Exam 2 Pharmacology
The nurse is teaching a client who is preparing to travel to a malarious country about the prophylactic medication chloroquine (Aralen). The nurse would instruct the client to take this drug for how long after leaving the affected area? 2 weeks 4 weeks 8 weeks 12 weeks
8 weeks
The nurse should question a prescription to administer acetylsalicylic acid (aspirin) to which client? A 62-year-old patient with a history of stroke A 45-year-old patient with a history of heart attack A 28-year-old patient with a history of sports injury A 14-year-old patient with a history of flulike symptoms
A 14-year-old patient with a history of flulike symptoms
When administering vitamin and mineral supplements, the nurse implements which appropriate interventions? select all that apply A. Not administering oral calcium tablet along with oral tetracyclines B. Administering intravenous calcium via a rapid intravenous push infusion C. Monitoring the heart rhythm of the patient receiving an intravenous magnesium infusion D. Giving oral niacin with milk or food to decrease gastrointestinal upset E. Monitoring for the formation of renal stones in patients taking large doses of vitamin C
A, c, d, and e
What is the MOST important action for the nurse to complete before administration of intravenous (IV) amphotericin B? Assess for nausea and vomiting. Monitor for cardiac dysrhythmias. Check for premedication prescriptions. Monitor IV site for signs of phlebitis.
Check for premedication prescriptions.
A new vaccination, Zostavax (Zoster Vaccine Live), has been approved to prevent the development of what condition in adults older than the age of 60 years? Influenza A Herpes zoster Avian influenza Herpes simplex
Herpes zoster
Which vaccination was developed to prevent bacterial meningitis caused by Haemophilus influenzae? Prevnar Gardasil Hepatitis B vaccine Hib conjugate vaccine
Hib conjugate vaccine
Current research has led to discovery of cancer-causing viruses in humans. Which virus is linked to cancer and can be prevented in humans? Leukemia viruses Rous sarcoma virus Shope papillomavirus Human papillomavirus (HPV)
Human papillomavirus (HPV)
The nurse would question a health care provider's prescription for vitamin D in a client with which condition? Graves' disease Hypothyroidism Chronic renal failure Hyperparathyroidism
Hyperparathyroidism
Administration of which substance provides passive immunity? Vaccines Toxoids Antitoxins Immunoglobulins
Immunoglobulins
The nurse has provided education to a client about fungal skin infections. Further client teaching is necessary when the client includes which condition in the discussion of fungal skin infections? Thrush Impetigo Athlete's foot Vaginal yeast infection
Impetigo
The nurse anticipates a client with low platelets will be prescribed which drug to stimulate platelet production? Epoetin (Epogen) Oprelvekin (Neumega) Aldesleukin (Proleukin) Interferon beta-1a (Avonex)
Oprelvekin (Neumega)
When administering ferrous sulfate (iron) to a client, the nurse plans to give this medication with which fluid to increase absorption of the iron? Black tea Orange juice 4 oz of milk 8 oz of water
Orange juice
When providing health promotion teaching at a senior citizen center, the nurse would include information about which medication used to decrease the duration of influenza A and B? Indinavir (Crixivan) Enfuvirtide (Fuzeon) Oseltamivir (Tamiflu) Ganciclovir (Cytovene)
Oseltamivir (Tamiflu)
The nurse is administering an IV amino glycoside to a patient who has had GI surgery. Which nursing measures are appropriate? (SATA) a. report a trough drug level of 0.8 mcg/mL, and hold the drug b. enforce strict fluid restriction c. monitor serum creatinine levels d. instruct the patient to report dizziness or a feeling of fullness in the ears e. warn the patient that the urine may turn darker in color
c and d
When a client is receiving cyclophosphamide (Cytoxan), the nurse should advise the client to drink plenty of fluids to prevent which condition? Neutropenia Renal failure Liver dysfunction Hemorrhagic cystitis
Hemorrhagic cystitis
the nurse is assessing a patient who has developed anemia after two rounds of chemotherapy. which of these may be indications of anemia? select all that apply. a. hypoxia b. fever c. infection d. bleeding e. fatigue
hypoxia and fatigue
When administering vancomycin, the nurse knows that which of these is most important to assess before giving the medication? a. renal function b. WBC count c. liver function d. platelet count
renal function
The formation of erythrocytes and maturation of the red blood cell (RBC) is driven by what hormone? Free thyroxin Progesterone Testosterone Erythropoietin
Erythropoietin
Which antifungal drug can be given intravenously to treat severe yeast infections as well as a one-time oral dose to treat vaginal yeast infections? Voriconazole (Vfend) Nystatin (Mycostatin) Fluconazole (Diflucan) Caspofungin (Cancidas)
Fluconazole (Diflucan)
Which types of antiviral drugs are used to treat HIV infection? (Select all that apply.) Fusion inhibitors Protease inhibitors Neuraminidase inhibitors Reverse transcriptase inhibitors Nonnucleoside reverse transcriptase inhibitors
Fusion inhibitors Protease inhibitors Reverse transcriptase inhibitors Nonnucleoside reverse transcriptase inhibitors
The nurse should assess a client for nephrotoxicity and ototoxicity when administering which antimicrobial? Cefazolin (Ancef) Clindamycin (Cleocin) Gentamicin (Garamycin) Erythromycin
Gentamicin (Garamycin)
The nurse would teach a client prescribed cyclosporine (Sandimmune) to avoid which substance? Sunscreen Chocolate milk Grapefruit juice Acetaminophen
Grapefruit juice
What is the MOST common drug used to treat oral candidiasis? Oseltamivir (Tamiflu) Nystatin (Mycostatin) Amantadine (Symmetrel) Griseofulvin (Fulvicin P/G)
Nystatin (Mycostatin)
Which are general adverse effects of chemotherapy? (Select all that apply.) Alopecia Leukocytosis Hypertension Urinary retention Thrombocytopenia
Alopecia Thrombocytopenia
When giving IV quinolones, the nurse needs to keep in mind that these drugs may have serious interactions with which drugs? a. SSRIs b. NSAIDs c. oral anticoagulants d. antihypertensives
c. oral anticoagulants
Which information should the nurse include in discharge teaching for a client prescribed doxycycline (Vibramycin)? "Keep the remainder of the medication in case of recurrence." "Take the medication until you have no fever and feel better." "Apply sunscreen or wear protective clothing when outdoors." "Take the medication with milk to minimize gastrointestinal upset."
"Apply sunscreen or wear protective clothing when outdoors."
The nurse is educating a client on vitamin supplementation. The client states, "I take a lot of vitamins every day to stay healthy." Based on knowledge and understanding of vitamin supplements, what is the nurse's best response? "That's good. You do not want to get sick from nutrient deficiencies." "You need to make certain that is okay with your health care provider." "Keep taking these vitamin pills because they are essential to any diet." "Can you tell me what vitamins you take and how many and how often?"
"Can you tell me what vitamins you take and how many and how often?"
Which client statement regarding his or her diagnosis of HIV infection indicates a need that further teaching is necessary? "I must take these medications exactly as prescribed for the rest of my life." "I don't need to use condoms as long as I take my medication as prescribed." "I will notify my health care provider immediately if I bruise or bleed more easily than normal." "I should remain upright for 30 minutes after taking my zidovudine to prevent esophageal ulceration."
"I don't need to use condoms as long as I take my medication as prescribed."
The nurse is providing education to a client who is prescribed metronidazole (Flagyl) for trichomoniasis. What client statement indicates that the client understood the teaching? "I will have my partner evaluated and treated." "I won't get this again because I have had it once." "I will stop taking the medication when the discharge stops." "I can continue to have intercourse as long as we use condoms."
"I will have my partner evaluated and treated."
Which client statement indicates to the nurse that the client understands the discharge teaching for ethambutol (Myambutol)? "Constipation will be a problem, so I will increase the fiber in my diet." "Dizziness and drowsiness are common adverse effects with this drug." "I will need to have my vision checked periodically while I am taking this drug." "This medication may cause my bodily secretions to turn red-orange-brown."
"I will need to have my vision checked periodically while I am taking this drug."
A nurse teaching a client receiving allopurinol (Zyloprim) should include which information? "Increase your fluid intake to 3 L per day." "This medication may cause your urine to turn orange." "Include salmon and organ meats in your diet on a weekly basis." "Take the medication with an antacid to minimize GI distress."
