NURS 3380 Final (New & Old)

A nurse is teaching a group of nursing students about cancer treatment. Which statement by a student indicates an understanding of the characteristics of cancer cells? a. "Cancer cells are characterized by unrestrained growth and division." b. "Division of cancer cells is characteristically rapid." c. "Malignant cells of solid tumors do not invade other tissues." d. "Telomerase is an enzyme produced by cancer cells that promotes metastases."

A

A nurse is teaching a patient who will begin taking verapamil [Calan] for hypertension about the drug's side effects. Which statement by the patient indicates understanding of the teaching? a. "I may become constipated, so I should increase fluids and fiber." b. "I may experience a rapid heart rate as a result of taking this drug." c. "I may have swelling of my hands and feet, but this will subside." d. "I may need to increase my digoxin dose while taking this drug."

A

A nurse provides teaching for a female patient with anemia who has had cancer chemotherapy and who will begin treatment with testosterone. Which statement by the patient indicates understanding of the teaching? A. "Testosterone treats anemia by stimulating the synthesis of a renal hormone." B. "Testosterone may increase my high-density lipoprotein (HDL) cholesterol and reduce my low-density lipoprotein (LDL) cholesterol." C. "I may experience an increase in breast size while taking this drug." D. "Facial hair may develop with this drug but will go away over time."

A

A patient asks a nurse about ways to minimize side effects of chemotherapy. Which response is correct? a. "Avoid contact with people who are ill." b. "Take antiemetics immediately after receiving chemotherapy." c. "Treat fevers immediately with ibuprofen." d. "Use a firm-bristled toothbrush to stimulate gums."

A

A patient has heart failure and is taking an ACE inhibitor. The patient has developed fibrotic changes in the heart and vessels. The nurse expects the provider to order which medication to counter this development? a. Aldosterone antagonist b. Angiotensin II receptor blocker (ARB) c. Beta blocker d. Direct renin inhibitor (DRI)

A

A patient who has developed opioid tolerance will experience which effect? a. Decreased analgesic effect b. Decreased constipation c. Increased euphoria d. Increased respiratory depression

A

A patient will begin taking propranolol [Inderal] for hypertension. Which statement by the nurse is important when teaching this patient about the medication? A. "Check your hands and feet for swelling and report that to your provider." B. "Stop taking the drug if you become short of breath." C. "Take your pulse and do not take the medication if your heart rate is fast." D. "It is safe to take this medication with a calcium channel blocker."

A

A patient with HIV who takes protease inhibitors develops tuberculosis and will begin treatment. Which drug regimen will be used for this patient? a. Isoniazid, pyrazinamide, ethambutol + rifabutin b. Isoniazid, pyrazinamide, ethambutol c. Isoniazid, rifampin, pyrazinamide, ethambutol d. Isoniazid + rifabutin

A

What is the target organ when a beta1 agonist is administered? a. Heart b. Kidney c. Respiratory d. Liver

A

Ms. Modlin owns a horse that has competed in the past. Which of the following names apply to her horse? (Select all that apply) A. Two Socks B. Steppin 'N' Stride C. Topper D. Top Hat and Tails E. Shimmy

A,B

A provider has written an order for a medication: drug 100 mg PO every 6 hours. The half- life for the drug is approximately 6 hours. The nurse is preparing to administer the first dose at 8:00 AM on Tuesday. On Wednesday, when will the serum drug level reach plateau? a. 2:00 am b. 8:00am c. 2:00 PM d. 8:00 PM

B

A nursing student is caring for a patient with community-acquired pneumonia (CAP) who also has a methicillin-resistant Staphylococcus aureus (MRSA) skin infection. The prescriber has ordered daptomycin [Cubicin]. The nurse encourages the student to approach the provider to request a different antibiotic because of which facts about daptomycin? (Select all that apply.) a. It causes significant renal impairment. b. It is approved only for bloodstream and skin infections. c. It increases the risk of serious cardiorespiratory events. d. It is more likely to produce resistant strains of bacteria. e. It is not effective against MRSA infections.

B,C

The nurse asks a graduate nurse, "When a patient in the initial phase of HIV infection is assessed, which findings would you expect to see?" The graduate nurse would be correct to respond with which conditions? (Select all that apply.) a. Respiratory distress b. Fever c. Myalgia d. Lymphadenopathy e. Insomnia

B,C,D

Which drugs are used to prevent migraine headaches? (Select all that apply.) A. Ergotamine (Ergomar) B. Divalproex (Depakote) C. Amitriptyline (Elavil) D. Timolol E. Acebutolol

B,C,D

A newborn infant has been given erythromycin ophthalmic ointment as a routine postpartum medication. The infant's mother learns that she has a C. trachomatis infection and asks the nurse if her baby will need to be treated. Which response by the nurse is correct? a. "The erythromycin ointment will prevent your baby from developing conjunctivitis." b. "Without additional treatment, your baby could develop blindness." c. "Your baby will need to be treated with oral erythromycin." d. "Your baby will need to take doxycycline [Vibramycin] for 10 days."

C

A nurse is discussing the differences between OxyContin OC and OxyContin OP with a group of nursing students. Which statement by a student indicates understanding of the teaching? a. "OxyContin OC cannot be drawn into a syringe for injection." b. "OxyContin OP has greater solubility in water and alcohol." c. "OxyContin OP is not easily crushed into a powder." d. "Patients using OxyContin OP are less likely to overdose."

C

A nurse is preparing to administer intramuscular penicillin to a patient who is infected with T. pallidum and notes that the order is for sodium penicillin G. Which action is correct? a. Administer the drug as prescribed. b. Contact the provider to discuss administering the drug intravenously. c. Contact the provider to discuss changing the drug to benzathine penicillin G. d. Request an order for piperacillin instead of penicillin G.

C

A nursing student asks a nurse about flucytosine [Ancobon]. Which statement by the nurse is correct? a. "Flucytosine has a broad antifungal spectrum." b. "Irreversible neutropenia and thrombocytopenia may occur with this drug." c. "Resistance is common with this medication." d. "Severe hepatic injury is common and limits this drug's use."

C

A patient has developed muscarinic antagonist toxicity from ingestion of an unknown chemical. The nurse should prepare to administer which medication? A. Pseudoephedrine (Ephedrine) B. An acetylcholinesterase activator C. Physostigmine (Antilirium) D. Atropine (Sal-Tropine) IV

C

A patient is receiving tobramycin 3 times daily. The provider has ordered a trough level with the 8:00 AM dose. The nurse will ensure that the level is drawn at what time? a. 4:00 AM b. 7:00 AM c. 7:45 AM d. 8:45 AM

C

Which fluoroquinolone antibiotics may be administered to children? (Select all that apply.) A. Ofloxacin B. Norfloxacin [Noroxin] C. Ciprofloxacin [Cipro] D. Levofloxacin [Levaquin] E. Moxifloxacin [Avelox]

C,D

What are the effects of prolactin secretion in males? (Select all that apply.) A. Breast Development B. Infertility C. Decreased libido D. Delayed puberty E. Galactorrhea

C,D,E

A nurse is preparing a patient who will stop taking lorazepam [Ativan] for anxiety and begin taking buspirone [Buspar]. Which statement by the patient indicates a need for further teaching? a. "I can drink alcohol when taking Buspar, but not grapefruit juice." b. "I may need to use a sedative medication if I experience insomnia." c. "I may not feel the effects of Buspar for a few weeks." d. "I should stop taking the Ativan when I start taking the Buspar."

D

A nurse is preparing to administer memantine [Nemanda] to a patient and notes a slight elevation in the patient's creatinine clearance level. What will the nurse expect the provider to order for this patient? a. Adding sodium bicarbonate to the patient's drug regimen b. Continuing the memantine as ordered c. Discontinuing the memantine d. Reducing the dose of memantine

D

A nurse is preparing to administer oral ofloxacin to a patient. While taking the patient's medication history, the nurse learns that the patient takes warfarin and theophylline. The correct action by the nurse is to request an order to: a. reduce the dose of ofloxacin. b. increase the dose of ofloxacin. c. increase the dose of theophylline. d. monitor coagulation levels.

D

A nurse is teaching a group of adolescent students about sexually transmitted diseases. Which statement by a student indicates understanding of infections caused by C. trachomatis? a. "C. trachomatis conjunctivitis in newborns can result in blindness." b. "The CDC recommends screening for chlamydial infections in all sexually active men." c. "Treatment for C. trachomatis should be initiated when infections are symptomatic." d. "Women with asymptomatic Chlamydia trachomatis infections can become sterile."

D

A nurse prepares to administer propranolol [Inderal] to a patient recovering from acute myocardial infarction. The patient's heart rate is 52 beats per minute, and the rhythm is regular. What action should the nurse take next? a. Administer the drug as prescribed. b. Request an order for atropine. c. Withhold the dose and document the pulse rate. d. Withhold the dose and notify the prescriber.

D

A patient develops CDAD. Which antibiotic is recommended for treating this infection? a. Chloramphenicol b. Clindamycin [Cleocin] c. Linezolid [Zyvox] d. Vancomycin

D

A patient has a localized skin infection, which is most likely caused by a gram-positive cocci. Until the culture and sensitivity results are available, the nurse will expect the provider to order a ____-spectrum ____ agent. a. broad; systemic b. broad; topical c. narrow; systemic d. narrow; topical

D

A patient starting therapy with efavirenz [Sustiva] asks about the timing of the medication with regard to meals. What patient education about the administration of this medication should the nurse provide? a. The drug must be taken within 30 minutes after a meal. b. The drug is best taken with a high-fat meal. c. The drug can be taken anytime without regard to meals. d. The drug should be taken once daily on an empty stomach.

D

A patient stops taking a proton pump inhibitor (PPI) after 6 weeks of therapy for treatment of peptic ulcer disease. The patient reports symptoms of dyspepsia to the nurse. The nurse will tell this patient to: a. come to the clinic to be tested for Clostridium difficile. b. resume taking the PPI, because long-term therapy is necessary. c. resume taking the PPI until symptoms resolve completely. d. try an antacid to see whether it relieves these symptoms.

D

A patient takes an ACE inhibitor to treat hypertension and tells the nurse that she wants to become pregnant. She asks whether she should continue taking the medication while she is pregnant. What will the nurse tell her? a. Controlling her blood pressure will decrease her risk of preeclampsia. b. Ask the provider about changing to an ARB during pregnancy. c. Continue taking the ACE inhibitor during her pregnancy. d. Discuss using methyldopa instead while she is pregnant.

D

A patient who has been using secobarbital for several months to treat insomnia tells the nurse that the prescriber has said the prescription will be changed to temazepam [Restoril] because it is safer. The patient asks why this agent is safer. The nurse is correct in telling the patient that temazepam: A. does not depress the central nervous system. B. shows no respiratory depression, even in toxic doses. C. mimics the actions of a central nervous system inhibitory neurotransmitter. D. potentiates endogenous gamma-aminobutyric acid (GABA) producing a finite CNS depression.

D

A patient who has drug-sensitive tuberculosis has completed 2 months of the standard four-drug therapy and asks the nurse how long he will have to take medication. Which response by the nurse is correct? a. "As long as you remain symptomatic, you will not have to take more medication." b. "The four-drug regimen will continue for 3 more months." c. "You will have to take maintenance drugs indefinitely." d. "You will need to take only two drugs for the next 4 months."

D

The nurse is caring for a patient who will begin receiving intravenous ciprofloxacin [Cipro] to treat pyelonephritis. The nurse learns that the patient has a history of myasthenia gravis. Which action by the nurse is correct? a. Administer the ciprofloxacin and monitor the patient for signs of muscle weakness. b. Ask the provider whether the ciprofloxacin can be given orally. c. Request an order for concurrent administration of metronidazole [Flagyl]. d. Suggest that the provider order a different antibiotic for this patient.

D

Which areas of the body show the effects of neuromuscular blockers last? a. Levator muscle of the eyelids and the muscles of mastication b. Muscles in the lower extremities c. Muscles controlling the glottis d. Muscles of respiration and the diaphragm

D

Dr. Taylors middle daughter was born closest to which holiday in which month?

Valentines Day in February

A patient asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient's: a. drug receptor sites. b. hypersensitivity potential. c. metabolism of drugs. d. psychosocial response.

c

The nurse is preparing to administer amphotericin B intravenously. The nurse will expect to pretreat the patient with which medications? a. Acetaminophen [Tylenol], diphenhydramine [Benadryl], and meperidine [Demerol] b. Aspirin, diphenhydramine [Benadryl], and meperidine [Demerol] c. Ibuprofen [Motrin], diphenhydramine [Benadryl], and meperidine [Demerol] d. Morphine sulphate [Morphine] and acetaminophen ]Tylenol]

A

The nurse is providing education to a patient who has been prescribed both an antacid and cimetidine [Tagamet]. Which instruction should the nurse give the patient about taking the medications? a. "Take the antacid 1 hour after the ranitidine." b. "The antacid and ranitidine should be taken at the same time for better effect." c. "Take the antacid 15 minutes before the ranitidine." d. "Take the antacid 30 minutes after the ranitidine."

A

A 60-year-old female patient is about to begin long-term therapy with a glucocorticoid. Which of the following will be important for minimizing the risk of osteoporosis? a. Baseline vitamin D level b. Calcium and vitamin D supplements c. Estrogen therapy d. Skeletal x-rays before treatment

B

Which patient should begin treatment for tuberculosis? a. A patient with HIV and a tuberculin skin test result of a 4-mm region of induration b. A recent immigrant from a country with a high prevalence of TB with a 10-mm region of induration c. A patient with no known risk factors who has a job-related tuberculin skin test result of a 12-mm area of induration d. An intravenous drug abuser with a tuberculin skin test result of a 5-mm region of induration

B

The nurse is teaching a nursing student about management of controlled substances in medication administration. Which statement by the nursing student indicates understanding of the teaching? A. "Schedule I drugs may only be given to hospitalized patients." B. "If there is a difference between state and federal laws governing a scheduled drug, the federal law takes precedence." C. "Prescriptions for drugs in Schedules III and IV may be written to include up to 5 refills." D. "To reduce the possibility of abuse of a drug that is Schedule II, the prescriber should call the prescription to the pharmacy."

C

The nurse is teaching a nursing student about the mechanism by which antimicrobial agents achieve selective toxicity. Which statement by the student indicates a need for further teaching? a. "Some agents disrupt the bacterial cell wall." b. "Some agents act to block the conversion of para-aminobenzoic acid (PABA) to folic acid." c. "Some agents cause phagocytosis of bacterial cells." d. "Some agents weaken the cell wall, causing cell wall lysis."

C

Which cephalosporin may be used to treat meningitis? a. Cefaclor b. Cefazolin c. Cefoxitin d. Cefotaxime

D

A nursing student is discussing with a nurse the plan of care for a patient about to undergo a third round of chemotherapy with cisplatin. Which statement by the nursing student about the treatment of CINV is correct? a. "Aprepitant [Emend] will be necessary to treat CINV caused by cisplatin." b. "Antiemetics are most effective if given just as the chemotherapy is finished." c. "Lorazepam probably would not be helpful for this patient." d. "This patient will need intravenous antiemetics for best effects."

A

A patient comes to the clinic and receives valacyclovir [Valtrex] for a herpes-zoster virus. The nurse instructs the patient to take the medication: a. without regard to meals. b. without any dairy products. c. each morning. d. on an empty stomach.

A

A patient complains of painful urination. A physical examination reveals vesicles on her labia, vagina, and the foreskin of her clitoris. The nurse will expect to teach this patient about which medication? a. Acyclovir [Zovirax] b. Azithromycin [Zithromax] c. Metronidazole [Flagyl] d. Tinidazole [Tindamax]

A

A patient taking risedronate IR [Actonel] for osteoporosis reports experiencing diarrhea and headaches. What will the nurse tell this patient? a. These are common side effects of this drug. b. These symptoms indicate serious toxicity. c. The patient should discuss taking risedronate DR [Atelvia] with the provider. d. The medication should be taken after a meal to reduce symptoms.

A

A patient who has a lower back injury exhibits muscle spasms. The provider orders cyclobenzaprine [Flexeril] 10 mg 3 times a day. What will the nurse include when teaching this patient about this drug? A. "You may experience blurred vision, dry mouth, or constipation." B. "You will need to have liver function tests performed while taking this medication." C. "This medication may cause your urine to turn brown, black, or dark green." D. "This drug carries some risk of developing hallucination and psychotic symptoms."

A

A patient who has arthritis has been taking ibuprofen [Motrin] and a glucocorticoid medication. The patient reports having tarry stools but denies gastric pain. Which action by the nurse is correct? a. Contact the provider to discuss ordering an antiulcer medication. b. Counsel the patient to use over-the-counter antacids. c. Reassure the patient not to worry unless there is gastric pain. d. Tell the patient to stop taking the glucocorticoid immediately.

A

A 20-year-old female patient has suprapubic discomfort, pyuria, dysuria, and bacteriuria greater than 100,000/mL of urine. Which are the most likely diagnosis and treatment? a. Uncomplicated lower urinary tract infection treatable with short-course therapy b. Complicated lower urinary tract infection treatable with single-dose therapy c. Uncomplicated upper urinary tract infection requiring 14 days of oral antibiotics d. Complicated upper urinary tract infection requiring parenteral antibiotics

A

A 43-year-old patient with a strong family history of breast cancer considers taking tamoxifen [Nolvadex] for cancer prevention. Which assessment finding is a possible contraindication? a. History of deep vein thrombosis (DVT) b. History of osteoporosis c. Hyperlipidemia d. Prior hysterectomy

A

A 65-year-old patient who receives glucocorticoids for arthritis is admitted to the hospital for treatment of a urinary tract infection. The prescriber has ordered intravenous ciprofloxacin [Cipro]. Before administering the third dose of this drug, the nurse reviews the bacterial culture report and notes that the causative organism is Escherichia coli. The bacterial sensitivity report is pending. The patient complains of right ankle pain. What will the nurse do? a. Withhold the dose of ciprofloxacin and notify the provider of the patient's symptoms. b. Instruct the patient to exercise the right foot and ankle to minimize the pain. c. Question the patient about the consumption of milk and any other dairy products. d. Request an order to increase this patient's dose of glucocorticoids.

A

A 7-year-old child with asthma uses a daily inhaled glucocorticoid and an albuterol MDI as needed. The provider has added montelukast [Singulair] to the child's regimen. Which statement by the child's parent indicates understanding of this medication? a. "I may notice mood changes in my child." b. "I should give this medication twice daily." c. "I will give my child one 4-mg chewable tablet daily." d. "This drug can alleviate symptoms during an acute attack."

A

A child has received amoxicillin [Amoxil] for three previous ear infections, but a current otitis media episode is not responding to treatment. The nurse caring for this child suspects that resistance to the bacterial agent has occurred by which microbial mechanism? A. Drug inactivation B. Antagonist production C. Reduction of drug concentration at the site of action D. Alteration of drug target molecules

A

A child with an ear infection is not responding to treatment with amoxicillin [Amoxil]. The nurse will expect the provider to order: a. amoxicillin-clavulanic acid [Augmentin]. b. ampicillin. c. nafcillin. d. penicillin G [Benzylpenicillin].

A

A patient who has been taking alprazolam [Xanax] to treat generalized anxiety disorder (GAD) reports recently stopping the medication after symptoms have improved but reports having feelings of panic and paranoia. Which initial action by the nurse is correct? a. Ask the patient if the medication was stopped abruptly. b. Instruct the patient to resume taking the alprazolam. c. Notify the provider that the patient is experiencing a relapse. d. Suggest that the patient discuss taking buspirone [Buspar] with the provider.

A

A child with an upper respiratory infection caused by B. pertussis is receiving erythromycin ethylsuccinate. After 2 days of treatment, the parent asks the nurse why the child's symptoms have not improved. Which response by the nurse is correct? a. "Erythromycin eliminates the bacteria that causes the infection, but not the toxin that causes the symptoms." b. "We may need to add penicillin or another antibiotic to increase the antimicrobial spectrum." c. "We will need to review the culture sensitivity information to see whether a different antibiotic is indicated." d. "Your child may have developed a suprainfection that we need to culture and treat."

A

A patient who has been taking an SSRI tells the nurse that the drug has caused reduced sexual performance, weight gain, and sedation. The nurse will suggest that the patient ask the provider about using which drug? a. Bupropion [Wellbutrin] b. Imipramine [Tofranil] c. Isocarboxazid [Marplan] d. Trazodone [Oleptro]

A

A female patient has come to the STD clinic and has been diagnosed with a Trichomonas vaginalis infection. What education should be provided to this patient? a. Male partners should always be treated, even if they are asymptomatic. b. The applicator for the vaginal gel should be washed after each application. c. The infection is not completely eliminated with the medication. d. The medication should be taken twice daily for 2 weeks.

A

A hospitalized patient is being treated for tuberculosis with a drug regimen that includes pyrazinamide. The patient complains of pain in the knee and shoulder joints. The nurse will contact the provider to request an order for: a. ibuprofen. b. renal function tests. c. discontinuation of the pyrazinamide. d. measurement of uric acid levels.

A

A male patient is being treated for benign prostatic hyperplasia and has stopped taking his alpha-adrenergic antagonist medication because of ejaculatory difficulties. Which medication does the nurse expect the provider to prescribe? a. Alfuzosin [Uroxatral] b. Prazosin [Minipress] c. Silodosin [Rapaflo] d. Tamsulosin [Flomax]

A

A male patient with hepatitis C will begin triple drug therapy with pegylated interferon alfa 2a [Pegasys], ribavirin [Ribasphere], and boceprevir [Victrelis]. The patient tells the nurse that his wife is pregnant. What will the nurse tell him? a. Boceprevir is contraindicated in males whose partners are pregnant. b. He should use a barrier contraceptive when having sex. c. He should use dual drug therapy with pegylated interferon alfa and ribavirin only. d. This combination drug therapy is safe for him to use.

A

A nurse counsels a patient who is to begin taking phenytoin [Dilantin] for epilepsy. Which statement by the patient indicates understanding of the teaching? a. "I should brush and floss my teeth regularly." b. "Once therapeutic blood levels are reached, they are easy to maintain." c. "I can consume alcohol in moderation while taking this drug." d. "Rashes are a common side effect but are not serious."

A

A nurse educator is conducting a continuing education class on pharmacology. To evaluate the learning of the nurses in the class, the nurse educator asks, "Which drug name gives infor- mation about the drug's pharmacologic classification?" Which is the correct response? a. Amoxicillin b. Tylenol c. Cipro d. Motrin

A

A nurse explains to a nursing student why opioid antidiarrheal medications are classified as drugs with little or no abuse potential. Which statement by the student indicates a need for further teaching? a. "Formulations for the treatment of diarrhea have very short half-lives." b. "Opioid antidiarrheal drugs contain other drugs with unpleasant side effects at higher doses." c. "Some opioid antidiarrheal drugs do not cross the blood-brain barrier." d. "Some opioid antidiarrheal medications are not water soluble and cannot be given parenterally."

A

A nurse is caring for a patient who has been taking low-dose aspirin for several days. The nurse notes that the patient has copious amounts of watery nasal secretions and an urticarial rash. The nurse will contact the provider to discuss: a. administering epinephrine. b. changing to a first-generation NSAID. c. reducing the dose of aspirin. d. giving an antihistamine.

A

A nurse is caring for an African American patient with severe hemophilia A who has been admitted for bleeding into the knee joint. The prescriber has ordered intravenous factor VIIa [NovoSeven RT]. A nursing student wants to know why this patient is not receiving factor VIII. Which statement by the nurse is correct? A. "Factor VIIa is used when patients develop antibodies against factor VIII." B. "Factor VIIa provides immune tolerance therapy so that factor VIII will be more effective." C. "Factor VIII is used for prophylaxis, and factor VIIa is used for acute episodes." D. "Factor VIIa is stringer than factor VIII and will work faster."

A

A nurse is discussing methicillin-resistant Staphylococcus aureus (MRSA) with a group of nursing students. Which statement by a student correctly identifies the basis for MRSA resistance? a. "MRSA bacteria have developed PBPs with a low affinity for penicillins." b. "MRSA bacteria produce penicillinases that render penicillin ineffective." c. "MRSA occurs because of host resistance to penicillins." d. "MRSA strains replicate faster than other Staphylococcus aureus strains."

A

A nurse is discussing the care of a patient with cancer with a nursing student. The patient is about to begin chemotherapy with a bifunctional alkylating agent. Which statement by the student indicates an understanding of this chemotherapeutic agent? a. "Alkylating agents are toxic to tissues that have rapidly dividing cells." b. "Bifunctional alkylating agents cannot form cross-links in DNA." c. "Resistance to alkylating agents is rare." d. "This drug needs to be given as a prolonged infusion."

A

A nurse is discussing the role of vitamin D in calcium regulation with a nursing student. Which statement by the student indicates a need for further teaching? a. "Adequate amounts of vitamin D occur naturally in the diet." b. "Vitamin D3 is preferred over vitamin D2." c. "Vitamin D can promote bone decalcification." d. "Vitamin D increases the absorption of calcium and phosphorus from the intestine."

A

A nurse is explaining to nursing students why a cephalosporin is used in conjunction with an aminoglycoside for a patient with an infection. Which statement by a student indicates understanding of the teaching? a. "Cephalosporins enhance the actions of aminoglycosides by weakening bacterial cell walls." b. "Cephalosporins prevent neuromuscular blockade associated with aminoglycosides." c. "Cephalosporins prolong the postantibiotic effects of the aminoglycosides so doses can be decreased." d. "Cephalosporins reduce bacterial resistance to aminoglycosides."

A

A nurse is preparing a patient who will stop taking lorazepam [Ativan] for anxiety and begin taking buspirone [Buspar]. Which statement by the patient indicates a need for further teaching? A. "I should stop taking the Ativan when I start taking the Buspar." B. "I may not feel the effects of Buspar for a few weeks." C. "I can drink alcohol when taking Buspar, but not grapefruit juice." D. "I may need to use a sedative medication if I experience insomnia."

A

A nurse is preparing to administer IV calcium chloride to a patient with a low serum calcium level. Which drug on the patient's medication record, administered concurrently, would require additional patient monitoring by the nurse? a. Digoxin [Lanoxin] b. Furosemide [Lasix] c. Lorazepam [Ativan] d. Pantoprazole [Protonix]

A

A nurse is preparing to administer a medication and learns that it is a nonselective agonist drug. What does the nurse understand about this drug? a. It directly activates receptors to affect many physiologic processes. b. It directly activates receptors to affect a specific physiologic process. c. It prevents receptor activation to affect many physiologic processes. d. It prevents receptor activation to affect a specific physiologic processes.

A

A nurse is preparing to administer an antibiotic to a patient with methicillin-resistant Staphylococcus aureus (MRSA). The nurse would expect the healthcare provider to order which antibiotic? a. Daptomycin [Cubicin] b. Levofloxacin [Levaquin] c. Norfloxacin [Noroxin] d. Ciprofloxacin [Cipro]

A

A nurse is preparing to administer medications to a patient recently started on delavirdine [Rescriptor]. Which concurrent prescription should the nurse question before administration? a. Alprazolam [Xanax] b. Diphenhydramine [Benadryl] c. Morphine d. Penicillin

A

A nurse is providing education about tetracycline [Sumycin]. Which statement by the patient best demonstrates understanding of the administration of this medication? a. "I should not take this medication with milk or other dairy products." b. "I should not worry if I experience an acnelike rash with this medication." c. "I should take an antacid, such as Tums, if I experience gastrointestinal distress." d. "I should take this antibiotic with a calcium supplement to improve absorption."

A

A nurse is providing teaching for a patient who will begin taking clarithromycin ER [Biaxin XL] to treat an Helicobacter pylori infection. Which statement by the patient indicates understanding of the teaching? a. "I may experience distorted taste when taking this medication." b. "I should take 1 tablet twice daily for 10 days." c. "I should take this medication on an empty stomach." d. "This medication does not interact with other drugs."

A

A nurse is providing teaching for an adult patient with arthritis who has been instructed to take ibuprofen [Motrin] for discomfort. Which statement by the patient indicates a need for further teaching? a. "I may experience tinnitus with higher doses of this medication." b. "I may take up to 800 mg 4 times daily for pain." c. "I should limit alcohol intake to fewer than three drinks a day." d. "I will take this medication with meals to help prevent stomach upset."

A

A patient who has been using secobarbital for several months to treat insomnia tells the nurse that the prescriber has said the prescription will be changed to temazepam [Restoril] because it is safer. The patient asks why this agent is safer. The nurse is correct in telling the patient that temazepam: A. potentiates endogenous gamma-aminobutyric acid (GABA) producing a finite CNS depression. B. mimics the actions of a central nervous system inhibitory neurotransmitter. C. does not depress the central nervous system. D. shows no respiratory depression, even in toxic doses.

A

A patient who has erectile dysfunction asks about medications to treat this disorder, but tells the nurse he doesn't want to have to plan sexual activity several hours in advance. Which medication will the nurse expect the provider to order for this patient? a. Avanafil [Stendra] b. Sildenafil [Viagra] c. Tadalafil [Cialis] d. Vardenafil [Levitra]

A

A patient who has renal impairment will begin taking ranolazine [Ranexa] as an adjunct to nitroglycerine to treat angina. What will the nurse include when teaching this patient? a. "You will need to monitor your blood pressure closely while taking this drug." b. "You should take this drug 1 hour before or 2 hours after a meal." c. "You may experience rapid heart rate while taking this medication." d. "You do not need to worry about drug interactions with this medication."

A

A patient who has undergone surgical removal of a solid tumor has just begun chemotherapy. The patient experiences severe nausea and vomiting as well as alopecia. The nurse will expect the provider to: a. continue the chemotherapeutic agent at the same dose. b. decrease the dose of chemotherapy to minimize side effects. c. order lab tests to evaluate for the presence of residual cancer cells. d. stop the chemotherapy because the tumor has been removed.

A

A patient who is an opioid addict has undergone detoxification with buprenorphine [Subutex] and has been given a prescription for buprenorphine with naloxone [Suboxone]. The patient asks the nurse why the drug was changed. Which response by the nurse is correct? a. "Suboxone has a lower risk of abuse." b. "Suboxone has a longer half-life." c. "Subutex causes more respiratory depression." d. "Subutex has more buprenorphine."

