N368 Chapters 30-34 Additional Practice Questions Flashcards
The nurse is preparing to give a patient in renal failure an injection of diuril. In regards to normal dosage, what dose should this patient receive?
A. The patient should receive the average dose
B. The Patient should receive higher than the average dose
C. The patient should receive less than the normal dose
D. The patients dose will be determined by their weight
C
What diagnostic test is the most commonly used and most useful for diagnosing renal failure? A: Urinalysis B: Serum Creatinine C: Biopsy D: Diagnostic Imaging
B
A patient has been diagnosed with chronic renal failure. The nurse understands that this patient most likely has a history of A: Diabetes Mellitus B: Hypertension C: Hypotension D: Both A and B
D
Acute renal failure is caused by hypoperfusion. The nurse understands that which of the following contribute to this? (Select all that apply) A: Heart Failure B: Diabetes Mellitus C: Arrhythmias D: Hemmorhage E: Dehydration
A C D E
Which of the following therapies are used to treat renal failure? (Select all that apply) A: Diuretic B: Cardiovascular Drugs C: Dietary Management D: Exercise
A B C
What drug is commonly used to treat anemia associated with renal failure? A: Procrit B: Diuril C: Aldactone D: None of these
A
How is hyperkalemia usually treated? A: Procrit B: Dietary Restriction C: Aldactone D: None of these
B
What drug is used to treat metabolic acidosis? A: Sodium Bicarb B: Magnesium Sulfate C: Diuril D: Alka Seltzer
A
It is widely understood that diuretics treat renal failure but they are also used to treat which of the following disorders? A: Hypertension B: Heart Failure C: Kidney Failure D: Liver Failure E: Edema
A B C D E
Which of the following are adverse effects of Diuretics? A: Fluid and Electrolyte Disturbances B: Dehydration C: Orthostatic Hypotension D: Heart Failure
A B C
What are the four classes of diuretics?
Loop
Thiazide
Postassium Sparing
Misc
Which of the following drugs belong to the strongest and most effective group of diuretics? A: Bumex B: Diuril C: Microzide D: Midamor
A
The nurse is preparing to administer a dose of Lasix to a patient. The nurse understands that which of the following is a serious adverse effect of drugs in the loop diuretic class? A: Coma B: Hyperglycemia C: Nausea D: Circulatory Collapse
D
What baseline information must be gathered for a patient taking loop and thiazide diuretics? (Select all that apply)
A: Lab Values (especially Potassium and Sodium)
B: Urinary Output
C: BUN and Creatinine
D: Glucose
E: Hgb and HcT
F: Uric Acid
A B C D F
D: None of the above statements report adequate teachig”
A
D” You can decided”
B
How does the drug torsemide compare to Lasix?
A: It is 40 times stronger than lasix
B: It has a longer half life than lasix
C: It treats treats hypertension and lasix does not
D: None of the above
B
How does the drug bumex compare to lasix?
A: It is 40 times stronger than lasix
B: It has a longer half life than lasix
C: It treats treats hypertension and lasix does not
D: None of the above
A
What is the largest and most commonly prescribed class of diuretics? A: Loop B: Thiazide C: Potassium Sparing D: Misc
B
The drug Diuril has been precribed for a patient suffering from severe renal failure. Why should this alert the nurse?
A: This drug can not be prescribe to a patient who is suffering from any type of renal failure
B: This drug can not treat severe renal failure
C: There should be no cause for concern about giving the patient diuril
D: Diuril has been taken off the market
B
What is the correct dose for an IV dose of the drug Diuril? A: 0.5g/10 minutes B: 0.5g/7 minutes C: 0.5g/5 minutes D: 0.7g / 7 minutes
C
If a patient is given the PO version of diuril, when should it be taken? A: A night before bed B: In the morning C: In the afternoon D: None of the above
B
Which of the following should be avoided if you are taking the drug diuril?(select all that apply) A: Licorice B: Garlic C: Gingko D: Hawthorn
A B D
Zaroxolyn belongs to which class of diuretics? A: Loop B: Potassium Sparing C: Thiazide D: Misc
C
If thiazide diuretics are used with Digoxin, what may happen?
A: There may be a decreased potassium level in the patient
B: There may be an increased potassium level
C: There could be toxicity
B
If thiazide diuretics are used with Lithium, what may happen?
