56. What tips can you provide the patient to ease the insertion of an NG tube?

57. Why would it be unsafe to use a petrolatum product, such as Vaseline, for lubrication of an NG tube?

58. What are the various methods used to verify tube placement prior to instillation of anything into the NG tube?

60. You suspect a patient is experiencing hypoglycemia. What are the signs and symptoms for which you should assess? List at least six. If you find several of these signs and symptoms, what should be your first intervention?

Mr. Conley, age 53, is about to be discharged from the hospital after treatment for recurrent ventricular fibrillation unresponsive to other agents. To prevent further ventricular ectopy, the health care provider prescribes amiodarone (Cordarone), 1000 mg PO daily as a loading dose for 2 weeks. Why is such a large loading dose required?

Select one:

A.Most of the drug is destroyed in the GI tract.

B.The drug has a long serum half-life.

C.A history of ventricular dysrhythmia necessitates a higher dose.

D.Males require larger dosages because of their faster metabolisms

When caring for a patient who is receiving morphine, it is most important that the nurse regularly assess for which of the following?

Select one:

A.frequent urination

B.respiratory depression

C.hyperactive bowel sounds

D.insomnia

A patient, taking a short-acting inhaled bronchodilator and a steroid inhaler at the same scheduled time, asks the nurse if the order of administration of the inhalers matters. The best response by the nurse is

Select one:

A.“The short-acting inhaled bronchodilator should be used first, followed by the steroid inhaler.”

B.“You should not take both inhalers at the same time.”

C.“Either medication can effectively be used first.”

D.“The steroid inhaler should be used first, followed by the short-acting inhaled bronchodilator.”

A patient with H. pylori develops a related ulcer. He is placed on ranitidine and Helidac, a drug combination that contains bismuth, metronidazole, and tetracycline. The patient had been instructed not to consume alcohol, ignored the teaching, and drank beer. The patient presents to the emergency department with tachycardia, headache, diaphoresis, and nausea and vomiting. This disulfiram-like reaction occurred because of the interaction between the alcohol and which drug in the combination?

Select one:

A.metronidazole

B.tetracycline

C.ranitidine

D.bismuth

The nurse in the emergency room anticipates an order of a severe allergic reaction with anaphylaxis, knowing that the drug of choice for severe allergic reactions with anaphylaxis is:

Select one:

A.epinephrine

B.atropine

C.cimetidine (Tagamet)

D.loratadine (Claritin)

Clear my choice

The nurse removes a patient’s transdermal nitroglycerin disc at bedtime as ordered to minimize nitrate tolerance. The patient awakens during the night and complains of anginal symptoms. The nurse’s first action is to:

Select one:

A.Notify the health care provider.

B.Apply a new transdermal disc.

C.Obtain further history of complaints.

D.Administer a short-acting nitrate as ordered.

The nurse explains to the patient being discharged who is taking sucralfate that the medication should be administered:

Select one:

A.with meals

B.at the same time as an antacid

C.after meals

D.2 hours before other drugs

Clear my choice

Cefuroxime (Ceftin) is a first generation antibiotic.

Select one:

True

False

Important points to include when teaching measures to promote healthy bowel function include all of the following except:

Select one:

A.Establish regular bowel habits.

B.Increase fluid intake.

C.Increase activity.

D.Eat a low-residue diet.

A patient asks the nurse how sucralfate (Carafate) works. The nurse replies that sucralfate:

Select one:

A.binds to normal and ulcerated mucosa, creating a protective barrier

B.enhances prostaglandin synthesis

C.increases mucus and bicarbonate secretion

D.inhibits gastric acid secretion

Hydralazine is more effective in childhood and adolescent hypertension than in adult disease.

Select one:

True

False

One of the most common adverse effects of misoprostol that makes the drug difficult to tolerate in older adults is:

Select one:

A.constipation

B.diarrhea

C.hyperphosphatemia

D.headache

Your patient has asked for an antihistamine to relieve his symptoms of an upper respiratory infection. You explain to him that studies have demonstrated that for treatment of the common cold, antihistamines:

Select one:

A.do not relieve symptoms and are not recommended

B.should be compounded with other products to be effective

C.are effective in relieving cold symptoms

D.relieve nonallergenic symptoms only

Clear my choice

For patients taking clozapine, the nurse should assess which of the following laboratory values weekly?

Select one:

A.complete blood count (CBC)

B.liver enzyme studies

C.hemoglobin and hematocrit

D.blood urea nitrogen and creatinine

Folic acid supplementation is especially important to prevent neural-tube birth defects (e.g., spina bifida).

Select one:

True

False

Discuss what kinds of choices you would make if you knew you were dying. What kind of medical care would you select? What would be most important to you? What are things you would not want done in your medical care? Would you want a funeral service?

Option 1: Assess the moral solutions arrived at through "care" (care-based ethics) and "rights" ethics to social issues of ethical import such as poverty, drug use, and/or lack of health care, That is, note any ethical problems that arise related to those particular issues. Then, say how both care-based and rights theory of ethics would solve those problems. Are those solutions correct? Why or why not? What is your own approach there?

Using Blake and Mouton's Leadership Grid, explain and discuss the leadership style displayed by management to the nursing staff .

Legal & Ethical Issues

Jonathan Kirkpatrick recently was hired as a nursing manager in an acute care hospital for orthopedics, neurology, and two medical-surgical units for a for-profit corporation. Nurse Kirkpatrick is responsible for the quality, cost, and morale for the units that he manages. As part of his employment package, he is rewarded with a bonus based on the amount of money that he is able to save the hospital.

1. What is the key challenge Nurse Kirkpatrick faces in most aspects of this new position?
2. One of the first things Nurse Kirkpatrick is asked to do in his new position is to “cut the fat” out of staff numbers. The corporation that owns the hospital believes there are too many nurses on the payroll. Personally, although he does not say so up front, Nurse Kirkpatrick disagrees. He believes the nurses currently on staff are all needed for quality of care. As he looks for ways to cut these numbers, what concerns might he raise to make administrative staff aware of the risks? Identify both ethical concerns and potential legal concerns.

the importance of the rebreather mask to maintain inflation

Ryan is a 12 year old diagnosed with Oppositional Defiant Disorder (ODD). As a small child, Ryan was first diagnosed with Attention Deficit, Hyperactivity Disorder. He had just started preschool and was unable to remain in one place for more than a minute or two. His parents had already had a very difficult time in disciplining him, because he would become very upset and throw temper tantrums when he could not do as he wished. He just seemed to be an unhappy, irritable child. This behavior continued in school. As time progressed, Ryan was diagnosed with Oppositional Defiant Disorder, because he continued to refuse to listen to adults and comply with the rules.

By the age of 12, he has begun to bully and annoy others. His parents have decided that the approaches they have used in the past are not working, and they are more afraid his behavior will only get worse.

Initial Post

Provide explanations for these questions and statements:

• Describe the behaviors apparent for each disorder in this scenario (Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder).
• If this behavior becomes worse and Ryan starts to violate the rights of others, what medical diagnosis will be given and why?
• Discuss at least two types of medication appropriate to treat Ryan and support your choices with rationale and credible resources
• Describe why therapy for the parent is important in this scenario including at least two supporting rationales.