ALL PREPU QUESTIONS

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The nurse has just begun administering phenobarbital intravenously to a child within status epilepticus. The nurse would expect this drug to begin working within which time frame? 60 seconds 5 minutes 15 to 20 minutes The time frame depends on the child's body surface area

5 minutes

The nurse is preparing to administer filgrastim intravenously (IV) to a patient. What solution would the nurse mix the medication in prior to administration? Dextrose and 1/2 normal saline Normal saline Lactated Ringer's solution. 5% dextrose in water (D5W)

5% dextrose in water (D5W)

A nurse is talking to a group of families from the local nursing home about Alzheimer's disease (AD). Approximately how many people in the United States are diagnosed with AD? 5,400 5.4 billion 5.4 million 540,000

5.4 million

A 69-year-old male is diagnosed with hypogonadism, and the physician orders testosterone. The patient is found to have hypertension on assessment by the nurse. What is this patient at increased risk for? Liver failure Aggravated cardiovascular disorders Kidney failure Impotence

Aggravated cardiovascular disorders

A pregnant woman who has had no prenatal care delivers an infant with significant physical malformations and microcephaly. What substance does the nurse question the patient about using during the pregnancy? Alcohol Opiates Benzodiazepines Marijuana

Alcohol

The patient with chronic renal failure requires an agent to increase red blood cell production. What drug does the nurse anticipate administering? Thrombopoetin Filgrastim Oprelvekin Epoetin alfa

Epoetin alfa

A patient has been prescribed epoetin alfa. In reviewing this patient's history, what would the nurse know contraindicates the use of epoetin alfa? Irritable bowel syndrome Asthma Hypertension Shortness of breath

Hypertension

A client is seen in the emergency department for third-degree burns over 50% of his body. The nurse knows that this client is experiencing what type of shock due to fluid loss? Hypovolemic shock Cardiogenic shock Septic shock Anaphylactic shock

Hypovolemic shock

Which CNS stimulant is used in the treatment of obesity? Methylphenidate (Concerta) Dexmethylphenidate (Focalin) Phentermine (Adipex-P) Modafinil (Provigil)

Phentermine (Adipex-P)

Your client informs you that she has been taking a muscle relaxant. She tells you that she has noted a change in urine color to dark green. You know that the medication she most likely taking is: Soma. Robaxin. Skelaxin. Flexeril.

Robaxin.

Your patient, a 24-year-old woman who is at 23 weeks of gestation, is concerned that her asthma medication is not as effective as it normally is. What might be the cause of the change? Temporary pharmacokinetic changes Effects of prolactin Increased weight Ingestion by the fetus

Temporary pharmacokinetic changes

A client's seizure activity, which is isolated to facial and neck muscles, has been identified as being caused by one area of the client's brain. The nurse should anticipate the administration of what drug? Gabapentin (Neurontin) Carbamazepine (Tegretol) Clorazepate (Tranxene) Felbamate (Felbatol)

Carbamazepine (Tegretol)

Diabetes insipidus is treated with replacement of which hormones? Adrenocorticotropic hormone (ACTH) Somatropin Vasopressin Gonadotropin

Vasopressin Diabetes insipidus is treated with replacement of vasopressin.

What is an adverse effect caused by all uterine stimulants because of their antidiuretic effect? Dehydration Polydipsia Hypotension Water intoxication

Water intoxication

A 11-year-old client has been hospitalized on the adolescent psychiatry unit with severe depression. For the past several weeks, the client has been prescribed a selective serotonin reuptake inhibitor (SSRI). What is the priority nursing action? Assess for weight loss and difficulty sleeping. Monitor the client for migraines. Monitor food intake and eliminate potential sources of tyramine. Implement suicide precautions.

Implement suicide precautions.

The nurse is assessing a client who was prescribed levodopa one week earlier. What change in the client's status would suggest the effectiveness of drug therapy? Stability of mood Improved attention span Slower chewing of food Improvement in handwriting

Improvement in handwriting

Which agent would the nurse identify as also being used to treat tetanus? Tizanidine Methocarbamol Orphenadrine Metaxolone

Methocarbamol

A hospice patient is receiving opioids for treatment of cancer pain. Which laxative will assist in the prevention of constipation? Saline Stimulant Lactulose (Cephulac) Bulk-forming

Lactulose (Cephulac)

During stage 1 of anesthesia, which occurs? Loss of vasomotor center stimuli Consciousness Combative behavior Loss of pain sensation Inability to communicate

Loss of pain sensation Consciousness

The nurse is administering regular insulin (Novolog) using a weight-based protocol. The nurse administers the insulin by using calculations performed by the: hospital pharmacist. computer system. health care prescriber. nurse with verification by a second nurse.

nurse with verification by a second nurse.

A nurse has viewed a bulletin from the FDA that has been posted in a children's hospital. The bulletin includes a warning about potentially adverse effects of a drug that has been used safely in adults. Differences between the effects of a drug in children and the effects of the same drug in adults reflect what aspect of pharmacotherapy? differences in pharmacodynamics in children differences in drug administration in children differences in drug adherence among children differences in drug absorption in children

differences in pharmacodynamics in children

What medication should not be given with zidovudine because of the risk of life-threatening hematologic toxicity? Rifampin Ganciclovir Interferon beta-1b Valproic acid

Ganciclovir

The physician has ordered a medication for the patient with hyperemesis gravidarum. It is an anti-emetic drug that promotes gastric emptying and promotes peristalsis. Which drug does the nurse administer? Dramamine Metoclopramide (Reglan) Meclizine Diphenhydramine (Benadryl)

Metoclopramide (Reglan)

Why are selective serotonin reuptake inhibitors considered the first line of drug therapy for patients with depression? The medications have no sexual side effects. The medications have fewer anticholinergic effects than alternatives. The medications eliminate the risk of suicide during treatment. The onset of action is sooner than with other medications.

The medications have fewer anticholinergic effects than alternatives.

The nurse is administering etanercept (Enbrel). Which administration technique would be considered appropriate? The nurse administers the medication subcutaneously weekly. The nurse administers the medication topically on the abdomen. The nurse administers the medication IV. The nurse administers the medication orally with other drugs.

The nurse administers the medication subcutaneously weekly.

A nurse has noted that an older adult patient on an acute care for elders (ACE) unit has an exceptionally lengthy medication administration record. The nurse has alerted the pharmacist because one of the patient's long-standing medications appears on the Beers list. What medication is the nurse likely addressing? Vitamin D Metoprolol (Lopressor) Digoxin (Lanoxin) Low-dose enteric-coated ASA

Digoxin (Lanoxin)

A client has been treated with abacavir for the past 6 weeks. The client contacts the physician's office with reports of diarrhea, abdominal pain, sore throat, cough, and shortness of breath. Which is the appropriate action to take for this situation? Reduce the dose. Discontinue the therapy. Discontinue the therapy and then reintroduce it. Administer the drug at bedtime.

Discontinue the therapy.

Which signs may be observed by the nurse in a patient receiving an underdosage of edrophonium (Tensilon) for myasthenia gravis? Muscle spasms Drooping of the eyelids Jaw clenching Excessive salivation

Drooping of the eyelids

A patient is administered cyclobenzaprine (Flexeril). Which adverse effect can the nurse expect with this medication? Insomnia Muscle spasms Urinary incontinence Drowsiness

Drowsiness

Prior to surgery, the nurse will review the client's chart and ensure that the surgeon and anesthesiologist are aware of what client issues? (Select all that apply.) Drug allergies Drug idiosyncrasies Abnormal lab values Client's occupation Names of significant others

Drug allergies Drug idiosyncrasies Abnormal lab values

A client with renal cancer is prescribed aldesleukin. What action should then nurse perform? Assess whether the client can sit upright after taking oral medications Ensure that the client is able to adhere to the prescribed treatment Assess the integrity of the client's oral mucosa Ensure the client has adequate intravenous access

Ensure the client has adequate intravenous access

The nurse is educating a patient who has been prescribed atropine, an anticholinergic drug. Which instructions should the nurse provide to the patient? "Increase your fluid intake and activity level." "If you experience eye pain, contact the physician about increasing the dosage." "Do not drive or operate machinery." "Take long, hot showers frequently to relieve uncomfortable side effects."

"Do not drive or operate machinery."

Which statement indicates a client understands the management of care after a thyroidectomy? "I should call my primary care provider when I experience hyperthyroid symptoms." "The scar on my chest should heal completely in 4-6 weeks." "Radioactive iodine treatments will be weekly until my thyroid shrinks completely." "I will have to take thyroid hormones for the rest of my life."

"I will have to take thyroid hormones for the rest of my life."

The nurse is discussing estrogen therapy with a woman age 52 years. What information will the nurse share with this client regarding estrogen's benefit to the cardiac system? "Low-dose estrogen in women under the age of 60 may be beneficial to the cardiac system." "High-dose estrogen in women under the age of 60 will reverse the effects of aging in the heart." "Estrogen therapy has shown no benefit to the cardiac system." "Estrogen therapy is only beneficial to the cardiac system if it is started before age 50."

"Low-dose estrogen in women under the age of 60 may be beneficial to the cardiac system."

A patient having chemotherapy is losing her hair. She asks the nurse if her hair will come back as it originally was. What is the best response by the nurse? "Your hair may not grow back, but we can refer you to a wig specialist." "Your hair will grow back, but the new hair may be a different color or texture." "I think you have more to worry about than if you have hair. You can buy a wig." "Your hair will grow back, but it will be very thin and straight."

"Your hair will grow back, but the new hair may be a different color or texture."

A nurse is reviewing a client's serum lithium level. Which finding would indicate that the client is experiencing lithium toxicity? 0.6 mEq/L 1.2 mEq/L 0.8 mEq/L 1.8 mEq/L

1.8 mEq/L

A pediatric client is admitted to the hospital. The nurse weighs the client and expresses the weight as: 22.2 pounds. 10,136 grams. 22 pounds 3 ounces. 10.1 kilograms.

10.1 kilograms.

The nurse is caring for a client who is prescribed haloperidol long term. What assessment should the nurse prioritize? Assessment for involuntary movements Assessment of the client's skin integrity Monitoring the client's white cell differential Monitoring the client's CD4 T-cell count

Assessment for involuntary movements

Which drug is used to reverse an overdose of cholinergic drugs? Atropine Norepinephrine Epinephrine Dopamine

Atropine

A patient is brought to the Emergency Department having a cholinergic reaction, which includes a severe drop in blood pressure. What drug will the nurse expect to administer? Edrophonium (Tensilon) Succinylcholine (Anectine) Atropine (Generic) Propranolol (Inderal)

Atropine (Generic)

A patient is brought to the Emergency Department having a cholinergic reaction, which includes a severe drop in blood pressure. What drug will the nurse expect to administer? Propranolol (Inderal) Atropine (Generic) Edrophonium (Tensilon) Succinylcholine (Anectine)

Atropine (Generic)

Many of the immunosuppressant drugs that are administered following organ transplantation may also be used for treatment of what condition? Seizure disorder Increased intracranial pressure Autoimmune disorder AIDS

Autoimmune disorder

When growth in a child is impaired by a deficiency of endogenous growth hormone, somatropin may be prescribed. When in the period of growth and development must somatropin (Humatrope) be administered to children? Before the start of elementary school Can be started anytime Before epiphyses closure By 8 years of age

Before epiphyses closure

What represents the parts of the central nervous system (CNS)? Autonomic nerves Spinal cord Brain Efferent nerves Afferent nerves

Brain Spinal cord

The nurse is aware that which medication will be used in the provision of local infiltrate anesthesia? Glycopyrrolate (Robinol) Secobarbital (Seconal) Bupivacaine (Marcaine) Diazepam (Valium)

Bupivacaine (Marcaine)

A nurse is caring for a patient undergoing glaucoma treatment. The nurse knows that which of the following combinations of drugs need to be administered to the patient to produce an additive effect on the treatment? Atropine and carbachol Corticosteroids and atropine Carbachol and pilocarpine Pilocarpine and atropine

Carbachol and pilocarpine

A 25-year-old woman with rheumatoid arthritis is being treated with acetaminophen and salicylates. The physician has switched her medication regimen to include DMARDs. What is the advantage of DMARDs over salicylates? DMARDs control the symptoms of rheumatoid arthritis. DMARDs can arrest the progression of rheumatoid arthritis. DMARDs have a lower risk of adverse effects. DMARDs are more effective with a lower dose.

DMARDs can arrest the progression of rheumatoid arthritis.

A patient develops malignant hyperthermia after receiving a NMJ blocker? Which would the nurse expect to be given? Naloxone Succinylcholine Protamine sulfate Dantrolene

Dantrolene

A 4-year-old is tested and found to have deficient GH. What does this condition cause in children? Acromegaly Miniaturism Gigantism Dwarfism

Dwarfism

In which organ are the majority of beta-adrenergic receptors found? (Choose one) Kidney Liver Brain Heart

Heart

A nurse should review a client's medical conditions prior to administering a dantrolene (Dantrium) as its use is contraindicated in clients with which issues? (Select all that apply.) Hypertension Diabetes Atrial fibrillation Hepatic disease Lactation

Hepatic disease Lactation

A client with diabetes has started thyroid hormone replacement therapy. The nurse should monitor closely for which effects? Decreased oral fluid intake Oliguria Hot, dry skin Decreased appetite

Hot, dry skin The client with diabetes who begins thyroid replacement hormones should be monitored closely for signs of hyperglycemia: increased thirst, increased hunger, polyuria (increased urine output) and hot, dry skin.

A patient with bladder cancer is to have intravesicular instillation of a chemotherapeutic agent into the bladder. What is a priority intervention of the oncology nurse? Attache the tubing to suction. Insert a Foley catheter. Keep the catheter unclamped. Assist the physician to place a thoracotomy tube.

Insert a Foley catheter.

What intervention will the nurse caring for a patient receiving cancer treatment with high doses of cyclophosphamide (Cytoxan) implement to prevent hemorrhagic cystitis? Provide increased protein intake. Monitor daily BUN. Maintain daily fluid intake of 2 to 3 L. Encourage moderate exercise.

Maintain daily fluid intake of 2 to 3 L.

For which chemotherapeutic medication should patients be monitored for abnormal liver function? Leuprolide (Lupron) Nilutamide (Nilandron) Estradiol (Estinyl) Femara (Letrozole)

Nilutamide (Nilandron) heavily metabolized in the liver

A nurse is preparing to administer fludrocortisone. The nurse would administer the drug by which route? Inhalation Intramuscular Subcutaneous Oral

Oral

A patient with dementia of Alzheimer's disease is prescribed rivastigmine by the primary health care provider. Which is the correct method of administering rivastigmine to the patient? Orally Subcutaneously Intramuscularly Intravenously

Orally

A postmenopausal woman is administered estradiol (Estraderm). What condition will be prevented in this patient? Uterine cancer Osteoporosis Amenorrhea Endometriosis

Osteoporosis

Estradiol is sometimes administered to postmenopausal women to prevent which condition? Osteoporosis Dysfunctional uterine bleeding Endometriosis Uterine cancer

Osteoporosis

A patient with breast cancer being treated with tamoxifin is also taking the oral anticoagulant coumadin for chronic atrial fibrillation. What is important to monitor in this patient? White blood count Liver enzymes Prothrombin time Blood urea nitrogen and creatinine levels

Prothrombin time

The nurse is preparing to admit a client who has received conscious sedation. What is the most important vital sign to assess when the client returns from the procedure? Respirations Blood pressure Temperature Pulse

Respirations

A 21 year-old male client is distraught about the implications of his recent diagnosis of seizure activity. When addressing this client's most likely psychosocial needs, what topic should the nurse address? Loss of libido and sexual performance The client's loss of his driver's license The consequences of needing bed rest during stressful times The consequences of quitting college

The client's loss of his driver's license

A client is prescribed Lugol's solution for the treatment of hyperthyroidism. Which is the mechanism of action of this medication? The drug causes decreased levels of T3 in the body. The drug increases the levels of thyroxin. The drug inhibits the release of thyroid-stimulating hormone. The drug causes the thyroid gland to decrease the production of thyroxin.

The drug inhibits the release of thyroid-stimulating hormone.

During an operation where the patient has been given isoflurane, the nurse has been asked to frequently change carbon dioxide adsorbents. Why is this necessary? To minimize the risk of nephrotoxicity To minimize the incidence of spontaneous abortions, birth defects, and stillbirths To minimize the risk of adverse effects such as shivering and tremor To minimize the risk of carboxyhemoglobinemia

To minimize the risk of carboxyhemoglobinemia

Anabolic steroids are analogs of testosterone with increased protein-building effects. False True

True

A patient, newly diagnosed with a seizure disorder, asks the nurse why they are receiving a specific drug. What would be the best answer by the nurse? Different drugs work differently in different people. When prescribing an AED, the physician takes into account the type of seizure the patient is having. Different drugs are more effective in certain people than other drugs are. When prescribing an AED, the physician takes into account the age and gender of the patient.

When prescribing an AED, the physician takes into account the type of seizure the patient is having.

A patient with acute lymphoblastic leukemia (ALL) is receiving imatinib on an inpatient basis. When planning the care of this patient, what assessment should be specified in the patient's plan of nursing care? daily weights assessment of deep tendon reflexes bilateral blood pressures pupillary response

daily weights

The home care nurse is caring for an 80-year-old patient who is receiving carbidopa-levodopa, a dopaminergic drug used to treat Parkinson's disease. The nurse knows that this drug may place the patient at increased risk for: excessive sedation. infection. falls. uncontrolled bleeding.

falls.

When describing thyroid function, the nurse would emphasize the need for intake of: calcium. sodium. iodine. vitamin B6.

iodine

The lower the client's viral load, the: shorter the time to AIDS diagnosis. shorter the survival time. longer the time immunity. longer the survival time.

longer the survival time.

A mother brings her child to the clinic and informs the physician that he is having a difficult time paying attention in school, seems to be getting in trouble several times a day, and is acting very impulsive. The nurse can expect the physician to order which of the following drugs for this patient? methylphenidate modafinil armodafinil diethylpropion

methylphenidate

A client has been diagnosed with cardiovascular disorder. The client is age 68; suffers from intermittent joint pain and is under drug therapy; eats meat, salads, and fruits; prefers alternative herb medications along with drug therapy; sometimes smokes; he lives alone and is looked after by a caregiver. Which item of information has the greatest implication for planning his drug therapy? sometimes smokes age of 68 lives alone prefers alternative herb medications

prefers alternative herb medications

Sotalol is a Class III antidysrhythmic drug with both beta-adrenergic-blocking and potassium channel-blocking activity. Use of sotalol is contraindicated in patients with colitis. sinus bradycardia. cataracts. renal impairment.

sinus bradycardia.

A nurse is caring for a patient who has received carbidopa/levodopa. After administration of the first dose of the drug, the patient has developed gastrointestinal disturbances. Which nursing intervention should the nurse perform when caring for this patient? Administer the next drug dose with meals. Administer the next drug dose with milk. Observe alterations in blood pressure. Withhold the next dose of the drug.

Administer the next drug dose with meals.

The mature red blood cell contains a nucleus. False True

False

The client is experiencing digitalis toxicity and presents with symptomatic bradycardia. The nurse knows that which medication may be administered to treat bradycardia? Milrinone Lasix Atropine Norvasc

Atropine

A patient has atony of the smooth muscle of the gastrointestinal tract. Which type of medication will be administered to increase smooth muscle strength? Muscle relaxants Anticholinergic drugs Cholinergic drugs Selective serotonin reuptake inhibitors

Cholinergic drugs

A patient has been receiving bethanechol (Urecholine) for 1 week. One hour after the dose is administered, the patient develops sweating, flushing, abdominal cramps, and nausea. What is the rationale for the development of these symptoms? Pulmonary edema Myasthenic crisis Anaphylactic reaction Cholinergic overdose

Cholinergic overdose

The nurse gives a 68-year-old client diphenhydramine to help the client sleep the night before surgery. At midnight, the nurse notes the client is awake and agitated. What pharmacologic principle would be the cause of this reaction? paradoxical excitement, which is the opposite reaction than what was expected pronounced effect from the medication due to the inability of the blood-brain barrier to work effectively medication error; the nurse actually gave the wrong medication delayed onset of action due to decreased distribution of the medication

paradoxical excitement, which is the opposite reaction than what was expected

The older client forgets to take medications as prescribed throughout the day. The client has medications prescribed several times each day. The nurse best aids the client to take medication by instructing the client to: line the medication containers on the kitchen counter. place medications in a pill box labeled by mealtime. post a sign on the bathroom mirror reminding of the administration times. obtain a pill box for the week.

place medications in a pill box labeled by mealtime.

The nurse is to administer 10 drops of an oral liquid medication to an infant with a poor sucking reflex. The best way to administer the medication and ensure the medication will be swallowed is by: adding the drops to the infant's formula. mixing the drops in a small amount of fluid. putting the drops in a bottle nipple. placing the drops in the buccal pouch.

placing the drops in the buccal pouch.

Adverse effects of dantrolene (Dantrium) include: potentially fatal hepatitis. severe anemia. incoordination and hypotension. hypoglycemia and hemolytic anemia.

potentially fatal hepatitis.

The client is a 5-year-old child prescribed a bitter-tasting liquid medication. To best aid in having the child take the medication, the nurse: places the medication in a medicine cup instead of oral syringe provides a flavored ice pop (Popsicle) first mixes the medication in applesauce offers the child a choice about times to take the medication

provides a flavored ice pop (Popsicle) first numbs the taste buds

The clinic nurse is to administer a vaccine by the intramuscular route to an infant. Which muscle site may the nurse choose to administer this medication? (Select all that apply.) deltoid rectus femoris ventrogluteal dorsogluteal vastus lateralis

rectus femoris vastus lateralis

An elderly client has been prescribed phenobarbital for seizure control. What unusual effects of the drug should the nurse monitor in the elderly client? Slurred speech Excessive sweating Marked excitement Excessive fatigue

Marked excitement

A patient with severe spasticity sees their physician. The physician orders dantrolene. In what circumstances is the drug dantrolene contraindicated? Spasticity that contributes to upright position, which would be lost if that spasticity were blocked Spasticity that involves both legs Spasticity the involves the arm and the leg on the same side Spasticity that involves the arm and the leg on opposite sides

Spasticity that contributes to upright position, which would be lost if that spasticity were blocked

A patient is prescribed daily doses of phenytoin for seizures. The nurse knows that a single dose should not be missed during the course of treatment. Which condition could result if a dose is missed? Status epilepticus Nystagmus CNS depression Hypotension

Status epilepticus

An HIV-positive patient is being treated for hypothyroidism with levothyroxine. The patient is also taking saquinavir therapy for HIV. Which clinical manifestations by the patient should the nurse be concerned about? Constipation, lethargy, abdominal discomfort Nausea, vomiting, headache Bradycardia, intolerance to cold, weight gain Tachycardia, intolerance to heat, weight loss

Tachycardia, intolerance to heat, weight loss

When focusing on the lifestyle of the patient with HIV, what are important teaching considerations? (Select all that apply.) No blood test will need to be done while on therapy. Advise the patient about the adverse effect of granulocytopenia. Take drug therapy as prescribed. Transmission can occur while on medication.

Take drug therapy as prescribed. Transmission can occur while on medication. Advise the patient about the adverse effect of granulocytopenia.

The home health nurse is making a plan of care for a new patient who is taking oral prednisolone. What suggestion may decrease the nausea related to oral administration of prednisolone? Take before bedtime Take with a meal Take on an empty stomach Split the dose into two equal doses

Take with a meal

A postmenopausal woman with breast cancer will most likely be treated with which anti-estrogen drug? Bleomycin Cyclophosphamide Cisplatin Tamoxifen

Tamoxifen

A client asks the nurse what cancer cell growth is called. What would the nurse tell the client? pleomorphism neoplasm anaplasia proliferation

proliferation

While discussing the use of laxatives a student, asks the nursing instructor what the best indication of normal bowel elimination is. What would be the best response by the instructor? "One bowel movement daily after dinner." "A semi-formed stool." "A soft, formed stool." "One bowel movement daily in the morning."

"A soft, formed stool."

A client asks the nurse dopamine is. What is a correct response by the nurse? "Dopamine is a neurotransmitter that deals with pleasure and reward in the brain." "Dopamine is an enzyme that regulates your temperature." "Dopamine is a part of the brain that controls your impulses and thoughts." "Dopamine is a medication that is given to fight infections and help with pain."

"Dopamine is a neurotransmitter that deals with pleasure and reward in the brain."

A 72-year-old male is newly diagnosed with Alzheimer's disease. The patient's daughter asks the nurse how her father's medication is going to help him. What would be the nurse's best response? "The drugs work by crossing the blood-brain barrier and decreasing ACh levels in the brain." "The drugs work by crossing the blood-brain barrier and decreasing ACh levels in the neuromuscular junctions." "The drugs work by increasing ACh levels in the brain and slowing the progression of the disease." "The drugs work by decreasing ACh levels in the brain and slowing the progression of the disease."

"The drugs work by increasing ACh levels in the brain and slowing the progression of the disease."

Which of the following patients has the greatest potential to benefit from treatment with rituximab? A lifelong smoker who has been diagnosed with non-small cell lung cancer A woman who has been diagnosed with ductal carcinoma in situ A man with AIDS who is currently being treated for Kaposi's sarcoma A woman who has chronic lymphocytic leukemia

A woman who has chronic lymphocytic leukemia

The nurse instructs a client to use benzocaine to soothe the itching and pain related to an insect bite. Benzocaine is considered to be what type of dermatologic agent? Pain relief Antiseptic Anesthetic Soothing

Anesthetic

A patient has been involved in a motor vehicle accident. Which hormone will be released in response to the patient's blood loss? Oxytocin Luteinizing hormone (LH) Melanocyte-stimulating hormone Antidiuretic hormone (ADH)

Antidiuretic hormone (ADH)

Which medications are prescribed for mild dementia? (Select all that apply.) Namenda Aricept Celexa Exelon Razadyne

Aricept Razadyne Exelon

A patient is admitted to the unit with central spasticity after a severe motor vehicle accident. The doctor plans on placing an intrathecal delivery pump for what medication to treat the central spasticity? Baclofen Flexeril Soma Dantrolene

Baclofen

The labor and delivery nurse is preparing to give pitocin to a patient to induce labor. Which of the following should be the most cause for concern for the nurse if the patient starts to exhibit it? Slight change in comfort level Statement by the patient that she just wants it to be over Nausea without vomiting Big change in blood pressure

Big change in blood pressure

Quinidine is prescribed to a patient with cardiac arrhythmia. When documenting the patient's drug history, the nurse inquires about the concomitant use of any other drug. Which drug when given concomitantly may cause an increase in serum Quinidine levels? Hydantoins Cimetidine Barbiturates Nifedipine

Cimetidine

A pregnant woman is diagnosed with a deep vein thrombosis in her left lower extremity. Which medication does the nurse anticipate administering to this patient? Coumadin Plavix Aspirin Heparin

Heparin

Which is the drug of choice in the treatment of status epilepticus, an emergency characterized continual seizure activity with no interruptions? Trimethadione (Tridione) Lorazepam (Ativan) Methsuximide (Celontin) Levetiracetam (Keppra)

Lorazepam (Ativan)

A patient with advanced-stage Alzheimer's disease is seen by a physician who prescribes a newer drug that is not a cholinesterase inhibitor. This drug is a N-methyl-D-asparate (NMDA) receptor antagonist. This drug is better known as: Aricept Namenda Exelon Cognex

Namenda

A 31-year-old pregnant woman has been prescribed administration of a tocolytic drug. During which period is a tocolytic drug usually administered? Postpartum Pre-term labor Second stage of labor Antepartum

Pre-term labor

The nurse is providing client education for a client newly prescribed a hydantoin antiseizure medication. The nurse has taught the client about the need to taper down the dose of the drug slowly when the provider decides it should be discontinued. What benefit of tapering should the nurse describe? Reduced risk of status epilepticus Reduced risk of cardiac dysrhythmias Shorter duration of absence seizures Improved blood pressure stability

Reduced risk of status epilepticus

A nursing student is failing chemistry class. The student is about to take the final examination and feels very nervous. Which action increases the rate of cortisol release? Negative feedback mechanism Atrophy of the adrenal cortex Release of epinephrine and norepinephrine Stimulation of the hypothalamus

Release of epinephrine and norepinephrine

The circulating nurse in the operating room knows that which stage of anesthesia is most dangerous to the client? Stage I Stage IV Stage III Stage II

Stage IV

A patient who has been diagnosed with Parkinson's disease was prescribed levodopa. The patient did not tolerate the administration of levodopa. Which of the following medications will be administered in place of the levodopa? Nafcillin sodium (Nafcil) Carbamazepine (Apo-Carbamazepine) Guanadrel sulfate (Hylorel) Benztropine (Cogentin)

Benztropine (Cogentin)

As part of a preconception class, the nurse stresses which time period the fetus is the most venerable to teratogenic agents? First trimester Entire gestational period Third trimester Second trimester

First trimester

After teaching a group of students about indirect acting cholinergic agonists used to treat myasthenia gravis, the instructor determines that the teaching was effective when the students identify which agent? Rivastigmine Neostigmine Tacrine Galantamine

Neostigmine

A client taking allopurinol exhibits an "itchy" skin rash on the neck and both arms. What is the nurse's top priority action? Document the finding as a common side effect. Apply a moisturizing lotion. Recommend the client trim fingernails. Notify the health care provider.

Notify the health care provider.

A client is prescribed methsuximide. The nurse should expect to administer this drug by which route? Oral Rectal Intramuscular Intravenous

Oral

What would the nurse teach the patient to monitor for when beginning an antidysrhythmic drug regimen? Gastric upset Diarrhea Dry mouth Syncope

Syncope

The nurse should monitor for which effect of drug interaction in a client taking thyroid hormones and a beta blocker? Hypoglycemia Tachycardia Visual changes Prolonged bleeding

Tachycardia Beta blockers and thyroid hormones interact, leading to decreased effectiveness of the beta blocker (i.e., cardiac drug, adrenergic blocker). Hypoglycemia may occur when thyroid hormones are taken with oral antidiabetic agents and insulin. Prolonged bleeding can occur when thyroid hormones and oral anticoagulants are taken together. Visual changes do not occur when beta blockers are taken with thyroid hormones.

The use of levodopa may interfere with which of the following test? (Choose one) Test for nitrites in the urine Test for leukocytes in the urine Tests for ketones in the urine Test for protein in the urine

Tests for ketones in the urine

A patient's physician has prescribed baclofen in an effort to treat the patient's neuropathic cancer pain. What patient education should the nurse prioritize when teaching the patient about this new medication? The importance of maintaining a sterile central venous catheter The need to maintain a diet that is high in iron and folic acid The importance of ensuring safety related to possible sedation The importance of regularly scheduled liver function testing

The importance of ensuring safety related to possible sedation

The nurse is administering a medication to a child. The nurse withholds the medication and obtains the data when the chart lacks the child's: body surface area. weight. vital signs within 4 hours. height.

based on the body surface area

The nurse is preparing to administer a medication to a pediatric client but does not see a child dose specified. How can a correct dose be determined from the adult dose? based on the water content of the child based on the child's age based on the weight of the child based on the body surface area

based on the body surface area

Which patient is most at risk for adverse effects from disease modifying anti-rheumatic drugs (DMARDs)? The patient with hepatic insufficiency The patient with supraventricular tachycardia The patient with chronic constipation The patient with joint pain

The patient with hepatic insufficiency

The nurse in the delivery room administers carboprost for which of the following reasons? To prevent hemorrhage caused by uterine atony To decrease the duration of contractions To prevent contractions To decrease the incidence of contractions

To prevent hemorrhage caused by uterine atony

Which treatment would be appropriate for a patient with breast cancer and an HER2-expressing tumor? Abciximab (ReoPro) Panitumumab (Vectibix) Ofatumumab (Arzerra) Trastuzamab (Herceptin)

Trastuzamab (Herceptin)

Terbutaline has been used to halt the contractions associated with preterm labor. True False

True

After teaching a client who is prescribed isocarboxazid, the nurse determines that additional teaching is needed when the client states a need to avoid what food? red wine. Parmesan cheese sausage. whole milk.

whole milk.

A 10-year-old child is being administered CNS stimulants for ADHD. What should the nurse instruct the parents to record periodically? Sleeping pattern Social interaction Voiding pattern Weight and growth

Weight and growth

During maturation in the bone marrow, white blood cells (WBCs) differentiate into three main cell types. Which of the following are the cell types? monocytes granulocytes hemoglobin platelets lymphocytes

granulocytes monocytes lymphocytes

Katie, a 45-year-old patient with breast cancer, is currently undergoing chemotherapy. She is started on epoetin alfa secondary to decreased hemoglobin and hematocrit levels. What rule is important when administering epoetin alfa, after reconstituting it? Shake the drug before use. Warm the drug before use. Do not shake the drug vigorously. Administer the drug immediately, without allowing time for the hematocrit to rise.

Do not shake the drug vigorously.

The symptoms of parkinsonism are caused by the depletion of dopamine in the: central nervous system. smooth muscle. peripheral nervous system. skeletal muscle.

central nervous system.

The nurse is about to administer diphenoxylate (Lomotil) to a client for the first time. Which of the following side effects should be included in the teaching about this medication? "Perianal irritation is a side effect of this medication." "You can expect to feel an increase in energy on this medication." "This medication may make you feel lightheaded or drowsy." "This medication has few side effects so you may not notice any."

"This medication may make you feel lightheaded or drowsy."

What should the nurse teach the patient about gold salts therapy? "This therapy can cause excessive bleeding." "This therapy can decrease inflammation." "This is a therapy for pain relief that is similar to opioids." "This therapy is contraindicated in patients with rheumatoid arthritis."

"This therapy can decrease inflammation." Gold salts or chrysotherapy can decrease inflammation. It is not an opioid and is used in rheumatoid arthritis treatment. It is not known to cause excessive bleeding.

A female patient has been prescribed ropinirole (Requip). She states, "I don't know why they are giving me this medicine. I don't have restless leg syndrome." What is the nurse's best response in teaching this patient with newly diagnosed Parkinson's disease about ropinirole (Requip)? "You are mistaken; ropinirole is not used for restless leg syndrome." "Ropinirole is used for restless leg syndrome and migraines, not parkinsonism." "Your doctor must have written the prescription wrong. I will call her." "You are right about ropinirole, but it is also used in early Parkinson's disease."

"You are right about ropinirole, but it is also used in early Parkinson's disease."

The nurse is teaching a nursing student about anemia and knows that it is important to start by explaining the causes of anemia. Which statement is true about the cause of anemia? "Anemia is a condition caused by reduced amounts of hematocrit, causing less oxygen to be delivered to the tissues." "Anemia is a condition caused by reduced amounts of platelets, causing less oxygen to be delivered to the tissues." "Anemia is a condition caused by reduced amounts of hemoglobin, causing less oxygen to be delivered to the tissues." "Anemia is a condition caused by reduced amounts of protein, causing less oxygen to be delivered to the tissues."

"Anemia is a condition caused by reduced amounts of hemoglobin, causing less oxygen to be delivered to the tissues."

A nurse on the oncology unit is caring for a client with an astrocytoma. The client has just been told that the tumor is growing very fast. The client asks the nurse how these tumors grow. What would be the nurse's best response? "Brain tumors grow by invading the surrounding grey matter." "Brain tumors spread down the spinal cord." "Brain tumors infiltrate the surrounding tissue." "Brain tumors grow by invading the surrounding white matter."

"Brain tumors infiltrate the surrounding tissue."

The prototype drug used to create RBCs is epoetin alfa (Epogen, Procrit). Which of the following statements made by students proves they understand this drug? Choose all that apply. "The product does not contain the same amino acid sequence as natural erythropoietin." "It is used to treat anemia associated with chronic kidney disease." "It is recombinant human erythropoietin." "It is a 165-amino acid glycoprotein manufactured by recombinant DNA technology."

"It is a 165-amino acid glycoprotein manufactured by recombinant DNA technology." "It is recombinant human erythropoietin." "It is used to treat anemia associated with chronic kidney disease."

The nurse is caring for a patient with cryptorchidism who is 28 years old and taking testosterone to treat his problem. What statement by this patient would lead the nurse to believe that he has understood the teaching? "My sexual desire may decrease." "My skin may become clear and soft." "My body hair may increase." "My voice may become higher."

"My body hair may increase."

A mother has just been told that her child has cancer and will need chemotherapy. The mother is worried about side effects. What is the nurse's best response? "An immediate side effect of many chemotherapy agents is nausea and vomiting. There are medications that can be given prior to chemotherapy to lessen these side effects." "There are no long-term side effects from chemotherapy. Infertility and organ failure issues seen in clients after chemotherapy are coincidental." "During the treatment cycle, bone marrow suppression is a common side effect, so it is important that the child goes back to school and is involved in all activities, such as football." "Children do not have side effects of chemotherapy because their immune systems are not fully developed until after 12 years of life."

"An immediate side effect of many chemotherapy agents is nausea and vomiting. There are medications that can be given prior to chemotherapy to lessen these side effects."

Rituximab has been prescribed for a patient who has longstanding history of severe rheumatoid arthritis that has been minimally responsive to standard therapies. When assessing the patient prior to the start of the course of treatment, what assessment question is the nurse's priority? "Do you have any history of heart disease or irregular heart rhythms?" "How would you describe your normal diet?" "Have you been in contact with anyone who has tuberculosis in the last several months?" "Are all of your vaccinations currently up to date?"

"Do you have any history of heart disease or irregular heart rhythms?"

A 56-year-old woman with a diagnosis of multiple sclerosis has begun taking dantrolene. What patient teaching should the nurse provide? "You'll have to come to the hospital daily to be administered this drug." "Make sure to see your doctor promptly if you develop yellowish skin or eyes." "Take an over-the-counter laxative so that you don't get constipated." "You'll find that your muscles will get progressively stronger over the next several weeks."

"Make sure to see your doctor promptly if you develop yellowish skin or eyes."

The nurse learns that a client in a clinic is taking folic acid to treat an associated anemia. The client decided to go on a fasting diet for the last two weeks to lose weight before her daughter's wedding. How would the nurse explain the importance of staying on the diet that the provider prescribed last month? "The fasting diet is acceptable as long as you go back on the prescribed diet within six weeks." "The prescribed diet is not necessary to correct anemia associated with folic acid deficiency." "The fasting diet is acceptable as long as you go back on the prescribed diet within six months." "The prescribed diet and drug are necessary to correct anemia associated with folic acid deficiency."

"The prescribed diet and drug are necessary to correct anemia associated with folic acid deficiency."

Which is a true statement for the nurse to teach the patient about disease modifying anti-rheumatic drugs (DMARDs)? "These medications suppress the immune system." "The medications may or may not help you." "These medications cause severe depression." "The medications are not very strong."

"These medications suppress the immune system."

Which of the following drugs is the specific medication for mushroom poisoning? Bethanechol Pralidoxime Neostigmine Atropine

Atropine

A student nurse is caring for a client who is receiving a hematopoietic agent. To test the student's understanding, the nursing instructor states that the drug could be administered by what route? Oral Subcutaneous Intravenous B and C

B and C

Which hormones stimulate the adrenal cortex to produce and secrete adrenocortical hormones? Somatotropin Gonadotropin Vasopressin Corticotropin

Corticotropin

A patient has been admitted to the unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the patient is taking baclofen (Lioresal). Which outcome would the nurse expect to be associated with use of this medication? Increased muscle strength Decreased muscle spasms Decreased severity and duration of exacerbations Reduction in the appearance of new lesions in magentic resonance imaging (MRI) studies

Decreased muscle spasms

What is the most important teaching point to emphasize from the plan of care when a client is prescribed a skeletal muscle relaxant? Do not drive or operate machinery until individual drug effects are known. Report increased muscle spasm to the health care provider immediately. Drink eight to 10 glasses of water daily to prevent constipation. Always take this medication with food to prevent nausea and vomiting.

Do not drive or operate machinery until individual drug effects are known.

The nurse may advise a patient to take what after a myocardial infarction to prevent straining during defecation? Lubiprostone (Amitiza) Psyllium (Metamucil) Docusate (Colace) Lactulose (Cephulac)

Docusate (Colace) The nurse may advise a patient to get docusate (Colace) after a myocardial infarction to prevent straining during defecation.

A 2-year-old boy with respiratory syncytial virus has a fluid volume deficit and requires intravenous rehydration. Prior to inserting a peripheral intravenous catheter, the nurse may apply what local anesthetic to the child's skin? Benzocaine cream Tetracaine hydrochloride EMLA cream Cocaine hydrochloride ointment

EMLA cream

Clients with Parkinson's disease experience a deterioration in intellectual functioning along with incoordination of unconscious muscle movement. False True

False

Muscle spasticity is the result of damage to peripheral structures rather than to injured neurons. False True

False

Sirolimus is the most commonly used immune suppressant. False True

False

Preanesthetic drugs are generally given by the nurse prior to which type of anesthesia? (Choose one) Topical anesthesia Local infiltration anesthesia Local anesthesia General anesthesia

General anesthesia

The nurse is administering chrysotherapy to a patient with rheumatoid arthritis. What drug will the nurse be administering? Humira Azothiaprine Gold salts Hydroxychloroquine

Gold salts

Matt, age 35, is being treated with methotrexate for osteosarcoma. He has a history of alcohol abuse, drinking 6 to 10 beers per day. Based on Matt's history, which adverse effects is he at a risk for? Blood dyscrasias Hepatic dysfunction Immunosuppression Methotrexate photosensitivity

Hepatic dysfunction

Adrenergic drugs produce which effect? Decreased kidney perfusion Decreased respiratory rate Urinary retention Increased heart rate

Increased heart rate

A 26-year-old is prescribed clomiphene as part of treatment for infertility. What is the mechanism of action of clomiphene? Decreases the output of LH Decreases secretion of FSH Increases the output of the pituitary gonadotropins Increases estrogen at the receptor sites

Increases the output of the pituitary gonadotropins

In pharmacology class the students are learning about the mechanism of action of different laxatives. What would the students learn about the mechanism of action of psyllium hydrophilic mucilloid? Reducing the surface tension of bowel contents Irritating the intestinal mucosa, thus increasing intestinal motility Creating a barrier between the colon wall and feces Increasing mass and water content of stool, promoting evacuation

Increasing mass and water content of stool, promoting evacuation

Mr. Tyler arrives for a follow-up visit. He began minoxidil 2 months ago for the treatment of his male pattern baldness. At today's visit, he expresses his concern because he has not noted any hair growth. What would be the best course of action for the nurse in this case? Assess whether the client suffers from a nonintact scalp. Assess whether the client suffers from frontal hair loss. Inform the patient that the therapy will require at least 4 months of twice-daily application. Advise the patient to consult a prescriber for an increased dose.

Inform the patient that the therapy will require at least 4 months of twice-daily application.

Antidiuretic hormone functions by causing all of the following EXCEPT: Raising blood volume and arterial blood pressure. Inhibiting secretion of thyrotropin. Dilution of extracellular fluids. Reabsorption of water.

Inhibiting secretion of thyrotropin. Antidiuretic hormone (ADH), also called vasopressin, functions to regulate water balance. When ADH is secreted, it makes renal tubules more permeable to water. This allows water in renal tubules to be reabsorbed into the plasma and so conserves body water. In the absence of ADH, little water is reabsorbed, and large amounts are lost in the urine. ADH is secreted when body fluids become concentrated (high amounts of electrolytes in proportion to the amount of water) and when blood volume is low. In the first instance, ADH causes reabsorption of water, dilution of extracellular fluids, and restoration of normal osmotic pressure. In the second instance, ADH raises blood volume and arterial blood pressure toward homeostatic levels.

