Med-Surg
Psychiatric
Potpourri
'Betes
Baby, Baby, Baby
100
A nurse reinforces discharge instructions to a postoperative client who is taking warfarin (Coumadin). Which statement made by the client reflects the need for further teaching? 1. "I will take my pills every day at the same time." 2. "I will be certain to avoid alcohol consumption." 3. "I have already called my family to pick up a Medic-Alert bracelet." 4. "I will take aspirin for my headaches."
Answer: 4 Rationale: Aspirin is a blood thinner and should be avoided.
100
Extrapyramidal symptoms include all, except: A. Psuedoparkinsonism B. Dytonia C. Tardive dyskinesia D. Agnosia
Answer: D Rationale: Agnosia is inability to interpret sensations and to recognize things. It's not EPS-related.
100
A 23-year-old client has been taking gabapentin (Neurontin) for control of partial seizures. He is admitted to the emergency department with slurred speech, dyspnea, reports of double vision, and sedation. The admitting nurse suspect the client has: 1. Not taken his drug for several days. 2. Taken an overdose of the drug, either accidentally or deliberately. 3. Taken the drug with grapefruit or grapefruit juice. 4. Continued to smoke despite prior client education that smoking interacts with the drug.
Answer: 2
100
A nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the same syringe. Which of the following actions, if performed by the client, indicates the need for further teaching? 1. Withdraws the NPH insulin first 2. Withdraws the regular insulin first 3. Injects air into NPH insulin vial first 4. Injects an amount of air equal to the desired dose of insulin into the vial
Answer: 1 Rationale: When preparing a mixture of regular insulin with another insulin preparation, the regular insulin is drawn into the syringe first. This sequence will avoid contaminating the vial of regular insulin with insulin of another type.
100
The nurse is teaching care of the newborn to a childbirth preparation class and describes the need for administering antibiotic ointment into the eyes of the newborn. An expectant father asks, "What type of disease causes infections in babies that can be prevented by using this ointment?" Which response by the nurse is accurate? A.Herpes B. Trichomonas C. Gonorrhea D. Syphilis
Answer: C Rationale: Erythromycin ointment is instilled into the lower conjunctiva (hey! We were just wondering where to put drops yesterday!) of each eye within 2 hours after birth to prevent ophthalmia neonatorum, an infection caused by gonorrhea (C), and inclusion conjunctivitis, an infection caused by Chlamydia. The infant may be exposed to these bacteria when passing through the birth canal. Ophthalmic ointment is not effective against (A, B, or D).
200
For how long should you check the apical pulse on a patient with orders to receive Digoxin?
A full minute. Hold if pulse rate is less than 60bpm. **** This is one of the questions that a senior told me was on their pharm exam, I don't remember if it was the fall or winter one but I just remembered it! ****
200
Which of the following condition is associated with long-term use of lithium in mood disorders? A. Hypothyroidism B. Hyperprolactinemia C. Hypoglycemia D. Hypertension E. Tardive dyskinesia
Answer: A
200
Carbamazepine (Tegretol) has been prescribed for a 24-year-old for the control of partial seizures. The nurse will teach the client to immediately report: 1. Blurred vision 2. Leg cramps 3. Blister-like rash 4. Lethargy
Answer: 3
200
A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is: 1. 2 to 4 hours after administration 2. 4 to 12 hours after administration 3. 16 to 18 hours after administration 4. 18 to 24 hours after administration
Answer: 2 Rationale: Humulin NPH is an intermediate-acting insulin. The onset of action is 1.5 hours, it peaks in 4 to 12 hours, and its duration of action is 24 hours. Hypoglycemic reactions most likely occur during peak time.
200
Which drug would the nurse choose to utilize as an antagonist for magnesium sulfate? 1. Oxytocin 2. Terbutaline 3. Calcium gluconate 4. Narcan
Answer: 3 Rationale: Calcium gluconate should be kept at the bedside while a client is recieivng mag sulfate infusion. If magnesium toxicity occurs, calcium gluconate is admined as an antidote
300
Ibuprofen (Advil) is prescribed for a client. The nurse tells the client to take the medication: 1. With 8 oz of milk 2. If glucose levels are between 80-100. 3. 60 minutes before breakfast 4. At bedtime on an empty stomach
Answer: 1 Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs should be given with milk or food to prevent gastrointestinal irritation.
