Pharm Final N334
As the nurse you know that there is a risk of a transfusion reaction during the administration of red blood cells. Which patient below it is at most RISK for a febrile (non-hemolytic) transfusion reaction? A. A 38 year old male who has received multiple blood transfusions in the past year. B. A 42 year old female who is immunocompromised. C. A 78 year old male who is B+ that just received AB+ blood during a transfusion. D. A 25 year old female who is AB+ and just received B+ blood.
A. A 38 year old male who has received multiple blood transfusions in the past year.
Your patient is taking Simvastatin. Which of the following findings below demonstrate this medication is providing therapeutic effects to this patient? Select-all-that-apply: A. HDL 80 mg/dL B. LDL 72 mg/dL C. HDL 30 mg/dL D. LDL 190 mg/dL
Answer: A and B Rationale: Want HDL to be above 60 and LDL to be below 100
The nurse is caring for a client receiving chemotherapy when an anaphylactic reaction occurs from the medication. The nurse should take which actions? Select all that apply. A. Stop the medication B. Remove the IV line C. Administer Oxygen D. Administer Epinephrine E. Position the patient in a reverse Trendelenburg position
Answer: A, C, D Rationale: During an anaphylactic reaction, the medication is immediately stopped. The nurse assesses and monitors the client vital signs. Emergency medications such as epinephrine is administered and the physician is contacted immediately.
A patient is experiencing dehydration caused by severe vomiting. Which fluid replacement therapy would you expect to administer for this patient? A. 0.9% Normal Saline B. Dextrose 5% in Normal Saline C. 0.11% Normal Saline D. 0.45% Normal Saline
Answer: A. 0.9% normal saline Rationale: Is a isotonic IV solution used in patients that have experienced severe dehydration from either severe GI losses (vomiting, diarrhea) or from inadequate water and salt intake.
A patient needs 2 units of packed red blood cells. The patient is typed and crossmatched. The patient has B+ blood. As the nurse you know the patient can receive what type of blood? Select all that apply: A. B- B. A+ C. O- D. B+ E. O+ F. A- G. AB+ H. AB-
Answer: A. B-, C. O-, D. B+, E, O+
Stimulants are contraindicated in which of the following patients? Select all that apply. A. Cardiac Disease B. Respiratory Disease C. Glaucoma D. Osteoporosis E. Hypothyroidism
Answer: A. Cardiac Disease and C. Glaucoma
Why should you never administer potassium chloride via IV push? A. Cardiac Arrest B. Fluid Volume Overload C. Hypovolemia Shock D. All of the above
Answer: A. Cardiac arrest
Antimuscarinic Anticholinergic Agents do what for COPD patients A. Help reduce secretions B. Constrict bronchioles C. Relaxes skeletal muscles D. All of the above.
Answer: A. Help reduce secretions
_______ fluids remove water from the extracellular space into the intracellular space. A. Hypotonic B. Hypertonic C. Isotonic D. Colloids
Answer: A. Hypotonic
What is the theory behind CNS stimulation in managing the manifestations of hyperactivity disorder? A. Low-arousal theory B. Theory of mind C. Hyperactive theory D. Cognitive Dissonance theory
Answer: A. Low-arousal theory Rationale: in someone with ADHD, lower levels of neurotransmitters (i.e., dopamine) are present in the brain. The brain is constantly looking for stimulus; CNS stimulants increase the brains levels of dopamine, norepinephrine, serotonin, etc. (Helps normalize levels)
You have a patient come in and is worried about experiencing motion sickness on the cruise they are going on next week. They ask about taking promethazine. What patient would this medication be contraindicated? A. Patient with Asthma B. Patient with HSV-1 C. Patient in there first trimester of pregnancy D. Patient with breast cancer
Answer: A. Patient with asthma
Which patient below would NOT be a candidate for a hypotonic solution? A. Patient with increased intracranial pressure B. Patient with Diabetic Ketoacidosis C. Patient experiencing Hyperosmolar Hyperglycemia D. All of the options are correct
Answer: A. Patient with increased intracranial pressure
Before a blood transfusion you educate the patient to immediately report which of the following signs and symptoms during the blood transfusion that could represent a transfusion reaction: A. Sweating B. Chills C. Hives D. Poikilothermia E. Tinnitus F. Headache G. Back pain H. Pruritus I. Paresthesia J. Shortness of Breath K. Nausea
Answer: A. Sweating, B. Chills, C. Hives, F. Headache, G. Back pain, H. Pruritus, J. Shortness of Breath, K. Nausea
Which beta blocker medication listed below is a nonselective beta blocker? A. Timolol B. Atenolol C. Metoprolol D. Esmolol
Answer: A. Timolol Rationale: Timolol affects both beta 1 and beta 2 receptors. -Atenolol, Metoprolol, and Esmolol are all selective beta 1 receptor blockers.
