Test
NURS 310 EXAM 1 PRACTIC EXAM
Preguntas del test (48)
1A client is taking several prescribed oral medications for treatment of congestive heart failure. He tells the nurse, "I'm going to take these at breakfast". Which response by the nurse is most appropriate?
- A"Let's look at each medication to determine the best time to take it"
- B"That depends on what you eat for breakfast"
- C"That's a great idea so you won't forget any medications"
- D"What time do you usually have breakfast?"
2In addition to less efficient renal excretion, what other physical change in aging may lead to a need to reduce medication dosage in an elderly client?
- AIncreased rate of drug absorption
- BDecreased total body fluid proportionate to body mass
- CDecreased efficiency in drug distribution
- DIncreased rate of drug metabolism by the liver
3A nurse is administering medication to a hospitalized client. Which of the following is the most accurate way to assure that the right patient gets the medication?
- AAsk the client, "are you Dale Jones?"
- BCheck the client's identification band
- CCheck the client's room number and bed assignment
- DAsk the client why he or she is getting the medication
4A client asks, "what's the difference between Advil and ibuprofen?" The nurse responds by saying which of the following?
- A"There is no difference between them"
- B"Advil and ibuprofen are two different drugs with similar effects"
- C"This question should be answered by your doctor"
- D"If you doctor orders Advil, you should not substitute any other medication"
5The nurse would expect the dose of morphine for a postoperative patient to be higher than usual for the patient's size and age is prescribed for a patient who routinely uses:
- Aalprazolam (Xanax)
- Bethanol (Alcohol)
- Coxycodone (OxyContin)
- Dtemazepam (Restoril)
6The decreased lean body mass common in the elderly is likely to affect:
- Aabsorption of drugs
- Bdistribution of drugs
- Cmetabolism of drugs
- Delimination of drugs
7Which of the following is an example of a primary prevention measure?
- AParticipating in cardiac rehabilitation
- BGetting an annual physical examination
- CAvoiding excessive sun exposure
- DPracticing monthly self-breast examinations
8An older adult client who experiences several adverse effects of medications could benefit from:
- AReduced drug dosages
- BNursing home placement
- CIncreased drug dosages at less frequent intervals
- DMore frequent physician visits
9One day after surgery, the nurse inspects the client's incision. Which of the following is evidence of a local inflammatory response?
- AClear yellow drainage from the surgical wound
- BRedness and warmth around the incision
- CPallor at the suture line
- DBrown exudate at the wound edges
10Which is the best way to increase client compliance with a medication regimen?
- AGive all the instructions at least three times
- BEncourage the client to hire a visiting nurse
- CUse a medication organizer
- DDevise the simplest schedule possible
11Which of the following provides the best rationale for encouraging a client with a wound to consume a diet high in vitamin C?
- ARestoration of the inflammatory response
- BEnhancement of oxygen transport
- CReduction of edema
- DIncreased protein synthesis
12The nurse is concerned about urinary retention in a client who has not voided for 8 hours since undergoing surgery. Which assessment finding is most likely?
- AThe nurse will be unable to palpate the bladder
- BThe bladder will be smooth to palpation
- CThe nurse can palpate the bladder at the symphysis pubis
- DThe bladder will be felt at the umbilicus
13A client who has had surgery has a poor cough effort due to incisional pain. He has crackles in his lower lobes bilaterally. Which of the following non-pharmacological interventions would be most effective in dealing with this problem?
- AIncreasing fluids to 2500cc/day
- BUsing incentive spirometry every 2 hours
- CSuctioning the client every 2 hours
- DSplinting the abdominal incisional
14The client is ordered to have morphine sulfate 2 mg IV every 6 minutes via PCA pump. However, the client has refused to take the medication. Which of the following actions by the nurse is most appropriate?
- APushing the PCA pump button for him
- BCalling the physician to request medication by mouth
- CGiving the medication in an intramuscular injection
- DExploring why he does not want to take the medication
15A nurse is evaluating a client for a post-operative infection. Which of the following signs is most indicative of an infection?
- APresence of an indwelling foley catheter
- BRectal temperature of 37.8 C (100 F)
- CProductive cough with yellow mucous
- DWhite blood cell count of 8,000/mm^3
16A client is at risk for hypovolemia in the postoperative period. Which of the following would insure the most accurate monitoring of fluid balance?
- AMeasuring and recording intake and output
- BMonitoring skin turgor for tenting
- CAssessing the vital signs every hour hours
- DChecking the lungs for crackles
17Which member of the healthcare team is responsible for obtaining informed consent from a client prior to a surgical procedure?
