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    Exam Review

    1. When administering zolpidem to an older adult client, which computer documentation indicates that the desired outcome has been achieved?
      A)Exhibits fewer emotional outbursts.
      B)Decreased episodes of incontinence.
      C)Improved ability to concentrate.
      D)Sleeps soundly through the night.
    2. A male client is admitted for observation because he is reporting progressively increasing fatigue over the past month and a brief episode of dizziness that occurred today. He has a history of heartburn and indigestion that the self treats with ibuprofen and antacids. Which assessment finding should the nurse report immediately to the healthcare provider (HCP)?Reference Ranges:Hemoglobin [14 to 18 g/dL (140 to 180 g/L)]Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)]Gastric pH (1.5 to 3.5]
      A)Positive guaiac of stool.
      B)Hemoglobin 13 g/dL (130 g/L).
      C)Hematocrit 42% (0.42 volume fraction).
      D)Gastric pH 2.
    3. Patient Data Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.
      ✓Take a set of baseline vital signs
      ✓Place the client on a cardiorespiratory monitor
      ✓Tachydysrhythmia
      ✓Breath sounds
      ✓Heart rate and rhythm
      Action to take
      ✕Administer diphenhydramine
      ✕Give a dose of albuterol
      ✓Take a set of baseline vital signs
      ✓Place the client on a cardiorespiratory monitor
      ✕Draw blood for a complete blood count
      Potential Condition
      ✕Methemoglobinemia
      ✕Anemia
      ✕Anaphylaxis
      ✓Tachydysrhythmia
      Parameters to Monitor
      ✕Methemoglobin level
      ✕Iron level
      ✓Breath sounds
      ✕Airway edema
      ✓Heart rate and rhythm
    4. A client who is a vegetarian has a new prescription for warfarin. The client reports eating green leafy vegetables every day. How should the nurse respond?
      A)Advise the client that the healthcare provider (HCP) needs to be made aware of the current diet.
      B)Suggest that the client replace the leafy vegetables with a protein source such as nuts or beans.
      C)Confirm that the clients diet choices will help the medication be more effective in preventing blood clots.
      D)Commend the client for a healthy lifestyle and encourage the client to continue current diet habits.
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    Exam Review

    1. The nurse is reviewing the laboratory results of a client who reports taking five times the recommended daily allowance of vitamins and minerals in a multivitamin form. Which finding indicates a possible vitamin D overdose?Reference Range:Bilirubin (0.3 to 1 mg/dL (5.1 to 17 μmol/L)]Calcium [9 to 10.5 mg/dL (2.3 to 2.6 mmol/L)] Sodium [136 to 145 mEq/L (136 to 145 mmol/L)] Blood Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]
      A)Total bilirubin 4 mg/dL (68.4 μmol/L).
      B)Total calcium level 12 mEq/L (3 mmol/L).
      C)Sodium level 140 mEq/L (140 mmol/L).
      D)Serum glucose 170 mg/dL (9.4 mmol/L).
    2. A client with chronic asthma receives a prescription for montelukast, a leukotriene modifier. Which statement by the client indicates to the nurse that medication teaching was effective?
      A)"I should take this medication only when I am having an asthma attack."
      B)"This medication will stop an asthma attack immediately."
      C)"I will take the tablet every evening to control my asthma."
      D)"I will not need to use my inhalers twice a day when I start this medicine."
    3. A client with generalized anxiety disorder (GAD) receives a new prescription for lorazepam. Which statement provided by the client requires additional instruction by the nurse?
      A)Use relaxation techniques to reduce excessive anxiety.
      B)Avoid alcohol and other sedatives while taking the medication.
      C)Move slowly from a sitting position to a standing position.
      D)Stop taking the medication if intended effect is not immediate.
    4. A client who had a kidney transplant last week is receiving cyclosporine. This morning the client reports experiencing a headache and blurred vision. Based on which assessment finding should the nurse withhold the medication until the healthcare provider (HCP) is notified?
      A)Temperature of 100.8° F (38.2° C).
      B)Elevated blood urea nitrogen (BUN).
      C)Renal output of 120 mL/hour.
      D)Blood pressure 180/98 mm Hg.
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    Exam Review

