Pharm 41, 42, 44
A patient is complaining of moderate bladder pain and spasms secondary to a UTI. Which drug would assist in relieving symptoms? a. Tolterodine (Detrol) b. Nitrofurantoin (Furadantin) c. Phenazopyridine hydrochloride (Pyridium) d. Oxybutynin chloride (Ditropan)
c
Which intervention(s) will help stimulate urination when a patient is experiencing postoperative urinary retention? (Select all that apply.) a. Reinforcing Kegel exercises b. Administration of bethanechol chloride (Urecholine) c. Pouring warm water over the perineum d. Increasing IV fluids e. Urinary catheterization
b c
A 14-year-old male is taking tolterodine (Detrol). What is the action of this drug? a. Restores bladder tone and function. b. Decreases the urge to void. c. Prevents urinary retention. d. Acidifies urine.
b
A patient taking antipsychotic medication for schizophrenia is admitted with a temperature of 106°F. The admitting diagnosis is neuroleptic malignant syndrome resulting from antipsychotic medication. Which drug is indicated in treatment of this condition? a. Edrophonium (Tensilon) b. Dantrolene (Dantrium) c. Baclofen (Lioresal) d. Metaxalone (Skelaxin)
b
In the intensive care unit, the nurse is taking care of a patient who is on a ventilator and is receiving succinylcholine (Anectine). Which is a priority nursing diagnosis for this patient? a. Pain b. Disturbed body image c. Risk for injury d. Self-care deficit
a
The nurse is educating a patient about a newly prescribed cholinergic agent. When relaying common adverse effects of this type of medication, the nurse will include information about: (Select all that apply.) a. conjunctival irritation. b. headache. c. salivation. d. hypotension. e. bradycardia.
a b
A patient taking a neuromuscular-blocking agent is assessed to have a heart rate of 120 and blood pressure of 80/50. The nurse will anticipate the physician writing an order for: a. ABGs. b. blood glucose level. c. CBC. d. liver function tests.
a
How often is fosfomycin (Monurol) usually administered when used in the treatment of UTIs? a. In a one-time dose b. Once per day c. Once per week d. Monthly
a
Patients with which conditions must be carefully assessed to determine whether they would tolerate treatment with a neuromuscular-blocking agent? (Select all that apply.) a. Pregnancy b. Hepatic disease c. Pulmonary disease d. Renal disease e. Neurologic disorders f. Psychiatric disorders
b c d e
Why are neuromuscular-blocking agents used? (Select all that apply.) a. Alleviation of pain b. Reducing the use and adverse effects of general anesthetics c. Easing endotracheal intubation and prevent laryngospasm d. Producing amnesia during painful procedures e. Decreasing muscular activity in electroshock therapy
b c e
A 42-year-old woman is admitted with complaints of dysuria, frequency, and lower back pain. The urinalysis report is positive for red blood cells, and the blood work shows an elevated white blood cell count. Which medication will the nurse anticipate that the healthcare provider will order? a. Meperidine (Demerol) b. Bethanechol chloride (Urecholine) c. Ciprofloxacin (Cipro) d. Metronidazole (Flagyl)
c
The nurse is caring for a patient immediately following a right-sided trabeculectomy. When positioning this patient, the nurse will encourage a _____ position. a. prone b. right side-lying c. left side-lying d. Trendelenburg
c
After undergoing prostate surgery, a patient is discharged on the medication phenazopyridine hydrochloride (Pyridium) to assist with urinary catheter discomfort. What information will the nurse include in the discharge teaching? a. Urine will have a foul smell while taking this medication. b. Diarrhea and abdominal cramping are expected adverse effects. c. The sclera of the eye is yellow while on therapy. d. Urine will appear reddish orange.
d
What is the action of timolol maleate (Timoptic), a beta-adrenergic blocking agent? a. Draws aqueous humor from the eye into the circulatory network. b. Increases the production of aqueous humor. c. Increases the outflow of aqueous humor. d. Decreases the production of aqueous humor.
