Pharm 6
A patient is taking risperidone (Risperdal) for schizophrenia. Recognizing the adverse effects of risperidone, you advise the patient to monitor for and report which of the following? A. Tremor B. Weight loss C. Oral ulcers D. Bronchospasm
A. Tremor
A nurse cares for a client who takes clozapine. Which of the following should is recognize as a potential adverse effect? A. WBC count 300/mm3 B. Urine specific gravity 1.005 C. Temperature 100.2 F D. Guaiac positive stool
A. WBC count 300/mm3
A client with schizophrenia has been started on medication therapy with clozapine (Clozaril). A nurse assesses the results of which laboratory study to monitor for adverse effect related to this medication? A. White blood cell. B. Platelet count. C. Liver function studies. D. Random blood sugar.
A. White blood cell.
The patient tells the nurse he worries about everything all day, feels confused, restless, and just can't stop worrying. What is the best response by the nurse? A. You have generalized anxiety; I will teach you some relaxation techniques B. This sounds like social anxiety. You need to calm down and you'll be fine C. You have PTSD, and it is time for your therapy sessions D. This is called panic disorder. I'll get your medication for you.
A. You have generalized anxiety; I will teach you some relaxation techniques
Early clinical manifestations of lithium (Lithobid) toxicity include which of the following? (Select all that apply.) A. Seizures B. Nausea C. Hypotension D. Ataxia E. Muscle weakness
B and E
A nurse is giving instructions to a client taking risperidone (Risperdal). The nurse advise the client to which of the following? A. Take it on an empty stomach. B. Change position slowly. C. Get a daily source of sunlight. D. Discontinue medication once the symptoms went away.
B. Change position slowly.
People taking an MAO Inhibitor should avoid: A. Loud noise, bright lights, social activities B. Citrus fruit, hot peppers, spices C. Over exertion, sexual activity, heavy lifting D. Coffee, cheese, beans and chocolate
D. Coffee, cheese, beans and chocolate Rationale: Tyramine-rich foods should be avoided when taking MAO Inhibitors
You should instruct a patient who is taking tamoxifen (Soltamox) to treat breast cancer to watch for and report which of the following serious adverse effects of this drug? A. Abnormal menstrual bleeding B. Muscle pain and weakness C. Yellowing of skin and eyes D. Peripheral edema
A. Abnormal menstrual bleeding
The nurse is preparing to administer lithium, an antimania medication, to a client diagnosed with bipolar disorder. The lithium level is 1.4 mEq/L. Which action should the nurse implement? A. Administer the medication B. Hold the medication C. Notify the health-care provider D. Verify the lithium level
A. Administer the medication Lithium levels should be between 0.8 and 1.4 mEq/L
You are instructing a patient about taking phenelzine (Nardil) to treat depression. Which of the following foods should you tell the patient avoid? A. Aged cheese B. Milk C. Potato chips D. Candy
A. Aged cheese
A client is experiencing an anxiety attack, the nurse reviews the clients home medications and notes they take an antianxiety medication. Which of the following medications is this client likely to take? A. Alprazolam B. Alendronate C. Amiodarone D. Amitryptiline
A. Alprazolam
A client is complaining that all their signs and symptoms started when they started to take their antidepressant. The nurse notes that the client is on an SSRI. Which of the following complaints would the nurse associate with the client taking an SSRI? A. Anxiety B. Increased heart rate C. Sun sensitivity D. Blurred vision
A. Anxiety
When administering antineoplastic drugs, the nurse needs to keep in mind that the general adverse effects of these drugs include: (select all that apply) a. bone marrow suppression b. birth defects c. vomiting d. urinary retention e. nausea f. stomatitis
a, b, c, e, f
The nurse monitors very closely for signs of renal toxicity when which of these antineoplastic drugs is given? a. doxorubicin b. cisplatin c. bevacizumab d. mitotane
b. cisplatin
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 b. hemorrhagic c. peripheral neuropathy d. ototoxicity
b. hemorrhagic
When assessing a patient who will be receiving the MMR 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 mother accompanies her 12 month old child to the health clinic for his scheduled immunizations. What statement by the mother would cause the nurse to question immunization administration at this visit? a. "My child has had a runny nose for the past week." b. "Joey hates getting these shots, it makes him so mad- watch yourself." c. "Joey had a slight temperature this morning but it went away after I gave him some Tylenol." d. "Last time Joey got a shot, his little thigh was red and sore afterwards for two days!"
c. "Joey had a slight temperature this morning but it went away after I gave him some Tylenol."
