Exam 3

the nurse explains to the patient being discharged who is taking sucralfate (carafate) that the med should be administered how? a) 60 mins before meals and at bedtime b) between meals and when patient has pain c) 60 mins after breakfast and when patient has pain d) with meals and at bedtime

a) 60 mins before meals and at bedtime

the nurse is teaching a patient who will begin taking 2 tablets of 325mg acetaminophen every 4-6 hours as need for pain. which statement by the patient indicates understanding of the teaching? a) I may take acetaminophen up to 6 times daily if needed b) I should increase the dose of acetaminophen if I drink caffeinated coffee c) if I take oral contraceptive pills, I should use back up contraception d) it is safe to take acetaminophen with any over the counter meds

a) I may take acetaminophen up to 6 times daily if needed

a nurse is teaching a client who has a new prescription for sucralfate to treat a gastric ulcer. which of the following statements by the client indicate an understanding of the teaching? a) I will take the med 1 hour before meals and at bedtime b) I will take this med with an antacid c) I will reduce my fluid intake with this med d) I will reduce my fluid intake with this med

a) I will take the med 1 hour before meals and at bedtime

a patient, who is post op abdominal surgery, is wincing and guarding his abdomen. he rates his pain as a 9 out of 20. assuming there is an order for it, which type of pain med sepia;d the nurse administer? a) IV opioid agonist b) IV opioid antagonist c) oral adjuvant therapy d) oral non-opioid analgesic

a) IV opioid agonist

the parent of a 5-year old child asks the nurse to recommend an over the counter pain med for the child. which analgesic will the nurse recommend? a) acetaminophen (Tylenol) b) aspirin c) diflunisal (dolobid) d) celecoxib (Celebrex)

a) acetaminophen (Tylenol)

a 6-year old child has the chickenpox and a fever of 102.9 F (39.4 C). the child's mother asks the nurse is she should use aspirin to reduce the fever. what is the best resins by the nurse? a) acetaminophen (Tylenol) should be used to reduce his fever, not aspirin b) ibuprofen (Motrin) should be used to reduce his fever, not aspirin c) it is best to wait to see if the fever gets worse d) you can use aspirin, nut be sure to follow the instructions on the bottle

a) acetaminophen (Tylenol) should be used to reduce his fever, not aspirin

all of the following statements regarding acetaminophen (Tylenol) are true except: a) acetaminophen has anti-inflammatory properties similar to aspirin b) acetaminophen inhibits prostaglandin synthesis c) acetaminophen is indicated for the treatment of mild to moderate pain

a) acetaminophen has anti-inflammatory properties similar to aspirin

a 38-year old man has come into urgent care with severe hip pain after falling from a ladder at work. he says he has taken several pain pills over the past few hours, but he cannot remember how many he has taken. he hands an empty bottle of acetaminophen (Tylenol). which med would the nurse expect to give? a) acetylcysteine b) acetylcholine c) aspirin d) arovastatin

a) acetylcysteine

a patient in the ICU has a nasogastric tube and is receiving a proton pump inhibitor (PPI). the nurse understands the purpose of the PPI is a) to help prevent stress ulcers b) to increase gastric acid formation c) to promote gastric motility d) to reduce bacteria in the stomach

a) to help prevent stress ulcers

a 78-year old patient is in the recovery room after having a lengthy surgery on this hip. as he is gradually waking up, he requests pain med.within 10 mins after receiving a dose of morphine sulfate, he is very lethargic and his respirations are shallow, with a rate of 6 per minute. the nurse prepares for which priority action at this time? a) administration of naloxone (narcan) b) assessment of the patient's pain level c) close observation of signs of opioid tolerance d) immediate intubation and artificial ventilation

a) administration of naloxone (narcan)

the patient takes an antacid for reflux and an iron supplement for anemia. what info will the nurse be sure to include in patient education regarding these drugs? a) antacids will decrease iron absorption b) iron and antacids must be taken on alternate days c) iron will decrease the effectiveness of antacids d) the drugs have a synergistic effect

a) antacids will decrease iron absorption

the nurse is performing a health history on a patient who has arthritis. the patient reports tinnitus. suspecting a drug adverse effect, the nurse will ask the patient about which med? a) aspirin b) acetaminophen c) anakinra d) prednisone

a) aspirin

a patient who takes high-dose aspirin to treat rheumatoid arthritis has a serum salicylate level of 35 mg/dL. the nurse will perform which action? a) assess the patient for tinnitus b) monitor the patient for signs of eye's syndrome c) notify the provider of severe aspirin dose d) request an order for an increased aspirin dose

