PHARM Exam 2
A 6-year-old child who has chickenpox also has a fever of 102.9° F (39.4° C). The child's mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse? "It's best to wait to see if the fever gets worse." "You can use the aspirin, but watch for worsening symptoms." "Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin." "You can use aspirin, but be sure to follow the instructions on the bottle."
"Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin."
What education and discharge information for a patient receiving an antilipemic medication would the nurse include for the patient? "This medication will take over for other interventions you have been trying to decrease your cholesterol." "It is important for you to double your dose if you miss one in order to maintain therapeutic blood levels." "Stop taking the medication if it causes nausea and vomiting." "Continue your exercise program, and maintain a diet high in omega-3 fatty acids."
"Continue your exercise program, and maintain a diet high in omega-3 fatty acids."
Which statement, made by the patient, demonstrates a knowledge deficit regarding colestipol (Colestid)? "The medication may cause constipation, so I will increase fluid and fiber in my diet." "I should take this medication 1 hour after or 4 hours before my other medications." "I might need to take fat-soluble vitamins to supplement my diet." "I should mix and stir the powder in a small amount of fluid as possible in order to maintain potency of the medication."
"I should mix and stir the powder in a small amount of fluid as possible in order to maintain potency of the medication."
Which statement, made by the patient, demonstrates a knowledge deficit regarding colestipol (Colestid)? Selected Answer: "The medication may cause constipation, so I will increase fluid and fiber in my diet." "I should take this medication 1 hour after or 4 hours before my other medications." "I might need to take fat-soluble vitamins to supplement my diet." "I should mix and stir the powder in a small amount of fluid as possible in order to maintain potency of the medication."
"I should mix and stir the powder in a small amount of fluid as possible in order to maintain potency of the medication."
The nurse evaluates and determines the patient has a good understanding of the discharge instructions regarding warfarin (Coumadin) when the patient responds with which statement? "I will double my dose if I forget to take it the day before." "I should keep taking ibuprofen for my arthritis." "I should decrease the dose if I start bruising easily." "I should use a soft toothbrush for dental hygiene."
"I should use a soft toothbrush for dental hygiene."
The nursing instructor asks a nursing student to describe the procedure for administering erythromycin ointment to the eyes of a newborn. Which student statement indicates that FURTHER teaching is needed? "I will flush the eyes after instilling the ointment." "I will clean the newborn's eyes before instilling ointment." "I need to administer the eye ointment within 1 hour after delivery." "I will instill the eye ointment into each of the newborn's conjunctival sacs."
"I will flush the eyes after instilling the ointment."
Which statement will indicate to the nurse that the patient understands the discharge instructions regarding cholestyramine (Questran)? "I will take Questran 1 hour before my other medications." "I will increase fiber in my diet." "I will weigh myself weekly." "I will have my blood pressure checked weekly."
"I will increase fiber in my diet."
Which statement when made by the patient indicates deficient knowledge regarding warfarin? "I will avoid contact sports." "I will take my medication in the early evening each day." "I will increase the dark green leafy vegetables in my diet." "I will contact my physician if I develop excessive bruising."
"I will increase the dark green leafy vegetables in my diet."
What teaching would the nurse provide to a patient receiving tetanus toxoid? "Increase fluid and fiber in your diet to prevent constipation." "Soreness at the injection site is a common reaction." "You will have lifetime immunity from this injection." "This medication must be repeated weekly for four weeks."
"Soreness at the injection site is a common reaction."
What instructions are given to a patient who is prescribed oral iron tablets? "Take the iron tablet in a powdered form." "Take an iron tablet just before going to bed." "Take the iron tablet after dissolving it in water using a straw." "Take the iron tablet with plenty of fluids."
"Take the iron tablet with plenty of fluids."
A nurse instructor is about to administer a vitamin K injection to a newborn. The student nurse asks the instructor regarding the purpose of the injection. The appropriate response would be: "The vitamin K provides active immunity " 'The vitamin K will prevent the occurrence of hyperbilirubinemia." "The vitamin K will protect the newborn from bleeding." "The vitamin K will serve as protection against jaundice and anemia "
"The vitamin K will protect the newborn from bleeding."
