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A client diagnosed with oral candidiasis has received instructions from the nurse about the use of nystatin (Mycostatin) suspension. Which of the following statements made by the client should indicate to the nurse that the teaching has been effective? - ans"I will hold the medication in my mouth for as long as possible." A client is taking ibuprofen (Advil, Motrin) to treat hip pain. The nurse should teach the client that, to minimize gastric mucosal irritation, she should take this medication at which of the following times? - ansImmediately after a meal A client tells the nurse she took a dose of dimenhydrinate (Dramamine) before coming to the health care clinic. The nurse determines that the medication is effective when the client reports relief of - ansnausea A client who is postoperative reports incisional pain. The surgeon has prescribed subcutaneous morphine. Before administering this medication, the nurse should complete which priority assessment? - ansRespiratory rate A female client who has rheumatoid arthritis asks the nurse if it is safe for her to take aspirin. Which of the following is a contraindication to this medication? - ansHistory of gastric ulcers. A home health nurse is reviewing the medication list of an older adult client who reports falling a couple of times over the past week. Which of the following medications should the nurse suspect is contributing to the client's falls? - ansAlprazolam (Xanax) A hospice nurse makes weekly visits to a client who has terminal cancer. For several weeks, the client has been taking morphine sulfate for pain relief. At today's visit, the client reports to the nurse that the usual dose of morphine does not seem to be working. The nurse should understand that the most likely explanation is that the client has - ansdeveloped a tolerance to the medication. A nurse is administering ipratropium bromide (Atrovent) via nebulizer to a client who has emphysema. Which of the following client findings should cause the nurse to consult the provider before administering the next dose? - ansVisual changes A nurse is caring for a child in status asthmaticus. Which of the following is the priority action for the nurse to take? - ansAdminister a short-acting ß2 -agonist. A nurse is caring for a client treated with intermittent IV vancomycin (Vancocin). The client reports pain at the IV site when the nurse starts the infusion. Which of the
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following nursing actions is appropriate at this time? - ansAssess the patency of the IV site. A nurse is caring for a client who asks how albuterol (Proventil) helps his breathing. Which of the following should the nurse include in the response? (Select all that apply.)
- ans- The medication will prevent wheezing
- The medication will open the airways.
- The medication will decrease coughing episodes. A nurse is caring for a client who has a prescription for diphenhydramine (Benadryl) to relieve pruritus. The client asks the nurse how he can minimize the daytime sedation he is experiencing. Which of the following is an appropriate response by the nurse? - ans"Take most of the daily dose at bedtime." A nurse is caring for a client who has anemia and has difficulty swallowing pills. The client's provider has prescribed a liquid oral iron supplement. The client should be instructed by the nurse to take the iron - answith orange juice to enhance absorption. A nurse is caring for a client who has been on levothyroxine (Synthroid) for several months. If the dose of this medication has been adequate, the nurse should expect to see a decrease in the - ansthyroid stimulating hormone (TSH). A nurse is caring for a client who has difficulty swallowing medications and is prescribed aspirin (Ecotrin) PO once daily. The client asks if the medication can be crushed to make it easier to swallow. The nurse's response should be, "Crushing the pill - ansmight cause you to have a stomachache or indigestion." A nurse is caring for a client who has poison ivy and dermatitis and is started on diphenhydramine (Benadryl). Which of the following nursing recommendations is appropriate for decreasing the dry mouth associated with the use of diphenhydramine? - ans"Chew on sugarless gum or suck on hard, sour candies." A nurse is caring for a client who has several environmental allergies and was admitted in status asthmaticus. The provider prescribes cromolyn sodium (Intal) via metered dose inhaler (MDI) to be added to the client's home management along with an albuterol (Proventil) MDI. When performing discharge teaching, the nurse should identify the need for additional teaching when the client states, - ans"I will be sure to take the Intal four times a day before using the Proventil."
