test 3 review

Question 1

A patient is prescribed digoxin and furosemide. It is most important for the nurse to assess which value before administering these medications?
a. serum sodium
b. blood urea nitrogen
c. serum potassium
d. plasma b-natriuretic peptide

Answer 1

c. serum potassium

Question 2

A nurse instructs a patient about signs and symptoms of digoxin toxicity. The nurse determines that teaching is successful if the patient makes which statement?
a. If my heart is racing, the dose may be too high.
b. I should report any muscle weakness or nausea.
c. My doctor should be notified if diarrhea occurs.
d. The dose will be reduced if I develop memory loss.

Answer 2

b. I should report any muscle weakness or nausea.

Question 3

A nurse administers quinidine sulfate to a patient with atrial fibrillation. The nurse should assess the ECG tracing knowing quinidine sulfate has what effect on the ECG?

a. Prolongation of the QT interval
b. Prolongation of the PR interval
c. Narrowing of the QRS complex
d. Tall, peaked T waves

Answer 3

a. Prolongation of the QT interval

Question 4

The nurse is preparing to administer adenosine to a patient tot treat paroxysmal supraventricular tachycardia. Which action by the nurse is most appropriate?

a. Inject the medication into the peripheral intravenous line
b. Infuse the dose by diluting the drug in 100 mL of saline
c. Administer a small test dose to determine hypersensitivity
d. Give the medication through the central line catheter

Answer 4

d. Give the medication through the central line catheter

Question 5

A patient with angina pectoris is prescribed sublingual nitroglycerin. Which statement made by the patient indicates understanding of the medication teaching?

a. I may experience a headache as a side effect
b. The chest pain should be relieved within 20 minutes
c. I should swallow the tablet and drink a glass of water
d. I should take this medication in the morning before breakfast

Answer 5

a. I may experience a headache as a side effect

Question 6

A patient is prescribed a nitroglycerine transdermal patch. The nurse should include which statement when teaching the patient how to use this medication?

a. Apply the patch to the chest over the heart
b. Change the patch each week
c. Remove the patch at bedtime
d. Put on the patch before exercising

Answer 6

c. Remove the patch at bedtime

Question 7

A patient is prescribed sustained-release oral nitroglycerin capsules for chronic stable angina. The nurse should include which instruction?

a. Avoid exercising to help prevent chest pain
b. Place the capsule under the tongue if chest pain occurs
c. Take the capsule as needed before exercise or exertion
d. Sit or lie down if dizziness or lighteadedness occurs

Answer 7

d. Sit or lie down if dizziness or lighteadedness occurs

Question 8

A patient in the emergency department is diagnosed with ST-elevation myocardial infarction. The patient has been prescribed 325 mg of aspirin. Which action by the nurse is appropriate?

a. Administer the medication to the patient if a headache develops
b. Administer the medication with a full glass of water
c. Instruct the patient to let the tablet dissolve under the tongue
d. Tell the patient to chew the tablet thoroughly

Answer 8

d. Tell the patient to chew the tablet thoroughly

Question 9

A patient has been diagnosed with a STEMI. Which medication does the nurse expect to be prescribed for this patient?

a. Beta blocker, angiotensin II receptor blocker, and oxygen
b. aspirin, angiotensin-converting enzyme inhibitor, and diuretics
c. aspirin, beta blocker, oxygen, morphine, and nitroglycerin
d. heparin, nitroprusside, morphine, and calcium channel blocker

Answer 9

c. aspirin, beta blocker, oxygen, morphine, and nitroglycerin

Question 10

A female patient who is diabetic sustained a STEMI and the nurse provides discharge teaching. Which statement, made by the patient, indicates the need for further teaching?

a. Medications are needed to prevent heart failure
b. I will take aspirin, atenolol, and captopril indefinitely
c. My blood pressure should be less than 130/80 mm Hg
d. Daily estrogen will prevent another heart attack

Answer 10

d. Daily estrogen will prevent another heart attack

Question 11

A patient is prescribed lovastatin. The nurse will teach the patient to take the medication at which time?

a. With any meal
b. With the evening meal
c. 1 hour before breakfast
d. 2 hours after a meal

Answer 11

b. With the evening meal

Question 12

Cholestyramine has been prescribed for a patient. Which instruction should the nurse include in patient teaching?

a. Cholestyramine can impair absorption of fat-soluble vitamins
b. Stop taking the drug if you develop constipation
c. Take cholestyramine with other drugs you are prescribed to enhance absorption
d. Do not take the medication if the formula is cloudy after mixing with water

Answer 12

a. Cholestyramine can impair absorption of fat-soluble vitamins

Question 13

A patient is receiving an intravenous infusion of heparin to treat a pulmonary embolism. What laboratory value will the nurse monitor to evaluate treatment with this medication?

