Pham final 6521
The nurse practitioner orders Amoxicillin 500 mg tid? What is the total amount of medication patient will take per day?
1500 mg
A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose?
2000 mg
A 62-year-old woman has been prescribed a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately
24 hours The nurse will instruct the patient that it will take approximately 24 hours for the full pain-relieving effect of a fentanyl transdermal patch to occur.
A Nurse Practitioner works at a weight management clinic. To which of the following overweight patients could the nurse safely administer dextroamphetamine?
A 48-year-old Caucasian man who has adult- onset diabetes
Which of the following patients will be at the greatest risk for anemia and would be the most likely candidate for epoetin alfa therapy?
A 62-year-old male with cancer
A NP is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation?
A child has a greater body surface area, creating greater permeability resulting in an increase in absorption of topical agents, which may result in more adverse effects.
A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the chance that the boy will take his prescribed medication, the nurse should A.offer a choice between liquid and chewable medications, if possible. B.insert a central intravenous line. C.teach the boy about the fact that he will feel much better after he takes his medications. D.have the mother hold the child firmly and sooth him while the drugs are administered.
A. offer a choice between liquid and chewable medications, if possible.
A patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are considered A. phytoestrogens. B. monotherapy. C. taboo. D. inappropriate.
A. phytoestrogens.
A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause A. staining of permanent teeth. B.sleep deprivation. C.orange-tinged urine. D. Deep muscle pain.
A. staining of permanent teeth.
A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia). After baseline physical data are obtained, the nurse will assess the patient's childbearing potential. The nurse will inform the patient that during sibutramine therapy she should A.use adequate contraception. B. abstain from sex. C.take a pregnancy test every month. D. obtain a pap smear .
A. use adequate contraception.
A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose? A.2000 mg B. 4000 mg C. 3000 mg D. 1000 mg
A.2000 mg
A preterm neonate received caffeine for the treatment of apnea. The nurse should monitor the neonate for which of the following? A.Bloody stools B. Bradycardia C. Constipation D. Hypoglycemia
A.Bloody stools
A nurse is administering drugs to a 10-year-old child who has multiple health problems. The child is underweight and is on a special diet. Which of the following will the nurse consider when planning for the best absorption of the prescribed drugs? (Select all that apply.) A.Disease process B. Weight C. Diet D.Route of administration E. Age
A.Disease process C. Diet D.Route of administration E. Age
The recommended treatment for trichomoniasis is A.Flagyl. B.Meclizine. c Amoxicillan. D.Diflucan
A.Flagyl.
A nurse is caring for a 10-year-old boy who complains of chronic headaches. His mother reports that she gives him Tylenol at least three times a day. Which of the following will the nurse work with the physician to evaluate? A.Hepatic function B. Renal function C. Cardiac function D.Respiratory function
A.Hepatic function
A 21-year-old female has a history of irregular menses. She recently became sexually active, and would like to begin taking oral contraceptives (OCs). The nurse practitioner recognizes that most likely this patient would benefit from taking which category of OCs. A.Monophasic B.Ortho Tri-Cyclen C.Triphasic OC D.Biphasic OC
A.Monophasic
A patient is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the patient develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is A.an allergic response. B.a paradoxical response. C.a hepatotoxic response. D.an idiosyncratic response.
A.an allergic response.
A nurse working in a cancer center is preparing to administer medication to a 5-year-old child. The nurse will calculate the drug dosage by using A.body surface area. B. weight. C.age in months. D. age in years.
A.body surface area.
A nurse is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an A.electrocardiogram (ECG). B. electroencephalogram (EEG). C. electromyelogram (EMG). D.electrophysiologic study (EPS).
A.electrocardiogram (ECG).
A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic can the nurse most safely recommend?
Acetaminophen
A patient is receiving radiotherapy for an overactive thyroid gland and asks whether her milk is safe for her baby. If her treatment cannot be discontinued, what should the nurse recommend?
Advise her to discard her breast milk in a biohazard container,: as it is unsafe for the baby.
A 4-year-old child is brought to the emergency department by her mother. The mother reports that the child has been vomiting, and the nurse notes that the child's face is flushed and she is diaphoretic. The mother thinks that the child may have swallowed carbachol drops. A diagnosis of cholinergic poisoning is made. Which of the following drugs would be administered?
