Pharm exam 4 pt2

A patient is being treated for benign prostatic hypertrophy (BPH). The nurse evaluates that the patient understands the disease when which statement is made?

These medications are not a cure. Taking an antihistamine might make my problem worse. Avoiding caffeine intake may reduce my symptoms. I should avoid drinking fluids in the late evening.

Estrogens are secreted by the

ovarian follicles

The nurse works in an obesity clinic and is screening patients for use of anorexiant medications. The nurse would evaluate that which patients could potentially be prescribed one of these drugs? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. A patient who has a BMI of 26. 2. A patient who has a BMI of 30. 3. A patient who has a BMI of 28 and has hypertension. 4. A patient who has a BMI of 27 and has osteoarthritis. 5. A patient who has a BMI of 25 and has diabetes.

2,3

The client is a vegetarian. What information would the nurse give the client as it relates to the avoidance of vitamin deficiencies? 1. A vegetarian diet is adequate to meet all of your needs, so there should be no vitamin deficiencies. 2. Look at the types of foods eaten on the vegetarian diet, and evaluate for possible vitamin B12 sources. 3. Increasing fluids and fiber with the vegetarian diet will help prevent vitamin deficiencies. 4. You are at risk for vitamin C deficiencies by following a vegetarian diet.

2. Look at the types of foods eaten on the vegetarian diet, and evaluate for possible vitamin B12 sources.

The nurse is planning care for a client who receives total parenteral nutrition. What will the best plan by the nurse include? 1. Check the feeding tube for residual prior to initiating feedings. 2. Remove the solution from the refrigerator 30 minutes prior to hanging. 3. Withhold oral medications while the total parenteral nutrition (TPN) is hanging. 4. Maintain a dedicated percutaneous endoscopic gastrostomy (PEG) tube for the solution.

2. Remove the solution from the refrigerator 30 minutes prior to hanging.

nurse assesses which client as being at greatest risk for developing vitamin deficiencies? 1. The young male client who takes phenytoin (Dilantin) for new-onset epilepsy 2. The young female client who uses oral contraceptives for birth control 3. The young male client who eats a well-balanced diet and does not take vitamins 4. The young pregnant female client who is taking prenatal vitamins

2. The young female client who uses oral contraceptives for birth control

The nurse teaches new mothers about the reason their infants receive vitamin K. The nurse evaluates instruction as being effective when the mother makes which statement? 1. "Babies do not need an injection of vitamin K unless bleeding is observed." 2. "Babies will be able to get enough vitamin K through breast milk." 3. "Babies do not have enough intestinal bacteria to synthesize vitamin K." 4. "Babies could receive vitamin K through a liquid or an injection."

3

Which vitamin can be toxic if consumed in large amounts? Niacin Vitamin C Vitamin A Folic acid

3

A nurse is teaching a patient about the possible adverse effects of oral contraceptives. The nurse evaluates that the patient understands this teaching if which statement is made?

"I may experience increased acne while on oral contraceptives." "If I experience chest pain, I will call the clinic immediately." "Any blurry vision or loss of vision should be reported immediately." "If I notice swelling in my feet, hands, or face, I will notify the clinic."

The nurse has taught the client with osteoporosis about how to manage the illness. Which statement by the client indicates that additional teaching is necessary?

"I will take my calcium at night

A client has been prescribed NuvaRing. What medication education should the nurse provide to this client?

"Contraceptive protection is provided for 3 weeks." "The ring uses estrogen and progestin to provide contraception."

The client receives estrogen for prostate cancer. He asks the nurse why he is receiving a female hormone. What is the best response by the nurse?

"It suppresses secretion of the androgens that make your cancer grow."

The client receives topical vitamin A for the treatment of psoriasis. Which laboratory test will the nurse review when assessing for an adverse effect?

1. As long as you meet the recommended daily allowance (RDA) requirements, there will be no problem. 2. "The prenatal vitamins supply all the vitamins you need during your pregnancy." 3. "This is dangerous; we need to do an ultrasound of your baby." 4. "Bring in your vitamins on the next visit so we can include them in your chart

An important function of vitamin A is to 1. promote visual pigment of the eye. 2. act as an antioxidant. 3. help with the clotting of blood. 4. help with bile excretion.

