ATI NCLEX Mock Questions and Answered Rated A+

ATI NCLEX Mock Questions and Answered Rated A+ A client is exhibiting early signs of hemorrhage. Which findings should the nurse anticipate? 1. Cold, clammy skin 2. Heart rate 120/min 3. Weak, thready pulse 4. Blood pressure 80/60 *ANS* 2. Heart rate 120/min An older adult client reports recurring calf pain after walking one to two blocks that disappears with rest. The client has weak pedal pulses, and skin on the left lower leg is shiny and cool to the touch. Which nursing intervention is appropriate at this time? 1. Position the left leg dependently 2. Elevate the left leg above the heart 3. Immobilize the left leg to prevent further injury 4. Assess dorsiflexion and extension of the left foot *ANS* 1. Position the left leg dependently A client who has just been diagnosed with rheumatoid arthritis is required to receive 3 months of methotrexate therapy. The nurse recognizes which of the following are adverse effects associated with the therapy? SATA 1. WBC 1,200 2. Weight gain 2.27 kg (5 lbs.) 3. Oral temperature of 37.2 (99) 4. Urine Specific Gravity 1.003 5. Platelets 5,000 *ANS* 1. WBC 1,200 5. Platelets 5,000 A nurse prepares a staff in-service on incident reports. Which information should the nurse include? SATA 1. Risk management investigates the incident 2. A copy of report is placed in client's health record 3. Reports include description of incident and actions taken 4. Reports are confidential and not shared with noninvolved staff 5. Completion of report should be documented in the nurses' notes *ANS* 1. Risk management investigates the incident 3. Reports include description of incident and actions taken 4. Reports are confidential and not shared with noninvolved staff A nurse is unsure of the proper technique when caring for a client who is prescribes enteral feedings. Which action should the nurse take? 1. Ask the charge nurse for step-by-step directions 2. Call the provider for specific instructions 3. Consult the unit procedure manual for guidance 4. Delegate task to a LPN to complete the feedings. *ANS* 3. Consult the unit procedure manual for guidance A nurse admits a client from a long-term care facility. Which action should be implemented? SATA 1. Verify the admission medications prescribed by the provider 2. Review the current medication regimen with the client 3. Obtain the most recent list of mediations from the long-term care facility 4. Locate a list of discharge medications from the most recent hospitalization. 5. Discuss any discrepancies with the health care provider *ANS* 1. Verify the admission medications prescribed by the provider 2. Review the current medication regimen with the client 3. Obtain the most recent list of medications from the long-term care facility 5. discuss any discrepancies with the health care provider A nurse cares for a client with terminal lung cancer. Which action should be delegated to the UAP? SATA 1. Encourage client to express feelings about the terminal diagnosis 2. Assist the client to ambulate to the bedside chair twice a day 3. Demonstrate to client the proper use of a bronchodilator inhaler 4. Complete vital signs that include oxygen saturation every 4 hours 5. Obtain a urine specimen from the client's indwelling bladder catheter *ANS* 2. Assist the client to ambulate to the bedside chair twice a day 4. Complete vital signs that include oxygen saturation every 4 hours A nurse cares for a group of clients on a med-surg unit. Which client should be delegated to the LPN? SATA. A client with 1. Newly diagnosed DM2 2. Facial lacerations and a subdural hematoma 3. Bronchitis receiving bronchodilator treatments 4. Exacerbation of myasthenia gravis admitted three hours ago 5. Advanced regular diet two days post chole *ANS* 3. Bronchitis receiving bronchodilator treatments 5. Advanced regular diet two days post chole A nurse enters the room of a client who is at the foot of the bed lying on the floor. Which should be the initial nursing action? 1. Examine the client for injuries 2. Obtain HR and BP 3. Assess vital signs and LOC 4. Determine intensity of pain with ROM *ANS* 3. Assess vital signs and LOC Four days after a ventral hernia repair, a client who is obese and has a history of COPD vomits and reports severe abdominal pain. The oxygen saturation is 90%. Which action should the nurse implement first? 1. Administer ondansetron hcl IV 2. Encourage pursed lip breathing 3. Assess the surgical incision site 4. Apply low dose oxygen via nasal cannula *ANS* 3. Assess the surgical incision site A nurse arrives at a work site explosion. Which client should be triaged first? A client who has 1. Fixed pupils an agonal respirations 2. Burns to the face and respiratory stridor 3. Type 2 DM who is disoriented 4. A closed fracture reporting "a pain level of 3" *ANS* 2. Burns to the face and respiratory stridor A home health nurse is performing an admission assessment on a client who has a knee arthroplasty one week ago. Which client statement should concern the nurse the most? 1. "I am so glad to be of those blood thinners" 2. "I will keep a pillow under my knee when I am in bed" 3. "I am planning to use a wheelchair to help me get around" 4. "I plan to take ibuprofen instead of the prescribed hydrocodone with acetaminophen for pain control" *ANS* 1. "I am so glad to be of those blood thinners" A nurse provides care for a client who has a chest tube. The nurse notes the chest tube has become disconnected from the chest drainage system. Which action should the nurse take? 1. Increase suction to the chest drainage system. 2. Reposition the client to a high-fowler's position 3. Apply to the client low-flow oxygen via nasal cannula 4. Immerse the end of the chest tube in a bottle of sterile water *ANS* 4. Immerse the end of the chest tube in a bottle of sterile water A client receives a transfusion of packed RBC's and tells the nurse "My IV site is painful and looks like it is swollen" Which action should the nurse take? 1. Continue to monitor the site for signs of infection or infiltration 2. Double check the blood type of the unit of blood with another nurse 3. Start a new IV at another site and resume the transfusion at the new site 4. Discontinue the transfusion and send the remaining blood and tubing to the lab *ANS* 3. Start a new IV at another site and resume the transfusion at the new site A client who has recently undergone surgery for a tracheostomy is now at home. The nurse recognizes a need for immediate intervention when the caregiver does which of the following? 1. Suctions intermittently for 15 seconds 2. Places an air humidifier at the bedside 3. Cuts a 4x4 gauze to put around the tracheostomy tube 4. Removes the ties before cleaning the tracheostomy *ANS* 4. Removes the ties before cleaning the tracheostomy A nurse assigns four clients to the LPN. Which finding should the LPN immediately report to the nurse? A client 1. Receiving long-term IV abx who has a rash in his left groin 2. with baseline regular apical pulse of 88 who has an irregular apical pulse of 120 today 3. Who has a recent diagnosis of terminal cancer and refuses to eat or participate in hygiene care. 4. eight hours post laparoscopic surgery who reports abdominal distention and shoulder pain. *ANS* 2. with baseline regular apical pulse of 88 who has an irregular apical pulse of 120 today A nurse plans to administer the following medication. Which medication should the nurse administer first? 