a. Activated partial thromboplastin time (aPTT)
b. Prothrombin time (PT)
c. platelet count
d. hemoglobin and hematocrit

Answer 13

a. Activated partial thromboplastin time (aPTT)

Question 14

What is the antidote for heparin?

a. ferrous sulfate
b. atropine sulfate
c. protamine sulfate
d. magnesium sulfate

Answer 14

c. protamine sulfate

Question 15

During administration of alteplase, the patient’s IV site starts to ooze blood around the catheter. Which action by the nurse is most appropriate?

a. discontinue the infusion
b. assess vital signs
c. apply direct pressure to the puncture site
d. administer aminocaproic acid

Answer 15

c. apply direct pressure to the puncture site

Question 16

After administration of clotting factor IX, a patient develops severe dyspnea and facial swelling. Which action should the nurse take first?

a. determine whether the patient has a fever or hives
b. obtain an arterial blood gas specimen for evaluation
c. give an oral dose of diphenydramine
d. administer a subcutaneous dose of epinephrine

Answer 16

d. administer a subcutaneous dose of epinephrine

Question 17

A patient with hemophilia reports mild joint pain. Which over-the-counter medication should the nurse recommend to this patient?

a. ibuprofen
b. acetaminophen
c. enteric-coated aspirin
d. ginkgo biloba

Answer 17

b. acetaminophen

Question 18

The nurse teaches a patient how to administer intranasal cyanocobalamin. The nurse should intervene if the patient makes which statement?

a. I should spray once in each nostril every day
b. Coffee should be avoided for 1 hour
c. I should not take the nasal spray if I have a cold
d. I can also take this medication by self-injection

Answer 18

a. I should spray once in each nostril every day

Question 19

A child is prescribed iron replacement therapy. The nurse is teaching a parent about prevention of accidental iron poisoning in children. The nurse should intervene if the parent makes which statement?

a. There is not an antidote for iron overdose
b. Iron should be kept in childproof containers
c. Early signs of iron poisoning include nausea and vomiting
d. Iron is most often the cause of poisoning death in children

Answer 19

a. There is not an antidote for iron overdose

Question 20

A patient receives a dose of epoetin alfa 3 times a week. What laboratory value will the nurse monitor to determine the therapeutic benefit of this medication?

a. white blood cell count
b. hemoglobin
c. serum potassium
d. platelet count

Answer 20

b. hemoglobin

Question 21

A patient is prescribed NPH insulin. Which statement should the nurse include in the discharge instructions?

a. The insulin will have a cloudy appearance in the vial
b. The onset of action is rapid
c. The patient should not mix insulin glargine with short-acting insulin
d. The patient will have no risk of allergic reactions with this insulin

Answer 21

a. The insulin will have a cloudy appearance in the vial

Question 22

A patient is prescribed metformin. Which statement about metformin does the nurse identify as true?

a. metformin increases absorption of vitamin B12
b. metformin can delay the development of type 2 diabetes in high-risk individuals
c. metformin causes patients to gain weight
d. metformin use predisposes patients to alkalosis

Answer 22

b. metformin can delay the development of type 2 diabetes in high-risk individuals

Question 23

The nurse instructs a patient about taking levothyroxine. Which statement by the patient indicates the teaching has been effective?

a. To prevent an upset stomach, I will take the drug with food
b. If I have chest pain or insomnia, I should call my doctor
c. This medication can be taken with an antacid
d. The drug should be taken before I go to bed at night

Answer 23

b. If I have chest pain or insomnia, I should call my doctor

Question 24

A patient takes levothyroxine 0.75 mcg every day. It is most appropriate for the nurse to monitor which laboratory test to determine whether a dose adjustment is needed?

a. Thyrotropin-releasing hormone (TRH)
b. thyroid-stimulating hormone (TSH)
c. serum free T4 test
d. serum iodine level

Answer 24

b. thyroid-stimulating hormone (TSH)

Question 25

A child with type 1 diabetes mellitus is diagnosed with growth hormone deficiency and is started on somatropin. It is most appropriate for the nurse to monitor the child for which condition? a. Renal insufficiency b. Hypertension c. Hyperglycemia d. Hypothyroidism

Answer 25

c. Hyperglycemia

Question 26

A patient with a urinary creatinine clearance of 55 mL/min is prescribed desmopressin. It is most important for the nurse to assess the patient for what? a. Irritability, muscle weakness, and back pain b. Drowsiness, listlessness, and headache c. Fever, tachycardia, and hypotension d. Decreased skin turgor, weight loss, and dry skin

Answer 26

b. Drowsiness, listlessness, and headache

Question 27

A patient with this condition would most likely be prescribed a glucocorticoid in low doses for replacement therapy? a. Addison’s disease b. Rheumatoid arthritis c. Systemic lupus erythematosus d. Cushing’s syndrome

