Pharm Final
A client diagnosed with an autoimmune disorder has just been prescribed a synthetic drug. Which characteristic is a noted advantage of synthetic drugs? A. The client is at a lesser risk for an allergic reaction. B. The client will require less frequent dosing. C. The medication will be available on an over-the-counter basis. D. The medication is available in a wider variety of administration routes.
A
A client has been administered heparin to prevent thromboembolism development status postmyocardial infarction. The client develops heparin-induced thrombocytopenia. Which medication will be administered? A. Argatroban 9 B. Vitamin K C. Calcium gluconate D. Aminocaproic acid
A
A client in cardiovascular collapse requires pharmacologic interventions. What route of administration is most likely appropriate? A. Intravenous B. Oral C. Rectal D. Topical
A
A client is administered an oral contraceptive. What is the process that occurs between the time the drug enters the body and the time it enters the bloodstream? A. Absorption B. Distribution C. Metabolism D. Excretion
A
A client is admitted with thrombophlebitis and sent home on enoxaparin therapy. Which statement indicates a good understanding of why enoxaparin is being administered? A. Enoxaparin inhibits the formation of additional clots. B. Enoxaparin eliminates certain clotting factors. C. Enoxaparin decreases the viscosity of blood. D. Enoxaparin will dissolve the clots.
A
A client is being administered warfarin to decrease blood clotting. Which herbal supplement may contribute alteration in blood clotting mechanisms? A. St. John's wort B. Glucosamine C. Chondroitin D. Melatonin
A
A client is receiving low-molecular-weight heparin to prevent thromboembolic complications. The nursing student asks the instructor the reason why this treatment is given instead of heparin. What is the instructor's best explanation of the rationale for LMWH over heparin? A. "LMWH is associated with less thrombocytopenia than standard heparin." B. "LMWH is associated with stronger anticoagulant effects than standard heparin." C. "LMWH is given to clients who have a history of blood dyscrasia." D. "LMWH is more effective than standard heparin for clients with hypertension."
A
A client who has been diagnosed with type 2 diabetes mellitus is being instructed on medication regimen, diet, and exercise. The client is having difficulty grasping information about care. Which nursing diagnosis is most appropriate for this client? A. Deficient knowledge: drug therapy regimen B. Noncompliance: overuse C. Risk for injury related to adverse effects D. Acute confusion related to insulin regimen
A
A client who is recovering in hospital from a bilateral mastectomy has developed minor bleeding at one of the incision sites. During the process of clot formation, plasminogen will become part of a clot by which means? A. By binding with fibrin B. By binding with platelets C. By activating plasmin D. By activating factor VII
A
A client with cancer is taking the prescribed dose of morphine sulfate, and a family member informs the nurse that the client is extremely sedated. What finding by the nurse would indicate the causative factor for the increased sedation experienced by the client? A. The client is taking St. John's wort for depression. B. The client has a glass of ginger ale by the bedside. C. A family member has a naloxone pen by the bedside. D. The client is taking metoprolol for hypertension.
A
A nurse has learned that an older adult client has been taking meperidine hydrochloride for pain control. The nurse should now include which assessment into the client's plan of care? A. Confusion B. Blood dyscrasias C. Gastrointestinal bleeding D. Hepatotoxicity
A
A nurse is conducting a medication reconciliation for a client who is newly admitted to a long-term care facility. When appraising the client's medication regimen in light of the Beers Criteria, the nurse will look for: A. drugs that are known to cause adverse effects in older adults. B. drugs for which generic equivalents are available at lower cost. C. drugs that have been found to be ineffective in older adults. D. drugs that are known to exacerbate the aging process.
A
A nurse is reviewing a new client's admission blood work, which indicates that the client's glomerular filtration rate is 51 mL/min/1.73 m2 (low). What implication does this have for the client's subsequent pharmacotherapy? A. The client may need lower-than-normal doses of some medications. B. The client may require a fluid challenge prior to medication administration. C. The client may need IV administration of a hypotonic solution to aid medication excretion. D. The client may need to receive medications by topical and subcutaneous routes rather than parenteral.
