Pharm Exam 2

A 6-year-old child who has chickenpox also has a fever of 102.9° F (39.4° C). The child's mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse? "It's best to wait to see if the fever gets worse." "You can use the aspirin, but watch for worsening symptoms." "Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin." "You can use aspirin, but be sure to follow the instructions on the bottle."

"Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin."

What education and discharge information for a patient receiving an antilipemic medication would the nurse include for the patient? "This medication will take over for other interventions you have been trying to decrease your cholesterol." "It is important for you to double your dose if you miss one in order to maintain therapeutic blood levels." "Stop taking the medication if it causes nausea and vomiting." "Continue your exercise program, and maintain a diet high in omega-3 fatty acids."

"Continue your exercise program, and maintain a diet high in omega-3 fatty acids."

The current immunization for tetanus and diphtheria toxoids and pertussis, Tdap, is administered to people in which age range? Under 6 years of age 11-12 years of age and older Any age range In the first two years of life

11-12 years of age and older

A patient with warfarin toxicity is prescribed vitamin K. Which nursing assessment ensures patient safety? Assess the prothrombin time of the patient. Assess the site for intramuscular drug delivery. Assess the white blood cell count of the patient. Assess the amount of blood loss in the patient.

Assess the prothrombin time of the patient.

The nurse would assess which laboratory value to determine the effectiveness of intravenous heparin? :Complete blood count (CBC) Activated partial thromboplastin time (aPTT) Prothrombin time (PT) Blood urea nitrogen (BUN)

Activated partial thromboplastin time (aPTT)

A patient arrives at the clinic with a wound inflicted by a rusty nail. After checking the patient's history, the nurse finds that the patient last received the tetanus booster about 10 years earlier. What is the most appropriate nursing action in this situation? Administer Tdap. Administer DTaP. Administer immunoglobulin Administer polyvalent vaccine

Administer Tdap.

The nurse plans which intervention to decrease the flushing reaction of niacin? Administer niacin with an antacid. Administer aspirin 30 minutes before nicotinic acid. Administer diphenhydramine hydrochloride (Benadryl) with the niacin. Apply cold compresses to the head and neck.

Administer aspirin 30 minutes before nicotinic acid.

A child who accidently ingested an enteric-coated iron supplement develops seizures and is immediately hospitalized. The serum iron concentration is found to be 350 mcg/dL. What intervention should the nurse expect the provider to prescribe to reduce the serum iron levels? Bowel irrigation An electrolyte infusion Administration of deferoxamine Abdominal radiographs

Administration of deferoxamine

When alteplase is administered to a client diagnosed with a cerebrovascular accident in the ED, the nurse determines that the priority nursing interventions in this client's care should include which of the following? Select all that apply. After administration, assess vital signs every 15 minutes during the first hour. Report dysrhythmias noted on the cardiac monitor. Insert urinary catheter and maintain accurate hourly output measures. Monitor the client for hypothermia for first 8 hours after infusion. Report increase in partial thromboplastin time (PTT).

After administration, assess vital signs every 15 minutes during the first hour. Report dysrhythmias noted on the cardiac monitor. Report increase in partial thromboplastin time (PTT).

Identify the most important question to ask a patient about an antibiotic prescription. History of hypertension Allergies History of anemia Allergy to shellfish

Allergies

What is the priority nursing assessment to monitor when administering vaccinations? Pain at the injection site Signs and symptoms of infection Anaphylaxis Myalgias

Anaphylaxis

A postpartum patient is admitted with a fever of 102.8° F (39.3° C), origin unknown. Assessment reveals cloudy, foul-smelling urine that is dark amber in color. Orders have just been written to obtain stat urine and blood cultures and to administer an antibiotic intravenously. The nurse will complete these orders in which sequence? Blood culture, antibiotic dose, urine culture Urine culture, antibiotic dose, blood culture Antibiotic dose, blood and urine cultures Blood and urine cultures, antibiotic dose

Blood and urine cultures, antibiotic dose

A client treated with heparin sodium exhibits signs and symptoms of heparin overdose. The nurse should place priority on initiating which action? Administer a standard dose of 50 mg of protamine sulfate over a 10-minute period. Draw a client's activated partial thromboplastin time. Determine amount of heparin infused along with time frame associated with infusion. Administer protamine sulfate concurrently with vitamin K to increase its therapeutic effect.

Determine amount of heparin infused along with time frame associated with infusion.

