Exam 4 Questions
A patient is receiving low molecular weight heparin to prevent thromboembolic complications. The nursing student asks the nursing instructor the reason why this treatment is given instead of heparin. What is the instructor's best explanation of the rationale for LMWH over heparin? A)"LMWH is associated with less thrombocytopenia than standard heparin." B)"LMWH is associated with stronger anticoagulant effects than standard heparin." C)"LMWH is given to patients who have a history of blood dyscrasia." D)"LMWH is more effective than standard heparin for patients with hypertension."
A)"LMWH is associated with less thrombocytopenia than standard heparin."
A nurse is providing health education for the family of a patient who has a substance use disorder. How should the nurse best explain the etiology of this disorder? A)"Substance abuse is multifactorial and involves genetics, personality, and culture." B)"Substance abuse is considered to be primarily a cultural concept, since definitions vary widely across time and place." C)"Many different factors contribute to substance abuse, but the primary ones are lack of willpower and impaired coping." D)"Substance abuse is a complex phenomenon, and science has not yet begun to truly understand the phenomenon."
A)"Substance abuse is multifactorial and involves genetics, personality, and culture."
After experiencing two workplace accidents in which he fell asleep, a 30-year-old construction worker has been diagnosed with narcolepsy. The patient admits that he is embarrassed to receive this diagnosis and is adamant that no one find out about it. The nurse should respond to the patient by explaining what aspect of the etiology? A)"This is the result of neurological factors over which you have no direct control." B)"In a lot of cases, making improvements to your sleep habits can resolve narcolepsy." C)"This is something that runs in certain families, and it's not your fault that this has happened." D)"This usually stems from suppressed emotions, so counseling usually helps greatly."
A)"This is the result of neurological factors over which you have no direct control."
A 12-year-old girl has undergone an extensive diagnostic workup that has resulted in a diagnosis of ADHD. The prescriber has reviewed the benefits and risks of dextroamphetamine therapy, and the nurse is now reviewing the correct schedule for taking the drug. The child should most likely take her dextroamphetamine at what times? A)07:00 and 11:30 B)7:30, 11:30, 16:30, and 20:00 C)08:00 and 20:000 D)9:00, 14:00, and 19:00
A)07:00 and 11:30
A 13-year-old child is started on atomoxetine (Strattera) for ADHD. The patient and his family should be taught about the peak plasma levels of the medication. He takes his medication at 07:00 AM. When will this medication reach its peak plasma level? A)08:00 to 09:00 AM B)09:45 to 10:30 AM C)10:30 to 11:45 AM D)13:00 to 14:00 PM
A)08:00 to 09:00 AM
A patient with a well-known history of heroin use has begun addiction treatment. The nurse had administered the patient's daily dose of methadone. The nurses should know that this medication aids in treating opioid addiction because it does which of the following? A)Acts as an agonist at opioid receptors and prevents withdrawal symptoms B)Acts as an opioid antagonist and causes unpleasant symptoms if the patient uses opioids C)Acts on the limbic system and the reticular system to suppress brain activity associated with addiction D)Depresses the CNS to a similar degree as opioids, aiding in detoxification
A)Acts as an agonist at opioid receptors and prevents withdrawal symptoms
A patient who suffers from alcoholism is prescribed disulfiram (Antabuse). How does this medication assist the patient in refraining from ingestion of alcohol? A)Allows the accumulation of acetaldehyde B)Increases the level of serotonin C)Increases the level of acetylcholine D)Decreases stimulation of the CNS
A)Allows the accumulation of acetaldehyde
A patient has been administered heparin to prevent thromboembolism development status postmyocardial infarction. The patient develops heparin-induced thrombocytopenia. Which of the following medications will be administered? A)Argatroban (Acova) B)Vitamin K C)Calcium gluconate D)Aminocaproic acid (Amicar)
A)Argatroban (Acova)
A patient with multiple sclerosis is admitted to the medical division for treatment of severe spasticity. What medication is used to treat spasticity and is administered intrathecally? A)Baclofen (Lioresal) B)Carisoprodol (Soma) C)Diazepam (Valium) D)Dantrolene (Dantrium)
A)Baclofen (Lioresal)
A patient who is recovering in hospital from a bilateral mastectomy has developed minor bleeding at one of her incision sites. During the process of clot formation, plasminogen will become part of a clot by which of the following means? A)By binding with fibrin B)By binding with platelets C)By activating plasmin D)By activating factor VII
A)By binding with fibrin
A male patient is taking atorvastatin calcium (Lipitor) to reduce serum cholesterol. Which of the following aspects of patient teaching is most important? A)Call his physician if he develops muscle pain. B)It is unacceptable to eat dietary fats. C)Decrease the dose if lethargy occurs. D)Eat two eggs per day to increase protein stores.
A)Call his physician if he develops muscle pain.