1. promote visual pigment of the eye.

The nurse manages care for several clients receiving hormone replacement therapy (HRT). What will the priority assessment by the nurse include as related to side effects?

Pain in the calf

Progestins are secreted by the

corpus luteum

A male client has been prescribed finasteride (Proscar). Which medication education should the nurse provide?

"Pregnant women should not touch this medication

A client has been prescribed testosterone. Which medication education should the nurse provide.

Place the patch on a place that does not have hair. Observe for a rash at the patch site. Keep these patches away from children.

A client has been prescribed an estrogen-progestin combination oral contraceptive. How should the nurse explain the mechanism of action of this pill?

"This pill will prevent you from ovulating." "This pill makes it less likely that an embryo will implant."

The nurse explains to a client who is taking oral contraceptives that these drugs can increase risk for

Thrombophlebitis

The drug that will most likely be used for treatment of erectile dysfunction (ED) is

Viagra sildenafil

A patient has been prescribed Seasonique for contraceptive. The nurse evaluates that the patient understands the use of this medication when which statement is made?

"After I have taken pills for 84 days, I will not take pills for 7 days."

A female client has been unable to conceive a child for 5 years. She asks the nurse about medications to treat her infertility. What is the best response by the nurse?

"Medications will only help if your infertility is related to an endocrine problem."

A client calls the clinic and tells the nurse that she has missed taking several of her contraceptive pills during the current cycle. What is the best instruction for the nurse to give the client?

"You should use an alternative form of birth control for the rest of this cycle."

A patient has been prescribed a bisphosphonate for treatment of osteoporosis. The nurse prioritizes teaching about immediately reporting which finding? 1. New onset thigh pain 2. Nausea 3. Headache 4. Dry, itchy skin

1

A client states, "I stopped taking my medications for osteoporosis. I couldn't see how they were helping me any." How should the nurse respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. "The results from these medications are hard for you to see." 2. "It takes about 6 months to see any results." 3. "When did you stop taking the medications?" 4. "Were there any other reasons that you decided to discontinue the medications?" 5. "You are not helping us help you when you don't follow directions.

134

During a medication history, the client states, "I take the calcium supplement called calcitriol." How should the nurse respond to this statement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. "Calcitriol is a vitamin D supplement." 2. "What other medications do you take?" 3. "You don't understand the medications you are taking." 4. "Do you also take a vitamin D supplement?" 5. "Do you take the prescription strength or over-the-counter?"

1,2

A patient who has been prescribed orlistat (Alli) for control of obesity has ordered dry toast, jelly, and orange juice for breakfast. What adjustment should the nurse make, if any, in the dose of orlistat? 1. Reduce the dose by half 2. Hold the pre-breakfast dose 3. Double the pre-breakfast dose 4. Give the normal dose

2

A patient who is obese says, "I have been taking orlistat (alli) that I buy over-the-counter at my drugstore. The nurse would review the patient's medical record for use of which medication? 1. Aspirin 2. Warfarin (Coumadin) 3. Vitamin C 4. Ibuprofen

2

The client is receiving enteral nutrition. He reads on the bag hanging at his bedside that the liquid is a polymeric formulation. He asks the nurse what this means. What is the best response by the nurse? 1. "It means that your formulation requires little or no digestion." 2. "It means that your formulation is meant for patients who are generally undernourished but whose gastrointestinal tract is still working." 3. "It means that your formulation is lactose free and low fat." 4. "It means that your formulation contains a single nutrient, protein, lipid, or carbohydrate."

2

The client is receiving total parenteral nutrition (TPN). What does the best plan by the nurse include to prevent complications from total parenteral nutrition? 1. Assess the client's potassium levels. 2. Assess the client's blood glucose levels. 3. Assess the client's mental status. 4. Assess the client's blood pressure

2

A nurse is providing administration instruction to the wife of a client going home on intermittent enteral nutrition. Which information should the nurse include? 1. "Clean the equipment between each feeding administration." 2. "Once mixed, enteral feeding should hang no more than 8 hours." 3. "Refrigerate any feeding that is not needed for a feeding." 4. "You may use plain tap water for scheduled tubing flushes." 5. "Keep the area around the insertion site clean

1,3,4,5

The nurse teaches older adults at a community center about the effectiveness of vitamin C in preventing the common cold. The nurse evaluates that learning has occurred when an older adult makes which statement? 1. "Vitamin C, in the form of orange juice, is the most effective aid in preventing the common cold." 2. "There is no proof that vitamin C prevents the common cold." 3. "Vitamin C is only effective in preventing the common cold if 2 grams/day are taken." 4. "Vitamin C must be taken prior to the onset of the cold to be most effective."

