Final 2

A 65-year-old man who weighs 180 pounds (81.8 kg) is to receive 1.5 mL of a viscous antibiotic by intramuscular (IM) injection. Which needle and syringe will be used? A. 5/8 inch, 25 gauge needle with 5 mL syringe B. 1 1/2 inch, 21 gauge needle with 3 mL syringe C. 3 inch, 16 gauge needle with 1.5 mL syringe D. 1 inch, 28 gauge needle with 4 mL syringe

B

Which substance(s) may increase the toxic effects of benzodiazepines? (Select all that apply) A. Alcohol B. Analgesics C. Sedatives D. Hypnotics E. Anti-histamines

A,B,C,D,E

How long after the administration of a parenteral pain medication will the nurse complete the next pain assessment to evaluate the effectiveness of the medication? A. 30 minutes B. 1 hour C. 10 minutes D. 2 hours

A

The nurse is educating a patient about diabetes. Based on recommendations from the American diabetes Association, which statement by the nurse is best regarding site rotation? A. "It is important to rotate injection sites systematically within one area before progressing to a new site for injection." B. "Insulin injection sites should always be in the abdomen to ensure absorption into the stomach." C. "Following exercise, site rotation is not indicated because the circulation in the muscles will absorb the medication efficiently." D. "If you aspirate, set rotation can be done every other day to avoid developing problems with absorption."

A

What is the appropriate nursing action when administering a vaginal suppository? A. Ask the patient to urinate prior to insertion B. Assist the patient to side lying position C. Keep suppository refrigerated prior to insertion D. Insert the suppository 1 inch into the vagina

A

In which case would the nurse be correct in with holding an opiate agonist? A. Presence of constipation B. Respiratory rate of 10 breaths/min C. Evidence of postural hypotension D. Pain rating of 7 on a 0 to 10 scale

B

Which statement(s) about administering medications parenterally is/are true? (Select all that apply) A. Subcut absorption is slower than intradermal absorption B. Needles 1 to 1 1/2 inches in length are common for IM injections C. Gluteal area is recommended for children D. Two mL or less should be administered in a subcut site E. The scapular areas of the back may be used for intradermal injections

B,D,E

A patient has been prescribed lorazepam (Ativan), a benzodiazepine used to treat insomnia. Which action will the nurse take? A. Instruct the patient to lay down before taking the medication B. Inform the patient discontinued medication went to sleep improves C. Assess the patient's blood pressure and sitting and lying positions D. Advise the patient to take the medication with food

C

A two-year-old child is hospitalized with the diagnosis of tonsillitis and bilateral otitis media. The nurse is preparing to administer eardrops. When instilling the ear drops, the nurse will pull the air lobe: A. Upward and back B. Sideways and up C. Downward and back D. Sideways and down

C

The nurse cleansing the skin surface of a patient prior to injection will start at the: A. Injection site and work outward in a straight line B. Periphery and work inward in a back-and-forth motion C. Injection site and work out word in a circular motion D. Periphery and work inward in a cyclical motion

C

After teaching a diabetic patient about proper disposal of used syringes and needles, which statement by the patient indicates a need for further teaching? A. "Even needles with sleeves should be disposed of appropriately." B. "It is important for me to use the designated container to dispose of my syringes and needles." C. "I am going to purchase the sharps by mail disposal system once I am home." D. "It is unusual that anyone could get a needle injury or disease from used needles."

D

Before the initiation of anticholinergic medications, it is important for the nurse to screen patients for which condition? A. Infectious diseases B. Diabetes C. Hypertension D. Closed angle glaucoma

D

Which syringe will the nurse use to administer insulin subcutaneously to a patient? A. A syringe calibrated in ml B. A syringe calibrated in minims C. A syringe calibrated in tenths of ml D. A syringe calibrated in units

D

Which type of lubricant with the nurse used to administer a rectal suppository? A. Petroleum jelly B. Water soluble C. Anesthetic D. Mineral oil

B

NG medication administration includes which principle(s)? (Select all that apply) A. All medications can be combined into one syringe B. Tablets and capsules should be dissolved in water C. Flush the tube with 30 ml of water after drug administration D. The tube must be assessed for correct placement E. The suction source should be immediately reconnected

B,C,D

A patient is being discharged on an adrenergic bronchodilator. Which common adverse effect(s) will the nurse include in discharge teaching? (Select all that apply) A. Hypoglycemia B. Tremors C. Dizziness D. Orthostatic hypotension E. Palpitations

B,C,D,E

When preparing parenteral medications, The nurse should perform which intervention(s)? (Select all that apply) A. Use sterile technique throughout the entire procedure B. Check calculations C. Check the drug dose from ordered against the source available D. Check the expiration date E. Prepare the drug in a clean well-lighted area