During a 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
During chemotherapy, the nurse will monitor the patient for which symptoms of stomatitis? a. indigestion b. severe vomiting and anorexia c. pain or soreness of the mouth d. diarrhea and perianal irritation
c. pain or soreness of the mouth
The newly hired nurse at Nurseslabs Medical Center is assessing a client who abuses barbiturates and benzodiazepine. The nurse would observe for evidence of which withdrawal symptoms? A. Anxiety, tremors, and tachycardia B. Respiratory depression, stupor, and bradycardia C. Muscle aches, cramps, and lacrimation D. Paranoia, depression, and agitation
A. Anxiety, tremors, and tachycardia
A nurse is administering RV, Dtap, Hib, PCV, and IPV vaccinations to a 4-month-old infant in an outpatient facility. Which of the following actions should the nurse plan to take? (Select all that apply) A. Administer oral vaccines before giving injectables B. Administer subcutaneous injections in the outer upper arm C. Administer IM injections in the deltoid muscle D. Teach parents to administer aspirin prior to vaccination to prevent inflammation
A and B
The client diagnosed with bipolar disorder is prescribed lithium (Eskalith), an antimania medication. Which interventions should the nurse discuss with the client? (Select all that apply) A. Monitor serum therapeutic levels B. Maintain an adequate fluid intake C. Decrease sodium intake in diet D. Do not take medication if the radial pulse is <60 E. Explain ways to prevent orthostatic hypotension
A and B
A patient who is addicted to heroin is seeking treatment in a methadone maintenance program. Which of the following describes appropriate use of methadone with treatment of opioid addiction? Select all that apply. A. The patient takes methadone in place of heroin B. The patient injects methadone in a manner similar to injecting heroin C. The patient takes methadone for a minimum of 24 hours D. The patient's methadone doses are managed through a clinic E. The patient may receive a prescription for methadone to fill at any pharmacy
A and D
You are instructing a school-age child and his parent about the use of amphetamine-dextroamphetamine (Adderall) to manage the child's attention-deficit hyperactivity disorder. You should tell the child and parent to watch for which of the following? (Select all that apply.) A. Weight loss B. Insomnia C. Hallucinations D. Orthostatic hypotension E. Flu-like symptoms
A, B, C
A patient is to start taking amitriptyline. For which of the following should the health care provider instruct the patient to monitor and report? (Select all that apply.) A. Blurred vision B. Urinary hesitancy C. Diarrhea D. Joint pain E. Tachycardia
A, B, E
Selective serotonin reuptake inhibitors include which of the following? (Select all that apply.) A. Fluoxetine B. Paroxetine C. Amitriptyline D. Nortriptyline E. Sertraline
A, B, and E
The nurse has completed group education for patients with anxiety disorders. The education is evaluated as successful when the patients make which statements? (select all that apply) A. Relaxation techniques will often decrease anxiety B. Anti-anxiety medications should be used until our anxiety is gone C. Anti-anxiety medications should not be used indefinitely D. We need therapy to learn where this anxiety comes from E. We need different medications for anxiety, and for difficulty in sleeping
A, C, D
You're about to administer cisplatin to a patient who has ovarian cancer. Before beginning the infusion, you should take which of the following actions? (Select all that apply.) A. Infuse 1 to 2 L of IV fluid. B. Check the patient's peripheral pulses. C. Administer an antiemetic. D. Evaluate the patient's hearing. E. Determine the patient's weight.
A, C, D, E
A nurse cares for a client who is receiving chlordiazepoxide to manage symptoms of alcohol withdrawal. Which of the following should indicate to the nurse a need for an additional dose. (Select all that apply.) A. Nausea B. Syncope C. Euphoria D. Tachycardia E. Hypertension F. Hallucinations
A, D, E, F These are symptoms of alcohol withdrawal, therefore an additional dose is needed
The physician has prescribed sertaline for the patient who is anxious and depressed. The patient called the nurse to report that he has experienced delayed ejaculation since being on the medication. What is the best response by the nurse? A. "I will let your doctor know, and he will most likely change your medication" B. "This does happen, but treating your depression is a bigger priority." C. "I am concerned that you will become suicidal if you stop the medication" D. "Keep taking the medication, as this usually goes away after a few months"
A. "I will let your doctor know, and he will most likely change your medication"
34. Nausea and vomiting are common adverse effects of radiation and chemotherapy. When should a nurse administer antiemetics? A. 30 minutes before the initiation of therapy. B. With the administration of therapy. C. Immediately after nausea begins. D. When therapy is completed
A. 30 minutes before the initiation of therapy.
The client receives cisplatin as therapy for cancer. Which assessment finding would prompt the nurse to contact the physician immediately? A. A temperature greater than 101ºF B. An elevated in blood glucose C. Nausea and projectile vomiting D. A complaint of leg cramps
A. A temperature greater than 101ºF
A nurse is giving instructions to a client receiving lithium citrate. The nurse tells the client to do which of the following to prevent lithium toxicity: A. Avoid becoming dehydrated during exercise. B. Instruct the client to change positions slowly. C. Restrict salt intake in the diet. D. Limit fluid intake.
A. Avoid becoming dehydrated during exercise.
A client is complaining that all their signs and symptoms started when they started to take their antidepressant. The nurse notes that the client is on a tricyclic antidepressant. Which of the following complaints would the nurse associate with the client taking a tricyclic antidepressant? A. Blurred vision B. Tremors C. Sweating D. Anxiety
A. Blurred vision
A patient is about to start taking mercaptopurine (Purinethol) to treat acute lymphocytic leukemia. You should instruct the patient to watch for and report which of the following indications of an adverse effect of this drug? A. Bruising B. Paresthesias C. Blurred vision D. Tinnitus
A. Bruising
The client who is a chronic alcoholic is admitted to the medical unit for pneumonia. Which medication would the nurse expect the health-care provider to prescribe to prevent alcohol withdrawal delirium? A. Chlordizaepoxide, a benzodiazepine B. Thiamine, a vitamin C. Disulfiram, an abstinence medication D. Fluoxetine, an antidepressant
A. Chlordizaepoxide, a benzodiazepine
Which of the following is the priority nursing diagnosis for a client undergoing chemotherapy? A. Decreased cardiac output B. Fear C. Altered nutrition D. Anxiety
A. Decreased cardiac output Decreased cardiac output is more important than the other choices because it can jeopardize the client's life.
A client is complaining that all their signs and symptoms started when they started to take their antidepressant. The nurse notes that the client is on a tricyclic antidepressant. Which of the following complaints would the nurse associate with the client taking a tricyclic antidepressant? A. Difficulty urinating B. Sweating C. Tremors D. Weight loss
A. Difficulty urinating
The cliet with non-hodgkins lymphoma is receiving Doxorubicin. Which of the following would indicate to the nurse that the client is experiencing an adverse effect related to the medication? A. Dysrhythmia. B. Weight loss. C. Nausea and vomiting. D. Peripheral neuropathy.
A. Dysrhythmia.
A nurse provides instructions to a client taking fluoxetine (Prozac) a selective serotonin reuptake inhibitors (SSRI) antidepressant. The nurse tells the client to take the medication: A. Early in the morning. B. During lunch time. C. At snack time. D. At bedtime.
