Pharm practice questions exam 4
Which of the following assessment findings reveals that the amoxicillin is decreasing the symptoms of acute otitis media? a. retracted tympanic membrane b. otalgia c. otorrhea d. visible cone of light
D
A 22-year-old man has developed a soft tissue cellulitis on his right heel. He has been swimming in the ocean and been in the hotel hot tub. It is cultured as a gram-negative organism. Which anti-infective agent will he receive? a. fluconazole b. acetazolamide c. ampicillin d. D. ciprofloxacin
D; Rationale- Ciprofoxacin is the drug of choice for a gram-negative soft tissue cellulitis.
Which of the following adverse effects of the imipramine is considered the most serious? a. dry mouth b. constipation c. urinary retention d. orthostatic hypotension
D
A boy comes to the school nurse's office and states, "I did not take my Ritalin today." Which of the following is the most appropriate nursing intervention? a. Call the child's parent or guardian to try to find out if the boy has taken his medicine. b. Give the child his morning dose because it is in the office. c. Send him back to class and tell him it is not necessary to take the medication. Call the child's physician to obtain a one-time dose of methylphenidate
A
A client diagnosed with chronic renal failure is currently taking lithium for severe depression. How will this affect the plan of care? A. The dose must be markedly reduced, and plasma lithium levels must be closely monitored B. No changes to the plan are required C. The drug must be discontinued immediately D. The dose will remain constant, but plasma lithium levels must be closely monitored
A
A client reports having taken OTC bisacodyl daily for the past several months. What assessment should the nurse prioritize when providing care? A. Electrolyte levels B. Apical heart rate C. Bleeding D. Deep tendon reflexes
A
A patient is taking phenobarbital for a seizure disorder. Which of the following statements indicates that the patient should be seen by a health care provider immediately? a. "I have a rash that started on my trunk, and now it is on my arms and legs." b. "I rest if I feel tired." c. "I take my medication routinely and do not skip doses." d. "I have my blood levels checked if my breathing decreases."
A
A patient stops taking clonazepam. What adverse effect will occur? a. status epilepticus b. bone marrow depression c. cerebral edema d. lethargy
A
Antacids have not been effective in managing a client's gastroesophageal reflux disease, so the health care provider is prescribing a proton pump inhibitor. Why might the health care provider prescribe a proton pump inhibitor (PPI) rather than a histamine2 receptor antagonist (H2RA)? A. PPIs suppress acid more strongly and for a longer time B. PPIs are less expensive C. PPIs suppress acid more strongly and for a shorter time D. H2RAs do not suppress acid
A
A client who has been prescribed long-term lithium therapy reports taking the medication only erratically since starting a new job. What assessments should the nurse prioritize? Select all that apply A. Manic behavior B. Fine tremors C. Mood swings D. Memory lapses E. Suicidal ideation
A, C
A nurse is teaching a group of older adults about nonpharmacologic strategies for preventing constipation. The nurse should recommend what practices? Select all that apply A. Consuming a high-fiber diet B. Introducing organic foods into the daily diet C. Drinking 6 to 10 glasses of fluid each day D. Engaging in frequent physical exercise E. Getting at least 8 hours of sleep each night
A, C, D
Postoperative nausea and vomiting may be managed with what serotonin receptor antagonists? Select all that apply A. Dolasetron B. Rizatriptan C. Granisetron D. Ondansetron E. Promethazine
A, C, D
A 70-year-old man has been diagnosed with necrotizing otitis media. What is the patient at risk for developing while being treated with ciprofloxacin? a. edema b. tendon rupture c. decreased QT interval d. chest pain
B
A client has been given an initial diagnosis of glaucoma. What signs or symptoms would the nurse expect to assess that confirm the diagnosis? A. Burning cessation B. Increased intraocular pressure C. Periorbital edema D. Redness
B
A client has begun taking orlistat to lose weight. When teaching the client about the medication, what should the nurse indicate about the potential for fatty stools? A. They indicate that the intake of dietary fat is too low B. They are a common adverse effect of orlistat C. Fatty stools indicate a need to decrease the dosage D. Fatty stools indicate the need to immediately discontinue the medication
B
A client reports the intention to use an OTC bismuth product. The nurse should inform the client that there is a potential that the medication will cause what side effect? A. HTN B. Dark Stool C. Hyperglycemia D. Photosensitivity
B
Which of the following medications prolongs the effect of local anesthetics? a. propofol b. epinephrine c. calcium d. labetalol
B
Which of the following statements indicate the patient is in need of further patient teaching regarding medication for attention deficit hyperactivity disorder? a. I should not crush my tablets. b. I can skip doses when I am feeling good. c. I should not change my dosage without consulting my health care provider. d. I should consult with my health care provider before taking any new medications.
