Exam 2 Pharmacology for Nurses (13, 48-50, 44-47, 39-40)

A patient is given a prescription for finasteride (Proscar) for treatment of benign prostatic hyperplasia. Essential teaching for this patient includes which of the following? (Select all that apply.) 1. Full therapeutic effects may take 3 to 6 months. 2. Hair loss or male-pattern baldness may be an adverse effect. 3. The drug should not be handled by pregnant women, especially if it is crushed. 4. Blood donation should not occur while taking this drug. 5. Report any weight gain of over 2 kg (5 lb) in 1 week

1. Full therapeutic effects may take 3 to 6 months. 3. The drug should not be handled by pregnant women, especially if it is crushed. 4. Blood donation should not occur while taking this drug. Chapter 47

The patient with erectile dysfunction is being evaluated for the use of sildenafil (Viagra). Which question should the nurse ask before initiating therapy with sildenafil? 1. "Are you currently taking medications for angina?" 2. "Do you have a history of diabetes?" 3. "Have you ever had an allergic reaction to dairy products?" 4. "Have you ever been treated for migraines?"

1. "Are you currently taking medications for angina?" Chapter 47

The nurse is teaching a patient who has a new prescription for testosterone gel. Which instruction should the nurse give to this patient? 1. "Avoid exposing women to the gel or to areas of skin where the gel has been applied." 2. "Report any weight gain over 2 kg (5 lb) in 1 month." 3. "Avoid showering or swimming for at least 12 hours after applying the gel." 4. "Apply the gel to the scrotal and perineal areas daily."

1. "Avoid exposing women to the gel or to areas of skin where the gel has been applied." Chapter 47

A man, age 67, reports taking diphenhydramine (Benadryl) for hay fever. Considering this patient's age, the nurse assesses for which findings? 1. A history of prostatic or urinary conditions 2. Any recent weight gain 3. A history of allergic reactions 4. A history of peptic ulcer disease

1. A history of prostatic or urinary conditions Chapter 39

A 65-year-old patient is prescribed ipratropium (Atrovent) for the treatment of asthma. Which condition should be reported to the healthcare provider before giving this patient the ipratropium? 1. A reported allergy to peanuts 2. A history of intolerance to albuterol (Proventil) 3. A history of bronchospasms 4. A reported allergy to chocolate

1. A reported allergy to peanuts Chapter 40

Which patients would have a higher risk for adverse effects from estradiol and norethindrone (OrthoNovum)? (Select all that apply.) 1. An 18-year-old with a history of depression 2. A 16-year-old with chronic acne 3. A 33-year-old with obesity per her body mass index (BMI) 4. A 24-year-old who smokes one pack of cigarettes per day 5. A 41-year-old who has delivered two healthy children

1. An 18-year-old with a history of depression 4. A 24-year-old who smokes one pack of cigarettes per day Chapter 46

The patient is prescribed timolol (Timoptic) for treatment of glaucoma. During the history and physical, the nurse assesses for which of the following medical disorders that may be a contraindication to the use of this drug? (Select all that apply.) 1. Heart block 2. Heart failure 3. Liver disease 4. Chronic obstructive pulmonary disease 5. Renal disease

1. Heart block 2. Heart failure 4. Chronic obstructive pulmonary disease Chapter 50

The nurse evaluates the patient's understanding of the procedure for application of triamcinolone (Kenalog, Aristocort) cream for acute contact dermatitis of the neck, secondary to a reaction to perfume. The patient asks why she can't just use up some fluocinonide (Lidex) cream she has left over from a poison ivy dermatitis last month. The nurse's response will be based on which of the following? 1. High-potency corticosteroid creams should be avoided on the neck or face because of the possibility of additional adverse effects. 2. All creams should be discarded after the initial condition has resolved. 3. Fluocinonide cream is too low potency to use for contact dermatitis. 4. Contact dermatitis from perfume is harder to treat than poison ivy dermatitis.

