Midterm
1. A patient receiving acetaminophen (Tylenol) for fever. The patient also has inflammation in the knees and elbows with pain. Why will acetaminophen (Tylenol) assist in reducing fever but not in decreasing the inflammatory process? A) Prostaglandin inhibition is limited to the central nervous system. B) Acetaminophen inhibits cyclooxygenase (COX-1 and Cox-2) only . C) Acetaminophen has an antiplatelet effect to decrease edema. D) Prostaglandins decrease the gastric acid secretion.
A
10. A 71-year-old woman with a history of chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) has begun tapering off of prednisone. The nurse should prioritize which of the following assessments during this phase of the woman's care? A) Daily weights B) Level of consciousness assessment C) Nonstress cardiac testing D) Positional blood pressure measurement
A
10. A perinatal nurse is preparing a dose of IV indomethacin for administration to a neonate. What is the most plausible indication for this treatment? A) Patent ductus arteriosus B) Tetralogy of Fallot C) Patent foramen ovale D) Cardiomyopathy
A
13. A patient with a diagnosis of breast cancer is administered a corticosteroid in addition to chemotherapy agents. What effect will the corticosteroids have on this patient's course of recovery? A) The corticosteroid will decrease signs and symptoms of cancer. в) The corticosteroid will alter the action of the chemotherapy agent. C) The corticosteroid will decrease metastasis to distant sites. D) The corticosteroid will decrease hepatic effects of the chemotherapy.
A
17. A patient suffers from gouty arthritis. Why is probenecid (Benemid) administered? A) To increase urinary excretion of uric acid в) To decrease the level of liver enzymes C) To diminish the temperature D) To increase protein metabolism
A
18. An adult patient is preparing to begin corticosteroid treatment for rheumatoid arthritis. When teaching this patient about the appropriate use of corticosteroids, the nurse should include what teaching point? A) "You will likely gain some weight after you start taking this drug." в) "Try to cat as many organic and natural foods as possible while taking this drug." C) "You might have some slight bleeding in your stool after you start this drug." D) "Ensure that you vary the times that you take your drug in order to maximize effectiveness."
A
19. A 12-year-old boy was recently diagnosed with asthma, and his primary care provider has prescribed a corticosteroid to be administered by metered-dose inhaler. This drug achieves a therapeutic effect by which of the following means? A) By increasing the number of beta-adrenergic receptors B) By increasing the muscle tone in the smooth muscle of the trachea C) By increasing the permeability of the alveolar membrane D) By increasing the number of binding sites on erythrocytes
A
19. Which of the following is the antidote for acetaminophen (Tylenol) poisoning? A) Acetyleysteine (Mucomyst) B) Allopurinol (Zyloprim) C) Diclofenac sodium (Voltaren) D) Ketorolac (Toradol)
A
2. A patient is diagnosed with a gram-negative infection and is prescribed an aminoglycoside. What is the action of an aminoglycoside? A) It blocks protein synthesis of the cell wall. B) It blocks DNA replication. C) It destroys the integrity of the cell wall structure. D) It increases white blood cell viability.
A
2. An outpatient has been prescribed hydrocodone for back pain related to a compression fracture. Which of the following interventions should the patient be taught regarding the medication administration? A) Consume a diet high in fiber. B) Decrease activity due to pain. C) Elevate the lower extremities. D) Take aspirin with the medication
A
3. A patient is administered acetylsalicylic acid (aspirin) for fever and headache. What is the action of acetylsalicylic acid (aspirin)? A) Inhibiting prostaglandin synthesis in the central and peripheral nervous system B) Providing selective action by inhibiting prostaglandin synthesis in the CNS C) Inhibiting the release of norepinephrine to increase blood pressure D) Suppressing the function of the hypothalamus to decrease inflammation
A
3. A patient is seen in the primary care provider's office with complaints of polydipsia and polyuria without polyphagia. He has very edematous ankles, and his blood pressure is elevated. From which disorder of the adrenal cortex is the patient suffering? A) Hyperaldosteronism B) Adrenocortical hyperfunction C) Androgen-producing tumors D) Adrenal hyperplasia
A
5. A patient began taking acetylsalicylic acid (aspirin) several years ago to prevent platelet aggregation following a myocardial infarction. Which dose of aspirin is most likely appropriate for this patient? A) 80 mg B) 180 mg C) 325 mg D) 650 mg
A
7. A patient is being treated with corticosteroids for chronic adrenocortical insufficiency. When should the patient be instructed to take the medication? A) Between 06:00 and 09:00 B) 12:00 C) Between 13:00 and 14:00 D) 21:00
A
8. A patient is to be discharged on prednisone to be administered every other day at 9:00 AM. When implementing discharge teaching, what should the nurse explain as the rationale for giving the medication every other day? A) It reduces adverse effects. B) It prolongs therapeutic effects. C) It prevents steroid tolerance. D) It increases effectiveness.
