Pharmacology exam 2 NCLEX questions
The nurse is caring for a client who has just recently been prescribed isoniazid. Which one of the following groups of symptoms is indicative of an adverse effect of the drug? SELECT ALL THAT APPLY: A)Numbness and tingling of the extremities B)Nausea, abdominal pain, and jaundice C)Decreased urine output and elevated blood urea nitrogen D)Dizziness and loss of hearing
A)Numbness and tingling of the extremities B)Nausea, abdominal pain, and jaundice
A home care nurse is visiting an 88-year-old man, who is taking acetaminophen for arthritic pain in his knees. Which of the following patient teaching statements is most appropriate to implement? A. "Acetaminophen will only relieve pain but not the inflammation from arthritis." B. "Acetaminophen is appropriate for the treatment of inflammation from arthritis." C. "Your primary health care provider should consider a prescription of Vicodin (acetaminophen/hydrocodone)." D. "The acetaminophen should be administered on an empty stomach."
A. "Acetaminophen will only relieve pain but not the inflammation from arthritis."
A patient is being treated with colchicine for acute gouty flare-up. Which of the following statements indicates the need for increased patient education? A. "I am going to stop taking the colchicine because of the diarrhea I am having." B. "The gastrointestinal effects are difficult to deal with, but I know they will decrease my gouty symptoms." C. "I will continue my colchicine just as it has been prescribed for me." D. "The diarrhea I am experiencing can result in dehydration. If I have lethargy, I will call my prescriber."
A. "I am going to stop taking the colchicine because of the diarrhea I am having."
A patient is taking phenobarbital for a seizure disorder. Which of the following statements indicates that the patient should be seen by a health care provider immediately? A. "I have a rash that started on my trunk, and now it is on my arms and legs." B. "I rest if I feel tired." C. "I take my medication routinely and do not skip doses." D. "I have my blood levels checked if my breathing decreases."
A. "I have a rash that started on my trunk, and now it is on my arms and legs." Potentially SJ syndrome
You are teaching Mr. Smith about his new prescription for beclomethasone. Which of the following instructions should would you include? A. "Rinse your mouth after each use of this medication." B. "Limit fluid intake while taking this medication." C. "Increase your intake of vitamin B12 while taking this medication." D. "You can take the medication as needed."
A. "Rinse your mouth after each use of this medication." preventing thrush
A female patient with chronic lymphocytic leukemia is beginning to receive an oral cyclophosphamide. Which of the following instructions is most accurate? (Select all that apply.) A. Administer the drug with food only with gastric upset. B. Take the drug on an empty stomach. C. Take the drug at bedtime. D. Administer the drug 1 hour before a meal or 2 hours afterward.
A. Administer the drug with food only with gastric upset. B. Take the drug on an empty stomach. D. Administer the drug 1 hour before a meal or 2 hours afterward
A patient who is undergoing hemodialysis has received a diagnosis of a systemic Candida infection. Which of the following interventions should be implemented when administering fluconazole? A. Administer the full dose of fluconazole after dialysis. B. Administer the full dose of fluconazole before dialysis. C. Administer one half of the dose of fluconazole after dialysis. D. Administer one half of the dose of fluconazole before dialysis.
A. Administer the full dose of fluconazole after dialysis.
A nurse practitioner sees a 19-year-old college student in the student health center for severe diarrhea. The nurse diagnoses traveler's diarrhea based on the young woman's history; she had recently returned from Mexico. She receives a prescription for rifaximin 200 mg orally three times daily for 3 days. Four days later, she calls the office and reports to the nurse that she has a fever and that the diarrhea has not resolved. Which of the following is the most appropriate information to communicate to the student? A. Advise the student to return to the clinic for further tests and a different antibiotic. B. Call the pharmacy and authorize one refill of rifaximin. C. Advise the student that it takes up to 48 to 72 hours after the completion of treatment for the diarrhea to completely resolve. D. Tell the student to continue to drink plenty of fluids and report back in 24 hours.
A. Advise the student to return to the clinic for further tests and a different antibiotic.
In explaining antineoplastic therapy to a family member of a patient who is to receive treatment with a cytotoxic drug, which of the following explanations is most accurate? A. Antineoplastic therapy damages both malignant and nonmalignant cells. B. It causes few adverse effects. C. It stimulates growth of cancer cells. D. It must be given daily.
A. Antineoplastic therapy damages both malignant and nonmalignant cells.
A 76-year-old woman is taking celecoxib for arthritic pain in her back. When administering celecoxib, which of the following patient teaching points is most important? A. Any chest pain should be reported to the prescriber immediately. B. Celecoxib can be administered with warfarin. C. Increased mobility should be reported to the prescriber. D. Celecoxib can be administered with aspirin during periods of infection.
A. Any chest pain should be reported to the prescriber immediately.
A nurse is preparing to administer the first dose of piperacillin/tazobactam to a patient in an infusion clinic. The nurse should take which of the following precautions? A. Ask the patient about past allergic reactions to penicillins. B. Ask the patient about past allergic reactions to aminoglycosides. C. Mix the piperacillin/tazobactam with lidocaine to reduce pain of infusion. D. Instruct the patient to eat a snack to decrease stomach upset from piperacillin/tazobactam.
A. Ask the patient about past allergic reactions to penicillins.
A patient is taking systemic corticosteroids. Which of the following nursing interventions is most important to implement? A. Assess for signs and symptoms of adrenocortical excess. B. Hold the corticosteroid before surgery or diagnostic testing. C. Assess for fluid volume deficit. D. Decrease the intake of vitamin C.
