Pharm I-Final
The nurse is caring for an older patient recently admitted to an assisted living center who is experiencing insomnia associated with the recent relocation. At bedtime, which nursing action will assist the patient to sleep?
performing back massage
The nurse assesses erythema, warmth, and burning pain along the patient's IV site. Which complication is this patient most likely experiencing?
phlebitis
The nurse has taught a patient's spouse to administer an injectable medication. After the spouse completed a return demonstration of the injection in the hospital, the nurse does not feel confident that this can be carried out independently at home and requests referral for a home health nurse. The nurse is using which phase of the nursing process?
planning
When teaching a patient who is taking thiazide diuretics, the nurse will encourage the patient to increase the intake of which electrolyte?
potassium
When obtaining urine for analysis on a patient in the labor and birth unit, the nurse assesses the urine to appear frothy. The nurse interprets this as a sign of possible:
preeclampsia (toxemia)
For what conditions are benzodiazepines prescribed?
preoperative sedation
Which nerve endings liberate norepinephrine?
Adrenergic
Which response by the nurse is accurate when a patient who has been on lamotrigine (Lamictal) for seizure control reports a skin rash and urticaria?
Advise the patient that this adverse effect usually resolves but should be reported to the healthcare provider.
The nurse is educating a 13-year-old boy newly diagnosed with diabetes and his parents about diet and glucose monitoring. Which domain of learning is represented when the patient expresses concern about feeling different from his peers?
Affective
Which is the most intangible portion of the learning process?
Affective
The nurse is teaching a patient who is taking clozapine (Clozaril) to have weekly blood tests for the first 6 months of treatment to monitor for which potential complication?
Agranulocytosis
A patient has an infected wound with large amounts of drainage. Which type of dressing would the nurse use?
AlgiDERM
The autonomic nervous system can be subdivided into which types of adrenergic receptors?
Alpha and beta
Which age-related change would affect transdermal drug absorption in geriatric patients the most?
Altered circulatory status
The nurse is administering sulfonylurea drugs to four different patients diagnosed with type 2 diabetes. Which patient should not receive the medication as ordered?
An 80-year-old woman with an allergy to sulfa
A patient with type 1 diabetes was prescribed a glucocorticoid for chronic obstructive pulmonary disease. Which will the nurse expect in the treatment plan?
An increase in the insulin needed
A patient at sports camp is complaining of itchy and watery eyes, coughing, and sneezing when outdoors. The patient's chart states that he has an allergy to grasses. Which medication will the nurse administer?
Antihistamine
The nurse is caring for a patient who is taking a newly prescribed drug, nefazodone, for treatment of depression. Which physical assessment finding is most important for the nurse to report to the healthcare provider immediately?
Bradycardia
The patient asks the nurse how sulfonylureas normalize glucose levels. Which response by the nurse is correct?
By stimulating pancreatic secretion of insulin
The nurse is providing nutrition information to a patient diagnosed with a lower respiratory tract disease. What is the rationale for limiting caffeine?
Caffeine can result in thicker lung secretions.
A nurse is preparing to provide morning hygiene care for a client who has Alzheimer's disease. The client becomes agitated and combative when the nurse approaches him. Which of the following actions should the nurse plan to take?
Calmly ask the client if he would like to listen to some music.
Which medication, if administered with spironolactone (Aldactone), will alert the nurse to assess the patient for signs and symptoms of hyperkalemia?
Captopril (Capoten)
Which technique by the nurse accurately maintains asepsis of a peripheral IV access device?
Change fluid administration sets according to institutional policy.
After entering the patient's room to administer oral medications, which action will the nurse take first?
Check the patient's identification.
A nurse is modifying the diet of a client who has Parkinson's disease and a prescription for selegiline, a monamine oxidase inhibitor (MAOI). Which of the following foods should the nurse eliminate from the client's diet?
Cheddar cheese
A 42-year-old woman is admitted with complaints of dysuria, frequency, and lower back pain. The urinalysis report is positive for red blood cells, and the blood work shows an elevated white blood cell count. Which medication will the nurse anticipate that the healthcare provider will order?
Ciprofloxacin (Cipro)
Which task is included in the assessment step of the nursing process?
Collecting and communicating data
What is medication reconciliation?
Comparing the patient's current medication orders to all of the medications actually being taken
The nurse determines that a prescribed medication has not been administered as ordered on the previous shift. What action will the nurse take?
Complete an incident report.
The nurse notes that a patient with cardiac disease has IV heparin infusing and that it is behind by 2 hours. What is the best nursing action?
Contact the healthcare provider for consultation.
Which action will the nurse take if a dosage is unclear on a healthcare provider's order?
Contact the healthcare provider to verify the correct dosage.
Which medication may be given to patients with allergic seasonal rhinitis who do not respond to antihistamines and sympathomimetics?
Corticosteroids
Which online drug reference makes available to healthcare providers and the public a standard, comprehensive, up-to-date look up and downloadable resource about medicines?
DailyMed
An adult patient is admitted for an asthma attack. Which assessment obtained by the nurse would support that albuterol (Proventil) was effective?
Decrease in wheezing present on auscultation
What is the action of zafirlukast (Accolate), a leukotriene receptor antagonist?
Decreases leukotriene release.
A 14-year-old male is taking tolterodine (Detrol). What is the action of this drug?
Decreases the urge to void.
The nurse is providing instruction to a patient recently prescribed a radioactive iodine isotope. Which is the correct action of this medication?
Destroys hyperactive thyroid tissue.
After a blood glucose reading, it is determined that the patient should receive 4 units of Lispro and 8 units of NPH. Which action will the nurse take to administer these medications?
Draw up the Lispro first and then the NPH using the same syringe.
Which assessment would the nurse expect to observe in a patient who has been prescribed trazodone for treatment anxiety?
Drowsiness
What is the most comprehensive reference available to research a drug interaction?
Drug Interaction Facts
Which organism causes most UTIs?
E. coli
Which action by the nurse is appropriate when administering enteric coated tablets?
Encourage the patient to drink a full glass of water.
Which nursing assessment accurately describes the results of an intradermal skin test?
Erythema and induration
The nurse has determined that the pain medication given to a patient an hour ago has been effective. The nurse is using which step of the nursing process?
Evaluation
What is the most common cause of nonadherence to antipsychotic pharmacologic treatment?
Extrapyramidal effects
Dystonic reactions, pseudoparkinsonism, akathisia, and tardive dyskinesia are types of which effect?
Extrapyramidal symptoms
What laboratory test is the preferred screening test for diabetes in children and nonpregnant adults?
FPG
What would the FDA do to expedite drug development and approval for an outbreak of smallpox, for which there is no known treatment?
Fast track the investigational drug.
Which legislation authorizes the FDA to determine the safety of a drug before its marketing?
Federal Food, Drug, and Cosmetic Act (1938)
A male patient becomes verbally aggressive and insists the nurse is poisoning him as she attempts to administer haloperidol (Haldol). Which action will the nurse take?
Firmly redirect the patient to take the medication.
Which is the drug of choice to treat a patient with obsessive-compulsive disorder (OCD)?
Fluvoxamine (Luvox)
On admission, a patient with a history of cardiac insufficiency complains of shortness of breath. The nurse auscultates the lungs and notes bilateral crackles throughout both fields. In addition, there is bilateral +2 edema of the lower extremities. Which medication does the nurse anticipate that the healthcare provider will prescribe?
Furosemide (Lasix)
Which condition is associated with hydantoin therapy?
Gingival hyperplasia
A patient with a history of heart failure has been diagnosed with hypothyroidism. The drug interaction with glycosides and thyroid replacement therapy will most likely require which change in therapy?
Gradual increase in the daily glycoside dosage
Which is a common expectorant in over-the-counter medications?
Guaifenesin
Which fluid replacement method will the nurse identify for a patient on a fluid restriction?
Half the volume with meals and the remainder divided among shifts
The nurse is assessing a patient who is complaining of hearing voices. What is this patient experiencing?
Hallucinations
Which is the most authoritative reference for medications that are injected?
Handbook on Injectable Drugs
What is the action of urinary antimicrobial agents?
Have an antiseptic effect on the urine and the urinary tract.
Which condition would the nurse expect to be treated with an isotonic solution?
Hemorrhagic shock
A patient with metastatic cancer is being admitted for pain control. Which action will the nurse perform in administering a transdermal patch?
Label the patch with date, time, dosage, and initials after patch placement.
The healthcare provider in an outpatient clinic has prescribed omalizumab (Xolair) to a patient. Which primary outcome will the nurse teach the patient to expect?
Less frequent asthma exacerbations
The nurse would expect to assess which serum potassium level in a patient who has severe vomiting and diarrhea?
Less than 3.5 mEq/L
Which medication is used in the treatment of hypothyroidism?
Levothyroxine (Synthroid)
A patient receiving diazepam (Valium) is complaining of nausea and vomiting and is becoming jaundiced. Which type of blood work will be performed?
Liver function tests
The nurse determines that an elderly patient's IV of D50.2 NS with 20 mEq KCl at 75 mL/hr is running 3 hours behind. After determining the IV site is patent, what action will the nurse take?
Maintain the ordered rate.
A nurse is caring for a client who ingested a poison and is now having seizures. Which of the following is the priority action the nurse should take?
Maintain the patency of the client's airway.
A patient who has been taking glucocorticoids over the past 3 months for Crohn's disease comes in for a follow-up visit. On assessment, the nurse notes facial edema, thinning extremities, and a fatty deposition (buffalo hump) on the scapular area. The patient reports the symptoms of the Crohn's disease are "somewhat better." What will the nurse expect the treatment to be?
Maintain the steroid dosage.
Which is an appropriate nursing intervention for a patient who has recently been prescribed clozapine (Clozaril)?
Measure the patient's waist circumference.
To what does potency of an antipsychotic medication refer?
Milligram doses used for the medication
Which postoperative narcotic analgesic will most likely be prescribed to a patient whose current medications include a monoamine oxidase inhibitor (MAOI), a thyroid hormone, and a multivitamin?
Morphine
Which medication order requires nursing judgment and means "administer if needed"?
