Monday, March 8, 2010

Pharmacology questions

Linton: Introduction to Medical-Surgical Nursing,
these are the questions I took from my nursing CD.

Chapter 1: Introduction

Review Questions
1. Controlled drugs are:
A. regulated by state and local laws more than federal laws.
B. categorized according to prescription or nonprescription status.
C. scheduled according to medical use and potential for abuse.
D. those that must demonstrate high standards of safety.

2. Why is it helpful for the nurse to know the generic names of more commonly used drugs?
3. Most modern drugs are:
A. synthetic products manufactured in laboratories.
B. synthetic modifications of natural products.
C. natural products derived from plants.
D. natural products derived from minerals.

Chapter 2: How Drugs Work

Review Questions
1. A person with liver disease may have impaired:
A. distribution.
B. absorption.
C. metabolism.
D. excretion.

2. Identify five factors that affect drug distribution in the body.

3. A drug is given orally. After absorption, most of the drug is inactivated as the blood passes through the liver, so there is no therapeutic effect. This is called:
A. tolerance.
B. first-pass effect.
C. antagonism.
D. pharmacodynamics.

4. The ability of drugs to attach to specialized regions of cells is the basis of which theory of drug action?
A. Chemical action
B. Physical action
C. Altered metabolic pathways
D. Receptor theory of drug action

5. Identify the factors that affect the way a person responds to a drug.

Chapter 3: Nurses and Drug Therapy

Review Questions
1. Which of the following statements is true regarding your responsibility for drug therapy?
A. You are not liable for mistakes as long as you follow orders.
B. You are accountable for your actions as a licensed nurse.
C. You cannot be expected to recognize adverse drug effects.
D. You cannot refuse to carry out a legal order.

2. During the initial admission assessment, a patient reports that he is allergic to a particular medication. The nurse should:
A. disregard the information as unimportant, because the patient will not be receiving that particular drug.
B. suspect that the patient overdosed on the drug.
C. ask what symptoms occurred with the allergic reaction.
D. determine whether the patient was taking any herbal supplements at the time.

3. In teaching a client about the adverse effects of a newly ordered drug, which of the following should be included?
A. Adverse effects that the client is likely to experience
B. A detailed list of all potential adverse effects
C. Percentages of particular adverse effects that occurred during clinical trials of the drug
D. Research data about rare adverse effects

Chapter 4: Anti-Inflammatory Drugs

Review Questions
1. Which body system is most often affected by adverse effects of PSIs?
A. Gastrointestinal
B. Central nervous
C. Cardiovascular
D. Endocrine

2. Teaching for the client who is taking a coxib should include which of the following?
A. “You may safely increase the dose as needed.”
B. “There is an increased risk of bleeding with this drug.”
C. “You will have no risk of increasing your blood pressure with this drug.”
D. “Notify your health care provider if abdominal pain or black stools occur.”

3. The actions of acetaminophen are similar to those of aspirin except that acetaminophen is NOT an:
A. anti-inflammatory.
B. analgesic.
C. antipyretic.
D. antimicrobial.

4. Aspirin should not be used to treat viral infections in children because it may cause:
A. kidney failure.
B. gastric ulcers.
C. Reye’s syndrome.
D. confusion.

Chapter 5: Anti-Infective Drugs

Review Questions
1. A client is to begin taking ampicillin. In her drug history, the nurse notes that she uses birth control pills for contraception and takes an over-the-counter antihistamine for allergies. What teaching will be important?
A. The antihistamine will interfere with the action of ampicillin.
B. Discontinue birth control pills while taking ampicillin.
C. Use an additional method of contraception while taking ampicillin.
D. Take ampicillin at least 1 hour before taking birth control pills.

2. When preparing to give a patient his first dose of ceftriaxone (Rocephin), the nurse asks if he is allergic to any drugs. He replies that he had an anaphylactic reaction to penicillin in the past. The nurse should:
A. administer the ceftriaxone and observe him closely for a reaction.
B. withhold the ceftriaxone and notify the health care provider.
C. tell him ceftriaxone is not a type of penicillin so it will be safe for him.
D. tell him this is what the doctor ordered.

3. The most serious adverse effects of aminoglycosides are:
A. constipation and abdominal pain.
B. migraine headaches and phlebitis.
C. muscle weakness and dry mouth.
D. ototoxicity and nephrotoxicity.

4. Which type of antimicrobial should not be given with dairy products?
A. Tetracycline
B. Aminoglycosides
C. Beta-lactams
D. Sulfonamides

5. A client is being treated with isoniazid (INH) to prevent development of active tuberculosis. Why has the health care provider also ordered pyridoxine (vitamin B6) in addition to the isoniazid?
A. People with tuberculosis tend to be undernourished and need vitamin supplements.
B. Vitamin B6 will decrease neurologic side effects of isoniazid.
C. Pyridoxine is effective against the organism that causes tuberculosis.
D. Vitamin B6 promotes absorption of isoniazid.

6. Why are multiple drugs recommended to treat active tuberculosis?

7. To be effective in the treatment of influenza A, amantadine (Symmetrel) must be given:
A. for a minimum of 2 weeks.
B. before symptoms develop.
C. 24 hours after exposure to the infection.
D. within 48 hours of the onset of symptoms.

8. Therapeutic effects of drugs used for treatment of the human immunodeficiency virus (HIV) are assessed by monitoring:
A. body temperature.
B. white blood cell counts.
C. CD4 T cell counts.
D. urine HIV RNA.

9. While receiving an intravenous infusion of amphotericin B, a patient complains of headache, nausea, and chills. The nurse should do which of the following?
A. Explain that this is expected.
B. Discontinue the infusion.
C. Contact the pharmacist for guidance.
D. Call the health care provider to request a change in drugs.

10. The adverse effects of amphotericin B infusions can be reduced by premedicating the patient with:
A. diphenhydramine, aspirin, and meperidine.
B. morphine, diazepam, and acetaminophen.
C. codeine, chlorpromazine, and Maalox.
D. meperidine, diazepam, and aspirin.

Chapter 6: Analgesics

Review Questions
1. Codeine, morphine, and meperidine are examples of:
A. nonsteroidal anti-inflammatory drugs.
B. opioid agonists.
C. opioid agonist-antagonists.
D. nonopioid analgesics.

2. The classic signs of opioid toxicity are:
A. nausea, vomiting, diarrhea.
B. respiratory depression, euphoria, physical dependence.
C. coma, respiratory depression, pinpoint pupils.
D. increased intracranial pressure, decreased reflexes, coma.

3. Place the patient in a recumbent position to administer parenteral opioids to reduce the risk of:
A. orthostatic hypotension.
B. respiratory depression.
C. increased intraocular pressure.
D. cardiac depression..

4. Nausea, vomiting, changes in vision and hearing, drowsiness, confusion, and hyperventilation are classic signs of:
A. opioid agonist-antagonist overdose.
B. orthostatic hypotension.
C. drug withdrawal.
D. salicylate toxicity.

5. The most important laboratory tests that the nurse should evaluate for a patient suspected of an acetaminophen overdose are:
A. hemoglobin, hematocrit, white blood cell count.
B. plasma salicylate.
C. liver function tests.
D. blood urea nitrogen and creatinine.

Chapter 7: Sedative/Hypnotics

Review Questions
1. Barbiturates are known as liver enzyme inducers. This means that:
A. an additional enzyme must be administered concurrently to prevent toxicity.
B. barbiturates will be metabolized very slowly.
C. use of barbiturates produces permanent alteration in drug-metabolizing enzymes.
D. barbiturates increase the liver’s ability to metabolize themselves, as well as other drugs given concurrently, producing drug tolerance.

2. Benzodiazepines are more commonly prescribed as hypnotics over the barbiturates because benzodiazepines:
A. induce liver enzymes.
B. provide pain relief also.
C. do not suppress REM sleep.
D. have no potential for physical dependence.

3. The antidote/antagonist specific for benzodiazepine overdose is:
A. naloxone (Narcan).
B. flumazenil (Romazicon).
C. neostigmine (Prostigmin).
D. naltrexone (ReVia, Trexan).

Chapter 8: General/Local Anesthetic Agents

Review Questions
1. Which of the following nursing actions is most appropriate to aid in excretion of a general anesthetic agent from a postoperative patient’s body?
A. Turn, cough, and deep breathe.
B. Increase IV fluid rate.
C. Offer oral fluids as soon as possible.
D. Use passive range-of-motion exercises.

2. Care for a patient who has received local anesthesia includes the knowledge that:
A. sensation returns before motor function.
B. motor function returns before sensation.
C. sensation and motor function return simultaneously.
D. close, frequent assessment of vital signs is not as important as for a patient receiving general anesthesia.

3. A patient has had topical local anesthesia applied to her mouth and throat for a diagnostic procedure. What is the most important information the nurse needs to know before offering her something to drink?
A. The patient’s urine output is adequate.
B. The patient is able to hold the glass herself.
C. The patient’s gag reflex has returned.
D. The nurse knows type of sedation used during the procedure.

Chapter 9: Skeletal Muscle Relaxants

Review Questions
1. Which of the following is the drug of choice to prevent or treat malignant hyperthermia?
A. diazepam (Valium)
B. acetaminophen (Tylenol)
C. edrophonium (Tensilon)
D. dantrolene (Dantrium)

2. A postsurgical patient who received succinylcholine as part of his anesthesia asks the nurse why his muscles and throat are so sore. The nurse’s best response is:
A. “This is a normal response to a muscle relaxant you received during surgery and should go away in 24 to 48 hours.”
B. “I’m very concerned about this. I will call your doctor right away.”
C. “You must have been fighting the anesthesia and had to be restrained.”
D. “I’ll get you some pain medication.”

