pharm exam 3
A patient will begin using sildenafil citrate (Viagra) to treat erectile dysfunction. The nurse will instruct the patient to take the medication a. daily in the morning. b. just prior to sexual activity. c. 30 minutes to 4 hours before sexual activity. d. twice daily.
30 minutes to 4 hours before sexual activity.
The nurse administers proparacaine HCl (Ophthaine) drops to a patient prior to an eye examination. What sign will the nurse look for to determine when the examination can begin? a. Absence of the blink reflex b. Blurred vision c. Drying of the corneal epithelium d. Photophobia
Absence of the blink reflex
The nurse is administering timolol (Timoptic) eye drops to a patient who has glaucoma. To prevent bradycardia, the nurse will perform which action? a. Apply pressure to the lacrimal ducts. b. Have the patient sit up after instilling the drops. c. Prepare to administer an alpha-adrenergic agonist. d. Wait 5 minutes between drops.
Apply pressure to the lacrimal ducts.
A patient who has recently had a myocardial infarction (MI) will begin taking clopidogrel (Plavix) to prevent a second MI. Which medication will the nurse expect the provider to order as adjunctive therapy for this patient? a. Aspirin b. Enoxaparin sodium (Lovenox) c. Ticagrelor (Brilinta) d. Warfarin (Coumadin)
Aspirin
The nurse is caring for a patient who has increased intraocular pressure. The provider has ordered a cholinergic agonist. The nurse will perform a thorough health history to make sure the patient does not have a history of which condition? a. Asthma b. Diabetes c. Hypertension d. Renal disease
Asthma
The nurse is teaching a group of parents about the use of syrup of ipecac. Which instruction will the nurse provide? a. Do not administer ipecac without consulting a poison control center. b. Expect the onset of emesis to be immediate. c. Give ipecac with a glass of milk to increase its emetic effect. d. Use ipecac fluid extract and not ipecac syrup.
Do not administer ipecac without consulting a poison control center.
The nurse is caring for a patient who is receiving warfarin (Coumadin) and notes bruising and petechiae on the patients extremities. The nurse will request an order for which laboratory test? a. International normalized ratio (INR) b. Platelet level c. Partial thromboplastin time (PTT) and activated partial thromboplastin time (aPTT) d. Vitamin K level
International normalized ratio (INR)
A patient who will begin antiretroviral therapy reports having trouble sticking with drug regimens in the past. Which action will the nurse take? a. Ask the patients family members to administer the medications. b. Avoid discussing adverse effects to prevent focus on negative aspects of ART. c. Give a detailed list of medications and stress the need to adhere to the schedule. d. Offer written and verbal information about each drugs purpose.
Offer written and verbal information about each drugs purpose.
A woman comes to the clinic for a Depo-Provera injection. The nurse reviews her medical record and notes that it has been 100 days since her last injection. What action will the nurse perform? a. Administer Depo-Provera 150 mg IM. b. Give Depo-Provera 300 mg IM. c. Perform a pregnancy test. d. Suggest she wait until she has had a period.
Perform a pregnancy test.
Which antacid is likely to cause acid rebound? a. Aluminum hydroxide b. Calcium carbonate c. Magnesium hydroxide d. Magnesium trisilicate
Calcium carbonate
The oral antiandrogen drug flutamide (Eulexin) is used to treat which condition? a. Benign prostatic hypertrophy (BPH) b. Breast cancer c. Male-pattern baldness d. Metastatic prostate cancer
Metastatic prostate cancer
A patient who is newly diagnosed with HIV infection after a recent exposure calls to report fever, sore throat, myalgia, and night sweats. The nurse will notify the provider that this patient is most likely experiencing a. acute retroviral syndrome. b. AIDS. c. an increased viral load. d. an opportunistic infection.
acute retroviral syndrome.
The child who is a candidate for treatment with syrup of ipecac after ingestion of a toxic substance or overdose is the child who has ingested which substance? a. Acetaminophen elixir b. Chlorine bleach c. Kerosene d. Toilet cleanser
Acetaminophen elixir
The nurse is preparing to administer olopatadine (Patanol) eyedrops to a patient who has allergic conjunctivitis. The patient tells the nurse that the drops have caused burning and stinging. What action will the nurse take? a. Administer the drops and reassure the patient that this is a normal side effect. b. Offer an over-the-counter eye lubricant to minimize this adverse effect. c. Request an order for antibiotic eyedrops. d. Withhold the medication and notify the provider.
Administer the drops and reassure the patient that this is a normal side effect.