Morphine 4 mg IV every 4 hours PRN
What information would be most important for the nurse to provide to a patient when teaching about the adverse effects of succinimide therapy?
Nausea, vomiting, and indigestion are common during the initiation of therapy.
A patient who is taking an MAOI to treat depression admits to eating pickled herring and cheese and drinking red wine. Which assessment finding alerts the nurse to a potential complication?
Neck stiffness
The nurse will monitor patients on cephalosporins and loop diuretics for which adverse effect?
Nephrotoxicity
Which statement regarding nursing diagnoses is accurate?
Nursing diagnoses describe patient problems that nurses treat.
Which condition would indicate to the nurse that a patient has phenytoin (Dilantin) toxicity?
Nystagmus
Which is the best description of when drug interactions occur?
On the alteration of the effect of one drug by another drug
The nurse is assessing a patient for adverse effects of long-term glucocorticoid therapy. Which condition would most likely be present?
Osteoporosis
What adverse effect may manifest as dizziness, tinnitus, and progressive hearing loss?
Ototoxicity
Which is a benzodiazepine of choice when treating anxiety associated with alcohol withdrawal?
Oxazepam (Serax)
Which statement is true regarding the adverse effects associated with antipsychotic medications?
Painful dystonic reactions can occur in the first 72 hours of initiation of therapy.
Which is an accurate nursing action when treating a patient's rash with a lotion?
Pat on the area with a gloved hand.
On what is the choice of tricyclic antidepressants based?
Patient age and gender
The outcome statement for a patient suffering from anxiety disorder reads, "After 1 week on alprazolam (Xanax) therapy, patient will exhibit a manageable level of anxiety." Which assessment finding validates that this outcome is met?
Patient reports sleeping better and increased interest in activities.
The nurse is caring for a patient with a new diagnosis of type 1 diabetes mellitus. When assisting with the plan of care, which goal set by the patient will require revision?
Patient will discontinue insulin use within 1 year.
Which patient is most likely to respond quickly to antianxiety therapy with benzodiazepines?
Patient with recent anxiety reactions
A patient is complaining of moderate bladder pain and spasms secondary to a UTI. Which drug would assist in relieving symptoms?
Phenazopyridine hydrochloride (Pyridium)
Where would the procedures and treatments directed by the healthcare provider be found?
Physician's order form
What is the pharmacologic action of entacapone, a potent catechol O methyl transferase (COMT) inhibitor?
Reduces the destruction of dopamine in peripheral tissues.
Which intervention would be considered to reduce accumulation of a drug in a patient who has decreased liver function?
Reducing the dosage
What process in the antigen-antibody reaction causes the symptoms of allergies?
Release of histamine
Which action will the nurse take when it is determined that the narcotic count is incorrect while obtaining a medication from the narcotic area?
Report the discrepancy to the charge nurse immediately.
Which type of nursing diagnosis will be written when the patient exhibits factors that make him or her susceptible to the development of a problem?
Risk diagnosis
What will the nurse caution a patient about when providing information about the prescribed azapirone antidepressant?
Risk of injury when using machinery
Within minutes of the initiation of a nebulizer treatment with a sympathomimetic bronchodilator, the patient turns on his call light and states that he feels "panicky" and his heart is racing. Which action will the nurse take?
Stop treatment and notify the healthcare provider.
A patient is scheduled to take tetracycline and aluminum hydroxide (Amphojel) at the same time. When will the nurse administer the medications to achieve the optimal effects?
Tetracycline 1 hour before Amphojel
When a nursing diagnosis statement is written, who or what directs the nurse to identify appropriate nursing interventions?
The etiologies of the problems identified in the nursing diagnoses
Which is most important for the successful management of diabetes mellitus?
The level of self-management
What is an advantage of administering a drug parenterally?
The onset of action is more rapid.
Which statement is true about neuropathic pain?
The pain is a result of nerve injury.
What is the nurse's primary source of information when obtaining a patient history?
The patient
Which represents the psychomotor domain of learning?
The patient draws up insulin in a syringe.
Which assessment finding in a patient taking a sedative for insomnia concerns the nurse?
The patient has a decreased ability to perform activities of daily living.
Which statement best describes the planning phase of the nursing process?
The patient will state the expected adverse effects of medication by the end of the teaching session.
Which is true regarding the unit dose drug distribution system?
The use of single dose packages of drugs dispensed to fill each dose requirement as it is ordered.
The nurse is developing a teaching plan for patients prescribed buspirone (BuSpar). Which information about this medication should be included?
There is minimal potential for abuse.
Why are sublingual and buccal medications rapidly absorbed?
These drugs pass directly into systemic circulation.
Which statement is true about over-the-counter (OTC) drugs?
They are sold without a prescription.
What do drug blood levels indicate?
They determine if the amount of drug in the body is in a therapeutic range.
What is the major advantage of selective serotonin reuptake inhibitors (SSRIs) over other types of antidepressant therapy?
They do not cause the anticholinergic and cardiovascular adverse effects.
What is the reason for administering sodium chloride to a patient with emphysema?
To decrease mucus viscosity
The healthcare provider has prescribed penicillin and probenecid for a patient with a sexually transmitted disease. What is the purpose of combining these medications?
To inhibit the excretion of the penicillin
Which medication is used to control seizures or prevent migraine headaches?
Topiramate (Topamax)
For which condition may carbamazepine (Tegretol) be used?
Trigeminal neuralgia pain
Which source contains information specific to nutritional supplements?
United States Pharmacopoeia/National Formulary (USP NF)
After undergoing prostate surgery, a patient is discharged on the medication phenazopyridine hydrochloride (Pyridium) to assist with urinary catheter discomfort. What information will the nurse include in the discharge teaching?
Urine will appear reddish orange.
Which action will the nurse perform when doing a wet to dry dressing every 4 hours on a patient with a deep wound?
Use Montgomery tapes or a binder to secure the dressing.
Which action by the nurse is most accurate when drawing up medication from an ampule?
Use a filter needle to withdraw the medication.
Which nursing action is accurate when administering parenteral medication?
Use clinical judgment when rescheduling missed doses of a medication.
What is the drug of choice when treating a generalized tonic-clonic seizure?
Valproic acid (Depakene)
Which is the preferred IM site for injecting a 6-month-old child?
Vastus lateralis
When is it acceptable to use the deltoid muscle as an injection site for infants?
Volume is quite small.
Which type of lubricant would the nurse use to administer a rectal suppository?
Water soluble
When applying nitroglycerin topically, which nursing intervention is correct?
Wear gloves while placing the new paper.
Which would positively affect readiness to learn?
Willingness to attain an optimal level of health
When is the best time for the nurse to administer Lispro?
Within 10 to 15 minutes of eating
Which condition can occur if congenital hypothyroidism is not treated?
cretinism
The nurse is caring for a patient being treated with an antimicrobial agent for the diagnosis of a sexually transmitted infection. Which statement made by the patient shows a need for further education?
"I will use a barrier method when having sexual intercourse during therapy."
The nurse has provided patient teaching about potassium sparing diuretic therapy. Which statement by the patient indicates a need for further teaching?
"I will use a salt substitute because I limit my salt intake."
The nurse is instructing a patient to use a corticosteroid inhaler. Which statement by the patient indicates the need for further teaching?
"I will use this when I'm lying in bed in the morning."
The nurse is providing discharge teaching to a patient prescribed phenytoin (Dilantin) for management of a seizure disorder. Which patient statement indicates a need for further teaching?
"If I develop enlarged gums, I will stop taking the medication."
The nurse caring for a Spanish-speaking patient uses the assistance of an interpreter to help with preoperative teaching. While implementing the education, the nurse should:
look directly at the patient.
Which herbal product has been used for the treatment of jet lag?
melatonin
The nurse is preparing to administer a single-dose packet of fosfomycin to a patient diagnosed with a UTI. When preparing this medication, the nurse will:
mix contents with 120 mL of water and administer by mouth.
The nurse is providing education to a patient who has been prescribed bupropion (Wellbutrin) for smoking cessation. Which statement by the patient would indicate the need for further teaching?
"If I have the urge to smoke, I will take more medication."
The nurse is educating a patient about diabetes. Based on recommendations from the American Diabetes Association, which statement by the nurse is best regarding site rotation?
"It is important to rotate injection sites systematically within one area before progressing to a new site for injection."
After teaching a diabetic patient about proper disposal of used syringes and needles, which statement by the patient indicates a need for further teaching?
"It is unusual that anyone could get a needle injury or disease from used needles."
A patient has questions regarding a recently prescribed antitussive agent. Which response by the nurse is the best?
"It will reduce the frequency of your cough."
Which information provided by the nurse is most important to include when teaching a patient about the use of an EpiPen?
"Monitor the expiration date of this medication."
The nurse is instructing a patient about insulin administration. Which statement by the patient indicates a need for further teaching?
"Once I open my insulin, I will store it in the refrigerator."
The nurse is providing education to a patient recently prescribed pregabalin (Lyrica). Which statement by the patient indicates a need for further instruction?
"Once my pain improves, I will stop taking this medication."
Which instruction will the nurse include when teaching a patient with seasonal rhinitis and blocked nasal passages about intranasal corticosteroid therapy?
"Use a decongestant prior to administration."
A nurse is reinforcing teaching for a client who has generalized anxiety disorder and has been prescribed alprazolam. Which of the following instructions should the nurse give the client?
"Watch for drowsiness and light-headedness while taking alprazolam."
A child has been diagnosed with asthma and the nurse is providing education to the family. Which statement by the mother indicates a need for further teaching?
"We will confine our dog to the kitchen area."
A patient with myxedema complains to the nurse that he has a "hangover" the next morning after taking a pain medication at night. Which explanation by the nurse is the most accurate?
"You have increased sensitivity to the medicine because of your thyroid condition."
What instruction is most important for the nurse to teach the patient who has recently been prescribed alprazolam (Xanax)?
"You may feel dizzy or unsteady when rising to a standing position."
A nurse is preparing to administer haloperidol 5 mg IM to a client. Available is haloperidol 50 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)
0.1 mL
A patient has just received a new prescription for a corticosteroid medication. The nurse is educating a patient on symptoms to report to the healthcare provider. When providing this education, the nurse will inform the patient to report:
-chest pain -dyspnea -confusion -weight gain -productive cough
The vastus lateralis muscle is appropriate for injections for which patient(s)?
