Exam 1
An elderly patient has refused to take his prescribed antihypertensive tablet. Which action would the nurse perform? 1 Continue to encourage the patient to take the medication. 2 Offer the medication to the patient again after a few hours. 3 Respect the patient's right to refuse and notify the health care provider. 4 Return the unwrapped medication to the medication drawer for future use.
"Document the reason for refusal."
Which response needs review to refocus on objective findings for pain assessment before medicating with analgesics? 1 "I will assess the vital signs." 2 "I will ask the patient to describe the pain." 3 "I will examine the skin for areas or redness or edema." 4 "I will gather medication history from the medical record."
"I will ask the patient to describe the pain."
A patient is prescribed a transdermal preparation of a muscarinic antagonist for overactive bladder. The nurse teaches the patient about methods to alleviate side effects of the medication. Which statement by the patient indicates the need for further teaching? 1 "I will take diphenhydramine for any itching caused by the patch." 2 "I should keep the site covered to protect other people from exposure." 3 "I may need to take a stool softener or laxative to relieve constipation." 4 "I can use some sugar-free gum or sugar-free candy to treat my dry mouth."
"I will take diphenhydramine for any itching caused by the patch."
A patient who is going on a cruise is prescribed scopolamine transdermal patch. Which instructions will the nurse provide to the patient? Select all that apply. 1 "Do not drive a motor vehicle." 2 "You should eat a low-fiber diet." 3 "Do not consume too much water." 4 "You should abstain from alcohol." 5 "You should not use heavy machinery.
do not drive a motor vehicle, you should abstain from alcohol, and you should not use heavy machinery
Which finding alerts the nurse to the possibility that the patient is experiencing adverse effects of morphine sulfate? 1 Diarrhea 2 Insomnia 3 Drowsiness 4 Hyperactive bowel sounds
drowsiness
A swab of a wound infection is sent for culture and, pending culture results, the health care provider starts an intravenous antibiotic. Which type of therapy has been prescribed for this patient? 1 Empiric 2 Palliative 3 Prophylactic 4 Maintenance
empiric
Which information would a nurse gather while performing an assessment of a patient's family support system for effective patient teaching? Select all that apply. 1 The family's eating habits 2 The family's financial status 3 The diseases that run in the family 4 The roles of the various family members 5 The family's communication patterns
family financial status, family member roles, family's communication patterns
Which is the most dangerous effect of thalidomide drugs? 1 Death 2 Renal failure 3 Fetal abnormalities 4 Severe hepatotoxicity
fetal abnormalities
The nurse is assessing a patient who is having intermittent episodes of back pain. The nurse asks the patient what he normally uses to relieve pain. The patient states that he uses a heating pad. Which cultural group does the patient most likely belong? 1 Asian 2 African 3 Hispanic 4 Native American
hispanic
Which drug is the antidote to a cholinergic overdose? 1 Atropine 2 Memantine 3 Epinephrine 4 Rivastigmine
Atropine
The nurse is caring for a patient who was prescribed bethanechol 1 month ago. Which statement made by the patient indicates the medication is effective? 1 "I feel like I am coughing up more phlegm." 2 "I can tell my muscle strength has gotten better." 3 "My family says that my memory has improved." 4 "I have noticed that I have been urinating more frequently."
I have noticed that i have been urinating more frequently
Which type of therapy has been prescribed when a patient is prescribed an oral antidiabetic drug? 1 Acute 2 Palliative 3 Maintenance 4 Supplemental
Maintenance
Which effect does the nurse expect in the patient with heart failure after administration of dobutamine? 1 Arteriolar vasodilation 2 Elevated blood pressure 3 Peripheral vasoconstriction 4 Increased cardiac contractility
increased cardiac contractility
Which characteristic aligns with chronic pain? 1 Sharp 2 Persistent 3 Sudden onset 4 Sympathetic nervous system respons
persistent
Which are therapeutic expected outcomes of adrenergic agonists? Select all that apply. 1 Pink skin color 2 +2 peripheral pulses 3 Wheezing bilaterally 4 Decreased urinary output 5 Pulse rate 60 to 100 beats/min
pink skin color, +2 peripheral pulses, and pulse rate 60-100 beats/min
Which precaution would the nurse take to obtain the informed consent of an older adult patient who will be undergoing retinal surgery? 1 Provide written instructions. 2 Print the material in bright colors. 3 Use interactive methods like audiovisuals. 4 Provide the instructions in an easy-to-read format.
print the material in bright colors
The nurse asks what strategy will be implemented when educating patients who are incapable of differentiating colors. Which answer describes effective learning technique? 1 Videotapes 2 Nonglare light 3 Reading glasses 4 Red and black colors
red and black colors
Which pharmacokinetic changes occur in patients older than 60 years? Select all that apply. 1 Reduction in body fat content 2 Reduced protein concentration 3 Increase in protein-binding sites 4 Presence of 55% of total body water in males 5 Presence of 46% of total body water in females
reduced protein function and presence of 46% of water in females
The nurse is caring for a child who has been prescribed an inhaler for asthma control. The child is having difficulty using the inhaler. Which intervention would the nurse implement? 1 Teach the child to use a spacer. 2 Tell the parent to hold the inhaler for the child. 3 Ask the health care provider to switch to oral medications. 4 Tell the parent that young children should not use inhalers.
