POST-TEST MS RLE P2W4

Total points38/40
 
The respondent's email (anpa.florentino.coc@phinmaed.com) was recorded on submission of
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0 of 0 points
LAST NAME, FIRST NAME*
Florentino, AngelynP.

SECTION*
C-08

TIME IN*
02:24pm

POST TEST MS RLE

38 of 40 points
 
You are caring for a patient at home who must take magnesium hydroxide/aluminum
hydroxide (Maalox) 30 mL PO. How will you instruct the patient to measure the dose
using ordinary household measuring devices?
*
1/1
1 tbsp
2 tbsp
 
3 tbsp
No, patient should buy calibrated glass regardless of her status
Feedback
You can always look for options available at home. One tablespoon is equal to 15 mL. Convert 30
mL to tablespoons by multiplying it by one tablespoon. Then, divide 30 by 15 mL to get the final
answer of 2 tbsp.

 
A patient has a bottle of warfarin (Coumadin) 5 mg tablets at home. After his most
recent international normalized ratio (INR), the doctor calls and tells him to take 7.5
mg/day. How many tablets (scored) should the patient take?
*
1/1
3.5 tablets
2.1 tablets
1.5 tablets
 
1 tablet
Feedback
Desired(D)×Vehicle(V) over on hand (H)

 
The physician orders alprazolam (Xanax) 0.5 mg PO. You have on hand Xanax 0.25 mg
tablets. How many tablet(s) will you give? 
*
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nothing
8 tablets
2 tablets
 
1 and 1/2 tablets

 
You need to administer 250 mg of erythromycin (Erythrocin) PO. You have on hand 0.5
g tablets. How many tablet(s) will you give? 
*
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1.8 tablets
1.2 tablet
0.5 tablet
 
0.3 tablet

 
You have available lorazepam (Ativan) 0.5 mg tablets, and you need to administer 1 mg
PO. How many tablet(s) will you administer? 
*
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1/2 tablet
2 tablets
 
2 and 1/2 tablets
3 tablets

 
A patient with heart failure has a daily order for digoxin (Lanoxin) 0.25 mg PO. Digoxin
0.125 mg tablets are available. How many tablet(s) should you give? 
*
1/1
2 tablets
 
3 tablets
4 and 1/4 tablets
1/2 tablet

 
The physician writes a STAT order for codeine 45 mg IM for a patient with a vertebral
compression fracture. You have on hand codeine 60 mg/2 mL. How many milliliters
should you give?  record your answer using one decimal place. 
*
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3.5 cc
5 cc
1.5 cc
 
0.05 cc

 
You have an order for phenobarbital (Luminal) 50 mg PO at bedtime. It is supplied as
phenobarbital elixir 20 mg/5 mL. How much in mL will you administer?
*
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9.5 cc
7 cc
5 cc
12.5 cc
 
 
You need to administer 400 mg of erythromycin (Erythrocin) PO. You have on hand a
suspension of 125 mg/5 mL. How many ml will you prepare?
*
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5 mL
16 mL
 
2.5 mL
none of the above.

 
A patient is placed on methadone (Methadose) maintenance therapy of 15 mg/day PO.
It is supplied as 10 mg in 5 mL oral solution. How many milliliters should you instruct the
patient to take?
*
1/1
8 cc
7.5 cc
 
5 cc
6 cc

 
A nurse is checking the nasogastric tube position of a client receiving a long-term
therapy of Omeprazole (Prilosec) by aspirating the stomach contents to check for the
PH level. The nurse proves the correct tube placement if the PH level is?
1/1
7.75
7.5
6.5
5.5
 
Feedback
Gastric placement is indicated by a pH of less than 4 but may increase to between pH 4-6 if the
patient is receiving acid-inhibiting drugs. Measuring the pH of stomach aspirate is considered more
accurate than visual inspection. Stomach aspirate generally has a pH range of 0 to 4, commonly
less than 4.

 
After the client had tolerated the weaning process, the physician ordered the removal of
the endotracheal tube and it will be shifted into a nasal cannula. Which of the following
findings after the removal requires immediate intervention by the physician?
*
1/1
Sore throat
Hoarseness of the voice
Coughing out blood
 
Neck discomfort
Feedback
A sign of a tracheal or esophageal perforation that prevents oxygen from reaching the lungs and can
result in internal bleeding. This life-threatening side effect of being intubated requires immediate
medical intervention. When hemoptysis begins after endotracheal intubation, upper airway trauma
caused by the intubation procedure, endotracheal tube, or endotracheal suction catheters must be
considered. If hemoptysis begins after a latent period of 1 or more weeks after intubation, a tracheo-
artery fistula may be the source of hemorrhage.