"Increase your fluid intake to 3 L per day."
Before discharge, the nurse is reviewing a client's prescribed medication regimen for tuberculosis (TB). The client asks the nurse why pyridoxine (vitamin B6) has been prescribed while continuing to take isoniazid (Nydrazid) to treat TB. What is the nurse's best response? "Multidrug therapy is necessary to prevent the occurrence of resistant bacteria." "You really should not be on that drug. I will check with the health care provider." "Pyridoxine is another antitubercular drug that will work synergistically with the isoniazid." "Pyridoxine will help prevent numbness, and tingling that can occur secondary to the isoniazid."
"Pyridoxine will help prevent numbness, and tingling that can occur secondary to the isoniazid."
What teaching would the nurse provide to a client receiving tetanus toxoid? "You will have lifetime immunity from this injection." "Soreness at the injection site is a common reaction." "This medication must be repeated weekly for 4 weeks." "Increase fluid and fiber in your diet to prevent constipation."
"Soreness at the injection site is a common reaction."
The client asks the nurse about the use of herbal and dietary supplements to treat arthritis pain. What is the nurse's best response? "High doses of vitamins and minerals have been used for many years to help maintain joint health." "There really are no safe herbal treatments for pain. Your best action would be to take your prescription medications." "Ginkgo biloba has shown tremendous benefit as an antiinflammatory drug and is used to treat the symptoms of pain." "There is evidence that glucosamine sulfate with chondroitin does decrease joint stiffness and pain. Discuss this with your health care provider."
"There is evidence that glucosamine sulfate with chondroitin does decrease joint stiffness and pain. Discuss this with your health care provider."
A client prescribed azithromycin (Zithromax) expresses concern regarding GI upset that was experienced when previously prescribed an erythromycin antibiotic. What is the nurse's best response? "Take an over-the-counter antiemetic to lessen the nausea." "Stop taking the drug if you experience heartburn and diarrhea." "I will call the health care provider and request a different antibiotic." "This drug is like erythromycin with less gastrointestinal adverse effects."
"This drug is like erythromycin with less gastrointestinal adverse effects."
A mother calls the clinic to ask what medication to give her 5-year-old child for a fever during a bout of chickenpox. The nurse's best response would be: a "Your child is 5 years old, so it would be okay to use children's aspirin to treat his fever." b "Start with acetaminophen or ibuprofen, but if these do not work, then you can try aspirin." c "You can use children's dosages of acetaminophen or ibuprofen, but aspirin is not recommended." d "It is best to wait to let the fever break on its own without medication."
"You can use children's dosages of acetaminophen or ibuprofen, but aspirin is not recommended."
When educating the client about immunosuppressant therapy, what information would the nurse include in the teaching? (Select all that apply.) "You must take all medications exactly as prescribed." "Over-the-counter medications are alright to take as needed." "Medications must be taken at the correct time every time to avoid interactions." "If you miss a dose of medication, take extra medicine to make up the missed dose." "Never stop taking these medications without being instructed by your health care provider."
"You must take all medications exactly as prescribed." "Medications must be taken at the correct time every time to avoid interactions." "Never stop taking these medications without being instructed by your health care provider."
when the nurse is teaching a pt who is taking acyclovir for genital herpes, which statement by the nurse is accurate? 1. this drug will help the lesions to dry and crust over 2. acyclovir will eradicate the herpes virus 3. this drug will prevent the spread of this virus to others 4. be sure to give this drug to your partner too
1. this drug will help the lesions to dry and crust over
he current immunization for tetanus and diphtheria toxoids and pertussis, Tdap, is administered to people in which age range? Younger than 6 years of age 11 years of age and older Any age range In the first 2 years of life
11 years of age and older
The nurse is planning care for a client prescribed once-daily IV gentamicin (Garamycin) therapy. When should the nurse schedule a trough drug level to be drawn? 12 hours after completing the antibiotic infusion 18 hours after completing the antibiotic infusion 30 minutes after beginning the antibiotic infusion 60 minutes after beginning the antibiotic infusion
12 hours after completing the antibiotic infusion
When preparing to administer an intravenous (IV) infusion of metronidazole (Flagyl), the nurse will anticipate infusing the medication over how many minutes? 1 to 5 5 to 10 15 to 30 30 to 60
30 to 60
The order for a child reads: "Give cefoxitin (Mefoxin) 160 mg/kg/day, IVPB, divided into doses given every 6 hours." If the child weighs 55 lbs, how much will the nurse administer for each dose? How much will the nurse administer in one day?
4000 mg/day; 1000 mg every six hours
What information should the nurse provide to a client prescribed rifampin (Rifadin)? Oral contraception is the preferred method of birth control when using rifampin. The patient will only need to take this medication for the prescribed 14-day period. A nonharmful adverse effect of this medication is red-orange discoloration of urine, sweat, tears, skin, salvia, and feces. Peripheral neuropathy is an expected side effect, and the patient should report any numbness or tingling of the extremities.
A nonharmful adverse effect of this medication is red-orange discoloration of urine, sweat, tears, skin, salvia, and feces.
When monitoring a patient who is receiving caspofungin the nurse will look for which serious adverse effects? Select all that apply. A. Blood dyscrasias B. Hypotension C. Pulmonary infiltrates D. Tinnitus E. Hepatotoxicity
A. Blood dyscrasias B. Hypotension E. Hepatotoxicity
While administering bevacizumab (Avastin), what will the nurse assess to look for drug-related toxicities? (Select all that apply) A. Blood pressure. B. Color of the skin and sclera of the eye (for jaundice) C. Blood glucose level D. Urine protein level. E. Hearing
A. Blood pressure, and D. Hearing
Before administering antiprotozoal drugs, the nurse will review which baseline assessment? A. CBC B. Serum magnesium level C. Creatinine clearance D. Arterial blood gas concentration
A. CBC
A patient is experiencing stomatitis after a round of chemotherapy. Which intervention by the nurse is correct? A. Clean the mouth with a soft bristle toothbrush and warm saline solution. B. Rinse mouth with commercial mouthwash twice a day. C. Use lemon-glycerin swabs to keep mouth moist. D. Keep dentures in the mouth between meals.
A. Clean the mouth with a soft bristle toothbrush and warm saline solution.
The nurse is assessing a patient who is about to receive antifungal drug therapy. Which problem would be of most concern? A. Endocrine disease b. Hepatic disease C. Cardiac disease D. Pulmonary disease
A. Endocrine disease
When giving metronidazole, the nurse implements appropriate administration techniques, including which of these? (SATA) A. Giving oral forms with food B. Giving oral forms on an empty stomach with a full glass of water C. Infusing intravenous doses over 30 to 60 min D. Administering intravenous doses by bolus over 5 min E. Obtaining ordered specimens before starting the medication
A. Giving oral forms with food C. Infusing intravenous doses over 30 to 60 min E. Obtaining ordered specimens before starting the medication
Bedaquiline (sirturo)is prescribed for a patient and the nurse is providing instructions to the patient about the medication. Which statement by the patient indicates a correct understanding of the instructions? A. I will take this with food B. I need to take this one hour before breakfast C. I can stop this drug if the side effects bother me D. It's okay to have a glass of wine while taking this drug
A. I will take this with food
Which client finding would the nurse hold the prescribed dose of filgrastim (Neupogen) and notify the health care provider? Temperature of 99.5° F Blood pressure of 142/88 mm Hg WBC count of 4.5/mm3 Absolute neutrophil count (ANC) count of 12,000 cells/mm3
Absolute neutrophil count (ANC) count of 12,000 cells/mm3
The nurse knows that antimalarial drugs are used to treat patients with infections caused by which microorganism? A. Plasmodium spp. B. Candida albicans C. Pneumocystitis jirovecci D. Mycobacterium
A. Plasmodium spp.
The nurse is reviewing the medical history of a patient who is about to receive therapy with etanercept (Enbrel). which conditions, if present, would be contraindicated or caution for therapy with this drug? (Select all that apply) A. Urinary tract infection. B. Psoriasis. C. Heart failure. D. Glaucoma. E. Latex allergy.
