Pharm Test Bank 2
.A woman has been taking a progestin-only oral contraceptive and will begin using a vaginal ring. The nurse will teach the patient to insert the ring: a. the day the last pill is taken and use backup contraception for 7 days. b. 1 week before taking the last pill. c. 1 to 5 days after taking the last pill and use backup contraception for 2 days. d. within 7 days after taking the last pill.
A
A 1-year-old child is scheduled to receive the MMR vaccine, pneumococcal vaccine (PCV), Varivax, and hepatitis A vaccine. The child's parents request that the MMR vaccine not be given, saying that, even though there is no demonstrated link with autism, they are still concerned about toxic levels of mercury in the vaccine. Which response by the nurse is correct? a. "Most U.S.-made vaccines have zero to low amounts of mercury." b. "Other vaccine preparations contain mercury as well." c. "Thimerosal is a nontoxic form of mercury." d. "You can get more mercury from breast milk and many foods on the market."
A
A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine [Synthroid]. The child comes to the clinic for a well-child checkup. The nurse will expect the provider to: a. change the dose of levothyroxine to 6 mcg/kg/day. b. discontinue the drug if the child's physical and mental development are normal. c. increase the dose to accommodate the child's increased growth. d. stop the drug for 4 weeks and check the child's TSH level.
A
A 14-year-old male patient has not begun puberty. His parents tell the nurse that their son does not want to go to school, because he gets teased. The nurse learns that the boy's father did not begin puberty until age 16 years. Laboratory tests on this child do not reveal true hypogonadism. What will the nurse tell these parents when they ask what can be done for their son? a. "A limited course of androgen therapy may be prescribed, but it is not necessary." b. "He will eventually begin puberty, so this is nothing to worry about." c. "He will probably have to receive injections of androgens for 3 to 4 years." d. "The risk of accelerated growth plate closure is too great to warrant androgentherapy."
A
A 5-year-old child with seasonal allergies has been taking 2.5 mL of cetirizine [Zyrtec] syrup once daily. The parents tell the nurse that the child does not like the syrup, and they do not think that the drug is effective. The nurse will suggest theydiscuss which drug with their child's health care provider? a. Cetirizine [Zyrtec] 5-mg chewable tablet once daily b. Loratadine [Claritin] 10-mg chewable tablet once daily c. Fexofenadine [Allegra] syrup 5 mL twice daily d. Desloratadine [Clarinex] 5-mg rapid-disintegrating tablet once daily
A
A 7-year-old child with asthma uses a daily inhaled glucocorticoid and an albuterol MDI as needed. The provider has added montelukast [Singulair] to the child's regimen. Which statement by the child's parent indicates understanding of this medication? a. "I may notice mood changes in my child." b. "I should give this medication twice daily." c. "I will give my child one 4-mg chewable tablet daily." d. "This drug can alleviate symptoms during an acute attack."
A
A clinic nurse is assessing an adolescent male patient who has been receiving androgen therapy for hypogonadism via a transdermal patch. The patient's last clinic visit was 4 weeks earlier. Which part of the interval history is of most concern to the nurse? a. Five-pound weight gain b. Increased growth of pubic hair c. Rash at the site of the patch d. Presence of acne
A
A clinic nurse receives a phone call from a parent who states that a 2-month-old infant has a severe cough, a low-grade fever, and a runny nose that have lasted over a week. What will the nurse ask the parent? a. Whether the infant has had the first set of vaccines b. Whether the infant received a hepatitis B vaccine as a newborn c. Whether the infant attends day care d. Whether there is a family history of respiratory disorders
A
A nurse is caring for a patient who has been taking low-dose aspirin for several days. The nurse notes that the patient has copious amounts of watery nasal secretions and an urticarial rash. The nurse will contact the provider to discuss: a. administering epinephrine. b. changing to a first-generation NSAID. c. reducing the dose of aspirin. d. giving an antihistamine
A
A nurse is discussing glucocorticoids with a group of nursing students. Which statement by a student indicates understanding of the teaching? a. "Glucocorticoids have both endocrine and non endocrine uses." b. "Patients treated for adrenocortical insufficiency receive pharmacologic doses." c. "Pharmacologic effects are achieved with low doses of glucocorticoids." d. "Physiologic doses are used to treat inflammatory disorders."
A
A nurse is discussing the administration of an intravenous infusion of rituximab (Rituxan) with a nursing student. Which statement by the student indicates a need for further education about the care of a patient receiving this drug? a. "Angioedema and hypersensitivity may occur, but they are usually self-limiting and mild." b. "I should be prepared to administer epinephrine, glucocorticoids, and oxygen if needed." c. "I will administer an antihistamine and acetaminophen before beginning the infusion." d. "I will monitor this patient's blood pressure, respiratory rate, and oxygen saturation closely."
A
A nurse is discussing the role of vitamin D in calcium regulation with a nursing student. Which statement by the student indicates a need for further teaching? a. "Adequate amounts of vitamin D occur naturally in the diet." b. "Vitamin D3 is preferred over vitamin D2." c. "Vitamin D can promote bone decalcification." d. "Vitamin D increases the absorption of calcium and phosphorus from the intestine."
A
A nurse is preparing to administer IV calcium chloride to a patient with a low serum calcium level. Which drug on the patient's medication record, administered concurrently, would require additional patient monitoring by the nurse? a. Digoxin [Lanoxin] b. Furosemide [Lasix] c. Lorazepam [Ativan] d. Pantoprazole [Protonix]
A
A nurse is providing education to a patient who will begin taking alendronate [Fosamax]. Which complication should the patient be instructed to report immediately? a. Difficulty swallowing b. Dizziness c. Drowsiness d. Pallor
A
A nurse is providing teaching for an adult patient with arthritis who has been instructed to take ibuprofen [Motrin] for discomfort. Which statement by the patient indicates a need for further teaching? a. "I may experience tinnitus with higher doses of this medication." b. "I may take up to 800 mg 4 times daily for pain." c. "I should limit alcohol intake to fewer than three drinks a day." d. "I will take this medication with meals to help prevent stomach upset."
A
A nurse is teaching a group of nursing students about antihistamines. Which statement by a student indicates an understanding of the mechanism of action of the antihistamines? a. "Antihistamines block H1 receptors to prevent actions of histamine at these sites." b. "Antihistamines block release of histamine from mast cells and basophils." c. "H1 antagonists can bind to H1 receptors, H2 receptors, and muscarinic receptors." d. "First-generation antihistamines are more selective than second generation antihistamines."
A
A nurse is teaching a group of nursing students about immunoglobulins. Which statement by a student indicates a need for further teaching? a. "IgD provides a first line of defense against microbes entering the bodythrough the lungs." b. "IgE plays a role in hypersensitivity reactions and responses to parasites." c. "IgG and IgM participate in the complement response to promote target-cell lysis." d. "Neonatal immunity is the result of IgG crossing the placenta."
A
A nurse is teaching a patient who has taken glucocorticoids for over a year about glucocorticoid withdrawal. Which statement by the patient indicates a need for further teaching? a. "I should reduce the dose by half each day until I stop taking the drug." b. "I will need to have cortisol levels monitored during the withdrawal process." c. "The withdrawal schedule may take several months." d. "If I have surgery, I may need to take the drug for a while, even after I have stopped."
A
A parent asks a nurse about growth suppression resulting from the use of an inhaled glucocorticoid in children. What will the nurse tell the parent? a. Growth may be slowed, but eventual adult height will not be reduced. b. The growth rate is not impaired, but overall height will be reduced. c. The growth rate slows while the drug is used and only resumes when the drug is stopped. d. Long-term use of the drug results in a decrease in adult height
A
A patient at increased risk for thromboembolic disorders will begin taking a progestin-only oral contraceptive. Which statement by the patient indicates understanding of how this oral contraceptive works? a. "I will need to use backup contraception if I miss a pill." b. "Irregular bleeding is an indication that I should stop using this drug." c. "The mini-pill is safer than combination OCs and is just as effective." d. "The progestin-only mini-pill will prevent me from ovulating."
A
A patient calls a family planning clinic and tells the nurse that her vaginal ring, which has been in place for 2 weeks, came out sometime during the night while she was sleeping. The nurse will instruct her to: a. clean the ring with warm water, reinsert it, and use condoms for 7 days. b. discard the ring and insert a new ring after 1 week has passed. c. discard the ring and insert a new one to begin a new cycle. d. wash the ring in hot, soapy water, and reinsert it.
A
A patient has been receiving intravenous ketorolac 30 mg every 6 hours for postoperative pain for 4 days. The patient will begin taking oral ketorolac 10 mg every 4 to 6 hours to prepare for discharge in 1 or 2 days. The patient asks the nurse whether this drug will be prescribed for management of pain after discharge. The nurse will respond by telling the patient that the provider will prescribe a(n): a. different nonsteroidal anti-inflammatory drug for home management of pain. b. fixed-dose opioid analgesic/nonsteroidal anti-inflammatory medication. c. lower dose of the oral ketorolac for long-term pain management. d. intranasal preparation of ketorolac for pain management at home.
A
A patient has been taking levothyroxine for several years and reports that "for the past 2 weeks, the drug does not seem to work as well as before." What will the nurse do? a. Ask the patient when the prescription was last refilled. b. Expect the patient to have an elevated temperature and tachycardia. c. Suggest that the patient begin taking calcium supplements. d. Tell the patient to try taking the medication with food.