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A nurse is developing home instructions for a client who is prescribed phenytoin (Dilantin) via the tube. Which of the following should the nurse include in the instructions? - ansAlcohol increases the chance of phenytoin toxicity. A nurse is giving discharge instructions to a client who has asthma and is about to start taking theophylline (Theo-24). The nurse should tell the client that this medication might cause which of the following adverse effects? - ansTachycardia A nurse is instructing a hospitalized client who has asthma about how to use an albuterol (Proventil) inhaler. The nurse should recognize that the client understands how to use the inhaler when the client demonstrates by - ansholding a breath for 10 seconds after inhaling the medication. A nurse is monitoring a client's IV site. Which of the following findings are associated with phlebitis and should be reported to the RN? (Select all that apply.) - ans- Erythema
- Throbbing
- Warmth at insertion site
- Streak formation A nurse is preparing a medication and is converting 0.8 grams to milligrams. The nurse should do which of the following? - ansMove the decimal point 3 places to the right. A nurse is preparing an injection using a single dose glass ampule. Which of the following techniques should the nurse use when opening the glass ampule? - ansTap the top of the ampule, place a gauze pad or unwrapped alcohol swab around the ampule neck, and break off the top with a forward motion away from the hands. A nurse is preparing to administer a bisacodyl (Dulcolax) 10 mg suppository. Which of the following are correct administration guidelines for the nurse to implement? (Select all that apply.) - ans- Lubricate index finger
- Insert suppository just beyond internal sphincter A nurse is preparing to administer an intramuscular (IM) dose of meperidine (Demerol) to a client, which of the following is the priority for the nurse to take? - ansRespiratory rate A nurse is preparing to administer hydrocodone/acetaminophen (Lortab) 5 mg. It is available in 7.5 mg/500 mg/15 mL elixir. How many mL should the nurse administer? (Round the answer to the nearest whole number.) - ans10 mL
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A nurse is preparing to administer potassium chloride (KCL). The nurse reviews the client's serum potassium level results and discovers the client's potassium level is 5. mEq/L. Which of the following actions should the nurse take? - ansCall the prescribing physician and inform her of the client's serum potassium level results. A nurse is preparing to use the Z-track technique to administer a medication to a client. Which of the following is an appropriate action during this procedure? - ansAspirate for 5 to 10 seconds. A nurse is providing teaching to a client who has hypothyroidism and has a new prescription for levothyroxine (Synthroid). The nurse should instruct the client to avoid which of the following herbal supplements? - ansSoy isoflavones A nurse is reinforcing the controlled substance guidelines with a newly licensed nurse. Which of the following should the nurse include in the teaching? (Select all that apply.) - ans- Count each dose of narcotics in inventory.
- Match number of available doses to record.
- Sign acceptance of narcotic count if correct. A nurse is reviewing a client's admission record. The nurse notes that there are prescriptions for several medications. Which of the following factors should the nurse recognize is of primary consideration when determining the schedule of administration?
