Pharm Exam 3 practice Q's

Which adverse effects in the client taking chloroquine would require the nurse to notify the provider immediately? 1. Nausea 2. Tinnitus 3. Diarrhea 4. Blurred vision

Correct Answer: 4 Rationale 4: Blurred vision could indicate retinal toxicity and should be reported immediately. Rationale 1: Nausea can occur but does not require immediate reporting to the provider. Rationale 2: Tinnitus is not an adverse effect of chloroquine. Rationale 3: Diarrhea, should it occur, would not need to be reported immediately.

The nurse correctly states that which function is not characteristic of the parietal cells? 1. Secretion of intrinsic factor 2. Microbial control 3. Secretion of hydrochloric acid 4. Secretion of pepsinogen

Correct Answer: 4 Rationale 4: Chief cells, not parietal cells, secrete the enzyme pepsinogen. Rationale 1: Parietal cells secrete intrinsic factor. Rationale 2: Secretions from parietal cells kill microbes that have been ingested. Rationale 3: Parietal cells secrete hydrochloric acid.

The nurse caring for which client would question an order for acyclovir (Zovirax)? 1. Client with hepatitis B 2. Client with varicella-zoster 3. Client with herpes simplex 2 encephalitis 4. Client with cytomegalovirus

Correct Answer: 1 Rationale 1: Acyclovir (Zovirax) is not used to treat hepatitis B. Rationale 2: Acyclovir (Zovirax) is used to treat the symptoms of varicella-zoster. Rationale 3: Acyclovir (Zovirax) is used to treat the symptoms of herpes simplex viruses 1 and 2. Rationale 4: Acyclovir (Zovirax) is used to treat the symptoms of cytomegalovirus.

A client is diagnosed with a gastric ulcer secondary to NSAID overuse. The nurse would question which health care provider order? 1. Clarithromycin 2. Omeprazole 3. Famotidine 4. Ranitidine

Correct Answer: 1 Rationale 1: A combination of antibiotics is concurrently used to eradicate H. pylori and help decrease antibiotic resistance. Those with peptic ulcers who are not infected with H. pylori have been shown to have a worse outcome when receiving H. pylori treatment. Rationale 2: Proton pump inhibitors are indicated for use in gastric ulcers. Rationale 3: H2-receptor antagonists are indicated for use in gastric ulcers. Rationale 4: H2-receptor antagonists are indicated for use in gastric ulcers.

A client with peptic ulcer disease is undergoing pharmacologic therapy. After reviewing the medication administration record, the nurse suggests changing a prn pain order of ibuprofen to: 1. acetaminophen. 2. aspirin. 3. ketorolac. 4. naprosyn.

Correct Answer: 1 Rationale 1: Acetaminophen has analgesic and antipyretic qualities only. This drug should not worsen the progression of PUD. Rationale 2: Aspirin, an NSAID, should be avoided in clients with PUD. Rationale 3: Ketorolac, an NSAID, should be avoided in clients with PUD. Rationale 4: Naprosyn, an NSAID, should be avoided in clients with PUD.

The client receives acyclovir (Zovirax) for treatment of genital herpes. What is a priority assessment by the nurse? 1. Increased serum creatinine 2. Thrombocytopenia 3. Respiratory distress 4. Auditory and visual hallucinations

Correct Answer: 1 Rationale 1: Acyclovir (Zovirax) is nephrotoxic, so serum creatinine should be monitored. Rationale 2: Thrombocytopenia is not an adverse effect of acyclovir. Rationale 3: Respiratory distress is not an adverse effect of acyclovir. Rationale 4: Auditory and visual hallucinations are not adverse effects of acyclovir.

The health care provider orders amantadine (Symmetrel) for a client with influenza. Which part of the client's health history would the nurse report to the health care provider prior to administering amantadine (Symmetrel)? 1. Epilepsy 2. Chronic obstructive pulmonary disease (COPD) 3. Diabetes mellitus 4. Allergy to shellfish

Correct Answer: 1 Rationale 1: Amantadine (Symmetrel) is associated with seizures, and should not be administered to a client with epilepsy. Rationale 2: Chronic obstructive pulmonary disease (COPD) is an indication for amantadine because influenza could be fatal in this client. Rationale 3: Diabetes is not a contraindication to the use of amantadine. Rationale 4: An allergy to shellfish is not a contraindication to the use of amantadine.

The nurse is caring for a client with irritable bowel syndrome (IBS). Which drugs would most likely be used to treat this disorder? 1. Antispasmodics 2. Saline cathartics 3. Sulfasalazine 4. Immunosuppressive agents

Correct Answer: 1 Rationale 1: Antispasmodics may be used to treat irritable bowel syndrome. Rationale 2: Saline cathartics would not be used to treat irritable bowel syndrome, as they would aggravate the symptoms. Rationale 3: Sulfasalazine would be used to treat inflammatory bowel disease. Rationale 4: Immunosuppressive agents would be used to treat inflammatory bowel disease.

A client diagnosed with GERD asks the nurse what his treatment will be. The nurse correctly states: 1. "You likely will be instructed to change your lifestyle to see if that helps relieve your symptoms." 2. "We will start you on an over-the-counter agent because you have easy access to them and a small chance of overdosing on them." 3. "We need to attack this early, and will start with combination therapy." 4. "GERD will require a surgical treatment for symptom relief."

Correct Answer: 1 Rationale 1: Before initiating pharmacotherapy, clients are usually advised to change lifestyle factors that might be contributing to the severity of GERD. Rationale 2: Lifestyle changes should be initiated prior to medications. Rationale 3: Combination therapy should follow if lifestyle modifications are not effective. Rationale 4: Surgery is not a first-line treatment for the symptoms of GERD.

A client with severe diarrhea asks the nurse why so much water is being expelled with each bowel movement. The nurse explains that: 1. the intestines are not reabsorbing sufficient fluid. 2. the client needs to take a laxative at this time. 3. the intestines are reabsorbing too much fluid. 4. peristalsis is too slow.

Correct Answer: 1 Rationale 1: Diarrhea occurs when the small or large intestine fails to reabsorb sufficient fluid. Rationale 2: Laxatives would be contraindicated in a client who is having severe diarrhea. Rationale 3: If the intestines are reabsorbing too much fluid, the likely outcome is constipation. Rationale 4: When the client has diarrhea, peristalsis is too fast for the fluids to be reabsorbed.

The nurse caring for a client with giardiasis expects the client to have symptoms that primarily affect the: 1. gastrointestinal system. 2. integumentary system. 3. renal system. 4. respiratory system.

Correct Answer: 1 Rationale 1: Giardiasis is a disorder affecting the GI system. Rationale 2: The skin is not disrupted in giardiasis. Rationale 3: Giardiasis does not primarily affect the renal system. Rationale 4: The respiratory system is not affected by giardiasis.

A 48-year-old male is returned from endoscopy with a diagnosis of a duodenal ulcer. The nurse is aware that the most likely causative agent for this ulcer is: 1. H. pylori. 2. prolonged NSAID use. 3. intermittent use of glucocorticoids. 4. chronic stress.

Correct Answer: 1 Rationale 1: H. pylori-associated ulcers are most likely to be duodenal. Rationale 2: NSAID-related ulcers are more likely to produce gastric ulcers. Rationale 3: Intermittent use of glucocorticoids is not the most common causative agent for this client population. Rationale 4: Chronic stress is not the most common causative agent for this client population.

What would the nurse assess in a client taking primaquine based on an understanding of the adverse effects? 1. The urine for evidence of hemoglobin 2. The eyes for evidence of icterus 3. The skin for photosensitivity 4. The stool for lack of bile

Correct Answer: 1 Rationale 1: Hemolytic anemia is the major adverse effect. Rationale 2: This would indicate liver inflammation, which is not a primary adverse effect of primaquine. Rationale 3: Photosensitivity is not an adverse effect of primaquine. Rationale 4: This is a symptom of bile blockage, not an adverse effect of primaquine.

A client who was taking large doses of ibuprofen (Motrin) for over a year developed a peptic ulcer. The client asks the nurse why this occurred. The nurse best answers the client by stating: 1. "Motrin works against your own body's ulcer defenses." 2. "It sounds like your stress might have caused your ulcer." 3. "Taking Motrin cannot cause a peptic ulcer." 4. "The natural defenses of your large intestine were overwhelmed."

Correct Answer: 1 Rationale 1: Ibuprofen is a prostaglandin antagonist. This will decrease the defenses of the gastric mucosa and could precipitate a peptic ulcer. Rationale 2: The nurse does not answer the client's question correctly and is eliciting information that is not pertinent to the discussion at this time. Rationale 3: The use of NSAIDs and corticosteroids is associated with the development of peptic ulcers. Rationale 4: Ibuprofen is a prostaglandin antagonist. This will decrease the defenses of the gastric mucosa and could precipitate a peptic ulcer.

A client with GERD must be cautioned against the overuse of antacids to avoid which syndrome? 1. Metabolic alkalosis 2. Metabolic acidosis 3. Respiratory alkalosis 4. Respiratory acidosis

Correct Answer: 1 Rationale 1: Ingestion of large amounts of antacid can leave a client with a pH base excess. This contributes to metabolic alkalosis. Rationale 2: Metabolic acidosis is a syndrome where there is a base deficit or acid excess. Rationale 3: Respiratory alkalosis is associated with hyperventilation. Rationale 4: Respiratory acidosis is associated with hypoventilation.

The nurse should teach the client taking itraconazole (Sporanox) capsules that: 1. the medication may take 2 or more weeks to reach therapeutic levels. 2. the medication should be taken on an empty stomach. 3. the skin could turn yellow. 4. gynecomastia could occur.

Correct Answer: 1 Rationale 1: It can take 2 weeks for this medication to reach therapeutic levels. Rationale 2: The medication should be taken with food. Rationale 3: Itraconazole does not turn the skin yellow. Rationale 4: Gynecomastia does not occur.

A nurse is ordered to administer lansoprazole to a client on a mechanical soft diet. How should the nurse administer this medication? 1. Sprinkle granules into applesauce, then administer. 2. Crush the tablet and stir it into pudding, then administer. 3. Ask the client to chew the medication. 4. First ask the client to drink an entire glass of water, then give the medication.

Correct Answer: 1 Rationale 1: Lansoprazole granules may be sprinkled from the capsule into soft foods such as applesauce. Rationale 2: Do not crush, break, or chew lansoprazole tablets. If taking lansoprazole capsules, the granules may be sprinkled from the capsule into soft foods such as applesauce. Rationale 3: Do not crush, break, or chew lansoprazole tablets. Rationale 4: The client should be ordered to drink a full glass of water after taking the medication to ensure all medication is taken.