A
A patient has just purchased a 1-year supply of 28-day-cycle oral contraceptives. She tells the nurse she wishes she had planned things better, because she has calculated that her period will begin during her upcoming honeymoon. What will the nurse suggest? a. She should discard the inert pills and start a new pack during the honeymoon. b. She should discontinue the oral contraceptives and use an alternative form of birth control. c. She should discuss a prescription for an extended-cycle product with her provider. d. She should discuss DMPA (Depo-Provera) injections in addition to the OC withher provider.
A
A patient has just received a prescription for fluticasone/salmeterol [Advair Diskus]. What will the nurse include as part of the teaching for this patient about the use of this device? a. "You do not need good hand-lung coordination to use this device." b. "You will begin to inhale before activating the device." c. "You will need to use a spacer to help control the medication." d. "You will take two inhalations twice daily."
A
A patient is admitted for treatment of gout that has been refractory to treatment with allopurinol and probenecid. The patient is taking colchicine, and the prescriber orders pegloticase [Krystexxa]. Before administering this drug, the nurse will expect to: a. administer an antihistamine and a glucocorticoid. b. discontinue the colchicine. c. increase the dose of colchicine. d. prepare to administer a bronchodilator if needed.
A
A patient is beginning therapy with oral methotrexate [Rheumatrex] for rheumatoid arthritis. The nurse will teach this patient about the importance of: a. having routine renal and hepatic function tests. b. limiting folic acid consumption. c. reporting alopecia and rash. d. taking the medication on a daily basis.
A
A patient receiving doxazosin presents for a routine evaluation. Which assessment finding would be most concerning? a. Blood pressure 96/58 b. Dizziness when standing c. Increased nasal congestion d. Diminished ejaculate volume
A
A patient receiving transurethral alprostadil asks about intracavernous administration. Which information would be included in the explanation? a. Transurethral administration has fewer side effects. b. Transurethral administration helps increase arterial flow to the penis. c. The desired effect can be achieved with only 0.1 mL of the medication. d. The required dose is much smaller with transurethral administration
A
A patient taking a glucocorticoid for arthritis reports feeling bloated. The nurse notes edema of the patient's hands and feet. Which action by the nurse is correct? a. Ask the patient about sodium intake. b. Obtain a blood glucose level. c. Suggest the patient limit potassium intake. d. Tell the patient to stop taking the drug.
A
A patient taking high doses of a glucocorticoid develops weakness in the muscles of the upper arms and in the legs. What will the nurse do? a. Contact the provider to ask about reducing the dose. b. Encourage the patient to restrict sodium intake. c. Reassure the patient that this is an expected side effect. d. Tell the patient to stop taking the drug.
A
A patient taking risedronate IR [Actonel] for osteoporosis reports experiencing diarrhea and headaches. What will the nurse tell this patient? a. These are common side effects of this drug. b. These symptoms indicate serious toxicity. c. The patient should discuss taking risedronate DR [Atelvia] with the provider. d. The medication should be taken after a meal to reduce symptoms.
A
A patient who has a viral upper respiratory infection reports having a runny nose and a cough that prevents sleep and asks the nurse to recommend an over-the-counter medication. Which medication will the nurse recommend? a. Diphenhydramine [Benadryl] b. Fexofenadine/pseudoephedrine [Allegra-D] c. Guaifenesin [Mucinex] d. Phenylephrine drops
A
A patient who has arthritis has been taking ibuprofen [Motrin] and a glucocorticoid medication. The patient reports having tarry stools but denies gastric pain. Which action by the nurse is correct? a. Contact the provider to discuss ordering an antiulcer medication. b. Counsel the patient to use over-the-counter antacids. c. Reassure the patient not to worry unless there is gastric pain. d. Tell the patient to stop taking the glucocorticoid immediately.
A
A patient who has been newly diagnosed with asthma is referred to an asthma clinic. The patient reports daily symptoms requiring short-acting beta2-agonist treatments for relief. The patient has used oral glucocorticoids three times in the past 3 months and reports awakening at night with symptoms about once a week. The patient's forced expiratory volume in 1 second (FEV1) is 75% of predicted values. The nurse will expect this patient to be started on which regimen? a. Daily low-dose inhaled glucocorticoid/LABA with a SABA as needed b. Daily low-dose inhaled glucocorticoid and a SABA as needed c. Daily medium-dose inhaled glucocorticoid/LABA combination d. No daily medications; just a SABA as needed
A
A patient who has chronic allergies takes loratadine [Claritin] and develops a severe reaction to bee stings. The patient asks the nurse why the antihistamine did not prevent the reaction. What will the nurse say? a. "Allergy symptoms that are severe are caused by mediators other than histamine." b. "H1 blockers do not prevent the release of histamine from mast cells and basophils." c. "Second-generation H1 blockers contain less active drug and do not work in severe reactions." d. "Severe allergic reactions occur through actions on muscarinic receptors."
A
A patient who uses an inhaled glucocorticoid for chronic asthma calls the nurse to report hoarseness. What will the nurse do? a. Ask whether the patient is rinsing the mouth after each dose b. Request an order for an antifungal medication. c. Suggest that the patient be tested for a bronchial infection. d. Tell the patient to discontinue use of the glucocorticoid.
A
A patient who will begin combination estrogen/progestin therapy (EPT) for menopause asks the nurse why she cannot take an estrogen-only preparation. The patient has not had a hysterectomy, has a slightly increased risk of cardiovascular disease, and has mild osteopenia. The nurse will tell her that the progestin is necessary to: a. decrease her risk of endometrial cancer. b. increase bone resorption to prevent fractures. c. lower her risk of myocardial infarction(MI). d. prevent deep vein thrombosis (DVT).
A
A patient will begin taking hydroxychloroquine [Plaquenil] for rheumatoid arthritis. The patient is currently taking high-dose NSAIDs and methotrexate. What will the nurse teach the patient? a. That an eye examination is necessary at the beginning of therapy with this drug b. That the dose of NSAIDs may be decreased when beginning hydroxychloroquine c. To obtain tests of renal and hepatic function while taking this drug d. To stop taking methotrexate when starting hydroxychloroquine
A
A patient with allergic rhinitis is taking a compound product of loratadine/pseudoephedrine [Claritin-D] every 12 hours. The patient complains of insomnia. The nurse notes that the patient is restless and anxious. The patient's heart rate is 90 beats/minute, and the blood pressure is 130/85 mm Hg. The nurse will contact the provider to: a. discuss using an intranasal glucocorticoid and loratadine [Claritin]. b. report acute toxicity caused by pseudoephedrine. c. suggest using an agent with a sympathomimetic drug only. d. suggest using a topical decongestant to minimize systemic symptoms
A
A patient with chronic gout is admitted to the hospital for treatment for an infection. The patient is receiving allopurinol and ampicillin. The nurse is preparing to administer medications and notes that the patient has a temperature of 101° F and a rash. What will the nurse do? a. Withhold the allopurinol and notify the prescriber of the drug reaction. b. Withhold the ampicillin and contact the provider to request a different antibiotic. c. Request an order for an antihistamine to minimize the drug side effects. d. Suggest giving a lower dose of the allopurinol while giving ampicillin
A
A patient with metastatic cancer has had several fractures secondary to bone metastases. The provider orders denosumab [Xgeva]. What will the nurse teach this patient? a. Denosumab may delay healing of these fractures. b. Denosumab should be given subcutaneously every 12 months. c. Denosumab will improve hypocalcemia. d. Unlike bisphosphonates, denosumab does not increase osteonecrosis of the jaw (ONJ)
A
A patient with severe glucocorticoid-induced osteoporosis will start therapy withteriparatide [Forteo]. What will the nurse expect to administer? a. 20 μg once daily subQ b. 20 μg twice daily subQ c. 10 μg once daily subQ d. 10 μg twice daily subQ
A
A patient with severe, chronic COPD uses an inhaled LABA/glucocorticoid but continues to have frequent exacerbation of symptoms. The nurse will contact the provider to discuss: a. adding roflumilast [Daliresp] once daily. b. changing to oral theophylline twice daily. c. prescribing oral steroids once daily. d. Using an ipratropium/albuterol combination twice daily.
A
A patient with stable COPD is prescribed a bronchodilator medication. Which type of bronchodilator is preferred for this patient? a. A long-acting inhaled beta2 agonist b. An oral beta2 agonist c. A short-acting beta2 agonist d. An intravenous methylxanthine
A
A patient with type 1 diabetes reports mixing NPH and regular insulin to allow for one injection. What should the nurse tell the patient? a. This is an acceptable practice. b. These two forms of insulin are not compatible and cannot be mixed. c. Mixing these two forms of insulin may increase the overall potency of the products. d. NPH insulin should only be mixed with insulin glargine
A
A pregnant patient asks the nurse if she can take antihistamines for seasonal allergies during her pregnancy. What will the nurse tell the patient? a. Antihistamines should be avoided unless absolutely necessary. b. Second-generation antihistamines are safer than first-generation antihistamines. c. Antihistamines should not be taken during pregnancy but may be taken when breastfeeding. d. The margin of safety for antihistamines is clearly understood for pregnant patients
A
A woman who has arthritis is breastfeeding her infant and asks the nurse if it is safe to take NSAIDs while nursing. What will the nurse tell this patient? a. NSAIDs are safe to take while breastfeeding. b. NSAIDs are not safe, even in small amounts. c. She should take only COX-2 inhibitors while breastfeeding. d. She should request a prescription for narcotic analgesics
A
A woman who is breastfeeding is prescribed a low pharmacologic dose of a glucocorticoid and asks the nurse about potential effects on her infant. What will the nurse tell her about this medication?a. "At this dose, the concentration in your breast milk is safe." b. "Contact your provider to discuss lowering the dose." c. "There will be reversible side effects for your baby." d. "This drug is likely to cause growth retardation in your baby."
