ATI RN
Test Bank Pharmacology and the Nursing Process Questions
Question 1 of 9
Which of the following BP changes alerts the nurse to increasing ICP, and should be reported immediately?
Correct Answer: B
Rationale: The correct answer is B, Widening pulse pressure. This indicates increasing intracranial pressure (ICP) as it signifies a significant difference between systolic and diastolic blood pressure. A widening pulse pressure is a key sign of impending herniation and requires immediate intervention. A: Gradual increase does not provide a clear indication of acute changes in ICP. C: Rapid drop followed by gradual increase may suggest other conditions and is not specific to increasing ICP. D: Rapid fluctuations may occur in various scenarios and do not specifically point to increasing ICP. In summary, a widening pulse pressure is the most critical and specific indicator of increasing ICP among the choices provided.
Question 2 of 9
A nurse in the emergency department is completing an emergency assessment for a teenager just admitted from a car crash. Which of the following is objective data?
Correct Answer: D
Rationale: The correct answer is D because "Unable to palpate femoral pulse in left leg" is an objective finding that can be measured or observed without interpretation or bias. It provides concrete, measurable information about the patient's condition. Choices A, B, and C are subjective data as they rely on the patient's feelings, emotions, and perceptions, which can vary and are open to interpretation. Objective data is crucial in making accurate assessments and decisions in healthcare.
Question 3 of 9
The client with rheumatoid arthritis reports GI irritation after taking piroxicam (Feldene). To prevent GI upset, the nurse should provide which instruction?
Correct Answer: D
Rationale: The correct answer is D. Taking piroxicam with food or an oral antacid can help reduce GI irritation as it can protect the stomach lining. Piroxicam is known to cause GI upset due to its effects on prostaglandin synthesis. Spacing the administration every 4 hours (choice A) may not necessarily prevent GI upset. Using the drug for a short time only (choice B) may not address the immediate concern of GI irritation. Decreasing the piroxicam dosage (choice C) may not be necessary if taking it with food or an antacid can effectively alleviate the GI upset.
Question 4 of 9
When instructing the client diagnosed with hyperparathyroidism about diet, the nurse should stress the importance of which of the following?
Correct Answer: C
Rationale: The correct answer is C: Restricting sodium. In hyperparathyroidism, there is an excess of parathyroid hormone leading to increased calcium levels. Sodium can worsen calcium excretion, exacerbating the condition. Restricting sodium can help reduce calcium loss. A: Restricting fluids is not necessary unless the client has kidney issues. B: Forcing fluids may not be beneficial and can lead to fluid overload. D: Restricting potassium is not typically necessary unless the client has kidney issues.
Question 5 of 9
When evaluating a client's response to fluid replacement therapy, the observation that indicates adequate tissue perfusion to vital organ is;
Correct Answer: A
Rationale: The correct answer is A: Urinary output of 30 ml in an hour. Adequate tissue perfusion is best indicated by a sufficient urinary output, as it demonstrates proper kidney perfusion and function. A low urinary output may suggest inadequate perfusion. Explanation for other choices: B: Central venous pressure reading of 2 cm H20 is not a reliable indicator of tissue perfusion to vital organs. C: Pulse rates alone are not enough to indicate tissue perfusion as they can be influenced by various factors. D: Blood pressure readings alone may not accurately reflect tissue perfusion, especially in the context of fluid replacement therapy.
Question 6 of 9
The nurse assesses the motor functions during a neurologic examination of a client. Which of the ff steps will help the nurse perform the examination effectively? Choose all that apply
Correct Answer: A
Rationale: Step-by-step rationale: 1. Allowing the client to grasp the nurse's hand firmly assesses grip strength and motor coordination. 2. This step helps evaluate the client's ability to follow instructions and perform a coordinated motor task accurately. 3. Assessing grip strength is essential in determining any muscle weakness or neurological deficits. 4. It also provides insight into the client's motor function and coordination abilities. Summary: - Choice B is incorrect because it focuses on sensory functions rather than motor functions. - Choice C assesses fine motor skills, not grip strength and coordination. - Choice D evaluates cognition and logic, which are not directly related to motor function assessment.
Question 7 of 9
A patient tells his nurse that he has delayed having TURP because he is afraid it will affect his sexual function. Which response by the nurse is most appropriate?
Correct Answer: C
Rationale: The correct answer is C: “This type of surgery rarely affects the ability to have an erection or ejaculation.” This response is appropriate because it provides accurate information that addresses the patient's concern about sexual function without making any false claims. TURP (Transurethral Resection of the Prostate) typically does not impact a patient's ability to have an erection or ejaculate. This reassurance can help alleviate the patient's fears and provide him with accurate information to make an informed decision. Explanation for why the other choices are incorrect: A: “Don’t worry about sterility; sperm production is not affected by this surgery.” - This is incorrect as the concern is more about sexual function than sterility. B: “Would you like some information about implants used for impotence?” - This is incorrect as it jumps to a solution without addressing the patient's specific concern about TURP affecting sexual function. D: “There are many methods of sexual expression that are alternatives to sexual intercourse
Question 8 of 9
When caring for an anxious patient with dyspnea, which of the ff. nursing actions is most helpful to include in the plan of care to relieve anxiety?
Correct Answer: C
Rationale: The correct answer is C: Staying at patient's bedside. This is the most helpful nursing action because it provides reassurance and support to the anxious patient experiencing dyspnea. By staying at the bedside, the nurse can monitor the patient closely, provide immediate assistance if needed, and offer a calming presence. Explanation of why other choices are incorrect: A: Increasing activity levels may worsen the dyspnea and anxiety of the patient. B: Pulling the privacy curtain does not directly address the patient's anxiety or dyspnea. D: Closing the patient's door may make the patient feel isolated and increase anxiety. In summary, staying at the patient's bedside is the most effective nursing action as it addresses both the physical and emotional needs of the anxious patient with dyspnea.
Question 9 of 9
A client with rheumatoid arthritis is being discharged with a prescription for aspirin (Ecotrin), 600mg PO every 6 hours. The nurse should instruct the client to notify the physician if which adverse drug reaction occurs?
Correct Answer: B
Rationale: The correct answer is B: Tinnitus. Aspirin can cause tinnitus (ringing in the ears) as an adverse drug reaction, which can indicate potential ototoxicity. Tinnitus is an important side effect that should be reported promptly to the physician to prevent further auditory complications. Dysuria (A), leg cramps (C), and constipation (D) are not typically associated with aspirin use and are less urgent compared to tinnitus. Reporting these side effects may still be necessary but are not as critical as tinnitus in this scenario.