Pharm exam 3 resp and fluids

Question 1

What is the most significant risk to patients if we push potassium?

Answer 1

Cardiac arrest

Question 2

A patient who take K every morning has an NG tube placed. What is the next nursing action?

Answer 2

notify MD and pharmacy that an order change is necessary. The patient will need a diluted liquid potassium

Question 3

Patient is receiving an infusion of K. What is the priority nurse intervention when monitoring the site?

Answer 3

monitoring for burning and irritation

Question 4

IV potassium, due to its caustic nature, must be infused slowly, What is the safe infusion rate?

Answer 4

10 MEQ per 50 mL

Question 5

Acute severe asthma in a patient requires which nursing intervention?

Answer 5

administering a short acting beta 2 adrenergic agonist

Question 6

A patient hasn’t had an asthma attack in months and she wants to discontinue her medication. What do we say?

Answer 6

Medication is still required, we need to decrease the inflammation in your airways to prevent an attack. This is a chronic disease, no need to refer to a MD… nurses are able to educate

Question 7

How would you perform discharge teaching educate an asthma patient?

Answer 7

take medications before exercise, avoid triggers, carry a rescue inhaler

Question 8

The asthma patients needs to take montelukast at what time?

Answer 8

Bedtime

Question 9

What medication, combined with albuterol can be used to change bronchodilation?

Answer 9

Ipratropium

Question 10

What are the side effects of albuterol?

Answer 10

Increased HR, chest pain, tremors and nervousness

Question 11

Theophylline has been used for asthma treatment. What education should be provided to the patient regarding dietary concerns… what should be eliminated?

Answer 11

caffeine- it is caffeine based, take in the morning

Question 12

Common side effects for ipratropium

Answer 12

Dry mouth, constipation, and urinary retention

Question 13

What is a possible side effect of treatment for acute acidosis?

Answer 13

Treatment for acidosis is Sodium Bicarb. If Pt receives too much bicarb they can go into metabolic alkalosis

Question 14

What is the primary reason for IV fluid replacement in a burn patient?

Answer 14

Maintain blood pressure

Question 15

What are nursing priority concerns for for a patient receiving IV Fluids

Answer 15

Risk for fluid volume overload, risk for electrolyte imbalance, risk for impaired skin integrity

Question 16

What type of IV solution contain electroltes and other substances that mimic the bodys normal ECF

Answer 16

CRYSTALLOID

Question 17

Priority nursing assessments for a client receiving a colloid solution?

Answer 17

blood pressure, urinary output, and lung sound assessment

Question 18

When is DEXTRAN 40 appropriate to give?

Answer 18

hypovolemic shock after surgery, burns, or hemorrhage

Question 19

Your patient is experiencing thirst, fatigue, muscle twitching, and AMS. Which electrolyte imbalance do we expect?

Answer 19

Hypernatremia

Question 20

If a patient is experiencing a sodium level of 149 MEQ/L. What should we expect to administer?

Answer 20

A hypotonic solution

Question 21

Treatment for moderate hyperkalemia

Answer 21

Administer intravenous insulin and intravenous dextrose

Question 22

This type of solution when given, water moves from the plasma to the interstitial fluid creating a decrease in plasma volume

Answer 22

Hypotonic

Question 23

Ipratropium belongs in what medication class

Answer 23

anti-cholinergic

Question 24

contraindications for diphenhydramine

Answer 24

pts with BPH or narrow angle glaucoma

Question 25

Treatment for overdose of aspirin

Answer 25

sodium bicarbonate

Question 26

A nurse is teaching a client who has a new prescription for beclomethasone. Which of the following instructions should the nurse include?
A) “Rinse your mouth after each use of this medication.”
B) “Limit fluid while taking this medication.”
C) “Increase your intake for vitamin B12 while taking this medication.”
D) “You can take the medication as needed.”

Answer 26

A) “Rinse your mouth after each use of this medication.”