Which is another approved and indicated use for bupropion, a second-generation antidepressant? A. Smoking cessation B. Orthostatic hypotension C. Nocturnal enuresis in children D. Anorexia in patients undergoing chemotherapy
Answer: A. smoking cessation
Your patient is experiencing acute toxicity from taking a high dose of promethazine. What treatment will be done to try and counteract this toxicity? A. Calcium gluconate B. Activated Charcoal C. Sodium Phosphate D. Potassium Chloride
Answer: Activated Charcoal Rationale: there is no specific antidote to antihistamine poisoning, treatment is directed at drug removal and managing symptoms.
Which class of drugs reduces efficacy of phenothiazine and should be avoided? A. Opioids B. Beta Blockers C. Anticholinergics D. Thiazide diuretics
Answer: Anticholinergics
Which of the following symptoms is classified as a mild lithium toxicity: A. Confusion and ataxia. B. Muscle fasciculations and oliguria. C. Tinnitus and blurred vision. D. Apathy and Lethargy.
Answer: Apathy and lethargy Rationale: Mild toxicity has a lithium serum level of 1.5 mEq/L. Symptoms include apathy, lethargy, coarse hand tremors and slight muscle weakness. A and C = moderate toxicity B = severe toxicity
A client is prescribed with sertraline (Zoloft). To guarantee a safe administration of the medication, a nurse would administer the dose: A. In the early morning B. As needed only for depression C. With a snack D. At bed time
Answer: At bed time Rationale: Sertraline (Zoloft) is an antidepressant. It may be administered in the morning or evening, but giving it in the evening is more favored since drowsiness is one of the side effects.
The nurse is caring for a client who is receiving Fluorouracil (Adrucil). Which of the following symptoms would necessitate the nurse to immediate discontinuation of the medication? A. Palmar-plantar erythrodysesthesia B. Ataxia C. Constipation D. Insomnia
Answer: Ataxia Rationale: During the administration of Fluorouracil. Monitor for symptoms of dizziness, weakness, and ataxia which are signs of cerebral dysfunction that would immediately lead to the discontinuation of the medication
A client is who is receiving edrophonium chloride suddenly is complaining of abdominal cramps and the nurse observes the client is experiencing increased perspiration and salivation. The nurse makes sure the availability of which of the following? A. Levodopa. B. Methylphenidate hydrohloride (Ritalin). C. Atropine sulfate. D. Carbamazepine (Tegretol).
Answer: Atropine Sulfate Rationale: The client is experiencing signs of cholinergic crisis. When administering edrophonium chloride, have emergency resuscitation equipment on hand and atropine sulfate available.
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 dehydration during exercise B. Instruct client to change positions slowly C. Restrict salt intake in diet D. Limit fluid intake
Answer: Avoid dehydration during exercise Rationale: Lithium toxicity usually occurs during chronic treatment because of reduced drug excretion (dehydration, worsening renal function, concurrent infections, and drug interactions).
A nurse is giving discharge instructions to a client who will be taking phenobarbital (Luminal). The nurse would educate the client in which of the following that directly correlates with the safety of the client? A. Take the medication at the same time each day. B. Take the medication with meals only. C. Avoid using sleep aids while taking the medication. D. Decrease the dosage once with symptoms of dizziness and lightheadedness.
Answer: Avoid using sleep aids while taking this medication Rationale: Phenobarbital (Luminal) is an anticonvulsant and hypnotic drug. The client should avoid drinking alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers).
Which of the following patient statements about the diabetic diet regime is correct? A. "I'll try to consume about 20% carbs and 40% fats on a daily basis." B. "Foods that are high in mono and poly fats are avocados, olives, and nuts." C. "Meats increase the glycemic index; therefore, I should only consume 5% of them on a daily basis." D. "I should completely avoid starchy vegetables like potatoes and corn."
