1. 1.ID: 310953449
A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch.
Which assessment finding indicates that the desired
... [Show More] effect of the medication has
been achieved?
A. Client denies recent episodes of angina. Incorrect
B. Change in peripheral edema from +3 to +1.
C. Client denies recent nausea or vomiting.
D. Blood pressure has changed from 180/120 to 140/70. Correct
Catapres acts as a centrally-acting analgesic and antihypertensive agent. (D)
indicates a reduction in hypertension. Catapres does not affect (A, B, or C), so
these findings do not indicate desired outcomes of Catapres.
Awarded 0.0 points out of 1.0 possible points.
2. 2.ID: 310972761
After abdominal surgery, a male client is prescribed low molecular weight heparin
(LMWH). During administration of the medication, the client asks the nurse why
he is receiving this medication. Which is the best response for the nurse to
provide?
A. This medication is a blood thinner given to prevent blood clot
formation. Correct
B. This medication enhances antibiotics to prevent infection.
C. This medication dissolves any clots that develop in the legs.
D. This abdominal injection assists in the healing of the abdominal
wound.
Unfractionated heparin or low molecular weight heparin (LMWH) is an
anticoagulant that inhibits thrombin-mediated conversion of fibrinogen to fibrin
and is given prophylactically to prevent postoperative venous thrombosis (A) or
to treat pulmonary embolism or deep vein thrombosis following knee and
abdominal surgeries. Heparin does not dissolve clots but prevents clot extension
or further clot formation (C). The anticoagulant heparin does not prevent
infection (B) or influence operative wound healing (D).
Awarded 1.0 points out of 1.0 possible points.
3. 3.ID: 310989365
A client with coronary artery disease who is taking digoxin (Lanoxin) receives a
new prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor
prescription, the nurse assesses the client. Which finding requires the most
immediate intervention?
A. Heartburn. Incorrect
B. Headache.
C. Constipation.
D. Vomiting. Correct
Vomiting, anorexia and abdominal pain are early indications of digitalis toxicity.
Since Lipitor increases the risk for digitalis toxicity, this finding requires the most
immediate intervention by the nurse (D). (A, B and C) are expected side effects
of Lipitor.
Awarded 0.0 points out of 1.0 possible points.
4. 4.ID: 310974953
A client with heart failure is prescribed spironolactone (Aldactone). Which
information is most important for the nurse to provide to the client about diet
modifications?
A. Do not add salt to foods during preparation.
B. Refrain for eating foods high in potassium. Correct
C. Restrict fluid intake to 1000 ml per day.
D. Increase intake of milk and milk products.
Spironolactone (Aldactone), an aldosterone antagonist, is a potassium-sparing
diuretic, so a diet high in potassium should be avoided (B), including potassium
salt substitutes, which can lead to hyperkalemia. Although (A) is a common diet
modification in heart failure, the risk of hyperkalemia is more important with
Aldactone. Restriction of fluids (C) or increasing milk and milk products (D) are
not indicated with this prescription.
Awarded 1.0 points out of 1.0 possible points.
5. 5.ID: 310950706
A client with a dysrhythmia is to receive procainamide (Pronestyl) in 4 divided
doses over the next 24 hours. What dosing schedule is best for the nurse to
implement?
A. q6h. Correct
B. QID.
C. AC and bedtime.
D. PC and bedtime.
Pronestyl is a class 1A antidysrhythmic. It should be taken around-the-clock (A)
so that a stable blood level of the drug can be maintained, thereby decreasing
the possibility of hypotension (an adverse effect) occurring because of too much
of the drug circulating systemically at any particular time of day. (B, C, and D) do
not provide an around-the-clock dosing schedule. Pronestyl may be given with
food if GI distress is a problem, but an around-the-clock schedule should still be
maintained.
Awarded 1.0 points out of 1.0 possible points.
6. 6.ID: 310949440
A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage
nurse at the clinic complaining of muscle pain and weakness in his legs. Which
statement reflects the correct drug-specific teaching the nurse should provide to
this client?
A. Increase consumption of potassium-rich foods since low
potassium levels can cause muscle spasms.
B. Have serum electrolytes checked at the next scheduled
appointment to assess hyponatremia, a cause of cramping.
