Final exam study set
Place the phases of the nursing process in the correct order, with 1 as the first phase and 5 as the last phase. (Select all that apply.) 1. Assessment 2. Nursing Diagnoses 3. Implementation 4. Planning 5. Evaluation
1, 2, 4, 3, 5
Which drugs would be affected by the first-pass effect? (Select all that apply.) A) Levothyroxine (Synthroid) tablets B) Transdermal nicotine patches C) Diphenhydramine (Benadryl) elixir D) Penicillin given by IV piggyback infusion E) Sublingual nitroglycerin tablets F) Esomeprazole (Nexium) capsules G) Morphine given by IV push injection
A, C, F
When given an intravenous medication, the patient says to the nurse, "I usually take pills. Why does this medication have to be given in the arm?" What is the nurse's best answer? A. "The action of the medication will begin sooner when given intravenously." B. "There is a lower chance of allergic reactions when drugs are given intravenously." C. "The medication will cause fewer adverse effects when given intravenously." D. "The intravenous medication will have delayed absorption into the body's tissues."
A. "The action of the medication will begin sooner when given intravenously."
A drug dose that delivers 250 mg has a half-life of 5 hours. Identify how much drug will remain in the body after one half-life. _______ A. 125 mg B. 200 mg C.50 mg D. 100 mg
A. 125 mg
The patient is receiving two different drugs. At current dosages and dosage forms, both drugs are absorbed into the circulation in identical amounts. Which term is used to identify this principle? A. Bioequivalent B. Synergistic C. Steady state D. Prodrugs
A. Bioequivalent
The medication order reads, "Give ondansetron (Zofran) 4 mg, 30 minutes before beginning chemotherapy to prevent nausea." The nurse notes that the route is missing from the order. What is the nurse's best action? A. Contact the prescriber to clarify the route of the medication ordered. B. Give the medication orally because the tablets are available in 4-mg doses. C. Hold the medication until the prescriber returns to make rounds. D. Give the medication intravenously because the patient might vomit.
A. Contact the prescriber to clarify the route of the medication ordered.
The nurse has been monitoring the patient's progress on a new drug regimen since the first dose and documenting the patient's therapeutic response to the medication. Which phase of the nursing process do these actions illustrate? A. Evaluation B. Planning C. Implementation D. Nursing diagnosis
A. Evaluation
Which insulin is rapid acting with an onset of action within 15 minutes? A. humalog B. NPH C. lantus D. regular
A. Humalog
The nurse is preparing to give a potassium supplement. Which laboratory test should be checked before the patient receives a dose of potassium? A. serum potassium level B. complete blood count C. serum sodium level D. liver function tests
A. Serum potassium level
The nurse is performing an assessment of a newly admitted patient. Which is an example of subjective data? A. The patient reports that he uses the herbal product ginkgo. B. Weight 255 pounds C. The patient's laboratory work includes a complete blood count and urinalysis. D. Blood pressure 158/96 mm Hg
