NURS 6521 Midterm Exam Latest 2021, Walden University, Exams of Nursing

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NURS 6521

Midterm Exam

Latest 2021,

Walden

University.

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NURS 6521 Midterm Exam (Complete Solution) Latest: Question 1. A nurse is caring for a postsurgical patient who has small tortuous veins and had a difficult IV insertion. The patient is now receiving IV medications on a regular basis. What is the best nursing intervention to minimize the adverse effects of this drug therapy? A) Monitor the patient's bleeding time B) Check the patient's blood glucose levels C) Record baseline vital signs D) Monitor the IV site for redness, swelling, or pain Question 2. A patient is in the clinic after 6 weeks of taking riluzole (Rilutek) for a recent diagnosis of amyotrophic lateral sclerosis. The nurse will priori- tize assessment for which of the following? A) Weight gain B) Constipation C) Increased energy D) Dizziness

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manifesta- tions would cause the nurse to notify the physician immediately? A) Confusion B) Headache C) Nausea D) Leg cramps Question 6. A nurse is caring for a patient who is admitted into the cardiac care unit with acute, decompensated heart failure. Nesiritide (Natrecor) has been ordered. When preparing for administration of the drug, the nurse will A) add the reconstituted vial of medication to a 1,000 mL IV bag. B) shake the vial vigorously to mix the medication for reconstitution. C) administer the initial IV bolus over approximately 60 seconds. D) use the reconstituted solution within a 36-hour period. Question 7. A patient has been prescribed lithium therapy. Which of the following signs and symptoms will the nurse tell the patient to report immediately? A) Increased urination B) Muscle twitching C) Hair loss D) Increased thirst Question 8.

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A nurse is caring for a patient who has just been diagnosed with Parkinson disease. The patient does not understand how the medication ordered, carbidopa-levodopa, is going to help her condition. Which of the following is the correct response by the nurse? A) "Carbidopa-levodopa will delay the loss of muscle strength and limb function for several months." B) "This drug will change the immune processes in your body to help decrease the tissue damage." C) "Carbidopa-levodopa increases the activity of dopamine in your body, which will decrease your symptoms." D) "Your drug therapy will reduce excessive reflex activity causing your muscle spasms and will allow for muscle relaxation." Question 9. A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following? A) Chronic diarrhea B) Dental hygiene practices C) Headaches D) Diet Question 10.

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C) Myasthenia gravis D) Multiple sclerosis Question 13. A 77-year-old man's chronic heart failure is being treated with a regi- men of quinapril (Accupril) and furosemide (Lasix). Which of the fol- lowing assessment findings would suggest that the loop diuretic is con- tributing to a therapeutic effect? A) The man's glomerular filtration rate and creatinine levels are within reference ranges. B) The man's heart rate is between 60 and 70 beats per minute with a regular rhythm. C) The man's potassium and sodium levels remain with reference ranges. D) The man's chest sounds are clear and his ankle edema is lessened. Question 14. A nurse explains to a patient that nitroglycerin patches should be ap- plied in the morning and removed in the evening. This medication schedule reduces the potential for A) adverse effects. B) nitrate dependence. C) nitrate tolerance. D) toxic effects. Question 15.

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A nurse who provides care on a busy medical unit of a large hospital is constantly faced with new drugs on patients' medication administra- tion records. What strategy should the nurse employ to foster up-to-date information about the nursing management of new or uncommon drugs? A) Focus on learning about a prototype drug that is characteristic of a larger drug class B) Identify similarities between new drugs and older drugs that are com- monly used on the unit C) Commit time and energy during each shift to learning about new drugs D) Liaise with pharmacists and pharmacy technicians who work at the hospital Question 16. A 58-year-old man is admitted to the emergency department. A diag- nosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs? A) Furosemide B) Digoxin immune fab C) Captopril D) Dopamine Question 17.

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D) Nicotine Question 19. A nurse is providing discharge instructions to a patient who will be taking fludrocortisone at home. The nurse will encourage the patient to eat a diet that is A) low in sodium and potassium. B) low in sodium, high in potassium. C) high in iron. D) low in proteins. Question 20. A nurse is developing a care plan for a patient who has multiple scle- rosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in A) chest pain. B) fatigue. C) breathing difficulties. D) heart palpitations. Question 21. An elderly postsurgical patient has developed postoperative pneumo- nia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption?

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A) A sublingual benzodiazepine that has been prescribed to help the pa- tient sleep B) An intravenous (IV) antibiotic that is being administered by IV pig- gyback at 150 mL/hour C) An oral antidepressant that the patient has been taking daily for sev- eral years D) An intramuscular (IM) injection of an opioid analgesic Question 22. A female patient diagnosed with chronic atrial flutter has been pre- scribed verapamil in conjunction with digoxin to control ventricular rate. To enhance the therapeutic effect of the drug, the nurse will instruct the patient to A) take the medication with meals. B) avoid grapefruit and grapefruit juice. C) take an aspirin every day. D) avoid fresh fruit. Question 23. A 28-year-old patient asks his nurse how phenelzine therapy would help him. An appropriate response by the nurse would be A) "This therapy will help reduce the severity of your bipolar episodes."

