Exam 1 Questions
Oral acetaminophen has been ordered for a young child who has a fever. A liquid form has been obtained by the nurse to increase the chance of problem-free administration. Prior to administration, the nurse is going through the rights of medication administration. When confirming the right dose, what term is most appropriate? A)"160 mg" B)"One teaspoon" C)"One third of a tablespoon" D)"5 mL"
A)"160 mg"
A primiparous woman tells the nurse that she and her partner are highly reluctant to have their infant vaccinated, stating, "We've read that vaccines can potentially cause a lot of harm, so we're not sure we want to take that risk." How should the nurse respond to this family's concerns? A)"Vaccinations are not without some risks, but these are far exceeded by the potential benefits." B)"The potential risks of vaccinations have been investigated and determined to be nonexistent." C)"Unfortunately, state laws mandate that your child receive the full schedule of vaccines." D)"Vaccines indeed cause several serious adverse effects, but these are usually treated at the site where your child receives the vaccination."
A)"Vaccinations are not without some risks, but these are far exceeded by the potential benefits."
A couple have been trying unsuccessfully for nearly a year to become pregnant and have now sought fertility counseling. The nurse should be aware of what potential etiological factors related to infertility? Select all that apply. A)Absence of sperm B)Endometriosis C)Vaginitis D)Blocked fallopian tubes E)Fibromyalgia
A)Absence of sperm B)Endometriosis D)Blocked fallopian tubes
A 2-year-old girl with a recent history of idiopathic nausea and vomiting was prescribed promethazine (Phenergan) by her primary care provider. The immaturity of this child's gastrointestinal system will primarily influence what aspect of pharmacokinetics? A)Absorption B)Distribution C)Metabolism D)Elimination
A)Absorption
A patient is to be administered antithymocyte globulin (ATG) to treat renal transplant rejection. What skin test should be assessed prior to the administration of the first dose of medication? A)Allergy to horse serum B)Allergy to ragweed C)Allergy to dust mites D)Tuberculosis
A)Allergy to horse serum
A 1-year-old child will receive her scheduled MMR vaccination shortly. The nurse should teach the child's parents that she may develop what possible adverse effect related to the administration of this medication? A)Cough and fever B)Pallor and listlessness C)Serum sickness D)Nausea and vomiting
A)Cough and fever
A patient with chronic renal failure is prescribed filgrastim (Neupogen). What is the major effect of filgrastim (Neupogen)? A)Decreases neutropenia related to chemotherapy B)Decreases white blood cells related to infection C)Decreases growth of blood vessels due to ischemia D)Decreases platelet count related to bleeding
A)Decreases neutropenia related to chemotherapy
A woman who is in the first trimester of her pregnancy has told the nurse, "I've stopped taking my blood pressure pill because I know it could harm the baby. Instead, I've started taking natural and herbal remedies." What nursing diagnosis is suggested by the woman's statement? A)Deficient knowledge related to drug and herbal effects during pregnancy B)Health-seeking behaviors related to protection of fetal health C)Acute confusion related to the potential teratogenic effects of herbs D)Effective therapeutic regimen management related to use of herbs rather than drugs
A)Deficient knowledge related to drug and herbal effects during pregnancy
A patient has been diagnosed with chronic renal failure. Which of the following agents will assist in raising the patient's hemoglobin levels? A)Epoetin alfa (Epogen, Procrit) B)Pentoxifylline (Pentoxil) C)Estazolam (ProSom) D)Dextromethorphan hydrobromide
A)Epoetin alfa (Epogen, Procrit)
A public health nurse is preparing to administer an intramuscular injection of a vaccine to an 8-year-old girl. The nurse recognizes that the child is uncharacteristically quiet and appears tense. The nurse should recognize the possibility of what nursing diagnosis? A)Fear related to IM injection B)Acute confusion related to misunderstanding of the necessity of IM injection C)Risk for injury related to IM injection D)Ineffective coping related to reluctance to receive IM injection
A)Fear related to IM injection
A woman was administered misoprostol (Cytotec) in an effort to induce labor, but the care team is unsatisfied with the results. Consequently, oxytocin will be used. Prior to administering oxytocin, what must occur? A)Four hours must elapse after the last dose of misoprostol. B)The woman must have a type and cross-match performed. C)The woman must receive a bolus of 500-mL normal saline. D)The woman must have her electrolytes measured.
A)Four hours must elapse after the last dose of misoprostol.
A pregnant woman is experiencing nausea and vomiting in her first trimester of pregnancy. Which herbal agent has traditionally been used as an antiemetic? A)Ginger B)Garlic C)Ginkgo biloba D)Green tea
A)Ginger
A patient has received a bone marrow transplant. What will occur if the patient receives inadequate immunosuppression after the transplant? A)Graft-versus-host disease B)Hepatotoxicity C)Acute kidney injury D)Sepsis
A)Graft-versus-host disease
A patient has been administered methotrexate, which is a purine antagonist used to treat a rapidly growing tumor. The patient develops stomatitis. What is the priority nursing diagnosis for a patient suffering from stomatitis? A)Impaired skin integrity B)Activity intolerance C)Self-care deficit: hygiene D)Risk for disuse syndrome
A)Impaired skin integrity
A patient is to be administered an immunization. The serum contains aluminum phosphate. What route is most appropriate to administer this immunization? A)Intramuscularly B)Subcutaneously C)Intravenously D)Orally
A)Intramuscularly
A patient has a low erythrocyte count. How may a colony-stimulating factor affect the patient's erythrocyte count? A)It stimulates growth of red blood cells. B)It suppresses T-cell production. C)It inhibits protein synthesis. D)It stimulates antibody production.
