Pharmacology Exam 9
when giving a vaccination to an infant the nurse will tell the mother to expect which adverse defect? a. fever over 101°F (38.3°C) b. rash C. soreness at the injection site D. chills
c
when receiving the various types of anti-nausea medications the nurse recognizes that prokinetic drugs are also used for a. motion sickness b. vertigo c. delayed gastric emptying d. GI obstruction
c
the nurse is providing wound care for a patient with a stage 4 pressure ulcer and expects that the patient will receive which supplements to assist in wound healing? (Select all that apply.) a. vitamin K b. vitamin B1 c. zinc d. calcium e. vitamin C
c e
Mr. A. has called to ask which antacid he should take. He has been to the store and is confused by the great variety on the shelves. He says he needs something for "occasional heartburn" when he eats something too spicy. He has a history of heart failure and is taking antihypertensive drugs. What type of antacid should he take, and what other instructions will he need?
Patients with heart failure or hypertension need to use antacids that are low in sodium. Suggest an aluminum-based antacid. Instruct patients to take the antacid alone, not at the same time as other medications (unless specifically instructed to do so) because the antacid will interfere with the absorption of the other medications. Antacids should be taken 1 hour before or 1 to 2 hours after other medications. If symptoms continue or worsen, consult the health care provider.
the nurse will assess which laboratory test results before administration of vitamin K? a. Prothrombin time and international normalized ratio b. red blood cell and white blood cell counts c. phosphorus and calcium levels d. total protein and albumin levels
a
when the nurse teaches a patient about taking bisacodyl tablets which instruction is correct? a. take this medication on an empty stomach b. cheetah tablet for quicker onset of actions c. take this medication with juice or milk d. take this medication with an antacid if it upsets your stomach
a
while caring for a newly admitted patient who has a long history of alcoholism the nurse anticipates that part of the patient's medication regimen will include which vitamin? a. vitamin B1 (thiamine) b. vitamin B6 (pyridoxine) c. vitamin C (ascorbic acid) d. vitamin A (retinol)
a
The nurse is giving medication to reduce nausea. Which antiemetic drug class is known to cause drying of secretions and drowsiness when given? (Select all that apply.) a. Antihistamines b. Antidopaminergic drugs c. Serotonin blockers d. Tetrahydrocannabinoids e. Anticholinergics
a b d e
The nurse is reviewing the use of bismuth subsalicylate (Pepto-Bismol). This medication would be the most appropriate choice for which patient? a. A 7-year-old child who has chickenpox b. A 23-year-old woman who has severe abdominal pain c. A 45-year-old man who is complaining of constipation d. A 58-year-old man who developed diarrhea after traveling out of the country
d
The nursing student would correctly identify which site as the storage location for the fat soluble vitamins? a. The pancreas b. The bone marrow c. The spleen d. The liver
d
Three days after beginning therapy with oral iron tablets, a patient calls the office, saying, "I'm very worried because my bowel movements are black!" What will the nurse do? a. Instruct the patient to stop the iron tablets for a week. b. Instruct the patient to take the tablets every other day instead of daily. c. Ask the patient to come into the office for a checkup. d. Explain to the patient that this is an expected effect of the medication.
d
When reviewing the diet of a patient who has a calcium deficiency, the nurse recalls that efficient absorption of calcium in the diet requires adequate amounts of which substance? a. Magnesium b. Intrinsic factor c. Coenzymes d. Vitamin D
d
When reviewing the drugs used for nausea and vomiting, the nurse recalls that which drug is a synthetic derivative of the major active substance in marijuana? a. Ondansetron (Zofran) b. Metoclopramide (Reglan) c. Prochlorperazine (Compazine) d. Dronabinol (Marinol)
d
Which drug class would be used as first-line therapy for gastroesophageal reflux disease (GERD) that has not responded to customary medical treatment? a. H2 blockers b. Antacids c. Mucosal protectants d. Proton pump inhibitors
d
Which substance contains microorganisms that trigger the formation of antibodies against specific pathogens? a. Antivenin b. Serum c. Toxoid d. Vaccine
d
A patient asks for an over-the-counter medication that will provide rapid relief of constipation. After ruling out possible contraindications, which drug would be most appropriate? a. Psyllium (Metamucil) b. Methylcellulose (Citrucel) c. Docusate sodium (Colace) d. Magnesium hydroxide (Milk of Magnesia)
d
A patient calls in to the clinic to ask for something for his upset stomach. He admits to "eating a lot of food that's bad for me" the night before and wants something to help him to feel better. The nurse expects which drug will be most appropriate for this patient? a. Metoclopramide (Reglan) b. Prochlorperazine (Compazine) c. Aprepitant (Emend) d. Phosphorated carbohydrate solution (Emetrol)
d
A patient has been taking alosetron (Lotronex) for 3 weeks as part of treatment for irritable bowel syndrome. Today she calls the clinic to report that she has been experiencing constipation. The nurse will expect which priority action to be taken? a. The dose will be increased by 1 mg. b. The patient will be told to take a bulk-forming laxative. c. The patient will be given Milk of Magnesia to relieve the constipation quickly. d. The drug will be discontinued immediately.
d
A patient has ingested an excessive amount of water-soluble vitamins. The nurse expects what to happen? a. The body will store them in muscle and fat tissue until needed. b. They are stored in the liver until needed. c. They circulate in the blood, bound to proteins, until needed. d. Excess amounts are excreted in the urine.
d
1. Drugs known as H2 blockers that reduce acid secretion in the stomach
h. histamine type 2 receptor antagonists
4. A condition caused by a vitamin D deficiency that is characterized by soft, pliable bones
h. rickets
7. A condition resulting from an ascorbic acid deficiency
i. scurvy
3. Generic name for a cytoprotective drug
i. sucralfate
The order reads: "Give prochlorperazine (Compazine) 10 mg IM every 4 hours as needed for nausea. Maximum of 4 doses/day." The medication is available in an ampule that contains 5 mg/mL.