The nurse is performing a medication history on a patient who has glaucoma. The patient cannot remember the name of the drug prescribed but tells the nurse that the drug causes light sensitivity. The nurse knows that the drug is among which class of medications? a. Alpha-adrenergic agonists b. Beta-adrenergic blockers c. Cholinergic agonists d. Cholinesterase inhibitors
Alpha-adrenergic agonists
A woman is taking a combination oral contraceptive and asks the nurse why progestin is necessary. The nurse will explain that progestin helps prevent pregnancy by which method? a. Altering the quantity and viscosity of cervical mucus b. Inhibiting proliferative and secretory changes in the endometrium c. Increasing motility of muscles and cilia in the fallopian tubes d. Stimulating a surge in luteinizing hormone
Altering the quantity and viscosity of cervical mucus
A patient is receiving a thrombolytic medication. The patient calls the nurse to report having bloody diarrhea. The nurse will anticipate administering which medication? a. Aminocaproic acid (Amicar) b. Enoxaparin sodium (Lovenox) c. Protamine sulfate d. Vitamin K
Aminocaproic acid (Amicar)
The nurse is caring for a patient who is receiving clopidogrel (Plavix). The patient calls the nurse to report flulike symptoms. The nurse notes a heart rate of 76 beats per minute, a blood pressure of 110/76 mm Hg, and a respiratory rate of 20 breaths per minute. The nurse suspects that the patient is experiencing which condition? a. Anaphylaxis b. An expected drug side effect c. Hemorrhage d. Possible myocardial infarction
An expected drug side effect
A 14-year-old male is being evaluated for delayed puberty. Which finding indicates delayed puberty in this child? a. Androgen deficiency b. Growth hormone deficiency c. Height of 2.5 standard deviations below the mean d. Lack of epiphyseal closure
Androgen deficiency
A male patient wants to begin taking tadalifil (Cialis) to treat erectile dysfunction. Which aspect of this patients history would be of concern? a. Angina pectoris b. Asthma c. Benign prostatic hypertrophy d. Color blindness
Angina pectoris
A patient arrives in the emergency department after developing a rash, runny nose, and sneezing after eating strawberries. What action will the nurse expect to take first? a. Administer diphenhydramine. b. Administer epinephrine. c. Assess for urinary retention. d. Assess heart rate, respiratory rate, and lung sounds.
Assess heart rate, respiratory rate, and lung sounds.
The nurse is caring for a postoperative patient who is receiving alteplase tPA (Activase) after developing a blood clot. The nurse notes a heart rate of 110 beats per minute and a blood pressure of 90/60 mm Hg. The nurse will perform which action? a. Ask the patient about itching or shortness of breath. b. Assess the surgical dressing for bleeding. c. Evaluate the patients urine output and fluid intake. d. Recheck the patients vital signs in 15 minutes.
Assess the surgical dressing for bleeding.
The nurse is assessing a patient prior to administering thrombolytic therapy. Which is an important assessment for this patient? a. Determining whether the patient has a history of diabetes b. Finding out about a history of renal disease c. Assessing which medications are taken for discomfort d. Assessing whether the patient eats green, leafy vegetables
Assessing which medications are taken for discomfort
A patient who experiences motion sickness when flying asks the nurse the best time to take the medication prescribed to prevent motion sickness for a 0900 flight. The nurse will instruct the patient to take the medication at which time? a. As needed, at the first sign of nausea b. At 0700, before leaving for the airport c. At 0830, just prior to boarding the plane d. When seated, just prior to takeoff
At 0830, just prior to boarding the plane
A patient who recently began having mild symptoms of GERD is reluctant to take medication. What measures will the nurse recommend to minimize this patients symptoms? (Select all that apply.) a. Avoiding hot, spicy foods b. Avoiding tobacco products c. Drinking a glass of red wine with dinner d. Eating a snack before bedtime e. Taking ibuprofen with food f. Using a small pillow for sleeping g. Wearing well-fitted clothing
Avoiding hot, spicy foods Avoiding tobacco products Taking ibuprofen with food
A patient who has narrow-angle glaucoma asks the nurse to recommend a medication to alleviate cold symptoms such as nasal congestion and runny nose. The nurse will suggest the patient talk to the provider about which medication? a. Azelastine (Astelin) b. Cetirizine (Zyrtec) c. Chlorpheniramine maleate (Chlor-Trimeton) d. Diphenhydramine (Benadryl)
Azelastine (Astelin)
A patient who is receiving chemotherapy will be given dronabinol (Marinol) to prevent nausea and vomiting. The nurse will tell the patient that this drug will be given at which time? a. Before and after the chemotherapy b. During chemotherapy c. Immediately prior to chemotherapy d. 24 hours prior to chemotherapy
Before and after the chemotherapy
The nurse is preparing to administer dipivefrin (Propine) drops as a mydriatic agent. Which assessment would cause the nurse to withhold the drug and notify the provider? a. Blood pressure of 140/90 mm Hg b. Heart rate of 60 beats per minute c. Respiratory rate of 12 breaths per minute d. Temperature of 37.9 C
Blood pressure of 140/90 mm Hg
The nurse is caring for a patient who has Zollinger-Ellison syndrome. Which medication order would the nurse question for this patient? a. Cimetadine (Tagamet) b. Pantoprazole (Protonix) c. Rabeprazole (Aciphex) d. Ranitidine (Zantac)
Cimetadine (Tagamet)
A patient will begin taking the protease inhibitor combination Kaletra (lopinavir/ritonavir). What information will the nurse include when teaching the patient about dietary changes? a. Consume a low-cholesterol diet. b. Consume more acidic foods. c. Take the pill on an empty stomach. d. Take the pill with fatty foods.
