28 yr old with wt. loss, tremors, heat intolerance, and palpitations. Elevated T3/T4, decreased TSH. Priority action?

Monitor for signs of thyroid storm and manage symptoms

What nursing intervention is appropriate to attempt first to manage pediatric supraventricular tachycardia?

Instruct the child to perform the Valsalva maneuver

When caring for an infant diagnosed w/ cystic fibrosis, which intervention is most critical for promoting gas exchange?

Implementing regular chest physiotherapy

Essential teaching for 72 yr old F with chronic atrial flutter being discharged on warfarin?

"You will need regular blood tests to monitor your INR."

Which lab result would the nurse expect to find in a patient with hypothyroidism?

Decreased T3/T4 with increased TSH

A pt w/ cystic fibrosis is prescribed dornase alfa (Pulmozyme). What is the primary nursing action for this medication?

Instruct the patient to use a nebulizer to deliver the medication

Priority intervention for 6 yr old pt. recovering from open-heart surgery, HR drops to 50 bpm, fatigue, and weakness?

Notify the HCP and prepare for transcutaneous pacing

Which risk factor is most commonly associated with the development of borderline personality disorder?

History of childhood trauma or abuse

40 yr old pt. w/ hypothyroidism on levothyroxine therapy asks the nurse about her treatment. Which is the best response?

"You should take this medication indefinitely to replace the hormones."

Pt. admitted with borderline personality disorder after a suicide attempt. What is priority action?

Develop a safety contract with the patient and initiate suicide precautions

What is the priority assessments for a patient receiving magnesium and calcium infusions through a central line?

Monitor the patient's cardiac rhythm closely

Which priority intervention for 58 yr old F pt. who develops atrial fibrillation 24 hours post coronary artery bypass?

Start a heparin infusion to prevent thromboembolic events

What is the priority intervention for a pt. with uncontrolled hyperthyroidism, chest pain, and HR 130 bpm?

Have an EKG performed and notify the HCP

Muscle spasms, tingling in hands and feet, and fatigue. Serum calcium level 7.8 mg/dL. Priority nursing intervention?

Administer IV calcium gluconate

Which nursing consideration is most important when administering magnesium oxide?

Administer with a full glass of water

Appropriate nursing action for 50 yr old pt. w/ BPD taking lithium developed tremors, more urination + increased thirst?

Hold the next dose of lithium and notify the healthcare provider

What is the priority intervention for muscle cramps, confusion, and weakness with a serum magnesium of 1.1

Administer IV magnesium sulfate

Which statement indicates understanding from pt. being discharged with lithium therapy?

"I need to get my blood levels checked regularly while taking lithium."

Priority action for 72 yr old pt. w/ non-tunneled central line for TPN with signs of infection and fever of 101 F?

Notify the HCP and prepare for blood cultures

What is the priority assessment for a pt. receiving calcium and magnesium infusions through a central line?

Monitor the patient's cardiac rhythm closely

Which statement needs further teaching about respiratory infections for parents of a 10 yr old pt. diagnosed with CF?

"We will avoid giving our child the flu vaccine to prevent illness."

45 yr old with CKD, hyperKalemia, develops ventricular fibrillation. What is priority medication to administer?

Calcium gluconate to stabilize cardiac membrane

What collaborative intervention for a pt. with BPD admitted for depressive symptoms?

Regular psychiatric evaluation to adjust medications

Which nursing assessment is a priority for the elderly pt. starting methimazole?

Monitoring WBC to detect agranulocytosis

Which pt. education should the nurse prioritize for pt. with chronic kidney disease at risk for hypermagnesemia?

"You should avoid using over-the-counter antacids that contain magnesium."

Which statement by 45 yr old pt. with recurrent infections scheduled for long-term PICC therapy needs more education?

"The PICC line will need to be flushed once a week with normal saline."

pt. w/ chronic hypomagnesemia discharged w/ oral supplements. Which statement by pt. indicates more education is needed?

"I will increase my magnesium dosage if I feel fatigued."

