Practice Questions

1. A patient is prescribed celecoxib for the treatment of rheumatoid arthritis. Which instruction does the nurse give to the patient for safe administration of the drug? a. Take the drug after a meal b. Take the drug with caffeine c. Avoid taking the drug with fluid d. Take the drug on an empty stomach

A

1. A patient newly diagnosed with type 2 diabetes is instructed to make dietary changes and perform aerobic exercise daily. For which reason would insulin therapy be delayed? a. Insulin therapy is initiated when other methods have failed b. It is not generally prescribed to obese patients c. It is ineffective without initial oral drug therapy d. Insulin therapy may cause heart failure to develop

A

1. A patient newly diagnosed with type 2 diabetes mellitus has been ordered insulin glargine. Which information is essential for the nurse to teach this patient? a. It has a duration of action of 24 hours b. Mix it with the regular insulin each morning c. It is very short-acting; eat after injecting it d. It is expensive but administered only a short time

A

1. After the placement of a new transdermal opioid patch, the patient complains of an increase in level of pain. Which error in placement of the new patch is the reason? a. Placed on a hairy area b. Placed on an area after cleaning it c. Placed on the same place as the old patch d. Placed on a new area, with the old patch still in place

A

1. The nurse cares for a patient on the second day after major abdominal surgery. The patient is receiving morphine sulfate via patient-controlled analgesia (PCA) and currently reports pain as a 2 on a scale of 0 to 10. The patient tearfully says to the nurse, "I'm so worried that I won't be able to go back to work. How am I going to manage my bills?" Which statement is the best response by the nurse? a. "Tell me more about your fears" b. "Your pain is well controlled now. Why are you so worried?" c. "Everything will be fine. You will be back to work in about 6 weeks" d. "The disability benefit of your insurance plan will help pay your bills"

A

1. The nurse is assessing a geriatric patient who has high blood pressure and prediabetes and was prescribed propranolol 10 mg. Which treatment can be given to the patient to reduce the risk of coronary artery disease? a. 81 mg of aspirin b. 10 units of insulin c. 50 mg of ketorolac d. 20 mg of propranolol

A

1. Which assessment finding in a patient taking nonsteroidal anti-inflammatory drugs (NSAIDs) requires immediate intervention? a. Black, tarry stools b. Palpitations c. Nonproductive cough d. Headache

A

1. Which category of medications increases the ulcerogenic effect of nonsteroidal anti-inflammatory drugs (NSAIDs)? a. Corticosteroids b. Bisphosphonates c. Coumarin analogs d. Prostaglandin analogs

A

1. Which medication is used to treat a patient experiencing severe adverse effects of an opioid analgesic? a. Naloxone b. Flumazenil c. Acetylcysteine d. Methylprednisolone

A

1. Which nonsteroidal anti-inflammatory drug (NSAID) is prescribed for the patient with myocardial infarction? a. Aspirin b. Celecoxib c. Prednisone d. Dexamethasone

A

1. Which nonsteroidal anti-inflammatory drug (NSAID) may cause Reye's syndrome in children with viral illnesses or fever? a. Aspirin b. Piroxicam c. Meloxicam d. Nabumetone

A

1. Which side effect of long-term treatment with corticosteroids requires patients to undergo an annual bone density exam? a. Osteoporosis b. Addison's disease c. Type 1 diabetes mellitus d. Chronic obstructive pulmonary disease

A

1. Which type of insulin can be given intravenously? a. Regular insulin b. Insulin glargine c. Insulin zinc suspension d. Isophane Insulin Suspension (NPH)

A

1. A patient is prescribed oxycodone extended release (ER) for pain management. Which information is essential to include in the teaching plan? Select all that apply: a. Do not crush the medication b. Swallow the medication whole c. Take the medication frequently d. Do not dissolve the medication in water e. Increase the dose if you experience no pain relief

A, B, D

1. A patient has taken an excessive dose of acetaminophen for pain management. Which adverse effects associated with acetaminophen are likely to be found in the patient? Select all that apply: a. Nausea b. Vomiting c. Blurred Vision d. Decreased earing e. Elevated liver enzymes