3. Use of succinylcholine may be contraindicated for patients with severe burns or trauma because of the risk of:
A. hypoglycemia.
B. hyperkalemia.
C. hypocalcemia.
D. metabolic alkalosis.

4. Identify the difference in the mechanism of action between depolarizing and nondepolarizing neuromuscular blocking agents.

5. Why is use of tubocurarine contraindicated for persons with asthma, bronchospasm, or cardiac disease?

Chapter 9: Skeletal Muscle Relaxants

Review Questions
1. Which of the following is the drug of choice to prevent or treat malignant hyperthermia?
A. diazepam (Valium)
B. acetaminophen (Tylenol)
C. edrophonium (Tensilon)
D. dantrolene (Dantrium)

2. A postsurgical patient who received succinylcholine as part of his anesthesia asks the nurse why his muscles and throat are so sore. The nurse’s best response is:
A. “This is a normal response to a muscle relaxant you received during surgery and should go away in 24 to 48 hours.”
B. “I’m very concerned about this. I will call your doctor right away.”
C. “You must have been fighting the anesthesia and had to be restrained.”
D. “I’ll get you some pain medication.”

3. Use of succinylcholine may be contraindicated for patients with severe burns or trauma because of the risk of:
A. hypoglycemia.
B. hyperkalemia.
C. hypocalcemia.
D. metabolic alkalosis.

4. Identify the difference in the mechanism of action between depolarizing and nondepolarizing neuromuscular blocking agents.

5. Why is use of tubocurarine contraindicated for persons with asthma, bronchospasm, or cardiac disease?

Chapter 11: Falls, Immobility, Confusion, Incontinence, Dementia

Review Questions
1. Because of age-related changes in renal and hepatic function, the older person:
A. metabolizes drugs more slowly.
B. requires higher drug dosages.
C. is less likely to have drug toxicities.
D. can take multiple drugs without interactions.

2. A patient is taking an anti-inflammatory drug, a diuretic, antacids, and a bronchodilator. He complains of dizziness when he first stands up. Which drug is most likely causing the problem?
A. Anti-inflammatory
B. Diuretic
C. Antacid
D. Bronchodilator

3. A patient’s blood pressure is 130/72 and her pulse is 80 when she is supine. On standing, her blood pressure is 100/54 and her pulse is 60. This is characteristic of:
A. fluid retention.
B. allergic drug reaction.
C. orthostatic hypotension.
D. normal effects of position change.

4. Cholinesterase inhibitors may improve symptoms of Alzheimer’s disease by:
A. destroying pathogens.
B. repairing damaged neurons.
C. stimulating cerebral circulation.
D. increasing acetylcholine in the brain.

5. Aspirin may be given to patients with vascular dementia in an effort to prevent:
A. stroke.
B. varicose veins.
C. congestive heart failure.
D. peptic ulcer disease.

Match the type of bladder control problem on the right with the drug on the left that may cause it.
6. _____ Diuretics A. Unable to reach toilet quickly enough
7. _____ Anticholinergics B. Bladder becomes distended; overflows
8. _____ Sedatives/hypnotics C. Urine leaks under stress
9. _____ Alpha-adrenergic blockers D. Patient unaware of need to void

10. Stress incontinence due to atrophic vaginitis may be relieved by:
A. imipramine (Tofranil).
B. estrogen cream.
C. oxybutynin (Ditropan).
D. bethanechol (Urecholine).

Chapter 12: Terminal Illness

Review Questions
1. The goal of pain management during terminal illness is to:
A. identify a safe and effective dose.
B. prevent excessive sedation.
C. avoid development of drug addiction.
D. control pain without opioids.

2. A type of drug that can help relieve cough is:
A. ACE inhibitor.
B. antidepressant.
C. mucolytic.
D. bronchoconstrictor.

3. What action is common to metoclopramide (Reglan), dexamethasone (Decadron), prochlorperazine (Compazine), and diazepam (Valium)?
A. Tranquilizer
B. Anti-Inflammatory
C. Muscle relaxant
D. Antiemetic

4. Corticosteroids may be used to treat delirium caused by:
A. cerebral edema.
B. kidney failure.
C. carbon monoxide.
D. electrolyte imbalances.

5. Alprazolam (Xanax) and lorazepam (Ativan) may be used during terminal illness to treat:
A. insomnia.
B. dyspnea.
C. constipation.
D. anxiety.

6. Bulk laxatives are not recommended in terminal illness because of the risk of:
A. diarrhea.
B. ruptured appendix.
C. excess gas formation.
D. intestinal obstruction.

Chapter 13: Antineoplastic Drugs

Review Questions
1. It is important to protect patients from trauma when they have:
A. anemia.
B. stomatitis.
C. xerostomia.
D. thrombocytopenia.

2. Good hydration is important when giving cisplatin (Platinol) to prevent:
A. dehydration.
B. pneumonia.
C. nephrotoxicity.
D. hearing loss.

3. Peripheral neuropathy is characterized by:
A. altered sensation.
B. diarrhea.
C. muscle spasms.
D. hyperactive reflexes

4. When a client is receiving a drug that causes bone marrow depression, which of the following should be emphasized with the client and family members or caregivers?
A. Fatigue and weakness are not commonly experienced.
B. Wash hands often and avoid people with colds, flu, or other infections.
C. More nausea and vomiting may occur when blood cell counts are low.
D. Take acetaminophen for fever.

5. Monoclonal antibodies used in the treatment of cancer:
A. are highly toxic to both cancer cells and normal cells.
B. change the hormonal components of cancer cells.
C. protect normal cells from cytotoxic drugs.
D. target specific antigens or vital processes of cancer cells.

6. How do angiogenesis inhibitors produce their effects on tumor growth?

Chapter 14: Adrenergics

Review Questions
1. Beta1 receptors are located primarily in the_______________. Stimulation of these receptors produces_______________ and_______________________________.

2. Activation of beta2 receptors produces what effect on the lungs?
A. Bronchoconstriction
B. Bronchodilation
C. No effect

3. A patient who is using an isoproterenol inhaler for treatment of asthma tells the nurse that his saliva and sputum are “pink.” Based on his knowledge of this drug, the nurse responds:
A. “I will call your health care provider right away.”
B. “The drug may be causing a small amount of bleeding in your airway.”
C. “This is a type of allergic reaction to the drug.”
D. “This is a normal, harmless effect of the drug.”

4. Patient teaching regarding use of alpha-adrenergic drugs to relieve nasal congestion includes information that:
A. excessive use may cause rebound nasal congestion when the drug is discontinued.
B. it is permissible for the patient to increase the dose if previous dose is ineffective.
C. concurrent use of any OTC cold or allergy medication is safe.
D. these drugs do not produce any effects that could affect driving a car.

Chapter 15: Antiadrenergics

Review Questions
1. Instruct patients who are taking antiadrenergic drugs for treatment of hypertension not to abruptly stop taking the medication because of the risk for:
A. edema.
B. postural hypotension.
C. urinary retention.
D. rebound hypertension.

2. A patient is started on prazosin (Minipress) to treat his hypertension. Which of the following patient teaching instructions should be stressed?
A. Rise slowly from lying or sitting position.
B. Take drug on an empty stomach.
C. Force fluids to 2000 mL/day.
D. Medication must always be taken in the morning.

3. Which side effect should a patient be aware of when taking clonidine (Catapres)?
A. Anxiety
B. Diarrhea
C. Drowsiness
D. Irritability

4. A patient who is taking doxazosin (Cardura) for treatment of hypertension asks if it is all right to take Advil for arthritis pain. Based on knowledge of the drug, the nurse’s best response is:
A. “You may continue to take the Advil without any problems.”
B. “You should not take Advil because it may cause fluid retention and increase your blood pressure.”
C. “I don’t know. I’ll have to ask your health care provider.”
D. “You shouldn’t take Advil, but you could take Motrin without problem.

Chapter 16: Cholinergics

Review Questions
1. The nurse should be prepared to administer which of the following drugs as an antidote to cholinergic overdose?
A. epinephrine (Adrenalin)
B. propranolol (Inderal)
C. atropine sulfate
D. diphenhydramine (Benadryl)

2. Activation of nicotinic receptor produces what effect on the body?
Activation of muscarinic receptors stimulates or suppresses cellular activity in what
areas of the body?

3. A 62-year-old man has been admitted to the hospital for treatment of benign prostatic hypertrophy (BPH). How should the nurse respond to an order for bethanechol (Urecholine) to treat urinary retention in this situation?
A. Insert a Foley catheter before administration of the drug.
B. Provide a urinal because urinary frequency will increase following drug administration.
C. Give the medication as ordered.
D. Question the order because the patient’s urinary retention is due to an obstructive process.

4. A client who has been taking pyridostigmine (Mestinon) for treatment of myasthenia gravis tells the nurse that she has noticed an increase in saliva production, increased sweating, and some abdominal cramping. The nurse’s best response should be which of the following?
A. “These are usual side effects from this drug.”
B. “You must call your health care provider immediately, as these are signs of a drug overdose.”
C. “You should decrease the drug dose, then these effects will go away.”
D. “Taking the drug with food will eliminate this problem.”

