Exam 1

The nurse on the cardiac unit has noted that the client's potassium level is 6.1 mEq/L (6.1 mmol/L). The nurse has notified the physician and removed the banana from the client's meal tray. When explaining the nursing actions to the client, which statement is appropriate?

"I need to monitor you for signs of high potassium; tell me if you feel as if your heart is beating quickly."

"The amount of potassium in your blood is too high, but I will change your intravenous fluids."

"Your potassium level is high so I need you let me know if you feel numbness, tingling or weakness."

"Your potassium levels in your blood are higher than they should be, which brings a risk of changes in kidney function."

"Your potassium level is high so I need you let me know if you feel numbness, tingling or weakness."

The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease. The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase?

Metabolism

Excretion

Distribution

Absorption

Excretion

A nurse is preparing to administer a medication that functions as an agonist to a client. Which of the following statements about the medication should the nurse make?

"This helps to maintain receptor activity at a stable baseline level."

"It reduces the receptor's activity by blocking molecular activity."

"It prevents the receptor from interacting with the natural chemicals in the body."

"The medicine binds to a receptor and enhances the receptor's natural activity."

"The medicine binds to a receptor and enhances the receptor's natural activity."

A nursing instructor is teaching pharmacology to student nurses. What will the nursing instructor include as the four major components of pharmacokinetics?

Select all that apply.

How drugs are removed from the body

How drugs change body illnesses and pathogens

How drugs are transported throughout the body

How drugs are converted to a form that is easily removed from the body

How drugs move from the site of administration to circulating fluids

How drugs are removed from the body

How drugs are transported throughout the body

How drugs are converted to a form that is easily removed from the body

How drugs move from the site of administration to circulating fluids

Which term is used to describe the study of the physicochemical properties of drugs and how they influence the body?

Pharmacodynamics

Pharmacognosy

Pharmacokinetics

Pharmacotherapeutics

Pharmacodynamics

The nursing student asks a clinical instructor about the characteristics of fat-soluble vitamins and water-soluble vitamins. Which response given by the clinical instructor is appropriate?

"Fat-soluble vitamins are stored in fatty tissues for a shorter duration than water-soluble vitamins."

"Fat-soluble vitamins are more likely to cause hypervitaminosis than water-soluble vitamins."

"Fat-soluble vitamins are more easily excreted in urine than water-soluble vitamins."

"Fat-soluble vitamins are stored in the liver for a shorter duration than water-soluble vitamins."

"Fat-soluble vitamins are more likely to cause hypervitaminosis than water-soluble vitamins."

Metabolic acidosis

Diarrhea

Respiratory alkalosis

Anxiety

Metabolic alkalosis

Vomiting

Respiratory acidosis

Pneumonia

Which description characterizes metaplasia?

It is a reversible replacement of one mature cell type by another less mature cell type.

It is a deranged cellular growth that can be reversed if the offending stimulus is removed.

It is an increase in cell number.

It is a decrease in cell size.

It is a reversible replacement of one mature cell type by another less mature cell type.

A patient has been receiving morphine for chronic pain management over the past six months. The healthcare provider notices that the patient now requires higher doses of morphine to achieve the same level of pain relief. Additionally, the patient experiences anxiety and restlessness when the medication is not administered on time. Which of the following statements best describes this patient's condition?

The patient has developed tolerance but not dependence

The patient has developed neither tolerance nor dependence

The patient has developed dependence but not tolerance

The patient has developed both tolerance and dependence

The patient has developed both tolerance and dependence

The nurse at a long-term care facility encourages the older adults to drink even though they may not feel thirsty at the time. Which statement supports the nurse's action?

The renin-angiotensin-aldosterone system (RAAS) is less able to facilitate sodium clearance in older adults.

The metabolic needs for both fluid and sodium in older adults differ from those of younger individuals.

Older adults often experience a decrease in the sensation of thirst, even when serum sodium levels are high.

Regulation and maintenance of effective circulating volume by the kidneys is less effective in older adults.

Older adults often experience a decrease in the sensation of thirst, even when serum sodium levels are high.

A patient with severe diarrhea is admitted to the emergency department with signs of hypovolemia. Which of the following isotonic solutions would be most appropriate for initial fluid replacement?

3% Sodium Chloride

5% Dextrose in Water (D5W)

0.9% Sodium Chloride (Normal Saline)

0.45% Sodium Chloride (Half-Normal Saline)

0.9% Sodium Chloride (Normal Saline)

Which vitamin deficiency can result from long-term alcohol abuse and potentially lead to Wernicke's encephalopathy?

Magnesium

Vitamin E

Thiamin (Vitamin B1)

Vitamin A

Thiamin (Vitamin B1)

When planning care for a cardiac patient, the nurse knows that in response to an increased workload, cardiac myocardial cells will experience hypertrophy which is an:

decrease in length.

increase in excitability.

increase in size.

decrease in number.

increase in size.

While reading a medication package insert, a nurse notes the information contained within the "black box." What is the significance of this information to the nurse?

Select all that apply.

It signifies the medication is generic.

It differentiates a prescribed medication from an over-the-counter (OTC) medication.

The drug can cause "special problems."

It identifies extreme adverse drug reactions.

It highlights the cost of the medication.

The drug can cause "special problems."

It identifies extreme adverse drug reactions.

The nurse is reviewing medication errors. Which situation is an example of a medication error?

A patient receives a double dose of a medication because the nurse did not cut the pill in half.

A patient develops hives after having started an IV antibiotic 24 hours earlier.

