Nurse Labs Mix Flashcards
Client with history of depression & suicide attempts comes into ED after taking 15 tylenol pills 45 minutes earlier.
Which will be the priority
A.Perform gastric lavage
B. Administer acetylcysteine (Mucomyst) orally
C. Start an IV with Dextrose 5% and 0.33% normal saline
D. Have the patient drink activated charcoal mixed with water
E. Conduct a psychiatric evaluation.
F. Apply wrist restraints to prevent further self-harm.
B. Administer acetylcysteine (Mucomyst) orally
Cardiac catheterization to evaluate potential coronary artery disease. known allergy to iodine-based contrast agents, which required premedication with corticosteroids and antihistamines. The procedure was successful, but the patient experienced brief hypotension during the administration of the contrast material. The patient has been transferred to the cardiac step-down unit for observation, and the nurse is aware of the potential complications that can arise in the initial 24 hours post-procedure. Which complication should the nurse monitor closely during this period
A. Persistent angina despite being at rest and receiving nitroglycerin
B. Thrombus formation leading to decreased peripheral pulses and cyanosis
C. Dizziness accompanied by a sudden drop in blood pressure when standing
D. Gradual decrease in blood pressure with no other symptoms
In the initial 24 hours after a cardiac catheterization, the nurse should closely monitor for thrombus formation
Which of the following is associated with Pelvic Inflammatory Disease (PID)
A.Trichomoniasis
B. Chlamydia
C. Staphylococcus
D. Streptococcus
E. Gonorrhea
F. Escherichia coli
B. Chlamydia
72-year-old client with a history of recurrent urinary tract infections and recent complaints of flank pain is scheduled for KUB (Kidney, Ureter, Bladder) radiography in an outpatient setting.
which of the following actions should the nurse take to adequately prepare the client for the test?
Select all that apply.
A. Instruct the client that they must be NPO for 6 hours before the examination.
B. Administer an enema the evening before the examination to ensure clear imaging.
C. Administer furosemide 20 mg IV half an hour before the examination to enhance visualization.
D. Reassure the client and inform them that no special preparation is needed for this examination.
E. Ask the client to drink fluids and empty the bladder just prior to the examination to ensure a clear view.
F. Check for any allergies to contrast, even though it’s not typically used in a standard KUB.
G. Advise the client to wear loose-fitting clothing without any metal objects for the examination.
A KUB radiography is a diagnostic imaging test that provides a view of the kidneys, ureters, and bladder. Typically, no special preparation is needed for this examination. However, asking the client to drink fluids and then empty the bladder just before the test can help ensure a clear view of the urinary structures
Heart failure and has a serum potassium level of 3.5 mEq/L, on the lower end of the normal range (3.5-5.0 mEq/L). Considering her clinical history and current condition, she is placed on a cardiac monitor and starts receiving an infusion of 40 mEq potassium chloride in 1000 ml of 5% dextrose in water IV. While monitoring her EKG, which of the following patterns should prompt you to discontinue the potassium infusion immediately?
A. Narrowed QRS complex
B. Shortened “PR” interval
C. Tall peaked “T” waves
D. Prominent “U” waves
C. Tall peaked “T” waves
Tall peaked “T” waves are a classic sign of hyperkalemia. Given Mrs. Thompson’s chronic kidney disease and acute heart failure, continuing to infuse potassium with this EKG finding could be dangerous. The infusion should be discontinued immediately.
Option A: Narrow QRS complex indicates fast cardiac rhythms (generally more than 100 beats/min) with a QRS duration of 100 ms or less.
Option B: A short PR interval (<120 ms) is seen with preexcitation syndromes and AV nodal (junctional) rhythm.
Option D: Prominent U waves are characteristic of hypokalemia.
Patient has V fib. What is the first response from the nurse who arrives to find this patient.
Start a peripheral IV
B. Initiate high-quality chest compressions
C. Establish an airway
D. Obtain the crash cart
Correct Answer: B. Initiate high-quality chest compressions
Circulation
Airway
Breathing
Is the guideline for finding a pulse person
The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services
What is its function
Nation’s medical research agency — making important discoveries that improve health and save lives
When many people share the same values it may be possible to identify a philosophy of utilitarianism, with proposes that:
A. The value of people is determined solely by leaders in the Unitarian church.
B. The decision to perform a liver transplant depends on a measure of the moral life that the client has led so far.
C. The best way to determine the solution to an ethical dilemma is to refer the case to the attending physician.
D. The value of something is determined by its usefulness to society.
Correct
Correct Answer: D. The value of something is determined by its usefulness to society.
