Advanced Pharmacology Walden

Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse's following assessment questions most directly addresses a common adverse effect of filgrastim? "Have you noticed any bleeding in your gums or cheeks?" "Do you feel like you're having any pain in your bones?" "Are you experiencing any waves of cool, clammy skin?" "Have you had any shortness of breath lately"

"Do you feel like you're having any pain in your bones?"

A Nurse Practitioner is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation? A child has an erratic blood flow from an immature peripheral circulation, which increases drug absorption, causing an increase in adverse effects. A child's gastric pH is decreased, causing less of the drug to be absorbed from the subcutaneous skin, therefore producing more adverse effects. A child has a greater body surface area, creating greater permeability resulting in an increase in absorption of topical agents, which may result in more adverse effects A child has a smaller body surface area, resulting in an increase in topical absorption, which can cause more adverse effects

A child has a greater body surface area, creating greater permeability resulting in an increase in absorption of topical agents, which may result in more adverse effects

A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose? A. 2000 mg B. 4000 mg C. 3000 mg D. 1000 mg

A. 2000 mg

A nurse is administering drugs to a 10-year-old child who has multiple health problems. The child is underweight and is on a special diet. Which of the following will the nurse consider when planning for the best absorption of the prescribed drugs? (Select all that apply.) A. Disease process B. Weight C. Diet D. Route of administration E. Age

A. Disease process C. Diet D. Route of administration E. Age

A nurse practitioner orders 150 mg of oral fluconazole for a patient with vulvovaginal candidiasis. The patient should expect to take medication A. once a day B. every day until the infection is gone C. for 30 days D. for 20 days

A. once a day

A patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are considered A. phytoestrogens B. monotherapy C. taboo D. inappropriate

A. phytoestrogens

A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause A. staining of permanent teeth B. sleep deprivation C. orange-tinged urine D. deep muscle pain

A. staining of permanent teeth

A 13-year-old female took a weight loss drug that activated the sympathetic nervous system. Which of the following assessment findings would the nurse expect? A. Decreased myocardial contraction B. Increased intranodal conduction time C. Increased cardiac conduction D. Decreased heart rate

C. Increased cardiac conduction

A 29-year-old woman who is morbidly obese has recently begun a comprehensive, medically supervised program of weight reduction. Prior to adding dextroamphetamine (Dexedrine) to her regimen, the patient should be questioned about her intake of A. alcohol B. grapefruit juice C. caffeine D. trans fat

C. caffeine

A man has a demonstrated history of androgen deficiency and the consequences of this health problem include an inability to maintain an erection. Which of the following medications would best address this patient's erectile dysfunction (ED)?

Exogenous testosterone

What schedule class of drug is Hydrocodone? I II III IV

II

A 16-year-old boy is prescribed cromolyn sodium nasal spray to treat a nasal allergy. To maximize the therapeutic effects of the drug, which of the following will the nurse include in instructions to the patient?

Take the drug for 1 full week before coming in contact with allergens

A 51-year-old female patient has been receiving doxorubicin (Adriamycin) for metastatic breast cancer. Her medical record indicates she has cardiomyopathy and a cumulative dose of 300 mg/m2 of doxorubicin. Which of the following measures would help limit the severity of the cardiomyopathy in this patient? A reduced dose A single large dose instead of multiple doses The use of dexrazoxane in conjunction with doxorubicin Meticulous monitoring during drug administration

The use of dexrazoxane in conjunction with doxorubicin

A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for recurring headaches. The nurse should recommend aspirin advil tylenol Motrin

Tylenol

A male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at each clinic visit? Serum cholesterol levels Bone growth Hemoglobin levels Urinary elimination patterns

Urinary elimination patterns

Terazosin (Hytrin) is classified under which of the following drug class: beta blockers tricyclic blockers alpha blockers calcium channel blockers

alpha blockers

Baby Jasmine is a 5 mth old breastfed infant with a fever. Treatment for her fever may include: Acetaminophen suppository "baby" aspirin Ibuprofen suppository Alternating acetaminophen and ibuprofen

alternating acetaminophen and ibuprofen

A 71-year-old man has just been prescribed finasteride (Proscar). Which of the following complaints by this patient most likely indicated a need for this drug? "My urine is extremely concentrated lately and it smells strong" "To be honest, I find that I can't get an erection for the past few months" "My urine's been cloudy for the last little while and it burns when I go to the bathroom" "Lately, I have to get up three or four times a night to go to the bathroom"

"Lately, I have to get up three or four times a night to go to the bathroom"

A 56-year-old woman will soon begin treatment of her overactive bladder with tolterodine (Detrol). What patient teaching should the nurse provide to this woman? "It's good to measure your heart rate before you take your Detrol each day, and withhold it if your heart rate is below 60 beats/minute." "You'll probably need to stop taking your hormone replacement therapy when you're taking Detrol" "You'll likely find that you have scant amounts of blood in your urine for the first few days, but this is not unusual or problematic" "You might find that you get a dry mouth or a headache from this drug, but this does not mean it has to be discontinued"