-children younger than 3 years of age -ambulatory -healthy
The nurse is preparing to administer Lanoxin to a patient on the telemetry unit. In addition to understanding the patient's diagnosis, the nurse must also know which characteristic(s) of the medication?
-contraindications for use -adverse effects -usual doing -expected actions
Which are common signs and symptoms of dehydration?
-decreased intake and output levels -furrowed tongue -mental confusion
Which action(s) would let the nurse know that the patient has mastered a psychomotor skill?
-demonstrate the process to another person while the nurse supervises
Which common adverse effect(s) is/are associated with opiate agonists?
-dizziness -confusion -orthostatic hypotension -respiratory depression
Oral drug administration includes which principle(s)?
-dosage forms are convenient and readily available -most economical
A nurse is preparing to administer vitamin K 1mg IM to a newborn. Available is vitamin K injection 1 mg/0.5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
0.5 mL
A nurse is preparing to administer diazepam 3 mg IM. The amount available is diazepam for injection 5 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
0.6 mL
A nurse is preparing to administer hydrocortisone 100 mg IM daily to a client. Available is hydrocortisone 250 mg/2 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth.)
0.8 mL
A patient is admitted with hypovolemia resulting from lack of fluid intake and requires an infusion of isotonic fluids. Which IV solution will the nurse administer?
0.9 NS
What is the recommended time over which antianxiety medications must be gradually tapered before discontinuation?
1 month
The nurse is teaching a patient about medication treatment for depression. The patient asks how long it will take before sleep and appetite will begin to improve. Which response by the nurse is most accurate?
1 week
A nurse is completing the 8-hr I&O record for a client who consumed 4 oz of clear soda, 1 piece of toast, 12 oz of water, 1 cup of fruit-flavored gelatin, and 1/2 cup of chicken broth. The client also received 300 mL of 0.9% sodium chloride IV. The nurse should record how many mL of intake on the client's record? (Round the answer to the nearest whole number.)
1,140 mL
A nurse is preparing to administer hydrocodone/acetaminophen 5 mg PO every 6 hr for pain. The amount available is hydrocodone/acetaminophen 7.5 mg/500 mg/15 mL elixir. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
10 mL
The nurse is preparing to administer insulin. What does U 100 indicate?
100 units/mL
Medications ordered on a patient with hypothyroidism include liotrix and cholestyramine. The nurse administers the dose of liotrix at 08:00. When is the best time for the nurse to administer the cholestyramine?
12:00
A nurse is preparing to administer dextrose 5% in water (D5W) 1,200 mL IV to infuse over 24 hr. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
13 gtt/min
A patient received the evening dose of Lispro subcutaneously at 16:30 PM. What time will symptoms of hypoglycemia likely occur?
18:30
A nurse is preparing to administer dexamethasone 3 mg PO. Available is dexamethasone 1.5 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
2 Tablets
A nurse is preparing to administer ondansetron 4 mg IM stat. The amount available is ondansetron for injection 2 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
2 mL
A nurse is preparing to administer fluoxetine 10 mg PO to an older adult client. Available is fluoxetine oral solution 20 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
2.5 mL
The nurse is obtaining a history of respiratory symptoms on a patient with the diagnosis of COPD. The patient reports smoking one pack of cigarettes per day for the past 20 years. The nurse calculates the pack years as:
20
A nurse is preparing to administer dextrose 5% in water (D5W) 100 mL to infuse over 1 hr. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number.)
25 gtt/min
Which gauge needles are used for subcut injections?
25- to 29-gauge
Which needle will the nurse use to administer an intramuscular (IM) immunization on an 18-month-old child?
25-gauge, -inch needle
A nurse is preparing to administer a dexamethasone 1.5 mg/kg/day PO to divide equally every 6 hr to a preschool-age child who weighs 22 lb. Available is dexamethasone oral solution 1 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
3.8 mL
What dose is within the acceptable range for administering IV phenytoin (Dilantin) to a patient with a seizure disorder?
30 mg/min
A nurse is preparing to administer a client's daily dose of NPH insulin at 0730. The nurse should expect this type of insulin to peak within which of the following timeframes after administration?
4-14 hours
A nurse is preparing to administer morning insulin to a client who has a prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneous daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe?
42 units
The nurse is teaching a patient about the administration of antihistamines. The nurse will instruct the patient to take the medication at what time of day?
45 minutes before exposure to an allergen
A nurse is preparing to administer 0. 9% sodium chloride IV infusion 1000 mL bag at a rate of 200 mL/hr for a client who has rhabdomyolysis The nurse should expect the IV pump to infuse over how many hrs? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
5 hrs
The nurse is preparing a patient's prescribed medications. In order to ensure patient safety, the nurse will perform which intervention(s)?
-educate patient regarding medications prescribed -select the correct supplies -administer the medication by the correct route -document in chart all aspects of medication administration
The prenatal nurse is educating a woman regarding preconception care. The patient informs the nurse that she is currently taking a benzodiazepine drug for management of anxiety. Appropriate teaching for this patient will include that benzodiazepines:
-enter fetal circulation -readily cross into the breast milk
The nurse is participating in the planning phase of the nursing process for a new admission to a long-term care facility. When formulating a plan to meet the patient's needs, the nurse will take which action(s)?
-formulate nursing interventions -set priorities -collect data -develop measurable goals
What are functions of glucocorticoids?
-have anti-inflammatory activities -regulate protein, carbohydrate, and fat metabolism -provide relief of rheumatoid arthritis
For which reason(s) is/are elderly patients at increased risk for drug interactions and toxicity?
-hepatic function is reduced -they have increased use of multiple medications -they have a higher incidence of malnourishment
Which assessment(s) would be included in the evaluation of a patient with anxiety?
-history of precipitation stressors -psychological evaluation -substance abuse history -medication history -physical examination
The nurse is preparing 0800 medications for a patient with the medical diagnosis of end-stage renal disease. When reviewing the medication administration record (MAR), the nurse notices the patient is scheduled to receive an MAOI drug. Which intervention(s) will the nurse perform before administering the drug?
-hold the MAOI drug -consult with the prescribed healthcare provider
The nurse transcribes an order to administer Valium 10 mg IV stat. This order is correctly interpreted by the nurse to mean it should be provided how?
-immediately -intravenously -one time only
Which receptacle(s) is/are commonly used in the hospital with pediatric oral medications?
-infant feeding nipple -oral syringe -medicine dropper
Which statement(s) about ipratropium bromide (Atrovent) is/are true?
-it has minimal effect on ciliary activity -it is administered by aerosol inhalation -it may cause tachycardia or urinary retention
Which statement(s) about acetylcysteine is/are true?
-it is given to improve airway flow -it treats acetaminophen toxicity -it reduces viscosity of secretions -it is administered by inhalation
What must the nurse have before administering any medication?
-knowledge of the medication -a medication order signed by a practitioner licensed with prescription privileges -a current license to practice -knowledge of the client's diagnosis
Which is/are extrapyramidal adverse effect(s) of antipsychotic agents?
-lip smacking -inability to sit in one place for an extended period -spasmodic movements of muscle groups -mask like expression
In preparing to administer medications to a patient with an NG tube, which would be appropriate to give through that route?
-liquid medication -capsules emptied into 30 mL of water -tablets crushed and diluted in 30 mL of water
Which physical assessment(s) would be pertinent to the patient with asthma?
-lung sounds -respiratory rate and effort -pulse oximetry reading -peak expiratory flow -patient color
Individuals with which disorder(s) are particularly susceptible to the development of electrolyte disturbances during diuretic therapy?
-massive trauma -serious burns -history of renal disease -history of hormonal disorders -history of cardiac disorders
An adult patient is to receive 10 mL of cough syrup at 0800. The nurse can prepare to administer this medication in a(n):
-medicine cup -oral syringe
Which clinical symptom(s) would the nurse observe in a patient with thyrotoxicosis?
-muscle tremors -sweating -restlessness -anxiety
A patient who has heart failure and difficulty breathing is being admitted. Which physical assessment(s) indicate(s) fluid volume excess?
-neck vein engorgement -shortness of breath -rapid bounding, irregular pulse rate -3+ pitting ankle edema
Which adverse effect(s) may occur as a result of antipsychotic drug therapy?
-neuroleptic malignant syndrome -akathisia -tardive dyskinesia -acute dystonia
Which premedication assessment(s) would the nurse obtain prior to the initiation of bumetanide (Bumex)?
-orientation level -blood pressure -lung sounds -serum potassium
The nurse is reviewing the urinalysis results of an older adult patient admitted with elevated temperature and incontinence. Which urinalysis properties are indicative of an infection?
-pH of 8.2 -foul odor
Which nursing intervention(s) would be performed for a patient who is on diuretic therapy?
-positioning techniques -auscultation of lung sounds -monitoring of intake and output -assessment of skin turgor
When preparing parenteral medications, the nurse should perform which intervention(s)?
-prepare the drug in a clean, well lit area -check the expiration date -check the drug dosage from ordered against the source available -check calculations
A patient on anticonvulsant therapy confides to the nurse at an outpatient clinic that she suspects she may be pregnant. The nurse should encourage the patient to take which action(s)?
-provide a list of seizure medications -consult an obstetrician -carry an identification card
Which area(s) should be addressed by the nurse when obtaining a history of a patient admitted with depression?
-recent stressors and support system -dietary patterns -family history of mood disorder -current medications and medical history
Which patient assessment finding(s) suggest(s) extravasation of an IV solution?
-redness at the site -coolness -pain at venipuncture site -edema
In addition to the relief of mild to moderate anxiety, hydroxyzine (Vistaril) has which additional therapeutic outcome(s)?
-reduce need for sedation and analgesia before and after surgery -control of itching in allergic reactions -control of vomiting
What would be primary therapeutic outcome(s) expected from fludrocortisone (Florinef) therapy?
-restored fluid and electrolyte balance -blood pressure control
The nurse is preparing to administer two inhalations of ipratropium bromide (Atrovent). When providing this medication, the nurse will instruct the patient to:
-shake the canister thoroughly prior to use. -keep the eyes closed. -wait 15 seconds before the second inhalation.
