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A woman who is 7 months pregnant is waking up at night with gastroesophageal reflux. Which of the following medications is most highly recommended? A) Terbutaline (Brethine) B) Diphenoxylate (Lomotil) C) Ranitidine (Zantac) D) Chlorothiazide (Diuril) Ans: C
Ans C
An older adult patient has just been diagnosed with community-acquired pneumonia and aztreonam (Azactam) has been ordered. What action should the nurse perform before administering the first dose? A) Administer a 500 mL bolus of normal saline. B) Confirm the patient's allergy status. C) Swab the patient's nares for the presence of MRSA. D) Teach the patient to expect discolored urine during treatment.
ANs B
A patient is administered Augmentin (amoxicillin and clavulanate potassium) to treat otitis media. How does a beta-lactamase inhibitor agent achieve a therapeutic effect? A) It extends the spectrum of antibacterial activity of penicillin. B) It extends the spectrum of the beta-lactamase inhibitor. C) It decreases the side effects of high-dose penicillin. D) It increases the absorption of the penicillin. Ans: A
ANs: A
Unasyn is being administered to a patient with an infection caused by Staphylococcus aureus. What type of anti-infective is Unasyn? A) Extended-spectrum antipseudomonal penicillin B) Penicillin-beta-lactamase inhibitor combination C) Cephalosporin D) Aminopenicillin
ANs: B
A 69-year-old female responded well to inpatient treatment with a third-generation cephalosporin. After being largely symptom free for 48 hours, the woman has developed a fever of 38.6°C and an elevated white cell count. What phenomenon may account for this patient's current clinical presentation? A) The patient may be infected with microorganisms that were resistant to the cephalosporin. B) The patient may be experiencing a delayed (type IV) hypersensitivity reaction to the cephalosporin. C) The patient may be developing glomerulonephritis secondary to the nephrotoxic cephalosporin. D) The cephalosporin may have initially caused leukopenia and made the patient susceptible to secondary infection.
Ans A
A 74-year-old woman states that many of her peers underwent hormone replacement therapy (HRT) in years past. The woman asks the nurse why her primary care provider has not yet proposed this treatment for her. What fact should underlie the nurse's response to the woman? A) The risks of stroke and breast cancer are unacceptably high in women taking HRT. B) HRT was found to cause mood disturbances in many of the women who used it long term. C) HRT was found to be a significant risk factor for bone fractures and osteoporosis. D) The risks of chronic obstructive pulmonary disease were found to be significantly higher in women taking HRT.
Ans A
A patient began taking acetylsalicylic acid (aspirin) several years ago to prevent platelet aggregation following a myocardial infarction. Which dose of aspirin is most likely appropriate for this patient? A) 80 mg B) 180 mg C) 325 mg D) 650 mg Ans: A
Ans A
A patient is administered acetylsalicylic acid (aspirin) for fever and headache. What is the action of acetylsalicylic acid (aspirin)? A) Inhibiting prostaglandin synthesis in the central and peripheral nervous system B) Providing selective action by inhibiting prostaglandin synthesis in the CNS C) Inhibiting the release of norepinephrine to increase blood pressure D) Suppressing the function of the hypothalamus to decrease inflammation Ans: A
Ans A
A patient is receiving acetaminophen (Tylenol) for fever. The patient also has inflammation in the knees and elbows with pain. Why will acetaminophen (Tylenol) assist in reducing fever but not in decreasing the inflammatory process? A) Prostaglandin inhibition is limited to the central nervous system. B) Acetaminophen inhibits cyclooxygenase (COX-1 and COX-2) only. C) Acetaminophen has an antiplatelet effect to decrease edema. D) Prostaglandins decrease the gastric acid secretion. Ans: A
Ans A
A patient is undergoing a cytotoxic chemotherapy regimen for the treatment of stage III lung cancer. What effect will this regimen likely have on the patient's hemostatic function? A) The patient's platelet count will decline. B) The patient will be at increased risk of deep vein thrombosis. C) The patient will require prophylactic heparin. D) The patient will likely experience thrombocytosis. Ans: A
Ans A
A patient with a complex medical history is considering the use of oral contraceptives. The nurse should be aware that many antibiotics and antiseizure medications cause what effect when combined with oral contraceptives? A) Increased risk of pregnancy B) Increased blood pressure C) Increased risk of thromboembolism D) Increased gastric acid Ans: A
Ans A
A pregnant woman states that she has been constipated since becoming pregnant. Which medication is most appropriate for preventing constipation related to pregnancy? A) Metamucil B) Mineral oil C) Saline cathartic D) Stimulant cathartic Ans: A
Ans A
A woman has been prescribed Climara, a transdermal estradiol patch. Which of the following should she be instructed by the nurse regarding the administration? A) Avoid prolonged sun exposure at the patch site due to increased plasma concentrations. B) The application of heat at the patch site will decrease effectiveness and result in pregnancy. C) The medication, when exposed to sunlight, can increase the risk of breast cancer development. D) Exposure of the medication to occasional cold will increase effectiveness with application once a month.
