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BSN 315 Week 7/8
Practice HESI BSN 315
| Question | Answer |
|---|---|
| A pt is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The RN prepares for IV administration of edrophonium chloride. What is the expected outcome for this client following the administration of this pharmacologic agent? | Decreased muscle weakness |
| Which method of medication administration provides the client with the greatest first-pass effect? | Oral |
| An adult client has prescriptions for morphine sulfate 2.5 mg IV every 6 hours and ketorolac 30 mg IV every 6 hours. Which action should the nurse implement? | Administer both medications according to the prescription. |
| Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol? | Wheezing, hypotension, and AV block. |
| A client with heart failure is prescribed spironolactone. Which information is most important for the nurse to provide to the client about diet modifications? | Refrain from eating foods high in potassium. |
| A category X drug is prescribed for a young adult female client. Which instruction is most important for the nurse to teach this client? | Use a reliable form of birth control. |
| The nitrate isosorbide dinitrate is prescribed for a client with angina. Which instruction should the nurse include in this client's discharge teaching plan? | Do not get up quickly. Always rise slowly. |
| A client is receiving metoprolol. Which assessment is most important for the nurse to obtain? | Blood Pressure |
| Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic? | A young adult with inflammatory bowel disease |
| The RN is preparing the 0900 dose of losartan, an angiotensin II receptor blocker (ARB), for a pt with HTN & HF. The RN reviews the pt's laboratory results and notes that the pt's serum K+ level is 5.9 mEq/L. Which action should the nurse take first? | Withhold the scheduled dose |
| Which nursing diagnosis is important to include in the plan of care for a client receiving the angiotensin-2 receptor antagonist irbesartan? | Risk for injury |
| An adult client is given a prescription for a scopolamine patch to prevent motion sickness while on a cruise. Which information should the nurse provide to the client? | Apply the patch at least 4 hours prior to departure |
| The RN is assessing a pt prior to giving the ordered dose of atenolol PO. The client's BP is 120/68, and the monitor shows sinus brady w/ a rate of 58 bpm, and a P-R interval of 0.24. Based on this assessment, what intervention should the RN implement? | Give the medication as prescribed and continue to monitor the client. |
| A client with hyperlipidemia receives a prescription for niacin. Which client teaching is most important for the nurse to provide? | Expected duration of flushing. |
| The healthcare provider prescribes naproxen twice daily for a client with osteoarthritis of the hands. The client tells the nurse that the drug does not seem to be effective after three weeks. Which is the best response for the nurse to provide? | Another type of nonsteroidal antiinflammatory drug may be indicated. |
| When assessing an adolescent who recently overdosed on acetaminophen, it is most important for the nurse to assess for pain in which area of the body? | Abdomen |
| A client with heart failure (HF) is being discharged with a new prescription for the angiotensin-converting enzyme (ACE) inhibitor captopril. The nurse's discharge instructions should include reporting which problem to the healthcare provider? | Dizziness |
| After abdominal surgery, a male client is prescribed low molecular weight heparin (LMWH). During the administration of the medication, the client asks the nurse why he is receiving this medication. Which is the best response for the nurse to provide? | This medication is a blood thinner given to prevent blood clot formation. |
| A client with Parkinson's disease is taking levodopa-carbidopa. Which observation by the nurse would indicate that the desired outcome of the medication is being achieved? | Lessening of tremors. |
| A client receiving albuterol tablets complains of nausea every evening with her 9:00 p.m. dose. Which action can the nurse take to alleviate this side effect? | Administer the dose with a snack. |
| Upon admission to the emergency center, an adult client with acute status asthmaticus is prescribed this series of medications. In which order should the nurse administer the prescribed medications? (Arrange from first to last.) | 1. Albuterol puffs. 2. Salmeterol. 3. Prednisone orally. 4. Gentamicin IM. |
| Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor antagonist valsartan has been achieved? | Blood pressure reduced from 160/90 to 130/80 mmHg. |
| The healthcare provider prescribes naloxone for a client in the emergency room. Which assessment data would indicate that the naloxone has been effective? | Respiratory rate is 16 breaths/minute. |
| A client with dysrhythmia is to receive procainamide in 4 divided doses over the next 24 hours. Which dosing schedule is best for the nurse to implement? | Every 6 hours |