1. A scheduled IV abx for a client with resolving pneumonia. 2. Pain medication to a client who rates their pain a 4-5 on a 0-10 scale 3. An antidiarrheal for a client with one diarrhea stool in the last hour 4. The antipyretic to a client with a temperature of 100.7 (38.2) *ANS* 1. A scheduled IV abx for a client with resolving pneumonia. A nurse cares for a group of clients. Which information can be disclosed about a client? 1. HIV status to the client's coworkers 2. Stage IV cancer diagnosis to the client's family 3. Uncontrolled seizure disorder to DMV 4. Alcohol detoxification recovery status to client's employer *ANS* 3. Uncontrolled seizure disorder to DMV A nurse notes the 16-year old signed the consent form for a surgical procedure. Which action should be first? 1. Cancel the surgical procedure until a valid consent form can be signed. 2. Verify the signature is witnessed appropriately and send the client for the surgery. 3. Determine whether the client meets legal requirements to sign the consent form. 4. Locate the client's patent or guardian to sign the consent form. *ANS* 3. Determine whether the client meets legal requirements to sign the consent form. A nurse prepares to document client assessment data to the unit's computer system and has forgotten the login password. Which action should the nurse take? 1. Ask to use a coworker's password 2. Let another nurse complete the data entry 3. Request assistance from the facility's IT department 4. Document on paper to enter the computer at a later time. *ANS* 3. Request assistance from the facility's IT department A nurse prepares a staff in-service on community health. Which information identifies the role of the nurse? SATA 1. Provides tertiary care to families 2. Screens for giardia with county water authority. 3. Develops influenza vaccination program for refugee center. 4. Speaks to adolescents about the impact of ETOH consumption 5. Focuses on medical model to guide practice. *ANS* 1. Provides tertiary care to families 3. Develops influenza vaccination program for refugee center. 4. Speaks to adolescents about the impact of ETOH consumption A fire is forcing evacuation of clients from a nursing unit. Which client should be evacuated first? A client who is 1. Admitted with pancreatitis with nasogastric tube and PCA device 2. 48 hour post op hip replacement whose son and daughter are visiting. 3. Receiving IV abx every 6 hours via saline lock for R leg ulcerations 4. Semi-comatose after CVA with an indwelling urinary catheter *ANS* 3. Receiving IV abx every 6 hours via saline lock for R leg ulcerations A nurse prepares discharge instructions for a client who only speaks Vietnamese. Which action should the nurse implement? 1. Contact a hospital assigned interpreter. 2. Refer client to use of graphic, visual aids. 3. Ask a family member who speaks english to translate. 4. Use Vietnamese translation from an electronic device. *ANS* 1. Contact a hospital assigned interpreter. A nurse documents "client placed in restraints after wandering and refusing to return to bed." Which conclusion should be made about the documentation? 1. It is an objective account of this client's potentially harmful behavior 2. It provides insufficient evidence to support the need to restrain the client. 3. It legally requires the signature of two nurses to support use of restraints. 4. It needs to describe attempts to resolve the insomnia before using restraints. *ANS* 2. It provides insufficient evidence to support the need to restrain the client. A nurse considers the use of a wrist restraint for a client with a peripheral IV. Which finding should be evaluated before applying the restraint? 1. The time required to restart the IV if site is compromised. 2. The current staffing level of the nursing unit. 3. The presence of family members at the bedside. 4. The reason the client may potentially pull out the IV. *ANS* 4. The reason the client may potentially pull out the IV. A nurse cares for a client who is receiving chemotherapy. Which action should be implemented if the IV tubing separates? 1. Notify housekeeping to clean the spilled solution 2. Complete incident report about the spill of chemotherapy. 3. Use towel to clean solution and dispose in a biohazard bag. 4. Obtain chemotherapy spill kit and use according to directions. *ANS* 4. Obtain chemotherapy spill kit and use according to directions. After eating lunch, a client who is immobile requests to be turned to the right side. Which actions should the nurse take? (place steps in order) 1. Flex left knee and roll toward the nurse 2. Place pillow under head and neck 3. Position arms 4. Place supine and move to side of bed 5. Position pillows to maintain alignment 6. Move right shoulder forward *ANS* 4. Place supine and move to side of bed. 1. Flex left knee and roll toward the nurse 2. Place pillow under the head and neck 6. Move right shoulder forward 5. Position pillows to maintain alignment 3. Position arms A nurse instructs the use o a cane to a client with left-sided weakness. Which instruction should be included? 1. Place the cane in the left hand. 2. Hold the cane on the right side and advance left foot forward. 3. Advance the cane 12-16 inches (30-40cm) with each step 4. Keep elbow flexed and move the right foot forward initially. *ANS* 2. Hold the cane on the right side and advance left foot forward. A nurse provides discharge teaching to a client who has acquired immunodeficiency syndrome. Which spill management technique should be included? 1. Clean area with detergent and rinse with ammonia 2. Disinfect area with 10% bleach solution after initial cleaning. 3. Clean area thoroughly with cold water and allow to air dry. 4. Disinfect area with 70% isopropyl alcohol after initial cleaning. *ANS* 2. Disinfect area with 10% bleach solution after initial cleaning. A nurse evaluates room assignments. Which room assignments (roommates) are appropriate? SATA. 1. HF exacerbation and hemoccult positive stool 2. Disseminated shingles and suspected TB 3. Accessed implanted port and Necrotizing fasciitis, group a beta hemolytic streptococcus 4. HIV positive WBC 5200 and Hep B positive 5. Ulcerative Colitis and Hep A positive *ANS* 1. HF exacerbation and hemoccult positive stool 4. HIV positive WBC 5200 and Hep B positive 5. Ulcerative Colitis and Hep A positive A nurse cares for a client 6 hours post total laryngectomy who has history of Hepatitis C and HIV. Which equipment is recommended during direct care? 1. Gloves only 2. Gloves and gown 3. Gloves, gown and mask 4. Gloves, gown, mask, goggles *ANS* 4. Gloves, gown, mask, goggles A nurse evaluates room assignments. Which room assignments require immediate modification? 