Exam 1 (use with quiz 1)

The nurse assesses an adverse effect of a medication that has been administered. No medication error was committed. What is the best plan of the nurse at this time? 1. Report the adverse effect to the Food and Drug Administration's (FDA) MedWatch Website. 2. Report the adverse effect to the Food and Drug Administration's (FDA) Adverse Event Website. 3. Report the adverse effect to the Food and Drug Administration's (FDA) Safe Medicine Website. 4. Report the adverse effect to the Food and Drug Administration's (FDA) Med MARX Website.

1

The patient tells the nurse that she is concerned about terrorist activity and questions if everyone should be immunized against smallpox. What is the best response by the nurse? 1. "The vaccine has side effects, which are serious and could kill many people." 2. "I really do not think our country has enough vaccine to do this." 3. "Don't be so concerned; if an attack comes, we will immunize people then." 4. "The vaccine has some serious side effects, but this is probably a good idea."

1

The pregnant patient tells the nurse that her prescribed medication is not as effective as it was before her pregnancy. What is the best response by the nurse? 1. "This is because your blood volume has increased." 2. "Tell me how you have been taking your medication." 3. "This is because your baby is receiving part of the medication." 4. "Maybe the medication has expired; check the label."

1

What is the best choice for preventing thyroid cancer in persons exposed to ionizing radiation? 1. Potassium-iodine tablets 2. Calcium tablets 3. Antibiotics 4. Salt tablets

1

A nurse presenting information regarding anthrax should include which information? (select all that apply) 1. Anthrax can spread easily. 2. There are three basic types of anthrax. 3. Anthrax is killed by heat. 4. The main area affected by inhalation anthrax is the lung periphery. 5. Anthrax causes disease by the emission of multiple toxins, each affecting a different part of the body.

1, 2

A nurse on the medical-surgical unit is caring for several very ill patients. One patient says, "I was supposed to get my medications an hour ago." The nurse recognizes that medication errors can have what repercussions? (select all that apply) 1. Medication errors can potentially extend the patient's length of hospital stay. 2. Medication errors can result in expensive legal costs to the facility. 3. Medication errors can damage the facility's reputation. 4. Medication errors can be physically devastating to nurse and patient. 5. Medication errors cause preventable deaths during hospitalizations.

1, 2, 3, 5

The patient tells the nurse that she plans to take St. John's wort to treat her depression. What is the best response by the nurse? (select all that apply) 1. "That should be fine as long as you are not suicidal." 2. "St. John's wort is successfully used in Europe for minor depression." 3. "It would be a good idea to try this before paying for a prescription medication." 4. "It would be better to have a psychiatric assessment first." 5. "Herbal preparations can interact with many other medications."

4, 5

A nurse is providing care to a patient who wears bilateral hearing aids. Which nursing interventions are indicated? (select all that apply) 1. Speak a bit slower than normal. 2. Speak more loudly than normal. 3. Ensure that verbal and nonverbal communication is congruent. 4. Allow extra time for communication. 5. Use bright lighting in the room.

1, 3, 4

Which information is essential for the nurse to collect when reviewing a patient's medication list? (select all that apply) 1. Drug names 2. Drug manufacturer 3. Dosage being taken 4. Frequency of administration 5. When last refill was obtained

1, 3, 4

The patient was exposed to cutaneous anthrax 2 weeks ago. What will the nurse see when assessing the patient's skin? 1. Large pustules, and later, reddish scabs 2. Small, fluid-filled vesicles, and later, small skin erosions 3. Ulcerated areas, and later, keloids 4. Small skin lesions, and later, black scabs

4

The patient has been exposed to anthrax. What treatment will the nurse plan to administer? 1. Penicillin (Bicillin LA) and vancomycin (Vancocin). 2. Tetracycline (Sumycin) and erythromycin (Erythrocin). 3. Ampicillin (Principen) and cefepime (Maxipime). 4. Ciprofloxacin (Cipro) and doxycycline (Vibramycin)

4

A patient with a family history of heart disease asks the nurse to recommend herbs that decrease the risk for heart disease. The nurse suggests the patient discuss which herbs with the health care provider? (select all that apply) 1. Flaxseed 2. Green tea 3. Soy 4. Milk thistle 5. Acai

1, 2, 3

The danger from radiation exposure arises primarily from: (select all that apply) 1. the amount of exposure. 2. the long-lasting effects. 3. the amount of cellular death. 4. the gender of the patient exposed. 5. the amount of naloxone (Narcan) ingested after exposure.

1, 2, 3

A patient presents with hypotension and bradycardia. The patient indicates that one of her physicians recently prescribed three new medications to her current list of 10 medications per day. Based on this information, which statement would be the most accurate? 1. The patient is having an allergic reaction to one of the new medications. 2. The patient is experiencing adverse reactions as a result of polypharmacy. 3. The patient is not in compliance with her prescribed medications. 4. The patient is experiencing an adverse effect that will go away in time.

2

The nurse is teaching a class on anthrax to a group of emergency response workers. What is the best instruction to include? 1. Anthrax is a deadly bacterium; the most common and deadly form is gastrointestinal anthrax. 2. Cutaneous anthrax is the most common form, but inhaled anthrax is the most lethal form. 3. Anthrax most commonly affects wild rodents such as mice, rats, squirrels, and chipmunks. 4. Cutaneous anthrax is serious because it quickly spreads by person-to-person contact.

2

The nurse uses a newly admitted patient's armband barcode to identify the patient prior to administering medications. The nurse should use ______ other means of identifying this patient.

2

A nurse is planning a discussion of emergency preparedness with newly hired nurses. Which events would this nurse use as historical examples of terrorism? (select all that apply) 1. The death of a patient in a Dallas, Texas, hospital was confirmed to be due to the Ebola virus. 2. Many people died as a result of sarin gas exposure in a Tokyo subway. 3. Twenty-two confirmed or suspected cases of anthrax infection occurred as a result of the bacillus being sent through U.S. mail. 4. There is typically a marked increase in overdoses during winter holidays. 5. More people are contracting H1N1 avian influenza.

2, 3

A nurse is reviewing medication records of older adults living in extended care. Which concepts about the pharmacotherapy of older adults should be considered? (select all that apply) 1. Plasma-binding of drugs is greater in those over age 65. 2. Drug distribution is slowed in the older adult. 3. The half-life of many drugs is lessened in older adults. 4. First-pass metabolism is reduced in the older adult. 5. Changes in the kidney may result in decreased drug excretion.

2, 4, 5

The nursing instructor teaches student nurses about the Food and Drug Administration (FDA) Pregnancy Categories. What is the best information to include? (select all that apply) 1. Food and Drug Administration (FDA) Pregnancy Category C is safe to use during pregnancy. 2. Food and Drug Administration (FDA) Pregnancy categories provide a framework for safe use of drugs in pregnant women. 3. Food and Drug Administration (FDA) Pregnancy categories for individual drugs seldom change once they are established. 4. Food and Drug Administration (FDA) Pregnancy categories are based on studies using clinical human research trials. 5. Food and Drug Administration (FDA) Pregnancy Category X has been associated with teratogenic effects.

2, 5

The Joint Commission documented that patient education was deficient on several medical-surgical units of a local hospital. A nursing committee was formed to address this problem and focused on what likely nursing intervention? 1. Providing educational pamphlets about medications to the patients. 2. Asking the physicians to provide medication education to the patients. 3. Discussing medications each time they are administered to patients. 4. Requesting more frequent pharmacy consults for the patients.

3

The nurse has several educational pamphlets for the patient about medications the patient is receiving. Prior to giving the patient these pamphlets, what is a primary assessment for the nurse? 1. Assess the patient's readiness to learn new information. 2. Assess the patient's religious attitudes toward medicine. 3. Assess the patient's reading level. 4. Assess the patient's cultural bias toward taking medicine.

3

The nurse is preparing an educational plan for parents about how to protect their children if a bioterrorist attack occurs. What is the best information to include? 1. "Don't worry, the Centers for Disease Control and Prevention (CDC) has everything under control." 2. "Plan to call the Centers for Disease Control and Prevention (CDC) if an attack occurs." 3. "Follow the Centers for Disease Control and Prevention (CDC) guidelines for immunizations." 4. "Realistically, there is nothing that can be done."