Question 27

A nurse is providing instructions to a client who has a new prescription for albuterol and beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?
A) Take the albuterol at the same time each day
B) Administer the albuterol inhaler prior to using the beclomethasone inhaler
C) Use beclomethasone if experiencing an acute episode
D) Avoid shaking the beclomethasone before use

Answer 27

B) Administer the albuterol inhaler prior to using the beclomethasone inhaler

Question 28

A nurse is teaching a client who has a prescription for long term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication?
A) weight gain
B) nervousness
C) bradycardia
D) constipation

Answer 28

A) weight gain

Question 29

A nurse is caring for a client who has been taking phenylephrine nasal drops for the past 10 days for sinusitis. The nurse should assess the client for which of the following manifestations as an adverse effect of this medication?
A) sedation
B) nasal congestion
C) productive cough
D) constipation

Answer 29

B) nasal congestion

Question 30

A nurse is teaching a client who has a new prescription for dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication?
A) diarrhea
B) anxiety
C) sedation
D) palpitations

Answer 30

C) sedation

Question 31

A nurse is teaching the family of a child who has cystic fibrosis and a new prescription for acetylcysteine. Which of the following information should the nurse include in the instructions?
A) “expect this medication to suppress your child’s cough.”
B) “expect this medication to smell like rotten eggs.”
C) “expect this medication to cause euphoria.”
D) “expect this medication to turn your child’s urine orange.”

Answer 31

B) “expect this medication to smell like rotten eggs.”

Question 32

A nurse is teaching a client who has a new prescription for diphenhydramine for allergic rhinitis. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication? SATA
A) dry mouth
B) nonproductive cough
C) drowsiness
D) urinary hesitation

Answer 32

A) dry mouth
C) drowsiness
D) urinary hesitation

Question 33

A nurse is teaching a client about the use of fluticasone to treat perennial rhinitis. Which of the following statements by the client indicated an understanding of the teaching?
A) “I should use the spray every 4hrs while I am awake.”
B) “It can take as long as 3 weeks before the medication takes a minimum effect.”
C) “This medication can also be used to treat motion sickness.”
D) “I can use this medication when my nasal passages are blocked.”

Answer 33

B) “It can take as long as 3 weeks before the medication takes a minimum effect.”

Question 34

What education will the registered nurse (RN) provide the client receiving guaifenesin?
A) “It is important to not do any driving while taking this medication.”
B) “It is important to increase physical activity while taking this medication.”
C) “It is important to drink at least 2 liters of water/day while taking this medication.”
D) “It is important to not drink any alcohol while taking this medication.”

Answer 34

C) “It is important to drink at least 2 liters of water/day while taking this medication.”

Question 35

Realizing that the administration of acetylcysteine is to be administered with caution to the client with a history of asthma, the registered nurse (RN) will monitor for what clinical manifestation and report to the healthcare provider?

A) Wheezing and dyspnea
B) Increased amount of coughing
C) increased thickness of mucus
D) improvement in breath sounds

Answer 35

A) Wheezing and dyspnea

Question 36

While using a fluticasone inhaler with spacer for treatment of asthma, which intervention will the registered nurse (RN) educate the client to implement to assist in preventing an oral yeast infection from occurring? Select all that apply.

A) rinse mouth after each inhalation/spacer administration
B) clean the spacer with a warm water each day of use
C) brush teeth using baking soda and water twice a day
D) avoid swallowing the water used to rinse the mouth after drug administration
E) scrub the tongue with a firm bristle toothbrush twice a day

Answer 36

A) rinse mouth after each inhalation/spacer administration
B) clean the spacer with a warm water each day of use
D) avoid swallowing the water used to rinse the mouth after drug administration

Question 37

Which point(s) will the registered nurse (RN) implement when providing drug education to the client prescribed cromolyn inhaler for asthma? Select all that apply.

