NRS 2020 Final
The nurse is administering morning medications. The nurse gives a patient multiple medications, two of which compete for plasma albumin receptor sites. As a result of this concurrent administration, the nurse can anticipate that what might occur? (Select all that apply.) A. Binding of one or both agents will be reduced. B. Plasma levels of free drug will rise. C. Plasma levels of free drug will fall. D. The increase in free drug will intensify effects. E. The increase in bound drug will intensify effects.
A, B, D
The nurse is caring for a client who is receiving a loop diuretic for treatment of heart failure. Which of these actions will be included in the plan of care? (Select all that apply.) A. Monitor serum potassium B. Encourage consumption of citrus fruits and greens C. Weigh the client weekly D. Assess daily weights
A, B, D
A client with peptic ulcer disease asks the nurse what medications they might be prescribed for this problem. The nurse tells the client that which medications will be prescribed? Select all that apply. A. Antacids B. Histamine H2-receptor blockers C. NSAIDs D. Proton pump inhibitors E. Antibiotics
A, B, D, E
In monitoring a client's response to disease-modifying antirheumatic drugs (DMARDs), which assessment findings would the nurse consider acceptable responses? Select all that apply. A. An increased range of motion in the affected joints 3 months into therapy B. A low-grade temperature on rising in the morning that remains throughout the day C. Normal white blood cell, platelet, and neutrophil counts D. Control of symptoms during periods of emotional stress E. Inflammation and irritation at the injection site 3 days after the injection is given F. Radiological findings that show no progression of joint degeneration
A, C, D, F
The nurse determines the client needs further instruction on cimetidine (Tagamet) if which statements were made? Select all that apply. A. "I'll know the medication is working if my diarrhea stops." B. "My episodes of heartburn will decrease if the medication is effective." C. "I will take the cimetidine with my meals." D. "Some of my blood levels will need to be monitored closely since I also take warfarin for atrial fibrillation." E. "Taking the cimetidine with an antacid will increase its effectiveness." F. "I will notify my health care provider if I become depressed or anxious."
A, C, E
A drug that is used for nerve pain (neuropathy) that is also a drug used as an anti-epileptic agent is / are: (Select all that apply) A. Carbamazepine (Tegretol) B. Diazepam (Valium) C. Phenytoin (Dilantin) D. Gabapentin (Neurontin)
A, D
Which statements below are true regarding a catecholamine? A. Catecholamines cannot cross the blood brain barrier B. Catecholamines are cholinergic in their effect C. Catecholamines are commonly given by the enteral route D. Catecholamines must be given by parenteral route E. Catecholamines are metabolized slowly
A, D
You are providing discharge teaching to a patient taking Sucralfate (Carafate). Which statement by the patient demonstrates they understand how to take this medication? (Select all that apply) A. "I will continue to take this medication as a preventative therapy" B. "It is best to take this medication with antacids." C. "I will take this medication once a week." D. "I will always take this medication on an empty stomach."
A, D
Which groups of people are especially sensitive to medication effects? (Select all that apply.) A. Older Adults B. Caucasians C. Women D. Minorities E. Infants
A, E
A patient with angina pectoris is prescribed sublingual nitroglycerin. Which statement made by the patient indicates understanding of the medication teaching? A. "I may experience a headache as a side effect." B. "The chest pain should be relieved within 20 minutes." C. "I should swallow the tablet and drink a glass of water." D. "I should take this medication in the morning before breakfast."
A. "I may experience a headache as a side effect."
The clinic nurse is providing instructions to a client with hypertension who will be taking captopril. Which statement by the client indicates a need for further instruction? A. "I need to drink at least 4 quarts (4 liters) of water daily." B. "I need to avoid taking hot baths or showers." C. "I need to sit down and rest if dizziness or lightheadedness occurs." D. "I need to change positions slowly."
A. "I need to drink at least 4 quarts (4 liters) of water daily."
A client on anticoagulant therapy is being discharged. Which statement by the client indicates an understanding of the anticoagulants drug action? A. "It should prevent my blood from clotting." B. "It will thin my blood." C. "It is used to dissolve blood clots." D. "It might cause me to get injured more often."
A. "It should prevent my blood from clotting."
A pregnant patient asks the nurse whether she should continue to take her prescription for tetracycline [Sumycin] to clear up her acne. Which response by the nurse is correct? A. "Tetracycline can be harmful to the baby's teeth and should be avoided." B. "Tetracycline will prevent asymptomatic urinary tract infections." C. "Tetracycline may cause allergic reactions in pregnant women." D. "Tetracycline is safe to take during pregnancy."
A. "Tetracycline can be harmful to the baby's teeth and should be avoided."
A nurse is preparing to administer medications. Which patient would the nurse consider to have the greatest predisposition to an adverse reaction? A. A 30-year-old man with kidney disease B. A 75-year-old woman with cystitis C. A 9-year-old boy with an ear infection D. A 50-year-old man with an upper respiratory tract infection
A. A 30-year-old man with kidney disease
Which client is most likely to receive opioids for extended periods of time? A. A client with progressive pancreatic cancer B. A client with fibromyalgia C. A client with trigeminal neuralgia D. A client with phantom limb pain
A. A client with progressive pancreatic cancer
A patient with stable COPD is prescribed a bronchodilator medication. Which type of bronchodilator is preferred for this patient? A. A long-acting inhaled beta2 agonist B. An oral beta2 agonist C. A short-acting beta2 agonist D. An intravenous methylxanthine
A. A long-acting inhaled beta2 agonist
A postoperative patient who is worried about pain control will be discharged several days after surgery. The nurse providing discharge teaching tells the patient that the prescribed Lortab is not as strong as the morphine the patient was given in the immediate postoperative period. Which response is the patient likely to experience? A. A negative placebo effect when taking the medication B. Optimistic, realistic expectations about the drug C. An increased compliance with the drug regimen D. A decreased likelihood of filling the prescription for the drug
A. A negative placebo effect when taking the medication
A patient is receiving an intravenous infusion of heparin to treat a pulmonary embolism. What laboratory value will the nurse monitor to evaluate treatment with this medication? A. Activated partial thromboplastin time (aPTT) B. Prothrombin time (PT) C. Platelet count D. Hemoglobin and hematocrit
A. Activated partial thromboplastin time (aPTT)
A patient is brought to the emergency department by friends, who report finding the patient difficult to awaken. The friends report removing three fentanyl transdermal patches from the patient's arm. On admission to the emergency department, the patient is slow to respond, has pinpoint pupils and a respiratory rate of 6 breaths per minute. The nurse recognizes the priority intervention as: A. Administer Naloxone (Narcan) per standing order. B. Administration of IV fluids containing glucose. C. Obtain an order for a head CT. D. Obtain an order for a different opioid analgesic to manage the patient's pain.
A. Administer Naloxone (Narcan) per standing order.
A patient newly diagnosed with diabetes is to be discharged from the hospital. The nurse teaching this patient about home management should begin by doing what? A. Asking the patient to demonstrate how to measure and administer insulin B. Discussing methods of storing insulin and discarding syringes C. Giving information about how diet and exercise affect insulin requirements D. Teaching the patient about the long-term consequences of poor diabetes control
A. Asking the patient to demonstrate how to measure and administer insulin
A first day postoperative client on a PCA pump reports that the pain control is inadequate. What is the first action you should take? A. Assess the pain for location, quality, and intensity. B. Deliver the bolus dose per standing order C. Contact the physician to increase the dose D. Try non-pharmacological comfort measures
A. Assess the pain for location, quality, and intensity.
A patient with a history of heart failure and hypertension is in the clinic for a follow-up visit. The patient is on lisinopril (Prinivil) and warfarin (Coumadin). The patient reports new-onset cough. What action by the nurse is most appropriate initial intervention? A. Assess the patient's lung sounds and oxygenation. B. Remind the patient that cough is a side effect of Prinivil. C. Obtain and document vital signs. D. Instruct the patient on another antihypertensive.
A. Assess the patient's lung sounds and oxygenation.
The nurse has administered a dose of docusate. The nurse evaluates that the medication has been effective if the client experiences which finding? A. Bowel movement with soft, formed stool B. Decrease in fatty stools C. Relief of sharp abdominal pain D. Decreased heartburn
A. Bowel movement with soft, formed stool
Cholestyramine has been prescribed for a patient. Which instruction should the nurse include in patient teaching? A. Cholestyramine can impair absorption of fat-soluble vitamins. B. Stop taking the drug if you develop constipation. C. Take cholestyramine with other drugs you are prescribed to enhance absorption. D. Do not take the medication if the formula is cloudy after mixing with water.
A. Cholestyramine can impair absorption of fat-soluble vitamins.
A patient is receiving digoxin twice daily. When assessing the patient before giving a dose, the nurse counts a pulse of 60 beats/min and learns that the patient is experiencing nausea. The nurse consults a drug manual and verifies that the ordered dose is correct. What should the nurse do? A. Contact the prescriber to report the symptoms. B. Delay the dose so the drug can clear from receptor sites. C. Give the medication as ordered, because the dose is correct. D. Request an anti-nausea medication from the prescriber.
A. Contact the prescriber to report the symptoms.
A nurse cares for a patient with diabetes mellitus who is prescribed metformin (Glucophage) and is scheduled for a contrast-enhanced CT. What action should the nurse take first? A. Contact the provider and recommend discontinuing the metformin. B. Administer intravenous fluids to dilute and increase the excretion of dye. C. Check the patient's bedside blood glucose and administer prescribed insulin. D. Keep the patient NPO for at least 6 hours prior to the examination.
A. Contact the provider and recommend discontinuing the metformin.
A nurse consults a drug manual before giving a medication to an 80-year-old patient. The manual states that older adult patients are at increased risk for hepatic side effects. Which action by the nurse is correct? A. Contact the provider to discuss an order for pretreatment laboratory work. B. Ensure that the drug is given in the correct dose at the correct time to minimize the risk of adverse effects. C. Notify the provider that this drug is contraindicated for this patient. D. Request an order to give the medication intravenously so that the drug does not pass through the liver.
