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Rasmussen Final Exam Questions and Complete Solutions Graded AI+

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Rasmussen Final Exam Questions and Complete Solutions Graded AI+ If you're on a med-surge unit taking care of patients, which patient would you help first? BP 130/90, pulse 62, penicillin allergy getting vancomycin, glucose of 80 and just received insulin 70/30 - Answer: Glucose patient If we have a diabetic patient with elevated glucose and giving insulin Lispro (takes 30 minutes), we want to give them - Answer: insulin right BEFORE eating to control after meal rise of blood glucose Lispro is a - Answer: rapid acting insulin, last 3-6 hours, clear in color Glargine (Lantus) - Answer: long-acting insulin, once a day dosing, clear in color, don't mix with other insulins Beta blockers can mask - Answer: symptoms of hypoglycemia If patient is on anti-diabetic medication, they CANNOT - Answer: drink alcohol Metformin - Answer: oral medication, contraindications are it should be held for 48 hours before & after tests using IV contrast dye, to prevent ACUTE RENAL FAILURE Levothyroxin - Answer: given in the morning before breakfast, take on empty stomach antibiotics and warfarin - Answer: antibiotics can increase bleeding and PTINR and INR should be closely monitored If we think patient is bleeding, they may have bruising Do we stop medications in pregnancy? - Answer: no If meds for asthma, seizure, diabetes, thyroid are stopped this can cause harm to the fetus. The health of the fetus depends on the health of the mother. If treating post-menopausal woman with hysterectomy, which hormone replacement therapy have less side-effects? - Answer: Transdermal has less side-effects than oral preparation What other risks are there with hormone replacement therapy? - Answer: Ovarian cancer, deep vein thrombosis, stroke If a patient is on a hormone replacement, where would they typically use transdermal creams/ointments - Answer: Thighs, not directly on genitals If a patient is on an androgen, an oral preparation can affect - Answer: liver and renal systems If they have acne, we wouldn't be too worried, but if they start to look discolored like jaundiced, we will have to notify doctor for possibly liver failure. Patient has Erectile Dysfunction, which medication is contraindicated for ED medication? - Answer: Nitroglycerin can cause a decrease in blood pressure which can be life threatening. Patient has symptoms of Benign Prostate Hyperplasia, voiding is difficult, starting stream is difficult, what medication would we use to help those symptoms that won't affect sexually active patients? - Answer: Doxazosin If patient is post-op and they have opiates, must worry about - Answer: respiratory depression and maintain their airway Counteract respiratory depression with Narcan (naloxone) If we give an opiate, prior to administration we need to have - Answer: baseline vitals, respiratory rate Urinary retention with opiates so foley catheter may be prescribed We want to have these patients up and moving, 7% body mass loss every day without movement Stool softener can be given for constipation If we have patients acutely on opioid and taking PRN, can tolerance be developed? Yes, med may not work for them the same Need to talk to the provider to adjust medication Patient on 2nd generation antihistamine symptoms - Answer: Non-drowsy, less sedating Do not mix alcohol, especially with diphenhydramine and hydroxyzine Avoid citrus juices Avoid during pregnancy unless absolutely necessary Aspirin can thin blood before surgery - Answer: Should stop 7 - 10 days before surgery Max dose of acetaminophen is 2000 g if patient has history of drinking 3+ drinks per day - Answer: 4000 g if normal person Symptoms of NSAIDs include - Answer: GI disturbances, ulcers, GI bleeding, DOES NOT typically cause tinnitus( ringing in the ears) Glucocorticoids - Answer: moon face, Cushing, hump on the back, need to be tapered off Warfarin - Answer: always check INR, no matter the situation meds for Acute attacks for gout - Answer: colchicine, NSAIDs(1st line) meds for long term attacks of gout - Answer: Alopurinol (inhibit uric acid formation) doesn't reduce inflammation or pain not useful in ACUTE attacks Vancomycin (Drug for C-diff, MRSA, and serious infections) - Answer: monitor renal function; nephrotoxic; may have high BUN and creatinine Antibiotics - hypercillin and tobramycin - Answer: aminoglycosides - inactivated by penicillin Redness, pain at IV infusion site of antibiotic - Answer: stop medication and check alternative site C. diff. is secondary super infection - treated with - Answer: vancomycin, Flagel (metronidazole) Antibiotics can cause upset GI and c. diff. - which side effect would we be most concerned about for antibiotic? - Answer: Diarrhea Methotrexate + antibiotic - Answer: monitor for bleeding, CBC Bactrum - Answer: 8 - 10 glasses of water a day Antibiotic with rash and crazy vitals - Answer: STOP MEDICATION Antibiotics with milk and grapefruit juice - Answer: NEVER Calcium supplements and antibiotic - Answer: separate two hours after or six hours before Antifungals - tinea corpus (ring worm) - Answer: Even after symptoms are gone, keep treating for at least a week