A) “This drug is not a rescue inhaler and should be used to reduce the risk of an attack.”
B) “This drug works to decrease swelling in the lungs that can cause an asthma attack.”
C) “This drug works to decrease inflammation in the bronchioles which can result in bronchospasm.”
D) “This drug needs to be stored in a container in a warm environment.”
E) “You will begin to feel the effects of this medication within a few days.”

Answer 37

A) “This drug is not a rescue inhaler and should be used to reduce the risk of an attack.”
B) “This drug works to decrease swelling in the lungs that can cause an asthma attack.”

Question 38

When presenting a comparison of diphenhydramine and loratadine, what primary advantage will the registered nurse (RN) provide for choosing loratadine over diphenhydramine for the treatment of seasonal allergies?

A) loratadine cost less than diphenhydramine
B) loratadine is shorter-acting than diphenhydramine
C) loratadine has less side effects than diphenhydramine
D) loratadine tastes better than diphenhydramine

Answer 38

C) loratadine has less side effects than diphenhydramine

Question 39

While providing care for the client hospitalized for acute bronchitis and prescribed aminophylline, which clinical manifestation will the registered nurse (RN) attribute to the initiation of this drug therapy? Select all that apply.

A) bradycardia
B) bradypnea
C) tachycardia
D) dysrhythmia
E) dry mouth

Answer 39

C) tachycardia
D) dysrhythmia

Question 40

While providing care for a client with a history of asthma and prescribed albuterol, the registered nurse (RN) is aware that which drug classification is contraindicated for this client? Select all that apply.

A) beta blockers
B) calcium channel blocker
C) angiotensin-converting enzyme inhibitor
D) nonsteroidal anti-inflammatory drug
E) antihistamines

Answer 40

A) beta blockers
D) nonsteroidal anti-inflammatory drug

Question 41

The nurse knows that the mother correctly understands the use and function of montelukast when she makes which statement?

A) it should be used at the onset of an asthma attack
B) it is used as a preventative as needed for asthma attacks
C) it should be taken nightly for asthma attack prevention
D) it should be given when he has been around irritants

Answer 41

C) it should be taken nightly for asthma attack prevention

Question 42

After obtaining a medical history of a client who has been prescribed codeine, what medical condition identified requires the registered nurse (RN) to notify the health care provider? Select all that apply.
A) chronic obstructive pulmonary disease
B) coronary heart disease
C) uncontrolled hypertension
D) asthma

Answer 42

A) chronic obstructive pulmonary disease
D) asthma

Question 43

What specific education point will the registered nurse (RN) provide the client prescribed methylprednisolone for the treatment of asthma?
A)”This drug needs to be the first drug used in the event of an asthma attack.”
B)”This drug is administered after albuterol and before ipratropium to treat asthma.”
C)”This drug will help to decrease the swelling that is occurring in your lungs because of asthma.”
D)”This drug works so well that you can omit albuterol and ipratropium from asthma treatment plan.”

Answer 43

C)”This drug will help to decrease the swelling that is occurring in your lungs because of asthma.”

Question 44

What education will the registered nurse (RN) provide the client receiving diphenhydramine to treat allergies?
A)”Take this medication once daily before breakfast with a full glass of water.”
B)”Take this medication every 2 hours until the allergy symptoms are gone.”
C)”Avoid eating any high carbohydrate foods while taking this medication.”
D)”Avoid driving or operating machinery while taking this medication.”

Answer 44

D)”Avoid driving or operating machinery while taking this medication.”

Question 45

What statement made by the client prescribed cromolyn inhaler will require further education by the registered nurse (RN)?
A)”I need to use the cromolyn inhaler as soon as I feel an asthma attack coming on.”
B)”I need to use the cromolyn inhaler before any event that increases my activity level.”
C)”I need to implement all techniques correctly when using the cromolyn inhaler.”
D)”I need to contact my healthcare provider if it appears that this drug is not preventing an asthma event.”