A. Urinary tract infection. C. Heart failure. E. Latex allergy.
The nurse is counseling a woman who is beginning antitubercular therapy with Rifampin. This patient also takes an oral contraceptive. Which statement by the nurse is most accurate regarding potential drug interactions? A. You will need to switch to another form of birth control while you are taking the Rifampin B. Your birth control pills will remain effective while you are taking the Rifampin C. You will need to take a stronger dose of birth control pills while you are on the right fanfin D. You will need to abstain from sexual intercourse while on the Rifampin to avoid pregnancy
A. You will need to switch to another form of birth control while you are taking the Rifampin
When planning care for a patient who is receiving interferon therapy, the nurse must keep in mind that the major dose-limiting factor is A. fatigue. B. bone marrow suppression. C. fever. D. nausea and vomiting.
A. fatigue.
Which condition is not an anticipated adverse effect of azathioprine (Imuran)? Alopecia Leukopenia Hepatotoxicity Thrombocytopenia
Alopecia
A client is prescribed monoclonal antibody therapy for the treatment of rheumatoid arthritis. What client condition should alert the nurse to question the prescription for this class of drugs? Nephrotic syndrome Hypertensive emergency Chronic obstructive pulmonary disease Acquired immune deficiency syndrome (AIDS)
Acquired immune deficiency syndrome (AIDS)
The nurse is obtaining a medication history from a client diagnosed with genital herpes. Which drug would the nurse expect this client to be prescribed? Ribavirin (Virazole) Acyclovir (Zovirax) Zidovudine (Retrovir) Amantadine (Symmetrel)
Acyclovir (Zovirax)
A client receiving vitamin K MOST likely has which abnormal clinical finding? Diarrhea Seizure activity Sudden severe confusion Altered coagulation studies
Altered coagulation studies
The nurse will question the use of a fluoroquinolone antibiotic in a client already prescribed which medication? Furosemide (Lasix) Omeprazole (Prilosec) Metoprolol (Lopressor) Amiodarone (Cordarone)
Amiodarone (Cordarone)
The nurse needs to know that major adverse effects are MOST common by which drug? Fluconazole (Diflucan) Ketoconazole (Nizoral) Griseofulvin (Fulvicin P/G) Amphotericin B (Amphocin)
Amphotericin B (Amphocin)
What is the priority nursing assessment to monitor when administering vaccinations? Myalgias Anaphylaxis Symptoms of infection Pain at the injection site
Anaphylaxis
The acetic acid derivative indomethacin (Indocin) has which properties? (Select all that apply.) Antinausea Antipyretic Anticonvulsant Antirheumatic Antiinflammatory
Antipyretic Antirheumatic Antiinflammatory
The nurse is reviewing the orders for wound care, which includes use of an antiseptic. What best describes the use of antiseptics? Select all that apply antiseptics are appropriate for use on living tissue. antiseptics work by sterilizing the surface of the wound. antiseptics are applied to nonliving objects to kill microorganisms. the patient's allergies must be assessed before using the antiseptic. antiseptics are used to inhibit the growth of microorganisms on the surface of the wound.
Antiseptics are appropriate for use on living tissue, the patient's allergies must be assessed before using the antiseptic, and antiseptics are used to inhibit growth of microorganisms on the wound surface.
When developing a nursing care plan for a client receiving epoetin alfa (Epogen), the nurse will include monitoring for which adverse effect? Chronic diarrhea Severe hypotension Impaired liver function Change in level of consciousness
Change in level of consciousness
When performing discharge teaching for a client prescribed oral linezolid (Zyvox) to treat methicillin-resistant Staphylococcus aureus (MRSA), the nurse should emphasize which important information? Stop the drug as soon as you feel better. Avoid ingestion of foods containing tyramine. Report any occurrence of constipation or facial flushing. Take the drug with an antacid to avoid gastrointestinal (GI) upset.
Avoid ingestion of foods containing tyramine.
What are the functional cells of the humoral immune system that mature into immunoglobulins? B cells T cells Granulocytes RBCs
B cells
The nurse is conducting a class on drugs for malignant tumors for a group of new oncology staff members. Which best describes the action of interferons in the management of malignant tumors? A. Interferons increase the production of specific anticancer enzymes. B. Interferons have antiviral and antitumor properties and strengthen the immune system. C. Interferons stimulate the production and activation of T lymphocyes and cytotoxic T cells. D. Interferons help improve the cell-killing action of T cells because they are retrieved from healthy donors.
B. Interferons have antiviral and antitumor properties and strengthen the immune system.
The nurse is monitoring for liver toxicity in a patient who has been receiving long-term isoniazid therapy. Manifestations of liver toxicity include: (select all that apply.) A. Orange discoloration of Sweat and Tears B. Darkened urine C. Dizziness D. Fatigue E. Visual disturbances F. Jaundice
B. Darkened urine D. Fatigue F. Jaundice
When teaching a patient who is taking Nystatin lozenges for oral candidiasis which instruction by the nurse is correct? A. To the lozenge carefully before swallowing B. Dissolve lozenge slowly and completely in your mouth C. Dissolve the lozenge until it's half the original size and then swallow it D. These lozenges needs to be swallowed whole with a glass of water
B. Dissolve lozenge slowly and completely in your mouth
The nurse is assessing a patient who has experienced severe neutropenia after chemotherapy and will monitor for which possible signs of infection? (Select all that apply) A. Elevated WBC count. B. Fever. C. Nausea. D. Sore throat. E. Chills.
B. Fever. D. Sore throat. E. Chills.
While teaching a patient who is about to receive cyclophosphamide (Cytoxan) chemotherapy, the nurse will instruct the patient to watch for potential adverse effects, such as A. Cholinergic diarrhea. B. Hemorrhagic cystitis. C. Peripheral neuropathy. D. Ototoxicity.
B. Hemorrhagic cystitis.
The nurse is caring for a patient who becomes severely nauseated during chemotherapy. Which intervention is most appropriate? A. Encourage light activity during chemotherapy as a distraction. B. Provide antiemetic medications 30 to 60 mins before chemotherapy. C. Provide antiemetic medications only upon request of the patient. D. Hold fluids during chemotherapy to avoid vomiting.
B. Provide antiemetic medications 30 to 60 mins before chemotherapy.
A patient receiving chemotherapy is experiencing severe bone marrow suppression. Which nursing diagnosis is most appropriate at this time? A. Activity intolerance. B. Risk for infection. C. Disturbed body image. D. Impaired physical mobility.
B. Risk for infection.
The nurse is reviewing the use of multidrug therapy for HIV with a patient. Which statements are correct regarding the reason for using multiple drugs to treat HIV? (select all that apply) A. The combination of drugs has fewer associated toxicities. B. The use of multiple drugs is more effective against resistant strains of HIV C. Effective treatment results in reduced TCell counts D. The goal of this treatment is to reduce the viral load. E. This treatment reduces the incidence of opportunistic infections.
B. The use of multiple drugs is more effective against resistant strains of HIV D. The goal of this treatment is to reduce the viral load. E. This treatment reduces the incidence of opportunistic infections.
Which teaching point would be appropriate to include when the nurse is informing a patient about the adverse effects of antimalarials? A. The skin may turn blotchy while these medications are taken. B. These medications may cause anorexia and abdominal distress. C. These medications may cause increased urinary output. D. The patient may experience periods of diaphoresis and chills.
