug will cause the nurse to monitor serum potassium levels in a patient taking digoxin for HF?

a. spironolactone
b. hydrochlorothiazide
c. furosemide
d. mannitol

Answer 19

C. furosemide

Question 20

What is an adverse effect of aspirin that differs from ibuprofen?

Answer 20

May lead to Reye syndrome in children

Question 21

What are labs to monitor for statin therapy? (4)

Answer 21

• cholesterol
• triglyceride
• LDL
• HDL

Question 22

A nurse is assessing a patient who experienced a loss of memory, slow speech, and facial edema. An increase in which lab finding would the nurse anticipate from these observations?

a. serum amylase
b. T4 levels
c. TSH levels
d. serum phosphate

Answer 22

C. TSH levels (indicates myxedema)

Question 23

A patient is prescribed esomeprazole. Which finding indicates that medication is effective?

Answer 23

No esophageal pain

Question 24

Which nursing intervention would the nurse take when caring for a patient during the acute phase of diabetic ketoacidosis?

Answer 24

Administering regular insulin through an IV

Question 25

The nurse is teaching a student about caring for a patient with Addison’s disease. What response indicates effective teaching?

Answer 25

“Patient may have dehydration due to a decrease in blood aldosterone concentrations.”

Question 26

What are s/s of DKA? (5)

Answer 26

• polyuria
• polydipsia
• polyphagia
• hyperglycemia
• Kussmaul breathing

Question 27

A HCP prescribes carbidopa-levodopa for PD. Which priority intervention does the nurse implement when noticed the patient is also taking a monoamine oxidase inhibitor (MAOI) antidepressant?

a. monitor for suicidal ideation
b. ensure the patient is on a low-protein diet
c. notify the HCP for adjusted dosage
d. obtain BP to establish baseline reading

Answer 27

C. notify the HCP for adjusted dosage

Question 28

Which action is most important for the nurse to take for a patient receiving phenytoin whose eyes are moving in a circular pattern?

a. assess serum phenytoin levels
b. monitor for seizure activity
c. decrease the phenytoin dosage
d. hold the dose of phenytoin

Answer 28

A. assess serum phenytoin levels

Question 29

Which action is appropriate for a nurse who determines a patient’s phenytoin level is 8 mcg/mL?

a. contact the HCP for an increase in dosage
b. hold the medication and call the HCP
c. document the value and continue to monitor the patient
d. draw another lab value within the hour

Answer 29

A. contact the HCP provider for an increase in dosage

Question 30

Which life-threatening adverse reaction would the nurse determine requires immediate intervention after the administration of diphenhydramine?

a. psychosis
b. palpitations
c. hypotension
d. ABD pain

Answer 30

A. psychosis

Question 31

Which statement made by the nurse in regard to comparing the mechanisms of action of anticoagulants, antiplatelets, and thrombolytics indicates effective learning?

a. antidote to heparin overdose is vitamin K
b. heparin promotes the conversion of fibrinogen to fibrin
c. antiplatelets are used to prevent thrombosis in the veins by suppressing platelet aggregation
d. necrosis resulting from a blocked artery caused by an embolus may be reduced using alteplase

Answer 31

D. necrosis resulting from a blocked artery caused by an embolus may be reduced using alteplase

Question 32

Which prescription would a nurse anticipate being ordered for a patient who has an INR of 1.5 and is receiving anticoagulant therapy?

a. administer protamine sulfate
b. increase the heparin drip rate
c. hold the next dose of warfarin
d. administer an additional dose of warfarin

Answer 32

D. administer an additional dose of warfarin

Question 33

Which assessment question would the nurse ask before administering an albuterol inhaler to a patient with asthma?

a. do you have an allergy to milk?
b. do you have an autoimmune disorder?
c. when was the last time you ate or drank?
d. have you ever taken this medication before?

Answer 33

A. do you have an allergy to milk?

Question 34

A patient prescribed diphenhydramine experiences HTN and palpitations. Which action would the nurse take?

a. contact the HCP
b. tell the patient to avoid caffeine
c. assess the patient for use of any other medications
d. tell the patient to stop taking the medication

Answer 34

C. assess the patient for use of any other medications

Question 35

Which drug class is suitable to prevent in a patient with transient ischemic attacks?

a. antiplatelets
b. thrombolytics
c. anticoagulants
d. antifibrinolytics

Answer 35

A. antiplatelets

Question 36

Which patient does a nurse anticipate will receive alteplase therapy?

a. patient with peptic ulcer disease
b. patient with GI bleed
c. patient with acute MI
d. patient with local thrombosis from a peripheral IV

Answer 36

C. patient with an acute MI

Question 37

A patient admitted with HTN was prescribed valsartan. Which lab result indicates the patient is experiencing an adverse reaction to the medication?

a. potassium levels
b. elevated creatinine level
c. neutrophil count
d. high-density lipoprotein

Answer 37

B. elevated creatinine levels (indicates rhabdomyolysis = adverse reaction)

Question 38

Which symptoms are associated with digoxin toxicity? (4)

Answer 38

• anorexia
• vomiting
• visual disturbances
• cardiac dysrhythmias

Question 39

A patient reports gasping for air at night with a burning sensation in the middle of the chest. Which condition would the nurse suspect?

a. dyspepsia
b. duodenal ulcer
c. H. pylori infection
d. GERD

Answer 39

D. GERD

Question 40

The nurse is educating a patient who is taking thyroid hormone replacement therapy. Which response by the patient indicates effective learning?

a. i should take the drug every night after dinner
b. i should take the tablet every morning with an empty stomach
c. i should take it twice daily, before breakfast and after
d. i can stop the medication whenever i want

Answer 40

B. i should take the tablet every morning with an empty stomach

Question 41

When applying mafenide acetate to a patient’s burn, the nurse notes that the patient has developed a rash, erythema, and swelling of the area. The patient reports a burning sensation and itching. Which conclusion does the nurse make regarding the patient’s response to the medication?

a. symptoms are consistent with burns
b. the adverse effect of the medication is occurring
c. symptoms are the result of medication side effects
d. a cause unrelated to the signs and is the source of the patient symptoms

Answer 41

C. symptoms are the result of medication side effects