A. Contact the provider to discuss an order for pretreatment laboratory work.
Which side effect of clindamycin [Cleocin] causes the most concern and may warrant discontinuation of the drug? A. Diarrhea B. Headache C. Nausea D. None of the above
A. Diarrhea
A patient asks the nurse what can be given to alleviate severe, chronic cancer pain of several months' duration. The patient has been taking oxycodone [OxyContin] and states that it is no longer effective. The nurse will suggest discussing which medication with the provider? A. Fentanyl [Duragesic] transdermal patch B. Pentazocine [Talwin] PO C. Hydrocodone [Vicodin] PO D. Naloxone (Narcan)
A. Fentanyl [Duragesic] transdermal patch
A patient is receiving Interferon Beta for treatment of multiple sclerosis. As the nurse you will stress the importance of? A. Hand hygiene to avoid infection B. Physical exercise to improve fatigue C. Reporting feelings of severe depression/suicide D. Low fat diet
A. Hand hygiene to avoid infection
The healthcare provider is assessing the glucose level of a patient with a diagnosis of diabetes. Which of these is most helpful in evaluating this patient's long-term glucose management? A. Hemoglobin A1c B. Fasting blood glucose level C. Urine specific gravity D. Urine glucose
A. Hemoglobin A1c
When a patient is taking an adrenergic drug, the nurse expects to observe which effect? A. Increased heart rate B. Bronchial constriction C. Increased intestinal peristalsis D. Constricted pupils
A. Increased heart rate
Dopamine is administered to a patient who has been experiencing hypotensive episodes. Other than an increase in blood pressure, which indicator would the nurse use to evaluate a successful response to the dopamine? A. Increased urine output B. Weight gain C. Improved gastric motility D. Decrease in pulse
A. Increased urine output
What is a desired outcome when a drug is described as easy to administer? A. It enhances patient adherence to the drug regimen. B. It can be stored indefinitely without the need for refrigeration. C. It does not interact significantly with other medications. D. It is usually relatively inexpensive to produce.
A. It enhances patient adherence to the drug regimen.
What occurs when a drug binds to a receptor in the body? A. It increases or decreases the activity of that receptor. B. It alters the receptor to become non-responsive to its usual endogenous molecules. C. It prevents the action of the receptor by altering its response to chemical mediators. D. It gives the receptor a new function.
A. It increases or decreases the activity of that receptor.
Which of the following insulins have no peak but a duration of 24 hours? A. Lantus (insulin glargine) B. NPH insulin C. Aspart insulin D. Humulin R (regular insulin)
A. Lantus (insulin glargine)
A patient has a prescription to take a powdered form of psyllium after discharge. The nurse should plan to include which information when teaching the client about this medication? A. Mix the medication with a full glass of water or juice. B. Decrease fluid intake following administration of the medication. C. Mix the medication with applesauce. D. Decrease the amount of fiber in the diet when taking this medication.
A. Mix the medication with a full glass of water or juice.
A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what? A. Monitor plasma drug levels. B. Administer this medication intravenously. C. Administer the drug at intervals longer than the drug half-life. D. Teach the patient that maximum drug effects will occur within a short period.
A. Monitor plasma drug levels.
A nurse is administering morphine sulfate to a postoperative patient. Which is NOT an appropriate routine nursing actions when giving this drug? A. Monitoring the patient's blood pressure closely for hypertension B. Encouraging physical activity and offering increased fluids C. Palpating the patients abdomen twice per shift and monitoring for constipation D. Monitoring respirations before giving the medication and throughout the course of therapy
A. Monitoring the patient's blood pressure closely for hypertension
A client has received a dose of dimenhydrinate (Dramamine), The nurse should observe relief of what sign or symptom to evaluate that the medication has been effective? A. Nausea and vomiting B. Buzzing sound in ears C. Headache D. Chills
A. Nausea and vomiting
A patient has been prescribed pharmacologic doses of glucocorticoids. It is most important for the nurse to teach the patient to do what? A. Never abruptly withdraw therapy. B. Take antibiotics to prevent infection. C. Increase intake of dietary sodium D. Have an eye exam every year.
A. Never abruptly withdraw therapy.
A client with rheumatoid arthritis is receiving Hydroxychloroquine (Plaquenil) in the recent months. The nurse tells the client to visit which of the following while on the treatment? A. Ophthalmologist B. Endocrinologist C. Dentist D. Pulmonologist
A. Ophthalmologist
A physician prescribes a Proton-Pump Inhibitor to a patient with a gastric ulcer. Which medication is considered a PPI? A. Pantoprazole B. Famotidine C. Metronidazole D. Famotidine
A. Pantoprazole
A young adult woman will begin using an inhaled glucocorticoid to treat asthma. The nurse will teach this patient about the importance of which action? A. Participating in weight-bearing exercises on a regular basis B. Taking oral glucocorticoids during times of acute stress C. Lowering her calcium intake and increasing her vitamin D intake D. Using two reliable forms of birth control to prevent pregnancy
A. Participating in weight-bearing exercises on a regular basis
A patient with gout has not experienced relief with conventional drug therapy. The nurse anticipates which agent will be prescribed for the patient? A. Pegloticase B. Allopurinol C. Probenecid D. Solu-Medrol
A. Pegloticase
A nurse assesses a patient after administering a prescribed beta-blocker. Which assessment would the nurse expect to find? A. Pulse decreased from 100 to 80 beats/min B. Oxygen saturation increased from 88% to 96% C. Blood pressure increased from 98/42 to 132/60 mm Hg D. Respiratory rate decreased from 25 to 14 breaths/min
A. Pulse decreased from 100 to 80 beats/min
A patient is prescribed allopurinol for chronic tophaceous gout. The patient develops a rash. What is the priority intervention by the nurse? A. Stop the medication and assess the patient for liver and kidney failure. B. Instruct the patient to avoid exposing the skin to sunlight. C. Administer diphenhydramine (Benadryl) with the dose of allopurinol. D. Monitor the patient for respiratory depression.
A. Stop the medication and assess the patient for liver and kidney failure.
A patient recently began receiving clindamycin [Cleocin] to treat an infection. After 8 days of treatment, the patient reports having 10 to 15 watery stools per day. What will the nurse tell this patient? A. The patient should stop taking the clindamycin now and contact the provider immediately. B. The patient should try taking Lomotil or a bulk laxative to minimize the diarrheal symptoms C. The provider may increase the clindamycin dose to treat this infection. D. This is a known side effect of clindamycin, and the patient should consume extra fluids
A. The patient should stop taking the clindamycin now and contact the provider immediately.
A patient is prescribed lovastatin [Mevacor]. The nurse will teach the patient to take the medication at which time? A. With the evening meal B. 1 hour before breakfast C. With any meal D. 2 hours after a meal
A. With the evening meal
A factory worker has been admitted to the emergency department after an industrial accident involving organophosphate insecticides. The nurse knows insecticides belong to which class of potentially toxic drugs? A. acetylcholinesterase inhibitors B. adrenergic antagonists C. cholinergic agonists D. adrenergic agonists
A. acetylcholinesterase inhibitors
A patient with post-operative pain who has been receiving an opioid analgesic reports having pain at a new location even though the previous pain is well controlled. The nurse will contact the provider to discuss: A. complication such as infection or deep vein thrombus. B. breakthrough pain C. drug-seeking behavior D. tolerance to drug therapy
A. complication such as infection or deep vein thrombus.
An older adult patient with chronic obstructive pulmonary disease (COPD) develops bronchitis. The patient has a temperature of 39.5°C. The nurse will expect the provider to: A. order empiric antibiotics while waiting for sputum culture results B. obtain a sputum culture and wait for the results before prescribing an antibiotic. C. treat symptomatically, because antibiotics are usually ineffective against bronchitis D. treat the patient with more than one antibiotic without obtaining cultures.
A. order empiric antibiotics while waiting for sputum culture results
The nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Upon assessing the patient, the nurse notices the individual has developed oral thrush. What describes the etiology of the thrush? A. superinfection B. community-acquired infection C. nosocomial infection D. antibiotic resistance
A. superinfection
A patient with asthma will be using a metered-dose inhaler (MDI) for delivery of an inhaled medication. The provider has ordered 2 puffs to be given twice daily. It is important for the nurse to teach this patient that: A. the patient should wait 1 minute between puffs. B. the patient should store the MDI in the refrigerator between doses. C. the patient should inhale suddenly to receive the maximum dose D. the patient should activate the device and then inhale.
A. the patient should wait 1 minute between puffs.
A nurse is reviewing a patient's medical record before administering a medication. Which factors can alter the patient's physiologic response to the drug? (Select all that apply) A. Ability to swallow pills B. Age C. Genetic factors D. Gender E. Height
B, C, D
What are the properties of an ideal drug? A. Irreversible action B. Predictability C. Ease of administration D. Chemical stability E. A recognizable trade name
B, C, D
A client with diarrhea for 3 days and inability to eat or drink well is brought to the emergency department (ED) by her family. She states she has been taking her diuretics for congestive heart failure (CHF). What nursing actions are indicated at this time? (Select all that apply.) A. Assess for orthostatic hypotension B. Place the client on bed rest C. Initiate cardiac monitoring D. Administer the ordered diuretic E. Evaluate the electrolyte levels
B, C, E
Which actions occur in 90% of fatal medication errors? (Select all that apply.) A. Confusing drugs with similar packaging B. Giving a drug intravenously instead of intramuscularly C. Giving Nasarel instead of Nizoral D. Using an infusion device that malfunctions E. Writing a prescription illegibly
B, C, E
A client with gout has begun to take allopurinol. The nurse informs the client that which medication may also be necessary during the beginning phase of medication therapy with allopurinol? Select all that apply. A. Oxycodone B. Indomethacin C. Hydromorphone D. Colchicine E. Naproxen
B, D, E
Before administering a medication, what does the nurse need to know to evaluate how individual patient variability might affect the patient's physiologic response to the medication? (Select all that apply.) A. Chemical stability of the medication B. Patient's age C. Ease of administration D. Family medical history E. Patient's diagnosis
B, D, E
Someone asks a nurse about a new drug that is in preclinical testing and wants to know why it cannot be used to treat a friend's illness. Which statement by the nurse is correct? A. "A drug at this stage of development can be used only in patients with serious disease." B. "At this stage of drug development, the safety and usefulness of the medication is unknown." C. "Clinical trials must be completed to make sure the drug is safe to use in humans." D. "Until post-marketing surveillance data are available, the drug cannot be used."
B. "At this stage of drug development, the safety and usefulness of the medication is unknown."
The nurse is teaching a patient how to self-administer triptan injections for migraine headaches. Which statement by the patient indicates that he needs further teaching? A. "I will keep a journal to record the headaches I have and how the injections are working." B. "I will take this medication regularly to prevent a migraine headache from occurring." C. "This medication does not reduce the number of migraines I will have." D. "I will take this medication when I feel a migraine headache starting."