A patient is admitted to the hospital for treatment of a stasis ulcer of the right leg. The patient's history indicates he has abused alcohol in the past, and he typically consumes at least eight alcoholic beverages daily. What symptoms should the nurse assess the patient for? A)Confusion, hallucination, agitation, tremors B)Denial, manipulation, combativeness C)Depression, remorse, withdrawal from reality D)Suspicion, mania, stubbornness, fear
A)Confusion, hallucination, agitation, tremors
A patient is seen in the ambulatory care clinic with a complaint of insomnia. What should the nurse assess in regard to the complaint of insomnia? A)Daily intake of caffeine-containing products B)The amount of exercise in which the patient engages C)The family history of insomnia and sleep D)Possible use of amphetamines
A)Daily intake of caffeine-containing products
A patient is recovering from a stroke and has developed severe muscle contractions. Which of the following medications will inhibit the release of calcium in skeletal muscle cells? A)Dantrolene sodium (Dantrium) B)Baclofen (Lioresal) C)Carisoprodol (Soma) D)Cyclobenzaprine (Flexeril)
A)Dantrolene sodium (Dantrium)
A patient was admitted to the emergency room with acute alcohol intoxication and has been diagnosed with alcohol abuse after subsequent assessment and treatment. What are the goals of long-term treatment of this patient's substance abuse disorder? A)Detoxification, abstinence, and prevention of relapse B)Withdrawal, reeducation, and compliance C)Withdrawal, abstinence, and accountability D)Assessment, planning, and intervention
A)Detoxification, abstinence, and prevention of relapse
A patient is admitted to the emergency room in status epilepticus. What medication may be administered intravenously to assist in reducing seizure activity? A)Diazepam (Valium) B)Hydromorphone (Dilaudid) C)Insulin D)Meperidine (Demerol)
A)Diazepam (Valium)
A patient is taking cholestyramine (Questran) to reduce LDL cholesterol. Cholestyramine will cause a decrease in absorption of which of the following medications? A)Digoxin (Lanoxin) B)Ibuprofen (Motrin) C)Aspirin D)Acetaminophen (Tylenol)
A)Digoxin (Lanoxin)
A patient is admitted with thrombophlebitis and sent home on enoxaparin (Lovenox). Which statement indicates a good understanding of why enoxaparin is being administered? A)Enoxaparin inhibits the formation of additional clots. B)Enoxaparin eliminates certain clotting factors. C)Enoxaparin decreases the viscosity of blood. D)Enoxaparin will dissolve the existing clots.
A)Enoxaparin inhibits the formation of additional clots.
A young woman is seen in the physician's office and wants to ensure that she is vaccinated against hepatitis. Vaccines are available for which of the following types of hepatitis? Select all that apply. A)Hepatitis A virus B)Hepatitis B virus C)Hepatitis C virus D)Hepatitis D virus E)Hepatitis G virus
A)Hepatitis A virus B)Hepatitis B virus
A patient is taking tizanidine (Zanaflex) to treat spasticity from multiple sclerosis. Which of the following adverse effects of muscle relaxants is most pronounced with this medication? A)Hypotension B)Dark black urine C)Excessive salivation D)Eczema
A)Hypotension
A child is prescribed an amphetamine for attention deficit hyperactivity disorder. Which of the following effects provide evidence that the medications are working? A)Improved grades B)Increased sleep quality C)Lethargy D)Polyphagia
A)Improved grades
A patient suffers from an autoimmune disorder. Which of the following represents a potential result of a viral infection in a patient with an autoimmune disorder? A)Lymphocytes recognize the host's tissue as foreign. B)Erythrocytes destroy the T cells in the host. C)The involution of the thymus gland increases infection cause. D)The differential decreases the sedimentation rate.
A)Lymphocytes recognize the host's tissue as foreign.
A 33-year-old patient with a diagnosis of alcoholism is to be treated with chlordiazepoxide on an inpatient basis. When a nurse is administering this medication, he or she should do which of the following actions? A)Monitor the patient's vital signs closely during IV administration B)Administer the oral form of the medication if the patient is combative C)Assess the patient's cardiac status prior to administering each dose D)Promptly stop administering the medication once status improvements are noted
A)Monitor the patient's vital signs closely during IV administration
A patient has begun taking cholestyramine. Which of the following are noted as the most common adverse effects? A)Nausea, flatulence, and constipation B)Increased appetite and blood pressure C)Fatigue and mental disorientation D)Hiccups, nasal congestion, and dizziness
A)Nausea, flatulence, and constipation
A patient is admitted to the hospital with severe dehydration and also has decreased albumin levels. What effect will the patient's current status have if a prescribed dose of phenytoin (Dilantin) is administered? A)Potentially toxic serum level B)Reduced serum level C)Increased seizure activity D)Thromboembolism
A)Potentially toxic serum level
A patient has been diagnosed with cytomegalovirus (CMV). Which of the following drugs would be ineffective in the treatment of this disease? A)Ribavirin (Rebetol) B)Ganciclovir (Cytovene) IV C)Foscarnet (Foscavir) IV D)Valganciclovir hydrochloride (Valcyte)
A)Ribavirin (Rebetol)
A boy has been diagnosed with ADHD and has been prescribed Ritalin. The boy's mother tells the nurse that she does not understand why a stimulant would help him, stating, "If anything, he's completely overstimulated, not understimulated!" What should the nurse explain to the mother about the therapeutic use of Ritalin? A)Ritalin helps with the symptoms of ADHD, but the reasons for this are not well understood. B)Ritalin stimulates the parasympathetic nervous system, resulting in increased control of behavior. C)Ritalin stimulates the limbic system, which regulates control over behavior and affect. D)Ritalin enhances the function of dopamine, which regulates cognition.
A)Ritalin helps with the symptoms of ADHD, but the reasons for this are not well understood.
Which herbal and dietary supplement has shown proven success in lowering LDL and total cholesterol in research studies? A)Soy B)Ginkgo biloba C)Green tea D)Garlic
A)Soy
Which single drug class is known to be most effective in reducing the major types of dyslipidemia? A)Statins B)Bile acid sequestrants C)Fibrates D)Niacin
A)Statins
A man has asked the care team to consider the use of benzodiazepines to treat his wife's severe alcoholism. The use of benzodiazepines for this purpose may be contraindicated in what circumstances? A)The patient is acutely intoxicated. B)The patient denies the severity of her addiction. C)The patient has previously been treated with benzodiazepines. D)The patient is also addicted to nicotine.