A. Early in the morning.
The client diagnosed with a general anxiety disorder is prescribed alprazolam, a benzodiazepine. Which information should the clinic nurse discuss with the client? A. Explain to the client that this medication is for short-term use. B. Inform the client that rage and excitement are expected side effects C. Tell the client to avoid foods that are high in vitamin K D. Instruct the client to take the medication with at least 8 ounces of water
A. Explain to the client that this medication is for short-term use.
A client who has been taking buspirone (BuSpar) for two months returns to the clinic for a follow-up. The nurse determines that the medication is effective if there is an absent display of? A. Feelings of panic, fear, and uneasiness. B. Thought broadcasting or delusions. C. Paranoid and suicidal thought process. D. Alcohol withdrawal symptoms.
A. Feelings of panic, fear, and uneasiness.
Which of the following medications are Selective Serotonin Re-uptake Inhibitors? A. Fluoxetine B. Lorazepam C. Alprazolam D. Metoprolol
A. Fluoxetine
A client is to receive epoetin alfa injections. What laboratory value should the nurse assess before giving the injection? A. Hematocrit B. Partial thromboplastin time C. Hemoglobin concentration D. Prothrombin time
A. Hematocrit
The nurse is monitoring a client who abuses alcohol for signs of alcohol withdrawal. Which of the following would alert the nurse to the potential for delirium tremors? A. Hypertension, changes in LOC, hallucinations B. Hypotension, ataxia, hunger C. Stupor, agitation, muscular rigidity D. Hypotension, coarse hand tremors, agitation
A. Hypertension, changes in LOC, hallucinations
The patient has been receiving amitriptyline for 2 weeks. He tells the nurse he doesn't think this med is working, as he is still depressed. What is the best response by the nurse? A. It is working, but it can take several weeks to have an effect. B. You might still feel depressed, but you are looking much better C. That may not be the best medicine for you. I'll call your doctor D. It is working, but it can take several months to have an effect
A. It is working, but it can take several weeks to have an effect.
Fluoxetine and sertaline are what type of medication? A. Serotonin-Specific Agents B. Tricyclics C. MAO Inhibitors D. Neuroleptics
A. Serotonin-Specific Agents
Combination chemotherapy is used in the treatment of cancer because: A. Single-agent therapy produces cell lines that are resistant. B. Two drugs are more likely to work. C. Single-agent therapy requires larger doses for long remissions. D. Two cancers may be present.
A. Single-agent therapy produces cell lines that are resistant.
A client with depression who has been taking amitriptyline for three months returns to the clinic for a follow-up. The nurse looks to observe the client in which of the following symptoms? A. Suicidal thoughts. B. Lack of energy. C. Loss of interest in personal appearance. D. Neglect of responsibilities.
A. Suicidal thoughts.
The client receives tamoxifen for treatment of breast cancer. She asks the nurse why the medication works. What is the best response by the nurse? A. Tamoxifen works by blocking estrogen receptors on breast tissue B. Tamoxifen works by inhibiting the cellular mitosis of breast cancer C. Tamoxifen works by inhibiting the metabolism of breast cancer cells D. Tamoxifen works by binding to the DNA of breast cancer cells
A. Tamoxifen works by blocking estrogen receptors on breast tissue
The patient receives imipramine as treatment for depression. He is admitted to the emergency department following an intentional overdose of this medication. What will the best assessment by the nurse include? A. The patient's cardiac status B. The patient's liver function C. The patient's renal status D. The patient's neurological function
A. The patient's cardiac status
A patient is taking venlafaxine to treat major depression. Which of the following information should you include when instructing the patient and family about the use of venlafaxine? (Select all that apply.) A. Discontinue it immediately for increased depression. B. Take it with food to reduce gastric disturbances. C. Monitor and report insomnia. D. Have blood pressure checked regularly. E. Check with the provider before taking any herbal supplements.
B, C, D, E
The nurse is teaching a class on immunizations for women with newborns. The nurse evaluates that learning has occurred when the women make which statement? (select all that apply) A. The immunizations are more effective if they are given close together B. Our babies might have a mild fever and be fussy for a few days C. If our babies develop a fever, we must call the doctor immediately D. We can give acetaminophen if our babies have a mild fever E. If our babies develop a mild fever, it means an allergic reaction
B, D
The 24-year-old female client with bipolar disorder is prescribed valproic acid, an anticonvulsant medication. Which question should the nurse ask the client? A. "Have you ever had a migraine headache?" B. "Are you taking any type of birth control?" C. "When was the last time you had a seizure?" D. "How long since you have had a manic episode?"
B. "Are you taking any type of birth control?"
The client diagnosed with bipolar disorder is taking lithium (Eskalith), an anti mania medication. Which statement by the client warrants further clarification by the nurse? A. "I will limit the amount of caffeine I drink." B. "I really enjoy playing soccer on weekends." C. "I will drink at least 2000 mL of water a day." D. "I need to call my HCP if I develop diarrhea."
B. "I really enjoy playing soccer on weekends." Playing soccer or any sport that includes running can lead to dehydration, and the nurse must make sure the client understands the need to stay well-hydrated during the activity. Therefore, this comment indicates the need for further clarification by the nurse.
The client diagnosed with obsessive-compulsive disorder is prescribed the selective serotonin reuptake inhibitor (SSRI) sertraline. Which statement indicates the client understands the medication teaching? A. "If I get a headache or become nauseated, I will notify my HCP." B. "It will take a couple of months before I see a change in my behavior." C. "I need to be careful because SSRIs may cause physical addiction." D. "I am glad I do not need to go to my psychologist's appointments."
B. "It will take a couple of months before I see a change in my behavior."
While discharging a client, the nurse is educating the client on their newly prescribed medication diazepam (Valium), the client asks why he can't drink while taking this medication, the best responce by the nurse is? A. "If you drink alcohol and take Valium you are at an increased risk for an addiction problem." B. "When alcohol and Valium are mixed they can stop your breathing effort." C. "Because taking both can get you high." D. "Alcohol increases the clearance of Valium in your body, making the effects less."
B. "When alcohol and Valium are mixed they can stop your breathing effort."
A patient has received a prescription for sertraline (Zoloft) for treatment of depression. The nurse is educating the patient about what types of side effects he should look for when taking this medication. Which of the following statements by the nurse is correct? A. "This medicine will probably increase your blood sugar levels." B. "You may have an increase in anxiety when you take this medicine." C. "This medication is most likely to cause a low heart rate and low blood pressure." D. "The most common side effect that people see with this medication is blood in their stools."