2 mL
A newborn will be receiving her first dose of hepatitis B vaccine (inactivated). The dose is 5 mcg IM at birth and then again at 1 month and 6 months. Five mcg is equivalent to how many mg?
0.005 mg
the order reads: "give vitamin K (Aquamephyton) 0.5 mg IM within 1 hour of birth." The medication is available in a vial that contains 1 mg/0.5 mL. How many milliliters will the nurse draw up for the injection?
0.25 mL
the order reads: "give promethazine (Phenergan) 12.5 mg IM q4h PRN nausea/vomiting. The medication is available in 25-mg/mL vials. How many milliliters will the nurse draw up for this dose?
0.5 mL
A patient will be receiving epoetin alfa (Epogen) 150 units/kg, subcutaneously, three times a week. The patient weighs 110 lb. The medication is available in a concentration of 10,000 units/mL. How many milliliters will the nurse administer for each dose? (Record answer using two decimal places.)
0.75 mL
the order reads: "give epoetin alfa (Epogen), 3500 units subcut 3 times a week." The medication is available in a vial that contains 4000 units/mL. How many milliliters will the nurse draw up with the ordered dose? (Record your answer using two decimal places.)
0.88 mL
A 5-year-old child who is receiving hemodialysis is to receive eight doses of sodium ferric gluconate (Ferrlecit) 1.5 mg/kg IV, with future dialysis sessions. The child weighs 38 lb. How many milligrams is each dose? (Record answer using a whole number.)
26 mg
The order reads, "Give vitamin K (AquaMEPHYTON) 2 mg subcutaneously now." The patient is a child, age 5 years. The medication is available in an ampule, 1 mg/0.5 mL. How many milliliters will the nurse draw up for the injection
1 mL
A patient is to receive 1 L of D5W with one ampule of multivitamins over the next 10 hours. The nurse will set the infusion pump at what rate for this IV infusion?
100 mL/hr
Mrs. S. will be taking iron for treatment of anemia, and her provider instructed her to take it with orange juice. She asks the nurse for an explanation of this. What will the nurse tell her?
1Orange juice contains ascorbic acid (vitamin C), which enhances the absorption of iron.
A patient is to receive cimetidine (Tagamet), 300 mg IVPB twice a day. The medication is available in a concentration of 150 mg/mL. How many milliliters will the nurse draw up to prepare for the IVPB dose?
2 mL
the order reads give: "cimetidine (Tagamet) 300 mg in 100 ml normal saline IVPB tid and at bedtime. Infuse over 30 minutes." The infusion pump can only be programmed to deliver over 60 minutes (mL per hour). The nurse will set the pump to deliver how many mL/hour for each IVPB dose?
200 mL/hour
The patient is to receive pantoprazole (Protonix) 40 mg, mixed in 100 mL of D5W over 30 minutes, IV. The nurse will set the infusion pump to what rate?
200 mL/hr
After Mr. W. is treated for colitis with a broadspectrum antibiotic, he begins to show signs of hypoprothrombinemia caused by vitamin K deficiency. How did this happen, and how will he receive supplements?
Broad-spectrum antibiotics can inhibit the intestinal flora, which provide the body with vitamin K2. As a result, a deficiency may occur. Vitamin K can be given either orally or by injection in adults.
A patient is about to receive his first chemotherapy treatment with a drug that is known to cause nausea and vomiting. One of the premedication orders reads, "Give ondansetron (Zofran) PO 24 mg one-half hour before chemotherapy begins." The medication is ordered in a syrup that contains 4 mg/5 mL because the patient does not like to take pills. How many milliliters of medication will the nurse administer for this dose?
30 mL
The order for a child reads: "Give lactulose (Chronulac) 5 g, PO daily after breakfast." The medication is available as an oral solution in a unitdose package that contains 10 g/15 mL. How many milliliters will the nurse administer per dose?
7.5 mL
the order for an adult who needs passive Hepatitis B prophylaxis reeds give Hepatitis B immunoglobulin (BayHep B) 0.06 mg/kg IM now, and then again in 30 days. The patient weighs 176 pounds. How many milligrams will this patient receive per dose?
4.8mg per dose
Mr. S. is taking enteric-coated aspirin for mild arthritis symptoms. He tells the nurse that he plans to take the aspirin with his favorite antacid, Maalox, because he does not want any stomach problems. What will the nurse tell him?
Antacids may promote premature dissolving of the enteric coating; if the coating is destroyed early in the stomach, gastrointestinal (GI) upset may occur. He needs to take the aspirin tablets with food, not with antacids.
Mr. P. is prescribed intramuscular iron dextran. However, before the nurse can give him his first injection, the pharmacist suggests that she give him a smaller dose of 25 mg first. Why does the pharmacist suggest this? How should intramuscular iron dextran be administered?