"You might find that you get a dry mouth or a headache from this drug, but this does not mean it has to be discontinued"

A school nurse has been teaching high school students about the risks associated with marijuana use. However, the nurse has been met with considerable skepticism on the part of students, most of whom believe that marijuana is a benign drug. Which of the following teaching points should the nurse provide? "Most people don't know that marijuana can be just as addictive as heroin or cocaine over time." "Marijuana can easily interact with other drugs and cause potentially fatal reactions." "Every year, thousands of Americans end up in emergency departments with marijuana overdoses." "Smoking marijuana is just as bad, or worse, for your lungs as smoking cigarettes"

"smoking marijuana is just as bad, or worse for your lungs as smoking cigarettes

An NP is seeing a child who weights 25 pounds, 2 oz and needs a medication. The NP learns that the recommended dosing for this drug is 30-35 mg per kg per day in three divided doses. The NP should order 110 mg daily 110 mg tid 330 mg once a day 330 mg tid

110 mg tid

A nurse has administered filgrastim to a diverse group of patients in recent months. Which of the following patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug?

A 19-year-old Male receiving radiation therapy

A Nurse Practitioner works at a weight management clinic. To which of the following overweight patients could the nurse safely administer dextroamphetamine? A 38-year-old Caucasian woman with glaucoma A 60-year-old African-American man who experiences angina A 48-year-old Caucasian man who has adult-onset diabetes A 28-year-old African-American woman with hyperthyroidism

A 48-year-old Caucasian man who has adult-onset diabetes

The recommended treatment for trichomoniasis is A. Flagyl B. Meclizine C. Amoxicillan D. Diflucan

A. Flagyl

A nurse is caring for a 10-year-old boy who complains of chronic headaches. His mother reports that she gives him Tylenol at least three times a day. Which of the following will the nurse work with the physician to evaluate? A. Hepatic function B. Renal function C. Cardiac function D. Respiratory function

A. Hepatic function

A 21-year-old female has a history of irregular menses. She recently became sexually active, and would like to begin taking oral contraceptives (OCs). The nurse practitioner recognizes that most likely this patient would benefit from taking which category of OCs. A. Monophasic B. Ortho Tri-Cyclen C. Triphasic OC D. Biphasic OC

A. Monophasic

A nurse working in a cancer center is preparing to administer medication to a 5-year-old child. The nurse will calculate the drug dosage by using A. body surface area B. weight C. age in months D. age in years

A. body surface area

A nurse is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamin e for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an A. electrocardiogram (ECG) B. electroencephalogram (EEG) C. electromyelogram (EMG) D. electrophysiologic study (EPS)

A. electrocardiogram (ECG)

A nurse who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to A. immature liver and kidney function in infants and children B. the inability of infants and children and describe symptoms of adverse drug reactions C. increased heart rate and subsequently rapid drug distribution among infants and children D. increased body surface area relative to body volume in infants and children

A. immature liver and kidney function in infants and children

A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the chance that the boy will take his prescribed medication, the nurse should A. offer a choice between liquid and chewable medications, if possible B. insert a central intravenous line C. teach the boy about the fact that he will feel much better after he takes his medications D. have the mother hold the child firmly and sooth him while the drugs are administered

A. offer a choice between liquid and chewable medications, if possible

A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia). After baseline physical data are obtained, the nurse will assess the patient's childbearing potential. The nurse will inform the patient that during sibutramine therapy she should A. use adequate contraception B. abstain from sex C. take a pregnancy test every month D. obtain a pap smear

A. use adequate contraception

A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic can the nurse most safely recommend? Aspirin Diflunisal (Dolobid) Acetaminophen Ibuprofen

Acetaminophen

A 30-year-old man with a BMI of 59 has recently been diagnosed with type 2 diabetes mellitus. In light of the man's lack of success with weight loss programs in the past, his care provider has prescribed sibutramine (Meridia). What instructions should the nurse consequently provide to this patient? A. "This drug will help you to lose weight without having to exercise or change your normal diet." B. "Take this drug once each day on an empty stomach." C. "Take a dose when you feel like you are tempted to binge on food." D. "It's best to take a dose of sibutramine after each meal."

B. "Take this drug once each day on an empty stomach."

A nurse works at a weight management clinic. To which of the following overweight patients could the nurse safely administer dextroamphetamine? A. A 28-year-old African-American woman with hyperthyroidism B. A 48-year-old Caucasian man who has adult-onset diabetes C. A 38-year-old Caucasian woman with glaucoma D. A 60-year-old African-American man who experiences angina

B. A 48-year-old Caucasian man who has adult-onset diabetes

A nurse is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation? A. A child's gastric pH is decreased, causing less of the drug to be absorbed from the subcutaneous skin, therefore producing more adverse effects. B. A child has a greater body surface area, creating greater permeability resulting in an increase in absorption of topical agents, which may result in more adverse effects. C. A child has an erratic blood flow from an immature peripheral circulation, which increases drug absorption, causing an increase in adverse effects. D. A child has a smaller body surface area, resulting in an increase in topical absorption, which can cause more adverse effects.