300
What is the antidote for an OD on anticholinergic drugs?
physostigmine (Antilirium)
300
The client is started on propranolol (Inderal). Which is the most important action to be included in the plan of care for this client related to this medication? 1. Monitor apical pulse and blood pressure. 2. Elevate the head during meals. 3. Take the medication after meals. 4. Consume food high in potassium.
Answer: 1
300
What is unique about NPH Insulin?
Answer: NPH is a suspension and is cloudy, thus requiring gentle agitation before drawing it up. All other insulins are clear solutions
300
A clients labor doesnt progress. After ruling out CPD, the doctor orders IV admin of 1,000 ml normal saline w/ Pitocin 10 units to run at 2 miliunits / min. 2 miliunits/min is equivalent to how many ml/unit 1. 0.002 2. 0.02 3. 0.2 4. 2.0
Answer: 3 (0.2) Rationale: each unit of oxytocin contains 1,000 miliunits. Therefore, 1,000 ml of IV fluid contains 10,000 miliunits (10 units) of Pitocin
400
Intravenous heparin therapy is prescribed for a client. While implementing this prescription, a nurse ensures that which of the following medications is available on the nursing unit? 1. Protamine sulfate 2. Potassium chloride 3. Phytonadione (vitamin K ) 4. Aminocaproic acid (Amicar)
Answer: 1 Rationale: The antidote to heparin is protamine sulfate; it should be readily available for use if excessive bleeding or hemorrhage occurs.
400
What is the antidote for an OD on benzodiazepines?
flumazenil (Romazicon)
400
A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to: 1. Treat thyroid storm. 2. Prevent cardiac irritability. 3. Treat hypocalcemic tetany. 4. Stimulate the release of parathyroid hormone.
Answer: 3 Rationale: Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally removed or injured during surgery. Manifestations develop 1 to 7 days after surgery. If the client develops numbness and tingling around the mouth, fingertips, or toes or muscle spasms or twitching, the health care provider is notified immediately. Calcium gluconate should be kept at the bedside.
400
What are the major adverse effects of Metformin?
Answer: GI Disturbance: decreased appetite, nausea, diarrhea. Also, weight loss.
400
A 17 y.o. primpigravida with severe PIH has been receiving mag sulfate IV for 3 hours. The latest assessment reveals DTR of +1, BP 150/100 mmgHg, pulse 92 bpm, respiratory rate 10bpm and urine output 20ml/hr. Which of the following actions would be most approp? 1. Continue monitoring per standards of care 2. Stop the mag sulfate infusion 3. Increase infusion by 5gtt/min 4. Decrease infusion by 5gtt/min
Answer: 2 Rationale: Mag sulfate should be withheld if the clients resp rate or urine output falls or if reflexes are diminished / absent.
500
Demerol is prescribed for the client with pain. Which of the following would the nurse monitor for as a side effect of this medication? 1. Diarrhea 2. Bradycardia 3. Hypertension 4. Urinary retention
Answer: 4 Rationale: Meperidine hydrochloride (Demerol) is an opioid analgesic. Side effects of this medication include respiratory depression, orthostatic hypotension, tachycardia, drowsiness and mental clouding, constipation, and urinary retention.
500
The most common side effect of benzodiazepines is: A. Sedation B. Seizures C. Vomiting D. Restlessness and agitation
Answer: A Rationale: Benzos depress the CNS.
500
A postoperative client has received a dose of naloxone (Narcan) for respiratory depression shortly after transfer to the nursing unit from the post-anesthesia care unit. After administration of the medication, the nurse checks the client for: 1. Pupillary changes 2. Scattered lung wheezes 3. Sudden increase in pain 4. Sudden episodes of diarrhea
Answer: 3 Rationale: Naloxone (Narcan) is an antidote to opioids and may also be given to the postoperative client to treat respiratory depression. When given to the postoperative client for respiratory depression, it may also reverse the effects of analgesics. Therefore, the nurse must check the client for a sudden increase in the level of pain experienced.
500
A patient with what disease should never use Metformin?
Answer: Renal insufficiency because it can rapidly accumulate to toxic levels causing lactic acidosis, which is rare, but often fatal.
500
After reviewing the client's maternal history of magnesium sulfate during labor, which condition would the nurse anticipate as a potential problem in the neonate? 1. hypoglycemia 2. jitteriness 3. resp depression 4. tachycardia
Answer: 3 Rationale: mag sulfate crosses the placenta and adverse neonatal effects are: resp depression hypotonia bradycardia
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