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Nursing NGN Med Surg Test bank ( Nursing NGN Med Surg Test bank ( Red HESI Test bank Med-Surg and other resources)2024 QUESTIONS AND ANSWERSNursing NGN Med Surg Test bank ( Red HESI Test bank Med-Surg and other resources)2024 QUESTIONS AND ANSWERSd HESI T$30.49
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Nursing NGN Med Surg
Nursing NGN Med Surg Test bank ( Red HESI Test bank Med-Surg and other resources)2024 QUESTIONS AND ANSWERS
Nursing NGN Med Surg Test bank ( Red HESI Test bank
Med-Surg and other resources)2024 QUESTIONS AND
ANSWERS
25. The nurse identifies the nursing diagnosis of activity intolerance for a patient with
asthma. The nurse assesses for which of the following etiologic factor for this nursing
diagnosis in patients with asthma?
A. Anxiety and restlessness
B. Effects of medications
C. Fear of suffocation
D. Work of breathing - D. Work of breathingWhen the patient does not have sufficient
gas exchange to engage in activity, the etiologic factor is often the work of breathing.
When patients with asthma do not have effective respirations, they use all available
energy to breathe and have little left over for purposeful activity.
26. The nurse is assigned to care for a patient in the emergency department admitted
with an exacerbation of asthma. The patient has received a β-adrenergic bronchodilator
and supplemental oxygen. If the patient's condition does not improve, the nurse should
anticipate which of the following is likely to be the next step in treatment?
A. Pulmonary function testing
B. Systemic corticosteroids
C. Biofeedback therapy
D. Intravenous fluids - B. Systemic corticosteroids Systemic corticosteroids speed the
resolution of asthma exacerbations and are indicated if the initial response to the β-
adrenergic bronchodilator is insufficient.
27. A patient with acute exacerbation of COPD needs to receive precise amounts of
oxygen. Which of the following types of equipment should the nurse prepare to use?
A. Venturi mask
B. Partial non-rebreather mask
C. Oxygen tent
D. Nasal cannula - A. Venturi mask The Venturi mask delivers precise concentrations of
oxygen and should be selected whenever this is a priority concern. The other methods
are less precise in terms of amount of oxygen delivered.
28. While teaching a patient with asthma about the appropriate use of a peak flow
meter, the nurse instructs the patient to do which of the following?
A. Use the flow meter each morning after taking medications to evaluate their
effectiveness.
,B. Empty the lungs and then inhale quickly through the mouthpiece to measure how fast
air can be inhaled.
C. Keep a record of the peak flow meter numbers if symptoms of asthma are getting
worse.
D. Increase the doses of the long-term control medication if the peak flow numbers
decrease. - C. Keep a record of the peak flow meter numbers if symptoms of asthma
are getting worse. It is important to keep track of peak flow readings daily and when the
patient's symptoms are getting worse. The patient should have specific directions as to
when to call the physician based on personal peak flow numbers. Peak flow is
measured by exhaling into the meters and should be assessed before and after
medications to evaluate their effectiveness.
29. The physician has prescribed salmeterol (Serevent) for a patient with asthma. In
reviewing the use of dry powder inhalers (DPIs) with the patient, the nurse should
provide which of the following instructions?
A. "Close lips tightly around the mouthpiece and breathe in deeply and quickly."
B. "To administer a DPI, you must use a spacer that holds the medicine so that you can
inhale it."
C. "Hold the inhaler several inches in front of your mouth and breathe in slowly, holding
the medicine as long as possible." D. "You will know you have correctly used the DPI
when you taste or sense the medicine going into your lungs." - A. "Close lips tightly
around the mouthpiece and breathe in deeply and quickly." Dry powder inhalers do not
require spacer devices. The patient should be instructed to breathe in deeply and
quickly to ensure medicine moves down deeply into lungs. The patient may not taste or
sense the medicine going into the lungs.
30. The nurse determines that a patient is experiencing common adverse effects from
the inhaled corticosteroid beclomethasone (Beclovent) after noting which of the
following?
A. Adrenocortical dysfunction and hyperglycemia
B. Elevation of blood glucose and calcium levels
C. Oropharyngeal candidiasis and hoarseness
D. Hypertension and pulmonary edema - C. Oropharyngeal candidiasis and hoarseness
Oropharyngeal candidiasis and hoarseness are common adverse effects from the use
of inhaled corticosteroids because the medication can lead to overgrowth of organisms
and local irritation if the patient does not rinse the mouth following each dose.
