PRACTICE TEST 2 Flashcards
The physician has prescribed tranylcypromine sulfate (Parnate) 10mg bid. The nurse should teach the client to Refrain from eating foods containing tyramine because it may cause: ❍ A. Hypertension ❍ B. Hyperthermia ❍ C. Hypotension ❍ D. Urinary retention
Answer A is correct. If the client eats foods high in tyramine, he might experience malignant hypertension. Tyramine is found in cheese, sour cream, Chianti wine, sherry, beer, pickled herring, liver, canned figs, raisins, bananas, avocados, chocolate, soy sauce, fava beans, and yeast. These episodes are treated with Regitine, an alpha-adrenergic blocking agent. Answers B, C, and D are not related to the question.
The client is admitted to the emergency room with shortness of breath, anxiety, and tachycardia. His ECG reveals atrial fibrillation with a ventricular response rate of 130 beats per minute. The doctor orders quinidine sulfate. While he is receiving quinidine, the nurse should monitor his ECG for: ❍ A. Peaked P wave ❍ B. Elevated ST segment ❍ C. Inverted T wave ❍ D. Prolonged QT interval
Answer D is correct. Quinidine can cause widened Q-T intervals and heart block. Other signs of myocardial toxicity are notched P waves and widened QRS complexes. The most common side effects are diarrhea, nausea, and vomiting. The client might experience tinnitus, vertigo, headache, visual disturbances, and confusion. Answers A, B, and C are not related to the use of quinidine.
Lidocaine is a medication frequently ordered for the client experiencing: ❍ A. Atrial tachycardia ❍ B. Ventricular tachycardia ❍ C. Heart block ❍ D. Ventricular brachycardia
Answer B is correct.
Lidocaine is used to treat ventricular tachycardia. This medication slowly exerts an antiarrhythmic effect by increasing the electric stimulation threshold of the ventricles without depressing the force of ventricular contractions. It is not used for atrial arrhythmias; thus, answer A is incorrect. Answers C and D are incorrect because it slows the heart rate, so it is not used for heart block or brachycardia.
The doctor orders 2% nitroglycerin ointment in a 1-inch dose every 12 hours. Proper application of nitroglycerin ointment includes: ❍ A. Rotating application sites ❍ B. Limiting applications to the chest ❍ C. Rubbing it into the skin ❍ D. Covering it with a gauze dressing
Answer A is correct. Sites for the application of nitroglycerin should be rotated, to prevent skin irritation. It can be applied to the back and upper arms, not to the lower extremities, making answer B incorrect. Answer C is incorrect because nitroglycerine should not be rubbed into the skin, and answer D is incorrect because the medication should be covered with a prepared dressing made of a thin paper substance, not gauze.
The physician prescribes captopril (Capoten) 25mg po tid for the client with hypertension. Which of the following adverse reactions can occur with administration of Capoten? ❍ A. Tinnitus ❍ B. Persistent cough ❍ C. Muscle weakness ❍ D. Diarrhea
Answer B is correct. A persistent cough might be related to an adverse reaction to Captoten. Answers A and D are incorrect because tinnitus and diarrhea are not associated with the medication. Muscle weakness might occur when beginning the treatment but is not an adverse effect; thus, answer C is incorrect.
The client is admitted with a BP of 210/100. Her doctor orders furosemide (Lasix) 40mg IV stat. How should the nurse administer the prescribed furosemide to this client? ❍ A. By giving it over 1–2 minutes ❍ B. By hanging it IV piggyback ❍ C. With normal saline only ❍ D. With a filter
Answer A is correct. Lasix should be given approximately 1mL per minute to prevent hypotension. Answers B, C, and D are incorrect because it is not necessary to be
given in an IV piggyback, with saline, or through a filter
The client is receiving heparin for thrombophlebitis of the left lower extremity. Which of the following drugs reverses the effects of heparin? ❍ A. Cyanocobalamine ❍ B. Protamine sulfate ❍ C. Streptokinase ❍ D. Sodium warfarin
Answer B is correct. The antidote for heparin is protamine sulfate. Cyanocobalamine is B12, Streptokinase is a thrombolytic, and sodium warfarin is an anticoagulant. Therefore, answers A, C, and D are incorrect
The nurse is making assignments for the day. Which client should be assigned to the pregnant nurse?
❍ A. The client receiving linear accelerator radiation therapy for lung cancer
❍ B. The client with a radium implant for cervical cancer
❍ C. The client who has just been administered soluble brachytherapy for thyroid cancer
❍ D. The client who returned from placement of iridium seeds for prostate cancer
Answer A is correct. The pregnant nurse should not be assigned to any client with radioactivity present. The client receiving linear accelerator therapy is not radioactive because he travels to the radium department for therapy, and the radiation stays in the department. The client in answer B does pose a risk to the pregnant nurse. The client in answer C is radioactive in very small doses. For approximately 72 hours, the client should dispose of urine and feces in special containers and use plastic spoons and forks. The client in answer D is also radioactive in small amounts, especially upon return from the procedure.
The nurse is planning room assignments for the day. Which client should be assigned to a private room if only one is available? ❍ A. The client with Cushing’s disease ❍ B. The client with diabetes ❍ C. The client with acromegaly ❍ D. The client with myxedema
Answer A is correct. The client with Cushing’s disease has adrenocortical hypersecretion. This increase in the level of cortisone causes the client to be immune suppressed. In answer B, the client with diabetes poses no risk to other clients. The client in answer C has an increase in growth hormone and poses no risk to himself or others. The client in answer D has hyperthyroidism or myxedema, and poses no risk to others or himself.
