Exam 4: NSG3100 / NSG 3100 (Latest 2026 / 2027) Fundamental Concepts & Skills for Nursing Practice I | 100% Correct Questions & Answers - Galen

Exam 4: NSG3100 / NSG 3100 (Latest 2026 / 2027) Fundamental Concepts & Skills for Nursing Practice I | 100% Correct Questions & Answers - Galen Which of the following blood tests requires the patient to be fasting? a. Hemoglobin b. Prothrombin time c. Cholesterol d. Creatinine c The patient tells the nurse that she has been on a high-protein, low-carbohydrate diet for the past 6 months. Which blood test results could be influenced by her diet? a. Bilirubin b. Creatinine c. Blood urea nitrogen d. Creatine kinase c The nurse is working at a health fair and providing information about reducing the risk of heart disease. A male asks what his ideal numbers should be for cholesterol and triglycerides. Which of the following are recommended levels for lipid? a. Total cholesterol: 200 mg/dL b. HDL: 45 mg/dL c. LDL: 100 mg/dL d. Triglycerides: 160 mg/dL b The nurse is preparing a patient for a barium swallow test. Which statements by the patient indicate that the patient has understood the nurse's teaching? (Select all that apply.) a. "The doctor will be able to view my stomach and intestines during the test." b. "I should increase fluids after the test." c. "I will have to drink a contrast agent." d. "Barium can cause constipation and I may need a mild laxative." e. "I will be NPO for 8 hours after the test." f. "My stools may turn black for a few days afterward." a,b,c,d 1. Which laboratory result should immediately be reported by the nurse to the primary care provider (PCP)? a. Hemoglobin: 15.6 b. Hematocrit: 32% c. Red blood cells: 5.3 d. White blood cells: 6000 b A patient has a 24-hour urine specimen ordered for creatinine clearance. Which instruction is correct? a. "Collect all urine from the time the collection begins until it ends." b. "Save only a sample from each voiding." c. "Clean the perineal area three times before you begin to urinate." d. "Discard the first urine specimen, and then collect all urine until the time period expires." d Which specimens should be collected using sterile technique in a sterile container? (Select all that apply.) a. Clean-catch urine b. Stool for occult blood c. Wound drainage d. Sputum e. Urine from a Foley catheter a,c,d,e Which blood test is used to monitor renal function? a. Creatine kinase b. Triglycerides c. Creatinine d. Alkaline phosphatase c For which patient is magnetic resonance imaging (MRI) contraindicated? a. A patient with an allergy to latex b. A patient with an infection c. A patient with a pacemaker d. A patient with a head injury c The nurse is caring for a patient after a lumbar puncture to obtain a cerebrospinal fluid specimen. Which are appropriate post procedure interventions? (Select all that apply.) a. Position the patient with head of bed up at least 90 degrees for 4 hours. b. Assess the puncture site for drainage or bleeding. c. Encourage PO fluids. d. Maintain NPO until the gag reflex returns. e. Encourage ambulation immediately after the test is complete. b,c You are instructing a patient on a sterile urine collection. Which statement would indicate the need for further instruction? a. "I separate the folds and clean from back to front." b. "I clean the area three times." c. "I begin the urine stream and then place the container under the stream midway through." d. "I make sure there is no stool in the urine specimen." a Which of the following colon screening guidelines does the nurse recommend for a 58-year-old patient with no family history of colon cancer? a. Fecal occult blood testing every 5 years b. Sigmoidoscopy every 10 years c. Cystoscopy every 5 years d. Colonoscopy every 10 years D A patient is admitted with advanced liver disease. Which of the following lab results would the nurse expect to see? a. Albumin 2.6 g/dL b. Blood urea nitrogen 18 mg/dL c. Homocysteine 2.4 mg/L d. Bilirubin 0.7 mg/dL a A patient is in the Emergency Department with a diagnosis of acute myocardial infarction within about the past 3 hours. Which of the following cardiac markers would the nurse expect to be elevated at this point? a. CK-MB b. Myoglobin c. Troponin I d. TroponinT b The nurse has explained a paracentesis to a patient. Which of the following statements would indicate the patient needs more teaching? a. "I will need to sign a consent form before the procedure." b. "You will be using a needle to remove fluid from my abdomen." c. "You will be measuring my abdomen before and after the procedure." d. "I will be lying on my left side during the procedure." d A patient just had a lumbar puncture. Which of the following would the off-shift nurse report during hand-off report to the new nurse? a. He is to lie flat for at least 4 hours. b. He should remain NPO for at least 4 hours. c. Assess for signs of postprocedure hypertension. d. Hold all sedatives and opioids for at least 4 hours. a Which of the following allergies would be problematic for a patient scheduled for computed tomography with contrast? a. Allergy to penicillin b. Allergy to shellfish c. Allergy to peanuts d. Allergy to latex b A patient is being discharged from the hospital with a new ileostomy. The patient expresses concern about caring for the ostomy. Before hospital discharge, it is most important for the nurse to coordinate with which member of the health care team? a. Home care nurse b. Wound ostomy continence nurse c. Registered dietitian d. Primary care provider b The nurse is assigned the care of a patient for whom a cleansing enema has been ordered. What information is most important for the nurse to know before administration of the enema? a. The proper way to position the patient b. Signs and symptoms of intolerance to the procedure c. Vital signs before the procedure d. History of surgery of the anus or rectum d To prevent constipation in an inactive patient, which early interventions should the nurse implement? (Select all that apply.) a. Stool softener administration b. Enema administration c. Increasing the fiber in the diet d. Increasing physical activity e. Increasing fluid intake a,c,d,e While performing an abdominal assessment on an unconscious patient, the nurse notes presence of an ostomy. The fecal output is liquid in consistency, with a pungent odor, from the stoma that is located in the upper right quadrant of the abdomen. What type of ostomy does the patient have? a. Descending colostomy b. Ureterostomy c. Ileostomy d. Ascending colostomy d 1. The patient states that she has been taking warfarin, an anticoagulant, for several years. The nurse notices several bruised areas on her arms. Which of the following laboratory results is the most clinically significant for this medication? a. Platelets: 450,000 b. Prothrombin time: 24.2 seconds c. Activated partial thromboplastin time: 30 seconds d. Fibrinogen: 350 mg/dL b The teaching plan for a patient with diarrhea should include which intervention? a. Drinking at least eight glasses of fluid each day b. Eating foods low in sodium and potassium c. Limiting the amount of soluble fiber in the diet d. Eliminating whole-wheat and whole-grain breads and cereal a The nurse knows that the teaching for a patient who was recently diagnosed with constipation has