1. High-potency corticosteroid creams should be avoided on the neck or face because of the possibility of additional adverse effects. Chapter 49

Following administration of phenylephrine (NeoSynephrine), the nurse would assess for which adverse drug effects? 1. Insomnia, nervousness, and hypertension 2. Nausea, vomiting, and hypotension 3. Dry mouth, drowsiness, and dyspnea 4. Increased bronchial secretions, hypotension, and bradycardia

1. Insomnia, nervousness, and hypertension Chapter 13

A 63-year-old patient with type 2 diabetes is admitted to the nursing unit with an infected foot ulcer. Despite previous good control on glyburide (DiaBeta), his blood glucose has been elevated the past several days and he requires sliding-scale insulin. What is the most likely reason for the elevated glucose levels? 1. It is a temporary condition related to the stress response with increased glucose release. 2. He is converting to a type 1 diabetic. 3. The oral antidiabetic drug is no longer working for him. 4. Patients with diabetes who are admitted to the hospital are switched to insulin for safety and tighter control.

1. It is a temporary condition related to the stress response with increased glucose release. Chapter 45

The patient has been prescribed oxymetazoline (Afrin) nasal spray for seasonal rhinitis. Which instructions will the nurse provide? 1. Limit use of this spray to 5 days or less. 2. The drug may be sedating so be cautious with activities requiring alertness. 3. This drug should not be used in conjunction with antihistamines. 4. This is an over-the-counter drug and may be used as needed for congestion.

1. Limit use of this spray to 5 days or less. Chapter 39

The patient is scheduled to receive 5 units of Humalog and 25 units of NPH (Isophane) insulin prior to breakfast. Which nursing intervention is most appropriate for this patient? 1. Make sure the patient's breakfast is available to eat before administering this insulin. 2. Offer the patient a high-carbohydrate snack in 6 hours. 3. Hold the insulin if the blood glucose level is greater than 100 mg/dL. 4. Administer the medications in two separate syringes.

1. Make sure the patient's breakfast is available to eat before administering this insulin. Chapter 45

A patient with rheumatoid arthritis will begin treatment with adalimumab (Humira). Which statement related to this therapy is correct? Select all that apply. Adlimumab: 1. May lower immune response and increase the risk of infections and malignancies. 2. Is associated with osteoporosis and baseline and periodic DXA scans should be conducted. 3. May reactivate latent TB. 4. May cause local injection-site irritations such as pain and bruising. 5. Must be taken daily for up to 6 months.

1. May lower immune response and increase the risk of infections and malignancies. 3. May reactivate latent TB. 4. May cause local injection-site irritations such as pain and bruising. Chapter 48

A patient is started on atenolol (Tenormin). Which is the most important action to be included in the plan of care for this patient related to this medication? 1. Monitor apical pulse and blood pressure. 2. Elevate the head of the bed during meals. 3. Take the medication after meals. 4. Consume foods high in potassium.

1. Monitor apical pulse and blood pressure. Chapter 13

What patient education should the nurse provide to the patient with diabetes who is planning an exercise program? (Select all that apply.) 1. Monitor blood glucose levels before and after exercise. 2. Eat a complex carbohydrate prior to strenuous exercise. 3. Exercise may increase insulin needs. 4. Withhold insulin prior to engaging in strenuous exercise. 5. Take extra insulin prior to exercise.

1. Monitor blood glucose levels before and after exercise. 2. Eat a complex carbohydrate prior to strenuous exercise. Chapter 45

hypertension reports being dizzy when first getting out of bed in the morning. The nurse should advise the patient to: 1. Move slowly from the recumbent to the upright position. 2. Drink a full glass of water before rising to increase vascular circulatory volume. 3. Avoid sleeping in a prone position. 4. Stop taking the medication.

1. Move slowly from the recumbent to the upright position. Chapter 13

After trying many other treatments, a 28-year-old female is started on isotretinoin for treatment of severe acne. While she is on this medication, what explicit instructions must be followed? (Select all that apply.) 1. She must use two forms of birth control and have pregnancy tests before beginning, during, and after she is on the therapy. 2. She must have vision checks performed every 6 months. 3. She must increase intake of vitamin A-rich foods. 4. She must return every 2 to 3 months for laboratory tests. 5. She must delay any future pregnancies for a period of 5 years.

