Pharm Hema/Resp Quiz

6. A client with a chronic obstructive pulmonary disease is prescribed with Ipratropium (Combivent). Upon reviewing the medical history of the patient, the nurse questions the prescription if which of the following is noted? A. History of smoking. B. History of allergy to egg. C. History of allergy to peanut. D. History of a previous infection.

C. History of allergy to peanut.

7. Montelukast (Singulair) is prescribed to a client with asthma. During the medication therapy, which of the following laboratories should be monitored? A. Complete blood count (CBC). B. Sodium and Potassium. C. Calcium and Platelet count. D. ALT and AST.

D. ALT and AST.

18. A patient is receiving a continuous heparin infusion for venous thromboembolism treatment. Which laboratory results should the nurse monitor

(Select all that apply.) *A. Platelets * B. Vitamin K C. Prothrombin time (PT) D. International normalized ratio (INR) *E. Activated partial thromboplastin time (aPTT)*

15. A nurse should teach a patient receiving oral pseudoephedrine [Sudafed] to observe for which adverse effects

(Select all that apply.) A. Sedation *B. Irritability * C. Paranoia *D. Anxiety * E. Weight loss

11. Which instruction should the nurse include in the teaching for a patient prescribed cetirizine [Zyrtec] for seasonal allergic rhinitis

A. "Clean the nasal applicator after use to prevent contamination." *B. "Take the medication daily throughout the allergy season." * C. "Expect a decrease in your nasal congestion in a day or two." D. "Take a stool softener daily to avoid the side effect of constipation."

1. A patient with a deep vein thrombosis receiving an intravenous (IV) heparin infusion asks the nurse how this medication works. What is the nurse's best response?

A. Heparin prevents the activation of vitamin K and thus blocks synthesis of some clotting factors. *B. Heparin suppresses coagulation by helping antithrombin perform its natural functions.* C. Heparin works by converting plasminogen to plasmin, which in turn dissolves the clot matrix. D. Heparin inhibits the enzyme responsible for platelet activation and aggregation within vessels.

10. A patient is receiving cyanocobalamin for the treatment of pernicious anemia. Which electrolyte should the nurse monitor as a result of this treatment

A. Sodium B. Calcium C. Chloride *D. Potassium*

6. Caution should be taken when using o A. Antihistamine eye drops o B. Corticosteroid eye drops o C. Antihistamine nasal sprays o D. Corticosteroid nasal sprays

o B. Corticosteroid eye drops

15. The nurse is caring for a group of patients taking warfarin [Coumadin]. Which patients are at moderate to high risk for harm as a result of warfarin therapy

(Select all that apply.) *A. A patient with variant genes that code for VKORC1 and CYP2CP * B. A patient with a current INR of 2.2 treated for deep vein thrombosis *C. A woman with a new onset of symptoms of a pulmonary embolus * D. A patient on day 4 after hip replacement with a new order for warfarin *E. A patient with a prosthetic heart valve, for whom an interacting drug is being deleted from the regimen*

10. The nurse should review which baseline data before starting epoetin alfa [Epogen] therapy in a patient with chronic renal failure (CRF)

(Select all that apply.) *A. Ferritin level* B. Temperature trends C. Blood glucose level *D. Blood pressure trends * *E. Hemoglobin and hematocrit*

10. The nurse is assessing a patient with hemophilia for complications of clotting factor administration. Which assessment findings would indicate an adverse effect of this treatment

(Select all that apply.) *A. Hives and urticaria * B. Potassium level of 3.2 mEq/L C. Creatinine level of 2.5 mg/dL *D. Bethesda titer of 40 units * E. Alkaline phosphatase of 303 units/L

14. Which are advantages of a dry-powder inhaler (DPI) over a metered-dose inhaler (MDI)

(Select all that apply.) *A. More of the drug is delivered to the lungs and less to the oropharynx. * *B. Use of a spacer is not necessary. * C. Less propellant is needed to deliver the medication. *D. Less hand-lung coordination is required. * *E. DPIs pose no environmental risk.*

13. The nurse is caring for a patient receiving vitamin B12 because of a deficiency. What are common causes of this deficiency

(Select all that apply.) *A. Regional enteritis and malabsorption * *B. Celiac disease * C. Decreased intake of foods with vitamin B12 *D. Advancing age * *E. Use of drugs that lower stomach acid*

9. A patient with nonmyeloid cancer is receiving oprelvekin [Neumega]. Which adverse effects are most likely associated with this drug

(Select all that apply.) A. Hypertension B. Accelerated tumor progression *C. Fluid retention * *D. Atrial fibrillation * *E. Anaphylactic reactions*

11. Which instruction should be included in the teaching for a patient for whom fluticasone propionate [Flovent] MDI has been ordered

*A. "Gargle after using your inhaler." * B. "Take the medication immediately at the onset of an attack." C. "Take your albuterol first, followed by the Flovent 5 minutes later." D. "Make sure you monitor your fingerstick blood glucose level each morning."

10. A patient with nonvalvular atrial fibrillation is to be discharged on dabigatran etexilate [Pradaxa]. Which statement should the nurse include in the discharge teaching

*A. "The medication must be stored in the manufacturer-supplied bottle." * B. "Once a new bottle is opened, the capsules maintain efficacy for 90 days." C. "If you have difficulty swallowing the capsule, you can open it and mix it with food." D. "You will need to learn how to give yourself a subcutaneous injection in your abdomen."