been effective if the patient's meal request specifies which food choice? a. Hot dog on a bun b. Grilled chicken c. Tuna sandwich on white bread d. Spinach salad with dressing d A 40-year-old patient complains of 4 days of frequent loose stools with abdominal cramping. What is the priority nursing diagnosis for this patient? a. Impaired Skin Integrity b. Fluid Imbalance c. Acute Pain d. Self-Care Deficit (i.e., toileting) b A patient is scheduled for a colonoscopy. After preprocedure teaching by the nurse, the patient demonstrates understanding when he makes which statement? a. "I can have coffee the morning of the procedure." b. "I should drink a red sports drink the day before to stay hydrated." c. "I should drink clear liquids for 2 days before the procedure." d. "I will be able to drive home immediately after the procedure." c Which nursing intervention is included for a patient experiencing diarrhea? a. Limiting fluid intake to 1000 mL/day b. Administering a cathartic suppository c. Increasing fiber in the diet d. Limiting exercise c When administering a cleansing enema, which techniques should the nurse use? (Select all that apply.) a. Assist the patient to a left side-lying (Sims) position. b. Add room-temperature solution to enema bag. c. Lubricate 2 to 4 cm (1 to 2 inches) of tip of rectal tube with lubricating jelly. d. Raise container, release clamps, and allow solution to fill tubing before administration. e. Clamp tubing after solution is instilled a,d,e To best determine the patient's competency in changing an ostomy appliance, what does the nurse ask the patient to do? a. Verbalize the procedure. b. Identify the supplies needed. c. Perform the procedure. d. List the steps in the procedure. c A patient with a history of diarrhea is seen in the clinic. Which nursing intervention is most essential to include in this patient's plan of care? a. Weighing the patient daily b. Encouraging a diet high in fiber c. Decreasing the patient's fluid intake d. Instructing the patient to increase protein in the diet a A patient is scheduled for an upper GI series. Which information is most important for the nurse to obtain before the procedure? a. Allergy to shellfish b. Last bowel movement c. Time the enema was administered d. Any difficulty swallowing d Which discharge instruction does the nurse provide to the patient following a colonoscopy? a. Some discomfort and bleeding are normal postprocedure. b. Return to the emergency room if you experience abdominal cramping. c. Do not drive or operate heavy machinery for 12 hours postprocedure. d. Return to your normal bowel pattern immediately postprocedure. c Select the most appropriate goal for a patient experiencing diarrhea related to antibiotic use: a. the patient will return to previous elimination pattern. b. the patient will increase intake of grains, rice, and cereals. c. the patient will discontinue antibiotic use. d. the patient will increase fluid intake. d What would be included in teaching for a patient who will be discharged with a prescription for a laxative? a. Calling the health care provider if nausea, vomiting, or abdominal pain occurs b. Continuing use of laxatives to encourage bowel evacuation c. Adding regular exercise, sufficient fluids, and regular defecation habits to his/her routine d. Knowing the difference between laxatives and cathartics c The nursing instructor is teaching information about constipation in the elderly. Which statement from the student indicates a need for further instruction on this topic? a. Patients receiving tube feedings often experience constipation. b. Poor fluid intake and inability to eat a high-fiber diet often cause constipation. c. Patients with impaired mobility may experience constipation. d. Medications commonly taken by elders often contribute to constipation. a Prior to discharge, the nurse teaches the patient the proper techniques for applying an ostomy pouch. When evaluating the teaching, the nurse observes the patient apply a new ostomy pouch without cleansing the skin underneath. What actions would the nurse implement following this patient's return demonstration? (Select all that apply.) a. Repeat the demonstration to show the patient how to clean the ostomy site. b. Document that the patient performed the initial return demonstration accurately and safely. c. Offer positive reinforcement regarding the need to cleanse the site to prevent skin breakdown below the appliance. d. Discharge the patient with written instructions and illustrations that demonstrate the correct procedure. e. Notify the health care provider that a repeat demonstration of the ostomy appliance procedure is needed. a,c,d A patient with an indwelling catheter reports a need to void. What is the priority intervention for the nurse to perform? a. Check to see if the catheter is patent. b. Reassure the patient that it is not possible to void while catheterized. c. Catheterize the patient again with a larger gauge catheter. d. Notify the primary care provider. a Which nursing instruction is correct when a urine specimen is collected for culture and sensitivity testing from a patient without a urinary catheter? a. Tell the patient to void and pour the urine into a labeled specimen container. b. Ask the patient to void first into the toilet, stop midstream, and finish voiding into the sterile specimen container. c. Instruct the patient to discard the first void and collect the next void for the specimen. d. Have the patient keep all voided urine for 24 hours in a chilled, opaque collection container. b A female patient has had frequent urinary tract infections. Which statement by the patient indicates that the nurse's teaching on prevention has been effective? a. "I will limit my fluid intake to 40 ounces per day." b. "I will use only organic bath bombs when bathing." c. "I will wait to wear my tight jeans until after my urine is clear." d. "I will wipe from the front to back after voiding." d A patient is scheduled for an intravenous pyelogram (IVP). Which piece of data would be most important to know before the procedure is carried out? a. Urinalysis negative for sugar and acetone b. History of allergies c. History of a recent thyroid scan d. Frequency of urination b When emptying a patient's catheter drainage bag, the nurse notes that the urine appears to be discolored. The nurse understands that what factors may change the color of urine? (Select all that apply.) a. Taking the urinary tract analgesic phenazopyridine b. A diet that includes a large number of beets or blackberries c. An enlarged prostate or kidney stones d. High concentrations of bilirubin secondary to liver disease e. Increased carbohydrate intake a,b,c,d What self-care measure is most important for the nurse to include in the teaching plan for a patient who will be discharged with a urostomy? a. Change the appliance before going to bed. b. Cut the wafer 1 inch larger than the stoma. c. Cleanse the peristomal skin with mild soap and water. d. Use firm pressure to attach the wafer to the skin. c An indwelling catheter is ordered for a postoperative patient who is unable to void. What is the primary concern of the nurse performing the procedure? a. Teaching deep-breathing techniques b. Maintaining strict aseptic technique c. Medicating the