Anyone who is about to receive a first dose of iron dextran is at risk for fatal anaphylaxis. Because of this, a test dose of 25 mg of iron dextran should be administered by the chosen route and appropriate method. An anaphylactic reaction may occur within a few moments, although waiting at least 1 hourbefore giving the rest of the initial dose is recommended. Intramuscular iron is to be administered deep in a large muscle mass using a Z-track method and a 23-gauge, 1 1/2-inch needle.
Mr. S. brings his toddler, Carl, in for a 12-month well-child checkup. Before the nurse gives the measles, mumps, and rubella (MMR) vaccine injection, what adverse effects will she tell Mr. S. to watch for in Carl's response to the immunization? What can be done to relieve these adverse effects?
Carl may experience localized swelling, redness, discomfort, and warmth at the injection site. Acetaminophen and rest are recommended for the relief of these side effects, and application of warm compresses to the injection site may also help ease some of the discomfort.
Anna has called the health clinic in a panic. She says that she has been taking Pepto-Bismol for diarrhea and noticed this morning that her tongue "is a funny color." She asks, "Have I overdosed on this stuff? What should I do?" What will the nurse tell Anna?
Darkening of the tongue or stool is a temporary and harmless side effect associated with the use of bismuth subsalicylate (Pepto-Bismol).
Mrs. S. has developed vitamin D deficiency as a result of long-term use of lubricant laxatives. She is advised to take supplements for her vitamin D deficiency. However, her health care provider also advises her to get vitamin D through more natural sources. Explain the "natural sources" of vitamin D.
Dietary sources of vitamin D include fish oils, salmon, sardines, and herring; fortified milk, bread, and cereals; and animal livers, tuna, eggs, and butter. In addition, vitamin D is synthesized in the skin through exposure to ultraviolet radiation (sunshine).
Chuck, age 33 years, is in a later stage of AIDS. He has lost much weight and has no appetite. His physician has prescribed dronabinol (Marinol). When Chuck finds out that this medication is derived from marijuana, he becomes very upset. "Why is the doctor giving me pot?" he asks. What will the nurse explain?
Dronabinol is a synthetic derivative of the major active substance in marijuana. The nurse explains to him that it is used to stimulate appetite and weight gain in patients with acquired immunodeficiency syndrome (AIDS).
Mrs. T., an 82-year-old widow, is in the office for a follow-up appointment to evaluate her emphysema. The physician recommends that she have an influenza virus vaccine. As the nurse prepares the injection, Mrs. T. says, "I had a flu shot last year—why do I need another one this year?" What is the nurse's explanation to her?
Each year a new influenza vaccine is developed that contains three influenza virus strains that represent the strains most likely to circulate in the United States in the upcoming winter. The vaccination from the previous year may not be effective for the influenza virus strains occurring in the current year.
Connie, age 58 years, is in the hospital because of extreme weakness. She has a history of chronic renal failure, and there is a new order for epoetin alfa (Epogen). What laboratory results are monitored during epoetin therapy, and why?
Hemoglobin level and hematocrit are to be monitored carefully. If therapy is not halted when the target hemoglobin level of 12 g/dL is reached or if the hemoglobin level and hematocrit rise too quickly, hypertension and seizures can result.
Mrs. K. is advised to take omeprazole (Prilosec) capsules to treat her severe case of GERD; nothing else has worked. Develop a patient teaching plan that will instruct Mrs. K. about how to take this medication.
Omeprazole must be taken 30 to 60 minutes before meals, and the capsule must be taken whole, not crushed, opened, or chewed. Omeprazole may also be given with antacids, if ordered.
Hillary has come to the physician's office complaining of constipation. During the nurse's assessment, Hillary mentions that she recently started graduate school and has not had time lately to keep up her usual exercise regimen and that her diet "is a disaster." She says that, on some days, all she has time to do is grab a milkshake or cheese and crackers at the student center. She also tells the nurse that she has been taking antacids for "heartburn." What might be causing Hillary's constipation?
Several factors may be causing Hillary's constipation, including lack of proper exercise, poor diet (which might involve inadequate roughage and an excess of dairy products), use of aluminum containing antacids, and stress.
Emily, age 25 years, has stepped on a rusty piece of metal and will be receiving a tetanus booster after the wound is cleansed and stitched. Her last tetanus booster, a Td, was 10 years ago. Which booster is she likely to receive today? Explain your answer.
She will most likely receive the DTaP (diphtheria, tetanus, and acellular pertussis vaccine [Adacel]). With the recent increase in cases of pertussis, DTaP is recommended for adults in place of tetanus diphteria, which lacks the pertussis component.
Jim, a cabinetmaker, is cut by a woodworking tool and comes to the clinic for stitches. When the nurse asks him about his tetanus vaccination history, he says, "I have no idea when my last tetanus shot was—I thought once I had all the shots for school that I was set for life! Surely I don't need any more." What will the nurse explain to Jim?
Sometimes, after vaccination, the levels of antibodies against a particular pathogen decline over time, and a second dose of the vaccine is given to restore the antibody titers to a level that can protect the person against the infection. This second dose is referred to as a booster shot.
What are the advantages of receiving ferric gluconate (Ferrlecit) or iron sucrose (Venofer) injections instead of iron dextran?
The risk of anaphylaxis for both drugs is much less than with iron dextran, and a test dose is not required.
Nellie has been prescribed prochlorperazine (Compazine) via an intramuscular injection. She is on "nothing by mouth" status and has no intravenous access at this time. The nurse is preparing the injection when Nellie says, "I hate shots. Can't I just take it by mouth?" What alternatives are there for this drug, and what will the nurse do?
