Pharm Test 2
The nurse is teaching a group of nursing students about the use of antipsychotic drugs for antiemetic purposes. The nurse will explain that, when given as antiemetics, these drugs are given a. in smaller doses. b. less frequently. c. with anticholinergics. d. with antihistamines.
A
A health care professional is reviewing the medical record of a patient who is to begin taking ranitidine (Zantac). Which of the following medications interacts with ranitidine? a. phenobarbital sodium (Luminal) b. ketoconazole c. lisinopril (Prinivil) d. hydrochlorothiazide (HydroDIURIL)
b
A health care professional should explain to a patient who is prescribed diphenhydramine that the most common side effect associate with the drug is a. muscle tremors b. sedation c. anxiety d. insomnia
b
A patient reports taking megadoses of vitamin C to prevent upper respiratory infections. The nurse will perform which action? a. Monitor the patient for hyperglycemia. b. Notify the provider and discuss a gradual taper of vitamin C. c. Request an order for a CBC to assess the patient's hemoglobin. d. Tell the patient that studies have confirmed this use of vitamin C.
b
A patient who has been receiving continuous enteral nutrition has had several large, watery stools. The nurse will contact the provider to discuss which intervention? a. Administering antidiarrheal medications b. Slowing the rate of infusion c. Starting total parenteral nutrition d. Thickening the nutrition solution
b
Vitamin A is stored in the liver, kidneys, and fat. How is it excreted? a. rapidly through the bile and feces b. slowly through the urine and feces c. rapidly through the bile only d. slowly through the feces only
b
What is a common side effect associated with enteral nutrition? a. constipation b. diarrhea c. urinary retention d. yeast infection
b
A health care professional should question the use of misoprostol (Cytotec) for a patient who has which of the following? a. a seizure disorder b. rheumatoid arhritis c. a positive pregnancy test d. heart failure
c
Protection of red blood cells from hemolysis is a role of which vitamin? a. A b. D c. E d. K
c
The patient has been involved in a motorcycle collision and has lost 1500 mL of blood from a pelvic fracture. Which mineral is essential for regeneration of hemoglobin? a. chromium b. copper c. iron d. selenium
c
The patient has recently had surgery and has been taking opioids for pain control. He has become constipated and has been prescribed a laxative. When providing health care teaching for this patient, what type of stool should the nurse tell the patient to expect? a. hard and dry b. liquid c. soft d. soft with hard pieces
c
What is the term used to describe the body fluid when the serum osmolarity is 285 mOsm/kg? a. hypoosmolar b. hyperosmolar c. isoomolar d. neoosmolar
c
A health care professional is caring for a patient who has recently had a myocardial infarction and is about to begin taking docusate sodium (Colace). The health care professional should explain that docusate sodium will have which of the following therapeutic effects? a. reduces inflammation b. reduces gastric acid c. prevents diarrhea d. prevents straining
d
A patient is taking a thiazide diuretic and reports anorexia and fatigue. The nurse suspects which electrolyte imbalance in this patient? a. Hypercalcemia b. Hypocalcemia c. Hyperkalemia d. Hypokalemia
d
The use of saline cathartics should be questioned by the nurse for which patient? a. 38-year-old with diabetes b. 48-year-old with peripheral vascular disease c. 50-year-old with chronic obstructive pulmonary disease (COPD) d. 62-year-old with heart failure
d
What is one of the effects of diphenhydramine? a. Anticoagulant b. Anticonvulsant c. Antihypertensive d. Antitussive
d
What is the advantage of systemic decongestants over nasal sprays and drops? a. Fewer side effects b. Less costly c. Preferred by older patients d. Provide longer relief
d
What is the average percentage of carbohydrates provided by TPN? a. <10% b. 10-20% c. 25-50% d. 60-70%
d
The nurse is administering hypertonic saline solution to treat a patient with severe hyponatremia. Which nursing intervention is the priority? a. monitor urinary output b. assess skin for flushing and assess increased thirst c. monitor temperature d. administer antiemetic for vomiting
v
A child is brought to the emergency department after ingestion of a toxic substance. The child is alert and conscious and is reported to have ingested kerosene 20 minutes prior. The nurse will anticipate administering a. activated charcoal. b. an anticholinergic antiemetic. c. gastric lavage. d. syrup of ipecac.
A
A patient is taking esomeprazole (Nexium) 15 mg per day to treat a duodenal ulcer. After 10 days of treatment, the patient reports that the pain has subsided. The nurse will counsel the patient to a. continue the medication for 4 more weeks. b. reduce the medication dose by half. c. stop taking the medication. d. take the medication every other day.
A
A patient reports having three to four stools, which are sometimes hard, per week. The nurse will perform which action? a. Recommend increased fluids and dietary fiber. b. Request an order for a laxative as needed. c. Request an order for a stool softener. d. Suggest discussing chronic constipation with the provider.
A
A patient who is receiving chemotherapy will be given dronabinol (Marinol) to prevent nausea and vomiting. The nurse will tell the patient that this drug will be given at which time? a. Before and after the chemotherapy b. During chemotherapy c. Immediately prior to chemotherapy d. 24 hours prior to chemotherapy
A
A patient who is taking diphenoxylate with atropine (Lomotil) to treat diarrhea asks the nurse why it contains atropine. The nurse will explain that atropine is added to a. decrease abdominal cramping. b. increase intestinal motility. c. minimize nausea and vomiting. d. provide analgesia.
A
A patient who takes propantheline bromine (Pro-Banthine) and omeprazole (Prilosec) for an ulcer will begin taking an antacid. The nurse will give which instruction to the patient regarding how to take the antacid? a. Take the antacid 2 hours after taking the propantheline. b. Take the antacid along with a meal. c. Take the antacid with milk. d. Take the antacid with the propantheline bromine.
A
An appropriate goal when teaching a patient who has diarrhea is that the patient a. will have less frequent, more formed stools. b. will not have a stool for 1 to 2 days. c. will receive adequate intravenous fluids. d. will receive appropriate antibiotic therapy.
A
The child who is a candidate for treatment with syrup of ipecac after ingestion of a toxic substance or overdose is the child who has ingested which substance? a. Acetaminophen elixir b. Chlorine bleach c. Kerosene d. Toilet cleanser
A
The nurse is caring for a patient who has Zollinger-Ellison syndrome. Which medication order would the nurse question for this patient? a. Cimetadine (Tagamet) b. Pantoprazole (Protonix) c. Rabeprazole (Aciphex) d. Ranitidine (Zantac)
A
The nurse is instructing a patient who will take psyllium (Metamucil) to treat constipation. What information will the nurse include when teaching this patient? a. The importance of consuming adequate amounts of water b. The need to monitor for systemic side effects c. The onset of action of 30 to 60 minutes after administration d. The need to use the dry form of Metamucil to prevent cramping
A
The nurse is teaching a group of parents about the use of syrup of ipecac. Which instruction will the nurse provide? a. "Do not administer ipecac without consulting a poison control center." b. "Expect the onset of emesis to be immediate." c. "Give ipecac with a glass of milk to increase its emetic effect." d. "Use ipecac fluid extract and not ipecac syrup."
A
The nurse is teaching a patient who is about to take a long car trip about using dimenhydrinate (Dramamine) to prevent motion sickness. What information is important to include when teaching this patient? a. "Do not drive while taking this medication." b. "Dry mouth is a sign of toxicity with this mediation." c. "Take the medication 1 to 2 hours prior to beginning the trip." d. "Take 100 mg up to 6 times daily for best effect."
A
A patient who recently began having mild symptoms of GERD is reluctant to take medication. What measures will the nurse recommend to minimize this patient's symptoms? (Select all that apply.) a. Avoiding hot, spicy foods b. Avoiding tobacco products c. Drinking a glass of red wine with dinner d. Eating a snack before bedtime e. Taking ibuprofen with food f. Using a small pillow for sleeping g. Wearing well-fitted clothing
A, B, E
A male patient who has been taking a histamine2 blocker for several months reports decreased libido and breast swelling. What will the nurse do? a. Contact the provider to report possible drug toxicity. b. Reassure the patient that these symptoms will stop when the drug is discontinued. c. Request an order for serum hormone levels. d. Suggest that the patient see an endocrinologist.
B
A patient asks the nurse the best way to prevent traveler's diarrhea. The nurse will provide which recommendation to the patient? a. "Ask your provider for prophylactic antibiotics." b. "Drink bottled water and eat only well-cooked meats." c. "Eat fresh, raw fruits and vegetables." d. "Take loperamide (Imodium) every day."
B
A patient who has been instructed to use a liquid antacid medication to treat gastrointestinal upset asks the nurse about how to take this medication. What information will the nurse include when teaching this patient? a. Take a laxative if constipation occurs. b. Take 60 minutes after meals and at bedtime. c. Take with at least 8 ounces of water to improve absorption. d. Take with milk to improve effectiveness.
B
A patient with a peptic ulcer has been diagnosed with H. pylori. The provider has ordered lansoprazole (Prevacid), clarithromycin (Biaxin), and metronidazole (Flagyl). The patient asks the nurse why two antibiotics are needed. The nurse will explain that two antibiotics a. allow for less toxic dosing. b. combat bacterial resistance. c. have synergistic effects. d. improve acid suppression.
