Science 3

50 Questions  I  By RNSTUDENT29
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  • 1. 
    When monitoring a patient who has diabetes and is receiving a carbonic anhydrase inhibitor for edema, the nurse monitors for which possible adverse effect?
    • A. 

      Metabolic alkalosis

    • B. 

      Elevated blood glucose

    • C. 

      Hyperkalemia

    • D. 

      Drowsiness


  • 2. 
    The nurse should monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of the following diuretics?
    • A. 

      Hydrochlorothiazide (HydroDIURIL)

    • B. 

      Furosemide (Lasix)

    • C. 

      Metolazone (Zaroxolyn)

    • D. 

      Spironolactone (Aldactone)


  • 3. 
    Mannitol (Osmitrol) has been ordered for a patient with acute renal failure. The nurse knows to administer this drug using which procedure?
    • A. 

      Intravenously, through a filter

    • B. 

      By rapid intravenous bolus

    • C. 

      By mouth in a single morning dose

    • D. 

      Through a gravity intravenous drip with standard tubing


  • 4. 
    Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct?
    • A. 

      “Keep a weekly journal or log of your weight.”

    • B. 

      “Avoid foods high in potassium, such as bananas, oranges, fresh vegetables, and dates.”

    • C. 

      “If you experience weight gain, such as five or more pounds a week, be sure to tell your physician during your next routine visit.”

    • D. 

      “Be sure to change your position slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes.”


  • 5. 
    When reviewing the mechanisms of action of diuretics, the nurse knows that which statement is true about the loop diuretics?
    • A. 

      They work by inhibiting aldosterone.

    • B. 

      They are very potent, having a diuretic effect that lasts at least 6 hours.

    • C. 

      They are particularly useful when rapid diuresis is desired because their onset of action is rapid.

    • D. 

      They have the disadvantage of ceasing to be effective when the creatinine clearance decreases below 25 mL/min.


  • 6. 
    When teaching about hydrochlorothiazide, the nurse should be sure the patient knows to be cautious in taking which medications with hydrochlorothiazide?
    • A. 

      Digitalis

    • B. 

      Penicillin

    • C. 

      Potassium supplements

    • D. 

      Over-the-counter vitamins


  • 7. 
    When a patient is receiving diuretic therapy, which of the following would best reflect the patient’s fluid volume status?
    • A. 

      Blood pressure and pulse

    • B. 

      Serum potassium and sodium levels

    • C. 

      Intake, output, and daily weight

    • D. 

      Measurements of abdominal girth and calf circumference


  • 8. 
    A patient is being discharged to home on a single daily dose of a diuretic. The health care provider instructs the patient to take the dose at which time so it will be least disruptive to the patient’s daily routine?
    • A. 

      In the morning

    • B. 

      At noon

    • C. 

      With supper

    • D. 

      At bedtime


  • 9. 
    A patient is started on a diuretic for antihypertensive therapy. The nurse expects that a drug in which of the following classes is likely to be used initially?
    • A. 

      Loop diuretics

    • B. 

      Osmotic diuretics

    • C. 

      Thiazide diuretics

    • D. 

      Vasodilators


  • 10. 
    A patient in the neurologic intensive care unit is being treated for cerebral edema and is given which type of drug to reduce intracranial pressure?
    • A. 

      Loop diuretics

    • B. 

      Osmotic diuretics

    • C. 

      Thiazide diuretics

    • D. 

      Vasodilators


  • 11. 
    A 79-year-old patient is taking a diuretic for treatment of hypertension. This patient is very independent and wants to continue to live at home, despite his diagnosis of mild heart failure. The nurse will know that which teaching point is important for this patient?
    • A. 

      He should take the diuretic with his evening meal.

    • B. 

      He should skip the diuretic dose if he plans to leave the house.

    • C. 

      If he feels dizzy while on this medication, he should stop taking it and take potassium supplements instead.

    • D. 

      He should take extra precautions when standing up because of possible orthostatic hypotension and resulting injury from falls.


  • 12. 
    A patient on diuretic therapy calls the clinic because he’s had the flu, with “terrible vomiting and diarrhea,” and he has not kept anything down for 2 days. He feels weak and extremely tired. What will the nurse advise this patient?
    • A. 

      “It’s important to try to stay on your prescribed medication. Try to take it with sips of water.”

    • B. 

      “Stop taking the diuretic for a few days, then restart it when you feel better.”

    • C. 

      “You will need an increased dosage of the diuretic because of your illness. Let me speak to the physician.”

    • D. 