This drug comes in oral, intramuscular, intravenous, and rectal forms, but because she was on "nothing-by-mouth" status and has no intravenous access, the intramuscular route was ordered. The nurse can call Nellie's health care provider to obtain an order for an alternate route but cannot change the route without an order because the dosage may also be different.
Mr. G. is hospitalized with severe hypocalcemia and will be receiving intravenous calcium. What are the safety concerns when giving intravenous calcium?
To avoid venous irritation, give intravenous (IV) calcium via an IV infusion pump and with proper dilution. Giving IV calcium too rapidly may precipitate severe hypercalcemia with subsequent cardiac irregularities, delirium, and coma. Administer IV calcium slowly, as ordered, and within the manufacturer guidelines (e.g., usually less than 1 mL/min). Patients need to remain recumbent for 15 minutes after the infusion to prevent further problems. If extravasation of the IV calcium solution occurs, discontinue the infusion immediately but leave the IV catheter in place for antidote administration. The prescriber may then order an injection of 1% procaine or other antidotes or fluids to reduce vasospasm at the site and dilute the irritating effects of calcium on surrounding tissue. However, follow all facility policies and procedural guidelines and manufacturer insert information as deemed appropriate.
Mrs. B. is a 65-year-old retiree with osteoporosis and narrow-angle glaucoma. She has recently developed diarrhea, and the physician is considering antidiarrheal therapy. Mrs. B. tells the nurse that her husband recently "had a bout of diarrhea" for which he took Donnatal. Mrs. B. wonders whether Donnatal would help in her case. What will the nurse tell her?
Use of the belladonna alkaloid preparations, such as Donnatal, is contraindicated in patients with narrow angle glaucoma. She should not use this drug.
A neighbor, Mr. M., comes over to get advice on antacids. He says he has taken Maalox "for years" for indigestion, but it is no longer helping. He asks the nurse, "Can you recommend another antacid or one of those expensive, fancy pills that the pharmacy sells? Or should I just take baking soda?" How will the nurse respond?
You need to let him know that long-term selfmedication with antacids may mask symptoms of serious underlying diseases. He needs to be evaluated for possible bleeding ulcer or even a malignancy, but you may not want to scare him with those possibilities! If his current self-treatment is no longer working, he needs a medical evaluation. Advise him not to take the baking soda but to instead see his provider.
The nurse is preparing to give a second dose of DTaP vaccine to a 6-month-old infant. The infant's mother tells the nurse that the last time he received this vaccination, the injection site on his leg became warm and slightly reddened. Which is the nurse's best action? a. Explain that these effects can be expected and give the medication. b. Give half the prescribed dose this week and the other half next week if tolerated well. c. Skip the dose and notify the physician. d. Wait 6 months and then administer the dose.
a
The nurse is preparing to give iron sucrose (Venofer) to a 58-year-old patient and will monitor for which common adverse effect? a. Hypotension b. Dyspnea c. Itching d. Cramps
a
The nurse will teach a patient who is self-treating with bismuth subsalicylate (Pepto-Bismol) to avoid which drug because of the possibility of toxicity? a. Aspirin b. Acetaminophen (Tylenol) c. Calcium supplements d. Vitamin tablets
a
Which laboratory finding would indicate to the nurse that the patient is responding favorably to epoetin alfa? a. An increase in reticulocytes b. A decrease in clotting time c. An increase in platelets d. A decrease in leukocytes.
a
a middle-aged woman is experiencing severe vertigo. the nurse expects this patient will receive which drug, which is considered the most appropriate drug treatment for vertigo? a. Meclizine (antivert) b. Prochlorperazine (Compazine) c. metoclopramide (Reglan) d. dronabinol (Marinol)
a
a patient who is taking oral tetracycline complains of heartburn and request an antacid. Which action by the nurse is correct? a. give the tetracycline but delay the antacid for 1 to 2 hours b. give the antacid but delay the tetracycline for at least 4 hours c. administer both medications together d. explain that the antacid can not be given while the patient is taking the tetracycline
a
a patient with renal failure has severe anemia and there is an order for darbepoetin (aranesp). As the nurse assesses patient which condition listed will the nurse consider a contraindication to use of this medication? a. uncontrolled hypertension b. diabetes mellitus c. hypothyroidism d. angina
a
the nurse is administering an intravenous dose of iron dextran. For which potential adverse effect is it most important for the nurse to monitor at this time? a. anaphylaxis b. gastrointestinal distress c. black tarry stools d. bradycardia
a
the nurse is assessing a patient who has been recently admitted to the hospital after living on the streets for over 1 year. The nurse notes that the patient has severely chapped and fissured lips. This could be a sign of which vitamin deficiency? a. vitamin B2 (riboflavin) b. vitamin B6 (pyridoxine) c. vitamin C (ascorbic acid) d. vitamin E (tocopherols)
a
The nurse is providing patient teaching to a 24-yearold woman regarding the human papillomavirus (HPV) vaccine. Which statement by the woman indicates that more teaching is needed? (Select all that apply.) a. "This vaccine only takes one injection." b. "I need to have this vaccine before I turn 26." c. "It is safe to take this vaccine if I am pregnant." d. "This vaccination prevents the virus that commonly causes genital warts." e. "My 13-year-old sister should take this vaccine, too."
