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Terms in this set (142)Which is an acceptable reason for giving antibiotic prophylaxis? Before a dental procedure in a patient with a history of bacterial endocarditis. ________ should not be given during pregnancy and lactation due to effects on developing bones and teeth of the fetus/infant. Tetracycline Which of the following methods has been identified as helping prevent the development of antimicrobial resistance? Using narrow spectrum antibiotics when possible The nurse is caring for a patient on a medical-surgical unit who has a fever of unknown origin and is beginning to exhibit signs of worsening condition. The prescriber has ordered a broad-spectrum antibiotic. Which intervention is the priority? Obtaining blood cultures quickly before administering the antibiotic Endotoxins are produced by Gram-negative bacteria. When a patient is receiving multidrug therapy with vancomycin and gentamicin the nurse should carefully monitor for impaired Renal function A patient has been receiving gentamicin for 3 days, and their urinary output has decreased and creatinine increased. The provider has ordered a trough level with the next dose; that dose is scheduled for 1700 today. The trough level should be drawn at 1630 today A patient has shingles (a viral infection). Which of the following would be an appropriate medication given this diagnosis? Acyclovir The action of penicillin G potassium could best be described as Bacteriocidal; inhibits synthesis of cell wall and causes rapid cell lysis Certain antibiotics, including some of the cephalosporins, can cause a disulfiram type reaction. This would occur if the patient uses _______ while on the drug, and the symptoms would include _______ Alcohol; flushing, nausea/vomiting, and headache A patient is admitted to a medical unit and prescribed IV ampicillin and gentamicin after a specimen was sent for blood culture and sensitivity. The nurse knows the priority reason for notifying the provider of culture results as soon as they are available is that ampicillin and gentamicin Provide broad spectrum coverage when given together, and there may be a more narrow-spectrum antibiotic appropriate for the organism. The mother of a child who has been prescribed antibiotics for strep throat telephones the pediatrician's office and states "my child's temperature is normal, and she says her throat doesn't hurt anymore, but we still have enough antibiotics for 5 more days. Do I really have to give her all of the antibiotics?" Which of the following responses by the nurse is appropriate? "It is important that you finish giving your child the antibiotics in order to prevent the infection from returning." A nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Upon assessing the patient, the nurse notices the individual has developed oral thrush. Which of the following terms describes the reason for thrush (oral candidiasis) with prolonged antibiotic use? Suprainfection Tendon rupture can occur in children and patients over the age of 60 as a side effect of which of the following medications? Ciprofloxacin A nurse transcribes a new prescription for penicillin G potassium given IV every 8 hours and gentamicin given IV every 12 hours. Which is the best schedule for administering these drugs? Give the penicillin at 0800, 1600, and 2400; give the gentamicin at 0600 and 1800 A patient who is receiving IV ciprofloxacin for pneumonia develops diarrhea. A stool culture is positive for C. diff. (Clostridium difficile). The nurse will expect the provider to Prescribe metronidazole. Which side effect of cefaclor causes the most concern and may warrant discontinuation of the drug? Bloody diarrhea The nurse effectively uses isolation equipment (gown, gloves, mask); how does this interrupt the chain of infection? Blocks the mode of transmission Which of the following is NOT TRUE regarding the progression from 1st to 4th generation cephalosporins? Decreasing tolerance by most patients The microorganisms that make up the normal human flora are important for Preventing the colonization and multiplication of pathogens. When immunoglobulin crosses the placenta what type of immunity does the fetus receive? Passive A client returns to the clinic to receive evaluation of his routine PPD test screening for tuberculosis. There is a 2 mm raised reddened area at the site of injection. What is the best nursing interpretation of this information? The positive results indicate that the client has been exposed to the tuberculosis bacilli and has had a delayed type IV response. A client has systemic lupus erythematosus (SLE). What statement best describes this client's immune response? An immune response that no longer recognizes normal body tissue. Which patient will develop active immunity? A patient who: Has natural exposure to an antigen or receives an immunization. A 30-year-old female complains of fatigue, arthritis, rash, and changes in urine color. Laboratory testing revels anemia, low lymphocyte