Hx of breast cancer with confusion, nausea, and constipation. Serum calcium 11.5 mg/dL. Priority nursing assessment?

Monitor cardiac rhythm for shortened QT intervals

Priority action for a 50 yr old M with HX of MI who developed ventricular tachycardia, unresponsive and absent pulse?

Defibrillate the patient immediately

65 yr old pt. with hx of COPD admitted with dyspnea and productive cough. What is priority action?

Administer bronchodilators and monitor oxygen saturation

Pregnant pt. diagnosed with hypothyroidism prescribed levothyroxine. What is the priority teaching?

"Untreated hypothyroidism can lead to miscarriage and preeclampsia."

Patient education for pt. with tunneled central line for long-term chemotherapy being discharged?

"You should flush the catheter daily with a heparin solution."

Most appropriate intervention to address tunneled hemodialysis catheter dysfunction?

Reposition the patient and attempt to flush the catheter

What is the priority education for the postpartum patient?

"It's important to take your thyroid education at the same time each day."

45 yr old post total thyroidectomy w/ numbness around the mouth, muscle cramps, and calcium 7.5. Priority intervention?

Administer calcium gluconate IV slowly

Pt. with chronic hypocalcemia discharged with oral calcium supplements + vit. D. Which statement = need more education?

"If I feel tired or weak, I will increase my calcium dose."

65 yr old pt recovering from GI surgery and has developed hypocalcemia/hypomagnesemia. Priority nursing interventions?

Monitor deep tendon reflexes and cardiac rhythm

Which patient outcome is most appropriate for a patient with BPD undergoing dialectical behavior therapy (DBT)?

The pt will express feelings verbally rather than through self-harm

12 yr old w/ hyperthroidism symptoms diagnosed with Graves' disease. Which nursing action is most appropriate?

Administer beta-blockers to reduce cardiac workload

Priority intervention for pt. w/ HTN, palpitations, dizziness, and atrial fibrillation w/ rapid ventricular response?

Monitor the patient's EKG continuously for changes in rhythm

Which assessment finding is most concerning in elderly pt. taking levothyroxine for hypothyroidism?

Unexplained weight loss and insomnia

Priority assessment for 3 month old w/ congenital heart defect (bradycardia secondary to hypoxia) and HR of 60 bpm?

Monitor the infant's oxygen saturation

When caring for an older adult patient with COPD, what should the nurse prioritize in their care plan?

