505 test 2
Your patient, a 37-year-old woman, was admitted due to elevated temperature, oliguria, and dehydration. With adequate hydration, the expected normal urine production would be approximately: A. 2 L/day. B. 0.5 L/day. C. 1L/day. D. 3 L/day.
A. 2 L/day.
A nurse should monitor a client closely for increased CNS depressant effects when a skeletal muscle relaxant is used concomitantly with which of the following? Select all that apply: A. Antihistamine B. Oral contraceptives C. Alcohol D. Opiates E. Antidiabetic medications
A. Antihistamine C. Alcohol D. Opiates
Bisphosphonates are drugs that bind to bone and inhibit calcium resorption from bone. These drugs are used to treat hypercalcemia. Which of the following are bisphosphontes? Choose all that apply. A. alendronate (Fosamax) B. ibandronate (Boniva) C. risedronate (Actonel) D. raloxifene (Evista) E. teriparatide (Forteo)
A. alendronate (Fosamax) B. ibandronate (Boniva) C. risedronate (Actonel)
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.
The nurse is providing discharge instructions to a 72-year-old patient who has been discharged home on a diuretic. What would the patient's instructions regarding the use of a diuretic at home include? A. Measuring their intake and output of urine B. To weigh themselves on the same scale, at the same time of day, in the same clothing C. Restrict fluids to 500 cc per day to limit the need to urinate D. Decrease exercise to conserve energy
B. To weigh themselves on the same scale, at the same time of day, in the same clothing
Which finding is most characteristic of Paget's disease? A. Joint inflammation B. Noninflammatory degeneration of articular cartilage C. Abnormal bone remodeling D. Advanced-stage malignancy with hypercalcemia
C. Abnormal bone remodeling
A 56-year-old woman will soon begin treatment of her overactive bladder with tolterodine (Detrol). What patient teaching should the nurse provide to this woman? A. "It's good to measure your heart rate before you take your Detrol each day, and withhold it if your heart rate is below 60 beats/minute." B. "You'll probably need to stop taking your hormone replacement therapy when you're taking Detrol." C. "You'll likely find that you have scant amounts of blood in your urine for the first few days, but this is not unusual or problematic." D. "You might find that you get a dry mouth or a headache from this drug, but this does not mean it has to be discontinued."
D. "You might find that you get a dry mouth or a headache from this drug, but this does not mean it has to be discontinued."
An elderly patient has been diagnosed with Paget's disease. Which serum electrolyte is altered in this disease process? A. Sodium B. Potassium C. Chloride D. Calcium
D. Calcium
Which is an example of a direct-acting cholinergic that acts like the neurotransmitter acetylcholine? A. Bethanechol (Urecholine) B. Pyridostigmine (Regonol) C. Pilocarpine (Pilopine) D. Ambenonium (Mytelase)
A. Bethanechol (Urecholine)
Which hormone would the nurse identify as important in decreasing serum calcium levels? A. Calcitonin B. Melatonin C. Gastrin D. Thyroid hormone
A. Calcitonin
A patient has been prescribed hydrocodone for back pain related to a compression fracture. Which of the following interventions should the patient be taught regarding the medication administration? A. Consume a diet high in fiber B. Decrease activity due to pain C. Elevate the lower extremities D. Take aspirin with the medication
A. Consume a diet high in fiber
A client sustained a musculoskeletal injury to his left leg that has resulted in occasional spasticity. What should the nurse expect the health care provider to prescribe? A. Cyclobenzaprine B. Baclofen C. Dantrolene D. Botulinum toxin type B
A. Cyclobenzaprine
The client has been diagnosed with urinary retention. The nurse expects the client to receive which medication for this condition? A. Ambenonium B. Bethanechol C. Benadryl D. Guanidine
B. Bethanechol
A patient has been prescribed the drug finasteride for the treatment of benign hypertrophy of the prostate. Which of the following adverse effects of the drug should the nurse caution the patient about? A. Hypertension B. Increased libido C. Impotence D. Hyperglycemia
C. Impotence
You are talking to your class of nursing students about the adverse effects of corticosteroid therapy. What dietary change would you tell the students may help prevent osteoporosis related to long-term corticosteroid administration? A. Decreasing protein intake B. Decreasing calcium intake C. Increasing vitamin D intake D. Increasing caloric intake
C. Increasing vitamin D intake
The client is taking cyclobenzaprine for muscle spasms secondary to an injury to the lumbar spine that occurred while lifting a motor at work. The client is being seen for a follow-up visit by the physician. The client reports dry mouth, blurred vision, and constipation. Why is the client having these side effects from cyclobenzaprine? A. Cyclobenzaprine produces an anticholinergic response, resulting in these side effects. B. Cyclobenzaprine acts in the peripheral nervous system, resulting in these side effects. C. Cyclobenzaprine has an effect at the neuromuscular junction, resulting in these side effects. D. Cyclobenzaprine is structurally similar to amitriptyline, resulting in these side effects.