Answer: B. "Foods that are high in mono and poly fats are avocados, olives, and nuts."
A patient with Type 2 Diabetes is started on the medication Glyburide. Which of the following statements by the patient causes concern? A. "I will monitor my blood glucose regularly because I know this medication can cause a low blood sugar." B. "I will consume no more than 8 oz. of alcohol per week." C. "I will continue monitoring my diet and participating in exercise while taking this medication." D. "This medication works by stimulating the beta cells in the pancreas to make insulin."
Answer: B. "I will consume no more than 8 oz. of alcohol per week." Rationale: Sulfonylureas should NEVER be taken with alcohol because it can cause severe hypoglycemia.
A patient takes metformin daily and the physician wants to do a CT scan. How long should you hold the medication before it is safe to proceed with the CT scan? A. 2 hours B. 2 days C. 12 hours D. 1 week
Answer: B. 2 days Rationale: A patient should stop taking metformin 48 hours prior to a CT scan and 48 hours after to avoid nephrotoxicity. Metformin and CT contrast dye are both excreted by the kidneys and when taken together can cause renal failure.
A mom with her child who has recently been diagnosed with ADHD and says she is concerned about her child forming a dependence for the medication prescribed because of family history of addiction. What alternative medication could be an option for this patient? A. Methylphenidate B. Atomoxetine C. Amphetamine D. Fluoxetine
Answer: B. Atomoxetine Rationale: Atomoxetine is a NON-CNS stimulant. This medication does not cause dependence and not a high-alert medication. - Methylphenidate and Amphetamine are both CNS Stimulants and can cause dependence and have a high risk for abuse. - Fluoxetine is a antidepressant/anti-anxiety medication
How is promethazine administered? A. PO B. Diluted through large-bore IV C. With 0.9% normal saline in a continuous transfusion D. Rectally
Answer: B. Diluted through large-bore IV
Your patient is prescribed a statin medication for the treatment of hyperlipidemia. What medication below may increase the patient's risk of developing rhabdomyolysis if taken with a statin? A. Ezetimibe B. Gemfibrozil C. Cholestyramine D. Colesevelam
Answer: B. Gemfibrozil Rationale: The usage of fibric acid derivatives (fibrates....such as Gemfibrozil or Fenofibrate) and statins together can increase the risk of rhabdomyolysis (break down of skeletal muscle which leads to renal failure).
What type of fluid would a patient with severe hyponatremia most likely be started on? A. Hypotonic B. Hypertonic C. Isotonic D. Colloid
Answer: B. Hypertonic
Which adverse effects result from antipsychotic drugs' action on alpha-adrenergic receptors? select all that apply A. Weight gain B. Lightheadedness C. Reflex tachycardia D. Tardive dyskinesia E. Postural Hypotension
Answer: B. Lightheadedness, C. Reflex tachycardia E. Postural Hypotension
When administering a hypertonic solution the nurse should closely watch for? A. Signs of dehydration B. Pulmonary Edema C. Fluid volume deficient D. Increased Lactate level
Answer: B. Pulmonary Edema
A patient is prescribed promethazine for motion sickness and states that they are having a hard time stay awake. What might the nurse suggest for this patient? A. Maybe talk to your physician B. Try taking a second-generation H1-antagonists instead C. This is a side effect that can't be avoided. D. Increase fluid intake while taking this medication
Answer: B. Try taking a second-generation H1-antagonist instead Rationale: Promethazine is a first generation H1-antagonist which have sedative effects. Second gen H1-antagonists produce a lower level of sedation.
For a patient taking oral potassium chloride what is the best way for them to avoid GI upset: A. Take 30 minutes before meals B. Taken with meals or glass of water C. Take before bed D. Take 1 hour after meals
Answer: B. take with meals or a glass of water
A patient is taking acarbose for diabetes management. When should this medication be taken? A. 30 minutes before breakfast B. With first bite of food C. 30 min after breakfast D. At bed time
Answer: B. with the first bite of food Rationale: Acarbose works by lowering the blood sugar by slowly breaking down starchy foods in the GI system which helps slowly rise the blood sugar. Therefore, it should be taken with the first bite of food.
