Pharmacology Exam #6

B Otic and oral antimicrobials

A 14-year-old patient is diagnosed with perforated tympanic membrane, OE, and otitis media. What does the nurse anticipate the provider will prescribe? A Otic antimicrobials only B Otic and oral antimicrobials C Oral antimicrobial only D Otic antimicrobial and otic antifungal

B. Long-term use may cause a life-threatening liver condition.

A 19-year-old college football player asked the nurse about taking steroids to help him "beef up" his muscles. Which statement is true? A. There should be no problem as long as he does not exceed the recommended dosage. B. Long-term use may cause a life-threatening liver condition. C. He would need to be careful to watch for excessive weight loss. D. These drugs also tend to increase the male's sperm count

D. She will need to use two forms of birth control while taking this medication.

A 22-year old woman is taking isotretinoin (Amnesteem) as part of the treatment for severe cystic acne. Which statement about isotretinoin therapy is true? A. The drug reduces acne by causing skin peeling. B. Its use is contraindicated if she is allergic to erythromycin. C. She will need to apply it twice a day to her face after washing her face thoroughly. D. She will need to use two forms of birth control while taking this medication.

b. Hepatic necrosis

A 38-year-old man has come into the urgent care center with severe hip pain after falling from a ladder at work. He says he has taken several pain pills over the past few hours but cannot remember how many he has taken. He hands the nurse an empty bottle of acetaminophen (Tylenol). The nurse is aware that the most serious toxic effect of acute acetaminophen overdose is which condition? a. Tachycardia b. Hepatic necrosis c. Central nervous system depression d. Nephropathy

b. The medication should be given 4 to 6 hours before bedtime to diminish insomnia.

A 6-year-old boy has been started on an extended-release form of methylphenidate hydrochloride (Ritalin) for the treatment of attention deficit hyperactivity disorder (ADHD). During a follow-up visit, his mother tells the nurse that she has been giving the medication at bedtime so that it will be "in his system" when he goes to school the next morning. What is the nurse's appropriate evaluation of the mother's actions? a. The medication should be taken with meals for optimal absorption. b. The medication should be given 4 to 6 hours before bedtime to diminish insomnia. c. She is giving him the medication dosage appropriately. d. The medication should not be taken until he is at school.

d. Significant decrease in blood pressure

A 73-year-old male patient is in the clinic for a yearly physical and is asking for a prescription for sildenafil (Viagra). He has listed on his health history that he is taking a nitrate for angina. The nurse is aware that which problem may occur if sildenafil is taken with a nitrate? a. Reduced effectiveness of the sildenafil b. Increased risk of bleeding c. Significant increase in pulse rate d. Significant decrease in blood pressure

B Congenital glaucoma

A child born with increased intraocular pressure is likely to be diagnosed with which type of glaucoma? A Angle-closure glaucoma B Congenital glaucoma C Pigmentary glaucoma D Open-angle glaucoma

C. Upper respiratory tract infection.

A child has a case of otitis media. The nurse knows that otitis media in children is usually preceded by: A. Participation on the swim team. B. Injury with a foreign object. C. Upper respiratory tract infection. D. Mastoiditis.

B History of thromboembolic events

A female patient arrives in the clinic for counseling on potential hormone replacement therapy. When taking the patient history, which finding would the nurse consider as a contraindication to use of hormone replacement therapy for the patient? A High cholesterol B History of thromboembolic events C Early menstrual onset D High number of pregnancies

b. "You will have to use two contraceptive methods while on this drug."

A female patient will be starting therapy with oral isotretinoin (Amnesteem) as part of treatment for severe acne, and the nurse is providing teaching. Which teaching point will the nurse include in her teaching plan about isotretinoin? a. "You will have to avoid pregnancy for 2 weeks after taking this drug." b. "You will have to use two contraceptive methods while on this drug." c. "You must avoid sexual activity while on this drug." d. "If you are taking an oral contraceptive, you may take this drug."

D. Provide an environment that is restful, ,and reduce loud noises.

A hospitalized patient is complaining of having difficulty sleeping. Which action will the nurse take first to address the problem? A. Administer a sedative-hypnotic drug if ordered B. Offer tea made with the herbal preparation valerian C. Encourage the pt to exercise by walking up and down the halls a few times if tolerated D. Provide an environment that is restful, ,and reduce loud noises.

D Tinea cruris

A male patient has been ordered clotrimazole (Lotrimin, Mycelex-G) after a diagnosis of jock itch. What is the technical name the nurse would use to document the diagnosis on the chart and the reason the patient has been prescribed this medication? A Tinea corporis B Tinea capitis C Tinea pedis D Tinea cruris

A. Finasteride (Propecia)

A male patient wants know if there are any drugs that can be used for baldness. The nurse noticed that which drug in low dosages, is used for androgenetic alopecia in men? A. Finasteride (Propecia) B. Vardenafil (Levitra) C. Danazol (Danocrine) D. Oxandrolone (Oxandrin)

B patient's level of sedation is inadequate.

A mechanically ventilated patient receiving a neuromuscular-blocking drug has tearing in the eyes and increased heart rate and blood pressure. The nurse interprets that the A patient is having an adverse reaction to the medication. B patient's level of sedation is inadequate. C patient's dose of the neuromuscular-blocking drug is insufficient. D patient's response to the drug is appropriate.

B Debrox

A mother of a young child asks what she can use to help keep her child's ears clean from wax. What over-the-counter medication will the nurse suggest? A Cortic B Debrox C Floxin D Ciprodex

C. erythromycin ointment

A newborn infant is about to receive medication that prevents gonorrheal eye infection. The nurse will prepare to administer which drug? A. dexamethasone (Maxidex) ointment B. gentamicin (Genoptic) solution C. erythromycin ointment D. sulfacetamide (Cetamide) solution

A, B, E

A nurse is providing education to a group of athletes on the topic of anabolic steroids. What side effects would the nurse include in the discussion with the group of athletes? (Select all that apply.) A Sterility B Liver cancer C Impotence D Stroke E Cardiovascular disease

B Schedule II

A nurse working with patients who are diagnosed with ADHD is aware such patients often take CNS stimulant drugs. These medications are potent with a high potential for abuse and dependence. Based on this potential, how are these medications classified? A Schedule I B Schedule II C Schedule III D Schedule IV

B Ataxia

A nurse would monitor older adults who are prescribed a benzodiazepine for treatment of insomnia for which potential side effect? A Hallucinations B Ataxia C Alertness D Dyspnea

B Cough suppressant

A patient admitted to the hospital with a diagnosis of pneumonia asks the nurse why she is receiving codeine when she does not have any pain. The nurse's response is based on knowledge that codeine also has what effect? A Stimulation of the immune system B Cough suppressant C Expectorant D Bronchodilation

A, B, D

A patient asks the nurse about a new drug advertised on television. The patient wants to know if Ambien would be better for her to use than her current medication, Restoril, for periodic insomnia. The nurse's response is based on knowledge that zolpidem (Ambien) (Select all that apply.) A is less likely to cause grogginess in the morning. B is a pregnancy category C medication. C is contraindicated with asthma. D should be limited to 7 to 10 days of treatment.

A, C

A patient asks the nurse why a second drug is given with his drugs for Parkinson's disease. The nurse notes that this drug, an anticholinergic, is given to control or minimize which symptoms? (Select all that apply) A. Drooling B. Constipation C. Muscle rigidity D. Bradykinesia E. Dry mouth

D. Fecal incontinence

A patient at a weight management clinic who was given a prescription for orlistat (Xenical) calls the clinic hotline complaining of a "terrible side effect." The nurse suspects that the patient is referring to which problem? A. Nausea B. Sexual dysfunction C. Urinary incontinence D. Fecal incontinence

A, E

A patient calls the clinic because she realized she missed one dose of an oral contraceptive. Which statement for the nurse is appropriate? (SATA) A. "Go ahead and take the missed dose now, along with today's dose." B. "Don't worry, you are still protected from pregnancy." C. "Please come to the clinic for a reevaluation of your therapy." D. "Wait 7 days, and then start a new pack of pills." E. "You will need to use a backup form of contraception concurrently for 7 days."

B St. John's wort

A patient currently prescribed duloxetine (Cymbalta) comes to the health clinic complaining of restlessness, agitation, diaphoresis, and tremors. The nurse suspects serotonin syndrome and questions the patient regarding concurrent use of which substance? A ibuprofen B St. John's wort C vitamin E supplements D glucosamine chondroitin

B buspirone (BuSpar)

A patient diagnosed with an anxiety disorder has been using lorazepam (Ativan) but finds the side effect of drowsiness to be interfering with life. Which anxiolytic medications might be a better option for this patient? A alprazolam (Xanax) B buspirone (BuSpar) C chlordiazepoxide (Librium) D hydroxyzine hydrochloride salt (Vistaril)

D There is a risk of toxicity when this medication is taken with alcohol.

A patient diagnosed with depression is started on a TCA after failure to improve symptoms on an SSRI. The nurse should include which teaching point when educating the patient about the new medication? A There are no contraindications to this medication. B The medication is safe; it has been used longer than many others. C This class of medications has no other use and is only for depression. D There is a risk of toxicity when this medication is taken with alcohol.

C "Nausea and vomiting occur much less frequently than in the past related to the use of a balanced approach to anesthesia."

A patient expresses fear of nausea and vomiting postoperatively from the anesthesia. Which is the nurse's best response? A "I understand your concern; that is one of the pitfalls of surgery." B "Don't worry, because you'll be heavily sedated if that occurs." C "Nausea and vomiting occur much less frequently than in the past related to the use of a balanced approach to anesthesia." D "You will need to speak to both the surgeon and the anesthesiologist in order to identify possible allergies to drugs that may be causing this side effect."

A, B, E

A patient has a new prescription for finasteride (Proscar). The nurse will instruct patient about which potential adverse effects? (SATA) A. Loss of erection B. Gynecomastia C. Headaches. D. Increased libido. E. Ejaculatory dysfunction.

B. Take the medication before the headache worsens.

A patient has a new prescription for sumatriptan (Imitrex). The nurse providing patient teaching on self-administration will include which information? A. Correct technique for IM injections B. Take the medication before the headache worsens. C. Allow at least 30 minutes between injections D. Take no more than 4 doses in a 24 hour period.

A. Aerosol spray

A patient has a painful sunburn that covers a large area of the body and has asked the nurse for "something to make it feel better." The nurse keeps in mind that which formulation of topical medication will be easiest to use to cover this large area? A. Aerosol spray B. Gel C. Oil D. Cream

A. Cardiac dysrhythmias

A patient has asked for a cup of coffee. The nurse keeps in mind that patients with a history of which condition need to avoid caffeine? A. Cardiac dysrhythmias B. Asthma C. Diabetes mellitus D. Gallbladder disease

C Acute hepatic necrosis

A patient has been admitted after overdosing on acetaminophen (Tylenol), with a total ingested dose of 14 g over a period of 1 hour. The nurse plans to monitor this patient for development of which of the following signs and symptoms related to the overdose? A Renal failure B Kidney stones C Acute hepatic necrosis D Metabolic alkalosis

B. Administration of flumazenil

A patient has been admitted to the ER because of an overdose of an oral benzodiazepine. He is very drowsy but still responsive. The nurse will prepare for which immediate intervention? A. Hemodialysis to remove the medication B. Administration of flumazenil C. Administration of naloxone D. Intubation & mechanical ventilation

B. diazepam (Valium)

A patient has been admitted to the emergency department with status epilepticus. The nurse knows that which of these drugs is considered the drug of choice for this condition? A. phenobarbital (Luminal) B. diazepam (Valium) C. valproic acid D. phenytoin (Dilantin)

c. Carbidopa prevents the breakdown of levodopa in the periphery.

A patient has been given a prescription for levodopa-carbidopa (Sinemet) for her newly diagnosed Parkinson's disease. She asks the nurse, "Why are there two drugs in this pill?" The nurse's best response reflects which fact? a. Carbidopa is the biologic precursor of dopamine and can penetrate into the CNS. b. There are concerns about drug-food interactions with levodopa therapy that do not exist with the combination therapy. c. Carbidopa prevents the breakdown of levodopa in the periphery. d. Carbidopa allows for larger doses of levodopa to be given.