count, and kidney inflammation. Assuming a diagnosis of systemic lupus erythematosus (SLE), which of the following is also likely to be present? Antinuclear antibodies (ANA) A 10-year old male is stung by a bee while playing in the yard. He experiences a severe allergic reaction and has to go to the ER. The nurse providing care realizes this reaction is the result of: IgE The spleen is an important structure of the immune system because it: Filters the blood The most abundant class of antibody in the serum is: IgG The first antibody to develop in a typical primary immune response is: IgM In addition to matching ABO antigens, a blood transfusion must also be matched for: Rh Antigen Functions of antibodies include all of the following EXCEPT: Phagocytosis Which of the following is NOT a possible side effect of a vaccine? Elevated liver enzymes A client with allergies is prescribed diphenhydramine (Benadryl), a first-generation antihistamine. Which statement indicates the client understands the teaching concerning this medication? "I will probably get drowsy when I take this medication" I client has a severe anaphylactic reaction to a bee sting. Which priority discharge intervention should the nurse discuss with the client? Have an Epi-Pen available at all times. A nurse begins a transfusion of blood to a patient. Twenty minutes later the patient is complaining of chills and back pain; when you assess the vital signs, the patient is febrile and hypotensive. Which intervention should the nurse implement first? Stop the transfusion of blood. Influenza vaccine should not be administered to patient who are hypersensitve to : Chicken or egg products Blood transfusions should always be given with what type of IV fluid? NS Which of the following is NOT true about Rheumatoid Arthritis (RA)? Symptoms are unilateral and usually begin in the feet. A 6-year-old female is diagnosed with a bacterial infection of the respiratory system. Which of the following will be made by her body to fight the antigen? Antibodies H1 antagonists cause which of the following: Dry mouth When CO2 levels in the blood rise, a state of hypercapnia occurs in the body. What factors contribute to hypercapnia? (Select all that apply) Abnormalities in respiratory function Put the events of IgE-mediated asthma reaction in the order in which they occur. 1. Exposure to allergen The lungs are the working structures of the respiratory system, and they have several functions. Which of the following are functions of the lungs? (select all that apply) Convert angiotensin I to angiotensin II Budesonide (Pulmicort Respules) 0.2 mg is prescribed via nebulizer. Budesonide is available as 250 mcg/2ml. How much budesonide should be administered via nebulizer at each dose? 1.6 ml Renders cough more productive by stimulating the flow of respiratory secretions. Guaifenesin Blocks cholinergic receptors, thereby decreasing rhinorrhea (runny nose). Ipratropium The most effective OTC nonopiod cough medicine, and the most widely used of all cough medicines Dextromethorphan
Cough suppression is achieved only at doses that produce prominent sedation. Diphenhydramine A patient with asthma will be using a metered-dose inhaler (MDI) for delivery of an inhaled medication. The provider has ordered 2 puffs to be given twice daily. It is important for the nurse to teach this patient that: The pt should wait 1 minute between puffs. A patient who has been given a prescription for an inhaled glucocorticoid for chronic asthma states they have a friend who got oral candidiasis when using this medication. What can the nurse recommend to the patient to prevent this from happening? Gargle/rinse out their mouth after each dose of the glucocorticoid. A patient is receiving theophylline. Which assessment finding indicates possible toxicity in the patient? Heart rate of 122 beats per minute. A nurse is instructing a client about the use of albuterol and beclomethasone inhalation therapy at home. The nurse should instruct the client to: use the bronchodilator followed by the corticosteroid A nurse is teaching a client who is taking bronchodilators. Which statement by the client indicates that the client understands the teaching? "I can use albuterol for an asthmatic crisis." On auscultation, the nurse hears wheezing in a client with asthma. Considering the pathophysiology of asthma, what would the nurse identify as the primary cause of this type of lung sound? Movement of air through narrowed airways. The nurse is monitoring a patient who is experiencing an acute asthma attack. What observations would indicate an improvement in the client's condition? Respiratory rate of 18 breaths per minute. The nurse understands that the physiologic mechanism that initiates breathing in a client with emphysema is: low O2 levels The nurse prioritizes that which of the following patients' needs immediate medical attention and emergency intervention? A patient: With a shift of the trachea to the left and no breath sounds on the right. A patient reports that