| A client who was prescribed atorvastatin one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug-specific teaching the nurse should provide to this client? | Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect. |
| The healthcare provider prescribes digitalis for a client diagnosed with heart failure. Which intervention should the nurse implement prior to administering the digitalis? | Assess serum potassium level |
| A 43-year-old female client is receiving thyroid replacement hormone following a thyroidectomy. Which adverse effects associated with thyroid hormone toxicity should the nurse instruct the client to report promptly to the healthcare provider? | Tachycardia and chest pain. |
| A female pt calls the clinic and talks with the nurse to inquire about a possible reaction after taking amoxicillin for 5 days. She reports having vaginal discomfort, itching, and a white discharge. The nurse should discuss which action with the client? | Consult with healthcare provider about another treatment for this effect. |
| The nurse is teaching a client with cancer about opioid management for intractable pain and tolerance-related side effects. The nurse should prepare the client on which side effect that is most likely to persist during long-term use of opioids? | Constipation |
| The nurse is assessing the effectiveness of high-dose aspirin therapy for an 88-year-old client with arthritis. The client reports that she can't hear the nurse's questions because her ears are ringing. Which action should the nurse implement? | Notify the healthcare provider of this finding immediately. |
| A client is receiving ampicillin sodium for a sinus infection. The nurse should instruct the client to notify the healthcare provider immediately if which symptom occurs? | Rash |
| While taking a nursing history, the client states, "I am allergic to penicillin." Which related allergy to another type of antiinfective agent should the nurse ask the client about when taking the nursing history? | Cephalosporins. |
| An older client with a decreased percentage of lean body mass is likely to receive a prescription that is adjusted based on which pharmacokinetic process? | Distribution |
| A female client with rheumatoid arthritis takes ibuprofen 600 mg PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol 100 mcg PO is prescribed. Which information is most important for the nurse to include in client teaching? | Use contraception during intercourse. |
| Which instruction(s) should the nurse give to a female client who just received a prescription for oral metronidazole for treatment of Trichomonas vaginalis? (Select all that apply.) | Increase fluid intake, especially cranberry juice. Avoid drinking alcohol while taking this medication. Use condoms until treatment is completed. Ensure that all sexual partners are treated at the same time. |
| A client has a continuous IV infusion of dopamine and an IV of sodium chloride at 50 mL/hour. The nurse notes that the client's urinary output has been 20 mL/hour for the last two hours. Which intervention should the nurse initiate? | Notify the healthcare provider of the urinary output. |
| A client with coronary artery disease who is taking digoxin receives a new prescription for atorvastatin. Two weeks after initiation of the prescription, the nurse assesses the client. Which finding requires the most immediate intervention? | Vomiting |
| The RN is reviewing the (PCA) pump w/ a pt in PACU. The pt will receive morphine 1 mg IV per hour basal rate with 1 mg IV every 15 minutes per PCA to total 5 mg IV max per hour. Which assessment has the highest priority before initiating the PCA pump? | The rate and depth of the client's respirations. |
| The nurse is transcribing a new prescription for spironolactone for a client who receives an angiotensin-converting enzyme (ACE) inhibitor. Which action should the nurse implement? | Verify both prescriptions with the healthcare provider. |
| The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription should the nurse prepare to administer to this client? | Epinephrine. |
| A client with osteoarthritis receives a new prescription for celecoxib orally for symptom management. The nurse notes the client is allergic to sulfa. Which action is most important for the nurse to implement prior to administering the first dose? | Notify Healthcare provider |
| Which medications should the nurse caution the client about taking while receiving an opioid analgesic? | Benzodiazepines. |
| Which drug is used as a palliative treatment for a client with tumor-induced spinal cord compression? | Dexamethasone |
| The nurse is caring for a pt who has taken atenolol for 2 yrs. The healthcare provider recently changed the medication to enalapril to manage the client's blood pressure. Which instruction should the nurse provide the client regarding the new medication? | Rise slowly when getting out of bed or a chair. |
| In evaluating the effects of lactulose, which outcome would indicate that the drug is performing as intended? | Two or three soft stools per day. |
| Dobutamine is an emergency drug most commonly prescribed for a client with which condition? | Heart Failure |
| An antacid, calcium carbonate, is prescribed for a client with peptic ulcer disease. The nurse knows that the purpose of this medication is to? | Maintain a gastric pH of 3.5 or above. |