The nurse recognizes that patient teaching regarding warfarin (Coumadin) has been successful when the patient acknowledges an increased risk of bleeding with concurrent use of which herbal product? (Select all that apply.) Garlic Ginkgo Dong quai Glucosamine St. John's wort

Garlic Ginkgo Dong quai St. John's wort

The nurse is caring for a patient who is prescribed long-term aspirin therapy to prevent a stroke. Which parameters should the nurse assess as a result of this prescription? Select all that apply. Heart rate Hemoglobin Respirations Platelet Count Blood Pressure Activated partial thromboplastin time (aPTT)

Hemoglobin Platelet Count Activated partial thromboplastin time (aPTT)

The nurse is monitoring a patient receiving alteplase for treatment of an arterial embolism in the left leg. Which finding indicates that the therapy is effective? 2+ pitting edema Faint posterior tibial pulse Left leg warm to touch Numbness in left leg

Left leg warm to touch

A client diagnosed with iron-deficiency anemia is taking iron supplements. The nurse should instruct the client to include which of the following foods to enhance absorption of the medication? Green leafy vegetables Whole-grain bread and cereals Yogurt Orange juice or lemonade

Orange juice or lemonade

Because a hypertensive client is experiencing postpartum hemorrhage, the nurse anticipates that the healthcare provider will likely prescribe which drug to treat the hemorrhage? Ergonovine Methylergonovine Oxytocin Carboprost tromethamine

Oxytocin

During a postpartum assessment, the nurse notes a boggy uterus and increased uterine bleeding. Which drug should the nurse anticipate will be prescribed? Oxytocin Terbutaline Clomiphene Prostaglandin E

Oxytocin

The nurse is monitoring the activated partial thromboplastin time (aPTT) for a client receiving heparin therapy. When the latest aPTT is 2.0 times the normal aPTT, the nurse should perform which action based on the result? Assess for bleeding gums after toothbrushing is complete. Perform a test for occult blood on stool. Assess client for abnormal bruising. Report the value during the intershift report.

Report the value during the intershift report.

The nurse interprets a patient's international normalized ratio (INR) value of 2.5. What is the meaning of this reported value? The patient is not receiving enough warfarin for a therapeutic effect. The patient's warfarin dose is therapeutic. The patient is not receiving enough subcutaneous heparin for a therapeutic effect. The patient is receiving a dangerously high amount of heparin.

The patient's warfarin dose is therapeutic

A postpartum patient who has a severe infection in her incision being given gentamicin (an aminoglycoside) therapy, the nurse will monitor the patient for which indicators of potential toxicity? Fever White blood cell count of 8000 cells/mm3 Tinnitus and rising BUN levels Decreased potassium levels

Tinnitus and rising BUN levels

A postpartum client who experienced postpartum depression has been taking daily doses of Fluoxetine for 6 months and has asked for information from the nurse about going off the medication. What should the nurse emphasize in the information session? Urge the client to continue taking the medication. Urge the client to consult with the health care provider and so they can taper the medication to avoid discontinuation syndrome Stop taking the medication immediately, increase physical activity level for 2-3 weeks to counteract side effects Advise the patient of probable weight gain after going off the medication

Urge the client to consult with the health care provider and so they can taper the medication to avoid discontinuation syndrome

The nurse received a prescription to start IV heparin on a client admitted with deep vein thrombosis. To implement this order appropriately, which action should the nurse take? Place vitamin K at the bedside. Tell client about need for being NPO while the medication is infusing. Use an infusion pump to administer the drug. Weigh the client twice weekly.

Use an infusion pump to administer the drug.

The nurse is assessing a patient who has been taking warfarin and vitamin K1 for the past week. The lab reports reveal that the patient has developed venous thromboembolism. What vitamin ingestion may be the reason for this finding? Vitamin A Vitamin D Vitamin E Vitamin K

Vitamin K

The nurse checks the lab values of a client receiving chemotherapy who is scheduled to receive epoetin alfa subcutaneously. Upon finding the hemoglobin is 12.2 grams/dL, the nurse should take which actions? Select all that apply. Administer the medication as prescribed. Withhold the medication dose. Check the client's platelet count before administering the epoetin alfa. Notify the primary care provider of the client's laboratory value. Assess the client for signs of internal bleeding.

Withhold the medication dose. Notify the primary care provider of the client's laboratory value.