B. "I will take this medication regularly to prevent a migraine headache from occurring."
A client with thyroid cancer has just received Iodine-131 ablative therapy. Which statement by the client indicates a need for further teaching? A. "I need to wash my clothes separately from everyone else's clothes." B. "I'm ready to hold my newborn grandson now." C. "I cannot share my toothpaste with anyone." D. "I must flush the toilet three times after I use it."
B. "I'm ready to hold my newborn grandson now."
The nurse instructs a patient about taking levothyroxine [Synthroid]. Which statement by the patient indicates the teaching has been effective? A. "To prevent an upset stomach, I will take the drug with food." B. "If I have chest pain or insomnia, I should call my doctor." C. "This medication can be taken with an antacid." D. "The drug should be taken before I go to bed at night."
B. "If I have chest pain or insomnia, I should call my doctor."
The nurse is preparing to administer penicillin G intramuscularly to a child. The child's parents ask why the drug cannot be given in an oral liquid form. What is the nurse's reply? A. "This drug has a narrow therapeutic range, and the dose must be tightly controlled." B. "This drug would be inactivated by enzymes in the stomach." C. "This drug causes severe gastric upset if given orally." D. "This drug is absorbed much too quickly in an oral form."
B. "This drug would be inactivated by enzymes in the stomach."
A patient has just received a prescription for fluticasone/salmeterol [Advair Diskus]. What will the nurse include as part of the teaching for this patient about the use of this device? A. "You will need to use a spacer to help control the medication." B. "You do not need good hand-lung coordination to use this device." C. "You will take 2 inhalations twice daily." D. "You will begin to inhale before activating the device."
B. "You do not need good hand-lung coordination to use this device."
A patient is receiving tobramycin 3 times daily. The provider has ordered a trough level with the 8:00 AM dose. The nurse will ensure that the level is drawn at what time? A. 0700 B. 0745 C. 0845 D. 0400
B. 0745
The nurse instructs a patient on how to correctly use an inhaler with a spacer. In which order would these steps occur? 1. "Press down firmly on the canister to release one dose of medication." 2. "Breathe in slowly and deeply." 3. "Shake the whole unit vigorously three or four times." 4. "Insert the mouthpiece of the inhaler into the nonmouthpiece end of the spacer." 5. "Place the mouthpiece into your mouth, over the tongue, and seal your lips tightly around the mouthpiece." 6. "Remove the mouthpiece from your mouth, keep your lips closed, and hold your breath for at least 10 seconds." A. 5, 3, 6, 1, 2, 4 B. 4, 3, 5, 1, 2, 6 C. 2, 3, 4, 5, 6, 1 D. 3, 4, 5, 1, 6, 2
B. 4, 3, 5, 1, 2, 6
A provider has written an order for a medication: drug × 100 mg PO every 6 hours. The half-life for the drug is approximately 6 hours. The nurse is preparing to administer the first dose at 8:00 AM on Tuesday. On Wednesday, when will the serum drug level reach plateau? A. 2:00 AM B. 8:00 AM C. 2:00 PM D. 8:00 PM
B. 8:00 AM
A patient with cancer is admitted to the hospital. The nurse obtains an admission history and learns that the patient has been taking oxycodone and a nonsteroidal anti-inflammatory drug (NSAID) for a year. The patient reports a recent increase in the intensity of pain, along with a new pain described as "burning" and "shooting." The nurse anticipates that the prescriber will order: A. A combination opioid/NSAID and an adjunctive analgesic. B. A fentanyl transdermal patch, acetaminophen, and an adjunctive analgesic for nerve pain. C. An increase in the oxycodone and NSAID doses. D. Intramuscular morphine sulfate and acetaminophen.
B. A fentanyl transdermal patch, acetaminophen, and an adjunctive analgesic for nerve pain.
When titrating an analgesic to manage pain, what is the priority goal? A. Titrate downwards to prevent toxicity. B. Administer smallest dose that provides relief with the fewest side effects. C. Titrate upward until the client is pain free. D. Ensure that the drug is adequate to meet the client's subjective needs.
B. Administer smallest dose that provides relief with the fewest side effects.
A nurse obtains a health history on a client prior to administering prescribed sumatriptan succinate (Imitrex), a serotonin agonist or triptan, for migraine headaches. Which condition would alert the nurse to hold the medication and contact the healthcare provider? A. Bronchial asthma B. Angina C. Diabetes mellitus D. Chronic kidney disease
B. Angina
A patient who uses an inhaled glucocorticoid for chronic asthma calls the nurse to report hoarseness. What will the nurse do next? A. Request an order for an antifungal medication. B. Ask whether the patient is rinsing the mouth after each dose. C. Suggest that the patient be tested for a bronchial infection. D. Tell the patient to discontinue use of the glucocorticoid.
B. Ask whether the patient is rinsing the mouth after each dose.
The nurse receives an order to give morphine 5 mg IV every 2 hours PRN pain. Which action is not part of the six rights of drug administration? A. Checking the medication administration record to see when the last dose was administered B. Assessing the patient's pain level 15 to 30 minutes after giving the medication C. Consulting a drug manual to determine whether the amount the prescriber ordered is appropriate D. Documenting the reason the medication was given in the patient's electronic medical record
B. Assessing the patient's pain level 15 to 30 minutes after giving the medication
The nurse recognizes that adrenergic drugs cause relaxation of the bronchi and bronchodilation by stimulating which type of receptors? A. Dopaminergic B. Beta2 adrenergic C. Alpha1 adrenergic D. Beta1 adrenergic
B. Beta2 adrenergic
When monitoring a patient who is taking a low-dose cholinergic drug, the nurse will watch for which cardiovascular effect? A. Palpitations B. Bradycardia C. Vasoconstriction D. Tachycardia
B. Bradycardia
A patient is in the emergency department with an unspecified supraventricular dysrhythmia. The physician orders a dose of diltiazem (Cardizem) IV push. While the nurse administers the medication through the IV lock, the patient says she feels something wet spilling on her arm. Her heart rate was unchanged. What will the nurse do next? A. Assess the patient for diaphoresis B. Check the IV lock to see if it is functioning properly C. Repeat the dose of diltiazem (Cardizem) D. Restart the IV in another location
B. Check the IV lock to see if it is functioning properly
A patient is prescribed amoxicillin and tetracycline to treat peptic ulcer disease. The nurse will instruct the patient that these medications will do what? A. Prevent GI infections that cause gastric bleeding. B. Destroy the bacteria in the stomach that are causing ulceration. C. Reduce gastric acid production and alkalize the stomach fluids. D. Reduce the secretion of pepsin in the stomach.
B. Destroy the bacteria in the stomach that are causing ulceration.
Which of the following is NOT a common adverse effect of opioid analgesics? A. Respiratory depression B. Diarrhea C. Sedation D. Nausea
B. Diarrhea
A patient with a urinary creatinine clearance of 55 mL/min is prescribed desmopressin (DDAVP). It is most important for the nurse to assess the patient for what? Normal creatine clearance is 88-137mL/min. A. Irritability, muscle weakness, and back pain B. Drowsiness, listlessness, and headache C. Fever, tachycardia, and hypotension D. Decreased skin turgor, weight loss, and dry skin
B. Drowsiness, listlessness, and headache
A client receives a dose of scopolamine for nausea from motion sickness. The nurse determines that which sign or symptom later displayed by the client is a result of medication side and adverse effects? A. Pupillary constriction B. Dry mouth C. Excessive urination D. Diaphoresis
B. Dry mouth
Which statement about enteracept (Enbrel), a Biologic non-TNF) Inhibitors, does the nurse identify as true? A. The patient should stop taking the drug if redness appears at the injection site. B. Enteracept can cause liver injury. C. Live vaccines can be administered with enteracept. D. Enteracept is used to treat CNS demyelinating disorders.
B. Enteracept can cause liver injury.
A hospitalized older client with rheumatoid arthritis needs to increase activity, but is unsteady and complains of dizziness with activity. The nurse establishes the nursing diagnosis of Activity Intolerance. Which action by the nurse is most important to implement next? A. Reassure the client that someone will help with ambulation. B. Evaluate the client's medications. C. Ask the client if he or she is just afraid of falling. D. Perform lower extremity strength testing.