Ans A
A woman was administered misoprostol (Cytotec) in an effort to induce labor, but the care team is unsatisfied with the results. Consequently, oxytocin will be used. Prior to administering oxytocin, what must occur? A) Four hours must elapse after the last dose of misoprostol. B) The woman must have a type and cross-match performed. C) The woman must receive a bolus of 500-mL normal saline. D) The woman must have her electrolytes measured. Ans: A
Ans A
A woman who is in the first trimester of her pregnancy has told the nurse, "I've stopped taking my blood pressure pill because I know it could harm the baby. Instead, I've started taking natural and herbal remedies." What nursing diagnosis is suggested by the woman's statement? A) Deficient knowledge related to drug and herbal effects during pregnancy B) Health-seeking behaviors related to protection of fetal health C) Acute confusion related to the potential teratogenic effects of herbs D) Effective therapeutic regimen management related to use of herbs rather than drugs
Ans A
A young woman is being seen in the gynecology clinic of the local health department. She has decided to begin hormonal contraceptives. What action is specific to hormonal contraceptives and should be taught to this woman? A) The cervical mucus is made resistant to penetration by spermatozoa. B) The follicle-stimulating hormone release is increased to block fertility. C) The maturation of the endometrial lining is activated by contraceptive. D) The pituitary gland increases the synthesis and release of luteinizing hormone.
Ans A
An older adult man has moved to a long-term care facility and the nurse is performing a medication reconciliation. The resident's current medication regimen includes alfuzosin (Uroxatral). After considering the most likely indication for this drug, the nurse should include what potential problem in the resident's interdisciplinary plan of care? A) Impaired urinary elimination B) Ineffective sexual pattern C) Sexual dysfunction D) Functional urinary incontinence Ans: A
Ans A
The family members of a geriatric patient are angered that she has been colonized with methicillin-resistant Staphylococcus aureus during her stay in the hospital. The nurse should explain what characteristic of colonization to the members of the family? A) The bacteria are present but are not causing infection. B) The bacteria are causing an infection, but the infection is not spreading. C) The bacteria are causing tissue injury at the site of colonization. D) The bacteria are spreading within a clearly defined body region. Ans: A
Ans A
When participating in the care of a patient who is being treated with antimicrobials, the nurse can promote the appropriate use of these medications in which of the following ways? A) Encouraging the use of narrow-spectrum, rather than broad-spectrum, antibiotics B) Promoting the use of prophylactic antibiotics for patients possessing risk factors for infection C) Initiating empiric therapy for all older adult patients admitted to a health care facility D) Promoting the use of herbal treatment for infection rather than antimicrobial drugs Ans: A
Ans A
A couple have been trying unsuccessfully for nearly a year to become pregnant and have now sought fertility counseling. The nurse should be aware of what potential etiological factors related to infertility? Select all that apply. A) Absence of sperm B) Endometriosis C) Vaginitis D) Blocked fallopian tubes E) Fibromyalgia Ans: A, B, D
Ans ABD
A 20-year-old college student has presented to the campus medical clinic seeking to begin oral contraceptive therapy. The nurse has recognized the need for adequate health education related to the patient's request. The nurse should emphasize the fact that successful prevention of pregnancy depends primarily on the patient's A) current health status. B) vigilant adherence to the drug regimen. C) knowledge of sexual health. D) risk factors for adverse effects. Ans: B
Ans B
A 22-year-old woman began using oral contraceptives several months ago and has presented for an appointment to discuss recent worrisome changes in her health status. Which of the following changes in the woman's health may the nurse potentially attribute to the use of oral contraceptives? A) Fatigue B) Frequent high blood pressure readings C) Frequent headaches without aura D) Nausea and vomiting Ans: B
Ans B
A 52-year-old has made an appointment with his primary care provider and has reluctantly admitted that his primary health concern is erectile dysfunction (ED). He describes the problem as increasing in severity and consequent distress. Which of the nurse's assessment questions is most likely to address a common cause of ED? A) "How would you describe your overall level of health?" B) "Are you taking any medications for high blood pressure?" C) "How has this problem been affecting your relationship with your wife?" D) "Have you suffered any injuries of any kind in the last several months?" Ans: B
Ans B