3

The nurse recognizes that agency system checks are in place to decrease medication errors. Who commonly collaborates with the nurse on checking the accuracy of the medication prior to administration? 1. The nursing supervisor 2. The nursing unit manager 3. The pharmacist 4. The physician

3

What would be most effective for the treatment of a person infected with anthrax? 1. Anthrax vaccination 2. Atropine 3. Ciprofloxacin 4. Antiviral agents

3

Which of the following antidotes would be indicated for a patient who overdosed on a benzodiazepine? 1. Acetylcysteine (Acetadote) 2. Digibind 3. Romazicon 4. Acetaminophen

3

Specialty supplements differ from herbal products in that: 1. specialty supplements must be prescribed. 2. herbal products are more specific in their actions. 3. specialty supplements are generally targeted for more general conditions. 4. specialty supplements can come from animal sources

4

The adolescent Hispanic male has been diagnosed with attention-deficit hyperactivity disorder (ADHD), and is taking methylphenidate (Ritalin). Even though the drug helps with focus and grades, the adolescent will not go to the school office at noon for his medication. Which statement best describes the result of the nurse's evaluation? 1. The adolescent has developed alternative coping mechanisms to increase his focus during classes. 2. The adolescent is fearful that this drug may be a "gateway drug" and he will abuse other substances. 3. The adolescent really does not need an additional dose of methylphenidate (Ritalin) at school. 4. The adolescent is embarrassed about having to take medicine at school; it is a social stigma.

4

The nurse follows the nursing process when conducting medication education about insulin. The step of evaluation is best demonstrated by which question? 1. "Is your abdomen the best place to inject insulin?" 2. "What questions do you have about insulin?" 3. "Can you recognize when you are experiencing hypoglycemia?" 4. "Can you tell me four points you remember about how to take your insulin?"

4

A nurse working in an obstetric practice should consider which fact when discussing medication use with pregnant patients? 1. Inhaled drugs may be absorbed to a greater extent. 2. Drug excretion rates are lowered. 3. Oral drug absorption rate is lowered. 4. Drugs should not be used during pregnancy.

1

A woman who wishes to become pregnant is concerned about the drugs she must take in order to treat a serious medical condition. The nurse reviewing the drug list would be most concerned about which kind of drug? 1. A drug with a long half-life 2. A drug with no active metabolites 3. A drug with high protein-binding ability 4. A drug taken only when needed

1

All of the patients listed have cancer and are receiving chemotherapy. Which patient does the nurse evaluate as having the highest probability for a remission? 1. The patient with a support group of cancer survivors 2. The patient who is also seeing a psychiatrist for treatment of depression 3. The wealthy patient who can afford the best medical care available 4. The patient who is a former physician

1

An adolescent patient comes to the school nurse with complaints of vague abdominal pain. What assessment data would help to confirm the nurse's suspicion that the adolescent has body image concerns? 1. The adolescent says, "Everyone makes a big deal about what I eat, so don't ask." 2. The adolescent tells the nurse, "I have been sexually active with my boyfriend." 3. The adolescent reports, "My periods are irregular. Should I see a doctor?" 4. The adolescent tells the nurse, "I just can't seem to get along with my parents."

1

Following a bioterrorism attack, the nurse finds that the victims are suffering from small, black lesions on their forearms. The nurse collaborates with the physician to treat exposure to which agent? 1. cutaneous anthrax 2. phosgene gas 3. gastrointestinal anthrax 4. hydrogen cyanide

1

The active ingredients of herbs: 1. can be found in all parts of the herb. 2. are found only in the root system. 3. are found only in the rhizome. 4. are found only in the stems and leaves.

1

The adolescent is supposed to go to the school nurse at 12:00 to receive his medication for attention-deficit hyperactivity disorder (ADHD). He often does not go for the medication. What best describes the nurse's understanding of this situation? 1. The adolescent is embarrassed in front of his peers. 2. The adolescent does not understand the need for the medication. 3. The adolescent forgets that he is supposed to take the medication. 4. The adolescent has made a conscious decision not to take the medication.

1

The nurse administers potassium iodide (KI) tablets to a patient who has been exposed to radiation from a nuclear weapon. What is the rationale for administering potassium iodide (KI) to this patient? 1. It was administered to prevent thyroid cancer. 2. It was administered to prevent brain cancer. 3. It was administered to prevent liver cancer. 4. It was administered to prevent renal cancer.

1

The nurse commits a medication error. The nurse documents the error in the patient's record and completes the incident report. What does the nurse recognize as the primary reason for doing this? 1. To verify that the patient's safety was protected 2. To protect the patient from further harm 3. To protect the health care facility from litigation 4. To protect the nurse from liability

1

The nurse is teaching a class on dietary supplements. The nurse determines that learning has occurred when the patients make which statement? 1. "Products can make claims based on body structure and function like 'promotes healthy urinary tract.'" 2. "Dietary supplements must go through rigorous testing prior to being marketed by the manufacturer." 3. "The Food and Drug Administration (FDA) is not involved with the approval of the dietary supplement and cannot remove it from the market." 4. "The manufacturer of the dietary supplement has the burden of proof for the safety of the supplement."

1

The nurse teaches a class about medication used during pregnancy to pregnant women. The nurse determines that additional instruction is required when a class participant makes which response? 1. "The baby can only be harmed by medications during the first trimester." 2. "It is important to not take over-the-counter (OTC) drugs during my pregnancy." 3. "Exposure to teratogens can result in my baby's death or in malformations." 4. "If I breastfeed my baby, drugs can come through my breast milk."

1

The nurse teaches a class to patients about how to help prevent medication errors when in the hospital. What is a priority question for the nurse to ask the patients? 1. "Do you know the names of all the medications you take?" 2. "Do you trust your physician to order the correct medication?" 3. "Do you have a friend to verify that you are receiving the correct medication?" 4. "Do you know what your illness is, and if you will need surgery?"

1

The older adult asks the nurse how dietary supplements will help support health. What is the best response by the nurse? 1. "Fish oil will help to enhance your brain function." 2. "Chromium will help you achieve and maintain optimum weight." 3. "Dietary supplements will help support and maintain hydration." 4. "Soy isoflavone will help prevent Alzheimer's disease."

1

The patient confides in the nurse that she is drawn to complementary and alternative medicine because it promotes the "whole person." The patient would like spirituality and prayer included in her plan of care. What is the best response by the nurse? 1. "We will include spirituality in your plan. Would you like to say a prayer?" 2. "I think your spiritual concerns are best left up to you and your minister." 3. "What exactly do you mean by spirituality and prayer?" 4. "We usually do not pray with patients; is there something you are worried about?"

1

The patient has been exposed to a nerve agent. For which symptoms will the nurse most likely assess? 1. Salivation, involuntary urination, and convulsions 2. Dilated pupils and increased blood pressure and heart rate 3. Pinpoint pupils, decreased blood pressure, and increased heart rate 4. Rapid breathing and cold, clammy skin

1

The patient is receiving albuterol (Proventil) for treatment of bronchospasm related to asthma. What is the primary nursing intervention as it relates to this medication? 1. Monitor the patient for relief of bronchospasms. 2. Monitor the patient for nausea and headache. 3. Monitor the patient's serum drug levels. 4. Provide the patient with age-appropriate education about albuterol (Proventil).

1

The patient takes St. John's wort for depression but does not tell anyone about this. The psychiatrist prescribes an SSRI. What could the nurse's assessment reveal due to this concurrent administration? 1. Dizziness 2. Serum glucose level of 340 3. Sedation 4. Serum potassium of 6.0

1

The patient, who is an American Indian, has been admitted to the hospital for chemotherapy. At any given time, five family members are in the patient's room, which is private. The nurse tells the patient that according to hospital policy, only two visitors at a time are allowed. What does the best analysis by the nurse manager reveal about the nurse's action? 1. The nurse should have assessed the patient's preferences about how many family members she wanted to be present. 2. The nurse should have called the physician and obtained an order for additional family members to be present. 3. This was the correct action; the nurse was following protocol by informing the patient about hospital policy. 4. The nurse should have allowed the patient to have as many family members as she wanted to be present.