a c
a patient has been instructed to use an over-the-counter (OTC) form of the bulk forming laxatives methylcellulose (citrucel) to prevent constipation. The nurse will advise the patient of the potential adverse effects including, (select all that apply) a. electrolyte imbalances b. decrease absorption of vitamins c. gas formation d. darkened stools e. discolored urine
a c
when the nurse is administering a proton pump inhibitor (PPI), which actions by the nurse are correct? Select all that apply. a. giving the PPI on an empty stomach b. giving the PPI with meals c. making sure the patient does not crush or chew the capsules d. instructing the patient to open the capsule and chew the contents for best absorption e. administering the PPI only when the patient complains of heartburn
a c
when administering vitamin and mineral supplements the nurse implements which appropriate interventions? Select all that apply. a. not administering oral calcium tablets along with oral tetracyclines b. administering intravenous calcium via a rapid intravenous push infusion c. monitoring the heart rhythm (ECG) of a patient receiving an intravenous magnesium infusion d. giving oral niacin with milk or food to decrease gastrointestinal upset e. monitoring for the formation of renal stones and patients taking large doses of vitamin C
a c d e
the nurse is preparing to administer dronabinol (Marinol) to a patient. Which statements about dronabinol therapy are true? (select all that apply.) a. it is approved for nausea and vomiting related to cancer chemotherapy b. it is approved for use with hyperemesis gravidarum (nausea and vomiting associated with pregnancy) c. it is approved to help stimulate the appetite in patients with nutritional wasting due to cancer or AIDS d. it may cause extrapyramidal symptoms e. it may cause drowsiness or euphoria
a c e
A 79-year-old woman visits the clinic today and tells the nurse that her "bowels just aren't right." She wants advice on the best laxative to take so that she can have a bowel movement every day. Which is an appropriate response by the nurse? (Select all that apply.) a. "A normal bowel pattern does not necessarily mean that you will have a bowel movement every day." b. "Try taking Metamucil with sips of water." c. "You can try taking Milk of Magnesia every other day—it's a mild laxative." d. "Let's talk about increasing fluids and fiber in your diet." e. "Mineral oil would be safe for long-term use if needed."
a d
When giving vitamins, the nurse needs to remember that certain vitamins can be toxic if consumed in excess amounts. These include which vitamins? (Select all that apply.) a. Vitamin A b. Vitamin C c. Niacin d. Vitamin D e. Vitamin K f. Folic acid
a d e
The order for a child with severe diarrhea reads: Give diphenoxylate with atropine (Lomotil) 0.3 mg/ kg/day in 4 divided doses. The medication is available in an oral solution with a concentration of 2.5 mg/5 mL. The child weighs 44 lb. a. How many milligrams will the child receive per dose? b. How many milliliters will the child receive per dose?
a. 1.5 mg per dose (6mg/day) b. 3 mL per dose
Ms. E. has recently undergone an ileal resection and is experiencing some signs of malabsorption. When routine laboratory tests are performed, the nurse discovers that she is mildly anemic. a. What type of anemia does the nurse expect? b. What about her condition is contributing to this deficiency? c. How is this condition treated?
a. Pernicious anemia b. The absorption of cyanocobalamin (vitamin B12, or extrinsic factor) requires the presence of intrinsic factor, which is a glycoprotein secreted by gastric parietal cells. After the binding takes place, the complex is absorbed in the small intestine. Because an ileal resection removes a portion of the small intestine, malabsorption of cyanocobalamin can occur. c. Cyanocobalamin injections are used to treat pernicious anemia caused by a lack of intrinsic factor.
Petra has gastroesophageal reflux disease, and the health care provider has ordered oral metoclopramide (Reglan), four times a day for 2 weeks. a. What instructions will the nurse give Petra regarding administration of the medication? b. A few days later, Petra calls to say that she thinks the medication is "too strong." She also mentions that her evening routine includes "a couple of glasses of wine." What will the nurse tell Petra?
a. Petra should take the metoclopramide 30 minutes before meals and at bedtime. b. Combining metoclopramide with alcohol can result in additive central nervous system depression. Petra needs to be instructed not to take the medication with alcohol.
6. Antacids that have constipating effects
a. aluminum-containing antacids b. calcium-containing antacids
10. A disease of the peripheral nerves caused by a dietary deficiency of thiamine
a. beriberi
A patient believes that taking megadoses of vitamin C is healthy. What should the nurse tell the patient about megadoses of vitamin C? a. They are usually nontoxic because vitamin C is water soluble. b. They can produce nausea, vomiting, headache, and abdominal cramps. c. Megadoses of vitamin C can lead to scurvy-like symptoms. d. They may cause dangerous heart dysrhythmias.
b
A pregnant woman asks the nurse about taking an antacid for indigestion. What is the nurse's best response? a. "You won't be allowed to take an antacid while you are pregnant." b. "Let's check with your obstetrician to see what is recommended." c. "Go ahead and use an aluminum-based antacid." d. "Sodium bicarbonate would be the safest choice."
b
A student nurse was informed of the need for a "booster" injection for hepatitis B. The student asks the health center nurse why another injection is indicated because the series of three injections was completed. Select the nurse's best response. a. Too much time has elapsed between the second and third injections and you need a second "third shot." b. With the three injections your body did not manufacture enough antibodies, and to be therapeutic, you need another injection. c. You have an altered immune response and may never be protected from hepatitis B. d. One of the initial injections you received must have been ineffective.