A. Cyclobenzaprine produces an anticholinergic response, resulting in these side effects.
The nurse receives a call from a male client who takes finasteride (Proscar) for treatment of BPH, and tells the nurse that his wife may be pregnant. What does the nurse expect the health care provider to do? A. Discontinue the medication. B. Decrease the dose of medication. C. Increase the dose of medication. D. Change the finasteride to dutasteride.
A. Discontinue the medication.
Constipation is a common adverse reaction seen with the use of cholinergic-blocking drugs, which of the following nonpharmacological treatments can a nurse recommend to a client with drug-induced constipation? Select all that apply: A. Eat a diet high in fiber. B. Decrease the dose of cholinergic-blocking medication. C. Increase fluid intake to 2000 mL daily. D. Stop taking the cholinergic-blocking medication. E. Obtain adequate exercise.
A. Eat a diet high in fiber. C. Increase fluid intake to 2000 mL daily. E. Obtain adequate exercise.
Osteoporosis is characterized by decreased bone density (osteopenia) and weak, fragile bones. Which of the following are risk factors for osteoporosis? Choose all that apply. A. Female gender B. Lean body mass C. Smoking D. Childbearing age E. African-American race
A. Female gender B. Lean body mass C. Smoking
A pregnant nurse should not handle crushed or broken tablets of which of the following medications as it is classified in pregnancy category X and its absorption poses substantial risk for abnormal growth to a male fetus? (Choose one) A. Finasteride B. Estradiol C. Medroxyprogesterone D. Nandrolone
A. Finasteride
Which drug exerts its diuretic effects by increasing the density of the filtrate in the glomerulus? A. Mannitol (Osmitrol) B. Furosemide (Lasix) C. Hydrochlorothiazide (Microzide) D. Spironolactone (Aldactone)
A. Mannitol (Osmitrol)
About 80% of water, sodium, potassium, and other substances are reabsorbed during renal processing; the remaining 20% enters the loop of Henle. What substance is reabsorbed in the ascending limb of the loop of Henle? A. Sodium B. Water C. Glucose D. Amino acids
A. Sodium
A 36-year-old male client undergoes dialysis three times weekly while waiting for renal transplant. A diuretic has been added to his current medications to combat developing edema. Why would potassium-sparing diuretics be contraindicated? A. They may cause hyperkalemia. B. They are strong diuretics. C. They promote excretion of potassium. D. They may cause rebound edema.
A. They may cause hyperkalemia.
A patient is receiving tamsulosin. The nurse understands that this drug is most likely being given for which reason? A. To relax prostatic smooth muscles B. To decrease vascular tone C. To promote vasodilation D. To induce a reflex tachycardia
A. To relax prostatic smooth muscles
You are a home health registered nurse who has a patient who cannot afford medications. The doctor has ordered a calcium supplement for your patient. Which of the following would you recommend for your patient? A. Tums (5 per day) B. Alendronate (Fosamax) C. Ibandronate (Boniva) D. Risedronate (Actonel)
A. Tums (5 per day)
When is calcitonin released by the body? A. When serum calcium levels rise B. When serum calcium levels fall C. When PTH secretion mobilizes calcium D. When PTH secretion immobilizes calcium
A. When serum calcium levels rise
A client asks a nurse to explain how the drug bethanechol works to help a person void. What would be a correct response from the nurse? A. "Bethanechol is an indirect-acting cholinergic drug that causes the bladder to constrict." B. "Bethanechol is a direct-acting cholinergic drug that causes contraction of the smooth muscles of the bladder and passage of urine." C. "Bethanechol is a diuretic that works in the loop of Henle, blocking the reuptake of sodium, which causes one to void." D. "Bethanechol is a medication that increases the amount of water that is produced by the kidneys, causing one to void."