Which sign(s) and/or symptom(s) of dehydration may occur as a result of a diuretic?
-soft, sunken eyeballs -skin remains peaked on turgor assessment
The nurse assesses a patient's right hand IV site to be infiltrated. Appropriate nursing actions include:
-stopping the infusion -elevating the affected limb -checking capillary refill -removing the catheter as directed by policy
An older adult with a history of asthma, rhinitis, and no known drug allergies has been admitted to receive IV antimicrobial therapy for bronchitis. The patient has received the oral form of the antimicrobial agent in the past. Which factors increase the risk for an allergic reaction?
-subsequent use of the same antimicrobial therapy -medical history of asthma -medical history of rhinitis
The nurse is completing the admission of an older adult patient with a history of COPD whose diagnosis is pneumonia. Which assessments would be most important to include in obtaining the history?
-support system -chief complaint and onset of symptoms -home oxygen use -smoking history and exposure to secondhand smoke -current medications
The nurse is providing counseling to a patient on cromolyn sodium (Nasalcrom) nasal spray. Information relayed to the patient will include that:
-the maximum is six sprays in each nostril daily. -the patient should blow the nose before nasal instillation.
What is characteristic of antithyroid drugs that act on the thyroid gland?
-they may be used before subtotal thyroidectomy -they block synthesis of T3 and T4 in the thyroid gland
What is true about arterial blood gases (ABGs)?
-they measure the partial pressures of carbon dioxide -they measure blood pH -they measure partial pressures of oxygen -they are measured from an arterial sample
Which risk factor(s) should be considered when administering medications by injection?
-trauma at the site of the needle puncture -irretrievability of the medication once administered -possibility of infection -chance of allergic reaction
Which medical condition(s) may contribute to fluid volume excess?
-use of corticosteroids -liver disease -pregnancy -hypertension
Which action(s) will the nurse perform when preparing to administer a topical medication?
-wear gloves during the application process -wash hands before and after administration
A patient recently completed radiation treatment for throat cancer and presents to the healthcare provider's office with symptoms indicating possible hypothyroidism. Which symptom(s) would most likely be exhibited and/or reported?
-weight gain -lethargy -cold intolerance
The nurse is educating a patient with diabetes mellitus regarding urine testing for ketones. Information provided will include that ketone testing should be done:
-when illness occurs -when blood glucose is above usual range -during pregnancy
The nurse is caring for a patient taking Pyridium for the diagnosis of UTI. What should the nurse report to the healthcare provider?
-yellow sclera -increased pain and burning
A nurse is preparing to administer 400 mL of 0.9% sodium chloride IV over 8 hr. The drop factor of the manual IV tubing is 60 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
50 gtt/min
A nurse is preparing to administer amoxicillin 350 mg PO. Available is amoxicillin 250 mg/5 mL. How many mL should the nurse administer? (Round to the nearest whole number.)
7 mL
A nurse is preparing to administer potassium chloride 20 mEq. The amount available is potassium chloride liquid 40 mEq/15 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
7.5 mL
Which angle is appropriate when administering an IM medication in the dorsogluteal site to a 46-year-old obese man?
90 degrees
A nurse is preparing to administer 0.9% sodium chloride (NaCl) 750 mL IV to infuse over 8 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
94 mL
Which patient can safely be treated with a fluoroquinolone medication?
A 30 year old with a fractured tibia
Which is an example of ethnocentrism?
A 36-year-old Asian prefers to take herbs instead of an oral medication.
Which patient would be a candidate for radioactive iodine therapy?
A 46-year-old man with heart disease and thyroid cancer
Which patient would the nurse identify as having the lowest rate of absorption of enteral medications?
A 55-year-old man
What is a critical care pathway?
A standardized care plan derived from best practice patterns
Which syringe will the nurse use to administer insulin subcutaneously to a patient?
A syringe calibrated in units.
What test determines glycemic control over the previous 8 to 10 weeks?
A1c test
Which disease is associated with insufficient sleep?
myocardial infarction
A patient is experiencing adverse effects of a medication. Which information obtained by the nurse is subjective?
nausea
What is the name under which a drug is listed by the US Food and Drug Administration (FDA)?
official
The nurse transcribes a new order for a patient for a fludrocortisone. When planning the time of administration, the nurse will schedule this medication to be given:
once daily in the evening.
A resident in a long-term care facility diagnosed with COPD has a new medication order for indacaterol. When the nurse is providing education to the resident regarding this medication, information will include that:
onset of action is within 5 minutes.
An older adult who has septicemia is receiving IV aminoglycoside therapy. Which symptom is most important for the nurse to monitor?
ototoxicity
Which is known as the "fifth vital sign"?
pain
A patient experiencing chronic pain as a result of metastatic cancer has a new order for fentanyl (Duragesic) transdermal patch. The initial patch is applied at 8 AM on Monday. At 8 PM on Monday, the patient reports a pain level of 8. The nurse's best response is to:
provide a PRN analgesic medication as ordered.
When assisting with the care of a patient with hyperthyroidism, the nurse will:
provide a cool environment.
A newly admitted psychiatric patient repetitively states, "I wish I were dead. I just want to kill myself." The priority nursing at this time is to:
provide for patient safety.
A long-term care resident is taking an anticholinergic agent. The nurse observes the resident to be disoriented and hallucinating. The priority nursing action is to:
provide for resident's safety.
A patient's liquid cough medicine has been discontinued with one-half of the bottle remaining. The home health nurse is aware that according to the US Food and Drug Administration (FDA) guidelines on prescription medication disposal, the next step should be to:
read the drug label for specific disposal instructions.
The operating room (OR) nurse is preparing medications for use in a sterile field during a surgical procedure. While preparing these medications, the nurse will:
read the label aloud for verification against the order from the surgeon.
Which effect would be important for the nurse to address when teaching a patient about the overuse of nose drops?
rebound
A teaching plan has been developed by the nurse to educate the mother of a preterm infant on prescribed medications. Before initiating this teaching plan, the nurse should:
recognize the individual's health beliefs
Which route of administration would be ordered by the healthcare provider if a patient is vomiting?
rectal
Which life-threatening illness may occur as a result of aspirin (salicylate) administration during viral illness to patients younger than 20 years of age?
reye's syndrome
What may become discolored by phenazopyridine (Pyridium) in addition to the urine?
sclera
A nurse is collecting data from a client who has Parkinson's disease and is experiencing bradykinesia. Which of the following findings should the nurse expect?
slurred speech
Which psychological manifestation of depression will improve in response to antidepressant therapy?
social withdrawal
Which medications are provided in dried, powdered form compressed into small disks?
tablets
The nurse is administering Somnote to a patient. When providing medication education to the patient, the nurse will include that Somnote should be:
taken with a full glass of water.
Which drugs cause birth defects?
teratogens
Where would the nurse apply nitroglycerin ointment on a male patient?
the upper arm
What is the advantage of taking a nonsteroidal antiinflammatory drug (NSAID) that is a COX-2 inhibitor?
there are fewer GI adverse effects
Which cholinergic symptoms of Parkinson's disease are reduced with anticholinergic drugs?
tremors and drooling
The nurse is administering an antibiotic intravenously. Which blood level determines the lowest amount of medication present in the patient?
trough
Where will the nurse administer a medication that was ordered to be given sublingually?
under the tougue
How soon will diuresis be expected to occur after the nurse has administered 20 mg of furosemide (Lasix) intravenously (IV) to a patient with heart failure?
within 10 minutes
The nurse is instructing a patient about the use of medications to treat insomnia. Which statement by the patient indicates the need for further teaching?
"It is OK to take a sleeping pill every night if I need one."
The nurse is assessing a patient who is being evaluated in an outpatient clinic for complaints of back pain. The patient reports taking diphenhydramine for insomnia related to job stress. Which statement by the nurse is accurate regarding this medication?
"This medication should only be taken for 1 week."
The nurse is assessing a patient prior to discharge from same day surgery following an incisional breast biopsy. When assessing the patient's central nervous system (CNS) function following sedative-hypnotic therapy, what will the nurse include?
-level of alertness -orientation -ability to perform motor function
When performing a baseline neurologic assessment prior to the administration of an NSAID medication, the nurse will assess which patient characteristic(s)?
-mental alertness -orientation to date, time, and place
The nurse is preparing to begin administration of apomorphine to a patient. Before administering, the nurse will perform a baseline assessment of the patient's:
-mobility -alertness -vital signs -orientation
Which adverse effect(s) is/are common when a patient is receiving a cholinergic agent?
-nausea -dizziness -bradycardia
A patient is being discharged on an adrenergic bronchodilator. Which common adverse effect(s) will the nurse include in discharge teaching?
-orthostatic hypotension -dizziness -palpitations -tremors
Which patients would the nurse expect an anticholinergic agent to be ordered?
-patient with nocturnal enuresis -patient with parkinson's disease -patient who needs an endotracheal tube
Parkinson's disease has which characteristic symptom(s)?
-posture alterations -slow body movement -muscle tremors
Barbiturates have which common adverse effect(s)?
-residual daytime sedation -blurred vision -headache -impaired coordination
Which condition is dopamine commonly used to treat?
-shock -hypertension
Why are benzodiazepines often preferred over barbiturates?
-they have selective action at specific receptor sites -there is a wide range of safety between therapeutic and lethal levels -REM sleep is decreased to a lesser extent -accidental overdoses are well tolerated
Which body function(s) is/are controlled by the autonomic nervous system?
-urination -body temperature -GI secretion -blood pressure
When teaching a patient who is starting therapy with NSAIDs, the nurse must be sure to mention drug interactions with which drug(s)?
-warfarin (coumadin) -lithium (eskalith) -diuretics
A nurse is caring for a client who has Alzheimer's disease. The nurse discovers the client entering the room of another client, who becomes upset and frightened. Which of the following actions should the nurse take?
Attempt to determine what the client was looking for
In which case would the nurse be correct in withholding an opiate agonist?
Respiratory rate of 10 breaths/min
Dopamine agonists have been linked with which adverse effects in patients with Parkinson's disease?