B. These medications may cause anorexia and abdominal distress.
During antitubercular therapy with isoniazid a patient received another prescription for pyridoxine. Which statement by the nurse best explains the rationale for the second medication? A. This vitamin will help to improve your energy levels B. This vitamin helps to prevent neurologic adverse effects C. This vitamin Works to protect your heart from toxic effects D. This vitamin helps to reduce gastrointestinal adverse effects
B. This vitamin helps to prevent neurologic adverse effects
When teaching a patient about the potential drug interactions with antiprotozoal drugs, the nurse will include information about A. acetaminophen B. warfarin C. decongestants D. antibiotics
B. warfarin
Before administration of any antiviral medication, what nursing responsibilities would be performed? (Select all that apply.) Baseline vital signs History of medication use Head-to-toe physical assessment Documentation of known allergies Monitor for medication adverse effects
Baseline vital signs History of medication use Head-to-toe physical assessment Documentation of known allergies
When teaching a client about potential adverse effects of NSAID therapy, the nurse will teach the client to immediately notify the health care provider of which effect? Diarrhea Mild indigestion Black tarry stools Nonproductive cough
Black tarry stools
When providing education to a client undergoing antineoplastic drug therapy, the nurse instructs the client to immediately notify the health care provider for which signs and symptoms? (Select all that apply.) Blood in urine Bleeding gums Swollen tongue Difficulty sleeping New and persistent cough Nausea on the day of treatment
Blood in urine Bleeding gums Swollen tongue New and persistent cough
For a client receiving an intravenous (IV) infusion of gentamicin (Garamycin), the nurse would monitor which laboratory values? Hematocrit and hemoglobin Blood urea nitrogen (BUN) and creatinine Prothrombin time and partial thromboplastin time Serum glutamic-oxaloacetic transaminase and alanine transaminase
Blood urea nitrogen (BUN) and creatinine
The nurse should teach the client about which expected adverse effect of filgrastim (Neupogen)? Insomnia Bone pain Hypotension Constipation
Bone pain
When a client is receiving tamoxifen (Soltamox), the nurse will suspect which type of cancer? Lung Renal Colon Breast
Breast
During treatment with doxorubicin (Adriamycin), the nurse must monitor closely for which potentially life-threatening adverse effect? A. Nephrotoxicity. B. Peripheral neuritis. C. Cardiomyopathy. D. Ototoxicity.
C. Cardiomyopathy.
The nurse notes in the patient's medication history that the patient is taking sofosbuvir (solvald) with ribavirin. Based on this finding the nurse interprets that the patient has which disorder? A. Cytomegalovirus B. Genital herpes C. Chronic hepatitis C D. Respiratory syncytial virus infection
C. Chronic hepatitis C
After surgery for organ transplantation, a patient is receiving ganciclovir, even though he does not have a viral infection. Which statement best explains the rationale for this medication therapy? A. Ganciclovir is used to prevent potential exposure to the HIV virus B. This medication is given prophylactically to prevent influenza A infection. C. Ganciclovir is given to prevent CMV infection. D. The drug works synergistically with antibiotics to prevent superinfections.
C. Ganciclovir is given to prevent CMV infection
The nurse is administering methotrexate as part of the treatment for rheumatoid arthritis and will monitor for which sign of bone marrow suppression? A. Edema. B. Tinnitus. C. Increased bleeding tendencies. D. Tingling in the extremities.
C. Increased bleeding tendencies.
In caring for a patient recieving therapy with a myelosuppressive antineoplastic drug, the nurse notes an order to begin filgrastim after the chemotherapy is completed. Which statement correcty describes when the the nurse will begin the filgrastin therapy? A. It can be started during the chemotherapy. B. It will begin immediately after the chemotherapy is completed. C. It will be initiated 24 hours after the chemotherapy is completed. D. It will not be started until at least 72 hours after the chemotherapy is completed.
C. It will be initiated 24 hours after the chemotherapy is completed.
The nurse is teaching a patient who is starting antitubercular therapy with Rifampin. Which adverse effects with the nurse expect to see? A. Headache and neck pain B. Gynecomastiac. C. Reddish brown urine D. numbness or tingling of extremities
C. Reddish brown urine
If extravasation of an antineoplastic medication occurs, which intervention will the nurse perform first? A. Apply cold compresses to the site while elevating the arm. B. Inject subcutaneous doses of epinephrine around the IV site every 2 hours. C. Stop the infusion immediately while leaving the catheter in place. D. Inject the appropriate antidote through the IV catheter.
C. Stop the infusion immediately while leaving the catheter in place.
During therapy with the cytotoxic antibiotic bleomycin, the nurse will assess for potentially serious adverse effect by monitoring A. blood urea nitrogen and creatinine levels. B. cardiac ejection fraction. C. respiratory function. D. cranial nerve function.
C. respiratory function.
To assess for the dose-limiting toxicity of ganciclovir (Cytovene), the nurse will monitor which laboratory test result? Blood urea nitrogen Liver function tests Complete blood count (CBC) Creatine phosphokinase
CBC
A newly admitted patient reports a penicillin allergy. The prescriber has ordered a second-generation cephalosporin as part of therapy. Which nursing action is appropriate? call the prescriber to clarify the order because of the patient's allergy. give the medication, and monitor for adverse effects. ask the pharmacy to change the order to a first generation cephalosporin. administer the drug with an NSAID to reduce adverse effects.
Call the prescriber to clarify the order because of the patient's allergy
Which are known contraindications for use of erythropoiesis-stimulating agents (ESAs) in clients? (Select all that apply.) Cancer of the neck History of thrombosis End-stage renal disease Uncontrolled hypertension Hemoglobin level of 15 g/dL
Cancer of the neck History of thrombosis Uncontrolled hypertension Hemoglobin level of 15 g/dL
What is considered a major dose-limiting adverse effect of doxorubicin (Adriamycin)? Hepatoxicity Nephrotoxicity Cardiomyopathy Hemorrhagic cystitis
Cardiomyopathy
A client who is allergic to penicillin is at increased risk for an allergy to which drug? Erythromycin (E-mycin) Gentamicin (Garamycin) Cefazolin sodium (Ancef) Demeclocycline (Declomycin)
Cefazolin sodium (Ancef)
Before administration of an immunosuppressant drug, the nurse should perform which actions? (Select all that apply.) Measure abdominal girth. Check liver enzyme tests. Assess level of consciousness. Assess blood pressure and heart rate. Check blood urea nitrogen and creatinine levels.
Check liver enzyme tests. Assess level of consciousness. Assess blood pressure and heart rate. Check blood urea nitrogen and creatinine levels.
A nurse is caring for a client diagnosed with malaria. What drug would the nurse expect to be prescribed? Chloroquine (Aralen) Penicillin Metronidazole (Flagyl) Pentamidine (Pentam)
Chloroquine (Aralen)
Bacterial resistance to antibiotics can occur with which situations? (Select all that apply.) Clients stop taking an antibiotic when they feel better. Antibiotics that are prescribed to treat a viral infection Taking an antibiotic and an antiviral medication at the same time Microorganisms arriving from foreign countries and overseas ports Antibiotics that are prescribed according to culture and sensitivity reports
Clients stop taking an antibiotic when they feel better. Antibiotics that are prescribed to treat a viral infection
When providing instructions to clients on use of antibiotics, which instructions would the nurse include in the teaching? (Select all that apply.) Complete the entire course of therapy. Increase fluid intake up to 3000 mL/day. Wash your hands before and after preparing food. Notify the provider of any possible reactions that occur. Save unused medication in a cool dry place for later use.
Complete the entire course of therapy. Increase fluid intake up to 3000 mL/day. Wash your hands before and after preparing food. Notify the provider of any possible reactions that occur.
The drug mycophenolate (CellCept) has a black box warning because of which potential adverse effect? Hypertension Suicidal ideations Abnormal heart rhythms Congenital malformations
Congenital malformations
The nurse knows iron supplementation has which common adverse effect? Flatus Fatigue Heartburn Constipation
Constipation
What are important for the nurse to monitor in a client receiving an antifungal medication? (Select all that apply.) Creatinine Daily weights Mental status Intake and output Blood urea nitrogen
Creatinine Daily weights Intake and output Blood urea nitrogen
In an effort to prevent superinfections of the GI tract such as Clostridium difficile, the nurse will instruct clients to eat which foods? Multigrain wheat bread Raw fruits and vegetables Cultured dairy products such as yogurt Low-fat meats such as chicken and pork
Cultured dairy products such as yogurt (to put normal flora/good flora in the gut)
during treatment with zidovudine, the nurse needs to monitor for which potential adverse effect? A) retinitis B) DVT C) karposi's sarcoma D) bone marrow supression
D) bone marrow supression
A patient who has been newly diagnosed with HIV has many questions about the effectiveness of drug therapy. After a teaching session, which statement by the patient reflects a need for more education? A. "I will be monitored for adverse effects and improvements while I'm taking this medicine." B. "These drugs do not eliminate the HIV, but hopefully the amount of virus in my body will be reduced." C. "there is no cure for HIV" D. "these drugs will eventually eliminate the virus from my body."
D. "these drugs will eventually eliminate the virus from my body."
A patient who is receiving chemotherapy with cisplatin (Platinol) has developed pneumonia. The nurse would be concerned about nephrotoxicity if which antibiotic was ordered as treament for the pneumonia at this time? A. Penicillin. B. Sulfa drug. C. Fluoroquinolone. D. Aminoglycoside.