B
The nurse is caring for a patient who has unexplained, recurrent vomiting and who is unable to keep anything down. Until the cause of the vomiting is determined, the nurse will anticipate administering which medications? a. Antibiotics and antiemetics b. Intravenous fluids and electrolytes c. Non-prescription antiemetics d. Prescription antiemetics
B
The parent of a child who is receiving chemotherapy asks the nurse why metoclopramide (Reglan) is not being used to suppress vomiting. The nurse will explain that, in children, this drug is more likely to cause which effect? a. Excess sedation b. Extrapyramidal symptoms c. Paralytic ileus d. Vertigo
B
Which antacid is likely to cause acid rebound? a. Aluminum hydroxide b. Calcium carbonate c. Magnesium hydroxide d. Magnesium trisilicate
B
A patient reports experiencing flatulence and abdominal distension to the nurse. Which over-the-counter medication will the nurse recommend? a. Alka-Seltzer b. Maalox c. Mylicon d. Tums
C
A patient who is diagnosed with peptic ulcer disease has been started on a regimen that includes ranitidine (Zantac) 300 mg daily at bedtime. The patient calls the clinic 1 week later to report no relief from discomfort. What action will the nurse take? a. Contact the provider to discuss changing to cimetidine (Tagamet). b. Notify the provider to discuss increasing the dose. c. Reassure the patient that the drug may take 1 to 2 weeks to be effective. d. Suggest that the patient split the medication into twice daily dosing.
C
A woman who is 2 months pregnant reports having morning sickness every day and asks if she can take any medications to treat this problem. The nurse will recommend that the patient take which action first? a. Contact the provider to discuss a possible need for intravenous fluids. b. Contact the provider to discuss a prescription antiemetic. c. Use nonpharmacologic measures such as saltines. d. Take over-the-counter antiemetics such as diphenhydramine.
C
A patient asks the nurse about using loperamide (Imodium) to treat infectious diarrhea. Which response will the nurse give? a. "Loperamide results in many central nervous system (CNS) side effects." b. "Loperamide has no effect on infectious diarrhea." c. "Loperamide is taken once daily." d. "Loperamide may prolong the symptoms."
D
A patient has been taking famotidine (Pepcid) 20 mg bid to treat an ulcer but continues to have pain. The provider has ordered lansoprazole (Prevacid) 15 mg per day. The patient asks why the new drug is necessary, since it is more expensive. The nurse will explain that lansoprazole a. can be used for long-term therapy. b. does not interact with other drugs. c. has fewer medication side effects. d. is more potent than famotidine.
D
A patient who has been taking ranitidine (Zantac) continues to have pain associated with peptic ulcer. A noninvasive breath test is negative. Which treatment does the nurse expect the provider to order for this patient? a. Adding an over-the-counter antacid to the patient's drug regimen b. A dual drug therapy regimen c. Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec) d. Lansoprazole (Prevacid) instead of ranitidine
D
A patient who has symptoms of peptic ulcer disease will undergo a test that requires drinking a liquid containing 13C urea and breathing into a container. The nurse will explain to the patient that this test is performed to a. assess the level of hydrochloric acid. b. detect H. pylori antibodies. c. measure the pH of gastric secretions. d. test for the presence of 13CO2.
D
An elderly patient reports using Maalox frequently to treat acid reflux. The nurse should notify the patient's provider to request an order for which laboratory tests? a. Liver enzymes and serum calcium b. Liver enzymes and serum magnesium c. Renal function tests and serum calcium d. Renal function tests and serum magnesium
D
The nurse is caring for a patient who has postoperative nausea and vomiting. The surgeon has ordered promethazine HCl (Phenergan). Which aspect of this patient's health history would be of concern? a. Asthma b. Diabetes c. GERD d. Glaucoma
D
The nurse is caring for a patient who will begin taking omeprazole (Prevacid) 20 mg per day for 4 to 8 weeks to treat gastroesophageal reflux disease esophagitis. The nurse learns that the patient takes digoxin. The nurse will contact the provider for orders to a. decrease the dose of omeprazole. b. increase the dose of digoxin. c. increase the omeprazole to 60 mg per day. d. monitor for digoxin toxicity.
D
The nurse is caring for an older adult who is receiving diphenoxylate with atropine (Lomotil) to treat severe diarrhea. The nurse will monitor this patient closely for which effect? a. Bradycardia b. Fluid retention c. Nervousness and tremors d. Respiratory depression
D
A patient has taken metaproterenol (Alupent). What is the nurse's priority action? a. Monitoring for heart rate >100 beats/min b. Telling the patient not to drive for 2 hours c. Monitoring for sedation d. Assessing for elevated blood pressure
a
A child is brought to the emergency department after ingesting a grandparent's warfarin (Coumadin) tablets. The nurse will anticipate administering which form of vitamin K? a. K1 (phytonadione) b. K2 (menaquinone) c. K3 (menadione) d. K4 (menadiol)
a
A female patient who has a history of heavy menstrual periods is experiencing shortness of breath with exertion, pallor, and fatigue. Her hemoglobin and hematocrit levels are both lower than normal, and her CBC reveals microcytic and hypochromic erythrocytes. What will the nurse do? a. Contact the provider to discuss an order for 600 mg of PO ferrous sulfate BID. b. Recommend an over-the-counter folic acid supplement of 400 mcg/day. c. Suggest an over-the-counter iron supplement of 325 mg/day. d. Tell her to consult a dietician about including iron-rich foods in her diet.
a
A health care professional is assessing a client who was administered ondansetron (Zofran) IV 1 hr ago. Which of the following findings is an adverse effect of this drug? a. dizziness b. rash c. tardive dyskinesia d. abdominal cramping
a
A health care professional is caring for an older adult patient who is about to begin taking cimetidine (Tagamet) to treat a duodenal ulcer. The health care professional should tell the patient to report which of the following adverse reactions? a. lethargy b. cellulitis c. dry mouth d. myalgia
a
A health care professional should question the use of metoclopramide (Reglan) for a patient who is taking which of the following drugs? a. digoxin (Lanoxin) b. warfarin (Coumadin) c. fluvoxamine (Luvox) d. allopurinol (Zyloprim)
a
A nurse is providing instructions about the use of laxatives to a client who has heart failure. The nurse should tell the client he should avoid which of the following laxatives? a. sodium phosphate b. psyllium c. bisacodyl d. polyethylene glycol
a
A parent calls the nurse to report that a 5-year-old child has taken five children's vitamins. Which action will the nurse take first? a. Ask whether the vitamins contain iron. b. Reassure the parent that over-the-counter vitamins are not toxic. c. Recommend that the parent take the child to the emergency department (ED). d. Tell the parent to watch for tarry stools and report them immediately.
a
A patient asks the nurse about taking calcium supplements to avoid hypocalcemia. The nurse will suggest that the patient follow which instruction? a. Take a calcium and vitamin D combination supplement. b. Take calcium along with phosphorus to improve absorption. c. Take calcium with antacids to reduce stomach upset. d. Use aspirin instead of acetaminophen when taking calcium.
a
A patient has been diagnosed with erosive GERD. Which drug is likely to have the highest success rate? a. esomeprazole b. lansoprazole c. omeprazole d. rabeprazole
a
A patient is admitted with orthopnea, cough, pulmonary crackles, and peripheral edema. The patient's urine specific gravity is 1.002. The nurse will expect this patient's provider to order which treatment? a. Diuretics b. Colloidal IV fluids c. Hypertonic IV fluids d. Hypotonic IV fluids
a
A patient is receiving high-molecular weight dextran after an explosion has burned over 50% of his body. What is the purpose of this fluid? a. temporarily restore circulating volume b. serve as a line to infuse blood into c. piggyback fluid for antibiotics d. whole blood substitute
a
A primary care provider should use caution when prescribing bisacodyl (Dulcolax) for a patient who has: a. anorexia nervosa b. myelosuppression c. hypomagnesemia d. diabetes mellitus
a
Magnesium deficiencies are frequently associated with which other electrolyte imbalance? a. hypocalcemia b. hyperkalemia c. hyponatremia d. hypophophatemia
a
The health care provider has indicated that the patient requires an elemental commercial enteral feeding preparation. The nurse anticipates that the provider will order which preparation? a. Criticare HN b. Sustacal c. Ensure d. Meritene
a
The nurse assesses a patient's laboratory results and finds a decreased white blood cell count as well as evidence of anemia. The nurse suspects that a vitamin deficiency is the source of the change in lab values. Based on the results, the patient is most likely to be experiencing a deficiency of which vitamin? a. folic acid b. Vitamin A c. Vitamin B6 d. Vitamin B1
a
The nurse assumes care for a patient who is being treated with enteral feeding. When performing the initial assessment, the nurse finds the patient supine and asleep. The nurse will perform which action? a. Elevate the head of the bed 30 degrees. b. Flush the tubing with water. c. Position the patient to the left side. d. Temporarily discontinue the infusion.
a
The nurse assumes care of a patient who has been receiving intermittent enteral feedings of 240 mL of Osmolite every 4 hours for the past 48 hours. The patient is in bed with the head of the bed elevated 60 degrees. The enteral tubing is intact, and the enteral pump is infusing at 360 mL per hour. The nurse notes 60 mL of solution left in the bag. The tubing is not labeled. What will the nurse do? a. Change and label the enteral tubing when this infusion is complete. b. Increase the infusion rate to 480 mL per hour to complete the infusion. c. Lower the head of the bed to 30 degrees. d. Stop the infusion and check for residual before resuming the infusion.
a
The nurse has taught the patient how to take his oral potassium supplement. Which statement by the patient indicates that he requires more education on taking this drug? a. "I can take this with a few sips of water." b. "It may upset my stomach." c. "I should drink at least six ounces of water or juice when I take it." d. "I must not chew up the tablet."
a
The nurse identifies that the patient has been ordered Compleat. The nurse recognizes that Compleat is an example of which type of commercial enteral feeding preparation? a. Blenderized b. Polymeric c. Lactose-free d. Elemental
a
The nurse is assessing a patient who follows a vegan diet. What assessment is highest priority for the nurse to make? a. assess for vitamin B12 deficiency b. assess for vitamin A deficiency c. assess for impaired elimination d. assess for bleeding disorders
a
The nurse is caring for a newly admitted patient who has severe gastroenteritis. The patient's electrolytes reveal a serum sodium level of 140 mEq/L and a serum potassium level of 3.5 mEq/L. The nurse receives an order for intravenous 5% dextrose and normal saline with 20 mEq/L potassium chloride to infuse at 125 mL per hour. Which action is necessary prior to administering this fluid? a. Evaluate the patient's urine output. b. Contact the provider to order arterial blood gases. c. Request an order for an initial potassium bolus. d. Suggest a diet low in sodium and potassium.