D. Suicidal thoughts or behavior

A patient has been taking anti epileptic drugs for a year. The nurse is reviewing his recent history and will monitor for which condition that may develop during this time? A. Loss of appetite B. Jaundice C. Weight loss D. Suicidal thoughts or behavior

C. Tardive dyskinesia

A patient has been taking antipsychotic medication for years, and his wife has noticed that he has had some new physical symptoms. She describes him as having odd-facial movements, sticking out his tongue, and having movements of his arms that he cannot seem to control. The nurse suspects that the patient is exhibiting signs of which condition? A. Hypomania B. Serotonin Syndrome C. Tardive dyskinesia D. Neuroleptic malignant syndrome

B. PSA levels

A patient has been taking finasteride (Proscar) for almost a year. The nurse knows that which is most important to evaluate at this time? A. CBC B. PSA levels C. BP D. Fluid retention

a. This drug causes deprivation of REM sleep and may cause the inability to deal with normal stress.

A patient has been taking phenobarbital for 2 weeks as part of his therapy for epilepsy. He tells the nurse that he feels tense and that "the least little thing" bothers him now. Which is the correct explanation for this problem? a. This drug causes deprivation of REM sleep and may cause the inability to deal with normal stress. b. This drug causes the rapid eye movement (REM) sleep period to increase, resulting in nightmares and restlessness. c. The drug must be stopped immediately because of possible adverse effects. d. These are adverse effects that usually subside after a few weeks.

a. Hypertension

A patient has been taking selegiline (Eldepryl), 20 mg per day for 1 month. Today, during his office visit, he tells the nurse that he forgot and had a beer with dinner last evening, and "felt awful." What did the patient most likely experience? a. Hypertension b. Gastrointestinal upset c. Hypotension d. Urinary discomfort

a. Immunosuppression may make it more difficult to eliminate the eye infection.

A patient has been taking the corticosteroid dexamethasone (Decadron) but has developed bacterial conjunctivitis and has a prescription for gentamicin (Garamycin) ointment. The nurse notes that which interaction is possible if the two drugs are used together? a. Immunosuppression may make it more difficult to eliminate the eye infection. b. The infection may become systemic. c. The corticosteroid may cause overgrowth of nonsusceptible organisms. d. The gentamicin effects may become more potent.

D. A foreign object.

A patient has come to the emergency department with an eye injury. After fluorescein (AK-Fluor) is applied, the physician sees an area with a green halo. This indicates which condition? A. A corneal defect. B. A conjuctival lesion. C. The presence of a hard contact lens. D. A foreign object.

A, C, E

A patient has undergone an eye procedure during which ophthalmic mydriatics and anesthetic drops were used. The nurse gives which instructions to the patient prior to discharge? (Select all that apply) a. "Do not rub or touch the numb eye" b. "You may reinsert your contact lenses before you leave" c. "Be sure to wear sunglasses when you go outside" d. "Your pupils will appear very tiny until the medication wears off" e."Report any increase in eye pain or drainage to the ophthalmologist immediately"

C. "The medications you receive will reduce any pain and help you not to remember the procedure."

A patient is about to undergo cardioversion, and the nurse is reviewing the procedure and explaining moderate sedation. The patient asks, "I am afraid of feeling it when they shock me?" What is the nurse's best response? A. "You won't receive enough of a shock to feel anything." B. "You will feel the shock but you won't remember any of the pain." C. "The medications you receive will reduce any pain and help you not to remember the procedure." D. "They will give you enough pain medication to prevent you from feeling it."

B activated charcoal

A patient is admitted to the emergency department after taking an overdose of a barbiturate 15 minutes prior to arrival. The nurse can anticipate that which drug will be prescribed? A naloxone (Narcan) B activated charcoal C flumazenil (Romazicon) D ipecac syrup

D flumazenil (Romazicon)

A patient is admitted to the emergency department with a severe overdose of a benzodiazepine. The nurse immediately prepares to administer which antidote from the emergency drug cart? A naloxone (Narcan) B naltrexone (ReVia) C nalmefene (Revex) D flumazenil (Romazicon)

B methadone

A patient is admitted to the psychiatric unit for treatment of narcotic addiction. The nurse would anticipate administration of which medication? A morphine B methadone C meperidine D naloxone

C. nonsteroidal anti-inflammatory drugs

A patient is asking about the use of saw palmetto for prostate health. The nurse tells him that drugs that interact with saw palmetto include: A. acetaminophen (Tylenol) B. nitrates C. nonsteroidal anti-inflammatory drugs D. antihypertensive drugs

A, B, D

A patient is being seen for acne issues. The nurse is discussing use of various topical drugs. Which drugs are used in the treatment of acne? (Select all that apply.) A benzoyl peroxide B clindamycin C isotretinoin D vitamin A acid E norethindrone and ethinyl estradiol

B "I will not get as dizzy when I change positions after I switch medications."

A patient is being switched from amitriptyline (Elavil) to citalopram (Celexa). Which statement made by the patient reflects understanding of patient education? A "I can just stop taking my Elavil and start taking the Celexa as ordered." B "I will not get as dizzy when I change positions after I switch medications." C "The doctor is switching me to this medication because it is less expensive but just as effective." D "I will need to limit my intake of cheese when taking Celexa to prevent a rise in my blood pressure."

D carbamide peroxide

A patient is complaining of excessive earwax, leading to diminished hearing ability. The nurse will expect to teach the patient regarding administration of which medication to correct this problem? A hydrocortisone B pramoxine C acetic acid D carbamide peroxide

A. status epilepticus

A patient is experiencing a seizure that has lasted for several minutes and he has not regained consciousness. The nurse recognizes that this is a life threatening emergency known as: A. status epilepticus B. tonic-clonic convulsion C. epilepsy D. secondary epilepsy

B Bacterial infection

A patient is prescribed bacitracin topical ointment. What does the nurse suspect as the possible diagnosis based on the medication prescribed? A Fungal infection B Bacterial infection C Parasitic infection D Viral infection

A "This is a typical adverse effect and may lessen over time. If this continues, we need to schedule an appointment with your provider."

A patient is prescribed epinephrine eye drops for treatment of chronic open-angle glaucoma. The patient complains of burning with instillation of the drops. How would the nurse respond to the patient? A "This is a typical adverse effect and may lessen over time. If this continues, we need to schedule an appointment with your provider." B "That should not occur. Come to the office now." C "This only occurs if the drop is not placed in the correct area of the eye." D "This is normal and will continue as long as you use the drops."

A, B, D, E

A patient is prescribed selegiline, an MAO-B inhibitor, as adjunctive therapy in treatment of Parkinson's disease. What potential adverse effects would the nurse include in education for this patient? (Select all that apply.) A Headache B Insomnia C Weight gain D Depression E Blood pressure changes

C. Administer an opiate antagonist per standing orders.

A patient is receiving an opioid via a PCA pump as part of his postoperative pain management program. During rounds, the nurse finds him unresponsive, with respirations of 8 breaths/min and blood pressure of 102/58 mmHg. After stopping the opioid infusion, what should the nurse do next? A. Notify the charge nurse. B. Draw arterial blood gases. C. Administer an opiate antagonist per standing orders. D. Perform a thorough assessment, including mental status examination.

a. A history of peptic ulcers

A patient is receiving instructions regarding the use of caffeine. The nurse shares that caffeine should be used with caution if which of these conditions is present? a. A history of peptic ulcers b. Asthma c. Migraine headaches d. A history of kidney stones

c. "Take the Restasis first, and then wait 15 minutes before taking the artificial tears."

A patient is receiving ocular cyclosporine (Restasis) and also has an order for an artificial tears product. The nurse includes which instructions in the teaching plan for these medications? a. "First take the artificial tears, and then take the Restasis after 5 minutes." b. "These two eye drugs cannot be given together. Let's check with your prescriber." c. "Take the Restasis first, and then wait 15 minutes before taking the artificial tears." d. "You may take these two drugs together at the same time."

A. Airway

A patient is recovering from general anesthesia, What is the nurse's main concern during the immediate postoperative period? A. Airway B. Pupillary reflexes C. Return of sensations D. Level of consciousness

A. Notify the patient that this drug causes discoloration of the urine.

A patient is taking entacapone (Comtan) as part of the therapy for Parkinson's disease. Which intervention by the nurse is appropriate at this time? A. Notify the patient that this drug causes discoloration of the urine. B. Limit the patient's intake of tyramine-containing foods. C. Monitor results of renal studies because this drug can seriously affect renal function. D. Force fluids to prevent dehydration.

A. postherpetic neuralgia

A patient is taking pregabalin (Lyrica) but does not have a history of seizures. The nurse recognizes that this drug is also indicateed for A. postherpetic neuralgia B. viral infections C. Parkinson's disease D. Depression

d. "The patch allows for better absorption of the medication."

A patient is to receive testosterone therapy via a transdermal patch. He asks the nurse, "Why am I getting a patch? Can't I just take a pill?" Which response by the nurse is correct? a. "You will only have to change the patch weekly." b. "If you don't take the patch, you will have to have injections instead." c. "The patch reduces the incidence of side effects." d. "The patch allows for better absorption of the medication."

a. Impaired gas exchange related to central nervous system depression produced by general anesthesia

A patient is undergoing abdominal surgery and has been anesthetized for 3 hours. Which nursing diagnosis would be appropriate for this patient? a. Impaired gas exchange related to central nervous system depression produced by general anesthesia b. Anxiety related to the use of an anesthetic c. Decreased cardiac output related to systemic effects of local anesthesia d. Risk for injury related to increased sensorium from general anesthesia

B. Oil

A patient needs a medication that has excellent emollient properties. Because she works as a swimming coach, the medication prescribed should not wash off when it comes in contact with water. If each has the same healing properties, which formulation would be best for this patient? A. Aerosol spray B. Oil C. Gel D. Cream

D morphine

A patient needs to switch analgesic drugs secondary to an adverse reaction to the present regimen. The patient is concerned that he will not receive an effective dose of a new drug to control pain. The nurse responds based on knowledge that potencies of analgesics are determined using an equianalgesic table comparing doses of these drugs with what prototype? A meperidine B fentanyl C codeine D morphine

C "Vasoconstriction caused by epinephrine enhances the duration of action for lidocaine and minimizes bleeding at the laceration site."

A patient questions the use of epinephrine for repair of a laceration, stating, "I thought that was the drug they use in the emergency room for patients who are coding." Which is the nurse's best response? A "Epinephrine is used with lidocaine to prevent side effects." B "The systemic absorption of lidocaine is maximized by the epinephrine, and the anesthetic effect is reached more quickly." C "Vasoconstriction caused by epinephrine enhances the duration of action for lidocaine and minimizes bleeding at the laceration site." D "Epinephrine is metabolized more quickly than lidocaine so that the anesthetic effect wears off more quickly once the laceration is sutured."

D increasing fluid and fiber in the diet.

A patient receiving narcotic analgesics for chronic pain can minimize the gastrointestinal (GI) side effects by A taking Lomotil with each dose. B eating foods high in lactobacilli. C taking the medication on an empty stomach. D increasing fluid and fiber in the diet.

A, B, C

A patient receiving valproic acid (Depakote) should be monitored for which adverse effects? (Select all that apply.) A Tremors B Weight gain C Hepatoxicity D Hypoglycemia E Insomnia

A "Use an alternative method of birth control this month during antibiotic use."

A patient taking oral contraceptives is being treated for a urinary tract infection with antibiotics. Which information should the nurse include as education related to the oral contraceptives? A "Use an alternative method of birth control this month during antibiotic use." B "The urinary tract infection can be passed to your partner, so he should be screened." C "Be sure to complete the full course of antibiotics." D "There is no interaction of oral contraceptives and antibiotics."

B. Plan a gradual reduction in dosage.

A patient who has been taking a benzodiazepine for 5 weeks has been instructed to stop the medication. Which instruction will the nurse provide to the patient on how to discontinue the medication? A. Stop taking the drug immediately. B. Plan a gradual reduction in dosage. C. Overlap this medication with another drug. D. Take the medication every other day for a number of weeks.