A
9. A child is prescribed therapy with glucocorticoids. The child is placed on alternate-day therapy. What is the advantage of altemate-day therapy in this child? A) The child will have less chance of infection. B) It will protect the child from hyperglycemia. C) The child will have less chance of hypertension. D) Adherence will be increased.
A
12. A patient is admitted with an acute asthma attack. He has been using inhaled corticosteroids two times daily. Based on this information in the patient's history, what should you anticipate will be required in his care? A) The patient will require an antibiotic to treat infection. B) The patient will require high doses of systemic drugs. C) The patient will need to be treated with an oral opioid. D) The patient will have diminished tidal volume after treatment.
B
13. A patient is allergic to acetylsalicylic acid (aspirin). Which of the following medications is contraindicated due to cross-hypersensitivity reactions? A) Acetaminophen (Tylenol) B) Naproxen sodium (Naprosyn) CO Morphine sulfate (MS Contin) D) Naloxone (Narcan)
B
15. A patient enters the emergency room with complaints of visual changes, drowsiness, and tinnitus. The patient is confused and hyperventilating. These symptoms may be attributable to which of the following? A) Acute acetaminophen toxicity B) Salicylism C) Ibuprofen overdose D) Caffeine overdose
B
16. A patient is admitted to the emergency department with a suspected overdose of acetaminophen (Tylenol). What adverse effect is most common in acute or chronic overdose of acetaminophen (Tylenol)? A) Nephrotoxicity B) Hepatotoxicity C) Pulmonary insufficiency D) Pancreatitis Ans:
B
18. A patient is diagnosed with salicylate overdose. Which of the following medications will be administered for the treatment of salicylate overdose? A) Intravenous meperidine (Demerol) в) Intravenous sodium bicarbonate C) Intravenous furosemide (Lasix) D) Inhaled acetyleysteine (Mucomyst)
B
2. A patient suffers from pain in the elbow related to inflammation. What are the chemical mediators of inflammation? A) Insulin, thyroid hormone, and calcitonin B) Bradykinin, histamine, and leukotrienes C) Phospholipids, arachidonic acid, and platelets D) Red blood cells, lymph, and serosa
B
20. A nurse is conducting a medication reconciliation for a 79-year-old man who has just relocated to the long-term care facility. The nurse notes that the man has been taking colchicine (Colerys) on a regular basis. This aspect of the man's medication regimen should signal the nurse the possibility that he has a diagnosis of A) osteoarthritis. B) gout. C) inflammatory bowel disease. D) bursitis or tendonitis.
B
3. The nurse is preparing to administer gentamicin (Garamycin) to a patient when he mentions that he has recently been experiencing diminished hearing. What action should the nurse take based on this statement? A) Administer the dosage and notify the physician of the alteration in hearing. B) Hold the dosage and notify the physician of the alteration in hearing. C) Administer the dosage and report the alteration in hearing to the audiologist. D) Hold the dosage and document the finding in the nurses' notes.
B
8. A patient is taking ibuprofen (Motrin) for knee pain. The patient is admitted to the hospital with abdominal pain. Which of the following assessments should the nurse prioritize? A) Assessment for diarrhea B) Assessment for occult blood in the patient's stool C) Assessment of the patient's urine for hematuria D) Assessment for hemoptysis
B
9. A child has symptoms of influenza, including a fever. Which of the following medications should not be administered to the child because of the risk of Reye's syndrome? A) Acetaminophen (Tylenol) B) Acetylsalicylic acid (aspirin) C) Ibuprofen (Motrin) D) Ascorbic Acid (vitamin C)
B
1. A patient is in the admission department prior to outpatient surgery, and she states that she is exceptionally nervous. Which of the following actions increases this patient's stress-related release of cortisol? A) Negative feedback mechanism B) Stimulation of the hypothalamus C) Release of epinephrine and norepinephrine D) Atrophy of the adrenal cortex
C
11. A patient has long-standing pain in her right hip, and the orthopedic surgeon has prepared an intra-articular injection. How long will it take for the patient to see improvement in her pain and mobility? A) Approximately 10 days B) I to 3 weeks C) 2 to 8 weeks D) I to 4 months
C
12. An elderly patient has taken ibuprofen (Motrin) 800 mg two times per day for the past 3 years. Which of the following laboratory tests is the priority assessment? A) Renin and aldosterone levels B) 24-hour urine for microalbumin C) Blood urea nitrogen and serum creatinine D) Complete blood count
C
14. A patient with osteoarthritis has been prescribed meloxicam (Mobic). Which of the following instructions should the patient be given? A) Take the medication with orange juice. в) Crush enteric-coated tablets to aid swallowing. C) Take the medication with food. D) Take the medication at bedtime.
