Practice questions

A patient currently taking sirolimus [Rapamune] tells the nurse that she is starting a very low-fat diet. Which statement by the nurse is the most appropriate? A. "Low-fat diets don't work. You should try a low-carb diet." B. "It is fine to be on a low-fat diet with your medication, as long as you take it with food." C. "If you change the fat content in your regular diet you should check with your prescriber." D. "Diet will not affect your medication, so you can do whatever diet you would like."

.C. "If you change the fat content in your regular diet you should check with your prescriber."

The healthcare provider orders diazepam [Valium] 5 mg IV every 8 hours. The medication available is diazepam [Valium] 5 mg/mL. How many mL will the nurse administer? A. 0.5 mL B. 1 mL C. 1.5 mL D. 2 mL

B. 1 mL

A nurse is teaching a group of nursing students how the CNS adapts to psychotherapeutic medications. Which statement by a nursing student indicates a need for further teaching? A. "Adaptation results in an increased sensitivity to side effects over time." B. "Adaptation can lead to tolerance of these drugs with prolonged use." C. "Adaptation helps explain how physical dependence occurs." D. "Adaptation often must occur before therapeutic effects develop."

A. "Adaptation results in an increased sensitivity to side effects over time."

The nurse is conducting discharge teaching related to a new prescription for phenytoin [Dilantin]. Which statements are appropriate to include in the teaching for this patient and family? (Select all that apply.) A. "Be sure to call the clinic if you or your family notice increased anxiety or agitation." B. "You may have some mild sedation. Do not drive until you know how this drug will affect you." C. "This drug may cause easy bruising. If you notice this, call the clinic immediately." D. "It is very important to have good oral hygiene and to visit your dentist regularly." E. "You may continue to have wine with your evening meals, but only in moderation."

A. "Be sure to call the clinic if you or your family notice increased anxiety or agitation." B. "You may have some mild sedation. Do not drive until you know how this drug will affect you." D. "It is very important to have good oral hygiene and to visit your dentist regularly."

The nurse teaches a patient about benazepril [Lotensin]. Which statement by the patient requires an intervention by the nurse? A. "I use NoSalt (a salt substitute) instead of salt to season foods." B. "I eat sweet potatoes once or twice a week." C. "I drink 4 ounces of prune juice each morning." D. "I like asparagus because it's high in vitamin K."

A. "I use NoSalt (a salt substitute) instead of salt to season foods."

Lovastatin [Mevacor] is prescribed for a patient for the first time. The nurse should provide the patient with which instruction? A. "Take lovastatin with your evening meal." B. "You may take lovastatin without regard to meals." C. "Take this medicine on an empty stomach." D. "Take this medicine before breakfast."

A. "Take lovastatin with your evening meal."

Which instruction would be inappropriate to include in the teaching plan for a patient being started on carbamazepine [Tegretol]? A. "Take the medication with a glass of grapefruit juice each morning." B. "Notify the physician if you are gaining weight or your legs are swollen." C. "Nausea, vomiting, and indigestion are common side effects of carbamazepine." D. "Have liver function tests performed on a routine basis."

A. "Take the medication with a glass of grapefruit juice each morning."

A patient who is taking spironolactone [Aldactone] is prescribed losartan [Cozaar]. The nurse should take which action? A. Assess for symptoms of hyperkalemia. B. Observe for a hypertensive crisis. C. Administer the medications as scheduled. D. Evaluate for first-dose hypotension.

A. Assess for symptoms of hyperkalemia. C. Administer the medications as scheduled.

A patient with multiple sclerosis (MS) is participating in a rehabilitation program. The patient has just been started on baclofen [Lioresal] 5 mg 3 times a day to help manage spasticity. How will the baclofen interfere with rehabilitation activities? A. By producing drowsiness, lethargy, and blurred vision B. By causing gastrointestinal distress C. By reducing sensation in the extremities D. By impairing coordinated movements

A. By producing drowsiness, lethargy, and blurred vision

Cholestyramine has been prescribed for a patient. Which instruction should the nurse include in patient teaching? A. Cholestyramine can impair absorption of fat-soluble vitamins. B. Stop taking the drug if you develop constipation. C. Take cholestyramine with other drugs you are prescribed to enhance absorption. D. Do not take the medication if the formula is cloudy after mixing with water.