      “Please come into the clinic for an evaluation to make sure there are no complications.”


  • 13. 
    When assessing a patient who is receiving a loop diuretic, the nurse looks for the manifestations of potassium deficiency, which would include which symptoms? Select all that apply.
    • A. 

      Dyspnea

    • B. 

      Constipation

    • C. 

      Tinnitus

    • D. 

      Muscle weakness

    • E. 

      Leg cramps

    • F. 

      Lethargy


  • 14. 
    A patient is to receive hydrochlorothiazide via a percutaneous endoscopic gastrostomy (PEG) tube. The order reads, “Give hydrochlorothiazide, 25 mg, per PEG tube once daily.” The medication is available in a liquid form, 50 mg/5 mL. How many milligrams will the nurse administer for each dose?

  • 15. 
    A patient has a deficiency in clotting factors. The nurse will prepare to administer which blood product?
    • A. 

      Cryoprecipitate

    • B. 

      Fresh frozen plasma

    • C. 

      Packed red blood cells (PRBCs)

    • D. 

      Plasma protein fractions


  • 16. 
    When reviewing the health history of a patient, the nurse recalls that potassium supplements are contraindicated in patients with a history of which problem?
    • A. 

      Burns

    • B. 

      Diarrhea

    • C. 

      Renal disease

    • D. 

      Cardiac tachydysrhythmias


  • 17. 
    During a blood transfusion, a patient begins to have chills and back pain. What action will the nurse take first?
    • A. 

      Observe for other symptoms.

    • B. 

      Slow the infusion rate and monitor vital signs.

    • C. 

      Discontinue the infusion immediately and notify the physician.

    • D. 

      Tell the patient that her symptoms are a normal reaction to the blood product.


  • 18. 
    The nurse is preparing to administer intravenous potassium. Which administration technique is correct?
    • A. 

      The intravenous rate should not exceed 30 mEq/hr.

    • B. 

      Oral forms should be given on an empty stomach to maximize absorption.

    • C. 

      Intravenous solutions should not contain more than 60 mEq/L of potassium.

    • D. 

      When given intravenously, potassium must always be given in diluted form.


  • 19. 
    A patient is in an urgent care center and is receiving treatment for mild hyponatremia after spending a long time doing gardening work in the heat of the day. The nurse expects which drug therapy will be used to treat her condition?
    • A. 

      Oral supplementation of fluids

    • B. 

      Intravenous bolus of lactated Ringer’s solution

    • C. 

      Normal saline infusion, administered slowly

    • D. 

      Oral administration of sodium chloride tablets


  • 20. 
    When monitoring a patient for signs of hypokalemia, the nurse looks for what early sign?
    • A. 

      Seizures

    • B. 

      Cardiac dysrhythmias

    • C. 

      Stomach cramps

    • D. 

      Muscle weakness


  • 21. 
    During the infusion of albumin, the nurse monitors the patient closely for the development of which adverse effect?
    • A. 

      Hypernatremia

    • B. 

      Fluid volume deficit

    • C. 

      Fluid volume overload

    • D. 

      Transfusion reaction


  • 22. 
    A patient is receiving an infusion of fresh frozen plasma. The nurse interprets that this patient has which disorder?
    • A. 

      Hypovolemic shock

    • B. 

      Anemia

    • C. 

      Coagulation disorder

    • D. 

      Previous transfusion reaction


  • 23. 
    The nurse is preparing to transfuse a patient with a unit of packed red blood cells (PRBCs). Which intravenous solution should be used along with the PRBC transfusion?
    • A. 

      5% dextrose in water (D5W)

    • B. 

      0.9% sodium chloride (NS)

    • C. 

      5% dextrose in 0.9% sodium chloride (D5NS)

    • D. 

      5% dextrose in lactated Ringer’s (D5LR)


  • 24. 
    The nurse is planning to transfuse a patient with a unit of packed red blood cells (PRBCs). Which patient would be best treated with this transfusion?
    • A. 

      A patient with a coagulation disorder

    • B. 

      A patient with severe anemia

    • C. 

      A patient who has lost a massive amount of blood after emergency surgery

    • D. 

      A patient who has a clotting-factor deficiency


  • 25. 
    After a severe auto accident, a patient has been taken to the trauma unit and has an estimated blood loss of more than 30% of his blood volume. The nurse prepares to administer which product?
    • A. 

      Fresh frozen plasma

    • B. 

      Albumin

    • C. 

      Packed red blood cells

    • D. 

