Exam 4 Review Questions

The nurse teaches clients with rheumatoid arthritis about the side effects of nonsteroidal anti-inflammatory drugs (NSAIDs). The nurse evaluates that education has been effective when the clients make which statement? 1. "Blood tests may be necessary to monitor for side effects of this drug." 2. "We must be careful about falling with this medication because it can cause drowsiness." 3. "We must take the medicine just as the doctor said to take it." 4. "We must be sure and keep all scheduled doctors' appointments."

1. "Blood tests may be necessary to monitor for side effects of this drug."

A patient has been prescribed ciprofloxacin (Cipro) for a severe sinus infection. The nurse evaluates that medication education has been effective when the patient makes which statements? Select all that apply. 1. "I should avoid milk while taking this medication." 2. "I should avoid coffee while taking this medication." 3. "If this medication upsets my stomach, I can take it with an antacid." 4. "I may have some diarrhea while taking this medication." 5. "If my stomach gets upset, I should take this medication with food."

1. "I should avoid milk while taking this medication." 2. "I should avoid coffee while taking this medication." 4. "I may have some diarrhea while taking this medication." 5. "If my stomach gets upset, I should take this medication with food."

The client has a fungal infection of the toenails and receives oral terbinafine (Lamisil). The client asks the nurse how a pill will heal his nail infection. What is the best response by the nurse? 1. "The medication accumulates in your nail beds and is there for many months." 2. "The medication should be combined with a topical agent to increase effectiveness." 3. "The medication works by destroying toxins excreted by the fungi in your nails." 4. "The medication works by destroying circulating fungi in your blood."

1. "The medication accumulates in your nail beds and is there for many months."

A patient has developed chronic hepatitis after being exposed to hepatitis C. The nurse is discussing treatment of this condition. What information should the nurse include? Select all that apply. 1. "There are some new medications that help keep the HCV virus from reproducing in your system." 2. "There is not much we can do except support your general health." 3. "Most current research supports the use of multidrug therapy." 4. "A new drug called pegylation has been shown to prevent liver damage." 5. "You should advise your family to take the hepatitis C vaccine."

1. "There are some new medications that help keep the HCV virus from reproducing in your system." 3. "Most current research supports the use of multidrug therapy."

The nurse educates clients with acquired immune deficiency syndrome (AIDS) about the nature of viruses. The nurse evaluates that learning has occurred when the clients make which responses? Select all that apply. 1. "Viruses are nonliving particles." 2. "The structure of viruses is complex." 3. "Viruses can infect plants as well as animals." 4. "A virion is a mature virus." 5. "Viruses are intracellular parasites."

1. "Viruses are nonliving particles." 3. "Viruses can infect plants as well as animals." 4. "A virion is a mature virus." 5. "Viruses are intracellular parasites."

A nurse manager is discussing employment requirements with a group of potential employees. One person says, "I am not certain I want to get a hepatitis shot." What information should the nurse provide? Select all that apply. 1. "Working in a hospital puts you at higher risk for being exposed to hepatitis B." 2. "You can be protected from hepatitis B with this one quick immunization." 3. "Children get this immunization before they are 2 years old." 4. "If you don't get this vaccine, you must wear gloves at all times." 5. "The vaccine is about 50% effective."

1. "Working in a hospital puts you at higher risk for being exposed to hepatitis B." 3. "Children get this immunization before they are 2 years old."

A patient has recovered from hepatitis B. Which discharge information should the nurse provide? Select all that apply. 1. "You are now immune to getting hepatitis B again." 2. "Chronic hepatitis B may take years to develop." 3. "You should get hepatitis B vaccines annually." 4. "You should get hepatitis immunoglobulin annually." 5. "You should get one dose of interferon to boost your immunity to hepatitis B."

1. "You are now immune to getting hepatitis B again." 2. "Chronic hepatitis B may take years to develop."

An antifungal topical cream has been prescribed to treat a patient's tinea pedis. What information should the nurse provide? Select all that apply. 1. "You may notice burning when you apply this medication." 2. "You should take precautions against spreading your disease." 3. "This drug is absorbed into your system and may make you nauseated." 4. "Expect to use this medication for an extended period of time." 5. "Don't drink coffee while you are using this drug."

1. "You may notice burning when you apply this medication." 2. "You should take precautions against spreading your disease." 4. "Expect to use this medication for an extended period of time."

Which drug is most likely to be ordered for the client with herpes simplex virus? 1. Acyclovir (Zovirax) 2. Zidovudine (Retrovir) 3. Nystatin (Fungizone) 4. Metronidazole (Flagyl)

1. Acyclovir (Zovirax)

A patient with a severe systemic fungal infection will be treated with amphotericin B (Fungizone). What nursing interventions are required? Select all that apply. 1. Administer the medication by IV push. 2. Give acetaminophen before giving the amphotericin B (Fungizone). 3. Review BUN level. 4. Give corticosteroids 1 hour after infusion is completed. 5. Monitor for gastrointestinal bleeding.

1. Administer the medication by IV push. 2. Give acetaminophen before giving the amphotericin B (Fungizone). 3. Review BUN level.

The client receives nystatin (Nilstat) for a fungal infection in the mouth. The nurse plans to do medication education prior to discharge. What will the best plan by the nurse include? 1. Dissolve the oral tablet in your mouth and then swallow it. 2. Take the oral suspension with a straw to prevent tooth discoloration. 3. Crush the oral tablet, mix it with orange juice, and then swallow it. 4. Swallow the oral tablet whole without chewing or crushing it.

1. Dissolve the oral tablet in your mouth and then swallow it.

A client receives metronidazole (Flagyl) for treatment of a vaginal yeast infection. What should the nurse include in medication education for this client? Select all that apply. 1. Do not drink alcohol with this medication. 2. Do not take this medication with milk or milk products. 3. Drink at least 3000 mL of fluid per day with this medication. 4. Do not become pregnant while taking this medication. 5. You may experience a metallic taste while on this medication.

1. Do not drink alcohol with this medication. 4. Do not become pregnant while taking this medication. 5. You may experience a metallic taste while on this medication.

A client is receiving amphotericin B. The nurse will reinforce teaching by telling the client that he should report which symptoms? Select all that apply. 1. Feeling hot 2. Hearing loss 3. Dizziness 4. Constipation 5. Heartburn

1. Feeling hot 2. Hearing loss 3. Dizziness

The nursing plan of care for a patient receiving oprelvekin (Neumega) should include careful monitoring for symptoms of which adverse effect? 1. Fluid retention 2. Severe hypotension 3. Impaired liver function 4. Severe diarrhea

1. Fluid retention

A 24-year-old patient reports taking acetaminophen (Tylenol) fairly regularly for headaches. The nurse knows that a patient who consumes excessive acetaminophen per day or regularly consumes alcoholic beverages should be observed for what adverse effect? 1. Hepatic toxicity 2. Renal damage 3. Thrombotic effects 4. Pulmonary damage

1. Hepatic toxicity

A patient has been diagnosed with genital herpes and has been started on oral acyclovir (Zovirax). What should be included in the teaching instructions for this patient? (Select all that apply.) 1. Increase fluid intake up to 2 L per day. 2. Report any dizziness, tremors, or confusion. 3. Decrease the amount of fluids taken so that the drug can be more concentrated. 4. Take the drug only when having the most itching or pain from the outbreak. 5. Use barrier methods such as condoms for sexual activity.

1. Increase fluid intake up to 2 L per day. 2. Report any dizziness, tremors, or confusion. 5. Use barrier methods such as condoms for sexual activity.

