Chapter 2

All of the following statements about cyanide are correct except: 1\. two forms of cyanide are used in chemical warfare: hydrogen cyanide and cyanogen chloride. 2\. cyanide causes severe respiratory distress, abdominal pain, and a rash. 3\. cyanide prevents cells from using oxygen. 4\. death may occur within 10 minutes.

At 8:30 AM on Thursday, several small canisters exploded in a bus station. Later in the day, many of the people who were present at the time of the explosion developed shortness of breath, muscle and chest pain. The hazardous materials (Hazmat) team has determined the canisters contained Ricin. All of the following statements about Ricin are correct except: 1\. inhaled Ricin attacks the respiratory system, causing pneumonia and pulmonary edema. 2\. ingested Ricin causes gastrointestinal bleeding, which can lead to death. 3\. ricin can be produced in an aerosolized form and solid form. 4\. symptoms of Ricin toxicity begin 48–72 hours after exposure

The signs and symptoms of smallpox are similar to those of: 1\. measles. 2\. meningitis. 3\. botulism. 4\. chicken pox.

Which of the following events would alert the nurse to biological terror? 1\. a client storing loose, white talc in a decorative canister 2\. several persons in close proximity, becoming ill simultaneously 3\. several persons with flulike symptoms in early January 4\. anecdotal reports of dead birds and fish in the local community

Based on sensitivity and specificity findings, the client is told that his test is positive, but in fact, the client does not have the disease. Which type of error is this an example? 1\. true positive 2\. false positive 3\. true negative 4\. false negative

The client’s culture report is negative for the suspected infection. A test that can correctly identify those who do not have the disease is: 1\. specific. 2\. sensitive. 3\. negative culture. 4\. marginal findings.

The nurse teaching a course on medication errors and drug overdose will report that the vast majority of deaths resulting from unintentional poisoning (or overdose) occurs in: 1\. infants. 2\. toddlers. 3\. teens. 4\. adults.

The community health nurse is asked to organize a health promotion project that plans to provide glucose screening. This activity will be most beneficial within what realm? 1\. if testing is performed by volunteers at a local department store and is open to all the public 2\. as a professional health fair activity available for selected persons who have been screened as being at risk 3\. by mass marketing via sending out vouchers for free fingersticks at a local drugstore so the pharmacist can make recommendations on the findings 4\. if testing is performed by a nurse professional and education regarding the findings given immediately

Hearing screening of prematurely born infants is an effective means of identifying disease and is an example of: 1\. primary prevention. 2\. secondary prevention. 3\. tertiary prevention. 4\. disability prevention.

A client is admitted for a lumpectomy with biopsy of a mass on the left breast. While the client is anesthetized and in surgery, the biopsy preliminary report is positive for an aggressive form of breast cancer. The surgeon had discussed this possible outcome with the client and advises the circulating nurse to notify the family that she will proceed with a mastectomy. The nurse’s first response is: 1\. advise the surgeon that it is his responsibility to discuss this with the family. 2\. proceed with the surgeon’s order and notify the family. 3\. refuse to follow the order and assist further with the surgery. 4\. question the surgeon reminding her of the legal ramifications of proceeding without informed consent.

The nurse is giving an intramuscular injection and aspirates blood. What is the next action? 1\. Document an incident form. 2\. Have a more experienced nurse administer the injection. 3\. Withdraw the needle, measure a new dose in a new syringe, and give the medication in another site. 4\. Slowly inject the medication observing the patient closely for a reaction.

The nurse is preparing to administer IV Vancomycin to the client. Which of the following nursing actions should be taken first? 1\. performing a physical assessment prior to administration 2\. ensuring the client is not allergic to the medication 3\. reviewing peaks and troughs for the past few days 4\. obtaining the most recent lab values regarding renal function

A patient taking isotretoin (Accutane) tells you that she is pregnant. What will the nurse teach the patient? 1\. Her pregnancy is threatened, and the fetus is at risk for teratogenesis. 2\. She has a reportable condition, and the pregnancy must be terminated. 3\. Accutane is a category D drug that means it is unsafe in pregnancy. 4\. Her pregnancy must be followed carefully by a genetic specialist.

When a drug is listed as Category X and prescribed to women of child-bearing age/capacity, the nurse collaboratively with the interdisciplinary team will counsel the client that: 1\. pregnancy tests may be unreliable while taking the drug. 2\. she must use a reliable form of birth control. 3\. she should not take the Category X drug on days she has intercourse. 4\. she must follow-up with an endocrinologist.

The nurse seeks to assess the renal function of an elderly client about to receive a nephrotoxic medication. Which of the following labs will provide the best indicator for renal function? 1\. urinalysis 2\. creatinine and blood urea nitrogen 3\. chemistry of electrolytes 4\. creatinine clearance

Just as the nurse administers an injection of penicillin, the client responds, “I forgot to tell you that I am allergic to penicillin.” The next action of the nurse is: 1\. notify the M.D. of the error. 2\. document the occurrence in the incident report. 3\. open the airway and establish breathing at two breaths per minute. 4\. obtain a complete history quickly and assess the client’s vital signs.

