ISPN & CGFNS Flashcards

An order for Bupropion (Wellbutrin) has been placed with a client. When is it appropriate for the nurse to give the order?

Answer: Early in the day

Bupropion (Wellbutrin) is an antidepressant that can have stimulating effects on the central nervous system. To minimize the risk of insomnia and other sleep disturbances, it is typically advised to administer bupropion early in the day, often in the morning. Taking it later in the day could interfere with the patient's ability to fall asleep.

A temperature of 101 degrees has been recorded in a patient with acquired immunodeficiency syndrome and pneumocystis jiroveci infection. Pentamidine is administered to the patient (pentam 300). Which of the following symptoms does a fever indicate?

Answer: Another infection developed as a result of the medication's leukopenic side effects.

Pentamidine, used to treat Pneumocystis jiroveci infection in AIDS patients, can cause bone marrow suppression, leading to leukopenia (low white blood cell count). In an immunocompromised patient with leukopenia, a fever is a critical indicator of a new or worsening infection. Their compromised immune system makes them highly susceptible to opportunistic infections, and fever signals the body's struggle against pathogens.

If a client is experiencing dizziness after receiving procainamide (Procanbid) intravenously, the first nursing action is to:

Answer: Obtain a blood pressure reading by auscultating the client's apical pulse.

Procainamide is an antiarrhythmic medication that can cause hypotension as a significant side effect, especially with intravenous administration. Dizziness is a common symptom of hypotension. Therefore, the nurse's first and most crucial action is to assess the client's blood pressure to confirm hypotension and guide appropriate interventions to ensure patient safety.

The therapy in which a client's feelings, attitudes, and behaviors are modified by focusing on the therapist-client relationship is called:

Answer: Interpersonal psychotherapy

Interpersonal psychotherapy (IPT) is a focused, time-limited form of therapy that emphasizes the role of interpersonal relationships and social functioning in mental health. It aims to help clients improve their communication patterns and the way they relate to others, thereby modifying maladaptive feelings, attitudes, and behaviors that contribute to their psychological distress.

When a client has been sexually abused, the nurse is in the preinteraction phase of the nurse-client relationship. During this time, the nurse should do:

Answer: Examine the personal beliefs, preconceptions, and biases as they relate to the nurse-client interaction.

The preinteraction phase of the nurse-client relationship occurs before the nurse physically meets the client. During this crucial phase, the nurse's primary task is self-reflection and self-assessment. This involves examining personal beliefs, preconceptions, and potential biases related to the client's situation to ensure the provision of non-judgmental, empathetic, and professional care.

Which of the following is the most important assessment for a client receiving bumetanide (Bumex) intravenously for acute congestive heart failure?

Answer: Monitoring blood pressure

Bumetanide (Bumex) is a potent loop diuretic used to treat fluid overload in conditions like acute congestive heart failure. Diuretics promote significant fluid excretion, which can lead to volume depletion and a dangerous drop in blood pressure (hypotension). Therefore, closely monitoring blood pressure is the most important assessment to ensure patient safety and prevent adverse cardiovascular events.

The nurse expects the following laboratory tests to evaluate the therapeutic impact of heparin intravenously given to the client:

Answer: Activated partial thromboplastin time

Heparin is an anticoagulant medication that works by enhancing the activity of antithrombin, which inhibits various clotting factors. The therapeutic effect of unfractionated heparin is primarily monitored by measuring the activated partial thromboplastin time (aPTT). The aPTT assesses the intrinsic and common pathways of coagulation, which are directly affected by heparin's action.

Which one of the following is not a source of acquired immunity?

Answer: Prescribed multivitamins

Acquired immunity refers to the immunity developed during an individual's lifetime, either actively (e.g., through exposure to disease or vaccination) or passively (e.g., through antibodies received from the mother or animal serum). Prescribed multivitamins provide essential nutrients that support overall health, but they do not directly confer or contribute to acquired immunity itself.

Dextroamphetamine (Dexedrine) has been prescribed for an 10-year-old child who has been acting out in class. The nurse will tell the parents to do the:

Answer: Give the last dose at least 6 hours before going to bed.

Dextroamphetamine (Dexedrine) is a central nervous system stimulant used to treat ADHD. A common side effect of stimulants is insomnia or difficulty sleeping. To minimize sleep disturbances, parents are typically instructed to administer the last dose of the medication at least 6 hours before the child's bedtime, allowing the stimulating effects to wear off.

A patient has voluntarily checked herself into the hospital's mental health unit. The nurse anticipates the following from the client:

Answer: The patient will be participating in the treatment and care planning.

A client who has voluntarily checked into a mental health unit has chosen to seek treatment and engage in their care. This implies a willingness to participate actively in their treatment and care planning. Voluntary admission grants the client more autonomy and rights regarding their treatment decisions compared to involuntary commitment.