| Which nursing intervention is most important when caring for a client receiving the antimetabolite cytosine arabinoside for chemotherapy? | Inspect the client's oral mucosa for ulcerations. |
| A client is receiving methylprednisolone 40 mg IV daily. The nurse anticipates an increase in which laboratory value as the result of this medication? | Serum Glucose |
| A client is receiving clonidine 0.1 mg/24hr via transdermal patch. Which assessment finding indicates that the desired effect of the medication has been achieved? | Blood pressure has changed from 180/120 to 140/70 mmHg. |
| Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved? | Client states Chest pain is relieved |
| A client is being treated for osteoporosis with alendronate, and the nurse has completed discharge teaching regarding medication administration. Which morning schedule would indicate to the nurse that the client teaching has been effective? | Take medication, go for a 30 minute morning walk, then eat breakfast. |
| A client's dose of isosorbide dinitrate is increased from 40 mg to 60 mg PO daily. When the client reports the onset of a headache prior to the next scheduled dose, which action should the nurse implement? | Administer the 60 mg dose of isosorbide dinitrate and a PRN dose of acetaminophen. |
| A client has myxedema, which results from a deficiency of thyroid hormone synthesis in adults. Which medication would be contraindicated for this client? | Phentobarbital sodium for sleep. |
| In teaching a client who had a liver transplant about cyclosporine, the nurse should encourage the client to report which adverse response to the healthcare provider? | Presence of hand tremors |
| A client asks the nurse if glipizide is an oral insulin. Which response should the nurse provide? | "No, it is not an oral insulin and can be used only when some beta cell function is present." |
| A client with giardiasis is taking metronidazole 2 grams PO. Which information should the nurse include in the client's instruction? | Take the medication with food. |
| A postop pt has been receiving a continuous IV meperidine 35 mg/hr for 4 days. The pt has a PRN for meperidine 100 mg PO q 3 hours. The RN notes that the pt has become restless, irritable, confused, & hallucinating. Which action should the RN take 1st? | Decrease the IV infusion rate of the meperidine per protocol. |
| Which action is most important for the nurse to implement prior to the administration of the antiarrhythmic drug adenosine? | Apply continuous cardiac monitoring |
| A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial infarction. Which medication prescription decreases both preload and afterload? | Nitroglycerin |
| A medication that is classified as a beta-1 agonist is most commonly prescribed for a client with which condition? | Heart Failure |
| Which antidiarrheal agent should be used with caution in clients taking high dosages of aspirin for arthritis? | Bismuth subsalicylate. |
| A pt who has been taking levodopa PO TID has a new prescription for sustained-release levodopa/carbidopa PO BID. The client took his levodopa at 0800. Which instruction should the nurse include in the teaching plan for this client? | "You can begin taking the levodopa-carbidopa this evening, but do not take any more levodopa." |
| Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone prescription? | Every 12 hours |
| A peak and trough level must be drawn for a client receiving antibiotic therapy. Which is the optimum time for the nurse to obtain the trough level? | Immediately before the next antibiotic dose is given. |
| Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription for warfarin. In conducting discharge teaching, the nurse advises the client to have which diagnostic test monitored regularly after discharge? | Prothrombin Time (PT/INR). |
| A client receiving doxorubicin intravenously (IV) complains of pain at the insertion site, and the nurse notes edema at the site. Which intervention is most important for the nurse to implement? | Discontinue the IV fluids |
| The nurse is making early morning rounds on a group of clients when a client begins exhibiting symptoms of an acute asthma attack. The nurse administers a PRN prescription for a Beta 2 receptor agonist agent. Which client response should the nurse expect? | Rapid resolution of wheezing. Improved pulse oximetry values. |
| A pt is taking hydromorphone PO q 4 hours following surgery, IV every 4 hours PRN, & butorphanol tartrate IV q 4 hrs PRN for pain. The pt received a dose IV 4 hours ago and is again requesting pain medication. | What intervention should the nurse implement? Administer only the hydromorphone every 4 hours PRN for pain. |
| A client is being treated for hyperthyroidism with propylthiouracil. The nurse knows that the action of this drug is to? | Inhibit synthesis of T3 and T4 by the thyroid gland. |
| A client is receiving digoxin for the onset of supraventricular tachycardia (SVT). Which laboratory finding should the nurse identify that places this client at risk? | Hypokalemia |
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