South U Pharm II Test 5

Which member of the active military would be a candidate for immediate smallpox vaccination?

A man whose father was diagnosed with acute coronary syndrome at age 42

A nurse should give which instruction about ear hygiene to the parent of a child who has "swimmer's ear"?

"After swimming, tip the head to each side to promote water drainage."

Which statement by a nursing student indicates a need for further instruction?

"Artificial tears should not be used more than 4 times daily to avoid adverse effects."

A patient tells the nurse, "I use a foam contraceptive by applying it 2 hours before having sex, and I have not gotten pregnant." What is the nurse's best response?

"Foam contraceptives should be applied no more than 1 hour before intercourse."

Which of these instructions should a nurse give a patient who is to start taking clomiphene (Clomid)?

"Have intercourse every other day for 5 to 10 days after the last dose of this medication."

A patient taking sildenafil (Viagra) asks a nurse what action to take if priapism occurs. Which response should the nurse make?

"Seek emergency help, because permanent damage can occur."

A patient diagnosed with Wilson's disease has been ordered penicillamine (Cuprimine) 250 mg 4 times/day. Which statement should the nurse include when providing discharge instructions?

"The medication should be taken 1 hour before meals and at bedtime."

A community nurse is teaching poisoning prevention to a patient who has several young children. Which statement should be included in the nurse's teaching?

"The poison control center facilitates rapid treatment of accidental poisoning."

Which instruction should the nurse include in the teaching plan for a patient who is to be started on brimonidine (Alphagan) ophthalmic drops?

"Wait 15 minutes after instilling the eye drops before putting in your contact lenses."

Which application instruction is the priority for a nurse to provide to a patient starting to use AndroGel testosterone gel?

"Wash your hands after applying the gel to prevent transfer to others

Which action should a nurse take when a pregnant patient develops uterine contractions after receiving dinoprostone (Cervidil) into the vaginal system?

Remove the insert using the long tape.

Which oral hypoglycemic agent must be used cautiously when a patient is taking deferasirox?

Repaglinide (Prandin)

A patient who has iron overload from receiving chronic blood transfusions is being started on deferasirox (Exjade) 500 mg daily. Which statements should be included in the discharge teaching for this patient? (Select all that apply.)

1. "Take the medication at the same time each day." 2. "Avoid taking antacids that contain aluminum." 3. "Disperse the tablet in 3½ ounces of water, orange juice, or apple juice for administration."

A nurse identifies therapeutic goals for androgen therapy for which patients? (Select all that apply.)

1. A male patient with hypogonadism 2. A female patient with breast engorgement 3. A female patient with acquired immunodeficiency syndrome (AIDS)

A nurse is teaching a class to new parents about the prevention of AOM. Which strategies should the nurse include? (Select all that apply.)

1. Avoid day care and childcare centers when respiratory infections are prevalent. 2. Eliminate exposure to tobacco smoke. 3. Promote bottle feeding in an upright position.

A nurse at a screening clinic for primary open-angle glaucoma (POAG) assesses patients for which major risk factors? (Select all that apply.)

1. Black race 2. Familial history 3. Advancing age 4. Elevated intraocular pressure (IOP)

A nurse should recognize that which therapies would be beneficial to a patient with BPH? (Select all that apply.)

1. Botulinum (Botox) 2. Tolterodine (Detrol) 3. Alfuzosin (Uroxatral)

A nurse who is assessing a patient with polycystic ovary syndrome (PCOS) would expect to observe which findings? (Select all that apply.)

1. High blood glucose levels 2. Infertility 3. Absence of menstrual cycles

Which beneficial metabolic effects does estrogen have in nonreproductive tissues? (Select all that apply.)

1. It promotes and suppresses coagulation 2. It reduces low-density lipoproteins (LDLs). 3. It suppresses bone resorption.

A nurse monitors for which adverse cardiovascular effects in a male patient taking testosterone (Androderm)? (Select all that apply.)

1. Pedal edema and weight gain 2. Decrease in high-density lipoprotein (HDL) levels

A nurse teaches a patient to consider which factors when purchasing a sunscreen to protect against a photosensitivity reaction from a medication? (Select all that apply.)

1. Provides UVA protection 2. Contains titanium dioxide 3. Has a sun protection factor (SPF) higher than 15

The Women's Health Initiative (WHI) landmark trial data led to which recommendations about hormone replacement therapy? (Select all that apply.)

1. There are benefits to using HRT short term to reduce vasomotor symptoms. 2. Postmenopausal women should avoid smoking, exercise regularly, and control hypertension. 3. Treatment with HRT for longer than 5 years increases the risk for pulmonary embolus and stroke.