A

A patient who is being treated for HIV infection has a 5-mm area of induration after a routine TST. The patient's chest radiograph is normal, and there are no other physical findings. The nurse will expect this patient to begin treatment with which drugs? a. Isoniazid and rifabutin b. Isoniazid and rifampin c. Isoniazid and rifapentine d. Isoniazid and pyrazinamide

A

A patient who is in her first trimester of pregnancy asks the nurse to recommend nonpharmaceutical therapies for morning sickness. What will the nurse suggest? a. Avoiding fatty and spicy foods b. Consuming extra clear fluids c. Eating three meals daily d. Taking foods later in the day

A

A patient who is receiving intravenous ciprofloxacin for pneumonia develops diarrhea. A stool culture is positive for Clostridium difficile. The nurse will expect the provider to: a. add metronidazole [Flagyl]. b. increase the dose of ciprofloxacin. c. restrict dairy products. d. switch to gemifloxacin.

A

A nurse is reviewing the medications of a patient with diabetes before discharge. The nurse realizes that the patient will be going home on colesevelam, a bile acid sequestrant, and insulin. What patient education should the nurse provide in the discharge teaching for this patient? a. The patient needs to monitor the blood sugar carefully, because colesevelam can cause hypoglycemia. b. The patient needs to monitor the blood sugar carefully, because colesevelam can cause hyperglycemia. c. The patient needs to take the insulin at least 3 hours before the colesevelam. d. The patient needs to use an oral antidiabetic agent or agents, not insulin, with colesevelam.

A

A patient who is taking drugs to treat HIV has tuberculosis and has been on a four-drug regimen for 3 months without improvement in symptoms. Which drug will the nurse anticipate that the provider will add to this patient's regimen? a. bedaquiline [Sirturo] b. capreomycin [Capastat Sulfate] c. ethionamide [Trecator] d. pyridoxine

A

A patient who is taking gentamicin and a cephalosporin for a postoperative infection requests medication for mild postsurgical pain. The nurse will expect to administer which of the following medications? a. Acetaminophen b. Aspirin c. Ibuprofen d. Morphine

A

A nurse is taking a history on a clinic patient who reports being constipated. Upon further questioning, the nurse learns that the patient's last stool was 4 days ago, that it was of normal, soft consistency, and that the patient defecated without straining. The patient's abdomen is not distended, and bowel sounds are present. The patient reports usually having a stool every 1 to 2 days. What will the nurse do? a. Ask about recent food and fluid intake. b. Discuss the use of polyethylene glycol [MiraLax]. c. Recommend a bulk laxative. d. Suggest using a bisacodyl [Dulcolax] suppository.

A

A nurse is teaching a class on addiction. Which statement by one of the class participants indicates a need for further teaching? a. "Addictive drugs lead to dopamine release in amounts similar to those released by normal reward circuits." b. "Neural remodeling leads to decreased dopamine release, leaving users with feelings of lifelessness and depression." c. "Over time, the brain will develop reduced responses to many addictive drugs." d. "With the use of a drug over time, the brain undergoes synaptic remodeling."

A

A patient who is taking morphine for pain asks the nurse how a pain medication can also cause constipation. What does the nurse know about morphine? A. It is selective to receptors that regulate more than one body process. B. It can cause constipation in toxic doses C. It causes only one type of response, and the constipation is coincidental. D. It binds to different types of receptors in the body

A

A nurse is teaching a group of nursing students about how cytotoxic anticancer drugs affect normal cells. Which statement by a student indicates an understanding of this teaching? a. "Cytotoxic drugs lack tissue specificity." b. "Cytotoxic drugs have a high degree of selective toxicity." c. "Differences between cancer cells and normal cells are qualitative." d. "Neoplastic cells and normal tissue cells are very different."

A

A patient who is taking nelfinavir [Viracept] calls the nurse to report moderate to severe diarrhea. What will the nurse expect the provider to recommend? a. An over-the-counter antidiarrheal drug b. Immediate discontinuation of the nelfinavir c. Reducing the dose of nelfinavir by half d. Taking the nelfinavir with food to avoid side effects

A

A nurse is teaching a group of nursing students how the CNS adapts to psychotherapeutic medications. Which statement by a nursing student indicates a need for further teaching? A. "Adaptation results in an increased sensitivity to side effects over time." B. "Adaptation helps explain how physical dependence occurs." C. "Adaptation often must occur before therapeutic effects develop." D. "Adaptation can lead to tolerance of these drugs with prolonged use."

A

A nurse is teaching a patient about a drug that induces P-glycoprotein. The nurse will explain that this drug may cause which effect on other drugs? A. Decreased absorption in the intestines B. Increased fetal absorption C. Increased brain exposure D. Decreased elimination through the kidneys

A

A nurse is teaching a patient about a medication that alters sympathetic nervous system func- tions. To evaluate understanding, the nurse asks the patient to describe which functions the sympathetic nervous system regulates. Which answer indicates the need for further teaching? a. "the digestive functions of the body." b. "The cardiovascular system" c. "The fight-or-flight response" d. "Body temperature"

A

A nurse is teaching a patient about the use of sildenafil [Viagra] for erectile dysfunction. Which statement by the patient indicates understanding of the teaching? a. "If my erection lasts longer than 4 hours, I should contact my provider." b. "I should not use nitroglycerin within 12 hours of using sildenafil." c. "I should take this drug about 15 minutes before sexual activity." d. "This drug may cause me to have an erection when I don't want one."

A

A patient who uses an inhaled glucocorticoid for chronic asthma calls the nurse to report hoarseness. What will the nurse do? a. Ask whether the patient is rinsing the mouth after each dose. b. Request an order for an antifungal medication. c. Suggest that the patient be tested for a bronchial infection. d. Tell the patient to discontinue use of the glucocorticoid.

A

A patient with severe glucocorticoid-induced osteoporosis will start therapy with teriparatide [Forteo]. What will the nurse expect to administer? a. 20 mcg once daily subQ b. 20 mcg twice daily subQ c. 10 mcg once daily subQ d. 10 mcg twice daily subQ

A

A prescriber has ordered cefoxitin for a patient who has an infection caused by a gram-negative bacteria. The nurse taking the medication history learns that the patient experienced a maculopapular rash when taking amoxicillin [Amoxil] several years earlier. What will the nurse do? a. Administer the cefoxitin and observe for any side effects. b. Give the cefoxitin and have epinephrine and respiratory support available. c. Request an order for a different, nonpenicillin, noncephalosporin antibiotic. d. Request an order to administer a skin test before giving the cefoxitin.

A

Dr. Taylors 3rd daughter was born approximately how long before he celebrated his birthday? A. 30 days B. They were born on the same day 30 years apart. C. 60 days D. 90 days

A

The prescriber orders 20 mg of hydrocortisone orally once each day. The nurse will make sure the drug is scheduled to be administered at what time? a. 8:00 AM b. 12:00 PM c. 4:00 PM d. 9:00 PM

A

Which fluoroquinolone antibiotics may be administered to children? (Select all that apply.) a. Ciprofloxacin [Cipro] b. Levofloxacin [Levaquin] c. Moxifloxacin [Avelox] d. Norfloxacin [Noroxin] e. Ofloxacin

A,B

Patients with a history of myocardial infarction should take which medications indefinitely? (Select all that apply.) A. Beta blockers B. Clopidogrel C. Aspirin D. Alteplase E. ACE inhibitors

A,C,E

Which are guidelines for selecting chemotherapeutic agents to use in combination therapy? (Select all that apply.) a. Drugs used should have different mechanisms. b. Each drug should be delivered by different routes. c. Each drug should be effective. d. Each drug should have different dosing schedules. e. Toxicities should be minimally overlapping.

A,C,E

A family is preparing for travel and the parents report that their 5-year-old child has frequent motion sickness. The nurse will tell the parents to ask the provider about which antihistamine to help prevent symptoms? a. Desloratadine [Clarinex] b. Dimenhydrinate [Dramamine] c. Hydroxyzine [Vistaril] d. Promethazine [Phenergan]

B

A patient newly diagnosed with cancer reports having pain at a level of 7 to 8 on a scale of 10. Which type of pain management will be used initially to treat pain in this patient? A. Nonpharmacologic measures B. Opioid analgesics C. Ibuprofen (Motrin) D. Acetaminophen (Tylenol)

B

A patient who has recurrent migraine headaches is prescribed sumatriptan [Imitrex]. Which aspect of this patient's history is of concern when taking this drug? a. Asthma b. Coronary artery disease c. Diabetes d. Renal disease

B

A woman in labor receives meperidine [Demerol] for pain. The nurse caring for the infant will observe the infant closely for: A. Tremors and hyperreflexia B. Respiratory depression C. Excessive crying and sneezing D. Congenital anomalies

B

In discussing the rationale for using methadone to ease opioid withdrawal, the nurse would explain that it has which pharmacologic properties or characteristics? A. Methadone lacks cross-tolerance with other opioids. B. Methadone can prevent abstinence syndrome. C. Methadone has a shorter duration of action than other opioids. D. Methadone is a nonopioid agent.

B

The nurse is providing patient education for a postmenopausal patient who is considering EPT. Which risks associated with EPT should the nurse discuss with the patient? (Select all that apply.) A. Increased colon cancer B. Deep vein thrombosis C. Stroke D. Ovarian cancer E. Decreased bone density

B,C,D

A 6-week-old infant who has not yet received immunizations develops a severe cough. While awaiting nasopharyngeal culture results, the nurse will expect to administer which antibiotic? a. Clindamycin [Cleocin] b. Doxycycline [Vibramycin] c. Erythromycin ethylsuccinate d. Penicillin G

C

A nurse is administering a vasodilator that dilates resistance vessels. The nurse understands that this drug will have which effect on the patient? a. Decreased cardiac preload b. Decreased cardiac output c. Increased tissue perfusion d. Increased ventricular contraction

C

A patient is admitted to the hospital with fever, headache, malaise, joint pain, and enlarged lymph nodes. Blood cultures are positive for Treponema pallidum. The nurse recognizes this as which type of syphilis? a. Congenital b. Primary c. Secondary d. Tertiary

C

A patient is receiving intravenous promethazine [Phenergan] 25 mg for postoperative nausea and vomiting. What is an important nursing action when giving this drug? a. Giving the dose as an IV push over 3 to 5 minutes b. Infusing the dose with microbore tubing and an infusion pump c. Observing the IV insertion site frequently for patency d. Telling the patient to report dry mouth and sedation

C

A patient shows signs and symptoms of conjunctivitis. Which aminoglycoside would the nurse expect to be ordered? a. Amikacin [Amikin] b. Kanamycin [Kantrex] c. Neomycin [Neomycin] d. Paromomycin [Humatin]

C

A patient with bipolar disorder takes lamotrigine [Lamictal]. Which statement by the patient would prompt the nurse to hold the drug and notify the prescriber for further assessment? a. "I get a little dizzy sometimes." b. "I had a headache last week that lasted for about an hour." c. "I've broken out in a rash on my chest and back." d. "Last night I woke up twice with a bad dream."

C

A woman in labor receives meperidine [Demerol] for pain. The nurse caring for the infant will observe the infant closely for: a. congenital anomalies. b. excessive crying and sneezing. c. respiratory depression. d. tremors and hyperreflexia.

C

A clinic patient who has cirrhosis of the liver develops hypervolemic hypernatremia. Which medication will the nurse expect the provider to order? A. Desmopressin [DDAVP] B. Vasopressin [Pitressin] C. Conivaptan [Vaprisol] D. Tolvaptan [Samsca]

D

A nurse preparing to administer intravenous gentamicin to a patient notes that the dose is half the usual dose for an adult. The nurse suspects that this is because this patient has a history of: a. antibiotic resistance. b. interpatient variation. c. liver disease. d. renal disease.

D

A patient begins taking nifedipine [Procardia], along with metoprolol, to treat hypertension. The nurse understands that metoprolol is used to: a. reduce flushing. b. minimize gingival hyperplasia. c. prevent constipation. d. prevent reflex tachycardia.

D

A patient has had three gouty flare-ups in the past year. Which drug class will the nurse expect the provider to order for this patient? a. Colchicine b. Glucocorticoids c. Nonsteroidal anti-inflammatory drugs d. Urate-lowering drugs

D

A patient is to receive a beta agonist. Before administration of this medication, which assessment finding would most concern the nurse? a. Pulse oximtery reading of 88% b. Blood pressure of 100/60 mmHg c. Respiratory rate of 28 breaths per minute d. Heart rate of 110 beats per minute

D

All of the following are used to treat cold symptoms. EXCEPT: a. Antihistamine b. Expectorants c. Nasal Decongestants d. Methylxantines

D

The nurse is caring for a patient who is HIV positive and is taking zidovudine [Retrovir]. Before administering the medication, the nurse should monitor which laboratory values? a. Ketones in the urine and blood b. Serum immunoglobulin levels c. Serum lactate dehydrogenase d. Complete blood count (CBC)

D

The nurse is preparing to administer medication to a patient receiving cyclophosphamide [Cytoxan]. To protect against the side effect of hemorrhagic cystitis, the nurse would expect to administer which drug? a. Decadron b. Diphenhydramine [Benadryl] c. Leucovorin d. Mesna [Mesnex]

D

Which medication used for asthma has off-label uses to treat allergic rhinitis? A. Diphenhydramine (Benadryl) B. Guaifenesin (Mucinex) C. Fexofenadine/Pseudoephedrine (Allegra-D) D. Omalizumab (Xolair)

D

14. A patient has been taking levothyroxine for several years and reports that "for the past 2 weeks, the drug doesn't seem to work as well as before." What will the nurse do? a. Ask the patient when the prescription was last refilled. b. Expect the patient to have an elevated temperature and tachycardia. c. Suggest that the patient begin taking calcium supplements. d. Tell the patient to try taking the medication with food.

A

A nurse is caring for a patient who is receiving a drug that causes constriction of arterioles. The nurse expects to observe which effect from this drug? a. Decreased stroke volume b. Increased stroke volume c. Decreased myocardial contractility d. Increased myocardial contractility

A

A nurse is concerned about renal function in an 84-year-old patient who is taking several medications. What will the nurse assess? a. Creatinine clearance b. Sodium levels c. Potassium levels d. Serum creatinine

A

A nurse is discussing glucocorticoids with a group of nursing students. Which statement by a student indicates understanding of the teaching? a. "Glucocorticoids have both endocrine and nonendocrine uses." b. "Patients treated for adrenocortical insufficiency receive pharmacologic doses." c. "Pharmacologic effects are achieved with low doses of glucocorticoids." d. "Physiologic doses are used to treat inflammatory disorders."

A

A nurse is discussing the administration of an intravenous infusion of rituximab (Rituxan) with a nursing student. Which statement by the student indicates a need for further education about the care of a patient receiving this drug? a. "Angioedema and hypersensitivity may occur, but they are usually self-limiting and mild." b. "I should be prepared to administer epinephrine, glucocorticoids, and oxygen if needed." c. "I will administer an antihistamine and acetaminophen before beginning the infusion." d. "I will monitor this patient's blood pressure, respiratory rate, and oxygen saturation closely."

A

A nurse is providing education to a patient who will begin taking alendronate [Fosamax]. Which complication should the patient be instructed to report immediately? a. Difficulty swallowing b. Dizziness c. Drowsiness d. Pallor

A

A nurse is teaching a patient who has taken glucocorticoids for over a year about glucocorticoid withdrawal. Which statement by the patient indicates a need for further teaching? a. "I should reduce the dose by half each day until I stop taking the drug." b. "I will need to have cortisol levels monitored during the withdrawal process." c. "The withdrawal schedule may take several months." d. "If I have surgery, I may need to take the drug for a while, even after I have stopped."

A

A nurse is teaching a patient who will undergo chemotherapy with fluorouracil [Adrucil] to treat a solid tumor. Which statement by the patient indicates understanding of this chemotherapeutic agent's actions? a. "Fluorouracil acts to deprive cancer cells of thymidylate needed to make DNA." b. "Fluorouracil causes accumulation of adenosine, which inhibits DNA synthesis." c. "Fluorouracil disrupts the biosynthesis of nucleic acids." d. "Fluorouracil inhibits DNA polymerase in cancer cells."

A

A nurse is teaching nursing students about the use of nonproprietary names for drugs. The nurse tells them which fact about nonproprietary names? A. They are assigned by the U.S. Adopted Names Council B. They are approved by the FDA and are easy to remember C. They clearly identify the drug's pharmacologic classification. D. They imply the efficacy of the drug and are less complex

A

A nurse is teaching parents how to use an Epi-Pen for their child, who has a peanut allergy. Which statement by the parents indicates understanding of the teaching? a. "After using the Epi-Pen, we must go to the emergency department." b. "The Epi-Pen should be stored in the refrigerator, because epinephrine is sensitive to heat." c. "The teacher should call us when symptoms start so that we can bring the Epi-Pen to school." d. "We should jab the device into the thigh until it is empty of solution."

A

A nurse transcribes a new prescription for potassium penicillin G given intravenously (IV) every 8 hours and gentamicin given IV every 12 hours. Which is the best schedule for administering these drugs? a. Give the penicillin at 0800, 1600, and 2400; give the gentamicin [Garamycin] at 1800 and 0600. b. Give the penicillin at 0800, 1600, and 2400; give the gentamicin [Garamycin] at 1200 and 2400. c. Give the penicillin at 0600, 1400, and 2200; give the gentamicin [Garamycin] at 0600 and 1800. d. Give the penicillin every 8 hours; give the gentamicin [Garamycin] simultaneously with two of the penicillin doses.

A

A nursing student asks a nurse about pharmaceutical research and wants to know the purpose of randomization in drug trials. The nurse explains that randomization is used to do what? a. To ensure that differences in outcomes are the result of treatment and not differences in subjects b. To compare the outcome caused by the treatment to the outcome caused by no treatment c. To make sure that researchers are unaware of which subjects are in which group d. To prevent subjects from knowing which group they are in and prevent preconcep- tion bias

A

A nursing student asks a nurse why chemotherapeutic agents are given intermittently instead of continuously. The nurse will tell the student that intermittent dosing: a. allows normal cells to recover and repopulate. b. catches malignant cells in latent phases. c. increases cancer cell kill and speeds up treatment. d. suppresses drug resistance in tumor cells.

A

A nursing student asks the nurse why more is not known about the teratogenic effects of maternal medication ingestion during pregnancy. Which response by the nurse is correct? a. "Clinical trials to assess this risk would put the fetus at risk." b. "It is safer to recommend that pregnant women avoid medications while pregnant." c. "Most women are reluctant to admit taking medications while they are pregnant." d. "The relatively new MEPREP study will allow testing of medications during pregnancy in the future."

A

A patient has a Pseudomonas aeruginosa infection that is sensitive to aminoglycosides, and the prescriber orders gentamicin. The patient tells the nurse that a friend received amikacin [Amikin] for a similar infection and wonders why amikacin was not ordered. What will the nurse tell the patient? a. "Amikacin is given when infectious agents are resistant to other aminoglycosides." b. "Amikacin is more vulnerable to inactivation by bacterial enzymes." c. "Amikacin is a narrow-spectrum drug and will probably not work for this infection." d. "Gentamicin is less toxic to the ears and the kidneys."

A

A patient has a positive urine culture 1 week after completion of a 3-day course of antibiotics. The nurse anticipates that the prescriber will: a. begin a 2-week course of antibiotics. b. evaluate for a structural abnormality of the urinary tract. c. initiate long-term prophylaxis with low-dose antibiotics. d. treat the patient with intravenous antibiotics.

A

A patient has a systemic candidal infection, and the provider has ordered oral fluconazole [Diflucan] 400 mg on day 1 and 200 mg once daily thereafter. What will the nurse do? a. Administer the drug as ordered. b. Contact the provider to discuss cutting the dosing in half. c. Contact the provider to discuss giving 400 mg on all days. d. Contact the provider to discuss giving the drug intravenously.

A

A patient has an infection caused by Pseudomonas aeruginosa. The prescriber has ordered piperacillin and amikacin, both to be given intravenously. What will the nurse do? a. Make sure to administer the drugs at different times using different IV tubing. b. Suggest giving larger doses of piperacillin and discontinuing the amikacin. c. Suggest that a fixed-dose combination of piperacillin and tazobactam [Zosyn] be used. d. Watch the patient closely for allergic reactions, because this risk is increased with this combination.

A

A patient has been receiving intravenous ketorolac 30 mg every 6 hours for postoperative pain for 4 days. The patient will begin taking oral ketorolac 10 mg every 4 to 6 hours to prepare for discharge in 1 or 2 days. The patient asks the nurse whether this drug will be prescribed for management of pain after discharge. The nurse will respond by telling the patient that the provider will prescribe a(n): a. different nonsteroidal anti-inflammatory drug for home management of pain. b. fixed-dose opioid analgesic/nonsteroidal anti-inflammatory medication. c. lower dose of the oral ketorolac for long-term pain management. d. intranasal preparation of ketorolac for pain management at home.

A

A patient has been taking digoxin [Lanoxin] 0.25 mg, and furosemide [Lasix] 40 mg, daily. Upon routine assessment by the nurse, the patient states, "I see yellow halos around the lights." The nurse should perform which action based on this assessment? a. Check the patient for other symptoms of digitalis toxicity. b. Withhold the next dose of furosemide. c. Continue to monitor the patient for heart failure. d. Document the findings and reassess in 1 hour.

A

A patient has begun taking dimethyl fumarate [Tecfidera] to treat relapsing MS and calls the clinic to report flushing of the skin with itching and burning sensations. What will the nurse recommend to this patient? a. "Take a non-enteric-coated aspirin 30 minutes before each dose." b. "The provider will order an antihistamine to treat this symptom." c. "Try taking the medication on an empty stomach." d. "You should notify the provider immediately."

A

A patient has lamivudine-resistant hepatitis B and has been taking entecavir [Baraclude] for 2 years. The patient asks the nurse why the provider has recommended taking the drug for another year. What will the nurse tell the patient? a. "Entecavir can reverse fibrosis and cirrhosis of the liver when taken long term." b. "It is necessary to continue taking entecavir to avoid withdrawal symptoms." c. "The drug will be given until the infection is completely eradicated." d. "You will need to continue taking entecavir to prevent lactic acidosis and hepatotoxicity."

A

A patient has received two doses of dinoprostone [Prepidil] to initiate labor. It has been 6 hours since the last dose. The nurse assesses the patient and notes that the cervix is ripe and dilated to 4 cm, but contractions are diminishing in intensity and frequency. What will the nurse expect to do? a. Administer oxytocin. b. Monitor urine output. c. Prepare for a cesarean section. d. Watch closely for fetal distress.

A

A patient has seasonal allergies and needs an antihistamine to control symptoms. The patient likes to have wine with dinner occasionally and wants to know which antihistamine will be the safest to take. The nurse will tell the patient to discuss which medication with the provider? A. Fexofenadine [Allegra] B. Cetirizine [Zyrtec] C. Loratadine [Claritin] D. Levocetirizine [Xyzal]

A

A patient in the postanesthesia recovery unit received ketamine [Ketalar] for right open reduction internal fixation surgery. What drug would be beneficial as a premedication to help minimize adverse reactions?\ A. Diazepam (Valium) B. Atropine (Sal-Tropine) C. Methohexital (Brevital) D. Sevoflurane (Ultane)

A

A patient is about to begin therapy with ethambutol. The nurse knows that, before initiating treatment with this drug, it is important to obtain which test(s)? a. Color vision and visual acuity b. Complete blood cell (CBC) count c. Hearing testing and a tympanogram d. Hepatic function tests

A

A patient is admitted for treatment of gout that has been refractory to treatment with allopurinol and probenecid. The patient is taking colchicine, and the prescriber orders pegloticase [Krystexxa]. Before administering this drug, the nurse will expect to: a. administer an antihistamine and a glucocorticoid. b. discontinue the colchicine. c. increase the dose of colchicine. d. prepare to administer a bronchodilator if needed.

A

A patient is admitted to a hospital for treatment for first-time symptoms of mania and is exhibiting euphoric mania. Which medication will the provider order? a. Lithium [Lithobid] b. Olanzapine [Zyprexa] c. Risperidone [Risperdal] d. Divalproex sodium [Valproate]

A

A patient is admitted to the intensive care unit for treatment of shock. The prescriber orders isoproterenol [Isuprel]. The nurse expects this drug to increase tissue perfusion in this patient by activating: A. Reducing the dose of memantine B. Discontinuing the memantine C. Continuing the memantine as ordered D. Adding sodium bicarbonate to the patient's drug regimen

A

A patient is admitted to the unit for treatment for an infection. The patient receives IV amikacin [Amikin] twice a day. When planning for obtaining a peak aminoglycoside level, when should the nurse see that the blood is drawn? a. 30 minutes after the IV infusion is complete b. 1 hour after the IV infusion is complete c. 1 hour before administration of the IV infusion d. A peak level is not indicated with twice-daily dosing.

A

A patient is beginning therapy with oral methotrexate [Rheumatrex] for rheumatoid arthritis. The nurse will teach this patient about the importance of: a. having routine renal and hepatic function tests. b. limiting folic acid consumption. c. reporting alopecia and rash. d. taking the medication on a daily basis.

A

A patient is being treated for a systemic fungal infection with amphotericin B [Abelcet] and will be discharged home from the hospital to complete every other day infusions of the medication for 6 to 8 weeks. The nurse provides discharge teaching before dismissal. Which statement by the patient indicates a need for further teaching? a. "I may experience headaches and pain in my lower back, legs, and abdomen." b. "I may need to take potassium supplements while taking this drug." c. "I should take acetaminophen and diphenhydramine before each infusion." d. "I will need to have blood drawn for serum creatinine and BUN levels every 3 to 4 days."

A

A patient is being treated with interferon beta-1a [Avonex] for relapsing-remitting MS. The patient calls the clinic to report headache, fever, chills, and muscle aches after administering a dose. What will the nurse recommend? a. Acetaminophen or ibuprofen b. Asking the provider to order a complete blood count (CBC) c. Coming to the clinic for evaluation for leukoencephalopathy d. Discontinuing the drug immediately

A

A patient is diagnosed with a lung infection caused by P. aeruginosa. The culture and sensitivity report shows sensitivity to all aminoglycosides. The nurse knows that the rate of resistance to gentamicin is common in this hospital. The nurse will expect the provider to order which medication? a. Amikacin [Amikin] b. Gentamicin c. Paromomycin d. Tobramycin

A

A patient is diagnosed with an infection caused by Staphylococcus aureus, and the prescriber orders intravenous gentamicin and penicillin (PCN). Both drugs will be given twice daily. What will the nurse do? a. Administer gentamicin, flush the line, and then give the penicillin. b. Give the gentamicin intravenously and the penicillin intramuscularly. c. Infuse the gentamicin and the penicillin together to prevent fluid overload. d. Request an order to change the penicillin to vancomycin.

A

A patient is diagnosed with peptic ulcer disease. The patient is otherwise healthy. The nurse learns that the patient does not smoke and that he drinks 1 or 2 glasses of wine with meals each week. The nurse anticipates that the provider will prescribe which drugs? a. Amoxicillin [Amoxil], clarithromycin, and omeprazole [Prilosec] b. Amoxicillin [Amoxil], metronidazole [Flagyl], and cimetidine [Tagamet] c. Clarithromycin, metronidazole [Flagyl], and omeprazole [Prilosec] d. Tetracycline, cimetidine [Tagamet], and lansoprazole [Prevacid]

A

A patient is given a new medication and reports nausea within an hour after taking the drug. The nurse consults the drug information manual and learns that nausea is not an expected adverse effect of this drug. When the next dose is due, what will the nurse do? a. Administer the drug and tell the patient to report further nausea. b. Hold the drug and notify the provider of the patient's symptoms. c. Report the symptoms of nausea to the MEDWATCH program. d. Request an order for an antiemetic to counter this drug's effects.

A

A patient is given a prescription for azithromycin [Zithromax] and asks the nurse why the dose on the first day is twice the amount of the dose on the next 4 days. Which reply by the nurse is correct? a. "A large initial dose helps to get the drug to optimal levels in the body faster." b. "The first dose is larger to minimize the first pass effect of the liver." c. "The four smaller doses help the body taper the amount of drug more gradually." d. "Tubular reabsorption is faster with initial doses, so more is needed at first."

A

A patient is receiving gentamicin once daily. A nursing student asks the nurse how the drug can be effective if given only once a day. The nurse explains drug dosing schedules for aminoglycosides. Which statement by the student indicates a need for further teaching? a. "Gentamicin has a longer half-life than other aminoglycosides." b. "Large doses given once daily yield higher peak levels." c. "The postantibiotic effect lasts for several hours." d. "There is less risk of ototoxicity and nephrotoxicity with large daily doses."

A

A patient is receiving intravenous vincristine [Oncovin]. The patient complains of pain at the IV insertion site. The nurse examines the site and notes an area of erythema and edema. What will the nurse do? a. Change the IV site and notify the provider of the extravasation. b. Contact the provider to suggest using a different chemotherapeutic agent. c. Obtain an order for a topical anesthetic to minimize discomfort. d. Slow the rate of infusion to reduce the patient's discomfort.

A

A patient is receiving oral iron for iron deficiency anemia. Which antibiotic drug, taken concurrently with iron, would most concern the nurse? a. Tetracycline b. Cephalosporin c. Metronidazole [Flagyl] d. Penicillin

A

A patient is receiving tobramycin three times daily. A tobramycin peak level is 4.5 and the trough is 1.2. What will the nurse do? a. Give the next dose as ordered. b. Hold the next dose and notify the provider. c. Monitor the patient for signs of nephrotoxicity. d. Tell the patient to report tinnitus.

A

A patient is to undergo orthopedic surgery, and the prescriber will order a cephalosporin to be given preoperatively as prophylaxis against infection. The nurse expects the provider to order which cephalosporin? a. First-generation cephalosporin b. Second-generation cephalosporin c. Third-generation cephalosporin d. Fourth-generation cephalosporin

A

A patient newly diagnosed with PUD reports taking low-dose aspirin (ASA) for prevention of cardiovascular disease. The nurse learns that the patient drinks 2 to 3 cups of coffee each day and has a glass of wine with dinner 3 or 4 nights per week. The patient eats three meals a day. The nurse will counsel this patient to: a. change the meal pattern to five or six smaller meals per day. b. discontinue taking aspirin, because it can irritate the stomach. c. stop drinking wine or any other alcoholic beverage. d. switch to a decaffeinated coffee and reduce the number of servings.