1. She must use two forms of birth control and have pregnancy tests before beginning, during, and after she is on the therapy. 2. She must have vision checks performed every 6 months. 4. She must return every 2 to 3 months for laboratory tests. Chapter 49

A patient is receiving treatment for asthma with albuterol (Proventil). The nurse teaches the patient that while serious adverse effects are uncommon, the following may occur. (Select all that apply.) 1. Tachycardia 2. Sedation 3. Temporary dyspnea 4. Nervousness 5. Headache

1. Tachycardia 4. Nervousness 5. Headache Chapter 40

Which teaching point will the nurse provide to a patient with a new prescription for alendronate (Fosamax)? 1. Take the medication with a full glass of water 30 minutes before breakfast. 2. Take the medication with a small snack or meal containing dairy. 3. Take the medication immediately before bed. 4. Take the medication with a calcium supplement.

1. Take the medication with a full glass of water 30 minutes before breakfast. Chapter 48

The nurse is planning health teaching for a patient who has been prescribed latanoprost (Xalatan) drops for open-angle glaucoma. The nurse should include which of the following in the teaching plan? 1. The drops may cause darkening and thickening of the eyelashes and upper lid and darkening of the iris color. 2. The drops may cause a temporary loss of eyelashes that will regrow once the drug is stopped. 3. The drops will cause dilation of pupils, and darkened glasses should be worn in bright light. 4. The drops will cause a permanent bluish tint to the conjunctiva that is harmless.

1. The drops may cause darkening and thickening of the eyelashes and upper lid and darkening of the iris color. Chapter 50

The nurse is talking with the parents of a child who will receive somatropin (Nutropin) about the drug therapy. Which important detail will the nurse include in the teaching for these parents? 1. The drug must be given by injection. 2. The drug must be given regularly throughout adolescence and young adulthood to achieve desired effects. 3. If the drug therapy is given throughout adolescence, it could add 6 (15 cm) to 8 inches (20 cm) to the child's height. 4. Daily laboratory monitoring will be required during the first weeks of therapy.

1. The drug must be given by injection. Chapter 44

A patient has started taking clomiphene (Clomid, Serophene) after an infertility workup and asks the nurse why she is not having in-vitro fertilization. Which statement would be most helpful in explaining the use of clomiphene to the patient? 1. The patient's diagnostic workup suggested that infrequent ovulation may be the cause for her infertility, and clomiphene increases ovulation. 2. In-vitro fertilization is expensive and because clomiphene is less expensive, it is always tried first. 3. There is less risk of multiple births with clomiphene. 4. The patient's past history of oral contraceptive use has prevented her from ovulating. Clomiphene is given to stimulate ovulation again in these conditions.

1. The patient's diagnostic workup suggested that infrequent ovulation may be the cause for her infertility, and clomiphene increases ovulation. Chapter 46

To avoid the first-dose phenomenon, the nurse knows that the initial dose of prazosin (Minipress) should be: 1. Very low and given at bedtime. 2. Doubled and given before breakfast. 3. The usual dose and given before breakfast. 4. The usual dose and given immediately after breakfast.

1. Very low and given at bedtime. Chapter 13

Which assessment findings would cause the nurse to withhold the patient's regularly scheduled dose of levothyroxine (Synthroid)? 1. A 1-kg (2-lb) weight gain 2. A blood pressure reading of 90/62 mmHg 3. A heart rate of 110 beats/minute 4. A temperature of 37.9°C (100.2°F)

3. A heart rate of 110 beats/minute Chapter 44

A patient is interested in taking levonorgestrel and estradiol (Seasonique) and asks how it is taken. Which explanation by the nurse is correct? 1. "Seasonique is taken year-round without a break and without a period." 2. "Seasonique is taken for 84 days and then followed by 7 days of a lower dose contained in the same package." 3. "Seasonique is a vaginal ring that is inserted monthly." 4. "Seasonique is taken for 2 months then off for 1 month using regular oral contraceptives."

2. "Seasonique is taken for 84 days and then followed by 7 days of a lower dose contained in the same package." Chapter 46

A 15-year-old patient started using topical benzoyl peroxide (Benzaclin, Fostex) 1 week ago for treatment of acne and is discouraged that her acne is still visible. What is the nurse's best response? 1. "The cream should have started working by now. Check with your healthcare provider about switching to a different type." 2. "Some improvement will be noticed quickly, but full effects may take several weeks to a month or longer." 3. "Acne is very difficult to treat. It may be several months before you notice any effects." 4. "If your acne is not gone by now, you may need an antibiotic too. Ask your healthcare provider."