The nurse is instructing a client who has been prescribed bulk-forming laxatives. Which statement by the client indicates understanding of the use of laxatives? 1. "They work to increase the frequency and quality of bowel movements." 2. "They are indicated for the relief of bowel obstruction." 3. "I should use them when I have diarrhea caused by an infection." 4. "I can use them liberally whenever I don't have regular bowel movements."

Correct Answer: 1 Rationale 1: Laxatives work to increase the frequency and quality of bowel movements. Rationale 2: Bulk-forming laxatives would not be helpful when a client has a bowel obstruction, and they could cause perforation of the bowel. Rationale 3: Laxatives cause diarrhea and would be contraindicated when the client has diarrhea. Rationale 4: It is important that laxatives be used only when necessary, as overdependence can be harmful.

The nurse is planning care for a client with PUD. What treatment goal should be included in the plan of care for this client? 1. Prevent recurrence of the disease. 2. Patient reports tolerating symptoms. 3. Reduce the level of H. pylori by one-third. 4. Promote stasis of the ulcer.

Correct Answer: 1 Rationale 1: Preventing the recurrence of the disease is a treatment goal. Rationale 2: Immediate relief of symptoms is a treatment goal. Rationale 3: Eradication of H. pylori is a treatment goal. Rationale 4: Healing of the ulcer is a treatment goal.

A client who has been hospitalized with a viral infection asks the nurse why the doctor did not prescribe a medication. The nurse explains that with some viruses, drug therapy is not warranted because: 1. some viruses are self-limiting, and adverse effects can occur. 2. the drugs are not strong enough for effective treatment. 3. most drugs work for only a short period. 4. some drugs work only on prevention, not treatment.

Correct Answer: 1 Rationale 1: Some viruses are self-limiting, and the adverse effects of drug therapy can be worse than the symptoms of the viral infection itself. Rationale 2: Many drugs are available for effective treatment. Rationale 3: Many drugs work for an extended period. Rationale 4: Many drugs are available for prevention and treatment of viruses.

A client is prescribed an H2-receptor antagonist. The nurse teaches this client that the purpose of the drug is to: 1. reduce gastric acid secretion in the stomach. 2. prevent the vasodilating effects of histamine. 3. alleviate nasal allergy symptoms. 4. prevent the release of histamine from MAST cells.

Correct Answer: 1 Rationale 1: The H2 receptors, located on the parietal cells in the stomach, promote acid secretion when activated. Rationale 2: Vasodilation is a symptom of inflammation and allergy associated with H1 receptors. Rationale 3: Nasal allergy symptoms are caused, in part, by H1 receptors. Rationale 4: H2 receptor antagonists do not stabilize MAST cells.

During a pain assessment, a client reports stomach pain that feels like gnawing in the upper abdomen that occurs about 1-1/2 hours after eating meals. The nurse identifies these symptoms to be most consistent with: 1. a duodenal ulcer. 2. acute appendicitis. 3. an exacerbation of diverticulitis. 4. cholelithiasis.

Correct Answer: 1 Rationale 1: The characteristic symptom of a duodenal ulcer is a gnawing or burning, upper abdominal pain that occurs 1-3 hours after a meal. The pain is worse when the stomach is empty and often disappears with ingestion of food. Rationale 2: The pain associated with acute appendicitis is localized in the right lower quadrant. Rationale 3: The pain associated with diverticulitis is localized in the left lower quadrant. Rationale 4: The pain of cholelithiasis, otherwise known as gallstones, is described as epigastric. Ingestion of fatty foods makes this pain worse.

A female client has a fungal infection and will receive griseofulvin. What assessment data is critical for the nurse to collect prior to administering this medication? 1. The type of birth control the patient is using 2. The client's height and weight 3. The client's cholesterol level 4. The amount of cheese products the client eats

Correct Answer: 1 Rationale 1: The medication is a pregnancy category C drug. Rationale 2: The client's height and weight do not impact this drug. Rationale 3: Cholesterol levels are not affected positively or negatively by this medication. Rationale 4: Cheese products do not interfere with this medication. They interfere with tetracycline antibiotics.

The nurse is providing education regarding ketoconazole (Nizoral). The nurse knows the client has understood the teaching when the client states: 1. "I could develop nausea, vomiting, and abdominal pain with this medication." 2. "I cannot take this medication longer than 10 days." 3. "I should take this medication on an empty stomach." 4. "I could develop resistance to this medication if I take it too often."

Correct Answer: 1 Rationale 1: The most common side effect of ketoconazole is nausea. Rationale 2: The client might need to take the medication for several weeks. Rationale 3: To prevent gastric upset, the medication should be taken with food or milk. Rationale 4: Clients taking ketoconazole do not develop resistance.

A client diagnosed with Barrett esophagus might require the most efficient pharmacologic therapy of GERD. This would include the use of which class of drug? 1. Proton pump inhibitor 2. Antacid 3. Magnesium citrate 4. H2-receptor antagonist

Correct Answer: 1 Rationale 1: The proton pump inhibitors reduce acid secretion to a greater extent than do the H2-receptor antagonists and have a longer duration of action. Rationale 2: Antacids are not as effective in treating GERD as are proton pump inhibitors. Rationale 3: Magnesium citrate generally is used as a cathartic and is not indicated for use in the treatment of GERD. Rationale 4: H2-receptor antagonists are not as effective in treating GERD as are proton pump inhibitors.

A client who is experiencing explosive diarrhea asks the nurse what causes the condition. The nurse responds that diarrhea can be a defense mechanism that removes: (Select all that apply). 1. toxins. 2. pathogens. 3. excess stool. 4. excess water. 5. excess nutrients.

Correct Answer: 1,2 Rationale 1: In some cases, diarrhea is a type of body defense, rapidly and completely ridding the body of toxins. Rationale 2: In some cases, diarrhea is a type of body defense, rapidly and completely ridding the body of pathogens. Rationale 3: Removing excess stool is not a body defense associated with diarrhea. Rationale 4: Removing excess water is not a body defense associated with diarrhea. Rationale 5: Removing excess nutrients is not a body defense associated with diarrhea.

The nurse knows that treatment with pyrimethamine must be stopped if the client exhibits which reactions? (Select all that apply). 1. Seizure 2. A drop in red blood cells 3. Nausea 4. Vomiting 5. Anorexia

Correct Answer: 1,2 Rationale 1: Pyrimethamine can stimulate the CNS and cause seizures. Rationale 2: Serious adverse effects such as folic acid deficiency, megaloblastic anemia, pancytopenia, thrombocytopenia, and leukopenia may occur. Rationale 3: Nausea is a common adverse effect and would not require the drug to be discontinued. Rationale 4: Vomiting is a common adverse effect and would not require the drug to be discontinued. Rationale 5: Anorexia is a common adverse effect and would not require the drug to be discontinued.

The nurse is caring for a client suspected of having a protozoan infection of the intestines. The nurse knows that which protozoan infections are spread by poor sanitation? (Select all that apply). 1. Amebiasis 2. Giardiasis 3. Cryptosporidiosis 4. Toxoplasmosis 5. Trichomoniasis

Correct Answer: 1,2,3 Rationale 1: Amebiasis is a protozoan infection that is typically spread by poor sanitation. Rationale 2: Giardiasis is a protozoan infection that is typically spread by poor sanitation. Rationale 3: Cryptosporidiosis is a protozoan infection that is typically spread by poor sanitation. Rationale 4: Toxoplasmosis is an infection caused by the protozoan Toxoplasma gondii. The domestic cat is an intermediate host to the parasite and serves as a primary means of transmission to humans. The only method of direct human-to-human transmission is from an infected mother to her fetus. Rationale 5: Trichomoniasis is a parasitic infection caused by the protozoan T. vaginalis. It is a common sexually transmitted infection (STI), affecting approximately 15% of women visiting STI clinics in the United States (2.5 to 3 million women).

The nurse is caring for a client with PUD. What signs and symptoms does the nurse expect the client to exhibit? (Select all that apply). 1. Anorexia 2. Weight loss 3. Vomiting 4. Heartburn 5. Belching

Correct Answer: 1,2,3 Rationale 1: Anorexia is a symptom that is often associated with PUD. Rationale 2: Weight loss is a symptom that is often associated with PUD. Rationale 3: Vomiting is a symptom that is often associated with PUD and GERD. Rationale 4: Heartburn is a symptom that is often associated with GERD. Rationale 5: Belching is a symptom that is often associated with GERD.

The nurse is providing chemoprophylaxis drug therapy for a client who will be traveling to a country with a high incidence of malaria. Which drugs are appropriate for chemoprophylaxis? (Select all that apply). 1. Chloroquine 2. Atovaquone-proguanil 3. Primaquine 4. Artemether-lumefantrine 5. Quinine sulfate

Correct Answer: 1,2,3 Rationale 1: Chloroquine is a medication that can be used for chemoprophylaxis of malaria. Rationale 2: Atovaquone-proguanil is a medication that can be used for chemoprophylaxis of malaria. Rationale 3: Primaquine is a medication that can be used for chemoprophylaxis of malaria. Rationale 4: Artemether-lumefantrine is a medication used to treat an acute malarial attack and is not used for chemoprophylaxis. Rationale 5: Quinine sulfate is a medication used to treat an acute malarial attack and is not used for chemoprophylaxis.

The nurse treating a client with malaria knows that the goals of pharmacotherapy include: (Select all that apply). 1. chemoprophylaxis. 2. treatment of acute attacks. 3. prevention of relapses. 4. prevention of bacterial infections. 5. prevention of viral infections.

Correct Answer: 1,2,3 Rationale 1: One of the three main goals of malaria pharmacotherapy is chemoprophylaxis. Rationale 2: One of the three main goals of malaria pharmacotherapy is the treatment of acute attacks. Rationale 3: One of the three main goals of malaria pharmacotherapy is the prevention of relapses. Rationale 4: Preventing bacterial infections is not a main goal of malaria pharmacotherapy. Rationale 5: Preventing viral infections is not a main goal of malaria pharmacotherapy.

