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RN Basic Exam Flashcards

1
Q

Your patient is receiving her first dose of Augmentin. She states that she has no know allergies, but has rarely taken medication. You will observe fro which symptoms of an anaphylactic reaction?

  • Coughing and watery eyes
  • Dyspnea and urticaria
  • Itchy throat and runny nose
  • Pruritus and burning upon urination
A
  • Dyspnea and urticaria
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2
Q

Your patient has an order for a medication 0.4mg PO BID. You will administer:

  • One 4 g tablet
  • Four 1mg tablets
  • Two 0.2 mg tablets
  • One-half 8mg tablet.
A
  • Two 0.2 mg tablets
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3
Q

Your patient has an order for 1000 mL of d5W to infuse at 125 mL/hour. You do not have a pump. Your tubing set has a 15 gtt/mL drip factor. You will infuse this solution at how many drops per minute?

11 gtts/minute
15 gtts/minute
31 gtts/minute
60 gtts/minute

A

31 gtts/minute

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4
Q

A nurse should explain to a client that the purpose of the Z-track injection technique is to:

  • decrease the pain associated with some medications.
  • allow for rapid administration of the medication.
  • prevent the medication from seeping out of the tissue.
  • deliver a large dose of a medication into a muscle.
A
  • prevent the medication from seeping out of the tissue.
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5
Q

When a client who is taking warfarin sodium (Coumadin) develops epistaxis, the nurse should anticipate an order for which of the following?

Phytonadione (vitamin K1).
Protamine sulfate.
Streptokinase (Kabikinase ).
Thrombin (Thrombogen).

A

Phytonadione (vitamin K1).

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6
Q

Which of these instructions should a nurse give to a client who is taking nystatin (Mycostatin) tablets for oral candidiasis?

“Chew the tablet thoroughly.”
“Dissolve the tablet in your mouth.”
“Mix the tablet with ice cream.”
“Swallow the tablet whole with a sip of water.”

A

“Dissolve the tablet in your mouth.”

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7
Q

A nurse should inform a client who is taking theophylline anhydrous (Theo-Dur) that it is essential to minimize the intake of foods which contain xanthine. Which of these foods should the nurse instruct the client to AVOID?

Cheese.
Eggs.
Chocolate.
Spinach.

A

Chocolate.

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8
Q

Several intravenous (IV) emergency drugs have been ordered for a client who is in cardiac arrest. The IV cannula should be flushed with 20 mL of normal saline after the administration of each drug accompanied by elevation of the extremity in order to:

  1. prevent chemical irritation of the blood vessels from the caustic nature of the drugs.
  2. facilitate delivery of the drugs into the central circulation.
  3. avoid toxicities resulting from the concentrated nature of the drugs.
  4. minimize potential for hypotension.
A

2.facilitate delivery of the drugs into the central circulation.

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9
Q

Before administering an intravenous solution containing potassium chloride, a nurse should assess the client’s:

respiratory rate.
urine output.
level of consciousness.
capillary refill.

A

urine output.

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10
Q

Which of these medications should a nurse have available to treat a client who has ketoacidosis?

Insulin glargine (Lantus).
Regular insulin (Humulin R).
Glucagon.
Glyburide (Micronase).

A

Regular insulin (Humulin R).

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11
Q

A nurse should include which of these instructions in the teaching plan for a client who is taking metoprolol tartrate (Lopressor)?

“If a dose is missed, double the next dose of the drug.”
“Report signs of jaundice.”
“If you drink alcohol, do so in moderation.”
“Do not stop the drug abruptly.

A

“Do not stop the drug abruptly.

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12
Q

Which of the following apply to the administration of enoxaparin (Lovenox) subcutaneously?

  • The upper arm is the preferred site of administration.
  • Do not massage the site after injection.
  • Administer using a 22 gauge, ½ inch needle.
  • Check INR and PT results prior to giving.
A
  • Do not massage the site after injection.
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13
Q

A nurse should carefully monitor a client who is receiving penicillin G sodium for adverse effects, which include:

urticaria.
hypotension.
bradycardia.
renal impairment

A

urticaria.