C
16. An adult patient has been taking oral prednisone for the treatment of an acute dermatological condition. When teaching this patient about this course of treatment, what teaching point should the nurse emphasize? A) The need to supplement prednisone with high doses of vitamin D B) The need to avoid drinking grapefruit juice for the duration of treatment C) The importance of gradually reducing rather than abruptly stopping the drug D) The importance of matching each day's dose to the severity of symptoms
C
17. A patient has questioned why she cannot stop taking her prescribed corticosteroid as soon as she achieves relief of her symptoms. The nurse should explain the rationale for the patient's regimen based on which of the following? A) The serum half-life of many corticosteroids can exceed 3 months. B) Corticosteroids are sequestered in hepatocytes and released over several weeks. C) The HPA axis does not normally resume full function for several months. D) Abrupt cessation of corticosteroid therapy can cause nephrotoxicity.
C
2. A patient is diagnosed with an adrenal tumor. With which of the following abnormalities of the adrenal gland will the patient most likely be diagnosed? A) Primary adrenocortical insufficiency в) Secondary adrenocortical insufficiency C) Adrenocortical hyperfunction D) Hyperaldosteronism
C
6. A 50-year-old male is admitted to the emergency room with a head injury after a motorcycle crash. He is unconscious with one eye dilated and one constricted. He has a widened pulse pressure. What corticosteroid will most likely be administered parenterally? A) Cortisone B) Prednisone C) Dexamethasone (Decadron) D) Fluticasone (Flonase)
C
6. A patient is suffering from bursitis in the right elbow. Which of the following orally administered medications is most likely to diminish inflammation and assist in relieving pain? A) Acetaminophen (Tylenol) B) Morphine sulfate C) Acetylsalicylic acid (aspirin) D) Codeine
C
7. A patient is diagnosed with familial adenomatous polyposis. Which of the following nonsteroidal anti-inflammatory agents has the potential to reduce the number of polyps and decrease the risk of colon cancer? A) Ibuprofen (Motrin) B) Nabumetone (Relafen) C) Celecoxib (Celebrex) D) Probenecid (Benemid)
C
11. A patient is admitted to a neurological unit with a confirmed cerebrovascular bleed. Which of the following medications used to treat inflammation is contraindicated in this patient? A) Furosemide (Lasix) B) Hydrochlorothiazide with triamterene C) Digoxin (Lanoxin) D) Ketorolac (Toradol)
D
15. A patient who is receiving chemotherapy is administered a corticosteroid agent. What is the mostly likely intended effect of this drug administration? A) Increased pulmonary function B) Decreased diarrhea C) Decreased infection susceptibility D) Decreased nausea
D
20. A 22-year-old male patient has been living with Crohn's disease for several years and is experiencing an exacerbation of symptoms. The nurse should anticipate the use of what corticosteroid? A) Oral fludrocortisone (Florinef) B) Topical hydrocortisone C) Oral dexamethasone (Decadron) D) Oral prednisone
D
4. A patient is receiving hydrocortisone 40 mg PO daily for treatment of severe autoimmune inflammation. Which of the following nursing interventions is most important to implement? A) Increase dietary sodium. в) Limit dietary protein. C) Assess BUN and creatinine regularly. D) Implement infection control measures.
D
4. When acetylsalicylic acid (aspirin) is administered in low doses, it blocks the synthesis of thromboxane A. What physiological effect results from this action? A) Inflammation is relieved. B) Core body temperature is reduced. C) Pain is relieved. D) Platelet aggregation is inhibited.
D
5. A male patient has been on chronic corticosteroid therapy for several years and has been scheduled for colonoscopy. How should the patient's corticosteroid therapy be altered to accommodate this impending stressful event? A) The patient should stop taking the corticosteroid 7 days prior to the procedure. B) The patient should continue taking the regular dose of his corticosteroid. C) The patient should temporarily change to IV administration of his corticosteroid. D) The patient should temporarily take a higher dose of his corticosteroid.
D
1. A patient is diagnosed with a fungal infection of the eye. What of the following medications is the most likely the cause of the fungal infection of the eye? A) Ophthalmic corticosteroid B) Systemic antibiotic agent C) Mydriatic D) Saline ophthalmic drops
a
10. A patient is being treated for a fungal infection with IV amphotericin B. In order to prevent drug discomfort, the nurse should consistently monitor the patient's levels of A) sodium. B) hemoglobin. C) calcium. D) leukocytes
a
10. The family members of a geriatric patient are angered that she has been colonized with methicillin-resistant Staphylococcus aureus during her stay in the hospital. The nurse should explain what characteristic of colonization to the members of the family? Page 3 A) The bacteria are present but are not causing infection. B) The bacteria are causing an infection, but the infection is not spreading. C) The bacteria are causing tissue injury at the site of colonization. D) The bacteria are spreading within a clearly defined body region.
a
14. A nurse is preparing to administer a patient's first scheduled dose of tetracycline. The nurse should first ensure that the patient has not recently eaten A) dairy products. B) leafy green vegetables. Page 4 C) any high-fat foods. D) acidic foods.
