Nokea
You are providing care to a patient with COPD who is receiving medical treatment for exacerbation. The patient has a history of diabetes, hypertension, and hyperlipidemia. The patient is experiencing extreme hyperglycemia and bruising. Which medication ordered for this patient can cause hyperglycemia and bruising?
- A. Prednisone
- B. Atrovent
- C. Flagyl
- D. Levaquin
Correct Answer: A
Rationale: Prednisone , a corticosteroid, commonly causes hyperglycemia and easy bruising as side effects. Atrovent , Flagyl , and Levaquin are not typically associated with these effects.
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The nurse is discussing the results of a tuberculosis skin test. Which explanation should the nurse provide the client?
- A. A red area is a positive reading that means the client has tuberculosis.
- B. The skin test is the only procedure needed to diagnose tuberculosis.
- C. A positive reading means exposure to the tuberculosis bacilli.
- D. Do not get another skin test for one (1) year if the skin test is positive.
Correct Answer: C
Rationale: A positive TB skin test (C) indicates exposure to TB bacilli, not active disease, requiring further testing (e.g., chest X-ray). Redness alone (A) is not diagnostic; induration is measured. The skin test (B) is not definitive for diagnosis. Annual testing (D) may be needed in high-risk groups.
A patient is ordered by the physician to take Pulmicort and Spiriva via inhaler. How should the patient take this medication?
- A. The patient should use the medications every 2 hours for acute episodes of shortness of breath.
- B. The patient should use the Spiriva first and then 5 minutes later the Pulmicort.
- C. The patient should use the Pulmicort first and then the Spiriva 5 minutes later.
- D. The patient should use the medications at the same exact time, regardless of the order.
Correct Answer: B
Rationale: Spiriva (anticholinergic) should be used first to open airways, followed by Pulmicort (corticosteroid) 5 minutes later to reduce inflammation. Every 2 hours is incorrect for maintenance drugs, and order matters (C, D).
You are assessing your newly admitted patients who are all presenting with atypical signs and symptoms of a possible lung infection. The physician suspects tuberculosis. So, therefore, the patients are being monitored and tested for the disease. Select all the risk factors below that increases a patient's risk for developing tuberculosis:
- A. Diabetes
- B. Liver failure
- C. Long-term care resident
- D. Inmate
- E. IV drug user
- F. HIV
- G. U.S. resident
Correct Answer: C,D,E,F
Rationale: Remember from our lecture we discussed the risk factors for developing TB and to remember them I said remember the mnemonic "TB Risk". It stands for tight living quarters (LTC resident, prison, homeless shelter etc.), below or at the poverty line (homeless), refugee (especially in high risk countries), immune system issue such as HIV, substance abusers (IV drugs or alcohol), Kids less than the age of 5....all these are risk factors.
A patient is receiving continuous IV Heparin for anticoagulation therapy for the treatment of a DVT. In order for this medication to have a therapeutic effect on the patient, the aPTT should be?
- A. 0.5-2.5 times the normal value range
- B. 2-3 times the normal value range
- C. 1.5-2.5 times the normal value range
- D. 1-3.5 times the normal value range
Correct Answer: C
Rationale: An aPTT should be 1.5-2.5 times the normal value range for Heparin to achieve a therapeutic effect in a patient to prevent blood clots. If the aPTT is too low, blood clots can form. If the aPTT is too high, bleeding can occur.
The client diagnosed with oat cell carcinoma of the lung tells the nurse, 'I am so tired of all this. I might as well just end it all.' Which statement should be the nurse's first response?
- A. Say, 'This must be hard for you. Would you like to talk?'
- B. Tell the HCP of the client's statement.
- C. Refer the client to a social worker or spiritual advisor.
- D. Find out if the client has a plan to carry out suicide.
Correct Answer: A
Rationale: Acknowledging feelings and offering to talk (A) opens communication for suicidal ideation. Notifying HCP (B), referring (C), and assessing plans (D) follow.