Respiratory Homework Qs

Question 1

Which action would be the most appropriate way for the nurse to evaluate a child’s understanding of how to use an inhaler?
A. Asking questions about using the inhaler
B. Having the child demonstrate inhaler use
C. Explaining how the inhaler will be used at home
D. Having the child tell the nurse about the technique that was learned

Answer 1

*B. Having the child demonstrate inhaler use

Return demonstration is best way to evaluate teaching

Question 2

Which goal is the priority for a client with asthma who has a prescription for an inhaled bronchodilator?
A. Is able to obtain pulse oximeter readings
B. Demonstrates use of a metered-dose inhaler
C. Knows the health care provider’s office hours
D. Can identify triggers that may cause wheezing

Answer 2

*B. Demonstrates use of a metered-dose inhaler

Pta with asthma use metered dose inhalers

Question 3

A nurse is providing discharge teaching to a client has a new prescription for a metered dose inhaler (MDI). Which of the following instructions should the nurse include in the teaching?

A. Shake the inhaler for 3 to 5 seconds.

B. Rinse the mouth with mouthwash after inhaling the medication.

C. Wait 2 min between inhalations.

D. Press down twice on the MDI canister.

Answer 3

• A. Shake the inhaler for 3 to 5 seconds.

After insertion, shake vigorously to mix med.

Question 4

A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of the following actions by the client indicates an understanding of the teaching?

A. The client takes slow deep breaths while inhaling the medication.

B. The client takes a quick inhalation while releasing the medication from the inhaler.

C. The client exhales as the medication is released from the inhaler.

D. The client waits 10 min between inhalations.

Answer 4

*A. The client takes slow deep breaths while inhaling the medication.

Inhale deeply as med is released then hold med in the lungs 3-5 sec

Question 5

A nurse is teaching the parents of a child who is to start using a metered-dose inhaler (MDI) to treat asthma. Which of the following information should the nurse include in the teaching?

A. “The spacer increases the amount of medication delivered to the oropharynx/back of throat.”

B. “The spacer increases the amount of medication delivered to the lungs.”

C. “Inhale rapidly using the spacer with the MDI.”

D. “Cover exhalation slots of the spacer with lips when inhaling.”

Answer 5

*B. “The spacer increases the amount of medication delivered to the lungs.”

Client should inhale slowly with spacer, it helps the med reach lungs

Question 6

A client with chronic obstructive pulmonary disease prepares to take a medication that is delivered via a nebulizer. Which instruction would the nurse provide when teaching about use of the nebulizer?
A. ‘Hold your breath, spray the medication into your mouth, then inhale deeply.’
B. ‘Depress the canister as you inhale deeply, then hold your breath for at least 10 seconds.’
C. ‘Seal your lips around the mouthpiece and breathe in and out, taking slow, deep breaths.’
D. ‘Inhale the medication from the nebulizer, remove the mouthpiece to exhale and then repeat.’

Answer 6

*C. ‘Seal your lips around the mouthpiece and breathe in and out, taking slow, deep breaths.’

Sealing lips ensures med is delivered on inspiration

Question 7

The nurse provides instructions about how to use a metered-dose inhaler (MDI) to a client with chronic obstructive pulmonary disease. The nurse concludes that additional teaching is needed when the client demonstrates which technique?
A. Places the tip of the inhaler just past the lips
B. Holds the inspired breath for at least 3 seconds.
C. Activates the inhaler during inspiration
D. Inhales rapidly with the lips sealed around the nebulizer opening

Answer 7

*D. Inhales rapidly with the lips sealed around the nebulizer opening

Pt should inhale slowly rather than fast when using metered dose inhaler

Question 8

A nurse is teaching an 80-year-old client how to use a metered dose inhaler. The nurse is concerned that the client is unable to coordinate the release of the medication during the inhalation phase. Which intervention should improve the delivery of the medication?
A. Ask a family member to assist the client with the inhaler.
B. Request a home health nurse to visit the client at home.
C. Use nebulized treatments at home instead.
D. Add a spacer device to the inhaler canister.

Answer 8

*D. Add a spacer device to the inhaler canister.

Spacer allows more time to inhale and less eye hand coordination.

Question 9

The nurse is teaching a school-aged child and family members about the use of inhalers prescribed for asthma. Which statement made by a family member indicates an understanding of the nurse’s instructions?
A. “We will keep a chart of daily peak flow meter results.”
B. “We can rely on our child’s self-report of symptoms.”
C. “Monitoring our child’s pulse rate is not necessary.”
D. “Skin color changes in our child is an early warning sign for airway constriction.”

Answer 9

*A. “We will keep a chart of daily peak flow meter results.”

Peak flow helps determine if s/s are in control or worsening

Question 10

A nurse is teaching a client who has a new diagnosis of asthma. Which of the following medications should the nurse instruct the client to use to abort/stop an acute asthma attack?

A. Beclomethasone

B. Salmeterol

C. Formoterol

D. Albuterol

Answer 10

• D. Albuterol

Albuterol dilates the airways, decreases wheezing, and improves O2

Question 11

A nurse in an urgent care center is caring for a client who is having an acute asthma exacerbation. Which of the following actions is the nurse’s highest priority?

A. Initiating oxygen therapy

B. Providing immediate rest for the client

C. Positioning the client in high-Fowler’s

D. Administering a nebulized beta-adrenergic

Answer 11

*D. Administering a nebulized beta-adrenergic

This med is a bronchodilators and provides relief of airflow obstruction

Question 12

Which intervention would the nurse implement for a client admitted for an exacerbation of asthma?
A. Determine the client’s emotional state.
B. Give prescribed medications, such as albuterol, to promote bronchiolar dilation.
C. Provide education about the effect of a family history.
D. Encourage the client to use an incentive spirometer routinely.

Answer 12

*B. Give prescribed medications, such as albuterol, to promote bronchiolar dilation.

Bronchiolar dilation will reduce airway resistance

Question 13

A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching?

A. “If my breathing begins to feel tight, I will use the cromolyn immediately.”

B. “I will be sure to take the albuterol before taking the cromolyn.”

C. “I will use both medications immediately after exercising.”

D. “I will administer the medications 10 minutes apart.”

Answer 13

*B. “I will be sure to take the albuterol before taking the cromolyn.”

Bronchodilator allows airways to be opened, cromolyn is prophylaxis tx

Question 14

The nurse is educating a client with end stage chronic obstructive pulmonary disease (COPD) about medication management. Which statement by the client indicates an understanding of the teaching?
A. “I will use the albuterol in the nebulizer before my other inhalers each morning.”
B. “I can use my tiotropium inhaler if I get short of breath.”
C. “I will only use the fluticasone inhaler on the days I am really out of breath.”
D “The side effects of these medications will be less severe because I’m not taking them by mouth.”

Answer 14

*A. “I will use the albuterol in the nebulizer before my other inhalers each morning.”

Upon waking, breathlessness is at its worst for people with COPD

Question 15

The nurse is providing discharge education to a client with moderate persistent asthma. The nurse should instruct the client to administer which medication first?
A. Bronchodilator
B. Glucocorticoid
C. Anticholinergic
D. Mast cell stabilizer

Answer 15

*A. Bronchodilator

Should be used first to allow the other meds to move more deeply

Question 16

A client with a history of asthma is admitted for a minor surgical procedure. Preoperatively, the peak flow is measured at 480 liters/minute. Postoperatively, the client reports chest tightness and the peak flow is now 200 liters/minute. What should the nurse do first?
A. Notify both the surgeon and primary care provider
B. Repeat the peak flow reading in 30 minutes
C. Administer the PRN dose of albuterol
D. Apply oxygen at two liters per nasal cannula

Answer 16

*C. Administer the PRN dose of albuterol

short acting beta agonist must be taken immediately

Question 17

Upon admission to the emergency center, an adult client with acute status asthmaticus is prescribed this series of medications. Which should the patient use first?
A. Prednisone (Deltasone) orally.
B. Gentamicin (Garamycin) IM.
C. Albuterol (Proventil) puffs.
D. Salmeterol (Serevent Diskus).

Answer 17

*C. Albuterol (Proventil) puffs.

short acting bronchodilator provides rapid and deep relieve

Question 18

The nurse administers albuterol to a 4-year-old child. Which intervention would assist the nurse in evaluating the effectiveness of this medication?
A. Auscultate breath sounds.
B. Collect a sputum sample.
C. Conduct a neurological examination.
D. Palpate chest excursion.

Answer 18

*A. Auscultate breath sounds.

Evaluate effectiveness of the med by audcultating

Question 19

The nurse is evaluating the effectiveness of therapy for a client who received albuterol via nebulizer during an acute episode of shortness of breath due to asthma. Which finding is the best indicator that the therapy was effective?
A. Accessory muscle use has decreased.
B. O2 Sat greater than 90%
C. Respiratory rate is 10 breaths/minute.
D. No breath sounds are audible.