teach the child to use a spacer
Which is an important characteristic to remember when giving toddlers medications? 1 The need to develop trust 2 The need to be with peers 3 The need to solve problems 4 The need to develop independence
the need to develop independence
A patient has taken an excessive dose of acetaminophen for pain management. Which adverse effects associated with acetaminophen are likely to be found in the patient? Select all that apply. 1 Nausea 2 Vomiting 3 Blurred vision 4 Decreased hearing 5 Elevated liver enzymes
nausea, vomiting, and elevated liver enzymes
Which drug is indicated in the treatment of myasthenia gravis? 1 Pilocarpine 2 Neostigmine 3 Rivastigmine 4 Succinylcholine
neostigmine
Which prophylactic therapy would the nurse expect to initiate before a patient has surgery? 1 Start preoperative antibiotics. 2 Check blood glucose levels daily. 3 Empty bowels as per the prescription. 4 Type and cross-match blood for transfusion.
start preop antibiotics
Which route of administration would be ideal for a patient with acute angina-like chest pain who is to receive nitroglycerin? 1 Oral 2 Rectal 3 Sublingual 4 Subcutaneous
sublingual
When caring for a patient taking a cholinergic medication for urinary retention, the nurse assesses the patient for which adverse effects? Select all that apply. 1 Sweating 2 Tachycardia 3 Pupil dilation 4 Hypertension 5 Increased salivation
sweating and increased salivation
Which behavior will result in severe hypotension in a 68-year-old patient who is taking tamsulosin? 1 Begins a daily exercise routine 2 Takes medication for erectile dysfunction 3 Sits at the bedside for 1 minute before standing 4 Consumes two alcoholic beverages a day
take medication for ED
Which response is a priority with an older adult who is taking a beta-adrenergic agonist and complaining of headaches? 1 Reassure the patient that this is an expected side effect of the medication. 2 Take the patient's blood pressure and notify the prescribing health care provider. 3 Ask what over-the-counter medications the patient uses to treat headaches. 4 Instruct the patient to maintain a symptom diary documenting the incidence of the headaches
take the patients BP and notify the prescribing health care provider
Which instruction is appropriate for a patient who is on nonsteroidal antiinflammatory drug (NSAID) therapy? 1 Increase fluid intake to 1 to 2 L per day. 2 Take the NSAID with food, milk, or an antacid. 3 Stop the medication if you have any gastrointestinal disturbance. 4 Slowly increase the dosage of medication based on pain intensity.
take with food, milk or an antacid
While admitting a patient for treatment of an acetaminophen overdose, the nurse would prepare to administer which medication to prevent toxicity? 1 Naloxone 2 Vitamin K 3 Acetylcysteine 4 Methylprednisolon
acetylcysteine
The nurse would instruct a patient to avoid caffeine and stimulants when the individual is using which medication? 1 Albuterol 2 Flunisolide 3 Tiotropium 4 Montelukast
albuterol
Which drugs will the nurse use with caution with an older adult with a history of falls and syncope? Select all that apply. 1 Decongestants 2 Anticholinergics 3 Antidepressants 4 Muscle relaxants 5 Antihypertensives
antidepressants, muscle relaxers, and antihypertensives
Which nonsteroidal antiinflammatory drug (NSAID) is prescribed for the patient with myocardial infarction? 1 Aspirin 2 Celecoxib 3 Prednisone 4 Dexamethasone
aspirin
When caring for an older adult, which physiologic cardiac changes would the nurse evaluate to assess for impact of the drug action? Select all that apply. 1 Blood flow 2 Blood group 3 Blood viscosity 4 Cardiac output 5 Blood cell count
blood flow and cardiac output
The nurse is providing education about cholinergic-blocking drug therapy to an older patient. Which information would the nurse include in the teaching plan about maximizing the therapeutic effects and minimizing the adverse effects of these drugs? Select all that apply. 1 "Eliminate high-fiber foods." 2 "Brush your teeth frequently." 3 "Drink six to eight glasses of water daily." 4 "Avoid exposure to high temperatures." 5 "Begin an exercise program three times a week."
