Which Agent Would the Nurse Expect to Find When Reviewing Over-the-counter Allergy Products?
101. A clinical situation in which the increased release of erythropoietin would be expected is:
a. Hypoxemia
b. Hypotension
c. Hyperkalemia
d. Fluid overload
>>See answer and rationale<<
102. An age-related change in the kidney that leads to nocturia in an older adult is:
a. Decreased renal mass
b. Decreased detrusor muscle tone
c. Decreased ability to conserve sodium
d. Decreased ability to concentrate urine
>>See answer and rationale<<
103. During concrete assessment of the urinary arrangement, the nurse:
a. Auscultates the lower abdominal quadrants for fluid sounds
b. Palpates an empty bladder at the level of the symphysis pubis
c. Percusses the kidney with a business firm accident at the posterior costovertebral angle
d. Positions the patient decumbent to palpate the kidneys with a posterior approach
>>See reply and rationale<<
104. A urinalysis of a urine specimen that is not processed inside 1 hour may effect in an erroneous measurement of:
a. Glucose
b. Bacteria
c. Specific gravity
d. White blood cells
>>See answer and rationale<<
105. Which of the post-obit urine specific gravity values would indicate to the nurse that the patient is receiving excessive Iv fluid therapy?
a. one.002
b. 1.010
c. one.025
d. i.030
>>Encounter answer and rationale<<
Neurologic Arrangement
106. A white female client is admitted to an acute intendance facility with a diagnosis of cerebrovascular accident (CVA). Her history reveals bronchial asthma, exogenous obesity, and iron deficiency anemia. Which history finding is a risk factor for CVA?
a. Caucasian race
b. Female sex
c. Obesity
d. Bronchial asthma
>>See answer and rationale<<
107. The nurse is pedagogy a female customer with multiple sclerosis. When education the client how to reduce fatigue, the nurse should tell the customer to:
a. Take a hot bathroom.
b. Rest in an air-conditioned room
c. Increase the dose of musculus relaxants.
d. Avoid naps during the twenty-four hours
>>Encounter respond and rationale<<
108. A male customer is having tonic-clonic seizures. What should the nurse exercise first?
a. Elevate the head of the bed.
b. Restrain the client's artillery and legs.
c. Place a tongue blade in the customer's mouth.
d. Take measures to prevent injury.
>>See answer and rationale<<
109. A female client with Guillain-Barré syndrome has paralysis affecting the respiratory muscles and requires mechanical ventilation. When the client asks the nurse about the paralysis, how should the nurse answer?
a. "You may have difficulty believing this, but the paralysis acquired by this disease is temporary."
b. "You'll take to accept the fact that you're permanently paralyzed. Withal, yous won't have any sensory loss."
c. "It must be hard to accept the permanency of your paralysis."
d. "Yous'll offset regain use of your legs then your arms."
>>Run into reply and rationale<<
110. The nurse is working on a surgical floor. The nurse must logroll a male client following a:
a. Laminectomy.
b. Thoracotomy.
c. Hemorrhoidectomy.
d. Cystectomy.
>>See respond and rationale<<
111. A female client with a suspected brain tumor is scheduled for computed tomography (CT). What should the nurse do when preparing the client for this test?
a. Immobilize the neck earlier the client is moved onto a stretcher.
b. Determine whether the customer is allergic to iodine, dissimilarity dyes, or shellfish.
c. Identify a cap over the client's caput.
d. Administer a sedative as ordered.
>>Run into answer and rationale<<
112. During a routine concrete examination to assess a male customer'due south deep tendon reflexes, the nurse should brand sure to:
a. Utilise the pointed terminate of the reflex hammer when striking the Achilles tendon.
b. Support the joint where the tendon is being tested.
c. Tap the tendon slowly and softly
d. Hold the reflex hammer tightly.
>>Run into respond and rationale<<
113. A female client is admitted in a disoriented and restless state after sustaining a concussion during a automobile accident. Which nursing diagnosis takes highest priority in this client'southward programme of care?
a. Disturbed sensory perception (visual)
b. Self-care deficient: Dressing/grooming
c. Impaired verbal advice
d. Take a chance for injury
>>Come across answer and rationale<<
114. A female client with amyotrophic lateral sclerosis (ALS) tells the nurse, "Sometimes I experience so frustrated. I can't do anything without help!" This annotate best supports which nursing diagnosis?
a. Anxiety
b. Powerlessness
c. Ineffective denial
d. Risk for disuse syndrome
>>Run into respond and rationale<<
115. For a male client with suspected increased intracranial pressure (ICP), a most appropriate respiratory goal is to:
a. Prevent respiratory alkalosis.
b. Lower arterial pH.
