NUR 282 Final Exam 2 Questions And All
Correct Answers.
A ct. w/ hx: type II DM is admitted to the hospital w/ chest pain. The ct. is scheduled for a
cardiac catheterization. Which med would need to be withheld for 24 hours before the
procedure and for 48 hours after the procedure?
1. Glipizide
2. Metformin
3. Repaglinide
4. Regular Insulin - Answer 2. Metformin
R: Metformin needs to be w/held 24 hours before and 48 hours after cardiac catheterization bc
of the injection of contrast medium during the procedure. If the contrast medium affects kidney
function, metformin in the system the ct. would be at increased risk for lactic acidosis.
The nurse is assessing the neurovascular status of a ct. who returned to the surgical nursing unit
4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse
notes redness and edema. The pedal pulse is palpable. How should the nurse interpret the ct.'s
neurovascular status?
1. The neurovascular status is normal bc of increased blood flow through the leg.
2. The neurovascular status is moderately impaired, and the surgeon should be called.
3. The neurovascular status is slightly deteriorating and should be monitored for another hour.
4. The neurovascular status shows adequate arterial flow, but venous complications are arising.
- Answer 1. The neurovascular status is normal bc of increased blood flow through the leg.
R: An expected outcome of aortoiliac bypass graft sx is warmth, redness, and edema in the sx
extremity bc of the increased blood flow. The remaining options are incorrect.
The nurse is monitoring a ct. w/ HTN who is taking propranolol. Which assessment finding
indicates a potential adverse complication associated w/ this med?
1. Report of infrequent insomnia
2. Development of expiratory wheezes
3. A baseline BP of 150/80 mmHg followed by a BP of 138/72 mmHg after 2 doses of medication
4. A baseline resting HR of 88 BPM followed by a resting HR of 72 BPM after 2 doses of
medication - Answer 2. Development of expiratory wheezes
R: Audible expiratory wheezes may indicate a serious adverse rxn, bronchospasm. Beta blockers
may induce this rxn, particularly in ct.'s w/ COPD or asthma. Normal decreases in HR and BP are
, 1. sulfa allergy
2. osteoporosis
3. hypokalemia
4. hypouricemia
5. hyperglycemia
6. hypercalcemia - Answer 1. sulfa allergy
3. hypokalemia
5. hyperglycemia
6. hypercalcemia
R: Thiazide diuretics such as hydrochlorothiazide are sulfa-based medications, and a ct. w/ a
sulfa allergy is at risk for an allergic rxn. Also cts. are at risk for hypokalemia, hyperglycemia,
hypercalcemia, hyperlipidemia, and hyperuricemia.
The nurse provides instructions to the ct. about nicotinic acid prescribed for hyperlipidemia.
Which statement by the ct. indicates understanding of the instructions?
1. The med should be taken w/ meals to decrease flushing
2. It is not necessary to avoid the use of alcohol when taking nicotinic acid
3. Clay-colored stools are a common SE and should not be a concern
4. Ibuprofen taken 30 minutes before the nicotinic acid may decrease the flushing - Answer 4.
Ibuprofen taken 30 minutes before the nicotinic acid may decrease the flushing
R: Flushing is an adverse effect of this med. Aspirin or a NSAID, as prescribed can be taken 30
minutes prior to taking the med to decrease flushing. Alcohol consumption needs to be avoided
bc it will enhance this effect. The med should be taken w/ meals to decrease GI upset, however
taking the med w/ meals has no effect on flushing. Clay-colored stools are a sign of hepatic
dysfunction and should be reported to the PHCP immediately.
The nurse is teaching a ct. w/ DM how to mix regular insulin and NPH insulin in the same
syringe. Which action, if performed by the ct. indicates a need for further teaching?
1. Withdraws the NPH insulin first
2. Withdraws the regular insulin first
3. Injects air into NPH insulin vial first
4. Injects an amount of air equal to the desired dose of insulin into each vial - Answer 1.
Withdraws the NPH insulin first
R: Air in clear, air in cloudy, draw up cloudy, draw up clear!