brush your teeth frequently, drink 6-8 glasses of water daily, and avoid exposure to high temps
Which action would the nurse perform to help prevent infiltration of a dopamine infusion site? 1 Assess blood pressures in the patient's other arm. 2 Check the site every hour for evidence of swelling. 3 Encourage the patient to call if the site becomes painful. 4 Encourage the patient to lie with her arm held completely straight
check the site every hour for evidence of swelling
he health care provider indicates that a patient will be prescribed an opioid antitussive. Which medication would the nurse anticipate the provider will order? 1 Codeine 2 Benzonatate 3 Levocetirizine
codeine
An older adult with pneumonia is experiencing a cough that is disrupting rest and sleep. Which types of medication would the nurse expect to administer to this patient to promote sleep and rest? Select all that apply. 1 Codeine 2 Fluticasone 3 Guaifenesin 4 Fexofenadine 5 Pseudoephedrine
codeine, and guaifenesin
After finishing a stressful day at work the nurse logs on to a social media website and discusses the day, including the patients at the clinic. Which legal or ethical principle does this violate? 1 Veracity 2 Autonomy 3 Confidentiality 4 Nonmaleficence
confidentiality
Which assessment would be completed prior to administering an adrenergic agonist? 1 Skin integrity 2 Temperature 3 Blood pressure 4 Respiratory rate
BP
Which response is the expected therapeutic effect after the administration of atropine to a patient with cholinergic-blocker poisoning? 1 Decrease in gastric secretions 2 Immediate increase in heart rate 3 Immediate decrease in heart rate 4 Increase in respiratory rate within 1 minute
immediate increase in HR
Which is an expected therapeutic outcome for a patient with Parkinson's disease and dementia who is prescribed rivastigmine? 1 Decreased tremors 2 Decreased salivation 3 Improvement in memory 4 Increased muscle strength
improvement in memory
When teaching an 83-year-old patient about the effects of adrenergic agonists, the nurse will advise the patient to avoid which activity? 1 Slow jog in summer 2 Daily walk around the block 3 Visiting wife in long-term care facility 4 Taking prescribed herbal supplements
slow jog in the summer
In which gestational period is drug transfer to the fetus more likely to happen? 1 First trimester 2 Third trimester 3 Postnatal period 4 Second trimester
third trimester
Which are adverse effects of albuterol? Select all that apply. 1 Tremors 2 Skin rashes 3 Palpitations 4 Tachycardia 5 Hypoglycemia
tremors, palpitations, and tachycardia
Which assessment findings may indicate a need for therapy for overactive bladder syndrome? Select all that apply. 1 Increased thirst 2 Urinating every hour 3 Sudden and strong urge to urinate 4 Constant use of caffeine in the diet 5 Urinating more than two times at night
urinating every hour, sudden and strong urge to urinate, and urinating more than two times at night
A patient is admitted to the emergency department with a diagnosis of "acetaminophen overdose." Which lab value is essential for the nurse to assess? 1 Platelet count 2 Neutrophil count 3 Blood urea nitrogen (BUN) and creatinine levels 4 Aspartate transaminase (AST) and alanine transaminase (ALT) levels
AST and ALT levels
The nurse is explaining to an older adult about age-related gastrointestinal changes that have an impact on drug action. Which changes would the nurse include in the teaching? 1 Reduced gastric pH 2 Altered metabolism 3 Increased peristalsis 4 Delayed gastric emptying
Delayed gastric emptying
Which information would the nurse include regarding the use of antileukotriene agents such as zafirlukast in the patient teaching? 1 "Take the medication as soon as you begin wheezing." 2 "It will take about 3 weeks before you notice a therapeutic effect." 3 "Increase fiber and fluid in your diet to prevent the side effect of constipation." 4 "This medication will prevent the inflammation that causes your asthma attack."
this medication will prevent inflammation that causes your asthma attack
Which question is a priority for the nurse to ask the patient with a recent diagnosis of hypertension who reports dizziness when standing? 1 "How much have you had to drink today?" 2 "What medications are you currently taking?" 3 "Do you have air conditioning in your home?" 4 "Have you been to the sauna in the past 24 hours?"
what medications are you currently taking
The nurse is caring for a patient who states, "I can't take aspirin. It makes my stomach hurt." Which response would the nurse make to the patient? 1 "Try taking the aspirin with milk." 2 "You can try enteric-coated aspirin." 3 "You should take ibuprofen instead." 4 "I will see if you can get a prescription for another pain reliever.
you can try enteric-coated aspirin
The nurse gives instructions about a drug regimen to a Chinese patient who has recently emigrated to the United States. The patient has minimal understanding of the English language. Which instruction given by the nurse is most appropriate? 1 "Don't take the tablet after eating." 2 "Do not take the tablet after eating." 3 "The tablet shouldn't be taken after eating." 4 "You are not supposed to be taking the tablet after eating."
"Do not take after eating"
The nurse is caring for a patient who received atropine tablets for diarrhea. The nurse observes that the patient has mydriasis, altered mental status, and fever. What is the best action for the nurse to take? 1 Administer fluids. 2 Administer aspirin. 3 Administer dicyclomine. 4 Administer physostigmine.
Administer physostigmine.
A patient is affected by dust allergy. Which antibodies are elevated in the patient? 1 Immunoglobulin M (IgM) 2 Immunoglobulin D (IgD) 3 Immunoglobulin E (IgE) 4 Immunoglobulin G (IgG)
IgE
Which statement by the patient indicates an understanding of the teaching regarding beclomethasone dipropionate? 1 "I need to take this medication only when my symptoms get bad." 2 "I will need to taper off the medication to prevent acute adrenal crisis." 3 "I will need to monitor my blood sugar more closely because it may increase." 4 "This medication will help prevent the inflammatory response of my allergies."
This medication will help prevent the inflammatory response of my allergies
A patient with chronic obstructive pulmonary disorder (COPD) is retaining carbon dioxide. Which respiratory therapy would the nurse administer to lower the patient's carbon dioxide concentration? 1 Salmeterol 2 Albuterol nebulizer 3 Fluticasone propionate 4 Oxygen via a nasal cannula, 2 L/min
albuterol nebulizer
The nurse is caring for a patient who is receiving epinephrine for status asthmaticus. The nurse finds that symptoms of status asthmaticus are persistent, even after administration of epinephrine. Which medication will the primary health care provider prescribe for this patient? 1 Albuterol 2 Salmeterol 3 Terbutaline 4 Aminophylline
aminophylline
Which type of drug would the nurse expect to be prescribed for a patient in the emergency department with urticaria after contact with shrubs? 1 Antitussive 2 Expectorant 3 Decongestant 4 Antihistamine
antihistamine
Which questions would the nurse ask when evaluating outcomes of the care plan for a patient beginning opioid therapy? Select all that apply. 1 "Are these outcomes realistic?" 2 "How much does this treatment cost?" 3 "Was a timeline established for meeting goals?" 4 "Are the planned interventions patient-centered?" 5 "What is being measured to determine if goals were met?"