The nurse is teaching a patient who is receiving aminocaproic acid the measures to prevent adverse effects. Which statement made by the patient indicates the need for further teaching? 1 "I should take oral contraceptives during the therapy." 2 "I should not use any acetaminophen during the therapy." 3 "I should refrain from eating broccoli during the therapy." 4 "I should follow a low-cholesterol diet during the therapy."
1 "I should take oral contraceptives during the therapy."
A nurse is providing care to a patient who is at risk for deep vein thrombosis (DVT). The health care provider prescribes aspirin therapy. Which statement from the patient supports this prescription? 1 "I've been on prolonged bed rest." 2 "I avoid tight-fitting stockings or leggings." 3 "I never sit with my legs crossed at the knees." 4 "I get up and walk around at least once an hour."
1 "I've been on prolonged bed rest."
A patient is experiencing chest pain, dyspnea, hemoptysis, and hypotension. The patient's arterial blood gas analysis indicates a decreased level of oxygen. Which medication prescription would the nurse expect for the patient based on the current assessment data? 1 Alteplase 2 Phytonadione 3 Tranexamic acid 4 Aminocaproic acid
1 Alteplase
Cilostazol belongs to which drug class? 1 Antiplatelet 2 Thrombolytic 3 Anticoagulant 4 Antifibrinolytic
1 Antiplatelet
Therapy with which medication would require an increased dose of warfarin? 1 Carbamazepine 2 Cholestyramine 3 Barbiturate 4 Cimetidine
1 Carbamazepine Warfarin administered concurrently with carbamazepine leads to a decreased anticoagulant effect; therefore therapy with carbamazepine require an increased dose of warfarin for effective treatment. The combination of warfarin with cholestyramine, barbiturates, and cimetidine causes an increased anticoagulant effect. These patients would benefit from a decreased dose of warfarin. Test-Taking Tip: Chart/exhibit items present a situation and ask a question. A variety of objective and subjective information is presented about the patient in formats such as the hospital record (e.g., laboratory test results, results of diagnostic procedures, progress notes, health care provider orders, medication administration record, and health history), physical assessment data, and nurse/patient interactions. After analyzing the information presented, the test taker answers the question. These questions usually reflect the analyzing level of cognitive thinking.
A patient with atrial fibrillation is admitted to the emergency unit for symptoms of warfarin toxicity. The primary health care provider instructs the nurse to administer 6 mg of vitamin K to the patient. Which medication would be included in the patient's prescription to provide safe and effective treatment? 1 Enoxaparin 2 Furosemide 3 Amiodarone 4 Ketoconazole
1 Enoxaparin
A patient is prescribed an antiplatelet medication. Which herbal supplement would the nurse warn the patient to avoid? 1 Ginkgo 2 Valerian 3 Hawthorn 4 Evening primrose
1 Ginkgo
The patient is being treated with a continuous intravenous infusion of heparin. Which action is the nurse's highest priority? 1 Have protamine sulfate readily available at all times. 2 Monitor the patient's laboratory values correctly. 3 Teach the patient about dietary restrictions while on the medication. 4 Ensure that a loading dose was initially administered when beginning treatment.
1 Have protamine sulfate readily available at all times.
The nurse is caring for a patient who is being treated with fondaparinux and notes a platelet count of 80,000/mm3. Based on this information, the nurse anticipates which change to the medication regimen? 1 Medication will be stopped. 2 Dose will be increased. 3 Dose will be decreased. 4 Dose will be unchanged
1 Medication will be stopped.
The nurse is caring for a patient who is being treated with warfarin. The patient has just been administered cimetidine. Which action would the nurse take? 1 Monitor the patient for increased action of the anticoagulant. 2 Monitor the patient for decreased action of the anticoagulant. 3 Continue to administer cimetidine with each dose of warfarin. 4 Instruct the patient to notify the nurse if he or she begins to experience discomfort.