A utilitarian system of ethics proposes that the value of something is determined by its usefulness.
“the greatest amount of good for the greatest number of people.”
The Nurse Practice Acts are an example of:
A. Statutory law
B. Common law
C. Civil law
D. Criminal law
Correct Answer: A. Statutory law
The NPA is then interpreted into regulations by each state and territorial nursing board with the authority to regulate the practice of nursing care and the power to enforce the laws
Option B: Common law results from judicial decisions made in courts when individual legal cases are decided. Examples of common law include informed consent, the patient’s right to refuse treatment, negligence, and malpractice.
The scope of Nursing Practice, the established educational requirements for nurses, and the distinction between nursing and medical practice is defined by:
A. Statutory law
B. Common law
C. Civil law
D. Nurse Practice Acts
Correct Answer: D. Nurse Practice Acts
The NPA is then interpreted into regulations by each state and territorial nursing board with the authority to regulate the practice of nursing care and the power to enforce the laws.
During surgery, there is an increased potential for arrhythmias when catecholamines are given with:
A. halothane (Fluothane)
B. digoxin (Lanoxin)
C. bupivacaine (Marcaine)
D. lidocaine (Xylocaine)
A. halothane (Fluothane)
(Inhalation anesthetics - nitrous oxide, halothane, isoflurane, desflurane, sevoflurane)
bupivacaine - Anesthetic
General anesthetics potentiate the effects of which of the following drugs?
A. Depolarizing agents
B. Skeletal muscle relaxants
C. Volatile liquids
D. Inhalation anesthetics
B. Skeletal muscle relaxants
Lorzone (chlorzoxazone)
Flexeril or Amrix (cyclobenzaprine)
Robaxin (methocarbamol)
A. Depolarizing Agents = relaxation of skeletal muscles & anesthesia Succinylcholine is a major one
C. Volatile liquids
D. Inhalation anesthetics
(Include halothane & other -thane medication)
The most dangerous metabolic side effect of general anesthesia that can occur during surgery is:
A. Hyperglycemia
B. Hyperthermia
C. Hypoglycemia
D. Hypothermia
B. Hyperthermia
Malignant hyperthermia
severe reaction to certain drugs used for anesthesia
the defective gene that puts you at risk of malignant hyperthermia is inherited, though sometimes it’s the result of a random genetic defect
General Anesthesia is associated Hyperglycemia and higher levels of catecholamines, cortisol, and glucagon than local or epidural anesthesia
Volatile anesthetic agents inhibit insulin secretion and increase hepatic glucose production.
Geneva is reviewing for her upcoming quiz in Pharmacology. She should be aware that local and regional anesthesia act by:
A. Inhibiting depolarization.
B. Increasing depolarization.
C. Producing a semiconscious state.
D. Inhibiting motor movement.
A. Inhibiting depolarization.
Local anesthetics are also class I antiarrhythmic drugs due to the blockade of cardiac sodium channels, with lidocaine being the class IB prototype. They selectively block channels that are frequently depolarizing (tachyarrhythmias) and slow transmission.
The nurse teaching a client who will receive thiopental (Pentothal) as an anesthetic explains what common adverse effects might occur?
A. Headache
B. Emergence delirium
C. Nausea and vomiting
D. Paralysis
B. Emergence delirium
Barbiturates are a group of sedative-hypnotic medications used for the treatment of seizure disorder, neonatal withdrawal, insomnia, preoperative anxiety, induction of coma for increased intracranial pressure. They are also useful for inducing anesthesia.
Barbiturates (phenobarbital, methohexital, butalbital, pentobarbital, primidone, and amobarbital.)
reduce the efficacy of warfarin, steroids
oral contraceptive
psychoactive
immunosuppressants.
Phenobarbital will also lower the plasma concentrations of other antiepileptic drugs such as lamotrigine, oxcarbazepine, phenytoin, tiagabine, and valproate.
No antidote exist
client received lidocaine viscous before a gastroscopy was performed. Following the procedure, the nurse places a priority on what assessment?
A. Return of the gag reflex
B. Ability to urinate
C. Abdominal pain
D. Ability to stand
Correct Answer: A. Return of the gag reflex
Because the throat is anesthetized, monitor the client for return of the gag reflex before drinking or eating.
