A 66 y.o with history of untreated HTN is now in left heart failure. Untreated HTN leads to:

myocardial hypertrophy and ventricular remodelling.

A nurse recalls that insulin has an effect on which of the following groups of electrolytes?

Potassium, magnesium, phosphate

Nurse is caring for a client who has leg cramps during hemodialysis. Which following actions should nurse do first?

Infuse a bolus of normal saline

A 68- y.o in ER reporting chest pain. History of stable angina that now appears to be unstable.What does he likely have?

Impending myocardial infarction

A patient diagnosed with high BP asks the nurse how this disease could have happened to them. best response from nurse?

Hypertension can happen from arterial changes that block the blood flow

A patient is diagnosed with chronic bronchitis causing closure of airway during exp. What does this condition involve?

Production of thick mucous from thypertophied glands

Patient taking levothyroxine for a decade, tells nurse that her cousin gets a cheaper, generic form. Nurse should say?

It's better not to switch brands until we check with your doctor."

A 60y.o female has survived a myocardial infarction. The nurse is providing care for impaired ventricular function b/c:

the resulting ischemia leads to hypoxic injury and myocardial cell death.

A 52y.o with chronic bronchitis. Tests reveal closure of the airway during expiration. What does this condition involve?

The production of thick mucus from hypertrophied glands

The nurse would identify which patient condition as a problem of impaired gas exchange secondary to a perfusion problem?

Peripheral arterial disease of the lower extremities

In which order should you treat Diabetic Ketoacidosis (DKA)?

Fluid resuscitation, correct electrolytes, insulin therapy

A patient with left heart failure starts to have a cough and dyspnea. Why does this happen?

Left heart failure results in pulmonary vascular congestion.

What is airway hyper-responsiveness in asthma related to?

Exposure to an allergen causing mast cell degranulation

Your non-diabetic patient is experiencing hyperglycemia. Which of the following may cause this?

Prednisone prescribed for tonsillitis

The nurse received shift report on her patients with COPD. Who should she see first?

client with a respiratory rate of 38

Patient is on a bronchodilator & corticosteriod puffer. What should the nurse include in her teaching?

The bronchodilator should be taken first.

40 y.o has surgery for PTH secreting tumor and parathyroid is removed. What could the nurse expect post-op?

Decreased calcium reabsorption in the kidney

The nurse is teaching about thyroid replacement therapy. Which of the following would indicate futher teaching required?

"Sometimes this medicine can make my heart skip a beat - this is normal"

A patient is on laxative therapy. What important information about this therapy should the nurse provide the patient?

Bisacodyl should be given with water only

Which statement is true of loop diuretics?

