RN Basic Exam

Question 1

Your patient is receiving her first dose of Augmentin. She states that she has no know allergies, but has rarely taken medication. You will observe fro which symptoms of an anaphylactic reaction?

• Coughing and watery eyes
• Dyspnea and urticaria
• Itchy throat and runny nose
• Pruritus and burning upon urination

Answer 1

• Dyspnea and urticaria

Question 2

Your patient has an order for a medication 0.4mg PO BID. You will administer:

• One 4 g tablet
• Four 1mg tablets
• Two 0.2 mg tablets
• One-half 8mg tablet.

Answer 2

• Two 0.2 mg tablets

Question 3

Your patient has an order for 1000 mL of d5W to infuse at 125 mL/hour. You do not have a pump. Your tubing set has a 15 gtt/mL drip factor. You will infuse this solution at how many drops per minute?

11 gtts/minute
15 gtts/minute
31 gtts/minute
60 gtts/minute

Answer 3

31 gtts/minute

Question 4

A nurse should explain to a client that the purpose of the Z-track injection technique is to:

• decrease the pain associated with some medications.
• allow for rapid administration of the medication.
• prevent the medication from seeping out of the tissue.
• deliver a large dose of a medication into a muscle.

Answer 4

• prevent the medication from seeping out of the tissue.

Question 5

When a client who is taking warfarin sodium (Coumadin) develops epistaxis, the nurse should anticipate an order for which of the following?

Phytonadione (vitamin K1).
Protamine sulfate.
Streptokinase (Kabikinase ).
Thrombin (Thrombogen).

Answer 5

Phytonadione (vitamin K1).

Question 6

Which of these instructions should a nurse give to a client who is taking nystatin (Mycostatin) tablets for oral candidiasis?

“Chew the tablet thoroughly.”
“Dissolve the tablet in your mouth.”
“Mix the tablet with ice cream.”
“Swallow the tablet whole with a sip of water.”

Answer 6

“Dissolve the tablet in your mouth.”

Question 7

A nurse should inform a client who is taking theophylline anhydrous (Theo-Dur) that it is essential to minimize the intake of foods which contain xanthine. Which of these foods should the nurse instruct the client to AVOID?

Cheese.
Eggs.
Chocolate.
Spinach.

Answer 7

Chocolate.

Question 8

Several intravenous (IV) emergency drugs have been ordered for a client who is in cardiac arrest. The IV cannula should be flushed with 20 mL of normal saline after the administration of each drug accompanied by elevation of the extremity in order to:

1. prevent chemical irritation of the blood vessels from the caustic nature of the drugs.
2. facilitate delivery of the drugs into the central circulation.
3. avoid toxicities resulting from the concentrated nature of the drugs.
4. minimize potential for hypotension.

Answer 8

2.facilitate delivery of the drugs into the central circulation.

Question 9

Before administering an intravenous solution containing potassium chloride, a nurse should assess the client’s:

respiratory rate.
urine output.
level of consciousness.
capillary refill.

Answer 9

urine output.

Question 10

Which of these medications should a nurse have available to treat a client who has ketoacidosis?

Insulin glargine (Lantus).
Regular insulin (Humulin R).
Glucagon.
Glyburide (Micronase).

Answer 10

Regular insulin (Humulin R).

Question 11

A nurse should include which of these instructions in the teaching plan for a client who is taking metoprolol tartrate (Lopressor)?

“If a dose is missed, double the next dose of the drug.”
“Report signs of jaundice.”
“If you drink alcohol, do so in moderation.”
“Do not stop the drug abruptly.

Answer 11

“Do not stop the drug abruptly.

Question 12

Which of the following apply to the administration of enoxaparin (Lovenox) subcutaneously?

• The upper arm is the preferred site of administration.
• Do not massage the site after injection.
• Administer using a 22 gauge, ½ inch needle.
• Check INR and PT results prior to giving.

Answer 12

• Do not massage the site after injection.

Question 13

A nurse should carefully monitor a client who is receiving penicillin G sodium for adverse effects, which include:

urticaria.
hypotension.
bradycardia.
renal impairment

Answer 13

urticaria.

Question 14

A client taking acetaminophen (Tylenol) is instructed to adhere to the dosing guidelines carefully because of the potential for:

hearing loss.
vascular collapse.
gastric ulcers
liver damage.