A 2-year-old patient is receiving vincristine (Oncovin) for Wilms' tumor. Which of the following findings will the nurse monitor to prevent or limit the main adverse effect for this patient? (Select all that apply.) 1. Numbness of the hands or feet 2. Angina or dysrhythmias 3. Constipation 4. Diminished reflexes 5. Dyspnea and pleuritis

1. Numbness of the hands or feet 3. Constipation 4. Diminished reflexes

The nurse would question an order for peginterferon alfa-2a (Pegasys) if the patient had which of the following conditions? (Select all that apply.) 1. Pregnancy 2. Renal disease 3. Hepatitis 4. Liver disease 5. Malignant melanoma

1. Pregnancy 2. Renal disease 4. Liver disease

An older adult patient diagnosed with iron-deficiency anemia will be taking ferrous sulfate (Feosol). The nurse will teach which of the required administration guidelines to the patient? (Select all that apply.) 1. Take the tablets on an empty stomach if possible. 2. Increase fluid intake and increase dietary fiber while taking this medication. 3. If liquid preparations are used, dilute with water or juice and sip through a straw placed in the back of the mouth. 4. Crush or dissolve sustained-release tablets in water if they are too big to swallow. 5. Take the drug at bedtime for best results.

1. Take the tablets on an empty stomach if possible. 2. Increase fluid intake and increase dietary fiber while taking this medication. 3. If liquid preparations are used, dilute with water or juice and sip through a straw placed in the back of the mouth.

The nurse teaches clients with acquired immune deficiency syndrome (AIDS) about the importance of taking their medications as prescribed. What does the nurse recognize as the primary factor for medication noncompliance in the acquired immune deficiency syndrome (AIDS) population? 1. The necessity of having to take multiple medications throughout the day 2. A lack of understanding for the reason to take the medications 3. The weight gain associated with the medications 4. The difficulty with availability of medications to treat acquired immune deficiency syndrome (AIDS)

1. The necessity of having to take multiple medications throughout the day

A nurse is preparing an education session for a group of public school teachers regarding prevention of influenza. What topics should be included in this session? Select all that apply. 1. They need to discuss immunization with their personal health care providers due to contact with children. 2. Encourage students and staff to stay home if they are ill. 3. Encourage frequent handwashing for all students and staff. 4. There is little we can do to prevent a pandemic. 5. Anti-influenza drugs should be reserved only for adults who have been diagnosed with influenza.

1. They need to discuss immunization with their personal health care providers due to contact with children. 2. Encourage students and staff to stay home if they are ill. 3. Encourage frequent handwashing for all students and staff.

A client has just recovered from a long course of therapy for shingles. The client says, "What can I do to keep from having that again?" What information should the nurse provide? Select all that apply. 1. Try to find healthy outlets for your stress. 2. Once you have had shingles, you are not likely to get it again. 3. Try to keep as physically healthy as possible. 4. There is little you can do to prevent outbreaks. 5. Try to keep your immune system strong by taking good care of your physical and emotional health.

1. Try to find healthy outlets for your stress. 3. Try to keep as physically healthy as possible. 5. Try to keep your immune system strong by taking good care of your physical and emotional health.

The nurse is preparing to administer a topical, oral antifungal medication to an adult client. The nurse will administer the medication 1. alone and will allow the client to swish and swallow the medication. 2. with other medications. 3. with milk. 4. with water.

1. alone and will allow the client to swish and swallow the medication.

A mother is distressed because her child has been diagnosed with ascariasis. What information should the nurse provide? Select all that apply. 1. "Your child has pinworms." 2. "Children get worms from playing in infected soil." 3. "Treatment will consist of medication for 3 days." 4. "No treatment will be necessary after I give this one pill." 5. "No treatment is necessary; the worms will die on their own."

2. "Children get worms from playing in infected soil." 3. "Treatment will consist of medication for 3 days."

The client asks the nurse why there aren't better drugs for human immunodeficiency virus (HIV) infection when so much money is spent on research. What is the best response by the nurse? 1. "Antiviral drugs are almost impossible to create." 2. "Developing new drugs is difficult because the virus mutates so readily." 3. "Developing new drugs is difficult because people think acquired immune deficiency syndrome (AIDS) is a rare disease." 4. "Developing new drugs is difficult because we still do not understand the virus."

2. "Developing new drugs is difficult because the virus mutates so readily."

A patient who is undergoing cancer chemotherapy asks the nurse why she is taking three different chemotherapy drugs. What is the nurse's best response? 1. "Your cancer was very advanced and therefore requires more medications." 2. "Each drug attacks the cancer cells in a different way, increasing the effectiveness of the therapy." 3. "Several drugs are prescribed to find the right drug for your cancer." 4. "One drug will cancel out the side effects of the other."

2. "Each drug attacks the cancer cells in a different way, increasing the effectiveness of the therapy."

A patient diagnosed with pernicious anemia is to start cyanocobalamin (Nascobal) injections. Which of the following patient statements demonstrates an understanding of the nurse's teaching? (Select all that apply.) 1. "I need to be careful to avoid infections." 2. "I will need to take this drug for the rest of my life." 3. "I should increase my intake of foods that contain vitamin 4. "I need to take the liquid preparation through a straw." 5. "I may be able to switch over to nasal sprays once my vitamin B12 levels are normal."

2. "I will need to take this drug for the rest of my life." 5. "I may be able to switch over to nasal sprays once my vitamin B12 levels are normal."

A patient is started on efavirenz (Sustiva) for HIV. What should the nurse teach the patient about this drug? 1. Efavirenz (Sustiva) will cure the disease over time. 2. Efavirenz (Sustiva) will not cure the disease but may significantly extend the life expectancy. 3. Efavirenz (Sustiva) will be used prior to vaccines. 4. Efavirenz (Sustiva) will prevent the transmission of the disease.

2. Efavirenz (Sustiva) will not cure the disease but may significantly extend the life expectancy.

When planning to teach the patient about the use of epoetin alfa (Epogen, Procrit), the nurse would give which of the following instructions? 1. Eating raw fruits and vegetables must be avoided. 2. Frequent rest periods should be taken to avoid excessive fatigue. 3. Skin and mucous membranes should be protected from traumatic injury. 4. Exposure to direct sunlight must be minimized and sunscreen used when outdoors.

2. Frequent rest periods should be taken to avoid excessive fatigue.

A client has been prescribed oseltamivir (Tamiflu) after complaining of influenza-like symptoms. What information should the nurse provide for this client? Select all that apply. 1. This medication is given by inhalation. 2. Get this prescription filled and begin taking the medication immediately. 3. This medication will keep you from getting the flu. 4. This is an expensive medication. 5. This medication will be helpful if you have influenza or a cold.

2. Get this prescription filled and begin taking the medication immediately. 4. This is an expensive medication.

An infant is prescribed nystatin (Mycostatin) for treatment of infant oral candidiasis, or thrush. Which information should the nurse provide to the infant's caregiver in regard to this medication? Select all that apply. 1. Give the medication right before a feeding. 2. Give the infant a small amount of water prior to administering the medication. 3. Use a cotton swab to place medication in several parts of the infant's mouth. 4. The infant should not breastfeed until this infection is gone. 5. The breastfeeding mother may also require treatment.

2. Give the infant a small amount of water prior to administering the medication. 3. Use a cotton swab to place medication in several parts of the infant's mouth. 5. The breastfeeding mother may also require treatment.

The nurse is teaching a community health class to a group of young adults who have recently immigrated to the United States about preventing hepatitis B. What is the most effective method of preventing a hepatitis B infection? 1. Peginterferon alfa-2a (Pegasys) 2. Hepatitis B vaccine (Engerix-B) 3. Adefovir dipivoxil (Hepsera) 4. Entecavir (Baraclude)

2. Hepatitis B vaccine (Engerix-B)

A patient with HIV has been taking lopinavir with ritonavir (Kaletra) for the past 8 years and has noticed a redistribution of body fat in the arms, legs, and abdomen (lipodystrophy). The nurse will evaluate this patient for what other additional adverse effects associated with this drug? (Select all that apply.) 1. Renal failure 2. Hyperglycemia 3. Pancreatitis 4. Bone marrow suppression 5. Hepatic failure

2. Hyperglycemia 3. Pancreatitis 5. Hepatic failure

A patient with a history of hypertension is to start drug therapy for rheumatoid arthritis. Which of the following drugs would be contraindicated, or used cautiously, for this patient? (Select all that apply.) 1. Aspirin 2. Ibuprofen (Advil, Motrin) 3. Acetaminophen (Tylenol) 4. Naproxen (Aleve) 5. Methylprednisolone (Medrol)

2. Ibuprofen (Advil, Motrin) 4. Naproxen (Aleve) 5. Methylprednisolone (Medrol)

The nurse notes that the patient has reached his nadir. What does this finding signify? 1. The patient is receiving the highest dose possible of the chemotherapy. 2. The patient is experiencing bone marrow suppression and his blood counts are at their lowest point. 3. The patient has peaked on his chemotherapy level and should be going home in a few days. 4. The patient is experiencing extreme depression and will be having a psychiatric consult.