A
An infant's current weight indicates that the maximum safe dose of acetaminophen is 30 mg by mouth. The health care provider orders 65 mg to be given, and the nurse administers acetaminophen 65 mg. Who is legally responsible in the event that the infant has a toxic reaction to the medication? A. The nurse B. The pharmacist C. The health care provider D. The pharmacy technician
A
An older adult client has an elevated serum creatinine level. This client is at greatest risk for which medication-related effect? A. Toxicity B. Increased absorption C. Delayed gastric emptying D. Idiosyncratic effects
A
In Phase 1 clinical trials, the potential uses and effects of a new drug are determined by which method? A. Administering doses to healthy volunteers B. Administering doses to people with the disease C. Administering in placebo-controlled design D. Calculating the risk-to-benefit ratio
A
The adult child of an older adult client states that the client has been taking alendronate for several years for the treatment of osteoporosis. The child tells the nurse that the client never reported nausea after taking this medication until recently. How should the nurse respond to the child's statement? A. "It could be that your parent's stomach empties more slowly than it used to, which is a normal result of aging." B. "As people get older, the medication travels down their esophagus more slowly than it is used to. This can cause nausea." C. "Because the client processes drugs more slowly than when younger, there is more time during which they can cause nausea." D. "As people age, they have more of the receptors that trigger nausea. This is a normal change that accompanies the aging process."
A
The nurse has learned that a client has begun supplementing the prescribed medication regimen with a series of herbal remedies. Which is the most important nursing intervention regarding the safe use of herbal supplements? A. Research for potential interactions with medications. B. Instruct the client to discontinue them if taking prescription medications. C. Instruct the client to take the supplements 1 hour before prescription medications. D. Instruct the client to take the supplements 3 hours after prescription medications.
A
The nurse is repeatedly unsuccessful in starting an IV on a client who requires antibiotic therapy. The client is prescribed an oral antibiotic. What is the major disadvantage of the oral route over the parenteral route? A. The associated fever will take longer to be resolved. B. The client will need close monitoring for adverse effects. C. The client is at risk of developing a future tolerance to the antibiotic. D. Resolution of the infection will initially require a larger dose of antibiotic.
A
The nurse makes an effort to provide high-quality care to clients by obtaining and analyzing the best available scientific research. This activity demonstrates which important component of practice? A. Evidence-based nursing B. Medical justification C. Nursing data synthesis D. Scientific nursing
A
When considering the dosage requirement for a 6-feet (1.8-m) tall client who weighs 280 pounds (127 kg), which statement is accurate? A. The dose will be higher than that required of a client who weighs 180 pounds (82 kg). B. The dose will be lower than that required of a client who weighs 180 pounds (82 kg). C. The dose will be similar to that required of a client who weighs 180 pounds (82 kg). D. The dose will be more effective if given parenterally.
A
When considering the half-life of naloxone, what are the implications for this medication therapy? A. Repeated doses of naloxone will likely be necessary. B. An increase in the dosage of naloxone will most likely be required. C. A different antidote will be required as the serum level of naloxone decreases. D. The antidote is unlikely to have a therapeutic effect on the client's symptoms.
A
Which assessment should be made by the nurse before administering a new medication? A. Determining the client's past medication history B. Evaluating the client's health beliefs C. Instructing the client on the effect of the medication D. Teaching the client about the desired outcomes of drug therapy
A
Which cellular structure stores hormones and other substances? A. Golgi apparatus B. Endoplasmic reticulum C. Mitochondria D. Lysosome
A
Which classification applies to morphine? A. Central nervous system depressant B. Central nervous system stimulant C. Anti-inflammatory D. Antihypertensive
A
Which medication reference is considered to be an authoritative, well-respected source of information? Select all that apply. A. American Hospital Formulary Service B. Drug Facts and Comparisons C. Physicians' Desk Reference D. Lippincott's Nursing Drug Guide E. Package inserts provided with each medication
A, B
A client tells the nurse, "I took my sleeping pill yesterday evening, but it didn't seem to work for me like it usually does." The nurse should consider which variable that can affect drug absorption? Select all that apply. A. GI function B. Blood flow to the site of administration C. The presence of other drugs D. Route of administration E. The presence of receptor agonists
A, B, C, D
A hospital nurse is vigilant in ensuring the safe use of medications and consistently applies the rights of medication administration. What are the rights of medication administration? Select all that apply. A. Right to refuse prescribed medication B. Right route for effective medication therapy C. Right to effective medication education D. Right evaluation of expected results E. Right to low-cost medication therapy
A, B, C, D
A health care facility is complying with the mandates of U.S. The Drug Enforcement Administration (DEA) concerning Schedule II medications when implementing which nursing intervention? Select all that apply. A. Access to narcotics is controlled by key or codes. B. Narcotics are administered by prescriptions only. C. Only selected narcotics may be automatically renewed. D. The administration of individual narcotic doses is recorded in specific unit documentation. E. Any recognized discrepancy involving a narcotic must be reported to the appropriate facility authority.
