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1. The nurseis caring for a patient on an intravenous heparin infusion. Which action ismost
appropriate in the care of this patient?
1. The nursereports which laboratory result as indicating an adverse reaction to heparin
1. Which ofthe patients listed below would be excluded from thrombolytic therapy? (Pickone )
1. In which instance does thenurse demonstrate appropriate technique when administering subcutaneous heparin?
1. The nurseevaluates heparin therapy as therapeutic when the PTT/aPTT is:
1. Which drugdoes the nurse keep on hand to stop bleeding associated with a heparin
1. Which teaching points doesthe nurse include for the patient prescribed warfarin (Coumadin) therapy?(Pick all that apply)
1. The nurse is administeringenoxaparin (Lovenox). Which action indicates the nurse is administering this medication in the correct manner?
1. Prior to administration,which medication does the nurse seek a second nurse to check that the correctdose has been prepared?
1. A nurse is administeringfresh frozen plasma to a patient. Which patient response is most expectedfollowing the transfusion? (Pick two two )
1. A nurse is providingteaching for the patient prescribed warfarin therapy. Which lifestyle habit does the nurse discourage while taking this drug?
1. The nurse demonstrates correct administration of intravenous furosemide (Lasix) when:
Administer at a rate not to exceed 4 mg/min (for doses > 120 mg) in adults to prevent ototoxicity.- n0 later than 5 pm
dilute in dextrose 5% water
may be given over 1-2 minutes for rapid insertion
1. A patient’s lab results indicate a low serum magnesium level. Which patient manifestation does thenurse interpret as most consistent with hypomagnesemia?
1. A patient’s serum potassiumlevel is 6.4mg/dL. Which medication does the nurse hold and contact thephysician prior to administration?
1. The patient is prescribedmannitol (Osmitrol). Which statement below concerning this medication is true?
• Active intracranial bleeding
1. To promote safe nursing care, which labvalue does the nurse check prior to the administration of intravenous furosemide (Lasix)?
Monitor electrolytes, renal and hepatic function, serum glucose, and uric acid levels before and periodically throughout therapy. Commonly ↓ serum potassium. May cause ↓ serum sodium, calcium, and magnesium concentrations. May also cause ↑ BUN, serum glucose, creatinine, and uric acid levels
1. A patient is admittedt hrough the emergency department with sudden onset of shortness of breath and adiagnosis of acute pulmonary edema. The nurse anticipates the physician willorder:
1. Which evaluative finding by the nurse is most indicative of effective diuretic therapy?
1. Whichevaluative finding indicates an adverse reaction to diuretic therapy?
1. A nurse working in the acute care setting is caring for a patient prescribed a loop diuretic. The nurse is providing appropriate care when:
1. Which statement is true regarding the administration of intravenous potassium by the nurse?
1. a patient is taking a large dose of oral thiazide on a daily basis. The nurse monitors for thedevelopment of:
Monitor blood pressure, intake, output, and daily weight and assess feet, legs, and sacral area for edema daily
» Assess patient, especially if taking digoxin, for anorexia, nausea, vomiting, muscle cramps, paresthesia, and confusion. Notify health care professional if these signs of electrolyte imbalance occur. Patients taking digitalis glycosides are at risk of digitalis toxicity because of the potassium-depleting effect of the diuretic
1. Which patient variable doesthe nurse assess as a contraindication to the administration of intravenousfurosemide (Lasix)?
1. Which teaching point doesthe nurse include when administering a histamine 2 blocker? This drug will:
Promotes intestinal adsorption of fluids and electrolytes and supresses the volume of acidity in parietal cell secretions
• Decreases synthesis of intestinal prostaglandins
1. A patienthas been prescribed omeprazole (Prilosec). Which information in this patient’shistory is most likely the reason for this prescription?
Gerd or pud-
Liver disease (dose ↓ may be necessary)
• OB: Lactation: Pedi: Safety not established in pregnant or breastfeeding women, or children <1 yr
• Patients using high-doses for >1 year (↑ risk of hip, wrist, or spine fractures)
1. A patient is prescribedaluminum hydroxide and magnesium hydroxide (Maalox) 10ml tid. Which teachingpoint does the nurse include for this patient? Take this medication:
drug is most affective at bedtime
one hour before eating
Use Cautiously in:
• Antacids containing magnesium in patients with any degree of renal insufficiency
1. A patient is admitted withnewly diagnosed renal failure. Which over the counter medication used at homeby this patient does the nurse recognize as typically contraindicated in thispatient’s care?
1. The nurse is administeringlactulose (Cephulac) to a patient four times a day. The patient is notconstipated. What other therapeutic use does the nurse recognize as anindication for this drug?
Decreased blood ammonia levels with improved mental status in PSE- alcoholics with alot of ammonia(liver)
1. A patient is prescribedpancrelipase (Pancrease). Which teaching point provided by the nurse to thepatient is most appropriate?
abdominal pain, distention, vomiting, constipatio
1. A patientis taking sucralfate (Carafate). The nurse recognizes which statement as trueregarding the administration of this medication?