A: There may be a decreased potassium level in the patient
B: There may be an increased potassium level
C: There could be toxicity
C
The patient taking thiazide diuretics should be educated about the use of
A: Water as an increased fluid in their diet
B: Not to take potassium supplements
C: Use of sunscreen
D: Medications to decrease joint pain
C
Which of the following symptoms may indicate that the patient is suffering from hypokalemia? (Select all that apply) A: Muscle weakness B: Muscle cramps C: Abdominal Pain D: Jaundice
A B
A patient taking thiazide diuretics can take potassium supplements. True or False
TRUE
In regards to glucose control a patient taking thiazide diuretics should be aware of the possiblity of developing
A: Hypoglycemia
B: Hyperglycemia
C: There should not be a concern about glucose control
D: None of the above
B
If a patient is taking potassium sparing diuretics they should not eat or drink which of the following?(Select all that apply) A: Banannas B: Orange Juice C: Grapefruit Juice D: Lettuce
A B
Which of the following are adverse effects of potassium sparing diuretics that either a male or female may wish to be aware of?(select all that apply)
A: Gynecomastic
B: Ammenorhea
C: Impotence
D: None of these are adverse effects of potassium sparing diuretics
A B C
Midamor belongs to which class of diuretics? A: Loop B: Thiazide C: Potassium Sparing D. Misc
C
Aldactone belongs to which class of diuretics? A: Loop B: Thiazide C: Potassium Sparing D: Misc
C
What should be assessed before giving a patient a potassium sparing diuretic?(Select all that apply) A: Electrolytes B: Glucose C: BUN D: Creatinine
A B D
If aldactone (spironolactone) is used with Ace Inhibitors what can this cause? A: Hypokalemia B: Hyperkalemia C: Hypernatremia D: Hyponatremia
B
Aldactone should be taken with A: Food B: Grapefruit juice C: Orange Juice D: Banannas
A
True or false a patient taking potassium sparing diuretics can take potassium supplements?
FALSE
True or False if potassium sparing diuretics with lithium and digoxin toxicity can occur.
TRUE
A Patient taking potassium sparing diuretics should understand that
A: They should use sunscreen
B: They should take potassium supplements
C: They should increase their intake of potassium
A
Diamox is a diuretic but it is also used to treat A: Intracranial Swelling B: Glaucoma C: CVA D: Hypokalemia
B
Manitol is used to treat A: Intracranial Swelling B: Glaucoma C: CVA D: Hypokalemia
A
For any type of diuretic therapy you must get some baseline information. What is that information?
Weight, Vital Signs especially blood pressure and pulse, breath sounds, Cardiac Monitoring with an ECG
What is the best beverage for a patient on diuretic therapy?
Plain Water
What are the signs of Diabetes Mellitus?
Polydypsia and Polyphagia
What is essential for hemostasis?
Water balance
IV therapy is indicated for
Body fluids
Electrolytes
Acid - Base
Where sodium goes
water goes
Hypertonic solution
water moves from interstial space to plasma
Hypotonic Solution
Water moves from plasma to interstitial space
Isotonic solution
No fluid shift
What is the most important regulator of fluid intake?
Thirst
What regulates fluid output?
Kidneys
If there is a defecit in fluid balance what is used to treat this?
Oral or IV fluids
if there is an excess in fluid balance what is used to treat this?
Diuretics
When giving IV fluid therapy what is used?
Crystalloids and Colloids
Which of the following are all ways that we lose water and electrolytes?(Select all that apply) A: Suctioning B: Vomiting C: Diarrhea D: Laxatives E: GI fluid Loss
A B C D E
Crystalloids contain
Electrolytes
Which of the following are examples of crystalloids? (Select all that apply) A: Normal Saline B: Lactated Ringers C: Albumin D: D5W
A B D
Which of the following are examples of colloids? (Select all that apply) A: Dextran B: Hetastarch C: Albumin D: Lactated Ringers
A B C
A person taking colloids should have their Hct monitored. When should a measurement be reported? A: Hct below 50 % B: Hct below 70% C: HCT below 30 % D: HCT does not have to be reported
C
When administering IV fluid replacement it is essential that you monitor for A: Fluid depletion B: Fluid Overload C: Fluid Excess D: All of the above
D
Dextran 40 is used to treat which of the following? A: Hypovolemic Shock B: Cardiac Shock C: Neurogenic Shock D: Anaphylactic Shock
A
What are the symptoms of fluid volume overload?(Select all that apply) A: tachy B: Pulmonary edema C: Distended neck veins D: Dyspnea E: Cough F: HTN
A B C D E F
Electrolytes are essential for
Nerve conduction
Membrane permeability
Water balance
What is the normal level of calcium A: 4-11 B: 95 -112 C: 0.5 -4 D: 1-6
A
What is the normal level of chloride A: 4-11 B: 95 -112 C: 0.5 -4 D: 1-6
B
What is the normal level of magnesium? A: 4-11 B: 95 -112 C: 0.5 -4 D: 1-6
C
What is the normal level of phosphate? A: 4-11 B: 95 -112 C: 0.5 -4 D: 1-6
D
What is the normal level of potassium? A: 3.5 - 5 B: 135 -45 C: 4-11 D: 0.5 -4
A
What is the normal level of Sodium? A: 3.5 - 5 B: 135 -45 C: 4-11 D: 0.5 -4
B
What is the most common cause of hypernatremia? A: Liver failure B: Kidney Disease C: Heart Failure D: Fluid loss
B
High doses of what drugs can cause hypernatremia?
