Pharmacology: Practice Questions for Exam 2
A patient is experiencing stomatitis after a round of chemotherapy. Which intervention by the nurse is correct? A. Clean the mouth with a soft-bristle toothbrush and warm saline solution B. Rinse the mouth with commercial mouthwash twice a day C. Use lemon-glycerin swabs to keep the mouth moist D. Keep dentures in the mouth between meals
A
When giving decongestants, the nurse must remember that these drugs have alpha adrenergic stimulating effects that may result in which effect? A. Fever B. Bradycardia C. Hypertension D. CNS depression
C
When giving dextromethorphan, the nurse understands that this drug suppresses the cough reflex by which mechanism of action? A. Causing depression of the central nervous system B. Anesthetizing the stretch receptors C. Having direct action on the cough center D. Decreasing the viscosity of the bronchial secretions
C
A patient took an accidental overdose of a cholinergic drug while at home. He comes to the emergency department with severe abdominal cramping and bloody diarrhea. The nurse expects that which drug will be used to treat this patient? A. Atropine B. Pilocarpine C. Bethanechol D. Phentolamine
A
A patient who has a history of asthma is experiencing an acute episode of shortness of breath and needs to take medication for immediate relief. The nurse will choose which medication that is appropriate for this situation? A. A beta agonist such as albuterol B. A leukotriene receptor antagonist such as montelukast C. A corticosteroid such as fluticasone D. An anticholinergic such as ipratropium
A
After a nebulizer treatment with the beta agonist albuterol, the patient complains of feeling a little "shaky," with slight tremors of the hands. The patient's heart rate is 98 beats/min, increased from the pretreatment rate of 88 beats/min. The nurse knows that this reaction is an A. Expected adverse effect of the medication. B. Allergic reaction to the medication. C. Indication that he has received an overdose of the medication. D. Idiosyncratic reaction to the medication.
A
The nurse is administering a cholinergic blocking drug to a patient who is experiencing drug-induced extrapyramidal effects would assess for which therapeutic effect? A. Decreased muscle rigidity and tremors B. Increased heart rate C. Decreased bronchial secretions D. Decreased GI motility and peristalsis
A
The nurse is assess a patient who has a prescription for dicyclomine. Which condition is considered a contraindication to this medication? A. GI atony B. Irritable bowel syndrome C. Overactive bladder D. Diabetes mellitus
A
The nurse is providing education about cholinergic blocking drug therapy to an older adult patient. Which is an important point to emphasize for this patient? A. Avoid exposure to high temperatures B. Limit liquid intake to avoid fluid overload C. Begin an exercise program to avoid adverse effects D. Stop the medication if excessive mouth dryness occurs
A
The nurse notes in a patient's medication history that the patient is taking benzoate as needed. Based on this finding, the nurse interprets that the patient has which problem? A. Cough B. Seasonal allergies C. Chronic rhinitis D. Motion sickness
A
When assessing a patient who is to receive a decongestant, the nurse will recognize that a potential contraindication to this drug would be which condition? A. Glaucoma B. Fever C. Peptic ulcer disease D. Allergic rhinitis
A
The nurse is reviewing the mechanism of action of alpha adrenergic drugs. Adrenergic blockage at the alpha receptors leads to which effects? SATA A. Miosis B. Vasodilation C. Vasoconstriction D. Bradycardia E. Reduced blood pressure
A, B, E
A patient is taking an alpha blocker as treatment for benign prostatic hyperplasia. The nurse will monitor for which potential drug effects? SATA A. Orthostatic hypotension B. Increased blood pressure C. Increased urine flow D. Headaches E. Bradycardia
A, C, D
The nurse is teaching a patient about the inhaler Advair. Which statements by the patient indicate a correct understanding of this medication? SATA A. I will rinse my mouth with water after each dose B. I need to use this inhaler whenever I feel short of breath, but not less than 4 hours between doses C. This medication is taken twice a day, every 12 hours D. I can take this inhaler if I get short of breath while exercising E. I will call my doctor if I notice white patches inside my mouth
A, C, E
A patient has been receiving an aminophylline infusion for 24 hours. The nurse will assess for which adverse effect when assessing the patient during the infusion? A. CNS depression B. Sinus tachycardia C. Increased appetite D. Temporary urinary retention
B
After the patient takes a dose of an inhaled corticosteroid, such as fluticasone, what is the most important action the patient needs to do next? A. Hold the breath for 60 seconds B. Rinse out the mouth with water C. Follow the corticosteroid with a bronchodilator inhaler, if ordered D. Repeat the dose in 15 minutes if the patient feels short of breath
B
The nurse is giving a dose of bethanechol to a postoperative patient. The nurse is aware that contraindications to bethanechol include: A. Bladder atony B. Peptic ulcer C. Urinary retention D. Hypothyroidism
B
The nurse is reviewing a patient's medication orders for PRN medications that can be given to a patient who has bronchitis with a productive cough. Which drug will the nurse choose? A. An antitussive B. An expectorant C. An antihistamine D. A decongestant
B
The nurse is reviewing the use of bethanechol in a patient who is experiencing postoperative urinary retention. Which statement best describes the mechanism of action of bethanechol? A. It causes decreased bladder tone and motility B. It causes increased bladder tone and motility C. It increases the sensation of a full bladder D. It causes the sphincters in the bladder to become tighter
B
When assessing for adverse effects of cholinergic blocking drug therapy, the nurse would expect to find that the patient complains of which drug effect? A. Diaphoresis B. Dry mouth C. Diarrhea D. Urinary frequency