Correct Answers.
A ct. w/ hx: type II DM is admitted to the hospital w/ chest pain. The ct. is scheduled for a
cardiac catheterization. Which med would need to be withheld for 24 hours before the
procedure and for 48 hours after the procedure?
1. Glipizide
2. Metformin
3. Repaglinide
4. Regular Insulin - Answer 2. Metformin
R: Metformin needs to be w/held 24 hours before and 48 hours after cardiac catheterization bc
of the injection of contrast medium during the procedure. If the contrast medium affects kidney
function, metformin in the system the ct. would be at increased risk for lactic acidosis.
The nurse is assessing the neurovascular status of a ct. who returned to the surgical nursing unit
4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse
notes redness and edema. The pedal pulse is palpable. How should the nurse interpret the ct.'s
neurovascular status?
1. The neurovascular status is normal bc of increased blood flow through the leg.
2. The neurovascular status is moderately impaired, and the surgeon should be called.
3. The neurovascular status is slightly deteriorating and should be monitored for another hour.
4. The neurovascular status shows adequate arterial flow, but venous complications are arising.
- Answer 1. The neurovascular status is normal bc of increased blood flow through the leg.
R: An expected outcome of aortoiliac bypass graft sx is warmth, redness, and edema in the sx
extremity bc of the increased blood flow. The remaining options are incorrect.
The nurse is monitoring a ct. w/ HTN who is taking propranolol. Which assessment finding
indicates a potential adverse complication associated w/ this med?
1. Report of infrequent insomnia
2. Development of expiratory wheezes
3. A baseline BP of 150/80 mmHg followed by a BP of 138/72 mmHg after 2 doses of medication
4. A baseline resting HR of 88 BPM followed by a resting HR of 72 BPM after 2 doses of
medication - Answer 2. Development of expiratory wheezes
R: Audible expiratory wheezes may indicate a serious adverse rxn, bronchospasm. Beta blockers
may induce this rxn, particularly in ct.'s w/ COPD or asthma. Normal decreases in HR and BP are
, 1. sulfa allergy
2. osteoporosis
3. hypokalemia
4. hypouricemia
5. hyperglycemia
6. hypercalcemia - Answer 1. sulfa allergy
3. hypokalemia
5. hyperglycemia
6. hypercalcemia
R: Thiazide diuretics such as hydrochlorothiazide are sulfa-based medications, and a ct. w/ a
sulfa allergy is at risk for an allergic rxn. Also cts. are at risk for hypokalemia, hyperglycemia,
hypercalcemia, hyperlipidemia, and hyperuricemia.
The nurse provides instructions to the ct. about nicotinic acid prescribed for hyperlipidemia.
Which statement by the ct. indicates understanding of the instructions?
1. The med should be taken w/ meals to decrease flushing
2. It is not necessary to avoid the use of alcohol when taking nicotinic acid
3. Clay-colored stools are a common SE and should not be a concern
4. Ibuprofen taken 30 minutes before the nicotinic acid may decrease the flushing - Answer 4.
Ibuprofen taken 30 minutes before the nicotinic acid may decrease the flushing
R: Flushing is an adverse effect of this med. Aspirin or a NSAID, as prescribed can be taken 30
minutes prior to taking the med to decrease flushing. Alcohol consumption needs to be avoided
bc it will enhance this effect. The med should be taken w/ meals to decrease GI upset, however
taking the med w/ meals has no effect on flushing. Clay-colored stools are a sign of hepatic
dysfunction and should be reported to the PHCP immediately.
The nurse is teaching a ct. w/ DM how to mix regular insulin and NPH insulin in the same
syringe. Which action, if performed by the ct. indicates a need for further teaching?
1. Withdraws the NPH insulin first
2. Withdraws the regular insulin first
3. Injects air into NPH insulin vial first
4. Injects an amount of air equal to the desired dose of insulin into each vial - Answer 1.
Withdraws the NPH insulin first
R: Air in clear, air in cloudy, draw up cloudy, draw up clear!
