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NURS 498 Midterm 1 2025 Exam Practice Questions with VERIFIED and Correct Answers, Exams of Nursing

Xavier UniversityNursing

NURS 498 Midterm 1 2025 Exam Practice Questions with VERIFIED and Correct Answers Complete and Full A+ Graded-Xavier University

Typology: Exams

2024/2025

Available from 03/19/2025

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NURS 498 Midterm 1 2025 Exam Practice
Questions with VERIFIED and Correct Answers
Complete and Full A+ Graded-Xavier University
A 75-year-old female patient has been given naproxen sodium (Aleve®) for the
treatment of rheumatoid arthritis. Which type of medication will have a possible
interaction with this NSAID?
Anticoagulants taken with NSAIDs may cause increased bleeding tendencies because
of platelet inhibition and hypoprothrombinemia.
A 75-year-old female patient has been given naproxen sodium (Aleve®) for the
treatment of rheumatoid arthritis. Which type of medication will have a possible
interaction with this NSAID?
Anticoagulants taken with NSAIDs may cause increased bleeding tendencies because
of platelet inhibition and hypoprothrombinemia.
Corticosteroids have many actions. These include:
- Reduces the release of interleukin-1
- Promotes the production of glycogen in the liver
- Promote the redistribution of fat
- Decreases migration of WBCs
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Download NURS 498 Midterm 1 2025 Exam Practice Questions with VERIFIED and Correct Answers and more Exams Nursing in PDF only on Docsity!

NURS 498 Midterm 1 2025 Exam Practice

Questions with VERIFIED and Correct Answers

Complete and Full A+ Graded-Xavier University

A 75-year-old female patient has been given naproxen sodium (Aleve®) for the treatment of rheumatoid arthritis. Which type of medication will have a possible interaction with this NSAID? Anticoagulants taken with NSAIDs may cause increased bleeding tendencies because of platelet inhibition and hypoprothrombinemia. A 75-year-old female patient has been given naproxen sodium (Aleve®) for the treatment of rheumatoid arthritis. Which type of medication will have a possible interaction with this NSAID? Anticoagulants taken with NSAIDs may cause increased bleeding tendencies because of platelet inhibition and hypoprothrombinemia. Corticosteroids have many actions. These include:

  • Reduces the release of interleukin- 1
  • Promotes the production of glycogen in the liver
  • Promote the redistribution of fat
  • Decreases migration of WBCs

Corticosteroids can cause many adverse effects except which one? Lethargy Which of the following is not a conventional disease-modifying antirheumatic drug (DMARD)? Peginterferon alfa-2a Which antiretroviral medication is offered during pregnancy to an HIV-positive woman? Zidovudine (retrovir) A person on immunosuppressant therapy has an increased risk for cancer? T/F TRUE A patient with RA is taking cyclosporine. What treatment should we avoid? Varicella zoster vaccine Which of the following class of medications is not an antiretroviral used for HIV?

The nurse determines that dietary teaching for an older-adult client who has osteoporosis has been most successful when the client selects which one of the following highest calcium meals? A sardine (85 g) sandwich on whole wheat bread, 237 mL of fruit yogurt, and 237 mL of skim milk The nurse is reinforcing health teaching about osteoporosis with an older-adult client who is hospitalized. Which of the following information will the nurse explain to the client in relation to osteoporosis?