A
An adolescent is brought to the emergency department by a parent who reports that the patient took a whole bottle of extended-release acetaminophen tablets somewhere between 8 and 10 hours ago. The nurse will anticipate administering which of the following? a. Acetylcysteine [Mucomyst] b. Activated charcoal c. Hemodialysis d. Respiratory support
A
An adolescent patient recently attended a health fair and had a serum glucose test. The patient telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?" What is the nurse's most accurate response? a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes." b. "At this level, you probably have diabetes. You will need an oralglucose tolerance test this week." c. "This level is conclusive evidence that you have diabetes." d. "This level is conclusive evidence that you do not have diabetes."
A
An otherwise healthy child receives a varicella virus vaccine. Three weeks later the parent calls to report that the child has a mild case of chickenpox and wonders how this could happen after the vaccination. What will the nurse tell the parent? a. "A varicella-like rash can occur after the vaccine is given." b. "The vaccine was probably ineffective." c. "This represents a serious vaccine side effect." d. "Give the child aspirin to treat any fever that may occur."
A
The nurse assesses a newly diagnosed patient for short-term complications of diabetes. What does this assessment include? a. Evaluation for hyperglycemia, hypoglycemia, and ketoacidosis. b. Cranial nerve testing for peripheral neuropathy. c. Pedal pulse palpation for arterial insufficiency. d. Auscultation of the carotids for bruits associated with atherosclerosis
A
The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were just admitted. Which patient should the nurse assess first? a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin. b. The patient with a pulse of 58 beats/minute who is about to receive digoxin [Lanoxin]. c. The patient with a blood pressure of 136/92 mm Hg who complains of having a headache. d. The patient with an allergy to penicillin who is receiving an infusion of vancomycin [Vancocin].
A
The parent of a 2-month-old infant who has just received the first dose of DTaP asks the nurse about expected reactions to the vaccine. The nurse will respond by saying that: a. "mild reactions, including a low-grade fever, are common." b. "most children do not experience any reaction." c. "seizures are common and may require anticonvulsant medication." d. "the most common reaction is a rash that develops into itchy vesicles."
A
The prescriber orders 20 mg of hydrocortisone orally once each day. The nurse will make sure the drug is scheduled to be administered at what time? a. 8:00 AM b. 12:00 PM c. 4:00 PM d. 9:00 PM
A
Which statement is correct about the contrast between acarbose and miglitol? a. Miglitol has not been associated with hepatic dysfunction. b. With miglitol, sucrose can be used to treat hypoglycemia. c. Miglitol is less effective in African Americans. d. Miglitol has no gastrointestinal side effects
A
A 3-year-old child who has asthma is in the clinic for a well-child checkup. The nurse notes that the child is up to date for the DTaP, hepatitis A, hepatitis B, and the MMR vaccines but has only had one each of the Hib, the rotavirus, and the PCV13 vaccines. Which vaccine(s) will the nurse anticipate administering to this child? a. Hib and rotavirus vaccines b. PCV13 c. PCV13 and Hib d. Rotavirus
B
A 4½-year-old child who has been receiving high-dose systemic glucocorticoids for several months comes to a clinic for school immunizations, which usually include the DTaP vaccine; varicella virus vaccine [Varivax]; the measles, mumps, and rubella virus (MMR) vaccine; and the inactivated poliovirus vaccine (IPV). The clinic nurse will expect to administer which vaccines to this child? a. All four school immunizations b. DTaP and IPV only c. DTaP, OPV, and Varivax only d. DTaP and IPV, along with immunoglobulins
B
A 60-year-old female patient is about to begin long-term therapy with a glucocorticoid. Which of the following will be important for minimizing the risk of osteoporosis? a. Baseline vitamin D level b. Calcium and vitamin D supplements c. Estrogen therapy d. Skeletal x-rays before treatment
B
A 7-year-old child has a cough, runny nose, congestion, and fever, and the parents ask the nurse to recommend an over-the-counter product. Which response by the nurse is correct? a. "Any product will be effective when combined with vitamin C and zinc." b. "It is best to use single-agent medications to treat individual symptoms." c. "The fever indicates that your child may need an antibiotic; you should call your provider." d. "You should ask your provider to prescribe a combination product that will treat multiple symptoms."
B
A child is to begin long-term glucocorticoid therapy. The parents ask the nurse about the effects of this drug on the child's growth. Which response by the nurse is correct? a. "A smaller dose may be indicated for your child." b. "Ask your provider about every-other-day dosing." c. "Long-acting glucocorticoid preparations should prevent growth suppression." d. "Oral glucocorticoids rarely cause growth suppression."
B
A child who has perennial allergic rhinitis has been using an intranasal glucocorticoid. The provider has ordered montelukast [Singulair] to replace the glucocorticoid because the child has frequent nosebleeds. When teaching this child's parents about montelukast, the nurse will include which statement? a. "Montelukast is also effective for treating infectious rhinitis." b. "Montelukast may cause behavior changes in your child." c. "Montelukast will treat both congestion and rhinitis." d. "Montelukast works best when combined with a topical decongestant."
B
A child with seasonal rhinitis has used budesonide [Rhinocort Aqua] for several years. The parents are concerned that the child's rate of growth has slowed. What will the nurse do? a. Reassure the parents that this is an expected side effect. b. Suggest that the parents discuss using fluticasone [Flonase] with the provider. c. Tell the parents to administer the drug only when symptoms are severe. d. Tell the parents that antihistamines work as well as intranasal glucocorticoids
B
A family is preparing for travel and the parents report that their 5-year-old child has frequent motion sickness. The nurse will tell the parents to ask the provider about which antihistamine to help prevent symptoms? a. Desloratadine [Clarinex] b. Dimenhydrinate [Dramamine] c. Hydroxyzine [Vistaril] d. Promethazine [Phenergan]
B
A nurse and a nursing student are reviewing the care of a 30-kg patient who will receive intravenous aminophylline. Which statement by the student indicates an understanding of the administration of this medication? a. "After the loading dose has been given, the patient will receive 6 mg/kg/hour." b. "Dosing is titrated based on the serum theophylline levels." c. "If the patient's serum theophylline level is less than 15 mcg/mL, the rate should be reduced." d. "The patient will receive a loading dose of 180 mg over 5 minutes."
B
A nurse caring for a patient notes that the patient has a temperature of 104°F and a heart rate of 110 beats/minute. The patient's skin is warm and moist, and the patient complains that the room is too warm. The patient appears nervous and has protuberant eyes. The nurse will contact the provider to discuss: a. cretinism. b. Graves disease. c. myxedema. d. Plummer disease
B
A nurse is educating the staff nurses about ketoacidosis. To evaluate the group's understanding, the nurse asks, "Which sign or symptom would not be consistent with ketoacidosis?" The group gives which correct answer? a. Blood glucose level of 600 mg/dL b. Blood glucose level of 60 mg/dL c. Acidosis d. Ketones in the urine
B
A nurse is providing medication teaching for a patient who will begin taking diclofenac [Voltaren] gel for osteoarthritis in both knees and elbows. Which statement by the patient indicates understanding of the teaching? a. "Because this is a topical drug, liver toxicity will not occur." b. "I should cover areas where the gel is applied to protect them from sunlight." c. "I will apply equal amounts of gel to all affectedareas." d. "The topical formulation has the same toxicity as the oral formulation."
B
A nurse is teaching a group of nursing students about cyclooxygenase (COX) inhibitors. A student asks the nurse about characteristics of COX-1 inhibitors. Which statement by the nurse is true? a. "COX-1 inhibitors protect against colorectal cancer." b. "COX-1 inhibitors protect against myocardial infarction and stroke." c. "COX-1 inhibitors reduce fever." d. "COX-1 inhibitors suppress inflammation."
B
A nurse is teaching a group of nursing students why glucocorticoids are preferred over nonsteroidal anti-inflammatory drugs in the treatment of inflammation. Which statement by a student indicates a need for further teaching? a. "Glucocorticoids act by multiple mechanisms and have more anti-inflammatory effects than NSAIDs." b. "Glucocorticoids have fewer side effects than nonsteroidal anti-inflammatorydrugs." c. "Glucocorticoids help avert damage to tissues from lysosomal enzymes." d. "Glucocorticoids reduce the immune component of inflammation."
B
A nurse is teaching a patient who will begin taking methimazole [Tapazole] for Graves disease about the medication. Which statement by the patient indicates understanding of the teaching? a. "Because of the risk for liver toxicity, I will need frequent liver function tests." b. "I should report a sore throat or fever to my provider if either occurs." c. "I will need a complete blood count every few months." d. "It is safe to get pregnant while taking this medication."
B
A nurse provides teaching for a woman who will begin taking supplemental calcium. Which statement by the woman indicates understanding of the teaching? a. "Chewable calcium tablets are not absorbed well and are not recommended." b. "I should not take more than 600 mg of calcium at one time." c. "I should take enough supplemental calcium to provide my total dailyrequirements." d. "If I take calcium with green, leafy vegetables, it will increase absorption."
B
A nurse provides teaching to a patient with allergic rhinitis who will begin using anintranasal glucocorticoid. Which statement by the patient indicates understanding of the teaching? a. "If the glucocorticoid causes burning or itching, I should use it every other day." b. "I should use a decongestant if necessary before using the glucocorticoid." c. "I should use the glucocorticoid whenever I have symptoms." d. "I will probably develop systemic effects from the topical glucocorticoid."