A. Cholestyramine can impair absorption of fat-soluble vitamins.

The nurse knows that diuretics mostly affect which function of the kidneys? A. Cleansing and maintenance of extracellular fluid volume B. Maintenance of acid-base balance C. Excretion of metabolic waste D. Elimination of foreign substances

A. Cleansing and maintenance of extracellular fluid volume

A nurse preparing to administer morning medications notes that a patient with a history of hypertension has been prescribed spironolactone [Aldactone]. The nurse assesses the patient and notes dyspnea, bilateral crackles, and pitting edema in both feet. Which intervention is appropriate? A. Contact provider to discuss an order for furosemide [Lasix]. B. Contact the provider to request an order for serum electrolytes. C. Administer the medications as ordered. D. Ask the patient about the use of salt substitutes.

A. Contact provider to discuss an order for furosemide [Lasix]

A nurse is caring for a patient who has been taking an antiepileptic drug for several weeks. The nurse asks the patient if the therapy is effective. The patient reports little change in seizure frequency. What will the nurse do? A. Contact the provider to discuss an order for serum drug levels. B. Ask the patient to complete a seizure frequency chart for the past few weeks. C. Reinforce the need to take the medications as prescribed D. Request an order to increase the dose of the antiepileptic drug.

A. Contact the provider to discuss an order for serum drug levels.

The nurse should monitor for which adverse effect after administering hydrochlorothiazide [HydroDIURIL] and digoxin [Lanoxin] to a patient? A. Digoxin toxicity B. Decreased diuretic effect C. Dehydration D. Heart failure

A. Digoxin toxicity

The nurse on an orthopedic unit routinely cares for patients receiving carisoprodol [Soma]. For which adverse effects should the nurse monitor these patients? (Select all that apply.) A. Drowsiness and sedation B. Decreased renal function C. Risk of dependence D. Decreased neutrophil count E. Unusual hair growth

A. Drowsiness and sedation C. Risk of dependence

A patient has chronic idiopathic urticaria. Which medication would be appropriate for the nurse to administer for this condition? A. Fexofenadine [Allegra] B. Loratadine [Claritin] C. Azelastine [Astelin] D. Diphenhydramine [Benadryl]

A. Fexofenadine [Allegra]

A provider has ordered captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct? A. Hold the dose and notify the provider. B. Administer the captopril and monitor for adverse effects. C. Request an order to administer fosinopril instead of captopril. D. Reassure the patient that this is not a serious side effect.

A. Hold the dose and notify the provider.

The nurse is reviewing the home medication list with the patient. The nurse recognizes that hydrochlorothiazide is used primarily for which condition? A. Hypertension B. Edema C. Diabetes insipidus D. Protection against postmenopausal osteoporosis

A. Hypertension

The nurse cares for a patient receiving digoxin [Lanoxin]. What indicates to the nurse that treatment with this medication is effective? A. Improved cardiac output B. Reduced exercise tolerance C. Increased body weight D. Decreased cardiac contractility

A. Improved cardiac output

Which drug should be used with caution in a patient with first-degree atrioventricular (AV) heart block? A. Lacosamide [Vimpat] B. Felbamate [Felbatol] C. Tiagabine [Gabitril] D. Levetiracetam [Keppra]

A. Lacosamide [Vimpat]

A nurse monitors a patient who takes azathioprine [Imuran] for which adverse effects? (Select all that apply.) A. Leukopenia B. Thrombocytopenia C. Alopecia D. Nephrotoxicity E. Red urine color

A. Leukopenia B. Thrombocytopenia C. Alopecia

A patient drinks five to six alcoholic beverages per day and takes acetaminophen [Tylenol] for pain relief. The nurse should caution the patient to do what? A. Limit intake of acetaminophen to less than 2000 mg/day B. Avoid taking acetaminophen for pain C. Take acetaminophen with food to reduce the risk of liver damage D. Avoid taking any pain reliever other than acetaminophen

A. Limit intake of acetaminophen to less than 2000 mg/day

Which of the following statements about mannitol [Osmitrol] are correct? (Select all that apply.) A. Mannitol cannot be given orally. B. Mannitol can cause edema. C. Mannitol can cause renal failure. D. Diuresis begins in 30 to 60 minutes after administration. E. Mannitol is a loop diuretic.

A. Mannitol cannot be given orally. B. Mannitol can cause edema. D. Diuresis begins in 30 to 60 minutes after administration.

The nurse is caring for a patient after total hip replacement on postoperative day 1. The nurse notes that the patient's urine is dark brown. The nurse reviews the medication administration record for which medication? A. Methocarbamol [Robaxin] B. Carisoprodol [Soma] C. Baclofen [Lioresal] D. Cyclobenzaprine [Flexeril]

A. Methocarbamol [Robaxin]

A patient with hypertension will begin taking an alpha1 blocker. What will the nurse teach this patient? A. Move slowly from sitting to standing when taking this drug. B. Report shortness of breath while taking this drug. C. Eat foods rich in potassium while taking this drug. D. A persistent cough is a known side effect of this drug.