A)It stimulates growth of red blood cells.
A pregnant woman states that she has been constipated since becoming pregnant. Which medication is most appropriate for preventing constipation related to pregnancy? A)Metamucil B)Mineral oil C)Saline cathartic D)Stimulant cathartic
A)Metamucil
An adult male patient is postoperative day 2 following a kidney transplant, and his regimen of antirejection drugs began just prior to surgery. What nursing action should be integrated into this patient's plan of care? A)Place the patient in a single, positive-pressure room. B)Arrange for the patient to receive a raw-food, organic diet. C)Wash the patient's skin with chlorhexidine twice daily. D)Have the patient wear a gown and gloves when outside his room.
A)Place the patient in a single, positive-pressure room.
A 71-year-old woman has experienced a sharp decline in her mobility and quality of life due to severe rheumatoid arthritis. As a result, her care provider has recently prescribed abatacept (Orencia). This fusion protein inhibitor will achieve a therapeutic effect by what means? A)Preventing the activation of T cells B)Increasing antibody production by B cells C)Antagonizing histamine receptors D)Inhibiting the production of mast cells
A)Preventing the activation of T cells
A patient is to begin treatment for rheumatoid arthritis with infliximab (Remicade). What potential risk should the nurse identify as being associated with this drug? A)Risk for infection B)Risk for decreased level of consciousness C)Risk for nephrotoxicity D)Risk for hepatotoxicity
A)Risk for infection
A patient who is undergoing chemotherapy for the treatment of non-Hodgkin's lymphoma will soon begin treatment with epoetin alfa (Epogen). The nurse should be aware that this drug may be administered by which of the following routes? Select all that apply. A)Subcutaneous B)Intramuscular C)Oral D)Buccal E)Intravenous
A)Subcutaneous E)Intravenous
An emergency department nurse is confirming that a child's ordered dose of IV analgesia is congruent with her body surface area (BSA). In order to calculate the child's BSA, the nurse must know which of the following variables? Select all that apply. A)The child's height B)The child's percentage of body water C)The child's weight D)The usual adult dose of the drug E)The child's age in months
A)The child's height C)The child's weight
A patient has been placed on tacrolimus, and the route will be changed from IV to oral prior to discharge home from the hospital. How will this change in administration route affect the patient's plan of care? A)The patient's dose of tacrolimus will have to be increased. B)The patient will receive the drug QID rather than BID C)The patient will have to be monitored more closely for adverse effects. D)The patient will have to take tacrolimus concurrently with an antiemetic.
A)The patient's dose of tacrolimus will have to be increased.
A patient is undergoing a cytotoxic chemotherapy regimen for the treatment of stage III lung cancer. What effect will this regimen likely have on the patient's hemostatic function? A)The patient's platelet count will decline. B)The patient will be at increased risk of deep vein thrombosis. C)The patient will require prophylactic heparin. D)The patient will likely experience thrombocytosis.
A)The patient's platelet count will decline.
A patient with a diagnosis of bladder cancer is started on a chemotherapeutic regimen that includes three agents. What is the rationale for using multiple antineoplastic agents? A)The use of three agents decreases the development of cell resistance. B)The use of three agents increases adherence to treatment. C)The use of three agents increases the serum levels of one of the agents. D)The use of three agents decreases the total adverse effects.
A)The use of three agents decreases the development of cell resistance.
An oncology nurse is preparing to administer cytotoxic chemotherapy medications. Which of the following measures best protects the nurse from harm related to the chemotherapy? A)Wearing protective equipment B)Performing thorough hand hygiene C)Mixing medication in a 1000-mL bag D)Administering medication intramuscularly whenever possible
A)Wearing protective equipment
A nurse is preparing to administer a nebulized bronchodilator to a young child with asthma. The nurse should be aware that this child's dosage is based primarily on what characteristic of the child? A)Weight B)Age C)Body type D)Development stage
A)Weight
A 70-year-old patient is seen in the family practice clinic. Which of the following vaccines should be administered to prevent shingles? A)Zoster vaccine B)Haemophilus influenzae Type b (Hib) vaccine C)Human papillomavirus (HPV) D)Pneumococcal polyvalent
A)Zoster vaccine
A patient has been diagnosed with a brain tumor and is dealing with this diagnosis by seeking detailed information about cancer. The nurse would explain to the patient that cancer is essentially a result of the disruption of the A)cell cycle. B)cell wall. C)lymphatic system. D)immune system.
A)cell cycle.
A pregnant woman asks why she needs to take a folic acid supplement. What is the nurse's best explanation for the administration of folic acid? A)"Folic acid prevents the development of contractions." B)"Folic acid prevents neural tube birth defects." C)"Folic acid builds strong fetal bones." D)"Folic acid will decrease nausea and vomiting."