a
14. A patient has been ordered a fentanyl patch known as Duragesic for chronic pain. What patient teaching should be provided to the patient and family? A) Remove the patch every 3 days. B) Apply it to the chest only. C) Apply it for breakthrough pain. D) Remove it daily and clean skin.
a
14. A patient with an autoimmune disorder has just been prescribed a synthetic drug. Which of the following characteristics is a noted advantage of synthetic drugs? A) Synthetic drugs are less likely to cause an allergic reaction than naturally occurring substances. B) Synthetic drugs typically require less frequent dosing than naturally occurring substances. C) Synthetic drugs are normally available on an over-the-counter basis. D) Synthetic drugs are available in a wider variety of administration routes than naturally occurring substances.
a
15. A patient has been brought to the emergency department by ambulance, and his friend states that he has overdosed on methadone, a long-acting opioid. The care team is preparing to administer the appropriate antidote, naloxone, which has a shorter half-life than methadone. What are the implications of this aspect of pharmacokinetics? A) Repeated doses of naloxone will likely be necessary. B) A different antidote will be required after the serum level of naloxone decreases. C) An increased dose of naloxone will be required. D) The antidote is unlikely to have a therapeutic effect on the patient's symptoms.
a
15. A patient has informed the nurse that he has begun supplementing his medication regimen with a series of herbal remedies recommended by his sister-in-law. Which of the following is the most important nursing responsibility regarding herbal supplements? A) Research for potential interactions with medications. B) Instruct the patient to discontinue them if taking prescription medications. C) Instruct the patient to take the supplements 1 hour before prescription medications. D) Instruct the patient to take the supplements 3 hours after prescription medications
a
15. An older adult who resides in a long-term care facility has been diagnosed with oral candidiasis (thrush). When considering factors that may have contributed to this health problem, the nurse should prioritize which of the following? A) The resident recently completed a course of broad-spectrum antibiotics. B) The resident takes metformin for the treatment of type 2 diabetes. C) The resident has been using OTC skin emollients several times a day. D) The resident was immunized against the influenza virus 1 week ago.
a
15. When participating in the care of a patient who is being treated with antimicrobials, the nurse can promote the appropriate use of these medications in which of the following ways? A) Encouraging the use of narrow-spectrum, rather than broad-spectrum, antibiotics B) Promoting the use of prophylactic antibiotics for patients possessing risk factors for infection C) Initiating empiric therapy for all older adult patients admitted to a health care facility D) Promoting the use of herbal treatment for infection rather than antimicrobial drugs
a
18. A hospital patient has been prescribed ciprofloxacin IV for the treatment of cellulitis. After initiating the infusion of the patient's first scheduled dose, the patient develops a pronounced rash to her chest and arms. How should the nurse respond to this event? A) Discontinue the infusion and inform the care provider promptly B) Slow down the rate so that the infusion takes place over 2 hours C) Administer oral diphenhydramine to the patient during the infusion D) Administer a STAT dose of acetylcysteine
a
2. A pediatric nurse practitioner has diagnosed a 4-year-old girl with otitis media. The nurse should understand that infectious microorganisms likely entered the girl's middle ear by what means? A) Through an alteration in the eustachian tube B) Through the external ear C) From within the cochlea or vestibule D) From the interstitial spaces in the middle ear
a
3. A patient is administered an oral contraceptive. Which of the following is the process that occurs between the time the drug enters the body and the time that it enters the bloodstream? A) Absorption B) Distribution C) Metabolism D) Excretion
a
3. A patient is to be administered an immunization. The serum contains aluminum phosphate. What route is most appropriate to administer this immunization? A) Intramuscularly B) Subcutaneously C) Intravenously D) Orally
a
4. A patient being treated for tuberculosis is determined to be drug resistant. Which of the following medications will the patient be resistant to in the treatment of the tuberculosis? A) Isoniazid (INH) and rifampin B) Carbamazepine (Tegretol) and phenytoin (Dilantin) C) Dextroamphetamine (Dexedrine) and doxapram (Dopram) D) Propranolol (Inderal) and sotalol (Betapace)
a
4. A patient has been prescribed an oral penicillin for an infection caused by gram-negative bacilli. When conducting health education for this patient, the nurse should emphasize which of the following? Page 1 Chapter 18- Drug Therapy With Beta-Lactam Antibacterial Agents A) The need to take the medication on an empty stomach B) The fact that a mild rash frequently follows the first few doses C) The need to increase fluid intake for the duration of treatment D) The fact that the drug should be discontinued once symptoms subside
a
5. A nurse has called an elderly patient's surgeon to question the order for meperidine hydrochloride (Demerol) for pain control. The nurse's action is prompted by the possibility of what adverse effect associated with the use of Demerol in older adults? A) Confusion B) Blood dyscrasias C) Gastrointestinal bleeding D) Hepatotoxicity
