Pharmacology Exam 4 PrepU
A child weighing 32 lb (14.5 kg) is to take ferrous sulfate 6 mg/kg/d PO. How many milligrams should the child receive per dose? Record the answer as a whole number.
87
Alendronate (Fosamax) is prescribed for a patient. Which statement made by the patient will indicate to the nurse that further instruction is needed? a) "I can go back to bed as soon as I take this drug." b) "I must wait at least 30 minutes after taking this drug before eating or drinking anything." c) "I will take this drug with a full glass of water." d) "I will immediately report any upper abdominal pain or heartburn."
a) "I can go back to bed as soon as I take this drug."
A client is undergoing chemotherapy for vulvar cancer. The client had a friend who died after treatment, which has caused severe anxiety and fear; the client is constantly tired and sees this as an indication she won't survive. The nurse knows that the client is scheduled for immunostimulant drug therapy to support the hematopoietic system. The nurse would include which statement to explain the action of drug? a) "Taking immunostimulants to stimulate the production of blood cells will help you feel better." b) "Chemotherapy makes you feel tired, but leave it to us to make you feel better." c) "I understand your depression; cancer can be hard to deal with." d) "Chemotherapy kills cancer cells but doesn't affect blood cells. I will discuss this with your health care provider."
a) "Taking immunostimulants to stimulate the production of blood cells will help you feel better."
The nurse is caring for a patient newly diagnosed with multiple sclerosis. The patient asks why MS is called an autoimmune disease. What would be the nurse's best response? a) "The body attacks its own cells because it responds to specific self-antigens to produce antibodies." b) "The body responds to a cell invaded by bacteria with antibody production against similar cells." c) "Production of autoantibodies is a normal process that goes on all the time, but immunosuppression limits B-cell response." d) "People with multiple sclerosis have a genetic predisposition to destroy autoantibodies."
a) "The body attacks its own cells because it responds to specific self-antigens to produce antibodies."
The nurse is evaluating an electrocardiogram (ECG) of a client in the emergency department. What does the nurse analyze on the ECG that might indicate a serum calcium level greater than 10.5 mg/dL? a) A shortened Q-T interval and inverted T wave b) Frequent premature atrial contractions c) A peaked T wave d) A prolonged P-R interval and missing ventricular beats
a) A shortened Q-T interval and inverted T wave
A nurse is preparing to administer epoetin alfa to a client. The nurse expects to see which diagnos(es) for the basis of this treatment? Select all that apply. a) Anemia of chronic kidney disease b) Iron deficiency anemia c) Vitamin B12 deficiency anemia d) Anemia caused by cancer chemotherapy e) Anemia caused be zidovudine therapy
a) Anemia of chronic kidney disease d) Anemia caused by cancer chemotherapy e) Anemia caused be zidovudine therapy
The nurse is reviewing the client's medication history. The client is to receive ibandronate. Which supplements would the nurse identify as possibly interfering with the drug's absorption? (Select all that apply.) a) Antacids b) Iron c) Calcium d) Multiple vitamins e) Aspirin
a) Antacids b) Iron c) Calcium d) Multiple vitamins
A nurse's assessment of a client has revealed signs and symptoms of Paget's disease. Which of the following is one of the signs the nurse may have observed? a) Bone deformity b) Nearsightedness c) Shuffling gait d) Decreased pain response
a) Bone deformity
A 45-year-old male client is scheduled for renal dialysis. He develops hypercalcemia. The health care provider orders a calcium-free solution for his dialysis treatments. What would the provider order to prevent hyperphosphatemia? a) Calcium acetate b) Calcium and vitamin D c) Vitamin D d) Magnesium
a) Calcium acetate
The following are examples of calcium and vitamin D preparations. Which of them are oral preparations for calcium supplementation? Choose all that apply. a) Calcium acetate (PhosLo) b) Calcium carbonate (Os-Cal, Tums) c) Calcium citrate (Citracal) d) Calcium chloride e) Calcitriol (Rocaltrol)
a) Calcium acetate (PhosLo) b) Calcium carbonate (Os-Cal, Tums) c) Calcium citrate (Citracal)
The client is a woman 65 years of age being treated for anemia secondary to chronic kidney disease. The nurse explains to the client that she will be getting a prescription for Epogen. Which of the following additional information would the nurse provide? a) Chronic kidney disease slows the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia. b) Chronic kidney disease stimulates the production of red blood cells causing anemia. Epogen slows the production of red blood cells to cause anemia. c) Chronic kidney disease has no affect on the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia. d) Chronic kidney disease has an affect on the production of red blood cells causing anemia. Epogen minimizes the effect on the production of red blood cells to cause anemia.