A

A patient newly diagnosed with Parkinson disease has been taking levodopa/carbidopa [Sinemet] for several weeks and complains of nausea and vomiting. The nurse tells the patient to discuss what with the provider? A. Taking a lower dose with a low-protein snack B. Taking a lower dose on an empty stomach C. Taking an increased dose along with a high-protein snack D. Taking dopamine in addition to levodopa/carbidopa

A

A patient newly diagnosed with diabetes is to be discharged from the hospital. The nurse teaching this patient about home management should begin by doing what? a. Asking the patient to demonstrate how to measure and administer insulin b. Discussing methods of storing insulin and discarding syringes c. Giving information about how diet and exercise affect insulin requirements d. Teaching the patient about the long-term consequences of poor diabetes control

A

A patient newly diagnosed with tuberculosis asks the nurse why oral medications must be given in the clinic. The nurse will tell the patient that medications are given in the clinic so that: a. clinic staff can observe adherence to drug regimens. b. nurses can monitor for drug toxicities. c. providers can adjust doses as needed. d. the staff can ensure that the U.S. Food and Drug Administration (FDA) regulations are met.

A

A patient recently was diagnosed with bipolar disorder. The patient, who has a history of seasonal allergies, is an athlete who participates in track. The nurse is teaching the patient about lithium [Lithobid], which the prescriber has just ordered. Which statement by the patient indicates the need for further teaching? A. "I can continue to use ibuprofen as needed for muscle pain." B. "I should drink extra fluids before and during exercise." C. "I should not use antihistamines while taking lithium." D. "I should report muscle weakness and tremors to my provider."

A

A patient taking a glucocorticoid for arthritis reports feeling bloated. The nurse notes edema of the patient's hands and feet. Which action by the nurse is correct? a. Ask the patient about sodium intake. b. Obtain a blood glucose level. c. Suggest the patient limit potassium intake. d. Tell the patient to stop taking the drug.

A

A patient taking high doses of a glucocorticoid develops weakness in the muscles of the upper arms and in the legs. What will the nurse do? a. Contact the provider to ask about reducing the dose. b. Encourage the patient to restrict sodium intake. c. Reassure the patient that this is an expected side effect. d. Tell the patient to stop taking the drug.

A

A patient who has a brain tumor will receive a nitrosourea agent. A nursing student asks why this type of drug is used for this type of cancer. The nurse will tell the student that nitrosoureas are useful because they: a. are lipophilic. b. are bifunctional alkylating agents. c. have a broad spectrum of antineoplastic characteristics. d. have delayed bone marrow suppression.

A

A patient who has been receiving intravenous gentamicin for several days reports having had a headache for 2 days. The nurse will request an order to: a. discontinue the gentamicin. b. obtain a gentamicin trough before the next dose is given c. give an analgesic to control headache discomfort. d. obtain renal function tests to evaluate for potential nephrotoxicity.

A

A patient who is taking oral contraceptives begins taking valproic acid [Depakote] for seizures. After a week of therapy with valproic acid, the patient tells the nurse that she is experiencing nausea. What will the nurse do? a. Ask the patient if she is taking the valproic acid with food, because taking the drug on an empty stomach can cause gastrointestinal side effects. b. Contact the provider to request an order for a blood ammonia level, because hyperammonemia can occur with valproic acid therapy. c. Suggest that the patient perform a home pregnancy test, because valproic acid can reduce the efficacy of oral contraceptives. d. Suspect that hepatotoxicity has occurred, because this is a common adverse effect of valproic acid.

A

A patient who reports regular consumption of two or three alcoholic beverages per day asks about taking acetaminophen when needed for occasional recurrent pain. What will the nurse tell the patient? a. "Do not take more than 2 gm of acetaminophen a day." b. "Do not take more than 3 gm of acetaminophen a day." c. "Do not take more than 4 gm of acetaminophen a day." d. "Do not take a fixed-dose preparation with opioid analgesics."

A

A patient will be discharged from the hospital with a prescription for TMP/SMZ [Bactrim]. When providing teaching for this patient, the nurse will tell the patient that it will be important to: a. drink 8 to 10 glasses of water each day. b. eat foods that are high in potassium. c. take the medication with food. d. take folic acid supplements.

A

A patient will be discharged home to complete treatment with intravenous cefotetan with the assistance of a home nurse. The home care nurse will include which instruction when teaching the patient about this drug treatment? a. Abstain from alcohol consumption during therapy. b. Avoid dairy products while taking this drug. c. Take an antihistamine if a rash occurs. d. Use nonsteroidal anti-inflammatory drugs (NSAIDs), not acetaminophen, for pain.

A

A patient will begin chemotherapy with cisplatin. Which medications will the nurse expect to administer to offset this agent's side effects? a. Amifostine [Ethyol], diuretics, and antiemetics b. Antiemetics, vitamin B12, and glucocorticoids c. Dexamethasone, antiemetics, and vistonuridine d. Folic acid, gabapentin, and vitamin B12

A

A patient will begin taking hydroxychloroquine [Plaquenil] for rheumatoid arthritis. The patient is currently taking high-dose NSAIDs and methotrexate. What will the nurse teach the patient? a. That an eye exam is necessary at the beginning of therapy with this drug b. That the dose of NSAIDs may be decreased when beginning hydroxychloroquine c. To obtain tests of renal and hepatic function while taking this drug d. To stop taking methotrexate when starting hydroxychloroquine

A

A patient will begin taking propranolol [Inderal] for hypertension. Which statement by the nurse is important when teaching this patient about the medication? a. "Check your hands and feet for swelling and report that to your provider." b. "It is safe to take this medication with a calcium channel blocker." c. "Stop taking the drug if you become short of breath." d. "Take your pulse and do not take the medication if your heart rate is fast."

A

A patient with HIV and mucocutaneous HSV is being treated with foscarnet after failing treatment with acyclovir. After 2 weeks, the patient's dose is increased to 90 mg/kg over 2 hours from 40 mg/kg over 1 hour. The patient reports numbness in the extremities and perioral tingling. What will the nurse do? a. Notify the provider and request an order for a serum calcium level. b. Notify the provider of potential foscarnet overdose. c. Request an order for a creatinine clearance level. d. Request an order of IV saline to be given before the next dose.

A

A patient with Stage C heart failure (HF) who has been taking an ACE inhibitor, a beta blocker, and a diuretic begins to have increased dyspnea, weight gain, and decreased urine output. The provider orders spironolactone [Aldactone]. The nurse will instruct the patient to: a. avoid potassium supplements. b. monitor for a decreased heart rate. c. take extra fluids. d. use a salt substitute instead of salt.

A

A patient with a history of renal calculi has fever, flank pain, and bacteriuria. The nurse caring for this patient understands that it is important for the provider to: a. begin antibiotic therapy after urine culture and sensitivity results are available. b. give prophylactic antibiotics for 6 weeks after the acute infection has cleared. c. initiate immediate treatment with broad-spectrum antibiotics. d. refer the patient for intravenous antibiotics and hospitalization.

A

A patient with a new-onset seizure disorder receives a prescription for phenobarbital. The patient reports being concerned about the sedative side effects of this drug. Which response by the nurse is correct? a. "Phenobarbital doses for seizures are nonsedating." b. "This is a short-acting barbiturate, so sedation wears off quickly." c. "Tolerance to the sedative effects will develop in a few weeks." d. "You may actually experience paradoxical effects of euphoria."

A

A patient with a urinary tract infection is given a prescription for TMP/SMZ. When reviewing the drug with the patient, the nurse learns that the patient has type 1 diabetes mellitus and consumes alcohol heavily. What will the nurse do? a. Contact the provider to request a different antibiotic for this patient. b. Obtain frequent blood glucose determinations while giving TMP/SMZ. c. Suggest that the patient take a potassium supplement while taking TMP/SMZ. d. Tell the patient to avoid excessive fluid intake while taking TMP/SMZ.

A

A patient with advanced cancer of the prostate begins treatment with leuprolide [Lupron Depot] injections and will receive 7.5 mg IM once per month. After the first injection, the patient experiences an increase in cancer symptoms. What will the nurse tell the patient? a. Desensitization to the drug over time will result in a decrease in these symptoms. b. The dose of leuprolide may have to be increased to 22.5 mg per month. c. These symptoms indicate a need for surgical castration to treat the cancer. d. This is a sign that the patient's cancer is getting worse.

A

A patient with angina who uses sublingual nitroglycerin tells the nurse that the episodes are increasing in frequency and usually occur when the patient walks the dog. The patient reports needing almost daily doses of the nitroglycerin and states that one tablet usually provides complete relief. What will the nurse do? A. Contact the provider to suggest ordering a transdermal patch for this patient B. Suggest that the patient limit walking the dog to shorter distances less frequently C. Question the patient about consumption of grapefruit juice D. Suggest that the patient take two tablets of nitroglycerin each time, because the symptoms are increasing in frequency

A

A patient with angina who uses sublingual nitroglycerin tells the nurse that the episodes are increasing in frequency and usually occur when the patient walks the dog. The patient reports needing almost daily doses of the nitroglycerin and states that one tablet usually provides complete relief. What will the nurse do? a. Contact the provider to suggest ordering a transdermal patch for this patient. b. Question the patient about consumption of grapefruit juice. c. Suggest that the patient limit walking the dog to shorter distances less frequently. d. Suggest that the patient take two tablets of nitroglycerin each time, because the symptoms are increasing in frequency.

A

A patient with cancer who is receiving chemotherapy develops a fever. The patient's chest radiograph is normal. The patient's neutrophil count is 750/mm3. The nurse expects the provider to: a. begin empiric therapy with intravenous antibiotics. b. obtain cultures and wait for results before prescribing antibiotics. c. order colony-stimulating factor to minimize neutrophilia. d. reassure the patient that serious infection is unlikely.

A

A patient with cerebral palsy has severe muscle spasticity and muscle weakness. The patient is unable to take anything by mouth. The nurse is correct to anticipate that which medication will be ordered for home therapy? a. Baclofen [Lioresal] b. Dantrolene [Dantrium] c. Diazepam [Valium] d. Metaxalone [Skelaxin]

A

A patient with chronic gout is admitted to the hospital for treatment for an infection. The patient is receiving allopurinol and ampicillin. The nurse is preparing to administer medications and notes that the patient has a temperature of 101°F and a rash. What will the nurse do? a. Withhold the allopurinol and notify the prescriber of the drug reaction. b. Withhold the ampicillin and contact the provider to request a different antibiotic. c. Request an order for an antihistamine to minimize the drug side effects. d. Suggest giving a lower dose of the allopurinol while giving ampicillin.

A

A patient with chronic myeloid leukemia (CML) begins treatment with imatinib [Gleevec]. Which statement by the patient indicates understanding of this medication? a. "Resistance to this drug may develop over time." b. "The intensity of side effects is dose dependent." c. "This drug does not have significant drug interactions." d. "This drug must be given intravenously."

A

A patient with colorectal cancer is admitted to the hospital oncology unit to receive cetuximab [Erbitux]. The nurse notes that the prescriber has not ordered any other medications. The nurse will contact the prescriber to request an order for which medication in order to minimize cetuximab's side effects? a. Diphenhydramine [Benadryl] b. Epinephrine c. Ondansetron [Zofran] d. Magnesium supplements

A

A patient with diabetes develops hypertension. The nurse will anticipate administering which type of medication to treat hypertension in this patient? a. ACE inhibitors b. Beta blockers c. Direct-acting vasodilators d. Thiazide diuretics

A

A patient with high-risk factors for tuberculosis will begin therapy for latent TB with isoniazid and rifampin. The nurse learns that this patient takes oral contraceptives. The nurse will counsel this patient to discuss ____ with her provider. a. another birth control method b. reducing the rifampin dose c. reducing the isoniazid dose d. increasing the oral contraceptive dose

A

A patient with lung cancer receives filgrastim [Neupogen] after chemotherapy to reduce neutropenia. The patient reports a moderate degree of bone pain. What will the nurse do? a. Obtain an order to administer acetaminophen. b. Request an order for a complete blood count (CBC). c. Request an order to reduce the dose of filgrastim. d. Suspect metastasis of the cancer to the bone.

A

A patient with metastatic cancer has had several fractures secondary to bone metastases. The provider orders denosumab [Xgeva]. What will the nurse teach this patient? a. Denosumab may delay healing of these fractures. b. Denosumab should be given subcutaneously every 12 months. c. Denosumab will improve hypocalcemia. d. Unlike bisphosphonates, denosumab does not increase osteonecrosis of the jaw (ONJ).

A

A patient with no known drug allergies is receiving amoxicillin [Amoxil] PO twice daily. Twenty minutes after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is 100/58 mm Hg. What will the nurse do? a. Contact the provider and prepare to administer epinephrine. b. Notify the provider if the patient develops a rash. c. Request an order for a skin test to evaluate possible PCN allergy. d. Withhold the next dose until symptoms subside.

A

A patient with pheochromocytoma is admitted for surgery. The surgeon has ordered an alpha-blocking agent to be given preoperatively. What does the nurse understand about this agent? a. It is ordered to prevent perioperative hypertensive crisis. b. It prevents secretion of catecholamines by the adrenal tumor. c. It reduces contraction of smooth muscles in the adrenal medulla. d. It is given chronically after the surgery to prevent hypertension.

A

A patient with polycystic ovary syndrome (PCOS) asks the nurse what she can do to improve her chances of getting pregnant. Which statement by the patient indicates a need for further teaching? A. "Spironolactone, which reduces androgens and facial hair, is helpful if I'm trying to conceive." B. "If I lose weight, my infertility and irregular periods could resolve without medications." C. "Metformin improves insulin sensitivity and reduces male hormone levels." D. "Clomiphene will help induce ovulation but will not treat the other symptoms of polycystic ovary disease."

A

A patient with vitamin B12 deficiency is admitted with symptoms of hypoxia, anemia, numbness of hands and feet, and oral stomatitis. The nurse expects the prescriber to order which of the following therapies? A. IM cyanocobalamin and folic acid B. IM cyanocobalamin and antibiotics C. PO cyanocobalamin and blood transfusions D. PO cyanocobalamin and folic acid

A

A pediatric nurse is teaching nursing students about medication administration in children. Which statement by a student indicates an understanding of the teaching? a. "Drugs effective in adults may not work in children, even if the dose is proportional for weight and size." b. "infants metablize druge more quickly than do older children and adults." c. "side effects of drugs in children are similar to side effects of drugs in adults." d. "The known differences in drug effects in children versus those in adults are related to the size

A

A pregnant adolescent patient asks the nurse whether she should continue to take her prescription for tetracycline [Sumycin] to clear up her acne. Which response by the nurse is correct? a. "Tetracycline can be harmful to the baby's teeth and should be avoided." b. "Tetracycline is safe to take during pregnancy." c. "Tetracycline may cause allergic reactions in pregnant women." d. "Tetracycline will prevent asymptomatic urinary tract infections."

A

A pregnant patient with fever, flank pain, and chills has a history of two previous bladder infections before getting pregnant. She is allergic to several antibiotics. She reports having taken methenamine successfully in the past. What will the nurse tell her? a. "This agent is not effective against infections of the upper urinary tract." b. "This antiseptic agent is safe for use during pregnancy and has no drug resistance." c. "This drug is linked to many serious birth defects and is not recommended during pregnancy." d. "You will need to take this medication with meals to avoid gastric upset."

A

A prescriber has ordered cefoxitin for a patient who has an infection caused by a gram-negative bacteria. The nurse taking the medication history learns that the patient experienced a maculopapular rash when taking amoxicillin [Amoxil] several years earlier. What will the nurse do? A. Administer the cefoxitin and observe for any side effects. B. Give the cefoxitin and have epinephrine and respiratory support available. C. Request an order to administer a skin test before giving the cefoxitin. D. Request an order for a different, nonpenicillin, noncephalosporin antibiotic.

A

A prescriber has ordered medication for a newborn. The medication is eliminated primarily by hepatic metabolism. The nurse expects the prescriber to: a. order a dose that is lower than an adult dose. b. order a dose that is higher than an adult dose. c. increase the frequency of medication dos- ing. d. discontinue the drug after one or two doses.

A

A prescriber has ordered propranolol [Inderal] for a patient with recurrent ventricular tachycardia. The nurse preparing to administer this drug will be concerned about what in the patient's history? a. Asthma b. Exercise-induced tachyarrhythmias c. Hypertension d. Paroxysmal atrial tachycardia associated with emotion

A

A prescriber orders clonidine [Kapvay] ER tablets for a 12-year-old child. The nurse understands that this drug is being given to treat which condition? a. ADHD b. Hypertension c. Severe pain d. Tourette's syndrome

A

A provider has ordered ceftriaxone 4 gm once daily for a patient with renal impairment. What will the nurse do? a. Administer the medication as prescribed. b. Contact the provider to ask about giving the drug in divided doses. c. Discuss increasing the interval between doses with the provider. d. Discuss reducing the dose with the provider.

A

A psychiatric nurse is teaching a patient about an antidepressant medication. The nurse tells the patient that therapeutic effects may not occur for several weeks. The nurse understands that this is likely the result of: a. changes in the brain as a result of prolonged drug exposure. b. direct actions of the drug on specific synaptic functions in the brain. c. slowed drug absorption across the blood-brain barrier. d. tolerance to exposure to the drug over time.

A

A surgical patient is receiving succinylcholine [Anectine] with an inhalation anesthetic. The patient is intubated, has an indwelling urinary catheter, and has ongoing monitoring of vital signs. Which symptom during the perioperative period is cause for concern? a. Elevated temperature b. Increased urine output c. Muscle paralysis d. No response to painful stimuli

A

A woman who has arthritis is breast-feeding her infant and asks the nurse if it is safe to take NSAIDs while nursing. What will the nurse tell this patient? a. NSAIDs are safe to take while breast-feeding. b. NSAIDs are not safe, even in small amounts. c. She should take only COX-2 inhibitors while breast-feeding. d. She should request a prescription for narcotic analgesics.

A

A woman who is breastfeeding is prescribed a low pharmacologic dose of a glucocorticoid and asks the nurse about potential effects on her infant. What will the nurse tell her about this medication? a. "At this dose, the concentration in your breast milk is safe." b. "Contact your provider to discuss lowering the dose." c. "There will be reversible side effects for your baby." d. "This drug is likely to cause growth retardation in your baby."

A

An adolescent is brought to the emergency department by a parent who reports that the patient took a whole bottle of extended-release acetaminophen tablets somewhere between 8 and 10 hours ago. The nurse will anticipate administering which of the following? a. Acetylcysteine [Mucomyst] b. Activated charcoal c. Hemodialysis d. Respiratory support

A

An adolescent patient comes to the clinic complaining of a burning sensation upon urination and a pus-like discharge from the penis. The nurse is correct to suspect that the patient has which disorder? a. Gonorrhea b. Herpes simplex c. Nongonococcal urethritis d. Syphilis

A

An infertile patient has received two 5-day courses of clomiphene [Clomid] to help her conceive. An ultrasound 1 week after the last dose reveals that follicular maturation has occurred without ovulation. The nurse expects the next step for this patient to be: a. administration of human chorionic gonadotropin (hCG). b. an order for cabergoline to be given twice weekly. c. evaluation of ovarian and pituitary function. d. repeating clomiphene once daily for 5 days.

A

An older adult patient has confusion, memory loss, and disorientation in familiar surroundings. The patient has been taking donepezil [Aricept] 10 mg once daily for 6 months. The patient's symptoms have begun to worsen, and the patient's spouse asks if the medication dose can be increased. What will the nurse tell the spouse? a. The dose can be increased, because the pa-tient has been taking the drug for longer than 3 months. b. The dose can be increased to twice daily dosing instead of once daily dosing. c. The increase in symptoms is the result of hepatotoxicity from the medication's side effects. d. The patient must take the drug for longer than 1 year before the dose can be in-creased.

A

Before giving methenamine [Hiprex] to a patient, it is important for the nurse to review the patient's history for evidence of which problem? a. Elevated blood urea nitrogen and creatinine b. History of reactions to antibiotic agents c. Possibility of pregnancy d. Previous resistance to antiseptic agents

A

During a routine screening, an asymptomatic, pregnant patient at 37 weeks' gestation learns that she has an infection caused by Chlamydia trachomatis. The nurse will expect the provider to order which drug? A. Azithromycin B. Doxycycline C. Erythromycin ethylsuccinate D. Sulfisoxazole

A

During a routine screening, an asymptomatic, pregnant patient at 37 weeks' gestation learns that she has an infection caused by Chlamydia trachomatis. The nurse will expect the provider to order which drug? a. Azithromycin b. Doxycycline c. Erythromycin ethylsuccinate d. Sulfisoxazole

A

In a discussion of drug-drug interactions, which would be the best example of a beneficial inhibitory interaction? a. Naloxone [Narcan] blocking morphine sulfate's actions b. Antacids blocking the action of tetracycline [Sumycin] c. Propanolol [Inderal] blocking the effects of albuterol d. Cholestyramine blocking the actions of antihypertensive drug

A

In discussing the rationale for using methadone to ease opioid withdrawal, the nurse would explain that it has which pharmacologic properties or characteristics? a. Methadone can prevent abstinence syndrome. b. Methadone has a shorter duration of action than other opioids. c. Methadone is a nonopioid agent. d. Methadone lacks cross-tolerance with other opioids.

A

Many medications list side effects that include dry mouth, constipation, and urinary retention. What kinds of effects are these? A. Anticholinergics B. Beta adrenergic C. Alpha adrenergic D. Sympathetic

A

The nurse educator is conducting a continuing education class on pharmacology. To evaluate the learning of the nurses in the class, the nurse educator asks, "Which drug name gives information about the drug's pharmacologic classification?" Which is the correct response? A. Metoprolol B. Motrin C. Cipro D. Tylenol

A

The nurse is caring for a patient after recent renal transplantation. The patient is taking sirolimus [Rapamune] to prevent transplant rejection. What other medications would the nurse expect the patient to be taking? A. Cyclosporine and glucocorticoids B. Carbamazepine and phenobarbital C. Amphotericin B and erythromyacin D. Rifampin and ketoconazole

A

The nurse is caring for a patient after recent renal transplantation. The patient is taking sirolimus [Rapamune] to prevent transplant rejection. What other medications would the nurse expect the patient to be taking? A. Cyclosporine and glucocorticoids B. Rifampin and ketoconazole C. Carbamazepine and phenobarbital D. Amphotericin B and erythromycin

A

The nurse is caring for a patient receiving intravenous acyclovir [Zovirax]. To prevent nephrotoxicity associated with intravenous acyclovir, the nurse will: a. hydrate the patient during the infusion and for 2 hours after the infusion. b. increase the patient's intake of foods rich in vitamin C. c. monitor urinary output every 30 minutes. d. provide a low-protein diet for 1 day before and 2 days after the acyclovir infusion.

A

The nurse is caring for a patient who is HIV positive and has a previous history of drug and alcohol abuse. The patient is being treated with combination therapies, including didanosine [Videx]. Which laboratory findings would most concern the nurse? a. Increased serum amylase and triglycerides and decreased serum calcium b. Decreased serum amylase and serum triglycerides and increased serum calcium c. Decreased hemoglobin and hematocrit d. Increased serum amylase, decreased triglycerides, and increased platelets

A

The nurse is caring for an older adult patient after a right hip open reduction internal fixation (ORIF). The patient is taking an opioid every 6 hours as needed for pain. The nurse discusses obtaining an order from the prescriber for which medication? a. Docusate sodium [Colace] b. GoLYTELY c. Lactulose d. Polyethylene glycol [MiraLax]

A

The nurse is preparing to discharge a patient who is receiving lithium (Lithobid) for Bipolar Disorder. Which of the following home medications would be a concern for a patient who is taking lithium and why? A. Furosemide used to treat congestive heart failure (CHF) which may cause increased lithium levels via alterations in sodium excretion. B. Aspirin used to reduce platelet aggregation due to the patient's cardiac history may decrease lithium levels to below the therapeutic range. C. Hydrochlorothiazide used to treat hypertension may cause a decrease lithium level, thus the patient would need an increased dosage of lithium for effectiveness to occur. D. Lithium decreases the effectiveness of meloxicam (Mobic) used to treat arthritis requiring the health care provider to modify the arthritis management regimen.

A

The nurse receives an order to give morphine 5 mg IV every 2 hours PRN pain. Which action is not part of the six rights of drug administration? a.Assessing the patient's pain level 15 to 30 minutes after giving the medication administered b. Checking the medication administration record to see when the last dose was c. Consulting a drug manual to determine whether the amount the prescriber ordered is appropriate d. Documenting the reason the medication was given in the patient's electronic medical record

A

The nurse receives an order to give morphine 5mg IV every 2 hours PRN pain. Which action is not part of the six rights of drug administration? A. Assessing the patient's pain level 15 to 30 minutes after giving the medication. B. Consulting a drug manual to determine whether the amount the prescriber ordered is appropriate. C. Checking the medication administration record to see when the last dose was administered D. Documenting the reason the medication was given in the patient's electronic medical record

A

The nursing students make the following statement to DR. T about what they have learned in Pharmacotherapeutics up to this point in time. Which one of the following statements would require Dr. T or Ms. M to correct the students? a. "absorption of drugs following intramuscular administration is slower in infants compared to that in neonates and adults." b. "Drug accumulation secondary to decreased renal excretion is the most common cause of adverse drug reactions (ADRs) in older adults." c. "The best time to take a required medication to minimize transfer to the infant is after breast feeding." d. "The majority of drugs used in the pediatric population have never been tested in children."

A

When educating a parent about administering one teaspoon of acetaminophen every four hours to their child, they would include all fo the following interventions EXCEPT: a. Have the parent perform a demonstration of administering 15 ml of acetaminophen and administering it to their child with the next dosing. b. Educate the parent that acetaminophen is the generic version of Tylenol and it is acceptable to administer either the generic brand of the trade name brand. c. Educate the parent to make sure that the medication is kept in the child proof container and is stored in high placed our of reach of children. d. Offer a syringe and observe the parent draw up the correct amount of acetaminophen (5ml).

A

When metronidazole [Flagyl] is a component of the H. pylori treatment regimen, the patient must be instructed to do what? a. Avoid any alcoholic beverages b. Avoid foods containing tyramine c. Take the drug on an empty stomach d. Take the drug with food

A

Which condition would cause the nurse to withhold a PRN order for magnesium hydroxide? a. Chronic renal failure b. Cirrhosis c. Hemorrhoids d. Prostatitis

A

Which side effect of clindamycin [Cleocin] causes the most concern and may warrant discontinuation of the drug? a. Diarrhea b. Headache c. Nausea d. Vomiting

A

Which superficial mycosis is generally treated with oral antifungal agents? a. Tinea capitis b. Tinea corporis c. Tinea cruris d. Tinea pedis

A

While preparing a patient for a second esophageal dilation procedure, the nurse explains that Succinylcholine (Anectine) will be used for muscle relaxation. The patient is anxious and reports not being able to swallow for several hours after the previous procedure. What will the nurse do? A. Request an order for a pseudocholinesterase level B. Reassure the patient that this is expected after neuromuscular blockade C. Have dantrolene available, because this patient is at increased risk for side effects D. Be prepared to provide mechanical ventilation after the procedure.

A

A nurse is providing education to a group of patients regarding amphetamines. To evaluate the group's understanding, the nurse asks a participant what effects amphetamines would have on her. The participant shows that she understands the effects of these drugs if she gives which answers? (Select all that apply.) A. "Amphetamines increase the heart rate." B. "Amphetamines suppress the perception of pain." C. "Amphetamines elevate mood." D. "Amphetamines increase appetite." E. "Amphetamines increase fatigue."

A,B,C

A patient is being started on nicotinic acid [Niaspan] to reduce triglyceride levels. The nurse is providing patient education and should include teaching about which adverse effects? (Select all that apply.) A. Gastric upset B. Itching C. Facial flushing D. Constipation E. hypoglycemia

A,B,C

A patient is given nitrous oxide, along with another inhalation anesthetic. The nurse knows that the benefits of nitrous oxide include what? (Select all that apply.) A. It is less likely to precipitate malignant hyperthermia B. It is a potent analgesic C. It can significantly reduce the dose of inhalation anesthetic D. It is less likely to cause nauseas and vomiting E. It has high anesthetic potency

A,B,C

When administering medications to infants, it is important to remember which of the following? (Select all that apply) A. Infants have immature livers, which slow drug metabolism B. Infants are more sensitive to medications that act on the central nervous system (CNS). C. Immaturity of renal function in infancy causes infants to excrete drugs less efficiently. D. Breast-feeding infants are more likely to develop toxicity when given lipid-soluble drugs E. Oral medications are contraindicated in infants, because PO administration requires a cooperative patient

A,B,C

Which are guidelines for selecting chemotherapeutic agents to use in combination therapy? (Select all that apply.) A. Toxicities should be minimally overlapping. B. Drugs used should have different mechanisms. C. Each drug should be effective. D. Each drug should be delivered by different routes. E. Each drug should have different dosing schedules.

A,B,C

Which drugs are used to treat spasticity? (Select all that apply.) A. Diazepam (Valium) B. Baclofen (Lioresal) C. Dantrolene (Dantrium) D. Metaxalone (Skelaxin) E. Tizanidine (Flexeril)

A,B,C

Which infections may be acquired through nonsexual transmission? (Select all that apply.) a. Chlamydia trachomatis b. Gardnerella vaginalis c. Herpes simplex d. Neisseria gonorrhea e. Treponema pallidum

A,B,C,D,E

A patient is given nitrous oxide along with another inhalation anesthetic. The nurse knows that the benefits of nitrous oxide include what? (Select all that apply.) A. It is a potent analgesic. B. It is less likely to precipitate malignant hyperthermia. C. It has high anesthetic potency. D. It can significantly reduce the dose of inhalation anesthetic. E. It is less likely to cause nausea and vomiting.

A,B,D

The nurse is administering morning medications. The nurse gives a patient multiple medications, two of which compete for plasma albumin receptor sites. As a result of this concurrent administration, the nurse can anticipate that what might occur? (Select all that apply.) A. The increase in free drug can intensify effects. B. Plasma levels of free drug will rise. C. Plasma levels of free drug will fall. D. Binding of one or both agents is reduced. E. The increase in bound drug can intensify effects.

