This chapter is from the book
This chapter is from the book
This chapter is from the book
Exam Prep Questions
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The client presents to the clinic with a serum cholesterol of 275 mg/dl and is placed on rosuvastatin (Crestor). Which instruction should be given to the client?
A.
Report muscle weakness to the physician.
B.
Allow 6 months for the drug to take effect.
C.
Take the medication with fruit juice.
D.
Ask the doctor to perform a complete blood count prior to starting the medication.
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The client is admitted to the hospital with a hypertensive crisis. Diazoxide (Hyperstat) is ordered. During administration the nurse should:
A.
Utilize an infusion pump.
B.
Check the blood glucose level.
C.
Place the client in Trendelenburg position.
D.
Cover the solution with foil.
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A 6-month-old client with a ventricular septal defect is receiving Lanoxin elixir for regulation of his heart rate. Which finding should be reported to the doctor?
A.
A blood pressure of 126/80
B.
A blood glucose of 110 mg/dl
C.
A heart rate of 60 bpm
D.
A respiratory rate of 30 per minute
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The client admitted with angina is given a prescription for nitroglycerine. The client should be instructed to:
A.
Replenish her supply every 3 months.
B.
Take one every 15 minutes if pain occurs.
C.
Leave the medication in the brown bottle.
D.
Crush the medication and take it with water.
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A 54-year-old male is admitted to the cardiac unit with chest pain radiating to the jaw and left arm. Which enzyme would be most specific in the diagnosis of a myocardial infarction?
A.
Aspartate aminotransferase
B.
Lactic acid dehydrogenase
C.
Hydroxybutyric dehydrogenase
D.
Creatine phosphokinase
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The client is instructed regarding foods that are low in fat and cholesterol. Which diet selection is lowest in saturated fats?
A.
Macaroni and cheese
B.
Shrimp with rice
C.
Turkey breast
D.
Spaghetti and meatballs
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The client is admitted with left-sided congestive heart failure. In assessing the client for edema, the nurse should check the:
A.
Feet
B.
Neck
C.
Hands
D.
Sacrum
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The nurse is checking the client's central venous pressure. The nurse should place the zero of the manometer at the:
A.
Phlebostatic axis
B.
Point of maximum impulse (PMI)
C.
Erb's point
D.
Tail of Sphence
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The physician orders lisinopril (Zestril) and furosemide (Lasix) to be administered concomitantly to the client with hypertension. The nurse should:
A.
Question the order.
B.
Administer the medications.
C.
Administer them separately.
D.
Contact the pharmacy.
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The best method of evaluating the amount of peripheral edema is:
A.
Weighing the client daily
B.
Measuring the extremity
C.
Measuring the intake and output
D.
Checking for pitting
Answer Rationales
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Answer A is correct. The client taking antilipidemics should be encouraged to report muscle weakness because this is a sign of rhabdomyositis. The medication takes effect within 1 month of beginning therapy, so answer B is incorrect. The medication should be taken with water. Fruit juice, particularly grapefruit juice, can decrease the drug's effectiveness, so answer C is incorrect. Liver function studies, not a CBC, should be checked prior to beginning the medication, so answer D is incorrect.
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Answer B is correct. Hyperstat is given IV push for hypertensive crisis. It often causes hyperglycemia. The glucose level will drop rapidly after the medication is administered. Answer A is incorrect because this medication is given IV push. The client should be placed in dorsal recumbent position, not Trendelenburg, so answer C is incorrect. Answer D is incorrect because the medication is ordered IV push.
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Answer C is correct. A heart rate of 60 in the 6-month-old receiving Lanoxin elixir (digoxin) should be reported immediately because bradycardia is associated with digoxin toxicity. The blood glucose, blood pressure, and respirations are not associated with administration of Lanoxin, so answers A, B, and D are incorrect.
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Answer C is correct. The client should leave the medication in the brown bottle because light deteriorates the medication. The supply should be replenished every 6 months, so answer A is incorrect. One tablet should be taken every 5 minutes times three, so answer B is incorrect. If the pain does not subside, the client should report to the emergency room. The medication should be taken sublingually and should not be crushed, so answer D is incorrect.
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Answer D is correct. CK-MB (creatine phosphokinase muscle bond isoenzyme) is the most specific for a myocardial infarction. Troponin is also extremely reliable. Answers A, B, and C are nonspecific to myocardial infarctions, so they are incorrect.
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Answer C is correct. Turkey contains the least amount of fat and cholesterol. Cheese, shrimp, and beef should be avoided by the client on a low cholesterol, low fat diet; therefore, answers A, B, and D are incorrect.
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Answer B is correct. The neck veins should be assessed for distension in the client with congestive heart failure. Edema of the feet and hands do not indicate central circulatory overload, so answers A and C are incorrect. Edema of the sacrum is an indication of right-sided congestive heart failure, so answer D is incorrect.
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Answer A is correct. The nurse should place the zero of the manometer at the phlebostatic axis (located at the fifth intercostal space mid-axillary line) when checking the central venous pressure. Answers B, C, and D are incorrect methods for determining the central venous pressure.
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Answer B is correct. Zestril is an ACE inhibitor and is frequently given with a diuretic such as Lasix. There is no need to question the order, give the drugs separately, or contact the pharmacy, so answers A, C, and D are incorrect.
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Answer B is correct. The best method for evaluating the amount of peripheral edema is measuring the extremity. A paper tape measure should be used rather than plastic or cloth, and the area should be marked with a pen. This provides the most objective assessment. Answers A, C, and D are not the best methods for evaluating the amount of peripheral edema, therefore they are incorrect.