Practice exam 2

A client tells the nurse that he is having nausea and decreased appetite during drug therapy with a tetracycline antibiotic. Which statement is the nurse's best advice to the patient? "Take it with cheese and crackers or yogurt." "Take each dose with a glass of milk." "Take an antacid with each dose as needed." "Drink a full glass of water with each dose."

Drink a full glass of water with each dose

When giving dextromethorphan, the nurse understands that this drug suppresses the cough reflex by which mechanism of action? Having direct action on the cough center Causing depression of the central nervous system Decreasing the viscosity of the bronchial secretions Anesthetizing the stretch receptors

Having direct action on the cough center

Before beginning a client's medication therapy with levodopa for Parkinson disease, it is important for the nurse to determine if the client takes what medication? Corticosteroids Monoamine oxidase inhibitors (MAOIs) Diuretics Bronchodilators

MAOIs

A client is receiving the third intravenous dose of a penicillin drug. The client calls the nurse to report that he is feeling "anxious" and is having trouble breathing. What will the nurse do first? Call for the Rapid Response team Stop the antibiotic infusion. Take the patient's vital signs. Notify the prescriber.

Stop the antibiotic infusion

A client with schizophrenia has been started on medication therapy with clozapine. The nurse would assess the results of which laboratory study in order to monitor for adverse effects from this medication? Liver enzymes Blood glucose level Platelet count White blood cell count

WBC (can dec WBC and can cause agranulocytosis)

A client is diagnosed with herpes simplex virus type 1 (HSV 1). The primary health care provider prescribes a topical medication for treatment. The nurse anticipates that which medication will be prescribed? Mupirocin calcium Acyclovir Gentamicin sulfate Salicylic acid

acyclovir

A client is in an urgent care center with an acute asthma attack. The nurse expects that which medication will be used for initial treatment? Ipratropium Fluticasone Salmeterol Albuterol

albuterol

A client is newly diagnosed with Parkinson's disease and is prescribed benztropine.. What is an important for the nurse to discuss with the client. Limit the amount of protein to only the palm of the hand. Avoid caffeine-containing products Taking vitamin B6 with each dose The need to avoid hot weather.

avoid hot weather

A client asks the nurse about the uses of echinacea. Which use will the nurse include in the response? Boosting the immune system Improving mood Promoting relaxation Memory enhancement

boosts immune system

A client is infected by invasive aspergillosis, and the medical history reveals that the patient has not been able to tolerate several antifungal drugs. The nurse anticipates an order for which medication to treat this infection? Fluconazole Nystatin Caspofungin Micafungin

caspofungin

A client has been started on long-term therapy with rifampin. The nurse would provide which information to the client about the medication? Would be double-dosed if one dose is forgotten May be discontinued independently if symptoms are gone in 3 months Would always be taken with food or antacids Causes orange discoloration of sweat, tears, and urine

causes orange discoloration of sweat, tears, urine

When reviewing the allergy history of a client, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics? Cephalosporins Quinolones Tetracyclines Sulfonamides

cephalosporins

The nurse is caring for a client with a urinary tract infection (UTI). The culture report reveals the presence of Pseudomonas aeruginosa. The nurse anticipates that which medication will be prescribed to treat the infection? Ciprofloxacin Isoniazid Rifampin Ethambutol

ciprofloxacin (others are tuberculosis)

A client has begun therapy with theophylline. The nurse would teach the client to limit the intake of which items while taking this medication? Cottage cheese, cream cheese, and dairy creamers Coffee, cola, and chocolate Oysters, lobster, and shrimp Melons, oranges, and pineapple

coffee, cola, chocolate (caffeine)

An infant in the neonatal intensive care unit (NICU)is receiving a ribavirin (Virazole) aerosol treatment. Which precaution is important for the pregnant health care provider? Wearing a mask while in the room during the treatment. Limiting exposure to the aerosol treatment to a maximum of 15 minutes per shift. Staying out of the room during the aerosol treatment. No special precautions are needed.

staying out of the room during the aerosol treatment

A client has a urinary tract infection. The nurse knows that which class of drugs is especially useful for such infections? Macrolides Sulfonamides Tetracyclines Carbapenems

sulfonamides

During antibiotic therapy, the nurse will monitor closely for signs and symptoms of a hypersensitivity reaction. Which of these assessment findings may be an indication of a hypersensitivity reaction? (Select all that apply.) Swelling of the tongue Black, hairy tongue Itching Shortness of breath Wheezing Diarrhea

swelling of the tongue, itching, SOB, wheezing (diarrhea is C.Diff and irritation of stomach not hypersensitivity)

A client has a prescription to take guaifenesin. The nurse would conclude that the client understands the most effective use of this medication if the client states the need to take which action? Crush the sustained-release tablet if immediate relief is needed. Watch for irritability as a side effect. Take the tablet with a full glass of water. Take an extra dose if the cough is accompanied by fever.