a) Chronic kidney disease slows the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia.
While studying the T- and B-cell immune suppressors, the nursing students learn that the most commonly used immune suppressant is: a) Cyclosporine . b) Azathioprine (Imuran). c) Pimecrolimus . d) Glatiramer (Copaxone).
a) Cyclosporine
A client has sought care because of seasonal allergies that are having a negative effect on the client's quality of life. The nurse should recognize the role of what immunoglobulin in this client's health problem? a) IgE b) IgG c) IgM d) IgA
a) IgE
In an allergic reaction, the immunoglobulin that binds to mast cells that release histamine is the: a) IgE. b) IgA. c) IgG. d) IdD.
a) IgE.
The nurse is caring for a 77-year-old client and understands that calcium deficiency commonly occurs in the elderly because of what factors? (Select all that apply.) a) Impaired absorption of calcium from the intestine b) Excessive exposure to ultraviolet rays c) Lack of exposure to sunlight d) Impaired liver or kidney metabolism of vitamin D d) Excessive intake of sodium
a) Impaired absorption of calcium from the intestine c) Lack of exposure to sunlight d) Impaired liver or kidney metabolism of vitamin D
A recent transplant client is prescribed enzyme-inhibiting drugs by the health care provider. The client is also prescribed tacrolimus. What could be the result of this drug combination? a) Increased blood levels b) Decreased blood levels c) Drug-induced diabetes mellitus d) Drug-induced liver failure
a) Increased blood levels
Calcium preparations can be given by two different routes. Which of the following are those routes? a) Intravenous b) Oral c) Intradermal d) Subcutaneous e) Intramuscular
a) Intravenous b) Oral
A nurse has been assigned to a 43-year-old man who is to receive epoetin alfa therapy. The patient is HIV-positive and has anemia related to zidovudine therapy. The nurse will monitor: a) Iron levels b) Chemotherapy c) Renal failure d) Swelling of veins
a) Iron levels
The nurse is caring for a client with a possible calcium deficiency and reads the client's history to see if the client has experienced which common reasons for calcium deficiency? (Select all that apply.) a) Long-term dietary deficiencies of calcium and vitamin D b) Impaired absorption of calcium from the intestine c) Lack of exposure to sunlight d) Overexposure to ultraviolet rays e) Chronic use of ampicillin
a) Long-term dietary deficiencies of calcium and vitamin D b) Impaired absorption of calcium from the intestine c) Lack of exposure to sunlight
A client has developed a wound infection and leukocytes are leaving the bloodstream to perform phagocytosis on pathogens. What white cells are most likely performing this function? a) Neutrophils b) Basophils c) Eosinophils d) Monocytes
a) Neutrophils
Which are the three hormones/vitamins that regulate calcium and bone metabolism? a) Parathyroid hormone (PTH) b) Calcitonin c) Vitamin D d) Thyroid-stimulating hormone (TSH) e) Vitamin B12
a) Parathyroid hormone (PTH) b) Calcitonin c) Vitamin D
Mycophenolate mofetil is being considered in the treatment of a 39-year-old female transplant recipient. Before the initiation of therapy, the nurse must assess the client for what information to ensure safety? a) Pregnancy status b) history regarding depression c) response to a cardiac nonstress test d) social support network
a) Pregnancy status
The anemia that occurs with chronic renal failure is caused by the kidneys themselves. What inability of the kidneys causes anemia in chronic renal failure? a) Produce erythropoietin b) Produce rennin c) Produce angiotensin d) Inactivate vitamin D
a) Produce erythropoietin
For what purpose would the nurse administer postoperative epoetin alfa to the client who is a Jehovah's Witness? a) Reduce the need for allogenic blood transfusion b) Treatment of anemia associated with chronic renal failure c) Treatment of HIV infection d) To prevent the need for chemotherapy
