Exam 3 Review Questions

A patient has a prescription for fluticasone (Flonase). 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 spray to first use 4. Spit out any excess liquid that drains into the mouth

3,2,1,4

The patient is using beclomethasone (Beclovent) for treatment of chronic asthma. Which statement indicates that the patient understands this drug therapy? A. "I will use my bronchodilator if my wheezing increases." B. "I will not need a flu shot now that I'm taking this medicine." C. "This is the only drug I will need to treat my asthma attacks." D. "I will use this drug only when I feel an attack coming on."

A. "I will use my bronchodilator if my wheezing increases."

A patient has been diagnosed with tuberculosis and is prescribed Rifater (pyrazinamide with isoniazid and rifampin). While the patient is on this medication, what teaching is essential? SATA A. "It is critical to continue therapy for at least 6 to 12 months" B. "Two or more drugs are used to prevent tuberculosis bacterial resistance" C. "These drugs may also be used to prevent tuberculosis" D. "No special precautions are required" E. "After 1 month of treatment, the medication will be discontinued"

A. "It is critical to continue therapy for at least 6 to 12 months" B. "Two or more drugs are used to prevent tuberculosis bacterial resistance" C. "These drugs may also be used to prevent tuberculosis"

A client who has been on antibiotic therapy for peptic ulcer caused by Helicobacter pylori is diagnosed with a superinfection. What is the most appropriate response by the nurse when the client asks why the superinfection occurred? A. "The normal host flora has been destroyed by the antibiotic." B. "The infectious agent has developed resistance to the drug." C. "The infection caused by H. pylori has become severe." D. "The H. pylori restricted the growth of microorganisms."

A. "The normal host flora has been destroyed by the antibiotic."

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

A. A history of prostatic or urinary conditions

A 65-year-old is prescribed ipratropium (Atrovent) for the treatment of asthma. Which of the following conditions should be reported to the health care provider before giving this patient the ipratropium? A. A reported allergy to peanuts B. A history of intolerance to albuterol (Proventil) C. A history of bronchospasm D. A reported allergy to chocolate

A. A reported allergy to peanuts

A nurse is administering oral sulfamethoxazole-trimethoprim (Bactrim) to a client for treatment of urinary tract infection. Which nursing actions are appropriate? (Select all that apply.) A. Ensure the client drinks a full glass of water with each dose. B. Monitor the client's intake of calcium-fortified drinks. C. Administer the medication around the client's meal times. D. Have the client take potassium supplements with this drug. E. Give the client a glass of milk to drink in case of GI upset

A. Ensure the client drinks a full glass of water with each dose. C. Administer the medication around the client's meal times. E. Give the client a glass of milk to drink in case of GI upset

A nurse is caring for a client receiving vancomycin intravenous infusion for treatment of a wound infected with MRSA. Which finding should the nurse report immediately to the healthcare provider? A. Hypotension and red rash on the chest area B. Joint and muscle pain with general malaise C. Chest discomfort and decreased heart rate D. Heel pain along with difficulty walking

A. Hypotension and red rash on the chest area

A nurse is caring for a client with chronic bronchitis and is prescribed acetylcysteine to loosen bronchial secretions. The nurse should administer this medication by which route? A. Inhalation B. Oral C. Intravenous D. Intramuscular injection

A. Inhalation

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

A. Limit use of this spray to 5 days or less

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. (SATA) A. Tachycardia B. Sedation C. Temporary dyspnea D. Nervousness E. Headache

A. Tachycardia D. Nervousness E. Headache

The client is prescribed diphenhydramine (Benadryl) for treatment of a respiratory allergy. Which statement best indicates that the client understands the drug therapy? A. "I will use my bronchodilator if my wheezing increases." B. "I will report blurred vision, constipation, or urinary retention." C. "This is the only drug I will need to treat my asthma attacks." D. "I will use this drug only when I feel an attack coming on."

B. "I will report blurred vision, constipation, or urinary retention."

The patient is receiving theophylline (Theo-Dur) for treatment of asthma. Nursing intervention is required if the patient makes which statement? A. "I will check my heart rate each day." B. "I will take my medicine with my coffee each morning." C. "I will notify my doctor if my vision changes." D. "I will use my inhaler if I am wheezing."

B. "I will take my medicine with my coffee each morning."

The client is receiving an antitussive with codeine for treatment of a cough. Which statement made by the client requires further teaching by the nurse? A. "I will avoid driving while I am on this medication." B. "I will take my medicine with red wine to help me sleep." C. "I will notify my doctor if my breathing changes." D. "I will keep this medication away from my children."

B. "I will take my medicine with red wine to help me sleep."

A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers should the nurse give to the patient? A. "The corticosteroid should be taken first." B. "The bronchodilator should be taken first." C. "The two drugs should be taken at least 2 hours apart." D. "The order of administration does not matter with these two drugs."