A,B,D

The nurse is providing patient education for a postmenopausal patient who is considering EPT. Which risks associated with EPT should the nurse discuss with the patient? (Select all that apply.) A. Ovarian cancer B. Deep vein thrombosis C. Increased colon cancer D. Stroke E. Decreased bone density

A,B,D

A nurse is teaching a group of nursing students about neuromuscular blocking agents. For what may these agents be used? (Select all that apply.) A. Mechanical ventilation B. Electroshock therapy C. Analgesia D. Malignant hyperthermia E. Surgery

A,B,E

The nurse is providing education to a group of patients who are HIV positive. The nurse is discussing the various medications used to treat HIV infection. A patient asks about nevirapine [Viramune]. Which statements by the nurse most accurately reflect the facts about nevirapine? (Select all that apply.) a. "Some herbal preparations can reduce the levels of this drug." b. "This agent can damage the liver; therefore, liver function tests are needed periodically." c. "Usually no adverse effects occur when this medication is used alone." d. "The drug must be dosed five times per day at evenly spaced intervals." e. "You should call your healthcare provider immediately if you develop a rash."

A,B,E

What contributes to drug resistance to chemotherapeutic agents? (Select all that apply.) a. Cellular production of P-glycoprotein b. Creation of selection pressure by drugs c. Drug-induced cellular mutation d. Increased drug uptake by tumor cells e. Reduced target molecule sensitivity

A,B,E

Which are therapeutic uses of verapamil? (Select all that apply.) A. Essential hypertension B. Angina of effort C. Sick sinus syndrome D. Suppression of preterm labor E. Cardiac dysrhythmias

A,B,E

Which drugs may be selected by the provider for initial treatment for a patient who is diagnosed with relapsing-remitting MS? (Select all that apply.) A. Teriflunomide (Aubagio) PO B. Dimethyl fumarate (Tecfidera) PO C. Methotrexate (Rheumatrex)PO D. Mitoxantrone (Novantrone) IV E. Interferon beta-1a (Avonex) IM

A,B,E

Which types of drugs are used to treat inflammatory bowel disease (IBD)? (Select all that apply.) A. Immunomodulators B. Aminosalicylates C. Opioid antidiarrheals D. Sulfonamide antibiotics E. Glucocorticoids

A,B,E

Before administering a medication, what does the nurse need to know to evaluate hoe individual patient variability might affect the patient's response to the medication? (Select all that apply) A. Patient's age B. Chemical stability of the medication C. Patient's diagnosis D. Family medical history E. Ease of administration

A,C,D

The nurse is administering morning medications. The nurse gives a patient multiple medication, two of which compete for plasma albumin receptor sites. As a result of this concurrent administration, the nurse can anticipate that what might occur? (Select all that apply) A. Plasma levels of free drug will rise B. Plasma levels of free drug will fall C. Binding of one or both agents will be reduced D. The increase in free drug will intensify effects E. The increase in bound drug will intensify effects

A,C,D

A pregnant patient is 1 week post-term and will receive intravenous oxytocin. Which will the nurse evaluate before starting the infusion? (Select all that apply.)I A. Uterine Activity B. Renal Function C. Cervical Ripening D. Respiratory function E. Fetal monitoring

A,C,E

Amphotericin B is the drug of choice for which systemic mycosis? (Select all that apply.) A. Histoplasmosis B. Dermatophytosis C. Mucormycosis D. Aspergillosis E. Candidiasis

A,C,E

A nurse recognizes that the actions of benzodiazepines include which findings? (Select all that apply.) A. Suppression of seizures and/or seizure activity B. Sleep deprivation C. Increase in muscle spasms D. Relief of general anxiety E. Development of tardive dyskinesia

A,D

Which antibiotics may be administered topically? (Select all that apply.) a. Bacitracin b. Daptomycin c. Ofloxacin d. Polymyxin B e. Rifampin

A,D

A patient will be taking amiodarone [Cordarone]. Which baseline tests are necessary before this medication is started? (Select all that apply.) A. Ophthalmologic examination B. Renal function tests C. Complete blood count with differential D. Thyroid function tests E. Chest radiograph and pulmonary function tests

A,D,E

Ketoconazole is used as an alternative to amphotericin B for less severe systemic mycosis. Which are the primary reasons for choosing ketoconazole? (Select all that apply.) a. It can be given orally. b. It can be used safely in patients with hepatic dysfunction. c. It can be given once weekly rather than daily. d. It is effective for severe, acute infections. e. It is less toxic.

A,E

A 45-year-old patient with a family history of breast cancer is considering using tamoxifen [Nolvadex] for cancer prevention. The nurse performs a health history and learns that the woman had a child when she was 35 years old, that she has not had a hysterectomy, and that she experienced DVT when she was pregnant. What will the nurse tell the patient? a. Because of her family risk and late childbearing, this drug is a good choice for her. b. Her history of DVT outweighs any possible benefits she may have with this drug. c. Since she has not had a hysterectomy, the risk of endometrial cancer is too great. d. When she turns 50 years old, this drug will carry fewer risks for her.

B

A 65-year-old female patient tells a nurse that she has begun taking calcium supplements. The nurse learns that the patient consumes two servings of dairy products and takes 1200 mg in calcium supplements each day. The patient's serum calcium level is 11.1 mg/dL. What will the nurse tell this patient? a. She should increase her dietary calcium in addition to the supplements b. The amount of calcium she takes increases her risk for heart attack and stroke c. To continue taking 1200 mg of calcium supplement since she is over age 50 d. To supplement her calcium with 10,000 units of vitamin D each day

B

A 68-year-old male patient receives a prescription for 25-mg tablets of sildenafil [Viagra] for erectile dysfunction. When he asks the nurse how to take the medication, the nurse will tell him to: a. begin taking one tablet twice daily, 12 hours apart. b. start with one tablet about 1 hour before anticipated sexual activity. c. take 25 to 100 mg per dose 30 minutes to 4 hours before sexual activity. d. take two tablets 1 hour before sexual activity with a high-fat meal.

B

A child is to begin long-term glucocorticoid therapy. The parents ask the nurse about the effects of this drug on the child's growth. Which response by the nurse is correct? a. "A smaller dose may be indicated for your child." b. "Ask your provider about every other day dosing." c. "Long-acting glucocorticoid preparations should prevent growth suppression." d. "Oral glucocorticoids rarely cause growth suppression."

B

A child with seasonal rhinitis has used budesonide [Rhinocort Aqua] for several years. The parents are concerned that the child's rate of growth has slowed. What will the nurse do? A. Reassure the parents that this is an expected side effect B. Suggest that the parents discuss using fluticasone (Flonase) with the provider C. Tell the parents that antihistamines work as well as intranasal glucocorticoids D. Tell the parent sot administer the drug only when symptoms are severe

B

A hospitalized patient with cancer is receiving chemotherapy and reports oral pain. Inspection of this patient's oral mucosa reveals erythema and inflammation without denudation or ulceration. The nurse understands that: a. chemotherapy will have to be stopped until healing of the oral mucosa occurs. b. the patient can use a mouthwash with a topical anesthetic to control pain. c. the patient will need an antifungal agent to treat Candida albicans. d. the patient will need systemic opioids to control discomfort.

B

A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding that penicillins: a. disinhibit transpeptidases. b. disrupt bacterial cell wall synthesis. c. inhibit autolysins. d. inhibit host cell wall function.

B

A nurse is caring for a patient after hip replacement surgery. The patient has been receiving iron replacement therapy for 2 days. The nurse notes that the patient's stools appear black. The patient is pale and complains of feeling tired. The patient's heart rate is 98 beats per minute, respirations are 20 breaths per minute, and the blood pressure is 100/50 mm Hg. The nurse will contact the provider to: a. report possible gastrointestinal hemorrhage. b. request a hemoglobin and hematocrit (H&H). c. request an order for a stool guaiac. d. suggest giving a hypertonic fluid bolus.

B

A nurse is caring for a patient who is receiving amphotericin B [Abelcet] for a systemic fungal infection. In spite of receiving diphenhydramine and acetaminophen before initiation of treatment, the patient has fever and chills with rigors. The nurse will contact the provider to discuss the addition of which drug? a. Aspirin b. Dantrolene c. Hydrocortisone d. Omeprazole

B

A nurse is caring for a patient who will begin taking hydralazine to treat hypertension. Which statement by the patient indicates understanding of the nurse's teaching about this drug? a. "I will need to ask for assistance when getting up out of a chair." b. "I will also take a beta blocker medication with this drug to prevent rapid heart rate." c. "I may develop joint pain, but this side effect will decrease over time." d. "This drug may cause excessive hair growth on my face, arms, and back."

B

A nurse is discussing the use of immunosuppressants for the treatment of inflammatory bowel disease (IBD) with a group of nursing students. Which statement by a student indicates understanding of the teaching? a. "Azathioprine [Imuran] helps induce rapid remission of IBD." b. "Cyclosporine [Sandimmune] can be used to induce remission of IBD." c. "Cyclosporine [Sandimmune] does not have serious adverse effects." d. "Methotrexate is used long term to maintain remission of IBD."

B

A nurse is giving an enteral medication. The patient asks why this method is preferable for this drug. How will the nurse reply? a. "This route allows more rapid absorption of the drug." b. "This route is safer, less expensive, and more convenient." c. "This route is the best way to control serum drug levels." d. "The route prevents inactivation of the drug by digestive enzymes."

B

A nurse is preparing to administer a dose of gentamicin to a patient who is receiving the drug 3 times daily. The nurse will monitor ____ levels. a. peak b. peak and trough c. serum drug d. trough

B

A nurse is preparing to administer a drug. Upon reading the medication guide, the nurse notes that the drug has been linked to symptoms of Parkinson's disease in some patients. What will the nurse do? a. Ask the patient to report these symptoms, which are known to be teratogenic effects. b. Observe the patient closely for such symptoms and prepare to treat them if needed. c. Request an order to evaluate the patient's genetic predisposition to this effect. d. Warn the patient about these effects and provide reassurance that this is expected.

B

A nurse is providing medication teaching for a patient who will begin taking diclofenac [Voltaren] gel for osteoarthritis in both knees and elbows. Which statement by the patient indicates understanding of the teaching? a. "Because this is a topical drug, liver toxicity will not occur." b. "I should cover areas where the gel is applied to protect them from sunlight." c. "I will apply equal amounts of gel to all affected areas." d. "The topical formulation has the same toxicity as the oral formulation."

B

A nurse is providing teaching to a nursing student about to care for a woman with irritable bowel syndrome with diarrhea (IBS-D) who is receiving alosetron [Lotronex]. Which statement by the student indicates a need for further teaching? a. "I should evaluate the patient's abdomen for distension and bowel sounds." b. "Patients with diverticulitis and IBS-C may take this drug." c. "This drug can cause ischemic colitis in some patients." d. "This drug is given only to women with severe IBS-D."

B

A nurse is teaching a group of nursing students about cyclooxygenase (COX) inhibitors. A student asks the nurse about characteristics of COX-1 inhibitors. Which statement by the nurse is true? a. "COX-1 inhibitors protect against colorectal cancer." b. "COX-1 inhibitors protect against myocardial infarction and stroke." c. "COX-1 inhibitors reduce fever." d. "COX-1 inhibitors suppress inflammation."

B

A nurse is teaching a group of nursing students about influenza prevention. Which statement by a student indicates understanding of the teaching? a. "I may develop a mild case of influenza if I receive the vaccine by injection." b. "I should receive the vaccine every year in October or November." c. "If I have a cold I should postpone getting the vaccine." d. "The antiviral medications are as effective as the flu vaccine for preventing the flu."

B

A nurse is teaching a group of nursing students about irreversible cholinesterase inhibitors. Which statement by a student indicates understanding of the teaching? a. "Diazepam is given to reverse inhibition of cholinesterase when overdose occurs." b. "Irreversible cholinesterase inhibitors are rapidly absorbed by all routes." c. "These agents are often used to treat glaucoma." d. "Toxic doses of these agents produce an anticholinergic crisis.

B

A nurse is teaching a group of nursing students about tricyclic antidepressants (TCAs). Which statement by a student indicates a need for further teaching? A. "TCAs block receptors for histamine, acetylcholine, and norepinephrine." B. "TCAs have many side effects, but none of them are serious." C. "TCAs block the uptake of norepinephrine and 5-HT." D. "TCAs have other uses than for depression."

B

A nurse is teaching a group of nursing students why glucocorticoids are preferred over nonsteroidal anti-inflammatory drugs in the treatment of inflammation. Which statement by a student indicates a need for further teaching? a. "Glucocorticoids act by multiple mechanisms and have more anti-inflammatory effects than NSAIDs." b. "Glucocorticoids have fewer side effects than nonsteroidal anti-inflammatory drugs." c. "Glucocorticoids help avert damage to tissues from lysosomal enzymes." d. "Glucocorticoids reduce the immune component of inflammation."

B

A nurse is teaching a group of women about medications. The women want to know why so many drugs have unpredictable effects in women. The nurse will tell them that: a. drugs usually have more toxic effects in women. b. most known drug effects are based on drug trials in men. c.women have varying responses to drugs during menstrual cycles d. women metabolize drugs more slowly.

B

A nurse is teaching a nursing student about dalfopristin/quinupristin [Synercid]. Which statement by the student indicates an understanding of the teaching? a. "Patients should stop taking the drug if they experience joint and muscle pain." b. "Patients taking this drug should have blood tests performed frequently." c. "Patients who are allergic to penicillin should not take this drug." d. "This drug will be administered intravenously over a 30- to 60-minute period."

B

A nurse is teaching a nursing student about the two classes of adrenergic agonist drugs. Which statement by the nursing student indicates understanding of the teaching? a. "Catecholamines may be given orally." b. "Catecholamines often require continuous infusion to be effective." c. "Noncatecholamines do not cross the blood-brain barrier." d. "Noncatecholamines undergo rapid degradation by monoamine oxidase."

B

A nurse is teaching a nursing student what is meant by "generations" of cephalosporins. Which statement by the student indicates understanding of the teaching? a. "Cephalosporins are assigned to generations based on their relative costs to administer." b. "Cephalosporins have increased activity against gram-negative bacteria with each generation." c. "First-generation cephalosporins have better penetration of the cerebrospinal fluid." d. "Later generations of cephalosporins have lower resistance to destruction by beta-lactamases."

B

A nurse is teaching a patient who will begin taking methimazole [Tapazole] for Graves' disease about the medication. Which statement by the patient indicates understanding of the teaching? a. "Because of the risk for liver toxicity, I will need frequent liver function tests." b. "I should report a sore throat or fever to my provider if either occurs." c. "I will need a complete blood count every few months." d. "It is safe to get pregnant while taking this medication."

B

A nurse provides teaching for a woman who will begin taking supplemental calcium. Which statement by the woman indicates understanding of the teaching? a. "Chewable calcium tablets are not absorbed well and are not recommended." b. "I should not take more than 600 mg of calcium at one time." c. "I should take enough supplemental calcium to provide my total daily requirements." d. "If I take calcium with green, leafy vegetables, it will increase absorption."

B

A nurse provides teaching to a patient who will begin taking oral cyclophosphamide to treat non-Hodgkin's lymphoma. Which statement by the patient indicates an understanding about how to minimize side effects while taking this drug? a. "I don't need to worry about bone marrow suppression with this drug." b. "I should drink plenty of fluids while taking this drug." c. "I should take this drug on an empty stomach." d. "If I shampoo less often, I can prevent hair loss."

B

A nurse receives an order to administer castor oil to a patient. Which action by the nurse is correct? a. Administer the medication at bedtime. b. Chill the medication and mix it with fruit juice. c. Provide teaching about home use of this medication. d. Teach the patient that the effects will occur slowly.

B

A nursing student asks about the differences between cell-cycle phase-specific chemotherapeutic agents and those that are cell-cycle phase nonspecific. What will the nurse explain? a. Cell-cycle phase-nonspecific drugs are less toxic. b. Cell-cycle phase-specific drugs do not harm "resting" cells. c. Cell-cycle phase-specific drugs should be given at specific intervals. d. Neither type is toxic to cells in the "resting" G0 phase.

B

A nursing student asks the nurse what differentiates antiestrogen drugs from aromatase inhibitors in the treatment of breast cancer. What is the correct response by the nurse? a. Antiestrogen drugs decrease the risk for thromboembolic events. b. Antiestrogen drugs increase the risk for endometrial cancer. c. Aromatase inhibitors block the production of estrogen by the ovaries. d. Aromatase inhibitors can be used for tumor cells that lack estrogen receptors.

B

A patient admitted to the hospital has a history of peptic ulcer disease. The patient takes ranitidine [Zantac] and sucralfate [Carafate]. The patient tells the nurse that discomfort is usually controlled but that symptoms occasionally flare up. What will the nurse do? a. Ask the provider about ordering an endoscopic examination. b. Contact the provider to discuss serologic testing and an antibiotic. c. Contact the provider to discuss switching to a proton pump inhibitor. d. Counsel the patient to avoid beverages containing caffeine.

B

A patient admitted to the hospital has been using phenylephrine nasal spray [Neo-Synephrine], 2 sprays every 4 hours, for a week. The patient complains that the medication is not working, because the nasal congestion has increased. What will the nurse do? a. Request an order for an oral decongestant to replace the intranasal phenylephrine. b. Request an order for an intranasal glucocorticoid to be used while the phenylephrine is withdrawn. c. Tell the patient to increase the dose of phenylephrine to 4 sprays every 4 hours. d. Tell the patient to stop using the phenylephrine and begin using an intranasal antihistamine.

B

A patient admitted to the hospital is using metronidazole [Flagyl] 0.75% gel. The nurse understands that this agent is used to treat which condition? a. Chlamydia trachomatis b. Gardnerella vaginalis c. Haemophilus ducreyi d. Trichomonas vaginalis

B

A patient asks a nurse why he cannot use digoxin [Lanoxin] for his heart failure, because both of his parents used it for HF. The nurse will explain that digoxin is not the first-line therapy for which reason? a. It causes tachycardia and increases the cardiac workload. b. It does not correct the underlying pathology of heart failure. c. It has a wide therapeutic range that makes dosing difficult. d. It may actually shorten the patient's life expectancy.

B

A patient comes to a clinic for tuberculosis medications 2 weeks after beginning treatment with a four-drug induction phase. The patient's sputum culture remains positive, and no drug resistance is noted. At this point, the nurse will expect the provider to: a. change the regimen to a two-drug continuation phase. b. continue the four-drug regimen and recheck the sputum in 2 weeks. c. obtain a chest radiograph and consider adding another drug to the regimen. d. question the patient about adherence to the drug regimen.

B

A patient has a positive test for hepatitis C and is admitted to the hospital. The admission laboratory tests reveal a normal ALT, and a liver biopsy is negative for hepatic fibrosis and inflammation. The nurse will prepare this patient for: a. dual therapy with pegylated interferon alfa and ribavirin. b. no medication therapy at this time. c. pegylated interferon alfa only until ALT levels are elevated. d. triple drug therapy with pegylated interferon alfa, ribavirin, and boceprevir.

B

A patient has a positive test for influenza type A and tells the nurse that symptoms began 5 days before being tested. The prescriber has ordered oseltamivir [Tamiflu]. The nurse will tell the patient that oseltamivir: a. may decrease symptom duration by 2 or 3 days. b. may not be effective because of the delay in starting treatment. c. may reduce the severity but not the duration of symptoms. d. will alleviate symptoms within 24 hours of the start of therapy.

B

A patient has a viral sinus infection, and the provider tells the patient that antibiotics will not be prescribed. The patient wants to take an antibiotic and asks the nurse what possible harm could occur by taking an antibiotic. Which response by the nurse is correct? a. "Antibiotics are mutagenic and can produce changes that cause resistance." b. "Even normal flora can develop resistance and transfer this to pathogens." c. "Host cells become resistant to antibiotics with repeated use." d. "Patients who overuse antibiotics are more likely to have nosocomial infections."

B

A patient has been taking fluoxetine [Prozac] for 2 years and reports feeling cured of depression. The nurse learns that the patient is sleeping well, participates in usual activities, and feels upbeat and energetic most of the time. The patient's weight has returned to normal. The patient reports last having symptoms of depression at least 9 months ago. What will the nurse tell this patient? a. Indefinite drug therapy is necessary to maintain remission. b. Discuss gradual withdrawal of the medication with the provider. c. Stop the drug while remaining alert for the return of symptoms. d. Take a drug holiday to see whether symptoms recur.

B

A patient has developed muscarinic antagonist toxicity from ingestion of an unknown chemi- cal. The nurse should prepare to administer which medication? a. atropine [Sal-Tropine] IV b. physostigmine [Antilirium] c. An acteylcholinesterase activator d. Pseudophedrine [Ephedrine]

B

A patient has localized muscle spasms after an injury. The prescriber has ordered tizanidine [Zanaflex] to alleviate the spasms. When obtaining the patient's health history, the nurse should be concerned about which possible reason for considering another drug? a. Concomitant use of aspirin b. A history of hepatitis c. A history of malignant hyperthermia d. Occasional use of alcohol

B

A patient has seasonal allergies and needs an antihistamine to control symptoms. The patient likes to have wine with dinner occasionally and wants to know which antihistamine will be the safest to take. The nurse will tell the patient to discuss which medication with the provider? a. Cetirizine [Zyrtec] b. Fexofenadine [Allegra] c. Levocetirizine [Xyzal] d. Loratadine [Claritin]

B

A patient has undergone a primary percutaneous coronary intervention with a stent placement. The provider has ordered a daily dose of 81 mg of aspirin and clopidogrel. The patient asks the nurse how long the medications must be taken. What will the nurse tell this patient about the medication regimen? a. This drug regimen will continue indefinitely. b. The clopidogrel will be discontinued in one year and the aspirin will be given indefinitely. c. The aspirin will be discontinued in one year and the clopidogrel will be given indefinitely. d. Both drugs will be discontinued in one year.

B

A patient is about to begin treatment for latent tuberculosis with a short course of daily rifampin. The patient asks why rifapentine [Priftin] cannot be used, because it can be given twice weekly. What will the nurse tell this patient about rifapentine? a. It is more toxic than rifampin. b. It is not approved for treatment of latent TB. c. It is not well absorbed and thus not as effective. d. It will stain contact lenses orange.

B

A patient is about to begin treatment for latent tuberculosis. The patient is an alcoholic, has difficulty complying with drug regimens, and has mild liver damage. What will the nurse tell this patient? a. "You must stop drinking before adequate treatment can begin." b. "You must take isoniazid with close monitoring of hepatic function." c. "You must take rifampin daily for 4 months." d. "You will begin a regimen of isoniazid and rifampin."

B

A patient is about to undergo a procedure to harvest hematopoietic stem cells from the bone marrow. Which medication will the nurse anticipate giving before this procedure? A. Pegfilgrastim [Neulasta] B. Filgrastim [Neupogen] C. Sargramostim [Leukine] D. Oprelvekin [Neumega]

B

A patient is beginning therapy with oral methotrexate [Rheumatrex] for rheumatoid arthritis. The nurse will teach this patient about the importance of: A. reporting alopecia and rash. B. having routine renal and hepatic function tests. C. taking the medication on a daily basis. D. limiting folic acid consumption.

B

A patient is diagnosed with periodontal disease, and the provider orders oral doxycycline [Periostat]. The patient asks the purpose of the drug. What is the nurse's response? a. "It is used because of its anti-inflammatory effects." b. "It inhibits collagenase to protect connective tissue in the gums." c. "It reduces bleeding and the pocket depth of oral lesions." d. "It suppresses bacterial growth in the oral mucosa."

B

A patient is experiencing toxic side effects from atropine, including delirium and hallucinations. Which medication will the nurse expect to administer? A. Edrophonium [Reversol] B. Physostigmine C. Donepezil [Aricept] D. Neostigmine [Prostigmin]

B

A patient is receiving an intraperitoneal aminoglycoside during surgery. To reverse a serious side effect of this drug, the nurse may expect to administer which agent? a. Amphotericin B b. Calcium gluconate c. Neuromuscular blocker d. Vancomycin

B

A patient is receiving chemotherapy. Seven days after a dose, the patient's neutrophil count is 1000 cells/mm3. The nurse will tell this patient: a. that hospitalization is necessary to provide infection prophylaxis. b. that the provider will probably repeat the lab work in 3 to 5 days. c. to ask the provider about skipping the next dose of chemotherapy. d. to report any symptoms such as pus, abscesses, or cough.

B

A patient is receiving fluorouracil [Adrucil] as a continuous intravenous dose to treat a solid tumor. The patient reports soreness and blisters in the mouth, loose stools, and tingling of the hands and feet. What will the nurse do? a. Contact the provider to discuss bolus dosing instead of continuous dosing. b. Discontinue the medication and contact the provider to report these symptoms. c. Reassure the patient that these are expected, uncomfortable side effects. d. Request an order for dexamethasone to treat these side effects.

B

A patient is receiving intravenous voriconazole [Vfend]. Shortly after the infusion starts, the patient tells the nurse, "Colors look different, and the light hurts my eyes." What will the nurse do? a. Observe the patient closely for the development of hallucinations. b. Reassure the patient that these effects will subside in about 30 minutes. c. Stop the infusion and notify the provider of CNS toxicity. d. Tell the patient that this is an irreversible effect of the drug.

B

A patient is started on immunosuppressant drugs after kidney transplantation and will be taking azathioprine [Imuran] as part of the drug regimen. The patient asks the nurse why it is necessary to have a specimen for a complete blood count drawn at the beginning of therapy and then periodically thereafter. The nurse explains that azathioprine can alter blood cells and tells the patient to report: a. alopecia. b. easy bruising. c. fatigue. d. gastrointestinal (GI) upset.

B

A patient is taking a combination oral contraceptive (OC) and tells the nurse that she is planning to undergo knee replacement surgery in 2 months. What will the nurse recommend for this patient? a. The patient should ask her provider about an OC with less progestin. b. The patient should discuss an alternate method of birth control prior to surgery. c. The patient should request an OC containing less estrogen after surgery. d. The patient should take the OC at bedtime after her surgery to reduce side effects.

B

A patient is taking a drug that interferes with venous constriction. The nurse will tell the patient to: A. notify the provider if headache occurs. B. ask for assistance when getting out of bed. C. report shortness of breath. D. expect bradycardia for a few days.

B

A patient is taking bismuth subsalicylate [Pepto-Bismol] to prevent diarrhea. The nurse performing an assessment notes that the patient's tongue is black. What will the nurse do? a. Assess further for signs of gastrointestinal (GI) bleeding. b. Reassure the patient that this is an expected side effect of this drug. c. Request an order for liver function tests to evaluate for hepatotoxicity. d. Withhold the drug, because this is a sign of bismuth overdose.

B

A patient is taking erythromycin ethylsuccinate for a chlamydial infection and develops vaginal candidiasis. The prescriber orders ketoconazole to treat the superinfection. What will the nurse do? a. Administer the erythromycin and the ketoconazole as ordered. b. Contact the provider to discuss changing to a different antifungal medication. c. Contact the provider to discuss increasing the dose of erythromycin. d. Contact the provider to suggest using erythromycin stearate.

B

A patient is taking hydrocodone and ibuprofen for cancer pain and is admitted to the hospital for chemotherapy. The nurse anticipates that the prescriber will ____ ibuprofen. a. reduce the dose of b. discontinue the c. increase the dose of d. order aspirin (ASA) instead of

B

A patient is taking oral ketoconazole [Nizoral] for a systemic fungal infection. The nurse reviews the medication administration record and notes that the patient is also taking omeprazole [Prilosec] for reflux disease. What action should the nurse take? a. Administer the omeprazole 1 hour before the ketoconazole. b. Administer the omeprazole at least 2 hours after the ketoconazole. c. Confer with the prescriber about a potential hazardous interaction. d. The nurse should not administer omeprazole to a patient receiving ketoconazole.

B

A patient receiving a cephalosporin develops a secondary intestinal infection caused by Clostridium difficile. What is an appropriate treatment for this patient? a. Adding an antibiotic, such as vancomycin [Vancocin], to the patient's regimen b. Discontinuing the cephalosporin and beginning metronidazole [Flagyl] c. Discontinuing all antibiotics and providing fluid replacement d. Increasing the dose of the cephalosporin and providing isolation measures

B

A patient reports taking an oral bisacodyl laxative [Dulcolax] for several years. The provider has suggested discontinuing the laxative, but the patient is unsure how to do this. The nurse will tell the patient to: a. stop taking the oral laxative and use a suppository until normal motility resumes. b. stop taking the laxative immediately and expect no stool for several days. c. switch to a bulk-forming laxative, such as methylcellulose [Metamucil]. d. withdraw from the laxative slowly to avoid a rebound constipation effect.

B

A patient taking stavudine [Zerit] telephones the clinic and reports numbness and tingling in the hands and feet. What should the nurse tell the patient? A. The numbness is an expected side effect of the medication and will diminish once the drug is withdrawn. B. The medication will probably be stopped, and the patient should come into the clinic for further evaluation. C. The patient should take the medication on a full stomach to reduce absorption of the drug. D. The dose may be too high, and the patient should cut the tablet in half.

B

A patient taking stavudine [Zerit] telephones the clinic and reports numbness and tingling in the hands and feet. What should the nurse tell the patient? a. The numbness is an expected side effect of the medication and will diminish once the drug is withdrawn. b. The medication will probably be stopped, and the patient should come into the clinic for further evaluation. c. The dose may be too high, and the patient should cut the tablet in half. d. The patient should take the medication on a full stomach to reduce absorption of the drug.

B

A patient who experiences motion sickness is about to go on a cruise. The prescriber orders transdermal scopolamine [Transderm Scop]. The patient asks the nurse why an oral agent is not ordered. The nurse will explain that the transdermal preparation: a. can be applied as needed at the first sign of nausea. b. has less intense anticholinergic effects than the oral form. c. is less sedating than the oral preparation. d. provides direct effects, because it is placed close to the vestibular apparatus of the ear.

B

A patient who has been diagnosed with rheumatoid arthritis (RA) for 1 month and has generalized symptoms is taking high-dose nonsteroidal anti-inflammatory drugs (NSAIDs) and an oral glucocorticoid. The provider has ordered methotrexate [Rheumatrex]. The patient asks the nurse why methotrexate is necessary since pain and swelling have been well controlled with the other medications. The nurse will tell the patient that: a. a methotrexate regimen can reduce overall costs and side effects of treatment. b. starting methotrexate early can help delay joint degeneration. c. starting methotrexate now will help increase life expectancy. d. with methotrexate, doses of NSAIDs can be reduced to less toxic levels.