B. "You may have an increase in anxiety when you take this medicine."
The nurse is reviewing a clients lab results. Which result for Lithium would the nurse know is therapeutic? A. 0.4 mEq/L B. 1.3 mEq/L C. 2.8 mEq/L D. 4.6 mEq/L
B. 1.3 mEq/L
A nurse is caring for several clients who came to the clinic for a seasonal influenza vaccination. Which of the following clients could receive the vaccine via nasal spray rather than the injection? A. A 1-year-old with no health problems B. A 17-year-old who has a hypersensitivity to penicillin C. A 25-year-old who is pregnant D. A 52-year old who takes a multivitamin supplement
B. A 17-year-old who has a hypersensitivity to penicillin Rationale: The nasal spray is a LIVE vaccine
For which client would the nurse expect the health-care provider to prescribe methadone, an abstinence medication? A. A client addicted to cocaine B. A client addicted to opioids C. A client addicted to amphetamines D. A client addicted to hallucinogens
B. A client addicted to opioids
To which client would it be most appropriate to prescribe disulfiram (Antabuse), an abstinence medication? A. A client with chronic alcoholism admitted to the medical unit B. A highly motivated client who wants to quit drinking alcohol C. A client who has been taking amphetamines for more than 1 year D. A highly motivated client who wants to quit taking heroin
B. A highly motivated client who wants to quit drinking alcohol
The patient comes to the ED and tells the nurse, "I have been off my drugs for 3 days." The nurse assesses the patient for withdrawal symptoms associated with the category of drug used. Withdrawal from which drug, if taken by the patient, should cause the nurse the most concern? A. Heroin B. Alprazolam C. Cocaine D. Marijuana
B. Alprazolam Rationale: At risk for seizures
The nurse would monitor for decreased effect of amphetamines when these drugs are given with: A. Caffeine B. Antidiabetic agents C. Tricyclic antidepressants D. All of the above
B. Antidiabetic agents
Enrique who is under chemotherapy has the following CBC results: WBC 5000/mm3, platelet 10,000/mm3. Which of the following is he at risk for? A. Infection B. Bleeding C. Angina D. None of the above
B. Bleeding
A 29-year-old patient is being seen for a diagnosis of schizophrenia. The physician has ordered an atypical anti-psychotic medication for disease management. Which best describes how this type medication works? A. By increasing the effects of gamma-aminobutyric acid (GABA) B. By acting on the neurotransmitters dopamine and serotonin C. By enhancing activity of the peripheral nervous system D. By interrupting function of the nerve cells in the brain to alter perception of reality
B. By acting on the neurotransmitters dopamine and serotonin
Ansherina who is receiving Risperidone complains that she is gaining weight. The nurse would: A. Be aware that this is probably delusional thinking because these agents cause weight loss. B. Encourage the client to follow a healthy diet to help stabilize her weight. C. Discuss a switch to a high-potency agent so the weight gain will not be a problem. D. Establish a contract with the client to carefully follow her high-calorie diet.
B. Encourage the client to follow a healthy diet to help stabilize her weight.
. Benzodiazipines generally have a low potential for dependency. A. True B. False
B. False
The nurse is providing teachings to a client receiving cyclophosphamide (Cytoxan). The nurse tells the client to which of the following? A. Eat foods rich in potassium. B. Increase fluid intake to 2-3 liters per day. C. Take the medication with food. D. Eat foods rich in purine.
B. Increase fluid intake to 2-3 liters per day
A severe allergic reaction to eggs is a contraindication for which vaccine? A. Inactivated Poliovirus (IPV) B. Influenza (TIV) C. Hep B D. Rotavirus (RV)
B. Influenza (TIV)
You are instructing a patient about taking buspirone. You inform the patient to monitor and report a paradoxical reaction to buspirone. Which of the following is a paradoxical effect of buspirone? A. Chest pain B. Insomnia C. Diaphoresis D. Fever
B. Insomnia
The client with a major depressive disorder taking the selective serotonin reuptake inhibitor (SSRI) fluoxetine (Prozac) calls the psychiatric clinic and reports feeling confused and restless and having an elevated temperature. Which action should the psychiatric nurse take? A. Determine if the client has flulike symptoms B. Instruct the client to stop taking the SSRI C. Recommend the client take the medication at night. D. Explain that these are expected side effects
B. Instruct the client to stop taking the SSRI Serotonin syndrome is a serious complication of SSRIs that produces mental changes (confusion, anxiety, and restlessness), hypertension, tremors, sweating, hyperpyrexia (elevated temperature), and ataxia. Conservation treatment includes stopping the SSRI and supportive treatment. If untreated, ESE can lead to death
A nurse is administering an antidepressant medication. The nurse knows which of the following types of antidepressant medications have adverse effects when combined with foods containing tyramine? A. TCAs B. MAOIs C. SNRIs D. SSRIs
B. MAOIs
The risk of experiencing serotonin syndrome when SSRI's are given with monoamine oxidase inhibitors such as phenelzine (Nardil). Serotonin syndrome is best characterized in which of the following? A. Hypotension and urinary retention. B. Muscle rigidity and high fever. C. A productive cough and vomiting. D. Tea-colored urine and constipation.
B. Muscle rigidity and high fever.
The client with non-Hodgkin's lymphoma is being managed with vincristine (Vincasar). Which of the following indicates a side effect specific to this medication? A. Alopecia. B. Numbness in the toes. C. Chest heaviness. D. Weight gain.
B. Numbness in the toes. A side effect specific to this medication is peripheral neuropathy. It can be manifested as numbness and tingling sensation in the finger and toes.
The nurse is monitoring the laboratory results of a male client receiving antineoplastic medications. The nurse plans to initiate bleeding precautions if which laboratory is value is noted? A. White blood cell count of 6,000/mm3. B. Platelet count of 45,000 cells/mm3 C. Clotting time of 8 minutes. D. Hemoglobin count of 15g/dl.
