PHARM2 Anesthesia and Immuno
A healthcare professional is caring for a patient who is about to begin taking tamoxifen (Soltamox) to treat breast cancer. The healthcare professional should recognize the need for cautious use of the drug if the patient also has which of the following? a.) Cataracts b.) COPD c.) Diabetes melitus d.) Alcohol use disorder
ANSWER: A. Tamoxifen, an estrogen-receptor blocker, can cause retinopathy, cataracts, and decreased visual acuity, its use requires caution with patients who already have cataracts.
A nurse is planning care for a client who has started taking prednisone. Which of the following interventions should the nurse include? A Monitor the client's blood glucose. B. Administer aspirin rather than NSAIDs if the clients has pain C. Monitor the Client for hyperkalemia D. Administer and antacid 30 min prior to prednisone
Answer A. Prednisone can cause hyperglycemia. The nurse should monitor the client's blood glucose regularly.
A nurse is caring for a client who is receiving morphine to relieve severe pain. The nurse should monitor the client for which of the following adverse drug reactions? (SATA) A. Diarrhea B. Urinary Retention C. Sedation D. Respiratory Depression E. Orthostatic Hypotension
Answer B, C, D, E B. Morphine can cause urinary retention. The nurse should monitor the client's fluid intake and output and assess for bladder distention. C. Morphine can cause sedation, dizziness, and lightheadedness. Clients who are taking the drug should avoid activities that require alertness. D. Morphine can cause severe respiratory depression. The nurse should withhold the drug for a respiratory rate below 12/min. E. Morphine can cause hypotension and postural hypotension. Clients who are taking the drug should change positions gradually.
A nurse is reviewing the medical record of a client who reports taking acetaminophen at home. The nurse should identify which of the following client conditions is a contraindication for acetaminophen. A. Diabetes Mellitus B. Heart Failure C. Asthma D. Alcohol use disorder
Answer D Acetaminophen can cause liver toxicity. Clients who have a history of alcohol use disorder should not take acetaminophen.
A nurse is collecting data from a client who has salicylism. which of the following findings should the nurse expect. (Select all that apply) A. dizziness B. diarrhea C. Jaundice D. Tinnitus E. Headache
Answer: A,B,D,E Rationale: manifestations of salicylism include diarrhea, nausea and vomiting, dizziness, drowsiness, tachypnea, tinnitus, sweating and flushing.
A nurse is planning care for a client who is postoperative and scheduled to ambulate. At which of the following times should the nurse plan to administer PO morphine to the client for peak analgesic effect during ambulation? A) 3 to 4 hours before ambulation B) 10 to 15 minutes prior to ambulation C) 60 to 90 minutes prior to ambulation D) Immediately before ambulation
Answer: C It takes 60 to 90 minutes for the peak effect of PO morphine to occur. Medicating the client 60 to 90 minutes prior to ambulation will provide the greatest analgesic effect.
A nurse is collecting data from a client who reports taking asprin about four times daily to relieve the pain of a wrist sprain. Which of the following medications interacts adversely with aspirin? A. Digoxin B. Levothyroxine C. Warfarin D. Nitroglycerin
Answer: C Rationale: Aspirin, which inhibits platelet aggregation increases the effects of warfarin and other anticoagulants. This client will have an increased risk of bleeding.
A nurse is caring for a client who has end-stage cancer and is receiving morphine. The clients daughter asks why the provider prescribed methylnaltrexone. Which of the following responses should the nurse make? A. "The medication will increase your mothers respiratory rate." B. "The medication will prevent dependence on morphine." C. "The medication will relieve your mothers constipation." D. "The medication works with morphine to increase pain relief."
Answer: C Rationale: Methylnaltrexone is an opioid antagonist that treats severe constipation that has not responded to laxatives in clients who have opioid dependency. The medication blocks MU opioid receptors in the G.I. tract.