Answer 45

A)”I need to use the cromolyn inhaler as soon as I feel an asthma attack coming on.”

Question 46

What intervention will the registered nurse (RN) instruct the client to implement who reports dry mouth after using the cromolyn inhaler?
A) rinse their mouth after administering the cromolyn inhaler
B) eat some chips and salsa after administering the cromolyn inhaler
C) drink 8 oz of water immediately after administering the cromolyn inhaler
D) drinks 8 oz of soda immediately after administering the cromolyn inhaler

Answer 46

A) rinse their mouth after administering the cromolyn inhaler

Question 47

The nurse teaches that which medication can be used to treat both allergies and asthma?
a) albuterol
b) prednisone
c) cetirizine
d) motelukast

Answer 47

d) motelukast

Question 48

The registered nurse (RN) identifies what body system is the main site of action for the drug codeine?
a) peripheral nervous system
b) central nervous system
c) parasympathetic nervous system
d) sympathetic nervous system

Answer 48

b) central nervous system

Question 49

The registered nurse (RN) identifies the need to use caution in the administration of acetylcysteine for the client with what medical condition?
a) hypertension
b) asthma
c) heart disease
d) seizure history

Answer 49

b) asthma

Question 50

What technique will the registered nurse (RN) educate the client to implement when administering the beclomethasone inhalation therapy?
a) place the beclomethasone inhaler under warm water as it works better warmed
b) place the becomethasone inhaler in the refrigerator as it works better chilled
c) administer the inhalation therapy through a spacer attached in the inhaler mouthpiece
d) position the mouthpiece of the inhaler one inch away from the open mouth as the drug is dispersed out

Answer 50

c) administer the inhalation therapy through a spacer attached in the inhaler mouthpiece

Question 51

After conducting a medical history of a client prescribed diphenhydramine, which medical condition assessed in the client will present the need for the registered nurse (RN) to clarify the drug order with the healthcare provider? Select all that apply.
a) peptic ulcer disease
b) closed angle glaucoma
c) chronic bronchitis
d) small bowel obstruction
e) urinary retention

Answer 51

a) peptic ulcer disease
b) closed angle glaucoma
d) small bowel obstruction
e) urinary retention

Question 52

Recognizing the risk of toxicity for the client prescribed theophylline, which order by the healthcare provider will the registered nurse (RN) seek clarification? Select all that apply.
a) capoten
b) celciferol
c) cimetidine
d) clonidine
e) ciprofloxacin

Answer 52

c) cimetidine
e) ciprofloxacin

Question 53

The nurse teaches that which medication can be used for asthma treatment?

a) motelukast
b) albuterol
c) levalbuterol
d) prednisone

Answer 53

a) motelukast

Question 54

Prior to the administration of a second dose of aminophylline to the client admitted to the hospital for acute bronchitis, what priority assessment will the registered nurse (RN) implement?

a) assess the client’s sleep pattern
b) assess the client’s appetite
c) assess the client’s heart rate
d) assess the client’s blood pressure

Answer 54

c) assess the client’s heart rate

Question 55

Recognizing that the client prescribed theophylline for the treatment of bronchitis is at risk for toxicity, which clinical manifestation will alert the registered nurse (RN) to this occurrence? Select all that apply.

a) loss of appetite
b) drowsiness
c) restlessness
d) onset of seizures
e) insomnia

Answer 55

a) loss of appetite
c) restlessness
d) onset of seizures
e) insomnia

Question 56

What statement presented by the client prescribed albuterol for asthma will the registered nurse (RN) identify as an unexpected clinical manifestation of this drug?

a) “I seem to have blurred vision anytime that I administer this drug to myself.”
b) “I have noticed that my heart feels like it is racing away after I take this drug.”
c) “Whenever I take this drug I notice that I just cannot fall asleep at night.”
d) “my hands get a little shaky after I take this drug, even if I take it just once.”

