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EE Pre-Assessment Quiz © CLOSE Time Remaining: a 08:19:50 « Question: 1 of 30 CORRECT Pause Remaining: PAUSE 00:05:00 FLAG A nurse is collecting data from a client who is to start taking digoxin for heart failure. The nurse should instruct the client to avoid taking which of the following herbal supplements? e e ° e ° ° oeoo 0 INCORRECT There are no interactions between feverfew and digoxin. ® t. John's wort CORRECT Taking St. John’s wort concurrently with digoxin can increase excretion of the medication and thus decrease its effectiveness. hinacea INCORRECT There are no interactions between echinacea and digoxin. Valerian INCORRECT There are no interactions between valerian and digoxin. ee Pre-Assessment Quiz © CLOSE Time Remaining: . 7 08:15:44 Question: 3 of 30 INCORRECT Pause Remaining: PAUSE *”« 00:05:00 FLAG A nurse is reinforcing teaching with a client who has diabetes mellitus and a new prescription for prednisone. Which of the following statements indicates an understanding of the teaching? oseoeeoeee Gere eOseeoeoece | might notice a decrease in my blood sugar while taking this medication. Prednisone, a glucocorticoid, might increase glucose levels. | should expect to feel hungrier while on this medication." CORRECT Prednisone causes an increase in appetite. "| might have a fever while taking this medication." INCORRECT Prednisone causes immunosuppression. The client should be instructed that any sign of infection, including fever or sore throat, needs to be reported to the provider. e "This medication can cause ringing in my ears. INCORRECT Prednisone does not cause tinnitus. —-PREMIOUS previous i —EEE——— Pre-Assessment Quiz © CLOSE Time Remaining: a 08:15:14 *” Question: 4 of 30 INCORRECT Pause Remaining: PAUSE 00:05:00 FLAG A nurse is caring for a client who has asthma. The client asks the nurse how albuterol helps his breathing. Which of the following information should the nurse include in the response? (Select all that apply.) * . ° e ° ° oo 8 © oO nedication will increase the amount of mucus he tion will prevent wheezing. VY The medication will open the airways. JV le Medication will reduce inflammation Vv The medication will decr ease coughing episoc INCORRECT The medication will increase the amount of mucus is incorrect, Asthma is characterized by bronchoconstriction, airway edema, and increased mucus production. Albuterol reduces inflammation and relaxes the airways, allowing for expectoration of mucus. The medication will prevent wheezing is correct. Albuterol may be used to Prevent or treat wheezing by promoting bronchodilation and relieving bronchospasm. The medication will open the airways is correct. Albuterol promotes bronchodilation. The primary purpose is to provide rapid relief of bronchoconstriction, thus Opening the airway and improving oxygenation. The medication will reduce inflammation is incorrect. Albuterol does not reduce inflammation. Steroid medications reduce inflammation. The medication will decrease coughing episodes is correct. Coughing is often an early indicator of bronchospasm. Albuterol provides a rapid response to reduce bronchoconstriction, which will decrease coughing. _ PREVIOUS ee Pre-Assessment Quiz © CLOSE Time Remaining: - 08:13:17 «7 Question: 6 of 30 CORRECT Pause Remaining: PAUSE 00:05:00 A nurse is reinforcing discharge teaching with a client who has pulmonary tuberculosis and is to start taking rifampin. Which of the following information should the nurse include? . ee @ eosoeeoeeeeeae04e48ee Purified protein derivative skin test results will improve in 3 months. If a client has a positive tuberculin skin test, he will always have a positive result to the test. Expect to have insomnia while taking this medication INCORRECT Rifampin is more likely to cause fatigue and drowsiness than insomnia. Take the medication with meals. INCORRECT The client should take rifampin 1 hr before or 2 hr after meals. e Urine and other secretions will turn orange. CORRECT Rifampin will turn the urine and other secretions a harmless reddish-orange color. This includes sputum, tears, and sweat. eS Pre-Assessment Quiz (x) CLOSE Time Remaining: . 7 08:11:04 FS Question: 7 of 30 CORRECT Pause Remaining: PAUSE 00:05:00 FLAG A nurse is preparing to administer amoxicillin 350 mg PO. Available is amoxicillin 250 mg/5 mL. How many mL should the nurse administer? (Round to the nearest whole number.) 3 e ° e ° ° ee 8 8 oO CORRECT Ratio and Proportion STEP 1: What is the unit of measurement the nurse should calculate? mL STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 350 mg STEP 3: What is the dose available? Dose available = Have 250 mg STEP 4: Should the nurse convert the units of measurement? No STEP 5: What is the quantity of the dose available? 