Chapter 17: Anticholinergics

Review Questions
1. A client is to begin taking benztropine (Cogentin) for treatment of Parkinson’s disease. Which of the following instructions would be appropriate for this client?
A. Change positions slowly to prevent orthostatic hypotension.
B. Be sure a bathroom is near, as this medication may cause diarrhea.
C. Avoid overheating and wear loose, cool clothing because this drug impairs sweating.
D. Limit fluid intake because this medication will cause fluid retention.

2. Soon after the administration of the first dose of atropine, a patient complains of acute eye pain. The nurse should:
A. Prepare to treat an allergic reaction with diphenhydramine (Benadryl).
B. Administer a PRN dose of an analgesic.
C. Place a cool, damp cloth over the patient’s eyes for comfort.
D. Hold further doses of atropine and notify health care provider immediately.

3. A patient has bradycardia with a heart rate of 46 bpm. She is confused and her skin is cool and clammy. What is the drug of choice in this situation?
A. atropine sulfate
B. epinephrine (Adrenalin)
C. isoproterenol (Isuprel)
D. dopamine (Intropin)

4. The drug of choice to treat anticholinergic overdose is which of the following?
A. diphenhydramine (Benadryl)
B. physostigmine (Antilirium)
C. epinephrine (Adrenalin)
D. dantrolene (Dantrium)

Chapter 18: Anticonvulsants

Review Questions
1. Which of the following statements made by a client taking phenytoin indicates understanding of the nurse’s teaching?
A. “I will increase the dose if my seizures don’t stop.”
B. “I don’t need to contact my health care provider before taking an over-the-counter cold remedy.”
C. “I will take good care of my teeth and see my dentist regularly.”
D. “I cannot take this drug with food.”

2. Teaching for patients taking carbamazepine includes which one of the following points?
A. Use sunscreen and protective clothing when out of doors.
B. This drug has no significant side effects.
C. Changes in skin pigmentation are normal and of no concern.
D. Your urine may turn a harmless blue color.

3. Nutrition teaching regarding foods high in vitamin D and folic acid is necessary for clients taking which of the following anticonvulsant drugs?
A. Clonazepam and clorazepate
B. Diazepam and lorazepam
C. Carbamazepine and valproic acid
D. Phenytoin and phenobarbital

4. A 20-year-old client presents to the clinic with complaints of breast tenderness, nausea, vomiting, and absence of menses for 2 months. She has a history of a seizure disorder well controlled with carbamazepine (Tegretol). She tells the nurse that she has been taking her oral contraceptives as directed, but she wonders if she might be pregnant. The nurse’s best response to her concern should be which of the following?
A. “You can’t be pregnant if you have been taking your oral contraceptives correctly.”
B. “Carbamazepine can decrease the effectiveness of oral contraceptive drugs, so we need to do a pregnancy test.”
C. “There is no need to worry. Oral contraceptives are very effective.”
D. “Taking antiseizure drugs with oral contraceptives significantly decreases your risk of getting pregnant.”

Chapter 19: Antiparkinson Drugs

Review Questions
1. The basic pathophysiology of Parkinson’s disease is a deficiency in the brain content of which of the following substances?
A. Acetylcholine
B. Dopamine
C. Glutamate
D. Serotonin

2. Carbidopa is usually given together with levodopa because it:
A. crosses the blood-brain and acts directly on the central nervous system.
B. directly stimulates dopamine receptors in the brain.
C. decreases adverse effects of levodopa.
D. inhibits metabolism of levodopa.

3. A client who is receiving amantadine (Symmetrel) for treatment of Parkinson’s disease tells the nurse that he is very worried because he has developed a bluish color on his legs. The nurse’s best response is:
A. “This is a normal reaction to the drug. The coloration will go away when the drug is stopped.”
B. “This is indicative of a serious vascular side effect. Please notify your health care provider right away.”
C. “If you take your medication with meals, this effect will go away.”
D. “I am not sure what that color change means, so you should call your health care provider soon.”

4. A client has been on levodopa for 2 weeks. A family member calls the clinic to tell the nurse that there seems to be no change in her relative’s symptoms. What is the nurse’s most appropriate response?
A. “I will have your health care provider increase the dose, because the current one does not seem to be working.”
B. “Apparently this is not the correct drug to use. We will need to consider changing to another one.”
C. “It may take several weeks before medication effects are seen, and you may not see maximum effects for 6 months.”
D. “It may be that your relative has developed resistance to this particular drug.”

Chapter 20: Central Nervous System Stimulants

Review Questions
1. Parent teaching for children taking methylphenidate (Ritalin) for ADHD should include which of the following?
A. Give your child the drug at bedtime.
B. Drowsiness may be a side effect.
C. If necessary, the child may take over-the-counter cold products without problems.
D. Provide for periodic “drug-free” holidays.

2. Caffeine and other central nervous system stimulants may cause which of the following adverse effects?
A. Increased appetite
B. Sedation
C. Cardiac arrhythmias
D. Respiratory depression

3. A child is receiving atomoxetine (Strattera) for treatment of ADHD. Which of the following would indicate therapeutic effects?
A. Increased activity
B. Improved performance in schoolwork
C. Increased appetite
D. Rapid changes in growth

Chapter 21: Hematologic Drugs

Review Questions
1. A patient is receiving heparin per continuous IV infusion. Which of the following laboratory tests should be done to monitor the anticoagulation effects of heparin therapy?
A. Complete blood cell count
B. Activated partial thromboplastin time
C. Prothrombin time
D. International normalized ratio

2. Persons on warfarin therapy should be advised to avoid:
A. aspirin.
B. vitamin C.
C. coffee.
D. sunlight.

3. Which of the following laboratory tests will be ordered to monitor warfarin therapy?
A. Complete blood cell count
B. Activated partial thromboplastin time
C. Lee-White clotting time
D. International normalized ratio

Chapter 22: Immunologic Drugs

Review Questions
1. A patient who has had a kidney transplant is taking cyclosporine (Sandimmune) and corticosteroids. Cyclosporine is prescribed to:
A. prevent surgical infection.
B. stimulate urine production.
C. treat urinary infection.
D. prevent rejection of transplanted kidney.

2. What laboratory tests are particularly important for persons taking cyclosporine?
A. Blood urea nitrogen, creatinine
B. Complete blood cell counts
C. Prothrombin time
D. Blood glucose

3. Which of the following statements should be included in patient teaching related to immunosuppressant therapy?
A. “You will probably notice some hair loss.”
B. “Avoid people with active infections.”
C. “Consume a high-potassium diet.”
D. “You may have some dizziness caused by low blood pressure.”

Chapter 23: Antihypertensive Drugs

Review Questions
1. A client with a history of hypertension comes to the emergency department with a blood pressure of 250/135 mm Hg. Sodium nitroprusside (Nitropress) is prescribed per continuous intravenous infusion and continual blood pressure monitoring. The nurse understands that this drug’s immediate action is to lower blood pressure by:
A. decreasing heart rate.
B. increasing peripheral vascular resistance.
C. dilating arterioles and veins.
D. increasing cardiac output.

2. Single-drug therapy with an ACE inhibitor would be least effective in which of the following groups of people?
A. Older adults
B. Children
C. Asians
D. African Americans

3. Which of the following is a common side effect to therapy with an ACE inhibitor?
A. Dry, nonproductive, persistent cough
B. Constipation
C. Muscle weakness
D. Tinnitus

4. 4. A client who is taking verapamil for treatment of hypertension tells the nurse that he only takes his medication when he feels like his blood pressure is high. The nurse’s best response would be:
A. “That is a perfectly acceptable way to manage your high blood pressure.”
B. “Hypertension usually has no symptoms, so it is not safe to stop your medication on the basis of symptoms.”
C. “Since hypertension always has symptoms, you would have no reason to stop taking your medication.”
D. “Since you are not having symptoms, you must no longer have high blood pressure.”

5. A client who is taking prazosin (Minipress) for treatment of hypertension tells the nurse that she feels lightheaded upon arising. Identify four ways the client can avoid this problem.

Chapter 24: Antacids, Antiulcer Drugs

Review Questions
CASE STUDY: Mr. Kennon has been diagnosed with peptic ulcer disease, and the presence of Helicobacter pylori has been confirmed. His health care provider prescribes Helidac qid for 14 days and famotidine (Pepcid) 40 mg hs. Complete the following statements related to these drugs.

1. Helidac is a package containing ___________, ____________, and____________.

2. Why are multiple antimicrobial agents used to treat peptic ulcer disease?

3. Mr. Kennon complains he has a sore mouth and a tingling sensation in the fingers. These are most likely adverse effects of _________________________.

4. The action of famotidine is to _______________________________________.

5. Famotidine is preferred over cimetidine because of the adverse effects of cimetidine, which include ____________ , ____________, and _____________.

6. Mr. Kennon takes warfarin (Coumadin) for atrial fibrillation. How will the famotidine affect his metabolism of the warfarin?

Chapter 25: Antiemetics and Drugs Used to Treat Poisoning

Review Questions
1. A patient is to receive an antiemetic, ondansetron (Zofran), during a chemotherapy treatment. This drug would be most effective when administered:
A. before an emetogenic drug is administered.
B. when nausea occurs but before vomiting occurs.
C. after the patient has experienced both nausea and vomiting.
D. any time; timing of administration has no relationship to drug effectiveness.