B

A patient who has been taking a glucocorticoid for several months arrives in the clinic. The nurse notes that the patient's cheeks appear full and that a prominent hump of fat is present on the upper back. The nurse will ask the provider to order which test(s)? a. Liver function tests b. Serum electrolytes c. Tuberculin skin test d. Vitamin D levels

B

A patient who has been taking gentamicin for 5 days reports a headache and dizziness. What will the nurse do? a. Request an order for a gentamicin peak level. b. Suspect ototoxicity and notify the prescriber. c. Tell the patient to ask for help with ambulation. d. Tell the patient to report any tinnitus.

B

A patient who has diabetes mellitus is diagnosed with schizophrenia and the provider orders thi-oridazine. The patient asks the nurse why the provider hasn't ordered olanzapine [Zyprexa], which the patient has seen advertised on television. Which response by the nurse is the most im-portant reason that this patient is not receiving olanzapine? a. "Olanzapine is more expensive than thiori-dazine." b. "Olanzapine causes more metabolic side effects than thioridazine." c. "Thioridazine has fewer side effects than olanzapine." d. "Thioridazine has a faster onset of action than olanzapine."

B

A patient who has just learned she is pregnant has stopped using a prescription medication that she takes for asthma because she doesn't want to harm her baby. What will the nurse tell her? a. That asthma medications will not affect the fetus b. That her baby's health is dependent on hers c. To avoid taking medications during her pregnancy d. To resume the medication in her second trimester

B

A patient who has leukemia is receiving chemotherapy and develops severe anemia. The provider has ordered hospitalization and blood transfusions. The patient asks the nurse about using erythropoietin (epoetin alfa) instead. What will the nurse tell this patient? a. "Ask your provider about ordering erythropoietin instead of a transfusion." b. "Erythropoietin (epoetin alfa) can make your leukemia worse." c. "Erythropoietin is used to prolong life in patients with myeloid malignancies." d. "You will probably receive erythropoietin along with the transfusion."

B

A patient who has urinary bladder cancer will begin receiving the chemotherapeutic agent valrubicin [Valstar]. What will the nurse do when administering this drug? a. Administer the drug intravenously using a large bore needle and tubing. b. Ensure that the tubing used to administer the drug does not contain polyvinyl chloride. c. Monitor the patient closely for a variety of systemic drug adverse effects. d. Use a normal saline or sterile water diluent to dilute the medication.

B

A patient who is a long-distance runner has been diagnosed with rheumatoid arthritis in both knees and will begin glucocorticoid therapy. When teaching the patient about the medication, the nurse will include what information? a. "By reducing inflammation, this drug will slow the progression of your disease." b. "Glucocorticoids are used as adjunctive therapy during acute flare-ups." c. "Oral glucocorticoids cause less toxicity than intra-articular injections." d. "You may resume running when the pain and swelling improve."

B

A patient who is an alcoholic is prescribed disulfiram [Antabuse] to help prevent relapse and the nurse provides teaching about the use of this drug. Which statement by the patient indicates understanding of the teaching? a. "I may use alcohol in cooking since heating foods destroys the alcohol." b. "I should avoid shaving lotion and mouthwashes that contain even small amounts of alcohol." c. "If I decide to drink, I should stop taking the disulfiram at least one week prior to consuming alcohol." d. "If I use alcohol, the effects will be uncomfortable but are not dangerous."

B

A patient who is having her sixth child has gone beyond term, and her labor is being induced with oxytocin [Pitocin]. The patient is having increased frequency, duration, and intensity of contractions. The nurse will interrupt the oxytocin infusion if what occurs? a. Contractions occur every 2 to 3 minutes. b. Individual contractions last 2 minutes. c. Mild to moderate pain occurs with uterine contractions. d. Resting intrauterine pressure is greater than 10 to 15 mm Hg.

B

A patient who is hospitalized for an acute gout attack has received several doses of hourly oral colchicine but still reports moderate to severe pain. As the nurse prepares to administer the next dose, the patient begins vomiting. What will the nurse do? a. Contact the provider to discuss giving a lower dose of colchicine. b. Hold the medication and notify the prescriber. c. Explain that this is a common side effect that will soon stop. d. Request an order for an antiemetic so that the next dose of colchicine may be given.

B

A patient who is morbidly obese is admitted for treatment. The prescriber orders lisdexamfetamine [Vyvanse]. The nurse will be concerned if this patient shows signs of: a. anorexia. b. dyspnea. c. insomnia. d. loquaciousness.

B

A patient who is taking a first-generation antipsychotic (FGA) drug for schizophrenia comes to the clinic for evaluation. The nurse observes that the patient has a shuffling gait and mild trem-ors. The nurse will ask the patient's provider about which course of action? a. Administering a direct dopamine antagonist b. Giving an anticholinergic medication c. Increasing the dose of the antipsychotic drug d. Switching to a second-generation antipsy-chotic drug

B

A patient who is taking acetaminophen for pain wants to know why it does not cause gastrointestinal upset, as do other over-the-counter pain medications. The nurse will explain that this is most likely because of which property of acetaminophen? a. It does not inhibit cyclooxygenase. b. It has minimal effects at peripheral sites. c. It is more similar to opioids than to nonsteroidal anti-inflammatory drugs (NSAIDs). d. It is selective for cyclooxygenase-2.

B

A patient who is taking ketoconazole tells the nurse that her periods have become irregular. What will the nurse tell her? a. This indicates that she should begin taking oral contraceptives. b. This is caused by a reversible effect on estradiol synthesis. c. This is a serious side effect that warrants discontinuation of the drug. d. This is a sign of hepatic toxicity, and the drug dose should be lowered.

B

A patient who recently started therapy with an HMG-COA reductase inhibitor asks the nurse, "How long will it take until I see an effect on my LDL cholesterol?" The nurse gives which correct answer? a. "It will take 6 months to see a change." b. "A reduction usually is seen within 2 weeks." c. "Blood levels normalize immediately after the drug is started. d. "Cholesterol will not be affected, but triglycerides will fall within the first week."

B

A patient who takes teriparatide [Forteo] administers it subcutaneously with a prefilled pen injector. The patient asks why she must use a new pen every 28 days when there are doses left in the syringe. Which is the correct response by the nurse? a. "Go ahead and use the remaining drug; I know it is so expensive." b. "The drug may not be stable after 28 days." c. "You are probably not giving the drug accurately." d. "You should be giving the drug more frequently.

B

A patient who takes the loop diuretic ethacrynic acid is given intravenous gentamicin for an infection. After several days of treatment with gentamicin, the nurse reviews the patient's most recent laboratory results and notes a gentamicin trough of 2.1 mcg/mL and normal blood urea nitrogen (BUN) and serum creatinine levels. The nurse will question the patient about: a. gastrointestinal (GI) symptoms. b. headache, dizziness, or vertigo. c. presence of rash. d. urine output.

B

A patient who will begin taking colchicine for gout reports taking nonsteroidal anti-inflammatory drugs, simvastatin, amoxicillin, and digoxin. What will the nurse do? a. Contact the provider to discuss using a different antibiotic while this patient is taking colchicine. b. Notify the provider about the potential risk of muscle injury when simvastatin is taken with colchicine. c. Request an order for cardiorespiratory monitoring, because the patient is taking digoxin. d. Suggest that the nonsteroidal anti-inflammatory drugs (NSAIDs) be withdrawn during colchicine therapy.

B

A patient will begin taking tamoxifen [Nolvadex] to treat breast cancer. The nurse performs a medication history and learns that the patient is taking sertraline [Zoloft] for depression. The nurse will tell the patient to contact her provider to ask about: a. increasing her dose of sertraline. b. changing from sertraline to escitalopram [Lexapro]. c. switching from sertraline to fluoxetine [Prozac]. d. decreasing her dose of tamoxifen.

B

A patient will receive oral ciprofloxacin [Cipro] to treat a urinary tract infection. The nurse provides teaching for this patient. Which statement by the patient indicates a need for further teaching? a. "I may have abdominal pain and nausea, but these are usually mild." b. "I should take this medication with food or milk to improve absorption." c. "I should stop taking the medication immediately if I experience heel pain." d. "I will need to use sunscreen every time I go outdoors."

B

A patient will undergo a colonoscopy, and the provider has ordered sodium phosphate as a bowel cleanser before the procedure. The nurse reviews the patient's chart and notes that the patient's creatinine clearance and blood urea nitrogen are both elevated. What will the nurse do? a. Reduce the amount of fluid given with the laxative to prevent fluid retention. b. Request an order to give polyethylene glycol and electrolytes (PEG-ELS) instead. c. Suggest that the patient reduce the dietary sodium intake. d. Suggest using a suppository laxative instead.

B

A patient with HIV contracts herpes simplex virus (HSV), and the prescriber orders acyclovir [Zovirax] 400 mg PO twice daily for 10 days. After 7 days of therapy, the patient reports having an increased number of lesions. The nurse will expect the provider to: a. extend this patient's drug therapy to twice daily for 12 months. b. give intravenous foscarnet every 8 hours for 2 to 3 weeks. c. increase the acyclovir dose to 800 mg PO 5 times daily. d. order intravenous valacyclovir [Valtrex] 1 gm PO twice daily for 10 days.

B

A patient with a history of cirrhosis of the liver is scheduled for a simple surgical procedure. The nurse anesthetist can choose from which of the following local anesthetic agents to use for this procedure? a. lidocaine (Xylocaine) or Bupivocaine (Marcaine) b. Tetracaine or Chloroprocaine (Nesacaine) c. Ropivacaine (Naropin) or Benzocaine d. procaine (Novocaine) or Prilocaine (Citanest)

B

A patient with a history of congestive heart failure and renal impairment has esophageal candidiasis. Which antifungal agent would the nurse anticipate giving to this patient? a. Amphotericin B [Abelcet] b. Fluconazole [Diflucan] c. Itraconazole [Sporanox] d. Voriconazole [Vfend]

B

A patient with advanced prostate cancer will begin treatment with leuprolide [Lupron]. The provider has ordered flutamide to be given as adjunct therapy. The patient asks the nurse why both drugs are necessary. The nurse will tell the patient that: a. flutamide reduces the side effects, such as hot flushes, caused by leuprolide. b. flutamide suppresses initial tumor flare caused by leuprolide. c. leuprolide helps to reduce the toxicity of flutamide. d. the combination of both drugs increases cancer survival.

B

A patient with arthritis is admitted to the hospital. The patient's serum glucose level is 350 gm/dL, and the blood pressure is 182/98 mm Hg. The nurse notes that the patient's face appears rounded and puffy. The patient complains of feeling weak. What will the nurse do? A. Contact the provider to discuss whether the patient has a pituitary carcinoma B. Ask which drugs the patient takes for arthritis C. Request an order for ketoconazole (Nizoral). D. Suspect that this patient has Addison's disease

B

A patient with bipolar disorder has frequent manic episodes alternating with depressive episodes. The prescriber orders risperidone [Risperdal] in addition to the lithium [Lithobid] that the patient is already taking. The patient asks the nurse why another drug is needed. The nurse will tell the patient that the risperidone is used to: A. elevate mood during depressive episodes. B. help control symptoms during manic episodes. C. prevent recurrence of depressive episodes. D. manage tremors associated with lithium use.

B

A patient with bipolar disorder who is taking divalproex sodium [Valproate] has just been admitted to the hospital. During the admission assessment, the patient tells the nurse about recent suicidal ideation. The nurse observes several areas of bruising over soft tissue areas and notes a weight gain of 10 lb since the last admission 1 year ago. What will the nurse do? A. Give the patient information about weight loss. B. Contact the provider to report these findings. C. Request an order for an increased dose to help with depressive symptoms. D. Ask the patient whether the bruises are self-inflicted.

B

A patient with bipolar disorder who is taking divalproex sodium [Valproate] has just been admitted to the hospital. During the admission assessment, the patient tells the nurse about recent suicidal ideation. The nurse observes several areas of bruising over soft tissue areas and notes a weight gain of 10 pounds since the last admission 1 year ago. What will the nurse do? a. Ask the patient whether the bruises are self-inflicted. b. Contact the provider to report these findings. c. Give the patient information about weight loss. d. Request an order for an increased dose to help with depressive symptoms.

B

A patient with cancer is admitted to the hospital. The nurse obtains an admission history and learns that the patient has been taking oxycodone and a nonsteroidal anti-inflammatory drug (NSAID) for a year. The patient reports a recent increase in the intensity of pain, along with a new pain described as "burning" and "shooting." The nurse anticipates that the prescriber will order: a. a combination opioid/NSAID and an adjunctive analgesic. b. a fentanyl transdermal patch, acetaminophen, and an adjunctive analgesic. c. an increase in the oxycodone and NSAID doses. d. intramuscular morphine sulfate and acetaminophen.

B

A patient with chronic congestive heart failure has repeated hospitalizations in spite of ongoing treatment with hydrochlorothiazide [HydroDIURIL] and digoxin. The prescriber has ordered spironolactone [Aldactone] to be added to this patient's drug regimen, and the nurse provides education about this medication. Which statement by the patient indicates understanding of the teaching? a. "I can expect improvement within a few hours after taking this drug." b. "I need to stop taking potassium supplements." c. "I should use salt substitutes to prevent toxic side effects." d. "I should watch closely for dehydration."

B

A patient with hepatitis B begins treatment with adefovir [Hepsera] and asks the nurse how long the drug therapy will last. The nurse will tell the patient that the medication will need to be taken for: a. a lifetime. b. an indefinite, prolonged period of time. c. 48 weeks. d. until nephrotoxicity occurs.

B

A patient with severe community-acquired pneumonia has been prescribed telithromycin [Ketek]. Which aspect of the patient's medical history is of concern to the nurse? a. Anemia b. Myasthenia gravis c. Renal disease d. Strep. pneumoniae infection

B

A pediatric nurse is teaching nursing students about medication administration in children. Which statement by a student indicates an understanding of the teaching? A. "The known differences in drug effects in children versus those in adults are related to the size of the patient" B. "Drugs effective in adults may not work in children, even if the dose is proportional for weight and size." C. "Side effects of drugs in children are similar to side effects of drugs in adults" D. "Infants metabolize drugs more quickly than do older children and adults"

B

A postoperative patient will begin anticoagulant therapy with rivaroxaban [Xarelto] after knee replacement surgery. The nurse performs a history and learns that the patient is taking erythromycin. The patient's creatinine clearance is 50 mL/min. The nurse will: a. administer the first dose of rivaroxaban as ordered. b. notify the provider to discuss changing the patient's antibiotic. c. request an order for a different anticoagulant medication. d. request an order to increase the dose of rivaroxaban.

B

A pregnant patient in her third trimester asks the nurse whether she can take aspirin for headaches. Which response by the nurse is correct? a. "Aspirin is safe during the second and third trimesters of pregnancy." b. "Aspirin may cause premature closure of the ductus arteriosus in your baby." c. "Aspirin may induce premature labor and should be avoided in the third trimester." d. "You should use a first-generation nonsteroidal anti-inflammatory medication."

B

A pregnant patient who is taking ondansetron [Zofran] for morning sickness tells the nurse she is experiencing headache and dizziness. What will the nurse tell her? a. It is not safe to take this drug during pregnancy. b. These are common side effects of ondansetron. c. She should stop taking the ondansetron immediately. d. She should report these adverse effects to her provider.

B

A prescriber has ordered pilocarpine [Pilocar]. A nurse understands that the drug stimulates muscarinic receptors and would expect the drug to have which action? a. Reduction of excessive secretions in a postoperative patient b. Lowering of intraocular pressure in patients with glaucoma c. Inhibition of muscular activity in the bladder d. Prevention of hypertensive crisis

B

A provider has ordered captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct? a. Administer the captopril and monitor for adverse effects. b. Hold the dose and notify the provider. c. Request an order to administer fosinopril instead of captopril. d. Reassure the patient that this is not a serious side effect.

B

A provider has written an order for a medication: drug Y x 50mh PO every 6 hours. The half life for the drug is approximately 6 hours. The nurse is preparing to administer the first dose at 6:00 AM on Tuesday. On Wednesday, when will the serum drug level reach plateau? A. 12:00 AM (noon) B. 6:00 AM C. 12:00 PM (midnight) D. 6:00 PM

B

A woman complains of burning on urination and increased frequency. The patient has a history of frequent urinary tract infections (UTIs) and is going out of town in 2 days. To treat the infection quickly, the nurse would expect the healthcare provider to order: a. aztreonam [Azactam]. b. fosfomycin [Monurol]. c. trimethoprim/sulfamethoxazole [Bactrim]. d. vancomycin [Vancocin].

B

A woman who is breast-feeding her infant must take a prescription medication for 2 weeks. The medication is safe, but the patient wants to make sure her baby receives as little of the drug as possible. What will the nurse tell the patient to do? a. Give the baby formula as long as the mother is taking the medication b. Take the medication immediately after breast-feeding c. Pump breast milk and feed the baby by bottle d. Take the medication 1 hour before breast-feeding

B

An adolescent patient with mild cervicitis is diagnosed with gonorrhea. The nurse will expect the provider to order which drug(s)? a. Azithromycin [Zithromax], 1 gm PO once, and doxycycline [Vibramycin], 100 mg PO twice daily for 7 days b. Ceftriaxone [Rocephin], 250 mg IM once, and azithromycin [Zithromax], 1 gm PO once c. Ceftriaxone [Rocephin], 125 mg IM once d. Doxycycline [Vibramycin], 100 mg IV twice daily for 12 days

B

An alcoholic patient's spouse asks a nurse about recovery from chronic alcoholism. The patient is confused and has abnormal eye movements and nystagmus. Which statement by the nurse is correct? a. "The symptoms your spouse shows are partly reversible in most people." b. "These symptoms can be reversed with vitamin therapy and good nutrition." c. "Your spouse has symptoms of an irreversible encephalopathy." d. "Your spouse will probably recover completely after detoxification."

B

An older adult patient with chronic obstructive pulmonary disease (COPD) develops bronchitis. The patient has a temperature of 39.5°C. The nurse will expect the provider to: a. obtain a sputum culture and wait for the results before prescribing an antibiotic. b. order empiric antibiotics while waiting for sputum culture results. c. treat symptomatically, because antibiotics are usually ineffective against bronchitis. d. treat the patient with more than one antibiotic without obtaining cultures.

B

Dopamine is administered to a patient who has been experiencing hypotensive episodes. Other than an increase in blood pressure, which indicator would the nurse use to evaluate a successful response? a. Decrease in pulse b. Increase in urine output c. Weight gain d. Improved gastric motility

B

Many medications list side effects that include dry mouth, constipation, and urinary retention. What kinds of effects are these? a. alpha adrenergic b. Anticholinergic c. Beta adregenergic d. Sympathetic

B

Patient is taking drug X and receives a new prescription for drug Y, which is listed as an inducing agent. The nurse caring for this patient understands that this patient may require _______ doses of drug ______. A. Higher; Y B. Higher; X C. Lower; X D. Lower; Y

B

Someone asks a nurse about a new drug that is in preclinical testing and wants to know why it cannot be used to treat a friend's illness. Which statement by the nurse is correct? a. "a drug at this stage of development can be used only in patients with serious disease." b. "At this stage of drug development, the safety and usefulness of the medication is unknown." c. "Clinical trail must be completed to make sure the drug is safe to use in humans." d. "Until postmarketing surveillance data are available, the drug cannot be used."

B

The client has just been prescribed levothyroxine for hypothyroidism. Which of the following educational statements provided by the nurse are true? Select ALL that apply. A. You will remain on this levothyroxine until the T3 and T4 levels stabilize and then you will be scheduled for the removal of your thyroid gland. B. Since you are taking warfarin for A-fib, we will monitor your PT levels closely and perhaps have to adjust the dosage since these two medications are highly protein bound and warfarin PT levels may increase. C. Take levothyroxine in the morning with breakfast since it is absorbed better with food. D. Once the symptoms are resolved, and T3, T4 & TSH are stabilized, you will be able to discontinue the therapy

B

The nurse administered 25 Units of Humulin N to a client with Type I Diabetes at 1600. Which interventions should the nurse implement? A. Asses the client for hypoglycemia around 1800. B. Ensure the client eats the nighttime (HS) snack. C. check the client's serum blood glucose level. D. Serve the client the supper tray at 1630 to prevent hypoglycemia by 180

B

The nurse is administering adenosine rapid IVP to a patient. While administering adenosine, the nurse sees the following rhythm displayed on the monitor. {{IMAGINE ASYSTOLE RHYTHM IMAGE HERE}} According to the rhythm, the nurse should perform which of the following interventions? A. Notify the Health Care Practitioner in charge immediately. B. Continue to monitor the patient and the cardiac rhythm displayed on the monitor. C. Call for Code Blue assistance. D. Start chest compressions and cardiopulmonary resuscitation immediately.

B

The nurse is caring for a patient in the oncology unit who was recently diagnosed with advanced renal carcinoma. The nurse prepares to administer aldesleukin [Proleukin] as part of the treatment regimen. What is the primary adverse effect of this drug? a. Hypertension b. Capillary leakage syndrome c. Hyperglycemia d. Hyperuricemia

B

The nurse is caring for a patient who has been receiving vinorelbine [Navelbine] for about 5 days. Which assessment finding in this patient would cause the nurse to withhold the next dose and notify the prescriber? a. Alopecia b. Dyspnea and cough c. Neutrophil count of 1200/mm3 d. Peripheral neuropathy

B

The nurse is caring for a patient who is receiving vancomycin [Vancocin]. The nurse notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The patient's heart rate is 120 beats per minute, and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with: a. allergic reaction. b. red man syndrome. c. rhabdomyolysis. d. Stevens-Johnson syndrome.

B

The nurse is caring for a pregnant patient who is in labor. The woman reports having had mild preeclampsia with a previous pregnancy. The nurse notes that the woman has a blood pressure of 168/102 mm Hg. The nurse will contact the provider to request an order for which drug? a. Angiotensin-converting enzyme (ACE) inhibitor b. Hydralazine (Apresoline) c. Magnesium sulfate d. Sodium nitroprusside

B

The nurse is performing a physical assessment on a patient who is receiving treatment with abacavir, zidovudine, and lamivudine [Trizivir]. The patient complains of fatigue. Upon further assessment, the nurse finds a rash and notes that the patient has a temperature of 101.1°F. What is the nurse's best course of action? a. Tell the patient that this is an expected response to these medications and to continue the agents as prescribed. b. Have the patient hold the medications and arrange for an immediate evaluation by the prescriber. c. Have the patient continue the abacavir but discontinue the other two agents for 3 weeks. d. Instruct the patient to continue all three medications and administer an antihistamine for the symptoms.

B

The nurse is preparing to administer a first dose of ado-trastuzumab emtansine [Kadcycla] to a patient who has metastatic breast cancer. Which nursing action is correct? a. Administer a test dose with an antihistamine. b. Ensure that the patient has HER2-positive disease. c. Infuse the initial dose over 30 to 45 minutes. d. Review renal function tests.

B

The nurse is preparing to discharge a patient with HIV who will continue to take enfuvirtide [Fuzeon] at home. The nurse is providing patient education about the medication. What information about the administration of enfuvirtide is most appropriate for the patient? a. The importance of injecting the drug into two alternating sites daily b. How to reconstitute and self-administer a subcutaneous injection c. The importance of taking the drug with high doses of vitamin E d. Likely drug interactions between enfuvirtide and other antiretroviral drugs

B

The nurse is providing education to a patient with ulcerative colitis who is being treated with sulfasalazine [Azulfidine]. What statement by the patient best demonstrates understanding of the action of sulfasalazine? a. "It treats the infection that triggers the condition." b. "It reduces the inflammation." c. "It enhances the immune response." d. "It increases the reabsorption of fluid."

B

The nurse is providing patient education to a patient who will begin taking fludrocortisone [Florinef] as adjunctive therapy to hydrocortisone. Which statement by the patient indicates understanding of the teaching? a. "I should move from sitting to standing slowly." b. "I should report any swelling of my hands and feet." c. "I should report weight loss to my provider." d. "I should report excessive urine output."

B

The nurse is teaching a patient about a medication that alters sympathetic nervous system functions. To evaluate understanding, the nurse asks the patient to describe which functions of the sympathetic nervous system regulates. Which answer indicates the need for further teaching? A. The 'fight-or-flight' response B. The digestive functions of the body C. Body Temperature D. The cardiovascular system

B

The nurse is teaching a patient who is newly diagnosed with myasthenia gravis about managing the disease. Which is important when teaching this patient about adverse effects of cholinesterase inhibitors? a. "There are very few serious side effects associated with your medication." b. "It is important to notify your provider if you have excessive saliva." c. "If you experience urinary urgency, you may need to increase your dose." d. "Excessive sweating is a minor side effect and will improve over time."

B

The nurse provides teaching for a patient who will begin taking rotigotine [Neupro] to treat Parkinson's disease. What will the nurse include in teaching? a. "If you develop nausea and vomiting, you should stop taking the medication." b. "If you need to stop this drug, your provider will order a gradual withdrawal." c. "You will start this drug regimen with a higher than usual loading dose." d. "You will take this medication by mouth with food."

B

The nurse would be correct to state that the purpose of angiogenesis inhibitors is to: A. enhance the size of collateral vessels. B. suppress the formation of new blood vessels in tumors. C. enhance red cell development in the bone marrow. D. kill existing cancer cells directly.

B

The nurse would be correct to state that the purpose of angiogenesis inhibitors is to: a. kill existing cancer cells directly. b. suppress the formation of new blood vessels in tumors. c. enhance the size of collateral vessels. d. enhance red cell development in the bone marrow.

B

What occurs when a drug binds to a receptor in the body? a. It alters the receptor to become nonresponsive to its usual endogenous molecules. b. It increases or decreases the activity of that receptor. c. It gives the receptor a new function. d. It prevents the action of the receptor by altering its response to chemical mediators.

B

Which are important considerations when spinal anesthesia is being administered? (Select all that apply.) A. Placing the agent into the spinal column outside the dura mater B. Encouraging the patient to remain supine after the procedure C. Using an anesthetic solution from a single-dose vial D. Having epinephrine available in case of adverse effects E. Injecting a local anesthetic into the sacral region

B,C,D

A nurse is teaching a group of nursing students about neuromuscular blocking agents. For what may these agents be used? (Select all that apply) A. Malignant hyperthermia B. surgery C. Mechanical ventilation D. Analgesia E. Electroshock therapy

B,C,E

A patient is brought to the emergency department after ingesting a handful of diphenhydramine [Benadryl] tablets. The patient has dilated pupils, a flushed face, and tremors. The patient is agitated and has a heart rate of 110 beats/min. The nurse may anticipate administering which agents? (Select all that apply.) A. Second- generation H1 antagonist B. Cathartics C. Lorazepam D. Atropine E. Activated charcoal

B,C,E

Amphotericin B is the drug of choice for which systemic mycosis? (Select all that apply.) a. Aspergillosis b. Candidiasis c. Dermatophytosis d. Histoplasmosis e. Mucormycosis

B,D,E

Clonidine is approved for the treatment of which conditions? (ISelect all that apply.) A. Smoking cessation B. Severe pain C. Opioid withdrawal D. Hypertension E. ADHD

B,D,E

2.A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet of Brand Y of the same drug. Both brands contain the same amount of the active ingredient. What does the nurse know to be most likely? a. Advertising by pharmaceutical companies can enhance patient expectations of one brand over another, leading to a placebo effect. b. Because the drug preparations are chemically equivalent, the effects of the two brands must be identical c. Tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug's effects in the body. d. The bioavailability of a drug is determined by the amount of the drug in each dose.

C

A 14-year-old male patient who plays football is admitted to the hospital. The nurse notes that the patient has short stature for his age according to a standard growth chart. The patient is muscular, has a deep voice, and needs to shave. The nurse notifies the provider of these findings. Which test will the nurse expect the provider to order? a. Coagulation studies b. Complete blood count (CBC) with differential c. Liver function tests and serum cholesterol d. Serum glucose and hemoglobin A1c

C

A 30-year-old male patient reports having two to four urinary tract infections a year. What will the nurse expect to teach this patient? a. "Make sure you void after intercourse and drink extra fluids to stay well hydrated." b. "We will treat each infection as a separate infection and treat with short-course therapy." c. "You will need to take a low dose of medication for 6 months to prevent infections." d. "You will need to take antibiotics for 4 to 6 weeks each time you have an infection."

C

A 30-year-old male patient will begin a three-drug regimen to treat peptic ulcer disease. The regimen will consist of bismuth subsalicylate, tetracycline, and cimetidine [Tagamet]. The nurse will include which information when teaching this patient about this drug regimen? a. Black discoloration of the tongue and stools should be reported immediately. b. Central nervous system depression and confusion are likely to occur. c. Decreased libido, impotence, and gynecomastia are reversible side effects. d. Staining of the teeth may occur and is an indication for discontinuation of these drugs.

C

A 4-year-old child is brought to the emergency department with symptoms of nausea and vomiting and a weak, thready pulse of 120 beats per minute after ingesting several cigarettes at home. The nurse caring for this child will expect to provide which treatment? A. Hemodialysis B. Vasoconstrictors C. Respiratory support D. Gastric lavage

C

A 55-year-old female patient asks a nurse about calcium supplements. The nurse learns that the patient consumes two servings of dairy products each day. The patient's serum calcium level is 9.5 mg/dL. The serum vitamin D level is 18 ng/mL. The nurse will recommend adding ____ daily and ____ IU of vitamin D3 each day. a. 1200 mg of calcium once; 10,000 b. 1500 mg of calcium twice; 1000 c. 600 mg of calcium once; 10,000 d. 600 mg of calcium twice; 2000

C

A 6-year-old child has frequent constipation. The nurse provides teaching after the parent asks the nurse why the provider recommended using laxatives only when needed. Which statement by the parent indicates a need for further teaching? a. "Children who take laxatives regularly can become dehydrated." b. "Chronic laxative use can cause electrolyte imbalances." c. "Frequent use of laxatives can cause diverticulitis." d. "The normal reflex to defecate can be inhibited with overuse of laxatives."