B)"Folic acid prevents neural tube birth defects."
A 9-year-old boy with severe influenza symptoms will be treated with ribavirin (Rebetol), an antiviral that is usually taken by adults twice daily in doses of 600 mg PO. After learning that the child's body surface area (BSA) is 1.10, the nurse will anticipate that the child will likely receive how much ribavirin for each dose? A)110 mg B)380 mg C)545 mg D)660 mg
B)380 mg
A health care worker has received her annual influenza vaccination and has remained at the clinic after administration so that the nurse may observe for adverse reactions. The worker complains of pain at the site of IM injection. The nurse should recommend which of the following? A)ASA B)Acetaminophen C)Meperidine (Demerol) D)Heat application
B)Acetaminophen
Which of the following nursing diagnoses would provide the most plausible indication for the use of epoetin alfa (Epogen) in a patient with renal failure? A)Risk for infection related to decreased erythropoiesis B)Activity intolerance related to decreased oxygen-carrying capacity C)Powerlessness-related sequelae of renal failure D)Ineffective breathing pattern related to inadequate erythropoietin synthesis
B)Activity intolerance related to decreased oxygen-carrying capacity
A hospital patient's complex medical history includes a recent diagnosis of kidney cancer. Which of the following medications is used to treat metastatic kidney cancer? A)Filgrastim (Neupogen) B)Aldesleukin (Proleukin) C)Interferon alfa-2b (Intron A) D)Darbepoetin alfa (Aranesp)
B)Aldesleukin (Proleukin)
An adult patient has recently begun cancer treatment with methotrexate (MTX). The nurse is aware of the importance of monitoring the patient closely for adverse effects of treatment. When reviewing this patient's laboratory work, the nurse should consequently prioritize assessment of which of the following? A)Sodium and potassium B)BUN and creatinine C)Calcium and magnesium D)Arterial blood gases
B)BUN and creatinine
A 79-year-old woman has recently moved to a long-term care facility, and the nurse at the facility is conducting a medication reconciliation. The nurse notes that the woman has recently been taking tamoxifen (Nolvadex). The nurse is justified in concluding that the woman has a history of what malignancy? A)Ovarian cancer B)Breast cancer C)Malignant melanoma D)Cervical cancer
B)Breast cancer
A woman in labor is being treated with magnesium sulfate intravenously and is beginning to show signs and symptoms of hypermagnesemia. The infusion has been discontinued, and the nurse should anticipate administration of what drug? A)Metoprolol (Lopressor) B)Calcium gluconate C)Potassium chloride D)Furosemide (Lasix)
B)Calcium gluconate
A 49-year-old patient is diagnosed with ovarian cancer. What is a characteristic of malignant cells that differentiates them from normal body cells? A)Cancerous cells do not require an energy source in order to proliferate. B)Cancerous cells grow in an uncontrollable fashion. C)Cancerous cells have a theoretically infinite lifespan. D)Cancerous cells are not responsive to the presence of drugs.
B)Cancerous cells grow in an uncontrollable fashion.
Fewer adverse effects are associated with monoclonal antibody therapy than those of cytotoxic drugs. However, some of the potential adverse effects of monoclonal antibodies can be life threatening, including which of the following? A)Heart failure and bleeding problems B)Changes in cognition and personality changes C)Ischemic heart disease D)Bronchoconstriction and pulmonary edema
B)Changes in cognition and personality changes
A patient is being treated with cyclophosphamide (Cytoxan). Which of the following laboratory values should the nurse follow most closely? A)D-dimer B)Complete blood count C)C-reactive protein level D)Arterial blood gases
B)Complete blood count
The nurse's medication reconciliation performed on a patient who is newly admitted to the hospital reveals that he regularly takes infliximab (Remicade), a humanized IgG monoclonal antibody. The nurse is justified in suspecting that this patient may have a history of which of the following? A)Osteoporosis B)Crohn's disease C)Organ transplant D)Severe seasonal allergies
B)Crohn's disease
An oncology nurse is providing for an adult patient who is currently immunocompromised. The nurse is aware of the physiology involved in hematopoiesis and immune function, including the salient role of cytokines. What is the primary role of cytokines in maintaining homeostasis? A)Cytokines perform phagocytosis in response to bacterial and protozoal infection. B)Cytokines perform a regulatory role in the development of diverse blood cells. C)Cytokines can be considered to be the basic "building blocks" of all blood cells. D)Cytokines are formed in response to the presence of antibodies.
B)Cytokines perform a regulatory role in the development of diverse blood cells.
