1. A client is diagnosed with Addisonian Crisis. List the lab values that will be affected by this
disease process.: Hyperkalemia, hypercalcemia, hyponatremia, hypoglycemia, decreased
cortisol levels, increased BUN/Creatinine
2. A client with peripheral vascular disease had a below the knee amputation three months
ago. The client now complains of phantom limb pain. List three
(3) interventions to address the pain associated with this condition.: Administer beta blockers
(propranolol) which may relieve dull or burning sensations, administer antiepileptics
(gabapentin, carbamazepine) to relieve sharp, stabbing sensations, alternative treatment such
as massage/heat therapy or relaxation therapy.
3. A nurse is caring for a client undergoing a clonidine suppresstion test to identify a
pheochromocytoma. If a client has a pheochromocytoma and is
administered clonidine, what will the outcome be?: No effect, clonidine will notdecrease BP
4. A mass casualty event has occurred and a nurse is responsible for clienttriage. What
categories should the nurse use and what do these mean? (Re-view the Nursing Leadership
Review Module): Emergent category (class 1) - highest priority given to pt. with life-
threatening injuries, high possibility of survival once stabilized
Urgent category (class 2) - second-highest priority given to pt. who have majorinjuries which
are not yet life-threatening and can wait 45-60mins for treatment
Non-urgent category (class 3) - third-highest priority given to pt. who have minorinjuries
which are not life threatening and do not require immediate treatment
Expectant category (class 4) - lowest priority given to pt. who are not expected to live and will
be allowed to die naturally, comfort measures may be provided, but norestorative care
5. What questions should a nurse ask when obtaining a health history for aclient with a
history of chest pain and dyspnea?: Frequency or intensity of thepain and if it radiates to
another area, any exacerbating events, if anything makesit better/worse, how long the
pain/SOB lasts, and if anything helps to reduce the dyspnea.
, 6. A client's lab values indicate a serum sodium level of 150 mEq/L. How could this affect the
client's vital signs?: Hypernatremia - hyperreflexia, seizures, coma, confusion, increased HR and
BP
7. A nurse is teaching a caregiver about the use of a vacuum-assisted closure system. How
should the nurse instruct the caregiver to apply the foam strips?: Use of foam strips laid into
the wound bed with an occlusive sealed drapeapplied and suction tubing is placed for a
negative pressure (suction) to occur oncethe tubing is connected to the systems therapy unit.
8. What class of medication is amitriptyline and why is this medication usedas an adjuvant
medication for pain?: Amitriptyline (Elavil)
Class: Tricyclic antidepressant
Use: Indicated for chronic pain syndromes (fibromyalgia, neuropathic pain,headache, lower
back pain)
The adjuvant medication is used to help the opiod work.
9. A nurse is caring for a client with asthma who asks if montelukast sodiumcan be taken for
acute asthma symptoms. When should montelukast sodiumbe taken?: Daily at bedtime, and 2
hours before exercise for exercise induced bronchospasms.
10. A client has a new prescription for salmeterol. The nurse is teaching the client about
adverse effects of the medication. What instructions should the nurse include in thus
education?: Salmeterol SE - headache, heart palpitations,tachycardia, abdominal pain,
diarrhea, nausea, soreness, muscle cramps, trembling, paradoxical bronchospasm, cough
Clients taking salmeterol should be taught to take their pulse daily and report an increase in 20
bpm.
11. A client has a new prescription for an albuterol inhaler and a beclomethasone inhaler.
What instructions should the nurse include concerning use of these inhalers?: Administer
albuterol first, as albuterol enhances glucocorticoid absorption, therefore enhancing the
beclomethasone absorption.
12. Identify three (3) priority teaching points to include when educating a clientto use a
cane.: Maintain two points of support on the ground at all times, keep thecane on the stronger
side of the body, move the cane forward about 6-10 inches andthen move the weaker leg toward
the cane before advancing the stronger leg pastthe cane.
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