Pharmacology
Lab values
Client Teaching
Cardio/Pulm
GI/Renal
100
A 72 year old female is being placed on hormone therapy (HT). The nurse knows to assess the client for the following complications? (Select All) A. VAGINAL DRYNESS B. NIGHT SWEATS C. MYOCARDIAL INFARCTION D. STROKE E.VENOUS THROMBOSIS
C, D, E COMPLICATIONS ARE MI, STROKE, VENOUS THROMBOSIS AND CANCER. VAGINAL DRYNESS IS A REGULAR SYMPTOM OF MENOPAUSE AND NIGHT SWEATS IS INCORRECT. REVIEW PAGE 726
100
A nurse is reviewing lab findings of a client who has an acute exacerbation of Crohn's. Which lab finding would be indicative of an exacerbation of Crohn's? (Select All) A. increased hematacrit B Elevated ESR (sed rate) C Increase WBC D. Increased folic acid E Increased serum albumin
B, C Please review pg 582. Remember the sed rate indicates inflammation- this will be elevated. The WBC count will be elevated because where there is inflammation white cells will follow.
100
A nurse is caring for a client who was just told she has breast cancer and the nurse evaluates the client's response. Which of the following statements by the client reflects a lack of understanding of an illness perspective? A. " I have no family history of breast cancer" B " I need a second opinion; there is no lump" C. I am glad we live in the city near several large hospitals" D. I will schedule surgery next week, during the holidays.
B. Statement of denial reflects a lack of understanding of the illness perspective and may influence the clients acceptance of diagnosis. (pg 3)
100
A nurse is caring for a patient with an arterial line. The nurse would assess the limb with the arterial line in by (select all) A. capillary refill B temperature of limb C color of limb D. IV fluid flowing smoothly E. Arterial WaveForm
A,B,C,E. (pg 297)
100
A nurse is caring for a patient status post bariatric surgery. What should the nurse include in dietary teaching. A. Drink fluids with meals. B. Eat two servings of protein daily C. Don't take a multivitamin D. Brush your teeth
B. Pg 530
200
A 35 YEAR OLD FEMALE IS IN YOUR CARE. YOU HAVE ADMINISTERED HER SCHEDULED DOSE OF FENTANYL. AFTER YOUR 30 MIN REASSESSMENT, HER VITALS ARE BP; 110/80, R:6, SP O2: 98%, TEMP: 97.8. HR: 88. AFTER GIVING HER NARCAN (NALAXONE) WHAT IS THE THERAPEUTIC RESPONSE? A. TEMP 100.3 B. BP: 120/80 C. R: 12 D. HR: 130
C. OPIOID TREATMENT HAVE AN ADVERSE EFFECT OF RESPIRATORY DEPRESSION. NARCAN IS AN OPIOID ANTAGONIST; THEREFORE, THE THERAPEUTIC RESPONSE IS AN INCREASE IN RESPIRATION.
200
A nurse in a provider's office is reviewing the health record of a client who is being evaluated for Graves' disease. Which of the following is an expected laboratory finding for this client? A. Decreased thyrotropin receptor antibodies. B. Decreased thyroid stimulating hormone. C. Decreased free thyroxine index D. Decreased triiodothyronine
B. In Graves disease, low TSH, is an expected finding. The pituitary gland decreases the production of TSH when thyroid hormone levels are elevated. (pg 869)
200
A nurse is providing teaching to a client who has a new prescription for digoxin. Which of the following may indicate digoxin toxicity and should be reported to the provider? (Select All) A. Fatigue B. Constipation C Anorexia D. Rash E. Diplopia
A,C,E Review pharm chap 21 pg 274 Fatigue, weakness, vision changes, GI effects are signs of toxicity.
200
A telemetry nurse is caring for patients. On one of her patient's ECG strip she notices the ST-segment is elevated. What does this tell her about the patient she is monitoring? A. Myocardial Injury B. Ischemia C. Necrosis D. angina
A. (pg 351) ST segment elevation indicates myocardial injury
200
A nurse is caring for a bed ridden patient on the med surg wing. She knows that many non nutritional factors could cause malnutrition. What would the nurse use to measure a patient's protein level? A. Age B. Cognitive status C. Albumin level D. Sodium level
Protein levels commonly are measured by serum albumin levels. (pg 25 nutrition ATI book)
300
YOU ARE PRECEPTING A STUDENT NURSE CARING FOR A CKD PT. WHAT STATEMENT BY THE STUDENT INDICATES THE NEED FOR FURTHER TEACHING? A. " I AM GOING TO ADMINISTER MR. J EPOGEN INJECTION" B. " IT IS TIME FOR ME TO GIVE MR. J HIS KAYEXALATE" C. " MR. J IS HURTING, I WILL GIVE HIM HIS IBUPROFEN NOW. D. " IT IS TIME FOR MR. J'S DIGOXIN DOSE."
