Final Exam Study Guide

An adult patient has been taking Titralac (Tums) on an increasingly frequent basis. When teaching this patient, the nurse should include suggestions for the prevention of which of the following adverse effects?

Constipation

A patient is suspected of having adrenal insufficiency. Which hormone may be administered to diagnose Addison's disease?

Corticotropin (ACTH)

A patient is suspected of having Cushing's disease. What hormone is used in the diagnosis of this disorder?

Corticotropin-releasing hormone

Which of the following statements by your patient leads you to believe that he has understood how to safely and effectively use bulk-forming laxatives?

"I will mix the medication with around a cup of fluid and then drink the mixture."

An older adult patient has been using levothyroxine (Synthroid) for several years on an outpatient basis. The patient has recently sought care, with complaints that are consistent with hypothyroidism. To which of the patient's following statements may the nurse attribute the decreased effect of Synthroid?

"I've been using a lot of antacids lately because of my indigestion."

A patient diagnosed with pernicious anemia asks why vitamin B12 is administered by injection. What is the best response to the patient?

"Oral forms of vitamin B12 will not be absorbed."

A new mother asks why her baby receives vitamin K IM at birth. What is the best statement to explain the need for vitamin K in a newborn?

"The administration of vitamin K prevents bleeding."

A patient is prescribed an antitussive agent with codeine. Which of the following statements by the patient indicates that the nurse's teaching has been effective?

"This medication will cause drowsiness, and I will not drive."

The results of a young man's plasma corticotropin (ACTH) stimulation test have confirmed a diagnosis of Addison's disease. The nurse has consequently provided health education around the necessity of hormone replacement therapy. The patient has asked the nurse, "How long am I going to have to take these medications?" How should the nurse best respond?

"You'll need to take these for the rest of your life."

A patient is receiving gentamicin (Garamycin) to treat meningitis. The physician has ordered a peak serum level be drawn in association with the 07:00 dose, which will finish infusing at 07:30. When should the peak serum level be drawn?

0800

A hospital patient is to receive 4 units of regular insulin prior to lunch. The nurse knows that the lunch trays are usually distributed at approximately 12:15. The nurse should plan to administer the patient's insulin at what time?

11:45

Hydrocortisone has been prescribed to a patient for the treatment of Addison's disease, and the patient will soon be discharged. The nurse should encourage the patient to take this medication

9 am

A 23-year-old female patient is prescribed misoprostol (Cytotec). Which of the following patient teaching interventions is most important?

Use effective contraceptive measures

A hospital patient has a standing order for aprepitant on an as-needed basis. The patient should be encouraged to request a dose of the drug

When she anticipates that she will become nauseous

A patient has been prescribed ciprofloxacin after being diagnosed with a sinus infection. Which of the following should the patient avoid taking concurrently with ciprofloxacin?

antacids

A patient who has a diagnosis of peptic ulcer disease has begun taking sucralfate (Carafate). The nurse should caution the patient against the concurrent use of

antacids

An unlicensed care provider administered Benadryl to an elderly resident who has been suffering from seasonal pollen allergies. Which of the following assessment findings should prompt the nurse at the facility to suspect that the resident is experiencing anticholinergic effects of this drug?

blurry vision

A patient is prescribed zanamivir (Relenza) to treat influenza B. The patient has a history of asthma. For which of the following symptoms should the nurse assess?

bronchospasm

A patient previously experienced an anaphylactic reaction to penicillin G. Which of the following medications should not be administered to this patient due to the potential for cross-sensitivity?

cefadrozil (Duricef)

A patient is experiencing an acute asthma attack. Which of the following medications is contraindicated for the treatment of acute bronchospasm?

cromolyn (Intal)

A nurse is preparing to administer a patient's first scheduled dose of tetracycline. The nurse should first ensure that the patient has not recently eaten

dairy products

A 4-year-old child has eaten many of his mother's prenatal vitamins. Which medication is indicated for iron toxicity?

deferoxamine (Desferal)

An adult patient has complained to the nurse that she has been experiencing a dry mouth and urinary retention after several nights of taking an OTC sleep aid. The nurse should suspect that this medication contains what antihistamine?

diphenhydramine (Benadryl)

A patient is being treated for active tuberculosis with ethambutol (Myambutol). The patient states to the nurse that he cannot identify the red and green on the traffic lights when he is driving. Based on this finding, what medical intervention is most appropriate?

discontinue the drug

An older adult's physician has recommended the occasional use of hydroxyzine for relief of nausea. Following administration, the nurse should assess the patient for

drowsiness

A patient is receiving hydrocortisone 40 mg PO daily for treatment of severe autoimmune inflammation. Which of the following nursing interventions is most important to implement?

implement infection control measures

A patient is administered isoniazid (INH) for tuberculosis. Which of the following adverse effects will result in discontinuation of the medication?

jaundice

A patient has developed Clostridium difficile associated with pseudomembranous colitis. Which of the following medications is effective in the treatment of Clostridium difficile?

metronidazole (Flagyl)