A, B, E

1. Which clinical indicators of hypoglycemia will the nurse identify for the patient and family? Select all that apply. a. Sweating b. Headache c. Polyphagia d. Weight loss e. Polydipsia f. Tachycardia

A, B, F

1. Which conditions in a patient with diabetes mellitus are indicative of diabetic ketoacidosis? Select all that apply. a. Ketones in the urine b. Severe hypothermia c. Isotonic dehydration d. Electrolyte imbalances e. Extreme Hyperglycemia

A, C, D, E

1. The nurse is performing a follow-up assessment of a patient who is being treated with glucocorticoids for an exacerbation of chronic obstructive pulmonary disease. Which assessment findings indicate that the treatment is effective? Select all that apply a. Respiratory rate of 16 breaths/minute b. Temperature of 100.6F c. Oxygen saturation of 95% d. Weight gain of 4.4lbs over a week e. Random glucose concentration of 150 mg/dL

A, C, E

1. Which precautions will the nurse take before administering insulin isophane suspension (NPH) to a patient? Select all that apply. a. Verify that insulin syringes are used b. Identify the intramuscular injection site c. Shake the drug vial gently for some time d. Rotate the injection locations weekly e. Monitor the patient's fasting serum glucose level

A, D, E

1. A patient with a history of Asthma frequently receives prednisone for acute bronchitis. Which adverse effects would the nurse anticipate that the patient may experience with continuous use of the therapy? Select all that apply a. Weight gain b. Hypoglycemia c. Increased sleep d. Personality changes e. Loss of muscle bulk f. Loss of bone density

A, D, E, F

1. A nursing student is asked to administer prednisone to a patient. Which statement by the nursing student reflects effective planning? a. The medication is administered on a strict, unchanging schedule to prevent adverse effects b. The medication should be administered with food to diminish the risk of gastric irritation c. The medication should not be administered intravenously because of the risk of hypotension d. The medication is administered early in the evening to coincide with the natural secretion of the adrenal cortex

B

1. A patient is prescribed enteric-coated aspirin for joint pain management. Which statement does the nurse make to the patient while administering enteric-coated aspirin? a. You should chew the tablet properly b. You should swallow the tablet with water c. You should crush the tablet and mix with food d. You should dissolve the tablet in water and then ingest

B

1. A patient who regularly takes acetaminophen returns to the clinic for a follow-up visit. Which assessment finding indicates the need for a change in the patient's therapy a. Hemoglobin 11.2g/dL b. Serum Bilirubin 3.2 mg/dL c. Serum creatinine 0.8 mg/dL d. Random blood Glucose 140 mg/dL

B

1. The nurse is administering aspirin to a patient. The nurse understands that aspirin is a nonsteroidal anti-inflammatory drug. Which property of aspirin makes it different from the other NSAID drug? a. Analgesic property b. Antiplatelet activity c. Antipyretic property d. Anti-inflammatory property

B

1. The nurse is assessing a 3-year-old child who has a fever. After checking the laboratory repots, the nurse finds that the child has Influenza B. Which medication(s) would the nurse expect to be included in the care plan? a. Aspirin b. Acetaminophen c. Aspirin and ibuprofen d. Aspiring combination drug

B

1. The nurse is assessing a patient who has just had a myocardial infarction and who has a history of peptic ulcer disease. While reviewing the prescription, the nurse finds that the patient is prescribed aspirin 35 mg. Which drug should be used as an alternative to aspirin to prevent the recurrence of peptic ulcers? a. Ibuprofen b. Enteric-coated aspirin c. Aspirin/antacid combination d. Aspirin/caffeine combination

B

1. The nurse is assessing an older adult who has rheumatoid arthritis and has been prescribed cyclosporine. While obtaining a medical history, the nurse learns that the patient is taking ibuprofen for pain relief. Which side effect does the nurse anticipate for the patient? a. Increased ulcerogenic effects b. Increased risk for nephrotoxicity c. Increased elimination of cyclosporine d. Increased risk of gastrointestinal bleeding