B
The nurse is caring for a client suspected of developing serotonin syndrome. What frequent assessments should the nurse include in the client's plan of care? Select all that apply A. Respiratory function B. Temperature C. Blood Pressure D. Level of consciousness E. Cardiac function
B, C, D
After receiving a prescription for a topical medication to treat a skin disorder, a client asks the nurse what the medication will do. The nurse should indicate that the medication could produce what actions? Select all that apply A. Toughening of the dermis B. Antimicrobial effect C. Regulation of cell proliferation D. Improved barrier function E. Decreased skin inflammation
B, C, D, E
A 68-year-old man is seen by a home care nurse. He has been taking chlorpromazine since 1969 for schizophrenia. Which of the following adverse effects are most commonly seen after use of chlorpromazine for long periods? a. lethargy b. amnesia c. tardive dyskinesia d. dystonia
C
The healthcare provider has determined that an older adult client would benefit from using a bulk-forming laxative. What instruction should the nurse include when providing education related to proper drug use? A. "increase your consumption of health fats" B. "Be sure to eat vegetables that provide roughage" C. "Make sure you take the laxative with a glass of water" D. "Make sure each of your meals includes some protein"
C
The nurse administers the preoperative medication, midazolam (Versed). The nurse will monitor the patient for which intended effect of this medication? a. Decreased bronchial secretions b. Reduction in anxiety c. Respiratory depression d. Suppression of cough
C
The nurse is preparing to insert a peripheral IV catheter into a school-age client. What local anesthetic is the nurse likely to apply prior to insertion? A. Cocaine hydrochloride ointment B. Tetracaine hydrochloride C. Eutectic mixture of local anesthetics (EMLA) cream D. Benzocaine cream
C
Which of the following patients are at risk for the development of otitis externa? a. a patient who wears ear plugs while swimming b. a patient who has hearing loss c. a patient who wears a hearing aid d. a patient with labyrinthitis
C
A client diagnosed with ocular HTN and prescribed an alpha 2 adrenergic agonist eye drop asks the nurse what the medication is expected to do. What is the basis for the nurse's explanation of the action of such a medication? A. It is intended to reduce the production of aqueous humor and so decrease IOP B. The effect is to increase the outflow of aqueous humor thus lowering IOP C. The goal is to reduce the viscosity of aqueous humor to allow for effective flushing of the eyeball D. The alpha 2 adrenergic agonist enhances the elasticity of the client's rigid cornea
A
A client has asked the nurse for the current recommendations surrounding sunscreen use. What dermatologic guidelines concerning SPF use should the nurse share with the client? A. No less than 30 B. No less than 15 C. At least 50 D. At least 20
A
A client has been admitted to the hospital with dehydration and hypokalemia secondary to severe diarrhea. Why might the health care team be reluctant to aggressively treat a client's diarrhea by slowing GI peristalsis? A. The client's body may be ridding itself of toxins B. The client may become fluid overloaded C. Rebound bowel obstruction is likely to occur D. A rapid cessation of diarrhea can exacerbate electrolyte imbalance
A
A client reports taking a medication for long-term treatment of obesity but cannot remember the name. What medication does the nurse suspect the client is taking? A. Phentermine- topiramate B. Bupropion- naltrexone C. Benzphetamine D. Phendimetrazine
A
A client who is planning a trip to a region with known water purity problems asks the nurse why the healthcare provider won't prescribe an antibiotic to prevent travelers' diarrhea. What explanation should the nurse identify as the primary reason? A. They may promote drug-resistant microbes B. They are ineffective in prevention C. They cause too many adverse effects D. They may increase diarrhea
A
A client with a history that suggests a possible hypersensitivity to chloroprocaine requires administration of the drug. Following administration, what assessment should the nurse prioritize? A. Respiratory B. Integumentary C. Musculoskeletal D. Neurological
A
A college student is distraught that facial acne has become more serious over the past several months and is requesting a prescription for isotretinoin. What assessment is the priority before the initiation of this treatment? A. Two consecutive pregnancy tests B. A fasting diabetes screening C. Assessment of creatinine clearance D. Bone Density testing
A
A man is hospitalized because of a relapse of his psychotic disorder. He states, "I quit taking my medicines because I always forget to take them at least one time a day." Which of the following regimens for his antipsychotic medications will increase medication adherence? a. monthly injection by a home care nurse b. low-dose daily therapy c. daily visits to the clinic to receive his medications d. once-a-week drug therapy
A
A man is taking chlorpromazine. He develops a high fever, respiratory depression, and diminished level of consciousness. What condition has the patient developed? a. neuroleptic malignant syndrome b. dystonia c. anhedonia d. akathisia
A
A mother who calls the clinic to report that her son has recently started medication to treat attention deficit hyperactivity disorder (ADHD) fears her son is experiencing side effects of the medication. Which of the following side effects are typically related to medications used for ADHD? a. poor appetite b. frequency of urination c. weight gain d. sedation
A
A patient is admitted to the diagnostic procedure center for a routine colonoscopy. Propofol is the drug of choice for sedation. Which of the following would contraindicate the use of propofol? a. a history of postoperative nausea and vomiting b. a diagnosis of hypertension c. an allergy to eggs d. the need for rapid emergence
A
Local anesthetics reduce the excitability neuronal cell membranes by decreasing permeability to which ion? a. sodium b. potassium c. chloride d. magnesium
A
The circulating nurse in the operating room explains to a small group of nursing students that thiopental sodium (Pentothal) is useful for the surgical client because of its action as a(n) a. ultra-short-acting barbiturate. b. long-acting benzodiazepine. c. intermediate-acting phenothiazine. d. dissociative barbiturate.