A nurse is planning care for an 18-year-old woman who has acne and is scheduled to start taking isotretinoin. The nurse should establish which outcomes on the plan of care? (Select all that apply.)

1. Use of two effective forms of birth control 2. Registration with the iPLEDGE program 3. Negative pregnancy test result before refills 4. Reports of depressed mood, suicidal thoughts 5. No elevation in blood triglyceride levels

A nursing care plan identifies the need for anthrax pre-exposure vaccination with BioThrax for which high-risk patients? (Select all that apply.)

1. Veterinarians 2. Military personnel

Which instruction should the nurse give a patient who is prescribed a topical glucocorticoid for a dermatologic disorder? (Select all that apply.)

1. You may note some local irritation when using this product." 2. Avoid using any tight-fitting bandages or dressings after applying." 3. "Apply in a thin film and gently rub into the affected area." 4. "Topical glucocorticoids pose a risk of local infection."

A nurse assesses the urine output of a patient receiving oxytocin (Pitocin). Which finding would require immediate follow-up by the nurse?

80 mL in the past 4 hours

Which therapeutic effect is the purpose of a progestin medication in hormone replacement therapy (HRT)?

To suppress endometrial proliferation

A nurse should use which approach when administering activated charcoal to a patient who has ingested a toxic agent?

Administer the dose within 30 minutes of ingestion of the poison.

A nurse is preparing teaching materials about high-dose amoxicillin for a parent whose child has AOM. The child must meet which treatment guideline?

Age younger than 6 months with a certain diagnosis

A patient is scheduled to start taking sildenafil (Viagra). A nurse should recognize that the patient is at risk for developing an adverse cardiac event if the patient's history reveals which of these conditions?

Angina

A nurse teaches a patient at risk of developing progressive vision loss from dry age-related macular degeneration (ARMD) to increase the dietary intake of which nutrients?

Antioxidants and zinc

A nurse prepares to apply timolol (Timoptic) eye drops to a patient who has asthma. Which action should the nurse take when applying the eye drops?

Apply pressure to the inner aspects of the eye during and after administration.

A nurse should report which finding of ovarian hyperstimulation in a woman receiving menotropins?

Ascites and weight gain

For which underlying condition would treatment with betaxolol ophthalmic drops for open-angle glaucoma be contraindicated?

Asymptomatic first-degree heart block

Melanin provides protection against ultraviolet radiation through which layer of the skin?

Basal layer of the epidermis

Which topical antimicrobial does not promote resistance in Propionibacterium acnes when used to treat acne?

Benzoyl peroxide

Which ophthalmic solution would be most appropriate for a patient with open-angle glaucoma and a history of chronic obstructive pulmonary disease (COPD)?

Betaxolol

A nurse teaches a patient who is to start taking brinzolamide (Azopt) about which adverse effect?

Bitter aftertaste

Seven to ten days after symptom onset, a nurse monitoring a patient who has cutaneous anthrax should recognize which finding?

Black eschar lesions

Which assessment should a nurse monitor more frequently in a patient who takes both an alpha blocker for BPH and metoprolol (Lopressor)?

Blood pressure

A patient in the emergency department reports taking sildenafil (Viagra) and nitroglycerin 1 hour before sexual activity. Which finding should the nurse immediately report to the physician?

Blood pressure (BP) of 70/50 mm Hg

A patient is disturbed by the social implications of severe axillary hyperhidrosis. Which agent may reduce the problem?

Botulinum toxin A injections

A nurse obtains a health history from a patient who is scheduled to take a combination OC. Which factor in the patient's history should the nurse recognize as a contraindication to this treatment?

Breast cancer

A nurse assesses a patient who has bacterial acute otitis media (AOM). The nurse should recognize which manifestation if identified in the patient?

Bulging tympanic membrane with otorrhea and otalgia

A patient is receiving dimercaprol (BAL in Oil) for an accidental poisoning. Which action should a nurse expect if the medication is having the desired therapeutic effect?

Chelate formation to inactivate heavy metals

A nurse should recognize which antibiotic regimen from a patient's medication administration record (MAR) as the treatment for inhalation anthrax?

Ciprofloxacin (Cipro) and doxycycline (Vibramycin)

A patient is diagnosed with otitis externa (OE) caused by Aspergillus organisms. Which treatment would not be effective against Aspergillus sp.?

Ciprofloxacin plus hydrocortisone (Cipro-HC) otic solution

A child with AOM and a previous type I allergic reaction to penicillin requires treatment with an antibiotic. Which antibiotic would be a safe choice?

