ATI comprehensive

ATI comprehensive A nurse is assessing a preschooler who has recurrent and persistent otitis media. When obtaining the child's history, which question should she ask? a. does anyone smoke around or in the same house? b. have you given your child aspirin lately? c. does your child wear a hat outdoors in cold weather? d. is your child's diet high in gluten? ANS - a. does anyone smoke around or in the same house? rationale: promotes adherence of pathogens to inner lining of the middle ear a nurse is teaching the patent of a child who has severe reactive airway disease about glucocorticoid therapy. the parent asks why her child has to inhale the medication instead of taking it orally. which information should the nurse provide? a. inhaled are less likely to cause thrush b. they are hazardous during times of stress c. they are more effective for acute bronchospasm d. more likely to slow linear growth in children ANS - d. more likely to slow linear growth in children rationale: chronic use in high doses by children can decrease linear growth why should you not take sertraline with st johns wort? ANS - it increases the risk for serotonin syndrome a pt is taking bleomycin for lympoma- what assessment should be the nurses priority? a. cbc b. peripheral edema c. urinary output d. pulmonary function ANS - d. pulmonary function rationale: it can cause severe lung injury which of the following should the nurse use as a common example suggesting child abuse in a preschooler? a. bilateral knee bruising with sutures in one b. frequent vague reports of stomach ache or headache c. arm cast for a spiral fracture d. consistent bedwetting ANS - c. arm cast for a spiral fracture rationale: happens due to twisting of extremity, likely due to an abusive injury a med/surg nurse with little pediatric experience is floated to the peds unit. which action should the nurse manager take? a. provide constant supervision b. delegate to the med surg nurse tasks that AP perform c. assign a unit nurse to act as a resource for the med surg nurse d. have the med-surg nurse provide relief during break and lunch ANS - c. assign a unit nurse to act as a resource rationale: provides consistent support what should the nurse monitor for in a pt with GERD? a. anemia b. aspiration c. infection d. weight loss ANS - b. aspiration rationale: food/gastric acid back up into esophagus, putting them at risk for aspiration is candidiasis an opportunistic infection? ANS - yes which is a sign that the pt has an abdominal aortic aneurysm that is expanding (AAA)? a. increased bp, decreased pulse b. report of sudden, severe back pain c. jugular vein distention and peripheral edema d. report of retrosternal chest pain radiating to the left arm ANS - b. report of sudden severe back pain rationale: indicates aaa extending downward and pressing on the lumbar sacral nerve roots what should the nurse monitor in a client taking clozapine? a. bp b. urine output c. urine specific gravity d. temperature ANS - d. temperature rationale: clozapine can cause agranulocytosis, increasing risk for infection which lab indicates hypovolemia? a. hct 55% b. cap refill 1.5 seconds c. urine specific gravity 1.001 d. BUN 18mg ANS - a. hct 55% rationale: indicates hemoconcentration What should the nurse tell pt regarding lasik? a. expect complete healing and clear vision in 1 weej b. you may drive home after the procedure c. continue to wear your contact lenses until the day of surgery d. you might need glasses after the surgery ANS - d. you might need glasses after the surgery rationale: overcorrection or undercorrecction is possible, some may still need glasses an ecg of a pt with hypocalcemia would look how? ANS - prolonged q-t intervals What should be monitored in a pt taking lamotrigine? a. headache b. diplopia c. rash d. dizziness ANS - c. rash rationale: pt at greater risk for stevens-johnson sydrome or toxic epidermal necrolysis- life threatening. manifests as a rash in the first 2-8 weeks which reaction is expected of an acute intravascular hemolytic reaction? a. low body temp b. decreased respirations c. severe htn d. sudden oliguria ANS - d. sudden oliguria rationale: reaction causes AKI which manifests as sudden oliguria what is a common adverse effect of the TB medication ethambutol? a. mottling of the extremities b. yellowing of sclera c. orange-red urine and bodily secretios d. loss of red/green color discrimination ANS - d. loss of red/green color discrimination rationale: occurs due to optic neuritis - orange/red secretions occurs with rifampin - yellowing of sclera occurs with izoniazid what adverse effect should the nurse monitor in a pt taking acarbose for dm? a. insomnia b. polycythemia c. joint pain d. diarrhea ANS - d. diarrhea rationale: GI upset is most common s/e when is it not appropriate to keep 4 side rails up? ANS - you cannot keep all 4 up if a client is confused- this may cause him to try to climb the side rails and increases risk for injury what is a severe s/e of the AIDS medication, Zioduvudine? ANS - anemia and neutropenia - monitor for decreased hgb A pt comes in with respiratory distress post left-sided blunt chest trauma. Left side has absent breath sounds with a tracheal shift to the right. what should the nurse prepare to do? a. ct scan of chest b. thoracentesis c. tracheostomy placement d. chest tube insertion ANS - d. chest tube insertion rationale: manifestations indicate pneumothorax d/t blunt chest trauma. should prepare for pcp to insert a chest tube and connect it to a water seal drainage system which lab value indicates a therapeutic response to taking warfarin? a. hgb 15 b. aptt 35 sec c. inr 3.0 d. hct 45% ANS - c. inr 3.0 rationale: INR of 3.0 indicates effective therapy - aptt monitors effectiveness of HEPARIN not warfarin a nurse is caring for a client who has chronic phantom limb pain following an above the knee amputation. which medication should the nurse verify with the provider? a. meperidine b. gabapentin. c. propranolol d. amitryptiline ANS - a. meperidine rationale: opiods are more effective for residual limb pain than phantom limb pain - this medication is not to be used long term d/t metabolite build up which symptom indicates a pt on hemodialysis is developing disequilibrium syndrome (DDS)? a. headache b. bradycardia c. elevated BUN d. temp 102.5 ANS - a. headache rationale: DDS is a CNS disorder that can develop in new dialysis pt d/t sudden removal of solutes. - headache, n/v, decreased LOC, sz, and restlessness are symptoms of DDS - can be fatal which has higher calcium? broccoli or collard greens? ANS - collard greens - broccoli is high in folic acid what is a common symptom of presbyopia? ANS - being unable to see things close d/t to age ex: being unable to read newspaper what is an adverse effect of doxycycline? a. blurred vision b. constipation c. photosensitivity d. ototoxicity ANS - c. photosensitivity rationale: avoid direct sunlight which medication would the dr prescribe for SIADH? a. vasopressin b. desmopressin c. chlorpropamide d. tolvaptan ANS - d. tolvaptan rationale: promotes excretion of water, helping to correct the fluid imbalance primary prevention ANS - ex: dietary teaching to prevent dm, cancer, etc secondary prevention ANS - ex: screening tertiary prevention examples ANS - ex: information about ostomy appliances, dm appliances what should the nurse teach the pt about an EEG? a. it's common to have temporary short term memory loss after the procedure b. shampoo your hair before the procedure and don't use any products in it c. you'll feel mild electrical sensations d. do not eat or drink anything except water after midnight ANS - b. shampoo your hair before the procedure and don't use any products in it - tech will attach electrodes to the scalp, so hair must be clean and free of oils what is an ex of associative looseness? ANS - a what is an ex of word salad? ANS - b what is an ex of clang association? ANS - c what is an example of echolalia? ANS - d