B
The nurse is teaching a patient about the possible adverse effects of donepezil for Alzheimer's disease. Which of these are possible adverse effects? SATA A. Constipation B. GI upset C. Drowsiness D. Dizziness E. Blurred vision
B, C, D
The nurse is giving an antihistamine and will observe the patient for which side effects? SATA A. Hypertension B. Dizziness C. "Hangover" effect D. Drowsiness E. Tachycardia F. Dry mouth
B, C, D, F
When giving intravenous cholinergic drugs, the nurse must watch for symptoms of a cholinergic crisis such as: SATA A. Peripheral tingling B. Hypotension C. Dry mouth D. Syncope E. Dyspnea F. Tinnitus
B, D, E
A patient has been given a prescription for transdermal scopolamine patches for motion sickness use during a vacation cruise. The nurse will conclude which instructions? SATA A. "Apply the patch as soon as you board the ship" B. "Apply the patch 3 to 4 hours before boarding the ship" C "The patch needs to be placed on a non-hairy area on your upper chest or upper arm" D. "The patch needs to be placed on a non-hairy area just behind your ear E. "Change the patch every 3 days" F. "Rotate the application sites"
B, D, E, F
A patient who is taking a xanthine derivative for chronic bronchitis asks the nurse, "I miss my morning coffee. I can't wait to go home and have some." What is the nurse's best response? A. I know how you feel. I'd miss my coffee too. B. I can get some coffee for you. I'll be right back. C. It's important not to take coffee or other caffeinated products with this medicine as it may cause an increased heart rate as well as other problems D. You've been on this medicine for a few days. I can call your prescriber to ask whether you can have some coffee
C
During a teaching session for a patient who will be receiving a new prescription for the LTRA montelukast, the nurse will tell the patient that the drug has which therapeutic effect? A. Improves the respiratory drive B. Loosens and removes thickened secretions C. Reduces inflammation in the airway D. Stimulates immediate bronchodilation
C
During the assessment of a patient about to receive a cholinergic blocking drug, the nurse will determine whether the patient is taking any drugs that may potentially interact with the anticholinergic including: A. opioids, such as morphine sulfate B. Antibiotics, such as penicillin C. Tricyclic antidepressants, such as amitriptyline D. Anticonvulsants, such as phenobarbital
C
The family of a patient who has recently been diagnosed with Alzheimer's disease is asking about the new drug prescribed to treat this disease. The patient's wife says, "I'm so excited that there are drugs that can cure this disease! I can't wait for him to start treatment." Which reply from the nurse is appropriate? A. The sooner he starts the medicine, the sooner it can have this effect B. These effects won't been seen for a few months C. These drugs do not cure Alzheimer's disease. Let's talk about what the physician said to expect with this drug therapy D. His response to this drug therapy will depend on how far along he is in the disease process
C
The nurse is reviewing the orders for a newly admitted patient and sees an order for edrophonium. The nurse expect that this drug is ordered for which reason? A. To reduce symptoms and delay the onset of Alzheimer's disease B. To treat the symptoms of myasthenia gravis C. To aid in the diagnosis of myasthenia graves D. To reverse the effects of non-depolarizing neuromuscular blocking drugs after surgery
C
The nurse knows that an antitussive cough medication would be the best choice for which patient? A. A patient with a productive cough B. A patient with chronic paranasal sinusitis C. A patient who has had recent abdominal surgery D. A patient who has influenza
C
The nurse providing teaching for a patient who has a new prescription for beta-1 blockers will keep in mind that these drugs may result in which effect? A. Tachycardia B. Tachypnea C. Bradycardia D. Bradypnea
C
A patient is taking a decongestant to help reduce symptoms of a cold. The nurse will instruct the patient to observe for which possible symptoms, which may indicate an adverse effect of this drug? A. Increased cough B. Dry mouth C. Slower heart rate D. Heart palpitations
D
A patient who has recently had a myocardial infarction has started therapy with a beta blocker. The nurse explains that the main purpose of the beta blocker for this patient is to A. Cause vasodilation of the coronary arteries B. Prevention hypertension C. Increase conduction through the SA node D. Protect the heart from circulating catecholamines
D
Before initiating therapy with a non-selective beta block, the nurse will assess the patient for a history of which condition? A. Hypertension B. Liver disease C. Pancreatitis D. Asthma
D
The nurse is giving a cholinergic blocking drug and will assess the patient for which contraindication to these drugs? A. Chronic bronchitis B. Peptic ulcer disease C. Irritable bowel syndrome D. Benign prostatic hyperplasia
D
For which of the following reasons should a patient attach a spacer to a metered-dose inhaler? A. To increase the speed of drug delivery B. To increase the amount of drug delivery on exhalation C. To increase the amount of drug delivered to the oropharynx D. To increase the amount of drug delivered to the lungs
D
The nurse is reviewing medication orders. Which digoxin dose is written correctly? A. digoxin .25 mg B. digoxin .250 mg C. digoxin 0.250 mg D. digoxin 0.25 mg
D
What are the steps in medication reconciliation? Select all that apply. A. Verification B. Clarification C. Identification D. Classification E. Reconciliation
A, B, E
The nurse is monitoring drug levels for a patient who is receiving theophylline. The most recent theophylline level was 22 mcg/mL, and the nurse evaluates this level to be: A. below the therapeutic level. B. at a therapeutic level. C. above the therapeutic level. D. at a toxic level.