2. "Some improvement will be noticed quickly, but full effects may take several weeks to a month or longer." Chapter 49

A postmenopausal woman is started on raloxifene (Evista) for prevention of osteoporosis. Because of the black box warning, what condition, noted in the patient's history, may indicate that this drug should not be given, or given with extreme caution? 1. A history of depression 2. A history of coronary artery disease or thrombophlebitis 3. A history of osteoarthritis 4. A history of using black cohosh to treat menopausal symptoms

2. A history of coronary artery disease or thrombophlebitis Chapter 48

Which of the following nursing assessments would be appropriate for the patient who is receiving testosterone? (Select all that apply.) 1. Monitor for a decrease in hematocrit. 2. Assess for signs of fluid retention. 3. Assess for increased muscle mass and strength. 4. Check for blood dyscrasias. 5. Assess for muscle wasting.

2. Assess for signs of fluid retention. 3. Assess for increased muscle mass and strength. Chapter 47

A nurse is preparing the teaching plan for a patient who will be discharged on methylprednisolone (Medrol Dosepak) after a significant response to poison ivy. The nurse will include instruction on reporting which adverse effects to the healthcare provider? (Select all that apply.) 1. Tinnitus 2. Edema 3. Eye pain or visual changes 4. Abdominal pain 5. Dizziness upon standing

2. Edema 3. Eye pain or visual changes 4. Abdominal pain Chapter 44

The patient is treated for head lice with permethrin (Nix). Following treatment, the nurse will reinforce which instruction? 1. Remain isolated for 48 hours. 2. Inspect the hair shafts, checking for nits daily for 1 week following treatment. 3. Shampoo with permethrin three times per day. 4. Wash linens with cold water and bleach.

2. Inspect the hair shafts, checking for nits daily for 1 week following treatment. Chapter 49

Which assessment findings in a patient who is receiving calcitriol (Calcijex, Rocaltrol) should the nurse immediately report to the healthcare provider? 1. Muscle aches, fever, dry mouth 2. Tremor, abdominal cramping, hyperactive bowel sounds 3. Bone pain, lethargy, anorexia 4. Muscle twitching, numbness, and tingling of the extremities

3. Bone pain, lethargy, anorexia Chapter 48

A 62-year-old female has received a prescription for alendronate (Fosamax) for treatment of osteoporosis. The nurse would be concerned about this order if the patient reported which condition? (Select all that apply.) 1. She enjoys milk, yogurt, and other dairy products and tries to consume some with each meal. 2. She is unable to sit upright for prolonged periods because of severe back pain. 3. She is lactose intolerant and rarely consumes dairy products. 4. She has had trouble swallowing and has been told she has "problems with her esophagus." 5. She has a cup of green tea every night before bed.

2. She is unable to sit upright for prolonged periods because of severe back pain. 3. She is lactose intolerant and rarely consumes dairy products. 4. She has had trouble swallowing and has been told she has "problems with her esophagus." Chapter 48

Vilanterol and fluticasone (Breo Ellipta) has been ordered for a patient with COPD. Because of the combination of drugs, what adverse effects may be expected? (Select all that apply). 1. Sedation and drowsiness 2. Tremor and nervousness 3. Hypotension 4. Dry mouth and hoarseness 5. Oropharyngeal cadidiasis and increased risk of infections

2. Tremor and nervousness 4. Dry mouth and hoarseness 5. Oropharyngeal cadidiasis and increased risk of infections Chapter 40

A patient has been prescribed fluticasone (Flonase) to use with oxymetazoline (Afrin). How should the patient be taught to use these drugs? 1. Use the fluticasone first, then the oxymetazoline after waiting 5 minutes. 2. Use the oxymetazoline first, then the fluticasone after waiting 5 minutes. 3. The drugs may be used in either order. 4. The fluticasone should be used only if the oxymetazoline fails to relieve the nasal congestion.

