Pharm test 1

A nurse is preparing to administer clindamycin 200mg by intermittent IV bolus. The amount available is clindamycin injection 200mg in 100mL 0.9% NaCl to infuse over 30min. The nurse should set the IV pump to deliver how many mL/hr?

200 ml/hr

A nurse is preparing to administer haloperidol 2mg PO every 12hr. The amount available is haloperidol 1mg/tablet. How many tablets should the nurse administer?

2 tablets

. The nurse is enrolling subjects for a double-blind experimental study. One patient asks the nurse to explain the role of the experimental group. The nurse will explain that subjects in the experimental group in this type of study: a. are selected for participation in that group. b. have unique baseline characteristics. c. receive a placebo. d. receive the treatment being evaluated.

D

A nurse is preparing to administer heparin 15,000 units subcutaneously every 12hr. The amount available is heparin injection 20,000 units/mL. How many mL should the nurse administer per dose?

0.8 mL

A nurse is preparing to administer D5W 750mL IV to infuse over 6hr. The nurse should set the IV pump to deliver how many mL/hr?

125 mL/hr

A nurse is preparing to administer vancomycin 1g by intermittent IV bolus. Available is vancomycin 1g in 100mL of D5W to infuse over 45 min. The drop factor of the manual IV tubing is 10gtt/mL. The nurse should adjust the manual IV infusion to deliver how many gtt/min?

22 gtt/min

A nurse is preparing to administer amoxicillin 20mg/kg/day PO to divide equally every 12hr to a preschooler who weighs 44lb. The amount available is amoxicillin suspension 250mg/5mL. How many mL should the nurse administer per dose?

4 mL

A nurse is preparing to administer acetaminophen 650mg PO every 6hr PRN for pain. The amount available is acetaminophen liquid 500mg/5mL. How many mL should the nurse administer per dose?

6.5 mL

A nurse is preparing to administer furosemide 80mg PO daily. The amount available is furosemide oral solution 10mg/1mL. How many mL should the nurse administer?

8 mL

A child exhibits acromegaly caused by a tumor that cannot be destroyed with radiation. Which medication will most likely be used to treat this child? a. Bromocriptine mesylate (Parlodel) b. Octreotide acetate (Sandostatin) c. Somatrem (Protropin) d. Somatropin (Genotropin)

A

A health care provider calls a nursing unit to leave a telephone order for a PRN antipyretic medication for a child. The provider tells the nurse to give PO acetaminophen for a fever greater than 101 F per protocol. What will the nurse do next? a. Ask the provider to verify how many mg per kg per dose and how frequently to give the medication. b. Look up the protocol in the unit manual and write the drug order for the provider to sign. c. Provide the child's weight to the hospital pharmacist to write the order based on the protocol. d. Transcribe the verbal order to the order sheet as give PO acetaminophen for a fever greater than 101 F per protocol.

A

A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take? A. Obtain a blood specimen immediately prior to administering the next dose of medication. B. Verify that the client has been taking the medication for 24 hr before obtaining a blood specimen. C. Ask the client to provide a urine specimen after the next dose of medication. D. Administer the medication,and obtain a blood specimen 30 min late

A

A nursing student asks why a direct-acting cholinergic agonist drug that is selective to muscarinic receptors is described as being non-specific. The nurse will explain that this is because: a. muscarinic receptors are present in many different tissues. b. the action of cholinesterase alters the bioavailability at different sites. c. these drugs can also affect nicotinic receptors. d. they vary in their reversible and irreversible effects.

A

A patient asks the nurse about an herbal supplement and reports that it has a USP seal of approval. The nurse explains that this indicates: a. identity, potency, purity, and labeling accuracy. b. premarket testing for safety and efficacy. c. structure and function claims may be made. d. the supplements ability to prevent and treat disease

A

A patient asks the nurse about taking calcium supplements to avoid hypocalcemia. The nurse will suggest that the patient follow which instruction? a. Take a calcium and vitamin D combination supplement. b. Take calcium along with phosphorus to improve absorption. c. Take calcium with antacids to reduce stomach upset. d. Use aspirin instead of acetaminophen when taking calcium.

A

A patient asks the nurse about the safety of herbal products in general. Which response by the nurse is correct? a. Consumers should research products and their manufacturers before taking. b. Manufacturers are required to list interactions of herbs with drugs and food. c. Products manufactured for drug and grocery store chains are safe. d. Toxicological analysis is required of all commercial herbal products.

A

A patient asks the nurse if an enteric-coated tablet can be crushed and put in pudding to make it easier to swallow. How will the nurse respond to the patient? a. Crushing the medication can lead to a possibly toxic medication dose. b. Crushing the medication is safe and can prevent gagging on pills. c. The tablet may be done if a small amount of pudding is used. d. The tablet may be dissolved in liquid but not crushed and put in food.

A

A patient is admitted with orthopnea, cough, pulmonary crackles, and peripheral edema. The patients urine specific gravity is 1.002. The nurse will expect this patients provider to order which treatment? a. Diuretics b. Colloidal IV fluids c. Hypertonic IV fluids d. Hypotonic IV fluids

A

A patient is ordered to receive insulin lispro at mealtimes. The nurse will instruct this patient to administer the medication at which time? a. 5 minutes before eating b. 15 minutes after eating c. 30 minutes before eating d. 10 minutes after eating

A

A patient is ordered to take an extended-release medication twice daily but has difficulty swallowing the tablet because of its size. The nurse will perform which action? a. Contact the provider to discuss an alternate form of the medication. b. Crush the tablet and put it in applesauce to help the patient swallow it. c. Cut the tablet in half so the patient can take it more easily. d. Dissolve the tablet in liquid.

A

A patient is taking doxazosin mesylate (Cardura) 1 mg per day to treat hypertension. The nurse notes a blood pressure of 110/72 mm Hg and a heart rate of 92 beats per minute. The nurse will contact the provider to discuss which change to the drug regimen? a. Changing to a beta-adrenergic blocker b. Decreasing the drug dose c. Increasing the drug dose d. Adding a diuretic

A

A patient reports taking St. Johns wort to treat symptoms of depression and asks the nurse how to use this product safely and effectively. Which response by the nurse is correct? a. Apply sunscreen while taking St. Johns wort. b. It is safe to take St. Johns wort with prescription antidepressants. c. St. Johns wort does not affect nutrition. d. You should take St. Johns wort as needed when symptoms occur

A

A patient who has irritable bowel syndrome would most likely receive which type of drug to treat this condition? a. An anticholinergic b. A cholinergic esterase inhibitor c. A muscarinic agent d. A nicotinic agent

A

A patient who has type 1 diabetes mellitus asks the nurse about using a combination insulin product such as Humalog 75/25. The nurse will tell the patient that use of this product: a. depends on individual insulin needs. b. is useful for patient with insulin resistance. c. means less rotation of injection sites. d. requires refrigeration at all times.

A

A patient who has type 2 diabetes mellitus asks the nurse why the provider has changed the oral antidiabetic agent from tolbutamide (Orinase) to glipizide (Glucotrol). The nurse will explain that glipizide: a. has a longer duration of action. b. has fewer gastrointestinal side effects. c. may be taken on an as-needed basis. d. results in less hypoglycemic potential.

A

A patient who is intubated develops bradycardia because of vagal stimulation. Which medication will the nurse anticipate administering to treat this symptom? a. Atropine sulfate (Atropine) b. Benztropine (Cogentin) c. Bethanechol chloride (Urecholine) d. Metoclopramide (Reglan)

A

A patient who takes the oral antidiabetic agent metformin (Glucophage) will begin taking levothyroxine (Synthroid). The nurse will teach this patient to monitor for a. hyperglycemia. b. hypoglycemia. c. hyperkalemia. d. hypokalemia.

A

A patient will begin taking albuterol (Proventil) to treat asthma. When teaching the patient about this drug, the nurse will make which recommendation? a. Report rapid or irregular heart rate. b. Drink 8 to 16 extra ounces of fluid each day. c. Monitor serum glucose daily. d. Take a calcium supplement.

A

A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication? A. One B. Two C. Three D. Four

A

An adult patient is brought to the emergency department for treatment of an asthma exacerbation. The patient uses inhaled albuterol as needed to control wheezing. The nurse notes expiratory wheezing, tremors, restlessness, and a heart rate of 120 beats per minute. The nurse suspects that the patient has: a. overused the albuterol. b. not been using albuterol. c. taken a beta-adrenergic blocker. d. taken a monoamine oxidase (MAO) inhibitor

A

During a clinical drug trial for a new medication, researchers note a previously unknown serious adverse effect occurring in more than 50% of subjects. The study is discontinued. Which ethical principle is being exercised? a. Beneficence b. Justice c. Respect for persons d. Veracity

A

The nurse administers albuterol to a patient who has asthma. The albuterol acts by stimulating beta2- adrenergic receptors to cause bronchodilation. The nurse understands that albuterol is a beta-adrenergic: a. agonist. b. antagonist. c. inhibitor. d. depressant.