Answer 19

*B. O2 Sat greater than 90%

Goal is to relieve bronchospasms

Question 20

The nurse administers albuterol to a child with asthma. Which common side effect would the nurse monitor for in the child?
A. Flushing
B. Dyspnea
C. Tachycardia
D. Hypotension

Answer 20

C. Tachycardia

Tachycardia, hypertension, pallor are common side effects

Question 21

The nurse is providing teaching to the client prescribed albuterol for the management of asthma. The nurse is including reportable side effects in the teaching plan. Which of the following side effects is the priority?
A. Nervousness
B. Headache
C. Palpitations
D. Muscle aches

Answer 21

*C. Palpitations

Side effects: nervousness, shakiness, headache, throat irritation, aches

Question 22

The nurse is teaching a pediatric client and family about prescribed albuterol sulfate extended-release tablets. Which statement should be included?
A. If you cannot swallow the tablet, it is ok to chew it
B. This medication can cause restlessness
C. Rinse your mouth after taking this medication
D. Oral albuterol can cause an increase in urination

Answer 22

*B. This medication can cause restlessness

adverse reactions are same for orally or via inhalation

Question 23

A client prescribed albuterol tablets reports nausea every evening with the 9:00 p.m. dose. Which action should the nurse perform to alleviate this side effect?
A. Change the time of the dose.
B. Hold the 9 p.m. dose.
C. Administer the dose with a snack.
D. Offer an antiemetic with the dose.

Answer 23

*C. Administer the dose with a snack.

Minimizes gastrointestinal discomofort like nausea

Question 24

The nurse is teaching a client diagnosed with asthma about the medication albuterol. Which statement by the nurse demonstrates appropriate teaching?
A. “Call your doctor’s office if you need to use the drug more often.”
B. “Use this medication at bedtime to promote rest.”
C. “Use this medication after other asthma inhalers.”
D. “Discontinue the inhaler if you feel dizzy.”

Answer 24

*A. “Call your doctor’s office if you need to use the drug more often.”

Med may no longer be effective, seek Dr guidance , do not exceed dose

Question 25

The nurse is preparing to administer an albuterol nebulizer treatment to a patient with asthma. Which assessment finding should be brought to the health care provider's attention prior to administering the medication? A. Temperature of 101°F (38.3°C) B. Heart rate of 116 bpm C. Respiratory rate of 28 D. Lower extremity edema

Answer 25

*B. Heart rate of 116 bpm | Increase HR is a common adervse effect

Question 26

While receiving an adrenergic beta 2 agonist medication for asthma, the client complains of palpitations, chest pain, and a throbbing headache. Which nursing action is the most appropriate? A. Withhold the medication and notify the health care provider. B. Tell the client that these are expected side effects from the medicine. C. Give instructions to breathe slowly and deeply for several minutes. D. Explain that the effects are temporary and will subside as medication tolerance develops.

Answer 26

*A. Withhold the medication and notify the health care provider. | Should not cause chest pain, shows toxic levels

Question 27

The nurse is teaching a client with asthma about albuterol. How should the nurse best describe the action of this medication? A. "The medication is given to reduce secretions that block airways." B. "The medication will help to relax smooth muscles in the airways." C. "The medication will stimulate the respiratory center in the brain." D. "The medication will help to prevent pneumonia."

Answer 27

*B. "The medication will help to relax smooth muscles in the airways." | Albuterol is a short acting beta adrefergic agonist to tx wheezing

Question 28

A health care provider prescribes metaproterenol for a client. For which therapeutic effect would the nurse monitor the client? A. Induced sedation B. Relaxed bronchial spasm C. Decreased blood pressure D. Productive cough

Answer 28

*B. Relaxed bronchial spasm | This med stimulates beta receptors causing bronchodilation

Question 29

Which intervention would the nurse implement for a client admitted for an exacerbation of asthma? A. Determine the client’s emotional state. B. Give prescribed medications to promote bronchiolar dilation. C. Provide education about the effect of a family history. D. Encourage the client to use an incentive spirometer routinely.

Answer 29

*B. Give prescribed medications to promote bronchiolar dilation. | Bronchiolar dilation reduces airway resistance and improve breathing

Question 30

The nurse is preparing to discharge a client who presented to the emergency room for an acute asthma attack. The nurse notes that upon discharge the health care provider has prescribed theophylline 300 mg orally to be taken daily at 9:00 AM. The nurse will teach the client to take the medication on which schedule? A. One hour before or 2 hours after eating B. At bedtime C. At the specific time prescribed D. Daily until symptoms are gone

Answer 30

*C. At the specific time prescribed | Therapeutic serum levels must be maintained by taking it on time

Question 31

A nurse in an emergency department is preparing to administer theophylline by continuous intravenous (IV) infusion to a client who is experiencing an asthma attack. Which of the following actions should the nurse take? A. Infuse the medication with an IV pump. B. Cover the IV container with dark paper. C. Administer a test dose first. D. Infuse the medication at 35 mg/min.

Answer 31

* A. Infuse the medication with an IV pump. | Theophylline should be administered slowly on an infusion pump.

Question 32

A client with chronic obstructive pulmonary disease (COPD) is receiving aminophylline 25 mg/hour intravenously (IV). Which finding would be associated with side effects of this medication? A. Flushing and headache B. Restlessness and palpitations C. Decreased urine volume D. Pruritus

Answer 32

*B. Restlessness and palpitations | Side Effects: Restlessness, palpitations, chest pain, discomfort

Question 33

A nurse is providing discharge instructions to a client who has asthma and is about to start taking theophylline (Theo-2). The nurse should tell the client that this medication might cause which of the following adverse effects? A. Drowsiness B. Constipation C. Oliguria D. Tachycardia

Answer 33

*D. Tachycardia | This med can increase cardiac stimulation and tachycardia

Question 34

A nurse is providing teaching to a client who has emphysema and a new prescription for theophylline. Which of the following instructions should the nurse provide? A. Consume a high-protein diet. B. Administer the medication with food. C. Avoid caffeine while taking this medication. D. Increase fluids to 1L/per day.

Answer 34

* C. Avoid caffeine while taking this medication. | Caffeine can increase central nervous system stimulation

Question 35

The nurse is monitoring an older adult client prescribed diphenhydramine for contact dermatitis related to poison ivy exposure. Which finding should be reported to the provider as a potential drug-related side effect? A. Confusion B. Hypertension C. Incontinence D. Bradypnea

Answer 35

*A. Confusion | Confusion with impaired thinking, judgement, and memory)

Question 36

A nurse notes an abrupt onset of confusion in an 85-year-old client. Which newly prescribed medication most likely caused this change in the client's mental status? A. Warfarin B. Metoprolol C. Pantoprazole D. Diphenhydramine

Answer 36

*D. Diphenhydramine | 1st gen histamines often cause confusion, especially at higher doses

Question 37

The nurse is caring for an 83-year-old client who is experiencing a sudden onset of confusion. Which medication most likely contributed to this change? A. Cardiac glycoside B. Anticoagulant C. Liquid antacid D. Antihistamine

Answer 37

*D. Antihistamine | Antihistamines can cause confusion in older adults

Question 38

An adolescent with hay fever has been taking a prescribed first-generation antihistamine every 8 hours for the past 2 days. The adolescent tells the nurse, 'This medicine is making me sleepy.' Which response by the nurse would be most appropriate? A. 'Take half a tablet before school.' B. 'Try omitting the early morning dose.' C. 'The drowsiness usually decreases after several days.' D. 'I’ll write your teacher a note to explain your inability to concentrate in class while taking this medicine.'

Answer 38

*C. 'The drowsiness usually decreases after several days.' | Central nervous depressant effects may disappear after several days

Question 39

The nurse is administering hydroxyzine to a client. The nurse would monitor the client for which side effect of this medication? A. Ataxia B. Drowsiness C. Vertigo D. Slurred speech

Answer 39

*B. Drowsiness | Hydroxyzine suppresses acitvity in subcortical area of CNS

Question 40

A nurse is teaching a client about taking diphenhydramine. The nurse should explain to the client that which of the following is an adverse effect of this medication? A. Sedation B. Constipation C. Hypertension D. Bradycardia

Answer 40

* A. Sedation | Side effects: sedation, diarrhea, hypotension, palpitations

Question 41

A nurse is caring for a client who has poison ivy and is prescribed diphenhydramine. Which of the following instructions should the nurse give regarding the adverse effect of dry mouth associated with diphenhydramine? A. "Administer the medication with food." B. "Chew on sugarless gum or suck on hard, sour candies." C. "Place a humidifier at your bedside every evening." D. "Discontinue the medication and notify your provider."

Answer 41

*B. "Chew on sugarless gum or suck on hard, sour candies." | dry mouth is relieved by sucking on hard candies

Question 42

The nurse is evaluating the plan of care for a client with benign prostatic hyperplasia (BPH). For which prescribed medication should the nurse notify the health care provider (HCP)? A. Diphenhydramine B. Finasteride C. Terazosin D. Metoprolol

Answer 42

*A. Diphenhydramine | H1 Blockers have anticholinergic effects and cause urinary retention

Question 43

A nurse is preparing a client for surgery. Prior to administering the prescribed hydroxyzine, the nurse should explain to the client that the medication is for all the indications EXCEPT for which one? A. Controlling emesis B. Diminishing anxiety D. Preventing thrombus formation E. Drying secretions

Answer 43

*D. Preventing thrombus formation | Hydroxyzine is an antihistamine

Question 44

A nurse is caring for a client who has Parkinson's disease and is taking diphenhydramine 25 mg PO TID. Which of the following therapeutic outcomes should the nurse expect to see? A. Delay in disease progression B. Improved bladder function C. Relief of depression D. Decreased tremors

Answer 44

* D. Decreased tremors | Antihistamines have mild anticholinergic effect and can control tremors

Question 45

A nurse is caring for a client who is prescribed diphenhydramine to relieve pruritus. The client asks the nurse how he can minimize the daytime sedation he is experiencing. Which of the following responses should the nurse give? A. "Gradually decrease the dose once tolerance to the effect is reached." B. "Distribute the doses evenly throughout the day." C. "Take most of the daily dose at bedtime." D. "Take the medication with meals."