Consume a low-cholesterol diet.
A woman will begin taking a combination oral contraceptive (COC) that has a higher estrogenic activity than her previous COC. When teaching this woman about the new product, the nurse will explain that she may experience which effect(s)? a. Cyclic breast changes and chloasma b. Decreased dysmenorrhea and menorrhagia c. Decreased libido d. Weight gain and fatigue
Cyclic breast changes and chloasma
The nurse is instructing a patient who will take psyllium (Metamucil) to treat constipation. What information will the nurse include when teaching this patient? a. The importance of consuming adequate amounts of water b. The need to monitor for systemic side effects c. The onset of action of 30 to 60 minutes after administration d. The need to use the dry form of Metamucil to prevent cramping
The importance of consuming adequate amounts of water
The nurse is teaching a patient who is about to take a long car trip about using dimenhydrinate (Dramamine) to prevent motion sickness. What information is important to include when teaching this patient? a. Do not drive while taking this medication. b. Dry mouth is a sign of toxicity with this mediation c. Take the medication 1 to 2 hours prior to beginning the trip. d. Take 100 mg up to 6 times daily for best effect.
Do not drive while taking this medication.
A patient asks the nurse the best way to prevent travelers diarrhea. The nurse will provide which recommendation to the patient? a. Ask your provider for prophylactic antibiotics. b. Drink bottled water and eat only well-cooked meats. c. Eat fresh, raw fruits and vegetables. d. Take loperamide (Imodium) every day.
Drink bottled water and eat only well-cooked meats.
The nurse is caring for a patient who is receiving diphenhydramine. The nurse notes that the patient has not voided for 12 hours. What action will the nurse take? a. Encourage the patient to drink more fluids. b. Evaluate the bladder to check for distension. c. Request an order for an intravenous fluid bolus. d. Request an order for urinary catheterization.
Evaluate the bladder to check for distension.
The parent of a child who is receiving chemotherapy asks the nurse why metoclopramide (Reglan) is not being used to suppress vomiting. The nurse will explain that, in children, this drug is more likely to cause which effect? a. Excess sedation b. Extrapyramidal symptoms c. Paralytic ileus d. Vertigo
Extrapyramidal symptoms
A patient is taking clopidogrel bisulfate (Plavix). When teaching this patient about dietary restrictions while taking this medication, the nurse will instruct the patient to avoid excessive consumption of which food? a. Garlic b. Grapefruit c. Green, leafy vegetables d. Red meats
Garlic
The parent of an 18-month-old toddler calls the clinic to report that the child has vomited 5 times that day. The nurse determines that the child has had three wet diapers in the past 6 hours. What will the nurse recommend for this child? a. Administering an OTC antiemetic medication such as diphenhydramine b. Giving frequent, small amounts of Pedialyte c. Keeping the child NPO until vomiting subsides d. Taking the child to the emergency department for IV fluids
Giving frequent, small amounts of Pedialyte
The nurse is caring for a patient who has postoperative nausea and vomiting. The surgeon has ordered promethazine HCl (Phenergan). Which aspect of this patients health history would be of concern? a. Asthma b. Diabetes c. GERD d. Glaucoma
Glaucoma
A patient has an infection of the eyelash follicles and in the gland on the eyelid margin. The nurse recognizes these symptoms as being consistent with which condition? a. Blepharitis b. Chalazion c. Endophthalmitis d. Hordoleum
Hordoleum
The nurse provides teaching to a man who will begin using an Androderm testosterone patch. Which statement by the patient indicates understanding of the teaching? a. I may stop using Androderm when my serum testosterone is normal. b. I should apply this to any skin other than the scrotum or bony areas. c. I will apply two skin patches every morning after a shower. d. My serum testosterone will continue to rise with each day of use.
I should apply this to any skin other than the scrotum or bony areas.