patient for pain before the procedure d. Positioning the patient for comfort during the procedure b The nurse is assessing a patient with an indwelling catheter and finds that the catheter is not draining and the patient's bladder is distended. What action should the nurse take next? a. Notify the primary care provider. b. Assess the tubing for kinks and ensure downward flow. c. Change the catheter as soon as possible. d. Aspirate the stagnant urine in the catheter for culture. b The nurse is placing an indwelling catheter in a female patient. The nurse accidentally inserts the catheter into the vagina. What is the next action for the nurse to implement? a. Collect a urine specimen and notify the primary care provider (PCP). b. Leave the catheter in place and insert a new catheter into the urethra. c. Remove the catheter from the vagina and place it into the urethra. d. Ask another nurse to attempt the catheterization of the patient. b Which nursing intervention would be the highest priority when caring for a patient complaining of voiding small amounts of urine in relation to his fluid intake? a. Placing a disposable waterproof pad on the patient's bed before he goes to sleep. b. Documenting in the patient's electronic health record that he is complaining of anuria. c. Notifying the patient's primary care provider (PCP) of the need for intermittent catherization. d. Palpating the patient's bladder for distention before scanning for possible retention. d Which organism is responsible for the majority of urinary tract infections in female patients? a. Escherichia coli b. Neisseria gonorrhoeae c. Candida albicans d. Haemophilus influenza a A patient with a history of kidney stones is experiencing difficulty urinating and laboratory findings indicate the patient is in acute renal failure. What is the probable cause of this condition? a. Hypovolemia b. Cardiogenic shock c. Nephrotoxic substances d. Urethral obstruction d The patient is ordered an ultrasound of the kidneys. The nurse knows that prior to the test the patient will: a. be required to have a bowel cleansing enema. b. be checked for any allergies to shellfish. c. be required to drink a large amount of fluids before the test. d. have no pretest requirements. d Nursing interventions for the patient who suffers from stress incontinence include: a. Kegel exercises. b. surgical interventions. c. bowel retraining. d. intermittent catheterization. a Average urine pH is: a. 4. b. 6. c. 7. d. 9. b The nurse is inserting an indwelling catheter into a male patient. While initially passing the catheter through the urethra, resistance is met. What action would the nurse take next? a. Withdraw the catheter and obtain a coude catheter. b. Straighten the penis and attempt to progress the catheter again. c. Remove the catheter and insert one with a smaller lumen. d. Inflate the balloon and wait for urine passage. a The nurse is teaching a patient about how to take a sublingual nitroglycerin tablet. Which statement by the patient best demonstrates understanding of the teaching? a. "I will take the tablet with plenty of water." b. "I will place the tablet inside my cheek." c. "I will put the tablet under my tongue." d. "I will take the tablet while I am eating." c The nurse is caring for a critically ill patient. What are the contraindications for administering medications by the oral route for this type of patient? (Select all that apply.) a. Vomiting b. Unconsciousness c. Diarrhea d. Penicillin allergy e. Intubation a,b,e The nurse is in a patient room ready to administer a new medication to the patient. Which action best demonstrates awareness of safe, proficient nursing practice? a. Identify the patient by comparing her name and birth date to the medication administration record (MAR). b. Determine whether the medication and dose are appropriate for the patient. c. Make sure the medication is in the medication cart. d. Check the accuracy of the dose with another nurse. a A patient has been using herbal medication as part of her daily routine. Which actions should the nurse take? (Select all that apply.) a. Document the herbs as part of the medication history. b. Recommend a reputable company from which to buy herbs. c. Allow the patient to self-administer the herbs with her morning medications. d. Inform the primary care provider of the findings. e. Identify possible adverse effects of the herbal medications. a,d,e A nurse must give 1 g of Keflex, PO, q 6 hr × 3 days. The supply on hand is 500 mg/capsule. How many capsules should the nurse administer at each dose? 2 capsules The health care provider prescribes a transdermal medication. The nurse understands what feature of the transdermal route? a. It is inhaled into the respiratory tract. b. It is dissolved inside the cheek. c. It is absorbed through the skin. d. It is inserted into the vaginal cavity. c The nurse is caring for a patient who is unable to hold a cup or spoon. How should the nurse administer oral medications to the patient? a. Crush the pills and mix them in pudding before administering. b. Ask the pharmacist to change all of the medications to a liquid form. c. Use a small paper cup to place the pills into the patient's mouth. d. Place the pills on the table and have the patient take the pills by hand. c What should the nurse do first when preparing to administer medications to a patient? a. Check the medication expiration date. b. Check the medication administration record (MAR). c. Call the pharmacy for administration instructions. d. Check the patient's name band. b The nurse is preparing a plan of care for a patient. What is the most appropriate goal for a patient related to medications? a. The patient will administer all medications correctly by discharge. b. The patient will be taught common side effects of prescribed medications. c. The patient will have a good understanding of prescribed medications. d. The patient will have all medications administered by staff as prescribed. a The nurse reviews a primary care provider's order and finds that the medication amount is greater than the standard dose. What should the nurse do? a. Give the standard dose rather than the one that is ordered. b. Consult with the nursing supervisor to get a second opinion. c. Call the primary care provider to discuss the order in question. d. Administer the medication as ordered by the primary care provider. c The nurse is selecting a site to administer a medication by the intramuscular route. The nurse chooses to avoid which site due to the high risk for injury? a. Vastus lateralis b. Ventrogluteal c. Dorsogluteal d. Deltoid c The home health nurse is called for a consultation on a patient with memory problems who is having difficulty remembering to take multiple medications prescribed to be taken throughout the day. What can the nurse do to help the patient remember to take the medications as prescribed? a. Arrange for the medications to be put in a pill organizer by week. b. Make a chart showing times when medications should be taken. c. Ask a family member to come over each day to administer medications. d. Ask the patient to set an alarm clock for when medications are due. a he nurse understands that medication absorption is affected by the administration route. Which route for medications