      Whole blood


  • 26. 
    A patient who is severely anemic also has acute heart failure with severe edema due to fluid overload. The physician wants to improve the patient’s anemia. The nurse anticipates that the patient will receive which blood product?
    • A. 

      Fresh frozen plasma

    • B. 

      Albumin

    • C. 

      Packed red blood cells (PRBCs)

    • D. 

      Whole blood


  • 27. 
    During diuretic therapy, the nurse monitors the fluid and electrolyte status of the patient. Which are symptoms of hyponatremia? Select all that apply.
    • A. 

      Red, flushed skin

    • B. 

      Lethargy

    • C. 

      Decreased urination

    • D. 

      Hypotension

    • E. 

      Stomach cramps

    • F. 

      Elevated temperature


  • 28. 
    The order reads, “Give 1500 mL of normal saline over 12 hours. The tubing drop factor is 15 gtt/mL.” The nurse will set the gravity drip infusion at how many drops per minute (gtt/min)?

  • 29. 
    The nurse notes in a patient’s medication history that the patient will be taking desmopressin. Based on this finding, the nurse interprets that the patient has which disorder?
    • A. 

      Diabetes mellitus

    • B. 

      Diabetes insipidus

    • C. 

      Adrenocortical insufficiency

    • D. 

      Carcinoid tumor


  • 30. 
    A 16-year-old boy who is taking somatropin comes into the office because he has had an asthma attack during a race at school. Because of this new development, the nurse expects which intervention to occur next?
    • A. 

      He should stop participation in school physical education classes.

    • B. 

      The somatropin must be discontinued immediately.

    • C. 

      The somatropin dosage may be adjusted.

    • D. 

      His growth should be documented and monitored for changes.


  • 31. 
    When a patient is receiving vasopressin, which therapeutic responses would the nurse expect to see?
    • A. 

      Improved appetite

    • B. 

      Increased serum albumin levels

    • C. 

      Increased serum potassium levels

    • D. 

      Decreased urinary output


  • 32. 
    A pituitary drug is prescribed for a patient with a hormone deficiency, and the nurse provides instructions about the medication. Which statement by the patient indicates a need for further instructions?
    • A. 

      “I will not stop the drug unless my doctor tells me to stop it.”

    • B. 

      “I will call my doctor if I have a fever or sore throat.”

    • C. 

      “I will have to stop drinking my nightly glass of wine.”

    • D. 

      “I am looking forward to a cure for my condition with this hormone replacement.”


  • 33. 
    An 8-year-old girl has been diagnosed with true pituitary dwarfism. She is being treated with somatropin. In follow-up visits, the nurse will monitor for which expected outcome?
    • A. 

      Increased growth

    • B. 

      Decreased urinary output

    • C. 

      Increased muscle strength

    • D. 

      Increased height when she reaches puberty


  • 34. 
    When reviewing the medication profile of a patient with a new order for desmopressin, the nurse is aware that which drugs may have an interaction with desmopressin?
    • A. 

      Aspirin

    • B. 

      Digoxin

    • C. 

      Lithium

    • D. 

      Penicillin


  • 35. 
    A patient’s medication order indicates that he is to receive a dose of cosyntropin. The nurse is aware that this drug is used for what problem?
    • A. 

      Adrenocortical insufficiency

    • B. 

      Diabetes insipidus

    • C. 

      Myasthenia gravis

    • D. 

      Pituitary dwarfism


  • 36. 
    A patient is about to receive a dose of octreotide. The nurse should assess for which of the following contraindications or cautions? Select all that apply.
    • A. 

      Carcinoid crisis

    • B. 

      Diarrhea

    • C. 

      Type 1 diabetes mellitus

    • D. 

      Type 2 diabetes mellitus

    • E. 

      Chronic renal failure

    • F. 

      Esophageal varices


  • 37. 
    A patient, newly diagnosed with hypothyroidism, received a prescription for a thyroid hormone replacement drug. The nurse assesses for which potential contraindication to this drug?
    • A. 

      Infections

    • B. 

      Diabetes mellitus

    • C. 

      Lupus erythematosus

    • D. 

      Recent myocardial infarction


  • 38. 
    A patient with hypothyroidism is given a prescription for levothyroxine. When the nurse explains that this is a synthetic form of the thyroid hormone, he states that he prefers to receive more “natural” forms of drugs. What will the nurse explain to him about the advantages of levothyroxine?
    • A. 

      It has a stronger effect than the natural forms.

    • B. 

      Levothyroxine is less expensive than the natural forms.

    • C. 

      The synthetic form has fewer adverse effects on the gastrointestinal tract.

    • D. 