Which drug may cause serotonin syndrome if given together with an antidepressant medication A. Buspirone B. Diazepam C. Lorazepam D. Alprazolam
Answer: Buspirone
Which medication would you expect to administer to a patient with a history of abusing opioid analgesic and needs an anti-anxiety agent? A. Diazepam B. Buspirone C. Fluoxetine D. Escitalopram
Answer: Buspirone Rationale: Buspirone has a low risk for abuse. Diazepam is a benzo is highly addictive so it is contraindicated. and Fluoxetine and Escitalopram are both SSRIs we do not know if the patient has depression with the anxiety so these are not indicated.
The nurse is monitoring a patient receiving an IV infusion of an antineoplastic medication. During the infusion, the patient complains of pain and redness at the insertion site. The nurse should take which actions? Select all that apply. A. Reinsert the IV at a distal part of the same vein. B. Increase the flow rate of the medication C. Notify the physician D. Apply a heat or ice compress to the site E. Administer the antidote as prescribed
Answer: C, D, E Rationale: Extravasation may occur during the infusion of chemotherapy. Signs of which are pain, redness and swelling on the insertion site. The infusion must stop and the physician is notified. The physician may order the administration of an antidote and a heat or cold compress is done.
The doctor orders an isotonic fluid for a patient. Which of the following is not an isotonic fluid? A. 0.9% Normal Saline B. Lactated Ringer's C. 0.45% Saline D. 5% Dextrose in 0.225% saline
Answer: C. 0.45% Saline
Your patient needs 1 unit of packed red blood cells. You've completed all the prep and the blood bank notifies you the patient's unit of blood is ready. You send for the blood and the transporter arrives with the unit at 1200. You know that you must start transfusing the blood within _________. A. 5 minutes B. 15 minutes C. 30 minutes D. 1 hour
Answer: C. 30 Minutes Rationale: Blood must be started within 30 min.
When treating a patient for hyperkalemia it is important to assess which of the following before administering the medication: A. Respirations B. Temperature C. Blood Pressure D. All of the above.
Answer: C. Blood pressure Rationale: hypokalemia increases the risk for hypertension and stroke.
A patient comes in having hallucinations. After reviewing the patients medication history you notice they are taking a high-dose CNS stimulant. What is the best treatment option for a patient experiencing toxicity to a CNS stimulant and is having hallucinations? A. Diazepam B. Fluoxetine C. Chlorpromazine D. Calcium Gluconate
Answer: C. Chlorpromazine
Patient is taking lovastatin, which food should not be taken with this medication? A. Bananas B. Spinach C. Grapefruit D. Aged-Cheese
Answer: C. Grapefruit Rationale: Grapefruit and Grapefruit juice can increase the toxicity in statins.
Which condition below could lead to cell lysis, if not properly monitored? A. Isotonicity B. Hypertonicity C. Hypotonicity D. None of the options are correct
Answer: C. Hypotonicity
When providing education to a patient regarding Fexofenadine, which of the following statements would alert you that more teaching should be done? A. I can take this medication with food B. This medication will not make me as sleepy so I should be okay to drive. C. I can take this medication with my daily glass of orange juice at breakfast time. D. I can take this medication once every 12 hours.
Answer: C. I will take this medication with fruit juice. Rationale: Fruit juices decrease the amount of medication the body absorbs. Educate them to take this medication with a glass of water.
Your patient has vertigo which antihistamine medication would be best for this patient? A. Terfenadine B. Guaifenesin C. Meclizine D. Hydrocodone
Answer: C. Meclizine Rationale: Meclizine is given for vertigo and motion sickness. Option A: Terfenadine is an antihistamine, but meclizine is the standard drug in the treatment of vertigo. Option B and D: Choices C and D are not antihistamines.
Upon reviewing your patients MAR you see that their glyburide is due. What would be a reason for holding this medication? A. Glucose level of 180mg/dL B. Patient is experiencing shortness of breath C. Patient is NPO D. Patient's urine output is about 120ml/hr
Answer: C. Patient is NPO Rationale: Patients who are NPO will not be able to take the oral agent. Patients who are lacking caloric intake are likely to become hypoglycemic very quickly after administration of this medication.
Which of the following patient's should not take prednisone? A. Patient with COPD B. Patient with hypotension C. Patient with PUD D. Patient with Anxiety
Answer: C. Patient with PUD (Peptic ulcer disease)
The provider orders Pioglitazone for your patient with diabetes. Which of the following patients would you question this order? A. Patient with osteoporosis B. Patient with a BMI of 30 C. Patient with Heart Failure D. Patient experiencing kidney stones
Answer: C. Patient with heart failure Rationale: Thiazolidinediones have a BLACK BOX warning for patients with heart failure.