A. Assess for signs and symptoms of adrenocortical excess
Which of the following medications should NOT be used during an acute asthma attack. SELECT ALL THAT APPLY: A. Formoterol B. Albuterol C. Salmeterol D. Ipratropium bromide
A. Formoterol C. Salmeterol D. Ipratropium bromide albuterol is used during an acute asthma attack
A boy has contracted a rash caused by poison ivy over a large portion of his arms and legs following a camping trip. His health care provider has prescribed oral prednisone, which is to be administered in a tapering dose over the next 10 days. What effect does the medication have on the rash? A. It decreases the accumulation of neutrophils and macrophages at the site, thus reducing inflammation. B. It eliminates the itching associated with the allergy. C. It increases the white blood cell count to assist in healing. D. It increases the protein metabolism to allow for the rejuvenation of tissue.
A. It decreases the accumulation of neutrophils and macrophages at the site, thus reducing inflammation.
Why would patients with genital herpes receive acyclovir? A. It decreases viral shedding and pain related to outbreak. B. It eliminates future viral outbreaks. C. It prevents sterility in infected patients. D. It prevents the development of cytomegalovirus.
A. It decreases viral shedding and pain related to outbreak.
Monoclonal antibodies are engineered to specifically target a certain antigen, such as one found on cancer cells. Which of the following actions by monoclonal antibodies have demonstrated effectiveness in cancer therapy? (Select all that apply.) A. Make the cancer cell more visible to the immune system. B. Block growth signals. C. Increase growth of new blood vessels. D. Deliver radiation or chemotherapy to cancer cells.
A. Make the cancer cell more visible to the immune system. B. Block growth signals.
A woman is being treated with long-term corticosteroid therapy. Her husband has just received a diagnosis of terminal cancer. How is his diagnosis likely to affect her treatment? A. She may need to have her dose of corticosteroid increased because of the stress. B. She may need a decrease in corticosteroids because of the increase in cortisol. C. She may need to be changed to a different corticosteroid because of the stress. D. She may be switched to a parenteral form of corticosteroid.
A. She may need to have her dose of corticosteroid increased because of the stress.
The nurse instructs a patient on the administration of clarithromycin. Which of the following patient teaching instructions is appropriate? A. Take the medication on an empty stomach. B. Take the medication with a calcium supplement. C. Take the medication with a glass of milk. D. Take the medication with cheese.
A. Take the medication on an empty stomach.
A teenage boy receives a prescription for erythromycin for an upper respiratory tract infection. He complains that he cannot hear the teacher, who then sends him to the school nurse's office. After assessing the patient's hearing with a tuning fork, the nurse determines that his hearing is diminished. What is the most important nursing intervention? A. The nurse should notify the parents to call the physician; this is an adverse effect of erythromycin. B. The nurse should inform the parents of a physician who specializes in ear, nose, and throat surgery. C. The nurse should instruct the patient to stop taking the erythromycin and his hearing will improve. D. The nurse should call the physician and inform the patient of a change in antibiotics.
A. The nurse should notify the parents to call the physician; this is an adverse effect of erythromycin.
A male patient is being treated for Hodgkin's lymphoma with vincristine. He also takes phenytoin daily in the morning for a seizure disorder. How will these two medications interact? A. Vincristine, when combined with phenytoin, will increase sedation. B. Phenytoin and vincristine are metabolized by CYP3A4, increasing vincristine toxicity. C. Phenytoin administered with vincristine will decrease cytotoxic drug effects. D. Vincristine will increase the patient's risk of having a seizure.
A. Vincristine, when combined with phenytoin, will increase sedation.
For a patient receiving a cytotoxic drug that will likely result in bone marrow depression, which of the following teaching considerations should be the priority for the nurse with the patient and family members or caregivers? A. Wash hands often, and avoid people with colds, flu, or other infections. B. Do not expect fatigue and weakness, which are uncommon. C. Expect gastrointestinal upset. More nausea and vomiting may occur when the blood cell counts are low. D. Take acetaminophen for fever.
A. Wash hands often, and avoid people with colds, flu, or other infections.
A common mucolytic used to liquefy mucus in the respiratory tract is A. acetylcysteine B. ipratropium C. dextromethorphan D. pseudoephedrine
A. acetylcysteine
A nurse is explaining to a parent how vaccines work. Vaccines provide which of the following? A. active immunity B. passive immunity C. innate immunity D. nonspecific immunity
A. active immunity
When administering long-term systemic corticosteroid medications, which of the following dosing schedules is recommended? A. alternate-day therapy B. once daily at noon C. weekly therapy D. nightly therapy
A. alternate-day therapy
A patient is receiving prednisone 10 mg orally every day to reduce symptoms of Crohn's disease. Which of the following effects is associated with daily administration of prednisone? A. atrophy of the adrenal cortex B. decreased serum glucose C. weight loss D. fluid volume deficit
A. atrophy of the adrenal cortex
Which laboratory value should the nurse assess in patients who are receiving demeclocycline? A. blood urea nitrogen (BUN) B. aspartate aminotransferase C. alanine aminotransferase D. creatinine
A. blood urea nitrogen (BUN)
In caring for a patient with nasal congestion, the nurse knows that adrenergic drugs are used as nasal decongestants to relieve symptoms by A. constricting arterioles and reducing blood flow to nasal mucosa B. stimulating air movement in the lungs C. stabilizing mast cells D. initiating the cough reflex
A. constricting arterioles and reducing blood flow to nasal mucosa
What assessment should the nurse implement when caring for a patient who is receiving metronidazole for intestinal amebiasis? A. diminished diarrhea B. hypomagnesemia C. increased temperature D. hyperkalemia
A. diminished diarrhea
A newborn infant has been treated with parenteral indomethacin for treatment of patent ductus arteriosus. Which of the following symptoms would be indicative of a reopening of the ductus arteriosus in 12 hours after the original dosage? A. dyspnea B. pain C. elevated creatinine level D. hepatic failure
