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Test review 2

Terms in this set (93)

Patients with PUD should decrease modified risk factors such as?
Caffeine and tobacco
Long term use of PPIs like Omeprazole, Pantoprazole increases risk of
bone loss, osteoporosis and osteopenia
combination therapy PPI and antibiotics are commonly prescribed for patients with H pylori + PUD. Most common combinations will add
amoxicillin, clarithromycin and metroindazole (flagly)
antacids should be administered
2 hours before oral medication
sulcrafate works by
dissolving into a gel and sticking to the ulcer almost like a bandaid.
sulcrafate should be taken
1 hour before meals and
the large intestine is responsible for?
the absorption of water and elimination of fecal matter
constipation can be connected to?
low ingestion of fiber containing foods
Constipation happens when..........
stool stays in the instestines for a long time and they get hard
lomotil is a combination of
diphenoxilate and atropine. analgesia is not noted becuase the opiate diphenoxilate does not have analgesic properties
If fat soluble vitamins are consumed in excess it can be
toxic
when a patient is receiving TPN the nurse should remind the physicians to order
blood sugar checks due to high glucose content in the TPN
Patients with diabetes type 1 are at risk for DKA because
endocrine function from the pancreas is not working, thus the pancreas is not producing insulin
if a patient with diabetes becomes unresponsive the nurse must
asses ABC then for hypoglycemia
unopened vials can be stored at room temp but should be stored away from
direct sunlight and heat
type 2 diabetes mellitus
the pancreas produces insulin, but the cells cannot use it
insulin must be injected because
if taken orally it is destroyed in the stomach acid
Metoformin (Glucophage)- type II dm
decreases sugar production in the liver and reduces insulin resistence
which is the only kind of insulin that can be given intravenously (IV)
regular insulin
what is the synthetic form of ADH
vasopressin (used if for diabetes insipudus)
Iodine 131 is utilized in treatment of
hyperthyroidism
if t3 and t4 production is too low, through the negative feedback system
patient may produce high TSH levels
increased risk factors of PUD include
intake of caffeine
intake of tobacco
type o blood
excess stress
reglan is a prokinetic agent because it
speeds up peristalsis and can be prescribed in the treatment of GERD
Misoprostol (cytotec)
inhibits gastric secretion and stimulates the production of protective mucus
Sucralfate
dissolves into a gel and adheres to the ulcer site
Bismuth (Pepto-Bismol)
inhibits bacterial growth
Antacids
neutralize the acids in the stomach
Levothyroxine
-higher affinity to the protein in the blood
-accelerates the degradation of vitamin K dependent clotting factors enhancing effects of warfarin
patients who are on warfarin and start taking levothyroxine should have their warfarin does
reduced
signs and symptoms of hyperthyroidism
low HR
low temp
pale skin
cold and tired
which hormone is lacking in diabetes insipudus
ADH
what disease is the most common cause of hyperthyroidism?
grave's disease
Elderly's have decreased ______ function
renal
If an elderly is given a medication that are highly excreted by the kidneys the nurse must order what kind of test?
a renal function test
the thyroid hormone requires what from the diet for the thyroid glands to be able to make T3 and T4
iodine
Characteristics of patients with Cushing disease
weight gain
osteoporosis
immune suppression
moon face
increased facial hair
Order of insulin draw
cloudy clear clear cloudy
air air draw draw
patients needing to take NSAIDS can minimize
damage to GI thus preventing ulcers by taking PPI like prilosec
parenteral nutrition such as TPN or PPN is nutrition
delivered through the vein
Due to IV delivery of parenteral there is an increase in
risk for infection
Vitamin C allows for
calcium absorption in the gut
Vitamin D is prescribed with _____ supplementation in patients with osteoporosis
calcium
if taken in excess, fat soluble vitamins can be stored in
the fat and liver
if taken in excess, water soluble vitamins will cause the excess to be
excreted in the urine
enteral feedings are hyperosmolar solution which can lead to
dehydration - w/o water intake. nurse must educate patient to consume extra fluids between feedings
if a patient is going to take a bulk forming laxative, it is extremely important that the nurse educates the patient to drink
lots of fluid
when taking a bulk forming laxative, it is important that they mix the medication with
a full glass of water and drink another full glass of water afterwards
The nurse is reviewing a patient's laboratory test results and current medications and notes that the patient's prothrombin time is prolonged. The nurse checks the patient's medication list. What vitamin or mineral might be contributing to this?