B. Platelet count of 45,000 cells/mm3
The client admitted to the psychiatric unit diagnosed with schizophrenia is prescribed clozapine (Clozaril), an atypical antipsychotic. Which laboratory data should the nurse evaluate? A. The client's clozapine therapeutic level B. The client's white blood cell count C. THe client's red blood cell count D. The client's arterial blood gases
B. The client's white blood cell count
The physician has prescribed haloperidol for the patient with schizophrenia. What is the priority patient outcome? A. The patient will consume adequate fluids and a high fiber diet B. The patient will be compliant with taking the medication as prescribed C. The patient will report a decrease in auditory hallucinations D. The patient will report symptoms of restlessness
B. The patient will be compliant with taking the medication as prescribed
A person newly begun on amitriptyline reports experiencing dry mouth, constipation and a feeling of lightheadedness when standing. Which is most true? A. These are probably a symptom of his or her disorder, not the medication. B. These side affects can be lessened with practice steps, such as sipping water, increasing dietary fiber, and moving more slowly when standing. C. These are dangerous side effects that indicate a more serious problem. The medication should be stopped immediately. D. The positive effects should be felt within a couple days and the negative side effects should disappear
B. These side affects can be lessened with practice steps, such as sipping water, increasing dietary fiber, and moving more slowly when standing.
A client taking lithium carbonate (Lithobid) started complaining of nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, blurred vision and ringing in the ears. The lithium level is 2 mEq/L. The nurse interprets this value as: A. Normal level. B. Toxic level. C. Below normal level. D. Above normal level.
B. Toxic level.
The best site to give an IM vaccine to an infant is: A. Deltoid B. Vastus Lateralis C. The fatty tissue behind the arm D. Dorsogluteal
B. Vastus Lateralis
To best monitor for therapeutic effects from filgrastim (Neupogen), the nurse will asses which of the following lab findings? A. Hgb and Hct B. WBC and ANC counts C. Serum electrolytes D. RBC count
B. WBC and ANC counts
Which information noted by the nurse reviewing the laboratory results of a patient who is receiving chemotherapy is most important to report to the health care provider? A. Hemoglobin of 10 g/L B. WBC count of 1700/µl C. Platelets of 65,000/µl D. Serum creatinine level of 1.2 mg/dl
B. WBC count of 1700/µl Neutropenia places the patient at risk for severe infection and is an indication that the chemotherapy dose may need to be lower or that white blood cell (WBC) growth factors such as filgrastim (Neupogen) are needed. The other laboratory data do not indicate any immediate life-threatening adverse effects of the chemotherapy.
A mother brings her child to the clinic for his last diphtheria-pertussis-tetanus (DPT) immunization. The mother tells the nurse that the child developed a red rash after the previous DPT immunization. What does the best action by the nurse include? A. Administer only a pertussis-tetanus immunization B. Withhold this immunization and contact the physician C. Tell the mother to give the child acetaminophen if another rash develops D. Administer diphenhydramine prior to the diphtheria-pertussis-tetanus immunization
B. Withhold this immunization and contact the physician
A chemotherapeutic agent known to cause alopecia is prescribed for a patient. To maintain the patient's self-esteem, the nurse plans to A. suggest that the patient limit social contacts until regrowth of the hair occurs. B. encourage the patient to purchase a wig or hat and wear it once hair loss begins. C. have the patient wash the hair gently with a mild shampoo to minimize hair loss. D. inform the patient that hair loss will not be permanent and that the hair will grow back.
B. encourage the patient to purchase a wig or hat and wear it once hair loss begins.
A nurse is caring for a patient who has developed an extravasation injury after infiltration of a vesicant into the tissue surrounding the IV site. Which of the following drugs could potentially cause extravasation? (Select all that apply). A. Methotrexate B. Topotecan C. Doxorubicin D. Vincristine E. Dactinomycin
C, D, E
The adolescent pt is in a drug rehab program. The mom of the pt says to the nurse, "the doctor said my son has a physical addiction to alcohol. What does this mean?" What is the best response by the nurse? A. "His brain remembers the euphoria he had with alcohol, and he has a craving to return to it" B. "He will have an intense craving for alcohol; this is best managed in group therapy" C. "His body is used to alcohol; he will have specific withdrawal symptoms when it is stopped" D. "He will have feelings of depression when stopping alcohol; we ned to monitor him for suicide."
C. "His body is used to alcohol; he will have specific withdrawal symptoms when it is stopped"
The client diagnosed with a major depressive disorder asks the nurse, "Why did my psychiatrist prescribe an SSRI medication rather than one of the other types of anti-depressants?" Which statement by the nurse would be most appropriate? A. "Probably it is the medication that your insurance will pay for" B. "You should ask your psychiatrist why the SSRI was ordered" C. "SSRIs have fewer side effects than the other classifications" D. "The SSRI medications work faster than the other medications"
C. "SSRIs have fewer side effects than the other classifications" SSRIs have the same efficacy as MAO inhibitors and tricyclics, but SSRIs are safer because they do not have the sympathomimetic effects (tachycardia and hypertension) and anticholinergic effects (dry mouth, blurred vision, urinary retention, and constipation) of the MAO inhibitors and tricyclics.
A client complains of getting an upset stomach when they take their Lithium. Which of the following should the nurse instruct the patient to do? A. "Take ondansetron to stop you from vomiting." B. "Stop taking the Lithium." C. "Take the Litium with meals" D. "Your dose may need to be adjusted."
C. "Take the Litium with meals"
A patient is being seen for treatment of depression after suffering from chronic back pain. The physician has prescribed Venlafaxine. The patient asks the nurse, "What kind of side effects does this medicine cause?" Which response from the nurse is correct? A. "You will mostly experience excessive daytime sleepiness, so do not take this before driving anywhere." B. "This medication often causes a fever and intense skin itching." C. "This might make you feel more irritable or it could increase your risk of worsening depression." D. "There are very few side effects associated with this drug."