A. dyspnea
The nurse would assess a patient taking isoniazid for A. elevated levels of serum aspartate aminotransferase B. symptoms of hyperkalemia C. decreased urine output D. hearing loss
A. elevated levels of serum aspartate aminotransferase would indicate liver damage
A male patient is receiving pyrazinamide. The nurse assesses him for which of the following? A. elevated liver enzymes and jaundice B. elevated white blood cell count and fever C. elevated cardiac troponin levels and chest pain D. elevated creatine kinase and muscle weakness
A. elevated liver enzymes and jaundice
Which of the following classes of cephalosporins have the best activity against gram-positive organisms? A. first-generation cephalosporins B. second-generation cephalosporins C. third-generation cephalosporins D. fourth-generation cephalosporins
A. first-generation cephalosporins
A patient diagnosed with Addison's disease is taking exogenous corticosteroids. The nurse should assess the patient for which of the following adverse effects? A. hyperglycemia B. hyperkalemia C. hypercalcemia D. hypermagnesemia
A. hyperglycemia
Because of the action of antihistamines on target tissues, these drugs are effective in producing which of the following actions? (Select all that apply.) A. inhibiting vascular permeability B. reducing pruritus C. minimizing edema formation D. preventing histamine release
A. inhibiting vascular permeability B. reducing pruritus C. minimizing edema formation
A patient is taking isoniazid. Which one of the following adverse effects does the nurse include in discharge teaching? A. numbness and tingling of extremities B. thirst and decreased urine output C. loose, watery bowel movements D. eye pain and visual disturbances
A. numbness and tingling of extremities
Which of the following foods should not be taken with tetracycline? A. orange juice with calcium B. cranberry juice cocktail C. tomato juice D. lemonade
A. orange juice with calcium tetracycline is contraindicated w/ dairy products or calcium
Which of the following medications is contraindicated with acetaminophen? A. oxycodone with acetaminophen B. furosemide C. phenytoin D. ampicillin
A. oxycodone with acetaminophen
A nurse who is scheduled to work at a hospital in Haiti in 2 weeks comes to the clinic for antimalarial medication. A health care provider should prescribe which of the following drugs prior to the nurse's trip? A. primaquine B. metronidazole C. amitriptyline D. clindamycin
A. primaquine similar to chloroquine
A man who is using a steroid inhaler complains of anorexia and discomfort when he eats. The nurse reports this to the care provider, and the patient receives a diagnosis of oropharyngeal candidiasis. It is possible to decrease this adverse effect by which of the following actions? (Select all that apply.) A. reducing the dose B. administering the drug more frequently C. rinsing the mouth after use D. using a spacer device
A. reducing the dose C. rinsing the mouth after use D. using a spacer device
An automobile worker visits an occupational health nurse. He has pain in his right hand due to repetitive movements, for which he has been taking aspirin 650 mg every 2 hours. Which of the following symptoms is indicative of salicylate toxicity? A. ringing in the ears B. halos around lights C. edema D. dysrhythmia
A. ringing in the ears
The most common cancers that develop with long-term immunosuppression after organ transplant are which of the following? A. skin cancers and lymphomas B. cancers of the gastrointestinal tract C. renal and liver cancers D. brain and spinal cord cancers
A. skin cancers and lymphomas
A nurse is caring for a patient who is taking immunosuppressant drugs. The most critical information to teach the patient is ways to do which of the following? A. to decrease infection B. to avoid weight gain C. to maintain a good fluid intake D. to increase rest and decrease exercise
A. to decrease infection
A man has had a urinary tract infection, and a prescriber orders phenazopyridine. Which of the following adverse effects should he report immediately to his health care provider? (Select all that apply.) A. yellowing of the skin B. edema C. bruising D. malaise E. sore throat F. fever
A. yellowing of the skin C. bruising E. sore throat F. fever
Mr. Smith's asthma attack has resolved and he is monitored on a med-surg floor for another 2 days. Mr. Smith is ordered for discharge and he is ordered to take an albuterol inhaler and a beclomethasone inhaler. He asks if it matters which inhaler he uses first. The best response by the nurse is which of the following? A."You should use the albuterol inhaler first followed in 3-5 minutes by the beclomethasone inhaler." B."You should use the beclomethasone inhaler first followed in 3-5 minutes by the albuterol inhaler." C."The order in which you use the inhalers does not matter." D."You should use the inhalers one right after the other."
A."You should use the albuterol inhaler first followed in 3-5 minutes by the beclomethasone inhaler." albuterol (rescue inhaler) is always used before the beclomethasone (maintenance inhaler)
In caring for a patient with nasal congestion, the nurse knows that adrenergic drugs are used as nasal decongestants to relieve symptoms by A.Constricting arterioles and reducing blood flow to nasal mucosa B.Stimulating air movement in the lungs C.Stabilizing mast cells D.Initiating the cough reflex
A.Constricting arterioles and reducing blood flow to nasal mucosa
An automobile worker visits an occupational health nurse. He has pain in his right hand due to repetitive movements, for which he has been taking aspirin 650 mg every 2 hours. Which of the following symptoms is indicative of salicylate toxicity? A.Ringing in the ears B.Halos around the lights C.Edema D.Sweating
A.Ringing in the ears
A patient has had a UTI and a prescriber orders phenazopyridine. Which of the following adverse effects should he report to his health care provider? A.Yellowing of the skin B.Edema C.Pain D.malaise
A.Yellowing of the skin black box warning for pyridium (monitor for jaundice)
When teaching a patient about the proper use of metered-dose inhalers, which of the following statements should be included? A. "Make sure that you puff out air repeatedly after you inhale the medication." B. "After you inhale the medication, hold the breath for approximately 10 seconds and exhale slowly." C. "After you inhale the medication once, repeat until you obtain relief." D. "Rinse out your mouth before using the inhaler to decrease the development of a mouth infection."