a
The nurse is caring for a patient who has a heart rate of 98 beats per minute and a blood pressure of 82/58 mm Hg. The patient is lethargic, is complaining of muscle weakness, and has had gastroenteritis for several days. Based on this patient's vital signs, which sodium value would the nurse expect? a. 126 mEq/L b. 140 mEq/L c. 145 mEq/L d. 158 mEq/L
a
The nurse is caring for a patient who is being treated with total parenteral nutrition (TPN). The patient is experiencing chest pain, and the nurse observes shortness of breath and coughing along with cyanosis. The nurse understands that this patient is most likely experiencing which condition? a. Air embolism b. Pneumonia c. Pneumothorax d. Pulmonary edema
a
The nurse is caring for a patient who is receiving isotonic intravenous (IV) fluids at an infusion rate of 125 mL/hour. The nurse performs an assessment and notes a heart rate of 102 beats per minute, a blood pressure of 160/85 mm Hg, and crackles auscultated in both lungs. Which action will the nurse take? a. Decrease the IV fluid rate and notify the provider. b. Increase the IV fluid rate and notify the provider. c. Request an order for a colloidal IV solution. d. Request an order for a hypertonic IV solution.
a
The nurse is caring for a patient who is receiving oral potassium chloride supplements. The nurse notes that the patient has a heart rate of 120 beats per minute and has had a urine output of 200 mL in the past 12 hours. The patient reports abdominal cramping. Which action will the nurse take? a. Contact the provider to request an order for serum electrolytes. b. Encourage the patient to consume less fluids. c. Report symptoms of hyperchloremia to the provider. d. Request an order to increase the patient's potassium dose.
a
The nurse is caring for a patient who is receiving total parenteral nutrition (TPN). The nurse will carefully monitor this patient for which symptom(s)? a. Coughing and shortness of breath b. Decreased breath sounds c. Diarrhea d. Nausea and abdominal distension
a
The nurse is caring for a patient who weighs 75 kg. The patient has intravenous (IV) fluids infusing at a rate of 50 mL/hour and has consumed 100 mL of fluids orally in the past 24 hours. Which action will the nurse take? a. Contact the provider to ask about increasing the IV rate to 90 mL/hour. b. Discuss with the provider the need to increase the IV rate to 150 mL/hour. c. Encourage the patient to drink more water so the IV can be discontinued. d. Instruct the patient to drink 250 mL of water every 8 hours.
a
The nurse is caring for a patient who will receive 10% calcium gluconate to treat a serum potassium level of 5.9 mEq/L. The nurse performs a drug history prior to beginning the infusion. Which drug taken by the patient would cause concern? a. Digitalis b. Hydrochlorothiazide c. Hydrocortisone d. Vitamin D
a
The nurse is caring for a patient whose serum sodium level is 140 mEq/L and serum potassium level is 5.4 mEq/L. The nurse will contact the patient's provider to discuss an order for a. a low-potassium diet. b. intravenous sodium bicarbonate. c. Kayexalate and sorbitol. d. salt substitutes.
a
The nurse is caring for an adult with severe burns who weighs 60 kg. Prior to initiating total parenteral nutrition (TPN) therapy, the nurse reviews the orders. Which TPN order is correct for this patient? a. 3000 kcal, 120 g amino acids per day b. 2400 kcal, 50 g amino acids per day c. 1500 kcal, 100 g amino acids per day d. 3600 kcal, 150 g amino acids per day
a
The nurse is caring for an older adult patient who arrives at the health clinic complaining of fatigue, lack of appetite, and changes in his vision. The nurse suspects that the symptoms may be related to a vitamin deficiency. Based on the symptoms, the patient is most likely to be experiencing a deficiency of which vitamin? a. Vitamin B1 b. Vitamin B2 c. Vitamin B6 d. Vitamin B12
a
The nurse is performing an assessment on a patient brought to the emergency department for treatment for dehydration. The nurse assesses a respiratory rate of 26 breaths/minute, a heart rate of 110 beats/minute, a blood pressure of 86/50 mm Hg, and a temperature of 39.5° C. The patient becomes dizzy when transferred from the wheelchair to a bed. The nurse notes cool, clammy skin. Which diagnosis does the nurse suspect? a. Fluid volume deficit (FVD) b. Fluid volume excess (FVE) c. Mild extracellular fluid (ECF) deficit d. Renal failure
a
The nurse is preparing to administer an enteral feeding to a patient who receives 300 mL of Isocal over 30 minutes every 4 hours. The nurse checks the residual prior to initiating the feeding and notes a residual amount of 50 mL of formula. Which action will the nurse take next? a. Administer the feeding as ordered. b. Administer the feeding over 60 minutes. c. Hold the feeding and notify the patient's provider. d. Wait 1 hour and recheck the residual again.
a
The nurse is preparing to administer enteral nutrition to a patient who has had a stroke and who cannot swallow. A family member asks why the patient isn't receiving intravenous nutrition. What information will the nurse provide to the family member? a. Parenteral nutrition carries a higher risk of infection. b. Parenteral nutrition does not provide sufficient calories. c. Parenteral nutrition increases the risk of aspiration. d. Parenteral nutrition is hyperosmolar and increases the risk of dehydration.
a
The nurse is reviewing a patient's medication history and notes that the patient is taking vitamin K. What is highest priority for the nurse to assess? a. coagulation studies b. confusion c. diarrhea d. seizure activity
a
The nurse is teaching a patient about water-soluble vitamins. Which statement by the patient indicates understanding of the teaching? a. "Water-soluble vitamins are excreted in the urine." b. "Water-soluble vitamins are generally toxic." c. "Water-soluble vitamins are highly protein-bound." d. "Water-soluble vitamins are usually metabolized in the liver."
a
The nurse is teaching a patient who has iron-deficiency anemia about iron supplementation. Which statement by the patient indicates understanding of the teaching? a. "I may improve iron absorption by taking this with orange juice." b. "I should take iron tablets with an antacid to reduce gastrointestinal upset." c. "Nausea and vomiting are minor side effects and will decrease over time." d. "Taking iron with food will help to increase the amount absorbed."
a
The older adult patient has a history of hypertension, arthritis, and diabetes. Which formula does the nurse anticipate will be ordered? a. Glucerna b. Ensure c. Criticare HN d. Peptamen
a
The patient has a serum potassium level of 3.2 mEq/L and has been prescribed an extended-release potassium supplement. She asks the nurse why she has to take the supplement. What it he nurse's best response? a. "A low possum level can be dangerous, and your level of 3.2 mEq/L is low and should be corrected." b. "You will only be on the drug for a few days, so don't worry." c. "You obviously aren't taking enough in your diet, so you have to take this." d. "Have you been constipated lately? Constipation will cause a low potassium level."
a
The patient has been prescribed a treatment regimen that includes nizatidine (Axid). Which statement by the patient indicates a therapeutic outcome? a. "I don't have any more stomach pain." b. "My constipation has been relieved." c. "I don't have such frequent headaches." d. "My anxiety has been under control."
a
The patient has cancer and is being treated with dronabinol for nausea and vomiting caused by chemotherapy. When should this drug be administered? a. 1-3 hours before chemotherapy b. 12 hours before chemotherapy c. 6 hours before chemotherapy d. every 4-6 hours as needed
a
The patient has pancreatitis. The nurse knows he is at risk for which electrolyte abnormality? a. hypocalcemia b. hypernatremia c. hypomagnesemia d. hyperkalemia
a
The patient is ordered an isotonic intravenous fluid. Which intravenous fluid is most likely to be ordered by the health care provider? a. normal saline b. 5% dextrose and normal saline (D5NS) c. 5% dextrose and lactated Ringer's (D5LR) d. 0.33% NaCl
a
The patient is receiving a bolus feeding through a gastrostomy tube and develops diarrhea. What is a priority nursing intervention? a. slow the bolus feedings b. finish the bolus and continue to monitor the patient c. stop the feeding and administer an antispasmodic d. call the health care provider
a
The patient is scheduled or a barium enema and has a prescription for bisacodyl the day before the procedure. She asks the nurse to explain how this drug works to prepare her for the test. What is the nurse's best response? a. "Bisacodyl increases peristalsis by irritating the lining of the intestines." b. "By stimulating more smooth muscle contraction, bisacodyl will cause our bowel to empty." c. "Bisadoyl increases water in the gut." d. "Bisacodyl is an emetic, so you will vomit and your stomach will be empty for the test."
a
The patient presents for her annual well-woman exam. She states that she does not take any drugs but she knows she supposed to take "some supplement in case I get pregnant." What is the nurse's best response? a. "Folic acid supplements are recommended in women who may become pregnant to prevent neural tube defects." b. "Vitamin A 8000 units should eat taken to promote bone growth." c. "Megadoses of iron are important for blood formation." d. "Vitamin C 1600 mg should be taken to prevent colds, which are more common in pregnant."
a
The patient receiving enteral feedings has poor skin turgor, and urinary output is 40 mL/hr. What is the nurse's first intervention? a. assess fluid intake b. call the health care provider c. assess blood pressure d. monitor hemoglobin and hematocrit
a
What is a priority nursing intervention when administering ranitidine (Zantac)? a. administer just before meals b. administer right after eating c. administer 1 to 2 hours after meals d. administer during meals
a
What is the goal behind giving activated charcoal? a. absorb poison b. cause diarrhea c. promote vomiting d. stop nausea
a
Which body fluid has a similar composition to lactated Ringer's IV solution? a. plasma b. skin c. tears d. white blood cells
a
Which is the priority intervention when the nurse is assessing a patient with a potassium level of 3.2 mEq/L? a. attach telemetry leads for monitoring. b. apply oxygen. c. administer Kayexalate. d. start IV fluids.