2. The nurse is administering epoetin alfa [Procrit] to a patient receiving chemotherapy. Which adverse effect is a potential risk with this drug

*A. Accelerated tumor progression * B. Hypotension C. Easy bruising D. Bone pain

7. The nurse is teaching a patient with vitamin B12 deficiency caused by a previous gastrectomy and lack of intrinsic factor. Which statement by the nurse is the most appropriate to include in the teaching plan

A. "Because your body does not have intrinsic factor, vitamin B12 injections will be required." B. "If you increase your intake of animal protein foods, you may be able to avoid injections." *C. "You may be prescribed a high dose of oral vitamin B12." * D. "You will need to return to the clinic each month for your vitamin B12 injections."

12. Which instruction about clopidogrel [Plavix] should the nurse include in the discharge teaching for a patient who has received a drug-eluting coronary stent

A. "Constipation is a common side effect of clopidogrel, so take a stool softener daily." B. "If you see blood in your urine or black stools, stop the clopidogrel immediately." *C. "Check with your healthcare provider before taking any over-the-counter medications for gastric acidity." * D. "Keep the amounts of foods containing vitamin K, such as mayonnaise, canola and soybean oil, and green, leafy vegetables, consistent in your diet."

3. The nurse is teaching the parent of a young child about administering ferrous sulfate to the child at home. Which teaching point should receive the highest priority

A. "Give the liquid iron with a straw to reduce tooth staining." *B. "Store the ferrous sulfate in a childproof container and keep it out of the child's reach." * C. "This medicine may cause the child's stool to look dark green or black." D. "Do not give iron with any other medications or vitamins."

6. The nurse is explaining the use of romiplostim [Nplate] to treat idiopathic thrombocytopenic purpura (ITP).Which patient statement indicates understanding of the nurse's explanation

A. "I'll call my healthcare provider if I notice any swelling in my legs." *B. "I'll let my healthcare provider know if I have any pain in my joints." * C. "I will have my white blood cell count evaluated in 1 month." D. "I shouldn't take this medication with food, because that prevents absorption of the drug."

4. Which statement by a patient indicates understanding of a nurse's teaching about fluticasone nasal spray [Flonase]

A. "I'll gradually stop taking this so I don't have any problems with withdrawal." *B. "This drug will help prevent the inflammation and irritation from my allergies." * C. "I'll have to be more careful about not falling, because my bones may break more easily." D. "I realize that I only need to take this when my symptoms are really bad."

4. A nurse is teaching a patient about montelukast [Singulair]. Which statement by the patient would indicate that the nurse's teaching was effective

A. "I'll take a dose as soon as I feel short of breath and start to cough." *B. "While taking this medicine, I may be able to reduce my steroid medication." * C. "This is the priority medication for preventing exercise-induced asthma symptoms." D. "If I have nosebleeds or excessive bruising, I'll stop the medication immediately."

5. Which instruction by the nurse should be the priority for a patient scheduled to start intranasal cromolyn [NasalCrom]

A. "It is only moderately effective." B. "There are few adverse reactions." *C. "Relief may take a week or two." * D. "It suppresses histamine release."

2. A nurse is teaching a patient who is to start taking an expectorant. The nurse provides the patient with which of these instructions

A. "Restrict cold fluids to promote reduced mucus production." B. "Take the medication once a day only, usually at bedtime." *C. "Increase your fluid intake to reduce the viscosity of secretions." * D. "Increase your fiber and fluid intake to prevent constipation."

13. Which instruction should be included in the teaching for a patient being started on the antihistamine azelastine [Astelin]

A. "Take the pill in the morning before breakfast." B. "Headache may be a side effect of the medication." *C. "You may experience an unpleasant taste in your mouth when using azelastine." * D. "You will experience a decrease in nasal congestion if the medication is working."

9. Which statement should the nurse include in the teaching for a patient who is to be started on zileuton [Zyflo]

A. "Use your zileuton [Zyflo] inhaler every 12 hours." *B. "Have your blood drawn once a month for the next 3 months so that your liver function can be checked." * C. "Take the zileuton [Zyflo] 2 hours before eating breakfast each day." D. "Take an extra dose of zileuton [Zyflo] if you have an asthmatic attack."

6. The nurse is caring for a patient receiving clopidogrel [Plavix] to prevent blockage of coronary artery stents. Which other drug on the patient's medication administration record may reduce the antiplatelet effects of clopidogrel

A. Aspirin [Bayer] *B. Omeprazole [Prilosec]* C. Acetaminophen [Tylenol] D. Warfarin [Coumadin]

7. A nurse teaches a patient with chronic obstructive pulmonary disease (COPD) about the adverse effects of tiotropium [Spiriva]. Which behavior by the patient would indicate that the teaching has been effective

A. Combines tiotropium with an antacid *B. Sucks on hard candy as needed * C. Prevents constipation with a stool softener D. Wears long sleeves and a wide-brim hat

2. The nurse is caring for a patient with anemia. What is a common cause of iron deficiency in the United States

A. Decreased intestinal uptake of iron *B. Chronic blood loss through the GI tract * C. Vegetarian eating patterns D. Rapid growth during adolescence