2

The physician prescribes multivitamins for the client. The client asks the nurse why she needs vitamins. What will the best teaching plan by the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Small amounts of vitamins are needed for health. 2. Vitamins will heal many illnesses. 3. Vitamins are inorganic compounds that are not stored in the body. 4. Your body cannot synthesize most vitamins. 5. Vitamins are needed for growth and maintenance of normal metabolic processes.

1,4,5

A woman calls the emergency department and says, "My 2-year-old just swallowed about 20 of my magnesium tablets." What direction should the nurse provide? 1. "Call 911 to bring your child to the emergency room immediately." 2. "Watch your child for decreased breathing." 3. "Give your child a glass of milk." 4. "Your child may be sleepy but will not have any permanent damage." 5. "Give your child a laxative tonight and come to the emergency room in the morning."

1-2

A client comes to the womens center and tells the nurse she has had unprotected sex. She asks for emergency contraception. What is the best assessment question for the nurse to ask?

1. "How long ago did you have unprotected sex?"

A patient has been prescribed a bisphosphonate for treatment of osteoporosis. The nurse evaluates that additional teaching is required if the patient makes which statement?

1. "It will take at least 5 years for the maximum effect of this drug to happen." 2. "If I stop taking this drug, all of the bone density improvement will rapidly disappear." 3. "I still need to eat foods high in calcium." 4. "I should spend 15 to 20 minutes in the sun on most days." 5. "The medication I took to correct my vitamin D deficiency was in preparation for this new treatment." 1,2

A client who has osteoporosis says, "I am exercising more. I go to the gym once a week." How should the nurse respond? Select all that apply. 1. "What kind of exercises are you doing?" 2. "You should try to exercise three to five times a week." 3. "That is not enough." 4. "Is there somewhere that you can walk on the days you don't go to the gym?" 5. "Exercise will not improve your osteoporosis

124

An adolescent client will receive Depo-Provera as a method of birth control. She asks the nurse how long the drug will be effective. What is the best response by the nurse?

3 months

A client is prescribed total parenteral nutrition (TPN). Which education should the nurse provide? 1. You will not be able to return home until the TPN is discontinued. 2. Once you go home, you will come in twice a week for TPN." 3. Since this is going to be a long-term treatment, your TPN will be given through a central line." 4. Your TPN will be infused via an infusion pump. "All of your nutrition can be supplied by TPN.

3,4,5

Vitamin C is necessary for the 1. maintenance of vision. 2. regulation of digestion. 3. development of bones and teeth. 4. manufacture of platelets.

3. development of bones and teeth.

An important function of calcium is to 1. regulate acid-base balance. 2. improve glucose absorption. 3. increase energy. 4. regulate nerve transmission.

4

The mechanism of action of selective estrogen receptor modulators (SERMs), such as raloxifene (Evista), is to 1. increase calcium levels in the bone. 2. slow bone resorption. 3. inhibit synthesis of microtubules. 4. increase bone mass and density.

4

The nurse plans medication education for a client who receives a prescription for sildenafil (Viagra). What will the best plan by the nurse include?

Be sure to take only one pill in a 24-hour period

The client has been consuming very high amounts of vitamin A. He asks the nurse why this is a problem since it is just a vitamin. What is the best response by the nurse? 1. "Water-soluble vitamins like vitamin A are readily excreted in your urine." 2. "It really isn't a problem; your body will just get rid of the excess vitamins." 3. "It's okay to take what you want; just cut back if you experience side effects." 4. "Fat-soluble vitamins like vitamin A are stored in your body and too much can be toxic.

4. "Fat-soluble vitamins like vitamin A are stored in your body, and too much can be toxic."