1 Monitor the patient for increased action of the anticoagulant.
The nurse is caring for a patient who is being treated with one of the coagulation modifier drugs. The patient tells the nurse that he or she has developed a rash. Which is the nurse's priority action? 1 Notify the provider; the medication will need to be discontinued. 2 Monitor the area of the rash; this is an expected side effect of the medication. 3 Notify the provider to obtain an order for a topical medication to apply to the rash. 4 Instruct the patient to wash the area with mild soap and water and leave open to the air.
1 Notify the provider; the medication will need to be discontinued.
The nurse is reviewing laboratory data before initiating a patient's heparin infusion. Which finding requires immediate action? 1 Platelet count of 95,000/mm3 2 Potassium level of 3.5 mEq/L 3 International normalized ratio (INR) of 1 4 Activated partial thromboplastin time (aPTT) of 37 seconds
1 Platelet count of 95,000/mm3
Which medication is contraindicated in a patient who has osteoporosis and a history of deep vein thrombosis? 1 Raloxifene 2 Denosumab 3 Risedronate 4 Alendronate
1 Raloxifene
The current immunization for tetanus and diphtheria toxoids and pertussis, Tdap, is administered to people in which age range? Under 6 years of age 11-12 years of age and older Any age range In the first two years of life
11-12 years of age and older
The nurse teaches the nursing student about statin drugs. Which statements by the student indicate effective learning? Select all that apply. 1 "Statins can be used along with gemfibrozil." 2 "Fluvastatin with warfarin increases the risk of bleeding." 3 "Simvastatin is the least potent inhibitor of the CYP3A4 enzyme." 4 "Atorvastatin with cyclosporine decreases the risk of rhabdomyolysis." 5 "Pravastatin is not as effective as simvastatin for the inhibition of CYP3A4."
2 "Fluvastatin with warfarin increases the risk of bleeding." 5 "Pravastatin is not as effective as simvastatin for the inhibition of CYP3A4."
A patient who is on enoxaparin therapy has hematuria, melena, petechiae, and bleeding from the gums. Which treatment strategy will be beneficial for the patient? 1 Administering vitamin K1 2 Administering protamine sulfate 3 Increasing the dose of enoxaparin 4 Infusing 50 mL of warfarin sodium
2 Administering protamine sulfate
A patient is admitted to the emergency department experiencing symptoms of a thrombolytic stroke. Which medication would the nurse expect to be prescribed for the patient? 1 Heparin 2 Alteplase 3 Clopidogrel 4 Fondaparinux
2 Alteplase
The nurse is monitoring a patient receiving alteplase therapy. Which assessment finding requires the most immediate action? 1 Nausea 2 Change in mental status 3 Bruising on the upper arm 4 Small amount of blood leaking around the intravenous catheter
2 Change in mental status
The nurse is assessing a patient who has hyperlipidemia and who is treated with antihyperlipidemic medications. During the assessment, the patient tells the nurse, "These days, my urine has a burnt odor." Which medications prescribed for the patient may be responsible for such an adverse effect? Select all that apply. 1 Ezetimibe 2 Colestipol 3 Fluvastatin 4 Gemfibrozil 5 Cholestyramine
2 Colestipol 5 Cholestyramine
The nurse is caring for a patient who is being treated with dabigatran and who is scheduled to be placed on phenytoin. The nurse anticipates which effect will occur when the phenytoin is administered? 1 Increased effect of the dabigatran 2 Decreased effect of the dabigatran 3 Therapeutic effect of the dabigatran 4 Anaphylactic reaction to the dabigatran
2 Decreased effect of the dabigatran
The nurse is administering whole blood to a patient who experienced severe blood loss and who also has an underlying coagulation disorder. Which formulation will the nurse expect to administer to this patient? 1 Intravenous heparin 2 Fresh frozen plasma 3 Lactated Ringer's solution 4 Hetastarch along with whole blood
2 Fresh frozen plasma
The nurse notes that the patient who will begin heparin therapy is currently undergoing treatment with enoxaparin. The nurse would notify the provider of which issue? 1 The patient is at risk for an allergic reaction. 2 Heparin should not be started on the patient. 3 The dosage of heparin will need to be increased. 4 The dosage of heparin will need to be decreased.