  • Even with a family history of osteoporosis, the calcium loss from bones can be slowed by increased calcium intake and exercise.
  • Regular physical activity is important to build up and maintain bone mass. Exercise also increases muscle strength, coordination, and balance. The best exercises are weight-bearing exercises that force an individual to work against gravity. These include walking, hiking, weight training, stair climbing, tennis, and dancing. Walking is preferred to high-impact aerobics or running, both of which may put too much stress on the bones, resulting in stress fractures. Walking for 30 minutes, three times a week is recommended. The nurse is caring for an older-adult client who has undergone left knee arthroplasty with prosthetic replacement of the knee joint to relieve the pain of severe osteoarthritis. Postoperatively the nurse expects which of the following interventions will be included in the care of the affected leg? Progressive leg exercises to obtain 90-degree flexion A 51-year-old female will be starting raloxifene as part of the treatment of postmenopausal osteoporosis. The nurse should inform this patient about which possible occurrence.
  • Venous thrombosis
  • Selective estrogen receptor modulators (SERMs), such as raloxifene, increase the risk of venous thromboembolism. The nurse is caring for a client following spinal surgery. Which of the following nursing interventions is most appropriate when turning the client?
  • Placing a pillow between the client's legs and turning the body as a unit.
  • Postoperative nursing interventions focus on maintaining proper alignment of the spine at all times until healing has occurred. The nurse is reinforcing health teaching about the management of osteoarthritis (OA) with a client. Which of the following client statements indicate a need for additional instruction? "I should try to stay standing all day to keep my joints from becoming stiff." The nurse is caring for a client with osteoarthritis who is about to undergo left total knee arthroplasty (TKA). The nurse assesses the client carefully to be sure that there is no evidence of which of the following symptoms in the preoperative period. Left knee infection The nurse is completing discharge teaching with an older-adult client who underwent right total hip arthroplasty (THA). Which of the following client statements indicates a need for further instruction?

Which of the following are contraindications for NSAID use? Peptic ulcer disease Salicylate intoxication includes which of the following symptoms: Tinnitus and hearing loss What herb is sometimes used for osteoarthritis? Glucosamine What is the required nursing action if a patients viral load is not decreasing/ experiencing too many side effects? ART may need to be changed if it is not reducing the viral load or if the patient is not tolerating the side effects What is reduced/ prevented with ART during pregnancy? Vertical transmission is reduced or prevented with ART during pregnancy What are immunosuppressants used for? Immunosuppressant medications are used to slow or shut off parts of the immune system, such as with autoimmune diseases, organ transplantation

What are some risks with taking immunosuppressants and what should you avoid when on them?

  • Risk of infections or malignancies
  • Avoid live vaccines, crowds, and places with high rates of illness (ER, doctors) What should a patient be assessed for before starting immunosuppressant therapy? latent diseases (TB, chest x-ray) What are the adverse effects of corticosteroids?
  • hyperglycemia, edema, osteoporosis, cataracts, depression, dryness of mouth and throat, coughing, hypertension, increased WBC What are the adverse effects of NSAIDs? GI irritation, tinnitus, hyperventilation, increased uric acid levels, bleeding, Edema, Acute Renal Failure What are you at risk for with an open fracture, open reduction, and external fixation? Risk for infection
  • Monitor for compartment syndrome characterized by the 6 Ps
  • Monitor for signs and symptoms of a fat embolism (e.g., dyspnea, chest pain, temperature elevation). What foods should you avoid when experiencing gout/ a gout flareup? foods high in purine (alcoholic beverages, some fish, seafood and shellfish, including anchovies, sardines, some meats, such as bacon, turkey, veal, venison and organ meats like liver) What are the 6 P's of fractures?
  1. Pain/ point of tenderness
  2. Pulselesness: distal to the fracture site
  3. Pallor
  4. Paresthesia: sensation distal to the fracture site
  5. Paralysis: movement distal to the fracture site
  6. Pressure: compartment syndrome What are you at risk for with a posterior approach with a hip fracture? dislocation What is included in the patient teaching for a posterior approach for a hip fracture? (3)
  • Do not bend the hip more than 90 degrees.
  • Do not cross legs or feet.
  • Sleep on the back for the first 6 weeks. What are bisphosphonates?
  • For osteoporosis.
  • Work by inhibiting osteoclast-mediated bone resorption, which in turn indirectly enhances the bone mineral density What are examples of bisphosphonates? alendronate (Fosamax), etidronate (Ditrocal), regimen risedronate (Actonel), zoledronic Acid (Aclasta) What are some patient teachings for taking bisphosphonates? (3)
  • GI burning, GI upset
  • Must take with a full glass of water and remain upright for 30 minutes
  • Let the dentist know if these medications When would a physician not prescribe bisphosphonates? (3)
  • Hot flashes, increased risk for DVT When taking a SERM, what should you do if you will be experiencing prolonged inactivity? (why) Discontinue use for 72 hours before planned prolonged inactivity
  • increased risk for VT Why is milrinone used for a patient with heart failure? Positive inotropic effect= Vasodilation What is the cardinal sign of digoxin toxicity? Vision changes If a patient is on a drug that has a positive inotropic effect, what will happen? Increased force of heart contraction What may put a patient at risk of digoxin toxicity? Hypokalemia