c. Promote carbon dioxide elimination.
d. Maintain partial pressure level of arterial oxygen (PaO2) to a higher place 80 mm Hg
>>See answer and rationale<<
116. Nurse Maureen witnesses a neighbor'due south hubby sustain a fall from the roof of his house. The nurse rushes to the victim and determines the need to open the airway in this victim past using which method?
a. Flexed position
b. Head tilt-mentum lift
c. Jaw thrust maneuver
d. Modified caput tilt-chin lift
>>See answer and rationale<<
117. The nurse is assessing the motor function of an unconscious male client. The nurse would use which of the post-obit to exam the client's peripheral response to hurting?
a. Sternal rub
b. Nail bed pressure
c. Pressure on the orbital rim
d. Squeezing of the sternocleidomastoid musculus
>>Run across answer and rationale<<
118. A female client admitted to the infirmary with a neurological trouble asks the nurse whether magnetic resonance imaging may be done. The nurse interprets that the client may exist ineligible for this diagnostic procedure based on the client'due south history of:
a. Hypertension
b. Eye failure
c. Prosthetic valve replacement
d. Chronic obstructive pulmonary disorder
>>See answer and rationale<<
119. A male person customer is having a lumbar puncture performed. The nurse would plan to identify the client in which position?
a. Side-lying, with a pillow under the hip
b. Prone, with a pillow under the belly
c. Prone, in slight-Trendelenburg's position
d. Side-lying, with the legs pulled up and head bent down onto the chest
>>Meet answer and rationale<<
120. The nurse is positioning the female client with increased intracranial pressure. Which of the following positions would the nurse avoid?
a. Head mildline
b. Head turned to the side
c. Neck in neutral position
d. Caput of bed elevated thirty to 45 degrees
>>See reply and rationale<<
121. A female client has articulate fluid leaking from the nose following a basilar skull fracture. The nurse assesses that this is cerebrospinal fluid if the fluid:
a. Is articulate and tests negative for glucose
b. Is grossly bloody in appearance and has a pH of 6
c. Clumps together on the dressing and has a pH of seven
d. Separates into concentric rings and test positive of glucose
>>Encounter answer and rationale<<
122. A male client with a spinal cord injury is decumbent to experiencing autonomic dysreflexia. The nurse would avoid which of the following measures to minimize the take chances of recurrence?
a. Strict adherence to a bowel retraining programme
b. Keeping the linen wrinkle-complimentary under the client
c. Preventing unnecessary pressure on the lower limbs
d. Limiting bladder catheterization to once every 12 hours
>>Meet answer and rationale<<
123. The nurse is caring for the male client who begins to feel seizure activity while in bed. Which of the following actions by the nurse would be contraindicated?
a. Loosening restrictive article of clothing
b. Restraining the client's limbs
c. Removing the pillow and raising padded side runway
d. Positioning the client to side, if possible, with the head flexed forward
>>See answer and rationale<<
124. The nurse is assigned to care for a female client with consummate correct-sided hemiparesis. The nurse plans care knowing that this condition:
a. The customer has consummate bilateral paralysis of the arms and legs.
b. The client has weakness on the right side of the body, including the face and tongue.
c. The client has lost the ability to motility the correct arm simply is able to walk independently.
d. The client has lost the ability to move the right arm but is able to walk independently.
>>Come across respond and rationale<<
125. The client with a brain assail (stroke) has residual dysphagia. When a diet lodge is initiated, the nurse avoids doing which of the following?
a. Giving the client thin liquids
b. Thickening liquids to the consistency of oatmeal
c. Placing food on the unaffected side of the rima oris
d. Assuasive enough of fourth dimension for chewing and swallowing
>>Come across answer and rationale<<
126. The nurse is assessing the adaptation of the female client to changes in functional status after a brain set on (stroke). The nurse assesses that the customer is adapting most successfully if the client:
a. Gets aroused with family if they interrupt a task
b. Experiences bouts of depression and irritability
c. Has difficulty with using modified feeding utensils
d. Consistently uses adaptive equipment in dressing cocky
>>See answer and rationale<<
127. Nurse Kristine is trying to communicate with a customer with brain attack (stroke) and aphasia. Which of the following actions past the nurse would be least helpful to the client?