A patient is administered a granulocyte colony-stimulating factor (G-CSF). What is the expected outcome of a G-CSF? A)Red blood cell count of 3000 mm3 B)Decreased number of infections C)Decreased fatigue and increased energy D)White blood cell count of 20,000 mm3
B)Decreased number of infections
A patient is seen in the emergency room for a laceration sustained on broken glass. The nurse assesses the patient for the last tetanus toxoid he received. How often should the patient be administered a tetanus toxoid? A)Every year B)Every 10 years C)Every 2 years D)Every 5 years
B)Every 10 years
An adult patient has developed renal failure secondary to an overdose of a nephrotoxic drug. Which of the following assessment findings would the nurse recognize as being most suggestive of impaired erythropoiesis? A)Frequent infections and low neutrophil levels B)Fatigue and increased heart rate C)Agitation and changes in cognition D)Increased blood pressure and peripheral edema
B)Fatigue and increased heart rate
A patient is receiving oxytocin (Pitocin). Which of the following is a maternal adverse effect of Pitocin? A)Acute confusion B)Hypertension C)Edema D)Inverted T wave
B)Hypertension
Significant pharmacodynamic variations exist between adult patients and pediatric patients. Which of the following factors are known to contribute to differences in the ways that drugs affect target cells in children and infants? Select all that apply. A)Inability of children to accurately describe adverse effects B)Immaturity of children's organ systems C)Differences in the body composition of children D)The lack of active immunity in children E)Differences in the function of humoral immunity in children
B)Immaturity of children's organ systems C)Differences in the body composition of children
A patient is being treated on the oncology unit and has developed worsening adverse effects over the past several days of chemotherapy. Administration of filgrastim (Neupogen) may aid in achieving what desired outcome? A)Resolution of mucositis B)Increased leukocytes C)Increased platelet levels D)Prevention of hemorrhagic cystitis
B)Increased leukocytes
An infant is being administered an immunization. Which of the following provides an accurate description of an immunization? A)It should be administered to a pregnant woman prior to the infant's birth. B)It is the administration of an antigen for an antibody response. C)It produces many adverse reactions, particularly autism, in the infant. D)It protects the infant from exposure to infectious antibodies.
B)It is the administration of an antigen for an antibody response.
When teaching new parents about the benefits of adhering to the recommended vaccination schedule, the nurse should cite protection against which of the following diseases? Select all that apply. A)HIV B)Measles C) Varicella D) Poliomyelitis E) Hepatitis B
B)Measles C) Varicella D) Poliomyelitis E) Hepatitis B
The nurse has experienced challenges in administering a 3-year-old boy's oral antibiotics due to the boy's resistance. How can the nurse best ensure that this patient receives his necessary medication? A)Convince the boy that the medication is actually a treat, especially reserved for him. B)Mix the medication with pleasantly flavored syrup or pureed fruit. C)Withdraw some of the child's privileges if he refuses to take his medication. D)Distract the child with a toy and then put it in his mouth quickly.
B)Mix the medication with pleasantly flavored syrup or pureed fruit.
A patient is administered cyclosporine (Sandimmune, Neoral) to prevent rejection of a kidney transplant. Which of the following is a major adverse effect of cyclosporine? A)Congestive heart failure B)Nephrotoxicity C)Anaphylaxis D)Respiratory arrest
B)Nephrotoxicity
A nursing student is scheduled to receive the hepatitis B series. What type of immunity will this immunization provide? A)Active immunity B)Passive immunity C)Innate immunity D)Natural immunity
B)Passive immunity
A patient's current medical condition is suggestive of impaired erythropoiesis. Which of the following laboratory studies would be most clinically relevant in diagnosing this health problem? A)White blood cell count with differential B)RBC, hemoglobin, and hematocrit C)INR and aPTT D)d-dimer and C-reactive protein
B)RBC, hemoglobin, and hematocrit
A patient is being administered chemotherapeutic agents for the treatment of cancer. Which of the following blood cells will be stimulated by the colony-stimulating factors in response to the effects of the chemotherapy? A)White blood cells B)Red blood cells C)Phagocytes D)Myocardial cells
B)Red blood cells
When administering magnesium sulfate, for what should the nurse assess the patient? A)Dry, pale skin B)Respiratory depression C)Agitation D)Tachycardia
B)Respiratory depression
An infant's mother is reluctant for the nurse to administer a suppository to her baby, stating, "It just seems so terribly invasive." What principle should guide the nurse's use of suppositories in infant patients? A)Suppositories are generally avoided unless absolutely necessary, due to the risk of injuring the rectal mucosa. B)Suppositories can be an effective means of administering medications to infants, since oral administration is often challenging. C)Suppositories should only be administered after the nurse manually clears the infant's rectum. D)Suppositories are poorly absorbed in infants due to their immature gastrointestinal tract.
B)Suppositories can be an effective means of administering medications to infants, since oral administration is often challenging.
An infant with recent seizures is being treated in the neonatal intensive care unit with phenytoin (Dilantin). The infant's low plasma protein levels during the first year of life have what consequence? A)The infant may have an unpredictable drug response. B)The infant may have an increased risk of toxicity. C)The infant may experience impaired elimination of the drug. D)The infant will have an increased rate of drug metabolism.
B)The infant may have an increased risk of toxicity.
The college health nurse is providing health education for freshmen. Which of the following pieces of information about immunizations is applicable to individuals of this age group? A)The oral polio should be updated. B)The yearly administration of flu vaccine is recommended. C)The tetanus toxoid must be within 2 years. D)The administration of hepatitis A vaccine is mandatory.
B)The yearly administration of flu vaccine is recommended.