Monitoring for medication side effects due to decreased renal function

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PCC 3 - exam 1

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1
28 yr old with wt. loss, tremors, heat intolerance, and palpitations. Elevated T3/T4, decreased TSH. Priority action?
Provide patient education on iodine supplementation
Administer levothyroxine to stabilize thyroid function
Monitor for signs of thyroid storm and manage symptoms
Encourage high-calorie, high-protein diet
2
What nursing intervention is appropriate to attempt first to manage pediatric supraventricular tachycardia?
Instruct the child to perform the Valsalva maneuver
Prepare the child for synchonized cardioversion
Administer adenosine intravenously
Start chest compressions immediately
3
When caring for an infant diagnosed w/ cystic fibrosis, which intervention is most critical for promoting gas exchange?
Providing high-calorie, high-protein feedings
Administering pancreatic enzyme supplements
Implementing regular chest physiotherapy
Encouraging physical therapy
4
Which diagnostic test is most important for assessing an 80 yr old pt. with hx of CAD and HF and a HR of 40 bpm?
12-lead EKG
Serum electrolyte levels
Echocardiogram
Chest X-ray
5
Essential teaching for 72 yr old F with chronic atrial flutter being discharged on warfarin?
"You will need regular blood tests to monitor your INR."
"It's important to avoid all physical activity to prevent complications."
"Take aspirin daily along with warfarin to prevent clots."
"You can stop taking warfarin once your symptoms improve."
6
Which lab result would the nurse expect to find in a patient with hypothyroidism?
Increased T3/T4 with increased TSH
Decreased T3/T4 with decreased TSH
Increased T3/T4 with decreased TSH
Decreased T3/T4 with increased TSH
7
A pt w/ cystic fibrosis is prescribed dornase alfa (Pulmozyme). What is the primary nursing action for this medication?
Monitor the patient for signs of hyperglycemia
Ensure the patient uses the medication with a bronchodilator
Instruct the patient to use a nebulizer to deliver the medication
Monitor the patient's blood pressure before administration
8
Levothyroxine will restore normal metabolism, which may help with weight stabilization.
True
False
9
Priority intervention for 6 yr old pt. recovering from open-heart surgery, HR drops to 50 bpm, fatigue, and weakness?
Administer atropine to increase the heart rate
Assess the patient's pain level and administer analgesics
Notify the HCP and prepare for transcutaneous pacing
Apply supplemental oxygen to increase oxygenation
10
Which risk factor is most commonly associated with the development of borderline personality disorder?
Family history of hypertension
Lack of physical activity
History of childhood trauma or abuse
Genetic predisposition to schizophrenia
11
40 yr old pt. w/ hypothyroidism on levothyroxine therapy asks the nurse about her treatment. Which is the best response?
"We will discontinue the medication once your symptoms improve."
"The medication is only temporary, we can taper it off gradually."
"You should take this medication indefinitely to replace the hormones."
"You will need to take levothyroxine for months for thyroid stabilization."
12
Pt. admitted with borderline personality disorder after a suicide attempt. What is priority action?
Encourage the patient to participate in group therapy immediately
Schedule regular family meetings to resolve interpersonal conflicts
Administer antipsychotic medications to reduce impulsive behavior
Develop a safety contract with the patient and initiate suicide precautions
13
What is the priority assessments for a patient receiving magnesium and calcium infusions through a central line?
Assess for decreased urine output
Monitor the patient's cardiac rhythm closely
Check for signs of hy[pomagnesemia and hypercalcemia
Monitor for local infection at the catheter site
14
Which priority intervention for 58 yr old F pt. who develops atrial fibrillation 24 hours post coronary artery bypass?
Elevate the patient's legs to improve perfusion
Monitor aspirin to prevent clot formation
Start a heparin infusion to prevent thromboembolic events
Monitor the patient's urine output
15
Pregnant woman with preeclampsia, receiving magnesium sulfate to prevent seizures. Magnesium 4.5. Priority intervention?
Reduce the magnesium sulfate infusion rate
Administer calcium gluconate
Prepare the patient for an emergency c-section
Increase the dose of magnesium sulfate to prevent seizures
16
What is the priority intervention for a pt. with uncontrolled hyperthyroidism, chest pain, and HR 130 bpm?
Administer methimazole and prepare for thyroidectomy
Have an EKG performed and notify the HCP