a. Vitamin A
b. Selenium
c. Vitamin D
d. Vitamin E
d. vitamin E
A patient comes to the office with a chief complaint of hair loss and peeling skin. The nurse notes many vitamins and minerals are on the medication list. The patient reports using vitamins to treat liver disease. The patient's complaint may be caused by an excess of which vitamin or mineral?

a. Vitamin A
b. Zinc
c. Vitamin C
d. Vitamin D
A. vitamin A
The nurse routinely includes health teaching about vitamins to patients. Vitamin D has a major role in which process?

a. Prevention of night blindness and improve vision
b. Regulating calcium and phosphorous metabolism
c. Important for growth and development in children
d. Responsible for DNA and prothrombin synthesis
B. Regulating calcium and phosphorous metabolism
A prenatal patient tells the nurse that she is not taking vitamins because she heard that vitamins may cause damage to the fetus if she becomes pregnant. What is the nurse's best response?

a. Vitamins are beneficial to the pregnant mother and baby.
b. Take extra vitamins now to make up for missed doses.
c. Megadose of vitamins can be harmful in the first trimester.
d. Taking vitamin doses above the RDA is not recommended.
c. Megadose of vitamins can be harmful in the first trimester.
A patient asks the nurse for information about fat- soluble vitamins. What is the nurse's best response?

a. Fat-soluble vitamins are metabolized rapidly.
b. Fat-soluble vitamins cannot be stored in the liver.
c. Fat-soluble vitamins are excreted slowly in urine.
d. Fat-soluble vitamins can never be toxic.
c. Fat-soluble vitamins are excreted slowly in urine.
A patient complains of night blindness. The nurse correctly recommends which foods?

a. Skim milk and peas
b. Fortified milk and eggs
c. Nuts and yeast
d. Enriched breads and cereals
b. Fortified milk and eggs
A patient diagnosed with alcoholism has questions about his medications. The nurse correctly explains that alcoholism can be associated with deficiency of which vitamin?

a. A (beta carotene)
b. B (B-complex)
c. D (ergocalciferol)
d. K (phytonadione)
b. B (B-complex)
A patient complains of anorexia, nausea, and vomiting. The patient's list of medications includes multiple large doses of vitamins. The nurse notes that the patient's complaints may be related to early signs of toxicity of which vitamin?

a. A
b. B
c. C
d. D
d. D
A patient takes iron on a daily basis. Which comment from the patient suggests the need for health teaching related to iron?

a. I will swallow the tablet whole.
b. I will take the tablet before I go to bed.
c. Some multivitamins might include iron.
d. I will keep the tablets out of chilterm-59dren's reach.
b. I will take the tablet before I go to bed.
A patient asks the nurse, "What does copper do for me? I think it must be bad for me." What is the nurse's "best" response?

a. Copper is needed for red blood cell formation.
b. Be sure to include nuts and seeds in your diet.
c. Why do you think copper is bad for you?
d. Are you taking 5 mg of copper a day?
c. Why do you think copper is bad for you?
The nurse is doing preconception counseling with a patient. The patient asks why she must take folic acid (folate) during pregnancy. What is the nurse's response?