she is having difficulty breathing and feels she cannot get enough air. What term should the nurse use to document this condition? dyspnea A patient presents to the ER for difficulty breathing. Physical exam reveals bluish skin and mucous membranes. How should the nurse document this physical finding? cyanosis A 30-year-old male is involved in a motor vehicle accident and sustains trauma to the lungs and chest wall. He experiences respiratory failure. Which of the following lab values would the nurse expect? Elevated PaCO2 The nurse is administering cromolyn sodium to a client with asthma. What is the action of this medication? Stabilizes the mast cell membranes The nurse assisting the client with chronic obstructive pulmonary disease would use which of the following statements to explain why dyspnea occurs? "Your airways open wider on inspiration, and trap air on expiration." A firefighter involved in fighting a house fire is hospitalized for smoke inhalation. About 18 hours later, he develops severe hypoxemia requiring intubation and ventilation. Which of the following is the most likely cause? Acute respiratory distress syndrome (ARDS) A patient with chronic bronchitis presents to the ER. Tests reveal closure of the airway during expiration. When planning care, the nurse recalls this is most likely caused by: Thick mucus from hypertrophied glands A patient is diagnosed with restrictive lung disease caused by fibrosis. The nurse would expect to see _______ on their pulmonary functions test. Decreased functional residual capacity. A nurse is preparing to teach the staff about asthma. Which information should the nurse include? Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by: Mucus secretion, bronchoconstriction, and airway edema When sympathomimetics such as oxymetazoline (Afrin) are used intranasally for more than 3-5 days, a common ADR is: Rebound congestion Deactivation of surfactant and/or decreased surfactant production lead to: Alveolar collapse Which plasma lipoprotein level is most concerning when considering the risk of coronary atherosclerosis? LDL of 180 mg/dL Which of the following is NOT a side effect of nicotinic acid? Hypoglycemia A nurse is instructing a patient receiving a cholesterol lowering drug. Which information should the nurse include in the patient education? you should continue an exercise program with the medication Which will the nurse anticipate in a patient who is taking both gemfibrozil and warfarin? increased bleeding time Lovastatin (Mevacor) is prescribed for a patient for the first time. The nurse should provide the patient with which instruction? take this medication in the evening A patient who is taking simvastatin (Zocor) develops an infection and the provider orders azithromycin to treat the infection. The nurse should be concerned if the patient complains of: muscle pain A patient taking nicotinic acid reports uncomfortable flushing of the face, neck, and ears when taking the drug. What should the nurse tell the patient? Taking 325 mg of aspirin 30 minutes before each dose of nicotinic acid may prevent this side effect. A 55-year-old patient died of a myocardial infarction. Autopsy would most likely reveal: Fibrin clot formation within an atherosclerotic coronary artery. After an MI, impaired ventricular function occurs due to: Ischemia leading to hypoxic injury and myocardial cell death. Fatty streaks cause damage to vessels by secreting: inflammatory cytokines A 56-year-old male is diagnosed with coronary artery disease. Which of the following modifiable risk factors would the nurse suggest the patient stop? Smoking cigarettes A 51-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. When he asks what causes the pain, how should the nurse respond? The pain occurs when: The myocardial oxygen supply has fallen below demand. The progression of atherosclerosis begins with: Endothelial injury and inflammation. A patient presents to the ER reporting chest pain. He has a history of stable angina that now appears to be unstable. He most likely has: Impending myocardial infarction. After walking from his car to the clinic, a patient develops substernal pain and discomfort in his left shoulder and his jaw that lasts for 2 minutes and subsides with rest. He indicates that this has occurred frequently over the past few months with similar exertion. The nurse suspects he is most likely experiencing: stable angina An important side effect of nitroglycerin that patients should be instructed about is: orthostatic hypotension What causes Printzmetal angina? idiopathic vasospasm A patient had severe chest pain. Lab tests reveal elevated levels of cardiac troponins I and II. Based upon these findings, the nurse suspects which of the following has occurred? myocardial infarction The patient above has an EKG revealing ST elevation. Which of the following interventions would be most beneficial? Apply oxygen to increase myocardial oxygen supply. Which type of angina occurs more often and women and can be a result of