a. Speaking to the client at a slower charge per unit
b. Allowing enough of time for the client to respond
c. Completing the sentences that the client cannot terminate
d. Looking directly at the client during attempts at speech
>>See reply and rationale<<
128. A female client has experienced an episode of myasthenic crisis. The nurse would assess whether the client has precipitating factors such as:
a. Getting too little exercise
b. Taking excess medication
c. Omitting doses of medication
d. Increasing intake of fat foods
>>See reply and rationale<<
129. The nurse is didactics the female person client with myasthenia gravis about the prevention of myasthenic and cholinergic crises. The nurse tells the client that this is most effectively done by:
a. Eating large, well-balanced meals
b. Doing muscle-strengthening exercises
c. Doing all chores early in the mean solar day while less fatigued
d. Taking medications on time to maintain therapeutic claret levels
>>Encounter answer and rationale<<
130. A male client with Bell's palsy asks the nurse what has caused this problem. The nurse's response is based on an understanding that the cause is:
a. Unknown, but perhaps includes ischemia, viral infection, or an autoimmune trouble
b. Unknown, just perchance includes long-term tissue malnutrition and cellular hypoxia
c. Principal genetic in origin, triggered by exposure to meningitis
d. Primarily genetic in origin, triggered past exposure to neurotoxins
>>See answer and rationale<<
131. The nurse has given the male customer with Bell'south palsy instructions on preserving muscle tone in the face and preventing denervation. The nurse determines that the customer needs additional data if the client states that he or she will:
a. Exposure to cold and drafts
b. Massage the confront with a gentle upward move
c. Perform facial exercises
d. Wrinkle the forehead, accident out the cheeks, and whistle
>>See answer and rationale<<
132. A female client is admitted to the hospital with a diagnosis of Guillain – Barré syndrome. The nurse inquires during the nursing access interview if the client has a history of:
a. Seizures or trauma to the brain
b. Meningitis during the last 5 years
c. Back injury or trauma to the spinal cord
d. Respiratory or gastrointestinal infection during the previous month.
>>See answer and rationale<<
133. A female client with Guillain – Barré syndrome has ascending paralysis and is intubated and receiving mechanical ventilation. Which of the following strategies would the nurse incorporate in the plan of care to assist the client cope with this affliction?
a. Giving client total control over intendance decisions and restricting visitors
b. Providing positive feedback and encouraging active range of motility
c. Providing data, giving positive feedback, and encouraging relaxation
d. Providing intravenously administered sedatives, reducing distractions and limiting visitors
>>Run across answer and rationale<<
134. A male customer has an damage of cranial nerve II. Specific to this impairment, the nurse would plan to do which of the following to ensure client to ensure client safety?
a. Speak loudly to the customer
b. Test the temperature of the shower water
c. Check the temperature of the food on the delivery tray
d. Provide a clear path for ambulation without obstacles
>>See reply and rationale<<
135. A female person client has a neurological deficit involving the limbic organization. Specific to this type of deficit, the nurse would certificate which of the following information related to the client's behavior.
a. Is disoriented to person, place, and time
b. Touch on is flat, with periods of emotional lability
c. Cannot recollect what was eaten for breakfast today
d. Demonstrate inability to add and subtract; does not know who is president
>>See answer and rationale<<
136. If a male person client experienced a cerebrovascular accident (CVA) that damaged the hypothalamus, the nurse would anticipate that the customer has problems with:
a. Torso temperature command
b. Balance and equilibrium
c. Visual vigil
d. Thinking and reasoning
>>Run across answer and rationale<<
137. A female customer admitted to an acute care facility later a car blow develops signs and symptoms of increased intracranial pressure level (ICP). The client is intubated and placed on mechanical ventilation to help reduce ICP. To prevent a further rise in ICP caused by suctioning, the nurse anticipates administering which drug endotracheally earlier suctioning?
a. Phenytoin (Dilantin)
b. Mannitol (Osmitrol)
c. Lidocaine (Xylocaine)
d. Furosemide (Lasix)
>>See answer and rationale<<
138. Afterwards striking his head on a tree while falling from a ladder, a fellow age eighteen is admitted to the emergency section. He'southward unconscious and his pupils are nonreactive. Which intervention would be the near dangerous for the customer?
a. Give him a barbiturate.
b. Place him on mechanical ventilation.
c. Perform a lumbar puncture.
d. Drag the head of his bed.
>>Run into answer and rationale<<
139. When obtaining the wellness history from a male client with retinal detachment, the nurse expects the customer to report:
a. Lite flashes and floaters in front of the middle.
b. A contempo driving blow while irresolute lanes.
c. Headaches, nausea, and redness of the optics.
d. Frequent episodes of double vision.
>>See answer and rationale<<
140. Which nursing diagnosis takes highest priority for a client with Parkinson'due south crisis?
a. Imbalanced diet: Less than body requirements
b. Ineffective airway clearance
c. Impaired urinary elimination
d. Risk for injury
>>Encounter answer and rationale<<
141. To encourage adequate nutritional intake for a female client with Alzheimer's illness, the nurse should:
a. Stay with the client and encourage him to eat.
b. Help the client fill out his menu.
c. Requite the client privacy during meals.
d. Fill out the carte du jour for the client.