a
6. A patient is predicted to benefit from dexamethasone eye drops. The presence of what eye disorder would contraindicate the use of this drug? A) Fungal infection B) Nearsightedness C) Cataracts D) Bacterial conjunctivitis
a
8. A nurse is teaching a patient about her prescription for Tylenol #3 that she will take at home. This medication consists of acetaminophen and what other drug? A) Codeine B) Acetylsalicylic acid (aspirin) C) Methadone (Dolophine) D) Tramadol (Ultram)
a
8. A patient is receiving gentamicin (Garamycin) to treat meningitis. The physician has ordered a peak serum level be drawn in association with the 07:00 dose, which will finish infusing at 07:30. When should the peak serum level be drawn? A) 08:00 B) 09:00 C) 10:00 D) 12:00
a
9. An adult patient has been assessed in the emergency department and diagnosed with necrotizing otitis externa. The primary care provider has prescribed ciprofloxacin. In preparation for administering this medication, what action should the nurse perform? A) Establish intravenous access. B) Remove as much cerumen as possible from the patient's ear canal. C) Flush the affected ear with warmed sterile water. D) Establish a sterile field around the perimeter of the ear
a
A 16-year-old has been brought to the emergency department by his football coach after twisting his ankle during a practice drill. Diagnostic testing reveals a fracture. This patient is experiencing what type of pain? A) Acute somatic pain B) Acute cutaneous pain C) Visceral pain D) Neuropathic pain
a
A 30-year-old male patient has been ordered Demerol 75 mg IM every 4 hours after a fractured femur. What action should the nurse take? A) Give the medication as ordered. B) Administer half the dose. C) Call the physician for a smaller dose. D) Give the dose by mouth.
a
1. A surgical patient has highly elevated AST and ALT levels. Standard orders specify that she is to receive morphine sulfate 10 mg postoperatively. What action should the nurse take prior to administering the medication? A) Draw up half of the medication for administration. B) Notify the physician for a reduced dosage. C) Assess the patient's respiratory status. D) Assess the patient's pain tolerance.
b
1. An infant is being administered an immunization. Which of the following provides an accurate description of an immunization? A) It should be administered to a pregnant woman prior to the infant's birth. B) It is the administration of an antigen for an antibody response. C) It produces many adverse reactions, particularly autism, in the infant. D) It protects the infant from exposure to infectious antibodies.
b
10. A nurse is administering eye drops of two different drugs to a patient. How long should the nurse wait between the instillation of the first medication and the second medication? A) At least 1 minute B) At least 5 minutes C) At least 15 minutes D) At least 20 minutes
b
10. A patient is administered a sulfonamide for a urinary tract infection. Which of the following nursing interventions is most appropriate to increase the alkalinity of the patient's urine? A) Provide at least 2000 mL of water daily. B) Administer sodium bicarbonate. C) Recommend a tub bath every evening. D) Provide orange juice daily.
b
11. A nurse has informed the laboratory technician that a patient's gentamicin has finished infusing and the technician will soon draw a blood sample to determine the patient's serum drug concentration. Why is assessment of gentamicin levels necessary? A) To identify possible changes in the patient's serum osmolality B) To identify whether the drug is at a therapeutic level C) To identify whether the drug is causing hepatotoxicity D) To identify possible hemolysis following administration
b
14. A resident of a long-term care facility was referred to an outpatient ophthalmology clinic for assessment, and the nurse has received the clinical report. The nurse reads that the resident's intraocular pressure was elevated above clinical norms. The nurse should recognize that the resident is at risk of A) cataracts. B) glaucoma. Page 4 C) myopia. D) conjunctivitis.
b
14. An influenza outbreak has spread through a long-term care residence, affecting many of the residents with severe malaise, fever, and nausea and vomiting. In an effort to curb the outbreak, the nurse has liaised with a physician to see if residents may be candidates for treatment with what drug? A) Saquinavir mesylate B) Oseltamivir phosphate C) Lamivudine D) Ribavirin
b
16. Nonopioid analgesics may sometimes be added to a narcotic analgesic. What action will result? A) Antagonism B) Additive effect C) Interference D) Increased excretion
b
17. A nurse who provides care on a postsurgical unit frequently administers Schedule II drugs to patients. Which of the following aspects of administering these drugs falls under the auspices of the Drug Enforcement Agency? A) Performing a thorough patient assessment prior to administration B) Recording each dose administration on an agency narcotic sheet C) Informing patients of the potential risks and benefits of Schedule II drugs prior to the first dose D) Assessing the patient shortly after administration to ensure therapeutic effect
b
18. A patient with traumatic injuries describes his current pain as being "unbearable." The pathophysiology of pain begins with a signal from A) myelin sheaths. B) nociceptors. C) baroceptors. D) synapses.