C
The patient has been ordered salmeterol as a medication to treat asthma symptoms. Which statement indicates that the patient understands how to take the medication? A. I will give myself one puff twice a day at 0700 and 1900 B. I will give myself two puffs at bedtime; that's when I really need it C. I will give myself a puff anytime I start to experience asthmatic symptoms D. I will give myself two puffs three times a day, at 0700, noon and bedtime
A
A health care professional is advising a patient about the adverse effects of pseudoephedrine. Which of the following should the health care professional include? SATA A. Restlessness B. Insomnia C. Bradycardia D. Anxiety E. Muscle pain
A, B, D
A health care professional who is advising a patient about the use of a mucolytic to treat a cough should explain that this type of drug is effective because it performs which of the following actions? A. Thins and loosens mucus B. Dries secretions C. Suppresses the cough stimulus D. Reduces inflammation
A
A nurse in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil? A. Isosorbide B. Phenytoin C. Metronidazole D. Prednisone
A
A nurse is assess a client prior to administering atenolol. Which of the following findings should prompt the nurse to withhold the medication? A. Heart rate 46/min B. Oxygen saturation 95% C. Respiratory rate 18/min D. Blood pressure 160/94 mmHg
A
A nurse is assessing a client who is receiving dopamine IV to treat left ventricular failure. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect? A. Systolic blood pressure is increased B. Cardiac output is reduced C. Apical heart rate is increased D. Urine output is reduced
A
A nurse is caring for a client who has tuberculosis and new prescriptions for rifampin and pyrazinamide. Which of the following laboratory tests should the nurse instruct the client will be required while on this medication regimen? A. Liver function tests B. Gallbladder studies C. Thyroid function studies D. Blood glucose levels
A
A nurse is monitoring a client who received epinephrine for angioedema after a first dose of losartan. Which of the following data indicates a therapeutic response to the epinephrine? A. Respirations are unlabored B. Client reports decreased groin pain of 3 on a 1 to 10 scale C. The client's blood pressure when arising from resting position is at premedication levels D. The client tolerates a second dose of medication with no greater than 1+ peripheral edema
A
A patient with cardiac decompensation is receiving dobutamine as a continuous infusion. The patient's blood pressure has increased from 100/70 mmHg to 130-80 mmHg. What is the nurse's priority action? A. Assess frequent blood pressure readings B. Assess the patient's electrocardiogram and slow the infusion C. Assess the patient's respiratory rate and measure arterial blood gases D. Assess the patient's intake and output and decrease fluids
A
As the nurse prepares to administer a medication intravenously to a patient, what should the nurse keep in mind? A. It is difficult to remove the effects of the drug once it is administered intravenously. B. Intravenous injection provides a slower onset of action than the intramuscular route. C. Intravenous administration decreases the rate of absorption of the medication given. D. Intravenous injection provides a slower onset of action than the subcutaneous route.