A pediatric nurse is well aware of the many physiological variables that influence safe pharmacotherapy in patients younger than 18. Which of the following principles should the nurse integrate into care? A)The physiology of patients older than 15 can be considered to be the same as an adult patient. B)The younger the patient, the greater the variation in medication action compared to an adult. C)The larger the patient's body mass index, the more his or her physiology varies from that of an adult. D)Pediatric patients have a greater potential to benefit from pharmacotherapy than adult patients.
B)The younger the patient, the greater the variation in medication action compared to an adult.
An adult male patient is being administered immunosuppressant agents on a long-term basis. Which of the following assessments should be made routinely with the use of long-term immunosuppressant therapy? A)Yearly bronchoscopy B)Yearly skin assessment C)Yearly bladder biopsy D)Yearly prostate examination
B)Yearly skin assessment
A patient is ordered to receive cyclosporine intravenously, and the nurse has explained the need for frequent blood work. This blood work is required because cyclosporine A)decreases erythropoiesis. B)has a narrow therapeutic range. C)has been linked to spontaneous hemolysis. D)can precipitate a thyroid storm.
B)has a narrow therapeutic range.
Following a successful kidney transplant in 1999, a 59-year-old woman has presented to the clinic for one of her regularly scheduled follow-up appointments. The nurse at the clinic should assess the patient in the knowledge that long-term use of antirejection drugs has been associated with A)early onset of dementia. B)increased risk of malignancy. C)atherosclerosis. D)increased risk of venous thromboembolism.
B)increased risk of malignancy.
A pediatric nurse practitioner is aware that there are many knowledge gaps that still exist in the evidence base that underlies pediatric pharmacology. Many of these knowledge gaps are rooted in A)a lack of scientific understanding of the anatomy and physiology of children and infants. B)the historical lack of pediatric participation in the drug testing process. C)the fact that research grants in pharmacology have traditionally specified adult participation. D)assumptions that there are no physiological differences between adults and children.
B)the historical lack of pediatric participation in the drug testing process.
A patient is administered mycophenolate (CellCept) to prevent rejection of his transplanted heart. It is recommended that he have a CBC drawn weekly. He asks the nurse the reason for the weekly CBC. Which of the following is the nurse's best response? A)"The weekly CBC is routine and ordered for all patients." B)"The weekly CBC assesses for the development of bleeding." C)"The weekly CBC assesses for the development of infection." D)"The weekly CBC assesses for changes in your blood's oxygen carrying capacity."
C)"The weekly CBC assesses for the development of infection."
A transplant nurse is aware of the need to closely monitor a patient's serum levels of cyclosporine. In order to do this, the nurse should ensure that blood is drawn at what time? A)30 minutes before a scheduled dose B)Simultaneous to the administration of a dose C)2 hours after a dose D)At the halfway point between two scheduled doses
C)2 hours after a dose
A 3-year-old Asian American boy has had culture and sensitivity testing performed, and antibiotic treatment is indicated. The prescriber knows that the recommended antibiotic has not been extensively studied in pediatric patients. Consequently, the prescriber will be obliged to do which of the following? A)Administer subtherapeutic doses in order to mitigate the potential for adverse effects B)Choose a different antibiotic that has been extensively tested in children C)Apply vigilant clinical judgment when administering the antibiotic to the child D)Have the child's family sign informed consent forms absolving the care team from responsibility for adverse effects
C)Apply vigilant clinical judgment when administering the antibiotic to the child
A woman who began labor several hours ago is to be administered oxytocin. What is the goal of oxytocin therapy? A)Prevent postpartum bleeding B)Decrease fetal hyperactivity C)Augment weak or irregular contractions D)Diminish periods of relaxation
C)Augment weak or irregular contractions
A patient with a diagnosis of renal failure is being treated with epoetin alfa (Epogen). Frequent assessment of which of the following laboratory values should be prioritized before and during treatment? A)AST B)C-reactive protein C)CBC D)ALT
C)CBC
A woman is being administered IV magnesium sulfate. What is a desired outcome related to the administration of magnesium sulfate? A)Increased contractions B)Respiratory rate above 18 C)Decreased blood pressure D)Increased uterine tone
C)Decreased blood pressure
A 69-year-old female patient has been diagnosed with malignant melanoma. The care team has collaborated with the patient and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the patient may develop which of the following adverse effects? A)Profound diaphoresis B)Decreased level of consciousness C)Flu-like symptoms D)Cyanosis and pallor
C)Flu-like symptoms
A patient is receiving omalizumab (Xolair) to treat allergic asthma, which is not relieved by inhaled corticosteroids. Which nursing intervention is appropriate with each dose administration of omalizumab? A)Administer high-flow oxygen prior to administration. B)Avoid high-fat foods during the course of treatment. C)Have epinephrine available during administration. D)Administer a corticosteroid prior to administration.
C)Have epinephrine available during administration.