Clarithromycin

The nurse would expect the healthcare provider to prescribe which of these medications, along with hCG, to promote ovulation in selected infertile women?

Clomiphene (Clomid)

A nurse should implement which action when administering the smallpox vaccine?

Cover the injection site with sterile gauze.

When evaluating the effects of ergonovine (Ergotrate), the nurse expects which assessment finding?

Decreased vaginal bleeding

A nurse develops a plan of care for a pregnant patient receiving nifedipine (Procardia). Which outcome should be included?

Delivery is postponed for at least 24 hours.

A nurse evaluates the effects of Augmentin ES-600 in a patient who has resistant AOM. The nurse should recognize which finding as an adverse effect?

Diarrhea

A nurse prepares a patient for an intraocular examination by administering a topical anticholinergic agent intended to achieve which outcome?

Dilation of the pupil

Which clinical manifestation is consistent with exposure to botulinum toxin?

Diplopia and ptosis

A nurse is teaching a postmenopausal patient taking estrogen/progestin therapy (EPT) about breast self-examination (BSE). Which of these instructions should the nurse give?

Do your breast self-examination the first day of each month."

A community health nurse should recognize which manifestation of smallpox if identified in a patient?

Draining pustules on the skin

A nurse teaches a health education class to male adolescents. Which of these topics should be a priority for the nurse to include?

Effects of performance-enhancing androgens

When assessing a patient who takes finasteride (Proscar), a nurse should monitor for which adverse effect?

Ejaculatory dysfunction

A patient reports unfavorable mucus. The healthcare provider would be expected to prescribe which medication to restore cervical mucus to its proper volume and consistency?

Estrogen

A nurse monitors a patient poisoned with botulinum toxin for which manifestation?

Flaccid paralysis

A nurse teaches a patient who has multiple areas of actinic keratoses on the face and scalp about the use of which medication?

Fluorouracil (Efudex)

When evaluating the effects of leuprolide (Lupron) in a patient who has endometriosis, a nurse should monitor the laboratory results for which hormone or hormones?

Follicle-stimulating hormone (FSH) and luteinizing hormone (LH)

A patient who is infertile is taking clomiphene (Clomid). A nurse should expect the patient to have which therapeutic response?

Follicular maturation

A comatose victim found in a garage with an empty antifreeze container is brought to the emergency department by the rescue squad. Which antidote should the nurse anticipate administering?

Fomepizole (Antizole) via intravenous (IV) infusion

A nurse is educating a patient about sildenafil (Viagra). The nurse should instruct the patient that which adverse effect would be a priority for the patient to report to his prescriber?

Hearing loss

A nurse caring for a patient who is taking the prostaglandin analog latanoprost (Xalatan) documents which finding as an adverse effect?

Heightened brown pigment of the iris

A patient who has severe psoriasis is scheduled to start receiving alefacept (Amevive). Which of these medical conditions in the patient's history should the nurse recognize as a contraindication to the treatment?

Human immunodeficiency virus (HIV) infection

Transmission of natural smallpox occurs in which manner?

Human to human

Which of these findings, if identified in a patient receiving ergonovine (Ergotrate), should a nurse report to a physician immediately?

Hypertension

Which statement by a patient being started on tretinoin (Retin-A) for acne treatment indicates a need for further teaching?

I'll apply the Retin-A after washing my face and while it is still slightly damp."

A nurse applies mupirocin (Bactroban) topically 3 times per day to several small vesicle lesions on the feet and legs of a patient with which medical condition?

Impetigo

Before administering calcium EDTA (calcium disodium versenate) to a patient who has lead poisoning, which action should the nurse take?

Infuse intravenous (IV) fluids to ensure an adequate urine flow.

A nurse should recognize which adverse effect in a patient taking a progestin-only OC?

Irregular vaginal bleeding

A nurse should administer which medication to a patient receiving Prussian blue (Radiogardase) after exposure to radioactive cesium?

Laxative

A patient brought to the emergency department is suspected of a heroin overdose based on witnesses' accounts. Which antidote should the nurse anticipate administering?

Naloxone (Narcan)

Which nursing action is the priority for a patient in preterm labor who is receiving magnesium sulfate?

Obtaining deep tendon reflexes

Sensory stimuli from the retina travel to the brain for interpretation by way of which cranial nerve?

Optic nerve

A nurse should recognize that a patient is at risk for developing necrotizing otitis externa (OE) if the patient shows which finding?

Pain at the mastoid or temporal bone

Which measurements should a nurse obtain to evaluate the effects of androgen therapy on the epiphyses of a patient with hypogonadism?

