Question Set A: Derive, Do Not Recall

SIX ITEMS · NO TIME LIMIT · WRITE THE CLASS BEFORE YOU READ THE OPTIONS

Beside each item, a ruled strip headed CLASS. Fill it in first. That single habit is the point of this page.

1. A client with hypertension began taking moexipril 3 weeks ago and now reports a dry, tickling cough present for 10 days. Temperature 98.4, lungs clear to auscultation, no sputum. Which action by the nurse is best?

1. Teach the client to use an over-the-counter dextromethorphan preparation at bedtime.
2. Reassure the client that the cough will resolve within 48 hours.
3. Contact the prescriber to discuss a change to an angiotensin II receptor blocker.
4. Withhold the medication and obtain a sputum specimen for culture.

2. A client is discharged with demeclocycline. Which teaching points should the nurse include? Select all that apply.

1. Take each dose with a glass of milk to prevent stomach upset.
2. Separate each dose from antacids, iron, and calcium supplements by at least 2 hours.
3. Use sunscreen and protective clothing when outdoors.
4. Sit upright with a full glass of water for each dose and report painful swallowing.
5. Stop taking the drug as soon as the symptoms improve.
6. Report new watery diarrhea or a new vaginal yeast infection.

3. Nebivolol is scheduled for 0900. The prescription carries a hold parameter for bradycardia. At 0845 the monitor technician reports a radial rate of 52 and a blood pressure of 104/62. Which action does the nurse take?

1. Give the dose as scheduled, because a slowed heart rate is the expected therapeutic effect.
2. Assess the apical pulse for one full minute, then withhold the dose and notify the prescriber per the ordered parameter.
3. Withhold this dose and plan to give both doses together this evening.
4. Withhold the drug and teach the client to stop taking it after discharge.

4. A client who takes dabigatran for atrial fibrillation is admitted with hematemesis and a falling hemoglobin. Which agent should the nurse anticipate?

1. protamine sulfate
2. phytonadione
3. idarucizumab
4. andexanet alfa

5. Complete the sentences by choosing from the lists below. Dexlansoprazole, a proton pump inhibitor, produces its effect by [5a], and long-term therapy with this class is therefore associated with [5b]. 5a 1. blocking histamine-2 receptors on the parietal cell · 2. irreversibly inhibiting the gastric hydrogen-potassium ATPase pump · 3. neutralizing acid already present in the stomach · 4. coating the ulcer base with a protective barrier 5b 1. low serum magnesium and reduced vitamin B12 absorption · 2. hyperkalemia and a dry persistent cough · 3. tendon rupture and photosensitivity · 4. loss of the tremor warning of low glucose

6. During a home visit, a client who takes lisinopril and hydrochlorothiazide reports starting over-the-counter ibuprofen twice daily for back pain 2 weeks ago. The client has noticed less urine output and puffy ankles. Which action is the priority?

1. Teach the client to take the ibuprofen with food to prevent stomach upset.
2. Report the combination to the prescriber and anticipate an order for renal function testing.
3. Advise the client to increase fluid intake and continue all three medications.
4. Instruct the client to stop the lisinopril until the back pain resolves.

Margin notewrite the class first, then read the options. Tick boxes: 1–6. → BOOK 05 · P13

TakeawayWriting the class before reading the options changes which option looks correct.