Onset is rapid so useful when rapid diuresis is desired

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N216 Final Review

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1
A 66 y.o with history of untreated HTN is now in left heart failure. Untreated HTN leads to:
ventricular dilation and wall thinning.
alterations in alpha and beta receptor function.
inhibition of renin and aldosterone.
myocardial hypertrophy and ventricular remodelling.
2
A nurse recalls that insulin has an effect on which of the following groups of electrolytes?
Potassium, magnesium, phosphate
Hydrogen, bicarbonate, chloride
Calcium, magnesium, potassium
Sodium, chloride, phosphate
3
Nurse is caring for a client who has leg cramps during hemodialysis. Which following actions should nurse do first?
Reposition the client
Massage the client's legs
Infuse a bolus of normal saline
Give acetaminophen
4
A 68- y.o in ER reporting chest pain. History of stable angina that now appears to be unstable.What does he likely have?
Impending myocardial infarction
Mild to moderate atherosclerosis
Electrical conduction problems in the heart
Decreased myocardial oxygen demand
5
A pregnant patient has been a BP of 210/110 due to pre-eclampsia. Which classification of HTN would be most appropriate?
Primary
Idiopathic
Essential
Secondary
6
Your patient is receiving Heparin therapy for treatment of a Pulmonary Embolism. Which blood test needs to be ordered?
aPTT
INR
WBCs
Fibrinogen
7
Patients who are placed on spironolactone (Aldactone®) should be assessed continuously for which condition?
Hypercalcemia
Hypokalemia
Hyperkalemia
Hyponatremia
8
Patient is started on a diuretic for antihypertensive therapy. Nurse expects which class of med to be used first?
Vasodilators
Osmotic diuretics
Loop diuretics
Thiazide diuretics
9
Which of the following would be prescribed for the treatment and prevention of a DVT (deep vein thrombosus)?
Warfarin
Plavix
Lovenox
ASA
10
A 35y.o hypertensive male begins taking a diuretic. Which of the following are common side effects of this medication?
Hyponatremia
Hypokalemia
Hypermagnesemia
Increased uric acid secretion
11
39 yr old male with hematuria, RBC casts and proteinuria 3-5g/d (albumin). What is the probable diagnosis?
Renal calculi
Chronic pyelonephritis
Acute glomerulonephritis
Cystitis
12
Patients who are receiving antilipemic drugs need to be closely monitored for the development of which adverse effect?
Photosensitivity
Pulmonary problems
Liver dysfunction
Vitamin C deficiency
13
A patient is brought to ER with prolonged bronchospasm and hypoxemia. These symptoms support which diagnosis?
Status asthmaticus
Atelectasis
COPD
Exercise-induced asthma
14
Which antiemetic blocks dopamine in the chemoreceptor trigger zone causing desensitized signal from GI?
metoclopramide
meclizine
prochlorperazine
ondansetron
15
Your patient is starting Warfarin for the treatment of A.Fib. Which blood test should the patient be ordered?
aPTT
HIT Assay
INR
CBC
16
A patient diagnosed with high BP asks the nurse how this disease could have happened to them. best response from nurse?
Hypertension can happen from eating a poor diet, so change what you eat
Hypertension happens to everyone sooner or later. Don't be concerned
Hypertension can happen from arterial changes that block the blood flow
Hypertension happens when people do not exercise,you should walk every day
17
Client with history of BPH with urinary retention& high BUN/CR. Which of the following therapies should be first?
Draw blood for complete blood count.
Infuse normal saline at 50 mL/hour.
Insert retention catheter.
Obtain renal ultrasound.
18
Patient tells nurse she smokes 2 packs/day for 27yrs. What may nurse find upon assessment?
Bounding pedal pulses
Elevated blood pressure
Reflux disease
Night blindness
19
A patient is diagnosed with orthostatic hypotension. Which of the following symptoms would most likely be reported?
Chest pain and palpitations
Headache and blurred vision
Nausea and vomiting
Syncope and fainting
20
Which of the following could cause hyperkalcemia?
Lasix
Mannitol
Spironolactone
Hydrochlorothiazide
21
A patient is diagnosed with chronic bronchitis causing closure of airway during exp. What does this condition involve?
Hyperventilation
Production of thick mucous from thypertophied glands
A ventilation/perfusion mismatch
Thinning smooth muscles in the bronchioles
22
Patient taking levothyroxine for a decade, tells nurse that her cousin gets a cheaper, generic form. Nurse should say?
You should never switch brands.
There's no difference in brands of this medication
"That would be a great way to save money."
It's better not to switch brands until we check with your doctor."
23
A 60y.o female has survived a myocardial infarction. The nurse is providing care for impaired ventricular function b/c:
there is a temporary alteration in electrolyte balance.
there is too much stress on the heart.
the resulting ischemia leads to hypoxic injury and myocardial cell death.
the cells become hypertrophic.
24
A 52y.o with chronic bronchitis. Tests reveal closure of the airway during expiration. What does this condition involve?
The production of thick mucus from hypertrophied glands
Thinning smooth muscle in the bronchioles
A ventilation-perfusion mismatch
Hyperventilation
25
If a patient has a problem with the adrenal medulla, which of the following hormones should the nurse monitor?
Androgens
Cortisol
Estrogens
Epinephrine
26
Male patient presents with flank pain & polyuria. Test shows enlarged prostate. He is at risk for which kidney failure?
Postrenal
Intrarenal
Prerenal
Extrarenal
27
75 y.o with DM Type 2 is on glyburide daily. When is the best time to take this?