Atropine Acetylcholine and cevimeline are both cholinergic agonists, and, like carbachol, would be contraindicated in this patient. Administration of either of these drugs could be fatal. Nicotine is a direct-acting nicotinic agonist and is not indicated in cholinergic poisoning. Atropine is considered the antidote for cholinergic poisoning. The actions of atropine are a reduction in salivary, bronchial, and sweat gland secretions; mydriasis; cycloplegia; changes in heart rate; contraction of the bladder detrusor muscle and of the gastrointestinal smooth muscle;decreased gastric secretion; and decreased gastrointestinal motility.
A 2-year-old child is diagnosed with a minor ailment and is to be administered medications at home for 2 weeks. The child lives with his mother, grandmother, and four other children between the ages of 14 months and 7 years. The home health nurse is asked to assess the home environment to determine if it is appropriate for the child to take his medication at home. Which of the following will have the greatest impact on the nurse's assessment? A.The health status of the other children B.Where the medications will be stored C.The mother and grandmother's understanding about the drugs D.How clean the house is
B. Where the medications will be stored
A nurse is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation? A. A child's gastric pH is decreased, causing less of the drug to be absorbed from the subcutaneous skin, therefore producing more adverse effects. B. A child has a greater body surface area, creating greater permeability resulting in an increase in absorption of topical agents, which may result in more adverse effects. C. A child has an erratic blood flow from an immature peripheral circulation, which increases drug absorption, causing an increase in adverse effects. D. A child has a smaller body surface area, resulting in an increase in topical absorption, which can cause more adverse effects.
B. A child has a greater body surface area, creating greater permeability resulting in an increase in
A patient reports to a clinic with complaints of breast tenderness, a right lumpy breast, and no breast discharge. The breast tenderness occurs primarily during her menstrual cycle. The nurse practitioner probably suspects A. breast cancer. B. PMS. C. pain in the heart. D. cancerous breast tenderness.
B. PMS.
A 30-year-old man with a BMI of 59 has recently been diagnosed with type 2 diabetes mellitus. In light of the man's lack of success with weight loss programs in the past, his care provider has prescribed sibutramine (Meridia). What instructions should the nurse consequently provide to this patient? A."This drug will help you to lose weight without having to exercise or change your normal diet." B."Take this drug once each day on an empty stomach." C."Take a dose when you feel like you are tempted to binge on food." D."It's best to take a dose of sibutramine after each meal."
B."Take this drug once each day on an empty stomach."
A nurse works at a weight management clinic. To which of the following overweight patients could the nurse safely administer dextroamphetamine? A.A 28-year-old African-American woman with hyperthyroidism B.A 48-year-old Caucasian man who has adult-onset diabetes C.A 38-year-old Caucasian woman with glaucoma D.A 60-year-old African-American man who experiences angina 1 points Saved
B.A 48-year-old Caucasian man who has adult-onset diabetes
An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or failure of a patient's chemotherapy. Which of the following cancerous cells is most susceptible to the effects of chemotherapeutic drugs?
Cells that have a rapid mitotic rate
A 39-year-old patient who is having trouble sleeping is beginning drug treatment with zaleplon (Sonata). The nurse will be sure to ask the patient if she is taking
Cimetidine Zantac The nurse will assess for cimetidine use. Cimetidine greatly increases the level of circulating zaleplon and could cause toxic : effects in the patient. Secobarbital is a barbiturate, and oxycodone and meperidine are narcotics that would not be used with lorazepam because the combinations may depress respiratory drive, create severe hypotension or bradycardia, and substantially alter level of consciousness.
Mr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his current wound care regimen involves the daily application of silver sulfadiazine to his wounds. The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering this medication?
Cleanse the wound of debris prior to applying the silver sulfadiazine
A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient to
Complete the entire course of drug therapy.
A 22-year-old woman has given birth to an infant who exhibits the signs and symptoms of maternal cocaine use during pregnancy. These signs and symptoms are a result of what pathophysiological effect of opioid use during pregnancy? A.Changes in blood chemistry as a result of nephrotoxicity and hepatotoxicity B.Hypoxia as a result of a prolonged second stage of labor C.Impaired maternal nutrition as a result of drug use D. Vasoconstriction leading to reduced placental blood flow
D. Vasoconstriction leading to reduced placental blood flow
A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the A. deltoid muscle. B.rectus femoris muscle. C. dorsogluteal muscle. D.ventrogluteal muscle.