A
The nurse is participating in a family meeting with the parents of a child diagnosed with ADHD and prescribed dextroamphetamine. The nurse should discuss what black box warning associated with this medication? A. Potential for abuse B. Hyperglycemic crisis C. Anticholinergic effects D. Risk of hemorrhagic stroke
A
The nurse knows that antiemetics are most effective when administered a. before an emetogenic event occurs b. during an episode of nausea but before vomiting has occurred c. after the patient has experienced nausea and vomiting d. any time: timing of administration has no impact on drug effectiveness
A
The nurse working at a long-term care facility screens residents for risk factors for constipation. What common risk factor does the nurse look for? A. Impaired mobility B. HTN managed by a beta-adrenergic factor C. DM D. Active infection
A
To decrease diarrhea with orlistat, it is important to instruct a patient to do which of the following? a. avoid large amounts of fatty foods b. drink eight glasses of water daily c. avoid caffeine-containing beverages d. increase physical activity
A
What is the benefit of adding proton pump inhibitors (PPIs) to the treatment regimen for an H. Pylori bacterial infection? A. Decreases production of gastric secretions B. Assists in eliminating the bacteria C. Protects ulcer craters D. Decreases pepsin production
A
What medication belongs to the category of inhaled anesthetics? A. Desflurane B. Atracurium C. Propofol D. Etomidate
A
Which laxative or cathartic is most likely prescribed for a postpartum client who experienced a posterior laceration during birth? A. Surfactant laxatives B. Saline Laxatives C. Bulk-forming laxatives D. Lubricant laxatives
A
Which of the following groups are most commonly used for drug management of the hyperactive child? a. central nervous system (CNS) depressants b. CNS stimulants c. anticonvulsants d. major tranquilizers
A
Which of the following nursing actions should be implemented when instilling eardrops? a. Tilt the head toward the opposite shoulder. b. Lay on the affected ear after instillation. c. Apply the medication on a cotton ball and insert in the outer auricle. d. Apply ear plugs after instilling eardrops.
A
You are the nurse working in the recovery room of an outpatient surgical center. Your patient has received general anesthesia with isoflurane, an inhaled anesthetic. Before discharging him to go home, you should verify: a. That his vital signs are stable and have returned to baseline. b. That he has voided. c. That he has someone to drive him home. d. All of the above
A
Which of the following are expected adverse effects of amphetamine sulfate? (Select all that apply.) a. weight loss b. anorexia c. dry mouth d. bradycardia e. constipation
A, B, C
A client has been started on an SSRI for the treatment of depression. The nurse should inform the client to watch for which adverse effect (s)? Select all that apply A. GI bleeding B. Nausea C. Weight loss D. Sexual Dysfunction E. HTN
A, B, C, D; rationale- Because serotonin release from platelets is essential for hemostasis and psychotic drugs interfere with serotonin reuptake, these agents are associated with increased risk of GI bleeding
Client teaching frequently includes explaining the potential adverse effects of prescribed medications. What classifications of medication can cause diarrhea? Select all that apply A. Antibacterials B. Magnesium-based antacids C. SSRI's D. Opioids E. Antineoplastic agents
A, B, C, E
The nurse is providing education to a client who has been prescribed MAOI therapy following unsuccessful treatment with other agents. What foods should the nurse instruct the client to avoid? Select all that apply A. Bananas B. Aged cheeses C. Milk D. Chocolate E. Coffee
A, B, D, E
Which of the following points should be included when teaching patients regarding measures to promote healthy bowel function? (Select all that apply.) a. increasing activity b. eating a low-residue diet c. maintaining adequate fluid intake d. establishing regular bowel habits
A, C, D
Specific therapy for diarrhea depends on the cause and may include which treatments? Select all that apply A. Antibacterial agents B. Anticholinergics C. Bile-binding medications D. Enzymatic replacement therapy E. 5-HT3 receptor antagonists
A, C, D, E
A client who is undergoing cancer treatment is being discharged home with a prescription for ondansetron. When providing medication education concerning ondansetron, the nurse should describe actions that the client can take to address what common adverse effects? Select all that apply A. Dizziness B. Anorexia C. Headache D. Dry cough E. Diarrhea
A, C, E
The nurse is circulating in the operating room when the anesthesia practitioner declares a malignant hyperthermia emergency. Which of the following symptoms are indicative of malignant hyperthermia? Select all that apply. a. muscle rigidity b. bradycardia c. rash d. hypercapnia e. increased serum creatinine f. hyperkalemia
A, D
The nurse should suggest to the parents of a toddler diagnosed with otitis media that their child's ear pain can be treated with what OTC adjuvant medication therapy? Select all that apply A. Acetaminophen B. Aspirin C. Lidocaine D. Benzocaine E. Ibuprofen
A, E
A 13-year-old girl has developed a mild case of acne vulgaris. Which of the following medications will be prescribed? a. doxycycline b. benzoyl peroxide c. isotretinoin d. fluconazole
A; Rationale- Benzoyl peroxide is applied topically for the treatment of a mild case of acne vulgaris. Doxycycline would be prescribed if the topical agent was ineffective.