Answer 27

a. Addison’s disease

Question 28

A patient with Cushing’s syndrome is prescribed an antibiotic, ketoconazole [Nizoral] 600 mg/day, before an adrenalectomy. The patient asks the nurse why an antibiotic is needed. Which response by the nurse is best? a. The medication will prevent an abdominal infection after surgery b. The medication will block the adrenal gland from producing steroids c. have a urinary tract infection that must be treated before surgery d. It is essential to prevent skin infection in patients undergoing surgery

Answer 28

b. The medication will block the adrenal gland from producing steroids

Question 29

When providing discharge teaching for a patient who has been prescribed furosemide, it is most important for the nurse to include which dietary items to prevent adverse effects of furosemide therapy? a. Oranges, spinach, and potatoes b. Baked fish, chicken, and cauliflower c. Tomato juice, skim milk, and cottage cheese d. Oatmeal, cabbage, and bran flakes

Answer 29

a. Oranges, spinach, and potatoes

Question 30

The nurse cares for a patient who is prescribed oral bumetanide twice daily. It is most important for the nurse to take which action? a. Monitor the patient for signs and symptoms of hyperkalemia b. Insert a urinary catheter and assess the hourly urine output c. Weigh the patient before administering each dose d. Schedule the medication to be given at 0800 and 1400

Answer 30

d. Schedule the medication to be given at 0800 and 1400

Question 31

A patient with heart failure who takes furosemide is diagnosed with bacterial pneumonia. Which medication, if ordered by the physician, should the nurse question? a. Ciprofloxacin b. Gentamicin c. Amoxicillin d. Erythromycin

Answer 31

b. Gentamicin

Question 32

A patient has a serum potassium level of 6.4 mEq/L and an arterial pH of 7.22. Which medication, if ordered by the physician, should the nurse question? a. Sodium bicarbonate infusion b. Glucose and insulin infusion c. Spironolactone by mouth d. Calcium gluconate infusion

Answer 32

c. Spironolactone by mouth

Question 33

The nurse teaches a patient about benazepril. Which statement by the patient requires an intervention by the nurse? a. I use NoSalt instead of salt to season foods b. I eat sweet potatoes once or twice a week c. I drink 4 ounces of prune juice each morning d. I like asparagus because it’s high in vitamin K

Answer 33

a. I use NoSalt instead of salt to season foods

Question 34

A patient is prescribed verapamil. The nurse should assess the patient for which common adverse effects? a. Atrial fibrillation, photosensitivity, and blurred vision b. Tachycardia, stomatitis, and inflammation of the joints c. Constipation, headache, and edema of the ankles and feet d. Dry mouth, lymphadenopathy, and decreased appetite

Answer 34

c. Constipation, headache, and edema of the ankles and feet

Question 35

The healthcare provider prescribes sustained-release verapamil to an 82-year-old patient who takes digoxin daily. Which action is most appropriate for the nurse to take? a. Monitor the patient’s cardiac rhythm continuously. b. Assess the patient for tachycardia and hypertension. c. Maintain the patient on bed rest for 8 to 10 hours. d. Reduce dietary fiber to prevent loose, watery diarrhea.

Answer 35

a. Monitor the patient’s cardiac rhythm continuously.

Question 36

A patient with severe hypertension is prescribed minoxidil. Which medications will the nurse expect to be administered to reduce adverse responses to minoxidil? a. Adenosine and ticlopidine b. Furosemide and propranolol c. Digoxin and captopril d. Donepezil and clonidine

Answer 36

b. Furosemide and propranolol

Question 37

Which of the following agents is appropriate to use in Type 1 Diabetes to control blood glucose? a. Insulin Glargine b. Sitagliptin c. Exenatide d. Isoniazid

Answer 37

a. Insulin Glargine

Question 38

Which of the following are nursing considerations for insulin preparations? Select all that apply. a. Always mix clear to cloudy b. Never mix short acting and long acting into one injection c. times of peak insulin levels pose the greatest risk for hypoglycemia d. they are useful in both type 1 and type 2 diabetes

Answer 38

a. Always mix clear to cloudy b. Never mix short acting and long acting into one injection c. times of peak insulin levels pose the greatest risk for hypoglycemia d. they are useful in both type 1 and type 2 diabetes

Question 39

A patient is receiving mannitol for increased intracranial pressure (ICP). Which statement is correct about this medication? a. mannitol reduces peripheral edema b. this agent removes water from the brain, but not from the periphery c. the nurse should monitor heart rate while administering this medication d. mannitol is nephrotoxic and causes renal failure

Answer 39

b. this agent removes water from the brain, but not from the periphery

Question 40

For a patient prescribed hydrochlorothiazide, the nurse should closely monitor for elevation of which laboratory test value? a. glucose b. sodium c. calcium d. potassium

Answer 40

a. glucose