A)The patient is acutely intoxicated.
A teenage boy is on amphetamine therapy for attention deficit hyperactivity disorder. The care provider has suggested a "drug holiday" for July and August. What is the purpose of this drug holiday? A)To minimize weight loss B)To prevent hyperthyroidism C)To allow electrolyte imbalances to resolve D)To slow bone resorption
A)To minimize weight loss
A patient who has been treated with warfarin (Coumadin) after cardiac surgery is found to have an INR of 9.0. Which medication will be administered to assist in the development of clotting factors? A)Vitamin K B)Vitamin E C)Protamine sulfate D)Acetylsalicylic acid (Aspirin)
A)Vitamin K
A patient will begin taking atorvastatin (Lipitor), and the nurse is conducting relevant health education. The nurse should emphasize the need to report any new onset of A)muscle pain. B)dry mouth. C)pruritus (itching). D)increased thirst.
A)muscle pain.
Methylphenidate will be used to treat a 9-year-old boy's ADHD. In light of this drug's most common adverse effects, the nurse who is working with the family should implement what strategy? A) A strategy to ensure that the boy maintains normal bladder function B) A plan to address the boy's loss of appetite C) A plan to enhance the boy's self-esteem D) A strategy to regularly monitor the boy's blood glucose levels
B) A plan to address the boy's loss of appetite
A patient is discharged from the hospital with a prescription of warfarin (Coumadin). Which of the following statements indicates successful patient teaching? A)"If I miss a dose, I will take two doses." B)"I will avoid herbal remedies." C)"I will eat spinach or broccoli daily." D)"I will discontinue my other medications."
B)"I will avoid herbal remedies."
A 66-year-old woman's most recent physical assessment and diagnostic workup reveal the presence of dyslipidemia. The woman is a candidate for monotherapy with a statin, and she will soon begin treatment with atorvastatin (Lipitor). The nurse should anticipate what order? A)"Lipitor 150 mg PO BID" B)"Lipitor 10 mg PO OD" C)"Lipitor 50 mg PO TID with meals" D)"Lipitor 75 mg PO BID"
B)"Lipitor 10 mg PO OD"
A female patient asks the nurse how much caffeine is safe to consume per day. What is the recommended amount of caffeine for a nonpregnant woman? A)125 mg of caffeine B)250 mg of caffeine C)500 mg of caffeine D)1 g of caffeine
B)250 mg of caffeine
A patient asks the nurse what dose of acetylsalicylic acid (Aspirin) is needed each day for antiplatelet effects to prevent heart attacks. What dose is most appropriate to reduce platelet aggregation? A)10 mg B)30 mg C)625 mg D)1000 mg
B)30 mg
A patient who has been diagnosed with human immune deficiency syndrome is given ganciclovir (Cytovene) to prevent cytomegalovirus. The patient develops granulocytopenia. How long will it take for the granulocytes to regenerate after the ganciclovir is discontinued? A)5 days B)7 days C)10 days D)14 days
B)7 days
A patient has a left temporal brain tumor. He smells an odor of ammonia prior to experiencing rapid rhythmic jerking movements. What is the odor of ammonia classified as? A)Chemical agent evoked by the tumor B)An aura prior to the seizure activity C)The metastatic process of tumor growth D)The inhibition of serotonin and acetylcholine
B)An aura prior to the seizure activity
A 55-year-old man has been diagnosed with coronary artery disease and begun antiplatelet therapy. The man has asked the nurse why he is not taking a "blood thinner like warfarin." What is the most likely rationale for the clinician's use of an antiplatelet agent rather than an anticoagulant? A)Antiplatelet agents do not require the man to undergo frequent blood work; anticoagulants require constant blood work to ensure safety. B)Antiplatelet agents are more effective against arterial thrombosis; anticoagulants are more effective against venous thrombosis. C)Antiplatelet agents are most effective in large vessels; anticoagulants are most effective in the small vessels of the peripheral circulation. D)Antiplatelet agents have fewer adverse effects than anticoagulants.
B)Antiplatelet agents are more effective against arterial thrombosis; anticoagulants are more effective against venous thrombosis.
A 77-year-old patient is admitted for the treatment of a fracture, and the nurse has identified that the patient has a history of heavy alcohol use. At what point should the care team administer pharmacologic treatments for alcohol withdrawal? A)After skeletal muscle relaxants have taken effect B)As soon as the patient shows signs of withdrawal C)After cognitive behavioral therapy has begun D)After treatment for the patient's acute injuries has been completed
B)As soon as the patient shows signs of withdrawal
A patient suffers from narcolepsy. Which of the following aspects of patient teaching should be provided? A)Take 250 mg of caffeine daily. B)Avoid working shifts. C)Take a lengthy nap every afternoon. D)Increase the Ritalin dose as needed.
B)Avoid working shifts.
