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The nurse administered phenylephrine eye drops to the client before performing an ophthalmoscopic eye examination. Which assessment finding should the nurse expect?
- A. Tremor
- B. Hypotension
- C. Pupil miosis
- D. Pupil mydriasis
Correct Answer: D
Rationale: A: Tremors are a side effect if phenylephrine is absorbed systemically. B: Because phenylephrine absorbed systemically is a vasoconstrictor, hypertension (not hypotension) can occur as a side effect. C: Miosis is pupil constriction, not an effect of phenylephrine. D: Phenylephrine (NeoSynephrine), an adrenergic agonist, produces pupil dilation (mydriasis) by activating alpha1-adrenergic receptors on the dilator muscles of the iris.
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Which of the following symptoms is most characteristic of a client with cancer of the lungs?
- A. Exertional dyspnea
- B. Persistent changing cough
- C. Air hunger; dyspnea
- D. Cough with night sweats
Correct Answer: B
Rationale: A persistent, changing cough is the most characteristic symptom of lung cancer, distinguishing it from symptoms associated with COPD, asthma, or tuberculosis.
The parent of the 2-year-old with asthma has been given instructions about asthma control and Step Therapy. Which statement, if made by the parent, should indicate to the nurse that the parent has an adequate understanding of the instructions?
- A. If my child has wheezing twice a week or less, I should add the nebulized corticosteroid and make an appointment.
- B. If my child has a respiratory tract infection I should add the nebulized corticosteroid and make an appointment.
- C. If my child has to use the nebulizer less than twice a week, I should add the nebulized corticosteroid and make an appointment.
- D. If my child has nighttime awakenings with wheezing twice a month or more, I should add the nebulized corticosteroid and make an appointment.
Correct Answer: D
Rationale: A: Asthma symptoms (wheezing) occurring 2 or fewer days per week should be treated at Step 1. B: A respiratory tract infection may require the increased use of short-acting beta agonists, but an inhaled corticosteroid should not be added until the child is evaluated by the HCP. C: The use of the nebulizer twice a week or less should be treated at Step 1. D: Nighttime waking with asthma symptoms 1 to 2 times per month indicates the need to proceed to Step 2 therapy, which includes the use of an inhaled corticosteroid.
The LPN is taking care of a 176-pound client who has recently been diagnosed with diabetes. The primary healthcare provider has written an order for Lantus (insulin glargine injection) 100 units/mL, using weight-based dosing of 0.2 units/kg per day. The LPN should prepare ___ units for administration.
- A. 12
- B. 35
- C. 16
- D. 9
Correct Answer: C
Rationale: To find the answer, you must convert 176 pounds to kilograms. 2.2 pounds = 1 kg. You must divide 176 by 2.2, which equals 80 kg. The client is 80 kg, and they should receive 0.2 units for every kilogram they weigh, so 80 × 0.2 = 16 units.
New medications are prescribed for the client taking lithium. Which medication, if prescribed, should the nurse question with the HCP?
- A. Isosorbide dinitrate by mouth tid
- B. Prednisone 20 mg by mouth daily
- C. Furosemide 80 mg by mouth daily
- D. Insulin aspart 2 units subcut with meals
Correct Answer: C
Rationale: Furosemide (Lasix) is a loop diuretic that promotes sodium loss and lithium retention, increasing serum lithium levels and risk of toxicity.
The nurse is storing vaccines for future use. What should the nurse do so they are properly stored? Select all that apply.
- A. Place all vaccines in a temperature-controlled refrigerator.
- B. Complete periodic checks of the expiration date on the vaccines.
- C. Place bulk supplies of vaccines in a temperature-controlled freezer.
- D. Avoid storing vaccines on the shelf in the door of the refrigerator.
- E. Do not store food or beverage in the same refrigerator or freezer as the vaccines.
Correct Answer: B,D,E,F
Rationale: A: Not all vaccines are refrigerated; some vaccines will be inactivated by refrigeration and freezing. B: Periodic checking for expiration dates is necessary to ensure that outdated vaccines are not administered. C: Not all bulk supplies should be placed in a freezer; some vaccines are inactivated by freezing. D: When refrigeration is required, a main shelf inside the refrigerator is best because a shelf in the door will have frequent temperature changes that will alter the potency of the vaccine. E: Storing food and beverage in the same unit may result in frequent opening of the unit, leading to greater chance of temperature instability and light exposure. Contamination may also result. F: Aluminum foil or packaging can be used to protect light-sensitive vaccines.