A nurse is reinforcing teaching for a client who is withdrawing from alcohol and has a new prescription for propranolol. Which of the following information should the nurse include? A. Increase the risk of seizure activity B. Provides a form of aversion therapy C. Decreases cravings D. Results in mild hypertension
Answer: C. Propranolol is an adjunct medication used during withdrawal to decrease the client's craving for alcohol
A healthcare professional is caring for an older adult patient who is about to begin taking aspirin to treat an ankle sprain. The health care professional should tell the patient to report which of the following adverse reactions? A) Polyuria B) Bone pain C) Weight gain D) Infection
Answer: C. Rationale: Aspirin can cause renal dysfunction, especially in older adults and patients who have pre-existing renal or liver dysfunction and heart failure. Patients should report reduced urine output, weight gain, edema, or bloating. Health care professionals should monitor BUN and creatinine values, and stop aspirin therapy for patients who develop signs of renal dysfunction
A healthcare professional should advise patients to take acetaminophen (Tylenol) for which of the following? SATA A. To reduce fever B. To decrease inflammation C. To relieve mild pain D. To promote sedation E. To alleviate anxiety
Answers: A, C Rationale: Acetaminophen reduces fever. It is important, however, to monitor patients taking the drug for signs of hepatotoxicity. Acetaminophen relieves mild-moderate pain. It is important, however, to monitor patients who might take doses for early signs of toxicity, including sweating, nausea, diarrhea, and abdominal discomfort.
A HCP is caring for a pt who is about to begin maraviroc (Selzentry) therapy. The HCP should tell the pt to report which of the following adverse effects of the drug? (SATA) a.) Paresthesias b.) Cough c.) Jaundice d.) Fever e.) Tinnitus
A/R: a.) Paresthesias - Maraviroc, a chemokine receptor 5 antagonist, can cause paresthesias, dizziness, and musculoskeletal pain. b.) Cough - Maraviroc can cause a cough & upper respiratory infection. c.) Jaundice - Maraviroc can cause liver damage. Pt should report an allergic reaction, such as rash, because it can precede liver damage, manifested as jaundice or abdominal pain. d.) Fever - Maraviroc can cause fever and sinus infection.
While assessing a patient who is receiving interferon alfa-2a (Roferon-A) to treat Kaposi's sarcoma, the health care professional should check for which of the following possible indications of an adverse reaction? a.) Bradycardia b.) Dilated pupils c.) Fever d.) Constipation
ANSWER: C. Interferon alfa 2-a, a biologic-response modifier, can cause a flu-like reaction, manifesting as fever, myalgia, and fatigue. For this effect, the healthcare professional should give the patient acetaminophen (Tylenol).
A nurse is teaching a client who is taking allopurinol about minimizing adverse effects. Which of the following instructions should the nurse include? A. Eat a small meal before taking the drug B. Suck on hard candy or chew gum C. Take a stool Softener daily D. Avoid the use of NSAIDs
Answer A. Taking allopurinol after eating a meal or drinking a glass of milk can prevent stomach upset.
A nurse is caring for a client who takes low-dose aspirin to prevent cardiovascular events. The client asks the nurse about taking ibuprofen to treat Rheumatoid Arthritis. Which of the following responses should the nurse take? A. "Ibuprofen will reduce the cardioprotective effects of low-dose aspirin." B. "Low-dose aspirin will reduce the anti-inflammatory effects of ibuprofen." C. "Ibuprofen will increase your risk for developing salicylism." D. "Low-dose aspirin will reduce the analgesic effects of ibuprofen."
Answer A. Ibuprofen, an NSAID, reduces the cardioprotective effects of low-dose aspirin. Clients taking low-dose aspirin for its ability to decrease platelet aggregation should not take ibuprofen.
A client is about to start taking oral morphine to treat acute pain for an injury. Which of the following instructions should you include when talking with the client about taking morphine? (select all that apply) A. Take it with food B. Rise slowly from sitting or reclining C. Take it on a fixed schedule D. Increase fluids and fiber intake E. Do not take it before driving
Answer- A, B, D, E Morphine can cause nausea and vomiting. Advise the client to take it with food or milk to reduce gastric upset. Morphine also causes orthostatic hypotension. Instruct the client to sit down or lie down if feeling lightheaded and to rise slowly from the sitting or reclining position. Morphing can cause Constipation and urinary retention. Tell the client to increase fluids and fiber intake. Morphine can cause sedation and drowsiness. tell the client not to take it before driving or engaging in activities that require alertness. Clients should take the drug only short-term for acute pain to prevent abuse and dependence. Clients taking morphine for cancer pain should take it on a fixed schedule around the Clock to ensure consistent therapeutic levels.