2. The nurse should question an order for which of the following antiemetics for treatment of nausea associated with motion sickness?
A. scopolamine (Transderm Scop)
B. prochlorperazine (Compazine)
C. dimenhydrinate (Dramamine)
D. cyclizine (Marezine)

3. A patient being treated with levodopa for Parkinson’s disease is to receive an antiemetic following surgery. Which of the following drugs would not be appropriate to use?
A. promethazine (Phenergan)
B. hydroxyzine (Vistaril)
C. thiethylperazine (Torecan)
D. metoclopramide (Reglan)

Chapter 25: Antiemetics and Drugs Used to Treat Poisoning

Review Questions
1. A patient is to receive an antiemetic, ondansetron (Zofran), during a chemotherapy treatment. This drug would be most effective when administered:
A. before an emetogenic drug is administered.
B. when nausea occurs but before vomiting occurs.
C. after the patient has experienced both nausea and vomiting.
D. any time; timing of administration has no relationship to drug effectiveness.

2. The nurse should question an order for which of the following antiemetics for treatment of nausea associated with motion sickness?
A. scopolamine (Transderm Scop)
B. prochlorperazine (Compazine)
C. dimenhydrinate (Dramamine)
D. cyclizine (Marezine)

3. A patient being treated with levodopa for Parkinson’s disease is to receive an antiemetic following surgery. Which of the following drugs would not be appropriate to use?
A. promethazine (Phenergan)
B. hydroxyzine (Vistaril)
C. thiethylperazine (Torecan)
D. metoclopramide (Reglan)

Linton: Introduction to Medical-Surgical Nursing, 4th Edition

Pharmacology Tutorial

Chapter 27: Pituitary Hormones

Review Questions
1. Why is it important to teach patients taking vasopressin to avoid using OTC cold preparations without consulting the health care provider?

2. A patient with multiple sclerosis is receiving corticotropin as part of her drug therapy. She asks the nurse why the health care provider recommended use of a salt substitute. The nurse’s best response is:
A. “Patients with multiple sclerosis cannot tolerate regular salt.”
B. “If regular salt is used with corticotropin, the risk of ulcer development is increased.”
C. “Use of salt substitutes, which contain potassium instead of sodium, helps prevent edema and low potassium levels.”
D. “Your health care provider can best explain that to you.”

3. A child is taking somatropin as part of therapy for pituitary dwarfism. His parents tell the nurse that he has been complaining of hip pain for a week. The nurse’s best response is:
A. “This pain just means he is starting to grow.”
B. “You need to call your health care provider. The pain could indicate a problem with his hip or upper leg.”
C. “Children often complain of pain. This is nothing to worry about.”
D. “He probably just strained a muscle while playing. The pain should go away soon.”

Chapter 28: Female Hormones

Review Questions
1. Patients taking estrogens need to be regularly assessed for:
A. Increased intraocular pressure.
B. Bradycardia.
C. Decreased urinary output.
D. Hypertension.

2. Which of the following instructions should be included in patient teaching for tamoxifen?
A. Report bone pain to health care provider immediately and stop taking the drug.
B. The drug cannot be taken with food.
C. Use sunblocks and protective clothing when out of doors.
D. Sodium supplements are necessary to prevent hyponatremia.

3. Which of the following statements indicates that the client needs additional teaching about birth control pills?
A. “I will elevate my legs and take aspirin if I experience leg pain.”
B. “I will monitor my weight and have my blood pressure checked monthly.”
C. “I may gain weight while I am taking these pills.”
D. “I know nausea is common, but it should go away in a few weeks.”

4. A 76-year-old male is started on estrogen for metastatic prostate cancer. Which of the following statements leads the nurse to believe he understands the information about his medication?
A. “I will take my pill on an empty stomach.”
B. “I may experience impotence, but it should go away when the drug is stopped.”
C. “If my breasts become enlarged I will apply ice to them.”
D. “I may have some hair loss from this drug.”

Chapter 29: Male Hormones

Review Questions
1. When androgens are administered to older adult men, which of the following may occur?
A. Rapid bone growth
B. Loss of pubic hair
C. Gynecomastia
D. Prostatic enlargement

2. If a patient develops symptoms of hypercalcemia during androgen therapy, the nurse needs to instruct him to:
A. remain in bed to avoid injury.
B. drink 2000 to 3000 mL/day of fluid to prevent kidney stones.
C. reduce the dose of the medication.
D. discontinue the medication.

3. Physical changes that occur with the use of anabolic steroids in women include:
A. increased distribution of hair on face and body.
B. increased menstrual flow.
C. increased endurance.
D. thinning of skin.

4. Androgen therapy has been ordered for an 11-year-old boy who is experiencing hypogonadism. Which of the following statements made by this boy leads the nurse to believe that he has understood the teaching regarding the medication?
A. “I may have some temporary visual changes.”
B. “If I experience acne, the drug will need to be stopped.”
C. “I will need to have x-rays every 6 months.”
D. “I can expect to lose weight as a result of taking this drug.”

Chapter 30: Ophthalmic Drugs

Review Questions
1. Match the term on the left with the definition on the right.
_____ mydriasis A. right eye
_____ cycloplegia B. dilation of the pupil
_____ miosis C. left eye
_____ OD D. both eyes
_____ OS E. constriction of the pupil
_____ OU F. paralysis of ciliary body

2. Which statement is correct about topical ophthalmic drugs?
A. There is no risk of systemic effects.
B. They are used for diagnostic and treatment purposes.
C. Only topical drugs applied to the eye can affect the pupil.
D. Ophthalmic drugs have no serious adverse effects.

3. A patient is recovering from cataract surgery in the outpatient surgery department. He has been prescribed anti-infective ophthalmic drops and corticosteroid ophthalmic drops for use at home. What would be the most critical question to ask before teaching about the anti-infective ophthalmic drops?
A. “Do you have any allergies?”
B. “Are you taking any over-the-counter drugs?”
C. “What kind of work do you do?”
D. “Do you have any pain in your eye?”

4. Patient teaching for ophthalmic drugs should include which of the following?
A. Press the outer canthus of the eye after instilling eye drops.
B. Instill eye drops in the upper conjunctival sac.
C. To stabilize the eye dropper, touch the tip to the conjunctival sac.
D. Wait 5 minutes between instilling two medications.

Chapter 31: Otic Drugs

Review Questions
1. Following an acute episode of Ménière's disease, a patient is being discharged from the hospital with a prescription for meclizine (Antivert). Meclizine is classified as a/an:
A. anti-infective.
B. cerumenolytic.
C. antiemetic.
D. anesthetic.

2. A positive response to meclizine (Antivert) would be that the:
A. client sleeps soundly at night.
B. client states nausea is relieved.
C. client’s blood pressure decreases.
D. client states pain in ear is diminished.

3. Match the term on the left with the definition on the right.
_____ tinnitus A. left ear
_____ cerumen B. right ear
_____ AD C. both ears
_____ otic D. ringing in the ears
_____ ototoxic E. earwax
_____ AS F. related to the ear
_____ AU G. causing damage to acoustic nerve

Linton: Introduction to Medical-Surgical Nursing, 4th Edition

Answers to the Review Questions

Chapter 1
1. C
2. The generic name of a drug never changes, whereas there may be multiple trade names for the same drug.
3. A
Chapter 2
1. C
2. Physical and chemical characteristics; circulation to intended site of action; plasma protein binding; affinity for fatty tissue; barriers (brain and placenta).
3. B
4. D
5. Body weight; age; gender; genetics; biologic rhythms; medical conditions; tolerance; cumulation; drug interactions; psychological factors.
Chapter 3
1. B
2. C
3. A
Chapter 4
1. A
2. D
3. A
4. C
Chapter 5
1. C
2. B
3. D
4. A
5. B
6. The Mycobacterium tuberculosis quickly becomes resistant to single drugs.
7. D
8. C
9. A
10. A
Chapter 6
1. B
2. C
3. A
4. D
5. C
Chapter 7
1. D
2. C
3. B
Chapter 8
1. A
2. B
3. C
Chapter 9
1. D
2. A
3. B
4. Depolarizing agents act at the neuromuscular junction to combine with cholinergic receptors to cause muscle contraction but not relaxation (muscle paralysis preceded by muscle spasms).
Nondepolarizing agents prevent acetylcholine from acting at the neuromuscular junction, so muscles remain in a relaxed state.
5. Tubocurarine has significant histamine-releasing properties, so is contraindicated for persons with conditions that may be made worse by histamine release and vasodilation.
Chapter 10
1. D
2. C
3. B
4. A
Chapter 11
1. A
2. B
3. C
4. D
5. A
6. A
7. B
8. D
9. C
10. B
Chapter 12
1. A
2. C
3. D
4. A
5. D
6. D
Chapter 13
1. D
2. C
3. A
4. B
5. D
6. Angiogenesis inhibitors block growth of new blood vessels necessary to supply tumors with oxygen and nutrients so that tumor growth is halted.
Chapter 14
1. heart, increased heart rate, increased force of heart muscle contraction
2. B
3. D
4. A
Chapter 15
1. D
2. A
3. C
4. B
Chapter 16
1. C
2. Nicotinic activation causes skeletal muscle contraction, and, in the brain, promotes release of acetylcholine in the cerebral cortex. Muscarinic activation stimulates or suppresses cellular activity in the heart and blood vessels, gastrointestinal tract, respiratory tract, urinary tract, and the eye.
3. D
4. A
Chapter 17
1. C
2. D
3. A
4. B
Chapter 18
1. C
2. A
3. D
4. B
Chapter 19
1. B
2. D
3. A
4. C
Chapter 20
1. D
2. C
3. B
Chapter 21
1. B
2. A
3. D
Chapter 22
1. D
2. A
3. B
Chapter 23
1. C
2. D
3. A
4. B
5. Avoid sudden position changes (change positions slowly); exercise legs before arising; avoid hot baths or showers; avoid prolonged standing in one place.
Chapter 24
1. Bismuth tablets, metronidazole, tetracycline
2. To discourage emergence of drug-resistant H. pylori
3. Metronidazole
4. Inhibit gastric acid secretion
5. Antiandrogenic effects, central nervous system effects, inhibition of drug-metabolizing enyzmes
6. There is no significant interaction between famotidine and warfarin. (NOTE: Cimetidine prolongs the action of warfarin so that warfarin dose would need to be reduced if cimetidine was prescribed.)
Chapter 25
1. A
2. B
3. D
Chapter 26
1. C
2. A
3. B
Chapter 27
1. These preparations frequently contain epinephrine or ephedrine, which can increase blood pressure.
2. C
3. B
Chapter 28
1. D
2. C
3. A
4. B
Chapter 29
1. D
2. B
3. A
4. C
Chapter 30
1. B, F, E, A, C, D
2. B
3. A
4. D
Chapter 31
1. C
2. B
3. D, E, B, F, G, A, C