Answer 14

liver damage.

Question 15

When an elderly client is receiving a barbiturate such as Phenobarbital, a nurse should observe the client for which of these paradoxical effects?

Marked excitement.
Nocturnal dyspnea.
Decreased anxiety.
Anginal pain.

Answer 15

Marked excitement.

Question 16

Penicillin G benzathine (Bicillin) is available in prefilled syringes containing 500,000 units/mL. If 125,000 units of Bicillin is ordered for a client, how many milliliters should a nurse administer?

0.25
0.75
2
4

Answer 16

0.25

Question 17

A nurse should recognize that a microdrip intravenous administration set is designed to administer how many drops of solution per milliliter?

10
15
20
60

Answer 17

60

Question 18

1000 mg = __ g

Answer 18

1

Question 19

1000 mcg= __ mg

Answer 19

1

Question 20

2.2 pounds = __ kg

Answer 20

1

Question 21

2.54cm = __ inch

Answer 21

1

Question 22

1000mL = __L

Answer 22

1

Question 23

30mL (cc) = __ ounce

Answer 23

1

Question 24

___ mg = 1 G

Answer 24

1000

Question 25

___ mcg = 1 milligram

Answer 25

1000

Question 26

__ lbs = 1kg

Answer 26

2.2

Question 27

1 in = __ cm

Answer 27

2.54

Question 28

1L = ___ mL

Answer 28

1000

Question 29

1 ounce = how many mL or cc?

Answer 29

30

Question 30

“5 Rights of Medication Administration”