Not for use in <3 yrs
> 3 use q3h not to exceed 8 doses daily
The nurse observes a co-worker preparing to administer a solution of lidocaine and epinephrine to a client with multiple premature ventricular contractions. The appropriate action by the nurse is to:
A. Offer to monitor the client’s heart rhythm.
B. Notify the supervisor of the error.
C. Do nothing; the drug choice is correct.
D. Prevent the administration and give a plain lidocaine solution.
Correct Answer: D. Prevent the administration and give a plain lidocaine solution.
Solutions of lidocaine containing preservatives or epinephrine are intended for local anesthesia only, and must never be given IV for dysrhythmias.
Phentolamine
Antihypertensive drug
It can prevent and control high blood pressure during surgery.
Name 2 more uses
SE
It can treat and prevent skin injury caused by norepinephrine injection. It is also used to diagnose an adrenal gland tumor (pheochromocytoma).
SE: Acute and prolonged hypotensive episodes, tachycardia, and cardiac arrhythmias
Name 4 stages of anesthesia
Stage 1: Induction. The earliest stage lasts from when you first take the medication until you go to sleep. …
Stage 2: Excitement or delirium. …
Stage 3: Surgical anesthesia. …
Stage 4: Overdose.
The client asks the nurse to explain the action of infiltration anesthesia. The nurse’s response is based on the knowledge that infiltration anesthesia:
A. Is applied only to mucous membranes to provide local anesthesia.
B. Blocks a specific group of nerves in tissues close to the operative area.
C. Blocks sensation to an entire limb, or a large area of the face.
D. Produces numbing to large, regional areas such as the lower abdomen and legs.
B. Blocks a specific group of nerves in tissues close to the operative area.
Infiltration anesthesia blocks a specific group of nerves close to the operative area by diffusion of a drug into the tissues. It is used to anesthetize small areas. Lower concentrations of local anesthetics are typically used for infiltration anesthesia. Infiltration anesthesia is accomplished with the administration of the local anesthetic solution intradermally (ID), subcutaneously (SC), or submucosally
A.Topical anesthetics are applied to mucous membranes.
C. action potential from forming.
Option C:Nerve blocks provide anesthesia to a large surface area. Regional anesthesia. Injected nerve or bundle. Last longer than local anesthesia.
Option D: Spinal anesthesia affects large, regional areas.
Miosis
excessive constriction of the pupil of the eye.
The half-life of morphine is:
A. 4 to 6 hours
B. 2 to 4 hours
C. 6 to 8 hours
D. 30 minutes to 1 hour
B. 2 to 4 hours
Which of the following statements about morphine is correct?
A. Morphine is contraindicated in pain relief caused by head injury.
B. Morphine’s withdrawal symptoms cannot be relieved by methadone.
C. Morphine is most effective by parenteral administration.
D. Morphine quickly enters all body tissues.
Correct Answer: D. Morphine quickly enters all body tissues.
As a well-rounded health care provider, you know that corticosteroid therapy is indicated in all of the following conditions except:
A. Osteoarthritis
B. Rheumatoid arthritis
C. Systemic lupus erythematosus
D. Acute spinal cord injury
A. Osteoarthritis (When cartilage in synovial joints wears down)
Osteoarthritis is not an indication for corticosteroid therapy. It has an inflammatory component, but the disease is not severe enough to suppress the immune system
RA: immune system attacks its own tissue, typically in the hands and feet. Sever inflammation
Orlando who has been taking steroids for rheumatoid arthritis over several years presents with a compression vertebral fracture. This fracture is due to:
A. An entirely separate condition.
B. The osteoporotic effect of long-term steroid use.
C. Deterioration in rheumatoid arthritis.
D. An excessively high dose of steroids.
B. The osteoporotic effect of long-term steroid use.
Favor osteoclasts (during the first 6 to 12 months of therapy) inhibit the absorption of calcium in the gut. Also, reduce the activity and lifespan of osteoblasts.
Prednisone doses as low as 5 mg/day can lead to bone loss.
Osteonecrosis
The death of bone tissue due to a lack of blood supply.
From: Corticosteroids & Alcohol
Tom is admitted to the emergency department with an acute spinal cord injury. Methylprednisolone is contraindicated for treatment when the injury:
A. Is a high cervical lesion.
B. Occurred less than 4 hours ago.
C. Occurred less than 8 hours ago.
D. Occurred more than 8 hours ago.
Occurred more than 8 hours ago.