 
A client with Congestive heart failure is about to take a dose of furosemide (Lasix).
Which of the following potassium levels, if noted in the client’s record, should be
reported before giving the due medication?
*
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5.1 mEq/L
4.9 mEq/L
3.9 mEq/L
3.3 mEq/L
 
Feedback
The normal potassium level is 3.5 to 5.5 mEq/L. Low potassium levels can be dangerous, especially
for people with CHF. Low potassium can cause fatal heart arrhythmias. An abnormal serum K+ level
is associated with an increased risk of ventricular arrhythmia and sudden cardiac death (SCD) and
these patients are generally prescribed furosemide and potassium chloride (KCl).

 
A client is brought to the emergency department and states that he has accidentally
been taking two times his prescribed dose of Warfarin (Coumadin). After observing that
the client has no evidence of any obvious bleeding, the nurse should do which of the
following?
1/1
Draw a sample for activated partial thromboplastin time (aPTT) level.
Draw a sample for prothrombin time (PT) level and international normalized ratio (INR).
 
Prepare to administer Vitamin K.
Prepare to administer Protamine sulfate.
Feedback
The next action for the nurse to take is to draw a sample for INR and PT level to check the client’s
anticoagulation status and risk for bleeding. These results will provide information on how to
manage the client by either giving an antidote such as Vitamin K or administering a blood
transfusion. Specific evaluation of warfarin toxicity should involve evaluation of the patient’s PT, INR,
CBC, and BMP with hepatic function, in addition to the standard co-ingestions and a focused
evaluation surrounding their symptoms.

 
A male client with atrial fibrillation who is receiving maintenance therapy of warfarin
(Coumadin) has a prothrombin time of 37 seconds. Based on the result, the nurse will
follow which of the following doctor’s orders?
*
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Administering the next dose of warfarin.
Increasing the next dose of warfarin.
Decreasing the next dose of warfarin.
Withholding the next dose of warfarin.
 
Feedback
The normal prothrombin time is 9.6 to 11.8 seconds (male adult). A therapeutic level PT level is 1.5
to 2 times higher than the normal level. Since the value of 37 seconds is high, the nurse should
expect that the client’s next dose of warfarin will be withheld. Patients receiving treatment with
warfarin should have close monitoring to ensure the safety and efficacy of the medication. Periodic
blood testing is recommended to assess the patient’s prothrombin time (PT) and the international
normalized ratio (INR).

 
The nurse is reviewing the laboratory result of a client receiving digoxin (Lanoxin) and
notes that the result is 2.5 ng/mL. The nurse plans to do which of the following?
*
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Give the next dose
Notify the physician
 
Check the client's pulse rate
Increase the next dose as ordered

No correct answers
 
The nurse is administering an intravenous vesicant chemotherapeutic agent to a client.
Which assessment would require the nurse’s immediate action?
*
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Stomatitis lesion in the mouth.
Severe nausea and vomiting.
Complaints of pain at the site of infusion.
 
A rash on the client’s extremities.

 
Nurse Celine is caring for a client with clinical depression who is receiving an MAO
inhibitor. When providing instructions about precautions with this medication, the nurse
should instruct the client to:
*
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Avoid walking without assistance
Avoid chocolate and cheese.
 
Take the medication with milk
Take frequent naps.
Feedback
Foods high in tryptophan, tyramine, and caffeine, such as chocolate and cheese may precipitate
hypertensive crises. Tyramine is an amino acid that helps regulate blood pressure. It occurs
naturally in the body, and it’s found in certain foods. Medications called monoamine oxidase
inhibitors (MAOIs) block monoamine oxidase, which is an enzyme that breaks down excess
tyramine in the body. Blocking this enzyme helps relieve depression.

 
While providing home care to a client with congestive heart failure, the nurse is asked
how long diuretics must be taken. The best response to this client should be:
*
1/1
“Please talk to your physician about medications and treatments.”
“You will have to take this medication for about a year.”
“The medication must be continued so the fluid problem is controlled.”
 
“As you urinate more, you will need less medication to control fluid.”
Feedback
This is the most therapeutic response and gives the client accurate information. Diuretics are used
to achieve and maintain euvolemia (the patient’s ‘dry weight’) with the lowest possible dose. This
means that the dose must be adjusted, particularly after the restoration of the dry body weight, to
avoid the risk of dehydration, which leads to hypotension and renal dysfunction.