C

A child has received amoxicillin [Amoxil] for three previous ear infections, but a current otitis media episode is not responding to treatment. The nurse caring for this child suspects that resistance to the bacterial agent has occurred by which microbial mechanism? a. Alteration of drug target molecules b. Antagonist production c. Drug inactivation d. Reduction of drug concentration at the site of action

C

A child has ringworm of the scalp. A culture of the lesion reveals a dermatophytic infection. The nurse teaching the child's parents about how to treat this infection will include which statement? a. "Adverse effects of the medication include itching, burning, and erythema." b. "Apply the topical medication daily until at least 1 week after the rash is gone." c. "Your child will need to take this oral medication for 6 to 8 weeks." d. "You will use an antifungal shampoo to treat this infection."

C

A child who has juvenile idiopathic arthritis and who has been taking methotrexate [Rheumatrex] will begin a course of abatacept [Orencia]. What will the nurse include when teaching the child's family about this drug? a. That abatacept and methotrexate must both be taken to be effective b. To continue getting vaccinations during therapy with abatacept c. That signs of infection may warrant immediate discontinuation of abatacept d. That a tumor necrosis factor (TNF) antagonist may be added if this therapy is not effective

C

A child who receives valproic acid [Depakote] begins taking lamotrigine [Lamictal] because of an increase in the number of seizures. The nurse will observe this child closely for which symptom? a. Angioedema b. Hypohidrosis c. Rash d. Psychosis

C

A clinic patient who has been taking a glucocorticoid for arthritis for several months remarks to the nurse, "It's a good thing my symptoms are better, because my mother has been quite ill, and I have to take care of her." The patient's blood pressure is 100/60 mm Hg. The nurse will report this to the provider and ask about: a. reducing the patient's dose. b. using every other day dosing. c. increasing the patient's dose. d. tapering the dose.

C

A clinic patient who has cirrhosis of the liver develops hypervolemic hypernatremia. Which medication will the nurse expect the provider to order? a. Conivaptan [Vaprisol] b. Desmopressin [DDAVP] c. Tolvaptan [Samsca] d. Vasopressin [Pitressin]

C

A college student who is unresponsive is brought to the emergency department by friends, who say that their friend drank more than half of a large bottle of whiskey 3 hours ago. Assessment reveals a blood alcohol level of 0.32%. The vital signs are BP, 88/32 mm Hg; R, 6/min; T, 96.8°F; and P, 76/min and weak and thready. The nurse should prepare the patient for which intervention? a. IV fluids and stimulants b. Charcoal administration c. Gastric lavage and dialysis d. Naloxone [Narcan] administration

C

A healthcare worker who is asymptomatic has a screening TST result of 10 mm of induration during a pre-employment physical. What will the nurse reading this test tell the patient? a. "This is a negative test, so you are cleared for employment." b. "You have latent TB and will need to take isoniazid for 6 to 9 months." c. "You need to have a chest radiograph and a sputum culture." d. "You will begin taking a four-drug regimen to treat tuberculosis."

C

A hospitalized patient complains of acute chest pain. The nurse administers a 0.3-mg sublingual nitroglycerin tablet, but the patient continues to complain of pain. Vital signs remain stable. What is the nurse's next step? a. Apply a nitroglycerin transdermal patch. b. Continue dosing at 10-minute intervals. c. Give a second dose of nitroglycerin in 5 minutes. d. Request an order for intravenous nitroglycerin.

C

A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will the nurse do? a. Instruct the patient not to get up without assistance. b. Make sure the patient takes a potassium supplement. c. Report the presence of a dry cough to the prescriber. d. Request an order for a diuretic to counter the side effects of the ACE inhibitor.

C

A nurse administers the same medication in the same preparation in the same dose to several patients and notes that some patients have a better response to the drug than others. What is the most likely explanation for this phenomenon? a. Altered bioavailability of the drug b. Patient compliance with the therapeutic regimen c. Pharmacogenomic defferences among individuals d. Placebo effects enhancing expectations of drug efficacy

C

A nurse caring for a patient who is undergoing a third round of chemotherapy is preparing to administer ondansetron [Zofran] 30 minutes before initiation of the chemotherapy. The patient tells the nurse that the ondansetron did not work as well the last time as it had the first time. What will the nurse do? a. Administer the ondansetron at the same time as the chemotherapy. b. Contact the provider to suggest using high-dose intravenous dolasetron [Anzemet]. c. Request an order to administer dexamethasone with the ondansetron. d. Suggest to the provider that loperamide [Lomotil] be given with the ondansetron.

C

A nurse explains to a patient with cancer why it is difficult to achieve 100% cell kill to cure cancer with chemotherapy. Which statement by the patient indicates a need for further teaching? a. "It is necessary to continue giving the same dose of chemotherapeutic agents throughout therapy, even if toxicity occurs." b. "Symptoms of cancer often disappear before all malignant cells are eradicated." c. "The immune system attacks chemotherapeutic agents and renders them impotent." d. "The immune system often fails to recognize cancer cells as foreign."

C

A nurse is administering drug X to a patient. The drug information states that the drug acts by activating receptors in the peripheral nervous system by increasing transmitter synthesis. The nurse understands that the effect of this drug is to: a. activate axonal conduction. b. enhance transmitter storage. c. Increase receptor activation d. synthesize supertransmitters.

C

A nurse is admitting a patient to the hospital who reports having recurrent, crampy abdominal pain followed by diarrhea. The patient tells the nurse that the diarrhea usually relieves the pain and that these symptoms have occurred daily for the past 6 months. The patient undergoes a colonoscopy, for which the findings are normal. The nurse will plan to teach this patient to: a. use antispasmodic medications. b. avoid food containing lactose and gluten. c. keep a food, stress, and symptom diary. d. use antidiarrheal drugs to manage symptoms.

C

A nurse is caring for a patient who takes an ACE inhibitor and an ARB medication who will begin taking TMP/SMZ to treat a urinary tract infection. Which serum electrolyte will the nurse expect to monitor closely? a. Calcium b. Chloride c. Potassium d. Sodium

C

A nurse is discussing fibrinolytic therapy for the acute phase of STEMI management with a group of nursing students. Which statement by a student indicates understanding of this therapy? a. "Fibrinolytics are effective when the first dose is given up to 24 hours after symptom onset." b. "Fibrinolytics should be given once cardiac troponins reveal the presence of STEMI." c. "Fibrinolytics should be used with caution in patients with a history of cerebrovascular accident." d. "Patients should receive either an anticoagulant or an antiplatelet agent with a fibrinolytic drug."

C

A nurse is discussing intravenous amphotericin B treatment with a nursing student who is about to care for a patient with a systemic fungal infection. Which statement by the student indicates a need for further teaching? a. "A test dose of amphotericin B may be given to assess the patient's reaction." b. "If I see any precipitate in the IV solution, I should stop the infusion immediately." c. "Infusions of amphotericin B should be administered over 1 to 2 hours." d. "The IV site should be rotated frequently to reduce the risk of phlebitis."

C

A nurse is discussing various ways to obtain a medical abortion with a patient. Which statement by the patient best demonstrates understanding of mifepristone (RU 486) [Mifeprex]? "This drug is most effective if I use it: a. before the first missed menstrual period." b. the day after unprotected intercourse." c. within 7 weeks of conception." d. immediately after ovulation."

C

A nurse is discussing vesicant chemotherapeutic agents with a nursing student. Which statement by the student indicates a need for further teaching about this type of drug? a. "Extravasation of this type of drug may result in the need for skin grafts." b. "If an IV line used for a vesicant drug infiltrates, it must be discontinued immediately." c. "These drugs may be administered orally as well as intravenously." d. "This type of drug may not be infused at a site of previous irradiation."

C

A nurse is explaining to nursing students why a cephalosporin is used in conjunction with an aminoglycoside for a patient with an infection. Which statement by a student indicates understanding of the teaching? A. "Cephalosporins reduce bacterial resistance to aminoglycosides." B. "Cephalosporins prevent neuromuscular blockade associated with aminoglycosides." C. "Cephalosporins enhance the actions of aminoglycosides by weakening bacterial cell walls." D. "Cephalosporins prolong the post antibiotic effects of the aminoglycosides so doses can be decreased."

C

A nurse is preparing a patient to go home from the emergency department after receiving sutures for a laceration on one hand. The provider used lidocaine with epinephrine as a local anesthetic. Which symptom in this patient causes the most concern? a. Difficulty moving the fingers of the affect-ed hand b. Inability to feel pressure at the suture site c. Nervousness and tachycardia d. Sensation of pain returning to the wound

C

A nurse is preparing to administer a second infusion of trastuzumab [Herceptin] to a patient who has breast cancer. The patient tells the nurse that she experienced chills, fever, pain, and nausea after her first infusion. What will the nurse do? a. Contact the provider to request a CBC to assess for neutropenia. b. Ensure that oxygen and respiratory support measures are readily available. c. Reassure the patient that these symptoms will diminish with each infusion. d. Request an order for an electrocardiogram.

C

A nurse is preparing to administer intramuscular penicillin to a patient who is infected with Treponema pallidum and notes that the order is for sodium penicillin G. Which action is correct? A. Administer the drug as prescribed. B. Request an order for piperacillin instead of penicillin G. C. Contact the provider to discuss changing the drug to benzathine penicillin G. D. Contact the provider to discuss administering the drug intravenously

C

A nurse is preparing to teach a forgetful older adult patient about a multiple drug regimen to follow after discharge from the hospital. To help promote adherence, what will the nurse do? a. Ask the patient to share the teaching with a neighbor or friend soon after discharge. b. Give the patient detailed written information about each drug. c. Cluster medication administration times as much as possible. d. Make sure the patient understands the actions and side effects of each drug.

C

A nurse is providing teaching for a patient with osteoporosis who has just switched from alendronate [Fosamax] to zoledronate [Reclast]. Which statement by the patient indicates a need for further teaching? a. "I will need to have blood tests periodically while taking this drug." b. "I will only need a dose of this medication every 1 to 2 years." c. "This drug is less likely to cause osteonecrosis of the jaw." d. "This drug is only given intravenously."

C

A nurse is reviewing a patient's medications before administration. Which drug-to-drug interactions will most concern the nurse in a patient with a history of heart failure and a potassium level of 5.5 mEq/L? a. Furosemide [Lasix] and enalapril [Vasotec] b. Amlodipine [Norvasc] and spironolactone [Aldactone] c. Captopril [Capoten] and spironolactone [Aldactone] d. Metoprolol [Lopressor] and furosemide [Lasix]

C

A nurse is reviewing an older adult patient's chart before giving medications. Which patient information is of most concern? a. Chronic constipation b. Increased body fat c. Low serum albumin d. Low serum creatinine

C

A nurse is reviewing the culture results of a patient receiving an aminoglycoside. The report reveals an anaerobic organism as the cause of infection. What will the nurse do? a. Contact the provider to discuss an increased risk of aminoglycoside toxicity. b. Continue giving the aminoglycoside as ordered. c. Request an order for a different class of antibiotic. d. Suggest adding a penicillin to the patient's drug regimen.

C

A nurse is teaching a nursing student who wants to know how aspirin and nonaspirin first-generation NSAIDs differ. Which statement by the student indicates a need for further teaching? a. "Unlike aspirin, first-generation NSAIDs cause reversible inhibition of cyclooxygenase." b. "NSAIDs do not increase the risk of myocardial infarction and stroke; however, unlike ASA, they do not provide protective benefits against those conditions." c. "Unlike aspirin, first-generation NSAIDs do not carry a risk of hypersensitivity reactions." d. "Unlike aspirin, first-generation NSAIDs cause little or no suppression of platelet aggregation."

C

A nurse is teaching nursing students about the pharmacology of methyldopa. Which statement by a student indicates the need for further teaching? a. "Methyldopa results in alpha2 agonist activation, but it is not itself an alpha2 agonist." b. "Methyldopa is not effective until it is converted to an active compound." c. "Methyldopa reduces blood pressure by reducing cardiac output." d. "Methyldopa's principal mechanism is vasodilation, not cardiosuppression."

C

A nurse provides teaching for a patient with cytomegalovirus (CMV) retinitis who will receive the ganciclovir ocular implant [Vitrasert]. Which statement by the patient indicates a need for further teaching? a. "My vision may be blurred for 2 to 4 weeks after receiving the implant." b. "Surgical placement of the implant is an outpatient procedure." c. "The implant will remain in place permanently." d. "The implant will slow progression of CMV retinitis."

C

A nurse provides teaching to a patient who has had a hysterectomy and is about to begin hormone therapy to manage menopausal symptoms. Which statement by the patient indicates understanding of the teaching? a. "Because I am not at risk for uterine cancer, I can take hormones indefinitely." b. "I can take estrogen to reduce my risk of cardiovascular disease." c. "I should take the lowest effective dose for the shortest time needed." d. "I will need a progestin/estrogen combination since I have had a hysterectomy."

C

A nurse provides teaching to a patient who has undergone kidney transplantation and will begin taking cyclosporine [Sandimmune], a glucocorticoid, and sirolimus [Rapamune]. Which statement by the patient indicates understanding of the teaching? a. "I should take sirolimus at the same time as the cyclosporine." b. "I will need to have my blood sugar checked regularly." c. "I will need to take an antibiotic to prevent lung infections." d. "Taking this combination of drugs lowers my risk of kidney damage."

C

A nurse tells a nursing student that the glucocorticoids given for rheumatoid arthritis are nearly identical to substances produced naturally by the body. The student remarks that the drug must be very safe. Which response by the nurse is correct? a. "As long as the drug is taken as prescribed, side effects usually do not occur." b. "By interrupting the inflammatory process, these drugs inhibit side effects." c. "Side effects can occur and are dependent on the dose and duration of treatment." d. "The negative feedback loop prevents side effects."

C

A nurse working in the emergency department is assigned to a child who is arriving by ambulance after being involved in a spill of organophosphate insecticides. What will the nurse expect to be the initial priority for treating this child? a. Administering diphenhydramine to control secretions b. Giving diazepam to control seizures c. Providing mechanical ventilation and oxygen d. Reporting the spill to the Environmental Protection Agency

C

A nursing student asks a nurse how cancer cells become resistant to methotrexate [Rheumatrex]. The nurse is correct to respond by saying that cancer cells acquire resistance to methotrexate by: a. reduced production of transporter that pumps methotrexate out of cells. b. reduced synthesis of dihydrofolate reductase. c. reduced uptake of methotrexate into cells. d. increased ability to convert the drug to a polyglutamated form.

C

A nursing student asks a nurse to clarify the differences between the mechanisms of spontaneous mutation and conjugation in acquired resistance of microbes. What will the nurse say? a. Conjugation results in a gradual increase in resistance. b. Conjugation results in random changes in the microbe's DNA. c. Spontaneous mutation leads to resistance to only one antimicrobial agent. d. Spontaneous mutation can transfer DNA from one organism to another.

C

A nursing student asks a nurse to explain the differences between amphotericin B [Abelcet] and the azoles group of antifungal agents. Which statement by the nurse is correct? a. "Amphotericin B can be given orally or intravenously." b. "Amphotericin B increases the levels of many other drugs." c. "Azoles have lower toxicity than amphotericin B." d. "Only the azoles are broad-spectrum antifungal agents."

C

A nursing student asks a nurse why pegylated interferon alfa is used instead of regular interferon for a patient with hepatitis C. The nurse will tell the student that pegylated interferon: a. decreases the need for additional medications. b. has fewer adverse effects than interferon. c. is administered less frequently than interferon. d. may be given orally to increase ease of use.

C

A nursing student is preparing to give a medication that has a boxed warning. The student asks the nurse what this means. What will the nurse explain about boxed warnings? a. They indicate that a drug should not be given except in life-threatening circumstances. b. They provide detailed information about the adverse effects of the drug. c. They alert prescribers to measures to mitigate potential harm from side effects. d. They proved information about antibiotics in the even that toxicity occurs

C

A patient asks a nurse why he cannot use digoxin [Lanoxin] for his heart failure, because both of his parents used it for HF. The nurse will explain that digoxin is not the first-line therapy for which reason? A. It causes tachycardia and increases the cardiac workload. B. It has a wide therapeutic range that makes dosing difficult. C. It does not correct the underlying pathology of heart failure. D. It may actually shorten the patient's life expectancy.

C

A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet of Brand Y of the same drug. Both brands contain the same amount of the active ingredient. What does the nurse know to be most likely? A. Because the drug preparations are chemically equivalent, the effects of the two brands must be identical B. Advertising by pharmaceutical companies can enhance patient expectations of one brand over another, leading to a placebo effect. C. Tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug's effects in the body. D. The bioavailability of a drug is determined by the amount of the drug in each dose.

C

A patient has an infection caused by Streptococcus pyogenes. The prescriber has ordered dicloxacillin PO. What will the nurse do? a. Administer the medication as ordered. b. Contact the provider to suggest giving the drug IV. c. Question the need for a penicillinase-resistant penicillin. d. Suggest ordering vancomycin to treat this infection.

C

A patient has been taking chlorthalidone to treat hypertension. The patient's prescriber has just ordered the addition of spironolactone to the patient's drug regimen. Which statement by the patient indicates a need for further teaching? A. "I will not experience a significant increase in diuresis when adding this drug." B. "I should not take an ACE inhibitor when adding this drug." C. "I will need to take potassium supplements when adding this drug." D. "I should continue following the DASH diet when adding this drug."

C

A patient has been taking chlorthalidone to treat hypertension. The patient's prescriber has just ordered the addition of spironolactone to the patient's drug regimen. Which statement by the patient indicates a need for further teaching? a. "I should continue following the DASH diet when adding this drug." b. "I should not take an ACE inhibitor when adding this drug." c. "I will need to take potassium supplements when adding this drug." d. "I will not experience a significant increase in diuresis when adding this drug."

C

A patient has been taking isoniazid [Nydrazid] for 4 months for latent tuberculosis. The patient reports bilateral tingling and numbness of the hands and feet, as well as feeling clumsy. The nurse expects the provider to: a. discontinue the isoniazid. b. lower the isoniazid dose and add rifampin. c. order pyridoxine 100 mg per day. d. recheck the tuberculin skin test to see whether it worsens.

C

A patient has been taking narcotic analgesics for chronic pain for several months. The nurse caring for this patient notes that the prescribed dose is higher than the recommended dose. The patient has normal vital signs, is awake and alert, and reports mild pain. What does the nurse recognize about this patient? a. This patient exhibits a negative placebo effect with a reduced response to the drug. b. This patient has developed a reaction known as tachyphylaxis because of repeated exposure to the drug. c. This patient has developed pharmacodynamic tolerance, which has increased the minimal effective concentration (MEC) needed for analgesic effect. d. This patient produces higher than normal hepatic enzymes as a result of prolonged exposure to the drug.

C

A patient has severe Paget's disease of the bone. The patient asks the nurse what can be done to alleviate the pain. The nurse will suggest that the patient discuss the use of which medication with the provider? a. Alendronate [Fosamax] b. Calcifediol [25-Hydroxy-D3] c. Calcitonin-salmon [Miacalcin] d. Long-acting NSAIDs

C

A patient is about to receive penicillin G for an infection that is highly sensitive to this drug. While obtaining the patient's medication history, the nurse learns that the patient experienced a rash when given amoxicillin [Amoxil] as a child 20 years earlier. What will the nurse do? a. Ask the provider to order a cephalosporin. b. Reassure the patient that allergic responses diminish over time. c. Request an order for a skin test to assess the current risk. d. Suggest using a desensitization schedule to administer the drug.

C

A patient is admitted to the intensive care unit for treatment of shock. The prescriber orders isoproterenol [Isuprel]. The nurse expects this drug to increase tissue perfusion in this patient by activating: A. Alpha1 receptors to increase blood pressure B. Beta2 receptors to cause bronchodilation C. Beta1 receptors to cause a positive inotropic effect D. Alpha1 receptors to cause vasodilation

C

A patient is admitted with lower abdominal pain and nausea. The nurse performing the initial assessment notes that the patient's abdomen is distended and firm, and hypoactive bowel sounds are present. The patient has not had a stool for 3 days. The nurse will contact the provider, who will: a. order a bulk-forming laxative. b. order extra fluids and fiber. c. perform diagnostic tests. d. prescribe a cathartic laxative.

C

A patient is being treated for chemotherapy-induced nausea and vomiting (CINV) with ondansetron [Zofran] and dexamethasone. The patient reports getting relief during and immediately after chemotherapy but has significant nausea and vomiting several days after each chemotherapy treatment. What will the nurse do? A. Contact the provider to discuss increasing the dose of ondansetron. B. Tell the patient to ask the provider about changing the ondansetron to aprepitant. C. Suggest adding aprepitant [Emend] to the medication regimen. D. Suggest giving prolonged doses of dexamethasone.

C

A patient is being treated for chemotherapy-induced nausea and vomiting (CINV) with ondansetron [Zofran] and dexamethasone. The patient reports getting relief during and immediately after chemotherapy but has significant nausea and vomiting several days after each chemotherapy treatment. What will the nurse do? a. Contact the provider to discuss increasing the dose of ondansetron. b. Suggest giving prolonged doses of dexamethasone. c. Suggest adding aprepitant [Emend] to the medication regimen. d. Tell the patient to ask the provider about changing the ondansetron to aprepitant.

C

A patient is being treated with amphotericin B [Abelcet] for a systemic fungal infection. After several weeks of therapy, the provider orders flucytosine [Ancobon] in addition to the amphotericin. The nurse understands that the rationale for this combination is that it: a. broadens the antifungal spectrum. b. improves the effectiveness of the amphotericin B. c. lowers the dose of amphotericin B and reduces toxicity. d. treats fungal central nervous system (CNS) infection.

C

A patient is diagnosed with Zollinger-Ellison syndrome. Which medication does the nurse expect the provider to order for this patient? A. Cimetidine [Tagamet] B. Esomeprazole [Nexium] C. Ranitidine [Zantac] D. Sucralfate [Carafate]

C

A patient is diagnosed with Zollinger-Ellison syndrome. Which medication does the nurse expect the provider to order for this patient? a. Cimetidine [Tagamet] b. Esomeprazole [Nexium] c. Ranitidine [Zantac] d. Sucralfate [Carafate]

C

A patient is diagnosed with anxiety after describing symptoms of tension, poor concentration, and difficulty sleeping that have persisted for over 6 months. Which medication will the nurse expect the provider to order for this patient? a. Alprazolam [Xanax] b. Amitriptyline [Elavil] c. Buspirone [Buspar] d. Paroxetine [Paxil]

C

A patient is diagnosed with pelvic inflammatory disease (PID). Which treatment regimen is most appropriate for reducing the risk of sterility in this patient? a. Azithromycin [Zithromax], 1 gm PO once, and cefoxitin, 2 gm IM once in the clinic b. Ceftriaxone [Rocephin], 250 mg IM once, with doxycycline [Vibramycin], 100 mg PO twice daily for 14 days as an outpatient c. Doxycycline [Vibramycin], 100 mg IV twice daily, and cefoxitin, 2 gm IV every 6 hours in the hospital d. Doxycycline [Vibramycin], 100 mg PO twice daily for 14 days, and metronidazole [Flagyl], 500 mg PO twice daily for 14 days in the hospital

C

A patient is receiving intravenous potassium penicillin G, 2 million units to be administered over 1 hour. At 1900, the nurse notes that the dose hung at 1830 has infused completely. What will the nurse do? a. Assess the skin at the infusion site for signs of tissue necrosis. b. Observe the patient closely for confusion and other neurotoxic effects. c. Request an order for serum electrolytes and cardiac monitoring. d. Watch the patient's actions and report any bizarre behaviors.

C

A patient is taking a beta1-adrenergic drug to improve the stroke volume of the heart. The nurse caring for this patient knows that this drug acts by increasing: A. venous return. B. cardiac afterload. C. myocardial contractility. D. cardiac preload.

C

A patient is taking a combination oral contraceptive (OC) and reports breast tenderness, edema, a. The patient should ask her provider about an OC with less progestin. b. The patient should discuss an alternate method of birth control. c. The patient should request an OC containing less estrogen. d. The patient should take the OC at bedtime to reduce side effects.

C

A patient is taking an FGA for schizophrenia. The nurse notes that the patient has trouble speaking and chewing and observes slow, worm-like movements of the patient's tongue. The nurse recognizes which adverse effect in this patient? A. Acute dystonia B. Akathisia C. Tardive dyskinesia D. Parkinsonism

C

A patient is taking gentamicin [Garamycin] and furosemide [Lasix]. The nurse should counsel this patient to report which symptom? A. Frequent nocturia B. Headaches C. Ringing in the ears D. Urinary retention

C

A patient is taking gentamicin [Garamycin] and furosemide [Lasix]. The nurse should counsel this patient to report which symptom? a. Frequent nocturia b. Headaches c. Ringing in the ears d. Urinary retention

C

A patient is to begin taking doxycycline to treat a rickettsial infection. Which statement by the patient indicates a need for teaching about this drug? a. "I should consult my provider before using laxatives or antacids while taking this drug." b. "I should not take a calcium supplement or consume dairy products with this drug." c. "I should take this drug with food to ensure more complete absorption." d. "If I get diarrhea, I should stop taking the drug and let my provider know immediately."

C

A patient newly diagnosed with Parkinson's disease has been taking levodopa/carbidopa [Sinemet] for several weeks and complains of nausea and vomiting. The nurse tells the patient to discuss what with the provider? a. Taking a lower dose on an empty stomach b. Taking an increased dose along with a high-protein snack c. Taking a lower dose with a low-protein snack d. Taking dopamine in addition to levodopa/carbidopa

C

A patient presents to the emergency department with complaints of chills, severe flank pain, dysuria, and urinary frequency. The patient has a temperature of 102.9°F, a pulse of 92 beats per minute, respirations of 24 breaths per minute, and a blood pressure of 119/58 mm Hg. The nurse would be correct to suspect that the patient shows signs and symptoms of: a. acute cystitis. b. urinary tract infection. c. pyelonephritis. d. prostatitis.

C

A patient received 500 mg of azithromycin [Zithromax] at 0800 as a first dose. What are the usual amount and time of the second dose of azithromycin? a. 250 mg at 2000 the same day b. 500 mg at 2000 the same day c. 250 mg at 0800 the next day d. 500 mg at 0800 the next day

C

A patient receives a neuromuscular blocking agent before a procedure. The patient's eyes close. The nurse knows this is a sign that the patient: a. has fallen asleep. b. has received a toxic dose of the medication. c. is beginning to feel the drug's effects. d. may need mechanical ventilation

C

A patient recently began receiving clindamycin [Cleocin] to treat an infection. After 8 days of treatment, the patient reports having 10 to 15 watery stools per day. What will the nurse tell this patient? a. The provider may increase the clindamycin dose to treat this infection. b. This is a known side effect of clindamycin, and the patient should consume extra fluids. c. The patient should stop taking the clindamycin now and contact the provider immediately. d. The patient should try taking Lomotil or a bulk laxative to minimize the diarrheal symptoms.

C

A patient reports becoming "immune" to a medication because it no longer works to alleviate symptoms. The nurse recognizes that this decreased effectiveness is likely caused by: a. antagonists produced by the body that compete with the drug for receptor sites. b. decreased selectivity of receptor sites, resulting in a variety of effects. c. desensitization of receptor sites by continual exposure to the drug d. synthesis of more receptor sites in response to the medication.

C

A patient tells the nurse that she takes aspirin for menstrual cramps, but she does not feel that it works well. What will the nurse suggest? a. The patient should avoid any type of COX inhibitor because of the risk of Reye's syndrome. b. The patient should increase the dose to a level that suppresses inflammation. c. The patient should use a first-generation nonsteroidal anti-inflammatory medication instead. d. The patient should use acetaminophen because of its selective effects on uterine smooth muscle.

C

A patient who has a lower back injury exhibits muscle spasms. The provider orders cyclobenzaprine [Flexeril] 10 mg three times a day. What will the nurse include when teaching this patient about this drug? a. "This drug carries some risk of developing hallucinations and psychotic symptoms." b. "This medication may cause your urine to turn brown, black, or dark green." c. "You may experience blurred vision, dry mouth, or constipation." d. "You will need to have liver function tests performed while taking this medication."

C

A patient who has been taking linezolid [Zyvox] for 6 months develops vision problems. What will the nurse do? a. Reassure the patient that this is a harmless side effect of this drug. b. Tell the patient that blindness is likely to occur with this drug. c. Tell the patient that this symptom is reversible when the drug is discontinued. d. Tell the patient to take tyramine supplements to minimize this effect.

C

A patient who has developed postmenopausal osteoporosis will begin taking alendronate [Fosamax]. The nurse will teach this patient to take the drug: a. at bedtime to minimize adverse effects. b. for a maximum of 1 to 2 years. c. while sitting upright with plenty of water. d. with coffee or orange juice to increase absorption.

C

A patient who has diabetes mellitus is diagnosed with schizophrenia and the provider orders thioridazine. The patient asks the nurse why the provider hasn't ordered olanzapine [Zyprexa], which the patient has seen advertised on television. Which response by the nurse is the most important reason that this patient is not receiving olanzapine? A. "Thioridazine has fewer side effects than olanzapine." B. "Olanzapine is more expensive than thioridazine." C. "Olanzapine causes more metabolic side effects than thioridazine." D. "Thioridazine has a faster onset of action than olanzapine."

C

A patient who has obsessive-compulsive disorder (OCD) has been undergoing behavioral therapy but continues to exhibit symptoms that interfere with daily life. Which intervention will the nurse expect the provider to order for this patient? A. Alprazolam [Xanax] B. Deep brain stimulation C. Fluoxetine [Paxil] D. Buspirone [Buspar]

C

A patient who is pregnant has a history of recurrent genital herpesvirus (HSV). The patient asks the nurse what will be done to suppress an outbreak when she is near term. The nurse will tell the patient that: a. antiviral medications are not safe during pregnancy. b. intravenous antiviral agents will be used if an outbreak occurs. c. oral acyclovir [Zovirax] may be used during pregnancy. d. topical acyclovir [Zovirax] must be used to control outbreaks.

C

A patient who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of pain and irritation at the infusion site. The nurse observes signs of redness at the IV insertion site and along the vein. What is the nurse's priority action? a. Apply warm packs to the arm, and infuse the medication at a slower rate. b. Continue the infusion while elevating the arm. c. Select an alternate intravenous site and administer the infusion more slowly. d. Request central venous access.

C

A patient who is taking doxycycline for a serious infection contacts the nurse to report anal itching. The nurse will contact the provider to discuss: a. adding an antihistamine to the patient's drug regimen. b. ordering liver function tests to test for hepatotoxicity. c. prescribing an antifungal drug to treat a superinfection. d. testing the patient for a C. difficile secondary infection.