>>See answer and rationale<<
142. The nurse is performing a mental condition examination on a male client diagnosed with subdural hematoma. This examination assesses which of the following?
a. Cerebellar part
b. Intellectual function
c. Cerebral part
d. Sensory function
>>Meet answer and rationale<<
143. Presently subsequently admission to an acute intendance facility, a male client with a seizure disorder develops status epilepticus. The physician orders diazepam (Valium) 10 mg I.V. stat. How soon can the nurse administrate a second dose of diazepam, if needed and prescribed?
a. In 30 to 45 seconds
b. In ten to xv minutes
c. In 30 to 45 minutes
d. In 1 to 2 hours
>>See answer and rationale<<
144. A female client complains of periorbital aching, trigger-happy, blurred vision, and photophobia in her right middle. Ophthalmologic examination reveals a pocket-sized, irregular, nonreactive pupil — a condition resulting from astute iris inflammation (iritis). Equally part of the customer'southward therapeutic regimen, the physician prescribes atropine sulfate (Atropisol), ii drops of 0.5% solution in the right eye twice daily. Atropine sulfate belongs to which drug classification?
a. Parasympathomimetic agent
b. Sympatholytic agent
c. Adrenergic blocker
d. Cholinergic blocker
>>See answer and rationale<<
145. Emergency medical technicians transport a 27-year-old fe worker to the emergency section. They tell the nurse, "He fell from a 2-story building. He has a big contusion on his left chest and a hematoma in the left parietal area. He has a compound fracture of his left femur and he'south comatose. We intubated him and he's maintaining an arterial oxygen saturation of 92% past pulse oximeter with a manual-resuscitation bag." Which intervention by the nurse has the highest priority?
a. Assessing the left leg
b. Assessing the pupils
c. Placing the client in Trendelenburg's position
d. Assessing level of consciousness
>>Meet answer and rationale<<
146. An auto mechanic accidentally has battery acid splashed in his eyes. His coworkers irrigate his eyes with water for 20 minutes, and then accept him to the emergency department of a nearby hospital, where he receives emergency care for corneal injury. The physician prescribes dexamethasone (Maxidex Ophthalmic Suspension), 2 drops of 0.1% solution to exist instilled initially into the conjunctival sacs of both optics every hour; and polymyxin B sulfate (Neosporin Ophthalmic), 0.5% ointment to be placed in the conjunctival sacs of both eyes every 3 hours. Dexamethasone exerts its therapeutic effect by:
a. Increasing the exudative reaction of ocular tissue.
b. Decreasing leukocyte infiltration at the site of ocular inflammation.
c. Inhibiting the action of carbonic anhydrase.
d. Producing a miotic reaction by stimulating and contracting the sphincter muscles of the iris.
>>See answer and rationale<<
147. Nurse April is caring for a customer who underwent a lumbar laminectomy ii days ago. Which of the post-obit findings should the nurse consider abnormal?
a. More back pain than the first postoperative day
b. Paresthesia in the dermatomes near the wounds
c. Urine retention or incontinence
d. Temperature of 99.2° F (37.iii° C)
>>Encounter answer and rationale<<
148. Later on an eye examination, a male client is diagnosed with open-angle glaucoma. The md prescribes pilocarpine ophthalmic solution (Pilocar), 0.25% gtt i, OU q.i.d. Based on this prescription, the nurse should teach the client or a family member to administer the drug by:
a. Instilling 1 driblet of pilocarpine 0.25% into both eyes daily.
b. Instilling 1 driblet of pilocarpine 0.25% into both optics four times daily.
c. Instilling one drop of pilocarpine 0.25% into the right eye daily.
d. Instilling one driblet of pilocarpine 0.25% into the left eye four times daily.
>>Run across answer and rationale<<
149. A female client who's paralyzed on the left side has been receiving physical therapy and attending teaching sessions virtually condom. Which behavior indicates that the client accurately understands safety measures related to paralysis?
a. The customer leaves the side rail down.
b. The client uses a mirror to inspect the skin.
c. The client repositions only after being reminded to do and then.
d. The client hangs the left arm over the side of the wheelchair.