Sudden sleep events
A patient undergoing withdrawal from an opiate agonist asks the nurse how long the withdrawal symptoms will last. Which response by the nurse is best?
Symptoms peak in about 2 days and then disappear by the end of a week.
Why are beta blockers used cautiously in patients with respiratory conditions?
They may produce severe bronchoconstriction.
Which patient assessment would indicate to the nurse that salicylate toxicity is occurring?
Tinnitus
What is the primary response to alpha-1-receptor stimulation?
Vasoconstriction
What is the best way for the nurse to evaluate the effectiveness of the patient's opiate agonist?
Verbal report of 2 on a 1 to 10 scale
An older adult patient is to receive atenolol, a beta-adrenergic blocking agent. Prior to administration of the drug, the nurse assesses an apical pulse rate of 58 and notes ankle edema. Which action will the nurse take first?
Withhold the medication.
Before the initiation of anticholinergic medications, it is important for the nurse to screen patients for which condition?
closed-angle glaucoma
The nurse is caring for a patient taking a cholinergic agent. When auscultating lung sounds, the nurse notes inspiratory and expiratory wheezing bilaterally. The best action for the nurse to take would be to:
withhold the next dose and notify the physician.
What is the rationale for monitoring vital signs of patients receiving corticosteroids?
infection
The nurse cleansing the skin surface of a patient prior to injection will start at the:
injection site and work outward in a circular motion.
The nurse is preparing an otic solution. When instructing the patient in regard to area of administration, the nurse will explain that the solution will be placed:
into the ear.
The nurse transcribes an order for lorazepam for a patient experiencing nausea and vomiting as a result of alcohol withdrawal. The most appropriate route of administration for lorazepam with this patient would be:
intramuscularly
The nurse is preparing to administer a medication in tablet form to a patient. In administering this medication, the nurse will encourage the patient to:
keep the head forward while swallowing.
A patient is admitted with glomerulonephritis. IV gentamicin therapy is started after cultures indicate gram-negative bacilli in the blood. The patient also receives IV furosemide (Lasix). The nurse will monitor for signs and symptoms of toxicity related to which organ?
kidneys
The nurse is teaching a patient about how to improve sleep quality. Which information does the nurse include in the teaching plan?
"Avoid heavy meals late in the evening."
Which statement(s) made by a patient on a corticosteroid medication show(s) a need for further education?
"I will avoid weight-bearing measures."
The nurse is teaching a patient about the anticholinergic agent prescribed for urinary retention. Which statement by the patient indicates a need for further teaching?
"I will limit my fluid intake."
The nurse is providing education to a patient recently placed on selegiline disintegrating tablets. Which statement by the patient indicates a need for further teaching?
"I will place the tablet on my tongue before breakfast."
The nurse is teaching a patient with Parkinson's disease about levodopa. Which statement by the nurse is accurate regarding drug administration?
"Take this medication with food or antacids to reduce GI upset."
A patient with chronic obstructive pulmonary disease (COPD) reports having insomnia and a racing heart after starting terbutaline therapy. Which explanation by the nurse is most accurate?
"The symptoms will tend to resolve with continued therapy."
A patient with Parkinson's disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate?
"These drugs inhibit the action of acetylcholine."
A patient with a history of type 1 diabetes after myocardial infarction has been placed on a beta-adrenergic blocking agent. Which statement by the patient indicates a need for further teaching?
"This medication lowers my blood pressure by helping me get rid of fluid."
A patient with type 2 diabetes mellitus, which was previously controlled with an oral antidiabetic agent, is hospitalized for treatment of a leg ulcer. The healthcare provider has ordered sliding scale insulin coverage with regular insulin for hyperglycemia. The nurse brings the injection into the room, and the patient becomes upset, stating "I don't want to start taking that drug! I'll need it the rest of my life." What is the nurse's best response?
"Your body is under stress right now, which raises your blood glucose level. This does not mean you will be on this drug permanently. Once you're feeling better, your provider will determine if your oral medication is all you will need."
A patient with type 2 diabetes is being discharged on glucocorticoid (prednisone) therapy for rheumatoid arthritis. Which information will the nurse include in discharge teaching?
-"Daily, single-dose therapy should be taken in the morning." -"Steroids should never be discontinued abruptly." -"Blood glucose levels will be elevated on corticosteroid therapy." -"Signs and symptoms of infections may not be evident."
A postoperative total thyroidectomy patient is started on levothyroxine (Synthroid) daily. What information will the nurse include in discharge teaching?
-"Notify your healthcare provider if you experience any palpitations or tachycardia." -"A variation in emotions and personality is normal during this adjustment period." -"Close follow-up with your healthcare provider is important."
Which instruction(s) is/are most pertinent to include in the discharge teaching of a patient on lithium (Eskalith) who is being discharged?
-"Persistent vomiting and profuse diarrhea are signs of toxicity and must be reported to the healthcare provider immediately." -"It is important to comply with schedules for blood tests to assess therapeutic levels." -"The common adverse effects to expect, which are excessive nausea, anorexia, and abdominal cramps, tend to resolve." -"Take the medication with food or milk."
The nurse is planning to administer an ertapenem IV to a patient in the intensive care unit. When preparing this medication, the nurse will consider reconstituting it with:
-0.9% sodium chloride -bacteriostatic water -water
Which patient(s) would be able to take an alpha-adrenergic decongestant safely?
-18 year old man with cold symptoms -24 year old woman with allergic rhinitis
Which dietary control measures are used in the management of diabetes mellitus?
-50% intake of carbohydrates daily -Adjustments to daily meals according to age, metabolic stress, pregnancy, and advanced age and/or older adults -20% intake of proteins daily -Consistent carbohydrate diabetes meal plan
A 65-year-old man is diagnosed with type 2 diabetes mellitus. Which patient symptom(s) would indicate type 1 diabetes mellitus and not type 2?
-A 10-lb weight loss within the past month -Increased thirst over the past week -Ketoacidosis -Polyphagia
Which statement(s) regarding type 2 diabetes mellitus would be correct?
-A genetic predisposition exists for the development of type 2 diabetes mellitus. -Type 2 diabetes is more prevalent in overweight people older than 45 years. -Type 2 diabetes is often diagnosed after complications have resulted. -Women have a higher incidence of type 2 diabetes.
Which factor(s) affect(s) drug actions?
-body weight -age -illness -metabolic rate
Which disorder(s) would indicate the use of anticholinergic agents?
-bradycardia -parkinson's disease -preparation for surgery
Which statement(s) about liberation of drugs is/are true?
-A solid drug taken orally must disintegrate and dissolve in GI fluids to allow for absorption into the bloodstream for transport to the site of action. -The process of converting the drug into a soluble form can be controlled to a certain degree by the dosage form. -Converting the drug to a soluble form can be influenced by administering the drug with or without food in the patient's stomach. -A drug must be dissolved in body fluids before it can be absorbed into body tissues.
Which lab test(s) would be used to assess liver and/or renal function before administering medications?
-ALT -LDH -Crs -BUN
The nurse is preparing to administer zonisamide (Zonegran) to a newly admitted patient with the diagnosis of adult partial seizures. The nurse should hold this medication if the patient has which sign(s) or symptom(s)?
-Allergy to Bactrim -Pruritus -Skin rash
Which action(s) is/are true of antihistamines?
-Are systemically distributed. -Antagonize H1 receptors. -May be administered orally. -Reduce inflammation locally.
Which topically active aerosol steroids are highly effective for reducing sneezing, nasal itching, stuffiness, and rhinorrhea?
-Budesonide (Rhinocort Aqua) -Fluticasone (Flonase) -Beclomethasone (Beconase AQ) -Flunisolide (Nasarel)
A patient admitted to the hospital is exhibiting psychotic behavior. Which sign(s) and/or symptom(s) would support the diagnosis of psychosis?
-Changing the topic of conversation inappropriately -Deterioration of social functioning -Confirmation of hearing voices in his head -Reporting that the FBI has solicited important secret information from his phone conversations
Which statement(s) about variables that influence drug action is/are true?
-Chronic smokers may metabolize drugs more rapidly than nonsmokers. -A patient's attitude and expectations affect the response to medication. -Body weight can affect the therapeutic response of a medication.
Which clinical manifestation(s) would the nurse assess in a patient with hypothyroidism?
-Cold intolerance, weight gain -Hypoactive reflexes -Increased susceptibility to infection
In which way(s) is nursing diagnosis different from a medical diagnosis?
-Conditions can be accurately identified by nursing assessment methods -Statement of the patient's alterations in structure and functions -Description of the patient's ability to function in relation to impairment
The healthcare provider orders diazepam (Valium) 10 mg IV stat for a patient who was admitted with status epilepticus. What important nursing interventions(s) associated with administration of this medication IV should the nurse perform?
-Continuously assess the patient's airway. -Obtain the correct dose (10 mg) and administer over slow IV push. -Apply a cardiac monitor to the patient to assess for continuous heart rate, if not already done.
Which advantage(s) does the unit dose drug distribution system include?
-Credit is given to the patient for unused medications. -There is less waste of medications. -The pharmacist is able to analyze prescribed medications for each client for drug interactions and contraindications.
Which data will the nurse document when administering a PRN oral pain medication to a patient?
-Date, time, drug name, dosage, and route of administration -Signs and symptoms of adverse drug effects -Essential patient education about the drug completed -Evaluation of therapeutic effectiveness
Which action(s) by the nurse can foster patient responsibility for adhering to the therapeutic regimen?
-Determining the patient's level of understanding of content -Assessing the patient's readiness to learn -Determining the patient's education level and learning style
Which statement(s) regarding critical pathways is/are true?
-Enhanced communication for a variety of healthcare providers -Standardized and enhanced quality care -Efficient for specific diseases or case types
Which statement(s) is/are true regarding the nursing assessment of a patient with a respiratory disorder?
-Episodes of apnea are present in Cheyne-Stokes. -Clubbing of the fingernails is a sign of hypoxia. -As oxygen levels diminish, mental alertness will progressively deteriorate.
The nurse is preparing to administer allergy sensitivity testing to a patient. Which statement(s) pertain(s) to this type of administration?