A, B, D, E
Which drug is formulated to be absorbed through the skin? Select all that apply. A. Lidocaine B. Clonidine C. Propranolol D. Nitroglycerin E. Fentanyl
A, B, D, E
A nurse at a long-term care facility is surprised to learn that a new resident's medication administration record runs four pages in length. The nurse knows that polypharmacy carries risks and will include which interventions into the resident's plan of care? Select all that apply. A. Assessment focused on possible drug complications B. Evaluation of swallowing ability C. Assessment of cognition and mood D. Evaluation of medication adherence E. Planning for effective cost containment
A, C
A nursing student in a pharmacology class should be encouraged to study the medications according to which categorization? Select all that apply. A. Prototype B. Controlled substance C. Drug use D. Generic names E. Therapeutic classification
A, E
A 50-year-old client has undergone a bunionectomy and has been admitted to the postsurgical unit. What aspect of the client's medical history would contraindicate the use of heparin for deep vein thrombosis (DVT) prophylaxis? A. Obesity B. Diagnosis of ulcerative colitis C. Myocardial infarction (MI) 18 months ago D. Diagnosis of type 2 diabetes mellitus
B
A 55-year-old client has been diagnosed with coronary artery disease and begun antiplatelet therapy. The client has asked the nurse why a "blood thinner like warfarin" hasn't been prescribed. What is the most likely rationale for the clinician's use of an antiplatelet agent rather than an anticoagulant? A. Antiplatelet agents do not require the client to undergo frequent blood work; anticoagulants require constant blood work to ensure safety. B. Antiplatelet agents are more effective against arterial thrombosis; anticoagulants are more effective against venous thrombosis. C. Antiplatelet agents are most effective in large vessels; anticoagulants are most effective in the small vessels of the peripheral circulation. D. Antiplatelet agents have fewer adverse effects than anticoagulants.
B
A client has an elevated total serum cholesterol of 260 mg/dL (14.4 mmol/L). Which aspect of client teaching of lifestyle changes is most important for the client? A. Eat organic foods. B. Stop smoking. C. Increase rest periods. D. Drink whole milk.
B
A client has been prescribed an antibiotic. This medication is a naturally occurring substance that has been chemically modified. What is another name for this type of medication? A. Synthetic drug B. Semisynthetic drug C. Biotechnology drug D. Prototype drug
B
A client has developed clots and has bruising. It is determined that there is a depletion of the client's coagulation factors and widespread bleeding. Which medication will be administered? A. Aminocaproic acid B. Heparin C. Warfarin D. Protamine sulfate
B
A client is confused and has stated to the nurse, "I wasn't sure whether I'm supposed to take Tylenol or acetaminophen." To best address the client's concern, the nurse should base the response on what information concerning generic and trade names? A. Prescribers should refer solely to generic names in their recommendations and written prescriptions. B. A generic name is independent of any particular drug manufacturer. C. Generic names change frequently, but trade names are more consistent. D. Prescribers should refer solely to trade names in their recommendations and written prescriptions.
B
A client is discharged from the hospital with a prescription of warfarin. Which statement indicates successful client teaching? A. "If I miss a dose, I will take two doses." B. "I will avoid herbal remedies." C. "I will eat spinach or broccoli daily." D. "I will discontinue my other medications."
B
A client is experiencing a cough associated with an upper respiratory infection. Which oral medication will likely produce the quickest therapeutic effect? A. A tablet B. A liquid C. A topical spray D. A timed-release tablet
B
A client with a diagnosis of bipolar disorder has begun lithium therapy. What is the primary rationale for the nurse's instructions regarding the need for regular monitoring of the client's serum drug levels? A. It is necessary to regularly test for blood-drug incompatibilities that may develop during treatment. B. It is necessary to ensure that the client's drug levels are therapeutic but not toxic. C. It is needed to determine if additional medications will be needed to potentiate the effects of lithium. D. It is needed in order to confirm the client's adherence to the drug regimen.