    1. The nurse is administering sucralfate to a client with stomatitis secondary to chemotherapy. The client wants to take the medication after breakfast. How should the nurse respond?
      A)Document the client's refusal of the medication at this time.
      B)Explain the need to take the medication at least 1 hour before meals.
      C)Allow the client to take the medication up to 1 hour after breakfast.
      D)Instruct the client to take it when the meal tray is delivered.
    2. A client with a cold is taking an antitussive medication. Which assessment information indicates to the nurse that the medication is effective?
      A)Expectorating bronchial secretions.
      B)Reports reduced nasal discharge.
      C)Able to sleep through the night.
      D)Denies having coughing spells.
    3. Prior to administration of the initial dose of the gastrointestinal (GI) agent misoprostol, which information should the nurse obtain from the client?
      A)History of glaucoma.
      B)Taking an antiemetic medication.
      C)Currently pregnant.
      D)D Allergy to aspirin.
    4. The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?
      A)Consult with a pharmacist about scheduling the dose one hour after the client eats.
      B)Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low fat milk.
      C)Withhold the medication until the client's breakfast tray is available on the unit.
      D)Instruct the client that it is necessary to take nothing but water with the medication.
    Page 3 of 5

    Exam Review

    1. Patient Data Exhibits The nurse is preparing the client's plan of care (POC). Select 4 findings that would indicate to the nurse that the administration of the vancomycin antibiotic would be safe to administer.(SATA)
      A)No known allergies
      B)Used for prophylaxis
      C)Potassium 4.4 mEq/L (4.4 mmol/L)
      D)Dosage in safe range
      E)Peripheral IV (PIV) in large vein
      F)Blood urea nitrogen 17 mg/dL (6.07 mmol/L)
    2. Patient Data Exhibits The nurse is assessing the client to update the plan of care (POC). Choose the most likely options for the information missing from the statement by selecting from the lists of options provided. The nurse determines that the client's is experiencing ▾ Adverse drug reaction and the blood pressure changes are the result of ▾ Need for IV fluids.
      Dropdown 1:
      Option 1: Adverse drug reaction
      Option 2: Medication side effects
      Option 3: Autonomic dysregulation
      Option 4: Fluid overload
      Dropdown 2:
      Option 1: Hypovolemia
      Option 2: Dehydration
      Option 3: Need for IV fluids
      Option 4: Cardiac arrhythmia
    3. When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. Which action should the nurse take?
      A)Administer an oral analgesic and evaluate its effectiveness before applying the new patch.
      B)Apply the new patch in a different location after removing the original patch.
      C)Place the patch on the client's shoulder and leave both patches in place for 12 hours.
      D)Remove the patch and consult with the healthcare provider (HCP) about the client's pain resolution.
    4. The healthcare provider (HCP) prescribes pantoprazole for a client who experienced partial and full thickness burns. The client is questioning the nurse if this medication is necessary. Which action(s) should the nurse implement? Select all that apply.(SATA)
      A)May stop taking medication if no symptoms of GI discomfort.
      B)Explain that pantoprazole may be taken with or without food.
      C)Teach the client about risk of developing a Curling's ulcer.
      D)Discuss the risk of gastric bleeding related to severe burns.
      E)Tell how pantoprazole effectively heals ulcers.
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    Exam Review

    1. Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?Reference Range:Calcium [8.5 to 10.5 mg/dL (2.25 to 2.75 mmol/L]
      A)Hold both medications until contacting the healthcare provider (HCP).
      B)Hold the calcitriol, but administer the calcium carbonate as scheduled.
      C)Hold the calcium carbonate, but administer the calcitriol as scheduled.
      D)Administer both prescribed medications as scheduled.
    2. Which client's laboratory value should the nurse review prior to administering the initial dose of a statin medication?
      A)Serum liver enzymes.
      B)Serum electrolytes.
      C)Complete blood count.
      D)Capillary blood glucose.
    3. Patient Data Exhibits Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided. According to the information gathered in the nurse's assessment, the nurse should prepare to give the client ▾ Insulin lispro and ▾ A bolus of IV fluids
      Dropdown 1:
      Option 1: Oral carbohydrates
      Option 2: Insulin lispro
      Option 3: Insulin glargine
      Option 4: Start continuous insulin infusion
      Dropdown 2:
      Option 1: A bolus of IV fluids
      Option 2: Glucagon injection
      Option 3: IV dextrose (D50)
      Option 4: Hold scheduled insulin dose
    4. Patient Data Exhibits The nurse prepares to give 2 units of insulin lispro. Which should the nurse double check with a second nurse? Select all that apply.(SATA)
      A)The site for the insulin administration
      B)The insulin vial for color and clarity
      C)The dose of insulin drawn up in the syringe
      D)The insulin concentration
      E)The expiration date on the insulin vial
      F)The sliding scale insulin lispro prescription
      G)The history and physical with the diabetes diagnosis listed
      H)The type of insulin to be administered
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