Sunday, February 7, 2010

Mnemonics Eeasy one

These are the mnemonics from my memory notebook of nursing

  • i feel on top of the world= SELF ACTUALIZATION
  • I like me = self esteem
  • i feel all warm and squishy.=love and belongings
  • i feel safe=security and safety
  • i'm warm ,dry, fed and rested=psysiological needs
  • O ODOR
Sepration or splitting open layers of surgical wound.
extrusion of viscera or intestinal through a surgical wound.






mental retardation



J judgement

A affect
M memory

C cognition
O orientation








The main one every nurse should remember is one you already know:

A,B, C

lead placement: FOR EKG
White on the right, smoke (black) over fire (red)

Four causes of cell injury,

think of how the injury tipped (or TIPD) the scale of homeostasis:
T: Toxin or other lethal (cytotoxic) substance
I: Infection
P: Physical insult or injury
D: Deficit, or lack of water, oxygen, or nutrients.

C: Change in bowel or bladder habits
A: A sore that doesn’t heal
U: Unusual bleeding or discharge
T: Thickening or lump
I: ingestion or difficulty swallowing
O: Obvious changes in a wart or mole
N: Nagging cough or hoarseness.

Use the ABCD rule to assess a mole’s
A: Asymmetry--Is the mole irregular in shape?
B: Border--Is the border irregular, notched, or poorly defined?
C: Color--Does the color vary (for example, between shades of brown, red, white, blue, or black)?
D: Diameter--Is the diameter more than 6 mm?

BEEP to remember the signs of minor Bleeding:

B: Bleeding gums
E: Ecchymoses (bruises)
E: Epistaxis (nosebleed)
P: Petechiae (tiny purplish spots)

C - Convulsions
A- Arrhythmias
T - Tetany
S - Spasms and stridor

Atrial, Pulmonic, Erb's point, Tricuspid, Matrial

PERRLA means your eyes condition

Pupils Equally Round and Reactive to Light and Accomodation

MR DICE RUNS = our clinical teacher told this one

M= Muscle
R= Respiratory
I= Integumentary
C= Circulatory
E= Endocrine
R= Reproductive
U= Urinary
N= Nervous
S= Skeletal

S/S of Hyponatremia

S tupor/coma
A norexia, N&V
L ethargy
T endon reflexes decreased

L imp muscles (weakness)
O rthostatic hypotension
S eizures/headache
S tomach cramping

R Respiratory
O Opposite

ph > PCO2 <>
ph <> Acidosis

M Metabolic
E Equal

ph> HCO3 > Alkalosis

Nerves Functions
I Olfactory -Oh -Sensory -Some
II Optic- Oh -Sensory -Say
III Occulomotor -Oh -Motor -Mary
IV Trochlear -To -Motor -Money
V Trigeminal -Touch -Both -But
VI Abducens -And -Motor -My
VII Facial -Feel -Both -Brother
VIII Acoustic (vestoblochlear) -A -Sensory -Says
IX Glosopharyngeal -Green -Both -Bad
X Vagus -Veggie -Both -Business
XI Spinal Accessory- Soon At -Motor -Mary
XII Hypoglosal -Harvest- Motor -Money

Effects of anticholinergics:
Can't see
Can't pee
Can't spit
Can't --defecate

LDL =bad"cholesterol

Hot and Dry : sugar high
cold and clammy need some candy

DEMENTIA can be used to remember potential causes:
  • D: Drugs and alcohol—including over-the-counter drugs
  • E: Eyes and ears—disorientation due to visual/auditory distortion
  • M: Medical disorders—e.g., diabetes, hypothyroidism
  • E: Emotional and psychological disturbances—e.g., mood or paranoid disorders
  • N: Neurological disorders—e.g., multiinfarct dementia
  • T: Tumors and trauma
  • I: Infections—e.g., urinary tract or upper respiratory tract
  • A: Arteriosclerosis—leading to hf insufficient blood supply to heart and brain, and confusion

Normal (Neutrophils)
Monkeys (Monocytes)
Like to (Lymphocytes)
Eat (Eosinophils)
Bananas (Basophils)



Wednesday, February 3, 2010



Chapter 9, 10, 11,12, 13 ( Rosedahl)

  1. Binuclear family: a family in which a separation or divorce of the adult partners occur, but both adults continue to assume a high level of child rearing responsibilities.
  2. Cohabitation: unmarried individuals in a committed partnership living together, with or without children.
  3. Communal family : family where many people live together, strive to be self -sufficient, and minimize contact with the outside society.
  4. Commuter family: a family in which both adults are usually professionals, one of whom lives in another city because of the employment, and the partners must travel a long distance, usually on weekends to be together.
  5. Dual-career/dual worker family: nuclear family in which both parents work outside the home
  6. Dysfunctional family: family whose coping systems disintegrates as stressors built.
  7. Extended family: ones family beyond that of parents and siblings
  8. Family: 2 or more people who are joined together by bonds of sharing and emotional closeness and who identify themselves as being part of the family.
  9. Foster family : family in which children live with paid caregivers.
  10. Functional family: a family that uses it’s resource to cope and become stronger under stress.
  11. Gay or lesbian family : partners of the same sex who live or own property together, with or without children.
  12. Nuclear dyad: a married couple who live together without children
  13. Nuclear family: a 2 generation unit consisting of husband, wife, and their immediate children-biological , adopted, or both living within one household.
  14. Reconstituted family: a family that consists of couple who both have a custody od their children from previous relationships and any new children from this arrangement.
  15. Siblings: 2 or more people having at least one parent in common.
  16. Single-adult household : adults who live alone in their own apartments or house with no children.
  17. Single parent family: a family in which one adult is head of house hold with dependent children. The adult who is single may be single by choice or a s a result of separation, divorce or death.
  18. Bonding: the development of a close emotional tie, as between parent and a child.
  19. Cephalocaudal: head to toe-developmental progression in infants
  20. Cognitive: involving knowledge, understanding and perception in the mind.
  21. Development : change in body function
  22. Enuresis: involuntary urine discharge usually occurring during sleep: bedwetting.
  23. Environment: one’s surroundings the situation in which a person lives ( as opposite to heredity.
  24. Growth: change in body’s structure or size, formational of abnormal tissue such as a tumor.
  25. Hereditary: genetically determined transmission from a parent to child, inherited ( not acquired.
  26. Infancy: a child from 1 to 12 months of age.
  27. Interdependent: depending on one another; one’s actions occurs because of abother. Activities of various organ systems ( for example the nerves, muscle, and bones are interdependent)
  28. Masturbation’: handling one’s own genitals for erotic stimulation.
  29. Newborn: human being in first 4 weeks of life.
  30. Object permanence: the knowledge that an object seen in a particular spot but temporarily hidden from view continues to exist and will return to view.
  31. Parallel play : 2 children playing side by side with the same or similar toys, without interacting with each other ( common in toddlers)
  32. Proximodistal: from the center or core outward ( patterns of development and achievement of motor control of the infant)
  33. Regression: return to a former state, a s the child regresses when ill. Regression of a disease process refers to it’s relief or subsiding.
  34. Solitary play : children playing alone with their own toys in the same general area, but not next to each other and with no interaction.
  35. Stranger anxiety: condition seen in infants and children, in which unfamiliar people, places and events upset them.
  36. Toddler: a child from 1-3 years in age.
  37. Adolescence: time between puberty onset and cessation of physical growth.
  38. Menarche: establishment of menstruation, the first menses.
  39. Nocturnal emission: involuntary discharge of semen while sleeping.
  40. Peer group: contemporaries and friends, the group of people with whom one is associated.
  41. Preadolescence : early adolescence
  42. Puberty: period in life when a person becomes sexually able to reproduce.
  43. Generativity : passing on ad sharing skills and younger generations.
  44. Intimacy: establishing relationships with others.
  45. Isolation : separation from others or separation of people with Infectious disease .
  46. Midlife transition: sense that arises in the middle adulthood that others of the same age have achieved more and that one must contribute to society before it’s too late.
  47. Ageism: prejudice against people based on age
  48. Gerontology : study of aging
  49. Mortality : death or rate of death per certain # of population and personal realization that one will die.
  50. Reminiscence : remembering past joys and successes.