a) Reduce the need for allogenic blood transfusion
The nurse is caring for a patient with chronic kidney disease who is receiving epoetin alfa. Which assessment finding would be of greatest concern for the nurse? a) Reports of calf pain on dorsiflexion of the foot b) A rash under the breast c) 1 pound weight gain in 1 week d) Dry, nonproductive cough
a) Reports of calf pain on dorsiflexion of the foot
You are caring for a patient with a serum calcium level of 8.1 mEq/dL. Which of the following assessment data would you expect to find after your examination? Choose all that apply. a) Reports of tingling around the mouth b) Spasms of the hand muscles c) Seizures d) Lethargy e) Coma
a) Reports of tingling around the mouth b) Spasms of the hand muscles c) Seizures
A client is receiving anakinra for treatment of rheumatoid arthritis. The client is scheduled to have arthroscopic evaluation of the right knee. What is the priority nursing diagnosis for this client after the procedure? a) Risk for infection b) Risk for injury c) Impaired skin integrity d) Acute pain
a) Risk for infection
A female client presents to the emergency department with symptoms and laboratory values indicative of hypercalcemia. What IV solutions would the health care provider order to treat the hypercalcemia? a) Sodium chloride (0.9%) b) D5 1/2 normal saline c) D5 1/4 normal saline d) Lactated Ringer's solution
a) Sodium chloride (0.9%)
Which symptom, if assessed after the administration of epoetin alfa (Epogen), would be cause for alarm? a) The patient displays weakness on one side of the body. b) The patient reports "bone pain." c) The patient is tired. d) The patient states the injection "hurts."
a) The patient displays weakness on one side of the body.
Which of the following are appropriate goals to set with your patient who is suffering from an alteration in calcium levels? Choose all that apply. a) The patient will achieve and maintain normal serum levels of calcium. b) The patient will comply with instructions for safe drug use. c) The patient will decrease dietary intake of calcium-containing foods to prevent or treat osteoporosis. d) The patient will be monitored closely for therapeutic and adverse effects of drugs used to treat hypercalcemia.
a) The patient will achieve and maintain normal serum levels of calcium. b) The patient will comply with instructions for safe drug use. d) The patient will be monitored closely for therapeutic and adverse effects of drugs used to treat hypercalcemia.
A client, diagnosed with chronic renal failure, has begun experiencing increasing shortness of breath. The nurse suspects that the client is experiencing symptoms associated with which resulting condition? a) anemia b) hypoglycemia c) hypertension d) thrombocytopenia
a) anemia
A client admitted to the ICU with gunshot wounds in the chest and thigh is noted to have extensive edema present. Anticipating a generalized reaction to tissue damage, the nurse concludes that the client's edema is the result of what development? a) inflammatory process. b) hypoxia. c) vasoconstriction. d) internal pathogenic control.
a) inflammatory process.
In addition to calcium, what electrolyte affects parathyroid hormone (PTH) secretion? a) magnesium b) sodium c) potassium d) zinc
a) magnesium
What organ provides the control over the amount of calcium in the blood? a) parathyroid glands b) thyroid gland c) pituitary d) kidneys
a) parathyroid glands
A client comes to the clinic asking what erythropoiesis means. The nurse would state that erythropoiesis is the process of making: a) red blood cells. b) white blood cells. c) stem cells. d) platelets.
a) red blood cells.
Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to: a) stand or sit upright for at least 30 minutes after taking alendronate. b) avoid drinking water with the drug. c) lift weights in the gym at least five times a week. d) take calcium and vitamin D supplements.
a) stand or sit upright for at least 30 minutes after taking alendronate.