What are the principal physiological stimuli that regulate acid secretion from the proton pump? (Select all that apply). 1. Gastrin 2. Histamine (H2) 3. Acetylcholine 4. Intrinsic factor 5. Dopamine

Correct Answer: 1,2,3 Rationale 1: Parietal cells receive messages from several sources, which tell them to increase or decrease acid production. These cells contain receptors for the hormone gastrin, which is a principal physiological stimulus that regulates acid secretion from the proton pump. Rationale 2: Parietal cells receive messages from several sources, which tell them to increase or decrease acid production. These cells contain receptors for histamine (H2), which is a principal physiological stimulus that regulates acid secretion from the proton pump. Rationale 3: Parietal cells receive messages from several sources, which tell them to increase or decrease acid production. These cells contain receptors for the neurotransmitter acetylcholine, which is a principal physiological stimulus that regulates acid secretion from the proton pump. Rationale 4: Intrinsic factor does not play a role in the regulation of acid secretion from the proton pump. Rationale 5: Dopamine does not play a role in the regulation of acid secretion from the proton pump.

The nurse who is planning care for a client with GERD anticipates that the health care provider will order medications from which drug class? (Select all that apply). 1. Proton pump inhibitors 2. H2-receptor antagonists 3. Antacids 4. Diuretics 5. Antianginals

Correct Answer: 1,2,3 Rationale 1: Proton pump inhibitors are utilized in the treatment of GERD. Rationale 2: H2-receptor antagonists are utilized in the treatment of GERD. Rationale 3: Antacids are utilized in the treatment of GERD. Rationale 4: Diuretics are not utilized in the treatment of GERD.

The nurse is teaching a pharmacology course when a student comments that bacteria and protozoans are alike. The nurse would be correct in noting that, in contrast to bacteria, protozoans: 1. are more easily treated. 2. do not have vectors. 3. go through maturation stages in the host. 4. are short lived.

Correct Answer: 3 Rationale 3: The protozoans go through maturation stages in the host. Rationale 1: Protozoans are not easily treated. Rationale 2: Protozoans can be passed through vectors. Rationale 4: Protozoans have long lives.

The nurse is providing instruction to a client with a fungal infection who will be discharged home soon. The nurse evaluates that learning has occurred when the client makes which statement(s)? (Select all that apply). 1. "Systemic infections require oral medications that have serious adverse effects." 2. "Superficial infections are considered more benign than are systemic infections." 3. "Newer medications can be used for superficial as well as systemic infections." 4. "Systemic infections are much more common than are superficial infections." 5. "Superficial infections are more difficult to treat than are systemic infections."

Correct Answer: 1,2,3 Rationale 1: Systemic fungal infections require many months of treatment with oral medications, many of which have serious side effects. Rationale 2: Superficial fungal infections are considered more benign than are systemic infections. Rationale 3: Newer medications can be used for both superficial and systemic infections. Rationale 4: Superficial fungal infections are more common. Rationale 5: Systemic infections are the most difficult to treat.

During an in-service on viruses, the nurse describes the components of a viral envelope, including: (Select all that apply). 1. phospholipids. 2. glycoprotein. 3. protein "spikes." 4. glucose. 5. carbohydrate.

Correct Answer: 1,2,3 Rationale 1: The viral envelope consists partly of phospholipids. Rationale 2: The viral envelope consists partly of glycoprotein. Rationale 3: The viral envelope consists partly of protein "spikes." Rationale 4: The viral envelope does not contain glucose. Rationale 5: The viral envelope does not contain carbohydrate.

The nurse recognizes that which clients in a medical-surgical unit are at increased risk for acquiring systemic fungal infections and may require prophylactic pharmacological therapy? (Select all that apply). 1. The client with lupus being treated with steroids 2. The client who has AIDS 3. The client who is being treated with chemotherapy for breast cancer 4. The client who is status post a heart transplant 5. The client recovering from an appendectomy

Correct Answer: 1,2,3,4 Rationale 1: Prophylactic antifungal therapy is sometimes indicated for high-risk clients, such as those receiving prolonged therapy with corticosteroids. Rationale 2: Prophylactic antifungal therapy is sometimes indicated for high-risk clients, such as those with HIV or AIDS. Rationale 3: Prophylactic antifungal therapy is sometimes indicated for high-risk clients, such as those being treated with antineoplastic medications. Rationale 4: Prophylactic antifungal therapy is sometimes indicated for high-risk clients, such as those who received an organ transplantation. Rationale 5: A client who is status post an appendectomy is not at increased risk for developing a systemic fungal infection and would not be a candidate for prophylactic antifungal therapy.

The nurse caring for a client with PUD explains that the treatment goals include: (Select all that apply). 1. immediate relief from symptoms. 2. promoting healing of the ulcer. 3. preventing complications of the disease. 4. preventing future recurrence of the disease. 5. reduction of the level of H. pylori by one-third.

Correct Answer: 1,2,3,4 Rationale 1: The goals of PUD pharmacotherapy are to provide immediate relief from symptoms. Rationale 2: The goals of PUD pharmacotherapy are to promote healing of the ulcer. Rationale 3: The goals of PUD pharmacotherapy are to prevent complications of the disease. Rationale 4: The goals of PUD pharmacotherapy are prevent future recurrence of the disease. Rationale 5: Eradication of H. pylori is a key factor in the goal of pharmacotherapy for PUD.

The nurse knows that in recent years there has been a rising need for effective treatments for fungal infections because of: (Select all that apply). 1. the increased incidence of HIV/AIDS. 2. advances in chemotherapeutic drugs. 3. increased use of indwelling IV catheters. 4. the overuse of broad-spectrum antibiotics. 5. the overuse of antiviral medications.

Correct Answer: 1,2,3,4 Rationale 1: The past few decades have seen a dramatic rise in the incidence of fungal infections due to AIDS. Fungi are much more complex than bacteria and require a different approach to pharmacotherapy. Rationale 2: The past few decades have seen a dramatic rise in the incidence of fungal infections due to aggressive cancer chemotherapy. Fungi are much more complex than bacteria and require a different approach to pharmacotherapy. Rationale 3: The past few decades have seen a dramatic rise in the incidence of fungal infections due to the widespread use of indwelling intravenous (IV) catheters. Fungi are much more complex than bacteria and require a different approach to pharmacotherapy. Rationale 4: The past few decades have seen a dramatic rise in the incidence of fungal infections due to the overuse of broad-spectrum antibiotics. Fungi are much more complex than bacteria and require a different approach to pharmacotherapy. Rationale 5: There is no evidence that the overuse of antiviral medications has increased the incidence of fungal infections.

The nurse receives an order to administer prochlorperazine (Compazine) to a client with nausea. The nurse can administer the medication by which routes? (Select all that apply). 1. By mouth 2. Per rectum 3. Intramuscularly (IM) 4. Subcutaneously (SQ) 5. Intravenously

Correct Answer: 1,2,3,5 Rationale 1: Prochlorperazine (Compazine) can be administered by mouth. Rationale 2: Prochlorperazine (Compazine) can be administered per rectum. Rationale 3: Prochlorperazine (Compazine) can be administered by IM injection. Rationale 5: Prochlorperazine (Compazine) can be administered intravenously. Rationale 4: Prochlorperazine (Compazine) cannot be administered by SQ injection.

The nurse caring for a hospitalized client monitors for which opportunistic fungal infections? (Select all that apply). 1. Candidiasis 2. Aspergillosis 3. Sporotrichosis 4. Cryptococcosis 5. Mucormycosis

Correct Answer: 1,2,4,5 Rationale 1: An opportunistic fungal infection that is likely to be acquired in a hospital setting is candidiasis. Rationale 2: An opportunistic fungal infection that is likely to be acquired in a hospital setting is aspergillosis. Rationale 3: Sporotrichosis is more commonly a community-acquired infection. Rationale 4: An opportunistic fungal infection that is likely to be acquired in a hospital setting is cryptococcosis. Rationale 5: An opportunistic fungal infection that is likely to be acquired in a hospital setting is mucormycosis.

The nurse would correctly identify a superficial mycosis as one affecting the: (Select all that apply). 1. skin. 2. mucous membranes. 3. dermis. 4. nails. 5. scalp.

Correct Answer: 1,2,4,5 Rationale 1: Infections in the skin would be considered superficial mycoses. Rationale 2: Infections in the mucous membranes would be considered superficial mycoses. Rationale 3: Infections in the dermis would be considered subcutaneous mycoses. Rationale 4: Infections in the nails would be considered superficial mycoses. Rationale 5: Infections in the scalp would be considered superficial mycoses.

Several clients are being seen in the emergency department for nausea and vomiting. Which clients are at an increased risk for dehydration and would require pharmacotherapy to treat this condition? (Select all that apply). 1. A 1-week-old neonate 2. A 2-year-old toddler 3. A 36-year-old female 4. A 22-year-old male 5. An 80-year-old female

Correct Answer: 1,2,5 Rationale 1: Dehydration is especially dangerous for infants, and nausea and vomiting should be treated due to the client's age. Rationale 2: Dehydration is especially dangerous for small children, and nausea and vomiting should be treated due to the client's age. Rationale 5: Dehydration is especially dangerous for the older adult. Nausea and vomiting may require treatment with pharmacotherapy. Rationale 3: Dehydration is not especially dangerous for healthy adults, and nausea and vomiting may not require treatment with pharmacotherapy. Rationale 4: Dehydration is not especially dangerous for healthy adults, and nausea and vomiting may not require treatment with pharmacotherapy.

The nurse is teaching the family of a client recently diagnosed with PUD. The nurse knows the family understands the teaching when they state that the risk factors for the development of PUD include: (Select all that apply). 1. infection with the bacterium Helicobacter pylori. 2. daily use of aspirin. 3. blood type AB. 4. consumption of caffeine-free soda. 5. smoking.

Correct Answer: 1,2,5 Rationale 1: Helicobacter pylori is a risk factor for the development of PUD. Rationale 2: Daily use of aspirin is a risk factor for the development of PUD. Rationale 5: The use of tobacco products is a risk factor for the development of PUD. Rationale 3: Blood type AB is not a risk factor for the development of PUD. Blood type O is a risk factor as the antigen may be a target of H. pylori attachment. Rationale 4: The consumption of caffeine-free soda is not a risk factor for the development of PUD. The consumption of caffeine is associated with the development of PUD.

The nurse would anticipate administering antiviral medications to which clients in the emergency department? (Select all that apply). 1. A client with an initial outbreak of the herpes-simplex virus 2. A client with ringworm 3. An infant with respiratory syncytial virus (RSV) 4. A client with hepatitis 5. A client with methicillin-resistant Staphylococcus aureus (MRSA)

Correct Answer: 1,3,4 Rationale 1: A client with herpes-simplex virus would benefit from the administration of antiviral medications. Rationale 3: An infant with RSV would benefit from the administration of antiviral medication. Rationale 4: A client with hepatitis would benefit from the administration of antiviral medication. Rationale 2: A client with ringworm would not benefit from the administration of antiviral medication. Rationale 5: A client with MRSA would not benefit from the administration of an antiviral medication. This client would require an antibacterial medication.