C. "This might make you feel more irritable or it could increase your risk of worsening depression."
The mother of a 7-year old child says to the nurse. "My child is distractible in school, cannot complete assignments on time, and interrupts other children while they are speaking. What do you think?" What is the best response by the nurse? A. "This sounds like your child is depressed. Depression looks different in children and is very serious" B. "This sounds like bipolar disorder, you might want to have your child tested by a child psychiatrist." C. "This sounds like ADHD; you might want to have your child tested" D."This sounds like typical 7-year-old behavior to me; if they do not resolve, have your child tested"
C. "This sounds like ADHD; you might want to have your child tested"
Children are in a high-risk group for seasonal flu, and should be vaccinated yearly, starting at what age? A. Birth B. 3 months C. 6 months D. 1 year
C. 6 months
A client has undergone chemotherapy. Which of the following is not an expected side effect of chemotherapy? A. Hair loss B. Ulceration of oral mucous membranes C. Constipation D. Headache
C. Constipation
A nurse is giving discharge instructions to a client who is prescribed with isocarboxazid (Marplan). The nurse will tell the client to anticipate which of the following side effects of this medication? A. Weight loss. B. Dry skin. C. Dizziness. D. Fever.
C. Dizziness. MAOI's can cause orthostatic hypotension
You are caring for a patient who is about to begin taking oprelvekin (Neumega) for thrombocytopenia. To evaluate the potential for adverse effects, you should monitor which of the following during drug therapy? A. Liver function B. Hearing C. ECG D. Level of consciousness
C. ECG
The client diagnosed with major depression who attempted suicide is being discharged from the psychiatric facility after a 2-week stay. Which discharge intervention is most important for the nurse to implement? A. Provide the family with the phone number to call if the client needs assistance B. Encourage the client to keep all follow-up appointments with the psychiatric clinic C. Ensure the client has no more than a 7-day supply of antidepressants D. Instruct the client not to take any over-the-counter medications without consulting with the HCP
C. Ensure the client has no more than a 7-day supply of antidepressants Ensuring the psychological and physical safety of the client is priority. As antidepressant medications become more effective, the client is at a higher risk for suicide. Therefore, the nurse should ensure that the client cannot take an overdose of medication
Nurse Wilma is teaching a client about disulfiram (Antabuse), which the client is taking to deter his use of alcohol. She explains that using alcohol when taking this medication can result in: A. Abdominal cramps and diarrhea. B. Drowsiness and decreased respiration. C. Flushing, vomiting, and dizziness. D. Increased pulse and blood pressure.
C. Flushing, vomiting, and dizziness.
Which of the following medications would be classified as an antipsychotic medication? A. Methylphenidate B. Secobarbital C. Haloperidol D. Alprazolam
C. Haloperidol
A nurse is caring for a patient who was diagnosed with depression and anxiety 3 years ago. The patient currently has prescriptions for 4 different medications for control of symptoms. Which nursing intervention is most appropriate to reduce the risks associated with taking many different medications in this situation? A. Tell the patient that he should never take over-the-counter medications when using this many prescription drugs B. Make an appointment for the patient to meet with a dietitian to discuss the nutritional effects of taking this many drugs C. Help the patient to organize the medications and make a list of their uses and side effects D. Have the patient contact the physician and ask to be changed to an all-in-one drug instead of taking 4 different kinds
C. Help the patient to organize the medications and make a list of their uses and side effects
You're administering cyclophosphamide and mesna (Mesnex) to a patient. Mesna, a chemoprotective agent, helps prevent which of the following adverse reactions to cyclophosphamide? A. Retinopathy B. Seizure activity C. Hemorrhagic cystitis D. Cardiotoxicity
C. Hemorrhagic cystitis
The client is discussing wanting to quit smoking cigarettes with the clinic nurse. Which intervention is most successful in helping the client to quit smoking cigarettes? A. Encourage the client to attend a smoking cessation support group B. Discuss tapering the number of cigarettes smoked daily C. Instruct the client to use nicotine replacement therapy, such as a patch D. Explain that clonidine can be taken daily to help decrease withdrawal symptoms
C. Instruct the client to use nicotine replacement therapy, such as a patch
Sheila who has been on a low-potency antipsychotic, such as Haloperidol, for 2 weeks has shown minimal response. The most probable explanation is: A. The client probably has refractory illness. B. The client needs a stronger medication. C. It is too early to see a full therapeutic response. D. The client is definitely not taking the medication.
C. It is too early to see a full therapeutic response
A client is receiving Methotrexate for a series of chemotherapy. Which of the following medication should be readily available to avoid toxicity? A. Mesna B. Vigabatrin C. Leucovorin D. Oseltamivir
C. Leucovorin
As a knowledgeable nurse, you know that you should never give amphetamines in combination with: A. Oral hypoglycemics B. Insulin C. MAO inhibitors D. Antihypertensives
C. MAO inhibitors
During an assessment of a patient taking chlorpromazine, the provider notes a slow shuffling gait, rigid facial expression, and fine tremors. The provider recognizes this as which of the following? A. Acute dystonia B. Tardive dyskinesia C. Parkinsonism D. Akathisia
C. Parkinsonism
During a hypertensive crisis, the nurse make sure which of this medicine is readily available? A. Lithium citrate. B. Diazepam. C. Phentolamine. D. Phenobarbital sodium.
C. Phentolamine.
The client with bipolar disorder who is taking lithium (Eskalith), an anti mania medication, has a lithium level of 3.1 mEq/L. Which treatment would the nurse expect the health-care provider to prescribe? A. No treatment because this is within the therapeutic range. B. Intravenous therapy with an 18-gauge angiocath C. Preparation for immediate hemodialysis D. The antidote for lithium toxicity
C. Preparation for immediate hemodialysis
Which of the vaccines given to infants betwen birth and 12 months is administered orally? A. Polio (IPV) B. Influenza (TIV) C. Rotavirus D. Polio (IPV) & Rotavirus (RV)
C. Rotavirus
During IV administration of doxorubicin (Adriamycin), the infusion site becomes swollen, red, and painful. Which of the following actions should you take? A. Slow the infusion rate. B. Apply pressure to the site. C. Stop the IV infusion. D. Apply ice and continue the infusion.