a
Which vitamin or mineral is responsible for collagen synthesis? a. Vitamin C b. Vitamin D c. Iron d. Zinc
a
With how many ounces of water should a patient take a liquid antacid for best results? a. 2-4 b. 4-6 c. 6-8 d. 8 or more
a
A 24-year-old patient has been prescribed large doses of vitamin A as treatment for acne. What will the nurse advise this patient? (Select all that apply.) a. Contact the health care provider concerning drug dosing. b. Report peeling skin, anorexia, or nausea and vomiting to the health care provider. c. Do not exceed the recommended dosage without consulting the health care provider. d. Avoid alcohol consumption. e. Megadoses of vitamin A are necessary for several months to alleviate acne.
a, b, c, d
What priority information regarding nonpharmacologic treatment can the nurse provide in the health education plan to a patient who has been diagnosed with GERD? (Select all that apply.) a. decrease or stop smoking b. elevate the head of the bed c. increase fluid intake d. NSAIDs should be taken with food e. spicy foods should be avoided
a, b, d, e
Which side effect(s) of ranitidine will the the nurse monitor in the patient? (Select all that apply.) a. confusion b. headache c. hypertension d. loss of libido e. nausea
a, b, d, e
The patient has been diagnosed with an ulcer caused by H. pylori. Which drug(s) is/are likely to be used for treatment? (Select all that apply.) a. amoxicillin b. clarithromycin c. famotidine d. misoprostol e. omeprazole
a, b, e
The patient has had diarrhea for several days and has a serum calcium level of 7.2 mg/dL. What clinical manifestations will the nurse expect to see in this patient? (Select all that apply.) a. hyperactive deep tendon reflexes b. irritability c. numbness of the fingers d. pathologic fractures e. tetany
a, b, e
What are the best reasons enteral feedings should be used before TPN? (Select all that apply.) a. less costly b. less risk for aspiration c. lower risk of infection d. maintenance of GI integrity e. promotes better wound healing
a, c, d
Which complication(s) is/are associated with the use of TPN? (Select all that apply.) a. air embolism b. aspiration c. hyperglycemia d. pneumothorax
a, c, d
A health care professional is about to administer ondansetron (Zofran) to a patient who is receiving chemotherapy. Which of the following actions should the health care professional take? (Select all that apply.) a. Infuse the drug 30 min prior to chemotherapy. b. Administer the drug when the patient reports nausea. c. Infuse the drug slowly over 15 min. d. Administer the drug immediately following chemotherapy. e. Repeat the dose 4 hr after chemotherapy.
a, c, e
The nurse is caring for a patient receiving total parenteral nutrition (TPN). Which interventions will the nurse include in the patient's plan of care? Select all that apply. a. monitor blood glucose levels b. protect the solution from exposure to light at all times c. monitor the patient for changes in temperature d. accelerate the rate of infusion to keep the infusion on time as needed e. monitor intake and output f. keep TPN solution that is not in use at room temperature
a, c, e
The patient has a serum potassium level of 6.1 mEq/L. What clinical manifestation(s) should the nurse expect to assess in this patient? (Select all that apply.) a. abdominal cramps b. muscle weakness c. oliguria d. paresthesias of the face d. tachycardia and later bradycardia
a, d, e
Which area(s) in the brain cause(s) vomiting when stimulated? (Select all that apply.) a. chemoreceptor trigger zone b. nausea center c. medulla d. vertigo center e. vomiting center
a, e
A patient is suspected of having severe hypocalcemia. While waiting for the patient's serum electrolyte results, the nurse will assess for which symptoms? (Select all that apply.) a. Laryngeal spasms b. Fatigue c. Muscle weakness d. Nausea and vomiting e. Numbness of fingers f. Twitching of the mouth
a, e, f
A health care professional should question the use of dimenhydrinate for a patient who has which of the following disorders? a. hyperthyroidism b. angle-closure glaucoma c. hypertension d. diabetes mellitus
b
A nurse is caring for a client who has diabetes and is experiencing nausea due to gastroparesis. The nurse should anticipate a prescription for which of the following medications? a. Lubiprostone b. Metoclopramide c. Bisacodyl d. Loperamide
b
A patient asks the nurse about whether it is necessary to take vitamin supplements. The patient is a 26-year-old female who is contemplating pregnancy. The nurse will recommend which supplement? a. Calcium and vitamin D b. Folic acid (folate) c. Iron d. Vitamin C
b
A patient has been prescribed aluminum hydroxide (Amphojel) and has received patient teaching. Which statement by the patient indicates an understanding of the instructions? a. "I will take aluminum hydroxide at mealtime." b. "I will drink 2 ounces of water after taking aluminum hydroxide." c. "I will take aluminum hydroxide within 30 minutes of my other medications." d. "I will take a laxative if I develop constipation."
b
A patient is diagnosed with anemia and asks the nurse why the provider has ordered vitamin B12 instead of iron. Which answer by the nurse is correct? a. "Vitamin B12 is given to improve your overall energy level." b. "Vitamin B12 is necessary for the development of red blood cells." c. "Vitamin B12 prevents excess iron loss to reduce demand." d. "Vitamin B12 will help you absorb iron more efficiently."
b
A patient is taking nicotinic acid (Niacin) to treat hyperlipidemia. The patient reports a flushing sensation along with gastrointestinal irritation. The nurse will perform which action? a. Contact the provider to discuss possible thromboembolism. b. Discuss decreasing the patient's dose of nicotinic acid with the provider. c. Reassure the patient that these effects will decrease over time. d. Suggest that the patient take niacin with a full glass of cool water.
b
A patient receiving total parenteral nutrition (TPN) begins having cough and dyspnea. The nurse auscultates rales and notes neck vein engorgement and weight gain. The nurse suspects that the patient is experiencing which condition? a. Air embolism b. Fluid overload c. Pneumonia d. Pneumothorax
b
A patient with severe head trauma is receiving 3% saline. It has an osmolarity of 900 mOsm/kg. This is considered to be which type of solution? a. hypotonic b. hypertonic c. isotonic d. neotonic
b
A primary care provider who is considering the various pharmacologic options for a patient who has peptic ulcer disease should understand that which of the following drugs require monitoring of the patient's phosphorus levels? a. omeprazole (Prilosec) b. aluminum hydroxide (Amphojel) c. sucralfate (Carafate) d. ranitidine (Zantac)
b
A young woman tells the nurse that she has a strong family history of osteoporosis and that she has been taking calcium supplements. Which vitamin will the nurse recommend as an adjunct to calcium supplementation? a. Vitamin A b. Vitamin D c. Vitamin E d. Vitamin K
b
Based on the condition of the patient, an intravenous fluid that is hypertonic will be ordered. Which intravenous fluid is most likely to be ordered by the health care provider? a. normal saline b. 5% dextrose and normal saline c. 2.5% dextrose and water d. 0.33% NaCl
b
Calcium is distributed inter cellularly and intracellularly in what proportions? a. 25% : 75% b. 50% : 50% c. 75% : 25% d. 90% : 10%
b
How is the majority of potassium excreted? a. feces b. kidneys c. liver d. lungs
b
In developing a plan of care for a patient receiving an antihistamine antiemetic agent, which nursing diagnosis is of highest priority? a. knowledge deficit regarding medication administration b. fluid volume deficit related to nausea and vomiting c. risk for injury related to side effects of medication d. alteration in comfort related to nausea and vomiting
b
The 65-year-old patient has recently had a myocardial infarction. His health care provider has ordered docusate sodium 200 mg daily. What is the purpose of this drug for this patient? a. treat diarrhea b. soften stools c. stop vomiting d. prevent nausea
b
The health care provider has written an order for the patient to receive a milk-based commercial enteral feeding preparation. The nurse anticipates that the provider will order which preparation? a. Criticare HN b. Sustacal c. Ensure d. Meritene
b
The nurse is administering intravenous fluids to a patient who is dehydrated. On the second day of care, the patient's weight is increased by 2.25 pounds. The nurse would expect that the patient's fluid intake has a. equaled urine output. b. exceeded urine output by 1 L. c. exceeded urine output by 2.5 L. d. exceeded urine output by 3 L.
b
The nurse is administering loperamide (Imodium) to a patient with diarrhea. What assessment is essential for the nurse to perform? a. vascular assessment b. gastric assessment c. hourly blood pressure measurements d. intake and output every shift
b
The nurse is caring for a patient who is experiencing gastric distress from the long-term use of aspirin for treatment of arthritis. Which intervention does the nurse anticipate that the provider may order? a. stop all aspirin therapy b. administer misoprostol (Cytotec) c. instruct the patient to take the aspirin with milk d. instruct the patient to take the aspirin on an empty stomach
b
The nurse is caring for a patient who is receiving total parenteral nutrition (TPN) and notes that the patient becomes dyspneic when transferring from the bed to a chair. The nurse auscultates rales in both lungs. Which action will the nurse take next? a. Ask the patient to perform the Valsalva maneuver. b. Decrease the TPN rate and request an order for a diuretic medication. c. Obtain an order for a chest radiograph and an antibiotic. d. Stop the TPN and request an order for intravenous isotonic dextrose.
b
The nurse is caring for a patient who is receiving total parenteral nutrition (TPN). The patient reports nausea, headache, and thirst. The nurse will contact the provider to discuss a. giving acetaminophen for headache pain. b. obtaining a serum glucose level. c. ordering an antiemetic to prevent vomiting. d. starting intravenous isotonic dextrose.
