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A patient taking Codeine 15-60 mg every 4-6 hours for pain relief reports constipation. The nurse would recommend which of the following? SATA
A. Increase fluid intake
B. Stay in bed as often as possible
C. Increase fiber intake
D. Take stool softeners as prescribed
A. Increase fluid intake
C. Increase fiber intake
D. Take stool softeners as prescribed
Rationale: Not b because you want to get more exercise to help with constipation
Match the lab value with the condition they may be indicative of: a. Lactate at 4 mmol/L, b. Thyroid-stimulating hormone (TSH) of 10 mU/L c. GFR (Glomerular Filtration Rate) of 50 mL/min, d. HbA1C (Hemoglobin A1c) of 8%
1. Diabetes mellitus -
2. Lactic acidosis -
3. Impaired kidney function (CKD or AKI) -
4. Hypothyroidism -
1. Diabetes mellitus - d
2. Lactic acidosis - a
3. Impaired kidney function (CKD or AKI) - c
4. Hypothyroidism - b
Rationale: Normal lactate levels: 0.5-2.2 mmol/L. Elevated levels could mean lactic acidosis from sepsis, shock, or hypoxia. The HbA1C is the percentage of hemoglobin proteins in your blood that are coated with glucose because RBCs have a lifespan of 2-3 months this is an average of your blood glucose levels over the past 2-3 months. The ranges are different with different sources but it should be below 5.7%. Prediabetes is 5.7–6.4% and diabetes is 6.5% or higher. The GFR is a measure of how well your kidneys are filtering your blood in milliliters per minute. A low GFR means the kidneys are not effectively filtering the blood allowing more waste products to build up in the body. The GFR should be between 90-120. Thyroid-stimulating hormone is an indicator of thyroid function because this hormone tells the thyroid to release thyroid hormone. If the levels are high, it could mean hypothyroidism because TSH is working extra hard to get the thyroid gland to do its job. (and vice versa). TSH should be 0.4-4.0 mU/L.
_______ is a result of _______.
A. Parkinson’s disease; inflammation and destruction of the myelin sheath
B. Amyotrophic lateral sclerosis (ALS); reduction in dopamine in the brain
C. Guillain–Barré Syndrome; destruction of ACh
D. Multiple sclerosis (MS); inflammation and destruction of the myelin sheath
D. Multiple sclerosis (MS); inflammation and destruction of the myelin sheath
Rationale: MS is an autoimmune disorder that causes inflammation and destruction of the myelin sheath (of the neurons in the CNS: brain and spinal cord) (and eventually the underlying nerve). It is actually believed that Parkinson’s disease is caused by a reduction of dopamine in the brain. Myasthenia gravis, not guillan barre, is caused by an autoimmune disease leading to the destruction of ACh. Guillain-Barré syndrome (GBS) is a rare autoimmune condition that's thought to be contracted after an infection or immunization, but the exact cause is unknown.
A nurse is educating a patient with hypertension about lifestyle modifications. Which of the following statements by the patient indicates a need for further education?
A. "I will reduce my alcohol intake and quit smoking."
B. "I should eat a diet high in sodium to help increase my blood pressure."
C. "I will try to exercise more regularly."
D. "I will reduce stress through relaxation techniques."
B. "I should eat a diet high in sodium to help increase my blood pressure."
Rationale: A patient with hypertension should reduce sodium intake to help lower blood pressure. Eating a diet high in sodium is not recommended, as it can worsen hypertension. The other statements reflect positive lifestyle changes for managing hypertension.
Place the steps of the renin-angiotensin-aldosterone system in order.
A. Angiotensin II brings about a variety of effects such as systemic vasoconstriction, and the reabsorption of sodium and water via aldosterone release to bring the blood pressure back up
B. The kidneys release renin into the blood
C. Angiotensin-converting enzyme (ACE) converts angiotensin I into angiotensin II
D. Renin converts angiotensinogen into angiotensin I
E. The kidneys detect a drop in blood pressure
E, B, D, C, A
Rationale: Correct order: The kidneys detect a drop in blood pressure, The kidneys release renin into the blood, Renin converts angiotensinogen into angiotensin I, Angiotensin-converting enzyme (ACE) converts angiotensin I into angiotensin II, Angiotensin II brings about a variety of effects such as systemic vasoconstriction, and the reabsorption of sodium and water via aldosterone release to bring the blood pressure back up
A patient is prescribed an Angiotensin II Receptor Blocker, Losartan for their high blood pressure. Which of the following should be taught to the patient? SATA
A. “With this medication, there is no risk for a cough as there is with ACE inhibitors”
B. “You should monitor your blood pressure daily”
C. “This medication works by blocking beta receptors in the sympathetic nervous system”
D. “This medication could cause hypotension”
B. “You should monitor your blood pressure daily”
D. “This medication could cause hypotension”
Rationale: With ARBs, there is still a potential risk for developing the side effects of upper respiratory infections and cough. The medication does not work by blocking beta receptors, that is for beta blockers. ARBs work by interfering with the last step of the RAAS system by binding with angiotensin II receptors.