A 46-year-old woman is undergoing treatment for breast cancer, and her current course of chemotherapy will be supplemented with trastuzumab (Herceptin). The nurse should anticipate which of the following routes of administration? Subcutaneous injection once a day for 1 week and then twice daily for the duration of treatment Oral administration of trastuzumab once a week in the home setting Intravenous administration with a dosage based on the patient's body weight Weekly intramuscular injections, either as an inpatient or an outpatient

Intravenous administration with a dosage based on the patient's body weight

The androgen, testosterone, is available in several dosage forms. In which route is testosterone not able to be given? Intravenously Topically Orally Subcutaneously

Intravenously

A post-menopausal patient has been diagnosed with breast cancer. The patient is being treated with methyltestosterone (Testred). What would indicate that she is developing a complication from the medication? Increased blood pressure Jaundice Weight loss High-pitched voice

Jaundice

Which nonpharmacological intervention may prevent cystitis caused by cyclophosphamide (Cytoxan)? Drinking cranberry juice Keeping well hydrated Wearing cotton underwear Drinking milk

Keeping well hydrated

An older adult has been prescribed a thyroid hormone replacement medication. The nurse should first clarify which prescription? Liotrix (Thyrolar) ½ grain tablet orally once per day Levothyroxine (Synthroid) 150 mcg orally once per day Armour 60 mg orally once per day Liothyronine (Cytomel) 25 mcg orally once per day

Levothyroxine (Synthroid) 150 mcg orally once per day Synthroid is prescribed 100-125 mcg/day orally. A dose of 150 mcg orally once per day is outside of the normally prescribed range. The other medication doses are within recommended parameters. In addition, older adults are at higher risk of adverse reactions; therefore, a smaller dose is started initially and increased in small increments over a period of weeks.

Terry, age 46, has a history of bipolar disorder and has been taking lithium for the past 15 years. He recently began showing signs of low thyroid function and changes in his urinary output. Which adverse effect could be affecting Terry's kidneys? Lithium causes a decrease in the levels of antidiuretic hormones. Lithium impairs the ability of the kidneys to concentrate urine. Lithium causes a reduction in the glomerular filtration rate. Lithium causes renal insufficiency.

Lithium impairs the ability of the kidneys to concentrate urine.

A patient experiences an acute convulsive seizure in the emergency department. Which of the following antiseizure drugs can be administered intravenously first to terminate this type of seizure? Lorazepam Gabapentin Ethosuximide Phenytoin

Lorazepam

A 10-year-old child with spina bifida is receiving bethanechol (Urecholine) for treatment of neurogenic bladder. What adverse effect will the nurse be sure to assess for? Decrease salivation Loss of bowel and bladder control Increased appetite Constipation

Loss of bowel and bladder control

The nurse educator is teaching a class of RN to BSN online learners about different types of immunostimulant drugs. A student asks about the goal of hematopoietic drugs. The nurse knows it is important to explain about stimulation of the body in order to make more of the specific cell. Which of the following cell counts would the nurse want to emphasize when the topic is chemotherapy? Abnormal partial thromboplastin and white blood cell count. Bleeding times and low white blood cell count. Fibrinogen levels and white blood cell count. Low platelet and low white blood cell count.

Low platelet and low white blood cell count.

A patient having twin daugthers begins to have contractions and calls her physician, who tells her to go to the emergency department (ED) for examination. The patient is only 34 weeks' gestation. In the ED, the contractions continue. The patient is admitted. The nurse expects the physician to order which of the following for this patient? Pitocin Magnesium Methergine Cytotec

Magnesium

What intervention can the nurse provide to improve adherence for elderly clients who are taking multiple drugs? Make drug regimens easy to follow and uncomplicated. Have a family member administer all medications. Have the physician decrease the amount of medication the client is taking. Have the client come in weekly and put all medication in a drug dispenser.

Make drug regimens easy to follow and uncomplicated.

An operating room nurse is assisting the anesthesiologist in the preparation of an intravenous dose of dantrolene. What emergent issue most likely prompted the need to give the patient dantrolene? Myocardial ischemia Uncontrolled hypertension Cerebrovascular accident Malignant hyperthermia

Malignant hyperthermia

The patient taking hydroxyurea states that she is having difficulty swallowing the pills. What suggestions by the oncology nurse can help minimize this problem? Mix the capsules with applesauce, water, or juice and swallow in liquid form. Administer the medication at the outpatient clinic intravenously. Switch the treatment regimen to one that the patient can tolerate. Suck on an ice cube to numb the pharynx prior to swallowing the medication.

Mix the capsules with applesauce, water, or juice and swallow in liquid form.

The nurse is caring for a client who has been prescribed cyclosporine following organ transplant. While teaching the client about the medication, the nurse describes its adverse effects. What would the nurse include in the discussion? Graft rejection Bone marrow depression Hypotension Nephrotoxicity

Nephrotoxicity

Ms. Nolan is prescribed cyclophosphamide as part of her treatment for non-Hodgkin's lymphoma. Which symptoms would Ms. Nolan report to her physician immediately? Pain and burning with urination Nausea and vomiting Nasal congestion Alopecia

Pain and burning with urination

The nurse should be aware that many older adults take multiple prescribed and over-the-counter (OTC) drugs. What is taking several drugs simultaneously known as? Elderly pharmacology abuse Multiple drug use Pharmacotherapeutic drug use Polypharmacy

Polypharmacy

Which of the following are true in regards to the effect of caffeine on the body? Select all that apply: Cardiac relaxation Central nervous system (CNS) stimulation Diuresis Skeletal muscle relaxation Respiratory stimulation

Respiratory stimulation Central nervous system (CNS) stimulation Diuresis

A 76-year-old woman has been taking a diuretic for the treatment of peripheral edema but her care provider discontinued it after the woman had two falls in the period of a week. The care provider's action demonstrates a consideration of the Consequences of polpharmacy Beers criteria Risk-to-benefit ratio Changing pharmacodynamics in older adults

Risk-to-benefit ratio

Which of the following reactions can occur in a patient who has been administered caffeine? Decrease in urinary output Skeletal muscle stimulation Feeling of euphoria and well-being Decease in heart rate

Skeletal muscle stimulation

The patient receiving a first infusion of paclitaxel complains of chills and dyspnea. The oncology nurse assesses the patient and observes facial flushing, wheezing, and extreme anxiety. What is the priority intervention by the nurse? Continue the infusion and administer diphenhydramine 50 mg, intravenously. Continue the infusion and administer epinenphrine 0.3 mg subcutaneously. Place the patient in supine position. Stop the infusion.

Stop the infusion.

The nurse can determine that the client taking uric acid inhibitors is drinking enough fluids when which of the following occurs? The daily urine output is about two liters. The client's daily fluid intake is 1000 mL. The client's lips are pink and moist. The client gains approximately one pound per week.

The daily urine output is about two liters.

A 14-year-old girl has been diagnosed with a seizure disorder necessitating long-term treatment with an oral anticonvulsant. What principle should guide this child's medication management in the home? The girl should manage her medication regimen independently. The girl should be encourage to manage her medications with with oversight from her parents. The girl's parents should pour and administer each dose of her anticonvulsant. The girl should liaise with a community-health nurse to ensure safe medication administration.

The girl should be encourage to manage her medications with with oversight from her parents.

A patient has been started on methocarbamol (Robaxin). Which of the following is the most important patient teaching intervention on which the nurse should instruct the patient? The medication will cause hypertension. The medication will cause constipation. The medication will turn urine green. The medication will increase coordination.

The medication will turn urine green.

The nurse is assessing a patient who received etanercept (Enbrel). What assessment indicates a potential side effect? The patient reports fatigue. The patient has diarrhea. The patient develops wheezing. The patient has a heart rate of 100 beats/minute.

The patient develops wheezing.

An HIV-positive patient is taking etavirenz and tells the nurse that she now has fat on the upper back and neck but is losing fat in the extremities and face. What does the nurse determine is causing this patient's symptoms? The patient is suffering from malnutrition and should be on supplements. The patient has lipodystrophy from the etavirenz. The patient is having a hypersensitivity reaction to the etavirenz and should be switched to another antiretroviral medication. The patient is having Cushing's syndrome from the antiretroviral medication.

The patient has lipodystrophy from the etavirenz. (Lipodystrophy may cause increased fat in the upper back, neck, breast, and trunk and loss of fat from the legs, arms, and face.)

Because of the systemic effects of anticholinergic drugs, older adults using these drugs are susceptible to: urinary frequency related to the diuretic effect of the medication. diarrhea related to increased peristalsis. heat stroke related to decreased perspiration. hypotension related to increased sympathetic response.

heat stroke related to decreased perspiration.

Red blood cells (RBCs) are mainly composed of _________________, which enables the cells to carry oxygen to the cells in the body. white blood cells platelets hematocrit hemoglobin potassium

hemoglobin

Which adrenergic receptor is responsible for the vasoconstriction of peripheral blood vessels? β2 receptors β1 receptors α1 receptors α2 receptors

α1 receptors

The nurse is monitoring the serum potassium levels of a patient receiving cortisone. Which result would lead the nurse to notify the prescriber? 2.6 mEq/L 4.5 mEq/L 3.8 mEq/L 3.2 mEq/L

2.6 mEq/L A serum potassium level less than 3.0 mEq/L would suggest hypokalemia, which should be reported to the prescriber.

A patient is brought to the Emergency Department after a motor vehicle accident. The patient is hemorrhaging. During hemorrhage, which hormone is secreted to restore blood volume? FSH ADH GH ACTH

ADH ADH possesses antidiuretic, hemostatic, and vasopressor properties. During hemorrhage GH, FSH and ACTH are not involved in blood volume restoration.

Ms. Kallie is admitted to the hospital from the physician's office with a headache, change in level of orientation, and jerking eye movements. Ms. Kallie is being treated with 5-fluorouracil (5-FU). What is she most likely to be suffering from? Drug overdose Ineffective treatment Cardiotoxicity Acute cerebellar syndrome

Acute cerebellar syndrome

Mr. Melika is treated with high-dose chemotherapy after a radical prostatectomy. What term would best describe this type of therapy? Induction therapy Adjuvant therapy Consolidation therapy Maintenance therapy

Adjuvant therapy Adjuvant therapy: This therapy involves a short course of high-dose drug therapy (usually with a combination of drugs) administered after radiation or surgery to destroy residual tumor cells or micrometastases and prevent recurrence.

A client taking a CNS stimulant may experience altered sleep patterns. What can the nurse instruct the client to do to help with altered sleep patterns? Select all that apply: Take frequent naps throughout the day. Be active during the day. Stop taking the medication. Administer the drug early in the day. Avoid other caffeine.

Administer the drug early in the day. Avoid other caffeine. Be active during the day.

A nurse is caring for a patient with intestinal stenosis who has been prescribed psyllium. During the course of the treatment, the patient shows the signs of colon obstruction. What intervention should the nurse perform to avoid the occurrence of colon obstruction? Administer the drug after chilling it. Provide foods high in bulk or roughage. Give mineral oil to the patient after meals. Administer the drug with adequate fluid intake.

Administer the drug with adequate fluid intake.

approach for the nurse to take when giving this medication? Administer the medication in the deltoid muscle with a 20-gauge needle. Administer the medication in the vastus lateralis with a 20-gauge needle. Administer the medication in the dorsogluteal with a 25-gauge needle. Administer the medication in the infant's vastus lateralis with a 25-gauge needle.

Administer the medication in the infant's vastus lateralis with a 25-gauge needle.

What interventions should the nurse perform when the patient is administered cholinergic blocking drugs preoperatively? Ensure that the patient's blood pressure is below 100/80 mmHg Position the patient in a semi-Fowler's position during drug administration Instruct the patient to have enough water before drug administration Administer the preoperative drug at the exact prescribed time

Administer the preoperative drug at the exact prescribed time

Venlafaxine (Effexor) is an antidepressant that has become more popular with adults in treating their depression. Why has it become more popular? It is an oral drug. It doesn't have side effects. An extended release form is available. It can be taken during pregnancy.

An extended release form is available.

A patient with chronic renal failure receiving epoetin alfa will be having a total left hip arthroplasty. What supplementation should the patient receive prior to surgery? A protein supplement A blood transfusion An iron supplement A folic acid supplement

An iron supplement

Long-term treatment of chronic illnesses is sometimes accomplished by corticosteroids. What effect of corticosteroid drugs would be considered an adverse effect? Anti-replacement Anti-inflammatory Anti-allergic Immunosuppressive

Anti-replacement Adrenocortical agents are now reserved for use to relieve inflammation during acute stages of illness or for replacement therapy to maintain hormone levels when the adrenal glands are not functioning adequately. Adverse effects of adrenocortical agents do not include anti-allergic, anti-inflammatory, or immunosuppressive response.

A nurse who works in an acute care for elders (ACE) unit recognizes the unique pharmacokinetics and pharmacodynamics that often occur in older adults. Which factor should the nurse take into account when administering medications to older adults on the unit? Older adults tend to achieve clearance of medication faster than younger clients. Drug metabolism shifts from the liver to the kidneys as individuals age. Older adults tend to need either higher doses or more frequent doses of a drug to achieve therapeutic effect. As a result of age-related changes, older adults face an increased risk of adverse medication effects.

As a result of age-related changes, older adults face an increased risk of adverse medication effects.

The physician has prescribed lithium to Mr. Johnson, a 34-year-old male with a history of obesity, cirrhosis of the liver secondary to alcohol abuse, diabetes, and hypertension. Which condition places him at highest risk of lithium toxicity? Cirrhosis of the liver Obesity Alcoholism Diabetes

Cirrhosis of the liver

The treatment protocol for a client with hyperthyroidism includes antithyroid medication and propranolol. The purpose of propranolol is to do which of the following? Decrease tachycardia and palpitations Relieve coughing Decrease the risk of infection Promote weight loss

Decrease tachycardia and palpitations Propranolol is an adrenergic blocking agent. It is prescribed as adjunctive treatment for several weeks during antithyroid treatment, until the therapeutic effects of the antithyroid drug are obtained. Propranolol decreases tachycardia and palpitations, but it does not decrease the risk of infection, relieve coughing, or promote weight loss.

A client with advanced Parkinson's disease has undergone diagnostic testing and diagnostic imaging. What are the results most likely to reveal? Increased gamma-aminobutyric acid (GABA) Brain infarcts Decreased enzyme dopa decarboxylase levels Degeneration of dopamine-producing nerve cells

Degeneration of dopamine-producing nerve cells

The client is a 7-year-old boy who has chronic kidney disease and is in the 5th percentile range on a growth chart. The client receives many medications and peritoneal dialysis every day, both managed by the parents. Siblings are in the home. The nurse is seeing the client and his mother in the home. Data supports the nursing diagnosis of: Deficient knowledge. Ineffective family therapeutic regimen management. Caregiver role strain. Delayed growth and development.

Delayed growth and development. The client is below the height and weight for a 7-year-old boy. Thus, the information supports delayed growth and development. Not enough information supports the other nursing diagnoses.

A patient has been diagnosed with cancer. The physician prescribes antineoplastic drug therapy to the patient. How should the nurse explain the use of antineoplastic drugs? Complete relief of symptoms of cancer. Delays spread of cancer to other sites. Leads to complete cure of cancer. Destroys only cancerous cells.

Delays spread of cancer to other sites.

Dexmethylphenidate has been prescribed to Scott, a 7-year-old boy who was diagnosed with ADHD. The mother asks how this medication will help her son. Which would be the most accurate description of the purpose of this medication? Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task. Dexmethylphenidate will improve Scott's memory. Dexmethylphenidate will increase Scott's ability to understand information better. Dexmethylphenidate will stabilize Scott's mood so that he can concentrate.

Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task.

A nurse must be aware that thyroid hormone can worsen control of which of the following and close observation of the patient is necessary? (Choose one) Irritable bowel syndrome Asthma Migraine headaches Diabetes

Diabetes

William is prescribed olanzapine to treat the symptoms of schizophrenia. He suddenly begins to exhibit signs of orthostatic hypotension. During the assessment, he reveals that he uses an anxiety-relieving drug obtained through a friend. What drug is William most likely self-administering? Rifampin Diazepam Haloperidol Omeprazole

Diazepam

What intervention is necessary for the patient who has started supplemental steroid therapy for rheumatoid arthritis? Select all that apply. Diet modification Blood glucose monitoring Daily blood pressure monitoring Hearing tests Reverse isolation

Diet modification Blood glucose monitoring

A nursing student is giving an oral report on multiple sclerosis (MS) to the med-surg class. The student should be able to identify which of the following as a primary symptom most likely to be assessed in a patient with MS? Bradykinesia Dementia Difficulty in coordination Contracture deformities

Difficulty in coordination

The nurse is preparing to administer temsirolimus (Torisel) to a patient with metastatic renal carcinoma. With what should the nurse prepare to premedicate the patient? Solu-Cortef Solu-Medrol Diphenhydramine Epinephrine

Diphenhydramine

The nursing instructor is discussing psychosis with the nursing students. What behavior would the instructor explain people with psychosis exhibit? Slowed reaction time and poor coordination Disorganized and often bizarre thinking Short manic episodes followed by long depressive episodes Short- and long-term-memory deficits

Disorganized and often bizarre thinking

Because it is unethical to conduct drug studies on pregnant women, data about the effects of medications on fetuses are gained from studies done on rats. What factors are considered in the use of such data? (Select all that apply.) Nonhuman primates are good predictors of human teratogenicity. Dissimilar physiology to humans makes comparisons more difficult. The metabolism in the rodent is similar to human metabolism. The ontogenetic development is very different from that of a human.

Dissimilar physiology to humans makes comparisons more difficult. The ontogenetic development is very different from that of a human.

A nurse is planning the care of a patient whose laceration requires the use of local anesthesia. The nurse recognizes that there is a risk to the patient who has local anesthesia due to what nursing diagnosis? Self-care deficit Autonomic dysreflexia Latex allergy response Disturbed sensory perception

Disturbed sensory perception

A nurse is conducting a medication reconciliation of a woman who is newly admitted to a long-term care facility. When appraising the woman's medication regimen in light of the Beers Criteria, the nurse will look for Drugs for which generic equivalents are available at lower cost. Drugs that have been found to be ineffective in older adults. Drugs that are known to exacerbate the aging process. Drugs that are known to cause adverse effects in older adults.

Drugs that are known to cause adverse effects in older adults.

A patient with a severe depression has been hospitalized, and the physician has ordered amitriptyline. What common adverse effect might this patient have? Hypertension Fever Decreased B/P Dry mouth

Dry mouth

Constipation is a common adverse reaction seen with the use of cholinergic-blocking drugs, which of the following nonpharmacological treatments can a nurse recommend to a client with drug-induced constipation? Select all that apply: Eat a diet high in fiber. Decrease the dose of cholinergic-blocking medication. Increase fluid intake to 2000 mL daily. Stop taking the cholinergic-blocking medication. Obtain adequate exercise.

Eat a diet high in fiber. Increase fluid intake to 2000 mL daily. Obtain adequate exercise.

The pregnant patient is admitted into the high-risk obstetrics department with seizure activity and severe hypertension. What condition does the nurse anticipate initiating drug therapy for? Pre-eclampsia Eclampsia Placental abruption Gestational diabetes

Eclampsia Eclampsia is a life-threatening condition resulting from uncontrolled preeclampsia, involving cerebral edema and convulsions.

A nurse is caring for a patient with adrenocortical deficiency. A physician has prescribed a fludrocortisone drug to the patient. Which adverse reaction should the nurse monitor for in the patient? Malaise Edema Sore throat Nasal congestion

Edema

Which drug is classified as a catechol-O-methyltransferase (COMT) inhibitor? Entacapone (Comtan) Biperiden (Akineton) Carbidopa (Lodosyn) Benztropine (Cogentin)

Entacapone (Comtan)

Which drug can be mixed, in certain situations, with an injectable local anesthetic in order to cause local vasoconstriction? Phenylephrine Oxymetazoline Diphenhydramine Epinephrine

Epinephrine

Which of the following is the adrenergic drug of choice for treatment of anaphylactic shock? Phenylephrine Dopamine Epinephrine Isoproterenol

Epinephrine

______________ is the prototype of the adrenergic drugs. Norepinephrine (Levophed) Ephedrine Epinephrine (Adrenalin) Pseudoephedrine (Sudafed)

Epinephrine (Adrenalin)

A child in renal failure is taking dandrolone (Durabolin) 25 mg IM every 3 weeks and is seen in the clinic every other month. What adverse effects related to this drug therapy would the nurse be most concerned with monitoring for? Growth of facial hair Weight gain Epiphyseal closure Skin color

Epiphyseal closure

The nurse is teaching a client about erythrocytes. Which information would the nurse include in the teaching plan? Erythrocytes are also called red blood cells. Erythrocytes are also called platelets. Erythrocytes are also called white blood cells. Erythrocytes are also called plasma.

Erythrocytes are also called red blood cells.

A patient who is HIV positive is receiving zidovudine 4,2000 mg/week and has an endogenous erythropoietin level of 350 mU/mL. What does the nurse anticipate will be administered for this patient? A blood transfusion Erythropoietin An increased dose of zidovudine Rocephin 1 GM IV

Erythropoietin

Typical antipsychotic medications are thought to exert their effects in which way? Stimulating the release of dopamine in the brain Stimulating GABA receptors in the brain Inhibiting the release of serotonin in the brain Inhibiting the release of dopamine in the brain

Inhibiting the release of dopamine in the brain

What best reflects the action of barbiturates when used to control seizures? Stimulation of motor nerve output Enhancement of cerebellar functioning Inhibition of impulse conduction Stimulation of the cerebral cortex

Inhibition of impulse conduction

Which would a nurse include when describing the action of tizanidine? Interference with calcium release from muscles Inhibition of acetylcholine release Inhibition of presynaptic motor neurons in the CNS Interference with the reflexes causing the spasm

Inhibition of presynaptic motor neurons in the CNS

The pharmacology instructor is describing the antithyroid drug propylthiouracil to the nursing students. What would the instructor identify as the primary mode of action for propylthiouracil? Suppression of the anterior pituitary gland's hormonal secretions Sedation of the central nervous system and suppression of cardiac function Inhibition of production of thyroid hormone Destruction of part of the thyroid gland

Inhibition of production of thyroid hormone

A school nurse is talking with a health class of freshman high school students about human immunodeficiency virus (HIV). What patient would the nurse tell the students is at the greatest risk of contracting HIV? Female homosexual Health care provider Blood transfusion recipient in 1995 Injecting drug user

Injecting drug user

A nurse is administering an antineoplastic extravasation occurs. How can the nurse best prevent tissue damage caused by extravasation? Administer through a hand vein, if possible Use an infusion pump Inspect the site frequently for redness or swelling Infuse into proximal veins whenever possible

Inspect the site frequently for redness or swelling

A nurse has received the glucose tolerance test results from a client and is concerned that the client is developing gestational diabetes mellitus (GDM). The nurse is preparing to teach the client regarding which of the following medications to treat GDM and try to prevent injury to the fetus? Glucophage Metformin Glyburide Insulin

Insulin

A patient has a tumor of the spinal cord. The patient is administered a corticosteroid. What effect will the corticosteroid have on the tumor? It will cause muscle weakness and atrophy, but decrease the tumor. It will decrease the chance of infection and meningitis. It will allow the tumor to be more susceptible to treatment. It will assist in decreasing the edema at the site of the tumor.

It will assist in decreasing the edema at the site of the tumor. The administration of corticosteroids to treat spinal cord tumors is used to decrease the edema around the tumor. The corticosteroid will not allow the tumor to be more susceptible to treatment. The corticosteroid will not prevent meningitis. An adverse effect of corticosteroid administration is muscle weakness and atrophy, but will not provide a therapeutic effect.

The nurse is providing education about a liquid antibiotic medication to the parent of a toddler. The prescribed medication is one teaspoon three times a day for 10 days. Other young children are in the home. How should the nurse instruct the parent to proceed? (Select all that apply.) Keep the medication out of reach of any child. Discontinue the medication when the toddler feels well. Use a household spoon to measure the medication. Prepare the toddler at least half an hour before administration. Separate each dose by 8 hours.

Keep the medication out of reach of any child. Separate each dose by 8 hours.

You have just admitted a 58-year-old client with alcohol abuse and chronic liver failure to your unit. The physician suspects hepatic encephalopathy. The client tells you she hasn't had a bowel movement in 5 days. What laxative can this patient take to lower the serum ammonia levels? Lactulose Polyethylene glycol-electrolyte solution Docusate sodium Sorbitol

Lactulose Lactulose is used for hepatic encephalopathy by decreasing ammonia accumulation in the intestine. The other drugs will not decrease this client's ammonia level.

A patient with alcoholism and chronic liver failure is admitted to the medical division. He is confused and has an elevated serum ammonia level. What laxative will be administered to lower the serum ammonia level? Lactulose (Cephulac) Sorbitol Docusate sodium (Colace) Polyethylene glycol-electrolyte solution (NuLYTELY)

Lactulose (Cephulac) Lactulose decreases production of ammonia in the intestine. Lactulose is a disaccharide that is not absorbed from the GI tract. It is used to treat hepatic encephalopathy. Docusate sodium only provides stool softening and has no effect on serum ammonia levels. Polyethylene glycol-electrolyte solution (NuLYTELY) is not used to decrease serum ammonia. Sorbitol is not used to decrease serum ammonia.

Which would be most important to assess in a patient receiving testosterone for a prolonged period of time? Serum electrolyte levels Complete blood count Platelet count Liver function studies

Liver function studies

A nurse is caring for a patient who is undergoing chemotherapy. The patient has experienced several episodes of vomiting. Which of the following activities should the nurse perform as part of ongoing assessment for signs of dehydration and electrolyte imbalances? Measure and record patient's temperature Measure and record patient's blood pressure Observe the results of liver function tests Measure all fluid intake and output

Measure all fluid intake and output

A nurse is caring for a patient with seizure disorders. The patient has been prescribed phenytoin. Which of the following ongoing assessment activities should a nurse perform during the treatment? Check for the patient's vital signs every three hours. Measure regular serum plasma levels of the drug. Measure the respiratory rate of the patient. Measure the pulse rate of the patient.

Measure regular serum plasma levels of the drug.

A nurse is treating a patient who is receiving carbamazepine for a seizure disorder. The nurse knows that carbamazepine is contraindicated in patients with which diseases or disorders? Bipolar disorder Bone marrow depression Diabetes Allergy to sulfonamides

Measure regular serum plasma levels of the drug.

Your client asks what the long-term adverse effects of corticosteroid therapy are. You explain that adverse effects may include: Weight loss. Mental changes ranging from mild agitation to psychosis. Decreased hair growth. Muscle growth and atrophy.

Mental changes ranging from mild agitation to psychosis. Adverse effects of systemic corticosteroids may include infections, hypertension, glucose intolerance, obesity, cosmetic changes, bone loss, growth retardation in children, cataracts, pancreatitis, peptic ulcerations, and psychiatric disturbances.

Which of the following are aspirin-like compounds with anti-inflammatory properties used in the treatment of client's with ulcerative colitis? Select all that apply: Magnesium oxide (Mag-Ox) Bisacodyl (Dulcolax) Polyethylene glycol (MiraLax) Olsalazine (Dipentum) Mesalamine (Asacol)

Mesalamine (Asacol) Olsalazine (Dipentum)

Which hormones are secreted by the adrenal gland? (Select all that apply.) Growth hormone Mineralocorticoids Prolactin Oxytocin Glucocorticoids

Mineralocorticoids Glucocorticoids

A female client 70 years of age is receiving lithium. Which nursing intervention is appropriate for this client? Monitor fluid and sodium intake every 12 hours. Encourage the client to check daily for weight loss. Check blood glucose levels every six hours. Instruct the client to use barrier contraceptives.

Monitor fluid and sodium intake every 12 hours.

A patient is having an intrapleural instillation of a chemotherapeutic agent. What does the oncology nurse need to monitor prior to instillation of the medication? Monitor for signs and symptoms of bleeding. Assess the patient for a headache. Monitor for signs and symptoms of infection. Monitor for complete drainage from the pleural cavity before instillation of the drug.

Monitor for complete drainage from the pleural cavity before instillation of the drug.

An older adult is prescribed a skeletal muscle relaxant for reports of neck pain. What is the top priority of care for the nurse to teach the family? Administer the medication with meals. Give the medication at the same time each day. Instruct on how to assess client's pain level. Monitor the client before ambulating.

Monitor the client before ambulating.

The nurse is caring for a patient who is receiving a combination of antineoplastic agents. The patient will most likely lose her hair. Why would the nurse suggest that she get a wig or use appropriate head cover? People may be uncomfortable seeing her bald head The hair will likely grow back if the head is covered at all times Most of the heat is lost through the head and it is important to cover it during extremes in temperature Her self-esteem will be better if the head is covered

Most of the heat is lost through the head and it is important to cover it during extremes in temperature

A patient who suffers from Parkinson's disease is being treated with levodopa (L-dopa). Which disorder will result in the discontinuation of levodopa (L-dopa) based on a disease-related contraindication? Narrow-angle glaucoma Normal-tension glaucoma Human immune deficiency virus Human papillomavirus

Narrow-angle glaucoma

A patient with Parkinson's disease is undergoing treatment in a health care facility. Which of the following nursing interventions should the nurse perform during ongoing assessment? Prepare a baseline for future evaluations of the patient's drug therapy. Assess the patient for ability to perform the daily activities. Observe the patient for various neuromuscular signs. Observe the current mental condition of the patient.

Observe the patient for various neuromuscular signs.

The nurse is performing an assessment of a patient taking saquinavir for HIV and observes the viral load is considerably higher than the previous test. What priority information should the nurse obtain from the patient? Obtain information about adherence to the medication regimen. Obtain information about the patient's adherence to an exercise regimen. Obtain information about the patient's use of over-the-counter vitamins. Obtain information about the patient's alcohol use.

Obtain information about adherence to the medication regimen.

A Hispanic client has just been diagnosed with cancer. The nurse notes that the client does not speak English very well, and no matter what the nurse says the client simply shakes his head and says "okay." How can the nurse best respond to this client? Continue to speak English to the client regarding the client's diagnosis. Give the client lots of literature regarding the client's diagnosis so that the client can read it at his leisure. Speak English very slowly and loudly so that the client can understand better what the nurse is saying. Obtain the services of an interpreter to translate the information to the client and obtain literature that is written in Spanish.

Obtain the services of an interpreter to translate the information to the client and obtain literature that is written in Spanish.

An elderly woman is given scopolamine while on a cruise. She becomes very agitated and confused. The nurse knows that which is a likely reason for these symptoms? Urinary retention often causes agitation. Older clients have a greater chance of adverse reactions to cholinergic blocking drugs. Elderly clients have more difficulty sleeping than regular clients, so the drowsiness that is a common side effect does not occur. Most elderly clients have dementia, which would prevent them from having normal, visual adverse reactions to cholinergic blocking drugs.

Older clients have a greater chance of adverse reactions to cholinergic blocking drugs.

After teaching a patient who is prescribed estradiol vaginal cream, the nurse determines that the patient has understood the instructions when she states that she will administer the medication at which frequency? Once a month Once a week Once every other day Once a day

Once a day

An elderly man must take a variety of medicines under different conditions and at different times of the day. His wife is available to help him most of the time. How can the couple best ensure that the man takes all his medicines under the correct conditions? Keep each vial where it will be used (kitchen, bath, or bedroom) by the client. Once a week, dispense all the medicines into a large, divided container. Each morning, dispense that day's medicines into a divided container. Have the wife dispense each medicine when it is needed.

Once a week, dispense all the medicines into a large, divided container.

A client is receiving auranofin as treatment for rheumatoid arthritis. The nurse should expect this drug to be given by which route? Oral Subcutaneous Intramuscular Intravenous

Oral

Medroxyprogesterone is an effective form of birth control. Long-term use can cause what serious adverse effect? Osteoporosis Nervousness Headaches Menstrual irregularities

Osteoporosis

Based on the metabolic action of glucocorticoids, a patient who is on long-term glucocorticoid therapy is at risk of developing what disease? Osteoporosis Swelling in the brain and spinal cord Bronchoconstriction Improved wound healing

Osteoporosis The patient who is on long-term glucocorticoid therapy is at risk for osteoporosis due to the reduction in new bone synthesis. Glucocorticoids are used to reduce swelling in the brain and spinal column and to promote bronchodilation, but they interfere with wound healing because of the elevated levels of circulating glucose.

Ms. Smith is started on antiarrhythmic therapy to treat atrial fibrillation. The nurse caring for Ms. Smith knows which occurrence is a potential side effect of this medication? Shortness of breath Angina Malignant hyperthermia Other arrhythmias

Other arrhythmias

After teaching a group of students about anabolic steroids, the instructor determines that the teaching was successful when the students identify which agent as an example? Alprostadil Tadalafil Danazol Oxandrolone

Oxandrolone

A patient has been diagnosed with a brain tumor, which has caused partial seizure activity. The patient is being treated with the newest antiepileptic medication. Which medication is administered as monotherapy to diminish or eliminate seizures? Levetiracetam (Keppra) Gabapentin (Neurontin) Oxcarbazepine (Trileptal) Fosphenytoin (Cerebyx)

Oxcarbazepine (Trileptal)

The nursing instructor is teaching the student about drugs given to induce uterine contractions and promote labor. These drugs are classified as which of the following? Oxytocic Cytotoxic Tocolytic Ergots

Oxytocic

Kalie, age 18, is prescribed progesterone for the treatment of primary amenorrhea. Which adverse effect would need to be reported immediately to the physician? Weight gain Abnormal menstrual bleeding Breast tenderness Pain in one leg

Pain in one leg Pain in one leg could indicate a thrombus formation. Common side effects of progesterone are abnormal menstrual bleeding, including spotting; breast tenderness; and weight gain.

Which of the following patients are at highest risk for alteration in bowel elimination? Diabetic Triathlete Hypertensive patient Paraplegic

Paraplegic

For which condition does the nurse understand the physician will order a combination therapy of rituximab and methotrexate? Rheumatoid arthritis Osteoarthritis Ulcerative colitis Pseudomembranous colitis

Rheumatoid arthritis

Which class of antidepressants exerts its effects by inhibiting reuptake serotonin? Tricyclic antidepressants Monoamine oxidase inhibitors Selective serotonin reuptake inhibitors Atypical antidepressants

Selective serotonin reuptake inhibitors

A patient is receiving immunosuppressant therapy. Which adverse effects should the patient be educated about regarding these effects? Liver failure Respiratory depression Myocardial infarction Serious infection

Serious infection

A nurse is having post-exposure prophylaxis to HIV. How often should laboratory follow-up testing for HIV antibodies be done for this nurse? Six weeks, 12 weeks, and 6 months after exposure Two months, 6 months, and 1 year after exposure Two weeks, 4 weeks, and 2 months after exposure One month, 2 months, and 4 months after exposure

Six weeks, 12 weeks, and 6 months after exposure

A patient scheduled for surgery has to undergo an insertion of the endotracheal tube. The nurse understands that which of the following drugs for general anesthesia would be the most appropriate for the patient? Skeletal muscle relaxants Benzodiazepines Barbiturates Opioid analgesics

Skeletal muscle relaxants

When describing the various effects of antineoplastic agents, the nurse explains that antineoplastic drugs primarily affect human cells that are rapidly multiplying, going through the cell cycle quickly. The nurse would identify which cells as an example? Testicles Ovaries Skin Breast

Skin

The essential components of the immune system are hematopoietic cells, barrier defenses, the nonspecific immune response, the specific immune response, and immunity. Which of the following describes barrier defenses? Choose all that apply. Hemoglobin carries oxygen to the cells. Skin is the first line of defense. The gastrointestinal tract provides an acid protector. Mucus is a barrier defense.

Skin is the first line of defense. Mucus is a barrier defense. The gastrointestinal tract provides an acid protector.

A patient is in the clinic for a follow-up visit after having been on hormone replacement therapy for 3 months. Which report by the patient would immediately concern the nurse? A decrease in weight bearing exercise A craving for sugar Smoking a pack of cigarettes a day Gaining ten pounds in the last 3 months

Smoking a pack of cigarettes a day

A nurse is monitoring the vital signs of a patient who has been administered epinephrine. Which of the readings should nurse report immediately to the primary health care provider? Temperatures reading of 97.6°F Pulse rate of 60 beats per minute A diastolic blood pressure of 75 mm Hg Systolic blood pressure below 100 mm Hg

Systolic blood pressure below 100 mm Hg

When reviewing the medical record of a client receiving levodopa, what client factors should alert the nurse to the need for closer monitoring after administering the drug? The client is obese and has usually led a sedentary lifestyle The client has peptic ulcer disease and takes bronchodilators for the treatment of asthma The client has taken calcium and vitamin D supplements for many years to prevent osteoporosis The client had cataract surgery last year and has hypertension

The client has peptic ulcer disease and takes bronchodilators for the treatment of asthma

The nurse is administering medications to a 2-year-old child with impaired renal function. What does the nurse understand about the dosage of medication for this child? The dose should be increased to achieve and maintain therapeutic drug levels. Only medications not excreted through the urine should be administered to this child. The dose should be adjusted to achieve and maintain therapeutic drug levels. The medication should be used in a half-dose so that the child will not become nephrotoxic.

The dose should be adjusted to achieve and maintain therapeutic drug levels.

A patient taking high doses of cyclophosphamide is exhibiting muscle cramps and confusion and reports headaches. The nurse assesses the laboratory tests and notices the sodium level is low. What does the nurse determine may be occurring with this patient? The patient is having a hypersensitivity reaction to the chemotherapy. The patient is exhibiting signs of diabetes insipidus caused by the high dose of cyclophosphamide. The patient is having a toxic reaction to the high level of cyclophosphamide. The patient is exhibiting signs of syndrome of inappropriate antidiuretic hormone caused by the high dose of cyclophosphamide.

The patient is exhibiting signs of syndrome of inappropriate antidiuretic hormone caused by the high dose of cyclophosphamide.

A patient receiving oxaliplatin (Eloxatin) requests a blanket because he is very cold. When the nurse comes back with the blanket, the patient becomes short of breath and reports difficulty swallowing. What does the nurse determine is happening with this patient? The patient is upset because he had to wait for the blanket to arrive. The patient is having a panic attack. The patient is having a hypersensitivity reaction to the medication. The patient is having acute syndrome of pharyngolaryngeal dysethesia.

The patient is having acute syndrome of pharyngolaryngeal dysethesia.

The nurse is administering rituximab to a patient who states "My heart feels like it is beating out of my chest." When the nurse connects the patient to the monitor, ventricular tachycardia is observed. What does the nurse understand is happening with this patient? The patient is having a dissecting aortic aneurysm. The patient is most likely having an infusion reaction syndrome. The patient is having a myocardial infarction. The patient is having a catecholamine response to fear.

The patient is most likely having an infusion reaction syndrome.

The nurse is caring for a patient who has HIV and is taking saquinavir therapy. What should the nurse include in the dietary education for this patient? The patient is not restricted to a specific diet while taking this medication. The patient should limit carbohydrates when taking this medication. The patient should limit proteins while taking this medication. The patient should not take this medication with grapefruit or pomegranate juice.

The patient should not take this medication with grapefruit or pomegranate juice.

A physician has ordered a drug for a pregnant woman to treat fetal tachycardia and congestive heart failure. What drug does the nurse anticipate administering? haloperidole (Haldol) Digitalis (Digoxin) Brethine (Terbutaline) Tenormin (Atenolol)

The risk for developing fetal hydantoin syndrome

The nurse is educating a patient who is attempting to get pregnant about the risk of taking phenytoin for her seizures during pregnancy. What concerns does the nurse convey to the patient? The risk for the development of of spina bifida The risk for developing fetal hydantoin syndrome The risk for developing Tay-Sachs disease The risk for developing Down's syndrome

The risk for developing fetal hydantoin syndrome

A patient is started on chemotherapy. The chemotherapy regimen includes three agents. What is the rationale for using three different antineoplastic agents? The use of three agents decreases the adverse effects. The use of three agents increases the quantity of one of the agents. The use of three agents increases the length of treatment. The use of three agents decreases the development of cell resistance.

The use of three agents decreases the development of cell resistance.

While monitoring a woman who is receiving IV oxytocin for induction of labor, what event would cause the nurse to contact the health care provider immediately? The client's blood pressure is 109/68. The uterine contractions are occuring every 90 seconds. The client's pulse is 90. The fetal heart rate is between 136 and 159.

The uterine contractions are occuring every 90 seconds.

Danny has been diagnosed with rheumatoid arthritis and begins methotrexate drug therapy. Why should the nurse document the severity of joint inflammation and any restriction in the range of motion when assessing Danny's health status? To minimize the adverse effects of methotrexate therapy To identify the signs of hepatic or renal insufficiency To later compare and assess the efficacy of methotrexate therapy To maximize the therapeutic effects of methotrexate therapy

To later compare and assess the efficacy of methotrexate therapy

The nurse is doing discharge teaching when the patient asks the nurse why their prednisone has been ordered on alternate days. What would be the nurse's best response? To eliminate side effects To prevent steroid tolerance To prolong therapeutic effects To minimize adverse effects

To minimize adverse effects

A 7-months-pregnant woman is experiencing contractions. She is admitted to the hospital in preterm labor. What will the physician prescribe in order to stop the labor? Oxytocics Estrogen Tocolytics Prostaglandins

Tocolytics

When the nurse sprays ethyl chloride to the skin before giving an injection to a patient, which type of anesthesia is being administered? Regional Local infiltration General Topical

Topical

A nurse is assessing a patient who is taking oxybutynin (Ditropan). What would be the priority nursing assessment for this patient? Skin condition Mental status Cardiac arrhythmia Vision changes

Vision changes

A nurse with a needle stick from a patient with HIV is told to see the occupational health nurse for postexposure prophylaxis (PEP). Ideally, when should the PEP start for this nurse? Within 1 week of exposure and no more than 1 month later Within 20 minutes of exposure and no more than 24 hours later The nurse should wash the area and finish her shift and then see the occupational health nurse. Within 1-2 hours after exposure and no more than 72 hours later

Within 1-2 hours after exposure and no more than 72 hours later

Phil is prescribed testosterone for erectile dysfunction secondary to androgen deficiency. During the assessment, the nurse notes that he also suffers from benign prostatic hypertrophy (BPH). What effect is the drug most likely to have in this case? Worsening of the BPH with possible urethral obstruction Decreased difficulty in voiding No progression of the BPH Improvement of the BPH

Worsening of the BPH with possible urethral obstruction

A female HIV-positive patient with a high CD4 count has been taking nevirapin (Viramune) for 9 weeks. What clinical manifestations indicate to the nurse that the patient is having complications from this medication? Constipation and nausea Yellow sclera and hepatomegaly Decreased urine output and thirst Nausea and headache

Yellow sclera and hepatomegaly

A client is experiencing absence seizures and has been prescribed a succinide. What prescription is most likely? Zarontin Dilantin Depakene Valium

Zarontin

The medication reconciliation of a newly admitted resident of a nursing home indicates that the patient takes cyclosporine. The nurse should initially suspect that this resident may have: a previous organ transplant. a history of multiple myeloma. AIDS. diabetes mellitus.

a previous organ transplant.

The nursing student correctly identifies that the transmitter in the cholinergic neuropathways that appears insufficient in patients with Alzheimer's disease is: memantine. acetylcholine. norepinephrine. epinephrine.

acetylcholine.

A 78-year-old man is admitted to the emergency department (ED) with bradycardia resulting from overdose of donepezil, a cholinergic drug prescribed for treatment of Alzheimer's disease. The nurse knows that the ED physician is likely to order: atropine. pseudoephedrine. bethanechol. propranolol.

atropine

In providing care to a client with wheezing, the nurse knows that a medication targets which receptors? alpha 1 alpha 2 beta 2 beta 1

beta 2

A new graduate working on a pediatric unit is giving a 3-year-old an injection intramuscularly (IM). The nurse uses the dorsogluteal site and the child screams and says it hurts down his leg. What potential damage may have been done using this site for a preschooler? damage to the sciatic nerve damage to the perineal nerve damage to the pudential nerve damage to the posterior femoral nerve

damage to the sciatic nerve

The client is a 10-year-old child prescribed 0.5 mL of a vaccine to be administered intramuscularly. The setting is a one-day vaccination clinic, and no privacy can be provided. The nurse administers the vaccine in the muscle site: vastus lateralis. ventrogluteal. rectus femoris. deltoid.

deltoid

A client, who has been diagnosed with schizophrenia and is taking an antipsychotic medication, reports constant thirst, frequent urination, and feeling nauseous. The nurse knows that the client may: be making up the symptoms simply to get attention. have the flu. have a urinary tract infection. have undiagnosed diabetes.

have undiagnosed diabetes.