A critically ill patient has developed a fever of 38.9°C, and blood cultures have been drawn and sent to the laboratory for culture and sensitivity testing. Determination of the culture will tell the care team A) whether the infection is antibiotic resistant. B) the exact identity of the infectious microorganism. C) the most likely location of the infection. D) the most likely origin of the infection. Ans: B
Ans B
A female patient is taking combined hormonal contraceptives to prevent pregnancy. She visits the gynecology clinic and is noted to have a blood pressure of 176/102 mm Hg. The patient is started on enalapril mesylate 10 mg. In collaboration with the primary care provider, what other patient teaching should be provided based on her current medication regimen? A) Instruct on a no-salt diet. B) Instruct to discontinue the contraceptives. C) Instruct on the use of relaxation to decrease stress. D) Instruct on the rationale for increasing contraceptive dose. Ans: B
Ans B
A patient is administered imipenem-cilastatin for the treatment of an E. coli infection. The nurse should be aware that cilastatin is combined with the imipenem for what purpose? A) To eliminate adverse effects of imipenem administration B) To inhibit the destruction of imipenem C) To potentiate the therapeutic effects of imipenem D) To allow imipenem to cross the blood-brain barrier
Ans B
A patient is receiving oxytocin (Pitocin). Which of the following is a maternal adverse effect of Pitocin? A) Acute confusion B) Hypertension C) Edema D) Inverted T wave Ans: B
Ans B
A patient is to be started on an antibiotic. Which of the following is most important to take into consideration before beginning the antibiotic regimen? A) Duration of symptoms B) Culture and sensitivity C) The patient's hydration status D) The patient's age and weight Ans: B
Ans B
A patient suffers from dysmenorrhea. Which oral medication will be prescribed that has the ability to provide physiological actions on the neuroendocrine control of ovarian function? A) Estrogen B) Progestins C) Naprosyn (Naproxen) D) Ibuprofen (Motrin) Ans: B
Ans B
A patient suffers from pain in the elbow related to inflammation. What are the chemical mediators of inflammation? A) Insulin, thyroid hormone, and calcitonin B) Bradykinin, histamine, and leukotrienes C) Phospholipids, arachidonic acid, and platelets D) Red blood cells, lymph, and serosa Ans: B
Ans B
A patient taking hormonal contraceptives will soon turn 35 years of age. She is moderately obese and has smoked for 15 years. Which of the following is most important? A) Begin an exercise regime. B) Begin smoking cessation. C) Begin daily aspirin therapy. D) Begin taking a loop diuretic to aid weight loss. Ans: B
Ans B
A patient with burns has developed a wound infection. This patient is experiencing what type of wound infection? A) Fungal infection B) Opportunistic infection C) Nosocomial infection D) Food-borne infection Ans: B
Ans B
An adult female patient has been living with human immunodeficiency virus (HIV) for several years but has recently been admitted to the hospital after being diagnosed with herpes simplex. How would this patient's herpes infection most likely be characterized? A) Community-acquired infection B) Opportunistic infection C) Secondary infection D) Nosocomial infection Ans: B
Ans B
4. A woman who began labor several hours ago is to be administered oxytocin. What is the goal of oxytocin therapy? A) Prevent postpartum bleeding B) Decrease fetal hyperactivity C) Augment weak or irregular contractions D) Diminish periods of relaxation
Ans C
A 34-year-old woman has presented to the clinic for the first time, and the nurse learns that she has been taking Depo Provera for the past 13 years. This aspect of the woman's medical history should prompt what assessment? A) Cardiac stress testing B) Renal ultrasound C) Bone density testing D) Evaluation of triglyceride levels
Ans C
A 37-year-old woman has a 10 pack-year smoking history and has been using oral contraceptives for the past 2 years. The nurse should plan health education interventions in the knowledge that this patient faces an increased risk of A) osteoporosis. B) dementia. C) myocardial infarction. D) deep vein thrombosis. Ans: C
Ans C
A female patient has been treated for strep throat with ampicillin by mouth. She visits the occupational health nurse and states she has vaginal itching. What organism is the cause of the vaginal itching? A) Klebsiella B) Enterobacter C) Candida albicans D) Proteus Ans: C
Ans C
A nurse is performing health education with a woman who has just learned that she is pregnant. The nurse has explained the concept of teratogenic drugs and emphasized the need to have her care provider assess any medications she should consider taking. The nurse should teach the woman that drug-induced teratogenicity is most likely to occur at what point in her pregnancy? A) During the second half of her third trimester B) In the 7 to 10 days after conception C) In the first trimester during organogenesis D) During 30 to 34 weeks of gestation Ans: C