B
A client with a history of clot formation is scheduled for bowel resection due to colorectal cancer. What anticoagulant agent will be administered prophylactically? A. Acetylsalicylic acid B. Heparin C. Warfarin D. Streptokinase
B
A nurse has administered a dose of a drug that is known to be highly protein bound. What are the implications of this characteristic? A. The client must consume adequate protein in order to achieve a therapeutic effect. B. The molecules of the drug that are bound to protein are inactive and do not affect body cells. C. Increased levels of serum protein will increase the effect of the drug. D. Each molecule of the drug must bind to a protein molecule to become effective.
B
A nurse is preparing to administer an intramuscular injection of an older adult's seasonal influenza vaccination. What size needle should the nurse use to administer the injection? A. 16 gauge B. 20 gauge C. 24 gauge D. 28 gauge
B
A nurse who provides care on a postsurgical unit frequently administers Schedule II drugs to clients. Which aspect of administering these drugs falls under the auspices of the U.S. Drug Enforcement Administration? A. Performing a thorough client assessment prior to administration B. Recording each dose administration on an agency narcotic sheet C. Informing clients of the potential risks and benefits of such drugs prior to the first dose D. Assessing the client shortly after administration to ensure existence of the expected therapeutic effect
B
A woman diagnosed with obsessive-compulsive disorder has been prescribed oral paroxetine hydrochloride. What is the expected effect for this prescription? A. Curative effect on symptoms B. Systemic effect on symptoms C. Local effect on symptoms D. Parenteral effect on symptoms
B
An obese client who has an elevated triglyceride level and reduced high-density lipoprotein cholesterol is seen by the primary health care provider. What do these data suggest in this client? A. The development of arthritic syndrome B. The development of metabolic syndrome C. The development of Reye's syndrome D. The development of Tay-Sachs disease
B
An older adult client has been prescribed a nitrate and a calcium channel blocker for the treatment of unstable angina. When performing health education to promote adherence to the client's medication regimen, the nurse should emphasize which point? A. The client will likely need medications until he or she no longer experiences signs of angina. B. The client should take medications as prescribed even if he or she feels well in the short term. C. Inconsistent medication use will likely cause the onset of hypertension. D. The client should gauge the day's dose based on how he or she feels in the morning.
B
An older adult client has developed chronic obstructive pulmonary disease (COPD) and has consequently been prescribed albuterol, a beta2-adrenergic agonist. When administering this medication, the nurse should be aware that: A. the drug carries a higher potential for hepatotoxicity in this client than in a younger client. B. the drug may be less effective than in a younger client due to decreased beta-receptor function. C. the client will need to take a beta-adrenergic blocker concurrently to mitigate the likelihood of adverse effects. D. the client will need to have serial complete blood counts (CBCs) drawn following the initiation of therapy.
B
An older adult client has sought care for a dermatologic health problem that most often requires treatment with an oral corticosteroid. When considering whether to prescribe steroids to this client, the health care provider should prioritize which question? A. "Should this client receive a medication that was likely tested on younger adults?" B. "Do the potential benefits of this medication outweigh the potential harm?" C. "Are there plausible herbal or complementary alternatives to this medication?" D. "Is there a younger adult who can oversee this client's medication regimen?"
B
An older adult client's most recent blood work reveals a serum albumin level of 21 g/L (low). This will most influence what aspect of pharmacokinetics? A. Absorption B. Distribution C. Metabolism D. Excretion
B
In the U.S., the administration of anabolic steroids is regulated by which law? A. The Food, Drug, and Cosmetic Act of 1938 B. The Comprehensive Drug Abuse Prevention and Control Act C. The Harrison Narcotic Act D. The Sherley Amendment
B
The health care provider orders potassium chloride 40 mEq to be added to the client's IV solution. The vial reads 10 mEq/5 mL. How many milliliters will be added to the IV solution? A. 0.25 mL B. 20 mL C. 200 mL D. 40 mL
B
The home visiting nurse observes an older adult prepare to administer a prescribed 8 units of insulin glargine. The client squints and draws up 10 units into the syringe. Which intervention should the nurse implement to best assure safe medication administration? A. Provide a magnifying glass. B. Assess the client's near vision. C. Ask the client to redraw again. D. Review the markings on the syringe.
B
The nurse has measured a client's capillary blood glucose and is preparing to administer NPH insulin. Which action should the nurse perform to effectively administer the medication? A. Administer intramuscularly. B. Rotate the medication vial. C. Vigorously shake the vial. D. Administer intradermally.