A client is about to start Taking tramadol to treat moderate pain. Which of the following instructions should you include when talking with the client about taking this drug? A. Allow 1 hr for it to take effect. B. Take it on an empty stomach C. Chew the extended- release tablets. D. Do not take it with grapefruit juice
Answer-A Clients take tramadol, a nonopioid analgesic, orally and thus they should allow 1 hr for the drug to take effect. Instruct the client to take it with food to reduce gastric distress and to swallow the extended-release tablets whole. Tramadol does not interact with CYP3A4 or grapefruit juice; however, clients are at risk for a hypertensive crisis if they take tramadol with monoamine oxidase inhibitors.
A nurse assisting with preparing discharge teaching for a client who has a bacterial infection about adverse effects of imipenem to report to the provider. Which of the following pieces of information should the nurse include? a) "Seizures can occur with this medication." b) "You should observe for manifestations of bleeding." c) "Check your hands and feet for sensory dysfunction." d) "This medication can increase the risk of ototoxicity."
Answer: A Rationale: The nurse should tell the client that seizures can occur when receiving imipenem. The client should notify the provider immediately if these occur.
A nurse is caring for a client who is taking naloxone to treat acute morphine toxicity. The nurse should monitor the client for which of the following adverse drug reactions? (Select all that apply.) A. Increased respiratory rate B. Increased pain C. Thrombophlebitis D. Ventricular arrhythmias E. Hypertension
Answer: A, B, D, E Rationale: A. Increased respiratory rate is correct. Naloxone treats respiratory depression, but it can cause hyperventilation. It is essential for the nurse to monitor the client's respiration and oxygenation. B. Increased pain is correct. Naloxone reverses the analgesic effects of opioids and can cause increased pain and discomfort. The nurse should assess the client's pain frequently. D. Ventricular arrhythmias is correct. Naloxone can cause ventricular arrhythmias. The nurse should monitor the client's heart rate and ECG. E. Hypertension is correct. Naloxone can cause hypertension. The nurse should monitor the client's blood pressure.
A nurse is caring for a client who is taking acetaminophen at regular intervals for mild discomfort. The nurse should tell the client to report which of the following early indications of acetaminophen toxicity? (Select all that apply.) A. Diaphoresis B. Palpitations C. Shortness of breath D. Nausea E. Diarrhea
Answer: A, D, E. Rationale: A. Diaphoresis is correct. Acetaminophen toxicity can cause diaphoresis, anorexia, and eventually, liver damage. Clients should follow the dosage guidelines on the labels of OTC drugs carefully to avoid toxicity. D. Nausea is correct. Acetaminophen toxicity can cause nausea, vomiting, and anorexia and can lead to liver damage. E. Diarrhea is correct. Acetaminophen toxicity can cause diarrhea, lethargy, and eventually, liver damage.
A Nurse is preparing to administer an opioid agonist to a client who has acute pain. The nurse should monitor for which of the following complications? A. Urinary retention B. Tachypnea C. Tinnitus D. Joint pain
Answer: A. Rationale: The nurse should monitor for urinary retention by palpating the client's abdomen regularly because morphine can suppress awareness that the bladder is full.
A nurse in a public health clinic is caring for several clients who request seasonal influenza immunization. Which of the following clients has contraindications to receiving the immunization? A. 2 month old who has no health problems B. 17-year old who has a hypersensitivity to penicillin C. 25 year old who is pregnant D. 52 year old who takes a statin for hyperlipidemia
Answer: A. Children younger than 3 months of age are not eligible to receive the influenza immunization.
A nurse is teaching a client about immunizations. Which of the following information should the nurse include in the teaching? A. "You should receive a tetanus booster every 10 years." B. "You should not receive the influenza immunization if you have a common cold." C. "You do not have to receive the shingles vaccine if you have received two doses of the varicella virus vaccine." D. "As long as you don't have risk factors, you will start receiving the pneumococcal vaccine when you are 50 years old."