B. "Bethanechol is a direct-acting cholinergic drug that causes contraction of the smooth muscles of the bladder and passage of urine."
A patient is brought to the Emergency Department after a motor vehicle accident. The patient is diagnosed with multiple injuries including a bladder injury. The patient is taken to surgery and develops a nonobstructive postoperative urinary retention. What drug would the nurse expect to be ordered for this patient? A. Neostigmine B. Bethanechol C. Ambenonium D. Pyridostigmine
B. Bethanechol
A patient has been receiving bethanechol (Urecholine) for 1 week. One hour after the dose is administered, the patient develops sweating, flushing, abdominal cramps, and nausea. What is the rationale for the development of these symptoms? A. Myasthenic crisis B. Cholinergic overdose C. Anaphylactic reaction D. Pulmonary edema
B. Cholinergic overdose
The nurse is aware that older men are more prone to urinary tract infections because of what physiologic change related to aging? A. Involuntary contractions of the bladder muscle B. Enlargement of the prostate C. Reduction in renal function D. Loss of muscle tone in the pelvic structures
B. Enlargement of the prostate
Which of the following drugs inhibit the conversion of testosterone into 5-alpha-dihydrotestosterone (DHT) which results in a decrease in prostate gland size and are useful in the treatment of benign prostatic hypertrophy? Select all that apply: A. Terazosin (Hytrin) B. Finasteride (Proscar) C. Methyltestosterone (Testred) D. Dutasteride (Avodart) E. Doxazosin (Cardura)
B. Finasteride (Proscar) D. Dutasteride (Avodart)
A nurse is performing patient education for a woman who has just been prescribed a bisphosphonate. Which diagnostic and history findings would have prompted the woman's care provider to prescribe a bisphosphonate? A. Height in the lowest quartile of the population and a history of joint pain B. Low bone density and a family history of osteoporosis C. Reports of cold intolerance, recurrent constipation, and evidence of diverticular disease D. Labile moods and short-term memory deficits
B. Low bone density and a family history of osteoporosis
An older adult is prescribed a skeletal muscle relaxant for reports of neck pain. What is the top priority of care for the nurse to teach the family? A. Administer the medication with meals. B. Monitor the client before ambulating. C. Instruct on how to assess client's pain level. D. Give the medication at the same time each day.
B. Monitor the client before ambulating.
The nursing instructor is discussing cholinergic drugs. According to the instructor, what system is acted upon by this family of drugs? A. Sympathetic nervous system B. Parasympathetic nervous system C. Cardiovascular system D .Genitourinary system
B. Parasympathetic nervous system
A 73-year-old woman has osteoporosis and is prescribed alendronate. She takes calcium and vitamin D supplements, drinks lots of water, and has just quit smoking. The nurse should advise the patient to also A. include adequate amounts of vitamin C in the diet. B. drink at least 6 to 8 oz of milk daily. C. stop using artificial sweeteners while taking alendronate. D. perform light-weight exercises and go for walks.
D. perform light-weight exercises and go for walks.
A 47-year-old female client with a history of asthma is treated with a steroid burst for the second time this year since moving to the area. Other significant history includes a BMI of 22, allergic rhinitis, and contact dermatitis. The client asks why she cannot just stay on the prednisone long term. What would be the best answer based on the long-term effects of prednisone therapy? A. Prednisone can lead to poor wound healing. B. Prednisone can lead to osteoporosis. C. Prednisone can lead to glucose intolerance. D. Prednisone can lead to fluid retention.