A

The nurse administers intravenous corticotropin (Acthar) to a patient. A serum cortisol level drawn 60 minutes later shows no change in serum cortisol levels from prior to the dose. What is the nurses first action? a. Notify the provider to discuss a possible non-functioning adrenal gland. b. Recognize the need for an increased dose to treat pituitary insufficiency. c. Request an order for a second dose of corticotropin to treat cortisone deficiency. d. Request an order to repeat the serum cortisol level in 1 to 2 hours.

A

The nurse is assisting with a clinical drug trial in which the side effects of two effective drugs are being compared. A patient who would benefit from either drug has elected to withdraw from the study, and the nurse assists with the paperwork to facilitate this. This is an example of: a. autonomy. b. beneficence. c. justice. d. veracity.

A

The nurse is assisting with data collection in a study of drug effects in healthy subjects. The nurse assists with blood and urine collection to determine serum drug levels and the presence of metabolites in the urine. Which phase of a drug study does this represent? a. Phase I b. Phase II c. Phase III d. Phase IV

A

The nurse is caring for a male patient with myasthenia gravis who will begin taking ambenonium chloride (Mytelase). When performing a health history, the nurse will be concerned about a history of which condition in this patient? a. Benign prostatic hypertrophy b. Chronic constipation c. Erectile dysfunction d. Upper respiratory infection

A

The nurse is caring for a newly admitted patient who has severe gastroenteritis. The patients electrolytes reveal a serum sodium level of 140 mEq/L and a serum potassium level of 3.5 mEq/L. The nurse receives an order for intravenous 5% dextrose and normal saline with 20 mEq/L potassium chloride to infuse at 125 mL per hour. Which action is necessary prior to administering this fluid? a. Evaluate the patients urine output. b. Contact the provider to order arterial blood gases. c. Request an order for an initial potassium bolus. d. Suggest a diet low in sodium and potassium.

A

The nurse is caring for a patient who has a heart rate of 98 beats per minute and a blood pressure of 82/58 mm Hg. The patient is lethargic, is complaining of muscle weakness, and has had gastroenteritis for several days. Based on this patients vital signs, which sodium value would the nurse expect? a. 126 mEq/L b. 140 mEq/L c. 145 mEq/L d. 158 mEq/L

A

The nurse gives 800 mg of a drug that has a half-life of 8 hours. How much drug will be left in the body in 24 hours if no additional drug is given? a. None b. 50 mg c. 100 mg d. 200 mg

C

The nurse is caring for a patient who has asthma and administers a selective beta2-adrenergic agonist to treat bronchospasm. The nurse will expect this drug to also cause which side effect? a. Increased blood glucose b. Increased blood pressure c. Increased heart rate d. Increased gastrointestinal (GI) motility

A

The nurse is caring for a patient who is a member of the local Native American community. The patient is refusing medications and treatments in spite of repeated attempts to explain the importance of these interventions. Which is an appropriate nursing action? a. Ask a family member about traditional healing practices that might be better accepted. b. Enlist the help of a family member to explain the need for the medications and treatments. c. Find a hospital staff member who is Native American to help provide teaching for this patient. d. Suggest a Social Work consult to the patients provider.

A

The nurse is caring for a patient who is receiving isotonic intravenous (IV) fluids at an infusion rate of 125 mL/hour. The nurse performs an assessment and notes a heart rate of 102 beats per minute, a blood pressure of 160/85 mm Hg, and crackles auscultated in both lungs. Which action will the nurse take? a. Decrease the IV fluid rate and notify the provider. b. Increase the IV fluid rate and notify the provider. c. Request an order for a colloidal IV solution. d. Request an order for a hypertonic IV solution.

A

The nurse is caring for a patient who is receiving oral potassium chloride supplements. The nurse notes that the patient has a heart rate of 120 beats per minute and has had a urine output of 200 mL in the past 12 hours. The patient reports abdominal cramping. Which action will the nurse take? a. Contact the provider to request an order for serum electrolytes. b. Encourage the patient to consume less fluids. c. Report symptoms of hyperchloremia to the provider. d. Request an order to increase the patients potassium dose.

A

The nurse is caring for a patient who weighs 75 kg. The patient has intravenous (IV) fluids infusing at a rate of 50 mL/hour and has consumed 100 mL of fluids orally in the past 24 hours. Which action will the nurse take? a. Contact the provider to ask about increasing the IV rate to 90 mL/hour. b. Discuss with the provider the need to increase the IV rate to 150 mL/hour. c. Encourage the patient to drink more water so the IV can be discontinued. d. Instruct the patient to drink 250 mL of water every 8 hours.

A

The nurse is caring for a patient who will receive 10% calcium gluconate to treat a serum potassium level of 5.9 mEq/L. The nurse performs a drug history prior to beginning the infusion. Which drug taken by the patient would cause concern? a. Digitalis b. Hydrochlorothiazide c. Hydrocortisone d. Vitamin D

A

The nurse is caring for a patient whose provider has just ordered a switch from atenolol (Tenormin) to reserpine. When preparing the patient to take this medication, what will the nurse do? a. Ask about herbal supplements. b. Counsel that NSAIDs are safe to take with reserpine. c. Teach about potential side effects of mood elevation and euphoria. d. Tell the patient to expect immediate therapeutic effects.

A

The nurse is caring for a patient whose serum sodium level is 140 mEq/L and serum potassium level is 5.4 mEq/L. The nurse will contact the patients provider to discuss an order for: a. a low-potassium diet. b. intravenous sodium bicarbonate. c. Kayexalate and sorbitol. d. salt substitutes.

A

The nurse is caring for a postoperative patient and notes that the patient received atropine sulfate preoperatively. Which assessment finding would prompt the nurse to notify the provider? a. Absent bowel sounds b. Drowsiness c. Dry mouth d. Heart rate of 78 beats per minute

A

The nurse is caring for an African-American patient who is taking warfarin (Coumadin) to prevent blood clots. The nurse will monitor this patient carefully for which effect? a. Decreased therapeutic effects b. Heightened risk for hemorrhage c. Increased risk of hypersensitivity d. Potential risk of paradoxical effects

A

The nurse is demonstrating the Z-track injection technique to a nursing student on a patient who is receiving iron dextran. Which statement by the student indicates understanding of the teaching? a. This is necessary to prevent staining of the patients skin. b. This technique allows slower, more sustained absorption. c. You may use the ventrogluteal site when using this method. d. I should use a 27-gauge needle to minimize discomfort with this method.

A

The nurse is participating in a clinical drug trial comparing two drugs for migraine headaches. Each group is randomly assigned to either drug A or drug B and then switched to the other drug group before being asked to compare the effects. This is an example of which type of study? a. Crossover design b. Double-blind experimental design c. Matched pair design d. Quasi-experimental design

A

The nurse is performing an assessment on a patient brought to the emergency department for treatment for dehydration. The nurse assesses a respiratory rate of 26 breaths/minute, a heart rate of 110 beats/minute, a blood pressure of 86/50 mm Hg, and a temperature of 39.5 C. The patient becomes dizzy when transferred from the wheelchair to a bed. The nurse notes cool, clammy skin. Which diagnosis does the nurse suspect? a. Fluid volume deficit (FVD) b. Fluid volume excess (FVE) c. Mild extracellular fluid (ECF) deficit d. Renal failure

A

The nurse is preparing an injectable drug and wants to administer it for rapid absorption. How will the nurse give this medication? a. IM into the deltoid muscle b. IM into the gluteal muscle c. SubQ into abdominal tissue d. SubQ into the upper arm

A

The nurse is preparing to administer a chewable tablet to a preschool-age child. The childs parent reports always crushing the tablet and mixing it with pudding when giving it at home. What is the nurses next action? a. Ask the pharmacist if the drug may be crushed. b. Crush the tablet and mix it with pudding. c. Insist that the tablet must be chewed as ordered. d. Request a liquid form of the medication from the pharmacy.

A

The nurse is preparing to administer a schedule II injectable drug and is drawing up half of the contents of a single-use vial. Which nursing action is correct? a. Ask another nurse to observe and cosign wasting the remaining drug from the vial. b. Keep the remaining amount in the patients drawer to give at the next dose. c. Record the amount unused in the patients medication record. d. Dispose of the vial with the remaining drug into a locked collection box

A

The nurse is preparing to administer an intramuscular injection to a 14-month-old toddler. To help with site selection for this injection, what will the nurse ask the child's parent? a. How long has your child been walking? b. How much does your child weigh? c. Is your child afraid to look at needles? d. Is your child right- or left-handed?

A

The nurse is preparing to administer the first dose of digoxin (Lanoxin) to a patient and notes that the dose ordered is much higher than the usual recommended dose. Which action will the nurse perform? a. Administer the dose as ordered. b. Give the dose and monitor for toxicity. c. Hold the dose until reviewing it with the provider. d. Refuse to give the dose.