2. Use the oxymetazoline first, then the fluticasone after waiting 5 minutes. Chapter 39

The nurse is initiating discharge teaching with the newly diagnosed patient with diabetes. Which statement indicates that the patient needs additional teaching? 1. "If I am experiencing hypoglycemia, I should drink 1/2 cup of apple juice." 2. "My insulin needs may increase when I have an infection." 3. "I must draw the NPH insulin first if I am mixing it with regular insulin." 4. "If my blood glucose levels are less than 60 mg/ dL, I should notify my healthcare provider."

3. "I must draw the NPH insulin first if I am mixing it with regular insulin." Chapter 45

A woman consults the nurse about Plan B (levonorgestrel) after unprotected intercourse that occurred 2 days earlier. Which instruction will the nurse give to this patient? 1. "You must wait 7 days before taking the pills for Plan B to be effective." 2. "Plan B is effective only within 24 hours of unprotected intercourse." 3. "You will take one pill of Plan B at first, followed by another pill 12 hours later." 4. "You will need to obtain a prescription for Plan B."

3. "You will take one pill of Plan B at first, followed by another pill 12 hours later." Chapter 46

A patient is being treated with methimazole (Tapazole) for hyperthyroidism, pending thyroidectomy. While the patient is taking this drug, what symptoms will the nurse teach the patient to report to the healthcare provider? 1. Tinnitus, altered taste, thickened saliva 2. Insomnia, nightmares, night sweats 3. General weakness, muscle cramps, and dry skin 4. Dry eyes, decreased blinking, reddened conjunctiva

3. General weakness, muscle cramps, and dry skin Chapter 44

Timolol (Timoptic) drops have been ordered to treat glaucoma. Because of the possibility of systemic adverse effects, what essential instruction should the patient receive? 1. Monitor urine output and daily weight. Promptly report any edema. 2. Monitor blood glucose and alert the healthcare provider to any significant changes. 3. Hold slight pressure on the inner canthus of the eye for 1 minute after instilling the drop. 4. Monitor respiratory rate and for signs and symptoms of upper respiratory infection.

3. Hold slight pressure on the inner canthus of the eye for 1 minute after instilling the drop. Chapter 50

The nurse is teaching a patient about the use of tadalafil (Cialis). What will the nurse teach him about the effects of tadalafil? 1. It should always result in a penile erection within 10 minutes. 2. It may heighten female sexual response. 3. It is not effective if sexual dysfunction is caused by psychologic conditions. 4. It will result in less intense sensation with prolonged use.

3. It is not effective if sexual dysfunction is caused by psychologic conditions. Chapter 47

Which of the following is the best advice that the nurse can give a patient with viral rhinitis who intends to purchase an over-the-counter combination cold remedy? 1. Dosages in these remedies provide precise dosing for each symptom that you are experiencing. 2. These drugs are best used in conjunction with an antibiotic. 3. It is safer to use a single-drug preparation if you are experiencing only one symptom. 4. Since these drugs are available over the counter, it is safe to use any of them as long as needed.

3. It is safer to use a single-drug preparation if you are experiencing only one symptom. Chapter 39

The patient who is receiving allopurinol (Lopurin) for treatment of gout asks why he should avoid the consumption of alcohol. The nurse's response is based on the knowledge that the use of alcohol along with allopurinol may result in which of the following? 1. It significantly increases the drug levels of allopurinol. 2. It interferes with the absorption of antigout medications. 3. It raises uric acid levels. 4. It causes the urine to become more alkaline.

3. It raises uric acid levels. Chapter 48

A patient with a history of glaucoma who has been taking latanoprost (Xalatan) eyedrops complains of severe pain in the eye, severe headache, and blurred vision. What should be the nurse's first response? 1. Document the occurrence; this symptom is expected. 2. Medicate the patient with a narcotic analgesic. 3. Notify the healthcare provider immediately. 4. Place the patient in a quiet, darkened environment.

3. Notify the healthcare provider immediately. Chapter 50

A patient will be started on desmopressin (DDAVP) for treatment of diabetes insipidus. Which instruction should the nurse include in the teaching plan? 1. Drink plenty of fluids, especially those high in calcium. 2. Avoid close contact with children or pregnant women for 1 week after administration of the drug. 3. Obtain and record your weight daily. 4. Wear a mask if around children and pregnant women.