A patient suffers from trigeminal neuralgia. What antiepileptic agent may be used to treat this disorder? A)Phenytoin (Dilantin) B)Carbamazepine (Tegretol) C)Fosphenytoin (Cerebyx) D)Ethosuximide (Zarontin)
B)Carbamazepine (Tegretol)
A patient is admitted with acute, painful muscle spasms and suffers from intermittent porphyria, an inherited enzyme deficiency. Which of the following muscle relaxants is contraindicated due to the patient's history of porphyria? A)Baclofen (Lioresal) B)Carisoprodol (Soma) C)Diazepam (Valium) D)Dantrolene (Dantrium)
B)Carisoprodol (Soma)
A patient has been reading about the use of flax seed to lower cholesterol. What should the patient be taught about the use of flax seed and cholestyramine (Questran)? A)Cholestyramine absorption will be increased with flax seed. B)Cholestyramine absorption will be decreased with flax seed. C)Bleeding will be increased with flax seed and cholestyramine. D)Hypoglycemia will result from flax seed and cholestyramine.
B)Cholestyramine absorption will be decreased with flax seed.
A 22-year-old male is brought to the emergency room due to an overdose of diazepam (Valium). What drug will be administered in the emergency room to treat the overdose? A)Disulfiram (Antabuse) B)Flumazenil (Romazicon) C)Methadone (Dolophine) D)Naloxone (Narcan)
B)Flumazenil (Romazicon)
A patient has a history of clot formation. She is scheduled for bowel resection due to colorectal cancer. What anticoagulant agent will be administered prophylactically? A)Acetylsalicylic acid (Aspirin) B)Heparin C)Warfarin (Coumadin) D)Streptokinase (Streptase)
B)Heparin
A patient has experienced the formation of clots and has bruising. It is determined that there is a depletion of the patient's coagulation factors and widespread bleeding. Which of the following medications will be administered? A)Aminocaproic acid (Amicar) B)Heparin C)Warfarin (Coumadin) D)Protamine sulfate
B)Heparin
A patient is taking dextroamphetamine for ADHD. He has developed constipation since beginning therapy. Which of the following should the patient be taught? A)Take an OTC laxative daily. B)Increase fiber intake. C)Take diphenoxylate hydrochloride (Lomotil). D)Take metronidazole (Flagyl).
B)Increase fiber intake.
A patient is prescribed fenofibrate (TriCor). When providing patient teaching, which of the following accurately describes the action of fenofibrate? A)It binds to bile acids in the intestinal lumen. B)It increases oxidation of fatty acids in the liver. C)It inhibits an enzyme required for hepatic synthesis. D)It inhibits mobilization of free fatty acids from peripheral tissues.
B)It increases oxidation of fatty acids in the liver.
An elderly patient with dyslipidemia has had fenofibrate (TriCor) added to her existing medication regimen. In addition to having her lipid profile drawn on a regular basis, the nurse should educate the patient about the need for what ongoing laboratory testing during therapy? A)Complete blood count (CBC) B)Liver panel C)INR and aPTT D)Reticulocyte count
B)Liver panel
A 13-year-old boy has been taking dextroamphetamine for the treatment of ADHD since he was 10, achieving significant improvements in behavior and mood. When assessing the boy during a scheduled follow-up appointment, the nurse should prioritize what physical assessment? A)Abdominal girth and assessment for peripheral edema B)Measurement of height and body weight C)Visual acuity and hearing ability D)Assessment of deep tendon reflexes and peripheral pulses
B)Measurement of height and body weight
An influenza outbreak has spread through a long-term care residence, affecting many of the residents with severe malaise, fever, and nausea and vomiting. In an effort to curb the outbreak, the nurse has liaised with a physician to see if residents may be candidates for treatment with what drug? A)Saquinavir mesylate B)Oseltamivir phosphate C)Lamivudine D)Ribavirin
B)Oseltamivir phosphate
A patient is being treated for a seizure disorder with phenytoin (Dilantin). He is admitted to the emergency room with sinus bradycardia. What action will occur regarding his antiepileptic agent? A)Phenytoin (Dilantin) dose will be reduced. B)Phenytoin (Dilantin) will be discontinued. C)Phenytoin (Dilantin) will be given every other day. D)Phenytoin (Dilantin) dose will be increased.
B)Phenytoin (Dilantin) will be discontinued.
A patient with a diagnosis of endocarditis has been admitted, and the care team is aware that IV opioid use is the origin of the patient's infection. The patient is open to the idea of treatment for her substance abuse disorder. When planning this aspect of the patient's care, what goal should the nurse first address? A)Compliance with treatment B)Safe detoxification C)Taking ownership of the problem D)Adequate stimulation of the CNS
B)Safe detoxification
A male patient has been diagnosed with moderately increased LDL, and his primary care provider wishes to begin him on a statin. What is a potential disadvantage of statins that the care provider should consider? Select all that apply. A)Statins are nephrotoxic. B)Statins are expensive. C)Statins are contraindicated in patients with a history of myocardial infarction. D)Statins require regularly scheduled blood work. E)Statins have an immunosuppressive effect.
B)Statins are expensive. D)Statins require regularly scheduled blood work.
A patient has an elevated total serum cholesterol of 260 mg/dL. Which of the following aspects of patient teaching of lifestyle changes is most important for the patient? A)Eat organic foods. B)Stop smoking. C)Increase rest periods. D)Drink whole milk.
B)Stop smoking.
An obese patient who has an elevated triglyceride level and reduced high-density lipoprotein cholesterol is seen by her primary care physician. What do these data suggest in this patient? A)The development of arthritic syndrome B)The development of metabolic syndrome C)The development of Reye's syndrome D)The development of Tay-Sachs disease
B)The development of metabolic syndrome
An 80-year-old patient with chronic renal failure is admitted to the hospital with herpes simplex. The acyclovir (Zovirax) is to be administered parenterally. When preparing to administer this medication, what would the nurse expect in regard to the dose? A)The dose is smaller due to the herpes simplex. B)The dose is smaller based on the patient's kidney function. C)The dose is higher in treating genital herpes. D)The dose is higher if the creatinine is above 4.0 mg/dL.