C

A patient who is taking immunosuppressant medications develops a urinary tract infection. The causative organism is sensitive to sulfonamides and to another, more expensive antibiotic. The prescriber orders the more expensive antibiotic. The nursing student assigned to this patient asks the nurse why the more expensive antibiotic is being used. Which response by the nurse is correct? a. "Immunosuppressed patients are folate deficient." b. "Patients who are immunosuppressed are more likely to develop resistance." c. "Sulfonamides are bacteriostatic and depend on host immunity to work." d. "Sulfonamides intensify the effects of immunosuppression."

C

A patient who takes daily doses of aspirin is scheduled for surgery next week. The nurse should advise the patient to: a. continue to use aspirin as scheduled. b. reduce the aspirin dosage by half until after surgery. c. stop using aspirin immediately. d. stop using aspirin 3 days before surgery.

C

A patient who takes nonsteroidal anti-inflammatory drugs (NSAIDs) for arthritis asks a nurse what can be done to prevent ulcers. The nurse will recommend asking the provider about using which medication? a. Antibiotics b. Histamine-2 receptor antagonists c. Proton pump inhibitors d. Mucosal protectants

C

A patient will begin taking an immunosuppressant medication. The nurse learns that the patient has a history of frequent candidal infections. The nurse will expect the provider to order which drug as prophylaxis? a. Fluconazole [Diflucan] b. Ketoconazole c. Posaconazole [Noxafil] d. Voriconazole [Vfend]

C

A patient will begin taking etanercept [Enbrel] for severe rheumatoid arthritis. The patient has been taking methotrexate [Rheumatrex]. The patient asks if the etanercept is stronger than the methotrexate. The nurse will tell the patient that etanercept ____ methotrexate. A. has synergistic effects with B. helps reduce adverse effects associated with C. is better at delaying progression of joint damage than D. has fewer adverse effects than

C

A patient will begin taking etanercept [Enbrel] for severe rheumatoid arthritis. The patient has been taking methotrexate [Rheumatrex]. The patient asks if the etanercept is stronger than the methotrexate. The nurse will tell the patient that etanercept ____ methotrexate. a. has synergistic effects with b. helps reduce adverse effects associated with c. is better at delaying progression of joint damage than d. has fewer adverse effects than

C

A patient will begin treatment with posaconazole [Noxafil] to treat oropharyngeal candidiasis that has not responded to fluconazole. The provider has ordered 200 mg three times daily. Which action by the nurse is correct? a. Administer the drug as ordered. b. Contact the provider to discuss decreasing the dose to twice daily. c. Discuss a 400-mg twice daily drug regimen with the provider. d. Suggest to the provider that this dose may be too high for this indication.

C

A patient with CRF who will begin receiving an erythropoiesis stimulating agent (ESA) is admitted to the hospital. The nurse notes that the patient's heart rate is 82 beats/min, and the blood pressure is 140/100 mm Hg. A complete blood count reveals a hemoglobin of 8 gm/dL and a hematocrit of 29%. What will the nurse do? A. Administer the ESA and request an order for a blood transfusion B. Suggest initiating dialysis while giving ESA C. Withhold the ESA and request an order for an antihypertensive medication D. Request an order to increase the dose of ESA to raise the hemoglobin more quickly

C

A patient with Crohn's disease will begin receiving an initial infusion of infliximab [Remicade]. The nurse explains how this drug works to treat this disease. Which statement by the patient indicates a need for further teaching? a. "I may have an increased risk of infections, such as tuberculosis, when taking infliximab." b. "I should report chills, fever, itching, and shortness of breath while receiving the infusion." c. "This drug sometimes provides a complete cure of inflammatory bowel disease." d. "I will take the second dose in 2 weeks, the third dose in 6 weeks, and then a dose every 8 weeks thereafter."

C

A patient with a form of epilepsy that may have spontaneous remission has been taking an AED for a year. The patient reports being seizure free for 6 months and asks the nurse when the drug can be discontinued. What will the nurse tell the patient? a. AEDs must be taken for life to maintain remission. b. Another AED will be substituted for the current AED. c. The provider will withdraw the drug over a 6- to 12-week period. d. The patient should stop taking the AED now and restart the drug if seizures recur.

C

A patient with a history of chronic alcohol abuse has been admitted to the unit with cirrhosis. Upon review of the patient's laboratory test results, the nurse notes that the patient's ammonia level is elevated at 218 mcg/dL. What medication should the nurse prepare to administer? a. 0.9% NS b. Docusate sodium [Colace] c. Lactulose d. Polyethylene glycol [MiraLax]

C

A patient with a new-onset seizure disorder receives a prescription for phenobarbital. The patient reports being concerned about the sedative side effects of this drug. Which response by the nurse is correct? A. "Tolerance to the sedative effects will develop in a few weeks." B. "This is a short-acting barbiturate, so sedation wears off quickly." C. "Phenobarbital doses for seizures are nonsedating." D. "You may actually experience paradoxical effects of euphoria."

C

A patient with a seizure disorder is admitted to the hospital and has a partial convulsive episode shortly after arriving on the unit. The patient has been taking phenytoin [Dilantin] 100 mg three times daily and oxcarbazepine [Trileptal] 300 mg twice daily for several years. The patient's phenytoin level is 8.6 mcg/mL, and the oxcarbazepine level is 22 mcg/mL. The nurse contacts the provider to report these levels and the seizure. What will the nurse expect the provider to order? a. A decreased dose of oxcarbazepine b. Extended-release phenytoin c. An increased dose of phenytoin d. Once-daily dosing of oxcarbazepine

C

A patient with an infection caused by Pseudomonas aeruginosa is being treated with piperacillin. The nurse providing care reviews the patient's laboratory reports and notes that the patient's blood urea nitrogen and serum creatinine levels are elevated. The nurse will contact the provider to discuss: a. adding an aminoglycoside. b. changing to penicillin G. c. reducing the dose of piperacillin. d. ordering nafcillin.

C

A patient with bronchitis is taking TMP/SMZ, 160/800 mg orally, twice daily. Before administering the third dose, the nurse notes that the patient has a widespread rash, a temperature of 103°F, and a heart rate of 100 beats per minute. The patient looks ill and reports not feeling well. What will the nurse do? a. Administer the dose and request an order for an antipyretic medication. b. Withhold the dose and request an order for an antihistamine to treat the rash. c. Withhold the dose and notify the provider of the symptoms. d. Request an order for intravenous TMP/SMZ, because the patient is getting worse.

C

A patient with chronic pain has been receiving morphine sulfate but now has decreased pain. The prescriber changes the medication to pentazocine [Talwin]. The nurse will monitor the patient for: A. euphoria. B. respiratory depression. C. yawning and sweating. D. hypotension.

C

A patient with colorectal cancer is admitted to the hospital oncology unit to receive cetuximab [Erbitux]. The nurse notes that the prescriber has not ordered any other medications. The nurse will contact the prescriber to request an order for which medication in order to minimize cetuximab's side effects? A. Epinephrine B. Ondansetron [Zofran] C. Diphenhydramine [Benadryl] D. Magnesium supplements

C

A patient with endometriosis is being treated with the gonadotropin-releasing hormone (GnRH) agonist leuprolide [Lupron Depot]. A nurse is teaching the patient about the drug. Which statement by the patient indicates understanding of the teaching? a. "I can continue to take the medication if I get pregnant." b. "I can expect the medication to cure my symptoms." c. "I may have menopausal-like symptoms when taking this medication." d. "I will need to take the medication for several years."

C

A patient with hemophilia is hospitalized for infusion of factor VIII replacement through a venous port. While giving the drug, the nurse notes that the patient's temperature is 101.5°F. The nurse will contact the provider to report which possibility? a. Anaphylactic reaction b. Contamination of factor replacement c. Port infection d. Thrombolytic event

C

A patient with histoplasmosis is being treated with itraconazole [Sporanox]. The nurse will teach this patient to report which symptoms? a. Gynecomastia and decreased libido b. Headache and rash c. Nausea, vomiting, and anorexia d. Visual disturbances

C

A patient with non-Hodgkin's lymphoma is about to begin chemotherapy with a massive dose of methotrexate [Rheumatrex]. The nurse will expect to administer which medication concurrently with this drug? a. Dexamethasone b. Folic acid c. Leucovorin d. Vitamin B12

C

A patient with renal disease is scheduled for a colonoscopy. Before the procedure, the nurse will anticipate administering: a. glycerin suppository. b. magnesium hydroxide (MOM). c. polyethylene glycol and electrolytes. d. sodium phosphate.

C

A patient with rheumatoid arthritis is taking leflunomide [Arava] and an oral contraceptive. She tells the nurse she would like to get pregnant. What will the nurse tell her? a. That leflunomide is not dangerous during the first trimester of pregnancy b. That plasma levels of leflunomide will drop rapidly when she stops taking it c. To ask her provider about an 11-day course of cholestyramine d. To stop taking leflunomide when she stops using contraception

C

A patient with second-degree burns is treated with silver sulfadiazine [Silvadene]. A nursing student asks the nurse about the differences between silver sulfadiazine and mafenide [Sulfamylon], because the two are similar products, and both contain sulfonamides. What does the nurse tell the student about silver sulfadiazine? a. It causes increased pain when the medication is applied. b. It has a broader spectrum of antimicrobial sensitivity. c. It has antibacterial effects related to release of free silver. d. It suppresses renal excretion of acid, causing acidosis.

C

A patient with type 1 diabetes is taking NPH insulin, 30 units every day. A nurse notes that the patient is also taking metoprolol [Lopressor]. What education should the nurse provide to the patient? a. "Metoprolol has no effect on diabetes mellitus or on your insulin requirements." b. "Metoprolol interferes with the effects of insulin, so you may need to increase your insulin dose." c. "Metoprolol may mask signs of hypoglycemia, so you need to monitor your blood glucose closely." d. "Metoprolol may potentiate the effects of the insulin, so the dose should be reduced."

C

A patient with type 2 diabetes mellitus takes glipizide. The patient develops a urinary tract infection, and the prescriber orders TMP/SMZ. What will the nurse tell the patient? a. Patients with diabetes have an increased risk of an allergic reaction. b. Patients taking TMP/SMZ may need increased doses of glipizide. c. The patient should check the blood glucose level more often while taking TMP/SMZ. d. The patient should stop taking the glipizide while taking the TMP/SMZ.

C

A patient's provider has recommended a bulk-forming laxative for occasional constipation. Which statement by the patient indicates understanding of the teaching about this agent? a. "I can take this medication long term." b. "I should not take this drug if I have diverticulitis." c. "I should take each dose with a full glass of water." d. "This drug can cause severe diarrhea."

C

A postmenopausal patient develops osteoporosis. The patient asks the nurse about medications to treat this condition. The nurse learns that the patient has a family history of breast cancer. The nurse will suggest discussing which medication with the provider? a. Estrogen estradiol b. Pamidronate [Aredia] c. Raloxifene [Evista] d. Teriparatide [Forteo]

C

A postoperative patient reports pain in the left lower extremity. The nurse notes swelling in the lower leg, which feels warm to the touch. The nurse will anticipate giving which medication? a. Aspirin b. Clopidogrel [Plavix] c. Enoxaparin [Lovenox] d. Warfarin [Coumadin]

C

A pregnant female patient with bacteriuria suprapubic pain, urinary urgency and frequency, and a low-grade fever is allergic to sulfa, ciprofloxacin, and amoxicillin. The nurse knows that the best alternative for treating this urinary tract infection is with: A. fosfomycin [Monurol]. B. nitrofurantoin [Macrodantin]. C. methenamine [Hiprex]. D. cephalexin [Keflex].

C

A pregnant female patient with bacteriuria, suprapubic pain, urinary urgency and frequency, and a low-grade fever is allergic to sulfa, ciprofloxacin, and amoxicillin. The nurse knows that the best alternative for treating this urinary tract infection is with: a. cephalexin [Keflex]. b. fosfomycin [Monurol]. c. methenamine [Hiprex]. d. nitrofurantoin [Macrodantin].

C

A prescriber orders ramipril [Altace] for an obese patient with type 2 diabetes mellitus who has developed hypertension. The nurse provides teaching before dismissing the patient home. Which statement by the patient indicates understanding of the teaching? a. "I am less likely to develop diabetic nephropathy when taking this medication." b. "I should check my blood sugar more often, because hyperglycemia is a side effect of this drug." c. "Taking this medication helps reduce my risk of stroke and heart attack." d. "This medication will probably prevent the development of diabetic retinopathy."

C

A recent campaign, initiated by the Centers for Disease Control (CDC), to delay the emergence of antibiotic resistance in hospitals, has what as one of its objectives? a. Allowing patients to stop antibiotics when symptoms subside b. Allowing prescribers to develop their own prescribing guidelines c. Increased adherence to prescribed antibiotics d. Increased use of antibiotics among parents of young children

C

A young woman with migraine headaches who has recently begun taking sumatriptan [Imitrex] calls the nurse to report a sensation of chest and arm heaviness. The nurse questions the patient and determines that she feels pressure and not pain. What will the nurse do? a. Ask the patient about any history of hypertension or coronary artery disease. b. Determine whether the patient might be pregnant. c. Reassure the patient that this is a transient, reversible side effect of sumatriptan. d. Tell the patient to stop taking the medication immediately.

C

An anesthesiologist completes preoperative teaching for a patient the night before surgery. The patient asks the nurse to clarify the reason midazolam [Versed] will be given as an adjunct to the anesthetic. Which statement by the patient indicates understanding? a. "Versed allows a larger amount of inhaled anesthetic to be used without increased side effects." b. "Versed is given to enhance the analgesic and muscle relaxation effects of the inhaled anesthetic." c. "Versed is used to produce rapid unconsciousness before administration of the inhaled anesthetic." d. "Versed is used to reduce cardiovascular and respiratory depression caused by the inhaled anesthetic."

C

An immunocompromised child is exposed to chickenpox and the provider orders valacyclovir [Valtrex] to be given orally three times daily. The nurse will contact the provider to change this order for which reason? a. Valacyclovir is not used as varicella prophylaxis. b. The dosage is too high for this indication. c. The drug may cause serious adverse effects in immunocompromised patients. d. Valacyclovir is not approved for use in children.

C

An older adult patient with severe gastroesophageal reflux disease (GERD) has had only minimal relief using a histamine2-receptor antagonist (H2RA). The patient is to begin taking omeprazole [Prilosec]. What will the nurse teach this patient? a. A complete cure is expected with this medication. b. Lifestyle changes can be as effective as medication therapy. c. Long-term therapy may be needed. d. The medication will be used until surgery can be performed.

C

In a discussion of drug-drug interactions, which would be the best example of a beneficial inhibitory interaction? A. Cholestyramine blocking the actions of antihypertensive drugs B. Propanolol (Inderal) blocking the effects of albuterol C. Naloxone (Narcan) blocking morphine sulfate's actions D. Antacids blocking the action of tetracycline (Sumycin)

C

The nurse is caring for a patient after recent renal transplantation. The patient is taking sirolimus [Rapamune] to prevent transplant rejection. What other medications would the nurse expect the patient to be taking? a. Rifampin and ketoconazole b. Carbamazepine and phenobarbital c. Cyclosporine and glucocorticoids d. Amphotericin B and erythromycin

C

The nurse is caring for a patient who is human immunodeficiency virus (HIV) positive and is taking high doses of zidovudine [Retrovir]. The nurse is providing patient education about the adverse effects of the medication. Which statement by the patient demonstrates a need for further teaching? a. "I may experience fatigue from anemia." b. "I may be more susceptible to infection from neutropenia." c. "I may have a deficiency of vitamin B6." d. "I may have a deficiency of folic acid."

C

The nurse is caring for a patient who is taking a protease inhibitor (PI). Upon review of the laboratory test results, the nurse notes that the patient has newly elevated plasma triglycerides and cholesterol. The nurse expects that the prescriber will manage these levels with: a. lovastatin [Mevacor]. b. simvastatin [Zocor]. c. modified diet and exercise. d. Pancrease.

C

The nurse is preparing to administer amphotericin B intravenously. The nurse will expect to pretreat the patient with which medications A. Aspirin, diphenhydramine [Benadryl], and meperidine [Demerol] B. Morphine sulfate [Morphine] and acetaminophen [Tylenol] C. Acetaminophen [Tylenol], diphenhydramine [Benadryl], and meperidine [Demerol] D. Ibuprofen [Motrin], diphenhydramine [Benadryl], and meperidine [Demerol]

C

The nurse is preparing to care for a patient who will be taking an antihypertensive medication. Which action by the nurse is part of the assessment step of the nursing process? a. Asking the prescriber for an order to monitor serum drug levels b. Monitoring the patient for drug interactions after giving the medication c. Questioning the patient about over-the-counter medications d. Taking the patient's blood pressure throughout the course of treatment

C

The nurse on an oncology unit prepares to administer the fourth cycle of docetaxel [Taxotere] to a patient with breast cancer. Which clinical finding would cause the nurse to withhold the dose and call the prescriber? a. Alanine transaminase (ALT) 1.2 times the upper limit b. Alkaline phosphatase 2 times the upper limit c. Neutrophil count below 1500/mm3 d. Creatinine clearance of 130 mL/min/1.73 m2

C

The nurse wants to evaluate a nursing student's understanding of chemotherapy. The nurse asks, "Which factor would be a major obstacle to successful chemotherapy?" What is the student's best response? a. "The patient's reluctance about the doses administered." b. "The patient's degree of nausea." c. "The toxicity of anticancer drugs to normal tissues." d. "The difficulty attaining and maintaining venous access."

C

The parent of a 5-year-old child who has had four urinary tract infections in the past year asks the nurse why the provider doesn't just order an antibiotic for the child's current symptoms of low-grade fever, flank pain, and dysuria since these are similar symptoms as before. Which is the most important reason given by the nurse? a. "Your child may need to be hospitalized for treatment." b. "Your child may need a urine culture before and after treatment." c. "Your child may need tests to assess for urinary tract abnormalities." d. "Your child may need additional medications, such as urinary tract antiseptics."

C

These patients are receiving chemotherapy. Which patient should the nurse see first? a. The patient with lightly bleeding gums b. The patient with nausea and vomiting c. The patient with a fever of 100.3°F d. The patient with diarrhea and stomatitis

C

To prevent yellow or brown discoloration of teeth in children, tetracyclines should not be given: a. to children once the permanent teeth have developed. b. to patients taking calcium supplements. c. to pregnant patients after the fourth month of gestation. d. with dairy products or antacids.

C

What is a desired outcome when a drug is described as easy to administer? a. it can be stored indefinitely without need for refrigeration. b. It does not interact significantly with other drug regimen c. It enhances patient adherence to the drug regimen. d. It is usually relatively inexpensive to produce

C

What occurs when a drug binds to a receptor in the body? A. It gives the receptor a new function. B. It alters the receptor to become nonresponsive to its usual endogenous molecules. C. It increases or decreases the activity of that receptor. D. It prevents the action of the receptor by altering its response to chemical mediators.

C

Two nurses are discussing theories of drug-receptor interaction. Which statements are true regarding the affinity of a drug and its receptor? (Select all that apply) A. Drugs with low affinity are strongly attracted to their receptors B. Affinity and intrinsic activity are dependent properties C. The affinity of a drug for its receptors is reflected in its potency D. Affinity refers to the strength of the attraction between a drug and its receptor E. Drugs with high affinity are strongly attracted to their receptors

C,D,E

Which disorders may be treated with glucocorticoids? (Select all that apply.) A. Anaphylaxis B. Bronchiolitis C. Gout D. Ulcerative colitis E. Allergic rhinitis

C,D,E

A 7-year-old child who is otherwise healthy is receiving mecasermin [Increlex] replacement therapy to treat severe primary deficiency of insulin-like growth factor-1 (IGF-1). The child develops tonsillar hypertrophy. The nurse anticipates that the provider will recommend: a. antibiotics. b. reducing the dose of mecasermin. c. discontinuing the mecasermin. d. tonsillectomy

D

A child has been receiving chloramphenicol for a Neisseria meningitidis central nervous system (CNS) infection. The nurse administers the dose and subsequently notes that the child has vomited and appears dusky and gray in color. The child's abdomen is distended. What will the nurse do? a. Contact the provider for an order to obtain a chloramphenicol level. b. Notify the provider that the child's meningitis is worsening. c. Recognize this as initial signs of a C. difficile infection. d. Stop the infusion immediately and notify the provider.

D

A child is receiving a combination albuterol/ipratropium [DuoNeb] inhalation treatment. The patient complains of a dry mouth and sore throat. What will the nurse do? a. Contact the provider to report systemic anticholinergic side effects. b. Discontinue the aerosol treatment immediately. c. Notify the provider of a possible allergic reaction. d. Reassure the patient that these are expected side effects.

D

A child with otitis media has had three ear infections in the past year. The child has just completed a 10-day course of amoxicillin [Amoxil] with no improvement. The parent asks the nurse why this drug is not working, because it has worked in the past. What will the nurse tell the patient? a. "Amoxicillin is too narrow in spectrum." b. "The bacteria have developed a three-layer cell envelope." c. "The bacteria have developed penicillin-binding proteins (PBPs) that have a low affinity for penicillins." d. "The bacteria have synthesized penicillinase."

D

A college student who is unresponsive is brought to the emergency department by friends, who say that their friend drank more than half of a large bottle of whiskey 3 hours ago. Assessment reveals a blood alcohol level of 0.32%. The vital signs are BP, 88/32 mm Hg; R, 6/min; T, 96.8°F; and P, 76/min and weak and thready. The nurse should prepare the patient for which intervention? A. Charcoal administration B. Naloxone [Narcan] administration C. IV fluids and stimulants D. Gastric lavage and dialysis

D

A female patient who has hepatitis C is being treated with pegylated interferon alfa and ribavirin [Ribasphere]. It will be important for the nurse to teach this patient that: a. if she gets pregnant, she should use the inhaled form of ribavirin [Virazole]. b. if she is taking oral contraceptives, she should also take a protease inhibitor. c. she should use a hormonal contraceptive to avoid pregnancy. d. she will need a monthly pregnancy test during her treatment.

D

A hospitalized patient who is given one dose of flurazepam continues to show drowsiness the next day. A nursing student asks the nurse the reason for this, because the drug's half-life is only 2 to 3 hours. Which response by the nurse is correct? a. "Benzodiazepines commonly cause residual effects lasting into the day after the dose is given." b. "The patient is having a paradoxical reaction to this medication." c. "This patient must have developed a previous tolerance to benzodiazepines." d. "When this drug is metabolized, the resulting compound has longer-lasting effects."

D

A hospitalized patient who is taking demeclocycline [Declomycin] reports increased urination, fatigue, and thirst. What will the nurse do? a. Contact the provider to report potential toxic side effects. b. Notify the provider to discuss changing the medication to doxycycline. c. Perform bedside glucometer testing to evaluate the serum glucose level. d. Provide extra fluids and reassure the patient that these are expected side effects.

D

A nurse is assisting a physician who is preparing to suture a superficial laceration on a patient's leg. The physician asks the nurse to draw up lidocaine with epinephrine. The nurse understands that epinephrine is used with the lidocaine to: a. allow more systemic absorption to speed up metabolism of the lidocaine. b. increase the rate of absorption of the lido-caine. c. improve perfusion by increasing blood flow to the area. d. prolong anesthetic effects and reduce the risk of systemic toxicity from lidocaine.

D

A nurse is caring for a patient who has a superficial fungal infection and notes that the provider has ordered 200 mg of ketoconazole [Nizoral] 200 mg PO once daily. Which action by the nurse is correct? a. Administer the drug as ordered. b. Contact the provider to discuss twice daily dosing. c. Discuss a 400-mg daily drug regimen with the provider. d. Request an order for a different antifungal medication.

D

A nurse is caring for a patient with cancer who has been undergoing chemotherapy. The patient has oral mucositis as a result of the chemotherapy, and the provider has ordered palifermin [Kepivance]. Which is an appropriate nursing action when giving this drug? a. Administering the drug as a slow IV infusion b. Flushing the IV line with heparin before infusing the drug c. Giving the drug within 6 hours of the chemotherapy d. Warning the patient about the potential for distortion of taste

D

A nurse is caring for an African American patient who has been admitted to the unit for long-term antibiotic therapy with sulfonamides. The patient develops fever, pallor, and jaundice. The nurse would be correct to suspect that the patient has developed: a. Stevens-Johnson syndrome. b. kernicterus. c. hepatotoxicity. d. hemolytic anemia.

D

A nurse is discussing microbial resistance among sulfonamides and trimethoprim with a nursing student. Which statement by the student indicates a need for further teaching? a. "Bacterial resistance to trimethoprim is relatively uncommon." b. "Resistance among gonococci, streptococci, and meningococci to sulfonamides is high." c. "Resistance to both agents can occur by spontaneous mutation of organisms." d. "Resistance to sulfonamides is less than resistance to trimethoprim."

D

A nurse is discussing the differences between OxyContin OC and OxyContin OP with a group of nursing students. Which statement by a student indicates understanding of the teaching? A. "OxyContin OP has greater solubility in water and alcohol." B. "OxyContin OC cannot be drawn into a syringe for injection." C. "Patients using OxyContin OP are less likely to overdose." D. "OxyContin OP is not easily crushed into a powder."

D

A nurse is obtaining a drug history from a patient about to receive sulfadiazine. The nurse learns that the patient takes warfarin, glipizide, and a thiazide diuretic. Based on this assessment, the nurse will expect the provider to: a. change the antibiotic to TMP/SMZ. b. increase the dose of the glipizide. c. monitor the patient's electrolytes closely. d. monitor the patient's coagulation levels.

D

A nurse is performing a physical assessment on a patient with tuberculosis who takes rifampin [Rifadin]. What would be an expected finding? a. Crystalluria b. Myopathy c. Peripheral neuropathy d. Red-orange-tinged urine

D

A nurse is providing education to a patient who is beginning therapy with AndroGel testosterone gel. What statement made by the patient demonstrates a need for further teaching? a. "I should not shower or swim for at least 5 to 6 hours after application." b. "I should avoid direct skin-to-skin contact with my spouse where the medication was applied." c. "I should have my blood drawn for laboratory tests in 14 days." d. "I should apply the medication to my genitals for best results."

D

A nurse is teaching a group of nursing students about neurotransmitters. Which statement by a student about acetylcholine indicates a need for further teaching? A. "it activates three cholinergic receptor subtypes." B. "it has effecrs in the parasympathetic, sympathetic, and somatic nervous systems." c. It is used at most junctions of the peripheral nervous systems." d. "Its transmission is terminated by reuptake into the cholinergic nerve terminal."

D

A nurse is teaching a group of nursing students about neurotransmitters. Which statement by a student about acetylcholine indicates a need for further teaching? A. "It is used at most junctions of the peripheral nervous system." B. "It activates three cholinergic receptor subtypes." C. "It has effects in the parasympathetic sympathetic, and somatic nervous systems." D. "Its transmission is terminated by reuptake into the cholinergic nerve terminal."

D

A nurse is teaching a group of students about how CNS drugs are developed. Which statement by a student indicates a need for further teaching? a. "Central nervous system drug development relies on observations of their effects on human behavior." b. "Studies of new central nervous system drugs in healthy subjects can produce paradoxical effects." c. "Our knowledge of the neurochemical and physiologic changes that underlie mental illness is incomplete." d. "These drugs are developed based on scientific knowledge of CNS transmitters and receptors."

D

A nurse provides teaching for a female patient with anemia who has had cancer chemotherapy and who will begin treatment with testosterone. Which statement by the patient indicates understanding of the teaching? a. "Facial hair may develop with this drug but will go away over time." b. "I may experience an increase in breast size while taking this drug." c. "Testosterone may increase my high-density lipoprotein (HDL) cholesterol and reduce my low-density lipoprotein (LDL) cholesterol." d. "Testosterone treats anemia by stimulating the synthesis of a renal hormone.

D

A nurse reads a tuberculin skin test on a patient and notes a 6- to 7-mm area of induration. The patient is a young adult who has recently immigrated from a country with a high prevalence of tuberculosis. The patient has no other risk factors. The nurse will expect the provider to: a. begin treating this patient with a two-drug regimen of isoniazid and rifampin. b. order a chest radiograph and a sputum culture to assess for active tuberculosis. c. order a nucleic acid amplification test of the patient's sputum. d. reassure the patient that this is not considered a positive test result.

D

A nurse teaches a patient about sulfonamides. Which statement by the patient indicates a need for further teaching? a. "I need to drink extra fluids while taking this medication." b. "I need to use sunscreen when taking this drug." c. "I should call my provider if I develop a rash while taking this drug." d. "I should stop taking this drug when my symptoms are gone."

D

A nursing student asks about drugs that interfere with the termination of transmitter action. Which statement by the nurse is correct? A. "Drugs act on this process by altering the diffusion of the transmitter away from the synaptic gap." B. "Drugs in this category lead to decreased activation by the transmitter in the synapse." C. "Drugs can interfere with termination by either increasing or decreasing reuptake of the transmitter." D. "These drugs reduce either reuptake or degradation of the transmitter, causing an increase in receptor activation."

D

A nursing student is caring for a patient who is taking sucralfate [Carafate] and ciprofloxacin [Cipro] to treat peptic ulcer disease. The student asks the nurse about the pharmacokinetics of sucralfate. Which statement by the student indicates a need for further teaching? a. "Sucralfate adheres to the ulcer and blocks the back-diffusion of hydrogen ions." b. "Sucralfate and ciprofloxacin should be administered 1 hour apart." c. "Sucralfate does not cause systemic side effects." d. "Sucralfate has a moderate acid-neutralizing capacity."

D

A nursing student wants to know why a patient who has been taking levodopa [Dopar] for years will now receive levodopa/carbidopa [Sinemet]. The nurse explains the reasons that levodopa as a single agent is no longer available. Which statement by the student indicates a need for further education? a. "Carbidopa increases the availability of levodopa in the central nervous system." b. "Carbidopa reduces the incidence of nausea and vomiting." c. "Combination products reduce peripheral cardiovascular side effects." d. "Combination products cause fewer dyskinesias and decreased psychosis."

D

A parent asks a nurse if the provider will prescribe an antibiotic for a child who attends school with several children who have strep throat. The child is complaining of a sore throat and has a fever. What will be the nurse's response? a. "Because strep throat is likely, your child should be treated empirically." b. "With good hand washing, your child should not get strep throat." c. "Your child probably has strep throat, so your provider will order an antibiotic." d. "Your child should come to the clinic to have a throat culture done today."