Answer: A. "You should receive a tetanus booster every 10 years." Rationale: The nurse should inform the patient that the tetanus-diphtheria (Td) vaccine is recommended every 10 years. It is recommended to receive the influenza immunization with mild infections such as the common cold. It is recommended to receive the shingles vaccine regardless of previous varicella virus vaccine doses. Pneumococcal vaccine is recommended beginning at age 55.
A nurse is preparing to administer the measles, mumps, and rubella (MMR) vaccine to a child. The nurse should recognize that the MMR vaccine provides which of the following types of immunity? A. Artificial active immunity B. Active C. Passive D. Artificial passive immunity
Answer: A. Artificial active immunity. Rationale: The nurse should recognize that the MMR vaccine provides artificial active immunity to the child. A vaccine contains a form of the disease that is live, attenuated, or killed, which will allow the body to build up an active immunity against the disease.
A nurse is teaching a client who has a new prescription for allopurinol. Which of the following instructions should the nurse include? A. Avoid driving or activities that require mental alertness. B. Avoid crushing the tablets. C. Limit fluid intake during therapy. D. Limit potassium while taking allopurinol.
Answer: A. Avoid driving or activities that require mental alertness. Rationale: Allopurinol can cause drowsiness. The nurse should instruct the client to avoid driving or activities that require mental alertness until they know the effect the drug will have on them.
A healthcare professional is caring for a patient who is about to begin taking celecoxib (Celebrex) to treat rheumatoid arthritis. The health care professional should tell the patient to report which of the following adverse effects? A. Chest pain B. Tinnitus C. Constipation D. Diaphoresis
Answer: A. Chest pain Rationale: Celecoxib, a COX-2 inhibitor, can cause cardiovascular or cerebrovascular events. Patients should report chest pain, shortness of breath, headache, numbness, weakness, or confusion. Primary care providers should prescribe the lowest effective dosage for the shortest time period possible.
A nurse is teaching the guardian of a 4-month-old infant about recommended immunizations for the infant. Which of the following immunizations should the nurse include? A. Haemophilus influenzae type B vaccine (Hib) B. Varicella vaccine C. Meningococcal conjugate vaccine(MCV4) D. Tetanus-diphtheria-acellular pertussis vaccine (Tdap)
Answer: A. Haemophilus influenzae type B vaccine (Hib) Rationale: The nurse should inform the guardian that Hib is recommended for infants and children to prevent a serious type of meningitis commonly seen in young children.
A nurse is teaching a client about recommended immunizations. Which of the following immunizations should the nurse recommend the client receive starting at 50 years of age? A. Herpes zoster vaccine B. Human papillomavirus vaccine (HPV) C. Pneumococcal vaccine D. Haemophilus influenzae type B vaccine (Hib)
Answer: A. Herpes zoster vaccine. Rationale: The herpes zoster, or shingles vaccine, is recommended for adults older than 50 years of age. Three doses of HPV are recommended for adolescents who are 11 to 12 years old. THe pneumococcal vaccine, which prevents meningitis, pneumonia, and middle ear infections caused by Streptococcus pneumoniae, is recommended for children who are 0-6 years old. Hib, which prevents a serious type of meningitis, is recommended for children who are 0-6 years old.
A nurse is reinforcing teaching with a client who has a migraine headache. Which of the following instructions should the nurse provide? (Select all that apply.) a. Take ergotamine to prevent migraine headaches. b. Identify and avoid factors that trigger migraine headaches. c. Lie down in a dark quiet room at the onset of a migraine headache. d. Avoid foods that contain tyramine. e. Avoid exercise that can increase heart rate.
Answer: Avoid foods that contain tyramine Rationale: Foods that contain tyramine can be a trigger for some migraine headaches. The client should avoid foods that contain tyramine (smoked meats, most cheeses, wine).
A nurse is teaching a client who has a new prescription for prednisone. Which of the following instructions should the nurse include? (Select all that apply.) A. Reduce the dose during periods of stress. B. Discontinue the drug gradually. C. Report illness or infection. D. Increase intake of calcium and vitamin D. E. Monitor for signs of gastric bleeding.
