NURS 304 - Exam 2
The order reads: "Give methylprednisolone (Solu-Medrol) 100 mg IV every 6 hours." The drug is available in vials of 80 mg/mL. How many mL will the nurse draw up for each dose?
1.25 mL
A patient with acute adrenal insufficiency is to receive 300 mg/day of hydrocortisone (Solu-Cortef), divided into 3 doses every 8 hours. How many milligrams will the patient receive for each dose?
100 mg
An order for a child reads: "Give ibuprofen suspension 30 mg/kg/day, divided into four doses, for pain." The child weighs 33 pounds. How many milligrams will this child receive per dose?
112.5 mg per dose
A 49-year-old patient has been admitted with possible chronic salicylate intoxication after self-treatment for arthritis pain. The nurse will assess for which symptoms of salicylate intoxication? (Select all that apply). a. Tinnitus b. Headache c. Constipation d. Nausea e. Bradycardia
A, B, D Tinnitus Headache Nausea
A nurse is assessing a client who has salicylism. Which of the following findings should the nurse expect? (select all that apply) A. Dizziness B. Diarrhea C. Jaundice D. Tinnitus E. Headache
A, D, E Dizziness Tinnitus Headache
A few months later, it is determined that Jane is not responding to treatment and is now prescribed isotretinoin. Which statement will the nurse include when teaching Jane about isotretinoin therapy? A. "Call your prescriber immediately if you experience any signs of depression." B. "If you become pregnant, the dose of isotretinoin will be cut in half." C. "Isotretinoin is administered by subcutaneous injection directly into the acne areas." D. "Isotretinoin should not be used with any form of birth control."
A. "Call your prescriber immediately if you experience any signs of depression?"
The nurse is instructing a parent on the use of lindane (Kwell) shampoo for treatment of a child's head lice. Which statement by the parent indicates a need for further education? a. "I will wash his hair, and then rinse out the shampoo immediately." b. "I will leave the shampoo on his hair for 4 minutes before rinsing." c. "After shampooing, I will rinse and dry his hair." d. "When the hair is dry, I will comb the hair to remove the nits."
A. "I will wash his hair, and then rinse out the shampoo immediately."
When the nurse is providing wound care with Dakin's solution for a patient who has a stage III pressure ulcer, the patient exclaims, "I smell bleach! Why are you putting bleach on me?" What is the nurse's best explanation? a. "This is a very dilute solution and acts to reduce the bacteria in the wound so that it can heal." b. "This solution is used instead of medication to promote wound healing." c. "This solution is used to dissolve the dead tissue in your wound." d. "Don't worry; we would never use bleach on a patient!"
A. "This is a very dilute solution and acts to reduce the bacteria in the wound so that it can heal."
The nurse should teach a patient taking an oral corticosteroid to take the medication at what time? A. 8:00 am B. 12 noon C. 5:00 pm D. 8:00 pm
A. 8:00 am
A nurse is admitting a toddler to the hospital after an acetaminophen overdose. Which of the following medications should the nurse anticipate administering to this client? A. Acetylcysteine B. Pegfilgrastim C. Misoprostol D. Naltrexone
A. Acetylcysteine
Which of the following should the nurse include when teaching a patient about glucocorticoid therapy? A. Do not abruptly stop taking the drug B. Take the medication on an empty stomach C. Avoid use of antiulcer medications when taking glucocorticoids D. When used long term, alternate-day dosing of glucocorticoids will help minimize thyroid suppression
A. Do not abruptly stop taking the drug
A patient is receiving prednisone as part of treatment for severe arthritis. He is also receiving furosemide (a loop diuretic), levothyroxine (for hypothyroidism), and a proton pump inhibitor and antacid (for gastroesophageal reflux disease). Which drug does the nurse identify as most likely to be a concern during the therapy with prednisone? A. Furosemide B. Levothyroxine C. Proton pump inhibitor D. Antacid
A. Furosemide
When teaching a patient who has been prescribed a daily dose of prednisone (Deltasone), the nurse knows that the patient will be told to take the medication at which time of day to help reduce adrenal suppression? a. In the morning b. At lunchtime c. At dinnertime d. At bedtime
A. In the morning
A woman who is taking isotretinoin calls the office to say that she thinks she may be pregnant. What will the nurse instruct the patient to do first? A. Stop the isotretinoin immediately. B. Reduce the dosage of the isotretinoin to every other day. C. Switch to tretinoin (retinoic acid). D. Consult an obstetrician.