b
The nurse is caring for a patient who is taking sucralfate (Carafate) for treatment of a duodenal ulcer. Which assessment requires action by the nurse? a. a sodium level 140 mEq/L b. absent bowel sounds, hard abdomen c. urinary output of 30 mL/hr d. a calcium level 8.5 mg/dL
b
The nurse is preparing a patient who will receive intermittent enteral nutrition at home with a hyperosmolar solution. What information will the nurse include when teaching this patient? a. How to perform the Valsalva maneuver b. The need to consume extra fluids between feedings c. The need to decrease dietary fiber d. The need to remain supine during infusion of the enteral solution
b
The nurse is preparing to administer digoxin to a patient who is newly admitted to the intensive care unit. The nurse reviews the patient's admission electrolytes and notes a serum potassium level of 2.9 mEq/L. Which action by the nurse is correct? a. Administer the digoxin and monitor the patient's electrocardiogram closely. b. Hold the digoxin dose and notify the provider of the patient's lab values. c. Request an order for an intravenous bolus of potassium. d. Request an order for oral potassium supplements.
b
The nurse is preparing to administer enteral nutrition to a patient. Which assessment finding would prompt the nurse to hold the nutrition and notify the patient's provider? a. Blood pressure of 90/60 mm Hg b. Decreased bowel sounds c. A productive cough d. A temperature of 37.8° C
b
The nurse is teaching the patient about calcium absorption and includes the health teaching that vitamin D is needed for calcium absorption. Where in the body does vitamin D help in calcium absorption? a. colon b. GI tract c. kidneys d. liver
b
The patient arrives at a local health clinic complaining of dry skin and not being able to see well in dim light. The nurse suspects that the patient is experiencing a vitamin deficiency. Based on the symptoms, the patient is most likely to be experiencing a deficiency of which vitamin? a. folic acid b. Vitamin A c. Vitamin B6 d. Vitamin B1
b
The patient arrives at the health clinic complaining of experiencing numbness in his extremities. He also tells the nurse that the rash on his nose will not go away despite use of many home remedies. The nurse suspects that the patient is deficient in which vitamin? a. Vitamin B1 b. Vitamin B2 c. Vitamin B6 d. Vitamin B12
b
The patient has a history of heavy alcohol abuse. He presents to the emergency department confused, combative, and complaining of double vision. The patient's family states he has become very forgetful recently. The nurse will anticipate that the provider will order which substance for this patient? a. Vitamin C b. Vitamin B1 c. Dextrose d. Vitamin B6
b
The patient has a history of tuberculosis and is on isoniazid therapy. The patient presents to the clinic with complaints of numbness and weakness in his hands and feet. He has no other significant medical history. Which vitamin supplement might be considered for his condition? a. Niacin b. Pyridoxine c. Riboflavin d. Thiamine
b
The patient has been ordered to receive a unit of packed red blood cells. What is the highest priority nursing action prior to initiating the infusion of the blood product? a. verify that a large bore IV is in place b. confirm the identity of the patient c. collect the blood product from the blood bank d. verify that the permit for infusion was witnessed
b
The patient has severe nausea and vomiting and has been prescribed promethazine 25 mg PO q4-6h. The patient asks how the drug works. What is the nurse's best response? a. "It stimulates the dopamine receptors in the rain associated with vomiting." b. "It blocks the histamine receptor sites and inhibits the CTZ." c. "It blocks the acetylcholine receptors associated with vomiting." d. "It prohibits the muscle contraction in the abdominal wall, preventing vomiting."
b
The patient has started taking an OTC antacid for "heartburn." He asks the nurse what is the best time to take it so it is most effective? What is the best answer? a. 1 hour before meals b. 1-3 hours after meals and at bedtime c. with meals and at bedtime d. with meals and 1 hour after
b
The patient has sustained a severe head injury and is on continuous tube feedings. These feedings are commonly infused a. over 30-60 minutes b. over 24 hours c. over 15 minutes d. over 8-16 hours
b
The patient is a full-time college student who sustained full-thickness burns to her face 2 months ago. She is now undergoing skin rafting and would repair and requires nutritional support. The nurse understands that the best way to administer nutrition to this patient is a. continuous b. cyclic c. gravity d. TPN
b
The patient is taking mineral oil as a laxative. If she continues to tae mineral oil for an extended period of time, what should concern the nurse? a. abdominal bloating and flatulence b. decrease absorption of fat-soluble vitamins A, D, E, and K c. dependence on the drug d. excessive fluid loss attributable to diarrhea
b
The patient's health care provider prescribes rabeprazole (Aciphex) to a patient. The nurse recognizes that this drug is effective for the patient because it belongs to which drug class? a. antiinfective agent b. proton pump inhibitor c. antacid d. histamine2 blocker
b
The provider calculates the enteral nutrition needs for a nonambulatory patient and determines that the patient will need 300 mL of Ultracal every 4 hours. Which method of delivery will the nurse use to administer these feedings? a. 300 mL every 4 hours given via syringe as a 10-minute bolus b. 300 mL every 4 hours given via enteral pump as a 45-minute infusion c. 75 mL per hour via enteral pump as a continuous infusion d. 150 mL every 2 hours via gravity infusion
b
What is the priority nursing intervention when administering intravenous potassium replacement to the patient? a. administer potassium as a bolus over 10 minutes b. administer the medication using an infusion device c. apply heat to the site of intravenous administration d. teach the patient and family the signs and symptoms of hypokalemia
b
When talking with a patient about taking omeprazole (Prilosect) to treat a duodenal ulcer, the health care professional should include which of the following instructions? a. take the drug with food b. swallow the capsules whole c. dissolve the tablets in water d. take the drug at bedtime
b
Which nonprescription drugs are most commonly used to treat motion sickness? a. anticholinergics b. antihistamines c. cannabinoids d. osmotic
b
Which patient might be most at risk for vitamin A deficiency? a. a 36-year-old pregnant patient b. an 18-year-old patient with celiac disease c. a 74-year-old patient with a urinary tract infection d. a 33-year-old patient with sickle cell anemia
b
Which statement demonstrates to the nurse that the patient understands instructions regarding the use of histamine2-receptor antagonists? a. "Since I am taking this medication, it is all right for me to eat spicy foods." b. "Smoking decreases the effects of the medication, so I should try a cessation program." c. "I should take this medication 1 hour after each meal to decrease gastric acidity." d. "I should decrease bulk and fluids in my diet to prevent diarrhea."
b
A patient has been receiving IV potassium supplements. The nurse notes that the patient's heart rate is now 116 beats/minute. What other symptom(s) might the nurse expect to see if the patient is becoming hyperkalemic? (Select all that apply.) a. abdominal distention b. nausea c. numbness in extremities d. polyuria e. confusion
b, c
Patients with which conditions would benefit from enteral feedings? (Select all that apply.) a. Burns of face, chest, and neck b. Cerebral palsy with severe dysphagia c. Crohn's disease d. Facial fractures e. Gluten enteropathy f. Stroke
b, d, f
The nurse is caring for a patient who will receive intravenous calcium gluconate. Which nursing actions are appropriate when giving this solution? (Select all that apply.) a. Administering through a central line b. Assessing for Trousseau's and Chvostek's signs c. Giving as a rapid intravenous bolus d. Mixing in a solution containing sodium bicarbonate e. Monitoring the patient's electrocardiogram (ECG) f. Reporting a serum calcium level >2.5mEq/L
b, e, f
A patient has a serum potassium level of 2.7 mEq/L. The patient's provider has determined that the patient will need 200 mEq of potassium to replace serum losses. How will the nurse caring for this patient expect to administer the potassium? a. As a single-dose 200 mEq oral tablet b. As an intravenous bolus over 15 to 20 minutes c. In an intravenous solution at a rate of 10 mEq/hour d. In an intravenous solution at a rate of 45 mEq/hour
c
A patient receiving a unit of red blood cells suddenly develops shortness of breath, chills, and fever. What will the nurse do first? a. reassure the patient that this is an expected reaction b. notify the health care provider while a peer monitors the blood transfusion c. discontinue the infusion d. decrease the infusion rate and reassess the patient in 15 minutes
c
A patient who has been receiving total parenteral nutrition (TPN) for several days accidently removes the intravenous (IV) line. While waiting for the IV therapy nurse, the nurse caring for this patient will monitor for which complication? a. Air embolism b. Dehydration c. Hypoglycemia d. Infection
c
A patient who has type 2 diabetes mellitus asks the nurse about taking chromium supplements. The nurse will tell this patient that taking chromium a. can increase the risk for ketoacidosis. b. is not recommended for persons with diabetes. c. may cause hypoglycemia if taken in large doses. d. should be taken in doses greater than 200 mcg/day.
c
A patient who spends most of the time indoors has been taking megadoses of vitamin D and is worried about vitamin D toxicity. The nurse will tell this patient to report which sign that may indicate vitamin D toxicity? a. Blurred vision b. Darkening of the skin c. Nausea and vomiting d. Palpitations
c
A patient's serum osmolality is 305 mOsm/kg. Which term describes this patient's body fluid osmolality? a. Iso-osmolar b. Hypo-osmolar c. Hyperosmolar d. Isotonic
c
Chromium is thought to be helpful in control of which condition? a. Alzheimer's disease b. common cold c. type 2 diabetes d. Raynaud's phenomenon
c
Ensure and Isocal are examples of which type of solution? a. blenderized solutions b. elemental or monomeric solutions c. polymeric d. modular
c
Supplementation with which fat-soluble vitamin should a patient discuss with a provider before having surgery? a. Vitamin A b. Vitamin D c. Vitamin E d. Vitamin K
c
The health care provider has ordered 5% dextrose in water as a maintenance fluid for the patient. The nurse is assessing the patient at the beginning of the shift and observes the fluid hanging to be 50% dextrose in water (D50W). Which is the highest priority nursing action? a. notify the health care provider of the error b. find out which nurse hung the D50W c. stop the infusion d. complete an incident report
c
The health care provider has prescribed lansoprazole (Prevacid) for the patient. Within 30 minutes of receiving the first dose of the medication, the patient experiences shortness of breath and develops a rash on his skin. What does the nurse expect that the patient is experiencing? a. unexpected side effect of the medication b. toxic level of the medication c. allergic reaction to the medication d. typical side effect of the medication
c
The health care provider prescribes lansoprazole (Prevacid) for a patient. Which assessment indicates to the nurse that the medication has had a therapeutic effect? a. the patient has no diarrhea b. the patient has no gastric pain c. the patient has no esophageal pain d. the patient is able to eat
c
The nurse dilutes an antibiotic before administering it through a patient's nasogastric tube. The patient asks why this is necessary. The nurse explains that diluting the antibiotic helps to a. improve absorption. b. improve hydration. c. prevent diarrhea. d. prevent emboli.