A client is being treated with amphotericin B for a serious systemic fungal infection. The nurse instructs the client to immediately report which adverse effects associated with this medication? (Select all that apply). 1. Loss of hearing 2. Visual disturbances 3. Dizziness 4. Ringing in the ears 5. Nausea and vomiting

Correct Answer: 1,3,4 Rationale 1: Amphotericin B can cause ototoxicity potentially affecting both branches, cochlear and vestibular, of cranial nerve VIII. A loss of hearing can be indicative of ototoxicity and should be reported. Rationale 2: Visual disturbances are not caused by this medication. Rationale 3: Amphotericin B can cause ototoxicity potentially affecting both branches, cochlear and vestibular, of cranial nerve VIII. Dizziness can be indicative of ototoxicity and should be reported. Rationale 4: Amphotericin B can cause ototoxicity potentially affecting both branches, cochlear and vestibular, of cranial nerve VIII. A ringing in the ears can be indicative of ototoxicity and should be reported. Rationale 5: At the onset of therapy, as many as 50% of patients experience acute, infusion-related fever and chills, vomiting, anorexia, and headache. These symptoms usually subside as treatment continues and would not need to be reported.

A client is being treated with sulfasalazine (Azulfidine) for inflammatory bowel disease (IBD). Which information is important for the nurse to provide to the client and family? (Select all that apply). 1. It is important to avoid prolonged sun exposure, because the skin might be sensitive. 2. The drug should not be taken for longer than 12 weeks unless recommended by the health care provider. 3. Fluid intake should be 2-3 liters per day to avoid crystal formation in the urine. 4. The medication can color urine and skin orange-yellow. 5. The medication can affect female fertility.

Correct Answer: 1,3,4 Rationale 1: Sulfasalazine can cause skin sensitivity to prolonged sun exposure. Rationale 3: Fluid intake for a client taking sulfasalazine for IBD should be 2-3 liters per day to avoid crystal formation in the urine. Rationale 4: Sulfasalazine can color urine and skin orange-yellow. Rationale 2: Sulfasalazine is indicated for long-term use. Rationale 5: The medication is known to affect male, not female, fertility. The adverse effects on fertility reverse when the medication is stopped.

For which groups of clients would the community nurse recommend vaccination for hepatitis B? (Select all that apply). 1. All infants 2. Sexually active people in a monogamous relationship 3. IV drug abusers 4. Homosexual males 5. Persons with end-stage renal disease

Correct Answer: 1,3,4,5 Rationale 1: All infants, beginning at birth, should be vaccinated against hepatitis B. Rationale 3: IV drug abusers should be vaccinated against hepatitis B. Rationale 4: Males who engage in sexual relations with other males should be vaccinated against hepatitis B. Rationale 5: Persons on dialysis are at increased risk. Rationale 2: Sexually active people who are not in a monogamous relationship should be vaccinated against hepatitis B.

Antiviral medications work by inhibiting or stopping a stage of viral replication. Which statements are descriptions of these stages? (Select all that apply). 1. Attachment of the virus to the host cell 2. Destruction of host cell DNA. 3. Synthesis of the viral nucleic acid and proteins by the host cell 4. Assembly of all viral components, structural proteins, enzymes, and nucleic acids 5. Release of virions from the host cell

Correct Answer: 1,3,4,5 Rationale 1: The first stage of viral infection is the attachment of the virus to the host cell. Rationale 3: The third stage of viral infection is synthesis of the viral nucleic acid and proteins by the host cell. Rationale 4: The fourth stage of viral infection is assembly. All the viral components, structural proteins, enzymes, and nucleic acids are packaged and made ready to leave the cell. Rationale 5: The fifth stage of viral infection is the release of the virions from the host cell. Rationale 2: Destruction of host cell DNA is not a stage of infection.

The nurse is caring for a group of clients on a medical-surgical unit. Which clients would the nurse assess as predisposed to constipation? (Select all that apply). 1. A client who is 85 years old 2. A client with a bacterial infection 3. A client with a history of malabsorption 4. A client with a sedentary lifestyle 5. A client with decreased food intake

Correct Answer: 1,4,5 Rationale 1: Aging slows fecal transit time, which may result in constipation. Rationale 4: Physical activity aids with peristalsis. A sedentary lifestyle could contribute to constipation. Rationale 5: Decreased food intake can decrease the bulk of stool and contribute to constipation. Rationale 2: Infections can contribute to diarrhea. Rationale 3: Malabsorption can contribute to diarrhea.

The nurse is reviewing the medication administration record for a client who is receiving an initial regimen for the eradication of H. pylori. The nurse anticipates the inclusion of which medications for this client? (Select all that apply). 1. Omeprazole 2. Metronidazole 3. Bismuth subsalicylate 4. Amoxicillin 5. Clarithromycin

Correct Answer: 1,4,5 Rationale 1: Omeprazole is a medication included in the initial medication regimen in the eradication of H. pylori. Rationale 4: Amoxicillin is a medication included in the initial medication regimen in the eradication of H. pylori. Rationale 5: Clarithromycin is a medication included in the initial medication regimen in the eradication of H. pylori. Rationale 2: Metronidazole is not included in the initial medication regimen in the eradication of H. pylori. Rationale 3: Bismuth subsalicylate is not included in the initial medication regimen in the eradication of H. pylori.

The client has been diagnosed as having hyperemesis gravidarum. When would the nurse expect the health care provider to prescribe antiemetics? 1. After the pregnancy is terminated 2. After determining that other antinausea methods have been ineffective 3. If the client is troubled by the symptoms 4. Upon diagnosis

Correct Answer: 2

A client is prescribed omeprazole, bismuth subsalicylate, and metronidazole for the treatment of H. pylori. The nurse explains that combination therapy will accomplish which outcome? 1. Increase the number of ulcerations 2. Eliminate the population of H. pylori 3. Allow H. pylori to adhere to the gastric mucosa 4. Immediately relieve symptoms of gastric ulceration

Correct Answer: 2 Rationale 2: A goal of combination therapy is to eliminate the population of H. pylori. Rationale 1: A goal of combination therapy is not to increase the number of ulcerations. Rationale 3: Combination therapy will inhibit bacterial growth by disrupting their cell wall and preventing H. pylori from adhering to the gastric mucosa. Rationale 4: The goal of combination therapy is to eradicate H. pylori and heal ulcerations. Symptoms will not immediately be relieved by this therapy.

Following treatment with praziquantel (Biltricide) for tapeworm infestation, the nurse would expect to administer: 1. yogurt. 2. a laxative. 3. an antacid. 4. a liquid diet.

Correct Answer: 2 Rationale 2: A laxative is administered after treatment for tapeworm infestation. Rationale 1: There is no specific indication for administration of yogurt. Rationale 3: An antacid could interfere with absorption of the medication. Rationale 4: A liquid diet is not indicated.

A client complains of gastroesophageal symptoms every evening. The nurse would include what in the teaching to decrease the client's symptoms? 1. Moderating alcohol use 2. Avoiding acidic foods 3. Sleeping with the legs elevated on pillows 4. Eating smaller meals at least 1 hour before sleep

Correct Answer: 2 Rationale 2: Acidic foods should be avoided in clients with GERD. Rationale 1: Alcohol should be eliminated in clients with GERD. Rationale 3: Clients with GERD should elevate the head of the bed during sleep. Rationale 4: Eating smaller meals at least 3 hours before sleep is recommended in clients with GERD

The nurse caring for a client with amebiasis explains that although other forms of transmission are possible, amebiasis is primarily acquired through: 1. blood transfer. 2. ingestion. 3. respiratory droplets. 4. open sores.

Correct Answer: 2 Rationale 2: Amebiasis is acquired primarily through ingestion. Rationale 1: It is extremely unlikely that amebiasis could be spread through blood transfer. Rationale 3: Amebiasis is not spread through respiratory droplets. Rationale 4: Amebiasis is not spread through open sores.

Which statement is true regarding the prevention and treatment of nausea and vomiting? 1. An antiemetic drug is indicated if the client has ingested a poisonous substance or taken an overdose of an oral medication. 2. Antihistamines and anticholinergic drugs may be used to treat nausea and vomiting due to motion sickness. 3. Medications for nausea and vomiting are available only by prescription. 4. Antiemetic drugs can be used throughout pregnancy.

Correct Answer: 2 Rationale 2: Antihistamines and anticholinergic drugs may be used to treat nausea and vomiting due to motion sickness. Rationale 1: An emetogenic drug (a drug used to produce vomiting) would be indicated if the client has ingested a poisonous substance or taken an overdose of an oral medication. Rationale 3: Medications used to treat nausea and vomiting are available both by prescription and over the counter. Rationale 4: Pharmacotherapy with fluid and electrolyte solutions and antiemetics is initiated after other antinausea measures have proven ineffective.

The nurse demonstrates knowledge of the different mechanisms of action of laxatives by stating: 1. "My client should be encouraged to use a stimulant laxative whenever he feels the need to have a bowel movement." 2. "My client should consume plenty of water, since he is taking a bulk-forming laxative." 3. "My client should not strain when having a bowel movement, so the health care provider likely will prescribe a bulk-forming laxative." 4. "My client should expect to have a delayed reaction to a saline cathartic."

Correct Answer: 2 Rationale 2: Because fiber absorbs water and expands to provide "bulk," bulk-forming laxatives must be taken with plenty of water. Rationale 1: Stimulant laxatives should not be used routinely because they can cause laxative dependence, abdominal cramping, and depletion of fluid and electrolytes. Rationale 3: A bulk-forming laxative can cause a client to have to strain to have a bowel movement, especially when the client does not consume plenty of water. Rationale 4: Saline cathartics can produce a bowel movement very quickly.

The most common reason for prescribing antiemetic drugs is: 1. psychosis. 2. morning sickness. 3. therapy with antineoplastic drugs. 4. hyperemesis gravidarum.

Correct Answer: 3 Rationale 3: Therapy with antineoplastic drugs is one of the most common reasons for prescribing antiemetic drugs. Rationale 1: Psychosis is not one of the most common reasons for prescribing antiemetic drugs. Rationale 2: Morning sickness is not one of the most common reasons for prescribing antiemetic drugs. Rationale 4: Hyperemesis gravidarum is not one of the most common reasons for prescribing antiemetic drugs.