A
Convert 250 micrograms to milligrams. Be sure to depict the number correctly according to the guidelines for decimals and zeroes A. 0.25 mg B. 2.50 mg C. .025 mg D. 20.5 mg
A
The nurse caring for a patient who is receiving beta-1 agonist drug therapy needs to be aware that these drugs cause which effect? A. Increased cardiac contractility B. Decreased heart rate C. Bronchoconstriction D. Increased GI tract motility
A
The nurse is about to administer a stat dose of intravenous atropine sulfate to a patient who is experiencing a symptomatic cardiac dysrhythmia. During administration of this drug, the nurse will monitor the patient closely for which adverse effect? A. tachycardia B. bradycardia C. ectopic beats D. cardiac standstill
A
The nurses assesses the peripheral intravenous (IV) infusion site of a patient receiving intravenous dopamine and suspects extravasation. What is the nurse's priority action? A. Stop the infusion B. Pull the IV immediately C. Apply a cold pad to the site D. Elevate the patient's extremity
A
The patient has been placed on salmeterol. The patient tells the nurse, "I don't understand why this inhaler doesn't help when I'm having an asthma attack." The nurse frames the response based on which information? A. Salmeterol is not designed to relieve acute symptoms B. Salmeterol can be given as needed throughout the day C. Salmeterol should never be combined with another inhalant D. Salmeterol must be administered according to specific instructions
A
What should the nurse remember when administering an intramuscular (IM) medication to a child? A. The nurse should insert the needle at a 90-degree angle. B. The nurse should choose a 2-inch needle for the injection. C. The nurse should administer 3 mL of the medication in one dose. D. The nurse should choose a tuberculin syringe for pediatric administration.
A
When administering a sublingual medication, which action should the nurse perform? A. Wear gloves to place the tablet under the patient's tongue. B. Have the patient swallow several times while the tablet dissolves. C. Ask the patient to chew the medication so that it will absorb faster. D. Instruct the patient to drink room-temperature water to enhance dissolution.
A
The nurse is administering medications. Examples of high-alert medications include: SATA A. Chemotherapeutic drugs B. Antibiotics C. Opiates D. Antithrombotics E. Potassium chloride for injection
A, C, D, E
The nurse is caring for a patient who becomes severely nauseated during chemotherapy. Which intervention is most appropriate? A. Encourage light activity during chemotherapy as a distraction B. Provide antiemetic medications 30-60 minutes before chemotherapy begins C. Provide antiemetic medications only upon the request of the patient D. Hold fluids during chemotherapy to avoid vomiting
B
The nurse is giving medications to a newly admitted patient who is to receive nothing by mouth (NPO status) and finds an order written as follows: "Digoxin, 250 mcg stat." Which action is appropriate? A. Give the medication immediately (stat) by mouth because the patient has no intravenous (IV) access at this time B. Clarify the order with the prescribing physician before giving the drug C. Ask the charge nurse what route the physician meant to use D. Start an IV line, then give the medication IV so that it will work faster because the patient's status is NPO at this time
B
Which strategies are helpful in preventing medication errors in nursing practice? Select all that apply. A. Provide patients with proper education. B. Verify medication orders before administering them. C. Develop professional relationships with pharmacists. D. Avoid using computerized prescriber order entry and bar coding. E. Instruct the patient no to question the primary care provider.
A, B, C
Methotrexate is ordered for a patient with a malignant tumor, and the nurse is providing education about self-care after the chemotherapy is given. Which statements by the nurse are appropriate for the patient receiving methotrexate? SATA A. Report unusual bleeding or bruising. B. Prepare for hair loss. C. Avoid areas with large crowds or gatherings. D. Avoid foods that are too hot or too cold or rough in texture. E. Restrict fluid intake to reduce nausea and vomiting.
A, B, C, D
The nurse is monitoring a patient who is receiving an infusion of a beta-adrenergic agonist. Which adverse effect may occur with this infusion? SATA A. Mild tremors B. Bradycardia C. Tachycardia D. Palpitations E. Drowsiness F. Nervousness
A, C, D, F
The nurse is assessing a patient who has developed anemia after two rounds of chemotherapy. Which of these may be indications of anemia? SATA A. Hypoxia B. Fever C. Infection D. Bleeding E. Fatigue
A, E
A 73-year-old male patient is in the clinic for a yearly physical and is asking for a prescription for sildenafil. He has listed on his health history that he is taking a nitrate for angina. The nurse is aware that which problem may occur if sildenafil is taken with a nitrate? A. Significant increase in pulse rate B. Significant decrease in blood pressure C. Increased risk of bleeding D. Reduced effectiveness of the sildenafil
B
A client has been admitted to the cardiac unit for heart failure and has been ordered carvedilol. The client's blood pressure is 80/50. What should the nurse do? A. Give the medication so that the blood pressure will increase. B. Call the provider and advise them of the client's blood pressure prior to administering the medication. C. Continue to take the client's blood pressure using different BP machines until a better blood pressure is obtained. D. Call the provider after giving the medication, informing the provider of client's blood pressure when the medication was administered.