What blood type is known as the "universal recipient"? A. Type A B. Type B C. Type AB D. Type O
Answer: C. Type AB
Which medication listed below for chemotherapy does NOT cause bone marrow suppression? A. Cyclophosphamide B. Methotrexate C. Vincristine D. Vinblastine
Answer: C. Vincristine Rationale: Vincristine is toxic to peripheral nerves, the rest of these drugs can cause bone marrow suppression.
Insulin effects potassium level by: A. inhibiting movement into the cell B. shifting from extravascular space to intravascular space C. shifting from the intravascular space to inside the cell D. inhibiting shift from inside the cell to intravascular space
Answer: C. shifting from the intravascular space to inside the cell Rationale: Insulin has a profound effect on the potassium level - it promotes potassium to be shifted from the intravascular space to inside the cell.
What acute poisoning reaction commonly happens in children taking antihistamine first generation medications? A. CNS B. Asthma attack C. Renal Failure D. Sedation
Answer: CNS Rationale: With acute poisoning in children you often see affects primarily in the CNS such as hallucinations, excitation, ataxia, and convulsions.
A neonate is experiencing apnea. Which of the following would you likely administer? A. Caffeine citrate B. Calcium Gluconate C. Atomoxetine D. Caffeine Nitrate
Answer: Caffeine Citrate Rationale: Improves respiratory and neurodevelopment outcomes in premature infants.
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 positions slowly C. Get a daily source of sunlight D. Discontinue once symptoms go away
Answer: Change positions slowly Rationale: Risperidone can cause orthostatic hypotension
A client with acquired immunodeficiency syndrome is prescribed with Zidovudine (Azidothymidine). Which of the following laboratory results should the nurse monitor while on this medication? A. Throat swab gram stain. B. Complete blood count. C. Random blood sugar. D. Blood uric acid.
Answer: Complete Blood Count Rationale: Zidovudine may decrease the number of a certain type of white blood cell in the blood and cause anemia and muscle disorders.
The client with an ovarian cancer is receiving Tamoxifen (Nolvadex). Which of the following indicates a side effect specific to this medication? A. Weak and brittle nails B. Facial Twitching C. Convulsions D. Constipation
Answer: Constipation Rationale: Tamoxifen (Nolvadex) is an antineoplastic medication that may increase calcium levels. Signs of hypercalcemia includes include constipation, abdominal pain,hypotonicity of muscle, nausea and vomiting etc.
Which solution below is NOT a hypertonic solution? A. 5% Dextrose in 0.9% Saline B. 5% Saline C. 5% Dextrose in Lactated Ringer's D. 0.33% saline (1/3 NS)
Answer: D. 0.33% saline (1/3 NS) Rationale: 1/3 NS is hypotonic
A donor has AB- blood. Which patient or patients below can receive this type of blood safely? A. A patient with O- blood. B. A patient with A- blood. C. A patient with B- blood. D. A patient with AB- blood.
Answer: D. A patient with AB- blood.
_______ solutions cause cell dehydration and help increase fluid in the extracellular space. A. Hypotonic B. Osmosis C. Isotonic D. Hypertonic
Answer: D. Hypertonic
The primary health care provider reviews the medical history of a patient who is receiving buspirone. The health care provider instructs the nurse to continuously monitor the patient's blood pressure to prevent hypertension due to a drug interaction. Which other medication is the patient taking? A. Iron Supplement B. Oral Contraceptives C. NSAIDs D. MAOIs
Answer: D. MAOIs Rationale: MAOIs taken with Buspirone cause hypertension by increasing the sympathomimetic activity.
A patient has a blood glucose of 400. Which of the following medications could be the cause of this? A. Glyburide B. Atenolol C. Bactrim D. Prednisone
Answer: D. Prednisone
Your patient is prescribed diphenhydramine what is a possible side effect? A. Tachycardia B. Increased Respirations C. Rash D. Sedation
Answer: D. Sedation
You're gathering supplies to start a blood transfusion. You will gather? A. PVC free tubing and dextrose B. Polyethylene-line tubing and 0.9% Normal Saline C. Y-tubing with in-line filter and dextrose D. Y-tubing with in-line and 0.9% Normal Saline
Answer: D. Y-tubing with in-line and 0.9% Normal Saline Rationale: This is the type of tubing and solution you will use to transfuse blood. Normal Saline is the ONLY solution used to transfuse blood!!