Ans C
A patient has chosen to receive palliative care after his lung cancer metastasized to his bones and liver. Which of the following is most appropriate during palliative cancer care? A) Abrupt cessation of chemotherapy immediately prior to entering palliative care B) Aggressive chemotherapy to reduce malignant cell proliferation C) The use of chemotherapy to reduce pain D) The replacement of chemotherapy with complementary and alternative treatments Ans: C
Ans C
A postmenopausal woman is administered estradiol (Estraderm). What condition will be prevented in this patient? A) Endometriosis B) Amenorrhea C) Osteoporosis D) Uterine cancer Ans: C
Ans C
A woman has been unable to conceive for many months and will soon begin treatment with clomiphene (Clomid). What health education should the nurse provide to this patient? A) Avoid drinking alcohol while taking Clomid. B) Perform daily OTC pregnancy tests beginning the day after taking Clomid. C) Take her basal temperature between 5 to 10 days after taking Clomid. D) Report any numbness or tingling in her hands or lips to her care provider. Ans: C
Ans C
A woman is prescribed hormonal contraceptives. What aspect of this treatment places her at greatest risk for the development of blood clots? A) Hormonal contraceptives increase serum triglyceride and cholesterol. B) Hormonal contraceptives increase platelet levels. C) Hormonal contraceptives increase blood levels of clotting factors. D) Hormonal contraceptives cause injury to blood vessel lumens. Ans: C
Ans C
A woman suffers from amenorrhea. Which of the following medications will most likely be prescribed? A) Testosterone B) Follicle-stimulating hormone C) Estrogen D) Lactate Ans: C
Ans C
An insulin-dependent diabetic patient has begun taking an oral contraceptive. What effect will this medication regime have on her physiologically? A) Increase risk of hypoglycemia B) Increase heart rate C) Increase blood glucose D) Increase risk of metabolic alkalosis Ans: C
Ans C
A 37-year-old woman has just experienced the end of a long-term relationship and has expressed a desire to begin using oral contraceptives. What aspect of this woman's current health status would contraindicate this treatment? A) The woman has a diagnosis of type 2 diabetes. B) The woman has asthma and uses inhaled corticosteroids and bronchodilators. C) The woman has a family history of breast cancer. D) The woman takes an antiplatelet medication for coronary artery disease. Ans: D
Ans D
A 50-year-old man has just been diagnosed with liver cancer, and the care team is finalizing the chemotherapy regimen that will begin imminently. Administration of chemotherapeutic drugs is best achieved through which of the following? A) An intramuscular depot B) A peripheral IV in the nondominant forearm C) Peripheral intravenous access in the antecubital fossa D) A central venous catheter
Ans D
A 71-year-old man with a history of osteoarthritis is scheduled for hip replacement surgery, and the surgeon has ordered a first-generation cephalosporin to be administered before and after surgery as prophylaxis. Which of the following drugs is a first-generation cephalosporin? A) Cefotetan (Cefotan) B) Cefoxitin (Mefoxin) C) Ceftriaxone (Rocephin) D) Cefazolin (Ancef)
Ans D
A group of nursing students are learning about the factors that underlie recent increases in the incidence and prevalence of antibiotic-resistant microorganisms. What factor is known to contribute to antibiotic resistance? A) Increased survival rates from acute infections B) Increased population density C) Use of antibiotics that are ineffective against the infectious microorganism D) Overuse of antibiotics Ans: D
Ans D
A medical nurse on a night shift is reviewing a patient's medication administration record for the following day. The nurse notes that a combination antimicrobial drug is ordered. What is implied by the fact that the patient has been ordered a combination drug? A) The patient's infection likely has a fungal or protozoal etiology. B) The patient likely has a history of recurrent, multisystemic infections. C) The patient may be unable to tolerate treatment with a single antimicrobial. D) The patient may have an infection caused by multiple microorganisms. Ans: D
Ans D
A nurse is teaching a young adult patient about oral contraceptives, which the patient will soon begin taking. The patient's primary concern is the effectiveness of the medication in preventing pregnancy. The nurse should teach the patient that oral contraceptives, when taken consistently, are how effective in preventing pregnancy? A) Between 96% and 98% B) Approximately 98.5% C) Highly effective, but partially dependent on genetic factors D) Nearly 100% Ans: D
Ans D
A patient is administered aztreonam (Azactam). What is the major advantage of this monobactam over the aminoglycosides in treating P. aeruginosa? A) It is a lower-cost medication. B) It is administered orally. C) It causes less GI distress. D) It has lower risk for hearing loss.