A nurse is performing health education with a woman who has just learned that she is pregnant. The nurse has explained the concept of teratogenic drugs and emphasized the need to have her care provider assess any medications she should consider taking. The nurse should teach the woman that drug-induced teratogenicity is most likely to occur at what point in her pregnancy? A)During the second half of her third trimester B)In the 7 to 10 days after conception C)In the first trimester during organogenesis D)During 30 to 34 weeks of gestation
C)In the first trimester during organogenesis
A patient is receiving epoetin alfa (Epogen) for anemia. Which of the following adjunctive therapies is imperative with epoetin alfa? A)Potassium supplements B)Sodium restriction C)Iron supplement D)Renal dialysis
C)Iron supplement
A patient is administered bevacizumab (Avastin) to treat tumor growth in a breast tumor. What is the action of a monoclonal antibody such as bevacizumab (Avastin)? A)It changes the RNA of the tumor cell to a normal form. B)It binds to the 30S ribosome. C)It prevents the activation of intracellular growth factors. D)It blocks the cell wall synthesis.
C)It prevents the activation of intracellular growth factors.
An infant who is 3 weeks old was born at full gestation but was just brought to the emergency department with signs and symptoms of failure to thrive. This pediatric patient will be classified into what pediatric age group? A)Full-term baby B)Young infant C)Neonate D)Early postnatal
C)Neonate
Which of the following is the most likely indication for the use of immunosuppressant agents? A)Intractable seizure disorders B)Increased intracranial pressure C)Organ transplantation D)HIV/AIDS with multiple drug resistance
C)Organ transplantation
A patient is scheduled to receive an immunization. In which of the following patients may the administration of a live vaccine be contraindicated? A)Patient with renal insufficiency B)Patient with hepatic failure C)Patient taking steroid therapy D)Patient over the age of 65 years
C)Patient taking steroid therapy
A patient is diagnosed with ischemic heart disease. She is prescribed filgrastim (Neupogen). What effect will this medication provide in the treatment of ischemic heart disease? A)Increase platelets B)Decrease platelets C)Promote angiogenesis D)Prevent thrombus formation
C)Promote angiogenesis
A woman who is 7 months pregnant is waking up at night with gastroesophageal reflux. Which of the following medications is most highly recommended? A)Terbutaline (Brethine) B)Diphenoxylate (Lomotil) C)Ranitidine (Zantac) D)Chlorothiazide (Diuril)
C)Ranitidine (Zantac)
A woman who takes highly active antiretroviral therapy (HAART) for HIV/AIDS has become pregnant. What effect will the woman's pregnancy have on her drug regimen? A)She must discontinue HAART due to the risk of teratogenic effects. B)Her dosages of HAART must be increased to reduce the risk of in utero transmission. C)She can continue her HAART unchanged. D)Some components of her HAART must be replaced or discontinued.
C)She can continue her HAART unchanged.
A woman has been unable to conceive for many months and will soon begin treatment with clomiphene (Clomid). What health education should the nurse provide to this patient? A)Avoid drinking alcohol while taking Clomid. B)Perform daily OTC pregnancy tests beginning the day after taking Clomid. C)Take her basal temperature between 5 to 10 days after taking Clomid. D)Report any numbness or tingling in her hands or lips to her care provider.
C)Take her basal temperature between 5 to 10 days after taking Clomid.
A public health nurse is responsible for the administration of numerous immunizations. Which of the following guidelines regarding anaphylaxis should the nurse adhere to? A)The patient should be observed for anaphylaxis for 1 minute after administration. B)The patient should be observed for anaphylaxis for 5 minutes after administration. C)The patient should be observed for anaphylaxis for 30 minutes after administration. D)The patient should be observed for anaphylaxis for 90 minutes after administration.
C)The patient should be observed for anaphylaxis for 30 minutes after administration.
A 32-year-old female patient is being treated with a cytotoxic antineoplastic agent. Which of the following is the most important instruction related to the potential for teratogenicity? A)The medication will be completely eliminated 24 hours after the administration. B)The patient should protect herself from infections and take Bactrim. C)The patient should not become pregnant for several months. D)The patient will not get pregnant due to the elimination of ova.
C)The patient should not become pregnant for several months.
A patient has developed a decubitus ulcer on the coccyx. What defense mechanism is most affected by this homeostatic change? A)The mucous membrane is affected. B)The respiratory tract is affected. C)The skin is affected. D)The gastrointestinal tract is affected.
C)The skin is affected.
Sirolimus and cyclosporine are being used to prevent renal transplant rejection in an adult patient. What principle should guide the nurse's administration of these two drugs? A)Sirolimus should be given orally; cyclosporine should be administered IV. B)The two drugs should be administered together to potentiate their effects. C)The two drugs should be given at least 4 hours apart. D)The drugs should be administered in a single intramuscular injection.
C)The two drugs should be given at least 4 hours apart.
A patient has chosen to receive palliative care after his lung cancer metastasized to his bones and liver. Which of the following is most appropriate during palliative cancer care? A)Abrupt cessation of chemotherapy immediately prior to entering palliative care B)Aggressive chemotherapy to reduce malignant cell proliferation C)The use of chemotherapy to reduce pain D)The replacement of chemotherapy with complementary and alternative treatments
C)The use of chemotherapy to reduce pain
The nurse is preparing to administer a vaccine to a newborn. Before administering the vaccine, the nurse should A)warm the vaccine to well above room temperature. B)vigorously massage the chosen injection site. C)check the infant's temperature. D)divide the dose for administration to three injection sites.