D. ventrogluteal muscle.
The clinical nurse educator who oversees the emergency department in a children's hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children? A.Avoiding intravenous administration of drugs whenever possible. B.Recording drug administration in both the nurse's notes and the medication administration record (MAR) C.Ensuring that a full assessment takes place no more than 30 minutes before giving a drug. D. Having nurses check their math calculations with a colleague before administering a drug.
D. Having nurses check their math calculations with a colleague before administering a drug.
A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather's antidepressant to improve his mood. After immediately phoning the boy's stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem? A. Hypokalemia B. Nephrotoxicity C.Cardiac dysrhythmia D. Hypertensive crisis
D. Hypertensive crisis
An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman's pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient's pain?
Twice-daily doses of long-acting morphine, with short- acting morphine available for breakthrough pain
A pregnant patient asks the what over-the-counter medication she can take for recurring headaches. The nurse should recommend
Tylenol.
A male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at each clinic visit?
Urinary elimination patterns
Alprostadil (Caverject), a drug used to treat erectile dysfunction, has been prescribed to a 42-year-old patient. When providing education to the patient and his wife, the nurse should inform the wife about which of the following adverse effects?
Vaginal burning
A patient has been admitted to the critical care unit of the hospital with bacterial septicemia that has failed to respond to initial antibiotic treatment. The patient's most recent blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the patient's blood. The nurse will anticipate that this patient will likely require intravenous administration of what antibiotic?
Vancomycin
A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The APRN will advise her to take which of the following vitamin supplements while taking the drug?
Vitamin B
A 2-year-old child is diagnosed with a minor ailment and is to be administered medications at home for 2 weeks. The child lives with his mother, grandmother, and four other children between the ages of 14 months and 7 years. The home health nurse is asked to assess the home environment to determine if it is appropriate for the child to take his medication at home. Which of the following will have the greatest impact on the nurse's assessment?
Where the medications will be stored
A 56-year-old woman will soon begin treatment of her overactive bladder with tolterodine (Detrol). What patient teaching should the nurse provide to this woman?
You might find that you get a dry mouth or a headache from this drug, but this does not mean it has to be discontinued."
A 59-year-old man with a recent history of erectile dysfunction has been assessed and prescribed sildenafil (Viagra). When providing patient education to this man, the nurse should tell him which of the following?
You might find that your face becomes flushed or you get a headache after you take Viagra."
A 64-year-old-patient has been prescribed lorazepam (Ativan) because of increasing periods of anxiety. The nurse should be careful to assess for
a history of current or past ETOH use The patient who has history of alcohol or substance abuse may be a poor candidate for lorazepam because the patient is more likely to develop dependence on the drug. Alcohol will also have an additive effect with lorazepam. A diet high in fat and carbohydrates or nicotine use should not affect the use of lorazepam.
A patient is suffering from acute inhalant intoxication. The priority nursing intervention will be to
administer oxygen therapy Patients suffering from acute inhalant intoxication may experience hypoxia from CNS depression; therefore, the patient will most likely be receiving oxygen therapy. Epinephrine is contraindicated because of possible cardiac stimulation. Arrhythmias may occur. Monitoring blood pressure and pulse is important; however, the patient could be short of breath due to the hypoxia. Therefore, monitoring respirations would be the priority. Nausea and vomiting could be present, and the nurse would need to provide the patient with an emesis basin, but it would not be the most important nursing intervention.
An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions?
administration in a covered trash can in the patient's room. ed
orphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The nurse will advise the patient to avoid
alcohol.
A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The APRN will be sure to
avoid the small veins in the dorsum of the hand or the wrist.
A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that
body fluids such as urine, saliva, tears, and sputum may become discolored.
A 12-year-old boy is being discharged from the hospital after major surgery. The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to
both the boy and his mother regarding all medication issued.
A trauma patient has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the patient's
bowel patterns Morphine, like most opioid analgesics, creates a risk for constipation. The drug is unlikely to influence the patient's temperature, skin integrity, or urine specific gravity.
A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by
decreasing the influx of sodium into the neurons Phenytoin reversibly binds to sodium channels while they are in the inactive state. This binding delays the return of the channel to an active state. Because sodium can enter the cell to initiate an action potential only when the channels are active, the time between action potentials is greatly lengthened, the neurons cannot fire at an excessive rate, and excessive muscle contractions that occur in grand mal-type seizures are prevented. Phenytoin does not directly affect the function of calcium channels or levels of GABA and glutamate.