1. COPD exacerbation on prednisone and Positive C. Diff 2. Positive VRE urine culture in client with urinary catheter and Acute MI post resuscitation 3. Positive influenza B and positive influenza B 4. Positive MRSA sputum and Post-op total knee replacement *ANS* 4. Positive MRSA sputum and Post-op total knee replacement A child is entering college and the parent asks about the need for meningococcal conjugate vaccine. Which information should guide the nurse's response? 1. Upper respiratory infections are more common on college campuses. 2. Living in a dormitory increases the risk of exposure to the disease. 3. Adults who contract meningitis frequently have complications. 4. Receiving the treatment provides guaranteed immunity. *ANS* 2. Living in a dormitory increases the risk of exposure to the disease. A nurse admits a client who is terminally ill for a palliative treatment. Which statements are correct regarding implementation of an advance directive? SATA 1. Provides written information to family 2. Status should be documented in health record. 3. Competent clients may change the status at any time. 4. Members of the health care team should be informed. 5. Documents are legal and must comply with state regulations. *ANS* 2. Status should be documented in health record. 3. Competent clients may change the status at any time. 4. Members of the health care team should be informed. 5. Documents are legal and must comply with state regulations. A client who is recently diagnosed with stage 4 lung cancer tells the nurse "I want to know more about advance directives." The nurse recognizes which topics should be discussed? SATA 1. Living will 2. Use of abx therapy 3. Durable power of attorney 4. Initiation of diagnostic assessments 5. Provision of nutrition by natural means 6. Prescription for do not resuscitate (DNR) *ANS* 1. Living will 2. Use of abx therapy 3. Durable power of attorney 4. Initiation of diagnostic assessments 6. Prescription for do not resuscitate (DNR) A nurse plans care for a client who is diagnosed with a CVA. Which members of the interprofessional team should participate in planning care? SATA 1. Dietician 2. Hospice Nurse 3. Speech Therapist 4. Physical Therapist 5. Rapid Response Team *ANS* 1. Dietician 3. Speech Therapist 4. Physical Therapist A nurse provides care for a client who recently had a tracheostomy placed. Which equipment should be placed at the bedside? SATA 1. Nasal cannula 2. O2 set up 3. Suction equipment 4. Manual ventilation bag 5. Two tracheostomy tubes *ANS* 2. O2 set up 3. Suction equipment 4. Manual ventilation bag 5. Two tracheostomy tubes A client plans to leave the facility "Against Medical Advice". Which actions should the nurse implement? SATA 1. Contact the provider 2. Notify the security department 3. Ask the client to sign an informed consent. 4. Obtain a discharge prescription immediately 5. Inform the client of complications that may occur without treatment *ANS* 1. Contact the provider 5. Inform the client of complications that may occur without treatment A community health nurse provides teaching about the Zika virus to clients who live in an at risk area. What information should be included? SATA 1. Flu-like symptoms should be reported to HCP 2. Vaccination is recommended for prevention. 3. The virus can spread through sexual intercourse 4. Infection during pregnancy can cause severe fetal defects 5. Mosquito repellent should be applied when going outdoors. *ANS* 1. Flu-like symptoms should be reported to HCP 3. The virus can spread through sexual intercourse 4. Infection during pregnancy can cause severe fetal defects 5. Mosquito repellent should be applied when going outdoors. A case management nurse plans discharge for an older adult. Which actions reflect effective care coordination? SATA 1. Resolving the plan of care 2. Arranging home health services 3. Administering scheduled medications 4. Performing nasogastric tube insertion 5. Facilitating referrals for community services 6. Scheduling follow-up provider appointments. *ANS* 1. Resolving the plan of care 2. Arranging home health services 5. Facilitating referrals for community services 6. Scheduling follow-up provider appointments. A nurse provides care for a client who has recently returned from West Africa. Which symptoms should be reported immediately? SATA 1. Fever 2. Dysuria 3. Epistaxis 4. Diarrhea 5. Vomiting *ANS* 1. Fever 3. Epistaxis 4. Diarrhea 5. Vomiting A nurse administers lisinopril to a client who is allergic to amoxicillin, enalapril, and latex. Which actions should the nurse take? SATA 1. Obtain vital signs 2. Monitor for angioedema 3. Complete an occurrence report 4. Assure the client lisinopril is not one of the stated allergies 5. Record dose, time, and route in the medication administration record. *ANS* 1. Obtain vital signs 2. Monitor for angioedema 3. Complete an occurrence report 5. Record dose, time, and route in the medication administration record. Autonomy *ANS* The right to make one's own decisions Beneficence *ANS* The obligation to do good for others Confidentiality *ANS* The obligation to observe privacy of another and maintain strict confidence Fidelity *ANS* The obligation to be faithful to agreements and responsibilities, to keep promises Justice *ANS* The obligation to be fair to all people (when allocating limited resources) Non-maleficence *ANS* The obligation not to harm others "Do no harm" Paternalism *ANS* Assuming the right to make decisions for another Veracity *ANS* The obligation to tell the truth A nurse provides teaching to a client prescribed lisinopril. Which findings should be reported to the provider immediately? 1. a persistent dry cough 2. a rash on the torso and neck 3. Swelling of the tongue and lips 4. Lightheadedness when standing *ANS* 3. Swelling of the tongue and lips A nurse cares for a client receiving vancomycin IV therapy. Which lab value should prompt the nurse to question a medication dosage increase? 1. A WBC count of 15,000 2. A WBC count of 3,000 3. A serum trough level that is lower than expected. 4. A serum peak level that is higher than expected. *ANS* 4. A serum peak level that is higher than expected. A nurse provides teaching to a client who is prescribed atorvastatin. Which statement indicated effective instruction? 1. "I do not need to modify my diet" 2. "I plan to take the medication with lunch" 3. "I will notify the provider if muscle aches occur" 4. "I will check renal function labs every 6 mos" *ANS* 3. "I will notify the provider if muscle aches occur" A nurse teaches a client the proper use of a metered dose inhaler. Which sequence should the nurse demonstrate to maximize medication effectiveness? Place the following steps in the proper order. 1. Inhale and depress the canister simultaneously 2. Place between teeth, and seal lips around inhaler. 3. Shake the metered dose inhaler 4. Inhale and exhale completely. 5. Remove mouthpiece cover 6. Hold breath for 5-10 seconds, then exhale slowly. *ANS* 5. Remove mouthpiece cover 3. Shake the metered dose inhaler 4. Inhale and exhale completely. 