8. Which medication promotes hemostasis in hemophilia A and B by inhibition of fibrinolysis

A. Desmopressin [DDAVP] *B. Aminocaproic acid [Amicar] * C. Celecoxib [Celebrex] D. Diphenhydramine [Benadryl]

7. What condition increases the patient's risk for the development of myocardial infarction (MI) and disseminated intravascular coagulation (DIC) when receiving anti-inhibitor coagulant complex (AICC)

A. Diabetes B. Chronic renal disease *C. Liver disease * D. Hypothyroidism

3. Which finding in a patient taking oxymetazoline [Afrin] nasal spray every 2 hours would indicate that the patient has developed an adverse effect

A. Dry mouth and constipation B. Drowsiness and sedation *C. Congestion and stuffiness * D. Itching and skin rash

3. A patient is taking oral theophylline for maintenance therapy of stable asthma. A nurse instructs the patient to avoid using which substance to prevent a complication

A. Echinacea B. Cimetidine [Tagamet] C. Sunscreen products *D. Caffeine*

6. Which outcome should a nurse establish as a priority for a patient taking an oral glucocorticoid for long-term treatment of asthma

A. Increases the daily intake of vitamin D and calcium B. Records daily peak expiratory flow rates *C. Supplements additional doses at times of stress * D. Uses alternate-day therapy to reduce adverse effects

6. The nurse knows that which statement is most accurate

A. Individuals with severe hemophilia A have less of a risk of developing inhibitors than those with the mild form. B. The risk of inhibitor development is higher in Caucasians than in Hispanics. C. Antibodies to factor VIII develop after 20 to 30 treatments. *D. Immune tolerance therapy is more successful in eliminating inhibitor production in hemophilia A than in hemophilia B.*

8. The nurse knows that which statement is accurate for enoxaparin [Lovenox]

A. It equally reduces the activity of thrombin and factor Xa. B. It has selective inhibition of factor Xa and no effect on thrombin. *C. It reduces the activity of factor Xa more than the activity of thrombin. * D. It has a lower bioavailability and shorter half-life than unfractionated heparin.

5. A patient who takes cromolyn for exercise-induced bronchospasm should follow which approach for maximum therapeutic effectiveness

A. It should be used infrequently because of systemic adverse effects. B. One 10-mg tablet should be taken at least 2 hours before exercising. *C. It should be administered by inhalation 15 minutes before anticipated exertion. * D. It should be used as a quick-relief agent if exercise triggers asthma symptoms.

3. The nurse is caring for a patient undergoing cancer chemotherapy who presents with rash, bone pain, hypertension, and pedal edema. Which symptom is most likely an adverse reaction to the filgrastim [Neupogen] the patient is receiving

A. Rash *B. Bone pain * C. Headache D. Swelling in feet

12. A patient being treated for pernicious anemia with cyanocobalamin reports new onset of muscle weakness and states, "My heart is skipping beats." Which laboratory value most likely is contributing to these new symptoms

A. Serum chloride level of 98 mEq/L B. Serum sodium level of 133 mEq/L C. Serum glucose level of 185 mg/dl *D. Serum potassium level of 2.3 mEq/L*

5. A patient received desmopressin preoperatively to maintain hemostasis during a surgical procedure. Which postoperative assessment finding indicates the patient has experienced an adverse effect of the drug

A. Serum sodium level of 150 mEq/L B. Blood glucose level of 220 mg/dL C. Serum potassium level of 5.5 mEq/L *D. +2 edema of the extremities*

9. Which is the priority nursing intervention for a patient receiving parenteral iron dextran (INFeD) infusion

A. The medication must be administered by deep subcutaneous injection. *B. An intravenous test dose of 25 mg over 5 minutes must be administered. * C. Erythropoietin must also be given when a patient is receiving parenteral iron dextran. D. After administration of a test dose of intramuscular (IM) iron dextran, the patient must be observed for 15 minutes before the full therapeutic dose is given.

1. Hemophilia is a genetically based bleeding disorder seen almost exclusively in which patients

A. Caucasian B. Hispanic *C. Male * D. Female

4. The nurse is ready to begin a heparin infusion for a patient with evolving stroke. The baseline activated partial thromboplastin time (aPTT) is 40 seconds. Which aPTT value indicates that a therapeutic dose has been achieved

A. 50 *B. 70* C. 90 D. 110

8. The healthcare provider prescribes hematopoietic growth factor for a patient. The nurse should notify the healthcare provider to question the prescription for which patient condition

A. A patient with chronic renal failure (CRF) *B. A patient with uncontrolled hypertension * C. A patient taking zidovudine for human immunodeficiency virus (HIV) D. A patient with nonmyeloid malignancy chemotherapy-induced anemia

7. A nurse instructs a patient that which nonprescription medication requires patient identification and a signature for purchase

A. Chlorpheniramine [Chlor-Trimeton] B. Cetirizine [Zyrtec] *C. Ephedrine * D. Ipratropium bromide [Atrovent]

3. The nurse is monitoring therapy for a patient with hemophilia B. Which evaluation criterion is most important to determine whether the medication dosage is effective

A. Clotting factor VIII levels *B. Clinical response * C. Clotting factor IX levels D. PT and INR

1. A nurse is planning care for a patient who takes fexofenadine [Allegra] for allergic rhinitis. Which outcome should the nurse anticipate

