Pharm exam 3 resp and fluids Flashcards
1
Q
What is the most significant risk to patients if we push potassium?
A
Cardiac arrest
2
Q
A patient who take K every morning has an NG tube placed. What is the next nursing action?
A
notify MD and pharmacy that an order change is necessary. The patient will need a diluted liquid potassium
3
Q
Patient is receiving an infusion of K. What is the priority nurse intervention when monitoring the site?
A
monitoring for burning and irritation
4
Q
IV potassium, due to its caustic nature, must be infused slowly, What is the safe infusion rate?
A
10 MEQ per 50 mL
5
Q
Acute severe asthma in a patient requires which nursing intervention?
A
administering a short acting beta 2 adrenergic agonist
6
Q
A patient hasn’t had an asthma attack in months and she wants to discontinue her medication. What do we say?
A
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
7
Q
How would you perform discharge teaching educate an asthma patient?
A
take medications before exercise, avoid triggers, carry a rescue inhaler
8
Q
The asthma patients needs to take montelukast at what time?
A
Bedtime
9
Q
What medication, combined with albuterol can be used to change bronchodilation?
A
Ipratropium
10
Q
What are the side effects of albuterol?
A
Increased HR, chest pain, tremors and nervousness
11
Q
Theophylline has been used for asthma treatment. What education should be provided to the patient regarding dietary concerns… what should be eliminated?
A
caffeine- it is caffeine based, take in the morning
12
Q
Common side effects for ipratropium
A
Dry mouth, constipation, and urinary retention
13
Q
What is a possible side effect of treatment for acute acidosis?
A
Treatment for acidosis is Sodium Bicarb. If Pt receives too much bicarb they can go into metabolic alkalosis
14
Q
What is the primary reason for IV fluid replacement in a burn patient?
A
Maintain blood pressure
15
Q
What are nursing priority concerns for for a patient receiving IV Fluids
A
Risk for fluid volume overload, risk for electrolyte imbalance, risk for impaired skin integrity
16
Q
What type of IV solution contain electroltes and other substances that mimic the bodys normal ECF
A
CRYSTALLOID
17
Q
Priority nursing assessments for a client receiving a colloid solution?
A
blood pressure, urinary output, and lung sound assessment
18
Q
When is DEXTRAN 40 appropriate to give?
A
hypovolemic shock after surgery, burns, or hemorrhage
19
Q
Your patient is experiencing thirst, fatigue, muscle twitching, and AMS. Which electrolyte imbalance do we expect?
A
Hypernatremia
20
Q
If a patient is experiencing a sodium level of 149 MEQ/L. What should we expect to administer?
A
A hypotonic solution
21
Q
Treatment for moderate hyperkalemia
A
Administer intravenous insulin and intravenous dextrose
22
Q
This type of solution when given, water moves from the plasma to the interstitial fluid creating a decrease in plasma volume
A
Hypotonic
23
Q
Ipratropium belongs in what medication class
A
anti-cholinergic
24
Q
contraindications for diphenhydramine
A
pts with BPH or narrow angle glaucoma
25
Treatment for overdose of aspirin
sodium bicarbonate
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."
A) "Rinse your mouth after each use of this medication."
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
B) Administer the albuterol inhaler prior to using the beclomethasone inhaler
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
A) weight gain
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
B) nasal congestion
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
C) sedation
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."
B) "expect this medication to smell like rotten eggs."
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
A) dry mouth
C) drowsiness
D) urinary hesitation
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."
B) "It can take as long as 3 weeks before the medication takes a minimum effect."
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."
C) "It is important to drink at least 2 liters of water/day while taking this medication."
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
A) Wheezing and dyspnea
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
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
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."
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."
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
C) loratadine has less side effects than diphenhydramine
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
C) tachycardia
D) dysrhythmia
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
A) beta blockers
D) nonsteroidal anti-inflammatory drug
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
C) it should be taken nightly for asthma attack prevention
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
A) chronic obstructive pulmonary disease
D) asthma
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."
C)"This drug will help to decrease the swelling that is occurring in your lungs because of asthma."
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."
D)"Avoid driving or operating machinery while taking this medication."
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."
A)"I need to use the cromolyn inhaler as soon as I feel an asthma attack coming on."
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
A) rinse their mouth after administering the cromolyn inhaler
47
The nurse teaches that which medication can be used to treat both allergies and asthma?
a) albuterol
b) prednisone
c) cetirizine
d) motelukast
d) motelukast
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
b) central nervous system
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
b) asthma
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
c) administer the inhalation therapy through a spacer attached in the inhaler mouthpiece
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
a) peptic ulcer disease
b) closed angle glaucoma
d) small bowel obstruction
e) urinary retention
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
c) cimetidine
e) ciprofloxacin
53
The nurse teaches that which medication can be used for asthma treatment?
a) motelukast
b) albuterol
c) levalbuterol
d) prednisone
a) motelukast
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
c) assess the client's heart rate
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
a) loss of appetite
c) restlessness
d) onset of seizures
e) insomnia
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."
a) "I seem to have blurred vision anytime that I administer this drug to myself."
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
a) moderate pain
d) ongoing coughing
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."
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."
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
d) this medicine should be taken at the onset of an asthma attack
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
b) increase in the productive cough
d) a decrease in anxiousness
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."
d) "now that I am taking this drug, I can stop taking the bronchodilator for the asthma treatment."
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."
c) "this is the drug that I will take first whenever I feel an asthma attack beginning."
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
c) administer a dose of cromolyn 15 mins prior to exercise
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
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
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."
b) "this is a drug that will loosen the mucus and help you cough it up easier."
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
b) sinusitis
c) allergies
d) hives
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."
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."
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
a) glaucoma
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."
b) "it takes 1-2 weeks to see a therapeutic response from the medication."
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
c) decreased blood pressure
d) decreased respirations
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
b) a slow healing wound
c) blood glucose of 142 mg/dL
d) inner mouth sores
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
a) treats total body inflammation
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."
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."