2. The patient is experiencing bone marrow suppression and his blood counts are at their lowest point.

To best monitor for therapeutic effects from filgrastim (Granix, Neupogen), the nurse will assess which laboratory finding? 1. Hemoglobin and hematocrit 2. White blood cell or absolute neutrophil counts 3. Serum electrolytes 4. Red blood cell count

2. White blood cell or absolute neutrophil counts

Superficial fungal infections differ from systemic fungal infections in that superficial fungal infections 1. can be fatal. 2. affect hair and skin. 3. are less common. 4. affect internal organs.

2. affect hair and skin.

The primary purpose of agents for herpes viruses is to 1. inhibit HIV protease. 2. prevent viral DNA synthesis. 3. bind directly to reverse transcriptase DNA. 4. create a defective DNA strand

2. prevent viral DNA synthesis.

The client has acquired immune deficiency syndrome (AIDS) and has just learned she is pregnant. She tearfully asks the nurse if her baby will die of acquired immune deficiency syndrome (AIDS). What is the nurse's best response? 1. "There are special tests that we can do to see if your baby is positive before birth." 2. "I know that is a great worry for all of us." 3. "Drug therapy can help prevent your child from contracting the virus." 4. "There are drugs that can be given after birth to reverse AIDS."

3. "Drug therapy can help prevent your child from contracting the virus."

The nurse does medication education for the client with histoplasmosis who receives ketoconazole (Nizoral). The nurse evaluates that learning has occurred when the client makes which statement? 1. "I cannot take this medication longer than 10 days." 2. "I could develop resistance to this medication if I take it too often." 3. "I could develop nausea, vomiting, and abdominal pain with this medication." 4. "I can't take my diabetes medicine with this drug."

3. "I could develop nausea, vomiting, and abdominal pain with this medication."

The nurse does health teaching with a client who has acquired immune deficiency syndrome (AIDS) and who has been started on antiviral medications. The nurse recognizes that teaching has been effective when the client makes which statement? 1. "I will need to limit my travel to avoid people with other infections." 2. "I will need to be on a high-calorie diet to enhance the effect of the medication." 3. "I will still need to take precautions to avoid spreading the virus to others." 4. "I will not be able to continue working at my high-stress job anymore."

3. "I will still need to take precautions to avoid spreading the virus to others."

The client receives oral nystatin (Mycostatin) suspension for an oral candidiasis infection. She tells the nurse she cannot continue to "swish and swallow" because her nausea is too great. What is the best response by the nurse? 1. "I will ask your doctor if a pill form can be substituted." 2. "Try drinking a 7-Up after you swallow the medication." 3. "It is all right to swish the medication and then spit it out." 4. "You can take a phenergan suppository before the nystatin (Mycostatin)."

3. "It is all right to swish the medication and then spit it out."

A patient on chemotherapy has a complete blood count (CBC) drawn and the nurse calculates the absolute neutrophil count (ANC). The white blood cell (WBC) count is 2,500 mm3 with 0.22 segmented neutrophils (segs) and 0.06 banded neutrophils (bands). What is the ANC? 1. 18.93 2. 89 3. 700 4. 2500.28

3. 700

Darbepoetin (Aranesp) is ordered for each of the following patients. The nurse would question the order for which condition? 1. A patient with chronic renal failure 2. A patient with AIDS who is receiving anti-AIDS drug therapy 3. A patient with hypertension 4. A patient on chemotherapy for cancer

3. A patient with hypertension

What is the most effective treatment method for the nausea and vomiting that accompanies many forms of chemotherapy? 1. Administer an oral antiemetic when the patient complains of nausea and vomiting. 2. Administer an antiemetic by intramuscular injection when the patient complains of nausea and vomiting. 3. Administer an antiemetic prior to the antineoplastic medication. 4. Encourage additional fluids prior to administering the antineoplastic medication.

3. Administer an antiemetic prior to the antineoplastic medication.

The client receives amphotericin B (Fungizone) for histoplasmosis. What does the best assessment by the nurse include? Select all that apply. 1. Serum amylase 2. Serum sodium 3. Blood urea nitrogen 4. Serum glucose 5. Serum creatinine

3. Blood urea nitrogen 5. Serum creatinine

Which of the following findings would suggest that myelosuppression is occurring in a patient who is taking zidovudine (Retrovir)? 1. Increase in serum blood urea nitrogen (BUN) levels 2. Increase in white blood cell (WBC) count 3. Decrease in platelet count 4. Decrease in blood pressure

3. Decrease in platelet count

A patient admitted with hepatitis B is prescribed hydrocodone with acetaminophen (Vicodin) 2 tablets for pain. What is the most appropriate action for the nurse to take? 1. Administer the drug as ordered. 2. Administer 1 tablet only. 3. Recheck the order with the health care provider. 4. Hold the drug until the health care provider arrives.

3. Recheck the order with the health care provider.

The nurse accidentally sticks herself with a needle after starting an intravenous (IV) line on a client with acquired immune deficiency syndrome (AIDS). The nurse tells the supervisor about the accident. What is the best initial response by the supervisor to decrease anxiety in the nurse? 1. "If you are started on medications soon, it will decrease the severity of the disease." 2. "Workers compensation will cover the cost of your illness and medications." 3. "Did you use the hospital protocols for starting intravenous (IV) lines on a client with acquired immune deficiency syndrome (AIDS)?" 4. "Fortunately, the chances of you contracting human immunodeficiency virus (HIV) after the stick are very small."

4. "Fortunately, the chances of you contracting human immunodeficiency virus (HIV) after the stick are very small."

Which of the following statements by a patient who is undergoing antineoplastic therapy would be of concern to the nurse? (Select all that apply.) 1. "I have attended a meeting of a cancer support group." 2. "My husband and I are planning a short trip next week." 3. "I am eating six small meals plus two protein shakes a day." 4. "I am taking my 15-month-old granddaughter to the pediatrician next week for her baby shots." 5. "I am going to go shopping at the mall next week."

4. "I am taking my 15-month-old granddaughter to the pediatrician next week for her baby shots." 5. "I am going to go shopping at the mall next week."

A patient was prescribed chloroquine (Aralen) prior to a trip to an area where malaria is known to be endemic. The nurse will instruct the patient to remain on the drug for up to 6 weeks after returning, and the patient asks why this is necessary. What is the nurse's best response? 1. "You may be carrying microscopic malaria parasites back with you on clothes or other personal articles." 2. "It helps prevent transmission to any of your family members." 3. "It will prevent any mosquito that bites you from picking up the malaria infection." 4. "It continues to kill any remaining malarial parasites that may have been acquired during the trip that are in your red blood cells."

4. "It continues to kill any remaining malarial parasites that may have been acquired during the trip that are in your red blood cells."

A patient has received a prescription for zanamivir (Relenza) for flulike symptoms. The patient states, "I think I'll hold off on starting this. I don't feel that bad yet." What is the nurse's best response? 1. "The drug has a stable shelf life so you can save it for later infections." 2. "It can be saved for later but you will also require an antibiotic to treat your symptoms if you wait." 3. "It can be started within two weeks after the onset of symptoms." 4. "To be effective, it must be started within 48 hours after the onset of symptoms."

4. "To be effective, it must be started within 48 hours after the onset of symptoms."

The client receives terbinafine (Lamisil) as treatment for a fungal infection of the toenails. What is an important assessment question for the nurse to ask? 1. "Are you HIV-positive?" 2. "How do you clean and clip your toenails?" 3. "Do you have diabetes mellitus?" 4. "What analgesic do you take for headaches?"

4. "What analgesic do you take for headaches?"