stress? silent cardiogenic shock is caused by an alteration in cardiac function obstructive shock is caused by an obstruction of flow through the circulatory system distributive shock is caused by excessive vasodilation with maldistribution of blood flow hypovolemic shock is caused by a decrease in blood volume circulatory shock is an acute failure of the circulatory system to suppy the peripheral tissues and organs of the body with an adequate blood supply What are the physiologic signs and symptoms of cardiogenic shock: (select all that apply) decrease in mean arterial blood pressure, rise in central venous pressure (CVP), and increased extraction of O2 from hemoglobin What is the primary physiologic result of obstructive shock? elevated right heart pressure An IV bolus of 50mg of amrinone is prescribed for a patient who weighs 154 lbs. Is the dose safe if the recommended dose is 0.75 mg/kg? yes Colesevelam is supplied as 625 mg tablets. How many tablets should the nurse administer if the prescribed dose is 1.9 grams? 3 Parasympathetic stimulation of the heart results in: decreased heart rate and slower AV conduction The impulse delay produced by the AV node allows the atria to: contract before the ventricles A patient admitted with an acute MI has a heart rate of 32 beats per minute. Based on this finding, which area of the heart is most likely serving as the pacemaker? purkinje fibers Beta blockers, such as metoprolol and atenolol, and calcium channel blockers, such as diltiazem may be used to treat: sinus tachycardia A patient who is being monitored by telemetry has a sinus rhythm with a heart rate of 54 beats per minute. The nurse appropriately documents this rhythm as: sinus bradycardia Which assessment data should the nurse obtain prior to administering a calcium channel blocker? the patient's blood pressure A patient is exhibiting multifocal PVCs (premature ventricular contractions) about every 3rd beat on their telemetry strip. The nurse should prepare to administer: amioderone A patient reports weakness, dizziness, and light-headedness, and is exhibiting sinus bradycardia on their telemetry strip. The nurse administers atropine sulfate intravenously. Which finding best demonstrates that the medication was effective? the patient's apical pulse rate is 68 beats per minute The nurse is preparing to administer adenosine for the patient diagnosed with SVT (supraventricular tachycardia). Which finding would indicate the effectiveness of the medication? the patient's ECG tracing shows normal sinus rhythm A patient who is 1 day post-op after open heart surgery has a heart rate of 120 with a P-wave preceding each beat and normal PR interval and QRS duration. The patient's vital signs are: Temp 101.8, Pulse 110, Respirations 24, and B/P 128/82. Which intervention should the nurse implement? administer acetaminophen A patient with atrial fibrillation is being discharged from the hospital. Which instructions will the nurse discuss with the patient? dietary restrictions while taking warfarin A patient's monitor shows an irregular rhythm and a rate that increases and decreases in consistent cycle with 8 beats counted in a 6-second strip. This rhythm most likely represents: sinus arrhythmia The treatment of choice for a patient with ventricular fibrillation is: defibrillation The term pulseless electrical activity (PEA) refers to a condition in which there is: electrical activity in the heart but no actual contraction Antiarrhythmic drugs that depress the rate of depolarization belong to class: I. The drug that blocks vagal stimulation and increases the heart rate is: atropine A drug known for lowering the resting heart rate is: propranolol Which cycle describes cardiac cells at rest? polarization A patient is experiencing substernal chest pain that radiates to his jaw. Which portion of the patient's ECG complex may become elevated or depressed indicating myocardial damage? ST segment A nurse is caring for a patient with supraventricular tachycardia who will go home on verapamil (extended release). Before discharge, you should instruct the patient: to avoid chewing the drug, which may cause him to get too much of the drug at once. Identify the following arrhythmia: atrial fibrillation Identify the following arrhythmia:
ventricular tachycardia Identify the following arrhythmia: asystole Identify the following arrhythmia: Torsades de pointes A patient with atrial fibrillation is receiving heparin via continuous drip infusion. The heparin comes prepared at 25,000 units in 500 mL of fluid. An order is given by the health care provider to decrease the drip rate by 100 units per hour. The current rate of infusion is 26 mL per hour. What should be the new rate of infusion for the drip (in mL/hr)? 24 A nurse is caring for a patient who is receiving a drug that causes constriction of arterioles. The nurse expects to observe which effect from this drug? decreased stroke volume A patient with a history of hypertension is admitted for a procedure. If the patient's arterial pressure decreases, which clinical manifestation would the nurse expect to see? increased heart rate When would a nurse expect a patient's blood pressure to be the highest? mid-morning