Ineffective
Which of the following statements about intravenous administration of steroids is true?
A. Steroids administered intravenously must be diluted.
B. Steroids administered intravenously can be either in diluted or undiluted form.
C. Steroids should be given IV push only.
D. Intravenous administration of steroids is contraindicated in acutely ill clients.
B. Steroids administered intravenously can be either in diluted or undiluted form.
No specific reversal agent exists for corticosteroids
Types of medications / therapies that are Contradicted with Corticosteroids use.
And why?
Nsaids & Anticoagulants
Corticosteroids increase the effectiveness
Live / attenuated-live vaccines
Steroids suppress the immune system and this could allow the live vaccine to infect the body.
Name diseases that are Contradictions for Corticosteroids
systemic fungal infection, osteoporosis
uncontrolled hyperglycemia
diabetes mellitus
glaucoma
joint infection
uncontrolled hypertension
herpes simplex keratitis
varicella infection.
Corticosteroids, also known as steroids, can ( decrease / increase) blood sugar levels in people with or without diabetes.
Increase
This is because corticosteroids, like prednisolone, can prevent insulin from working properly.
Corticosteroids are Contradicted with DM
Teaching has been adequate when a client being treated with acetylsalicylic acid states:
A. “I can crush the pills before I swallow them.”
B. “I should take the pills with antacids.”
C. “Taking the pills on an empty stomach will help absorption.”
D. “If the pills smell like vinegar, I should throw them out.”
D. “If the pills smell like vinegar, I should throw them out.”
Aspirin is pH dependent to be absorbed in the small intestine. Antacids will interfere with absorption
Taking on an empty stomach will cause GI distress
Which of the following groups of clients are most at risk for GI bleeding from the use of NSAIDs?
A. Clients with dysmenorrhea.
B. Clients with headaches.
C. Clients with arthritis.
D. Clients with renal failure.
C. Clients with arthritis.
Due to arthritic patients taking steroids for a prolonged period of time.
Renal failure is also Contradicted with NSAIDS due to excretion via urine.
Leading to fluid and electrolyte disorders, renal papillary necrosis, and nephrotic syndrome/ interstitial nephritis.
To minimize the risk of dyspnea and GI bleeding, OTC ibuprofen is given:
A. IV.
B. With orange juice.
C. On an empty stomach.
D. With meals.
D. With meals.
Ibuprofen = NSAID and should be taken with food or milk to avoid upsetting stomach
Which of the following NSAIDs is used to prevent thrombosis?
A. ibuprofen (Motrin)
B. ketorolac tromethamine (Toradol)
C. aspirin (Zorprin)
D. naproxen (Naprosyn)
Aspirin (Zorprin)
_____ is considered the first-line treatment for acute gouty arthritis, osteoarthritis, musculoskeletal pain, inflammation, and dysmenorrhea (painfulmenstruation)
Naproxen (Naprosyn)
NSAID
Nurse Corrine may expect to administer azathioprine (Imuran) to a transplant client in which of the following conditions?
A. Prevention of chronic rejection.
B. Prevention of acute rejection.
C. Management of chronic rejection.
D. Treatment of acute rejection.
Correct Answer: B. Prevention of acute rejection
Azathioprine inhibits humoral and cellular immunity during the early stages of lymphoid differentiation and is useful in preventing the onset of acute rejection.
Also, for symptomatic treatment of active Rheumatoid Arthritis.
Which of the following laboratory tests should be monitored when a client is receiving azathioprine (Used for prevention of acute organ transplant rejection & RA)
A. CBC
B. BUN
C. Electrolytes
D. Sedimentation rate
A. CBC
CBC will identify Leukopenia, a common side effect. (CBC) and liver function test (LFT) monitoring weekly are recommended initially for the first 4 to 8 weeks.
Maintenance dose achieved, CBC and LFT should get checked every three months.
a transplant client, the action of cyclosporine is to:
A. Defend the body against foreign antigens.
B. Inhibit T cells in response to antigens.
C. Inhibit B cell immunoglobulin.
D. Intensify the production of T lymphocytes.
B. Inhibit T cells in response to antigens.
Immunosuppressive drug
It can prevent organ rejection after transplant in its oral form. It can also treat rheumatoid arthritis and psoriasis. In eye drop form it can treat chronic dry eye.
client who is taking mycophenolate mofetil (immunosuppressant drug) must follow which of the following instructions?