31. The nurse determines that the patient understood medication instructions about the
use of a spacer device when taking inhaled medications after hearing the patient state
which of the following as the primary benefit?
A. "Now I will not need to breathe in as deeply when taking the inhaler medications."
B. "This device will make it so much easier and faster to take my inhaled medications."
C. "I will pay less for medication because it will last longer."
D. "More of the medication will get down into my lungs to help my breathing." - D. "More
of the medication will get down into my lungs to help my breathing." A spacer assists
,more medication to reach the lungs, with less being deposited in the mouth and the
back of the throat.
32. Which of the following test results identify that a patient with an asthma attack is
responding to treatment?
A. A decreased exhaled nitric oxide
B. An increase in CO2 levels
C. A decrease in white blood cell count
D. An increase in serum bicarbonate levels - A. A decreased exhaled nitric oxide. Nitric
oxide levels are increased in the breath of people with asthma. A decrease in the
exhaled nitric oxide concentration suggests that the treatment may be decreasing the
lung inflammation associated with asthma.
33. The nurse determines that the patient is not experiencing adverse effects of
albuterol (Proventil) after noting which of the following patient vital signs?
A. Oxygen saturation 96%
B. Respiratory rate of 18
C. Temperature of 98.4° F
D. Pulse rate of 76 - D. Pulse rate of 76 Albuterol is a β2-agonist that can sometimes
cause adverse cardiovascular effects. These would include tachycardia and angina. A
pulse rate of 76 indicates that the patient did not experience tachycardia as an adverse
effect.
34. The patient has an order for each of the following inhalers. Which of the following
should the nurse offer to the patient at the onset of an asthma attack? A. Albuterol
(Proventil)
B. Beclomethasone (Beclovent)
C. Ipratropium bromide (Atrovent)
D. Salmeterol (Serevent) - A. Albuterol (Proventil) Albuterol is a short-acting
bronchodilator that should initially be given when the patient experiences an asthma
attack.
35. The nurse who has administered a first dose of oral prednisone (Deltasone) to the
patient with asthma writes on the care plan to begin monitoring which of the following
patient parameters?
A. Intake and output
B. Bowel sounds
C. Apical pulse
D. Deep tendon reflexes - A. Intake and output Corticosteroids such as prednisone can
lead to fluid retention. For this reason, it is important to monitor the patient's intake and
output.
36. The nurse is assisting a patient to learn self-administration of beclomethasone two
puffs inhalation q6hr. The nurse explains that the best way to prevent oral infection
while taking this medication is to do which of the following as part of the self-
administration techniques?
, A. Chew a hard candy before the first puff of medication.
B. Ask for a breath mint following the second puff of medication.
C. Rinse the mouth with water before each puff of medication.
D. Rinse the mouth with water following the second puff of medication. - D. Rinse the
mouth with water following the second puff of medication. The patient should rinse the
mouth with water following the second puff of medication to reduce the risk of fungal
overgrowth and oral infection.
37. The nurse is scheduled to give a dose of salmeterol by metered dose inhaler (MDI).
The nurse would administer the right drug by selecting the inhaler with which of the
following trade names?
A. Vanceril
B. Serevent
C. AeroBid
D. Atrovent - B. Serevent The trade or brand name for salmeterol, an adrenergic
bronchodilator, is Serevent.
38. The nurse is evaluating whether a patient understands how to safely determine
whether a metered dose inhaler is empty. The nurse interprets that the patient
understands this important information to prevent medication underdosing when the
patient describes which method to check the inhaler?
A. Place it in water to see if it floats.
B. Shake the canister while holding it next to the ear.
C. Check the indicator line on the side of the canister.
D. Keep track of the number of inhalations used. - D. Keep track of the number of
inhalations used. It is no longer appropriate to see if a canister floats in water or not as
research has demonstrated this is not accurate. The best method to determine when to
replace an inhaler is by knowing the maximum puffs available per MDI and then
replacing when those inhalations have been used.
39. The nurse is scheduled to give a dose of ipratropium bromide by metered dose
inhaler. The nurse would administer the right drug by selecting the inhaler with which of
the following trade names?
A. Vanceril
B. Pulmicort
C. AeroBid
D. Atrovent - D. Atrovent The trade or brand name for ipratropium bromide, an
anticholinergic medication, is Atrovent.
40. The patient has an order for albuterol 5 mg via nebulizer. Available is a solution
containing 2 mg/ml. How many milliliters should the nurse use to prepare the patient's
dose?
A. 0.2
B. 2.5
C. 3.75
D. 5.0 - B. 2.5
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