2 Heparin should not be started on the patient.
A patient with a low platelet count is prescribed a drug to stimulate platelet production. Which drug would the nurse anticipate being prescribed? 1 Epoetin 2 Oprelvekin 3 Aldesleukin 4 Interferon beta-1a
2 Oprelvekin
Which condition is a contraindication for dabigatran? Select all that apply. 1 Atrial fibrillation 2 Peptic ulcer disease 3 Chronic kidney disease 4 History of myocardial infarction 5 Chronic obstructive pulmonary disease
2 Peptic ulcer disease 3 Chronic kidney disease
A patient with deep vein thrombosis is receiving fondaparinux therapy. After reviewing the patient's laboratory reports, the nurse believes that discontinuing the therapy will be beneficial for the patient. Which finding supports the nurse's suspicion? 1 Hemoglobin level is 16.5 g/dL. 2 Platelet count is 75,000 cell/μL. 3 Fasting blood glucose level is 95 mg/dL. 4 Creatinine clearance value is 40 mL/min.
2 Platelet count is 75,000 cell/μL.
A patient taking warfarin was found to have a variation in the CYP2C9 allele that suggests that the patient is a slow metabolizer. Which intervention will the health care provider implement? 1 Withhold warfarin while checking for a CYP2D6 variation. 2 Prescribe a lower dose of warfarin. 3 Prescribe steroid therapy with the warfarin. 4 Increase the frequency of warfarin administration
2 Prescribe a lower dose of warfarin.
The nurse is caring for a patient who is scheduled to begin warfarin treatment and is currently being treated with amiodarone. Based on this information, the nurse anticipates that which change will be made to the medication regimen? 1 The dosage of the warfarin will be increased by half. 2 The dosage of the warfarin will be decreased by half. 3 The dosage of the amiodarone will be increased by half. 4 The dosage of the amiodarone will be decreased by half.
2 The dosage of the warfarin will be decreased by half.
A patient who has been taking warfarin is admitted with coffee-ground emesis. Which medication would the nurse anticipate being prescribed for this patient? 1 Vitamin E 2 Vitamin K 3 Protamine sulfate 4 Calcium gluconate
2 Vitamin K
A patient taking warfarin reports drinking chamomile tea every evening. Which instruction would the nurse give this patient? 1 "Limit your intake to one cup per day." 2 "Chamomile is safe and has no side effects." 3 "Chamomile may have an interaction with your warfarin." 4 "Ask your health care provider to assess your bleeding time more frequently."
3 "Chamomile may have an interaction with your warfarin."
After talking with a patient who is receiving warfarin sodium therapy, the nurse believes that the patient is at increased risk for bleeding. Which statement made by the patient supports the nurse's conclusion? 1 "I do not take aspirin for pain relief." 2 "I eat 1 cup of green leafy vegetables daily." 3 "I take ginkgo supplements for memory enhancement." 4 "I refrain from drinking coffee and citrus fruit juices daily."
3 "I take ginkgo supplements for memory enhancement."
Which statement made by the patient indicates an understanding of discharge instructions on antihyperlipidemic medications? 1 "I will stop taking the medication if it causes nausea and vomiting." 2 "It is important to double my dose if I miss one in order to maintain therapeutic blood levels." 3 "I will continue my exercise program to help increase my high-density lipoprotein serum levels." 4 "Antihyperlipidemic medications will replace the other interventions I have tried to decrease my cholesterol."
3 "I will continue my exercise program to help increase my high-density lipoprotein serum levels."
Which patient statement indicates a need for additional teaching about the safe use of dabigatran? 1 "I will store the bottle in a dry place." 2 "I will take the medication with food." 3 "I will place the pills in an organizer for easy use." 4 "I will use the medication within 60 days after it is opened."
3 "I will place the pills in an organizer for easy use."