B
The nurse is providing care for a client who has been diagnosed with osteoarthritis. Which herbal supplement should the nurse educate the client on when discussing the interest in supplementing cartilage repair? A. Gingko B. Glucosamine C. St. John's wort D. Saw palmetto
B
What is the expected therapeutic outcome of the simultaneous administration of two medications? A. The adverse effects of one of the drugs are nullified by the other drug. B. The combined effects are greater than the effects of either one of the drugs alone. C. One of the drugs enhances metabolism, while the other drug enhances either distribution or absorption. D. Both drugs are toxic in isolation but therapeutic when administered together.
B
What is the primary role of protein binding on drug action? A. Increasing the medication's speed of action B. Decreasing the medication's speed of action C. Increasing the rate of the medication's excretion D. Averting the risk of adverse effects posed by the medication
B
Which factor accounts for the increased risk for drug reactions among clients aged 65 years and older? A. Drugs more readily crossing the blood-brain barrier in older people B. Physiologic changes affecting all pharmacokinetic processes C. Increased drug-metabolizing enzymes in older people D. Diminished immune response
B
Which phrase accurately describes the concept of a medication's serum half-life? A. The time required for IV medications to penetrate the brain tissue B. The time needed for the serum level to fall by 50% C. The safest margin to prevent toxicity D. The dose adjustment that reduces the risk of adverse effects by one half
B
Which statement best describes drug efficacy and toxicity in pediatric clients? A. Drug requirements for infants have been studied extensively. B. Drug dosage is altered by disease state and weight in children. C. Children should be administered the same dose of aspirin as adults. D. Infants and children are at lowest risk for drug toxicity.
B
The nurse prepares to administer an antibiotic, gentamicin IV, to the older adult client. The nurse would predict the pharmacokinetics that influence drug action to include which concepts? Select all that apply. A. With aging, there is an increased gastric pH and delayed or lack of absorption of drugs. B. Toxicity risk is increased with water-soluble drugs because drug concentrations are larger. C. The aging liver decreases in size and function leading to decreased metabolism of drugs and longer half-life for medications. D. Decrease in muscle mass and changes in the circulation leads to abnormal drug concentrations and altered absorption. E. The creatinine level is the most accurate method to determine renal function for the older adult.
B, C
The nurse prepares to administer the following medications to a 62-year-old client with a recent onset of confusion: carbidopa-levodopa, benztropine, cimetidine, benazepril, and atenolol. The nurse would determine which medications are potentially inappropriate? Select all that apply. A. Carbidopa-levodopa B. Benztropine C. Diazepam D. Benazepril E. Atenolol
B, C
A client is administered amoxicillin. The generic name of this medication belongs to which drug group? A. Selective serotonin reuptake inhibitors B. Diuretics C. Penicillins D. ACE inhibitors
C
A client is being administered heparin IV and has been started on warfarin. The client asks the nurse why both medications have been prescribed. What is the nurse's most accurate response? A. "After a certain period of time, you must start warfarin and heparin together." B. "You will need both warfarin and heparin for several days." C. "Warfarin takes 3 to 5 days to develop anticoagulant effects, and you still need heparin." D. "Warfarin cannot be given without heparin due to the amount of clotting you need."
C
A client is taking a medication that is metabolized by the CYP enzymes. Which medication inhibits several of the CYP enzymes? A. Cisplatin B. Acebutolol hydrochloride C. Cimetidine D. Dicloxacillin sodium
C
A client is taking warfarin to prevent clot formation related to atrial fibrillation. How are the effects of the warfarin monitored? A. RBC B. aPTT C. PT and INR D. Platelet count
C
A gerontological nurse is aware that age is a salient variable that must be considered during pharmacotherapy in adults. However, the nurse knows that many other important variables must also be considered, including race. Members of which racial group typically require lower doses of many common medications? A. Native American/First Nation clients B. White clients C. Clients of Asian descent D. Black clients
C
A new medication for the treatment of Alzheimer's disease is being administered to a group of subjects with the disease. The subjects receiving this medication are unaware of whether they are being administered the medication or a placebo. This testing occurs in which phase? A. Phase 1 B. Phase 2 C. Phase 3 D. Phase 4
C
A nurse has noted that an older adult client on an acute care for elders (ACE) unit has an exceptionally lengthy medication administration record. The nurse has alerted the pharmacist because one of the client's long-standing medications appears on the Beers list. What medication is the nurse likely addressing? A. Low-dose enteric-coated ASA B. Metoprolol C. Digoxin D. Vitamin D
C
A nurse is responsible for maintaining an accurate count and record of the controlled substances on the nursing division. This nursing action is regulated by which U.S. law or agency? A. The Food, Drug, and Cosmetic Act of 1938 B. The Public Health Service C. The Drug Enforcement Administration D. The Sherley Amendment
C
An older client has developed syncope since an antihypertensive agent was added to the client's medication regime. The development of syncope may be related to which physiologic process? A. Interaction of other medications B. Ingestion of herbal supplements C. Diminished excretion of the medication D. Increased metabolism of the medication
C
Laboratory testing of an older adult client who is well-known to the clinic nurse indicates that liver function has been gradually decreasing over the last several years. How will this age-related physiologic change influence drug metabolism? A. The client will metabolize drugs more quickly but derive less of a therapeutic benefit from them. B. The liver will sequester drug molecules in the hepatocytes, and they will be released at unpredictable times. C. Many of the client's medications will remain in the body for a longer time. D. The client's kidneys will be forced to metabolize a disproportionate quantity of medications.