5 mL STEP 6: Set up an equation and solve for X. Have/Quantity = Desired/X 250 mg/5 mL = 350 mg/X mL X=7mL STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 250 mg/5 mL and the prescription reads 350 mg, it makes sense to administer 7 mL. The nurse should administer amoxicillin 7 mL PO. Desired Over Have STEP 1: What is the unit of measurement the nurse should calculate? mL STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 350 mg STEP 3: What is the dose available? Dose available = Have 250 mg STEP 4: Should the nurse convert the units of measurement? No STEP 5: What is the quantity of the dose available? 5 mL STEP 6: Set up an equation and solve for X. Desired x Quantity/Have = X 350 mg x 5 mL/250 mg = X mL X=7mL STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 250 mg/5 mL and the prescription reads 350 mg, it makes sense to administer 7 mL. The nurse should administer amoxicillin 7 mL PO. Dimensinnal Analvcis SS Pre-Assessment Quiz © CLOSE Time Remaining: Question: 8 of 30 CORRECT . 08:08:22 pause «“ ause Remaining: 00:05:00 FLAG A nurse is caring for a client whose serum potassium level is 5.3 mE q/L. The nurse should anticipate a prescription for which of the following medications? » ° ° ® ° @e @Ceee¢ee Potassium chloride INCORRECT Aserum potassium level of 5.3 mEq/L is above the expected reference range. The nurse should not anticipate the administration of potassium chloride, because it is used to treat hypokalemia. tylcysteine INCORRECT Acetylcysteine is an antidote used to treat acetaminophen poisoning. ® Sodium polystyrene CORRECT In addition to calcium gluconate, glucose and insulin, sodium polystyrene is administered orally or rectally to absorb excess potassium. otassium iodide INCORRECT A serum potassium level of 5.3 mEq/L is above the expected reference range. The nurse should not anticipate the administration of potassium iodide, because it is used to treat hypokalemia. i EE— Pre-Assessment Quiz © CLOSE Time Remaining: — 08:09:03 m= Question: 9 of 30 CORRECT Pause Raewainieag PAUSE 00:05:00 FLAG A nurse is reinforcing teaching with a client who has a new prescription for codeine. Which of the following information should the nurse include in the teaching? oeeor Ct ert ee eeeoeeeee Take on an empty stomach to prevent nausea INCORRECT Nausea and vomiting are common adverse effects that can be minimized by taking the medication with food or milk. Limit alcohol intake to 12 oz daily. INCORRECT Codeine causes CNS depression. Therefore, other CNS depressants such as alcohol should be avoided. Diarrhea is an expected adverse effect. INCORRECT Codeine is an opioid analgesic that can cause constipation. e Change positions slowly. CORRECT Codeine is an opioid analgesic that causes CNS depression and orthostatic hypotension. The client should change positions slowly to avoid the risk of falls. TT —— Pre-Assessment Quiz © CLOSE Time Remaining: . 7 08:07:52 ne Question: 11 of 30 CORRECT Pause Remaining: PAUSE 00:05:00 FLAG A nurse is caring for a client who has herpes zoster. Which of the following actions should the nurse take? eof e er Os eer eoseeoeseaaeaoee Apply dry, sterile gauze dressings to affected areas. INCORRECT The nurse can apply cool compresses to the affected areas of herpes zoster; however, dry gauze should be avoided. e Prepare to administer acyclovir CORRECT Acyclovir is effective in the treatment of herpes zoster, especially if administered within the first 2 to 3 days of the eruption. Instruct family with a history of chickenpox that they should not visit the client. INCORRECT Individuals with a history of chickenpox or the varicella vaccine are not at risk for contracting herpes zoster and can visit the client. Apply topical corticosteroids to the affected areas. INCORRECT Systemic corticosteroids can be used for the treatment of herpes zoster to decrease pain and attempt to prevent postherpetic pain. bi i —EeEE— Pre-Assessment Quiz (x) CLOSE Time Remaining: Question: 12 of 30 CORRECT 08:07:31 eae ~ Pause Remaining: 00:05:00 A nurse is caring for a client who is scheduled for surgical repair of a femur fracture and has a prescription for lorazepam preoperatively. Which of the following statements by the client should indicate to the nurse that the medication has been effective? 2 e ° e ° ° ooo oOo 0 Vly mouth is very dry.” INCORRECT The nurse should recognize that oral dryness is most likely a result of the client being NPO prior to surgery and not an effect of lorazepam. e feel very sleepy. CORRECT The nurse should recognize that preoperative doses of benzodiazepines such as lorazepam relieve anxiety and promote sedation. m not nungry any long INCORRECT The nurse should recognize anorexia as an adverse, but unintended, effect of lorazepam. eels numb INCORRECT The nurse should identify that one of the effects of lorazepam is muscle relaxation, which may decrease the pain experienced with a femur fracture; however, numbness of the extremity is not an effect of lorazepam. I Pre-Assessment Quiz @ CLOSE Time Remaining: _— 08:06:51 « Question: 14 of 30 CORRECT Pause Remaining: PAUSE 00:05:00 FLAG A nurse is reinforcing teaching with a client who is prescribed ferrous sulfate. Which of the following statements by the client indicates an understanding of the teaching? ° e ° e o. @ oo 80 8 Oo will expect the color of my urine to be amber.’ INCORRECT The nurse should instruct the client that color of the urine is an indication of how concentrated the urine is and can be affected by food and medications, but that ferrous sulfate does not affect the color of the urine. e will expect dark, tarry sto CORRECT Ferrous sulfate is an iron supplement used to treat clients with iron deficiency anemia. An expected side effect of this medication is black, tarry stools. | take INCORRECT 2 care to protect against increased bruising. The nurse should instruct the client that anticoagulant medications affect bleeding and can make the client prone to bruising. Blood counts and iron levels can help determine the effectiveness of ferrous sulfate therapy. | will not get as many infections INCORRECT Ferrous sulfate is an iron supplement that will not impact white blood cells. The nurse should instruct the client to practice appropriate hygiene and food preparation techniques. EE Pre-Assessment Quiz © CLOSE Time Remaining: — 08:05:10 Question: 15 of 30 CORRECT Pause Remaining: PAUSE = 00:05:00 FLAG A nurse is caring for a client who is postoperative and receiving fentanyl via patient controlled analgesia. The client has a prescription for naloxone. The nurse understands that the purpose of naloxone is which of the following? @ * ° e > @ »* @ © @ @ @ @ o To suppress t espiratory secretions INCORRECT Atropine suppresses respiratory secretions. e Block the effects of opioids on the central nervous system CORRECT Naloxone is a narcotic antagonist that combines competitively with Opiate receptors and blocks or reverses the action of narcotic analgesics. By blocking the effects of narcotics on the central nervous system (CNS), it prevents CNS and respiratory depression. treat nausea INCORRECT Ondansetron is used to treat postoperative nausea. O treat urinary retention INCORRECT Bethanechol is used to treat postpartum and postoperative urinary retention. PREVIOUS Ee Pre-Assessment Quiz © CLOSE Time Remaining: . . 08:03:06 Question: 17 of 30 CORRECT Pinas asnaininge PAUSE *« 00:05:00 FLAG A nurse is collecting data from a client who has been taking esomeprazole for several months. Which of the following client statements should the nurse identify as indicating effectiveness of the medication? e ° ° ° °o ° oo 90 OO My feet are no longer sore and itchy.’ INCORRECT Esomeprazole is not prescribed for pain or itching. Adverse effects of esomeprazole include dry skin and rash. an move my joints more easily." INCORRECT Esomeprazole (Nexium) is a proton pump inhibitor that works by decreasing gastric acid secretion, thereby decreasing the gastric acidity that contributes to the symptoms of GERD. Abdominal distention can be a result of increased gas production or decreased intestinal peristalsis. If the client states his abdomen is no longer firm and is soft and flat, it is unlikely that he is experiencing distention. However, because abdominal distention is not the main symptom of GERD, it is not the best indication that the medication is working effectively. e don't have pain in my stomach anymore. CORRECT Esomeprazole is a proton pump inhibitor that treats gastric ulcers, duodenal ulcers, and gastroesophageal reflux disease. Therefore, this statement indicates the medication is improving the client's condition. / bowel movements have increased in frequency and are much softer INCORRECT Esomeprazole Is not prescribed to promote bowel movements. The nurse should instruct the client to report diarrhea while taking esomeprazole because the medication can increase the risk of Clostridium difficile infection. i E—— Pre-Assessment Quiz © CLOSE Time Remaining: "_ 08:02:39 * Question: 18 of 30 CORRECT Pause Remaining: (aaa 00:05:00 A nurse is preparing to administer ceftriaxone 3 mL intramuscularly to an adult client. Which of the following actions should the nurse plan to take? ° . ° « oO, 0 ooo 80 oO Select a 5/8-inch needle. INCORRECT Ceftriaxone, a cephalosporin, should be injected deeply into the muscle. The nurse should select a 1.5-inch needle to administer this medication intramuscularly for most adult clients. For obese clients, a 2-inch needle might be needed to inject the medication safely into the muscle. nject at a 45° angle. INCORRECT When administering an IM injection, the syringe should be held at a 90° angle. A 45° or 90° angle can be used when administering a subcutaneous injection. 5-gauge needle INCORRECT A 21- or 22-gauge needed should be chosen to administer ceftriaxone intramuscularly. cate the ventrogluteal site CORRECT When administering ceftriaxone intramuscularly, it should be injected deeply into a large muscle. The ventrogluteal site is preferred when more than 1 mL of medication is to be injected. This site contains no large nerves or blood vessels and has less subcutaneous fat than other parts of the buttock area. 