-Equipment needed includes gloves, antiseptic pledget, metric ruler, and physician's order sheet. -Allergy sensitivity testing requires the intradermal route. -The needle should be inserted at a 15-degree angle with the needle bevel up.
NG medication administration includes which principle(s)?
-Flush the tube with 30 mL of water after drug administration. -The tube must be assessed for correct placement. -Tablets and capsules should be dissolved in water.
The psychiatric nurse is educating an elderly patient and family about antipsychotic drug therapy. When providing this education, the nurse will include which statement(s)?
-Full therapeutic response may require 6 to 8 weeks to be achieved. -Tardive dyskinesia may be reversible in early stages. -Rapid increase in dosages will increase the frequency of adverse effects.
Which are routes of drug excretion?
-GI tract, feces -Genitourinary (GU) tract, urine -Respiratory system, exhalation
Which drugs may reach toxic blood levels if administered with macrolide antibiotics?
-HMG-CoA reductase inhibitors -Digoxin -Benzodiazepines -Theophylline
The nurse is administering an oral medication to a 90-year-old patient who has difficulty swallowing pills. One of the medications to be administered is a spansule type capsule. What nursing consideration(s) should be applied in this case?
-Have an 8-oz glass of water available. -Wash hands before preparing medications and before administration. -Check with the pharmacist to see if the spansule medication comes in a liquid form. -Check the patient's ID band with the MAR to ensure patient rights are followed.
The nurse is assisting with postpartum care for a mother who has given birth to her fourth child. She reports a moderate amount of urinary incontinence since the birth of the third child and is concerned that this problem will worsen. Which instruction(s) may facilitate management of incontinence?
-Information of incontinence products and appliances -Instruction of proper wiping techniques to prevent bacterial infection -Importance of establishing a regular toileting schedule -Education on bladder training and Kegel exercises -Information on personal hygiene measures to prevent perianal breakdown
Why is a combination of antipsychotic agents with benzodiazepines useful in initial treatment of the agitated patient?
-It assists in calming the psychotic patient. -Benzodiazepines allow for lower dosages of antipsychotic agents to be used, thereby decreasing serious adverse effects seen with high-dose therapy.
Which statement(s) regarding gestational diabetes would be true?
-Most women with gestational diabetes have normal glucose tolerance postpartum. -Women need to be reevaluated postpartum to determine their classification with respect to glucose tolerance. -The risk of developing diabetes after pregnancy is increased. -Fetal development may be complicated as a result of gestational diabetes.
When does allergic rhinitis occur?
-Nasal mucosa become inflamed. -Histamine is released following allergen exposure. -Exposure as a result of an allergen produces inflammation.
The nurse is preparing education for a patient who has developed rebound nasal congestion resulting from use of topical decongestants. What information will the nurse include?
-Nasal steroid solutions can be used but may take several days to reduce inflammation and congestion. -Stop the topical decongestant at once. -For future topical decongestant use, follow the dosage directions daily. Do not overuse. -Use nasal saline spray to moisturize irritated mucosa.
Which nursing assessment(s) is/are important before the initiation of antidepressant therapy?
-Nonverbal interactions among patient and significant others present -Appearance and posture -Evaluation of the coherency, relevancy, and organization of thoughts in responses -Compliance with medication therapy within the last 2 months
A patient has been receiving home healthcare and IV antimicrobial therapy for osteomyelitis (infection of the bone) of the lower right leg for the past 4 weeks. What will the nurse assess to evaluate the effectiveness of the antimicrobial agent?
-Pain of the right leg -Complete blood count (CBC) and sedimentation rate laboratory values -Presence of edema, redness, or swelling in the right lower leg -Patient temperature
A patient admitted to a psychiatric facility is hallucinating, pacing, and acting highly suspicious. Based on this information, the nurse will take which action(s)?
-Provide high-protein, high-calorie foods. -Be open and direct when handling the patient
Which statement(s) is/are true regarding computerized prescriber order entry (CPOE)?
-Provides instant access to online information to facilitate patient care needs. -Facilitates review of drugs for appropriateness of dosages. -Facilitates review of ordered medications for potential drug interactions. -Integrates the ordering system with the pharmacy, laboratory, and nurses' stations.
What is included in the nursing management of the patient with generalized tonic-clonic seizure activity?
-Requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over -Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain -Placing padding around or under the patient's head
Which statement(s) is/are true regarding the pharmacologic actions of certain antidepressant drugs?
-SSRIs inhibit the destruction and reuptake of serotonin at the synaptic cleft. -Monocyclic antidepressants such as bupropion (Wellbutrin) have an unknown mechanism of action. -SNRIs prolong the action of neurotransmitters by decreasing the destruction of serotonin and norepinephrine.
A female patient is admitted to the adult psychiatric floor with a diagnosis of generalized anxiety disorder. Anxiolytic medications and group therapy have been prescribed. Evaluation of therapeutic outcomes related to her acute stay can be measured by which assessment(s)?
-She is able to attend and actively participate in group sessions. -She is able to sleep 5 hours during the night. -The tremor and pacing she exhibited on admission are reduced.
Which item(s) would be considered characteristic of the cognitive domain level of learning?
-Skill demonstration using a step-by-step approach -Relationship between prior experiences and new concepts -Incorporation of a person's previous experiences and perceptions
Fluoxetine, erythromycin, clarithromycin, ketoconazole, itraconazole, miconazole, vinblastine, ritonavir, and nefazodone may inhibit the metabolism of which drugs?
-Solifenacin -Tolterodine -Darifenacin
Which dressings would be appropriate to use for treating wounds with exudates?
-Sorbsan -Kaltostat -AlgiDERM
Which statement(s) is/are true regarding the types of medication orders?
-Standing orders indicate the number of specified doses of a medication to be given. -Renewal orders facilitate physician review before continuance of high-risk medications.
The nurse is preparing to instruct a patient and his wife on technique and importance of assessing pulse prior to taking heart medication. Which principle(s) of learning would be appropriate in this situation?
-The objectives/goal statements listed on the patient's care plan -The patient's understanding of the seriousness of his illness -The learning environment -The patient's and wife's learning styles
Which order(s) would be examples of percutaneous medication administration?
-Timolol 0.5% 1 drop to each eye daily -Silvadene 1% topically to affected area -Albuterol nebulizer 2.5 mg qid
The nurse transcribes a new order for ethacrynic acid (Edecrin) on a patient with edema resulting from cirrhosis of the liver. Which currently prescribed medication(s) should the nurse report to the ordering healthcare provider?
-Tobramycin -Prednisone -Digoxin
Which drug(s) interact(s) with SSRI agents?
-Tranylcypromine (Parnate) -Propranolol (Inderal) -Lithium (Eskalith) -Warfarin (Coumadin)
Which principle(s) would be when teaching a patient to use a steroid inhaler?
-When taking a steroid drug as well as a bronchodilator, the bronchodilator should be administered first. -Hold the breath for 10 seconds during inhalation of the medication. -Rinse and spit after inhalation of the medication. -Frequent oral hygiene is necessary.
Which principle(s) is/are correct for mixing insulin?
-Withdraw the shorter-acting insulin first. -Insulin orders and calculations must be checked with another nurse. -The nurse must verify the compatibility of the insulin types.
Which measure(s) for monitoring hydration and fluid balance would be inappropriate for the patient on steroid therapy?
-abdominal girth measurements -daily weights
A third subclass of diabetes mellitus includes additional types of diabetes that are part of other diseases having features not generally associated with the diabetic state. Which disorder(s) may have an associated diabetic component?
-acromegaly -cushing's syndrome -patient's receiving high-dose corticosteroid therapy for disease maintenance -malnutrition
Which intervention(s) will help stimulate urination when a patient is experiencing postoperative urinary retention?
-administration of bethanechol chloride (Urecholine) -pouring warm water over the perineum
Which food(s) containing significant amounts of tyramine will be contraindicated when a patient is on MAOI therapy?
-aged cheeses -beer -bananas
Which sign(s) and symptom(s) may occur in neuroleptic malignant syndrome?
-alterations in consciousness -hypertension -severe extrapyramidal symptoms -fever
A patient has been taking an antimicrobial agent prescribed to treat a UTI for 2 days. She contacts the healthcare provider's office to report persistence of symptoms. In evaluating the medication effectiveness, which assessment(s) would be important?
-amount of pain with urination as well as frequency -GI symptom complaints -complete emptying of the bladder -amount of daily fluid intake and output -bleeding with urination
Which substance(s) may increase the toxic effects of benzodiazepines?
-analgesics -sedatives -alcohol -antihistamines -hypnotics
The nurse administers B12 IM to a patient in a long-term care facility. After administering this medication, the nurse will:
-apply a small bandage to the site. -dispose of the used needle according to policy.
What will the nurse include in a teaching plan for a patient with depression being treated with amitriptyline (Elavil)?
-avoid alcohol and barbiturates -Dryness of the mouth is normal; sucking on sugar free hard candy and ice chips or chewing gum may help alleviate this problem. -Rise slowly from a supine or sitting position to avoid dizziness and orthostatic hypotension.
The nurse is instructing a patient about adverse effects associated with corticosteroid therapy. What information would be important to include?
-avoid crowds or people with an infection -monitor and care for your skin daily, change positions frequently -follow a diet low in sodium -During periods of physical or psychological stress, higher doses of corticosteroids are necessary. Contact your healthcare provider.
A patient has been diagnosed with rheumatoid arthritis and will begin daily oral corticosteroid treatment. Which baseline assessment(s) would be important for a patient receiving corticosteroids?
-baseline weight -blood pressure -electrolyte studies -hydration status
Patients taking phenytoin (Dilantin) for control of seizures must be aware of the risk for which adverse effect(s)?
-blood dyscrasias -gingival hyperplasia -sedation -hyperglycemia
The nurse must be sure to instruct the patient about which potential adverse effect(s) of tricyclic antidepressants?
-blurred vision -dryness of mouth, nose, and throat -constipation -urinary retention
Which principle(s) will the nurse include in a teaching plan for antihistamine therapy?
-blurred vision is an expected adverse effect -dietary fiber and fluids should be increased -do not take prescription medications unless approved by a physician
The nurse is administering Lomotil, a Schedule V drug. Which statement is true about this drug's classification?