One week ago, a 74-year-old was started on a benzodiazapine for the treatment of an anxiety disorder. The client comes into the clinic for a follow-up visit and states feeling nervous, is having trouble sleep, and feels hyperactive. What does the nurse understand may be occurring as a result of this medication? taking too much of the medication (nonadherence) allergic reaction to the benzodiazepine not taking the medication as ordered (noncompliance) paradoxical excitement

paradoxical excitement

An elderly client with high blood pressure has been prescribed a single dose of aspirin for intermittent joint pain but it does not seem to be effective. What is the most likely reason for this? decreased efficiency of liver decreased body mass prolonged absorption of drug poor excretion of drug

prolonged absorption of drug

The nurse is preparing to administer an intramuscular injection to an 8-month-old infant. Which site would the nurse select? vastus lateralis deltoid dorsogluteal muscle rectus femoris

vastus lateralis

A 1-month-old baby is severely ill and has been prescribed an injection as part of drug therapy. What is the preferred injection site? ventrogluteal muscle deltoid muscle vastus lateralis muscle dorsogluteal muscle

vastus lateralis muscle

The nurse is preparing to administer an intramuscular (IM) injection to a 2-year-old-child. Which is the preferred site of injection for this child? deltoid muscle rectus femoris muscle vastus lateralis muscle dorsogluteal muscle

vastus lateralis muscle

The client is a 5-year-old child with minor burns to the lower extremities. The client is prescribed a medication to be administered by the intramuscular route. The nurse administers the medication in this muscle site: deltoid dorsogluteal vastua lateralis ventrogluteal

ventrogluteal b/c injury to lower extremity, will not use vastus lateralis

An elderly client is prescribed a medication to take twice a day at breakfast and dinner. The client is now prescribed a second medication to take once a day. The nurse tells the client to take the medication: two hours after the other medication. at 0900 each day. with breakfast. at hour of sleep.

with breakfast. To help with this client's adherence, the nurse keeps the medication regimen simple. The nurse has the client take his medications at the same time, such as with breakfast. The client does not have to remember another time to take the new medication.

Bismuth salicylate (Pepto-Bismol) is contraindicated in clients with which of the following conditions? Hypertension Rheumatoid arthritis Allergy to aspirin Viral gastroenteritis

Allergy to aspirin

A patient is receiving lithium carbonate for treatment of bipolar disorder. Which of the following statements should be included in discharge education for this patient? "Keep your scheduled appointments for measurement of lithium levels." "Limit fluid intake to 500 mL daily." "Take this medication on an empty stomach." "Do not drive while on this medication."

"Keep your scheduled appointments for measurement of lithium levels."

A nurse instructs a patient taking an antidiarrheal agent to stop the drug and call the health care provider if the patient does not experience relief within which time frame? 48 hours 24 hours 72 hours 36 hours

48 hours

After teaching a group of students about mineralocorticoids, the instructor determines that the teaching was successful when they state which agent as an example? Beclomethasone Flunisolide Fludrocortisone Dexamethasone

Fludrocortisone

A client is taking tolcapone for Parkinson's disease. What blood test will the nurse perform often on this client? Chemistry panel CBC ALT CRP

ALT

A patient on methotrexate therapy complains of mouth ulcers. Which treatment does the nurse anticipate the patient will be prescribed? Folic acid 1 mg daily by mouth Allopurinol 300 mg dissolved in 50 mg of water, swish and spit Ibuprofen 400 mg every 6 hours by mouth Nystatin oral suspension, swish and swallow

Allopurinol 300 mg dissolved in 50 mg of water, swish and spit

The physician has prescribed growth hormone for a 12-year-old boy with growth impairment. The boy's parents should be instructed to contact the physician if they notice which signs in their son? Development of a limp Severe knee pain Severe hip pain Any of the above

Any of the above

A client taking methimazole develops a rash. What is the nurse's best recommendation to treat the rash? Avoid topical lubricants. Wear gloves to prevent scratching and subsequent skin damage. Apply a soothing cream until the rash subsides. Use an antibacterial soap when bathing.

Apply a soothing cream until the rash subsides.

An instructor is preparing a class on local anesthetics. Which would the instructor include as an example of an amide? Tetracaine Lidocaine Procaine Benzocaine

Lidocaine

Which of the following classes of antineoplastic drugs are considered cell cycle-specific? Select all that apply: Akylating agents Plant alkaloids Antimetabolites Retinoids Antineoplastic antibiotics

Plant alkaloids Antimetabolites

A patient suffers from bronchial asthma. Which medication will be administered? Epinephrine Norepinephrine Acetylcysteine (Mucomyst) Dantrolene sodium (Dantrium)

Epinephrine In bronchial asthma, epinephrine is used as a bronchodilator to relieve bronchoconstriction and bronchospasm.

A client is diagnosed with HIV infection. What is the most important factor to consider when initiating chemoprophylaxis? band cells present WBC level prior history of infections CD4 count

CD4 count

Which is usually the most important consideration in decisions to initiate antiretroviral therapy? ELISA Western Blot assay CD4 counts HIV RNA

CD4 counts

A patient with cortical focal seizures has been prescribed phenobarbital. What adverse reaction should the nurse monitor for in the patient? Gingival hyperplasia Ataxia Urticaria CNS depression

CNS depression

The nurse is caring for a client with glaucoma and is aware that which category of preanesthetic medication is contraindicated in this client? Antiemetic Opioid Cholinergic blocking Antianxiety

Cholinergic blocking

After the instillation of an intrapleural chemotherapeutic agent, what should the oncology nurse do for the medication to reach optimal absorption? Infuse the medication, allow it to dwell, and then drain the solution. Clamp the tube for 18 hours and then connect to suction. Clamp the tube and reposition the patient every 10 to 15 minutes for 2 hours. Clamp the tube for 1 hour and unclamp for 1 hour.

Clamp the tube and reposition the patient every 10 to 15 minutes for 2 hours. Following installation of the chemotherapeutic agent, clamp tubing and reposition the patient every 10 to 15 minutes for 2 hours. Attach tubing to suction for 18 hours. Assess the patient for pain, fever, or anxiety and provide analgesic, antipyretic, and emotional support.

The nurse has developed a plan of care for an older adult client newly diagnosed with Parkinson's disease. What outcome is most likely to be appropriate for this client? Client will demonstrate a full return to independent activities of daily living with two weeks of starting treatment Client will return to pre-diagnosis levels of fine motor skill within 48 hours of beginning treatment Client will demonstrate the ability to ambulate the length of the hall within one week of starting medication Client will be oriented to person, place and time within 48 hours of beginning treatment

Client will demonstrate the ability to ambulate the length of the hall within one week of starting medication

A patient has been diagnosed with leukemia. Which alkylating agent is the only one that can be used for both acute and chronic leukemia? Chlorambucil Carmustine Cyclophosphamide Streptozocin

Cyclophosphamide

Which microorganism is known to cause retinitis in people with HIV/AIDS? Cryptococcus neoformans Pneumocystic carinii Cytomegalovirus Mycobacterium avium

Cytomegalovirus

A gerontological nurse is highly aware of the changes in pharmacokinetics that accompany the aging process. What phenomenon is primarily responsible for these changes? Increased prevalence of chronic diseases Hemodynamic changes Changes in cognition, including concentration and decision-making abilty Decreased function of vital organs

Decreased function of vital organs

A client is brought to the emergency department in the midst of acute alcohol withdrawal accompanied by seizure activity. What drug is most likely to meet this client's needs? Gabapentin (Neurontin) Diazepam (Valium) Ethosuximide (Zarontin) Phenytoin (Dilantin)

Diazepam (Valium)

Which blood test confirms the presence of antibodies to HIV? Erythrocyte sedimentation rate (ESR) Enzyme-linked immunoabsorbant assay (ELISA) Reverse transcriptase p24 antigen

Enzyme-linked immunoabsorbant assay (ELISA)

An instructor is preparing a teaching plan for a group of students about adrenergic agonists. Which would the nurse include as an alpha- and beta-adrenergic agonist? Phenylephrine Epinephrine Terbutaline Albuterol

Epinephrine

A physician has ordered a drug for a pregnant woman to treat fetal tachycardia and congestive heart failure. What drug does the nurse anticipate administering? haloperidole (Haldol) Tenormin (Atenolol) Digitalis (Digoxin) Brethine (Terbutaline)

Digitalis (Digoxin) Digoxin (a drug that slows the heart rate and strengthens the force of contraction) is administered to the mother to treat fetal tachycardia and congestive heart failure in the fetus.

One of the direct acting muscle relaxants is also used to treat malignant hyperthermia. What drug is used for the treatment of hyperthermia? Orphenadrine Chlorzoxazone Metaxalone Dantrolene

Dantrolene

Which medications can be used to treat or prevent malignant hyperthermia? Methocarbamol (Robaxin) Metaxalone (Skelaxin) Carisoprodol (Soma) Dantrolene (Dantrium)

Dantrolene (Dantrium)

A patient is having surgery to repair a ruptured Achilles tendon. The patient develops severe muscle contractions and hyperthermia. Which medications will be administered? Carisoprodol (Soma) Cyclobenzaprine (Flexeril) Dantrolene sodium (Dantrium) Baclofen (Lioresal)

Dantrolene sodium (Dantrium)

Alpha- and beta-specific adrenergic agonists are primarily used to treat obstructive pulmonary conditions. True False

False

The nurse is caring for a patient who is taking an oral neuroleptic medication. What would be important to include in the patient teaching? Tardive dyskinesias Urge incontinence Bradycardia Orthostatic hypotension

Tardive dyskinesias

Mrs. Keen is treated for leukemia. Her most recent laboratory results show a decrease in her platelet level. The physician has prescribed oprelvekin to increase her platelet count. What is the main adverse effect of oprelvekin? Exfoliative dermatitis Eye hemorrhage Hyperthyroidism Weight gain/fluid retention, which can worsen heart failure

Weight gain/fluid retention, which can worsen heart failure

A client has been diagnosed with subclinical hypothyroidism. The client reports feeling fine and does not want to take any medications. The nurse informs the client that some medical providers encourage pharmacological intervention to improve all of the following EXCEPT: Cholesterol metabolism. Left ventricular function. Muscle function. Weight loss.

Weight loss. The FDA has issued a BLACK BOX WARNING regarding the use of thyroid hormones for the treatment of obesity or for weight loss, either alone or with other therapeutic agents. Significant and serious complications may develop.

Some older adults are at risk for medication-related problems. Which group(s) are at highest risk for these problems? (Select all that apply.) older adults with six chronic medical conditions older adults who take one or more medications or more than 12 doses of medication per day adults age 60 to 65 years older adults in long-term care facilities adults older than 85 years

adults older than 85 years older adults who take one or more medications or more than 12 doses of medication per day older adults with six chronic medical conditions

Which agents would be considered cancer non-cell cycle specific agents? antimetabolites protein tyrosine kinase inhibitors mitotic inhibitors alkylating agents

alkylating agents

An elderly client comes into the clinic with a family member. The client reports back pain. The physician prescribes cyclobenzaprine (Flexaril) for the client. What type of adverse effects should the nurse educate the client and family about? anti-cholinergic side effects such as sedation and weakness may cause delirium and hallucinations asymptomatic gastrointestinal pathology increased agitation and irritability

anti-cholinergic side effects such as sedation and weakness

A 78-year-old patient is admitted to the Emergency Department (ED) and is diagnosed with bradycardia. The patient tells the nurse that the patient is taking donepezil (Aricept), a cholinergic agent, for Alzheimer's disease. The nurse knows that the drug of choice for this bradycardia is: bethanechol. pseudoephedrine. propranolol. atropine.

atropine

Abciximab (ReoPro) is a monoclonal antibody that actually is a fragment called the "Fab fragment." There are many ways to describe this drug. Choose all that apply. can be used for ischemic heart disease may be given immediately following a total knee replacement binds to a glycoprotein receptor on human platelets and inhibits their aggregation may be given in conjunction with coumadin

binds to a glycoprotein receptor on human platelets and inhibits their aggregation can be used for ischemic heart disease

A 72-year-old has been taking disopyramide (Norpace) for cardiac dysrhythmias. What assessment by the nurse indicates complications from this medication? oliguria, dry skin, and uremia crackles, dyspnea, orthopnea nausea, vomiting, and diarrhea confusion, lethargy, and constipation

crackles, dyspnea, orthopnea Disopyramide, of all anti-arrhythmic drugs, is the most potent negative inotrope, and therefore may induce heart failure in elderly clients. It is also strongly anticholinergic. Other anti-arrhythmic drugs should be used instead.

Palivizumab (Synagis) is a monoclonal antibody like rituximab; unlike rituximab, it has a unique function. Which of the following characteristics describe palivizumab? Choose all that apply. injection given only once cytotoxic to the respiratory syncytial virus (RSV) administered within 6 hours of reconstitution can cause injection site erythema

cytotoxic to the respiratory syncytial virus (RSV) administered within 6 hours of reconstitution can cause injection site erythema

Many times a combination of antineoplastic medications are used to: decrease the development of cell resistance. increase the length of treatment. increase the quantity of each medication used. decrease the side effects of each medication.

decrease the development of cell resistance.

You are the nurse in a respiratory clinic. You should be aware that the effects of anticholinergic agents include decreased respiratory secretions. increased salivation. impaired lung function. hiccups.

decreased respiratory secretions.

While the nurse is talking with a client, the client informs the nurse that the client has been under treatment for weight loss management. The client indicates taking antithyroid medication to increase weight loss. Included in client education about antithyroid medication is that taking: antithyroid medication will increase weight loss; however, the client needs to take a calcium supplement as well. excessive or unnecessary antithyroid medication may produce serious or life-threatening manifestations of toxicity. antithyroid medication will not contribute to weight loss; it only results in fat redistribution. antithyroid medication will increase weight loss; however, the client needs to take additional dietary supplements of iodine as well.

excessive or unnecessary antithyroid medication may produce serious or life-threatening manifestations of toxicity.

A client with multiple sclerosis asks the nurse to explain why deep tissue massages do not relieve spasticity. The nurse should explain that spasticity is caused by: stimulation of "association areas" in the brain; therefore, only nerve blocks will be effective. nerve damage in the brain and spinal cord, and it is a permanent condition. inflammation of the muscles; therefore, NSAIDs may be effective. skeletal muscle trauma and will improve in time.

nerve damage in the brain and spinal cord, and it is a permanent condition.

A child who has been hospitalized with pneumonia is being discharged with two new medications. What information does the nurse need to educate the family about? (Select all that apply.) what the medication is being taken for how the drug works adverse effects the name of the drug when the child feels better, the child can stop the medication

the name of the drug what the medication is being taken for how the drug works adverse effects

A 4-year-old boy is postoperative day one following surgery for trauma suffered in a motor vehicle accident. The boy is in pain, and the nurse is preparing to administer a dose of hydromorphone syrup as ordered. To administer this drug, the nurse should use a(n): teaspoon. parenteral syringe with the needle removed. oral syringe. transparent, 2-ounce medication cup.

oral syringe.

The nurse reviews the plan of care for a patient receiving antineoplastic therapy. The nurse notes a nursing diagnosis of risk for infection. Which adverse effect would the nurse expect the patient to exhibit? alopecia dehydration pancytopenia gastrointestinal toxicity

pancytopenia

A patient has been prescribed melphalan, an alkylating agent, for the treatment of an ovarian tumor. The patient wants to know the action of the drug in treating the tumor. Which of the following should the nurse inform the patient? Neutralizes the alkalinity of the cell environment. Changes the cell to a more alkaline environment. Increases the acidity of the cell environment. Changes the cell to a neutral environment.

Changes the cell to a more alkaline environment.

A 67-year-old patient who has a history of pleural and pericardial effusions is given sargramostim for the first time. What precaution should the nurse take when administering the first dose of the drug? Check for effects such as respiratory distress, hypotension, and syncope in the first 20 minutes. Administer diphenhydramine along with sargramostim to increase therapeutic effect. Rub ice gently at the injection site before and after injection. Rotate injection sites among the upper arms, abdomen, and thighs.

Check for effects such as respiratory distress, hypotension, and syncope in the first 20 minutes.

A medical-surgical registered nurse (RN) is requested to go to the oncology unit, which is short staffed. When the RN arrives to the unit, the oncology nurse states, "We are so short today that you are going to have to administer chemotherapy to some of the clinic patients." According to the Oncology Nurses Society (ONS), of what should the oncology nurse be aware? Because there is a critical shortage of oncology nurses in the unit, it is within the scope of practice for the RN to administer the chemotherapy. The oncology nurse should be aware that he or she must watch the RN administer the chemotherapy. The oncology nurse should be aware that he or she may delegate chemotherapy to another nurse as long as the oncology nurse is in the department. Chemotherapy should be administered by RNs who have successfully completed a course in chemotherapy administration.

Chemotherapy should be administered by RNs who have successfully completed a course in chemotherapy administration.

Upon return from from active duty in Zimbabwe, a military veteran asks the nurse about a painful rash on her side that is triggered by stress. The nurse knows to ask the history of where the veteran has traveled and about any exposure to rash-causing agents. An order for a PCR shows that the rash is caused by herpes zoster (shingles). The nurse explains that the painful rash is called shingles and is caused later in life by which of the following infections? Chickenpox Mumps Measles HSV-1

Chickenpox

A client is receiving cyclosporine as an oral solution. What would the nurse mix this drug with to make it easy to administer to children? (Select all that apply.) Water Milk Chocolate milk Soda Orange juice

Chocolate milk Orange juice Milk

A student asks the pharmacology instructor to describe the function of a cholinergic agonist. What would the instructor reply? Cholinergic agonists decrease the activity of GABA receptor sites throughout the body. Cholinergic agonists increase the activity of acetylcholine receptor sites throughout the body. Cholinergic agonists increase the activity of dopamine receptor sites throughout the brain and spinal cord. Cholinergic agonists decrease the activity of norepinephrine receptor sites throughout the brain and spinal cord.

Cholinergic agonists increase the activity of acetylcholine receptor sites throughout the body.

The nurse is caring for a client with glaucoma and is aware that which category of preanesthetic medication is contraindicated in this client? Opioid Antiemetic Cholinergic blocking Antianxiety

Cholinergic blocking

Administration of which classes of medications can decrease secretions of the upper respiratory tract? Cholinergic blocking drug Opioids Antiemetics Antianxiolytic

Cholinergic blocking drug

A nurse is caring for a 49-year-old patient who has been taking bethanechol, a cholinergic agonist, for treatment of neurogenic bladder. After one week, the patient develops sweating, heavy salivation, and bronchospasm. What would the nurse suspect is happening with this patient? Pulmonary edema Myasthenic crisis Anaphylactic reaction Cholinergic crisis

Cholinergic crisis

The nurse is caring for a 49-year-old patient who has been receiving bethanechol (Duvoid) for 1 week. The patient develops progressive muscle weakness and respiratory difficulty. What would the nurse suspect is happening with the patient? Cholinergic overdose Anaphylactic reaction Myasthenic crisis Pulmonary edema

Cholinergic overdose

When assessing a patient who has received a nondepolarizing NMJ blocker, the nurse determines that the patient is experiencing excessive effects of the drug. What would the nurse expect to be used? Peripheral nerve stimulator Narcotic antagonist Direct acting skeletal muscle relaxant Cholinesterase inhibitor

Cholinesterase inhibitor

Mr. Jones is prescribed loperamide for diarrhea. Loperamide can be used for which type of diarrhea? Diarrhea caused by pseudomembranous colitis Diarrhea caused by ingestion of Salmonella organisms Diarrhea caused by gastroenteritis Chronic diarrhea

Chronic diarrhea Unlike diphenoxylate, loperamide may be used for chronic as well as acute diarrhea. Loperamide is contraindicated for diarrhea related to infections and pseudomembranous colitis. Salmonellosis and gastroenteritis are both infectious diseases and should not be treated with loperamide.

A patient has just received etanercept (Enbrel). What medications cannot be administered with this drug? Select all that apply. Motrin Steroids Cyclophosphamide (Cytoxan) Imatinib (INN)

Cyclophosphamide (Cytoxan) Imatinib (INN) This medication should not be administered with Cytoxan or imatinib due to the increased risk of myelosuppression. Motrin and steroid therapy should not produce any severe effects if administered with Enbrel.

The physician has decided to prescribe T- and B-cell suppressors for a patient diagnosed with psoriasis. What drug will be ordered for this patient? Alefacept (Amevive) Tacrolimus (Prograf) Cyclosporine (Neoral) Azathioprine (Imuran)

Cyclosporine (Neoral)

While studying the T- and B-cell immune suppressors, the nursing students learn that the most commonly used immune suppressant is: Glatiramer (Copaxone). Azathioprine (Imuran). Cyclosporine (Sandimmune). Pimecrolimus (Elidel).

Cyclosporine (Sandimmune). Several T- and B-cell immune suppressors are available for use. Of the numerous agents available, cyclosporine is the most commonly used immune suppressant. The other options are all T- and B-cell immune suppressors; they are just not the most commonly prescribed.

Which of the U.S. FDA Pregnancy Categories should the nurse consider in assessing the risk vs. benefit of a drug for use in pregnant women before administration of the medication? (Select all that apply.) B C D X

D, C, X

The pregnant woman is at increased risk for toxicity with highly protein-bound drugs due to what physiologic change that occurs during pregnancy? Increase in plasma volume by 50% Increased levels of protein in the blood Increase in cell volume by 30% Vasodilatation

Increase in plasma volume by 50%

Kelly is 7 months pregnant. The physician has prescribed an inhaled bronchodilator to treat Kelly's asthma. What physiologic change occurs in pregnancy that affects absorption of inhaled medications? Increase in plasma volume due to progesterone Increase in pulmonary dilation Decrease in tidal volume Decrease in minute volume

Increase in pulmonary dilation

A patient with dementia of Alzheimer's disease is administered donepezil HCL. What are the actions associated with cholinesterase inhibitors? Increase in the level of adenosine tri-phosphate in the blood Increase in the level of cholinesterase in the blood Increase in the level of acetylcholine in CNS Decrease in the level of neurotoxins in the brain

Increase in the level of acetylcholine in CNS

The nurse has been administering interleukins to a client. What change in the client's health status would indicate successful therapy? Decrease in inflammation Maintenance of adequate circulating platelets Decrease in number of natural killer cells Increase in the number of lymphocytes

Increase in the number of lymphocytes

The nurse has been administering interleukins to a client. What change in the client's health status would indicate successful therapy? Increase in the number of lymphocytes Decrease in number of natural killer cells Decrease in inflammation Maintenance of adequate circulating platelets

Increase in the number of lymphocytes

A client's depression is believed to exist because of a deficiency of biogenic amines in key areas of the client's brain. What phenomenon would be most likely to cause this deficiency? Increase in the number or sensitivity of postsynaptic receptors Depletion of norepinephrine because biogenic amines feed off of loose particles of the neurotransmitter. Monoamine oxidase (MAO) strengthening the impact of biogenic amines. A slowing of the action of the neurons may lead to their depletion.

Increase in the number or sensitivity of postsynaptic receptors

A group of students are reviewing the actions of laxatives on the GI tract. The students demonstrate understanding when they state what about bulk stimulants? Directly stimulate the nerve plexus in the intestinal wall Increase the fluid in the intestinal contents Allow formation of a slippery coat on the intestinal contents Selectively antagonize opioid binding

Increase the fluid in the intestinal contents

A man is taking an anabolic steroid. He has an undiagnosed prostate tumor. What effect will the anabolic steroid have on the prostate tumor? Increase vascularization Decrease the size Limit metastasis Increase the size

Increase the size

The pharmacology class learns that epoetin alfa is an immunosuppressant drug that is designed to have what expected outcome? Increased WBC count Decreased WBC count Increased RBC count Decreased RBC count

Increased RBC count

A nurse is caring for a patient with subacute lymphocytic thyroiditis. The physician prescribes thyroid hormones to the patient. From which of the following signs during ongoing assessment should the nurse conclude that the patient is responding to the therapy? Increased appetite Excessive sweating Flushing Swollen neck

Increased appetite The nurse should observe for signs of therapeutic responses, which include increased appetite, weight loss, mild diuresis, an increased pulse rate, and decreased puffiness of the face, hands, and feet. The nurse need not observe swollen neck, excessive sweating, or heat intolerance as signs of responding to therapy. Swollen neck, sore throat, and cough may occur after two to three days of administering radioactive iodine. Sweating and flushing are the adverse reactions to thyroid hormones.

In older adult men, anabolic steroids may be prescribed for a deficiency condition. If hypertensive, what might be the cause for an increase in blood pressure? Increased bioavailability of androgens Potassium retention Increased RBD production Increased fluid and sodium retention

Increased fluid and sodium retention

In older adult men, anabolic steroids may be prescribed for a deficiency condition. If hypertensive, what might be the cause for an increase in blood pressure? Potassium retention Increased fluid and sodium retention Increased RBD production Increased bioavailability of androgens

Increased fluid and sodium retention

Which is an effect of epinephrine? Peripheral vasodilation Bronchoconstriction Increased heart rate Decreased blood pressure

Increased heart rate

When the patient is taking filgrastim, what positive outcome does the nurse anticipate observing from the laboratory studies? Increased neutrophil count Improved tissue oxygenation Elevated red blood cell count levels Increased platelet count

Increased neutrophil count

Experienced nurses know the importance of administering a pre-anesthetic on time. What is one complication that can occur if a pre-anesthetic is not administered on time? Increased respiratory secretions Decreased urine output Coma Decreased potassium

Increased respiratory secretions

A physician has prescribed difenoxin HCl to a patient with acute diarrhea. The patient informs the nurse that he is also taking MAOI antidepressants. What condition should the nurse monitor for in this patient as a result of the interaction of the two drugs? Increased risk of CNS depression Increased cholinergic-blocking adverse reactions Increased risk of hypertensive crisis Decreased effect of difenoxin HCl

Increased risk of hypertensive crisis

A patient undergoing antineoplastic drug therapy is administered an alkylating drug. The patient is also administered an aminoglycoside as an anti-infective agent. Which of the following interactions of the alkylating drug with the aminoglycoside should the nurse assess the patient for? Increased risk of methotrexate toxicity Increased risk of hypoglycemia Increased risk of nephrotoxicity Increased risk of bleeding

Increased risk of nephrotoxicity

A patient is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce? Decreased cerebral circulation Increased vasoconstrictive effects Decreased coronary circulation Increased bronchoconstriction

Increased vasoconstrictive effects

You are talking to your class of nursing students about the adverse effects of corticosteroid therapy. What dietary change would you tell the students may help prevent osteoporosis related to long-term corticosteroid administration? Increasing vitamin D intake Decreasing protein intake Decreasing calcium intake Increasing caloric intake

Increasing vitamin D intake

Which of the following drugs are used to prevent uterine contractions? Select all that apply: Ritodrine (Yutopar) Oxytocin (Pitocin) Indomethacin (Indocin) Misoprostal (Cytotec) Terbutaline (Brethine)

Indomethacin (Indocin) Terbutaline (Brethine) Ritodrine (Yutopar)

A patient is beginning a course of chemotherapy for the treatment of chronic lymphocytic leukemia. To what is the start of this therapy referred? Palliative therapy Induction therapy Consolidation therapy Maintenance therapy

Induction therapy

Ms. Preston, age 26, just delivered a 9-pound, 8-ounce boy yesterday. You review the laboratory values for specimens drawn this morning. The patient's white blood cell count is 26,000/mm3. Which of the following factors is most likely NOT a contributor to this laboratory result? Infection of the placental site Stress from the labor Exertion in the labor and delivery Normal healing of the open placental site

Infection of the placental site

The nurse is conducting genetic counseling of a couple who is planning to have a baby in the next year. The wife reports that she has a seizure disorder. What important information should the nurse discuss with the couple? (Select all that apply.) Inform them about the possible effects of an antiepileptic drug on the fetus. Inform them about the risk of fetal hypoxia and CNS damage if the mother experiences seizures. Inform them about the need to stop all drug therapy during pregnancy. Inform them that 1% to 5% of women have a seizure disorder before pregnancy and that they need not worry.

Inform them about the possible effects of an antiepileptic drug on the fetus. Inform them about the risk of fetal hypoxia and CNS damage if the mother experiences

Which intervention would be an appropriate part of a plan of care for a patient with a seizure disorder? Informing the patient and family that excessive frustration is to be expected Informing the patient and family that seizure control is gained immediately Informing the patient and family that unrealistic expectations can occur Informing the patient and family that seizure control is not gained immediately

Informing the patient and family that seizure control is not gained immediately

A male client informs his physician that sildenafil therapy is not working for him. What is most likely to be the reason for this and needs to be carefully assessed for by the nurse? Nonadherence to the prescribed dosage Prescribed dosage is less than normal Urethral blockage Ingestion of high-fat meal along with the drug

Ingestion of high-fat meal along with the drug

A client has been diagnosed with Kaposi sarcoma and admitted to the unit. The physician has order an IV infusion of an interferon. What drug has the physician ordered? Interferon beta-1a Interferon gamma-1b Interferon alfa-2b Peginterferon alfa-2b

Interferon alfa-2b Interferon alfa-2b indications include hairy cell leukemia, malignant melanoma, AIDS-related Kaposi sarcoma, chronic hepatitis B and C, and intralesional treatment of condylomata acuminata in clients 18 years of age or older.

When caring for a patient receiving estrogen therapy, which action would be an appropriate part of the evaluation process? Directing the patient to weigh herelf weekly and to report sudden weight gain Interviewing the patient and observing for therapeutic and adverse effects Teaching the patient that combined estrogen-progestin therapy may increase blood sugar levels in women with diabetes Teaching the patient to take estrogens and progestins with food or at bedtime to decrease nausea

Interviewing the patient and observing for therapeutic and adverse effects

A patient is receiving menotropins. The nurse would anticipate administering this drug by which route? Subcutaneous Oral Intradermal Intramuscular

Intramuscular

A patient is receiving carboplatin. The nurse would expect to administer this drug by which route? Subcutaneous Intravenous Intramuscular Oral

Intravenous

A child is born with cretinism. What element was lacking in the mother's diet during pregnancy? Potassium Magnesium Iodine Sodium

Iodine

Which cholinergic-blocking drugs are used in the treatment of chronic obstructive pulmonary disease (COPD)? (Select all that apply.) Benztropine (Cogentin) Darifenacin (Enablex) Tiotropium (Spiriva) Ipratropium (Atrovent) Biperiden (Akineton)

Ipratropium (Atrovent) Tiotropium (Spiriva)

A client who was diagnosed with iron deficiency anemia is worried because she does not know why she was prescribed iron supplements. The nurse teaches the client about which action of oral iron administration? Iron supplements prevent infection so hemoglobin cells grow back faster to treat anemia. Iron supplements prevent bleeding to replenish hemoglobin cells faster to treat anemia. Iron supplements prevent depletion of hemoglobin cells from anxiety to treat anemia. Iron acts by elevating the serum iron concentration to replenish hemoglobin to treat anemia.

Iron acts by elevating the serum iron concentration to replenish hemoglobin to treat anemia.

The nurse is caring for a client who is receiving epoetin alfa. What adjunct treatment will the nurse expect the physician to order for this client? Potassium supplement Sodium restriction Renal dialysis Iron supplement

Iron supplement

A patient is administered atropine to increase the heart rate. What is the action of atropine? It blocks the parasympathetic vagal stimulation. It exacerbates the parasympathetic vagal stimulation. It provides long-acting antihistamine blockage. It blocks cell wall synthesis of gram-negative bacilli.

It blocks the parasympathetic vagal stimulation.

A patient is administered bevacizumab (Avastin) to treat tumor growth in a breast tumor. What is the action of bevacizumab (Avastin)? It binds to the 30S ribosome. It inhibits the formation of blood vessels. It changes the RNA of the tumor cell. It blocks the cell wall synthesis.

It inhibits the formation of blood vessels.

The nurse knows that which of the following is true about tardive dyskinesia? It consists of prolonged muscle contractions. It is irreversible. It is reversible. It causes hallucinations.

It is irreversible.

The nurse provides drug teaching to a client who has Parkinson's disease and who has been prescribed amantadine. How should the nurse describe the action of this drug? It stimulates the natural release of dopamine It acts on effector cells in the same manner as dopamine It binds directly with postsynaptic dopamine receptors It acts a direct precursor of dopamine synthesis

It stimulates the natural release of dopamine

A patient with myasthenia gravis is administered neostigmine (Prostigmin). How does this cholinergic drug produce its effect? It stimulates the parasympathetic nervous system. It stimulates the cardiac system. It stimulates the sympathetic nervous system. It stimulates the respiratory system.

It stimulates the parasympathetic nervous system.

Jack Thomas is a 45-year-old automobile mechanic with a history of throat cancer. Jack has just undergone radical neck resection. As a result of the surgery, Jack suffers from xerostomia, a dry mouth condition. He is prescribed pilocarpine therapy. What advice should you give Jack regarding the drug therapy? Jack should be encouraged to consume more caffeine-containing beverages because that cuts the craving for smoking. Jack should be near a urinal at all times. Jack should be instructed about the Ocusert system. Jack should be cautioned about blurred vision and its hazards.

Jack should be cautioned about blurred vision and its hazards.

The nurse educator is teaching an online pharmacology class. The topic of the online seminar is the contraindications for the use of colony stimulation factor. The nurse includes which contraindication? Asthma Food allergies Known hypersensitivity to the drug or any component of the drug Rash

Known hypersensitivity to the drug or any component of the drug

Cholinesterase inhibitors should not be administered to patients in which stage of Alzheimer's disease? (Choose one) Middle Late Early Pre

Late

An older patient is experiencing diarrhea. Which is a likely cause of diarrhea? Glaucoma Diabetes Laxative abuse Antihypertensive agents

Laxative abuse

A home health nurse is caring for a 72-year-old male in his home. The client reports diarrhea on an almost-daily basis. What would the nurse explain to this client is a common cause of diarrhea in older adults? Glaucoma Diabetes Hypertensive medications Laxative overuse

Laxative overuse

A male patient who uses a transdermal testosterone gel for treatment of his oligospermia applies the medication first thing in the morning and washes it off before bed. What patient education is necessary? Use additional doses of the gel. Use the same amount of doses, just increase the amount of gel used. Only use the gel at times of procreation. Leave the gel on until the next application is due.

Leave the gel on until the next application is due.

The oncology nurse is preparing to administer 5-fluorouracil to a patient with colon cancer. To potentiate the action of the 5-fluorouracil, what other medication may be administered with the drug? Hydroxyurea Paclitaxel Etoposide Leucovorin

Leucovorin

A patient with impaired liver function is suffering from a seizure disorder, which is noted to consist of partial seizures. Which medication is administered to a patient with impaired liver function? Fosphenytoin (Cerebyx) Levetiracetam (Keppra) Carbamazepine (Tegretol) Oxcarbazepine (Trileptal)

Levetiracetam (Keppra)

For a client diagnosed with Parkinson's and narrow angle glaucoma, what medication would be contraindicated? Neurontin Amantadine Levodopa Dilantin

Levodopa

Which of the following drugs may be administered intravenously to treat clients with hypothyroidism? Select all that apply: Liothyronine (Triostat) Liotix (Thyrolar) Methimazole (Tapazole) Desiccated thyroid (Armour Thyroid) Levothyroxine (Synthroid)

Levothyroxine (Synthroid) Liothyronine (Triostat)

What should the nurse include as a possible adverse effect when teaching a client about phenytoin? Liver toxicity Increased white blood cell count Diarrhea Physical dependence

Liver toxicity

The nurse is prepared to assist the health care provider with what type of anesthesia for a client with a laceration (requires sutures) of the foot? Local General Topical Conduction block

Local

The nursing instructor is teaching the students about anesthesia and informs them that there are two types. What are those two types of anesthesia? (Select both that apply.) General anesthesia Local anesthesia Spinal anesthesia Topical anesthesia Regional anesthesia

Local anesthesia General anesthesia

A patient visits a dental health care clinic for a tooth extraction. Which of the following types of anesthesia should the assigned nurse administer to the patient? Topical anesthesia Local infiltration anesthesia Regional anesthesia General anesthesia

Local infiltration anesthesia

The nurse is educating nursing students about drugs that affect gastrointestinal motility. Which drug inhibits intestinal peristalsis through direct effects on the longitudinal and circular muscles of the intestinal wall? Bismuth subsalicylate Loperamide Magnesium citrate Paragoric

Loperamide

A patient has been taking lithium carbonate (Eskalith) for many years to treat bipolar disorder. Which of the following diets will require the dose of lithium carbonate (Eskalith) be reduced? Low calorie Low residue Low carbohydrate Low sodium

Low sodium

Which tissue type does not respond well to reproductive hormone therapy for cancer? Breast Lung Endometrial Prostate

Lung

A patient has received a large amount of chemotherapy to treat leukemia. The patient develops gastrointestinal upset, hypertension, and paresthesias. What syndrome is the patient developing? Epidermal nevus syndrome Irritable bowel syndrome Lysis syndrome Fröhlich's syndrome

Lysis syndrome

During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act? M G0 G1 S

M

A pregnant client wants to know what drugs she can take safely during her pregnancy. Which of the following drugs should the nurse tell her is relatively safe during pregnancy? Estazolam Valproic acid Magnesium sulfate Dihydroergotamine mesylate

Magnesium sulfate

A pregnant woman who is at 26 weeks' gestation is being admitted after seeing her obstetrician at the office. Her blood pressure is 178/110, 3+ pitting edema of the bilateral lower extremities, and 3+ proteinuria. What drug therapy does the nurse anticipate starting for this patient? Insulin Dramamine Magnesium sulfate Reglan (metoclopramide)

Magnesium sulfate

What is the primary treatment goal for the patient with gestational diabetes to decrease the incidence of congenital anomalies? Ensure early delivery to prevent a large-for-gestational-age fetus. Prevent fluid overload. Maintain blood glucose levels slightly below normal to increase placental perfusion. Maintain normal blood glucose levels.

Maintain normal blood glucose levels.

What does the nurse understand is the safest medication choice for the pregnant woman with a seizure disorder? Discontinue all antiepileptic medications. Maintain therapy to control seizures with two or more antiepileptic drugs so that one drug will not have to be used at maximum safe dose. Maintain therapy to control seizures with the maximum dose so that seizures will be well controlled. Maintain therapy to control seizures with the smallest dose and monotherapy when possible.

Maintain therapy to control seizures with the smallest dose and monotherapy when possible.

The patient in remission is receiving a low-dose cytotoxic drug so that there will be a delay in the regrowth of residual cancer cells. What is this form of therapy called? Neoadjuvant Maintenance Intensification Palliative

Maintenance

Laboratory testing of an 80-year-old patient who is well-known to the clinic nurse indicates that his liver function has been gradually decreasing over the last several years. How will this age-related physiological change influence drug metabolism? Many of the patient's medications will remain in his body for a longer time. The patient's kidneys will be forced to metabolize a disproportionate quantity of medications. The liver will sequester drug molecules in the hepatocytes, and they will be released at unpredictable times. The patient will metabolize drugs more quickly but derive less of a therapeutic benefit from them.

Many of the patient's medications will remain in his body for a longer time.

A female athlete is using high doses of anabolic steroids to enhance her performance. When a female use anabolic steroids at high doses, what result may she have? Immobility of joints Hypotension Obesity Masculinization

Masculinization

A woman who has been prescribed high doses of anabolic steroids should be instructed on which effects? Hypotension Obesity Immobility of joints Masculinization

Masculinization

Which of the following drugs used to manage lower gastrointestinal disorders increases the risk of bleeding when administered to clients taking warfarin (Coumadin)? Select all that apply: Mesalamine (Asacol) Polyethylene glycol (MiraLax) Bisacodyl (Dulcolax) Psyllium (Metamucil) Olsalazine (Dipentum)

Mesalamine (Asacol) Olsalazine (Dipentum) Aminosalicylates, like mesalamine (Asacol) and olsalazine (Dipentum), can increase the risk of bleeding in clients taking warfarin (Coumadin).

A patient suffers from recurrent sinus infections. Which of the following medications will be prescribed to decrease sinus inflammation? Mometasone (Nasonex) Dexamethasone (Decadron) Cortisone Prednisone

Mometasone (Nasonex) Mometasone (Nasonex) is formulated for nasal inhalation and decreases sinus inflammation. Cortisone is the drug of choice for adrenal insufficiency. Prednisone is the glucocorticoid of choice in nonendocrine disorders in which anti-inflammatory, antiallergic, antistress, and immunosuppressive effects are desired. Dexamethasone is considered the corticosteroid of choice for cerebral edema.

Ms. Ellis is treated for thrombocytopenia secondary to chemotherapy. As the nurse caring for Ms. Ellis, you are aware that during therapy for this condition, what ongoing assessment will be important? Monitor the blood pressure. Monitor the blood sugar levels. Check for any blood-related adverse effect. Monitor the platelet count.

Monitor the platelet count.

You are teaching your client about diphenoxylate with atropine sulfate, which the physician has prescribed for treatment of acute diarrhea. Which of the following adverse effects should you be sure to mention? Nausea Diaphoresis Increased appetite Bradycardia

Nausea

The nurse should advise clients taking laxatives of which of the following adverse effects? Select all that apply: Nausea Perianal irritation Constipation Bloating Cramps

Nausea Perianal irritation Bloating Cramps

A 34-year-old man is prescribed interferon alfa-2a for the treatment of chronic hepatitis C. When teaching John about the medication, which side effect will the nurse explain is among the most common? Significant weight loss Dry skin Changes in blood pressure Nausea and changes in taste

Nausea and changes in taste

Mr. Mass has been diagnosed with lung cancer. The physician orders chemotherapy prior to the surgery to reduce the tumor burden. What strategy relates to chemotherapy administered to reduce the tumor burden before surgery or radiation, to improve the outcomes of these methods? Palliative therapy Induction therapy Consolidation therapy Neoadjuvant therapy

Neoadjuvant therapy Neoadjuvant therapy relates to chemotherapy administered to reduce the tumor burden before surgery or radiation, to improve the outcomes of these methods.

A patient is administered cyclosporine (Sandimmune, Neoral) to prevent rejection of a kidney transplant. Which is a major adverse effect of cyclosporine? Anaphylaxis Respiratory arrest Nephrotoxicity Congestive heart failure

Nephrotoxicity

The student asks the physiology instructor where the motor neuron communicates with a skeletal muscle fiber. What would the instructor respond? Synaptic cleft Afferent junction Synapse Neuromuscular junction

Neuromuscular junction

A client mentions at her prenatal visit that she has been using an OTC cough syrup with alcohol. The nurse is concerned and suggests an alternative therapy for which of the following reasons? The cough syrup will be ineffective during pregnancy. Prescribed cough syrup is safer than OTC remedies for the mother and fetus. The cough syrup safety during pregnancy is uncertain. No amount of alcohol is considered safe during pregnancy.

No amount of alcohol is considered safe during pregnancy.

Which anticonvulsant elicits its effects by stabilizing the hyperexcitability postsynaptically in the motor cortex of the brain? Phenytoin (Dilantin) Zonisamide (Zonegran) Valproic acid (Depakote) Ethosuximide (Zarontin)

Phenytoin (Dilantin)

The nurse knows that oxytocin (Pitocin) is usually contraindicated in what obstetrical conditions? Select all that apply. Hypertonic uterus Placenta previa Premature rupture of membranes Cephalopelvic disproportion Uterine inertia

Placenta previa Cephalopelvic disproportion Hypertonic uterus

During pregnancy, physiologic changes can alter the pharmacokinetics of medications. What contributes to the decreased predictability of medications? Select all that apply.

Plasma volume expansion Increased elimination by the kidneys Increased metabolism by the liver

A patient who has been experiencing liquid stools is prescribed polycarbophil (FiberCon). What is the reason for administering a bulk-forming laxative? Polycarbophil will diminish the absorption of intestinal fiber and water. Polycarbophil will increase bile and diminish bacterial flora in the intestines. Polycarbophil absorbs large amounts of water and decreases fluidity of stools. Polycarbophil will provide pain relief and decrease cramping and bloating.

Polycarbophil absorbs large amounts of water and decreases fluidity of stools.