B. "After you inhale the medication, hold the breath for approximately 10 seconds and exhale slowly."
When applying spinosad to a dry scalp for treatment of head lice, how long should it be left on? A. 5 minutes B. 10 minutes C. 20 minutes D. 30 minutes
B. 10 minutes
A man is receiving treatment for a Mycoplasma pneumoniae infection. He says that drinking orange juice hurts his mouth. What priority assessment should the nurse make? A. Assess the patient's fecal output for signs and symptoms of diarrhea. B. Assess the patient's mouth for signs of candidal infection. C. Assess the patient's lung sounds for rales or rhonchi. D. Assess the patient's intake and output.
B. Assess the patient's mouth for signs of candidal infection.
When a patient fails to respond to an antibiotic, the nurse suspects antibiotic resistance. Which mechanism of resistance does the nurse recognize as an example of acquired antibiotic resistance? A. Alterations are made in the bacterial cell wall structure to make it less permeable. B. Bacteria exchange genetic content that transfers resistance from one bacterial strain to another. C. Efflux is used to extrude bacteria from within the bacterial cell. D. Metabolic pathways are altered so bacteria targeting a specific enzyme of the metabolic pathway are ineffective.
B. Bacteria exchange genetic content that transfers resistance from one bacterial strain to another.
Which of the following aspects of teaching is most important to provide to a patient who is taking chloroquine phosphate? A. Take chloroquine with vitamin C. B. Have frequent ophthalmologic examinations. C. Administer antacids to reduce gastric distress. D. Take chloroquine on an empty stomach.
B. Have frequent ophthalmologic examinations.
A patient who is taking an antibiotic for an infection shows no signs of improvement. When a laboratory report indicates that the causative organism is not susceptible to the prescribed antibiotic, what is the priority nursing intervention? (Select all that apply.) A. Notify the pharmacist to provide a different antibiotic. B. Notify the prescriber of the culture report. C. Stop the current antibiotic and use the susceptible antibiotic. D. Inform the patient that the antibiotic is ineffective. E. Notify the prescriber of the sensitivity report.
B. Notify the prescriber of the culture report. E. Notify the prescriber of the sensitivity report. the nurse should not request a new antibiotic from the pharmacy, stop the antibiotic and use a new one(it has not been ordered), or inform the patient that the antibiotic is ineffective (as they were prescribed that as an empiric treatment while the culture was being performed)
A nurse working in the neurointensive care unit is caring for a patient with a head injury who has been experiencing seizures and now has pneumonia caused by Pseudomonas aeruginosa. The physician has prescribed imipenem 1 g IV every 6 hours plus gentamicin for the pneumonia. Before administering the antibiotics, the nurse should do which of the following? A. Avoid mixing the imipenem and gentamicin in the same IV bag to prevent inactivation of the gentamicin. B. Remind the physician of the patient's seizures and inquire whether a different antibiotic might be safer. C. Suggest to the physician that imipenem is used to treat gram-positive infections and will not be effective in this patient. D. Set the infusion pump to deliver the imipenem over 15 minutes.
B. Remind the physician of the patient's seizures and inquire whether a different antibiotic might be safer. an adverse effect of imipenem is CNS toxicity, including seizures
A physician has ordered trimethoprim-sulfamethoxazole (TMP-SMZ) for a woman with a urinary tract infection. The nurse has asked the patient about whether she takes any over- the-counter medications. The patient reports that she regularly takes St. John's wort as a mood elevator. Which of the following patient teaching interventions is most important? A. Taking St. John's wort and TMP-SMZ results in no known interactions. B. TMP-SMZ combined with St. John's wort leads to an increased therapeutic effect of the TMP-SMZ. C. TMP-SMZ has a decreased effect when given with St. John's wort. D. When given in combination, TMP-SMZ and St. John's wort result in manic tendencies.
B. TMP-SMZ combined with St. John's wort leads to an increased therapeutic effect of the TMP-SMZ.
When a woman who is taking an antibiotic develops a thick, white, curdlike vaginal discharge with pruritus, the nurse suspects that the patient has a vaginal yeast infection. What would explain this development? A. A drug for a fungal infection should have been prescribed instead of a drug for bacterial infection. B. The antibiotic has altered the normal vaginal environment. C. The antibiotic that was prescribed was not effective. D. Yeast infections are side effects of antibiotics
B. The antibiotic has altered the normal vaginal environment.
A health care worker has nasal colonization of methicillin-resistant Staphylococcus aureus (MRSA). Which interpretation of this finding by the nurse is correct? A. The health care worker has a nasal infection caused by MRSA. B. The health care worker poses a danger to patients. C. The health care worker is immune to MRSA. D. The health care worker produces beta-lactamase.