B
A health care professional cautions a patient who is taking guaifenesin about using combination OTC cold products because A. Rebound congestion is likely B. They can also contain guaifenesin C. Drug tolerance is likely D. Serious interactions are possible
B
A healthcare professional who is advising a patient about the use of an expectorant to treat a cough should explain that this type of drug is effective because it performs which of the following actions? A. Suppresses the cough stimulus B. Reduces surface tension C. Reduces inflammation D. Dries mucous membranes
B
A hospitalized patient is experiencing a severe anaphylactic reaction to a dose of intravenous penicillin. Which drug will the nurse expect to use to treat this condition? A. ephedra B. epinephrine C. phenylephrine D. pseudoephedrine
B
A nurse in the ICU is caring for a client who has heart failure and is receiving a dobutamine drip. The nurse should identify that which of the following findings indicates that the medication is effective? A. Increased pulse B. Increased urine output C. Decreased blood pressure D. Decreased blood glucose level
B
A nurse is assessing a client who is receiving a continuous IV infusion of dopamine. Which of the following findings should the nurse recognize as a therapeutic effect? A. Increased pulse B. Increased urine output C. Decreased blood pressure D. Decreased dysrhythmias
B
A nurse is reviewing the medical record of a client who has hypertension and a new prescription for metoprolol. Which of the following findings should the nurse investigate further? A. Diet-controlled Type 2 DM B. A history of left-side heart failure C. A concurrent prescription for tadalafil D. Recently treated bilateral pneumonia
B
A nurse is teaching a client who has chronic obstructive pulmonary disease (COPD) and is to start using fluticasone metered-dose inhaler (MDI) twice daily. The nurse should include: A. "Check your heart rate before each dose." B. "Inspect your mouth for lesions daily." C. "Use this medication to relieve an acute attack." D. "Skip the morning dose if you do not have any symptoms."
B
A patient receiving chemotherapy is experiencing severe bone marrow suppression. Which nursing diagnosis is most appropriate at this time? A. Activity intolerance B. Risk for infection C. Disturbed body image D. Impaired physical mobility
B
An adrenergic agonist is ordered for a patient in shock. The nurse will note that this drug has had its primary intended effect if which expected outcome occurs? A. Volume restoration B. Increased cardiac output C. Decreased urine output D. Reduced anxiety
B
During a cardiopulmonary resuscitation emergency, the nurse expects to administer which injectable, fast-acting medication? A. Salmeterol B. Epinephrine C. Naphazoline D. Dopamine
B
During a follow-up visit, a patient who has been on estrogen therapy admits that she has continued to smoke cigarettes. The nurse will remind the patient that smoking while on estrogen may lead to increased: A. incidence of nausea. B. risk for thrombosis. C. levels of triglycerides. D. tendency to bleed during menstruation.
B
During a teaching session for a patient who is receiving inhaled salmeterol, the nurse emphasizes that the drug is indicated for which condition? A. Rescue treatment of acute bronchospasm B. Prevention of bronchospasm C. Reduction of airway inflammation D. Long-term treatment of sinus congestion
B
The nurse is performing medication reconciliation during a patient's admission assessment. Which question by the nurse reflects medication reconciliation? A. "Do you have any medication allergies?" B. "Do you have a list of all the medications, including OTC, you are currently taking?" C. "Do you need to take anything to help you to sleep at night?" D. "What pharmacies do you use when you fill your prescriptions?"
B
The nurse is reviewing infection-prevention measures with a patient who is receiving antineoplastic drug therapy. Which statement by the patient indicates the need for further teaching? A. "I will avoid those who have recently had a vaccination." B. "I will eat only fresh fruits and vegetables." C. "I will report a sore throat, cough, or low-grade temperature." D. "It is important for both my family and me to practice good hand washing."
B
The order for chemotherapy reads: "Gives asparaginase IV 200 units/kg/day." The patient weighs 297 lb. The pharmacy department will prepare the medication for intravenous infusion. How much drug will be given per dose? A. 26,700 units B. 27,000 units C. 27,500 units D. 28,000 units
B
When a drug is characterized as having a negative chronotropic effect, the nurse knows to expect which effect? A. Reduced blood pressure B. Decreased heart rate C. Decreased ectopic beats D. Increased force of cardiac contractions
B
When a patient has experienced extravasation of a peripheral infusion of a dopamine, the nurse will inject the alpha blocker phentolamine into the area of extravasation and expect which effect? A. Vasoconstriction B. Vasodilation C. Analgesia D. Hypotension
B
Which assessment is most important for a nurse to report to the health care provider for a patient receiving labetalol intravenously? A. Potassium level of 4.1 B. Electrocardiogram changes C. Sodium level of 140 mEq/mL D. Blood pressure 120/70 mmHg
B
Which outcome would be most appropriate to establish for patients taking beta-1 agonists? A. Relaxation of uterine smooth muscle B. Increased contractility of myocardium C. Relaxation of bronchial smooth muscle D. Increased resistance of peripheral vessels
B
Which statement about the dorsogluteal site for intramuscular injections is true? A. Pinch the skin before administering the injection. B. The dorsogluteal region is no longer recommended for injection. C. Select the injection by marking a "V" between the anterior superior iliac spine and the greater trochanter. D. Select the injection site by marking at one hand breadth below the greater trochanter and the sacroiliac joint.