has the fastest absorption rate? a. Cream applied to the skin b. Enteric-coated capsules c. Subcutaneous injection d. Intravenous injection d What action does the nurse take immediately after instilling the prescribed eye drops into the patient's eye? a. Apply a sterile eye patch to each eye receiving drops. b. Maintain light pressure on the lower eyelid to keep it pulled down. c. Wipe the eyelid toward the inner canthus area. d. Press gently on the inner canthus area. d Which statement by the patient about herbs and prescription medications demonstrates understanding of education by the nurse? a. "I can stop taking my prescription medication when I begin an herbal preparation." b. "I know herbal preparations are highly regulated to prevent interactions with prescription medications." c. "I should check with my provider before beginning an herbal preparation." d. "I cannot ever take an herbal preparation while I am using prescription medication." c Before administering a dose of a prescribed medication, the nurse finds an unlabeled, filled syringe in the patient's medication drawer. What action by the nurse is most appropriate? a. Discard the syringe. b. Obtain a label for the syringe. c. Use the medication in the syringe. d. Verify the contents of the syringe with another nurse. a The nurse is to give amoxicillin 750 mg PO, q8h x 10 days. The amount that is on hand is 0.5g/tablet. How many tablets should the nurse administer at each dose? Write your answer to the first decimal place. tablet(s). 1.5 Obtaining a capillary blood specimen to measure blood glucose, you should ensure there is good blood flow at the puncture site True or False When testing for fecal occult blood, a green color indicates a guaiac positive result. False A RN instructing a female patient on obtaining a clean catch urine specimen should stress to: Void a small amount of urine before collecting the specimen The client has an indwelling catheter. The nurse should obtain a sterile urine specimen by using a syringe to withdraw urine from the catheter tubing port An x-ray of the abdomen visualizing the kidneys, ureters and bladder is known as: KUB What is an echocardiogram? Visualization of the structures of the heart by using ultrasound What does MRI stand for? Magnetic Resonance Imaging Thoracentesis is removal of fluid from: pleural space While assisting with a thoracentesis the nurse should do all of the following EXCEPT: Have the patient cough periodically during the procedure A noninvasive method of estimating bladder volume would be: Bladder Scanner Your urine should smell aromatic What is a normal urine output per hour? 30 mL Urge incontinence is due to an overactive bladder Stress incontinence is when urine leaks when you laugh, cough or sneeze The presence of ketones in the urine indicates rapid breakdown of fat The nurse who teaches a client about preventing UTIs would include which statement? Void immediately after sexual intercourse How much space should you leave from the tip of the penis and the drainage tube when applying a condom cath? 1 Inch The nurse understands that a straight catheterization: empties the bladder and the catheter is immediately removed The purpose of a three way Foley after a TURP is to Irrigation A nurse is inserting a Foley catheter in a female and obtains clear urine. What next? Advance the catheter another 2 inches (5 cm) Where should Foley indwelling catheter drainage bag be positioned after insertion of catheter? Lower than the level of the bladder What are the causes of constipation? poor bowel habits diet low in fiber chronic use of laxatives What indicates a correct understanding of the use of laxatives for constipation? Laxatives should only be taken for a few days. Which position is the patient placed in for the administration of an enema? Sims When giving an enema, you should insert the tube 7-10 cm (3-4 inches). True or False? True When changing the colostomy appliance, cut the opening in the skin barrier no more than larger than the stoma. 1/8 inch The best time to change a pouching system is in the morning or 2 to 4 hours after meals. True or False True An unlicensed assistive personnel (UAP) reports to the nurse that a client being fed experienced coughing and choking when swallowing. The client states, "It feels like the food is stuck in my throat." What does the nurse suspect is happening with this client? The client is having dysphagia. While undergoing a soapsuds enema, the client complains of mild abdominal cramping. The nurse should: lower the bag The client has an indwelling catheter. The nurse should obtain a sterile urine specimen by: syringe to withdraw from cath port limiting fluids has what effect on urine? raises specific gravity The nurse is alert to the possibility that for 24 to 48 hours after the postoperative procedure, clients may experience the following as a result of the anesthetic used during the surgery: paralytic ilyus before fecal occult test eat bread diagnosis of Alteration in urinary elimination, retention. On assessment, the nurse anticipates that this client will exhibit: a feeling of pressure and voiding of small amounts. diarrhea patients should consume lean meats A colonoscopy is ordered and the patient has questions about the examination. Before the colonoscopy, the nurse teaches the patient that: light sedation is normally used In an assessment of a client with overflow incontinence, the nurse expects to find that the client has: constant dribbling of urine A nurse is monitoring a client's fluid intake. For breakfast, the client consumed 8 oz of milk, 10 oz of water, 4 oz of flavored gelatin, 1 scrambled egg, 1 crisp piece of bacon, and 2 biscuits with jelly. The nurse should record the fluid intake as: 660 mLs 24 hour urine needs to be restarted in the event that: client voids in the toilet Which interventions prevent or minimize the risk factors in clients at risk for spiration? Feeding the patient small bites. Keeping suction equipment nearby. Positioning the client upright at 90 degrees. Providing liquids with a thickening agent. The client receiving a tube feeding develops diarrhea. The nurse should: adjust rate of infusion Critical care element for clients with ileostemy skin care Why would a nurse order a guaiac test blood in stool most important question for MRI Any metal in body? considerations for diagnostic procedures what type of sample? NPO? Contrast? Medications? Duration of test consent? what is included in the CBC Hgb Hct Erythrocytes RBC Leukocytes diff wbc Components of BMP (basic metabolic panel) BUN Creatinine Potassium Sodium Calcium Chloride Glucose Components of a CMP (Comprehensive Metabolic Panel) Liver Proteins albumin bilirubin obtaining capillary specimens warm finger dependent position antiseptic swab to clean-no alcohol wipe away first drop reasons for testing feces occult blood analyze diet and digestion parasites bacteria/virus collecting fecal sample clean bedpan/bedside commode do not contaminate with urine no toilet paper send fresh specimen steatorrhea fat in the feces rules for dietary fecal testing whole sample rules for bacterial fecal testing notify lab if pt is on abics clean-voided sample 1st morning void clean catch sample mid stream clean perineum with antiseptic begin stream-pause-put