are these outcomes realistic, was a timelines established for meeting goals, are the interventions patient centered, what is being measured to determine if goals were met
The nurse is educating a patient about aspirin administration and its side effects. Which response by the patient indicates effective learning? Select all that apply. Correct1 "Aspirin may produce tarry stools." 2 "Aspirin can be administered before a meal." Correct3 "Aspirin may produce red spots on the body." 4 "Aspirin consumption may cause lower back pain." Correct5 "Aspirin should not be administered if it has a vinegar odor."
aspirin may produce tarry stools, aspirin may produce red spots on the body, and aspirin should no be admin if it has a vinegar odor
A patient with cardiac decompensation is receiving dobutamine as a continuous infusion. The patient's blood pressure has increased from 100/70 mm Hg to 130/80 mm Hg. Which action would the nurse take while the patient is receiving this infusion? 1 Assess frequent blood pressure readings. 2 Assess the patient's electrocardiogram and slow the infusion. 3 Assess the patient's respiratory rate and measure arterial blood gases. 4 Assess the patient's intake and output and decrease intravenous fluids
assess frequent BP readings
Thirty minutes after surgery the nurse in the postanesthesia care unit (PACU) notes that a patient has a respiratory rate of 6 breaths/min. Which action is the nurse's priority? 1 Administer flumazenil. 2 Prepare intravenous naloxone. 3 Initiate resuscitative measures. 4 Assess the patients' responsiveness.
assess the patient's responsiveness
A patient is admitted to the emergency department with a suspected cholinesterase-inhibitor overdose. Which action is the priority nursing intervention? 1 Administer fluids. 2 Monitor urinary output. 3 Administer physostigmine. 4 Attach the patient to a telemetry monitor
attach a patient to a telemetry monitor
Which ethical principle is referred to by promoting decision-making by patients and supporting informed consent? 1 Justice 2 Autonomy 3 Beneficence 4 Confidentiality
autonomy
Which information regarding exercise would the nurse teach a patient who is receiving anticholinergic medications? 1 "Only perform isometric exercise daily." 2 "Exercise regularly to reach a target heart rate." 3 "Avoid exercises that could cause excessive sweating." 4 "Exercise using large muscles such as with jogging or swimming."
avoid exercise that could cause excessive sweating
Which assessment finding in a patient taking nonsteroidal antiinflammatory drugs (NSAIDs) requires immediate intervention? 1 Black, tarry stools 2 Palpitations 3 Nonproductive cough 4 Headache
black, tarry stools
How can the nurse ensure an effective teaching-learning interaction with a Spanish-speaking patient who is visually impaired? 1 By taking help from a translator 2 By providing written instructions 3 By using printed materials with a larger font 4 By performing a baseline hearing assessment
by taking help from a translator
The nurse will administer a drug to an older adult. Which lab will the nurse assess for the patient's renal function to administer this drug safely? 1 Urine urea 2 Serum troponin 3 Urine creatinine 4 Creatinine clearance
creatinine clearance
Effective treatment of pheochromocytoma with an alpha blocker is indicated by elimination of which patient problem? 1 Shoulder pain 2 Severe hypotension 3 Throbbing headaches 4 Hypertensive episodes
hypertensive episodes
Which statement by a patient taking beta blockers has the highest priority for the nurse to address? 1 "I check my sugar more often because it has been high." 2 "I feel dizzy when standing quickly, so I have to get up slowly." 3 "I stopped taking my medicine yesterday because it made me feel tired." 4 "My migraines are not 100% better, so I don't think the medicine is working.
i stopped taking my medicine yesterday because it made me feel tired
Which statement indicates that the patient understands how to take salmeterol for asthma symptoms? 1 "I will give myself one puff twice a day at 7 AM and 7 PM." 2 "I will give myself two puffs at bedtime; that's when I really need it." 3 "I will give myself a puff anytime I start to experience asthmatic symptoms." 4 "I will give myself two puffs three times a day, at 7 AM, noon, and bedtime."
i will give myself one puff twice a day at 7 AM and 7 PM
The health care provider has prescribed epinephrine for a patient to treat an allergic reaction. After reviewing the patient's history, the nurse finds that the patient takes metformin for treatment of diabetes. Which changes may the nurse expect in the primary health care provider's prescription for safe drug administration? 1 Increase in dose of metformin 2 Increase in dose of epinephrine 3 Replacement of metformin with aminophylline 4 Replacement of epinephrine with aminophylline
increase in dose of metformin
A patient is prescribed guaifenesin for treatment of productive cough. Which instruction would the nurse give to the patient for maximum therapeutic effect? 1 "Increase your fluid intake." 2 "Increase your fiber intake." 3 "Increase your protein intake." 4 "Increase your carbohydrate intake."