The nurse is reviewing a new prescription for promethazine. The nurse will immediately contact the health care provider if the prescription is for which client? A. An 18-month old child B. A client in the first trimester of pregnancy C. An adult client with type 1 diabetes D. an adult client taking a tricyclic antidepressant
A; Rationale- Black box warning, contraindicated in children younger than 2 years
A patient has been diagnosed with atopic dermatitis. She receives a prescription for pimecrolimus cream. What is she at increased risk for developing? a. skin cancer b. infection c. papilledema d. joint pain
A; Rationale- Clients who use pimecrolimus are prone to the development of skin cancer.
A patient is beginning a new drug regimen of escitalopram for depression. Before administering this medication, it is necessary to assess for which of the following? a. prior recent use of monoamine oxidase (MAO) inhibitors b. prior diet high in tyramine-containing foods c. history of cigarette use d. history of seizure disorders
A; rationale- A potentially fatal reaction (serotonin syndrome) may occur when monoamine oxidase (MAO) inhibitors and selective serotonin reuptake inhibitors (SSRIs) are used concurrently. Te MAO inhibitor should be discontinued 2 weeks before treatment when SSRIs are initiated
A hospitalized client requests a magnesium citrate "bisacodyl pill" every night to "stay regular". The nurse should initially be most concerned about what potential health risk for this client? A. Poor intake of dietary fiber B. Laxative abuse C. Effective knowledge related to laxative use D. Bulimia-induced purging
B
A laxative is contraindicated in a patient: a. with cancer taking daily narcotics for pain control b. complaining of abdominal pain and distention c. scheduled for a colonoscopy d. with limited mobility due to Parkinson's disease
B
A man has been taking imipramine for 1 week for depression. He tells the nurse that he is going to stop taking this medication because it is not working. The best response is which of the following? a. "Contact your prescriber about taking a different antidepressant medication." b. "It may take up to 4 weeks before this medication makes you feel better." c. "You should slowly taper rather than suddenly discontinue this medication." d. "You should take an extra dose today to build up your blood level and get faster results."
B
A man is diagnosed with schizophrenia. He exhibits anhedonia, which is defined as which of the following? a. seizure activity b. inability to experience pleasure c. wormlike movements d. depression
B
A nurse in an extended care facility has instilled medicated ear drops into a resident's left ear as prescribed. What instruction should the nurse provide to a client after instilling ear drops into the client's left ear? A. "Gently massage your left ear until you can hear normally again" B. "Keep lying on your right side for the next 20 minutes or so" C. Let's put your hearing aid back in to keep the medication in the ear canal" D. It's important that you avoid touching your left ear for at least the next hour"
B
A nurse is teaching the importance of proper diet to a patient taking the MAO inhibitor tranylcypromine for depression. Which of the following food selections by the patient indicates that further teaching is needed? a. a tossed salad and a bowl of vegetable soup b. a salami and Swiss cheese sandwich and a banana c. a hamburger and French fries d. a cold plate with cottage cheese, chicken salad, and grapes
B
An appropriate nursing measure when treating a 5-year-old child with a 1-day onset of mild diarrhea involves encouraging which of the following? a. regular diet b. intake of clear liquids c. intake of milk products d. no fluids for 24 hours
B
An operating room nurse is aware that isoflurane has sustained effects on the brain without significant absorption into blood or body tissues. What is an implication of these aspects of the drug's pharmacokinetics? A. Any route may be used for administration B. Induction takes place quickly C. Consciousness is altered with no effect on vital signs D. Adverse effects are absent
B
How does ondansetron achieve its therapeutic effect when prescribed for postoperative nausea? A. inhibits the action of acetylcholine in the brain B. Antagonizes serotonin receptors C. Blocks the activity of substance P at NK1 receptors D. Blocks dopamine from receptor sites in the brain
B
In monitoring the status of a patient on a course of a phenothiazine antipsychotic, the nurse needs to be most aware that an adverse effect of phenothiazine antipsychotics is the development of which of the following? a. glaucoma b. akathisia c. hypertension d. diabetes
B
Lidocaine is frequently used for: a. Spinal anesthesia b. Local anesthesia c. Intravenous anesthesia d. General Anesthesia
B
Phentermine aids weight loss by doing which of the following? a. decreasing appetite b. increasing satiety and feelings of fullness c. increasing metabolism d. decreasing absorption of dietary fat
B
The emergency department nurse explains to a new nurse that local anesthesia for treatment of minor injuries is achieved by: a. inhibiting medullary activity. b. inhibiting nerve conduction. c. depressing the central nervous system. d. depressing cerebral activity.