A patient is scheduled for a colonoscopy in the morning. Which laxative is most likely prescribed the evening before the colonoscopy? Castor oil Polyethylene glycol-electrolyte solution (NuLYTELY) Lactulose (Cephulac) Psyllium (Metamucil)

Polyethylene glycol-electrolyte solution (NuLYTELY) Polyethylene glycol-electrolyte solution (NuLYTELY) is a nonabsorbable oral solution that induces diarrhea within 30-60 minutes and rapidly evacuates the bowel, usually within 4 hours for a colonoscopy. Psyllium is not strong enough for a colonoscopy preparation. Castor oil is not the most commonly prescribed preparation for a colonoscopy. Lactulose is used only when the serum ammonium level is elevated.

Jennifer, the nurse caring for Ms. Cox, is explaining how she will administer a suppository of mesalamine in order to produce the maximum effectiveness of the medication. How should Jennifer administer this medication? Administer the suppository after a cleansing enema. Position Ms. Cox in a left side-lying position. Assist Ms. Cox into a prone position. Warm the suppository in hot water before administration.

Position Ms. Cox in a left side-lying position.

What is the first priority action of the oncology nurse when there is a spill of a chemotherapeutic agent? Pick up glass fragments with a scoop. Wear an approved respirator. Post a sign to warn people away from the exposed area. Rinse the absorbed spill area with clean water. Repeat the washing and rinsing.

Post a sign to warn people away from the exposed area.

What is oxytocin, an endogenous hormone, produced by? Posterior pituitary gland Corpus luteum Uterus Adrenal gland

Posterior pituitary gland

The nurse is caring for a client experiencing the following issues. Which of the following is a risk factor for constipation? Select all that apply. Opioid pain medication Lactose intolerance Postsurgical immobility Parkinson's disease An anti-infective antibiotic

Postsurgical immobility Parkinson's disease Opioid pain medication

Which of the following are non-ergot dopamine receptor agonists? Select all that apply: Ropinirole (Requip) Pramipexole (Mirapex) Benztropine (Cogentin) Entacapone (Comtan) Amantadine (Symmetrel)

Pramipexole (Mirapex) Ropinirole (Requip)

The patient is having an acute exacerbation of rheumatoid arthritis. What medication does the nurse anticipate giving as "pulse therapy"? Cyclosporine Prednisone Remicade Etanercept

Prednisone Glucocorticoid steroids such as prednisone and prednisolone can be administered as oral or intravenous preparation for systemic effects and as an intra-articular injection for a local effect. They are generally given as "pulse therapy" for an acute exacerbation of rheumatoid arthritis.

Which glucocorticoid used for replacement therapy is available only as an oral agent? Cortisone (Cortone Acetate) Hydrocortisone (Cortef) Prednisone (Deltasone) Triamcinolone (Aristocort)

Prednisone (Deltasone) Prednisone is available in oral form only and is used for replacement therapy. Cortisone can be administered orally or intramuscularly and is used for replacement therapy. Hydrocortisone, used for replacement therapy, is administered by the oral, IV, IM, topical, ophthalmic, rectal, and intra-articular routes. Triamcinolone is administered by the oral, IM, inhalant, intra-articular, and topical routes and is used for treatment of allergic and inflammatory disorders and in the management of asthma.

A 24-year-old woman who is at 23 weeks' gestation is concerned that her asthma medication is not as effective. What might be the cause of the change? Medication is near expiration date Pregnancy Increased weight Decreased medication quality

Pregnancy

Which of the following conditions and activities may exacerbate multiple sclerosis (MS)? Range-of-motion (ROM) exercises Pregnancy Urine retention Swimming

Pregnancy

A client is started on terbutaline therapy. What would indicate that the therapy has been successful? The mother did not require any labor induction. Premature birth is avoided for at least 24 hours. There has been less or no bleeding in the delivery. The mother does not experience adverse effects.

Premature birth is avoided for at least 24 hours.

The nurse is caring for a child who will be receiving a renal transplant and who has been prescribed cyclosporine. When teaching the parents and child about this drug, the nurse should explain what primary rationale for administering this drug? Prevention of infection due to immunocompromised status Prevention of organ rejection Preservation of remaining renal function Slowing of metabolic processes postoperatively to prevent an immune response

Prevention of organ rejection

The nurse is caring for a child who will be receiving a renal transplant and who has been prescribed cyclosporine. When teaching the parents and child about this drug, the nurse should explain what primary rationale for administering this drug? Prevention of organ rejection Slowing of metabolic processes postoperatively to prevent an immune response Prevention of infection due to immunocompromised status Preservation of remaining renal function

Prevention of organ rejection

Mr. Craig, age 55, is seen by his family physician today for follow-up care. He was hospitalized 2 months ago for a myocardial infarction. Mr. Craig is taking the following medications: atenolol, Zetia, and Zestril. In addition to requesting a refill of his medication for his cardiac condition, he also asks for something to help with his erectile dysfunction, which has increased in severity over the last year. What would be the most appropriate response to Mr. Craig with regard to sildenafil? Sildenafil will not work for you because of the type of erectile dysfunction that you have. It is not recommended that you have sexual intercourse for a year after having a heart attack. It is not recommended that you take sildenafil, because you are on atenolol. Prior to being prescribed sildenafil, you will need to have a stress test.

Prior to being prescribed sildenafil, you will need to have a stress test.

A client has chronic renal failure. As the disease progresses, the client is experiencing increasing shortness of breath, due to anemia. The nurse would anticipate which medication order? Neupogen Procrit Interferon gamma Penicillin

Procrit

The pregnant woman requires monitoring of orally administered drug therapy because of decreased gastric tone and motility. What hormone is responsible for this alteration? Oxytocin Prolactin Progesterone Estrogen

Progesterone Progesterone decreases gastric motility and prolongs stomach emptying time, which may alter the pharmacokinetics of orally administered drugs.

The nurse knows that, in a client whose uterus is intact, estrogen must be paired with what other drug when used to treat menopausal symptoms? Antispasmodics Progestins Aromatase inhibitors Androgen hormone inhibitors

Progestins

A patient with AIDS is at risk for the development of Pneumocystis jiroveci pneumonia. When should this patient begin prophylactic therapy? Prophylactic therapy should begin when the patient develops flu-like symptoms. Prophylactic therapy should be done when the patient has a positive tuberculin skin test. Prophylactic therapy is not recommended because of the possibility of encountering resistant strains. Prophylactic therapy should start when the patient's CD4 cell counts are less than 200/cells.

Prophylactic therapy should start when the patient's CD4 cell counts are less than 200/cells.

In the defecation process, what is caused by gastrocolic and duodenocolic reflexes? Propulsion of feces into the rectum Expulsion of fecal mass Propulsion of food into the stomach Propulsion of chime into rectum

Propulsion of feces into the rectum

A patient who is receiving chemotherapy is administered a corticosteroid agent. What is the intended effect for the administration? Decrease diarrhea Increase pulmonary function Decrease infection susceptibility Provide antiemetic effects

Provide antiemetic effects

A nurse is caring for a patient who has been prescribed diphenhydramine for the treatment of allergies. The nurse observes that the patient has developed diplopia and the patient reports blurred vision. What nursing intervention should the nurse perform when caring for this patient? Provide eye protection to the patient. Provide proper assistance with ambulation. Instruct the patient to avoid direct sunlight. Instruct the patient to place a cool cloth over eyes.

Provide proper assistance with ambulation.

A nurse is caring for a patient being treated for depression. Which of the following interventions should the nurse perform when the patient complains of dry mouth? Suggest intake of only fibrous food Suggest intake of only fluids Provide sugarless gum or hard candy Provide food rich in fiber

Provide sugarless gum or hard candy

Which medication is used to treat narcolepsy and does not cause cardiac and other systemic stimulatory effects like other CNS stimulants? Provigil Caffeine Dopram Focalin

Provigil

A patient receiving prescribed magnesium sulfate shows signs of dyspnea, tachycardia, and increased respiratory rate and rales. The nurse notices frothy sputum. Which of the following conditions should the nurse suspect? Cardiac arrest Renal failure Pulmonary edema Water intoxication

Pulmonary edema

A client who is on estrogen therapy calls the clinic and tells the nurse that she is experiencing sudden, sharp chest pain. The nurse tells the client to go to the emergency department immediately, because the nurse suspects what adverse reaction related to estrogen therapy? Pulmonary embolism Deep vein thrombosis Skeletal pain Breast pain

Pulmonary embolism

Anticholinergic drugs are used in ophthalmology because they produce which effect? Sedation Decreased lacrimal secretions Pupil constriction Pupil dilation

Pupil dilation

Anticholinergic drugs are used in ophthalmology because they produce which effect? Sedation Pupil constriction Decreased lacrimal secretions Pupil dilation

Pupil dilation

A nurse should counsel patients receiving levodopa to avoid foods high in which vitamin as it reduces the effect of levodopa? Cyanocobalamin (vitamin B12) Ascorbic acid (vitamin C) Phylloquinone (vitamin K1) Pyridoxine (vitamin B6)

Pyridoxine (vitamin B6)

A nurse in the intensive care unit is caring for a patient with a myocardial infarction who also is HIV positive. The physician has ordered amiodarone to treat the ventricular dysrhythmias the patient is having. For what should the nurse monitor? Hyperglycemia T-cell count and viral load Rhabdomyolysis QT prolongation and dysrhythmias

QT prolongation and dysrhythmias

Which of the following is an important assessment for the nurse to make before administering a laxative? Once a medication is ordered by the physician, it is unnecessary to make any additional assessments before administering the medication. An abdominal circumference measurement is an important assessment for the nurse to make in order to evaluate medication effectiveness. Question the client regarding the type and intensity of symptoms to provide a baseline evaluation. It is imperative to ask clients whether they are expecting any visitors because the effects of the medication may hinder visitation.

Question the client regarding the type and intensity of symptoms to provide a baseline evaluation.

A male patient is taking an MAOI. The patient reports seasonal rhinitis and the physician has ordered a phenylephrine nasal spray. What should the nurse do before administering this drug? Have another nurse double check the order. Verify patency of the nares. Question the order with the prescriber. Give the drug as ordered.

Question the order with the prescriber. Phenylephrine, combined with MAOIs, can cause severe hypertension, headache, and hyperpyrexia.

Which of the following is of greatest risk if the patient does not take non-nucleoside reverse transcriptase inhibitors (NNRTI) as prescribed? Rapid onset of drug resistance Increased risk of pneumocystis pneumonia Increased risk of candidiasis Rapid onset of AIDS-related symptoms

Rapid onset of drug resistance

The nurse has taught a client who is receiving lamotrigine about possible adverse effects. The nurse determines that the client has understood the teaching when the client identifies a need to promptly report what adverse effect? Rash Anorexia Fatigue Signs of upper respiratory infection

Rash

A client is prescribed doxorubicin drug therapy for carcinoma of the breast. On the second day of drug therapy, she calls in to report reddish urine. What should the nurse do? Suggest some nonpharmacologic interventions. Reassure the patient that it is a harmless and expected response to the drug. Reassure the patient about adequate monitoring and follow-up in her home setting. Caution the patient against taking aspirin or caffeine.

Reassure the patient that it is a harmless and expected response to the drug.

A patient has been using phenylephrine (Neo-Synephrine) for nasal congestion. He states to the nurse that he is using more every day because his nose is so congested. What effect is the medication producing? Hypotension Reflex bradycardia Rebound nasal congestion Tachycardia

Rebound nasal congestion

A patient has been prescribed an amphetamine as part of obesity treatment. Which of the following interventions should the nurse perform before the dosage regimen starts? Record the patient's blood glucose level. Record the patient's temperature. Review arterial blood gas studies. Record the patient's weight.

Record the patient's weight.

Beta-1 selective blockers have what as an effect? Reduction in arrhythmia Increased cardiac workload Increased release of renin Increased heart rate

Reduction in arrhythmia Beta-1 selective blockers decrease the release of renin to aid in decreasing blood pressure. Beta-1 selective blockers decrease heart rate. Beta-1 selective blockers decrease cardiac excitability and exert a membrane stabilizing effect leading to a decrease in arrhythmias. Beta-1 selective blockers decrease cardiac workload. Reference:

The nurse caring for a patient who is on prednisone understands that the drug's anti-inflammatory effects are due to what mechanism of action? Increased C-reactive protein Reduction in erythrocyte sedimentation rate Increased granulocytosis Increase in fibrinogenesis

Reduction in erythrocyte sedimentation rate Anti-inflammatory effects of prednisone include retardation of the migratory polymorphonuclear leukocytes, suppression of tissue repair and granulation, reduction in the erythrocyte sedimentation rate, decrease in fibrinogenesis, and diminished C-reactive protein.

A nurse is caring for a patient who is receiving cyclobenzaprine. Which of is the action of the drug on the patient? Relief from nervous disorder Prevention of convulsion Reduction of muscle spasm Relief from anxiety

Reduction of muscle spasm

The cholinergic blocking drug glycopyrrolate (Robinul) is used in conjunction with anesthesia for which reason? Relaxation Prolongation of anesthesia Reduction of oral secretions Increase muscle rigidity

Reduction of oral secretions

A patient being treated for HIV with saquinavir informs the nurse they he has been "suffering from depression" and taking St. John's wort to help. What is important for the nurse to discuss with this patient? Taking St. John's wort only as directed by the manufacturer to decrease the toxic effects Reporting to the health care provider if any yellowing of the eyes or skin develops Refraining from use of St. John's wort, which can cause decreased effectiveness of saquinavir Informing the health care provider if any bleeding or bruising is observed when taking the St. John's wort

Refraining from use of St. John's wort, which can cause decreased effectiveness of saquinavir

A patient with obesity returns to the clinic and informs the nurse that she has not lost any weight even though she has been taking a stimulant drug for 6 weeks. What is the most important thing for the nurse to teach this patient at this time? Reinforce prescribed dietary and exercise program for weight loss. Reinforce the reason for taking the drug. Reinforce the dose of the drug. Reinforce the side effects of the drug.

Reinforce prescribed dietary and exercise program for weight loss.

The anatomy and physiology instructor is discussing what happens to the body during times of stress. What would the instructor tell the students causes the release of cortisone during times of stress? Stimulation of the hypothalamus Negative feedback mechanism Release of epinephrine and norepinephrine Adrenal cortex atrophy

Release of epinephrine and norepinephrine

The patient informs the nurse that he has been taking methotrexate for 1 week and it is not working to control the rheumatoid arthritis (RA) symptoms. What should the nurse explain to the patient about the onset of action? Relief of symptoms should occur within 3-6 weeks. Relief of symptoms should occur within 3 days. Relief of symptoms should occur within 1 week. Relief of symptoms should occur within 2 months.

Relief of symptoms should occur within 3-6 weeks.

A priority assessment prior to a 70-year-old patient being given succinylcholine (Anectine) as adjunct to general anesthesia for surgery is: Renal and hepatic function Activity level Blood glucose level and complete blood count Nutritional status and weight

Renal and hepatic function

The nurse is aware that progestins will be prescribed with great caution in a client with which condition? (Select all that apply.) Epilepsy Tension headaches Renal disase Asthma Arthritis

Renal disase Epilepsy Asthma Progestins are used with great caution in clients with renal impairment, migraine headaches, epilepsy, asthma, and cardiac disease. There is no caution if clients with tension headache or arthritis use progestins.

The nurse should be cautious and closely monitor clients receiving carbidopa/levodopa (Sinemet) with which medical conditions? (Select all that apply.) Renal disease Seizure disorder Asthma Peptic ulcer disease Hyperthyroidism

Renal disease Asthma Peptic ulcer disease

A group of students are reviewing the drugs that are available for treating Alzheimer's disease. The students demonstrate understanding of the information when they identify which drug as appropriate for treatment? Cevimeline Pyridostigmine Edrophonium Rivastigmine

Rivastigmine

Which is a cholinesterase inhibitor that is available in the form of a transdermal patch? Memantine (Namenda) Galantamine (Razadyne) Rivastigmine (Exelon) Donepezil (Aricept)

Rivastigmine (Exelon)

Your patient is being prepped for a colonoscopy. He has been receiving hemodialysis three times weekly awaiting his kidney transplant. Which laxative/cathartic is contraindicated due to the potential of developing hypermagnesemia, hyperphosphatemia, or hyperkalemia? Saline cathartics Mineral cathartics None of these Aloe cathartics

Saline cathartics

The anatomy and physiology instructor is describing the secretion of endogenous estrogen in nonpregnant women. According to the instructor, what happens to estrogen secretion two to three days before the onset of menstruation? Secretion is stopped. Secretion decreases gradually. Secretion decreases abruptly. Secretion increases abruptly.

Secretion decreases abruptly. In nonpregnant women, between puberty and menopause, estrogens are secreted in a monthly cycle called the menstrual cycle. During the first half of the cycle, before ovulation, estrogens are secreted in progressively larger amounts. During the second half of the cycle, estrogens and progesterone are secreted in increasing amounts until 2 to 3 days before the onset of menstruation. At that time, secretion of both hormones decreases abruptly.

The nurse should be cautious and closely monitor clients receiving donepezil (Aricept) with which medical condition? (Select all that apply.) Hyperthyroidism Seizure disorder Asthma Renal disease GI bleeding

Seizure disorder Renal disease Asthma GI bleeding

The physician has prescribed selegiline (Eldepryl), an MAOI. You are providing patient teaching to Mr. Jones about this medication. Which statement by the patient would indicate the need for additional teaching? Selegiline can cause a change in my blood pressure, so I should change positions slowly. Selegiline will increase the breakdown of dopamine in the tissues. Selegiline inhibits monoamine oxidase type B, which breaks down dopamine. Selegiline is given in conjunction with carbidopa-levodopa.

Selegiline will increase the breakdown of dopamine in the tissues.

Patient education is necessary to ensure proper use of exogenous estrogen and to enable the patient to recognize adverse effects. Which of the following should a nurse teach the patient? Maintenance of proper records Self-breast examination Proper use of barriers to prevent STDs Basal body temperature evaluation

Self-breast examination

A female client has completed immunosuppressive therapy in preparation for transplantation. When explaining the risks of immunosuppression, the nurse would state: Once the transplant is completed, complications with immunosuppression are no longer a concern. Excessive immunosuppression can be corrected easily with other medications. Serious complications can occur if you are not monitored carefully. Taking both of the medications together will make her periods lighter and shorter duration.

Serious complications can occur if you are not monitored carefully.

The nursing instructor is explaining the best way to assess whether active immunity has developed from the administration of the hepatitis B series. What would the instructor cite as the best assessment method? Serum antibody levels Client does not develop hepatitis B AST is within normal limits Liver is not palpable

Serum antibody levels In many cases, antibody titers (levels of the antibody in the serum) can be used to evaluate a person's response to an immunization and determine the need for a booster dose.

What laboratory studies would be important for the nurse to especially monitor to check for lactic acidosis in the pregnant client on zidovudine therapy, especially during the last trimester? Serum electrolytes and liver function tests Serum creatinine and blood urea nitrogen APTT and INR Complete blood and platelet counts

Serum electrolytes and liver function tests

A patient has been diagnosed with ulcerative colitis. The physician has prescribed sulfasalazine to the patient. What effect associated with the disorder should the nurse monitor for in the patient? Severe blood- and mucus-filled diarrhea Mild symptoms of contact dermatitis Frequent loose or watery stools Abdominal pain and distention

Severe blood- and mucus-filled diarrhea

A patient is receiving melphalin for the treatment of multiple myeloma. What does the nurse determine may be a problem for this patient in high doses? Hemorrhagic cystitis Diabetis insipidus Severe oral mucositis Syndrome of inappropriate antidiuretic hormone

Severe oral mucositis

A breastfeeding mother is to begin treatment with radioactive iodine for hyperthyroidism. What can the nurse advise the patient at this time? She will not be able to breastfeed at any time and will have to bottle feed the baby. She can continue to breastfeed during this time because the radioactive iodine will not cross over into the breast milk. She can pump during the time that breast milk is radioactive then discard in a biohazard container. She can resume breast feeding when treatment is complete. She can pump and give the baby the breast milk.

She can pump during the time that breast milk is radioactive then discard in a biohazard container. She can resume breast feeding when treatment is complete.

A 25-year-old female client is diagnosed with hypothyroidism. The client is prescribed levothyroxine. Which instruction about the administration of this medication would be important? She should take the medication in the morning before breakfast. She should take the medication when she takes her other morning medications. She should take the medication with grapefruit juice to promote absorption. She should take the medication at dinner time.

She should take the medication in the morning before breakfast.

Julie, 25 years old, is started on the sibutramine weight loss program for obesity. What may cause the "serotonin syndrome" in the patient as a result of the therapy? Sibutramine having an effect on platelet function Sibutramine interactions with other drugs Sibutramine overdosage Sibutramine combined with a low-calorie diet

Sibutramine interactions with other drugs

You are caring for a client who has a diagnosis of HIV. Part of this client's teaching plan is educating the client about their medications. What is essential for the nurse to include in the teaching of this client? The action of each antiretroviral drug What vaccinations to have The use of condoms Side effects of drug therapy

Side effects of drug therapy

A patient taking modafinil (Provigil), a CNS stimulant, for narcolepsy has recently needed an increased dosage. At a follow-up visit, the patient is combative and confused, and has a low-grade fever. The nurse knows that this clinical presentation is most likely which of the following? Signs of toxicity from the medication A result of a concomitant infection Unrelated to taking this medication Normal side effects of taking CNS stimulants

Signs of toxicity from the medication

A woman is diagnosed with pulmonary hypertension. The nurse explains the drug prescribed and the patient states, "That's a drug that used to treat erectile dysfunction." Which drug would this most likely be? Vardenafil Sildenafil Tadalafil Alprostadil

Sildenafil

After teaching a group of students about beta-1 selective blockers, the instructor determines that the teaching was successful when the students identify what as a contraindication to using this group of drugs? Diabetes Thyroid disease Sinus bradycardia COPD

Sinus bradycardia

A client has just been told she is pregnant. The nurse knows that the client smokes. Why would the nurse tell the client it would be best for the fetus if she stopped smoking? Smoking causes fetal birth defects Smoking causes fetus to be large for gestation Smoking causes low birth weight Smoking causes fetal cardiac dysrhythmias

Smoking causes low birth weight

When using drugs to treat rheumatoid arthritis (RA), the nurse should tell the client to notify the health care provider if the client experiences which problems? Select all that apply. Itching Fever Blood pressure 122/78 Nausea Sore mouth

Sore mouth Fever Itching Nausea

Which herbal product should a nurse specifically question patients about due to the potential for adverse reactions when taken with antidepressants? St. John's wort Fever few Ginseng Eucalyptus

St. John's wort

The nursing instructor is teaching students about anesthesia and instructs that general surgical anesthesia is divided into four different stages. In which stage would the nurse expect to see delirium? Stage 1 Stage 2 Stage 3 Stage 4

Stage 2 Stage 1 is analgesia, stage 2 is delirium, stage 3 is surgical anesthesia, and stage 4 is respiratory paralysis.

The students are learning about the stages of anesthesia. What stage would the students learn is the stage of anesthesia that involves relaxation of skeletal muscles and return of regular respirations? Stage 2 - Excitement stage Stage 3 - Surgical anesthesia stage Stage 1 - Analgesia stage Stage 4 - Medullary paralysis

Stage 3 - Surgical anesthesia stage

The patient is undergoing surgery for a small bowel resection. At this time the patient is experiencing complete respiratory paralysis and is in the most dangerous stage of general anesthesia. Which stage would the nurse say this patient is in by this description? Stage 3 Stage 4 Stage 2 Stage 1

Stage 4

The nurse knows that the client is completely pain-free and ready for the surgical procedure during which stage of surgery? Stage I Stage II Stage III Stage IV

Stage III Stage III is the stage of surgical analgesia. It is during this stage that the client is ready for the surgical procedure. Stage I is the general analgesia stage and may only last a few seconds. Stage II is the stage of delirium and excitement, where the client experiences exaggerated reactions to noise. Stage IV is the stage of respiratory paralysis and is very dangerous. The client may experience a respiratory arrest and lose all vital signs.

A patient has been prescribed cyclophosphamide (Cytoxan) to treat refractory rheumatoid arthritis (RA). What intervention should the nurse teach the patient about this therapy? Stay hydrated and void often. Take stool softeners to prevent constipation. Take aspirin to potentiate the medication. Monitor temperature daily.

Stay hydrated and void often.

How does ephedrine, once used for everything from shock to allergic rhinitis, act on the body? Stimulates the release of dopamine Acts indirectly on beta adrenergic receptor sites Acts indirectly on alpha adrenergic receptor sites Stimulates the release of norepinephrine

Stimulates the release of norepinephrine

Which adverse effects does the nurse attribute to methotrexate (Rheumatrex) therapy for rheumatoid arthritis (RA)? Select all that apply. Stomatitis Angina Fatigue Cirrhosis Thinning hair

Stomatitis Thinning hair Fatigue Cirrhosis

A client is receiving an IV immune stimulant and develops a cardiac arrhythmia. What is the nurse's priority action? Stop the drug immediately. Notify the prescriber that the client is experiencing an adverse effect. Reposition the client Auscultate the client's apical heart rate for 2 minutes.

Stop the drug immediately.

The nurse is administering rituximab to a patient who develops an infusion-related reaction. What should the first action by the nurse be? Administer only one half of the dose until the medication is complete. Administer epinephrine 0.3 mL subcutaneously. Administer a corticosteroid medication. Stop the drug until the symptoms resolve.

Stop the drug until the symptoms resolve.

Disease-modifying antirheumatic drugs (DMARDs) are administered to produce which therapeutic effect? Increase cerebrospinal fluid secretion. Stop the progression of the disease. Increase the immune response. Reverse joint deformity.

Stop the progression of the disease.

A nurse is preparing a presentation for a local woman's group about irritable bowel syndrome. Which of the following would the nurse include in the presentation? Select all that apply. Abdominal distress and bouts of diarrhea or constipation are common. Stress may play a role in the cause of this disorder. An underlying anatomical cause has not been identified. It usually affects men 3 to 4 times more often than women. It is a relatively rare disorder.

Stress may play a role in the cause of this disorder. Abdominal distress and bouts of diarrhea or constipation are common. An underlying anatomical cause has not been identified.

A patient that has a history of glaucoma is to receive a NMJ blocker. Which agent would the nurse identify as being most problematic for this patient? Vecuronium Succinylcholine Rocuronium Pancuronium

Succinylcholine

The nurse is preparing a male client for surgery. The nurse is reviewing the family history, which includes familial plasma pseudocholinesterase. The patient has a history of malignant hyperthermia and narrow-angle glaucoma. Which anesthetic is highly contraindicated for such a patient? Succinylcholine Vecuronium Lidocaine Propofol

Succinylcholine

A patient receiving chemotherapy complains of a metallic taste in the mouth. What suggestions by the oncology nurse may help to minimize this problem? Use an antifungal troche. Use an astringent mouthwash. Brush teeth before and after chemotherapy. Suck on hard candy.

Suck on hard candy.

When prescribing estrogen therapy, the U.S. Food and Drug Administration (FDA) recommends what dosing protocol? Following age dosage chart as provided by pharmaceutical company Adequate dose to maintain a certain serum blood level Supervised use at the lowest dose for the shortest duration Following recommendations of the pharmaceutical company

Supervised use at the lowest dose for the shortest duration

When administering a continuous intravenous drip (IV) to a child, what special precaution should the nurse perform so that the child does not receive an excess of fluid? Administer a diuretic prophylactically. Use the smallest IV catheter possible. Place an armboard on the affected extremity to avoid dislodging the IV. Supply no more than 1 hour's worth of fluid.

Supply no more than 1 hour's worth of fluid. in case the pump malfunctions

Anorexiants are primarily used for which of the purposes? (Choose one) Stimulate the respiratory system Suppress the appetite Suppress the cardiovascular system Treat attention deficit hyperactivity disorder

Suppress the appetite

What would the nurse recognize as the primary goal(s)of highly active antiretroviral therapy (HAART)? Select all that apply. Reverse the effects of AIDS. Delay drug-resistant mutations. Preserve CD4 counts. Suppress virema. Treat opportunistic infections.

Suppress virema. Delay drug-resistant mutations. Preserve CD4 counts.

An adult female has been taking prescribed androgens. What result of taking androgens should be included in the patient teaching? Atrophy of breasts Rapid bone growth Loss of pubic hair Suppression of menstruation

Suppression of menstruation

A female client is prescribed cyclosporine after her bone marrow transplant. What is the mechanism of action of cyclosporine that makes this an ideal drug for this patient? Suppression of the normal effects of the immune system in the body Increased stimulation of the normal effects of the immune system in the body Targeting of various receptor sites of cells Targeting of specific receptor sites of cells

Suppression of the normal effects of the immune system in the body

The nursing instructor is discussing adverse effects of non-selective alpha-adrenergic blocking drugs. What adverse effect would the nurse monitor for when giving a patient phentolamine (Rogitine)? Hypertension Tachycardia Wheezing Depressed respirations

Tachycardia

A patient is receiving a thyroid hormone to treat hypothyroidism. Which would indicate to the nurse that the patient needs a reduced dosage of the drug? Slowed reflexes Intolerance to cold Pale dry skin Tachycardia

Tachycardia Tachycardia suggests hyperthyroidism due to excessive thyroid hormone; this would require a reduction in dosage. Slowed reflexes would suggest hypothyroidism and drug ineffectiveness. Pale dry skin would suggest hypothyroidism and drug ineffectiveness. Intolerance to cold suggests hypothyroidism and drug ineffectiveness.

The nurse is caring for an 84-year-old diabetic patient who is receiving hydrocortisone 40 mg daily, PO, for treatment of an arthritic flareup. When writing a plan of care for this patient, which nursing intervention would be most appropriate? Increase sodium in diet. Restrict protein in diet. Increase fluids to 2000 mL per day. Take daily blood glucose levels.

Take daily blood glucose levels. Caution should be used in patients with diabetes because the glucose-elevating effects disrupt glucose control. The use of hydrocortisone would not indicate increasing sodium, restricting protein, or increasing fluid in the diet.

A 42-year-old female with breast cancer has had a radical mastectomy. She will have radiation therapy and then begin chemotherapy. Drug therapy will consist of a combination of doxorubicin, cyclophosphamide, and paclitaxel. What will the nurse include in the teaching plan concerning the drug therapy? Continue to go to church or to the mall just as she did before the diagnosis of cancer. Take special care when shaving or brushing her teeth. Stay in bed 2 days after each administration. Stay on a low-fat diet during the course of the drug therapy.

Take special care when shaving or brushing her teeth.

A client being treated with desmopressin exhibits confusion and drowsiness, and reports a headache. What is the nurse's best action? Administer the next dose of desmopressin. Take the client's vital signs. Hold the prescribed diuretic. Encourage increased oral fluid intake.

Take the client's vital signs.

The nurse is teaching a client newly-diagnosed with Parkinson's disease about the appropriate use of levodopa-carbidopa (Sinemet). What should the nurse teach the client? Take the drug three times each day, at the times that are specified Take the daily dose at bedtime to minimize sedative effects Use a moisturizing cream if a rash develops after beginning the medication Remain seated upright for 30 minutes after taking the medication, if possible

Take the drug three times each day, at the times that are specified

A patient with partial seizures has been prescribed succinimides at a health care facility. The patient experiences GI upset after succinimides administration. What should the nurse instruct the patient to do? Take the drug with food or milk. Take the drug once only at bedtime. Take the drugs before meals.

Take the drug with food or milk.

The nurse is caring for a patient taking erlotinib (Tarceva) for the treatment of non-small cell lung cancer. In providing discharge instructions, how should the nurse inform the patient to take this medication? Take the pills with food. The pills may have a bitter taste and can be crushed and taken with applesauce. Take the pills with milk. Take the medication on an empty stomach 1 hour before and 2 hours after food.

Take the medication on an empty stomach 1 hour before and 2 hours after food.

Why does the presence of estrogen in oral contraceptives increase the risk for developing blood clots? The estrogen increases serum triglyceride, cholesterol, and glucose levels. The estrogen causes peripheral vasoconstriction. The estrogen stimulates skeletal growth, causing increased production of red blood cells. The estrogen increases production of clotting factors.

The estrogen increases production of clotting factors.

A healthy 70-year-old man has been having trouble sleeping at night. Additionally, he has been having difficulties with gastroesophageal reflux. He buys generic Benadryl to help him sleep and buys generic Tagamet for his reflux. After 7 days of taking these over-the-counter medications, he exhibits signs of confusion and disorientation. His wife calls the primary care facility to speak with the nurse. What should the nurse suspect first? The older adult is having transient ischemic attacks. The older adult has an electrolyte imbalance, leading to delirium. The older adult is experiencing mental changes as an adverse drug effect. The older adult has an overwhelming infection.

The older adult is experiencing mental changes as an adverse drug effect.

The nurse is caring for a client who has a diagnosis of chronic hepatitis B and has been prescribed an immune stimulant. The client provides patient education. How would the nurse evaluate the effectiveness of the teaching plan? The patient can state specific measures to avoid adverse effects. The patient can state who will administer their medication. The patient can state where to get their medication. The patient can state what positive effects to watch for.

The patient can state specific measures to avoid adverse effects.

The nurse is obtaining nutritional information prior to the patient beginning methotrexate therapy for psoriatic arthritis. What information obtained by the nurse would be of greatest concern? The patient eats two eggs daily for breakfast. The patient drinks two glasses of wine once every 2 weeks. The patient eats three fruits per day. The patient drinks six cups of coffee daily.

The patient drinks six cups of coffee daily. Caffeine decreases effectiveness

An asymptomatic patient infected with HIV asks the nurse, "When will I have to start taking antiviral therapy?" What is the recommendation for initiating treatment in this patient? Select all that apply. The patient has a CD4 count of 500 cell/mm. The patient has a CD4 count of 250 cell/mm. The patient has active hepatitis B virus(HBV) with the intent to treat the HBV. The patient has a positive HIV test. The patient has HIV nephropathy.

The patient has a CD4 count of 250 cell/mm. The patient has HIV nephropathy. The patient has active hepatitis B virus(HBV) with the intent to treat the HBV.

The nurse is administering rituximab therapy when the patient has a seizure and then progresses into a comatose state. What does the nurse recognize has possibly occurred with this patient? The patient has developed meningococcal meningitis. The patient has a pre-existing electrolyte disorder. The patient had an undiagnosed seizure disorder. The patient has progressive multifocal leukoencephalopathy.

The patient has progressive multifocal leukoencephalopathy.

The nurse has an order to administer a saline cathartic to a patient who has a history of congestive heart failure. Why is this type of cathartic contraindicated with this patient? The patient is at risk for hypomagnesemia. The patient is at risk for hypernatremia. The patient is at risk for hypochloremia. The patient is at risk for hyperphosphatemia

The patient is at risk for hypernatremia.

The operating room nurse is taking a male patient into the OR when the patient informs the operating nurse that his grandmother spiked a 104°F temperature in the operating room and nearly died 15 years ago. The nurse knows that the anesthetist is planning to use a volatile liquid as part of the anesthetic. What relevance is this information regarding the patient? The grandmother's surgery has no relevance to the patient's surgery. The patient may be at risk for developing malignant hyperthermia. The patient may be at risk for hypothermia. The patient may be nervous.

The patient may be at risk for developing malignant hyperthermia.

A patient with HIV has had close contact with a family member who has active tuberculosis. What treatment should the HIV-positive patient receive? The patient should have a tuberculin skin test to see if the results are positive before beginning treatment. The patient should be started on SMZ-TMP immediately. The patient does not require treatment at this time because he has not developed any symptoms. The patient should be started on prophylactic therapy with Isoniazid regardless of tuberculin skin test results.

The patient should be started on prophylactic therapy with Isoniazid regardless of tuberculin skin test results.

A patient has been administered a cytotoxic antineoplastic agent. The patient is a 32-year-old female. Which of the following is the most important instruction related to teratogenicity? The patient will not get pregnant due to the elimination of ova. The patient should protect herself from infections and take Bactrim. The medication will be completely eliminated 24 hours after the administration. The patient should not become pregnant for several months.

The patient should not become pregnant for several months.

For which patient would cyclobenzaprine not be prescribed for muscle spasms? The patient who is having muscle spasms because of cerebral palsy The patient who strained a quadriceps muscle playing baseball The patient who is having muscle spasms in the left leg after a fracture The patient who underwent a lumbar laminectomy and is having back spasms

The patient who is having muscle spasms because of cerebral palsy

The nurse is caring for a patient who is receiving drug therapy for a psychotic disorder. Which goals should the nurse include in a care plan for the patient following discharge from the hospital? The patient will exhibit decreased symptoms of acute psychosis. The patient will take medications as prescribed. The patient will return for follow-up appointments when the patient believes they are necessary. The patient will normalize sleeping and eating patterns.

The patient will take medications as prescribed.

A client is being treated with saquinavir for AIDS. The client history includes a BMI of 37.98%, hyperlipidemia, and sleep apnea. Based on the client history, why would caution be used when the client is started on saquinavir? There are potential adverse effects associated with hyperlipidemia. The drug is largely metabolized by the liver. It may cause an exacerbation requiring a dosage change. Saquinavir has a possible association with cardiovascular events.

There are potential adverse effects associated with hyperlipidemia.

Biologic modulators, or biologic modifiers, are a group of biopharmaceuticals that are naturally occurring proteins used to alter the body's hematologic or immunologic responses. Which of the following best describes more about these biologic modulators? Choose all that apply. They stimulate immunologic activity to combat specific antigens. They are synthetic substances created to mimic the body's natural responses. They interfere with the body's ability to create new cells. There has been rapid growth of these therapies over the past decade.

There has been rapid growth of these therapies over the past decade. They stimulate immunologic activity to combat specific antigens.

For what reason is the creatinine level alone not a good indicator of renal function in the older adult? The increased glomerular filtration rate leads to lower creatinine levels. There is a decline in overall muscle mass, which produces a lower creatinine level. The decreased blood flow to the kidneys will produce a lower creatinine level. Increased renal tubular secretion of creatinine causes abnormally low levels in the blood.

There is a decline in overall muscle mass, which produces a lower creatinine level.

A 52-year-old male client is being treated for Parkinson's disease. The nurse is aware that Parkinson's disease results in muscle rigidity, tremor at rest, and postural instability. What occurs in the neurons that causes these symptoms? There is a decrease in stimulation of the nigrostriatal neural tracts. There is an increased level of GABA at the striatum. There is an imbalance between dopamine and acetylcholine. There is an increase in dopamine in the terminal nerve endings.

There is an imbalance between dopamine and acetylcholine.

A student asks the pharmacology instructor to explain the action of anticholinergic agents. What would be the instructor's best response? They block nicotinic receptors. They act to block the effects of the parasympathetic nervous system. They compete with serotonin for muscarinic acetylcholine receptor sites. They increase norepinephrine at the neuromuscular junction.

They act to block the effects of the parasympathetic nervous system.

The nurse knows that megestrol (Megace) is used in the treatment of breast and endometrial cancer, but it is used for what reason in clients with human immunodeficiency (HIV) infection? Improved mental acuity Pain control Weight gain Reduction of viral load

Weight gain

A client is going through menopause. She informs you that her health care provider has prescribed estrogen and progesterone. She asks why she should take two medications. The nurse's best response is: You need both estrogen and progesterone to stop the hot flashes. Taking both of the medications together will make your periods lighter and of shorter duration. You should speak to your health care provider because you do not need to take both prescriptions. When estrogens are used alone, they cause endometrial hyperplasia and may cause endometrial cancer.

When estrogens are used alone, they cause endometrial hyperplasia and may cause endometrial cancer.

When would treatment with medication be considered for a child with attention deficit hyperactivity disorder (ADHD)? Select all that apply. When symptoms interfere with behavioral functioning When symptoms interfere with social and academic functioning Before beginning psychotherapy When symptoms are moderate to severe Within 2 to 4 weeks of the onset of symptoms

When symptoms are moderate to severe When symptoms interfere with social and academic functioning When symptoms interfere with behavioral functioning

A client is being treated with clozapine. What should the nurse monitor most closely? Urine quantity and quality White blood cell count AST, ALT and bilirubin Cardiac enzymes

White blood cell count

A nurse is performing discharge teaching with a client who will soon return home. The client will continue taking imatinib for the foreseeable future, and the nurse is teaching the client about the safe administration of this drug. How should the nurse instruct the client to take imatinib? Thirty minutes before breakfast and in the early evening, at least 2 hours after dinner On an empty stomach With food and a large glass of water With a glass of grapefruit or cranberry juice

With food and a large glass of water

A nurse is required to administer propranolol to a patient for the treatment of cardiac arrhythmias. The nurse checks the patient's apical pulse rate and blood pressure before administration of the drug and observes that the pulse rate is below 60 bpm. What nursing intervention should the nurse perform in this case? Provide proper ventilation to the patient. Withhold the drug administration and contact PHCP. Provide oxygen support to the patient. Delay drug administration for some time.

Withhold the drug administration and contact PHCP.

When a nurse is educating a patient taking anorexiants for weight management, which of the following should be included? Select all that apply. You may experience some side effects of this medication, including agitation, dizziness, and restlessness. You should not deviate from the prescribed dosage unless your provider instructs you to do so. You should take your medication before you eat dinner. You may take this medication in lieu of diet and exercise modifications to manage your weight. Once you begin this medication, you will have to remain on it for several years.

You should not deviate from the prescribed dosage unless your provider instructs you to do so. You may experience some side effects of this medication, including agitation, dizziness, and restlessness.

Polycarbophil, a bulk-forming laxative, may occasionally be used as an antidiarrheal because it has antibacterial effects. decreases intestinal motility. contributes digestive enzymes. absorbs water.

absorbs water.

A client has an IV of dopamine administered in the right arm. The IV becomes dislodged from the vein and dopamine has been being given in the surrounding tissue instead of the vein. The nurse should stop the IV and: wrap the site tightly with gauze to help the dopamine be absorbed by the underlining tissue. put ice on the infusion site to decrease circulation and cause necrosis. administer atenolol (a beta adrenergic blocking drug) to the site to minimize necrosis. sdminister phentolamine (an alpha adrenergic blocking drug) to the site to minimize necrosis.

administer phentolamine (an alpha adrenergic blocking drug) to the site to minimize necrosis.

To gain a preschooler's cooperation to swallow an oral medication, the nurse's best approach would be to: offer to play a game with the child if the preschooler takes the medicine. leave the medicine on the stand so the child can take it independently. ask if the child would like to take the medicine in a cup or through an oral syringe. compare the taste of the medicine to a chocolate bar.

ask if the child would like to take the medicine in a cup or through an oral syringe.

Which shape makes the RBCs flexible enough to maneuver through the small capillaries to deliver oxygen to the tissues? biconcave convex concave plano-concave

biconcave The biconcave disc shape of the RBCs makes them flexible enough to maneuver through the small capillaries to deliver oxygen to the tissues. The cell is concave on two sides, allowing for an increased rate in diffusion.

A 2-year-old client is diagnosed with stomach flu and is suffering from vomiting and diarrhea. What is the most important factor in determining the correct dosage for his infection? age past experience body surface area adult dosage

body surface area

The nurse should exercise caution when administering antimetabolites to a patient with: hypertension. seizure activity. diabetes mellitus. bone marrow suppression.

bone marrow suppression.

The oncology nurse understands that chemotherapeutic agents are most effective during a particular phase of the cell cycle. This means the agents are: cell cycle-specific. cell cycle-nonspecific. cell targeting. growth fraction.

cell cycle-specific.

An emergency department nurse is confirming that a child's ordered dose of IV analgesia is congruent with the body surface area (BSA). In order to calculate the child's BSA, the nurse must know which variables? (Select all that apply.) child's age in months child's percentage of body water child's height usual adult dose of the drug child's weight

child's height child's weight

A nurse observing a patient receiving treatment with edrophonium (Tensilon) for myasthenia gravis notices the patient clenching the jaw, salivating excessively, experiencing and muscle weakness, rigidity, and spasm. These are all symptoms of: cholinergic crisis. acetylcholinesterase crisis. status epilepticus. hypertensive emergency.

cholinergic crisis.

Unwanted anticholinergic effects include: wakefulness, mental alertness, and decreased fatigue. increasing hyperactivity, excessive talking, nervousness, and insomnia. constipation and dry mouth. drowsiness or sleep; decreased muscle tone; and decreased ability to move.

constipation and dry mouth.