IN PATIENTS WITH CKD OR ARF, AVOID GIVING ANTIMICROBIAL MEDS(AMINOGLYCOSIDES AND AMPHOTERICEN B), NSAIDS, ACE INHIBITORS AND ARBS, IV CONTRAST DYE WHICH ARE ALL NEPHROTOXIC. (C) PG 679
300
A nurse is reviewing lab values of a client who has a diagnosis of MI and reports that his dyspnea began 2 weeks ago. Which lab value would confirm the infart happen 14 days ago? A. CK-MB B. Troponin I C. Troponin T D Myoglobin
C. The Troponin T level will still be evident 14 to 21 days following an MI. pg 351
300
A nurse is providing discharge instructions to a female client who has a prescription for phenytoin (Dilantin). Which of the following information should the nurse include?
C. The nurse should instruct the client to take phenytoin at the same time daily to enhance effect. pg 65
300
The nurse is monitoring her patients chest tube. What assessment finding would indicate to the nurse the system has sustained an air leak. A. greenish sputum in tubing B. continuous bubbling around water seal C. chest pain compliant from pt. D. right shoulder pain
B. (pg 193)
300
The nurse knows an inflammation of the glomerular capillaries that is caused by a streptococcal infection is called? A. Diabetes B Glomerulonephritis C Pruritus D hyperkalemia
B. pg 664
400
A NURSE IS CARING FOR A CLIENT USING ENOXAPARIN AT HOME. THE NURSE KNOWS THAT THE CLIENT SHOULD ADMINISTER THIS INJECTION IN WHICH AREA OF THE BODY? A. ABDOMEN B. WRIST C. ANTERIOR THIGH D. BUTTOCKS
A. DEEP SUB CUT INJECTION SHOULD BE ADMIN IN STOMACH 2IN AWAY FROM UMBILICUS. DON'T ASPIRATE! PG 324 IN ATI PHARM BOOK
400
The nurse is reviewing labs on a CKD patient. Which lab value requires a priority intervention by the nurse? A. K+: 6.7 B. Ca+: 9.0 C. Na+=140 D. TSH= 1.01
A. (pg 675) CKD pt can develop hyperkalemia quickly. A potassium this elevated needs priority intervention b/c cardiac disturbances will occur.
400
A nurse is presenting info to a group of clients about nurtition habits that prevent type II mellitus. What information should she include? A. Eat less meat and processed foods. B Decrease intake of saturated fats C. Increase daily fiber intake D. Limit saturated fat intake to 15% of daily caloric intake. E Include omega 3 fatty acids in diet.
A,B C, E pg 920
400
A nurse is caring for a client who is 4hr post op following CABG. He is able to inspire 200mL with the incentive spirometer, then refuses b/c he is tired and hurting. Which of the following is an appropriate nursing action. A. Allow the client to rest, and return in 1hr. B. Administer IV bolus analgesic, and return in 15mins. C. Document the 200mL as an appropriate inspired volume. D. Tell the client that he must cough if he doesn't want pneumonia.
B. provide analgesia and return in 15min will reduce pain and improve coughing effectiveness (pg 339 second bullet under assess and control pain)
400
A nurse educator is presenting on complications of hemodialysis. What should be included in the presentation? (Select All) A. Clotting B infection of access site C Disequilibrium syndrome D polyuria E increased thirst
A, B, C (pgs 642-643)
500
IT IS YOUR FIRST DAY AND YOU HAVE TO INITIATE IV THERAPY ON YOUR PT. WHAT ASSESSMENT DATA WOULD INDICATE A COMPLICATION RESULTED FROM THE IV PLACEMENT. (SELECT ALL) A. PHLEBITIS b. COOLNESS C SWELLING D. SLOW HR E DEPRESSED RESPIRATORY
A, B C. ALL ARE SIGNS OF COMPLIC ATION. READ 305-307
500
A nurse in the preoperative unit is assessing a client's lab values before surgery. Which of the following should the nurse report to the provider? A. Potassium 3.9mEq/L B. Sodium chloride 145mEq/L C. Creatinine 2.8 mg/dL D. Blood glucose 235mg/dL E. WBC 17,850/uL
C, D, E (pg 1096) The nurse should report an elevated creatinine level, glucose and WBC before a pt goes to surgery.
500
A nurse is caring for a client following a trabeculectomy. Which of the following statements should the nurse include in teaching? A You may resume playing golf B You need to tilt your head back when washing hair C You may continue driving to and from work D You need to limit your housekeeping duties.
D. The nurse should instruct the client to limit housekeeping activities following cataract surgery. This activity could elevate the IOP or result in injury to the eye. (pg 126)
500
A nurse is caring for a client who has dyspnea and is to receive oxygen continuously. Which of the following oxygen devices should the nurse use to deliver a precise amount of oxygen to the client? A. Nonrebreather mask B. Venturi C. Nasal cannula D. Simple face mask.
A venturi mask incorporates an adapter that allows a precise amount of oxygen to be delivered to the client. (Pgs 199-201)
500
A nurse is admitting a client who has bleeding esophageal varices. The nurse should anticipate a script for which med? A. propranolol B. Reglan C Zantac D Terlipressin
D. pg 543
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