B
The nurse instructs a patient on the procedure to occlude the tear ducts for 5 minutes after administering eyedrops. What is the purpose of this patient teaching? a. It prevents eye infections. b. It prevents systemic absorption of the medication. c. It makes self-administration easier. d. It allows for the administration of a smaller dose.
B
The nurse is preparing to administer ear drops to a client diagnosed with otitis externa. What action should the nurse perform prior to administration? A. Irrigating the ear with a 1% chlorhexidine solution B. Removing any excess cerumen from the client's ear C. Having the client lie on the side of the infected ear for 15 to 20 minutes D. Assessing the client's vestibular function by testing balance
B
The patient has received isoflurane (Forane) as a general anesthetic. In the immediate postoperative period, the nurse will closely observe the patient for: a. elevated blood pressure. b. decreased respiratory rate. c. malignant hyperthermia. d. decreased pulse rate.
B
The rationale for withholding food or fluids following the application of a local anesthetic to the mouth or throat is to a. prevent aspiration b. prevent infection c. minimize a hypersensitivity reaction d. enhance pain control
B
The surgical unit nurse would take which of the following postoperative nursing actions to help the client recover from the effects of anesthesia? a. Ambulate client once a day b. Turn, cough, and deep breathe frequently c. Force fluids to 1000 mL per shift d. Insert a urinary catheter to prevent retention
B
To best assure client safety, what information should the nurse provide to a client whose fluoxetine therapy is being discontinued? A. It will be important that the client avoid stressful situations until another selective SSRI can be prescribed B. The dosage of the medication will be gradually reduced over a period of 6 to 8 weeks C. ECT will be prescribed 2 to 3 weeks before stopping the fluoxetine D. MAOI will be prescribed concurrently with the fluoxetine for 2 to 3 weeks
B
What is the expected outcome for a central nervous system stimulant in a child? a. increased behavioral problems b. improved performance in schoolwork c. decreased ability to complete a task d. increased hyperactivity
B
What type of seizure is characterized by generalized tonic-clonic convulsions lasting for several minutes during which the client does not regain consciousness? A. Motor B. Status epilepticus C. Febrile D. Akinetic
B
When administering 5-HT3 receptor antagonists before cancer chemotherapy, the nurse should also be prepared to administer which of the following adjunctive medications? a. promethazine b. dexamethasone c. dronabinol d. hydroxyzine
B
When the nurse is caring for a child receiving a central nervous system stimulant for attention deficit hyperactivity disorder, which assessment is most important to monitor? a. liver function b. weight loss c. fever d. seizure activity
B
Which behavior would a nurse expect in the child who takes methylphenidate every morning? a. sitting and playing with toys for 90 minutes b. getting along well with peers c. expressing anger in an appropriate manner d. not throwing toys across the room
B
Which of the following mechanism of action is shown by over-the-counter drug magnesium hydroxide (milk of magnesia)? a. increased gastric secretions b. increased osmotic pressure in the intestinal lumen c. binding to diarrhea-causing bacteria for excretion d. decreased gastrointestinal motility
B
Which of the following medications is administered for status epilepticus? a. phenytoin b. diazepam c. levetiracetam d. clobazam
B
The nurse is providing care for an adult client whose nausea is being treated with promethazine. The nurse should consequently assess for what adverse effects? Select all that apply A. peripheral edema B. Tachycardia C. urinary retention D. Acute confusion E. Blurred vision
B, C, D, E
The nurse is providing education to the parents of an adolescent who has been prescribed an antidepressant medication. What behaviors should the nurse indicate are associated with the increased risk of suicidal ideation? Select all that apply A. Slurred speech B. Mania C. Irritability D. Impulsivity E. Panic Attacks
B, C, D, E
An elderly woman with dementia is receiving haloperidol. What adverse effect is this woman at increased risk for developing? a. anorexia b. increased temperature c. infection d. tardive dyskinesia
D
A man is admitted to the post-anesthesia care unit following surgery, where he received vecuronium. He is unable to raise his head and develops shortness of breath. What are the priority nursing interventions? Select all that apply. a. Draw an arterial blood gas. b. Notify the anesthesia practitioner. c. Administer furosemide. d. Apply high-flow oxygen. e. Intubate the patient.