- AThe primary nurse
- BThe surgeon
- CThe nurse at the physician's office
- DThe surgeon's assistant
18The nurse inadvertently gives the client a double dose of the medication. Who should be notified first?
- AThe client
- BThe prescriber
- CThe nurse's lawyer
- DThe nursing supervisor
19Of the following clients, who is at the greatest risk for developing wound infection?
- AOne who requires frequent pain medication
- BOne who is 25 lbs. overweight
- COne who walks shortly after surgery
- DOne who is 10 lbs. underweight
20A client had surgery two hours ago. Vital signs at that time were BP 140/74, P 82, R 16, skin warm and dry. Vitals signs are now BP 110/62, P 102, R 22, skin cool. Which of the following should the nurse do first?
- ARe-checking of vital signs to verify they are correct
- BEvaluate the head of the bed to help the client breath more effectively
- CCheck the client's urine output for more than 30mL/hour
- DAdminister pain medication
21Which of the following is a form of secondary prevention?
- AGetting a tetanus booster
- BLosing 10 pounds
- CGetting mammograms and pap smears regularly
- DHaving physical therapy for low back pain
22Which nursing action may help decrease the anxiety of a pre-operative client?
- AEncouraging her to sleep until it is time for surgery
- BReassuring her that she will be fine and has no need to worry
- CSpending time with her and answering all of her questions
- DTeaching her how to avoid postoperative complications
23Regular use of which of the following places a surgical client at increased risk for bleeding?
- AGinseng
- BOmega 3 fatty acids
- CEchinacea
- DKava kava
24A client is experiencing confusion in the immediate post-operative period. Which of the following assessments is most essential to determine the reason for confusion?
- Aairway status
- Bcardiac rhythm
- Clevel of anxiety
- Dbody temperature
25The nurse is caring for a client post-operatively. Which of the following indicates that the client has a compromised airway?
- AThe client states he is anxious
- BThe client rates his pain a 6 out of 10
- CHis pulse oximetry reading is 90%
- DHis skin is cool and clammy
26In reviewing the chart of a patient about to undergo general anesthesia, which of the following is the greatest risk factor?
- AHe expresses anxiety about the upcoming procedure
- BHe ate a snack two hours ago
- CHe smokes and states his last cigarette was 6 hours ago
- DHe has a history of hypertension controlled by diet
27Which of the following instructions should be included in the medication teaching for an older adult who has back pain who is prescribed an opioid with codeine?
- ACheck your breathing rate three times a day
- BIncrease your intake of fiber and fluids
- CLimit taking the medication unless pain is severe
- DAvoid taking the medication more than twice a day
28The nurse is preparing to administer Clarinex (desloratadine) to an adult with seasonal allergies. The order reads 15mg once/day but the acceptable dose is 5mg/day. What should the nurse do next?
- AHold the medication and check the original order
- BCall the prescriber
- CAsk the client if this is his usual dose
- DAdminister the dose because it was prescribed
29A patient is taking lovastatin (Mevacor) for cholesterol control. She asks what might happen if she takes the medication with grapefruit juice. The nurse replies:
- A"The medication will not get to its site of action"
- B"You may build up toxic levels of the medication"
- C"The liver can be damaged"
- D"The medication cannot be absorbed properly"
30Before administering acetaminophen (Tylenol) the nurse reviews the patient's lab results. Which of the following is the nurse specifically looking for?
- AAlterations in BUN and creatinine
- BLow potassium level
- CElevated AST and ALT levels
- DLow hemoglobin and hematocrit
31Warfarin sodium (Coumadin) is a highly protein bound drug. When the nurse gives this medication to a client with a low serum protein level, which of the following responses is expected?
- AMore intense drug response and greater risk for bleeding
- BLess intense drug response and greater risk for bleeding
- CMore intense drug response and less risk for bleeding
- DLess intense drug response and less risk for bleeding
32A client develops a rash after receiving the medication Oxycodone. The prescriber discontinues the oxycodone and orders diphenhydramine (Benadryl). The nurse must be alert for which drug-drug interaction?
- AConfusion
- BFever
- CHypotension
- DUrinary retention
33A client is scheduled for an elective surgical procedure. He tells the nurse that he usually takes gingko biloba to help his memory but he hasn't taken it for three days. What action should the nurse take?
- ADocument this information in the chart
- BNotify the nurse anesthetist immediately
- CRequest a stat electrocardiogram and chest x-ray
- DDetermine how long the client has taken the gingko
34The client has had a general anesthetic for an exploratory laparotomy. The nurse notes that there is no antiemetic medication ordered for post-op care. Which action should the nurse take?
