NURSING2058 Health Assessment Exam 2 study guide Q & As best exam solution guaranteed succ, Exams of Nursing

Download NURSING2058 Health Assessment Exam 2 study guide Q & As best exam solution guaranteed succ and more Exams Nursing in PDF only on Docsity! BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS  A patient is discharge from the hospital on warfarin for DVT prevention. Which instructions should the nurse include in the patient’s discharge teaching plan? Select all that apply. a. Wear a medical alert bracelet b. Check all urine and stool for discoloration c. Do not start any new medication without first talking to your HCP d. Enteric-coated aspirin and any aspirin products can be used unless they cause a GI ulcer BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS Week 3/5: CARDIAC a. +2 edema of the lower extremeties  Potassium A patient is prescribed Lisinopril as part of the treatment plan for heart failure. Which finding indicates the patient is experiencing the therapeutic effect of this drug? b. level of 3.5mEq/L BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS  A patient is discharge from the hospital on warfarin for DVT prevention. Which instructions should the nurse include in the patient’s discharge teaching plan? Select all that apply. a. Wear a medical alert bracelet b. Check all urine and stool for discoloration c. Do not start any new medication without first talking to your HCP d. Enteric-coated aspirin and any aspirin products can be used unless they cause a GI ulcer BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS c. Crackles in the lungs are no longer heard d. Jugular vein distention RATIONALE: Because ACE inhibitors promote venous dilation, they provide the therapeutic effect of reducing pulmonary congestion and peripheral edema. Absence of previously heard crackles would be an indicator of effectiveness. Edema and jugular vein distention are manifestations of heart failure. A potassium level of 3.5 is a normal value.  The nurse is caring for a patient with bipolar disorder treated with lithium. The patient as a new prescription for captopril for BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS  A patient is discharge from the hospital on warfarin for DVT prevention. Which instructions should the nurse include in the patient’s discharge teaching plan? Select all that apply. a. Wear a medical alert bracelet b. Check all urine and stool for discoloration c. Do not start any new medication without first talking to your HCP d. Enteric-coated aspirin and any aspirin products can be used unless they cause a GI ulcer BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS products should be avoided (Increase effects). ING should be determined frequently  The nurse is preparing to administer a daily dose of digoxin. What is the priority nursing intervention? a. Analyze HR and rhythm b. Assess for Homan’s sign c. Check BP d. Palpate the pedal pulses BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS RATIONALE: Before giving digoxin, the nurse will assess the HR and rhythm. The dosage will be held and the prescriber notified if the HR is below 60bpm or if the cardiac rhythm has changes. Digoxin can cause bradycardia and electrical changes in the heart.  Which patient symptoms should cause the nurse to be concerned about digoxin toxicity? Select all that apply a. Fatigue b. Vomiting c. Dizziness d. Blurred vision e. Muscle Weakness RATIONALE: Fatigue, vomiting, and blurred vision are common non-cardiac symptoms that can provide advance warning of digoxin toxicity. Muscle weakness is an early sign of hypokalemia. Dizziness is not a symptom of digoxin toxicity. Week 6: Opioids  A nurse administers naloxone (Narcan) to a post-op patient BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS experiencing respiratory sedation. What undesirable effect would the nurse anticipate after giving this medication? a. Drowsiness b. Tics and tremors c. Increased Pain d. Nausea and vomiting RATIONALE: Naloxone reverses the effects of narcotics. Although patient’s respiratory status will improve after administration of naloxone, the pain will be more acute.  The nurse is teaching a patient prescribed captopril for the treatment of hypertension. Which instructions should the nurse include? Select all that apply. a. Take the medication with food b. Expect a sore throat and fever BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS a. “I will take the medication with grapefruit juice each morning.” b. “I should expect occasional loose stools from this medication” c. “I’ll need to reduce the amount of fiber in my diet” d. “I must swallow the pill whole.” RATIONALE: “SR” indicates that the drug is sustained release; therefore, the patient must swallow the pill intact, without chewing or crushing, which would result in bolus effect. Grapefruit juice should be avoided, because it can inhibit intestinal and hepatic metabolism of the drug, thereby raising the drug level. Constipation, not loose stools, is a common side effect. Increasing fluids and dietary fiber can help prevent this adverse effect. BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS  What is the most appropriate nursing consideration a patient who is prescribed verapamil and digoxin? a. Restrict intake of oral fluids and high-fiber food b. Take an apical pulse for 30 seconds before administration c. Notify the healthcare provider of nausea, vomiting, and visual changes d. Hold the medications if the heart rate is greater than 110bpm RATIONALE: Verapamil can raise digoxin blood serum levels, increasing the risk of digoxin toxicity. Symptoms of digoxin toxicity may include nausea, vomiting and visual changes. Increase intake of oral fluids and high fiber food can decrease the adverse effect of constipation. An apical pulse should be taken for a full minute prior to administering digoxin. Verapamil and Digoxin can cause bradycardia not tachycardia  A patient is prescribed Lisinopril 40mg by mouth once a day for hypertension. For which therapeutic effect will the nurse monitor? a. Slowing of the heart rate b. Decrease in blood pressure c. Symptoms such as dizziness and fainting BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS d. Pulse oximetry oxygen saturation of 100% RATIONALE: The therapeutic effect of ACE inhibitors is to reduce BP in patients with HTN. ACE inhibitors do not affect patient’s heart rate. Dizziness and fainting are all symptoms of hypotension. ACE inhibitors do not affect oxygen saturation.  