B
A patient admitted to the hospital has been using phenylephrine nasal spray [Neo- Synephrine], 2 sprays every 4 hours, for a week. The patient complains that the medication is not working, because the nasal congestion has increased. What will the nurse do? a. Request an order for an oral decongestant to replace the intranasal phenylephrine. b. Request an order for an intranasal glucocorticoid to be used while the phenylephrine is withdrawn. c. Tell the patient to increase the dose of phenylephrine to 4 sprays every 4 hours. d. Tellthe patient to stop using the phenylephrine and begin using an intranasal antihistamine
B
A patient asks the nurse what type of medications would be most effective for treating seasonal and perennial rhinitis. Which response by the nurse is correct? a. Pseudoephedrine [Sudafed] b. Fluticasone propionate [Fluticasone] c. Loratadine [Claritin] d. Intranasal cromolyn sodium [Atrovent]
B
A patient has been experiencing side effects with a combination oral contraceptive, and her provider has ordered a different combination product. The nurse will instruct the patient to do what? a. Begin taking the new product immediately. b. Change products at the beginning of her next cycle. c. Stop taking the old OC 1 week before starting the new OC. d. Use an alternate method of contraception for 1 month before starting the new OC
B
A patient has seasonal allergies and needs an antihistamine to control symptoms. The patient likes to have wine with dinner occasionally and wants to know which antihistamine will be the safest to take. The nurse will tell the patient to discuss which medication with the provider? a. Cetirizine [Zyrtec] b. Fexofenadine [Allegra] c. Levocetirizine [Xyzal] d. Loratadine [Claritin]
B
A patient is admitted to the hospital and will begin taking levothyroxine [Synthroid]. The nurse learns that the patient also takes warfarin [Coumadin]. The nurse will notify the provider to discuss the dose. a. reducing; levothyroxine b. reducing; warfarin c. increasing; levothyroxine d. increasing; warfarin
B
A patient is taking a combination oral contraceptive (OC) and tells the nurse that she is planning to undergo knee replacement surgery in 2 months. What will the nurse recommend for this patient? a. The patient should ask her provider about an OC with less progestin. b. The patient should discuss an alternative method of birth control prior to surgery. c. The patient should request an OC containing less estrogen after surgery. d. The patient should take the OC at bedtime after her surgery to reduce side effects.
B
A patient tells a nurse that antihistamines help relieve cold symptoms and wants to know why they are not recommended or prescribed for this purpose. The nurse tells the patient that antihistamines provide only mild relief from some cold symptoms by: a. anticholinergic properties that decrease rhinorrhea. b. blocking H1 receptors in nasal passages. c. reducing secretions at H2 receptor sites. d. having sedative effects, which help patients rest and sleep.
B
A patient who has been diagnosed with rheumatoid arthritis (RA) for 1 month and has generalized symptoms is taking high-dose nonsteroidal anti-inflammatory drugs (NSAIDs) and an oral glucocorticoid. The provider has ordered methotrexate [Rheumatrex]. The patient asks the nurse why methotrexate is necessary since pain and swelling have been well controlled with the other medications. The nurse will tell the patient that: a. a methotrexate regimen can reduce overall costs and side effects of treatment. b. starting methotrexate early can help delay joint degeneration. c. starting methotrexate now will help increase life expectancy. d. with methotrexate, doses of NSAIDs can be reduced to less toxic levels
B
A patient who has beentaking a glucocorticoid for several months arrives in the clinic. The nurse notes that the patient's cheeks appear full and that a prominent hump of fat is present on the upper back. The nurse will ask the provider to order which test(s)? a. Liver function tests b. Serum electrolytes c. Tuberculin skin test d. Vitamin D levels
B
A patient who is a long-distance runner has been diagnosed with rheumatoid arthritis in both knees and will begin glucocorticoid therapy. When teaching the patient about the medication, the nurse will include what information? a. "By reducing inflammation, this drug will slow the progression of your disease." b. "Glucocorticoids are used as adjunctive therapy during acute flare-ups." c. "Oral glucocorticoids cause less toxicity than intra-articular injections." d. "You may resume running when the pain and swelling improve."
B
A patient who is hospitalized for an acute gout attack has received several doses of hourly oral colchicine but still reports moderate to severe pain. As the nurse prepares to administer the next dose, the patient begins vomiting. What will the nurse do? a. Contact the provider to discuss giving a lower dose ofcolchicine. b. Hold the medication and notify the prescriber. c. Explain that this is a common side effect that will soon stop. d. Request an order for an antiemetic so that the next dose of colchicine may be given
B
A patient who is taking a combination oral contraceptive begins taking carbamazepine. After several weeks, the patient tells the nurse she has begun experiencing spotting during her cycle. What will the nurse tell her to do? a. Change to condoms instead of oral contraceptives. b. Discuss an oral contraceptive with increased estrogen. c. Request a decreased dose of carbamazepine. d. Stop taking the oral contraceptive immediately.
B
A patient who is taking acetaminophen for pain wants to know why it does not cause gastrointestinal upset, as do other over-the-counter pain medications. The nurse will explain that this is most likely because of which property of acetaminophen? a. It does not inhibit cyclooxygenase. b. It has minimal effects at peripheral sites. c. It is more similar to opioids than to nonsteroidal anti-inflammatory drugs (NSAIDs). d. It is selective for cyclooxygenase-2.
B
A patient who takes oral theophylline [Theochron] twice daily for chronic stable asthma develops an infection and will take ciprofloxacin. The nurse will contact the provider to discuss: a. changing to a different antibiotic. b. reducing the theophylline dose. c. giving theophylline once daily. d. switching from theophylline to a LABA
B
A patient who takes teriparatide [Forteo] administers it subcutaneously with a prefilled pen injector. The patient asks why she must use a new pen every 28 days when there are doses left in the syringe. Which is the correct response by the nurse? a. "Go ahead and use the remaining drug; I know it is so expensive." b. "The drug may not be stable after 28 days." c. "You are probably not giving the drug accurately." d. "You should be giving the drug more frequently.
B
A patient who will begin taking colchicine for gout reports taking nonsteroidal anti- inflammatory drugs, simvastatin, amoxicillin, and digoxin. What will the nurse do? a. Contact the provider to discuss using a different antibiotic while this patient is taking colchicine. b. Notifythe provider about the potential risk of muscle injury when simvastatin is taken with colchicine. c. Request an order for cardiorespiratory monitoring because the patient is taking digoxin. d. Suggest that the nonsteroidal anti-inflammatory drugs (NSAIDs) be withdrawn during colchicine therapy.
B
A patient will begin taking fexofenadine [Allegra] for hay fever. The nurse teaching this patient will tell the patient that: a. fexofenadine should be taken with food to prevent gastrointestinal (GI) symptoms. b. the medication may be taken once or twice daily. c. tolerance to sedation will occur in a few weeks. d. with renal impairment, this drug should be taken every other day
B
A patient with a cough has been advised to use guaifenesin. The patient asks the nurse to explain the purpose of the drug. The nurse will explain that guaifenesin: a. dries secretions to help suppress coughing so patients can rest. b. helps stimulate the flow of secretions to increase cough productivity. c. helps to relieve chest pain associated with a cough. d. stimulates the body's natural immune responses.
B
A pregnant patient in her third trimester asks the nurse whether she can take aspirin for headaches. Which response by the nurse is correct? a. "Aspirin is safe during the second and third trimesters of pregnancy." b. "Aspirin may cause premature closure of the ductus arteriosus in your baby." c. "Aspirin may induce premature labor and should be avoided in the third trimester." d. "You should use a first-generation nonsteroidal anti-inflammatory medication."
B
A young adult woman will begin using an inhaled glucocorticoid to treat asthma. The nurse will teach this patient about the importance of which action? a. Lowering her calcium intake and increasing her vitamin D intake b. Participating in weight-bearing exercises on a regular basis c. Taking oral glucocorticoids during times of acute stress d. Using two reliable forms of birth control to prevent pregnancy
B
After educating a patient about administration of papaverine plus phentolamine for erectile dysfunction, which statement made by the patient indicates a need for further teaching? a. "I can expect rapid onset of an erection." b. "I will take the pill 30 minutes before sex." c. "I should get up from my seat slowly when taking this." d. "I will notify the provider if I feel hard areas on my penis."
B
An adolescent female patient with multiple sexual partners asks a nurse about birth control methods. The patient tells the nurse she tried oral contraceptives once but often forgot to take her pills. The nurse will recommend discussing which contraceptive method with the provider? a. An intrauterine device with a spermicide b. DMPA (Depo-Provera) and condoms c. Tubal ligation and condoms d. Progestin-only oral contraceptive
B
An adult male patient will begin androgen therapy for testicular failure. Which statement by the patient indicates understanding of the treatment regimen? a. "I will need to have x-rays of my hands and feet every 6 months." b. "My libido may improve while I am taking this medication." c. "Taking this drug may lead to the development of prostate cancer." d. "This will restore fertility, so I can have a child."
B
The nurse at a public health infant immunization clinic is acting as a preceptor for a nursing student. To assess the student's understanding of vaccinations, the nurse asks the student where the hepatitis B vaccine (HepB) should be administered. The student would be correct to respond that the hepatitis B vaccine should be administered in the: a. dorsogluteal muscle in an adult. b. anterolateral thigh in infants. c. ventrogluteal muscle in adolescents. d. deltoid of toddlers.