 
An order is written to start an IV on a 74-year-old client who is getting ready to go to the
operating room for a total hip replacement. What gauge of catheter would best meet the
needs of this client?
*
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g. 20
g. 18
 
g. 25
g. 21
Feedback
Clients going to the operating room ideally should have an 18- gauge catheter. This is large enough
to handle blood products safely and to allow rapid administration of large amounts of fluid if
indicated during the perioperative period. An 18-gauge catheter is recommended.

 
A client with an acute exacerbation of rheumatoid arthritis is admitted to the hospital for
treatment. Which drug, used to treat clients with rheumatoid arthritis, has both an anti-
inflammatory and immunosuppressive effect?
*
1/1
Naproxen (Naprosyn)
Prednisone (Deltasone)
 
Azathioprine (Imuran)
Gold sodium thiomalate (Myochrysine)
Feedback
Prednisone is used to treat persons with acute exacerbations of rheumatoid arthritis. This
medication is given for its anti-inflammatory and immunosuppressive effects. Prednisone is in a
class of medications called corticosteroids. It works to treat patients with low levels of corticosteroids
by replacing steroids that are normally produced naturally by the body. It works to treat other
conditions by reducing swelling and redness and by changing the way the immune system works.

 
The nurse is caring for an elderly client who has been diagnosed as having sundown
syndrome. He is alert and oriented during the day but becomes disoriented and
disruptive around dinnertime. He is hospitalized for evaluation. The nurse asks the client
and his family to list all of the medications, prescription and nonprescription, he is
currently taking. What is the primary reason for this action?
*
1/1
Medications taken by a client are part of every nursing assessment.
Multiple medications can lead to dementia.
 
The medications can provide clues regarding his medical background.
Ability to recall medications is a good assessment of the client’s level of orientation.

 
Ms.Clark has hyperthyroidism and is scheduled for a thyroidectomy. The physician has
ordered Lugol’s solution for the client. The nurse understands that the primary reason
for giving Lugol’s solution preoperatively is to:
*
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Decrease the risk of agranulocytosis postoperatively.
Prevent tetany while the client is under general anesthesia.
Reduce the size and vascularity of the thyroid and prevent hemorrhage.
 
Potentiate the effect of the other preoperative medication so less medicine can be given while
the client is under anesthesia.

 
Corinne is experiencing diarrhea after consuming her prescribed antibiotics for the
whole week. This is because:
*
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Gastric flora is disturbed.
The drugs render food indigestible.
Normal intestinal bacteria are destroyed.
 
Fluid is added into the intestine.
Feedback
The destruction of normal intestinal flora causes diarrhea. Bacteria in the gut, for example, help
break down food. Antibiotics kill these “good” microbes along with bacteria that are causing an
infection. This upsets the balance of the normal flora in the intestines. The result is often loose,
watery stools known as antibiotic-associated diarrhea.

 
When assessing clients for evidence of a penicillin allergy, which of the following
symptoms may not be considered to be a true hypersensitivity reaction?
1/1
Nausea
 
Wheezing
Urticaria
Angioneurotic edema

 
All of the following symptoms are evidence of a superinfection except:
*
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Creamy vaginal discharge
Darkened tongue
Skin rash
 
White oral plaques

 
Antonietta is taking antitubercular, the most common adverse effect she may be
experiencing is:
*
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Hepatotoxicity
 
Red-orange discoloration of urine
Hypersensitivity
CHF

 
In the treatment of tuberculosis, the therapeutic rationale for combination drug therapy
is to:
*
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Reduce the incidence of cumulative effects.
Decrease emergence of drug-resistance strains.
 
Decrease cost and improve compliance.
Increase blood dyscrasias.
 
Changes in visual acuity and color perception are associated with treatment by which of
the following agents?
*
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PZA (pyrazinamide)
INH (isoniazid)
D. SM (streptomycin)
ETH (ethambutol)
 
 
Which of the following groups of antitubercular agents includes first-line agents?
*
1/1
SM, PAS, INH
INH, PZA, RIF
 
NH, cycloserine, RIF
EMB, PAS, INH

 
A nurse is preparing to care for a client who had undergone an above-knee amputation
of the right leg. The nurse plans to allow which position for the client in the first 24
hours?
*
0/1
Supine position, with the affected limb flat on the bed.
 