cup under stream what does specific gravity of urine measure? # of solutes present normal urine pH 6 anoscopy visualizing the anus proctoscopy rectum proctosigmoidoscopy the viewing of the rectum and sigmoid colon colonoscopy large intestine IV pyelography contrast medium injected IV to visualize the kidney and ureters retrograde pyelography contrast medium injected directly into the kidneys via the urethra cytoscopy lighted instrument inserted into the urethra xray bone ct scan soft tissue mri soft tissue magnetic field tattoos can become warm during procedure electrocardiography graphic recording of hearts electrical activity (ecg) angiography invasive dye to visualize blood flow echocardiogram noninvasive ultrasound used to visualize structures of the heart v/q lung scan how well gasses are exchanged in the lungs where is needle in lumbar puncture placed? between 3-4 or 4-5 vert what is the result of draining too much fluid during paracentesis hypovolemic shock factors affecting elimination developmental factors psychosocial fluid/food intake meds muscle tone pathologic conditions surgical/diagnostic procedures polyuria large amounts of urine oliguria decreased urinary output anuria lack of urine production frequency voiding at frequent intervals nocturia voiding 2+ times per night urgency strong desire to void dysuria painful urination enuresis involuntary urination past age of potty training urinary incontinence inability to control the passage of urine urge incontinence a sudden strong urge to void, followed by rapid bladder contraction mixed incontinence combination of stress and urge incontinence overflow incontinence continuous leaking from the bladder either because it is full or because it does not empty completely CAUTI catheter associated urinary tract infection constipation fewer than 3 bowel movements per week patient teaching for constipation exercise fiber fluids do not ignore urge to defecate avoid certain meds tx for constipation stool softeners laxatives enemas diarrhea patient teaching fiber no alcohol/caffeine limit fat intake ostomies are named: according to their location (colostomy, gastrostomy, etc). stoma piece of bowel pulled through abdominal wall drug abuse inappropriate intake of a substance drug dependence persons need to take a drug physiological dependence changes in body and nervous system tissues tissues require drug to function properly psychological dependence emotional reliance on a drug drug habituation mild form of psychological dependence pharmacodynamics what the drug does to the body Pharmacokinetics The process by which drugs are absorbed, distributed within the body, metabolized, and excreted. absorbtion how drug enters bloodstream route of admin matters distribution transportation of a drug from site of absorption to site of action Where does biotransformation occur? liver start order give meds immediately single order one time order standing order may or may not have a termination date prn order as needed essential parts of a drug order -Full name of the client -Date and time the order is written -Name of the drug to be administered -Dosage of the drug -Frequency of administration -Route of administration -Signature of the person writing the order when should medication reconciliation take place admission, transfer, discharge 10 rights of medication administration Right medication Right dose Right time Right route Right client Right client education Right documentation Right to refuse Right assessment Right evaluation intradermal injections are commonly used for allergy testing and TB screening subcutaneous injections are commonly used for vaccines insulin heparin subq injection needle specs syringe-1-2 mLs needle size-#25 gauge #30 for insulin needle length-5/8" site for subcutaneous injections Abdomen Upper arm Thigh Scapular Upper ventrodorsal gluteal Site for IM injections Ventrogluteal Vastus lateralis Deltoid transdermal patch administration Wear gloves, remove old patch, choose new site, clean and dry skin, apply new patch, avoid applying to broken skin, fold patch inwards when removing otic med administration rules up and back for over age of 3 down and back for under age of 3 retain meds for 5 mins in side laying position hypertonic enema Osmotic pressure Isotonic enema Expands the colon Main job of cleansing enemas Empty bowels by stimulating peristalsis oil retention enema Feces absorbs oil and becomes softer and easier to pass Pt teaching for oil retention enema Must retain for 1-3 hours Main job of oil retention enema Lubricate rectum and colon hypertonic enema Osmotic pressure draws fluid into colon isotonic enema Expands the colon to promote peristalsis How much fluid for a cleansing enema 120-1000 mLs oil retention enema feces absorb the oil and become softer and easier to pass Retain enema for 1-3 hours How much liquid for oil retention enema 120-150 mLs Colonoscopy Large intestine A client's heart rate is 72 beats per minute with a regular rhythm. How does the nurse interpret this data in relation to the client's peripheral nervous system? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. The sympathetic system is in control. B. The parasympathetic system is dominating. C. Both parasympathetic and sympathetic systems are influencing cardiac status. D. The autonomic nervous system is affecting cardiac status. E. The somatic nervous system is affecting cardiac status. The parasympathetic system is dominating. Both parasympathetic and sympathetic systems are influencing cardiac status. The autonomic nervous system is affecting cardiac status. A nurse is reading about the development of drugs that inhibit the parasympathetic nervous system. The nurse would look for articles about which drug classes? Select all that apply. A. Anticholinergics B. Parasympathomimetics C. Parasympatholytics D. Cholinergics E. Muscarinic blockers Anticholinergics Parasympathomimetics Muscarinic blockers Which is an adrenergic receptor associated with the sympathetic nervous system? A. Dopamine B. Beta C. Muscarinic D. Norepinephrine Beta A client has been prescribed an oral drug containing atropine. The nurse would hold the drug and contact the prescriber if the client states which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. "I would like to wait a few minutes to take this as I just drank some aloe juice." B. "Can I take this at the same time as my procainamide?" C. "I have had a headache this morning." D. "I am allergic to penicillin." E. "My gallbladder surgery is scheduled for next week." "I would like to wait a few minutes to take this as I just drank some aloe juice." "Can I take this at the same time as my procainamide?" The nurse has completed medication education about pyridostigmine (Mestinon), an indirect cholinergic drug, for a client with myasthenia gravis. The nurse determines that learning has occurred when the client makes which statement? A. "My heart may beat slower while I am on this drug." B. "I will need to increase my fluid intake with this medication." C. "It is really important to take my medication on time." D. "I must take this medication immediately before eating a full meal." "It is really important to take my medication on time." The health-care provider has ordered bethanechol (Urecholine), a