C)check the infant's temperature.
A patient is administered methotrexate for the treatment of severe rheumatoid arthritis. Administration of this drug should be performed with particular care because of the associated high risk of A)intracapsular bleeding. B)thrombophlebitis. C)hepatotoxicity. D)myocardial infarction or CVA.
C)hepatotoxicity.
A patient's chemotherapy regimen has been deemed successful, but the patient is experiencing debilitating nausea and vomiting. These adverse effects should signal the nurse to the possibility of what nursing diagnosis? A) Acute pain B) Adult failure to thrive C) Ineffective therapeutic regimen management D) Imbalanced nutrition: less than body requirements
D) Imbalanced nutrition: less than body requirements
A patient with a diagnosis of chronic renal failure will soon begin a regimen of epoetin that will administered by the patient at home. Which of the following statements indicates that the nurse's initial health education has been successful? A)"I'll make sure to take my Epogen pill on a strict schedule and make sure I never miss a dose." B)"I'm glad that Epogen can help to protect me from getting an infection." C)"I'm excited that there's a medication that can help my kidneys work better." D)"I'm not all that comfortable with giving myself an injection, but I'm sure I'll be able to learn."
D)"I'm not all that comfortable with giving myself an injection, but I'm sure I'll be able to learn."
A 50-year-old man has just been diagnosed with liver cancer, and the care team is finalizing the chemotherapy regimen that will begin imminently. Administration of chemotherapeutic drugs is best achieved through which of the following? A)An intramuscular depot B)A peripheral IV in the nondominant forearm C)Peripheral intravenous access in the antecubital fossa D)A central venous catheter
D)A central venous catheter
Which of the following patients would likely be the most appropriate candidate for treatment with filgrastim (Neupogen)? A)A patient who has undergone a mastectomy for the treatment of breast cancer B)A patient with acquired immune deficiency syndrome (AIDS) who has been diagnosed with Kaposi's sarcoma C)A patient who developed acute renal failure secondary to rhabdomyolysis D)A patient whose acute myelogenous leukemia necessitated a bone marrow transplant
D)A patient whose acute myelogenous leukemia necessitated a bone marrow transplant
A patient develops tumor lysis syndrome during the administration of chemotherapy agents. Which of the following treatments is implemented to resolve this health problem? A)Administration of potassium IV B)Administration of anti-inflammatory agents C)Limiting of fluid intake and reduction in IV fluid rate D)Administration of IV normal saline and sodium bicarbonate
D)Administration of IV normal saline and sodium bicarbonate
It is important for the nurse to stay informed of the most current recommendations for immunizations. Which of the following sources is most accurate regarding immunization guidelines? A)American Academy of Pediatrics B)American Academy of Family Physicians C)American Academy of Infectious Disease Physicians D)Centers for Disease Control and Prevention
D)Centers for Disease Control and Prevention
A patient with colorectal cancer is being treated with oxaliplatin (Eloxatin). Which of the following potential adverse effects should the nurse explain to the patient? A)Dysuria B)Diarrhea C)Insomnia D)Cold-induced neuropathy
D)Cold-induced neuropathy
A patient with Crohn's disease is given a corticosteroid to decrease inflammation. Which of the following effects will occur with the use of corticosteroids? A)Increased joint pain B)Increased C-reactive protein levels C)Increased T-cell counts D)Decreased antibody production
D)Decreased antibody production
A patient is being administered magnesium sulfate for preterm labor. The patient's serum magnesium level is elevated at 11 mg/dL. With what sign or symptom will the patient likely present? A)Tachypnea B)Muscle rigidity C)Tachycardia D)Depressed deep tendon reflexes
D)Depressed deep tendon reflexes
A woman is at 42 weeks of gestation. Which of the following medications will be administered to promote cervical ripening? A)Calcium gluconate B)Magnesium sulfate C)Terbutaline (Brethine) D)Dinoprostone (Cervidil)
D)Dinoprostone (Cervidil)
A nurse is administering a mumps vaccine to an adolescent. Which of the following medications should be available when administering an immunization? A)Diphenhydramine (Benadryl) B)Hydroxyzine (Vistaril) C)Physostigmine D)Epinephrine
D)Epinephrine
Which of the following laboratory tests relates most directly with the impaired drug elimination that is expected in neonates? A)C-reactive protein level B)Creatine kinase C)Serum albumin level D)Glomerular filtration rate
D)Glomerular filtration rate
An infant's antiseizure medication has been ordered after careful consideration of the unique pharmacokinetics among this population. What characteristic of neonates has the greatest bearing on drug metabolism? A)The undeveloped state of the blood-brain barrier B)Increased gastric motility in infants C)The infant's undeveloped renal function D)Immaturity of the infant's liver
D)Immaturity of the infant's liver
When providing patient teaching to parents regarding measles, mumps, and rubella vaccine administration, which of the following is most important regarding the schedule for administration? A)It is administered at 1 to 2 months. B)It is administered at 3 to 4 months. C)It is administered at 5 to 6 months. D)It is administered at 12 to 15 months.