An infant girl with a tympanic membrane temperature of 38.3 C is scheduled to receive the second diphtheria, pertussis, and tetanus (DPT) vaccine along with the inactivated poliovirus vaccine (IPV). The nurse should take which action? Withhold vaccines and reschedule her visit when she is not febrile. Administer injection and instruct mother to administer an antipyretic when she gets home. Administer acetaminophen orally and give immunizations. Obtain titers on needed immunizations and withhold them until the results are obtained.

Withhold vaccines and reschedule her visit when she is not febrile.

Which medication helps reduce postpartum uterine hemorrhage? Megestrol Raloxifene Clomiphene Methylergonovine

Methylergonovine

Discharge teaching for a patient receiving simvastatin (Zocor) would include the importance of reporting which symptoms that might indicate a serious adverse reaction to the medication? Muscle pain Headache Weight loss Fatigue

Muscle pain

The home health nurse instructs the client to avoid taking ibuprofen after noting a decrease in which laboratory result? Ferritin level Triglyceride level Neutrophil count Platelet count

Platelet count

A patient had a total gastrectomy 12 months ago. The nurse learns that the patient has been eating a well-balanced diet rich in vitamin B12, folic acid, iron, and other micronutrients. Despite this, the patient is diagnosed with anemia. What is the most likely cause of anemia in this patient? Fecal occult blood loss Bone Marrow Depression Deficiency of renal erythropoietin Poor absorption of vitamin B12

Poor absorption of vitamin B12

What is the difference between postpartum psychosis and postpartum depression? Postpartum psychosis is identified by a patient having suicidal or homicidal thoughts. Postpartum psychosis is more common than postpartum depression Postpartum depression requires hospitalization and postpartum psychosis does not. All of the above.

Postpartum psychosis is identified by a patient having suicidal or homicidal thoughts.

Nursing care for a patient receiving alteplase (Activase) would include which action? (Select all that apply.) Record vital signs and report changes. Observe for signs and symptoms of bleeding. Monitor liver enzymes. Assess for cardiac dysrhythmias.

Record vital signs and report changes. Observe for signs and symptoms of bleeding. Assess for cardiac dysrhythmias.

The patient is exhibiting excessive guilt, anxiety, and depression four to six weeks postpartum. What class of medications would you anticipate the physician to order? ECT SSRI NSAID antipsychotic

SSRI

A patient who has been receiving an infusion of heparin has an activated partial thromboplastin time (aPTT) of 120 seconds. What is the nurse's first action? Assess for bleeding Shut off the heparin drip Keep the patient on bed rest Call the health care provider

Shut off the heparin drip

What teaching would the nurse provide to a patient receiving tetanus toxoid? "Increase fluid and fiber in your diet to prevent constipation." "Soreness at the injection site is a common reaction." "You will have lifetime immunity from this injection." "This medication must be repeated weekly for four weeks."

Soreness at the injection site is a common reaction.

What information should the nurse present in an educational seminar for clients who are taking nicotinic acid for elevated cholesterol levels? Select all that apply. Because niacin treatment is individualized, dose adjustments are correlated with lab values. Facial flushing may occur immediately after ingesting dose. Eating a diet high in niacin will ensure medication works effectively. For maximum effect, niacin can be taken concurrently with lovastatin. Taking an aspirin 30 minutes before taking niacin helps reduce flushing.

Taking an aspirin 30 minutes before taking niacin helps reduce flushing. Facial flushing may occur immediately after ingesting dose.

The nurse assesses the patient's activated partial thromboplastin time (aPTT) to determine the effectiveness of the heparin regimen and notes that it is 35 seconds. How will the nurse interpret this value? The aPTT is inadequate to evaluate treatment. The aPTT is significantly decreased. The aPTT is significantly elevated. The aPTT is within normal limits.

The aPTT is significantly decreased.

A client is taking epoetin alfa for treatment of anemia related to chronic renal disease. The nurse uses which clinical finding as the best measure of the drugs effectiveness? The client is not experiencing any related bone pain when the medication is administered. The hemoglobin and hematocrit levels are rising rapidly based on latest two daily blood draws. The client's hemoglobin increases to 12 grams/dL. The client maintains an afebrile state.

The client's hemoglobin increases to 12 grams/dL.

Which statement will indicate to the nurse that the patient understands the discharge instructions regarding cholestyramine (Questran)? "I will take Questran 1 hour before my other medications." "I will increase fiber in my diet." "I will weigh myself weekly." "I will have my blood pressure checked weekly."

"I will increase fiber in my diet."