C
The nurse has received an order for a medication to be administered buccally. Where is the medication administered? A. Eye B. Vagina C. Cheek D. Nose
C
Trials of a new drug are scheduled to begin soon. The testing methodology will integrate the stipulations of the National Institutes of Health (NIH) Revitalization Act. According to this act, the manufacturer must address which requirement? A. Independently fund the entire testing process. B. Make the results of the testing process publicly available. C. Include women and minorities in the testing process. D. Exclude any potential for financial gain during the testing process.
C
What is the primary purpose of American drug laws? A. To ensure maximum choice for consumers B. To expedite the workload of health care providers C. To protect the safety of the public D. To enhance the efficient delivery of health care
C
Which organization is responsible for approving new drugs in the United States? A. The American Medical Association (AMA) B. The American Pharmaceutical Association (APA) C. The Food and Drug Administration (FDA) D. The U.S. Pharmacopeia
C
A 79-year-old client has been brought to the emergency department by ambulance with signs and symptoms of ischemic stroke. The care team would consider the immediate (STAT) administration of what drug? A. Low-molecular-weight heparin B. Vitamin K C. Clopidogrel D. Alteplase
D
A client has a gastrostomy tube, and the pharmacy has delivered an extended-release tablet. What is the most appropriate action taken by the nurse to assure effective administration of the medication? A. Administer the medication orally. B. Administer the medication through the tube. C. Crush the medication and administer half of it at a time. D. Call the pharmacy to obtain the medication in liquid form.
D
A client has increased intracranial pressure and is prescribed a diuretic. Which diuretic would be the most appropriate for this client? A. Furosemide B. Hydrochlorothiazide C. Spironolactone D. Mannitol
D
A client is being discharged from the hospital with warfarin to be taken at home. Which food should the client be instructed to avoid in the diet? A. Eggs B. Dairy products C. Apples D. Spinach
D
A client is prescribed eptifibatide, which inhibits platelet aggregation by preventing activation of GP IIb/IIIa receptors on the platelet surface and the subsequent binding of fibrinogen and von Willebrand factor to platelets. Which syndrome is treated with eptifibatide? A. Blocked carotid arteries B. Intermittent claudication C. Hypertension D. Unstable angina
D
A client is receiving IV heparin every 6 hours. An activated partial thromboplastin time (aPTT) is drawn 1 hour before the 08:00 am dose. The PTT is 92 seconds. What is the most appropriate action by the nurse? A. Give the next two doses at the same time. B. Give the dose and chart the client response. C. Check the client's vital signs and give the dose. D. Hold the dose and the call the aPTT result to the health care provider's attention.
D
A client taking warfarin after open heart surgery reports pain in both knees that began this week. The nurse notes bruises on both knees. Based on the effects of the medications and the report of pain, what should the nurse suspect is the cause of the pain? A. Joint thrombosis B. Torn medial meniscus C. Degenerative joint disease caused by medication D. Bleeding
D
A client who is receiving warfarin has blood in the urinary drainage bag. What medication will likely be prescribed by the health care provider? A. Aminocaproic acid B. Platelets C. Protamine sulfate D. Vitamin K
D
A client with a long-standing dermatologic health problem has been advised to use a drug with a local effect. The nurse should recognize what characteristic of this drug? A. It affects only the organ system in which it is metabolized. B. The drug requires application at multiple sites. C. It is effective only as long as it is in contact with skin. D. The drug acts primarily at the site where it is applied.