A nurse is preparing to administer enoxaparin sodium to a patient for prevention of deep vein thrombosis. Which nursing intervention is essential? 1 Rub the administration site after injecting. 2 Utilize the Z-track method to inject the medication. 3 Administer the medication into subcutaneous tissue of the abdomen. 4 Draw up the medication in a syringe with a 22-gauge, 1.5-inch needle
3 Administer the medication into subcutaneous tissue of the abdomen.
Which test result provides a rationale for a lower-than-routine dose of warfarin sodium for a patient? 1 Presence of HER2/neu protooncogene 2 Decreased BUN and creatinine 3 Alteration in the CYP2C9 gene 4 Rapid metabolizer of CYP-metabolized drugs
3 Alteration in the CYP2C9 gene
A registered nurse is teaching a student nurse about safe and effective administration of heparin. Which action by the student nurse is appropriate? 1 Massaging the site after the injection 2 Administering the medication when convenient 3 Checking if the patient's prescription contains enoxaparin 4 Administering the medication intramuscularly in the vastus lateralis
3 Checking if the patient's prescription contains enoxaparin
What is another name for vitamin K-dependent blood coagulation factor IX? 1 Prothrombin 2 Proconvertin 3 Christmas factor 4 Stuart-Prower factor
3 Christmas factor
Which change to a dabigatran regimen would take place for a patient with a creatinine clearance of 25 mL/min? 1 Medication will be stopped 2 Dose will be increased. 3 Dose will be decreased. 4 Dose will be unchanged.
3 Dose will be decreased.
A patient who was admitted with deep vein thrombophlebitis is complaining of difficulty breathing and chest pain. Which is the most likely cause of these symptoms? 1 Anxiety 2 Medication reaction 3 Embolus to the lungs 4 Fatigue from walking with pain
3 Embolus to the lungs
Which patient finding indicates effective treatment of atrial fibrillation with dabigatran therapy? 1 Bowel sounds have increased. 2 Heart rate is 50 beats/min. 3 Extremities are pink and warm. 4 Rate of respiration is 11 breaths/min.
3 Extremities are pink and warm
Which patient finding indicates effective treatment of atrial fibrillation with dabigatran therapy? 1 Bowel sounds have increased. 2 Heart rate is 50 beats/min. 3 Extremities are pink and warm. 4 Rate of respiration is 11 breaths/min.
3 Extremities are pink and warm.
A patient is found to have low levels of clotting factors. Which treatment will the provider order for this patient? 1 Dextran 70 2 Conivaptan 3 Fresh frozen plasma (FFP) 4 Packed red blood cells (PRBCs)
3 Fresh frozen plasma (FFP)
The nurse assesses the patient's activated partial thromboplastin time (aPTT) to determine the effectiveness of the heparin regimen and notes that it is 35 seconds. Which interpretation of this aPTT is correct? 1 Within normal limits 2 Too high 3 Too low 4 Inadequate to evaluate treatment
3 Too low
A nurse understands that warfarin works by affecting which substance? 1 Factor Xa 2 Thrombin 3 Vitamin K 4 Antithrombin III
3 Vitamin K
A patient diagnosed with benign prostatic hyperplasia (BPH) is on tamsulosin therapy. On the follow-up visit, the nurse finds that the patient has an increased clotting time. Which medication in the patient's medical history does the nurse expect to be the cause of this condition? 1 Insulin 2 Nadolol 3 Warfarin 4 Epinephrine
3 Warfarin
The patient asks the nurse to explain the difference between dalteparin and heparin. Which response by the nurse is accurate? 1 "There is no real difference; dalteparin is interchangeable with heparin." 2 "The only difference is that heparin dosing is based on the patient's weight." 3 "You should ask your doctor why dalteparin was ordered instead of heparin." 4 "Dalteparin is a low-molecular-weight heparin that is more predictable in its effect and has a lower risk of bleeding."
4 "Dalteparin is a low-molecular-weight heparin that is more predictable in its effect and has a lower risk of bleeding."