Answer 45

* C. "Take most of the daily dose at bedtime." | Allows pt to obtain the benefit of maximum relief

Question 46

An adolescent prescribed loratadine 10 mg daily for hay fever is concerned the medication will cause drowsiness during the school day. Which action would the school nurse take? A. Explain this medication rarely causes drowsiness. B. Advise to take half a tablet in the morning before school. C. Suggest skipping the next day’s dose if hay fever is better. D. Recommend contacting the allergist for a prescription containing a stimulant

Answer 46

*A. Explain this medication rarely causes drowsiness. | Loratadube causes little or no drowsiness

Question 47

The nurse is caring for a client with a sore throat who developed urticaria after the administration of prescribed antibiotics. The client is now receiving cetirizine. Which finding indicates that the cetirizine is having the intended effect? A. The client reports less itching. B. The tonsils are decreasing in size. C. The client reports less muffled hearing. D. The pain rating is decreased.

Answer 47

*A. The client reports less itching. | Cetirizine binds to peripheral rather than central reducing drowsiness

Question 48

A nurse is reviewing the medical record of a client who reports taking pseudoephedrine for sinus congestion as needed. The nurse should identify that pseudoephedrine is contraindicated for which of the following client conditions? A. Eczema B. Migraines C. Hypertension D. Diverticulitis

Answer 48

* C. Hypertension | Potential for vasoconstriction

Question 49

The nurse is providing education to the client with sinusitis who has asked about taking over-the-counter pseudoephedrine. Which of the following statements is appropriate? A. If you take pseudoephedrine and phenylephrine together, you will get more relief B. Continue the medication until your congestion resolves C. Using these kinds of medications may make you jittery and restless D. It is safe to chew over the counter medications if you have trouble swallowing pills

Answer 49

*C. Using these kinds of medications may make you jittery and restless | Side effects: Tachycardia, impaired coordination, dizziness

Question 50

The nurse is collecting the health history of a client who reports taking over-the-counter pseudoephedrine for nasal congestion. Which statement by the client would require follow-up by the nurse? A. I take this medication at night before I go to bed B. I have to use a normal saline nasal spray since I started this medication C. I avoid drinking beverages with caffeine while taking the medication D. I chew gum when I take this medication to help with my dry mouth

Answer 50

*A. I take this medication at night before I go to bed | Med is a stimulant, avoid taking at night

Question 51

An adolescent is prescribed phenylephrine nasal spray. The nurse would determine teaching has been effective when the adolescent identifies which complication that may occur if the spray is used more frequently or longer than recommended? A. Tinnitus B. Nasal polyps C. Bleeding tendencies D. Increased nasal congestion

Answer 51

*D. Increased nasal congestion | Continued use of phenylephrine can cause rebound congestion of mucous

Question 52

Which effect would the nurse assess a teenager for if more than the recommended dose of oxymetazoline nasal spray is taken? A. Nasal polyps B. Ringing in the ears C. Bleeding tendencies D. Increased nasal congestion

Answer 52

*D. Increased nasal congestion | oxymetazoline can cause rebound congestion of mucous membranes.

Question 53

A nurse is preparing an in-service for coworkers about various herbal supplements clients might report using. The nurse should include in the presentation which of the following herbal supplements which have been found to be unsafe for clients losing weight? A. Licorice B. Feverfew C. Comfrey D. Ephedra

Answer 53

*D. Ephedra | ephedra is an extremely dangerous weight loss supplement

Question 54

The client who was admitted with exacerbation of ulcerative colitis has developed hyperglycemia. Which medication that the client was prescribed most likely caused this adverse drug effect? A. Dicyclomine B. Acetaminophen C. Prednisone D. Diphenoxylate/atropine

Answer 54

*C. Prednisone | Common adverse effects include hyperglycemia

Question 55

A client is receiving dexamethasone to treat acute exacerbation of asthma. For which side effect would the nurse monitor the client? A. Hyperkalemia B. Liver dysfunction C. Orthostatic hypotension D. Increased blood glucose

Answer 55

*D. Increased blood glucose | Dexamethasone increases gluconeogensis

Question 56

When a client is receiving dexamethasone for adrenocortical insufficiency, which action would the nurse take to monitor for an adverse effect of the medication? A. Auscultate for bowel sounds. B. Assess deep tendon reflexes. C. Culture respiratory secretions. D. Measure blood glucose levels.

Answer 56

*D. Measure blood glucose levels. | Corticosteroids have a hyperglycemic effect, BG should be monitored.

Question 57

Which action will a nurse take when a male client receiving prolonged steroid therapy complains of always being thirsty and urinating frequently? A. Have the client assessed for an enlarged prostate. B. Obtain a urine specimen from the client to test for ketonuria. C. Perform a finger stick to test the client’s blood glucose level. D. Assess the client’s lower extremities for the presence of pitting edema.

Answer 57

*C. Perform a finger stick to test the client’s blood glucose level. | Increased serum glucose can be from steroid therapy.

Question 58

A male client receiving prolonged steroid therapy complains of always being thirsty and urinating frequently. Which is the nurse’s initial action? A. Have the client assessed for an enlarged prostate. B. Obtain a urine specimen from the client to test for ketonuria. C. Perform a finger stick to test the client’s blood glucose level. D. Assess the client’s lower extremities for the presence of pitting edema.

Answer 58

*C. Perform a finger stick to test the client’s blood glucose level.

Question 59

A pediatric client is prescribed an intravenous infusion of methylprednisolone. Which clinical manifestation requires immediate intervention during administration of the initial dose? A. Polyuria B. Tinnitus C. Drowsiness D. Hypotension

Answer 59

*A. Polyuria | IV steroid can cause rapid increase in BG, early sign of hyperglycemia

Question 60

A client is receiving methylprednisolone 40 mg IV daily. The nurse should monitor which laboratory value closely? A. Serum glucose. B. Serum calcium. C. Red blood cells. D. Serum potassium.

Answer 60

*A. Serum glucose. | Glucocorticoid and mineralocorticoid actions can lead to hyperglycemia

Question 61

A nurse is caring for a client who is on warfarin therapy for atrial fibrillation. The client's INR is 5.2 (too high). Which of the following medications should the nurse prepare to administer? A. Epinephrine B. Atropine C. Protamine D. Vitamin K

Answer 61

D. Vitamin K | Vitamin K reverses the effects of warfarin. ## Footnote Epinephrine treats anaphylaxis or cardiac arrest. It does not reverse the effects of warfarin. Atropine treats bradycardia. It does not reverse the effects of warfarin. Protamine reverses the effects of heparin, not warfarin.

Question 62

The laboratory report establishes that the client has a warfarin overdose. Which antidote would the nurse anticipate administering? A. Physostigmine B. Vitamin K C. Iron dextran D. Protamine sulfate

Answer 62

B. Vitamin K | Warfarin inhibits formation of vitamin K–dependent clotting factors. ## Footnote Its effect is overcome by increasing vitamin K. Iron dextran is an iron supplement, not an antidote for warfarin. Protamine sulfate is the antidote for heparin overdose. Physostigmine is an antidote for anticholinergic overdose.

Question 63

A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide? A. Check the pulse after medication administration. B. Take the medication with meals. C. Rinse the mouth after administration. D. Limit caffeine intake.

Answer 63

* C. Rinse the mouth after administration. | Glucocorticoids can allow fungal overgrowth in the mouth

Question 64

A nurse is reviewing the medication list for a client who has a new prescription for warfarin. The nurse should recognize that which of the following medications is incompatible with warfarin? A. Furosemide B. Alprazolam C. Vitamin K D. Vitamin A

Answer 64

C. Vitamin K | These two medications are not compatible. ## Footnote Vitamin K antagonizes the action of warfarin and is the antidote for warfarin toxicity. Furosemide can cause potassium loss and increase the risk for digoxin toxicity when used concurrently with digoxin. Alprazolam, used with sedative hypnotic medications, can increase the risk for CNS depression. Oral contraceptives can increase vitamin A levels.

Question 65

Which antidote would the nurse anticipate administering to a client whose laboratory report establishes a warfarin overdose? A. Physostigmine B. Vitamin K C. Iron dextran D. Protamine sulfate

Answer 65

B. Vitamin K | Warfarin inhibits formation of vit. K–dependent clotting factors ## Footnote Its effect is overcome by increasing vitamin K. Physostigmine is an antidote for anticholinergic overdose. Iron dextran is an iron supplement, not an antidote for warfarin. Protamine sulfate is the antidote for heparin overdose.