Prone position, with the affected limb in a dependent position.
Trendelenburg's position.
Supine position, with the affected limb supported with pillows.

Correct answer
Supine position, with the affected limb supported with pillows.

 
A client is to be on bed rest for 24 hours and the affected extremity is to be kept straight
during this time. Which of the following procedures would require a client to do the
above?
*
1/1
Abdominal aneurysm resection.
Myelogram.
Arterial Vascular Grafting.
 
Varicose vein surgery.
Feedback
To promote graft patency after the procedure, bedrest is maintained for the first 24 hours and the
affected extremity is kept straight. The pathophysiology of vein graft failure has been attributed to
acute thrombosis within the first month, intimal hyperplasia up to 1 year, and atherosclerosis beyond
1 year.

 
A nurse is caring for a client who has returned to the recovery unit following a
craniotomy. The nurse can safely place the client in which position?
*
1/1
Trendelenburg position.
Semi-fowler's position with the head in a midline position.
 
Fowler's position with the head leaning on the left side.
Supine position with the neck flexed.
Feedback
Post-craniotomy clients should be placed in a semi-Fowler’s position and the head is in a midline
position to facilitate venous drainage from the head. For nearly all types of craniotomy, the patient is
observed for at least the first 24 hours in a neurological intensive care unit (NICU) or general
surgical ICU. Basic laboratory tests are sent (complete blood cell count and basic metabolic panel).
Neurological examinations are performed by the nursing staff every 1-2 hours and any changes in
neurologic status.

 
A nurse is caring for a indigenous client who experiences emotional distress due to a
family problem. In anticipating pharmacological treatment for the client, the nurse
understands that they would most likely:
*
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A. Establish the trust of the health care provider first before accepting the treatment.
D. Resort with the use of herbal medicines with healing properties.
 
B. Call a clergy to ask for the religious preference of the treatment.
C. Manage the emotional distress on their own to avoid disgrace.
 
A nurse is preparing a plan of care for a client who is a Jehovah’s Witness. The client
has been told that surgery is necessary. The nurse considers the client’s religious
preferences in developing the plan of care and documents that:
*
1/1
Giving any medication is not allowed.
Alternative medicines can be advised.
Blood products can not be administered.
 
Surgery is strictly prohibited.
Feedback
Among Jehovah’s Witnesses, the administration of blood and blood products is prohibited.
Jehovah’s Witnesses believe that it is against God’s will to receive blood and, therefore, they refuse
blood transfusions, often even if it is their own blood. The willing acceptance of blood transfusions
by Jehovah’s Witnesses has in some cases led to expulsion from and ostracisation by their religious
community.

 
some patients develop urticaria (hives) or generalized itching during a transfusion; the
cause is thought to be sensitivity reaction to a plasma protein within the blood
component being transfused.

*
1/1
Bacterial Contamination
Allergic Reaction
 
Febrile Nonhemolytic Reaction
Aromatherapy reaction

 
The nurse is caring for an elderly woman who has had a fractured hip repaired. In the
first few days following the surgical repair, which of the following nursing measures
will best facilitate the resumption of activities for this client?
*
1/1
Arranging for the wheelchair
Asking her family to visit
Assisting her to sit out of bed in a chair qid
Encouraging the use of an overhead trapeze
 
Feedback
Exercise is important to keep the joints and muscles functioning and to prevent secondary
complications. Using the overhead trapeze prevents hazards of immobility by permitting movement
in bed and strengthening of the upper extremities in preparation for ambulation. Facilitates
movement during hygiene or skincare and linen changes; reduces the discomfort of remaining flat in
bed. “Post position” involves placing the uninjured foot flat on the bed with the knee bent while
grasping the trapeze and lifting the body off the bed.

 
Below are the purposes of blood transfusion except for:*
1/1
Restore blood volume
Replace Clotting factors
Improve oxygen carrying capacity
Restore red blood only
 
 
This is caused by antibodies to donor leukocytes that remain in the unit of blood or
blood component; it is the most common type of transfusion reaction.

*
1/1
Allergic Reaction
Acute Hemolytic Reaction
Bacterial Contamination
Febrile Nonhemolytic Reaction
 
 
the most dangerous and potentially life threatening, type of transfusion reaction occurs
when the donor blood is incompatible with that of the recipient

*
1/1
Acute Hemolytic Reaction
 
Allergic Reaction
Bacterial Contamination
Febrile Nonhemolytic Reaction
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