Methamphetamine (Desoxyn) was prescribed to a 8-year-old girl who was overly energetic at home. The nurse instructs the parents to do:

Answer: Give the last dose at least 6 hours before going to bed.

Methamphetamine (Desoxyn) is a central nervous system stimulant used for ADHD, similar to other amphetamines. Like other stimulants, it can cause insomnia and interfere with sleep. To prevent sleep disturbances, the last dose of the medication should be given at least 6 hours before bedtime, allowing its stimulating effects to diminish before the child attempts to sleep.

A assistance group has been talking with a depressed hospital patient. Which behaviors suggest that the patient is on the verge of committing suicide?

Answer: The patient begins to give away his or her stuff.

A critical warning sign of impending suicide, especially in a depressed individual, is the act of giving away cherished possessions or making final arrangements. This behavior often indicates that the person has made a decision to end their life and is 'tying up loose ends.' It suggests a shift from suicidal ideation to concrete planning and intent, requiring immediate and urgent intervention.

An indwelling abdominal catheter is used by a client who is having peritoneal dialysis for chronic renal failure. If the client spills water over the catheter dressing, what should the nurse do?

Answer: Change the dressing

An indwelling abdominal catheter for peritoneal dialysis creates a direct pathway into the peritoneal cavity, making sterility paramount. Spilling water on the dressing compromises its sterile barrier and creates a moist environment conducive to bacterial growth. Changing the dressing immediately is crucial to prevent infection, which is a serious and potentially life-threatening complication of peritoneal dialysis.

What might a nurse anticipate to see after transfusing platelets into a trauma patient who has several cuts?

Answer: Decreased blood flow from cuts

Platelets are crucial for hemostasis, the process of stopping bleeding by forming clots. In a trauma patient with cuts, a platelet transfusion directly addresses any deficiency in the body's ability to clot blood. Therefore, the anticipated therapeutic effect is improved clot formation and a reduction in active bleeding from the cuts.

A 35-year-old male who has used cocaine is being assessed by an emergency room nurse. What are the signs that the client has overdosed?

Answer: Myocardial infarction and ataxia

Cocaine is a powerful stimulant that causes severe vasoconstriction, increased heart rate, and elevated blood pressure. These effects significantly increase the risk of myocardial infarction (heart attack) due to coronary artery spasm and increased cardiac oxygen demand. Ataxia, or impaired coordination, is also a common neurological sign of severe cocaine intoxication or overdose, reflecting its impact on the central nervous system.

The treatment of which symptom is the expected effect of omeprazole (Prilosec).

Answer: Heartburn

Omeprazole (Prilosec) is a proton pump inhibitor (PPI) that works by irreversibly blocking the enzyme responsible for producing stomach acid. Heartburn is a primary symptom caused by stomach acid refluxing into the esophagus. By significantly reducing acid production, omeprazole effectively alleviates and prevents heartburn associated with gastroesophageal reflux disease (GERD).

For a client using codeine sulfate, the nurse would specifically include the following in the treatment plan:

Answer: Monitor bowel activity

Codeine sulfate is an opioid analgesic, and a very common and significant side effect of opioids is constipation. Opioids slow down gastrointestinal motility, leading to decreased peristalsis and hardened stools. Therefore, monitoring the client's bowel activity and implementing preventative measures for constipation are essential components of the nursing care plan.

During a softball game, the client was hit by a wild pitch and incurred an eye injury. What is the nurse's initial response?

Answer: Put on an eye patch.

The immediate priority for an eye injury is to protect the eye from further damage and prevent the client from inadvertently touching or rubbing it. Applying an eye patch immobilizes the eye, shields it from external irritants, and helps reduce pain. While other actions like visual acuity tests and notifying the doctor are important, immediate protection is the initial critical step.

On Coumadin, the client had a prothrombin time of 20 seconds and a control time of 11 seconds. According to the nurse, this means:

Answer: Within the therapeutic range

Coumadin (warfarin) is an anticoagulant, and its therapeutic effect is monitored by the prothrombin time (PT) and International Normalized Ratio (INR). A common therapeutic range for PT when a client is on warfarin is 1.5 to 2.5 times the control value. With a client's PT of 20 seconds and a control of 11 seconds, the ratio is approximately 1.82 (20/11), which falls within this established therapeutic range.

Which of the following conditions is metoclopramide prescribed for?

Answer: Vomiting after chemotherapy

Metoclopramide (Reglan) is a prokinetic agent and an antiemetic that blocks dopamine receptors in the chemoreceptor trigger zone (CTZ) in the brain, thereby reducing nausea and vomiting. It also increases gastrointestinal motility, which helps empty the stomach. These actions make it particularly effective in managing severe nausea and vomiting, such as that experienced after chemotherapy.