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2024 MILESTONE EXAM 1 WITH CORRECT ANSWERS
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2024 MILESTONE EXAM 1 WITH CORRECT ANSWERS
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2024 MILESTONE EXAM 1 WITHCORRECT ANSWERS
The nurse is preparing a child for transport to the operating room for an
emergency appendectomy. The anesthesiologist prescribes atropine sulfate,
IM STAT. What is the primary purpose for administering this drug to the child
at this time?
A.Decrease the oral secretions.
B.Reduce the child's anxiety.
C.Potentiate the opioid effects.
D.Prevent possible peritonitis.
A - CORRECT-ANSWERSRationale:Atropine sulfate, an anticholinergic agent,
is given to decrease oral secretions during a surgical procedure. Options B,
C, and D are not actions of anticholinergic agents.
Two hours after taking the first dose of penicillin, a client arrives at the
emergency department complaining of feeling ill, exhibiting hives, having
difficulty breathing, and experiencing hypotension. The nurse will develop an
immediate plan of care based on which finding?
A.Severe acute anaphylactic response
B.Side reaction that should resolve
C.Idiosyncratic reaction
D.Cumulative drug response
A - CORRECT-ANSWERSRationale: Anaphylaxis related to penicillin can cause
a life-threatening allergic response characterized by bronchospasm,
laryngeal edema, and a precipitous drop in blood pressure. This client's
ingestion of penicillin and presenting clinical picture indicate the client is
having an acute reaction with respiratory difficulty. Options B, C, and D are
other physiologic responses to medications, but immediate action is required
for a potential loss of airway, breathing, and circulation.
The nurse is administering the early morning dose of insulin aspart, 5 units
subcutaneously, to a client with diabetes mellitus type 1. The client's
fingerstick serum glucose level is 140 mg/dL. Considering the onset of insulin
aspart, when should the nurse ensure that the client's breakfast be given?
A.5 minutes after subcutaneous administration
B.30 minutes after subcutaneous administration
C.1 to 2 hours after administration
D.At any time because of a flat peak of action
, A - CORRECT-ANSWERSRationale:Insulin aspart is a very rapidly acting
insulin, with an onset of 5 to 15 minutes. Insulin aspart should be
administered when the client's tray is available. Insulin aspart peaks in 45
minutes to 1½ hours and has a duration of 3 to 4 hours. The client should
have eaten to ensure absorption of the meal so that serum glucose levels
will coincide with the peak. Insulin glargine has a flat peak of action and is
usually given at bedtime.
A client with angina pectoris is instructed to take sublingual nitroglycerin
tablets PRN for chest pain. Which instruction should the nurse include in the
client's teaching plan?
A.Take one tablet every 3 minutes, up to five tablets.
B.Take one tablet at the onset of angina and stop the activity.
C.Replace nitroglycerin tablets yearly to maintain freshness.
D.Allow 30 minutes for a tablet to provide relief from angina.
B - CORRECT-ANSWERSRationale:Nitroglycerin tablets should be taken at the
onset of angina, and the client should stop activity and rest. One tablet can
be taken every 5 minutes, up to three doses. Nitroglycerin should be
replaced every 3 to 6 months, not every 12 months. Nitroglycerin should
provide relief in 5 minutes, not 30 minutes.
During therapy with isoniazid, it is most important for the nurse to monitor
which laboratory value closely?
A.Liver enzyme levels
B.Blood urea nitrogen (BUN) level
C.Serum electrolyte levels
D.Complete blood count (CBC)
A - CORRECT-ANSWERSRationale:The client receiving isoniazid is at risk for
the development of hepatitis; therefore, liver function test results should be
monitored carefully during drug therapy. Options B, C, and D are not specific
indicators of liver function, so they are not monitored closely during isoniazid
therapy.
During the initial nursing assessment history, the client reports taking
tetracycline hydrochloride for urethritis. Which concurrent medication will
the nurse report to the health care provider?
A.Sucralfate
B.Hydrochlorothiazide
C.Acetaminophen
D.Phenytoin
A - CORRECT-ANSWERSSucralfate is used to treat duodenal ulcers and will
bind with tetracycline hydrochloride, inhibiting this antibiotic's absorption.
Options B, C, and D have no drug interaction properties that prohibit
concurrent use with tetracycline hydrochloride.
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