increase your fluid intake
Which effect is caused by stimulation of the parasympathetic nervous system by a cholinergic drug? 1 Mydriasis 2 Vasoconstriction 3 Urinary retention 4 Increased gastrointestinal (GI) motility
increased GI motility
Which response is elicited by the activation of beta1 receptors located on the sinoatrial node? 1 Vasodilation 2 Vasoconstriction 3 Increased heart rate 4 Increased contractility
increased HR
A cholinergic-blocking agent is administered to a patient with chronic bronchitis. Which finding is an expected outcome of this therapy? 1 Bronchoconstriction 2 Increased secretions 3 Increased respiratory rate 4 Increased airflow to the lungs
increased airflow to the lungs
Which finding indicates donepezil is having a therapeutic effect? 1 Wakefulness 2 Relaxed muscles 3 Urination 4 Increased cognition
increased cognition
Which assessment outcome indicates a therapeutic effect of the administration of pyridostigmine to a patient who has myasthenia gravis? 1 No longer dizzy 2 Improved memory 3 Able to walk long distances 4 Increased muscle strength
increased muscle strength
A patient admitted with Crohn's disease is prescribed intravenous infliximab. Which test would be performed before giving infliximab to this patient? 1 Liver function 2 Cardiac thallium scan 3 Latent tuberculosis 4 Ventricular dysfunction
latent TB
A patient who underwent coronary artery bypass surgery 2 months ago has an acute upper respiratory infection (URI) and is losing sleep because of a cough. Which instructions would the nurse give to manage the URI if the patient is using codeine as an antitussive? Select all that apply. 1 "Maintain hydration." 2 "Take an expectorant." 3 "Take a decongestant." 4 "Take an antihistamine." 5 "Productively cough."
maintain hydration, take an expectorant, and productively cough
A patient has started treatment with an adrenergic-blocking drug. Which assessment is the nurse's highest priority? 1 Count the radial pulse for 1 full minute. 2 Count the patient's respiratory rate for 1 minute. 3 Measure both supine and standing blood pressures. 4 Take the patient's temperature by both the oral and axillary routes
measure both supine and standing BP
Which drug has abortifacient properties and is avoided in pregnant women? 1 Sulindac 2 Misoprostol 3 Indomethacin 4 Diclofenac sodium
misoprostol
Which intervention will assist the patient in coping with orthostatic hypotension caused by cholinergic drug therapy? 1 Take ibuprofen before rising. 2 Call for someone before rising. 3 Move from a sitting to standing position slowly. 4 Increase fluid intake to increase blood volume.
move from a sitting to standing position slowly
Which assessment findings does the nurse determine are possible adverse effects associated with morphine sulfate administration? Select all that apply. 1 Nausea 2 Diarrhea 3 Urinary retention 4 Decreased peristalsis 5 Delayed gastric emptying
nausea, urinary retention, decreased peristalsis, and delayed gastric emptying
An older adult will begin taking a nonsteroidal antiinflammatory drug (NSAID) to manage somatic pain. The patient reports epigastric pain after 2 days. Which action with the nurse take? 1 Notify the health care provider. 2 Supplement with corticosteroids. 3 Increase the dose of the NSAID. 4 Supplement with opioid analgesics.
notify the health care provider
Which statement is the most accurate outcome criteria for the nurse to use when determining if a patient is responding appropriately to use of an adrenergic drug? 1 Patient is able to correctly state three side effects of the medication. 2 Patient is alert to time, person, and place and makes coherent conversation. 3 Patient awakens easily during nurse's morning rounds and states, "I feel fine." 4 Patient's respiratory rate is 16 breaths/min, and blood pressure is 130/72 mm Hg
patients respiratory rate is 16 breaths/min and BP is 130/72
Which term would best describe a possible drug reaction resulting in very low blood glucose levels that can cause lightheadedness and profuse sweating? 1 Allergic 2 Drug interaction 3 Idiosyncratic 4 Pharmacologic
pharmacologic
The nurse teaches a group of adolescent girls from a low socioeconomic background that contraceptives are not an effective treatment for sexually transmitted diseases. Which educational strategy would the nurse use to support the teaching process? 1 Pictures 2 Pamphlets 3 Written instructions 4 Educational materials
pictures
Which strategies would the nurse use in discharge teaching with an older adult patient who has short-term memory problems? Select all that apply. 1 Repeat information frequently. 2 Provide written instructions for home use 3 Perform several short teaching-learning sessions. 4 Instruct patient to take all medications in the morning. 5 Encourage use of daily medication containers with alarms
repeat info frequently, provide written instructions for home use, perform several short teaching-learning sessions, and encourage use of daily medication containers with alarms
A patient is prescribed naphazoline for the treatment of hay fever. During an assessment, the nurse finds that the patient has hypertension. Which action by the nurse is correct? 1 Lower the dose of naphazoline. 2 Report this finding to the primary health care provider. 3 Request a prescription to give naphazoline with methyldopa. 4 Request a prescription to give naphazoline with a monoamine oxidase inhibitor
report this finding to the primary health care provider
Which instruction would the nurse give to a patient who is prescribed dextromethorphan for treatment of a cough? 1 "Use a humidifier while sleeping." 2 "Elevate your bed while sleeping." 3 "Increase your fluid intake to 3000 mL per day." 4 "Restrict activities that require mental alertness."
restrict activities that require mental alertness
Which actions will the nurse document if an incorrect dosage of medication is administered to a patient? Select all that apply. 1 The reason the mistake was made 2 The route of the medication delivered 3 That an incident report was completed 4 The patient's response to the medication 5 The time, message, and response of the provider
route, response, time, message and response to provider
Which actions will the nurse perform to ensure that the medication dose for a pediatric patient is correct? Select all that apply. 1 Determine the safe range. 2 Use the patient's weight in pounds. 3 Determine the usual dosage per 24 hours. 4 Determine the amount of drug to administer per dose and per day. 5 Compare the drug dosage prescribed with the calculated safe range. 6 If the drug dosage prescribed varies from the recommended reference range, notify the provider
safe range, usual dose per 24 hrs, amount of drug per dose and per day, and If the drug dosage prescribed varies from the recommended reference range, notify the provider.