A. Stop the isotretinoin immediately
A patient is prescribed allopurinol for chronic tophaceous gout. The patient develops a rash. What is the priority intervention by the nurse? A. Stop the medication and assess the patient for liver and kidney failure. B. Instruct the patient to avoid exposing the skin to sunlight. C. Administer diphenhydramine (Benadryl) with the dose of allopurinol. D. Monitor the patient for respiratory depression.
A. Stop the medication and assess the patient for liver and kidney failure
A nurse is teaching a client about the new prescription for celecoxib. Which of the following information should the nurse include in the teaching? A. Increases the risk for a myocardial infarction B. Decreases the risk of stroke C. Inhibits COX-1 D. Increases platelet aggregation
A. Increases the risk for a myocardial infarction
A patient is prescribed an antibiotic to treat a urinary tract infection. What statement by the patient indicates a need for further teaching? A. "I can stop the medication as soon as the symptoms have disappeared." B. "I will drink more fluids to help clear up the infection." C. "I will stop the medication and contact the doctor if I develop a rash." D. "I should immediately report vaginal itching or discharge."
A: "I can stop the medication as soon as the symptoms have disappeared"
During long-term corticosteroid therapy, the nurse will monitor the patient's laboratory results for adverse effects, such as: (Select all that apply.) a. Increased serum potassium levels b. Decreased serum potassium levels c. Increased sodium levels d. Decreased sodium levels e. Hyperglycemia f. Hypoglycemia
B, C, E Decreased serum potassium levels Increased sodium levels Hyperglycemia
The nurse is performing wound care on a burned area using silver sulfadiazine cream in a patient with an arm wound. Which actions by the nurse are correct? (Select all that apply.) a. Applying the cream over the previous layer to avoid disturbing the wound bed b. Gently cleansing the wound to remove the previous layer of cream and wound debris c. Using clean gloves to apply the ointment d. Using sterile gloves to apply the ointment e. Always covering the wound with a dressing after applying the cream f. Washing hands before and after the procedure
B, D, F Gently cleansing the wound to remove the previous layer of cream and wound debris Using sterile gloves to apply the ointment Washing hands before and after the procedure
When the nurse is teaching a patient about the mechanism of action of tretinoin, which statement by the nurse is correct? a. "This medication acts by killing the bacteria that cause acne." b. "This medication actually causes skin peeling." c. "This medication acts by protecting your skin from UV sunlight." d. "This medication has antiinflammatory actions."
B. "This medication actually causes skin peeling."
A patient is prescribed linezolid (Zyvox) to treat hospital-acquired pneumonia. It is most important for the nurse to determine if the patient is also taking which medication? A. A diuretic B. An SSRI C. A cardiac glycoside D. A thyroid replacement drug
B. An SSRI
The nurse is assessing the skin of a teenage patient who has been using a benzoyl peroxide product for 2 weeks as part of treatment for acne. Which assessment findings indicate that the patient is having an allergic reaction and will need to stop treatment? a. Reddened skin over the treatment area b. Blistering skin over the treatment area c. Peeling skin over the treatment area d. Sensation of warmth when the product is applied
B. Blistering skin over the treatment area
A patient is taking an inhaled corticosteroid for asthma. After the patient takes a dose of the inhaler, the nurse's priority should be to A. Listen to the patient's breath sounds B. Have the patient rinse his mouth with warm water C. Instruct the patient to cough and deep breathe D. Take the patient's apical pulse for 1 minute
B. Have the patient rinse his mouth with warm water
A patient is taking ibuprofen 800 mg three times a day by mouth as treatment for OA. While taking a health history, the nurse finds out that the patient has a few beers on weekends. What concern would there be with the interaction of the alcohol and ibuprofen? A. Increased bleeding tendencies B. Increased chance for GI bleeding C. Increased nephrotoxic effects D. Reduced antiinflammatory effects of the NSAID
B. Increased chance for GI bleeding
A patient is receiving Augmentin (amoxicillin and clavulanic acid) liquid solution through a percutaneous endoscopic gastrostomy tube. What is the purpose of the clavulanic acid? A. It works synergistically with the antibiotic to improve potency. B. It inhibits the action of the enzymes produced by beta-lactamase-producing bacteria. C. It protects the antibiotic from the harmful gastric acid secretions in the stomach. D. It enhances the absorption of the antibiotic in the small intestine.