a. Folic acid prevents neural tube defects in the developing fetus.
b. Folic acid is known to lower blood glucose in diabetic patients.
c. Folic acid in the gastrointestinal system prevents celiac disease.
d. Folic acid will prevent migraine headaches in pregnant women.
a. Folic acid prevents neural tube defects in the developing fetus.
The nurse is determining a patient's gastric residual before administering an enteral feeding; the last feeding was 240 mL. The patient will be discharged on enteral feedings. It is important to include in the teaching plan that a residual of more than which amount would indicate delayed gastric emptying (based on the last feeding)?

a. 60 mL
b. 125 mL
c. 150 mL
d. 75 mL
c. 150 mL
Name the four categories of enteral formulas? (Select all that apply.)

a. Enteral macronutrient
b. Elemental/semi-elemental
c. Disease-specific
d. Polymeric formula
e. Modular formula
b, c, d, e
The nurse is reviewing the plan of care for a patient receiving enteral therapy. What is the most common complication of enteral therapy?

a. Aspiration
b. Constipation
c. Diarrhea
d. Muscle weakness
c. Diarrhea
Which is appropriate nursing care for a patient receiving total parenteral nutrition (TPN) in an acute care seing? (Select all that apply.)

a. Monitor patient's blood glucose level.
b. Measure intake and output each shift.
c. Administer blood through the TPN line.
d. Monitor the TPN insertion site for erythema.
e. Monitor the patient's weight monthly.
A, B, D
A patient has been on TPN for 1 month, and there is an order to discontinue TPN tomorrow. The nurse contacts the health care provider because sudden interruption of TPN therapy may cause which condition?

a. Dehydration
b. Tremors
c. Urinary retention
d. Hypoglycemia
d. Hypoglycemia
A patient is receiving TPN at home. The visiting nurse assists the family with the care plan, which
includes changing the TPN solution and tubing. What is the recommended initial frequency for changing the tubing?

a. Every 24 hours
b. Every 36 hours
c. Every 48 hours
d. Every 72 hours
a. Every 24 hours
The nurse is reviewing the care plan with a patient using enteral nutrition (EN). Which interventions by the nurse are appropriate for this strategy? (Select all that apply.)

a. Check the continuous route for gastric residual every 2 to 4 hours.
b. Elevate the bed to a 30- to 45-degree angle before administering EN.
c. Change the enteral feeding bag and tubing every 3 to 4 days.
d. Report absent bowel sounds to the health care provider.
e. Explain that any diarrhea is related to the nutrition formula.
A B D
The nurse is to administer enteral medications to a patient who cannot swallow and is receiving continuous enteral feedings. Which is correct concerning administration of the enteral medications?

a. All ordered medications are added to the enteral feeding solution.
b. Dilute liquid medications before administering through the feeding tube.
c. Extra amounts of water are used to dissolve timed- release medications.
d. Undiluted hyperosmolar medications may be given to patients on fluid restriction.
b. Dilute liquid medications before administering through the feeding tube.
A patient complains of constipation and requires a laxative. In providing teaching for this patient, the nurse reviews the common causes of constipation, including which cause?

a. Motion sickness
b. Poor dietary habits
c. Food intolerance
d. Bacteria (Escherichia coli)
b. Poor dietary habits
A patient with nausea is taking ondansetron. She asks the nurse how this drug works. The nurse is aware that this medication has which action?
a. Enhances histamine1 receptor sites 1696
b. Blocks serotonin receptors in the chemoreceptor trigger zone
c. Blocks dopamine receptors in the chemoreceptor trigger zone
d. Stimulates anticholinergic receptor sites
b. Blocks serotonin receptors in the chemoreceptor trigger zone
A patient who has constipation is prescribed a bisacodyl suppository. Which explanation will the nurse use to explain the action of bisacodyl?

a. Acts on smooth intestinal muscle to gently increase peristalsis
b. Absorbs water into the intestines to increase bulk and peristalsis
c. Lowers surface tension and increases water accumulation in the intestines
d. Pulls salts into the colon and increases water in the feces to increase bulk
a. Acts on smooth intestinal muscle to gently increase peristalsis
A patient is using scopolamine to prevent motion sickness. About which common side effect should the nurse teach the patient?