The nurse is looking for new serious adverse effects of a drug that have been seen in few people after the drug was marketed. Which information would the nurse refer to? 1 The black box warning 2 Ethnopharmacologic studies 3 The phase I trials of the drug 4 The phase II trials of the drug
the black box warning
How would the nurse respond to a person who reports no improvement in a family member who has been taking donepezil for a week? 1 "The medication has an onset of action of about 3 weeks." 2 "Let me assess what other medications the patient is taking." 3 "Sometimes family members aren't the best at assessing these things." 4 "I will call the health care provider and ask for the medication to be changed."
the medication has an onset of action of about 3 weeks
Which statement indicates a nurse's failure to assess and evaluate a patient correctly? 1 The nurse has used inappropriate techniques to administer the drug. 2 The nurse has not clarified the unclear medication orders from the prescriber. 3 The nurse has not implemented appropriate hygiene measures while administering the drug. 4 The nurse has not documented the changes in the patient's condition after the patient took a medication.
the nurse did not document the changes of the patient's condition after the patient took the medication
A patient reports nausea, shortness of breath, joint pain, weakness, and fatigue. On review of the patient's history, the nurse finds that the patient is prescribed prednisone to treat asthma. The nurse also learns that the patient has abruptly discontinued the medicine shortly after getting some relief from asthma. Which would the nurse interpret from the assessment? 1 The patient experiences Addisonian crisis. 2 The patient has coronary ischemia. 3 The patient has rheumatoid arthritis. 4 The patient has Cushing's syndrome.
the patient experiences Addisonian crisis
The nurse observes that a patient has moon face, acne, an increase in fat pads, and swelling. After checking the patient history, the nurse finds that the patient is taking methylprednisolone for bronchospastic disorder. Which condition will the nurse infer from the assessment? 1 The patient has thyrotoxicosis. 2 The patient has hypothyroidism. 3 The patient is in Addisonian crisis. 4 The patient has Cushing's syndrome.
the patient has Cushing's syndrome
Which response would the nurse give to explain why codeine has been prescribed for a patient admitted to the hospital with a chronic nonproductive dry cough? 1 "This medication helps to open up your airways." 2 "This medication will help your immune system." 3 "This medication is used as a cough suppressant." 4 "This medication will help you get rid of mucous."
this medication is used as a cough suppressant
Drugs in which class may interact with adrenergic drugs? 1 Opioids 2 Thyroid preparations 3 Nonsteroidal antiinflammatory drugs 4 Selective serotonin reuptake inhibitors
thyroid preparations
be included in a presentation focused on documentation of medication delivery? Select all that apply. 1 The time each dose was administered 2 The response to delivered medication 3 All patient education provided related to the medication 4 Any incident reports that accompany a mistaken dose 5 Documentation before the dose is given to save time returning to the chart
time of dose, response to medication, education relayed to patient
Which adverse effects are associated with nonsteroidal antiinflammatory drugs (NSAIDs)? Select all that apply. 1 Delusions 2 Tinnitus 3 Anorexia 4 Dyspepsia 5 Constipation
tinnitus, anorexia and dyspepsia
Which is the appropriate educational strategy for the nurse to use with a patient who has thickening and yellowing of the lenses of the eyes? 1 Decrease external stimuli as much as possible. 2 Use nonglare lighting and avoid contrast of light. 3 Ensure that the patient's glasses are clean and in place and that the prescription is current. 4 Slow the pace of the presentation and attend to verbal and nonverbal patient cues to verify understanding.
use nonglare lighting and avoid contrast of light
Which outcome would be appropriate to establish for patients taking beta1 agonists? 1 Relaxation of uterine smooth muscle 2 Increased contractility of myocardium 3 Relaxation of bronchial smooth muscle 4 Increased resistance of peripheral vessels
increased contractility of myocardium
When assessing a 75-year-old patient with benign prostatic hyperplasia (BPH) who is taking an alpha blocker, the nurse would observe for which desired effect of this medication? 1 Tachycardia 2 Bronchodilation 3 Increased urinary flow 4 Increased blood pressure
increased urinary flow
Which laboratory test would a nurse anticipate for a patient receiving alpha-adrenergic medication? 1 Increased level of glucose 2 Increased level of calcium 3 Increased level of potassium 4 Increased level of magnesium
increases level of glucose
A patient is prescribed albuterol. The nurse is explaining the most common route of administration of albuterol to the patient. Which route would the nurse discuss? 1 Inhalation 2 Intravenous 3 Subcutaneous 4 Intramuscular
inhalation
Which prescribing guideline for methotrexate would the nurse keep in mind before administering the drug to a patient for rheumatoid arthritis? 1 It is given at 4-week intervals. 2 It can be given to patients with liver disease. 3 It is given once per week and not once per day. 4 It can be given to patients with pulmonary disease
it is given once per week and not once per day
The nurse is caring for two patients in the hospital. One patient has Medicaid, and the other patient has private insurance. The patient with Medicaid reports severe pain, whereas the other patient has slight abdominal discomfort. The nurse attends first to the patient with Medicaid and then to the patient with private insurance. Which ethical principle is followed in this situation? 1 Justice 2 Veracity 3 Autonomy 4 Beneficence
justice
How would the nurse respond when a patient asks how to use a fentanyl patch at home? 1 "Keep new and used patches away from children." 2 "Apply heat over the patch to increase absorption." 3 "Dispose of patches by melting them with a flame." 4 "Store the patches in the bathroom medicine cabinet
keep new and used patches away from children
Which advice would the nurse give a patient who has been prescribed an antibiotic capsule to treat pharyngitis and is reluctant to swallow the capsule? 1 Crush the capsule. 2 Chew the granules in the capsule. 3 Dissolve the granules in a beverage. 4 Open the capsule and sprinkle the granules on soft food.