You've started the first unit of packed red blood cells on a patient. You stay with the patient during the first 15 minutes and: A. run the blood at 100 mL/min and then increase the rate after 15 minutes, if tolerated by the patient. B. run the blood at 20 mL/min and then increase the rate after 15 minutes, if tolerated by the patient. C. run the blood at 200 mL/min and then decrease the rate after 15 minutes, if tolerated by the patient. D. run the blood at 2 mL/min and then increase the rate after 15 minutes, if tolerated by the patient.
Answer: D. run the blood at 2 mL/min and then increase the rate after 15 minutes, if tolerated by the patient. Rationale: The blood will be started on an infusion pump at 2 mL/min, and if the blood is tolerated by the patient, it will be increased AFTER 15 minutes. Remember the blood must be transfused within 2-4 hours....most bags are 250 to 300 mL. During the first 15 minutes is when the patient is most likely to have a transfusion reaction. Running the blood slowly during the first 15 minutes allows the patient to receive the LEAST amount of blood possible if a reaction does occur.
Which of the following is not a hypertonic fluid? A. 3% Saline B. D5W C. 10% Dextrose in Water (D10W) D. 5% Dextrose in Lactated Ringer's
Answer: D5W Rationale: It is hypotonic
Patients taking MAOIs have the tendency to experience hypertensive crisis especially during an interaction with other drugs such as epinephrine. Which of the following is a sign of hypertensive crisis? A. Orthostatic Hypotension B. Diplopia C. Delay in ejaculation D. Hair loss
Answer: Diplopia Rationale: Monoamine Oxidase Inhibitor Toxicity symptoms include hypertension, tachycardia, diplopia, nausea, dilated pupils, palpitations, constricting chest pain and altered mental status. Options A and C are a common side effect of monoamine oxidase inhibitor. Option D is not a related symptoms of hypertensive crisis.
Which is the main receptor in the CNS that is blocked by conventional antipsychotic drugs? A. Serotonin B. Dopamine C. Acetylcholine D. Norepinephrine
Answer: Dopamine
The client with non-hodgkins lymphoma is receiving Idarubucin (Idamycin). 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
Answer: Dysrhythmias Rationale: Idarubicin (Idamycin) and Daunorubicin (Daunoxome) may cause cardiotoxicity (such as dysrhythmia, fatigue, shortness of breath), cardiomyopathy and ECG changes
Your patient who is taking a statin develops yellowing of the skin, abdominal pain in the right upper quadrant, and nausea. What lab result below correlates with this finding? A. Elevated ALT and AST level B. Elevated BUN and creatinine C. Decreased WBC D. Decreased Hbg
Answer: Elevated ALT and AST level Rationale: Liver injury is a risk with statins. Therefore, a liver functions test (LFTs) should be ordered to assess the liver's function. The patient is presenting with signs and symptoms of liver injury. An elevated ALT and AST level would correlate with these presenting signs and symptoms.
The most important concern for patients receiving tamoxifen therapy is the development of what? A. Ovarian Cancer B. Endometrial Cancere C. Hodgkin's Disease D. Leukemia
Answer: Endometrial Cancer Rationale: because we block estrogen receptors to kill the breast cancer but have activated it in the endometrium.
Isotonic fluids cause shifting of water from the extracellular space to the intracellular space. True False
Answer: False
True or False: The Somogyi effect causes the patient to experience an increase in their blood glucose during the hours of 2-3 am. True False
Answer: False Rationale: The Somogyi effect causes the patient to experience a DECREASE in their blood glucose during the hours of 2-3 am.
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
Answer: Feelings of panic, fear, and uneasiness Rationale: Buspirone (BuSpar) is used to treat symptoms of anxiety, such as fear, tension, irritability, dizziness, pounding heartbeat, and other physical symptoms.