2. Place between teeth, and seal lips around inhaler. 1. Inhale and depress the canister simultaneously 6. Hold breath for 5-10 seconds, then exhale slowly. A nurse provides teaching to a client prescribed two sprays of desmopressin acetate per nostrils as directed. Which instruction should be included? 1. Discard medication bottle every 7 day. 2. Instill both sprays into same nostril daily. 3. Sit upright for 30 min after administration. 4. Store unused medication in the refrigerator. *ANS* 4. Store unused medication in the refrigerator. A nurse cares for a client receiving levothyroxine. Which findings indicate the medication dosage should be increased? SATA 1. Tachycardia 2. Hypotension 3. Paresthesia 4. Constipation 5. Excessive sweating 6. Decreased appetite *ANS* 2. Hypotension 3. Paresthesia 4. Constipation 6. Decreased appetite A nurse provides teaching to a client who is prescribed omeprazole. Which statement indicates a need for further instruction? 1. "Ibuprofen should be avoided" 2. "I will eat additional dairy products" 3. "This medication is taken with each meal" 4. "My provider will be called if I have a cough" *ANS* 3. "This medication is taken with each meal" A nurse cares for a client with DM who reports labia irritation and vaginal cheese-like discharge. Which of the following medications should be expected? 1. Imiquimod 2. Ceftriaxone 3. Fluconazole 4. Metronidazole *ANS* 3. Fluconazole A nurse provides discharge teaching to a client receiving rifampin. Which instructions should be included regarding the use of contact lenses? 1. "Wait two weeks until you have established a medication level" 2. "It's inadvisable to wear plastic contact lenses during treatment" 3. "It might be best to wait until you have completed treatment" 4. "Avoid consuming alcohol while you are taking the medication" *ANS* 2. "It's inadvisable to wear plastic contact lenses during treatment" A nurse provides medication teaching to a client who is taking ibandronate. Which instruction should the nurse question? 1. "Drink a full glass of juice when you take this medication" 2. "Take this medication at least 30 minutes before eating" 3. "Sit up for at least 30 minutes after taking this medication" 4. "Call your provider if you experience joint or muscle pain" *ANS* 1. "Drink a full glass of juice when you take this medication" A nurse plans discharge teaching for a client who is prescribed phenelzine. Which dietary option should the nurse instruct the client to avoid? SATA 1. Pepperoni 2. Fresh fish 3. Lettuce salad 4. Cottage cheese 5. Cheddar cheese *ANS* 1. Pepperoni 5. Cheddar cheese A nurse provides discharge teaching to a client prescribed levodopa/carbidopa. Which instruction should the nurse include? SATA. 1. Eat a high-protein diet 2. Change positions slowly 3. Take the medication with food. 4. Inform symptoms will improve within a week. 5. Instruct to report irregular or fast heartbeats. 6. Discuss potential for hallucinations or paranoia. *ANS* 2. Change positions slowly 3. Take the medication with food. 5. Instruct to report irregular or fast heartbeats. 6. Discuss potential for hallucinations or paranoia. A nurse cares for a client with a PCA. Which synergistic effects of anesthetic agents and opioids should the nurse expect? SATA. 1. SpO2 89% 2. BP 154/86 3. Pulse 82/min 4. Respirations 10/min 5. Temperature 97.2 6. Urine output 100mL/hour *ANS* 1. SpO2 89% 4. Respirations 10/min A nurse provides care for a client who has received an epidural analgesia. Which finding requires immediate intervention? 1. Inability to urinate. 2. Reports of a headache 3. Bilateral upper extremity itching 4. Decreased level of consciousness. *ANS* 4. Decreased level of consciousness. A nurse admits a client who has dehydration secondary to vomiting. Which lab values should the nurse expect to be elevated? SATA. 1. Serum pH 2. Hematocrit 3. Urine osmolarity 4. Serum potassium 5. Urine specific gravity *ANS* 1. Serum pH 2. Hematocrit 3. Urine osmolarity 5. Urine specific gravity A nurse admits a client who has a potassium level of 3.2 mEq/L. Which response does the nurse recognize as therapeutic to the prescribed KCL 40 mEq/L IV infusion over 4 hours? SATA. 1. Trousseau's sign becomes negative 2. Reports leg cramps are no longer present 3. Serum potassium is 3.6 mEq/L after infusion 4. HR decreased from 110 bpm to 85 bpm 5. Peaked T-waves disappeared from electrocardiogram *ANS* 2. Reports leg cramps are no longer present 3. Serum potassium is 3.6 mEq/L after infusion An older adult client is receiving IV fluids at 150 mL/hr and suddenly reports, "I feel like I am suffocating." Respirations are labored at 40/min and crackles are auscultated bilaterally. Which actions should the nurse take? SATA 1. Increase IV fluids 2. Administer oxygen 3. Assess jugular vein 4. Administer PRN dose of furosemide. 5. Monitor HR and BP 6. Place in modified Trendelenburg position *ANS* 2. Administer oxygen 3. Assess jugular vein 4. Administer PRN dose of furosemide. 5. Monitor HR and BP A client has a pulmonary embolism. Initial treatment includes 40% oxygen via Venturi mask, IV heparin therapy, and bed rest. Which finding should indicated to the nurse therapy is effective? 1. PaO2 75 mmHg 2. aPTT 70 seconds 3. CT scan of chest positive for infiltrate 4. Calf edema and erythema are resolved. *ANS* 2. aPTT 70 seconds A nurse cares for a client who has a chest tube and notices that tidaling in the water seal chamber has stopped. Which complication is the most likely cause? 1. Obstruction is present in the tubing. 2. Crackles are heard upon auscultation. 3. Water level in suction chamber is low. 4. Air is no longer present in the pleural space. *ANS* 1. Obstruction is present in the tubing. A client is receiving mechanical ventilation and the high-pressure alarm sounds. Which action should the nurse implement? 1. Check for a leak or break in the ventilator system. 2. Administer a sedative to decrease the client's anxiety. 3. Assess the client to determine the need for suctioning. 4. Check for air escaping around the cuff of the endotracheal tube. *ANS* 3. Assess the client to determine the need for suctioning. A nurse plans care for a surgical client who has undergone a bowel resection. Which action should the nurse implement to prevent circulatory complications? 1. Monitor bowel sounds in each quadrant 2. Apply pneumatic compression stockings. 3. Assist with pulmonary hygiene measures. 4. Maintain patent IV with isotonic infusions. *ANS* 2. Apply pneumatic compression stockings. A client had a ventral hernia 4 days ago. Which action should the nurse take when performing suture line care? 1. Remove crusty exudate with sterile saline. 2. Obtain culture and sensitivity of drainage. 3. Reinforce the dressing with saline soaked gauze. 4. Maintain aseptic technique during dressing change. *ANS* 4. Maintain aseptic technique during dressing change. A nurse provides dietary teaching to a client who has recently been diagnosed with acute cholecystitis. Which instruction should the nurse include? 