B Wearing-off phenomenon

A patient who has been taking antiparkinson medications for years begins to have increased symptoms on a constant basis. In documenting these symptoms, what term will the nurse use? A On-off phenomenon B Wearing-off phenomenon C Chorea D Dystonia

c. diazepam (Valium)

A patient who has received some traumatic news is panicking and asks for some medication to help settle down. The nurse anticipates giving which drug that is most appropriate for this situation? a. zolpidem (Ambien) b. phenobarbital c. diazepam (Valium) d. cyclobenzaprine (Flexeril)

C. gabapentin (Neurontin)

A patient who is experiencing neurotic pain tells the nurse that the physician is going to start him on a new medication that is generally used to treat seizures. The nurse anticipates that which drug will be ordered? A. phenobarbital (Luminal) B. phenytoin (Dilantin) C. gabapentin (Neurontin) D. tiagabine (Gabitril)

C. "You should notice a difference within a few days"

A patient who is newly diagnosed with Parkinson's disease and beginning medication therapy with entacapone (Comtan), a COMT inhibitor, asks the nurse, "How soon will improvement occur?" What is the nurse's best response. A. "That varies from patient to patient" B. "You should discuss that with your physician" C. "You should notice a difference within a few days" D. "It may take several weeks before you notice any degree of improvement."

A Candidiasis

A patient who is prescribed the drug miconazole (Monistat), a topical antifungal, has most likely been diagnosed with which condition? A Candidiasis B Pruritus C Eczema D Folliculitis

C. Malignant hyperthermia

A patient who just returned from surgery has suddenly developed a severe elevation in body temperature. The nurse recognizes that this change may indicate which condition? A. A normal temperature change after surgery B. Malignant hypertension C. Malignant hyperthermia D. Fever

a. The patient will need to restrict fat intake to less than 30% to help reduce these adverse effects.

A patient who started taking orlistat (Xenical) 1 month ago calls the clinic to report some "embarrassing" adverse effects. She tells the nurse that she has had episodes of "not being able to control my bowel movements." Which statement is true about this situation? a. The patient will need to restrict fat intake to less than 30% to help reduce these adverse effects. b. These are expected adverse effects that will eventually diminish. c. The patient will need to stop this drug immediately if these adverse effects are occurring. d. The patient will need to increase her fat intake to prevent these adverse effects.

A. Ultrashort.

A patient who will be undergoing a brief surgical procedure to obtain a biopsy from a superficial mass on his arm. The nurse expects that which type of barbiturate will be used at this time. A. Ultrashort. B. Short C. Intermediate D. Long

a. How to prevent constipation

A patient will be discharged with a 1-week supply of an opioid analgesic for pain management after abdominal surgery. The nurse will include which information in the teaching plan? a. How to prevent constipation b. How to prevent dehydration due to diarrhea c. Importance of taking the drug only when the pain becomes severe d. Importance of taking the drug on an empty stomach

A, B, D, E

A patient will be receiving fluorouracil (Efudex) cream as part of treatment for basal cell carcinoma of skin on her nose. The nurse will instruct the patient about which possible adverse effects? (SATA) A. Swelling B. Scaling C. Pallor D. Burning E. Tenderness

A, C, D, E

A patient will be receiving the barbiturate phenobarbital as part of treatment for seizures. The nurse assesses the patient's current list of medications. Which medication(s) is/are known to cause interactions with barbiturates? (Select all that apply) A. Benzodiazepines B. Proton Pump Inhibitors C. Oral Contraceptives D. Anticoagulants E. MAOI's

B. Monitor for dizziness.

A patient will be taking selegiline (Eldepryl), 10 mg daily, in addition to dopamine replacement therapy for Parkinson's disease. The nurse will implement which precautions regarding selegiline? A. Teach the patient to avoid foods containing tyramine. B. Monitor for dizziness. C. Inform the patient that this drug may cause urine discoloration. D. Monitor for tachycardia and palpitations.

B, C, D

A patient will be taking sumatriptan (Imitrex) as part of treatment for migraine headaches. Before beginning therapy, the nurse reviews the patient's current list of medications. Which medications may have an interaction with sumatriptan? (Select all that apply) A. Opioids B. Ergot alkaloids C. SSRI's D. MAOI's E. NSAID's

B. Dyskinesia

A patient with Parkinson's disease has difficulty performing voluntary movements. What is the correct term for this symptom? A. Akinesia B. Dyskinesia C. Chorea D. Dystonia

A Use of benzodiazepines decrease the therapeutic effect of the levadopa and may result in an increase in the symptoms of Parkinson's disease.

A patient with Parkinson's disease is discussing a recent bout of insomnia with the nurse. The patient asks if he can take an old prescription he has to treat insomnia. What does the nurse know about the use of benzodiazepines in patients taking levodopa? A Use of benzodiazepines decrease the therapeutic effect of the levadopa and may result in an increase in the symptoms of Parkinson's disease. B Use of benzodiazepines increases the therapeutic effect of the levadopa and may result in a decrease in the symptoms of Parkinson's disease. C Use of benzodiazepines decreases the therapeutic effect of the levadopa and may result in a decrease in the symptoms of Parkinson's disease. D Use of benzodiazepines increase the therapeutic effect of the levadopa and may result in an increase in the symptoms of Parkinson's disease.

C. Physical Therapy

A patient with back muscle spasms is being treated with a skeletal muscle relaxant. In order to ensure that these drugs are most effective, the nurse will make sure what other treatment is ordered? A. Benzodiazepines B. Moist Heat C. Physical Therapy D. Aspirin

A. more constant drug levels for analgesia.

A patient with bone pain caused by metastatic cancer will be receiving transdermal fentanyl patches. The patient asks the nurse what benefits these patches have. The nurse's best response includes which of these features? A. more constant drug levels for analgesia. B. less constipation and minimal dry mouth. C. Less drowsiness than with oral opioids. D. Lower dependency potential and no major adverse effects.

B, C, E

A patient with migraine headaches is being evaluated. One potential treatment is ergotamine tablets. The nurse notes that the patient has the following conditions. Which would be a contraindication to the use of ergotamine? (Select all that apply) A. Asthma B. Hypertension C. Glaucoma D. Diabetes mellitus E. Coronary heart disease

B. Nervousness

A patient with narcolepsy will begin treatment with a CNS stimulant. The nurse expects to see which adverse effect? A. Bradycardia B. Nervousness C. Mental Clouding D. Drowsiness at night

A. The entacapone can reduce on-off effects.

A patient with parkinson's disease will start taking entacapone (Comtan) along with the carbidopa-levodopa (Sinemet) he has been taking for a few years. The nurse recognizes that the advantage of taking entacapone is that A. The entacapone can reduce on-off effects. B. The levodopa may be stopped in a few days. C. There is less GI upset with entacapone. D. It does not cause the cheese effect.

D. Systemic antibiotics

A patient with severe middle ear infection will generally require treatment with which type of drug? A. Topical steroids B. Systemic steroids C. Topical antibiotics D. Systemic antibiotics

B diazepam (Valium)

A postoperative craniotomy patient is received in the intensive care unit. The nurse makes sure which prescribed drug is readily available to treat acute seizure activity? A gabapentin (Neurontin) B diazepam (Valium) C ethosuximide (Zarontin) D flumazenil (Romazicon)

B. Between the 20th and 37th weeks.

A pregnant woman is experiencing contractions. The nurse remembers that the pharmacological measures to stop contractions are used during which time frame? A. Before the 20th week of gestation. B. Between the 20th and 37th weeks. C. After the 37th week. D. At any time during the pregnancy if delivery is not desired.

a. "This drug may cause increased redness of your skin."

A teenage boy is taking tretinoin (Retin-A) for acne. Which statement will the nurse include in the teaching plan? a. "This drug may cause increased redness of your skin." b. "Avoid foods that are heavy in salt and oils." c. "Being out in the sunlight will help your skin heal." d. "Try using an abrasive cleanser to remove old skin layers."

B The patient must use at least two forms of contraception while taking this medication.

A teenage female patient is going to be prescribed isotretinoin (Amnesteem) for acne. Which information is most important for the nurse to include in the education of the patient? A The drug is supplied in oral form. B The patient must use at least two forms of contraception while taking this medication. C The drug is used in treatment of severe acne. D Providers who prescribe this medication must be registered with the FDA.

b. Pregnancy test

A woman visits a health center requesting oral contraceptives. Which laboratory test is most important for the nurse to assess before the patient begins oral contraceptive therapy? a. Vaginal cultures b. Pregnancy test c. Serum potassium level d. Complete blood count

D. naloxone (Narcan)

A young man has been taken to the ER because of a suspected overdose of morphine tablets. The nurse prepares to administer which drug? A. atropine B. meperedine (Demerol) C. flumazenil (Romazicon) D. naloxone (Narcan)

c) Suicidal ideations

After a patient has been treated for depression for 4 weeks, the nurse calls the patient to schedule a follow-up visit. What concern should the nurse know to look for during the conversation with the patient? a) Weakness b) Hallucinations c) Suicidal ideations d) Difficulty with urination

a. Nonopioid analgesic, such as indomethacin (Indocin)

An 18-year-old basketball player fell and twisted his ankle during a game. The nurse will expect to administer which type of analgesic? a. Nonopioid analgesic, such as indomethacin (Indocin) b. Opium alkaloid, such as morphine sulfate c. Opioid antagonist, such as naloxone HCL (Narcan) d. Synthetic opioid, such as meperidine (Demerol)

C. relieve neuropathic pain.

An anticonvulsant drug has been ordered as part of a patient's pain management program. The nurse explains to the patient that the purpose of the anticonvulsant is to: A. produce sleep. B. prevent seizures. C. relieve neuropathic pain. D. reduce anxiety.

B Venous thromboembolism

An elderly woman being treated for osteoporosis with a selective estrogen receptor modulator (SERM) should be alerted to the potential for an increased risk of which condition? A Elevated blood pressure B Venous thromboembolism C Hypercalcemia D Skin color changes

C propofol (Diprivan)

An intubated, mechanically ventilated patient in the intensive care unit is becoming increasingly restless and anxious. The nurse expects to administer which intravenous anesthetic drug? A isoflurane (Forane) B nitrous oxide C propofol (Diprivan) D halothane (Fluothane)

C. Paradoxical

An older adult has been given a benzodiazepine for sleep induction, but the night nurse noted that the pt was awake most of the night, watching tv & reading in bed. The nurse documents that the pt has had which type of reaction to the medication? A. Allergic B. Teratogenic C. Paradoxical D. Idiopathic

B. Earwax emulsifier

An older adult patient has a buildup of cerumen in his left ear. The nurse expects that this patient will receive which type of drug for this problem? A. Antifungal B. Earwax emulsifier C. Steroid D. Local analgesic

C Neisseria gonorrhoeae

At the time of birth, infants are often treated with erythromycin eye ointment as prophylactic treatment against what possible organism? A Aspergillus fumigatus B Candida albicans C Neisseria gonorrhoeae D Malassezia furfur

D. Prostate-specific antigen level (PSA)

Before a patient begins therapy with finasteride (Proscar), the nurse should make sure that which laboratory test has been performed? A. Blood glucose level. B. Complete blood count C. Urinalysis D. Prostate-specific antigen level (PSA)

c. Anticoagulants

Before beginning a patient's therapy with selective serotonin reuptake inhibitor (SSRI) antidepressants, the nurse will assess for concurrent use of which medications or medication class? a. Aspirin b. Diuretics c. Anticoagulants d. Nonsteroidal antiinflammatory drugs

A. Eardrum perforation

Before giving ear drops, the nurse checks for potential contraindications to the use of otic preparations, such as which of these conditions? A. Eardrum perforation B. Infection C. Presence of cerumen D. Mastoiditis

A. Shellfish

Before using povidone-iodine (Betadine) solution to prepare skin for surgery, the nurse will ask the patient about allergies to which substance? A. Shellfish B. Penicillin C. Mercury D. Milk

A, C, E

Carbidopa-levodopa (Sinemet) is prescribed for a patient with Parkinson's disease. The nurse will inform the patient of which possible adverse effects? A. Palpitations B. Insomnia C. Hypotension D. Urinary frequency E. GI distress

A. Peliosis of the liver

During a counseling session for a group of teenage athletes, the use of androgenic steroids is discussed. The nurse will explain that which problem is a rare but devastating effect of androgenic steroid use? A. Peliosis of the liver B. Bradycardia C. Kidney failure D. Tachydysrhythmias

b. Infiltration of the puncture wound with lidocaine

During a fishing trip, a patient pierced his finger with a large fishhook. He is now in the emergency department to have it removed. The nurse anticipates that which type of anesthesia will be used for this procedure? a. Topical benzocaine spray on the area b. Infiltration of the puncture wound with lidocaine c. Topical prilocaine (EMLA) cream around the site d. No anesthesia

B. Somatic pain

During a marathon, a runner had to drop out after 16 miles because of severe muscle spasms. Which type of pain is the runner experiencing? A. Chronic pain B. Somatic pain C. Visceral pain D. Superficial pain

D. "Take care to change positions slowly to prevent falling due to a drop in blood pressure."

During a patient teaching session about antiparkinson drugs, the nurse will include which statement? A. "The drug will be stopped when tremors and weakness are relieved." B. "If a dose is missed, take two doses to avoid significant decreases in blood levels." C. "Be sure to notify your physician if your urine turns brownish-orange in color." D. "Take care to change positions slowly to prevent falling due to a drop in blood pressure."