Which client is at the greatest risk of acquiring a serious fungal infection? 1. A teenager with no health problems 2. A client with a history of heart problems 3. A client with diabetes mellitus 4. A client who is immunosuppressed

4. A client who is immunosuppressed

A client has been prescribed a topical antifungal medication for treatment of ringworm. What teaching should the nurse provide? Select all that apply. 1. Avoid alcohol while using this medication. 2. Scrub the area vigorously prior to applying the medication. 3. Cover the area with an occlusive dressing after applying the medication. 4. Apply a thin layer of the medication. 5. After applying the medication, let the area air-dry.

4. Apply a thin layer of the medication. 5. After applying the medication, let the area air-dry.

A patient has been diagnosed with trichomoniasis. The nurse would give which medication without questioning the prescription 1. Praziquantel (Biltricide. 2. Chloroquine (Aralen) 3. Nitazoxanide (Alinia) 4. Metronidazole (Flagyl)

4. Metronidazole (Flagyl)

The nurse works in infection control at a large hospital. Which client does the nurse recognize as being at greatest risk for acquiring a fungal infection? 1. The client with severe burns over 20% of the body 2. The adolescent client with a fractured femur from an auto accident 3. The client with anemia who is pregnant with triplets 4. The client with malignant melanoma who is receiving chemotherapy

4. The client with malignant melanoma who is receiving chemotherapy

An older adult patient tells the nurse that she has been using several herbal products recommended by a friend. Why would the nurse be concerned with this statement, given the age of the patient? 1. The older adult patient may have difficulty reading labels and opening bottles and confuse medications. 2. The older adult patient may have difficulty paying for additional medications and stop using prescribed drugs. 3. The older adult patient may be more prone to allergic reactions from herbal products. 4. The older adult patient may have other disease conditions that could increase the risk for a drug reaction.

4. The older adult patient may have other disease conditions that could increase the risk for a drug reaction.

The client is noncompliant with taking medications to prevent malaria prior to an overseas business trip. The nurse identifies which rationale for this action is most likely? 1. The taste of the various tablets was really too offensive to the client. 2. The medication dosing was too frequent for the client to tolerate. 3. The cost of the medications was too high for the client's budget. 4. The side effects of vomiting and diarrhea were too uncomfortable.

4. The side effects of vomiting and diarrhea were too uncomfortable.

While educating the patient about hydrocortisone (Cortef), the nurse would instruct the patient to contact the health care provider immediately if which of the following occurs? 1. There is a decrease of 1 kg (2 lb) in weight. 2. There is an increase in appetite. 3. There is tearing of the eyes. 4. There is any difficulty breathing.

4. There is any difficulty breathing.

Histamine release produces which response? 1. Bronchodilation 2. Vasoconstriction 3. Diarrhea 4. Vasodilation

4. Vasodilation

The nurse plans to teach the client with acquired immune deficiency syndrome (AIDS) about bacterial infections. Which information should the nurse include in this teaching? Select all that apply. 1. "If just a few bacteria make you sick, this is virulence." 2. "Most bacteria have developed antibiotic resistance." 3. "Pathogens are divided into two classes, bacteria and viruses." 4. "Pathogenicity means the bacteria can cause an infection." 5. "Actually, most bacteria will not harm us."

1. "If just a few bacteria make you sick, this is virulence." 4. "Pathogenicity means the bacteria can cause an infection." 5. "Actually, most bacteria will not harm us."

The client is prescribed amoxicillin (Amoxil) for 10 days to treat strep throat. After 5 days, the client tells the nurse he plans to stop the medication because he feels better. What is the best response by the nurse? 1. "If you stop the medicine early, you have not effectively killed out the bacteria making you sick." 2. "You should get another throat culture if your symptoms return." 3. "If you stop the medicine early, this could result in resistance to the antibiotic." 4. "You should get another throat culture to see if the infection is gone."

1. "If you stop the medicine early, you have not effectively killed out the bacteria making you sick."

A patient has been diagnosed with tuberculosis and is prescribed Rifater (pyrazinamide with isoniazid and rifampin). While the patient is on this medication, what teaching is essential? (Select all that apply.) 1. "It is critical to continue therapy for at least 6 to 12 months." 2. "Two or more drugs are used to prevent tuberculosis bacterial resistance." 3. "These drugs may also be used to prevent tuberculosis." 4. "No special precautions are required." 5. "After 1 month of treatment, the medication will be discontinued."

1. "It is critical to continue therapy for at least 6 to 12 months." 2. "Two or more drugs are used to prevent tuberculosis bacterial resistance." 3. "These drugs may also be used to prevent tuberculosis." 4. "No special precautions are required."

A patient has been prescribed a second 10-day course of a corticosteroid. The nurse should provide which medication education? Select all that apply. 1. "Make certain you do weight-bearing exercises at least three times each week." 2. "Weigh yourself every day." 3. "Let us know if you develop a fever." 4. "Monitor the color of your urine." 5. "If you feel jittery or anxious, discontinue the medication."

1. "Make certain you do weight-bearing exercises at least three times each week." 2. "Weigh yourself every day." 3. "Let us know if you develop a fever."

A client presents with a rash and is prescribed an over-the-counter ointment for treatment. The client says, "I thought I would need a shot or an expensive prescription." How should the nurse respond? Select all that apply. 1. "Medications that go on your skin don't usually have as many side effects." 2. "Mild rashes often respond well to topical ointments." 3. "Many of the products used on the skin are available over-the-counter." 4. "You should try to discover what caused your rash." 5. "Prescription ointments are usually better at healing."

1. "Medications that go on your skin don't usually have as many side effects." 2. "Mild rashes often respond well to topical ointments." 3. "Many of the products used on the skin are available over-the-counter." 4. "You should try to discover what caused your rash."

Which client statement would the nurse evaluate as indicating the goal of treatment with an anti-inflammatory drug has been met? Select all that apply. 1. "My fever went away yesterday." 2. "I've not been coughing up so much phlegm." 3. "The skin over my knee is red and hot to the touch." 4. "The pain in my shoulder is much relieved." 5. "My rash is spreading."

1. "My fever went away yesterday." 4. "The pain in my shoulder is much relieved."

The client receives prednisone as treatment for his inflammatory disease. He has experienced great relief and asks the nurse if he can just keep taking this medication. What is the best response by the nurse? 1. "No, because this medication has serious adverse effects." 2. "No, your doctor said the best treatment for your illness is to alternate medications." 3. "No, your body would get used to it and it would lose its effectiveness." 4. "No, because your illness is in remission and you don't need medication now."

1. "No, because this medication has serious adverse effects."

The client tells the nurse that the doctor told him his antibiotic did not kill his infection but just slowed its growth. The client is anxious. What is the best response by the nurse to decrease the client's anxiety? 1. "This is okay because your body will help kill the infection too." 2. "This is okay because your doctor is an infectious disease specialist." 3. "This is okay because your blood work is being monitored daily." 4. "This is okay because your infection is not really that serious."

1. "This is okay because your body will help kill the infection too."

A 17-year-old confides to the nurse that he smokes marijuana but that "it isn't as bad as tobacco cigarettes; it's not addicting like nicotine!" Which statement would be an appropriate response by the nurse? 1. Although marijuana may not be addicting in the same way that nicotine is, it damages lung tissue and may cause breathing problems and cancer. 2. Marijuana is not approved for any use except under highly regulated conditions. 3. Marijuana is four times as addicting as nicotine. 4. The effects of marijuana are much more prolonged than nicotine because it stays in the body longer.

1. Although marijuana may not be addicting in the same way that nicotine is, it damages lung tissue and may cause breathing problems and cancer.

