12. A nurse is caring for a client who is taking digoxin to treat heart failure.
ID: 247536 • Letter: 1
Question
12. A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to developing digoxin toxicity?
Having a prolapsed mitral valve
Having a 10-year history of COPD
Taking a high-ceiling diuretic
Taking an HMG CoA reductase inhibitor
39. A nurse is reviewing the medication administration record of a client who reports having a dry productive cough for the past 2 weeks. Which of the following medications should the nurse report to the provider?
Furosemide
Lisinopril
Diltiazem
Metoprolol
35. A nurse is teaching a client who has a seizure disorder and a prescription for phenytoin. Which of the following instructions should the nurse include?
“Floss teeth on a daily basis.”
“Increase daily fluid intake to 3,000 milliliters.”
“Take this medication on an empty stomach.”
“Limit alcohol intake to two drinks per day.”
62. A nurse is monitoring the laboratory values of a client who is receiving heparin. Which of the following values should the nurse report to the provider?
Platelets 300,000/mm3
Hematocrit 45%
PT 11 seconds
aPTT 50 seconds
66. A nurse is caring for a client who has nicotine use disorder and asks about taking varenicline. The nurse should identify that which of the following conditions is a contraindication for this medication?
Rheumatoid arthritis
COPD
Anorexia nervosa
Major depressive disorder
46. A nurse is caring for a client who is receiving IV amphotericin B. Which of the following findings should the nurse identify as an acute infusion reaction?
Dry cough
Fever
Hyperglycemia
Pedal edema
13. A nurse is completing a medication reconciliation for a client prior to his transfer to a long-term care facility. Which of the following actions should the nurse take?
Remove duplicate medications of different dosages from the reconciliation list.
Compare the current list of medications to medications the client will receive after transfer.
Omit over-the-counter medications from the at-home medication list.
Include medications the client receives in the acute setting, but will no longer need after transfer.
44. A nurse is assessing a client who is receiving oxytocin via continuous IV infusion for labor augmentation. The nurse notes six contractions in a 10 min period with a non-reassuring FHR. Which of the following actions should the nurse take first?
Discontinue the oxytocin IV infusion.
Turn the client to her left side.
Administer terbutaline 0.25 mg subcutaneously.
Apply oxygen at 10 L/min via face mask.
49. A nurse is preparing to administer the initial dose of penicillin G IM to a client. The nurse should monitor for which of the following as an allergic reaction following the injection?
Dyspepsia
Bradycardia
Urticaria
Pallor
56. A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to a client who has diabetes mellitus. Which of the following actions should the nurse take first?
Withdraw the regular insulin from the vial.
Inject air into the NPH vial.
Withdraw the NPH insulin from the vial.
Inject air into the regular insulin vial.
50. A nurse is caring for a young adult female client who has chronic acne. Prior to administering tetracycline, which of the following nursing actions should the nurse take?
Determine the clients age at the onset of menses.
Ask the client if she is using birth control.
Check the client’s history for an allergy to penicillin.
Measure the client’s vital signs.
11. A nurse is teaching a client about nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching?
“This medication has a slower onset than a nitroglycerin pill that is swallowed.”
“I should take this medication as soon as pain begins.”
“I can crush this medication for faster relief.”
“This medication should completely dissolve within 15 minutes.”
47. A nurse is preparing to administer lidocaine via continuous IV infusion at 4 mg/min. Available is lidocaine 2 g dextrose 5% in water 500 mL. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if applicable. Do not use a trailing zero.)
68. A nurse is teaching a newly licensed nurse about safe medication administration. The nurse should instruct that which of the following actions is included in the 6 rights of medication administration?
Verify dosage calculation with a second nurse.
Obtain a current list of the client’s medications.
Document medication prior to administration.
Compare a new prescription with an old prescription.
3. A nurse is teaching a client who has a new prescription for nitroglycerin patches. The nurse should identify which of the following statements as an indication that the client understands the teaching?
“I will move the patch to my leg if I get a headache.”
“I will rotate the application site to avoid skin irritation.”
“I will apply a new patch if I have chest pain.”
“I cannot take a sublingual tablet of nitroglycerin after applying the patch.”
Explanation / Answer
12. Most of the cardiac patients will receive digoxin to decrease cardiac workload. So having a prolapsed mitral valve is an appropriate option. These group of patients will have tendency to develop digoxin toxicity.
39. Among the given medication Lisinopril is the ACE inhibitor. The side effect of ACE inhibitor is dry cough.
35. The action of Phenytoin will diminish when it is taken with food. So the Phenytoin should be taken in an empty stomach.
62. When there is Heparin infusion , aPTT should be monitored. Normal range of aPTT is 20-36 seconds. aPTT 50 seconds is an appropriate option.
66. Verenicille which is used for nicotine use disorder will affect the mood. So major depressive disorder is an contraindication for this drug.
46. Acute infusion reaction for IV Amphotericin B is fever , headache , nausea , vomiting , loss of appetite , increased heart rate and shivering. So among the given options fever is an appropriate option.
13. Remove duplicate medication of different dosages from the reconciliation list.
44. 6 contractions in ten minutes interval with non reassuring FHR patterns indicates IV Oxytocin to be discontinued.Non reassuring FHR indicates fetal distress. So the appropriate action of nurse is discontinue the Oxytocin infusion.
49. Allergic reaction following Penicillin injection among the given options is urticaria.
56. Inject air into the NPH vial is the first nursing action. If we want to mix regular and NPH insulin , draw back air into the empty syringe ; push air of desired dosage into NPH insulin vial and push balance air of desired dosage into regular insulin vial. Without removing the syringe aspirate desired dosage of regular insulin and remove the syringe. Without adding air , withdraw desired dosage of NPH insulin carefully.There by we did mixing of NPH insulin and regular insulin.
50. Ask the client if she is using birth control pills. Tetracycline will produce teratogenic effects during pregnancy. So asking the client about birth control measure is an appropriate nursing action.
11. I should take this medication as soon as the pain begins. This statement indicates the understanding of teaching about nitroglycerin sublingual tablets.
47. 2g = 2000 mg. 2000 mg of lidocaine available in 500 ml of 5% dextrose.
500 ml = 2000 mg
Therefore 1 ml = 4 mg
Nurse has to administer 4 mg/ min = 1 ml/ min
In one hour we have to set the infusion pump as 60ml/hr
68. Verify dosage calculation with the second nurse.
3. I cannot take a sublingual tablet of nitroglycerin after applying the patch.
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