B
The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells the nurse she does not want to take medications while she is pregnant. What will the nurse explain to this patient? a. Hypothyroidism is a normal effect of pregnancy and usually is of no consequence. b. Neuropsychologic deficits in the fetus can occur if the condition is not treated. c. No danger to the fetus exists until the third trimester. d. Treatment is required only if the patient is experiencing symptoms
B
The nurse prepares a patient with Graves disease for radioactive iodine (131I) therapy. Which statement made by the patient best demonstrates understanding of 131I therapy? a. "I will have to isolate myself from my family for 1 week so that I do not expose them to radiation." b. "This drug will be taken up by the thyroid gland and will destroy the cells to reduce my hyperthyroidism." c. "This drug will help reduce my cold intolerance and weight gain." d. "I will need to take this drug on a daily basis for at least 1 year."
B
What is ipratropium bromide [Atrovent]? a. A cholinergic agent used for perennial rhinitis b. An anticholinergic used for allergic rhinitis and colds c. A medication that is used only in patients with asthma d. A drug that is inappropriate for use in patients with allergic rhinitis
B
A 1-year-old child receives the MMR vaccine. The next day, the child's parent calls the nurse to report that the child has a temperature of 103°F. What will the nurse do? a. File an adverse event report with the Vaccine Adverse Event Reporting System(VAERS). b. Notify the child's provider that thrombocytopenia is likely to occur. c. Reassure the parent that fever can occur with the MMR vaccine. d. Tell the parent to take the child to the emergency department.
C
A 11-year-old boy received all childhood immunizations before attending school as a kindergartner. Which vaccines are recommended for this child at his current age? a. DTaP, MCV4, Varivax b. PCV-23, Td, MMR c. Tdap, MCV4, HPV d. Tdap, Varivax, hepatitis B
C
A 12-year-old male patient diagnosed with hypogonadism will begin testosterone injections. What will the nurse include when teaching the family about this therapy? a. Annual x-rays of the hands and wrists are necessary to monitor epiphysealclosure. b. Gynecomastia may occur and is a common side effect. c. Injections are given every 2 to 4 weeks for 3 to 4 years. d. Use of this drug may lead to prostate cancer later in life.
C
A 14-year-old male patient who plays football is admitted to the hospital. The nurse notes that the patient has short stature for his age according to a standard growth chart. The patient is muscular, has a deep voice, and needs to shave. The nurse notifies the provider of these findings. Which test will the nurse expect the provider to order? a. Coagulation studies b. Complete blood count (CBC) with differential c. Liver function tests and serum cholesterol d. Serum glucose and hemoglobin A1c
C
A 5-year-old child is brought to the emergency department after ingesting diphenhydramine [Benadryl]. The child is uncoordinated and agitated. The nurse observes that the child's face is flushed, the temperature is 37.1°C, and the heart rate is 110 beats/minute. The nurse will expect to: a. administer atropine to reverse the adverse effects. b. apply ice packs to stop the flushing. c. give activated charcoal to absorb the drug. d. prepare to provide mechanical ventilation.
C
A 55-year-old female patient asks a nurse about calcium supplements. The nurse learns that the patient consumes two servings of dairyproducts each day. The patient's serumcalcium level is 9.5 mg/dL. The serum vitamin D level is 18 ng/mL. The nurse will recommend adding daily and IU of vitamin D3 each day. a. 1200 mg of calcium once; 10,000 b. 1500 mg of calcium twice; 1000 c. 600 mg of calcium once; 10,000 d. 600 mg of calcium twice; 2000
C
A child who has juvenile idiopathic arthritis and who has been taking methotrexate [Rheumatrex] will begin a course of abatacept [Orencia]. What will the nurse include when teaching the child's family about this drug? a. That abatacept and methotrexate must both be taken to be effective b. To continue getting vaccinations during therapy with abatacept c. That signs of infection may warrant immediate discontinuation of abatacept d. That a tumor necrosis factor (TNF) antagonist may be added if this therapy is not effective
C
A clinic patient who has been taking a glucocorticoid for arthritis for several months remarks to the nurse, "It is a good thing my symptoms are better, because my mother has been quite ill, and I have to take care of her." The patient's blood pressure is 100/60 mm Hg. The nurse will report this to the provider and ask about: a. reducing the patient's dose. b. using every-other-day dosing. c. increasing the patient's dose. d. tapering the dose.
C
A nurse is discussing the role of antibodies in the complement system with a group ofnursing students. Which statement by a student is correct? a. "Antibodies activate the complement cascade by turning on the alternative pathway." b. "Antibodies that are free in solution can activate the complement system." c. "Antibodies flag target cells to be lysed by membrane attack complexes." d. "Antibody receptors are nonspecific to antigenic determinants."
C
A nurse is providing teaching for a patient with osteoporosis who has just switched from alendronate [Fosamax] to zoledronate [Reclast]. Which statement by the patient indicates a need for further teaching? a. "I will need to have blood tests periodically while taking this drug." b. "I will only need a dose of this medication every 1 to 2 years." c. "This drug is less likely to cause osteonecrosis of the jaw." d. "This drug is only given intravenously."
C
A nurse is teaching a group of nursing students about antibodies. The nurse correctly explains which type of response is triggered when antigens bind to antibodies on mast cells or basophils? a. Acquired immune response b. Autoimmune response c. Hypersensitivity reaction d. Transplant rejection
C
A nurse is teaching a male adult patient about the use of testosterone gel. Which statement by the patient indicates an understanding of the teaching? a. "I should apply this to my forearms and neck after showering." b. "I should keep treated areas exposed to the air so that they can dry." c. "I should not let my child touch the gel to prevent behavioral problems." d. "I should not swim or bathe for 3 to 4 hours after applying the gel."
C
A nurse is teaching a nursing student who wants to know how aspirin and non aspirin first generation NSAIDs differ. Which statement by the student indicates a need for further teaching? a. "Unlike aspirin, first-generation NSAIDs cause reversible inhibition of cyclooxygenase." b. "NSAIDs do not increase the risk of myocardial infarction and stroke; however, unlike ASA, they do not provide protective benefits against those conditions." c. "Unlike aspirin, first-generation NSAIDs do not carry a risk of hypersensitivity reactions." d. "Unlike aspirin, first-generation NSAIDs cause little or no suppression of platelet aggregation."
C
A nurse is teaching an adolescent female patient about 28-day monophasic combination oral contraceptives. The provider has instructed the patient to begin taking the pills on the first Sunday after the onset of her next period. What will the nurse tell the patient? a. "If breakthrough spotting occurs, you should begin taking a new pack of pills." b. "Protection from pregnancy will begin immediately." c. "Use another form of contraception for the next month." d. "You may take the pills at different times of day."
C
A nurse obtaining an admission history on an adult patient notes that the patient has a heart rate of 62 beats/minute, a blood pressure of 105/62 mm Hg, and a temperature of 96.2°F. The patient appears pale and complains of always feeling cold and tired. The nurse will contact the provider to discuss tests for which condition? a. Cretinism b. Graves disease c. Hypothyroidism d. Plummer disease
C
A nurse provides teaching to a patient who has had a hysterectomy and is about to begin hormone therapy to manage menopausal symptoms. Which statement by the patient indicates understanding of the teaching? a. "Because I am not at risk for uterine cancer, I can take hormones indefinitely." b. "I can take estrogen to reduce my risk of cardiovascular disease." c. "I should take the lowest effective dose for the shortest time needed." d. "I will need a progestin/estrogen combination since I have had a hysterectomy."
C
A nurse tells a nursing student that the glucocorticoids given for rheumatoid arthritis are nearly identical to substances produced naturally by the body. The student remarks that the drug must be very safe. Which response by the nurse is correct? a. "As long as the drug is taken as prescribed, side effects usually do not occur." b. "By interrupting the inflammatory process, these drugs inhibit side effects." c. "Side effects can occur and are dependent on the dose and duration of treatment." d. "The negative feedback loop prevents side effects."
C
A nurse working in a family planning clinic is teaching a class on intrauterine devices (IUDs). Which patient should be advised against using an IUD for contraception? a. A 45-year-old married woman with four children. b. A 30-year-old monogamous married woman. c. An 18-year-old woman with multiple sexual partners. d. A 35-year-old woman with a history of rosacea
C
A parent asks a nurse to recommend an intranasal decongestant for a 6-year-old child. Which response by the nurse is correct? a. "Decongestants are too sedating for children and should not be used." b. "Decongestants should not be given to children under 7 years old." c. "Decongestant drops are recommended instead of decongestant sprays." d. "Decongestant sprays should be used no longer than 5 to 10 days."
C
A patient has severe Paget disease of the bone. The patient asks the nurse what canbe done to alleviate the pain. The nurse will suggest that the patient discuss the use of which medication with the provider? a. Alendronate [Fosamax] b. Calcifediol [25-Hydroxy-D3] c. Calcitonin-salmon [Miacalcin] d. Long-acting NSAIDs
C
A patient in her twenties with Graves disease who takes methimazole [Tapazole] tells a nurse that she is trying to conceive and asks about disease management during pregnancy. What will the nurse tell her? a. Methimazole is safe to take throughout pregnancy. b. Propylthiouracil should be taken throughout her pregnancy. c. The patient should discuss changing to propylthiouracil from now until her second trimester with her provider. d. The patient should discuss therapy with iodine-131 instead of medications with her provider
C
A patient is taking a combination oral contraceptive (OC) and reports breast tenderness, edema, and occasional nausea. What will the nurse recommend? a. The patient should ask her provider about an OC with less progestin. b. The patient should discuss an alternate method of birth control. c. The patient should request an OC containing less estrogen. d. The patient should take the OC at bedtime to reduce side effects.