A client, currently prescribed epoetin alfa, has recent blood work that reveals a hemoglobin level of 12.8 g/dL. What action does this assessment finding necessitate regarding the epoetin alfa? a) temporarily withholding administration b) administering an unscheduled dose c) changing the route of administration d) requesting a change in the dosage
a) temporarily withholding administration
Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse's following assessment questions most directly addresses a common adverse effect of filgrastim? a) "Have you noticed any bleeding in your gums or cheeks?" b) "Do you feel like you're having any pain in your bones?" c) "Are you experiencing any waves of cool, clammy skin?" d) "Have you had any shortness of breath lately?"
b) "Do you feel like you're having any pain in your bones?"
Ms. Ziem is prescribed filgrastim. The nurse provides education to Ms. Ziem about this therapy. Which statement would indicate the patient understood the teaching? a) "Filgrastim will be discontinued when the neutrophil count drops unexpectedly." b) "I will avoid crowds and people with illnesses." c) "Filgrastim will be discontinued to prevent excessively high neutrophil counts." d) "I will never refrigerate the drug."
b) "I will avoid crowds and people with illnesses."
You are precepting a nursing student and together you are caring for a patient who is to receive interleukins. The student nurse asks you what happens physiologically when a patient receives interleukins. What would be your best response? a) "It really helps the patient!" b) "The patient has increases in the number of natural killer cells." c) "The patient has decreased cytokine activity." d) "The patient gets really sick from flu-like symptoms and then gets better."
b) "The patient has increases in the number of natural killer cells."
A female nursing student is diagnosed with rheumatoid arthritis. What is the probable cause of her rheumatoid arthritis? a) Injury b) Abnormal immune response c) Overuse of NSAIDs d) Overuse of acetaminophen
b) Abnormal immune response
A patient with chronic renal failure receiving epoetin alfa will be having a total left hip arthroplasty. What supplementation should the patient receive prior to surgery? a) A protein supplement b) An iron supplement c) A blood transfusion d) A folic acid supplement
b) An iron supplement
A patient has an elevated white blood cell (WBC) count. What is the nurse's primary action related to this finding? a) Assess the patient for exposure to antigens. b) Assess the patient for other signs of infection. c) Protect the patient from other sources of infection. d) Place the patient in protective isolation.
b) Assess the patient for other signs of infection.
The home care nurse is caring for a client who is self-administering epoetin. What assessment is most important for the nurse to complete during the visit? a) Pulse b) Blood pressure c) Temperature d) Respirations
b) Blood pressure
A home care nurse is caring for a 70-year-old female client who has been diagnosed with osteoporosis. When developing a plan of care for this client, the nurse should include measures to prevent what complication of the disease? a) Low estrogen levels b) Bone fracture c) Hypocalcemia d) Bone hardening
b) Bone fracture
The nurse should review which lab result before advising a client about taking the first dose of ibandronate (Boniva)? a) Potassium b) Calcium c) Glucose d) Magnesium
b) Calcium
A client who is taking tetracycline has been prescribed a calcium supplement. What guidance should the nurse include in medication teaching? a) Calcium enhances the effectiveness of tetracycline. b) Calcium should be taken at least 2 hours before or after taking tetracycline. c) Calcium presents no considerations associated with tetracycline therapy. d) Calcium and tetracycline should be taken 4 to 6 hours after meals to prevent toxicity.
b) Calcium should be taken at least 2 hours before or after taking tetracycline.
A nurse determines a nursing diagnosis of constipation is appropriate for a client receiving iron supplements. Which suggestion would be appropriate for the nurse to recommend to the client to promote resolution of this problem? a) Increase the intake of milk and dairy products. b) Consume a diet high in fiber. c) Take antacids after consuming meals. d) Perform vigorous exercises.
b) Consume a diet high in fiber.