A. No complaints of dry mouth *B. Relief of sneezing and itching * C. Use limited to allergy season D. Absence of rebound congestion

2. To achieve therapeutic effectiveness, a nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule

A. Only in an emergency *B. On a continuing, daily basis * C. To abort an asthma attack D. 2 weeks on, 2 weeks off

10. A patient is admitted to the emergency department with acute severe exacerbation of asthma. Which drug should the nurse anticipate will be included in the treatment plan

A. Oral theophylline [Elixophyllin] B. Subcutaneous omalizumab [Xolair] C. Inhaled mometasone furoate [Asmanex] *D. High-dose albuterol [Proventil] via nebulizer treatment*

2. On-demand therapy is indicated for which type of patient

A. Patient with mild hemophilia B. Patient with severe hemophilia C. Patient who is allergic to factor VIII (Bioclate) *D. Patient who is bleeding or about to undergo surgery*

1. A Cromolyn sodium (Intal) inhaler is prescribed to a client with asthma. A nurse provides instructions regarding the side effects of this medication. The nurse tells the client that which undesirable effect is associated with this medication? A. Wheezing. B. Insomnia. C. Hypotension. D. Constipation.

A. Wheezing.

13. A nurse is caring for a client who is starting a long-term therapy of isoniazid (INH). The nurse plans to instruct the client to which of the following? A. To discontinue vitamin supplements such as Vit B6. B. To report an incidence of yellowish skin. C. To increase intake of tuna for additional nutrition. D. To drink alcohol in moderation.

B. To report an incidence of yellowish skin.

15. A nurse is monitoring a client receiving an Ethambutol (Myambutol) for adverse effects. The nurse determines that the client is experiencing a side effect of the medication, in which of the following? A. Red-orange colored bodily secretions. B. Damaged hearing. C. Loss of balance. D. Difficulty distinguishing the color red from green.

D. Difficulty distinguishing the color red from green.

12. A client is to begin taking Rifampin (Rifadin). The nurse correctly teaches the client this medication: A. Is to be discontinued after three months. B. Is to be taken with food and antacids. C. Take an additional dose once with skip dose. D. Will cause orange discoloration of sweat, urine, and feces.

D. Will cause orange discoloration of sweat, urine, and feces.

11. The first line of therapy asthma is o A. Pulmonary function tests o B. Daily inhaled steroids o C. Xanthines o D. Short acting beta-2 agonists

o B. Daily inhaled steroids

2. Which of the following is an Anticholinergic side effect o A. Antiemetic o B. Diuretic o C. Bradycardia o D. None of the above

o A. Antiemetic

36. Which of the following stabilizes the cell membranes of inflammatory cells o A. Cromolyn (Intal) o B. Trimacinolone o C. Fexofenadine ( Allegra) o D. All of the above o E. None of the above

o A. Cromolyn (Intal)

21. Side effects of this drug includes Acne exacerbation labile emotions and weight gain o A. Medrol Dose Pack o B. Xileuton (Zyflo) o C. Zarfiruklast (Accolate) o D. Theophylline (Theo-dur) o E. None of the above

o A. Medrol Dose Pack

33. Anticholinergic inhalers such as Ipatropium (Atrovent) o A. Prevent bronchoconstriction o B. Include Levalbuterol (xopenex) o C. Have beta 2 selectivity o D. All of the above

o A. Prevent bronchoconstriction

31. A long acting inhaled beta 2 agonist would be o A. Fluticasone . salmeterol (Advair) o B. Budesonide / formoterol (symbicort) o C. All of the above o D. None of the above

o C. All of the above

3.The immunoglobulin IgE o A. Binds to basophils and mast cells o B. Releases hjstamine and heparin o C. Binds to antigens o D. None of the above

o C. Binds to antigens

43. Rhinitis medicimentosa is o A. Rebound congestion from inhaled beta 2 agonist o B. Viral infection o C. Rebound congestion from nasal spray o D. None of the above

o C. Rebound congestion from nasal spray

30. Albuterol (Proventil) is o A. Sub Q dosage o B. Metabolised in kidneys o C. Short acting beta 2 agonist o D. Increases specific beta 2 selectivity with frequent use o E. None of the above

o C. Short acting beta 2 agonist

11. A client with influenza is prescribed with an antiviral drug. The nurse determines that the client indicates an understanding of the treatment if he or she state the following? A. "I will take the medication exactly as prescribed". B. "I will not be able to infect others while I am on this treatment". C. "I will stop the medication once I feel okay". D. "I will resume my usual activities because these medications have minimal undesirable effects".

A. "I will take the medication exactly as prescribed".

2. A client is prescribed with Guaifenesin (Mucinex). The nurse determines that the client understands the proper administration of this medication if the client states that he or she will: A. Drink extra fluids while taking this medication. B. Take the medication with meals only. C. Take an additional dose once fever and cough persist. D. Limit oral fluid intake.

A. Drink extra fluids while taking this medication.

19. All of which are examples of antiviral influenza medications except? A. Ethionamide (Trecator). B. Amantadine (Symmetrel). C. Oseltamivir (Tamiflu). D. Zanamivir (Relenza).