A. Move slowly from sitting to standing when taking this drug.

A patient is prescribed sirolimus [Rapamune] and cyclosporine [Sandimmune] after renal transplantation. It is most important for the nurse to closely monitor which value? A. Serum creatinine B. Aspartate aminotransferase C. Serum potassium D. Partial thromboplastin time

A. Serum creatinine

A patient is to begin taking phenytoin [Dilantin] for seizures. The patient tells the nurse that she is taking oral contraceptives. What will the nurse tell the patient? A. She should consider a different form of birth control while taking phenytoin. B. She may need to increase her dose of phenytoin while taking oral contraceptives. C. She should remain on oral contraceptives, because phenytoin causes birth defects. D. She should stop taking oral contraceptives, because they reduce the effectiveness of phenytoin. Question 10

A. She should consider a different form of birth control while taking phenytoin.

A patient is admitted with severe hypertensive crisis. The nurse will anticipate administering which medication? A. Sodium nitroprusside [Nitropress] IV B. Captopril PO C. Hydralazine [Apresoline] 25 mg PO D. Minoxidil 20 mg PO

A. Sodium nitroprusside [Nitropress] IV

The nurse is caring for a patient receiving phenytoin [Dilantin] for treatment of tonic-clonic seizures. Which symptoms, if present, would indicate an adverse effect of this drug? (Select all that apply.) A. Swollen, tender gums B. Measles-like rash C. Productive cough D. Unusual hair growth E. Nausea and vomiting

A. Swollen, tender gums B. Measles-like rash D. Unusual hair growth

A patient with heart failure who has been given digoxin [Lanoxin] daily for a week complains of nausea. Before giving the next dose, the nurse will: A. assess the heart rate (HR) and give the dose if the HR is greater than 60 beats per minute. B. contact the provider to report digoxin toxicity. C. review the serum electrolyte values and withhold the dose if the potassium level is greater than 3.5 mEq/L. D. request an order for a decreased dose of digoxin.

A. assess the heart rate (HR) and give the dose if the HR is greater than 60 beats per minute.

A psychiatric nurse is teaching a patient about an antidepressant medication. The nurse tells the patient that therapeutic effects may not occur for several weeks. The nurse understands that this is likely the result of: A. changes in the brain as a result of prolonged drug exposure. B. direct actions of the drug on specific synaptic functions in the brain. C. slowed drug absorption across the blood-brain barrier. D. tolerance to exposure to the drug over time.

A. changes in the brain as a result of prolonged drug exposure.

The nurse is caring for a patient whose seizures are characterized by a 10- to 30-second loss of consciousness and mild, symmetric eye blinking. Which seizure type does this most closely illustrate? A. Tonic-clonic B. Absence C. Atonic D. Myoclonic

B. Absence

The nurse is preparing to give ethosuximide [Zarontin]. The nurse understands that this drug is only indicated for which seizure type? A. Tonic-clonic B. Absence C. Simple partial D. Complex partial

B. Absence

A patient asks the nurse to explain how antibodies protect the body against bacterial diseases. Which statement is an accurate response by the nurse? A. "Antibodies that destroy bacteria are part of the body's natural immunity. No prior exposure to the bacteria is needed for the body to respond." B. "Antibodies attach to the antigens (or large molecules) on the bacteria surface, creating a way for white blood cells to attach and destroy the bacteria." C. "Antibodies are large molecules present on the surface of bacteria. White blood cells are able to neutralize these antibodies and destroy the bacteria." D. "Most antibodies that protect against bacteria are called immunoglobulin A.These antibodies are found on the surface of mature B cells."

B. "Antibodies attach to the antigens (or large molecules) on the bacteria surface, creating a way for white blood cells to attach and destroy the bacteria."

A patient with chronic congestive heart failure has repeated hospitalizations in spite of ongoing treatment with hydrochlorothiazide [HydroDIURIL] and digoxin. The prescriber has ordered spironolactone [Aldactone] to be added to this patient's drug regimen, and the nurse provides education about this medication. Which statement by the patient indicates understanding of the teaching? A. "I should use salt substitutes to prevent toxic side effects." B. "I need to stop taking potassium supplements." .C. "I should watch closely for dehydration." D. "I can expect improvement within a few hours after taking this drug."

B. "I need to stop taking potassium supplements."

A nurse instructs a patient about signs and symptoms of digoxin toxicity. The nurse determines that teaching is successful if the patient makes which statement? A. "If my heart is racing, the dose may be too high." B. "I should report any muscle weakness or nausea." C. "My doctor should be notified if diarrhea occurs." D. "The dose will be reduced if I develop memory loss.