B. Evaluate the client's medications.
You are working near a war zone and are taking care of a soldier who has been given an irreversible cholinesterase inhibitor during warfare. What action would be the BEST thing to do first in this situation? A. Assess his urine output B. Give the atropine dose that has been ordered C. Notify his family that he has been hospitalized D. Give him acetylcholine
B. Give the atropine dose that has been ordered
A patient is taking a drug that does not bind to albumin. Which aspect of renal drug excretion is affected by this characteristic? A. Active tubular secretion B. Glomerular filtration C. Passive tubular reabsorption D. pH-dependent ionization
B. Glomerular filtration
What patient history would the nurse recognize as a contraindication for beginning Niacin therapy? A. Allergy to erythromycin B. Gout C. Coronary artery disease D. Hypothyroidism
B. Gout
The nurse is caring for a patient with atrial fibrillation (AF). In addition to an antidysrhythmic, what medication does the nurse plan to administer? A. Atropine B. Heparin C. Dobutamine D. Magnesium sulfate
B. Heparin
A patient with rheumatoid arthritis is experiencing sudden vision changes. Which medication found in the patient's medication list can cause retinal damage? A. Lefluomide (Arava) B. Hydroxychloroquine (Plaquenil) C. Methylprednisolone (Medrol) D. Sulfasalazine (Azulfidine)
B. Hydroxychloroquine (Plaquenil)
A patient is taking ibuprofen 800 mg three times a day by mouth as treatment for OA. While taking a health history, the nurse finds out that the patient has a few beers on weekends. What concern would there be with the interaction of the alcohol and ibuprofen? A. Reduced anti-inflammatory effects of the NSAID B. Increased chance for GI bleeding C. Increased nephrotoxic effects D. Increased risk for falls
B. Increased chance for GI bleeding
A nurse is teaching a patient about a drug that induces P-glycoprotein. The nurse will explain that this drug may cause which effect on other drugs? A. Increased brain exposure B. Increased elimination through the kidneys C. Increased fetal absorption D. Decreased absorption in the intestines
B. Increased elimination through the kidneys
The nurse identifies which of the following laxatives as having the added response of ridding the body of ammonia? A. Polyethylene glycol B. Lactulose C. Lubiprostone D. Mineral oil
B. Lactulose
The nurse is obtaining a medication history on a patient presenting with chest pain. What drug classification would necessitate the nurse informing the provider before beginning the prescribed nitroglycerin? A. Proton pump inhibitor B. Phosphodiesterase inhibitors (Erectile Dysfunction medications) C. Inhaled beta blocker D. Acetylsalicylic acid (aspirin)
B. Phosphodiesterase inhibitors (Erectile Dysfunction medications)
The nurse is teaching a patient about home administration of insulin to treat diabetes mellitus. As part of the teaching, the patient and nurse identify goals to maintain specific blood glucose ranges. This represents which aspect of the nursing process? A. Evaluation B. Planning C. Implementation D. Assessment
B. Planning
A patient is receiving oral quinidine. Which assessment finding is of most concern? A. Nausea B. Prolonged QT interval C. Diarrhea D. Occasional palpitations
B. Prolonged QT interval
A patient who takes nonsteroidal anti-inflammatory drugs (NSAIDs) for arthritis asks a nurse what can be done to prevent ulcers. The nurse will recommend asking the provider about using which medication? A. Histamine-2 receptor antagonists B. Proton pump inhibitors C. Mucosal protectants D. Antibiotics
B. Proton pump inhibitors
A patient is admitted for diabetic ketoacidosis (DKA), and an IV drip titrated to maintain blood glucose levels between 120 and 200 is ordered (intravenous infusion). The only insulin that would be administered IV is: A. NPH insulin B. Regular insulin C. None of the above, insulin cannot be administered IV D. Lantus (Glargine) insulin
B. Regular insulin
Prior to administering a client's daily dose of digoxin, the nurse reviews the client's laboratory data and notes the following results: serum calcium 9.8 mg/dL serum magnesium 1.0 mEq/L serum potassium 4.1 mEq/L serum creatinine 0.9 mg/dL Which result should alert the nurse that the client is at risk for digoxin toxicity? A. Serum creatinine B. Serum magnesium C. Serum calcium D. Serum potassium
B. Serum magnesium
A patient is mowing his lawn on a hot Saturday afternoon. He begins to notice chest pain. What should his first action be? A. Take his nitroglycerin tablet B. Stop mowing and sit or lie down C. Go inside the house to cool off and get a drink of water D. Call 911
B. Stop mowing and sit or lie down
A patient diagnosed with type 2 diabetes mellitus is admitted to the medical unit with pneumonia. The patient's oral antidiabetic medication has been discontinued and the patient is now receiving insulin for glucose control. Which of the following statements best explains the rationale for this change in medication? A. Insulin administration will help prevent hypoglycemia during the illness B. Stress-related states such as infections increase risk of hyperglycemia C. Infection has compromised beta cell function so the patient will need insulin from now on D. Acute illnesses like pneumonia will cause increased insulin resistance
B. Stress-related states such as infections increase risk of hyperglycemia
A client has just been prescribed with Methotrexate (Trexall) for the treatment of rheumatoid arthritis who did not respond to any other treatment. An important reminder for the client is? A. Pregnancy is not contraindicated with the use of the medication. B. Strict hand washing. C. Clay-colored stool is a normal response of the treatment D. Get a daily source of sunlight during the day.
B. Strict hand washing.
A patient who has been taking gentamicin for 5 days reports a headache and dizziness. What will the nurse do? A. Tell the patient to report any tinnitus B. Suspect ototoxicity and notify the prescriber C. Request an order for a gentamicin peak level D. Tell the patient to ask for help with ambulation.
B. Suspect ototoxicity and notify the prescriber
The nurse is aware that adrenergic drugs produce effects similar to which of these nervous systems? A. Parasympathetic NS B. Sympathetic NS C. Somatic NS D. Central NS
B. Sympathetic NS
The nurse will teach a patient who is prescribed niacin [Niacor] to prevent flushing of the face by doing what? A. Drinking a full glass of water after taking the medication B. Taking 325 mg of aspirin 30 minutes before each dose C. Ingesting a meal before taking the medication D. Increasing dietary fiber before and after each dose
B. Taking 325 mg of aspirin 30 minutes before each dose
A nurse is caring for an intubated patient who is receiving pancuronium (Pavulon) for neuromuscular blockade. The patient's eyes are closed, and the patient is not moving any extremities. The patient's heart rate is 76 beats per minute, and the blood pressure is 110/70 mm Hg. The nurse caring for this patient will do what? A. Request an order for serum electrolytes to evaluate for hyperkalemia. B. Talk to the patient while giving care and explain all procedures. C. Review the patient's chart for a history of myasthenia gravis (MG). D. Request and order for an antihistamine to prevent a further drop in blood pressure.
B. Talk to the patient while giving care and explain all procedures.
A patient with asthma is prescribed triamcinolone acetonide [Azmacort]. What should the nurse do? A. Take the patient's pulse before administering the medication. B. Teach the patient to use a spacer to prevent a fungal infection. C. Instruct the patient to use this drug to treat an acute attack. D. Encourage the patient to avoid weight-bearing activity.
B. Teach the patient to use a spacer to prevent a fungal infection.
A patient takes levothyroxine (Synthroid) 0.75 mcg every day. It is most appropriate for the nurse to monitor which laboratory test to determine whether a dose adjustment is needed? A. Thyrotropin-releasing hormone (TRH) B. Thyroid-stimulating hormone (TSH) C. Serum free T4 test D. Serum iodine level
B. Thyroid-stimulating hormone (TSH)
Loop diuretics have all of the following potential adverse effects except: A. Hypokalemia B. Urinary retention C. Hyponatremia D. Hypotension
B. Urinary retention
A patient newly diagnosed with PUD reports taking low-dose aspirin (ASA) for prevention of cardiovascular disease. The nurse learns that the patient drinks 2 to 3 cups of coffee each day and has a glass of wine with dinner 3 or 4 nights per week. The patient eats three meals a day. The nurse will counsel this patient to: A. discontinue taking aspirin, because it can irritate the stomach. B. change the meal pattern to five or six smaller meals per day C. switch to a decaffeinated coffee and reduce the number of servings.
B. change the meal pattern to five or six smaller meals per day
The U.S. Food and Drug Administration (FDA) recommends genetic testing of patients receiving certain medications. Genetic testing helps prescribers: A. better establish a drug's therapeutic index B. determine whether a patient is a rapid or slow metabolizer of the drug C. identify racial characteristics that affect psychosocial variation in drug response D. produce a drug that is tailored to an individual patient's genetic makeup
B. determine whether a patient is a rapid or slow metabolizer of the drug
A patient is beginning therapy with oral methotrexate [Rheumatrex] for rheumatoid arthritis. The nurse will teach this patient about the importance of: A. reporting alopecia and rash B. having routine renal and hepatic function tests C. taking the medication on a daily basis D. limiting folic acid consumption
B. having routine renal and hepatic function tests
The nurse is caring for a child who has ingested a toxic amount of aspirin. The provider orders an intravenous drug that will increase pH in the blood and urine. The nurse understands that this effect is necessary to: A. decrease the gastric absorption of aspirin. B. increase the urinary excretion of aspirin. C. increase the serum protein binding of aspirin. D. decrease the lipid solubility of aspirin.
B. increase the urinary excretion of aspirin.
An adrenergic agonist is ordered for a patient in cardiogenic shock. The nurse will note that this drug has had its primary intended effect if which expected outcome occurs? A. reduced anxiety B. increased cardiac output C. volume restoration D. decreased urine output
B. increased cardiac output
The mechanism of action for carbidopa (Lodosyn), used in the treatment of Parkinson's disease is: A. activating dopamine receptors in the CNS B. increasing availability of levodopa available to the CNS by reducing its breakdown C. decreasing cholinergic receptor activation in the CNS
B. increasing availability of levodopa available to the CNS by reducing its breakdown
When an adrenergic drug stimulates beta1-adrenergic receptors, the result is an increased force of contraction, which is known as what type of effect? A. negative dromotropic B. positive inotropic C. positive chronotropic D. anti-adrenergic
B. positive inotropic
A child ingests a parent's aspirin tablets, and the prescriber orders sodium bicarbonate to block the toxic effects of the aspirin. The nurse caring for this patient knows that sodium bicarbonate is effective against the aspirin because it: A. induces CYP isoenzymes to increase drug metabolism. B. raises the pH of the interstitial fluid to facilitate passage out of the cells. C. alters urinary pH to enhance renal excretion. D. accelerates its passage through the intestine.
B. raises the pH of the interstitial fluid to facilitate passage out of the cells.
The nurse is caring for a patient who is receiving vancomycin [Vancocin]. The nurse notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The patient's heart rate is 120 beats/min, and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with: A. allergic reaction B. red man syndrome C. rhabdomyolysis D. Stevens-Johnson syndrome
B. red man syndrome
Benign prostatic hypertrophy (BPH) symptoms may be treated with an adrenergic antagonist such as tamsulosin (Flomax) because: A. affected patients generally have hypertension also. B. these agents block alpha1 receptors to reduce contraction of smooth muscle in the bladder neck and prostatic capsule. C. these agents can cause permanent shrinkage of the prostate gland. D. these agents can increase bladder capacity and thus decrease the sensation of needing to void.
B. these agents block alpha1 receptors to reduce contraction of smooth muscle in the bladder neck and prostatic capsule.
A client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition? A. intestinal obstruction B. vomiting following cancer chemotherapy C. diverticulitis with perforation D. peptic ulcer with melena
B. vomiting following cancer chemotherapy
The nurse is administering morning medications. The nurse gives a patient multiple medications, two of which compete for plasma albumin receptor sites. As a result of this concurrent administration, the nurse can anticipate that what might occur? (Select all that apply.) A. Plasma levels of free drug will fall. B. The increase in bound drug will intensify effects. C. The increase in free drug will intensify effects. D. Plasma levels of free drug will rise. E. Binding of one or both agents will be reduced.
C, D, E
Two nurses are discussing theories of drug-receptor interaction. Which statements are true regarding the affinity of a drug and its receptor? (Select all that apply.) A. Drugs with low affinity are strongly attracted to their receptors. B. Affinity and intrinsic activity are dependent properties. C. Drugs with high affinity are strongly attracted to their receptors. D. Affinity refers to the strength of the attraction between a drug and its receptor. E. The affinity of a drug for its receptors is reflected in its potency.
C, D, E
What are the results of using glucocorticoid drugs to treat asthma? (Select all that apply.) A. Increased synthesis of inflammatory mediators B. Reduced number of bronchial beta2 receptors C. Increased responsiveness to beta2-adrenergic agonists D. Reduced bronchial hyperreactivity E. Reduced edema of the airway
C, D, E
Which drugs are used to treat COPD? (Select all that apply.) A. Monoclonal antibodies B. Leukotriene modifiers C. Glucocorticoids D. Anticholinergic medications E. Long-acting beta2 agonists
C, D, E
A patient asks how to apply transdermal nitroglycerin. What is the nurse's best response? A. "Always apply the transdermal patch over the area of your chest where your heart is." B. "Keep the previous patch on for 1 full day so you always have two patches on at a time." C. "Apply the patch to hairless areas of the body." D. "First apply Vaseline to your body; then apply the transdermal patch."