Question 66

A child recovering from a severe asthma attack is given oral prednisone 15 mg twice daily. Which intervention would be a priority for the nurse? A. Having the child rest as much as possible B. Checking the child’s eosinophil count daily C. Preventing exposure of the child to infection E. Offering sips of water when administering the medication

Answer 66

*C. Preventing exposure of the child to infection | Prednisone reduces resistance to certain infectious processes

Question 67

A nurse is providing discharge teaching to a client who has asthma and a new prescription for fluticasone/salmeterol. For which of the following adverse effects should the nurse instruct the client to report to the provider? A. Sedation B. Increased appetite C. White coating in the mouth and tongue D. Dry oral mucous membranes

Answer 67

* C. White coating in the mouth and tongue | This med depresses immune system thus thrush in mouth/white coating

Question 68

A child is prescribed fluticasone after an acute asthma attack. Which instruction would the nurse give the family about the administration of this medication? A. 'Fluticasone needs to be taken with food or milk.' B. 'Fluticasone is primarily used to treat acute asthma attacks.' C. 'The child should suck on hard candy to help relieve dry mouth.' D. 'Watch for white patches in the mouth and report to the health care provider.'

Answer 68

*D. 'Watch for white patches in the mouth and report to the health care provider.' | Oral thrush is a side effect that manifest as white patches

Question 69

Which action would the nurse perform when administering fluticasone propionate to a client with asthma? A. Assessing heart rate and rhythm B. Monitoring liver function blood tests C. Rinsing the oral cavity with water after use D. Obtaining blood glucose levels before meals E. Giving stool softeners to prevent constipation

Answer 69

C. Rinsing the oral cavity with water after use | Inhaled glucocorticoids are at an increased risk for oral candidiasis.

Question 70

A client is taking warfarin. If an antidote is needed, which agent will be used? A. Vitamin K B. Fibrinogen C. Prothrombin D. Protamine sulfate

Answer 70

A. Vitamin K | Warfarin sodium inhibits vitamin K ## Footnote therefore vitamin K is the antidote for warfarin sodium. Fibrinogen and prothrombin are blood-clotting factors, not the antidotes for warfarin sodium. Protamine sulfate is the antidote for heparin, not warfarin sodium.

Question 71

The nurse is educating a client on self-administration of a fluticasone inhaler. What statement indicates an understanding of the teaching? A. I will rinse my mouth with water after using the inhaler B. Disinfectant wipes can be used to clean the spacer C. I need to wait 15 minutes between puffs D. This inhaler should be used before the others

Answer 71

*A. I will rinse my mouth with water after using the inhaler | To prevent thrust, rinse mouth and spit it out

Question 72

A nurse is caring for a client who has cirrhosis and a prothrombin time of 30 seconds (too high). Which of the following medications should the nurse plan to administer? A. Vitamin K B. Heparin C. Warfarin D. Ferrous sulfate

Answer 72

A. Vitamin K | Vitamin K injection increases the synthesis of prothrombin by the liver ## Footnote A prothrombin time of 30 seconds indicates the clotting time is prolonged and bleeding could occur. Vitamin K injection increases the synthesis of prothrombin by the liver; therefore, the nurse should plan to administer vitamin k. The nurse should not anticipate that the provider will prescribe heparin, as the client's clotting time is prolonged. The nurse should not anticipate that the provider will prescribe warfarin, as the client's clotting time is prolonged. While clients who have cirrhosis often have anemia, the nurse should not plan to administer ferrous sulfate in response to the prolonged prothrombin time.

Question 73

A nurse is teaching a client with asthma about the correct use of the fluticasone inhaler. Which statement, if made by the client, would indicate that the teaching was effective? A. "The inhaler can be used when I feel short of breath." B. "If I forget a dose, I will double the next dose." C. "I should rinse my mouth after using the inhaler." D. "I should not use a spacer with my inhaler."

Answer 73

*C. "I should rinse my mouth after using the inhaler." | Rinse away residue in the mouth to reduce risk of an oral fungal infect

Question 74

A client with chronic liver disease reports, 'My gums have been bleeding spontaneously.' The nurse identifies small hemorrhagic lesions on the client’s face. The nurse concludes that the client needs which additional supplement? A. Bile salts B. Folic acid C. Vitamin A D. Vitamin K

Answer 74

D. Vitamin K | Fat-soluble vit K is essential for synthesis of prothrombin by the liver ## Footnote a lack results in hypoprothrombinemia, inadequate coagulation, and hemorrhage. Although cirrhosis may interfere with production of bile, which contains the bilirubin needed for optimum absorption of vitamin K, the best and quickest manner to counteract the bleeding is to provide vitamin K intramuscularly. Folic acid is a coenzyme with vitamins B 12 and C in the formation of nucleic acids and heme; thus a deficiency may lead to anemia, not bleeding. Vitamin A deficiency contributes to the development of polyneuritis and beriberi, not hemorrhage.

Question 75

A nurse is providing education on activities of daily living to a client taking warfarin. Which statement made by the client indicates further teaching is required? A. “I will brush my teeth using a soft-bristled toothbrush.” B. “I will wear a medical alert bracelet on my wrist.” C. “I will be sure to consume plenty of green leafy vegetables.” D. “I need to shave using an electric razor.”

Answer 75

C. “I will be sure to consume plenty of green leafy vegetables.” | Green leafy veg contain a high amount of vit K, antidote for warfarin. ## Footnote Warfarin is an anticoagulant medication used in the treatment of blood clotting disorders. Green leafy vegetables contain a high amount of vitamin K, the antidote for warfarin. The client should be instructed to limit their intake of vitamin K-containing foods. Using a soft-bristled toothbrush and an electric razor decrease the risk of bleeding. A medical alert bracelet is necessary for clients who are on blood-thinning medications to alert first responders in case of an emergency

Question 76

Which statement about appropriate foods to consume when taking warfarin would indicate that the client needs further teaching? A. "Eggs provide a good source of iron, which is needed to prevent anemia." B. "Yellow vegetables are high in vitamin A and should be included in the diet." C. "Dark green leafy vegetables are high in vitamin K, so I should eat them more often." D. "Milk and other high-calcium dairy products are necessary to counteract bone density loss."

Answer 76

C. "Dark green leafy vegetables are high in vitamin K, so I should eat them more often." | Limit foods high in vit. when establishing the PT/int normalized ratio

Question 77

The nurse teaches the client about appropriate foods to consume when taking warfarin. The nurse evaluates that the client needs further teaching when the client makes which statement? A. 'Eggs provide a good source of iron, which is needed to prevent anemia.' B. 'Yellow vegetables are high in vitamin A and should be included in the diet.' C. 'Dark green leafy vegetables are high in vitamin K, so I should eat them more often.' D. 'Milk and other high-calcium dairy products are necessary to counteract bone density loss.'

Answer 77

C. 'Dark green leafy vegetables are high in vitamin K, so I should eat them more often.'

Question 78

A 6-year-old child with asthma is prescribed an inhaled corticosteroid. The nurse would conclude the mother understands teaching about the medication side effects when the mother makes which statement? A. 'I’ll watch for frequent urination.' B. 'I’ll check for white patches in the mouth.' C. 'I’ll be alert for short episodes of not breathing.' D. 'I’ll monitor for an increased blood glucose level.'

Answer 78

*B. 'I’ll check for white patches in the mouth.' | Rinse mouth after each inhalation to prevent oral candidiasis

Question 79

A client with rheumatoid arthritis has been taking a corticosteroid medication for the past year. Prolonged use of corticosteroids puts this client at increased risk for which complication? A. Decreased white blood cells B. Increased C-reactive protein C. Increased sedimentation rate D. Decreased serum glucose levels

Answer 79

*A. Decreased white blood cells | Prolonged use of steroids can cause leukopenia

Question 80

A child undergoing prolonged steroid therapy takes on a cushingoid appearance. The nurse would expect to find which of these manifestations during further assessment? A. Truncal obesity/thin extremeties B. Increased linear growth C. Loss of hair on the body D. Decreased blood pressure

Answer 80

*A. Truncal obesity/thin extremeties | An increase in appetite results in fat on the abdomen and trunk

Question 81

The nurse is teaching a client about precautions while taking warfarin. The nurse should instruct the client to avoid foods with excessive amounts of which nutrient? A. Calcium B. Vitamin E C. Iron D. Vitamin K

Answer 81

D. Vitamin K

Question 82

Which response to fludrocortisone will the nurse teach a client with adrenal insufficiency to report? A. Edema/Rapid weight gain B. Fatigue in the afternoon C. Unpredictable changes in mood D. Increased frequency of urination

Answer 82

*A. Edema/Rapid weight gain | This med causes sodium retention causing edema and weight gain

Question 83

Which side effect of prolonged cortisone therapy for adrenal insufficiency would the nurse NOT teach the client and family to expect? A. Anorexia B. Weakness C. Moon face D. Weight gain

Answer 83

*A. Anorexia

Question 84

A female client receiving cortisone therapy for adrenal insufficiency expresses concern that she is developing facial hair. How would the nurse respond? A. 'It is just another sign of adrenal insufficiency.' B. 'This side effect will disappear after therapy.' C. 'This is not important as long as you are feeling better.' D. 'The medication contains a hormone that causes male characteristics.'

Answer 84

*D. 'The medication contains a hormone that causes male characteristics.' | 17-keto-steroid (androgenic) properities result in hirsutism

Question 85

A nurse is providing discharge instructions to a client who has rheumatoid arthritis and a prescription for oral betamethasone. Which of the following statements should the nurse make about how to take this medication? A. "Take the medication between meals." B. "Take the medication with orange juice." C. "Take the medication with milk." D. "Take the medication on an empty stomach."