A. Ethionamide (Trecator).

20. Rifabutin (Mycobutin) is prescribed to a client with active Mycobacterium avium complex disease and tuberculosis. The nurse determines that the client is experiencing side effects in which of the following, except? A. Tingling and numbness of the fingers. B. Blurred vision. C. Arthralgia. D. Flu-like symptoms.

A. Tingling and numbness of the fingers.

9. A nurse is giving teachings to a client receiving Desloratadine (Clarinex). Which of the following statements made by the client will need further instructions? A. "I can eat gum after I drink the medicine". B. "I can take the medicine on an empty stomach". C. "I should avoid using alcohol". D. "I will avoid driving while using this medication".

B. "I can take the medicine on an empty stomach".

42. Alpha adrenergic decongestants are o A. Oral o B. Sub q o C. Topical o D. A & C o E. All of the above

o D. A & C

18. A client is taking streptomycin. The nurse explains the nervous system side effects of this medication. The nurse correctly states that this medication causes damage in which cranial nerve? A. Cranial nerve VII. B. Cranial nerve VIII. C. Cranial nerve IX. D. Cranial nerve X.

B. Cranial nerve VIII.

4. A nurse is about to administer Naloxone hydrochloride (Narcan) to a client with known opioid overdose. Which of the following equipment should be readily available at the bedside? A. Suction machine. B. Resuscitative equipment. C. Nasogastric tube. D. Dressing tray.

B. Resuscitative equipment.

17. A nurse is giving instructions to a client receiving Pyrazinamide. Which of the following is not true regarding this medication? A. Take the medication with food. B. Photosensitivity is one of the side effects. C. It enhances the effect of allopurinol. D. Use with caution in patients with diabetes mellitus.

C. It enhances the effect of allopurinol.

14. A client has been taking isoniazid (INH). The client went to the health care facility with complaints of numbness and tingling sensation in the extremities. The nurse determines that the client is most likely suffering from? A. Impaired peripheral circulation. B. Hypercalcemia. C. Peripheral neuritis. D. Guillan Barre syndrome.

C. Peripheral neuritis.

10. A pediatric client with asthma has just received Omalizumab (Xolair). The nurse determines that the client might be suffering a life-threatening effect in which of the following? A. Headache and dizziness. B. Nausea and vomiting. C. Swelling of the tongue. D. Joint pain.

C. Swelling of the tongue.

16. A client with tuberculosis is receiving Ethambutol (Myambutol). All of which are laboratories to be examined, except? A. Complete blood count. B. Liver function test. C. Triglyceride level. D. Uric acid level.

C. Triglyceride level.

3. A nurse is about to administer Albuterol (Ventolin HFA) 2 puff and Budesonide (Pulmicort Turbohaler) 2 puff by metered dose inhaler. The nurse plans to administer by? A. Alternating with a single puff each, starting with albuterol. B. Alternating with a single puff each, starting with budesonide. C. Budesonide inhaler first then the albuterol. D. Albuterol inhaler first then the budesonide.

D. Albuterol inhaler first then the budesonide.

8. The nurse is giving medication teachings to a client receiving theophylline. The nurse instruct the client to limit the intake of which of the following? A. Apple and banana. B. Yogurt and cheese. C. Tuna and oysters. D. Cola and chocolate.

D. Cola and chocolate.

5. A client is receiving theophylline intravenously. After several dosages, the client started to become restless and complains of palpitations. The nurse determines that the client is experiencing theophylline toxicity in which of the following? A. Theophylline level of 10mcg/ml B. Theophylline level of 15mcg/ml C. Theophylline level of 20mcg/ml D. Theophylline level of 25mcg/ml

D. Theophylline level of 25mcg/ml

26. Which of the following is derived from plant alkaloids o A. Xanthines o B. Theophylline (Theo-dur) o C. All of the above o D. None of the above

o C. All of the above

34. Tiotropium (spiriva) and Ipatropium ( Artovent) are not indicated for acute asthma attacks o A. True o B. False

o A. True

44. Oral decongestants are less potent than topicals o A. True o B. False

o A. True

48. Expectorants have direct and reflex stimulation o A. True o B. False

o A. True

39. Which of the following is a nasal spray antihistamine o A. Certirizine (Zyrtec) o B. Azelastine (Astelin) o C. Desloratadine (Clarinex) o D. Fexofenadine (allegra)

o B. Azelastine (Astelin)

25. Aminophylline (Truphylline) is best described as o A. Beta-2 Agonist o B. Bronchodilator o C. All of the above o D. None of the above

o B. Bronchodilator

27. Which of the following is not related to Xanthines o A. Derived from plant alkaloids o B. Decreased CNS stimulation o C. Increased CV stimulation o D. Treating refractory asthma o E. None of the above

o B. Decreased CNS stimulation

52. Which of the following is not a drug action of Epinephrine o A. Bronchodilation o B. Decreased respiratory rate o C. Stimulate alpha and beta receptors o D. Vasoconstriction o E. None of the above

o B. Decreased respiratory rate

49. Which of the following is a mucolytic o A. Terpin hydrate o B. Dornase alfa (Pulmozyme) o C. Iodinated glycerol o D. Guaifenesin

o B. Dornase alfa (Pulmozyme)