C. "Apply the patch to hairless areas of the body."
A 7-year-old child with asthma uses a daily inhaled glucocorticoid and an albuterol MDI as needed. The provider has added montelukast [Singulair] to the child's regimen. Which statement by the child's parent indicates understanding of this medication? A. "I will give my child one 4-mg chewable tablet daily." B. "This drug can alleviate symptoms during an acute attack." C. "I may notice mood changes in my child." D. "I should give this medication twice daily."
C. "I may notice mood changes in my child."
The nurse is teaching a client about thyroid replacement therapy. Which statement by the client indicates a need for further teaching? Select one: A. "I will take the medication every morning." B. "I will have more energy with this medication." C. "If I continue to lose weight, I may need an increased dose." D. "If I gain weight and feel tired, I may need an increased dose."
C. "If I continue to lose weight, I may need an increased dose."
The nurse teaches a patient diagnosed with chronic stable angina about the mechanism of action of nitroglycerin. The nurse should include which instruction? A. "Nitroglycerin reduces vasospasms of the heart's arteries, which improves blood supply." B. "Nitroglycerin opens the arteries to allow more oxygen to be delivered to the heart muscle." C. "Nitroglycerin dilates veins, which decreases the amount of oxygen needed by the heart." D. "Nitroglycerin improves blood flow to the heart muscle by increasing blood pressure."
C. "Nitroglycerin dilates veins, which decreases the amount of oxygen needed by the heart."
A child with otitis media has had three ear infections in the past year. The child has just completed a 10-day course of amoxicillin [Amoxil] with no improvement. The parent asks the nurse why this drug is not working, because it has worked in the past. What will the nurse tell the patient? A. "The bacteria have developed penicillin-binding proteins (PBPs) that have a low affinity for penicillins." B. "The bacteria have developed a three-layer cell envelope." C. "The bacteria have synthesized penicillinase." D. "Amoxicillin is too narrow in spectrum."
C. "The bacteria have synthesized penicillinase."
A nursing professor is teaching a class about a medication that alters the parasympathetic nervous system functions. To evaluate understanding, the nurse asks the students to describe which functions the parasympathetic nervous system regulates. Which of the following statements represent functions that are primarily regulated by the parasympathetic nervous system: A. "The cardiovascular system" B. "The fight-or-flight response" C. "The digestive functions of the body" D. "Body temperature"
C. "The digestive functions of the body"
A nurse instructs a parent about the administration schedule for Adderall XR (amphetamine/dextroamphetamine mixture) to treat the child's ADHD. The nurse determines that teaching is successful if the parent makes which statement? A. "The best time to give the medication is at bedtime." B. "I will ask the school nurse to administer the drug at lunchtime." C. "The drug should be given in the morning, before school." D. "The medicine should be taken 1 hour before a meal."
C. "The drug should be given in the morning, before school."
The nurse is overseeing a nursing student who is administering medications to a group of clients receiving treatment for pulmonary embolism. The nurse recognizes the student understands safety and administration of anticoagulant therapy when the student makes which of these statements? A. "The client will receive a dose of enoxaparin (Lovenox) intramuscularly for 3 days." B. "If bleeding develops, we will give platelets to reverse the anticoagulant." C. "Therapy with warfarin (Coumadin) is effective when the INR is between 2 and 3." D. "Once the health care provider orders warfarin (Coumadin), the intravenous heparin can be discontinued."
C. "Therapy with warfarin (Coumadin) is effective when the INR is between 2 and 3."
A patient with a new prescription for a HMG-CoA (statin) drug is instructed to take the medication with the evening meal or at bedtime. The patient asks why it must be taken at this time of day. What is the nurses' best response? A. "The medication is better absorbed at this time." B. "There will be fewer adverse effects if taken at night instead of with the morning meal." C. "This timeframe correlates better with the natural diurnal rhythm of cholesterol production." D. "This timing reduces the incidence of myopathy."
C. "This timeframe correlates better with the natural diurnal rhythm of cholesterol production."
A patient who has gastroesophageal reflux disease (GERD) receives a prescription for a proton pump inhibitor (PPI) medication. What will the nurse include when teaching the patient about this drug? A. "The FDA has determined that there is a gastric cancer risk with this drug." B. "This drug will be given on a short-term basis only." C. "You should report any fever and cough to your provider." D. "You may experience hypermagnesemia when taking this drug."
C. "You should report any fever and cough to your provider."
A client is taking methimazole (Tapazole) for hyperthyroidism and would like to know how soon this medication will begin working. What is the nurse's best response? A. "You will see effects of this medication immediately." B. "You will see effects of this medication within 1 week." C. "You will see some effects of this medication within 2 weeks." D. "You will see full effects from this medication within 1 to 2 days."
C. "You will see some effects of this medication within 2 weeks."
A patient with gout who has increasingly frequent acute gouty attacks will begin receiving allopurinol [Zyloprim] and colchicine. The nurse will include which statement when teaching the patient about this drug regimen? A. "Allopurinol helps reduce the gastrointestinal side effects of colchicine." B. "The colchicine is given to enhance the effects of the allopurinol." C. "You will take both drugs initially and then stop taking the colchicine." D. "Allopurinol reduces the likelihood of gouty episodes that usually occur with initial colchicine therapy."
C. "You will take both drugs initially and then stop taking the colchicine."
A client with diabetic neuropathy reports a burning, electrical-type in the lower extremities that is not responding to NSAIDs. You anticipate that the physician will order which adjuvant medication for this type of pain? A. Methylphenidate (Ritalin) B. Lorazepam (Ativan) C. Amitriptyline (Elavil) D. Corticosteroids
C. Amitriptyline (Elavil)
During administration of alteplase [Activase], the patient's IV site starts to ooze blood around the catheter. Which action by the nurse is most appropriate? A. Discontinue the infusion of alteplase. B. Assess the patient's vital signs. C. Apply direct pressure over the puncture site. D. Administer aminocaproic acid (Amicar)
C. Apply direct pressure over the puncture site.
A patient has been receiving an antibiotic with a small therapeutic index for 10 days. Upon assessment, the nurse notes an increase in the drug's side effects. What would be the nurse's priority action? A. Call the prescriber and have the antibiotic changed. B. Suspect an allergic reaction and administer a PRN antihistamine. C. Ask the prescriber to order a plasma drug level test. D. Set up oxygen and obtain an order for an antagonist.
C. Ask the prescriber to order a plasma drug level test.
When metronidazole [Flagyl] is a component of the H.pylori treatment regimen, the patient must be instructed to do what? A. Take the drug on an empty stomach. B. Avoid foods containing tyramine. C. Avoid any alcoholic beverages D. Take the drug with food
C. Avoid any alcoholic beverages
Place the examples of drugs in the order of usage according to the World Health Organization (WHO) analgesic ladder. a. Morphine, hydromorphone, acetaminophen and lorazepam b. NSAIDs and corticosteroids c. Codeine, oxycodone and diphenhydramine A. A, B, C B. B, A, C C. B, C, A D. C, A, B
C. B, C, A
The nurse identifies which of the following as the most common type of laxative abused by the general public? A. Magnesium hydroxide [Milk of Magnesia] B. Docusate sodium [Colace] C. Bisacodyl [Dulcolax] D. Polyethylene glycol [MiraLax]
C. Bisacodyl [Dulcolax]
A patient with no known drug allergies is receiving amoxicillin [Amoxil] PO twice daily. Twenty minutes after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is 100/58 mm Hg. What will the nurse do? A. Request an order for a skin test to evaluate possible PCN allergy. B. Withhold the next dose until symptoms subside. C. Contact the provider and prepare to administer epinephrine. D. Notify the provider if the patient develops a rash.
C. Contact the provider and prepare to administer epinephrine.
A patient admitted to the hospital has a history of peptic ulcer disease. The patient takes ranitidine [Zantac] and sucralfate [Carafate]. The patient tells the nurse that discomfort is usually controlled but that symptoms occasionally flare up. What will the nurse do? A. Contact the provider to discuss switching to a proton pump inhibitor. B. Contact the provider to discuss serologic testing and an antibiotic. C. Counsel the patient on non-drug intervention such as avoiding beverages containing alcohol D. Ask the provider about ordering an endoscopic examination.
C. Counsel the patient on non-drug intervention such as avoiding beverages containing alcohol
A patient who has been newly diagnosed with asthma is referred to an asthma clinic. The patient reports daily symptoms requiring short-acting beta2-agonist treatments for relief. The patient has used oral glucocorticoids three times in the past 3 months and reports awakening at night with symptoms about once a week. The nurse will expect this patient to be started on which regimen? A. Continue current medication regimen as is B. No daily medications; just a SABA as needed C. Daily low-dose inhaled glucocorticoid/LABA with a SABA as needed
C. Daily low-dose inhaled glucocorticoid/LABA with a SABA as needed
Which statement is INCORRECT about Histamine-receptor blockers? A. "Antacids and H2 blockers should not be given together." B. H2 Blockers absorption is slowed if taken with meals C. H2 blockers decrease gastric pH D. "Ranitidine and Famotidine are two types of histamine-receptor blocker medications."
C. H2 blockers decrease gastric pH
A patient is receiving instructions regarding the use of caffeine for migraine headaches. The nurse shares that caffeine should be used with caution if which of these conditions is present? A. Tension headache B. History of kidney stones C. History of peptic ulcers D. Asthma
C. History of peptic ulcers
Which of the following is NOT a serious adverse effect of long-term oral glucocorticoid therapy? A. Adrenal suppression B. Osteoporosis C. Hypoglycemia D. Peptic ulcer disease
C. Hypoglycemia
A patient with a known history of angina was walking his dog and developed chest pain. The patient immediately stops walking and sits down. He continues to experience chest pain when sitting down. When should he call 911? A. Immediately B. If the pain becomes more severe C. If one sublingual tablet does not relieve the pain after 5 minutes D. If the pain is not relieved after three sublingual tablets, taken 5 minutes apart
C. If one sublingual tablet does not relieve the pain after 5 minutes
A patient with persistent, frequent asthma exacerbations asks a nurse about a long-acting beta2-agonist medication. What will the nurse tell this patient? A. LABAs are safer than short-acting beta2 agonists. B. LABAs can be used on an as-needed basis to treat symptoms. C. LABAs should be combined with an inhaled glucocorticoid. D. LABAs reduce the risk of asthma-related deaths.