B

1. The nurse will advise a patient receiving opioid analgesics for chronic pain to perform which action to minimize the gastrointestinal side effects? a. Eat foods high in lactobacilli b. Increase fluid and fiber in diet c. Take the medication on an empty stomach d. Take diphenoxylate/atropine with each dose

B

1. The nurse would include which statement when teaching a patient about insulin glargine a. You can mix this insulin with NPH insulin to enhance its effect b. You cannot mix this insulin with any other insulin in the same syringe c. You should inject this insulin just before meals because it is very fast-acting d. The duration of action for this insulin is approximately 8-10 hours, so you will need to take it twice a day.

B

1. What role does the release of cortisol play in the stress response? a. Decreases oxygen delivery b. Provides more fuel for cells c. Decreases coagulability of blood d. Reduces blood flow to vital organs

B

1. Which action does the nurse take when finding a hospitalized patient with type 1 diabetes mellitus unresponsive, cold, and clammy? a. Start an insulin drip b. Administer intravenous glucose c. Draw blood and send to the laboratory d. Administer subcutaneous insulin

B

1. Which assessment finding indicates that the patient may have received an overdose of morphine sulfate? a. Blood in urine b. Pinpoint pupils c. Heart rate 110 beats/minute d. Respiratory rate 28 breaths/minute

B

1. Which condition listed in the patients' medical history could be a contraindication to administration of morphine sulfate? a. Cancer b. Asthma c. Anorexia d. Diarrhea

B

1. Which dermatological change would the nurse monitor for in a patient receiving long-term corticosteroid therapy? a. Cysts b. Bruising c. Jaundice d. Cyanosis

B

1. Which information will the nurse include in the teaching plan for repaglinide? a. This medication will not cause hypoglycemia b. You will need to be sure you eat as soon as you take this medication c. You do not have to worry about side effects when taking this medication d. When taking this medication, use aspirin rather than acetaminophen for pain relief

B

1. Which instruction is appropriate for a patient who is on nonsteroidal anti-inflammatory drug (NSAID) therapy? a. Increase fluid intake to 1 to 2 L per day b. Take the NSAID with food, milk, or an antacid c. Stop the medication if you have any gastrointestinal disturbance d. Slowly increase the dosage of medication based on pain intensity

B

1. Which medication will the nurse administer to treat hypoglycemia in a patient brought to the emergency department who was experiencing tremors, sweating, and irritability before losing consciousness? a. Insulin b. Glucagon c. Exenatide d. Liraglutide

B

1. Which site should be used for injecting insulin? a. Deltoid b. Abdomen c. Vastus Lateralis d. Gluteus Maximus

B

1. Which symptom would the nurse assess for in a patient taking prednisone that suggests adrenal crisis? a. Edema b. Hypotension c. Hypoglycemia d. Increased Appetite

B

1. Which adverse effects are associated with Nonsteroidal anti-inflammatory drugs (NSAIDS)? Select all that apply: a. Delusions b. Tinnitus c. Anorexia d. Dyspepsia e. Constipation

B, C, D

1. Which patient conditions are contraindicated for administration of aspirin? Select all that apply: a. Patient with gout b. Patient with rhinitis c. Patient with severe peptic ulcer d. Patient with vitamin K deficiency e. Patient with myocardial infarction

B, C, D

1. Which early symptoms of hypoglycemia does the nurse instruct the patient's family to treat with a fast-acting carbohydrate source? a. Coma b. Tremor c. Sweating d. Confusion e. Irritability

B, C, D, E

1. A patient develops black stools, bleeding around the gums, and very small red-brown spots on the body after taking a nonsteroidal anti-inflammatory drug to relieve joint pain. The nurse would contact the health care provider to request which tests? Select all that apply: a. Urine test b. Hematocrit test c. Hemoglobin test d. Chest radiography e. Total blood count test