The nurse is administering medications that are metabolized in the liver to a 68-year-old. What normal age-related changes to metabolism may alter the dose a client will be prescribed? (Select all that apply.) decreased hepatic mass decreased glomerular filtration decreased hepatic blood flow decreased total body water decreased cardiac output

decreased hepatic mass decreased hepatic blood flow

You are the nurse in a respiratory clinic. You should be aware that the effects of anticholinergic agents include hiccups. impaired lung function. increased salivation. decreased respiratory secretions.

decreased respiratory secretions.

An elderly client is being admitted to the hospital for surgery. The nurse is reconciling the client's medications. The client is prescribed digoxin 0.125 mg daily, furosemide 40 mg two times a day, Lanoxin 0.125 mg daily, metoprolol XL 25 mg once a day, and pravastatin (Pravachol) 40 mg at hours of sleep daily. The nurse recognizes a problem when the nurse notes: pravastatin should be taken in the morning and not the evening. digoxin and Lanoxin are the same medications. furosemide is not recommended to be given two times a day. the dose of metoprolol XL is too small for an extended-release medication.

digoxin and Lanoxin are the same medications. All the listed medications are common ones with which the nurse should be familiar. Digoxin is the generic name for Lanoxin. Furosemide may be given twice a day, the dose of metoprolol XL is appropriate, and pravastatin is to be taken in the evening.

Pharmacokinetics involves the study of how medications are absorbed, distributed, metabolized, and eliminated. What are the two key factors that influence pharmacokinetics in children? body surface area height and weight body mass index age and size

height and weight ?

When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean antibodies to the AIDS virus are in his blood his body has not produced antibodies to the AIDS virus he has not been infected with HIV he is immune to the AIDS virus

his body has not produced antibodies to the AIDS virus

An infant's antiseizure medication has been ordered after careful consideration of the unique pharmacokinetics among this population. What characteristic of neonates has the greatest bearing on drug metabolism? the undeveloped state of the blood-brain barrier immaturity of the infant's liver increased gastric motility in infants the infant's undeveloped renal function

immaturity of the infant's liver

A client is on daily doses of prednisone. To minimize adrenal suppression, the nurse's instructions for administration should include to take the medication: in the morning. just before bedtime. with the evening meal. on an empty stomach.

in the morning.

An adolescent taking oral contraceptives has been prescribed an anticonvulsant medication. The nurse should tell the client to: stop driving due to the increased depressant effects and excessive drowsiness. watch for signs of hyperglycemia, such as increased thirst, hunger, and urination. use another form of birth control, such as condoms. be aware that these two drugs will interact and increase seizure activity initially.

use another form of birth control, such as condoms.

A nurse is taking care of a woman receiving an abortifacient. The nurse is aware that the most serious adverse effect is: vaginal bleeding. skin rash. vomiting. diaphoresis.

vaginal bleeding.

A client who is positive for HIV infection is prescribed zidovudine as part of the drug therapy. The client is age 66; has hypertension, diabetes, vitamin B12 deficiency; and has a drug history of insulin injections and vitamin B12 supplements. Why would the nurse administer zidovudine with caution to this client? zidovudine may interact with the client's diabetes drug and cause adverse effects vitamin B12 deficiency increases the risk for severe hematologic toxicities zidovudine is contraindicated in clients with hypertension zidovudine may cause myelosuppression due to the client's age

vitamin B12 deficiency increases the risk for severe hematologic toxicities

What factors must the nurse consider as part of core drug knowledge when administering a medication to a pediatric client rather than an adult? (Select all that apply.) the child's immature body systems The child's smaller size weight age

weight the child's immature body systems The child's smaller size

Which adrenergic receptor is responsible for increased heart rate and increased force of myocardial contraction? α2 receptors α1 receptors β1 receptors β2 receptors

β1 receptors

Which adrenergic receptor is responsible for vasodilation of peripheral vessels and bronchodilation? α1 receptors β2 receptors α2 receptors β1 receptors

β2 receptors

The school nurse sees a child who has had an absence seizure. Which characteristics are typical of this type of seizure? Automatic and repetitive movements Abnormal movements and bizarre behavior Sustained contraction of skeletal muscle Alterations in consciousness that last seconds

Alterations in consciousness that last seconds

The nurse is teaching post-administration cardiovascular system reactions to the immunostimulant drug oprelvekin. The nurse would include which cardiovascular system reactions in the client teaching plan? Fainting resulting in falls with injury Arrhythmia resulting in stroke and pulmonary edema Bone loss Vomiting resulting in dehydratio

Arrhythmia resulting in stroke and pulmonary edema

A patient with AIDS is being prepared for discharge. The nurse caring for the patient with AIDS knows the patient receives Agenerase. What dietary counseling will the nurse provide based upon the patient's medication regimen? Avoid high-fat meals while taking this medication Limit fluid intake to 2 liters a day Avoid meals high in protein while taking this medication Limit sodium intake to 2 grams per day.

Avoid high-fat meals while taking this medication

What is the normal range for CD4+ cells in the human body? A. 300 to 600 CD4+ cells/mm3 D. 1200 to 1500 CD4+ cells/mm3 C. 800 to 1200 CD4+ cells/mm3 B. 500 to 800 CD4+ cells/mm3

C. 800 to 1200 CD4+ cells/mm3

A patient with bipolar disorder taking lithium carbonate for mood stabilization is also taking filgrastim. What laboratory tests should the patient be instructed to have more than twice a week? CBC BUN and creatinine Lithium levels Potassium level

CBC

A client has been diagnosed with liver failure. The nurse knows that which of the following class of medications is contraindicated for this client? ACE inhibitors Beta blockers COMT inhibitors Anticholinergics

COMT inhibitors

The anatomy and physiology instructor is discussing what causes muscle contraction and relaxation. What element is part of the process that causes muscle contraction and relaxation? Chloride Magnesium Calcium Hydrogen

Calcium

The nurse is caring for a 3-year-old child admitted with pneumonia. The physician has ordered clarithromycin to be administered. The drug guide the nurse is using for a reference lists only the recommended adult dose. What should the nurse do to ensure that the proper dose of the medication is given to the child? Calculate the drug dosage based on the child's BSA. Calculate the adult dosage, minus 25%. Contact the physician for clarification of the order. Calculate the dose according to the child's weight and a standard mg/kg dosage of the drug.

Calculate the drug dosage based on the child's BSA.

A client has been taking levodopa (L-dopa) for the treatment of Parkinson's disease. What additional medication may decrease the amount of levodopa needed to reach a therapeutic level in the brain, thereby reducing adverse effects of levodopa? Bromocriptine Trihexyphenidyl Carbidopa Amantadine

Carbidopa

Which drug is classified as a dopaminergic agent that treats Parkinsonism by supplementing the amount of dopamine in the brain? Procyclidine (Kemadrin) Carbidopa (Lodosyn) Benztropine (Cogentin) Biperiden (Akineton)

Carbidopa (Lodosyn)

An 80-year-old client has been brought to the Emergency Department in shock. The client is receiving dopamine . The nurse should prioritize the assessment for what potentially serious adverse effect? Renal insufficiency Blood dyscrasias Hepatic toxicity Cardiac arrhythmia

Cardiac arrhythmia

Mrs. Kelly Johnson, aged 46, was admitted to the hospital due to prior myocardial infarction, or heart attack. The diagnostic test revealed that her heart was unable to pump enough blood to adequately perfuse the vital organs. What type of shock does she seem to have suffered from? Hypovolemic shock Septic shock Obstructive shock Cardiogenic shock

Cardiogenic shock

Mark, age 42, is prescribed sildenafil for the treatment of pulmonary hypertension. The nurse caring for Mark would explain that sildenafil works by what mechanism? Decreasing arterial blood flow Causing vasodilation in the pulmonary vascular bed Decreasing the function of the right ventricle Increasing systemic vascular resistance

Causing vasodilation in the pulmonary vascular bed

Propranolol is used in the treatment of which disorders? Arrhythmias Angina Hypertension All the above

All the above

The nurse is caring for a 5-year-old in a clinic setting. The child is due for a scheduled immunization. Which approach is the best for the nurse to take when administering the IM injection? Allow the child to pick which arm the injection will go in. Ask the child if the nurse can give the injection now. Tell the child it won't hurt a bit. Tell the child to hold very still and be very quiet during the injection.

Allow the child to pick which arm the injection will go in.

A woman is seen in the primary care provider's office with chronic severe diarrhea-predominant irritable bowel syndrome, which has not responded to conventional therapy. Which medication is the drug of choice? Rifaximin (Xifaxan) Nitazoxanide (Alinia) Alosetron (Lotronex) Cholestyramine (Questran)

Alosetron (Lotronex)

The nursing student learned in pharmacology class that drugs that affect the CNS do which of the following? (Check all that apply.) Lower glucose levels Alter mood Decrease K+ Alter the interpretation of information in the brain Alter sensation

Alter mood Alter the interpretation of information in the brain Alter sensation

A nurse is caring for a client hospitalized with AIDS. The family comes to visit and a family member asks the nurse about safety when visiting a client with AIDS. What is the best response for addressing the family member's fears? "Why do you think you are at risk?" "Don't worry, you will not contract the disease from the client." "The client should be isolated and have limited visitation." "AIDS is commonly transmitted by contact with blood and body fluids."

"AIDS is commonly transmitted by contact with blood and body fluids."

Which statement should be included in the teaching plan for a patient receiving methylphenidate (Ritalin)? "The drug may cause weight gain." "There is no risk of dependence." "The medication is usually taken just before bedtime." "Adverse effects include hypertension and nervousness."

"Adverse effects include hypertension and nervousness."

An HIV-positive patient comes to the clinic and asks the nurse if the patient should receive a flu vaccine. The patient states, "I never get the flu, so why should I take it?" What is the best response by the nurse? "If you have never had the flu, there is no reason for you to get the vaccine now." "If you don't get the flu vaccine, you could die if you get the flu." "You could skip it this year, but I would suggest you taking it next year." "All HIV-positive patients should receive the flu vaccine as prophylaxis."

"All HIV-positive patients should receive the flu vaccine as prophylaxis."

A female client with a six-month-old infant has been prescribed propylthiouracil (PTU). What is the most important question the nurse should ask this client? "Are you breast or bottle feeding?" "Did your baby have hyperthyroidism in utero?" "How long have you had thyroid related symptoms?" "Have you ever taken thyroid replacement medications in the past?"

"Are you breast or bottle feeding?"

What statement made by the patient indicates to the nurse that the patient does not understand the transmission of HIV? "As long as I am taking the HAART therapy, I cannot transmit the virus to anyone else." "I may transmit the virus to someone if I have unprotected sex." "If I have unprotected sex with someone with HIV, I may be re-infected with another strain." "I should not breast feed because I can transmit the virus to the baby this way."

"As long as I am taking the HAART therapy, I cannot transmit the virus to anyone else."

The 68-year-old client states, "I have been taking aspirin on occasion for my arthritis for many years but notice that it takes longer for it to start working now." What is the best response by the nurse? "You may be immune to the action of the aspirin." "You should try taking something else for your arthritis if this is not working for you anymore." "As you get older, absorption is prolonged and medications may take a little longer to act than normal." "As you get older, absorption is quicker and the medication will leave your system faster."

"As you get older, absorption is prolonged and medications may take a little longer to act than normal."

A client asks a nurse to explain how the drug bethanechol works to help a person void. What would be a correct response from the nurse? "Bethanechol is a diuretic that works in the loop of Henle, blocking the reuptake of sodium, which causes one to void." "Bethanechol is an indirect-acting cholinergic drug that causes the bladder to constrict." "Bethanechol is a direct-acting cholinergic drug that causes contraction of the smooth muscles of the bladder and passage of urine." "Bethanechol is a medication that increases the amount of water that is produced by the kidneys, causing one to void."

"Bethanechol is a direct-acting cholinergic drug that causes contraction of the smooth muscles of the bladder and passage of urine."

A client who has been on estrogen therapy for two months calls the clinic and tells the nurse that she has developed increased pigmentation to her facial skin. What is the nurse's best response to this client? "This must be a reaction to some makeup you are using. It is not related to the estrogen." "This will go away as soon as you stop the therapy." "Changes to the skin may not go away even after the medication is discontinued." "If you wash your face in hot, soapy water three times a day, it will go away."

"Changes to the skin may not go away even after the medication is discontinued."

The client is a woman, age 42 years, who returns to the Cancer Treatment Center diagnosed with chemotherapy-induced thrombocytopenia. The nurse knows that the interleukin drug oprelvekin is used to increase platelet production and explains to the client the need for the drug. The client will not sign the informed consent because she doesn't understand why she needs platelets. Which information would the nurse include in the explanation? "Chemotherapy has caused you to have a low platelet count, which puts you at risk for bleeding. Oprelvekin is used to increase platelet production to decrease the risk." "Chemotherapy has caused you to have a low platelet count that puts you at risk for bleeding. Oprelvekin is just like aspirin and, in combination with chemotherapy, will reverse the risk for bleeding." "Chemotherapy has caused you to have a low platelet count that puts you at risk for bleeding, and without the drug you will bleed to death tonight." "We don't know why, but you have a low platelet count that puts you at risk for bleeding. Oprelvekin is used to increase platelet production to decrease the risk."

"Chemotherapy has caused you to have a low platelet count, which puts you at risk for bleeding. Oprelvekin is used to increase platelet production to decrease the risk."

The client is a woman, 42 years of age, admitted after breast cancer chemotherapy. The client has a low white blood cell count and is concerned about acquiring an infection. The client will not sign the informed consent because she doesn't understand the drug action. What explanation would the nurse give for how a CSF increases white blood cell production? "Chemotherapy kills cancer cells as well as good cells needed to prevent and control infection. These cells are called white blood cells that grow in stages but are not effective until the cell is in the immature stage. A colony-stimulating drug acts on the cell to stimulate growth to the immature white blood cell stage so the cells can help protect you from infection." "Chemotherapy kills cancer cells as well as good cells needed to prevent and control infection. The cells are called white blood cells that grow in stages but are not effective until the cell is in the adult stage. A colony-stimulating drug acts on these cells to stimulate growth to the mature adult white blood cell stage, so that the cells can go to work to help protect you from infection." "Chemotherapy kills cancer cells but has no effect on white cells that fight infection. A colony-stimulating drug acts on white cells to stimulate growth to the mature adult stage to help protect you from infection." "Chemotherapy kills cancer cells as well as good cells needed to prevent and control infection. The cells are called white blood cells that grow in stages, but are not effective until the cell is in the adult, mature stage. But a colony-stimulating drug has no affect on white cell stimulation in the body. "

"Chemotherapy kills cancer cells as well as good cells needed to prevent and control infection. The cells are called white blood cells that grow in stages but are not effective until the cell is in the adult stage. A colony-stimulating drug acts on these cells to stimulate growth to the mature adult white blood cell stage, so that the cells can go to work to help protect you from infection."

The nurse is teaching a novice nurse hire how to administer colony-stimulating factors. It is important to include which of the following information? "Colony-stimulating factors are stable and can be mixed and stored on ice for up to 72 hours before administration." "Colony-stimulating factors are stable and come from the pharmacy premixed before administration." "Colony-stimulating factors are fragile and must be mixed before administration." "Colony-stimulating factors are fragile and can evaporate quickly, so the drug is only given intravenously after mixing."

"Colony-stimulating factors are fragile and must be mixed before administration."

The nurse is teaching a novice nurse hire how to administer colony-stimulating factors. It is important to include which of the following information? "Colony-stimulating factors are stable and come from the pharmacy premixed before administration." "Colony-stimulating factors are fragile and must be mixed before administration." "Colony-stimulating factors are fragile and can evaporate quickly, so the drug is only given intravenously after mixing." "Colony-stimulating factors are stable and can be mixed and stored on ice for up to 72 hours before administration."

"Colony-stimulating factors are fragile and must be mixed before administration."

What question is important for the nurse to ask a client who is scheduled to receive a first dose of radioactive iodine for hyperthyroidism? "Have you discussed your cancer treatment plan with your provider?" "Are you afraid of needles?" "Do you have any trouble swallowing?" "Does anyone ever have trouble finding your veins?"

"Do you have any trouble swallowing?" Radioactive iodine is given orally, either as a solution or in a gelatin capsule. Since it is not given intravenously, any questions regarding needles or veins is not necessary. Radioactive iodine is given for the treatment of hyperthyroidism or cancer of the thyroid. The question states this client is taking radioactive iodine for hyperthyroidism.

A patient with Parkinson's disease has been prescribed entacapone (Comtan). The patient asks how this medication works. Which response is most appropriate? "It is excreted in the urine, and your renal function is adequate." "Entacapone is best given parenterally to relieve symptoms." "Entacapone inhibits COMT to metabolize dopamine in the brain." "It increases the metabolism of levodopa (L-dopa) in the bloodstream."

"Entacapone inhibits COMT to metabolize dopamine in the brain."

A pharmacology professor wants to know if the class has understood the lecture on hematopoietic cells. Which of the following statements would confirm the students understand the material presented? Choose all that apply. "Erythropoietin is produced by the kidneys in response to tissue hypoxia." "Thrombopoietin is produced in the liver." "No drugs are available that affect blood cells." "Iron is necessary to support erythropoiesis."

"Erythropoietin is produced by the kidneys in response to tissue hypoxia." "Iron is necessary to support erythropoiesis." "Thrombopoietin is produced in the liver."

As the nurse caring for Ms. Quil, you discuss home administration of zidovudine. Which statement by Ms. Quil indicates she needs additional teaching in order to understand correct self-administration? "I will take the medication at the same time daily." "I need to eat a high-carbohydrate diet while taking this medication." "I can eat just before taking the medication." "I can consume as many fats as I want."

"I can consume as many fats as I want." (decreases drugs absorption)

Which patient statement indicates to the nurse that the patient is experiencing an adverse effect of hyoscyamine? "I feel like my heart is going to jump out of my chest." "I have urinated twice in the last 6 hours." "Things don't look blurry to me." "I moved my bowels this morning."

"I feel like my heart is going to jump out of my chest."

The nurse tells a 9-year-old child that the child will be receiving an injection today. What statement by the child is most indicative of the fear that children of this age group feels? "I don't want to be without my mother." "Please don't give me a shot. Blood leaks out when I have a shot." "I would rather have my medication in a liquid." "I hate getting shots. The last time I got one it hurt so bad."

"I hate getting shots. The last time I got one it hurt so bad." usually related to negative past experiences

Which statement indicates that the client understands immunosuppressant therapy following a solid organ transplant? "I know that I will need to stay on this medication for the rest of my life." "I know that I will need to stay on my medication for at least 1 year." "I do not need to worry about taking any special precautions." "I know that I will need to stay on this medication for a few months."

"I know that I will need to stay on this medication for the rest of my life."

The nurse is administering an injection to a toddler who is screaming, kicking, and trying to bite the nurse. After the injection is over, what is the best statement by the nurse? "I know that was not very comfortable for you. Let's go to the prize drawer and get something." "Your behavior was inappropriate and I hope that the next time you come to get your shots, you behave better." "You were a bad boy today. You were so good the last time you had your shots." "You cannot get a prize today because of your behavior, but next time, when you are better, you can get one."

"I know that was not very comfortable for you. Let's go to the prize drawer and get something."

Carla, age 27, is treated with aminoglutethimide for Cushing syndrome. The nurse explains the adverse effects of this medication. Which statement made by Carla would indicate that the teaching session was successful? "I may have drowsiness and dizziness when I start the therapy." "I will develop a low heart rate from the direct effects of the drug." "I will have an increase in blood pressure." "The drug may increase my appetite and lead to weight gain."

"I may have drowsiness and dizziness when I start the therapy."

After teaching a patient who is prescribed sildenafil about using the drug, the nurse determines that the teaching was successful when the patient states: "I need to take the pill about an hour before any sexual stimulation." "I should take the medication just before I start having sex." "I can take the pill in the morning before I engage in sex later in the day." "I should take the pill after dinner if I'm planning to have sex later that night."

"I need to take the pill about an hour before any sexual stimulation."

Connie, age 43, is being discharged on methotrexate. Which statement by the patient indicates that she understands how the medication will work and how to take the medication? "I need to limit my fluid intake to prevent excretion of the drug." "I will start to see an improvement in my symptoms within the week." "I should take the drug twice a day as prescribed." "I should take the medication on an empty stomach to promote absorption of the drug."

"I should take the medication on an empty stomach to promote absorption of the drug."

The nurse provides client teaching about use of levodopa for treatment of Parkinson's disease. What statement by the client would indicate a good understanding of levodopa? "I'll know within about a year and then stopwhether this drug has cured my Parkinson's disease." "I should take this drug with food to avoid an upset stomach." "I will take multivitamins to ensure that I have good nutrition." "I should avoid exercising while taking this drug so that I don't get injured."

"I should take this drug with food to avoid an upset stomach."

The nurse is caring for a 55-year-old patient with Hashimoto's thyroiditis. During discharge teaching, which statement by the patient tells the nurse the patient understands the teaching? "If I feel nauseated, I may take this drug with an antacid." "I may use the generic brand if I can find it cheaper than the one prescribed." "I should take this medication on an empty stomach in the morning." "I can take this medication any time of day."

"I should take this medication on an empty stomach in the morning."

A client needs further teaching about medication prescribed for muscle spasms and cramping when making which statements? "I made an appointment in two to three weeks to be reevaluated." "I take my medication right after dinner." "I usually lie down for a few minutes after taking my medication." "I take my medicine with three to four beers each evening."

"I take my medicine with three to four beers each evening."

A gerontological nurse is conducting a medication assessment of a new client on a subacute medicine unit. Which of the client's statements should signal to the nurse a need for education? "I've made a reminder system for myself so that I don't miss any of my pills during the day." "My family doctor has me on so many different pills now, so I want to talk with her about whether they're all necessary." "Overall, I much prefer to prevent getting sick than having to rely on different drugs to stay healthy." "I use a lot of herbs and supplements, but I'm careful to make sure that they're all natural."

"I use a lot of herbs and supplements, but I'm careful to make sure that they're all natural."

A home care nurse is caring for a client who has received a liver transplant. The nurse is reinforcing earlier teaching about the client's immunosuppressant therapy and the need for appropriate self-care. Which client statement suggests that the client understands? "I will always be at risk for serious infection." "I should stop taking these drugs if I get sick." "I need to take these drugs until my prescription runs out." "I'm at risk for infection until my body accepts my new liver."

"I will always be at risk for serious infection."

Ms. Ziem is prescribed filgrastim. The nurse provides education to Ms. Ziem about this therapy. Which statement would indicate the patient understood the teaching? "I will avoid crowds and people with illnesses." "Filgrastim will be discontinued when the neutrophil count drops unexpectedly." "Filgrastim will be discontinued to prevent excessively high neutrophil counts." "I will never refrigerate the drug."

"I will avoid crowds and people with illnesses."

A bipolar client is being discharged home in 48 hours. What statement by the client indicates an understanding of treatment with lithium? "I will increase my fluid intake." "I will decrease my salt intake." "I will decrease my fluid intake." "I will increase my salt intake."

"I will increase my fluid intake."

A female client 25 years of age has begun taking lithium for treatment of bipolar disorder. Which statement indicates that the client needs further instruction? "I will call the health care provider if I experience diarrhea." "My lithium dose may change depending on the results of my blood tests." "I will need to come to the clinic regularly for blood tests." "I will need to stop taking my birth control pills while I take lithium."

"I will need to stop taking my birth control pills while I take lithium."

A patient has suffered a severe laceration to his thumb and index finger during a workplace accident, and local anesthetic is to be utilized to facilitate suturing. Which of the patient's statements should prompt the nurse to provide further health education? "They told me that it will take a few hours before I can feel my hand again." "I have to admit I'm relieved that they'll be freezing my hand before they stitch it up." "I'm feeling pretty queasy about getting stitches, so I'm glad they'll be knocking me out." "If I understand correctly, I won't be able to move my hand normally for a while after getting the anesthesia."

"I'm feeling pretty queasy about getting stitches, so I'm glad they'll be knocking me out."

The nurse is providing prenatal education for several pregnant women. One of the women asks, "My mother smoked during her pregnancy with me and had no problems. Why do I have to stop?" What is the best response by the nurse? "If a mother smokes while pregnant, the fetus may have growth retardation." "The fetus will become addicted to nicotine if you do not stop." "You don't have to stop altogether. It will be okay if you smoke a few cigarettes per day." "If a mother smokes while pregnant, the baby may have mental retardation."

"If a mother smokes while pregnant, the fetus may have growth retardation."

A male patient has been diagnosed with impotence and is started on a regimen of androgens. Which statement by the patient indicates that he has understood the patient teaching? "If my skin appears yellow or my urine turns dark, I will contact my physician." "My blood count will drop, but if I have bruising, I will contact my physician." "I know headaches are common, so I won't get alarmed if it is severe." "If I experience increasing baldness, I will contact my physician immediately."

"If my skin appears yellow or my urine turns dark, I will contact my physician."

The U.S. Food and Drug Administration (FDA) has issued a Black Box Warning concerning estrogen's use and associated increased risk of which of the following? Lung disease Pelvic inflammatory disease Osteosarcoma Endometrial carcinoma

Endometrial carcinoma

A patient newly diagnosed with CML has been prescribed treatment with imatinib. The patient asks the nurse how imatinib works. What would be the nurse's best response? "Imatinib inhibits folic acid reductase, leading to inhibition of DNA synthesis and inhibition of cellular replication." "Imatinib binds to DNA and inhibits DNA synthesis in susceptible cells, causing cell death." "Imatinib alkylates cellular DNA." "Imatinib inhibits the enzyme created by the Philadelphia chromosome abnormality in CML."

"Imatinib inhibits the enzyme created by the Philadelphia chromosome abnormality in CML."

Basiliximab (Simulect) is a monoclonal antibody that is an IL-2 receptor antagonist. A pharmacology professor asks the class to describe this drug's characteristics. Which of the following responses indicates the students understand the drug? Select all that apply. "Patients will report gastrointestinal upset." "A patient taking this drug will have a WBC count above 6,000 cells/mL." "It acts by binding to and blocking the CD25 antigen receptor site." "It helps with allograft rejection."

"It acts by binding to and blocking the CD25 antigen receptor site." "It helps with allograft rejection." "Patients will report gastrointestinal upset."

Infliximab (Remicade) is a monoclonal antibody, a chimeric human-murine IgG antibody. A pharmacology professor asks the class to describe this drug. Which of the following statements indicate a student knows all about infliximab? Select all that apply. "The patient may report having acne breakouts." "It is licensed for treating moderate to severe Crohn's disease." "It acts by blocking tumor necrosis factor (TNF)." "The most common adverse effect is gastric upset."

"It acts by blocking tumor necrosis factor (TNF)." "It is licensed for treating moderate to severe Crohn's disease." "The patient may report having acne breakouts."

A nurse is educating a patient newly diagnosed with Parkinson's disease. Which description would the nurse offer to describe the disease? "It is characterized by abnormalities in behavior." "It is characterized by joint pliancy." "It is characterized abnormalities in posture." "It is an acute disorder."

"It is characterized abnormalities in posture."

The husband of a newly married couple has been diagnosed with acute leukemia and will be on high-dose cyclophosphamide. He states to the nurse, "We want so much to have children. I will have to have chemotherapy and won't ever be able to have children!" What is the best response by the nurse? "You can adopt children if you want them in the future." "Your wife could always have artificial insemination with another donor." "I understand how you feel. That is a terrible side effect of the chemotherapy." "It is very possible to bank sperm so that you and your wife will be able to have children in the future."

"It is very possible to bank sperm so that you and your wife will be able to have children in the future."

A female client reports nervousness and her heart still "racing" one week after starting antithyroid medication. How should the nurse respond to the client's report? "I'll notify the primary care provider about increasing the dosage." "It may take three to four weeks for the effects of this medication to be seen." "Have you counted your resting heart rate?" "Increase the dosage of medication each day until relief of symptoms is achieved."

"It may take three to four weeks for the effects of this medication to be seen." Therapeutic effects of the antithyroid drugs may not be observed for three to four weeks. Counting the resting heart rate doesn't address the client's reports. Increasing the dosage is not initially recommended until the client has been taking the medication at least three to four weeks.

The nurse is reviewing medications with an elderly client who has a history of spinal cord injury. The client reports taking bisacodyl (Dulcolax) every day. When providing client education, the nurse states "You can switch to the suppository form of bisacodyl if you experience vomiting." "You should increase the fat content in your diet when taking bisacodyl." "Bisacodyl is recommended for you on a long-term basis to ensure daily bowel movements." "Let me explore other alternative methods with you to assist in having bowel movements."

"Let me explore other alternative methods with you to assist in having bowel movements."

A 50-year-old woman has begun taking baclofen to treat her recently diagnosed multiple sclerosis (MS). What teaching point should the nurse provide to the patient about her new drug regimen? "Even though baclofen is a drug that's available over the counter, it still has the potential to cause serious adverse effects if taken incorrectly." "It's best to avoid taking a dose of baclofen unless your spasticity becomes impossible to manage." "Make sure that you don't stop taking baclofen suddenly because it might cause your symptoms to rebound quite sharply." "You'll likely have to stop taking your other medications for a week to ten days before starting to take baclofen."

"Make sure that you don't stop taking baclofen suddenly because it might cause your symptoms to rebound quite sharply."

A nurse is treating a patient who has been started on amantadine. What statement by the patient would indicate the need for additional teaching? "I'll stop taking this drug after a couple of weeks." "This drug is not effective for long-term treatment." "This drug can accumulate if one has decreased renal function." "My tremors and rigidity will improve about 3 weeks after I begin taking this drug."

"My tremors and rigidity will improve about 3 weeks after I begin taking this drug."

A patient being placed on drug therapy for rheumatoid arthritis (RA) asks the nurse why she will have to take methotrexate as well as naprosyn (Naproxyn). What is the best response by the nurse? "Methotrexate will work only with a nonsteroidal anti-inflammatory drug (NSAID)." "NSAIDs reduce the disease activity more than methotrexate." "NSAIDs are given to control the symptoms of rheumatoid arthritis until the methotrexate action starts." "NSAIDs begin the immunosuppression until methotrexate takes over."

"NSAIDs are given to control the symptoms of rheumatoid arthritis until the methotrexate action starts."

A 16-year-old has come to the clinic and asks to talk to a nurse. The nurse asks the teen what she needs and the teen responds that she has become sexually active and is concerned about getting HIV. The teen asks the nurse what she can do keep from getting HIV. What would be the nurse's best response? "There's no way to be sure you won't get HIV except to use condoms correctly." "The correct use of male and female condoms protects against the transmission of HIV." "There are new ways of protecting yourself from HIV that are being discovered every day." "Other than abstinence, only the consistent and correct use of condoms is effective in decreasing the risk of getting HIV."

"Other than abstinence, only the consistent and correct use of condoms is effective in decreasing the risk of getting HIV."

A client 72 years of age has been diagnosed with iron deficiency anemia. The client comes to the clinic for the nurse to teach the recommended way to take the iron supplement. Which of the following information would the nurse include in the client's teaching plan? "Be sure to take your fluoroquinolone medicine at the same time you take the iron dose." "Be sure to take your antacid medicine at the same time you take the iron dose." "Be sure to take your tetracycline medicine at the same time you take the iron dose." "Take this drug with water on an empty stomach."

"Take this drug with water on an empty stomach."

While the nurse is preparing the patient for discharge, the patient asks why the physician has prescribed administration of prednisone every other day instead of daily. What would be the nurse's best response? "Taking it every other day eliminates side effects." "Taking it every other day prolongs the therapeutic effects." "Taking it every other day prevents the development of drug tolerance." "Taking it every other day minimizes adverse effects."

"Taking it every other day minimizes adverse effects."

The nurse is teaching a patient about safe use of adrenergic drugs. Which statement should be included in the teaching? "You can take cold medications while on this drug, but talk to your doctor about other medications." "You shouldn't take cold remedies or appetite suppressants while on this drug, but you can take any other medication safely." "Talk to your doctor before taking any other medications." "Tell your health care provider if you are allergic to penicillin."

"Talk to your doctor before taking any other medications."

The nurse is preparing an immunostimulant drug called oprelvekin to administer to a client 32 years of age who is diagnosed with a chemotherapy-induced bleeding disorder. The nurse plans to teach the client about why the provider ordered the drug. What reason will the nurse give the client? "The drug is used to increase platelet count associated with immunosuppression during chemotherapy." "The drug is used to increase platelet count associated with low red blood cell count during chemotherapy." "The drug is used to increase platelet count and dehydration associated with chemotherapy." "The drug is used to increase platelet count and treat influenza virus infection."

"The drug is used to increase platelet count associated with immunosuppression during chemotherapy."

A young man asks the nurse about the goal of the cancer therapy his mother is receiving. What would be the nurse's best response? "The goal is to keep the cancer cells from spreading all over your mother's body." "The goal is to control the spread of the cancer." "The goal is to limit the cancer cells so the immune system can respond without causing too much toxicity to your mother." "The goal is to kill the cancer cells so your mother will be well again."

"The goal is to limit the cancer cells so the immune system can respond without causing too much toxicity to your mother."

The nurse is mentoring a first-year nursing student while caring for a client with a disease that affects the hematopoietic system. The student looks confused and says "I've never heard of that system. What is it?" How would the nurse repond? "The hematopoietic system is composed of fluid, red blood cells, white blood cells, and fibrosis." "The hematopoietic system is composed of fluid, red blood cells, white blood cells, and fibrinogen." "The hematopoietic system is composed of fluid, red blood cells, white blood cells, and platelets." "The hematopoietic system is composed of fluid, red blood cells, white blood cells, and fibrin."

"The hematopoietic system is composed of fluid, red blood cells, white blood cells, and platelets."

A patient has been diagnosed with depression. The physician has ordered sertraline. The patient asks, "How soon will it be until I feel better?" What would be the best response? "The medication will start to work in as soon as 10 days, but it may take up to 4 weeks to be fully effective." "The medication will improve your energy in 1 to 2 days, but the symptoms of sadness will not improve for a week." "The medication will start to work immediately." "The medication will decrease only your visible symptoms of depression."

"The medication will start to work in as soon as 10 days, but it may take up to 4 weeks to be fully effective."

A nurse is precepting a nursing student, and together they are caring for a patient who is to receive interleukins. The student nurse asks what happens physiologically when a patient receives interleukins. What would be the nurse's best response? "It really helps the patient!" "The patient gets really sick from flu-like symptoms and then they get better." "The patient has increases in the number of natural killer cells." "The patient has decreased cytokine activity."

"The patient has increases in the number of natural killer cells."

You are precepting a nursing student and together you are caring for a patient who is to receive interleukins. The student nurse asks you what happens physiologically when a patient receives interleukins. What would be your best response? "It really helps the patient!" "The patient has increases in the number of natural killer cells." "The patient has decreased cytockine activity." "The patient gets really sick from flu-like symptoms and then gets better."

"The patient has increases in the number of natural killer cells."

A patient who takes phenytoin for a seizure disorder expresses a desire to become pregnant. What is the best response by the nurse? "We should asks the physician to stop all antiepileptic drug therapy while you are trying to get pregnant." "We should see if the physician will switch your medication to valproic acid, which does not have a high risk for teratogenic effects." "I would not advise you to have children because they may also have seizures." "The physician may start you on newer antiepileptic drugs that do not have a high risk for teratogenic effects."

"The physician may start you on newer antiepileptic drugs that do not have a high risk for teratogenic effects."

A female client asks why it is not legal to have a year's worth of prescription refills for Ritalin, since she has been on it for more than a year. She would also like to have the largest dose possible, so she can use the prescription for 2 months, instead of one. She explains that it is very hard to get off work and come in for appointments. The nurse's best response would be: "It is important that you take the largest dose possible to keep the condition under control." "You will speak with her health care provider about getting her a new prescription." "You have to come in at least every month to have blood work done." "The prescription dose is always started as low as possible and the refills are monitored to prevent abuse."

"The prescription dose is always started as low as possible and the refills are monitored to prevent abuse."

A patient is diagnosed with a brain tumor. The patient is told that the cancer cells proliferate. The patient asks the nurse what this means. What is the nurse's best response? "The proliferation of cancer cells is the metastasis of the tumor." "The proliferation of the cancer cells is the suppression of growth." "The proliferation of the cancer cells is the treatment with chemotherapy." "The proliferation is the growth of cancer cells and the rate of growth."

"The proliferation is the growth of cancer cells and the rate of growth."

A patient received an injection of doxorubicin and is now observing a reddish urine. The patient states, "Do you think I am bleeding?" What is the best response by the nurse? "We need to notify the physician because this is a complication of the medication." "Let's get a urinalysis to confirm a urinary tract infection." "You may have hemorrhagic cystitis." "The reddish urine is harmless and an expected response to the drug."

"The reddish urine is harmless and an expected response to the drug."

A client is brought into the emergency department in status epilepticus and the nurse is administering phenobarbital 300 mg IV as prescribed. Family members ask the nurse how long it will take to stop the seizures. What is the nurse's best response? "It will probably take about 30 minutes before the seizures begin to subside." "We should see results in about 10 minutes." "It may be an hour, or slightly more, before the seizures stop." "The seizures will probably stop in around 5 minutes."

"The seizures will probably stop in around 5 minutes."

The nursing student asks the instructor why the newer targeted therapies are more effective than what is currently being used for cancer treatment. What is the best response by the instructor? "The targeted cancer therapies will eliminate the need for other drugs to be used with them." "The targeted cancer therapies are less expensive than the current therapies, and more patients are seeking treatment." "The targeted cancer therapies have fewer adverse effects than current therapies." "The targeted cancer therapies are more toxic and more effective than current therapies."

"The targeted cancer therapies have fewer adverse effects than current therapies."

A patient is administered mycophenolate (CellCept) to prevent rejection of the transplanted heart. It is recommended that the client have a CBC drawn weekly. The client asks the nurse the reason for the weekly CBC. What is the nurse's best response? "The weekly CBC assesses for the development of bleeding." "The weekly CBC assesses for the development of infection." "The weekly CBC assesses for the decrease in hematocrit." "The weekly CBC is routine and ordered for all patients."

"The weekly CBC assesses for the development of infection."

A new mother asks her nurse about the safety of taking St. John's wort for postpartum depression. What would be the nurse's best response? "Most experts agree that St. John's wort is effective in treating depression but that it can contribute to hypertension." "St. John's wort is a natural and safe alternative to prescription antidepressants." "There is insufficient evidence to support the use of St. John's wort, and drug interactions may be extensive." "It's not clear that St. John's wort is effective in treating depression, but it won't cause any harm."

"There is insufficient evidence to support the use of St. John's wort, and drug interactions may be extensive."

A woman at 32 weeks' gestation has a generalized rash from eating seafood. The nurse is preparing to administer diphenhydramine (Benadryl) when the patient states, "Will that hurt my baby?" What is the best response by the nurse? "The benefits of this drug will outweigh the harm to the baby." "You are too far along for this to cause harm to the baby." "There is no evidence that this drug will cause harm to your baby." "This drug may cause some respiratory depression but it will not last."

"There is no evidence that this drug will cause harm to your baby."

A physician has prescribed an antidepressant medication for a 15-year-old female patient. Which statement would be appropriate for inclusion in patient teaching? "Patients may lose all inhibitions while on this drug." "There may be an increased risk of suicide while taking this drug." "There may be an increased risk of socialization while taking this drug." "If you miss a dose of this drug, double the dose the next time you take it."

"There may be an increased risk of suicide while taking this drug."

The nurse is caring for a patient in the emergency department with severe hypertension. The nurse is preparing to administer labetolol when the patient states, "Are you sure that I can have that medication? I am breastfeeding." What is the best response by the nurse? "I will have to ask the doctor what else we can give you because this drug shouldn't be given to breastfeeding mothers." "This drug will be safe to give because it will not affect the baby's blood pressure." "You will have to have this medication because your blood pressure is dangerously high. You may have to give up breastfeeding." "The baby may be irritable when you breast feed or pump because of the medication."

"This drug will be safe to give because it will not affect the baby's blood pressure."

A patient is prescribed amantadine (Symmetrel). Which of the following statements indicates the patient has understood the patient teaching? "This drug is also used to decrease my drooling." "This drug is excreted in my stool and urine." "This drug will improve my tremors in 1-5 days." "This drug is effective when it is given long term."

"This drug will improve my tremors in 1-5 days."

A physician informs a patient who is a Jehovah's Witness that the patient needs epoetin alfa injections. The patient asks the nurse if any blood products are in this medication. What is the best response by the nurse? "Anyone can take this medication." "This medication is not considered a blood component by religious affiliations that object to transfusions." "Although blood products are in this medication, you will need it to treat the anemia." "If you do not take this medication, there will be severe complications from which you may not recover."

"This medication is not considered a blood component by religious affiliations that object to transfusions."

A pregnant client asks about the safety of taking thyroid hormone replacement drugs during her pregnancy. What is the nurse's best response? "Thyroid hormones are pregnancy category A drugs and should be taken during pregnancy." "You don't need thyroid hormones anymore if you took fertility drugs." "Continue thyroid medication only if you have a history of heart disease." "Take thyroid hormones if you gain more than the recommended amount of weight during pregnancy."

"Thyroid hormones are pregnancy category A drugs and should be taken during pregnancy."

A mother has brought her infant to the clinic for a well-baby check-up. The mother asks the nurse for a steroid cream to put on a diaper rash that her infant has. What would be an appropriate response by the nurse? "If that is what you would like to use, I'll be glad to talk to the doctor for you." "Topical steroids should be used cautiously with children. We should discuss this with your child's physician." "Steroids should not be used in children. The physician will order an appropriate drug for the rash." "That's a great suggestion. I'll talk to the doctor about it."

"Topical steroids should be used cautiously with children. We should discuss this with your child's physician."

A patient with severe arthritis is taking high dose corticosteroids. The patient approaches the clinic nurse and requests a pneumonia vaccine. What would be the nurse's best response? "Pneumonia vaccines are only given if you are at risk for serious pulmonary problems." "Corticosteroids will protect the body from respiratory infections." "Since the body is fighting the arthritis, the vaccine can cause serious adverse effects." "Vaccines cannot be given to people who are significantly immune suppressed."

"Vaccines cannot be given to people who are significantly immune suppressed." Corticosteroids block the inflammatory response and are very helpful in conditions such as arthritis. However, they also block the immune response, making a person immune suppressed. The vaccine would not be given to this patient because the patient's body would not respond by mounting an immune response.

After teaching the parents of a child diagnosed with ADHD about the disorder and its treatment, the nurse determines that the teaching has been effective when the parents state: "We should set up regular routines for him but not worry if he violates the limits once in a while." "We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention." "We need to be careful so he doesn't develop a substance abuse problem as he grows older." "We should stop the medication after 2 months to see how effective it is in really controlling his symptoms."

"We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention."

A toddler has been prescribed a liquid anti-epileptic medication. Following discharge from the hospital, the toddler has experienced an increase in seizure activity. The question the nurse asks that provides the most information is "What difficulties have you experienced giving the medication to your child?" "Are you giving the prescribed dose of the medication to your child?" "Does your child spit out the medication?" "Were you able to get the prescription filled?"

"What difficulties have you experienced giving the medication to your child?" open ended questions

The elderly client has been noncompliant with taking a prescribed medication. The nurse asks the client: "Are you having difficulty remembering to take the medication?" "Is there anyone who can help you to adhere to the planned schedule?" "What is the reason you have not taken the medication?" "Don't you know this medication is to make you feel better?"

"What is the reason you have not taken the medication?"

The parents of a child on methylphenidate (Ritalin) want to know why they need to withhold the medication during the summer months. What is the nurse's best response? "Withholding the medication will assist in evaluating psychotherapy." "Withholding the medication will assist in better drug response." "Withholding the medication will decrease the growth suppression." "Withholding the medication will allow for stabilized cardiac function."

"Withholding the medication will decrease the growth suppression."

A woman who is pregnant for the first time is surprised to be diagnosed with gestational diabetes. She asks the nurse whether she will have to take insulin while she is pregnant. How should the nurse reply? "Unfortunately, insulin can't be used during pregnancy because it poses a risk to the baby." "Your care provider will likely provide insulin, because it's effective and it's safe to use during pregnancy." "You'll likely be prescribed pills that will lower your blood sugar levels." "If you're vigilant, you can probably control your blood sugar sufficiently with a healthy diet."

