NUR 111 FINAL EXAM 2025

NUR 111 FINAL EXAM 2025 What is epoetin alfa used for? - correct ans-its an erythropoietin used to increase production of Rbcs monitor for an increase in bp Monitor Hgb and hct twice per week hypertension is a common adverse effect A nurse in a clinic receives a phone call from a client seeking info about a new prescription for erythopoietin. Which of the following information should the nurse review with the client? A. The client needs an erythrocyte sedimentation rate (esr) test weekly. B. The should have their hemoglobin checked weekly until stable C. Oxygen saturation levels should be monitored D. Folic acid production will increase - correct ans-b. The should have their hemoglobin checked weekly until stable What is bumetanide and furosemide used for? - correct ans-it is a loop diuretic to decrease preload and promote fluid excretion ***ingest foods high in potassium What is nitroglycerin used for? - correct ans-treats angina and help control bp; is placed under the tongue, **up to 2 more doses can be taken at 5 min intervals ***monitor for orthostatic hypotension Headache is common adverse effect of this medication Stable angina - correct ans-occurs w/ exercise or stress **relieved by nitroglycerin Unstable angina - correct ans-occurs w/ exercise or at rest **increases in occurrence, severity, or duration over time Variant angina - correct ans-due to a coronary artery spasm, often at rest Risk factors of angina - correct ans--male or postmenopausal clients -ethnic background -hypertension -tobacco use -hyperlipidemia -bmi greater than 30 -excessive alcohol consumption -metabolic disorders (dm, metabolic syndrome, hyperthyroidism) -meth or cocaine use -stress NUR 111 NUR 111 How can angina be prevented? - correct ans--exercise -manage cholesterol -low fat/sodium diet -smoking cessation Expected findings of angina - correct ans--anxiety -reports of tight squeezing, crushing, heavy/aching pressure, or constricting feeling in the chest. -weakness or numbness in arms -indigestion, nausea -dizziness -females (sex assigned at birth) and older adult clients can experience atypical angina, which is characterized by pain between the shoulders, ache in the jaw, or sensation of choking with exertion. Physical findings -pallor, and cool, clammy skin -tachycardia and heart palpitations -tachypnea and shortness of breath -diaphoresis -vomiting -decreased level of consciousness What is myocardial infarction? - correct ans--occur w/o cause, especially in morning at rest -relieved by opioids -manifestations lasts more than 30 min -associated with nausea, epigastric distress, dyspnea, anxiety, diaphoresis A nurse is assisting with the admission of a client who has a suspected myocardial infarction (mi) and a history of angina. Which of the following findings will help the nurse distinguish stable angina from an mi? A. Stable angina can be relieved with rest and nitroglycerin. B. The pain of an mi resolves in less than 15 min. C. The type of activity that causes an mi can be identified. D. Stable angina can occur for longer than 30 min. - correct ans-a. Stable angina can be relieved with rest and nitroglycerin. Dx tests for myocardial infarction - correct ans--ck-mb -troponin i -troponin t -myoglobin What is acute mi? - correct ans-a complication of angina not relieved by nitroglycerin or rest NUR 111 NUR 111 Nursing actions for someone with acute mi - correct ans--administer oxygen to maintain oxygen saturations of 90% or greater. -notify the provider immediately What is heart failure? - correct ans-failure to pump effectively, resulting in inadequate cardiac output Risk factors of heart failure - correct ans--less access to health care in vulnerable populations -cost of health care and medications compete with the need of food and housing -unemployment is associated with alcohol use disorders, smoking, and depression -food insecurity can lead to undernutrition and lack of access to fresh fruits and vegetables Left-sided heart (ventricular) failure causes - correct ans--hypertension -coronary artery disease, angina, mi -valvular disease (mitral and aortic) -smoking Right-sided heart (ventricular) failure causes - correct ans--left-sided heart (ventricular) failure -right ventricular mi -pulmonary problems (copd, pulmonary fibrosis) Cardiomyopathy (leading to heart failure) causes - correct ans--coronary artery disease -infection or inflammation of the heart muscle -various cancer treatments -prolonged alcohol use -heredity Left-sided heart failure symptoms - correct ans-left side= all lung symptoms Dyspnea, orthopnea (shortness of breath while lying down), nocturnal dyspnea Fatigue Displaced apical pulse (hypertrophy) S3 heart sound (gallop) Pulmonary congestion (dyspnea, cough, bibasilar crackles) Frothy sputum (can be blood-tinged) Altered mental status Manifestations of organ failure, such as oliguria (decrease in urine output) Nocturia Right-sided heart failure symptoms - correct ans-right side = rest of the body symptoms ******* NUR 111 NUR 111 Jugular vein distention Ascending dependent edema (legs, ankles, sacrum) Abdominal distention, ascites Fatigue, weakness Nausea and anorexia Polyuria at rest (nocturnal) Liver enlargement (hepatomegaly) and tenderness Weight gain What level of a bnp lab test would indicate that a patient is in heart failure? - correct ans-greater than 400 pg/ml What is the purpose of administering aspirin during a myocardial infarction? - correct ans-it limits the formation of blood clots and inhibits platelt aggregration The lab value that indicates heart failure severity is? - correct ans-bnp What type of anemia is caused by vitamin b12 deficiency? - correct ans-pernicious anemia How is nitroglycerin stored? - correct ans-in a dark container What do you tell a pt who is having chest pain about nitroglycerin? - correct ans-if pain is unrelieved in 5 mins, call 9-1-1 then take another