B)The dose is smaller based on the patient's kidney function.
A 50-year-old man has undergone a bunionectomy and has been admitted to the postsurgical unit. What aspect of the man's medical history would contraindicate the use of heparin for DVT prophylaxis? A)The man is morbidly obese. B)The man has a diagnosis of ulcerative colitis. C)The man had a myocardial infarction 18 months ago. D)The man has a diagnosis of type 2 diabetes mellitus.
B)The man has a diagnosis of ulcerative colitis.
A patient is taking disulfiram (Antabuse) and later consumes several shots of vodka. What effect will be produced from the combination of alcohol and disulfiram? A)Hypertension B)Vomiting C)Hyperalertness D)Oral bleeding
B)Vomiting
A patient has been started on cyclobenzaprine (Flexeril). For the duration of treatment, the nurse should teach the patient to avoid A)OTC vitamin supplements. B)alcohol. C)stool softeners. D)fatty foods.
B)alcohol.
A patient was admitted with a diagnosis of a gastrointestinal bleed, the latest of several hospital admissions that have been attributed to his alcohol abuse. The addictions medicine specialist has prescribed disulfiram, which will A)prevent the patient from experiencing euphoria if he drinks alcohol. B)produce unpleasant reactions if the patient drinks alcohol. C)intensify the patient's CNS depression if he drinks alcohol. D)result in a depressed mood if he drinks alcohol.
B)produce unpleasant reactions if the patient drinks alcohol.
A patient is being prescribed dextroamphetamine for the treatment of ADHD. During health education, the nurse should make the patient aware of the black box warning relating to A)the risks of kidney failure. B)the potential for abuse. C)the risk of stroke with excessive doses. D)the potential for unstable blood glucose levels.
B)the potential for abuse.
A 21-year-old male is being started on zidovudine (AZT) for treatment of HIV/AIDS. Which of the following statements made by the patient indicates that he has understood the patient teaching? A)"AZT inactivates the virus and prevents recurrence of the disease." B)"AZT therapy may result in the development of AZT-resistant strains." C)"AZT slows the progression of the disease but does not cure it." D)"AZT prevents the occurrence of opportunistic infections."
C)"AZT slows the progression of the disease but does not cure it."
The nurse has been educating the patient on the self-administration of phenytoin (Dilantin). Which of the following statements by the patient demonstrates an understanding of the medication? A)"I'll only take the drug when I feel an impending seizure." B)"I'll reduce my dose if I remain seizure free." C)"I'll make sure to take the drug with food." D)"I'll stop taking the drug if I don't have a seizure for 8 weeks."
C)"I'll make sure to take the drug with food."
A patient began antiretroviral therapy several weeks ago for the treatment of HIV, and he has now presented to the clinic for a scheduled follow-up appointment. He states to the nurse, "I've been pretty good about taking all my pills on time, though it was a bit hit and miss over the holiday weekend." How should the nurse best respond to this patient's statement? A)"Remember that if you miss a dose, you need to take a double dose at the next scheduled time." B)"It's acceptable to miss an occasional dose as long as your symptoms don't get worse, but it's not really recommended." C)"Remember that your antiretroviral drugs will only be effective if you take them very consistently." D)"If you're not consistent with taking your medications, you're likely to develop more side effects."
C)"Remember that your antiretroviral drugs will only be effective if you take them very consistently."
A patient is being administered heparin IV and has been started on warfarin (Coumadin). The patient asks the nurse why she is taking both medications. What is the nurse's most accurate response? A)"After a certain period of time, you must start warfarin and heparin together." B)"You will need both warfarin and heparin for several days." C)"Warfarin takes 3 to 5 days to develop anticoagulant effects, and you still need heparin." D)"Warfarin cannot be given without heparin due to the amount of clotting you need."
C)"Warfarin takes 3 to 5 days to develop anticoagulant effects, and you still need heparin."
A patient is scheduled to have her serum triglyceride level assessed. How long should the patient be without food or fluids prior to the serum triglyceride test? A)6 hours B)8 to 10 hours C)12 hours D)24 hours
C)12 hours
A patient has a long history of heavy alcohol use and has been admitted to the hospital for traumatic injuries after a motor vehicle accident. How should the nurse best assess the patient for physical dependence on alcohol? A)Assess the patient's perceptions of his coping strategies. B)Assess whether the patient ever feels guilty about his drinking. C)Assess the patient for signs and symptoms of alcohol withdrawal. D)Assess the patient's typical alcohol intake.
C)Assess the patient for signs and symptoms of alcohol withdrawal.