The nurse teaches young females in college about the importance of vitamins for anyone planning on becoming pregnant. Which vitamin does the nurse include as being most essential in the prevention of neural tube defects in a fetus? 1. Thiamine 2. Niacin 3. Riboflavin 4. Folic acid

4. Folic acid

The client receives alendronate (Fosamax) as treatment for osteoporosis. Which symptoms, caused by an adverse effect of the medication, does the nurse teach should be reported to the physician? 1. Ringing of the ears 2. Hot and dry skin 3. Vision changes and photophobia 4. Muscle spasms and facial twitching

4. Muscle spasms and facial twitching

The nurse is assessing a client and notes that he is receiving finasteride (Proscar). The client denies having any history of a significant prostate disorder. What is the best assessment question for the nurse to ask at this time

A. "Do you have male pattern baldness?"

The nurse teaches the postpartum client about oxytocin (Pitocin). The nurse evaluates that learning has occurred when the client makes which statement?

A. "It will increase my uterine contractions"

The client takes Ortho-Novum for 3 months and calls the clinic to report she is having vaginal bleeding. What is the best plan by the nurse at this time?

Ask the client if she is bleeding between cycles or if this is her regular period.

The client is premenopausal and asks the nurse if she should be taking hormone replacement therapy (HRT). What will the best plan by the nurse include?

Discuss alternative methods of dealing with premenopausal symptoms.

Which comments would the nurse interpret as indicating that a high school athlete understands the risks of using anabolic steroids?

I might become mentally dependent on these drugs. I should not take ibuprofen while taking these other drugs.

The nurse advised the wife of a man who is receiving treatment with a testosterone cream to report any assessment findings of virilization. The patient would report which findings?

Increased oiliness of the skin Increased hair growth on the upper lip Deepening of the voice Reduced menstrual flow

A client is receiving therapy for gout. Which information should the nurse provide?

Limiting or eliminating alcohol consumption is standard treatment for gout."Increase your fluid intake to 2 to 4 liters each day.""If your joint pain does not improve, let us know.

A 75-year-old woman is taking medroxyprogesterone (Provera) for treatment of inoperable metastatic uterine carcinoma. The nurse would immediately collaborate with the prescriber if the patient's family made which statement?

Mom seems much more depressed today. "Mom is more confused today."

The client's calcium level is low. What will be the nurse's primary concern? 1. Seizures 2. Bone fractures 3. Hypoglycemia 4. Depression

Seizure

The client receives topical vitamin A for the treatment of psoriasis. Which laboratory test will the nurse review when assessing for an adverse effect?

Serum calcium level Hemoglobin level Thyroid profile Serum potassium level

A client calls the clinic and tells the nurse she has nausea and breast tenderness and is afraid she might be pregnant. She is taking oral contraceptives and has taken them exactly as prescribed. What is the best response by the nurse?

Tell the client that these symptoms can be side effects of oral contraceptives.

A client has benign prostatic hyperplasia (BPH) and hypertension. Which medication could the client safely receive for hypertension?

Terazosin (Hytrin)

The client plans to use an estrogen/progestin oral contraceptive for birth control. Which client behavior would the nurse be most concerned about?

The client smokes one-half pack of cigarettes per day.

A male patient has been started on a 5-alpha reductase inhibitor for the treatment of benign prostatic hyperplasia (BPH). Which information should the nurse provide?

Use a condom during intercourse. Keep this medication in a secure place away from children. Do not give blood while you are taking this medication."

The client is receiving oxytocin (Pitocin) for induction of labor. Which assessment finding will most likely result in the nurse stopping the infusion?

Uterine contractions are continuous and sustained.

A college student calls the family planning clinic and states, "I had unprotected sex, and now I am afraid I will get pregnant." The nurse would provide which information about Plan B?

You can purchase Plan B without a prescription. "You may take two separate doses of Plan B. Plan B will prevent ovulation and implantation."

A client with benign prostatic hyperplasia is to receive finasteride (Proscar). The nurse understands that this drug works by

a. promoting shrinkage of an enlarged prostate gland

Which finding is an adverse effect of 5-alpha reductase inhibitors?

sexual dysfunction

Oxytocics are different from tocolytics in that oxytocics

stimulate uterine contractions