b
The immunity that is passed from a mother to her nursing infant through antibodies in breast milk is known as which type of immunity? a. Artificially acquired passive immunity b. Naturally acquired passive immunity c. Active immunity d. Genetic immunity
b
When giving dronabinol (Marinol) to a patient with acquired immunodeficiency syndrome (AIDS), the nurse knows that this drug may also have what therapeutic effect in addition to reducing nausea? a. Euphoria b. Enhanced appetite c. Reduced pain d. Enhanced sleep
b
a 45 year old woman has been diagnosed with irritable bowel syndrome (IBS) and will taking linaclotide (linzess). The nurse assesses for conditions that may be contraindications to this drug such as a. constipation b. bowel obstruction c. renal calculi d. anemia
b
a a 33 year old patient is in the Outpatient Cancer Center for his first round of chemotherapy. the nurse knows that which schedule is the most appropriate timing for the intravenous antiemetic drug? a. 4 hours before that chemotherapy begins b. 30 to 60 minutes before the chemotherapy begins C. at the same time as a chemotherapy drugs are given d. at the first sign of nausea
b
a patient has GI malabsorption due to severe intestinal damage from a gastrointestinal infection. The nurse will need to assess for signs of deficiency of which vitamin? a. vitamin A (retinol) b. vitamin B12 (cyanocobalamin) c. vitamin B6 (pyridoxine) D. vitamin E (tocopherols)
b
a patient has been receiving long term antibiotic therapy as part of treatment for an infected leg wound. He tells the nurse that he has had spells of diarrhea for the last week. which medication is most appropriate for him at this time? a. bismuth subsalicylate b. L acidophilus c. diphenoxylate with atropine d. codeine
b
a patient has given a new prescription for alosetron (lotronex) and the nurse is providing education about this medication. Which statement by the patient indicates a need for further education? a. I will not take a double dose in the afternoon if I forgot my morning dose b. I should be seeing Improvement within a few days c. I will call my doctor if I experience severe constipation or bloody diarrhea d. this drug will improve symptoms but won't cure my IBS
b
a patient with a history of renal problems is asking for advice about which antacid he should use. the nurse will make which recommendation? a. patients with renal problems cannot use antacids b. aluminum-based antacids are the best choice for you c. calcium-based antacids are the best choice for you d. magnesium-based antacids are the best choice for you
b
a woman who is planning to become pregnant ask the nurse when she should start to take folic acid supplements. what is the nurse's best response? a. there's no evidence to support the use of folic acid during pregnancy b. you should start taking it at least one month before you become pregnant and continue it throughout early pregnancy c. you need to start it as soon as you discover you are pregnant d. you should only take it during the last trimester of your pregnancy and not any earlier
b
during a routine check-up a 72 year old patient is advised to receive an influenza vaccine injection. He questions this saying "I had one last year do I need another one?" What is the nurses best response? a. the effectiveness of the vaccine wears off after 6 months b. each year new vaccine is developed based on the flu strains that are likely to be in circulation C. When You Reach 65 years of age you need boosters on an annual basis D. taking the flu vaccine each year allows you to build your immunity to a higher level each time
b
the nurse is assessing a patient who is to receive folic acid supplements. It is important to rule out which condition before giving the folic acid? a. malabsorption syndromes b. pernicious anemia c. tropical spruce d. pregnancy
b
the nurse is providing patient teaching regarding Scopolamine transdermal patches (Transderm-Scõp) to a patient who is planning an ocean cruise. Which instruction is most appropriate? a. apply the patch the day before traveling b. apply the patch at least 4 hours before traveling c. apply the patch to the shoulder area D. apply the past to the temple just above the ear
b
the nurse is teaching a patient about oral iron supplements. Which statement is correct? a. you need to take this medication on an empty stomach or else it won't be absorbed b. it is better absorbed on empty but if that causes your stomach to be upset you can take it with food c. take this medication with a sip of water and then lie down to avoid problems with low blood pressure d. if you have trouble swallowing the tablet you may crush it
b
when assessing a patient who will be receiving a measles vaccine the nurse will consider which condition to be a possible contraindication? a. anemia b. pregnancy c. ear infection D. common cold
b
which is the correct action when the nurse is administering sucralfate? a. giving the drug with meals. b. giving the drug on an empty stomach c. instructing the patient to restrict fluids d. waiting 30 minutes before administering other drugs
b
A patient is about to receive folic acid supplementation. The nurse knows that indications for folic acid supplementation include which of the following? (Select all that apply.) a. Iron-deficiency anemia b. Tropical sprue c. Prevention of fetal neural tube defects d. Pernicious anemia e. Hemolytic anemia
b c
Which patient should be advised to limit or avoid use of sodium bicarbonate as an antacid? (Select all that apply.) a. A patient who is 6 months pregnant b. A patient with hypertension c. A patient with heart failure d. A patient with gout e. A patient with scleroderma
b c
When teaching a patient about oral iron preparations, the nurse will include which instructions? (Select all that apply.) a. Mix the liquid iron preparations with antacids to reduce gastrointestinal distress. b. Take the iron with meals if gastrointestinal distress occurs. c. Liquid forms should be taken through a straw to avoid discoloration of tooth enamel. d. Oral forms should be taken with juice or water, not milk. e. Iron products will turn the stools black.
b c d e
the nurse is reviewing the current medications for a patient who has a new prescription for aprepitant (emend). Which of these medications may have an interaction with. (select all that apply.) a. digoxin b. Warfarin c. oral contraceptives d. nonsteroidal anti-inflammatory drugs e. corticosteroids
b c e
A patient will be taking an oral iron preparation. Which of these are possible adverse effects? (Select all that apply.) a. Dizziness b. Nausea c. Vomiting d. Drowsiness e. Orthostatic hypotension f. Stomach cramps
b c f
The nurse is administering a proton pump inhibitor during morning medication rounds. Which statements about proton pump inhibitors are true? (Select all that apply.) a. They should be taken 1 hour before antacids. b. They should be taken 30 to 60 minutes before meals. c. They should be taken with meals. d. They are part of the treatment of patients with H. pylori infections. e. There are very few adverse effects with these drugs.
b d e
A patient with renal failure wants to take an antacid for "sour stomach." The nurse needs to consider that some antacids may be dangerous when taken by patients with renal failure and will recommend which type of antacid? a. Activated charcoal b. Aluminum-containing antacids c. Calcium-containing antacids d. Magnesium-containing antacids
b.