The nurse is caring for a client who would like to increase her phosphorus intake. The nurse instructs the client to increase the amount of what foods that are high in phosphorus? a) Apples b) Dairy products c) Tomatoes d) Potatoes
b) Dairy products
A nurse is to use a single-dose 1 mL vial to administer 0.5 mL of epoetin alfa to a 39-year-old woman who is being treated for chemotherapy-induced anemia. Which of the following will the nurse do with the unused portion of the drug? a) Refrigerate the medication for a future use. b) Discard the unused portion of the drug. c) Store the medication in the drug cart for the next dose. d) Put the medication in the freezer compartment of the refrigerator.
b) Discard the unused portion of the drug.
A client has chronic renal failure. As the disease progresses, the client is experiencing increasing shortness of breath, due to anemia. The nurse would anticipate which medication order? a) Penicillin b) Epoetin alfa c) Filgrastim d) Interferon gamma
b) Epoetin alfa
During recovery from a gastrointestinal bleed, a client has been prescribed an iron preparation. Prior to beginning therapy, what assessment should the nurse prioritize? a) White cell differential b) Hematocrit and hemoglobin c) Aspartate transaminase levels d) Serum creatinine levels
b) Hematocrit and hemoglobin
The nurse administers teriparatide (Forteo) and evaluates the drug as effective in achieving desired effects when what is assessed? a) Increase in serum calcium and phosphorous b) Increase in serum calcium and decrease in serum phosphorous c) Decrease in serum calcium and phosphorous d) Decrease in serum calcium and increase in serum phosphorous
b) Increase in serum calcium and decrease in serum phosphorous
The pharmacology class learns that epoetin alfa is an immunosuppressant drug that is designed to have what expected outcome? a) Decreased RBC count b) Increased RBC count c) Increased WBC count d) Decreased WBC count
b) Increased RBC count
A nurse administers erythropoietin. What assessment finding is attributable to the increased effect of this hormone? Select all that apply. a) Increased urinary output b) Increased red blood cell count c) Decreased oxygenation in the bloodstream d) Increased hemoglobin e) Anemia
b) Increased red blood cell count d) Increased hemoglobin
The nurse is caring for a client whose diabetic nephropathy has resulted in anemia. What is the cause of this client's anemia? a) Low serum iron levels b) Low erythropoietin levels c) Inadequate oxygenation of tissue d) Lack of B12 and folic acid intake
b) Low erythropoietin levels
The nurse is discussing the use of corticosteroids with a group of nursing students and tells that students that both men and women who take corticosteroids are at risk for what side effect? a) Infertility b) Osteoporosis c) Hypertension d) Paget's disease
b) Osteoporosis
A male client is prescribed interferon. What is his probable diagnosis? a) Hypertension b) Viral hepatitis c) Sepsis d) Bacteremia
b) Viral hepatitis
The nurse is providing education to a client who is taking calcium for the treatment of osteopenia. What is the rationale for the nurse suggesting that the client limit whole grains in the diet? a) Whole grains contain insufficient amounts of needed calcium. b) Whole grains are known to interfere with calcium absorption. c) Whole grains interact with calcium and increase serum phosphate levels. d) Whole grains increase the client's risks of adverse effects when taking calcium supplements.
b) Whole grains are known to interfere with calcium absorption.
While reviewing a client's the record, the nurse sees that the client received a dose of interferon alpha-2b? For what disorder does the nurse suspect the client was being treated? a) asthma b) chronic hepatitis C c) bacterial pneumonia d) ankylosing spondylosis
b) chronic hepatitis C
The nurse improves client compliance with the drug regimen of epoetin alfa by: a) providing the client with an appointment card for each drug administration day. b) helping the client set up a reminder system for days when the drug is to be administered. c) arranging a referral for community transportation. d) having the client pharmacy contact the client on days when the drug should be administered.
b) helping the client set up a reminder system for days when the drug is to be administered.
A nurse is providing patient education to a 45-year-old man who is taking cyclosporine (Sandimmune). The nurse will provide the patient with education related to one of the most common and severe adverse effects of cyclosporine, which is: a) hyperthyroidism. b) nephrotoxicity. c) gastritis. d) cardiac effects.
b) nephrotoxicity.
