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Reviewer for the Board Exam part 3

Reviewer for the Board Exam part 3

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Published by jamchan
i hope it can help to my fellow nursing student:)
i hope it can help to my fellow nursing student:)

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Categories:Types, Reviews, Book
Published by: jamchan on Nov 28, 2010
Copyright:Attribution Non-commercial

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07/25/2014

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Q&A - Pharmacology 2
Questions are numbered by the order in which they appeared
 in the test.* Represents the correct answer.
Question 1
 
A 4 year-old child is admitted with burns on hislegs and lower abdomen. When assessing thechild’s hydration status, which of the followingindicates a less than adequate fluid replacement?A)Decreasing hematocrit and increasing urinevolumeB)Rising hematocrit and decreasing urinevolumeC)Falling hematocrit and decreasing urinevolumeD)
Stable hematocrit and increasingurine volume
Review Information
: The correct answer is B:Rising hematocrit and decreasing urine volumeA rising hematocrit indicates a decreased total bloodvolume, a finding consistent with dehydration.
Question 2
 
Prior to administering Alteplase (TPA) to a clientadmitted for a cerebral vascular accident (CVA), itis critical that the nurse assess:A) Neuro signsB) Mental statusC) Blood pressureD)
PT/PTT
Review Information
: The correct answer is D:PT/PTTTPA is a potent thrombolytic enzyme. Because bleeding is the most common side effect, it is mostessential to evaluate clotting studies including PT,PTT, APTT, platelets, and hematocrit before beginning therapy.
Question 3
 
A nurse who has been named in a lawsuit can usewhich of these factors for the best protection in acourt of law?A)Clinical specialty certification in theassociated area of practiceB)Documentation on the specific client recordwith a focus on the nursing processC)Yearly evaluations and proficiency reports prepared by nurse’s manager D)
Verification of provider's orders for the plan of care with identification of outcomes
Review Information
: The correct answer is B:Documentation on the specific client record with afocus on the nursing processDocumentation is the key to protect nurses when alawsuit is filed. The thorough documentation shouldinclude all steps of the nursing process – assessment,analysis, plan, intervention, evaluation. In addition,it should include pertinent data such as times,dosages and sites of actions, assessment data, thenurse’s response to a change in the client’scondition, specific actions taken, if and when thenotification occurred to the provider or other healthcare team members, and what was prescribed alongwith the client’s outcomes.
Question 4
 
The nurse is caring for clients over the age of 70.The nurse knows that due to age-related changes,the elderly clients tolerate diets that areA) high proteinB) high carbohydratesC) low fatD)
high calories
Review Information
: The correct answer is C: lowfatDue to age related changes, the diet of the elderlyshould include a lower quantity and higher quality of food. Fewer carbohydrates and fats are required intheir diets.
Question 5
 
A client is to receive 3 doses of potassium chloride10 mEq in 100cc normal saline to infuse over 30minutes each. Which of the following is a priorityassessment to perform before giving thismedication?A) Oral fluid intakeB) Bowel soundsC) Grip strengthD)
Urine output
Review Information
: The correct answer is D:Urine outputPotassium chloride should only be administered after adequate urine output (>20cc/hour for 2 consecutivehours) has been established. Impaired ability toexcrete potassium via the kidneys can result inhyperkalemia.
Question 6
 
A hypertensive client is started on atenolol(Tenormin). The nurse instructs the client toimmediately report which of these findings?A) Rapid breathingB) Slow, bounding pulseC) Jaundiced scleraD)
Weight gain
Review Information
: The correct answer is B:Slow, bounding pulseAtenolol (Tenormin) is a beta-blocker that can causeside effects including bradycardia and hypotension.
1
 
Question 7
 
During nursing rounds which of these assessmentswould require immediate corrective action andfurther instruction to the practical nurse (PN)about proper care?A)The weights of the skin traction of a clientare hanging about 2 inches from the floor B)A client with a hip prosthesis 1 day postoperatively is lying in bed with internalrotation and adduction of the affected legC)The nurse observes that the PN moves theextremity of a client with an external fixationdevice by picking up the frameD)
A client with skeletal traction states"The other nurse said that the clear,yellow and crusty drainage aroundthe pin site is a good sign"
Review Information
: The correct answer is B: Aclient with a hip prosthesis 1 day post operatively islying in bed with internal rotation and adduction of the affected legThis position should be prevented in order to preventdislodgment of the hip prosthesis, especially in thefirst 48 to 72 hours post-op. The other assessmentsare not of concern.
Question 8
 
A client is scheduled for an intravenous pyelogram(IVP). After the contrast material is injected,which of the following client reactions should bereported immediately?A) Feeling warmB) Face flushingC) Salty tasteD)
Hives
Review Information
: The correct answer is D:HivesThis is a sign of anaphylaxis and should be reportedimmediately. The other reactions are considerednormal and the client should be informed that theymay occur.
Question 9
 