a) assess the patient for tinnitus

a patient who recently began having mild symptoms of GERD is reluctant to take meds. what non-pharmacological measures will the nurse recommend to minimize this patients symptoms? select all that apply a) avoid spicy foods b) avoid tobacco products c) take ibuprofen with food d) drink a glass of red wine with dinner e) wear tight clothing

a) avoid spicy foods b) avoid tobacco products

a client is tarting celecoxib (Celebrex) to treat osteoarthritis. the nurse should instruct the client to watch for and report which of the following adverse effects? a) black, tarry stools b) bone pain c) dry mouth d) polyuria

a) black, tarry stools

a patient with nausea is taking ondansetron (zofran). she asks the nurse how the drug works. the nurse is aware that this med has which action? a) blocks afferent vagal nerve terminal in the upper GI tract b) blocks dopamine receptors in the chemoreceptor trigger zone (CTZ) c) enhances histamine 2 receptor sites d) stimulates anticholinergic receptor sites

a) blocks afferent vagal nerve terminal in the upper GI tract

the patient is taking Hugh-dose NSAID therapy for arthritis. she is also taking sucralfate (carafate). what lab value would concern the nurse? a) blood glucose 195 mg/dL b) magnesium 2.0 mEq/L c) potassium 3.6 mEq/L d) sodium 144 mEq/L

a) blood glucose 195 mg/dL

bisacodyl (dulcolax) has been ordered for a patient the nurse check the patient's med history and would be concerned if he saw a history of which condition? a) bowel obstruction b) chronic constipation c) high ammonia levels due to liver failure d) prolonged QT interval

a) bowel obstruction

a patient has been prescribed diphenoxylate/atropine (lomotil). the nurse knows atropine is added to decrease abdominal cramping and discourage abuse. which side effect would the nurse NOT expect the patient to experience while taking this med? a) bradycardia b) constipation c) dry mouth d) urinary retention

a) bradycardia

a patient is taking pantoprazole, (protonix) 20 mg per day to treat duodenal ulcer. after 10 days of treatment the patient reports that the pain has subsided. the nurse will counsel the patient to: a) continue the med for up to 4-8 total weeks of treatment b) reduce the med dose by half c) stop taking the med d) take the med every other day

a) continue the med for up to 4-8 total weeks of treatment

a patient is taking ibuprofen 400 mg every 4 hours to treat moderate arthritis pain and reports that is is less effective than before, what action will the nurse take? a) counsel the patient to discuss a change in dose or changing to a prescription NSAID with the provider b) recommend adding aspirin to increase the anti-inflammatory effect c) suggest asking the provider about a short course of corticosteroids d) tell the patient to increase the dose to 800 mg every 4 hours

a) counsel the patient to discuss a change in dose or changing to a prescription NSAID with the provider

the nurse is teaching a patient who is about to take a long care trip about using dimenhydrinate (dramamine), an over the counter antiemetic, to prevent motion sickness. what info is important to include when teaching this patient? a) do not drive while taking this med b) dry mouth is a sign of toxicity with this med c) take this med 1 to 2 hours prior to beginning the trip d) take 100 mg up to 6 times daily for best effect

a) do not drive while taking this med

a patient who is taking NSAIDs for arthritis complains of persistent heartburn. what further question(s) should the nurse ask the patient about the heartburn? select all that apply a) do you take your drug with food? b) have you been drinking an increased amount of water? c) have you noticed a change in the color of your bowel movements? d) what dosage of the NSADI are you taking? e) where is the heartburn located

a) do you take your drug with food? c) have you noticed a change in the color of your bowel movements? d) what dosage of the NSADI are you taking? e) where is the heartburn located

the nurse knows that promethazine, an antiemetic, can cause the following side effects: a) drowsiness, dizziness, confusion b) increased hunger and diarrhea c) nausea and vomiting d) hyperglycemia and increase in cholesterol

a) drowsiness, dizziness, confusion

which of the following are characteristic signs of inflammation? select all that apply a) edema b) erythema c) heat d) loss of feeling e) pain

a) edema b) erythema c) heat e) pain

the nurse is caring for a patient who has been prescribed pantoprazole (protonix) for GERD. the patient is also taking digoxin (Lanoxin) for atrial-fibrillation. the nurse knows the pantoprazole (protonix) will have what type of effect on digoxin: a) enhance the action of digoxin b) decrease the effectiveness of digoxin c) have no effect on digoxin d) create a need for higher dose of digoxin