gluccocoritcoids and estrogens
How do we treat hypernatremia?
Low salt diet
What is the most common cause of hyponatremia? A: Decrease in antidiuretic hormone B: Excess antidiuretic hormone C: Vomiting D: None of the above
B
How do we treat hyponatremia?(Select all that apply) A: loops B: Normal Saline C: Lactated Riingers D: Albumin
A B C
When the level of sodium falls below 130 what is used to treat? A: Sodium bicarb B: Sodium Chloride C: Lactated Ringers D: Albumin
B
Potassium imbalances can be
fatal
Hyperkalemia becomes a risk when a patient is taking
Potassium sparing diuretics
How do we treat hyperkalemia? (Select all that apply)
A: Decrease K Sparing Diuretics
B: Gluocose and insulin
C: Calcium to stop toxicity on the heart
D: Kayexalate and Sorbitol
A B C D
How do we treat hypokalemia? (Select all that apply) A: Increase dietary intake of potassium B: Oral K supplements C: Parenteral K Supplements D: K chloride
A B C D
Never give potassium IV
Push
What is the normal Ph balance?
7.35 - 7.45
Respiratory acidosis is caused by
hypoventilation
Metabolic Acidosis is caused by
severe diarrhea Kidney failure DM Excess alcohol intake Starvation
How do we treat metabolic acidosis? A: Potassium chloride B: Sodium Chloride C: Sodium Bicarb D: None of the above
C
What are the respiratory causes of alkalosis?
hyperventilation
What are the metabolic causes of alkalosis?
constipation
Excess sodium bicarb
K wasting diuretics
Severe vomiting
How do we treat Alkalosis in severe cases?
Amonium chloride
How do we treat alkalosis in mild cases?
sodium and potassium chloride
What baseline information should be gathered for IV fluid replacement?
Weight
Vital signs
LOC
Urinary Output
A patient taking IV fluid replacement should avoid A: Grapefruit B: Oranges C: Alcohol D: Diuretics
C
If a person has hypokalemia what should be increased?
fresh fruits and other foods high in potassium
If a person has hyperkalemia what should be decreased?
K based salt subsitutes and other foods high in potassium`
What type of defense is inflammation?
non-specific
Acute inflammation lasts
8-10 days
Chronic inlfammation lasts
months or years
What are the signs of inflamation? (Select all that apply) A; Swelling B: Warmth C: Pain D: Redness E: Bruising
A B C D
What is the chemical mediator of inflammation? A: Bradykinin B: Histamine C: Prostaglandins D: Complement system
B
H1 receptors are located in the
bronchi
H2 receptors are located in the
stomach
How do we treat inflammation that is mild? (Select all that apply) A: Ice packs B: Rest C: topical agents D: Reduce Fever
A B C D
What are the primary drugs used to treat mild to moderate inflammation?
NSAID’s
Tylenol is not an
NSAID
Aspirin causes GI upset so it should be taken with
food
Aspirin can cause
tinnitus
Cox 2 inhibitors are the most _______ version of drugs for inflammation and fever.
controversial
What is the most common Side effect of Ibuprofen?
nausea and vomiting
Vioxx has been shown to
double the risk of heart attack or stroke
What is the only remaining drug in the cox 2 class?
celebrex
What is the max dose daily for Ibuprofen?