3. Obtain and record your weight daily. Chapter 44

A patient has a prescription for fluticasone (Flonase) for allergic rhinitis. Place the following instructions in the order in which the nurse will instruct the patient to use the drug. 1. Instill one spray directed high into the nasal cavity. 2. Clear the nose by blowing. 3. Prime the inhaler prior to first use. 4. Spit out any excess liquid that drains into the mouth.

3. Prime the inhaler prior to first use. 2. Clear the nose by blowing. 1. Instill one spray directed high into the nasal cavity. 4. Spit out any excess liquid that drains into the mouth. Chapter 39

A patient who received a prescription for montelukast (Singulair) returns to his provider's office after 3 days, complaining that "the drug is not working." She reports mild but continued dyspnea and has had to maintain consistent use of her bronchodilator inhaler, albuterol (Proventil). What does the nurse suspect is the cause of the failure of the montelukast? 1. The patient is not taking the drug correctly. 2. The patient is not responding to the drug and will need to be switched to another formulation. 3. The drug has not had sufficient time of use to have full effects. 4. The albuterol inhaler is interacting with the montelukast.

3. The drug has not had sufficient time of use to have full effects. Chapter 40

The biologic DMARDs such as adalimumab (Humira) are used for psoriasis and psoriatic arthritis when topical treatments have not achieved desirable results. What is a major clinical disadvantage of DMARD therapy when compared to conventional topical drugs? 1. They take months to be effective. 2. They only treat certain types of psoriasis. 3. They increase the risk of serious infections, including reactivation of TB. 4. They are expensive.

3. They increase the risk of serious infections, including reactivation of TB. Chapter 49

A patient with asthma has a prescription for two inhalers, albuterol (Proventil) and beclomethasone (Qvar). How should the nurse instruct this patient on the proper use of the inhalers? 1. Use the albuterol inhaler, and use the beclomethasone only if symptoms are not relieved. 2. Use the beclomethasone inhaler, and use the albuterol only if symptoms are not relieved. 3. Use the albuterol inhaler, wait 5-10 minutes, then use the beclomethasone inhaler. 4. Use the beclomethasone inhaler, wait 5-10 minutes, then use the albuterol inhaler.

3. Use the albuterol inhaler, wait 5-10 minutes, then use the beclomethasone inhaler. Chapter 40

The nurse emphasizes to the patient with glaucoma the importance of notifying the healthcare provider performing an eye examination of a glaucoma diagnosis because of potential adverse reactions to which drugs? 1. Antibiotic drops 2. Cycloplegic drops 3. Anti-inflammatory drops 4. Anticholinergic mydriatic drops

4. Anticholinergic mydriatic drops Chapter 50

The nurse is teaching a patient about the use of dextromethorphan with guaifenesin (Robitussin-DM) syrup for a cough accompanied by thick mucus. Which instruction should be included in the patient's teaching? 1. Lie supine for 30 minutes after taking the liquid. 2. Drink minimal fluids to avoid stimulating the cough reflex. 3. Take the drug with food for best results. 4. Avoid drinking fluids immediately after the syrup but increase overall fluid intake throughout the day.

4. Avoid drinking fluids immediately after the syrup but increase overall fluid intake throughout the day. Chapter 39

Propranolol (Inderal) has been ordered for a patient with hypertension. Because of adverse effects related to this drug, the nurse would carefully monitor for which adverse effect? 1. Bronchodilation 2. Tachycardia 3. Edema 4. Bradycardia

4. Bradycardia Chapter 13

The nurse is planning teaching for a patient prescribed desoximetasone (Topicort) for atopic dermatitis. The nurse will teach the patient to anticipate which possible adverse effects? 1. Localized pruritus and hives 2. Hair loss in the application area 3. Worsening of acne 4. Burning and stinging of the skin in the affected area

4. Burning and stinging of the skin in the affected area Chapter 49

The nurse is assisting a patient with chronic adrenal insufficiency to plan for medication consistency while on a family vacation trip. He is taking hydrocortisone (Cortef) and fludrocortisones (Florinef) as replacement therapy. What essential detail does this patient need to remember to do? 1. Take his blood pressure once or twice daily. 2. Avoid crowded indoor areas to avoid infections. 3. Have his vision checked before he leaves. 4. Carry an oral and injectable form of both drugs with him on his trip.