c
The nurse finds that the patient's enteral feeding is infusing at 150 mL/hr instead of the ordered rate of 50 mL/hr. What is the nurse's highest priority initial action? a. notify the health care provider of the error b. complete an incident report c. stop the infusion and check the patient d. call the pharmacy to stop the next bag
c
The nurse is caring for a patient who has been experiencing convulsions. The patient's laboratory results also show evidence of anemia. The nurse suspects that the patient may be experiencing a deficiency of which vitamin? a. folic acid b. Vitamin A c. Vitamin B6 d. Vitamin B1
c
The nurse is caring for a patient who has had severe vomiting. The patient's serum sodium level is 130 mEq/L. The nurse will expect the patient's provider to order which treatment? a. Diuretic therapy b. Intravenous hypertonic 5% saline c. Intravenous normal saline 0.9% d. Oral sodium supplements
c
The nurse is caring for a patient who is ordered to take nothing by mouth. The patient weighs 65 kg. What volume of intravenous fluid should this patient receive in 24 hours? a. 2225 mL b. 2400 mL c. 2520 mL d. 2640 mL
c
The nurse is caring for a patient who is taking ascorbic acid (vitamin C). The nurse plans to monitor the patient for which adverse effect of ascorbic acid? a. frequent constipation b. excessive bleeding tendencies c. nausea, vomiting, heartburn d. seizure activity
c
The nurse is caring for a patient with severe burns who will begin receiving total parenteral nutrition (TPN). The patient asks why TPN is necessary. The nurse explains that TPN is used for which reason? a. To minimize pulmonary complications b. To prevent hyperglycemia and fluid overload c. To promote wound healing and maintain cell integrity d. To restore fluid and electrolyte imbalance
c
The nurse is caring for an elderly patient who has poor nutrition. The nurse notes cracked skin at the corners of the patient's mouth along with generalized scaly dermatitis. The nurse will contact the provider to discuss a possible deficiency of which vitamin? a. Nicotinic acid b. Pyridoxine c. Riboflavin d. Thiamine
c
The nurse is instructing a group of patients about nutrition. The nurse is discussing vitamin deficiencies in this week's class. A patient asks if a B12 deficiency is a significant problem. The nurse explains that a B12 deficiency can result in which symptom? a. dermatitis b. blurred vision c. gastrointestinal disorders d. loss of appetite
c
The nurse is preparing to discontinue total parenteral nutrition (TPN) therapy for a patient who has been receiving TPN for several days. The nurse will contact the provider to discuss an order for a. antibiotics. b. intravenous insulin. c. isotonic dextrose. d. nasogastric feedings.
c
The nurse is preparing to hang a new bag for a patient who is receiving total parenteral nutrition (TPN). During this procedure, the nurse will instruct the patient to take a deep breath and then perform which action? a. Exhale slowly and bear down. b. Exhale slowly to the count of 10. c. Hold the breath and bear down. d. Take several rapid, shallow breaths.
c
The patient has just given birth, and the nurse is preparing to administer vitamin K to the newborn. The patient asks, "Why do you have to give that to my baby?" What is the nurse's best response? a. "It will help the baby's digestive tract work better." b. "Vitamin K helps a baby maintain its temperature." c. "Newborns re vitamin K-deficient at birth." d. "This will help prevent infections for the first month."
c
The patient takes an antacid for reflux and an iron supplement for anemia. Which information will the nurse be sure to include in patient education regarding these drugs? a. "The drugs have a synergistic effect." b. "Iron and antacids must be taken on alternate days." c. "Antacids will decrease iron absorption." d. "Iron will decrease the effectiveness of the antacids."
c
The patient's a history of seasickness but is going boating this weekend. How far in advance should the nurse advise her to apply a scopolamine patch? a. immediately b. 1 hour c. 4 hours d. 24 hours
c
The provider has ordered Kayexalate and sorbitol to be administered to a patient. The nurse caring for this patient would expect which serum electrolyte values prior to administration of this therapy? a. Sodium 125 mEq/L and potassium 2.5 mEq/L b. Sodium 150 mEq/L and potassium 3.6 mEq/L c. Sodium 135 mEq/L and potassium 6.9 mEq/L d. Sodium 148 mEq/L and potassium 5.5 mEq/L
c
What information will the nurse include in a teaching plan for the patient who is prescribed sucralfate (Carafate)? a. "This medication will neutralize gastric acid." b. "This medication will enhance gastric absorption of meals." c. "This medication will form a protective barrier over the gastric mucosa." d. "This medication will inhibit gastric acid."
c
What instruction is most important for the nurse to teach a patient who is taking an anticholinergic agent to treat nausea and vomiting? a. "Assess your stools for dark streaks." b. "Do not take more than two doses of this medication." c. "Brush your teeth and gargle to help with dryness in your mouth." d. "Check your heart rate and call the health care provider if it gets below 50 beats/min."
c
What will the nurse teach the patient about the reason for administering multiple medications for relief of nausea and vomiting? a. combination therapy decreases the risk of constipation b. combination therapy is more cost-effective c. combination therapy blocks different vomiting pathways d. combination therapy decreases side effects due to lower doses of each drug
c
When talking with a patient about taking loperamide (Imodium), the health care professional should include which of the following instructions? a. dissolve the powder thoroughly in 8 oz of water b. have diphenhydramine available c. avoid activities that require alertness d. take 30 min before activities that trigger nausea
c
When talking with a patient about taking metoclopramide (Reglan) to treat GERD, the health care professional should include which of the following instructions? a. take the drug once a day in the morning b. stop taking the drug if drowsiness develops c. chew gum or suck on hard candy d. take acetaminophen (Tylenol) for headaches
c
Which assessment is most important for the patient who is taking stimulant laxatives? a. monitor bowel elimination daily b. monitor intake and output c. monitor signs and symptoms of fluid and electrolyte imbalance d. monitor heart rate and blood pressure every 4 hours
c
Which nursing intervention is a priority before administering magnesium hydroxide to a patient? a. obtain a history of constipation and causes b. record baseline vital signs c. assess renal function d. advise the patient to take the medication with a glass of water
c
Which outcome assessment is essential to monitor for in the patient taking diphenoxylate with atropine (Lomotil)? a. increase in bowel sounds b. increase in number of bowel movements c. decrease in gastric motility d. decrease in urination
c
Which statement by the patient indicates that further teaching is needed about antiemetic medication? a. "I will not drive while I am taking these medications because they may cause drowsiness." b. "I may take Tylenol to treat the headache caused by ondansetron (Zofran)." c. "I will apply the scopolamine patches to rotating sites on my upper arms." d. "I should take my prescribed antiemetic before receiving my chemotherapy dose and continue afterwards."
c
The patient is experiencing diarrhea. Which food(s) will the nurse advise the patient to avoid? (Select all that apply.) a. bottled water b. clear liquids c. fried foods d. milk products e. gelatin
c, d
The patient is taking potassium chloride. She is also taking hydrochlorthiazide 50 mg daily to control her hypertension. the patient's serum potassium level is 2.4 mEq/L. What clinical manifestation would the nurse expect to see in this patient? (Select all that apply.) a. bradycardia b. headache c. muscle weakness d. nausea
c, d
Which drugs are used to treat hyperkalemia? (Select all that apply.) a. digoxin and furosemide b. glucagon and magnesium c. glucose and insulin d. sodium polystyrene sulfonate and sorbitol e. sodium bicarbonate and calcium gluconate
c, d, e
A health care professional is caring for a patient who is about to begin taking ranitidine (Zantac) to treat GERD. The health care professional should tell the patient to take certain precautions when taking which of the following over-the-counter drugs? a. ginkgo biloba b. antidiarrheals c. St. John's wort d. antacids
d
A health care professional is caring for a patient who takes phenytoin (Dilantin) for a seizure disorde and is about to begin sucralfate (Carafate) therapy to treat a duodenal ulcer. The health care professional should tell the patient to take the drugs at least 2 hr apart because... a. phenytoin increases the metabolism of sucralfate b. phenytoin reduces the effectiveness of sucralfate c. sucralfate increases the risk for phenytoin toxicity d. sucralfate interferes with the absorption of phenytoin
d
A patient has been receiving IV potassium therapy and the nurse notices that the site has become erythematous and edematous. What is the nurse's best action? a. Flush the IV site with normal saline and increase the rate b. Flush the IV site with heparin c. Stop the IV and check for blood return d. Discontinue the IV and restart in another site
d
A patient is admitted after experiencing vomiting and diarrhea for several days. The provider orders intravenous lactated Ringer's solution. The nurse understands that this fluid is given for which purpose? a. To increase interstitial and intracellular hydration b. To maintain plasma volume over time c. To pull water from the interstitial space into the extracellular fluid d. To replace water and electrolytes
d
A patient is advised to drink a liquid iron preparation through a straw because it may cause which effect? a. bleeding gums b. esophageal varices c. corroded tooth enamel d. tooth discoloration
d
A patient is being treated for shock after a motor vehicle accident. The provider orders 6% dextran 75 to be given intravenously. The nurse should expect which outcome as the result of this infusion? a. Decreased urine output b. Improved blood oxygenation c. Increased interstitial fluid d. Stabilization of heart rate and blood pressure
d
A patient is prescribed lorazepam (Ativan) and a glucocorticoid during chemotherapy treatments. What is the nurse's best action? a. call the health care provider and question the order b. only administer the Ativan if the patient seems anxious c. administer the two medications at least 12 hours apart d. administer the medications and assess the patient for relief.
