Exam 4 Review Questions (multiple choice)

For which client conditions should the nurse anticipate administering antibiotic therapy for chemoprophylactic purposes? (Select all that apply.) a. Neurologic abnormality b. Prosthetic heart valve c. Dental surgical procedure d. Chronic respiratory infection e. Kidney transplantation

b. Prosthetic heart valve; c. Dental surgical procedure; e. Kidney transplantation

The nurse should be concerned with which aspect of the health history of a patient who is taking a magnesium-based antacid? a. Peptic ulcer disease b. Renal failure c. Hypertension d. Heart failure

b. Renal failure

The patient is using beclomethasone (Beclovent) for treatment of chronic asthma. Which statement indicates that the patient understands this drug therapy? a. "I will use my bronchodilator if my wheezing increases." b. "I will not need a flu shot now that I'm taking this medicine." c. "This is the only drug I will need to treat my asthma attacks." d. "I will use this drug only when I feel an attack coming on."

a. "I will use my bronchodilator if my wheezing increases."

A client who has been on antibiotic therapy for peptic ulcer caused by Helicobacter pylori is diagnosed with a superinfection. What is the most appropriate response by the nurse when the client asks why the superinfection occurred? a. "The normal host flora has been destroyed by the antibiotic." b. "The infectious agent has developed resistance to the drug." c. "The infection caused by H. pylori has become severe." d. "The H. pylori restricted the growth of microorganisms."

a. "The normal host flora has been destroyed by the antibiotic."

A nurse is caring for a client who is prescribed oral metronidazole (Flagyl) for a fungal infection. Which health history information should the nurse obtain? a. Alcohol use b. Nutritional intake c. Sexual activity d. Nicotine use

a. Alcohol use

In addition to the use of multiple antibiotics, the nurse should anticipate which medication to be included in the patient's treatment of PUD due to H. pylori infection? a. Antacids b. H2-receptor inhibitors c. Bismuth compounds d. Vitamin E compounds

a. Antacids

A nurse is caring for a client receiving chemotherapy with high emetogenic potential. Which drugs should the nurse prepare to administer prior to chemotherapy administration? (Select all that apply.) a. Anticholinergics b. Serotonin (5-HT3) antagonists c. Corticosteroids d. Neurokinin receptor antagonists e. Phenothiazines

a. Anticholinergics; d. Neurokinin receptor antagonists; e. Phenothiazines

A client who will be traveling on a plane is prescribed dimenhydrinate (Dramamine) for management of motion sickness. Which instruction about administration of the drug should the nurse provide the client? a. Apply the patch behind the ear the day before travel. b. Take the medication by mouth 20-60 minutes prior to the trip. c. Take the medication by mouth at onset of motion sickness. d. Inject the medication on the thigh intramuscularly.

a. Apply the patch behind the ear the day before travel.

The nursing care plan for a client receiving epoetin alfa (Epogen, Procrit) should include careful monitoring for which symptom? a. Chest pain b. Severe hypotension c. Impaired liver function d. Severe diarrhea

a. Chest pain

A patient tells the nurse that she has been taking sodium bicarbonate antacid 3-4 times a day for the past 3 weeks to relieve symptoms of GERD. For what should the nurse assess in this patient? a. Constipation b. Respiratory acidosis c. Metabolic alkalosis d. Hypokalemia

a. Constipation

A nurse is caring for a client who will be receiving a protease inhibitor (PI)-based HAART regimen. Which drug combination should the nurse expect to administer to the client? a. Darunavir + emtricitabine + tenovir b. Efavirenz + emtricitabine + tenofovir c. Raltegravir + tenofovir + emtricitabine d. Dolutegravir + abacavir + lamivudine

a. Darunavir + emtricitabine + tenovir

The nurse teaches the client to immediately report to the healthcare provider which adverse reaction to oprelvekin (Neumega)? a. Difficulty breathing b. Nausea c. Muscle pain d. Thirst

a. Difficulty breathing

Which drug should the nurse prepare to administer to prevent constipation in a client who had a surgical procedure? a. Docusate sodium (Colace) b. Prochlorperazine (Compazine) c. Loperamide (Imodium) d. Promethazine (Phenergan)

a. Docusate sodium (Colace)