Answer 85

*C. "Take the medication with milk." | Milk or food prevents gastric irritation

Question 86

A nurse in a clinic is caring for a client who has recently begun taking warfarin. The nurse is reviewing potential drug and food interaction risks and should instruct the client to avoid which of the following? A. Cabbage B. Cantaloupe C. Green beans D. White beans

Answer 86

A. Cabbage | Cabbage is rich in vitamin K

Question 87

Which substance does vitamin K contributes to the formation of? A. Bilirubin B. Prothrombin C. Thromboplastin D. Cholecystokinin

Answer 87

B. Prothrombin | Vit K is necessary in the formation of prothrombin to prevent bleeding.

Question 88

Which vitamin is essential for the synthesis of prothrombin by the liver? A. B 12 B. C C. D D. K

Answer 88

D. K | Prothrombin is synthesized in the liver in the presence of vitamin K ## Footnote vitamin K initiates the vital process of coagulation.

Question 89

The nurse provides discharge medication education to a client who has a prescription for warfarin. Which client statement indicates to the nurse that teaching was effective? A. 'I will avoid taking aspirin and nonsteroidal anti-inflammatory drugs [NSAIDs].' B. 'I will need to develop a more sedentary routine.' C. 'I will need to have regular complete blood counts to guide warfarin dosage.' D. 'Before going to the dentist, I will ask my health care provider for antibiotics.'

Answer 89

A. 'I will avoid taking aspirin and nonsteroidal anti-inflammatory drugs [NSAIDs].' | Aspirin should be avoided because it interferes w/ platelet aggregation

Question 90

Which medication is often contraindicated when taking warfarin? A. Atenolol B. Ferrous sulfate C. Chlorpromazine D. Aspirin

Answer 90

D. Aspirin | Aspirin can decreased platelet aggregation increasing the risk for bleed ## Footnote Aspirin can cause decreased platelet aggregation, increasing the risk for undesired bleeding that may occur with administration of anticoagulants. It should not be administered unless specifically prescribed, usually by a cardiologist or other specialist, to manage serious risks of thrombosis. Ferrous sulfate does not affect warfarin; it is used for red blood cell synthesis. Atenolol is a beta-blocker that reduces blood pressure; it does not affect bleeding. Chlorpromazine is a neuroleptic; it does not affect bleeding.

Question 91

The home health nurse is completing a medication reconciliation of a client who has a new prescription for warfarin. Which medication should the nurse question the healthcare provider about? A. Aspirin B. Nifedipine C. NPH insulin D. Vitamin D supplement

Answer 91

A. Aspirin | Warfarin anticoag, prevents blood clotting by block synthesis of vit K ## Footnote Warfarin is an anticoagulant that prevents blood from clotting by blocking the synthesis of vitamin K. Clients taking warfarin are at increased risk for bleeding. Aspirin, which is an anti-platelet aggregation, prevents platelets from clumping together. Taking warfarin and aspirin together could increase the risk of bleeding and should be questioned. Nifedipine is a calcium channel blocker and does not interact with warfarin. Insulin and vitamin D supplement do not cause adverse effects when taken with warfarin.

Question 92

The nurse is reinforcing medication interactions with a client who is taking warfarin. Which over-the-counter (OTC) medication should the nurse remind the client to avoid? A. Diphenhydramine B. Acetaminophen C. Naproxen (NSAID) D. Pantoprazole

Answer 92

C. Naproxen (NSAID) | Naproxen can prolong bleeding time

Question 93

The nurse has provided instructions to a client on the use of warfarin. Which statement by the client requires further teaching? A. "If I become constipated, I can take laxatives containing magnesium salts." B. "If I develop a headache, I should take ibuprofen to help my pain." C. "If I develop an itchy rash, I will use a cream with diphenhydramine." D. "If I catch a cold, I will use guaifenesin to make my cough better."

Answer 93

B. "If I develop a headache, I should take ibuprofen to help my pain." | warfarin shouldnt take NSAIDs @same time due to increased risk for blee ## Footnote Warfarin is an anticoagulant that prolongs bleeding time and is used to treat and prevent blood clots. One of the most serious side effects of warfarin is excessive bleeding and hemorrhage. Warfarin interacts with a number of other drugs. Clients taking warfarin should not take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen at the same time due to an increased risk for bleeding. There are no known drug interactions between warfarin and laxatives containing magnesium salts, guaifenesin, or diphenhydramine cream. As a result, they may be taken together.

Question 94

A client is being discharged with a prescription for warfarin. The client asks "May I take aspirin with this medication? It helps my arthritis." Which response by the nurse is appropriate to address the client's concern? A. "Use about half the recommended dose of aspirin." B. "When you take the aspirin, do not take the warfarin that day." C. "Avoid aspirin because it can increase the bleeding effects of warfarin." D. "Take the warfarin in the morning and the aspirin at night."

Answer 94

C. "Avoid aspirin because it can increase the bleeding effects of warfarin." | Aspirin is a salicylate, which inhibits platelet aggregation.

Question 95

Which instruction will the nurse include when performing discharge teaching to a client now receiving hydrocortisone by mouth after stabilization of an acute adrenal insufficiency? A. "Eat a diet high in sodium." B. "Take the medication with food." C. "Maintain the same dose indefinitely." D. "Eliminate a dose if side effects occur."

Answer 95

*B. "Take the medication with food." | Taken with food minimizes the side effects of GI irritation

Question 96

Which nursing assessment is important for a school-age child undergoing long-term steroid therapy? A. Monitoring pulse for irregularities B. Testing of stools for occult blood C. Inspection of urine for mucous threads D. Check of oral mucous membranes for ulcers

Answer 96

*B. Testing of stools for occult blood | Steroids decrease production of prostaglandins that protect the stomach

Question 97

Which statement regarding mealtime administration by a client who has arthritis and is prescribed corticosteroid medication indicates that the teaching was effective? A. "This will decrease gastric irritation." B. "This will serve as a reminder to take the medication." C. "The presence of food will enhance absorption." D. "The medication is ineffective in an acid medium."

Answer 97

*A. "This will decrease gastric irritation." | Food limits irritating effect of steroids on gastric mucosa.

Question 98

Which complication is an adverse effect of cortisone therapy? A. Hypoglycemia B. Severe anorexia C. Anaphylactic shock D. Behavioral changes

Answer 98

*D. Behavioral changes | Behavioral changes happen with long term use of glucocorticoids

Question 99

Which side effect would the nurse assess for in a child receiving prednisone? A. Alopecia B. Anorexia C. Weight loss D. Mood changes

Answer 99

*D. Mood changes | Glucocorticoids cause fluid andelectrolyte changescausesbehavioralchange

Question 100

A client receiving corticosteroid therapy states, 'I have difficulty controlling my temper, which is so unlike me, and I don’t know why this is happening.' How will the nurse respond? A. Tell the client it is nothing to worry about. B. Reassure that everyone does this at times. C. Instruct the client to attempt to avoid situations that cause irritation. D. Inquire about mood swings.

Answer 100

*D. Inquire about mood swings. | steroids increase exciteability of CNS which can cause labile emotions

Question 101

A client with systemic lupus erythematosus is taking prednisone. Which foods would the nurse encourage the client to eat while receiving treatment to prevent hypokalemia? A. Broccoli B. Oatmeal C. Fried rice D. Cooked carrots

Answer 101

*A. Broccoli | Green leafy veggies = potassium

Question 102

Which information from the client’s history would the nurse identify as a risk factor for developing osteoporosis? A. Takes estrogen therapy B. Receives long-term steroid therapy C. Has a history of hypoparathyroidism D. Engages in strenuous physical activity

Answer 102

*B. Receives long-term steroid therapy | Steroids can accelerate bone demineralization

Question 103

A nurse is teaching with a client about taking high doses of oral glucocorticoids/prednisone for an extended period of time to treat rheumatoid arthritis. Which of the following instructions should the nurse include in the teaching? A. "Plan to check blood glucose levels for hypoglycemia once yearly." B. "Glucocorticoids will boost immunity." C. "Limit the intake of calcium rich foods while taking the medication." D. "Monitor for compression fractures of the back and neck."

Answer 103

*D. "Monitor for compression fractures of the back and neck." | Steroids can result in bone loss in the back and neck within weeks

Question 104

Which increased risk would the nurse consider when assessing a client with diabetes who is receiving long-term corticosteroid therapy and is admitted with leg ulcers? A. Weight loss B. Hypoglycemia C. Decreased blood pressure D. Inadequate wound healing

Answer 104

*D. Inadequate wound healing | People on long term steroid therapy tend to heal slowly

Question 105

The nurse is caring for a client prescribed warfarin therapy for treatment of persistent atrial fibrillation. Which of the following may potentiate the effect of this medication? A. St. John wort B. Estrogen C. Vitamin K D. Green tea

Answer 105

D. Green tea | Green tea can potentiate the effect of warfarin and increase bleeding.

Question 106

A nurse is providing teaching to a client who is taking warfarin about monitoring its therapeutic effects. Which of the following explanations should the nurse provide about the international normalized ratio (INR) test? A. "The INR also monitors heparin therapy if the provider switches the medication prescription." B. "The INR is the only test available for anticoagulant therapy monitoring." C. "You will only need the test twice per month." D. "The INR is a standardized test that eliminates the variations between laboratories reports in prothrombin times."