The nurse is reviewing the medical record of a client prescribed mebendazole for the treatment of pinworm. Which patient would the nurse plan to monitor most closely? 1. Age under 12 years 2. Age of 35 years with cirrhosis 3. Age of 42 with lupus 4. Age of 17 with a femoral fracture

Correct Answer: 2 Rationale 2: Because it is metabolized by the liver, patients with serious hepatic impairment should be monitored carefully. Rationale 1: A child under the age of 12 could take this drug if indicated. Rationale 3: Lupus is an inflammatory disorder and would not be a contraindication. Rationale 4: A client with a femoral fracture could take this drug if needed.

The nurse works in infection control at a large hospital. Which client does the nurse recognize as being at greatest risk of acquiring a fungal infection? 1. The client with severe burns over 20% of the body 2. The client with malignant melanoma who is receiving chemotherapy 3. The adolescent client with a fractured femur from an automobile accident 4. The client with anemia who is pregnant with triplets

Correct Answer: 2 Rationale 2: Chemotherapy will decrease the client's immune response, thereby increasing susceptibility to fungal infection. Rationale 1: Even though the line of defense of the skin is partially removed, there is no information that suggests the client is immunocompromised and at great risk. Rationale 3: Adolescents have a healthy immune response. The fractured femur does not increase the risk for infection. Rationale 4: Anemia does not increase the risk of fungal infection.

The nurse understands that a client with which condition might respond abnormally to primaquine therapy? 1. Diabetes insipidus 2. G-6-PD deficiency 3. Gout 4. Trisomy 13

Correct Answer: 2 Rationale 2: Clients with G-6-PD deficiency are at greater risk for hemolytic anemia. Rationale 1: Diabetes insipidus would not affect primaquine therapy. Rationale 3: Gout is associated with uric acid and is not related to greater risk for primaquine therapy. Rationale 4: Trisomy 13 is related to birth defects.

When implementing nursing care, what should the nurse instruct the client and family about laxative use? 1. A side effect of stool softeners is abdominal cramping. 2. Dependence on laxatives can cause constipation. 3. Stool softeners are appropriately used to treat constipation. 4. Laxatives are never harmful because they are available over the counter and should be used anytime the client feels the need to have a bowel movement.

Correct Answer: 2 Rationale 2: Dependence on laxatives can cause constipation. Rationale 1: Stool softeners do not cause the bowels to move; they ease the passage of the stool. They do not cause abdominal cramping. Rationale 3: Stool softeners do not treat constipation. They are used to prevent constipation. Rationale 4: Laxative use can be harmful and should be used only when the client has constipation that is not self-limiting.

When oral mebendazole (Vermox) is prescribed for the treatment of ascariasis, the nurse would expect the drug regimen to be administered: 1. for 1 month. 2. over 3 days. 3. for 7 days. 4. as a single dose.

Correct Answer: 2 Rationale 2: Dosage of oral mebendazole (Vermox) is 3 days. Rationale 1: This dosage schedule would result in overdose of the clients Rationale 3: This dosage schedule is too long. Vermox can treat this infestation in less time. Rationale 4: A single dose of Vermox would not be effective in eliminating scariasis.

The nurse would question the use of amphotericin B in the client concurrently receiving which medication? 1. Actos 2. Vancomycin 3. Captopril 4. Coumadin

Correct Answer: 2 Rationale 2: Drug interactions with amphotericin B focus on worsening two of its potentially serious adverse effects: nephrotoxicity and hypokalemia. For example, concurrent therapy with aminoglycosides, cyclosporine, vancomycin, carboplatin, and furosemide is not recommended. Rationale 1: Actos is used to treat type II diabetes, and is not contraindicated for concurrent use of amphotericin B. Rationale 3: Captopril is not contraindicated for concurrent use of amphotericin B. Rationale 4: Coumadin is not contraindicated for concurrent use of amphotericin B.

What information should the nurse provide to the parents of a child being treated for enterobiasis (pinworms)? 1. A stool specimen analysis will be needed to determine if the treatment was successful. 2. Everyone in the family should be treated. 3. Special precautions should be employed in disposing of bowel contents. 4. Mebendazole will be administered daily for one week.

Correct Answer: 2 Rationale 2: Everyone in the family should be treated Rationale 1: A stool specimen is not needed. Rationale 3: Special precautions are not needed. Rationale 4: A single dose is usually sufficient to eradicate the pinworms, although the dose may be repeated in 2 weeks to maximize therapeutic success.

The nurse is providing discharge education for the patient with tinea corporis who will be taking nystatin cream. What instructions should the nurse include? 1. "Wash your hair at least three times a day for 2 weeks." 2. "Do not share any towels with family members." 3. "Comb the medication into your hair and cover with a towel." 4. "Avoid meat and high-protein foods while taking this medication."

Correct Answer: 2 Rationale 2: Not sharing towels helps prevent the spread of the disease. Rationale 1: The client should wash the hair at the usual frequency. Rationale 3: Combing the medication into the hair is not necessary. Rationale 4: There are no dietary restrictions with this medication, which is administered externally.

A client is prescribed omeprazole (Prilosec). The nurse prepares to perform client teaching based on the knowledge that omeprazole is a: 1. nicotinic receptor blocker. 2. proton pump inhibitor. 3. muscarinic receptor blocker. 4. histamine-2 receptor agonist.

Correct Answer: 2 Rationale 2: Omeprazole is a proton pump inhibitor. Rationale 1: Omeprazole is not a nicotinic receptor blocker. Rationale 3: Omeprazole is not a muscarinic receptor blocker. Rationale 4: Omeprazole is not a histamine-2 receptor blocker.

The nurse is reviewing a client's medical record and notes that recent culture results identify the organism aspergillosis. Based on this report, the nurse would recognize that the client has which type of infection? 1. Community-acquired 2. Opportunistic 3. Transmitted by direct contact 4. Vector-transmitted

Correct Answer: 2 Rationale 2: Opportunistic fungal infections are more likely to be candidiasis, aspergillosis, cryptococcosis, and mucormycosis. Rationale 1: Community-acquired infections include sporotrichosis, blastomycosis, histoplasmosis, and coccidioidomycosis. Rationale 3: Aspergillosis is acquired through the inhalation of spores, not through direct contact. Rationale 4: Fungal infections are not vector-transmitted.

Which type of laxative, as its mechanism of action, pulls water into the fecal mass to create a more watery stool? 1. Bulk-forming laxatives 2. Saline cathartics 3. Surfactant laxatives 4. Stimulant laxatives

Correct Answer: 2 Rationale 2: Saline cathartics, also called osmotic laxatives, are poorly absorbed in the intestine. They pull water into the fecal mass to create a more watery stool. Rationale 1: Bulk-forming agents absorb water, thus adding size to the fecal mass. Rationale 3: Surfactants, commonly called stool softeners, cause more water and fat to be absorbed into the stools. Rationale 4: Stimulant laxatives promote peristalsis by irritating the bowel.

A client taking metronidazole telephones the nurse to report that he has a strange metallic taste in his mouth. The nurse correctly responds by saying: 1. "You may also experience changes in your sense of smell. Do not be alarmed." 2. "This is a common side effect and is produced by the medication." 3. "This indicates an allergic response to the drug; please come in immediately." 4. "This could be an indication of a problem with your kidneys. Increase your fluid intake to 2,000 mL per day."

Correct Answer: 2 Rationale 2: Some patients experience a metallic taste. Rationale 1: Changes in sense of smell should not occur. Rationale 3: Metallic taste is not a symptom of an allergic response. Rationale 4: Increasing fluid intake will not alleviate this symptom.

A nurse is performing discharge teaching for a client being discharged with a diagnosis of gastroesophageal reflux disease. The nurse should teach the client to eliminate what foods from the diet? 1. Mashed potatoes 2. Tomato sauce 3. Bananas 4. Toast

Correct Answer: 2 Rationale 2: Substances that worsen GERD symptoms include caffeine, alcohol, citrus fruits, tomato-based products, onions, carbonated beverages, spicy foods, chocolate, and smoking. Rationale 1: Mashed potatoes do not worsen the symptoms of GERD. Rationale 3: Bananas do not worsen the symptoms of GERD. Rationale 4: Toast does not worsen the symptoms of GERD.

The nurse demonstrates an understanding of the different mechanisms of action of laxatives by stating: 1. "Bulk-forming laxatives are also called osmotic laxatives." 2. "Surfactant laxatives cause water and fat to be absorbed into the stools." 3. "Mineral oil can interfere with the absorption of water-soluble vitamins." 4. "Stimulant laxatives must be taken with plenty of water."

Correct Answer: 2 Rationale 2: Surfactant laxatives do cause water and fat to be absorbed into the stools. Rationale 1: Bulk-forming laxatives are fiber agents. These have a much different mechanism of action than do saline cathartics or osmotic laxatives, which pull water into the fecal mass to create a more watery stool. Rationale 3: Mineral oil can interfere with the absorption of fat-soluble vitamins. Rationale 4: Stimulant laxatives increase peristalsis and are not necessarily dependent upon water consumption.

A client wants to be vaccinated against viral hepatitis. The nurse would inform the client that a vaccine is available for: 1. Hepatitis B only. 2. Hepatitis A (HAV) and B (HAB). 3. Hepatitis non-A non-B. 4. Hepatitis B and C.

Correct Answer: 2 Rationale 2: The best treatment for viral hepatitis is prevention through immunization, which is available for HAV and HBV. Rationale 1: The best treatment for viral hepatitis is prevention through immunization, which is available for HAV and HBV. Rationale 3: There is no vaccine available for non-A non-B viruses. Rationale 4: There is no vaccine available for hepatitis C.

The nurse correctly identifies that the client with which disorder is at greatest risk of acquiring a fungal infection of the nail? 1. The client with arthritis 2. The client with diabetes 3. The client with gallbladder disease 4. The client with gout

Correct Answer: 2 Rationale 2: The client with diabetes has a 1-in-4 chance of developing a fungal infection of the nail due to poor circulation. Rationale 1: The client with arthritis is at risk for nodules, but not for fungal nail infections. Rationale 3: Clients with gallbladder disease are not at increased risk of fungal infections of the nails. Rationale 4: Clients with gout are not at greater risk for fungal infections of the nails.

The nurse is caring for a client with a protozoan infection. The nurse instructs the client that the growing stage of a protozoan is termed a: 1. worm. 2. trophozoite. 3. vector. 4. cyst.