Administer on an empty stomach, 1 hr before meals and at bedtime. Tablet may be broken or dissolved in water before ingestion. Shake suspension well before administration
1. A patient complains offrequent loose stools. The nurse checks the medication profile for which of thefollowing prn medications to treat this patient’s diarrhea?
1. A father asks why his sonis given charcoal following a drug overdose. The nurse explains that thismedication:
Decreased intestinal absorption of drugs or chemicals in the overdose situation
1. A patient is prescribed astimulant laxative. As a general contraindication to laxative use, whichpatient variable suggests the nurse should question the use of this drug?
• Abdominal pain, nausea, or vomiting, especially when associated with fever or other signs of an acute abdomen
• Concomitant use of mineral oilUse Cautiously in:
Assess for abdominal distention, presence of bowel sounds, and usual pattern of bowel function
• Assess color, consistency, and amount of stool produced
1. patient is taking metoclopramide(Reglan). The nurse most closely monitors for which adverse effect associatedwith this drug?
CNS: drowsiness, extrapyramidal reactions, restlessness, NEUROLEPTIC MALIGNANT SYNDROME, anxiety, depression, irritability, tardive dyskinesia.
CV: arrhythmias (supraventricular tachycardia, bradycardia), hypertension, hypotension.
GI: constipation, diarrhea, dry mouth, nausea.
Hemat: methemoglobinemia, neutropenia, leukopenia, agranulocytosis.
1. A patient is admitted witha deep vein thrombosis (DVT) and has a history of hyperemesis. Which medicationis not consistent with this patient’s history or admitting diagnosis andprompts further investigation by the nurse?
1. A patient is taking a HMG-CoA reductase inhibitor (statin drug). Whichpatient outcome most suggests drug efficacy for this patient? Pick two (2).
• Decrease in LDL and total cholesterol levels
» Increase in HDL cholesterol levels
» Decrease in triglyceride levels
• Slowing of the progression of coronary artery disease
1. Before administeringdigoxin (Lanoxin), an appropriate nursing action is checking:
Monitor apical pulse for 1 full min before administering. Withhold dose and notify physician if pulse rate is <60 bpm in an adult, <70 bpm in a child, or <90 bpm in an infant. Also notify health care professional promptly of any significant changes in rate, rhythm, or quality of pulse
1. Whichassessment finding(s) alerts the nurse that the patient receiving digoxin(Lanoxin) may be experiencing an adverse drug reaction? (Pick two )
CNS: fatigue, headache, weakness.
EENT: blurred vision, yellow or green vision.- halos
CV: ARRHYTHMIAS, bradycardia, ECG changes, AV block, SA block.
GI: anorexia, nausea, vomiting, diarrhea.
Metabolic: electrolyte imbalances with acute digoxin toxicity.
1. In which situation wouldthe nurse hold the morning digoxin (Lanoxin) and call the physician?
1. The physician prescribes 1mg of digoxin (Lanoxin)to be given in divided doses over 24 hours. The nurse:
1. The nurse cautions the patient taking captopril (Capoten) to:
-Ca channel blockers, no to BP meds, caution patient to change positions slowly
• Patients with collagen vascular disease, renal impairment, hypovolemia, hyponatremia, and concurrent diuretic therapy
• Surgery/anesthesia (hypotension may be exaggerated)
1. A patientis admitted with congestive heart failure. To increase myocardialcontractility, the
nurseanticipates the physician may order:
1. A patient is receivingdiltiazem (Cardizem) to regulate heart rate. In addition to heart rate, thenurse would check:
1. The nurserecognizes which adverse reaction as a common concern for any patient on an
antiarrhtyhmic or dysrhythmicagent?
1. A nurse is administeringsublingual nitroglycerin to a patient for chest pain. Which action indicatesthe nurse is administering the medication in the correct manner? (Pick two )
1. A patient’s heart rate is30 beats per minute and the patient is lightheaded and confused. Which actionby the nurse is most appropriate to treat this patient’s condition?
1. A patient has beenprescribed lovastatin (Mevacor). Which patient variable alerts the nurse to discuss this medication order withthe physician prior to administration?
History of liver disease
• Renal impairment
• Concurrent use of gemfibrozil, azole antifungals, protease inhibitors, niacin, cyclosporine, amiodarone or verapamil (higher risk of myopathy/rhabdomyolysis)
1. Aphysician prescribes a patient nitroglycerin by transdermal patch. Whichfollow-up question by the nurse is appropriate?
1. A nurse is administering metoprolol XL (Toprol) to a patient. Which actions by the nurse show attention to safe and effective care? (Pick two )
• Monitor vital signs and ECG every 5–15 min during and for several hours after parenteral administration. If heart rate <40 bpm, especially if cardiac output is also decreased, administer atropine 0.25–0.5 mg IV
• Monitor intake and output ratios and daily weights. Assess routinely for signs and symptoms of CHF (dyspnea, rales/crackles, weight gain, peripheral edema, jugular venous distention)
1. Which statements are true concerning baroreceptors? (Pick two ) They are:
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