b
19. A hospital nurse is vigilant in ensuring the safe use of medications and consistently applies the rights of medication administration. Which of the following is one of the traditional rights of medication administration? A) Right to refuse B) Right route C) Right education D) Right evaluation
b
2. A patient has been prescribed an antibiotic. This medication is a naturally occurring substance that has been chemically modified. What is another name for this type of medication? A) Synthetic drug B) Semisynthetic drug C) Biotechnology drug D) Prototype drug
b
2. A patient has edema of the lower extremities and abdomen. What is the reason for administering a stronger diuretic than a thiazide diuretic to this patient? A) A thiazide diuretic will reabsorb potassium in the distal tubule. B) A thiazide diuretic will be ineffective for immediate diuresis. C) A thiazide diuretic will provide peak effects in 2 hours. D) A thiazide diuretic will be excreted in more than 72 hours.
b
20. A nurse is preparing to administer an intramuscular injection of an older adult's seasonal influenza vaccination. What size needle should the nurse use to administer the injection? A) 16 gauge B) 20 gauge C) 24 gauge D) 28 gauge
b
3. A hospice patient has been ordered morphine (Roxanol) 5 mg sub-Q every 2 hours. Roxanol contains 10 mg/mL. How many milliliters will be administered? A) 0.25 mL B) 0.5 mL C) 1 mL D) 2 mL
b
3. A patient has a foreign body in the right eye. What medication will most likely be administered before removal of the foreign body? A) Cortisporin ointment B) Proparacaine eye drops C) Cephalosporin orally D) Atropine eye drops
b
3. A patient is seen in the clinic after a bite from a tick. She has a rash over her arms and legs and arthritic pain in the joints. What is the drug of choice for Lyme's disease? A) Ibuprofen (Motrin) B) Tetracycline (Sumycin) C) Phenazopyridine (Pyridium) D) Nitrofurantoin (Macrodantin)
b
3. A patient with burns has developed a wound infection. This patient is experiencing what type of wound infection? A) Fungal infection B) Opportunistic infection C) Nosocomial infection D) Food-borne infection
b
4. A patient who suffers from cancer pain is receiving morphine every 2 hours. For iwhich of the following should the family be taught to assess while the patient is on morphine? A) Diarrhea B) Respiratory depression C) Lung sounds D) Urinary incontinence
b
5. A patient has sustained a burn from a gas grill. She has been prescribed a sulfonamide to prevent a burn infection. What route is preferred in the prevention of a burn infection? A) Intrathecal B) Topical C) Parenteral D) Oral
b
5. A patient who was frequently homeless over the past several years has begun a drug regimen consisting solely of isoniazid (INH). What is this patient's most likely diagnosis? A) Active tuberculosis B) Latent tuberculosis C) Mycobacterium avium complex D) Human immunodeficiency virus
b
6. A nursing student is scheduled to receive the hepatitis B series. What type of immunity will this immunization provide? A) Active immunity B) Passive immunity C) Innate immunity D) Natural immunity
b
6. The administration of anabolic steroids is regulated by which of the following laws? A) The Food, Drug, and Cosmetic Act of 1938 B) The Comprehensive Drug Abuse Prevention and Control Act C) The Harrison Narcotic Act D) The Shirley Amendment
b
7. A patient has a genitourinary infection and is being treated with a fluoroquinolone. What is the advantage of a fluoroquinolone over an aminoglycoside? A) The fluoroquinolone does not have adverse effects. B) The fluoroquinolone can be given orally. Page 2 C) The fluoroquinolone has a nearly immediate peak. D) The fluoroquinolone has a broader spectrum.
b
7. A patient has been administered an opioid. For which of the following effects should the patient be assessed? A) Oliguria B) Decreased level of consciousness C) Edema D) Tachycardia
b
7. A patient has presented to the emergency department after suffering a severe laceration to his hand in a workplace accident. During the subsequent process of acute inflammation, what physiological event took place first? A) The patient's B cells produced antibodies. Page 2 B) The patient's blood vessels constricted. C) Neutrophils migrated to the injury site. D) Opsonization occurred.
b
7. A patient is administered a third-generation cephalosporin. Which of the following microorganisms are cephalosporins most effective in treating? A) Gram-positive B) Gram-negative C) Fungi D) Virus
b
7. A patient receiving isoniazid (INH) and rifampin (Rifadin) has a decreased urinary output and decreased sensation in his great toes. Which laboratory values should be assessed? A) Hematocrit and hemoglobin B) ALT and AST C) Urine culture and sensitivity D) Erythrocyte count and differential
b
7. The nurse has measured a patient's capillary blood glucose and is preparing to administer NPH insulin. Which of the following actions should the nurse perform? A) Administer intramuscularly. B) Rotate the liquid. C) Vigorously shake the vial. D) Administer intradermally.