A nurse is caring for a client with chronic renal failure who is receiving epoetin alfa. Which health-promotion strategy should the nurse include in the client's plan of care? a. Maintain adequate dietary intake of iron and folic acid. b. Encourage frequent exercise or aerobic activity. c. Monitor for signs of cardiac adverse effects. d. Assess for symptoms of peripheral thrombosis.

a. Encourage adequate dietary intake of iron and folic acid

A nurse is administering oral sulfamethoxazole-trimethoprim (Bactrim) to a client for treatment of urinary tract infection. Which nursing actions are appropriate? (Select all that apply.) a. Ensure the client drinks a full glass of water with each dose. b. Monitor the client's intake of calcium-fortified drinks. c. Administer the medication around the client's meal times. d. Have the client take potassium supplements with this drug. e. Give the client a glass of milk to drink in case of GI upset.

a. Ensure the client drinks a full glass of water with each dose; c. Administer the medication during the client's meal times; e. Give the client a glass of milk to drink in case of GI upset

A nurse is caring for a client receiving vancomycin intravenous infusion for treatment of a wound infected with MRSA. Which finding should the nurse report immediately to the healthcare provider? a. Hypotension and red rash on the chest area b. Joint and muscle pain with general malaise c. Chest discomfort and decreased heart rate d. Heel pain along with difficulty walking

a. Hypotension and red rash on the chest area

A patient asks the nurse why the healthcare provider had advised against use of calcium carbonate as an antacid. What is the nurse's best response? a. Its use may result in kidney stones. b. It causes decreased gastric acid production. c. It often causes severe diarrhea. d. It may result in fluid retention and edema.

a. Its use may result in kidney stones

A nurse is caring for a patient preparing to undergo a colonoscopy. The nurse should anticipate administering which drug? a. Laxative b. Diuretic c. Cathartic d. Antihypertensive

a. Laxative

A nurse is caring for a client receiving iron preparation for treatment of iron-deficiency anemia. What are nursing considerations for administering this drug? (Select all that apply.) a. Monitor intravenous site for infiltration. b. Give the medication close to bedtime. c. Tablets may be crushed for ease of swallowing. d. Administer subcutaneously in the abdominal folds. e. Avoid taking antacids at the same time as the iron preparation. f. Take the medication 2 hours after a meal.

a. Monitor for infiltration at intravenous site; e. Avoid taking antacids at the same time as the iron preparation

A client presents at the clinic with intractable diarrhea for 2 weeks. The nurse would expect to administer what type of drug for the treatment of this condition? a. Opioids b. Laxatives c. Cathartics d. Bulk-forming agents

a. Opioids

When treating a patient experiencing nausea and vomiting with antiemetics, which is important for the nurse to consider? a. Patient safety is a concern, as drowsiness is a common side effect. b. Over-the-counter antiemetics are just as effective in relieving nausea. c. Sports drinks replace the essential ingredients lost by dehydration. d. The most effective antiemetic is determined by trial and error.

a. Patient safety is a concern, as drowsiness is a common side effect

A nurse is conducting a health history assessment of a patient and determines which findings as risk factors for development of peptic ulcer disease (PUD)? (Select all that apply.) a. Smoking cigarettes b. Having blood type A c. Drinking caffeinated beverages d. Using NSAIDs e. Having a family history of PUD

a. Smoking cigarettes; c. Drinking caffeinated beverages; d. Using NSAIDs; e. Having a family history of PUD

A patient being treated for peptic ulcer disease (PUD) due to Helicobacter pylori asks the nurse why two or more antibiotics need to be taken. What is the nurse's best response? a. They lower the potential for bacterial resistance. b. They decrease the chances of development of duodenal ulcers. c. They completely eliminate redevelopment of gastric ulcers. d. They decrease the cost of future drug therapies.

a. They lower the potential for bacterial resistance

The patient is receiving theophylline (Theo-Dur) for treatment of asthma. Nursing intervention is required if the patient makes which statement? a. "I will check my heart rate each day." b. "I will take my medicine with my coffee each morning." c. "I will notify my doctor if my vision changes." d. "I will use my inhaler if I am wheezing."

b. "I will take my medicine with my coffee each morning."

