New material (test bank)

Question 1

Which of the following is the definition of constipation used by health care providers?
1. It is a decrease in the frequency of bowel movements.
2. It is defined as fewer than one bowel movement every three days.
3. It is defined as two bowel movements or fewer per week.
4. It is defined as lumpy, hard stools at least 25% of the time.

Answer 1

4

Question 2

. The nurse knows that the client is experiencing constipation when the client makes which of the following statements?
1. “I haven’t had a bowel movement today, but I had one yesterday.”
2. “I have been having trouble with pain, bloating, and gas. My last bowel movement was four days ago.”
3. “I have only had a bowel movement every other day for the past week.”
4. “I feel like I am constipated. Please give me a laxative.”

Answer 2

2

Question 3

A client who is hospitalized has an order for a laxative as needed for constipation. To which client would the nurse expect to administer a laxative?
1. A client who has daily bowel movements that are formed
2. A client who did not have a bowel movement today, but had one yesterday
3. A client who had a bowel movement yesterday and one the day before but not yet today
4. A client who has not had a bowel movement in 4 days

Answer 3

4

Question 4

he student nurse demonstrates an understanding of the different mechanisms of action of laxatives when the student nurse states:
1. “Stimulant laxatives must be taken with plenty of water.”
2. “Surfactant laxatives cause water and fat to be absorbed into the stools.”
3. “Bulk-forming laxatives are also called osmotic laxatives.”
4. “Mineral oil can interfere with the absorption of water-soluble vitamins.”

Answer 4

2

Question 5

The student nurse demonstrates knowledge of the different mechanisms of action of laxatives when the student nurse states:
1. “My client should consume plenty of water, since he is taking a bulk-forming laxative.”
2. “My client should expect to have a delayed reaction to a saline cathartic.”
3. “My client should be encouraged to use a stimulant laxative whenever he feels the need to have a bowel movement.”
4. “My client should not strain when having a bowel movement, and so the physician likely will prescribe a bulk-forming laxative.”

Answer 5

1

Question 6

Which of the following types of laxative have, as their mechanism of action, causing water and fat to be absorbed into the stools, thereby softening the stool?
1. Bulk-forming laxatives
2. Stimulant laxatives
3. Surfactant laxatives
4. Saline cathartics

Answer 6

3

Question 7

The student nurse correctly explains to the client the origin of her constipation when the student nurse says:
1. “Ordinarily, fluid is absorbed in your large intestine as it travels through. If the stool stays in the large intestine too long, too much water is absorbed, which will cause your stool to be small, hard, and difficult to pass without straining.”
2. “If the waste material passes through the colon too quickly, excess fluids are not absorbed, and the result is a watery stool.”
3. “Constipation is usually caused by infection.”
4. “If you would use the laxatives daily, you would not have a problem with constipation.”

Answer 7

1

Question 8

A client with severe diarrhea asks the nurse why so much water is being expelled with each bowel movement. The nurse correctly states that:
1. The intestines are not reabsorbing sufficient fluids.
2. The peristalsis is too slow.
3. The intestines are absorbing too much fluid.
4. The client needs to take a laxative at this time.

Answer 8

1

Question 9

Which of the following is the most common reason for prescribing antiemetic drugs?
1. Morning sickness
2. Hyperemesis gravidarum
3. Therapy with antineoplastic drugs
4. Psychosis

Answer 9

3

Question 10

Which of the following is true regarding the prevention and treatment of nausea and vomiting?
1. Antihistamines and anticholinergic drugs may be used to treat nausea and vomiting due to motion sickness.
2. Medications used to treat nausea and vomiting are only available via prescription.
3. An antiemetic drug is indicated if the client has ingested a poisonous substance or taken an overdose of an oral medication.
4. Antiemetic drugs can be used throughout pregnancy.

Answer 10

1

Question 11

Which of the following is true of the use of bulk-forming laxatives?
1. They should be used liberally by any client who has difficulty having regular bowel movements.
2. They are indicated for the relief of bowel obstruction.
3. They should be used when the client has diarrhea caused by an infection.
4. They work to increase the frequency and quality of bowel movements.

Answer 11

4

Question 12

When implementing nursing care, which of the following should be included when teaching the client and family about laxative use?
1. Laxatives are never harmful, because they are available over the counter, and should be used anytime the client feels the need to have a bowel movement.
2. Dependence on laxatives can cause constipation.
3. Stool softeners are appropriately used to treat constipation.
4. A side effect of stool softeners is abdominal cramping.

Answer 12

2

Question 13

Which of the following is a priority assessment for the nurse to make immediately after administering a bulk-forming laxative?
1. The time of the client’s last bowel movement
2. If the client has retrosternal pain after taking the drug
3. If the client is allergic to any medications
4. If the client is taking other medications

Answer 13

2

Question 14

The nurse is processing the history of a patient who underwent deep brain surgery that resulted in damage to the hypothalamus. The nurse recognizes that the patient’s deficit of all pituitary hormones is related to the location of the hypothalamus, which is found:
1. Deep within the brainstem.
2. Within the parietal lobe of the brain.
3. Just anterior to the occipital lobe of the brain
4. In the diencephalon, just above the brainstem.