A postmenopausal patient is prescribed bisphosphonates to treat osteoporosis. The nurse will instruct the patient to take the drug
first thing in the morning.
A NP who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to
immature liver and kidney function in infants and children.
A patient who is experiencing acute alcohol withdrawal is being treated with intravenous lorazepam (Ativan). This drug achieves a therapeutic effect by
increasing the effects of the neurotransmitter GABA. Like all benzodiazepines, lorazepam increases the effects of GABA, which has an inhibitory effect on the CNS. However, noneof the benzodiazepines act like GABA or increase the amount of GABA present. MAOIs inhibit monoamine oxidase and tricyclic antidepressants primarily affect serotonin and norepinephrine levels. SSRIs increase the availability of serotonin in the synapses.
A patient with chronic heart failure has begun treatment with epoetin alfa, which she will receive in her own home from a home health nurse. The nurse should teach the patient to supplement this treatment with a diet that is high in
iron-rich foods such as beans and leafy green vegetables.
An immunocompromised patient with a diagnosis of candidiasis has failed to respond to conservative therapy and has consequently begun treatment with amphotericin B. The nurse is aware that this drug achieves a therapeutic effect by way of its influence on
the permeability of fungal cell walls.
A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to
take the vitamins at least 2 hours before or after taking ciprofloxacin.
A female patient is taking filgrastim (Neupogen) to decrease the incidence of infection. The nurse notices a small increase in the neutrophil count 2 days after starting therapy. The nurse's evaluation of the increase is that
the increase in the neutrophil count is only transient.
A school nurse has been teaching high school students about the risks associated with marijuana use. However, the nurse has been met with considerable skepticism on the part of students, most of whom believe that marijuana is a benign drug. Which of the following teaching points should the nurse provide?
"Smoking marijuana is just as bad, or worse, for your lungs as smoking cigarettes."
A is providing patient education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which of the following statements by the patient will alert the nurse that special instructions regarding insulin are necessary?
"I am on the middle school track team."
A postsurgical patient has been provided with a morphine patient- controlled analgesic (PCA) but has expressed her reluctance to use it for fear of becoming addicted. How can the nurse best respond to this patient's concerns?
"It is not uncommon to develop a dependence on pain medications, but this usually takes place over a long period andis not the same as addiction." Addiction to opioids is a rare occurrence among hospital patients who do not have a history of drug abuse. It would be inappropriate to downplay the patient's concerns, however. A more appropriate response would be to explain the phenomenon of dependence and to differentiate it from addiction.
An immunocompromised 7-year-old child was recently discharged home with a peripherally- inserted central line (PIC line) for home antibiotic therapy. He has now been brought to the emergency department by his mother and father with signs and symptoms of line sepsis. Upon questioning, the mother states that she has been removing the PIC dressing daily and washing the site with warm water and a cloth. What nursing diagnosis is most appropriate in this situation? A.Caregiver Role Strain B.Knowledge Deficit C.Ineffective Family Therapeutic Regimen Management D.Delayed Growth and Development
B.Knowledge Deficit
A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse's priority assessment would be A. Vision. B.body temperature. C. height and weight. D. blood pressure.
C. height and weight.
A 19-year-old patient reports to a clinic with vaginal discharge with a foul odor. A microscopic exam reveals trichomonas vaginalis. The nurse practitioner is aware that A.trichomoniasis is an incurable disease. B.trichomoniasis discharge is typically thin and clear. C. asymptomatic women are diagnosed with trichomoniasis by a routine pap smear. D.it is unusual to have an odor with trichomoniasis.
C. asymptomatic women are diagnosed with trichomoniasis by a routine pap smear.
A nurse practitioner orders 150 mg of oral fluconazole for a patient with vulvovaginal candidiasis. The patient should expect to take medication A.once a day. B.every day until the infection is gone. C. for 30 days. D. for 20 days.
C. for 30 days.
A nurse is going to administer medication to an infant using a medicine dropper. The best method is to open the child's mouth by gently squeezing the cheeks and placing the drops A child has a greater body surface area, creating greater permeability resulting in an increase in absorption of topical agents, which may result in more adverse effects. A.under the tongue. B.at the back of the mouth. C. in the buccal pouch. D. on top of the tongue.