A. The patient reports that he uses the herbal product ginkgo.
A patient will be discharged with a 1- week supply of an opioid analgesic for pain management after abdominal surgery. The nurse will include which information in the teaching plan? A. how to prevent constipation B. the importance of taking the drug on an empty stomach C. how to prevent dehydrationdue to diarrhea D. the importance of taking the drug only when the pain becomes severe
A. how to prevent constipation
The addictive chemical in tobacco products is ________? A. nicotine B. heroin C. morphine D. cocaine
A. nicotine
An 18- year -old basketball player fell and twisted his ankle during a game. The nurse will expect to administer which type of analgesic? A. nonopioid analgesic such as indomethicin ( indocin) B. opioid antagonist such as narcan C. opium alkaloid such as morphine D. synthetic opioid such as demerol
A. nonopioid analgesic such as indomethicin ( indocin)
A patient has been treated for lung cancer for 3 years.Over the past few months, the patient has noticed that the opioid analgesic is not helping as much as it had previously and more medication is needed for pain relief. The nurse is aware that this patient is experiencing which of these? A. opioid tolerance B. opioid toxicity C. opioid abstinence syndrome D. opioid addiction
A. opioid tolerance
The nurse is assessing a patient's pain. When the patient describes his pain as cramping and burning which component of the pain history is being addressed? A. quality B. location C. depth D. severity
A. quality
A patient has been instructed to take one enteric coated low dose spirin a day as part of therapy to prevent strokes. The nurse will provide which instruction when providing patient teaching about the medication? A. take the medication with 6-8 ounces of water and with food B. aspirin needs to be taken on an empty stomach to ensure maximal absorption C. coated tablets may e crushed if necessary for easier swallowing D. low dose aspirin therapy rarely causes probems with bleeding
A. take the medication with 6-8 ounces of water and with food
The nurse is working with a student nurse to prepare an intravenous dose of potassium. Which statement by the student reflects a need fo further teaching? A. the IV potassium dose will be given undiluted B. the intravenous potassium will be diluted before we give it C. the infusion rate should not go over 10 mEq/hr D. we will need to monitor this infusion closely
A. the IV potassium dose will be given undiluted
A patient has had recent mechanical heart valve surgery and is receiving anticoagulant therapy. While monitoring the patient's laboratory work, the nurse interprets that the patient's international normalized ratio (INR) levelof 3 indicates that? A. the patient;s warfarin dose is at therapetic levels B. the patient's intravenous heparin dose is dangerously high C. the patient is not receiving enough warfarin to have a therapeutic effect D. the patient's intravenous heparin dose is at therapeutic levels
A. the patient;s warfarin dose is at therapetic levels
A patient will be receiving a thrombolytic drug as part of the treatment for acute myocardial infarction. The nurse explains to the patient that this drug is used for which purpose? A. to dissolve the clot in the coronary artery B. to prevent further myocardial infarction C. to relieve chest pain D. to control bleeding in the coronary vessels
A. to dissolve the clot in the coronary artery
A patient admitted 48 hours ago has a diagnosis of gastrointestinal (GI) bleeding and is receiving IV hydration and transfusions. When making rounds, the nurse observes the patient to be having a tonic clonic seizure. What may be the cause of the seizure? A. alkalosis B. alcohol withdrawal C. inadequate nutrition D. low bloodcounts from bleeding
B. Alcohol withdrawal
___________ insulin has an onset of 5-15 minutes. A. NPH B. humalog C. lantus D. regular
B. Humalog
All drugs must eventually be removed from the body by excretion: the primary organ responsible for this elimination is? A. liver B. kidney C. lungs D. skin
B. Kidneys
When monitoring a paient for signs of hypokalemia, the nurse looks for what early sign? A. seizures B. muscle weakness C. diarrhea D. vomitting
B. Muscle weakness
The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs? A. Absorption of parenteral drugs is affected by reduced blood flow to the stomach. B. Parenteral drugs bypass the first-pass effect. C. Parenteral drugs exert their effects while circulating in the bloodstream. D. Absorption of parenteral drugs is faster when the stomach is empty.