C. Make an appointment to see the healthcare provider, because
muscle pain may be an indication of a serious side effect. Correct
D. Be sure to consume a low-cholesterol diet while taking the drug
to enhance the effectiveness of the drug.
Myopathy, suggested by the leg pain and weakness, is a serious, and potentially
life-threatening, complication of Lipitor, and should be evaluated immediately by
the healthcare provider (C). Although electrolyte imbalances such as (A or B) can
cause muscle spasms in some cases, this is not the likely cause of leg pain in the
client receiving Lipitor, and evaluation by the healthcare provider should not be
delayed for any reason. A low-cholesterol diet is recommended for those taking
Lipitor since the drug is used to lower total cholesterol (D), but diet is not related
to the leg pain symptom.
Awarded 1.0 points out of 1.0 possible points.
7. 7.ID: 310962739
A category X drug is prescribed for a young adult female client. Which instruction
is most important for the nurse to teach this client?
A. Use a reliable form of birth control. Correct
B. Avoid exposure to ultra violet light.
C. Refuse this medication if planning pregnancy.
D. Abstain from intercourse while on this drug.
Drugs classified in the category X place a client who is in the first trimester of
pregnancy at risk for teratogenesis, so women in the childbearing years should
be counseled to use a reliable form of birth control (A) during drug therapy. (B) is
not a specific precaution with Category X drugs. The client should be encouraged
to discuss plans for pregnancy with the healthcare provider, so a safer alternative
prescription (C) can be provided if pregnancy occurs. Although the risk of birth
defects during pregnancy explains the restriction of these drugs during
pregnancy, (D) is not indicated.
Awarded 1.0 points out of 1.0 possible points.
8. 8.ID: 310953453
A client receiving Doxorubicin (Adriamycin) intravenously (IV) complains of pain
at the insertion site, and the nurse notes edema at the site. Which intervention is
most important for the nurse to implement?
A. Assess for erythema.
B. Administer the antidote.
C. Apply warm compresses.
D. Discontinue the IV fluids. Correct
Doxorubicin is an antineoplastic agent that causes inflammation, blistering, and
necrosis of tissue upon extravasation. First, all IV fluids should be discontinued at
the site (D) to prevent further tissue damage by the vesicant. Erythema is one
sign of infiltration and should be noted, but edema and pain at the infusion site
require stopping the IV fluids (A). Although an antidote may be available (B),
additional fluids contribute to the trauma of the subcutaneous tissues. Depending
on the type of vesicant, warm or cold compresses (C) may be prescribed after the
infusion is discontinued.
Awarded 1.0 points out of 1.0 possible points.
9. 9.ID: 310993901
The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II
receptor blocker (ARB), for a client with hypertension and heart failure. The nurse
reviews the client's laboratory results and notes that the client's serum
potassium level is 5.9 mEq/L. What action should the nurse take first?
A. Withhold the scheduled dose. Correct
B. Check the client's apical pulse.
C. Notify the healthcare provider.
D. Repeat the serum potassium level.
The nurse should first withhold the scheduled dose of Cozaar (A) because the
client is hyperkalemic (normal range 3.5 to 5 mEq/L). Although hypokalemia is
usually associated with diuretic therapy in heart failure, hyperkalemia is
associated with several heart failure medications, including ARBs. Because
hyperkalemia may lead to cardiac dysrhythmias, the nurse should check the
apical pulse for rate and rhythm (B), and the blood pressure. Before repeating the
serum study (D), the nurse should notify the healthcare provider (C) of the
findings.
Awarded 1.0 points out of 1.0 possible points.
10. 10.ID: 310962715
Which change in data indicates to the nurse that the desired effect of the
angiotensin II receptor antagonist valsartan (Diovan) has been achieved?
A. Dependent edema reduced from +3 to +1.
B. Serum HDL increased from 35 to 55 mg/dl. Incorrect
C. Pulse rate reduced from 150 to 90 beats/minute.
D. Blood pressure reduced from 160/90 to 130/80. Correct
Diovan is an angiotensin receptor blocker, prescribed for the treatment of
hypertension. The desired effect is a decrease in blood pressure (D). (A, B, and C)
do not describe effects of Diovan. [Show Less]