d
What information will the nurse include when instructing a patient on the correct method of instilling eyedrops? (Select all that apply.) a. With an infection, prevent cross-contamination and use a separate source of medication and droppers for each eye. b. Wash hands before and after administration. c. Place the lid on the surface area as instructed to avoid contamination. d. Never touch the tip of the dropper or opening of the ointment container. e. Wipe eye from the outer to inner canthus.
a b c d
A patient has been taking an antimicrobial agent prescribed to treat a UTI for 2 days. She contacts the healthcare provider's office to report persistence of symptoms. In evaluating the medication effectiveness, which assessment(s) would be important? (Select all that apply.) a. Complete emptying of the bladder b. Amount of pain with urination as well as frequency c. Amount of daily fluid intake and output d. GI symptom complaints e. Bleeding with urination f. Persistence of nocturia
a b c d e
The nurse is assisting with postpartum care for a mother who has given birth to her fourth child. She reports a moderate amount of urinary incontinence since the birth of the third child and is concerned that this problem will worsen. Which instruction(s) may facilitate management of incontinence? (Select all that apply.) a. Instruction of proper wiping techniques to prevent bacterial infection b. Education on bladder training and Kegel exercises c. Information on personal hygiene measures to prevent perianal breakdown d. Information of incontinence products and appliances e. Importance of establishing a regular toileting schedule f. Importance of increasing fluid intake
a b c d e
A factory worker had a chemical inadvertently splashed into his right eye. An eyewash was used at the work site. Which nursing assessment(s) would be important to include? (Select all that apply.) a. Visual acuity b. Presence of pain, blurred or halo vision, or lack of vision c. Type of chemical d. Presence of nystagmus e. Presence of contacts or use of eyeglasses
a b c e
What is the mechanism of action of osmotic agents when used to decrease IOP? a. Promoting outflow of the aqueous humor into the tear ducts b. Increasing plasma osmolarity and drawing extracellular fluid into the blood c. Blocking production of aqueous humor d. Decreasing viscosity of the tears and allowing fluid to drain away from the eye
b
What may become discolored by phenazopyridine (Pyridium) in addition to the urine? a. Feces b. Sclera c. Sputum d. Saliva
b
Which common adverse effects occur with neuromuscular-blocking agents? a. Fever b. Flushing c. Nausea d. Ataxia
b
Which is a potential serious adverse effect associated with mannitol (Osmitrol)? a. Bradycardia b. Fluid overload c. Anaphylaxis d. Fever
b
Which laboratory values will the nurse review prior to beginning medication therapy for skeletal and muscle disorders? a. Sodium, magnesium, and chloride b. C-reactive protein (CRP), human leukocyte antigen (HLA), and liver function tests c. Arterial blood gases (ABGs), complete blood count (CBC), and electrolytes d. Glucose, high-density lipoproteins (HDL), and prothrombin time (PT)
b
Which type of medication would be used to dilate the pupils before an eye examination? a. Osmotics b. Adrenergic agent c. Beta-adrenergic agent d. Corticosteroid
b
An employee at a factory has not been to work because of low back muscle spasms. His wife contacts the occupational health nurse to report that her spouse is on a centrally acting skeletal muscle relaxant and is having problems with sleepiness. Based on the medication action, what will the nurse tell her? (Select all that apply.) a. "The healthcare provider should be notified because these drugs are contraindicated in the treatment of low back pain." b. "Your husband should avoid activities requiring alertness, such as driving or operating power equipment." c. "I need additional and specific information regarding the amount of your husband's sedation." d. "I will review baseline laboratory studies, discuss your husband's status with the healthcare provider, and call you back." e. "Sedation is an adverse effect of these medications and tends to resolve with continued therapy."
b c d e
The nurse is reviewing the urinalysis results of an older adult patient admitted with elevated temperature and incontinence. Which urinalysis properties are indicative of an infection? (Select all that apply.) a. Straw color b. Foul odor c. Trace glucose d. pH of 8.2 e. Specific gravity of 1.014
b d
Which discharge instruction will the nurse include for a patient sent home from the clinic who is taking an adrenergic ophthalmic solution for an acute inflammation? a. Headaches and eye pain are adverse effects to be reported to the healthcare provider immediately. b. Mouth dryness should be reported immediately. c. Avoid driving or operating machinery until blurring subsides. d. "Halos" or yellow rings around objects will be seen while taking this medication.