B. Parenteral drugs bypass the first-pass effect.
The nurse is preparing to transfuse a patient with a unit of packed red blood cells (PRBC's).Which patient would be best treated with this transfusion? A. patientwho has lost massive amounts of blood B. patient with severe anemia C. patient with coagulation disorder D. patient who has a clotting disorder
B. Patient with severe anemia
A 78- year -old patient is in the recovery room after having a lengthy surgery on his hip. As he is gradually awakening he requests more pain medicine. Within 10 minutes after receiving a dose of morphine, he is very lethargic and his respirations are shallow with a rate of 7 per minute. The nurse prepares for which priority action at this time? A. assessment of the patient's pain level B. administration of narcan C. immediate intubation and artificial ventilation D. close observation of signs of opioid tolerance
B. administration of narcan
During a blood transfusion, the patient begins to have chills and back pain. What is the nurse's priority action? A. observe for other symptoms B. discontinuethe infusion immediately and notify the prescriber C. slow the infusion rate D. tell the patient thet these symptoms are a normal reaction to the blood product
B. discontinuethe infusion immediately and notify the prescriber
During an information session about drug abuse, the nurse relates that the most common drug effects that leads to abuse of opioids includes ? A. sleep B. euphoria C. hallucinations D. stimulation
B. euphoria
A patient with a known history of chronic excessive ingestion of alcohol has developed memory problems and comes to the health clinic with hard-to-believe stories of what has happened to him.The nurse recognizes that these symptoms are associated with which disorder? A. cerebral vascular accident B. korsakoff's psychosis C. narcolepsy D. bipolar disorder
B. korsakoff's psychosis
The nurse is assessing a patient for contraindications to drug therapy with tylenol. Which patient should not receive tylenol? A. patient with a fever of 101 B. patient with a history of liver disease C. patient with a history of peptic ulcer D. patient who complains of a headache
B. patient with a history of liver disease
A patient has received an overdose of intravenous heparin, and is showing signs of excessive bleeding.Which substance is the antidote for heparin overdose? A. potassium chloride B. protamine sulfate C. vitamin K D. vitamin E
B. protamine sulfate
When teaching a patient about drug interactions,the nurse is aware that combining benzodiazepines with alcohol or barbiturates may lead to death from? A. convulsions B. respiratory arrest C. stroke D. cardiac dysrhythmia
B. respiratory arrest
All of the following are rights of medication administration except? A) patient has the right to refuse B) make sure patient has therapeutic effects of medication C) right medicine cup D) inform the patient of action and therapeutic effect and side effects of medication
C) right medicine cup
NPH insulin has an onset of ______ and a peak of_______. A. 5-10 minutes,2 hours B. 8 hours, 24 hours C. 1-2 hours,4-12 hours D. 4-5 hours,16 hours
C. 1-2 hours,4-12 hours
The nurse is writing a nursing diagnosis for a plan of care for a patient who has been newly diagnosed with type 2 diabetes. Which statement reflects the correct format for a nursing diagnosis? A. Anxiety related to new drug therapy, as evidenced by statements such as "I'm upset about having to test my blood sugars." B. Anxiety C. Anxiety related to anxious feelings about drug therapy, as evidenced by statements such as "I'm upset about having to test my blood sugars." D. Anxiety related to new drug therapy
C. Anxiety related to anxious feelings about drug therapy, as evidenced by statements such as "I'm upset about having to test my blood sugars."
Which medication is contraindicated when a patient is taking warfarin (Coumadin)? A. tylenol B. darvon C. aspirin D. morphine
C. Aspirin
One way to prevent medication errors from misinterpretation of the prescriber's orders is? A. ask the patient if they ave taken the drug before B. ask the pharmacist to transcribe the order C. Avoid the use of abbreviations D. ask a co-worker to interpret the order
C. Avoid the use of abbreviations
Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with hypertension? A. Setting goals and outcome criteria with the patient's input B. Formulating nursing diagnoses regarding deficient knowledge related to the new treatment regimen C. Providing education on keeping a journal of blood pressure readings D.Recording a drug history regarding over-the-counter medications used at home
C. Providing education on keeping a journal of blood pressure readings
When reviewing the health history of a patient, the nurse will note that a potential contraindication to potassium supplements exists if the patient has which problem? A. diarrhea B. burns C. renal disease D. vomitting
C. Renal disease
The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent? A. "Right route" B. "Right medication" C. "Right time" D. "Right dose"
C. Right time
A nurse working the night shift suspects that a colleague is abusing alcohol. Which action by the nurse is most important? A. reporting will result in loss of the colleague's license B. reporting it would mean she is being unfaithful to her colleague C. state guidelines may mandate to report substance abuse D. it is not of concern, andthe nurse worn't be pernalized for refusing to get involved
C. State guidelines may mandate to report substance abuse
The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an outcome criterion for this patient? A. The patient will not experience complications. B. The patient will adhere to the new insulin treatment regimen. C. The patient will demonstrate correct blood glucose testing technique. D. The patient will follow instructions.