B, D
The healthcare provider has recommended that an older adult client take a psyllium laxative. When providing client teaching, what potential effect should the nurse explain? Select all that apply A. Rectal Bleeding B. Bloating C. Gastroesophageal reflux D. Gas E. Opportunistic infections
B, D
A patient has been administered lidocaine via an epidural. Which of the following symptoms indicate the patient is having an adverse reaction to the anesthesia? (Select all that apply.) a. blood pressure of 130/86 mm Hg b. metallic taste in mouth c. pulse rate of 76 beats/min d. crackles in the right lower lobe of the lung e. circumoral numbness f. anxiety
B, F
A 14-year-old girl visits the school nurse's office. The girl wants longer eyelashes after watching a commercial for Latisse. What information should the school nurse provide the girl regarding this form of bimatoprost? a. "This medication is only given to patients with glaucoma." b. "This medication is not recommended for anyone under the age of 16." c. "You do not need this medication—your eyelashes are long enough." d. "You should talk to your guidance counselor about ways to build your self-esteem."
B; Rationale- The school nurse should instruct the girl that bimatoprost is recommended only in clients 16 years of age and older due to hyperpigmentation.
A woman reports to the prescriber that she has developed a fever, sore throat, and malaise after starting clozapine therapy. Which of the following interventions is most important? a. Treat the patient with a broad-spectrum antibiotic. b. Discontinue the clozapine and obtain a complete blood count with differential. c. Inform the patient that this is normal when taking clozapine. d. Assess the patient for diminished mental alertness.
B; rationale- The development of a fever, sore throat, and malaise after beginning clozapine therapy is indicative of a low white blood cell count. The client needs to have a complete blood count with differential.
A 12-year-old boy comes to the school nurse's office after falling during gym class. The nurse assesses the child and notes that he has bruising and petechiae over most of his legs, arms, and torso. The child has a history of absence seizures that are treated with valproate. Based on the child's history, what would the nurse suspect? a. abuse b. leukemia c. adverse effect d. anemia
C
A client diagnosed with an H. Pylori- associated ulcer has been prescribed treatment that includes two antimicrobials. What does the nurse identify as the reason for using multiple antimicrobials? A. Two different microbes are involved, requiring two different antimicrobials B. A single antimicrobial is generally not strong enough to eradicate the infection C. Two antimicrobials help prevent the emergence of drug-resistant H. pylori organisms D. One antimicrobial tends to alter the action of the adjunct medications
C
A client diagnosed with hemorrhoids reports intense pain when straining to pass stools. What type of agent would the nurse expect to be the first choice for this client? A. Saline cathartic B. Bulk-forming laxative C. Surfactant stool softener D. Stimulant cathartic
C
A client has been prescribed phentermine for weight management. What common adverse effects should the nurse identify when providing client teaching? A. Increased flatulence and diarrhea B. nausea and vomiting C. Nervousness and agitation D. Drowsiness and lethargy
C
A client who has reduced cigarette consumption from 1 pack per day to 1 pack per week has been prescribed treatment for duodenal ulcer. What teaching would be most important for the nurse to include in relation to treatment? A. Stopping the medication once symptoms are relieved B. Taking the prescribed medication only when experiencing stomach pain C. Smoking's effects on healing D. The general health dangers of smoking
C
A hospitalized patient on antibiotic therapy begins to experience fever, abdominal pain, and diarrhea containing mucus, pus, and blood. The best nursing intervention in this situation is to do which of the following? a. Continue the antibiotic because the patient has signs of a gastrointestinal infection. b. Monitor the patient's vital signs and notify the provider if there is further deterioration. c. Withhold the antibiotic and notify the provider of the patient's condition. d. Encourage fluid intake because fever is a sign of dehydration.
C
A man tells the nurse that he has bought the over-the-counter drug bismuth subsalicylate for the next episode of diarrhea. The nurse should assess for what allergy that would contraindicate use of bismuth subsalicylate? a. penicillin b. acetaminophen c. aspirin d. sulfa
C
A nurse is preparing to apply a client's scheduled dose of Latanoprost. To reduce this client's risk of infection during administration, what action should the nurse take? A. Administering antibiotic eye drops immediately after administration of latanoprost B. Warming the drops prior to instillation C. Preventing the applicator from coming in contact with any surface D. Using sterile gloves when instilling the drug
C
A nurse is providing care for a client diagnosed with ADHD who has been taking methylphenidate for several months. When monitoring for potential adverse effects, the nurse should include what assessment? A. Pupillary response B. Sexual function C. Sleep patterns D. Orientation to person, place, and time
C
A patient is receiving haloperidol decanoate 100 mg intramuscularly. What assessment should the nurse make before and after the administration of the medication? a. pulse rate b. respiratory rate c. blood pressure d. mental status
C
A woman who is stable on lithium therapy for her bipolar disorder is shortly going to be receiving a drug for her hypertension. Which drug would be of greatest concern if added to the treatment regimen? a. a vasodilator b. an angiotensin-converting enzyme inhibitor c. a diuretic d. A calcium channel blocker
C
A woman with diarrhea begins to complain of eye pain after administration of diphenoxylate with atropine. The nurse should do which of the following? a. Offer an over-the-counter analgesic such as acetaminophen. b. Discontinue the diphenoxylate with atropine and notify the provider. c. Tell the patient that this is a common side effect and will soon pass. d. Apply a cool compress to the eyes for relief of the discomfort.