B. The health care worker poses a danger to patients.
Cold remedies listed as "nondrowsy" or labeled as "daytime" formulas do not contain A. a nasal decongestant B. a first-generation antihistamine C. a pain reliever D. any of the above
B. a first-generation antihistamine
Which of the following patients is at greatest risk for developing a life-threatening system mycosis? A. a patient who develops a sexually transmitted disease and is being treated with doxycycline B. a patient with breast cancer being treated with the chemotherapeutic agent cyclophosphamide C. a patient who is taking warfarin for the prevention of a thromboembolism D. a patient with a strep throat who is being treated with cephalexin
B. a patient with breast cancer being treated with the chemotherapeutic agent cyclophosphamide a patient who is taking a cytotoxic medication is at greater risk for developing a systemic fungal infection
A toddler is running a fever of 103°F. Which of the following medications is alternated to treat the fever? A. aspirin and acetaminophen B. acetaminophen and ibuprofen C. naproxen sodium and ibuprofen D. aspirin and ibuprofen
B. acetaminophen and ibuprofen
The nurse receives an order to administer diphenhydramine. This medication is recommended for use in which of the following? A. premature or full-term infants B. adults to prevent allergic reactions C. children with chickenpox D. children with a flulike infection
B. adults to prevent allergic reactions
Montelukast is effective in relieving the inflammation and bronchoconstriction associated with acute asthmatic attacks through which principal action? A. stabilizing mast cells B. blocking leukotriene receptors C. binding to immunoglobulin E (IgE) D. decreasing prostaglandin synthesis
B. blocking leukotriene receptors
In acute renal failure, doses of which of the following antibiotics must be reduced? (Select all that apply.) A. nafcillin B. cefazolin C. meropenem D. aztreonam
B. cefazolin C. meropenem D. aztreonam
A patient who is receiving ethambutol comes into the clinic for a follow-up visit. Which finding on the assessment indicates a serious adverse reaction to the drug? A. a sputum culture that is negative for acid-fast bacilli B. changes in visual acuity C. poor appetite and GI upset D. dizziness and hearing loss
B. changes in visual acuity
A patient with chronic obstructive pulmonary disease is being administered a corticosteroid by nebulizer. What effect does the corticosteroid have? A. decrease in blood pressure B. decrease in mucus secretion C. decrease in edema D. increase in immunity
B. decrease in mucus secretion
A patient has asked for an antihistamine to relieve symptoms of an upper respiratory infection. The nurse explains that studies have demonstrated that for treatment of the common cold, which of the following is true of antihistamines? A. are effective in relieving cold symptoms B. do not relieve symptoms and are not recommended C. should be compounded with other products to be effective D. relieve nonallergenic symptoms only
B. do not relieve symptoms and are not recommended
A patient is admitted to the emergency department following opening an envelope containing a substance that experts have identified as anthrax. Which of the following medications is likely to be administered? A. tetracycline B. doxycycline C. amoxicillin-clavulanic acid combination D. neomycin
B. doxycycline pts who have possible anthrax poisoning receive doxycycline
A critically ill patient is receiving gentamicin 1.5 mg/kg intravenously every 8 hours. The patient has recently stopped making urine, and the most recent laboratory results indicate that the patient's creatinine level has risen from a normal value of 0.8 to 3.6 mg/dL. At the next scheduled time for administration of gentamicin, the nurse should A. administer half the prescribed dose B. hold the gentamicin and notify the provider C. administer gentamicin as prescribed D. draw a blood sample for testing the gentamicin trough level before the dose and then administer as prescribed
B. hold the gentamicin and notify the provider nephrotoxicity is an adverse effect of gentamicin
The nurse is reviewing a patient's medications and sees that the patient is receiving rifampin. The nurse's greatest concern about rifampin and its drug interactions is A. it decreases the metabolism of many other drugs B. it increases the metabolism of many other drugs C. it increases the risk for GI bleeding if given with warfarin D. it increases the risk of adverse effects from antiseizure drugs
B. it increases the metabolism of many other drugs
A prescriber in an orthopedic care practice orders meloxicam for the treatment of osteoarthritis. Which of the following medications when combined with meloxicam places the patient at greatest risk? A. antimicrobials B. lithium C. selective serotonin inhibitors D. hydrochlorothiazide
B. lithium
The nurse should teach patients taking isoniazid to avoid alcohol because of the increased risk of A. central nervous system depression B. liver damage C. drug-resistant tuberculous organisms D. rapid drug metabolism
B. liver damage
A 5-month-old infant is receiving ribavirin for respiratory syncytial virus. The nurse assesses the infant visually. Which of the following indicate that the infant's pulmonary status is impaired? A. shallow respirations B. nasal flaring C. respiratory rate of 36 breaths/min D. sleeping
B. nasal flaring
The nurse is caring for a patient who is taking isoniazid and rifampin. Which one of the following groups of symptoms is indicative of an adverse effect that is worsened by the combination of the two drugs? A. numbness and tingling of the extremities B. nausea, abdominal pain, and jaundice C. decreased urine output and elevated blood urea nitrogen D. dizziness and loss of hearing
B. nausea, abdominal pain, and jaundice
A nurse is caring for a 74-year-old man. The nurse recognizes that he would most likely to have a decreased immune response to the influenza vaccine if he is taking which of the following medications? A. levothyroxine B. prednisone C. metoprolol D. lovastatin
B. prednisone
A child is receiving an immunization. The nurse should inform the parents that common aftereffects may include which of the following? A. skin rash and itching B. redness and soreness at the injection site C. muscle weakness and difficulty in walking D. nausea, vomiting, and diarrhea