Abuse potential for this drug is low.
Which nursing action is accurate when administering an IM injection using the Z-track method?
Add 0.5 mL of air to the syringe.
Which condition would require mineralocorticoid replacement?
Addison's disease
It is 2:00 PM and a patient who has been NPO since 12:00 AM for a bronchoscopy is complaining of a headache and shakiness and is extremely irritable. Vital signs are within normal limits, and a one touch glucose reads 50 mg/dL. Which action is most important for the nurse to take?
Administer glucagon subcutaneously.
What is a guideline for the nurse when administering phenytoin (Dilantin) intravenously?
Administer without mixing with other medications.
Which example best demonstrates safe drug administration by the nurse?
Administering an oral medication with the patient sitting upright
A patient with schizophrenia has been nonadherent with his home medication regimen. He requires frequent admissions to the intensive psychiatric unit for treatment of acute psychotic episodes. Which medication regimen would be appropriate for this patient?
Administration of depot antipsychotic medication
When is the ideal time for a nursing mother to take her own medications?
As soon as the infant finishes breastfeeding.
What is the appropriate nursing action when administering a vaginal suppository?
Ask the patient to urinate prior to insertion.
Which nursing action is most important when providing care to a patient diagnosed with a mood disorder?
Assess the patient for thoughts of suicide.
A patient has been prescribed lorazepam (Ativan), a benzodiazepine used to treat insomnia. Which action will the nurse take?
Assess the patient's blood pressure in sitting and lying positions.
The nurse is teaching a patient with a history of COPD to self-administer tiotropium (Spiriva) by dry powder inhalation. Which information provided by the nurse is accurate?
Avoid breathing into the mouthpiece.
Which instruction by the nurse is accurate to include when providing teaching to a patient recently diagnosed with diabetes who has been prescribed insulin?
Beta blockers can mask symptoms of hypoglycemia.
Lithium (Eskalith) is the drug of choice for which of the following disorders?
Bipolar disorders
What is the action of MAOIs on neurotransmitters?
Blocking their destruction
What is the mechanism of action of propylthiouracil?
Blocks synthesis of hormone in the thyroid gland.
What is the most reliable method to calculate a pediatric patient's medication dosage?
Body surface area (BSA)
Which assessment by the nurse is most important to obtain prior to performing allergy sensitivity testing?
Determine if the patient is using aspirin.
Which premedication assessment by the nurse is most important prior to the initiation of carbamazepine (Tegretol) therapy?
Determine patient's ancestry.
An adult patient is to receive two medications IM. Which action by the nurse is most important in order to mix the medications in one syringe?
Determine the compatibility of the medications.
The nurse is preparing to educate a patient and significant other about antianxiety medications before the patient's discharge. What is pertinent information to be included in the teaching plan?
Discuss, review, and validate the behavior monitoring system and intervention flow sheet the patient and significant other will continue to use following discharge.
What occurs with mania associated with bipolar disorder?
Distinct episodes of elation
What is the process by which a drug is transported by circulating body fluids to receptor sites?
Distribution
Which nursing diagnosis may be identified for a patient with hyperthyroidism?
Disturbed sleep pattern
What is the rationale for administering levodopa instead of dopamine for treatment of Parkinson's disease?
Dopamine does not cross the blood-brain barrier when administered orally.
Which site is identified by the posterior superior iliac spine and greater trochanter?
Dorsogluteal
What is the basis of the NANDA-I taxonomy?
Human response patterns
The nurse is preparing discharge instructions for a patient with a history of diabetes who has just been diagnosed with seizure disorder. The patient has been prescribed hydantoin therapy. What will the patient most likely experiencing?
Hyperglycemia
Meperidine (Demerol) is a narcotic with a high potential for physical and psychological dependency. Under which classification does this drug fall?
II
The nurse administers an initial dose of a steroid to a patient with asthma. Thirty minutes after administration, the nurse finds the patient agitated and stating that "everyone is out to get me." What is the term for this unusual reaction?
Idiosyncratic reaction
A patient is diagnosed with cancer and requires 6 months of chemotherapy infusions. Which type of intravenous (IV) access device will likely be used?
Implantable venous infusion port
Where does the nurse correctly administer ophthalmic medication?
In the lower conjunctival sac
What would the nurse anticipate if a patient with a history of type 2 diabetes is prescribed a thiazide diuretic?
Increased blood sugar levels
Which condition warrants the use of acetazolamide (Diamox) as a diuretic?
Increased intraocular pressure
The nurse is explaining the use of medications to a patient with insomnia. Which statement about sedatives is true?
Increased relaxation occurs with sedatives.
Which potential complication will the nurse expect in patients with a venous access device?
Infection
Which action by the nurse is most accurate when administering an intradermal injection?
Inject 0.1 mL.
Which action by the nurse is accurate when withdrawing medication into a syringe from a vial?
Inject an amount of air equal to the medication into the vial.
Which technique by the nurse is accurate when administering heparin to a thin, older adult patient?
Inject at a 45-degree angle.
What initiates the sneeze reflex?
Irritation of the nasal mucosa by foreign particulate matter
Which drug is the cornerstone of treatment for prophylaxis and treatment of tuberculosis (TB)?
Isoniazid (Nydrazid)
The nursing assessment identifies that the client is nauseated and cannot take acetaminophen (Tylenol) orally. Which is true regarding the substitution of this medication to suppository form?
It is contraindicated without an order from the healthcare provider.
The nurse is teaching a patient about nitroglycerin ointment. Which is an advantage of this form of the medication?
It provides relief of anginal pain for several hours longer than sublingual medication.
Which is true regarding psychological drug dependence?
It requires medical intervention to treat.
Following the insertion of a central venous access device, the nurse notes a weak, thready pulse and decreased blood pressure. The patient complains of shortness of breath and palpitations. Which action will the nurse take first?
Place the patient on the left side.
Which condition will neostigmine be used to treat?
Postoperative or postdelivery urinary retention
Which foods will the nurse recommend for a patient taking loop diuretics?
Potassium-rich foods such as raisins, figs, and bananas
What is the most important nursing consideration when teaching an older adult patient about a newly prescribed medication?
Present information slowly.
What is the rationale for the nurse applying gentle pressure to the inner corner of the eyelid after instilling eyedrops?
Prevents systemic effects.
What is the rationale for administering glucocorticoid therapy as an adjunct to chemotherapeutic agents?
Produces immunosuppression effects.
What occurs in the nasal structures when cholinergic fibers are stimulated?
Production of serous and mucous secretions in the nostrils
Which medication is used to treat hyperthyroidism?
Propylthiouracil (Propacil)
A patient on a high dosage of corticosteroids over a period of time may develop which type of psychiatric complication?
Psychotic behaviors
Which two phases make up normal sleep?
Rapid eye movement (REM) and non REM
Which will the nurse include in the teaching plan for a patient asking about the use of salt substitutes while on a sodium-restricted diet?
Salt substitutes may be high in potassium and should be used sparingly.
What can result if a patient overuses topical decongestants?
Secondary congestion
Which conditions may occur with the administration of broad-spectrum antibiotics over an extended period of time?
Secondary infection
In which position would the nurse place a patient before the administration of an enteral feeding?
Semi-Fowler's
On what is the selection of an antimicrobial agent based?
Sensitivity of the microorganism to the drug
Which patient assessment would alert the nurse to withhold a loop diuretic?
Serum potassium of 2.6 mEq/L
The nurse is reviewing lab work received on a patient admitted with the diagnosis of dehydration. The nurse will notify the physician of which lab value?
Serum sodium level: 115 mEq/L
A patient is seen in the emergency department. The patient had been maintained on theophylline (Theo Dur), and a blood sample reveals the serum theophylline level is subtherapeutic. Which may cause a subtherapeutic serum level?
Smoking
From where do the fluids of the respiratory tract originate?
Specialized mucous glands called goblet cells
The nurse finds that a patient is extremely agitated, yells frequently, and is attempting to get out of bed without assistance. What is the nurse's initial action?
Spend uninterrupted time listening to the patient.
Which medication is a potassium sparing diuretic?
Spironolactone (Aldactone)
Which sleep pattern stage diminishes as an effect of aging?
Stage IV
What do the classification systems NIC and NOC provide?
Standardized language for reporting and analyzing nursing care delivery
Which instruction is most important for the nurse to teach a patient with diabetes who is receiving metformin?
Stop taking the drug 24 to 48 hours prior to radiopaque dye procedures.
What is albuterol (Proventil) used to treat?
acute bronchospasm
The nurse transcribes a new order for liothyronine for a patient diagnosed with hypothyroidism. When educating the patient about this medication, the nurse will include that:
adverse effects may occur up to 3 weeks after changes in therapy have been initiated.
A patient is taking meperidine (Demerol) as needed for moderate to severe pain following an open appendectomy. The nurse assesses the following: current pain level 2, temperature 99°F, BP 130/76, respirations 10, lung sounds clear, abdomen soft and tender, bowel sounds present. Based on this assessment information, the priority nursing diagnosis is:
altered breathing pattern.
Which classification of medications commonly causes allergic reactions in children?
antibiotics
Which medication is contraindicated when a patient is taking warfarin (Coumadin)?
aspirin
Prior to the administration of a nephrotoxic drug, the nurse determines that the kidney lab data are within normal range. Which step of the nursing process is being used?
assessment
A 90-year-old woman is admitted to an acute care facility with the diagnosis of pneumonia. She has a past medical history of diabetes mellitus, hypertension, and right-sided mastectomy. When starting an IV for infusion of antibiotic therapy, the nurse will:
attempt insertion into the left antecubital space vein.
In assessing a patient with a central venous access device, which sign or symptom indicates that the patient is experiencing an air embolism?
chest pain
What structures in the respiratory tract assist in removing foreign bodies such as smoke and bacteria?
ciliary hairs
Which vitamin will reduce the therapeutic effects of levodopa?
b6
A patient has been on high-dose corticosteroid therapy for the treatment of lupus erythematosus. In addition to monitoring electrolyte levels, which laboratory studies will the nurse monitor?
blood glucose levels
Prior to the administration of metoprolol, a beta-adrenergic blocking agent, which is most important for the nurse to assess?
blood pressure
The physician has written an order for a drug with which the nurse is unfamiliar. Which section of the Physicians' Desk Reference (PDR) is most helpful to get information about this drug?
brand and generic name section
The nurse administers a skin prick test (SPT) to a patient at 9:00 AM. The earliest time the nurse can expect to read the test is:
by 9:10 AM the same day.