B. "I should report any muscle weakness or nausea."

Which statement made by a female patient newly diagnosed with complex partial seizures and starting treatment with valproic acid indicates a need for further teaching by the nurse? A. "The medication should not make me feel sleepy." B. "I should take the medication on an empty stomach." C. "I'll need to discuss a reliable form of birth control with my gynecologist." D. "I'll call my physician immediately if I develop a yellow tint to my skin or my urine appears tea-colored."

B. "I should take the medication on an empty stomach."

Which statement made by a patient indicates a need for further discharge instruction about baclofen [Lioresal]? A. "If I develop any difficulty urinating, I will call my physician." B. "I'm glad I can still have a glass or two of wine at dinner." C. "I'll contact my healthcare provider when I feel I no longer need the medication." D. "I'll need to check with my healthcare provider before taking my allergy medications."

B. "I'm glad I can still have a glass or two of wine at dinner."

A nurse is teaching the parent of a child with spastic quadriplegia about intrathecal baclofen [Lioresal]. Which statement by the parent indicates a need for further teaching? A. "I can expect my child to be more drowsy when receiving this medication." B. "If my child has a seizure, I should stop giving the medication immediately." C. "I should not notice any change in my child's muscle strength." D. "I will contact the provider if my child is constipated or cannot urinate."

B. "If my child has a seizure, I should stop giving the medication immediately."

Which drugs are used to treat spasticity? (Select all that apply.) A. Metaxalone [Skelaxin] B. Baclofen [Lioresal] C. Dantrolene [Dantrium] D. Tizanidine [Flexeril] E. Diazepam [Valium]

B. Baclofen [Lioresal] C. Dantrolene [Dantrium] E. Diazepam [Valium]

Which medication does the nurse identify as a monoclonal antibody used to inhibit allograft rejection in transplant recipients? A. Mycophenolate mofetil [CellCept] B. Basiliximab [Simulect] C. Tacrolimus [Prograf] D. Sirolimus [Rapamune]

B. Basiliximab [Simulect]

patient is prescribed celecoxib [Celebrex] and warfarin [Coumadin]. The nurse should monitor the patient for what? A. Renal toxicity B. Bleeding C. Stroke symptoms D. Dysrhythmias

B. Bleeding

Which skeletal muscle relaxant is also the drug of choice for treating malignant hyperthermia? A. Baclofen [Lioresal] B. Dantrolene [Dantrium] C. Diazepam [Valium] D. Tizanidine [Zanaflex]

B. Dantrolene [Dantrium]

A female patient who begins taking spironolactone [Aldactone] as an adjunct to furosemide [Lasix] complains that her voice is deepening. What will the nurse do? A. Report this side effect to the provider and request another medication for this patient. B. Explain that this drug binds with receptors for steroid hormones, causing this effect. C. Contact the provider to obtain an order for a complete blood count (CBC) and liver function tests. D. Teach the patient to report any associated cough, which may indicate a more severe side effect.

B. Explain that this drug binds with receptors for steroid hormones, causing this effect.

A patient with severe hypertension is prescribed minoxidil. Which medications will the nurse expect to be administered to reduce adverse responses to minoxidil? A. Adenosine [Adenocard] and ticlopidine [Ticlid] B. Furosemide [Lasix] and propranolol [Inderal] C. Digoxin [Lanoxin] and captopril [Capoten] D. Donepezil [Aricept] and clonidine [Catapres]

B. Furosemide [Lasix] and propranolol [Inderal]

A patient is newly prescribed carbamazepine [Tegretol]for seizure control. It is most important for the nurse to teach the patient to avoid which food? A. Tomatoes B. Grapefruit juice C. Spinach D. Kiwi fruit

B. Grapefruit juice

A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will the nurse do? A. Request an order for a diuretic to counter the side effects of the ACE inhibitor. B. Instruct the patient not to get up without assistance. C. Report the presence of a dry cough to the prescriber. D. Make sure the patient takes a potassium supplement.