A patient with angina pectoris has been prescribed nifedipine. Which possible adverse effects should the nurse expect with this medication? Select all that apply. a. Headache b. Constipation c. Nausea and vomiting d. Edema of ankle and feet e. Overgrowth of gum tissue RATIONALE: Some adverse effects of nifedipine are headache, edema of ankles and feet, and gingival hyperplasia. Nifedipine causes very little constipation. Nausea and vomiting are common side effects of clevidipine.  The nurse is teaching a patient with essential hypertension who has a new prescription for verapamil. Which statements by the patient BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS spironolactone (Aldactone). Which statement by the patient indicated that the teaching was effective? a. “I will use salt substitutes to lower my sodium intake” b. “I will increase my intake of foods that are high in potassium” c. “I will call my doctor if I begin having menstrual irregularities” d. “I will take this medication at bedtime each evening” RATIONALE: Spironolactone is a potassium-sparing, aldosterone-blocking diuretic. As such, it can cause endocrine effects, such as gynecomastia, menstrual irregularities, impotence, hirsutism, and deepening of the voice. Patients taking spironolactone should avoid salt substitutes because they contain potassium, high-potassium foods should be avoided with this drug. Ideally, all diuretics should be taken in the morning to prevent nocturia.  The nurse is reviewing the home medication list with the patient. The nurse recognizes that hydrochlorothiazide is used primarily for which condition? a. Hypertension b. Edema c. Diabetes insipidus d. Protection against postmenopausal osteoporosis BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS RATIONALE: The primary indication for hydrochlorothiazide is HTN, a condition for which thiazides are often the drugs of first choice. Hydrochlorothiazides are used for the other conditions, but primarily HTN.  The nurse is caring for a patient who takes warfarin for prevention of deep vein thrombosis. The patient as an INR of 1.2. Which action by the nurse is most appropriate? BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS a. Administer IV push protamine sulfate b. Continue with current prescription. c. Prepare to administer Vitamin K d. Call HCP to increase the dose RATIONALE: An INR in the range of 2-3 is considered the level for warfarin therapy. For a level of 1.2, the nurse should contact the HCP to discuss an order for an increased dose.  The nurse is monitoring a patient receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding most likely related to an adverse effect of heparin? a. HR of 60bpm b. BP of 160/88 c. Discoloured urine d. Inspiratory wheezing RATIONALE: The primary and most serious adverse effect of heparin is bleeding. Bleeding can occur from any site and may be manifested in various ways, including reduced BP, increased HR, bruises, petechiae, hematomas, red/black stools, cloudy or discoloured urine, pelvic pain, headache and lumbar pain.  What is the goal of pharmacologic therapy in the treatment of BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS anaphylactic reaction c. Tell the parent that a live vaccine will cause a mild case of measles BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS d. Obtain and fill out a Vaccine Adverse Event Report form RATIONALE: Low-grade fever, malaise, and muscle-aches are common reactions. Acetaminophen usually alleviates these problems. MMR is a live vaccine but it is attenuated or completely avirulent and does not cause measles in healthy children only immunocompromised children  Which statement by an 18-year-old women vaccinated with Gardasil indicates that more teaching is necessary? a. “This vaccination will cure the HPV infection I got when I was 16” b. “I will still need to have a routine PAP screen performed.” c. “Gardasil can prevent genital warts in males and females.” d. “This drug does not protect against all types of HPV.” RATIONALE: Gardasil does not prevent against HPV infection that was present before vaccination. All other statements are true.  A nurse administers Gardasil, the HPV vaccine, to an 11-year-old girl. The nurse informs the parent that routine screening with which diagnostic test is needed? a. Beta hCG BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS b. Chlamydia test c. PAP test d. mammogram RATIONALE: Routine screening with a PAP test is still necessary, because Gardasil protects against four types of HPV which may leave those vaccinated at risk for cervical cancer from other types. Does not eliminate pre-existing HPV infection.  A nurse is educating a patient about sildenafil (Viagra). The nurse should instruct the patient that which adverse effect would be a priority for the patient to report to his prescriber? a. Flushing b. Diarrhea c. Hearing loss d. Dyspepsia RATIONALE: In rare cases, Viagra has caused sudden hearing loss, usually in one ear, which may be partial or complete. Medication should be discontinued if it is being used for erectile dysfunction. All other options are less serious adverse effects  A patient is taking sildenafil (Viagra) asks a nurse what action to take if BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS c. Methyprednisolone (Solu-Medrol d. Protamine Sulfate RATIONALE: Naloxone is a narcotic antagonist that can reverse the effects, both adverse and therapeutic, of opioid narcotic analgesics.  