A

The nurse is preparing to administer tolterodine tartrate (Detrol LA) to a patient who has incontinence. Which symptom would be a contraindication for this drug? a. Decreased bowel sounds b. Drooling c. Gastric upset d. Pain

A

The nurse is reviewing medication information with a nursing student prior to administering an oral drug and notes that the drug has extensive first-pass effects. Which statement by the student indicates a need for further teaching about this medication? a. The first-pass effect means the drug may be absorbed into systemic circulation from the intestinal lumen. b. The first-pass effect means the drug may be changed to an inactive form and excreted. c. The first-pass effect means the drug may be changed to a metabolite, which may be more active than the original. d. The first-pass effect means the drug may be unchanged as it passes through the liver.

A

The nurse is teaching a patient how to use phenylephrine HCl (Neo-Synephrine) nasal spray to treat congestion from a viral upper respiratory infection. What instruction will the nurse give the patient? a. Stop using the medication after 3 days. b. Spray the medication into the nose while lying supine. c. Use frequently since systemic side effects do not occur. d. Use the medication with any other over-the-counter medications.

A

The nurse is teaching a patient who will begin taking bethanechol (Urecholine). Which statement by the patient indicates a need for further teaching? a. Excessive sweating is a normal reaction to this medication. b. Excess salivation is a serious side effect. c. I should get out of bed slowly while taking this drug. d. I will not take the drug if my heart rate is less than 60 beats per minute.

A

The nurse is teaching an overweight patient to administer subcutaneous heparin. Which statement by the patient indicates understanding of the teaching? a. I should insert the needle and inject the medication without aspirating for blood. b. I should put firm pressure on the injection site to decrease the risk for bleeding. c. I will insert the needle at a 10-degree angle when injecting. d. The subcutaneous route is used because absorption is faster this way.

A

The nurse prepares to change a patient's medication from an intravenous to an oral form and notes that the oral form is ordered in a higher dose. The nurse understands that this is due to differences in a. bioavailability. b. pinocytosis. c. protein binding. d. tachyphylaxis.

A

The nurse provides teaching for a patient receiving corticotropin. The nurse will instruct the patient to contact the provider if which condition occurs? a. Bruising b. Constipation c. Myalgia d. Nausea

A

Which is characteristic of preclinical in vivo testing? a. A comparison of experimental and control data in animals b. A study conducted in a test tube in a laboratory c. A study that determines the parameters of safe therapeutic doses d. A study to assess the seriousness of the disease to be treated

A

The nurse caring for a patient who is taking an adrenergic agent will expect which side effects? (Select all that apply.) a. Dilated pupils b. Increased heart rate c. Increase gastrointestinal motility d. Vasodilation e. Bronchospasm f. Relaxed uterine muscles

A, B, F

A nurse assessing the IV catheter insertion site for a client receiving a nonvesicant solution & notes swelling at the site with decreased skin temperature. Which of the following actions should the nurse take? (Select all that apply.) A) Stop the infusion. B) Start a new IV access distal to this site. C) Apply warm compresses to the insertion site. D) Elevate the client's arm. E) Obtain a specimen for culture at the insertion site.

A, C, D

A nurse is preparing a client's medications. Which of the following actions should the nurse take in following legal practice guidelines? (Select all that apply.) A) Teach the client about the medication. B) Determine the dosage. C) Monitor for adverse effects. D) Lock compartments for controlled substances. E) Determine the client's insurance status.

A, C, D

A nurse is assessing a client before administering medications. Which of the following data should the nurse obtain? (Select all that apply.) A) Use of herbal products B) Daily fluid intake C) Ability to swalloe D) Previous surgical history E) Allergies

A, C, E

Which are responsibilities of the U.S. Food and Drug Administration (FDA)? (Select all that apply.) a. To ensure a drug has accurate labeling b. To ensure a drug is affordable c. To ensure a drug is effective d. To ensure a drug is free from adverse reactions e. To ensure a drug is tested for harmful effects

A, C, E

A patient is suspected of having severe hypocalcemia. While waiting for the patients serum electrolyte results, the nurse will assess for which symptoms? (Select all that apply.) a. Laryngeal spasms b. Fatigue c. Muscle weakness d. Nausea and vomiting e. Numbness of fingers f. Twitching of the mouth

A, E, F

Which herbal remedies are often used for gastrointestinal disorders? (Select all that apply.) a. Chamomile b. Cranberry c. Dong quai d. Echinacea e. Ginger f. Peppermint

A, E, F

. The nurse is preparing to administer benztropine (Cogentin) to a patient who has Parkinson's disease. When performing an assessment, which aspect of the patients history would cause the nurse to hold the medication and notify the provider? a. Asthma b. Glaucoma c. Irritable bowel syndrome d. Motion sickness

B

A Native American patient has just been diagnosed with diabetes mellitus. The nurse preparing a teaching plan for this patient understands that which aspect of the disease and disease management may be most difficult for this patient? a. Body image changes b. Management of meal and medication schedules c. Perception of the disease as punishment from God d. The sense of dependence on others

B

A nurse is caring for a client experiencing IV extravasation. The facility requires the administration of an antidote for the prescribed IV solution. After stopping the IV infusion, which of the following actions should the nurse take first? A) Remove the IV catheter. B) Withdraw the solution from the IV access. C) Administer the antidote to the vesicant. D) Insert a new IV access in a different extremity.

B

A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following is an appropriate nursing action? A. Administer the prescribed dose. B. Withhold the medication. C. Ask the provider to change the prescription to an oral form. D. Administer an oral antihistamine at the same time.

B

A nurse is working with a newly licensed nurse who is administering medications to clients. Which of the following actions should the nurse identify as an indication that the newly hired nurse understands medication error prevention? A) Taking all medications out of the unit-dose wrappers before entering the client's room B) Checking the prescription when a single dose requires administration of multiple tablets C) Aministering a medication, then looking up the usual dosage range D)Relying on another nurse to clarify a medication prescription

B

A patient asks the nurse why the provider has ordered a transdermal form of a medication. How will the nurse respond? a. The patch can always be cut when dosage adjustments are needed. b. Drug levels fluctuate less with the patch. c. There are fewer systemic side effects with transdermal patches. d. There is less risk of toxicity when using a patch.

B

A patient has administered regular insulin 30 minutes prior but has not received a breakfast tray. The patient is experiencing nervousness and tremors. What is the nurses first action? a. Administer glucagon. b. Give the patient orange juice. c. Notify the kitchen to deliver the tray. d. Perform bedside glucose testing

B

A patient has hypocalcemia caused by parathyroid hormone deficiency. Which medication will the nurse anticipate giving to this patient? a. Calcitonin b. Calcitriol c. Calcium d. Vitamin D

B

A patient is admitted to the hospital to treat hypothyroidism. For rapid improvement in symptoms, the nurse will expect to administer which medication? a. Levothyroxine sodium (Synthroid) b. Liothyronine (Cytomel) c. Liotrix (Thyrolar) d. Thyroid desiccated (Armour Thyroid)

B

A patient is receiving a glucocorticoid medication to treat an inflammatory condition, and the provider has ordered a slow taper in order to discontinue this medication. The nurse explains to the patient that this is done to prevent which condition? a. Acromegaly b. Adrenocortical insufficiency c. Hypertensive crisis d. Thyroid storm

B

A patient is taking methadone as part of a heroin withdrawal program. The nurse understands that, in this instance, methadone is classified as which drug schedule? a. C-I b. C-II c. C-III d. C-V

B

A patient who has HIV asks the nurse about taking echinacea to improve immune function. What will the nurse tell this patient? a. The root extract is useful for treating upper respiratory and urinary tract infections. b. This use is currently being studied in patients who have HIV. c. Use it as needed when antibiotics fail to treat your infections. d. You may use it safely up to 8 weeks at a time as a preventive medication.

B

A patient who has asthma is diagnosed with hypertension. The nurse understands that which drug will be safe to give this patient? a. Pindolol (Visken) b. Metoprolol (Lopressor) c. Nadolol (Corgard) d. Propranolol (Inderal)

B

A patient who has asthma will begin taking an inhaled corticosteroid medication to be used with a spacer. The patient asks why the spacer is necessary. The nurse will explain that the spacer: a. allows a larger dose to be given safely. b. distributes medication to target tissues. c. minimizes adverse effects of the steroid. d. prevents contamination of the metered-dose inhaler.

B

A patient who is diagnosed with atrial fibrillation is to begin taking warfarin (Coumadin). The patient refuses to take the medication because it is rat poison. After the nurse provides teaching, the patient still refuses. What action will the nurse take? a. Hold the dose and document the patient's refusal. b. Hold the dose, notify the provider of the situation, and document these actions. c. Put the medication in the patients food. d. Tell the patient that the drug is necessary for treatment.

B

A patient who is unconscious and has a pulse is brought to the emergency department. The patient is wearing a Medic-Alert bracelet indicating type 1 diabetes mellitus. The nurse will anticipate an order to administer: a. cardiopulmonary resuscitation (CPR). b. glucagon. c. insulin. d. orange juice.

B

A woman reports using aloe vera to treat constipation. Which response by the nurse is correct? a. Aloe vera is for external use only. b. Please tell me if you are taking cardiac medications or diuretics. c. Side effects of aloe vera are common. d. You may experience a decrease in menstrual flow while taking aloe vera.