take the tablet with a full glass of water

The client who has been receiving haloperidol on a long-term basis begins to exhibit bizarre facial and tongue movements. Based on these nursing assessment findings, the client is most likely exhibiting signs and symptoms of which disorder? Tardive dyskinesia Cholinergic crisis Akathisia Oculogyric crisis

tardiva dyskinesia

A client receiving a dose of intravenous vancomycin begins to experience chills, tachycardia, syncope, and flushing of the face and trunk. What is the nurse's best interpretation of these findings? The medication has interacted with another medication the client is receiving. The medication is infusing too rapidly. The client is experiencing upper airway obstruction. The client is allergic to the medication.

the med is infusing too rapidly

A client asks the nurse, "Which herbal supplement can help me sleep at night?" Which supplement would the nurse suggest? Garlic Valerian Turmeric Echinacea

valerian

A client who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for therapy? Vancomycin Metronidazole Tobramycin Ciprofloxacin

vancomycin

The nurse is preparing to administer piperacillin/tazobactam. An abnormal elevation in which laboratory value would prompt the nurse to withhold the medication and notify the primary health care provider (PHCP) before administering the medication? Blood urea nitrogen and creatinine Prothrombin time and partial thromboplastin time Aspartate aminotransferase and alanine transaminase (ALT and AST) Hematocrit and hemoglobin

BUN and creatinine

The nurse is reading the laboratory results for a client being treated with carbamazepine for prophylaxis of complex partial seizures. When evaluating the client's laboratory data, the nurse determines that which value is consistent with a side or adverse effect of this medication? Platelet count, 350,000 mm3 Sodium level, 136 mEq/L Blood urea nitrogen (BUN), 19 mg/dL White blood cell count, 3200 mm3

WBC count 3200 (normal 4500-11000)

The nurse is assessing the chart of a client who has been prescribed aminoglycoside therapy. Which problem may occur in a client who has started aminoglycoside therapy? Gynecomastia Renal damage Constipation Leukocytosis

renal damage

An infant has been hospitalized with a severe lung infection caused by the respiratory syncytial virus (RSV) and will be receiving medication via the inhalation route. The nurse expects which drug to be used? Amantadine Ganciclovir Acyclovir Ribavirin

ribavirin

When obtaining a health history, the nurse expects a client with a recent diagnosis of Parkinson disease to report which sign or symptom? Depression Slowness of movement Weight loss Continual motor tremors

slowness of movement

The nurse is providing teaching to a client taking an oral tetracycline antibiotic. Which statement by the nurse is correct? "Milk and cheese products result in increased levels of tetracycline." "Antacids taken with the medication help to reduce gastrointestinal distress." "Take the medication until you are feeling better." "Avoid direct sunlight and tanning beds while on this medication."

Avoid direct sunlight and tanning beds while on this medication

The nurse is monitoring a client with herpes simplex virus (HSV) who is receiving intravenous (IV) acyclovir. Which laboratory result would be of concern as a possible adverse effect of this medication? -Platelet count of 300,000 mm3 -Prothrombin time of 12 s -Blood urea nitrogen (BUN) of 36 mg/dL -WBC count of 6000 mm3

BUN 36 mg/dL (normal is 8-20)

A client is admitted with a fever of 102.8° F (39.3° C), origin unknown. Assessment reveals cloudy, foul-smelling urine that is dark amber in color. Orders have just been written to obtain STAT urine and blood cultures and to administer an antibiotic intravenously. The nurse will complete these orders in which sequence? Urine culture, antibiotic dose, blood culture Blood and urine cultures, antibiotic dose Blood culture, antibiotic dose, urine culture Antibiotic dose, blood and urine cultures

Blood and urine cultures, antibiotic dose

A client has been given a prescription for levodopa-carbidopa for a new diagnosis of Parkinson's disease. The client asks the nurse, "Why are there two drugs in this pill?" The nurse's best response reflects which fact? arbidopa is the biologic precursor of dopamine and can penetrate into the central nervous system. There are concerns about drug-food interactions with levodopa therapy that do not exist with the combination therapy. Carbidopa prevents the breakdown of levodopa in the periphery. Carbidopa allows for larger doses of levodopa to be given.

Carbidopa prevents the breakdown of levodopa in the periphery

A young adult calls the clinic to ask for a prescription for "that new flu drug." He says he has had the flu for almost 4 days and just heard about a drug that can reduce the symptoms. What is the nurse's best response to his request? "Now that you've had the flu, you will need a booster vaccination, not the antiviral drug." "We will need to do a blood test to verify that you actually have the flu." "Drug therapy should be started within 2 days of symptom onset, not 4 days." "We'll get you a prescription. As long as you start treatment within the next 24 hours, the drug should be effective."