A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers should the nurse give to the patient? a. "The corticosteroid should be taken first." b. "The bronchodilator should be taken first." c. "The two drugs should be taken at least 2 hours apart." d. "The order of administration does not matter with these two drugs."

b. "The bronchodilator should be taken first."

A nurse anticipates administering which drug to a client for influenza prophylaxis? a. Oseltamivir (Tamiflu) b. Amantadine (Symmetrel) c. Zanamivir (Relenza) d. Famciclovir (Famvir)

b. Amantadine (Symmetrel)

The nurse is caring for a client receiving an oral antifungal medication. What should the nurse consider when administering this medication? a. Do not administer with food. b. Give with plenty of fluids. c. Alternate with capsule and oral solution. d. Can be given with an antacid.

b. Give with plenty of fluids

A patient on chemotherapy is receiving ondansetron (Zofran) for treatment of nausea. The nurse will instruct the patient to watch for which adverse effect from this drug? a. Hiccups b. Headache c. Dry mouth d. Blurred vision

b. Headache

What should the nurse monitor while caring for a client receiving intravenous acyclovir (Zovirax) for acute herpesvirus infection? a. Nausea and vomiting b. Kidney function tests c. Liver function tests d. Cardiovascular status

b. Kidney function tests

A nurse is caring for a client who is experiencing pseudomembranous colitis. Which medication should the nurse anticipate administering? a. Pentamidine (Pentam) b. Metronidazole (Flagyl) c. Atovaquone (Malarone) d. Caspofungin (Cancidas)

b. Metronidazole (Flagyl)

A client with a diagnosis of cancer is receiving epoetin alfa (Epogen, Procrit) as part of the treatment regimen. Which nursing action is most appropriate for determining the effectiveness of this drug? a. Assessing the client's energy level b. Monitoring the hematocrit and hemoglobin levels c. Monitoring the client's blood pressure d. Assessing the client's level of consciousness

b. Monitoring the hematocrit and hemoglobin levels

A nurse is preparing to administer a broad-spectrum antibiotic to a client with a severe respiratory infection. Which is an important nursing action to take prior to administering the medication? a. Reviewing the results of the culture and sensitivity test b. Obtaining a specimen for culture and sensitivity testing c. Performing a peak and trough level of the antibiotic d. Determining the course antibiotic therapy based on half-life

b. Obtaining a specimen for culture and sensitivity testing

A client will be taking mebendazole (Vermox) for a pinworm infection. What information should the nurse include regarding administration of this drug? a. The drug should be taken with a low-fat meal. b. Only a single dose of the drug will be taken. c. The medication should be swallowed whole. d. Increase fiber in the diet to prevent constipation.

b. Only a single dose of the drug will be taken

A client presents to the emergency department with severe nausea and vomiting following a case of food poisoning. Which antiemetic drug should concern the nurse if the client is taking quinidine? a. Metoclopramide (Reglan) b. Prochlorperazine (Compazine) c. Scopolamine (Transderm-Scop) d. Dronabinol (Marinol)

b. Prochlorperazine (Compazine)

A client received a drug for treatment of nausea and vomiting and is now complaining of dry mouth, constipation, and a rapid heart rate. The nurse concludes that which drug was taken by the client? a. Loperamide (Imodium) b. Prochlorperazine (Compazine) c. Peppermint d. Diphenoxylate (Lomotil)

b. Prochlorperazine (Compazine)