C. in the buccal pouch.
A 15-year-old boy has been diagnosed with bone cancer after several months of fatigue and pain. What question should the nurse include in an assessment when trying to minimize the potential for adverse drug reactions? A."Did Tylenol or other over-the-counter pain remedies ever relieve your pain?" B."How much do you weigh?" C."Do you ever use alcohol or drugs?" D."On a scale of zero to ten, what level of pain is acceptable to you?"
C."Do you ever use alcohol or drugs?"
A nurse is providing patient education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which of the following statements by the patient will alert the nurse that special instructions regarding insulin are necessary? A."My mother is going to give me my insulin." B."I walk two blocks to school every day." C."I am on the middle school track team." D."We live in a two-story house."
C."I am on the middle school track team."
A school nurse has been teaching high school students about the risks associated with marijuana use. However, the nurse has been met with considerable skepticism on the part of students, most of whom believe that marijuana is a benign drug. Which of the following teaching points should the nurse provide? A."Every year, thousands of Americans end up in emergency departments with marijuana overdoses." B."Most people don't know that marijuana can be just as addictive as heroin or cocaine over time." C."Smoking marijuana is just as bad, or worse, for your lungs as smoking cigarettes." D."Marijuana can easily interact with other drugs and cause potentially fatal reactions."
C."Smoking marijuana is just as bad, or worse, for your lungs as smoking cigarettes."
A nurse who provides care on a pediatric medicine unit has conducted a medication reconciliation of a recently-admitted patient. In light of the fact that the child takes methylphenidate (Ritalin), the nurse is justified in considering a history of what health problem? A.Respiratory depression B. Obesity C.ADHD D. Anxiety
C.ADHD
A 13-year-old female took a weight loss drug that activated the sympathetic nervous system. Which of the following assessment findings would the nurse expect? A.Decreased myocardial contraction B.Increased intranodal conduction time C.Increased cardiac conduction D.Decreased heart rate
C.Increased cardiac conduction
A 29-year-old woman who is morbidly obese has recently begun a comprehensive, medically- supervised program of weight reduction. Prior to adding dextroamphetamine (Dexedrine) to her regimen, the patient should be questioned about her intake of A. alcohol. B. grapefruit juice. C.caffeine. D. trans fat.
C.caffeine.
A child is admitted to the burn unit with second and third degree burns on both arms and part of his or her face. When administering topical medications to the burned areas, the nurse should A.allow the child to apply the medication if possible. B.cool the medication prior to administration. C.use sterile technique when applying the medication. D.use clean technique only when applying the medication.
C.use sterile technique when applying the medication.
A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug? A.That there is decreased absorption rates of topical drugs in infants B.That there is a lower concentration of water in an infant's body compared with an adult C.That there is less body surface area to be concerned about D. That the infant's skin has greater permeability than that of an adult
D. That the infant's skin has greater permeability than that of an adult
To which of the following patients would a medication nurse most likely administer caffeine as part of the treatment plan? A.A school-age child with severe ADHD B.A 34-year-old woman with a diagnosis of gastric ulcerations C.A 52-year-old man with narcolepsy D.A preterm neonate who has apnea
D.A preterm neonate who has apnea
A nurse is having difficulty administering a bitter drug to a 5-year-old child. The nurse should A. Involve the child in a play therapy session, and then tell the child that the medicine is candy. B. give the drug in a pill form. C. Havee the parent gently force the child's mouth open. D. Offerr the child a flavored ice chip or ice pop prior to administering the drug.
D.offer the child a flavored ice chip or ice pop prior to administering the drug.
Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The nurse will advise the patient to avoid
E The nurse should advise the patient to avoid alcohol and any other CNS depressants while taking morphine. These combinations can cause serious respiratory depression and sedation. Vitamin C, fatty foods, and dairy products are not known to interact with morphine.
A patient is taking etoposide for a testicular tumor refractory to treatment. The nursing assessment reveals that he is also taking warfarin. The nurse must carefully monitor for which of the following?
Elevated prothrombin time
A NP is caring for a patient who is at 28 weeks' gestation and is receiving terbutaline (Brethine) to control preterm labor. Which of the following assessment parameters should the nurse prioritize?
Fetal heart rate (FHR)
The recommended treatment for trichomoniasis is
Flagyl.
The clinical nurse educator who oversees the emergency department in a children's hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children?
Having nurses check their math calculations with a colleague before administering a drug.