Answer 30

``` Right time Right Patient Right drug Right dose Right route ```

Question 31

Remember that analgesics such as morphine and demerol have adverse effects of ___ and ___

Answer 31

respiratory depression (hold for RR

Question 32

most absorption of oral medicine happens in the____

Answer 32

small intestine

Question 33

in an edematous patient, a drug dose must be ___ volume than normal patient

Answer 33

larger

Question 34

in an dehydrated patient, a drug dose must be ___ volume than normal patient

Answer 34

smaller

Question 35

What organ metabolizes most drugs?

Answer 35

Liver

Question 36

What organ excretes most drugs?

Answer 36

Kidneys

Question 37

Patients with decreased renal function need ___ doses and maybe ____ intervals to avoid drug toxicity

Answer 37

lower doses longer dosage intervals

Question 38

Elderly patients have decreased hepatic and renal perfusion which may result in the need to ___ doses

Answer 38

lower

Question 39

Measure infant doses in a ___ to provide accurate dose

Answer 39

syringe

Question 40

For children, never mix a drug with __ or ___

Answer 40

food or formula

Question 41

Rapid infusion of Vancomycin may cause

Answer 41

"red neck syndrome"

Question 42

Lipitor and Zocor are what class?

Answer 42

Anticholesterol/antihyperlipidemics/statin

Question 43

What is the antagonist of Heparin?

Answer 43

protamine sulfate

Question 44

For Dilantin, when do you measure BP?

Answer 44

during administration and 1 hour after infusion due to small interval between therapeutic and toxic

Question 45

What classification is Dilantin?

Answer 45

Anti-convulsant

Question 46

For anti fungal agents, what organ function studies must be monitored?

Answer 46

liver

Question 47

What is a side effect of AZT and DDC (antiretroviral) that must be reported?

Answer 47

Neuropathy

Question 48

Versed and Valium are

Answer 48

benzodiazepines

Question 49

Atenolol, Lopressor, and Inderal are all

Answer 49

beta blockers and antihypertensive agents

Question 50

Which beta blocker has an increased risk for liver damage?

Answer 50

Inderal

Question 51

Pro-Xanthine is a ___ medication that can cause ____

Answer 51

anticholinergic (for bladder) orthostatic hypotension

Question 52

Atropine is contraindicated with ___

Answer 52

glaucoma

Question 53

Glaucoma medications promue the outflow of aqueous humor to decrease

Answer 53

ocular pressure

Question 54

When mixing insulin in a syringe, pull up ___ and then ___

Answer 54

regular (shorter acting) then NPH (longer acting)

Question 55

What types of insulin are given by sliding scale?

Answer 55

Rapid acting: HumaLog, lispro and Novolog, aspart Short acting: Humulin R, Novocain R, regular

Question 56

What types of insulin are given daily?

Answer 56

Intermediate acting: Humulin N, Novocain N, NPH Long acting: Lantus, glargine

Question 57

Do not mix ___ with other insulin

Answer 57

glargine

Question 58

Lantus, glargine are ___ acting insulin

Answer 58

long

Question 59

Humulin N, Novocain N, NPH are ___ acting insulin

Answer 59

intermediate

Question 60

Humulin R, Novocain R, regular are ___ acting insulin

Answer 60

short

Question 61

HumaLog, lispro and Novolog, aspart are ___ acting insulin

Answer 61

rapid

Question 62

Use NSAIDs with caution in hx of __ allergy

Answer 62

aspirin

Question 63

Cytarabine, Epogen, Folic Acid, Lupron and Tamoxifen are all

Answer 63

oncology medications

Question 64

Use __ with caution or avoid in presence of neuro problems

Answer 64

opioids

Question 65

What med is most common in PCA?

Answer 65

morphine

Question 66

Avoid ___ before antibiotics

Answer 66

antacids

Question 67

Avoid ___ with blood thinners

Answer 67

NSAIDS

Question 68

Tip head ___ for nasal spray and __ for nasal drops

Answer 68

forward for spray back for drops

Question 69

administer ear drops in ___ position

Answer 69

side-lying

Question 70

How do you administer eye drops?

Answer 70

ask patient to look up pull lower lid down and administer drop into lower conjunctival sac apply gentle pressure at inside bridge of nose for 1-2 min (minimizes systemic absorption)

Question 71

Rectal administration - position, etc.

Answer 71

patient should be in left lateral Sims position must be inserted beyond anal sphincter into rectal mucosa

Question 72

For intravaginal administration, lying flat for ___ min will help retain the suppository

Answer 72

30

Question 73

Subcutaneous administration points - needle size, degrees

Answer 73

25-27 gauge 1/2-5/8in needle 45 degree with average weight

Question 74

Don't aspirate when administering __ or ___

Answer 74

heparin or insulin both are sub-q

Question 75

1 tsp = ___ mL

Answer 75

5

Question 76

1 tbsp = __ mL

Answer 76

15mL

Question 77

For a PICC, do not flush catheter with __ before removal

Answer 77

heparin

Question 78

Removal of catheter with PICC should be slow and at __ in increments to prevent spasms

Answer 78

1-2

Question 79

For IM injections, what's the needle gauge and size?

Answer 79

18-23 gauge 1 1/4-3" needle

Question 80

Avoid >___ mls IM at one site

Answer 80

3

Question 81

Oral potassium chloride and prednisone can both cause

Answer 81

GI irritation

Question 82

Depoakote has a black box warning re:

Answer 82

hepatic failure

Question 83

Gabapentin (Neutrontin) is a ____ also used to treat peripheral neuropathy. Do you need to taper when discontinuing?

Answer 83

anticonvulsant Yes taper

Question 84

Albuterol (Proventil) is a ___ that has the 2 main adverse effects of ___ and ___

Answer 84

bronchodilator tachycardia and anxiety

Question 85

Possible effect of the first dose of ACE inhibitor enalapril (Vaster) is

Answer 85

dizziness upon standing

Question 86

Metformin (Glucophage) should be held when the patient is

Answer 86

NPO

Question 87

Glucocorticoids such as prednisone have the adverse effect of ___ and can be given with ___

Answer 87

GI irritation food or milk

Question 88

With iodinated contrast media (ICM), what serum lab values should you measure?

Answer 88

Serum creatinine

Question 89

What is the reversal agent for benzos?

Answer 89

Flumazenil (Romazicon)

Question 90

What is the reversal agent for opioids?

Answer 90

Naloxone (Narcan)

Question 91

What is the antidote for heparin?

Answer 91

Protamine sulfate

Question 92

Buspirone is what classification?

Answer 92

anti-anxiety

Question 93

``` A nurse should monitor a client who is receiving cefotaxime sodium (Claforan) for side effects, which include • Diarrhea • Vertigo • Tinnitus • Insomnia ```

Answer 93

• Diarrhea

Question 94

APTT is important with which drug?

Answer 94

Heparin

Question 95

PT and INR are used with which drug?

Answer 95

Warfarin

Question 96

With statins, Depakote and metformin (Glucophage), what organ function tests are important?