D. Aminoglycoside
When administering antifungal drug therapy the nurse knows that an issue that contributes to many of the drug interactions with antifungals is the patient's A. History Of cardiac disease B. History of gallbladder surgery C. Ethnic background D. Cytochrome P - 450 enzyme system
D. Cytochrome P - 450 enzyme system
When counseling a patient who has been newly diagnosed with TB, the nurse will make sure that the patient realizes that he or she is contagious A. During All Phases of the illness B. Anytime up to 18 months after therapy begins C. During the postictal phase of TB D. During the initial period of the illness and its diagnosis
D. During the initial period of the illness and its diagnosis
A patient is receiving her third course of 5-fluorouracil therapy and knows that stomatitis is a potential adverse effect of antineoplastic therapy. What will the nurse teach her about this problem? A. Aspirin should be taken to prevent the development of stomatitis. B. She should watch for and report black, tarry stools immediately. C. She should increase her intake of foods containing fiber and citric acid. D. She should examine her mouth daily for bleeding, painful areas and ulcerations.
D. Examine mouth daily for bleeding, painful areas and ulcerations.
The nurse is monitoring a patient who has been receiving aldesleukin (IL-2) (Proleukin) for treatment of malignant melanoma. Which adverse effect, if noted on assessment, is of primary concern? A. Chills. B. Fatigue. C. Headache. D. Fluid retention.
D. Fluid retention.
The nurse is reviewing the medication history of the patient who is taking hydroxychloroquine. However, the patient's chart does not reveal a history of malaria or travel out of the country. The patient is most likely taking his medication for A. Plasmodium B. thyroid disorders C. roundworms D. rheumatoid arthritis
D. rheumatoid arthritis
When planning care for a client receiving a sulfonamide antibiotic, it is important for the nurse to perform which intervention? Encourage fluid intake of 2000 to 3000 mL/day. Avoid direct sun exposure and tanning beds. Take the medication with dairy products such as milk or yogurt. Advise the client to report any tinnitus to the health care provider.
Encourage fluid intake of 2000 to 3000 mL/day (to prevent crystalluria)
While monitoring a patient the nurse knows that a therapeutic response to antitubercular drugs would be? A. The patient states that he or she is feeling much better B. The patient's Laboratory test results show a lower white blood cell count C. The patient reports a decrease coughs and night sweats D. There is a decrease in symptoms along with improved chest x-ray and sputum culture results
D. There is a decrease in symptoms along with improved chest x-ray and sputum culture results
The nurse monitors a patient who is experiencing thrombocytopenia from severe bone marrow suppression by looking for A. severe weakness and fatigue. B. elevated body temp. C. decreased skin turgor. D. excessive bleeding and bruising.
D. excessive bleeding and bruising.
A client states to the nurse, "I must take my iron supplement with a meal to avoid stomach upset." To increase uptake of oral iron, which food group should the nurse instruct the client to avoid? Dairy Fruits Proteins Vegetables
Dairy
When administering intravenous magnesium sulfate, the nurse will monitor for which signs and symptoms of hypermagnesemia? Tachycardia Hyperthermia Decrease in deep tendon reflexes Excessive perspiration or sweating
Decrease in deep tendon reflexes
The nurse knows colchicine (Colcrys) exerts its therapeutic effect by what action? Increases uric acid metabolism Decreases mobility of leukocytes Increases process of phagocytosis Increases production of lactic acid
Decreases mobility of leukocytes
What is the mechanism of action of biologic response-modifying drugs? (Select all that apply.) Direct toxic effect on tumor cells, causing them to rupture Regulation of gene expression that occurs during transcription Enhancement or restoration of the host's immune system defenses against a tumor Interruption of the cell lifecycle at the genetic level to interfere with growth of the cancer cell Adverse modification of a tumor's biology, making it harder for the tumor cells to survive and reproduce
Direct toxic effect on tumor cells, causing them to rupture Enhancement or restoration of the host's immune system defenses against a tumor Adverse modification of a tumor's biology, making it harder for the tumor cells to survive and reproduce
When a client is receiving an IV infusion of metronidazole (Flagyl), what adverse effect would the nurse immediately report to the health care provider? Dark colored urine Dizziness or confusion Elevated blood pressure Diminished breath sounds
Dizziness or confusion
The nurse is educating a client on dietary sources of folic acid. The nurse should teach the client that which food source has the highest amount of folic acid? Steak Apples Dried beans Swiss cheese
Dried beans
An allergy to which substance is a contraindication to the administration of an immunizing drug? Soy Egg Corn Wheat
Egg
What instruction should the nurse include for a client prescribed rifampin (Rifadin) and isoniazid (Nydrazid) prophylactically secondary to TB exposure? Advise that these drugs will only need to be taken for 7 to 10 days. Remind that sunscreen is not needed during outdoor activities. Explain that isoniazid may decrease blood serum glucose in susceptible people. Emphasize that oral contraceptives become ineffective when given with rifampin.
Emphasize that oral contraceptives become ineffective when given with rifampin.
When administering a nonsteroidal antiinflammatory drug and a penicillin drug together, the displacement of the penicillin antibiotic from the protein-binding sites will result in which effect? Increased free drug in blood Decreased free drug in blood No change in free drug in blood Absence of free drug in the blood
Increased free drug in blood
What is the mechanism of action of nonsteroidal antiinflammatory drugs (NSAIDs)? Enhancing pain perception Inhibiting prostaglandin production Increasing blood flow to painful areas Increasing the supply of natural endorphins
Inhibiting prostaglandin production
The nurse will plan to inject iron dextran by which technique? Intramuscular (IM) injection using the Z-track method Subcutaneous injection with a ½-inch, 25-gauge needle IM injection with a ½-inch, 18-gauge needle Intradermal injection with a sunburst technique of administration
Intramuscular (IM) injection using the Z-track method
The most significant drug interactions with use of antivirals occur when antivirals are administered via which route? Rectally Topically Optically Intravenously
Intravenously
When teaching a client receiving paclitaxel (Taxol), the nurse should instruct the client about which common adverse effect? Vertigo Joint pain Weight gain Hypertension
Joint pain
Which NSAID would the nurse anticipate administering parenterally for the treatment of acute postoperative pain? Ketorolac (Toradol) Diclofenac (Cataflam) Allopurinol (Zyloprim) Indomethacin (Indocin)
Ketorolac (Toradol)
The nurse would anticipate administering which medication to clients receiving high-dose methotrexate (Trexall)? Cisplatin (Platinol) Bleomycin (Blenoxane) Leucovorin (Wellcovorin) Dactinomycin (Cosmegen)
Leucovorin (Wellcovorin)
A client who is prescribed metronidazole (Flagyl) for a gynecologic infection provides the nurse with a list of medications that are routinely taken. Which medication would lead the nurse to question the prescription for Flagyl? Ibuprofen (Advil) Lithium (Eskalith) Levothyroxine (Synthroid) Multivitamin (Thera-Tabs)
Lithium (Eskalith)
What conditions are considered contradictions for use of antifungal medications? (Select all that apply.) Heart failure Liver failure Kidney failure Pancreatic failure Respiratory failure
Liver failure Pancreatic failure
When assessing for adverse effects to Rifamate (combination isoniazid and rifampin), the nurse would monitor which laboratory values? (Select all that apply.) Cholesterol Uric acid levels Sputum cultures Liver function tests Complete blood cell count
Liver function tests Complete blood cell count
Which mineral is essential for energy metabolism but may also be used in higher doses to treat certain seizures and preeclampsia? Zinc Calcium Magnesium Phosphorus
Magnesium
What is advantage of COX-2 inhibitors over other NSAIDs? Maintain GI mucosa Have a longer duration of action Have a more rapid onset of action Are less likely to cause hepatic toxicity
Maintain GI mucosa
Before administering an intravenous (IV) injection of basiliximab (Simulect), the nurse should anticipate giving which medication? Meperidine (Demerol) Acetaminophen (Tylenol) Diphenhydramine (Benadryl) Methylprednisolone (Solu-Medrol)
Methylprednisolone (Solu-Medrol)
The anthrax vaccine is recommended for which groups of people? (Select all that apply.) Military personnel Veterinarians Workers who process imported animal hair Emergency department health care providers