C
After being prescribed a keratolytic, a client has asked the nurse to clarify the purpose of the medication. The nurse's reply is based upon what information regarding the purpose of the class of medications? A. Relieving dermatitis B. Improved barrier functions C. Repair of sun-damaged skin D. Microbial effects
C
An 8-year-old boy has been taking dexmethylphenidate 5 mg daily for 3 months. His mother is concerned that this dosage is not adequately treating his symptoms of attention deficit hyperactivity disorder. Which of the following behaviors would support the mother's concerns? a. increased concentration during school b. weight gain of 8 lbs over the past 3 months c. increased activity d. bradycardia
C
An otherwise healthy surgical client has developed sharply increased muscle tone and rapid increase in heart rate and core body temperature. The operating room team should proceed with assessments and interventions that address what health problem? A. Rhabdomyolysis B. Orthostatic hypotension C. Malignant hyperthermia D. Anaphylaxis
C
Drug therapy for weight management may be prescribed for patients with which of the following? a. a body mass index (BMI) of 22 kg/m2 and a desire to lose 10 lb b. a BMI of 24.5 kg/m2 and physically fit c. a BMI of 30 kg/m2 or more with weight-related health problems d. a BMI of 25 to 29 kg/m2 and healthy
C
Fluoxetine achieves its effects by a. blocking the uptake of monoamines b. inhibiting monoamine oxidase A (MAO-A) enzyme in nerve terminals c. selectively inhibiting serotonin reuptake d. directly stimulating serotonin receptors
C
The psychiatric nurse is conducting health education addressing the adverse effects of clozapine. What teaching point should the nurse convey to the client? A. "Sometimes people who take this drug are more prone to getting infections such as colds and flus" B. "There's a chance that you could develop breathing problems when using this drug, making you vulnerable to pneumonia" C. "There's a possibility that this drug might cause you to gain weight and have high blood sugar levels" D. "You'll have to ear more protein while you're taking this drug to help heal any wounds"
C
Which statement made by a man indicates that he requires further patient teaching regarding adherence to his medication regimen? a. "If I experience muscle spasms in my neck, I must report that to the health care provider." b. "If I experience sudden fever and difficulty breathing, I must report that to the health care provider." c. "If I experience sedation, I must cut down on my medication." d. "If I experience dizziness, I must report that to the health care provider."
C
While assisting the healthcare provider with a minor procedure involving a local anesthetic, the nurse monitors the client for a systemic toxicity event. What is the usual trigger for such an event? A. A type I hypersensitivity response to the anesthetic B. A type II hypersensitivity response to the anesthetic C. Systemic absorption of a local anesthetic D. A genetic predisposition toward incomplete metabolism of the anesthetic
C
Androgens play a role in the development of acne vulgaris by increasing production of which of the following? a. testosterone b. estrogen c. sebum d. facial oil
C; Rationale- Androgens increase the production of sebum, contributing to the development of acne vulgaris.
A child receives a diagnosis of acute otitis media. His physician orders amoxicillin. The onset of which of the following adverse effects warrants the discontinuation of the medication? a. diarrhea b. abdominal pain c. diminished appetite d. wheezing
D
A child returns to school after a dental procedure requiring anesthesia. He visits the school nurse's office to take his pain medication. The most important assessment the nurse should make prior to the administration of the pain medication is to assess the a. prescription for an expiration date b. child's blood pressure and pulse c. child's mouth for bleeding d. child's mouth for numbness
D
A child with attention deficit hyperactivity disorder would most likely exhibit which of the following symptoms? a. anxiety b. positive peer relationships c. hostility d. restlessness
D
A client begun taking orlistat to lose weight. When teaching the client about the medication, how should the nurse explain its action? A. Fat remains sequestered in the stomach for a longer period B. Fat is stored in the liver rather than as subcutaneous fat C. Fat is metabolized more efficiently D. Fat passes through the GI tract unchanged
D
A client has been prescribed phentermine for weight management. When providing client teaching, how should the nurse explain the action of the medication? A. It increases the metabolic rate B. It inhibits absorption of fats C. It reduces gastric surface area D. It suppresses appetite
D
A client has been taking isotretinoin for the past 4 months. What question should the nurse ask to best assess for a serious adverse effect associated with this drug? A. "Are you aware of the signs of hypoglycemia?" B. "When did you last have lab work to evaluate your liver function?" C. "Have you any reason to believe that you are experiencing macular degeneration?" D. "Are you experiencing any signs of depression?"