"Your care provider will likely provide insulin, because it's effective and it's safe to use during pregnancy."

A mother brings her 9-year-old son to the clinic for a routine check-up. The 9-year-old has cerebral palsy and is very spastic. The mother asks the nurse what causes the spasticity in her son. What would be the nurse's best reply? "Your son's spasticity is caused by deficiency of the neurotransmitter serotonin." "Your son's spasticity is caused by injury to the musculoskeletal system." "Your son's spasticity is caused by injury to peripheral structures of the CNS." "Your son's spasticity is caused by damage to neurons within the CNS."

"Your son's spasticity is caused by damage to neurons within the CNS."

A patient treated for bipolar disorder with lithium carbonate (Eskalith) is scheduled for a lithium blood level. What is the therapeutic serum lithium level? 2.7-2.9 milliequivalents per liter 2.75-3.25 milliequivalents per liter 0.5-1.2 milliequivalents per liter 1.5-2.0 milliequivalents per liter

0.5-1.2 milliequivalents per liter

A patient is being treated with corticosteroids for chronic adrenocortical insufficiency. When should the patient be instructed to take the medication? 21:00 pm 12:00 pm 13:00-14:00 pm 06:00 and 09:00 am

06:00 and 09:00 am

How long does a patient need to wait after stopping a phenelzine (Nardil) before starting paroxetine (Paxil)? 14 days 10 days 1 day 7 days

14 days

The nurse should counsel a patient to discontinue use of over-the-counter antidiarrheals and seek treatment from a physician if diarrhea persists for how long? 12 hours 7 days 2 days 1 day

2 days The nurse should counsel a patient to discontinue use of over-the-counter antidiarrheals and seek treatment from a physician if diarrhea persists for more than 2 days.

A patient is taking tizanidine (Zanaflex) to treat spasticity from multiple sclerosis. Which adverse effect of muscle relaxants is most pronounced with this medication? Eczema Dark black urine Hypotension Excessive salivation

Hypotension

When a normal muscle functions several actions take place. These actions include: 1) ACh broken down by acetylcholinesterase 2) ACh interacts with the nicotinic cholinergic receptors 3) ACh is released by the motor nerve 4) ACh crosses the synaptic cleft 5) Depolarization of the muscle membrane 6) Repolarization of the muscle membrane Put these actions in the correct order. 6, 5, 4, 1, 2, 3 3, 4, 2, 5, 1, 6 1, 3, 5, 2, 4, 6 2, 4, 6, 5, 3, 1

3, 4, 2, 5, 1, 6

When should a patient receiving propantheline (Pro-Banthine) as an adjunctive therapy for peptic ulcers be advised to take the medication? 1 hour after meals During a meal 30 minutes before meals Only as needed for symptom relief

30 minutes before meals

A patient is to receive succinylcholine. The nurse would expect this drug to begin acting within which time frame? 8 to 10 minutes 1 to 2 minutes 30 to 60 seconds 4 to 6 minutes

30 to 60 seconds

A nurse caring for a patient receiving bethanechol (Urecholine) for urinary retention should advise the patient that voiding usually occurs how long after oral administration? 5 to 15 minutes 12 to 24 hours 2 to 4 hours 30 to 90 minutes

30 to 90 minutes

A pre-op nurse is caring for a very anxious 33-year-old female patient who is having a tubal ligation. The patient tells the nurse that "the person from anesthesia said that they were going to use something called anectine to help me during surgery," and the patient wants to know how long it takes for this medicine to work. What would the nurse respond? 1-2 minutes 15-30 seconds 10-15 seconds 30-60 seconds

30-60 seconds

Testosterone therapy would be recommended for all these patients except for a: 25-year-old with low testosterone levels and loss of pubic hair. 52-year-old female with inoperable metastatic breast cancer. 35-year-old male with erectile dysfunction due to diabetes mellitus. 14-year-old who is diagnosed with hypogonadism.

35-year-old male with erectile dysfunction due to diabetes mellitus. Erectile dysfunction due to diabetes is caused by damage to the nerves that innervate the penis, not by low androgen levels.

In what patient is propranolol (Inderal) contraindicated? 65-year-old woman with persistent migraines 42-year-old male with hypertension 26-year-old male with viral myocarditis 35-year-old post-MI female with heart rate 42

35-year-old post-MI female with heart rate 42

A patient diagnosed with erectile dysfunction has been advised to take Viagra. For up to how many hours does the action of the drug persist? 8 hours 12 hours 24 hours 4 hours

4 hours

A male client comes into the emergency department and is agitated, swiping his arms at "the bugs" and screaming that Harry Potter sent the bugs to take him away. After two security officers help to restrain the client, the doctor orders 5 mg of Haldol STAT. How would the nurse administer this drug? two 2.5 mg tablets rectally 5 mg IM in the client's left hand 5 mg IV after calming the client down and placing an IV 5 mg IM in the client's gluteus maximus

5 mg IM in the client's gluteus maximus

Maternal medication that enters fetal circulation is then metabolized by immature fetal organs and excreted into the amniotic fluid. How much of a regularly ingested medication is in fetal blood? 50% to 100% 25% to 50% None 10% to 25%

50% to 100%

The physician has ordered a daily dose of corticosteroid for a patient. What should the nurse teach the patient about the time to take a daily dose of a corticosteroid? 8:00 AM 12:00 noon 6:00 PM 9:00 PM

8:00 AM Administer drug daily at 8:00 AM to 9:00 AM to mimic normal peak diurnal concentration levels and thereby minimize suppression of the hypothalamic-pituitary axis.

A 78-year-old female patient who is about to begin home care has been prescribed anticholinergic drugs. What should the home care nurse explain to the patient and her family? The patient may be at increased risk of heat stroke. The patient may need assistance with ambulation. The patient may benefit from additional fiber and fluids in her diet. All the above

All the above

Conjugated estrogen therapy would be most appropriate for which one of these patients? A 72-year-old with newly diagnosed breast cancer A 25-year-old female with primary ovarian failure A 35-year-old with a history of thrombophlebitis, to prevent pregnancy A 65-year-old with a history of abnormal vaginal bleeding

A 25-year-old female with primary ovarian failure Conjugated estrogen is used primarily in hormone replacement therapy (HRT), female hypogonadism, female castration, and primary ovarian failure. Estrogen is contraindicated in the following conditions: estrogen-dependent neoplastic diseases, undiagnosed abnormal genital bleeding, active thrombophlebitis or thromboembolic disorders, history of thrombophlebitis, thrombosis, or thromboembolic disorders, and known or suspected pregnancy (estrogen is a pregnancy category X drug because of known adverse effects on the developing fetus).

For which oncology patient is doxorubicin (Doxil) therapy contraindicated? A 58 year old with ovarian cancer and osteoarthritis A 29 year old with Kaposi's sarcoma and cardiomyopathy A 17 year old with leukemia and polycystic ovaries A 42 year old with breast cancer and peptic ulcer disease

A 29 year old with Kaposi's sarcoma and cardiomyopathy

Which patient receiving 5-FU therapy has the potential for severe neurotoxicity? A 32 year old with psoriasis A 52-year-old male with myelosuppression A 29-year-old female with familial pyrimidinemia A 54 year old with a history of coronary artery disease

A 29-year-old female with familial pyrimidinemia

The nurse is preparing discharge teaching for four clients. Which client should be advised by the nurse that over-the-counter cold and allergy preparations contain phenylephrine and should be avoided? A 17-year-old female with symptoms of an upper respiratory infection A 52-year-old male with type 2 diabetes A 47-year-old female with hypertension A 62-year-old male with gout

A 47-year-old female with hypertension

In which of these patients would cyclophosphamide not likely be effective? A 47 year old with Hodgkin's lymphoma A 57 year old with endometrial cancer A 60 year old with a brain tumor A 62 year old with multiple myeloma

A 60 year old with a brain tumor

The nurse is caring for 4 patients. Which patient would have the highest risk for hepatoxicity from dantrolene (Dantrium)? A 32-year-old male who it taking an antipsychotic drug A 65-year-old female who is on hormone replacement therapy A 48-year-old female who is taking an antihypertensive agent An 87-year-old male who is taking a cardiac glycoside

A 65-year-old female who is on hormone replacement therapy b/c combined with estrogen

The nurse is working in the postanesthesia care unit, and several patients are having surgery today. Which patient would be at greatest risk for complications after surgery? A 64-year-old male who had bilateral femoral bypass grafting using spinal anesthesia A 26-year-old female who had a tubal ligation using general anesthesia A 35-year-old female who had a hysterectomy using general anesthesia A 72-year-old female who had general anesthesia for lung removal

A 72-year-old female who had general anesthesia for lung removal

The nurse is working with a male client diagnosed with chronic renal disease. To increase compliance with the drug regimen, what should the nurse provide the patient who has been prescribed epoetin alfa? The telephone number of the pharmacy where the medication can be purchased A referral for community transportation An appointment card for each drug administration day A calendar to mark the days of the week the drug is to be administered

A calendar to mark the days of the week the drug is to be administered

A nurse provides care on a psychiatric unit, and many of the clients on the unit take antidepressants. What client factor would the nurse have to consider when administering these medications? A client has a history of pulling out her IV cannula A client has an intense fear of injections A client actively resists IM injections A client has dysphagia

A client has dysphagia

What psychiatric client is most likely to have the lowest risk of extrapyramidal effects? A client taking thiothixene (Navane) 5 mg PO t.i.d. A client taking haloperidol (Haldol) 1.5 mg PO t.i.d. A client taking chlorpromazine 50 mg PO t.i.d. A client taking clozapine (Clozaril) 25 mg PO t.i.d.

A client taking clozapine (Clozaril) 25 mg PO t.i.d.

While learning about corticosteroids in pharmacology class, a student asks the instructor what a clinical indication for the use of corticosteroids would be. What would be the instructor's best response? A disease without an immunological component Any systemic disease state A disease with an inflammatory component Any hormone excessive state

A disease with an inflammatory component

A patient sees a physician for pain in the joints of fingers with significant swelling. X-rays reveal extensive joint damage from rheumatoid arthritis (RA); laboratory results are definitive. Which medication does the nurse anticipate the patient will receive to decrease the extensive joint damage? A glucocorticoid steroid, such as prednisone A nonsteroidal anti-inflammatory medication, such as Ibuprofen An uricosuric medication, such as Allopurinol A disease-modifying antirheumatic drug (DMARD), such as methotrexate

A disease-modifying antirheumatic drug (DMARD), such as methotrexate

Progestin medications can cause a variety of adverse effects. When assessing a patient who is taking such a medication, what might you observe? Mental depression Breakthrough bleeding Weight gain All the above

All the above

A patient sees a physician for pain in the joints of fingers with significant swelling. X-rays reveal extensive joint damage from rheumatoid arthritis (RA); laboratory results are definitive. Which medication does the nurse anticipate the patient will receive to decrease the extensive joint damage? A nonsteroidal anti-inflammatory medication, such as Ibuprofen A glucocorticoid steroid, such as prednisone An uricosuric medication, such as Allopurinol A disease-modifying antirheumatic drug (DMARD), such as methotrexate

A disease-modifying antirheumatic drug (DMARD), such as methotrexate

What type of medication is given in conjunction with levodopa/carbidopa to lower the dosage of levodopa and provide more effective relief of symptoms? Acetylcholine derivatives A dopamine agonist Tricyclic antidepressants An anticholinergics agent

A dopamine agonist

The health care provider would not prescribe duloxetine (Cymbalta) for a client with a mood disorder if the client took which other medication? A medication for diabetes A medication for hypertension A medication for diarrhea. A medication for tonsillitis

A medication for hypertension

The nurse is to administer an off-label medication to a premature infant. To check for an appropriate dose for this client, the nurse refers to A pediatric drug reference The Food and Drug Administration Web site Information provided by the manufacturer The Physician's Desk Reference

A pediatric drug reference

A patient arrives at the clinic and states that she is going to be traveling outside of the United States and requires a smallpox vaccine. What laboratory study should the patient have prior to receiving the vaccine? A pregnancy test A CBC AST and ALT levels A BUN and creatinine

A pregnancy test

A client learning to self-administer desmopressin subcutaneously should be taught to administer the injection at which site? Deltoid Ventrogluteal Forearm Abdomen

Abdomen The abdomen is a subcutaneous injection site. The forearm is an intradermal injection site. The deltoid and ventrogluteal areas are intramuscular injection sites.

A patient is being sent home with orders for a laxative PRN. The nurse is conducting patient teaching on the use of a laxative. What will the nurse inform the patient is one of the most common adverse effects of a laxative? Abdominal cramping Weakness Dizziness Headache

Abdominal cramping

The nurse is administering magnesium sulfate to a client for preeclampsia. What outcome would indicate successful management of preeclampsia with magnesium sulfate? Respiratory rate less than 16 Absent reflexes Decreased contractions Absence of seizure activity

Absence of seizure activity

A school-aged child is brought to the clinic by her parents. The parents state that the child will be engaged in some activity at home and then will just stop suddenly for a few seconds and then pick up the activity again as if there had been no break in what she was doing. This child should be assessed for what neurological disorder? Status epilepticus Myoclonic seizures Tonic-clonic seizures Absence seizures

Absence seizures

The nurse is checking a drug label prior to administering a medication to a child, but the drug label does not include a recommended pediatric dose. What should the nurse do to find this information? Call and inform the physician that the medication will not be given until this information is on the label. Call and have the supervisor obtain a drug label. Access a computerized pharmacology database. Ask another nurse what should be done.

Access a computerized pharmacology database.

When causing depolarization of the muscle membranes, what neurotransmitter interacts with the nicotinic cholinergic receptors leading to the release of calcium ions? GAMA Serotonin Epinephrine Acetylcholine

Acetylcholine

A nurse is caring for an adolescent with hypogonadism who has been prescribed fluoxymesterone (Androxy) for replacement. What adverse effect of this drug will the nurse alert the patient to that could cause self-esteem concerns? Acne Dizziness Insomnia Fatigue

Acne

The anatomy and physiology instructor is discussing reactions of the body to stress. According to the instructor, what is responsible for the release of cortisol (hydrocortisone) during times of stress? The negative feedback mechanism Activation of the parasympathetic nervous system Activation of the sympathetic nervous system Stimulation of the thyroid

Activation of the sympathetic nervous system The stress response activates the sympathetic nervous system, causing the adrenal cortex to secrete adrenocortical hormones such as cortisol.

A patient has received a chemotherapy infusion and within 3 hours after the infusion begins to have severe nausea and vomiting. What type of emesis does the nurse determine this patient is having? Breakthrough Delayed Anticipatory Acute

Acute

A client is newly diagnosed with parkinsonism and has been prescribed levodopa. After several weeks, no appreciable reduction in symptoms has been noted. The nurse should anticipate what change in the client's medication regimen? Adding carbidopa to the client's medication regimen Temporary change in levodopa route from oral to intravenous Addition of vitamin B6 to the client's medication regimen Substitution of diphenhydramine for levodopa

Adding carbidopa to the client's medication regimen

A female client is admitted to the hospital with hypoglycemia, nausea, muscle weakness, and depression. What is the most likely cause? Cushing disease Stroke Addison disease Hypertension

Addison disease Characteristics of Addison disease include those related to glucocorticoid deficiency, such as hypoglycemia, anorexia, nausea, vomiting, flatulence, diarrhea, hyperpigmentation of skin, anxiety, depression, and loss of mental acuity, and those related to mineralocorticoid deficiency, such as fluid and electrolyte imbalance, orthostatic hypotension, hyponatremia, hyperkalemia, general malaise, muscle weakness, muscle pain, and cardiac arrhythmias. Hypertension, stroke, and Cushing disease are not associated with this array of signs and symptoms.

The patient taking a CNS stimulant reports insomnia. The best option for the nurse in this case is which of the following? Hold the drug. Administer the drug 2 hours before bedtime. Administer the drug right before bedtime. Administer the drug earlier in the day.

Administer the drug earlier in the day.

A primary health care provider has prescribed levothyroxine to a patient with hypothyroidism. What should the nurse tell the patient to promote an optimal response to the drug therapy? Record the pulse rate and bring the record to the PHCP. Offer suggestions about the dosage schedule. Apply soothing creams or lubricants to prevent rashes. Administer the drug early in the morning before breakfast.

Administer the drug early in the morning before breakfast.

Kate is experiencing status epilepticus. The physician orders IV diazepam. What special precautions need to be taken by a nurse to administer IV diazepam? Administer the drug very slowly, no faster than 5 mg/min. Dilute the drug with 5 to 10 mL normal saline. Administer the drug through an IV pump. Administer the drug in the small veins in the dorsum of the hand or the wrist.`

Administer the drug very slowly, no faster than 5 mg/min.

A patient calls the clinic and reports to the nurse that they are not feeling good. The patient goes on to say that they were recently prescribed a laxative. The nurse knows that the patient takes other medications for congestive heart failure and osteoarthritis. What should the nurse question the patient about? Administration of the laxative in relation to taking her other medications The use of laxatives in the morning or at night The amount of fat in her diet How many times a day she takes the laxative

Administration of the laxative in relation to taking her other medications

A patient is taking low-dose corticosteroids on a long-term basis for COPD. What does prolonged use of corticosteroids put the patient at risk for? Hypothalamic insufficiency Adrenal storm Stunted growth Adrenal atrophy

Adrenal atrophy Prolonged use of corticosteroids suppresses the normal hypothalamic-pituitary axis and leads to adrenal atrophy from lack of stimulation.

Some anticholinergic drugs have the same clinical indications in the pediatric population as in the adult population. Which statement accurately describes a difference between the populations related to the use of anticholinergics? Anticholinergic drugs create different adverse effects in children. Adverse effects tend to be more severe in children. Anticholinergic drugs are more effective in the pediatric population. Adverse effects tend to be less severe in children.

Adverse effects tend to be more severe in children.

A nurse who provides care for older adults is aware of the decreased rate of drug distribution among this population. The ability of older adults to adequately distribute drugs that are ingested is highly dependent on serum levels of Blood urea nitrogen Albumin Sodium Creatinine

Albumin

A patient has just been told that their cancer has metastasized to their right kidney. An interferon (Aldesleukin) has been prescribed to treat this metastasis. The patient asks why the interferon is ordered. What is the nurse's best response? Aldesleukin has been shown to enhance allogeneic stem-cell transplantation. Aldesleukin has been shown to protect autologous tumor cells. Aldesleukin has been shown to inhibit tumor growth. Aldesleukin has been shown to have a direct proliferative effect on renal tumors.

Aldesleukin has been shown to inhibit tumor growth.

What is the most prevalent mineralocorticoid that regulates fluid balance? Potassium Chloride Sodium Aldosterone

Aldosterone The mineralocorticoids (aldosterone is the most prevalent naturally occurring mineralocorticoid) exert a major influence on regulating potassium, sodium, and water balance.

Malignant cells seem to be more susceptible than normal cells to the effects of which of the following class of antineoplastic drugs? (Choose one) Antineoplastic antibiotics Alkylating agents Antimetabolites Vinca alkaloids

Alkylating agents

The nurse is discharging a 32-year-old patient with newly prescribed thyroid drugs. What would the nurse teach the patient to report to their physician? Nervousness Insomnia Chest pain All of the above

All of the above Report chest pain, heart palpitations, nervousness, or insomnia. These adverse effects result from excessive stimulation and may indicate that drug dosage or intake of other stimulants needs to be reduced.

A nurse is caring for a patient suffering from a severe form of hyperthyroidism called thyrotoxicosis or thyroid storm. Which of the following should the nurse observe in the patient as a characteristic of thyroid storm? Memory impairment Cold intolerance Altered mental status Constipation

Altered mental status A severe form of hyperthyroidism called thyrotoxicosis or thyroid storm is characterized by high fever, extreme tachycardia, and altered mental status. The nurse need not observe memory impairment, cold intolerance, or constipation as characteristics of thyroid storm. Memory impairment, cold intolerance, and constipation are the manifestations of myxedema, which is a severe hypothyroidism.

A nurse is instructing a mother about a new drug her son was prescribed for ADHD. The nurse should include which of the following instructions? Always take the drug 30 minutes before lunch and dinner. Always take the drug in the morning 30 to 45 minutes before breakfast and lunch. Always take the drug in the morning before breakfast and before going to bed at night. Always take the drug after breakfast and after lunch.

Always take the drug in the morning 30 to 45 minutes before breakfast and lunch.

Cholinesterase inhibitors are utilized for the treatment of which of the following medical conditions? (Choose one) Alzheimer's disease Urinary retention Glaucoma Myasthenia gravis

Alzheimer's disease

A client has developed drug induced Parkinson's disease following prolonged treatment with metoclopramide. The nurse should anticipate the use of what drug that is also classified as an antiviral? Ropinirole (Requip) Amantadine (Symmetrel) Entacapone (Comatan) Diphenhydramine (Benadryl)

Amantadine (Symmetrel)

What client is being treated with a typical antipsychotic? A client with schizophrenia who received paliperidone 6 mg PO daily An agitated client who was given haloperidol during acute psychosis A client who recently began taking ziprasidone A client whose thought disorder requires clozapine 25 mg PO b.i.d.

An agitated client who was given haloperidol during acute psychosis

A patient will begin taking sildenafil (Viagra) for penile erectile dysfunction. The nurse will teach him what concerning use of this drug? He should use his nitroglycerin before intercourse to protect his heart. There is no need to worry about interactions with any other drugs. An erection will only occur in the presence of sexual stimulation of the penis. He will have an erection exactly one hour after taking the drug.

An erection will only occur in the presence of sexual stimulation of the penis.

A patient at the clinic reports amenorrhea and has participated in competitive bodybuilding for years. She tested positive for pregnancy. After obtaining a health history, you find healthy eating habits, regular exercise, herbal supplement use, and alcohol avoidance. What patient education should follow? Anabolic steroid use is contraindicated in pregnancy. Anabolic steroid use is indicated in pregnancy. Anabolic steroid use during pregnancy is an individual choice. Anabolic steroid use during pregnancy decreases the need for exercise during pregnancy.

Anabolic steroid use is contraindicated in pregnancy.

Matt, age 16, has been taking testosterone since age 7 for the treatment of hypogonadism. He is in the physician's office today for follow-up care. He asks about taking anabolic steroids instead of testosterone because he heard this will increase his growth. What is the primary difference between anabolic steroids and testosterone? Anabolic steroids produce both anabolic and androgenic effects. Anabolic steroids are given via the buccal route. Anabolic steroids have a greater anabolic effect. Anabolic steroids are synthetic.

Anabolic steroids have a greater anabolic effect.

The nurse is about to administer a Category C drug to a pregnant client. Which of the following describes this FDA category of risk potential during pregnancy? Animal studies show no risk, but there is inadequate documentation in humans. Animal studies show adverse affects but there are no adequate studies in humans. A risk has not been documented during pregnancy. There is evidence of human fetal risk, but the benefits may outweigh risks.

Animal studies show adverse affects but there are no adequate studies in humans.

A client is receiving carbamazepine therapy and the client's latest serum level of the drug is 13 mcg/mL. What action is most appropriate? Anticipate a reduction is dosage Assess the client's renal function Call an emergency code Contact the provide to request a one-time supplementary dose

Anticipate a reduction is dosage Range: 4-12

A patient had severe nausea and vomiting with the first dose of a chemotherapeutic agent. The patient states to the nurse, "I just know I will have a problem again." When the patient has a learned response from the negative experience, what type of emesis is this considered? Breakthrough emesis Anticipatory emesis Acute emesis Delayed emesis

Anticipatory emesis

A patient who has been taking valproic acid (sodium valproate) for a seizure disorder is asking the nurse about getting pregnant. Why is pregnancy discouraged in women who are being treated for seizure disorders? Seizure disorders are genetic Seizure disorders are familial Antiepilepsy drugs are teratogenic Antiepilepsy drugs decrease fertility

Antiepilepsy drugs are teratogenic

A client with dementia has been very agitated lately. What type of medication might the provider prescribe to help with the agitation? Antibiotic Antidepressant Narcotic Antipsychotic

Antipsychotic

What intervention by the nurse can reduce pain for a 4-year-old child who is to receive an intramuscular (IM) injection? Inject the site with 2% Lidocaine prior to administering the medication. Apply a topical anesthetic cream (EMLA) 30 minutes prior to administering the injection. Use an ice pack to numb the area prior to administering the medication. Use the dorsogluteal site to decrease the pain felt from the injection.

Apply a topical anesthetic cream (EMLA) 30 minutes prior to administering the injection.

A 13-year-old girl is brought to the clinic by her mother for a skin rash. The patient is diagnosed with severe poison ivy, and a steroid cream is ordered to be administered topically. What would be important to teach this patient and her mother about the application of this medication? Apply the medication sparingly. Apply as often as you need to keep the rash covered. Cover the cream with an air-tight dressing. Apply a thick layer of cream to the lesions.

Apply the medication sparingly. Corticosteroids are used topically and locally to achieve the desired anti-inflammatory effects at a particular site without the systemic adverse effects that limit the usefulness of the drugs. Patient teaching would include leaving the lesions open to air and applying the topical cream as directed by the physician.

What can the nurse do to maximize a patient's adherence to the medication regimen? Inform patients to research other options to antiretroviral therapy. As an advocate of the patient, discuss benefits and risks of antiretroviral therapy as well as administration. Teach that patients who do not take the medication could have poor outcomes. Inform patients that they have to be compliant with the approved treatment regimen to receive care.

As an advocate of the patient, discuss benefits and risks of antiretroviral therapy as well as administration.

When preparing to administer a tablet by mouth to a hospitalized 4-year-old child, what can the nurse do to enlist cooperation of the child to take the medication? Tell the child that the medication is candy. Tell the child that the medication has to be taken so that the child can leave the hospital. Tell the child that the child can sit on the parent's lap. Ask the child if the child would prefer the liquid form of the medication.

Ask the child if the child would prefer the liquid form of the medication.

A patient is receiving hydrocortisone 40 mg by mouth daily for treatment of severe autoimmune inflammation. Which nursing intervention is most important to implement? Limit fluid intake Limit dietary protein Assess daily blood glucose Increase dietary sodium

Assess daily blood glucose Hydrocortisone increases the disposition of liver glycogen. The patient's blood sugar should be assessed daily. When taking hydrocortisone daily, the patient should limit dietary sodium due to fluid retention. The patient should maintain a diet high in protein. The patient should not alter fluid intake unless the patient shows signs of fluid volume overload.

The physician orders bismuth subsalicylate (Pepto-Bismol) for your patient. What assessment is most important to make before administering this medication? Assess for allergy to aspirin Assess for allergy to opioids Assess electrolytes Assess for pain

Assess for allergy to aspirin

The nurse is preparing to give a 25-year-old female patient an injection of carboprost. What would be most important for the nurse to do? Assess for contraindications or cautions. Draw up the medication and inject within 5 minutes. Try to talk the mother out of taking the drug. Assess vital signs.

Assess for contraindications or cautions.

A woman in preterm labor is being treated with magnesium sulfate intravenously. Which of the assessments should be implemented during the administration of magnesium sulfate? Assess for fever Assess uterine bleeding Assess magnesium level Assess potassium level

Assess magnesium level

In order to reduce an older adult's risk of experiencing adverse drug effects or interactions, what action should the nurse prioritize? Encourage patients to taper down their dosages until they sense the reemergence of symptoms. Assess the patient's use of herbal remedies and OTC medications. Assess the degree to which patients understand the indications for their medications. Encourage patients to seek a second opinion whenever prescribed a new drug.

Assess the patient's use of herbal remedies and OTC medications.

A nurse is caring for a hospital client who has just been prescribed phenytoin (Dilantin) for a seizure disorder. What assessment should the nurse prioritize when assessing for adverse effects? Assessment of level of consciousness Assessment for chest pain or shortness of breath Assessment of urinary output and urine appearance Assessment of respiratory rate and oxygen saturation

Assessment of respiratory rate and oxygen saturation

A client, newly diagnosed with Parkinson's disease, has been prescribed an anticholinergic drug. What assessment should the nurse perform when monitoring for adverse effects of anticholinergic agents used for the treatment of Parkinson's disease? Monitoring of prothrombin time and international normalized ratio (INR) Focused respiratory assessment Monitoring of laboratory results for blood dyscrasias Assessment of the client's bowel pattern

Assessment of the client's bowel pattern Anticholinergics often cause decreased bowel motility, resulting in constipation.

A patient is being prescribed a central nervous system stimulant. Which will have the lowest risk of abuse and dependence? Atomoxetine (Strattera) Amphetamine Adderall Dexmethylphenidate (Focalin)

Atomoxetine (Strattera)

A patient is brought to the Emergency Department (ED) and is found to have cholinergic toxicity. What is the drug of choice to treat this condition? Atropine Lidocaine Tensilon Epinepherine

Atropine

The client is experiencing digitalis toxicity and presents with symptomatic bradycardia. The nurse knows that which medication may be administered to treat bradycardia? Norvasc Atropine Milrinone Lasix

Atropine

A client with intractable rheumatoid arthritis has been prescribed a gold salt. What medication should the nurse look for on the client's medication administration record? Anakinra Celecoxib Mesalamine Auranofin

Auranofin Auranofin is a gold salt. Celecoxib is a COX-2 inhibitor. Mesalamine is a salicylate. Anakinra is an interleukin-1 receptor antagonist.

A patient has been prescribed Didrex. Which of the following precautions should the nurse take while administering the drug? Provide carbonated beverages. Avoid administering antidepressants. Administer the drug around dinner time. Provide tea, coffee, and other stimulants.

Avoid administering antidepressants.

A nurse is discussing interferon alfa-2b with a patient. What will the nurse encourage the patient to do while taking this drug? Eat 3 meals a day Decrease milk intake Avoid alcohol Increase salt intake

Avoid alcohol

An older adult client comes to the clinic and tells the nurse the client needs sleeping pills. What interventions can the nurse discuss with the client? (Select all that apply.) Drink a cup of coffee or tea before going to sleep. Perform some type of mild exercise during the day such as walking. Avoid eating a heavy meal prior to going to bed. Take an extra sleeping pill for nights that it is difficult to sleep. Perform some mild exercise prior to going to bed.

Avoid eating a heavy meal prior to going to bed. Perform some type of mild exercise during the day such as walking.

A woman has been prescribed Climara, a transdermal estradiol patch. Which of the following should she be instructed regarding the administration? The medication, when exposed to sunlight, can increase the risk of breast cancer development. Avoid prolonged sun exposure at the patch site due to increased plasma concentrations. Exposure of the medication to cold will increase effectiveness with application once a month. The application of heat at the patch site will decrease effectiveness and result in pregnancy.

Avoid prolonged sun exposure at the patch site due to increased plasma concentrations.

The circulating nurse knows that what is the most important nursing intervention during Stage II of general anesthesia? Clip the hair over the client's operative area. Prepare the postoperative bed. Make sure that the lights are centered on the operative area. Avoid unnecessary noise in the operating room.

Avoid unnecessary noise in the operating room.

Which would the nurse include in a teaching plan for a patient who is prescribed an anticholinergic agent? Encouraging outside activity in the warm weather Avoiding activities that require alertness Decreasing fiber intake Limiting fluid intake during the day

Avoiding activities that require alertness

Alemtuzumab (Campath 1-H) is humanized monoclonal antibody directed against the CD52 cell surface antigen. Which of the following best describes this drug? Select all that apply. Lymphocyte counts only need to be monitored monthly risk for cytomegalovirus B- and T-cell chronic lymphocytic leukemia only given intravenously

B- and T-cell chronic lymphocytic leukemia risk for cytomegalovirus

An elderly client has received gentamicin intravenously for several days. To assess for toxicity of gentamicin, the nurse evaluates: (select all) complete blood counts. BUN and creatinine levels. gentamicin peak and trough levels. for any tinnitus or hearing loss. daily weight of the client.

BUN and creatinine levels. for any tinnitus or hearing loss. daily weight of the client. gentamicin peak and trough levels.

A patient with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered? Cyclobenzaprine Carisoprodol Chlorzoxazone Baclofen

Baclofen

A 20-year-old female has been diagnosed with multiple sclerosis. Which drug will most likely be prescribed? Cyclobenzaprine (Flexeril) Baclofen (Lioresal) Orphenadrine (Banflex) Metaxalone (Skelaxin)

Baclofen (Lioresal)

The nurse is preparing to administer a client's prescribed dose of immune sera. How should the nurse describe this treatment to the client? A viral protein coat Weakened bacterial cell membrane Chemically weakened actual virus Bacterial antibodies in serum

Bacterial antibodies in serum

A patient has been treated for diarrhea. Which of the following foods should be introduced back into the diet after 2 days of diarrhea? Beef stew Hamburger Hot dog Baked potato

Baked potato Following 2 days of diarrhea, bland foods should be introduced back into the diet, such as baked potato. The patient should not resume a diet with hamburger, beef stew, or hot dog.

What can the oncology nurse do to minimize the exposure risk to chemotherapeutic agents? Only administer chemotherapy agents that are not toxic. Be familiar with institution's policies and procedures and use them as precautionary measures. Attend in-service education. Recognize the dangers of administering chemotherapeutic agents.

Be familiar with institution's policies and procedures and use them as precautionary measures.

In a patient who is to be given vecuronium (Norcuron), anesthesia is induced before neuromuscular blockade is started. What is the reason for this? Because it helps prevent the patient from undergoing the frightening experience of paralysis and the inability to breathe Because it helps reduce the adverse effects of vecuronium Because it enhances the therapeutic effects of vecuronium Because it ensures that vecuronium does not cross the blood-brain barrier

Because it helps prevent the patient from undergoing the frightening experience of paralysis and the inability to breathe

A patient who has been diagnosed with Parkinson's disease was prescribed levodopa. The patient did not tolerate the administration of levodopa. Which of the following medications will be administered in place of the levodopa? Guanadrel sulfate (Hylorel) Benztropine (Cogentin) Nafcillin sodium (Nafcil) Carbamazepine (Apo-Carbamazepine)

Benztropine (Cogentin)

Which drug is classified as a cholinergic blocking drug used to treat parkinsonism? Benztropine (Cogentin) Entacapone (Comtan) Apomorphine (Apokyn) Carbidopa (Lodosyn)

Benztropine (Cogentin)

Which adrenocortical hormone drugs influence or regulate functions such as the immune response, glucose, fat, and protein metabolism, and the anti-inflammatory response? (Select all that apply.) Budesonide (Entocort EC) Dexamethasone (Decadron) Hydrocortisone (Cortef) Fludrocortisone (Florinef) Betamethasone (Celestone)

Betamethasone (Celestone) Budesonide (Entocort EC) Hydrocortisone (Cortef) Dexamethasone (Decadron) Glucocorticoids, like betamethasone (Celestone), budesonide (Entocort EC), hydrocortisone (Cortef), and dexamethasone (Decadron), influence or regulate functions such as the immune response, glucose, fat, and protein metabolism, and the anti-inflammatory response.

A patient is brought to the Emergency Department after a motor vehicle accident. The patient is diagnosed with multiple injuries including a bladder injury. The patient is taken to surgery and develops a nonobstructive postoperative urinary retention. What drug would the nurse expect to be ordered for this patient? Ambenonium Pyridostigmine Bethanechol Neostigmine

Bethanechol

The client has been diagnosed with urinary retention. The nurse expects the client to receive which medication for this condition? Bethanechol Ambenonium Guanidine Benadryl

Bethanechol

Which is an example of a direct-acting cholinergic that acts like the neurotransmitter acetylcholine? Ambenonium (Mytelase) Bethanechol (Urecholine) Pilocarpine (Pilopine) Pyridostigmine (Regonol)

Bethanechol (Urecholine)

Which is an example of a direct-acting cholinergic that acts like the neurotransmitter acetylcholine? Ambenonium (Mytelase) Bethanechol (Urecholine) Pyridostigmine (Regonol) Pilocarpine (Pilopine)

Bethanechol (Urecholine)

The nurse is caring for a patient with a history of uncontrolled hypertension. For which chemotherapy agent should the nurse question an order? Panitumumab (Vectibix) Ofatumumab (Arzerra) Abciximab (ReoPro) Bevacizumab (Avastin)

Bevacizumab (Avastin)

A 17-year-old client has just been diagnosed with schizophrenia. When educating the family about the cause of this disease, the nurse should address what factors? Select all that apply. Seizure activity at a young age Genetic factors Biochemical disruptions Psychosocial trauma Impaired coping

Biochemical disruptions

Psychosis is a severe mental illness characterized by what? Increased social interaction Paranoid hallucinations Hypoactivity with aggressiveness Bizarre behavior

Bizarre behavior

Immunosuppressants often are used in conjunction with corticosteroids, which block the inflammatory reaction and decrease initial damage to cells. They are especially beneficial in cases of organ transplantation and in the treatment of autoimmune diseases. How do they work when ordered for a patient who has had an organ transplant? Block normal effects of the immune system Stimulate immune system to fight off infection Work with corticosteroids to strengthen immune system Work with corticosteroids to enhance healing

Block normal effects of the immune system

What best reflects the action of tolterodine? Blockage of parasympathetic activity Blockage of the muscarinic receptors to reduce bladder muscle tone Exertion of a direct topical analgesic effect Action as a buffer to control cell permeability

Blockage of parasympathetic activity

What should the nurse's ongoing assessment of a client receiving a CNS stimulant for respiratory depression include? (Select all that apply.) Level of consciousness Pulse Respiratory rate Blood pressure Respiratory pattern

Blood pressure Pulse Respiratory rate Respiratory pattern Level of consciousness

A 31-year-old woman is being treated with fludrocortisone for Addison disease. In addition to monitoring the client's urinary output, what other assessment should the nurse prioritize? Level of consciousness Blood pressure Hydration status Measures of coagulation

Blood pressure Fludrocortisone acts on the distal renal tubule to enhance the reabsorption of sodium and to increase the urinary excretion of both potassium and hydrogen ions. In small oral doses, the mineralocorticoid effects of fludrocortisone predominate: urinary excretion of potassium, marked sodium retention, and a rise in blood pressure as a result of the physiologic effects of these electrolyte levels. The level of consciousness is not affected by fludrocortisone unless there are significant changes in the fluid balance.

After administering desmopressin to a patient with diabetes insipidus, which would the nurse identify as indicating drug effectiveness? Increased urination Decreased reports of thirst Decreased skin turgor Elevated blood glucose levels

Decreased reports of thirst

An athlete has been administered growth hormone. He states that he has a severe headache and flashes before his eyes. What assessment should the nurse make? Respiratory rate Blood pressure Levels of anxiety Equilibrium

Blood pressure The administration of growth hormone can lead to hypertension. The patient should be assessed for increased blood pressure. Equilibrium is important to assess, but blood pressure is the primary assessment. Growth hormone can cause anxiety, but is not an objective assessment in this case. The respiratory rate is not the most important objective assessment in this case.

The nurse knows that which assessment finding suggests hyperthyroidism? Heart rate 55 beats per minute Blood pressure 145/87 Cool, dry skin Hard, thick nails

Blood pressure 145/87 Moderate hypertension is a sign of hyperthyroidism. Bradycardia, cool and dry skin, and hard, thick nails are suggestive of hypothyroidism.

A gerontological nurse is aware that older adults' abilities to excrete medications diminish with age. When appraising an older adult's ability to excrete medications, what laboratory or diagnostic finding should the nurse prioritize? Renal ultrasound Complete blood count (CBC) Serum bilirubin and albumin levels Blood urea nitrogen and creatinine levels

Blood urea nitrogen and creatinine levels The nurse should assess an older adult's blood urea nitrogen and creatinine clearance (CrCl) levels to determine the patient's ability to excrete the medications. Renal ultrasound identifies structural abnormalities in the kidneys but is less useful in diagnosing function. The patient's CBC and bilirubin and albumin levels do not help the nurse assess the patient's ability to excrete medications.

Carter, age 13, is prescribed testosterone for delayed onset of puberty. What is a priority when monitoring the prepubescent? Sodium and potassium levels Hemoglobin levels Fluid intake and output Bone growth

Bone growth

The essential components of the immune system are hematopoietic cells, barrier defenses, the nonspecific immune response, the specific immune response, and immunity. Which of the following describe the specific immune response? Choose all that apply. Hemoglobin enables cells to carry oxygen to the cells. It involves natural killer cells and lymphokine activated killer cells. The skin is the first line of defense. Bone marrow stem cells develop into two types of lymphocytes.

Bone marrow stem cells develop into two types of lymphocytes. It involves natural killer cells and lymphokine activated killer cells.

A veteran nurse is teaching a new nurse how to administer colony-stimulating factors. It is important to include which adverse reactions in the lesson plan? Yeast infections Fungal infections Bone pain, nausea and vomiting, alopecia, and hypertension Fluid retention and peripheral edema

Bone pain, nausea and vomiting, alopecia, and hypertension

A young mother is requesting oral contraceptives at her 6-week postnatal visit. Which of the following would be a contraindication for the use of progestin? Family history of cardiovascular disease History of recent cholecystectomy History of pelvic inflammatory disease Breastfeeding

Breastfeeding

Your patient, a 15-year-old girl, is brought to your office by her mother, who reports the patient has chronic diarrhea. The patient reports lack of appetite and is significantly underweight with dry hair and skin. Oral assessment reveals erosion of tooth enamel. When asked, the patient reports occasional laxative use for "constipation." What do you suspect? Sodium retention Anorexia nervosa Dehydration Bulimia with laxative abuse

Bulimia with laxative abuse

The client is a woman 65 years of age being treated for anemia secondary to chronic kidney disease. The nurse explains to the client that she will be getting a prescription for Epogen. Which of the following additional information would the nurse provide? Chronic kidney disease slows the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia. Chronic kidney disease has an affect on the production of red blood cells causing anemia. Epogen minimizes the effect on the production of red blood cells to cause anemia. Chronic kidney disease has no affect on the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia. Chronic kidney disease stimulates the production of red blood cells causing anemia. Epogen slows the production of red blood cells to cause anemia.

Chronic kidney disease slows the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia.

A nurse should administer which of the following antidepressants in the morning as it has a great likelihood to cause insomnia? Select all that apply: Bupropion (Welbutrin) Amitiptyline (Elavil) Paroxetine (Paxil) Citalopram (Celexa) Sertraline (Zoloft)

Citalopram (Celexa) Paroxetine (Paxil) Sertraline (Zoloft)

Clonidine is an adrenergic agonist that is used to treat hypertension. What is the rationale for this use? Clonidine stimulates release of dobutamine from nerve axons Clonidine blocks release of dobutamine from nerve axons Clonidine stimulates release of norepinephrine from nerve axons Clonidine blocks release of norepinephrine from nerve axons

Clonidine blocks release of norepinephrine from nerve axons

A nurse recommends a client avoid other CNS stimulants while taking dexmethylphenidate (Focalin) which include which of the following? Select all that apply: Coffee Chocolate Milk Cola drinks Tea

Coffee Chocolate Cola drinks Tea

A patient diagnosed with acute primary HIV infection is in the clinic. What treatment should be initiated for this patient? Combination antiretroviral therapy Didanosine therapy once daily Zidovudine therapy once daily Monotherapy protease inhibitor therapy

Combination antiretroviral therapy

The nurse is preparing to administer an oral medication to a toddler. To elicit cooperation from the child, what should the nurse do before administering the medication? Tell the child that he or she can get a toy if good. Tell the child if he or she does not cooperate, you will obtain help to hold him or her down. Communicate with the child at the appropriate developmental level. Communicate with the parent, not the child.

Communicate with the child at the appropriate developmental level.

A patient taking oral prednisone informs the home care nurse that the medication is upsetting his stomach. What guidance can the nurse provide to help the patient? Confirm that the patient takes the medication on an empty stomach. Confirm that the patient takes the medication with a meal. Recommend that the patient split the dose into two smaller, equal doses. Recommend that the patient take the medication shortly before bedtime.

Confirm that the patient takes the medication with a meal.

A client in the clinic with a history of epilepsy has just tested positive for pregnancy. What is the nurse's next action? Explain how to taper off her seizure medication as the risk for seizures decreases during pregnancy. Discuss the most serious birth defects that may occur due to treating epilepsy during pregnancy. Advise the client to continue her current medication for epilepsy. Consult with the primary health care provider.

Consult with the primary health care provider.