B

If a drug has a half-life of 12 hours and is given twice daily starting at 0800 on a Monday, when will a steady state be achieved? a. 0800 on Tuesday b. 0800 on Wednesday c. 0800 on Thursday d. 0800 on Friday

B

In a 5-year experimental clinical trial to investigate a new cancer treatment, researchers in the second year note overwhelming improvement in almost all of the subjects in the treatment group. The lead researcher elects to continue the study. Which ethical principle is being violated? a. Beneficence b. Justice c. Respect for persons d. Veracity

B

The nurse administers bethanechol (Urecholine) to a patient to treat urinary retention. After 30 minutes, the patient voids 800 mL of urine and reports having a loose stool but no cramping or gastrointestinal pain. The patients blood pressure is 110/70 mm Hg. The nurse will perform which action? a. Notify the provider of bethanechol adverse effects. b. Record the urine output and the blood pressure and continue to monitor. c. Request an order for intravenous atropine sulfate. d. Suggest another dose of bethanechol to the provider.

B

The nurse administers subcutaneous epinephrine to a patient who is experiencing an anaphylactic reaction. The nurse should expect to monitor the patient for which symptom? a. Bradycardia b. Decreased urine output c. Hypotension d. Nausea and vomiting

B

The nurse assumes care of a patient who had surgery that morning. The provider has ordered hydrocodone (Lortab) every 4 hours for mild to moderate pain and morphine sulfate for moderate to severe pain. The nurse reviews the patients record and notes the patient has received two doses of hydrocodone 4 hours apart for a pain level of 7 to 8 on a scale of 1 to 10 and has reported a decrease in pain to a level of 6 to 7 after 30 minutes. It has been 4 hours since the last dose, and the patient reports a pain level of 7. What will the nurse do? a. Administer the hydrocodone. b. Administer morphine. c. Ask the patient which drug to give. d. Notify the provider of the patients current pain level.

B

The nurse gives a medication to a patient with a history of liver disease. The nurse will monitor this patient for: a. decreased drug effects. b. increased drug effects. c. decreased therapeutic range. d. increased therapeutic range

B

The nurse is administering intravenous fluids to a patient who is dehydrated. On the second day of care, the patients weight is increased by 2.25 pounds. The nurse would expect that the patients fluid intake has: a. equaled urine output. b. exceeded urine output by 1 L. c. exceeded urine output by 2.5 L. d. exceeded urine output by 3 L.

B

The nurse is caring for a patient who has asthma. The provider has ordered an albuterol metered-dose inhaler (MDI), 2 puffs q4 to 6h PRN wheezing. The patients last dose was 4 hours ago. What is the nurses next action? a. Administer 2 puffs of albuterol with the MDI. b. Auscultate the patients lung sounds. c. Give the albuterol if the patient reports wheezing. d. Give the medication and evaluate its effectiveness

B

The nurse is caring for a patient who is being treated for hypothyroidism. The patient reports insomnia, nervousness, and flushing of the skin. Before notifying the provider, the nurse will perform which action? a. Assess serum glucose to evaluate possible hypoglycemia. b. Check the patients heart rate to assess for tachycardia. c. Perform an assessment of hydration status. d. Take the patients temperature to evaluate for infection.

B

The nurse administers a drug and miscalculates the dose by placing the decimal place one space to the right, resulting in a 10-fold overdose and the death of the patient. What offense does this represent? a. Malfeasance b. Malpractice c. Misfeasance d. Nonfeasance

C

The nurse is caring for a patient who will begin taking a thiazide diuretic to treat hypertension. The patient says, I know this will lower my blood pressure, but how does it work? How will the nurse respond? a. It can cause orthostatic hypotension, so be careful. b. It reduces the volume of fluid in your blood stream to lower blood pressure. c. The actions are complicated, but its an effective drug. d. Your provider should explain this medication to you.

B

The nurse is caring for a patient who will begin taking atenolol (Tenormin). What information will the nurse include when teaching the patient about taking this medication? a. The drug must be taken twice daily. b. The patient must rise slowly from a chair or bed. c. The medication is safe to take during pregnancy. d. Use NSAIDs as needed for mild to moderate pain.

B

The nurse is counseling a female patient who reports taking feverfew to treat premenstrual syndrome and migraines. Which statement by the patient indicates understanding of the teaching? a. I should experience immediate effects with this herb. b. I should not take feverfew if I get pregnant. c. I should take feverfew with nonsteroidal anti-inflammatory drugs (NSAIDs) to enhance its effects. d. If I develop gastrointestinal (GI) upset, I should stop taking feverfew immediately.

B

The nurse is enrolling subjects for a clinical drug trial in which subjects will be randomly assigned to either a treatment or a placebo group. The pills in both groups will be in identical packaging with identical appearance. This is an example of which type of study? a. Crossover b. Double-blind c. Open-label d. Single-blind

B

The nurse is obtaining consent from a subject newly recruited for a clinical drug trial that will last for 6 months. All subjects will be given gift certificates for participating. One subject says, Well, I guess if the drug doesn't work, I'll just have to put up with the symptoms for 6 months. What will the nurse tell the subject? a. Participation for the duration of the study is required. b. Participation may end at any time without penalty. c. Withdrawal from the study may end at any time, but the gift certificate will not be given. d. You can request placement in the treatment group.

B

The nurse is performing an admission assessment on a patient who has recently begun taking reserpine. The patient reports using St. Johns wort. The nurse anticipates that the patient will have: a. hypotension. b. hypertension. c. bradycardia. d. tachycardia

B

The nurse is preparing to administer a combination drug containing acetaminophen and codeine. The nurse knows that this drug is classified as which drug schedule? a. C-II b. C-III c. C-IV d. C-V

B

The nurse is preparing to administer a drug that is ordered to be given twice daily. The nurse reviews the medication information and learns that the drug has a half-life of 24 hours. What will the nurse do next? a. Administer the medication as ordered. b. Contact the provider to discuss daily dosing. c. Discuss every-other-day dosing with the provider. d. Hold the medication and notify the provider

B

The nurse is preparing to administer an oral medication that is water-soluble. The nurse understands that this drug: a. must be taken on an empty stomach. b. requires active transport for absorption. c. should be taken with fatty foods. d. will readily diffuse into the gastrointestinal tract.

B

The nurse is preparing to administer digoxin to a patient who is newly admitted to the intensive care unit. The nurse reviews the patients admission electrolytes and notes a serum potassium level of 2.9 mEq/L. Which action by the nurse is correct? a. Administer the digoxin and monitor the patients electrocardiogram closely. b. Hold the digoxin dose and notify the provider of the patients lab values. c. Request an order for an intravenous bolus of potassium. d. Request an order for oral potassium supplements.

B

The nurse is providing preoperative education to a patient who will have surgery in several weeks. The patient denies taking anticoagulant medications but reports using herbal supplements. Which herb would cause the nurse to be concerned? a. Echinacea b. Ginkgo biloba c. Kava d. Sage

B

The nurse is teaching a group of nursing students about diabetes. The nurse explains that which type of diabetes is the most common? a. Type 1 diabetes mellitus b. Type 2 diabetes mellitus c. Diabetes insipidus d. Secondary diabetes

B

The nurse is teaching a nursing student about giving liquid medications. Which statement by the student indicates understanding of the teaching? a. A suspension is a mixture in which drug particles are dissolved in solution. b. I will line up the bottom of the medication curve with the line in the syringe. c. I will need to shake an elixir before measuring the dose. d. I will not need to refrigerate liquids once they are reconstituted.

B

The nurse receives the following order for insulin: IV NPH (Humulin NPH) 10 units. The nurse will perform which action? a. Administer the dose as ordered. b. Clarify the insulin type and route. c. Give the drug subcutaneously. d. Question the insulin dose.

B

The nurse understands that the length of time needed for a drug to reach the minimum effective concentration (MEC) is the: a. duration of action. b. onset of action. c. peak action time. d. time response curve.

B

Which is a violation of a nurses right when administering medications? a. A hospital policy for off-label drug uses b. A medication preparation area at the unit secretary's desk c. A multiple-dose drug vial requiring the nurse to calculate and measure the dose d. A new drug ordered that the nurse must look up in a drug manual

B

A nurse is preparing to administer medications to a 4-month-old infant. Which of the following pharmacokinetic principles should the nurse consider when administering medications to this client? (Select all that apply) A. Infants have a more rapid gastric emptying time B. Infants have immature liver function C. Infants blood-brain barrier is poorly developed D. Infants have an increased ability to absorb topical medications E. Infants have an increased number of protein-binding sites

B, C, D

Cholinergic drugs have specific effects on the body. What are the actions of cholinergic medications? (Select all that apply.) a. Dilate pupils b. Decrease heart rate c. Stimulate gastric muscle d. Dilate blood vessels e. Dilate bronchioles f. Increase salivation g. Constrict pupils

B, C, D, F, G

A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.) A) A client at 8 weeks of gestation who asks for an influenza immunization. B) A client who takes prednisone and has a possible fungal infection. C) A client who has chronic liver disease and is taking hydrocodone/acetaminophen. D) A client who has peptic ulcer disease, takes sucralfate, and has started taking over-the-counter aluminum hydroxide. E) A client who has a prosthetic heart valve, who takes warfarin, and reports a suspected pregnancy.