A patient is prescribed zanamivir (Relenza) to treat influenza B. The patient has a history of asthma. For which of the following symptoms should the nurse assess? A)Bradycardia B)Pneumonia C)Bronchospasm D)Pulmonary embolism
C)Bronchospasm
A patient's antiretroviral therapy has not been as efficacious as her care team had predicted, and maraviroc (Selzentry) has consequently been added to her drug regimen. The nurse should recognize this drug as belonging to what category of antiretroviral? A)Fusion protein inhibitors B)Protease inhibitors C)CCR5 antagonists D)Integrase strand transfer inhibitors
C)CCR5 antagonists
A neonate is suffering from apnea. Which of the following medications may be administered as a respiratory stimulant? A)Caffeine and methylphenidate B)Caffeine and Mefoxitin C)Caffeine and sodium benzoate D)Caffeine and sodium bicarbonate
C)Caffeine and sodium benzoate
A 4-year-old child is brought to the pediatric clinic by his mother. She states, "I don't know what to do with him. He is in constant motion. He won't sit for more than a few seconds and he is doing something else. He often throws his toys and yells loudly, even compared with other kids his age." The child is diagnosed with attention deficit hyperactivity disorder. Which of the following medications will most likely be administered in conjunction with treatment? A)ACE inhibitors B)SSRIs C)Central nervous system stimulants D)MAO inhibitors
C)Central nervous system stimulants
A patient is admitted to the inpatient alcohol rehabilitation program. What medication will the patient most likely be prescribed to treat alcohol withdrawal syndromes? A)Clonidine (Catapres) B)Methyldopa (Aldomet) C)Chlordiazepoxide (Librium) D)Atenolol (Tenormin)
C)Chlordiazepoxide (Librium)
A patient who has been taking a statin has seen an improvement in his cholesterol laboratory values; however, the low-density lipoprotein remains elevated. What medication will be added to the medication regimen? A)Digoxin (Lanoxin) B)Vitamin D C)Cholestyramine (Questran) D)Calcium carbonate
C)Cholestyramine (Questran)
A patient is prescribed acyclovir (Zovirax) for the treatment of genital herpes. What is the expected outcome of this medication? A)Decreased testosterone production B)Decreased libido C)Decreased viral shedding D)Decreased bacterial replication
C)Decreased viral shedding
A patient has been treated with dextroamphetamine for ADHD. At the age of 16 years, she is diagnosed with hyperthyroidism. What intervention should be implemented with this patient? A)Discontinue the high-calorie diet. B)Assess the patient for pulmonary edema. C)Discontinue the amphetamines. D)Administer a proton pump inhibitor.
C)Discontinue the amphetamines.
A patient with muscle spasms is administered cyclobenzaprine (Flexeril). Which adverse effect should the nurse assess for with this medication? A)Muscle spasms B)Insomnia C)Drowsiness D)Urinary incontinence
C)Drowsiness
A 74-year-old male patient is being treated in the hospital for a stroke and is undergoing an extended stay on a rehabilitation unit. The patient's wife has been participating actively in his care and performs much of his feeding and hygiene. This evening, the patient's wife has brought in a number of healthy snacks to keep at his bedside. Knowing that the patient's medication regimen includes simvastatin, the nurse would remove which of the following items? A)Purple grapes B)Cranberry cocktail C)Grapefruit juice D)Trail mix (salted nuts and seeds)
C)Grapefruit juice
A patient has sought care from her primary care provider after feeling "under the weather" for several days. The care provider suspects that the patient is suffering from a viral illness. What signs and symptoms typically accompany viral infections? Select all that apply. A)Increased white cell count B)Idiopathic bleeding C)Malaise D)Fever E)Headache
C)Malaise D)Fever E)Headache
A patient is being treated for opioid abuse after many years of cocaine and heroin use. The nurse should anticipate that this patient will be treated with what drug? A)Disulfiram (Antabuse) B)Flumazenil (Romazicon) C)Methadone (Dolophine) D)Naloxone (Narcan)
C)Methadone (Dolophine)
A patient visits the occupational health office of the factory in which he works. He has fallen asleep on the line and has a history of muscle weakness. This instance is not the first time he has fallen asleep on the line. From what disease process does the occupational health nurse suspect the patient is suffering? A)Sleep apnea B)Insomnia C)Narcolepsy D)Substance abuse
C)Narcolepsy
A patient is taking warfarin (Coumadin) to prevent clot formation related to atrial fibrillation. How are the effects of the warfarin (Coumadin) monitored? A)RBC B)aPTT C)PT and INR D)Platelet count
C)PT and INR
A patient who is undergoing treatment for cytomegalovirus received his first dose of IV ganciclovir 3 days ago. When reviewing this patient's most recent blood work, what abnormality should the nurse most likely attribute to the use of this drug? A)Hemoglobin 17 g/dL (high normal) B)INR 3.8 (high) C)Platelet count 118,000/mm3 (low) D)Leukocytes 11,900/mm3 (high)
C)Platelet count 118,000/mm3 (low)
A patient is admitted to the emergency room suffering from symptoms of alcohol withdrawal. The nurse should plan care with the goal of preventing which of the following? A)Bradycardia B)Hypotension C)Seizures D)Gastrointestinal bleeding
C)Seizures
A patient is being treated for addiction to cocaine and heroin and will begin treatment with naltrexone (ReVia). If the patient uses an opioid after taking this drug, the nurse should expect what effect? A)The patient will experience a decline in neurological function. B)The patient will experience visual disturbances and unpleasant hallucinations. C)The patient will not experience the usual physiological effects of opioids. D)The patient will experience a sudden onset of nausea and vomiting.
C)The patient will not experience the usual physiological effects of opioids.
A patient who has long abused alcohol is being treated with disulfiram (Antabuse). The patient currently takes phenytoin (Dilantin) for an underlying seizure disorder. Based on the interaction of these two medications, what will need to be adjusted in the medication administration? A)The patient will require more frequent administration of disulfiram (Antabuse). B)The patient will require a larger dose of disulfiram (Antabuse). C)The patient will require a reduced dose of phenytoin (Dilantin). D)The patient will require phenytoin (Dilantin) to be administered twice daily.