With breakfast
Any time of day
After the midday meal.
At night.
28
The nurse would identify which patient condition as a problem of impaired gas exchange secondary to a perfusion problem?
Peripheral arterial disease of the lower extremities
Chronic asthma
Severe anemia secondary to chemotherapy
Chronic obstructive pulmonary disease (COPD)
29
In which order should you treat Diabetic Ketoacidosis (DKA)?
Do nothing
Correct electrolytes, fluid resuscitation, insulin therapy
Insulin therapy, correct electrolytes, fluid resuscitation
Fluid resuscitation, correct electrolytes, insulin therapy
30
A patient has been prescribed an ACE inhibitor, Ramipril. Which of the following is not a side effect of this med?
Headache
Dry cough
Tremors
Fatigue
31
A patient receiving heparin therapy is having profuse rectal bleeding. Which med do you anticipate being ordered?
Atropine sulphate
Warfarin
Vitamin K
Protamine sulphate
32
Your patient is receiving Dalteparin and is experincing hypotension, fatigue and dizziness. Which test should be ordered
CBC
INR
aPTT
HIT assay
33
A patient with left heart failure starts to have a cough and dyspnea. Why does this happen?
Pulmonary symptoms are due to inflammatory pulmonary edema.
There is a decreased cardiac output.
Reflexive bronchoconstriction occurs.
Left heart failure results in pulmonary vascular congestion.
34
What is airway hyper-responsiveness in asthma related to?
Hereditary decrease in IgE responsiveness
Increased sympathetic nervous system response
The release of stress hormones
Exposure to an allergen causing mast cell degranulation
35
Your non-diabetic patient is experiencing hyperglycemia. Which of the following may cause this?
Metformin prescribed for PCOS
Metoprolol prescribed for HTN
Prednisone prescribed for tonsillitis
Keppra prescribed for seizures
36
Client with chronic heart failure has dyspnea, dry, hacking cough. Which actions should the nurse take first?
Assess the orientation.
Check the capillary refill.
Auscultate the lung sounds.
Palpate the abdomen.
37
The nurse received shift report on her patients with COPD. Who should she see first?
client with a respiratory rate of 38
client with loud expiratory wheezes
client who has a cough productive of thick, green mucus
client with jugular vein distension and peripheral edema
38
A persistent cough is an adverse effect of which class of antihypertensive drugs?
β-Blockers
Calcium channel blockers
Angiotensin receptor blockers
ACE inhibitors
39
Patient is on a bronchodilator & corticosteriod puffer. What should the nurse include in her teaching?
The order of administration does not matter with these two drugs.
he corticosteroid should be taken first.
The bronchodilator should be taken first.
The two drugs should be taken at least 2 hours apart.
40
Which of the following medications should not be combined with sildenafil (Viagara)?
Metoprolol
Potassium
Nitroglycerin
Adenosine
41
A 29y.o female presents with cloudy urine, flank pain, and hematuria. These signs and symptoms support which diagnosis?
Acute cystitis
Renal calculi
Postrenal kidney failure
Chronic kidney failure
42
A 44 y.o patient with pulmonary tuberculosis is evaluated for SIADH. Which assessment finding would support this?
Peripheral edema
Tachycardia
Concentrated urine
Low blood pressure
43
40 y.o has surgery for PTH secreting tumor and parathyroid is removed. What could the nurse expect post-op?
Decreased bone formation
Increased calcitonin
Increased serum calcium
Decreased calcium reabsorption in the kidney
44
Pancreas controls the release of :
potassium and sodium
ADH and aldosterone
insulin and glucagon
sugar and insulin
45
A patient is having diarrhea and is requesting Pepto-Bismol. Which med is contraindicated to give with pepto?
ASA
Acetaminophen
Calcium supplements
Vitamin C
46
The nurse is teaching about thyroid replacement therapy. Which of the following would indicate futher teaching required?
"I will take this pill on an empty stomach and wait about an hour til I eat
"I will take my pill in the morning"
"I will go to the clinic to have my thyroid levels checked"
"Sometimes this medicine can make my heart skip a beat - this is normal"
47
A patient is on laxative therapy. What important information about this therapy should the nurse provide the patient?
Bisacodyl should be given with water only
Psyllium can be mixed in food, such as applesauce
A normal bowel pattern is when a bowel movement occurs daily.
All laxative tablets should be crushed for improved action
48
Which statement is true of loop diuretics?
Disadvantage of being ineffective when creatine clearance is low
They are potent,providing diuretic effects lasting 6hrs
They are also called aldosterone-inhibiting diuretics.
Onset is rapid so useful when rapid diuresis is desired
49
A diabetic patient is brought in with DKA. which of the following is seen in uncontrolled DM and ketoacidosis?
Decreased thirst
Report of no urine output
Increased respiratory rate
Decreased hunger sensation
50
What is the major mechanism of airflow limitation in a patient diagnosed with emphysema?
Airway edema
Loss of elastic recoil
Excessive mucus production
Infection and inflammation
51
A patient receiving insulin therapy has developed hypoglycemia. Which of the following is not a manifestation of this?
Weakness, sweating, confusion
Increased HR, fruity/acetony breath
Increased urinary output and thirst
Decreased HR, decreased RR and flushed skin
52
A patient is diagnosed with coronary artery disease. Which of the following modifiable risk factors would nurse suggest?
Decreasing tomato juice consumption
Stop smoking cigarettes
Change living arrangements
Eating out to increase variety