cholinergic drug, for the client with urinary retention. The client also has an enlarged prostate gland. What is the priority action by the nurse? A. Hold the drug and prepare to catheterize the client. B. Administer the drug and measure urinary output. C. Administer the drug and push fluids. D. Hold the drug and contact the health-care provider. Hold the drug and contact the health-care provider. A preoperative client will be receiving glycopyrrolate (Robinul), which is an anticholinergic drug. The client asks the nurse, "Why do I need to take that medication?" What is the best response by the nurse? A. "It will help you breathe better during surgery." B. "It will decrease your respiratory secretions during surgery." C. "It will help maintain your blood pressure during surgery." D. "It will increase your urinary output during surgery." "It will decrease your respiratory secretions during surgery." The nurse is preparing to administer benztropine (Cogentin), which is an anticholinergic drug. The nurse understands this drug is contraindicated in which client? A. The client with an irritable colon. B. The client with diarrhea. C. The client with a fractured femur. D. The client with tachycardia. The client with tachycardia. The nurse is preparing to administer medications to a group of clients. One of the medications is atropine, an anticholinergic drug. This drug is contraindicated in which client? A. The client with a hiatal hernia. B. The client with hyperthyroidism. C. The client with lung cancer. D. The client with glaucoma. The client with glaucoma. The health-care provider orders dicyclomine (Bentyl), an anticholinergic drug, for a client. What is the nurse's priority assessment prior to administering this drug? A. Does the client have light sensitivity? B. Is the client dizzy upon standing? C. Does the client have a history of alcoholism? D. Is the client able to urinate? Is the client able to urinate? The client is quadriplegic and receives the anticholinergic drug oxybutynin (Ditropan) to increase his bladder capacity. What is an important assessment of this client by the nurse? A. Is he constipated? B. Is he gaining weight? C. Is he lethargic? D. Is he irritable? Is he constipated? The nursing instructor teaches the student nurses about the nervous system. The instructor determines that learning has occurred when the students make which statement(s)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. "The central nervous system includes the brain and spinal cord." B. "The peripheral nervous system has mainly sensory functions." C. "The somatic nervous system gives us voluntary control over our gastrointestinal (GI) tract." D. "The nervous system helps us react to environmental changes." E. "The somatic nervous system gives us voluntary control over moving." "The central nervous system includes the brain and spinal cord." "The nervous system helps us react to environmental changes." "The somatic nervous system gives us voluntary control over moving." The nursing instructor teaches the student nurses about the autonomic nervous system. The instructor determines that learning has occurred when the students make which statement(s)? Select all that apply. A. "The sympathetic and parasympathetic systems are not always opposite in their effects." B. "The parasympathetic nervous system is the "fight-or-flight" response." C. "Sympathetic stimulation causes dilation of arterioles." D. "The parasympathetic nervous system causes bronchial constriction." E. "The sympathetic nervous system is activated under stress." "The sympathetic and parasympathetic systems are not always opposite in their effects." "The parasympathetic nervous system causes bronchial constriction." "The sympathetic nervous system is activated under stress." The student nurse asks the nursing instructor, "Do medications actually make more neurotransmitters?" What is the best response by the nursing instructor? A. "Yes, some of the newer medications are very good at doing this." B. "No, but medications can heal diseases of the autonomic nervous system." C. "Yes, but the newer drugs that do this have some serious side effects." D. "No, medications can only increase or decrease the action of neurotransmitters." "No, medications can only increase or decrease the action of neurotransmitters." A student nurse asks a nursing instructor which part of the nervous system primarily regulates the ability of a person to use his arm muscles to lift a weight. What is the instructor's best response? A. Autonomic nervous system. B. Sympathetic nervous system. C. Parasympathetic nervous system. D. Somatic nervous system. Somatic nervous system. A nursing instructor is teaching student nurses about the sympathetic nervous system. The instructor recognizes that learning has occurred when the students say which of the following responses are regulated by the sympathetic nervous system. A. Sex organ stimulation. B. Pupil dilation. C. Stimulates salivation. D. Bronchial constriction. Pupil dilation. A nurse is working with a student nurse. The nurse explains what a client would experience if the adrenergic receptors are activated. Which of the following comments by the student nurse indicates that the education was effective? A. Rest-and-digest effects. B. Bronchial constriction. C. Increased blood volume. D. Fight-or-flight effects. Fight-or-flight effects. A student nurse is reviewing the autonomic nervous system. The student understands that which substance would inhibit the function of the autonomic nervous system? A. Drugs that prevent the storage of neurotransmitter in vesicles. B. Drugs that bind and then stimulate the postsynaptic neuron. C. Drugs that increase neurotransmitter synthesis. D. Drugs that prohibit neurotransmitter reuptake. Drugs that prevent the storage of neurotransmitter in vesicles. A nursing instructor is reviewing receptor types with a nursing student. The instructor identifies that learning has occurred when the student responds that which type of receptor is found at the ganglionic synapse of both the sympathetic and parasympathetic nervous systems? A. Nicotinic. B. Muscarinic. C. Alpha receptors. D. Beta receptors. Nicotinic. A client is prescribed an anticholinergic drug. What discharge instructions should the nurse provide? Select all that apply. A. Wear sunglasses in bright light. B. Limit fluid intake. C. Increase fiber intake. D. Avoid hot showers. E. Avoid milk and dairy products. Wear sunglasses in bright light. Increase fiber intake. Avoid hot showers. A nursing instructor is planning to teach nursing students about exogenous acetylcholine. The instructor should include which information? A. Acetylcholine is broken down rapidly within the body, preventing it from producing adverse effects. B. When given in small amounts, acetylcholine will produce profound parasympathetic effects. C. Acetylcholine will cause the heart rate to increase and blood pressure to drop. D. Acetylcholine has almost no therapeutic effects because it is rapidly destroyed once given. Acetylcholine has almost no therapeutic effects because it is rapidly destroyed once given. A student nurse asks a nurse how atropine (Atropair) increases heart rate. What is the nurse's best response? A. Directly stimulating the sympathetic nervous