C
A patient tells the nurse that she takes aspirin for menstrual cramps, but she does not feel that it works well. What will the nurse suggest? a. The patient should avoid any type of COX inhibitor because of the risk of Reye syndrome. b. The patient should increase the dose to a level that suppresses inflammation. c. The patient should use a first-generation nonsteroidal anti-inflammatory medication instead. d. The patient should use acetaminophen because of its selective effects on uterine smooth muscle
C
A patient who has developed postmenopausal osteoporosis will begin taking alendronate [Fosamax]. The nurse will teach this patient to take the drug: a. at bedtime to minimize adverse effects. b. for a maximum of 1 to 2 years. c. while sitting upright with plenty of water. d. with coffee or orange juice to increase absorption.
C
A patient who has type 2 diabetes will begin taking glipizide [Glucotrol]. Which statement by the patient is concerning to the nurse? a. "I will begin by taking this once daily with breakfast." b. "It is safe to drink grapefruit juice while taking this drug." c. "I may continue to have a glass of wine with dinner." d. "I will need to check my blood sugar once daily or more."
C
A patient who takes daily doses of aspirin is scheduled for surgery next week. The nurse should advise the patient to: a. continue to use aspirin as scheduled. b. reduce the aspirin dosage by half until after surgery. c. stop using aspirin immediately. d. stop using aspirin 3 days before surgery
C
A patient will begin taking etanercept [Enbrel] for severe rheumatoid arthritis. The patient has been taking methotrexate [Rheumatrex]. The patient asks if the etanercept is stronger than the methotrexate. The nurse will tell the patient that etanercept methotrexate. a. has synergistic effects with b. helps reduce adverse effects associated with c. is better at delaying progression of joint damage than d. has fewer adverse effects than
C
A patient with asthma is admitted to an emergency department with a respiratory rate of 22 breaths/minute, a prolonged expiratory phase, tight wheezes, and an oxygen saturation of 90% on room air. The patient reports using fluticasone [Flovent HFA] 110 μg twice daily and has used 2 puffs of albuterol[Proventil HFA], 90 mcg/puff, every 4 hours for 2 days. The nurse will expect to administer which drug? a. Four puffs of albuterol, oxygen, and intravenous theophylline b. Intramuscular glucocorticoids and salmeterol by metered-dose inhaler c. Intravenous glucocorticoids, nebulized albuterol and ipratropium, and oxygen d. Intravenous theophylline, oxygen, and fluticasone (Flovent HFA) 220 mcg
C
A patient with hypothyroidism begins taking PO levothyroxine [Synthroid]. The nurse assesses the patient at the beginning of the shift and notes a heart rate of 62 beats/minute and a temperature of 97.2°F. The patient is lethargic and difficult to arouse. The nurse will contact the provider to request an order for which drug? a. Beta blocker b. Increased dose of PO levothyroxine c. Intravenous levothyroxine d. Methimazole [Tapazole]
C
A patient with rheumatoid arthritis is taking leflunomide [Arava] and an oralcontraceptive. She tells the nurse she would like to get pregnant. What will the nurse tell her? a. That leflunomide is not dangerous during the first trimester of pregnancy. b. That plasma levels of leflunomide will drop rapidly when she stops taking it. c. To ask her provider about an 11-day course of cholestyramine. d. To stop taking leflunomide when she stops using contraception
C
A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing schedule for her. What is the recommended monitoring schedule? a. Before each meal and before bed. b. In the morning for a fasting level and at 4:00 PM for the peak level. c. Six or seven times a day. d. Three times a day, along with urine glucose testing
C
A postmenopausal patient develops osteoporosis. The patient asks the nurse about medications to treat this condition. The nurse learns that the patient has a family history of breast cancer. The nurse will suggest discussing which medication with the provider? a. Estrogen estradiol b. Pamidronate [Aredia] c. Raloxifene [Evista] d. Teriparatide [Forteo]
C
A prescriber orders hydroxyzine [Vistaril] for a patient with acute urticaria. The nurse will include which information when teaching the patient about this drug? a. The drug will reduce redness and itching but not edema. b. This antihistamine is not likely to cause sedation. c. The patient should avoid drinking alcohol while taking the drug. d. The patient should report shortness of breath while taking the drug
C
A provider has ordered intravenous promethazine [Phenergan] for an adult patient postoperatively to prevent nausea and vomiting (N/V). What will the nurse do? a. Administer the drug at a rate of 25 mg/minute or more to achieve maximum effects. b. Contact the provider to suggest using dimenhydrinate [Dramamine] instead. c. Ensure that the IV is infusing freely through a large-bore needle. d. Monitor the patient closely for cardiac dysrhythmias
C
An 18-month-old child develops an urticarial reaction after a transfusion. The prescriber orders intravenous promethazine [Phenergan]. What will the nurse do? a. Give the medication as ordered. b. Monitor the child for bronchoconstriction. c. Question the order. d. Request an order to give the drug orally.
C
An elderly patient who has type 2 diabetes has a history of severe hypoglycemia. The patient's spouse asks the nurse what the optimal A1c level is for the patient. Which is correct? a. Between 6.5 and 7.0 b. Below 7.0 c. Below 8.0 d. Between 7.0 and 8.5
C
Insulin glargine is prescribed for a hospitalized patient who has diabetes. When will the nurse expect to administer this drug? a. Approximately 15 to 30 minutes before each meal b. In the morning and at 4:00 PM c. Once daily at bedtime d. After meals and at bedtime
C
The parents of an infant who will be attending day care tell the nurse that they do not want their child vaccinated against rotavirus because an older cousin developed intussusception after receiving this vaccine. Which response by the nurse is correct? a. "Intussusception is much less serious than getting the disease." b. "It was probably just a coincidental reaction to the vaccine." c. "The newer vaccines for rotavirus are not associated with intussusception." d. "Your child will have herd immunity and will not need the vaccine."
C
Which finding would indicate that terazosin has been effective for a patient with BPH? a. Decreased prostate size b. Increased urinary frequency c. Improved urinary hesitation d. Decreased serum PSA levels
C
Which statement is true about helper T cells? a. They are useful but are not essential to immune responses. b. They do not play a role in antibody production. c. They have highly specific receptors to antigens on their surface. d. They prevent CD4 molecules from attaching to antigens.
C
A 50-year-old postmenopausal patient who has had a hysterectomy has moderate to severe vasomotor symptoms and is discussing estrogen therapy (ET) with the nurse. The patient is concerned about adverse effects of ET. The nurse will tell her that: a. an estrogen-progesterone product will reduce side effects. b. an intravaginal preparation may be best for her. c. side effects of ET are uncommon among women her age. d. transdermal preparations have fewer side effects.
D
A child is receiving a combination albuterol/ipratropium [DuoNeb] inhalation treatment. The patient complains of a dry mouth and sore throat. What will the nurse do? a. Contact the provider to report systemic anticholinergic side effects. b. Discontinue the aerosol treatment immediately. c. Notify the provider of a possible allergic reaction. d. Reassure the patient that these are expected side effects.
D
A nurse at an immunization clinic is providing vaccines to children. The parent of a child waiting to receive vaccines tells the nurse that the child has an immune deficiency disorder. The nurse understands which vaccine should not be administered to this child? a. Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine b. Haemophilus influenzae type b (Hib) vaccine c. Polio injection d. Varicella virus vaccine
D
A nurse is caring for a patient who has undergone organ transplantation. Because the sequence of amino acids in the major histocompatibility complex (MHC) molecules of the donor is different from that of the patient, the nurse will expect to administer which class of drugs? a. Antibiotics b. Antihistamines c. Immune globulins d. Immunosuppressants
D
A nurse is obtaining a history and reviewing the chart of an adult male patient who has been taking oral androgens. Which assessment would warrant notifying the provider? a. Acne and increased facial hair b. Breast enlargement c. Increased libido d. Nausea, anorexia, and fatigue
D
A nurse is preparing to administer vaccines to a 1-year-old child. The parents ask the nurse to give the child acetaminophen before administering the vaccine to reduce the pain. Which response by the nurse is correct? a. "Children do not remember pain, so it is not necessary to give acetaminophen." b. "The small needles used to inject the vaccines cause hardly any discomfort." c. "You can apply a topical anesthetic when you get home to reduce pain from the injection." d. "Your child's immune response may not be as effective if I give acetaminophen before the vaccine."
D
A nurse is providing education to a patient who is beginning therapy with AndroGel testosterone gel. Which statement made by the patient demonstrates a need for further teaching? a. "I should not shower or swim for at least 5 to 6 hours after application." b. "I should avoid direct skin-to-skin contact with my spouse where the medication was applied." c. "I should have my blood drawn for laboratory tests in 14 days." d. "I should apply the medication to my genitals for best results."
D
A nurse is reviewing the immune system with a group of nursing students. One student asks about the difference between cell-mediated immunity and humoral immunity. What should the nurse reply? a. "Humoral immunity does not involve helper T cells in the immune response." b. "Humoral immunity does not have a role in hypersensitivity reactions." c. "Humoral immunity requires cytolytic T cells that attack antigens directly." d. "Humoral immunity uses cells produced by B lymphocytes in the immune response."
D
A nurse is teaching a community education class on contraceptives. The nurse tells the class that if spermicides containing nonoxynol-9 are used, the patient should take special precautions, because these spermicides have been linked to: a. human papillomavirus (HPV) infections. b. spontaneous abortions. c. endometrial cancer. d. increased transmission of the human immunodeficiency virus (HIV).