The nurse is providing teaching for a patient who will begin using tobramycin ointment (Nebcin) 0.5 inches 3 times daily. The patient currently uses pilocarpine HCl (Isopto Carpine) drops to treat glaucoma. Which statement by the patient indicates a need for further teaching? a. I should apply the third dose of tobramycin at bedtime each day. b. I should instill the drops in the conjunctival sac of the lower eyelid. c. I should not stop the medications without consulting my provider. d. I should put the ointment on first and then instill the eyedrops.
I should put the ointment on first and then instill the eyedrops.
The nurse is teaching an adult male patient about the use of testosterone gel. Which statement by the patient indicates understanding of the teaching? a. A decreased urinary stream is an expected side effect. b. I should apply the gel to my forearms every day. c. I will have hand and wrist x-rays every 6 months. d. I will need regular evaluation of serum lipid levels.
I will need regular evaluation of serum lipid levels.
The nurse is teaching a patient who will begin taking warfarin (Coumadin) for atrial fibrillation. Which statement by the patient indicates understanding of the teaching? a. I should eat plenty of green, leafy vegetables while taking this drug. b. I should take a nonsteroidal anti-inflammatory drug (NSAID) instead of acetaminophen for pain or fever. c. I will take cimetidine (Tagamet) to prevent gastric irritation and bleeding. d. I will tell my dentist that I am taking this medication.
I will tell my dentist that I am taking this medication.
The nurse is instructing a patient about the buccal muco-adhesive testosterone system (Striant) to treat low testosterone. What information will the nurse include when teaching this patient about this drug? a. If the product slides out of position more than 4 hours before the next dose, replace it with a new system. b. Place the flattened surface against the gum and hold it firmly in place for 30 seconds. c. The product may be swallowed after it has been in place for at least 4 hours. d. To remove the product, slide it upwards away from the tooth until it releases.
If the product slides out of position more than 4 hours before the next dose, replace it with a new system.
A patient will begin taking finasteride (Propecia) to treat benign prostatic hypertrophy (BPH) and asks the nurse how long the medication will be necessary. The nurse will tell the patient that he will need to take this medication for how long? a. 6 months b. 12 months c. Indefinitely d. Until symptoms resolve
Indefinitely
The nurse is caring for a patient who has unexplained, recurrent vomiting and who is unable to keep anything down. Until the cause of the vomiting is determined, the nurse will anticipate administering which medications? a. Antibiotics and antiemetics b. Intravenous fluids and electrolytes c. Non-prescription antiemetics d. Prescription antiemetics
Intravenous fluids and electrolytes
The parent of a toddler asks the nurse what can be done to prevent otitis media. What will the nurse recommend? a. Administer diphenhydramine when the child has a runny nose. b. Give phenylephrine (Neo-Synephrine Ophthalmic) to prevent congestion. c. Keep the childs immunizations up to date. d. Remove cerumen with carbamide peroxide (Auro Ear Drops).
Keep the childs immunizations up to date.
A pregnant patient is HIV-positive. Which antiretroviral agent will the nurse expect the patients provider to order? a. Abacavir/lamivudine/zidovudine (Trizivir) b. Efavirenz/emtricitabine/tenofovir (Atripla) c. Lamivudine/zidovudine (Combivir) d. Rilpivirine/emtricitabine/tenofovir (Complera)
Lamivudine/zidovudine (Combivir)
A patient who has been taking ranitidine (Zantac) continues to have pain associated with peptic ulcer. A noninvasive breath test is negative. Which treatment does the nurse expect the provider to order for this patient? a. Adding an over-the-counter antacid to the patients drug regimen b. A dual drug therapy regimen c. Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec) d. Lansoprazole (Prevacid) instead of ranitidine
Lansoprazole (Prevacid) instead of ranitidine
A patient asks the nurse about using loperamide (Imodium) to treat infectious diarrhea. Which response will the nurse give? a. Loperamide results in many central nervous system (CNS) side effects. b. Loperamide has no effect on infectious diarrhea. c. Loperamide is taken once daily. d. Loperamide may prolong the symptoms.
Loperamide may prolong the symptoms.
The nurse is caring for a postoperative patient. The nurse will anticipate administering which medication to this patient to help prevent thrombus formation caused by slow venous blood flow? a. Alteplase (Activase) b. Aspirin c. Clopidogrel (Plavix) d. Lowmolecular-weight heparin
Lowmolecular-weight heparin
A patient reports experiencing flatulence and abdominal distension to the nurse. Which over-the-counter medication will the nurse recommend? a. Alka-Seltzer b. Maalox c. Mylicon d. Tums
Mylicon
The nurse is caring for a woman who will begin taking ibuprofen to treat arthritis. The woman tells the nurse that she takes Yasmin for contraception. The nurse will perform which action? a. Counsel the patient to use a backup method of contraception while taking ibuprofen. b. Notify the provider to discuss an alternate combination oral contraceptive. c. Suggest a COX-2 inhibitor instead of ibuprofen for arthritis pain. d. Tell the patient to use a lower dose of ibuprofen to prevent adverse effects.