C. The patient will demonstrate correct blood glucose testing technique.
When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug? A. The patient's height B. The patient's ability to swallow C. The patient's last meal D. The patient's allergies
C. The patient's last meal
When administering drugs, the nurse remembers that the duration of action of a drug is defined as which of these? A. The time it takes for a drug to achieve its maximum therapeutic response B. The amount of time needed to remove a drug from circulation C. The time period at which a drug's concentration is sufficient to cause a therapeutic response D.The time it takes for a drug to elicit a therapeutic response
C. The time period at which a drug's concentration is sufficient to cause a therapeutic response
A patient who has been anticoagulated with warfarin (coumadin) has been admitted for gastrointestinal (GI) bleeding.The history and physical examination indicates that the patient may have taken too much warfarin. The nurse anticipates that the patient will receive which antidote? A. protamine sulfate B. vitamin E C. vitamin K D. potassium chloride
C. Vitamin k
A patient is receivng heparin therapy as part of the treatment for a pulmonary embolism. The nurse monitors the results of which laboratory test to check the drug's effectiveness? A. prothrombin time/international ratio ( PT/INR) B. vitamin K levels C. activated partial thromboplastin time (aPTT) D. bleeding times
C. activated partial thromboplastin time (aPTT)
What information is most accurate regarding the nurse's understanding of pain management? A. pain meds ordered PRN will maintain a constant blood level B. use the smallest dose possible to control pain C. encourage patients to report pain before it becomes too severe D. older patients have difficulty describing their pain
C. encourage patients to report pain before it becomes too severe
A patient is recovering from abdominal surgery which he had this morning. He is groggy but complaining of severe pain around his incision. What is the most important assessment data to consider before the nurse administers a dose of morphine? A. the date of his last bowel movement B. his pulse rate C. his respiratory rate D. the appearance of the incision
C. his respiratory rate
____________ requires the patient to provide a list of all the medications they are currently taking. A. verification B. doctor's orders C. medication reconciliation D. "brown bag list"
C. medication reconciliation
A patient is in an urgent care center and is receiving treatment for mild hyponatremia after spending several hours doing gardening in the heat of the day.The nurse expects that which drug therapy will be used to treat this condition? A. oral supplementation of fluids B. slow normal saline infusion C. oral administration of sodium chloride tablets D. IV bolusof lactated ringers solution
C. oral administration of sodium chloride tablets
The nurse will monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of these diuretics? A.acetazolamide B.hydrochlorothiazide C.spironolactone D.lasix
C. spironolactone
Which statement is true about neuropathic pain? A. it commonly originates in the abdominal region B. patients describe it as dull and aching C. the pain is a result of nerve injury D. this pain is a result of a stimulus to pain reeptors
C. the pain is a result of nerve injury
A nurse is caring for a client with type I diabetes mellitus. Which client complaint would alert the nurse to the presence of a possible hypoglycemic reaction? A. hot skin B. anorexia C. tremors D. muscle cramps
C. tremors
A patient arrives at the urgent care complaining of leg pain after a fall when rock climbing.The x-ray shows no broken bones but he has a large bruise on his thigh. The patient says he drives a truck and does not want to take anything strong because he needs to stay awake. Which statement by the nurse is most appropriate? A. it would be best for you not to take anthing if you are planning to drive B. you can take tylenol for pain but no more than 1000mg per day C. you can take tylenol for pain,but no more than 3000mg per day D. we will discuss with your doctor about taking an opioid because that would work best for pain
C. you can take tylenol for pain,but no more than 3000mg per day
A patient has been started on a calcium channel blocker for hypertension. The nurse knows that the patient should be informed of which fruit juice to avoid? A)apple B) prune C) orange D) grapefruit
D) grapefruit
Which sign or symptom displayed by a patient would be indicative of opiate withdrawal? A. hypothermia B. lethargy C. bradycardia D. diarrhea
D. Diarrhea
The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease. The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase? A. Absorption B. Metabolism C. Distribution D. Excretion