>>See respond and rationale<<
150. A male client in the emergency department has a suspected neurologic disorder. To assess gait, the nurse asks the customer to have a few steps; with each step, the customer'due south feet make a half circumvolve. To document the client's gait, the nurse should use which term?
a. Ataxic
b. Dystrophic
c. Helicopod
d. Steppage
>>Meet answer and rationale<<
151. A client, age 22, is admitted with bacterial meningitis. Which infirmary room would be the best choice for this customer?
a. A private room down the hall from the nurses' station
b. An isolation room three doors from the nurses' station
c. A semiprivate room with a 32-year-old client who has viral meningitis
d. A two-bed room with a client who previously had bacterial meningitis
>>Run across answer and rationale<<
152. A medico diagnoses a client with myasthenia gravis, prescribing pyridostigmine (Mestinon), sixty mg P.O. every 3 hours. Before administering this anticholinesterase agent, the nurse reviews the client'southward history. Which preexisting status would contraindicate the utilise of pyridostigmine?
a. Ulcerative colitis
b. Blood dyscrasia
c. Abdominal obstruction
d. Spinal string injury
>>Meet answer and rationale<<
153. A female person client is admitted to the facility for investigation of residuum and coordination issues, including possible Ménière'southward disease. When assessing this customer, the nurse expects to note:
a. Vertigo, tinnitus, and hearing loss.
b. Vertigo, vomiting, and nystagmus
c. Vertigo, pain, and hearing damage.
d. Vertigo, blurred vision, and fever.
>>See answer and rationale<<
154. A male customer with a conductive hearing disorder caused by ankylosis of the stapes in the oval window undergoes a stapedectomy to remove the stapes and replace the impaired bone with a prosthesis. Later on the stapedectomy, the nurse should provide which customer instruction?
a. "Lie in bed with your head elevated, and refrain from blowing your nose for 24 hours."
b. "Attempt to ambulate independently later on about 24 hours."
c. "Shampoo your hair every day for ten days to help prevent ear infection."
d. "Don't wing in an airplane, climb to loftier altitudes, make sudden movements, or expose yourself to loud sounds for thirty days."
>>Run across reply and rationale<<
155. Nurse Oliver is monitoring a customer for adverse reactions to dantrolene (Dantrium). Which adverse reaction is near common?
a. Excessive violent
b. Urine retention
c. Muscle weakness
d. Slurred speech
>>See answer and rationale<<
156. The nurse is monitoring a male person client for agin reactions to atropine sulfate (Atropine Intendance) eyedrops. Systemic absorption of atropine sulfate through the conjunctiva tin cause which adverse reaction?
a. Tachycardia
b. Increased salivation
c. Hypotension
d. Apnea
>>See answer and rationale<<
157. A male customer is admitted with a cervical spine injury sustained during a diving accident. When planning this client's care, the nurse should assign highest priority to which nursing diagnosis?
a. Impaired physical mobility
b. Ineffective breathing blueprint
c. Disturbed sensory perception (tactile)
d. Self-intendance deficient: Dressing/grooming
>>Come across answer and rationale<<
158. A male client has a history of painful, continuous muscle spasms. He has taken several skeletal muscle relaxants without experiencing relief. His physician prescribes diazepam (Valium), 2 mg P.O. twice daily. In addition to being used to salve painful muscle spasms, diazepam likewise is recommended for:
a. Long-term treatment of epilepsy.
b. Postoperative pain management of laminectomy clients.
c. Postoperative pain management of diskectomy clients
d. Treatment of spasticity associated with spinal cord lesions.
>>See answer and rationale<<
159. A female client who was constitute unconscious at home is brought to the infirmary by a rescue squad. In the intensive care unit of measurement, the nurse checks the client'southward oculocephalic (doll's eye) response by:
a. Introducing ice water into the external auditory canal.
b. Touching the cornea with a wisp of cotton.
c. Turning the customer'southward head all of a sudden while holding the eyelids open.
d. Shining a vivid calorie-free into the pupil.
>>Come across answer and rationale<<
160. While reviewing a client's chart, the nurse notices that the female customer has myasthenia gravis. Which of the following statements about neuromuscular blocking agents is truthful for a client with this condition?
a. The client may be less sensitive to the effects of a neuromuscular blocking amanuensis.
b. Succinylcholine shouldn't exist used; pancuronium may be used in a lower dosage.
c. Pancuronium shouldn't exist used; succinylcholine may exist used in a lower dosage.
d. Pancuronium and succinylcholine both require cautious assistants.
>>See respond and rationale<<
161. A male person customer is color blind. The nurse understands that this client has a trouble with:
a. Rods.
b. Cones.
c. Lens.
d. Aqueous humor.