Notify the provider to discuss an alternate combination oral contraceptive.
A patient who is HIV-positive begins therapy with the fixed-dose combination nucleoside reverse transcriptase inhibitor (NRTI) Combivir (lamivudine/zidovudine) twice daily. The patient is in the clinic for follow-up 1 week after initiation of therapy and reports having nausea. The patients creatinine clearance is 40 mL/minute. Based on these findings, the nurse will perform which action? a. Instruct the patient to take the medication 60 minutes prior to meals. b. Notify the provider to discuss single-dose NRTI products. c. Request an order for once-daily dosing of this medication. d. Suggest that the patient increase fluid intake.
Notify the provider to discuss single-dose NRTI products.
A patient has been receiving intravenous heparin. When laboratory tests are drawn, the nurse has difficulty stopping bleeding at the puncture site. The patient has bloody stools and is reporting abdominal pain.The nurse notes elevated partial thromboplastin time (PTT) and activated partial thromboplastin time (aPTT). Which action will the nurse perform? a. Ask for an order for oral warfarin (Coumadin). b. Obtain an order for protamine sulfate. c. Request an order for vitamin K. d. Suggest that the patient receive subcutaneous heparin.
Obtain an order for protamine sulfate.
A patient who is diagnosed with peptic ulcer disease has been started on a regimen that includes ranitidine (Zantac) 300 mg daily at bedtime. The patient calls the clinic 1 week later to report no relief from discomfort. What action will the nurse take? a. Contact the provider to discuss changing to cimetidine (Tagamet). b. Notify the provider to discuss increasing the dose. c. Reassure the patient that the drug may take 1 to 2 weeks to be effective. d. Suggest that the patient split the medication into twice daily dosing.
Reassure the patient that the drug may take 1 to 2 weeks to be effective.
A male patient who has been taking a histamine2 blocker for several months reports decreased libido and breast swelling. What will the nurse do? a. Contact the provider to report possible drug toxicity. b. Reassure the patient that these symptoms will stop when the drug is discontinued. c. Request an order for serum hormone levels. d. Suggest that the patient see an endocrinologist.
Reassure the patient that these symptoms will stop when the drug is discontinued.
A patient reports having three to four stools, which are sometimes hard, per week. The nurse will perform which action? a. Recommend increased fluids and dietary fiber. b. Request an order for a laxative as needed. c. Request an order for a stool softener. d. Suggest discussing chronic constipation with the provider.
Recommend increased fluids and dietary fiber.
An elderly patient reports using Maalox frequently to treat acid reflux. The nurse should notify the patients provider to request an order for which laboratory tests? a. Liver enzymes and serum calcium b. Liver enzymes and serum magnesium c. Renal function tests and serum calcium d. Renal function tests and serum magnesium
Renal function tests and serum magnesium
The nurse is caring for an older adult who is receiving diphenoxylate with atropine (Lomotil) to treat severe diarrhea. The nurse will monitor this patient closely for which effect? a. Bradycardia b. Fluid retention c. Nervousness and tremors d. Respiratory depression
Respiratory depression
The nurse is teaching the parents of a boy who has inadequate pituitary function and delayed puberty about testosterone enanthate injections. Which statement by the parents indicates a need for further teaching? a. He will need x-rays of his hands every 6 months. b. Injections will be given deep into his gluteal muscles. c. Sexual development will occur in 1 to 2 years. d. We should report urinary tract problems immediately.
Sexual development will occur in 1 to 2 years.
A patient who is taking clopidogrel (Plavix) and aspirin is preparing for orthopedic surgery. The nurse will consult with the surgeon and provide which instruction to the patient? a. Continue taking aspirin and stop taking clopidogrel 2 weeks prior to surgery. b. Continue taking clopidogrel and stop taking aspirin 5 days prior to surgery. c. Continue both medications to prevent thromboembolic events during surgery. d. Stop taking both medications 7 days prior to surgery.
Stop taking both medications 7 days prior to surgery.
A patient who has been instructed to use a liquid antacid medication to treat gastrointestinal upset asks the nurse about how to take this medication. What information will the nurse include when teaching this patient? a. Take a laxative if constipation occurs. b. Take 60 minutes after meals and at bedtime. c. Take with at least 8 ounces of water to improve absorption. d. Take with milk to improve effectiveness.
Take 60 minutes after meals and at bedtime.