40. Antihistamines should be given o A. Post-treatment o B. Early in treatment o C. Late in treatment o D. Any time

o B. Early in treatment

37. Omalizumab (Xolair) Sub q works by o A. Burst and taper o B. Inhibits IgE binding to mast cells/ basophils o C. Compete with histamine for specific receptor sites o D. All of the above

o B. Inhibits IgE binding to mast cells/ basophils

23. The currently available Antileukotrienes are o A. IV o B. PO o C. Topical o D. All of the above

o B. PO

35. Mast cells stabilizers are used for o A. Acute asthma attack o B. Prophylaxis of brochospasm o C. To prevent bronchodilation o D. All of the above

o B. Prophylaxis of brochospasm

32. The usual dosage for this drug is 1 puff BID o A. Prednisone o B. Salmeterol (Serevent) o C. Tiotropium (Spiriva) o D. Emedastine (Emadine) o E. None od the above

o B. Salmeterol (Serevent)

24. Bronchodilators can be used for o A. Facilitating respiration by dilating the airways o B. Relief of acute bronchospasm o C. Prevention of bronchial asthma o D. All of the above o E. None of the above

o D. All of the above

45. Systemic effects of oral decongestion have systemic effects due to adrenergic stimulation of o A. Heart o B. Blood vessels o C. CNS o D. All of the above o E. None of the above

o D. All of the above

4. Mr. T presents with the following Sx and lab tests showing increased Histamine and Heparin circulation. What is the most likely Dx? o A. Asthma o B. Pneumoconiosis o C. Urticaria o D. Allergic Rhinitis

o D. Allergic Rhinitis

51. Which place would be a site of epinephrine administration o A. Finger o B. Toes o C. Nose o D. Chest o E. All of the above

o D. Chest

54. A side/adverse effect of this drug is tremor o A. Dexamethasone o B. Tiotropium (Spiriva) o C. Acetylcysteine (Mucomyst) o D. Epinephrine

o D. Epinephrine

28. Which is not true about Beta-2 agonists o A. Long acting formula help with prevention of asthma exacerbation o B. Used for acute phase of asthmatic attacks o C. Rapidly reduce airway constriction and restore normal airflow o D. None of the above

o D. None of the above

50. Which of the following is not route of administration of epinephrine o A. Sub Q o B. IM o C. ETT o D. None of the above

o D. None of the above

47. Which drug is most likely to cause constipation especially in the elderly and should be prescribed with a stool softener o A. Robitussin-DM o B. Montelukast (singulair) o C. Xileuton (Zyflo) o D. Robitussin AC o E. None of the above

o D. Robitussin AC

29. Which of the following is not a type of Beta Agonist o A. Non-selective Adrenergic agonists o B. Non selective beta agonists o C. Selective beta2 agonists o D. Selective adrenergic agonists

o D. Selective adrenergic agonists

46. Which of the following is an antitussive o A. Benzonatate ( tessalon Perles) o B. Codeine ( robitussin A-c) o C. Chlorpheniramine/ hydrocodone (Tussionex) o D. B & C o E. All of the above

o E. All of the above

16. Acute exacerbations of asthma are treated with o A. First line of therapy o B. Rescue medications o C. All of the above o D. None of the above

o B. Rescue medications

16. A patient diagnosed with a pulmonary embolism is receiving a continuous heparin infusion at 1000 units/hr. Of which findings should the nurse immediately notify the healthcare provider

(Select all that apply.) A. aPTT of 65 seconds *B. aPTT of 40 seconds * *C. Nosebleeds * *D. aPTT of 100 seconds * E. Platelet count of 300,000/mcL

13. Which of the following is an expected result of inhaled corticosteroids o A. Reduced bronchial reactivity o B. Decreased airway caliber o C. Direct relaxation of bronchial smooth muscle o D. All of the above

o A. Reduced bronchial reactivity

18. Steroid inhaler should be used before beta agonist inhaler o A. True o B. False

o A. True

5. The nurse is administering iron dextran (INFeD) by intravenous (IV) infusion to a patient with iron deficiency. Which is the priority nursing action during the administration of this drug

*A. Ensure that epinephrine is available as needed. * B. Assess the lung sounds and respiratory rate. C. Monitor the blood urea nitrogen and creatinine levels. D. Use Y-connector tubing to connect to the primary line.

1. Which organ regulates the body's iron stores

*A. Intestines * B. Kidneys C. Liver D. Bloodstream

3. The laboratory calls to report a drop in the platelet count to 90,000/mm3 for a patient receiving heparin for the treatment of postoperative deep vein thrombosis. Which action by the nurse is the most appropriate

*A. Notify the healthcare provider to discuss the reduction or withdrawal of heparin. * B. Call the healthcare provider to discuss increasing the heparin dose to achieve a therapeutic level. C. Obtain vitamin K and prepare to administer it by intramuscular (IM) injection. D. Observe the patient and monitor the activated partial thromboplastin time (aPTT) as indicated.