A patient complains of severe pain still present 60 minutes after a pain medication was given.

A patient refuses her morning medications.

A patient receives a double dose of a medication because the nurse did not cut the pill in half.

A 78-year-old patient is admitted to the hospital with severe diarrhea and vomiting for the past 48 hours. The patient appears lethargic and complains of muscle cramps. Laboratory results show:

- Serum sodium: 132 mEq/L (Normal: 135-145 mEq/L)

- Serum potassium: 2.8 mEq/L (Normal: 3.5-5.0 mEq/L)

- Serum chloride: 94 mEq/L (Normal: 98-108 mEq/L)

- Serum bicarbonate: 18 mEq/L (Normal: 22-26 mEq/L)

Which of the following electrolyte imbalances is most critical and requires immediate attention?

Hypochloremia

Hyponatremia

Metabolic acidosis

Hypokalemia

Hypokalemia

The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs?

Absorption of parenteral drugs is affected by reduced blood flow to the stomach.

Parenteral drugs bypass the first-pass effect.

Parenteral drugs exert their effects while circulating in the bloodstream.

Absorption of parenteral drugs is faster when the stomach is empty.

Parenteral drugs bypass the first-pass effect.

Which statement would a nurse tell a client to best describe apoptosis?

"Apoptosis is an increase in the size of cells."

"Apoptosis describes increase in number of cells."

"Apoptosis is the natural removal of injured or worn out cells."

"Apoptosis occurs in irreversibly damaged cells."

"Apoptosis is the natural removal of injured or worn out cells."

Mrs. Johnson, an 82-year-old patient, is admitted to the hospital with complaints of dizziness and confusion. Her medication list includes:

- Lisinopril 10mg daily for hypertension

- Metformin 500mg twice daily for diabetes

- Simvastatin 20mg at bedtime for high cholesterol

- Aspirin 81mg daily for heart health

- Calcium + Vitamin D supplement daily

- Over-the-counter sleep aid as needed

During assessment, you notice Mrs. Johnson has difficulty recalling her medication schedule and mentions occasionally doubling doses when she forgets. What is the most appropriate initial nursing intervention?

Immediately discontinue all medications

Increase the dosage of her antihypertensive medication

Recommend switching all medications to once-daily dosing

Conduct a thorough medication review and reconciliation

Conduct a thorough medication review and reconciliation

Which statement describes the most serious consequence of hypocalcemia?

Cardiac dysrhythmias

Pathologic fractures

Stupor

Personality changes

Cardiac dysrhythmias

The nurse is caring for a patient who is taking aspirin to treat rheumatoid arthritis. The nurse learns that the patient uses a ginkgo supplement. Which adverse effect will the nurse expect in the patient?

Increased risk of bleeding

Nephrotoxicity

Leukopenia

Decreased uric acid excretion

Increased risk of bleeding

The nurse is caring for a client with metabolic alkalosis. Which of these arterial blood gas results supports this diagnosis?

pH of 7.35 and HCO3 of 22 mEq/L (22 mmol/L)

pH of 7.50 and HCO3 of 45 mEq/L (45 mmol/L)

pH of 7.25 and HCO3 of 18 mEq/L (18 mmol/L)

pH of 7.45 and HCO3 of 24 mEq/L (24 mmol/L)

pH of 7.50 and HCO3 of 45 mEq/L (45 mmol/L)

A nurse is talking with a client about taking tetracycline along with an antacid. The nurse tells the client not to take these two medications at the same time because the antacid can reduce the absorption of tetracycline. Which of the following describes the action of one medication reducing the effect of another medication?

Allergic reaction

Antagonistic effect

Adverse reaction

Synergistic effect

Antagonistic effect

When given an intravenous medication, the patient says to the nurse, "I usually take pills. Why does this medication have to be given in the arm?" What is the nurse's best answer?

"The medication will cause fewer adverse effects when given intravenously."

"The action of the medication will begin sooner when given intravenously."

"The intravenous medication will have delayed absorption into the body's tissues."

"There is a lower chance of allergic reactions when drugs are given intravenously."

"The action of the medication will begin sooner when given intravenously."

A patient is prescribed a new antibiotic with a half-life of 6 hours. The nurse explains to the patient that this medication needs to be taken every 12 hours. The patient asks why they can't just take it once a day for convenience. Which of the following best explains the rationale for the dosing schedule?

Taking it once daily would lead to toxic drug levels

The medication is fully eliminated after one half-life

Half-life has no impact on dosing frequency

The dosing schedule ensures steady-state drug levels

The dosing schedule ensures steady-state drug levels

Which intravenous (IV) solution would cause cellular shrinkage?

Hypotonic

Isotonic

Hypertonic

Diluted

Hypertonic

A mother who is a carrier for an X-linked recessive disorder has a son. What is the probability that the son will be affected by the disorder?

25%

50%

75%

100%

50%

Which clinical manifestation would lead the nurse to suspect a client has developed fluid volume excess?

decreased blood pressure

weight gain

increased blood urea nitrogen (BUN)

decreased urine output

weight gain

A nurse recalls that regulation of acid-base balance through removal or retention of volatile acids is accomplished by the:

skin.

lungs.

buffer systems.

liver.

lungs

A student nurse asks a nurse what the generic name of a drug means. Which of the following is true regarding the generic name of a drug?

The name the drug is assigned by the company marketing the drug.

It describes the chemical composition of the medication.

There is only one name for each medication.

Drugs that contains more than one active ingredient are classified as generic drugs.

There is only one name for each medication.