      The half-life of levothyroxine is long enough to permit once-daily dosing.


  • 39. 
    Levothyroxine has been prescribed for a patient with hypothyroidism. The nurse provides information to the patient about the medication and tells the patient to contact the prescriber if which potential adverse effect occurs?
    • A. 

      Fatigue

    • B. 

      Constipation

    • C. 

      Palpitations

    • D. 

      Drowsiness


  • 40. 
    During a teaching session for a patient on antithyroid drugs, the nurse should discuss which dietary instructions?
    • A. 

      Using iodized salt when cooking

    • B. 

      Avoiding foods containing iodine

    • C. 

      Increasing fluid intake to 2500 mL per day

    • D. 

      Increasing intake of sodium- and potassium-containing foods


  • 41. 
    A patient who is taking propylthiouracil for hyperthyroidism wants to know how this medicine works. What should the nurse explain to her?
    • A. 

      It blocks the action of thyroid hormone.

    • B. 

      It impedes the formation of thyroid hormone.

    • C. 

      It destroys overactive cells in the thyroid gland.

    • D. 

      It inactivates already existing thyroid hormone in the bloodstream.


  • 42. 
    A 19-year-old college student has been diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 1 week, she calls the clinic to report that she feels no better. The nurse’s response is based on the fact that
    • A. 

      She will probably require surgery for a cure.

    • B. 

      Full therapeutic effects may not occur for 3 to 4 weeks.

    • C. 

      She probably did not take her medication as instructed.

    • D. 

      Her diet may be causing absorption problems.


  • 43. 
    When reviewing the drugs taken by a patient who will be starting thyroid replacement preparations, the nurse notes that an interaction may occur with which of the following drugs?
    • A. 

      Vitamin supplements

    • B. 

      Antibiotics

    • C. 

      Anticoagulants

    • D. 

      Beta-blockers


  • 44. 
    When monitoring a patient who is taking a thyroid replacement hormone, which of the following are signs of an excessively high dose of this drug?
    • A. 

      Bradycardia, somnolence, and ataxia

    • B. 

      Nervousness, irritability, and palpitations

    • C. 

      Dry skin, weakness, and weight gain

    • D. 

      Drowsiness, coughing, and neck pain


  • 45. 
    A patient, newly diagnosed with hypothyroidism, has received a prescription for thyroid replacement therapy. The nurse should instruct the patient to take this medication at which time of day?
    • A. 

      In the morning

    • B. 

      With the evening meal

    • C. 

      At bedtime

    • D. 

      Whenever the patient experiences symptoms


  • 46. 
    The nurse is teaching a class about thyroid disease. Which condition is caused by low levels of thyroid hormone during youth?
    • A. 

      Goiter

    • B. 

      Myxedema

    • C. 

      Cretinism

    • D. 

      Graves’ disease


  • 47. 
    A patient has been taking levothyroxine (Synthroid) for more than a decade for primary hypothyroidism. Today she calls because she has a cousin who can get her the same medication in a generic form from a pharmaceutical supply company. The nurse’s best advice would be:
    • A. 

      “This would be a great way to save money.”

    • B. 

      “There’s no difference in brands of this medication.”

    • C. 

      “This should never be done; once you start with a certain brand, you must stay with it.”

    • D. 

      “It’s better not to switch brands unless we check with your doctor.”


  • 48. 
    A patient has a diagnosis of primary hypothyroidism. Which statement accurately describes this problem?
    • A. 

      The hypothalamus is not secreting thyrotropin-releasing hormone (TRH), therefore thyroid-stimulating hormone (TSH) is not released from the pituitary gland.

    • B. 

      The pituitary gland is dysfunctional and is not secreting TSH.

    • C. 

      The abnormality is in the thyroid gland itself.

    • D. 

      The abnormality is caused by an excess intake of iodine.


  • 49. 
    A 19-year-old college student has been diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 6 months, she calls the nurse to say that she feels better and wants to stop the medication. What is the nurse’s best response?
    • A. 

      “You can stop the medication if your symptoms have improved.”

    • B. 

      “You need to stay on the medication for at least a year before a decision about stopping it can be made.”

    • C. 

      “You need to stay on this medication until you become pregnant.”

    • D. 

      “Medication therapy for hypothyroidism is necessary for life, and you should not stop taking the medication.”


  • 50. 
    The nurse is giving morning medications. The Medication Administration Record has an order for “levothyroxine, 75 mcg PO.” The drug-dispensing cabinet contains levothyroxine tablets in milligram strengths instead of micrograms. Calculate the milligram equivalent dose of 75 mcg.

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