When a client is allergic to a medication, the warning found in the literature to not give the drug is known as: 1\. legend. 2\. side effects. 3\. contraindication. 4\. toxicity

Which of the following most accurately represent an adverse effect from a drug? 1\. gastrointestinal bleeding after taking a regular dose of ibuprofen 2\. a contraindication to certain vaccines due to an egg allergy 3\. increased clotting time after taking the prescribed dose of aspirin 4\. hypotension leading to cardiac arrest after mixing sildenafil and nitroglycerine

The patient is starting treatment for bipolar disorder with Lithium. What main point will the nurse emphasize in patient education? 1\. The drug has a narrow therapeutic index; therefore, careful drug monitoring by blood levels is essential. 2\. The drug must not be mixed with tyramine-based foods such as aged cheese and wine. 3\. The drug is absolutely contraindicated for a woman who may become pregnant. 4\. The drug has the side effects of nausea, drowsiness, and itching.

The nurse is administering tetracycline to a patient. Which of the following actions will she take? 1\. The drug will be given with fruit juice. 2\. The drug will be given on an empty stomach. 3\. The drug will be given with a glass of milk. 4\. The drug will be given to a pediatric client.

The nurse will teach the client receiving the anti-fungal, Griseofulvin, what measure to enhance absorption? 1\. Do not mix with milk. 2\. Take the medicine on an empty stomach. 3\. Take the medicine with a high fat meal. 4\. Take the medicine with alcohol.

The nurse will teach the client taking nitrates about which problem? 1\. hallucinations and bad dreams 2\. a metallic taste in the mouth if not taken with juice drink 3\. tachyphylaxis requiring being off the drug for 8–12 hours each day 4\. the need for blood level monitoring on a periodic basis to ensure the drug is in the therapeutic range

When a client is taking more than one drug strongly bound to protein, the nurse will caution the client regarding what potential problem? 1\. metabolic tolerance 2\. increase side effects from all the drugs 3\. toxicity 4\. allergic drug response

The client is admitted via the emergency department with a diagnosis of Morphine overdose, and intravenous Naloxone is given. The nurse understands the rationale for administering Naloxone is: 1\. to agonize the Morphine effects. 2\. to antagonize the effects of the Morphine. 3\. to sensitize the cellular receptors and prevent further metabolism. 4\. to speed elimination of the Morphine via renal metabolism.

Which of the following drugs will not require the client to have blood drug level monitoring done? 1\. Lanoxin 2\. Librium 3\. Propranolol 4\. Theophylline

A client’s drug order includes changing the route and dose of Propranolol from 1 mg intravenously to 10 mg intramuscularly, and the nurse understands this relates to: 1\. enterohepatic circulation. 2\. drug half-life principles. 3\. first pass effects in the liver. 4\. renal drug excretion.

What nursing action would cause an inadvertent toxic dose to be administered? 1\. The nurse administers an enteric-coated tablet with an antacid. 2\. The nurse crushes a sustained-release tablet and administers it via the gastrostomy tube. 3\. The nurse administers a suspension medication through the nasogastric tube and then flushes the tubing with clear water. 4\. The nurse administers the intravenous dose of Demerol via the intramuscular route.

Drug “X” has a therapeutic index of 20. The nurse knows that this indicates the drug: 1\. is relatively safe to administer. 2\. is unsafe to administer. 3\. is prone to many drug interactions. 4\. is a lethal dose.

Drug “X” is given IV at 10 o’clock at a dose of 60 mg. The half-life is 2 hours. At 11 o’clock, the drug will be: 1\. at the minimum effective concentration. 2\. in the therapeutic range. 3\. at the toxic concentration range. 4\. undetectable in the blood.

Iatrogenic disease is defined as: 1\. a disease or condition acquired because of hospitalization. 2\. a disease or condition produced by medical, nursing, or other discipline’s care. 3\. an uncommon, unpreventable drug response linked to the client’s genetic predisposition. 4\. a disease or condition triggered by nosocomial exposure to infection.

Which of the following measures is associated with decreasing hospital clients’ risk for iatrogenic harm? 1\. providing a health promotion program of annual physical examinations and age-specific screenings for employees 2\. requiring nursing personnel to successfully complete a medication administration test 3\. requiring medical personnel to complete a guest relations/interpersonal communication training program 4\. requiring pharmacists to become specialized in their respective areas of care

Which of the following actions assures the client that care is being provided by a competent professional? 1\. a copy of the nurse’s license in plain view at the nurses’ station 2\. the original nursing license being worn on the nurse’s person at all times 3\. a plaque posting the JCAHOA accreditation in the main lobby of the hospital 4\. the nurse’s wearing of a photo-identification with the title of RN displayed

Several passengers aboard an airliner suddenly become weak, suffer difficulty breathing, and collapse. The differential diagnosis is highly suspicious for: 1\. outbreak of Asian flu. 2\. chemical act of terror. 3\. bacterial pneumonia. 4\. allergic reaction.