A patient who takes propantheline bromine (Pro-Banthine) and omeprazole (Prilosec) for an ulcer will begin taking an antacid. The nurse will give which instruction to the patient regarding how to take the antacid? a. Take the antacid 2 hours after taking the propantheline. b. Take the antacid along with a meal. c. Take the antacid with milk. d. Take the antacid with the propantheline bromine.
Take the antacid 2 hours after taking the propantheline.
A 50-year-old male patient reports having decreased libido and testicular atrophy. The nurse will anticipate that the provider may order which medication to treat these symptoms? a. Testosterone (Androderm) b. Finasteride (Proscar) c. Gonadotropin-releasing hormone (Gn-RH) d. Sildenafil (Viagra)
Testosterone (Androderm)
A patient experiences a blood clot in one leg, and the provider has ordered a thrombolytic medication. The patient learns that the medication is expensive and asks the nurse if it is necessary. Which response by the nurse is correct? a. The drug will decrease the likelihood of permanent tissue damage. b. This medication also acts to prevent future blood clots from forming. c. You could take aspirin instead of this drug to achieve the same effect. d. Your body will break down the clot, so the drug is not necessary.
The drug will decrease the likelihood of permanent tissue damage.
A patient with HIV infection has been receiving antiretroviral therapy for 2 months. At the initiation of treatment, the patient had a viral load (VL) of 60 copies/mL and a CD4 count of 450 cells/mm3. Todays lab results reveal a VL of 20 copies/mL and a CD4 cell count of 800 cells/mm3. How will the nurse interpret the patients results? a. A drug-resistant strain is likely. b. The patient is progressing as expected. c. The patients treatment goals have been met. d. Treatment failure has occurred.
The patient is progressing as expected.
A nursing student asks why the anticoagulant heparin is given to patients who have disseminated intravascular coagulation (DIC) and are at risk for excessive bleeding. The nurse will explain that heparin is used in this case for which reason? a. To decrease the risk of venous thrombosis b. To dissolve blood clots as they form c. To enhance the formation of fibrous clots d. To preserve platelet function
To decrease the risk of venous thrombosis
The nurse is caring for an African-American patient who has been diagnosed with glaucoma. The nurse anticipates that which medication will be most effective for this client? a. Bimatoprost (Lumigan) b. Latanoprost (Xalatan) c. Travoprost (Travatan Z) d. Unoprostone (Rescula)
Travoprost (Travatan Z)
A patient who has recently begun antiretroviral therapy with a combination drug develops immune reconstitution inflammatory syndrome (IRIS) with mild symptoms. What does the nurse expect that the provider will order? a. Administration of a high dose of corticosteroids b. Changing the regimen to a single antiretroviral drug c. Temporarily discontinuing the antiretroviral therapy d. Treating an underlying opportunistic infection
Treating an underlying opportunistic infection
A woman who is 2 months pregnant reports having morning sickness every day and asks if she can take any medications to treat this problem. The nurse will recommend that the patient take which action first? a. Contact the provider to discuss a possible need for intravenous fluids. b. Contact the provider to discuss a prescription antiemetic. c. Use nonpharmacologic measures such as saltines. d. Take over-the-counter antiemetics such as diphenhydramine.
Use nonpharmacologic measures such as saltines.
A patient who has seasonal allergies with a runny nose during the daytime reports increasing nighttime symptoms of coughing and sneezing that are interfering with sleep. The provider recommends diphenhydramine (Benadryl) at bedtime. What information will the nurse include when teaching the patientabout this medication? a. Avoid fluids at bedtime to prevent urinary retention. b. This will help clear your daytime symptoms, too. c. You should be able to sleep better when you take this medication. d. You should take this medication on an empty stomach.
You should be able to sleep better when you take this medication.
The nurse is caring for a patient who is HIV-positive and has been receiving antiretroviral therapy for several months. The nurse experiences a needlestick injury resulting in exposure to the patients blood. The nurse asks the Occupational Health nurse if treatment is necessary. How will the Occupational Health nurse respond? a. No treatment is necessary since the patient is receiving antiretroviral therapy. b. We will treat you if the patients VL is > 20 copies/mL. c. You will require 4 weeks of antiretroviral therapy. d. You will undergo HIV testing and will be treated if you are positive.
You will require 4 weeks of antiretroviral therapy.
The nurse is preparing to administer a first dose of clopidogrel (Plavix) to a patient. As part of the history, the nurse learns that the patient has a previous history of peptic ulcers, diabetes, and hypertension. The nurse understands it will be necessary to notify the provider and obtain an order for a. a proton pump inhibitor (PPI) medication. b. frequent serum glucose monitoring. c. increased antihypertensive medications. d. nonsteroidal antiinflammatory medications.
a proton pump inhibitor (PPI) medication.