Correct Answer: 2 Rationale 2: The growing stage of a protozoan is a trophozoite. Rationale 1: A worm is a helminth. Rationale 3: A vector is a transmitter of organisms. Rationale 4: Cysts are developed to protect an organism and are not part of the growing stage.

The nurse asked to identify the most likely infestation site of helminths would be correct in identifying the: 1. lungs. 2. intestine. 3. eyes. 4. feet.

Correct Answer: 2 Rationale 2: The most likely site of infection of helminths is the intestine. Rationale 1: Helminths typically do not infest the lungs. Rationale 3: The eyes are not the most likely site of infection of helminths. Rationale 4: The feet are not the most likely site of infection of helminths.

A client has been diagnosed with inflammatory bowel disease (IBD). The nurse anticipates that the health care provider may prescribe a drug in which category to treat this disorder? 1. Symptom-targeted therapy, antidepressants, and antianxiety drugs 2. 5-aminosalicylic acid (5-ASA) agents, immunosuppressive agents, and biologic therapies 3. Antispasmodics, serotonin agents, and biologic therapies 4. 5-aminosalicylic acid (5-ASA) agents, symptom-targeted therapy, and antianxiety agents

Correct Answer: 2 Rationale 2: The pharmacotherapy for inflammatory bowel disease (IBD) includes 5-aminosalicylic acid (5-ASA) agents, immunosuppressive agents, and biologic therapies. Rationale 1: Symptom-targeted therapy, antidepressants, and antianxiety drugs are used to treat irritable bowel syndrome (IBS). Rationale 3: Antispasmodics and serotonin agents are used to treat irritable bowel syndrome (IBS). Rationale 4: 5-aminosalicylic acid (5-ASA) agents are used to treat inflammatory bowel disorder (IBD). Symptom-targeted therapy and antianxiety agents are used to treat irritable bowel syndrome (IBS).

A client with a chronic cough, wheezing, and a sore throat states these symptoms have been present for 3 months, and asthma is not the cause. What does the nurse suspect to be causing this client's respiratory issues and sore throat? 1. Zollinger-Ellison syndrome 2. Gastroesophageal reflex disease 3. Crohn disease 4. A gastric ulcer

Correct Answer: 2 Rationale 2: There is growing evidence that clients with GERD also can present with symptoms such as chronic cough, wheezing, bronchitis, sore throat, or hoarseness. Rationale 1: Zollinger-Ellison syndrome presents similarly to PUD. Wheezing and a chronic cough are not associated symptoms. Rationale 3: Crohn disease is a component of inflammatory bowel disease, and does not present with these symptoms. Rationale 4: These symptoms are not consistent with those of a gastric ulcer.

Several hospitalized clients have an order for a laxative as needed for constipation. To which client would the nurse expect to administer a laxative? 1. A client who had a bowel movement yesterday and one the day before but not yet today 2. A client who has not had a bowel movement in 4 days 3. A client who did not have a bowel movement today, but had one yesterday 4. A client who has daily bowel movements that are formed

Correct Answer: 2 Rationale 2: This client is likely constipated, as the definition of constipation is two or fewer bowel movements per week. Rationale 1: This client is not likely to have constipation, as the definition of constipation is two or fewer bowel movements per week. Rationale 3: This client is not likely to have constipation, as the definition of constipation is two or fewer bowel movements per week. Rationale 4: This client is not likely to have constipation, as the definition of constipation is two or fewer bowel movements per week.

Effective client teaching regarding the treatment of H. pylori has been done for a client when the client states: 1. "I will stop taking this medication when my symptoms subside." 2. "I will be sure to take all of the medication exactly as prescribed." 3. "I will stop taking this medication if I get an upset stomach." 4. "I will take this medication when I experience pain or heartburn."

Correct Answer: 2 Rationale 2: This statement indicates that effective client teaching has been performed. Rationale 1: Combination antibiotic therapy for the treatment of H. pylori must be continued, as prescribed, for 7-14 days. Failure to complete a course of antibiotic therapy can result in resistant strains of H. pylori. Rationale 3: Combination can result in dyspepsia. Rationale 4: Combination antibiotic therapy for the treatment of H. pylori must be continued, as prescribed, for 7-14 days. Failure to complete a course of antibiotic therapy can result in resistant strains of H. pylori.

A male client has been diagnosed with a dermatomycosis. The nurse informs the client that he has been diagnosed with which infection affecting the feet? 1. Tinea cruris 2. Tinea pedis 3. Tinea corporis 4. Tinea capitis

Correct Answer: 2 Rationale 2: Tinea pedis affects the feet. Rationale 1: Tinea cruris affects the groin, perineum, and perianal regions of the body. Rationale 3: Tinea corporis affects relatively hairless skin in places other than the feet. Rationale 4: Tinea capitis affects the hair of the head, eyebrows, or eyelashes.

A client has been prescribed a new antifungal medication and asks the nurse why the medication must be taken for so many days. The nurse's response is based on the knowledge that fungal infections: 1. require drug holidays to prevent side effects. 2. are often resistant to treatment, and can require months of therapy. 3. occur at locations that are difficult to reach with traditional routes of medication administration. 4. are capable of destroying certain medications, so new medications must be added.

Correct Answer: 2 Rationale 2: Treatment requires many months to fully eradicate the organism. 1. no needs continuous treatment 3. Some fungal infections occur in superficial skin layers. 4. Fungal infections do not destroy medications.

A client with AIDS is suffering from a systemic fungal infection. The nurse anticipates that the drug of choice for this client will be: 1. fluconazole. 2. amphotericin B. 3. nystatin. 4. griseofulvin.

Correct Answer: 2 Rationale 1: Fluconazole is for simple fungal infections. Rationale 2: The drug of choice for these disorders is amphotericin B. Rationale 3: Nystatin is for simple fungal infections such as Candida. Rationale 4: Griseofulvin is for superficial fungal infections.

A client new to the clinic reports having peptic ulcer disease and a weight loss of 14 pounds in 2 months. The symptom of weight loss would be most consistent with: 1. a duodenal ulcer. 2. a gastric ulcer. 3. frequent exercise. 4. anorexia nervosa.

Correct Answer: 2 Rationale 2: Anorexia, weight loss, and vomiting are more common with gastric ulcers. Rationale 1: Weight gain, not loss, would be more consistent with a duodenal ulcer. Rationale 3: This client is not reporting frequent exercise. Rationale 4: This client is complaining of peptic ulcer disease, which is likely the cause of weight loss.

Which statements about bulk-forming laxative drugs are accurate? (Select all that apply). 1. They work immediately after one dose. 2. They are contraindicated when the client has undiagnosed abdominal pain, suspected intestinal obstruction, or fecal impaction. 3. They must be taken with plenty of water, or they can cause an esophageal obstruction. 4. The prototype of bulk-forming laxatives is milk of magnesia. 5. Bulk-forming laxative powder should never be taken dry.

Correct Answer: 2,3,5 Rationale 2: Bulk-forming laxatives are contraindicated when the client has undiagnosed abdominal pain, suspected intestinal obstruction, or fecal impaction. Rationale 3: Bulk-forming laxatives must be taken with plenty of water; otherwise, psyllium could swell in the esophagus and cause an obstruction. Rationale 5: Powders should never be swallowed dry, or esophageal obstruction may result. Rationale 1: Bulk-forming laxatives increase the size of the fecal mass and stimulate defecation. Several doses of psyllium might be needed over 1-3 days to produce an optimum therapeutic effect. Rationale 4: The prototype of bulk-forming laxative drugs is psyllium mucilloid.

A client is due to receive fluconazole (Diflucan) for a fungal infection. The nurse would question an order specifying which route of administration? (Select all that apply). 1. By mouth 2. By intramuscular injection 3. By intravenous injection 4. By subcutaneous injection 5. Topically

Correct Answer: 2,4,5 Rationale 1: The nurse would not question an order for this medication to be administered by mouth. Rationale 2: The nurse should question an order for this medication to be administered by IM injection. Rationale 3: The nurse would not question an order for this medication to be administered by IV injection. Rationale 4: The nurse should question an order for this medication to be administered by SQ injection. Rationale 5: The nurse should question an order for this medication to be administered topically.

The nurse is caring for a client with a fungal infection. Which statement by the client would indicate understanding of this type of infection? 1. "There are many drugs available to treat fungal infections." 2. "Fungal infections grow quickly once they enter the body system." 3. "Treating fungal infections can require several weeks." 4. "Fungal infections are common in healthy athletes."

Correct Answer: 3 Rationale 3: Fungal infections can require months of treatment.

A client is being treated with antiviral pharmacotherapy. The nurse understands that treatment with antiviral drugs is extremely challenging because: 1. their broad spectrum causes severe adverse effects. 2. the drug scheduling makes compliance difficult. 3. the rapid mutation of viruses quickly makes drugs ineffective. 4. high doses of medication are required to achieve therapeutic effects.

Correct Answer: 3 Rationale 3: Antiviral pharmacotherapy is extremely challenging because the rapid mutation of viruses quickly makes drugs ineffective. Rationale 1: Many antiviral drugs are very narrow in spectrum (effective against only one particular virus). Rationale 2: Scheduling of the medications is adjusted according to virulence, potency of the medicine, and client need. Rationale 4: Dosages are adjusted according to virulence, potency of the medicine, and client need.

The nurse is comparing fungal infections with bacterial infections. Which statement by the nurse is true? 1. "Antifungals are only fungistatic." 2. "Antibiotics are effective against fungi." 3. "Fungi are more similar to human cells." 4. "Bacteria are more similar to human cells."

Correct Answer: 3 Rationale 3: Fungal cells are eukaryotic, as are human cells.

A nurse teaches a health education class for grade school children in a rural community. Which information should the nurse include to reduce the incidence of helminthic infections? 1. "Do not share hair combs and brushes with your friends." 2. "Limit the amount of sandwiches that you eat." 3. "Wash your hands after going to the restroom and before eating." 4. "Do not drink from someone else's glass or cup."

Correct Answer: 3 Rationale 3: Hand hygiene is most important. Rationale 1: Helminthes are not transmitted by touching the hair. Rationale 2: Avoiding sandwiches would not reduce the incidence of helminthiasis. Rationale 4: Although this is important, it is not the best answer, because helminthes are not transmitted in this manner.

The nurse is caring for an adult male diagnosed with a peptic ulcer. The nurse states that the most likely causative agent is: 1. Cryptococcus. 2. Pneumocystis carinii. 3. Helicobacter pylori. 4. Mycobacterium avium.