1

Which method would the nurse use to administer medications to school-age children? 1. Allow the child to make decisions regarding how medications are taken 2. Provide a brief explanation 3. Administer drugs while holding the child down 4. Provide a lengthy explanation followed by quick drug administration

1

Which of the following best indicates an ethnic characteristic that can affect pharmacotherapy? 1. Genetic differences 2. Diet 3. Health beliefs 4. Alternative therapies

1

Which of the following is a reason for the increase in popularity of herbal remedies? 1. They are being marketed very aggressively. 2. Most insurance policies cover them. 3. They are more effective for treating bacterial infections. 4. Their popularity is decreasing, not increasing.

1

Which situation best represents adherence to a standard of care? 1. Administering a medication within the time frame specified by hospital policy 2. Administering a medication intramuscularly when a patient refuses to take it orally 3. Using abbreviations while charting to save time 4. Discontinuing a medication at the request of a patient

1

Which situation is an example of a medication error? 1. The wrong dose of a medication is drawn up but is caught and corrected prior to administration. 2. A medication is administered to a patient with no allergies, yet an anaphylactic response occurs. 3. A medication is administered in liquid form instead of tablet form due to the patient's difficulty swallowing. 4. A patient experiences unexpected hypotension as a result of medication administration.

1

Which statement is accurate regarding gender and pharmacology? 1. Women tend to seek medical care earlier than men do. 2. Heart disease has traditionally been thought of as a woman's disease. 3. Since the 1980s, the FDA has mandated that research studies include both male and female subjects. 4. Studies indicate that men and women suffer from Alzheimer's disease in equal numbers.

1

A home health nurse's patient caseload is ethnically diverse. Which interventions show understanding of cultural variables? (select all that apply) 1. Discussing cultural preferences for herbs and spices and possible alternatives when drug interactions are possible 2. Assessing the patient's response to acupuncture for pain 3. Discussing the patient's beliefs regarding treatment 4. Notifying the health care provider of the patient's intentions to consult with a medicine man for spiritual guidance 5. Removing the patient's collection of herbs to decrease the risk of an adverse effect when taken with Western medicine

1, 2, 3

A patient asks the nurse why a medication prescribed by the provider "didn't do anything at all." Which statement by the nurse accurately describes how genetics influence drug action? (select all that apply) 1. "Genetic differences can result in significant differences in how each patient's body handles the same medication." 2. "Genetic differences can cause mutations in enzymes, changing the way they function. This can alter how the body metabolizes and excretes drugs." 3. "Because of genetic differences, medication may accumulate to toxic levels in one patient while in another patient may be inactivated before it can have a therapeutic effect." 4. "Genetic differences can be expressed as an alteration in the structure of an enzyme, which can cause a defective receptor and an allergic response to drugs." 5. "Genetic differences in patients who are biracial result in an allergic response to medications."

1, 2, 3

A patient experiencing occasional minor digestive problems asks the nurse about herbal therapy. Which herbs would the nurse recommend? (select all that apply) 1. Wheat grass 2. Green tea 3. Ginger 4. Grape seed 5. Stevia

1, 2, 3

A patient who is considering taking a dietary supplement recommended by the nurse asks how to determine if the supplement is safe. The nurse explains that the Dietary Supplement and Nonprescription Drug Consumer Protection Act of 2007 requires that companies marketing herbal and dietary supplements: (select all that apply) 1. include their contact information on the label so consumers can report adverse effects. 2. notify the Food and Drug Administration (FDA) within 15 days of receiving a report of an adverse effect. 3. keep records of adverse effects for at least 6 years and make these records available for inspection by the Food and Drug Administration (FDA). 4. demonstrate product effectiveness prior to release of the product to the public. 5. state which conditions the product is intended to cure or prevent.

1, 2, 3

A patient with inflammatory arthritis asks about adding an anti-inflammatory herb to the medication regimen to decrease the use of prescription drugs. The nurse suggests the patient discuss the efficacy of which herbs with the health care provider? (select all that apply) 1. Evening primrose 2. St. John's wort 3. Ginger 4. Ginseng 5. Bilberry

1, 2, 3

A postmenopausal patient with a history of stroke is told she cannot take female hormones because of the risk for future thromboembolic events. The patient asks about nonpharmacologic ways to manage her symptoms. Which herbs does the nurse suggest as alternatives? (select all that apply) 1. Soy 2. Black cohosh 3. Evening primrose 4. Saw palmetto 5. Acai

1, 2, 3

A pregnant patient suspected of drug abuse is admitted to the emergency department. The nurse plans to teach the patient about which complications associated with drug use during pregnancy? (select all that apply) 1. Preterm birth 2. Low birth weight 3. Birth defects 4. Allergies to narcotics 5. Increased labor

1, 2, 3

For which patient would the nurse expect the health care provider to continue prescribed medications during pregnancy? (select all that apply) 1. The patient recently diagnosed with gonorrhea 2. The patient with a history of frequent asthma attacks 3. The patient with hypertension 4. The patient with frequent insomnia 5. The patient with a family history of stroke

1, 2, 3

The nurse in charge of a clinical study welcomes the participants in an open forum. One patient is surprised that there are men and women from several ethnic groups. The nurse tells the group that in the past, ethnic variables were largely unknown or ignored for what reasons? (select all that apply) 1. Clinical trials failed to include ethnically diverse subjects. 2. Clinical trials comprised mostly Caucasian males. 3. Little attention was focused on identifying the different effects drugs had on various ethnic groups. 4. Research proved there were no differences among ethnic groups. 5. The large majority of clinical trials included Caucasian females.

1, 2, 3

The nurse in the emergency department is caring for several patients from diverse cultures. Which statement shows the nurse's ability to provide culturally competent care? (select all that apply) 1. "I understand your religion prohibits blood transfusions. Would you consider nonblood alternatives?" 2. "I just want to make sure you and your spouse understand the risks as you consider the options." 3. "I don't really understand why you are afraid to take the medication. Do you have any questions I can answer to alleviate your fear?" 4. "I really don't understand why you won't consider an abortion. Your admission papers say you are an atheist." 5. "I'm not quite sure why the health care provider is giving you these prescriptions. You didn't get them filled the last time you were here."

1, 2, 3

The nurse is assessing several patients. For which patient does assessment reveal a psychosocial history that may affect the patient's outcome? (select all that apply) 1. Older adult who recently suffered a stroke, has an unsteady gait, and lives in a two-story home 2. Middle-aged patient with Down syndrome living in a group home 3. Recently divorced mother of three children with breast cancer 4. Sixteen-year-old requesting birth control without parental consent 5. Seven-year-old with asthma in a foster care home

1, 2, 3

The nurse is planning care for a pregnant patient prone to substance abuse. When the patient states, "My baby isn't getting my drugs, I am," how does the nurse respond? (select all that apply) 1. "Most illicit drugs will cross the placenta and hurt the baby." 2. "Drugs may work longer in your baby." 3. "Some drugs result in your baby not growing enough." 4. "You are correct. You are far enough along in your pregnancy that drugs will not harm your baby." 5. "If you continue to take drugs, it will make you have a very irritable infant."

1, 2, 3

The nurse is teaching patients in a senior center about complementary and alternative therapies. Which statement by a patient indicates understanding of the information the nurse has presented? (select all that apply) 1. "I see now that 'natural' doesn't really mean 'safe,' and I should ask my health care provider about any supplements I want to take." 2. "I didn't realize some herbal supplements may be just as strong as a prescription drug. I will need to discuss any supplements I want to try with my doctor." 3. "I understand now that when I choose to use a natural product over a prescription medication, I could be delaying my recovery." 4. "It's good to know that herbs contain ingredients that are as powerful as a prescribed medication and are an option for safe and effective therapy." 5. "I'm allergic to many foods. It's good to know that because herbal products are natural, I don't have to worry about an allergic reaction."

1, 2, 3

The nurse is working very hard to prevent medication errors. What plans will assist the nurse in preventing most errors? (select all that apply) 1. Plan to always check the patient's identification band prior to administration of medications. 2. Plan to open all of the medications immediately prior to administration. 3. Plan to tell physicians that verbal orders will not be accepted. 4. Plan to record the medication on the medication administration record (MAR) immediately prior to administration. 5. Plan to validate all orders with another nurse prior to administration of medications.