B, C, E

A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse take? (Select all that apply.) A) Have the client lie on one side. B) Ask the client to look up at the ceiling. C) Tell the client to blink when the drops enter the eye. D) Drop the medication into the client's conjunctival sac. E) Instruct the client to close the eye gently after instillation.

B, D, E

The nurse is caring for a patient who will receive intravenous calcium gluconate. Which nursing actions are appropriate when giving this solution? (Select all that apply.) a. Administering through a central line b. Assessing for Trousseaus and Chvosteks signs c. Giving as a rapid intravenous bolus d. Mixing in a solution containing sodium bicarbonate e. Monitoring the patients electrocardiogram (ECG) f. Reporting a serum calcium level >2.5mEq/L

B, E, F

A 45-year-old patient who is overweight has had a diagnosis of type 2 diabetes for 2 years. The patient uses 20 units of insulin per day. The patients fasting blood glucose (FBG) is 190 mg/dL. The patient asks the nurse about using an oral antidiabetic agent. The nurse understands that oral antidiabetic agents: a. cannot be used if the patient is overweight. b. cannot be used once a patient requires insulin. c. may be used since this patient meets criteria. d. may not be used since this patients fasting blood glucose is too high.

C

A clinical drug trial is concluding a study of pharmacokinetics and safety of a drug in healthy individuals. The nurse will assist enrollment of participants into the next phase of the study and will include which subjects? a. Healthy subjects b. Healthy and ill subjects c. Subjects with the disease the drug will treat d. Subjects with other diseases

C

A nurse in a provider's office is reviewing the medical record of a client who is pregnant and at the first prenatal visit. Which of the following immunizations can the nurse administer safely to this client? A. Varicella vaccine B. Rubella C. Inactivated influenza vaccine D. Measles

C

A nurse is caring for a client who is taking oral oxycodone. The client is also taking ibuprofen in three recommended doses daily. The nurse should identify that an interaction between these two medications will cause which of the following findings? A. A decrease in blood levels of ibuprofen, possibly leading to a need for increased doses of the medication B. A decrease in blood levels of oxycodone, possibly leading to a need for increased doses of this medication C. An increase in the expected therapeutic effect of both medications D. An increase in expected adverse effects for both medications

C

A nurse is preparing to administer an oral drug that is best absorbed in an acidic environment. How will the nurse give the drug? a. On an empty stomach b. With a full glass of water c. With food d. With high-fat food

C

A nurse is preparing to initiate IV therapy for an older adult client. Which of the following actions should the nurse plan to take? A) Use a disposable razor to remove excess hair on the extremity. B) Select the back of the client's hand to insert the IV catheter. C) Distend the veins by using a blood pressure cuff. D) Direct the client to raise their arm above the heart.

C

A nurse is reviewing a client's health record and notes that the client experienced permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client? A) Cardiovascular B) Immune C) Central nervous D) Gastrointestinal

C

A nurse is reviewing a client's prescribed medicaitons. Which of the following situations represents a contraindication to medication administration? A) The client drank grapefruit juice, which could reduce a medication's effectiveness. B) The medication has orthostatic hypotension as an adverse effect. C) A medication is approved for ages 12 and older, and the client is 8 years old. D) An antianxiety medication that has an adverse effect of drowsiness is prescribed as a preoperative sedative.

C

A nurse is teaching a client about transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands? A) "I will clean the site with an alcohol swab before I apply the patch." B) "I will rotate the application site weekly." C) "I will apply the patch to an area of skin with no hair." D) "I will place the new patch on the site of the old patch."

C

A nurse is teaching a patient how to use phenylephrine (Neo-Synephrine) nasal spray. To avoid systemic absorption, the nurse teaches the patient to perform which action? a. Apply pressure to the nose after spraying. b. Administer the spray while in the supine position. c. Insert the spray while sitting up. d. Exhale deeply while injecting the nasal spray.

C

A nurse on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness? A. Reduced cardiac function B. First-pass effect C. Reduced hepatic function D. Delayed toxic effect

C

A patient develops type 2 diabetes mellitus. The nurse will explain that this type of diabetes: a. is generally triggered by medications. b. is not as common as type 1 diabetes. c. is often related to heredity and obesity. d. will not require insulin therapy.

C

A patient has a serum potassium level of 2.7 mEq/L. The patients provider has determined that the patient will need 200 mEq of potassium to replace serum losses. How will the nurse caring for this patient expect to administer the potassium? a. As a single-dose 200 mEq oral tablet b. As an intravenous bolus over 15 to 20 minutes c. In an intravenous solution at a rate of 10 mEq/hour d. In an intravenous solution at a rate of 45 mEq/hour

C

A patient has been taking a drug that has a protein-binding effect of 75%. The provider adds a new medication that has a protein-binding effect of 90%. The nurse will expect: a. decreased drug effects of the first drug. b. decreased therapeutic range of the first drug. c. increased drug effects of the first drug. d. increased therapeutic range of the first drug.

C

A patient is taking prednisolone and fludrocortisone (Florinef). When teaching this patient about dietary intake, the nurse will instruct the patient to consume a diet: a. high in carbohydrates. b. high in fat. c. high in protein. d. low in potassium.

C

A patient is taking valerian, or herbal valium, to induce sleep. What will the nurse teach this patient about this herb? a. Habituation and addiction are likely. b. Hangover effects are common with usual doses. c. Liver function tests must be monitored with long-term use. d. Valerian has a high risk for overdose.

C

A patient receives a prescription on which the provider has noted that a generic medication may be given. The patient asks the nurse what this means. What will the nurse tell the patient about generic drugs? a. They contain the same inert ingredients as brand-name drugs. b. They have chemical structures that are identical to proprietary drugs. c. They tend to be less expensive than brand-name drugs. d. They undergo extensive testing before they are marketed.

C

A patient who has been taking a sulfonylurea antidiabetic medication will begin taking metformin (Glucophage). The nurse understands that this patient is at increased risk for which condition? a. Hypoglycemia b. Hyperglycemia c. Renal failure d. Respiratory distress

C

A patient who is newly diagnosed with type 1 diabetes mellitus asks why insulin must be given by subcutaneous injection instead of by mouth. The nurse will explain that this is because: a. absorption is diminished by the first-pass effects in the liver. b. absorption is faster when insulin is given subcutaneously. c. digestive enzymes in the gastrointestinal tract prevent absorption. d. the oral form is less predictable with more adverse effects.

C

A patient who is of Filipino descent is admitted to the hospital. The nurse goes to the room to start intravenous fluids and to perform an admission assessment and finds several family members in the room. Which action by the nurse is appropriate? a. Ask the family to wait in the hallway until the admission tasks are completed. b. Determine which family member is the family patriarch and address questions to him. c. Invite family members to assist with appropriate tasks during the admission process. d. Provide chairs for family members and ask them to stay seated during the admission.

C

A patient who takes warfarin (Coumadin) and digoxin (Lanoxin) develops hypothyroidism and will begin taking levothyroxine (Synthroid). The nurse anticipates which potential adjustments in dosing for this patient? a. Decreased digoxin and decreased warfarin b. Decreased digoxin and increased warfarin c. Increased digoxin and decreased warfarin d. Increased digoxin and increased warfarin

C

A patient will be discharged on beta blockers. Which skill is essential for the nurse to teach the patients family? a. How to prepare a low-sodium diet b. Assessments to detect fluid retention c. How to monitor heart rate and blood pressure d. Early signs of changing level of consciousness

C

A patient with Graves disease exhibits tachycardia, heat intolerance, and exophthalmos. Prior to surgery, which drug is used to alter thyroid hormone levels? a. Liotrix (Thyrolar) b. Propranolol (Inderal) c. Propylthiouracil (PTU) d. Thyroid (Thyrotab)

C

A patients serum osmolality is 305 mOsm/kg. Which term describes this patients body fluid osmolality? a. Iso-osmolar b. Hypo-osmolar c. Hyperosmolar d. Isotonic

C

A woman who is experiencing hot flashes associated with menopause asks the nurse about using black cohosh. Which response by the nurse is correct? a. Black cohosh may be used long term in place of hormone replacement therapy. b. Black cohosh may contribute to iron toxicity. c. Black cohosh may interact with antihypertensive drugs. d. Black cohosh treats menopausal symptoms without altering hormone levels.

C

Many drugs marketed in the 1980s may not be effective in a majority of the population. The nurse understands that this is because these drugs: a. did not pass through the appropriate phases of clinical trials. b. did not require human subject protections and are invalid. c. were not tested on women, minorities, or children. d. were tested on healthy subjects only.

C

The nurse is assisting the parent of a 6-month-old infant to administer an oral liquid medication. The parent asks why the medication cant be given in a bottle of formula to make it taste better. How will the nurse respond? a. Adding a medication to the formula will cause the formula to curdle. b. Formula and medications can form toxic compounds if mixed together. c. The infant may not always take the entire bottle of formula. d. This may cause the infant to refuse formula in the future.