a. Diarrhea
b. Vomiting
c. Insomnia
d. Dry mouth
d. Dry mouth
When metoclopramide is given for nausea, the nurse plans to caution the patient to avoid which substance?

a. Milk
b. Coffee
c. Alcohol
d. Carbonated beverages
c. Alcohol
The nurse is administering difenoxin with atropine to a patient. Which should be included in the patient teaching regarding this medication? (Select all that apply.)

a. Caution the patient to avoid laxative abuse.
b. Record the frequency of bowel movements.
c. Caution the patient against taking sedatives concurrently.
d. Encourage the patient to increase fluids.
e. Instruct the patient to avoid this drug if he or she has narrow-angle glaucoma.
f. Teach the patient that the drug acts by drawing water into the intestine.
A B C D E
A patient is diagnosed with peptic ulcer disease. The nurse realizes that which of these is a predisposing factor for this condition?

a. Helicobacter pylori
b. Hyposecretion of pepsin
c. Decreased hydrochloric acid
d. Escherichia coli
a. Helicobacter pylori
A student nurse is preparing to administer sucralfate to a patient. Which statement by the student nurse demonstrates understanding of sucralfate's mechanism of action?

a. Sucralfate neutralizes gastric acidity.
b. Gastric acid secretion is decreased by inhibiting histamine at histamine2 receptors in parietal cells.
c. Gastric acid secretion is suppressed by inhibiting the hydrogen/potassium adenosine triphosphatase enzyme.
d. Sucralfate combines with protein to form a viscous substance that forms a protective covering over the ulcer.
d. Sucralfate combines with protein to form a viscous substance that forms a protective covering over the ulcer.
A patient is taking famotidine. What information should the nurse teach the patient about this drug? (Select all that apply.)
1732

a. The drug should be administered for 4 to 8 weeks.
b. The drug must be administered 30 minutes before meals.
c. The drug must be administered separately from iron by at least 1 hour.
d. The drug must always be administered with magnesium hydroxide.
e. Smoking should be avoided while taking this drug.
f. Foods high in vitamin B12 should be increased in the diet.
A C E F
When a patient complains of pain accompanying a peptic ulcer, why should the nurse give an antacid?

a. Antacids decrease gastrointestinal motility.
b. Antacids decrease gastric acid secretion.
c. Antacids strengthen the lower esophageal sphincter's action.
d. Antacids neutralize hydrochloric acid and reduce pepsin activity.
d. Antacids neutralize hydrochloric acid and reduce pepsin activity.
A patient is taking famotidine to inhibit gastric secretions. Which side effects of famotidine will the nurse teach the patient? (Select all that apply.)

a. Dizziness
b. Headaches
c. Hypokalemia
d. Hyperkalemia
e. Blurred vision
f. Erectile dysfunction
A B F
The patient is taking esomeprazole for erosive gastroesophageal reflux disease. Which should the nurse include in patient teaching?

a. Take the medication daily with breakfast.
b. Healing should occur in 1 week.
c. This medication decreases stomach acid secretion.
d. A blood test to check kidney function should be done.
c. This medication decreases stomach acid secretion.
A patient is receiving the drug somatropin. Which drug action will the nurse anticipate?

a. Act as an anti-inflammatory agent
b. Increase metabolic rate and oxygen consumption
c. Stimulate growth in long bones at epiphyseal plates
d. Promote water reabsorption from the renal tubules
c. Stimulate growth in long bones at epiphyseal plates
A patient is given desmopressin acetate. The nurse knows that this drug is used to treat which condition?

a. Gigantism
b. Diabetes mellitus
c. Diabetes insipidus
d. Adrenal insufficiency
c. Diabetes insipidus
A patient is taking levothyroxine. For which adverse effect would the nurse monitor?