Ans D
A patient is being treated for preterm labor. Which beta-adrenergic medication is administered orally to decrease uterine contractions? A) Magnesium sulfate B) Oxytocin (Pitocin) C) Nifedipine (Procardia) D) Terbutaline (Brethine) Ans: D
Ans D
A patient with an infection has not responded appreciably to antibiotic therapy, and the nurse suspects antibiotic resistance. What phenomenon is known to contribute to acquired antibiotic resistance? A) Bacteria take on genetic material from healthy body cells, reducing antigen recognition. B) Microorganisms remain in resting (G0) phase during antibiotic treatment. C) Distribution of an antibiotic is insufficient to cause resolution of the infection. D) The strongest microorganisms survive antibiotic treatment while the weakest are eradicated. Ans: D
Ans D
A patient's chemotherapy regimen has been deemed successful, but the patient is experiencing debilitating nausea and vomiting. These adverse effects should signal the nurse to the possibility of what nursing diagnosis? A) Acute pain B) Adult failure to thrive C) Ineffective therapeutic regimen management D) Imbalanced nutrition: less than body requirements Ans: D
Ans D
A primiparous woman was vigilant in avoiding medications and herbs during her pregnancy and states that she is similarly committed to protecting her baby's health now that she is breast-feeding. What principle should guide the woman's use of medications while breast-feeding? A) Very few medications are explicitly contraindicated while breast-feeding. B) It is generally safer to use herbs rather than medications while breast-feeding. C) Most women can resume their prepregnancy medication regimen after delivery. D) Most medications are contraindicated while a woman is breast-feeding. Ans: D
Ans D
A woman is at 42 weeks of gestation. Which of the following medications will be administered to promote cervical ripening? A) Calcium gluconate B) Magnesium sulfate C) Terbutaline (Brethine) D) Dinoprostone (Cervidil) Ans: D
Ans D
A woman of childbearing age is diagnosed with breast cancer. She is currently taking hormonal contraceptives. What information should the woman be given regarding the hormonal contraceptives? A) The hormonal contraceptives do not affect the course of the disease. B) The hormonal contraceptives will stimulate uterine bleeding. C) The hormonal contraceptives will impair uterine bleeding. D) The hormonal contraceptives will stimulate tumor growth. Ans: D
Ans D
An elderly man who is a resident of a skilled nursing facility develops methicillin-resistant Staphylococcus aureus. What type of infection has this man developed? A) Community acquired B) Postoperative C) Sustained infection D) Nosocomial infection Ans: D
Ans D
An intensive care unit (ICU) nurse is preparing to administer an intravenous dose of imipenem-cilastatin to a patient who is being treated for sepsis. What aspect of this patient's history would contraindicate the use of this drug? A) The patient has a history of type 1 diabetes mellitus. B) The patient is showing signs and symptoms of fluid volume excess. C) The patient's most recent creatinine level was 140 mmol/L (high). D) The patient has a documented allergy to penicillin.
Ans D
An oncology nurse is reviewing the medication administration record of a patient being treated for advanced prostate cancer. In addition to two chemotherapeutic agents, the nurse reads that the patient has been ordered a cytoprotective agent. The goal of this agent is to A) buffer the cytotoxins that result from the metabolism of chemotherapeutic agents. B) protect the patient from pathophysiological effects of his malignancy. C) potentiate the beneficial effects of chemotherapy. D) reduce the incidence or severity of adverse drug effects. Ans: D
Ans D
During patient teaching, a young woman asks the nurse the following question: "If I get pregnant on the 'pill,' should I continue to take it?" What is the nurse's best response? A) "The pill has no effect on pregnancy." B) "The pill will cause miscarriage." C) "This is a personal choice for each woman." D) "The pill can be harmful to the fetus and should be discontinued."