Correct Answer: 3 Rationale 3: Helicobacter pylori is associated with 70% of peptic ulcers. Rationale 1: Cryptococcus is not associated with the development of peptic ulcers. Rationale 2: Pneumocystis carinii is not associated with the development of peptic ulcers. Rationale 4: Mycobacterium avium is not associated with the development of peptic ulcers.

The nurse would recognize which symptom as a sign of a serious adverse effect in a client taking amphotericin B? 1. Hypokalemia 2. Leukopenia 3. Hematuria 4. Paresthesia

Correct Answer: 3 Rationale 3: Hematuria is a symptom of nephrotoxicity and possible renal failure. Rationale 1: Although hypokalemia can occur, it is not as significant as another symptom. Rationale 2: Leukopenia can occur, but is not as serious as another symptom. Rationale 4: Paresthesia is not a symptom of a serious adverse effect of amphotericin B.

A client has genital herpes simplex 2. The nurse teaches the client that: 1. spermicides can help prevent transmission. 2. antiviral medication can cure this disease. 3. This infection is for life, but recurrences usually have a shorter course and are less severe. 4. HSV can only be transmitted when there are visible lesions.

Correct Answer: 3 Rationale 3: Herpes simplex is not curable and is lifelong, but with treatment, the recurrent episodes usually have a shorter course and are less severe Rationale 1: Spermicide contraceptives cannot prevent transmission. Rationale 2: Herpes simplex is not curable. Rationale 4: Transmission can still occur without visible lesions.

Considering potential harmful side effects, which system would the nurse address as a priority area of assessment when a client is given lamivudine (Epivir)? 1. Cardiac 2. Renal 3. Hepatic 4. Pulmonary

Correct Answer: 3 Rationale 3: Lamivudine can cause an unusual type of liver abnormality called lactic acidosis and hepatomegaly with steatosis. This can result in death. Rationale 1: Although important, cardiac assessment is not as important an area of assessment as another area. Rationale 2: Although important, renal assessment is not as important an area of assessment as another area. Rationale 4: Although important, pulmonary assessment is not as important an area of assessment as another area.

Lamivudine targets which stage in the pathogenesis of a viral infection? 1. Lamivudine inhibits the release of the virus. 2. Lamivudine inhibits penetration of the viral material. 3. Lamivudine inhibits viral replication. 4. Lamivudine inhibits attachment at the receptor site.

Correct Answer: 3 Rationale 3: Lamivudine inhibits the viral replication stage in the pathogenesis of a viral infection. Rationale 1: Lamivudine does not inhibit release of the virus. Rationale 2: Lamivudine does not inhibit penetration of the viral material. Rationale 4: Lamivudine does not inhibit attachment at the receptor site.

A client with known peptic ulcer disease is placed on a clear-liquid diet pending an endoscopy. What proton pump inhibitor can be given in a liquid form to this client? 1. Famotidine (Pepcid) 2. Ranitidine (Zantac) 3. Lansoprazole (Prevacid) 4. Esomeprazole (Nexium)

Correct Answer: 3 Rationale 3: Lansoprazole is available in a liquid suspension. Rationale 1: Famotidine is not a proton pump inhibitor. Rationale 2: Ranitidine is not a proton pump inhibitor. Rationale 4: Esomeprazole is not offered in a liquid formulation.

The nurse caring for a client diagnosed with amebiasis understands that amebiasis is best treated with: 1. nitaxoanide. 2. tinidazole. 3. metronidazole. 4. pentamidine.

Correct Answer: 3 Rationale 3: Metronidazole is the primary treatment choice for amebiasis. Rationale 1: Nitaxoanide treats giardiasis. Rationale 2: Tinidazole is the second treatment of choice of amebiasis. Rationale 4: Pentamidine treats trypanosomiasis.

A client with a diagnosis of peptic ulcer disease is prescribed omeprazole (Prilosec) and asks the nurse where in the body this medication will work. The nurse correctly answers: 1. "On the gastric mucus layer." 2. "On the mucosa of the trachea." 3. "On the surface of parietal cells." 4. "On the H2 receptors."

Correct Answer: 3 Rationale 3: Omeprazole is a proton pump inhibitor and works on the proton pump, which is located on the surface of parietal cells. Rationale 1: Omeprazole is a proton pump inhibitor and works on the proton pump, which is located on the surface of parietal cells. Rationale 2: Omeprazole is a proton pump inhibitor and works on the proton pump, which is located on the surface of parietal cells. Rationale 4: H2-receptor antagonists work on H2 blockers. Omeprazole is a proton pump inhibitor and works on the proton pump, which is located on the surface of parietal cells.

What client has the greatest risk of having a peptic ulcer? 1. A 24-year-old who complains of being stressed mentally 2. A 52-year-old who smokes 3. A 56-year-old who is taking prednisone and ibuprofen for chronic low-back pain 4. A 48-year-old who is taking acetaminophen and aspirin to reduce fever

Correct Answer: 3 Rationale 3: This client has two risk factors for developing a peptic ulcer, making this the best choice. Rationale 1: Psychological stress is one risk factor towards the development of a peptic ulcer, but this is not the best choice. Rationale 2: Smoking puts a client at risk for a peptic ulcer, but this is not the best choice. Rationale 4: Taking aspirin, an NSAID, puts this client at risk for a peptic ulcer, but this is not the best choice. Acetaminophen is not associated with the development of peptic ulcers.

It is crucial for the nurse to monitor which laboratory tests when a client is taking acyclovir (Zovirax)? 1. Fasting and postprandial blood glucose 2. White blood count (WBC) and aspartate aminotransferase (AST) 3. Blood urea nitrogen (BUN), creatinine, and complete blood count (CBC) 4. Viral culture and urinalysis

Correct Answer: 3 Rationale 3: This drug causes nephrotoxicity, hemolytic uremic syndrome, and thrombocytopenia purpura. These complications can be identified promptly by monitoring BUN, creatinine, and CBC frequently. Rationale 1: Blood glucose does not need to be monitored with acyclovir. Rationale 2: WBC can be monitored in a CBC, but AST is not necessary to monitor. Rationale 4: A viral culture and urinalysis are not necessary with acyclovir.

The nurse determines that instruction of a client taking ganciclovir (Cytovene) is effective when the client states: 1. "I can take this medication on an empty stomach." 2. "This medication is OK to take during pregnancy." 3. "I should avoid becoming pregnant while on this medication." 4. "I can stop taking the medication when my symptoms are gone."

Correct Answer: 3 Rationale 3: This response is correct. Ganciclovir is in pregnancy category C and should be avoided during pregnancy. Rationale 1: Ganciclovir should be taken with food. Rationale 2: Ganciclovir is in pregnancy category C and should be avoided during pregnancy. Rationale 4: Clients should talk with their doctor before stopping the medication, as it may need to be taken even after symptoms subside.

Which statement correctly explains to a client the origin of the client's constipation? 1. "If you would use the laxatives daily, you would not have a problem with constipation." 2. "If the waste material passes through the colon too quickly, excess fluids are not absorbed, and the result is a watery stool." 3. "Ordinarily, fluid is absorbed in your large intestine as waste travels through. If the stool stays in the large intestine too long, too much water is reabsorbed, causing the stool to be small, hard, and difficult to pass without straining." 4. "Constipation is usually caused by infection."

Correct Answer: 3 Rationale 3: Too much water being reabsorbed results in small, hard stools that are difficult to pass without straining. This is the origin of constipation. Rationale 1: It is not recommended that clients use laxatives daily, as this might promote laxative dependence, which will increase constipation. Rationale 2: Waste material passing through the colon too quickly, resulting in watery stool, is the origin of diarrhea. Rationale 4: Constipation is not usually caused by infection, but diarrhea can be caused by infection.

A client has been diagnosed with trichomoniasis. The nurse expects the client to exhibit symptoms in the: 1. gastrointestinal system. 2. integumentary system. 3. reproductive system. 4. respiratory system.

Correct Answer: 3 Rationale 3: Trichomoniasis is a disorder affecting the reproductive system. Rationale 1: Trichomoniasis does not affect the integrity of the gastrointestinal system. Rationale 2: Trichomoniasis does not affect the integumentary system. Rationale 4: Trichomoniasis does not affect the respiratory system.

A client is being treated for inflammatory bowel disease (IBD). The nurse anticipates receiving orders for which medications? (Select all that apply). 1. Loperamide (Imodium) 2. Doxepin (Sinequan) 3. Sulfasalazine (Azulfidine) 4. Prednisone 5. Azathioprine (Imuran)

Correct Answer: 3,4,5 Rationale 3: The first step of IBD treatment is usually with a 5-aminosalicylic acid (5-ASA) agent, which can include sulfasalazine (Azulfidine). Rationale 4: When IBD is especially severe or when clients have not responded well to the 5-ASA drugs, oral corticosteroids such as prednisone are used. Rationale 5: Should therapy with corticosteroids fail, or if they are needed for prolonged periods, step 3 of IBD therapy includes immunosuppressive agents, such as azathioprine (Imuran). Rationale 1: Loperamide (Imodium), an antidiarrheal, is effective at relieving symptoms of diarrhea in clients with IBS. Rationale 2: For many years, tricyclic antidepressants such as doxepin (Sinequan) have been used to treat clients with IBS who have pain as a major symptom.

A client telephones the nurse to report fatigue since starting ribavirin therapy 4 months ago. The client has also developed shortness of breath over the past week, which has been worsening. What should the nurse tell the client? 1. "This is a normal adverse effect of this medication. Take it easy, and your symptoms will resolve." 2. "Stop taking the medication. Your health care provider will try another medication for hepatitis treatment." 3. "These symptoms could be signs of an allergy to the medication. Take an antihistamine and see if you notice improvement." 4. "You should come into the office to have some blood work done for possible hemolytic anemia."

Correct Answer: 4 Rationale 4: An adverse effect of ribavirin can be hemolytic anemia. The client should be evaluated immediately with a complete blood count. Rationale 1: This is not a normal side effect, and the client should be evaluated immediately. Rationale 2: Before stopping the medication and starting another, the client should be evaluated for possible hemolytic anemia. Rationale 3: The client should not just be treated with an antihistamine, as this could be a serious side effect and should be evaluated immediately.

A primary indication for the use of an antiemetic medication is: 1. morning sickness in pregnancy. 2. diarrhea accompanied by severe abdominal cramping. 3. constipation. 4. nausea and vomiting associated with chemotherapy.