Periodic hand and wrist x-rays

In the event of radiation fallout, which medication should be included in the nursing care plan to reduce the risk of thyroid cancer after exposure to iodine-131?

Potassium iodide (Pima)

A patient who takes an angiotensin-converting enzyme (ACE) medication is scheduled to begin taking the Yaz oral contraceptive (OC). Which laboratory results should the nurse monitor during the first cycle of use?

Potassium level

During the follicular phase of the menstrual cycle, estrogen has which effects on the female reproductive organs?

Proliferation of the endometrium

Which treatment would not be used for the management of wet (neovascular) ARMD?

Prostaglandin analogs

Which nursing action is appropriate for an individual exposed to ricin?

Provide supportive care based on the clinical manifestations.

A nurse administers pilocarpine (Pilocar) eye drops to a patient who has glaucoma. The nurse would expect an increase in which outcome if the medication is having the desired effect?

Pupillary constriction

Which outcome would be appropriate for a nurse to establish for a patient who has otitis media with effusion (OME) after resolution of AOM?

Recovery of hearing loss

A patient takes fluoxetine (Prozac) for premenstrual syndrome (PMS). Which priority assessment allows the nurse to evaluate the effectiveness of this treatment?

Reports of mood improvement

In addition to standard infection control precautions, a nurse implements which additional precautions when caring for a patient with pneumonic plague?

Respiratory precautions

Which description should a nurse document for a patient experiencing miosis as an adverse effect of a systemic medication?

Small, constricted pupils

Which factor should a nurse recognize as one that would increase the risk of thromboembolic phenomena arising from OC use?

Smoking

A female patient is being treated for acne with Ortho Tri-Cyclen. Adequate effectiveness has not been achieved, so spironolactone (Aldactone) is added to the treatment plan. Why is spironolactone added only after a trial of Ortho Tri-Cyclen?

Spironolactone is teratogenic, and contraception must be implemented before the drug is added to the treatment plan.

A patient who is near term gestation is receiving oxytocin (Pitocin). Which response should the nurse expect if the medication is having the desired therapeutic effect?

Stimulation of uterine smooth muscle

The nursing instructor asks a student nurse which bacterial pathogen is most commonly found in the middle ear of children with AOM. The nursing student demonstrates understanding by giving which answer?

Streptococcus pneumoniae

A patient is scheduled to start using tretinoin (Retin-A) topically for acne. The nurse instructs the patient also to begin using which product?

Sunscreen

A nurse plans care for a patient who has ingested a toxic agent. The nurse assigns priority to which measure during the emergent phase of poisoning management?

Supportive care

A parent has four children ranging in age from 3 months to 10 years. At a health screening clinic, a nurse identifies which child as having the highest risk of experiencing an accidental poisoning?

The 2-year-old

Which laboratory value does not require monitoring for a patient receiving treatment with methotrexate (Rheumatrex) for psoriasis?

Thyroid-stimulating hormone (TSH) levels

A nurse teaches a patient who is applying salicylic acid (Lactisol) for acne to report which finding as a manifestation of systemic toxicity?

Tinnitus

A 6-year-old is diagnosed with acute otitis externa (AOE). What would not be recommended as part of the treatment plan for this child?

Tympanostomy tubes may need to be inserted if no response is seen to conventional treatment.

Which approach should a nurse take when performing gastric lavage and aspiration on a patient who has ingested a toxic agent?

Use 10 washes of 150 mL of tap water.

Which finding in a patient receiving an oxytocin (Pitocin) infusion should be reported to the physician immediately?

Uterine contractions lasting longer than 1 minute

Which response is the first indicator of successful vaccination for smallpox?

Within 3 to 4 days of vaccination, a red, itchy bump appears.

Which statement should a nurse include when providing teaching to a patient who is scheduled to start taking dutasteride (Avodart)?

You cannot donate blood while on this medication or for 6 months after stopping it."

A patient infected with the human immunodeficiency virus (HIV) is diagnosed with severe necrotizing otitis externa. Which would be the most appropriate treatment for this condition?

intravenous imipenem/cilastatin (Primaxin)

Luteinizing hormone (LH) levels rise at

midcycle, causing rupture of the follicle, which evolves into a corpus luteum

All women should perform regular breast self-examinations, preferably 1 week after the menstrual cycle ends. It is especially important for postmenopausal women taking a

progestin combined with an estrogen, because this treatment is associated with an increased risk of breast cancer.

Follicle-stimulating hormone (FSH) acts on

the developing ovarian follicles, causing them to ripen and release estrogens in the first half of the cycle.