- ansSpecific characteristics of the medications A nurse is reviewing medications for a client who has a diagnosis of a small bowel obstruction. The nurse should withhold senna (Senoket) prescribed orally based on understanding of which of the following? - ansLaxatives are contraindicated in clients who have a small bowel obstruction. A nurse is talking with a client about how to use montelukast (Singulair) to treat asthma. Which of the following client statements should indicate that the client understood the nurse's instructions? - ans"I'll take this medication once a day in the evening." A nurse is talking with a client about taking an expectorant to treat a cough. The nurse should explain that this type of medication treats coughs because of which of the following actions? - ansStimulates secretions A nurse is talking with a client about taking diphenhydramine (Benadryl). The nurse should explain that the most common side effect of this medication is - anssedation
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a community nurse is instructing a group of high school students about the transmission of hep A, what following modes of transmission should the nurse include in the teaching
- ansfecal oral a county public health nurse is developing a list of interventions to address the 3 core functions of public health, what interventions should the nurse include as a part of the assurance function - ansorganize an immunization clinic for at-risk members of the community a forensic nurse is using the epidemiological triangle to explain factors that predispose an individual to violent behavior which of the following factors should the nurse identify as an environmental factor in the epidemiological triangle - anscrowded living conditions a home health nurse is providing teaching to a family of a client who has seizure manifestations as a result of an inoperable brain tumor. what interventions should the nurse include in the teaching? - anspad the side rails of the bed a home health nurse is providing teaching to a pt who has a new diagnosis of a gastric ulcer and a new prescription for sucralfate oral suspension, what statements by the pt should the nurse identify as a understanding of the teaching - ansi will take this medicine 1 hour before meals and at bedtime a home health nurse is teaching about CPT treatments with a pt who has COPD, what client statements should the nurse identify as an indication that the teaching has been understood - ansCPT treatments will decrease my respiratory infections a hospice nurse is providing teaching to a pt who has a new diagnosis of a terminal illness and her family. which statement should the nurse include in the teaching? - anshospice care continues to help families with grief after a death occurs a newly licensed nurse is giving a change of shift report using ISBAR to an oncoming nurse. which of the following statements by the newly licensed nurse should be included in the intro portion of the report - ansthe pt is a 45 year old male admitted 8 hours ago a newly licensed nurse tells a charge nurse he is unsure about accepting telephone med prescriptions. which of the following providers should the charge nurse identify as having the legal ability to give telephone medication prescriptions - ansanesthesiologists physician assistants nurse practitioners
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a nurse enters a pts room and finds the client pulseless, the living will requests no resuscitation be performed, but the provider has not written the prescription. what actions should the nurse take - ansbegin CPR a nurse in a clinic is caring for a pt who has UTI, what prescription should the nurse verify with a provider - ansoxybutynin a nurse in an ED is preparing change of shift report for an older adult pt transffering to the med surg unit using SBAR communication tool, what info should the nurse include in the report - ansthe pt has a DNR prescription the pt has continuous IV of LR the pt was straight cathed for 350mL 2 hours ago a nurse is caring for a newborn in the nursery following a circumcision, the newborn's grandparent, who does not have an identification bracelet, requests to take the newborn to his mother's room, what actions should the nurse take - ansrespectfully deny the grandparents request a nurse is caring for a pt and realizes she administered the wrong medication, what actions should the nurse take first - anscheck the condition of the pt a nurse is caring for a pt who has an ethical conflict about the care she is receiving, what resources should the nurse consult about resolving the dilemma - anshospital ethics committee a nurse is caring for a pt who has been in a motor vehicle crash and has a minor TBI, what findings should the nurse recognize as a complication and report to the provider - ansbradycardia vomiting drainage from the ear unequal pupils a nurse is completing an assessment of a recently widowed older adult, he states he is unable to drive and is afraid to cook on the stove, the nurse should recommend which of the following community resources - ansmeals on wheals a nurse is conducting a home visit with an older adult client, what observation should the nurse address to promote safe environment - anslow chairs without armrests