The pediatric nurse is caring for a patient diagnosed with refractory seizures. The physician orders a ketogenic diet. When the child receives his food tray, the nurse should remove any food containing high levels of:
carbohydrates
A patient allergic to penicillin is being evaluated for a gram-negative infection. Which antimicrobial drug class would the healthcare provider be cautious in prescribing because of a possible cross sensitivity and/or allergic reaction?
cephalosporins
When a patient taking a monoamine oxidase B inhibitor receives his dietary tray, the nurse knows to remove the:
cheese
The nurse is preparing to administer kindergarten immunizations at the local health clinic. Which anatomic site would be best for the injection of the immunizations containing 0.5 mL?
deltoid
Which sign or symptom displayed by a patient would be indicative of opiate withdrawal?
diarrhea
Which medication would require the nurse to monitor for changes in hepatic function and blood dyscrasias?
diazepam
A nurse is reinforcing teaching with a client who is taking benztropine to treat Parkinson's disease. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication?
difficulty voiding
A young male patient taking an antipsychotic is experiencing an oculogyric crisis. The nurse prepares to administer:
diphenhydramine.
What occurs when two drugs compete for the same receptor site, resulting in increased activity of the first drug?
displacement
A 2-year-old child is hospitalized with the diagnosis of tonsillitis and bilateral otitis media. The nurse is preparing to administer eardrops. When instilling the eardrops, the nurse will pull the earlobe:
downward and back
The nurse assesses which blood level to determine the amount of circulating medication in a patient?
drug
What is the definition of cumulative effect of a drug?
drug buildup related to decreased metabolism
The nurse is providing instruction about ipratropium (Atrovent) to a patient with chronic obstructive pulmonary disease (COPD). Which is a common adverse effect that tends to resolve with therapy?
dry mouth
The clinic nurse is assessing a patient being seen for a severe allergic reaction to environmental allergens. Which symptom should the nurse prioritize as the most important?
dyspnea
Which type of adverse effects is present when a patient displays prolonged tonic contractions of the tongue, oculogyric crisis, and torticollis?
dystonic reactions
A college student is being seen at an outpatient clinic with reports of allergic rhinitis and conjunctivitis. The healthcare provider orders fexofenadine. When providing information regarding this medication, the nurse will include statements indicating that:
fexofenadine is one of the least sedating antihistamines.
A patient taking vilazodone has been vomiting persistently for 12 hours. The priority nursing diagnosis for this patient is:
fluid volume deficit.
The nurse is about to administer a prescribed medication IV push into a patient's Hickman catheter. When providing this medication, the nurse will first:
flush with saline
When assessing aspirated stomach contents, the nurse notes the color to be green with sediment. The nurse is aware that this most likely represents ___________ fluid.
gastric
Which drug is incompatible with heparin?
gentamicin
A 37-year-old male presents at the emergency department reporting severe vomiting for the past 48 hours. When assessing skin turgor, the nurse will:
gently pinch the skin together over the sternum.
Premedication assessments before the use of anticholinergic bronchodilating agents should verify that the patient has no history of which condition?
glaucoma
The mother of a 6-year-old child informs the school nurse that the child is allergic to insect stings and requires an EpiPen. If the child is stung by an insect while in school, the nurse must:
hold the EpiPen perpendicularly against the thigh and activate.
Which is a serious adverse effect of decongestants?
hypertension
A patient is admitted to a long-term psychiatric setting. The MAOI medication previously prescribed is discontinued by the physician. New orders are obtained to initiate imipramine therapy. The nurse will provide the first dose of imipramine to the patient _____ the MAOI drug.
in 14 days following the last dose of
How often is fosfomycin (Monurol) usually administered when used in the treatment of UTIs?
in a one-time dose
A 65-year-old man who weighs 180 lb (81.8 kg) is to receive 1.5 mL of a viscous antibiotic by intramuscular (IM) injection. Which needle and syringe will be used?
inch, 21-gauge needle with 3 mL syringe
A patient taking rasagiline is assessed by the nurse to have a lasting significant increase in blood pressure. When reviewing the patient's current list of medications, the nurse decides to hold the next dose of:
ciprofloxacin
Which instruction(s) given by the nurse will assist a patient to cope with the common adverse effects of anticholinergic medications?
-increase fluids daily -suck on candy or ice chips
An 86-year-old patient who was admitted with GI bleeding as a result of salicylate therapy is being discharged. As the nurse reviews the discharge medication list, the patient states that she doesn't understand why Tylenol doesn't work as well as the aspirin she had been taking. What would be the nurse's best response?
"Tylenol does not help with inflammatory discomfort."
Which additional nursing intervention(s) would be effective with pain management in the pediatric population?
-Allow uninterrupted sleep and rest. -Provide diversional activities such as coloring, puzzles, and games. -Perform hygiene measures. -Encourage parental participation with caregiving to diminish the child's anxiety.
Which statement(s) is/are true about efferent nerves?
-They leave the CNS to carry impulses to other body parts. -They transmit signals that control contractions of some glandular secretions. -They are part of the peripheral nervous system. -They transmit signals that control contractions of smooth and skeletal muscles.
What point(s) should be included when teaching a patient about the use of apomorphine for treatment of Parkinson's disease?
-You may experience nausea and vomiting, which can be treated with trimethobenzamide (Tigan). -A multidose injector pen is commonly used to administer apomorphine. -You may experience sleep attacks or episodes of daytime sleepiness. -Apomorphine does not have any opioid activity.
What can occur as a result of rapid withdrawal from long-term use of barbiturate therapy?
-anxiety -delirium -weakness -grand mal seizures
Which common adverse effects might a patient experience when taking an anticholinergic agent?
-blurred vision -dryness of mouth
Which medications that may inhibit therapeutic activity for a patient receiving adranergic agents?
-bretylium tosylate (Bretylate) -propranolol (Inderal)
Which condition(s) may be managed by salicylates?
-fever -muscle aches -myocardial infarction -swollen joints
Neurotransmitter(s) include:
-histamine -epinephrine -serotonin -gamma aminobutyric acid
Which conditions are potentially more sensitive to the effects of adrenergic agents?
-impaired hepatic function -thyroid disease -heart disease
A nurse is teaching a group of newly licensed nurses about the progressive nature of Alzheimer's disease. Which of the following should the nurse include in the teaching as manifestations seen in the moderate stage of Alzheimer's disease?
-inability to perform common tasks -exhibits wandering behaviors
How long after the administration of a parenteral pain medication will the nurse complete the next pain assessment to evaluate the effectiveness of the medication?
30 minutes
Which patient is most at risk for a paradoxical response to a barbiturate characterized by excitement, restlessness, and confusion?
A 76-year-old with severe pain
Which category of medications is used for peripheral vascular diseases characterized by excessive vasoconstriction, such as Raynaud's disease?
Alpha-adrenergic blocking agents
In addition to facilitating sleep, what is another benefit of sedatives?
Decreased patient anxiety
A nurse is caring for a client who has Parkinson's disease and is taking selegiline 5 mg by mouth twice daily. Which of the following therapeutic outcomes should the nurse monitor for with a client who is taking this medication?
Decreased tremors
The nurse is providing information to a patient recently prescribed entacapone. Which statement is correct?
Dosage is adjusted according to the patient's response.
Which condition would alert the nurse of the need to use beta-adrenergic blockers cautiously?
Emphysema
What information is most accurate regarding the nurse's understanding of pain management?
Encourage patients to report pain before the pain becomes too severe.
The nurse is completing an assessment on a nonverbal adult patient. Which type of pain scale assessment tool is the most accurate to use?
FLACC
A nurse is caring for a client who has Alzheimer's disease and is confused. Which of the following actions should the nurse take?
Keep familiar personal items in client's room.
A patient asks the nurse why her doctor said she could take her "sleeping pill," which is a benzodiazepine, for no more than 4 weeks. Which information serves as the basis of the nurse's response?
Long-term use results in bizarre dreams and rebound insomnia when the drug is discontinued.
A nurse is caring for a client who is experiencing insomnia. Which of the following recommendations should the nurse make?
Maintain a consistent sleep and wake time.
Which medication does the nurse hold if a patient's vital signs are blood pressure 144/90 mm Hg, pulse 60, and respirations 10?
Morphine
Which medication would the nurse administer to a patient who is rating the pain at 8 on a 0 to 10 scale?
Morphine (Roxanol)
Which action will the nurse take when a patient receiving morphine sulfate via percutaneous coronary angioplasty (PCA) has a shallow, irregular respiratory rate of 6 breaths/min?
Notify the healthcare provider and prepare to administer naloxone (Narcan).
Which adverse effects associated with levodopa therapy would support the nursing diagnosis risk for injury?
Orthostatic hypotension
The nurse is assessing an older patient with Parkinson's disease who was started on entacapone 1 week ago. The patient has a history of coronary artery disease and takes an antihypertensive and aspirin. Which information would support the need for a reduction in medication dosage by the healthcare provider?
dizziness
A patient hospitalized in an acute care setting reports to the nurse that since starting on an adrenergic medication, he has been feeling "dizzy and weak." The most appropriate action for the nurse is to:
monitor the blood pressure in both the supine and standing positions.
An older adult patient received a hypnotic agent at 9:00 PM. At 2:00 AM, the nurse discovers that the patient has removed her gown and is attempting to get out of bed without assistance. What type of medication effect is the patient exhibiting?
paradoxical
What term is used to define an awareness of pain?
perception
When reviewing a patient's history and physical information, the nurse notes that the patient has physician's orders for chloral hydrate and warfarin. During assessment of this patient, the nurse observes areas of petechiae and ecchymosis on the upper and lower extremities. The most appropriate lab work for the nurse to assess next is:
prothrombin time
The nurse is assessing a patient's pain. When the patient describes his pain as cramping and burning, which component of the pain history is being addressed?
quality