A client receiving chemotherapy has a low white blood cell count. For which reason will the nurse provide the client with filgrastim as prescribed? a) treat nausea b) prevent infection c) improve appetite d) prevent stomatitis
b) prevent infection
The first physical line of defense in innate immunity is: a) plasma proteins. b) skin and mucous membranes. c) specialized lymphocytes. d) neutrophils.
b) skin and mucous membranes.
A client diagnosed with iron deficiency has been taking oral ferrous sulfate for the past several days. When the nurse is assessing for therapeutic effects, what question is most warranted? a) "Is your skin feeling itchy when you're at rest?" b) "Are you having any leg spasms or restless legs at night?" c) "How is your energy level compared with a few days ago?" d) "Do you feel like you're able to see a bit more clearly now?"
c) "How is your energy level compared with a few days ago?"
The nurse is caring for a client with a WBC of 700 cells/mm3. Which discharge instruction is most important for the nurse to share with this client? a) "Go for a walk in the mall everyday to increase your endurance." b) "Eat foods rich in iron to increase your energy level." c) "Stay out of crowded places such as grocery stores." d) "Watch for signs of excessive bruising."
c) "Stay out of crowded places such as grocery stores."
A client who has recently been diagnosed with HIV is waiting for the results of lab work to determine their T-cell count. How should the nurse best explain a T cell to the client? a) "T cells are monocytes, which are a type of white blood cell that helps to fight off infections and other foreign bodies that enter the body." b) "T cells are neutrophils, which are a type of white blood cell that helps to fight off infections and other foreign bodies that enter the body." c) "T cells are lymphocytes, which are a type of white blood cell that helps to fight off infections and other foreign bodies that enter the body." d) "T cells are basophils, which are a type of white blood cell that helps to fight off infections and other foreign bodies that enter the body."
c) "T cells are lymphocytes, which are a type of white blood cell that helps to fight off infections and other foreign bodies that enter the body."
A nurse is discussing nutrition with a group of older adults at a community senior center. The nurse informs the group that the recommended daily calcium intake is: a) 1500-2000 mg b) 750-1250 mg c) 1000-1500 mg d) 2000-2500 mg
c) 1000-1500 mg
Which patient will be at the greatest risk for anemia and be the most likely candidate for epoetin alfa therapy? a) A 20-year-old female b) A 30-year-old pregnant woman c) A 62-year-old male with cancer d) A 40-year-old male with a high white blood cell count
c) A 62-year-old male with cancer
The nurse elicits a positive Chvostek sign when tapping on the facial nerve. What action by the nurse is a priority after this assessment is complete? a) Assess the client's level of thyroid hormone. b) Assess the client's sodium level for hyponatremia. c) Assess the client's calcium level for hypocalcemia. d) Assess the client's potassium level for hypokalemia.
c) Assess the client's calcium level for hypocalcemia.
The client has taken epoetin alfa (Epogen) with good results for several months. On this visit, the nurse analyzes the client's lab results and finds indications of severe anemia and cytopenia. What order will the nurse anticipate receiving? a) Increase the dosage of Epogen. d) Change the client to another erythropoiesis-stimulating agent. c) Discontinue Epogen. d) Begin administering Epogen IV instead of subcutaneously.
c) Discontinue Epogen.
A nurse is preparing to administer iron dextran to a client. The nurse will obtain which information on the preadministration assessment to calculate the drug dosage? a) Client's age b) Client's height c) Hemoglobin level d) Platelet count
c) Hemoglobin level
What is the best position for the client after the administration of a bisphosphonate medication? a) Supine b) Prone c) High Fowler's d) Lateral recumbent
c) High Fowler's
Several nursing students are reviewing information about osteoporosis in preparation for a class discussion. The students demonstrate a need for additional review when they state that which of the following is a risk factor? a) Excess caffeine intake b) Prolonged corticosteroid use c) Hypothyroidism d) Sedentary lifestyle
c) Hypothyroidism
The nurse has just admitted a client to the unit who is newly diagnosed with Kaposi's sarcoma. The health care provider has order an IV infusion of an interferon. What drug has the provider ordered? a) Interferon beta-1a b) Interferon gamma-1b c) Interferon alfa-2b d) Peginterferon alfa-2b
c) Interferon alfa-2b
Adverse effects of epoetin and darbepoetin include increased risks of what condition? a) Hyperlipidemia b) Diabetes mellitus type 2 c) Myocardial infarction d) Cirrhosis of the liver
c) Myocardial infarction
A patient who is receiving an immune modulator has been admitted to the unit. What would be a priority action by the nurse? a) Monitor nutritional status. b) Provide patient teaching regarding the drug. c) Protect the patient from exposure to infection. d) Provide support and comfort measures in relation to adverse effects of the drug.