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C) The patient will identify satisfying and acceptable sexual practices and some alternative ways of dealing with sexual expression. D) The patient will adopt strategies to maintain proper fluid balance. Question 26. A nurse is caring for a patient who is taking sodium polystyrene sul- fonate (Kayexalate) therapy. The nurse will monitor for which of the fol- lowing? A) Cardiac arrhythmias B) Ventricular arrhythmias C) Hypokalemia D) Cardiotoxicity Question 27. A nurse is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a patient who has just been admitted. What is the most likely goal of this intervention? A) To treat sinus bradycardia accompanied by hypotension B) To resolve the patient's uncompensated heart failure C) To treat the patient's ventricular tachycardia D) To convert the patient's atrial fibrillation to normal sinus rhythm Question 28.

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A nurse is working in a women's hospital where she is caring for a new mother who is experiencing postpartum urinary retention. Bethane- chol (Urecholine) has been ordered. The nurse will observe for which of the following? A) Bradycardia B) Hypertension C) Hypotension D) Decreased salivation Question 29. A 12-year-old child who has been taking sertraline for the past 2 weeks has returned to the clinic to be seen. It will be critical for the nurse to assess for A) onset of suicidal ideation. B) weight loss. C) feelings of grandiosity. D) decreased sleep. Question 30. A 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully monitored for A) dizziness. B) diarrhea. C) increased secretions.

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D) A woman who has recently begun treatment for idiopathic seizure ac- tivity Question 33. The nurse has been assigned a 49-year-old patient who has acute col- itis, and the nurse just completed gathering data concerning core drug knowledge and core patient variables. To implement nursing manage- ment of drug therapy for this patient, the nurse will then A) evaluate the outcome of the drug therapy. B) devise strategies to maximize the therapeutic effects of the drug. C) implement planned nursing actions. D) assess for data that will indicate interactions between core drug knowledge and core patient variables. Question 34. A nurse has been caring for a 49-year-old man who was hospitalized with recurrent ventricular fibrillation and received IV amiodarone. The man is now scheduled to be discharged on oral amiodarone, and the nurse has just completed discharge instructions. Which of the following statements made by the patient indicates that further instruction is neces- sary?

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A) "I will notify my physician if I develop a cough and have difficulty breathing." B) "I am going on a cruise next week and plan to just lie in the sun all day and relax." C) "I plan to see my ophthalmologist in 2 weeks." D) "It is important for me to have my thyroid gland checked regularly." Question 35. A 73-year-old man was diagnosed with Parkinson disease earlier this year and has begun taking carbidopa-levodopa four times daily in an ef- fort to control the signs and symptoms of the disease. The nurse should recognize that this therapeutic effect is achieved by influencing the A) uptake of acetylcholine. B) dopamine receptors in the brain. C) synthesis of epinephrine. D) sensitivity of beta-2 receptors. Question 36. A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous nitroglyc- erin 5 mcg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infu- sion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments? A) Blood pressure

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A) 0.3 mEq/L B) 0.6 mEq/L C) 1.7 mEq/L D) 1.2 mEq/L Question 40. A patient experiencing a serious allergic reaction to a bee sting is brought to the emergency department. The patient's right hand is swollen, red, and painful. She is extremely upset, short of breath, and the nurse detects wheezing and stridor. The nurse is ordered to administer epinephrine to relieve the patient's A) pain and swelling around the sting site. B) discoloration in her hand. C) acute anxiety. D) acute bronchospasm. Question 41. A nurse is educating a patient who has Parkinson disease and her husband about the possible adverse effects of carbidopa-levodopa. The nurse should emphasize the need for the patient and her husband to mon- itor for any sudden increase in A) involuntary movements. B) perspiration.

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C) appetite or thirst. D) mobility. Question 42. A nurse has an order to apply nitroglycerin topically, twice a day. The nurse's initial action will be to A) wipe off the previous dose from the patient's body. B) don a pair of gloves. C) place the ointment on an area free of excessive hair and of unbroken skin. D) wipe off any medication that is on the outside of the medication con- tainer. Question 43. A woman with an inflammatory skin disorder has begun taking pred- nisone in an effort to control the signs and symptoms of her disease. The nurse who is providing care for this patient should prioritize which of the following potential nursing diagnoses in the organization of the pa- tient's care? A) Fluid Volume Excess B) Constipation C) Acute Confusion D) Impaired Gas Exchange