B. A child has a greater body surface area, creating greater permeability resulting in an increase in absorption of topical agents, which may result in more adverse effects

An immunocompromised 7-year-old child was recently discharged home with a peripherally- inserted central line (PIC line) for home antibiotic therapy. He has now been brought to the emergency department by his mother and father with signs and symptoms of line sepsis. Upon questioning, the mother states that she has been removing the PIC dressing daily and washing the site with warm water and a cloth. What nursing diagnosis is most appropriate in this situation? A. Caregiver Role Strain B. Knowledge Deficit C. Ineffective Family Therapeutic Regimen Management D. Delayed Growth and Development

B. Knowledge Deficit

A patient reports to a clinic with complaints of breast tenderness, a right lumpy breast, and no breast discharge. The breast tenderness occurs primarily during her menstrual cycle. The nurse practitioner probably suspects A. breast cancer. B. PMS. C. pain in the heart. D. cancerous breast tenderness

B.PMS

A 21-year-old has been placed on risperidone. Monitoring for risperidone includes Bradykinesia, akathisia and agitation Excessive weight gain Hypertension Potentially fatal agranulocytosis

Bradyknesia, akathisia and agitation

A 15-year-old boy has been diagnosed with bone cancer after several months of fatigue and pain. What question should the nurse include in an assessment when trying to minimize the potential for adverse drug reactions? A. "Did Tylenol or other over-the-counter pain remedies ever relieve your pain?" B. "How much do you weigh?" C. "Do you ever use alcohol or drugs?" D. "On a scale of zero to ten, what level of pain is acceptable to you?"

C. "Do you ever use alcohol or drugs?"

A school nurse has been teaching high school students about the risks associated with marijuana use. However, the nurse has been met with considerable skepticism on the part of students, most of whom believe that marijuana is a benign drug. Which of the following teaching points should the nurse provide? A. "Every year, thousands of Americans end up in emergency departments with marijuana overdoses." B. "Most people don't know that marijuana can be just as addictive as heroin or cocaine over time." C. "Smoking marijuana is just as bad, or worse, for your lungs as smoking cigarettes." D. "Marijuana can easily interact with other drugs and cause potentially fatal reactions."

C. "Smoking marijuana is just as bad, or worse, for your lungs as smoking cigarettes."

A nurse who provides care on a pediatric medicine unit has conducted a medication reconciliation of a recently-admitted patient. In light of the fact that the child takes methylphenidate (Ritalin), the nurse is justified in considering a history of what health problem? A. Respiratory depression B. Obesity C. ADHD D. Anxiety

C. ADHD

A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse's priority assessment would be A. Vision B. body temperature C. height and weight D. blood pressure

C. Height and weight

A 19-year-old patient reports to a clinic with vaginal discharge with a foul odor. A microscopic exam reveals trichomonas vaginalis. The nurse practitioner is aware that A. trichomoniasis is an incurable disease. B. trichomoniasis discharge is typically thin and clear. C. asymptomatic women are diagnosed with trichomoniasis by a routine pap smear. D. it is unusual to have an odor with trichomoniasis

C. asymptomatic women are diagnosed with trichomoniasis by a routine pap smear

A 12-year-old boy is being discharged from the hospital after major surgery. The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to A. the boy by telling him not to worry about the medications and to take them as directed. B. the mother and be sure to reinforce the need to force the medications, if her son does not want to take them. C. both the boy and his mother regarding all medication issued D. the mother regarding why the boy needs to take the medications

C. both the boy and his mother regarding all medication issued

A nurse is going to administer medication to an infant using a medicine dropper. The best method is to open the child's mouth by gently squeezing the cheeks and placing the drops A. under the tongue. B. at the back of the mouth. C. in the buccal pouch. D. on top of the tongue

C. in the buccal pouch

A child is admitted to the burn unit with second and third degree burns on both arms and part of his or her face. When administering topical medications to the burned areas, the nurse should A. allow the child to apply the medication if possible. B. cool the medication prior to administration. C. use sterile technique when applying the medication. D. use clean technique only when applying the medication.

C. use sterile technique when applying the medication.

Ms. LW is on hyrdroxychloroquine (Plaquenil) for rheumatoid arthritis. Certain tests are recommended before a patient starts this medication. Which of the following is NOT recommended before starting Hydroxychoroquine (Plaquenil)? Comprehensive Eye Exam CBC (Complete Blood Count) Liver Function profile 24 hour urine

CBC (complete blood count)

Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient's physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician's order if the patient has a history of osteoporosis or low bone density chronic obstructive pulmonary disease (COPD) diabetes mellitus cardiac arrhythmias

Cardiac arrhythmias

During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient's platelet count to be 92,000 cells/mm3. The nurse should do which of the following? Consult the prescriber for an increase in dosage Consult the prescriber for a decrease in dosage Consult the prescriber for discontinuation of the drug Continue the therapy as prescribed

Consult the prescriber for discontinuation of the drug

To which of the following patients would a medication nurse most likely administer caffeine as part of the treatment plan? A. A school-age child with severe ADHD B. A 34-year-old woman with a diagnosis of gastric ulcerations C. A 52-year-old man with narcolepsy D. A preterm neonate who has apnea