Answer 56

a) “I seem to have blurred vision anytime that I administer this drug to myself.”

Question 57

While providing care for a client prescribed codeine, the registered nurse (RN) is aware that this drug is prescribed to treat which clinical presentation? Select all that apply.

a) moderate pain
b) anorexia
c) chronic diarrhea
d) ongoing coughing
e) continued nausea

Answer 57

a) moderate pain
d) ongoing coughing

Question 58

Which educational point will the registered nurse (RN) provide to the client prescribed codeine as an antitussive? Select all that apply.

a) “increase the fluid intake to at least 64 oz per day.”
b) “increase the number of small meals eaten each day.”
c) “avoid the addition of fiber or fat to the daily meal plan.”
d) “take the prescribed drug with food each time.”
e) “ stand slowly to prevent dizziness or falling.”

Answer 58

a) “increase the fluid intake to at least 64 oz per day.”
d) “take the prescribed drug with food each time.”
e) “ stand slowly to prevent dizziness or falling.”

Question 59

The nurse is teaching the patient’s family about montelukast. Which statement by the family requires further teaching?

a) this medicine works by reducing inflammation of the lungs
b) this medicine works by blocking the inflammation process
c) this medication is used for maintenance therapy to prevent asthma attacks
d) this medicine should be taken at the onset of an asthma attack

Answer 59

d) this medicine should be taken at the onset of an asthma attack

Question 60

After the administration of albuterol during an asthma attack, the registered nurse (RN) is aware of what clinical manifestations indicate that the drug has been effective? Select all that apply.

a) presence of irregular heart rate
b) increase in the productive cough
c) decrease in alertness to surroundings
d) a decrease in anxiousness

Answer 60

b) increase in the productive cough
d) a decrease in anxiousness

Question 61

What statement made by the client who is prescribed cromolyn inhalation requires further education by the registered nurse (RN)?

a) “i need to take this drug exactly as the healthcare provider instructed me to.”
b) “i can expect better breathing when the drug works to prevent an asthma event with exercising.”
c) “i need to discuss any over-the-counter drugs with my healthcare provider prior to taking these.”
d) “now that I am taking this drug, I can stop taking the bronchodilator for the asthma treatment.”

Answer 61

d) “now that I am taking this drug, I can stop taking the bronchodilator for the asthma treatment.”

Question 62

What statement made by the client prescribed salmeterol will the registered nurse (RN) identify as the need for further education?

a) “i understand that this drug will help to improve my breathing while treating my asthma.”
b) “it will be necessary to take this drug with other drugs prescribed to treat my asthma.”
c) “this is the drug that I will take first whenever I feel an asthma attack beginning.”
d) “it will be necessary for me to take this drug as a long term treatment for asthma.”

Answer 62

c) “this is the drug that I will take first whenever I feel an asthma attack beginning.”

Question 63

What specific intervention will the registered nurse (RN) instruct the client to implement when using a cromolyn inhaler to prevent an asthma attack?

a) administer a dose of cromolyn 60 mins prior to exercise
b) administer a dose of cromolyn 30 mins prior to exercise
c) administer a dose of cromolyn 15 mins prior to exercise
d) administer a dose of cromolyn 15 mins after completion of exercise

Answer 63

c) administer a dose of cromolyn 15 mins prior to exercise

Question 64

The registered nurse (RN) is aware that which condition is treated by acetylcysteine administration? Select all that apply.

a) treatment of conditions that result in severe mucus
b) assist in loosening severe mucus in airways
c) reverse the effects of acetaminophen in an overdose
d) treatment for asthma and chronic bronchitis
e)protect kidneys during the administration of contrast media dye

Answer 64

b) assist in loosening severe mucus in airways
c) reverse the effects of acetaminophen in an overdose
e)protect kidneys during the administration of contrast media dye

Question 65

When asked by a client the purpose of the drug, what explanation provided by the registered nurse (RN) best presents the action of guaifenesin?

a) “this is an expectorant drug that works to clear airways.”
b) “this is a drug that will loosen the mucus and help you cough it up easier.”
c) “this is a drug that is going treat and cure the cause of your cough.”
d) “this is a drug that is going to make your lungs work better for breathing.”