Which of the following would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a patient taking estrogen?
Headaches and chest pain
A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather's antidepressant to improve his mood. After immediately phoning the boy's stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem
Hypertensive crisis
A 13-year-old female took a weight loss drug that activated the sympathetic nervous system. Which of the following assessment findings would the nurse
Increased cardiac conduction
An immunocompromised 7-year-old child was recently discharged home with a peripherally-inserted central line (PIC line) for home antibiotic therapy. He has now been brought to the emergency department by his mother and father with signs and symptoms of line sepsis. Upon questioning, the mother states that she has been removing the PIC dressing daily and washing the site with warm water and a cloth. What nursing diagnosis is most appropriate in this situation?
Ineffective Family Therapeutic Regimen Management
A 46-year-old man is receiving a quinupristin/dalfopristin IV infusion for a life- threatening infection. Which of the following would be most important for the nurse to monitor?
Infiltration, edema, or phlebitis at the infusion site
A is assigned to a patient who is at 32 weeks' gestation and is receiving terbutaline (Brethine) IV for 24 hours to control preterm labor. Which of the following nursing actions will the nurse take to decrease the risk of hypotension and promote circulation to the fetus?
Instruct the patient to lie on her left side during the infusion.
A 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe for which of the following adverse effects of the drug?
Lid margin crusting and pruritus
A will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months?
Liver function tests
A NP is performing patient education for a woman who has just been prescribed a bisphosphonate. Which of the following diagnostic and history findings would have prompted the woman's care provider to prescribe a bisphosphonate?
Low bone density and a family history of osteoporosis
A Nurse Practitioner is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for which of the following?
Neurotoxicity
A nurse practitioner has been assigned to a 55-year-old woman who has a malignant brain tumor. The patient is receiving her first dose of carmustine. It will be critical for the nurse to observe for which of the following?
Respiratory difficulty
A patient with non-Hodgkin's lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient's care, what nursing diagnosis should the nurse prioritize?
Risk for Infection related to suppressed bone marrow function
A 20-year-old female patient is receiving topical clindamycin for acne vulgaris. She develops a rash and urticaria along with severe itching where the medication is applied. The nurse will formulate which of the following nursing diagnoses for the patient
Risk for Injury related to allergic reactions
A is providing patient education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the patient to avoid which of the following drugs?
Salicylates
Drugs have a valid medical use but a high potential for abuse, both psychological and physiologic. In an emergency, a Schedule 2 drug may be prescribed by telephone if a written prescription cannot be provided at the time. However, a written prescription must be provided within 72 hours with the words authorization for emergency dispensing written on the prescription. These prescriptions cannot be refilled. A new prescription must be written each time. Examples include certain amphetamines and barbiturates. This is scheduled drug
Schedule 2
A 51-year-old female patient has been receiving doxorubicin (Adriamycin) for metastatic breast cancer. Her medical record indicates she has cardiomyopathy and a cumulative dose of 300 mg/m2 of doxorubicin. Which of the following measures would help limit the severity of the cardiomyopathy in this patient?
Selected The use of dexrazoxane in conjunction with doxorubicin
The NP has established a peripheral IV access and began an infusion of magnesium sulfate on a 29-year-old antepartum patient who is 35 weeks pregnant. Which of the following assessment findings most likely prompted the patient's physician to order magnesium sulfate for this patient?
Systolic blood pressure readings in excess of 190 mmHg
A 16-year-old boy is prescribed cromolyn sodium nasal spray to treat a nasal allergy. To maximize the therapeutic effects of the drug, which of the following will the nurse include in instructions to the patient?
Take the drug for one full week before coming in contact with allergens
A educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session?
Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected.
A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment?
The importance of vigilant hygiene for the boy and the other members of the family
An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identified potential benefits of imatinib. Which of the following characteristics of this patient's current health status may preclude the use of imatinib?
The patient has chronic heart failure resulting in significant peripheral edema.
A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this patient would most likely contraindicate the use of tadalafil for his ED?
The patient has unstable angina and uses a nitroglycerin patch
A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective?
The patient's hemoglobin level is 11 g/dL
Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse's response to Mr. Lepp?
The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients.