D. A preterm neonate who has apnea

The clinical nurse educator who oversees the emergency department in a children's hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children? A. Avoiding intravenous administration of drugs whenever possible. B. Recording drug administration in both the nurse's notes and the medication administration record (MAR) C. Ensuring that a full assessment takes place no more than 30 minutes before giving a drug. D. Having nurses check their math calculations with a colleague before administering a drug

D. Having nurses check their math calculations with a colleague before administering a drug

A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather's antidepressant to improve his mood. After immediately phoning the boy's stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem? A. Hypokalemia B. Nephrotoxicity C. Cardiac dysrhythmia D. Hypertensive crisis

D. Hypertensive crisis

A 16-year-old boy is prescribed cromolyn sodium nasal spray to treat a nasal allergy. To maximize the therapeutic effects of the drug, which of the following will the nurse include in instructions to the patient? A. Take the drug on a full stomach B. Avoid high noise levels C. Drink plenty of fluids. D. Take the drug for one full week before coming in contact with allergen

D. Take the drug for one full week before coming in contact with allergen

A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug? A. That there is decreased absorption rates of topical drugs in infants B. That there is a lower concentration of water in an infant's body compared with an adult C. That there is less body surface area to be concerned about D. That the infant's skin has greater permeability than that of an adult

D. That the infant's skin has greater permeability than that of an adult

A 22-year-old woman has given birth to an infant who exhibits the signs and symptoms of maternal cocaine use during pregnancy. These signs and symptoms are a result of what pathophysiological effect of opioid use during pregnancy? A. Changes in blood chemistry as a result of nephrotoxicity and hepatotoxicity B. Hypoxia as a result of a prolonged second stage of labor C. Impaired maternal nutrition as a result of drug use D. Vasoconstriction leading to reduced placental blood flow

D. Vasoconstriction leading to reduced placental blood flow

A nurse is having difficulty administering a bitter drug to a 5-year-old child. The nurse should A. involve the child in a play therapy session, and then tell the child that the medicine is candy. B. give the drug in a pill form. C. have the parent gently force the child's mouth open. D. offer the child a flavored ice chip or ice pop prior to administering the drug

D. offer the child a flavored ice chip or ice pop prior to administering the drug

A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the A. deltoid muscle B. rectus femoris muscle C. dorsogluteal muscle D. ventrogluteal muscle

D. ventrogluteal muscle

What is the best initial treatment plan for a sleep disorder in the older adult patient? Medicate with amitriptyline (Elavil) Medicate with trazodone (Desyrel) Decrease noise and light in the environment Discuss the importance of naps daily

Decrease noise and light in the environment

A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following?

Dental hygiene practices

A Nurse Practitioner is to use a single-dose 1 mL vial to administer 0.5 mL of epoetin alfa to a 39-year-old woman who is being treated for chemotherapy-induced anemia. Which of the following will the nurse do with the unused portion of the drug? Refrigerate the medication for future use Discard the unused portion of the drug Store the medication in the drug cart for the next dose Put the medication in the freezer compartment of the refrigerator

Discard the unused portion of the drug

A Nurse Practitioner is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient? Avoid high-fat foods Drink plenty of water every day Take the tablets before bedtime Avoid red meat

Drink plenty of water every day

A Nurse Practitioner is caring for a patient who is at 28 weeks' gestation and is receiving terbutaline (Brethine) to control preterm labor. Which of the following assessment parameters should the nurse prioritize? Maternal body temperature Fetal heart rate (FHR) Correct fetal position Fetal blood pressure

Fetal heart rate (FHR)

Some drugs are given to patients using other routes such as sublingual or topical to avoid movement through the liver and possible side effects. Which of the following effects is the Nurse Practitioner attempting to avoid by administering certain medications via alternative routes? Prodrug effect Plasma concentration-time curve effect First-Pass effect Drug-receptor interaction effect

First pass effect

A postmenopausal patient is prescribed bisphosphonates to treat osteoporosis. The nurse will instruct the patient to take the drug at bedtime. after meals. at any time of the day with tea or coffee. first thing in the morning

First thing in the morning

The recommended treatment for trichomoniasis is Flagyl Diflucan Amoxicillan Meclizine

Flagyl

A patient who is at risk for DVT tells the NP she has just learned she is pregnant. The NP should expect that this patient will use which of the following anticoagulant medications? Aspirin Heparin Dabigatran Warfarin

Heparin

A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather's antidepressant to improve his mood. After immediately phoning the boy's stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem?