Administer aspirin and monitor for signs of myocardial infarction
Administer oxygen and monitor pulse oximetry
17
Muscle spasms, tingling in hands and feet, and fatigue. Serum calcium level 7.8 mg/dL. Priority nursing intervention?
Prepare patient for dialysis
Administer IV calcium gluconate
Administer a loop diuretic
Encourage increased dairy intake
18
Which nursing consideration is most important when administering magnesium oxide?
Administer with meals to enhance absorption
Encourage pt. to increase calcium intake to improve magnesium levels
Administer with a full glass of water
Monitor the patient's serum potassium levels
19
Appropriate nursing action for 50 yr old pt. w/ BPD taking lithium developed tremors, more urination + increased thirst?
Reassure the patient that these are normal side effects of lithium
Encourage the patient to increase their fluid intake
Teach the patient to take lithium with food to decrease side effects
Hold the next dose of lithium and notify the healthcare provider
20
What is the priority intervention for muscle cramps, confusion, and weakness with a serum magnesium of 1.1
Administer IV magnesium sulfate
Monitor the patient for signs of hypercalcemia
Administer oral magnesium sulfate
Encourage increased dietary intake of magnesium-rich foods
21
Which statement indicates understanding from pt. being discharged with lithium therapy?
"I should increase my salt intake while on lithium to avoid side effects."
"I need to get my blood levels checked regularly while taking lithium."
"I should avoid drinking too much water while taking lithium."
"I can stop taking my lithium when I start feeling better."
22
Priority action for 72 yr old pt. w/ non-tunneled central line for TPN with signs of infection and fever of 101 F?
Remove the central line immediately and culture the catheter tip
Notify the HCP and prepare for blood cultures
Discontinue the TPN and start antibiotics
Apply a warm compress to the insertion site
23
What is the priority assessment for a pt. receiving calcium and magnesium infusions through a central line?
Monitor urine output for signs of fluid overload
Check for signs of hypomagnesemia and hypercalcemia
Monitor the patient's cardiac rhythm closely
Monitor for signs of local infection at the catheter site
24
Which statement needs further teaching about respiratory infections for parents of a 10 yr old pt. diagnosed with CF?
"We will use a nebulizer daily to help clear mucus from the lungs."
"We will monitor our child for any changes in breathing or cough."
"We should encourage our child to take antibiotics exactly as prescribed."
"We will avoid giving our child the flu vaccine to prevent illness."
25
45 yr old with CKD, hyperKalemia, develops ventricular fibrillation. What is priority medication to administer?
Furosemide to promote potassium excretion
Calcium gluconate to stabilize cardiac membrane
Atropine to increase the heart rate
Sodium bicarbonate to treat metabolic acidosis
26
What collaborative intervention for a pt. with BPD admitted for depressive symptoms?
Physical therapy to improve physical functioning
Occupational therapy to develop coping skills for stress
Regular psychiatric evaluation to adjust medications
Family therapy to address interpersonal conflicts
27
Which nursing assessment is a priority for the elderly pt. starting methimazole?
Assessing for symptoms of hypocalcemia (muscle cramps and tingling)
Assessing the pt. sleep pattern for signs of insomnia
Monitoring WBC to detect agranulocytosis
Monitor for signs of hypothyroidism (fatigue, cold intolerance)
28
Which pt. education should the nurse prioritize for pt. with chronic kidney disease at risk for hypermagnesemia?
"You should monitor your calcium intake to balance magnesium levels."
"You can increase your magnesium intake by eating leafy green vegetables."
"You should avoid using over-the-counter antacids that contain magnesium."
"It's okay to use magnesium supplements if you experience muscle cramps."
29
Spirometry is the primary diagnostic tool used to assess lung function and gas exchange in COPD patients
True
False
30
Which statement by 45 yr old pt. with recurrent infections scheduled for long-term PICC therapy needs more education?
"I can take a shower as long as the insertion site has waterproof cover."
"The PICC line will need to be flushed once a week with normal saline."
"I should avoid lifting heavy objects w/ the arm that has the PICC line."
"I will need to have a chest x-ray after the PICC line is placed."
31
Which medication is commonly prescribed to patients with borderline personality disorder?
Lithium (lithobid)
Lorazepam (ativan)
Fluoxetine (prozac)
Metoprolol (lopressor)
32