The nurse is caring for of a client who is receiving a chemotherapy. Which of the following would be expected as a result of the massive cell destruction that occurred from the chemotherapy? A. Leukopenia B. Thrombocytopenia C. Anemia D. Hyperuricemia
Answer: Hyperuricemia Rationale: Increase level of uric acid (Hyperuricemia) in the body is common following the treatment for leukemias and lymphomas because chemotherapy results in massive cell destruction
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 L/day C. Take medication with food. D. Eat foods rich in purine
Answer: Increase fluid intake to 2-3 L/day Rationale: Cyclophosphamide can cause hemorrhagic cystitis. Encourage the client to increase their fluid intake to 2- 3 liters per day, unless contraindicated.
A patient is experiencing hyperkalemia and is acidotic what is the physician going to order: A. oral administrations of sodium polystyrene sulfonate B. Hemodialysis C. Infusion of glucose and insulin D. Infusion of sodium bicarbonate
Answer: Infusion of sodium bicarbonate Rationale: This is the option for patients who are acidotic and experiencing high levels of potassium.
A client is receiving Methotrexate (Rheumatrex) for a series of chemotherapy. Which of the following medication should be readily available to avoid toxicity? A. Mesna (Mesnex) B. Vigabatrin (Sabril) C. Leucovorin (Folinic Acid) D. Oseltamivir (Tamiflu)
Answer: Leucovorin Rationale: Large doses of Methotrexate (Rheumatrex) may lead to harmful effects in the body. Leucovorin is administered to prevent toxicity. Mesna is given with ifosfamide to decrease the potential of ifosfamide induced cystitis. B: is an anticonvulsant D: is an antiviral influenza medication.
A patient is receiving high-dose methotrexate for lymphoma. Which adjunctive medication does the nurse anticipate administering? A. Amifostine B. Leucovorin C. D5W infusion D. Mensa
Answer: Leucovorin Rationale: Leucovorin is given with Methotrexate to allow normal cells to synthesize thymidylate and other compounds minimizing risk of cell kill to normal cells. - Amifostine is adjunct given with Cisplatin. - Mensa given with cyclophosphamide.
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
Answer: Muscle rigidity and high fever Rationale: Serotonin syndrome symptoms include high body temperature, agitation, muscle rigidity, tremor, sweating, dilated pupils, and diarrhea.
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. Chest Heaviness C. Numbness in the toes D. Weight gain
Answer: Numbness in the toes Rationale: 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 evaluating the medical history of a client who will be receiving Asparaginase (Elspar). The nurse contacts the health care provider if which of the following is noted in the history? A. Type 2 Diabetes B. Asthma C. Pancreatitis D. Ischemic Heart Disease
Answer: Pancreatitis Rationale: One of the major toxicities associated with asparaginase therapy is pancreatitis. Pancreatic function test should be performed before and during the administration of the medication.
Vincristine is prescribed for a patient with bladder cancer. The nurse will teach the patient that a common adverse effect of the medication is what? A. Peripheral neuropathies B. Hair Loss C. Nausea and vomiting D. Bone marrow suppression
Answer: Peripheral Neuropathies Rationale: Vinca alkaloid Mitotic inhibitor that is toxic to peripheral nerves but does not cause bone marrow suppression.
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
Answer: Phentolamine Rationale: In a hypertensive emergency, the first goal is to bring down the blood pressure as quickly as possible with intravenous (IV) blood pressure medications to prevent further organ damage. Phentolamine Mesylate (phentolamine mesylate) is used as an antidote for a hypertensive crisis. Option A: Lithium citrate is a mood stabilizer.
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
Answer: Platelet count of 45,000 cells/mm3 Rationale: The normal value for platelet is 150,000 to 450,000 cells/mm3. When platelet count is less than 50,000 cells/mm3, minor trauma can lead to episodes of prolonged bleeding; when less than 20,000 cells/mm3, spontaneous and uncontrolled bleeding can occur. Option A: Normal white blood cell count is 4,000 to 11,000/mm3. Option C: Normal clotting time is 8-15 minutes. Option D: Normal hgb is 13.5-17.5 g/dl.
Methylphenidate and Atomoxetine are pregnancy class? A. Pregnancy Category B B. Pregnancy Category X C. Pregnancy Category D D. Pregnancy Category C
Answer: Pregnancy Category C
Which atypical antipsychotic would the nurse anticipate a health care provider prescribing for treatment of refractory schizophrenia? A. Trazodone B. Phenelzine C. Amoxapine D. Risperidone
Answer: Risperidone
A client with depression who has been taking amitriptyline for three months returns to the clinic for a follow-up. The nurse observes the client in which of the following symptoms? A. Suicidal thoughts B. Lack of energy C. Loss of interest in appearance D. Neglect of responsibilities
Answer: Suicidal thoughts Rationale: Clients may have thoughts about suicide when taking an antidepressant such as amitriptyline, especially clients younger than 24 years old.