A nurse is caring for a client receiving sargramostim (Leukine). What should the nurse assess when administering this medication? a. Blood pressure b. Respirations c. Level of consciousness d. Bowel sounds

b. Respirations

When teaching a patient who is taking twice-daily dosages of an aluminum antacid along with other medications, which instruction should the nurse provide? a. The other medications can be taken with the antacid, as long as it is with meals. b. The antacid should be taken at least 2 hours before or after the other medications. c. The antacid should be taken at least 4-6 hours apart from the other medications. d. The patient will not be able to take the antacid therapy at this time.

b. The antacid should be taken at least 2 hours before or after the other medications

A patient using a beta-adrenergic agonist for treatment of asthma asks the nurse how the medication works. What is the nurse's best response? a. The drug reduces mucus production. b. The drug causes bronchodilation. c. The drug liquefies thick mucus. d. The drug suppresses the cough reflex.

b. The drug causes bronchodilation

A client is being prescribed penicillin for an upper respiratory infection. What information should the nurse emphasize in providing instructions to the client? a. The antibiotic therapy can be taken while breast-feeding. b. The entire prescription must be completed as instructed. c. The medication can be taken without regard to eating. d. The most common side effect is urinary discoloration.

b. The entire prescription must be completed as instructed

A nurse is caring for a client who tested positive for HIV infection and will be starting highly active antiretroviral therapy (HAART). What is the most accurate information the nurse can provide about HAART? a. The main purpose of the therapy is to prevent HIV transmission. b. The goal of the therapy is to keep plasma HIV levels as low as possible. c. The primary target of the therapy is HIV present in the lymph nodes. d. The aim of the therapy is to restore and preserve immunologic function.

b. The goal of the therapy is to keep plasma HIV levels as low as possible

A patient receiving treatment for a respiratory condition asks the nurse why the medication is given through aerosol therapy. What is the nurse's best response? a. The aerosol has no systemic side effects. b. The medication is delivered to the site of action. c. The patient requires no skill to use it. d. The delivery method is safe for all patients.

b. The medication is delivered to the site of action

When the client is started on antiretroviral drugs for management of HIV infection, which information is important for the nurse to provide the client? a. This drug therapy will cure the disease over a period of time. b. This drug regimen can extend life expectancy. c. This drug therapy is used prior to giving the vaccine. d. This drug regimen is available throughout the world.

b. This drug regimen can extend life expectancy

A client diagnosed with a systemic fungal infection is prescribed amphotericin B (Fungizone). The nurse should include which information during client education? a. "Drug therapy will be for a very short time, probably 2-4 weeks." b. "Carefully inspect all intramuscular injection sites for bruising." c. "Notify the clinic if you gain 2 pounds or more in a 24-hour period." d. "You can stop the medication when you start feeling better."

c. "Notify the clinic if you gain 2 pounds or more in a 24-hour period."

A patient presents at the emergency department with an acute asthma attack. The nurse expects that which medication will be used for initial treatment? a. An anticholinergic such as ipratropium (Atrovent) b. A leukotriene receptor antagonist such as montelukast (Singulair) c. A beta-2 agonist such as albuterol (Proventil) d. A corticosteroid such as fluticasone (Flovent)

c. A beta-2 agonist such as albuterol (Proventil)

A nurse should administer hepatitis A immunoglobulin (HAIg) to which client? a. A 6-year-old child who lives in a rural area b. A client who uses illicit drugs intravenously c. A client traveling to a country where HAV is prevalent d. A male client who has sex with other men

c. A client traveling to a country where HAV is prevalent

A nurse is caring for a client who will be receiving chloroquine (Aralen) for acute infection with malaria. Which nursing action is most appropriate to take prior to administration of this drug? a. Obtain a comprehensive travel history. b. Send stool sample for O & P testing. c. Conduct a baseline visual exam. d. Assess respiratory status.

c. Conduct a baseline visual exam

A nurse is conducting a health history assessment of a client and determines that which factor places the client at risk for development of irritable bowel disease (IBD)? a. Stress b. Peptic ulcers c. GERD (gastroesophageal reflux disease) d. Helicobacter pylori

c. GERD (gastroesophageal reflux disease)