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14
Q

A client taking acetaminophen (Tylenol) is instructed to adhere to the dosing guidelines carefully because of the potential for:

hearing loss.
vascular collapse.
gastric ulcers
liver damage.

A

liver damage.

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15
Q

When an elderly client is receiving a barbiturate such as Phenobarbital, a nurse should observe the client for which of these paradoxical effects?

Marked excitement.
Nocturnal dyspnea.
Decreased anxiety.
Anginal pain.

A

Marked excitement.

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16
Q

Penicillin G benzathine (Bicillin) is available in prefilled syringes containing 500,000 units/mL. If 125,000 units of Bicillin is ordered for a client, how many milliliters should a nurse administer?

0.25
0.75
2
4

A

0.25

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17
Q

A nurse should recognize that a microdrip intravenous administration set is designed to administer how many drops of solution per milliliter?

10
15
20
60

A

60

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18
Q

1000 mg = __ g

A

1

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19
Q

1000 mcg= __ mg

A

1

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20
Q

2.2 pounds = __ kg

A

1

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21
Q

2.54cm = __ inch

A

1

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22
Q

1000mL = __L

A

1

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23
Q

30mL (cc) = __ ounce

A

1

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24
Q

___ mg = 1 G

A

1000

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25
Q

___ mcg = 1 milligram

A

1000

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26
Q

__ lbs = 1kg

A

2.2

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27
Q

1 in = __ cm

A

2.54

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28
Q

1L = ___ mL

A

1000

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29
Q

1 ounce = how many mL or cc?

A

30

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30
Q

“5 Rights of Medication Administration”

A 
Right time 
Right Patient 
Right drug 
Right dose 
Right route
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31
Q

Remember that analgesics such as morphine and demerol have adverse effects of ___ and ___

A

respiratory depression (hold for RR

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32
Q

most absorption of oral medicine happens in the____

A

small intestine

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33
Q

in an edematous patient, a drug dose must be ___ volume than normal patient

A

larger

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34
Q

in an dehydrated patient, a drug dose must be ___ volume than normal patient

A

smaller

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35
Q

What organ metabolizes most drugs?

A

Liver

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36
Q

What organ excretes most drugs?

A

Kidneys

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37
Q

Patients with decreased renal function need ___ doses and maybe ____ intervals to avoid drug toxicity

A

lower doses

longer dosage intervals

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38
Q

Elderly patients have decreased hepatic and renal perfusion which may result in the need to ___ doses

A

lower

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39
Q

Measure infant doses in a ___ to provide accurate dose

A

syringe

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40
Q

For children, never mix a drug with __ or ___

A

food or formula

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41
Q

Rapid infusion of Vancomycin may cause

A

“red neck syndrome”

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42
Q

Lipitor and Zocor are what class?

A

Anticholesterol/antihyperlipidemics/statin

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43
Q

What is the antagonist of Heparin?

A

protamine sulfate

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44
Q

For Dilantin, when do you measure BP?

A

during administration and 1 hour after infusion due to small interval between therapeutic and toxic

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45
Q

What classification is Dilantin?

A

Anti-convulsant

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46
Q

For anti fungal agents, what organ function studies must be monitored?

A

liver

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47
Q

What is a side effect of AZT and DDC (antiretroviral) that must be reported?

A

Neuropathy

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48
Q

Versed and Valium are

A

benzodiazepines

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49
Q

Atenolol, Lopressor, and Inderal are all

A

beta blockers and antihypertensive agents

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50
Q

Which beta blocker has an increased risk for liver damage?

