Question

The nurse is preparing to assist in the sedation of a client with propofol (Diprivan) prior to surgery. Which of the following contraindications associated with propofol (Diprivan) should the nurse assess for?

Answer 1

Correct Answers:

Allergies to egg or soy products

Rationale :

📕Propofol (Diprivan) is a short-acting sedative-hypnotic commonly used for induction and maintenance of anesthesia.

📕 It is formulated in a lipid emulsion that contains egg lecithin and soybean oil, making it contraindicated for clients with allergies to egg or soy products.

📕Administering it to such individuals may provoke a severe hypersensitivity reaction, including anaphylaxis.

📕Assessing for these allergies prior to administration is a critical safety measure before sedation.

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Answer 2

Correct Answers:

Eat foods that contain plenty of potassium.

Rationale :

🔶Furosemide is a loop diuretic that promotes significant excretion of sodium and potassium.

🔶Hypokalemia is a common side effect and can lead to muscle weakness, arrhythmias, and fatigue.

🔶 To prevent potassium depletion, clients should be encouraged to consume potassium-rich foods such as bananas, oranges, spinach, and potatoes.

🔶Clients should not take it at bedtime due to its diuretic effects potentially disturbing sleep.

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Answer 3

Correct Answers:

Empiric therapy

Rationale :

♦️Empiric therapy refers to initiating treatment based on the most likely cause of a condition before the specific pathogen is identified.

♦️In this case, antibiotics are started while awaiting culture results, which is standard for infections when immediate treatment is necessary to prevent worsening or sepsis.

♦️Once culture results return, therapy may be tailored more specifically.

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Answer 4

Correct Answers:

An oral anticoagulant medication

Rationale :

🔶Atrial fibrillation significantly increases the risk of thrombus formation, which can lead to embolic strokes and transient ischemic attacks (TIAs).

🔶The most effective way to prevent these complications is through the use of oral anticoagulants such as warfarin, dabigatran, or apixaban, which reduce the risk of clot formation in the atria.

🔶These medications are crucial in stroke prevention in AFib patients.

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Answer 5

Correct Answers:

800 mL

Rationale :

✍️To calculate total intake:

Use 1 ounce = 30 mL

4 oz juice = 120 mL
6 oz tea = 180 mL
100 mL ice chips = 50 mL (ice chips count as 50% of volume)
IV bolus = 150 mL
8 oz broth = 240 mL

👉Total: 120 + 180 + 50 + 150 + 240 =

👉= 740 mL

(Rounded as per standard intake rounding), the closest correct answer is 800 mL.

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Answer 6

Correct Answers:

Auscultate lung fields.

Rationale :

🔹Prior to initiating percussion, vibration, and postural drainage, the nurse must auscultate the client's lung fields to identify specific areas of abnormal breath sounds such as crackles.

🔹This assessment directs where to apply the therapy for maximum effectiveness.

🔹 Lung auscultation helps locate mucus accumulation or atelectasis

🔹It allows the nurse to avoid applying mechanical techniques to clear areas that are already aerated or potentially compromised.

🔹This step ensures safe and targeted respiratory care, especially in clients with conditions like pneumonia, bronchitis, or cystic fibrosis.

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Answer 7

Correct Answers:

A client who has had a cerebrovascular accident
A client who has had trauma to the head and neck
A client who is 4 hours postoperative following a leg amputation with general anesthesia

Rationale :

🔷A client who has had a cerebrovascular accident

Clients post-stroke often have impaired swallowing reflexes (dysphagia) due to cranial nerve involvement, increasing the risk of aspiration pneumonia when eating or drinking.
They may also lack cognitive awareness of unsafe eating practices.

🔷 A client who has had trauma to the head and neck

Head and neck trauma can compromise the airway, swallowing mechanism, or neurological control, impairing the protective reflexes needed to prevent aspiration during meals.

🔷A client who is 4 hours postoperative following a leg amputation with general anesthesia

General anesthesia can cause temporary suppression of the gag and cough reflexes, placing the client at risk for aspiration if they eat before full recovery of reflexes.
Post-op sedation and analgesia may further dull alertness and airway protection.

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Answer 8

Correct Answers:

History of NSAID use

Rationale :

✍️Nonsteroidal anti-inflammatory drugs (NSAIDs) are a well-documented cause of gastric mucosal injury and peptic ulcer disease (PUD).

✍️They work by inhibiting cyclooxygenase (COX-1 and COX-2) enzymes, which reduces the synthesis of prostaglandins that protect the gastric lining by enhancing mucus and bicarbonate production.

✍️ Chronic NSAID use can lead to gastric irritation, erosions, and ulcer formation, especially in elderly patients or those with concurrent corticosteroid or anticoagulant therapy.

✍️ PUD caused by NSAIDs may be silent until a complication such as bleeding or perforation arises.

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Answer 9

Correct Answers:

Have another nurse witness the wasted medication.

Rationale :

💎For controlled substances, such as narcotics, wasting any unused portion requires two licensed healthcare professionals to verify and document the amount discarded.

💎This is a regulatory requirement to prevent drug diversion, misuse, and legal liability.

💎Documentation must be completed immediately after the waste occurs and signed by both parties.

💎Placing medication in the sharps container or returning it to the dispenser without a witness violates medication administration policy and increases the risk of medication discrepancies.

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Answer 10

Correct Answers:

3

Rationale :

✍️To determine the mL to be administered;

▲Use formula ;

▲Ordered ÷ Available

👉 Ordered gabapentin = 900 mg PO once daily.

👉 Available dose = 300 mg per capsule.

900 mg ÷ 300

👍= 3 capsules

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RN ATI Medsurg Nurs120 Final Exam

No.

1 : The nurse is preparing to assist in the sedation of a client with propofol (Diprivan) prior to surgery. Which of the following contraindications associated with propofol (Diprivan) should the nurse assess for?

2 : A nurse is providing discharge teaching for a client who has pulmonary edema and is about to start taking furosemide. Which of the following instructions should the nurse include?

3 : A client is prescribed antibiotics while pending the results of their wound culture. The nurse understands this method of medication therapy is known as:

4 : A client is diagnosed with atrial fibrillation and has experienced a transient ischemic attack (TlAs)

5 : A nurse is completing an 8-hour intake and output (1&0) record for a client who consumed 4 oz juice, 6 oz hot tea, 100 mL ice chips, an IV bolus of 150 mL, and 8 oz broth. The nurse should record how many mL of intake on the client's record.

6 : A nurse is preparing an adolescent client who has pneumonia for percussion, vibration, and postural drainage. Prior to the procedure, which nursing action should the nurse complete first?

7 : A nurse is caring for a group of clients. Which of the following clients should the nurse identify as having an increased risk of aspiration while eating (select all that apply)?

8 : A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the following findings should the nurse recognize as a risk factor for this condition?

9 : A nurse has withdrawn a narcotic from the medication dispenser and must waste a portion of the medication. What should the nurse do?

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