B
A health care professional is caring for a patient who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the health care professional expect to administer? A. Beclomethasone B. Azelastine C. Acetylcysteine D. Ipratropium
C
A healthcare professional is monitoring plasma drug levels in a patient who is taking theophylline. Which of the following adverse effects should the health care professional expect to see if the patient's level indicates toxicity? A. Vomiting B. Constipation C. Restlessness D. Seizures
D
The nurse is reviewing medications for the treatment of asthma. Which drugs are used for acute asthma attacks? SATA A. salmeterol inhaler B. albuterol nebulizer solution C. epinephrine D. montelukast E. fluticase inhaler
B, C
Which statement is correct about administering an injection via the Z-track method? SATA A. The Z-track method is not used to administer iron dextran. B. The Z-track method prevents the skin from staining at the injection site. C. The Z-track method reduces pain at the site of medication administration. D. The Z-track method produces a great deal of irritation at the injection site. E. The Z-track method prevents medication leakage into the subcutaneous tissue.
B, C, E
The nurse is providing instructions to a patient who has a new prescription for a corticosteroid metered-dose inhaler. Which statement by the patient indicates that further instruction is needed? Select all that apply. A. "I will rinse my mouth with water after using the inhaler and then spit out the water." B. "I will gargle after using the inhaler and then swallow." C. "I will continue to use this inhaler, even if I am feeling better." D. "I will use this inhaler for asthma attacks." E. "I will clean the plastic inhaler casing weekly and then let it dry before reassembling."
B, D
The nurse is assessing a patient who has experienced severe neutropenia after chemotherapy and will monitor for which possible signs of infection? SATA A. Elevated WBC count B. Fever C. Nausea D. Sore throat E. Chills
B, D, E
A 79-year-old patient has just received a beta-adrenergic agonist. The patient now complains of chest pain. What is the nurse's priority action? A. Take the patient's temperature B. Count the patient's respiratory rate C. Ask the patient to rate pain intensity D. Obtain a 12-lead electrocardiogram (ECG) at the bedside
C
A child will be receiving diphenhydramine, 5 mg/kg/day, in divided doses, every 6 hours. The child weighs 80 pounds. Identify how many milligrams of medication will the child receive with each dose. A. 44.5 mg/dose B. 45.0 mg/dose C. 45.5 mg/dose D. 46.0 mg/dose
C
A health care professional is talking to a patient who is prescribed albuterol via inhaler and fluticasone via inhaler for asthma management. The health care professional should tell the patient to use the albuterol before using the fluticasone inhaler for which of the following reasons? A. Albuterol will decrease inflammation B. Fluticasone will reduce the adverse effects of albuterol C. Albuterol will increase the absorption of fluticasone D. Albuterol will reduce nasal secretions
C
A nurse is teaching a client who has benign prostatic hypertrophy and has a new prescription for finasteride. Which instruction should the nurse include in teaching? A. "Avoid drinking grapefruit juice when taking this medication." B. "Expect to see a response from the medication within one week." C. "Decreased libido is an adverse effect of the medication." D. "PSA levels will increase while taking the medication."
C
A patient is ordered 4 mL of liquid medication to be taken orally. What is the safest method to administer the medication? A. Use a teaspoon for administration. B. Use a hypodermic syringe with a needle. C. Measure the volume in a calibrated oral syringe. D. Measure the volume accurately in a calibrated medicine cup.
C
Before administering an adrenergic agonist, what is the most important assessment for the nurse to complete? A. Skin integrity B. Temperature C. Blood pressure D. Respiratory rate
C
Before prescribing dextromethorphan (Robitussin) to a patient, the primary care provider should know that, when given with an opioid, the drug can result in which of the following? A. Increased renal reabsorption of the dextromethorphan B. Delayed analgesic effect of the opioid C. Potentiation of the analgesic effect of the opioid D. Reduced antitussive effect of dextromethorphan
C
For a patient receiving a vasoactive drug such as intravenous dopamine, which action by the nurse is most appropriate? A. Monitor the gravity drip infusion closely and adjust as needed B. Assess the patient's cardiac function by checking the radial pulse C. Assess the intravenous site hourly for possible infiltration D. Administer the drug by intravenous boluses according to the patient's blood pressure
C
If extravasation of an antineoplastic medication occurs, which intervention will the nurse perform first? A. Apply cold compresses to the site while elevating the arm B. Inject subcutaneous doses of epinephrine around the IV site every 2 hours C. Stop the infusion immediately while leaving the catheter in place D. Inject the appropriate antidote through the IV catheter
C
The nurse administers a medication to the wrong patient. Which is the appropriate nursing action following this error? A. Document the medication error. No further action is required. B. Report the error and document the medication on the patient's chart. C. Notify the health care provider and document the error on an incident report. D. Assess the patient for an adverse reaction and report if an adverse event occurs.