Answer 14

4

Question 15

The nurse is teaching a patient who is recovering from a hypophysectomy because of an anterior pituitary adenoma. The patient is learning about the need for supplemental thyroid hormone. The patient says, “I thought thyroid hormone came from a gland in my neck.” Which follow-up statement by the nurse is most appropriate?
1. “Your thyroid gland was damaged because of the long surgical procedure.”
2. “Your thyroid gland no longer gets messages from the pituitary.”
3. “You will only need to take thyroid hormone until healing occurs.”
4. “You need this hormone because your TSH is too high since surgery.”

Answer 15

2

Question 16

A nurse is administering desmopressin to a patient with a head injury that put pressure on the posterior pituitary. The nurse recognizes that this form of artificial ADH will have the most impact on which portion of the assessment?
1. Urine output and blood pressure
2. Peripheral nervous system function, including reflexes
3. Cardiac function, including the conduction system
4. The Glasgow coma scale.

Answer 16

1

Question 17

A nurse is conducting an admission assessment on a patient with an admission diagnosis of SIADH. The nurse would anticipate these physical findings to be consistent with:
1. Severe overhydration.
2. Severe dehydration.
3. A shock state.
4. Acute renal failure.

Answer 17

1

Question 18

A nurse is explaining the need to track blood sugar to a patient who will be receiving growth hormone injections. The explanation is based on the recognition that additional growth hormone will:
1. Decrease blood glucose levels.
2. Trigger type I diabetes mellitus.
3. Increase insulin resistance.
4. Promote very rapid growth.

Answer 18

3

Question 19

A client diagnosed with asthma asks the nurse why an albuterol (Proventil) inhaler is better than isoproterenol (Isuprel). The nurse’s response should be based on the physiologic concept that isoproterenol affects:
1. Alpha-1 receptors.
2. Beta-2 receptors.
3. Beta-1 and beta-2 receptors.
4. All of the receptors.

Answer 19

3

Question 20

One of the reasons epinephrine causes an intense fight-or-flight response throughout the body is because it stimulates:
1. All four types of adrenergic receptors.
2. Only the alpha receptors.
3. Only the beta-1 receptors.
4. Only the beta-2 receptors.

Answer 20

1

Question 21

A client receives epinephrine for anaphylactic shock. The nurse should be aware of which one of the following mechanisms by which epinephrine acts?
1. Indirectly, by promoting release of norepinephrine
2. Directly, by stimulating adrenergic receptors
3. Inhibiting reuptake of norepinephrine from the synaptic cleft
4. Inhibiting destruction of norepinephrine by enzyme MAO

Answer 21

2

Question 22

A low-dose dopamine infusion is to be started for a client with hypovolemic shock. For which of the following desired therapeutic effects of this drug should the nurse be monitoring?
1. Increased urine output
2. Nausea
3. Chest pain
4. Tinnitus

Answer 22

1

Question 23

Adrenergic agonists like epinephrine are not given orally but parenterally or by inhalation because:
1. They produce toxic by-products in the blood.
2. They are metabolized by the enzyme COMT in the intestinal tract.
3. They are rapidly absorbed by the blood.
4. They are not easily digested in the gastrointestinal tract.

Answer 23

2

Question 24

A client diagnosed with narcolepsy is prescribed ephedrine, and asks the nurse how this medication will improve the problem. The nurse’s response will be based on which one of the following physiologic concepts?
1. Ephedrine can be easily destroyed by the enzymes in the synaptic cleft.
2. Ephedrine can easily cross the blood-brain barrier.
3. Ephedrine cannot be easily absorbed through the intestinal tract.
4. Ephedrine will prevent any attacks of epilepsy.

Answer 24

2

Question 25

A client is prescribed albuterol (Proventil) oral tablets for asthma. During client teaching, the nurse should include which one of the following? 1. “This drug is very effective in treating acute attacks.” 2. “This drug must be taken 15 minutes before exercise.” 3. “This drug can be taken every five minutes for maximal effect.” 4. “The dosage for this drug should be doubled up if no effect is seen in a short time.”

Answer 25

2

Question 26

A client is prescribed salmeterol (Serevent) by inhalation for asthma. The client asks the nurse how the medication can help. The nurse’s response should be based on the fact that salmeterol (Serevent) is a: 1. Selective beta-1 agonist. 2. Selective beta-2 agonist. 3. Selective alpha-1 agonist. 4. Non-selective adrenergic agonist.

Answer 26

2

Question 27

The nurse is starting a high-dose dopamine infusion for a client diagnosed with shock. The nurse should monitor the client for which of the following side effects of this drug? 1. Angina 2. Bronchospasm 3. Urinary retention 4. Ventricular tachycardia

Answer 27

4

Question 28

A client is given ephedrine (Efedron) for bronchial asthma. The nurse should ask the client to report which one of the following effects of this drug? 1. Increased appetite 2. Palpitations 3. Drowsiness 4. Excessive vomiting

Answer 28

2

Question 29

. A client is to be given isoproterenol for ventricular dysrhythmia. The nurse should question the order of this drug if the client is also on which one of the following drugs? 1. MAO inhibitors 2. Cardiac glycosides 3. Analgesics 4. Anti-inflammatory drugs

Answer 29

1

Question 30

A patient with a newly diagnosed adrenal adenoma suffers from frequent infections. The nurse understands that the rationale for the frequent infections is secondary to: 1. Suppression of the immune response. 2. Decreased blood glucose. 3. Lipolysis. 4. Bone demineralization.