c) Protect the patient from exposure to infection.
A client has been prescribed epoetin alfa. What assessment finding may suggest that the drug is contraindicated? a) The client takes bupropion for the treatment of depression. b) The client frequently has loose stools. c) The client's blood pressure is 161/107 mm Hg. d) The client is short of breath on exertion.
c) The client's blood pressure is 161/107 mm Hg.
A client taking epoetin alfa requests changing the medication from the subcutaneous route to the PO route. How should the nurse respond? a) The oral route is not as effective. b) The drug dose must be increased if being given via the oral route. c) This medication is destroyed in the stomach and can only be given by injection. d) This medication causes severe diarrhea if given orally.
c) This medication is destroyed in the stomach and can only be given by injection.
Which statement reflects the relationship between calcium and phosphate? a) There is no relationship with calcium and phosphate. b) When there is an increase in calcium, the phosphate is elevated. c) When there is an increase in calcium, the phosphate is decreased. d) When there is a decrease in calcium, the phosphate is decreased.
c) When there is an increase in calcium, the phosphate is decreased.
A client diagnosed with excessive parathyroid production is prone to develop: a) Alzheimer's disease. b) hypertension. c) osteopenia. d) heart disease.
c) osteopenia.
The nurse is caring for a client who takes alendronate. What laboratory result best demonstrates successful treatment? a) serum iodine 515 nmol/L (65.3 µg/L) b) free thyroxine 22 pmol/L (1.7 ng/dL) c) serum calcium 2.45 mmol/L (9.8 mg/dL) d) thyrotropin 3.1 mIU/L (3.1 mIU/L)
c) serum calcium 2.45 mmol/L (9.8 mg/dL)
The nurse is preparing a teaching tool on the action of calcium preparations. The nurse will identify that calcium is absorbed through which body area? a) mouth b) stomach c) small intestine d) large intestine
c) small intestine
A 56-year-old client, discharged from the hospital following a successful kidney transplant, is prescribed antirejection drug therapy. When performing health education with the client and the client's family, which topic should the nurse emphasize? a) the safe use of any required assistive devices b) strategies for reducing the client's risk of infection c) strategies for managing the client's energy and activity levels d) the role of nutrition in health maintenance and the prevention of rejection
c) strategies for managing the client's energy and activity levels
A home care nurse is caring for a client who has received a liver transplant. The nurse is reinforcing earlier teaching about the client's immunosuppressant therapy and the need for appropriate self-care. Which client statement suggests that the client understands? a) "I should stop taking these drugs if I get sick." b) "I need to take these drugs until my prescription runs out." c) "I'm at risk for infection until my body accepts my new liver." d) "I will always be at risk for serious infection."
d) "I will always be at risk for serious infection."