D
A client is scheduled for the surgical removal of a spinal tumor. During the induction phase of anesthesia, what event will occur? A. Establishing IV access B. Introduction of adjunctive medications C. Inserting laparoscopic instruments D. Securing a patent airway
D
A client prescribed fluoxetine 1 week ago presents for a scheduled follow-up appointment. What should be the focus of the client's nursing assessment to best assure client safety? A. Cardiac rate and rhythm B. Indications of a type IV hypersensitivity reaction C. Improvement in the ability to concentrate D. Presence of suicidal ideation
D
A male infant is admitted to the emergency department. His parents report that he had a seizure. The infant's aural temperature is 104.3°F. What is the most likely cause of the seizure? a. head injury b. developmental delay c. sepsis d. fever
D
A nurse practitioner plans to order lithium for a patient with bipolar disorder. Lithium is contraindicated in a patient with an impairment of which of the following systems? a. respiratory system b. cardiac system c. endocrine system d. renal system
D
A patient is having a seizure that lasts longer than 30 minutes. What type of generalized seizure is the patient experiencing? a. tonic-clonic b. absence seizure c. atonic seizure d. status epilepticus
D
A patient taking lithium is having problems with coordination and unstable gait. The patient's lithium level is 2.3 mEq/L. The nurse should do which of the following? a. Continue to administer the lithium three times per day. b. Skip a dose of lithium and then resume the regular medication schedule. c. Administer an extra dose of lithium. d. Withhold the lithium, offer fluids, and notify the prescriber of the lithium level.
D
A primiparous woman who has been in the first stage of labor for 2 hours will receive an anesthetic. What would the perinatal nurse anticipate being the anesthetic of choice? A. IV anesthesia B. Spinal anesthesia C. Topical anesthesia D. Epidural anesthesia
D
How does IV propofol achieve central nervous system (CNS) depression? A. Slowing the reuptake of serotonin B. Antagonizing the effects of acetylcholine C. Binding the acetylcholinesterase D. Enhancing the effects of gamma-aminobutyric acid (GABA)
D
Monoamine oxidase (MAO) inhibitors are indicated in which of the following? a. in patients who have previously developed serotonin syndrome b. in patients who are first beginning treatment of depression c. in patients who are having trouble sleeping d. in patients who have not responded successfully to selective serotonin reuptake inhibitors and tricyclic antidepressants
D
Patient teaching for children taking methylphenidate for attention deficit hyperactivity disorder should include which of the following? a. Give the child the drug at bedtime. b. Drowsiness may be a side effect. c. If necessary, the child may take over-the-counter cold products without problems. d. Provide for periodic drug-free holidays.
D
The nurse anesthetist is providing education to a client regarding scheduled surgery that will involve induction with propofol. What common adverse events should be mentioned in the teaching? A. Hemorrhage B. Risk for infection C. Autonomic dysreflexia D. Acute Pain
D
The nurse is providing education to a client who has been scheduled to receive spinal anesthesia. What anatomical location will the nurse identify as the site of administration? A. Nerve ganglion B. Epidural space C. Mucous Membrane D. Lumbar region
D
When a 7-year-old child, already of short stature, is prescribed amphetamine sulfate, which intervention will promote growth? a. administering growth hormone b. encouraging daily exercise c. maintaining a 2200-calorie diet d. drug holidays when on school breaks
D
Which finding is indicative of an adverse effect of dextroamphetamine? a. increased appetite b. respiratory depression c. sedation d. cardiac dysrhythmias
D
Which nursing action should be implemented prior to instilling eardrops? a. Evaluate the patient's pain level. b. Assess the amount of hearing loss. c. Instruct the patient to lie on the affected ear. d. Assess if cerumen is visible.
D
The mother of a boy being treated for acne vulgaris asks a nurse why her son is being treated with doxycycline and a topical benzoyl peroxide agent. Which of the following is the best response the nurse can make to the patient's mother? a. "Benzoyl peroxide cannot be administered without doxycycline." b. "Doxycycline should be administered only until the acne vulgaris improves." c. "If your son's acne does not improve in 2 weeks, then one of the two agents will be stopped." d. "Doxycycline orally and benzoyl peroxide topically will provide better treatment of the acne vulgaris."
D; Rationale- Doxycycline and topical benzoyl peroxide are more effective in treating acne than the administration of one agent alone.
A nurse observing a client notices that the client has developed muscle rigidity, altered mental status, tachycardia, and sweating. The nurse interprets these findings as suggesting which disorder? A. EPS B. Agranulocytosis C. Tardive Dyskinesia D. Neuroleptic malignant syndrome
D; rationale- NMS is a rare reaction characterized by a combination of EPS, hyperthermia, and autonomic disturbance