Hypertensive crisis

A nurse who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to

Immature liver and kidney function in infants and children

A 46-year-old man is receiving a quinupristin/dalfopristin IV infusion for a life-threatening infection. Which of the following would be most important for the nurse to monitor? Increased heart rate Breathlessness Infiltration, edema, or phlebitis at the infusion site Nausea and vomiting

Infiltration, edema, or phlebitis at the infusion site

Which of the following is a true statement about aspirin and its action on platelets It's effects on platelets may last up to three weeks It is used for prophylaxis against strokes and acute myocardial infarction It's effects only last two weeks and are reversible It's effects on platelets are irreversible

It is used for prophylaxis against strokes and acute myocardial infarction

How is hydrocodone eliminated from the body? Skin Liver Gastrointestinal tract Kidney

Kidney

Off label prescribing is: Regulated by the FDA Illegal by NPs in all states and provinces Legal if there is scientific evidence for the use Regulated by the DEA

Legal if there is scientific evidence for the use

Nurse Practitioner is assessing a patient who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the patient for which of the following? Diabetes mellitus Hypertension Leukopenia Hypoglycemia

Leukopenia

A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor which of the following? Visual function Blood counts Pap test results Liver function

Liver function

Alprostadil (Caverject), a drug used to treat erectile dysfunction, has been prescribed to a 42 year-old patient. When providing education to the patient and his wife, the nurse should inform the wife about which of the following adverse effects?

Low blood pressure Vaginal burning

A nurse is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for which of the following?

Neurotoxicity

A patient reports to a clinic with complaints of breast tenderness, a right lumpy breast, and no breast discharge. The breast tenderness occurs primarily during her menstrual cycle. The nurse practitioner probably suspects breast cancer. cancerous breast tenderness pain in the heart. PMS

PMS

Which test should the NP order for monitoring effectiveness of the patient receiving heparin? Arterial blood gas levels PTT Complete blood count Hemoglobin level

PTT

All insects have an FDA black box warning regarding Potential for causing life-threatening G.I. bleed Increase risk of developing systemic arthritis with prolonged use Risk of life-threatening rashes to include Stevens Johnson syndrome Risk for changes in serum glucose

Potential for causing life-threatening G.I. bleed

An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions? Dispose of intravenous lines used for chemotherapy administration in a covered trash can in the patient's room Use an IV system for administration that includes needles to reduce the risk of accidental spills Prime the IV tubing with an approved IV solution rather than with the drug itself Encourage patients who have been receiving chemotherapy to use a bedside commode rather than a toilet

Prime the IV tubing with an approved IV solution rather than with the drug itself

A Nurse Practitioner is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered? Coumadin Alteplase Ticlopidine Protamine sulfate

Proatamine Sulfate

Cindy has been on Citalopram (Lexapro) For a year and is willing to try tapering off of the selective serotonin reuptake inhibitor. What is the initial dosage adjustment when tapering off antidepressants Reduce dose by 50% for 3 to 4 days Reduce dose by 50% every other day Change Dose to every other day dosing for a week Lexapro can be stopped abruptly due to its long half life

Reduce dose by 50% for 3 to 4 days

Gold compounds are contraindicated in patients with all of the following conditions except: Hepatic disease Renal disease Blood dyscrasias Rheumatoid arthritis

Rheumatoid arthritis

Drugs have a valid medical use but a high potential for abuse, both psychological and physiologic. In an emergency, a Schedule 2 drug may be prescribed by telephone if a written prescription cannot be provided at the time. However, a written prescription must be provided within 72 hours with the words authorization for emergency dispensing written on the prescription. These prescriptions cannot be refilled. A new prescription must be written each time. Examples include certain amphetamines and barbiturates. This is scheduled drug Schedule 1 Schedule 2 Schedule 3 Schedule 4

Schedule 2

A nurse educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session?

Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected

A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment? The importance of vigilant hygiene for the boy and the other members of the family The need for the boy to provide serial stool samples for 6 months following treatment The need to supplement the anthelminthic drug with prophylactic antibiotics The need to use prescription skin cleansers during treatment and for 6 weeks after

The importance of vigilant hygiene for the boy and the other members of the family

An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identified potential benefits of imatinib. Which of the following characteristics of this patient's current health status may preclude the use of imatinib? The patient has type 2 diabetes mellitus that is controlled using diet and oral antihyperglycemics The patient has chronic heart failure resulting in significant peripheral edema The patient experienced a mild ischemic stroke several years ago and had transient ischemic attacks last year The patient had a total knee arthroplasty several months earlier

The patient has chronic heart failure resulting in significant peripheral edema

66-year-old man has made an appointment with his primary care provider to discuss his recent ...and has requested a prescription for ...based on television commercials he has seen. What characteristic of this patient would most likely contraindicate the use of

The patient has unstable angina and uses a nitroglycerin patch

A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this patient would most likely contraindicate the use of tadalafil for his ED? The patient takes allopurinol for the treatment of gout The patient has a family history of osteoporosis and has undergone bone density testing The patient has unstable angina and uses a nitroglycerin patch The patient often takes ginseng when he gets a common cold

The patient has unstable angina and uses a nitroglycerin patch

A 68-year-old man is being treated for benign prostatic hypertrophy (BPH) and began treatment with finasteride (Proscar) 3 months ago. When planning the care of this patient, what desired outcome should the nurse prioritize? The patient will remain free of sexual side effects related to drug therapy The patient will experience complete bladder emptying The patient will remain free of urethral pain The patient will not experience hematuria