Answer 106

D. "The INR is a standardized test that eliminates the variations between laboratories reports in prothrombin times." | The INR monitors warfarin therapy, not heparin therapy

Question 107

Which drink would a nurse teach a client on warfarin to avoid? A. Apple juice B. Grape juice C. Orange juice D. Cranberry juice

Answer 107

D. Cranberry juice | Antioxidants in cranberry may inhibit mechanism, metabolizes warfarin

Question 108

Which information would the nurse include when teaching a client about warfarin? A. Periodic blood testing is necessary. B. Increase intake of green leafy vegetables. C. Limit the amount of daily physical activity. D. It should be continued for minor surgical procedures.

Answer 108

A. Periodic blood testing is necessary.

Question 109

The international normalized ratio (INR) results of a client receiving warfarin have been variable. Which factor can help the nurse identify the cause of the INR fluctuations? A. Intake of foods high in potassium B. Serum glucose level C. Platelet count D. Adherence to the prescribed medication regimen by patient

Answer 109

D. Adherence to the prescribed medication regimen by patient | dosage of warfarin is adjusted according to INR results;

Question 110

A nurse is reviewing the INR results for caring for a client who had a cerebral vascular accident and is receiving prescribed warfarin. The nurse notes the INR is 5.2. Which finding requires priority follow-up? A. Gum bleeding B. Generalized weakness C. Pharyngitis D. Anorexia

Answer 110

A. Gum bleeding | Normal INR 2-3; this elevated level is risk for internal bleeding

Question 111

A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin? A. Hemoglobin (Hgb) B. Prothrombin time (PT) C. Bleeding time D. Activated partial thromboplastin time (aPTT)

Answer 111

B. Prothrombin time (PT) | PT is used to monitor warfarin therapy.

Question 112

A client being discharged is prescribed warfarin for the treatment following a pulmonary embolism. Which diagnostic test should the nurse instruct the client to receive once a month? A. Perfusion scan. B. Prothrombin Time (PT). C. Activated partial thromboplastin (aPTT). D. Serum Coumadin level (SCL).

Answer 112

B. Prothrombin Time (PT). | client taking warfarin should PT or INR levels checked at a min 1x month

Question 113

The nurse is reviewing the prothrombin time results for a client who is taking warfarin. The nurse notes the value is 20 seconds. What is an appropriate nursing action? A. Recognize that this is a therapeutic level while on this drug. B. Assess for bleeding gums or IV sites. C. Notify the primary health care provider immediately. D. Observe the client for hematoma development.

Answer 113

A. Recognize that this is a therapeutic level while on this drug. | Therapeutic levels for warfarin are usually 1.5 to 2x the normal level.

Question 114

Warfarin is prescribed for a client who has been receiving intravenous (IV) heparin for a partial occlusion of the left common carotid artery. The client expresses concern about why both medications are needed at the same time. Which rationale would the nurse include to address the client’s concern? A. This permits the administration of smaller doses of each medication. B. Giving both medications allows clot dissolution while preventing new clot formation. C. Heparin provides anticoagulant effects until warfarin reaches therapeutic levels. D. Administration of heparin with warfarin provides immediate and maximum protection against clot formation.

Answer 114

C. Heparin provides anticoagulant effects until warfarin reaches therapeutic levels.

Question 115

A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make? A. "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level." B. "I will call the provider to get a prescription for discontinuing the IV heparin today." C. "Both heparin and warfarin work together to dissolve the clots." D. "The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay."

Answer 115

A. "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level."

Question 116

A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following statements by the client indicates an understanding of the teaching? A. "It's okay to have a couple of glasses of wine with dinner each evening." B. "I'll be sure to eat more foods with vitamin K." C. "I'll take aspirin for my headaches." D. "I'll use my electric razor for shaving."

Answer 116

D. "I'll use my electric razor for shaving."

Question 117

A client who had surgery is discharged on warfarin. Which statement by the client is incorrect and indicates a need for further teaching? A. "I will report any bruises or unusual bleeding." B. "I know I must avoid crowds." C. "I plan on using an electric razor for shaving to prevent cutting." D. "I will keep all laboratory appointments to monitor my INR."

Answer 117

B. "I know I must avoid crowds."

Question 118

A nurse is teaching a client who has a new prescription for prednisone to treat rheumatoid arthritis. The nurse should inform the client that which of the following is a therapeutic effect of this medication? A. Reduces risk of infection B. Decreases inflammation C. Improves peripheral blood flow D. Increases bone density

Answer 118

*B. Decreases inflammation

Question 119

A client with rheumatoid arthritis asks the nurse why it is necessary to inject hydrocortisone into the knee joint. Which reason would the nurse include in a response to this question? A. Lubricates the joint B. Reduces inflammation C. Provides physiotherapy D. Prevents ankylosis of the joint

Answer 119

*B. Reduces inflammation

Question 120

A health care provider prescribes dexamethasone for a client with head trauma. The nurse recognizes that it reduces swelling in the brain by which process? A. Acts as a hyperosmotic diuretic B. Increases resistance to infection C. Reduces the inflammatory response of tissues D. Decreases the formation of cerebrospinal fluid

Answer 120

*C. Reduces the inflammatory response of tissues | Steroids decrease inflammation, decreasing edema

Question 121

A beclomethasone inhaler would be prescribed for which purpose? A. Prevents atelectasis B. Decreases inflammation C. Relaxes smooth muscle in the airways D. Reduces bacteria in the respiratory tract

Answer 121

*B. Decreases inflammation | This med reduces the inflamm response in bronchial walls

Question 122

Which action is the primary purpose of a topical steroid application to a basal cell carcinoma surgical site? A. Preventing infection of the wound B. Increasing fluid loss from the skin C. Reducing inflammation at the surgical site D. Limiting itching around the area of the lesion

Answer 122

*C. Reducing inflammation at the surgical site

Question 123

Which intervention would the nurse anticipate providing teaching on when a client presents with extensive lesions caused by psoriasis (skin autoimmune inflammation)? A. Advising sunscreen and special clothing B. Topical application of steroids C. Potassium permanganate baths D. Débridement of necrotic plaques

Answer 123

*B. Topical application of steroids

Question 124

A client is being discharged with a prescription for warfarin. Which information is most important to be included in the nurse's discharge teaching? A. Take acetaminophen for minor pain B. Use a soft toothbrush C. Avoid eating leafy green vegetables D. Report nose or gum bleeding

Answer 124

D. Report nose or gum bleeding

Question 125

The nurse is preparing to administer prescribed warfarin to a client with a mechanical heart valve. Which finding should the nurse report to the healthcare provider? A. The INR is 3.0 (normal) B. The peripheral IV site has been oozing blood. C. The aPTT is 30 (normal) D. The client has cola-colored urine.

Answer 125

D. The client has cola-colored urine. | Cola-colored urine is a sign of hematuria

Question 126

A client presents with extensive lesions caused by psoriasis. Which intervention would the nurse anticipate providing teaching on? A. Advising sunscreen and special clothing B. Topical application of steroids C. Potassium permanganate baths D. Débridement of necrotic plaques

Answer 126

*B. Topical application of steroids

Question 127

The nurse provides client teaching on the administration of a topical steroid application to a basal cell carcinoma surgical site. The nurse evaluates the teaching as effective when the client identifies which action as the primary purpose of the medication? A. Preventing infection of the wound B. Increasing fluid loss from the skin C. Reducing inflammation at the surgical site D. Limiting itching around the area of the lesion

Answer 127

*C. Reducing inflammation at the surgical site

Question 128

A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give? A. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level." B. "A pharmacist is the person to answer that ." C. "Heparin does not dissolve clots. It stops new clots from forming." D. "The oral medication you will take after this IV will dissolve the clot."

Answer 128

C. "Heparin does not dissolve clots. It stops new clots from forming." | The effects of heparin begin within minutes.

Question 129

The nurse is caring for a child undergoing chemotherapy for acute lymphoid leukemia. The parents ask why the child needs prednisone. Which response by the nurse would be correct? A. 'It decreases inflammation.' B. 'It suppresses the production of lymphocytes.' C. 'It increases appetite and a sense of well-being.' D. 'It may decrease skin irritation and edema.'

Answer 129

*A. 'It decreases inflammation.'

Question 130

The nurse is caring for a child receiving prednisone. Which consideration is most important for the nurse to remember when administering adrenocorticosteroid therapy? A. It suppresses inflammation. B. It may produce hyperkalemia. C. Wound healing is accelerated. D. Antibody production increases.

Answer 130

*A. It suppresses inflammation.

Question 131

The nurse is caring for a client who is scheduled for a bilateral adrenalectomy. Which medication would the nurse expect to be prescribed for this client? A. Methimazole B. Regular insulin C. Pituitary extract D. Hydrocortisone

Answer 131

*D. Hydrocortisone

Question 132

Immediately after a bilateral adrenalectomy, a client is receiving corticosteroids that are to be continued after discharge from the hospital. Which statement by the client indicates to the nurse that additional education is needed? A. 'I need to have periodic tests of my blood for glucose.' B. 'I am glad that I only have to take the medication once a day.' C. 'I must take the medicine with meals.' D. 'I should tell my health care provider if I am overly restless or have trouble sleeping.'