>>See answer and rationale<<
162. A female client who was trapped inside a car for hours after a head-on standoff is rushed to the emergency department with multiple injuries. During the neurologic examination, the client responds to painful stimuli with decerebrate posturing. This finding indicates damage to which part of the encephalon?
a. Diencephalon
b. Medulla
c. Midbrain
d. Cortex
>>Run into answer and rationale<<
163. The nurse is assessing a 37-year-old client diagnosed with multiple sclerosis. Which of the following symptoms would the nurse expect to detect?
a. Vision changes
b. Absent deep tendon reflexes
c. Tremors at rest
d. Flaccid muscles
>>Meet reply and rationale<<
164. The nurse is caring for a male client diagnosed with a cerebral aneurysm who reports a astringent headache. Which action should the nurse perform?
a. Sit down with the client for a few minutes.
b. Administer an analgesic.
c. Inform the nurse managing director.
d. Call the medico immediately.
>>See answer and rationale<<
165. During recovery from a cerebrovascular accident (CVA), a female person client is given nothing by mouth, to help prevent aspiration. To determine when the client is prepare for a liquid diet, the nurse assesses the client'south swallowing ability once each shift. This cess evaluates:
a. Cranial nerves I and 2.
b. Cranial fretfulness 3 and Five.
c. Cranial fretfulness Half dozen and VIII.
d. Cranial nerves IX and 10.
>>See reply and rationale<<
Pharmacology
166. Sildenafil (Viagra) is prescribed to treat a customer with erectile dysfunction. A nurse reviews the customer'south medical record and would question the prescription if which of the following is noted in the client's history?
a. Neuralgia
b. Indisposition
c. Use of nitroglycerin
d. Use of multivitamins
>>Run across answer and rationale<<
167. A nurse reinforces belch instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for farther teaching?
a. "I will accept my pills every twenty-four hours at the same time."
b. "I will be sure to avoid alcohol consumption."
c. "I take already called my family unit to pick up a Medic-Warning bracelet."
d. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated."
>>See answer and rationale<<
168. Heparin sodium is prescribed for the client. The nurse expects that the health care provider will prescribe which of the following to monitor for a therapeutic effect of the medication?
a. Hematocrit level
b. Hemoglobin level
c. Prothrombin time (PT)
d. Activated partial thromboplastin fourth dimension (aPTT)
>>Run into answer and rationale<<
169. A nurse is monitoring a client who is taking propranolol (Inderal LA). Which data collection finding would point a potential serious complication associated with propranolol?
a. The development of complaints of insomnia
b. The evolution of audible expiratory wheezes
c. A baseline blood pressure level of 150/fourscore mm Hg followed by a claret pressure of 138/72 mm Hg after two doses of the medication
d. A baseline resting center rate of 88 beats/min followed by a resting heart charge per unit of 72 beats/min subsequently ii doses of the medication
>>Encounter reply and rationale<<
170.) Oxybutynin chloride (Ditropan 40) is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this medication?
a. Pallor
b. Drowsiness
c. Bradycardia
d. Restlessness
>>See answer and rationale<<
171. A client with myasthenia gravis is suspected of having cholinergic crisis. Which of the following betoken that this crisis exists?
a. Clutter
b. Oral cavity sores
c. Hypotension
d. Hypertension
>>See respond and rationale<<
172. A customer with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse monitors for signs and symptoms of cholinergic crisis caused by overdose of the medication. The nurse checks the medication supply to ensure that which medication is available for administration if a cholinergic crisis occurs?
a. Vitamin K
b. Atropine sulfate
c. Protamine sulfate
d. Acetylcysteine (Mucomyst)
>>See answer and rationale<<
173. Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson'south illness, and the nurse monitors the client for agin reactions to the medication. Which of the post-obit indicates that the client is experiencing an adverse reaction?
a. Pruritus
b. Tachycardia
c. Hypertension
d. Dumb voluntary movements
>>See respond and rationale<<
174. Phenytoin (Dilantin), 100 mg orally three times daily, has been prescribed for a client for seizure control. The nurse reinforces instructions regarding the medication to the client. Which statement past the customer indicates an understanding of the instructions?
a. "I will utilise a soft toothbrush to brush my teeth."
b. "It's all right to interruption the capsules to arrive easier for me to swallow them."
c. "If I forget to take my medication, I tin wait until the next dose and eliminate that dose."
d. "If my pharynx becomes sore, it'due south a normal effect of the medication and information technology's goose egg to be concerned about."
>>Encounter answer and rationale<<
175. A client is taking phenytoin (Dilantin) for seizure command and a sample for a serum drug level is fatigued. Which of the following indicates a therapeutic serum drug range?
a. 5 to ten mcg/mL
b. 10 to xx mcg/mL
c. twenty to thirty mcg/mL
d. 30 to forty mcg/mL
>>Run into answer and rationale<<
176. Ibuprofen (Advil) is prescribed for a client. The nurse tells the customer to take the medication:
a. With eight oz of milk
b. In the morn afterward arising
c. lx minutes before breakfast
d. At bedtime on an empty stomach
>>See respond and rationale<<
177. A nurse is caring for a client who is taking phenytoin (Dilantin) for command of seizures. During information collection, the nurse notes that the client is taking birth control pills. Which of the following data should the nurse provide to the client?
a. Pregnancy should be avoided while taking phenytoin (Dilantin).
b. The client may stop taking the phenytoin (Dilantin) if information technology is causing severe gastrointestinal effects.
c. The potential for decreased effectiveness of the birth control pills exists while taking phenytoin (Dilantin).
d. The increased risk of thrombophlebitis exists while taking phenytoin (Dilantin) and nascence control pills together.