Cimetidine - Answer: space apart at least two hours What to give pregnant patient to prevent herpes outbreak before delivery? - Answer: Acyclovir - helps to not pass to baby IV acyclovir - can cause nephrotoxicity Teach patients to stay hydrated to flush kidneys out What alternative medicine causes risk of bleeding? - Answer: Garlic Gingko baloba Muahuang is a - Answer: Stimulant St John's can cause - Answer: serotonin syndrome Continue patients on asthma medication while pregnant because there is a chance of them having - Answer: a still born Immunosuppressant therapy - Answer: don't want patient to take echinacea In labor and delivery, patient has history of alcohol use, asthma, morphine during labor, what will be concerned about? - Answer: Respiratory rate because of morphine Should have Narcan readily available Meds contraindicated in pregnancy - Answer: D and X Ibuprofen is ok during breast feeding Mindful about OTC medications for babies because they - Answer: metabolize the drugs faster Don't use ORAL corticosteroids in kids because - Answer: it could stop their growth Kids' medications are based off of their - Answer: weight compared to adults, so it'll be smaller doses Renal and hepatic function slows down in older clients, so we anticipate less medication - Answer: If worried about renal function, monitor BUN and creatinine Lithium - used for - Answer: mania, be aware of sodium levels, can be used with antidepressants; first line for mania in bipolar disorder Normal respiratory rate is - Answer: 12-20 breaths per minute Hold morphine if less than 12 Beta blocker side effect - Answer: decrease heart rate, decrease blood pressure, bronchoconstriction and bradycardia Post op patients commonly have narcotic WITH - Answer: Tylenol, so never give additional Tylenol Phenytoin (Dilantin, used to suppress seizures) - Answer: focus on oral care, brushing teeth and flossing can cause gingival hyperplasia Antidiabetic agent - Answer: if patient looks pale and agitated, we suspect hypoglycemia, CHECK BLOOD SUGAR FIRST BEFORE TREATING People on long-term steroid use have - Answer: impaired immune systems Cause issues with wound healing Can cause increased glucose levels, elevated HR and BP Be aware of temperature due to infection Check heart rate before giving digoxin( used in heart failure increases myocardial contractile force) - Answer: Hold less than 60 Check apical HR When patients take nitro, it can cause - Answer: low bp Must teach patient to sit down before taking nitro Can cause orthostatic hypotension Normal BP is around - Answer: 120/80 Do we ever give BP med and antihypertensive to patient who has BP close to 90/60 - Answer: no Furosemide should be given in the - Answer: MORNING because of excessive urination ACE inhibitors cause - Answer: cough, angio edema, and end in pril Diuretics pull fluid and may cause - Answer: hypokalemia Help treat fluid overload and heart failure Must watch their weight, and gain or loss of 2 pounds in 24 hours, we must tell provider Warfarin interferes with many mediations but interferes with antibiotics in particular - Answer: INR must be monitored If patient is on coumadin and antibiotic, the dose will have to be adjusted Critical sign/side effect of patient on digoxin is - Answer: yellow/green halos in the eyes - indicated toxicity If patient is on spironolactone, we are not worried about potassium because it is potassium sparing diuretic - Answer: Want patients to avoid sodium substitutes If INR is above 3 - Answer: we do not give the medication Asthma patients - leukotriene blockers (monoleukast) - Answer: will only be taken once a day Theophylline - Answer: treats asthma, number 1 adverse effect is tachycardia digoxin levels - Answer: 0.8-2.0 ng/mL Potassium levels - Answer: 3.5-5.0 Inhaled steroids (fluticasone) require patients to - Answer: rinse their mouth between and after puffs Bronchodilators are - Answer: fast acting and are used first because they are rescue inhalers to open up airways If a patient has asthma, we're listening to their - Answer: wheezing and treating it Wheezing means air is not moving in and out properly Omeprazole medication administration - Answer: Take on an empty stomach first thing in the morning. Peptic ulcer disease and starting therapy with sucralfate - Answer: Always take 30 - 60 minutes before meals to help coat the stomach Patient taking aspirin should be monitored for bleeding - Answer: Report bruising, tarry stools, pink urine Can cause tinnitus Toxic to kidneys May cause gastric erosion Stimulants - methylphenidate - used for - Answer: ADHD, not used at night, it is a narcotic and must be kept safe and locked away If patient is on warfarin, we don't want them to take - Answer: alcohol and GREEN LEAFY VEGETABLES BECAUSE OF VITAMIN K If they have dark stools, we still don't want them to stop medication, must check INR first Steroids cause - Answer: ulcers and erosion in stomach Can take PPI to suppress gastric acid to help stomach Lantus (glargine) last - Answer: 18 - 24 hours administering medications to infants - Answer: More sensitive to medications because they have immature organs More likely to be toxic because of lipid soluble drugs Naloxone - Answer: antagonist blocks the receptor - narcotic, treat narcotic overdose