The nurse is teaching a patient with cancer about a new prescription for a fentanyl patch, 25mcg/hr. for chronic back pain. Which statement is the most appropriate to include in the teaching plan. a. “You will need to change this patch every day, regardless of your pain level.” b. “This type of pain medication is not as likely to cause breathing problems.” c. “With the first patch, it will take about 24hrs before you feel the full effects.” BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS d. “Use your heating pad for the back pain. It will also improve the patch’s effectiveness.” RATIONALE: Full analgesic effects can take up to 24 hours to develop with fentanyl patches. Most patches are changed every 72 hours. Has the same adverse effects as other opioids, including respiratory depression. Should avoid exposing the patch to external heat sources, because this may increase toxicity  Which agent is most likely to cause serious respiratory depression as a potential adverse reaction? a. Morphine b. Pentazocine c. Hydrocodone d. Nalmefene RATIONALE: Morphine is a strong opioid agonist and as such has the highest likelihood of causing respiratory depression. Pentazocine, a partial agonist, and hydrocodone, a moderate to strong agonist, may cause respiratory depression, but they do not do so as often or as seriously as morphine. Nalmefene, an opioid antagonist, would be used to reverse respiratory depression with opioids. BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS  The nurse is planning care for a patient receiving morphine sulfate by means of a patient controlled analgesia pump. Which intervention may be required because of a potential adverse effect of this drug? a. Administering a cough suppressant b. Inserting a Foley catheter c. Administering an anti-diarrheal d. Monitoring LFTs RATIONALE: Morphine can cause urinary hesitancy and urinary retention. If bladder distention or inability to void is noted, the prescriber should be notified. Urinary catheterization may be required. Morphine acts as a cough suppressant and an anti-diarrheal, so neither of those types of drugs would be needed to counteract an adverse effect of morphine. Liver toxicity is not a common adverse effect of morphine. Week 7: Glucocorticoids and Antihistamines  A patient takes glucocorticoids and digoxin. It is most important for the nurse to monitor which electrolyte? a. Calcium b. Magnesium c. Sodium BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS d. Hyperkalemia e. Cataracts RATIONALE: Adverse effects of long-term glucocorticoid therapy include adrenal insufficiency, osteoporosis, hyperglycemia, hypokalemia and cataracts  The nurse should question an order for glucocorticoids in the treatment of a patient with what? a. Systemic fungal infection b. Diabetes Mellitus c. Myasthenia Gravis d. Glaucoma RATIONALE: Glucocorticoids are contraindicated in the treatment of a patient with systemic fungal infection or in patients receiving live vaccines. Should be used with caution in patients with DM, myasthenia gravis and glaucoma.  A patient is receiving glucocorticoids for the treatment of rheumatoid arthritis. The patient complains of having a headache. Which ordered medication should the nurse administer? a. Aspirin BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS b. Acetaminophen c. Ibuprofen d. Naproxen Sodium (Aleve) RATIONALE: The risk of GI irritation and ulceration for a patient taking glucocorticoids is increased by concurrent use of other medications, such as aspirin and NSAIDs  A patient is taking a first-generation H1 blocker for the treatment of allergic rhinitis. It is most important for the nurse to assess for which adverse effect? a. Skin flushing b. Wheezing c. Insomnia d. Dry mouth RATIONALE: Adverse Effect of Histamine – First Generation H  A patient develops hypotension, laryngeal edema, and bronchospasm after eating peanuts. Which medication should the nurse prepare to administer? a. Promethazine BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS b. Epinephrine c. Diphenhydramine d. Hydroxyzine RATIONALE: The patient is showing signs of anaphylaxis caused by a peanut allergy Week 8: OTC, Antacids, PPI, L-Dopa, Immunizations, MMR, HPV  A nurse assesses a male patient who has developed gynecomastia while receiving treatment for peptic ulcers. Which medication from the patient’s history should the nurse recognize as a contributing factor? a. Amoxicillin (Amoxil) b. Cimetidine (Tagamet) c. Metronidazole (Flagyl) d. Omeprazole (Prilosec) RATIONALE: Cimetidine binds to androgen receptors, producing receptor blockade, which can cause enlarged breast tissue, reduced libido, and impotence. All these effects reverse when dosing stops. Amoxicillin, metronidazole, and omeprazole are not associated with gynecomastia. BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS Which question is the most important for that nurse to ask? a. “Have you noticed any swelling in your feet?” b. “Are you having vivid dreams or hallucination?” c. “Have you noticed any changes in your stool?” BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS d. “Have you had your flu vaccine?” RATIONALE: Patients taking levodopa/carbidopa (Sinemet) are at increased risk for the psychiatric side effects of levodopa, including visual hallucinations, vivid dreams, nightmares, and paranoid ideation. The other questions are not directly related to problems that are likely to occur with this drug. BIOL3080 NCLEX STYLE PRACTICE QUESTIONS ANSWERS NCLEX STYLE PRACTICE QUESTIONS FOR PHARM EXAM WEEKS 3-8- ANSWERS