C. LABAs should be combined with an inhaled glucocorticoid.
An older adult patient with severe gastroesophageal reflux disease (GERD) has had only minimal relief using a histamine2-receptor antagonist (H2RA). The patient is to begin taking omeprazole [Prilosec]. What will the nurse teach this patient? A. The medication will be used until surgery can be performed. B. A complete cure is expected with this medication. C. Long-term therapy may be needed. D. Lifestyle changes can be as effective as medication therapy.
C. Long-term therapy may be needed.
A client with gastrointestinal hypermotility has a prescription to receive atropine sulfate. The nurse should withhold the medication and question the prescription if the client has a history of which disease process? A. Peptic ulcer disease B. Biliary colic C. Narrow-angle glaucoma D. Sinus bradycardia
C. Narrow-angle glaucoma
A patient with systemic lupus erythematosus is prescribed prednisone. It is most important for the nurse to monitor the patient for what? A. Hypotension B. Elevated potassium levels C. Neck and back pain D. Hypoglycemia
C. Neck and back pain
The nurse is caring for a patient on a medical-surgical unit who has a fever of unknown origin. The prescriber has ordered a broad-spectrum antibiotic. Which intervention is the priority? A. Delaying administration of the antibiotic until the culture results are available B. Administering the antibiotic immediately C. Obtaining all cultures before the antibiotic is administered (not the results of the cultures) D. Administering antipyretics as soon as possible
C. Obtaining all cultures before the antibiotic is administered (not the results of the cultures)
Which patient does the nurse identify as most likely needing an increased dose of warfarin [Coumadin] to have the same anticoagulant effect? A. Patient taking acetaminophen [Tylenol] for back pain B. Patient taking cimetidine [Tagamet] to prevent gastric ulcers C. Patient taking oral contraceptives to prevent pregnancy D. Patient taking prednisone [Deltasone] for rheumatoid arthritis
C. Patient taking oral contraceptives to prevent pregnancy
A nurse administers the same medication in the same preparation in the same dose to several patients and notes that some patients have a better response to the drug than others. What is the most likely explanation for this phenomenon? A. Altered bioavailability of the drug B. Patient compliance with the therapeutic regimen C. Pharmacogenomic differences among individuals D. Placebo effects enhancing expectations of drug efficacy
C. Pharmacogenomic differences among individuals
A nurse is caring for a patient who takes an ACE inhibitor and an ARB medication who will begin taking TMP/SMZ to treat a urinary tract infection. Which serum electrolyte will the nurse expect to monitor closely? A. Calcium B. Sodium C. Potassium D. Magnesium
C. Potassium
A 17 year-old high school athlete with a history of asthma comes to your clinic seeking a preventative medication for migraine headaches. Which of the following would be contraindicated? A. Valproate (valproic acid) B. Topiramate (Topamax) C. Propranolol (Inderal) D. Amitriptyline (Axert)
C. Propranolol (Inderal)
Intravenous heparin therapy is prescribed for a client. While implementing this prescription, the nurse ensures that which medication is available on the nursing unit? A. Aminocaproic acid B. Vitamin K C. Protamine sulfate D. Potassium chloride
C. Protamine sulfate
The nurse is preparing to care for a patient who will be taking an antihypertensive medication. Which action by the nurse is part of the assessment step of the nursing process? A. Asking the prescriber for an order to monitor serum drug levels B. Monitoring the patient for drug interactions after giving the medication C. Questioning the patient about over-the-counter medications D. Taking the patient's blood pressure throughout the course of treatment
C. Questioning the patient about over-the-counter medications
Jane is a 67 year-old woman with a history of mild hypertension and classic angina pectoris. She is seeking treatment for migraine headaches of moderate intensity. Her headaches are preceeded by bilateral light flashes and dizziness that last about 10 minutes prior to the onset of pain. Her headaches are also frequently accompanied by photophobia, severe nausea and occasional vomiting. What medication would be contraindicated for acute treatment of Jane's headaches? A. Propranolol B. Caffeine C. Sumatriptan D. Aspirin E. Acetaminophen
C. Sumatriptan
A 23 year old woman with a history of depression comes to your clinic seeking relief for a severe migraine headache that began 20 minutes ago. She is currently taking the SSRI (selective serotonin repute inhibitor) Citalopram for her depression and an estrogen/progesterone combined oral contraceptive. What medication would you avoid using for her acute treatment? A. Ergotamine (Ergomar) B. Topiramate (Topamax) C. Sumatriptan (Imitrex) D. Morphine
C. Sumatriptan (Imitrex)
A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet of Brand Y of the same drug. Both brands contain the same amount of the active ingredient. What does the nurse know to be most likely? A. Advertising by pharmaceutical companies can enhance patient expectations of one brand over another, leading to a placebo effect. B. Because the drug preparations are chemically equivalent, the effects of the two brands must be identical. C. Tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug's effects in the body. D. The bioavailability of a drug is determined by the amount of the drug in each dose.
C. Tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug's effects in the body.
A patient will begin taking hydroxychloroquine [Plaquenil] for rheumatoid arthritis. The patient is currently taking high-dose NSAIDs and methotrexate. What will the nurse teach the patient? A. To obtain tests of renal and hepatic function while taking this drug B. To stop taking methotrexate when starting hydroxychloroquine C. That an eye exam is necessary at the beginning of therapy with this drug D. That the dose of NSAIDs may be decreased when beginning hydroxychloroquine
C. That an eye exam is necessary at the beginning of therapy with this drug
A patient has been ordered the powdered form of the bile acid sequestrant colestipol. Which of the following does the nurse identify as true? A. The nurse should have the patient swallow the dose of the colestipol powder one teaspoonful at a time. B. The powder should be dissolved and immediately administered. C. The colestipol should be administered 1 hour before or 4 to 6 hours after any other oral medication. D. The colestipol should be administered with meals.
C. The colestipol should be administered 1 hour before or 4 to 6 hours after any other oral medication.
During therapy with a beta blocker, the patient notices that she has swollen feet, has gained 3 pounds within 2 days, feels short of breath even when walking around the house, and has been dizzy. The nurse suspects that which of these is occurring? A. The patient is experiencing expected adverse effects of the drug. B. More time is needed for the patient to see a therapeutic response to the drug. C. The patient may be developing heart failure D. The patient is experiencing an allergic reaction
C. The patient may be developing heart failure
A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels. The dosing is correct, and this medication has been tolerated by this patient in the past. Which could be a probable cause of the test result? A. The medication is being given at a frequency that is longer than its half-life. B. The drug was not completely dissolved in the IV solution. C. The patient is taking another medication that binds to serum albumin. D. A loading dose was not given.
C. The patient was taking another medication that binds to serum albumin.
A nursing student is preparing to give a medication that has a "High Alert" or "Black Boxed Warning". The student asks the nurse what this means. What will the nurse explain about boxed warnings? A. They provide information about antidotes in the event that toxicity occurs. B. They provide detailed information about the adverse effects of the drug. C. They alert prescribers to measures to mitigate potential harm from side effects. D. They indicate that a drug should not be given except in life-threatening circumstances.
C. They alert prescribers to measures to mitigate potential harm from side effects.
The nurse is caring for a client with a diagnosis of gout. Which laboratory value would the nurse expect to note in the client? A. Potassium level of 4.1 mEq/L B. Phosphorus level of 3.1 mg/dL C. Uric acid level of 9.0 mg/dL D. Calcium level of 9.0 mg/dL
C. Uric acid level of 9.0 mg/dL
Which information should the nurse include when teaching a patient about inhaled glucocorticoids? A. Inhaled glucocorticoids have many significant adverse effects. B. The principal side effects of inhaled glucocorticoids include hypertension and weight gain. C. Use of a spacer can minimize side effects. D. Patients should rinse the mouth and gargle before administering inhaled glucocorticoids.
C. Use of a spacer can minimize side effects.
A patient with asthma is prescribed albuterol [Proventil], 2 puffs 3 times a day. The nurse should teach the patient to do what? A. Rinse the mouth after taking the prescribed dose. B. Take an extra dose if breathing is compromised. C. Wait 1 minute between puffs from the inhaler. D. Take adequate amounts of calcium and vitamin D.
C. Wait 1 minute between puffs from the inhaler.
A patient tells the nurse that the oral drug that has been prescribed has caused a lot of stomach discomfort in the past. What will the nurse ask the prescriber? A. Whether a sublingual form of the medication can be given B. Whether the medication can be given by a parenteral route instead C. Whether an enteric-coated form of the drug is available D. Whether the patient can receive a sustained-release preparation of the drug
C. Whether an enteric-coated form of the drug is available
A child with an ear infection is not responding to treatment with amoxicillin [Amoxil]. The nurse will expect the provider to order: A. penicillin G B. nafcillin C. amoxicillin-clavulanic acid (Augmentin) D. ampicillin
C. amoxicillin-clavulanic acid (Augmentin)
A client is being tapered off opioids and the nurse is watchful for signs of withdrawal. What is one of the first signs of withdrawal? A. fever B. abdominal cramps C. diaphoresis D. nausea
C. diaphoresis
An adrenergic agonist is ordered for a patient in cardiogenic shock. The nurse will note that this drug has had its primary intended effect if which expected outcome occurs? A. reduced anxiety B. decreased urine output C. increased cardiac output D. volume restoration
C. increased cardiac output
A patient asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient's: A. drug receptor sites. B. hypersensitivity potential. C. metabolism of drugs D. psychosocial response
C. metabolism of drugs
A patient with chronic pain has been receiving morphine sulfate but now has decreased pain. The prescriber changes the medication to ketolorac [Toradol]. The nurse will monitor the patient for: A. respiratory depression B. euphoria C. nausea and sweating D. hypotension
C. nausea and sweating
What is the antidote for heparin? A. ferrous sulfate B. atropine sulfate C. protamine sulfate D. magnesium sulfate
C. protamine sulfate
Your patient is taking levodopa (Dopar), and you have been conducting an analysis of the patient's diet. You find that she eats three times the recommended amount of protein at each meal. Your best response to this is to tell her: A. that protein in her diet will benefit the transport of levodopa throughout her body. B. that she is likely to damage her kidneys if she maintains this diet plan. C. that too much dietary protein could make the levodopa less effective. D. that her protein intake is good, as protein increases the effect of levodopa.