80 yr old w/ chronic renal failure, lethargy, nausea, and decreased urine output. Calcium 12.3. What will HCP order?
Phosphate binders to reduce calcium excretion
Vitamin D supplementation to reduce calcium levels
IV calcium gluconate to reduce calcium absorption
Loop diuretics and IV fluids
33
pt. w/ chronic hypomagnesemia discharged w/ oral supplements. Which statement by pt. indicates more education is needed?
"I will increase my magnesium dosage if I feel fatigued."
"I will take my magnesium supplements with meals."
"I will follow up with my HCP to monitor my magnesium levels regularly,"
"I will notify my provider if I experience muscle cramps or weakness."
34
Hx of breast cancer with confusion, nausea, and constipation. Serum calcium 11.5 mg/dL. Priority nursing assessment?
Assess for signs of hypocalcemia including muscle twitching
Assess for signs of Chvostek's and Trousseau's signs
Monitor cardiac rhythm for shortened QT intervals
Assess for deep tendon reflexes
35
Grandiose thoughts and inflated self-esteem are key characteristics of borderline personality disorder
False
True
36
Priority action for a 50 yr old M with HX of MI who developed ventricular tachycardia, unresponsive and absent pulse?
Defibrillate the patient immediately
Begin chest compressions
Administer IV epinephrine
Administer oxygen via non-breather mask
37
65 yr old pt. with hx of COPD admitted with dyspnea and productive cough. What is priority action?
Place the patient on 4L oxygen mask to main sPO2 of 100%
Restrict fluids to reduce the risk of pulmonary edema
Administer bronchodilators and monitor oxygen saturation
Encourage the patient to lie flat to improve lung expansion
38
Pregnant pt. diagnosed with hypothyroidism prescribed levothyroxine. What is the priority teaching?
"You will need to lower your levothyroxine dosage as pregnancy progresses."
"You should avoid all thyroid medication until after delivery."
"Untreated hypothyroidism can lead to miscarriage and preeclampsia."
"Hypothyroidism has no impact on your pregnancy if it's well managed."
39
Patient education for pt. with tunneled central line for long-term chemotherapy being discharged?
"You should clean the catheter site with alcohol before a new dressing."
"Come back to the hospital weekly to have the catheter flushed."
"You can remove the dressing if the insertion site looks healed."
"You should flush the catheter daily with a heparin solution."
40
Most appropriate intervention to address tunneled hemodialysis catheter dysfunction?
Administer a bolus of normal saline through the catheter
Reposition the patient and attempt to flush the catheter
Remove the catheter and insert a new one
Administer heparin to dissolve any clots in the catheter
41
What is the priority education for the postpartum patient?
"It's important to take your thyroid education at the same time each day."
"You should stop breastfeeding while taking thyroid medications."
"Thyroid medication will not affect your postpartum recovery."
"Post partum hypothyroidism is temporary and requires no treatment."
42
45 yr old post total thyroidectomy w/ numbness around the mouth, muscle cramps, and calcium 7.5. Priority intervention?
Prepare for emergent parathyroidectomy
Adminiter oral calcium supplements
Administer calcium gluconate IV slowly
Restrict dietary calcium until levels stabilize
43
Pt. with chronic hypocalcemia discharged with oral calcium supplements + vit. D. Which statement = need more education?
"If I feel tired or weak, I will increase my calcium dose."
'"I should take my calcium supplements with meals."
"I will take my vit. D supplements to help with calcium absorption."
"I will follow up with my HCP to monitor my calcium levels."
44
65 yr old pt recovering from GI surgery and has developed hypocalcemia/hypomagnesemia. Priority nursing interventions?
Restrict fluid intake to prevent fluid shifts
Monitor deep tendon reflexes and cardiac rhythm
Educate the patient on the signs of hypocalcemia/hypomagnesemia
Administer oral calcium and magnesesium supplements
45
Which patient outcome is most appropriate for a patient with BPD undergoing dialectical behavior therapy (DBT)?
The patient will achieve complete symptom remission after 3 sessions
The patient will require no further psychiatric interventions
The pt will express feelings verbally rather than through self-harm
The patient will avoid all interpersonal conflicts through isolation
46
12 yr old w/ hyperthroidism symptoms diagnosed with Graves' disease. Which nursing action is most appropriate?
Administer beta-blockers to reduce cardiac workload
Teach the family about the importance of radioactive iodine therapy
Monitor growth and development milestones regularly
Encourage a low-iodine diet to decrease thyroid hormone production
47