1, 2, 3

When teaching the patient about a new medication, the nurse should include which information? (select all that apply) 1. Adverse effects that can be expected 2. Which adverse effect to report to the health care provider 3. The drug's therapeutic action 4. Chemical composition of the drug 5. Name of the drug manufacturer

1, 2, 3

A community health nurse is preparing a teaching plan regarding medications and safety for a new parent class. Which topics should be addressed? (select all that apply) 1. Parents should maintain a list of current medications for each child. 2. Parents should be aware of each child's medication allergies. 3. Parents should know what the child's prescribed medication is for, how it should be administered, and when to expect the child to feel better. 4. Parents should be aware that any leftover medication should be appropriately disposed of, not saved for future use. 5. Parents should read the prescription label for any foods the child should avoid while taking the medication and for possible adverse effects to watch out for.

1, 2, 3, 4

A new nurse on the orthopedic floor makes a medication error. Which statements by the nurse manager foster a safe environment in which nurses will report medication errors? (select all that apply) 1. "Many of us have made a medication error in our careers. The most important issue is to identify why the error occurred." 2. "I know you could not feel any worse than you already do. We need to discuss how this error happened and how we can prevent it from happening again." 3. "It's really good that your patient is OK and did not suffer any harmful effects of this error. We should discuss why this error occurred and how it can be prevented in the future." 4. "Because you are a new nurse, we should sit down and discuss the procedure you followed to see what you could have done to prevent this error." 5. "We need to sit down as soon as possible and write up an incident report describing everything you did incorrectly that caused this error."

1, 2, 3, 4

A nurse administering medications to a variety of patients on a medical-surgical floor recognizes that which patients may need additional education about medication adherence? (select all that apply) 1. Fifty-year-old recently remarried male taking antihypertensive medication 2. Thirty-four-year-old female with family history of blood clots taking an estrogen oral contraceptive 3. Thirty-eight-year-old male recently started on an antidepressant 4. Twenty-eight-year-old female started on acne medication known to cause male-patterned hair growth 5. Seventy-eight-year-old female being treated for shingles

1, 2, 3, 4

A nurse is preparing care for a newly admitted patient with diabetes. Which information would be critical for the nurse to assess? (select all that apply) 1. Medical history 2. Current lab results 3. Medication allergies 4. Use of dietary supplements 5. Number of previous hospitalizations

1, 2, 3, 4

The nurse has made a medication error. The nurse manager determines the error was based on a common misinterpretation of which abbreviation? (select all that apply) 1. IU 2. SQ 3. Q.O.D. 4. U 5. mcg

1, 2, 3, 4

The nurse is reviewing the components of the Strategic National Stockpile (SNS), which include: (select all that apply) 1. intravenous administration equipment. 2. antibiotics. 3. life-support medications. 4. chemical antidotes. 5. hospital beds.

1, 2, 3, 4

The nurse preparing a teaching plan for an adolescent postpartum mother includes which topics? (select all that apply) 1. Most medications are secreted into breast milk. 2. Dietary supplements should be avoided. 3. Over-the-counter (OTC) herbal products are secreted into breast milk and have the potential to cause harm to the infant. 4. All tobacco products should be avoided. 5. Most drugs are safe to take right after breastfeeding because they will clear the bloodstream prior to the next feeding.

1, 2, 3, 4

Which interventions will the nurse include when planning care to enhance the removal of poison from a patient who has overdosed on drugs? (select all that apply) 1. Administering activated charcoal 2. Changing pH of urine 3. Preparing the patient for enemas 4. Inserting a nasogastric tube 5. Preparing corticosteroids for administration

1, 2, 3, 4

Which patient would be most likely to seek complementary and alternative therapies as a treatment modality? (select all that apply) 1. A 48-year-old male who wants to boost his immune system 2. A 22-year-old male athlete who is preparing for the Olympics 3. A 50-year-old female going through menopause 4. A 58-year-old male with prostate problems 5. None of these patients would be wise to seek these therapies.

1, 2, 3, 4

A nurse has been asked to present health promotion information at a community clinic whose clients are primary non-Hispanic Black women. After review of health disparity and inequality statistics the nurse chooses to include information about which disorders? (select all that apply) 1. Stroke 2. Coronary artery disease 3. Diabetes 4. Illicit drug use 5. Prenatal care

1, 2, 3, 5

The nurse has been hired to work in the risk management office of a hospital. What situations would the nurse expect to be included in this job? (select all that apply) 1. Participating in the investigation of a sentinel medication event 2. Using the computer to track data 3. Working with staff nurses to identify work flow problems 4. Meeting with the nurse executive to identify nurses who are prone to medication errors 5. Participating in a committee who will recommend changes to the policy and procedures regarding medication administration

1, 2, 3, 5

The nurse is beginning medication reconciliation for a newly admitted patient. What should the nurse include in this list? (select all that apply) 1. The patient takes ibuprofen for an occasional headache. 2. The patient mixes a powdered form of vitamin C into his morning orange juice. 3. The patient applies essential oils to his forehead to help with his allergies. 4. The patient drinks milk fortified with vitamin D. 5. The patient takes a prescription medication for osteoporosis once a week.

1, 2, 3, 5

The nurse is preparing a teaching plan for an older patient who is taking multiple medications. Which principles should the nurse keep in mind during the planning phase? (select all that apply) 1. The patient should use only one pharmacy to fill prescriptions. 2. The patient should keep a list of all medications for easy accessibility. 3. Polypharmacy is a common cause of medication errors in older patients. 4. Polypharmacy is unique to older patients and is the most common cause of medication errors. 5. The patient should be aware of each prescribed medication, the dose, and possible side effects.

1, 2, 3, 5

The nurse makes a medication error, but the patient is not harmed. The patient's family asks the nurse manager what is considered a medication error. Which are potential responses by the nurse manager? (select all that apply) 1. Failure to follow health care provider's orders 2. Failure to give the right medication 3. Failure to give a medication at the ordered time 4. Failure to call the pharmacy and report that the medication has been given 5. Failure to give the right dose of the medication

1, 2, 3, 5

The patient says, "I am convinced that the mind-body interventions I am using are improving my health." The nurse would ask additional questions about which complementary and alternative therapies that belong to this category? (select all that apply) 1. Yoga 2. Massage 3. Dance 4. Herbal therapies 5. Biofeedback

1, 2, 3, 5

A patient returns to the clinic for follow-up after taking a newly prescribed medication for a month. The nurse recognizes medication teaching was successful when the patient makes which statement? (select all that apply) 1. "I've been taking my medication on an empty stomach like the prescription label said to." 2. "I take my medication first thing in the morning, just like you said." 3. "I have been able to decrease my medication to every other day and that saves me some money." 4. "I switched all my medications to one pharmacy like you suggested." 5. "Did you say I need to take this medication with water or milk?"

1, 2, 4

A patient's genetic testing indicates presence of a genetic polymorphism of the CYP 450 enzyme. The nurse expects this difference to be one of which classifications? (select all that apply) 1. Extensive 2. Poor 3. Normal 4. Ultrarapid 5. Inefficient

1, 2, 4

The nurse works for the Centers for Disease Control and Prevention (CDC). In planning for a bioterrorist attack, what will the best plan of the nurse include? (select all that apply) 1. Learn the signs and symptoms of chemical and biological agents. 2. Obtain a listing of health and law enforcement contacts. 3. Assist in the stockpiling of medications. 4. Obtain current knowledge of emergency management. 5. Assist in triage at local hospitals.

1, 2, 4

During evaluation, the nurse, patient, and physician determine that the goals of antibiotic therapy have not been met. What actions are indicated? (select all that apply) 1. Review the dosage of the medication 2. Consider checking serum drug levels 3. Discard the idea that the infection is treatable 4. Consider prolonging therapy 5. Consider using a different antibiotic

1, 2, 4, 5

The nurse assesses the patient with diabetes mellitus prior to administering medications. Which questions are important to ask the patient? (select all that apply) 1. "Are you allergic to any medications?" 2. "Are you taking any herbal or over-the-counter medications?" 3. "How difficult is it for you to maintain your ideal body weight?" 4. "Will you please tell me about the kind of diet you follow?" 5. "What other medications are you currently taking?"