Angiotensin II produces ________ in systemic vascular resistance. an increase A nurse is reviewing a patient's medications before administration. Which drug combination is most concerning in a patient with a history of heart failure and a potassium level of 5.8 mEq/L? captopril and spironolactone A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient? The patient should stop taking the medication and contact her provider immediately. _______ is the primary factor influencing systolic blood pressure, and _______is the major determinant of diastolic pressure. stroke volume; systemic vascular resistance A patient begins taking an ACE inhibitor and complains of a dry cough. What does the nurse correctly tell the patient about this symptom? they should notify their HCP if cough develops A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will the nurse do? instruct the pt not to get up without assistance A side effect of drugs that block calcium access to the cells is: edema of the extremities A provider has ordered captopril for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril in the past. Which action by the nurse is correct? hold the dose and notify the provider Which of the following is the most common form of hypertension? primary hypertension A patient with diabetes develops hypertension. Which type of medication could mask a primary sign of hypoglycemia? beta blockers A nurse has provided education for a patient newly diagnosed with hypertension who is just beginning therapy with antihypertensive medications. Which statement by the patient indicates a need for further teaching? When my symptoms subside, I may discontinue the medications. A nurse is discussing how beta blockers work to decrease blood pressure with a nursing student. Which statement by the student indicates a need for further teaching? Beta blockers block the actions of angiotensin II A patient who does not consume alcohol or nicotine products reports a strong family history of hypertension and cardiovascular disease. The patient has a blood pressure of 126/82 and a normal weight and body mass index for height and age. The nurse will expect to teach this patient about: The dash diet, sodium restriction, and exercise. A client with hypertension has been taking a calcium channel blocker, a loop diuretic, and an ACE inhibitor for 3 years. Which statement by the client would warrant intervention by the nurse? "I drink grapefruit juice every morning with my breakfast." What is the equation used to express cardiac output (CO)? CO=SV+HR As the needs of the body change, the heart's ability to increase output needs to change too. This ability in the heart depends on what factors? (Select all that apply) preload, afterload, heart rate, cardiac contractility Put the sequence and actions of the renin-angiotensin-aldosterone system into chronological order. 1. decrease in blood
pressure Students also viewedMidterm 320120 terms murphy_ana medsurg final (from shannons guide)266 terms rowankasicaPlus 329 COL 1 Flashcards74 terms sampleavatar11 OB exam 1148 terms rowankasicaPlus Sets found in the same folderM6: Immunity70 terms haley_perryman01 patho: respiratory88 terms haley_perryman01 Assessment 9 - Hypertension20 terms haley_perryman01 Patho Online Quiz 1 + all patho questions from sli…101 terms CatFish_Yum Other sets by this creatorPediatric Nursing Test 3126 terms haley_perryman01 Mental Health Exam One56 terms haley_perryman01 patho: Mi and Heart Failure96 terms haley_perryman01 patho: cardiac valves and rhythms72 terms haley_perryman01 Other Quizlet setsSociology Final28 terms morgan_keyPlus neuroscience chapter 15119 terms macyumphrey_ ADVSS - Unit 447 terms Spezz509 Intro to Health Care Exam III44 terms dzediker What are the stages of atherosclerosis?Atherogenesis can be divided into five key steps, which are 1) endothelial dysfunction, 2) formation of lipid layer or fatty streak within the intima, 3) migration of leukocytes and smooth muscle cells into the vessel wall, 4) foam cell formation and 5) degradation of extracellular matrix.
Which occurs first in the development of atherosclerosis?The oxidation of low density lipoprotein (LDL) to Ox-LDL indicates the first step of atherosclerosis in cardiovascular diseases.
What process occurs in atherosclerosis quizlet?Atherosclerosis is an inflammation process that results in fatty lesions. Arteriosclerosis causes the hardening of the arterial wall, resulting in a loss of elasticity and distensibility.
When does atherosclerosis occur quizlet?Atherosclerosis is a condition in which an artery wall thickens as a result of the buildup up fatty material like cholesterol.
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In which chronological order does the progress of atherosclerosis occur quizlet?
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