Regression - a child’s behavior may go backward to that of an earlier stage of development
Enuresis-bedwetting-most likely occurs in boys
Pee-ka-bo: child’s play or infant game
Age of toddler: 1-3 years
Maslow’s hierarchy needs: basic needs of all people as a progression from simple physical needs to more complex ones.
Erikson says each individual is a product of interactions among heredity, environment and culture.
Piaget says thta term cognitive-knowledge, understanding, perception. It’s a continuous progression.
Play-(5-10 min) attention span of most infants last about 5-10 minutes
Head to tail-cephalocaudal ( center t outside)
Children’s favorite word: NO
Growth and development occurs in an orderly manner or sequence
Bottle mouth- serious dental condition that results when infants are placed in bed with the bottle of breast milk.
Anticipatory guidance
Object permanence: knowledge than an object seen in a particular spot.
Separation anxiety when child
Sibling rivalry
Family members should try to minimize children’s exposure to threatening elements and images.


  1. What is the most important etiological factor in developing a dysfunctional family? Poor response to stressors.
  2. The establishment of a family, childbearing, and childrearing are parts of which stage of the family cycle? Expanding family
  3. During the separations stage of divorce, development tasks include which of the following ? Adapting to a new living arrangements
  4. Why it is most important for a nurse to understand various family forms? To provide informed care.
  5. Which of the following belong to a single adult household? A career oriented young adult.
  6. The nurse is caring for a client who has given birth. The nurse understands that both p[arents are working and not very stable financially. Which of the following would to e the most appropriate suggestion with regard to caring for the child? Work in different shifts.
  7. A client arrives at the healthcare facility recombined by her male partner. The nurse understands that 2 are unmarried individuals in a committed partnership. To what kind of family do they belong? cohabitation
  8. A nurse is caring for a client in his 80’s who is assisted by his grandchildren. Which of the flowing should the nurse suggest to help the client cope with a decline in his physical faculties? Provide adequate diet, ensure sufficient rest, have a good sense of humor.
  9. According to having Hurst, developmental tasks that must be accomplished by the toddler orr preschool child include: control of the process of elimination
  10. Concepts of G&D include : growth in an orderly sequence
  11. The leading cause of death in toddler hood is : motor vehicle accidents
  12. What are the 3 important theories that a nurse should identify for understanding , explaining and predicting behaviors in children : Erikson’s theory , piaget theory, having Hurst theory
  13. Which of the following should the nurse identify as a common fear faced by preschoolers : darkness
  14. What are the characteristics displayed by the infants during the preoperational phase: child investigates and explores the environment
  15. What kind of play do older school aged children indulge in? structured games with defined roles.
  16. What should a nurse communicate to parents about how they can offer anticipatory guidance in their child’s G & D? : recognize the child’s pace of learning abilities.
  17. What is the most important psychosocial challenge experienced by an infant? : trust in primary caregivers.
  18. A nurse is caring for an infant who has been diagnosed with nursing bottle mouth. The nurse knows that which of the following is the effect of nursing bottle mouth? Serious dental condition.
  19. What instructions should the nurse give to caregivers in order to handle toddler tantrums in the public ? remove the child from public views
  20. What instructions should the nurse gives in order to handle a toddler’s separation anxiety? : deal with the toddler firmly.
  21. What advice should the nurse offer to a caregiver whose preschooler is experiencing sibling rivalry: individual attention
  22. According to having Hurst, the primary task of adolescence is to : grow up
  23. Which of the following behaviors would the nurse expect to see during late adolescence? : dealing with everyday issues.
  24. Which strategy would be most effective when teaching adolescents about risk taking behaviors?: make the adolescent aware of the consequences of risk taking behaviors
  25. A client reveals to the nurse that she was involved in homosexual activities during her adolescence and that now she is interested in a male friends but is afraid to have an intimate relationship with him because of her sexual history. What should the nurse explain to the client to allay he fears? Homosexual activities at an experimental level do not affect heterosexuality later.
  26. While taking care of a teenager in the early adolescence stage, what behavior of the client should the nurse anticipate? Childish way of appearing, thinking and behaving.
  27. The mother of a teenager is worried because her son does not listen to her and makes his own decisions in almost all matters. What advice should the nurse give the client? : making independent decisions is a natural task of a adolescence.
  28. A nurse is assessing a group of clients between 15 and 16 years of age to prepare a survey report on development of adolescence. What relevant characteristics should the nurse include in her checklist. : show increased interest in opposite sex , form ideas about the future, take more responsibility for self care and personal cleanliness.
  29. The father of a 14 year old girl is worried because his daughter is very inactive and has no interest in school activities that could help her make educational and career choices on future. What should the nurse suggest to the client to solve the problem? : adult encouragement and guidance are needed for skill development.
  30. A teenage client, while being assessed for fever, reveals the nurse his confusion regarding sexuality. How can a nurse help sexually active adolescents from healthy sexual attitudes? By providing sex education.
  31. According to Erikson , a 30 year old adult faces which psychosocial developmental challenge? Intimacy versus isolation
  32. A 47 year old adult expresses concerns of not achieving lifelong goals. The client displays increased alcohol intake and depression. The client is experiencing: A midlife crisis
  33. Women in their 30s face specific decision related to : childbearing
  34. A 25 year old client has recently graduated wants to know what he should focus on this point of his life. Which of the following is the best choice for the client?: selecting an occupation
  35. A housewife in her 30’s complains of regular headache and tells the nurse that she is contemplating a divorce. How should the nurse react? Inform the client about the risk of financial instability after divorce.
  36. A middle aged client is contemplating retirement. What advice should the nurse give the client: develop interest of hobbies, look for part time work, enroll in university.
  37. A 25 year old client is wondering why people choose to get married. What should the nurse response include? Marriage provides a sense of protection, provide support during sad times, is required for prestige.
  38. The nurse is caring for a 53 year old client who is worried that he will not achieve all his professional goals before he dies. What are the consequences of an adult’s failure in resolving midlife crisis that the nurse should consider? Brooding, physical illness, chemical dependency
  39. Prejudice based on chronological age by labeling and discriminating against older adults is known as: ageism
  40. According to having Hurst, developmental task for the older adult include: adjusting to decreasing physical strength
  41. Changing demographics pose which of the following challenges for future healthcare practices: providing quality , cost effective services.
  42. An elderly client believes that developmental tasks related to social changes can be prevented if older adults continue to stay with their families. Based on the having Hurst theory, what should the nurse tell the client? : developmental tasks focus on necessary adjustments to physical change, they focus on the social changes associated with age, they focus on the acceptance of one’s own mortality.
  43. A client complains that her 60 year old father is no longer sticking to the day to day routine that he has been following for the past 2 decades. How can the nurse help the client, using levenson’s theory? : explain that her father is choosing modes of living more freely.
  44. A 55 year old client at an extended care facility asks the nurse for advice on maintaining independence at this stage. What are the psychosocial considerations of maintaining independence? Sustaining health, social, responsibilities, and financial stability.
  45. A client who has lost his spouse recently is very depressed and needs some consolation. How can the nurse help the client to overcome this condition? Talk To the client about the principles of beliefs and spirituality.
  46. A 60 year old client is not ready to accept the physician limitations associated with age. What should the nurse instruct the client to do according to Sheehy’s theory? : feel comfortable with life changes to attain dignity.