A

Inderal

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51
Q

Pro-Xanthine is a ___ medication that can cause ____

A

anticholinergic (for bladder)

orthostatic hypotension

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52
Q

Atropine is contraindicated with ___

A

glaucoma

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53
Q

Glaucoma medications promue the outflow of aqueous humor to decrease

A

ocular pressure

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54
Q

When mixing insulin in a syringe, pull up ___ and then ___

A

regular (shorter acting)

then

NPH (longer acting)

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55
Q

What types of insulin are given by sliding scale?

A

Rapid acting: HumaLog, lispro and Novolog, aspart

Short acting: Humulin R, Novocain R, regular

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56
Q

What types of insulin are given daily?

A

Intermediate acting: Humulin N, Novocain N, NPH

Long acting: Lantus, glargine

57
Q

Do not mix ___ with other insulin

58
Q

Lantus, glargine are ___ acting insulin

59
Q

Humulin N, Novocain N, NPH are ___ acting insulin

A

intermediate

60
Q

Humulin R, Novocain R, regular are ___ acting insulin

61
Q

HumaLog, lispro and Novolog, aspart are ___ acting insulin

62
Q

Use NSAIDs with caution in hx of __ allergy

63
Q

Cytarabine, Epogen, Folic Acid, Lupron and Tamoxifen are all

A

oncology medications

64
Q

Use __ with caution or avoid in presence of neuro problems

65
Q

What med is most common in PCA?

66
Q

Avoid ___ before antibiotics

67
Q

Avoid ___ with blood thinners

68
Q

Tip head ___ for nasal spray and __ for nasal drops

A

forward for spray

back for drops

69
Q

administer ear drops in ___ position

A

side-lying

70
Q

How do you administer eye drops?

A

ask patient to look up

pull lower lid down and administer drop into lower conjunctival sac

apply gentle pressure at inside bridge of nose for 1-2 min (minimizes systemic absorption)

71
Q

Rectal administration - position, etc.

A

patient should be in left lateral Sims position

must be inserted beyond anal sphincter into rectal mucosa

72
Q

For intravaginal administration, lying flat for ___ min will help retain the suppository

73
Q

Subcutaneous administration points - needle size, degrees

A

25-27 gauge 1/2-5/8in needle

45 degree with average weight

74
Q

Don’t aspirate when administering __ or ___

A

heparin or insulin

both are sub-q

75
Q

1 tsp = ___ mL

76
Q

1 tbsp = __ mL

77
Q

For a PICC, do not flush catheter with __ before removal

78
Q

Removal of catheter with PICC should be slow and at __ in increments to prevent spasms

79
Q

For IM injections, what’s the needle gauge and size?

A

18-23 gauge 1 1/4-3” needle

80
Q

Avoid >___ mls IM at one site

81
Q

Oral potassium chloride and prednisone can both cause

A

GI irritation

82
Q

Depoakote has a black box warning re:

A

hepatic failure

83
Q

Gabapentin (Neutrontin) is a ____ also used to treat peripheral neuropathy. Do you need to taper when discontinuing?

A

anticonvulsant

Yes taper

84
Q

Albuterol (Proventil) is a ___ that has the 2 main adverse effects of ___ and ___

A

bronchodilator

tachycardia and anxiety

85
Q

Possible effect of the first dose of ACE inhibitor enalapril (Vaster) is

A

dizziness upon standing

86
Q

Metformin (Glucophage) should be held when the patient is

87
Q

Glucocorticoids such as prednisone have the adverse effect of ___ and can be given with ___

A

GI irritation

food or milk

88
Q

With iodinated contrast media (ICM), what serum lab values should you measure?

A

Serum creatinine

89
Q

What is the reversal agent for benzos?

A

Flumazenil (Romazicon)

90
Q

What is the reversal agent for opioids?

A

Naloxone (Narcan)

91
Q

What is the antidote for heparin?

A

Protamine sulfate

92
Q

Buspirone is what classification?

