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A client receives a new prescription for and ACE inhibitor. Which client history contraindicates
its use?
A. ASthma
B. Heart failure
D. Renal artery stenosis
D. Coronary artery disease C
A client prescribed furosemide for the past six months is scheduled to receive digoxin for heart
failure. Which laboratory serum levels should the nurse review before administering the digoxin?
A. Calcium
B. Magnesium
C. Potassium
D. Furosemide C
The nurse is planning discharge instructions for a client newly prescribed amitriptyline for
depression. Which instruction is important for the nurse to include in the client's teaching?
A. Do not ingest foods with tyramine
B. Avoid the consumption of alcohol
C. Obtain daily blood pressure readings
D. Take with a glass of orange juice B
A client at 30 weeks gestation in labor receives two 12 mg doses of betamethasone
intramuscularly 12 hours apart. The clients asks the nurse why she is receiving the
betamethasone. Which explanation should the nurse give the client?
A. The medication suppresses uterine contractions
B. the medication stimulates fetal surfactant production
C. The medication reduces maternal and fetal tachycardia
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,D. The medication maintains adequate maternal respiratory effort B
The mother of a newborn refuses to have her newborn administer the vitamin K injection. Which
information should the nurse provide the mother?
A. Bacteria that synthesize vitamin K are not present in the newborn's intestinal tract
B. Oral vitamin K impedes the synthesis of clotting factors in the liver
C. The maternal diet is often deficient in vitamin K, so the newborn is deficient in the vitamin K
D. The synthesis of vitamin K is inadequate for 3 to 4 months in the newborn A
An end-stage terminally ill client being cared for at home is receiving morphine via a patient-
controlled pump for intractable cancer pain. When the hospice nurse visits, the client awakens,
moans in severe pain, and asks for an increase in the morphine dosage. The client's heart rate is
80 beats/minute, respirations are 10 breaths/minute, and the blood pressure is 102/68 mHg.
Which is he best action for the nurse to implement?
A. Titrate the morphine dose upward until the client has adequate pain relief
B. Suggest to the family that they can also give the client ibuprofen, a non-narcotic analgesic
C. Hold additional morphine until the client's respirations are at least 16 per minute
D. Inform the client that an increased dose of morphine increases side effects without additional
pain control A
The nurse is performing a physical assessment for a client who received fentanyl via an epidural
infusion eight hours ago. Which finding should the nurse anticipate?
A. headache
B. Agitation
C. Urinary retention
D. Abdominal cramping and diarrhea C
A client receives a new prescription for pentazocine (Talwin), a mixed opioid agonist-antagonist,
after an opioid agonist is discontinued. What is the advantage for the client when the new
prescription is implemented?
A. tolerance does not occur
B. less agitation is experienced
C. The analgesic ceiling is higher
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, D. Respiratory depression is less D
A client is being treated with imipramine, an anti-depressant for chronic cancer pain asks the
nurse, "What is the reason for the antidepressant medication?" Which explanation should the
nurse provide the client?
A. Increases pain threshold by stimulating opiate receptors in the CNS to release of endogeneous
enkephalins
B. Decreases perception of pain by blocking opiate receptors in the brain and descending
inhibitory nerves
C. Decreases transmission of pain impulses by altering serotonin and norepinephrine activity at
nerve synapses
D. Increases pain tolerance through relief of depression by increasing the amounts of
norepinephrine in the brain C
The nurse should implement which action to provide analgesic titration for a client in pain?
A. teach the client to increase the time range between doses of pain medicatin
B. Monitor the effects of continuous intravenous infusion of narcotic analgesics
C. Plan with the client how to use a specific total dose of analgesic over a 24-hour period
D. Determine the optimal analgesic dosage required that causes the least side effects D
The nurse receives a unit of blood from the blood bank for a postoperative client who is currently
in the X-ray department. Which action should the nurse implement?
A. Return the blood to the blood bank for refrigeration within 30 minutes
B. Hang the blood transfusion as soon as the client returns to the unit
C. Store the blood bag in the nursing unit's refrigerator until the client returns
D. take the unit of blood to the X-ray department to initiate the transfusion A
A client is admitted for atrial fibrillation, and the healthcare provider prescribes disopyramide
(Norpace). After explaining the action of the antidysrhythmic agent, which complaint should the
nurse instruct the client to report?
A. Joint pain
B. Dizziness of muscle weakness
C. Daily weight gain fo 2 pounds
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