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Pharm exam 9

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Question
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A young pt is brought to the ER by friends, who say they found him unresponsive at home. The prescriber suspects that the pt was poisoned. During the assessment, the man mumbles a word and becomes comatose. The nurse should immediately prepare to admin   intravenous dextrose.  
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A pt is brought to the ER after ingestion of an unknown substance. The pt has been vomiting and complains of abd pain. The nurse observes that the pt’s oral muc membranes are dry, the HR is 88 bpm, the BP is 90/60 The nurse will prepare to initially:   infuse normal saline as an IV bolus.  
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A pediatric patient ingested a narcotic analgesic at a grandparent’s house 15 minutes before arriving in the emergency department. The nurse is preparing to administer activated charcoal. Which statement by the nurse is correct?   “The charcoal will cause the child’s stools to be black.”  
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A parent brings a child to the emergency department, because the child drank a solution containing ferrous sulfate. The nurse will prepare for:   whole-bowel irrigation.  
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A patient overdosed on aspirin several hours ago and is brought to the emergency department. The nurse assists with supportive care and then asks the provider about an order for which drug?   Sodium bicarbonate  
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A child is admitted to the hospital after a routine lead screen reveals an elevated serum lead level. The prescriber has ordered edetate calcium disodium (calcium EDTA) as a chelating agent. During this drug treatment, the nurse will expect to:   collect a daily urine specimen.  
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A nurse is teaching a patient who works with heavy metals and who is about to begin taking a chelating agent to treat heavy metal poisoning. Which statement by the patient indicates a need for further teaching?   Chelating agents interact with metals to form chelates, which then can be excreted from the body. Chelating agents can strip metals already bound and prevent the binding The chelates are less toxic and can be excreted safely.  
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A prescriber has ordered deferasirox (Exjade) to treat iron overload associated with chronic blood transfusions. The nurse learns that the patient takes cholestyramine to reduce cholesterol. The nurse will contact the provider to request an order to:   increase the deferasirox dose.  
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A patient will begin taking dimercaprol (BAL in Oil) for arsenic poisoning. The nurse performs a medical history on this patient. Which aspect of the patient’s history would cause the most concern?   Peanut allergy  
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The nurse is caring for several patients who have been exposed to various types of poisoning. Which of the following interventions by the nurse would be most inappropriate for the specified toxic (poisoning) situation?   Activated charcoal; heavy metal poisoning  
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The nurse is teaching a class about potential poisons in the home & options for Tx to a group of parents w sml children. One of the parents asks the nurse about syrup of ipecac. Which statement indicates a need for further teaching?   “Ipecac is useful when corrosive acids have been ingested.”  
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The nurse is orienting a graduate nurse to a medical-surgical unit. The nurses receive an order to administer a whole bowel irrigation. The graduate nurse would be correct to   ave the patient drink a solution of polyethylene glycol  
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The nurse works on a med-surg unit and admits a new pt from the ER with many orders, including one to admin an IV sol of sodium bicarbonate. The nurse suspects that the pt has ingested toxic amounts of.. & understands that the sodium bicarbonate will   aspirin; create an alkaline urine to accelerate excretion  
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Parents frantically rush their child to the ER & report that she got into lead at the house of a friend who makes lead fishing weights. The prescriber confirms lead poisoning & orders calcium EDTA. What is the correct initial method of admin this med?   Intramuscularly (IM) twice daily for 3 to 5 days  
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pt is brought to ER by ambulance. Friends arrive after the ambulance & tell the prescriber & nurses that they were all wking on the man’s car, & he accidentally drank some antifreeze. Alcohol also was involved. The 1st med the nurse should prepare is   fomepizole (Antizole).  
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police bring man to ED whos visibly ill. Hes vomiting & complains of stomach pain. He tells staff, “wife is trying to kill me.” The police officer states man gave a bottle w white powder prescriber runs tests confirms arsenic poisoning nurse should admin   dimercaprol (BAL In Oil).  
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A nurse in the ED is caring for a 17-year-old patient brought in by his parents. The parents say they think he overdosed on acetaminophen (Tylenol), because he just had a serious break up with a gf. Which antidote would the nurse anticipate admin?   Acetylcysteine (Mucomyst)  
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The nurse is teaching a community program on poisons in the home. The nurse asks the group, “What services could a poison control center offer?” Which response by a participant demonstrates need for further teaching? “The poison control center offers   services provided 5 days a week.”  
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An individual brought to the ED is suspected of having taken an OD of pilocarpine (Pilocar) 3 hrs ago Upon assessment, that nurse notes profuse salivation, lacrimation, bronchospasm, diarrhea, a BP of 82/40 and a HR of 51 The nurse should prepare to admin   atropine (Sal-Tropine).  