1, 2, 4, 5

The nursing instructor teaches the student nurses about how medication errors can occur. What information will the nursing instructor include in the presentation? (select all that apply) 1. The nurse miscalculates the medication dose. 2. The nurse does not check the patient's identification band. 3. The nurse does not validate an order with the physician. 4. The nurse misinterprets a physician's order. 5. The nurse administers the incorrect drug.

1, 2, 4, 5

The risk management department is using a root-cause analysis to improve a nursing unit's medication administration accuracy. What questions will be used to develop this tool? (select all that apply) 1. What kind of errors are occurring? 2. What is the current medication administration accuracy rate? 3. How do the unit nurses rank in the number of errors committed? 4. What do the nurses think can be done to prevent errors from continuing? 5. What is the impact of changes made to improve accuracy?

1, 2, 4, 5

The nurse is doing a holistic assessment on a patient prior to the initiation of antihypertensive medication. What will the best assessment include? (select all that apply) 1. Blood pressure 2. The biologic cause of the hypertension 3. Mood 4. Level of education 5. Belief in a higher power

1, 3, 4, 5

When possible, drug therapy is postponed until after pregnancy and lactation. However, certain acute and chronic conditions must be managed during pregnancy, including: (select all that apply) 1. epilepsy. 2. serious cystic acne. 3. sexually transmitted infections. 4. gestational diabetes. 5. hypertension

1, 3, 4, 5

A nurse has provided discharge medication instructions to the parents of a child being released from the emergency department. The nurse evaluates that learning has occurred when the parents make which statements? (select all that apply) 1. "I should give this antibiotic as prescribed until the bottle is empty." 2. "I should use a spoon to give this medication." 3. "I will keep this medication in the refrigerator as the label directs." 4. "If my child develops any adverse effects, I will discard the rest of the medicine." 5. "This antibiotic should help my child's infection clear."

1, 3, 5

The nurse is conducting a holistic assessment of a patient with alcoholism. What are the important questions to ask? (select all that apply) 1. "How is drinking alcohol viewed by your culture?" 2. "Have you ever attended Alcoholics Anonymous meetings?" 3. "Did you see your parents drinking alcohol when you were growing up?" 4. "Have you been in alcohol rehabilitation before now?" 5. "What blood relatives of yours are addicted to alcohol?"

1, 3, 5

The nurse is teaching the importance of drugs for emergency preparedness to local firemen. The nurse determines that learning has occurred when the firemen make which statements? (select all that apply) 1. "The vendor-managed inventory (VMI) package can reach any community within 24 to 36 hours." 2. "Our local hospital is supposed to be stockpiling antibiotics." 3. "The push package can reach any community within 12 hours of an attack." 4. "The Strategic National Stockpile is located at the Centers for Disease Control and Prevention (CDC) in Atlanta." 5. "Our country's drug stockpile is managed by the Centers for Disease Control and Prevention (CDC)."

1, 3, 5

The patient asks if there are any supplements that would help improve or preserve his memory. Which supplements would the nurse discuss? (select all that apply) 1. Carnitine 2. Coenzyme Q10 3. Glucosamine 4. DHEA 5. Selenium

1, 4

A nurse is teaching a community group about holistic medicine. Which information should the nurse include about Western medicine? (select all that apply) 1. Western medicine focuses on the cause of disease. 2. Western medicine is not compatible with holistic medicine. 3. The patient is at the center of concern in Western medicine 4. Disease is often viewed as a malfunction in a specific body system. 5. Western medicine may focus on disease treatment.

1, 4, 5

A nurse who is presenting community education states, "Drugs are among our most powerful weapons for emergency preparedness." What additional statements, made by the nurse, would support this statement? (select all that apply) 1. "Drugs help us treat the diseases that could be caused by bioterrorism." 2. "We can use drugs to neutralize our enemies." 3. "If we control the manufacture and distribution of drugs, we will control global politics." 4. "Without drugs, we might be quickly overwhelmed by a bioterrorist attack." 5. "Drugs can be used in chemical or nuclear attacks."

1, 4, 5

Which patient statements would the nurse evaluate as negatively affecting access to health care? (select all that apply) 1. An older adult says, "If I tell my doctor that I fall frequently, I might have to go to a nursing home." 2. A young adult says, "A benefit of my new job is that it pays for my health, dental, and vision insurance." 3. A patient being discharged says, "Can you call my prescriptions in to the pharmacy?" 4. The patient's new insurance plan requires a $10 copay for office visits. 5. A patient asks to be discharged before noon as he has a 3-hour drive home

1, 4, 5

The nurse preparing to transfer to a pediatric hospital would expect to administer medications to children from birth to age _____ years.

16

A drug for which research has shown an adverse effect in animals but not in pregnant women would be categorized as Category 1. A. 2. B. 3. D. 4. C

2

A patient with hypertension is receiving medication to lower his blood pressure. Which nursing action demonstrates the evaluation process related to medication administration? 1. Asking the patient whether he is compliant in taking his medications 2. Determining that goals were not met 3 days following medication administration 3. Administration of IV antihypertensive agents 4. Determination of the patient's baseline blood pressure

2

A small nuclear weapon has been detonated in a nearby city. For which immediate symptoms of radiation sickness will the nurse assess in patients who have been exposed? 1. Dilated pupils and aggression 2. Nausea, vomiting, and diarrhea 3. Weight loss and fatigue 4. Anorexia and fatigue

2

Atropine would be most useful for a victim of bioterrorism who experienced exposure to: 1. ionizing radiation. 2. nerve gas. 3. bacterial agents. 4. viral agents

2

Patients who are discharged from the hospital on new medications should 1. be advised that their local pharmacy will provide them with the drug information and instructions they need. 2. be provided with oral and written drug information and instructions. 3. be provided oral drug information and instructions as opposed to written. 4. be provided with written drug information and instructions only.

2

The African American patient had a myocardial infarction and is receiving atorvastatin (Lipitor). The nurse caring for the patient is Caucasian. The nurse assesses the patient's diet to be very high in fat. What is the best plan by the nurse to improve the patient's diet and reduce the risk for additional medications? 1. With the patient's permission, plan to ask an African American nurse to speak to him about a low-fat diet. 2. With the patient's permission, plan to discuss his diet with whomever prepares meals for his family. 3. Plan to give the patient information specific to African Americans about low-fat diets. 4. Plan to ask the physician for a consult by dietary services so a dietician can teach the patient about low-fat diets.

2

The African American patient has panic attacks, is suicidal, and is on an inpatient psychiatric unit. The psychiatrist orders sertraline (Zoloft) and clonazepam (Klonopin). The patient refuses the drugs; he requests to have herbs and African objects in his room to "remove the curse." What is the priority action by the nurse? 1. Allow the request without seeking further information from the patient. 2. Allow the request as long as the herbs and objects do not pose a safety risk for the patient or other patients. 3. Allow the request after the patient signs a release of responsibility to avoid litigation. 4. Allow the request after all members of the treatment team agree to it.

2

The nurse administers an evening medication to the patient in the morning. The medication did go to the correct patient. What is the nurse's best course of action at this time? 1. Change the medication administration time to the morning. 2. Notify the physician about the error and complete an incident report. 3. Tell the evening nurse to hold the evening dose just for tonight. 4. Notify the physician and ask if any further action needs to be taken.

2

The nurse has been teaching a patient about herbal preparations and determines that additional teaching is required when the patient makes which statement? 1. "I should check with you before using an herbal product." 2. "Herbal products usually contain only one active ingredient." 3. "I need to be careful about where I store my herbal product." 4. "Herbal preparations are available in solid and liquid forms."

2

The nurse in the emergency department administers an adult dose of an antibiotic to a 3-month-old baby. As a result, the baby suffers permanent brain damage. What best describes the effect of this error on the health care facility? 1. The professional license of the nurse will be lost. 2. The morale of the staff involved will be depleted. 3. The reputation of the health care facility will suffer. 4. The health care facility will pay a very large settlement.

2

The nurse is administering medications to an older adult. Which laboratory tests are most important for the nurse to assess prior to the administration of medication? 1. Complete blood count (CBC) and electrolytes 2. Kidney and liver function tests 3. Arterial blood gases (ABGs) and basic metabolic panel 4. Lipid panel and thyroid function tests

2

The nurse is assessing a newly admitted patient's current medications. What does the best objective data include? 1. The patient's wife tells the nurse what medications the patient has been receiving. 2. The nurse checks the prescription bottles the patient has brought to the hospital. 3. The nurse asks the physician what medications the patient was currently taking. 4. The patient lists the medications that have been prescribed.