c
Which drug interaction may occur when an aminoglycoside or tetracycline is given in conjunction with neuromuscular-blocking agents? a. Deep sedation b. Decreased effectiveness of antibiotics c. Increased neuromuscular-blocking activity d. Sensitivity to antibiotics and possible allergic reaction
c
Which organism causes most UTIs? a. Proteus mirabilis b. Klebsiella pneumoniae c. E. coli d. Pseudomonas aeruginosa
c
Which symptoms will be most important for the nurse to assess for early signs of respiratory distress in the patient who has been given a neuromuscular-blocking agent? a. Nasal flaring and retraction of intercostal muscles b. Dyspnea, increased respiratory rate, and cyanosis c. Restlessness, anxiety, and lethargy d. Pallor, stridor, and diaphoresis
c
Which medication is used to produce miosis following a diagnostic procedure? a. Pilocarpine (Pilocar) b. Mannitol (Osmitrol) c. Atropine (Isopto Atropine) d. Epinephrine (EpiPen)
a
What is the reason for a paraplegic patient to receive baclofen (Lioresal)? a. It interrupts reflexes at the level of the spinal cord. b. It acts directly on the skeletal muscles to reduce spasticity. c. It interrupts transmission of impulses from motor nerves to muscles at the skeletal neuromuscular junction. d. It produces generalized mild weakness of skeletal muscles and decreases the force of reflex muscle contractions.
a
When assessing a patient for signs and symptoms of early respiratory depression immediately after leaving the postoperative area, the nurse will be alert for signs of what? (Select all that apply.) a. Restlessness b. Anxiety c. Lethargy d. Increased mental alertness e. Cyanosis
a b c
The nurse is examining a patient in the emergency department whose chief complaint is a dislocated shoulder. Which assessment data are needed to evaluate the patient? (Select all that apply.) a. Details related to the mechanism of injury b. Degree of impairment c. Pain level d. Inspection of the affected part for swelling, capillary refill, bruising, redness, localized tenderness, deformities, and paresthesia e. Elevation of the affected extremity
a b c d
What is the purpose of administering a cycloplegic agent? (Select all that apply.) a. Facilitate examination of the eye. b. Facilitate surgery on the eye. c. Cause pupillary dilation. d. Paralyze the ciliary muscle. e. Decrease the production of aqueous humor.
a b d
A patient recently diagnosed with glaucoma is to begin drug therapy with carbonic anhydrase inhibitors. For which assessment(s) would the nurse need to contact the healthcare provider? (Select all that apply.) a. Electrolyte levels b. Any signs of gastric symptoms before initiating drug therapy c. Allergy to sulfonamides d. Patient history of menopause e. Elevated IOP levels
a c
Which are important teaching points for the nurse to review with a patient recently diagnosed with open-angle glaucoma? (Select all that apply.) a. The disease will cause damage to the optic disk if left untreated. b. Symptoms are sudden and painful when the disease begins. c. Loss of peripheral vision is a common trigger for diagnosis. d. Total blindness may result if the glaucoma is not treated. e. Glaucoma is not a serious disease and will cause only mild inconvenience to the patient. f. Treatment is only necessary when symptoms are bothersome.
a c d
What information will the nurse include when teaching the patient and family about postoperative care for a trabeculectomy? (Select all that apply.) a. Use aseptic technique for all dressing changes and medication administration. b. Place the patient on the operated side. c. Avoid heavy lifting. d. Redness in the eye, pain, and swelling are common occurrences after surgery. e. Avoid straining on defecation.
a c d e
Which statement(s) about aqueous humor is/are true? (Select all that apply.) a. Bathes and feeds the lens, posterior surface of the cornea, and iris. b. Maintains the iris color. c. Drains out of the eye through drainage channels located near the junction of the cornea and sclera. d. Manufactures fluid for tear production. e. Flows out of the canal of Schlemm into the venous system of the eye.