B, C, E

During a patient's recovery from a lengthy surgery, the nurse monitors for signs of malignant hyperthermia. In addition to a rapid rise in body temp, which assessment findings would indicate the possible presence of this condition? (SATA) A. Respiratory depression B. Tachypnea C. Tachycardia D. Seizure activity E. Muscle rigidity

B oxytocin (Pitocin)

During a postpartum assessment, the nurse notes a boggy uterus and increased vaginal bleeding. Based upon this assessment and standing physician orders, the nurse prepares to administer which medication? A prostaglandin E B oxytocin (Pitocin) C terbutaline (Brethine) D clomiphene (Clomid)

D. Hypotension

During a procedure, the nurse is monitoring a patient who has received dexmedetomidine (Pecedex) for moderate sedation. The nurse will observe for which potential adverse effect? A. Respiratory depression B. Tachycardia C. Dizziness D. Hypotension

B. "The steroid reduces itching and inflammation."

During a teaching session about ear drops, the patient tells the nurse, "I know why an antibiotic is in this medicine, but why do I need to take a steroid?" Which is the nurse's best answer? A. "The steroid will help to soften the cerumen." B. "The steroid reduces itching and inflammation." C. "The steroid also has antifungal effects." D. "This medication helps to anesthetize the area to decrease pain."

C. Hold the medication, and check with the prescriber.

During an examination, the nurse notes that a patient has a perforated tympanic membrane. There is an order for ear drops. Which action by the nurse is most appropriate? A. Give the medication as ordered. B. Check the patient's hearing, and then give the drops. C. Hold the medication, and check with the prescriber. D. Administer the drops with a cotton wick.

B. To produce immediate miosis during ophthalmic surgery.

During an ophthalmic procedure, the patient receives ophthalmic acetylcholine. The nurse is aware that which effect is the purpose of administering this drug? A. To produce mydriasis for ophthalmic examination. B. To produce immediate miosis during ophthalmic surgery. C. To cause cycloplegia to allow for measurement of intraocular pressure. D. To provide topical anesthesia during ophthalmic surgery.

c. "Be sure to place the drop in the conjunctival sac of the lower eyelid"

During patient teaching regarding self-administration of ophthalmic drops, which statement by the nurse is correct? a. "Hold the eye drops over the cornea, and squeeze out the drop" b. "Apply pressure to the lacrimal area for 5 minutes after administration" c. "Be sure to place the drop in the conjunctival sac of the lower eyelid" d. "Squeeze your eyelid closed tightly after placing the drop into your eye"

C "Most drugs produce sedation at low doses and sleep, the hypnotic effect, at higher doses."

During patient teaching, the nurse explains the difference between a sedative and hypnotic with which statement? A "Sedatives are much stronger than hypnotic drugs and should only be used for short periods of time." B "Sedative drugs induce sleep, whereas hypnotic drugs induce a state of hypnosis." C "Most drugs produce sedation at low doses and sleep, the hypnotic effect, at higher doses." D "There really is no difference; the terms are used interchangeably."

d. It must not be handled by pregnant women.

During the administration of finasteride (Proscar), the nurse must remember which important precaution? a. The patient needs to be warned that alopecia is a common adverse effect. b. It must be taken on an empty stomach. c. It is given by deep intramuscular injection to avoid tissue irritation. d. It must not be handled by pregnant women.

a. Allergy to sulfa drugs

During the assessment of a glaucoma patient who has newly prescribed carbonic anhydrase inhibitor eye drops, the nurse would report a history of which condition? a. Allergy to sulfa drugs b. Decreased renal function c. Diabetes mellitus d. Hypertension

A. Suicidal thoughts

During therapy for depression with a SSRI, it is most important for the nurse to instruct the family to monitor for which adverse effect? A. Suicidal thoughts B. Visual disturbances C. Tardive dyskinesia D. Bleeding tendencies

A vasoconstriction.

Ergot alkaloids such as ergotamine tartrate (Ergostat) exert a therapeutic effect by causing A vasoconstriction. B vasodilation. C blockade of the beta2 receptors. D simulation of the alpha receptors.

D. around the clock, with additional doses as needed for breakthrough pain

For best results when treating severe pain associated with pathologic spinal fractures related to metastatic bone cancer, the nurse should remember that the best type of dosage schedule is to administer the pain medication A. as needed B. around the clock C. on schedule during waking hours only D. around the clock, with additional doses as needed for breakthrough pain

C Notify the physician.

Immediate postoperative assessment of a patient reveals a body temperature of 102° F. Which action will the nurse perform? A Administer acetaminophen as ordered and recheck in 1 hour. B Apply a cooling blanket per protocol. C Notify the physician. D Assess for signs and symptoms of infection related to the surgical wound.

b) Benzodiazepines

In caring for a patient experiencing ethanol withdrawal, the nurse expects to administer which medication or medication class as treatment for this condition? a) Lithium (Eskalith) b) Benzodiazepines c) Buspirone (BuSpar) d) Antidepressants

C Impaired gas exchange related to respiratory depression

In developing a plan of care for a patient receiving morphine sulfate, which nursing diagnosis is a priority? A Acute pain B Risk for injury related to central nervous system side effects C Impaired gas exchange related to respiratory depression D Constipation related to gastrointestinal side effects

C the chemoreceptor trigger zone.

In monitoring a patient for adverse effects related to morphine sulfate, the nurse assesses for stimulation of A autonomic control over circulation. B the cough reflex center. C the chemoreceptor trigger zone. D respiratory rate.

B, D, F

In which situations would androgens be prescribed for women? (SATA) A. Development of secondary sex characteristics. B. Fibrocystic breast disease. C. Ovarian cancer D. Treatment of endometriosis E. Postmenopausal osteoporosis prevention F. Inoperable breast cancer.

B, C, E

Intravenous morphine is prescribed for a patient who has had surgery, The nurse informs the patient that which common adverse effects can occur with this medication? (SATA) A. Diarrhea B. Constipation C. Pruritis D. Urinary frequency E. Nausea

A acne.

Isotretinoin (Amnesteem) and tretinoin (Retin-A) are common dermatologic drugs used to treat A acne. B male pattern baldness. C keloid scarring. D fungal infections.

B massaging muscles activates large sensory nerve fibers that send signals to the spinal cord to close the gate, thus blocking painful stimuli from reaching the brain.

Massage therapy is ordered as adjunct treatment for a patient with musculoskeletal pain. The patient asks the nurse how "rubbing my muscles" will help the pain go away. The nurse responds based on the knowledge that A massaging muscles decreases the inflammatory response that initiates the painful stimuli. B massaging muscles activates large sensory nerve fibers that send signals to the spinal cord to close the gate, thus blocking painful stimuli from reaching the brain. C massaging muscles activates small sensory nerve fibers that send signals to the spinal cord to open the gate and allow endorphins to reach the muscles and relieve the pain. D massaging muscles helps relax the contracted fibers and decrease painful stimuli.

B Amnesia

Midazolam (Versed) has been ordered for a patient to be administered by injection 30 minutes prior to a colonoscopy. The nurse informs the patient that one of the most common side effects of this medication is which effect? A Decreased heart rate B Amnesia C Constipation D Dry mouth

D. fentanyl (Duragesic)

Moderate to severe pain is best treated with which of these medications? A. acetaminophen (Tylenol) B. naloxone (Narcan) C. alprazolam (Xanax) D. fentanyl (Duragesic)

B Miosis

Parasympathomimetic ophthalmic drugs such as pilocarpine (Pilocar) reduce intraocular pressure in the treatment of glaucoma by which mechanism of action? A Mydriasis B Miosis C Decrease in drainage of aqueous humor D Pupillary dilatation

d) Swiss cheese

Patient teaching for a patient receiving an MAOI would include instructions to the patient to avoid which food product? a) Grapefruit juice b) Milk c) Shrimp d) Swiss cheese

A. Apply the patch only to the scrotum.

Patient will be receiving testosterone therapy for male hypogonadism and has a new prescription for transdermal testosterone (Testoderm). The nurse needs to include which teaching about the use of this medication? A. Apply the patch only to the scrotum. B. Apply the patch to the chest, back, shoulders. C. If the adverse effects become bothersome, the patient should stop using the patch. D. The patch should be applied to a different area of the upper body each day.

A nitroglycerin

Patients prescribed sildenafil (Viagra) should be instructed regarding the potential fatal drug interaction with which medication(s)? A nitroglycerin B aspirin C acetaminophen D Anticoagulants

A, B, C

Phenytoin (Dilantin) is prescribed for a patient. The nurse checks the patient's current list of medications and notes that interactions may occur with which drugs or drug classes? (Select all that apply) A. Proton pump inhibitors B. Warfarin (Coumadin) C. Sulfonamide antibiotics D. Corticosteroids E. Oral contraceptives

A Blocking the reuptake of neurotransmitters at nerve endings

Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) both function by which mechanism? A Blocking the reuptake of neurotransmitters at nerve endings B Increasing alertness levels in the brain C Decreasing levels of epinephrine and serotonin at nerve endings D Increasing the placebo effect

C. A patient admitted with severe hepatitis

Several patients have standard orders for acetaminophen as needed for pain. When the nurse reviews their histories and assessments, the nurse discovers that one of the patients has a contraindication to acetaminophen therapy. Which patient should receive an alternate medication? A. A patient with a fever of 103.4F (39.7C) B. A patient admitted with a DVT C. A patient admitted with severe hepatitis D. A patient who had abdominal surgery 1 week earlier

A Thyroid hormones

Sympathomimetic mydriatics have the potential to react with other drugs if sufficient topical absorption occurs. When given concurrently, drugs in which class may interact with the sympathomimetic mydriatics? A Thyroid hormones B Oral contraceptives C Nonsteroidal antiinflammatories D Calcium channel blockers

B Endometrial cancer

The addition of continuous administration of progestin to an estrogen regimen reduces the risk of which cancer? A Ovarian cancer B Endometrial cancer C Breast cancer D Vaginal cancer

B Reduce inflammation

The health care provider has ordered ciprofloxacin/dexamethasone (Ciprodex) otic drops for a patient with OE. The nurse knows the combination medication has both antibacterial medication and topical steroid medication. What is the purpose of the steroid in this medication? A Relieve pain B Reduce inflammation C Treat infection D Decrease the amount of earwax

A atomoxetine (Strattera)

The mother of a child with attention deficit hyperactivity disorder (ADHD) who has been prescribed methylphenidate (Ritalin) expresses concern regarding the use of a controlled substance to treat her child and asks if there are any other options. The nurse's response is based on the knowledge that an option for treatment for ADHD might include which non-controlled central nervous system (CNS) stimulant? A atomoxetine (Strattera) B dextroamphetamine sulfate (Dexedrine) C methylphenidate (Concerta) D amphetamine aspartate (Adderall)

B warming the eardrops to room temperature before administration helps reduce a vestibular-type reaction.

The nurse bases the plan of care regarding administration of eardrops on knowledge that A proper administration includes holding the pinna up and out in an infant. B warming the eardrops to room temperature before administration helps reduce a vestibular-type reaction. C the pinna of an adult should be held down and back. D eardrops may be warmed in the microwave before administration.

B Cardiac dysrhythmias

The nurse explains to a patient using caffeine that which disease process/condition may be exacerbated by this drug? A Myelin degeneration B Cardiac dysrhythmias C Constipation D Heart block

b. "I will need to take extra care of my teeth and gums while on this medication."

The nurse has given medication instructions to a patient receiving phenytoin (Dilantin). Which statement by the patient indicates that the patient has an adequate understanding? a. "I will be able to stop taking this drug once the seizures stop." b. "I will need to take extra care of my teeth and gums while on this medication." c. "I can skip doses if the side effects bother me." d. "I can go out for a beer while on this medication."