C

The nurse is caring for a patient in the post-anesthesia recovery unit. The nurse notes that the patient received atropine sulfate 2 mg 30 minutes prior to anesthesia induction. The patient has received 1,000 mL of intravenous fluids and has 700 mL of urine in the urinary catheter bag. The patient reports having a dry mouth. The nurse notes a heart rate of 82 beats per minute. What action will the nurse perform? a. Administer a fluid bolus. b. Give the patient ice chips. c. Palpate the patients bladder. d. Reassess the patient in 15 minutes.

C

The nurse is caring for a patient who has had severe vomiting. The patients serum sodium level is 130 mEq/L. The nurse will expect the patients provider to order which treatment? a. Diuretic therapy b. Intravenous hypertonic 5% saline c. Intravenous normal saline 0.9% d. Oral sodium supplements

C

The nurse is caring for a patient who has recently begun taking atenolol (Tenormin) to treat hypertension. The patient reports dizziness, nausea, vomiting, and decreased libido since beginning the medication. What will the nurse do? a. Hold the next dose until the provider can be notified of these side effects. b. Reassure the patient that these symptoms are common and not worrisome. c. Recommend that the patient discuss these effects with the provider. d. Suggest that the patient request a different beta-adrenergic blocker

C

The nurse is caring for a patient who has taken an overdose of aspirin several hours prior. The provider orders sodium bicarbonate to be given. The nurse understands that this drug is given for which purpose? a. To counter the toxic effects of the aspirin b. To decrease the half-life of the aspirin c. To increase the excretion of the aspirin d. To neutralize the acid of the aspirin

C

The nurse is caring for a patient who is ordered to take nothing by mouth. The patient weighs 65 kg. What volume of intravenous fluid should this patient receive in 24 hours? a. 2225 mL b. 2400 mL c. 2520 mL d. 2640 mL

C

The nurse is caring for a patient who will have surgery that morning. The patient usually takes an antihypertensive medication every morning. The patient has been NPO since midnight. What action will the nurse perform? a. Ask the patient to swallow the pill without water. b. Give the medication with a small sip of water. c. Consult the provider and surgeon about giving the medication. d. Hold the medication until after the patients surgery.

C

The nurse is caring for an African-American patient who appears to understand instructions for self-care but does not carry out basic self-care tasks. The nurse understands that the patient may a. be poorly educated and lack basic comprehension skills. b. need more time and personal space to assimilate what is taught. c. require the use of culturally appropriate words and phrases when teaching. d. view illness as punishment and lack desire to change the outcome.

C

The nurse is obtaining signatures on consent forms for participation in a clinical drug trial. One patient says, I'm not sure I want to do this, but I need the cash. The nurse will take which action? a. Ask the patient to clarify concerns. b. Reinforce that cash is given to all subjects equally. c. Report this statement to the party named on the consent. d. Review the elements of the study and obtain consent.

C

The nurse is participating in a clinical study of the effects of teaching on drug compliance. The subjects are randomly assigned to either an experimental group or a control group. Health professionals deliver one of two teaching modules to each patient. This is an example of which kind of study? a. Double-blind b. Open-label c. Single-blind d. Triple-blind

C

The nurse is performing a pain assessment on a patient of Asian descent. The patient does not describe the pain when asked to do so and looks away from the nurse. What will the nurse do next? a. Ask the patient's family member to evaluate the patients pain. b. Conclude that the patient's pain is minimal. c. Evaluate the patients non-verbal pain cues. d. Suspect that the patient is experiencing severe pain.

C

The nurse is preparing to administer a drug and learns that it is an indirect-acting cholinergic agonist. The nurse understands that this drug: a. acts on muscarinic receptors. b. acts on nicotinic receptors. c. inhibits cholinesterase. d. inhibits cholinergic receptors.

C

The nurse is preparing to administer a medication from a unit-dose system. The nurse verifies that the medication, dose, and time are correct and that the expiration date was the day prior. Which action is correct? a. Administer the medication and observe for adequate drug effects. b. Notify the pharmacist and provider of a medication error. c. Return the medication to the pharmacy to be replaced. d. Verify the right patient and administer the medication.

C

The nurse is preparing to administer a rectal suppository antipyretic medication. Which action by the nurse is correct? a. Allowing the suppository to soften at room temperature before inserting b. Asking the patient to lie on the right side during insertion of the medication c. Having the patient remain in a side-lying position for 20 minutes after insertion d. Using a lubricant such as petrolatum gel (Vaseline) to lubricate the medication

C

The nurse is preparing to administer an oral medication and wants to ensure a rapid drug action. Which form of the medication will the nurse administer? a. Capsule b. Enteric-coated pill c. Liquid suspension d. Tablet

C

The nurse is preparing to discuss long-term care needs with a patient newly diagnosed with a chronic disease. The patient is of Latin American descent. The nurse will plan to take which action when teaching this patient? a. Discussing long-term outcomes associated with compliance of the prescribed regimen b. Highlighting various traditional healing practices that will not be effective for this patients care c. Providing factual information and answering all questions as they arise d. Providing teaching in increments, allowing periods of silence to allow assimilation of information

C

The nurse is preparing to give a medication to a child. The child's parent asks whether the drug is safe for children. How will the nurse respond to the parent? a. Drugs are tested on adults and safe doses for children are based on weights compared to adult weights. b. Drugs are deemed safe for children over time when repeated use proves effectiveness and safety. c. Drugs are tested for both efficacy and safety in children in order to be marketed for pediatric use. d. Drugs are tested on children in postmarketing studies and on a limited basis.

C

The nurse is preparing to start an intravenous (IV) line in a preschool-age child. After applying a eutectic mixture of local anesthetics, what will the nurse do to prepare the child? a. Describe what the IV line will feel like and how long it will be in place. b. Explain the purpose of the procedure. c. Give the child equipment to handle and practice on a doll. d. Reassure the child that the pain will only last a few minutes.

C

The nurse is teaching a parent to administer medications using a child's gastrostomy tube. The parent asks why it is necessary to give water after each medication. The nurse explains that the water is given for which purpose? a. To decrease gastrointestinal upset b. To dilute the medication and enhance absorption c. To ensure that all medication is infused into the stomach d. To improve overall hydration

C

The nurse is teaching a patient about home administration of insulin. The patient will receive regular (Humulin R) and NPH (Humulin NPH) insulin at 0700 every day. What is important to teach this patient? a. Draw up the medications in separate syringes. b. Draw up the NPH insulin first. c. Draw up the regular insulin first. d. Draw up the medications after mixing them in a vial.

C

The nurse is teaching a patient how to administer insulin. The patient is thin with very little body fat. The nurse will suggest injecting insulin: a. by pinching up the skin and injecting straight down. b. in the abdomen only with the needle at a 90-degree angle. c. subcutaneously with the needle at a 45- to 60-degree angle. d. using the thigh and buttocks areas exclusively.

C

The nurse is teaching a patient who is going on a cruise about the use of transdermal scopolamine . What information will the nurse include when teaching this patient? a. Apply the patch as needed for nausea and vomiting. b. Apply the patch to your upper arm. c. Change the patch every 3 days. d. Restrict fluids while using this patch.

C

The nurse is teaching a patient who is newly diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient indicates a need for further teaching? a. I may use a chosen site daily for up to a week. b. I should give each injection a knuckle length away from a previous injection. c. I will not be concerned about a raised knot under my skin from injecting insulin. d. Insulin is absorbed better from subcutaneous sites on my abdomen.

C

The nurse is teaching a patient who will be discharged home with a prescription for an enteric-coated tablet. Which statement by the patient indicates understanding of the teaching? a. I may crush the tablet and put it in applesauce to improve absorption. b. I should consume acidic foods to enhance absorption of this medication. c. I should expect a delay in onset of the drugs effects after taking the tablet. d. I should take this medication with high-fat foods to improve its action.

C

The nurse provides counseling to a patient who reports taking kava to treat anxiety-related symptoms. Which statement by the patient indicates understanding of the teaching? a. I may take kava with lorazepam (Ativan). b. I may develop a serious skin disorder while taking kava. c. I should avoid alcohol while taking kava. d. I should avoid St. Johns wort and valerian while taking kava

C

The parents of an 11-year-old boy ask about growth hormone therapy for their child who is shorter than his 10-year-old sister. The nurse will tell the parents that growth hormone: a. does not affect other hormones when given. b. is available as an oral tablet to be taken once daily. c. is given after tests prove that it is necessary. d. may be given until the child's desired height is reached.

C

The pediatric nurse reviews a hand-written medication order which reads, 09/16/2013, acetaminophen 160 mg (5 mL) PO q4h for fever. What will the nurse do next? a. Administer the drug when indicated. b. Ask the provider to confirm if dose is correct for the patients age. c. Clarify the nursing assessments necessary for giving a dose. d. Contact the provider to request patient allergy information.