Which statement, made by the patient, demonstrates a knowledge deficit regarding colestipol (Colestid)? "The medication may cause constipation, so I will increase fluid and fiber in my diet." "I should take this medication 1 hour after or 4 hours before my other medications." "I might need to take fat-soluble vitamins to supplement my diet." "I should mix and stir the powder in a small amount of fluid as possible in order to maintain potency of the medication."

"I should mix and stir the powder in a small amount of fluid as possible in order to maintain potency of the medication."

Which statement, made by the patient, demonstrates a knowledge deficit regarding colestipol (Colestid)? "I should mix and stir the powder in as small amount of fluid as possible in order to maintain potency of the medication." "The medication may cause constipation, so I will increase fluid and fiber in my diet." "I should take this medication 1 hour after or 4 hours before my other medications." "I might need to take fat-soluble vitamins to supplement my diet."

"I should mix and stir the powder in as small amount of fluid as possible in order to maintain potency of the medication."

The nurse evaluates and determines the patient has a good understanding of the discharge instructions regarding warfarin (Coumadin) when the patient responds with which statement? "I should use a soft toothbrush for dental hygiene. I will double my dose if I forget to take it the day before. ""I should keep taking ibuprofen for my arthritis." "I should decrease the dose if I start bruising easily."

"I should use a soft toothbrush for dental hygiene.

The nursing instructor asks a nursing student to describe the procedure for administering erythromycin ointment to the eyes of a newborn. Which student statement indicates that FURTHER teaching is needed? "I will flush the eyes after instilling the ointment." "I will clean the newborn's eyes before instilling ointment." "I need to administer the eye ointment within 1 hour after delivery." "I will instill the eye ointment into each of the newborn's conjunctival sacs."

"I will flush the eyes after instilling the ointment."

Which statement when made by the patient indicates deficient knowledge regarding warfarin? "I will avoid contact sports." "I will take my medication in the early evening each day." "I will increase the dark green leafy vegetables in my diet." "I will contact my physician if I develop excessive bruising."

"I will increase the dark green leafy vegetables in my diet.

A new parent asks the maternal-newborn nurse for information about immunizations for the infant. Which information should be included in client teaching? Select all that apply. "Immunizations to prevent contagious diseases are required by law." "Infants tend to be more susceptible to contagious diseases." "Immunizations are safe without side effects." "The injections are inexpensive or free at the health department." "Immunity to the disease develops immediately after the first immunization, so you may consider not having booster vaccines."

"Immunizations to prevent contagious diseases are required by law." "Infants tend to be more susceptible to contagious diseases." The injections are inexpensive or free at the health department."

What instructions are given to a patient who is prescribed oral iron tablets? "Take the iron tablet in a powdered form." "Take an iron tablet just before going to bed." "Take the iron tablet after dissolving it in water using a straw." "Take the iron tablet with plenty of fluids."

"Take the iron tablet with plenty of fluids."

A nurse instructor is about to administer a vitamin K injection to a newborn. The student nurse asks the instructor regarding the purpose of the injection. The appropriate response would be: "The vitamin K provides active immunity " 'The vitamin K will prevent the occurrence of hyperbilirubinemia." "The vitamin K will protect the newborn from bleeding." "The vitamin K will serve as protection against jaundice and anemia "

"The vitamin K will protect the newborn from bleeding."

The nurse is providing medication information about warfarin to a client who is being discharged following a mechanical heart valve replacement. Which items of information would provide the best protection to the client? Select all that apply. "Follow-up lab testing is required every 3 months." "Use an electric razor and a soft-bristle toothbrush." "Take this medication upon arising in the morning on an empty stomach." "If a dose is missed, take the missed dose with the next scheduled dose." "Eat a diet containing consistent but not large amounts of vitamin K."

"Use an electric razor and a soft-bristle toothbrush." "Eat a diet containing consistent but not large amounts of vitamin K."

When the client with pernicious anemia is asked why vitamin B12 injections are necessary, the nurse should provide which of the following responses? "They contribute to the increased production of red blood cells after a significant blood loss" "Vitamin B12 is needed to prevent the red blood cells from sickling." "Your stomach doesn't produce a substance needed for intestinal of vitamin B12." "Vitamin B12 is needed to prevent excessive production of red blood cells."

"Your stomach doesn't produce a substance needed for intestinal of vitamin B12."