>>See respond and rationale<<
178. A client with trigeminal neuralgia is being treated with carbamazepine (Tegretol). Which laboratory result would indicate that the client is experiencing an adverse reaction to the medication?
a. Sodium level, 140 mEq/L
b. Uric acrid level, 5.0 mg/dL
c. White blood cell count, 3000 cells/mm3
d. Blood urea nitrogen (BUN) level, 15 mg/dL
>>See answer and rationale<<
179. Dantrolene sodium (Dantrium) is prescribed for a client experiencing flexor spasms, and the client asks the nurse virtually the action of the medication. The nurse responds, knowing that the therapeutic activeness of this medication is which of the following?
a. Depresses spinal reflexes
b. Acts directly on the skeletal muscle to relieve spasticity
c. Acts within the spinal cord to suppress hyperactive reflexes
d. Acts on the cardinal nervous system (CNS) to suppress spasms
>>See respond and rationale<<
180. A nurse is reviewing the laboratory studies on a client receiving dantrolene sodium (Dantrium). Which laboratory test would identify an adverse effect associated with the administration of this medication?
a. Creatinine
b. Liver office tests
c. Blood urea nitrogen
d. Hematological function tests
>>See answer and rationale<<
181. Cyclobenzaprine (Flexeril) is prescribed for a customer to treat muscle spasms, and the nurse is reviewing the client's record. Which of the following disorders, if noted in the client's tape, would indicate a need to contact the health intendance provider regarding the assistants of this medication?
a. Glaucoma
b. Emphysema
c. Hyperthyroidism
d. Diabetes mellitus
>>See answer and rationale<<
182. Disulfiram (Antabuse) is prescribed for a customer who is seen in the psychiatric health care clinic. The nurse is collecting data on the client and is providing instructions regarding the employ of this medication. Which is most important for the nurse to determine before administration of this medication?
a. A history of hyperthyroidism
b. A history of diabetes insipidus
c. When the terminal full repast was consumed
d. When the final alcoholic drink was consumed
>>See answer and rationale<<
183. A nurse is collecting data from a client and the client's spouse reports that the client is taking donepezil hydrochloride (Aricept). Which disorder would the nurse suspect that this customer may have based on the use of this medication?
a. Dementia
b. Schizophrenia
c. Seizure disorder
d. Obsessive-compulsive disorder
>>See reply and rationale<<
184. Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions to the client regarding the administration of the medication. Which statement by the client indicates an understanding nigh administration of the medication?
a. "I should take the medication with my evening meal."
b. "I should take the medication at noon with an antacid."
c. "I should have the medication in the morning when I kickoff arise."
d. "I should have the medication right before bedtime with a snack."
>>Encounter answer and rationale<<
185. A client receiving a tricyclic antidepressant arrives at the mental health clinic. Which observation indicates that the customer is correctly following the medication programme?
a. Reports not going to work for this past week
b. Complains of not being able to "do anything" anymore
c. Arrives at the clinic neat and advisable in appearance
d. Reports sleeping 12 hours per night and 3 to 4 hours during the mean solar day
>>Encounter answer and rationale<<
186. A nurse is performing a follow-up teaching session with a client discharged 1 month ago who is taking fluoxetine (Prozac). What information would exist important for the nurse to assemble regarding the agin effects related to the medication?
a. Cardiovascular symptoms
b. Gastrointestinal dysfunctions
c. Bug with oral cavity dryness
d. Bug with excessive sweating
>>See reply and rationale<<
187. A client taking buspirone (BuSpar) for 1 month returns to the dispensary for a follow-up visit. Which of the following would indicate medication effectiveness?
a. No rapid heartbeats or feet
b. No paranoid thought processes
c. No thought dissemination or delusions
d. No reports of alcohol withdrawal symptoms
>>Encounter answer and rationale<<
188. A client arrives at the health care clinic and tells the nurse that he has been doubling his daily dosage of bupropion hydrochloride (Wellbutrin) to assistance him get better faster. The nurse understands that the client is now at risk for which of the following?