B. redness and soreness at the injection site
A physician tells a patient to take aspirin for back pain. It is most important to instruct the patient to A. take the medication on an empty stomach to enhance absorption B. take the medication after a meal to prevent gastric irritation C. crush the enteric-coated tablet for increased effectiveness D. take the medication 2 hours after a meal to enhance absorption
B. take the medication after a meal to prevent gastric irritation
The nurse is caring for a patient with severe immunosuppression. This condition is a contraindication to which of the following? A. all injectable immunizations B. the use of live bacterial or viral vaccines C. the use of immune globulins for passive immunity D. annual influenza vaccine
B. the use of live bacterial or viral vaccines
A nurse is applying silver sulfadiazine (Silvadene) to a child's burns. Which of the following nursing interventions is most important when applying the medication? A. providing pain medication B. using sterile gloves C. giving the child a bath D. teaching the parent to apply the medication
B. using sterile gloves
The nurse who is giving isoniazid (INH) anticipates an order for which one of the following vitamins, usually given with INH? A. vitamin B3 (niacin) B. vitamin B6 (pyridoxine) C. folic acid (folate) D. vitamin D (calcitriol)
B. vitamin B6 (pyridoxine)
Which of the following herbal preparations appears to play a role in the defense mechanisms of the respiratory system in adults? A. echinacea B. vitamin C C. zinc gluconate D. valerian
B. vitamin C
•A nurse reading a patient's chart notices that the patient is scheduled to receive ciprofloxaxin 500mg PO at 09:00. The medication admin record also indicates that Maalox(milk of magnesia) 30mL PO and hydrochlorothiazide 25mg PO are due at 09:00. The nurse should: A.Administer all the medications as scheduled B.Hold the Maalox until 11:00 am C.Ask the provider to discontinue hydrochlorothiazide because of increased risk of ototoxicity D.Administer the Maalox and ciprofloxacin but hold the hydrochlorothiazide
B.Hold the Maalox until 11:00 am Can take 2 hrs before or after antibiotic administration
A cardiac surgeon orders cefazolin 1g IV "on call" to the OR for a patient scheduled for a heart valve replacement. The surgery is scheduled for 07:00 the next morning. What is the rationale for giving the antibiotic at 06:30am? The last dose was administered more than 8 hours ago. A.The cefazolin must be given within 60 minutes before the procedure for legal reasons B.The cefazolin must be given within 60 minutes before the first skin incision to reach therapeutic concentrations C.The cefazolin trough level will be checked at 06:00, which would allow the level to come back before administration of the "on call" dose. D.The last dose was administered yesterday
B.The cefazolin must be given within 60 minutes before the first skin incision to reach therapeutic concentrations
uA nurse who is scheduled to work at a hospital in Haiti in 2 weeks comes to the clinic for antimalarial medication. A health care provider should prescribe which of the following drugs prior to the nurse's trip? A) Metronidazole B) Clindamycin C) Chloroquine D) Amitriptyline
C) Chloroquine
A health care provider has prescribed rifampin for a patient who is being discharged to home. The nurse should include which one of the following in the discharge teaching? A. "You will have to measure your urine output while taking rifampin." B. "Rifampin increases the risk of having seizures or convulsions." C. "Ask your eye care provider about wearing your contact lenses." D. "There is no necessary follow-up blood work."
C. "Ask your eye care provider about wearing your contact lenses." b/c of the orange-red color of the tears from rifampin, the pt should contact their eye care provider before wearing contacts
A prescriber has ordered oral fluconazole. Which of the following patient teaching guidelines is important to implement? A. Administer the medication on an empty stomach. B. Administer the medication 2 hours following breakfast. C. Administer the medication with meals. D. Administer the medication with a full glass of water.
C. Administer the medication with meals helps prevent GI upset
A woman is using topical acyclovir. Which of the following is the most important intervention to instruct the patient regarding medication administration? A. Administer the medication after meals to enhance absorption. B. Discontinue the medication when lesions are crusted over. C. Apply the medication to the lesions with a gloved hand. D. Increase oral fluids to enhance healing.
C. Apply the medication to the lesions with a gloved hand.
A cancer patient asks the nurse why he is being given a corticosteroid before his chemotherapy. Which of the following is the nurse's best response? A. It will prevent the development of anemia related to the chemotherapy. B. It will prevent the development of hiccups, which is associated with chemotherapy. C. It will prevent nausea and vomiting that occur with chemotherapy. D. It will boost your immune system and prevent infection.
C. It will prevent nausea and vomiting that occur with chemotherapy.
A patient who is being treated for a seizure disorder with phenytoin receives a diagnosis of candidiasis. The prescriber orders fluconazole. What effect does fluconazole have on phenytoin? A. The dosage of phenytoin should be increased. B. The fluconazole will be ineffective with the phenytoin. C. The patient should be assessed for phenytoin toxicity. D. The fluconazole dosage will need to be increased.
C. The patient should be assessed for phenytoin toxicity.
A college student is seen in the campus health center with a sore throat. Examination of the throat reveals redness and swelling but no sign of infection. Which of the following is an accurate description of the inflammatory process? A. A granuloma will develop if the inflammation is unresolved. B. The student is not at risk for the development of an infection. C. There is an influx of leukocytes to the throat. D. Scarring will result from phagocytic action.