B. "The bronchodilator should be taken first."

A 32-year-old female has been started on amoxicillin (Amoxil, Trimox) for severe UTI. Before sending her home with this prescription, the nurse will provide which instruction? A. Teach her to wear sunscreen B. Ask her about oral contraceptive use and recommend an alternative method for the duration of the ampicillin course C. Assess for hearing loss D. Recommend taking the pill with some antacid to prevent gastrointestinal upset

B. Ask her about oral contraceptive use and recommend an alternative method for the duration of the ampicillin course

A client will be receiving an opioid antitussive for a cough associated with a cold infection. For what should the nurse assess in the client prior to administering the medication? A. Hypertension B. Asthma C. Headache D. Sore throat

B. Asthma

A client is receiving an antihistamine through intranasal route for treatment of an upper respiratory condition. The nurse should expect to administer which medication? A. Beclomethasone (Beconase) B. Azelastine (Astelin) C. Cetirizine (Zyrtec) D. Mometasone (Nasonex)

B. Azelastine (Astelin)

A client is using an intranasal oxymetazoline (Afrin) for treatment of nasal congestion. Which instruction should the nurse include during client teaching? A. Monitor respiratory rate. B. Limit use of the drug to 3-5 days. C. Drink plenty of fluids. D. Use with caution with SSRIs.

B. Limit use of the drug to 3-5 days.

A nurse is preparing to administer a broad-spectrum antibiotic to a client with a severe respiratory infection. Which is an important nursing action to take prior to administering the medication? A. Reviewing the results of the culture and sensitivity test B. Obtaining a specimen for culture and sensitivity testing C. Performing a peak and trough level of the antibiotic D. Determining the course antibiotic therapy based on half-life

B. Obtaining a specimen for culture and sensitivity testing

For which client conditions should the nurse anticipate administering antibiotic therapy for chemoprophylactic purposes? (Select all that apply.) A. Neurologic abnormality B. Prosthetic heart valve C. Dental surgical procedure D. Chronic respiratory infection E. Kidney transplantation

B. Prosthetic heart valve C. Dental surgical procedure E. Kidney transplantation

A patient using a beta-adrenergic agonist for treatment of asthma asks the nurse how the medication works. What is the nurse's best response? A. The drug reduces mucus production. B. The drug causes bronchodilation. C. The drug liquefies thick mucus. D. The drug suppresses the cough reflex.

B. The drug causes bronchodilation

A client is being prescribed penicillin for an upper respiratory infection. What information should the nurse emphasize in providing instructions to the client? A. The antibiotic therapy can be taken while breast-feeding. B. The entire prescription must be completed as instructed. C. The medication can be taken without regard to eating. D. The most common side effect is urinary discoloration.

B. The entire prescription must be completed as instructed.

A patient will be discharged after surgery with a prescription for penicillin. When planning at-home instructions, what will the nurse include? A. Penicillins can be taken while breast-feeding B. The entire prescription must be finished C. All penicillins can be taken without regard to eating D. Some possible side effects include abdominal pain and constipation

B. The entire prescription must be finished

A patient receiving treatment for a respiratory condition asks the nurse why the medication is given through aerosol therapy. What is the nurse's best response? A. The aerosol has no systemic side effects. B. The medication is delivered to the site of action. C. The patient requires no skill to use it. D. The delivery method is safe for all patients.

B. The medication is delivered to the site of action

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

B. Use the oxymetazoline first, then the fluticasone after waiting 5 minutes

A patient presents at the emergency department with an acute asthma attack. The nurse expects that which medication will be used for initial treatment? A. An anticholinergic such as ipratropium (Atrovent) B. A leukotriene receptor antagonist such as montelukast (Singulair) C. A beta-2 agonist such as albuterol (Proventil) D. A corticosteroid such as fluticasone (Flovent)

C. A beta-2 agonist such as albuterol (Proventil)

Which of the following drugs is most immediately helpful in treating acute asthma attack? A. Beclomethasone (Qvar) B. Zileuton (Zyflo CR) C. Albuterol (Proventil, Ventolin) D. Salmeterol (Serevent Diskus)

C. Albuterol (Proventil, Ventolin)

What important information should be included in the patient's education regarding taking ciprofloxacin (Cipro)? A. The drug can cause discoloration of the teeth B. Fluid intake should be decreased to prevent urine retention C. Any heel or lower leg pain should be reported immediately D. The drug should be taken with an antacid to reduce gastric effects

C. Any heel or lower leg pain should be reported immediately

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

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

A nurse is caring for a client who is taking dextromethorphan (Delsym). The client presents at the clinical with symptoms of hypotension and hyperpyrexia. For which drug interaction should the nurse assess in the client? A. Opioids B. Barbiturates C. MAOIs D. Grapefruit juice

C. MAOIs

Which intervention should the nurse implement when caring for a patient on long-term oral glucocorticoids? A. Monitoring liver function tests B. Monitoring for cardiac dysrhythmias C. Monitoring for signs of GI bleeding D. Monitoring blood glucose levels

C. Monitoring for signs of GI bleeding

A nurse is caring for a client who is prescribed fluticasone (Afrin) for allergic rhinitis. Which assessment finding should the nurse report immediately to the healthcare provider? A. Headache B. Hypertension C. Sore throat D. Hyperglycemia