C)The patient will require a reduced dose of phenytoin (Dilantin).
A patient is administered a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor. What is the main rationale for administering these medications together? A)They facilitate increased adherence to treatment. B)They decrease the length of illness. C)They have synergistic antiviral effects. D)They prevent the development of opportunistic infections.
C)They have synergistic antiviral effects.
A 79-year-old woman has been brought to the emergency department by ambulance with signs and symptoms of ischemic stroke. The care team would consider the STAT administration of what drug? A)Low molecular weight heparin B)Vitamin K C)Clopidogrel (Plavix) D)Alteplase (Activase)
D)Alteplase (Activase)
A patient who has been taking valproic acid (sodium valproate) for a seizure disorder is asking the nurse about getting pregnant. Why is pregnancy discouraged in women who are being treated for seizure disorders? A)Seizure disorders are genetic. B)Seizure disorders are familial. C)Antiepilepsy drugs decrease fertility. D)Antiepilepsy drugs are teratogenic.
D)Antiepilepsy drugs are teratogenic.
A patient is taking warfarin (Coumadin) after open heart surgery. The patient tells the home care nurse she has pain in both knees that began this week. The nurse notes bruises on both knees. Based on the effects of her medications and the complaint of pain, what does the nurse suspect is the cause of the pain? A)Joint thrombosis B)Torn medial meniscus C)Degenerative joint disease caused by her medication D)Bleeding
D)Bleeding
A patient has been diagnosed with a brain tumor, which has caused partial seizure activity. The patient is being treated with gabapentin (Neurontin). After administering the medication, the nurse should assess the patient because of the potential for what adverse effect? A)Tetany B)Hypersensitivity C)Paradoxical seizures D)CNS depression
D)CNS depression
A high school boy has been brought to the emergency department (ED) by his friends who state that he has taken a "whole handful of Dex" and is now lapsing in and out of consciousness. The ED nurse should prioritize what assessment related to dextroamphetamine overdose? A)Blood glucose monitoring B)Cognitive assessment C)Lung function testing D)Cardiac monitoring
D)Cardiac monitoring
A patient has been brought to the emergency department by paramedics. The patient's known history and highly agitated state are suggestive of cocaine-induced psychosis. What assessment should the nurse prioritize prior to administering pharmacologic treatments? A)Assessment of blood glucose levels B)Assessment of cranial nerve function C)Lung auscultation D)Cardiovascular assessment
D)Cardiovascular assessment
A patient is prescribed indinavir sulfate (Crixivan) for the treatment of HIV infection. What patient teaching should be provided regarding renal function? A)Drink grape juice daily for antioxidants. B)Drink grapefruit juice to enhance absorption. C)Assess for pulmonary edema. D)Consume at least 48 ounces of fluid per day.
D)Consume at least 48 ounces of fluid per day.
A patient is admitted to the hospital for severe back spasms and pain. Which of the following skeletal muscle relaxants will act peripherally on the muscle itself? A)Cyclobenzaprine (Flexeril) B)Carisoprodol (Soma) C)Methocarbamol (Robaxin) D)Dantrolene sodium (Dantrium)
D)Dantrolene sodium (Dantrium)
A patient has been taking phenytoin (Dilantin) for a seizure disorder. He has recently run out of his medication and has not obtained a refill. What is the patient at risk for developing? A)Hypotension B)Migraine headaches C)Status epilepticus D)Depression
D)Depression
Mr. Burris is a 66-year-old man who leads a sedentary lifestyle and who has recently been diagnosed with dyslipidemia. Mr. Burris is disappointed to learn of this apparent deterioration in his health, stating, "First it was the diabetes and then the arthritis, now this." The nurse has performed health education with Mr. Burris and has described metabolic syndrome. In addition to his elevated cholesterol levels, what aspect of Mr. Burris' health is congruent with a diagnosis of metabolic syndrome? A)Sedentary lifestyle B)Age over 65 coupled with male gender C)Arthritis D)Diabetes mellitus
D)Diabetes mellitus
A school nurse is meeting with a high school student who mentions that she is frustrated with her repeated outbreaks of cold sores. The student states that she tried an over-the- counter topical cream but that it failed to produce an appreciable improvement. The nurse should recognize that this student used what drug? A)Ganciclovir B)Valacyclovir (Valtrex) C)Famciclovir (Famvir) D)Docosanol (Abreva)
D)Docosanol (Abreva)
An 80-year-old patient has severe pain after a case of shingles. The pain is noted along the shoulder and back. He states the pain is so severe he cannot sleep. What is the primary medication that will relieve this pain? A)Meperidine (Demerol) B)Morphine sulfate (MS Contin) C)Naproxen sodium (Naprosyn) D)Gabapentin (Neurontin)
D)Gabapentin (Neurontin)
A patient has been started on dantrolene (Dantrium). What is the most serious adverse effect about which the patient should be instructed? A)Metabolic acidosis B)Hypercarbia C)Renal calculi D)Hepatitis
D)Hepatitis
A patient is receiving IV heparin every 6 hours. An activated partial thromboplastin time (aPTT) is drawn 1 hour before the 08:00 dose. The PTT is 92 seconds. What is the most appropriate action by the nurse? A)Give the next two doses at the same time. B)Give the dose and chart the patient response. C)Check the patient's vital signs and give the dose. D)Hold the dose and call the aPTT result to the physician's attention.
D)Hold the dose and call the aPTT result to the physician's attention.