A nurse is caring for a patient who is prescribed digoxin for heart failure. Which of the following statements by the patient indicates that further teaching is needed?
A. "I will take my digoxin at the same time every day."
B. "I should call my doctor if I notice yellow or green halos around lights."
C. "I will check my blood pressure before taking my digoxin."
D. "I need to make sure my pulse is over 60 beats per minute before taking digoxin."
C. "I will check my blood pressure before taking my digoxin."
Rationale: The nurse should instruct the patient to check their apical pulse before administering digoxin, not their blood pressure. The apical pulse should be above 60 bpm before giving the medication. Blood pressure monitoring is not as critical for digoxin administration.
A nurse is caring for a patient with Peripheral Artery Disease (PAD). Which of the following is the most important intervention for the nurse to prioritize?
A. Educate the patient on the importance of increasing dietary fat intake.
B. Encourage the patient to quit smoking and adopt a healthier lifestyle.
C. Encourage the patient to use warm compresses on the affected extremity.
D. Recommend long periods of rest to prevent worsening of symptoms.
B. Encourage the patient to quit smoking and adopt a healthier lifestyle.
Rationale: The most important intervention for patients with PAD is smoking cessation and lifestyle modification, including dietary changes (reducing fat intake) and increasing physical activity. Smoking is a major risk factor for PAD and can significantly worsen the condition.
A nurse is treating a patient with left-sided heart failure. The nurse knows to monitor for which of the following adverse signs and symptoms? SATA
A. Pulmonary edema
B. Coughing and/or wheezing
C. Peripheral edema
D. Ascites
E. Cyanosis and s/sx of hypoxia
A. Pulmonary edema
B. Coughing and/or wheezing
E. Cyanosis and s/sx of hypoxia
Rationale: Think about the patho behind left-sided heart failure. Where does the blood back up?? Into the lungs! The left ventricle is not efficiently pumping the blood into the systemic circulation and therefore its backing up into the pulmonary circulation.
For a patient with heart failure taking a loop diuretic, the nurse should be aware to monitor which of the following:
A. BUN, creatinine, and GFR
B. Potassium levels
C. Blood pressure
D. Daily weights
E. Input & output
A, B, C, D, E
Rationale: All of these! Since diuretics alter the fluid balance in the body, the nurse must monitor the patients daily weights and input and output. Diuretics can lead to hypotension as they cause fluid to leave the body. The kidney lab levels should be monitored for any patient taking a diuretic. Loop diuretics can lead to hypokalemia, while potassium-sparing diuretics can cause hyperkalemia.
A patient with deep vein thrombosis (DVT) asks why anticoagulants are being prescribed. The nurse's response should be based on which of the following principles?
A. Anticoagulants are given to dissolve the clot.
B. Anticoagulants are given to prevent the formation of new clots.
C. Anticoagulants help increase blood flow to the affected area.
D. Anticoagulants are used to reduce the inflammation around the clot.
B. Anticoagulants are given to prevent the formation of new clots.
Rationale: Anticoagulants do not dissolve existing clots, but rather prevent the formation of new clots and the extension of existing clots. Thrombolytics are the drugs used to dissolve existing clots.
A nurse is educating a patient who has been prescribed aspirin for pain relief. The nurse should inform the patient which of the following food supplements or vitamins should they avoid?
A. Vitamin C
B. Vitamin E
C. Calcium
D. Magnesium
B. Vitamin E
Rationale: Vitamin E is known to increase the risk of bleeding when taken with aspirin because it has anticoagulant properties. Patients should be educated to avoid taking vitamin E in high doses while on aspirin therapy. Other supplements, such as garlic and ginkgo, can also increase bleeding risk.
A nurse is caring for a patient taking Digoxin. Which of the following statements made by the patient indicates the need for further teaching?
A. “I should not take this drug if my heart rate falls below 60.”
B. “I should immediately report any changes in my vision to the nurse such as any (yellow/green or white halos.”
C. “It is okay if I take this drug at different times each day.”
D. “This drug has a very narrow therapeutic range so it can accumulate in my body quickly.”
C. “It is okay if I take this drug at different times each day.”
Rationale: Since this drug has a very narrow therapeutic range, it should be taken at the same time every day.