B, C, E

1. A patient is being discharged with a prescription for morphine for postoperative pain. Which information would the nurse include in the discharge teaching plan? Select all that apply: a. Rest before taking the medication b. Drink at least 3 liters of fluid a day c. Take acetaminophen with the morphine d. Take an over-the-counter stool softener daily Increase the dose of morphine if there is no relief of

B, D

1. The nurse is teaching a patient who has been prescribed a daily oral dose of prednisone about the medication regimen. Which instructions will the nurse provide the patient to ensure safe administration? Select all that apply a. Take aspirin with the prednisone b. Take each dose with milk or food c. Take the medication early evening d. Take the medication early morning e. Take the medication on an empty stomach

B, D

1. What are signs and symptoms of an adrenal crisis? Select all that apply a. Buffalo Hump b. Hyperkalemia c. Hypernatremia d. Delayed wound healing e. Drop in extracellular fluid volume

B, E

1. A patient is about to receive steroid therapy. Which disorder would contraindicate administration of the medication? a. Asthma b. Rheumatoid arthritis c. Uncontrolled diabetes mellitus d. Chronic obstructive pulmonary disease

C

1. A patient is prescribed high-dose acetaminophen for long-term treatment of pain. Which medication may be part of the patient's treatment plan to prevent complications associated with acetaminophen toxicity? a. Naloxone b. Nalbuphine c. Acetylcysteine d. Naltrexone Hydrochloride

C

1. A patient is receiving long-term prednisone therapy. During the follow-up visit, the nurse finds that the patient has gained weight and has low levels of adrenal hormone. Which actions by the patient would have led to an alteration in the hormone level? a. The patient took the medication with milk b. The patient took the medication after meals c. The patient took the medication during the night d. The patient included high-protein food in the diet

C

1. A patient is undergoing glucocorticoid therapy. Which medication would the nurse administer to the patient for mild pain management? a. Aspirin b. Ibuprofen c. Acetaminophen d. Naproxen Sodium

C

1. A patient with diabetes mellitus has recently undergone pancreas transplantation. According to the prescription, the nurse administers a long-acting depot formulation of methylprednisolone. The next day, the patient's blood glucose concentration and blood pressure are higher than the normal levels. Which factor may be the reason for the high blood glucose concentration? a. Failure of the pancreas transplantation b. Complete elimination of the drug from the body c. Release of excess drug from the depot formulation d. Presence of benzyl alcohol in the depot formulation

C

1. A patient with type 1 diabetes mellitus asks the nurse "Why can't I take a sulfonylurea like my friend who has diabetes?" Which response is correct? a. You must be mistaken. If your friend has diabetes mellitus, she is taking insulin b. Sulfonylurea will lower your blood sugar too much, and you will be hypoglycemic c. Sulfonylurea increases beta-cell stimulation to secrete insulin, and your beta cells do not contain insulin d. You are unable to store glucose because you do not have insulin, and sulfonylurea helps with glucose storage

C

1. A patient's medication administration record has the following entry: Morphine sulfate 1 mg IV push q2h PRN severe pain. Upon assessment, the patient continues to complain of pain that is 8 on a scale of 0 to 10. The patient received 1 mg of Morphine an hour ago. Which action would the nurse take? a. Administer 1 mg of morphine and notify the primary health care provider b. Hold the drug, record the assessment, and reassess the patient in 1 hour. c. Consult the primary health care provider and obtain another drug prescription d. Administer another 1 mg of morphine and reevaluate the pain scale in 15 minutes

C

1. Potencies of analgesics are determined using an equianalgesic table comparing doses of these drugs with which prototype? a. Codeine b. Fentanyl c. Morphine d. Meperidine

C

1. The Nurse finds that a patient with type 2 diabetes mellitus who is taking glipizide is also prescribed sitagliptin. Which action will the nurse take? a. Decrease the oral dose of glipizide b. Administer both medications simultaneously c. Notify the prescribing primary health care provider d. Give both drugs and check the patient's blood glucose