C. There is an influx of leukocytes to the throat.
A child is taking long-term systemic corticosteroids. What factor influences the child's diminished growth? A. hypokalemia B. fluid retention C. altered DNA synthesis D. increase in parathyroid hormone
C. altered DNA synthesis
The nurse questions an order for pyrazinamide for a patient with A. active TB B. a recent heart attack C. an acute attack of gout D. a history of smoking
C. an acute attack of gout pyrazinamide decreases renal excretion of urates
A man is taking allopurinol for acute gout. He has also been receiving anticoagulant therapy since having a myocardial infarction. What is the priority assessment? A. diminished pain in the inflamed joint B. adherence to the medication regimen C. bleeding D. abdominal pain
C. bleeding
A patient from a nursing home arrives at the emergency department with acute pyelonephritis. The provider prescribes ciprofloxacin 500 mg PO twice daily. The patient has a history of seizures and bradycardia. The nurse should: A. counsel the patient's caregiver to avoid administering the ciprofloxacin with the patient's anticonvulsant B. ask the provider to check blood levels of the patient's anticonvulsant(s) before giving the first dose of ciprofloxacin C. call the patient's seizure and dysrhythmia history to the provider's attention and inquire whether another type of antibiotic might be selected D. counsel the patient's caregiver to discontinue the ciprofloxacin after the patient's fever is gone
C. call the patient's seizure and dysrhythmia history to the provider's attention and inquire whether another type of antibiotic might be selected Cipro can cause drug interactions with anticonvulsants and antidysrhythmics
The nurse working in the emergency department anticipates an order of a severe allergic reaction with anaphylaxis, knowing that the drug of choice for severe allergic reactions with anaphylaxis is which of the following? A. diphenhydramine B. cimetidine C. epinephrine D. loratadine
C. epinephrine
A patient is admitted to the critical care unit with a diagnosis of Legionnaires disease. Based on your knowledge of pharmacology, which medication is the drug of choice to treat the infection? A. azithromycin B. clarithromycin C. erythromycin D. vancomycin
C. erythromycin
A man with intestinal amebiasis has received a prescription for metronidazole. He later develops a cough and takes a prescription cough syrup. What adverse effect will he experience? A. edema B. bronchospasm C. flushing D. bradycardia
C. flushing
The nurse should instruct the patient taking cyclosporine or tacrolimus that toxic levels of the drug may be reached if taken with which of the following beverages that inhibit metabolism of the drugs? A. orange juice B. coffee C. grapefruit juice D. milk
C. grapefruit juice
A child who is diagnosed with pneumonia is taking ibuprofen for a fever. The nurse observes a rash. Which of the following reactions does the nurse suspect? A. thromboembolism B. streptococcal reaction C. hypersensitivity D. viral infection
C. hypersensitivity
A patient is admitted to the emergency department in anaphylactic shock following numerous bee stings. The prescriber orders parenteral administration of corticosteroids. What effect is expected from the administration of these agents? A. decreased heart rate and blood pressure B. increased circulation to the lower extremities C. increased or restored cardiovascular responsiveness D. decreased production of aldosterone
C. increased or restored cardiovascular responsiveness
A client is taking adalimumab for rheumatoid arthritis, and the provider monitors the client's laboratory results on a regular basis. Which of the following laboratory findings indicates that the patient is experiencing an adverse effect? A. increased red blood cell count B. decreased creatinine C. increased white blood cell count D. decreased liver enzymes
C. increased white blood cell count we worry about signs/symptoms of infection we would also worry if this were increased liver enzymes
A patient in an outpatient clinic is taking mycophenolate after a kidney transplant. Which of the following over-the-counter products is likely to interfere with the activity of this immunosuppressant? A. diphenhydramine, used for itchy mosquito bites B. acetaminophen, used for a tension headache C. magnesium/aluminum hydroxide, used for heartburn D. benzocaine/dextromethorphan throat lozenges, used for throat irritation
C. magnesium/aluminum hydroxide, used for heartburn
A liver transplant patient is receiving corticosteroids. These drugs are important to the care of this patient because they A. prevent thrombocytopenia B. increase immunity C. prevent tissue rejection D. decrease inflammation
C. prevent tissue rejection
As the nurse caring for a patient with nasal congestion who is using the OTC decongestant oxymetazoline, the nurse counsels the patient that this medication should be used only for the time recommended on the package and no longer because excessive use may produce A. copious lower respiratory tract secretions B. ringing in the ears C. rebound nasal congestion D. a suppressed cough reflex
C. rebound nasal congestion
After organ transplantation, immunosuppressants are given to prevent which of the following? A. nephrotoxicity B. hepatotoxicity C. rejection reaction D. bleeding disorders
C. rejection reaction
A man arrives in the emergency department with a swollen right ankle from a fall. He is complaining of pain and limited mobility. What factor is contributing to the pain in the right ankle? (Select all that apply.) A. blocking of cyclooxygenase-1 (COX-1) B. blocking of COX-1 and COX-2 C. release of prostaglandin E2 D. release of cytochrome P450 E. release of arachidonic acid
C. release of prostaglandin E2 E. release of arachidonic acid
Which of the following is most important to teach a patient who is being administered lamotrigine? A. to report the development of edema B. to report anxiety C. to report the development of a skin rash D. to report anorexia
C. to report the development of a skin rash potentially SJ syndrome
A 76 year-old woman is taking celecoxib for arthritic pain in her back. When administering celecoxib, which of the following patient teaching points is most important? A.Celecoxib can be administered with warfarin. B.Increased mobility should be reported to the prescriber. C.Any chest pain should be reported to the prescriber immediately. D.Celecoxib can be administered with amoxicillin.
C.Any chest pain should be reported to the prescriber immediately. Black box warning for MI & CVA
A man with an acute gouty flare-up is taking allopurinol. Which of the following subjective statements indicates that he has developed uric acid kidney stones? A. "I have pain in my right toe and left elbow." B. "I am dizzy and feel like I am going to faint." C. "I am urinating every hour—approximately 8 oz." D. "I have excruciating pain in my lower abdomen."
D. "I have excruciating pain in my lower abdomen."
A woman has received a diagnosis of Trichomonas vaginalis. What should the nurse teach the patient? A. Avoid yeast-containing foods. B. Wear a feminine pad to absorb the drainage. C. Use acetic acid douches. D. Avoid sexual intercourse.
D. Avoid sexual intercourse.
A nurse is preparing to administer an unfamiliar vaccine. To obtain current information and provide patient teaching about vaccine recommendations and contraindications, it is best to do which of the following? A. Ask a coworker about the vaccine (when and how it should be administered). B. Use a drug guide to look up the vaccine information. C. Access an Internet search engine to find vaccine information. D. Obtain vaccine information and a Vaccine Information Statement (VIS) from the Centers for Disease Control and Prevention (CDC) Web site.
D. Obtain vaccine information and a Vaccine Information Statement (VIS) from the Centers for Disease Control and Prevention (CDC) Web site.
A patient receiving tetracycline should receive the following instruction regarding the medication? A. Take tetracycline with food. B. Take tetracycline in combination with antacids. C. Take the first dose and then obtain a test known as culture and sensitivity. D. Take tetracycline with a full glass of water.