Priority intervention for pt. w/ HTN, palpitations, dizziness, and atrial fibrillation w/ rapid ventricular response?
Encourage the patient to ambulate to improve circulation
Monitor the patient's EKG continuously for changes in rhythm
Administer oxygen to improve tissue perfusion
Perform chest compressions immediately to maintain circulation
48
Which assessment finding is most concerning in elderly pt. taking levothyroxine for hypothyroidism?
Temperature of 98.6 F
Mild anxiety and tremors
Unexplained weight loss and insomnia
Heart rate of 60 bpm
49
Which intervention will the provider order for diabetic pt. with hypotension and magnesium level of 3.2?
Initiate fluid restriction to reduce magnesium levels
IV calcium gluconate
Increase oral magnesium intake
Administer magnesium sulfate via IV
50
Priority assessment for 3 month old w/ congenital heart defect (bradycardia secondary to hypoxia) and HR of 60 bpm?
Monitor the infant's blood pressure
Monitor the infant's oxygen saturation
Assess the infant's urine output
Auscultate the infant's heart sounds
51
When caring for an older adult patient with COPD, what should the nurse prioritize in their care plan?
Administering sedatives to reduce respiratory effort
Monitoring for medication side effects due to decreased renal function
Encouraging intense physical activity
Providing a high-protein, high-calorie diet to promote weight loss
52
Which specialty is most appropriate for collaboration in managing a 45 yr old pt. with newly diagnosed hyperthyroidism?
Cardiologist
Dermatologist
Respiratory therapist
Endocrinologist
53
When assessing a pt with COPD, the nurse notes wheezing and a barrel chest. Which pathophysiologic process is indicated?
Increased lung perfusion and alveolar expansion
Decreased respiratory rate
Decreased lung compliance and air trapping
Bronchial smooth muscle relaxation
54
When treating an adolescent pt w/ Borderline Personality Disorder (BPD), the nurse should prioritize which intervention?
Focus on building coping strategies and establishing trust with the pt.
Encourage the use of antipsychotic medication to manage mood swings
Emphasize the importance of attending daily group therapy sessions
Advise the family to limit interactions w/ the pt during emotional episodes
55
When assessing a pt w/ CF, the nurse observes cyanosis and clubbing of the fingers. These findings are likely due to?
Decreased respiratory rate
Chronic hypoxia and poor gas exchange
Increased oxygen saturation levels
Hyperinflation of the alveoli
56
Nursing intervention for a patient with COPD prescribed tiotropium (anticholinergic)?
Instruct the patient to rinse their mouth after inhalation
Encourage fluid restriction to prevent dehydration
Assess for signs of hyperkalemia
Monitor signs of hypotension
57
Which nursing consideration is most important when administering calcium carbonate?
Encourage the patient to increase vitamin D intake through diet only
Monitor the patient's serum potassium levels
Administer with a full glass of water
Administer with food to enhance absorption
58
Which of the following statements is correct regarding the patho and risk factors of hyperthyroidism?
It is caused by low levels of T3 and T4, leading to metabolic slowing
Graves' disease is a common cause
Patients with hyperthyroidism exhibit decreased metabolic rates
Older pt. less likely to experience hyperthyroidism due to slow metabolism
59
7 yr old w/ hyperreflexia, seizures, and magnesium of 1.1, important nursing action when administering IV magnesium?
Monitor the child's urine output for signs of renal impairment
Administer the magnesium sulfate as a rapid IV push
Apply continuous cardiac and respiratory monitoring
Administer the magnesium over a prolong infusion period
60
A calm firm tone is essential in therapeutic communication with patients who have borderline personality disorder
True
False
61
Which nursing intervention is a priority to prevent thyroid storm?
Administer beta-blockers and antithyroid medications
Administer IV fluids to correct dehydration
Place the patient in a warm room to reduce tremors
Educate the patient about avoiding iodine-rich foods
62
A 12. yr old pt w/ cystic fibrosis is fearful about undergoing a pulmonary function test. Most appropriate response?
"Don't worry, your parents will be with you the whole time."
"It is okay to be nervous. Let's talk about what the test involves."
"You should not worry; the test is not important."
"The test will be over quickly, and you will feel much better afterward."
63
65 yr old recovering from GI surgery with hypomagnesemia and hypocalcemia. Priority interventions?
Monitor deep tendon reflexes and cardiac rhythm
Administer oral magnesium and calcium supplements