D
A client's current medication administration record includes a drug that the nurse recognizes as an Institute for Safe Medication Practices (ISMP) high-alert medication. This designation signals the nurse to what characteristic of the drug? A. It can only be administered by a health care provider or advanced practice nurse. B. Administration must be cosigned by a second registered nurse or practical/vocational nurse. C. It is currently undergoing Phase 4 testing and is pending full FDA approval. D. Administration errors carry a heightened risk of causing significant client harm.
D
A client, diagnosed with pneumonia, has been prescribed an antibiotic to treat the infection. Which nursing action will assist in increasing lung capacity? A. Promoting hand hygiene B. Increasing rest C. Frequent repositioning D. Promoting deep breathing
D
A nurse at a long-term care facility is conducting a medication reconciliation for a client who has just moved into the facility. The client is currently taking clopidogrel. The nurse is most justified suspecting that this client has a history of what condition? A. Hemorrhagic cerebrovascular accident B. Hemophilia A C. Idiopathic thrombocytopenic purpura (ITP) D. Myocardial infarction
D
A nurse begins a client interaction by systematically gathering information on the client's care and eventually evaluating the outcomes of care. Which represents this continuum of care? A. Assessment process B. Outcomes analysis C. Nursing interventions D. Nursing process
D
A nurse is teaching an older adult client about the risk for potential adverse effects before beginning a course of antibiotics for an upper respiratory infection. What characteristic of older adults predisposes them to adverse drug reaction? A. Increased excretion time due to increased bowel motility B. Impaired distribution due to polypharmacy C. A decrease in overall body surface area D. A decrease in the number of receptors needed for distribution
D
An older adult client has been taking a diuretic and a beta-blocker for the treatment of hypertension for the past several months. During the latest clinic visit, the client reports measuring blood pressure regularly at the local drug store and claims that it is usually in the range of 120/78 mm Hg. As a result, the client has cut down on doses of both drugs. The client's actions should indicate the initial need for which intervention? A. Assess the client's ability to pay for this long-term medication regimen. B. Assess the client's cognitive status for signs of confusion that could interfere with medication adherence. C. Evaluate the client's ability to accurately monitor blood pressure. D. Instruct on the need to adhere to the prescribed medication regimen.
D
The administration of diphenhydramine is regulated by which U.S. government agency? A. Public Health Service B. Federal Trade Commission C. Occupational Safety and Health Administration D. Food and Drug Administration
D
What is the characteristic action of an agonist? A. Agonists alter the normal processes of distribution and metabolism. B. Agonists counteract the action of specific neurotransmitters. C. Agonists block the action of specific neurotransmitters. D. Agonists bind to receptors and cause a physiologic effect.
D
What is the effect of a significant first-pass effect on the metabolism of a medication? A. The medication must pass through the client's bloodstream several times in order to generate a therapeutic effect. B. The medication must pass through the renal tubules and is excreted in large amounts. C. The medication's effectiveness increases with each subsequent dose. D. The medication is biotransformed extensively in the client's liver.
D
What is the mechanism that allows mannitol to produce diuresis? A. Competes with aldosterone for cellular receptor sites B. Inhibits the reabsorption of sodium and chloride in the loop of Henle C. Interferes with absorption of sodium ions across the distal renal tubule D. Increases the osmolarity of plasma and pulls water out of the tissues into the bloodstream
D
What is the primary importance of a black box warning? A. It will result in the medication being removed from the market. B. It acknowledges that the medication has been tested on only a selected portion of the population. C. It suggests that the prescription of the medication be avoided when treating certain populations. D. It alerts health care professionals of the potential of serious adverse effects associated with the medication.
D
When appraising an older adult's ability to excrete medications, what laboratory or diagnostic finding should the nurse prioritize? A. Renal ultrasound B. Complete blood count (CBC) C. Serum bilirubin and albumin levels D. Blood urea nitrogen and creatinine levels
D
Which nursing action when administering medication to children is appropriately directed toward medication safety? A. If a child is resistant, the nurse should tell the child that the medication is candy. B. Measurement by teaspoons is as accurate as milliliters. C. If a drug is not supplied in liquid form, the nurse can always crush the pill. D. Assess the child's weight prior to initial drug administration.
D
Which site of drug absorption is considered to have the largest surface area? A. Rectum B. Vagina C. Eye D. Lungs
D
