NR 293 Evolve Questions & Answers HESI Chamberlain Students 1. Which response best supports the observations that the nurse identifies in a client who is experiencing a placebo effect? ✓ Psychological response to inert medication 2. Methylphenidate HCl (Concerta) is prescribed for daily administration to a 10-yearold child with attention deficit-hyperactivity disorder (ADHD). In preparing a teaching plan for the parents of this child newly diagnosed with ADHD, which instruction is most important for the nurse to provide to the parents? ✓ Administer the medication in the morning before the child goes to school. 3. Which physiologic mechanism explains a drug's increased metabolism that is triggered by a disease process? ✓ Pharmacokinetics 4. The health care provider prescribes ipratropium (Atrovent) for a client. An allergic reaction to which other medication would cause the nurse to question the prescription for Atrovent? ✓ Atropine sulfate (Atropine) 5. A 42-year-old client is admitted to the emergency department after taking an overdose of amitriptyline (Elavil) in a suicide attempt. Which drug should the nurse plan to administer to reverse the cardiac & central nervous system effects of amitriptyline (Elavil)? ✓ Sodium bicarbonate 6. A client who is hypertensive receives a prescription for hydrochlorothiazide (HCTZ) – thiazide diuretic cause potassium wasting in the urine. When teaching about the side effects of this drug, which symptoms are most important for the nurse to instruct the client to report? ✓ Fatigue & muscle weakness 7. The nurse is preparing to apply a surface anesthetic agent for a client. Which action should the nurse implement to reduce the risk of systemic absorption? ✓ Avoid abraded skin areas when applying the anesthetic. – apply to the smallest surface of intact skin 8. The health care provider prescribes cisplatin (Platinol) to be administered in 5% dextrose & 0.45% normal saline with mannitol (Osmitrol) added. Which assessment parameters would be most helpful to the nurse in evaluating the effectiveness of the Osmitrol therapy? ✓ Urine output 9. A 19-year-old male client who has sustained a severe head injury is intubated & placed on assisted mechanical ventilation. To facilitate optimal ventilation & prevent the client from "fighting" the ventilator, the health care provider administers pancuronium bromide (Pavulon) IV, with adjunctive opioid analgesia. What medication should the nurse maintain at the client's bedside? ✓ Neostigmine bromide (Prostigmin) 10. The nurse is reviewing a client's laboratory results before a procedure in which a neuromuscular blocking agent is a st&ing order. Which finding should the nurse report to the health care provider? ✓ Hypokalemia - Low potassium levels enhance the effects of neuromuscular blocking agents 11. A female client with myasthenia gravis is taking a cholinesterase inhibitor & asks the nurse what can be done to remedy her fatigue & difficulty swallowing. What action should the nurse implement? ✓ Develop a teaching plan for the client to self-adjust the dose of medication in response to symptoms. - Clients should be taught to recognize signs of overmedication & undermedication so that they can modify the dosage themselves based on a prescribed sliding scale. 12. A client receives pancuronium (Pavulon), a long-acting, nondepolarizing neuromuscular blocker, during surgical anesthesia. Which client situation should alert the nurse to evaluate the client for a prolonged muscle relaxation response to this medication? ✓ Renal insufficiency 13. A client is ordered 22 mg of gentamicin by IM injection. The drug is available in 20 mg/2 mL. How many mL should be administered? ✓ 2.2 mL - (22 mg/20 mg) × 2 mL = 2.2 mL 14. A client is receiving oral griseofulvin (Grisactin) for a persistent tinea corporis infection. Which response by the client indicates an accurate underst&ing of the drug teaching conducted by the nurse? ✓ "I'll wear sunscreen whenever I mow the lawn." - Photosensitivity is a side effect of griseofulvin (Grisactin), so clients should be cautioned to wear protective sunscreen during sun exposure. 15. The nurse has completed diabetic teaching for a client who has been newly diagnosed with diabetes mellitus. Which statement by this client would indicate to the nurse that further teaching is needed? ✓ "When I exercise, I should plan to increase my insulin dosage." - Exercise helps facilitate the entry of glucose into the cell, so increasing insulin doses with exercise would place the client at high risk for a hypoglycemic reaction. 16. The nurse is evaluating a client's underst&ing of the prescribed antilipemic drug lovastatin (Mevacor). Which client statement indicates that further teaching is needed? ✓ "I will take the medication every day before breakfast." - The enzyme that helps metabolize cholesterol is activated at night, so this medication should be taken with the evening meal. 17. A client with acute lymphocytic leukemia is to begin chemotherapy today. The health care provider's prescription specifies that ondansetron (Zofran) is to be administered IV 30 minutes prior to the infusion of cisplatin (Platinol). What is the rationale for administering Zofran prior to the chemotherapy induction? ✓ Reduction or elimination of nausea & vomiting 18. A client who arrives in the postanesthesia care unit (PACU) after surgery is not awake from general anesthesia. Which action should the nurse implement first? ✓ Review the medication administration record (MAR). - Most general anesthetics produce cardiovascular & respiratory depression, so a review