C

1. The nurse Is caring for a patient who has systemic lupus erythematosus who has been taking prednisone for several years. Which change in the patient will the nurse assess to detect complications from long-term therapy? a. Hair loss b. Pale skin c. Presence of belly fat d. Sudden increase in height

C

1. The nurse administers insulin to a patient at 8:30 a.m. and knows it will peak in about 2.5 hours after administration. Which insulin did the nurse administer if this is true? a. Insulin lispro b. Insulin Aspart c. Regular Insulin d. Insulin Glulisine

C

1. The nurse is caring for several patients who are receiving glucocorticoid therapy. Which patient would the nurse assess first? a. A patient with septic shock b. A patient with rheumatoid arthritis c. A patient with uncontrolled diabetes mellitus d. A patient experiencing an exacerbation of asthma

C

1. The nurse teaches a patient receiving long-term corticosteroid drug therapy about the dosage regimen. Which response by the patient indicates the need for further teaching? a. I will take this medication with food or milk regularly? b. I will not touch or interact with people who have infections c. I will stop taking this medication if I have any adverse effect d. I will report to you immediately if I have a fever or sore throat

C

1. Which assessment will the nurse make for a patient who is prescribed metformin for treatment of type 2 diabetes? a. Edema b. Weight gain c. Renal function d. Cholesterol level

C

1. Which condition would a nurse expect in a patient who abruptly withdrawals from a glucocorticoid medication? a. Cataracts b. Osteoporosis c. Addison's disease d. Cushing's syndrome

C

1. Which instruction does the nurse give when a patient receiving metformin therapy will undergo angiography? a. There are chances of renal failure after the test b. Your blood glucose levels need to be reevaluated c. Do not take your metformin on the day of the test d. You can take the medication an hour after the test

C

1. Which laboratory value would the nurse monitor in a patient receiving methylprednisolone? a. Sodium b. Magnesium c. Blood glucose d. Carbon dioxide

C

1. Which statement about glucocorticoids is accurate? a. They decrease serum sodium and glucose concentrations b. They stimulate defense mechanisms to produce immunity c. They influence carbohydrate, lipid, and protein metabolism d. They are produced in decreased amounts during times of stress

C

1. Which statement indicates to the nurse that the patient needs additional teaching on oral hypoglycemic agents? a. I will monitor my blood sugar daily b. I will limit my alcohol consumption c. I will take the medication only when I need it d. I will report symptoms of fatigue and loss of appetite

C

1. Which statement made by the patient about type 1 diabetes mellitus indicates effective learning? a. Endogenous insulin levels are elevated early in the disease b. Type 1 diabetes mellitus accounts for 90% of all diabetic cases c. Patients with type 1 diabetes mellitus require exogenous insulin d. Type 1 diabetes mellitus leads to developing acute hypoglycemia

C

1. Which technique would the nurse teach the patient about mixing insulin when the patient must administer 30 units regular insulin and 70 units NPH insulin in the morning? a. Use the z track method for administration b. Draw the medication into two separate syringes, but inject it into the same spot c. Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin d. Administer these insulins at least 10 minutes apart so that you will know when they are working

C

1. A nurse Is caring for a patient who is prescribed metformin therapy. The patient's blood glucose level is 200 mg/dL. Which assessment findings indicate lactic acidosis? Select all that apply. a. Diarrhea b. Bloating c. Muscle pain d. Abdominal pain e. Cold, clammy skin

C, D, E

1. Which conditions can be treated with glucocorticoid drugs? Select all that apply a. Glaucoma b. Septicemia c. Cerebral edema d. Varicella infection e. Systemic lupus erythematous f. Chronic obstructive pulmonary disease

C, E, F

1. A patient has been taking aspirin for chronic pain. The patient states that the patient is not relieved with 650 mg of aspirin every 4 hours. Which instruction would the nurse give the patient? a. Increase your dose to 1000 mg every 4 hours b. Take aspirin and a cyclooxygenase-1 (COX-1) inhibitor at the same time c. Alternate aspirin and a narcotic analgesic every 4 hours Notify your health care provider that the mediation is not effective

