NRS 301 EXAM 3 (EAQ) QUESTIONS
WITH ACCURATE SOLUTIONS AND
RATED A.
A patient is admitted to the hospital after a suspected overdose of
barbiturates. What is the priority treatment approach for this patient?
1
Administer furosemide
2
Maintain an adequate airway
3
Administer intravenous fluids
4
Administer activated charcoal
2
Overdose of barbiturates may cause respiratory depression. Therefore,
maintaining an adequate airway with assisted ventilation is the mainstay of
the therapy. Intravenous fluids are administered only if indicated.
Administration of furosemide can hasten the elimination of the barbiturate.
However, the intervention should be performed only after the patient's airway
has been maintained. Activated charcoal is a common regimen for treating the
overdose of barbiturates; however, this is not the priority approach for
treatment.
The nurse is assessing patients who are scheduled for surgery. Which
patient will the nurse expect to be at higher risk while undergoing
anesthesia?
1
A 15-year-old who is scheduled for a leg fracture surgery
2
A 30-year-old who is undergoing surgery for the first time
,3
A 48-year-old athlete who is undergoing laser-assisted in situ
keratomileusis (LASIK) eye surgery
4
A 50-year-old alcoholic patient who is scheduled for hernia surgery
4
Excessive intake of alcohol alters a patient's response to general anesthesia. In
addition, patients with hernias are at greater risk of having malignant
hyperthermia. Therefore, the 50-year-old alcoholic who is scheduled for
hernia surgery is at higher risk. A 30-year-old who is undergoing surgery for
the first time may have fear of surgery, but the nurse can reduce it by
preparing the patient for the surgery. Athletes usually have lower pulse rates
compared to other individuals. A 48-year-old athlete who is undergoing
LASIK eye surgery is not at higher risk, as this surgery requires only local
anesthesia. A 15-year-old who is scheduled for leg fracture surgery is also at
a lower risk as the patient is old enough to tolerate anesthesia.
A patient presents with a migraine headache associated with severe
nausea and vomiting. Which routes are most appropriate for this patient's
abortive migraine medication? Select all that apply.
1
Oral tablet
2
Oral liquid
3
Nasal spray
4
Rectal suppository
5
Intramuscular injection
3, 4, 5
The nurse prepares to administer morphine sulfate 5 mg intravenous (IV)
to a patient who underwent surgery 30 minutes earlier. What is the most
,important reason for the nurse to record baseline vital signs before
administering this drug?
1
Morphine sulfate dilates vascular smooth muscle.
2
Morphine sulfate depresses the respiratory center.
3
Morphine sulfate causes the release of histamines.
4
Morphine sulfate reduces the level of consciousness.
2
The risk of respiratory depression is the most important reason that the nurse
records baseline vital signs before administering the morphine IV. Opioid
analgesics can cause respiratory depression and death when administered in
standard dosages in compromised patients and in an overdose. Because this
patient is in the immediate postoperative period and is likely to experience
residual effects of anesthesia, including respiratory depression and an
inability to maintain an airway, the risk for respiratory depression is high. The
patient is also at risk because the IV route of administration is used.
Intravenous administration of an opioid means that the onset of action occurs
quickly, the peak drug level is reached more quickly, and the risk of
respiratory depression increases as a result of generally high plasma drug
concentrations. The nurse records baseline data for comparison to vital signs
taken 15 minutes after IV administration of morphine to determine whether the
patient is experiencing adverse effects of therapy. Morphine dilates vascular
smooth muscle, releases histamines, and causes sedation; however, airway and
breathing issues are more important. Death following overdose is almost
always a result of respiratory arrest.
An immediate postoperative assessment of a patient reveals a body
temperature of 104° F. Select the nurse's first action.
1
Apply a cooling blanket per the agency's protocol.
2
, Assess for signs and symptoms of a wound infection.
3
Administer acetaminophen as ordered and recheck in 1 hour.
4
Notify the physician to discuss the risk of malignant hyperthermia.
4
A fever in the immediate postoperative period may indicate malignant
hyperthermia. Malignant hyperthermia is treated with the skeletal muscle
relaxant dantrolene and cardiorespiratory supportive care as needed to
stabilize heart and lung function. Acetaminophen plays no role here as it will
not treat malignant hyperthermia. A cooling blanket does not help with this
condition. Infection of a surgical wound takes several days to develop.
Which antipyretic drug will the nurse recommend to the parent of a child
with influenza?
1
Aspirin
2
Ibuprofen
3
Naproxen
4
Acetaminophen
4
The use of nonsteroidal antiinflammatory drugs, which include ibuprofen,
naproxen, indomethacin, and especially aspirin, by children with influenza or
chickenpox may precipitate Reye's syndrome. This is a potentially fatal
multisystem organ disease. Acetaminophen may be used safely to reduce
fever in children with influenza.
The nurse is teaching a group of coworkers the mechanisms of action of
nonsteroidal antiinflammatory drugs that are specific for cyclooxygenase-
2 (COX-2) inhibition. What would the nurse include as adverse effects?