Ans D
When acetylsalicylic acid (aspirin) is administered in low doses, it blocks the synthesis of thromboxane A2. What physiological effect results from this action? A) Inflammation is relieved. B) Core body temperature is reduced. C) Pain is relieved. D) Platelet aggregation is inhibited. Ans: D
Ans D
A nurse has established intravenous access in a patient whose infection necessitates treatment with IV cefazolin. What potential adverse reaction is most likely during this patient's course of treat? A) Gastrointestinal upset B) Dry skin and pruritus C) Drowsiness D) Orthostatic hypotension
Ans: A
A patient has been prescribed an oral penicillin for an infection caused by gram-negative bacilli. When conducting health education for this patient, the nurse should emphasize which of the following? A) The need to take the medication on an empty stomach B) The fact that a mild rash frequently follows the first few doses C) The need to increase fluid intake for the duration of treatment D) The fact that the drug should be discontinued once symptoms subside
Ans: A
A patient is to receive imipenem-cilastatin (Primaxin) IM to treat P. aeruginosa. What should imipenem-cilastatin be mixed with prior to administering intramuscularly? A) Meropenem (Merrem) B) Gentamicin (Garamycin) C) Lidocaine D) Epinephrine
Ans: C
A patient with septicemia is administered cefotaxime sodium (Claforan), a second-generation cephalosporin. How is this medication excreted? A) It is excreted by the lungs. B) It is excreted by the liver. C) It is excreted by the kidneys. D) It is excreted through the GI tract.
Ans: C
A patient is administered a third-generation cephalosporin. Which of the following microorganisms are cephalosporins most effective in treating? A) Gram-positive B) Gram-negative C) Fungi D) Virus
Ans: B
A patient is diagnosed with infective endocarditis. Which of the following medications is most effective in treating this patient? A) Dicloxacillin B) Ampicillin C) Nafcillin D) Oxacillin
Ans: B
A patient is scheduled for a vaginal hysterectomy. Which of the following medications is the drug of choice for surgical prophylaxis? A) Cefadroxil (Duricef) B) Cefazolin sodium (Ancef) C) Cephalexin (Keflex) D) Cephradine (Velosef)
Ans: B
A patient is diagnosed with B. fragilis, an anaerobic organism resistant to most drugs. What is the drug of choice to treat this microorganism? A) Cefaclor (Ceclor) B) Cefamandole nafate (Mandol) C) Cefoxitin (Mefoxin) D) Cefuroxime sodium (Zinacef)
Ans: C
Oral ampicillin has been ordered for a female patient whose urinary tract infection will be treated in a home setting. When teaching this patient about her antibiotic, the nurse should instruct the patient to do which of the following? A) Take the first dose together with diphenhydramine to reduce the chance of an allergic reaction. B) Take the drug immediately before a meal, unless the meal will contain large amounts of fat. C) Drink a full glass of water when taking a dose of the drug. D) Taper off the drug rather than abruptly stopping it.
Ans: C
Medroxyprogesterone acetate (Provera) is indicated for the treatment of women with A) uterine bleeding. B) cervical cancer. C) ovarian cancer. D) fibromyalgia. Ans: A
AnsA
A patient previously experienced an anaphylactic reaction to penicillin G. Which of the following medications should not be administered to this patient due to the potential for cross-sensitivity? A) Lactulose (Chronulac) B) Ketoconazole (Nizoral) C) Kanamycin (Kantrex) D) Cefadroxil (Duricef)
Cefadroxil (dericef)
An adult patient has a history of rheumatic fever. Which of the following medications should be administered as prophylaxis for rheumatic fever? A) Cyclacillin (Cyclapen) B) Amoxicillin (Augmentin) C) Dicloxacillin D) Penicillin G benzathine (Bicillin LA)
D Penicillin G benzathine (Bicillin LA)
A patient is administered penicillin V orally for a strep throat. What is the mechanism of action of this medication?
It inhibits cell wall synthesis.
