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Milestone Exam 1 Questions with correct Answers 2024( A+ GRADED 100% VERIFIED).
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Milestone Exam 1 Questions with correct Answers 2024( A+ GRADED 100% VERIFIED).
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Milestone Exam 1Two hours after taking the first dose of penicillin, a client arrives at the emergency department
complaining of feeling ill, exhibiting hives, having difficulty breathing, and experiencing
hypotension. The nurse will develop an immediate plan of care based on which finding?
A.Severe acute anaphylactic response
B.Side reaction that should resolve
C.Idiosyncratic reaction
D.Cumulative drug response
A - ANS Rationale: Anaphylaxis related to penicillin can cause a life-threatening allergic
response characterized by bronchospasm, laryngeal edema, and a precipitous drop in blood
pressure. This client's ingestion of penicillin and presenting a clinical picture indicate the client is
having an acute reaction with respiratory difficulty. Options B, C, and D are other physiologic
responses to medications, but immediate action is required for a potential loss of airway,
breathing, and circulation.
Which response best supports the observations that the nurse identifies in a client who is
experiencing a placebo effect?
A.Beneficial response or cure for disease
B.Behavioral or psychotropic responses
C.Malingering or drug-seeking behaviors
D.Psychological response to inert medication
D - ANS Rationale:The placebo effect is a response in the client that is caused by the
psychological impact of taking an inert drug that has no biochemical properties. A placebo effect
can be therapeutic, negative, or ineffective but provides no cure or benefit to the client's
progress. The placebo effect may evoke behavioral changes but does not affect neurochemical
psychotropic changes. Malingering and drug seeking are behaviors that a client exhibits to
obtain treatment for nonexistent disorders or obtain prescription medications.
A mother brings her 18-month-old child to the community health center because the child has
had "bad diarrhea" for the last 3 days. She states, "I bought some of this liquid at the pharmacy
and gave my child a half-ounce." The nurse sees that the bottle contains loperamide. What is
the next nursing action?
A.Tell the mother never to give this drug to her toddler.
B.Ask if any other siblings have experienced diarrhea.
C.Take the child's oral and tympanic temperatures.
D.Ask the mother when the child last voided.
D - ANS Rationale: Determining when the child last voided is most important because urine
output is decreased with dehydration and an 18-month-old with a 3-day history of diarrhea could
be severely dehydrated. Although the manufacturer states that loperamide should not be given
to a child younger than 2 years except under the direction of a healthcare provider, option A is
, not the best answer for this question. In addition, loperamide causes an anticholinergic effect of
urinary retention. Data obtained in options B and C are not as high a priority as option D in this
situation.
A client receives an antihypertensive agent daily. Which action is most important for the nurse to
implement prior to administering the medication?
A.Verify the expiration date.
B.Obtain the client's blood pressure.
C.Determine the client's history of adverse reactions.
D.Review the client's medical record for a change in drug route.
B - ANS Rationale:To determine the most accurate response to antihypertensive therapy,
baseline blood pressures should be obtained before an antihypertensive drug is administered
and should be compared with orthostatic vital signs to determine whether any side effects are
occurring. Although options A, C, and D are required nursing actions prior to giving any drug,
the therapeutic response should be determined before another dose is administered.
A client with trichomoniasis (Trichomonas vaginalis) receives a prescription for metronidazole.
Which instruction is most important for the nurse to include in this client's teaching plan?
A.Avoid alcohol consumption.
B.Complete the medication regimen.
C.Use a barrier contraceptive method.
D.Treat partner(s) concurrently.
A - ANS Rationale:Clients should be instructed to avoid alcohol and products containing alcohol
while taking metronidazole because of the possibility of a disulfiram-like reaction. Option B helps
prevent the development of metronidazole-resistant T. vaginalis. To prevent reinfection, clients
should abstain from sexual contact or use a barrier contraceptive while taking metronidazole,
and their partner(s) should be treated concurrently. The most important instruction for client
well-being is option A.
A client with HIV who was recently diagnosed with tuberculosis (TB) asks the nurse, "Why do I
need to take all of these medications for TB?" What information should the nurse provide?
A.Antiretroviral medications decrease the efficacy of the TB drugs.
B.Multiple drugs prevent the development of resistant organisms.
C.Duration of the medication regimen is shortened.
D.Potential adverse drug reactions are minimized.
B - ANS A multidrug regimen is prescribed for a client with HIV and TB to prevent the
development of resistance of the tubercle bacilli. Although antitubercular medications can inhibit
some antiretrovirals, a multidrug regimen is needed to inhibit the proliferation of the virulent
tubercle bacilli. The duration of antitubercular therapy is typically 6 to 9 months and is not
shortened by the use of multiple medications. A client who is receiving HIV and TB therapy is at
an increased risk of adverse reactions because of the complex medication regimens and
complications secondary to immunosuppression.
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