C. Sore throat

An elderly male patient with benign prostatic hypertrophy is prescribed ipratropium (Atrovent) for the treatment of asthma. Which nursing intervention is most appropriate? A. Teaching the patient to avoid caffeine in the diet B. Assessing the patient for enlarged liver C. Teaching the patient to report inability to urinate D. Monitoring for development of diarrhea

C. Teaching the patient to report inability to urinate

A client has been prescribed oral tetracycline for treatment of severe acne. Which assessment finding is most important for the nurse to communicate with the healthcare provider? A. The client's nutritional status B. The pathogen causing the acne C. The client's pregnancy status D. The presence of open lesions

C. The client's pregnancy status

A patient who received a prescription for montelukast (Singulair) returns to his provider's office after three 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? A. The patient is not taking the drug correctly B. The patient is not responding to the drug and will need to be switched to another formulation C. The drug has not had sufficient time of use to have full effects D. The albuterol is interacting with the montelukast

C. The drug has not had sufficient time of use to have full effects

A nurse is caring for a client receiving the antitussive dextromethorphan (Robitussin A-C). What should the nurse emphasize during medication teaching with the client? A. The medication is irritating to the bronchial tree. B. The cost of the medication can be expensive. C. The medication can cause motor dysfunction. D. The client may use the medication for 14 days.

C. The medication can cause motor dysfunction.

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? A. Use the albuterol inhaler, then use the beclomethasone only if symptoms are not relieved B. Use the beclomethasone inhaler, and use the albuterol only if symptoms are not relieved C. Use the albuterol inhaler, wait 5-10 minutes, then use the beclomethasone inhaler D. Use the beclomethasone inhaler, wait 5-10 minutes, then use the albuterol inhaler

C. Use the albuterol inhaler, wait 5-10 minutes, then use the beclomethasone inhaler

A client has been prescribed ciprofloxacin (Cipro) 500 mg twice daily by mouth. Which information should the nurse include during client teaching about administration of this medication? A. The dose must be taken on an empty stomach to increase absorption. B. The client can have an unlimited amount of caffeinated drinks. C. The drug can be taken with an antacid to decrease GI symptoms. D. The dose should not be taken with supplements containing iron.

D. The dose should not be taken with supplements containing iron.

Which information should the nurse include during patient teaching on long-term therapy with beta-adrenergic agonists for asthma treatment? A. Discontinuing the drug if heart rate increases B. Monitoring daily intake and output C. Reducing dosage of the drug if insomnia occurs D. Notifying the healthcare provider if the drug no longer seems effective

D. Notifying the healthcare provider if the drug no longer seems effective

When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects? A. Fatigue and depression B. Anxiety and peripheral vasoconstriction C. Headache and rapid heart rate D. Oral candidiasis and dry mouth

D. Oral candidiasis and dry mouth

A nurse is caring for a client who is prescribed benzonatate (Tessalon) to suppress coughing from a cold infection. Which instruction should the nurse include during client teaching? A. Monitor blood pressure. B. Chew the gel tablet thoroughly. C. Check pulse before taking the drug. D. Stand up slowly and carefully.

D. Stand up slowly and carefully.

A client asks the nurse why the healthcare provider did not prescribe the usual antibiotic for the same infection. Which is the best response by the nurse? A. "It does not matter which antibiotic is taken." B. "If you are not better in 10 days, return to the office." C. "You do not want to take the same antibiotic all the time." D. "Bacteria can become resistant to some antibiotics."

D. "Bacteria can become resistant to some antibiotics."

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

D. Avoid drinking fluids immediately after the syrup but increase overall fluid intake throughout the day

A patient has been prescribed tetracycline. When providing information regarding this drug, the nurse should include what information about tetracycline? A. It is classified as a narrow-spectrum antibiotic with minimal adverse effects B. It is uses to treat a wide variety of disease processes C. It has been identified to be safe during pregnancy D. It is contraindicated in children younger than 8 years

D. It is contraindicated in children younger than 8 years

Superinfections are an adverse effect common to all antibiotic therapy. Which of the following best describes a superinfection? A. An initial infection so overwhelming that it requires multiple antimicrobial drugs to treat successfully B. Bacterial resistance that creates infections that are difficult to treat and are often resistant to multiple drugs C. Infections requiring high-dose antimicrobial therapy with increased chance of organ toxicity D. The overgrowth of normal body flora or opportunistic organisms such as viruses and yeast no longer held in check by normal, beneficial flora

D. The overgrowth of normal body flora or opportunistic organisms such as viruses and yeast no longer held in check by normal, beneficial flora

A patient has been using a fluticasone (Flovent) inhaler as a component of his asthma therapy. He returns to his health care 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 of these findings? A. The patient has been consuming hot beverages after the use of the inhaler B. The patient has limited his fluid intake, resulting in dry mouth C. The residue of the inhaler propellant is coating the inside of the mouth D. The patient has developed thrush as a result of the fluticasone

D. The patient has developed thrush as a result of the fluticasone

A nurse is caring for a client receiving gentamicin for treatment of a Pseudomonas infection. Which assessment finding should the nurse report to the healthcare provider immediately? A. Dysrhythmia B. Constipation C. Diuresis D. Tinnitus

D. Tinnitus