What discharge instructions should the nurse provide to the patient going home after rituximab therapy? Consume large amounts of water and report decreased urine output. Eat a bland diet for 24 hours after therapy. Limit fluid intake to 1 L per 24 hour period and report increased urine output. Take acetaminophen for the discomfort related to the transfusion.

Consume large amounts of water and report decreased urine output.

A client is prescribed lamotrigine (Lamictal) for control of partial seizures. What is the most important medication teaching information the nurse should emphasize from the plan of care? A mild headache may occur while taking this medication. Seek assistance when walking if dizziness occurs. Take this medication with food to prevent nausea and vomiting. Contact the health care provider immediately if rash appears.

Contact the health care provider immediately if rash appears.

A nurse is caring for a male client who is being given an adrenergic drug for shock. Which action should the nurse do? Continually assess the client for physiological changes and notify the primary care provider with relevant changes. Observe the client closely for seizures, hypothermia, and dementia. If any of these symptoms are seen, stop the infusion immediately. Leave the room so that the client can sleep and not risk sleep deprivation psychosis. Prepare the family by telling them how sick their loved one is and that he may die.

Continually assess the client for physiological changes and notify the primary care provider with relevant changes.

When interneurons synapse within the spinal cord, what physiologic adjustments are made? Coordinate balance Adjust response and recovery Adjust to upright position Coordinate movement and position

Coordinate movement and position

A 54-year-old woman with a history of asthma is prescribed prednisone to treat an exacerbation of her condition. The nurse is explaining to the patient how this medication works to decrease the immune response and places the patient at risk for infection. What mechanism of action of the drug causes a decrease in the immune response? Increase in phagocytosis Increase in immunoglobulins Increased antigen-antibody reaction Decrease in the number of eosinophils

Decrease in the number of eosinophils Its immunosuppressant effects are attributable to suppression of phagocytosis, a decrease in the number of circulating eosinophils and lymphocytes, suppression of delayed hypersensitivity reactions, a decrease in antigen-antibody tissue reactions, and a decrease in plasma immunoglobulins.

Which of the following effects can be noticed in a patient who has been administered amphetamines? Drowsiness Low blood pressure Decreased appetite Depression

Decreased appetite

A patient with postpartum thyroiditis could potentially experience all the following adverse cardiovascular effects from caffeine, EXCEPT: Decreased cardiac output Hypertension Increased heart rate Palpitations

Decreased cardiac output

A patient is undergoing corticotropin therapy at a health care facility. The patient is also receiving a cholinergic blocker for the treatment of Parkinson's disease. What effect of the interaction of these two drugs should the nurse observe for in the patient? Decrease in serum levels Decreased effect of ACTH Decreased muscle function Increased risk of hypokalemia

Decreased muscle function The nurse should observe decreased muscle function in the patient as the effect of the interaction of corticotropin with cholinergic blockers. When the patient is administered barbiturates with the corticotropin drug, there will be the decreased effect of adrenocorticotropic hormones (ACTH). Increased risk of hypokalemia is an effect of the interaction of amphotericin B and diuretics. When salicylates are administered with fludrocortisone, there will be a decrease in serum levels of the patient.

A patient has been admitted to the unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the patient is taking baclofen (Lioresal). Which outcome would the nurse expect to be associated with use of this medication? Decreased muscle spasms Reduction in the appearance of new lesions in magentic resonance imaging (MRI) studies Decreased severity and duration of exacerbations Increased muscle strength

Decreased muscle spasms

The nurse is reviewing a client's current medication list at her first prenatal visit to determine if there should be any changes. The nurse is aware that some drugs may produce greater effects during pregnancy for which of the following reasons? Decreased serum albumin Decreased cardiac output Decreased estrogen Decreased renal blood flow

Decreased serum albumin Serum albumin levels fall during pregnancy because of plasma volume expansion. The decreased capacity for drug binding leaves more free drug available for therapeutic or adverse effects.

A nurse is assessing a client with Parkinson's disease. The nurse determines that the client's drug therapy is effective when the client exhibits what? Improved short term memory Improved level of intellectual functioning Decreased aggression Decreased tremors

Decreased tremors

In order to improve client outcomes, early recognition of the signs and symptoms of shock by the nurse is important. A nurse is caring for a client that has recently suffered an acute myocardial infarction. Which of the following are signs and symptoms of shock for which the nurse should monitor the client? Select all that apply: Bradycardia Tachypnea Hypoxia Decreased urinary output Increased blood pressure

Decreased urinary output Hypoxia Tachypnea

A patient diagnosed with diabetes insipidus is taking vasopressin (Desmopressin). What outcome would indicate to the nurse that the desmopressin is producing a therapeutic effect? Decreased blood volume Decreased urine output Increased plasma osmolarity Decreased water reabsorption

Decreased urine output

Thyroid hormones are principally concerned with the increase in metabolic rate of tissues that can result in certain effects? What are some of these effects? (Select all that apply.) Increased heart rate Increased body temperature Decreased respiratory rate Decreased oxygen consumption Increased cardiac output

Decreased urine output Increased heart rate Increased body temperature Increased cardiac output

A patient diagnosed with pre-eclampsia is being treated on the obstetrics unit. What treatment outcomes promote an optimal result for this patient and fetus? (Select all that apply.) Decreasing central nervous system irritability Decrease peristalsis Reduce increased intracranial pressure related to vomiting Decrease rising glucose levels Reduction of maternal blood pressure

Decreasing central nervous system irritability Reduction of maternal blood pressure

A female patient receiving fluoxymesterone, an androgenic drug, for metastatic breast cancer is disturbed by the physical changes seen in her body. Which feature of virilization may be seen in the patient receiving this therapy? Increase in body weight Hypopigmentation of the skin Decrease in clitoris size Deepening of the voice

Deepening of the voice

The nurse is caring for an 89-year-old client with frequent liquid stools. When preparing a plan of care for this patient, what nursing diagnosis is a priority? Deficient knowledge related to medications Deficient fluid volume Pain related to abdominal cramping Imbalanced nutrition: Less than body requirements

Deficient fluid volume Fluid volume deficits may develop rapidly in older adults with diarrhea. Older adults are more likely to develop adverse effects associated with the use of these drugs, including sedation, confusion, dizziness, electrolyte disturbances, fluid imbalance, and cardiovascular effects.

The nuring instructor is teaching students about Alzheimer's disease. The instructor informs the students that patients with this illness experience problems with memory and thinking. The reason that this happens is: Increased level of acetylcholine Regenration of cholinergic pathways Degeneration of cholinergic pathways Lack of neural destruction

Degeneration of cholinergic pathways

A 50-year-old male is admitted to the emergency room after a motorcycle crash. He was not wearing a helmet and has a head injury. He is unconscious with one eye dilated and one constricted. He has a widened pulse pressure. What corticosteroid will be administered parenterally? Dexamethasone (Decadron) Cortisone Prednisone Fluticasone (Flonase)

Dexamethasone (Decadron) Dexamethasone is considered the corticosteroid of cerebral edema. It is thought to penetrate the blood-brain barrier more readily and achieve higher concentrations in cerebrospinal fluid. Cortisone is the drug of choice for adrenal insufficiency. Prednisone is the glucocorticoid of choice in nonendocrine disorders in which anti-inflammatory, antiallergic, antistress, and immunosuppressive effects are desired. Fluticasone (Flonase) is administered by oral inhalation.

A patient with leukemia receiving cytarabine (Ara-C) has developed a toxicity called chemical keratitis. What medication can the oncology nurse anticipate using for treating this? Prostaglandin analogs Dexamethasone eye drops Decongestant eye drops Neosporin ophthalmic solution

Dexamethasone eye drops

A patient is experiencing symptoms of a hyperactive bowel. Which agent would the nurse expect to be ordered? Glycopyrrolate Methscopolamine Dicyclomine Floavoxate

Dicyclomine

The anatomy and physiology instructor is discussing hormones with the pre-nursing class. Which gland would the instructor tell the students controls secretions of the pituitary gland? Adrenal cortex Pineal Hypothalamus Thyroid

Hypothalamus

A patient has been treated with amphetamines for ADHD. At the age of 16 years, she is diagnosed with hyperthyroidism. What intervention should be implemented with this patient? Discontinue the high-calorie diet Assess the patient for pulmonary edema Administer a proton pump inhibitor Discontinue the amphetamines

Discontinue the amphetamines

The nurse evaluates the client's latest serum phenytoin (Dilantin) level which is revealed to be 16 mcg/mL. What is the nurse's best action? Promptly establish seizure precautions Document the fact that the client's phenytoin level is therapeutic Contact the provider to discuss withholding the next scheduled dose Contact the provider to discuss the need for a supplementary dose of phenytoin

Document the fact that the client's phenytoin level is therapeutic

The nurse is reviewing the results of a hospital client's serum phenytoin level, which has just become available. The results indicate that the client's phenytoin level is 17.5 mcg/mL. What is the nurse's best action? Document the fact that the nurse checked the client's phenytoin levels Perform a focused neurological assessment Raise the client's bed rails and maintain the client on bed rest Contact the care provider to communicate this result

Document the fact that the nurse checked the client's phenytoin levels

The nurse is caring for a new mother who had to have an episiotomy during the birth of her baby. Two days after delivery the client is in need of a laxative. What will the nurse administer? Magnesium citrate Castor oil Docusate Bisacodyl

Docusate A mild laxative may be used after delivery with care that it not enter breast milk and affect the newborn if the mother is nursing. Docusate would be the drug of choice from this list because it is mild and will produce a soft stool and decrease the need to strain. The other options would not be appropriate for this client.

A 70-year-old female patient has just been diagnosed with Alzheimer's disease. What cholinergic drug is used for the treatment of Alzheimer's disease? Bethanechol (Duvoid) Neostigmine (Prostigmine) Endrophonium (Tensilon) Donepezil (Aricept)

Donepezil (Aricept)

A patient is diagnosed with Alzheimer's disease. Which medications are administered for the treatment of Alzheimer's disease? Bethanechol (Urecholine) Neostigmine (Prostigmin) Donepezil (Aricept) Physostigmine salicylate (Antilirium)

Donepezil (Aricept)

One of the neurotransmitters can become decreased in the area of the corpus striatum. This results in the manifestations of Parkinson's disease. Which neurotransmitter will cause this? Gamma-aminobutyric acid (GABA) Serotonin Acetylcholine Dopamine

Dopamine

The nurse is administering haloperidol to a patient with psychosis. The nurse understands that the mechanism of action of this drug is to block the response of receptors in the brain. Which of the following receptors does it block? Dopamine (specifically D2), alpha, serotonin, and histamine receptors Dopamine (specifically D1), alpha, serotonin, cholinergic, and histamine receptors Dopamine (specifically D1), cholinergic, and histamine receptors Dopamine (specifically D2), serotonin, and histamine receptors

Dopamine (specifically D2), alpha, serotonin, and histamine receptors

After teaching a group of students about antineoplastic antibiotics, the instructor determines that the teaching was successful when the students identify which drug as an example? Doxorubicin Vincristine Imatinib Methotrexate

Doxorubicin

Which should be included in client teaching as a means of avoiding constipation? (Select all that apply.) Take an opioid pain medication daily. Avoid defecating when the urge occurs. Drink plenty of fluids. Be active and exercise daily. Eat foods high in bulk or roughage.

Drink plenty of fluids. Be active and exercise daily. Eat foods high in bulk or roughage.

Moderate CNS depression is characterized by: Wakefulness, mental alertness, and decreased fatigue. Drowsiness or sleep; decreased muscle tone; decreased ability to move; and decreased perception of sensations such as pain, heat, and cold. A lack of interest in surroundings and inability to focus on a topic. Increasing hyperactivity, excessive talking, nervousness, and insomnia.

Drowsiness or sleep; decreased muscle tone; decreased ability to move; and decreased perception of sensations such as pain, heat, and cold.

A female client has cut her leg playing soccer. The physician is planning to suture the leg. The nurse notes that the client is nervous. The nurse has informed the client how the local anesthetic works and that the area will be numb before the procedure begins. What else must the nurse tell the client to calm her throughout the procedure? Encourage the patient to verbalize any discomfort during the procedure. Encourage the patient to maintain a calm breathing pattern throughout the procedure. Encourage the patient to shift into comfortable positions throughout the procedure. Encourage the patient to sleep through the procedure.

Encourage the patient to verbalize any discomfort during the procedure.

A nurse is aware that older adults tend to have a significantly decreased rate of hepatic blood flow compared with younger adults. What effect is this likely to have on pharmacokinetics and pharmacodynamics in an older adult? Elimination half-time is likely to be faster. The kidneys will likely compensate for decreased hepatic capacity. Drug clearance is likely to be slower. Multiple bioactive substances will be needed for therapeutic effect.

Drug clearance is likely to be slower.

Mrs. Dermon has called to report that her husband, who is on SSRI therapy, appears to be overly stimulated, especially after breakfast and dinner. What is likely to have caused this effect? Drug interaction with nicotine Drug interaction with a monoamine oxidase inhibitor Drug interaction with a caffeinated beverage Drug interaction with a diet drug

Drug interaction with a caffeinated beverage

Many drugs prescribed to pediatric clients are used off label. What is the main reason that this occurs? The prescribing community realizes that the dosage of any drug can be safely calculated, even if there is not a recommended pediatric range given. Pharmaceutical companies have no financial incentive to seek FDA approval for a drug that is already on the market. Drug studies do not typically involve children. Physicians and prescribing providers do not need to follow drug label recommendations if their particular practice dictates the need to prescribe the medication.

Drug studies do not typically involve children.

You have begun working with a client on corticosteroids following a liver transplant. The client asks you if she will have to take this medication for the rest of her life. You respond: It depends upon how healthy the transplanted organ is. Clients are able to wean off corticosteroids as soon as they have stabilized. Drug therapy is not required for life. No. Most clients discontinue corticosteroids within 6 weeks. Drug therapy is usually continued as long as the transplanted tissue is in place. In order to prevent rejection, you will have to take this every day.

Drug therapy is usually continued as long as the transplanted tissue is in place. In order to prevent rejection, you will have to take this every day.

When combination therapy is ineffective, what needs to be reassessed? Understanding of drug therapy regimen Drug-drug interactions Whether the patient is truly having seizures Age and gender of patient

Drug-drug interactions

A 4-year-old is tested and found to have deficient GH. What does this condition cause in children? Miniaturism Acromegaly Dwarfism Gigantism

Dwarfism

The nursing instructor is talking with a student about erythropoietin drug therapy. What is an adverse effect of erythropoietin drug therapy that the instructor would tell the student about? Hypotension Depression Constipation Edema

Edema

A client has been prescribed carbamazepine for the prevention of seizures. What action should the nurse perform? Educate the client about the need to ake the pills as scheduled Teach the client how to self-administer subcutaneous injections Educate the client about taking the medication at the first sign of impending seizure activity Establish intravenous access

Educate the client about the need to ake the pills as scheduled

During initial therapy with levothyroxine (Synthroid), what are some of the most common reactions a nurse might observe in a client? (Select all that apply.) Insomnia Tachycardia Hypotension Elevated body temperature Weight loss

Elevated body temperature Weight loss Tachycardia Insomnia

A grandmother brings a 2-year-old grandchild into the clinic for treatment of a cough and cold. The nurse observes that the child is playing with the grandmother's pocketbook that has several bottles of medications. What should the nurse educate the grandparent about? If the child is going to play with the pocketbook, be sure the medications have child-proof containers. Eliminate accessibility to all medications and provide safe storage in the home. Allow the child to play with the empty bottle containers so that the child won't play with the real ones. Keep pocketbooks zipped so it won't be so easy for the child to get into it.

Eliminate accessibility to all medications and provide safe storage in the home.

Ms. Masters is currently breast-feeding her 1-month-old daughter. She calls the physician's office because she is concerned about the severe diarrhea her daughter has had for the past week. You review current medications Ms. Masters is taking and discover she is taking aspirin three times a day for headaches. What advice would the nurse give to minimize any risk of adverse effects? Suggest that the mother limit the dosage of aspirin to just one tablet a day. Encourage the mother to take the aspirin just after having breast-fed or when the infant is expected to sleep for a long time and will not be feeding. Encourage the mother to take a nonaspirin product just after having breast-fed or when the infant is expected to sleep for a long time and will not be feeding. Make no suggestions regarding the use of aspirin, since aspirin is not known to have any effect on the breast-fed infant.

Encourage the mother to take a nonaspirin product just after having breast-fed or when the infant is expected to sleep for a long time and will not be feeding. aspirin has been associated with adverse effects in breastfeeding infants (ex. use acetaminophen)

The nurse is administering a drug metabolized in the liver to an infant. Because of the immaturity of the infant liver, what does the nurse determine should be done for dosing of this drug? Ensure that a higher drug dosage is given because the liver will rapidly metabolize the drugs. Have the pharmacy lower the dose but decrease the interval between dosages. Ensure that lower drug dosages or an increased interval between doses is scheduled. Inform the physician that drugs metabolized in the liver should not be used for an infant.

Ensure that lower drug dosages or an increased interval between doses is scheduled.

A client with renal cancer is prescribed aldesleukin. What action should then nurse perform? Assess whether the client can sit upright after taking oral medications Ensure the client has adequate intravenous access Assess the integrity of the client's oral mucosa Ensure that the client is able to adhere to the prescribed treatment

Ensure the client has adequate intravenous access

The nurse is providing care for a client with Parkinson's disease. Which of the lient's medications will most directly affect catecholamine-O-methyl transferase (COMT) function? Benztropine Entacapone Diphenhydramine Selegiline

Entacapone

Which are classified as catechol-O-methyltransferase (COMT) inhibitor drugs? (Select all that apply.) Amantadine (Symmetrel) Biperiden (Akineton) Bromocriptine (Parlodel) Entacapone (Comtan) Tolcapone (Tasmar)

Entacapone (Comtan) Tolcapone (Tasmar)

A client is menopausal and has been given a prescription for estrogen. She asks the nurse what some of the risks are in taking this medication. The nurse's best response is: As long as estrogen and progesterone are taken together, there are no increased health risks. Estrogen increases the risk of certain cancers, myocardial infarctions, and blood clots. Estrogen has not been proven to increase any medical conditions. Estrogen decreases the risk of dementia, myocardial infarctions, strokes, breast cancer, and blood clot.

Estrogen increases the risk of certain cancers, myocardial infarctions, and blood clots.

It was formerly common practice to include progestin with estrogen in hormone replacement therapy (HRT) to prevent endometrial cancer resulting from unopposed estrogenic stimulation. Why is long-term use of this combination no longer recommended? It was found that unopposed estrogen stimulation does not actually increase the risk of endometrial cancer. The combination was found to increase the incidence of endometrial cancer. Estrogen-progestin combinations were found to cause serious adverse effects. None of the above

Estrogen-progestin combinations were found to cause serious adverse effects.

The most common cause of subclinical hyperthyroidism is: Untreated osteoporosis. Excess thyroid hormone therapy. Taking central nervous system depressants. Previous neck radiation.

Excess thyroid hormone therapy.

A patient is being treated for syndrome of inappropriate antidiuretic hormone (SIADH). What is the cause of SIADH? Excessive secretion of ADH Excessive secretion of androgens Insufficient secretion of ADH Insufficient secretion of antidepressants

Excessive secretion of ADH Syndrome of inappropriate antidiuretic hormone (SIADH), occurs with excessive secretion of ADH.

A patient presenting with an androgen deficiency state is prescribed an oral anabolic steroid. A higher dose of steroid is indicated due to its: High excretion rate in feces. Being metabolized more slowly by the kidneys. Antagonistic effects on male sex hormones. Extensive metabolism in the first pass through liver.

Extensive metabolism in the first pass through liver.

A nurse is caring for a patient with depression. Which symptom should the nurse closely monitor for in the patient? Dilated pupils Extreme sadness Drowsiness Severe headache

Extreme sadness

A client with schizophrenia will exhibit fluctuations in mood swings from depression to mania. True False

False

Androgens are used as replacement therapy for hypergonadism. True False

False

No cancer cells have been identified that can remain dormant for more than 2 years. False True

False

Testosterone is injected directly into the corpus spongiosum. True False

False

The development of diabetes mellitus is associated with the use of typical antipsychotics. False True

False

Gold compounds are commonly used as first-line therapy for the treatment of rheumatoid arthritis. True False

False Gold compounds are used for a client with rheumatoid arthritis who does not respond to the usual anti-inflammatory agents and in whom the conditions worsen despite weeks or months of standard pharmacologic treatment.

A nurse is writing a plan of care for a patient who is taking bethanechol (Urecholine). What would be an appropriate outcome for this patient? Improved bladder function Pupillary dilation Decreased secretions Increased blood pressure

Improved bladder function

The nurse is caring for a 7-year-old hospitalized client who is taking several different medications. The nurse educates the family about all of the medications being administered. What is the importance of this education for the family? Families should be aware of all the medications given so that they can check their bill when the child is discharged. Families should be aware of medications that the child is taking so that they can administer them if the nurse is busy. Families become active partners with the rest of the health care team in preventing medication errors. Families need to understand the importance of the different classifications and actions of the drugs administered.

Families become active partners with the rest of the health care team in preventing medication errors.

A patient has been started on dantrolene (Dantrium). What is the most serious adverse effect on which the patient should be instructed? Fatal hepatitis Metabolic acidosis Hypercarbia Renal calculi

Fatal hepatitis

A client is to receive etanercept. What characteristic of the client may contraindicate the use of this medication? Employment involving heavy machinery Occasional dysphagia Lack of social support Fear of injections

Fear of injections

The nurse is caring for a patient scheduled for abdominal surgery in the morning. The patient confides watching a movie last week about someone who has surgery and the anesthetic didn't work, but no one knew because the patient couldn't move. What would be an important nursing diagnosis for the nurse to include for this patient? Risk for skin impairment Fear related to paralysis Alteration in fluid volume Deficient knowledge regarding drug therapy

Fear related to paralysis

A student asks the pharmacology instructor what effect the administration of androgens can have on a fetus if administered during pregnancy. What should the instructor respond? Female child may have masculinized features Sex of child will be female Increased growth of fetus Sex of child will be male

Female child may have masculinized features

The pharmacology instructor is discussing the differences between monotherapy and therapy that includes AEDs. What would the instructor cite as an advantage of monotherapy? Lower patient compliance Less cost effective More effective than combination therapy Fewer drug-drug interactions

Fewer drug-drug interactions

The nurse should monitor a client closely for increased CNS depression when diphenoxylate (Lomotil) is given to a client taking which of the following medications? Select all that apply: Glyburide (Diabeta) Sucralfate (Carafate) Temazepam (Restoril) Fexofenadine (Allegra) Zolpidem (Ambien)

Fexofenadine (Allegra) Zolpidem (Ambien) Temazepam (Restoril)

While maternal medication ingestion can affect the fetus at any point during pregnancy, at what time is drug-induced teratogenicity most likely to occur? Third trimester Second trimester First trimester No specific trimester is more likely

First trimester

Which is an example of an androgen that can be used to treat hypogonadism? Nandrolone Oxymetholone Dutasteride Fluoxymesterone

Fluoxymesterone

A patient has been administered atropine for sinus bradycardia. Which symptom is noted with large doses of atropine? Edema Pallor Incontinence Flushing

Flushing

During the hot summer months, the nurse should pay particular attention to which of the following signs that indicate heat prostration in clients receiving cholinergic-blocking drugs? Select all that apply: Flushing Mental confusion Bradycardia Chills Cool, moist skin

Flushing Mental confusion

Which action by the nurse follows safety protocols when administering doxorubicin (Doxil)? Monitors for digoxin toxicity if given along with doxorubicin Administers doxorubicin, then flushes the line with heparin Uses a Y-site adaptor to infuse doxorubicin and furosemide together Frequently checks IV site for patency during doxorubicin infusion

Frequently checks IV site for patency during doxorubicin infusion

The primary care provider of a patient with a long history of neuropathic pain is considering the addition of gabapentin (Neurontin) to the patient's extensive drug regimen. How will the addition of gabapentin likely influence the other medications that the patient currently receives? The patient will require a 10-day "drug holiday" before taking gabapentin. The patient will need to take gabapentin one hour before or two hours after meals. Gabapentin will not likely interact with any of the patient's other drugs. The patient will need to add calcium supplements to his drug regimen.

Gabapentin will not likely interact with any of the patient's other drugs.

The patient is scheduled for surgery in two hours. The physician orders preoperative administration of glycopyrrolate and meperidine. These drugs might be contraindicated for the patient if the patient had what disorder? Diabetes mellitus Asthma Diverticulitis Glaucoma

Glaucoma

The nurse is caring for a 7-month-old infant who has been brought to the clinic by his mother. The mother reports that the baby has not had a bowel movement in 4 days. The nurse will recommend: Cascara (Generic) Polyethylene glycoelectrolyte solution (GoLytely) Magnesium hydroxide (Milk of Magnesia) Glycerin (Sani-Supp)

Glycerin (Sani-Supp) Glycerin suppositories are the best choice for infants and young children if constipation is a problem. The other choices are not recommended for infants or children.

An infant is brought to the pediatric clinic. The mother tells the nurse the child is constipated and she doesn't know what to do. What would the nurse tell the mother is the safest and most effective way to treat constipation in children prior to bowel training? Sorbitol Glycerin suppositories Dulcolax suppositories Milk of magnesia

Glycerin suppositories

Which drugs are classified as cholinergic blocking drugs and are used to decrease respiratory secretions prior to surgery? (Select all that apply.) Fentanyl (Sublimaze) Glycopyrrolate (Robinul) Atropine Hydroxyzine (Vistaril) Lorazepam (Ativan)

Glycopyrrolate (Robinul) Atropine

What drugs used to treat rheumatoid arthritis are contraindicated in a patient who has a history of toxic levels of heavy metals? Gold salts Propionic Acids Fenamates Cox 2 inhibitors

Gold salts

What drugs used to treat rheumatoid arthritis are contraindicated in a patient who has a history of toxic levels of heavy metals? Propionic Acids Gold salts Fenamates Cox 2 inhibitors

Gold salts

Kate, age 34, comes to your office for preconception counseling. She is currently drinking 10 to 12 cans of diet cola each day. She verbalizes her concern about her excessive caffeine intake and the adverse effects that caffeine will have on the baby. She asks what she can do to limit her caffeine intake. What is the best recommendation for you to make? Increase the intake of grapefruit juice to reduce the adverse effects of caffeine. Limit her caffeine intake to no more than three or four caffeine-containing beverages per day. Stop the intake of all beverages containing caffeine immediately. Gradually decrease her daily intake of caffeine.

Gradually decrease her daily intake of caffeine.

A patient has received a bone marrow transplant. What will occur if the patient receives inadequate immunosuppression after the transplant? Renal failure Hepatic failure Graft-versus-host disease Serious infection

Graft-versus-host disease

Which of the following may occur if a patient is being administered a cholinergic drug with other cholinergics? Greater risk for toxicity Risk of hypertension and dyskinesia Greater risk for cardiac symptoms Increased risk of CNS depression

Greater risk for toxicity

An adolescent has begun weight training. Which hormone will be released in response to the growth of muscle cells? Adrenocorticotropic hormone Thyroid-stimulating hormone Corticotropin-releasing hormone Growth hormone

Growth hormone

When fluoxymesterone is administered to a 14-year-old male for hypogonadism, what is the expected result? Growth of sexual organs Higher voice Euphoria Decreased muscle mass

Growth of sexual organs

A 9-year-old boy is taking testosterone injections for treatment of hypogonadism. What should be measured every 6 months on this child? Hand and wrist epiphyseal growth plates LFT Cholesterol level Vision

Hand and wrist epiphyseal growth plates

An 8-year-old boy is being administered testosterone injections for treatment of hypogonadism. What should be measured every 6 months? Electroencephalogram Electrocardiogram Visual acuity Hand and wrist epiphyseal growth plates

Hand and wrist epiphyseal growth plates

The nurse is performing an assessment on a 7-year-old child in the clinic. The nurse observes the child's teeth are darkly stained. What information should the nurse obtain from the parent? Has the child taken a corticosteroid for treatment? Has the child taken a cephalosporin for treatment? Has the child taken tetracycline for treatment? Has the child taken a sulfonamide for treatment?

Has the child taken tetracycline for treatment? Tetracycline administered to a child between the ages of 4 months and 8 years will stain the permanent teeth.

Jeff's mother tells you that she finds it difficult to give ritonavir solution to him. Jeff is an 8-year-old boy suffering from HIV infection. Your advice is to combine the drug with chocolate milk, which will mask its bitter taste. Which of the following actions is important for Jeff's mother to learn? Drink the milk with the drug before bedtime. Refrigerate the milk and the drug. Have Jeff drink the milk with the drug within 1 hour of mixing. Keep the milk with the drug at room temperature.

Have Jeff drink the milk with the drug within 1 hour of mixing.

The nurse is preparing a teaching plan for a patient who is taking rivastigmine. What precaution should the nurse teach the patient and family to minimize the risk of GI adverse effects? Having small, frequent meals Eating nutrient- and calorie-rich foods Monitoring weight throughout the therapy Establishing appropriate sleep and rest patterns

Having small, frequent meals

A home health nurse is evaluating the patient teaching that was done with a 49-year-old COPD patient who has been started on two inhalers: budesonide (Pulmicort) 2 puffs and fluticasone (Flovent) 3 puffs t.i.d. What statement by the patient would let the nurse know that the patient teaching will need clarifying? I must replace the inhalers before they run out. I should use one inhaler or the other for each dose. I must use the inhalers even when my symptoms start to subside. I should rinse my mouth after administering the doses.

I should use one inhaler or the other for each dose.

A male client is being seen in the emergency department because he has a high fever and cannot move his arm. During the history-taking process, he says he is being treated with an antipsychotic medication for schizophrenia. The nurse knows that what may be happening with this client? He may have neuroleptic malignant syndrome, which will self-resolve in a few hours after rest and Tylenol. He may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately. He may have influenza A and will need to be put into isolation. He may have broken his arm and not remember what happened because of his schizophrenia.

He may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately.

A 26-year-old man with testicular cancer is prescribed combination chemotherapy that involves using two drugs that are effective against testicular tumors. Combination drug therapy is superior to single-drug therapy because of: Higher tumor response rates Decreased duration of remissions Lower risk for secondary cancers Increased capillary permeability

Higher tumor response rates

A patient taking antihypertensive medication is beginning rituximab therapy. What should the nurse instruct the patient to do prior to starting the rituximab? Hold the antihypertensive medications for 24-48 hours after the rituximab has been administered. Take the antihypertensive medication 30 minutes before rituximab therapy and hold 12 hours after. Be sure and take the antihypertensive medication the morning prior to rituximab therapy. Hold the antihypertensive medication for 12 hours before rituximab administration and 12-24 hours after.

Hold the antihypertensive medication for 12 hours before rituximab administration and 12-24 hours after.

A woman is prescribed hormonal contraceptives. What places her at risk for the development of blood clots? Hormonal contraceptives increase blood levels of clotting factors. Hormonal contraceptives stimulate skeletal growth and RBC production. Hormonal contraceptives will cause peripheral vasoconstriction. Hormonal contraceptives increase serum triglyceride and cholesterol.

Hormonal contraceptives increase blood levels of clotting factors.

Heartburn and GERD can become more common in pregnant women for both mechanical and chemical reasons. Mechanically, the growing fetus increases abdominal pressure. What could be a chemical cause for increased heartburn and GERD? Hormones relax the upper esophageal sphincter. Hormones relax the lower esophageal sphincter. Hormones increase flatulence. Hormones increase acid production.

Hormones relax the lower esophageal sphincter.

A 37-year-old woman recently underwent a bilateral salpingo-oophorectomy. During the assessment, which of the following situations should the nurse ask about to determine the client's surgical menopausal status? Headaches Decreased appetite Weight gain Hot flashes

Hot flashes

A pregnant woman arrives in the emergency department, reporting severe vomiting. The nurse assesses that the patient has tenting skin turgor, pale, dry mucous membranes, and ketones in her urine. What complication of pregnancy does the nurse suspect in this patient? Hyperemesis gravidarum Eclampsia Preeclampsia Gestational diabetes

Hyperemesis gravidarum Hyperemesis gravidarum is commonly called pernicious vomiting of pregnancy. Dehydration, ketonuria, and vitamin deficiency can be a complication.

The use of methylergonovine (Methergine) is contraindicated in patients with which medical condition? Hypertriglyceridemia Hypertension Diabetes Asthma

Hypertension

A patient who is 26 weeks' gestation is diagnosed with pre-eclampsia by her obstetrician. What triad of symptoms leads the physician to this diagnosis? Hypertension, edema, proteinuria Altered level of consciousness, edema, glycosuria Hypertension, elevated blood glucose levels, seizure Hypotension, edema, glycosuria

Hypertension, edema, proteinuria

A client presents at the clinic reporting weight loss despite an increased appetite. For which condition should this client be assessed? Chronic thyroiditis Hyperthyroidism Hyperglycemia Hypothyroidism

Hyperthyroidism

The nurse has just completed client education relative to chronic adrenocortical insufficiency and corticosteroid medication treatment. What statement indicates the client requires further instruction? I need to minimize my exposure to anyone who may be ill. I will call my health care provider if I develop a fever. I will report any weight gain above 5 pounds in 1 week to my health care provider. I will start this medication when I am feeling ill or tired.

I will start this medication when I am feeling ill or tired.

A client is newly diagnosed with Parkinson's disease and levodopa (Dopar) has been prescribed. What health education should the nurse provide? The need for weekly laboratory blood work for the first six weeks The fact that adverse effects will subside when the body adjusts to the drug Identifying foods and supplements high in vitamin B6 Matching doses to the daily severity of symptoms

Identifying foods and supplements high in vitamin B6

A student asks the physiology instructor what causes loss of muscle function, or paralysis. What would the instructor respond? If the β-adrenergic muscle receptor cannot be activated paralysis, or loss of muscle function, occurs If ACh cannot react with the α-adrenergic receptors If ACh cannot react with the cholinergic muscle receptor to allow new stimulation muscle contraction, muscle paralysis, or loss of muscle function, occurs If the anticholinergic muscle receptor cannot be activated paralysis, or loss of muscle function, occurs

If ACh cannot react with the cholinergic muscle receptor to allow new stimulation muscle contraction, muscle paralysis, or loss of muscle function, occurs

A nurse is making a care plan for a client with Parkinson's disease and has started on an antiparkinson medication. Which nursing diagnosis would be appropriate for this client's care plan? (Select all that apply.) Altered Bowel Movements: Diarrhea Imbalanced Nutrition: Less than Body Requirements Risk for Injury Altered Bowel Movements: Constipation Imbalanced Nutrition: More than Body Requirements

Imbalanced Nutrition: Less than Body Requirements Altered Bowel Movements: Constipation Risk for Injury

A client receiving a dopaminergic agent has recently experienced nausea, vomiting, and dysphagia. Which nursing diagnosis would be most appropriate for this client? Imbalanced nutrition: less than body requirements Impaired dentition Risk for injury Impaired skin integrity

Imbalanced nutrition: less than body requirements

The nurse is providing patient education to a patient taking corticosteroids. When would the nurse advise the patient to take their medication? At 3:00 PM in the afternoon Immediately on awakening in the morning With the noon meal At bedtime

Immediately on awakening in the morning Corticosteroids should be taken immediately on awaking in the morning in order to mimic the normal diurnal pattern. The peak levels of cortisol usually come between 6:00 AM and 8:00 AM. The levels then fall off slowly and reach a low in the late evening with the lowest levels around midnight. For those patients who work night shifts, the schedule would be changed to accommodate their sleep pattern.

A nurse administers methotrexate (Rheumatrex). What assessment finding is attributable to the effect of this medication? Decreased urination Increased red blood cell count Immunosuppression Increased hemoglobin

Immunosuppression

A patient has been administered methotrexate, which is a purine antagonist used to treat a rapidly growing tumor. The patient develops stomatitis. What is the priority nursing diagnosis for a patient suffering from stomatitis? High risk for infection Imbalanced nutrition Impaired skin integrity Increased bleed risk

Impaired skin integrity

What would be the priority nursing diagnosis for a patient who is prescribed epoetin alfa? Altered skin integrity due to the disease process Impaired tissue oxygenation related to anemia Alteration in bowel elimination due to side effects of the medication Alteration in nutrition due to poor intake of iron

Impaired tissue oxygenation related to anemia

A nurse is caring for a patient who has just been started on an anticholinergic medication as adjunct therapy for peptic ulcers. In writing this patient's plan of care, an appropriate nursing diagnosis would be: Chronic pain related to GI, CNS, genitourinary, and cardiovascular effects Risk for hyperthermia related to increased ability to sweat Impaired urinary elimination related to bladder relaxation Increased cardiac output related to cardiovascular effects

Impaired urinary elimination related to bladder relaxation

When a nurse is doing a shift assessment on a patient, which symptom should be reported as a possible side effect from administration of methylprednisolone? Constipation Sensitivity to light Urinary retention Impaired wound healing

Impaired wound healing

The nurse is caring for a pregnant woman with a history of depression. What concern does the nurse have with untreated depression in the postpartum phase? Potential harm of the child by the mother Teratogenic effects of the newborn Impairment of the mother-infant bond Mental impairment of the child

Impairment of the mother-infant bond

A client has a history of atrial fibrillation and is taking an oral anticoagulant. The client has been newly diagnosed with hypothyroidism and placed on levothyroxine (Synthroid). What assessment should the nurse prioritize? Monitoring the client's electrolyte levels Assessing for signs and symptoms of infection Assessing the client's level of consciousness Monitoring the client for increased bruising

Monitoring the client for increased bruising The effectiveness of an oral anticoagulant is increased if it is used in combination with a thyroid hormone. This may lead to increased bleeding and the need to decrease the dosage of the oral anticoagulant. This combination of medications does not create a heightened risk for infection, changes in LOC or electrolyte imbalances.

A client, newly diagnosed with a seizure disorder, has been prescribed valproic acid. When assessing for adverse effects, what assessment should the nurse prioritize? Assessing the client's apical heart rate and rhythm Assessing the client for signs of esophageal varices Performing musculoskeletal assessment Monitoring the client's liver enzyme levels

Monitoring the client's liver enzyme levels

Which of the following drugs must the nurse question when it is given with an anti-diarrheal medication, because it can lead to a hypertensive crisis? Antihistamines for allergy An antiflatulent medication Mineral oil laxative Monoamine oxidase inhibitor (MAOI) antidepressants

Monoamine oxidase inhibitor (MAOI) antidepressants Monoamine oxidase inhibitors (MAOIs) used for depression management place a client at increased risk of having a hypertensive crisis. A laxative, while opposite in action to an antidiarrheal, does not cause a hypertensive crisis. An antiflatulent medication that may be ordered with an antidiarrheal also does not cause a hypertensive crisis. Antihistamines may enhance central nervous system depression but do not cause a hypertensive crisis.

A primiparous woman was vigilant in avoiding medications and herbs during her pregnancy and states that she is similarly committed to protecting her baby's health now that she is breast-feeding. What principle should guide the woman's use of medications while breast-feeding? It is generally safe to use herbs rather than medications while breast-feeding. Most women can resume their prepregnancy medication regimen after delivery. Very few medications are explicitly contraindicated while breast-feeding. Most medications are contraindicated while a woman is breast-feeding.

Most medications are contraindicated while a woman is breast-feeding.

The client is about to begin therapy for erectile dysfunction and asks the nurse about the likelihood of priapism occurring with these medications. The nurse knows that priapism is most likely to occur in clients with which condition? Select all that apply. Testicular torsion Multiple myeloma Iron deficiency anemia Raynaud's disease Leukemia

Multiple myeloma Leukemia Priapism is more likely to occur in clients with sickle cell anemia (no iron deficiency), multiple myeloma, leukemia, or an anatomic deformity of the penis. A history of testicular torsion or Raynaud's disease does not increase the chance that the client will develop priapism.

The nurse is caring for a patient who had renal transplantation. What drug will the nurse administer to prevent allograft rejection in this patient? Muromonab-CD3 (Orthoclone OKT3) Basiliximab (Simulect) Denosumab (Xgeva) Daclizumab (Zenapax)

Muromonab-CD3 (Orthoclone OKT3)

Oxybutynin (Ditropan) used for the treatment of over active bladder exerts it effect by inhibiting the action of which receptors? Alpha-adrenergic receptors Nicotinic receptors Muscarinic receptors Beta-adrenergic receptors

Muscarinic receptors

The nurse is caring for a client who has anticholinesterase drugs prescribed. When administering anticholinesterase drugs, the nurse should assess the client for which toxic effect? Hypertension Abdominal distension Paralytic ileus Muscle weakness

Muscle weakness

The nurse should monitor a client closely for which of the following symptoms after an abrupt reduction in levodopa dose as neuroleptic malignant-like syndrome may occur? Select all that apply: Fever Urinary incontinence Muscular rigidity Mental status changes Hypotension

Muscular rigidity Fever Mental status changes

A patient has been diagnosed with narrow-angle glaucoma. What ocular effect will be produced if the patient is prescribed an adrenergic agent? Mydriasis Hypertension Hypothyroidism Decreased heart rate

Mydriasis

John is a 45-year-old man who is obese. He is coming to see the physician today about diet and medications to help him lose weight. He wants to be prescribed dextroamphetamine. Based on John's history, what would contraindicate the use of this medication? Use of CPAP at night for sleep apnea Blood pressure of 118/72 Shortness of breath with moderate activity Myocardial infarction 2 months previously

Myocardial infarction 2 months previously

The nurse is teaching a client about loperamide, which the physician has prescribed for treatment of chronic diarrhea. Which adverse effects should the nurse be sure to mention? Nausea Flatulence Disorientation Tremors

Nausea

An elderly client calls the physician's office and tells the nurse that prescriptions for three medications have run out and the pharmacy will not refill them this close together. A home health referral is made and the client is found to be taking the medication more often than prescribed. What is a priority nursing diagnosis for this client? Noncompliance with the therapeutic medication regimen Altered mental status Depression related to the therapeutic medication regimen Nonadherence to therapeutic medication regimen

Nonadherence to therapeutic medication regimen

Which is an example of a progestin? Raloxifene (Evista) Estradiol (Estrace) Norethindrone (Aygestin) Bicalutamide (Casodex)

Norethindrone (Aygestin)

The oncology nurse is preparing to reconstitute gemcitabine (Gemzar). With what solution should the nurse prepare the medication? Bacteriostatic water Normal saline Dextrose and water Lactated Ringers

Normal saline

The preoperative nurse is caring for a patient who is to receive local anesthesia. While taking the admission history, the nurse notes that the patient is allergic to lidocaine. What should the nurse do? Notify the surgeon. Tell the perioperative nurse. Cancel the surgery. Notify the anesthesiologist.

Notify the anesthesiologist.

A nurse is caring for a patient prescribed phenobarbital for status epilepticus. What intervention should the nurse perform when the patient has been administered the drug? Monitor blood glucose levels. Monitor body temperature. Observe respirations frequently. Record fluid input and output.

Observe respirations frequently.

A patient is prescribed dicyclomine. The nurse would expect to administer this drug by which route? Subcutaneous Intravenous Intramuscular Oral

Oral

A patient is receiving conjugated estrogens. The nurse would anticipate administering this drug by which route? Intravenous Intravaginal Oral Subcutaneous

Oral

Kalie, age 18, is prescribed progesterone for the treatment of primary amenorrhea. Which adverse effect would need to be reported immediately to the physician? Abnormal menstrual bleeding Weight gain Breast tenderness Pain in one leg

Pain in one leg (thrombus formation)

A patient with a pancreatic tumor will be starting on chemotherapy to decrease the size of the tumor, give the patient a better quality of life, and reduce the discomfort. What is this form of therapy called? Adjuvant therapy Consolidation therapy Palliative therapy Neoadjuvant therapy

Palliative therapy

A client is receiving a cholinergic medication for urinary retention. What assessment should the nurse perform prior to administering the medication? Assess the client's grip strength. Obtain the client's blood pressure. Palpate the upper abdomen for ascites. Palpate the pelvic region to assess fullness of bladder.

Palpate the pelvic region to assess fullness of bladder.