2

The nurse is aware that it is most important to be accurate in which portion of the nursing process? 1. Evaluation 2. Assessment 3. Diagnosis 4. Planning

2

The nurse is managing care for several patients at a diabetic treatment center. What is the primary intervention for the nurse? 1. To administer the correct medicine to the correct patient at the correct dose and the correct time via the correct route 2. To return the patient to an optimum level of wellness while limiting adverse effects related to the patient's medical diagnosis 3. To include any cultural or ethnic preferences in the administration of the medication 4. To answer any questions the patient may have about the medicine, or any possible side effect of the medication

2

The nurse is preparing for medication administration to a group of patients. What is the best overall outcome for the patients? 1. Patients will take the medications after receiving medication instruction. 2. Patients will receive the best therapeutic outcome from the medications. 3. Patients will state the reason they are receiving the medications. 4. Patients will experience minimal side effects after taking the medications.

2

The nurse is teaching a caregivers' support group for caretakers of older adult patients. The focus is medication compliance. The nurse determines that learning has occurred when the caregivers make which response? 1. "We should crush their medicine and put it in applesauce so they will swallow it." 2. "We should use a medication management box so they won't forget to take it." 3. "We should ask the doctor if all the medication is really necessary." 4. "We should give them more education about the medicine so they will take it."

2

The nurse plans to teach patients about the difference between herbal preparations and prescription medications. Which statement describes the best plan by the nurse? 1. "Herbs, like prescription drugs, usually only contain one active ingredient." 2. "The active ingredients in an herb, unlike prescription drugs, may be present in just one part or many parts." 3. "Most herbs, like prescription drugs, are standardized and regulated by the Food and Drug Administration (FDA)." 4. "Herbs are considered to be safer than prescription medications as they are natural."

2

The nurse provides care for elders in an assisted living facility. What does the nurse assess as a primary contributing factor for drug toxicity in the elderly? 1. Older adults often abuse alcohol. 2. Older adults are frequently dehydrated. 3. Older adults are frequently constipated. 4. Older adults have increased stomach acid.

2

The nurse was very busy and unfamiliar with a new medication, but administered it anyway. Later the nurse looked up the medication. How does the nurse manager evaluate this behavior? 1. This was acceptable as long as the nurse looked up the action and side effects of the drug later. 2. An error could have occurred because the nurse was unfamiliar with the medication. 3. The nurse manager was partially at fault because the nursing unit was understaffed and the nurse was too busy. 4. An error did occur because the nurse could have administered the medication via the incorrect route.

2

The nurse who is writing a risk nursing diagnosis will write a ______ part statement.

2

The patient has been exposed to a nerve agent. Which antidote will the nurse plan to administer? 1. Apomorphine 2. Atropine 3. Acetate of ammonia 4. Hydroxyzine (Vistaril)

2

The patient is admitted to the hospital following an abortion, and she is septic. The physician orders antibiotics that the patient refuses stating, "I don't deserve them." The nurse providing care has anti-abortion beliefs. What is the best response by the nurse? 1. "I think you need to do what is best for you." 2. "You have a serious infection and really need the drug." 3. "It seems you think you should be punished because you had an abortion" 4. "I'll call your physician and let him know about your decision."

2

The patient is being treated for a cardiac dysrhythmia with amiodarone (Cordarone). The patient has elevated liver function tests (LFTs). Which assessment finding would the nurse suspect as contributing to the elevated LFTs? 1. The patient was taking Kava-Kava for anxiety. 2. The patient was taking Echinacea to treat cold symptoms. 3. The patient was taking St. John's wort for depression. 4. The patient was taking gingko biloba for memory problems.

2

The patient is pregnant and asks the nurse about changing from her prescription antidepressant medication to St. John's wort because it is natural. What is the best response by the nurse? 1. "It should be okay because your baby has been exposed to an antidepressant." 2. "St. John's wort is a drug, and this should be discussed with your doctor." 3. "No, herbal preparations are just not safe to take during pregnancy." 4. "Yes, you can change, but let your doctor know at your next appointment."

2

The patient takes several prescription medications and asks the nurse about using complementary and alternative medicine. What is the best reply by the nurse? 1. "Complementary and alternative medicine (CAM) is a good idea that you should discuss with your doctor." 2. "Complementary and alternative medicine (CAM) is an approach that might reduce your need for medications." 3. "Complementary and alternative medicine (CAM) might help, but you will still need your medications." 4. "Complementary and alternative medicine (CAM) has not been demonstrated to help with your kind of symptoms."

2

The physician has prescribed quetiapine (Seroquel) for the patient with chronic auditory hallucinations. The patient has stopped taking the medication. The nurse incorrectly uses the diagnosis of "noncompliance." In which situation would this diagnosis be appropriate? 1. The patient reported a physical change as the reason for stopping the medication. 2. The patient made an informed decision not to take the medication. 3. The patient was unsure about how to order a refill for the prescription. 4. The patient did not understand why the medication was prescribed.

2

The pregnant patient plans to breastfeed her baby. She asks the nurse about the use of herbal products during breastfeeding. What is the best response by the nurse? 1. "Be sure to check the label to see if the herbal product could be used during breastfeeding." 2. "Most drugs can be transferred to the infant during breastfeeding, so this is not recommended." 3. "Herbal products are considered natural, so it should be fine to use them during breastfeeding." 4. "This should be fine, as long as there is at least 12 hours between the time you use the product and when you breastfeed."

2

The toddler refuses to take his oral medication. What is the best suggestion to the mother from the nurse for ensuring the toddler receives his medication? 1. "Tell him you will buy him a toy if he takes the medication." 2. "Crush the tablet and mix it with a small amount of jam." 3. "Crush the tablet and mix it with milk." 4. "Tell him he will be punished if he does not take the medicine."

2

What is the most significant role for nurses as defined by state nurse practice acts and by regulating bodies such as The Joint Commission? 1. Planning care 2. Teaching 3. Assessment 4. Evaluating care

2

Which nursing intervention would take priority following administration of a new medication? 1. Monitoring lab values 2. Monitoring the patient's respiratory status 3. Prescribing additional medications if side effects occur 4. Measuring patient weight

2

Which statement best describes the relationship of complementary and alternative therapies to pharmacology? 1. They are more effective than medication use. 2. They can reduce patient medication needs. 3. They serve as competitors and should not be promoted. 4. They have little-to-no value in disease prevention and treatment.

2

Which statement is accurate regarding the Dietary Supplement Health and Education Act (DSHEA) of 1994? 1. It ensures that herbal products provide proof of their intended effects. 2. It mandates that herbal product labels state that the products are not intended to diagnose, treat, cure, or prevent disease. 3. It mandates that herbal product labels contain accurate information. 4. It requires that herbal products undergo the same rigorous testing as drugs do under the FDA.

2

Place these methods of communicating with a non-English speaking patient in order of their desirability and usefulness. 1. Adult family member interprets 2. Health care agency interpreter is present 3. The nurse uses drawings and body language to communicate 4. Child relative interprets 5. No interpretation is attempted

2, 1, 4, 3, 5

A patient who is strictly vegetarian due to religious beliefs has been prescribed a medication contained in a gelatin capsule. Which nursing actions are indicated? (select all that apply) 1. Do not tell the patient the capsule contains gelatin. 2. Collaborate with the prescriber to find an alternative medication. 3. Check to see if the capsule can be opened for administration. 4. Work to convince the patient that this application does not violate vegetarian beliefs. 5. Tell the patient that the gelatin is an inactive ingredient in the medication

2, 3

A patient has been received in the emergency department for treatment of poison ingestion. Gastric lavage and placement of activated charcoal has been prescribed. The nurse would withhold this treatment and collaborate with the prescriber if which instances occur? (select all that apply) 1. The patient vomits. 2. The patient becomes unconscious. 3. The patient discloses that lithium was the drug taken. 4. Paramedics report that it has been 2 hours since the drug was taken. 5. The patient begins to pass copious amounts of watery diarrhea.