D. Take tetracycline with a full glass of water.
A 68-year-old man, well controlled on theophylline for 2 years, complains of insomnia, nervousness, nausea and vomiting, and tachycardia. He originally thought the nervousness was due to his recent smoking cessation. He had smoked one pack per day for 10 years. The nurse practitioner assesses the patient and tells him that he is likely experiencing theophylline toxicity. A serum theophylline level confirms the diagnosis. What is the best explanation for theophylline toxicity in this patient? A. Because of his age, the patient is likely having renal insufficiency. B. The patient is not taking the medication as prescribed. C. A concurrent medication is altering the metabolism of theophylline. D. The metabolism of theophylline has decreased with the recent smoking cessation.
D. The metabolism of theophylline has decreased with the recent smoking cessation.
A sputum specimen report from the laboratory states, "Contamination with typical oral flora." Which interpretation is correct? A. Bacteria in the mouth are growing in the lungs. B. The normal flora has become pathogenic. C. The patient has a pulmonary infection. D. The sputum from the lungs has mixed with bacteria in the mouth.
D. The sputum from the lungs has mixed with bacteria in the mouth.
A nurse is teaching a child care class to prospective grandparents. Which of the following medications is contraindicated in children? A. ibuprofen B. acetaminophen C. amoxicillin D. aspirin
D. aspirin
When administering amphotericin B, what drug is administered to prevent the development of chilling, fever, malaise, and nausea? A. aminophylline B. ibuprofen C. penicillin G D. aspirin
D. aspirin
A recent nursing graduate is preparing to administer vancomycin to a man intravenously. The nurse states the patient reported that he experienced flushing with his last dose of vancomycin. The nurse should: A. infuse the vancomycin over 30 minutes to decrease the chance of a reaction B. hold the vancomycin dose until the physician's rounds the following morning C. dilute the vancomycin in 50 mL of normal saline solution and infuse over 60 minutes D. contact the physician, report the reaction, and request an order for diphenhydramine pretreatment
D. contact the physician, report the reaction, and request an order for diphenhydramine pretreatment
A woman is experiencing periods of increased anxiety and panic attacks over her illness and that of her family members. Epinephrine and norepinephrine are released. What glucocorticoid is released by the adrenal cortex in response to stress? A. insulin B. glucose C. thyroid hormone D. cortisol
D. cortisol
An 18-year old man is having an open reduction external fixation of a hip following a football injury. During surgery, he develops a fever of 105O F. Which of the following medications is administered? A. cyclobenzaprine hydrochloride B. diazepam C. phenytoin D. dantrolene sodium
D. dantrolene sodium used to treat the rare but dangerous malignant hyperthermia related to anesthesia
A patient is admitted to the emergency department with dehydration. Which of the following assessments of the patient's vital signs does the nurse expect to assess? A. elevated blood pressure B. diminished pulse C. diminished respirations D. elevated temperature
D. elevated temperature
A parent of a high school student calls the school nurse regarding her daughter's crying. The parent states that this behavior is unusual for her daughter. Which of the following medications contributes to changes in behavior? A. metronidazole B. naproxen sodium C. vitamin C D. erythromycin
D. erythromycin labile emotions is an AE of erythromycin
Which of the following psychosocial changes are most likely to occur with the administration of corticosteroids? A. lethargy B. malaise C. ataxia D. euphoria
D. euphoria also insomnia or psychosis
A female patient has not adhered to her drug regimen for tuberculosis. Which of the following is most effective to enhance adherence? A. explaining the importance of adherence B. having the patient's family administer the medication C. evaluating serum drug levels to determine adherence D. having nursing staff directly watch her take her medication
D. having nursing staff directly watch her take her medication
A patient is taking fluticasone 440 mcg inhaled two times per day. The patient is being seen in the pulmonary clinic and says, "I have been very congested and it has been hard to breathe, so for the past 10 days, I have been using my inhaler four times per day." The nurse should assess the patient for which of the following systemic adverse effects? A. hypoglycemia B. hypercalcemia C. anxiety D. hypothalamic-pituitary-adrenal (HPA) suppression
D. hypothalamic-pituitary-adrenal (HPA) suppression taking too much fluticasone (corticosteroid) can put a pt into adrenocortical insufficiency
When administering a sulfonamide, which of the following interventions is most effective in decreasing crystalluria? A. administering 8 oz of cranberry juice B. providing a full liquid diet during the course of drug therapy C. inserting a Foley catheter for the measurement of an accurate intake and output D. providing a minimum of 1500 mL of fluid per day
D. providing a minimum of 1500 mL of fluid per day
An outpatient has just received a prescription for ciprofloxacin 500 mg PO twice daily for acute bronchitis. The nurse should teach the patient A. not to take ciprofloxacin with a meal B. to restrict fluid intake to avoid fluid overload C. to take ciprofloxacin with an antacid (e.g., Tums) to decrease the chance of stomach upset D. to avoid prolonged exposure to sunlight
D. to avoid prolonged exposure to sunlight
A woman develops a urinary tract infection following the delivery of an infant. The nurse practitioner is considering prescribing trimethoprim-sulfamethoxazole. What assessment is necessary to make? A.If the woman is breast-feeding B.If the woman has been treated with the medication in the past C.If anyone in her family has a known allergy to the drug D.If she is experiencing hematuria
D.If she is experiencing hematuria TMP-SMZ specifically can cause bleeding
What is the best action a nurse can take to prevent infection? A.Instruct patients with respiratory illnesses on proper pulmonary hygiene B.Recommend influenza and pneumococcal vaccines to patients older than 65 years of age C.Teach a patient the importance of adequate nutrition and rest D.Wash hands before and after each patient contact
D.Wash hands before and after each patient contact question specifically asks which action is best for the NURSE to take