B. Instruct the patient not to get up without assistance.

A patient who is taking digoxin is admitted to the hospital for treatment of congestive heart failure. The prescriber has ordered furosemide [Lasix]. The nurse notes an irregular heart rate of 86 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82 mm Hg. The nurse auscultates crackles in both lungs. Which laboratory value causes the nurse the most concern? A. Sodium level of 140 mEq/L (normal) B. Potassium level of 3.5 mEq/L (low) C. Oxygen saturation of 90% (low) D. Blood glucose level of 120 mg/dL (elevated)

B. Potassium level of 3.5 mEq/L (low)

A patient is prescribed hydralazine. What is most important for the nurse to teach the patient? A. Precautions for postural hypotension B. Prevention of reflex tachycardia C. High initial dose for slow acetylators D. Recognition of hypertrichosis

B. Prevention of reflex tachycardia

A nurse is admitting a patient to the hospital. The patient reports taking oral baclofen [Lioresal] but stopped taking the drug the day before admission. The nurse would be correct to anticipate which adverse effects? A. Weakness and dizziness B. Seizures and hallucinations C. Fatigue and drowsiness D. Respiratory depression and coma

B. Seizures and hallucinations

A patient with multiple sclerosis is prescribed baclofen [Lioresal]. Which assessment by the nurse indicates that the medication is exerting its desired effect? A. Decreased strength B. Suppression of spasticity C. Improved muscle tone D. Increased muscle resistance

B. Suppression of spasticity

The nurse will teach a patient who is prescribed niacin [Niacor] to prevent flushing of the face by doing what? A. Drinking a full glass of water after taking the medication B. Taking 325 mg of aspirin 30 minutes before each dose C. Ingesting a meal before taking the medication D. Increasing dietary fiber before and after each dose

B. Taking 325 mg of aspirin 30 minutes before each dose

The nurse suspects that a female patient is experiencing phenytoin toxicity if which manifestation is noted? (Select all that apply.) A. The patient complains of excessive facial hair growth. B. The patient is walking with a staggering gait. C. The patient's gums are swollen, tender, and bleed easily. D. The patient complains of double vision. E. The nurse observes rapid back-and-forth movement of the patient's eyes.

B. The patient is walking with a staggering gait. D. The patient complains of double vision. E. The nurse observes rapid back-and-forth movement of the patient's eyes.

A patient shows loss of consciousness, jaw clenching, contraction and relaxation of muscle groups, and periods of cyanosis. The nurse correctly identifies this as which type of seizure? A. Absence B. Tonic-clonic C. Myoclonic D. Atonic

B. Tonic-clonic

A nurse counsels a patient who is to begin taking phenytoin [Dilantin] for epilepsy. Which statement by the patient indicates understanding of the teaching? A. "I can consume alcohol in moderation while taking this drug." B. "Once therapeutic blood levels are reached, they are easy to maintain." C. "I should brush and floss my teeth regularly." D. "Rashes are a common side effect but are not serious."

C. "I should brush and floss my teeth regularly."

The nurse is teaching a patient who has a new prescription for spironolactone [Aldactone]. Which statement by the patient indicates that the teaching was effective? A. "I will use salt substitutes to lower my sodium intake." B. "I will increase my intake of foods that are high in potassium." C. "I will call my doctor if I begin having menstrual irregularities." D. "I will take this medication at bedtime each evening."

C. "I will call my doctor if I begin having menstrual irregularities."

The nurse receives a phone call from a patient who has been taking a CNS drug for 3 days. The patient tells the nurse that the medication causes nausea. Which response by the nurse is best? A. "Nausea is not a common side effect of this drug." B. "You should stop taking the medication immediately." C. "The nausea will most likely decrease over time." D. "Try taking the medication on an empty stomach."

C. "The nausea will most likely decrease over time."

Which instruction should be the priority for the nurse to teach a patient scheduled to start taking sirolimus [Rapamune]? A. "A lipid-lowering medication can be given to lower cholesterol levels." B. "There might be some joint pain, diarrhea, and rash with this medicine." C. "You'll need to notify your doctor if you experience any sore throat or fever." D. "Take this medication with food, but you'll need to avoid taking it with grapefruit juice."

C. "You'll need to notify your doctor if you experience any sore throat or fever."

A patient has localized muscle spasms after an injury. The prescriber has ordered tizanidine [Zanaflex] to alleviate the spasms. When obtaining the patient's health history, the nurse should be concerned about which possible reason for considering another drug? A. Concomitant use of aspirin B. A history of malignant hyperthermia C. A history of hepatitis D. Occasional use of alcohol

C. A history of hepatitis

Administration of dantrolene [Dantrium] for the treatment of muscle spasticity is contraindicated in which patient? A. A patient with a C6 spinal cord injury B. A patient with cerebral palsy C. A patient with multiple sclerosis and underlying cirrhosis D. A patient experiencing malignant hyperthermia

C. A patient with multiple sclerosis and underlying cirrhosis

A patient with cerebral palsy has severe muscle spasticity and muscle weakness. The patient is unable to take anything by mouth. The nurse is correct to anticipate that which medication will be ordered for home therapy? A. Dantrolene [Dantrium] B. Diazepam [Valium] C. Baclofen [Lioresal] D. Metaxalone [Skelaxin]

C. Baclofen [Lioresal]

A nurse is assessing a patient who becomes motionless and seems to stare at the wall and then experiences about 60 seconds of lip smacking and hand wringing. What should the nurse do? A. Notify the provider that the patient has had a grand mal seizure. B. Ask the patient about a history of absence seizures C. Contact the provider to report symptoms of a complex partial seizure 4. Request an order for intravenous diazepam [Valium] to treat status epilepticus.