2, 3, 4

Medication reconciliation has been started for a newly admitted patient. At which points would the nurses and others caring for this patient check this list? (select all that apply) 1. At each time that medications are administered to the patient. 2. When admission orders are received. 3. When the patient is transferred to a different unit within the hospital. 4. When the patient is discharged. 5. If any medication error occurs.

2, 3, 4

The nurse manager would determine that a nurse understands culturally sensitive care if which statements are made? (select all that apply) 1. "Since all of our patients have the same illnesses, I sometimes get bored." 2. "I have been helping my patient understand how to choose foods from our diet menu." 3. "I am concerned because my patient needs sterile dressing changes but has no running water at home." 4. "My patient and I worked out a way to get her medications delivered to her at home." 5. "I invited a group from my church to come and sing hymns for our patients."

2, 3, 4

A series of category E medication errors have occurred on a hospital unit. When discussing this trend with the nursing staff, the risk manager would list which characteristics of a category E error? (select all that apply) 1. The error contributed to the death of a patient. 2. A patient was harmed. 3. No interventions to sustain life were required as a result of the error. 4. Harm to the patient was permanent. 5. The patient's hospitalization was not prolonged as a result of the error.

2, 3, 5

A patient's genetic testing reveals a change in CYP2A6. The nurse would plan which interventions based on this discovery? (select all that apply) 1. Teaching the patient to avoid caffeine-containing drugs. 2. Planning additional time and interventions to help the patient stop smoking. 3. Use of an alternative to the drug warfarin. 4. Increased surveillance for the development of lung cancer. 5. Frequent monitoring of blood pressure.

2, 4

The nurse plans to teach a safety class to parents of toddlers about household exposure to medications. What will the best plan of the nurse include? (select all that apply) 1. Keep the toddler awake and observe for side effects of the medication. 2. Keep all medications locked up and stored out of reach of the toddler. 3. Use syrup of ipecac immediately if the toddler has ingested medication. 4. Call the Poison Control Center for guidance with any medication ingested. 5. Teach the toddler that medications are for adult use only.

2, 4

A patient who has traveled to an area when Ebola is present is hospitalized with fever and malaise. The nurse anticipates this patient will be considered potentially infected for the length of the ______ day incubation period.

21

A patient is diagnosed with cancer. The physician has recommended chemotherapy, which would likely save the patient's life. The patient tells the nurse, "This is punishment from God for sins I have committed; some women at my church say so." What will the best plan of the nurse include? 1. With the patient's permission, plan to involve a hospital minister to discuss the patient's perspective about cancer. 2. With the patient's permission, plan to bring the case before the hospital's board of ethics. 3. With the patient's permission, plan to contact the patient's minister to discuss the patient's perspective about cancer. 4. With the patient's permission, plan to meet with family members to discuss the patient's perspective about cancer.

3

Notice has been received that smallpox virus was aerosolized at a parade attended by thousands of people. The nurse working in the emergency department explains that the vaccine for this virus provides a high level of protection if given within _____ days of exposure.

3

Patients at a senior citizen center have asked the nurse to do a presentation on herbal preparations. Which statement would be included in the best plan by the nurse? 1. "Herbal preparations are safe as long as you carefully read the label." 2. "As long as the herbal preparation has been tested in the clinical setting, it is safe." 3. "Herbal preparations actually are drugs; you must be careful with them." 4. "Herbal preparations can be dangerous if you are allergic to them."

3

The nurse is on a committee to reduce medication errors in a large health care facility. What is a recommendation the nurse proposes that will most likely help to reduce medication errors? 1. Train medication technicians to administer medications. 2. Use robots to prepare all medications for administration by the nurse. 3. Use automated, computerized cabinets on all nursing units. 4. Designate nurses whose only function is to administer medication.

3

The nurse will administer medication to a school-age child. What is the preferred action by the nurse? 1. Teach the child the action and expected side effects of the medication. 2. Tell the child he will not be allowed to go to recess if the medication is not taken. 3. Offer the child a choice of beverage with which to take the medication. 4. Offer to play with the child prior to medication administration.

3

The patient comes to the emergency department with an anxiety attack. He tells the nurse he heard that there was another anthrax attack in the capitol and is concerned about running out of medications. What is the best response by the nurse? 1. "You don't need to worry about another attack at all; I think our government can take care of us." 2. "Your health is in danger due to the anxiety; we really need to focus on reducing your anxiety now." 3. "The Centers for Disease Control and Prevention (CDC) maintains a large stockpile of medications for us in case that occurs." 4. "I'm sure the Centers for Disease Control and Prevention (CDC) has contingency plans in the event of an anthrax attack."

3

The patient is receiving a beta-blocker medication. The nurse has done medication education and provided the patient with printed information to take home. During the next appointment, the nurse notes that the patient is not taking the medication properly. What is a therapeutic assessment question to ask this patient? 1. "Do I have to inform your physician about your noncompliance?" 2. "Why didn't you take your medicine as we talked about?" 3. "Are you able to read and comprehend the printed information?" 4. "Don't you understand how important it is to take the medicine?"

3

The patient is receiving an oral antibiotic as treatment for cellulitis of the lower extremity. The patient's outcome is "Patient will state a key point about antibiotic treatment for cellulitis." Which statement would the nurse evaluate as best indicating this outcome has been met? 1. "If the pain gets too bad, I can take my prescribed pain medication." 2. "If the swelling continues, I can apply an ice pack." 3. "I need to take all the pills even if my leg looks better." 4. "I must keep my leg elevated until the swelling goes down."

3

The patient tells the nurse that he has been taking herbal preparations to boost his immune system functioning. He does not know the names of the preparations. What is the best assessment question for the nurse to ask? 1. "Would you please tell your doctor about the herbs during the next visit?" 2. "Would you please ask your wife to discuss this with me during her next visit?" 3. "Would you please have your wife bring the bottles to the hospital?" 4. "Would you please ask your wife to call the hospital pharmacist with the names?"

3

The physician has prescribed a chemotherapeutic drug for the patient with cancer. This drug commonly causes loss of hair. The patient asks the nurse, "Will all of my hair fall out?" What is the most therapeutic response by the nurse? 1. "We are not really sure; applying an ice bag to your head may help." 2. "Don't worry, we can recommend an excellent wig company if need be." 3. "Yes, that is one of the expected side effects of this medication." 4. "It might. Have you discussed this with your physician?"

3

The public health nurse notices that several patients in the hypertension clinic have poorly controlled hypertension, even though they have been prescribed appropriate antihypertensive drugs. Which question will best enable the nurse to assess these patients? 1. "Does your religion allow the use of high blood pressure medication?" 2. "Do you think your high blood pressure is a problem?" 3. "Can you afford the high blood pressure medication?" 4. "Does your culture use herbs to treat high blood pressure?"

3

Which assessment identifies the collection of objective data? 1. The patient rates her pain a 5 on a 0-10 pain scale. 2. The patient states she is anxious. 3. The patient has a wound measured at 5 centimeters in length. 4. The patient informs the nurse that she weighs 150 pounds.

3

Which list correctly identifies and orders the primary steps of the nursing process? 1. Establish nursing diagnosis, assessment, intervene, collaborate, evaluation 2. Establish goals, assessment, intervention, planning, communication 3. Assessment, establish nursing diagnosis, planning, interventions, evaluation 4. Assessment, planning, establish objectives, communication, evaluation

3

Which statement about the nursing process is accurate? 1. Generally, goals are more measurable than outcomes. 2. Goals involve very specific criteria that evaluate interventions. 3. Obtaining the outcomes is essential for goal attainment. 4. After selecting the nursing diagnosis, interventions are completed.

3

Which statement correctly identifies factors that contribute to medication errors? 1. A nurse who observes the five rights will prevent all medication errors from occurring. 2. Nurses are always liable when a medication error occurs. 3. Handwritten orders are more frequently associated with medication errors than are typed orders. 4. An incorrect dose (based on weight) is ordered, dispensed, and administered to a patient. The administering nurse and ordering clinician would be the only parties held accountable.

3

Which statement regarding human DNA sequences is accurate? 1. Only 2% of human DNA is different among the different ethnicities. 2. Due to enzyme polymorphism, Hispanics are less likely to metabolize codeine to morphine. 3. Even though human genetic differences are small, significant differences can be seen with drug metabolism. 4. Asian Americans are the ethnic group known to be slow acetylators.