A. "When I take that long flight to Asia, I will need to stop taking this drug at least 3 days before I travel."

The nurse has provided patient education regarding therapy with the SERM raloxifene (Evista). Which statement from the patient reflects a good understanding of the instructions? A. "When I take that long flight to Asia, I will need to stop taking this drug at least 3 days before I travel." B. "I can continue this drug even when traveling as long as I take it with a full glass of water each time." C. "After I take this drug, I must sit upright for at least 30 minutes." D. "One advantage of this drug is that it will reduce my hot flashes."

A Gingival hyperplasia

The nurse instructs a patient receiving phenytoin (Dilantin) to visit the dentist regularly and perform frequent oral hygiene. What common side effect is the nurse educating the patient about for this medication? A Gingival hyperplasia B Oral candidiasis C Increased risk of dental abscesses D Increased incidence of dental caries

D. Hypertensive crisis

The nurse instructs a patient who is undergoing therapy with MAOI's to avoid tyramine-containing foods. What medical emergency may occur if the patient eats these foods while taking MAOI's? A. Gastric hemorrhage B. Toxic shock C. Cardiac arrest D. Hypertensive crisis

B, C, E

The nurse is administering a stimulant drug. Which are results of stimulation of the central nervous system by these drugs? (Select all that apply) A. Increased fatigue B. Decreased drowsiness C. Increased respiration D. Bradycardia E. Euphoria

B-1 D-2 C-3 A-4

The nurse is administering an NMBD to a patient during a surgical procedure. Number the following phases of muscle paralysis in the order in which the patient will experience them (Number 1 is first step) A. Paralysis of intercostals and diaphragm muscles B. Muscle weakness C. Paralysis of muscles of the limbs, neck, and trunk D. Paralysis of small rapidly moving muscles (fingers, eye)

A, C, E

The nurse is administering an anti epileptic drug and will follow which guidelines? (Select all that apply) A. Monitor the patient for drowsiness B. Medications may be stopped if seizure activity disappears. C. Give the medication at the same time every day. D. Give the medication on an empty stomach. E. Notify the prescriber if the patient is unable to take the medication.

a. It is a local anesthetic that causes temporary relief of pain.

The nurse is administering an otic preparation as part of treatment for a severe fungal ear infection. Why is pramoxine added to the otic medication? a. It is a local anesthetic that causes temporary relief of pain. b. It is a corticosteroid that reduces inflammation. c. It is an emulsifying drug that works to soften the cerumen. d. It works synergistically to enhance the effect of the antifungal drug.

c. The corticosteroid reduces the inflammation and itching associated with ear infections.

The nurse is administering eardrops that contain a combination of an antibiotic and a corticosteroid. What is the rationale for combining these two drugs in eardrops? a. The corticosteroid reduces pain associated with ear infections. b. The combination works to help soften and eliminate cerumen. c. The corticosteroid reduces the inflammation and itching associated with ear infections. d. The drops help to eliminate fungal infections.

C. drowsiness

The nurse is administering phenobarbital (Luminal) and will monitor the patient for which possible adverse effect? A. constipation B. gingival hyperplasia C. drowsiness D. dysrhythmias

B, C, E

The nurse is administering the antipsychotic drug clozapine (Clozaril) and should monitor the patient for what long-term problem(s) associated with this drug? (Select all that apply) A. Mood swings B. Agranulocytosis C. Weight gain D. Photosensitivity E. Increased appetite

A, B, D

The nurse is administering topical antiviral drugs. Which statements about these drugs are true? (SATA) A. Common adverse effects include stinging, itching, and rash. B. Topically applied acyclovir (Zovirax) does not cure viral skin infections but does seem to decrease the healing time and pain. C. Topically applied acyclovir can cure viral skin infections if applied as soon as symptoms appear. D. Antiviral drugs are applied topically for the treatment of both initial and recurrent herpes simplex infections. E. Topical antiviral drugs are used more often than systemic antiviral drugs for the treatment of viral skin conditions.

b. Take the drops out of the refrigerator 1 hour before the dose is due.

The nurse is administrating eardrops that have been refrigerated. Which action by the nurse is correct before administering the drops? a. Heat the chilled solution for 10 seconds in the microwave. b. Take the drops out of the refrigerator 1 hour before the dose is due. c. Leave the drops in the refrigerator until use. d. Soak the bottle for 60 seconds in a container of very hot water.

D. diazepam (Valium)

The nurse is assessing a newly admitted patient who has a history of seizures. During the assessment, the patient has a generalized seizure that does not stop for several minutes. The nurse expects that which drug will be ordered for this condition? A. valproic acid (Depakote) B. neurontin (Gabapentin) C. carbamazepine (Tegretol) D. diazepam (Valium)

A, C, D

The nurse is assessing a patient who has begun therapy with amantadine (Symmetrel) for parkinson's disease. The nurse will look for which possible adverse effects? (Select all that apply) A. Nausea B. Palpitations C. Dizziness D. Insomnia E. Edema

C. Ectopic pregnancy

The nurse is assessing a patient who is to receive dinoprostone (Prostin E2). Which condition would be a contraindication to the use of this drug? A. Pregnancy at 15 weeks gestation B. GI upset or ulcer disease C. Ectopic pregnancy D. Incomplete abortion

B. Blistering skin over the treatment area.

The nurse is assessing the skin of a teenage patient who has been using a benzoyl peroxide product for 2 weeks as part of treatment for acne. Which assessment findings would indicate that the patient is having an allergic reaction and will need to stop treatment? A. Reddend skin over the treatment area. B. Blistering skin over the treatment area. C. Peeling skin over the treatment area. D. Sensation of warmth when the product is applied.

b) WBC count

The nurse is caring for a patient who has been taking clozapine (Clozaril) for 2 months. Which laboratory test(s) should be performed regularly while the patient is taking this medication? a) Platelet count b) WBC count c) Liver function studies d) Renal function studies

D This is a normal occurrence related to entacapone (Comtan).

The nurse is caring for a patient with Parkinson's disease. The patient has been taking entacapone (Comtan) for the past week to treat an on-off phenomenon. The patient expresses concern over brown-orange urine. What information will the nurse provide? A The patient may be developing renal failure. B The patient may be developing hepatic failure. C Brown-orange urine signifies a lack of fluid intake. D This is a normal occurrence related to entacapone (Comtan).

D. Imbalanced nutrition, less than body requirements

The nurse is developing a plan of care for a patient receiving an anorexiant. Which nursing diagnosis is most appropriate? A. Deficient fluid volume B. Sleep deprivation C. Impaired memory D. Imbalanced nutrition, less than body requirements

C. Multiple pregnancy (twins or more)

The nurse is discussing therapy with clomiphene (Clomid) with a husband and wife who are considering trying this drug as part of treatment for infertility. It is important that they be informed of which possible effect of this drug? A. Increased menstrual flow B. Increased menstrual cramping C. Multiple pregnancy (twins or more) D. Sedation

B. loosen impacted cerumen so that it may be removed by irrigation.

The nurse is discussing treatment of earwax buildup with a patient. Which statement about earwax emulsifiers is true? These drugs: A. are useful for treatment of ear infections. B. loosen impacted cerumen so that it may be removed by irrigation. C. are used to rinse out excessive earwax. D. enhance the secretion of earwax.

B, C

The nurse is educating a patient about medications used to treat erectile dysfunction. Which erectile dysfunction medications have the longest therapeutic effect when taken orally? (Select all that apply.) A sildenafil (Viagra) B vardenafil (Levitra) C tadalafil (Cialis) D alprostadil (Caverject)

A, C, D

The nurse is educating a patient newly diagnosed with open-angle glaucoma on the adverse effects of the indirect-acting miotic eye drops prescribed. What will the nurse include in the teaching as possible adverse effects? (Select all that apply.) A Blurred vision B Farsightedness C Stinging on instillation D Decreased nighttime vision E Paralysis of eyelids

A, B, C

The nurse is educating a patient who has been prescribed methylphenidate for narcolepsy about the drug's adverse effects. What potential adverse effects would the nurse include in the patient teaching? (Select all that apply.) A Weight Loss B Headache C Insomnia D Decreased blood pressure E Increased appetite

B Use of sunglasses is encouraged to decrease sunlight sensitivity.

The nurse is educating a patient who was administered atropine sulfate solution for an eye exam. The nurse includes which information in the education? A The patient will have to wait 72 hours to wear contacts. B Use of sunglasses is encouraged to decrease sunlight sensitivity. C The patient may have small pupils for 12 hours after administration. D A common side effect is dry eyes.

A Mother demonstrates accurate medication administration technique.

The nurse is educating the mother of an infant on how to instill eardrops for otitis media with a perforated eardrum. Which is an appropriate nursing outcome criterion for this patient? A Mother demonstrates accurate medication administration technique. B Mother takes infant's temperature prior to administration of medication. C Patient lies still for administration of medication and 5 minutes after administration. D Patient stops using medication when the ear no longer has active drainage.

B Improved hearing

The nurse is evaluating the effectiveness of the otic medication used for OE. What will the nurse evaluate for to determine if the goals of therapy have been met? A Increased pain in ear B Improved hearing C Redness around ear D Discharge in canal

B, C, D

The nurse is giving an IV dose of phenytoin (Dilantin). Which guidelines will the nurse follow for administration? (Select all that apply) A. Inject phenytoin quickly B. Inject phenytoin slowly C. The injection of phenytoin is followed by an IV inception of sterile saline. D. Do no infuse phenytoin continuously E. Mix the phenytoin with D5W for the infusion.

a) Thiazides

The nurse is giving medications to a patient. Which drug(s), when administered with lithium, increases the risk for lithium toxicity? a) Thiazides b) Levofloxacin c) Calcium citrate d) Beta-blockers

A. "I will wash his hair, then rinse out the shampoo immediately."

The nurse is instructing a parent on the use of lindane (Kwell) shampoo for the treatment of a child's head lice. Which statement by the parent indicates a need for further education? A. "I will wash his hair, then rinse out the shampoo immediately." B. "I will leave the shampoo on his hair for 4 minutes before rinsing." C. "After shampooing, I will rinse and dry his hair." D. "When the hair is dry, I will comb the hair to remove the nits."

C. Itching and burning

The nurse is monitoring for an allergic reaction to topical bacitracin, which would be evident by presence of A. Petechia B. Thickened skin C. Itching and burning D. Purulent drainage

C. Medication list that includes nitrates

The nurse is performing an assessment of a patient who is asking for a prescription for sildenafil (Viagra). Which finding would be a contraindication to its use? A. Age of 65 years B. History of thyroid disease C. Medication list that includes nitrates D. Medication list that includes saw palmetto

B, D, F

The nurse is performing wound care on a burned area using silver sulfadiazine cream in a patient with an arm wound. Which actions by the nurse are correct? (SATA) A. Applying the cream over the previous layer to avoid disturbing the wound bed. B. Gently cleansing the wound to remove the previous layer of cream and wound debris. C. Using clean gloves to apply the ointment. D. Using sterile gloves to apply the ointment. E. Always covering the wound with a dressing after applying the cream. F. Washing hands before and after the procedure.

B. Because of their rapid onset, these drugs need to be taken just before bedtime

The nurse is preparing to administer a medication for sleep. Which intervention applies to the administration of a nonbenzodiazepine, such as zaleplon (Sonata)? A. These drugs need to be taken 1 hour before bedtime B. Because of their rapid onset, these drugs need to be taken just before bedtime C. The pt needs to be cautioned about the high incidence of morning drowsiness that may occur after taking these drugs D. These drugs are less likely to interact with alcohol

b. Perforated eardrum

The nurse is preparing to administer a new order for eardrops. Which is a potential contraindication to the use of many otic preparations? a. Ear canal itching b. Perforated eardrum c. Staphylococcus aureus otitis externa infection d. Escherichia coli ear infection

B Notify the physician and delay drug administration.

The nurse is preparing to administer an injection of morphine to a patient. Assessment notes a respiratory rate of 10 breaths/min. Which action will the nurse perform? A Administer a smaller dose and record the findings. B Notify the physician and delay drug administration. C Administer the prescribed dose and notify the physician. D Hold the drug, record the assessment, and recheck in 1 hour.

B, C, E

The nurse is preparing to administer an opioid analgesic. Which factors should be assessed before the dose is given? (SATA) A. Blood clotting times B. The level of pain rated on a scale C. Prior analgesic use (time, type, amount, and effectiveness) D. Dietary history E. Allergies

A, D, E

The nurse is preparing to administer carbamide peroxide (Debrox) to an adult patient with impacted cerumen. Which actions by the nurse are correct? (SATA) A. Have the patient lie on his side with the affected ear up. B. Chill the medication before administering it. C. Pull the pinna of the ear down and back. D. Pull the pinna of the ear up and back. E. Gently irrigate the ear with warm water to remove the softened ear wax.