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a nurse manager is discussing EMR with a new nurse, what should the nurse to maintain client confidentiality - anslog off computer terminal before leaving change computer access passwords on a regular basis avoid accessing information about pts admitted to other units shred computer generated client worksheets after use a nurse manager is implementing a quality improvement project to to reduce the number of MRSA infections, what action should the nurse manager take first - ansconduct a chart review to evaluate precepting factors of clients who develop MRSA a nurse manager is preparing to complete staff performance appraisals. which of the following principles should the nurse manger consider when completing the appraisals - ansperformance appraisals should be written in measurable terms a nurse manager is teaching a class about proper body mechanics during a facility's annual competency event. which of the following statements by one staff member in attendance indicates the use of proper body mechanics - ansi should bend my knees when lifting objects off the floor a nurse manager is teaching a group of employees about QSEN, what statements by an employee should the nurse manager identify as quality improvement - answe should start tracking how soon pts are discharged after laparoscopic versus open surgery a nurse manager of a rural clinic is orienting a new employee on characteristics of residents in the area, what facts about rural health should the nurse manager include - ansincreased rates of chronic illness a nurse manager on the acute care unit is preparing a staff presentation about promoting cost-effective care, what strategies should the nurse plan to include in the presentation - anseducate staff about the correct use of PPE for isolation precautions a nurse on a rehab unit is creating a plan of care for a newly admitted pt who has difficulty swallowing following a stroke, what interprofessional team members should the nurse anticipate consulting the pts condition - ansSLP OT dietician a nurse working in a mobile health clinic is assessing a migrant farm worker, what finding should the nurse identify as priority - ansreport of muscle twitching and skin rash
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a parent of a child who is terminally ill tells a nurse that she wants to take her child home, what response should the nurse make - anstell me more about your desires a PH nurse is developing guidelines for management of botulism outbreak, what info should the nurse include - ansrinse skin with soap and water following exposure to the botulism toxin a school nurse is developing a teaching plan about testicular cancer for a group of adolescents. what info should the nurse include in the teaching? - ansexpect testicles to be uniform in consistency when performing a testicular self-examination a school nurse is providing care for students in an elementary education facility, what interventions by the nurse addresses the primary level of prevention - ansteach students about healthy food choices a staff nurse is challenging a shift assignment with the charge nurse, what statement made by the charge nurse is an example of smoothing to resolve conflict - ansyou have been a nurse a long time, so I'm sure you're capable of the tasks after signing a informed consent form, a client states, "i have changed my mind and do not want to have the procedure" which of the following actions should the nurse take? - ansnotify the surgeon that the client wishes to withdraw informed consent for the procedure during an initial visit, a home health nurse is assessing a pt who has different cultural beliefs than her own, what questions should the nurse ask to determine the pts beliefs about environmental control - answhat do you think you can do to affect your health status clients should avoid taking their medications with which of the following? - ansGrapefruit juice A nurse is to administer a rectal suppository to a client. The nurse should instruct the client to lie in which of the following position's while in bed? - ansSim's position A nurse observes a parent of an infant administer a prescribed oral medication. Which of the following actions by the parent indicates a need for further instruction? - ansPositions infant in a supine position A nurse who has just admitted a client to an inpatient medical unit notices that the client brought a container of ginkgo biloba with him. When the nurse asks him about it, he
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a nurse is assessing a pt who is receiving oxytocin via continuous IV infusion for labor induction, what actions is the nurse's priority - ansperform electronic fetal monitoring a nurse is caring for a newborn who has a blood glucose of 45mg/dl, what action should the nurse take - ansencourage the mother to breastfeed the newborn a nurse is caring for a newborn whose father voices concerns about his ability to bond with his baby, what action should the nurse take to facilitate bonding - anspoint out to the father that the newborn turns toward his voice encourage the father to touch and stroke the newborn's skin demonstrate diapering and swaddling techniques for the father a nurse is caring for a postpartum pt who has DVT and is receiving heparin therapy via subcutaneous injections, what action should the nurse take - ansadminister the injection in the pt's abdomen a nurse is caring for a pt at 39 weeks of gestation