D
A nurse is teaching a group of nursing students about the different formulations of beta2- adrenergic agonist medications. Which statement by a student indicates understanding of the teaching? a. "Beta2-adrenergic agonists provide quick relief via any formulation." b. "Long-acting beta2 agonists may be used alone to prevent attacks." c. "Short-acting beta2 agonists are usually given bynebulizer." d. "Oral beta2 agonists are not useful for short-termtreatment."
D
A nurse is teaching a nursing student about a specific acquired immunity system. Which statement by the student indicates a need for further teaching? a. "Cell-mediated immunity and humoral immunity are both types of specific acquired immune responses." b. "Each exposure to an antigen causes a faster, more intense response." c. "Immune responses occur only after exposure to a foreign substance." d. "The skin is a factor in specific acquired immunity."
D
A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine [Synthroid]. Which statement by the patient indicates a need for further teaching? a. "I should not take heartburn medication without consulting my provider." b. "I should report insomnia, tremors, and an increased heart rate to myprovider." c. "If I take a multivitamin with iron, I should take it 4 hours after the Synthroid." d. "If I take calcium supplements, I may need to decrease my dose of Synthroid."
D
A nurse provides dietary counseling for a patient newly diagnosed with type 1 diabetes. Which instruction should be included? a. "You mayeat any foods you want and cover the glucose increase with sliding scale, regular insulin." b. "Most of the calories you eat should be in the form of protein to promote fat breakdown and preserve muscle mass." c. "Your total caloric intake should not exceed 1800 calories in a 24-hour period." d. "You should use a carbohydrate counting approach to maintain glycemic control."
D
A nurse provides teaching for a female patient with anemia who has had cancer chemotherapy and who will begin treatment with testosterone. Which statement by the patient indicates understanding of the teaching? a. "Facial hair may develop with this drug but will go away over time." b. "I may experience an increase in breast size while taking this drug." c. "Testosterone may increase my high-density lipoprotein (HDL) cholesterol and reduce my lowdensity lipoprotein (LDL) cholesterol." d. "Testosterone treats anemia by stimulating the synthesis of a renal hormone."
D
A nurse provides teaching to a group of nursing students about the risks and benefits of hormone therapy (HT), including estrogen therapy (ET) and combination estrogen/progestin therapy (EPT). Which statement by a student indicates understanding of the teaching? a. "ET can provide protection against coronary heart disease and reverse osteoporosis." b. "EPT is generally safer than ET, especially in women who have undergone hysterectomies." c. "In women with established coronary heart disease, EPT can protect against myocardial infarction." d. "Principal benefits of ET are suppression of menopausal symptoms and prevention of bone loss."
D
A nurse working in a family planning clinic is preparing to administer a first dose of intramuscular DMPA [Depo-Provera] to a young adult patient. The woman tells the nurse she has just finished her period. What will the nurse do? a. Administer the injection today and counsel backup contraception for 7 days. b. Administer the injection today and tell her that protection is immediate. c. Obtain a pregnancy test to rule out pregnancy before administering the drug. d. Schedule an appointment for her to receive the injection in 3 weeks.
D
A parent asks a nurse about giving diphenhydramine [Benadryl] to a child to relieve cold symptoms. Which response by the nurse is correct? a. "Benadryl must be given in higher doses to provide relief for cold symptoms." b. "Intranasal glucocorticoids are more effective for treating cold symptoms." c. "Nasal antihistamines are more effective for treating cold symptoms." d. "Because histamine does not cause cold symptoms, Benadryl would not be effective."
D
A patient about to begin therapy with etanercept has a positive tuberculin skin test. A chest radiograph is negative. The nurse will expect this patient to: a. begin taking antituberculosis drugs at the beginning of treatment with etanercept. b. have periodic chest radiographs during treatment with etanercept. c. have regular monitoring of symptoms to detect active tuberculosis. d. undergo tuberculosis treatment prior to beginning etanercept treatment
D
A patient arrives in the emergency department with a heart rate of 128 beats/minute and a temperature of 105°F. The patient's skin feels hot and moist. The free T4 level is 4 ng/dL, the free T3 level is 685 pg/dL, and the TSH level is 0.1 microunits/mL. The nurse caring for this patient will expect to administer: a. intravenous levothyroxine. b. iodine-131 (131I). c. methimazole [Tapazole]. d. propylthiouracil (PTU).
D
A patient calls the nurse to report that she forgot to take a combination OC pill during the third week of her cycle. She tells the nurse that she missed another pill earlier that week. The nurse will tell her to: a. continue the pack, skip the inert pills, and use an additional form of contraception for 7 days. b. not to worry, because up to 7 days can be missed without an increased risk of pregnancy. c. take a pill immediately, continue the pack, and use an additional form of contraception for 1 month. d. take a pill now, continue the pack, skip the placebo pills, and start a new pack on week 4.
D
A patient has a Type IV hypersensitivity (delayed-type hypersensitivity) response to an infection. The nurse understands which two types of cells are necessary for this response? a. Antigen-presenting cells and mast cells b. Cytolytic T lymphocytes and target cells c. Immunoglobulin cells and dendriticcells d. Infected macrophages and CD4 helper T cells
D
A patient has a free T4 level of 0.6 ng/dL and a free T3 level of 220 pg/dL. The patient asks the nurse what these laboratory values mean. How will the nurse respond? a. "These laboratory values indicate that you may have Graves disease." b. "These results suggest you may have hyperthyroidism." c. "We will need to obtain a total T4 and a total T3 to tell for sure." d. "We will need to obtain a TSH level to better evaluate your diagnosis."
D
A patient has had three gouty flare-ups in the past year. Which drug class will the nurse expect the provider to order for this patient? a. Colchicine b. Glucocorticoids c. Nonsteroidal anti-inflammatory drugs d. Urate-lowering drugs
D
A patient is about to receive prednisone for tendonitis. The nurse reviewing the chart would be concerned about which of the following in the patient's medical history? a. Asthma and allergic rhinitis b. Gouty arthritis c. Seborrheic dermatitis d. Systemic fungal infection
D
A patient is being treated with warfarin [Coumadin] to prevent thrombus. The patient develops hyperuricemia, and the provider orders allopurinol [Zyloprim]. The nurse will contact the provider to discuss the dose. a. increasing; allopurinol b. increasing; warfarin c. reducing; allopurinol d. reducing; warfarin
D
A patient is taking alendronate [Fosamax] to treat Paget disease. The patient asks the nurse why calcium supplements are necessary. The nurse will tell the patient that calcium supplements are necessary to: a. reduce the likelihood of atrial fibrillation. b. maximize bone resorption of calcium. c. minimize the risk of esophageal cancer. d. prevent hyperparathyroidism.
D
A patient prescribed dutasteride 2 weeks ago presents with continued complaints of urinary hesitancy. Which action is most appropriate? a. Obtain a urine sample. b. Double the daily dose. c. Perform a prostate examination. d. Document these findings.
D
A patient reports experiencing weakness, fatigue, nausea, vomiting, constipation, and nocturia. Total serum calcium is 10.5 mg/dL. A dipstick urinalysis shows a positive result for protein. When questioned, the patient reports taking vitamin D and calcium supplements. The nurse will counsel the patient to: a. reduce the amount of vitamin D and stop taking the calcium. b. discuss taking calcitonin-salmon [Fortical] with the provider. c. stop both supplements and discuss the use of a diuretic with the provider. d. stop taking vitamin D, reduce the amount of calcium, and increase the fluid intake.
D
A patient who has gout will begin taking febuxostat [Uloric] and colchicine. What will the nurse include when teaching this patient about this drug regimen? a. "You are taking both drugs in order to prevent hepatic side effects." b. "You may stop taking the febuxostat after your uric acid levels decrease." c. "You will have to take both drugs indefinitely to treat your symptoms." d. "You will stop taking the colchicine within 6 months after starting therapy."
D
A patient who has seasonal allergies in the spring and fall asks the nurse about oral antihistamines. Which response by the nurse is correct? a. "Anticholinergic effects are more common with second-generation antihistamines." b. "First-generation antihistamines, such as diphenhydramine [Benadryl], are more effective." c. "Make sure you take antihistamines only when you have symptoms to minimize side effects." d. "You should take oral antihistamines daily during each allergy season to get maximum effects."
D
A patient who is at risk for osteoporosis will begin taking the selective estrogen receptor modulator raloxifene [Evista]. Which statement will the nurse include when teaching this patient about the medication? a. Raloxifene reduces the risk of thromboembolism. b. The drug is associated with an increased risk of breast cancer. c. Use of this drug increases the risk of endometrial carcinoma. d. Vasomotor symptoms are a common side effect of this drug.
D
A patient who takes aspirin for rheumatoid arthritis is admitted to the hospital complaining of headache and ringing in the ears. The plasma salicylate level is 300 μg/mL, and the urine pH is 6.0. What will the nurse do? a. Increase the aspirin dose to treat the patient's headache. b. Notify the provider of possible renal toxicity. c. Prepare to provide respiratory support, because the patient shows signs of overdose. d. Withhold the aspirin until the patient's symptoms have subsided.
D
A patient with COPD is prescribed tiotropium [Spiriva]. After the initial dose, the patient reports only mild relief within 30 minutes. What will the nurse tell the patient? a. "You may have another dose in 4 hours." b. "You may need to take two inhalations instead of one." c. "You should have peak effects in about 6 hours." d. "You should see improved effects within the next week."