b
9. A nurse is aware that the dosing scheduling of a patient's new medication takes into account the serum half-life of the drug. What is the serum half-life of a medication? A) The time required for IV medications to penetrate the brain tissue B) The time needed for the serum level to fall by 50% C) The safest margin to prevent toxicity D) The dose adjustment that reduces the risk of adverse effects by one half
b
1. A patient is prescribed acyclovir (Zovirax) for the treatment of genital herpes. What is the expected outcome of this medication? A) Decreased testosterone production B) Decreased libido C) Decreased viral shedding D) Decreased bacterial replication
c
1. A young boy has just returned home from his family's tropical vacation and is now complaining of worsening tenderness in his right ear. He is subsequently diagnosed with otitis externa. What causative factor of this infection should the nurse suspect? A) Immunocompromised state resulting from sleep deprivation while on vacation B) The potential for foodborne pathogens ingested while on vacation C) Frequent swimming and water sports while the boy was on vacation D) Ear trauma related to pressurization and depressurization while flying
c
11. A patient is administering eye drops. What should the patient be taught in order to Page 3 decrease systemic absorption of eye drops? A) Lie supine for 1 minute after instillation. B) Apply pressure for 2 minutes over the tear duct. C) Apply pressure for 5 minutes over the tear duct. D) Remain still for 10 minutes after instillation
c
13. A 4-month-old baby has been brought to the emergency department by her parents, and initial assessment is highly suggestive of bacterial meningitis. Consequently, the baby has been admitted, and empiric antibiotic therapy has been ordered. The nurse should understand what characteristic of this infant's current treatment plan? Page 4 A) Success or failure of treatment will not be apparent for several weeks. B) The infant will receive aggressive treatment with a narrow-spectrum antibiotic. C) Culture and sensitivity results of the infant's cerebrospinal fluid are still pending. D) The infant is suspected of having an antibiotic-resistant infection.
c
13. A nurse is providing health education about the way the normal intraocular pressure (IOP) is maintained. The nurse should explain that normal IOP results from which of the following? A) Consistent production and resorption of tears B) Consistent feedback from baroreceptors located throughout the retina C) A balance between production and drainage of aqueous humor D) Two-way interaction between the medulla oblongata and the eye
c
18. A nurse is providing care for a patient who is on the third day of her prescribed course of ciprofloxacin eye drops. The nurse should conclude that this patient most likely has a diagnosis of what health problem? A) Astigmatism B) Cataracts C) Conjunctivitis D) Increased IOP
c
18. Numerous residents of a long-term care facility have developed Clostridium difficile- associated diarrhea over the past week. The nurses at this facility would anticipate that many residents would require which of the following drugs? A) Linezolid (Zyvox) B) Daptomycin (Cubicin) C) Metronidazole (Flagyl) D) Chloramphenicol (Chloromycetin)
c
18. The nurse is providing care for a patient who is taking isoniazid and rifampin (Rifadin) for the treatment of active tuberculosis. The patient should be taught that an improvement in symptoms will likely be noticed within A) 48 hours. B) a week to 10 days. C) 2 to 3 weeks. D) 4 to 6 weeks.
c
2. A patient is scheduled to receive an immunization. In which of the following patients may the administration of a live vaccine be contraindicated? A) Patient with renal insufficiency B) Patient with hepatic failure C) Patient taking steroid therapy D) Patient over the age of 65 years
c
2. A patient states that his eyes are "watering" excessively, and he claims that he has a gritty feeling of the eye. What common eye disorder is suspected? A) Hordeolum B) Blepharitis C) Conjunctivitis D) Glaucoma
c
4. 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? A) Low-dose enteric-coated ASA B) Metoprolol (Lopressor) C) Digoxin (Lanoxin) D) Vitamin D
c
4. A patient is given Abelcet instead of amphotericin B. What is the advantage of Abelcet Page 1 Chapter 24- Drug Therapy for Fungal Infections over amphotericin B? A) It is a newer medication with a lower cost. B) It is the same as amphotericin B in hepatotoxicity. C) It reaches higher concentration in diseased tissue. D) It constricts afferent renal arterioles to reduce blood flow.
c
5. A patient is admitted to the surgical division after a mastectomy. The patient has a PCA pump and states to you that she is fearful she will overdose on morphine. Which of the following interventions is most appropriate to teach the patient? A) "The pump will administer all of the doses, so you don't have to worry." B) "If you follow the instructions, that won't happen to you." C) "The device is preset, so you cannot receive more than you need." D) "The device will give you a placebo when you press it often."
c
7. A nurse is responsible for maintaining an accurate count and record of the controlled substances on the nursing unit. This nursing action is regulated by which of the following laws or agencies? A) Food, Drug, and Cosmetic Act of 1938 B) Public Health Service C) Drug Enforcement Administration D) Shirley Amendment
c
7. A patient is scheduled for an ophthalmic examination. Which of the following medications will be administered? A) Pseudoephedrine hydrochloride B) Epoetin alfa (Epogen) C) Phenylephrine D) Pilocarpine (Pilocar)
c
8. A nursing student is learning about the effects of bactericidal agents. How does rifampin (Rifadin) achieve a therapeutic action against both intracellular and extracellular tuberculosis organisms? A) It is metabolized in the liver. B) It binds to acetylcholine. C) It inhibits synthesis of RNA. D) It causes phagocytosis.