C. Contact the provider to report symptoms of a complex partial seizure

The nurse plans to closely monitor for which clinical manifestation after administering furosemide [Lasix]? A. Decreased pulse B. Decreased temperature C. Decreased blood pressure D. Decreased respiratory rate

C. Decreased blood pressure

A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this patient will expect to administer which drug? A. Mannitol [Osmitrol] B. Hydrochlorothiazide [HydroDIURIL] C. Furosemide [Lasix] D. Spironolactone [Aldactone]

C. Furosemide [Lasix]

The nurse knows that the production of memory T and B cells will do what? A. Slow the immune response. B. Augment the release of specific cytokines. C. Increase the intensity of the immune response D. Provide the code for major histocompatibility complexes.

C. Increase the intensity of the immune response

The nurse is assessing a patient receiving valproic acid [Depakene] for potential adverse effects associated with this drug. What is the most common problem with this drug? A. Increased risk of infection B. Reddened, swollen gums C. Nausea, vomiting, and indigestion D. Central nervous system depression

C. Nausea, vomiting, and indigestion

A patient has been prescribed pharmacologic doses of glucocorticoids. It is most important for the nurse to teach the patient to do what? A. Increase intake of dietary sodium. B. Take antibiotics to prevent infection. C. Never abruptly withdraw therapy. D. Have an eye examination every year.

C. Never abruptly withdraw therapy.

A nurse checks a patient's vital signs in the hospital and notes a blood pressure of 146/98 mm Hg. What will the nurse do? A. Prepare the patient for an electrocardiogram and blood tests. B. Request an order for a thiazide diuretic. C. Recheck the patient's blood pressure in the other arm. D. Instruct the patient to consume a low-sodium diet.

C. Recheck the patient's blood pressure in the other arm.

A patient is prescribed digoxin [Lanoxin] and furosemide [Lasix]. It is most important for the nurse to assess which value before administering these medications? A. Serum sodium B. Blood urea nitrogen C. Serum potassium D. Plasma B-natriuretic peptide

C. Serum potassium

A patient has 2+ pitting edema of the lower extremities bilaterally. Auscultation of the lungs reveals crackles bilaterally, and the serum potassium level is 6 mEq/L (elevated). Which diuretic agent ordered by the prescriber should the nurse question? A. Furosemide [Lasix] B. Hydrochlorothiazide [HydroDIURIL] C. Spironolactone [Aldactone] D. Bumetanide [Bumex]

C. Spironolactone [Aldactone]

The nurse is caring for a patient with heart failure who needs a diuretic. Which agent is likely to be chosen, because it has been shown to greatly reduce mortality in patients with heart failure? A. Furosemide [Lasix] B. [HydroDIURIL] C. Spironolactone [Aldactone] D. Mannitol [Osmitrol]

C. Spironolactone [Aldactone]

A transplant recipient is receiving cyclosporine [Sandimmune]. Which response should a nurse expect if the medication is having the desired effect? A. Increased antibody response B. Increased natural killer (NK) cellular activity C. Suppression of T lymphocytes D. Suppression of hepatic metabolism of steroids

C. Suppression of T lymphocytes

After receiving an allograft liver transplant, a patient is prescribed cyclosporine [Sandimmune] oral solution. What is the most critical component of patient teaching that the nurse should stress? A. The medication will help prevent transplant rejection. B. The oral solution can be mixed with orange juice. C. The medication will be taken every day for life. D. The medication causes reversible increase of hair growth.

C. The medication will be taken every day for life.

A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient? A. The fetus must be monitored closely while the patient is taking this drug. B. The fetus most likely will have serious congenital defects. C. The patient should stop taking the medication and contact her provider immediately. D. The patient's prescriber probably will change her medication to an ARB.

C. The patient should stop taking the medication and contact her provider immediately.

A group of nursing students asks a nurse to explain the blood-brain barrier. The nurse would be correct to say that the blood-brain barrier: A. allows only ionized or protein-bound drugs to cross into the central nervous system. B. causes infants to be less sensitive to CNS drugs and thus require larger doses. C. prevents some potentially toxic substances from crossing into the central nervous system. D. prevents lipid-soluble drugs from entering the central nervous system.