C. that too much dietary protein could make the levodopa less effective.
A client is taking large doses of acetylsalicylic acid (ASA) for rheumatoid arthritis. Which assessment findings indicate that the client is experiencing ototoxicity as a result of the medication? A. GI upset and dizziness B. dizziness, sore throat, purpura C. tinnitus, hearing loss, ataxia D. GI bleeding, ecchymosis, dizziness
C. tinnitus, hearing loss, ataxia
Which statement(s) about the neurotransmitter acetylcholine is true? A. "Cholinesterase inhibitors will decrease levels of acetylcholine." B. "Acetylcholine effects are restricted to the parasympathetic nervous system." C. "Acetylcholine is a catecholamine." D. "Acetylcholine activates three cholinergic receptor subtypes."
D. "Acetylcholine activates three cholinergic receptor subtypes."
A client with hypertension is started on verapamil (Calan), a calcium channel blocker. What teaching does the nurse provide for this client? A. "Consume foods high in potassium." B. "Monitor for muscle cramping." C. "Monitor for irregular pulse." D. "Avoid grapefruit juice."
D. "Avoid grapefruit juice".
A nurse is teaching a nursing student what is meant by "generations" of cephalosporins. Which statement by the student indicates understanding of the teaching? A. "First-generation cephalosporins have better penetration of the cerebrospinal fluid." B. "Later generations of cephalosporins have lower resistance to destruction by beta-lactamases." C. "Cephalosporins are assigned to generations based on their relative costs to administer." D. "Cephalosporins have increased activity against gram-negative bacteria with each generation."
D. "Cephalosporins have increased activity against gram-negative bacteria with each generation."
A patient with chronic congestive heart failure has repeated hospitalizations in spite of ongoing treatment with hydrochlorothiazide [HydroDIURIL] (diuretic). The prescriber has ordered spironolactone [Aldactone] (diuretic) to be added to this patient's drug regimen, and the nurse provides education about this medication. Which statement by the patient is correct? A. "I can expect improvement within a few hours after taking this drug." B. "I should watch closely for dehydration." C. "I should use salt substitutes to prevent toxic side effects." D. "I need to stop taking potassium supplements."
D. "I need to stop taking potassium supplements."
A nurse teaches a patient with diabetes mellitus about sick-day management. Which statement would the nurse include in this patient's teaching? A. "Try to continue your prescribed exercise regimen even if you are sick." B. "If vomiting, do not use insulin or take your oral antidiabetic agent." C. "When ill, avoid eating or drinking to reduce vomiting and diarrhea." D. "Monitor your blood glucose levels at least every 4 hours while sick."
D. "Monitor your blood glucose levels at least every 4 hours while sick."
A patient is prescribed sustained-release oral nitroglycerin capsules for chronic stable angina. The nurse should include which instruction? A. "Avoid exercising to help prevent chest pain." B. "Place the capsule under the tongue if chest pain occurs." C. "Take the capsule as needed before exercise or exertion." D. "Sit or lie down if dizziness or lightheadedness occurs."
D. "Sit or lie down if dizziness or lightheadedness occurs."
A client with type 2 diabetes controlled with Metformin is recovering from surgery. The primary health care provider has placed the client on insulin in addition to the metformin. What is the nurse's best response about why the client needs to take insulin? A. "You can't take your metformin while in the hospital." B. "You must take insulin from now on because the surgery will affect your diabetes." C. "Your diabetes is getting worse, so you will need to take insulin." D. "Stress, such as surgery, increases blood glucose levels. You'll need insulin to control your blood glucose temporarily."
D. "Stress, such as surgery, increases blood glucose levels. You'll need insulin to control your blood glucose temporarily."
The nurse is providing education to a patient who has been prescribed both an antacid and a cimetidine [Tagamet]. Which instruction should the nurse give the patient about taking the medications? A. "Take the antacid 15 minutes before the ranitidine." B. "The antacid and ranitidine should be taken at the same time for better effect." C. "Take the antacid 30 minutes after the ranitidine." D. "Take the antacid 1 hour after the ranitidine."
D. "Take the antacid 1 hour after the ranitidine."
A patient with stable COPD receives prescriptions for an inhaled glucocorticoid and an inhaled short acting beta2-adrenergic agonist. Which statement by the patient indicates understanding of this medication regimen? A. "The beta2-adrenergic agonist suppresses the synthesis of inflammatory mediators." B. "I will need to use the beta2-adrenergic agonist drug daily." C. "I should use the glucocorticoid as needed when symptoms flare." D. "The glucocorticoid is used as prophylaxis to prevent exacerbations."
D. "The glucocorticoid is used as prophylaxis to prevent exacerbations."
The nurse is overseeing a nursing student who is administering medications to a group of clients receiving treatment for pulmonary embolism. The nurse recognizes the student understands safety and administration of anticoagulant therapy when the student makes which of these statements? A. "Once the health care provider orders warfarin (Coumadin), the intravenous heparin can be discontinued." B. "If bleeding develops, we will give platelets to reverse the anticoagulant." C. "The client will receive a dose of enoxaparin (Lovenox) intramuscularly for 3 days." D. "Therapy with warfarin (Coumadin) is effective when the INR is between 2 and 3."
D. "Therapy with warfarin (Coumadin) is effective when the INR is between 2 and 3."
A nursing student asks the nurse why the provider has ordered a combination product containing an opioid analgesic and an NSAID for a patient who has cancer. Which response by the nurse is correct? A. "There is a decreased likelihood of opioid dependence when it is given in combination with an NSAID." B. "There are decreased effects of NSAIDs on the GI tract when a combination product is used." C. "There are fewer adverse effects from both drugs when used in a combination product." D. "There is increased pain relief with the combination than when either product is used alone."
D. "There is increased pain relief with the combination than when either product is used alone."
A client with type 1 diabetes mellitus received regular insulin at 7:00 a.m. The client will need to be monitored for hypoglycemia at which time? A. 0730 B. 1400 C. 1930 D. 1100
D. 1100
A nurse cares for a patient who has diabetes mellitus. The nurse administers 6 units of regular insulin and 10 units of NPH insulin at 07:00. At which time would the nurse assess the patient for potential problems related to the NPH insulin? A. 2300 B. 0800 C. 2000 D. 1600
D. 1600
An older adult patient who has cancer and Alzheimer's disease is crying but shakes his or her head "no" when asked about pain. The prescriber has ordered morphine sulfate 2 to 4 mg IV every 2 hours PRN pain. It has been 4 hours since a dose has been given. What will the nurse do? A. Give 2 mg of morphine for pain to avoid increasing this patient's level of confusion. B. Withhold any analgesic at this time and reassess the patient in 30 to 60 minutes. C. Request an order for a nonopioid analgesic or an antidepressant adjuvant analgesic. D. Administer 4 mg of morphine and monitor this patient's verbal and nonverbal responses.
D. Administer 4 mg of morphine and monitor this patient's verbal and nonverbal responses.
A diabetic patient has the following presentation: unresponsive to voice or touch, tachycardia, diaphoresis, and pallor. Which of the following actions by the healthcare provider is the priority? A. Send blood to the laboratory for analysis B. Administer oxygen per nasal cannula C. Administer the prescribed insulin D. Administer 50% dextrose IV per hypoglycemia protocol
D. Administer 50% dextrose IV per hypoglycemia protocol
Which drug does the nurse associate with the development of potentially life-threatening skin adverse effects of exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis? A. Probenecid B. Colchicine C. Febuxostat (Uloric) D. Allopurinol (Zyloprim)
D. Allopurinol (Zyloprim)
A patient has a long history of hypertension. Which category of medications would the nurse expect to be ordered to avoid chronic kidney disease (CKD)? A. Histamine blocker B. Bronchodilator C. Antibiotic D. Angiotensin-converting enzyme (ACE) inhibitor
D. Angiotensin-converting enzyme (ACE) inhibitor
What is the best way to schedule medication for a client with constant pain? A. PRN at client's request B. IV bolus after pain assessment C. Prior to painful procedures D. Around-the-clock
D. Around-the-clock
A nurse administers medications to a patient who has asthma. Which medication classification is paired correctly with its physiologic response to the medication? A. Corticosteroid (Glucocorticoid)—relaxes bronchiolar smooth muscles by binding to and activating pulmonary beta2 receptors B. Bronchodilator—stabilizes the membranes of mast cells and prevents the release of inflammatory mediators C. Cromolyn—disrupts the production of pathways of inflammatory mediators D. Cholinergic antagonist—causes bronchodilation by inhibiting the parasympathetic nervous system
D. Cholinergic antagonist—causes bronchodilation by inhibiting the parasympathetic nervous system
DA client with a clot in the right atrium is receiving a heparin sodium infusion at 1000 units/hour and warfarin sodium 7.5 mg at 5:00 p.m. daily. The morning laboratory results are as follows: activated partial thromboplastin time (aPTT), 32 seconds; international normalized ratio (INR), 1.3. The nurse should take which action based on the client's laboratory results? A. Collaborate with the health care provider (HCP) to discontinue the heparin infusion and administer the warfarin sodium as prescribed. B. Collaborate with the HCP to withhold the warfarin sodium since the client is receiving a heparin infusion and the aPTT is within the therapeutic range. C. Collaborate with the HCP to continue the heparin infusion at the same rate and to discuss use of dabigatran (Pradaxa) in place of warfarin sodium. D. Collaborate with the HCP to obtain a prescription to increase the heparin infusion and administer the warfarin sodium as prescribed.
D. Collaborate with the HCP to obtain a prescription to increase the heparin infusion and administer the warfarin sodium as prescribed.
A patient who has pancreatitis reports a pain level of 8 on a 1 to 10 pain scale with 10 being the most severe pain. The patient has an order for acetaminophen (Tylenol) as needed for pain, and has been taking it as ordered around the clock. Which action by the nurse is correct? A. Administer an additional dose of the acetaminophen (Tylenol) as ordered. B. Explain to the patient the importance not exceeding 4000mg of acetaminophen daily C. Contact the provider to discuss nonpharmacologic pain measures D. Contact the prescriber and request the addition of an opioid
D. Contact the prescriber and request the addition of an opioid
A patient has received an IV dose of adenosine, and almost immediately the heart monitor shows asystole. What should the nurse do next? A. Check the patient's pulse B. Prepare to administer CPR C. Set up for defibrillation D. Continue to monitor the patient.