The nurse is teaching a group of nursing students about statin drugs and asks about the mechanism of action of lovastatin. Which response from the students indicates effective learning? 1 "It inhibits the absorption of dietary cholesterol in the small intestine." 2 "It stimulates the biliary system to increase the excretion of dietary cholesterol." 3 "It binds to bile in the intestinal tract, forming an insoluble complex that is excreted in the feces." 4 "It inhibits hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase to reduce the biosynthesis of cholesterol in the liver."
4 "It inhibits hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase to reduce the biosynthesis of cholesterol in the liver."
Which instruction will the nurse provide to the patient regarding storing dabigatran for home use? 1 "Refrigerate and keep away from direct sunlight." 2 "Discard the drug within 21 days of opening the original container." 3 "Remove from the original package and place in aluminum foil." 4 "Store the drug with the desiccant-drying agent in the packing cap."
4 "Store the drug with the desiccant-drying agent in the packing cap."
A patient is receiving an intravenous heparin drip. Which laboratory value requires immediate action by the nurse? 1 Platelet count of 150,000 mm3 2 International normalized ratio (INR) of 1.0 3 Blood urea nitrogen (BUN) level of 12 mg/dL 4 Activated partial thromboplastin time (aPTT) of 120 seconds
4 Activated partial thromboplastin time (aPTT) of 120 seconds
A patient is receiving anticoagulant therapy. The international normalized ratio (INR) value for a patient receiving warfarin is 1.5 today. In response to this, the nurse would anticipate the health care provider placing which order? 1 Increase the heparin drip rate. 2 Administer protamine sulfate. 3 Hold the next dose of warfarin. 4 Administer an additional dose of warfarin.
4 Administer an additional dose of warfarin.
Which treatment will be used for the management of severe headache 2 days after an epidural anesthetic? 1 Administration of a 0.05 mg/kg dose of fentanyl over a 2-minute period 2 Administration of a 4 mg/kg dose of succinylcholine over a 2-minute period 3 Administration of a one dose per day of dantrolene to the patient for 4 days 4 Administration of a small volume of the patient's own blood into the epidural space
4 Administration of a small volume of the patient's own blood into the epidural space
Which is the action of simvastatin? 1 By inhibiting lipolysis in the adipose tissue 2 By activating the lipoprotein lipase enzyme 3 By preventing the reabsorption of bile acids 4 By inhibiting the enzyme HMG-CoA reductase
4 By inhibiting the enzyme HMG-CoA reductase
A patient is prescribed dabigatran to treat atrial fibrillation. On a follow-up visit, the medication prescription is reduced by half. Which assessment finding supports the change in the prescribed dose? 1 Loss of 10 pounds 2 Diagnosis of diabetes mellitus 3 Platelet count of 80,000/mm3 4 Creatinine clearance of 25 mL/min
4 Creatinine clearance of 25 mL/min
Which drug has antifibrinolytic properties? 1 Heparin 2 Alteplase 3 Fondaparinux 4 Desmopressin
4 Desmopressin
Which medication helps reduce postpartum uterine hemorrhage? 1 Megestrol 2 Raloxifene 3 Clomiphene 4 Methylergonovine
4 Methylergonovine
A patient has been receiving intravenous heparin. The nurse notes that today's activated partial thromboplastin time (aPTT) result is elevated. Which action would the nurse take? 1 Stop the medication. 2 Increase the dose of heparin. 3 Notify the health care provider immediately. 4 Monitor the patient and check the therapeutic range.
4 Monitor the patient and check the therapeutic range.
The nurse is teaching a medication regimen to a patient who has type II hyperlipoproteinemia and who has been prescribed cholestyramine. Which information will the nurse give the patient during the teaching? 1 Include milk in the diet while taking this medication. 2 Avoid doing deep breathing exercises after taking the medication. 3 Avoid taking vitamin A supplements while taking the medication. 4 Take other medications 1 hour before the administration of cholestyramine.
4 Take other medications 1 hour before the administration of cholestyramine.
The nurse would assess which laboratory value to determine the effectiveness of intravenous heparin? Complete blood count (CBC) Activated partial thromboplastin time (aPTT) Prothrombin time (PT) Blood urea nitrogen (BUN)
Activated partial thromboplastin time (aPTT)
A patient arrives at the clinic with a wound inflicted by a rusty nail. After checking the patient's history, the nurse finds that the patient last received the tetanus booster about 10 years earlier. What is the most appropriate nursing action in this situation? : Administer Tdap. Administer DTaP. Administer immunoglobulin Administer polyvalent vaccine
Administer Tdap.