B,C,D,E

Why are benzodiazepines often preferred over barbiturates? (Select all that apply) A. There are no hypotensive episodes when rising to a sitting position B. They have selective action at specific receptor sites C. REM sleep is decreased to a lesser extent D. There is a wide range of safety between therapeutic and lethal levels E. Accidental overdoses are well tolerated

B,C,D,E

The nurse is providing education to a patient who has been prescribed bupropion (Wellbutrin) for smoking cessation. Which statement by the patient would indicate the need for further teaching? A. "If I have the urge to smoke, I will take more medication" B. "My dose will increase after three days" C. "I do not need to taper my dose when the drug is discontinued" D. "I should swallow this medication whole"

A

The nurse is teaching a patient about nitroglycerin ointment. Which is an advantage of this form of the medication? A. It provides relief of anginal pain for several hours longer than sublingual medication B. It is not give the patient a bad taste in the mouth C. The amount of ointment does not matter in obtaining a therapeutic response D. It does not cause headaches as an adverse effect

A

What instruction is most important for the nurse to teach the patient was recently been prescribed alprazolam (Xanax)? A. "You may feel dizzy or unsteady when rising to a standing position" B. "Smoking will require a reduction in dosage of the medication" C. "Over the counter medications are safe to take while on this medication" D. "The medication needs to be taken on an empty stomach"

A

Which is an accurate nursing action when treating a patient's rash with a lotion? A. Pat on the area with a glove hand B. Cover the area with gauze because of the oil base C. Cleansed area with alcohol prior to treatment D. Avoid shaking the container prior to application

A

Which is the preferred IM site for injecting a 6 month old child? A. Vastus lateralis B. Dorsogluteal C. Abdominal D. Deltoid muscle

A

Which patient assessment would indicate to the nurse that salicylate toxicity is occurring? A. Tinnitus B. Occasional nausea C. Gastrointestinal (GI) bleeding D. Increased bleeding times

A

Which route of administration would be ordered by the healthcare provider if a patient is vomiting? A. Rectal B. Gastrostomy tube C. Ophthalmic D. Intradermal

A

An adult pt is to receive 10 ml of cough syrup at 0800. The nurse can prepare to administer this medication in a(n): (select all the apply) A. Oral syringe B. Medicine cup C. Nipple D. Teaspoon E. Soufflé cup

A,B

The nurse is assessing a patient prior to discharge from same-day surgery following an incisional breast biopsy. When assessing the patient's central nervous system (CNS) function following sedative-hypnotic therapy, what was the nurse include? (Select all that apply) A. Orientation B. Ability to perform motor functions C. Level of alertness D. Usual pattern of sleep E. Blood pressure

A,B,C

What will the nurse include in the teaching plan for a patient with depression being treated with amitriptyline (Elavil)? (Select all that apply) A. Rise slowly from supine or sitting position to avoid dizziness and orthostatic hypotension B. Dryness of the mouth is normal; sucking on sugar-free hard Candy and ice chips or chewing gum may help alleviate this problem C. Avoid alcohol and barbiturates D. If adverse effects occur, discontinue the medication E. An immediate elevation in mood will be noted

A,B,C

Which nursing action(s) would be appropriate when administering a disposable enema? (Select all that apply) A. Maintain the six rights of medication administration B. Position the pt on the left side C. Lubricate the rectal tube D. Instruct the pt to hold the solution 30 minutes before defecating E. Allow the solution to flow in by gravity

A,B,C,D

The nurse administering an oral medication to a 90 year old pt who has difficulty swallowing pills. One of the medications to be administered is a spansule type capsule. What nursing consideration(s) should be applied in this case? (Select all that apply) A. Check with the pharmacist to see if the spansule medication comes in a liquid form B. Check the patient's ID band with the MAR to ensure pt rights are followed C.crush medications and administer with a soft food, such as applesauce D. Have an 8-oz glass of water available E. Wash hands before preparing medications and before administration

A,B,D,E

Patients taking phenytoin (Dilantin) for control of seizures must be aware of the risk for which adverse effects? (Select all that apply) A. Hyperglycemia B. Urinary retention C. Gingival hyperplasia D. Blood dyscrasias E. Sedation

A,C,D,E

Which common adverse effect(s) is/are associated with opiate agonists? (Select all that apply) A. Confusion B. Urinary urgency C. Respiratory depression D. Dizziness E. Orthostatic hypotension

A,C,D,E

Which action(s) will the nurse perform when preparing to administer a topical medication? (Select all that apply) A. Wear gloves during the application process B. Maintain a dry environment to encourage wound healing C. Use sterile dressings for all wounds D. Wash hands before and after administration

A,D

A patient receiving diazepam (Valium) is complaining of nausea and vomiting and is being jaundice. Which type of bloodwork will be performed? A. Renal function tests B. Liver function tests C. Electrolyte panels D. Clotting times

B

A patient with a history of type 1 diabetes after myocardial infarction has been placed on a beta-adrenergic blocking agent. Which statement by the patient indicates a need for further teaching? A, "This medication should not be discontinued suddenly." B. "This medication lowers my blood pressure by helping me get rid of fluid." C. "This medication may take a few weeks to work." D. "I may not have my usual symptoms of a hypoglycemic reaction while on this drug."