D. Continue to monitor the patient.
An unresponsive patient who has diabetes is brought to the emergency department with slow, deep respirations. Additional findings include: blood glucose 450 mg/dL (24.9 mmol/L), arterial pH 7.2 (acidosis), and urinalysis showing presence of ketones and glucose. Which of the following best describes the underlying cause of this patient's presentation? A. Respiratory acidosis B. Hyperosmolar Hyperglycemic Syndrome (HHS) C. Hypoglycemia D. Diabetic Ketoacidosis (DKA)
D. Diabetic Ketoacidosis (DKA)
A patient is prescribed bisacodyl. Which of the following should the nurse include in patient teaching? A. Your urine will turn yellow-brown when taking this medication. B. Crush the bisacodyl tablet and sprinkle it on your food. C. Chew the bisacodyl tablet. D. Do not take the bisacodyl with an antacid.
D. Do not take the bisacodyl with an antacid.
In caring for a young child with pain, which assessment tool is the most useful? A. 0-10 numeric pain scale B. McGill-Melzack pain questionnaire C. Simple description pain intensity scale D. Faces pain-rating scale
D. Faces pain-rating scale
A patient with hyperthyroidism is taking propylthiouracil (PTU). It is most important for the nurse to assess the patient for which adverse effects? A. Gingival hyperplasia and dysphagia B. Dyspnea and a dry cough C. Blurred vision and nystagmus D. Fever and sore throat
D. Fever and sore throat
The prescriber's order says to administered the diuretic Lasix 40 mg IV twice a day. The patient has bilateral lower extremity edema and complains of leg pain. The patient has the following morning labs: Na+ 148, K+ 2.9, and BUN 10. Which of the following is a nursing priority? A. Administer Lasix as ordered B. Assess the patient's lung sounds C. Notify the provider of the Na+ level D. Hold the Lasix dose and notify the prescriber of the potassium level.
D. Hold the Lasix dose and notify the prescriber of the potassium level.
When considering replacement therapy options for a patient who has Adrenocortical insufficiency, the nurse should recognize that the provider will choose which of the following drugs? A. Somatotropin B. Glucagon C. Desmopressin D. Hydrocortisone
D. Hydrocortisone
A patient with extremely high blood pressure (BP) is in the emergency department. The physician will order therapy with nitroglycerin to manage the patient's BP. Which form of nitroglycerin is most appropriate? A. Sublingual spray B. Transdermal patch C. Oral capsule D. IV infusion
D. IV infusion
A nurse assesses a patient with diabetes mellitus who self-administers subcutaneous insulin. The nurse notes a spongy, swelling area at the site the patient uses most frequently for insulin injection. What action would the nurse take? A. Apply ice to the site to reduce inflammation. B. Assess the patient for other signs of cellulitis. C. Consult the provider for a new administration route. D. Instruct the patient to rotate sites for insulin injection.
D. Instruct the patient to rotate sites for insulin injection.
Which route of administration is preferred if immediate analgesia and rapid titration are necessary? A. Sublingual B. Intramuscular C. Intraspinal D. Intravenous
D. Intravenous
A patient has an infection caused by Pseudomonas aeruginosa.The prescriber has ordered piperacillin and amikacin, both to be given intravenously. What will the nurse do? A. Suggest that a fixed-dose combination of piperacillin and tazobactam [Zosyn] be used B. Watch the patient closely for allergic reactions, because this risk is increased with this combination C. Suggest giving larger doses of piperacillin and discontinuing the amikacin. D. Make sure to administer the drugs at different times using different IV tubing.
D. Make sure to administer the drugs at different times using different IV tubing.
A patient with acute gouty arthritis requests information on the preferred drug to take to treat a painful flare-up. The nurse should recommend which medication? A. Allopurinol B. Febuxostat C. Probenecid D. Naproxen
D. Naproxen
A nurse administers quinidine sulfate to a patient with atrial fibrillation. The nurse should assess the electrocardiogram (ECG) tracing knowing that quinidine sulfate has what effect on the ECG? A. Narrowing of the QRS complex B. Tall, peaked T waves C. Prolongation of the PR interval D. Prolongation of the QT interval
D. Prolongation of the QT interval
A child is receiving a combination albuterol/ipratropium [DuoNeb] inhalation treatment. The patient complains of a dry mouth and sore throat. What will the nurse do? A. Contact the provider to report systemic anticholinergic side effects. B. Discontinue the aerosol treatment immediately. C. Notify the provider of a possible allergic reaction. D. Reassure the patient that these are expected side effects.
D. Reassure the patient that these are expected side effects.
A patient wants to take garlic tablets to improve his cholesterol levels. Which condition would be a contraindication? A. HTN B. Bowel obstruction C. Sinus infection D. Scheduled surgery
D. Scheduled surgery
A patient who has been taking a long-acting morphine to treat severe pain for a few months complains of constipation. The nurse anticipates which of the following will be prescribed for the patient? A. Polycarbophil [FiberCon] B. Mineral oil C. Psyllium [Metamucil] D. Senna [Senokot]
D. Senna [Senokot]
Which medication should be used for asthma patients as part of step 1 management? A. Combination inhaled glucocorticoids/long-acting beta2 agonists B. Long-acting beta2 agonists C. Inhaled low-dose glucocorticoids D. Short-acting beta2 agonists
D. Short-acting beta2 agonists
Which statement about food and drug interactions is true? A. Medications are best absorbed on an empty stomach. B. Foods alter drug absorption and metabolism but not drug action. C. Patient discomfort is the food and drug interaction of most concern. D. Some foods, such as grapefruit, can inhibit CYP isoenzymes and alter drug metabolism.
D. Some foods, such as grapefruit, can inhibit CYP isoenzymes and alter drug metabolism.
A patient will be taking niacin as part of antilipemic therapy. What is the best way to avoid problems with flushing or pruritus? A. Take the medication at bedtime. B. Take the medication with a small dose of a steroid. C. Take the medication with a full glass of water on an empty stomach. D. Start with a low initial dose and then increase it gradually.
D. Start with a low initial dose and then increase it gradually.
Which medication is used to promote gastric ulcer healing by providing a protective barrier? A. Cimetidine B. Misoprostol C. Omeprazole D. Sucralfate
D. Sucralfate
A patient is using a metered-dose inhaler containing albuterol for asthma. The medication label instructs the patient to administer "2 puffs every 4 hours as needed for coughing or wheezing." The patient reports feeling jittery sometimes when taking the medication, and he or she doesn't feel that the medication is always effective. Which action is outside the nurse's scope of practice? A. Asking the patient to demonstrate the use of the inhaler B. Assessing the patient's exposure to tobacco smoke C. Auscultating lung sounds and obtaining vital signs D. Suggesting that the patient use 1 puff to reduce side effects
D. Suggesting that the patient use 1 puff to reduce side effects
A patient has had three gouty flare-ups in the past year. Which drug class will the nurse expect the provider to order for this patient? A. Colchine B. Glucocorticoids C. NSAIDs D. Urate-lowering drugs
D. Urate-lowering drugs
A patient is prescribed cimetidine [Tagamet] and aluminum hydroxide [Maalox] for the treatment of peptic ulcer disease. What should the nurse teach the patient to do? A. Drink an 8-ounce glass of water when taking these medications. B. Take the medications together to enhance their effectiveness. C. Take the Tagamet 2 hours before the Maalox. D. Wait at least 1 hour between administration of the two medications.
D. Wait at least 1 hour between administration of the two medications.
A patient who has developed opioid tolerance will experience which effect? A. increased respiratory depression B. decreased analgesic effect C. decreased constipation D. increased euphoria
D. decreased analgesic effect
A patient with gout has been treated with allopurinol (Zyloprim) for 2 months. The nurse will monitor laboratory results for which therapeutic effect? A. Increased hemoglobin and hematocrit levels B. Decreased prothrombin time C. Decreased white blood cell count D. decreased uric acid levels
D. decreased uric acid levels
The U.S. Food and Drug Administration (FDA) recommends genetic testing of patients receiving certain medications. Genetic testing helps prescribers: A. better establish a drug's therapeutic index. B. identify racial characteristics that affect psychosocial variation in drug response. C. produce a drug that is tailored to an individual patient's genetic makeup. D. determine whether a patient is a rapid or slow metabolizer of the drug.
D. determine whether a patient is a rapid or slow metabolizer of the drug
A patient who takes oral theophylline [Theochron] twice daily for chronic stable asthma develops an infection and will take ciprofloxacin. The nurse will contact the provider to discuss: A. changing to a different antibiotic. B. giving theophylline once daily. C. switching from theophylline to a LABA. D. reducing the theophylline dose.
D. reducing the theophylline dose.
A patient with asthma is admitted to an emergency department with a respiratory rate of 22 breaths per minute, a prolonged expiratory phase, tight wheezes, and an oxygen saturation of 90% on room air. The patient reports using fluticasone [Flovent HFA] 110 mcg twice daily and has used 2 puffs of albuterol [Proventil HFA], 90 mcg/puff, every 4 hours for 2 days. The nurse will expect to administer which drug? A. Intravenous glucocorticoids, nebulized albuterol and ipratropium, and oxygen B. Intravenous theophylline, oxygen, and fluticasone (Flovent HFA) 220 mcg C. Four puffs of albuterol, oxygen, and intravenous theophylline D. Intramuscular glucocorticoids and salmeterol by metered-dose inhaler
Intravenous glucocorticoids, nebulized albuterol and ipratropium, and oxygen
The nurse is preparing to administer prescribed medications to a client with hepatic encephalopathy. The nurse anticipates that the health care provider's prescriptions will include which medication? A. Lactulose (an osmotic laxative) B. Bisacodyl suppository (a stimulant laxative) C. Magnesium hydroxide (saline laxative) D. Psyllium hydrophilic mucilloid (a bulk laxative)
Lactulose (an osmotic laxative)
The nurse notes in a patient's medication history that the patient is taking allopurinol (Zyloprim). Based on this finding, the nurse interprets that the patient has which disorder? A. gout B. rheumatoid arthritis C. systemic lupus erythematosus D. osteoarthritis
a. gout
A patient is taking ibuprofen 800 mg (NSAID)three times a day by mouth as treatment for OA. While taking a health history, the nurse finds out that the patient has a few beers on weekends. What concern would there be with the interaction of the alcohol and ibuprofen? A. increased risk for falls B. increased risk for GI bleeding C. increased nephrotoxic effects D. reduced anti-inflammtory effects of the NSAID
b. increased chance for GI bleeding
A nurse is giving an enteral medication. The patient asks why this method is preferable for this drug. How will the nurse reply? How would your answer change if the medication were being administered IV? A. "This route allows more rapid absorption of the drug." B. "This route is safer, less expensive, and more convenient." C. "This route is the best way to control serum drug levels." D. "This route prevents inactivation of the drug by digestive enzymes."
for enteral - B for IV - A