9. A type of antacid that may contribute to the development of kidney stones
b. calcium-contianing antacids
3. A nonprotein substance that combines with a protein molecule to form an active enzyme
b. coenzyme
A mother discovers that her child has eaten half a bottle of children's multivitamins. Which is the appropriate first action in this situation? a. Give one dose of antacid and repeat in 30 minutes. b. Take the child to the pediatric clinic. c. Call the national poison control hotline for instructions. d. Call 911 for emergency transport to a hospital.
c
A nurse has been stuck by a used needle while starting an intravenous line. Which preparation is used as prophylaxis against disease after exposure to blood and body fluids? a. Hib vaccine b. Rho(D) immune globulin c. Hepatitis B immune globulin d. Hepatitis antitoxin
c
A patient has been given PEG-3350 in a solution of polyethylene glycol (GoLYTELY) as preparation for a colonoscopy. He started having diarrhea after about 45 minutes. Two hours later, he tells the nurse that "the diarrhea has not stopped yet." What will the nurse do? a. Give the patient an antidiarrheal drug, such as loperamide (Lomotil). b. Give the patient another dose of the GoLYTELY to finish cleansing his bowel. c. Remind the patient that it may take up to 4 hours to completely evacuate the bowel. d. Report this to the physician immediately.
c
A patient is undergoing chemotherapy. When giving antiemetics, the nurse will remember that these drugs are most effective against nausea when given at which time? a. Before meals b. At bedtime c. Before the chemotherapy begins d. Just after the chemotherapy begins
c
A patient who has been taking Pepto-Bismol for diarrhea telephones the nurse and states, "My stools are black, I think I am bleeding rectally!" Select the nurse's best response. a. "Yes, you may be right, go the emergency department immediately." b. "Have you been taking any additional vitamins with iron?" c. "This is an expected response to the Pepto-Bismol." d. "Contact your doctor and ask for a stool evaluation."
c
A patient will be receiving darbepoetin (Aranesp) as part of treatment for postchemotherapy bone marrow suppression. Which finding is a contraindication to darbepoetin therapy? a. Pulse rate of 100 beats/min b. Blood pressure of 128/79 mm Hg c. Hemoglobin level of 11 g/dL d. White blood cell count of 7000/mm3
c
A patient with peptic ulcer disease will be starting medication therapy. He tells the nurse that he smokes and wonders if that will affect his treatment. Which is the nurse's best response? a. "Smoking has no effect on these medications." b. "The actions of antacids are less potent when you smoke." c. "Smoking has been shown to decrease the effectiveness of H2 blockers." d. "Smoking has been shown to increase the adverse effects of H2 blockers."
c
In addition to its use in maintaining homeostasis, the nurse would recognize a secondary use for vitamin B3 as a treatment for which disorder? a. Night blindness b. Anemia c. Hyperlipidemia d. Azotemia
c
The nurse is preparing to administer folic acid. What occurs if folic acid is given to treat anemia without determining the underlying cause of the anemia? a. Erythropoiesis is inhibited. b. Excessive levels of folic acid may accumulate, causing toxicity. c. The symptoms of pernicious anemia may be masked, delaying treatment. d. Intestinal intrinsic factor is destroyed.
c
The patient asks the nurse why increased fiber intake is a solution to constipation. Select the nurse's best response. a. Fiber increases peristaltic waves increasing fecal movement. b. Fiber lowers the surface tension of GI fluids. c. Fiber increases bulk and distends the bowel to initiate reflex bowel activity. d. Fiber initiates the adrenergic response, increasing flow of catecholamines into the bowel.