Answer 96

Liver

Question 97

Peaks and troughs are important with

Answer 97

antibiotic therapy

Question 98

Range for PT

Answer 98

11-15 sec

Question 99

Range for INR

Answer 99

0.7-1.8

Question 100

Range for APTT

Answer 100

60-70 sec

Question 101

Range for WBC

Answer 101

3.4-11.2

Question 102

Range for Hemoglobin

Answer 102

12-16

Question 103

Range for HCT hematocrit

Answer 103

35-47

Question 104

Range for Platelets

Answer 104

150-450

Question 105

Range for Na

Answer 105

135-145

Question 106

Range for Cl

Answer 106

94-110

Question 107

Range for BUN

Answer 107

5-25

Question 108

Range for Glucose

Answer 108

70-105

Question 109

Range for K

Answer 109

3.5-5.2

Question 110

Range for Co2

Answer 110

22-32

Question 111

Range for Creatinine

Answer 111

0.5-1.5

Question 112

What is the maximum safe rate for Potassium chloride?

Answer 112

10 mEq/hr

Question 113

Long-acting benzos can have risk for __ with elderly patients

Answer 113

falling

Question 114

Lorazepam Ativan can have effects of ___ and ___

Answer 114

respiratory depression and Co2 retention

Question 115

When administering Midazolam (Versed), you should have ___ available

Answer 115

Flumazenil

Question 116

Use Lorazepam cautiously in patients with

Answer 116

COPD

Question 117

NO grapefruit juice with

Answer 117

Statins Antihistamines Calcium channel blockers (blood pressure drugs): nitrendipine, felodipine (Plendil), nifedipine (Adalat, Procardia) Psychiatric drugs: buspirone (BuSpar), triazolam (Halcion), carbamazepine (Tegretol), diazepam (Valium), midazolam (Versed), sertraline (Zoloft) Immunosuppressants: cyclosporine (Neoral), tacrolimus (Program) Pain medications: methadone Viagra HIV medication: saquinavir (Inverse) Antiarrhythmics: amiodarone (Cordarone)

Question 118

What labs must you monitor with Aminoglycosides (gentamicin)?

Answer 118

tinnitus BUN and creatinine urine output

Question 119

Do not mix Aminoglycosides (gentamicin) with ___

Answer 119

Penicillin - give 2 hours apart

Question 120

Vancomycin has vesicant properties, meaning

Answer 120

capable of causing blistering, tissue sloughing or necrosis when it escapes from the intended vascular pathway into surrounding tissue.

Question 121

Diltiazem-SR has toxic effects, so absolutely do not

Answer 121

crush

Question 122

70/30 insulin is 70% __ and 30% ___

Answer 122

70 NPH 30 Regular

Question 123

Rapid and short acting insulin cover meals immediately __ the injection

Answer 123

after

Question 124

Intermediate acting insulin is expected to cover ___ meals

Answer 124

subsequent

Question 125

Long acting insulin like ___ and ___ provides relatively constant level of insulin and acts as a basal insulin

Answer 125

Ultralente and Glargine (Lantus)

Question 126

Only ___ insulin is given IV

Answer 126

regular

Question 127

Remember to __ sites when doing insulin admin

Answer 127

rotate

Question 128

When mixing insulins, withdraw __ and then ___. Rule is "____"

Answer 128

Regular THEN NPH clear to cloudy

Question 129

Do not mix __ with other insulins

Answer 129

glargine/lantus

Question 130

Short acting Regular R insulin should be given

Answer 130

20-30 min before meal

Question 131

NPH, Humulin N, or Lente should be given

Answer 131

after meals

Question 132

in patients with kidney failure, the plasma half-life of furosemide is ___ because both urinary excretion and conjugation by the kidney are reduced

Answer 132

prolonged

Question 133

lithium therapeutic level is

Answer 133

.5-1.2 mEqL

Question 134

patients on lithium need to have what tests and how often?

Answer 134

lithium level TSH renal function Q6mo

Question 135

side effects of lithium

Answer 135

weight gain tremor ataxia memory problems

Question 136

What antibiotic should you give for a UTI?

Answer 136

Septa trimethoprim / sulfamethoxazole

Question 137

Therapeutic range for digoxin

Answer 137

0.5-2.0

Question 138

ADE of Digoxin

Answer 138

``` bradycardia n/v visual disturbances diplopia halos ```

Question 139

Hold digoxin if apical HR is