A nurse is caring for a client who is receiving cyanocobalamin injections once a month. For what should the nurse monitor while the client is on this drug? a. Bone marrow depression b. Lack of intrinsic factor c. Hypokalemia d. Hemorrhage

c. Hypokalemia

The client receiving chemotherapy is prescribed oprelvekin (Neumega) as part of the treatment regimen. Which explanation by the nurse of the rationale for the drug is most accurate? a. It promotes white blood cell production. b. It reverses bone marrow suppression. c. It stimulates platelet cell production. d. It reduces excessive immature white cells.

c. It stimulates platelet cell production

Which intervention should the nurse implement when caring for a patient on long-term oral glucocorticoids? a. Monitoring liver function tests b. Monitoring for cardiac dysrhythmias c. Monitoring for signs of GI bleeding d. Monitoring blood glucose levels

c. Monitoring for signs of GI bleeding

A patient has been using over-the-counter omeprazole (Prilosec) for relief of gastric upset. The nurse should provide which teaching regarding appropriate administration of this medication? a. Drink a full glass of water with administration. b. Do not take the medication with antacids. c. Never crush or chew the medication. d. Take medication 30 minutes after meals.

c. Never crush or chew the medication

A nurse conducting a health history with a patient identifies that which health condition places the patient at risk for developing gastroesophageal reflux disease (GERD)? a. Cigarette smoking b. Type II diabetes mellitus c. Obesity d. Alcohol use

c. Obesity

A nurse is caring for a client who is receiving high doses of chloroquine (Aralen) for acute infection with malaria. Which is the most appropriate action for the nurse to take? a. Monitor the client's respirations the first 30 minutes after taking the first dose. b. Ensure that daily weights are taken every morning and documented in the chart. c. Obtain baseline neurologic and cardiovascular status, and assess regularly. d. Administer the medication with antacids to prevent gastrointestinal distress.

c. Obtain baseline neurologic and cardiovascular status, and assess regularly

A nurse is caring for a newborn whose mother has an HIV infection. Which pharmacotherapy intervention should the nurse implement? a. Oral administration of trimethoprim-sulfamethoxazole (Bactrim) within 24 hours of birth b. Intravenous administration of zidovudine following confirmation of HIV status in 1 week c. Oral administration of zidovudine immediately after delivery and for the next 6 weeks d. Intramuscular administration of HIV vaccine, with a booster shot within 6 months

c. Oral administration of zidovudine immediately after delivery and for the next 6 weeks

A client is prescribed paromomycin (Humatin) for an intestinal amebiasis infection. For which serious adverse effect should the nurse monitor in the client? (Select all that apply.) a. Agranulocytosis b. Peripheral neuropathy c. Ototoxicity d. Transient leukopenia e. Nephrotoxicity

c. Ototoxicity; e. Nephrotoxicity

A nurse is caring for a client diagnosed with hepatitis C virus (HCV) infection. Which pharmacotherapies should the nurse anticipate to administer to this client? (Select all that apply.) a. HCV immunoglobulin b. Twinrix c. Ribavarin d. Tenofovir disoproxil (Viread) e. Pegylated interferon (PEG-IFN) f. Telaprivir (Incivek)

c. Ribavarin; e. Pegylated interferon (PEG-IFN); f. Telaprivir (Incivek)

Which information should the nurse emphasize when providing education to a client receiving drug therapy for HIV-AIDS? a. It will take about 1 year of therapy to reduce plasma HIV to undetectable levels. b. Genotypic drug testing is performed to determine the client's resistance to the therapy. c. Strict adherence to the drug regimen promotes effectiveness of the therapy. d. The medications can help the client become a long-term nonprogressor.