You are caring for a hypertensive client with anew order for captopril (Capoten). Whichinformation should the nurse include in clientteaching?A) Avoid green leafy vegetablesB) Restrict fluids to 1000cc/dayC) Avoid the use of salt substitutesD)
Take the medication with meals
Review Information
: The correct answer is C:Avoid the use of salt substitutesCaptopril can cause an accumulation of potassium or hyperkalemia. Clients should avoid the use of saltsubstitutes, which are generally potassium-based.
Question 10
 
A client has bilateral knee pain from osteoarthritis.In addition to taking the prescribed non-steroidalanti-inflammatory drug (NSAID), the nurse shouldinstruct the client toA) start a regular exercise programB)rest the knees as much as possible todecrease inflammationC) avoid foods high in citric acidD)
keep the legs elevated when sitting
Review Information
: The correct answer is A: starta regular exercise programA regular exercise program is beneficial in treatingosteoarthritis. It can restore self-esteem and improve physical functioning.
Question 11
 
A client in respiratory distress is admitted witharterial blood gas results of: PH 7.30; PO
2
58,PCO
2
34; and HCO
3
19. The nurse determines thatthe client is inA) metabolic acidosisB) metabolic alkalosisC) respiratory acidosisD)
respiratory alkalosis
Review Information
: The correct answer is A:metabolic acidosisThese lab values indicate metabolic acidosis: the PHis low, PCO
2
is normal, and bicarbonate level is low.
Question 12
 
A woman with a 28 week pregnancy is on the wayto the emergency department by ambulance with atentative diagnosis of abruptio placenta. Whichshould the nurse do
first
when the woman arrives?A) administer oxygen by mask at 100%B) start a second IV with an 18 gauge cannulaC) check fetal heart rate every 15 minutesD)
insert urethral catheter with hourlyurine outputs
Review Information
: The correct answer is A:administer oxygen by mask at 100%Administering oxygen in this situation wouldincrease the circulating oxygen in the mother’scirculation to the fetus’s circulation. This action will
2
 
minimize complications.
Question 13
 
You are caring for a client with deep veinthrombosis who is on Heparin IV. The latestAPTT is 50 seconds. If the laboratory normalrange is 16-24 seconds, you would anticipateA) maintaining the current heparin doseB)increasing the heparin as it does not appear therapeutic.C) giving protamine sulfate as an antidote.D)
repeating the blood test 1 hour after giving heparin.
Review Information
: The correct answer is A:maintaining the current heparin doseThe range for a therapeutic APTT is 1.5-2 times thecontrol. Therefore the client is receiving atherapeutic dose of Heparin.
Question 14
 
A client newly diagnosed with Type I DiabetesMellitus asks the purpose of the test measuringglycosylated hemoglobin. The nurse shouldexplain that the purpose of this test is to determine:A)The presence of anemia often associatedwith DiabetesB)The oxygen carrying capacity of the client'sred cellsC)The average blood glucose for the past 2-3monthsD)
The client's risk for cardiaccomplications
Review Information
: The correct answer is C: Theaverage blood glucose for the past 2-3 monthsBy testing the portion of the hemoglobin that absorbsglucose, it is possible to determine the average bloodglucose over the life span of the red cell, 120 days.
Question 15
 
An 80 year-old client is admitted with a diagnosisof malnutrition. In addition to physicalassessments, which of the following lab testsshould be closely monitored?A) Urine proteinB) Urine creatinineC) Serum calciumD)
Serum albumin
Review Information
: The correct answer is D:Serum albuminSerum albumin is a valuable indicator of proteindeficiency and, later, nutritional status in adults. Anormal reading for an elder’s serum albumin is between 3.0-5.0 g/dl.
Question 16
 
A 66 year-old client is admitted for mitral valvereplacement surgery. The client has a history of mitral valve regurgitation and mitral stenosis sinceher teenage years. During the admissionassessment, the nurse should ask the client if as achild she hadA) measlesB) rheumatic fever C) hay fever D)
encephalitis
Review Information
: The correct answer is B:rheumatic fever Clients that present with mitral stenosis often have ahistory of rheumatic fever or bacterial endocarditis.
Question 17
 
Which of these clients should the charge nurseassign to the registered nurse (RN)?A)A 56 year-old with atrial fibrillationreceiving digoxinB)A 60 year-old client with COPD on oxygenat 2 L/minC)A 24 year-old post-op client with type 1diabetes in the process of dischargeD)
An 80 year-old client recovering 24hours post right hip replacement
Review Information
: The correct answer is C: A 24year-old post-op client with type 1 diabetes in the process of dischargeDischarge teaching must be done by an RN.Practical nurses (PNs) or unlicensed assistive personnel (UAPs) can reinforce education after theRN does the initial teaching.
Question 18
 
The nurse discusses nutrition with a pregnantwoman who is iron deficient and follows avegetarian diet. The selection of which foodsindicates the woman has learned sources of iron?A) Cereal and dried fruitsB) Whole grains and yellow vegetablesC) Leafy green vegetables and orangesD)
Fish and dairy products
Review Information
: The correct answer is A:Cereal and dried fruitsBoth of these foods would be a good source of iron.
Question 19
 
A client diagnosed with gouty arthritis is admittedwith severe pain and edema in the right foot. Whenthe nurse develops a plan of care, whichintervention should be included?A) high protein diet
3

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