A patient has been admitted to the postsurgical unit from postanesthetic recovery following a transurethral prostatic resection. The patient is experiencing nausea subsequent to anesthesia. What antiemetic is the most common first-line drug for the treatment of postoperative nausea and vomiting?

ondansetron (Zofran)

A patient's fluid overload has required several doses of furosemide (Lasix). Which medication will be administered if the patient's serum potassium level is 2.8 mEq/L?

potassium chloride

An adult patient with a diagnosis of asthma has been prescribed montelukast (Singulair). The nurse should teach the patient that this drug will help relieve symptoms by

preventing the bronchoconstriction and inflammation that is caused by leukotrienes

A patient is in diabetic ketoacidosis. The patient blood glucose level is over 600 mg/dL. The physician has ordered the patient to receive an initial dose of 25 units of insulin intravenously. What type of insulin will most likely be administered?

regular insulin

A 21-year-old male is being started on zidovudine (AZT) for treatment of HIV/AIDS. Which of the following statements made by the patient indicates that he has understood the patient teaching?

slows the progression of the disease but does not cure it."

A patient is started on albuterol (Proventil). Of what adverse reaction should the patient be warned?

tachycardia

A patient is seen in the clinic after a bite from a tick. She has a rash over her arms and legs and arthritic pain in the joints. What is the drug of choice for Lyme's disease?

tetracycline (Sumycin)

The nurse has an order to administer a saline cathartic to a patient who has a history of congestive heart failure. Why is this type of cathartic contraindicated with this patient?

the patient is at risk for excess fluid volume.

A patient has sustained a burn from a gas grill. She has been prescribed a sulfonamide to prevent a burn infection. What route is preferred in the prevention of a burn infection?

topical

A patient is administered an antihistamine for nausea. Which of the following is an adverse effect of this classification of medication?

urinary retention

A patient who is being administered metronidazole (Flagyl) to treat Clostridium difficile will also be administered which medication orally to assist in restructuring the flora of the intestinal tract?

vancomycin (Vancocin)

An adult patient has questioned whether fexofenadine (Allegra) would be preferable to the first-generation H1 receptor antagonists that he has long taken in the treatment of his environmental allergies. When describing the benefits of second-generation drugs such as Allegra, the nurse should cite what advantage?

Decreased sedation

A patient is prescribed acyclovir (Zovirax) for the treatment of genital herpes. What is the expected outcome of this medication?

Decreased viral shedding

Your patient is taking psyllium hydrophilic mucilloid (Metamucil) daily. What information should be included in the discharge plan?

Drink at least 8 ounces of fluid with the medication.

A 20-month-old child is experiencing diarrhea. When planning the child's care, the nurse should prioritize assessments related to what health problem?

Electrolyte deficiencies

A hospital patient is complaining of nausea and vomiting that has failed to respond to first-line antiemetics. Which of the following medications may be administered for the treatment of nausea and vomiting?

First generation antihistamine: hydroxyzine (Vistaril)

A nurse has established intravenous access in a patient whose infection necessitates treatment with IV cefazolin. What potential adverse reaction is most likely during this patient's course of treat?

Gastrointestinal upset

A male patient is taking cimetidine (Tagamet). Which adverse effect is more likely to occur with cimetidine than with other histamine2 receptor antagonists?

Gynecomastia

The nurse is preparing to administer gentamicin (Garamycin) to a patient when he mentions that he has recently been experiencing diminished hearing. What action should the nurse take based on this statement?

Hold the dosage and notify the prescriber of the alteration in hearing.

A home care nurse observes that a client's supply of Synthroid has run out in less than half the time that it should have. What assessment findings would be most consistent with overuse of Synthroid?

Hyperactivity and insomnia

A patient has been prescribed omeprazole by her primary care provider. When questioned by the nurse about her perceived effectiveness of the drug, the patient states, "I think it's working quite well, and I've gotten in the routine of taking it every morning before breakfast." How should the nurse respond?

I'm glad to hear that. It sounds like you're taking it exactly like it should be taken.

A patient with a diagnosis of active TB has begun second-line therapy that includes the use of pyrazinamide. When monitoring this patient, the nurse should suspect that adverse effects of this drug may account for which of the following laboratory values?

Increased AST, ALT, and GGT

A patient with a traumatic head injury and a diagnosis of diabetes insipidus is being treated with intravenous vasopressin (Pitressin). What change in the patient's status would prompt the immediate cessation of the drug infusion?

Infiltration at the IV site

A patient is instructed on the administration of inhaled corticosteroid agents to treat asthma. How do inhaled corticosteroid agents assist in the treatment of asthma?

Inhaled corticosteroid agents will reduce airway inflammation.

A patient has an increased serum potassium level and has developed a cardiac arrhythmia. How do insulin and glucose assist in decreasing the serum potassium level?

Insulin and glucose drive potassium into the cells.

A patient is diagnosed with type 1 diabetes. What distinguishing characteristic is associated with type 1 diabetes?

Insulin is required for life

A patient is admitted to the hospital with hyperkalemia. The patient is prescribed sodium polystyrene sulfonate (Kayexalate). How does this medication lower the patient's potassium level?