D

1. A patient is admitted to the emergency department with a diagnosis of "acetaminophen Overdose." Which lab value is essential for the nurse to assess? a. Platelet count b. Neutrophil count c. Blood Urea Nitrogen (BUN) and creatinine levels d. Aspartate Transaminase (AST) and Alanine Transaminase (ALT) levels

D

1. A patient newly diagnosed with diabetes asks, "how does insulin normally work in my body?" Which response by the nurse is correct? a. It Stimulates the pancreas to reabsorb glucose b. It promotes synthesis of amino acids c. It stimulates the liver to convert glycogen to glucose d. It promotes the passage of glucose into the cells for energy

D

1. A patient who has been receiving long-term corticosteroid therapy has undergone surgery for the treatment of an abdominal hernia. Which potential side effect of this therapy would the nurse expect to have the most impact on the patient's recovery? a. Hypotension b. Osteoporosis c. Muscle Weakness d. Delayed wound healing

D

1. A patient with type 1 diabetes mellitus has been ordered insulin aspart 10 units at 7:00am. Which nursing intervention will the nurse perform after administering this medication? a. Flush the IV b. Perform a fingerstick blood glucose test c. Have the patient void and dipstick the urine d. Make sure the patient eats breakfast immediately

D

1. The Nurse is assessing a patient who underwent surgery and is prescribed oxycodone. Which assessment finding requires the nurse to take action? a. Heart rate 90 beats/minute b. Vague feeling of anxiety c. Respiratory rate 12 breaths/minute d. No bowel movement in 72 hours

D

1. The adrenal cortex is essential for survival through the secretion of which substance a. Aldosterone b. Epinephrine c. Corticotrophins d. Glucocorticoids

D

1. The nurse is caring for a patient who has been taking metformin for several months. The patient reports abdominal pain. Upon assessment, the nurse detects an irregular heartbeat. Which will the nurse assess to determine the severity of the patient's condition? a. Renal function b. Vitamin b12 levels c. The patient's weight d. Blood glucose levels

D

1. Which assessment finding indicates that the nonsteroidal anti-inflammatory drug has been effective? a. PTT is 100 seconds b. Patient's bleeding time is prolonged c. Patient has increased circulation to his legs d. Pain has decreased from a 6 to 1 on the scale of 10

D

1. Which drug interacts with insulin and increases the risk for unrecognized hypoglycemia in a patient? a. Aspirin b. Codeine c. Thiazide Diuretics d. Beta-adrenergic Blockers

D

1. Which information would the nurse obtain prior to giving glucocorticoids to a 10-year-old-patient? a. Visual acuity b. Bone density c. Blood glucose d. Height and weight

D

1. Which instruction will the nurse give a patient who self-administers regular insulin injections? a. Insert the insulin needle at a 30-degree angle b. Rotate the insulin injection site every 2 weeks c. Administer the insulin 15 minutes before meals d. Administer the insulin injection subcutaneously

D

1. Which instruction will the nurse give a patient who takes isophane suspension (NPH) insulin? a. You need to obtain your blood glucose levels every hour b. Unused vials can be stored in the refrigerator for 5 months c. Discontinue insulin if you are undergoing diagnostic studies d. You should eat 30-45 minutes before taking the NPH insulin

D

1. Which laboratory test provides evidence or adequate glucose management and adherence to a diabetes treatment regimen over the past few months? a. Serum albumin b. Fasting serum glucose level c. 2-hour postprandial blood glucose d. Glycosylated Hemoglobin (HbA1C)

D

1. Which medication would be prescribed for a patient experiencing an exacerbation of chronic obstructive pulmonary disease? a. Aldosterone b. Betamethasone c. Fludrocortisone d. Methylprednisolone

D

1. Which medication would the nurse withhold for a patient with type 2 diabetes mellitus who is scheduled for a computed tomography scan with contrast? a. Glipizide b. Glimepiride c. Humalog insulin d. Metformin

D