A child presents to the clinic with a skin rash and low-grade temperature. The lesions are widely distributed on the extremities distally, maculopapular and oozing a honey-colored liquid and are in different stages of healing. The caregiver states that the sores are getting worse and seem to spread with the child’s scratching. Which of the following advisory comments will be given? 1\. The history and presentation indicates chicken pox, a highly contagious disease. 2\. The lesions may indicate a contagious infection that will require isolation. 3\. The history and presentation may indicate a infectious illness called impetigo. 4\. The lesions are not contagious unless others have open wounds or lesions themselves

The nurse is teaching the client about Rifampin for prophylaxis against an exposure to meningitis. What change in bodily functions will he advise? 1\. “Your urine will turn blue.” 2\. “You will remain infectious to others for 48 hours.” 3\. “Your contacts may be stained orange.” 4\. “Your skin may take on a crimson glow.”

The client with HIV is being treated for oral irritation characterized by patchy areas of white plaques. He asks the nurse whether these lesions are contagious to his partner. The nurse teaches the client that: 1\. HIV viral infection is transmitted by blood/body fluids contact. 2\. the lesions are not contagious to others. 3\. the lesions are contagious only if transmitted sexually. 4\. a culture of the plaque will be taken and then the client will know for sure.

To determine the stage of infection of HIV/AIDS, what laboratory tests are taken? 1\. Elisa 2\. CD4, HIV load 3\. Polymerase Chain Reaction (PCR) 4\. Hepatitis, PPD

A stool culture reveals “Shigella.” The nurse recognizes what corollaries regarding this bacterial infection? 1\. Persons who have been in contact with the client will need to be tested. 2\. Shigella is an airborne infection. 3\. Shigella is a bacteria sometimes found in stagnate water. 4\. The nurse will wear a one-way breathing apparatus when giving patient care.

Serum Vancomycin levels are taken to measure which of the following? 1\. renal function 2\. therapeutic range 3\. trough levels 4\. antibiotic resistanc

The client on floxacin must be alerted to which of the following adverse effects? 1\. stunting of height in teens and young adults 2\. propensity of anovulatory uterine bleeding 3\. intractable diarrhea 4\. tendon rupture

Which agency is responsible for laws mandating the reporting of certain infections and diseases? 1\. Center for Disease Control (CDC) 2\. individual state laws 3\. National Institute of Health Research (NIH) 4\. Health and Human Services (HHS)

Several members of a local church arrive at the local ER complaining of abdominal cramping, diarrhea, and high fever. The onset of symptoms began two days after a congregational picnic. The nurse explains that what treatment is needed? 1\. Stool cultures will be needed from every person suffering symptoms. 2\. Hospitalization may be required for those who are severely ill. 3\. All persons will require hospitalization and IV antibiotic therapy. 4\. Care will be supportive, and no one will require hospitalization or antibiotics.

The client is suffering from a severe adverse drug effect associated with the use of antibiotics manifested by intractable diarrhea. The client asks what causes the problem, and the nurse will explain what? 1\. an overgrowth of E. Coli 2\. a bacteria known as Shigella 3\. an overgrowth of Candida 4\. a bacteria known as Clostridium difficile

A female client intends to be treated with Isotretinoin (Accutane). What will the nurse explain to the client? 1\. This is a category X medication indicating teratogenesis is probable. 2\. This medication is a nuclear isotope and emits radioactive substances. 3\. This medication has a narrow therapeutic index and can not be mixed with any other medication. 4\. This medication will lower the immune response, making you and the fetus at risk for opportunistic infections.

Epidemiology is best defined as: 1\. the number of cases of illness and the percentage of a specific population affected. 2\. the study of the distribution of health and determinants of diseases and injuries in human populations. 3\. the study of the etiology of the disease. 4\. the study of the relationship between prepathogenesis and pathological states

Which of the following rationales will the nurse give for explaining to the elderly client his need of tetanus immunoglobulin with treatment of a puncture wound? 1\. Herd immunity has virtually eradicated the need for tetanus immunoglobulin among the elderly. 2\. Many elderly were not immunized and do not have sufficient antibodies against tetanus. 3\. Tetanus toxoid is not effective in providing protection against tetanus. 4\. Prophylactic antibiotics may be given to prevent infection instead of immunization

A sexually active teen with a yellow vaginal discharge comes to the clinic for birth control. The nurse documents information obtained from the HEADSS risk assessment, which is positive for multiple sexual partners, use of alcohol, and street drugs. In addition to documenting the information obtained from the client’s history, the nurse will advise the client that she will be screened for: 1\. pregnancy. 2\. STD. 3\. HIV. 4\. all of the above.

Someone who has received a recent tattoo should be screened for: 1\. tuberculosis. 2\. HIV. 3\. Hepatitis C. 4\. Syphilis.

Which of the following is a contraindication to the administration of immunizations that the nurse would document and discuss with the prescriber? 1\. fever 2\. diagnosed seizure disorder 3\. anaphylaxis 4\. cough

5\. Which of the following is another name for Yersinia pestis? 1\. Pneumonic Plague 2\. Smallpox 3\. Tularemia 4\. Viral Hemorrhagic Fever