Military personnel Veterinarians Workers who process imported animal hair
The client is being treated with the drug fingolimod (Gilenya). The nurse would expect that this drug is prescribed for what client condition? Multiple sclerosis (MS) Parkinson's disease Guillain-Barré syndrome Amyotrophic lateral sclerosis
Multiple sclerosis (MS)
The nurse would anticipate administering which medication to a client demonstrating acute organ rejection? Azathioprine (Imuran) Basiliximab (Simulect) Sirolimus (Rapamune) Muromonab-CD3 (Orthoclone OKT3)
Muromonab-CD3 (Orthoclone OKT3)
Client teaching regarding the administration of vitamin C would include monitoring for which signs or symptoms that may indicate vitamin C toxicity? Focal or generalized seizures Easy bleeding and/or bruising Lightheadedness and dizziness Nausea and abdominal cramping
Nausea and abdominal cramping
When a client is receiving cisplatin (Platinol), the nurse will monitor the client for which possible severe adverse effects? (Select all that apply.) Ototoxicity Nephrotoxicity Pulmonary toxicity Nausea and vomiting Peripheral neuropathy
Ototoxicity Nephrotoxicity Nausea and vomiting Peripheral neuropathy
Which are known severe adverse effects of alkylating agents? (Select all that apply.) Ototoxicity Neurotoxicity Cardiotoxicity Nephrotoxicity Bone marrow suppression
Ototoxicity Neurotoxicity Nephrotoxicity Bone marrow suppression
Which vaccination is marketed and recommended in the prevention of a virus that is known to cause cervical cancer? Herpes zoster vaccine (Zostavax) Papillomavirus vaccine (Gardasil) Pneumococcal vaccine (Prevnar 13) Hepatitis B virus vaccine (Recombivax HB)
Papillomavirus vaccine (Gardasil)
When admitting a client to a medical-surgical unit with a diagnosis of Pneumocystis jirovecii pneumonia, the nurse will anticipate administering which medication? Iodoquinol (Yodoxin) Albendazole (Albenza) Pentamidine (Pentam) Paromomycin (Humatin)
Paromomycin (Humatin)
The client's culture has grown gram-positive cocci, and the health care provider prescribes two different antibiotics, one of which is gentamicin (Garamycin). To treat this type of infection, which type of antibiotic is typically prescribed together with gentamicin (Garamycin)? Penicillin Cephalosporin Fluoroquinolone Aminoglycoside
Penicillin
Which adverse effect can result if tetracycline is administered to children younger than 8 years of age? Drug-induced neurotoxicity Delayed growth development Gastrointestinal (GI) and rectal bleeding Permanent discoloration of the teeth
Permanent discoloration of the teeth
Cyanocobalamin (vitamin B12) is indicated for the treatment of which condition? Pernicious anemia Optic nerve atrophy Bone marrow suppression Acute lymphocytic leukemia
Pernicious anemia
The nurse should question a prescription of hydroxyurea (Hydrea) for a client with which laboratory test result? Hemoglobin of 15 g/dL Platelet count of 8000/mm3 Serum creatinine of 1.0 mg/dL White blood cell (WBC) count of 8000/mm3
Platelet count of 8000/mm3
What are the possible severe adverse effects specific to the cytotoxic antibiotics? Pneumonitis Liver toxicity Neurotoxicity Nephrotoxicity Cardiovascular toxicity
Pneumonitis Liver toxicity Nephrotoxicity Cardiovascular toxicity
. The nurse would question a prescription to administer misoprostol (Cytotec) to a client with which condition? Pregnancy Peptic ulcer Gastroesophageal reflux disease Chronic obstructive pulmonary disease
Pregnancy
Combinations of antineoplastic drugs are frequently used for which purpose? (Select all that apply.) Prevent drug resistance Lower cost of treatment Decrease drug tolerance Provide a synergistic action Decrease the severity of adverse effects
Prevent drug resistance Provide a synergistic action Decrease the severity of adverse effects
The nurse is administering probenecid (Benemid) to a client with recurrent strep throat. The nurse teaches the client that the MOST likely reason for taking this medication is for what drug effect? Increase uric acid excretion Prevent the occurrence of gout Inhibit bacterial growth and replication Prolong the effectiveness of penicillin therapy
Prolong the effectiveness of penicillin therapy
A client with a known heart condition is prescribed an antibiotic before a dental procedure. What type of antibiotic therapy is this considered? Empiric Definitive Supportive Prophylactic
Prophylactic
The nurse would question a prescription for voriconazole (Vfend) if the client was taking which medication? Quinidine Prednisone (Deltasone) Captopril (Capoten) Clindamycin (Cleocin)
Quinidine
Which is a complication of vancomycin IV infusions? Angioedema Neurotoxicity Cardiomyopathy Red man syndrome
Red man syndrome
Which nursing diagnosis is appropriate for a client prescribed colchicine (Colcrys)? Constipation related to adverse effect of the medication Risk for infection related to medication-induced leukocytosis Risk for injury related to adverse effect of life threatening seizures Risk for fluid volume deficient related to nausea, vomiting, and diarrhea
Risk for fluid volume deficient related to nausea, vomiting, and diarrhea
A patient has been admitted for treatment of an infected leg ulcer and will be started on IV linezolid. The nurse is reviewing the list of the patient's current medications. Which type of medication, if listed, would be of most concern if taken with the linezolid? a. beta blocker b. oral anticoagulant c. SSRI d. thyroid replacement hormone
SSRI
During antibiotic therapy, the nurse will assess the client for a condition that may occur because of the disruption of normal flora. The nurse knows this as what condition? Organ toxicity Superinfection Hypersensitivity Allergic reaction
Superinfection
Which cells are activated by aldesleukin (Proleukin), interleukin-2? T cells Neutrophils RBCs Undifferentiated cells
T cells
Quinolones are a class of antibiotics known for several significant complications. Which are possible adverse effects with these drugs? (Select all that apply.) Ototoxicity Nephrotoxicity Tendon rupture Prolongation of the QT interval Abnormal cartilage development in children
Tendon rupture Prolongation of the QT interval Abnormal cartilage development in children
A client visits the health care provider for treatment of tinea pedis (athlete's foot). Which medication would the nurse MOST likely instruct the client to take to treat this condition? Terbinafine (Lamisil) Voriconazole (Vfend) Caspofungin (Cancidas) Amphotericin B (Amphocin)
Terbinafine (Lamisil)
How would the nurse define the term nadir to a client? The client's tolerance and resistance to the chemotherapy's bone marrow suppressant effect The maximum dose for a chemotherapy medication in reference to bone marrow suppression The average number of days it takes the bone marrow to recover from a dose of chemotherapy The average number of days it takes for chemotherapy to have its peak effect on the bone marrow
The average number of days it takes for chemotherapy to have its peak effect on the bone marrow
Which statement best describes health care-associated infections? They develop in more than 15% of hospitalized clients. The infection develops in response to various antibiotics. The infection was not incubating at the time of admission. Clients are admitted to the hospital with an infectious disease.
The infection was not incubating at the time of admission.
What is the general action of immunosuppressants? They inhibit T-lymphocytes. They increase antibody response. They reduce hepatic metabolism of steroids. They increase natural killer cellular activity.
They inhibit T-lymphocytes.
During patient education regarding an oral macrolide such as erythromycin, the nurse will include which information? if GI upset occurs, the drug will have to be stopped. The drug needs to be taken with an antacid to avoid GI problems. The patient needs to take each dose with a sip of water. The patient may take the drug with a small snack to reduce GI irritation.
The patient may take the drug with a small snack in order to prevent GI irritation.
A teenage patient is taking a tetracycline drug as part of treatment for severe acne. When the nurse teaches this patient about drug-related precautions, which is the most important information to convey? when the acne clears up, the medication can be discontinued. this medication need to be taken with antacids to reduce GI upset. the patient needs to use sunscreen or avoid exposure to sunlight because this drug may cause photosensitivity. the teeth should be observed closely for signs of mottling or other color changes.
The patient needs to use sunscreen or avoid exposure to sunlight because this drug may cause photosensitivity.
The nurse is discussing the use of alkylating drugs with a client. What is the best way for the nurse to describe the action of alkylating drugs on cancer cells? They interact within the cell through intercalation. They stop the meiosis of cell division and reproduction. They alter the chemical structure of the deoxyribonucleic acid (DNA). They specifically change the messenger ribonucleic acid sequence.