Answer 65

b) “this is a drug that will loosen the mucus and help you cough it up easier.”

Question 66

The registered nurse (RN) is aware that fexofenadine is prescribed to treat which condition? Select all that apply.

a) anphylaxis
b) sinusitis
c) allergies
d) hives
e) bronchitis

Answer 66

b) sinusitis
c) allergies
d) hives

Question 67

The registered nurse (RN) provides which education point to the client prescribed albuterol for the treatment of an asthma attack? Select all that apply.

a) “this drug is indicated as the first drug for a treatment of an asthma attack.”
b) “it is important to wash the mouthpiece of the device at least twice monthly.”
c) “this drug works best by preventing the occurrence of an asthma attack.”
d) “take 2 to 4 puffs every 20 mins for three treatments during an asthma attack.”
e) “if this drug is not beneficial in stopping the attack, seek medical attention immediately.”

Answer 67

a) “this drug is indicated as the first drug for a treatment of an asthma attack.”
d) “take 2 to 4 puffs every 20 mins for three treatments during an asthma attack.”
e) “if this drug is not beneficial in stopping the attack, seek medical attention immediately.”

Question 68

The registered nurse (RN) is aware that fexofenadine is not prescribed to clients with what medical condition?

a) glaucoma
b) cataracts
c) myopia
d) hyperopia

Answer 68

a) glaucoma

Question 69

The parent expresses frustration to the nurse that the montelukast just isn’t working though she has been giving it to her child nightly for the past 3 nights. The nurse correctly educates the mother with which correct statement?

a) “it may not be the correct medication for your child’s asthma symptoms”
b) “it takes 1-2 weeks to see a therapeutic response from the medication.”
c) “I will notify the provider, he may need a higher dosage of medication.”
d) “stop giving the medication if it is not working for your child.”

Answer 69

b) “it takes 1-2 weeks to see a therapeutic response from the medication.”

Question 70

While providing care for the client prescribed codeine as an antitussive, which clinical manifestation will the registered nurse (RN) expect to assess? Select all that apply.

a) increased heart rate
b) increased bowel sounds
c) decreased blood pressure
d) decreased respirations
e) increased appetite

Answer 70

c) decreased blood pressure
d) decreased respirations

Question 71

While providing care for the client prescribed beclomethasone, which assessment finding will the registered nurse (RN) attribute to the current drug therapy? Select all that apply.

a) increased drowsiness
b) a slow healing wound
c) blood glucose of 142 mg/dL
d) inner mouth sores
e) loss of appetite

Answer 71

b) a slow healing wound
c) blood glucose of 142 mg/dL
d) inner mouth sores

Question 72

The registered nurse (RN) is aware of what primary benefit of the prescription of a drug classified as a glucocorticosteroid?

a) treats total body inflammation
b) weakens the overall immune system
d) relieves body irritation
e) prevents the spread of infection

Answer 72

a) treats total body inflammation

Question 73

Which instruction will the registered nurse (RN) provide the client who is prescribed theophylline for the treatment of asthma? Select all that apply.

a) “it is recommended to take this drug at the end of the day.”
b) “it is recommended to take this drug at the beginning of the day.”
c) “this drug needs to be taken whenever you feel an asthma attack occurring.”
d)”this drug needs to be taken every day as prescribed for your asthma.”
e) “it is beneficial to avoid all forms of caffeine while taking this drug.”

Answer 73

b) “it is recommended to take this drug at the beginning of the day.”
d)”this drug needs to be taken every day as prescribed for your asthma.”
e) “it is beneficial to avoid all forms of caffeine while taking this drug.”