A patient is suffering from bursitis in the right elbow. Which of the following orally administered medications is most likely to diminish inflammation and assist in relieving pain? A) Acetaminophen (Tylenol) B) Morphine sulfate C) Acetylsalicylic acid (aspirin) D) Codeine Ans: C
ans C
A 70-year-old man has enjoyed good overall health for all of his adult life, but he has been experiencing urinary frequency and dribbling that has culminated in a diagnosis of benign prostatic hypertrophy (BPH). As a result, the patient has been prescribed finasteride (Proscar). When teaching the patient about the potential adverse effects of the drug, the nurse should ensure that he knows about the possibility of A) sexual dysfunction. B) urethral burning. C) kidney stones. D) visual disturbances. Ans: A
and a
A patient has been using Viagra on an intermittent basis for several years. However, he has cited delays in the onset and peak of action as the occasional source of frustration. What PDE5 inhibitor may be of particular benefit to this patient's needs? A) Avanafil (Stendra) B) Tadalafil (Cialis) C) Vardenafil (Levitra) D) Alprostadil (Caverject) Ans: A
ans A
An elderly patient is treated for pneumonia with clindamycin (Cleocin). One week after the completion of the medication, she develops diarrhea. What is the most probable cause of the diarrhea? A) Change in normal flora B) Food-borne illness C) Crohn's disease D) Incontinence
ans A
An oncology nurse is preparing to administer cytotoxic chemotherapy medications. Which of the following measures best protects the nurse from harm related to the chemotherapy? A) Wearing protective equipment B) Performing thorough hand hygiene C) Mixing medication in a 1000-mL bag D) Administering medication intramuscularly whenever possible Ans: A
ans A
Mr. Garcia has been taking antibiotics at home for the treatment of a respiratory infection for the past 6 days, and there is no evident improvement in his infection. Which of the following nursing assessments is most appropriate? A) Assess Mr. Garcia's adherence to his medication regimen. B) Assess Mr. Garcia's home hygiene. C) Assess Mr. Garcia's understanding of his illness. D) Assess Mr. Garcia's use of herbal or alternative remedies. Ans: A
ans A
A child has symptoms of influenza, including a fever. Which of the following medications should not be administered to the child because of the risk of Reye's syndrome? A) Acetaminophen (Tylenol) B) Acetylsalicylic acid (aspirin) C) Ibuprofen (Motrin) D) Ascorbic Acid (vitamin C) Ans: B
ans B
A patient is taking ibuprofen (Motrin) for knee pain. The patient is admitted to the hospital with abdominal pain. Which of the following assessments should the nurse prioritize? A) Assessment for diarrhea B) Assessment for occult blood in the patient's stool C) Assessment of the patient's urine for hematuria D) Assessment for hemoptysis Ans: B
ans B
A young man has received a diagnosis of androgen deficiency and has been prescribed testosterone. At clinic follow-up appointments, the nurse should prioritize which of the following assessments? A) Bladder ultrasound and urine testing for glucose and ketones B) Weight and measurement of blood pressure C) Hearing assessment and abdominal girth measurement D) Deep tendon reflexes and random blood glucose testing Ans: B
ans B
An 81-year-old female patient has been admitted to the hospital after a urinary tract infection developed into urosepsis. What assessments should the nurse prioritize when monitoring the course of this patient's infection? Select all that apply. A) Blood urea nitrogen and creatinine B) White blood cell count C) Heart rhythm D) Temperature E) Liver panel Ans: B, D
ans BD
A 4-month-old baby has been brought to the emergency department by her parents, and initial assessment is highly suggestive of bacterial meningitis. Consequently, the baby has been admitted, and empiric antibiotic therapy has been ordered. The nurse should understand what characteristic of this infant's current treatment plan? A) Success or failure of treatment will not be apparent for several weeks. B) The infant will receive aggressive treatment with a narrow-spectrum antibiotic. C) Culture and sensitivity results of the infant's cerebrospinal fluid are still pending. D) The infant is suspected of having an antibiotic-resistant infection. Ans: C
ans C
A hospital nurse is aware that nosocomial infections pose a significant threat to many patients' health status. In order to reduce the spread of nosocomial infections, the nurse should prioritize which of the following actions? A) Increased use of empiric antibiotic therapy B) Use of disinfectants when providing patient hygiene C) Vigilant and thorough hand hygiene D) Patient education on the causes of infection Ans: C
ans C
A nurse is instructing a patient on the antibiotic regimen for the treatment of pneumonia. Which of the following is most important to teach the patient? A) Take the medication with orange juice. B) Supplement the medication with multivitamins. C) Complete the entire prescription of medication. D) Administer the medication with dairy products. Ans: C
ans C