B. It inhibits the action of the enzymes produced by beta-lactamase-producing bacteria
During long-term corticosteroid therapy, the nurse will monitor the patient for Cushing's syndrome, which is manifested by a. weight loss b. moon face c. hypotension d. thickened hair growth
B. Moon face
a nurse is caring for a client who has a new prescription for adalimumab for the rheumatoid arthritis. Based on the route of administration of adalimumab, which of the following should the nurse plan to monitor? A. The vein for thrombophlebitis during IV administration B. The subcutaneous site for redness following injection C. The oral mucosa for ulceration after oral administration D. The skin for irritation following removal of transdermal patch
B. The subcutaneous site for redness following injection
During a regular follow-up visit, Jane points out a sore that she has developed on her mouth. She is diagnosed with herpes simplex. Which medication does the nurse anticipate Jane will receive? A. miconazole (Monistat) B. acyclovir (Zovirax) C. clotrimazole (Lotrimin) D. anthralin (Anthra-Derm)
B. acyclovir (Zovirax)
When monitoring for a therapeutic response to prednisone, the nurse will look for which potential outcome? a. Increased lymphocyte levels b. Decreased inflammation c. Increased growth characteristics d. Decrease in Cushing's syndrome characteristics
B. decreased inflammation
When a patient is receiving long-term NSAID therapy, which drug may be given to prevent the serious gastrointestinal adverse effects of NSAIDs? a. misoprostol (Cytotec) b. metoprolol (Lopressor) c. metoclopramide (Reglan) d. magnesium sulfate
B. Metoprolol (Lopressor)
The nurse recognizes that manifestations of NSAID toxicity include a. constipation. b. nausea and vomiting. c. tremors. d. urinary retention.
B. Nausea and vomiting
Which statement about superinfections does the nurse identify as true? A. Superinfections are more common in patients treated with narrow-spectrum drugs. B. Superinfection is defined as a new infection that appears during the course of treatment for a primary infection. C. Superinfections are caused by viruses. D. Superinfections are easy to treat.
B. Superinfection is defined as a new infection that appears during the course of treatment for a primary infection
A nurse is providing teaching for a client who has gout and a new prescription for allopurinol. For which of the following adverse effects should the client be taught to monitor? (select all that apply) A. Stomatitis B. Insomnia C. Nausea D. Rash E. Increased gout pain
C, D, E Nausea Rash Increased gout pain
The nurse has provided teaching about oral corticosteroid therapy to a patient. Which statement by the patient shows a need for more teaching? a. "I will report any fever or sore throat symptoms." b. "I will stay away from anyone who has a cold or infection." c. "I can stop this medication if I have severe adverse effects." d. "I will take this drug with food or milk."
C. "I can stop this medication if I have severe adverse effects"
A nurse is evaluating teaching for a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following statements by the client indicates understanding of the teaching? A. " I will be sure to return to the clinic at least once a year to have my blood drawn while I'm taking methotrexate" B. "I will take this medication on an empty stomach" C. "I`ll let the doctor know if I develop sores in my mouth while I'm taking this medication" D. "I should stop taking oral contraceptives while I'm taking methotrexate"
C. "I`ll let the doctor know if I develop sores in my mouth while I'm taking this medication"
Jane is a 17-year-old patient who is being seen in the dermatology clinic for treatment of acne vulgaris. The nurse practitioner prescribes benzoyl peroxide topically four times a day. Jane tells the nurse that she wants take the drug more frequently so the acne will go away quickly. What information will the nurse provide to Jane? A. "Improvement is usually seen in 1 week." B. "If you want faster results, a pill form of benzoyl peroxide will be used." C. "Overuse of this drug can result in painful, reddened skin." D. "Benzoyl peroxide causes the skin to blister or swell to clear the acne."
C. "Overuse of this drug can result in painful, reddened skin"
Which teaching is appropriate for a patient who is taking an inhaled glucocorticoid for asthma? a. "Exhale while pushing in on the canister of the inhaler." b. "Blow your nose after taking the medication." c. "Rinse your mouth thoroughly after taking the medication." d. "Do not eat immediately after taking the medication."