What does a negative chronotropic effect mean? DECREASED HEART RATE What is the reason an ACE-I may be used for a patient with heart failure? Decrease preload ARBs are used to decrease systemic vascular resistance. This is also known as what? Afterload Beta blockers do what? (4)

  1. Protect the heart from norepinephrine
  2. Slow the heart rate
  3. Lower the blood pressure
  4. Delay the AV node conduction All patients with A. Fib should be on this medication. Anticoagulant
  • More for antidysrhythmic properties
  • decreased the automaticity of the SA node
  • decreases the conduction in the AV node What are the Class III dysrhythmic drugs? potassium channel blockers
  • delay repolarization What are the Class IV dysrhythmic drugs? Calcium Channel Blockers
  • limited use in tachycardia
  • decreased the automaticity of the SA node
  • delay AV node conduction What do digoxin and adenosine do?
  • They decreased the conduction through the AV node.
  • Reduce the automaticity of the SA node What should you do before administering cardiac drugs? Monitor vital signs before giving most cardiac drugs (BP and HR)

What are signs of Digoxin toxicity? bradycardia, headache, fatigue, malaise, confusion, halo effect, seeing green, color changes What can Antidysrhythmic drugs cause? Antidysrhythmic drugs can cause dysrhythmia Why are statins are used for vascular diseases?

  • reduce the amount of fatty deposits in your arteries and stop any more from building up.
  • make existing deposits less likely to break off and cause a blood clot.
  • increase endothelium-dependent vasodilation. What are the treatments for venous insufficiency? (8)
  • Daily moisturizer for the area
  • Avoid long periods of standing
  • Daily walking program
  • Leg position above the heart
  • Compression Stockings
  • Salted nuts.
  • Beans canned with salt added.
  • soups A patient with active HIV has been taking zidovudine (Retrovir®). Which potential adverse effect may limit the length of time this medication can be taken?
  • Bone marrow suppression.
  • The major dose-limiting adverse effect of zidovudine is bone marrow suppression, and this is often the reason a patient with an HIV infection must be switched to another anti-HIV medication. A patient has used buffered acetylsalicylic acid (Aspirin) for several years as a treatment for osteoarthritis. However, the patient's symptoms are worsening, and now something stronger is needed. The physician prescribes an NSAID and misoprostol. The patient asks the nurse why two pills now have to be taken for arthritis. Which is the nurse's best response to the patient?
  • Misoprostol may help to prevent gastric ulcers that may occur when taking NSAIDs.
  • Misoprostol inhibits gastric acid secretions and stimulates mucous secretions and has proved successful in preventing gastric ulcers that may occur in patients taking NSAIDs. A patient with acquired immune deficiency syndrome (AIDS) has been taking zidovudine (AZT) therapy for almost 1 year. The physician has decided to change the medication to a new ART called didanosine (Videx EC®). The patient is very concerned about this medication change. What is the nurse's best explanation to the patient?
  • The patient may have been experiencing bone marrow suppression due to the zidovudine therapy. - Bone marrow suppression is often the reason why a patient with a human immunodeficiency virus (HIV) infection needs to be switched to another anti- HIV drug, such as didanosine. Zidovudine and didanosine can be taken together by cutting back on the doses of both, thus decreasing the likelihood of toxicity. The nurse is teaching a client about immunosuppressant therapy after a kidney transplant about the post-transplant drug regimen. Which of the following statements by the client should alert the nurse that additional teaching is required?
  • After a couple of years, it is likely that I will be able to stop taking the calcineurin inhibitor.
  • The calcineurin inhibitor will need to be continued for life. The other client statements are accurate and indicate that no further teaching is necessary about those topics. Which potential problem is of most concern for a patient receiving immunosuppressant drugs? Increased susceptibility to infections Neurotoxicity and confusion may be a problem with some immunosuppressants but a heightened susceptibility to opportunistic infections is a major risk factor for immunosuppressed patients. When providing patient education related to immunosuppressive therapy, which items of information will the nurse include?
  • It is important to have a 1-week supply of medication.