Care of surgical patient study guide

Care of surgical patient study guide

Chapters 57, 55, 58


  1. The nurse explains to the client that the most important reason for inserting an indwelling catheter is to: remove urine continuously from the bladder
  2. While performing a sterile procedure, part of the sterile field becomes wet. Which action should the nurse take? Set up a new sterile field.
  3. Prior to inserting a urinary catheter into the male client who is uncircumcised, which action should the nurse take? : retract the foreskin
  4. After teaching a client how to change a dressing, it is most important for the nurse to document which information? Client’s ability to perform sterile technique
  5. When cauterizing a male client, the nurse knows that the catheter is inserted into the bladder when: urine flows into the tubing
  6. A client has a painful pressure ulcer that looks like a 1-cm* 2-cm blister. The nurse should document this pressure ulcer and the physician would probably diagnose it as stage : 2
  7. A client with darkly pigmented skin has an area that appears persistently purple and feels warm and boggy. The physician would most likely diagnose this as a : stage 1 pressure ulcer
  8. Most surgical wounds heal by : primary intention
  9. The nurse recognizes that which factor in a client history is most significantly related to his or her formation of pressure ulcer? : restricted to bed
  10. Which of the following foods would the nurse recommend to promote wound healing? : meals and citrus fruits
  11. What is the most important goal of care of a client who is receiving sterile wound irrigation?: cleanse the wound
  12. A nurse is preparing to inject insulin into a diabetic patient. Which of the following teachings is appropriate for the process? : surgical asepsis
  13. A nurse is required to care for a newborn. Which of the following should be used to disinfect the nurses hands before she handles the baby? : Hexachlorophene
  14. A 35 year old female client is cauterized after a hysterectomy , and the urine flow seems undiminished after withdrawal of a normal quantity of urine. What immediate action the nurse take? : remove the catheter and inform the physician
  15. The inanimate objects in the blood collection room need to be cleaned. Which of the following should be used for the mechanical cleansing of inanimate objects? : antiseptic cleanser
  16. A nurse is preparing to assist the ehalthcare provider in performing a lumbar puncture, which is sterile procedure. The nurse has put on sterile gloves and sterile gown. Where on the surgical gown can the nurse safely place his gloves hands while waiting for the healthcare provider to be ready? : between the nipples and the waist
  17. In the operating room, the nurse touches the strings of the surgical gown worn by another nurse with the sterile gloves hand. What is the next step to be taken by the nurse? Discard the gloves and use a fresh pair
  18. A 30 year old male client is cauterized after major abdominal surgery. For which of the folowing reasons is th drainage bag placed in a position lower than that of the clients’s urinary bladder after catherization? : for proper drainage of urine
  19. A nurse is preparing to assist the surgeon in major operation. What are the guidelines taken into consideration to maintain sterility? : reaching over a sterile field should be avoided, unless sterile clothing is worn, the mask must be changes for a new sterile mask if it becomes wet, when the nurse is pouring a sterile solution, the inside of the bottle should not be touched.
  20. Given below are the fewer steps for removal of a retention catheter. Arrange the steps in the correct order. : adjust bed to the comfortable height, deflate the ballon by completely aspirating all the fluid, ask the client to inhale and exhale slowly and deply, gently and slowly pull the catheter out.
  21. A 30 year old client has received mutiple wounds on her arm and face in motor vehicle accident. The nurse uses betadine to clean the wounds. What term best describes this process? : disinfection