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A pt reported to have been exposed to mustard gas is brought to the ED. The pts skin is red & swollen w/ sml blisters, & the pts eyes are red and tearing. The patient has a runny nose and a dry, barking cough. What should the nurse’s initial action be?   Remove the patient’s clothing and clean the skin with soap and water.  
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A nurse is teaching a course in bioterrorism to a group of military nurses. Which statement by a military nurse indicates understanding of the teaching?   “Although smallpox has been eradicated, it remains a threat.”  
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A nurse responds when a patient asks why the smallpox vaccine is no longer given. Which statement by the patient indicates a need for further teaching?   “The smallpox vaccine is too expensive to give routinely.”  
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A group of people has been exposed to ricin by inhalation of ricin mist. When preparing to receive these victims in the emergency department, nurses will prepare to:   provide respiratory support.  
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Terrorists have detonated a “dirty bomb” in a shopping center. Nurses are called to the site to assist with triage of victims. Besides treating injuries incurred from the blast itself, the priorities for treatment for most of the victims will include:   removing clothing and bathing victims.  
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A member of a community disaster response team received the smallpox vaccine 3 weeks ago and sees a nurse for a follow-up appointment. The nurse examines the area and should expect to see a:   small area of scarification.  
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A pt is admit to the hospital with fever, cough, malaise, & weakness. 48hrs later the symptoms have become progressively worse, & they progress to severe respiratory distress, septicemia, & hemorrhagic meningitis. nurse recognizes these signs &symptoms as   inhalation anthrax.  
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A nurse is attending a conference about terrorism and emergency response. During a discussion of radiation emergencies, the use of potassium iodide is reviewed. When should potassium iodide be administered to be most effective after exposure to radiation?   Immediately after exposure  
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he nurse is providing smallpox vaccinations after determining that an individual who works for a local military laboratory was exposed. After administering the vaccine, how should the nurse instruct the individual to care for the site?   Cover the site with sterile gauze and tape the edges.  
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A nurse driving home p wk is flagged down by neighbor in the country who says husband was exposed to mustard gas.skin is red &swollen w sml blisters & eyes are red & tearing. The victim has a runny nose & dry, barking cough. What should nurse’s action be   Have the patient remove his clothes and bathe with soap and water three times.  
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A pt comes to clinic w a large, fluid-filled vesicle on his rt hand. The NP diagnoses cutaneous anthrax and prescribes an antibiotic. Which statement by the patient demonstrates a need for further teaching by the nurse? “I should anticipate   that I may develop a systemic infection.”  
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Army nurse is prep to admin BioThrax to a grp of soldiers who are being deployed to an active combat area. grp is receiving the 1st of series of anthrax vaccs& nurse provides edu. What statement about vaccine demonstrates need for further teaching?   “I can expect a scar from this vaccine.”  
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The Defense Department is providing education on potential bioterrorism agents. The instructor asks the nurses to identify the correct causative agent for an illness. Which response best demonstrates understanding?   Tularemia; deer fly  
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A person who has newly immigrated to the US comes to the ED w/complaints of coughnauseavomiting & diarrhea. Upon assessment, the nurse finds a high fever 104.1° F, SOB, respirations 36 pulse 122 BP 108/51 & hemoptysis. MD suspects primary pneumonic plague   Obtain the O2 saturation level and administer oxygen.  
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A member of a community disaster response team received the smallpox vaccine 3 weeks ago. He sees a nurse for a follow-up appointment. The nurse examines the area and should expect to see a   small scar known as scarification.  
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An individual is brought to the ED by some friends, who say they think she had a stroke. Upon assessment, she complains of blurred vision, has drooping eyelids, slurred speech, & difficulty swallowing. The nurse suspects that she has ... & anticipates ...   botulism poisoning; symmetrical descending flaccid paralysis  
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A nurse is at a ntl conference on weapons of mass destruction. The predominant topic is smallpox. The nurse is reviewing the main points of the topic. Which of the following statements by the nurse would indicate the need for further reinforcement?   “The incubation phase is 7 to 10 days.”  
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he nurse is attending a conference about terrorism & emergency response. During discussion of radiation emergencies, the use of potassium iodide is reviewed. Which time frame allows the use of potassium iodide to be most effective p exposure to radiation?   Immediately after exposure  
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The nurse is providing smallpox vaccinations after determining that an individual who works for a local military laboratory was exposed. After administering the vaccine, how should the nurse instruct the individual to care for the site?   Cover the site with sterile gauze and tape the edges.  
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A nurse in the emergency department has just received word that the emergency department will be receiving a small group of military personnel (18) who have been exposed to inhalation anthrax. The nurse should prepare to administer   intravenous ciprofloxacin (Cipro).  
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