C
The nurse is caring for a patient who has been recently diagnosed with hypertension and is to receive an initial dose of atenolol. What is the nurse's primary intervention? A. Assess the patient's lungs B. Call the health care provider C. Teach the patient about beta blockers D. Ask the patient if he has any history of respiratory disease
C
The nurse is caring for a patient who is receiving intravenous epinephrine. Which assessment will indicate the patient has having the expected therapeutic effect of this medication? A. Increased bowel sounds B. Decreased blood pressure C. Increased heart rate and strong pulse D. Bronchial constriction and wheezing
C
The nurse is performing postoperative teaching for a patient prescribed bethanechol. The patient is prescribed this drug for the treatment of which condition? A. Ischemic colitis B. Orthostatic hypotension C. Urinary atony D. Respiratory atelectasis
C
The nurse keeps in mind that which measure is used to reduce the risk of medication errors? A. When questioning a drug order, keep in mind that the prescriber is correct B. Be careful about questioning the drug order a board-certified physician has written for a patient C. Always double-check the many drugs with sound-alike and look-alike names because of the high risk of error D. If the drug route has not been specified, use the oral route
C
The nurse observes redness and swelling on the patient's forearm where an intravenous (IV) epinephrine injection was made. The nurse anticipates administration of which medication to counteract the effects on the surrounding tissue at the IV site? A. Labetalol B. Doxazosin C. Phentolamine D. Norepinephrine
C
The nurse will monitor for which adverse effect when administering an anticholinergic drug? A. Excessive urination B. Diaphoresis C. Dry mouth D. Pupillary constriction
C
When administering beta blockers, the nurse will follow which guideline for administration and monitoring? A. The drug may be discontinued at any time B. Postural hypotension rarely occurs with this drug C. Tapering off the medication is necessary to prevent rebound hypertension D. The patient needs to stop taking the medication at once if he or she gains 3 to 4 pounds in a week
C
Which of the following should a health care professional include when advising a patient about the use of montelukast? A. Rinse the mouth to prevent an oral fungal infection B. Take the drug at the onset of bronchospasm C. Take the drug once a day in the evening D. Use a spacer to improve inhalation
C
A nurse is caring for a client who has active pulmonary tuberculosis and is to be started on intravenous rifampin therapy. The nurse should instruct the client that this medication can cause which of the following adverse effects? A. Constipation B. Black colored stools C. Staining of teeth D. Body secretions turning a red-orange color
D
When administering adrenergic agonist medications to an older adult, the nurse will monitor this patient closely because of what common physiologic changes found in this age group? SATA A. Increase in cardiac output B. Increased filtering capacity of kidneys C. Diminished stroke volume of the heart D. Decline in efficiency of the heart muscle E. Increase in contractility of the heart muscle
C, D
A health care professional administers oxybutynin to a patient to treat neurogenic bladder. Which of the following assessment findings should the health care professional recognize as an adverse effect? SATA A. Diaphoresis B. Fever C. Dilated pupils D. Distended bladder E. Dizziness
C, D, E
A 49-year-old patient is in the clinic for a follow-up visit 6 months after starting a beta blocker for treatment of hypertension. During this visit, his blood pressure is 169/98 mm Hg, and he eventually confesses that he stopped taking this medicine 2 months ago because of an "embarrassing problem." What problem did the patient most likely experience with this medication that caused him to stop taking it? A. Urge incontinence B. Dizziness when standing up C. Excessive flatus D. Impotence
D
A client experiencing a serious allergic reaction to a bee sting is brought to the emergency department. The client's right hand is swollen, red, and painful. She is extremely upset, short of breath, and the nurse detects wheezing and stridor. The nurse is ordered to administer epinephrine to relieve which of the client's symptoms? A. Pain and swelling around the sting site. B. Discoloration in her hand. C. Acute anxiety. D. Acute bronchospasm.