1. Eat balanced meals with complete protein. 2. Consume low fat diet rich in HDL food sources. 3. Avoid eating snacks within two hours of bedtime. 4. Ingest small frequent meals, omitting liquids with meals. *ANS* 2. Consume low fat diet rich in HDL food sources. A nurse should make the following assessments when caring for a client who has a NG tube to low wall suction? SATA 1. Bowel control 2. Aspirate color 3. Throat comfort 4. Device stability 5. Oral cavity hydration 6. Nares mucosa condition *ANS* 2. Aspirate color 3. Throat comfort 4. Device stability 5. Oral cavity hydration 6. Nares mucosa condition A nurse provides dietary instruction to a client who has Crohn's disease. Which foods should the nurse include as a low fiber, low residue diet? SATA. 1. Fresh avocado 2. Cooked lentils 3. Cream of wheat 4. Puffed rice cereal 5. Whole grain pasta 6. Canned green beans. *ANS* 3. Cream of wheat 4. Puffed rice cereal 6. Canned green beans. A nurse provides discharge teaching to a client regarding colostomy care. Which instructions should be included? SATA 1. "Clip hair surrounding the peristomal site" 2. "Empty colostomy bag when one third full" 3. "Add cranberry juice and yogurt to your diet" 4. "apply moisturizing soap to cleanse skin surrounding stoma" 5. "avoid use of stoma powder, if peristomal skin becomes raw" *ANS* 1. "Clip hair surrounding the peristomal site" 2. "Empty colostomy bag when one third full" 3. "Add cranberry juice and yogurt to your diet" A client who has ulcerative colitis is scheduled for discharge following placement of a permanent ileostomy. Which instructions should the nurse include? SATA 1. Take enteric-coated medications. 2. Notify the provider if no stool in 24 hours. 3. Avoid raw cabbage, nuts, and popcorn. 4. Change the entire pouch system every 3 to 7 days. 5. Include an adequate amount of sodium and water in the diet. 6. Assume knee-chest position if abdominal cramping occurs. *ANS* 3. Avoid raw cabbage, nuts, and popcorn. 4. Change the entire pouch system every 3 to 7 days. 5. Include an adequate amount of sodium and water in the diet. 6. Assume knee-chest position if abdominal cramping occurs. A client who has cirrhosis is admitted with an elevated ammonia level. The nurse should request a nutritional consult if the client reports which dietary change? 1. Eliminating protein intake 2. Reducing salt consumption 3. Increasing carbohydrate foods 4. Including a moderate amount of fat. *ANS* 1. Eliminating protein intake A nurse cares for a client who has Syndrome of Inappropriate Antidiuretic Hormone (SIADH) and a serum sodium level of 116 mEq/L. Which action should be implemented? 1. Prepare D5W IV infusion 2. Initiate seizure precautions. 3. Obtain 12-lead electrocardiogram. 4. Monitor client's serum osmolarity. *ANS* 2. Initiate seizure precautions. A nurse reviews results for a client diagnosed with hypoparathyroidism. Which laboratory values should be expected? SATA. 1. Sodium 140 mEq/L 2. Potassium 3.6 mEq/L 3. Total calcium 7.1 mg/dL 4. Phosphorus 6.2 mg/dL 5. Fasting glucose 100mg/dL *ANS* 3. Total calcium 7.1 mg/dL 4. Phosphorus 6.2 mg/dL Place the following actions for blood administration in the correct order: 1. Complete transfusion within 4 hours after unit leaves blood bank 2. Obtain unit of PRBC's from blood bank. 3. Verify client ID & compatibility of blood at bedside with 2nd nurse. 4. Verify client IV access (20 g or larger) and patency. 5. Obtain client's baseline VS. 6. Initiate transfusion slowly, monitor client initial 15 minutes. 7. Prime y-tubing with NaCl and spike blood product. *ANS* 4. Verify client IV access (20 g or larger) and patency. 2. Obtain unit of PRBC's from blood bank. 3. Verify client ID & compatibility of blood at bedside with 2nd nurse. 5. Obtain client's baseline VS. 7. Prime y-tubing with NaCl and spike blood product. 6. Initiate transfusion slowly, monitor client initial 15 minutes. 1. Complete transfusion within 4 hours after unit leaves blood bank A nurse receives report and prepares to assess which client first? The client 1. With hypertrophic cardiomyopathy who is reporting dyspnea. 2. Who has a cardiac catheterization and will be ambulating for the first time. 3. Receiving abx for bacterial endocarditis who is reporting anxiety and chest pain. 4. 2 days postop Coronary Artery Bypass Surgery (CABG) surgery with a temperature of 37.2 (99.0) *ANS* 3. Receiving abx for bacterial endocarditis who is reporting anxiety and chest pain. A nurse cares for a client who is receiving epoetin alpha. Which finding indicates an expected response? 1. Serum calcium 8.0 2. Hemoglobin level 12 3. Serum potassium 5.2 4. Urine creatinine 300mg/24 hrs *ANS* 2. Hemoglobin level 12 A nurse cares for a client who has acute pyelonephritis. Which finding should the nurse recognize as an effective response to therapy? 1. 24 hr urine collection of 1550mL 2. Flank pain decreased since initial treatment 3. Clear liquids tolerated without nausea or vomiting. 4. WBC changed from 18,000 to 13,000. *ANS* 4. WBC changed from 18,000 to 13,000. A nurse cares for a client who is receiving peritoneal dialysis. Which action should the nurse implement after one half of the total dialysate solution is returned? 1. Provide additional dialysate solution. 2. Reposition client by turning side to side. 3. Advance catheter further into abdomen. 4. Milk catheter using thumb and index finger. *ANS* 2. Reposition client by turning side to side. Class: Opioid agonist Indication: Moderate to severe pain Side Effects: Respiratory depression, nausea *ANS* Hydromorphone Class: Long acting insulin Indication: type 1 &2 DM Side Effect: N/V, hypoglycemia *ANS* insulin detemir Class: Narcotic- Centrally Acting Analgesic Indication: Moderate to severe pain Low incidence of abuse Side Effect: Sedation, dizziness, HA, dry mouth, constipation *ANS* Tramadol Class: Ergot alkaloid Indication: Postpartum bleeding Side Effects: Nausea, HA, HTN *ANS* Methylergonovine Class: Antineoplastic; Immunosuppressant Indications: RA, cancer, psoriasis, Crohn's Side Effects: Nausea, elevated LFT's, fatigue *ANS* Methotrexate Class: Anticonvulsant Indication: Partial seizures, neuropathic pain Side Effects: Drowsiness, dizziness, fatigue *ANS* Gabapentin Class: Organic Nitrate Indication: Angina Side Effects: HA, hypotension, tachycardia *ANS* Nitroglycerin Class: Uterine Stimulant Indication: Induce or augment labor; postpartum hemorrhage Side Effect: Tachysystole, uterine rupture, elevated BP, fetal hypoxia *ANS* Oxytocin Class: 1st generation NSAID Indication: analgesia for mild to moderate pain such as OA and RA Side Effects: Dyspepsia, abdominal pain, nausea, long-term use, GI bleeding/perforation *ANS* Meloxicam Class: Atypical antipsychotic Indications: Schizophrenia, acute bipolar mania, autism Side Effects: weight gain, dyslipidemia, diabetes *ANS* Risperidone Class: Glucocorticoid Indication: Inflammation Side Effects: Euphoria, Infection, Cushing's syndrome *ANS* Methylprednisolone Class: Glucocorticoid/bronchodilator Indications: Prophylaxis