The nursing instructor is discussing cholinergic drugs. According to the instructor, what system is acted upon by this family of drugs? Genitourinary system Parasympathetic nervous system Cardiovascular system Sympathetic nervous system

Parasympathetic nervous system

The nursing instructor is discussing cholinergic drugs. According to the instructor, what system is acted upon by this family of drugs? Sympathetic nervous system Cardiovascular system Parasympathetic nervous system Genitourinary system

Parasympathetic nervous system

A 60-year-old male patient has developed a tremor of the right hand with a pill rolling motion. Upon interviewing the patient, he states he sustained several head injuries playing football. Based on this information, what do you suspect the patient is suffering from? Degenerative joint disease Parkinson's disease Seizure disorder Amyotrophic lateral sclerosis

Parkinson's disease

A patient with Alzheimer's disease is being treated with Exelon. The nurse knows that this drug is also used to treat which disorder? hepatic disease asthma seizures Parkinson's disease

Parkinson's disease

Your patient has been prescribed antiadrenergic medications for a condition. Understanding the pharmacology of antiadrenergics, what mainly determines the specific effects of the medication? Sympathetic nerve stimulation Drug binding with any adrenergic receptor Successfully stimulating pathology Patient's health status when drug is administered

Patient's health status when drug is administered

The nurse is caring for a patient taking tamoxifen (Nolvadex) for treatment of breast cancer. What instruction will help the patient control hot flashes? Select all that apply. Avoid caffeinated products. Use lubricant during intercourse. Eat a low-sodium diet. Wear absorbent cotton clothing. Perform regular aerobic exercise.

Perform regular aerobic exercise. Avoid caffeinated products. Wear absorbent cotton clothing.

A patient with attention deficit hyperactivity disorder (ADHD) has not had an adequate response to behavioral therapy. All the following medications would be acceptable for this patient, EXCEPT: Amphetamine (Adderall) Atomoxetine (Strattera) Methylphenidate (Ritalin) Phentermine (Ionamin)

Phentermine (Ionamin)

Which agent would the nurse expect to find when reviewing over-the-counter allergy products? Phenylephrine Dopamine Midodrine Clonidine

Phenylephrine

Laura, 25 years old, is treated for eclampsia with magnesium sulfate. Which antiepileptic drug would work as an alternative to magnesium sulfate? Digoxin Phenytoin Lorazepam Diazepam

Phenytoin

The nurse is caring for a client receiving ethotoin to control seizure activity. When reviewing the client's laboratory results, the nurse learns that the client's serum ethotoin level is 67 mcg/mL. What is the nurse's best action? Report this finding to the provider and monitor closely for seizure activity Administer naloxone (Narcan) as prescribed Report this to the provider and monitor for signs of toxicity Document the fact that the client's ethotoin levels are therapeutic

Report this to the provider and monitor for signs of toxicity

The nurse is caring for a patient with chronic kidney disease who is receiving epoetin alfa. Which assessment finding would be of greatest concern for the nurse? Reports of calf pain on dorsiflexion of the foot 1 pound weight gain in 1 week A rash under the breast Dry, nonproductive cough

Reports of calf pain on dorsiflexion of the foot The nurse should determine whether the patient has pre-existing vascular disease, because it may increase the patient's risk for developing thrombotic adverse effects

The nurse is giving discharge instructions to a patient who just had botox A instructions around their eyes. What adverse effects would the nurse include in the discharge instructions? (Mark all that apply.) Cough Droopy eyelids Diarrhea Respiratory infections Flu-like syndrome

Respiratory infections Flu-like syndrome Droopy eyelids

Mental dysfunction in an elderly person may seem like a normal part of aging, but it can result from disease or another cause. What should the ER staff do first for a presenting elderly person with a mental dysfunction such as extreme confusion? Check serum electrolyte levels. Order an ECG. Review the drugs being taken. Administer a stimulant.

Review the drugs being taken.

Marge, a 38-year-old woman, is seen in the physician's office for the first time. She complains of fatigue, decreased range of motion in her hands, pain with activities that require her to use her hands, loss of strength in her hands and arms, and a low-grade fever. What is the most likely diagnosis that would explain Marge's symptoms? Inflammatory osteoarthritis Rheumatoid arthritis Multiple sclerosis Gouty arthritis

Rheumatoid arthritis

Marge, a 38-year-old woman, is seen in the physician's office for the first time. She complains of fatigue, decreased range of motion in her hands, pain with activities that require her to use her hands, loss of strength in her hands and arms, and a low-grade fever. What is the most likely diagnosis that would explain Marge's symptoms? Rheumatoid arthritis Multiple sclerosis Inflammatory osteoarthritis Gouty arthritis

Rheumatoid arthritis

Which diffuse connective tissue disease is the result of an autoimmune reaction that results in phagocytosis, producing enzymes within the joint that break down collagen and cause edema? Rheumatoid arthritis (RA) Systemic lupus erythematosus Osteoporosis Polymyositis

Rheumatoid arthritis (RA)

A patient has been diagnosed with rheumatoid arthritis. The patient shows the nurse small nodules on both elbows and hands. What does the nurse understand that these nodules are? Rheumatoid nodules Calcification nodules Tophi Lipomas

Rheumatoid nodules

The physician prescribed riluzole to Mr. Tom, a 63-year-old man who was diagnosed with amyotrophic lateral sclerosis one month ago. You are teaching him the importance of taking the medication as prescribed. What is the main reason the physician prescribed this medication? Riluzole is given to increase respiratory function in the patient. Riluzole reverses the progression of the disease. Riluzole is given to slow the progression of the disease. Riluzole is the only drug shown to provide a cure for the disease.

Riluzole is given to slow the progression of the disease.

The oncology nurse is preparing a chemotherapy agent and not wearing goggles. Some medication splashes in the eyes. What is the priority action for the eye exposure? Have a co-worker take the nurse to the emergency department. Place drops in the eyes for the discomfort and then irrigate with water. Cover the eyes with sterile gauze. Rinse with copious amounts of water for no fewer than 15 minutes.

Rinse with copious amounts of water for no fewer than 15 minutes.

A male patient who experienced a lower back injury while doing yard work has seen his range of motion decrease and his pain increase over the past several weeks. As a result, he has been prescribed cyclobenzaprine. What nursing diagnosis should the nurse prioritize in light of the patient's drug regimen? Risk for Injury related to CNS depression Risk for Sexual Dysfunction related to endocrine changes Risk for Ineffective Airway Clearance related to increased secretions and decreased lung function Risk for Impaired Swallowing related to adverse neuromuscular effects

Risk for Injury related to CNS depression

A nursing student is preparing a care plan and is choosing a nursing diagnosis for her client with Alzheimer's disease. The client is taking Exelon. Which would be an appropriate nursing diagnosis for this client? Imbalanced Nutrition: More Than Body Requirements Risk for Injury related to being confined to the Alzheimer's unit Learning Impairment related to decreased hearing Risk for Injury related to dizziness and fatigue

Risk for Injury related to dizziness and fatigue

An elderly patient has received a neuromuscular junction blocker during surgery. What would be an appropriate nursing diagnosis for this patient? Risk for impaired skin integrity Deficient fluid volume Excess fluid volume Chronic confusion

Risk for impaired skin integrity

A nurse is writing a plan of care for a patient who is receiving a glucocorticoid. What would be an appropriate nursing diagnosis for this patient? Increased cardiac output related to fluid retention Imbalanced nutrition: Less than body requirements Risk for infection related to immunosuppression Deficient fluid volume related to water retention

Risk for infection related to immunosuppression Risk for infection related to immunosuppression would be the appropriate nursing diagnosis because steroids suppress the immune system. Decreased cardiac output and excess fluid volume would also be appropriate nursing diagnoses for this patient. Imbalance nutrition: More than body requirements might be appropriate since usually patients taking steroids gain weight.

The nursing instructor is discussing short-term versus long-term corticoid steroid therapy with the nursing students. What would be the most appropriate teaching for a patient on long-term corticosteroid therapy? Give with meals Long-term therapy is anything 10 days or longer Taper doses when discontinuing drug Short-term therapy is 1 week or less

Taper doses when discontinuing drug Taper doses when discontinuing from high doses or from long-term therapy to give the adrenal glands a chance to recover and produce adrenocorticoids. All answers are correct, but most important to teach the patient is tapering the drug.

The nurse is caring for a patient who is being discharged home from the rehab unit. The patient is being switched from baclofen to soma for use as an outpatient. What should the nurse instruct the patient about discontinuing baclofen to prevent the development of psychoses and hallucinations? Taper drug over 72 hours. Start the soma right away and you won't experience side effects. Alternate doses of baclofen and soma over 10 days. Taper drug slowly over 1 to 2 weeks.

Taper drug slowly over 1 to 2 weeks.

A client with a history of partial seizures has been taking lamotrigine (Lamictal) for the past several days. The client calls the clinic and reports the development of a facial and torso rash to the nurse. What is the nurse's best action? Tell the client to take the medication with a high-fat food to minimize adverse effects Recommend that the client take 50 mg diphenhydramine PO and check back tomorrow Rule out any shortness of breath and inform the client that this adverse effect will resolve with time Tell the client to take no further doses and come be assessed at the clinic immediately

Tell the client to take no further doses and come be assessed at the clinic immediately

Hormones from various organs regulate the menstrual cycle. Which of the following hormones does not directly influence the cycle? Gonadotropin-releasing hormone Testosterone Follicle-stimulating hormone Luteinizing hormone

Testosterone

Which would the nurse expect to administer as a depot injection? Danazol Testosterone Methyltestosterone Fluoxymesterone

Testosterone Testosterone is administered IM, transdermally, and in long-acting depository (depot injection) forms. Danazol is administered orally only. Methyltestosterone is administered orally. Fluoxymesterone is administered orally.

An older male patient will begin taking an androgen. The patient has difficulty swallowing tablets and pills. Because of the available drug route, a good choice for this patient would be: Danazol (Danocrine) Fluoxymesterone (Halotestin) Testosterone (Testoderm) Testolactone (Teslac)

Testosterone (Testoderm)

A nurse is caring for patients receiving androgen therapy. For which of the following conditions may androgen therapy be given as replacement therapy? Select all that apply. Delayed puberty Male pattern baldness Testosterone deficiency Benign prostatic hypertrophy Failure of development of the testes

Testosterone deficiency Delayed puberty Failure of development of the testes

The nurse is reviewing a client's medication list. This client just recently delivered her first child but has a few chronic problems. The nurse recognizes which of the following drugs are not recommended to be used during lactation? Select all that apply. Lithium Acetaminophen Tetracycline Corticosteroids Loratadine Labetalol

Tetracycline Loratadine Lithium

The cell cycle consists of 5 phases. Each cell goes through these phases. How would cell phase G1 be defined? Protein synthesis occurs. The cell increases in size and synthesis of RNA. The resting phase of the cell Mitosis occurs.

The cell increases in size and synthesis of RNA.

A client asks the nurse why he has to have several courses of a chemotherapy drug instead of just one dose. The nurse states that it is based on the cell kill theory. Which of the following statements describes the cell kill theory? The cell kill theory is based on the premise that one dose of a chemotherapy drug will kill all the cancer cells if enough of the medication is given to a client. The cell kill theory describes the ways that different chemotherapy medications work to kill both healthy and cancerous cells within the human body. The cell kill theory describes the phenomenon that occurs during the life cycle of a cancer cell as it is treated with a chemotherapy medication. The cell kill theory describes the process of giving multiple doses of chemotherapy with each dose, killing approximately 90% of the cancer cells. After several rounds of chemotherapy, nearly all of the cancer cells are killed and the body's immune system will kill the few cancer cells that are left.

The cell kill theory describes the process of giving multiple doses of chemotherapy with each dose, killing approximately 90% of the cancer cells. After several rounds of chemotherapy, nearly all of the cancer cells are killed and the body's immune system will kill the few cancer cells that are left.

The nurse is planning the care of a 10-year-old child with asthma who will be placed on long-term corticosteroids. What desired outcome would be indicated for this child? The child will not require hospitalization for complications from drug therapy. The child will not have an allergic reaction to the drug therapy. The child will achieve normal growth and development during drug therapy. The child will have a hemoglobin and hematocrit within normal range.

The child will achieve normal growth and development during drug therapy.

A patient has Parkinson's disease. Apomorphine (Apokyn), a dopamine agonist, has been prescribed for periods of hypomobility. What should be discussed with the patient regarding administration of the drug? The drug will be administered subcutaneously 3 times a day with a dosage range of 1-6 mg. The drug will be injected intramuscularly 3 times a day in a range of 1.0-1.5 mL. The drug will be given intravenously, 50 mg every third day. The drug is taken orally, 20 mg 3 times a day.

The drug will be administered subcutaneously 3 times a day with a dosage range of 1-6 mg.

An immigrant and his wife are both HIV positive. The physician prescribes antiretroviral medications. However, the client, tell the nurse he is concerned about his ability to afford the treatment. What advice can the nurse provide to the client to help begin the treatment? It is not the responsibility of the nurse to advise clients on the financial aspect of a treatment The client should consider a second opinion from another medical expert The client can approach social agencies and pharmaceutical companies that provide antiretroviral drugs on compassionate grounds The client can choose an alternative, less expensive medication and later shift to taking antiretroviral medications

The client can approach social agencies and pharmaceutical companies that provide antiretroviral drugs on compassionate grounds

A client is prescribed topiramate. The nurse cautions the client to avoid the intake of alcohol for which reason? A disulfiram-like reaction can occur. The client is at risk for increased CNS depression. The client's risk for dependence is increased. The combination may lead to a hypertensive crisis.

The client is at risk for increased CNS depression.

A client in the locked psychiatric unit continually tells the nurse he is the king of England, even though the staff has corrected him that he is not the king of England. How could the nurse best describe this in the client's chart? The client likes to talk and be funny. The client is delusional. The client is having hallucinations. The client is showing extrapyramidal symptoms.

The client is delusional.

A 79-year-old male client is brought to the emergency department by his family because he is "talking to people who aren't there." During the initial admission assessment, his daughter mentions that her mother died 4 months ago and "Dad just hasn't been the same. The doctor has even put him on antidepressant medication. I go by the house every day to make sure he takes his medication." What would the nurse suspect is happening to this client? The client probably has a urinary tract infection , caused by changes in pH from his antidepressant The client is having hallucinations as an adverse effect of antidepressant therapy The mental status change is due to the patient's age a paradoxical medication effect The client is having delusions because of his depression over the loss of his wife.

The client is having hallucinations as an adverse effect of antidepressant therapy

A client has a new diagnosis of a seizure disorder. What aspect of this client's health status would contraindicate the use of carbamazepine (Tegretol)? The client has type 2 diabetes, controlled through diet The client's most recent blood work reveal pancytopenia The client has an allergy to sulfonamides The client is 17 years old

The client's most recent blood work reveal pancytopenia

The nurse is preparing to administer a client's scheduled dose of Sinemet. What is the nurse's rationale for administering levodopa with carbidopa? Carbidopa makes the blood-brain barrier temporarily permeable. The combination allows a lower dose of levodopa than if levodopa were administered alone. Carbidopa potentiates the action of levodopa to prevent nerve cell degeneration. Carbidopa prevents excessive amounts of levodopa from being excreted by the kidneys and in feces

The combination allows a lower dose of levodopa than if levodopa were administered alone.

Prior to initiating drug therapy for a pregnant or breastfeeding patient, what should the nurse include in the assessment of the patient? The cultural beliefs of the patient How the patient feels about her physician The relationship between the patient and the father of the child If the patient has a substance abuse problem

The cultural beliefs of the patient

What factors are important for the fetus during pregnancy when the mother must take medication? (Select all that apply.) The classification of the drug administered The dose and duration of drug therapy If the fetus has any congenital defects When during pregnancy the drug is taken The type of adverse effects that may appear

The dose and duration of drug therapy The type of adverse effects that may appear When during pregnancy the drug is taken

While caring for Mr. Egelton, the nurse develops a teaching plan regarding proper administration and storage of interferon alfa-2a, which instruction is important to include? The drug should be administered in the same site daily. The reconstituted drug can be stored at room temperature. It is not necessary to report any change in temperature to the provider; this is an expected adverse reaction. The drug is good for only 30 days once reconstituted.

The drug is good for only 30 days once reconstituted.

A patient has been prescribed sildenafil citrate. What should the nurse teach the patient about this medication? A dose of more than 80 mg will result in a change of vision, making everything appear blue. Facial flushing or headache should be reported to the physician immediately. The drug should be taken 1 hour prior to intercourse. Sexual stimulation is not needed to obtain an erection.

The drug should be taken 1 hour prior to intercourse.

A 5-week-old infant is being administered a drug that affects the central nervous system. What characteristic of the infant's blood-brain barrier must be considered? The blood-brain barrier does not develop until 6 to 8 weeks of age. The blood-brain barrier will block the passage of drugs from the blood to the CNS. The blood-brain barrier does not develop until 4 months of age. The drug will affect the infant's CNS more readily than in an older child.

The drug will affect the infant's CNS more readily than in an older child.

When administering an oral medication to an infant whose primary diet is formula, why is it important for the nurse to be concerned about food and drug interactions? The formula decreases the acidity and decreases gastric pH and will affect drug absorption. The formula increases the acidity and decreases gastric pH and will affect drug absorption. The formula increases the acidity and increases gastric pH and will affect drug absorption. The formula decreases the acidity and increases gastric pH and will affect drug absorption.

The formula decreases the acidity and increases gastric pH and will affect drug absorption.

A woman of childbearing age is diagnosed with breast cancer. She is currently taking hormonal contraceptives. What information should the woman be given regarding the hormonal contraceptives? The hormonal contraceptives will impair uterine bleeding. The hormonal contraceptives will inhibit tumor growth. The hormonal contraceptives will stimulate tumor growth. The hormonal contraceptives will stimulate uterine bleeding.

The hormonal contraceptives will stimulate tumor growth.

An 8-month-old infant who is being treated for respiratory syncytial virus does not process her prescribed antiviral in the same way as an adult. Which of the following statements regarding infant pharmacokinetics is most accurate? The blood-brain barrier is impermeable to drugs until 6 months of age. Infants have a lower percentage of body water than older children and adults. The immature liver of infants makes drug metabolism less effcient. Decreased skin permeability makes topical medications less effective in young children.

The immature liver of infants makes drug metabolism less effcient.

An infant with recent seizures is being treated in the neonatal intensive care unit with phenytoin (Dilantin). The infant's low plasma protein levels during the first year of life have what consequence? The infant will have an increased rate of drug metabolism. The infant may have an increased risk of toxicity. The infant may experience impaired elimination of the drug. The infant may have an unpredictable drug response.

The infant may have an increased risk of toxicity.

A neonate has been prescribed a water-soluble drug for the treatment of an acute infection. The nurse recognizes that the percentage of body water in an infant is significantly higher than that of an adult. What implication does this have for pharmacotherapy of an infant? The drug will need to be emulsified before administration. The infant's fluid intake will be reduced before and after administration. The infant will have a fat-soluble drug substituted. The infant may require an increased dose of the drug.

The infant may require an increased dose of the drug.

A 76-year-old client with congestive heart failure is being admitted to the hospital. The client states only taking medications that the physician prescribes, but when the nurse assesses the medications, three over-the-counter laxatives are in the client's bag of medications. What concerns does the nurse have about this omission? The client is nonadherent and is taking too many prescription medications. The laxatives can interact with and complicate prescribed drug therapy. The nurse feels as though the client is not being truthful. The client is noncompliant with the therapeutic drug regimen.

The laxatives can interact with and complicate prescribed drug therapy.

A female client has been diagnosed with depression. She also has a history of alcoholism. She has been sober now for 4 months, but at her last physical examination, the physician noted right-upper-quadrant tenderness and elevated liver enzyme levels. The physician has prescribed sertraline to treat Ms. Tooka's depression. Which factor would need to be considered prior to administering this medication to her? The patient should have monthly evaluation of liver function to monitor the disease progression. The patient should not take any medications because of her liver dysfunction. She should have an ultrasound of the liver to check for disease. The medication should be started at a lower dose due to liver dysfunction, and the patient should be monitored for side effects.

The medication should be started at a lower dose due to liver dysfunction, and the patient should be monitored for side effects.

The oncology nurse is discussing when the patient should administer oral doses of cyclophosphamide at home. What time is the patient instructed to take the medication? As long as the patient takes the medication by 9 AM, there will be a decrease in side effects. The medication should be taken before 4 or 5 PM daily. The patient should take the medication at 11 PM. The patient should take the medication by midnight.

The medication should be taken before 4 or 5 PM daily.

A patient has been started on methocarbamol (Robaxin). Which of the following is the most important patient teaching intervention on which the nurse should instruct the patient? The medication will cause constipation. The medication will increase coordination. The medication will turn urine green. The medication will cause hypertension.

The medication will turn urine green.

The nurse is caring for a client with bipolar disorder whose medication regimen includes lithium and who will soon be discharged. What health education should the nurse prioritize? The need to avoid high-potassium foods and salt substitutes Strategies for managing anticholinergic effects The need to avoid driving or operating machinery during therapy The need to have follow-up blood samples drawn on schedule

The need to have follow-up blood samples drawn on schedule

A 30-year-old woman has been diagnosed with leukemia and will be using an immune modulator for treatment. What will be important to discuss with the patient when the nurse provides patient teaching about her treatment? The importance of taking an aspirin daily to decrease the adverse effects of the drug The need to avoid sexual intercourse while taking the drug The need to continue oral contraceptives The need to use barrier contraceptives while taking the drug

The need to use barrier contraceptives while taking the drug

The pharmacology instructor is explaining interleukins to the class. What would be the best definition of interleukins? They are chemicals used to communicate between leukocytes and are produced by T cells. They attach to specific receptor sites and respond to very specific situations. They are substances naturally produced and released by human cells that have been invaded by viruses. They block the inflammatory reaction and decrease initial damage to cells.

They are chemicals used to communicate between leukocytes and are produced by T cells.

While studying for a pharmacology test, a student asks peers about interferons. What statement about interferons is true? They stimulate B lymphocyte activity. They stimulate growth and differentiation of lymphoid cells into lymphocytes. They interfere with multiplication of stem cells. They interfere with the ability of viruses in infected cells to replicate.

They interfere with the ability of viruses in infected cells to replicate.

Administration of atropine in doses less than 0.5 mg should be avoided, because: This dosage causes rebound hypertension. This dosage may result in a paradoxical bradycardia. This dosage may result in a paradoxical abdominal pain. This dosage may result in a dysrhythmia.

This dosage may result in a paradoxical bradycardia.

The nurse is gathering a client's medication and cannot find the bottle for the methylphenidate, Daytrana. What is the best reason for this? This is a transdermal patch medication, so there is no pill bottle. This is an IM medication, so there is no pill bottle. This is an IV medication, so there is no pill bottle. Nurses often misplace medication bottles.

This is a transdermal patch medication, so there is no pill bottle.

The nurse administered neostigmine to a patient with myasthenia gravis. The nurse is doubling the dose that the patient was taking at home. Three hours later, the nurse is assessing the patient and notes the following symptoms: nausea with vomiting, diarrhea, and sweating. What does the nurse interpret these symptoms to be? An idiosyncratic allergic reaction that should be reported to MedWatch The patient is having a myasthenic crisis and should be transferred to the intensive care unit. This is cholinergic crisis, and the physician needs to be notified immediately. An adverse effect of the medication that should be reported to the physician when the nurse rounds in the morning

This is cholinergic crisis, and the physician needs to be notified immediately.

A nurse starts an intravenous (IV) line on a patient. Not using the safety, the nurse punctures the finger on her left hand with the bloody needle. What is the nurse's risk of becoming infected with HIV? This nurse has a decreased risk of seroconversion. This nurse has in increased risk of seroconversion. This nurse does not have any risk of developing HIV. This nurse will develop HIV due to the exposure to a bloody needle.

This nurse has in increased risk of seroconversion.

A nurse tells a patient to take a prescribed glucocorticoid in the morning based on the understanding that: This time ensures that the patient will take the drug. The drug is absorbed better in the morning. This time mimics the normal peak diurnal concentration levels. The drug needs to suppress the hypothalamic pituitary axis.

This time mimics the normal peak diurnal concentration levels.

A nurse is caring for a patient being treated with antineoplastic drugs. The patient reports recently experiencing bloody urine. What complication might this patient be experiencing? Hodgkin's disease Thrombocytopenia Megaloblastic anemia Crystalluria

Thrombocytopenia

When caring for a patient receiving estrogen replacement therapy for postmenopausal symptoms, the nurse documents a diagnosis related to impaired tissue perfusion. Which condition is the nurse referring to in the diagnosis? Edema of the feet Thromboembolism Chloasma Gastrointestinal upset

Thromboembolism The nursing diagnosis of impaired tissue perfusion is related to thromboembolism, which is a complication of estrogen replacement therapy.

A patient has had surgery. After the surgical procedure, the patient starts to shiver and chill. What hormone will be released in response to the reaction to cold? Somatostatin Thyroid-stimulating hormone Leuteinizing hormone Corticotropin

Thyroid-stimulating hormone

Which of the following hypothalamic hormones causes the release of TSH in response to stress, such as exposure to cold? Gonadotropin-releasing hormone (GnRH) Growth hormone-releasing hormone (GHRH) Prolactin-inhibitory factor (PIF) Thyrotropin-releasing hormone (TRH)

Thyrotropin-releasing hormone (TRH)

Why is it important for the nurse to obtain baseline information from a client, such as a drug profile, an accurate history of the client's usual abilities, and changes in abilities or health status? To determine if the client is noncompliant with medication regimen To determine if the client is able to take the medication as prescribed To determine if the client needs another medication added to the present drug profile To determine any new signs and symptoms in the client that could be related to drug therapy

To determine any new signs and symptoms in the client that could be related to drug therapy

The labor and delivery nurse administers ergonovine to a patient after delievery of the placenta. The nurse does this: To decrease the duration of contractions To prevent postpartum hemorrhage To decrease the frequency of contractions To decrease the strength of contractions

To prevent postpartum hemorrhage

Which type of anesthesia may be applied by the nurse with a cotton swab or sprayed on the area to be desensitized? Topical anesthesia Conduction block anesthesia Local infiltration anesthesia General anesthesia

Topical anesthesia

A client requires local anesthesia to be administered. The nurse knows which methods can be used for the administration of local anesthesia? Local-infiltration anesthesia Regional anesthesia Opioid treatment Topical anesthesia General anesthesia

Topical anesthesia Regional anesthesia Local-infiltration anesthesia

Which treatment would be appropriate for a patient with breast cancer and an HER2-expressing tumor? Ofatumumab (Arzerra) Trastuzamab (Herceptin) Panitumumab (Vectibix) Abciximab (ReoPro)

Trastuzamab (Herceptin)

The nurse is describing to a child diagnosed with ADHD the different parts of her assessment. What are the common parts of an assessment for a child with ADHD prior to being prescribed medications? Select all that apply. Pulse rate Oxygen saturation BP Respiratory rate Weight

Weight BP Pulse rate Respiratory rate

Which statement reflects the treatment of HIV infection? Treatment of HIV infection for an individual client is based on the clinical condition of the client, CD4 T cell count level, and HIV RNA (viral load). Treatment should be offered to individuals with plasma HIV RNA levels less than 55,000 copies/mL (RT-PCR assay.) Treatment should be offered to only selected clients once they reach CDC category B - HIV symptomatic Treatment should be offered to all clients once they reach CDC category B - HIV symptomatic

Treatment of HIV infection for an individual client is based on the clinical condition of the client, CD4 T cell count level, and HIV RNA (viral load).

What is chrysotherapy? Treatment with gold salts Treatment with DMARDs Treatment with anti-malerials Treatment with salicylates

Treatment with gold salts

A patient has been administered chlorpromazine (Thorazine) for many years to treat his psychotic disorder. He has recently developed extrapyramidal symptoms related to long-term administration of chlorpromazine (Thorazine). Which of the following medications can be administered to assist in relieving these symptoms? Darifenacin (Enablex) Benztropine (Cogentin) Trihexyphenidyl (Trihexy) Trospium chloride (Sanctura)

Trihexyphenidyl (Trihexy)

What medication should the nurse prepare to administer to prevent Pneumocystis jirovechi for a patient taking alemtuzumab who has lymphopenia? Trimethoprim-sulfamethoxazole DS Rocephin 1 GM IV prior to injection Acyclovir Famciclovir

Trimethoprim-sulfamethoxazole DS

A client with alopecia should cover the head if the client will be exposed to extremes of temperature. False True

True

Activation of beta3-adrenergic receptors produces lipolysis and increased release of free fatty acids into the blood. True or false? True False

True

An adverse effect of tamoxifen therapy involves menopausal symptoms. False True

True

Anticholinergics block acetylcholine at the muscarinic receptors. False True

True

Dopaminergic agents can exacerbate cardiovascular disease due to dopamine receptor stimulation. True False

True

Graves' disease is the most common cause of hyperthyroidism. False True

True

Levodopa is used as treatment for Parkinson's disease primarily acting as a replacement neurotransmitter. True False

True

Most of the drugs that affect the immune system are not recommended for use in children or have not been tested in children. True False

True

Muscle spasms are thought to arise from the flood of sensory impulses coming to the spinal cord from an injured area. False True

True

Rheumatoid factor (RF) interacts with circulating IgG to form immune complexes that deposit in the joints precipitating an inflammatory reaction. True False

True

The action of immune stimulants ultimately results in the development of flu-like symptoms as adverse effects. True False

True

The adverse effects of selective serotonin reuptake inhibitors are less than other antidepressants. False True

True

Typical antipsychotics block dopamine receptors. True False

True

Thyroid hormones can be measured as protein-bound iodine. False True

True When thyroid hormone is needed in the body, the stored thyroid hormone molecule is absorbed into the thyroid cells, where the T3 and T4 are broken off and released into circulation. These hormones are carried on plasma proteins, which can be measured as protein-bound iodine levels.

The patient is being prescribed epoetin alfa for the treatment of anemia related to the renal failure. The patient also has a history of diabetes mellitus, uncontrolled hypertension, osteoarthritis, and hypothyroidism. Which of these conditions should the nurse bring to the physician's attention prior to administering the medication? Osteoarthritis Hypothyroidism Uncontrolled hypertension Diabetes mellitus

Uncontrolled hypertension

The nursing instructor is discussing HIV/AIDS with the junior nursing class. The instructor tells the students that it is important to understand how HIV-1 integrates itself into a person's immune system and how immunity plays a role in the course of HIV disease. What else is this knowledge essential for? Understanding medication therapy Understanding vaccine distribution Knowing expected results of different therapies Knowing therapy options for different patients

Understanding medication therapy

A home health nurse is visiting an older adult client with Parkinson's disease. What should the nurse assess this man for related to common adverse effects? Jaundice Increased dopamine activity Urinary retention Skin lesions

Urinary retention

A patient is taking an FDA Pregnancy Category X medication and tells the nurse she wants to get pregnant. What should the nurse inform the patient about the medication she is presently taking and its effect on a fetus? Drugs are given if the benefit justifies the risk. Use in pregnant or potentially pregnant women is contraindicated. In life-threatening situations, the benefit may be acceptable despite the risk. Controlled human studies in pregnant women fail to demonstrate a risk to the fetus.

Use in pregnant or potentially pregnant women is contraindicated.

A patient is undergoing glucocorticoid therapy at a health care facility. The patient develops acne. What should the nurse instruct the patient with acne? Use water-based cosmetics or creams. Avoid exposure to infections. Avoid the use of alcohol while taking the drug. Do not receive live virus vaccines.

Use water-based cosmetics or creams.

A patient has come to the short-stay unit to receive their IV chemotherapy. What action by the nurse would be the least beneficial to the patient? Using an infusion pump to administer the medication Premedication the patient as ordered Starting the IV in a large, distal vein Checking the IV line frequently

Using an infusion pump to administer the medication

Which are used to produce active immunity? (Select all that apply.) Antibodies Immune globulin Vaccines Antigens Toxoids

Vaccines Toxoids

What can occur when methylergonovine (Methergine) is administered to a patient that is a heavy smoker? Electrolyte imbalance Vasoconstriction Vasodilation Diuresis

Vasoconstriction

The nurse is aware that when using oxytocin for labor induction, oxytocin is similar to what other hormone? Thyroid stimulating hormone Parathyroid hormone Insulin Vasopressin

Vasopressin

Which of the following drugs is most commonly used in the treatment of bleeding esophageal varices? Pitocin Somavert Thyrogen Vasopressin

Vasopressin

What medication is used to treat diabetes insipidus caused by hypofunction of the posterior pituitary gland? Dexamethasone (Decadron) Vasopressin (Pitressin) Methylprednisolone (Solu-Medrol) Physostigmine (Antilirium)

Vasopressin (Pitressin) Posterior pituitary disorders that are seen clinically involve ADH release and include diabetes insipidus, which results from insufficient secretion, and syndrome of inappropriate antidiuretic hormone (SIADH), which occurs with excessive secretion of ADH.

A patient with HIV is taking pimozide for Tourette's syndrome. The physician writes an order to begin the patient on saquinavir. What is the priority action by the nurse? Monitor the T-cell count and viral load. Call the pharmacy to obtain the medication. Monitor the patient for hyperglycemia. Verify the order with the health care provider because co-administration is contraindicated.

Verify the order with the health care provider because co-administration is contraindicated.

Which of the following is an example of an antineoplastic drug that interferes with amino acid production in the S phase and the formation of microtubules in the M phase? Etoposide (Toposar) Irinotecan (Camptosar) Teniposide (Vumon) Vinblastine (Velban)

Vinblastine (Velban)

A client's medication has been changed to clozapine (Clozaril). What assessment should the nurse perform to identify a life-threatening adverse effect early? Monitoring urine output Lung auscultation Vital signs monitoring Observation for bleeding

Vital signs monitoring

The physiology instructor is talking with the students about the development of blood cells. What would the instructor tell the students causes a hemocytoblast to change into an immature RBC? Vitamin C Vitamin A Vitamin B12 Vitamin D

Vitamin B12

A client is taking levodopa. What should the nurse caution the client to avoid? St. John's wort Vitamin B6 Aged cheese Analgesics

Vitamin B6

The Food and Drug Administration (FDA) has determined that some drugs are too dangerous for a woman to use during her pregnancy due to the potential harm to the fetus. Which of the following medications fall in the pregnancy risk category X? Select all that apply. Atorvastatin Tetracycline Lorazepam Methotrexate Warfarin Acetampnophen

Warfarin Methotrexate Atorvastatin Tetracycline and lorazepam are category D.

A patient is prescribed clozapine (Clozaril). The patient and family should be instructed on the adverse effects of this medication. What laboratory test is most important in the first 6 months of the medication regime? Weekly liver enzymes Daily blood glucose Monthly creatinine levels Weekly WBC counts

Weekly WBC counts

The nurse is caring for a 72-year-old patient receiving imatinib. What intervention should the nurse perform regularly to prevent pulmonary complications? Have the patient use incentive spirometry daily. Administer Lasix 40 mg IV. Have the patient deep breathe and cough. Weigh the patient on a regular basis to assess for fluid retention.

Weigh the patient on a regular basis to assess for fluid retention.

An elderly client has been brought to the clinic by her daughter. The daughter reports the client has been progressively becoming more confused over the past few weeks. The nurse reviews the client's list of over-the-counter medications and seeks more information when she notes the client has been taking diphenhydramine (Benadryl) for seasonal allergies acetaminophen (Tylenol) for minor aches and pains docusate (Colace) as a stool softener daily omeprazole (Prilosec) for occasional heartburn

diphenhydramine (Benadryl) for seasonal allergies Diphenhydramine is listed on The Beers Criteria, a tool for identification of potentially inappropriate medications in older adults.

The seasoned labor and delivery nurse knows that which of the following is not administered until after the placenta is delivered? (Select all that apply.) indocin ergonovine methylergonovine magnesium

ergonovine methylergonovine

The nurse administers an oral liquid medication to a child. The child spits out some of the medication. The nurse next: notifies the health care provider. administers additional medication. estimates the amount of medication lost. charts administration of the full dose of the medication.

estimates the amount of medication lost.

A 49-year-old female patient is asking the nurse about how her changing hormones relate to menopause. The nurse explains that atrophic vaginitis is a common problem during menopause. The treatment for atrophic vaginitis requires replacing: estrogen. testosterone. human chorionic gonadotropin. progesterone.

estrogen

A 75-year-old male patient is started on flavoxate, an anticholinergic drug used in the treatment of overactive bladder. When teaching the patient about the medication, the nurse should explain that the patient may be at increased risk of: infection. diarrhea related to GI effects. falls related to visual effects. hypothermia related to effects on body temperature regulation.

falls related to visual effects.

A patient calls the clinic and tells the nurse of a need to sleep. In talking with the patient, the nurse notes that the patient has had diarrhea and has taken loperamide (Imodium). The nurse knows that a common side effect of loperamide (Imodium) is: tremors. flatulence. disorientation. fatigue.

fatigue

The antibody prototype is the monoclonal antitumor antibody called rituximab (Rituxan). The adverse effects of this drug are described by which of the following? Choose all that apply. respiratory distress, more common if tumor is larger fever, flushing, chills, and rigors increased appetite Hgb > 13 g/dL

fever, flushing, chills, and rigors respiratory distress, more common if tumor is larger

A 76-year-old is brought into the clinic via wheelchair by a family member. The client has end-stage renal disease, hypertension, diabetes mellitus, and two prior myocardial infarctions. What category of elderly is this client considered? old-old young elderly middle-old frail elderly

frail elderly Some older adults are not independent and are in poor or compromised health. These are the frail elderly, a term that describes all people older than 65 years who have one or more debilitating conditions. Being frail and elderly places a person at higher risk for developing serious adverse drug effects.

An 8-year-old is going home on medication after surgery. The nurse is preparing to review the discharge instructions with the mother. What basic information and/or instructions should be given to her to continue the drug therapy at home? (Select all that apply.) description of the intended therapeutic drug effect schedule and duration of administration generic and trade names of drugs refer to books on teaching children about medicines

generic and trade names of drugs schedule and duration of administration description of the intended therapeutic drug effect

Parents of a 10-year-old child with asthma are concerned about their child's lack of growth. The parents say that the child is much shorter than anyone in the class and want to know what could have caused the problem. What medication may this child have taken that contributed to the growth suppression? cephalosporin brethine (Terbutaline) phenobarbital glucocorticoid

glucocorticoid

The client is an active 30-month-old child. The nurse is to start an intravenous access to provide fluids and medications. The nurse starts the access site in the: scalp. antecubital fossa. foot. hand.

hand.

An antibiotic has been ordered for a toddler who is showing signs and symptoms of sepsis. The dose will be determined based on the child's body surface area (BSA). In addition to knowing the child's weight, the care team will also have to consider the child's: developmental stage. height. body mass index (BMI). ethnicity.

height

Ofatumumab (Arzerra™) is a fully human monoclonal antibody licensed by the Food and Drug Administration in 2009. Please choose which of the following best describes this drug. Select all that apply. indicated for fludarabine-resistant CD20 CLL creates direct antibody cytotoxicity causes leukocyte elevation may cause rash and nausea

indicated for fludarabine-resistant CD20 CLL creates direct antibody cytotoxicity may cause rash and nausea

The elderly client is being seen in an outpatient clinic. The client has multiple health problems, including peripheral vascular disease, and is now being seen for a respiratory infection. The client is prescribed an antibiotic. The route least preferred for this client is: intramuscular. oral tablet. intravenous. oral liquid.

intramuscular Elderly clients, particularly those with peripheral vascular disease, will experience erratic blood concentrations of a medication from alteration in tissue perfusion and reduced muscle mass. Thus, other routes for medication administration will be preferred over the intramuscular route.

The nurse is working in a pediatric Emergency Department and uses caution when administering medications. The client most at risk for a medication error is the client who: demonstrates a decrease in weight of 2 pounds due to vomiting. is being admitted to the pediatric unit for observation. has a minor injury. is 18 months old.

is 18 months old.

A nurse is teaching a class at the local high school on the abuse of anabolic steroids. One potential adverse reaction the nurse should cite is: hypotension. sedation. excessive testicular growth. liver tumors.

liver tumors.

The nurse would contact the health care provider prior to administering atropine preoperatively to which client? female age 58 years female age 13 years male age 35 years male age 79 years

male age 79 years

A young women attends a "Botox Party" and is injected with botulinum toxin type A to decrease "frown lines" between her eyebrows. Later that evening, the patient is admitted to the ED and is hysterical because she cannot move her eyebrows. The ED nurse explains that that toxin causes: muscle death, which smoothes wrinkles in the area. muscle relaxation, preventing movement and relieving wrinkles. death to nerves in the area. permanent muscle relaxation, and the muscles will never move again.

muscle relaxation, preventing movement and relieving wrinkles.

The nurse should teach clients who are taking thyroid hormones to take the medication: in divided doses in the morning and evening. on an empty stomach. in the evening after dinner. at bedtime.

on an empty stomach.

A 73-year-old client has been given metoclopramine to take before meals. The client tells the nurse that the client has noticed tremors of the hands and the head has been shaking. What does the nurse understand may be occurring? parkinsonian effects from the metoclopramide Parkinson's disease a high level of anxiety an allergic reaction to the metoclopramide

parkinsonian effects from the metoclopramide

A female patient prescribed methotrexate for meningeal leukemia is asking the nurse about adverse effects of the drug. What would the nurse tell this patient should be avoided while taking methotrexate? pregnancy aerobic exercise alcohol smoking

pregnancy

The patient is admitted to the medical floor with a diagnosis of narcolepsy. The nurse can anticipate the physician to order which of the following medications to treat this disorder? dospan provigil dopram didrex

provigil

The nurse knows that when caring for the older adult, there are several normal aging processes that put the client at risk for toxicity. What factor puts such clients at increased risk for drug toxicity? reduced plasma protein levels reduced efficiency of blood-brain barrier reduced efficiency of renal function reduced gastric acidity

reduced efficiency of renal function Normal renal function decreases with aging. Drugs that depend on renal elimination are not excreted as quickly in the older adult. This decrease in function leads to elevated circulating active drug levels, which places the client at risk for adverse effects or drug toxicity. Reduced efficiency of the blood-brain barrier, reduced plasma protein levels, and reduced gastric acidity affect the distribution of the drug but do not directly increase risk for drug toxicity.

The nurse is caring for an older adult and is reviewing the normal age-related changes that occur in this group of clients and realizes that such changes extend the half-life of drugs. What is the physiologic change that causes this to occur? reduced oxidation in phase II of hepatic metabolism reduced oxidation in phase I of hepatic metabolism increased oxidation in phase I of hepatic metabolism increased oxidation in phase II of hepatic metabolism

reduced oxidation in phase I of hepatic metabolism

The main goal of therapy when using CNS stimulants is to: increase the ability to study for long periods of time. increase productivity and work longer hours. use the drugs as they are ordered. relieve the symptoms for which they were prescribed.

relieve the symptoms for which they were prescribed.

A 92-year-old male patient is being sent home on disopyramide (Norpace) for a ventricular arrhythmia. The patient asks why he must continue to take this drug. The nurse's best response would be that a ventricular arrhythmia may: result in the atria beating independently. cause edema in the extremities. lead to the formation of clots in the legs. result in death.

result in death.

The FDA has issued a BLACK BOX WARNING for clients taking lamotrigine (Lamictal), instructing them to discontinue the medication immediately if they develop: skin rashes. headaches. blurred vision. bruising.

skin rashes.

A patient who has suffered a crushing injury to his thumb and two fingers in an accident at a factory is relieved to be administered a local anesthetic prior to treatment. The drugs that were administered decrease the permeability of the nerve cell membrane to: glucose. sodium. phosphorus. bicarbonate.

sodium. Local anesthetics decrease the permeability of the nerve cell membrane to ions, especially sodium.

A client reports gastrointestinal (GI) upset when taking phenytoin (Dilantin). The nurse should tell the client to: take the medication two hours after ingesting dairy products. take the medication with meals. take the medication at bedtime. ask the health care provider to change the route from oral to injection.

take the medication with meals.

The nurse is to administer an intramuscular medication to a 2-year-old toddler. The nurse uses: a 45-degree angle when inserting the needle into the muscle. the vastus lateralis muscle as the site for administration. a 20-gauge needle for injection. a 1-inch needle for injection.

the vastus lateralis muscle as the site for administration.


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