a. Indisposition
b. Weight gain
c. Seizure activity
d. Orthostatic hypotension
>>See respond and rationale<<
189. A hospitalized client is started on phenelzine sulfate (Nardil) for the treatment of depression. The nurse instructs the client to avoid consuming which foods while taking this medication? Select all that apply.
a. Figs
b. Yogurt
c. Crackers
d. Anile cheese
due east Tossed salad
f. Oatmeal cookies
>>Run across answer and rationale<<
190. A client with diabetes mellitus who has been controlled with daily insulin has been placed on atenolol (Tenormin) for the control of angina pectoris. Because of the effects of atenolol, the nurse determines that which of the following is the almost reliable indicator of hypoglycemia?
a. Sweating
b. Tachycardia
c. Nervousness
d. Depression claret glucose level
>>See answer and rationale<<
191. A nurse is preparing to administrate digoxin (Lanoxin), 0.125 mg orally, to a client with heart failure. Which vital sign is nigh of import for the nurse to check before administering the medication?
a. Middle rate
b. Temperature
c. Respirations
d. Blood pressure
>>See answer and rationale<<
192. A nurse is caring for a client who has been prescribed furosemide (Lasix) and is monitoring for adverse furnishings associated with this medication. Which of the following should the nurse recognize as a potential agin event Select all that apply.
a. Nausea
b. Tinnitus
c. Hypotension
d. Hypokalemia
e. Photosensitivity
f. Increased urinary frequency
>>Come across answer and rationale<<
193. A nurse is providing instructions to an adolescent who has a history of seizures and is taking an anticonvulsant medication. Which of the following statements indicates that the client understands the instructions?
a. "I volition never be able to drive a machine."
b. "My anticonvulsant medication volition articulate up my skin."
c. "I tin't drink alcohol while I am taking my medication."
d. "If I forget my morning medication, I tin accept two pills at bedtime."
>>Encounter answer and rationale<<
194. A client complaining of not feeling well is seen in a clinic. The client is taking several medications for the control of heart illness and hypertension. These medications include a β-blocker, digoxin (Lanoxin), and a diuretic. A tentative diagnosis of digoxin toxicity is fabricated. Which of the following assessment information would support this diagnosis?
a. Dyspnea, edema, and palpitations
b. Breast pain, hypotension, and paresthesia
c. Double vision, loss of appetite, and nausea
d. Constipation, dry oral fissure, and sleep disorder
>>Run across answer and rationale<<
195. A client is being treated for acute congestive center failure with intravenously administered bumetanide. The vital signs are equally follows: blood pressure, 100/60 mm Hg; pulse, 96 beats/min; and respirations, 24 breaths/min. After the initial dose, which of the following is the priority assessment?
a. Monitoring weight loss
b. Monitoring temperature
c. Monitoring claret pressure
d. Monitoring potassium level
>>See answer and rationale<<
196. Intravenous heparin therapy is prescribed for a client. While implementing this prescription, a nurse ensures that which of the post-obit medications is available on the nursing unit?
a. Protamine sulfate
b. Potassium chloride
c. Phytonadione (vitamin K )
d. Aminocaproic acid (Amicar)
>>See respond and rationale<<
197. Meperidine hydrochloride (Demerol) is prescribed for the customer with hurting. Which of the following would the nurse monitor for equally a side event of this medication?
a. Diarrhea
b. Bradycardia
c. Hypertension
d. Urinary retention
>>Run into answer and rationale<<
198. Carbamazepine (Tegretol) is prescribed for a client with a diagnosis of psychomotor seizures. The nurse reviews the client's health history, knowing that this medication is contraindicated if which of the following disorders is present?
a. Headaches
b. Liver disease
c. Hypothyroidism
d. Diabetes mellitus
>>Run across answer and rationale<<
199. A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the client regarding the medication. Which client statement would signal a need for further instructions?
a. "My urine may plough brownish or green."
b. "This medication is prescribed to help salve my muscle spasms."
c. "If my vision becomes blurred, I don't need to be concerned about it."
d. "I need to telephone call my doctor if I experience nasal congestion from this medication.
>>Run into reply and rationale<<
200. Atenolol hydrochloride (Tenormin) is prescribed for a hospitalized client. The nurse should perform which of the following as a priority action earlier administering the medication?
a. Listen to the client's lung sounds.
b. Cheque the customer's blood pressure.
c. Check the recent electrolyte levels.
d. Assess the client for musculus weakness.
>>See answer and rationale<<
More NCLEX Questions:
NCLEX-RN Practice Questions (Role i)
NCLEX-RN Practice Questions (Part two)
NCLEX-RN Practice Questions (Part 3)
Source: https://www.nursebuff.com/nclex-rn-practice-questions-4/
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