who is in active labor and had a positive GBS culture at 36 weeks of gestation, what action should the nurse take - ansadminister prophylactic antibiotics a nurse is caring for a pt who had a vaginal birth 2 hours ago and has soaked 2 perineal pads in the past 30 min, what action should the nurse take - ansassess the pt's uterine tone a nurse is caring for a pt who has a prescription for ibuprofen for postpartum cramping, what question should the nurse ask prior to admin - ansare you taking OTC meds do you have a history of gastric problems are you being treated for high BP a nurse is caring for a pt who has placenta previa, what interventions should the nurse implement for this pt - ansfrequently assess the maternal HR initiate bed rest with bathroom privileges have O2 equipment available a nurse is caring for a pt who is at 14 weeks of gestation and has hyperemesis gravidarum, what med should the nurse plan to administer - ansvitamin B a nurse is caring for a pt who is at 38 weeks of gestation and is experiencing continuous abdominal pain and vaginal bleeding, the pt has a history of cocaine use, the nurse should identify that the pt is likely experiencing what complication - ansabruptio placentae
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a nurse is caring for a pt who is experiencing preterm labor and has a new prescription for terbutaline, what finding is a contraindication to administration of this medication - ansheart disease a nurse is caring for a pt who is in active labor and notes early decels of the FHR on the fetal monitor tracing, the nurse should identify that which of the following conditions causes early decels in the FHR - anshead compression a nurse is caring for a pt who is in active labor and notes late decelerations in the FHR on the external fetal monitor, what actions is the nurse's priority - anschange the pt's positions a nurse is caring for a pt who is in labor and has a diagnosis of strep B hemolytic group B infection, what med should the nurse plan to administer - ansampicillin a nurse is caring for a pt who is in labor and has an epidural for pain control, what clinical manifestation is an adverse effect of epidural anesthesia - anspruritus a nurse is caring for a pt who is in the latent phase of labor, what clinical manifestation should the nurse expect - anstalkative a nurse is caring for a pt who is in the third stage of labor, what actions should the nurse take - ansclean the pt's perineum with warm water a nurse is caring for a pt who is in the transition phase of labor, what action should the nurse take - ansencourage the pt to use a rapid pant-blow breathing pattern a nurse is caring for a pt who is postoperative following a mastectomy, the pt expresses concern about losing her femininity and fears that she will no longer be attractive to her partner, what is a therapeutic response by the nurse - ansclarify the pt's concerns about her body image a nurse is caring for a pt who is pregnant for the 4th time, she delivered 2 full term newborns and had one spontaneous abortion at 10wk of gestation, the ob history is - ansG4 P a nurse is caring for a pt who is receiving oxytocin to augment labor, the pt has an intrauterine pressure catheter and an internal fetal scalp electrode for monitoring, what is an indication that the nurse should discontinue the infusion - anscontraction duration of 100 seconds
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a nurse is providing education about prenatal nutrition with a pt who is at 13 weeks of gestation and has a BMI of 22, what information should the nurse include - ansconsume about 71g of protein each day during pregnancy a nurse is providing teaching about pain management to a young adult client who has dysmenorrhea, what instructions should the nurse include - ansuse a heating pad on your lower abdomen when experiencing pain a nurse is providing teaching to a group of young adult women about risk factors for ovarian cancer, what should the nurse include - ansnulliparity high-fat diet hormone replacement therapy a nurse is providing teaching to a pt about depot medroxyprogesterone acetate, what info should the nurse include in the teaching - ansloss of bone mineral density can occur a nurse is providing teaching to a pt about pap tests, what information should the nurse include in the teaching - ansavoid having sex for 48h prior to the pap test a nurse is providing teaching to a pt who has fibrocystic breast changes and is experiencing breast discomfort during menstruation, what instructions should the nurse include - ansdecrease daily intake of caffeine a nurse is providing teaching to a pt who is experiencing hot flashes and has a new prescription for hormone therapy with conjugated equine estrogen, what information should the nurse include in the teaching - ansestrogen decreases the risk for osteoporosis estrogen use and smoking increases the risk for TBE estrogen therapy can cause break-through vaginal bleeding a nurse is reviewing a pt's medical records and notes that the pt is taking tamoxifen, the pt should identify that this is used to treat - ansbreast cancer (estrogen receptor blockers) a nurse is teaching a pregnant client who is Rh-negative about Rho(D) immune globulin, what statements by the pt indicate an understanding of the teaching - ansthe shot may be given after birth to protect future pregnancies