a c e
A patient who has undergone a lengthy surgical procedure under general anesthesia is unable to breathe on his own following the procedure. Which drug will the nurse expect to be administered as an antidote to the neuromuscular-blocking agent? a. Dantrolene (Dantrium) b. Neostigmine methylsulfate (Prostigmin) c. Ether d. Baclofen (Lioresal)
b
The nurse is assisting with applanation tonometry on a patient at the ophthalmologist's office. The results indicate the patient's reading to be 15 mm Hg. The nurse interprets this result as _____ IOP. a. decreased b. normal c. slightly increased d. severely increased
b
The nurse is preparing a patient for an ophthalmic examination. Which action occurs when the nurse instills eyedrops to produce mydriasis? a. Drying of tears in the eyes b. Extreme dilation of the pupil c. Opening of the canal of Schlemm d. Paralysis of the ciliary muscle
b
The nurse is teaching a patient about the anticholinergic agent prescribed for urinary retention. Which statement by the patient indicates a need for further teaching? a. "I will chew gum to relieve dry mouth." b. "I will limit my fluid intake." c. "I will eat fresh fruits." d. "I will not drive if I develop blurred vision."
b
The nurse receives a conscious patient from the postoperative unit after administration of a neuromuscular blocker. Once the patient's vital signs are stable, the best position for the nurse to assist the patient into is _____ position. a. Sims' b. semi-Fowler's c. supine d. prone
b
Fluoxetine, erythromycin, clarithromycin, ketoconazole, itraconazole, miconazole, vinblastine, ritonavir, and nefazodone may inhibit the metabolism of which drugs? (Select all that apply.) a. Warfarin b. Tolterodine c. Phenytoin d. Darifenacin e. Heparin f. Solifenacin
b d f
The nurse is caring for a patient taking Pyridium for the diagnosis of UTI. What should the nurse report to the healthcare provider? (Select all that apply.) a. Orange-colored urine b. Yellow sclera c. Flushing of the skin d. Headache e. Increased pain and burning
b e
When obtaining urine for analysis on a patient in the labor and birth unit, the nurse assesses the urine to appear frothy. The nurse interprets this as a sign of possible: a. gestational diabetes. b. infection. c. preeclampsia (toxemia). d. dehydration.
c
Which assessment is most important for the nurse to obtain when a patient is being treated with a neuromuscular-blocking agent? a. Skin assessment for rash and urticaria b. Blood pressure assessment for orthostatic hypotension c. Respiratory assessment for patent airway d. Assessment for fluid volume overload
c
Which condition will neostigmine be used to treat? a. OAB b. UTI c. Postoperative or postdelivery urinary retention d. Benign prostatic hypertrophy
c
The nurse is preparing to administer a single-dose packet of fosfomycin to a patient diagnosed with a UTI. When preparing this medication, the nurse will: a. pour contents into a soufflé cup and administer by mouth. b. mix with 3 mL of normal saline and inject subcutaneously. c. pour contents into 90 mL of juice, stir, and administer by mouth. d. mix contents with 120 mL of water and administer by mouth.
d
The patient's family asks why neuromuscular-blocking agents are used before electroconvulsive therapy. Which explanation by the nurse is most accurate? a. "They stimulate respirations while therapy is delivered." b. "They prevent aspiration of respiratory secretions during the therapy." c. "They decrease intracranial pressure resulting from therapy." d. "They reduce the risk of injury during therapy."
d
What is the action of urinary antimicrobial agents? a. Reduce pain associated with bladder spasms caused by the infection. b. Enhance output enough to flush out the infection from the urinary tract. c. Eliminate urinary retention. d. Have an antiseptic effect on the urine and the urinary tract.
d
Which medication will be prescribed for a patient complaining of muscle spasms resulting from a back injury? a. Acetaminophen (Tylenol) b. Morphine sulfate c. Bethanechol (Urecholine) d. Cyclobenzaprine (Flexeril)
d