Answer: B, C, D, E. Rationale: B. Prednisone, a glucocorticoid, suppresses adrenal function. The nurse should instruct the client to taper the dosage before discontinuing it to allow for resumption of adrenal activity. C. Clients can need higher doses of prednisone during illness or infection. The nurse should instruct the client to report signs of infection. D. Prednisone, a glucocorticoid, can cause bone loss and reduced calcium absorption. The nurse should instruct the client to increase their intake of calcium and vitamin D. E. Prednisone can cause peptic ulcer disease. The nurse should instruct the client to report signs of gastric bleeding such as hematemesis or black tarry stools.
You have a patient still in pain but cannot reach the healthcare provider for a prescription. There are several non drug options that you can utilize instead. Which of the following, however, would NOT be a suitable non drug therapy for pain relief? A. Ice or cold compress B. Six ounces of red wine or 1 ounce of liquor C. Exercise D. Acupuncture
Answer: B. Alcohol isn't a suitable pain reliever because it could lead to dependence or exacerbation of the symptoms/pain
A nurse is reinforcing teaching with a client who will be taking dexamethasone daily for pain due to spinal edema. The nurse should identify which of the following client statements as an indication that the client understands the instructions? A) "I should eat a snack at bedtime to avoid low blood glucose." B) "I should stay away from people who are ill." C) "I should increase my fluid intake to about 3 quarts per day." D) "I'll call my provider if I am experiencing too much sedation."
Answer: B. This medication is a glucocorticoid that decreases inflammation by affecting the client's immune system. As a result, the client is susceptible to infection and should avoid large crowds as well as people who are ill.
A nurse is reviewing the medical record of a client who has a new prescription for tramadol. The nurse should identify which of the following conditions is a contraindication for tramadol? A. Hyperthyroidism B. Seizure disorder C. Rheumatoid arthritis D. Urinary incontinence
Answer: B. Seizure disorder Rationale: Tramadol, a nonopioid analgesic, can cause seizure activity. Clients who have seizure disorders, head injuries, or increased intracranial pressure should not take tramadol.
A healthcare professional should understand that enfuvirtide (Fuzeon) is an appropriate choice for patients who have which of the following? A. Advanced prostate cancer B. Primary brain tumors C. Advanced HIV disease D. Metastatic ovarian cancer
Answer: C. Advanced HIV disease Rationale: Enfuvirtide, a fusion inhibitor, treats HIV disease that is advanced or resistant to other types of treatment. Health care professionals should always give the drug along with other antiretroviral drugs.
A healthcare professional is caring for an older adult patient who is about to begin taking prednisone for long-term treatment of rheumatoid arthritis. The healthcare professional should monitor the patient for which of the following adverse effects? A. Pulmonary Embolism B. Hepatitis C. Bone loss D. Breast cancer
Answer: C. Bone loss Rationale: Prednisone, a glucocorticoid, can cause osteoporosis, especially with long-term use. Patients taking the drug should increase weight-bearing activity and report back pain. Health care professionals should monitor bone density.
While assessing a patient who is receiving interferon alfa-2a (Roferon-A) to treat Kaposi's sarcoma, the health care professional should check for which of the following possible indications of an adverse reaction? A. Bradycardia B. Dilated pupils C. Fever D. Constipation
Answer: C. Fever Rationale: Interferon alfa-2a, a biologic-response modifier, can cause a flu-like reaction, manifesting as fever, myalgia, and fatigue. For this effect, the health care professional should give the patient acetaminophen (Tylenol).
A nurse is reviewing the medical record for a client who has a new prescription for celecoxib. The nurse should identify which of the following conditions is a contraindication to celecoxib? A. Rheumatoid arthritis B. Ankylosing spondylitis C. Sulfonamide allergy D. Adrenocortical insufficiency
Answer: C. Sulfonamide allergy. Rationale: Clients who are allergic to sulfonamides can have severe allergic reactions to celecoxib, a COX-2 inhibitor. CLients who are allergic to salicylates can also react adversely to celecoxib.