  1. A client is diagnosed with an oblique fracture to the ulna. A cast is applied to the client’s arm to immobilize the fractured area. What assessment would indicate complications of pressure due to immobilization? : lack of distal pulsation in the affected arm.
  2. A nurse is caring for an elderly client who has undergone hip replacement surgery. What measures must the nurse employ when caring for the client. :Turn the client every ½ hours from the unaffected side to the back , support the client with pillows or sandbags and trichinae rolls , avoid elevating the head of the bed when the client is on her back.
  3. A young client is diagnosed with the dislocation of the hip joint after a motorcycle accident. The dislocation segment is repositioned and stabilized with traction. What measures must the nurse employ when caring for a client with traction? : Encourage the client to frequently position the ankles in a neutral position.
  4. An adult client who has undergone spinal fusion surgery is put in a body cast. The client complains of frequent abdominal pains and a bloated feeling. What considerations must the nurse employ when caring for a client in a body cast? :report the symptoms to the healthcare provider
  5. What type of traction would be used for a 2-year old client with a fracture of the femur? : Bryant’s traction
  6. Which of the following statements is true about a client with malignant bone tumor? : malignant bone tumors can lead to pathologic fractures.
  7. A young child with the cast on his fractured arm visits with the healthcare facility with complaints of pain that is unrelieved by medications and aggravated by passive stretching of the arm. The clients also exhibits signs and symptoms of swelling, tightness, and parenthesia of the affected extremity. What do these symptoms indicate?: compartment syndrome
  8. An adult female client diagnosed with scleroderma comes to the healthcare facility with complaints of joint pains. What consideration must the nurse employ when caring for a client with scleroderma? : instruct the client to avoid smoking and exposure to heat.
  9. What considerations must the nurse employ when caring for a client with ankylosing spondylitis ? Teach the client to refrain from lying on her side.
  10. A 45 year old client diagnosed with sciatica undergoes lumbar decompression surgery to relieve the pressure over the nerve. A thoracic - lumbar -sacral orthosis brace is applied to the client to support his back. What consideration must the nurse employ when caring for the client? : smooth all wrinkles over the skin before applying the brace
  11. Which of the folowing statements by the client with gout indicates that the cleint has understood patient teaching? : ‘’I need to limit drinking alcohol.’’
  12. Which of the following should be included in a preventive teaching plan of osteoporosis? : increased calcium and vitamin D in the diet.
  13. Which of the following findings in a client who has a hip replacement would require immediate nursing intervention? : legs are crossed
  14. Which of the following statements made by a client leads the nurse to realize that further teaching is necessary to salicylates? : I should expect small amounts of blood in my stools.
  15. A client with casted left arm complains of increased pain at the site. The client was last medicated 1 hour ago with Demerol 100 milligrams IM. The nurse notes that the fingers are swollen and pressing on the cast. The arm is elevated, and the client is unable to separate the fingers on the casted arm. The priority nursing action would be : call the physician and report findings
  1. Chapter 41, 42, 43
  2. The joints between the bones of the skull are classified as : SYNARTHROSES
  3. Age related changes in a connective tissue include the following : loss of cartilage elasticity
  4. A patient who has gout calls the clinic to report having flank pain and blood in the urine. You should: recognize signs and symptoms of urinary stones, and notify the physician immediately.
  5. A continuous passive motion machine (CPM) has been ordered for a patient after a total joint replacement . The primary purpose of CPM machine is to :prevent scar tissue formation
  6. One week after total hi replacement surgery, a patient complains of sudden severe pain in the affected hip and inability to bear weight on that leg. You should suspect: prosthesis dislocation
  7. Common nursing diagnoses for a patient with rheumatoid arthritis( RA) include of the following: activity intolerance related to fatigue
  8. What is the recommended daily calcium intake for a patient who is postmenopausal and not taking hormone replacement therapy? : 1500 mg
  9. When probenecid (Benemid) is prescribed for a patient with gout, a patient teaching should include which of the following pieces of advice? : drink at least eight 8-ounce glasses of fluid each day to prevent urinary stones.
  10. Which statement should be included in the teaching plan for a patient with progressive systemic sclerosis ( PSS/scleroderma) : remain upright for 1-2 hours after meals.
  11. A disorder in which the eyes, mouth and vagina become dry because of the obstructed secretory ducts is: Sjogren’s syndrome
  12. A pt is brought to the ER with an injury to his arm that was incurred in a fall. A bone end protrudes from his forearm. The surrounding skin is bruised and swollen. Exposed muscle tissue is also swollen. The patient has normal sensation in his fingers. His injury is best described as: grade II complete open fracture
  13. During which stage of bone healing do the ends of the broken bone begins to knit: Stage IV
  14. A pt with the femoral fracture suddenly complains that he cannot catch the breath. His pulse is 106, respirations 30. You notice a measles- like rash on his neck and chest. You should suspect : fat embolism
  15. Methods used to stimulate bone growth include the following: electric stimulation
  16. A pt is being discharged with a plaster of Paris cast on her arm. Patient teaching should include the flowing: notify the physician if the fingers become discolored.
  17. Crutches are properly fitted when the : crutch pad is 3 to 4 fingers breaths from the axilla.
  18. The main advantage of surgery over traction for older patients with hip fracture is: surgery allows earlier mobilization, which results in fewer complications.
  19. The most common cause of Colles’ fracture is: using an outstretched hand to break a fall
  20. The diet for a patient with a serious fracture should include the following: increased protein and calcium to build new bone
  21. A grafting sound heard when fractured bone ends rub together is called: Crepitus
  22. The most common cause of lower extremity amputation is : vascular disease
  23. Smoking is contraindicated after replantation because nicotine: causes vasoconstriction
  24. In which situation when an open amputation be most likely: an accident victim with a crushing injury
  25. A patient complains that her amputated foot itches and feels hot? This represents which of the following? Phantom limb sensation
  26. In the early postoperative period, the greatest danger to the patient who had an amputation is : Hemorrhage
  27. A compression dressing or a cast is applied after amputation to : shape the residual limb
  28. Measures to prevent contractures in a residual limb after lower extremity amputation include the following: guide the patient thought active range of motion exercises.
  29. Patient teaching related to care of a residual limb and prosthesis should include which of the following statements? Clean, rinse, and dry the prosthetic socket every day.
  30. The best way to preserve an amputated body part for possible replantaion is to : seal the part in a plastic bag and put in ice water
  31. When you examine a patient’s replanted hand, it is slightly bluish, swollen, and warm. These findings indicate: venous congestion
  1. A 49 year old woman was admitted to a physical rehabilitation unit 2 weeks before surgery for a below-the-knee amputation on her right leg. She asks, why do I have to keep wrapping my stump? The nurses best response is : you will have to shrink and shape the residual limb to fit the prosthesis.
  2. After a below-the-knee amputation, a client states please tell me I’m not crazy because it still feels like my right foot is still there. The nurses best response is : you are experiencing phantom limb sensation which is normal.
  3. In caring for a residual limb after a below-the-knee amputation, the nurse knows that which of the following statements by the clients indicates a need for further teaching? I should: apply lotion or alcohol to the stump
  4. A 17 year old girl was injured in a car accident. She now has paraplegia secondary to a T11 spinal cord injury. The nurse identifies the four divisions of spinal column are: cervical, thoracic, lumbar sacral.
  5. The nurse assess for which of the following symptoms in a T11 spinal cord injury? Loss of movements in the upper extremities
  6. Your client is being discharged and has been instructed how to lift objects to avoid lower back strain. Which of the following statements made by the client is correct? I must: maintain alignment of the head, neck, and back while lifting.
  7. A 33 year old client recently had an inguinal hernia repair. The nurse modifies postoperative care from the given most general surgery clients as follows: the client should not cough.
  8. A 23 year old client received multiple superficial; injuries in a motorcycle accident. The nurse in the emergency room will: administer a tetanus injection as prescribed
  9. A 44 year old male client recently had a lumbosacral laminectomy to repair a herniated nucleus pulpous. The nurse would: log-roll the client when changing his position his position in bed.
  10. After a thyroidectomy, a client develops spasms of the hands and feet accompanied by muscle twitching. The nurse identifies these symptoms as sign of : Hypocalcaemia
  11. A client has sustained a head injury from a motor vehicle accident. The nurse would assess for which of the following early signs of increasing ICP ? : lethargy and changing levels of consciousness
  12. The nurse is planning a bowel program for a client with multiple sclerosis. This would include: a high fiber diet
  13. A client in traction for a fractured femur. Which of the following statements indicates understanding of the nurses instructions? : the weights must hang freely at all times.
  14. A 42 year old client returned from the operating room 2 hours ago after having a lumbar disentomb. The nurse would: turn the client every 2 hours by log rolling him.
  15. A 53 year old client is scheduled for an arteriogram to elevate a femoral-distal bypass in the right leg. In order to protect the kidneys from the effects of the iodine - based contrast medium to be used, the nurse should? : check for allergies to the contrast medium.
  16. When assessing cleints over 65 years old the nurse would correctly identify which of the flowing as the most chronic condition in older Americans: Arthritis
  17. The nurse teaching a group of older people about early signs of aging. Which of the following occur in the early stages of aging? : osteoarthritis changes in the cervical spine, difficulty staying up at night and working the next day, difficulty reading fine print without glasses.
  18. A 65-year old client has been taking several aspirins daily for her arthritis. It would be most important for the nurse to observe: GI hemorrhage, decreased neural function
  19. A 68 year old client has bilateral : incomplete question pg 544
  20. A 38 year old woman was hospitalized with a medical diagnosis of cholecystitis. The nurse would expect the history of her present illness include intolerance to which of the following nutrients? : FAT
  21. The preoperative teaching for prevention of postoperative complications includes leg exercises. The nurse teaches leg exercises preoperative to gallbladder surgery to help prevent: stasis and clot formation
  22. A 68 year old client had bilateral total knee replacement under general anesthesia. The surgical procedure lasted 4 hours. Preoperatively the client received instruction on deep -breathing exercises to increase lung ventilation and gas exchange postoperatively. The post surgical nurse observes correct technique when the client is able to : take a slow, deep breath through the nose, hold it, exhale, and cough deeply from the chest.
  23. On the morning of the second day after surgery, data collections reveals pains, tenderness, and swelling in the clients’ left calf. She has not taken the as-needed pain meds ordered for her since the previous day. The nurses next action should to be: immobilize her leg and have her maintain bed rest until the physician examines her leg.
  24. A 78 year old man has been admitted for total joint replacement of his fractures right hip. In conjenction with the hip surgery, the physican orders aspirin 325 mg every day.The nurse is aware that this medication is probably ordered for which of the folowing effects? Anticoagulant
  25. For effective traction, a 9year old boy must be maintained in appropriate position. The nurse is aware that his buttock must be: elevated and clear of the bed.
  26. A pt with gout is discharged from the hospital. Which of the following might best describe the dietary regimen on discharge from the hospital: potatoes, milk, increased fluids.
  27. A nursing diagnosis for a client with gout is alteration in comfort as a result of pain, related to the disease process. when talking about what the client can do to provide comfort and relieve pain, the client gives the following measures. Which one indicates a need for further teaching? Apply pressure to the affected joint as ordered
  28. When planning care for a client with gout, the nurse identifies the major goal of drug therapy in arthritis and related conditions as: reducing inflammation of joints
  29. In teaching a client about the care of leg brace, the nurse should emphasize : the need to inspect skin daily and to expect some minor irritations.
  30. A 28 year-old client was injured in a motorcycle accident. The right leg was amputated above the knee. The nurse explains that a temporary prosthesis will be fitted to the leg. The most important use for a temporary prosthesis immediately after surgery is that it: allows the client to stand with aid within a few days.
  31. A client is learning to use crutches for the first time when planning care for the client , which of the following is most important? Carefully assessing the clients’ activity level.
  32. To prepare for a client for crutch walking, it would be most important for the nurse to: Initiate muscle strengthening exercises for arms and shoulders.
  33. When a client receives a permanent prosthesis, the nurse should teach the client to : inspect the prosthesis daily for loose or worn parts.
  34. A 12 year old boy is in a leg cast for a fractures femur. The most important nursing intervention is to: palpate the pedal pulse.
  35. A 72 year old client is leaving rehabilitation still requires assistance with walking. The physician order her to relocate to a center that will permit daily assistance in walking. Concerned about leaving her husband , who is in poor health, she tells the nurse that she would rather give up walking than leave her husband. The nurses’ response is: I understand that staying with your husband is more important than walking.
  36. A mother has her 12 year old daughter in the arthritis clinic. The physician prescribes naproxen ( Naprosyn)-the first dose 500 mg, then 250 mg every 8 hours- for signs and complains of inflamed joints and pain. The mother asks how long it will take for the naproxen to be effective. Which of the following is the most accurate response by the nurse? Therapeutic effects may bit be noticed for 3-4 weeks.
  37. The nurse is applying an elastic bandage to the sprained ankle of a client in an outpatient clinic. The nurse leaves the toes exposed to : check for circulation and sensation of the extremity.
  38. When positioning a postoperative client who has had a total hip replacement, the nurse is careful to keep the operative leg: abducted
  39. The nurse is to apply an Ace bandage to sprained ankle. The nurse would wrap it beginning at the DISTAL aspect.
  40. A 9 year old child has a short leg cast for a fractures ankle. Instructions to the child and mother on discharge from the ER include: avoid lifting the cast with the finger tips.
  41. A 22 year old client just had a leg cast applied. Wich symptom would be of most concern to the nurse? Loss of sensation in the toes
  42. A 35 year old client is hospitalized with a fractures right femur. Which of the following blood pressures would be considered within the normal range for him: 124/80 mm Hg
  43. A 45 year old auto accident victim has fractures of both arms. The client is in bilateral ( both sides) casts from the shoulders to the hands. Appropriate sites to take the client’s pulse include: carotid or femoral
  44. When teaching healthcare to an older client with osteoporosis, the nurse would: instruct the client to eat foods rich in calcium and to increase physical activity.
  45. The best source of dietary calcium to recommend to a pregnant client is: MILK
  46. Medications used to treatment of rheumatoid arthritis include: anti-inflammatory agents
  47. A clients will be ambulatory on the first day after surgery. The primary benefits of early ambulation are: to facilitate the normal functioning of all body organs and systems, and reduce the danger of potential postoperative complications.
  48. A 44 year old paranoid client is admitted for corrective orthopedic surgery. He refuses oral medication saying that the nurse is trying ti poison him. The nurse would: given him the choice of taking it orally or IM.
  49. A 45 year old client had just had electroconvulsive therapy. The nurse would: reorient the client to time and place
  50. A 12 year old client needs a leg operation. Who should sign the consent form?: let the parents decide
  51. A 45 year old client is scheduled for knee surgery. Because he does not like the hospital food , his wife brings food from home. He is on the regular diet. The nurses best response is to: allow the client to eat the food.
  52. A 42 year old laminectomy client is discharged home. He tells the nurse that he still has pain and is going to see an acupuncturist when he gets home. What is the nurses best response? Be sure to tell your physician that you are seeing an acupuncturist, and to br sure to tell the acupuncturist that you have had a laminectomy.
  53. A 45 year old client on crutches is demonstrating her crutch walking for the nurse. The nurse knows that she is using the crutches correctly if: places her weight on the palms of her hands.
  54. A 33 year old client is recovering from an endoscopy before giving fluids, the most important assessment is determining : bowel sounds
  55. A 30 year old woman fractures her tibia and several metatarsal bones during a fall while she was jogging. A cast was applied extending from the knee to the toes. The nurse makes frequent observations of which of the following: color, temp, and sensation in the toes.
  56. Which of the following statements would indicate that the parent of a child with a newly applied cast needs further instructions? I should use my fingertips to handle the cast.
  57. An 80 year old was being discharged after a below the knee amputation. He told the nurse that his wife has AD. Which action should the nurse take: notify physician to obtain home health consult.
  58. An 87 year old client is scheduled for an above the knee amputation ( AKA). To best prepare the client for postoperative therapy the nurse would: teach crutch walking.
  59. A 79 year old client with osteoarthritis is scheduled to have an arthroplasty ( joint replacement) surgery to the right hip. The client has been active since retirement and is in good health. In the preoperative teaching, the nurse instructs the client that the physician will most likely begin ambulation on the third postoperative joint replacement is : prolonged inactivity in an older adult increases the chance of venous thrombosis.
  60. Preoperative instructions to arthroplasty clients include hip precautions measures. The nurse correctly instructs the client : do not bend to put on your shoes; use a long shoe horn.
  61. A 75 year old client is admitted with gangrene of the right leg. The physician discuss the need for an AKA of the extremity. The initial approach by the nurse flowing the discussion is: spend time with the client and allow him to verbalize feelings.
  62. During a home health visit, the nurse observes that a clients AKA wound was completely healed 1 month postoperative. The nurse most appropriate action by the nurse following the observation is: provide strengthening exercises to all limbs.