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a nurse is teaching a pt about caring for her newborn's umbilical cord, what statement by the pt indicates understanding - ansi should wash around the cord with plain water daily a nurse is teaching a pt about using an IUD for contraception, what statement by the pt indicates an understanding - ansi should check for the string each month after menstruation a nurse is teaching a pt who is at 10 weeks of gestation about chronic vius sampling (CVS), what information should the nurse include in the teaching - ansa CVS test can detect chromosomal anomalies a nurse is teaching a pt who is to start using a diaphragm for contraception, what statment by the pt indicates an understanding of the teaching - ansI will place 2 teaspoons of spermicide on the inside on the inside of the diaphragm for inserting it a nurse is teaching the parents of a newborn how to care for their son's uncircumcised penis, what instruction should the nurse include - answash the penis once per day with soap and water a nurse on a postpartum unit is teaching a pt about techniques for storing breast milk, what info should the nurse include in the teaching - ansfreshly pumped breast milk can be stored at room temp for up to 8 hours 1 puff MDI, 2 puff albuterol, what is the correct order - anshave pt take one puff of albuterol pt rests for one min take 2nd puff of albuterol have pt rest for 5 min have pt take one puff of fluticasone a charge nurse is orienting a newly licensed nurse to the unit-dose med system, what info should the nurse include? - ansthe pharmacist restocks the med drawer every day a nurse in ICU is monitoring a pt who has cardiogenic shock and is receiving a continuous IV infusion of dopamine. what requires an immediate intervention by the nurse? - ansinfiltration of the peripheral IV
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a nurse is assessing a pt who has open angle glaucoma and a new prescription for timolol, the nurse should monitor for what AE - anshypoglycemia a nurse is assessing a pt who is in preterm labor and is receiving mg sulfate via continuous IV infusion, what findings should the nurse identify as the priority - ansdeep tendon reflexes 1+ (indicates depressed CNS and possible mg sulf toxicity) a nurse is assessing a pt who is taking ondansetron, what is a therapeutic effect? - anssuppressed emesis a nurse is caring for 4 clients who have peptic ulcer disease, the nurse should recognize that misoprostol is contraindicated for which of the following clients? - ansa client who might be pregnant (category X, can cause spontaneous abortion) a nurse is caring for a client who has a prescription for metoclopramide, what outcomes should the nurse use to evaluate the effectiveness of this med? - ansreduced nausea a nurse is caring for a client who has a prescription for vancomycin 1g IV intermittent infusion over 30min every 12 hours, what should the nurse take? - anscontact the provider for prescription clarification (administer over 60min or more to reduce risk of infusion reaction--hypotension, flushing) a nurse is caring for a client who has a systemic fugal infection and is receiving IV amphotericin B deoxycholate, during previous infusions the pt developed a fever and chills, what should the nurse take - ansadminister diphenhydramine prior to administration (admin an antipyretic, corticosteroid, antihistamine, or antiemetic prior to to minimize the effects) a nurse is caring for a client who has an infection and is starting to take gentamicin, what lab test should the nurse monitor to detect an AE of the med? - anscreatinine (Cr, BUN, U.O.)
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a nurse is caring for a client who has HF and a prescription for acetazolamide. prior to administration of the first dose, the nurse should ask the client if she has allergy to what meds? - anssulfa-based meds a nurse is caring for a client who has HIV-1 and is starting therapy with ritonavir and zidovudine. the client asks why she has to take both medications, which explanation should the nurse provide? - anstaking the 2 meds together keeps you from becoming resistant to either of them a nurse is caring for a client who has prescription for terazosin, the nurse should identify that this medication is indicated for which of the following disorders? - anshypertension BPH a nurse is caring for a client who has recurrent lower UTIs which of the following meds should the nurse expect to administer? - ansnitrofuratoin ab for lower recurrent UTIs a nurse is caring for a client who has varicella zoster, what med should the nurse administer - ansacyclovir a nurse is caring for a client who is receiving morphine, what assessment is priority - ansRR a nurse is caring for a female client who has a new prescription for alosetron, what therapeutic effects should the nurse expect in this pt? - ansa decrease in the frequency of defecation a nurse is caring for a female client who has osteoporosis and a new prescription for raloxifene, what should the nurse assess prior to initiating therapy? - anspregnancy status (risk category X) a nurse is caring for a pt who has a new diagnosis of adrenal insufficiency. which of the following prescriptions should the nurse anticipate? - ansfludrocortisone (mineralcorticoid replacement med used to treat adrenal insufficiency, monitor for hypertension and edema)