B

In which position would the nurse place a patient before the administration of an enteral feeding? A. Supine B. Semi-Fowler's C. Prone D. Left lateral

B

On what is the choice of tricyclic antidepressant based? A. The need to decrease the action of norepinephrine, dopamine, or serotonin B. Patient age and gender C. An absence of adverse effects, such as orthostatic hypotension D. The need for stimulation and increased mental alertness

B

The nurse is completing an assessment on a nonverbal adult patient. Which type of pain skill assessment tool is the most accurate to use? A. MOPS B. FLACC C. TPPPS D. POCIS

B

The nurse is preparing and otic solution. When instructing the patient in regard to area of administration, the nurse will explain that the solution will be placed: A. Into the eye B. Into the ear C. Under the tongue D. Topically

B

What instruction is most important for the nurse to teach the patient who has recently been prescribed alprazolam (Xanax)? A. "Smoking will require a reduction in dosage of the medication." B. "You may feel dizzy or unsteady when rising to a standing position." C. "The medicaton needs to be taken on an empty stomach." D. "Over-the-counter medications are safe to take while on this medication."

B

What is the action of MAOIs on neurotransmitters? A. Increasing their reuptake B. Blocking their destruction C. Increasing the production D. Blocking the reuptake

B

What is the rationale for the nurse applying gentle pressure to the inner corner of the eyelid after instilling eyedrops? A. Provides comfort to the patient B. Prevent systemic effects C. Maintains intraocular pressure D. Decreases the risk of infection

B

When a patient taking a monoamine oxidase B inhibitor receives his dietary tray, the Nurse knows to remove the: A. Coffee B. Cheese C. Eggs D. Bread

B

Which action by the nurse is accurate when withdrawing medication into a syringe from a vial? A. Remove the rubber stopper on the top of the vial B. Inject an amount of air equal to the medication into the vial C. Discard the initial 0.5 ml of medication to ensure sterility D. Break the thin neck of the vial container

B

Which category of medications is used for peripheral vascular diseases characterized by excessive vasoconstriction, such as Raynaud's disease? A. Cholinergic agents B. Beta-adrenergic blocking agents C. Alpha-adrenergic blocking agents D. Adrenergic agents

B

Which is a characteristic of medication administration via the recta route? A. Use of the first pass metabolism B. Bypassing of the digestive enzyme C. Nausea and vomiting D. Irritation of the mouth

B

Which statement(s) is/are true regarding the pharmacologic actions of certain antidepressant drugs? (Select all that apply) A. MAOIs block the effects of dopamine in the CNS B. Monocyclic antidepressants such as bupropion (Wellbutrin) have an unknown mechanism of action C. SNRIs prolong the action of neurotransmitters by decreasing the destruction of serotonin and norepinephrine D. Tricyclic antidepressants block the action of norepinephrine and epinephrine in the SNS E. SSRIs inhibit the destruction and reuptake of serotonin at the synaptic cleft

B,C,E

Which instruction(s) given by the nurse will assist a patient to cope with a common adverse effects of anticholinergic medications? (Select all that apply) A. "Decrease fiber in the diet" B. "Increase fluids daily" C. "Take the medication with meals" D. "Suck on candy or ice chips" E. "Monitor blood glucose"

B,D

Which food(s) containing significant amount of tyramine will be contraindicated when a patient is on MAOI therapy? (Select all that apply) A. Green vegetables B. Aged cheeses C. Red meat D. Beer E. Bananas

B,D,E

The nurse Is providing education to a patient recently prescribed pregabalin (Lyrica). Which statement by the patient indicates a need for further instruction? A. "I may feel tired at first, but this should improve with continued use." B. "This drug may affect my mental alertness, so I need to be careful around the machinery." C. "Once my pain approves, I will stop taking this medication." D. "Taking sleeping aids will increase the sedative effect of this medication."