A nurse is caring for a client who is receiving morphine postoperatively. Which of the following actions should the nurse take ? A-have alvimopan available to reverse excessive sedation B- protect the clients skin from severe diarrhea that morphine causes C- withhold medication if respiratory rate is less than 16/min D- Encourage the client to cough at regular intervals
Answer: D Rationale: the nurse should remind the client to cough at regular intervals to prevent the accumulation of secretions in the airway, because Morphine is an opioids which can cause cough suppression.
A nurse is administering amitriptyline to a client who has cancer pain. For which of the following manifestations should the nurse monitor as an adverse effect of this medication? A. Decreased appetite B. Severe diarrhea C. Decreased heart rate D. Orthostatic hypotension
Answer: D. Rationale: Amitriptyline can cause orthostatic hypotension. The nurse should monitor for this effect and instruct the client to move slowly from lying down or sitting after taking this medication.
Which of the following drugs can increase the risk of Reyes's Syndrome in children who have viral infections? A. Butorphanol (Stadol) B. Acetaminophen (Tylenol) C. Tramadol (Ultram) D. Aspirin
Answer: D. NSAIDs, especially aspirin, can increase the risk for Reye's syndrome in children who have a viral infection, particularly chickenpox or influenza. Manifestations of Reye's syndrome include lethargy and persistent vomiting.
Unless there are any specific contraindications, which of the following immunizations should adults receive once each year? a) varicella b) tetanus c) influenza d) hepatitis B
Answer: c) influenza. All adults should receive the seasonal influenza immunization once per year. All children 6 months older and older adults should also receive this immunization once per year.
A healthcare professional is caring for a patient who is opioid-dependent and is about to begin taking butorphanol (Stadol). The healthcare professional should recognize that the patient is at risk for developing a syndrome that causes which of the following? a)Vomiting b) Abdominal cramps c) Hypertension d) Abstinence syndrome
Answer: d) Abstinence syndrome due to sudden drug withdrawal or use of an opioid agonist-antagonist such as butorphanol (Stadol) by a patient who is opioid -dependent. It can also cause fever and tremors, nausea, anorexia, anxiety, restlessness.
A healthcare professional should understand that naloxone can reverse the effects of an excessive dosage of which of the following drugs? A. Aspirin B. Acetaminophen C. Morphine D. Prednisone
Rationale: C. Naloxone, an opioid antagonist, reverses the effects of morphine, an opioid analgesic. Health care professionals should monitor respirations and reassess patients after the effects of naloxone have diminished (20 to 40 minutes) for recurrence of the adverse effects of morphine.
A nurse is speaking to a group of new parents about immunizations. CDC recommendations call for completion of which of the following vaccines by the first birthday? A. Pneumococcal conjugate B. Meningococcal conjugate C. Varicella D. Rotavirus
Rationale: D, rotavirus vaccine is administered only to infants less than 8 months old, 0 days of age.
A nurse is preparing to administer butorphanol to a client who has a history of substance use disorder. The nurse should be aware of which of the following information about butorphanol? A. Butorphanol has a greater risk for misuse than morphine B. Butorphanol causes higher incidence of respiratory depression than morphine C. Opioid antagonists cannot reverse the effects of butorphanol D. Butorphanol can cause abstinence syndrome in clients who have opioid dependency
Rationale: D. Opioid agonists/antagonists medications, such as butorphanol, can cause abstinence syndrome in clients who have opioid dependency. Manifestations include hypertension, vomiting, fever, and anxiety.
A healthcare professional is caring for a patient who takes furosemide (Lasix) and is about to begin taking prednisone to treat inflammatory bowel disease. The healthcare professional should monitor the patient for which of the following results of concurrent use of the two drugs? A. Hypercalcemia B. Hypoglycemia C. Hypothermia D. Hypokalemia
Rationale: D. Prednisone, a glucocorticoid, can cause hypokalemia. The risk for this electrolyte imbalance increases with potassium-depending diuretics, such as furosemide. Health care professionals should monitor potassium levels of patients who are taking both drugs or recommend the primary care provider prescribe a safer combination.