A child is brought to the emergency department after ingestion of a toxic substance. The child is alert and conscious and is reported to have ingested kerosene 20 minutes prior. The nurse will anticipate administering a. activated charcoal. b. an anticholinergic antiemetic. c. gastric lavage d. syrup of ipecac.
activated charcoal.
A patient who is HIV-infected takes 800 mg of indinavir (Crixivan), a protease inhibitor medication. The provider has ordered adding ritonavir (Norvir) to the regimen. The nurse will teach the patient that the addition of ritonavir a. allows decreasing the dosing from 3 times daily to twice daily. b. can lead to increased cholesterol and triglycerides. c. may worsen insulin resistance. d. will require increased dietary restrictions.
allows decreasing the dosing from 3 times daily to twice daily.
A patient with a peptic ulcer has been diagnosed with H. pylori. The provider has ordered lansoprazole (Prevacid), clarithromycin (Biaxin), and metronidazole (Flagyl). The patient asks the nurse why two antibiotics are needed. The nurse will explain that two antibiotics a. allow for less toxic dosing. b. combat bacterial resistance. c. have synergistic effects. d. improve acid suppression.
combat bacterial resistance.
A patient is taking esomeprazole (Nexium) 15 mg per day to treat a duodenal ulcer. After 10 days of treatment, the patient reports that the pain has subsided. The nurse will counsel the patient to a. continue the medication for 4 more weeks. b. reduce the medication dose by half. c. stop taking the medication. d. take the medication every other day.
continue the medication for 4 more weeks.
A 45-year-old woman reports cessation of menses for the past 6 months and asks the nurse if she needs to continue using contraception. The nurse will tell her a. that she may discontinue using contraception. b. that she most likely has premature ovarian failure. c. to begin hormone therapy to prevent menopausal symptoms. d. to continue using contraception for at least 6 more months.
to continue using contraception for at least 6 more months.
A woman who is using a NuvaRing transvaginal contraceptive product calls to report that the ring has slipped out while sleeping. The nurse will instruct the patient to rinse the ring with lukewarm water, reinsert the ring, and a. abstain from sexual intercourse for 24 hours. b. replace it with a new ring as soon as possible. c. take an oral contraceptive product for 2 weeks. d. use a backup method of contraception for 7 days.
use a backup method of contraception for 7 days.
The nurse is counseling an adolescent patient who has recurrent otitis externa and who works as a lifeguard in the summer about preventing this condition. The nurse will teach this patient to a. avoid using ear plugs while swimming. b. request a prescription for prophylactic antibiotic eardrops. c. use a hair dryer to dry the ears after swimming. d. wear a medical alert bracelet.
use a hair dryer to dry the ears after swimming.
An appropriate goal when teaching a patient who has diarrhea is that the patient a. will have less frequent, more formed stools. b. will not have a stool for 1 to 2 days. c. will receive adequate intravenous fluids. d. will receive appropriate antibiotic therapy.
will have less frequent, more formed stools.
he nurse is caring for a 55-year-old patient who has been HIV-infected for 15 years. The nurse understands that this patient a. has an increased risk of transmitting the HIV infection. b. is less likely to develop AIDS than younger persons with HIV infection. c. is less likely to respond to antiretroviral agents. d. may have comorbid illnesses that can complicate HIV.
may have comorbid illnesses that can complicate HIV.
The nurse is caring for a patient who will begin taking omeprazole (Prevacid) 20 mg per day for 4 to 8 weeks to treat gastroesophageal reflux disease esophagitis. The nurse learns that the patient takes digoxin. The nurse will contact the provider for orders to a. decrease the dose of omeprazole. b. increase the dose of digoxin. c. increase the omeprazole to 60 mg per day. d. monitor for digoxin toxicity.
monitor for digoxin toxicity.
A patient who is taking warfarin has an international normalized ratio (INR) of 5.5. The nurse will anticipate giving a. fresh frozen plasma. b. intravenous iron. c. oral vitamin K. d. protamine sulfate.
oral vitamin K.
A patient who has HIV infection will begin treatment with efavirenz. The nurse expects this agent to be given in the combination product Atripla in order to a. avoid development of psychiatric comorbidities. b. prevent dizziness, sedation, and nightmares. c. reduce viral resistance. d. prevent severe rash and hepatotoxicity.
reduce viral resistance.
The nurse has just begun administering intravenous streptokinase (Streptase). The nurse assesses vital signs and notes a temperature of 37 C, a heart rate of 70 beats per minute, and a blood pressure of 88/58 mm Hg. The nurse will contact the provider to a. request an adjustment of the streptokinase dose. b. request an order for aminocaproic acid (Amicar). c. request epinephrine to prevent anaphylaxis. d. report potential hemorrhage in this patient.
request an adjustment of the streptokinase dose.