system. B. Blocking the beta receptors of the parasympathetic nervous system. C. Potentiating the effects of acetylcholine on nicotinic receptors. D. Blocking the effects of acetylcholine by occupying muscarinic receptors. Blocking the effects of acetylcholine by occupying muscarinic receptors. A student nurse asks a nurse which client situations are considered involuntary responses to autonomic nervous system control? What is the nurse's best response(s)? Select all that apply. A. Sweating when hot. B. Stepping over a chair to prevent falling. C. Complaining of nausea. D. Salivating at the smell of food. E. Breathing deeper when running. Sweating when hot. Salivating at the smell of food. Breathing deeper when running. A client has sustained a large blood loss. During the assessment, the nurse realizes that which findings are under the control of the nervous system? Select all that apply. A. Heart rate B. Blood pressure C. Pupil size D. Bowel sounds E. Fluid volume Heart rate Blood pressure Pupil size Bowel sounds The nurse is caring for a client with multisystem organ failure. Which client assessment findings are under the control of the sympathetic nervous system? Select all that apply. A. Blood glucose level 210 mg/dL. B. Blood pressure 180/90 mmHg. C. Extremities are cool. D. Respiratory rate 14 and regular. E. Hyperactive bowel sounds. Blood glucose level 210 mg/dL. Blood pressure 180/90 mmHg. Extremities are cool. A student nurse is learning about a medication that affects the autonomic nervous system. When instructing the student about the effects of this medication, the nurse will begin by explaining the basic structures of this system. What does this include? Select all that apply. A. The preganglionic neuron. B. The postganglionic neuron. C. The synaptic cleft. D. Norepinephrine. E. Dopamine. The preganglionic neuron. The postganglionic neuron. The synaptic cleft. The nurse educator is reviewing the process of synaptic transmission following the sympathetic pathway. In which order will the nurse explain the steps of synaptic transmission? Action potential travels across the preganglionic neuron Action potential encounters cholinergic receptors Action potential travels across the postganglionic neuron Action potential encounters adrenergic receptors Target tissue is reached. Action potential travels across the preganglionic neuron Action potential encounters cholinergic receptors Action potential travels across the postganglionic neuron Action potential encounters adrenergic receptors Target tissue is reached. A client is prescribed a medication that will block muscarinic receptors. The nurse realizes that this medication has implications for which body systems? Select all that apply. A. Eyes B. Respiratory C. Cardiac D. Endocrine E. Metabolic Eyes Respiratory Cardiac A client has been prescribed scopolamine (Transderm-Scop) for the prevention of motion sickness. The nurse should teach the client to immediately report which adverse effects? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Slow heart rate B. Cardiac palpitations C. Decreased urinary output D. Development of tremors E. Diarrhea Cardiac palpitations Decreased urinary output Development of tremors A client who has myasthenia gravis (MG) presents to the emergency department with abrupt onset of increased muscle weakness and difficulty swallowing. An attempt to distinguish worsening of the MG symptoms from overdose of the client's prescribed anticholinergic is planned. What medications should the nurse obtain for use in this procedure? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Donepezil (Aricept) B. Pyridostigmine (Mestinon) C. Neostigmine (Prostigmin) D. Edrophonium (Edrophonium Injectable) E. Atropine (Atropine Injectable) Edrophonium (Edrophonium Injectable) Atropine (Atropine Injectable) The client receives methyldopa (Aldomet). Which statement below indicates the patient is experiencing side effects? A. "I am so anxious; I really need to walk around the room." B. "Will you check my pupils? I can't see very well at all." C. "I am so thirsty; will you please bring me another pitcher of water?" D. "I feel so sleepy that I don't think I can eat my dinner." "I am so anxious; I really need to walk around the room." The nurse notes that a client prescribed carteolol (Cartrol), routinely takes metaproterenol (Alupent). Which should the nurse be concerned with? A. The effects of metaproterenol (Alupent) will be decreased. B. The client is at risk for a hypertensive crisis. C. The effects of metaproterenol (Alupent) will be increased. D. The drugs are compatible; there will not be any adverse effects. The effects of metaproterenol (Alupent) will be decreased. The nurse has provided the education for the client prescribed atenolol (Tenormin). Which statement made by the client indicates an understanding of the information? A. "I cannot continue to have my morning cup of coffee." B. "I need to take my pulse every day." C. "If I have any side effects, I will stop the medication." D. "I cannot take this drug if I develop glaucoma." "I need to take my pulse every day." A client is prescribed prazosin (Minipress). Which information should the nurse include in the client education? A. Instruct the client to not take tub baths. B. Instruct the client to not take OTC herbal preparations containing saw palmetto. C. Instruct the client to decrease his intake of sodium. D. Instruct the client to wear sunglasses when outdoors Instruct the client to not take OTC herbal preparations containing saw palmetto. A client has been prescribed an alpha1 adrenergic agonist drug. The nurse would plan to monitor for effects from which organs? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Kidneys B. Eyes C. Heart D. Bowels E. Lungs Kidneys Eyes Bowels Lungs A client is prescribed a drug that activates alpha2 receptors. Which physiological response should anticipate when plan of care for the client? A. Inhibition of norepinephrine release. B. Destruction of presynaptic nerve terminals. C. Increased lipolysis. D. Absence of monoamine oxidase. Inhibition of norepinephrine release. Which client conditions should the nurse anticipate to be treated with a beta2 agonists? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Heart failure B. Asthma C. COPD D. Overactive bladder E. Nasal congestion Asthma COPD Which substance is used in the initial production of catecholamines? A. Dopamine B. Norepinephrine C. Tyrosine D. L-dopa Tyrosine A client who is in heart failure is administered a beta1 agonist. Which assessment finding indicates the prescription is effective? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Heart rate increases B. Pulse becomes stronger C. Pupils dilate D. Dysrhythmias dissipate E. Blood pressure drops Heart rate increases Pulse becomes stronger A client has been prescribed isoproterenol (Isuprel). The nurse understands that which receptors will be stimulated? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Alpha1 B. Alpha2 C. Beta1 D. Beta2 E. Beta3 Beta1 Beta2 The nurse has provided teaching about the use of an auto injection of epinephrine. Which statement made by the client indicates further teaching is required? A. "I will use my auto-injector immediately if I think I am having an allergic reaction." B. "I will notify my healthcare provider after I inject the epinephrine." C. "I will make sure I have my auto-injector available at all times." D. "I will call 911 after I inject the epinephrine." "I will call 911 after I inject the epinephrine." The nurse is preparing to provide instructions on the use of an epinephrine auto-injector. Which information should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. If you need to use this pen, seek medical advice as follow-up. B. You can dispose of a used EpiPen in your regular trash. C. Keep an extra EpiPen on hand. D. Store this device in your refrigerator. E. Carry an EpiPen in your car's glovebox. If you need to use this pen, seek medical advice as follow-up. Keep an extra EpiPen on hand. A client has been prescribed phenylephrine (Neo-Synephrine) spray for nasal congestion. Which information about adverse effects should the nurse provide in discharge teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. "This drug may cause some stinging or burning in your nose." B. "You may notice that your nasal secretions take on a slightly orange tint." C. "You may feel like your blood pressure is low for the first few times you use this spray." D. "Rebound congestion may occur if the prescription is used more than a few days." E. "Do not drink herbal teas while taking this medication." "This drug may cause some stinging or burning in your nose." "Rebound congestion may occur if the prescription is used more than a few days." The nurse is preparing to administer an adrenergic drug intravenously. Which should the nurse include in the plan of care? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Give the drug as rapidly as possible by intravenous push. B. Dilute the drug before administration. C. Use an infusion pump to control rate of administration. D. Monitor for blanching at the infusion site. E. Advise the patient that a sweet taste may occur as the drug is being given. Dilute the drug before administration. Use an infusion pump to control rate of administration. Monitor for blanching at the infusion site. The nurse is reviewing routine medications for a client prescribed phenylephrine (Neo Synephrine). Which medications are most concerning? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. MAO inhibitors B. Tricyclic antidepressants C. Iron supplements D. Digoxin E. Aspirin MAO inhibitors Tricyclic antidepressants Iron supplements Digoxin A client recently prescribed an adrenergic drug states to the nurse, "I am so nervous and I cannot sleep." Based on the client's statement, which questions should the nurse ask? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. "How much coffee do you drink?" B. "Have you recently increased your intake of dairy products?" C. "Do you eat chocolate?" D. "When was the last time you ate pickled foods or aged cheese?" E. "How much wine or other alcoholic beverages do you drink?" "How much coffee do you drink?" "Do you eat chocolate?" A client who has used an adrenergic nasal spray for 2 weeks states to the nurse, "I am more stuffed up now than I was when I was sick." Which information should the nurse provide the patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. "You are having an allergic reaction to the nasal spray. Stop using it immediately." B. "You are having an allergic reaction to the nasal spray. Stop using it immediately." C. "Try increasing the amount of fluids you are drinking." D. "Switch to a saline-based nasal spray." E. "Continue to use your current nasal spray until the congestion goes away. "Try increasing the amount of fluids you are drinking." "Switch to a saline-based nasal spray." An older adult has received adrenergic eye drops prior to a retinal exam. Which information should the nurse include in the client's discharge teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. "Do not drive until the effects of the eye drops have worn off." B. "Wear sunglasses when in bright light." C. "You may be more comfortable in a darkened room." D. "You may experience burning in your eyes for a couple of days." E. "Do not eat or drink anything for at least an hour after discharge." "Do not drive until the effects of the eye drops have worn off." "Wear sunglasses when in bright light." "You may be more comfortable in a darkened room." A client has been prescribed an adrenergic nasal spray. Which information should the nurse include in the teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. "Do not share this spray with anyone." B. "Sit upright while using this spray." C. "Only use this spray for 3-5 days." D. "Do not shake the bottle before using this spray." E. "Keep this spray refrigerated." "Do not share this spray with anyone." "Sit upright while using this spray." "Only use this spray for 3-5 days." Which statement is accurate concerning drugs classified as adrenergic antagonists? A. They are also known as anticholinergics. B. The actions are the opposite of those of sympathomimetics. C. They will stimulate the sympathetic nervous system. D. The actions will block the neurotransmitter acetylcholine. The actions are the opposite of those of sympathomimetics. A client with a preexisting conditions states to the nurse, "I took my blood pressure at home and it was high so I have been taking my husband's propranolol (Inderal) for the last week." Based on the client's statement, which preexisting conditions should the nurse be most concerned with? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Obesity B. Diabetes mellitus C. COPD D. Asthma E. Rheumatoid arthritis Diabetes mellitus COPD Asthma A client states to the nurse, "I stopped taking that beta blocker last week because it made me so tired." Which are the priority nursing assessments? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Blood pressure B. Heart rhythm C. Urinary output D. Presence of chest pain E. Presence of respiratory crackles Blood pressure Heart rhythm Presence of chest pain A client has been prescribed prazosin (Minipress). Which information should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. "Stay out of the sun until you determine if you become sun-sensitive." B. "Take this medication just before you go to bed." C. "This medication may make you dizzy." D. "This medication may slow your heart rate noticeably." E. "Do not take this medication with milk." "Take this medication just before you go to bed." "This medication may make you dizzy." A client who was administered prazosin (Minipress) became unconscious 30 minutes after the first dose. Which prescriptions should the nurse prepare for resuscitation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Normal saline B. Dobutamine C. Atenolol (Tenormin) D. Carvedilol (Coreg) E. Propranolol (Inderal) Normal saline Dobutamine A client has been prescribed an adrenergic-blocker for treatment of hypertension. Which information should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. "Rise from a sitting position slowly B. "Sit on the side of the bed a few moments before you stand." C. "If you feel dizzy, add more salt to your diet." D. "If you feel dizzy, sit or lie down until the dizziness passes." E. "Dizziness is expected so just continue your daily activities." "Rise from a sitting position slowly "Sit on the side of the bed a few m