NUR2407 Module 06 End of Module Open Book Quiz

Module 06 Content

Question 1A client with type I diabetes reports taking propranolol for hypertension. Why would this cause the nurse to be concerned?

1.The beta blocker can cause insulin resistance and hyperglycemia.

2.Using the two agents together increases the risk of ketoacidosis.

3.Propranolol increases insulin requirements because of receptor blocking.

4.The beta blocker can mask the symptoms of hypoglycemia.

Question 2The nurse is administering the first dose of vancomycin to a client with methicillin-resistant staph aureus (MRSA). The client suddenly becomes hypotensive, nauseated and develops hives. What should the nurse do?

1.Give diphenhydramnie to control the symptoms and continue the infusion

2. Stop the infusion and consult the provider for the next steps

3. Report that sepsis is setting in and obtain a stat order for blood cultures

4. Slow down the infusion and offer the client hydroxyzine

Question 3When metronidazole is a component of the H. pylori treatment regimen, what instructions should the client receive?

1. Avoid foods containing tyramine.

2. Take the drug with food.

3. Take the drug on an empty stomach.

4. Avoid any alcoholic beverages.

Question 4In which of these situations would the nurse question the administration of steroid eye drops?

1. For an eye infection

2. After cataract surgery

3. After a corneal abrasion

4. After a chemical eye splash

 Question 5What advice should the nurse offer a client who is being started on a significant amount of prednisone?

1."Consult your doctor if nausea prevents you from taking this drug. Don’t stop it abruptly."

2. "Take the medication on an empty stomach. This will help assure full absorption."

3."Snack often on simple starches and comfort foods. This will help you avoid hypoglycemia."

4."Use table salt. Avoid salt substitute because steroids cause potassium retention and sodium losses."

Question 6Insulin glargine is prescribed for a hospitalized patient who is diabetic. When is this form of insulin usually administered?

1. Approximately 15 to 30 minutes before each meal

2. In the morning and at 4 PM

3. Once daily at bedtime

4. After meals and at bedtime

Question 7A nurse is reinforcing instructions about the effects of diphenhydramine. Which statement by the client indicates that this client needs further instruction?

1."I should avoid driving or activities requiring alertness when taking this medicine.”

2. "I should to use sugarless gum, candy, or oral rinses to decrease dry mouth."

3. "I should avoid alcohol while taking this medication."

4."I should only take this medication in the morning."

Question 8Given these reports on clients receiving chemotherapy, which client should the nurse see first?

1. The client whose gums bleed when he brushes his teeth

2. The client with persistent nausea

3. The client with a temperature of 100.3° F

4. The client with perianal irritation and mouth sores

Question 9The nurse is caring for a client who comes to the clinic with tinea corporis, for which the prescriber orders clotrimazole. What education about this medication should the nurse provide?

1. “Use the medication over the entire body once a week for 1 month.”

2. “Sun exposure will negate the drug’s effects.”

3. “Continue the therapy for at least 1 week after the symptoms have cleared up.”

4. “This drug is effective after a single application.”

Question 10A client in ketoacidosis needs intravenous (IV) insulin. What should the nurse understand before giving IV insulin?

1. The nurse should ask whether insulin detemir or insulin glargine should be given.

2. The same dose that would be given subcutaneously per sliding scale should be used.

3. Insulin should never be given IV, so this order should be questioned.

4.Only regular insulin can be administered IV. It is given in smaller increments.

Question 11An elderly client who lives alone in the community is concerned about recent exposure to the flu and asks for an influenza vaccination. What client education should the nurse provide?

1. “Because exposure has already occurred, the injection will not be of any use to you”

2. “Protection against the flu should begin about 1 to 2 weeks after injection.”

3. “A person should not receive the vaccine unless direct contact has been confirmed.”

4. “The vaccine is given only if the exposures have been verified as type A influenza.”

Question 12A campus nurse is teaching a group of college students about safe use of oral contraceptives. Which of these groups should be counseled to avoid the use of oral contraceptives?

1. Women who had an abortion

2. Women who have given birth

3. Women who have had an intrauterine device (IUD) in the past

4. Women who smoke heavily

Question 13A steroid dependent client has a blood glucose level of 249 mg/dL. Her blood pressure is 178/99 mm Hg and she is complaining of muscle aches and weakness. Her face appears very round and puffy. What type of advocacy does the client need?

1. Advocacy for a thyroid-stimulting hormone (TSH) level is needed because these symptoms indicate Graves' disease

2. Advocacy for fludrocortisone is needed because these symptoms are consistent with Addison’s disease

3.Diuretics and glucose control may be needed, Cushing’s syndrome presents this way

4. Diabetic ketoacidosis is causing the client's sodium pump to shut down, an intravenous insulin drip is needed

Question 14A public health nurse is providing client education for a client who is being treated for scabies. The client has been prescribed 5% permethrin cream to eradicate the scabies. What instruction about applying the cream should the nurse provide?

1. “Apply lotion, covering head to toe every day for 7 to 10 days. Shower after 30 minutes”

2. “Apply cream once over body, but not head, wrap with gauze, rinse after 8-12 hours.”

3. “Apply cream once, cover yourself from head to toe and rinse after 10 minutes.”

4. “Apply permethrin cream to your hair. Cover with a shower cap. Leave in place for 16 hours."

Question 15A client is receiving fluconazole. What should the nurse know to give this medication safely?

1. It is safe to take with liver insufficiency but not with renal insufficiency

2. It can only be given with orange juice

3. It is a class D medication but breastfeeding is fine due to its short half life

4. It may be given every third day, or even as a single dose, due to its long half-life and lingering effects

Question 16The nurse is giving an injection to a client with suspected hepatitis B. After the injection, the nurse suffers a dirty needle stick. What is the most important thing the nurse should do for self protection?

1. Have repeated titers to determine exposure to Hepatitis B

2. Start hepatitis immune globulin injections and the hepatitis B vaccine series (if needed)

3.Start antibiotic therapy immediately

4. Go on sick leave until all screening tests are negative

Question 17The nurse manages care for a client with diabetes who takes metformin. Which laboratory result would cause the nurse to question the prescription?

1.Elevated creatinine

2. Decreased hemoglobin

3. Decreased platelets

4. Increased iron

Question 18A client calls from home to report that his lispro insulin has granules in it. What would be the nurse’s best response?

1.“Agitate the solution, and the granules should disperse.”

2. “Discard the vial. The solution should be clear.”

3. “Use a filter needle to draw it into the syringe.”

4. “Lispro is always cloudy. Proceed with the injection.”

Question 19The nurse is providing client education after laboratory findings reveal an elevated thyroid-stimulating hormone (TSH). How would the nurse best explain the implications of the laboratory finding to the client?

1. “Hypothyroidism causes a decrease in TSH.”

2. “The test result is probably an error because you don’t have a goiter.”

3. “TSH is not a good screening test for thyroid disease.”

4. “ A high TSH implies the need for thyroid medication.”

Question 20Parents bring their child to the clinic because they suspect the child has pinworms. What education is most important for the nurse to provide to the parents?

1. “Albendazole can only be given once in a life time."

2. “The infestation is not easily spread.”

3. “Everyone in the family should be treated.”

4.“The treatment should be limited to symptomatic infestations.”