A patient is receiving methylergonovine IM after a vaginal delivery. Which postpartum assessment is the nurse's priority to prevent complications of therapy? Hypertension Hypoglycemia Decreased lochia Uterine contractions

Hypertension

A 12-month-old infant has received an MMR II (measles, mumps, and rubella virus vaccine), and her mother calls the clinic that afternoon to ask about helping her fussy infant to "feel better." What will the nurse suggest? Apply an ice pack to the injection site. Apply warm compresses to the injection site. Observe the site for further swelling and redness. Bring the infant in to the emergency department for an immediate examination.

Apply warm compresses to the injection site.

The home health nurse is scheduling appointments for several clients who are taking folic acid for treatment of folic-acid anemia. Which client should have the first appointment? Client taking vitamin B12 100 mcg daily by subcutaneous injection for pernicious anemia. Client taking tetracycline 500 mg PO four times daily for gonorrhea. Client taking allopurinol 100 mg PO daily for hyperuricemia. Client taking an oral contraceptive daily.

Client taking an oral contraceptive daily.

An allergy to which substance is listed as a contraindication to the administration of an immunizing drug? Soy Corn Wheat Egg

Egg

A nurse is assessing an athlete who has been admitted for cardiac arrest. The investigation reports reveal increased blood viscosity. Which drug did the patient likely receive? Folic acid Ferrous fumarate Epoetin alfa Cyanocobalamin (vitamin B12)

Epoetin alfa

What drug is given for postpartum depression? Fluoxetine oxytocin Naloxalone morphine

Fluoxetine

The nurse would question an order for simvastatin (Zocor) in a patient with which condition? Leukemia Diabetes Hepatic disease Chronic obstructive pulmonary disease (COPD)

Hepatic disease

Which vaccination is recommended in the prevention of a virus that is known to cause cervical cancer? Herpes zoster vaccine Human papillomavirus vaccine Pneumococcal vaccine Hepatitis B virus vaccine

Human papillomavirus vaccine

After taking an antiplatelet medication for several weeks, a client presents with a noticeable bruise on his right arm. What assessment data is most significant to managing the client's health needs? Whether the bruise is the result of specific injury. Whether the client is taking the medication as prescribed. If the client self-monitors for skin manifestations. If the client's response to injury is different now.

If the client's response to injury is different now.

Hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are generally administered at which time? When the stomach is empty In the evening With breakfast With an antacid

In the evening.

By which action does atorvastatin (Lipitor) decrease lipid levels? Inhibiting absorption of dietary cholesterol in the small intestine Binding to bile in the intestinal tract, forming an insoluble complex that is excreted in the feces Stimulating the biliary system to increase excretion of dietary cholesterol Inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver

Inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver

When managing the care of a client receiving intravenous anisteplase, the nurse should take which of the following actions? Select all that apply. Instruct the client to avoid activities that could lead to bruising or bleeding. Handle the client gently when turning and positioning in bed. Post sign at beside that states, "No intramuscular injections." Anticipate medicating the client with ibuprofen for joint pain prn. Monitor laboratory results for 50% decrease in bleeding time.

Instruct the client to avoid activities that could lead to bruising or bleeding. Handle the client gently when turning and positioning in bed. Post sign at beside that states, "No intramuscular injections."

Which test will the nurse use to assess for adverse reactions to HMG-CoA reductase inhibitors? Serum cholesterol levels Liver function tests Serum electrolytes Complete blood count

Liver function tests

Enoxaparin sodium (Lovenox) is an anticoagulant used to prevent and treat deep vein thrombosis and pulmonary embolism. This drug is in which drug group? Low-molecular-weight heparin Oral anticoagulant Glycoprotein IIb/IIIa inhibitor Thrombolytic drug

Low-molecular-weight heparin

While observing a patient self-administer enoxaparin (Lovenox), the nurse identifies the need for further teaching when the patient completes which action? Does not aspirate prior to injecting the medication Massages the site after administration of the medication Administers the medication greater than 2 inches away from the umbilicus Injects the medication and then waits 10 seconds before withdrawing the needle

Massages the site after administration of the medication

The nurse should teach which item of information to a client being discharged on long-term warfarin therapy following cardiac valve replacement therapy? Eat lettuce and tomatoes for lunch only a few times per week. Limit dietary intake of yellow wax beans to twice weekly. Use aspirin for minor aches and pains. Wear shoes that completely enclose the feet.

Wear shoes that completely enclose the feet.

Which medication has antiplatelet properties? clopidogrel enoxaparin heparin alteplase

clopidogrel