A

anti-anxiety

93
Q 
A nurse should monitor a client who is receiving cefotaxime sodium (Claforan) for side effects, which include
• Diarrhea
• Vertigo
• Tinnitus
• Insomnia
A

• Diarrhea

94
Q

APTT is important with which drug?

95
Q

PT and INR are used with which drug?

96
Q

With statins, Depakote and metformin (Glucophage), what organ function tests are important?

97
Q

Peaks and troughs are important with

A

antibiotic therapy

98
Q

Range for PT

99
Q

Range for INR

100
Q

Range for APTT

101
Q

Range for WBC

102
Q

Range for Hemoglobin

103
Q

Range for HCT hematocrit

104
Q

Range for Platelets

105
Q

Range for Na

106
Q

Range for Cl

107
Q

Range for BUN

108
Q

Range for Glucose

109
Q

Range for K

110
Q

Range for Co2

111
Q

Range for Creatinine

112
Q

What is the maximum safe rate for Potassium chloride?

113
Q

Long-acting benzos can have risk for __ with elderly patients

114
Q

Lorazepam Ativan can have effects of ___ and ___

A

respiratory depression and Co2 retention

115
Q

When administering Midazolam (Versed), you should have ___ available

A

Flumazenil

116
Q

Use Lorazepam cautiously in patients with

117
Q

NO grapefruit juice with

A

Statins

Antihistamines

Calcium channel blockers (blood pressure drugs): nitrendipine, felodipine (Plendil), nifedipine (Adalat, Procardia)

Psychiatric drugs: buspirone (BuSpar), triazolam (Halcion), carbamazepine (Tegretol), diazepam (Valium), midazolam (Versed), sertraline (Zoloft)

Immunosuppressants: cyclosporine (Neoral), tacrolimus (Program)

Pain medications: methadone

Viagra

HIV medication: saquinavir (Inverse)

Antiarrhythmics: amiodarone (Cordarone)

118
Q

What labs must you monitor with Aminoglycosides (gentamicin)?

A

tinnitus
BUN and creatinine
urine output

119
Q

Do not mix Aminoglycosides (gentamicin) with ___

A

Penicillin - give 2 hours apart

120
Q

Vancomycin has vesicant properties, meaning

A

capable of causing blistering, tissue sloughing or necrosis when it escapes from the intended vascular pathway into surrounding tissue.

121
Q

Diltiazem-SR has toxic effects, so absolutely do not

122
Q

70/30 insulin is 70% __ and 30% ___

A

70 NPH 30 Regular

123
Q

Rapid and short acting insulin cover meals immediately __ the injection

124
Q

Intermediate acting insulin is expected to cover ___ meals

A

subsequent

125
Q

Long acting insulin like ___ and ___ provides relatively constant level of insulin and acts as a basal insulin

A

Ultralente and Glargine (Lantus)

126
Q

Only ___ insulin is given IV

127
Q

Remember to __ sites when doing insulin admin

128
Q

When mixing insulins, withdraw __ and then ___. Rule is “____”

A

Regular THEN NPH

clear to cloudy

129
Q

Do not mix __ with other insulins

A

glargine/lantus

130
Q

Short acting Regular R insulin should be given

A

20-30 min before meal

131
Q

NPH, Humulin N, or Lente should be given

A

after meals

132
Q

in patients with kidney failure, the plasma half-life of furosemide is ___ because both urinary excretion and conjugation by the kidney are reduced

133
Q

lithium therapeutic level is

A

.5-1.2 mEqL

134
Q

patients on lithium need to have what tests and how often?

A

lithium level
TSH
renal function

Q6mo

135
Q

side effects of lithium

A

weight gain
tremor
ataxia
memory problems

136
Q

What antibiotic should you give for a UTI?

A

Septa trimethoprim / sulfamethoxazole

137
Q

Therapeutic range for digoxin

138
Q

ADE of Digoxin

A 
bradycardia
n/v
visual disturbances
diplopia
halos
139
Q

Hold digoxin if apical HR is

RN Basic Exam (1 decks)

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