Drug therapy should be started within 2 days of symptom onset, not 4 days

The nurse checks the client's laboratory work prior to administering a dose of vancomycin and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next? Repeat the test to verify results. Hold the drug, and administer 4 hours later. Administer the vancomycin as ordered. Hold the drug, and notify the prescriber.

Hold the drug and notify the prescriber The reference range for vancomycin trough levels is 10-20 mcg/mL. The reference range for vancomycin peak levels is 20-40 mcg/mL.

A client is taking guaifenesin as part of treatment for a sinus infection. Which instruction will the nurse include during patient teaching? Report symptoms that last longer than 2 days. Report clear-colored sputum to the prescriber. Increase fluid intake to help loosen and liquefy secretions. Increase fluid intake to help loosen and liquefy secretions.

Increase fluid intake to help loosen and liquefy secretions (Idk why its listed twice as an option)

The nurse is developing a teaching plan for a client receiving clozapine. What is important to include in the teaching plan? Monitor liver function studies monthly and watch for signs of jaundice. Have a monthly electroencephalogram (EEG) and polysomnography (sleep study). Have a follow-up echocardiogram and adenosine stress-test. Monitor white blood cell (WBC) count and differential weekly for first 6 months, then every 2 weeks.

MOnitor WBC count and differential weekly for first 6 months and then every 2 weeks

The nurse is monitoring a client who has been on antibiotic therapy for 2 weeks. Today the client tells the nurse "I have watery diarrhea and abdominal cramps". The client's oral temperature is 101° F (38.3° C). Based on these findings, which conclusion will the nurse draw? The client will need to take a different antibiotic. The client's original infection has not responded to the antibiotic therapy. The client needs to be tested for Clostridium difficile infection. The client is showing typical adverse effects of antibiotic therapy.

Needs to be tested for C.Diff

The nurse is discussing adverse effects of antitubercular drugs with a client who has active tuberculosis. Which potential adverse effect of antitubercular drug therapy should the client report to the prescriber? Reddish-orange urine and stool Numbness and tingling of extremities Gastrointestinal upset Headache and nervousness

Numbness and tingling of extremities

The nurse is counseling a female client who will be starting rifampin as part of antitubercular therapy. The client is currently taking oral contraceptives. Which statement is true regarding rifampin therapy for this client? A higher dose of rifampin will be necessary because of the contraceptive. Oral contraceptives are less effective while the patient is taking rifampin. Women have a high risk for thrombophlebitis while on this drug. The incidence of adverse effects is greater if the two drugs are taken together.

Oral contraceptives are less effective while the patient is taking rifampin

The nurse has a prescription to give a client salmeterol, 2 puffs, and beclomethasone dipropionate, 2 puffs, by metered-dose inhaler. The nurse would administer the medication using which procedure? Salmeterol first and then the beclomethasone. Alternating a single puff of each. beginning with the salmeterol. Alternating a single puff of each, beginning with the beclomethasone. Beclomethasone first and then the salmeterol.

Salmeterol first and then the beclomethasone

A client has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers will the nurse give to the patient? "It does not matter which inhaler you use first." "Take the corticosteroid inhaler first." "Take the bronchodilator inhaler first." "Take these two drugs at least 2 hours apart."

Take the bronchodilator inhaler first

A client is receiving aminoglycoside therapy and will be receiving a beta-lactam antibiotic as well. The client asks why two antibiotics have been ordered. What is the nurse's best response? "We can give a reduced amount of each one if we give them together." "The combined effect of both antibiotics is greater than each of them alone." We have not yet isolated the bacteria, so the two antibiotics are given to cover a wide range of microorganisms." "One antibiotic is not strong enough to fight the infection."

The combined effect of both antibiotics is greater than each of them alone

When reviewing the medication orders for a client who is taking penicillin, the nurse notes that the client is also taking the oral anticoagulant warfarin. What possible effect may occur as the result of an interaction between these drugs? The penicillin will cause the anticoagulant effect of the warfarin to decrease. The warfarin will reduce the anti-infective action of the penicillin. The penicillin will cause an enhanced anticoagulant effect of the warfarin. The warfarin will increase the effectiveness of the penicillin.

The penicillin will cause an enhanced anticoagulant effect

A client newly diagnosed with tuberculosis (TB) has been taking antitubercular drugs for 1 week calls the clinic and is very upset. The client states, "My urine is dark orange! What's wrong with me?" Which response by the nurse is correct? "This is an expected side effect of the medicine. Let's review what to expect." "You will need to stop the medication, and it will go away." "This is not what we usually see with these drugs. Please come in to the clinic to be checked." "It's possible that the TB is worse. Please come in to the clinic to be checked."