a. Tachycardia
b. Drowsiness
c. Constipation
d. Weight gain
a. Tachycardia
A patient has just begun taking calcitriol. Which nursing implication would the nurse do?

a. Monitor the patient's weight.
b. Monitor serum calcium levels.
c. Teach side effects of alopecia and petechiae.
d. Instruct the patient to avoid persons with respiratory infections.
b. Monitor serum calcium levels.
A patient is given corticotropin. The nurse knows to monitor the patient for which condition?

a. Weight gain
b. Hyperkalemia
c. Hypoglycemia
d. Dehydration
a. Weight gain
The nurse is administering prednisone to a newly admied patient who is taking multiple other drugs. The nurse would consider which drug interactions with prednisone? (Select all that apply.)

a. Cardiac and central nervous system actions are increased when drug is taken with an adrenergic agent.
b. Potassium-wasting diuretics increase potassium loss, resulting in hypokalemia.
c. Risk for gastrointestinal bleeding and ulceration increases when drug is taken with aspirin or other nonsteroidal antiinflammatory drugs (NSAIDs).
d. The action of prednisone is decreased when taken with phenytoin because phenytoin increases glucocorticoid metabolism.
e. Risk for dysrhythmias and digitalis toxicity increase when drug is taken with cardiac glycosides.
f. Dosage of antidiabetic agents may need to be decreased when taken concurrently with glucocorticoids.
B C D E
The nurse is administering vasopressin to a patient. Which nursing interventions are indicated when administering vasopressin? (Select all that apply.)

a. Record urinary output.
b. Observe the patient's weight and note edema.
c. Monitor the patient for decreased blood pressure.
d. Closely monitor the patient's blood glucose levels.
e. Monitor the patient's pulse for increased heart rate.
f.. Record the patient's daily calcium levels.
A B C E
A patient is diagnosed with type 2 diabetes mellitus. The nurse is aware that which statement is true about this patient?

a. The patient is most likely a teenager.
b. The patient is most likely a child younger than 10 years.
c. Heredity and obesity are major causative factors.
d. Viral infections contribute most to disease development.
c. Heredity and obesity are major causative factors.
Antidiabetic drugs are designed to control signs and symptoms of diabetes mellitus. The nurse primarily expects a decrease in which?

a. Blood glucose
b. Fat metabolism
c. Glycogen storage
d. Protein mobilization
a. Blood glucose
A patient is to receive insulin before breakfast, and the time of breakfast tray delivery is variable. The nurse knows that which insulin should not be administered until the breakfast tray has arrived and the patient is ready to eat?
a. NPH
b. Lispro
c. Glargine
d. Regular
b. Lispro
A patient is receiving a daily dose of NPH insulin at 7:30 a.m. The nurse expects the peak effect of this drug to occur at what time?

a. 8:15 a.m.
b. 10:30 a.m.
c. 5:00 p.m.
d. 11:00 p.m.
c. 5:00 p.m.
A patient is prescribed glipizide. The nurse knows that which side effects and adverse effects may be expected? (Select all that apply.)

a. Tachypnea
b. Tachycardia
c. Increased alertness
d. Increased weight gain
e. Visual disturbances
f. Hunger
B E F
A nurse is teaching a patient how to recognize symptoms of hypoglycemia. Which symptoms should be included in the teaching? (Select all that apply.)

a. Headache
b. Nervousness
c. Bradycardia
d. Sweating
e. Thirst
f. Sweet breath odor
A B D
A patient is newly diagnosed with type 1 diabetes mellitus and requires daily insulin injections. Which instructions should the nurse include in the teaching of insulin administration? (Select all that apply.)

a. Teach family members how to administer glucagon by injection when the patient has a hyperglycemic reaction.
b. Instruct the patient about the necessity for compliance with prescribed insulin therapy.
c. Teach the patient that hypoglycemic reactions are more likely to occur at the onset of action time.
d. Instruct the patient in the care and handling of the insulin container and syringe.
B D
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