D
A health care professional should recognize that using pseudoephedrine to treat allergic rhinitis requires cautious use with patients who have which of the following? A. A seizure B. Peptic ulcer disease C. Anemia D. Coronary artery disease
D
A patient is receiving dobutamine for shock and is complaining of feeling more "skipping beats" than yesterday. What will the nurse do next? A. Monitor for other signs of a therapeutic response to the drug B. Titrate the drug to a higher dose to reduce the palpitations C. Discontinue the dobutamine immediately D. Assess the patient's vital signs and cardiac rhythm
D
During the medication administration process, it is important that the nurse remembers which guideline? A. When in doubt about a drug, ask a colleague about it before giving the drug B. Ask what the patient knows about the drug before giving it C. When giving a new drug, be sure to read about it after giving it D. If a patient expresses a concern about a drug, stop, listen and investigate concerns
D
If a student nurse realizes that he or she has made a drug error, the instructor should remind the student of which concept? A. The student bears no legal responsibility when giving medications B. The major legal responsibility lies with the health care institution at which the student is placed for clinical experience C. The major legal responsibility for drug errors lies with the faculty members D. Once the student has committed a medication error, his or her responsibility is to the patient and to being honest and accountable
D
The health care provider has prescribed lidocaine with epinephrine for injection to be administered before obtaining a biopsy. The nurse will question the prescription after the patient makes which statement? A. "I get faint when I see needles" B. "I'm getting over a cold I've had for 3 days" C. "I break out in a rash when I take antibiotics" D. I am taking a new medicine for high blood pressure"
D
The nurse is caring for a patient diagnosed with heart failure and chronic obstructive pulmonary disease (COPD). The patient is ordered carvedilol. What is the nurse's primary intervention? A. Maintain the patient on intake and output B. Assess the heart rate before administration C. Make sure the patient is on telemetry monitoring D. Call the health care provider to request a different medication
D
The nurse is caring for a patient who has undergone surgery and is on morphine. The nurse goes out for a break and asks the other nurse to stay with the patient. What should the other nurse do if it is time to administer medications? A. The other nurse should wait for the first nurse to return. B. The other nurse should contact the primary health care provider. C. The other nurse should administer the drug already prepared by the first nurse. D. The other nurse should review the patient's medical records and administer the drug.
D
The nurse is providing instructions about the Advair inhaler (fluticasone propionate and salmeterol). Which statement about this inhaler is accurate? A. It is indicated for the treatment of acute bronchospasms. B. It needs to be used with a spacer for best results. C. Patients need to avoid drinking water for 1 hour after taking this drug. D. It is used for the prevention of bronchospasms.
D
The nurse monitors a patient who is experiencing thrombocytopenia from severe bone marrow suppression by looking for A. Severe weakness and fatigue B. Elevated body temperature C. Decreased skin turgor D. Excessive bleeding and bruising
D
The nurse will instruct patients about a possible systemic effect that may occur if excessive amounts of topically applied adrenergic nasal decongestants are used. Which systemic effect may occur? A. heartburn B. bradycardia C. drowsiness D. palpitations
D
The nurse working in a preoperative admitting unit administers an anticholinergic medication to a patient before surgery. What is the purpose of this drug in the preoperative setting? A. Control the heart rate B. Relax the patient C. Reduce urinary frequency D. Reduce oral and gastrointestinal secretions
D
The nurse would question a prescription for estrogen replacement therapy in a patient with a history of which condition? A. Weight loss B. Vaginal bleeding C. Dysmenorrhea D. Deep vein thrombosis
D
The patient has been ordered two drugs of the same class to be used for treatment of asthma. That patient asks the nurse, "Why do I have to use more than one medication to treat this? Isn't one enough?" What is the nurse's most appropriate response? A. "You need to ask your health care provider questions like that" B. "I will arrange for the pharmacist to do a presentation for you" C. "No, in this case, one drug is not enough to do what's needed for you" D. "Sometimes use of more than one drug will give a combined therapeutic effect"
D
The patient has been placed on midodrine. The nurse recognizes that the patient has a clear understanding of how to administer the medication when the patient states that the last dose of the medication will be taken when? A. At bedtime B. After 6 pm C. Upon awakening D. No later than 1800
D
What is the best nursing action to administer an oral medication to a crying infant? A. Administer the medication sublingually. B. Add the medication to a bottle of formula. C. Change the route of administration to intramuscular or intravenous. D. Administer the medication with an oral syringe once the infant stops crying.
D
What is the objective of administering phenylephrine as an adjunct to local anesthesia? A. Bradycardia B. Tachycardia C. Vasodilation D. Vasoconstriction
D
What possible common adverse effect would the nurse include in the discharge teaching for a patient prescribed finasteride? A. Hair loss B. Muscle weakness C. Increased libido D. Ejaculatory dysfunction
D
When explaining how a patient should use ipratropium, a health care professional should include which of the following instructions? A. This drug is used to thin respiratory secretions B. Check pulse rate after inhaling the drug C. Do not drink anything for 30 minutes after using the drug D. Wait 5 minutes between using the drug and another inhaled drug
D
When teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, the nurse will include which instruction? A "Driving is allowed after 2 weeks of therapy." B "If seizures recur, take a double dose of the medication." C "Antacids can be taken with the AED to reduce gastrointestinal adverse effects." D "Regular, consistent dosing is important for successful treatment."
D