The patient returns to the postanesthesia recovery unit (PACU) for observation and recovery following surgery with a general anesthetic. Which of the following assessment findings may the nurse expect to find during this recovery period? (Select all that apply.) 1. Bradycardia 2. Severe headache 3. Hypertension 4. Respiratory depression 5. Urinary frequency

1. Bradycardia 4. Respiratory depression

The patient with a history of alcohol abuse is admitted to the hospital. The nursing care plan includes assessment for symptoms of alcohol withdrawal. What symptoms will the nurse observe for? (Select all that apply.) 1. Confusion 2. Violent yawning 3. Tremors 4. Constricted pupils 5. Hallucinations

1. Confusion 3. Tremors 5. Hallucinations

Patients who may have been exposed to nerve agents may be expected to display which of these symptoms? 1. Convulsions and loss of consciousness 2. Memory loss and fatigue 3. Malaise and hemorrhaging 4. Fever and headaches

1. Convulsions and loss of consciousness

The patient states that she is going to quit smoking "cold turkey." The nurse teaches the patient to expect which of the following symptoms during withdrawal from nicotine? (Select all that apply.) 1. Headaches 2. Increased appetite 3. Tremors 4. Insomnia 5. Increased heart rate and blood pressure

1. Headaches 2. Increased appetite 4. Insomnia

What key roles does the nurse play in the event of a potential bioterrorist attack? (Select all that apply.) 1. Helping to plan for emergencies and develop emergency management plans 2. Recognizing and reporting signs and symptoms of chemical or biologic agent exposure and assisting with treatment 3. Storing antidotes, antibiotics, vaccines, and supplies in their homes 4. Keeping a list of resources such as health and law enforcement agencies and other contacts who would assist in the event of bioterrorist attack 5. Keeping up to date on emergency management protocols and volunteering to become members of a first-response team

1. Helping to plan for emergencies and develop emergency management plans 2. Recognizing and reporting signs and symptoms of chemical or biologic agent exposure and assisting with treatment 4. Keeping a list of resources such as health and law enforcement agencies and other contacts who would assist in the event of bioterrorist attack 5. Keeping up to date on emergency management protocols and volunteering to become members of a first-response team

The client has MRSA and receives vancomycin (Vancocin) intravenously (IV). The nurse assesses an upper body rash and decreased urine output. What is the nurse's priority action? 1. Hold the next dose of vancomycin (Vancocin) and notify the physician. 2. Obtain a stat X-ray and notify the physician. 3. Administer an antihistamine and notify the physician. 4. Obtain a sterile urine specimen and notify the physician.

1. Hold the next dose of vancomycin (Vancocin) and notify the physician.

Metronidazole (Flagyl) is being used to treat a patient's Giardialambliainfection, a protozoan infection of the intestines. Which of the following are appropriate to teach this patient? (Select all that apply.) 1. Metronidazole may leave a metallic taste in the mouth. 2. The urine may turn dark amber brown while on the medication. 3. The metronidazole may be discontinued once the diarrhea subsides to minimize adverse effects. 4. Taking the metronidazole with food reduces GI upset. 5. Current sexual partners do not require treatment for this infection.

1. Metronidazole may leave a metallic taste in the mouth. 2. The urine may turn dark amber brown while on the medication. 4. Taking the metronidazole with food reduces GI upset. 5. Current sexual partners do not require treatment for this infection.

The client receives gentamicin (Garamycin) intravenously (IV) in the clinical setting. What is a priority nursing action? 1. Monitor the client for hearing loss. 2. Draw daily blood chemistries. 3. Decrease the fluids for the client during therapy. 4. Place the client on isolation precautions

1. Monitor the client for hearing loss.

A patient reports that he has been taking aspirin to treat the muscle pain that results from his new walking routine. The nurse would be concerned about this treatment plan if the patient has which history? Select all that apply. 1. Myocardial infarction at age 61 2. Helicobacter pylori infection treatment last month 3. No influenza vaccine in last 2 years 4. Mild hypertension 5. History of migraine headaches

1. Myocardial infarction at age 61 2. Helicobacter pylori infection treatment last month

What is the difference between physical and psychological dependence? 1. Physical dependence is the adaptation of the body to a substance over time such that when the substance is withdrawn, withdrawal symptoms will result. Psychological dependence is the overwhelming desire to continue using a substance after it is stopped or withdrawn but without physical withdrawal symptoms occurring. 2. Physical and psychological dependence are terms that are used interchangeably. In both cases, physical withdrawal symptoms will result if the substance is withdrawn from use. 3. They occur together: psychological dependence is the first type of dependence to occur with a substance, followed by physical dependence. 4. Psychological dependence develops when the brain adapts over time to the use of the substance. Physical dependence is the active seeking of a substance associated with a desire to continue using the substance.

1. Physical dependence is the adaptation of the body to a substance over time such that when the substance is withdrawn, withdrawal symptoms will result. Psychological dependence is the overwhelming desire to continue using a substance after it is stopped or withdrawn but without physical withdrawal symptoms occurring.

The patient received lidocaine viscous before a gastroscopy was performed. Which of the following would be a priority for the nurse to assess during the postprocedural period? 1. Return of gag reflex 2. Ability to urinate 3. Leg pain 4. Ability to stand

1. Return of gag reflex

How does the Centers for Disease Control and Prevention categorize biologic threats? 1. Based on their potential adverse effects 2. Based on the potential impact on public health 3. Based on their potential cost of treatment 4. Based on the potential loss of life

2. Based on the potential impact on public health

The client experienced a sports-related injury to his leg. During the morning assessment, what signs of inflammation will the nurse most likely assess? Select all that apply. 1. Swelling 2. Pain 3. Warmth 4. Pallor 5. Pitting edema

1. Swelling 2. Pain 3. Warmth

Appropriate teaching to provide safety for a patient who is planning to use herbal products should include which of the following? 1. Take the smallest amount possible when starting herbal therapy, even less than the recommended dose, to see if allergies or other adverse effects occur. 2. Read the labels to determine composition of the product. 3. Research the clinical trials before using the products. 4. Consult the Internet or herbal store staff to determine the safest dose and length of time the dose should be taken.

1. Take the smallest amount possible when starting herbal therapy, even less than the recommended dose, to see if allergies or other adverse effects occur.

A patient has received succinylcholine (Anectine, Quelicin) along with the general anesthetic in surgery. Which of the following abnormal findings in the recovery period should be reported immediately to the provider? 1. Temperature 38.9 degrees Celsius (102 degrees Fahrenheit) 2. Heart rate 56 3. Blood pressure 92/58 4. Respiratory rate 15

1. Temperature 38.9 degrees Celsius (102 degrees Fahrenheit)

The nurse is providing community education regarding ways to reduce development of antibiotic resistance. Which information should be included? Select all that apply. 1. The best way to prevent antibiotic resistance is to prevent infections from occurring. 2. Do not expect to receive an antibiotic prescription for colds and influenza. 3. Take the full amount of any prescribed medication. 4. Go to the doctor as soon as you feel ill. 5. Use good infection control measures.

1. The best way to prevent antibiotic resistance is to prevent infections from occurring. 2. Do not expect to receive an antibiotic prescription for colds and influenza. 3. Take the full amount of any prescribed medication. 5. Use good infection control measures.

A patient has been prescribed a short course of high dose aspirin. The nurse would educate the patient to monitor for which findings associated with salicylism? Select all that apply. 1. Tinnitus 2. Excessive sweating 3. Cold chills 4. Headache 5. Bloating

1. Tinnitus 2. Excessive sweating 4. Headache

Following surgery, a client is placed on cefotaxime (Claforan). The assessment for possible adverse effects should include observing for 1. diarrhea. 2. headache. 3. constipation. 4. tachycardia.

1. diarrhea.

Acetaminophen reduces fever by 1. directly acting on the hypothalamus. 2. inhibiting prostaglandins. 3. blocking impulses to the brain. 4. affecting nerve fibers.

1. directly acting on the hypothalamus.

Pathogenicity is different than virulence in that pathogenicity can 1. lead to the ability of organisms to cause infection. 2. kill pathogens. 3. cause a disease when pathogens are present. 4. disrupt cell lining.

1. lead to the ability of organisms to cause infection.

Treatment of tuberculosis usually involves 1. the use of two or more drugs at the same time. 2. surgical removal of tubercular lesions. 3. keeping the client hospitalized. 4. the use of a single drug.

1. the use of two or more drugs at the same time.

A client is taking aspirin (ASA) for arthritis. The nurse will advise the client to take the medication 1. with a glass of milk. 2. with other medications. 3. with orange juice at bedtime. 4. on an empty stomach in the morning.

1. with a glass of milk.