They alter the chemical structure of the deoxyribonucleic acid (DNA).
The nurse is aware that viruses can enter the body through various routes. Through which routes can viruses enter the body? (Select all that apply.) Through an animal bite Transplacentally from mother to infant Inhalation through the respiratory tract Localized allergic reaction to medication Ingestion via the gastrointestinal (GI) tract
Through an animal bite Transplacentally from mother to infant Inhalation through the respiratory tract Ingestion via the gastrointestinal (GI) tract
A 49-year-old patient has been admitted with possible chronic salicylate intoxication after self-treatment for arthritis pain. The nurse will assess for which symptoms of salicylate intoxication? a Tinnitus b Headache c Constipation d Nausea e Bradycardia
Tinnitus Headache Nausea
The nurse is caring for a client who is prescribed epoetin alfa (Epogen). What does the nurse expect as the reason for use of this medication in this client? To cure or reverse kidney failure To replace blood loss from surgery Treatment of anemia due to renal failure Management of pregnancy-associated anemia
Treatment of anemia due to renal failure
Nausea and vomiting are frequent adverse effects associated with antineoplastic therapy. What should the nurse advise clients experiencing these unpleasant adverse effects? Increase intake of dry or high-fiber foods, and foods that have a rough texture. Consider relaxation techniques because these symptoms should improve over time. Use antacids to relieve the irritation to the stomach, which should stop the nausea. Try to maintain hydration and nutrition, which are very important during treatment.
Try to maintain hydration and nutrition, which are very important during treatment.
The nurse would question the prescription for epoetin alfa (Epogen) in a client with which condition? End-stage renal disease Uncontrolled hypertension Chemotherapy-induced anemia Acquired immunodeficiency syndrome (AIDS
Uncontrolled hypertension
Which statement MOST accurately describes the pharmacodynamics of vaccines? Vaccines work by stimulating the humoral immune system. Vaccines provide IgG antibodies to protect against infection. Vaccines prevent the formation of antibodies against a specific antigen. Vaccines work by suppressing the amino acid immunoglobulin sequence.
Vaccines work by stimulating the humoral immune system.
The nurse would question a prescription for chloroquine (Aralen) in a client also prescribed which medication? Diazepam (Valium) Doxycycline (Doryx) Clindamycin (Cleocin) Valproic acid (Depakote)
Valproic acid (Depakote)
What vitamins are MOST likely to lead to toxic levels, hypervitaminosis, when administered in megadoses? (Select all that apply.) Vitamin A Vitamin C Vitamin D Vitamin K Vitamin B complex
Vitamin A Vitamin D Vitamin K
a patient has GI malabsorption due to severe intestinal damage from a gastrointestinal infection. The nurse will need to assess for signs of a deficiency of which vitamin? A. Vitamin A (retinol) B. Vitamin b12 (cyanocobalamin) C. Vitamin b6 (pyrodoxine) D. Vitamin e (tocopherols)
Vitamin B 12 (cyanocobalamin)
While caring for newly admitted patient who has a long history of alcoholism, the nurse anticipates that part of the patient's medication regimen will include which vitamin? A. Vitamin B1 (thiamine) B. Vitamin b6 (pyridoxine) C. Vitamin c (ascorbic acid) D. Vitamin A (retinol)
Vitamin B1
The nurse anticipates a prescription for vitamin supplementation for a client who is receiving isoniazid (Nydrazid) therapy. What vitamin supplement is usually prescribed with isoniazid? Folate Calcium Vitamin E Vitamin B6
Vitamin B6
What vitamin can be synthesized by the skin when exposed to sunlight but can also be supplemented as needed? Vitamin C Vitamin K Vitamin D Vitamin B complex
Vitamin D
The nurse would teach a client prescribed metronidazole (Flagyl) to avoid ingestion of which drink? Milk Wine Coffee Orange juice
Wine
Which groups of individuals are at highest risk for development of iron deficiency anemia? (Select all that apply.) Women ages 12 to 40 years Children Men ages 20 to 40 years Men older than age 50 years Pregnant women
Women ages 12 to 40 years Children Pregnant women
The nurse is providing wound care for a patient with stage four pressure ulcer and expects the patient will receive which supplements to assistant wound healing? Select all that apply A. Vitamin K B. Vitamin B1 C. Zinc D. Calcium E. Vitamin c
Zinc and vitamin c
13. When a patient is receiving long-term NSAID therapy, which drug may be given to prevent the serious gastrointestinal adverse effects of NSAIDs? a misoprostol (Cytotec) b metoprolol (Lopressor) c metoclopramide (Reglan) d magnesium sulfate
a misoprostol (Cytotec)
A woman who has been taking an antibiotic for a UTI calls the nurse practitioner to complain of severe vaginal itching. She has also noticed a thick, white-colored vaginal discharge. The nurse practitioner suspects: this is an expected response to antibiotic therapy. the UTI has become worse instead of better. a superinfection has developed. the UTI is resistant to the antibiotic.
a superinfection has developed.
The nurse is administering an intravenous dose of iron Dextran. For which potential adverse effect is it most important for the nurse to monitor at this time? a. anaphylaxis b. gastrointestinal distress c. black, tarry stools d. bradycardia
a. anaphylaxis
during drug therapy with basiliximab, the nurse monitors for signs of cytokine release syndrome, which results in a. fever, dyspnea, and general malaise b. neurotoxicity and peripheral neuropathy c. hepatotoxicity with jaundice d. thrombocytopenia with increased bleeidng tendencies
a. fever, dyspnea, and general malaise
When assessing a patient who is to begin therapy with an immunosuppressant drug, the nurse recognizes that such drugs should be used cautiously in patients with which conditions? select all that apply a. pregnancy b. glaucoma c. anemia d. myalgia e. renal dysfunction f. hepatic dysfunction
a. pregnancy e. renal dysfunction f. hepatic dysfunction
the nurse will assess which lab tests before the administration of vitamin k? a. ptt and international normalized ratio b. RBC and WBC counts c. phosphorus and calcium levels d. total protein and albumin levels
a. ptt and international normalized ratio
the day before a third round of chemo, the nurse reads that a patient's neutrophil count is 1650 cellls/mm3. the nurse expects that the oncologist will follow hwich course of treatment? a. the chemo will be started as scheduled b. the chemo will be given at a lower dosage c. the oncologist will order a neutrophil transfusion to be given first d. the chemo will not be given today
a. the chemo will be started as scheduled
A patient with renal failure has severe anemia, and there is an order of darbepoetin (Aranesp). As the nurse assesses the patient, which condition listed will the nurse consider a contraindication to use of this medication? a. uncontrolled hypertension b. diabetes mellitus c. hypothyroidism d. angina
a. uncontrolled hypertension
What is the priority assessment data for a client prescribed antibiotic therapy? Allergies Immunizations History of seizures Cardiac dysrhythmias
allergies
Medications used to treat HIV infections are more specifically classified as what type of drugs? Antiviral Antifungal Antiparasitic Antiretroviral
antiretroviral
the nurse is reviewing the orders for a patient who has been admitted for treatment of pneumonia. the antibiotic orders include an order for doxycycline. However, when the patient is asked about his allergies, he lists doxycycline as one of them. what is the priority action at this time? call the prescriber to clarify the order because of the patient's allergy. ask the patient to explain what happened when he had an allergic reaction. ask the pharmacy to order a different antibiotic. administer the drug with an antihistamine to reduce adverse effects.
ask the patient to explain what happened when he had an allergic reaction.
A patient has been receiving therapy with the amino glycoside tobramycin, and the nurse notes that the patient's latest trough drug level is 3 mpg/mL. this drug is given daily, and the next dose is to be administered now. based on this trough drug level, what is the nurse's priority action? a. administer the drug as ordered b. hold the drug, and notify the prescriber c. call the laboratory to have the test repeated and verified d. hold this dose, but administer the next dose as scheduled
b
14. The nurse recognizes that manifestations of NSAID toxicity include a constipation. b nausea and vomiting. c tremors. d urinary retention.
b nausea and vomiting.