c. Strict adherence to the drug regimen promotes effectiveness of the therapy

An elderly male patient with benign prostatic hypertrophy is prescribed ipratropium (Atrovent) for the treatment of asthma. Which nursing intervention is most appropriate? a. Teaching the patient to avoid caffeine in the diet b. Assessing the patient for enlarged liver c. Teaching the patient to report inability to urinate d. Monitoring for development of diarrhea

c. Teaching the patient to report inability to urinate

A client has been prescribed oral tetracycline for treatment of severe acne. Which assessment finding is most important for the nurse to communicate with the healthcare provider? a. The client's nutritional status b. The pathogen causing the acne c. The client's pregnancy status d. The presence of open lesions

c. The client's pregnancy status

A client asks the nurse why the healthcare provider did not prescribe the usual antibiotic for the same infection. Which is the best response by the nurse? a. "It does not matter which antibiotic is taken." b. "If you are not better in 10 days, return to the office." c. "You do not want to take the same antibiotic all the time." d. "Bacteria can become resistant to some antibiotics."

d. "Bacteria can become resistant to some antibiotics."

A patient is taking omeprazole (Prilosec) for the treatment of gastroesophageal reflux disease (GERD). Which information should the nurse emphasize when teaching about this medication? (Select all that apply.) a. The medication should not be taken with alcohol. b. This medication is for long-term therapy. c. The medication can affect kidney function. d. Although rare, blood disorders may occur. e. Common side effects include headache and diarrhea.

d. Although rare, blood disorders may occur; e. Common side effects include headache and diarrhea

A nurse is caring for a client with diabetes who is being treated for infection with Candida. When administering fluconazole (Diflucan) to this client, which nursing action is most appropriate? a. Instruct the client to chew the tablet. b. Double the dose the next day if a dose is missed. c. Provide at least eight glasses of water daily. d. Assess the client for signs of hypoglycemia.

d. Assess the client for signs of hypoglycemia

The nurse should monitor the client receiving filgrastim (Neupogen) for which common adverse effect? a. Hypoglycemia b. Elevated liver enzymes c. Elevated serum creatinine d. Bone pain

d. Bone pain

A nurse caring for a client who has an HIV infection should monitor for effectiveness of antiretroviral therapy using which laboratory test? a. Complete blood count b. Absolute neutrophil count c. Blood cultures d. CD4 lymphocyte count

d. CD4 lymphocyte count

What should the nurse anticipate as the rationale for administering filgrastim (Neupogen) to a client? a. Bone marrow transplant immunosuppressant b. Diagnosis of acute lymphoblastic leukemia c. Treatment for non-Hodgkin's lymphoma d. Neutropenia secondary to chemotherapy

d. Neutropenia secondary to chemotherapy

Which information should the nurse include during patient teaching on long-term therapy with beta-adrenergic agonists for asthma treatment? a. Discontinuing the drug if heart rate increases b. Monitoring daily intake and output c. Reducing dosage of the drug if insomnia occurs d. Notifying the healthcare provider if the drug no longer seems effective

d. Notifying the healthcare provider if the drug no longer seems effective

When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects? a. Fatigue and depression b. Anxiety and peripheral vasoconstriction c. Headache and rapid heart rate d. Oral candidiasis and dry mouth

d. Oral candidiasis and dry mouth

A nurse is caring for a client who is prescribed nystatin (Mycostatin) suspension for oral candidiasis. Which instruction is most appropriate for the nurse to provide with administration of this drug? a. Take the medication with meals to prevent nausea and vomiting. b. Swallow the medication dose quickly, and drink a full glass of water. c. Apply the medication in affected areas of the mouth using a swab applicator. d. Swish the liquid medication in the mouth for approximately 2 minutes.

d. Swish the medication in the mouth for 2 minutes

A client has been prescribed ciprofloxacin (Cipro) 500 mg twice daily by mouth. Which information should the nurse include during client teaching about administration of this medication? a. The dose must be taken on an empty stomach to increase absorption. b. The client can have an unlimited amount of caffeinated drinks. c. The drug can be taken with an antacid to decrease GI symptoms. d. The dose should not be taken with supplements containing iron.

d. The dose should not be taken with supplements containing iron

A nurse is caring for a client receiving gentamicin for treatment of a Pseudomonas infection. Which assessment finding should the nurse report to the healthcare provider immediately? a. Dysrhythmia b. Constipation c. Diuresis d. Tinnitus

d. Tinnitus