d
A patient reports having taken a large dose of ascorbic acid (vitamin C) and is experiencing diarrhea and gastrointestinal upset. The nurse will prepare to take which action? a. Administer activated charcoal. b. Administer sodium bicarbonate. c. Perform gastric lavage. d. Provide symptomatic care.
d
A patient reports wanting to take vitamin A to prevent blindness. Which response by the nurse is correct? a. "Vitamin A can be taken prophylactically without serious adverse effects." b. "Vitamin A does not have any effects on vision." c. "Vitamin A is difficult to obtain through dietary intake alone." d. "Vitamin A is stored in the liver for up to 2 years, and toxicity can occur."
d
A patient who is being treated for dehydration is receiving 5% dextrose and 0.45% normal saline with 20 mEq/L potassium chloride at a rate of 125 mL/hour. The nurse assuming care for the patient reviews the patient's serum electrolytes and notes a serum sodium level of 140 mEq/L and a serum potassium level of 3.6 mEq/L. The patient had a urine output of 250 mL during the last 12-hour shift. Which action will the nurse take? a. Contact the patient's provider to discuss increasing the potassium chloride to 40 mEq/L. b. Continue the intravenous fluids as ordered and reassess the patient frequently. c. Notify the provider and discuss increasing the rate of fluids to 200 mL/hour. d. Stop the intravenous fluids and notify the provider of the assessment findings.
d
A patient who will begin taking an antibiotic reports taking several vitamin supplements every day. Which vitamin or mineral will the nurse counsel the patient about during antibiotic therapy? a. Selenium b. Vitamin A c. Vitamin C d. Zinc
d
Based on the condition of the patient, an intravenous fluid that is hypotonic will be ordered. Which intravenous fluid is most likely to be ordered by the health care provider? a. normal saline b. 5% dextrose and normal saline (D5NS) c. 5% dextrose and lactated Ringer's (D5LR) d. 0.33% NaCl
d
Regulation of calcium and phosphorous metabolism and calcium absorption from the intestine is a major role of which of the following vitamins? a. A b. B12 c. C d. D
d
The nurse assesses a patient with hyperparathyroidism and notes that the patient is to receive a vitamin D supplement. What is essential for the nurse to assess initially? a. urinary output b. hemoglobin and hematocrit c. clotting factors d. calcium levels
d
The nurse identifies that the patient has been ordered Peptamen Liquid. The nurse recognizes that Peptamen Liquid is an example of which type of commercial enteral feeding preparation? a. Blenderized b. Polymeric c. Lactose-free d. Elemental
d
The nurse is caring for a child who receives all nutrition parenterally. The nurse will be alert for signs of a deficiency of which mineral in this child? a. Chromium b. Copper c. Iron d. Zinc
d
The nurse is caring for a newly admitted patient who will receive digoxin to treat a cardiac dysrhythmia. The patient takes hydrochlorothiazide (HydroDIURIL) and reports regular use of over-the-counter laxatives. Before administering the first dose of digoxin, the nurse will review the patient's electrolytes with careful attention to the levels of which electrolytes? a. Calcium and magnesium b. Sodium and calcium c. Potassium and chloride d. Potassium and magnesium
d
The nurse is caring for a patient who has a history of chronic alcohol abuse. The patient is confused and exhibits nystagmus and blurred vision. Which vitamin will the nurse expect to administer to this patient? a. Nicotinic acid b. Pyridoxine c. Riboflavin d. Thiamine
d
The nurse is preparing to administer a transfusion of a blood product. What is the most appropriate intravenous fluid to hang as a maintenance infusion? a. Lactated Ringer's b. 5% dextrose and water c. Ringer's solution d. normal saline
d
The nurse is teaching a patient who has a folic acid deficiency about treatment for this disorder. Which statement by the patient indicates understanding of the teaching? a. "Food sources of folic acid are better than synthetic folic acid products." b. "I should take megadoses of folic acid to compensate for the deficiency." c. "Most folic acid is stored in the liver." d. "Symptoms of folic acid deficiency often do not appear for months."
d
The patient has been diagnosed with hypokalemia and will be admitted to the hospital for IV potassium replacement. What is the nurse's best action the preparing to give this drug? a. Prepare the syringe with the ordered amount of drug to give IV push b. Push the potassium into the IV bag and keep it still before administration c. Push the potassium chloride into the IV bag and shake vigorously d. Obtain an IV pumped pump tubing since this IV drug must be controlled
d
The patient has sustained burns to 40% of his body and is receiving long-term parenteral nutrition. This patient is at risk for which mineral deficiency? a. copper b. iron c. selenium d. zinc
d
The patient has ulcerative colitis and is in the midst of a flare-up. He has been prescribed TPN. Which site will the nurse select to administer TPN? a. accessory vein b. brachiocephalic vein c. radial vein d. subclavian vein
d
The patient is receiving enteral feedings through a gastrostomy tube at a rate of 100 mL per hour. The nurse assesses residual volume as 80 mL. What is the nurse's primary intervention? a. discard the residual volume and continue to monitor the feeding b. decrease the feeding to 80 mL per hour for the next hour c. assess the patient's bowel sounds d. stop the feeding for 1 hour and reassess
d
The patient presents to the emergency department with an overdose of the oral anticoagulant warfarin. The nurse will anticipate administration of which vitamin for this patient? a. B2 b. C c. E d. K
d
The patient presents to the hospital and its found to be hyperkalemic. What will the nurse anticipate administering? a. 10 mEq/L magnesium mixed in 1000 mL of normal saline b. 0.9% saline bolus of 500 mL c. a fluid challenge of 250 mL of high-molecular weight dextran d. sodium bicarbonate
d
The patient with a functional GI system is at risk for aspiration because of difficulty swallowing. Which supplemental nutrition does the nurse anticipate will be ordered? a. enteral via nasogastric tube b. parenteral via peripheral IV c. parenteral via central IV d. enteral vis jejunostomy tube
d
What type of enteral feeding is administered over 30-60 minutes by pump infusion? a. bolus b. continuous c. gravity d. intermittent
d
Which food is highest in copper? a. broccoli b. grapefruit c. lamb d. shellfish
d
Which patient is most likely to be a candidate for total parenteral nutrition (TPN) rather than enteral nutrition? a. A patient who is comatose after having had a stroke b. A patient who has a fractured mandible following a motor vehicle accident c. A patient who has cerebral palsy and severe dysphagia d. A patient who is pregnant and has intractable hyperemesis gravidarum
d
Which patient should not use a laxative/cathartic? a. 48-year-old patient with cirrhosis b. 55-year-old patient with Parkinsonism c. 60-year-old patient with stable angina d. 65-year-old patient with bowel obstruction
d
A health care professional is caring for a patient who is having difficult mobilizing thick respiratory secretions. Which of the following drugs should the HCP expect to administer? a. ipratropium (Atrovent) b. beclomethasone (Beconase AQ) c. acetylcysteine (Acetadote) d. azelastine (Astelin)
c
A health care professional who is advising a patient about the sue of antihistamines to treat allergic rhinitis should explain that these drugs are effective because they perform which of the following actions? a. decreases viscosity of nasal secretions b. blocks H2 receptors c. prevents histamine from binding to receptors d. reduces nasal congestion
c
A health care professional who is advising a patient about the use of a mucolytic to treat a cough should explain that this type of drug is effective because it performs which of the following actions? a. suppresses the cough stimulus b. reduces inflammation c. things and loosens mucus d. dries secretions
c
A health care professional who is advising a patient about using intranasal glucocorticoids should include which of the following instructions? a. start at a low dose and gradually increase it b. take the drug as needed for nasal congestion c. allow at least 2 weeks for the full therapeutic effect d. use the drug prior to exercise
c
A health care provider is caring for a patient who is taking codeine. Which of the following is the most important following administration of the drug? a. blood pressure b. apical heart rate c. resirations d. level of consciousness
c
A healthcare professional is advising a patient about the use of beclomethasone (Beconase AQ) to treat asthma. The health care professional should explain that the drug treats asthma because it performs which of the following actions? a. thin mucus b. relaxes bronchial smooth muscle c. decreases inflammation d. increases the cough threshold
c
A healthcare professional is advising a patient about the use of cromolyn sodium. Which of the following instructions should the health care professional include? a. report signs of jaundice b. anticipate difficulty sleeping c. expect a bitter aftertaste d. increase calcium and vitamin D intake
c
A nurse is teaching a child how to use a metered dose-inhaler (MDI). Which of the following statements by the child indicates an understanding of the teaching? a. "I will hold the inhaler at a 45 degree angle to release the medication." b. "I will tilt my head forward while inhaling the medication." c. "I will hold my breath for 10 seconds after inhaling the medication." d. "I will wait 5 minutes before taking a second puff of the medication."
c
A nurse is teaching a client who has a new prescription for dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? a. diarrhea b. anxiety c. sedation d. palpitations
c
A patient is admitted to the hospital after developing pneumonia. During the admission assessment, the patient reports having used a nasal decongestant spray for the past few weeks but thinks the nasal congestion is getting worse. The nurse will a. request an order for a systemic decongestant medication b. request an order so the patient can continue to use the decongestant spray c. tell the patient the congestion will clear up after stopping the spray d. tell the patient to increase oral fluid intake
c
A patient presents to the health care provider's office for a follow-up visit. The patient is taking theophylline, and the nurse is reviewing the lab results. What level of theophylline would fall in the therapeutic range? a. 2 mcg/mL b. 8 mcg/mL c. 14 mcg/mL d. 23 mcg/mL
c
A patient taking an oral theophylline drug is due for her next dose and has a blood pressure of 100/50 mm Hg and a heart rate of 110 bpm. The patient is irritable. What is the nurse's best action? a. Continue to monitor the patient. b. Call the health care provider. c. Hold the next dose of theophylline. d. Administer oxygen 2 L per minute via nasal cannula.