A. Take with food.
B. Avoid use of corticosteroid.
C. Monitor for adverse effects.
D. Practice effective contraception.
D. Practice effective contraception.
mycophenolate = Immune Suppressant & is given with corticosteroids to Prevent Acute organ rejection
It will lower effectiveness of birthcontrol pills
Take on empty stomach
Which of the following client comments demonstrates that teaching has been successful regarding cyclosporine therapy?
A. “I need to mix the medicine in Styrofoam.”
B. “I should take the medication on an empty stomach.”
C. “If I vomit I should take another dose.”
D. “I need to be consistent about when I take it and also monitor how much fat is in my food.”
Cyclosporine (withimmunosuppressiveproperties used to prevent the rejection ofgraftsandtransplants) needs to be taken consistently in relation to meals, and fat content should not vary to maintain serum levels. The patient’s BUN creatinine ratio, magnesium levels, and blood pressure require monitoring while on therapy.
Liquid cyclosporine (T-cell immune Suppressant- Prevents organ transplant rejection) be diluted in milk, chocolate milk, or orange juice. Do not dilute in….
Use a Glass, Styrofoam, or it doesn’t matter to mix it.
Don’t dilute in grapefruit, pineapple, or papaya juice.
Use Glass to mix it
Antirheumatics are used to:
A. Retard progression of joint deterioration.
B. Encourage excretion of autoantibodies.
C. Directly affect the inflammatory response.
D. Mediate the action of NSAIDs.
A. Retard progression of joint deterioration
Examples: Aspirin, Nonsteroidal anti-inflammatory drugs, Corticosteroids, Methotrexate, Hydroxychloroquine
Sodium aurothiomalate &
Auranofin contain Gold Compounds.
Used to treat & Contradicted with which diseases
Treats RA Rheumatoid arthritis
Contradicted in Liver Disease
Which of the following agents can be used in the treatment of rheumatoid arthritis, Sjögren’s syndrome, and SLE?
A. auranofin (Ridaura)
B. allopurinol (Zyloprim)
C. sulfasalazine (Azulfidine)
D. chloroquine (Aralen)
D. chloroquine (Aralen)
Chloroquine has had documented success in the treatment of rheumatoid arthritis, Sjögren’s syndrome (Autoimmune: Dry eyes & Mouth), and SLE.
Auranofin and sulfasalazine are used in the treatment of rheumatoid arthritis.
Frequent eye examinations are recommended in clients receiving:
A. chloroquine
B. colchicine
C. penicillamine
D. gold compounds
A. chloroquine
Used to treat RA & SLE
Corneal deposits are an adverse reaction associated with chloroquine.
Nurse Tyra is instructing a client receiving probenecid (Benemid), she should cover all of the following information except the need to:
A. Change in dietary habits.
B. Increase fluid intake.
C. Have frequent laboratory work done.
D. Recognize side effects.
C. Have frequent laboratory work done.
Pretty safe medication.
Drink 6 - 8 glasses of water daily to prevent Kidney Stones
Probenecid is used to treat chronic gout and gouty arthritis.
It is used to prevent attacks related to gout, not treat them once they occur.
It acts on the kidneys to help the body eliminate uric acid.
Probenecid is also used to make certain antibiotics more effective by preventing the body from passing them in the urine.
Enrique who is under chemotherapy has the following CBC results: WBC 5000/mm3, RBC platelet 10,000/mm3. Which of the following is he at risk for?
A. Infection
B. Bleeding
C. Angina
D. None of the above
B. Bleeding
10,000 /mm3 = 10,000 like you already learned which is very low.
Normal is 150,000 - 400,000
Lorraine who is on chemotherapy has a history of cardiac disease. The client is at risk for cardiac complications because:
A. White blood cells are reduced.
B. Oxygen-carrying capacity may be reduced.
C. Sodium levels may rise meaning fluid overload.
D. Hematocrit is lowered.
B. Oxygen-carrying capacity may be reduced.
Due to myelosupression
Put at risk for Angina
acetylcysteine (Mucomyst) is used for…
Antidote to acetaminophen
Give first in a OD
Cyclosporine(immunosuppressiveprevent the rejection ofgraftsandtransplants)
Nurse will monitor these lab values
Also, don’t use while breast feeding
BUN
Serum creatinine
Blood pressure
Causes high blood pressure