C. Stop the IV infusion.
A nurse notes that a client with schizophrenia and receiving an antipsychotic medication is having uncontrolled movement of the lips and tongue. The nurse determines that the client is experiencing? A. Hypertensive crisis. B. Parkinsonism. C. Tardive dyskinesia. D. Neuroleptic malignant syndrome.
C. Tardive dyskinesia.
To which client would the nurse question administering lithium, an antimania medication? A. The 54-year-old client on a high sodium diet B. The 23-year-old client taking an antidepressant medication C. The 42-year-old client taking a loop diuretic D. The 30-year-old client with a urine output of 40 mL/hour
C. The 42-year-old client taking a loop diuretic Diuretics increase the excretion of lithium from the kidneys; therefore, the nurse would question administering lithium to this client
A nurse is teaching a patient about possible side effects associated with his new prescription for amitriptyline as treatment for depression. Which of the following information should the nurse provide for the client? A. The medication increases urinary output B. The medication will cause difficulties sleeping C. The medication can cause dry mouth and blurred vision D. The medication may cause hypertensive crisis
C. The medication can cause dry mouth and blurred vision
A patient is preparing to have chemotherapy for treatment of bone cancer. Which information would the nurse most likely include in teaching of this patient? A. The patient can expect to experience hair loss, as well as nausea and vomiting B. Chemotherapy will most likely lower red blood cell counts and cause decreased tissue perfusion C. The patient should contact the physician if he develops a fever prior to undergoing chemotherapy D. There is a direct relationship between how the chemotherapy makes the patient feel and the amount of benefit he receives
C. The patient should contact the physician if he develops a fever prior to undergoing chemotherapy A patient who has cancer and who needs chemotherapy is in an immunocompromised state and is at risk of infection. Before starting chemotherapy treatments, the patient should check his temperature and contact the provider if he has a fever, so as to reduce the risk of further infection and its potential consequences.
The client is receiving Cisplatin (Platinol-AQ). Which of the following side effect is related to the medication? A. Depressed tendon reflexes. B. Photosensitivity. C. Tinnitus. D. Ptosis.
C. Tinnitus.
Which vaccines are contraindicated for pregnant women? A. Tetanus (Td) B. Influenza C. Varicella D. Hep A
C. Varicella Rationale: Pregnant women cannot receive live vaccines
The client prescribed an antidepressant 1 week ago tells the psychiatric clinic nurse, "I really don't think this medication is helping me." Which statement by the psychiatric nurse would be most appropriate? A. "Why do you think the medication is not helping you?" B. "You think your medication is not helping you?" C. "You need to come to the clinic so we can discuss this." D. "It takes about 3 weeks for your medication to work"
D. "It takes about 3 weeks for your medication to work"
A nurse is caring for a group of clients who are not protected against varicella. Which of the following clients should receive a varicella vaccine at this time? A. A 24-year-old woman in the 3rd trimester of pregnancy B. A 3-year-old child who has a tumor and is receiving chemotherapy C. A 2-month-old infant with no health problems D. A 32 year old man who has hypertension
D. A 32 year old man who has hypertension
Chemotherapy is one of the therapeutic modalities for cancer. This treatment is contraindicated to which of the following conditions? A. Recent surgery B. Pregnancy C. Bone marrow depression D. All of the above
D. All of the above
A client who is severely depressed is being prescribed a tricyclic antidepressant. Which of the following medications fall in that category? A. Alprazolam B. Alendronate C. Amiodarone D. Amitryptiline
D. Amitryptiline
A client with depression is taking phenelzine (Nardil). The nurse advises the client to avoid consuming which foods while taking the medication A. Crackers. B. Vegetable salad. C. Oatmeal. D. Cheese.
D. Cheese. Phenelzine is a MAOI, which interacts with tyramine-rich foods such as cheese
You're assessing a patient who is receiving imatinib (Gleevec) to treat chronic myeloid leukemia. Which of the following findings may indicate an adverse reaction to this drug? A. Bradycardia B. Dry mouth C. Constricted pupils D. Crackles at lung bases
D. Crackles at lung bases Imatinib, a targeted antineoplastic drug, can cause fluid retention and pulmonary edema. You should monitor the patient's weight and report weight gain. Assess for peripheral edema by listening to breath sounds and monitoring for shortness of breath. Report crackles in the lung bases as they might indicate pulmonary edema. Imatinib is unlikely to cause bradycardia. Paclitaxel (Taxol), an antimitotic, is an example of an immune-system drug that can cause bradycardia during infusion. Imatinib is unlikely to cause dry mouth or constricted pupils, although it can cause muscle pain and cramping.
When talking with the patient about chemotherapy with doxorubicin (Adriamycin), you explain the need for periodic diagnostic tests. The result of which of the following diagnostic tests or procedures requires monitoring? A. Lumbar puncture B. IV pyelogram C. Bone density scan D. ECG
D. ECG
The client with major depressive disorder has been taking amitriptyline (Elavil), a tricyclic antidepressant, for more than 1 year. The client tells the psychiatric clinic nurse that the client wants to quit taking the antidepressant. Which intervention is most important for the nurse to discuss with the client? A. Ask questions to determine if the client is still depressed B.. Ask the client why he or she wants to stop taking the medication C. Tell the client to notify the HCP before stopping medication D. Explain the importance of tapering off the medication
D. Explain the importance of tapering off the medication
You should monitor this patient for which of the following indications of an adverse reaction to cyclophosphamide? A. Gynecomastia B. Dilated pupils C. Bradycardia D. Fever
D. Fever Cyclophosphamide, a nitrogen mustard, can cause bone marrow suppression. The health care professional will monitor the patient for indications of leukopenia, such as a fever, and instruct the patient to report a sore throat, fever, or easy or unexplained bruising. The patient and her family should wash their hands frequently and thoroughly and avoid crowds and people who have infections. Cyclophosphamide is unlikely to cause dilated pupils, but it can cause dizziness and facial flushing. This drug is unlikely to cause bradycardia, but it can cause hyperkalemia. It is unlikely to cause gynecomastia (growth of breast tissue). Flutamide is an example of an immune system drug that can cause gynecomastia and hot flushes.