D
A patient with asthma comes to a clinic for treatment of an asthma exacerbation. Thepatient's medication history lists an inhaled glucocorticoid, montelukast [Singulair], and a SABA as needed via MDI. The nurse assesses the patient and notes a respiratory rate of 18 breaths/minute, a heart rate of 96 beats/minute, and an oxygen saturation of 95%. The nurse auscultates mild expiratory wheezes and equal breath sounds bilaterally. What will the nurse do? a. Contact the provider to request a systemic glucocorticoid. b. Contact the provider to suggest using a long-acting beta2 agonist. c. Evaluate the need for teaching about MDI use. d. Question the patient about how much albuterol has been used.
D
A patient with asthma will be using a metered-dose inhaler (MDI) for delivery of an inhaled medication. The provider has ordered 2 puffs to be given twice daily. It is important for the nurse to teach this patient that: a. the patient should inhale suddenly to receive the maximum dose. b. the patient should activate the device and then inhale. c. the patient should store the MDI in the refrigerator between doses. d. the patient should wait 1 minute between puffs
D
A patient with chronic gout has an acute gouty episode and is admitted to the hospital. The patient has been taking nonsteroidal anti-inflammatory drugs for several months. The prescriber plans to begin therapy with probenecid. What will the nurse do? a. Give the medication as ordered and observe the patient closely for gastrointestinalside effects. b. Request an order to lower the dose of the nonsteroidal anti-inflammatorydrug. c. Restrict the patient's fluid intake to minimize the risk of renal injury. d. Suggest delaying the probenecid therapy until the acute episode has subsided.
D
A patient with erectile dysfunction is prescribed sildenafil (Viagra) 50 mg PRN. Which assessment finding would be most concerning? a. Blood pressure reading of 118/76 b. Patient notes erection lasting 3 hours c. Patient reports of blurred vision d. Snoring now wakens the patient's wife
D
A patient with erectile dysfunction is prescribed tadalafil (Cialis) 2.5 mg daily. Which medication history finding would indicate the need to discontinue this prescription? a. Labetolol 25 mg PO BID b. Nitrofurantoin 100 mg daily c. Carvedilol 6.25 mg twice daily d. Nitro-tab 0.4 mg sublingual PRN
D
A patient with gout who has increasingly frequent acute gouty attacks will begin receiving allopurinol [Zyloprim] and colchicine. The nurse will include which statement when teaching the patient about this drug regimen? a. "Allopurinol helps reduce the gastrointestinal side effects of colchicine." b. "Allopurinol reduces the likelihood of gouty episodes that usually occur with initial colchicine therapy." c. "The colchicine is given to enhance the effects of the allopurinol." d. "You will take both drugs initially and then stop taking the colchicine."
D
A patient with osteopenia asks a nurse about the benefits of hormone therapy in preventing osteoporosis. Which statement by the nurse is correct? a. "Estrogen can help reverse bone loss." b. "Hormone therapy increases bone resorption." c. "Hormone therapy does not decrease fracture risk." d. "When hormone therapy is discontinued, bone mass is quickly lost."
D
A patient with persistent, frequent asthma exacerbations asks a nurse about a long-acting beta2- agonist medication. What will the nurse tell this patient? a. LABAs are safer than short-acting beta2 agonists. b. LABAs can be used on an as-needed basis to treat symptoms. c. LABAs reduce the risk of asthma-related deaths. d. LABAs should be combined with an inhaled glucocorticoid
D
A patient with stable COPD receives prescriptions for an inhaled glucocorticoid and an inhaled beta2-adrenergic agonist. Which statement by the patient indicates understanding of this medication regimen? a. "I should use the glucocorticoid as needed when symptoms flare." b. "I will need to use the beta2-adrenergic agonist drug daily." c. "The beta2-adrenergic agonist suppresses the synthesis of inflammatory mediators." d. "The glucocorticoid is used as prophylaxis to prevent exacerbations."
D
A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer? a. No insulin should be administered b. NPH c. 70/30 mix d. Lispro [Humalog]
D
A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned? a. The beta blocker can cause insulin resistance. b. Using the two agents together increases the risk of ketoacidosis. c. Propranolol increases insulin requirements because of receptor blocking. d. The beta blocker can mask the symptoms of hypoglycemia.
D
A postmenopausal patient is at high risk for developing osteoporosis. The patient's prescriber orders raloxifene [Evista], and the nurse provides teaching about this drug. Which statement by the patient indicates understanding of the teaching? a. "I may experience breast tenderness while taking this drug." b. "I may experience fewer hot flashes while taking this drug." c. "I should discontinue this drug several weeks before any surgery." d. "I should walk as much as possible during long airline flights."
D
A postmenopausal patient who has had a hysterectomy and who has a family history of coronary heart disease reports experiencing vaginal dryness and pain with intercourse but tells the nurse that she does not want to take hormones because she is afraid of adverse effects. The nurse will suggest that the woman ask her provider about: a. Depo Provera. b. Estraderm. c. low-dose estrogens. d. Premarin vaginal.
D
An adolescent male patient is beginning androgen therapy for delayed puberty. His parents ask the nurse when this treatment may be stopped. The nurse will offer which response? a. After 3 to 4 years of therapy b. If acne and facial hair develop c. When complete sexual maturation has occurred d. When testicular enlargement occurs
D
An immigrant child is in the clinic for MMR vaccination. The nurse learns that the child has recently received an immune globulin injection for a viral infection, currently has an upper respiratory infection with a temperature of 100°F, and has a recent history of thrombocytopenia, which has resolved. What does the nurse tell the child's parents? a. "The vaccine is contraindicated in this child because of the history of thrombocytopenia." b. "The child should be brought back for the vaccine when the temperature is back to normal." c. "The child is at increased risk of developing autism from this vaccine." d. "The vaccine must be postponed for 3 months after administration of the immune globulin."
D
An older adult patient is diagnosed with hypothyroidism. The initial free T4 level is 0.5 mg/dL, and the TSH level is 8 microunits/mL. The prescriber orders levothyroxine [Levothroid] 100 μg/day PO. What will the nurse do? a. Administer the medication as ordered. b. Contact the provider to discuss giving the levothyroxine IV. c. Request an order to give desiccated thyroid (Armour Thyroid). d. Suggest that the provider lower the dose
D
An older male patient with an increased risk of MI is taking furosemide [Lasix] and low- dose aspirin. The patient is admitted to the hospital, and the nurse notes an initial blood pressure of 140/80 mmHg. The patient has had a 10-pound weight gain since a previous admission 3 months earlier. The patient has voided only a small amount of concentrated urine. The serum creatinine and blood urea nitrogen (BUN) levels are elevated. The nurse will contact the provider to discuss: a. adding an antihypertensive medication. b. obtaining serum electrolytes. c. ordering a potassium-sparing diuretic. d. withdrawing the aspirin.
D
The nurse is providing patient education about the application of transdermal estrogen spray. Which statement made by the patient best demonstrates understanding of the application of this medication? "I should apply this medication to my: a. waistline and shoulders." b. abdomen and arms." c. breasts and abdomen." d. thighs and calves."
D
The parent of a child who attends day care questions the need for Varivax. What will the nurse tell the parent? a. "Chickenpox is not as contagious as other communicable diseases." b. "The child will be protected by herd immunity and does not need the vaccine." c. "Varicella is an uncomfortable disease, but it is not that serious." d. "Varicella in adults can have serious consequences."
D
What is the most reliable measure for assessing diabetes control over the preceding 3- month period? a. Self-monitoring blood glucose (SMBG) graph report b. Patient's report c. Fasting blood glucose level d. Glycosylated hemoglobin level
D
Which medication should be used for asthma patients as part of step 1 management? a. Combination inhaled glucocorticoids/long-acting beta2 agonists b. Inhaled low-dose glucocorticoids c. Long-acting beta2 agonists d. Short-acting beta2 agonists
D
Which medication used for asthma has off-label uses to treat allergic rhinitis? a. Diphenhydramine [Benadryl] b. Fexofenadine/pseudoephedrine [Allegra-D] c. Guaifenesin [Mucinex] d. Omalizumab [Xolair]
D
Which statement is accurate about the long-term complications of diabetes? a. Long-term complications are almost always the result of hypoglycemia and ketoacidosis. b. The complication rates for patients with optimally controlled type 2 diabetes are the same as for those whose disease is not optimally controlled. c. Optimal control of type 1 diabetes produces excessive episodes of life-threatening hypoglycemia. d. Optimal control of both types of diabetes reduces the risk of eye, kidney, and nerve damage
D
A patient has been taking a progestin-only, or "minipill," OC for 3 months and reports spotting and irregular menstrual cycles. The nurse will: a. question the patient about any possible missed doses of the pill. b. reassure the patient that this is normal with this form of contraception. c. recommend that she take a pregnancy test to rule out pregnancy. d. suggest that she use a backup form of contraception until these symptoms resolve.
b
A nurse is discussing various ways to obtain a medical abortion with a patient. Which statement by the patient best demonstrates understanding of mifepristone (RU 486) [Mifeprex]? "This drug is most effective if I use it: a. before the first missed menstrual period." b. the day after unprotected intercourse." c. within 7 weeks of conception." d. immediately after ovulation."
c
A patient who breastfeeds her infant asks the nurse about the immunity the infantreceives from breast milk. What does the nurse tell the patient about immunity through breastfeeding? a. "The immunity protects the infant from hypersensitivity reactions." b. "The immunity provides phagocytes to help the infant fight infections." c. "The immunity results from the transfer of IgA through the breast milk." d. "The immunity protects the infant from respiratory and gastrointestinal (GI) microbes."
c
A nurse is caring for a patient infected with the human immunodeficiency virus (HIV). Which finding would most concern the nurse? a. High level of macrophages b. Low neutrophil count c. Low red blood cell (RBC) count d. Very low helper T lymphocyte count
d