Select all that apply.
WITH ACCURATE SOLUTIONS AND
RATED A.
A patient is admitted to the hospital after a suspected overdose of
barbiturates. What is the priority treatment approach for this patient?
1
Administer furosemide
2
Maintain an adequate airway
3
Administer intravenous fluids
4
Administer activated charcoal
2
Overdose of barbiturates may cause respiratory depression. Therefore,
maintaining an adequate airway with assisted ventilation is the mainstay of
the therapy. Intravenous fluids are administered only if indicated.
Administration of furosemide can hasten the elimination of the barbiturate.
However, the intervention should be performed only after the patient's airway
has been maintained. Activated charcoal is a common regimen for treating the
overdose of barbiturates; however, this is not the priority approach for
treatment.
The nurse is assessing patients who are scheduled for surgery. Which
patient will the nurse expect to be at higher risk while undergoing
anesthesia?
1
A 15-year-old who is scheduled for a leg fracture surgery
2
A 30-year-old who is undergoing surgery for the first time
,3
A 48-year-old athlete who is undergoing laser-assisted in situ
keratomileusis (LASIK) eye surgery
4
A 50-year-old alcoholic patient who is scheduled for hernia surgery
4
Excessive intake of alcohol alters a patient's response to general anesthesia. In
addition, patients with hernias are at greater risk of having malignant
hyperthermia. Therefore, the 50-year-old alcoholic who is scheduled for
hernia surgery is at higher risk. A 30-year-old who is undergoing surgery for
the first time may have fear of surgery, but the nurse can reduce it by
preparing the patient for the surgery. Athletes usually have lower pulse rates
compared to other individuals. A 48-year-old athlete who is undergoing
LASIK eye surgery is not at higher risk, as this surgery requires only local
anesthesia. A 15-year-old who is scheduled for leg fracture surgery is also at
a lower risk as the patient is old enough to tolerate anesthesia.
A patient presents with a migraine headache associated with severe
nausea and vomiting. Which routes are most appropriate for this patient's
abortive migraine medication? Select all that apply.
1
Oral tablet
2
Oral liquid
3
Nasal spray
4
Rectal suppository
5
Intramuscular injection
3, 4, 5
The nurse prepares to administer morphine sulfate 5 mg intravenous (IV)
to a patient who underwent surgery 30 minutes earlier. What is the most
,important reason for the nurse to record baseline vital signs before
administering this drug?
1
Morphine sulfate dilates vascular smooth muscle.
2
Morphine sulfate depresses the respiratory center.
3
Morphine sulfate causes the release of histamines.
4
Morphine sulfate reduces the level of consciousness.
2
The risk of respiratory depression is the most important reason that the nurse
records baseline vital signs before administering the morphine IV. Opioid
analgesics can cause respiratory depression and death when administered in
standard dosages in compromised patients and in an overdose. Because this
patient is in the immediate postoperative period and is likely to experience
residual effects of anesthesia, including respiratory depression and an
inability to maintain an airway, the risk for respiratory depression is high. The
patient is also at risk because the IV route of administration is used.
Intravenous administration of an opioid means that the onset of action occurs
quickly, the peak drug level is reached more quickly, and the risk of
respiratory depression increases as a result of generally high plasma drug
concentrations. The nurse records baseline data for comparison to vital signs
taken 15 minutes after IV administration of morphine to determine whether the
patient is experiencing adverse effects of therapy. Morphine dilates vascular
smooth muscle, releases histamines, and causes sedation; however, airway and
breathing issues are more important. Death following overdose is almost
always a result of respiratory arrest.
An immediate postoperative assessment of a patient reveals a body
temperature of 104° F. Select the nurse's first action.
1
Apply a cooling blanket per the agency's protocol.
2
, Assess for signs and symptoms of a wound infection.
3
Administer acetaminophen as ordered and recheck in 1 hour.
4
Notify the physician to discuss the risk of malignant hyperthermia.
4
A fever in the immediate postoperative period may indicate malignant
hyperthermia. Malignant hyperthermia is treated with the skeletal muscle
relaxant dantrolene and cardiorespiratory supportive care as needed to
stabilize heart and lung function. Acetaminophen plays no role here as it will
not treat malignant hyperthermia. A cooling blanket does not help with this
condition. Infection of a surgical wound takes several days to develop.
Which antipyretic drug will the nurse recommend to the parent of a child
with influenza?
1
Aspirin
2
Ibuprofen
3
Naproxen
4
Acetaminophen
4
The use of nonsteroidal antiinflammatory drugs, which include ibuprofen,
naproxen, indomethacin, and especially aspirin, by children with influenza or
chickenpox may precipitate Reye's syndrome. This is a potentially fatal
multisystem organ disease. Acetaminophen may be used safely to reduce
fever in children with influenza.
The nurse is teaching a group of coworkers the mechanisms of action of
nonsteroidal antiinflammatory drugs that are specific for cyclooxygenase-
2 (COX-2) inhibition. What would the nurse include as adverse effects?
Select all that apply.