B. Prednisone can lead to osteoporosis.
A 68-year-old man is being treated for benign prostatic hypertrophy (BPH) and began treatment with finasteride (Proscar) 3 months ago. When planning the care of this patient, what desired outcome should the nurse prioritize? A. The patient will remain free of sexual side effects related to drug therapy B. The patient will experience complete bladder emptying C. The patient will remain free of urethral pain D. The patient will not experience hematuria
B. The patient will experience complete bladder emptying
A nurse is planning care for a patient who is taking tolterodine. Which is an appropriate nursing diagnosis that is an indication for using this drug? A. Risk for Injury related to multiple drug therapies and drug interactions B. Risk for Injury related to hyperkalemia secondary to use of the drug C. Altered Urinary Elimination related to overactive bladder D. Risk for Deficient Fluid Volume related to the action of the drug
C. Altered Urinary Elimination related to overactive bladder
A student asks the pharmacology instructor to describe the function of a cholinergic agonist. What would the instructor reply? A. Cholinergic agonists increase the activity of dopamine receptor sites throughout the brain and spinal cord. B. Cholinergic agonists decrease the activity of GABA receptor sites throughout the body. C. Cholinergic agonists increase the activity of acetylcholine receptor sites throughout the body. D. Cholinergic agonists decrease the activity of norepinephrine receptor sites throughout the brain and spinal cord.
C. Cholinergic agonists increase the activity of acetylcholine receptor sites throughout the body.
A nurse is assessing a patient who has come to the emergency department complaining of back spasms. The patient states that he has a history of opioid addiction and does not want to take any drug that "puts me at risk of becoming physically dependent." Which of the following medications would the nurse question, if ordered? A. Methocarbamol (Robaxin) B. Orphenadrine (Norflex) C. Cyclobenzaprine (Flexeril) D. Metaxalone (Skelaxin)
C. Cyclobenzaprine (Flexeril)
A nurse is caring for a patient who is taking sodium polystyrene sulfonate (Kayexalate) therapy. The nurse will monitor for which of the following? A. Cardiac arrhythmias B. Ventricular arrhythmias C. Hypokalemia D. Cardiotoxicity
C. Hypokalemia
A 70-year-old woman is taking a cholinergic blocking drug. Her family has noticed that she is very excited, a little confused, and is not able to void normally. What action by the nurse would be most appropriate to deal with these symptoms? A. Instruct the client to continue to take the medication and ignore the symptoms. B. Instruct the client to increase the dose of the medication to combat these symptoms. C. Instruct the client to withhold the next dose and contact the prescribing provider. D. Instruct the client to go to the emergency department immediately.
C. Instruct the client to withhold the next dose and contact the prescribing provider.
A client is receiving a cholinergic medication for urinary retention. What assessment should the nurse perform prior to administering the medication? A. Assess the client's grip strength. B. Obtain the client's blood pressure. C. Palpate the pelvic region to assess fullness of bladder. D. Palpate the upper abdomen for ascites.
C. Palpate the pelvic region to assess fullness of bladder.
A patient with muscular pain has been prescribed an NSAIDs. What advice should the nurse give the patient to promote an optimal response to NSAID therapy? A. Suggest the patient take the NSAID with fiber-rich food. B. Suggest the patient take the NSAID on an empty stomach. C. Suggest the patient take the NSAID with food and milk. D. Suggest the patient take the NSAID with a calcium supplement.
C. Suggest the patient take the NSAID with food and milk.
A client diagnosed with excessive parathyroid production is prone to develop: A. Alzheimer's disease. B. hypertension. C. osteopenia. D. heart disease.
C. osteopenia.
A patient is admitted to emergency and is unconscious as a result of a head injury. The patient's intracranial pressure is increased. What diuretic will be administered to the patient? A. Loop diuretic B. Potassium-sparing diuretic C. Thiazide diuretic D. Osmotic diuretic
D. Osmotic diuretic
A client is prescribed a selective estrogen receptor modifier for treatment of osteoporosis. The nurse would identify which drug as belonging to this class? A. Alendronate B. Calcium gluconate C. Tamoxifen D. Raloxifene
D. Raloxifene
A male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at each clinic visit? A. Serum cholesterol levels B. Bone growth C. Hemoglobin levels D. Urinary elimination patterns
D. Urinary elimination patterns
A patient with osteoporosis has bones that become progressively porous, brittle, and especially prone to fracture. This increased susceptibility to fracture manifests most commonly as: A. spiral fracture of the tibia. B. dislocation of the shoulder. C. boxer's fracture. D. compression fracture of the vertebrae.
D. compression fracture of the vertebrae.
Unwanted anticholinergic effects include: A. wakefulness, mental alertness, and decreased fatigue. B. drowsiness or sleep; decreased muscle tone; and decreased ability to move. C. increasing hyperactivity, excessive talking, nervousness, and insomnia. D. constipation and dry mouth.
D. constipation and dry mouth.