The client is receiving Cisplatin (Platinol-AQ). Which of the following side effect is related to the medication? A. Depressed Deep Tendon Reflexes B. Photosensitivity C. Tinnitus D. Ptosis
Answer: Tinnitus Rationale: Cisplatin (Platinol-AQ), an alkylating medication, may cause ototoxicity, tinnitus, hypokalemia, hypomagnesemia, hypocalcemia and nephrotoxicity.
Which reason is necessary for monitoring blood sodium levels in a patient with bipolar disorder who takes lithium citrate? A. To ensure proper nourishment in the patient B. To prevent renal toxicity caused by the drug C. To maintain therapeutic concentration of lithium D. To maintain normal cholesterol levels in the body.
Answer: To maintain therapeutic concentration of lithium
Which reason would a nurse advise a patient to use steam inhalation for a cold rather than taking ceetirizine, when the patient has depression and takes isocarboxazid? A. To prevent the increased risk of bleeding B. To prevent central nervous system depression C. To prevent increased risk of infection D. To prevent impaired cardiovascular function
Answer: To prevent central nervous system depression Rationale: Isocarboxazid is a MAOI. This drug class interacts with antihistamine medications such as cetirizine and causes increased CNS depression. Due to this the patient may experience increased sedation, dizziness, and hallucinations.
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 D. Above normal
Answer: Toxic Level Rationale: Normal range is 0.6-1.2 mEq/L
A male client with breast cancer is receiving Tamoxifen (Nolvadex). The nurse specifically monitors which laboratory value? A. Triglyceride Level B. Activate partial thromboplastin time C. Fasting blood sugar D. Serum sodium and potassium
Answer: Triglyceride Level Rationale: Tamoxifen (Nolvadex) is an antineoplastic medication that may increase cholesterol, triglyceride and calcium levels. Complete blood count, platelet count, serum calcium, cholesterol, and triglyceride level must be monitored periodically before the administration of this medication.
The client with acute myelocytic leukemia is being treated with Busulfan (Myleran). The nurse specifically monitors which laboratory value while the client is taking this medication? A. Serum Calcium B. Uric Acid Level C. Prothrombin Time D. Platelet Count
Answer: Uric acid level Rationale: Busulfan (Myleran) is an antineoplastic medication that can cause an increase uric acid level in the body.
An HIV-positive client who has been started on highly active antiretroviral therapy (HAART) came back for a follow-up checkup. Which of the following will be the most helpful in determining the response to the therapy? A. Rapid HIV antigen test. B. Western Blot analysis. c. Viral load test. D. White blood cell count
Answer: Viral load test Rationale: A viral load test helps provide information on the health status and how well antiretroviral therapy (ART - treatment with HIV medicines) is controlling the virus.
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. Yogurt
Answer: Yogurt Rationale: Phenelzine (Nardil) is a monoamine oxidase (MAO) inhibitor. The client should avoid eating tyramine-rich foods such as chocolate, alcoholic beverages, aged cheese, yogurt, processed meats, and fruits such as raisins, avocados, bananas, or figs.
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 amounts during the evening. B. To eat high fiber rich foods C. To take acetylsalicylic acid as needed for headaches D. To consult with health care providers before receiving immunizations.
Answer: consult with health care providers before receiving immunizations. Rationale: Because antineoplastic medications lower the resistance of the body, clients must be informed not to received immunizations without a health care provider's approval.
The client with a testicular cancer is being treated with Etoposide (Etopophos). Which of the following side effect is specifically associated with this medication? A. Chest Pain B. Edema C. Alopecia D. Orthostatic Hypotension
D. Orthostatic Hypotension Rationale: While on etoposide infusion, blood pressure is monitored throughout and it should be administered slowly over 30-60 minutes to avoid hypotension. Options A and B are not related to this medication.
True or False: Patients who are Rh positive can only receive Rh positive blood, while patients who are Rh negative can only receive blood from donors who are Rh negative. True False
False Rationale: Rh positive patients can receive BOTH negative and positive blood....while Rh negative patients can receive ONLY negative blood.
HIV is treatable? True or False
True