53
A female patients wants oral contraceptives. Which lmedical condition would be okay to prescribe this medication?
Pregnancy
Multiple sclerosis
Thromboembolic disorders
Estrogen Dependent Cancers
54
A patient is prescribed Fluticasone. What should the nurse include in the teaching for this medication?
Tip the head back when taking this medication to maximize airway opening
After taking this medication the patient should hold their breath for 20sec
Rinsing mouth after inhaler use is recommended
Medication tubing & mouthpiece should be cleaned with hot water
55
Which of the following medical conditions would cause an elevated ACTH?
Dwarfism
Acromegaly
Addison's Disease & Cushing's Disease
Alopecia
56
Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?
Anticholinergics
Intestinal flora modifiers
Adsorbents
Lubricants
57
For which condition would the nurse anticipate treatment with montelukast (Singulair®)?
Long-term treatment of emphysema
Acute bronchospasm
Prophylaxis of asthma in children
Exacerbation of chronic obstructive pulmonary disease
58
A patient has been prescribed finasteride (Proscar). Which lab test should the nurse assess prior to administering?
Prostate-specific antigen (PSA)
Urinalysis
Complete blood count
Fasting glucose level
59
65 y.o with COPD and elevated PVR: Which heart failure should the nurse assess for in the patient?
High-output
Low-output
Left heart
Right heart
60
Individuals with a recent diagnosis of emphysema should be assessed for which most common presenting factor?
Dyspnea
Cor pulmonale
A productive cough
Cyanosis
61
A patient is going home with a prescription for Atenolol. What information should the nurse tell the patient?
Change positions slowly to reduce postural hypotension
Never abruptly stop taking this medication
This medication should be stopped once symptoms subside
Report any weight gain of more than 0.5kg/week or signs of fluid buildup
62
Difficulty breathing when lying down. What term should the nurse use to document this condition?
Tachypnea
Dyspnea
Apnea
Orthopnea
63
A patient who is on estrogen therapy should be counselled that smoking may cause what?
Increased levels of triglycerides
An increased incidence of nausea
An increased tendency to bleed during menstruation
An increased risk for thrombosis
64
The absence of a menstrual cycle of 6 months or longer is called...
Hematochezia
Dysmennorhea
Endometriosis
Amenorrhea
65
A patient is requesting a med to provide rapid relief for constipation. Which of the following is most appropriate?
Colace
Pepto-Bismol
Psyllium
Milk of magnesia
66
A patient is receiving finasteride (Proscar^®) for treatment of benign prostatic hypertrophy (BPH). Adverse effect?
Increased prostate size
Increased hair growth
Alopecia
Urinary retention
67
Which of the following is not present in Hyperosmolar Hyperglycemia State?
Hyperglycemia
Dehydration
Hyperosmolality
Ketoacidosis
68
A patient has been ordered a long-acting insulin to be administered at bedtime. Which of the following would be correct?
Lantus
Humulin R
Humalog
Novolin NPH
69
Which of the following is not considered a low molecular weight heparin?
Dalteparin
Argatroban
Tinzaparin
Lovenox
70
At around what blood glucose level should you add dextrose IV fluids, in the treatment of DKA?
25 mmol/L
15 mmol/L
5 mmol/L
You never add dextrose IV fluids
71
A patient has been prescribed transdermal nitroglycerin patches. What important instructions for applying these patches?
Apply the patch to the same site consistently.
Use the patches only on the chest area.
Temporarily remove the patch while swimming.
Use the patches on any nonhairy area on the body.
72
Your patient receiving Warfarin has an INR of 7. What med do you anticipate being ordered?
Platelets
Protamine sulphate
Additional dose of warfarin
Vitamin K
73
Nurse caring for a client who states "I wish I were dead! I can't be independent anymore!" Which nursing diagnosis?
Social isolation r/t insufficient personal resources (more physical depende
Ineffective coping related to insufficient sense of control
Deficient knowledge related insufficient information (education about COPD)
Hopelessness related to chronic stress (expectation of death)
74
THC is an antiemetic used for treatment of nausea and vomiting associated with which situation?
Motion sickness
Ménière's disease
Chemotherapy treatment
Surgical treatment
75
A patient is being treated for DKA. Which of the following insulins would be ordered in the acute treatment of this?
Humalog
Humulin R
Lantus
Ozempic
76
Which of the following food choices should the nurse teach the patient to avoid when taking antithyroid medications?
Dairy products
Bananas and oranges
Processed meats and cheeses
Soy products and seafood
77
Which of the following would not cause a deficiency in vitamin B12?
Damage to parietal cells in digestive tract
Liver disease
Metformin
Inadequate intrinsic factor secretion
78
An 11-year-old is newly diagnosed with type 1 DM. Which classic symptoms should the nurse assess the patient for?
Polydipsia, polyuria, polyphagia, and weight loss
Weakness, vomiting, hypotension, and mental confusion
Vomiting, abdominal pain, sweet, fruity breath, dehydration, and Kussmauls
Recurrent infections, visual changes, fatigue, and paresthesia
79
Client with CKD on calcium carbonate. Which parameter should the nurse assess to determine effectiveness?
Neurological status
Blood pressure
Creatinine clearance
Phosphate level
80
A nurse checks laboratory results as both Cushing's disease and Addison's disease can manifest with elevated levels of:
estrogen
aldosterone.
adrenocorticotropic hormone (ACTH)
ADH.

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