MIDTERM Flashcards
The triage nurse in the emergency department admits a 16-year-old client brought in by ambulance and accompanied by a friend. The client is in respiratory distress, is vomiting, and blood is noted in the vomitus. The client is somnolent and the electrocardiogram demonstrates an arrhythmia. The friend admits that the client took a “bunch of little green pills” from the cupboard at the grandparents’ house. The nurse should recognize the likelihood of what adverse reaction?
serum sickness
poisoning
anaphylaxis
delayed hypersensitivity
Poisoning
A client with an upper respiratory infection has been prescribed erythromycin 250 mg orally twice a day on an outpatient basis. The nurse has provided education and the client states, “I’ll be careful to avoid grapefruit juice, take the medication before every meal, and watch out for any confusion or cognitive changes.” What is the nurse’s best response?
“You won’t be taking the medication before each meal of the day.”
“There’s no particular need to avoid grapefruit juice with this medication.”
“There are several possible side effects, but these don’t affect your cognition or mood.”
“It’s normal to experience some confusion when starting the medication, but this will pass.”
You wont be taking before each meal
The nurse is engaged in a conversation with a client newly prescribed an antibiotic. What client statement represents a commonly held misconception about antibiotic medications?
“Antibiotics are expensive and not generally covered by medical insurance.”
“An antibiotic will likely be effective for a multitude of infections and so can be shared.”
“When you start feeling better, the antibiotic should be stopped.”
“Antibiotics are a cure-all for all discomforts including a fever.”
Antibiotics are a cure all
A nurse is caring for a client taking multiple drugs and is concerned about a possible drug–drug interaction. How should the nurse best avoid a drug-drug interaction?
Consult a drug guide prior to drug administration.
Perform a comprehensive health assessment prior to drug administration.
Ensure that there is 90 minutes between administration of different drugs.
Ask for input from a pharmacist or the prescriber.
Consult a drug guide
A nurse is caring for two clients who are status postoperative for abdominal surgery. What is the best way to evaluate pain response after administering analgesia?
The nurse should observe the client when the client is not aware the nurse is watching.
Use a pain assessment tool before and 30 minutes after medication administration.
Ask the non-licensed personnel (aide) to find out if the medication worked.
If a family member is present, ask him or her if the medication worked.
Use pain assessment tool
What client is experiencing an adverse effect that is a result of primary action?
A client who develops diarrhea shortly after beginning a course of antibiotics
A client taking anticoagulants who develops a gastrointestinal bleed
A client who takes an antihistamine and falls asleep
An older adult client who becomes agitated and disoriented after being given a narcotic
A client taking coagulants
The nurse has just administered an opioid antagonist medication. Which side effect might the nurse anticipate that the client will experience? (Select all that apply.)
Decreased blood pressure
Nausea and vomiting
Bradycardia
Tremors
Sweating
Nausea
Tremors
Sweating
Patient should be cautioned to avoid which when taking skeletal muscle relaxants?
Green, leafy vegetables
Potassium
Alcohol
Cranberry juice
Alcohol
How should the nurse best describe prostaglandins when asked to do so?
They are chemical mediators that participate in the inflammatory response and that are found in most body tissues.
They sensitize pain receptors that participate in the inflammatory response.
They are chemical mediators released in the periphery, which prevent sensitization of pain receptors to various chemical substances released by damaged cells.
They are chemical mediators that produce chronic, painful, inflammatory disorders that affect the synovial tissue of hinge-like joints.
They are chemical mediators that participate in the inflammatory response and that are found in most body tissues.
The nurse is caring for a client who has been admitted after an acetaminophen overdosage. Which of the nurse’s assessment findings suggest liver damage? (Select all that apply.)
The client’s skin and eyes are visibly jaundiced.
The client’s AST and ALT levels are elevated.
The client’s temperature is 102.5° F (39.2° C).
The client has an elevated red blood cell count.
The client’s eyes are sensitive to light.
The client’s skin and eyes are visibly jaundiced.
The client’s AST and ALT levels are elevated.
The client’s temperature is 102.5° F (39.2° C).
During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act?
M G0 G1 S
M
The health care provider has prescribed a cholinergic blocking drug for a client with Parkinson disease. Which finding in the health record alerts the nurse to the need for cautious administration?
Decreased liver function
History of hallucinations or psychosis
Cardiovascular disease
Pulmonary disease
Decreased liver function
When teaching a client about the action of an opioid antagonist, what should the nurse include in the education?
A medication called an opioid antagonist is given to enhance the effect of the opioid.
An antagonist increases the rate of respirations to counter the effects of the opioid medication.
An opioid antagonist acts on the central nervous system to elevate the level of consciousness.
This medication competes with the opioid pain medication, binding to the cell receptors instead.
This medication competes with the opioid pain medication, binding to the cell receptors instead.
Which equipment should be placed in the client’s room when administering an opioid antagonist? (Select all that apply.)
A different opioid medication to replace the drug being countered
Suction equipment in case the client begins to vomit
A cardiac monitor to assess the client’s cardiac function
A pulse oximeter to monitor the client’s oxygen saturation levels Extra pillows to help reposition the client for comfort
Suction equipment in case the client begins to vomit
A cardiac monitor to assess the client’s cardiac function
A pulse oximeter to monitor the client’s oxygen saturation levels
A client has been prescribed a medication that is known to be a drug agonist. This drug will have what effect?
It will react with a receptor site on a cell preventing a reaction with another chemical on a different receptor site.