The patient will experience complete bladder emptying

When planning care for a patient who is receiving filgrastim (Neupogen) for a non-myeloid malignancy, the nurse should formulate which of the following patient outcomes? (Select all that apply.) The patient will not develop an infection The patient will not experience bone pain The patient will be able to self-administer filgrastim at home The patient will not develop febrile neutropenia The patient will not retain fluid

The patient will not develop an infection The patient will not experience bone pain The patient will be able to self-administer filgrastim at home The patient will not develop febrile neutropenia

Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse's response to Mr. Lepp? Epoetin alfa is normally contraindicated in patients who are receiving radiotherapy or chemotherapy Treatment with epoetin alfa will likely begin 4 to 6 days before Mr. Lepp's first round of chemotherapy and continue indefinitely The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients Mr. Lepp's oncologist should have begun treatment with epoetin alfa immediately after he was diagnosed

The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients

A Nurse Practitioner has questioned why a patient's physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of a patient's infection. Which of the following facts provides the best rationale for the use of narrow-spectrum antibiotics whenever possible? Broad-spectrum antibiotics confound the results of subsequent culture and sensitivity testing Narrow-spectrum antibiotics normally require a shorter duration of treatment The efficacy of most narrow-spectrum antibiotics has not been proven The use of broad-spectrum antibiotics can create a risk for a superinfection

The use of broad-spectrum antibiotics can create a risk for a superinfection

A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis? Ciprofloxacin is safe to use in pregnancy and the patient may use the same dose and route as a nonpregnant patient The use of ciprofloxacin is contraindicated in pregnancy It is safe for the patient to use topical ciprofloxacin but the oral route is potential teratogenic The patient will require a lower dose and longer course of ciprofloxacin than a nonpregnant, adult patient

The use of ciprofloxacin is contraindicated in pregnancy

An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman's pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient's pain? Alternating doses of long-acting morphine with short-acting morphine A large long-acting dose of morphine at 8 a.m. with smaller doses at 12 p.m., 5 p.m., and 10 p.m. Twice-daily doses of long-acting morphine, with short-acting morphine available for breakthrough pain Scheduled doses of short-acting morphine q1h around the clock

Twice-daily doses of long-acting morphine, with short-acting morphine available for breakthrough pain

Which antibiotic is most frequently associated with "Red man Syndrome" Rifampin Vancomycin Amphotericin B Ciprofloxacin

Vancomycin

Ms. Lewis Is in 74-year-old female who presents to your clinic for routine visit today. You review her medical record and notice she is prescribed aspirin therapy. You provide patient education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is: Tremors Vomiting Tinnitus Black, tarry stools

Vomiting

Ms. Shackleford Has been placed on Ambien to help for her insomnia. The NP must educate the patient regarding the rapid onset of Ambien. Which statement below is correct? Zolpidem should be taken just before going to bed Zolpidem may cause dry mouth and constipation They may need to double the dose for effectiveness They should stop drinking alcohol at least 30 minutes before taking zolpidem

Zolpidem should be taken just before going to bed

The nurse practitioner, Jill, is deciding what medication to put her patient on. She recognizes that the mechanism of action of triptans is as: a Selective serotonin receptor agonist A dopamine antagonist A vasoconstrictor An inhibitor of leukotriene synthesis

a selective serotonin receptor agonist

A Nurse Practitioner will instruct a patient taking allopurinol to take each dose at night first thing in the morning after a meal before a meal

after a meal

Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The nurse will advise the patient to avoid dairy products fatty foods alcohol vitamin C

alcohol

When a NP chooses a benzodiazepine to treat anxiety the prescriber needs to be aware of the possibility of dependence. The Benzodiazepine associated with the greatest likelihood of causing rapid dependence is: Chlordiazepoxide (Librium) Clonazepam (Klonopin) Alprazolam (Xanax) Oxazepam (serax)

alprazolam (Xanax)

A 34-year-old male has been diagnosed with TB and will be started on INH therapy. The medication history reveals that he currently takes antacids on a regular basis. The nurse will instruct the patient to take antacids during the day and INH only at night antacids before meals and INH 1 or 2 hours after meals INH before meals and antacids 1 or 2 hours after meals antacids not less than 1 hour before or 2 hours after taking INH

antacids not less than 1 hour before or 2 hours after taking INH

A 12-year-old boy is being discharged from the hospital after ... The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to

both the boy and his mother regarding all medication issued

A 12-year-old boy is being discharged from the hospital after major surgery. The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to the mother regarding why the boy needs to take the medications both the boy and his mother regarding all medication issued the boy by telling him not to worry about the medications and to take them as directed the mother and be sure to reinforce the need to force the medications, if her son does not want to take them

both the boy and his mother regarding all medication issued

A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The patient has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect? By promoting the rapid excretion of vitamin K by the gastrointestinal mucosa By inhibiting the action of vitamin K at its sites of action By inhibiting platelet aggregation on vessel walls and promoting fibrinolysis By inactivating clotting factors and thus stopping the coagulation cascade

by inactivating clotting factors and thus stopping the coagulation cascade

I did not make drugs have a little effect when administered: Orally Intramuscularly Intravenously By inhalation