4. The nurse is evaluating the effectiveness of the drug oprelvekin [Neumega] in a patient undergoing cancer chemotherapy. Which finding is most indicative that this drug is having its intended effect

*A. Platelet count of 150 × 103/mm3 * B. Hemoglobin level of 13.2 g/dL C. White blood cell count of 5500/mm3 D. Total lymphocyte count of 1000/mm3

6. A nurse should monitor more frequently the blood pressure of a patient with a history of hypertension who takes which medication for allergic rhinitis

*A. Pseudoephedrine [Sudafed] * B. Montelukast [Singulair] C. Mometasone [Nasonex spray] D. Oxymetazoline [Afrin spray]

6. A patient has vitamin B12 deficiency following a subtotal gastrectomy. The nurse understands the patient has which type of anemia

A. Microcytic B. Iron deficiency C. Hemolytic *D. Megaloblastic*

1. A patient with asthma is scheduled to start taking a glucocorticoid medication with a metered-dose inhaler (MDI). The nurse should give the patient which instruction about correct use of the inhaler

A. "After you inhale the medication once, repeat until you obtain symptomatic relief." B. "Wait no longer than 30 seconds after the first puff before taking the second one." *C. "Use a spacer with the inhaler and rinse your mouth after each dose administration." * D. "Breathe in through the nose and hold for 2 seconds just before activating the inhaler."

9. Fondaparinux [Arixtra] is not approved for use in which circumstance

A. Prevention of deep vein thrombosis (DVT) after knee replacement B. Treatment of acute pulmonary embolism (PE) (in conjunction with warfarin) C. Prevention of deep vein thrombosis (DVT) after abdominal surgery *D. Prevention of ischemic complications in patients with unstable angina*

10. Which complaint indicates that a patient is experiencing an adverse effect of beclomethasone [Beconase AQ] nasal spray

A. Sneezing *B. Sore throat * C. Runny nose D. Rebound congestion

8. Bronchiectasis is reversible o A. True o B. False

o B. False

38. Benadryl is o A. Non-sedating o B. Peripherally acting o C. Nonselective central H1 receptor blocker o D. 2nd generation

o C. Nonselective central H1 receptor blocker

53. Epinephrine should be used with precaution when experiencing o A. Heart disease o B. Angle closure glaucoma o C. Diabetes o D. Hypertension o E. All of the above

o E. All of the above

17. Multiple inflammatory indications exist for o A. Bronchodilators o B. Anticholinergic inhalers o C. Corticosteroids o D. None of the above

o C. Corticosteroids

9. Which of the following is associated with Emphysema o A. Blue Bloaters o B. Early hypoxia and cyanosis o C. Pink puffers o D. All of the above

o C. Pink puffers

15. Medrol Dose pack is an example of a o A. Antileukotrienes o B. Bronchodilators o C. Systemic Corticosteroid o D. None of the above

o C. Systemic Corticosteroid

17. A patient is being discharged from the hospital on warfarin [Coumadin] for deep vein thrombosis prevention. Which instructions should the nurse include in the patient's discharge teaching plan

(Select all that apply.) *A. Wear a medical alert bracelet. * *B. Check all urine and stool for discoloration. * *C. Do not start any new medication without first talking to your healthcare provider. * D. Enteric-coated aspirin and any aspirin products can be used unless they cause a gastrointestinal ulcer. E. No laboratory or home monitoring of international normalized ratio (INR) is required after the first 6 months.

9. The nurse is teaching a patient with severe hemophilia A about the disease. Which statements by the nurse are appropriate to include in the teaching plan

(Select all that apply.) *A. "You will need to be vaccinated for hepatitis A and B." * B. "Take aspirin [Bayer] when you have mild pain." C. "You will receive prophylactic blood transfusions to manage your disease." *D. "You will learn to reconstitute powdered medication with saline." * E. "It will be important to get regular testing for HIV."

13. A nurse should establish which outcomes on the care plan for a patient taking oral terbutaline

(Select all that apply.) *A. Absence of tachycardia * *B. No reports of chest pain * C. Less irritation of gum tissue *D. Decrease in bronchospasm*

7. Which of the following is not a COPD o A. Asthma o B. Emphysema o C. Acute Bronchitis o D. Bronchiectasis

o C. Acute Bronchitis

7. Which finding indicates a positive outcome from treatment with filgrastim [Neupogen]

A. Bone pain is eliminated. *B. The neutrophil count increases. * C. Cancer goes into remission. D. The red blood cell count increases.

4. The nurse reviews the prescribed medication for a patient with hemophilia who complains of bleeding-related pain. Which medication should the nurse question if ordered for this patient

A. Codeine *B. Percodan * C. MS Contin D. Tylenol

8. Using a stepwise approach to managing asthma, a nurse teaches a patient who is at step 1 to use albuterol MDI [Proventil] at which of these times

*A. Whenever needed (PRN) as a quick-relief agent * B. Twice daily combined with an inhaled glucocorticoid C. Only with a long-acting beta2 agonist (LABA) D. If nighttime awakenings occur more than 2 days a week

7. A patient presents to the emergency department with symptoms of acute myocardial infarction. After a diagnostic workup, the healthcare provider prescribes a 15-mg IV bolus of alteplase (tPA), followed by 50 mg infused over 30 minutes. In monitoring this patient, which finding by the nurse most likely indicates an adverse reaction to this drug

A. Urticaria, itching, and flushing B. Blood pressure of 90/50 mm Hg *C. Decreasing level of consciousness * D. Potassium level of 5.5 mEq/L

11. A patient admitted with deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) requires immediate anticoagulation. What medication would be appropriate for this patient who has a history of heparin-induced thrombocytopenia (HIT)