C

The provider has ordered Kayexalate and sorbitol to be administered to a patient. The nurse caring for this patient would expect which serum electrolyte values prior to administration of this therapy? a. Sodium 125 mEq/L and potassium 2.5 mEq/L b. Sodium 150 mEq/L and potassium 3.6 mEq/L c. Sodium 135 mEq/L and potassium 6.9 mEq/L d. Sodium 148 mEq/L and potassium 5.5 mEq/L

C

The spouse of a patient who is an alcoholic asks the nurse about dietary supplements that may help prevent liver disease. Which herb will the nurse suggest the patient discuss with a provider who has prescriptive authority? a. Ginkgo biloba b. Kava c. Milk thistle d. Sage

C

Which cholinesterase inhibitor would be prescribed for a patient who has Alzheimer's disease? a. Ambenonium chloride (Myletase) b. Benztropine (Cogentin) c. Donepezil HCl (Aricept) d. Neostigmine methylsulfate (Prostigmin)

C

Which drugs will go through a pharmaceutic phase after it is administered? a. Intramuscular cephalosporins b. Intravenous vasopressors c. Oral analgesics d. Subcutaneous antiglycemics

C

Which information can consumers expect to be included in labeling of herbal products? a. Actions and uses b. Interactions and precautions c. Scientific name of the product d. Safety and efficacy study results

C

Which law(s) govern all drug administration by nurses? a. Drug Regulation and Reform Act b. FDA Amendments Act c. Nurse Practice Acts d. The Controlled Substances Act

C

A nurse educator is reviewing medication metabolism at an in-service presentation. Which of the following factors should the educator include as a reason to admminister lower medication dosages? (Select all that apply.) A) Increased renal excretion B) Increased medication-metabolizing enzymes C) Liver failure D) Peripheral vascular disease E) Concurrent use of medication the same pathway metabolizes.

C, E

A 35-year-old woman reports lethargy, difficulty remembering things, facial edema, dry skin, and cessation of menses. The nurse notes a heart rate of 60 beats per minute and a weight increase of 5 pounds from a previous visit. The nurse will notify the provider of which possible condition? a. Cretinism b. Early menopause c. Hyperthyroidism d. Myxedema

D

A family member expresses concern that a patient is taking several herbal remedies and worries that they may be unsafe. The nurse will respond by saying that herbs: a. are classified as medications by the Dietary Supplement Health and Education Act of 1994. b. are regulated by the government and are determined to be safe. c. aren't usually effective but are generally harmless. d. should be discussed with the patients provider in conjunction with other medications

D

A man is diagnosed with benign prostatic hypertrophy and wants to avoid surgery. He asks the nurse about using saw palmetto. What information will the nurse include when teaching this patient about this herb? a. Gastric disturbances are common while using this herb. b. Saw palmetto may help treat erectile dysfunction (ED) as well. c. Use saw palmetto for up to 30 days and stop taking it when effects occur. d. You should stop taking the herb 1 to 2 weeks prior to prostate-specific antigen (PSA) testing.

D

A nurse is preparing to administer Digoxin to a client who states, "I don't want to take that medication. I do not want one more pill." Which of the following responses should the nurse make? A) "Your physician prescribed it for you, so you really should take it." B) "Well, let's just get it over quickly then." C) "Okay, I'll just give you your other medications." D) "Tell me your concerns about taking this medication."

D

A nurse is providing discharge instructions for a client who has a new prescription for an antihypertensive medication. Which of the following statements should the nurse give? A. "Be sure to limit your potassium intake while taking the medication." B. "You should check your blood pressure every 8 hr while taking this medication." C. "Your medication dosage will be increased if you develop tachycardia." D. "Change positions slowly when you move from sitting to standing."

D

A patient is admitted after experiencing vomiting and diarrhea for several days. The provider orders intravenous lactated Ringers solution. The nurse understands that this fluid is given for which purpose? a. To increase interstitial and intracellular hydration b. To maintain plasma volume over time c. To pull water from the interstitial space into the extracellular fluid d. To replace water and electrolytes

D

A patient is being treated for shock after a motor vehicle accident. The provider orders 6% dextran 75 to be given intravenously. The nurse should expect which outcome as the result of this infusion? a. Decreased urine output b. Improved blood oxygenation c. Increased interstitial fluid d. Stabilization of heart rate and blood pressure

D

A patient is prescribed a medication and asks the nurse if the drug is available in a generic form. The nurse understands that a generic medication will have a name that a. is a registered trademark. b. is always capitalized. c. describes the drugs chemical structure. d. is non-proprietary.

D

A patient is taking a thiazide diuretic and reports anorexia and fatigue. The nurse suspects which electrolyte imbalance in this patient? a. Hypercalcemia b. Hypocalcemia c. Hyperkalemia d. Hypokalemia

D

A patient who has Parkinson's disease will begin treatment with benztropine (Cogentin). Which symptom of Parkinson's disease would be a contraindication for this drug? a. Drooling b. Muscle rigidity c. Muscle weakness d. Tardive dyskinesia

D

A patient who has Raynauds disease will begin taking an alpha-adrenergic blocker. The patient asks the nurse how the drug works to treat symptoms. The nurse explains that alpha-adrenergic blockers treat Raynauds disease by causing: a. decreased peripheral vascular resistance. b. orthostatic hypotension. c. reflex tachycardia. d. vasodilation.

D

A patient who has hyperthyroidism will begin treatment with an antithyroid medication. The patient asks the nurse about dietary requirements. The nurse will counsel the patient to avoid which food(s)? a. Fava beans b. Foods high in purine c. Grapefruit d. Shellfish

D

A patient who has insulin-dependent diabetes mellitus must take a glucocorticoid medication for osteoarthritis. When teaching this patient, the nurse will explain that there may be a need to: a. decrease the glucocorticoid dose. b. decrease the insulin dose. c. increase the glucocorticoid dose. d. increase the insulin dose.

D

A patient who is being treated for dehydration is receiving 5% dextrose and 0.45% normal saline with 20 mEq/L potassium chloride at a rate of 125 mL/hour. The nurse assuming care for the patient reviews the patients serum electrolytes and notes a serum sodium level of 140 mEq/L and a serum potassium level of 3.6 mEq/L. The patient had a urine output of 250 mL during the last 12-hour shift. Which action will the nurse take? a. Contact the patients provider to discuss increasing the potassium chloride to 40 mEq/L. b. Continue the intravenous fluids as ordered and reassess the patient frequently. c. Notify the provider and discuss increasing the rate of fluids to 200 mL/hour. d. Stop the intravenous fluids and notify the provider of the assessment findings.

D

A patient who is overweight is being evaluated for diabetes. The patient has a blood glucose level of 160 mg/dL and a hemoglobin A1c of 5.8%. The nurse understands that this patient has which condition? a. Diabetes mellitus b. Hypoglycemia c. Normal blood levels d. Prediabetes

D

A patient who takes high-dose aspirin to treat arthritis will need to take prednisone to treat an acute flare of symptoms. What action will the nurse perform? a. Observe the patient for hypoglycemia. b. Monitor closely for increased urine output. c. Observe the patient for hypotension. d. Request an order for enteric-coated aspirin.

D

A pregnant woman tells the nurse that she is taking ginger to reduce morning sickness. What will the nurse tell this patient? a. Ginger can cause fetal birth defects. b. Ginger is not safe during pregnancy. c. Ginger can cause abortion in low doses. d. Ginger may be taken in low doses for up to 4 days.

D

Before marketing a new drug that has been approved for use based on clinical effectiveness and safety, the manufacturer wishes to study the potential new uses for the drug. This is an example of which phase of study? a. Phase I b. Phase II c. Phase III d. Phase IV

D

In order to ensure that a medication is given to the right patient, the nurse must perform which action? a. Ask the patient to spell their last name. b. Match the patient with a photo ID. c. Swipe a bar code on the patients ID bracelet. d. Verify the patient using two identifiers.

D

The nurse administers a narcotic analgesic to a patient who has been receiving it for 1 day after orthopedic surgery. The patient reports no change in pain 30 minutes after the medication is given. The nurse recognizes that this patient is exhibiting: a. drug-seeking behavior. b. drug tolerance. c. the placebo effect. d. tachyphylaxis.

D

The nurse is administering two drugs to a patient and learns that both drugs are highly protein-bound. The nurse may expect: a. decreased bioavailability of both drugs. b. decreased drug effects. c. decreased drug interactions. d. increased risk of adverse effects

D

The nurse is assisting with a clinical drug trial to test the safe dose of an analgesic medication and learns that subjects have been told that the study is about measuring the analgesic effects. Which ethical principle has been violated? a. Beneficence b. Justice c. Respect for persons d. Veracity

D

The nurse is busy and neglects to give a drug to a patient resulting in the patient's death. What offense does this represent? a. Malfeasance b. Malpractice c. Misfeasance d. Nonfeasance

D

The nurse is caring for a 20-kg child who is ordered to receive amoxicillin 400 mg PO TID for 10 days. The nurse reviews the drug information and notes that the correct dose of amoxicillin is 40 to 50 mg/kg/day in two to three divided doses. Which action by the nurse is correct? a. Adjust the drug dose based on drug manufacturer dosing information. b. Administer the medication as ordered. c. Ask the pharmacist to double-check that the dose is correct. d. Contact the provider and ask whether the drug should be given BID instead of TID.