The nurse plans which intervention to decrease the flushing reaction of niacin? Administer niacin with an antacid. Administer aspirin 30 minutes before nicotinic acid. Administer diphenhydramine hydrochloride (Benadryl) with the niacin. Apply cold compresses to the head and neck.
Administer aspirin 30 minutes before nicotinic acid.
A child who accidently ingested an enteric-coated iron supplement develops seizures and is immediately hospitalized. The serum iron concentration is found to be 350 mcg/dL. What intervention should the nurse expect the provider to prescribe to reduce the serum iron levels? Bowel irrigation An electrolyte infusion Administration of deferoxamine Abdominal radiographs
Administration of deferoxamine
What is the priority nursing assessment to monitor when administering vaccinations? Pain at the injection site Signs and symptoms of infection Anaphylaxis Myalgias
Anaphylaxis
A 12-month-old infant has received an MMR II (measles, mumps, and rubella virus vaccine), and her mother calls the clinic that afternoon to ask about helping her fussy infant to "feel better." What will the nurse suggest? Apply an ice pack to the injection site. Apply warm compresses to the injection site. Observe the site for further swelling and redness. Bring the infant in to the emergency department for an immediate examination
Apply warm compresses to the injection site.
A patient with warfarin toxicity is prescribed vitamin K. Which nursing assessment ensures patient safety? Assess the site for intramuscular drug delivery. Assess the white blood cell count of the patient. Assess the amount of blood loss in the patient. Assess the prothrombin time of the patient.
Assess the prothrombin time of the patient.
An allergy to which substance is listed as a contraindication to the administration of an immunizing drug? Soy Corn Wheat Egg
Egg
A nurse is assessing an athlete who has been admitted for cardiac arrest. The investigation reports reveal increased blood viscosity. Which drug did the patient likely receive? Folic acid Ferrous fumarate Epoetin alfa Cyanocobalamin (vitamin B12)
Epoetin alfa
The nurse recognizes that patient teaching regarding warfarin (Coumadin) has been successful when the patient acknowledges an increased risk of bleeding with concurrent use of which herbal product? (Select all that apply.) Garlic Ginkgo Dong quai Glucosamine St. John's wort
Garlic Ginkgo Dong quai St. John's wort
The nurse is caring for a patient who is prescribed long-term aspirin therapy to prevent a stroke. Which parameters should the nurse assess as a result of this prescription? Select all that apply. Heart rate Hemoglobin Respirations Platelet Count Blood Pressure Activated partial thromboplastin time (aPTT)
Hemoglobin Platelet Count Activated partial thromboplastin time (aPTT)
The nurse would question an order for simvastatin (Zocor) in a patient with which condition? Leukemia Diabetes Hepatic disease COPD
Hepatic disease
Which vaccination is recommended in the prevention of a virus that is known to cause cervical cancer? Herpes zoster vaccine Human papillomavirus vaccine Pneumococcal vaccine Hepatitis B virus vaccine
Human papillomavirus vaccine
A patient is receiving intravenous methylergonovine after a vaginal delivery. Which postpartum assessment is the nurse's priority to prevent complications of therapy? Hypertension Hypoglycemia Decreased lochia Uterine contractions
Hypertension
Hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are generally administered at which time? When the stomach is empty In the evening With breakfast With an antacid
In the evening
By which action does atorvastatin (Lipitor) decrease lipid levels? Inhibiting absorption of dietary cholesterol in the small intestine Binding to bile in the intestinal tract, forming an insoluble complex that is excreted in the feces Stimulating the biliary system to increase excretion of dietary cholesterol Inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver
Inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver
The nurse is monitoring a patient receiving alteplase for treatment of an arterial embolism in the left leg. Which finding indicates that the therapy is effective? 2+ pitting edema Faint posterior tibial pulse Left leg warm to touch Numbness in left leg