A nurse is teaching nursing students about different medications used for high blood pressure. Which of the following would indicate that further teaching is needed?
A. “Labetalol can decrease the HR”
B. “It is okay to consume grapefruit juice while taking Diltiazem”
C. “Furosemide can lead to orthostatic hypotension”
D. “Enalapril can lead to hyperkalemia”
B. “It is okay to consume grapefruit juice while taking Diltiazem”
Rationale: Diltiazem is a calcium channel blocker. Mixing it with grapefruit juice can create toxic levels of the drug in the body.
A patient is diagnosed with Stage 1 Hypertension (HTN) with a blood pressure of 135/85 mmHg. What is the most appropriate initial intervention for this patient?
A. Start antihypertensive medications immediately.
B. Educate the patient on lifestyle modifications and repeat BP measurement in 1-2 weeks.
C. Monitor the patient closely for signs of hypertensive crisis.
D. Administer IV antihypertensive medication.
B. Educate the patient on lifestyle modifications and repeat BP measurement in 1-2 weeks.
Rationale: Stage 1 hypertension often involves non-pharmacologic interventions first, such as lifestyle modifications(diet, exercise, stress reduction, etc.). The BP should be rechecked in a few weeks to assess the effectiveness of these changes before considering medication.
A nurse is assessing a patient who has been prescribed NSAIDs for osteoarthritis. The nurse is concerned about potential nephrotoxicity and should prioritize monitoring for which of the following lab values?
A. Sodium levels
B. BUN and creatinine levels
C. Liver enzymes
D. Hemoglobin and hematocrit
B. BUN and creatinine levels
Rationale: Nephrotoxicity is a potential side effect of NSAIDs, which can lead to acute kidney injury. Monitoring BUN (blood urea nitrogen) and creatinine levels is essential to assess kidney function and detect any early signs of renal impairment.
True/ False
A patient prescribed sublingual nitroglycerin tabs for their angina should be taught to take one tablet every 15 minutes for up to 3 doses.
False
Rationale: A patient should be taught to take the tablet every 5 minutes for 3 doses. If their angina continues to persist they need to call 911.
Match the neurological disorder with its signs/symptoms:
Guillain-barre syndrome -
Myasthenia Gravis -
Parkinson’s disease -
a. weakness and drooping of the eyelids, double vision, dysphagia, muscle weakness
b.tremors, rigidity, akinesia, bradykinesia, and postural changes
c. progressive ascending muscle weakness of the limbs, paresthesias, numbness, and facial flushing
Guillain-barre syndrome - c
Myasthenia Gravis - a
Parkinson’s disease - b
Rationale: Myasthenia gravis = mind to ground; guillan-barre = ground to brain
A 60-year-old patient with a history of hypertension has been prescribed a beta blocker for blood pressure control. What is the primary effect of beta blockers in the management of hypertension?
A. They increase heart rate and improve blood circulation.
B. Block vasoconstriction, decrease heart rate, decrease cardiac muscle contraction, and tend to increase blood flow to the kidneys, leading to a decrease in the release of renin
C. They cause vasodilation to lower blood pressure.
D. They decrease the renal absorption of sodium, which lowers blood volume and pressure.
B. Block vasoconstriction, decrease heart rate, decrease cardiac muscle contraction, and tend to increase blood flow to the kidneys, leading to a decrease in the release of renin
Rationale: Block vasoconstriction, decrease heart rate, decrease cardiac muscle contraction, and tend to increase blood flow to the kidneys, leading to a decrease in the release of renin. Beta Blockers block beta receptors in the sympathetic nervous system and are non-selective
A 4-year-old child is brought to the clinic with a viral illness. The child has a history of fever and the parent is asking if aspirin can be given to reduce the fever. Which of the following is the nurse's best response?
A. "Aspirin is safe for children and can help reduce the fever."
B. "Aspirin should be avoided in children due to the risk of Reye’s syndrome."
C. "You should give the child aspirin only if the fever is greater than 102°F."
D. "Aspirin is contraindicated only if the child has a known bleeding disorder."
B. "Aspirin should be avoided in children due to the risk of Reye’s syndrome."
Rationale: Aspirin is contraindicated in children due to the risk of Reye’s syndrome, a rare but serious condition that causes brain and liver damage. Acetaminophen or ibuprofen is recommended for managing fever in children.