D)It is administered at 12 to 15 months.
A patient is exposed to a viral infection. What role will interferon most likely play during this exposure? A)It will stimulate B-lymphocyte activity. B)It will interfere with stem cell multiplication. C)It will stimulate growth of lymphoid cells. D)It will interfere with virus replication.
D)It will interfere with virus replication.
A primiparous woman was vigilant in avoiding medications and herbs during her pregnancy and states that she is similarly committed to protecting her baby's health now that she is breast-feeding. What principle should guide the woman's use of medications while breast-feeding? A)Very few medications are explicitly contraindicated while breast-feeding. B)It is generally safer to use herbs rather than medications while breast-feeding. C)Most women can resume their prepregnancy medication regimen after delivery. D)Most medications are contraindicated while a woman is breast-feeding.
D)Most medications are contraindicated while a woman is breast-feeding.
A woman in preterm labor has been administered terbutaline sulfate (Brethine). For what potential adverse effects should the nurse assess the patient? A)Pruritus (itching) and copious diaphoresis B)Joint pain and numbness in her extremities C)Headache and visual disturbances D)Palpitations and shortness of breath
D)Palpitations and shortness of breath
A patient has received a rubella immunization. The patient was unaware that she was pregnant. What risk is associated with the administration of the rubella immunization in this patient? A)Risk of development of the disease in the newborn B)Risk of low infant birth weight C)Risk of preterm labor D)Risk of birth defects
D)Risk of birth defects
A patient is undergoing a bone marrow transplant. Which of the following medications is most effective in stimulating the production of granulocytes and macrophages? A)Bacillus Calmette-Guérin (BCG) B)Epoetin alfa (Epogen) C)Aldesleukin (Proleukin) D)Sargramostim (Leukine)
D)Sargramostim (Leukine)
An infant is seen in the clinic for her first immunizations. When providing patient teaching to the parent, which of the following is no longer recommended for administration? A)Rubella and mumps vaccine B)Polio vaccine C)Diphtheria, pertussis, and tetanus vaccine D)Smallpox vaccine
D)Smallpox vaccine
A patient has been discharged from the hospital after a kidney transplant. Which of the following nursing interventions is the first line of defense against the immunosuppressed patient developing an infection? A)Ensure visitors do not come to the home. B)Teach the patient to wear a mask consistently. C)Administer prophylactic antibiotics. D)Teach the patient the importance of personal hygiene.
D)Teach the patient the importance of personal hygiene.
When instructing the parents of a child who has received immunization in the vastus lateralis, which reaction is most common in the days after the administration? A)Nausea, vomiting, and diarrhea B)Rash and edema C)Weakness and difficulty walking D)Tenderness and redness at the site
D)Tenderness and redness at the site
A patient is being treated for preterm labor. Which beta-adrenergic medication is administered orally to decrease uterine contractions? A)Magnesium sulfate B)Oxytocin (Pitocin) C)Nifedipine (Procardia) D)Terbutaline (Brethine)
D)Terbutaline (Brethine)
A patient is receiving immunosuppressant therapy and is preparing for discharge. For which of the following should the patient be educated? A)The importance of a high-protein diet B)The need to maximize fluid intake C)The need for regular physical activity D)The importance of keeping the home clean
D)The importance of keeping the home clean
A neonate has been prescribed a water-soluble drug for the treatment of an acute infection. The nurse recognizes that the percentage of body water in an infant is significantly higher than that of an adult. What implication does this have for pharmacotherapy of an infant? A)The drug will need to be emulsified before administration. B)The infant's fluid intake will be reduced before and after administration. C)The infant will have a fat-soluble drug substituted. D)The infant may require an increased dose of the drug.
D)The infant may require an increased dose of the drug.
A patient has undergone an aggressive chemotherapeutic regimen to treat leukemia. The patient develops gastrointestinal upset, hypertension, and paresthesias. What syndrome is the patient developing? A)Fröhlich's syndrome B)Epidermal nevus syndrome C)Irritable bowel syndrome D)Tumor lysis syndrome
D)Tumor lysis syndrome
When providing a health promotion presentation to a group of seniors, how often should you instruct the senior group to obtain influenza vaccines? A)One time only B)Every 10 years C)Two times per year D)Yearly
D)Yearly
A 4-year-old boy is postoperative day one following surgery for trauma suffered in a motor vehicle accident. The boy is in pain, and the nurse is preparing to administer a dose of hydromorphone syrup as ordered. To administer this drug, the nurse should use A)a teaspoon. B)a transparent, 2-ounce medication cup. C)a parenteral syringe with the needle removed. D)an oral syringe.
D)an oral syringe.
An oncology nurse is reviewing the medication administration record of a patient being treated for advanced prostate cancer. In addition to two chemotherapeutic agents, the nurse reads that the patient has been ordered a cytoprotective agent. The goal of this agent is to A)buffer the cytotoxins that result from the metabolism of chemotherapeutic agents. B)protect the patient from pathophysiological effects of his malignancy. C)potentiate the beneficial effects of chemotherapy. D)reduce the incidence or severity of adverse drug effects.
D)reduce the incidence or severity of adverse drug effects.