D

The nurse is caring for a newly admitted patient who will receive digoxin to treat a cardiac dysrhythmia. The patient takes hydrochlorothiazide (HydroDIURIL) and reports regular use of over-the-counter laxatives. Before administering the first dose of digoxin, the nurse will review the patients electrolytes with careful attention to the levels of which electrolytes? a. Calcium and magnesium b. Sodium and calcium c. Potassium and chloride d. Potassium and magnesium

D

The nurse is caring for a patient who has experienced head trauma in a motor vehicle accident. The patient is having excessive output of dilute urine. The nurse will notify the provider and will anticipate administering which medication? a. Calcifediol (Calderol) b. Corticotropin (Acthar) c. Prednisolone (AK-Pred) d. Vasopressin (Pitressin)

D

The nurse is caring for a patient who has hypothyroidism. To assist in differentiating between primary and secondary hypothyroidism, the nurse will expect the provider to order which drug? a. Liothyronine sodium (Cytomel) b. Liotrix (Thyrolar) c. Methimazole (Tapazole) d. Thyrotropin (Thytropar)

D

The nurse is caring for a patient who is receiving desmopressin acetate (DDAVP). Which assessments are important while caring for this patient? a. Blood pressure and serum potassium b. Heart rate and serum calcium c. Lung sounds and serum magnesium d. Urine output and serum sodium

D

The nurse is caring for a patient who is receiving growth hormone. Which assessment will the nurse monitor daily? a. Complete blood count b. Height and weight c. Renal function d. Serum glucose

D

The nurse is caring for a patient who is receiving intravenous dopamine (Intropin). The nurse notes erythema and swelling at the IV insertion site. What is the nurses initial action? a. Apply warm soaks to the area. b. Monitor the patient closely for hypertension. c. Obtain an order for an electrocardiogram. d. Notify the provider of a need for phentolamine mesylate (Regitine).

D

The nurse is caring for a postoperative patient who is of Asian descent. The patient reports little relief from pain even while taking an opioid analgesic containing codeine and acetaminophen. What does the nurse suspect that this patient is exhibiting? a. Drug-seeking behavior b. Heightened pain perception c. Poor understanding of expected drug effects d. Rapid metabolism of one of the drugs components

D

The nurse is explaining to the patient why a nonspecific drug has so many side effects. Which statement by the patient indicates a need for further teaching? a. Nonspecific drugs can affect specific receptor types in different body tissues. b. Nonspecific drugs can affect a variety of receptor types in similar body tissues. c. Nonspecific drugs can affect hormone secretion as well as cellular functions. d. Nonspecific drugs require higher doses than specific drugs to be effective.

D

The nurse is performing tuberculin testing on a patient. Which action by the nurse is correct? a. Insert the needle, bevel up, at a 30-degree angle. b. Massage the area gently after the injection. c. Measure the diameter of the area of erythema when reading the result. d. Use a 25-gauge, 3/8 needle.

D

The nurse is preparing to administer a drug and learns that it binds to protein at a rate of 90%. The patient's serum albumin level is low. The nurse will observe the patient for: a. decreased drug absorption. b. decreased drug interactions. c. decreased drug toxicity. d. increased drug effects.

D

The nurse is preparing to administer a drug that is eliminated through the kidneys. The nurse reviews the patient's chart and notes that the patient has increased serum creatinine and blood urea nitrogen (BUN). The nurse will perform which action? a. Administer the drug as ordered. b. Anticipate a shorter than usual half-life of the drug. c. Expect decreased drug effects when the drug is given. d. Notify the provider and discuss giving a lower dose.

D

Which statement by a patient who will begin using an external insulin pump indicates understanding of this device? a. I will have an increased risk for hypoglycemia. b. I will leave this on when bathing or swimming. c. I will not need to count carbohydrates anymore. d. I will still need to monitor serum glucose.

D

The nurse is preparing to administer bethanechol (Urecholine) to a patient who is experiencing urinary retention. The nurse notes that the patient has a blood pressure of 90/60 mm Hg and a heart rate of 98 beats per minute. The nurse will perform which action? a. Administer the drug and monitor urine output. b. Administer the medication and monitor vital signs frequently. c. Give the medication and notify the provider of the increased heart rate. d. Hold the medication and notify the provider of the decreased blood pressure.

D

The nurse is preparing to administer piperacillin to a patient to treat an infection caused by pseudomonas. The nurse learns that the patient receives corticotropin to treat multiple sclerosis. The nurse will request an order for: a. a different antibiotic. b. blood glucose monitoring. c. cardiac monitoring. d. serum electrolytes.

D

The nurse is preparing to administer the anticholinergic medication benztropine (Cogentin) to a patient who has Parkinson's disease. The nurse understands that this drug is used primarily for which purpose? a. To decrease drooling and excessive salivation b. To improve mobility and muscle strength c. To prevent urinary retention d. To suppress tremors and muscle rigidity

D

The nurse is preparing to give a dose of gentamicin to a patient and notes that the most recent serum gentamicin trough level was 2 mcg/mL. What will the nurse do next? a. Administer the drug as ordered. b. Administer the drug and monitor for adverse effects. c. Notify the provider to discuss decreasing the dose. d. Notify the provider to report a toxic drug level.

D

The nurse is teaching a patient about the use of an anticholinergic medication. What information will the nurse include when teaching this patient about this medication? a. Check your heart rate frequently to monitor for bradycardia. b. Drink extra fluids while you are taking this medication. c. Rise from a chair slowly to avoid dizziness when taking this drug. d. Use gum or lozenges to decrease dry mouth caused by this drug.

D

The nurse is teaching a patient about using sublingual nitroglycerin at home. Which statement by the patient indicates understanding of the teaching? a. I may put the tablet in food if I don't like the taste. b. I may take a sip of water after placing the tablet in my mouth. c. I will place the tablet between my cheek and gum. d. I will place the tablet under my tongue and let it absorb.

D

The nurse notes that a patient of African American descent who is taking an oral antihypertensive medication continues to have elevated blood pressure three months after beginning the medication regimen. The nurse suspects that the patient may be: a. consuming ethnic foods that interfere with absorption of the drug. b. discarding the medication. c. experiencing allergic reactions to the medication. d. metabolizing the drug differently than expected.

D

The nurse reviews information about a drug and notes the initials USP after the drugs official name. The nurse understands that this designation indicates the drug a. is a controlled substance. b. is approved by the U.S. Food and Drug Administration (FDA). c. is available in generic form. d. meets quality and safety standards

D

The nurse will administer parenteral insulin to a patient who will receive a mixture of NPH (Humulin NPH) and regular (Humulin R). The nurse will give this medication via which route? a. Intradermal b. Intramuscular c. Intravenous d. Subcutaneous

D

The parent of a junior high-school child who has type 1 diabetes asks the nurse if the child can participate in sports. The nurse will tell the parent: a. that strenuous exercise is not recommended for children with diabetes. b. that the child must be monitored for hyperglycemia while exercising. c. to administer an extra dose of regular insulin prior to exercise. d. to send a snack with the child to eat just prior to exercise.

D

The parents of a 16-year-old boy who plays football want their child to receive growth hormone to improve muscle strength. What will the nurse tell the parents? a. Growth hormone may be used to improve strength in young athletes. b. If the epiphyses are not fused, growth hormone may be an option. c. Small doses of growth hormone may be used indefinitely for this purpose. d. Using growth hormone to build muscle mass is not recommended.

D

The patient asks the nurse about storing insulin. Which response by the nurse is correct? a. All insulin vials must be refrigerated. b. Insulin will last longer if kept in the freezer. c. Opened vials of insulin must be discarded. d. Some combination pens do not require refrigeration.

D

The patient has been ordered to receive Sudafed to treat nasal congestion. The nurse performing an admission assessment learns that the patient has diabetes mellitus. What action is appropriate for the nurse to take? a. Administer the medication as ordered. b. Contact the provider to discuss a lower dose. c. Give the medication and monitor serum glucose closely. d. Hold the medication and contact the provider.

D

The patient has been started on a treatment regimen that includes atenolol (Tenormin) and complains to the nurse of feeling weak. Which is the best response from the nurse? a. I will hold your next dose of the medication. b. You may need an increase in your next dose of the medication. c. This is an adverse reaction to the medication. I will stop the drug. d. This is a side effect of the medication. I will notify your physician.

D

When administering topical medications, which is an important nursing action? a. Applying the medication liberally b. Cleaning skin with alcohol before applying c. Using sterile technique d. Wearing gloves

D

When the nurse practices the 5-plus-5 rights of medication administration, what does it ensure? a. Adequate information is given b. Cost-effective use of medications c. Informed consent for drug administration d. Safe administration of medications

D

Which statement about the safety and efficacy of medications in children is accurate? a. Children cannot give consent, so clinical drug trials are not performed on children. b. Children can only be subjects in quasi-experimental clinical studies. c. Data from adult clinical drug trials can be extrapolated to children. d. Federal law requires that drugs for children be tested on children.

D

Which would be a contraindication for hormone therapy with somatropin (Genotropin) in a school-age child? a. Asthma b. Dwarfism c. Enuresis d. Prader-Willi syndrome

D