open the capsule and sprinkle the granules on soft food
Which assessment finding indicates that the nonsteroidal antiinflammatory drug has been effective? 1 PTT is 100 seconds. 2 Patient's bleeding time is prolonged. 3 Patient has increased circulation to his legs. 4 Pain has decreased from a "6" to "1" on a scale of 10.
pain has decreased from a 6 to 1 on a 10 scale
Which outcomes would be appropriate to establish for a patient who is taking a selective alpha1-receptor blocker? 1 Patient reports no difficulty breathing or shortness of breath. 2 Patient's urine output is less than 240 mL in an 8-hour period. 3 Patient's heart rate is 90 beats/min when ambulating. 4 Patient's blood pressure readings are systolic,118 mm Hg and diastolic, 78 mm Hg
patients BP reading 118/78
Which actions will be included in a presentation focused on delivery of the right drug to the patient? Select all that apply. 1 Remain current in drug names. 2 Check drug name twice before administration. 3 Ensure all verbal orders are signed within 24 hours. 4 Contact the prescriber with any administration questions. 5 Use generic names to compare orders to medication pulled.
remain current in drug names, ensure all verbal orders were signed within 24 hours, contact prescriber with any admin questions, Use generic names to compare orders to medication pulled
Which medication is an example of a colony-stimulating factor? 1 Anakinra 2 Infliximab 3 Filgrastim 4 Etanercept
Filgrastim
A patient is given a drug that has a half-life of 8 hours. The peak level of this drug is 100 mg/L. What would be the concentration of the drug after two half-lives? Record your answer using a whole number. ________ mg/L
25
An infant who was born weighing 8 pounds weighs _______________ kg. Round your answer to the nearest tenth.
3.6 kg
The nurse administers a drug to a patient that has a half-life of 6 hours. If the dose of the drug is 200 mg/L, what would be the concentration of the drug after 12 hours? Record your answer using a whole number. _____ mg/L
50
The nurse will administer medication to a child with an ordered dose of 2 mg/kg of body weight. The child weighs 10 pounds. What is the appropriate dose for this child? Record your answer using a whole number. ______ mg
9 mg
During a case presentation, the nurse mistakenly mentions the name, age, and diagnosis of a patient. Which specific law has the nurse violated? 1 Common law 2 American Nurses Association (ANA) code of ethics 3 International Council of Nurses (ICN) code of ethics 4 Health Insurance Portability and Accountability Act (HIPAA)
HIPAA
Which legislation, passed in 1996, ensures that the privacy of patient information is protected? 1 Durham-Humphrey Amendment 2 Federal Food, Drug, and Cosmetic Act 3 Health Insurance Portability and Accountability Act 4 Medicare Prescription Drug, Improvement, and Modernization Act
HIPAA
Which pieces of information would the nurse include on how to create a human needs statement for a patient with declining cognition? Select all that apply. 1 Part 1 addresses the response to declining cognition. 2 Subjective and objective data are used to create the statement. 3 Part 2 includes factors related to the response of declining cognition. 4 The human needs statement includes a medical diagnosis of dementia. 5 The statement concludes with evidence supporting the declining cognition.
Part 1 addresses the response to declining cognition, subjective and objective data are used to create the statement, do you have any drug related allergies, and do you have any other medical issues
A patient has difficulty reading without reading glasses, which are not at the hospital with the patient. Which intervention promotes an effective teaching session? 1 Repeat the instructions as many times as possible. 2 Avoid contrast lighting when providing instructions. 3 Observe the verbal and nonverbal cues of the patient. 4 Place the instructional materials within the patient's visual field.
Place the instructional materials within the patients visual field
Which statement reflects understanding of the nursing action to take when medication is refused? 1 "Contact the family immediately." 2 "Document the reason for refusal." 3 "Force the patient to take the medication." 4 "Return unwrapped medication to the container."
Respect the patient's right to refuse and notify the health care provider.
Which over-the-counter product would the nurse instruct a patient to avoid when taking theophylline? 1 Echinacea 2 St. John's wort 3 Acetaminophen 4 Diphenhydramine
St Johns wort
The nurse is assessing a patient who reports abdominal pain. Which subjective data should the nurse document? 1 The abdominal radiograph is normal. 2 Bowel sounds are heard on auscultation. 3 No abnormality is detected on palpation. 4 The patient reports abdominal pain since yesterday.
The patient reports abdominal pain since yesterday.
The nurse is caring for multiple patients on the pulmonary unit. The nurse would question the administration of prescribed epinephrine to which patient? 1 A patient who is 16 years old 2 A patient with a history of emphysema 3 A patient with a history of type 2 diabetes 4 A patient with atrial fibrillation with a rate of 100 beats/min
a patient with atrial fibrillation with a rate of 100 beats/min
Which patient lab report would alert the nurse to request that the primary health care provider discontinue filgrastim therapy? 1 Platelet count above 700 cells/mm3 2 Red blood cell (RBC) count below 500 cells/mm3 3 Absolute neutrophil count above 10,000 cells/mm3 4 White blood cell (WBC) count below 100 cells/mm3
absolute neutrophil count above 10,000 cells/mm3
The nurse is assessing a 3-year-old child who has a fever. After checking the laboratory reports, the nurse finds that the child has influenza B. Which medication(s) would the nurse expect to be included in the care plan? 1 Aspirin 2 Acetaminophen 3 Aspirin and ibuprofen 4 Aspirin combination drug
acetaminophen
The care provider prescribes albuterol and beclomethasone inhalers for a patient. Which is the nurse's best action? 1 Administer each inhaler at 30-minute intervals. 2 Question the prescription; two inhalers should not be given at one time. 3 Administer beclomethasone, wait 2 minutes, and then administer albuterol. 4 Administer the albuterol, wait 5 minutes, and then administer beclomethasone.