in chronic restrictive airway diseases (asthma, COPD) Side Effects: GI upset, infection *ANS* Budesonide/formoterol Class: Uricosuric Indication: Chronic gout Side Effects: Nausea, Hypersensitivity, fever, nausea, and rash *ANS* Allopurinol Class: Antibacterial (glycopeptide) Indication: Clostridium difficile, MRSA Side Effects: Nephrotoxicity, "red man syndrome" *ANS* Vancomycin Class: Antibiotic Indication: Bacterial Infection Side Effect: GI upset, leukopenia *ANS* Piperacillin/tazobactam Is piperacillin/tazobactam okay to give to someone with an allergy to penicillin? *ANS* No! When a patient is taking vancomycin, what labs should the nurse monitor for signs of nephrotoxicity? *ANS* BUN 10-20 Serum Creatinine 0.6-1.2 When a patient is taking Allopurinol, what should the nurse do if the patient complains of nausea? *ANS* Give med with food Why does taking Budesonide/formoterol place the client at risk for infection? *ANS* Immunosuppression What are the symptoms of Cushing's syndrome? *ANS* Buffalo hump, moon face, general weakness, hypokalemia, hyperglycemia, hypernatremia Why does the client using risperidone need routine blood tests? *ANS* Monitor for elevated cholesterol and hyperglycemia What may decrease the risk of ulcer formation when taking Meloxicam? *ANS* Administer a PPI or H2 receptor antagonist to decrease risk of ulcer formation. Take meloxicam with food or 8oz of water or milk. What is a tocolytic? *ANS* The opposite of oxytocin: relaxes myometrium What safety precautions should the nurse implement for a patient taking nitroglycerin? *ANS* Fall risk (vasodilation causes dizziness) Why is gabapentin most effective 3x/day? *ANS* Doses peak in 2-3 hours How does methotrexate improve symptoms of RA? *ANS* Immunosuppression What places a woman at risk for postpartum hemorrhage? *ANS* Uterine atony, laceration, impaired maternal clotting, retained placenta fragments Tramadol should not be administered to a client who has a history of _________________________. *ANS* Seizure disorder Is detemir given prior to meals to control postprandial blood glucose? *ANS* No, peak time is 6-8 hours What should the nurse do if the client has a respiratory rate of 10 while on IV Hydromorphone? *ANS* Stop hydromorphone and contact the provider What is a tocolytic? *ANS* The opposite of oxytocin: Relaxes myometrium A nurse cares for a client following a below-the-knee-amputation. The client states "I can't look where my leg used to be." Which response by the nurse is therapeutic? 1. "I would have a hard time too" 2. "You are struggling with looking at your body?" 3. "Let me show you some range of motion exercises" 4. "I can come back later if you are not ready for your assessment." *ANS* 2. "You are struggling with looking at your body?" A nurse cares for a client who is prescribed olanzapine. Which client statement indicates a need for further instruction? 1. "I can eat whatever I want while taking the medication" 2. "I will continue taking olanzapine even when I have no delusions" 3. "It may take up to 1 month before symptoms are managed" 4. "I will go to the lab frequently to monitor WBC level during the first 2 months" *ANS* 1. "I can eat whatever I want while taking the medication" A client who is diagnosed with schizophrenia states, "I am testiculated and the confrazzlement of the issue warrants you to leave the room." How should the nurse interpret this information? The client is 1. unable to use abstract reasoning 2. demonstrating gradniose delusions. 3. incapable of accurately associating concepts 4. exhibiting a disruption in thought process *ANS* 4. exhibiting a disruption in thought process A nurse cares for a client who is newly diagnosed with Autism Spectrum Disorder. Which actions should the nurse implement? SATA 1. Introduce new activities slowly 2. Monitor level of attention span 3. Decrease environmental stimuli 4. Administer stimulant medication 5. Promote positive reinforcement *ANS* 1. Introduce new activities slowly 3. Decrease environmental stimuli 5. Promote positive reinforcement A nurse for a client who is prescribed paroxetine. Which client statement should be reported immediately? 1. "I can cut back on my coffee intake" 2. "When I feel better, I can be more social" 3. "This should help my St. John's Wort work better" 4. "I will remember to take another pill at bedtime" *ANS* 3. "This should help my St. John's Wort work better" A nurse cares for a client who is prescribed lithium carbonate therapy. Which findings should the nurse recognize as early signs of toxicity? SATA 1. Lethargy 2. Mild thirst 3. Dehydration 4. Blurred vision 5. Slurred speech *ANS* 1. Lethargy 3. Dehydration 5. Slurred speech A nurse plans discharge for a client who has dependent personality disorder. Which findings indicate a desired response to therapy? SATA 1. Demonstrates empathy for others 2. Creates a daily list of short-term goals. 3. Gathers information before decision-making 4. Self-administers diazepam to control anger 5. Manages delusions of grandiosity with quetiapine. *ANS* 2. Creates a daily list of short-term goals. 3. Gathers information before decision-making A nurse cares for a client who is admitted for treatment of opioid addiction. Which manifestations of opioid withdrawal should the nurse expect? SATA 1. Fever 2. Euphoria 3. Somnolence 4. Diaphoresis 5. Irritability 6. Vomiting *ANS* 1. Fever 4. Diaphoresis 5. Irritability 6. Vomiting A nurse cares for a client who has been admitted for detoxification of CNS stimulant addiction. Which finding should be expected eight hours after admission? 1. Tachycardia 2. Increased appetite 3. Tonic-clonic seizures 4. Paranoia with delusions *ANS* 2. Increased appetite A nurse admits a client with anorexia nervosa who has had a 14 pound weight loss in the past two weeks. Which action should be the priority? 1. Explore client's feelings 2. Remain with client after meals 3. Foster a therapeutic relationship 4. Initiate IV fluid therapy as prescribed *ANS* 4. Initiate IV fluid therapy as prescribed A nurse cares for an older client who has unexplained weight loss and extensive bruising. Which action should be the priority? 1. Use short, simple sentences 2. Refer client to medical social worker 3. Maintain client's self-esteem and dignity 4. Collect physical data and communicate findings to charge nurse. *ANS* 4. Collect physical data and communicate findings to charge nurse. A nurse cares for a client who has PTSD. Which actions should the nurse implement? SATA 1. Reinforce behavioral therapy 2. Allow expression of traumatic event 3. Administer haloperidol orally PRN 4. Encourage family participation in therapy 5. Approach client in calm, reassuring manner. *ANS* 2. Allow expression of traumatic event 4. Encourage family participation in therapy 5. Approach client in calm, reassuring manner. A nurse provides dietary teaching to a client during the initial prenatal visit. Which food should be identified as a source of vitamin B12? SATA 1. Liver 2. Lentils 3. Yogurt 4. Papaya 5. Asparagus *ANS* 1. Liver 3. Yogurt A nurse cares for a client who is receiving magnesium sulfate IV for preeclampsia. Assessment findings include: absent deep tendon reflexes and respiratory rate of 10//minute. Which action should be implemented first? 