Restrict fluid intake to prevent fluid shifts
Educate the patient on the s/s of hypocalcemia and hypomagnesemia
64
A COPD pt is receiving oxygen therapy at 2 L/min via nasal cannula. What desired outcome should the nurse prioritize?
The patient will avoid coughing during deep breathing exercises
The pt will report decreased shortness of breath and SpO2 between 88%-92%
The patient will demonstrate normal oxygen saturation of 100%
The patient will show improved lung compliance with decreased wheezing
65
Most appropriate intervention for 35 yr old pt. w/ BPD in depressive state. Poor eye contact and hopelessness feelings?
Encourage participation in group therapy
Avoid discussing the patient's feelings to prevent distress
Schedule frequent short visits with the patient
Limit the patient's contact with family until mood stabilizes
66
78 yr old w/ fatigue, constipation, weight gain, and cold intolerance. High TSH and low T3/T4. Which pt. care techology?
Continuous pulse oximetry for oxygen saturation montoring
Central venous access line for levothyroxine administration
Portable oxygen for dyspnea management
Continuous cardiac monitoring for bradycardia
67
65 yr old with end-stage renal disease with nausea, lethargy, and flushing. Magnesium level 3.8. Priority assessment?
Assess for Chvostek's and Trousseau's signs
Monitor for seizures and neuromuscular activity
Monitor for decreased respiratory rate and depth
Assess for hyperactive deep tendon reflexes
68
Priority action for 28 yr old F with BPD in depressive phase and suicidal ideation?
Create a safety plan with the patient for after discharge
Administer antidepressants as ordered
Encourage the patient to discuss her feelings with the healthcare team
Monitor the patient every 15 minutes for safety
69
Which statement made by the patient indicates understanding of new medication lamotrigine therapy?
"I don't need to worry about blood tests with this medication."
"I can drink alcohol occasionally while taking lamotrigine."
"I should stop taking lamotrigine if I get a rash."
"I will take extra doses if I feel manic symptoms coming on."
70
Priority action for 25 yr old pt. w/ BPD admitted for manic episode. Vital signs stable, agitated, and refusing to rest?
Ask the patient to explain his feelings in detail to gain insight
Administer PRN benzodiazepine as ordered to calm the patient
Provide a quiet, low-stimulation environment for the patient
Encourage the patient to attend group therapy session
71
A 16-year-old pt with cystic fibrosis is admitted with increasing dyspnea and productive cough. Priority action?
Administer IV fluids to prevent dehydration
Restrict physical activity to conserve energy
Encourage chest physiotherapy and administer PRN bronchodilators
Increase dietary intake of carbohydrates to support lung function
72
Which of the following is a primary cause of respiratory complications in patients with cystic fibrosis?
Overproduction of alveolar macrophages
Increased red blood cell production due to hypoxia
Decreased surfactant production
Excessive mucus production due to impaired chloride transport
73
A pt w/ COPD is frustrated about their limited ability to perform ADLs due to SOB. How should you communicate w/ them?
Tell the patient that exercise will resolve their issues
Acknowledge the pt’s frustration and explore potential coping strategies
Instruct the patient to remain quiet and practice deep breathing exercises
Ignore the patient’s concerns to avoid causing more stress
74
5 yr old with hypocalcemia from low vit. D admitted w/ convulsions. Priority nursing action when administering calcium?
Restrict the child's fluid intake to prevent overload
Administer the calcium as rapid IV push
Monitor the child's respiratory rate and rhythm
Apply continuous cardiac monitoring during infusion
75
Best initial nursing action for a dislodged/migrated PICC line?
Notify the HCP and stop all infusions
Secure the catheter and continue using it as normal
Push the catheter back to its original insertion depth
Flush the catheter with saline to check for patency
76
Nursing intervention to reduce the risk of complications in 30 yr old pt. with long QT syndrome experiencing syncope?
Encourage ambulation to improve circulation
Educate the patient about increasing potassium intake
Administer a beta-blocker to prevent tachycardia
Instruct the patient to avoid all physical activity
77
Priority action for 58 yr old w/ CVC for chemotherapy develops SOB, chest pain, O2 sat 85% and diminished breath sounds?
Clamp the central line and position the pt. in trendelenburg
Perform chest compressions immediately
Notify the HCP and prepare for chest tube insertion
Administer oxygen via non-rebreather mask

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