Left leg warm to touch
Which test will the nurse use to assess for adverse reactions to HMG-CoA reductase inhibitors? Serum cholesterol levels Liver function tests Serum electrolytes Complete blood count
Liver function tests
Enoxaparin sodium (Lovenox) is an anticoagulant used to prevent and treat deep vein thrombosis and pulmonary embolism. This drug is in which drug group? Low-molecular-weight heparin Oral anticoagulant Glycoprotein IIb/IIIa inhibitor Thrombolytic drug
Low-molecular-weight heparin
While observing a patient self-administer enoxaparin (Lovenox), the nurse identifies the need for further teaching when the patient completes which action? Massages the site after administration of the Does not aspirate prior to injecting the medication Massages the site after administration of the medication Administers the medication greater than 2 inches away from the umbilicus Injects the medication and then waits 10 seconds before withdrawing the needle
Massages the site after administration of the medication
Which medication helps reduce postpartum uterine hemorrhage? Megestrol Raloxifene Clomiphene Methylergonovine
Methylergonovine
Discharge teaching for a patient receiving simvastatin (Zocor) would include the importance of reporting which symptoms that might indicate a serious adverse reaction to the medication? Muscle pain Headache Weight loss Fatigue
Muscle pain
During a postpartum assessment, the nurse notes a boggy uterus and increased uterine bleeding. Which drug should the nurse anticipate will be prescribed? Oxytocin Terbutaline Clomiphene Prostaglandin E
Oxytocin
After reviewing the laboratory reports of a patient who was prescribed long-term heparin therapy, the nurse is asked to administer argatroban. Which laboratory result indicates the need for this medication? 1 Prothrombin time: 13 sec 2 Hemoglobin level: 11 g/dL 3 Platelet count: 100,000/mm3 4 Leukocyte count: 3000 cells/mm3
Platelet count: 100,000/mm3
A patient had a total gastrectomy 12 months ago. The nurse learns that the patient has been eating a well-balanced diet rich in vitamin B12, folic acid, iron, and other micronutrients. Despite this, the patient is diagnosed with anemia. What is the most likely cause of anemia in this patient? Fecal occult blood loss Bone Marrow Depression Deficiency of renal erythropoietin Poor absorption of vitamin B12
Poor absorption of vitamin B12
Nursing care for a patient receiving alteplase (Activase) would include which action? (Select all that apply.) Record vital signs and report changes. Observe for signs and symptoms of bleeding. Monitor liver enzymes. Assess for cardiac dysrhythmias.
Record vital signs and report changes. Observe for signs and symptoms of bleeding. Assess for cardiac dysrhythmias.
A patient who has been receiving an infusion of heparin has an activated partial thromboplastin time (aPTT) of 120 seconds. What is the nurse's first action? Assess for bleeding Shut off the heparin drip Keep the patient on bed rest Call the health care provider
Shut off the heparin drip
The nurse assesses the patient's activated partial thromboplastin time (aPTT) to determine the effectiveness of the heparin regimen and notes that it is 35 seconds. How will the nurse interpret this value? The aPTT is inadequate to evaluate treatment. The aPTT is significantly decreased. The aPTT is significantly elevated. The aPTT is within normal limits.
The aPPT is significantly decreased.
The nurse interprets a patient's international normalized ratio (INR) value of 2.5. What is the meaning of this reported value? The patient is not receiving enough warfarin for a therapeutic effect. The patient's warfarin dose is therapeutic. The patient is not receiving enough subcutaneous heparin for a therapeutic effect. The patient is receiving a dangerously high amount of heparin.
The patient's warfarin dose is therapeutic.
The nurse is assessing a patient who has been taking warfarin and vitamin K1 for the past week. The lab reports reveal that the patient has developed venous thromboembolism. What vitamin ingestion may be the reason for this finding? Vitamin A Vitamin D Vitamin E Vitamin K
Vitamin K
Which medication has antiplatelet properties? clopidogrel enoxaparin heparin alteplase
clopidogrel