C. "Rinse your mouth thoroughly after taking the medication"
A mother calls the clinic to ask what medication to give her 5-year-old child for a fever during a bout of chickenpox. The nurse's best response would be: a. "Your child is 5 years old, so it would be okay to use children's aspirin to treat his fever." b. "Start with acetaminophen or ibuprofen, but if these do not work, then you can try aspirin." c. "You can use children's dosages of acetaminophen or ibuprofen, but aspirin is not recommended." d. "It is best to wait to let the fever break on its own without medication."
C. "You can use children's dosages of acetaminophen or ibuprofen, but aspirin is not recommended."
When completing an admission assessment, the patient states that she is allergic to sulfa drugs. What will the nurse do next? A. Mark the allergy on her medical record. B. Place an "allergy" armband on the patient. C. Ask the patient for more information about the allergic reaction she had. D. Notify the physician about the patient's allergy.
C. Ask the patient for more information about the allergic reaction she had
A patient has an infected stage II pressure ulcer that contains some necrotic tissue and some normal, healing granulation tissue. The patient is taking warfarin (Coumadin). Which product would be most appropriate for wound care? A. Sodium hypochlorite (Dakin's solution) B. Hydrogen peroxide C. Collagenase (Santyl) D. Sterile water
C. Collagenase (Santyl)
The nurse is monitoring for an allergic reaction to topical bacitracin, which would be evident by presence of a. petechia. b. thickened skin. c. itching and burning. d. purulent drainage.
C. Itching and burning
The nurse identifies Zosyn as being a member of which group? A. Cephalosporins B. Macrolides C. Penicillins D. Sulfonamides
C. Penicillins
During intravenous (IV) quinolone therapy in an 88-year-old patient, which potential problem is of most concern when assessing for adverse effects? A. Hepatotoxicity B. Rhabdomyolysis C. Tendon rupture D. Nephrotoxicity
C. Tendon rupture
A hospitalized patient has an order for ketorolac (Toradol). The nurse notes that the order is only for 5 days. What is the reason for this? A. The patient's pain should subside by that time B. There are concerns about addiction to the drug C. The drug can cause severe renal and GI effects D. The drug loses its effectiveness over time
C. The drug can cause severe renal and GI effects
A nurse is taking a history for a client who reports that he is taking aspirin about four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin? A. Digoxin B. Metformin C. Warfarin D. Nitroglycerin
C. Warfarin
A group of office workers is concerned because a package was opened that contained a white powder substance. There is a concern that the white powder is anthrax. Which drug does the nurse anticipate being prescribed for the office workers? A. Amoxacillin-clavulanate B. ibuprofen C. ciprofloxacin D. quinupristin-dalfopristin
C. ciprofloxacin
The nurse is reviewing a patient's medication list during a preoperative visit. The patient is scheduled for diagnostic laparoscopy in 2 weeks. He asks the nurse, "I hope I can continue the Motrin, because I really ache if I don't take it. It's just minor surgery, right?" What is the nurse's best response? a. "You can continue to take it as the laparoscopy is considered minor surgery." b. "You will need to take a lower dosage during the preoperative period. c. "I'll check with your prescriber, but this drug is usually stopped a week before the surgery because it can cause increased bleeding tendencies." d. "You can switch to aspirin before the surgery; both aspirin and Motrin are over-the-counter pain relievers."
C. "I'll check with your prescriber, but this drug is usually stopped a week before the surgery because it can cause increased bleeding tendencies."
When the nurse is teaching about antigout drugs, which statement by the nurse is accurate? a. "Drink only limited amounts of fluids with the drug." b. "This drug may cause limited movements of your joints." c. "There are very few drug interactions with these medications." d. "Colchicine is best taken on an empty stomach."