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Subido en
27 de marzo de 2025
Número de páginas
9
Escrito en
2024/2025
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Examen
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Rasmussen Final Exam Questions and
Complete Solutions Graded AI+
If you're on a med-surge unit taking care of patients, which patient would you help first? BP 130/90,
pulse 62, penicillin allergy getting vancomycin, glucose of 80 and just received insulin 70/30 - Answer:
Glucose patient



If we have a diabetic patient with elevated glucose and giving insulin Lispro (takes 30 minutes), we want
to give them - Answer: insulin right BEFORE eating to control after meal rise of blood glucose



Lispro is a - Answer: rapid acting insulin, last 3-6 hours, clear in color



Glargine (Lantus) - Answer: long-acting insulin, once a day dosing, clear in color, don't mix with other
insulins



Beta blockers can mask - Answer: symptoms of hypoglycemia



If patient is on anti-diabetic medication, they CANNOT - Answer: drink alcohol



Metformin - Answer: oral medication, contraindications are it should be held for 48 hours before & after
tests using IV contrast dye, to prevent ACUTE RENAL FAILURE



Levothyroxin - Answer: given in the morning before breakfast, take on empty stomach



antibiotics and warfarin - Answer: antibiotics can increase bleeding and PTINR and INR should be closely
monitored

If we think patient is bleeding, they may have bruising



Do we stop medications in pregnancy? - Answer: no

If meds for asthma, seizure, diabetes, thyroid are stopped this can cause harm to the fetus. The health
of the fetus depends on the health of the mother.

, If treating post-menopausal woman with hysterectomy, which hormone replacement therapy have less
side-effects? - Answer: Transdermal has less side-effects than oral preparation



What other risks are there with hormone replacement therapy? - Answer: Ovarian cancer, deep vein
thrombosis, stroke



If a patient is on a hormone replacement, where would they typically use transdermal
creams/ointments - Answer: Thighs, not directly on genitals



If a patient is on an androgen, an oral preparation can affect - Answer: liver and renal systems

If they have acne, we wouldn't be too worried, but if they start to look discolored like jaundiced, we will
have to notify doctor for possibly liver failure.



Patient has Erectile Dysfunction, which medication is contraindicated for ED medication? - Answer:
Nitroglycerin can cause a decrease in blood pressure which can be life threatening.



Patient has symptoms of Benign Prostate Hyperplasia, voiding is difficult, starting stream is difficult,
what medication would we use to help those symptoms that won't affect sexually active patients? -
Answer: Doxazosin



If patient is post-op and they have opiates, must worry about - Answer: respiratory depression and
maintain their airway

Counteract respiratory depression with Narcan (naloxone)



If we give an opiate, prior to administration we need to have - Answer: baseline vitals, respiratory rate



Urinary retention with opiates so foley catheter may be prescribed

We want to have these patients up and moving, 7% body mass loss every day without movement

Stool softener can be given for constipation

If we have patients acutely on opioid and taking PRN, can tolerance be developed? Yes, med may not
work for them the same

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