When caring for a pt who is taking flutamide to tx prostate cancer, the HCP should monitor the pt for which of the following adverse effects of the drug? a.) Dehydration b.) Gynecomastia c.) Constipation d.) Tachycardia
A: Gynecomastia R: Flutamide, an androgen receptor blocker, tx early and metastatic prostate cancer. It can cause gynecomastia, or growth of breast tissue, decreased libido, and impotence.
A charge nurse is reinforcing teaching with a newly licenced nurse about the purpose of a client being prescribed a transdermal fentanyl patch. Which of the following clients should the charge nurse include in the teaching as a client who requires this medication. a) A client who is opioid-tolerant b) A client who has difficulty swallowing c) A client who has severe intermittent pain d) A client who is postoperative following abdominal surgery
Answer: A Rationale: The charge nurse should include in the teaching that a client who is opioid tolerant can be prescribed a fentanyl patch to manage pain.
A nurse is reviewing the drug list for a client who has a new prescription for allopurinol. The nurse should identify which of the following drugs interacts with allopurinol? A. Warfarin B. Ibuprofen C. Insulin D. Furosemide
Answer: A. Warfarin Rationale: Allopurinol can increase the effectiveness of warfarin. A lower dosage of warfarin might be required.
How do you assess whether a patient is experiencing pain? A. By observing his of her body movements B. By asking the patient to identify whether he or she is in pain C. Based on when the patient last received a prescribed dosage of pain relief drug D. By monitoring vital signs to determine if there are significant changes
Answer: B. The nurse should always ask, never assume. The nurse should believe the patient when they say they're in pain.
A nurse is caring for a client who receives an injection of lidocaine during the repair of a skin laceration. The nurse should monitor for which of the following adverse reactions? a. Seizures b. Tachycardia c. Hypertension d. Fever
Answer: Seizures. Rationale: Seizure activity is an adverse effect that can occur as a result of local anesthetic injection
A healthcare professional should question the use of morphine for a patient who is taking which of the following drugs? a) phenobarbital (Luminal) for a seizure disorder b) Warfarin (Coumadin) for anticoagulation c) Glipizide (Glucotrol) for diabetes mellitus d) Alendronate (Fosamax) for osteoporosis
Answer: a) phenobarbital (Luminal) for a seizure disorder. Taking morphine and phenobarbital together can cause increased CNS depression. Lower morphine doses are essential for patients who are taking phenobarbital. Health care professionals should monitor patients who are taking both drugs for decreased respirations and blood pressure and increased sedation.
A pt recovering from a total knee arthroplasty has been prescribed acetaminophen for mild discomfort that doesn't require an opioid. The HC professional should tell the patient to report what early indications of acetaminophen overdose? a) Restlessness b) Diaphoresis c) Nausea d) Diarrhea
Answer: b) Diaphoresis Acetaminophen toxicity can cause diaphoresis, anorexia, nausea, lethargy, diarrhea, and liver damage.
A 12-month old just received the first measles, mumps, and rubella (MMR) vaccine. For which of the following possible reactions to this vaccine should the nurse inform the parents to monitor? (select all that apply). A. Rash B. Swollen glands C. Bruising D. Headache E. Inconsolable crying
Rationale: A, B, C. A rash and fever develop in children 1 to 2 weeks following MMR immunization, Swollen glands can develop in children 1 to 2 weeks following MMR immunization, a temporary low platelet count, causing bruising or bleeding, can occur occasionally following MMR immunizations.
A nurse is reviewing the medication administration record of a client who is receiving transdermal fentanyl for the relief of severe pain. Which of the following medications should the nurse expect to cause an adverse effect if the client receives it concurrently with fentanyl? A. Ampicillin B. Diazepam C. Furosemide D. Prednisone.
Rationale: B diazepam, a benzodiazepine, is a CNS depressant, which can interact by causing excessive sedation when the client receives it concurrently with an opioid agonist/ antagonist.
A Healthcare professional should question the use of Morphine for a patient who is recovering from which of the following procedures. A)Mastectomy B)Knee Arthroplasty C)Colectomy D)Cholecystectomy
Rationale: D -Cholecystectomy. Morphine can cause biliary colic. It is inappropriate for patients who have just had biliary tract surgery, such as a cholecystectomy.