C

The nurse is preparing to administer a medication in tablet form to a patient. In administering this medication, the nurse will encourage the patient to: A. Drink a large amount of water prior to administration so that swallowing is easier B. Placed the medication on the front of the tongue C. Keep the head forward while swallowing D. Minimize the amount of fluid taken following medication administration

C

Which action by the nurse is appropriate when administering enteric-coated tablets? A. Crush the tablet and mix with applesauce B. Instruct the patient to place the medication between the cheek and teeth C. Encourage the patient to drink a full glass of water D. Administer with an antacid

C

Which action by the nurse is most accurate when administering an intradermal injection? A. Wipe the site with alcohol after injection B. Insert the needle at a 45° angle C. Inject 0.1 mL D. You say 22 gauge needle

C

Which condition would indicate to the nurse that a patient has phenytoin (Dilantin) toxicity? A. Strabismus B. Oculogyric crisis C. Nystagmus D. Amblyopia

C

In preparing to administer medications to a pt with an NG tube, which would be appropriate to give through that route? (Select all that apply) A. Timed release capsules emptied into 30 ml of water B. Enteric coated tablets crushed and diluted in 30 ml of water C. Tablets crushed and diluted in 30 ml of water D. Liquid medication E. Capsules emptied into 30 ml of water

C,D,E

Which needle will the nurse use to administer an intramuscular (IM) immunization on an 18 month old child? A. 25 gauge, 1 1/2 inch needle B. 18 gauge, 1 inch needle C. 20 gauge, 1/2 inch needle D. 27 gauge, 1 1/2 inch needle

D

Which nerve endings liberate norepinephrine? A. Cholinergic B. Muscarinic C. Anticholinergic D. Adrenergic

D

Which nursing action is accurate when administering and IM injection using the Z track method? A. Vigorously massage the injection site B. Pinch up the skin C. Use a 1 inch needle D. Add 0.5 mL of air to the syringe

D

Which patient assessment would indicate to the nurse that salicylate toxicity is occurring? A. Gastrointestinal (GI) bleeding B. Occasional nausea C. Increased bleeding times D. Tinnitus

D

An older adult patient is to receive atenolol, a beta adrenergic blocking agent. Prior to administration of the drug, the nurse assesses an apical pulse rate of 58 and notes ankle edema. Which action will the nurse take first? A. Elevate the patients legs B. Encourage the patient to decrease water intake C. Determine the therapeutic blood level D. Withhold the medication

D

Lithium (Eskalith) is the drug of choice for which of the following disorders? A. Depressive disorders B. Obsessive compulsive disorders (OCDs) C. Psychotic episodes D. Bipolar disorders

D

The nurse is preparing to administer insulin. What does U 100 indicate? A. 10 units/ml B. 10 units/100 ml C. 100 ml/unit D. 100 units/ml

D

The nurse is providing information to a patient recently prescribed entacapone. Which statement is correct? A. Medication increases the production of dopamine in the brain B. There will be fewer incidences of dopaminergic effects such as confusion C. This medication is not to be taken with carbidopa levodopa D. Dosage is adjusted according to the patient response

D

The nurse is teaching a patient with Parkinson's disease about levodopa. Which statement by the nurse is accurate regarding drug administration? A. "Take this medication in between meals" B. "Take this medication at bedtime to prevent dizziness" C. "Take this medication when your tremors get worse" D. "Takes medication with food or anti-acids to reduce G.I. upset"

D

The outcome statement for a patient suffering from anxiety disorder reads, "After 1 week on alprazolam (Xanax) therapy, patient will exhibit a manageable level of anxiety." Which assessment finding validates that this outcome is met? A. Patient is unable to participate in group therapy conversations B. Patient verifies that family reunions triggering anxiety and excessive drinking C. Patient reports persistent fear about dying of a rare illness D. Patient reports sleeping better and increased interest in activities

D

What information is most accurate regarding the nurses understanding of pain management? A. Older patients have difficulty describing their pain level B. Use the smallest dose of medication possible to control pain C. Pain medication administration ordered PRN with maintain a constant blood level D. Encourage patients to report pain before the pain becomes too severe

D

What is the major advantage of selective serotonin reuptake inhibitor's (SSRIs) over other types of antidepressant therapy? A. They are less expensive than the other classes of antidepressants B. The cure major depressive illnesses C. Therapeutic relief is immediate D. They do not cause the anti-cholinergic and cardiovascular adverse effects

D

When applying Nitroglycerin topically, which nursing intervention is correct? A. Remind the patient to discontinue use of the medication is chest pain is relieved B. Shave the area prior to application of the paper C. Secure the paper on two sides with tape D. Wear gloves while placing the new paper

D

Which angle is appropriate when administering an IM medication in the dorsogluteal site to a 46-year-old obese man? A. 45 degrees B. 60 degrees C. 75 degrees D. 90 degrees

D

Oral drug administration includes which principle(s)? (Select all that apply) A. Insulin able to be administered via this route B. Drugs delivered directly by the oral, recital, or nasogastric (NG) methods C. Dependable rate of absorption D. Most economical E. Dosage forms re convenient and readily available

D,E