D. Excretion
A 38-year-old man has come to the urgent care center with severe hip pain after falling from a ladder at work. He says he has taken several pain pills over the past few hours but cannot remember how many he has taken.. He hands the nurse an empty bottle of acetaminophen(tylenol). The nurse is aware that the most serious toxic effect of acute tylenol overdose is which condition? A. central nervous system depression B. nephropthy C. tachycardia D. hepatic necrosis
D. Hepatic necrosis
A 42 year old man is diagnosed with diabetes mellitus.He has tried diet and exercise with out success. A second generation sulfonylurea agent is prescribed ( glyburide). Which of the following is the most likely side effect he will experience? A. lactic acidosis B. agranulocytosis C. myositis D. hypoglycemia
D. Hypoglycemia
The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which sentence defines a drug's half-life? A. The time it takes for one half of the original amount of a drug to be absorbed into the circulation B. The time it takes for one half of the original amount of a drug to reach the target cells C. The time it takes for the drug to cause half of its therapeutic response D. The time it takes for one half of the original amount of a drug to be removed from the body
D. The time it takes for one half of the original amount of a drug to be removed from the body
A 45 year old female with a past history of typeII diabetes presents for routine follow-up. Her fasting blood sugars are controlled in the 80-100's range. However on her lab report the hemoglobin A1C is elevated at 8.5. You presume she need better mealtime glucose control. SHe is already taking and oral antidiabetic drug.Which of the following agents would help with her prandial or mealtime glucose control without persisting in her system to cause later hypoglycemia? A. NPH insulin B. insulin detemir C. repaglinide D. insulin aspart
D. insulin aspart
A patient who is severely anemic also has acute heart failure with severe edema due to fluid overload. The prescriber wants to raise the patient's hemoglobin and hematocrit levels.The nurse anticipates that the patient will receive which blood products? A. fresh frozen plasma B. albumin C. whole blood D. packed red blood cells (PRBC's)
D. packed red blood cells (PRBC's)
Which statement best supports the nursing diagnosis of "Deficient knowledge related to medication therapy"? A. patient is not taking medication as directed B. patient is unwilling to comply with medication therapy C. patient is not reporting adverse effects as directed D. patient is unable to verbalize reason for taking the medications
D. patient is unable to verbalize reason for taking the medications
The nurse notes in the patient's medication orders that the patient will be starting anticoagulant therapy. What is the primary goal of anticoagulant therapy? A. stabilizing existing thrombus B. dilating the vessel around the clot C. dissolving an existing thrombus D. preventing thrombus formation
D. preventing thrombus formation
The nurse is assessing a patient who has been admitted to the emergency department for a possible opioid overdose. Which assessment finding is characteristic of an opioid overdose? A. diluted pupils B. restlessness C. heart rate of 80 D. respiratory rate of 6 breaths per minute
D. respiratory rate of 6 breaths per minute
This gland is a relay station for pain perception A. adrenal gland B. pituatary C. thyroid gland D. thalamus
D. thalamus
When adminnistering heparin subcutaneously, the nurse will follow which procedure? A. massaging the site after injection B. applying heat to the injection site C. aspirating the syringe before injecting the medication D. use a 1/2 to 5/8 inch 25-28 gauge needle
D. use a 1/2 to 5/8 inch 25-28 gauge needle
A patient is to receive acetylcysteine ( mucomyst) as part of the treatment for a tyenol overdose. Which action by the nurse is appropriate when giving this medication? A.giving it through a nebulizer B.avoid using a straw C.giving it undiluted D.disguising the flavor with soda or flavored water
D.disguising the flavor with soda or flavored water
acute pain
Pain that is sudden and usually subsides when treated.
Vascular pain
Pain that is thought to account for most migraine headaches.
Central pain
Pain that occurs with tumors, trauma, or inflammation of the brain.
somatic pain
Pain that originates from skeletal muscles, ligaments, or joints.
superficial pain
Pain that originates from the skin or mucous membranes
phantom pain
Pain that relates to a body part that has been removed.
neuropathic pain
Pain that results from injury or damage to the peripheral nerve fibers.
chronic pain
Persistent or recurring pain that is often difficult to treat.
visceral pain
pain that originates from organs or smooth muscles