C. prevents some potentially toxic substances from crossing into the central nervous system.

A patient who was in a motor vehicle accident sustained a severe head injury and is brought into the emergency department. The provider orders intravenous mannitol [Osmitrol]. The nurse knows that this is given to: A. restore extracellular fluid. B. reduce peripheral edema. C. reduce intracranial pressure. D. reduce reduce renal perfusion.

C. reduce intracranial pressure.

A nurse is caring for a patient receiving intrathecal baclofen [Lioresal]. The patient is unresponsive. After asking a coworker to contact the provider, the nurse anticipates performing which intervention? A. Obtaining an electrocardiogram B. Administering an antidote to baclofen C. Administering diazepam to prevent seizures D. Obtaining an electrocardiogram Preparing to support respirations

D. Preparing to support respirations

A nurse is discussing how beta blockers work to decrease blood pressure with a nursing student. Which statement by the student indicates a need for further teaching? A. "Beta blockers decrease the release of renin." B. "Beta blockers decrease peripheral vascular resistance." C. "Beta blockers decrease heart rate and contractility." D. "Beta blockers block the actions of angiotensin II."

D. "Beta blockers block the actions of angiotensin II."

A patient has been taking a medication for 2 months. Which statement, if made by the patient, would indicate to the nurse that drug tolerance is occurring? A. "The medication seems to be working better than it did at first." B. "I feel really sick if I do not take the medication every day." C. "The side effects are not bothering me anymore." D. "The medication does not seem to be working as well."

D. "The medication does not seem to be working as well."

A patient with a history of elevated triglycerides and LDL cholesterol begins taking nicotinic acid [Niacin]. The patient reports uncomfortable flushing of the face, neck, and ears when taking the drug. What will the nurse advise the patient? A. "You should stop taking the Niacin immediately since this is a serious adverse effect." B. "Ask your provider about assessing your serum uric acid levels which may be elevated." C. "You should stop taking the Niacin immediately since this is a serious adverse effect." D. "You should take 325 mg of aspirin a half hour before each dose of Niacin to prevent this effect."

D. "You should take 325 mg of aspirin a half hour before each dose of Niacin to prevent this effect."

Which patient is the most appropriate candidate for both lifestyle changes and drug therapy with an antihypertensive medication? A. A 47-year-old patient with blood pressure of 110/78 mm Hg and with type 2 diabetes mellitus B. A 76-year-old patient with blood pressure of 128/88 mm Hg and a history of dyslipidemia C. A 52-year-old patient with blood pressure of 136/89 mm Hg who smokes 1 pack of cigarettes per day D. A 32-year-old patient with blood pressure of 142/94 mm Hg who is sedentary

D. A 32-year-old patient with blood pressure of 142/94 mm Hg who is sedentary

Which patient would most likely be prescribed sodium nitroprusside [Nitropress]? A. A patient with a recent diagnosis of essential hypertension B. A patient with heart failure who receives weekly home visits C. A patient who is hypotensive after a myocardial infarction D. A patient with a hypertensive crisis in the intensive care unit

D. A patient with a hypertensive crisis in the intensive care unit

The nurse prepares to administer dantrolene [Dantrium] to a patient. Before the administration of the drug, it is most important for the nurse to assess which laboratory value? A. Serum amylase B. Creatinine clearance C. Blood glucose D. Aminotransferases

D. Aminotransferases

The potassium-sparing diuretic spironolactone [Aldactone] prolongs survival and improves heart failure symptoms by which mechanism? A. Reducing venous pressure B. Increasing diuresis C. Reducing afterload D. Blocking aldosterone receptors

D. Blocking aldosterone receptors

The nurse is caring for a patient receiving dantrolene [Dantrium] for spasticity associated with MS. Which laboratory test will be important in monitoring for a potential adverse effect of this drug? A. Blood urea nitrogen (BUN) B. Albumin level C. Gamma-glutamyltransferase (GGTP) D. Complete blood count (CBC)

D. Complete blood count (CBC)

Which plasma lipoprotein level is most concerning when considering the risk of coronary atherosclerosis? A. Elevated total cholesterol B. Elevated high density lipoprotein C. elevated triglycerides D. Elevated low-density lipoprotein

D. Elevated low-density lipoprotein

A patient is taking enalapril [Vasotec]. The nurse understands that patients taking this type of drug for heart failure need to be monitored carefully for: A. Hypernatremia B. Hypertension C. Hypokalemia D. Hyperkalemia

D. Hyperkalemia

Which statement regarding antihistamine administration to older adults does the nurse identify as true? A. Antihistamines cause CNS excitation in older adults. B. Larger doses of antihistamines are needed for older adults. C. Antihistamines can be used to reduce intraocular pressure. D. Older men with benign prostatic hypertrophy can experience worse symptoms when taking antihistamines.