admin the albuterol, wait 5 minutes, and then administer beclomethasone
Which drug will the primary health care provider prescribe for a patient who has nighttime insomnia and motion sickness? 1 Cetirizine 2 Loratadine 3 Fexofenadine 4 Diphenhydramine
diphenhydramine
Pharmacokinetics involves the study of which factor? 1 Physiologic interactions of drugs 2 Interactions among various drugs 3 Adverse reactions to medications 4 Distribution rates among various body compartments
distribution rates among different body compartments
patient received the first dose of an alpha-blocking medication 15 minutes ago. The charge nurse must intervene when observing a nursing student perform which action? 1 Listening for the patient's apical pulse 2 Encouraging the patient to ambulate in the hallway 3 Taking the patient's blood pressure while the patient is lying down 4 Telling the patient to eat the chicken on the lunch tray before the pudding
encouraging the patient to ambulate in the hallway
During a cardiopulmonary resuscitation emergency, the nurse expects to administer which injectable, fast-acting medication? 1 Salmeterol 2 Epinephrine 3 Naphazoline 4 Oxymetazoline
epinephrine
If a drug has a high first-pass effect, which statement about the drug is appropriate? 1 Formation of active metabolites is high in bile. 2 Formation of inactive metabolites is high in feces. 3 Formation of inactive metabolites is high in the liver. 4 Formation of inactive metabolites is low in the kidneys.
formation of inactive metabolites is high in the liver
A patient who has Parkinson's disease is prescribed a high dose of an anticholinergic medication. Which assessment findings may indicate adverse reactions to this dose? Select all that apply. 1 Hallucinations 2 Increase in the heart rate 3 Decrease in blood pressure 4 Onset of shortness of breath 5 Increase in body temperature
hallucinations, increase BP, and increase body temp
The nurse is caring for a patient who is receiving morphine sulfate for pain management. Which assessment findings are cause for immediate nursing action? Select all that apply. 1 Hallucinations 2 Excess urination 3 Slow pupil reaction 4 Altered consciousness 5 Change in sputum color
hallucinations, slow pupil reactions, and altered consciousness
When planning care for an assigned patient, the nurse identifies the outcome of "Patient will be able to safely self-administer enoxaparin subcutaneously upon discharge." Which method evaluates the patient's achievement of this outcome? 1 Visually demonstrate the correct procedure to the patient. 2 Have the patient verbalize the correct procedure step by step. 3 Have the patient perform a return demonstration of the procedure. 4 Give the patient detailed written instructions illustrating the procedure.
have the patient perform a return demonstration of the procedure
Which patient conditions indicate the need for a nasal decongestant? Select all that apply. 1 Hay fever Correct2 Dust allergy 3 Nasal surgery 4 Chronic rhinitis 5 Productive cough
hay fever, dust allergy, nasal surgery and chronic rhinitis
A patient develops black stools, bleeding around the gums, and very small red-brown spots on the body after taking a nonsteroidal antiinflammatory drug to relieve joint pain. The nurse would contact the health care provider to request which tests? Select all that apply. 1 Urine test 2 Hematocrit test 3 Hemoglobin test 4 Chest radiography 5 Total blood count test
hematocrit test, hemoglobin test, and total blood count test
A patient who is taking a monoamine oxidase inhibitor (MAOI) for is scheduled to begin treatment with an adrenergic drug. Which action would the nurse take? 1 Administer the adrenergic drug as prescribed. 2 Monitor the patient closely during treatment for evidence of side effects. 3 Plan for the health care provider decreasing the dose of the adrenergic drug. 4 Hold the dose of the adrenergic drug and notify the health care provider of the use of the MAOI medication
hold the dose of the adrenergic drug and notify the health care provider of the use of the MAOI medication
A patient taking an oral theophylline drug is due for the next dose and has a blood pressure of 100/50 mm Hg and a heart rate of 110 beats/min. The patient is irritable. Which is the nurse's best action? 1 Administer oxygen at 2 L per minute via nasal cannula. 2 Continue to monitor the patient and give the medication. 3 Hold the next dose of theophylline and assess the patient. 4 Call the health care provider to request an increased dose.
hold the next dose of theophylline and asses the patient
A primary health care provider prescribes omalizumab for a patient. Which would the nurse assess to ensure safety of drug administration? 1 Urine frequency 2 Body temperature 3 Gastrointestinal upset 4 Hypersensitivity reactions
hypersensitivity reactions
Beta blockers are used to treat which conditions? Select all that apply. 1 Hypertension 2 Angina pectoris 3 Heart failure (HF) 4 Sinus bradycardia 5 Cardiogenic shock 6 Chronic obstructive pulmonary disease (COPD)
hypertension, angina pectoris, and heart failure
The nurse knows that alpha blockers may be prescribed to treat which conditions? Select all that apply. 1 Asthma 2 Hypertension 3 Cardiac arrest 4 Raynaud's disease 5 Benign prostatic hyperplasia
hypertension, raynaud's disease, and benign prostatic hyperplasia
