N368 Chapters 30-34 Additional Practice Questions Flashcards by Joshua Meyer

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

What drug is commonly used to treat anemia associated with renal failure?
A: Procrit
B: Diuril
C: Aldactone
D: None of these

How well did you know this?

Not at all

Perfectly

How is hyperkalemia usually treated?
A: Procrit
B: Dietary Restriction
C: Aldactone
D: None of these

How well did you know this?

Not at all

Perfectly

What drug is used to treat metabolic acidosis?
A: Sodium Bicarb
B: Magnesium Sulfate
C: Diuril
D: Alka Seltzer

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

What are the four classes of diuretics?

Loop
Thiazide
Postassium Sparing
Misc

How well did you know this?

Not at all

Perfectly

Which of the following drugs belong to the strongest and most effective group of diuretics?
A: Bumex
B: Diuril
C: Microzide
D: Midamor

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

D: None of the above statements report adequate teachig”

How well did you know this?

Not at all

Perfectly

D” You can decided”

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

What is the largest and most commonly prescribed class of diuretics?
A: Loop
B: Thiazide
C: Potassium Sparing
D: Misc

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Zaroxolyn belongs to which class of diuretics?
A: Loop
B: Potassium Sparing
C: Thiazide 
D: Misc

How well did you know this?

Not at all

Perfectly

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

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

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

``` 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

``` 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 ```

``` Aldactone belongs to which class of diuretics? A: Loop B: Thiazide C: Potassium Sparing D: Misc ```

``` 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 ```

``` Aldactone should be taken with A: Food B: Grapefruit juice C: Orange Juice D: Banannas ```

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

``` Diamox is a diuretic but it is also used to treat A: Intracranial Swelling B: Glaucoma C: CVA D: Hypokalemia ```

``` Manitol is used to treat A: Intracranial Swelling B: Glaucoma C: CVA D: Hypokalemia ```

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 ```

``` 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 ```

``` Dextran 40 is used to treat which of the following? A: Hypovolemic Shock B: Cardiac Shock C: Neurogenic Shock D: Anaphylactic Shock ```

``` 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 ```

``` What is the normal level of chloride A: 4-11 B: 95 -112 C: 0.5 -4 D: 1-6 ```

``` What is the normal level of magnesium? A: 4-11 B: 95 -112 C: 0.5 -4 D: 1-6 ```

``` What is the normal level of phosphate? A: 4-11 B: 95 -112 C: 0.5 -4 D: 1-6 ```

``` What is the normal level of potassium? A: 3.5 - 5 B: 135 -45 C: 4-11 D: 0.5 -4 ```

``` What is the normal level of Sodium? A: 3.5 - 5 B: 135 -45 C: 4-11 D: 0.5 -4 ```

``` What is the most common cause of hypernatremia? A: Liver failure B: Kidney Disease C: Heart Failure D: Fluid loss ```

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 ```

``` 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 ```

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 ```

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 ```

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 ```

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

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 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

``` 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

``` When giving cephalasporins a nurse must asess for which of the following? A: Edema B: Hypertension C: Bleeding D: None of these ```

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

Cloforan treats A: Respiratory infections B: Gonhorrea C: Syphillis

When are tetracyclines contraindicated? A: Pregnancy and Lactation B: 3rd trimester of pregnancy C: 2nd trimester of pregnancy

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

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 ```

``` When giving an aminoglycoside you should monitor for A: Ototoxicity B: Nephrotoxicity C: Tinnitus D: All of the above ```

``` A nurse should understand that an aminoglycoside may cause A: nuromuscular dysfunction B: Cataracts C: Blood Dyscrasias D: Pregnancy ```

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

Cipro must be given at least ______ hours before antacids and iron

``` Caffeine and dairy should be limited when taking A: fluroquinolones B: Aminoglycosides C: Loop Diuretics D: None of the above ```

``` When giving sulfonamides you sould assess for A: Renal Function B: Anemia C: Gout D: All of the above ```

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 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 ```

``` Flagyl treats A: H. Pylori B: Oral infection C: MRSA D: skin infections ```

``` Vancomycin treats A: H. Pylori B: Oral infection C: MRSA D: skin infections ```

``` Cubicin treats A: H. Pylori B: Oral Infection C: MRSA D: Skin Infections ```

What is the broadest spectrum antibiotic?

Primaxin

``` Ketex treats A: H. Pylori B: Oral Infections C: Resp Infections D: Skin Infections ```

``` Tyscal treats A: H. Pylori B: oral infection C: Abdominal Infection D: Skin Infections ```

``` 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 ```

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 ```

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 ```

``` Remicade treats A: rejection of organ transplants B: Autoimmune disorders C: Psoriasis D: Inflammation ```

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

``` Immunosuppressants are contraindicated in A:Leukemia B:Metastatic cancer C: Active infection D: All of the above ```

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

``` 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 ```

``` Cyclosporine is used for A: Prophylacis of organ transplant rejection B: Heart Failure C: Kidney Failure D: None of the above ```

What can not be taken with cyclosporine? A: Lemonade B: Grapefruit juice C: Orange juice

Calerenium inhibitors can cause A: Ototoxicity B: Nephrotoxicity C: Autoimmune disorders