Answer 132

*B. 'I am glad that I only have to take the medication once a day.' | Usually two doses are given to mimic hormonal secretion

Question 133

Which times for the medication schedule would a nurse teach when corticosteroid therapy is prescribed for a client with an exacerbation of ulcerative colitis? A. At bedtime with a snack B. Three times a day with meals C. Take twice a day with food D. One hour before or 2 hours after eating

Answer 133

*C. Take twice a day with food | Taking med early in AM mimics usual adrenal secretions and evening

Question 134

A client who is on long-term corticosteroid therapy after an adrenalectomy is admitted to the surgical intensive care unit after being involved in a motor vehicle crash. Which statement is an important concern for client safety? A. The dosage of steroids will have to be tapered down slowly to prevent acute adrenal crisis. B. Steroid therapy will need to be increased to avert a life-threatening crisis. C. Osteoporosis secondary to long-term corticosteroids increases fracture risk. D. The client is at risk for Cushing syndrome if taking long-term corticosteroid therapy.

Answer 134

*B. Steroid therapy will need to be increased to avert a life-threatening crisis. | Pts with Adrenocroticoid insufficiency need increase steroids

Question 135

A client is scheduled for an adrenalectomy. Which action would the nurse expect in the plan of care? A. Provide a low-protein diet. B. Administer parenteral corticosteroids. C. Collect a preoperative 24-hour urine specimen. D. Withhold all medications 48 hours before surgery.

Answer 135

*B. Administer parenteral corticosteroids.

Question 136

A client is scheduled for a bilateral adrenalectomy. Which rationale describes why steroids are administered to the client? A. To foster accumulation of glycogen in the liver B. To increase the inflammatory action to promote healing C. To facilitate urinary excretion of salt and water after surgery D. To compensate for sudden lack of these hormones after surgery

Answer 136

*D. To compensate for sudden lack of these hormones after surgery

Question 137

A nurse is receiving a client who is immediately postoperative following hip arthroplasty. Which of the following medications should the nurse plan to administer for DVT prophylaxis? A. Aspirin PO B. Enoxaparin subcutaneous C. Heparin infusion D. Warfarin PO

Answer 137

B. Enoxaparin subcutaneous | Enoxaparin, a low molecular heparin, inhibits thrombus & clot formation

Question 138

A client develops a deep vein thrombophlebitis in her leg 3 weeks after giving birth and is admitted for anticoagulant therapy. The nurse would anticipate developing a teaching plan for which anticoagulant? A. Heparin B. Warfarin C. Clopidogrel D. Enoxaparin

Answer 138

A. Heparin

Question 139

4) After abdominal surgery, a client is prescribed low molecular weight heparin (LMWH). During administration of the medication, the client asks the nurse the reason for the medication. Which is the best response for the nurse to provide the client? A. This medication is given to prevent blood clot formation. B. This medication enhances antibiotics to prevent infection. C. This medication dissolves clots that develop in the legs. D. This medication enhances the healing of wounds.

Answer 139

A. This medication is given to prevent blood clot formation | LMWH an anticoag inhibit thrombin-mediated convert fibrinogen to fibrin

Question 140

Enoxaparin 40 mg subcutaneously daily is prescribed for a client who had abdominal surgery. The nurse explains that the medication is given for which purpose? A. To control postoperative fever B. To provide a constant source of mild analgesia C. To limit the postsurgical inflammatory response D. To provide prophylaxis against postoperative thrombus formation

Answer 140

D. To provide prophylaxis against postoperative thrombus formation

Question 141

A client is admitted to the hospital for an adrenalectomy. When teaching the client about the prescribed medications, which advice will the nurse emphasize? A. Medication therapy will be given in conjunction with insulin. B. Once regulated, the dosage will remain the same for life. C. Medications will need to be held for surgery or other invasive procedures. D. Salt intake may have to be restricted.

Answer 141

*D. Salt intake may have to be restricted. | Adrenocrotical hormones causes sodium retention

Question 142

A client who is 34 weeks gestation is diagnosed with a pulmonary embolism. Which of these medications should the nurse plan to administer? A. Oral low-dose aspirin B. Oral warfarin C. Intravenous heparin D. Subcutaneous enoxaparin

Answer 142

C. Intravenous heparin | Dx w/PE, preg or not, are initially Tx w/ iv unfractionated heparin

Question 143

A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse plan to take? A. Insert the needle at a 45º angle. B. Aspirate for a blood return before depressing the plunger. C. The nurse should not expel the air bubble in the prefilled syringe. D. Administer the medication 2.54 cm (1 in) from the umbilicus.

Answer 143

C. The nurse should not expel the air bubble in the prefilled syringe. ## Footnote Enoxaparin should only be injected deep into the fatty layer of the abdominal wall at a 90º angle. The nurse should not aspirate for a blood return when administering enoxaparin. Enoxaparin is a low-molecular weight anticoagulant medication that should be administered in the fatty tissue of the abdomen, avoiding a 2-inch diameter around the umbilicus for best absorption

Question 144

A nurse is preparing to administer heparin subcutaneously to a client who has a deep vein thrombosis. Which of the following techniques should the nurse use? A. Cleanse the skin with an alcohol swab, insert the needle, aspirate, and inject the heparin. B. Cleanse the skin with an alcohol swab, insert the needle, aspirate, inject the heparin, and massage the site. C. Cleanse the skin with an alcohol swab, insert the needle, inject the heparin, and observe for bleeding. D. Cleanse the skin with an alcohol swab, insert the needle, inject the heparin, aspirate, and observe for bleeding.

Answer 144

C. Cleanse the skin with an alcohol swab, insert the needle, inject the heparin, and observe for bleeding.

Question 145

To prevent excessive bruising when administering subcutaneous heparin, which technique will the nurse employ? A. Administer the injection via the Z-track technique. B. Avoid massaging the injection site after the injection. C. Use 2 mL of sterile normal saline to dilute the heparin. D. Inject the medication into the vastus lateralis muscle in the thigh.

Answer 145

B. Avoid massaging the injection site after the injection.

Question 146

The health care provider prescribes enoxaparin to be administered subcutaneously. To ensure client safety, which measure would the nurse take when administering this medication? A. Remove air pocket from the prepackaged syringe before administration. B. Rub the injection site for 30 seconds after administration. C. Administer the medication over 2 minutes. D. Administer in the abdomen area only.

Answer 146

D. Administer in the abdomen area only.

Question 147

A health care provider prescribes enoxaparin 30 mg subcutaneously daily. Which measure would the nurse take when administering this medication? A. Push over 2 minutes. B. Administer in the abdomen. C. Massage site after administration. D. Remove air pocket from prepackaged syringe before administration.

Answer 147

B. Administer in the abdomen.

Question 148

A nurse is caring for a client who is receiving a continuous IV infusion of heparin. Which of the following actions should the nurse take? A. Administer 50,000 units of heparin by IV bolus every 12 hr. B. Check the activated partial thromboplastin time (aPTT) every 4 hr. C. Have vitamin K available on the nursing unit. D. Use IV tubing specific for heparin sodium when administering the infusion.

Answer 148

B. Check the activated partial thromboplastin time (aPTT) every 4 hr.

Question 149

A client is prescribed heparin therapy for a deep vein thrombosis (DVT). Which laboratory value should the nurse monitor closely? A. D-dimer B Platelet count C. Activated partial thromboplastin time D. Bleeding time

Answer 149

C. Activated partial thromboplastin time

Question 150

) A client who has atrial fibrillation with rapid ventricular response is started on a continuous heparin infusion. Which clinical finding enables the nurse to conclude that the heparin therapy is effective? A. Atrial fibrillation converts to a sinus rhythm. B. The heart rate is stabilized at 70 to 90 beats per minute. C. The international normalized ratio (INR) is within normal range. D. An activated partial thromboplastin time (aPTT) is twice the usual value.

Answer 150

D. An activated partial thromboplastin time (aPTT) is twice the usual value.

Question 151

The nurse is caring for a client after cardiac surgery who has been prescribed protamine sulfate due to receiving too much heparin. Which finding indicates that the treatment is having the intended effect? A. The international normalized ratio (INR) is trending down. B. The bleeding from the surgical site has slowed. C. The client reports decreased chest pain. D. The respiratory rate is increased.

Answer 151

B. The bleeding from the surgical site has slowed.

Question 152

A nurse is caring for a client who is receiving heparin by continuous IV infusion. Which of the following medications should the nurse plan to administer in the event of an overdose? A. Iron B. Glucagon C. Protamine D. Vitamin K

Answer 152

C. Protamine

Question 153

The nurse is caring for a client who is receiving a continuous intravenous heparin infusion. The client's most recent activated partial thromboplastin time (aPTT) is 120 seconds (overdose). Which medication should the nurse plan to administer? A. Protamine B. Naloxone C. Vitamin K D. Enoxaparin

Answer 153

A. Protamine

Question 154

The spouse of a client with an intracranial hemorrhage asks the nurse, 'Why aren’t they administering an anticoagulant?' How will the nurse respond? A. 'It is not advisable because bleeding will increase.' B. 'If necessary, it will be started to enhance circulation.' C. 'If necessary, it will be started to prevent pulmonary thrombosis.' D. 'It is inadvisable because it masks the effects of the hemorrhage.'

Answer 154

A. 'It is not advisable because bleeding will increase.'

Question 155

The nurse is discharging a client who is at risk for venous thromboembolism (VTE). The client is prescribed enoxaparin. Which instruction should the nurse provide to this client? A. "Notify your health care provider if your stools appear tarry or black." B. "You must have your partial thromboplastin time (PTT) checked weekly." C. "You should massage the injection site for better absorption." D. "An intravenous (IV) catheter will be placed to administer the medication."