During a routine checkup, a 72-year-old patient is advised to receive an influenza vaccine injection. He questions this, saying, "I had one last year. Why do I need another one?" What is an appropriate response from the nurse? a. "The effectiveness of the vaccine wears off after 6 months." b. "Each year a new vaccine is developed based on the flu strains that are likely to be in circulation." c. "When you reach 65 years of age, you need boosters on an annual basis." d. "Taking the flu vaccine each year allows you to build your immunity to a higher level each time."
b. "Each year a new vaccine is developed based on the flu strains that are likely to be in circulation."
The nurse is teaching a patient about oral iron supplements. Which statement is correct? a. "you need to take this medication on an empty stomach or else it won't be absorbed." b. "it is better absorbed on an empty stomach to be upset, you can take it with food." c. "take this medication with a sip of water, and then lie down to avoid problems with low blood pressure." d. "if you have trouble swallowing the tablet, you make crush it."
b. "it is better absorbed on an empty stomach, but if it causes your stomach to be upset, you can take it with food."
while assessing a patient who is to receive muromonabCD3 the nurse knows that which condition would be a contraindication for this drug? a. acute myalgia b. fluid overload c. polycythemia d. diabetes mellitus
b. fluid overload
Praziquintel (Biltricide) is prescribed for a patient with a tapeworm infection. The nurse prepares to administer the medication via which route? a. rectal b. oral c. IV d. inhalation
b. oral
When assessing a patient who will be receiving a measles vaccine, the nurse will consider which condition to be a possible contraindication? a. Anemia b. Pregnancy c. Ear infection d. Common cold
b. pregnancy
a woman who is planning to become pregnant asks the nurse when she should start to take folic acid supplements. what is the nurse's best response? a. there is no evidence to support the use of folic acid during pregnancy b. you should start taking it at least one month before you become pregnant, and continue it throughout early pregnancy c. you need to take it as soon as you become pregnant d. you should only take it during the last trimester of your pregnancy, and not any earlier
b. you should start taking it at least one month before you become pregnant, and continue it throughout early pregnancy
While monitoring a patient who is receiving intravenous amphotericin B the nurse expects to see which adverse effects? A. Hypertension B. Bradycardia c. Fever and chills D. Diarrhea and stomach cramps
c. Fever and chills
The nurse is providing teaching after an adult receives a booster immunization. Which adverse reactions should be reported immediately to the health care provider? (Select all that apply.) a. Swelling and redness at the injection site b. Fever of 100° F (37.8° C) c. Joint pain d. Heat over the injection site e. Rash over the arms, back, and chest f. Shortness of breath
c. Joint pain e. Rash over the arms, back, and chest f. Shortness of breath
When giving a vaccination to an infant, the nurse should tell the mother to expect which adverse effect? a. Fever over 101° F (38.3° C) b. Rash c. Soreness at the injection site d. Chills
c. Soreness at the injection site
A 28-year-old is in the urgent care center after stepping on a rusty tent nail. The nurse evaluates the patient's immunity status and notes that the patient thinks she had her last tetanus booster about 10 years ago, just before starting college. Which immunization would be most appropriate at this time? a. Immunoglobulin intravenous (Gammar-P IV) b. DTaP (Daptacel) (diphtheria, tetanus, and acellular pertussis) c. Tdap (Adacel) (diphtheria, tetanus, and acellular pertussis) d. No immunizations are necessary at this time.
c. Tdap (Adacel) (diphtheria, tetanus, and acellular pertussis)
When iron sucrose is administered, which nursing interventions are correct? (select all that apply) a. administer a test dose before giving the full dose b. give via deep intramuscular injection into a large muscle mass using the Z-track method. c. administer large doses over 2.5 to 3.5 hours, intravenously d. monitor the patient for hypertension e. monitor the patient for hypotension
c. administer large doses over 2.5 to 3.5 hours, intravenously e. monitor the patient for hypotension
the nurse is reviewing cyclosporine and recognizes that this drug works by which MOA? a. suppressing viral replication b. enhancing the action of macrophages c. inhibiting activation of t-cell lymphocytes d. increasing the number of t-cell lymphocytes
c. inhibiting activation of t-cell lymphocytes
during a teaching session for a patient receiving an immunosuppressant drug the nurse will include which statement? a. it is better to use oral forms of these drugs to prevent the occurrence of thrush b. you will remain on antibiotics to prevent infections c. it is important to use some form of contraception during treatment and for up to 12 weeks after ending therapy d. be sure to take your meds with grapefruit juice to increase absorption
c. it is important to use some form of contraception during treatment and for up to 12 weeks after ending therapy
. When the nurse is teaching about antigout drugs, which statement by the nurse is accurate? a "Drink only limited amounts of fluids with the drug." b "This drug may cause limited movements of your joints." c "There are very few drug interactions with these medications." d "Colchicine is best taken on an empty stomach."
d "Colchicine is best taken on an empty stomach."
During a teaching session about antigout drugs, the nurse tells the patient that antigout drugs work by which mechanism? a Increasing blood oxygen levels b Decreasing leukocytes and platelets c Increasing protein and rheumatoid factors d Decreasing serum uric acid levels
d Decreasing serum uric acid levels
when giving calcium intravenously, the nurse needs to administer it slowly, keeping in mind that rapid IV administration of calcium may cause which problem? a. ototoxicity b. renal damage c. tatny d. cardiac dysrhythmas
d. cardiac dysrhythmas
The nurse notes in a patient's medication history that the patient is taking terbinafine (Lamisil) based on this finding the nurse interprets that the patient has which disorder? a. vaginal candidiasis b. cryptococcal meningitis c. invasive aspergillosis d. onychmycosis
d. onychmycosis
When administering oral iron tablets, the nurse should keep in mind that the most appropriate substance, other than water, to give with these tablets is: A. pudding b. an antacid c. milk d. orange juice
d. orange juice
While assessing a woman who is receiving quinolone therapy for pneumonia, the nurse notices that the patient has a history of heart problems. The nurse will monitor for which potential cardiac effect of quinolone therapy? a. bradycardia b. dysrhythmias c. tachycardia d. prolonged QT interval
d. prolonged QT interval
A patient has a new order for glatiramer acetate. the patient has not had an organ transplant. the nurse knows that the patient is receiving this drug for which condition? a. psoriasis b. rheumatoid arthritis c. IBS d. relapse-remitting MS
d. relapse-remitting MS
the nurse is reviewing the cdc recommendations for vaccines. the pneumococcal vaccine is recommended for which age group? a. newborn infants b. patients who are immunosupressed c. patients who are transplant candidates d. smokers between 19 and 64 years of age
d. smokers between 19 and 64 years of age
During therapy with azathioprine (Imuran) the nurse must monitor for which common adverse effect? a. bradycardia b. diarrhea c. vomiting d. thrombocytopenia
d. thrombocytopenia
an animal control officer was bitten by a stray dog that showed signs of rabies. which statement by the nurse is correct regarding treatment of rabies prophylaxis? a. you will receive treatment if you begin to show symptoms of rabies b. you will receive one oral dose of medication today, and one more in a week c. you will need to receive 3 subQ injections over the next week d. you will need to receive 5 IM injections over the next 28 days
d. you will need to receive 5 IM injections over the next 28 days
a patient is scheduled for colorectal surgery tomorrow. he does not have sepsis. his wbc count is normal, he has no fever, and he is other wise in good health. however there is an order to adminster an antibiotic on call before he goes to surgery. the nurse knows that the rationale for this antibiotic order is to provide empiric therapy provide prophylactic therapy treat for a superinfection reduce the number of resistant organisms
provide prophylactic therapy.
During therapy with an IV amino glycoside, the patient calls the nurse and says, "I'm hearing some odd sounds, like ringing, in my ears." What is the nurse's priority action at this time? a. reassure the patient that these are expected adverse effects b. reduce the rate of the IV infusion c. increase the rate of the IV infusion d. stop the infusion immediately
stop the infusion immediately
How is the effectiveness of antiviral drugs administered to treat HIV infection assessed and evaluated? Viral load Megakaryocytes Lymphocyte counts Red blood cell counts
viral load
after giving an injection to a patient with HIV infection, the nurse accidentally receives a needle stick from a too-full needle disposal box. Recommendations for occupation HIV exposure may include the use of which drugs? didanoside lamivudine and enfuviritude zidovudine lamivudine and indinavir acyclovir
zidovudine lamivudine and indinavir