- AAsk the anesthesiologist if the client was nauseated during surgery
- BTell the client to report any nausea
- CContact the surgeon and request an order for an antiemetic
- DGive the client sips of ginger ale to reduce nausea
35A patient admitted to the hospital with a diagnosis of pneumonia asks the nurse, "Why am I receiving codeine? I don't have any pain." The nurse's response is based on knowledge that codeine also has what effect?
- AImmunostimulant
- BAntitussive
- CAnti-infective
- DImmunosuppressant
36The nurse is walking in the hallway with a client who had surgery yesterday. The client is receiving morphine sulfate via a patient controlled analgesia system. The client complains of nausea. Of the following, which should the nurse do first?
- AAdminister the anti-nausea medication
- BAssist the client to sit down
- CGet an emesis basin
- DWalk the client back to his room
37A patient who has received morphine sulfate becomes becomes slightly disoriented. If this effect is due to the morphine, which intervention by the nurse would be most likely to reverse this adverse effect?
- AAssist the patient to walk
- BInstruct the patient to change positions slowly
- CInstruct the patient to take slow, deep breaths
- DKeep the room well lit
38The caregiver of a patient calls to report, "My mother just took her first dose of the prescribed opioid and became very nauseated." Select the nurse's best response:
- A"She is probably allergic to the agent and should discontinue it now"
- B"If the nausea is not as bad as the pain, she should continue the opioid as prescribed"
- C"This is generally a temporary effect and is lessened by keeping still"
- D"Try cutting the dose in half and take the medication on an empty stomach"
39A nurse suspects that a patient is still in pain because of non-adherance to the opioid regimen. Which physical sign would help confirm this suspicion?
- ADilated pupils
- BConstricted pupils
- CHypotension
- DSlow respiration
40While reviewing discharge instructions, a patient asks the nurse why the oral dose of the opioid is so much higher than the intravenous dose was. Select the nurse's best response.
- A"When patients go home, they need higher doses of medication"
- B"The oral form of the drug passes through the liver, and a lot is metabolized before it can achieve the desired effect"
- C"When the physician converted the dosages, there was an error in calculation"
- D"The doses should be the same. The physician must think your pain is not well controlled"
41Select the most accurate description of physical dependence.
- AIt is a state in which larger doses are required to produce the same response formerly produced by a smaller dose.
- BIt is a state in which an individual will seek and use the drug despite physical, psychological, or social harm
- CIt is a state in which pain is undertreated and the patient appears to be drug seeking
- DIt is a state in which an abstinence syndrome will occur if the drug is abruptly discontinued
42In the emergency department a nurse assesses a stuporous patient who is suspected of overdosing on opioids. The nurse should prepare to administer which agent if the patient becomes comatose or develops respiratory depression?
- AFlumazenil (Romazicon)
- BNaloxone (Narcan)
- CAtropine
- DVitamin K
43A patient who has been taking opioids for 2 years is preparing to stop. How should the nurse instruct the patient to discontinue the opioids after prolonged use?
- AStop the agents abruptly
- BContinue a very low dose for 3-6 months
- CTaper slowly over 7-10 days
- DSwitch to an equianalgesic dose of another opioid and then discontinue
44While caring for an unconscious client, the nurse knows that:
- AThe patient will not feel pain
- BAny noxious stimulus should be treated as potentially painful
- CIf pain is perceived the client will always have an observable change in behavior
- DPain is best assessed by asking a family member
45Which of the following are commonly experienced side effects associated with administration of opioid analgesics? (select all that apply)
- AConstipation
- BPupillary dilation
- CUrinary retention
- DSlowed respiratory rate
- ERapid pulse
- FHeadache
- GDrowsiness
- HIncreased blood pressure
- IDry mouth
46Nursing practice should be guided by which of the following principles of pain management?
- APain medication should be used only as needed when pain becomes severe
- BNurses should give pain medication at the first sign of pain using a large enough dose to obtain relief
- CIt is best to begin with a very small dose, adding more as needed for relief
- DMedication should be given no more frequently than every four hours to avoid overdose
47Which of the following factors have the most significant effect on a client's response to pain medications? (select all that apply)
- AAge
- BGender
- CBody mass index
- DTime of day medication is given
- ENutritional status
- FGeneric substitution
48An 80 year-old woman is brought to the health center for the first time by her 64 year-old daughter. Which of the following approaches by the nurse would be most appropriate at the time?
- AAsk the daughter whether the client has any urgent needs or problems
- BObtain a health history from the client herself
- CInterview the client and daughter together so that pertinent information can be obtained
- DRefer the client for an interdisciplinary comprehensive geriatric assessment since she will have multiple needs
Información
- Descripción
- Practice exam for first exam of NURS 310
- Autor
- harlacherha
- Idioma
- English
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