The drug will interfere with the enzyme systems that act as catalyst for different chemical reactions.
The drug will interact directly with receptor sites to cause the same activity that a natural chemical would cause at that site.
It will react with receptor sites to block normal stimulation, producing no effect.
The drug will interact directly with receptor sites to cause the same activity that a natural chemical would cause at that site.
A client with HIV has had a CCR5 co-receptor antagonist added to the antiretroviral regimen. What assessment should the nurse prioritize?
Liver function
Kidney function
Cardiac monitoring
Respiratory function
Liver function
All drugs have adverse reactions when taken. Organ and tissue damage is one such adverse reaction. Which is an example of organ and tissue damage caused by a drug?
Stevens–Johnson syndrome
Atropine-like (cholinergic) effects
Parkinson-like syndrome
Neuroleptic malignant syndrome (NMS)
Sjs
A client has a blood serum drug level of 50 units/mL. The drug’s half-life is 1 hour. If concentrations of 25 units/mL and above are toxic and no more of the drug is given, how long will it take for the blood level to reach the nontoxic range?
30 minutes 1 hour 2 hours 3 hours
2hr
The nurse is assessing a client new to the clinic. The client says they are allergic to penicillin. What action should the nurse take next?
Assess the exact nature of the client’s response to the drug.
Document that the client is allergic to penicillin.
Perform a comprehensive health assessment.
Continue to assess the client for other allergies.
Assess the mature of the client
A client, who began antiretroviral therapy several weeks ago, states to the nurse, “I’ve been pretty good about taking all my pills on time, though it was a bit hit and miss over the holiday weekend.” How should the nurse best respond to this client’s statement? Select all that apply.
“Remember that if you miss a dose, you need to take a double dose at the next scheduled time.”
“It’s acceptable to miss an occasional dose as long as your symptoms don’t get worse, but it’s not really recommended.”
“Remember that your antiretroviral drugs will only be effective if you take them very consistently.”
“If you’re not consistent with taking your medications, you’re likely to develop more side effects.”
“Missing doses occasionally is alright, but be sure you make up for the missed doses.”
Remember that your antiretroviral drugs will only be effective if you take them very consistently.”
“If you’re not consistent with taking your medications, you’re likely to develop more side effects.”
A client is suspected of having a liver injury as a result of drug therapy. What laboratory finding would best support this diagnosis?
Elevated aspartate aminotransferase (AST) level
Elevated blood urea nitrogen (BUN)
Elevated serum creatinine level
Sudden drops in hemoglobin, hematocrit and red cell count
Ast
The nurse caring for a client diagnosed with influenza is explaining why viruses are more difficult to treat than many bacteria. What should the nurse teach the client?
Viruses are contained inside the human cell and cannot be destroyed without destroying that cell.
Release of interferons by the host cell makes the virus replicate more quickly allowing the virus to spread.
Drugs exist to treat all viral infections but they carry serious adverse effects and the benefit often does not outweigh the risk.
Individual antiviral drugs are often effective in treating many different viruses because one virus in a category behaves like others in the same category.
Viruses are contained
The nurse is caring for a client who is exhibiting adverse medication effects. The nurse should recognize that adverse effects can be extensions of what?
the primary action of a drug
anaphylaxis
the secondary action of a drug
an anticholinergic response to the drug
The primary
An immunocompromised client with a diagnosis of candidiasis has failed to respond to conservative therapy and has consequently begun treatment with amphotericin B. The nurse is aware that this drug achieves a therapeutic effect by its influence on:
the osmolarity of fungal intracellular fluid.
protein synthesis of fungal cells.
the production and maturation of CD4+ T-cells.
the permeability of fungal cell walls.
The permeability of fungal cell walls
A nurse is teaching a colleague about the factors that are known to contribute to antibiotic resistance. When phenomenon should the nurse describe?
Use of antibiotics for viral illnesses
Use of excessive doses during anti-infective therapy
Over-the-counter availability of some antibiotics in the United States
Increasing incidence of adverse effects of anti-infectives in recent years
Use of antibiotics for viral
A client has been admitted to the emergency department after overdosing on oxycodone. What nursing diagnosis should the nurse prioritize?
impaired swallowing
impaired gas exchange
ineffective airway clearance
ineffective role performance
Impaired gas exchange
A nurse is assessing a client for possible factors that may affect the pharmacokinetics of a drug. A history of what disease would lead the nurse to suspect that the client may experience an alteration in the distribution of a drug?
gastrointestinal disease
liver disease
kidney disease
vascular disease
Vascular disease
A client is diagnosed with a gram-negative infection and is prescribed an aminoglycoside. What is the action of an aminoglycoside?
It blocks protein synthesis of the cell wall.
It blocks the process of DNA replication.
It destroys the integrity of the cell wall structure.
It increases white blood cells viability.
It blocks protein synthesis of the cell wall
Access to information has become so broad over the last decade that consumers are often overwhelmed with details, facts, and choices that affect their health care. Which of the following have influenced how a patient approaches the health care provider when it comes to prescriptions? Select all that apply.
Wikipedia
Herbalism
Dr. Oz
Dentists
Wiki
Herbalism
Dr. Oz
The nurse is conducting an ongoing assessment after administering an antiepileptic. The nurse determines the client has a risk of increased CNS depression after noting the client is also administered which additional medication(s)? Select all that apply.
Analgesics
Oral contraceptives
Alcohol
Antibiotics
Antidiabetic medications
Analgesics
Alcohol