c
8. A patient with hypertension has been prescribed a combination diuretic. What is the major purpose in administering a combination diuretic agent? A) It prevents sodium imbalance. B) It is less expensive than two medications. C) It prevents potassium imbalance. D) It prevents allergic reactions.
c
9. The nurse is preparing to administer a vaccine to a newborn. Before administering the vaccine, the nurse should A) warm the vaccine to well above room temperature. B) vigorously massage the chosen injection site. C) check the infant's temperature. D) divide the dose for administration to three injection sites.
c
A patient is prescribed ophthalmic corticosteroids. What eye disorder may result from long-term use of ophthalmic corticosteroids? A) Conjunctivitis B) Hordeolum C) Glaucoma D) Blepharitis
c
5. The nurse is providing health education for the parents of a child whose otitis media has warranted treatment with Cortisporin Otic. The nurse should explain that this medication contains which of the following components? Select all that apply. A) An analgesic B) A topical anesthetic C) An antibiotic D) A steroid E) An immunomodulator
c, d
10. A patient who is being administered isoniazid (INH) for tuberculosis has a yellow color in the sclera of her eye. What other finding would lead you to believe that hepatotoxicity has developed? A) Diarrhea B) Numbness C) Diminished vision D) Light-colored stools
d
13. A young adult male who has had multiple sex partners in the preceding months has been diagnosed with hepatitis B virus (HBV) and begun treatment with lamivudine (Epivir). Shortly after beginning treatment, the man complains of a 24-hour history of intense abdominal pain. The nurse should recognize the possibility of what adverse effect of lamivudine therapy? A) Gastroenteritis B) Gastroesophageal reflux disease C) Bowel obstruction D) Pancreatitis
d
15. When providing patient teaching to parents regarding measles, mumps, and rubella vaccine administration, which of the following is most important regarding the schedule for administration? A) It is administered at 1 to 2 months. B) It is administered at 3 to 4 months. C) It is administered at 5 to 6 months. D) It is administered at 12 to 15 months.
d
4. A patient is diagnosed with multidrug-resistant tuberculosis. Which of the following Page 1 Chapter 19- Drug Therapy With Aminoglycosides and Fluoroquinolones aminoglycoside medications is used in a 4- to 6-drug regimen? A) Tetracycline hydrochloride (Achromycin) B) Amoxicillin (Amoxil) C) Sulfadiazine (Sulfisoxazole) D) Streptomycin (Sulfate)
d
4. An elderly man who is a resident of a skilled nursing facility develops methicillinresistant Staphylococcus aureus. What type of infection has this man developed? A) Community acquired B) Postoperative C) Sustained infection D) Nosocomial infection
d
6. A child's primary health care provider has prescribed Cortisporin Otic for a child who has otitis media in her right ear. What administration instructions should the nurse provide to the parents of the child? A) "Put one drop into her right ear each morning." B) "Place two drops in her right ear each morning and then again before bedtime." C) "Put one to two drops in her right ear whenever you notice discharge or she complains of pain." D) "Place three drops into her ear four times a day."
d
6. A patient has a gastrostomy tube, and the pharmacy has delivered an extended-release tablet. What is the most appropriate action taken by the nurse? A) Administer the medication orally. B) Administer the medication through the tube. C) Crush the medication and administer half of it at a time. D) Call the pharmacy to obtain an immediate-release form
d
6. A patient is taking spironolactone (Aldactone). When providing patient teaching about this medication, what foods should the patient be instructed to avoid? A) Fish B) Apples C) Crackers D) Bananas
d
8. A patient is being administered phenylephrine in an outpatient clinic. Which of the following conditions requires that phenylephrine be administered cautiously? A) Cataracts B) Hypothyroidism C) Diabetes mellitus D) Hypertension
d
8. An infant is seen in the clinic for her first immunizations. When providing patient teaching to the parent, which of the following is no longer recommended for administration? A) Rubella and mumps vaccine B) Polio vaccine C) Diphtheria, pertussis, and tetanus vaccine D) Smallpox vaccine Ans:
d
8. The nurse is providing care for a teenager with otitis media. When assessing the patient for potentially adverse effects of Cortisporin Otic, what question should the nurse ask? A) "Have you developed a fever since you started to use the ear drops?" B) "Have you been getting any headaches since you started taking the drops?" C) "Has there been any blood that you've noticed in your outer ear?" D) "Have you noticed any loss of hearing since you started taking the drops?"
d
9. A neonatal intensive care unit nurse is caring for an infant with RSV. What route of delivery will the nurse use when ribavirin (Virazole) is administered? A) Oral suspension B) Topical C) Intravenous D) Inhaled
d
A patient is near the end of life and has developed increased respiratory secretions and labored breathing. The physician is likely to order which of the following Page 3 medications to decrease these symptoms? A) Meclizine (Antivert) B) Ampicillin C) Naloxone (Narcan) D) Morphine sulfate
d