Answer 30

1

Question 31

Which of the following is not secreted from the adrenal gland? 1. Glucocorticoids 2. Adrenocorticotropic hormone (ACTH) 3. Corticosteroids 4. Mineralocorticoids

Answer 31

2

Question 32

A patient had one adrenal gland removed. The nurse anticipates administration of medication to raise blood pressure, which will most closely mimic the effects of: 1. Glucocorticoids. 2. Mineralocorticoids. 3. Gonadocorticoids. 4. Cortisone.

Answer 32

2

Question 33

A nurse is ordered to administer cortisol to a patient. The outcome of this intervention should result in: 1. Increased secretion from the pituitary. 2. Decreased secretion from the pituitary. 3. Increased secretion from the hypothalamus. 4. Decreased level of consciousness.

Answer 33

2

Question 34

A patient with an allergic skin disorder becomes pregnant, and asks why she can’t be placed on a steroid taper like she usually is. The nurse’s best response is: 1. “The cause of your skin disorder is directly linked to your pregnancy. After you deliver, your skin should get better.” 2. “Steroids will likely cause you to have an abortion; you’ll have to put up with your skin disorder for about ten months.” 3. “Steroids can cause liver failure, and are not recommended at this time.” 4. “Steroids have the potential to cross the placenta, and should be avoided during pregnancy.”

Answer 34

4

Question 35

A diabetic patient is being placed on a prednisone taper for an acute asthma exacerbation. The patient asks if this medication will affect his blood sugar. The nurse’s best response is: 1. “Your blood sugar will be unaffected.” 2. “Your blood sugar might drop unexpectedly.” 3. “Your blood sugar might be elevated.” 4. “Would you like to speak to the physician about this?”

Answer 35

3

Question 36

A patient is taking long-term corticosteroid therapy for adrenal insufficiency. Which medication does the nurse recommend the patient take for the relief of minor aches and pains? 1. Acetaminophen (Tylenol) 2. Ibuprofen (Motrin) 3. Aspirin (Bayer) 4. Ketorolac (Toradol)

Answer 36

1

Question 37

A patient taking long-term corticosteroid therapy is starting a new job. The occupational nurse recommends that the patient speak to her primary health care provider prior to: 1. Providing a urine specimen. 2. Receiving live vaccines. 3. Providing a blood specimen. 4. Taking an eye exam.

Answer 37

2

Question 38

A patient with adrenocortical insufficiency has been taking corticosteroids for nine months. Which of the following should be reported to the health care provider immediately? 1. Frequent palpitations 2. Fatigue 3. Nasal congestion 4. Headache

Answer 38

1

Question 39

A nurse is reviewing a patient’s records, and notes that the patient is taking corticosteroids. The nurse suspects that the patient has a history of adrenocortical insufficiency when the use of which other medication is documented on the record? 1. Metformin 2. Ciprofloxacin 3. Isosorbide 4. Florinef

Answer 39

4

Question 40

A patient arrives at the Emergency Department in anaphylactic shock. As part of the treatment plan, the physician orders intravenous solumedrol. The nurse is aware that the desired action of the solumedrol is to: 1. Inhibit the inflammatory process. 2. Stimulate the sympathetic nervous system. 3. Raise circulating glucose levels. 4. Raise serum oncotic pressure.

Answer 40

1

Question 41

A nurse posts a sign, limiting visitors, outside of the door of a patient receiving high-dose intravenous corticosteroids. When the family inquires why visitors are limited, the nurse best responds: 1. “The germs of the patient put all visitors at risk for infection.” 2. “The germs of visitors put the patient at risk for infection.” 3. “Visitors are not required to wash their hands when they enter the room.” 4. “This patient is very sick, and needs rest.”

Answer 41

2

Question 42

Identify the rationale for administering corticosteroids to a patient for transplant rejection prophylaxis. 1. To promote graft-versus-host disease 2. To prevent the patient’s immune system from rejecting the implant 3. To provide prophylaxis against opportunistic infection 4. To enhance perfusion through the transplanted organ

Answer 42

2

Question 43

A nurse is planning care for a diabetic patient who is about to begin taking lifelong therapy for adrenal insufficiency. Which of the following advice should not be given to this patient? 1. Always wear socks with shoes. 2. Cut your toenails straight across. 3. Call your health care provider if your get injured, or are sick. 4. Keep a diary of your blood glucose measurements.

Answer 43

2

Question 44

A patient receiving lifelong therapy with corticosteroids should immediately report which of the following to the health care provider? 1. Ravenous appetite, insomnia, and weight gain 2. A change in prescription bottles 3. Cravings for sweet or salty foods 4. A change in health insurance plans

Answer 44

1