The client receives a nonsteroidal anti-inflammatory drug (NSAID) for treatment of arthritis. What is a priority for the nurse to include when doing medication education? 1. "Constipation is common; include roughage in your diet." 2. "Drink at least eight glasses of water a day." 3. "Take your medication with food." 4. "Take your medication on an empty stomach."

2. "Drink at least eight glasses of water a day."

A client has been prescribed trimethoprim-sulfamethoxazole (Septra) for treatment of a urinary tract infection. Which comments, made by the client, would the nurse discuss with the prescriber before allowing the client to leave the clinic? Select all that apply. 1. "My husband and I plan to start a family as soon as possible." 2. "I forgot to take my potassium supplement today." 3. "Is it okay to take this with my warfarin?" 4. "It is so cloudy today." 5. "My 80-year-old mother is coming to visit today."

2. "I forgot to take my potassium supplement today." 3. "Is it okay to take this with my warfarin?"

The client receives multiple drugs for treatment of tuberculosis. The nurse teaches the client the rationale for multiple drug treatment and evaluates learning as effective when the client makes which statement? 1. "Current research indicates that the most effective way to treat tuberculosis is with multiple drugs." 2. "Multiple drugs are necessary because the bacteria are likely to develop resistance to just one drug." 3. "Treatment for tuberculosis is complex, and multiple drugs must be continued for as long as I am contagious." 4. "Multiple drug treatment is necessary for me to be able to develop immunity to tuberculosis."

2. "Multiple drugs are necessary because the bacteria are likely to develop resistance to just one drug."

The nursing instructor teaches the student nurses about fungal infections. The nursing instructor evaluates that learning has occurred when the student nurses make which statements? Select all that apply. 1. "Superficial infections are more difficult to treat than systemic infections." 2. "Newer medications can be used for superficial as well as systemic infections." 3. "Systemic infections are much more common than superficial infections." 4. "Superficial infections are considered more benign than systemic infections." 5. "Systemic infections require oral medications that have serious adverse effects."

2. "Newer medications can be used for superficial as well as systemic infections." 4. "Superficial infections are considered more benign than systemic infections." 5. "Systemic infections require oral medications that have serious adverse effects."

The nurse plans to teach a class on acetaminophen (Tylenol) to mothers with young children. What will the best plan by the nurse include? 1. "It is best to give your child acetaminophen (Tylenol) with a high-carbohydrate meal." 2. "Read the labels of all over-the-counter (OTC) medications for the amount of acetaminophen (Tylenol) in them." 3. "Acetaminophen (Tylenol) will only need to be given once a day because it is long-lasting." 4. "It is okay to substitute a baby aspirin for acetaminophen (Tylenol) if you run out of acetaminophen (Tylenol)."

2. "Read the labels of all over-the-counter (OTC) medications for the amount of acetaminophen (Tylenol) in them."

Following a surgical procedure, the patient states that he does not want to take narcotic analgesics for pain because he is afraid he will become addicted to the drug. What is the best response by the nurse to the patient's concerns? 1. Dependence on narcotics is common among postoperative patients but can be managed successfully. 2. Addiction to prescription drugs is rare when used as prescribed and according to medical protocol such as for pain control. 3. Older patients are more likely to become addicted. 4. Addiction is rare if the patient has a high pain threshold.

2. Addiction to prescription drugs is rare when used as prescribed and according to medical protocol such as for pain control.

A patient has recurrent skin infections. The nurse anticipates administering an aminopenicillin such as which drug? Select all that apply. 1. Oxacillin 2. Ampicillin 3. Piperacillin 4. Amoxicillin 5. Dicloxacillin

2. Ampicillin 4. Amoxicillin

A 32-year-old female has been started on amoxicillin (Amoxil, Trimox) for a severe UTI. Before sending her home with this prescription, the nurse will provide which instruction? 1. Teach her to wear sunscreen. 2. Ask her about oral contraceptive use and recommend an alternative method for the duration of the ampicillin course. 3. Assess for hearing loss. 4. Recommend taking the pill with some antacid to prevent gastrointestinal upset.

2. Ask her about oral contraceptive use and recommend an alternative method for the duration of the ampicillin course.

The client is to receive an injection of penicillin G benzathine (Bicillin LA) in the outpatient clinic. What are the priority nursing actions prior to administering this injection? Select all that apply. 1. Have the client lie down and assess vital signs before she leaves. 2. Ask the client if she has ever had an allergy to penicillin before. 3. Inform the client that she will need to wait 30 minutes before leaving the clinic. 4. Inform the client that she must have someone drive her home. 5. Advise the client to rest for the remainder of the day.

2. Ask the client if she has ever had an allergy to penicillin before. 3. Inform the client that she will need to wait 30 minutes before leaving the clinic.

The client receives multiple antibiotics to treat a serious infection. What will the priority assessment of the client by the nurse include? 1. Assessing blood cultures for the presence of bacteria 2. Assessing changes in stool, white patches in the mouth, and urogenital itching or rash 3. Assessing renal and liver function tests 4. Assessing whether or not the client has adequate food and fluid intake

2. Assessing changes in stool, white patches in the mouth, and urogenital itching or rash

Planning teaching needs for a patient who is to be discharged postoperatively with a prescription for oxycodone with acetaminophen (Percocet) should include which of the following? 1. Refer the patient to a drug treatment center if addiction occurs. 2. Encourage increased fluids and fiber in the diet. 3. Monitor for GI bleeding. 4. Teach the patient to self-assess blood pressure.

2. Encourage increased fluids and fiber in the diet.

A patient with type 2 diabetes treated with oral antidiabetic medication is receiving oral fluconazole (Diflucan) for treatment of chronic tinea cruris (jock itch). The nurse instructs the patient to monitor blood glucose levels more frequently because of what potential drug effect? 1. Fluconazole (Diflucan) antagonizes the effects of many antidiabetic medications, causing hyperglycemia. 2. Fluconazole (Diflucan) interacts with certain antidiabetic drugs, causing hypoglycemia. 3. Fluconazole (Diflucan) causes hyperglycemia. 4. Fluconazole (Diflucan) causes hypoglycemia.

2. Fluconazole (Diflucan) interacts with certain antidiabetic drugs, causing hypoglycemia.

The nurse is evaluating drug effects in a patient who has been given interferon alfa-2b (Intron-A) for hepatitis B and C. Which of the following is a common adverse effect? 1. Depression and thoughts of suicide 2. Flulike symptoms of fever, chills, or fatigue 3. Edema, hypotension, and tachycardia 4. Hypertension, renal or hepatic insufficiency

2. Flulike symptoms of fever, chills, or fatigue

The nurse is managing care for clients who will receive ibuprofen (Advil) for long-term therapy. What are the primary laboratory tests the nurse will assess prior to initiation of therapy? Select all that apply. 1. Electrolytes 2. Hemoglobin and hematocrit 3. Bleeding times 4. Liver function tests 5. Serum amylase

2. Hemoglobin and hematocrit 3. Bleeding times 4. Liver function tests

A patient with a severe systemic fungal infection is to be given amphotericin B (Fungizone). Before starting the amphotericin infusion, the nurse premedicates the patient with acetaminophen (Tylenol), diphenhydramine (Benadryl), and prednisone (Deltasone). What is the purpose of premedicating the patient prior to the amphotericin? 1. It delays the development of resistant fungal infections. 2. It decreases the risk of hypersensitivity reactions to the amphotericin. 3. It prevents hyperthermia reactions from the amphotericin. 4. It works synergistically with the amphotericin so a lower dose may be given.

2. It decreases the risk of hypersensitivity reactions to the amphotericin.

Which of the following patients may be most at-risk for adverse effects related to specialty supplements? (Select all that apply.) 1. Adolescents 2. Pregnant women 3. School-age children 4. Older adult patients 5. Patients taking prescription medication

2. Pregnant women 4. Older adult patients 5. Patients taking prescription medication

A patient will be discharged after surgery with a prescription for penicillin. When planning at-home instructions, what will the nurse include? 1. Penicillins can be taken while breast-feeding. 2. The entire prescription must be finished. 3. All penicillins can be taken without regard to eating. 4. Some possible side effects include abdominal pain and constipation.