a) enhance the action of digoxin

a patient is taking aspirin to help prevent myocardial infarction and is experiencing moderate GI upset. the nurse will contact the patient's provider to discuss changing the patient to which drug? a) enteric-coated aspirin b) acetaminophen (Tylenol) c) celecoxib (Celebrex) d) ibuprofen (Motrin)

a) enteric-coated aspirin

a patient will be discharged within a 1 week supply of an opioid analgesic for pain management after abdominal surgery. the nurse will include which info in the teaching plan? a) how to prevent constipation b) how to prevent dehydration due to diarrhea c) the importance of taking the drug on an empty stomach d) the importance of taking the drug only when the pain is severe

a) how to prevent constipation

the nurse is caring for a patient who has unexplained, recurrent vomiting, is dehydrated, and is unable to keep anything down. until the cause of the vomiting is determined, the nurse will anticipate administering which meds? a) intravenous fluid and electrolytes b) antibiotics and antiemetics c) nonprescription antiemetics d) prescription antiemetics

a) intravenous fluid and electrolytes

a patient who's osteoarthritis with mild to moderate pain asks the nurse about taking OTC ibuprofen (Motrin). what will the nurse tell the patient? a) it may take several weeks to achieve therapeutic effects b) combine ibuprofen with acetaminophen for best effect c) take ibuprofen twice daily for maximum analgesic benefit d) unlike aspirin, there is no increase risk of bleeding with ibuprofen

a) it may take several weeks to achieve therapeutic effects

which of the following statements most accurately demonstrates a knowledge of effective pain management? a) pain should be treated before it is severe b) pain is perceived by all cultures equally c) pain med should be prescribed at the highest possible dose d) PRN pain ,ed maintains a consistent therapeutic level of the drug

a) pain should be treated before it is severe

the nurse knows the amount of pain a person can endure without interfering with normal function is known as: a) pain tolerance b) absolute pain c) pain threshold d) therapeutic level of pain

a) pain tolerance

the nurse is caring for a patient who is experiencing abdominal cramping, watery stools, and has a fever of 102.4 F (39.1 C). the patient is diagnosed with clostridium difficile-associated diarrhea (CDAD). in reviewing the patient's med list, the nurse knows this med can cause CDAD a) pantoprazole (protonix) b) ibuprofen (Motrin) c) diphenoxylate/atropine (lomotil) d) sucralfate (carafate)

a) pantoprazole (protonix)

the nurse is preparing to administer a first dose of clopidogrel (plavix) to a patient. as part of the history, the nurse learns that the patient has a previous history of peptic ulcers and hypertension. the nurse understands that it will be necessary to notify the provider and obtain an order fir a) proton pump inhibitor med b) frequent serum glucose monitoring c) increased antihypertensive meds d) non steroidal anti-inflammatory meds

a) proton pump inhibitor med

a patient with peptic ulcer disease is noted to have a positive breath test for H. pylori. the nurse would anticipate treating treating the patient with which meds? a) proton pump inhibitors and antibiotics b) antacids and narcotics c) emetic agents and tranquilizers d) pepsin inhibitors and antibiotics

a) proton pump inhibitors and antibiotics

during assessment of a patient with osteoarthritis pain, the nurse knows that which condition is a contraindication to the use of non steroidal anti-inflammatory drugs (NSAIDs)? a) renal insufficiency b) diabetes mellitus c) headaches d) rheumatoid arthritis

a) renal insufficiency

a nurse is caring for a post op patient who had abdominal surgery and reports incisional pain. the surgeon has prescribed morphine 4 mg IV every 6 hours as needed. before administering this med, the nurse should complete which priority assessment? a) respiratory rate b) blood pressure c) apical heart rate c) temp

a) respiratory rate

what is the mechanism of action of a stimulant laxative? a) stimulant laxatives irritate the intestine directly, promoting peristalsis and evacuation b) stimulant laxatives draw water into the small intestine to facilitate the passage of feces c) stimulant laxatives increase bulk and stimulates peristalsis d) stimulant laxatives lubricate the intestinal wall and softens stool

a) stimulant laxatives irritate the intestine directly, promoting peristalsis and evacuation

a hospice nurse is caring for a client who her terminal cancer and takes PO morphine for pain relief. the client reports that he had to increase the dose of morphine this week to obtain pain relief. which of the following scenarios should the nurse document as the explanation for this situation? a) the client has developed a tolerance to this med b) the client has not been taking the med properly c) the client is experiencing episodes of confusion d) the client has become addicted to the med