It combines with potassium ions for elimination.

A patient has been prescribed acarbose (Precose). What is the advantage of acarbose over alternative drugs?

It delays the digestion of complex carbohydrates

A patient is administered Augmentin (amoxicillin and clavulanate potassium) to treat otitis media. How does a beta-lactamase inhibitor agent achieve a therapeutic effect?

It extends the spectrum of antibacterial activity of penicillin.

A patient is administered penicillin V orally for a strep throat. What is the mechanism of action of this medication?

It inhibits cell wall synthesis

A woman in her last trimester of pregnancy is diagnosed with toxemia. The patient is admitted to labor and delivery and suffers a seizure. What medication will be administered parenterally?

Magnesium sulfate

A patient who regularly takes metformin has developed a severe infection. How will the infection change his diabetic regimen?

Metformin is contraindicated in the presence of an infection

A patient has sought care for follow-up to his recent diagnosis of peptic ulcer disease. The patient states that he has achieved adequate symptom relief with the use of OTC antacids but has asked the nurse about the optimal schedule for taking these drugs. What should the nurse recommend?

One and three hours after meals and at bedtime

A 3-year-old child has been diagnosed with an acute gastrointestinal infection that has caused her severe diarrhea for the past 36 hours. The pediatric nurse should anticipate the use of

Pedialyte

A patient is diagnosed with peptic ulcer disease complicated by H. pylori. What is the rationale for adding bismuth to the patient's medication regimen?

Protects the gastric mucosa from stomach acid

A gerontological nurse has encouraged a group of caregivers who work with older adults to avoid administering first-generation H1 receptor antagonists to these patients. The nurse's cautionary message is an acknowledgment of what possible nursing diagnosis?

Risk for falls related to sedation

A patient is scheduled to begin a drug regimen for the treatment of hyperthyroidism. Prior to administering propylthiouracil (PTU), the nurse has reviewed the relevant black box warning and should teach the patient about the need for what form of follow-up?

Routine liver function testing

A patient has been diagnosed with hyperthyroidism. She is scheduled to receive a medication to destroy the thyroid gland. Which medication will be administered?

Sodium Iodine 131 (Idotope)

A patient has hypertension and wants to take a nasal decongestant for cold symptoms. Which of the following statements by the nurse best describes the effect of decongestants on blood pressure?

The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels.

Somatropin has been prescribed for a child who has been diagnosed with growth hormone deficiency. When providing health education to the child's parents, what teaching point should then nurse prioritize?

The correct technique for daily injections of the drug

A patient is prescribed ciprofloxacin (Cipro). Which of the following nursing interventions will best prevent crystalluria?

The nurse should administer oral fluids of 2000 mL/day.

A nurse has returned to a patient's hospital room for a follow-up assessment during the intravenous infusion of vancomycin. What assessment finding would signal the nurse to the possibility that the patient's infusion is running too quickly?

The patient is flushed and has a visible skin rash.

A patient will soon begin treatment for diabetes using glyburide. Which of the following conditions must be met in order for treatment to be effective?

The patient must have functioning pancreatic beta cells.

A male patient has been on chronic corticosteroid therapy for several years and has been scheduled for a colonoscopy. How should the patient's corticosteroid therapy be altered to accommodate this impending stressful event?

The patient should temporarily take a higher dos of his corticosteroid.

A patient is administered rifampin (Rifadin). Which of the following facts should the patient be taught?

The urine, tears, and sweat will be discolored orange.

A patient is undergoing a course of radiotherapy for the treatment of leukemia. Treatments in the past have caused the patient severe nausea and vomiting. The oncology nurse should normally administer antiemetics on what schedule?

30 to 60 minutes before the treatment

A patient with Cushing's disease will soon begin treatment with ketoconazole. When planning the patient's care, the nurse should be cognizant of the black box warning for this drug and consequently monitor what laboratory values?

AST, ALT, and GGT

A patient is to be administered glipizide (Glucotrol). Which of the following factors would contraindicate the administration of glipizide (Glucotrol) to this patient?

Allergy to sulfonamides

A patient is being treated for a urinary tract infection with trimethoprim-sulfamethoxazole (Bactrim). What assessment should the nurse make prior to the administration of the medication?

Assessing for renal insufficiency

An older adult patient has received his third dose of diphenoxylate (Lomotil) and the nurse is monitoring the patient's bowel patterns closely. In addition to monitoring the number and consistency of the patient's stools, the nurse should prioritize what assessment?

Assessment of fluid and electrolyte balance

A patient who has been taking oral prednisone for several months abruptly ceased treatment several days ago on the advice of a family member. The patient has now been admitted to the emergency department with signs and symptoms that are characteristic of addisonian crisis. When assessing this patient, the nurse should prioritize what assessment?

Assessment of serum potassium levels

A 22-year-old college student is allergic to penicillin. Consequently, her current chlamydial infection is being treated with oral erythromycin. What assessment should the nurse prioritize during this patient's course of treatment?

Assessment of the patient's hearing