D. Remove the bottle from the refrigerator 1 hour before the drops are to be given.

The nurse is preparing to administer ear drops and finds that the bottle has been stored in the medication room refrigerator. Which is the best action by the nurse? A. Remove the bottle from the refrigerator, and administer the drops. B. Head the bottle for 5 seconds in the microwave oven before administering the drops. C. Let the bottle sit in a cup of hot water for 15 minutes before administering the drops. D. Remove the bottle from the refrigerator 1 hour before the drops are to be given.

D. Gently insert a cotton ball inter the outer ear canal after the drops are given.

The nurse is preparing to administer ear drops. Which technique for administering ear drops is correct? A. Warm the solution to 100 degrees F before using. B. Position the patent so that the unaffected ear is accessible. C. Massage the tragus before administering the ear drops. D. Gently insert a cotton ball inter the outer ear canal after the drops are given.

d. "These drugs work to reduce the inflammation in your eyes"

The nurse is preparing to administer ketorlac (Acular) eye drops. The patient asks, "Why am I getting these eye drops?" Which is the correct answer by the nurse? a. "These drops will reduce the pressure inside your eye as part of treatment for glaucoma: b. "These drugs are for bacterial eye infection" c. "These drugs will relieve your dry eyes" d. "These drugs work to reduce the inflammation in your eyes"

b. Drainage from the ear canal

The nurse is preparing to give an earwax emulsifier to a patient and will assess the patient for which contraindication before administering the drops? a. Partial deafness in the affected ear b. Drainage from the ear canal c. Allergy to penicillin d. Excessive earwax in the outer ear canal

B. Administer in normal saline solutions.

The nurse is preparing to give medications. Which is the most appropriate nursing action for intravenous phenytoin (Dilantin)? A. Give IV doses via rapid IV push B. Administer in normal saline solutions. C. Administer in dextrose solutions. D. Ensure continuous infusion of the drug.

B. flumazenil (Romazicon)

The nurse is providing care for a patient who has accidentally taken an overdose of benzodiazepines. Which drug would be used to treat this patient? A. methamphetamine B. flumazenil (Romazicon) C. epinephrine D. naloxone (Narcan)

C COMT inhibitors

The nurse is providing care for a patient who has been diagnosed with Parkinson's disease. The patient is also in early stage liver failure. What class of medications, if prescribed, would the nurse question? A Dopamine modulator B Anticholinergics C COMT inhibitors D Ergot derivative

C It must not be touched or handled by his daughter due to teratogenic effects.

The nurse is providing education to a patient and his caregiver—his pregnant daughter—about dutasteride (Avodart), which he will be taking for benign prostatic hyperplasia (BPH). What important teaching would the nurse provide to the patient and his daughter about the administration of this medication? A It should be taken with food containing dairy. B It may be placed in daily medication container with other medications. C It must not be touched or handled by his daughter due to teratogenic effects. D For best results, it needs to be taken at hour of sleep on empty stomach.

C "I will use the eardrops in the ear canal to treat this condition."

The nurse is providing education to a patient diagnosed with otitis externa (OE). Which statement by the patient indicates an understanding of the OE treatment plan? A "I will finish taking all the pills for my ear infection." B "This is contagious, and I need to stay away from others for 24 hours." C "I will use the eardrops in the ear canal to treat this condition." D "The cold I had last week caused this to occur; it will go away on its own."

A Patient is allergic to sulfa drugs.

The nurse is providing education to a patient who was diagnosed with bilateral conjunctivitis (pink eye). The patient is prescribed sulfacetamide (Bleph-10) for the diagnosis. What information in the patient history has the highest priority and should be reported immediately to the health care provider? A Patient is allergic to sulfa drugs. B Patient does not like eyedrops. C Patient reports never having pink eye before. D Patient wears contacts.

B. Urine discoloration

The nurse is providing teaching on COMT inhibitors to a patient with a new prescription. The nurse will be sure to educate the patient on the possibility of which adverse effect? A. Dizziness B. Urine discoloration C. Leg edema D. Visual changes

B. to treat drug-induced respiratory depression

The nurse is reviewing a patient's medication administration record. Which best describes a common use for doxapram (Dopram)? A. to control increased respiration caused by other drugs. B. to treat drug-induced respiratory depression C. To treat postoperative respiratory excitation. D. to stimulate respirations in patients with a head injury.

B, C, E

The nurse is reviewing a policy for local anesthesia. Local anesthesia is indicated for which procedure(s)? (SATA) A. Cardioversions B. Suturing a skin laceration C. Diagnostic procedures D. Long duration surgery E. Dental procedures

C, D, E

The nurse is reviewing medication therapy with the parents of an adolescent with ADHD. Which statement is correct? (Select all that apply) A. "Be sure to have your child blow his nose before administering the nasal spray." B. "This medication is used only when symptoms of ADHD are severe." C. "The last dose should be taken 4 to 6 hours before bedtime to avoid interference with sleep." D. "Be sure to contact the physician right away if you notice expression of suicidal thoughts." E. "We will need to check your child's height and weight periodically to monitor physical growth." F. "If adverse effects become severe, stop the medication for 3 to 4 days."

a. phenobarbital

The nurse is reviewing the dosage schedule for several different antiepileptic drugs (AEDs). Which antiepileptic drug allows for once-a-day dosing? a. phenobarbital b. valproic acid (Depakote) c. gabapentin (Neurontin) d. levetiracetam (Keppra)

B. acetaminophen (Tylenol)

The nurse is reviewing the drugs currently taken by a patient who will be starting drug therapy with carbamazepine (Tegretol). Which drug may raise a concern for interactions? A. digoxin (Lanoxin) B. acetaminophen (Tylenol) C. diazepam (Valium) D. Warfarin (Coumadin)

A. Cardiovascular disease

The nurse is reviewing the history of a patient who will be starting the triptan sumatriptan (Imitrex) as part of treatment for migraine headaches. Which condition, if present, may be a contraindication to triptan therapy? A. Cardiovascular disease B. Chronic bronchitis C. History of renal calculi D. Diabetes mellitus type 2

D. Induction of labor at full term

The nurse is reviewing the use of obstetric drugs. Which situation is an indication for an oxytocin (Pitocin) infusion? A. Termination of a pregnancy at 12 weeks B. Hypertonic uterus C. Cervical stenosis in a patient who is in labor D. Induction of labor at full term

D. seek medical attention immediately

The nurse is teaching a patient about the possible adverse effect of priapism, which may occur when taking erectile dysfunction drugs. The nurse emphasizes that, if this occurs the most important action is to..... A. stay in bed till the erection ceases B. apply an ice pack for 30 min C. turn toward his left side and rest D. seek medical attention immediately

B, C, D, F

The nurse is teaching a patient about treatment with an SSRI antidepressant. Which teaching considerations are appropriate? (Select all that apply.) a) The patient should be told which foods contain tyramine and instructed to avoid these foods. b) The patient should be instructed to use caution when standing up from a sitting position. c) The patient should be told that if sexual dysfunction occurs, the drug will be stopped. d) This medication should not be stopped abruptly. e) Drug levels may become toxic if dehydration occurs. f) The patient should be told to check with the prescriber before taking any over-the-counter medications.

A "Hold the pinna down and back."

The nurse is teaching the mother of a 1-year-old patient how to instill ear drops for OE. What instructions on instillation does the nurse provide to the mother? A "Hold the pinna down and back." B "Just put in as many drops as you can get into the ear." C "Put a cotton ball in to keep the medication in the ear." D "Keep the ear drops in cold place so they work better."

A. Respiratory arrest

The nurse monitoring a patient after surgery keeps in mind that the primary concern with use of neuromuscular blocking drug is which adverse effect? A. Respiratory arrest B. Headache C. Bradycardia D. Hypertension

A Dystonia

The nurse monitors a patient taking an antipsychotic medication for extrapyramidal side effects. What is the nurse assessing for in the patient? A Dystonia B Orthostatic hypotension C Dry mouth and constipation D Neuroleptic malignant syndrome

C Bipolar disorder

The nurse notes lithium on a patient's drug history upon admission. Which condition would the nurse suspect that this patient has been diagnosed with? A Obsessive-compulsive disorder B Absence seizures C Bipolar disorder D Paranoid schizophrenia

C pain relief is best obtained by administering analgesics around the clock.

The nurse plans pharmacologic therapy for a patient with pain based on the knowledge that A narcotic analgesics should not be used for more than 24 hours secondary to the risk of addiction. B analgesics should be administered as needed (prn) to minimize side effects. C pain relief is best obtained by administering analgesics around the clock. D patients should request analgesics when the pain level reaches a "6" on a scale of 1 to 10.

a. Anxiety disorder

The nurse reads in the patient's medication history that the patient is taking buspirone (BuSpar). The nurse interprets that the patient may have which disorder? a. Anxiety disorder b. Bipolar disorder c. Schizophrenia d. Depression

b. A woman with a history of thrombophlebitis

The nurse recognizes that use of estrogen drugs is contraindicated in which patient? a. A patient who has atrophic vaginitis b. A woman with a history of thrombophlebitis c. A patient who has inoperable prostate cancer d. A woman who has just given birth and wants to prevent postpartum lactation

C Every 72 hours

The nurse teaches a patient prescribed the fentanyl (Duragesic) transdermal delivery system to change the patch at what interval? A When pain recurs B Every 24 hours C Every 72 hours D Once a week

A mupirocin (Bactroban)

The nurse will anticipate application of which medication to treat a patient diagnosed with impetigo? A mupirocin (Bactroban) B benzoyl peroxide C isotretinoin (Amnesteem) D retinoic acid (Renova)

d. mannitol (Osmitrol)

The nurse will be giving ophthalmic drugs to a patient with glaucoma. Which drug is used to reduce intraocular pressure? a. tobramycin (Tobrex) b. bacitracin (AK-Tracin) c. ketorolac (Acular) d. mannitol (Osmitrol)

A. CNS depression

The nurse will monitor the patient who is taking a muscle relaxant for which adverse effect? A. CNS depression B. Hypertension C. Peripheral edema D. Blurred vision

C Hyperkalemia

The nurse would question the administration of testosterone to a patient with which condition? A Hypocalcemia B Hyponatremia C Hyperkalemia D Hypovolemia

A Deep vein thrombosis

The nurse would question the order for estrogen replacement therapy in a patient with a history of which condition? A Deep vein thrombosis B Vaginal bleeding C Weight loss D Dysmenorrhea

D. "These drops will cause your pupils to dilate, which makes the eye examination easier."

The ophthalmologist has given a patient a dose of ocular atropine drops before an eye examination. Which statement by the nurse accurately explains to the patient the reason for these drops? A. "These drops will cause the surface of your eye to become numb so that the doctor can do the examination." B. "These drops are used to check for any possible foreign bodies or corneal defects that may be in your eye." C. "These drops will reduce your tear production for the eye examination." D. "These drops will cause your pupils to dilate, which makes the eye examination easier."

A "Ropinirole is a dopamine agonist that has fewer side effects than carbidopa-levodopa."

The patient asks the nurse to explain the difference between carbidopa-levodopa (Sinemet) and ropinirole (Requip). How will the nurse respond? A "Ropinirole is a dopamine agonist that has fewer side effects than carbidopa-levodopa." B "Carbidopa-levodopa is less effective than ropinirole in treating the symptoms of Parkinson's disease." C "Both drugs have the same pharmacodynamic and side effect profiles." D "Carbidopa-levodopa acts as a dopamine agonist, whereas ropinirole directly replaces dopamine."

C "Fosphenytoin is converted to phenytoin once it is in your bloodstream. Since you are NPO, fosphenytoin is easier on your veins than phenytoin."

The patient asks the nurse why she is receiving a different drug than her usual phenytoin (Dilantin). The patient is NPO (nothing by mouth) secondary to illness and is receiving intravenous fosphenytoin (Cerebyx). Which is the nurse's most accurate response? A "Your serum phenytoin levels were not therapeutic, so your health care provider has changed your medication to a more effective drug." B "Phenytoin is not effective while you are NPO, so your health care provider has changed your medication to a more effective drug." C "Fosphenytoin is converted to phenytoin once it is in your bloodstream. Since you are NPO, fosphenytoin is easier on your veins than phenytoin." D "Since you are NPO, you cannot take phenytoin orally. Phenytoin does not come in an intravenous form. You will be transferred back to phenytoin after you recover from this illness."