A 45-year-old woman who has not had a period for 15 months reports severe hot flashes and poor sleep. The nurse reviews information about hormone replacement therapy and tells this woman that hormone therapy a. is very safe and may be used freely to treat menopausal symptoms. b. may be used indefinitely to treat menopausal symptoms. c. should be used at the lowest dose possible for less than 5 years. d. will be necessary to prevent osteoporosis caused by estrogen depletion.
should be used at the lowest dose possible for less than 5 years.
A woman who is taking a combined oral contraceptive (COC) that contains 21 days of active pills and 7 days of inert pills reports having headaches accompanying withdrawal bleeding every month. The nurse will a. counsel her to take ibuprofen to counter these side effects. b. notify her provider to discuss these adverse effects. c. recommend a Loestrin Fe product. d. suggest she ask her provider about Mircette.
suggest she ask her provider about Mircette.
A patient who has symptoms of peptic ulcer disease will undergo a test that requires drinking a liquid containing 13C urea and breathing into a container. The nurse will explain to the patient that this test is performed to a. assess the level of hydrochloric acid. b. detect H. pylori antibodies. c. measure the pH of gastric secretions. d. test for the presence of 13CO2.
test for the presence of 13CO2.
A woman who has recently begun taking a combination oral contraceptive calls the clinic to report breakthrough bleeding. The nurse will a. advise her to use a backup method of contraception. b. counsel her to continue taking the contraceptive as prescribed. c. recommend discussing an alternative contraceptive with her provider. d. suggest that she perform a home pregnancy test to rule out pregnancy.
counsel her to continue taking the contraceptive as prescribed.
A patient who is taking diphenoxylate with atropine (Lomotil) to treat diarrhea asks the nurse why it contains atropine. The nurse will explain that atropine is added to a. decrease abdominal cramping. b. increase intestinal motility. c. minimize nausea and vomiting. d. provide analgesia.
decrease abdominal cramping.
A patient who has received heparin after previous surgeries will be given enoxaparin sodium (Lovenox) after knee-replacement surgery. The patient asks how this drug is different from heparin. The nurse will explain that enoxaparin a. decreases the need for laboratory tests. b. has a shorter half-life than heparin. c. increases the risk of hemorrhage. d. may be taken orally instead of subcutaneously.
decreases the need for laboratory tests.
A 35-year-old woman asks the nurse about oral contraceptives. The nurse learns that the patient smokes and has a family history of venous thromboembolism (VTE). The nurse will suggest that the patient a. discuss a progestin-only oral contraceptive with her provider. b. may want to consider having a tubal ligation. c. use a transdermal contraceptive product. d. will not be a candidate for oral contraceptive products.
discuss a progestin-only oral contraceptive with her provider.
The nurse is assessing a patient who takes warfarin (Coumadin). The nurse notes a heart rate of 92 beats per minute and a blood pressure of 88/78 mm Hg. To evaluate the reason for these vital signs, the nurse will assess the patients a. gums, nose, and skin. b. lung sounds and respiratory effort. c. skin turgor and oral mucous membranes. d. urine output and level of consciousness.
gums, nose, and skin.
The nurse is teaching a group of nursing students about the use of antipsychotic drugs for antiemetic purposes. The nurse will explain that, when given as antiemetics, these drugs are given a. in smaller doses. b. less frequently. c. with anticholinergics. d. with antihistamines.
in smaller doses.
A patient has been taking famotidine (Pepcid) 20 mg bid to treat an ulcer but continues to have pain. The provider has ordered lansoprazole (Prevacid) 15 mg per day. The patient asks why the new drug is necessary, since it is more expensive. The nurse will explain that lansoprazole a. can be used for long-term therapy. b. does not interact with other drugs. c. has fewer medication side effects. d. is more potent than famotidine.
is more potent than famotidine.
A man who has been using androgen therapy tells the nurse that he and his wife wish to conceive a pregnancy. The nurse will tell this patient that a. androgen therapy will not harm the fetus. b. he will need to increase his dose of testosterone to increase his sperm count. c. it may take 3 months after cessation of androgen therapy to conceive. d. there should be no problems conceiving while using androgen therapy.
it may take 3 months after cessation of androgen therapy to conceive.
A young woman who is taking Ortho-Tri-Cyclen for contraception tells the nurse that her provider has told her it will help to treat her acne. The nurse explains that this is because this product is a. high in progestin. b. low in androgenic activity. c. low in estrogen. d. triphasic.
low in androgenic activity.