dose. Normal wbc range - correct ans-5,000-10,000 mm3 Normal rbc range - correct ans-females: 4.2 to 5.4 million/ul Males: 4.7 to 6.1 million/ul Normal platelet range - correct ans-150,000 to 400,000 mm3 What is a hallmark of multiple myeloma? - correct ans-bone pain A nurse is checking laboratory values for an adult client who has sickle cell anemia and is in crisis. For which of the following complications should the nurse monitor? A. Hypokalemia B. Lead poisoning C. Hypercalcemia D. Elevated bilirubin - correct ans-d. Elevated bilirubin A nurse is caring for a client who has a platelet count of 500,000/mm^3. After discontinuing the client's peripheral iv site, which of the following actions should the nurse take? A. Apply warm compress B. Apply pressure to the catheter removal site for 10 mins NUR 111 NUR 111 C. Place the affected arm in a dependent position D. Clean the insertion site w/ alcohol - correct ans-b. Apply pressure to the catheter removal site for 10 mins A nurse is collecting data from a client who has peripheral vascular disease and a venous ulcer on the right ankle. Which of the following findings should the nurse expect in the client's affected extremity? A. Absent pedal pulses B. Ankle swelling C. Hair loss D. Skin atrophy - correct ans-b. Ankle swelling A nurse is caring for a client who has heart failure and is lethargic with muscle weakness. The client's telemetry reading displays dysrhythmias. Which of the following laboratory results should the nurse anticipate? A. Potassium 2.8 meq/l B. Digoxin level 0.7 ng/ml C. Hemoglobin 11.5 g/dl D. Calcium 8.0 mg - correct ans-a. Potassium 2.8 meq/l A nurse is contributing to the plan of care for a client during a sickle cell crisis. Which of the following interventions should the nurse recommend? A. Ambulate the client every hour B. Apply cold compresses to painful joints C. Withhold opioids until the crisis is resolved D. Administer oxygen via nasal cannula - correct ans-d. Administer oxygen via nasal cannula A nurse is reinforcing discharge teaching with a client who has a new permanent pacemaker. Which of the following pieces of information should the nurse include in the teaching? A. "avoid lifting both arms above your head when dressing." B. "use your cell phone on the same ear as the pacemaker site is located." C. "do not travel by airplane." D. "hiccups are an expected outcome of having a pacemaker." - correct ans-a. "avoid lifting both arms above your head when dressing." A nurse is assisting with developing the plan of care for an older adult client who is to receive a unit of packed red blood cells (rbcs). Which of the following actions should the nurse recommend? A. Verify the information on the packed rbcs with another nurse B. Administer the packed rbcs through an 18-gauge iv catheter C. Infuse the packed rbcs over 2 hr D. Allow the packed rbcs to warm at room temperature for 1 hr before starting the transfusion - correct ans-a. Verify the information on the packed rbcs with another nurse NUR 111 NUR 111 A nurse is monitoring a client who is receiving a transfusion of packed red blood cells. Which of the following actions should the nurse take first when suspecting a transfusion reaction? A. Prepare emergency medications B. Monitor vital signs every 5 minutes C. Stop the infusion D. Send the blood container and tubing to the laboratory - correct ans-c. Stop the infusion A nurse is preparing to administer packed rbcs to a client who is anemic. Which of the following actions should the nurse take? (select all that apply.) A. Insert a 23-gauge angiocatheter with an iv adaptor. B. Check the expiration date on the unit of packed rbcs. C. Administer the packed rbcs over a 6-hour period. D. Seek verification from 2 rns to compare the packed rbcs label against the medical record. E. Prime the transfusion tubing with 0.9% sodium chloride. - correct ans-b. Check the expiration date on the unit of packed rbcs. D. Seek verification from 2 rns to compare the packed rbcs label against the medical record. E. Prime the transfusion tubing with 0.9% sodium chloride. A client who has just learned that he has variant (prinzmetal's) angina asks the nurse how this condition compares to stable angina. Which of the following replies should the nurse make? A. "exertion often brings on pain." B. "variant angina occurs randomly at various times." C. "variant angina can cause changes on your electrocardiogram." D. "reducing your cholesterol can help you experience less pain." - correct ans-c. "variant angina can cause changes on your electrocardiogram." A client who has thrombocytopenia asks the nurse why platelets are so important. Which of the following responses should the nurse make? A. "platelets help the body fight infection." B. "platelets help break down clots in the body." C. "platelets plug breaks in blood vessels." D. "platelets produce the molecules that carry oxygen." - correct ans-c. "platelets plug breaks in blood vessels." A nurse is reinforcing discharge teaching with a client who had a sickle cell crisis. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A. "i should try to drink at least 2 liters of fluid per day." B. "i can still fly out to visit my sister in colorado for a while." C. "physical activity is good for me, but i need to avoid overexertion." NUR 111 NUR 111 D. "i can still go skiing during the cold winter months." - correct ans-c. "physical activity is good for me, but i need to avoid overexertion." A nurse is reinforcing discharge teaching with a client who has a newly inserted permanent pacemaker. Which of the following instructions should the nurse include in the teaching? A. "request a provider's prescription when traveling to alert airport security." B. "stand at least 3 feet away while using a microwave." C. "use a cellular phone on the opposite ear from the pacemaker." D. "avoid showering for the first 2 weeks following surgery.