A patient is diagnosed with familial adenomatous polyposis. Which of the following nonsteroidal anti-inflammatory agents has the potential to reduce the number of polyps and decrease the risk of colon cancer? A) Ibuprofen (Motrin) B) Nabumetone (Relafen) C) Celecoxib (Celebrex) D) Probenecid (Benemid) Ans: C
ans C
A woman who takes highly active antiretroviral therapy (HAART) for HIV/AIDS has become pregnant. What effect will the woman's pregnancy have on her drug regimen? A) She must discontinue HAART due to the risk of teratogenic effects. B) Her dosages of HAART must be increased to reduce the risk of in utero transmission. C) She can continue her HAART unchanged. D) Some components of her HAART must be replaced or discontinued. Ans: C
ans C
Sildenafil has been prescribed to a patient in his 60s, and the nurse is providing health education about the safe and effective use of the drug. The nurse should teach the patient to A) avoid taking sildenafil if he experiences heartburn. B) take the drug every 30 minutes if necessary, to a maximum of three doses. C) take the drug on an empty stomach. D) avoid taking the drug more than once in any 24-hour period. Ans: D
ans D
A 41-year-old male patient with a complex medical history has been referred to the endocrinology department. Diagnostic testing and assessment have resulted in a diagnosis of secondary hypogonadism. Which of the following health problems is the most likely etiology of his diagnosis? A) Type 1 diabetes B) Mumps C) An inflammatory process in the testicles D) Testicular trauma Ans: A
ans a
A 17-year-old boy has been admitted to the emergency department after suffering a knee sprain during a football practice. The nurse notes that the patient has exceptional muscle mass, and the boy quietly admits that this is mostly attributable to the use of steroids, which he obtains from a teammate. What should the nurse teach the boy about anabolic steroid abuse? A) The ability of anabolic steroids to build muscle is greatly exaggerated in the media. B) Anabolic steroids are universally dangerous but are especially harmful to adolescents. C) The muscle mass resulting from steroid use will atrophy unless doses are continually increased. D) Anabolic steroids will reduce the boy's ability to perform weight-bearing exercise later in life. Ans: B
ans b
A 72-year-old patient has been diagnosed with benign prostatic hypertrophy (BPH) and will begin treatment with tamsulosin (Flomax). The patient admits that he is skeptical about the drug's ability to relieve his distressing symptoms. The nurse should respond in what way? A) "Flomax can increase the amount of urine your kidneys produce, resulting in better urine flow." B) "Flomax can relax your prostate and your bladder neck, making it easier to pass urine." C) "Flomax makes your urine less alkaline, reducing the irritation that makes your prostate enlarge." D) "Flomax increases the strength of your bladder muscle and results in a stronger flow of urine." Ans: B
ans b
A middle-aged patient with erectile dysfunction has sought care and is receiving health education from the nurses. The patient has expressed a desire to understand the physiology of the sex hormone production and the sexual response. The nurse should describe the fact that testosterone is normally secreted in response to A) sexual arousal. B) stimulation by luteinizing hormone. C) ACTH release by the adrenal cortex. D) decreased cortisol levels. Ans: B
ans b
An 8-year-old boy has been diagnosed with a sex hormone deficiency and has begun a course of treatment with testosterone. What change in the boy's health status would necessitate a stop to the course of treatment? A) Excessive growth in height B) Signs of puberty C) Recurrent urinary tract infections D) Increased blood pressure Ans: B
ans b
An adult patient is suspected of having an androgen deficiency and has spoken with his primary care provider about the possibility of treatment with testosterone. The use of testosterone would be most complicated by the presence of what preexisting health problem? A) Urinary incontinence B) BPH C) Chronic renal failure D) Type 2 diabetes Ans: B
ans b
After experiencing several months of worsening nocturia, a patient has been assessed for benign prostatic hypertrophy (BPH) and has begun drug treatment. In addition to nocturia, what other sign or symptom is most likely to accompany BPH? A) Hematuria B) Erectile dysfunction C) Urinary frequency D) Flank pain Ans: C
ans c
On the advice of his brother, a 53-year-old man has made an appointment to request a prescription for Sildenafil (Viagra). The nurse who works at the clinic is reviewing the man's medical history and would recognize what health problem as being prohibitive to this treatment? A) Type 2 diabetes, treated with metformin B) Hypercholesterolemia, treated with simvastatin C) Angina, treated with nitroglycerin D) Hypertension, treated with metoprolol Ans: C
ans c
The nurse is closely following a patient who began treatment with testosterone several months earlier. When assessing the patient for potential adverse effects of treatment, the nurse should prioritize which of the following assessments? A) Skin inspection for growing lesions B) Lung function testing C) Assessment of serum calcium levels D) Assessment of arterial blood gases Ans: C
ans c