Methylphenidate (Ritalin) is prescribed to an 8-year-old child for the treatment of attention deficit hyperactivity disorder (ADHD). The nurse will most likely monitor which of the following during the medication therapy? A. Deep tendon reflex. B. Intake and output. C. Temperature and breath sound. D. Height and weight
D. Height and weight CNS stimulants can cause growth suppression
A client is taking Cyclophosphamide (Cytoxan) for the treatment of lymphoma. The nurse is very cautious in administering the medication because this drug poses the fatal side effect of: A. Alopecia B. Myeloma C. CNS toxicity D. Hemorrhagic cystitis
D. Hemorrhagic cystitis
A nurse is teaching a group of parents about immunizations. Which of the following vaccines should the nurse tell the parents is administered to children younger than 1 year of age and not to older children or adults? A. Pneumococcal vaccine B. Meningococcal vaccine C. Varicella vaccine D. Rotavirus vaccine
D. Rotavirus vaccine
A newly admit client has started taking bupropion (Wellbutrin). The nurse monitors in which of the following side effects that would indicate an overdosage of the medication? A. Headache. B. Dizziness. C. Constipation. D. Seizure.
D. Seizure.
A client has been prescribed paroxetine (Paxil) while in the hospital. Several hours after receiving the first dose, the patient becomes confused and agitated; he starts sweating and is having hallucinations. Which of the following best describes the most likely cause of this reaction? A. Withdrawal syndrome B. Infection C. Anaphylaxis D. Serotonin syndrome
D. Serotonin syndrome
Which information should the nurse discuss with the client diagnosed with bipolar disorder who is taking the anticonvulsant carbamazepine (Tegretol)? A. Instruct the client to use a soft-bristled toothbrush B. Encourage the client to get ophthalmic examinations annually. C. Teach the client to monitor the blood pressure daily. D. Tell the client to avoid hazardous activities
D. Tell the client to avoid hazardous activities
The client receives infliximab, an immunosuppressant medication. What is the priority to teach this client about the medication? A. The client should get adequate exercise B. The client should drink plenty of fluids C. The client should eat plenty of fruits and vegetables D. The client should avoid crowds
D. The client should avoid crowds
The patient has an extensive history of alcoholism. He is having coronary bypass surgery. While administering anesthesia, the CRNA notes that the patient requires higher-than-usual amounts of the drug. The nurse correctly evaluates this response as what phenomenon? A. The nurse anesthetist most likely did not calculate the correct amount of anesthesia for this patient B. The patient has developed a paradoxical reaction to the anesthesia, and will require a different drug C. The patient has developed a resistance to the anesthesia, so it will not work very well D. The patient has developed a cross-tolerance to the anesthesia, and will require higher amounts
D. The patient has developed a cross-tolerance to the anesthesia, and will require higher amounts
The clinic nurse provides instructions to a client receiving an antineoplastic medication. When implementing the plan, the nurse tells the client to? A. To drink beverages containing alcohol in moderate amount during the evening. B. To avoid hot foods and high fiber rich foods. C. To take acetylsalicylic acid as needed for headache. D. To consult with health care providers before receiving immunization.
D. To consult with health care providers before receiving immunization.
The client receives methotrexate. The nurse assesses for side effects of this drug. Which side effects are a primary concern for the nurse? A. Hyperglycemia and fatigue B. Nausea and vomiting C. Hypertension and seizures D. Ulcerative stomatitis and diarrhea
D. Ulcerative stomatitis and diarrhea
If extravasation of an antineoplastic medication occurs, which intervention will the nurse perform first? a. apply cold compresses o the site while elevating the arm b. eject subcutaneous doses of epinephrine around the IV site every 2 hours c. stop infusion immediately while leaving the catheter in place d. inject appropriate antidote through the IV catheter
c. stop infusion immediately while leaving the catheter in place
A patient who is receiving chemotherapy with cisplatin (Platinol) has developed pneumonia. The nurse would be concerned about nephrotoxicity if which type of antibiotic was ordered as treatment for the pneumonia at this time? a. Penicillin b. Sulfa drug c. Fluoroquinolone d. Aminoglycoside
d. Aminoglycoside Increases risk for renal toxicity
The nurse understands that unless contraindicated, in the United States, all newborns receive the following immunization: a. Varicella zoster b. Rubella c. DTaP d. Hepatitis B
d. Hepatitis B
A patient will be receiving chemotherapy with paclitaxel (Taxol). What will the nurse expect to do along with administering this drug? a. administer platelet infusions b. provide acetaminophen (Tylenol) as needed. c. Keep the patient on "nothing-by-mouth" status d. Pre-medicate with an antiemetic
d. Pre-medicate with an antiemetic
A 10-year old pediatric male client diagnosed with ADHD has been taking Methylphenidate hydrochloride over the past two years. The nurse understands the following are all normal side effects of this therapy EXCEPT: a. weight loss b. anorexia c. dry mouth d. bradycardia
d. bradycardia
A patient who has cancer is to receive a course of a chemotherapy with doxorubicin (Adriamycin). Which coexisting condition will require very close monitoring while the patient is taking this drug? a. hypertension b. diabetes mellitus c. gout d. cardiomyopathy
d. cardiomyopathy
The nurse monitors a patient who is experiencing thrombocytopenia from severe bone marrow suppression by looking for... a. severe weakness and fatigue b. elevated body temperature c. decreased skin turgor d. excessive bleeding and bruising
d. excessive bleeding and bruising
A patient is receiving leucovorin as part of his chemotherapy regimen. The nurse expects that the patient is receiving which antineoplastic drug? a. cladribine b. fluorouracil c. vincristine d. methotrexate
d. methotrexate