by inhalation

Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient's physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician's order if the patient has a history of

cardiac arrhythmias

Which of the following agents would not be expected to cause nausea, vomiting, Flushing, dizziness, headache, and abdominal discomfort after consumption of alcohol? Cefotetan Chlorpropamide Metronidazole Fomepizole

cefotetan

A patient has endocarditis and is taking gentamicin. The Nurse Practitioner will be sure to monitor which of the following? Potassium level Creatinine clearance Serum albumin level Prothrombin time

creatinine clearance

A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following? Chronic diarrhea Dental hygiene practices Headaches Diet

dental hygiene practices

A patient has been taking doxazosin (Cardura) 2 mg PO daily for 3 weeks for treatment of BPH. He returns to the clinic and is complaining of feeling dizzy when he stands up. Which action would the family nurse practitioner take? Order urinalysis (UA) to determine hematuria and presence of bacteria. Determine blood pressure (BP) with patient lying down, standing, and sitting. Review with patient his symptoms over the past 3 weeks. Perform digital rectal exam to determine if prostate is smaller than previously noted

determine blood pressure with patient lying down, standing, and sitting

A Nurse Practitioner is explaining to a pregnant 21-year-old college student why she cannot continue to take ibuprofen (Advil) for her headaches. The nurse draws a picture depicting drug molecules crossing the placental membrane and entering into the fetal circulation. The nurse tells the patient that the main reason this happens is because there is a 40% increase in blood volume during pregnancy the mother's heart rate is 10 to 15 beats per minute faster during pregnancy drugs compete with the hormones of pregnancy for albumin-binding sites hemodilution of plasma albumin occurs

drugs compete with the hormones of pregnancy for albumin-binding sites

A Nurse Practitioner is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an electrocardiogram (ECG) electromyelogram (EMG) electroencephalogram (EEG) electrophysiologic study (EPS)

electrocardiogram ECG

The NP is reviewing Mrs. Oglethorpe's medication list and recognizes that which drug listed below has been associated with increased risk for MI in women? Aspirin Beta blockers Lipid lowering agents Estrogen replacement

estrogen replacement

A 54-year-old woman with a history of osteoporosis has been prescribed ciprofloxacin for recurrent cystitis. Because of the patient's history, the nurse would be sure to discuss with the woman the use of alcohol grapefruit juice food containing iron or calcium nicotine

food containing iron or calcium

Jennifer, the Nurse Practitioner, is seeing Mr. Johns, a 65 year old male in the clinic today with c/o Arthritis pain. What is a serious side effect of ibuprofen use in the older adult patient? Rebound headaches Neuropathy Pancreatic failure Impairment of renal function

impairment of renal function

Phenytoin decreases folic acid absorption by altering in the pH of the stomach Increasing gastric emptying time Inhibiting intestinal enzymes require for folic acid absorption Chelation of the folic acid into inactive ingredients

inhibiting intestinal enzymes require for folic acid absorption

Which of the following oral agents has the most rapid analgesic onset Naproxen (Naprosyn) Liquid ibuprofen (Motrin, Advil) Diclofenac (Voltaren) Enteric coated naproxen (Naproxen EC)

liquid ibuprofen (motrin, advil)

A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is perspiring, and her blood pressure is 88/50. The serum magnesium level is 10 mg/dL. The nurse will interpret these manifestations as common adverse effects of magnesium sulfate magnesium sulfate toxicity a hypersensitivity reaction to magnesium sulfate an idiosyncratic reaction from the magnesium sulfate

magnesium sulfate toxicity

A Nurse Practitioner is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that he or she is taking an oral form of methamphetamine cocaine marijuana nicotine

marijuana

A 38-year-old pregnant patient admits to the Nurse Practitioner that she is an alcoholic and has been consuming alcohol during her pregnancy. The nurse knows that using alcohol during pregnancy may result in a child who presents with a high-pitched cry microcephaly an electrolyte imbalance thrombocytopenia

microcephaly

A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse will monitor the site of injection monitor the patient for bleeding gums continue therapy until 2 days after symptoms have resolved administer the medication with small amounts of food and fluids

monitor the patient for bleeding gums

Which of the following would a Nurse Practitioner assess for in a patient who is taking polymyxin B systemically? Peripheral neuropathy Nephrotoxicity and hepatotoxicity Hyperkalemia and hyponatremia Endocarditis and hypertension

nephrotoxicity and hepatotoxicity

A Nurse Practitioner is having difficulty administering a bitter drug to a 5-year-old child. The nurse should have the parent gently force the child's mouth open give the drug in a pill form involve the child in a play therapy session, and then tell the child that the medicine is candy offer the child a flavored ice chip or ice pop prior to administering the drug

offer the child a flavored ice chip or ice pop prior to administering the drug

A nurse practitioner orders 150 mg of oral fluconazole for a patient with vulvovaginal candidiasis. The patient should expect to take medication every day until the infection is gone once a day for 30 days for 20 days

once a day

A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause

orange-tinged urine, staining of permanent teeth, sleep deprivation, deep muscle pain