D. Isosorbide dinitrate (Isordil), a nitrate

The patient has asked for a new prescription of sildenafil (Viagra), and erectile dysfunction drug. As the nurse reviews his current medications, which drug, if taken by the patient, would cause a significant interaction? A. Warfarin (Coumadin), an oral anticoagulant B. Amoxicillin (Amoxil), and antibiotic C. Esomeprazole (Nexium), a proton pump inhibitor. D. Isosorbide dinitrate (Isordil), a nitrate

C Competing at histamine receptor sites

The patient has been prescribed an ocular antihistamine, olopatadine (Patanol), for treatment of allergic conjunctivitis. The nurse knows the medication works though which action? A Vasoconstriction of blood vessels to reduce edema B Isotonic action to lubricate and reduce symptoms C Competing at histamine receptor sites D Inhibiting release of mast cells

A, D

The patient is beginning a new prescription of reloxifine (Evista). The nurse will teach the patient to expect which potential adverse effects? (SATA) A. Leg cramps. B. Loss of appetite C. Diarrhea. D. Hot flashes E. Drowsiness.

C. This medication should not even be handled by pregnant women because it may harm fetus.

The patient is taking finasteride (Proscar) for the treatment of benign prostatic hyperplasia. His wife, which is 3 months pregnant, is worried about the adverse effects that may occur with this drug. Which statement by the nurse is most important at this time? A. Gastric upset may be reduced if he takes this drug on an empty stomach. B. He should notice therapeutic effects of increased libido an erection within one month. C. This medication should not even be handled by pregnant women because it may harm fetus. D. He may experience transient hair loss while taking this medication.

C 12 mcg/mL

The patient receiving phenytoin (Dilantin) has a serum drug level drawn. Which level will the nurse note as therapeutic? A 8 mcg/mL B 30 mcg/mL C 12 mcg/mL D 6 mcg/mL

C "This is called the 'on-off phenomenon.' Your health care provider can change your medication regimen slightly to help diminish this effect."

The patient with Parkinson's disease who has been positively responding to carbidopa-levodopa (Sinemet) suddenly develops a relapse of symptoms. Which explanation by the nurse is appropriate? A "You have obviously developed resistance to your current medication and will have to be switched to another drug." B "This is an atypical response. Unfortunately, there are no other options of drug therapy to give you." C "This is called the 'on-off phenomenon.' Your health care provider can change your medication regimen slightly to help diminish this effect." D "You just need to keep taking your medication and these effects will go away."

B Malignant hyperthermia

The patient's chart notes the administration of dantrolene (Dantrium) immediately postoperatively. What does the nurse expect the patient has experienced? A Delirium tremens B Malignant hyperthermia C Tonic-clonic seizure D Respiratory arrest

D. Obesity

The physician has ordered orlistat (Xenical). The nurse recognizes that this drug is used to treat which condition? A. Anorexia B. Malnutrition C. Narcolepsy D. Obesity

D. reduces bleeding in the surgical area

The physician has requested "lidocaine with epinephrine." The nurse recognizes that the most important reason for adding epinephrine is that it A. helps to calm the patient before the procedure B. minimizes the risk of allergic reaction C. enhances the effect of the local lidocaine D. reduces bleeding in the surgical area

A. A 79-year-old woman who is about to have her gallbladder removed

The surgical nurse is reviewing operative cases scheduled for the day. Which of these patients is more prone to complications from general anesthesia? A. A 79-year-old woman who is about to have her gallbladder removed B. A 49-year-old male athlete who quit heavy smoking 12 years ago C. A 30-year-old woman who is in perfect health but has never had anesthesia D. A 50-year-old woman scheduled for outpatient laser surgery for vision correction

C. "It may take 4 to 6 weeks before you see an improvement."

The wife of a patient who has started taking antidepressant therapy asks, "How long will it take for him to feel better?" What is the nurse's best response? A. "Well, depression rarely responds to medication therapy." B. "He should be feeling better in a few days." C. "It may take 4 to 6 weeks before you see an improvement." D. "You may not see any effects for several months."

B. Maintain strict bedrest.

To decrease the possibility of a headache after a spinal anesthesia, the nurse will provide which instruction to the patient? A. Sit in high Fowler's position. B. Maintain strict bedrest. C. Limit fluids. D. Ambulate in the hall several times a day.

B Limit dietary intake of fat to <30% of total calories.

To reduce the gastrointestinal side effects of orlistat (Xenical), what will the nurse encourage the patient to do? A Take the medication with an antacid. B Limit dietary intake of fat to <30% of total calories. C Supplement diet with fat-soluble vitamins. D Increase fluid and fiber in the diet.

D risperidone (Risperdal)

What atypical antipsychotic medication would the nurse anticipate a provider prescribing for treatment of refractory schizophrenia? A trazodone (Desyrel) B phenelzine (Nardil) C amoxapine (Asendin) D risperidone (Risperdal)

C Ejaculatory dysfunction

What common side effect would the nurse include in the discharge teaching for a patient receiving finasteride (Proscar)? A Hair loss B Increased libido C Ejaculatory dysfunction D Muscle weakness

B Smoking cessation

What is another approved and indicated use for bupropion (Zyban), a second-generation antidepressant? A Orthostatic hypotension B Smoking cessation C Anorexia in patients undergoing chemotherapy D Nocturnal enuresis in children

C To balance cholinergic and dopaminergic activity in the brain

What is the goal of pharmacologic therapy in treating Parkinson's disease? A To increase the amount of acetylcholine at the presynaptic neurons B To decrease the amount of dopamine available in the substantia nigra C To balance cholinergic and dopaminergic activity in the brain D To block dopamine receptors in both presynaptic and postsynaptic neurons

C, E, F

What patient teaching is appropriate for a patient taking alendronate (Fosamax)? (SATA) A. Take with food. B. Taken at night just before going to bed. C. Take with an 8 ounce glass of water. D. Take with a sip of water. E. Take 1st thing in the morning upon arising. F. Do not lie down for at least 30 minutes after taking

B. Physical growth, especially weight

When a child is taking drugs for ADHD, what will the nurse instruct the caregivers to closely monitor in the child? A. Blood glucose levels B. Physical growth, especially weight C. Grades at school D. Respiratory rates

a. Decreased paranoia and delusions

When a patient is receiving a second-generation antipsychotic drug, such as risperidone (Risperdal), the nurse will monitor for which therapeutic effect? a. Decreased paranoia and delusions b. Fewer panic attacks c. Improved tardive dyskinesia d. Decreased feeling of hopelessness

d. Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth.

When a patient is taking an anticholinergic such as benztropine (Cogentin) as part of the treatment for Parkinson's disease, the nurse should include which information in the teaching plan? a. Discontinue the medication if adverse effects occur. b. Minimize the amount of fluid taken while on this drug. c. Take the medication on an empty stomach to enhance absorption. d. Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth.

A, C, D

When administering certain antipsychotic drugs, the nurse monitors for extrapyramidal effects such as: (SATA) A. tremors B. elation and a sense of well-being C. painful muscle spasms D. motor restlessness E. bradycardia

B Flush the line with normal saline before and after administration to prevent precipitation.

When administering intravenous phenytoin (Dilantin), which action will the nurse perform? A Always use an infusion pump. B Flush the line with normal saline before and after administration to prevent precipitation. C Administer through peripheral intravenous sites only. D Monitor for hypertension.

B, C, D, E

When applying ophthalmic drugs, the nurse will follow which instructions? (SATA) A. Apply drops directly onto the cornea. B. Apply drops into the conjunctival sac. C. Apply pressure to the inner can thus for 1 minute after medication administration. D. Apply ointments in a thin layer. E. Avoid touching the eye with the tip of the medication dropper.

A, C, D

When assessing a patient for adverse effects related to morphine sulfate, which effects would the nurse expect to find? (Select all that apply.) A Decreased peristalsis B Diarrhea C Delayed gastric emptying D Urinary retention

B. It causes miosis, or pupil constriction

When assessing a patient who is receiving a direct-acting cholinergic eye drop as part of treatment for glaucoma, the nurse anticipates that the drug effects the pupil in which way? A. It causes mydriasis, or pupil dilation B. It causes miosis, or pupil constriction C. It changes the color of the pupil D. It causers no change in pupil size

A, B, D, E

When assessing for otitis media, the nurse remembers that common symptoms of this condition include which of the following? (SATA) A. Pain B. Malaise C. Ear drainage D. Hearing loss E. Fever

A Insomnia

When assessing for side effects expected in a patient taking analeptics, the nurse would monitor for which effect? A Insomnia B Bradycardia C Hypotension D Decreased mental alertness

A Respiratory rate

When assessing for the most serious adverse reaction to a narcotic analgesic, what does the nurse monitor for in the patient? A Respiratory rate B Heart rate C Blood pressure D Mental status

A. They are not effective if the woman is already pregnant.

When combination oral contraceptives are given to provide post-coital emergency contraception, the nurse must remember which fact? A. They are not effective if the woman is already pregnant. B. They should be taken within 12 hours of unprotected intercourse. C. They are given in one dose. D. They are intended to terminate pregnancy.

D. Ointment

When considering the variety of OTC topical corticosteroid products, the nurse is aware that which type of preparation is generally most penetrating and effective? A. Gel B. Lotion C. Spray D. Ointment

C "The different color pills are due to different amounts of hormones in each week."

When educating a patient about the use of oral contraceptives, the nurse provides what explanation for the pills having different colors each week? A "They help you remember which week you are taking." B "There isn't a reason for the color, just the choice of the drug company." C "The different color pills are due to different amounts of hormones in each week." D "They are color coded for the weeks of the month."

B. Permanent eye color changes, from light eye colors to brown.

When giving lantoprost (Xalatan) eye drops, the nurse will advise the patient of which possible adverse effects? A. Temporary eye color changes, from light eye colors to brown. B. Permanent eye color changes, from light eye colors to brown. C. Photosensitivity D. Bradycardia and hypotension.

B. Insert once daily at bedtime for 7 consecutive days.

When instructing a patient on how to use miconazole (Monistat) vaginal cream for vaginal yeas infections, the nurse will keep in mind that this medication will be given in which manner? A. Insert once every other day at bedtime for 1 week. B. Insert once daily at bedtime for 7 consecutive days. C. A one-time dose is administered in the morning. D. Insert every night at bedtime until symptoms stop.

D silver sulfadiazine (Sulfadine)

When planning care for a burn patient, the nurse would anticipate applying which topical medication? A erythromycin (E-Mycin) B lindane C minoxidil (Rogaine) D silver sulfadiazine (Sulfadine)

A. produces sleep

When reviewing actions of drugs, the nurse recognizes that a hypnotic is a drug that performs which action? A. produces sleep B. Stops seizures C. Prevents nausea and vomiting D. Relieves pain

B. To improve cervical ripening near term for labor induction

When reviewing an order for dinoprostone cervical gel (prepidil), the nurse recalls that this drug is used for which purpose? A. To induce abortion during the 3rd trimester. B. To improve cervical ripening near term for labor induction C. To soften the cervix in women who are experiencing infertility problems. D. To reduce postpartum uterine atony and hemorrhage

B, C, E

When reviewing the health history of a patient who wants to begin taking oral contraceptives, the nurse recalls that, which conditions are contraindications to this drug therapy? (SATA) A. Multiple sclerosis B. Pregnancy. C. Thrombophlebitis disorders. D. Hypothyroidism. E. Estrogen-dependent cancers.

C. Allergy to sulfa drugs

When reviewing the medical record of a patient with a new order for a carbonic anhydrase inhibitor, the nurse knows that which condition would be a potential problem for a patient taking this drug? A. Glaucoma B. Ocular hypertension C. Allergy to sulfa drugs D. Allergy to penicillin

A Carbidopa decreases levodopa's conversion in the periphery, increasing the levodopa available to cross the blood-brain barrier.

When teaching a patient about carbidopa-levodopa (Sinemet), what information will the nurse include in the teaching? A Carbidopa decreases levodopa's conversion in the periphery, increasing the levodopa available to cross the blood-brain barrier. B Carbidopa increases levodopa's conversion in the periphery, enhancing the amount of dopamine available to the brain. C Giving both drugs together minimizes side effects. D Carbidopa crosses the blood-brain barrier to increase the metabolism of levodopa to dopamine in the brain.

c. "Regular, consistent dosing is important for successful treatment."

When teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, the nurse will include which instruction? a. "Driving is allowed after 2 weeks of therapy." b. "If seizures recur, take a double dose of the medication." c. "Regular, consistent dosing is important for successful treatment." d. "Antacids can be taken with the AED to reduce gastrointestinal adverse effects."

a. "Apply the drops into the conjunctival sac instead of directly onto the eye."

When teaching a patient about the proper application of timolol (Timoptic) eyedrops, the nurse will include which instruction? a. "Apply the drops into the conjunctival sac instead of directly onto the eye." b. "Tilt your head forward before applying the eyedrops." c. "Apply the drops directly to the eyeball (cornea) for the best effect." d. "Blot your eye with a tissue immediately after applying the drops."

C Place the patch on clean, dry, shaved scrotal skin.

When teaching a patient regarding proper application of a Testoderm transdermal patch, the nurse will instruct the patient to perform which action? A Replace the patch every 72 hours. B Replace the patch every 36 hours. C Place the patch on clean, dry, shaved scrotal skin. D Place the patch on the back, abdomen, upper arms, or thigh.

B. Nausea

When teaching a patient who is taking oral contraceptive therapy for the first time, the nurse relates that adverse effects may include which of the following? A. Dizziness B. Nausea C. Tingling in the extremities D. Polyuria

B, E

When the Testoderm form of testosterone is ordered to treat hypogonadism in a teenage boy, which instruction by the nurse are correct? (SATA) A. Place the patch on clean, dry skin on the back, upper arms, abdomen or thighs. B. Place the patch on clean, dry scrotal skin that has been shaved. C. Place the patch on clean, dry scrotal skin, but do not shave the skin first. D. Place the patch on any clean, dry, nonhairy area of the body. E. Remove the old patch before applying a new patch.

b. Decreasing intraocular pressure

When the nurse is providing teaching about eye medications for glaucoma, the nurse tells the patient that miotics help glaucoma by which mechanism of action? a. Decreasing intracranial pressure b. Decreasing intraocular pressure c. Increasing tear production d. Causing pupillary dilation

A. "This is a very dilute solution and acts to reduce the bacteria in the wound so that it can heal."

When the nurse is providing wound care with Dakin's solution for a patient who has a stage III pressure ulcer, the patient exclaims, "I smell bleach! Why are you putting bleach on me?" The nurse's best explanation is: A. "This is a very dilute solution and acts to reduce the bacteria in the wound so that it can heal." B. "This solution is used instead of medication to promote wound healing." C. "This solution is used to dissolve the dead tissue in your wound." D. "Don't worry; we would never use bleach on a patient!"

B. "This medication actually causes skin peeling."

When the nurse is teaching a patient about the mechanism of action of tretinoin, which statement by the nurse is correct? A. "This medication acts by killing the bacteria that cause acne." B. "This medication actually causes skin peeling." C. "This medication acts by protecting your skin from UV sunlight." D. "This medication has anti-inflammatory actions."

A. The smallest dose that is affected will be prescribed.

When the nurse is teaching patients about postmenopausal estrogen replacement therapy which statement is correct? A. The smallest dose that is affected will be prescribed. B. Oral forms should be taken on an empty stomach for best absorption. C. Estrogen therapy should be long-term to prevent menopausal symptoms. D. If estrogen is taken, supplemental calcium will not be needed.

C Eating aged cheese

Which activity should the patient be cautioned to avoid while taking an MAO inhibitor? A Participating in a bowling league B Sunbathing at the pool C Eating aged cheese D Smoking a low-nicotine cigarette

C selegiline

Which antiparkinson drug causes an increase in the levels of dopaminergic stimulation in the central nervous system and therefore allows a decreased dose of other medications? A levodopa B carbidopa C selegiline D diphenhydramine

C. Angle-closure glaucoma

Which condition will alert the nurse to a potential caution or contraindication regarding the use of a dopaminergic drug for treatment of mild Parkinson's disease? A. Diarrhea B. Tremors C. Angle-closure glaucoma D. Unstable gait

C, E

Which considerations are important for the nurse to remember when administering a benzodiazepine as a sedative hypnotic drug? (SATA) A. These drugs are intended for long-term management of insomnia B. These drugs can be administered safely with other CNS depressants for insomnia C. The dose needs to be given about 1 hr before the patient's bedtime D. The drug is used as a first choice for treatment of sleepiness E. The pt needs to be evaluated for the drowsiness that may occur the morning after benzodiazepine is taken

A, C, E

Which drug classes are used as adjunctive drugs with anesthesia? (SATA) A. Sedative-hypnotics B. Anticonvulsants C. Anticholinergics D. Inhaled gas E. Opioid analgesics

A. amantadine (Symmetrel)

Which drug may be used early in the treatment of Parkinson's disease but eventually loses effectiveness and must be replaced by another drug? A. amantadine (Symmetrel) B. levodopa (Larodopa) C. selegiline (Eldepryl) D. tolcapone (Tasmar)

D. Selegiline (Eldepryl)

Which drug may be used prophylactically to delay the development of the debilitation of Parkinson's disease for up to 18 years? A. levodopa (Larodopa) B. Benztropine (Cogentin) C. Carbidopa (Lodosyn) D. Selegiline (Eldepryl)

B Increased protein synthesis

Which is a pharmacodynamic effect of exogenous androgens? A Decreased erythropoiesis B Increased protein synthesis C Increased nitrogen excretion D Decreased sperm production

B oxytocin

Which is the most common drug used for induction of labor in pregnant women and to promote ejection of milk during lactation? A clomiphene B oxytocin C misoprostol D mifepristone

B Complete blood count

Which laboratory test should be monitored frequently to assess for a potential life-threatening adverse reaction to clozapine (Clozaril)? A Renal panel B Complete blood count C Liver function tests D Immunoglobulin levels

B Liver function tests

Which laboratory test would the nurse expect to be ordered to monitor a patient for adverse effects related to progestin medications? A Cardiac enzymes B Liver function tests C BUN and creatinine D Complete blood count

A naloxone (Narcan)

Which medication is used to treat a patient suffering from severe adverse effects of a narcotic analgesic? A naloxone (Narcan) B acetylcysteine (Mucomyst) C methylprednisolone (Solu-Medrol) D flumazenil (Romazicon)

C Risk for injury

Which nursing diagnosis is appropriate for a patient who has received a sedative-hypnotic drug? A Ineffective peripheral tissue perfusion B Fluid volume excess C Risk for injury D Risk for infection

D. Impaired gas exchange due to the CNS depressant effect of general anesthesia

Which nursing diagnosis is possible for a patient who is now recovering after having been under general anesthesia for 3 to 4 hours during surgery? A. Impaired urinary elimination related to the use of vasopressors as anesthetics B. Increased cardiac output related to the effects of general anesthesia C. Risk for falls related to decreased sensorium for 2 to 4 days postoperatively D. Impaired gas exchange due to the CNS depressant effect of general anesthesia

B Turning, coughing, and deep breathing every 2 hours

Which postoperative nursing action will help the patient recover from the effects of anesthesia? A Ambulating once a day B Turning, coughing, and deep breathing every 2 hours C Forcing fluids to 400 mL per shift D Administering loperamide (Imodium) as needed

A. Ataxia

Which response would the nurse to expect to find in a patient with a phenytoin (Dilantin) level of 35 mcg/mL? A. Ataxia B. Hypertension C. Seizures D. No unusual response; this level is therapeutic.

A. The length of treatment required to eradicate the organism may be from several weeks to as long as a year.

Which statement accurately describes antifungal therapy for topical infections? A. The length of treatment required to eradicate the organism may be from several weeks to as long as a year. B. Antifungal therapy works best when the affected area is exposed to sunlight. C. Oral drugs are the preferred drugs for treating topical fungal infections. D. Antifungal therapy is palliative only; fungi are rarely eradicated from topical areas.

B CNS stimulants increase release of and block reuptake of neurotransmitters.

Which statement correctly identifies the pharmacodynamics of CNS stimulants? A CNS stimulants decrease the production of excitatory neurotransmitters. B CNS stimulants increase release of and block reuptake of neurotransmitters. C CNS stimulants block the activity of inhibitory neurons. D CNS stimulants enhance the effects of phosphodiesterase and subsequent breakdown of cyclic adenosine monophosphate (cAMP).

C "It is okay to take this drug with a small glass of wine to help relax me."

Which statement made by a patient demonstrates a lack of understanding of patient teaching regarding phenothiazine drug therapy? A "I need to change positions slowly to prevent dizziness." B "I will need to wear sunscreen and protective clothing when outdoors." C "It is okay to take this drug with a small glass of wine to help relax me." D "I should call my doctor if I notice any uncontrollable movements of my tongue."

C "I will rinse the eyedropper with tap water after each use."

Which statement, made by a patient, indicates the need for further patient teaching regarding proper administration of eyedrops? A "I will put pressure on the inside corner of my eye after I administer the drops." B "I will be careful not to touch my eye with the dropper." C "I will rinse the eyedropper with tap water after each use." D "I will turn my head slightly toward the outside of the eye I am putting the drops in."

C "I will take the medication first thing in the morning with 8 ounces of water and remain upright for 30 minutes."

Which statement, made by the patient, indicates an understanding of discharge teaching regarding alendronate (Fosamax)? A "I need to decrease my intake of dairy products so as to prevent hypercalcemia." B "I need to take this medication with food to prevent damage to my esophagus." C "I will take the medication first thing in the morning with 8 ounces of water and remain upright for 30 minutes." D "This medication will help relieve the bone pain I have from my osteoporosis."

B acetylcysteine (Mucomyst)

While admitting a patient for treatment of an acetaminophen overdose, the nurse prepares to administer which medication to prevent toxicity? A naloxone (Narcan) B acetylcysteine (Mucomyst) C methylprednisolone (Solu-Medrol) D vitamin K

B. Infiltration

While assisting with a procedure in the ED, the nurse prepares lidocaine (Xylocaine) for use with which type of anesthesia? A. Moderate sedation B. Infiltration C. Intravenous D. General

A Rebound seizure activity

While completing discharge activity for a patient prescribed an antiepileptic drug, the nurse instructs the patient that what potential complication could occur if he or she abruptly stopped taking the antiepileptic drug? A Rebound seizure activity B Acute withdrawal syndrome C Hypotension D Confusion and delirium

A produces deep muscle relaxation and loss of consciousness.

While completing preoperative patient teaching, the nurse explains that general anesthesia A produces deep muscle relaxation and loss of consciousness. B results in moderate sedation in which the patient can follow commands but will not remember anything following the procedure. C provides anesthesia to a specific region of the body and generalized sedation. D typically is achieved using only one type of medication.

c. Malignant hyperthermia

While monitoring a patient who had surgery under general anesthesia 2 hours ago, the nurse notes a sudden elevation in body temperature. This finding may be an indication of which problem? a. Malignant hypertension b. Tachyphylaxis c. Malignant hyperthermia d. Postoperative infection

D. Respiratory arrest

While monitoring a patient who took an overdose of barbiturates, the nurse keeps in mind that the cause of death would be which of these? A. Tachycardia B. Hypertension C. Dyspnea D. Respiratory arrest

A Absence seizures

While obtaining a patient history, the nurse notes that the patient has been prescribed ethosuximide (Zarontin). Which condition will the nurse suspect that the patient experiences? A Absence seizures B Tonic-clonic seizures C Panic attacks D Partial seizures

C Anesthetic-induced complications

While taking a patient's history prior to surgery for a cardiac problem, the patient informs the nurse he is addicted to cocaine. The nurse alerts the anesthesiologist of the finding because the nurse knows the use of cocaine can cause which effect when a patient is under anesthesia? A Immediate withdrawal symptoms B Blood-clotting problems C Anesthetic-induced complications D Complications during recovery

A. mastoiditis

While teaching a patient about treatment of otitis media, the nurse should mention that untreated otitis media may lead to A. mastoiditis B. Throat infections C. Fungal ear infection D. Decreased cerumen production

C Maximally reducing seizure activity while minimizing side effects of medication therapy.

While teaching a patient newly diagnosed with a seizure disorder, what does the nurse state as the goal of pharmacologic therapy of this medication? A Eradicating all seizure activity and then weaning off medication once the patient is seizure free for 3 months. B Reducing seizure occurrence to one per week. C Maximally reducing seizure activity while minimizing side effects of medication therapy. D Maximizing drug dosages to control seizure activity.