D. Older men with benign prostatic hypertrophy can experience worse symptoms when taking antihistamines.

A patient is prescribed phenytoin [Dilantin] for epileptic seizures. Which of the following is the priority for patient teaching? A. Teach the patient to adjust the dose according to the presence of symptoms. B. Tell the patient to take the medication with meals. C. Inform the patient about the prevention of gingival hyperplasia. D. Teach the patient to avoid the abrupt cessation of treatment.

D. Teach the patient to avoid the abrupt cessation of treatment.

A patient who takes over-the counter-diphenhydramine [Benadryl] for seasonal allergy symptoms complains of drowsiness. What should the nurse do? A. Instruct the patient to drink caffeinated beverages. B. Recommend taking the medication with meals. C. Ask the patient's health care provider to prescribe hydroxyzine [Vistaril]. D. Tell the patient to take cetirizine [Zyrtec] instead of diphenhydramine.

D. Tell the patient to take cetirizine [Zyrtec] instead of diphenhydramine.

Nonaspirin NSAIDs differ from aspirin in all but which way? A. They cause reversible inhibition of COX, so their effects decline as soon as their blood levels decline. B. They can suppress platelet aggregation, but they are not used to prevent MI and stroke. C. They increasethe risk of MI and stroke and therefore should be used in the lowest effective dosage for the shortest possible time. D. They are safe to use in children with chickenpox or influenza.

D. They are safe to use in children with chickenpox or influenza.

Which medication acts as an agonist at the presynaptic alpha-2 receptor site? A. Baclofen [Lioresal] B. Dantrolene [Dantrium] C. Diazepam [Valium] D. Tizanidine [Zanaflex]

D. Tizanidine [Zanaflex]

A patient asks a nurse to explain what drug tolerance means. The nurse responds by telling the patient that when tolerance occurs, it means the patient: A. will have increased sensitivity to drug side effects B. has developed a psychologic dependence on the drug. C. will cause an abstinence syndrome if the drug is discontinued abruptly. D. may need increased amounts of the drug over time.

D. may need increased amounts of the drug over time.

Which drug is the most effective for lowering LDL cholesterol? a) Atorvastatin [Lipitor] b) Cholestyramine [Questran] c) Gemfibrozil [Lopid] d) Ezetimibe [Zetia]

a) Atorvastatin [Lipitor]

Which are beneficial effects that can be derived from simvastatin [Zocor] and other drugs in this class? (Select all that apply.) a) Reduction of LDLs b) Elevation of HDLs c) Stabilization of the plaque in coronary arteries d) Reduction of risk of cardiovascular events e) Improvement of liver function

a) Reduction of LDLs b) Elevation of HDLs c) Stabilization of the plaque in coronary arteries d) Reduction of risk of cardiovascular events

Which laboratory result may be a consequence of therapy with a thiazide diuretic? a) Serum glucose level of 58 mg/dL b) Serum potassium level of 5.3 mEq/L c) Serum sodium level of 135 mEq/L d) Serum uric acid level of 10.4 mg/dL

d) Serum uric acid level of 10.4 mg/dL

The nurse is teaching a patient who has just been prescribed a vasodilator. Which statement by the patient indicates that the teaching was effective? a) "I can take this medication in the morning to reduce nighttime urination." b) "I will rise slowly when changing from a sitting to a standing position." c) My heart rate may slow down with this drug. I will call if my pulse is below 60." d) "I need to increase my intake of fluids and foods that are high in fiber."

b) "I will rise slowly when changing from a sitting to a standing position."

The nurse understands that cholesterol is carried through the blood by lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis? a) Very-low-density lipoprotein (VLDL) b) polipoprotein B-100 c) Low-density lipoprotein (LDL) d) High-density lipoprotein (HDL)

c) Low-density lipoprotein (LDL)

The nurse is caring for a patient receiving hydralazine [Apresoline]. The healthcare provider prescribes propranolol [Inderal]. The nurse knows that a drug such as propranolol often is combined with hydralazine for what purpose? a) To reduce the risk of headache b) To improve hypotensive effects c) To prevent heart failure d) To protect against reflex tachycardia

d) To protect against reflex tachycardia

A patient is admitted to the hospital with a diagnosis of hypertension. The nurse understands that which medication works by preventing angiotensin II from binding with its receptor sites? a) Quinapril [Accupril] b) Aliskiren [Tekturna] c) Eplerenone [Inspra] d) andesartan [Atacand]

d) andesartan [Atacand]