D. "Colchicine is best taken on an empty stomach"
At 1300, the nurse assesses a patient who has just returned to the oncology unit after receiving radiation therapy. The patient tells the nurse that his skin "burns a little" in the area that was radiated. The nurse notes an order for Biafine topical emulsion. When will the nurse apply the Biafine? A. 1315 B. 1400 C. 1530 D. 1700
D. 1700
A nurse is caring for a client who has a new diagnosis of fibromyalgia. Which of the following medications should the nurse anticipate being prescribed for this client? A. Colchicine B. Hydroxychloroquie C. Auranofin D. Duloxetine
D. Duloxetine
A patient is admitted with salicylate toxicity. When assessing the patient, the nurse anticipates which manifestation associated with salicylate toxicity? A. Bradycardia B. Hypoventilation C. Constipation D. Hyperglycemia
D. Hyperglycemia
A nurse is preparing to administer belimumab for a client who has systemic lupus erythematosus. Which of the following actions should the nurse plan to take? A. Warm the medication to room temperature over 1 hour before administering B. Administer the medication by IV bolus over 5 minutes C. Dilute the medication in 5% dextrose and water solution D. Monitor the client for hypersensitivity reactions
D. Monitor the client for hypersensitivity reactions
The nurse is assessing a patient who has been diagnosed with MRSA on the right arm. The nurse anticipates use of which medication to treat the MRSA? A. bacitracin B. neomycin C. polymyxin B D. mupirocin (Bactroban)
D. Mupirocin (Bactroban)
When considering the variety of OTC topical corticosteroid products, the nurse is aware that which type of preparation is generally most penetrating and effective? a. Gel b. Lotion c. Spray d. Ointment
D. Ointment
An 82-year-old woman is taking ibuprofen (Motrin) 3200 mg divided three times daily as treatment for arthritis. She has had no other health problems. What is the most important assessment for the nurse to monitor while the patient is on this therapy? A. Blood sugar B. Liver function studies C. Assessment of hearing D. Renal function studies
D. Renal function studies
A nurse in an emergency department is performing an admission assessment for a client who has severe aspirin toxicity. Which of the following findings should the nurse expect? A. Body temperature 95 degrees F B. Lung crackles C. Cool, dry skin D. Respiratory depression
D. Respiratory depression
A 58-year-old man is receiving vancomycin as part of the treatment for a severe bone infection. After the infusion, he begins to experience some itching and flushing of the neck, face, and upper body. He reports no chills or difficulty breathing. The nurse should suspect A. an allergic reaction has occurred. B. an anaphylactic reaction is about to occur. C. the medication will not be effective for the bone infection. D. the IV dose may have infused too quickly.
D. The IV dose may have infused too quickly
The nurse is administering medications. One patient has an order for aspirin 325 mg by mouth daily and another patient has an order for aspirin 650 mg 4 to 6 times daily (maximum 4 g/day). The nurse understands that the indication for the 325 mg of aspirin once daily is: A. pain management. B. fever reduction. C. treatment of OA. D. thromboprevention
D. Thromboprevention
The nurse is reviewing the use of topical anesthetic drugs. Which of these is an appropriate use for the lidocaine/prilocaine combination cream known as EMLA? a. To reduce the discomfort of insect bites b. To reduce the pain of sunburn c. To relieve the itching associated with poison ivy d. To reduce pain before a needle insertion
D. To reduce pain before a needle insertion
A patient has a prescription for a sulfa drug as treatment for a UTI. She is also taking an oral contraceptive, an oral sulfonylurea antidiabetic drug, and phenytoin for a history of seizures. Which drug may pose a potential serious interaction with the sulfa drug? A. The oral contraceptive B. The oral antidiabetic drug C. The phenytoin D. All of these
D. All of these
A patient with acute gouty arthritis requests information on the preferred drug to take to treat a painful flare-up. The nurse should recommend which medication? A. Allopurinol B. Febuxostat C. Probenecid D. Naproxen
D. Naproxen
Which of the following does the nurse identify as being a concern for patients receiving tetracycline? A. Tetracycline should not be administered to anyone older than age 65 years. B. Tetracycline has no impact on the effectiveness of oral contraceptives. C. Tetracycline used with warfarin decreases its effectiveness and enhances clot formation. D. Tetracyclines should not be administered with dairy products.
D. Tetracyclines should not be administered with dairy products
During a teaching session about antigout drugs, the nurse tells the patient that antigout drugs work by which mechanism? a. Increasing blood oxygen levels b. Decreasing leukocytes and platelets c. Increasing protein and rheumatoid factors d. Decreasing serum uric acid levels
D. Decreasing serum uric acid levels
Which drug does the nurse associate with the development of potentially life-threatening skin adverse effects of exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis? A. probenecid B. colchicine C. febuxostat (Uloric) D. allopurinol (Zyloprim)
D. allopurinol (Zyloprim)