c
When caring for an older adult patient diagnosed with peptic ulcer disease and receiving each of the following medications, the nurse would relate the onset of confusion as a possible side effect to which medication? a. Antacids b. Carafate c. H2 antagonists d. Cytotec
c
When reviewing various immunizing drugs, the nurse recalls that one product is purposefully administered to pregnant women. Which is an example of this type of product? a. Poliovirus vaccine b. Tetanus immune globulin c. Rho(D) immune globulin d. Black widow spider antivenin
c
Which classifications of anti-emetics work by blocking dopamine receptors in the chemo trigger zone (CTZ)? a. Neurokinin blockers b. Serotonin blockers c. Prokinetic drugs d. Anticholinergic drugs
c
a 28 year old patient is in the Urgent Care Center after stepping on a rusty tent nail. The nurse evaluates the patient's immunity status and notes that the patient thinks she had her last tetanus booster about 10 years ago, just before starting College. Which immunization would be most appropriate at this time? a. immunoglobulin intravenous (Gamma-P IV) b. DTaP (daptacel) (diphtheria tetanus and acellular pertussis) c. Tdap (Adacel) (diphtheria tetanus and acellular pertussis) d. no immunizations necessary at this time
c
a patient is being prepared for a colonoscopy. The nurse expects which laxative to be used as a preparation for this procedure? a. methylcellulose b. docusate sodium c. PEG-3350 d. glycerin
c
the nurse is preparing to administer the first dose of misoprostol (cytotec) for a patient who has been diagnosed with a gastric ulcer. What condition would be a contraindication to this medication? a. hypothyroidism b. type 2 diabetes mellitus c. pregnancy d. hypertension
c
when evaluating the medication list of a patient who will be starting therapy with an H2 receptor antagonist the nurse is aware that which drug may interact with it? a. codeine b. penicillin c. phenytoin d. acetaminophen
c
A nurse is reviewing chemotherapy with a newly hired nurse on the oncology unit. Which antinausea drug or drug class is indicated for preventing chemotherapy-induced nausea and vomiting? (Select all that apply.) a. Antihistamines b. Antidopaminergic drugs c. Serotonin blockers d. Phosphorated carbohydrate solution (Emetrol) e. Tetrahydrocannabinoids
c e
when iron sucrose is administered which nursing interventions are correct? (Select all that apply.) a. administer a test dose before giving the full dose b. give via deep intramuscular injection into a large muscle mass using the z-track method c. administer large doses over 2.5 to 3.5 hours intravenously d. monitor the patient for hypertension e. monitor the patient for hypotension
c e
the nurse is providing teaching after an adult receives a booster immunization. Which adverse reactions will the nurse immediately report to the health care provider ? (select all that apply.) a. swelling and redness at the injection site b. fever of a 100°F c. joint pain d. heat over the injection site e. rash over the arms back and chest f. shortness of breath
c e f
1. A specialized protein that catalyzes biochemical reactions
c. Enzyme
5. A type of antacid that can cause diarrhea
c. magnesium-containing antacids
a 30 year old patient is taking simethicone for excessive flatus associated with diverticulitis. During a patient teaching session the nurse explains the mechanism of action of simethicone by saying: a. it neutralizes gastric pH thereby preventing gas b. it buffers the effects of pepsin on the gastric wall C. in decreases gastric acid secretion and thereby minimizes flatus d. it causes mucus coated gas bubbles to break into smaller ones
d
a parent calls to ask about giving a medication for diarrhea to his child, 15 years of age, who is recovering from the flu. the nurse expects the prescriber to recommend which medication? a. bismuth subsalicylate (Pepto-Bismol) b. lactobacillus GG (culturelle) c. Belladonna alkaloid/phenobarbital combination (donnatal elixir) d. loperamide (Imodium A-D)
d
a patient who has been receiving chemotherapy tells the nurse that he has been searching the internet for antinausea remedies and that he found a reference to a product called emetrol (phosphorated carbohydrate solution). He wants to know if this drug would help him. What is the nurse's best answer? a. this may be a good remedy for you. Let's talk to your prescriber. b. this drug is used only after other drugs have not worked c. this drug is used only to treat severe nausea and vomiting caused by chemotherapy d. this drug may not help the more severe nausea symptoms associated with chemotherapy
d
an animal control officer was bitten by a stray dog that showed signs of rabies. Which statement by the nurse is correct regarding the treatment for rabies prophylaxis? a. you will receive treatment if you begin to symptoms of rabies b. you will receive 1 oral dose of medication today and on e more in 1 week c. you will need to receive 3 subcutaneous injections over the next week d. you will need to receive 5 intramuscular injections over the next 28 days
d
the nurse is reviewing the Centers for Disease Control (CDC) recommendation for vaccines. The pneumococcal vaccine (Pneumovax 23) is recommended for which group? a. newborn infants b. patients who are immunocompromised C. patients who are transplant candidates D. smokers between 19 and 64 years of age
d
the nurses administering oral methylcellulose (citrucel) and keeps in mind that a major potential concern with this drug is a. dehydration b. tarry stools c. renal calculi d. esophageal obstruction
d
when administering oral iron tablets the nurse should keep in mind that the most appropriate substance other than water to give with these tablets is a. pudding b. an antacid c. milk d. orange juice
d
when giving calcium intravenously the nurse needs to administer it slowly keeping in mind that rapid intravenous administration of calcium may cause which problem? a. ototoxicity b. renal damage c. tetany d. cardiac dysrhythmias
d
8. Drugs used to relieve the painful symptoms associated with gas
d. antiflatulents
8. An essential organic compound that can be dissolved and stored in the liver and fatty tissues
d. fat-soluble vitamin
5. An inorganic substance that, when ingested, attaches to enzymes or other organic molecules
e. mineral
2. Drugs that block all acid secretion in the stomach
e. proton pump inhibitors
7. The cause of many peptic ulcers
f. helicobacter pylori
12. A disease resulting from a niacin deficiency or a metabolic defect that interferes with the conversion of tryptophan to niacin
f. pellagra
2. A condition that results from a deficiency of cyanocobalamin
g. pernicious anmeia
10. A highly soluble antacid form with a quick onset but short duration of action
g. sodium bicarbonate
9. Biologically active chemicals that make up vitamin E compounds
j. tocopherols
4. The cells responsible for producing and secreting hydrochloric acid in the stomach
k. parietal cells
6. An organic compound essential in small quantities for normal physiologic and metabolic functioning of the body
k. vitamin
11. An essential organic compound that can be dissolved in water but is not stored in the body for long periods of time
l. water-soluble vitamin