3

Which statement regarding medication error rates is ethically accurate? 1. Medication errors are acceptable when well below the national average. 2. Medication errors are acceptable when associated costs exceed the costs necessary for preventative actions. 3. Medication errors are never acceptable. 4. Medication errors are only acceptable when associated costs are less than 5% of the facility's yearly profit.

3

Place these nursing activities in the correct order of the nursing process. 1. The nurse analyzes the data collected. 2. The nurse documents the time and route of an administered medication. 3. The nurse weighs the patient. 4. The nurse writes an individualized nursing intervention. 5. The nurse changes a nursing intervention that is not working.

3, 1, 4, 2, 5

Which concepts should the nurse use when formulating a nursing diagnosis? (select all that apply) 1. Base the nursing diagnosis on the medical diagnosis 2. Focus on what the nurse needs to help the patient return to health 3. Include the patient in the identification of needs 4. Consider the patient's response to the current health problem 5. Be certain the diagnosis is measureable

3, 4

Which patient outcome statements are correctly formatted? (select all that apply) 1. The patient will understand the effects of the medication administered prior to discharge. 2. The nurse will administer all medications with ten minutes of their scheduled time. 3. The patient will identify two adverse effects of enoxaprarin (Lovenox) prior to self-administering the drug. 4. The patient will verbalize the storage requirements for NPH insulin prior to discharge. 5. The physician will discuss the desired effects of discharge medications with the patient the evening before discharge.

3, 4

The clinic nurse will immediately alert the health care provider when which category X drugs are identified on the medication record of a recently diagnosed pregnant patient? (select all that apply) 1. Tetracycline 2. ACE inhibitor antihypertensive medication 3. Methotrexate 4. Isotretinoin (Accutane) 5. Oral contraceptives

3, 4, 5

The nursing supervisor tells a nurse that the medication error the nurse made yesterday has been determined to be a sentinel event. What should the nurse expect to occur? (select all that apply) 1. Her employment will be terminated. 2. Her personal malpractice insurance company will be notified. 3. An immediate investigation will occur. 4. Interventions to prevent the error from occurring again will quickly be put in place. 5. A root-cause analysis will be performed.

3, 4, 5

The nurse conducts a seminar in a local community center on how Americans can be affected by radiation from a nuclear attack. The nurse determines that the education is effective when the patients make which statement? 1. "I can protect myself from cancers by taking potassium iodide (KI)." 2. "I need to stay inside my house for at least 2 days after the attack to be safe." 3. "I need to take at least four showers every day or I will develop skin ulcers." 4. "I am at risk to develop leukemia as a result of radiation exposure."

4

The nurse is preparing medications for a group of patients. Another nurse begins telling the nurse about her recent engagement. What is the best action by the first nurse? 1. Ask the second nurse to help with administering medications so they can have more time to talk. 2. Continue to prepare the medications for administration and pretend to listen to the first nurse. 3. Stop preparing medications until the first nurse has finished talking about her engagement. 4. Tell the second nurse that the conversation is distracting and must cease while medications are being prepared.

4

The nurse is providing education about warfarin (Coumadin) to a patient of Asian ancestry. The nurse determines that learning has occurred when the patient makes which statement? 1. "I may need to have more frequent blood tests." 2. "I may need to have less frequent blood tests." 3. "I may need more medication than someone from a different ethnic group." 4. "I may need less medication than someone from a different ethnic group."

4

The nurse knows that one of the more common complications resulting from drug-herbal interactions would involve: 1. hair growth. 2. urine output. 3. vision loss. 4. blood coagulation.

4

The nurse makes a medication error and a patient dies. In court, the attorney for the family of the deceased patient asks the nurse if she followed standards of care in administering the medication. How would the attorney phrase this question? 1. "Did you follow agency guidelines as in previous circumstances?" 2. "Did you follow the physician's orders and double-check them before administration?" 3. "Did you do the three checks and follow the five rights as taught in school?" 4. "Did you do what another nurse would have done under similar circumstances?"

4

The nurse plans to administer medication to the preschool child. Which approach indicates the nurse has an understanding of growth and development? 1. The child is often more cooperative if the parent is not in the room. 2. The child does better with verbal instruction than with play instruction. 3. There should be no need to restrain a child of this age. 4. Use a brief rationale, followed by quick administration of the medication.

4

The nurse prepares to teach patients about the safety and efficacy of herbal preparations. Which statement would be included in the best plan by the nurse? 1. "Herbal preparations must be tested for safety and efficacy prior to marketing." 2. "The label on the herbal preparation is required by the Dietary Supplement Health and Education Act (DSHEA) to be accurate." 3. "Herbal preparations have to meet the same safety and efficacy standards as prescription and over-the-counter (OTC) drugs." 4. "The manufacturer does not have to prove the safety or efficacy of the herbal preparation."

4

The nurse teaching a pre-conception class would tell participants that they should be most careful about exposure to drugs during which stage of pregnancy? 1. Each stage is equal in risk. 2. Pre-implantation period 3. Third trimester 4. Embryonic

4

The nursing instructor is teaching student nurses about the use of viruses in a bioterrorism attack. The nurse determines that learning has occurred when the students make which statement? 1. "The Centers for Disease Control and Prevention (CDC) has a plan to vaccinate Americans against most viruses." 2. "Actually, a bigger concern is a nuclear weapon exploding in a city." 3. "Most Americans have already been vaccinated against the lethal viruses." 4. "A bioterrorist attack with viruses is a real threat to Americans."

4

The patient is from an Arab culture and is in labor and delivery. Her husband insists he must stay with her and will not allow her to receive any analgesia during the experience. What is the best action by the nurse? 1. Inform the husband that it is his wife's choice whether or not to receive analgesia. 2. Inform the husband that he must sign a release of responsibility to avoid future litigation against the hospital. 3. Allow the request but inform the husband that the physician will make the final decision about analgesia. 4. Allow this request and be available in the event the request changes

4

The patient uses Ginkgo biloba to enhance memory functioning but has not told the nurse about this herb. The physician orders warfarin (Coumadin) for the patient. Which findings may the nurse find upon assessment?? 1. Headache, dizziness, sweating, and agitation 2. A blood glucose of 56 3. An international normalized ratio (INR) of 3.0 4. Petechiae and bleeding from the gums

4

The physician has prescribed a nitroglycerine (Nitrodur) patch for the patient. What is the best outcome for this patient as it relates to use of the medication? 1. Patient will be able to identify the expiration date of the medication prior to discharge. 2. Patient will verbalize three side effects of the medication prior to discharge. 3. Patient will state the reason for receiving the medication prior to discharge. 4. Patient will demonstrate correct application of the patch prior to discharge.

4

Victims of a bioterrorism attack experienced initial nausea and vomiting followed by weight loss and eventual thyroid cancer. What was the most likely causative agent? 1. Chemical agent 2. Viral agent 3. Bacterial agent 4. Ionizing radiation

4

Which classification of drugs would the nurse refuse to administer to a pregnant patient? 1. category A 2. category B 3. cautionary 4. teratogenic

4

Which herbal product would be of most concern if taken by a patient being treated for seizures? 1. Feverfew 2. Goldenseal 3. Ginger 4. Ginkgo

4

Which of the following correctly and completely identifies the items found within the Strategic National Stockpile (SNS)? 1. Bandages, airway devices, and IV supplies 2. Antibiotics and IV fluids 3. Emergency equipment 4. Antibiotics, vaccines, and support supplies

4

Which situation demonstrates ethical reporting of a medication error? 1. The nurse does not report the error, because the error was caught and corrected prior to drug administration. 2. The nurse does not report or document the error, since the error did not result in any harm to the patient. 3. The nurse reports the error to the physician and the charge nurse but does not document the error due to possible legal action. 4. The nurse informs the patient, documents the error as per hospital policy, and notifies the physician.

4

Which statement is accurate regarding pharmacotherapy in the older adult? 1. Increased body water can lead to a higher risk of drug toxicity. 2. Plasma levels are increased, leading to a heightened drug response. 3. Generally, drug doses should be increased due to prolonged drug metabolism. 4. Drug absorption is slower due to increased gastric pH.

4