This is an expected side effect of the medicine. Let's review what to expect.

A client who has started drug therapy for tuberculosis wants to know how long he will be on the medications. Which response by the nurse is correct? "Drug therapy will last until the symptoms have stopped." "You should expect to take these drugs for as long as 24 months." "Drug therapy will continue until the tuberculosis develops resistance." "You will be on this drug therapy for the rest of your life."

You should expect to take these drugs for as long as 24 months

Which supplies would the nurse obtain for the administration of ribavirin to a hospitalized child with respiratory syncytial virus (RSV)? A mask and pair of goggles An intravenous (IV) pole and hood Intramuscular (IM) syringe and needle Isolation gown and sterile gloves

a mask and a pair of goggles

The health care provider ordered tetracycline for a 5-year-old pediatric client. The nurse questions this prescription for what reason? It is used to treat a wide variety of disease processes. It is classified as a narrow-spectrum antibiotic. It is contraindicated in children younger than 8 years of age. It is identified as safe for use during pregnancy.

contraindicated in children younger than 8 years of age

The nurse is monitoring for therapeutic results of antibiotic therapy in a client with an infection. Which laboratory value would indicate therapeutic effectiveness of this therapy? Decreased white blood cell count Increased red blood cell count Decreased platelet count Increased hemoglobin level

decreased WBC count

When a client is receiving risperidone, the nurse will monitor for which therapeutic effect? Decreased feeling of hopelessness Decreased paranoia and delusions Improved tardive dyskinesia Fewer panic attacks

decreased paranoia and delusions

A client is receiving amphotericin B by the intravenous (IV) route. The nurse determines that the client is having an adverse effect to the medication if which laboratory study result is noted? Lowered hemoglobin and hematocrit Low white blood cell count Elevated serum creatinine Elevated platelet count

elevated serum creatinine

When monitoring clients on antitubercular drug therapy, the nurse knows that which drug may cause a decrease in visual acuity? Ethambutol Rifampin Isoniazid Streptomycin

ethambutol

A client who has undergone a lung transplant has contracted cytomegalovirus (CMV) retinitis. The nurse expects which drug to be ordered for this patient? Acyclovir Ganciclovir Amantadine Ribavirin

ganciclovir

A client with a tracheostomy has difficulty removing excessive, thick mucus from the respiratory tract. The nurse expects that which drug will be ordered to aid in the removal of mucus? Diphenhydramine Dextromethorphan Guaifenesin Benzonatate

guaifenesin (mucinex)

A gardener needs a decongestant because of seasonal allergy problems and asks the nurse whether he should take an oral form or a nasal spray. Which of these is a benefit of orally administered decongestants? Immediate onset Shorter duration A more potent effect Lack of rebound congestion

lack of rebound congestion

A client has been advised to add a nasal spray (an adrenergic decongestant) to treat a cold. The nurse will include which instruction? "Avoid use of this spray if a fever develops." "You won't see effects for at least 1 week." "Avoid use of this spray if a fever develops." "Limit use of this spray to 3 days."

limit use of this spray to 3 days

A client is taking a xanthine derivative as part of treatment for chronic obstructive pulmonary disease. The nurse will assess for which adverse effects associated with the use of xanthine derivatives? Bradycardia Drowsiness Palpitations Diarrhea

palpitations

A provider has ordered cefoxitin intravenous piggyback (IVPB). Prior to administering the first dose, the nurse validates that the client has not had a serious allergic response to which of the following? Sulfa antibiotics Iodine Aspirin Penicillin

penicillin

A client who has been taking isoniazid (INH) has a new prescription for pyridoxine. The client is wondering why she needs this medication. The nurse explains that pyridoxine is often given concurrently with the isoniazid to prevent which condition? Renal failure Steven Johnson Syndrome Peripheral neuropathy Heart failure

peripheral neuropathy

During a physical examination of a child diagnosed with chronic recurrent seizures who is receiving antiepileptic medication, the nurse notes hyperplasia of the gums. Which situation will the nurse suspect? A common side effect of long term phenytoin use An unusual side effect of carbamazepine Caused by poor oral hygiene A common occurrence with chronic recurrent seizures

phenytoin

The nurse is reviewing the medication history of a client who will be taking a sulfonamide antibiotic. During sulfonamide therapy, a significant drug interaction may occur with which of these drugs or drug classes? (Select all that apply.) Antihistamines Phenytoin Warfarin Opioids Oral contraceptives

phenytoin warfarin oral contraceptives

The nurse administering phenytoin, to an older adult client. Knowing that phenytoin has a low therapeutic index, what would the nurse assess for? Increased therapeutic effects Potential adverse drug effects Increased drug response time Potential allergic reactions

potential adverse effects (toxicity)