The charge nurse witnesses the nursing assistant hitting the client in the long-term care facility. The nursing assistant can be charged with: ❍ A. Negligence ❍ B. Tort ❍ C. Assault ❍ D. Malpractice
Answer C is correct. Assault is defined as striking or touching the client inappropriately, so a nurse assistant striking a client could be charged with assault. Answer A, negligence, is failing to perform care for the client. Answer B, a tort, is a wrongful act committed on the client or their belongings. Answer D, malpractice, is failure to perform an act that the nurse assistant knows should be done, or the act of doing something wrong that results in harm to the client.
Which assignment should not be performed by the licensed practical nurse? ❍ A. Inserting a Foley catheter ❍ B. Discontinuing a nasogastric tube ❍ C. Obtaining a sputum specimen ❍ D. Starting a blood transfusion
Answer D is correct. The licensed practical nurse cannot start a blood transfusion, but can assist the registered nurse with identifying the client and taking vital signs.
Answers A, B, and C are duties that the licensed practical nurse can perform.
The client returns to the unit from surgery with a blood pressure of 90/50, pulse 132, respirations 30. Which action by the nurse should receive priority?
❍ A. Continue to monitor the vital signs
❍ B. Contact the physician
❍ C. Ask the client how he feels
❍ D. Ask the LPN to continue the post-op care
Answer B is correct. The vital signs are abnormal and should be reported to the doctor immediately. Answer A, continuing to monitor the vital signs, can result in deterioration of the client’s condition. Answer C, asking the client how he feels, would supply only subjective data. Involving the LPN, in Answer D, is not the best solution to help this client because he is unstable.
The nurse is caring for a client with B-Thalassemia major. Which therapy is used to treat Thalassemia? ❍ A. IV fluids ❍ B. Frequent blood transfusions ❍ C. Oxygen therapy ❍ D. Iron therapy
Answer B is correct. Thalasemia is a genetic disorder that causes the red blood cells to have a shorter life span. Frequent blood transfusions are necessary to provide oxygen to the tissues. Answer A is incorrect because fluid therapy will not help; answer C is incorrect because oxygen therapy will also not help; and answer D is incorrect because iron should be given sparingly because these clients do not use iron stores adequately.
The child with a history of respiratory infections has an order for a sweat test to be done. Which finding would be positive for cystic fibrosis? ❍ A. A serum sodium of 135meq/L ❍ B. A sweat analysis of 69 meq/L ❍ C. A potassium of 4.5meq/L ❍ D. A calcium of 8mg/dL
Answer B is correct. Cystic fibrosis is a disease of the exocrine glands. The child with cystic fibrosis will be salty. A sweat test result of 60meq/L and higher is considered positive. Answers A, C, and D are incorrect because these test results are within the normal range and are not reported on the sweat test.
The nurse caring for the child with a large meningomylocele is aware that the priority care for this client is to:
❍ A. Cover the defect with a moist, sterile saline gauze
❍ B. Place the infant in a supine position
❍ C. Feed the infant slowly
❍ D. Measure the intake and output
Answer A is correct. A meningomylocele is an opening in the spine. The nurse should keep the defect covered with a sterile saline gauze until the defect can be repaired. Answer B is incorrect because the child should be placed in the prone position. Answer C is incorrect because feeding the child slowly is not necessary. Answer D is not correct because this is not the priority of care.
The nurse is caring for an infant admitted from the delivery room. Which finding should be reported? ❍ A. Acyanosis ❍ B. Acrocyanosis ❍ C. Halequin sign ❍ D. Absent femoral pulses
Answer D is correct. Absent femoral pulses indicates coarctation of the aorta. This defect causes strong bounding pulses and elevated blood pressure in the upper body, and low blood pressure in the lower extremities. Answers A, B, and C are incorrect because they are normal findings in the newborn.
The nurse is aware that a common mode of transmission of clostridium difficile is: ❍ A. Use of unsterile surgical equipment ❍ B. Contamination with sputum ❍ C. Through the urinary catheter ❍ D. Contamination with stool
Answer D is correct. Clostrium dificille is primarily spread through the GI tract, resulting from poor hand washing and contamination with stool containing clostridium dificille. Answers A, B, and C are incorrect because the mode of transmission is not by sputum, through the urinary tract, or by unsterile surgical equipment.
The nurse has just received the change of shift report. Which client should the nurse assess first?
❍ A. A client 2 hours post-lobectomy with 150ml drainage
❍ B. A client 2 days post-gastrectomy with scant drainage
❍ C. A client with pneumonia with an oral temperature of 102°F
❍ D. A client with a fractured hip in Buck’s traction
Answer A is correct. The first client to be seen is the one who recently returned from surgery. The other clients in answers B, C, and D are more stable and can be seen
later.
A client has been receiving cyanocobalamine (B12) injections for the past six weeks. Which laboratory finding indicates that the medication is having the desired effect? ❍ A. Neutrophil count of 60% ❍ B. Basophil count of 0.5% ❍ C. Monocyte count of 2% ❍ D. Reticulocyte count of 1%
Answer D is correct. Cyanocolamine is a B12 medication that is used for pernicious anemia, and a reticulocyte count of 1% indicates that it is having the desired effect. Answers A, B, and C are white blood cells and have nothing to do with this medication.
The nurse is providing discharge teaching for a client taking dissulfiram (Antabuse). The nurse should instruct the client to avoid eating:
❍ A. Peanuts, dates, raisins
❍ B. Figs, chocolate, eggplant
❍ C. Pickles, salad with vinaigrette dressing, beef
❍ D. Milk, cottage cheese, ice cream
Answer C is correct. The client taking antabuse should not eat or drink anything containing alcohol or vinegar. The other foods in answers A, B, and D are allowed.