A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia. Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.)
it is available in both quick-onset and continuous-release oral forms the drug does not cause sleepiness one of the most common adverse effects of the drugs is a headache Zolpidem generally is not used for more than 7 to 10 days at a time. It induces sleep rapidly and should be taken immediately before going to bed. It is true that the drug does not seem to produce residual effects the next morning or cause prolonged rebound effects when it is discontinued. It is available in both quick-onset and continuous-release oral forms, and common adverse effects of the drug are headache, prolonged
A is assessing a patient who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the patient for which of the following?
leukopenia
A patient with mild low back pain has been advised to take acetaminophen. The nurse will inform him that excessive intake of acetaminophen may result in
liver damage A patient taking acetaminophen should be taught the common adverse effects of the drug, which include rash, urticaria, and nausea. Nausea, not gastrointestinal distress, is a common adverse effect of acetaminophen. Flushing, dizziness, and feelings of tingling, heat, and fatigue are the most common adverse effects of sumatriptan, not acetaminophen.
A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is perspiring and her blood pressure is 88/50. The serum magnesium level is 10 mg/dL. The nurse will interpret these manifestations as
magnesium sulfate toxicity.
A NP is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that he or she is taking an oral form of
marijuana .
A nurse is caring for a patient who abuses marijuana. The treatment for marijuana abuse consists mainly of
nonpharmacologic interventions combined with an exercise program Treatment for marijuana abuse consists mainly of nonpharmacologic interventions combined with an exercise program to help deal with withdrawal symptoms and cravings for the drug. Treatment of LSD and PCP use is necessary only when the user experiences a "bad trip." Parlodel is given for cocaine addiction. Patients with acute inhalant intoxication may need respirator assistance.
A patient has been prescribed oral tetracycline. The nurse will instruct the patient to take the drug
on an empty stomach 1 hour before or 2 hours after taking any meals or other drugs.
A nurse practitioner orders 150 mg of oral fluconazole for a patient with vulvovaginal candidiasis. The patient should expect to take medication
once a day.
A patient has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that may cause
ototoxicity or nephrotoxicity.
A patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are considered
phytoestrogens.
A patient has acquired primary hypogonadism and has been prescribed testosterone transdermal (Androderm) patches. When educating the patient on how to administer the drug, the nurse will instruct him to
place the patch on the back, abdomen, upper arms, or thighs.
A 15-year-old patient has meningitis caused by Haemophilus influenzae. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitor
plasma concentrations regularly
A 67-year-old man who is being treated for prostate cancer is taking epoetin alfa. The nurse will instruct the patient to
schedule an appointment to measure hemoglobin twice a week for at least 2 to 6 weeks.
Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain and burning during the infusion by
slowing the infusion.
A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause
staining of permanent teeth.
Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to
stand or sit upright for at least 30 minutes after taking alendronate..
A is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to
stay well hydrated by drinking at least eight 8-oz glasses of water daily.
A nurse is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the nurse should be aware that
there is a risk of systemic absorption of the lidocaine through the patient's traumatized skin. Applying lidocaine preparations to severely traumatized mucosa (large skin abrasions, eczema, and burns) can increase its absorption, which in turn increases the risk of systemic toxicity. Intravenous lidocaine is not normally used for analgesia. The destruction of nerve endings in a burn site does not mitigate the need for topical pain control and lidocaine does not need to be potentiated with another anesthetic.
An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman's pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient's pain?
twice-daily doses of long-acting morphine, with short-acting morphine available for breakthrough pain the use of long-acting analgesia combined with short-acting opioids for breakthrough pain is a proactive pain management technique that maximizes therapeutic benefit while minimizing the risks of adverse effects.
A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia). After baseline physical data are obtained, the nurse will assess the patient's childbearing potential. The nurse will inform the patient that during sibutramine therapy she should
use adequate contraception.
A is instructing a 19-year-old female patient on the use of fluconazole for candida vaginitis. A teaching priority will be to
use an alternative form of birth control, if taking an oral contraceptive.
A child is admitted to the burn unit with second and third degree burns on both arms and part of his or her face. When administering topical medications to the burned areas, the nurse should
use sterile technique when applying the medication.
An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with
vancomycin.
A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the APRN is responsible for facilitating this new aspect of the patient's drug regimen. This will involve the administration of
weekly subcutaneous injections
A Nurse Practitioner is working with a 16-year-old pregnant teen and assessing for behavior that may put the baby at risk. The most important assessment the nurse can make is
whether the pregnant woman uses illegal substances.
A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug
with a glass of water 1 hour before or 2 hours after a meal.