3200 mg
What should be routinely monitored when taking ibuprofen?
blood tests
What are used to treat severe inflammation?
glucocorticoids
What is naturally released by the adrenal cortex
glucocoritcoids
In regards to vision are are some adverse effects of glucocoritcoids?
cataracts
In regards to bone function what are some adverse effects of glucocorticoids?
osteoporosis
When a patient stops taking glucocorticoids how should they be discontinued?
gradually
The dose of glucocorticoids should remain as ____ as possible
low
What type of dosing schedule should be used with glucocorticoids?
alternate day dosing
What is the most serious adverse effect of prednisone?
cushings syndrome
What herbal medications should be avoided when taking prednisone? (Select all that apply) A: St. Johns Wort B: Licorice C: Buckthorn D: Senna
A B C D
What type of tylenol should an infant be given?
infant drops
If african americans take tylenol what can they develop?
hemolysis
What can not be taken with tylenol concurrently?
warfarin
What shouldn’t a person drink if they are taking tylenol?
alcohol
Bascillus anthracis causes
anthrax
Borellia Burgdoferri cuases
lyme disease
Trichamonas causes
chlamydia
E coli causes
travelers diarrhea, UTI and childrens menigitis
Haemophilus
pneuomia
Klebsellia causes
pneumonia and UTI
Mycobacterium Leprae causes
Leprosy
Mycobaterium Tuberculosis causes
TB
Mycoplasma Pneumoniae
Pneumonia
Nessiria Menigitis causes
meningitis in children
Rickettsia causes
rocky mountain spotted fever
Staph Aureus causes
impetigo
A Bacterialcidal drug will
kill bacteria
A bacteriostatic drug will
slow bacteria growth
Antibiotics should only be prescribed when
necessary
Nosocomial infections
hospital acquired
When giving a penicillin drug a nurse should monitor for A: Hypernatremia and Hyperkalemia B: Hyponatremia and Hypokalemia C: Hyponatremia D: Hypokalemia
A
A student nurse is preparing and injection of penicillin for a patient. The patient has also be prescribed an Aminoglycoside. The student nurse begins to mix the two together. What should be the correct intervention from the student nurses instructor?
A: The instructor should teach the student nurse how to mix the two medications
B: The instructor should stop the student from mixing the medications as they can not be put in the same solution
C: The instructor should not intervene
B
Penicillin is effective in treating which of the following disorders? (Select all that apply) A: Gonhorrea B: Syphillis C: CVA D: All infections
A B
A female patient has been given the drug penicillin. She is also taking oral contraceptives. What should the nurse tell her? (Select all that apply)
A: Use an alternate form of birth control
B: do not take the contraceptives and penicillin concurrently
C: IM injections of birth control are more effective when you are taking penicillin
D: Penicillin will not effect oral contraceptives
A
When giving cephalasporins a nurse must asess for which of the following? A: Edema B: Hypertension C: Bleeding D: None of these
C
In regards to organ function what should be monitored for the patient taking cephalasporins?
renal and hepatic function
When giving the drug cloforan these injections must be given
A: IM into a small muscle
B: IM into a large muscle
C: Never give a cloforan injection
B
Cloforan treats
A: Respiratory infections
B: Gonhorrea
C: Syphillis
A
When are tetracyclines contraindicated?
A: Pregnancy and Lactation
B: 3rd trimester of pregnancy
C: 2nd trimester of pregnancy
A
Tetracyclines effect what type of medication
oral contraceptives
What should not be taken with tetracyclines? (Select all that apply) A: Milk B: Magnesium Laxatives C: Iron D: Antacids
A B C D
Tetracycline should be taken with
a full glass of water
When taking a tetracycine you should wait________ hours before you take an antacid?
1-3 hours
When taking a tetracycline you should wait ________ hours before you take antilipidemics?
2 hours before or after
Tetracyclines can treat which of the following? (select all that apply) A: Clamydia B: Rickettsia C: Mycoplasma D: TB
A B C
When giving a patient a macrolide you should assess for
A :Respiratory infections and Cardiac disorders
B: Respiratory infection
C: Cardiac Disorders
D: STD’s
A
You should give a PO version of a macrolide on an
empty stomach with a full glass of water
Macrolides should not be given before or after drinking a
fruit juice
What herbal medication should avoided when taking macrolides
St. John’s Wort
Emycin can treat A: Most gram positive bacteria B: Diptheria C: Whooping Cough D: All of the above
D
When giving an aminoglycoside you should monitor for A: Ototoxicity B: Nephrotoxicity C: Tinnitus D: All of the above
D
A nurse should understand that an aminoglycoside may cause A: nuromuscular dysfunction B: Cataracts C: Blood Dyscrasias D: Pregnancy
A
When giving Gentamicin IM the drug should be given into a
large muscle
A solution of gentamicin must be
clear and colorless
If the serum level is above 5-10mcg/mL gentamicin must be
withheld
Gentamicin drops are available for
eye infections
You should monior the _______ blood count when giving fluroquinolones.