2. The entire prescription must be finished.

The nurse teaches the patient relaxation techniques and guided imagery as an adjunct to medication for treatment of pain. What is the main rationale for the use of these techniques as adjuncts to analgesic medication? 1. They are less costly techniques. 2. They may allow lower doses of drugs with fewer adverse effects. 3. They can be used at home. 4. They do not require self-injection.

2. They may allow lower doses of drugs with fewer adverse effects.

Potassium iodine (KI) taken immediately following a nuclear incident can prevent 100% of radioactive iodine from entering which body organ? 1. Brain 2. Thyroid 3. Kidney 4. Liver

2. Thyroid

The patient states that he has been using the herbal product saw palmetto. The nurse recognizes that this supplement is often used to treat which condition? 1. Insomnia 2. Urinary problems associated with prostate enlargement 3. Symptoms of menopause 4. Urinary tract infection

2. Urinary problems associated with prostate enlargement

The physician orders acetaminophen (Tylenol) four time a day for a client with arthritis. The nurse would plan to validate which other order with the physician? 1. Heparin 5000 units subcutaneously every 8 hours 2. Warfarin (Coumadin) 2 mg orally every day 3. Penicillin G benzathine (Bicillin LA) 2.4 million units IM one time 4. Paroxetine (Paxil) 37.5 mg orally every day

2. Warfarin (Coumadin) 2 mg orally every day

The client has experienced a sports-related injury. He asks the nurse how long it will take for him to respond to treatment. What is the best response by the nurse? 1. "With proper care, it will take about a month for symptoms to resolve." 2. "It will depend on your response to the medications." 3. "It will take about a week and a half for symptoms to resolve." 4. "The inflammatory process is too complex to predict a time frame for healing."

3. "It will take about a week and a half for symptoms to resolve."

The nurse teaches a group of clients with arthritis about the use of ibuprofen (Motrin), emphasizing the maximum daily amount. The nurse evaluates that education has been most effective when the clients make which statement? 1. "We cannot take over 4000 mg/day." 2. "We cannot take over 3600 mg/day." 3. "We cannot take over 3200 mg/day." 4. "We cannot take over 3000 mg/day."

3. "We cannot take over 3200 mg/day."

The patient who is scheduled to have a minor inoffice surgical procedure will receive nitrous oxide and expresses concern to the nurse that the procedure will hurt. Which of the following would be the nurse's best response? 1. "You may feel pain during the procedure but you won't remember any of it." 2. "You will be unconscious the entire time and won't feel any pain." 3. "You will not feel any pain during the procedure because the drug blocks the pain signals." 4. "You will feel pain but you won't perceive it the same way; that's why it's called 'laughing gas.'"

3. "You will not feel any pain during the procedure because the drug blocks the pain signals."

What is the difference between an herbal product and a specialty supplement? 1. An herbal product is safer to use than a specialty supplement. 2. A specialty supplement tends to be more expensive than an herbal product. 3. A specialty supplement is a nonherbal dietary product used to enhance a variety of body functions. 4. There are less adverse effects or risk of allergy with specialty supplements than there are with herbal products.

3. A specialty supplement is a nonherbal dietary product used to enhance a variety of body functions.

What important information should be included in the patient's education regarding taking ciprofloxacin (Cipro)? 1. The drug can cause discoloration of the teeth. 2. Fluid intake should be decreased to prevent urine retention. 3. Any heel or lower leg pain should be reported immediately. 4. The drug should be taken with an antacid to reduce gastric effects.

3. Any heel or lower leg pain should be reported immediately.

Which of these medications is primarily used as a treatment of anthrax? 1. Diphtheria vaccine 2. Amoxicillin (Amoxil) 3. Ciprofloxacin (Cipro) 4. Smallpox vaccine

3. Ciprofloxacin (Cipro)

Discharge planning for the client prescribed tetracycline will include which instruction? 1. Take the medication with antacids. 2. Take the medication with iron supplements. 3. Do not take the medication with milk. 4. Decrease the amount of vitamins.

3. Do not take the medication with milk.

The nurse recognizes which of the following to be initial symptoms of inhaled anthrax? (Select all that apply.) 1. Cramping and diarrhea 2. Skin lesions that develop into black scabs 3. Fever 4. Headache 5. Cough and dyspnea

3. Fever 5. Cough and dyspnea

What is the most appropriate method to ensure adequate pain relief in the immediate postoperative period from an opioid drug? 1. Give the drug only when the family members report that the patient is complaining of pain. 2. Give the drug every time the patient complains of acute pain. 3. Give the drug as consistently as possible for the first 24 to 48 hours. 4. Give the drug only when the nurse observes signs and symptoms of pain.

3. Give the drug as consistently as possible for the first 24 to 48 hours.

The drug that would most likely be used in the treatment of tuberculosis is 1. Erythromycin (E-mycin). 2. Vancomycin (Vancocin). 3. Isoniazid (INH). 4. Gentamicin (Garamycin).

3. Isoniazid (INH).

A patient has been diagnosed with a fungal nail infection. The health care provider has prescribed griseofulvin (Fulvicin). The nurse will include which of the following in her teaching to the patient? 1. Drug therapy will be for a very short time, probably 2 to 4 weeks. 2. Carefully inspect all intramuscular injection sites for bruising. 3. Notify the provider if symptoms of infection worsen. 4. Limit fluid intake to approximately 1,000 mL/day.

3. Notify the provider if symptoms of infection worsen.

The patient has been taking aspirin for several days for headache. During the assessment, the nurse discovers that the patient is experiencing ringing in the ears and dizziness. What is the most appropriate action by the nurse? 1. Question the patient about history of sinus infections. 2. Determine whether the patient has mixed the aspirin with other medications. 3. Tell the patient not to take any more aspirin. 4. Tell the patient to take the aspirin with food or milk.

3. Tell the patient not to take any more aspirin.

The nurse plans care for an older adult receiving nonsteroidal anti-inflammatory drug (NSAID) therapy. What is the best outcome for this client as it relates to side effects of nonsteroidal anti-inflammatory drugs (NSAIDs)? 1. The client will refrain from taking other medications with the nonsteroidal anti-inflammatory drug (NSAID). 2. The client will avoid the use of caffeine while taking the nonsteroidal anti-inflammatory drug (NSAID). 3. The client will report any bleeding or bruising while taking the nonsteroidal anti-inflammatory drug (NSAID). 4. The client will report any mood changes while taking the nonsteroidal anti-inflammatory drug (NSAID).

3. The client will report any bleeding or bruising while taking the nonsteroidal anti-inflammatory drug (NSAID).

A nurse is preparing to administer a hepatitis B vaccination to a patient. Which of the following would cause the nurse to withhold the vaccination and check with the health care provider? 1. The patient smokes cigarettes, one pack per day. 2. The patient is frightened by needles and injections. 3. The patient is allergic to yeast and yeast products. 4. The patient has hypertension.

3. The patient is allergic to yeast and yeast products.

The nurse administers morphine 4 mg IV to a patient for treatment of severe pain. Which of the following assessments require immediate nursing interventions? (Select all that apply.) 1. The patient's blood pressure is 110/70 mmHg. 2. The patient is drowsy. 3. The patient's pain is unrelieved in 15 minutes. 4. The patient's respiratory rate is 10 breaths per minute. 5. The patient becomes unresponsive.

3. The patient's pain is unrelieved in 15 minutes. 4. The patient's respiratory rate is 10 breaths per minute. 5. The patient becomes unresponsive.

The patient states that she has been increasing the amount and frequency of the antianxiety drug she is using because "it just isn't working like it did before." What effect does this indicate? 1. Immunity 2. Resistance 3. Tolerance 4. Addiction

3. Tolerance

After the client begins taking glucocorticoid medications, the nurse would observe for adverse effects of 1. hypoglycemia. 2. hypotension. 3. bruising. 4. weight loss.

3. bruising.

A client is placed on aspirin. A toxic reaction to this medication that the nurse will teach the client to report is 1. blurred vision. 2. muscle cramps. 3. tinnitus. 4. joint pain.

3. tinnitus.