A 39-year-old woman is receiving doxorubicin for the treatment of cancer. After each treatment, the patient has acute nausea and vomiting accompanied by a slightly increased heart rate. The nurse will advise her to

perform relaxation techniques after the treatments

A patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are considered taboo inappropriate phytoestrogens monotherapy

phytoestrogens

A 15-year-old patient has meningitis caused by Haemophilus influenzae. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitor blood sugar levels daily. liver enzymes monthly. plasma concentrations regularly. urine output daily

plasma concentrations regularly

A male patient is trying to decide if he should use finasteride (Proscar) to treat benign prostatic hypertrophy (BPH). When providing information about the drug, the nurse will include which of the following as a risk associated with finasteride therapy? Excess fluid volume related to potential effects of drug therapy Hypercalcemia related to drug therapy, immobility, and breast cancer Sexual dysfunction related to erectile dysfunction Prostatic neoplasia

prostatic neoplasia

A 67-year-old man who is being treated for prostate cancer is taking epoetin alfa. The nurse will instruct the patient to stop taking the drug after a 2-week period. schedule an appointment to measure hemoglobin twice a week for at least 2 to 6 weeks schedule an appointment to check if the patient has a high WBC count begin taking a calcium channel blocker to treat hypertension, which usually develops as an adverse effect of epoetin alfa therapy

schedule an appointment to measure hemoglobin twice a week for at least 2 to 6 weeks

Which of the following drugs is most likely to cause sexual dysfunction and males? Selective serotonin reuptake inhibitors Angiotensin converting enzyme inhibitors Atypical antidepressants Amphetamines

selective serotonin reuptake inhibitors

Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain and burning during the infusion by slowing the infusion decreasing the volume used for dilution decreasing the total volume of the primary IV infusion administering a dose of 2 units of bleomycin before carmustine

slowing the infusion

A child is taking permethrin for head lice. The Nurse Practitioner will instruct her mother to wash her hair daily with a good shampoo increase her daily intake of milk maximize the child's fluid intake stop using creams, ointments, and oils on the child's skin and scalp

stop using creams, ointments, and oils on the child's skin and scalp

Finasteride (Proscar) is prescribed for a 50-year-old man who is experiencing a problem with urination secondary to an enlarged prostate. The practitioner would teach the patient that while he is taking this medication, it is important to: Increase his fluid intake. Restrain from sexual activity Take special precautions around women of childbearing age Begin folic acid

take special precautions around women of childbearing age

A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to take the vitamins at least 2 hours before or after taking ciprofloxacin. alternate the dosage of ciprofloxacin and vitamin supplements reduce the dosage of vitamin supplements reduce the dosage of vitamin supplements and double the dosage of ciprofloxacin

take the vitamins at least 2 hours before or after taking ciprofloxacin

A female patient is taking filgrastim (Neupogen) to decrease the incidence of infection. The nurse notices a small increase in the neutrophil count 2 days after starting therapy. The nurse's evaluation of the increase is that

the increase in the neutrophil count is only transient

A 30-year-old African-American woman tested positive for ...and is prescribed ... The nurse will plan the patient's care to include close monitoring of the drug therapy because

the patient is at greater risk for high serum levels of the drug

The NP has just placed Mr. Johnson on a selective serotonin reuptake inhibitor. What symptoms should be reviewed with the patient who is newly prescribed this class of medication? They will no longer have dreams they could feel a bit of nausea, but this will resolve in about a week or so They Will have excessive flatus They may have insomnia but only for about a week

they may have insomnia but only for about a week

A 19-year-old patient reports to a clinic with vaginal discharge with a foul odor. A microscopic exam reveals trichomonas vaginalis. The nurse practitioner is aware that asymptomatic women are diagnosed with trichomoniasis by a routine pap smear trichomoniasis is an incurable disease trichomoniasis discharge is typically thin and clear it is unusual to have an odor with trichomoniasis

trichomoniasis by a routine pap smear

An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with ciprofloxacin clindamycin vancomycin an antistaphylococcic penicillin

vancomycin

A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the APRN is responsible for facilitating this new aspect of the patient's drug regimen. This will involve the administration of weekly subcutaneous injections daily, oral administration weekly administration of an enteric coated tablet daily, outpatient intravenous therapy

weekly subcutaneous injections

A child with chronic allergic symptoms uses an intranasal steroid for control of symptoms. At this child's annual well-child checkup, the NP should carefully review what? blood pressure weight and height liver function tests urinalysis

weight and height

Steady state is: The point on the drug concentration current absorption exceeds excretion With the amount of drug in the body stays below the minimum toxic concentration (MTC) When the amount of drug in the body remains constant All of the above

when the amount of drug in the body remains constant

A Nurse Practitioner is working with a 16-year-old pregnant teen and assessing for behavior that may put the baby at risk. The most important assessment the nurse can make is whether the pregnant woman uses illegal substances whether the pregnant woman has health insurance the pregnant woman's exercise habits the pregnant woman's dietary habits

whether the pregnant woman uses illegal substances