4. Carry an oral and injectable form of both drugs with him on his trip. Chapter 44

A patient with type 2 diabetes has been nothing by mouth (NPO) since midnight for surgery in the morning. He has been on a combination of oral type 2 antidiabetic drugs. What would be the best action for the nurse to take concerning the administration of his medications? 1. Hold all medications as per the NPO order. 2. Give him the medications with a sip of water. 3. Give him half the original dose. 4. Contact the healthcare provider for further orders.

4. Contact the healthcare provider for further orders. Chapter 45

The nurse completes an assessment of a patient in labor who is receiving an intravenous infusion of oxytocin. Which assessment indicates the need for prompt intervention? 1. There is no vaginal bleeding noted. 2. The patient is managing her pain through breathing techniques. 3. Fetal heart rate remains at baseline parameters. 4. Contractions are sustained for 2 minutes in duration.

4. Contractions are sustained for 2 minutes in duration. Chapter 46

The healthcare provider prescribes epinephrine (Adrenalin) for a patient who was stung by several wasps 30 minutes ago and is experiencing an allergic reaction. The nurse knows that the primary purpose of this medication for this patient is to: 1. Stop the systemic release of histamine produced by the mast cells. 2. Counteract the formation of antibodies in response to an invading antigen. 3. Increase the number of white blood cells produced to fight the primary invader. 4. Increase a declining blood pressure and dilate constricting bronchi associated with anaphylaxis.

4. Increase a declining blood pressure and dilate constricting bronchi associated with anaphylaxis. Chapter 13

A 43-year-old patient is receiving medroxyprogesterone (Depo-Provera) for treatment of dysfunctional uterine bleeding. Because of related adverse effects, which condition may indicate a potential adverse effect? 1. Breakthrough bleeding between periods 2. Insomnia or difficulty falling asleep 3. Eye, mouth, or vaginal dryness 4. Joint pain or pain on ambulation

4. Joint pain or pain on ambulation Chapter 46

Appropriate administration is key for patients who are taking eyedrops for the treatment of glaucoma to optimize therapeutic effects and reduce adverse effects. The nurse would be concerned if the patient reports administering the drops in which manner? 1. Into the conjunctival sac 2. Holding slight pressure on the tear duct (lacrimal duct) for 1 minute after instilling the eyedrops 3. Avoiding direct contact with the eye dropper tip and the eye 4. Leaving contact lenses in to be sure the eyedrop is maintained in the eye

4. Leaving contact lenses in to be sure the eyedrop is maintained in the eye Chapter 50

A patient with a history of benign prostatic hyperplasia is complaining of feeling like he "cannot empty his bladder." He has been taking finasteride (Proscar) for the past 9 months. What should the nurse advise this patient to do? 1. Continue to take the drug to achieve full therapeutic effects. 2. Discuss the use of a low-dose diuretic with the healthcare provider. 3. Decrease the intake of coffee, tea, and alcohol. 4. Return to the healthcare provider for laboratory studies and a prostate exam.

4. Return to the healthcare provider for laboratory studies and a prostate exam. Chapter 47

A patient has been using a fluticasone (Flovent) inhaler as a component of his asthma therapy. He returns to his healthcare provider's office complaining of a sore mouth. On inspection, the nurse notices white patches in the patient's mouth. What is a possible explanation for these findings? 1. The patient has been consuming hot beverages after the use of the inhaler. 2. The patient has limited his fluid intake, resulting in dry mouth. 3. The residue of the inhaler propellant is coating the inside of the mouth. 4. The patient has developed thrush as a result of the fluticasone.

4. The patient has developed thrush as a result of the fluticasone. Chapter 40

A patient receives NPH and regular insulin every morning. The nurse is verifying that the patient understands that there are 2 different peak times to be aware of for this insulin regimen. Why is this an important concept for the nurse to stress? 1. The patient needs to plan the next insulin injection around the peak times. 2. Additional insulin may be needed at peak times to avoid hyperglycemia. 3. It is best to plan exercise or other activities around peak insulin activity. 4. The risk for hypoglycemia is greatest around the peak of insulin activity.

4. The risk for hypoglycemia is greatest around the peak of insulin activity. Chapter 45