A. Warfarin [Coumadin] *B. Lepirudin [Refludan] * C. Bivalirudin [Angiomax] D. Eptifibatide [Integrilin]

8. Which outcome would be most appropriate for a nurse to establish for a patient with a cough who takes an antitussive with codeine

A. Warm, dry, pink skin B. Oriented to time, place, and person *C. Respiratory rate of 12 to 24 breaths per minute * D. Effective productive cough

13. Which needle length and gauge should the nurse choose to administer subcutaneous heparin

A. ½ inch; 20 gauge *B. 1 inch; 25 gauge * C. 1½ inch; 18 gauge D. 1 inch; 26 gauge

19. Side effects include bad taste in mouth and oral thrush o A. Triamcinolone o B. Beclomethasone (Qvar) o C. Montelukast (Singulair) o D. None of the above

o B. Beclomethasone (Qvar)

14. Which of the following describes dosage of PO systemic corticosteroids o A. B.I.D o B. Burst & Taper o C. Q.D o D. None of the above

o B. Burst & Taper

12. A history of allergy to which substance is a contraindication to the use of ipratropium/albuterol [Combivent]

A. Mold *B. Peanuts * C. Penicillin D. Dairy products

8. Which nursing action should prevent an adverse effect of a liquid iron preparation

*A. Administer the iron preparation through a dropper. * B. Administer the liquid iron preparation along with vitamin C. C. Administer the liquid buccally to delay absorption and lessen adverse effects. D. Mix the liquid iron preparation with an antacid for patients with underlying peptic ulcer disease.

9. The parent of a pediatric patient with nasal stuffiness and congestion asks a nurse about cold remedies. Which additional information is the priority for the nurse to obtain

*A. Age * B. Developmental stage C. Body weight D. Swallowing ability

14. Which medication is indicated for suppression of cough

*A. Benzonate [Tessalon] * B. Guaifenesin [Mucinex] C. Acetylcysteine [Mucomyst] D. Fluticasone furoate [Veramyst]

11. For which medication order should the nurse notify the healthcare provider

*A. Cyanocobalamin 100 mcg intravenously (IV) every month * B. Folic acid 1 mg orally daily × 2 weeks then folic acid 400 mcg orally daily C. Iron dextran [INFeD] test dose 25 mg (IV) over 5 minutes D. Sodium-ferric gluconate complex [Ferrlecit] 125 mg in 100 mL NSS to run intravenously over 15 minutes

5. A maintenance dose of epoetin alfa [Epogen] is ordered for a dialysis patient. What is an appropriate dosage for administration

A. 100 units/kg IV 3 times/week *B. 75 units/kg IV 3 times/week * C. 40,000 units subQ weekly D. 150 units/kg subQ 3 times/week

14. A patient with an acute myocardial infarction is prescribed an intravenous (IV) bolus of tenecteplase [TNKase]. The patient weighs 160 pounds. The nurse will administer what dosage

A. 30 mg B. 35 mg *C. 40 mg * D. 45 mg

5. The nurse is caring for a patient who takes warfarin [Coumadin] for prevention of deep vein thrombosis. The patient has an international normalized ratio (INR) of 1.2. Which action by the nurse is most appropriate

A. Administer intravenous (IV) push protamine sulfate. B. Continue with the current prescription. Incorrect C. Prepare to administer vitamin K. *D. Call the healthcare provider to increase the dose.*

12. Which class of drugs is most effective in preventing and treating seasonal and allergic rhinitis

A. Antitussives B. Oral antihistamines C. Oral sympathomimetics *D. Intranasal glucocorticoids*

4. After 3 weeks of therapy with oral ferrous sulfate, a patient calls the clinic nurse, complaining of continuous nausea and vomiting with this drug. Which is the most appropriate response to this patient

A. "This may indicate a serious adverse effect of this drug. You need to come into the clinic." B. "Try to take your medication with meals. This should reduce your nausea and vomiting." *C. "You may need a lower dose, I will contact your primary healthcare provider and call you back." * D. "Try taking an antacid just before taking your medication. This can help reduce stomach acid, which causes nausea."

1. The nurse is caring for a patient with anemia related to chronic renal failure. Which agent might be used to treat the anemia

A. Filgrastim [Neupogen] B. Sargramostim [Leukine] C. Oprelvekin [Neumega] *D. Epoetin alfa [Procrit]*

1. Anticholinergics have which of the following respiratory effects o A. Prevent bronchodilation o B. Decreased respiratory secretion o C. Increase bronchoconstriction o D. All of the above o E. None of the above

o B. Decreased respiratory secretion

22. Which best describes Antileukotrines o A. Beclomethasone (Qvar) o B. Prevents bronchial contraction and decreases mucus production o C. Medrol Dose Pack o D. Facilitate respiration by dilating the airways

o B. Prevents bronchial contraction and decreases mucus production

12. Pulmonary function tests measure o A. Lung volumes o B. Lung capacities o C. All of the above o D. None of the above

o C. All of the above

20. Used for nasal polyp prophylaxis and rhinitis o A. Ciclesonide (Omnaris) o B. Budesonide (rhinocort) o C. All of the above o D. None of the above

o C. All of the above

2. The nurse is monitoring a patient receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding most likely relates to an adverse effect of heparin

A. Heart rate of 60 beats per minute B. Blood pressure of 160/88 mm Hg *C. Discolored urine* D. Inspiratory wheezing