White
A client who has renal or liver dysfunction and is taking fluroquinolones should be
monitored
Noroxan can cause
A: Photosensivity
B: Sunburns
C: Photophobia
C
Cipro must be given at least ______ hours before antacids and iron
4
Caffeine and dairy should be limited when taking A: fluroquinolones B: Aminoglycosides C: Loop Diuretics D: None of the above
A
When giving sulfonamides you sould assess for A: Renal Function B: Anemia C: Gout D: All of the above
D
Sulfonamides can cause what serious skin disorder?
SJS
Sulfunamides that are PO should be taken with
full glass of water
What supplements can not be taken with sulfonamides?
Potassium
AntiTB medications are contraindicated in
alcoholics, AIDS, liver disease and kidney failure
If you give an antiTB medication you should assess for
A: Gouty arthritis
B: Pregnancy
C: STDs
A
A patient taking an AntiTB should be told to use _______ form of birth control.
Alternate
What is the drug of choice for TB?
INH
If a patient is taking INH, what foods should be avoided?
Tryamine containing foods
Multidrug thereapy is used to treat TB, how long does therapy usually last?
6-12 months
Cleomicin treats A: H. Pylori B: Oral infection C: MRSA D: skin infections
B
Flagyl treats A: H. Pylori B: Oral infection C: MRSA D: skin infections
A
Vancomycin treats A: H. Pylori B: Oral infection C: MRSA D: skin infections
C
Cubicin treats A: H. Pylori B: Oral Infection C: MRSA D: Skin Infections
D
What is the broadest spectrum antibiotic?
Primaxin
Ketex treats A: H. Pylori B: Oral Infections C: Resp Infections D: Skin Infections
C
Tyscal treats A: H. Pylori B: oral infection C: Abdominal Infection D: Skin Infections
C
Haemophilus type B vaccine should be given at what ages (Select all that apply) A: 2 months B: 4 months C: 6 months D: 15 months E: 7 Years
A B C D
At what age should children receive the HEP B vaccine A: 1-4 months and 6-18 months B: 2 and 4 years C: 6 and 10 Years D: 1-6 Months and 18-24 months
A
Adult hepatitis vaccine should be given
in three doses the second 30 days after the first and the final dose 6 months after the first
Children flu vaccine should be give in
2 doses one month apart
Adult flu vaccine should be given
one time annually
MMR should be given at what age
one dose 15 months
Pneumovax should be give to children in
4 doses at 2 4 6 12 -15 months
Adult pneumovax
one single dose
Poliovirus should be given at A: 4-8 weeks B: 2-4 months C: 6-12 months D: All of the above
D
Active immunity comes from
vaccines
Passive immunities come from
mother to child and injection of antibodies
BayRho should be given at
28 weeks
Immunostiumlants
boost immune system
Interferons
slow spread of viral infection
Interlukins treat
metastatic renal carcinoma
Corticosteroids suppress
immune response
A patient taking immunosuppressants should avoid
crowds
Calcereniun inhibitors treat
psoriasis
Simulect and Zanapax treat A: rejection of organ transplants B: Autoimmune disorders C: Psoriasis D: Inflammation
A
Remicade treats A: rejection of organ transplants B: Autoimmune disorders C: Psoriasis D: Inflammation
B
If a patient is taking immunostimulants they should be well
hydrated
Immunostimulants can cause
A: Sucidal ideation
B: Decrease in heart function
C: Muscle dysfunction
A
Immunosuppressants are contraindicated in A:Leukemia B:Metastatic cancer C: Active infection D: All of the above
D
Thrombocytopenia and Leukopenia can be caused by
Immunosuppressants
If a patient is taking imuran they should be monitored for
A: Secondary malignancies
B: Heart Failure
C: Kidney Failure
A
When giving Hep B vaccine what should you keep available? A: Epinephrine 1- 10000 B: Epinephrine 1 - 1000 C: Regitine D: None of the above
B
Cyclosporine is used for A: Prophylacis of organ transplant rejection B: Heart Failure C: Kidney Failure D: None of the above
A
What can not be taken with cyclosporine?
A: Lemonade
B: Grapefruit juice
C: Orange juice
B
Calerenium inhibitors can cause
A: Ototoxicity
B: Nephrotoxicity
C: Autoimmune disorders
B