The physician orders penicillin for a female client who has a sinus infection. What is a priority question to ask the client prior to administering the medication? 1. "Are you pregnant?" 2. "Do you plan to become pregnant?" 3. "Are you breastfeeding?" 4. "Are you taking birth control pills?"

4. "Are you taking birth control pills?"

Which of the following statements by a patient who is taking cyclosporine (Neoral, Sandimmune) would indicate the need for more teaching by the nurse? 1. "I will report any reduction in urine output to my health care provider." 2. "I will wash my hands frequently." 3. "I will take my blood pressure at home every day." 4. "I will take my cyclosporine at breakfast with a glass of grapefruit juice."

4. "I will take my cyclosporine at breakfast with a glass of grapefruit juice."

A mother calls the clinic and tells the nurse that her 4-month-old baby has a fever. The mother asks if she can use the liquid acetaminophen (Tylenol) that is used for her 10-year-old child. What is the best response by the nurse? 1. "Infants should not have acetaminophen (Tylenol) because it damages the liver." 2. "It is best if the pediatrician is called; he can be asked this question." 3. "It is fine to use the same medicine for both children." 4. "Infant drops should be used for the baby; they are different from liquid medicine."

4. "Infant drops should be used for the baby; they are different from liquid medicine."

The client has had malaria for many years. He asks the nurse why medications might not cure his illness when there are several drugs available. What is the best response by the nurse? 1. "When erythrocytes rupture, the parasites are too numerous for medications to be effective." 2. "Late in the illness, the immune system is too overwhelmed for medications to be effective." 3. "Once the parasite starts multiplying in your liver, medications are usually ineffective." 4. "When cysts occur late in the disease, the parasite is too resistant for medications to be effective."

4. "When cysts occur late in the disease, the parasite is too resistant for medications to be effective."

A 32-year-old female patient is started on metronidazole (Flagyl) for treatment of a trichomonas vaginal infection. What must the patient eliminate from her diet for the duration she is on this medication? 1. Caffeine 2. Acidic juices 3. Antacids 4. Alcohol

4. Alcohol

A 55-year-old female patient is receiving cyclosporine (Neoral, Sandimmune) after a heart transplant. The patient exhibits a white blood cell count of 12,000 cells/mm3 a sore throat, fatigue, and a low-grade fever. The nurse suspects which of the following conditions? 1. Transplant rejection 2. Heart failure 3. Dehydration 4. Infection

4. Infection

The nurse is counseling a mother regarding antipyretic choices for her 8-year-old daughter. When asked why aspirin is not a good drug to use, what should the nurse tell the mother? 1. It is not as good an antipyretic as is acetaminophen. 2. It may increase fever in children under age 10. 3. It may produce nausea and vomiting. 4. It increases the risk of Reye's syndrome in children under 19 with viral infections.

4. It increases the risk of Reye's syndrome in children under 19 with viral infections.

A patient has been prescribed tetracycline. When providing information regarding this drug, the nurse should include what information about tetracycline? 1. It is classified as a narrow-spectrum antibiotic with minimal adverse effects. 2. It is used to treat a wide variety of disease processes. 3. It has been identified to be safe during pregnancy. 4. It is contraindicated in children younger than 8 years.

4. It is contraindicated in children younger than 8 years.

A young patient requires suturing of a laceration to the right forearm and the provider will use lidocaine (Xylocaine) with epinephrine as the local anesthetic prior to the procedure. Why is epinephrine included in the lidocaine for this patient? 1. It will increase vasodilation at the site of the laceration. 2. It will prevent hypotension. 3. It will ensure that infection risk is minimized postsuturing. 4. It will prolong anesthetic action at the site.

4. It will prolong anesthetic action at the site.

A client comes to the emergency department with a fever of 104°F. The nurse anticipates which actions to help identify the correct antibiotic? 1. Obtaining liver and renal function tests. 2. Obtaining a complete blood count (CBC) test. 3. Obtaining a sterile urine specimen. 4. Obtaining blood for culture and sensitivity.

4. Obtaining blood for culture and sensitivity.

A patient is admitted to the postanesthesia recovery unit (PACU) after receiving ketamine (Ketalar) after his minor orthopedic surgery. What is the most appropriate nursing action in the recovery period for this patient? 1. Frequently orient the patient to time, place, and person. 2. Keep the patient in a bright environment so there is less drowsiness. 3. Frequently assess the patient for sensory deprivation. 4. Place the patient in a quiet area of the unit with low lights and away from excessive noise.

4. Place the patient in a quiet area of the unit with low lights and away from excessive noise.

A client comes to the emergency department complaining of a sore throat. He has white patches on his tonsils, and he has swollen cervical lymph nodes. What will the best plan by the nurse include? 1. Plan to administer a narrow-spectrum antibiotic. 2. Plan to administer a broad-spectrum antibiotic. 3. Plan to obtain blood cultures. 4. Plan to obtain a throat culture.

4. Plan to obtain a throat culture.

The nurse plans to provide health promotion to a group of business travelers who are going to travel to Africa. What will the best teaching plan by the nurse include? 1. Plan to take antibiotics prophylactically. 2. Plan to take protease inhibitors prophylactically. 3. Plan to receive immunizations for malaria. 4. Plan to take antimalarial drugs prophylactically.

4. Plan to take antimalarial drugs prophylactically.

The emergency department nurse is caring for a patient with a migraine. Which drug would the nurse anticipate administering to abort the patient's migraine attack? 1. Morphine 2. Propranolol (Inderal) 3. Ibuprofen (Motrin) 4. Sumatriptan (Imitrex)

4. Sumatriptan (Imitrex)

The nurse obtains information during the admission interview that the patient is taking herbal supplements in addition to prescribed medications. What is the nurse's primary concern for this patient? 1. Herbal products are natural and pose no risk to the patient but may be costly. 2. Herbal products are a welcome supplement to conventional medications but do not always come with instructions. 3. The patient may be at risk for allergic reactions. 4. The herbal products may interact with prescribed medications and affect drug action.

4. The herbal products may interact with prescribed medications and affect drug action.

Superinfections are an adverse effect common to all antibiotic therapy. Which of the following best describes a superinfection? 1. An initial infection so overwhelming that it requires multiple antimicrobial drugs to treat successfully 2. Bacterial resistance that creates infections that are difficult to treat and are often resistant to multiple drugs 3. Infections requiring high-dose antimicrobial therapy with increased chance of organ toxicity 4. The overgrowth of normal body flora or of opportunistic organisms such as viruses and yeast no longer held in check by normal, beneficial flora

4. The overgrowth of normal body flora or of opportunistic organisms such as viruses and yeast no longer held in check by normal, beneficial flora

The nurse is admitting a patient with rheumatoid arthritis. The patient has been taking prednisone (Orasone) for an extended time. During the assessment, the nurse observes that the patient has a very round moon-shaped face, bruising, and an abnormal contour of the shoulders. What does the nurse conclude based on these findings? 1. These are normal reactions with the illness. 2. These are probably birth defects. 3. These are symptoms of myasthenia gravis. 4. These are symptoms of adverse drug effects from the prednisone.

4. These are symptoms of adverse drug effects from the prednisone.

A 5-year-old child is due for prekindergarten immunizations. After interviewing her mother, which of the following responses may indicate a possible contraindication for giving this preschooler a live vaccine (e.g., measles, mumps, and rubella [MMR]) at this visit and would require further exploration by the nurse? 1. Her cousin has the flu. 2. The mother has just finished her series of hepatitis B vaccines. 3. Her arm became very sore after her last tetanus shot. 4. They are caring for her grandmother who has just finished her second chemotherapy treatment for breast cancer.

4. They are caring for her grandmother who has just finished her second chemotherapy treatment for breast cancer.

What is the action of bactericidal drugs? 1. They disrupt normal cell function. 2. They will slow the growth of the bacteria. 3. They have a high potency. 4. They will kill the bacteria.

4. They will kill the bacteria.

The nurse is caring for a client receiving gentamicin IV. The nurse would observe for adverse effects of 1. diarrhea. 2. bleeding 3. increased urinary output 4. ototoxicity.

4. ototoxicity.