A neonatal intensive care unit nurse is caring for an infant with RSV. What route of delivery will the nurse use when ribavirin (Virazole) is administered? A)Oral suspension B)Topical C)Intravenous D)Inhaled
D)Inhaled
A child suffers from absence seizures and has been prescribed acetazolamide (Diamox). The nurse should know that this medication is an adjuvant medication useful in the treatment of seizures. What is the therapeutic action of Diamox? A)It slows the action potential of neurons. B)It slows the reuptake of acetylcholine. C)It suppresses the limbic and reticular systems. D)It controls fluid secretion in the CNS.
D)It controls fluid secretion in the CNS.
A patient with a diagnosis of cardiovascular disease is taking atorvastatin calcium (Lipitor) to reduce serum cholesterol. What is the goal of therapy for LDL cholesterol for a patient taking atorvastatin calcium (Lipitor)? A)100 to 115 mg/dL B)75 to 85 mg/dL C)Less than 60 mg/dL D)Less than 100 mg/dL
D)Less than 100 mg/dL
A patient with impaired liver function is suffering from a seizure disorder that most often results in partial seizures. Which of the following AEDs may be administered to a patient with impaired liver function? A)Oxcarbazepine (Trileptal) B)Fosphenytoin (Cerebyx) C)Carbamazepine (Tegretol) D)Levetiracetam (Keppra)
D)Levetiracetam (Keppra)
A patient with narcolepsy is placed on a central nervous system stimulant. What is the central nervous system stimulant of choice to treat narcolepsy? A)Atomoxetine (Strattera) B)Guarana C)Caffeine D)Modafinil (Provigil)
D)Modafinil (Provigil)
A 15-year-old boy with a complex psychosocial history is being treated for inhalant abuse. When providing health education to this boy, the nurse should cite which of the following risks associated with inhalant abuse? A)Hyperactivity B)Psychological dependence C)Physiological dependence D)Organ damage
D)Organ damage
A young adult male who has had multiple sex partners in the preceding months has been diagnosed with hepatitis B virus (HBV) and begun treatment with lamivudine (Epivir). Shortly after beginning treatment, the man complains of a 24-hour history of intense abdominal pain. The nurse should recognize the possibility of what adverse effect of lamivudine therapy? A)Gastroenteritis B)Gastroesophageal reflux disease C)Bowel obstruction D)Pancreatitis
D)Pancreatitis
A patient has been largely unsuccessful in achieving adequate control of dyslipidemia through lifestyle changes and the use of a statin. As a result, the patient has been prescribed cholestyramine (Prevalite, Questran). What change in this patient's lipid profile will the nurse identify as the most likely goal of therapy? A)Reduction in triglycerides B)Reduction in total serum cholesterol levels C)Increase in HDL levels D)Reduction in LDL cholesterol levels
D)Reduction in LDL cholesterol levels
A patient is being discharged from the hospital with warfarin (Coumadin) to be taken at home. Which of the following foods should the patient be instructed to avoid in his diet? A)Eggs B)Dairy products C)Apples D)Spinach
D)Spinach
A patient is taking cholestyramine (Questran) and ezetimibe (Zetia). What administration guideline is most important to teach this patient? A)The two medications should be taken together. B)The ezetimibe inhibits cholesterol in the liver. C)The cholestyramine (Questran) is administered 1 hour after ezetimibe. D)The administration of ezetimibe (Zetia) is 2 hours before cholestyramine.
D)The administration of ezetimibe (Zetia) is 2 hours before cholestyramine.
A 42-year-old female patient with HIV has been receiving antiretroviral therapy for several years, and her care team has recently added raltegravir (Isentress) to her drug regimen. When appraising the success or failure of this change in treatment and the patient's ability to fight infection, the nurse should prioritize which of the following laboratory values? A)The patient's C-reactive protein levels B)The patient's erythrocyte sedimentation rate (ESR) C)The patient's viral load D)The patient's CD4 count
D)The patient's CD4 count
A patient is prescribed eptifibatide (Integrilin), which inhibits platelet aggregation by preventing activation of GP IIb/IIIa receptors on the platelet surface and the subsequent binding of fibrinogen and von Willebrand factor to platelets. Which of the following syndromes are treated with eptifibatide? A)Blocked carotid arteries B)Intermittent claudication C)Hypertension D)Unstable angina
D)Unstable angina
A patient who is receiving warfarin (Coumadin) has blood in his urinary catheter drainage bag. What medication will likely be ordered by the physician? A)Aminocaproic acid (Amicar) B)Platelets C)Protamine sulfate D)Vitamin K
D)Vitamin K
A patient who suffers from asthma is given theophylline. Theophylline will have an increased effect if taken with A)Ritalin. B)atomoxetine (Strattera). C)modafinil (Provigil). D)caffeine.
D)caffeine.
A nurse at a long-term care facility is conducting a medication reconciliation for a man who has just moved into the facility. The man is currently taking clopidogrel (Plavix). The nurse is most justified is suspecting that this man has a history of A)hemorrhagic cerebrovascular accident. B)hemophilia A. C)idiopathic thrombocytopenic purpura (ITP). D)myocardial infarction.
D)myocardial infarction.
When administering the fusion protein inhibitor enfuvirtide (Fuzeon) to a patient with HIV, the nurse should A)have the patient gargle with normal saline immediately after taking the drug. B)flush the patient's central venous catheter with 100 Unit/mL heparin prior to administration. C)inject the drug into the patient's ventrogluteal site using the z-track method. D)regularly rotate the subcutaneous injection sites that are used.
D)regularly rotate the subcutaneous injection sites that are used.