1. Administer calcium gluconate IV 2. Place client in high-fowler's position 3. Stop the magnesium sulfate infusion 4. Decrease magnesium sulfate infusion *ANS* 3. Stop the magnesium sulfate infusion A nurse is preparing a client who is in active labor for epidural anesthesia. Which action should be implemented at this time? 1. Infuse an isotonic IV bolus. 2. Place indwelling bladder catheter 3. Assist client in left-side-lying position 4. Measure bilateral deep tendon reflexes. *ANS* 1. Infuse an isotonic IV bolus. A client who is in the transitional phase of labor reports lightheadedness and tingling hands. Which should be the initial action by the nurse? 1. Apply oxygen via nasal cannula. 2. Obtain vital signs and pulse oximetry. 3. Instruct client to breathe into her cupped hands. 4. Support client to decrease rate and depth of breathing. *ANS* 3. Instruct client to breathe into her cupped hands. A nurse cares for a client who is receiving oxytocin and has uterine contractions with a duration of 120 seconds. The fetal HR is 85 bpm. Which action should be the priority? 1. Place client in supine position 2. Discontinue oxytocin infusion 3. Apply 100% oxygen via face mask 4. Notify health care provider immediately. *ANS* 2. Discontinue oxytocin infusion A nurse teaches a client about breastfeeding. Which observation indicates a need for further instruction? 1. Feeds until breast tissue softens. 2. Given a bottle during the night 3. Infant nurses every 3 hours during the day 4. Keeps infant to each breast for 15 minutes *ANS* 2. Given a bottle during the night A nurse cares for a client who has Rh negative blood and delivered a newborn with Rh positive blood. Which maternal lab should be monitored to determine RhoGAM administration? 1. Platelets 2. Hemoglobin 3. Direct Coombs' 4. Indirect Coombs' *ANS* 4. Indirect Coombs' A nurse cares for a client who is 2 hours postpartum. Which finding should be of most concern? 1. Two perineal pads saturated since delivery. 2. Fundus 1 cm above the level of the umbilicus. 3. Painful uterine contractions while infant breastfeeds 4. Large amount of dark blood from vagina when standing the first time. *ANS* 1. Two perineal pads saturated since delivery. A client who is 1 hour postpartum presses the call light and reports "a lot of blood and clots are coming from my vagina" What should the nurse do first? 1. Check time and amount of last void 2. Determine uterine firmness and location 3. Assess for orthostatic changes in vital signs 4. Examine the episiotomy for signs of bleeding *ANS* 2. Determine uterine firmness and location A nurse cares for a client 48 hours postpartum who has developed endometritis. Which interventions should the nurse anticipate? SATA 1. Lochia assessment 2. Sitz bath as needed 3. Cephalosporin IV therapy 4. Perineal pads changed every 6 hours 5. Abdominal binder when ambulating. *ANS* 1. Lochia assessment 2. Sitz bath as needed 3. Cephalosporin IV therapy A nurse assigns an Apgar score of 8 at one minute. Which action should the nurse take next? 1. Begin CPR 2. Suction the nose then mouth via bulb syringe 3. Transfer to the NICU 4. Implement routine newborn care *ANS* The axillary temperature of the newborn client is 35.8 C (96.4 F). Which finding should indicate to the nurse the presence of cold stress? 1. Apical heart rate of 160/min with shivering. 2. Moist skin with vernix caseosa in skin folds. 3. Cool, cyanotic extremities with warm trunk. 4. Respirations 35/min with sternal retractions. *ANS* 3. Cool, cyanotic extremities with warm trunk. A nurse cares for a newborn delivered at 41 weeks gestation who is jittery with a weak cry. Which action should be first? 1. Send a specimen for a serum glucose. 2. Perform a heel-stick for glucose levels. 3. Request provider to order a drug screen. 4. Administer soy based formula to newborn. *ANS* 2. Perform a heel-stick for glucose levels. A nurse plans to teach a parenting class. Which measure should be included to prevent the most common cause of death for infants and children? 1. Avoid unknown animals 2. Place infant on back during sleep 3. Secure a child in a restraint car seat. 4. Apply a water safety jacket when near a body of water. *ANS* 3. Secure a child in a restraint car seat. A nurse admits a toddler who is scheduled for surgery. Which assessment is most important to document in the care plan? 1. The child's rituals and routines at home 2. The parent's methods of reward and discipline 3. The child's ability to separate from the parents 4. The parent's understanding of the child's hospitalization. *ANS* 1. The child's rituals and routines at home A nurse provides teaching to parents of an infant who has Tetralogy of Fallot. The nurse should identify these as triggers of hypercyanotic spells. SATA 1. When resting 2. During feeding 3. Upon wakening 4. After a crying episode 5. During painful procedures *ANS* 2. During feeding 3. Upon wakening 4. After a crying episode 5. During painful procedures A nurse provides discharge teaching to parents of a newborn who has a cleft lip. Which of the feeding guidelines should be included? SATA 1. Provide special feeding devices 2. Place nipple toward the cleft lip 3. Feed in an upright, sitting position 4. Introduce solid foods after 12 months 5. Feed slowly over a 20 to 30 minute period 6. Wait to burp until the feeding is complete. *ANS* 1. Provide special feeding devices 3. Feed in an upright, sitting position 5. Feed slowly over a 20 to 30 minute period A nurse assesses a toddler who has a 36-hr history of vomiting and diarrhea. Which of the findings should the nurse report to the provider? SATA 1. Absence of tears 2. Skin cool, clammy 3. HR 110 bpm 4. 6% loss of body weight 5. Capillary refill 2 seconds 6. BP 78/52 *ANS* 1. Absence of tears 2. Skin cool, clammy 4. 6% loss of body weight 6. BP 78/52 A nurse receives report on a group of clients. Which client should be assessed first? 1. An infant with an axillary temperature of 100.1 (37.8) who is tugging at left ear. 2. A school-ages client with sore throat who is sitting upright in tripod position and drooling. 3. A pre-school aged child with harsh cough, expiratory wheezes, and milk intercostal retractions. 4. A toddler with barking cough, infrequent inspiratory stridor, and oxygen saturation 94% on RA. *ANS* 2. A school-ages client with sore throat who is sitting upright in tripod position and drooling. A nurse cares for a toddler who has glomerulonephritis. Which intervention should be the priority of care? 1. Record intake/output every 2 hours 2. Assess blood pressure every 1 hour. 3. Maintain diet with reduced sodium content. 4. Plan activities to allow for frequent rest periods. *ANS* 2. Assess blood pressure every 1 hour. A nurse cares for an infant who has cystic fibrosis and is receiving pancrelipase powder. Which finding is a desired effect of the medication? 