D

A patient about to begin therapy with etanercept has a positive tuberculin skin test. A chest radiograph is negative. The nurse will expect this patient to: a. begin taking antituberculosis drugs at the beginning of treatment with etanercept. b. have periodic chest radiographs during treatment with etanercept. c. have regular monitoring of symptoms to detect active tuberculosis. d. undergo tuberculosis treatment prior to beginning etanercept treatment.

D

A patient administers interferon beta-1a SQ [Rebif] 22 mcg/0.5 mL three times each week. The patient calls the nurse to report unrelieved itching and erythema at the injection site, despite the use of topical hydrocortisone for several weeks. What will the nurse tell this patient to do? a. Apply ice to the injection site before and after the injection. b. Ask the provider to reduce the dose of interferon beta to 8.8 mcg/0.2 mL. c. Discuss using a prescription-strength hydrocortisone product with the provider. d. Take oral diphenhydramine [Benadryl].

D

A patient asks a nurse how nitroglycerin works to relieve anginal pain. The nurse correctly states, "Nitroglycerin: A. increases ventricular filling to improve cardiac output." B. dilates coronary arteries to increase blood flow to the heart." C. increases the oxygen supply to the cardiac muscle." D. promotes vasodilation, which reduces preload and oxygen demand."

D

A patient diagnosed with STEMI is about to undergo a primary percutaneous coronary intervention (PCI). Which combination of pharmacotherapeutic agents will be given to augment this procedure? A. Angiotensin-converting enzyme (ACE) inhibitor and aspirin B. Abciximab and a fibrinolytic drug C. Beta blocker and nitroglycerin D. Heparin, aspirin, and clopidogrel

D

A patient has a skin infection and the culture reveals methicillin-resistant Staphylococcus aureus (MRSA). What is an appropriate treatment for this patient? a. Cefaclor b. Cefazolin c. Cefotaxime d. Ceftaroline

D

A patient has an invasive aspergillosis infection. Which antifungal agent is the drug of choice for this infection? a. Amphotericin B b. Fluconazole [Diflucan] c. Posaconazole [Noxafil] d. Voriconazole [Vfend]

D

A patient has been receiving intravenous penicillin for pneumonia for several days and begins to complain of generalized itching. The nurse auscultates bilateral wheezing and notes a temperature of 38.5°C (101°F). Which is the correct action by the nurse? a. Administer the next dose and continue to evaluate the patient's symptoms. b. Ask the prescriber if an antihistamine can be given to relieve the itching. c. Contact the prescriber to request an order for a chest radiograph. d. Hold the next dose and notify the prescriber of the symptoms.

D

A patient has been taking psyllium [Metamucil] two to three times daily for several days. The patient complains of stomach pain but has not had a stool. What will the nurse do? a. Ask the patient to drink a full glass of water. b. Give another dose of the psyllium. c. Request an order for a bisacodyl [Dulcolax] suppository. d. Palpate the patient's abdomen and auscultate for bowel sounds.

D

A patient has been taking senna [Senokot] for several days, and the nurse notes that the urine is yellowish-brown. What does the nurse know about this symptom? a. It indicates that renal failure has occurred. b. It is caused by dehydration, which is a laxative side effect. c. It is a sign of toxicity, indicating immediate withdrawal of the drug. d. It is an expected, harmless effect of senna.

D

A patient has come to the clinic with tinea corporis, and the prescriber has ordered clotrimazole. When educating the patient about this medication, the nurse will include which statement? a. "Apply the medication over the entire body twice daily for 2 weeks." b. "Sun exposure will minimize the drug's effects." c. "This drug is effective after a single application." d. "Use the medication for at least 1 week after the symptoms have cleared."

D

A patient has just been diagnosed with cancer and will begin chemotherapy. The patient asks the nurse about the possibility of nausea and vomiting. The nurse will tell the patient that: a. nausea and vomiting can be avoided by having a snack before chemotherapy. b. nausea and vomiting are common side effects and will abate over time. c. nausea and vomiting are common and will be treated with antiemetics when they occur. d. the provider will order drugs to help prevent nausea and vomiting before each dose.

D

A patient has undergone a primary percutaneous coronary intervention with a stent placement. The provider has ordered a daily dose of 81 mg of aspirin and clopidogrel. The patient asks the nurse how long the medications must be taken. What will the nurse tell this patient about the medication regimen? A. This drug regimen will continue indefinitely. B. The aspirin will be discontinued in one year and the clopidogrel will be given indefinitely. C. Both drugs will be discontinued in one year. D. The clopidogrel will be discontinued in one year and the aspirin will be given indefinitely.

D

A patient in the postanesthesia recovery unit received ketamine [Ketalar] for right open reduction internal fixation surgery. What drug would be beneficial as a premedication to help minimize adverse reactions? a. Methohexital [Brevital] b. Sevoflurane [Ultane] c. Atropine [Sal-Tropine] d. Diazepam [Valium]

D

A patient is about to begin treatment with isoniazid. The nurse learns that the patient also takes phenytoin [Dilantin] for seizures. The nurse will contact the provider to discuss: a. increasing the phenytoin dose. b. reducing the isoniazid dose. c. monitoring isoniazid levels. d. monitoring phenytoin levels.

D

A patient is about to receive prednisone for tendonitis. The nurse reviewing the chart would be concerned about which of the following in the patient's medical history? a. Asthma and allergic rhinitis b. Gouty arthritis c. Seborrheic dermatitis d. Systemic fungal infection

D

A patient is about to undergo a procedure to harvest hematopoietic stem cells from the bone marrow. Which medication will the nurse anticipate giving before this procedure? A. Sargramostim (Leukine) B. Oprelvekin (Neumega) C. Pegfilgrastim (Neulasta) D. Filgrastim (Neupogen)

D

A patient is admitted to the hospital. The patient's initial laboratory results reveal megaloblastic anemia. The patient complains of tingling of the hands and appears confused. The nurse suspects what in this patient? a. Celiac disease b. Folic acid deficiency c. Iron deficiency anemia d. Vitamin B12 deficiency

D

A patient is admitted with severe hypertensive crisis. The nurse will anticipate administering which medication? a. Captopril PO b. Hydralazine [Apresoline] 25 mg PO c. Minoxidil 20 mg PO d. Sodium nitroprusside [Nitropress] IV

D

A patient is beginning treatment for active tuberculosis (TB) in a region with little drug-resistant TB. Which treatment regimen will be used initially? A. Rifampin, pyrazinamide, and ethambutol B. Isoniazid, pyrazinamide, and ethambutol C. Isoniazid and pyrazinamide D. Isoniazid, rifampin, pyrazinamide, and ethambutol

D

A patient is beginning treatment for active tuberculosis (TB) in a region with little drug-resistant TB. Which treatment regimen will be used initially? a. Isoniazid and pyrazinamide b. Isoniazid, pyrazinamide, and ethambutol c. Rifampin, pyrazinamide, and ethambutol d. Isoniazid, rifampin, pyrazinamide, and ethambutol

D

A patient is being treated with warfarin [Coumadin] to prevent thrombus. The patient develops hyperuricemia, and the provider orders allopurinol [Zyloprim]. The nurse will contact the provider to discuss ____ the ____ dose. a. increasing; allopurinol b. increasing; warfarin c. reducing; allopurinol d. reducing; warfarin

D

A patient is experiencing toxic side effects from atropine, including delirium and hallucinations. Which medication will the nurse expect to administer? a. Donepezil [Aricept] b. Edrophonium [Reversol] c. Neostigmine [Prostigmin] d. Physostigmine

D

A patient is preparing to travel to perform missionary work in a region with poor drinking water. The provider gives the patient a prescription for ciprofloxacin [Cipro] to take on the trip. What will the nurse instruct this patient to do? a. Combine the antibiotic with an antidiarrheal medication, such as loperamide. b. Start taking the ciprofloxacin 1 week before traveling. c. Take 1 tablet of ciprofloxacin with each meal for best results. d. Use the drug if symptoms are severe or do not improve in a few days.

D

A patient is taking alendronate [Fosamax] to treat Paget's disease. The patient asks the nurse why calcium supplements are necessary. The nurse will tell the patient that calcium supplements are necessary to: a. reduce the likelihood of atrial fibrillation. b. maximize bone resorption of calcium. c. minimize the risk of esophageal cancer. d. prevent hyperparathyroidism.

D

A patient is taking an FGA for schizophrenia. The nurse notes that the patient has trouble speak-ing and chewing and observes slow, wormlike movements of the patient's tongue. The nurse recognizes which adverse effect in this patient? a. Acute dystonia b. Akathisia c. Parkinsonism d. Tardive dyskinesia

D

A patient is taking digoxin [Lanoxin] and quinidine to treat sustained ventricular tachycardia. Before giving medications, the nurse reviews the patient's electrocardiogram (ECG) and notes a QRS complex that has widened by 50% from the baseline ECG. What will the nurse do? a. Administer the medications as ordered, because this indicates improvement. b. Contact the provider to discuss reducing the digoxin dose. c. Contact the provider to request an increase in the quinidine dose. d. Withhold the quinidine and contact the provider to report the ECG finding.

D

A patient on an oncology unit has been receiving ifosfamide [Ifex] for a few days. Before administering the next dose, the nurse reviews the patient's laboratory test results. Which finding would cause the nurse to hold the dose? a. Elevated white blood cell count b. Low hemoglobin and hematocrit levels c. Low levels of ketones in the urine d. Microscopic hematuria

D

A patient reports experiencing weakness, fatigue, nausea, vomiting, constipation, and nocturia. Total serum calcium is 10.5 mg/dL. A dipstick urinalysis shows a positive result for protein. When questioned, the patient reports taking vitamin D and calcium supplements. The nurse will counsel the patient to: a. reduce the amount of vitamin D and stop taking the calcium. b. discuss taking calcitonin-salmon [Fortical] with the provider. c. stop both supplements and discuss the use of a diuretic with the provider. d. stop taking vitamin D, reduce the amount of calcium, and increase the fluid intake.

D

A patient taking an FGA medication develops severe parkinsonism and is treated with aman-tadine [Symmetrel]. The amantadine is withdrawn 2 months later, and the parkinsonism returns. The nurse will expect the provider to: a. give anticholinergic medications. b. make a diagnosis of idiopathic parkinson-ism. c. resume the amantadine indefinitely. d. try a second-generation antipsychotic (SGA).

D

A patient who has a history of asthma experiences three or four migraine headaches each month. The patient uses sumatriptan [Imitrex] as an abortive medication and has developed medication overuse headaches. The patient asks the nurse what can be done to prevent migraines. The nurse will suggest that the patient discuss which preventive medication with the provider? a. Botulinum toxin b. Meperidine [Demerol] c. Timolol d. Topiramate [Topamax]

D

A patient who has been taking a medication with a side effect of drowsiness stops taking the medication after several weeks. The patient reports feeling anxious and jittery. The nurse understands that this response is due to: a. addiction. b. psychologic dependence. c. tolerance. d. withdrawal syndrome.

D

A patient who has cystic fibrosis has a Pseudomonas aeruginosa infection and the provider has ordered aztreonam [Cayston]. What will the nurse teach this patient about administration of this drug? a. Administer the drug intramuscularly twice daily. b. Give a daily dose every day for 28 days and then stop. c. Inhale the powdered drug as ordered three times each day. d. Use the nebulizer to administer the drug three times daily.

D

A patient who has erectile dysfunction asks about medications to treat this disorder, but tells the nurse he does not want to have to plan sexual activity several hours in advance. Which medication will the nurse expect the provider to order for this patient? A. Sildenafil (Viagra) B. Tadalafil (Cialis) C. Vardenafil (Levitra) D. Avanafil (Stendra)

D

A patient who has gastroesophageal reflux disease (GERD) receives a prescription for a proton pump inhibitor (PPI) medication. What will the nurse include when teaching the patient about this drug? a. "The FDA has determined that there is a gastric cancer risk with this drug." b. "This drug will be given on a short-term basis only." c. "You may experience hypermagnesemia when taking this drug." d. "You should report any fever and cough to your provider."

D

A patient who has gout will begin taking febuxostat [Uloric] and colchicine. What will the nurse include when teaching this patient about this drug regimen? a. "You are taking both drugs in order to prevent hepatic side effects." b. "You may stop taking the febuxostat after your uric acid levels decrease." c. "You will have to take both drugs indefinitely to treat your symptoms." d. "You will stop taking the colchicine within 6 months after starting therapy."

D

A patient who has had abdominal surgery has been receiving morphine sulfate via a patient-controlled analgesia (PCA) pump. The nurse assesses the patient and notes that the patient's pupils are dilated and that the patient is drowsy and lethargic. The patient's heart rate is 84 beats per minute, the respiratory rate is 10 breaths per minute, and the blood pressure is 90/50 mm Hg. What will the nurse do? a. Discuss possible opiate dependence with the patient's provider. b. Encourage the patient to turn over and cough and take deep breaths. c. Note the effectiveness of the analgesia in the patient's chart. d. Prepare to administer naloxone and possibly ventilatory support.

D

A patient who has recurrent migraine headaches is prescribed sumatriptan [Imitrex]. Which aspect of this patient's history is of concern when taking this drug? A. Renal disease B. Asthma C. Diabetes D. Coronary artery disease

D

A patient who has traveler's diarrhea asks the nurse about using loperamide to stop the symptoms. What will the nurse tell the patient about this drug? a. "Loperamide is used for moderate to severe symptoms only." b. "This drug is useful as prophylaxis to prevent symptoms." c. "This drug is only effective to treat certain infectious agents." d. "Use of this drug may prolong symptoms by slowing peristalsis."

D

A patient who is an active alcoholic is admitted to the hospital for surgery. The nurse reviewing orders for this patient would be correct to question which postoperative medication for this patient? A. Thiamine B. Diazepam C. Morphine D. Acetaminophen

D

A patient who is at risk for osteoporosis will begin taking the selective estrogen receptor modulator raloxifene [Evista]. Which statement will the nurse include when teaching this patient about the medication? a. Raloxifene reduces the risk of thromboembolism. b. The drug is associated with an increased risk of breast cancer. c. Use of this drug increases the risk of endometrial carcinoma. d. Vasomotor symptoms are a common side effect of this drug.

D

A patient who is taking calcium supplements receives a prescription for ciprofloxacin [Cipro] for a urinary tract infection. The nurse will teach this patient to: a. consume extra fluids while taking the ciprofloxacin to prevent hypercalciuria. b. stop taking the calcium supplements while taking the ciprofloxacin. c. take the two medications together to increase the absorption of both. d. take the calcium either 6 hours before or 2 hours after taking the ciprofloxacin.

D

A patient who is taking didanosine [Videx] reports nausea, vomiting, and abdominal pain. What will the nurse recommend to this patient? a. "Take the drug with food to minimize these side effects." b. "Stop taking the drug immediately and resume taking it once your symptoms subside." c. "Take the medication in the evening to avoid experiencing these kinds of symptoms." d. "You will need laboratory tests to determine if these are serious effects of the drug."

D

A patient who is taking morphine for pain asks the nurse how a pain medication can also cause constipation. What does the nurse know about morphine? a. It binds to different types of receptors in the body. b. It can cause constipation in toxic doses. c. It causes only one type of response, and the constipation is coincidental. d. It is selective to receptors that regulate more than one body process

D

A patient who is taking nitrofurantoin calls the nurse to report several side effects. Which side effect of this drug causes the most concern and would require discontinuation of the medication? a. Anorexia, nausea, and vomiting b. Brown-colored urine c. Drowsiness d. Tingling of the fingers

D

A patient who takes aspirin for rheumatoid arthritis is admitted to the hospital complaining of headache and ringing in the ears. The plasma salicylate level is 300 mcg/mL, and the urine pH is 6.0. What will the nurse do? a. Increase the aspirin dose to treat the patient's headache. b. Notify the provider of possible renal toxicity. c. Prepare to provide respiratory support, because the patient shows signs of overdose. d. Withhold the aspirin until the patient's symptoms have subsided.

D

A patient who wants to quit smoking has a prescription for varenicline [Chantix], which will be used with a nicotine patch. The patient asks the nurse why the varenicline is necessary. Which statement by the nurse is correct? a. "It helps patients experiencing withdrawal to sleep better." b. "It helps reduce anxiety and other withdrawal symptoms." c. "It will help reduce the likelihood of addiction to the patch." d. "The drug blocks nicotine's access to 'pleasure' receptors."

D

A patient who wants to quit smoking has begun taking varenicline [Chantix]. The patient reports experiencing mood swings and depression and a desire to cause harm to herself. What will the nurse tell this patient? a. "These symptoms are common and will disappear over time." b. "These symptoms may indicate an underlying psychiatric disorder." c. "You may need an increased dose to overcome these symptoms of nicotine withdrawal." d. "You should notify your provider of these symptoms immediately."

D

A patient will begin receiving vincristine [Oncovin] to treat Hodgkin's lymphoma. Which side effect(s) will the nurse tell the patient to report immediately? a. Diarrhea, nausea, and vomiting b. Hair loss c. Headaches d. Tingling of the extremities

D

A patient will begin taking a cholinesterase inhibitor for early Alzheimer's disease. The nurse is teaching the patient's spouse about the medication. Which statement by the spouse indicates a need for further teaching? a. "Gastrointestinal symptoms are common with this medication." b. "People taking this drug should not take antihistamines." c. "This drug helps neurons that aren't al-ready damaged to function better." d. "This drug significantly slows the progres-sion of the disease."

D

A patient will receive intrathecal liposomal cytarabine [DepoCyt] to treat acute myelogenous leukemia. The provider has ordered the concurrent administration of dexamethasone. The nurse understands that this is given to: a. prevent bone marrow suppression. b. prevent hair loss and stomatitis. c. reduce the incidence of pulmonary edema. d. reduce the severity of chemical arachnoiditis.

D

A patient will receive intravenous midazolam [Versed] combined with fentanyl while undergoing an endoscopic procedure. The nurse is explaining the reasons for this to a nursing student before the procedure. Which statement by the student indicates understanding of the teaching? a. "The patient may appear anxious and restless during the procedure." b. "The patient will be unconscious during the procedure." c. "The patient will not need cardiorespiratory support during the procedure." d. "The patient will not remember the procedure."

D

A patient with Cushing's syndrome has undergone surgery and radiation treatment. The nurse will expect to teach the patient about which medication? a. Cosyntropin b. Dexamethasone c. Fludrocortisone acetate [Florinef] d. Ketoconazole [Nizoral]

D

A patient with Parkinson disease is taking levodopa/carbidopa [Sinemet] and reports occasional periods of loss of drug effect lasting from minutes to several hours. The nurse questions the patient further and discovers that these episodes occur at different times related to the medication administration. The nurse will contact the provider to discuss: A. giving a direct acting dopamine agonist B. shortening the dosing intercal of levodopa/carbidopa C. adding the DA-releasing agent amantadine to the regimen D. administering a catechol-O-methyltransferase (COMT) inhibitor, such as entacapone

D

A patient with a seizure disorder is admitted to the hospital and has a partial convulsive episode shortly after arriving on the unit. The patient has been taking phenytoin [Dilantin] 100 mg 3 times daily and oxcarbazepine [Trileptal] 300 mg twice daily for several years. The patient's phenytoin level is 13.5 mcg/mL, and the oxcarbazepine level is 82 mcg/mL. The nurse contacts the provider to report these levels and the seizure. What will the nurse expect the provider to order? A. An increased dose of phenytoin B. Once daily dosing of oxcarbazepine C. Extended release phenytoin D. A decreased dose of oxcarbazepine

D

A patient with cancer has a tumor composed mostly of G0 cells. When teaching this patient about the disease, the nurse will make which statement? a. "Cells in this patient's type of tumor will proliferate rapidly." b. "Chemotherapeutic agents that are not toxic to other tissues may be used." c. "This type of tumor is especially sensitive to chemotherapy." d. "This tumor will be managed primarily with surgery."

D

A patient with chronic gout has an acute gouty episode and is admitted to the hospital. The patient has been taking nonsteroidal anti-inflammatory drugs for several months. The prescriber plans to begin therapy with probenecid. What will the nurse do? a. Give the medication as ordered and observe the patient closely for gastrointestinal side effects. b. Request an order to lower the dose of the nonsteroidal antiinflammatory drug. c. Restrict the patient's fluid intake to minimize the risk of renal injury. d. Suggest delaying the probenecid therapy until the acute episode has subsided.

D

A patient with chronic pain has been receiving morphine sulfate but now has decreased pain. The prescriber changes the medication to pentazocine [Talwin]. The nurse will monitor the patient for: a. euphoria. b. hypotension. c. respiratory depression. d. yawning and sweating.

D

A patient with gastroesophageal reflux disease (GERD) is to begin taking oral metoclopramide [Reglan]. The patient asks the nurse about the medication. Which response by the nurse is correct? a. "After 3 months, if the drug is not effective, you may need to increase the dose." b. "Metoclopramide may cause hiccups, especially after meals." c. "Serious side effects may occur but will stop when the drug is discontinued." d. "You should take the drug 30 minutes before each meal and at bedtime."

D

A patient with gout who has increasingly frequent acute gouty attacks will begin receiving allopurinol [Zyloprim] and colchicine. The nurse will include which statement when teaching the patient about this drug regimen? a. "Allopurinol helps reduce the gastrointestinal side effects of colchicine." b. "Allopurinol reduces the likelihood of gouty episodes that usually occur with initial colchicine therapy." c. "The colchicine is given to enhance the effects of the allopurinol." d. "You will take both drugs initially and then stop taking the colchicine."

D

A patient with hemophilia B is admitted to the hospital for surgery. The patient's history reveals long-term use of factor replacement as prophylaxis for bleeding episodes. The nurse anticipates that the provider will order which medication to prevent excessive perioperative bleeding? A. Desmopressin B. Factor VIII C. Ibuprofen D. Tranexamic acid

D

A patient with hypertension is taking furosemide [Lasix] for congestive heart failure. The prescriber orders digoxin to help increase cardiac output. What other medication will the nurse expect to be ordered for this patient? a. Bumetanide [Bumex] b. Chlorothiazide [Diuril] c. Hydrochlorothiazide [HydroDIURIL] d. Spironolactone [Aldactone]

D

A patient with polycystic ovary syndrome (PCOS) asks the nurse what she can do to improve her chances of getting pregnant. Which statement by the patient indicates a need for further teaching? a. "Clomiphene will help induce ovulation but will not treat the other symptoms of polycystic ovarian disease." b. "If I lose weight, my infertility and irregular periods could resolve without medications." c. "Metformin improves insulin sensitivity and reduces male hormone levels." d. "Spironolactone, which reduces androgens and facial hair, is helpful if I'm trying to conceive."

D

A postmenopausal patient is at high risk for developing osteoporosis. The patient's prescriber orders raloxifene [Evista], and the nurse provides teaching about this drug. Which statement by the patient indicates understanding of the teaching? a. "I may experience breast tenderness while taking this drug." b. "I may experience fewer hot flashes while taking this drug." c. "I should discontinue this drug several weeks before any surgery." d. "I should walk as much as possible during long airline flights."

D

A postoperative patient will begin anticoagulant therapy with rivaroxaban [Xarelto] after knee replacement surgery. The nurse performs a history and learns that the patient is taking erythromycin. The patient's creatinine clearance is 50 mL/min. The nurse will: A. Request an order for a different anticoagulant medication B. Administer the first dose of rivaroxaban as ordered C. Request an order to increase the dose of rivaroxaban D. Notify the provider to discuss changing the patients antibiotic

D

A pregnant patient is treated with trimethoprim/sulfamethoxazole (TMP/SMZ) [Bactrim] for a urinary tract infection at 32 weeks' gestation. A week later, the woman delivers her infant prematurely. The nurse will expect to monitor the infant for: a. birth defects. b. hypoglycemia. c. rash. d. kernicterus.

D

A premenopausal woman has ER-positive breast cancer, and her prescriber has ordered tamoxifen [Nolvadex]. She asks the nurse if anastrozole [Arimidex] would work better for her. What will the nurse tell her? a. Anastrozole is more likely to cause hot flushes than tamoxifen. b. Anastrozole is more likely to promote endometrial carcinoma. c. Cancer recurrence is higher with anastrozole. d. Until she is postmenopausal, anastrozole will not be effective.

D

A provider has ordered oral voriconazole [Vfend] for a patient who has a systemic fungal infection. The nurse obtains a medication history and learns that the patient takes phenobarbital for seizures. The nurse will contact the provider to discuss which possibility? a. Administering intravenous voriconazole b. Reducing the dose of phenobarbital c. Reducing the dose of voriconazole d. Using a different antifungal agent

D

A provider orders intravenous moxifloxacin [Avelox] for a patient who has sinusitis. Before administering the drug, the nurse will review this patient's chart for: a. a history of asthma. b. concurrent use of digoxin. c. concurrent use of warfarin. d. recent serum electrolyte levels.

D

A university student who is agitated and restless and has tremors is brought to the emergency department. The patient's heart rate is 110 beats per minute, the respiratory rate is 18 breaths per minute, and the blood pressure is 160/95 mm Hg. The patient reports using concentrated energy drinks to stay awake during finals week. What complication will the nurse monitor for in this patient? a. CNS depression b. Cardiac arrest c. Respiratory failure d. Seizures

D

A young adult patient is admitted to the hospital for evaluation of severe weight loss. The nurse admitting this patient notes that the patient has missing teeth and severe tooth decay. The patient's blood pressure is 160/98 mm Hg. The patient has difficulty answering questions and has trouble remembering simple details. The nurse suspects abuse of which substance? a. Cocaine b. Ecstasy c. Marijuana d. Methamphetamine

D

A young, nonpregnant female patient with a history of a previous urinary tract infection is experiencing dysuria, urinary urgency and frequency, and suprapubic pain of 3 days' duration. She is afebrile. A urine culture is positive for more than 100,000/mL of urine. The nurse caring for this patient knows that which treatment is most effective? a. A 14-day course of amoxicillin with clavulanic acid [Augmentin] b. A 7-day course of ciprofloxacin [Cipro] c. A single dose of fosfomycin [Monurol] d. A 3-day course of trimethoprim/sulfamethoxazole [Bactrim]

D

After starting an antiviral protease inhibitor, a patient with HIV telephones the nurse, complaining, "I'm so hungry and thirsty all the time! I'm urinating 10 or 12 times a day." The nurse recognizes these findings to be consistent with: a. pancreatic infiltration by HIV. b. allergic reaction. c. nonadherence to the antiviral regimen. d. hyperglycemia.

D

An adult patient will begin taking atomoxetine [Strattera] for attention-deficit/hyperactivity disorder. What will the nurse teach this patient? a. Appetite suppression does not occur, because this drug is not a stimulant. b. Stopping the drug abruptly will cause an abstinence syndrome. c. Suicidal thoughts may occur and should be reported to the provider. d. Therapeutic effects may not be felt for 1 to 3 weeks after beginning therapy.

D

An older male patient comes to the clinic with complaints of chills, malaise, myalgia, localized pain, dysuria, nocturia, and urinary retention. The nurse would most likely suspect that the patient has: a. acute cystitis. b. urinary tract infection. c. pyelonephritis. d. prostatitis.

D

An older male patient with an increased risk of MI is taking furosemide [Lasix] and low-dose aspirin. The patient is admitted to the hospital, and the nurse notes an initial blood pressure of 140/80 mm Hg. The patient has had a 10-pound weight gain since a previous admission 3 months earlier. The patient has voided only a small amount of concentrated urine. The serum creatinine and blood urea nitrogen (BUN) levels are elevated. The nurse will contact the provider to discuss: a. adding an antihypertensive medication. b. obtaining serum electrolytes. c. ordering a potassium-sparing diuretic. d. withdrawing the aspirin.

D

Dr. Taylor's wife was admitted to the hospital to receive a transfusion when her hemoglobin was _____ g/dL. and she was admitted to the hospital for cancer chemotherapy when her hemoglobin was ___g/dl. A. 7.4; 7.0 B. 9.2; 9.5 C. 8.5; 8.1 D. 6.0; 5.6

D

The nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Upon assessing the patient, the nurse notices the individual has developed oral thrush. What describes the etiology of the thrush? a. Antibiotic resistance b. Community-acquired infection c. Nosocomial infection d. Superinfection

D

The nurse is caring for a patient on a medical-surgical unit who has a fever of unknown origin. The prescriber has ordered a broad-spectrum antibiotic. Which intervention is the priority? a. Administering the antibiotic immediately b. Administering antipyretics as soon as possible c. Delaying administration of the antibiotic until the culture results are available d. Obtaining all cultures before the antibiotic is administered

D

The nurse wants to evaluate a nursing student's understanding of chemotherapy. The nurse asks "Which factor would be a major obstacle to successful chemotherapy?" What is the student's best response? A. "The patient's reluctance about the doses administered." B. "The difficulty attaining and maintaining venous access." C. "The patient's degree of nausea." D. "The toxicity of anticancer drugs to normal tissues."

D

The parent of a child with cerebral palsy reports that the child has pebble-like stools most of the time and seems uncomfortable if several days have passed between stools. The nurse will suggest that the parent discuss which medication with the child's provider? a. Bisacodyl [Dulcolax] suppositories b. Magnesium citrate c. Methylcellulose [Citrucel] d. Polyethylene glycol [MiraLax]

D

The parent of an infant with otitis media asks the nurse why the prescriber has ordered amoxicillin [Amoxil] and not ampicillin [Unasyn]. What will the nurse tell the parent? a. Amoxicillin is a broader spectrum antibiotic than ampicillin. b. Amoxicillin is not inactivated by beta-lactamases. c. Ampicillin is associated with more allergic reactions. d. Ampicillin is not as acid stable as amoxicillin.

D

There are multiple factors that affect the response of a patient to a medication. A nurse should recognize that all of the following have the potential to effect how a patient responds to a medication EXCEPT: A. Metabolic differences between individuals b. Gender c. Concurrent use of non-prescription medications d. Sexual activity

D

Which patient with a urinary tract infection will require hospitalization and intravenous antibiotics? a. A 5-year-old child with a fever of 100.5°F, dysuria, and bacteriuria b. A pregnant woman with bacteriuria, suprapubic pain, and fever c. A young man with dysuria, flank pain, and a previous urinary tract infection d. An older adult man with a low-grade fever, flank pain, and an indwelling catheter

D