A nurse administers filgrastim to a client who is also prescribed chemotherapy. The nurse monitors the client's absolute neutrophil count (ANC) and anticipates stopping the drug when the ANC reaches which level? a) 2500/mm3 b) 5000/mm3 c) 7500/mm3 d) 10,000/mm3
d) 10,000/mm3
What ordered dosage for epoetin alfa (Procrit) could the nurse administer without needing to question the order? a) 0.45 mcg/kg IV once per week b) 1 mg/d IM c) 100 mg/d PO d) 100 units/kg subcutaneously three times per week
d) 100 units/kg subcutaneously three times per week
The nurse would contact the prescriber immediately if interferon was prescribed for which client? a) 34-year-old male with chronic hepatitis B b) 48-year-old female with hepatitis C c) 72-year-old male with AIDS-related Kaposi's sarcoma d) 11-month-old female with HIV acquired from her mother
d) 11-month-old female with HIV acquired from her mother
The nurse is caring for a client who is being monitored for hypercalcemia. The nurse understands that what calcium level is considered a medical emergency? a) 8.5 mg/dL b) 9.0 mg/dL c) 10.5 mg/dL d) 12 mg/dL
d) 12 mg/dL
The pharmacology instructor is talking about interferon. The instructor explains that agents such as interferons have more than one biologic function. What function is NOT associated with interferons? a) Immunomodulatory b) Antiviral c) Antiproliferative d) Antibacterial
d) Antibacterial
The nurse is caring for a client who had a postpartum hemorrhage 2 weeks ago that resulted in anemia. The client has called the clinic after passing dark stools, stating, "I looked this up online, and I'm worried I might have stomach or intestinal bleeding." What is the nurse's best initial action? a) Assess whether the client was given erythropoietin. b) Ask the client is she knows how much blood she lost postpartum. c) Assess the client's usual bowel pattern. d) Ask the client whether she is taking iron supplements.
d) Ask the client whether she is taking iron supplements.
A 44-year-old man has come to the clinic with an asthma exacerbation. He tells the nurse that his father and brother also suffer from asthma, as does his 15-year-old son. The nurse explains that this is an allergic response based on a genetic predisposition. The specific allergen initiated by immunological mechanisms is usually mediated by immunoglobulin: a) A. b) M. c) G. d) E.
d) E.
A female client presents to the health care provider's office for a routine physical examination. The nurse assesses her current over-the-counter drug history and discovers that she takes vitamin D 600 international units daily. The nurse recognizes that the client is at risk for what condition? a) Paget's disease b) Hypocalcemia c) Hypocalciuria d) Hypercalcemia
d) Hypercalcemia
A patient is diagnosed with hypercalcemia. The nurse knows that which statement regarding hypercalcemia is correct? a) Hypercalcemia can be the result of vitamin D deficiency. b) Hypercalcemia can be caused by administration of cisplatin (Platinol). c) Hypercalcemia causes twitching of facial muscles. d) Hypercalcemia can lead to calcium deposits that damage the kidneys.
d) Hypercalcemia can lead to calcium deposits that damage the kidneys.
The nurse knows that phosphates should be given only when hypercalcemia is accompanied by hypophosphatemia. Hypophosphatemia is assumed when the serum phosphorus is less than what level? a) Less than 5 mg/dL b) Less than 10 mg/dL c) Less than 4 mg/dL d) Less than 3 mg/dL
d) Less than 3 mg/dL
A client presents to the emergency department with a swollen, reddened, painful leg wound and has been diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) cellulitis. The health care provider has ordered a complete blood count and white cell differential. Which blood components would the provider most likely anticipate to be elevated? a) Basophils b) Eosinophils c) Platelets d) Neutrophils
d) Neutrophils
What is an adverse effect of excessive immunosuppression? a) Graft-versus-host disease b) Respiratory depression c) Graft rejection d) Serious infection
d) Serious infection
The nurse is evaluating the effectiveness of treatment for a client diagnosed with hypocalcemia. What outcome does the nurse assess that would indicate treatment has been effective? a) The client will have a urine output of 30 mL/hr. b) The client reports relief of chest pain and left jaw pain. c) The client has a temperature in the normal range. d) The client reports a decrease in muscle spasms and decreased paresthesia.
d) The client reports a decrease in muscle spasms and decreased paresthesia.
The nurse is caring for four clients. Which client is at the highest risk for osteoporosis? a) The client receiving diuretic therapy b) The client with a diagnosis of renal hypertension c) The client with frequent falls d) The female client aged 76
d) The female client aged 76
A 79-year-old woman with a medical history that includes osteoporosis has recently moved to a long-term care facility. Medication reconciliation indicates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is a) subcutaneous. b) intramuscular. c) intravenous. d) intranasal.
d) intranasal.