Correct Answer: 4 Rationale 4: Antiemetic medications are indicated for nausea and vomiting associated with chemotherapy. Rationale 1: Morning sickness is usually limited to the first trimester of pregnancy. Antiemetics are usually reserved for cases of hyperemesis gravidarum, which are much more severe and persistent and are not relieved by other measures. Rationale 2: Diarrhea that is accompanied by severe abdominal cramping is a different symptom than nausea and vomiting. Rationale 3: Antiemetic medications are indicated for nausea and vomiting, not constipation.

The nurse is caring for several clients on a medical unit in the hospital. Which client does the nurse recognize as being at greatest risk of acquiring an oral Candida infection? 1. The client with braces 2. The client who uses smokeless tobacco 3. The client with sleep apnea 4. The client using a steroid inhaler for asthma

Correct Answer: 4 Rationale 4: Clients taking inhaled corticosteroids experience local immunosuppression in the oral cavity. Rationale 1: The client with braces does not have an increased risk of Candida. These clients typically maintain better oral hygiene than do other patients, actually decreasing their risk. Rationale 2: This client is at risk for oral cancer, not for a fungal infection. Rationale 3: Mouth breathing does not increase the risk of fungal infection.

The nurse is performing a head-to-toe assessment on a client taking aluminum hydroxide (AlternaGel). Why must the nurse closely assess for bowel changes? 1. Hyperactive bowel sounds indicate imminent vomiting; suction should be made available. 2. Hypoactive bowel sounds indicate duodenal ulcerations. 3. Hematochezia is a sign that the medication is working. 4. A distended abdomen could indicate constipation, a side effect of this medication.

Correct Answer: 4 Rationale 4: During treatment with aluminum hydroxide, the nurse must assess for bowel changes. Magnesium-based products can cause diarrhea, and those with calcium and aluminum can cause constipation. Rationale 1: Hyperactive bowel sounds indicate increased gastric motility and a possible obstruction if bowel sounds are absent below the level of obstruction. Rationale 2: Hypoactive bowel sounds do not indicate duodenal ulcers. Rationale 3: Hematochezia, which is bright red blood per rectum, is not a sign that aluminum hydroxide is working. This symptom should be reported to the health care provider immediately.

The nurse is caring for a client with a tinea fungal infection. The nurse expects the client will have symptoms that primarily affect the: 1. bowel. 2. mucous membranes of the mouth. 3. urinary tract. 4. skin and hair.

Correct Answer: 4 Rationale 4: Fungal infections of the skin and hair are called dermatomycoses. These infections are named by their Latin terms, beginning with tinea. Rationale 1: Tinea infections do not affect the bowel. Rationale 2: Fungal infections of the mouth are called oral candidiasis. Rationale 3: Fungal infections of the urinary tract are caused by Candida or Cryptococcus.

The health care team is attempting to determine cause for a client's duodenal ulcer. Which factors are not associated with peptic ulcer disease? 1. Smoking cigarettes 2. Having a parent diagnosed with a peptic ulcer 3. Excessive stress at home 4. Having type A blood

Correct Answer: 4 Rationale 4: Having type O blood places one at risk for developing a peptic ulcer. Rationale 1: Smoking tobacco places one at risk for developing a peptic ulcer. Rationale 2: Having a close family member diagnosed with PUD places one at risk for developing it. Rationale 3: Excessive psychological stress places one at risk for developing a peptic ulcer.

Immediately after administering a bulk-forming laxative, the nurse should assess: 1. if the client is taking other medications. 2. if the client is allergic to any medications. 3. the time of the client's last bowel movement. 4. whether the client has retrosternal pain.

Correct Answer: 4 Rationale 4: If the client has retrosternal pain after taking the drug, it might have been caused by a gelatinous mass from poor mixing of the bulk-forming laxative with liquids before administration. Rationale 1: The client's drug history should be assessed before administering any medication. Rationale 2: The client's allergies to medications should be assessed before administering any medication. Rationale 3: The time of the client's last bowel movement should be assessed before the bulk-forming laxative is administered.

Which statement is accurate regarding non-HIV antiviral drugs? 1. Antivirals decrease the effects of the host cell's biological processes. 2. Research on antivirals has yielded more useful results than has research on antibacterials. 3. Antivirals have fewer adverse effects than antibiotics. 4. Antivirals have a narrow spectrum of coverage.

Correct Answer: 4 Rationale 4: Non-HIV antiviral drugs have a very narrow spectrum of activity. Rationale 1: This is not true. Rationale 2: This is not true. Antiviral agents remain the least effective of all the anti-infective classes. Rationale 3: Antivirals have many adverse effects.

The nurse is aware that to achieve the most therapeutic effects, the best time to administer oseltamivir (Tamiflu) or zanamivir (Relenza) is: 1. as soon as the client has been exposed to someone with influenza. 2. any time during the course of the illness. 3. at the same time as the vaccine. 4. within 48 hours of the onset of symptoms.

Correct Answer: 4 Rationale 4: Oseltamivir (Tamiflu) and zanamivir (Relenza) are examples of a new classification of drugs called neuraminidase inhibitors that are used to treat active influenza infection. When given within 48 hours of the onset of symptoms, their use can shorten the normal 7-day course of influenza to 5 days. Rationale 1: Oseltamivir (Tamiflu) and zanamivir (Relenza) should be given within 48 hours of the onset of symptoms. Rationale 2: When oseltamivir and zanamivir are given within 48 hours of the onset of symptoms, their use can shorten the normal 7-day course of influenza to 5 days. Rationale 3: Oseltamivir (Tamiflu) and zanamivir (Relenza) should be given within 48 hours of the onset of symptoms, not at the same time as the vaccine.

A client is receiving mebendazole (Vermox) as treatment for hookworm. The nurse teaches that part of the effectiveness of the drug is due to excretion through the: 1. urine 2. lung 3. bile 4. feces

Correct Answer: 4 Rationale 4: The drug is eliminated through the feces. Rationale 1: The drug is not eliminated through the urine. Rationale 2: The drug is not eliminated through the lungs. Rationale 3: The drug is not eliminated through the bile.

What drug would the nurse expect to be the first choice of drugs ordered during the chemoprophylaxis stage in the treatment of malaria? 1. Doxycycline 2. Primaquine 3. Mefloquine 4. Chloroquine

Correct Answer: 4 Rationale 4: The first-line agent for prophylaxis for malaria is chloroquine. Rationale 1: Doxycycline is a second-line agent. Rationale 2: Primaquine is a second-line agent. Rationale 3: Mefloquine is a second-line agent.

The role of the capsid in the viral structure includes: 1. facilitating viral replication involving RNA and DNA. 2. allowing for release of the viral infection from the host. 3. triggering body defenses to remove the invader. 4. helping the virus attach to the cell membrane of the host.

Correct Answer: 4 Rationale 4: The role of the capsid is to help the virus attach to the cell membrane of the host. Rationale 1: This is the role of the viral proteins. Rationale 2: This does not describe the role of the capsid. Rationale 3: This does not describe the role of the capsid.

A client is prescribed ranitidine (Zantac). The nurse checks the client's BUN and serum creatinine levels prior to administering the drug for the first time. The rationale for checking these labs is: 1. serum BUN and creatinine should be checked on all clients. 2. that the drug is primarily biometabolized by the liver. 3. to identify a hidden drug allergy. 4. that the drug is primarily excreted by the kidneys.

Correct Answer: 4 Rationale 4: These drugs are mainly excreted by the kidneys, and clients with diminished kidney function require smaller doses. Rationale 1: Serum creatinine and BUN do not need to be checked on all clients. Rationale 2: Serum creatinine and BUN do not measure liver function. Rationale 3: Serum creatinine and BUN will not identify hidden drug allergies.

The synthesis stage of viral replication for viruses includes: 1. the virus living dormant in the environment for months to years. 2. the cell bursting and releasing viral particles throughout the host. 3. the virus penetrating the host cell in order to "inject" its genetic material into the host. 4. the virus replicating by making viral capsid proteins and enzymes.

Correct Answer: 4 Rationale 4: This accurately describes the synthesis stage. Rationale 1: This does not describe the synthesis stage. Rationale 2: This describes the final stage. Rationale 3: This describes the second stage.

The nurse would correctly understand that pharmacotherapy of cryptosporidiosis is targeted at treating: 1. cough. 2. vomiting. 3. bullous rash. 4. diarrhea.

Correct Answer: 4 Rationale 4: Treatment of cryptosporidiosis targets the diarrhea it causes. Rationale 1: Cough is not a manifestation of cryptosporidiosis. Rationale 2: Vomiting is not a symptom of cryptosporidiosis. Rationale 3: Bullous rash is not a symptom of cryptosporidiosis.

The nurse teaches a client with genital herpes that a virus is known as an intracellular parasite because: 1. it is surrounded by a protein coat called a capsid. 2. it affects only one species of living organism. 3. it contains DNA or RNA, but not necessarily both. 4. it is incapable of causing infection unless it has invaded a host cell.

Correct Answer: 4 Rationale 4: Viruses must be inside a host cell to cause infection. They do not have the cellular equipment necessary for self-survival. Rationale 1: This is true, but it does not explain why a virus is called an intracellular parasite. Rationale 2: Most viruses affect only one species of living organism, but this is not why a virus is known as an intracellular parasite. Rationale 3: This is true, but it does not explain why a virus is called an intracellular parasite.

A client is diagnosed with enterobiasis. The nurse recognizes the primary symptom of enterobiasis as: 1. severe diarrhea with dehydration. 2. erythematous rash on the chest and body. 3. chronic cough with sweating at night. 4. perianal itching, especially at night.

Rationale 1: Enterobiasis does not promote severe diarrhea. Rationale 2: Pinworms are not manifested by a rash. Rationale 3: Pinworms are not manifested by chronic cough with sweating at night. These symptoms describe tuberculosis. Rationale 4: Pinworms are manifested by perianal itching, especially at night.

The client has a fungal infection of the toenails, and receives oral terbinafine (Lamisil). The client asks the nurse how a pill will heal a nail infection. The nurse explains that terbinafine: 1. accumulates in nail beds and remains for several months. 2. breaks the cytoplasm in the fungal cell wall. 3. works by destroying toxins excreted by the fungi in the nails. 4. destroys circulating fungi in the blood.

Rationale 1: Lamisil accumulates in the toenail. Rationale 2: Lamisil works by inhibiting ergosterol biosynthesis. Rationale 3: Antifungals do not destroy toxins excreted by the fungi in the nails. Rationale 4: Lamisil does not possess strong systemic antifungal properties.