1. Clear lung breath sounds. 2. Skin is free of salt crystals. 3. Steady weight/height gain. 4. Fewer respiratory infections. *ANS* 3. Steady weight/height gain. Class: Platelet Aggregation Inhibitor Indications: Prevent stenosis after cardiac stent placement, MI, and CVA. Side Effects: Abdominal pain, dyspepsia, diarrhea, bleeding *ANS* Clopidogrel What would you assess in a client taking clopidogrel? *ANS* H & H, epistaxis, bruising and bleeding Class: mood stabilizer Indication: bipolar disorder Side effects: Anorexia, confusion, thirst *ANS* Lithium What are the signs of Lithium Toxicity? *ANS* Vomiting, Diarrhea, slurred speech Class: Antipsychotic Indication: Schizophrenia, acute psychosis, Tourette's Side Effects: Mild leukopenia, EPS (high risk), TD, laryngospasm, respiratory depression, NMS *ANS* Haloperidol What are the symptoms of Neuroleptic Malignant Syndrome (NMS)? *ANS* Rigidity, sudden high fever, BP instability Class: Sedative-hypnotic Indication: Insomnia Side Effects: Daytime fatigue and drowsiness, dizziness *ANS* Zolpidem Class: Proton Pump Inhibitor Indication: GERD, gastric ulcers Side effects: N/V, abdominal pain *ANS* Esomeprazole When is esomeprazole taken? *ANS* one hour prior to eating Class: Antidysrhythmic Indication: A-fib, V-fib, V-tach Side Effects: Pulmonary toxicity, liver injury, heart block *ANS* Amiodarone What findings indicate respiratory failure? *ANS* Dyspnea, diminished breath sounds, rales, friction rub Class: Atypical antipsychotic Indication: Schizophrenia, major depressive disorder, autism, bipolar mania Side effects: Anxiety, insomnia, agitation, EPS (low risk) *ANS* Aripiprazole What mental health safety concerns are associated with Aripiprazole? *ANS* Increased depression, suicidal ideation Class: Biphosphonate Indication: Osteoporosis Side Effects: Bone pain, leg cramps, colitis *ANS* Risedronate Class: growth factor Indication: anemia (CKD/Chemotherapy) Side effects: HTN, thrombotic stroke, clotting of AV fistula *ANS* Epoetin What labs should the nurse monitor when the patient is on Epoetin? *ANS* H&H, CBC, BUN, potassium, iron Class: Insulin (rapid acting) Indication: Type 1 and type 2 diabetes Side effects: hypoglycemia *ANS* Aspart When is insulin aspart given in relationship to food? *ANS* 5-10 minutes prior to eating How is risedronate taken? *ANS* With a full glass of water; after taking: must sit or stand and remain NPO for 30 minutes to one hour Class: loop diuretic Indications: Heart failure, renal or hepatic failure, uncontrolled HTN, pulmonary edema SE: Hypokalemia, ototoxicity *ANS* Furosemide How would the nurse assess for ototoxicity? *ANS* Observe for s/sx of hearing loss: Indifference, turning up volume on TV, irritability when conversing Class: Statin Indication: Lower cholesterol & LDL levels, raise HDL levels SE: Rhabdomyolysis, hepatotoxicity *ANS* Atorvastatin Which labs should be assessed related to side effects of Atorvastatin? (rhabdo, hepatotoxicity) *ANS* LFT: ALT/AST Rhabdo: Myoglobin, CK Class: Calcium Channel Blocker Indication: HTN, Angina, A-fib, A-flutter, SVT Side Effects: Heart failure, peripheral edema *ANS* Diltiazem What are signs and symptoms of heart failure? *ANS* weight gain, edema, dyspnea Class: Smoking Cessation aid Indication: Aid efforts to stop smoking Side Effects: Nausea, anorexia, unusual dreams, mood changes, suicidal thoughts *ANS* Varenicline How long will a client expect to take varenicline? *ANS* 12 weeks Class: Antibiotic Indication: Pneumonia, Sinusitis, Skin infections SE: Tendonitis, photosensitivity *ANS* Levofloxacin What should the nurse do if a client experiences joint pain while taking levofloxacin? *ANS* Hold the next dose, place client on bedrest and notify provider; Associated with tendonitis/tendon rupture Class: Phosphodiesterase inhibitor Indication: Erectile dysfunction Side Effects: Hypotension, priapism, flushing, HA *ANS* Sildenafil Why is sildenafil contraindicated with NTG? *ANS* Life threatening hypotension can occur. Class: SSRI Indication: Depression, OCD, PTSD, panic attacks Side Effects: Insomnia, agitation, weight gain, sexual dysfunction, suicidal thoughts *ANS* Sertraline How many days should the client be instructed to wait when stopping an MAOI and starting Sertraline (SSRI)? *ANS* 14 days Class: Narcotic Analgesic Indication: Chronic pain, surgical analgesia, control of breakthrough pain in clients taking other opioids SE: Respiratory depression, sedation, constipation, urinary retention *ANS* Fentanyl How long is a Fentanyl patch worn? *ANS* 72 hours Class: Glucocorticoid Indications: Prophylaxis for asthma, allergic rhinitis SE: Oropharyngeal candidiasis, horseness *ANS* Fluticasone How often should the client use fluticasone? *ANS* Daily Class: Beta blocker/Antihypertensive Indication: HTN, angina, dysrhythmias, MI, acute anxiety SE: Bradycardia, AV heart block, heart failure, bronchoconstriction *ANS* Propranolol What is the black box warning for propranolol? *ANS* Exacerbation of angina/MI if abruptly discontinued Class: Cholinesterase inhibitor Indication: Mild to severe Alzheimer's Disease SE: Nausea, vomiting, diarrhea, GI bleeding, anorexia, dizziness, bronchoconstriction, bradycardia *ANS* Donepezil What important teaching is needed for a client taking Donepezil? *ANS* Take it at bedtime, may cause vivid unusual dreams, implement safety precautions Class: ACE inhibitor Indication: HTN, heart failure, acute MI SE: Persistent dry cough, hyperkalemia, renal failure, angioedema *ANS* Lisinopril Should women use a reliable form of birth control while taking Lisinopril? *ANS* yes, black box warning of being associated with fetal injury/death Class: Antibiotic Indication: Tuberculosis SE: Hepatotoxicity, causes body secretions to turn orange *ANS* Rifampin How would the nurse assess liver toxicity? *ANS* Increased LFT, jaundice, dark urine, light stools, RUQ pain Class: Anticoagulant Indication: DVT prevention, ischemia prevention in unstable angina and MI SE: Bleeding, neurological injury *ANS* Enoxaparin What is the antidote for enoxaparin? *ANS* Protamine sulfate Class: Antidysrhythmic Indications: Paroxysmal SVT SE: Bradycardia, dyspnea, hypotension, flushing, chest discomfort *ANS* Adenosine What client outcome should the nurse expect after giving a client Adenosine? *ANS* Conversion to normal sinus rhythm Class: 5-alpha-reductase inhibitor Indication: Benign prostatic hyperplasia SE: decreased ejaculate and libido *ANS* Dutasteride Should clients using dutasteride donate blood? *ANS* No, it is teratogenic Class: Anticoagulant Indication: Prophylaxis for thrombosis, TIAs and MI SE: Black box warning: Serious/fatal bleeding events *ANS* Warfarin should foods containing vitamin K be avoided while taking warfarin? *ANS* No, consistent intake recommended Class: Antiepileptic Indication: Seizures SE: Gingival hyperplasia, thrombocytopenia *ANS* Phenytoin Is a client taking Phenytoin susceptible to Stevens Johnson Syndrome? *ANS* Yes, (flu like s/sx, skin rash) Instruct client to stop taking medication and notify provider