Answer 155

A. "Notify your health care provider if your stools appear tarry or black."

Question 156

A nurse is reviewing the laboratory data on a client who has a new prescription for heparin for treatment of a pulmonary embolism. Which of the following data should the nurse report to the provider? A. Hematocrit 45% B. Partial thromboplastin time (PTT) 65 seconds C. White blood cell count 8,000/mm3 D. Platelets 74,000/mm3

Answer 156

D. Platelets 74,000/mm3

Question 157

Hydrocortisone is prescribed for a client with Addison's disease. Which response is a therapeutic effect of this medication? A. Supports a better response to stress B. Promotes a decrease in blood pressure C. Decreases episodes of shortness of breath D. Controls an excessive loss of potassium

Answer 157

*A. Supports a better response to stress | This med has anti-inflamm action and aids in metabolism of carbohydrates

Question 158

A client with myasthenia gravis is to receive immunosuppressive therapy with corticosteroids. Which mechanism of action assures the nurse that this therapy will be effective? A. Inhibits the breakdown of acetylcholine at the neuromuscular junction B. Stimulates the production of acetylcholine at the neuromuscular junction C. Decreases the production of autoantibodies that attack acetylcholine receptors D. Promotes the removal of autoantibodies that impair the transmission of impulses

Answer 158

*C. Decreases the production of autoantibodies that attack acetylcholine receptors | Steroids limits production of antibodies

Question 159

Dexamethasone has been prescribed for a client after a craniotomy for a brain tumor. Which physiological response is responsible for this medication’s therapeutic effect? A. Reduced cell growth B. Reduced cerebral edema C. Increased renal reabsorption D. Increased response to sedation

Answer 159

*B. Reduced cerebral edema | Anti-inflamm effects which will reduce cerebral edema

Question 160

A client is scheduled for a craniotomy to remove a brain tumor. To prevent the development of cerebral edema after surgery, the nurse anticipates the use of medications from which class? A. Glucocorticoids B. Anticholinergics C. Anticonvulsants D. Antihypertensives

Answer 160

*A. Glucocorticoids | Decreases cerebral edema

Question 161

A child with nephrotic syndrome has been receiving prednisone for 1 week. Which information in the child’s record indicates to the nurse that the medication has NOT been effective? A. Weight loss B. Lower blood pH C. Decreased lethargy D. Increased urine output

Answer 161

*B. Lower blood pH | Steroids do not affect blood pH

Question 162

A child who has nephrotic syndrome is prescribed steroid therapy. Which explanation would the nurse give the parents regarding the goal of this treatment? A. Prevents infection B. Stimulates diuresis C. Provides hemopoiesis D. Reduces blood pressure

Answer 162

*B. Stimulates diuresis | Steroids produce diuresis in most children with nephrotic syndrome

Question 163

A nurse is teaching a client who has diabetes mellitus and a new prescription for prednisone for a rash. Which of the following statements by the client indicates the need for further teaching? A. "I might need to increase my regular insulin during this time." B. "I will stop the prednisone when my rash goes away." C. "I should expect my stools to become very dark and sticky while on this medication." D. "I might have a hard time falling asleep while taking prednisone."

Answer 163

*B. "I will stop the prednisone when my rash goes away."

Question 164

A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects? A. Hyperglycemia B. Adrenocortical insufficiency C. Severe dehydration D. Rebound pulmonary congestion

Answer 164

*B. Adrenocortical insufficiency

Question 165

The nurse is teaching the parents of a child prescribed a high dose of oral prednisone for asthma. Which information is critical for the nurse to include when teaching about this medication? A. It protects against infection. B. It should be stopped gradually. C. An early growth spurt may occur. D. A moon-shaped face will develop.

Answer 165

*B. It should be stopped gradually.

Question 166

Which effect explains the purpose for gradual dosage reduction of glucocorticoids such as dexamethasone? A. Builds glycogen stores in the muscles B. Produces antibodies by the immune system C. Allows the increased intracranial pressure to return to normal D. Promotes return of cortisone production by the adrenal glands

Answer 166

*D. Promotes return of cortisone production by the adrenal glands

Question 167

The nurse is preparing a client with rheumatoid arthritis (RA) for discharge to an assisted living facility. Which statement about the prescribed oral glucocorticoid is correct? A. "The medication will reverse the joint deterioration of RA." B. "You will be taking the medication for several years." C. "It is normal to experience some memory loss or hallucinations." D. "The medication will be gradually tapered off over 5 to 7 days."

Answer 167

*D. "The medication will be gradually tapered off over 5 to 7 days."

Question 168

A client who recently started receiving oral corticosteroids for a severe allergic reaction is instructed that the dosage will be reduced gradually until all medication is stopped at the end of 2 weeks. Which reason would the nurse provide for this gradual reduction in dosage? A. Discontinuing the medication too fast will cause the allergic reaction to reappear. B. Slow reduction of the medication will prevent a physiological crisis because the adrenal glands are suppressed. C. The health care provider is attempting to determine the minimal dose that will be effective for the allergy. D. Sudden cessation of the medication will cause development of serious side effects, such as moon face and fluid retention.

Answer 168

*B. Slow reduction of the medication will prevent a physiological crisis because the adrenal glands are suppressed. | Avoiding abrupt cessation of the med will give the body time to adjust

Question 169

Which statement by a client who had an endarterectomy that is prescribed clopidogrel would cause the nurse to conclude that teaching was effective? A. "Clopidogrel will limit inflammation around my incision." B. "Taking this medication will help prevent further clogging of my arteries." C. "The medication will lower the slight fever I have had since surgery." D. "I will take this medication to reduce the discomfort I feel at the surgical incision."

Answer 169

B. "Taking this medication will help prevent further clogging of my arteries."

Question 170

Which explanation would the nurse provide for administering prednisone to a client with an exacerbation of colitis? A. The client will be protected from getting an infection. B. Symptoms associated with the colitis will decrease slowly over time. C. Although the medication causes anorexia, weight loss may not occur. D. Although the medication decreases intestinal inflammation, it will not cure the colitis.

Answer 170

*D. Although the medication decreases intestinal inflammation, it will not cure the colitis.

Question 171

Which information would the nurse provide when administering the first dose of prednisone prescribed to a client with an exacerbation of colitis? A. "Prednisone protects you from getting an infection." B. "The medication may cause weight loss by decreasing your appetite." C. "Prednisone is not curative but does cause a suppression of the inflammatory process." D. "The medication is relatively slow in precipitating a response but is effective in reducing symptoms."

Answer 171

*C. "Prednisone is not curative but does cause a suppression of the inflammatory process." | Prednisone inhibits inflammation

Question 172

For the client taking clopidogrel, the nurse will monitor for which adverse effect? A. Nausea B. Epistaxis/nose bleed C. Chest pain D. Elevated temperature

Answer 172

B. Epistaxis/nose bleed

Question 173

A client who had a femoropopliteal bypass graft is receiving clopidogrel postoperatively. Which instruction will the nurse teach the client related to the medication? A. Eliminate starches and red meats from the diet. B. Eat more roughage if constipation occurs. C. Report any occurrence of multiple bruises. D. Take the medication on an empty stomach.

Answer 173

C. Report any occurrence of multiple bruises.

Question 174

A client at risk for a stroke has been prescribed clopidogrel. Which information is most important for the nurse to reinforce with the client? A. "You must take the medication on an empty stomach." B. "If you miss a dose, take a double dose the next day." C. "You must stop the medication a week before your surgery." D. "You must have your lab tests checked weekly."

Answer 174

C. "You must stop the medication a week before your surgery."

Question 175

A nurse is teaching a client who has a new prescription for clopidogrel. Which of the following instructions should the nurse include? A. "Take this medication with food." B. "You might have to stop taking this medication 5 days before any planned surgeries." C. "Take this medication three times daily." D. "Expect to have black-colored stools while taking this medication."

Answer 175

B. "You might have to stop taking this medication 5 days before any planned surgeries."

Question 176

A nurse is assessing a client receiving alteplase for a pulmonary embolism. The client suddenly becomes confused and is unable to follow commands. What action does the nurse take first? A. Notify the healthcare provider B. Reorient the client C. Check the client pupils D. Stop the infusion

Answer 176

D. Stop the infusion

Question 177

Tissue plasminogen activator (t-PA) is to be administered to a client in the emergency department. Before beginning the infusion, which assessment is the nurse’s priority? A. Vital signs B. Electrocardiogram (ECG) monitoring C. Signs of bleeding D. Level of chest pain

Answer 177

C. Signs of bleeding

Question 178

The nurse is caring for a client who received tenecteplase to open an occluded coronary artery. Which finding should be of highest concern for the nurse? A. Epistaxis B. Bleeding gums C. Hematemesis D. Urinary retention

Answer 178

C. Hematemesis

Question 179

The nurse is monitoring a client who is receiving the thrombolytic agent alteplase for treatment of an acute myocardial infarction (AMI). What outcome indicates the client is receiving adequate therapy within the first few hours of treatment? A. Reduction of ST-segment elevation on a 12-lead ECG B. Stabilization of blood pressure C. Absence of cardiac arrhythmias D. Cardiac enzymes are within normal limits

Answer 179

A. Reduction of ST-segment elevation on a 12-lead ECG