a) the client has developed a tolerance to this med

the patient is taking a COX-2 inhibitor for ankylosing spondylitis. the nurse knows the COX-2 enzyme acts by doing which of the following a) triggering inflammation b) decreasing fever c) promoting platelet aggregation d) protecting stomach lining

a) triggering inflammation

a patient arrives at the urgent care center complaining of the leg pain after a fall when rock climbing. the x-ray shows no broken bones, but he has a large bruise on his thigh. the patient says he drives a truck and does not want to take anything strong because he needs to stay awake. which statement by the nurse is most appropriate? a) you can take acetaminophen (Tylenol) for pain, but should not take more than 4000 mg per day b) it would be best for you not to take anything if you are planning to drive your truck c) we will discuss with your doctor about taking an opioid because that would work best for your pain d) you can take acetaminophen (Tylenol) for pain, but should not take more than 2000 mg per day

a) you can take acetaminophen (Tylenol) for pain, but should not take more than 4000 mg per day

the parent of an 18-month old toddler calls the clinic to report that the child has vomited 5 times that day. the nurse determines that the child has had 3 wet diapers in the past 6 hours. what will the nurse recommend for this child? a) administering an OTC antiemetic med such as diphenhydramine b) giving frequent, small amounts of pedialyte c) keeping the child NPO until committing subsides d) taking the child to the emergency department for IV fluids

b) giving frequent, small amounts of pedialyte

the nurse assumes care of a patient in the post-anesthesia care unit (PACU). the patient has abdominal surgery and is receiving intravenous morphine sulfate for pain. the patient is asleep and has not voided since prior to surgery. the nurse assesses a respiratory rate of 9 breaths per minutes endnotes hypoactive bowel sounds. the nurse will contact the surgeon to report which condition? a) paralytic ileus b) respiratory depression c) somnolence d) urinary retention

b) respiratory depression

a patient is taking esomeprazole (Nexium) 15 mg per day to treat a duodenal ulcer. after 10 days of treatment, the patient reports that the pain has subsided. the nurse will counsel the patient to do which of the following? a) reduce the med dose by half b) stop taking the med c) continue the med for 4 ,more weeks d) take the med every other day

c) continue the med for 4 ,more weeks

a patient who is taking aspirin for arthritis pain asks the nurse why it also causes GI upset. the nurse understands that this is because aspirin: a) increases gI secretions b) increases hypersensitivity reactions c) inhibits COX-1 and COX-2 d) selectively inhibits COX-2

c) inhibits COX-1 and COX-2

the nurse is performing an admission assessment on an adolescent who reports taking extra-strength acetaminophen (Tylenol) regularly to treat daily headaches. the nurse will notify the patients provider and discuss an order of which of the following? a) morphine for headache pain b) hydrocodone for headache pain c) liver enzyme test d) serum glucose testing

c) liver enzyme test

a woman who is 2 months pregnant reports having morning sickness every day and asks if she can take any meds to treat this problem. the nurse will recommend that the patient try which intervention first? a) discuss a possible need for intravenous fluids with her provider b) contacting the provider to discuss prescribing a [prescription antiemetic c) use nonpharmacologic measures, such as eating crackers or dry toast d) take over-the counter antiemetics such as diphenhydramine

c) use nonpharmacologic measures, such as eating crackers or dry toast

a patient asks the nurse about using an antidiarrheal to treat infectious diarrhea. which response will the nurse give? a) an antidiarrheal may result in many CNS side effects b) an antidiarrheal has no effect on infectious diarrhea. to simvastatin c) an antidiarrheal is taken once daily d) an antidiarrheal may prolong the symptom

d) an antidiarrheal may prolong the symptom

the nurse is caring for a patient who has postoperative nausea and vomiting. the surgeon has ordered promethazine HCl (phenergan). which aspect of this patient's health history would be of concern? a) asthma b) diabetes c) GERD d) glaucoma

d) glaucoma

the nurse is caring for a patient who will begin taking a proton pump inhibitor 20 mg per day for 4-8 weeks to treat gastroesophageal reflux disease esophagitis. the nurse learns that the patient takes digoxin. the nurse will contact the provider for orders to : a) decrease the dose of the proton pump inhibitor b) increase the dose of digoxin c) increase the dose of the proton pump inhibitor to 60 mg per day d) monitor for digoxin toxicity

d) monitor for digoxin toxicity