c
A patient taking diphenhydramine breastfeeds her infant daughter. What advice will the nurse give her? a. Breastfeeding provides allergy relief to the infant. b. Large amounts of the drug pass into breast milk; breastfeeding is not recommended. c. Small amounts of the drug pass into breast milk; breastfeeding is not recommended. d. The drug does not affect breastfeeding.
c
A patient who has seasonal allergies with a runny nose during the daytime reports increasing nighttime symptoms of coughing and sneezing that are interfering with sleep. The provider recommends diphenhydramine (Benadryl) at bedtime. What information will the nurse include when teaching the patient about this medication? a. "Avoid fluids at bedtime to prevent urinary retention." b. "This will help clear your daytime symptoms, too." c. "You should be able to sleep better when you take this medication." d. "You should take this medication on an empty stomach."
c
A patient with a history of asthma is short of breath and says, "I feel like I'm having an asthma attack." What is the nurse's highest priority action? a. Calling a code b. Asking the patient to describe the symptoms c. Administering a beta2 adrenergic agonist d. Administering a long-acting glucocorticoid
c
A provider has prescribed ipratropium bromide/albuterol sulfate (Combivent) for a patient who has chronic obstructive pulmonary disease (COPD). The nurse explains that this combination product is prescribed primarily for which reason? a. to be more convenient for patients who require both medications b. to improve compliance in patients who may forget to take both drugs c. to increase forced expiratory volume, an indicator of symptom improvement d. to minimize the side effects that would occur if the drugs are given separately
c
The health care provider indicates that the patient will be ordered an opioid antitussive. Which medication does the nurse anticipate the provider will order? a. Promethazine with dextromethorphan b. Benzonatate (Tessalon Perles) c. Codeine CSS II d. Levocetirizine (Xyzal)
c
The nurse is caring for a patient with a theophylline level of 14 mcg/mL. What is the priority nursing intervention? a. Increase the IV drip rate. b. Monitor the patient for toxicity. c. Continue to assess the patient's oxygenation. d. Stop the IV for an hour then restart at lower rate.
c
The nurse is performing a medication history on a patient who reports long-term use of montelukast (Singulair) and an albuterol metered-dose inhaler (Proventil). The nurse will contact the provider to discuss an order for which laboratory tests? a. cardiac enzymes and serum calcium b. electrolytes and a complete blood count c. liver function tests and serum glucose d. urinalysis and serum magnesium
c
The nurse is teaching a patient about the use of an expectorant. What is the most important instruction for the nurse to include in the patient teaching? a. "Restrict your fluids in order to decrease mucus production." b. "Take the medication once a day only, at bedtime." c. "Increase your fluid intake in order to decrease viscosity of secretions." d. "Increase your fiber and fluid intake to prevent constipation."
c
The nurse is teaching a patient who will begin taking oral theophylline (Theo-Dur) when discharged home from the hospital. What information will the nurse include when teaching the patient about this drug? a. an extra dose should be taken when symptoms worsen b. anorexia and gastrointestinal upset are unexpected side effects c. avoid caffeine while taking this medication d. food will decrease the amount of drug absorbed.
c
The nurse will include which information regarding the use of antileukotriene agents such as zafirlukast (Accolate) in the patient teaching? a. "Take the medication as soon as you begin wheezing." b. "It will take about 3 weeks before you notice a therapeutic effect." c. "This medication will prevent the inflammation that causes your asthma attack." d. "Increase fiber and fluid in your diet to prevent the side effect of constipation."
c
The patient is being treated for chronic obstructive pulmonary disease (COPD). His medication is delivered via a metered-dose inhaler. Related health teaching would include which priority information? a. Hold the inhaler upside down. b. Refrigerate the inhaler. c. Shake the inhaler well just before use. d. Test the inhaler each time to see if the spray works.
c
The patient who has nasal congestion asks the nurse to recommend a decongestant medication. The nurse performs a medication history and learns that the patient takes a beta blocker to treat hypertension. Which over-the-counter product will the nurse recommend? a. diphenhydramine (Benadryl) b. ephedrine HCl (Pretz-D) c. phenylephrine nasal (NeoSynephrine Nasal) d. loratadine (Claritin)
c
What will the nurse expect to find that would indicate a therapeutic effect of acetylcysteine (Mucomyst)? a. Decreased cough reflex b. Decreased nasal secretions c. Liquefying and loosening of bronchial secretions d. Relief of bronchospasms
c
Which instruction will the nurse include when teaching a patient about the proper use of metered-dose inhalers? a. "After you inhale the medication once, repeat until you obtain relief." b. "Make sure that you puff out air repeatedly after you inhale the medication." c. "Hold your breath for 10 seconds if you can after you inhale the medication." d. "Hold the inhaler in your mouth, take a deep breath, and then compress the inhaler."
c
A health care professional is advising a patient about the use of cromolyn sodium to prevent bronchospasm. The health care professional should explain that the drug prevents bronchospasm because it performs which of the following actions? a. increase leukocyte activity b. block muscarinic receptors c. causes bronchodilation d. reduces inflammation
d
A health care professional should recognize that using presudophedrine (Sudafed) to treat allergic rhinitis requires cautious use with patients who have which of the following? a. peptic ulcer disease b. a seizure disorder c. anemia d. coronary artery disease
d
A health care professional should tell a patient who is taking albuterol (Proventil) to report which of the following possible indications of a serious adverse effect? a. fever b. bruising c. polyuria d. palpitations
d
A patient arrives in the emergency department after developing a rash, runny nose, and sneezing after eating strawberries. What action will the nurse expect to take first? a. administer diphenhydramine b. administer epinephrine c. assess for urinary retention d. assess heart rate, respiratory rate, and lung sounds
d
A patient asks the nurse about using dextromethorphan for cough. What information will the nurse include when teaching this patient about this drug? a. "It does not cause sedation except at high doses." b. "It may be used to treat cough for up to 2 weeks." c. "It is non-narcotic, and it is OK to consume alcohol while taking this drug." d. "It should not be taken by patients who have chronic obstructive pulmonary disease (COPD)."
d
A patient who uses an inhaled glucocorticoid medication reports having a sore tongue. The nurse notes white spots on the patient's tongue and oral mucous membranes. After notifying the provider, the nurse will remind the patient to perform which action? a. avoid using a spacer with the inhaled glucocorticoid medication b. clean the inhaler with hot, soapy water after each use c. consume yogurt daily while using this medication d. rinse the mouth thoroughly with water after each use
d
A patient will be discharged home with albuterol (Proventil) to use for asthma symptoms. What information will the nurse include when teaching this patient about this medication? a. failure to respond to the medication indicates a need for a higher dose b. monitor for hypoglycemia symptoms when using this medication c. palpitations are common with this drug even at normal, therapeutic doses d. overuse of this medication can result in airway narrowing and bronchospasm
d
In discharge teaching, the nurse will emphasize to a patient receiving a beta-agonist bronchodilator the importance of reporting which side effect? a. Hypoglycemia b. Nonproductive cough c. Sedation d. Tachycardia
d
The 40-year-old patient has been taking theophylline for long-term treatment of his asthma. He has also been taking ephedra to stay alert while finishing a project at work. The patient presents to the clinic with complaints of feeling ill. Vital signs are temperature 36.4 Celsius oral, heart rate 124 beats/min, respiratory rate 18 breaths/min, blood pressure 170/90mm Hg, and oxygen saturation 99% on room air. Fingerstick blood glucose is 210 mg/dL. His theophylline level is 26 mcg/mL. What does the nurse suspect may be the cause of the patients symptoms? a. Acute allergic reaction b. Asthma attack c. Stevens-Johnson syndrome d. Theophylline toxicity
d
The U.S. Food and Drug Administration has ordered removal of all cold remedies containing which drug? a. Dextromethorphan b. Guaifenesin c. Histamine d. Phenylpropanolamine
d
The nurse is caring for a child who has been prescribed an inhaler for asthma control. The child is having difficulty using the inhaler. What will the nurse do? a. Tell the parent to hold the inhaler for the child b. Ask the health care provider to switch to oral medications c. Tell the parent that young children should not use inhalers d. Teach the child to use a spacer
d
The nurse is caring for a patient in the clinic who states that he is afraid of taking antihistamines because he is a truck driver. What is the best information for the nurse to give this patient? a. "Take the medication only when you are not driving." b. "Take a lower dose than normal when you have to drive." c. "You are correct; you should not take antihistamines." d. "You may be able to safely take a second-generation antihistamine."
d
The nurse is caring for multiple patients on the pulmonary unit. The nurse would question the administration of prescribed epinephrine to which patient? a. The patient with a history of emphysema b. The patient with a history of type 2 diabetes c. The patient who is 16 years old d. The patient with atrial fibrillation with a rate of 100
d
The nurse is preparing to administer isoproterenol (Isuprel) to a patient who is experiencing an acute bronchospasm. The nurse understands that, because isoproterenol is a nonselective beta-adrenergic agonist, the patient will experience which effects? a. alpha- and beta-adrenergic agonist effects b. anticholinergic effects c. a shorter duration of therapeutic effects d. cardiac and pulmonary effects
d
The nurse provides teaching for patient who will begin taking montelukast sodium (Singulair). The patient reports sensitivity to aspirin. Which statement by the patient indicates a need for further teaching? a. "I will need to have periodic laboratory tests while taking this medication." b. "I will not take ibuprofen for pain or fever while taking this drug." c. "I will take one tablet daily at bedtime." d. "I will use this as needed for acute symptoms."
d
What over-the-counter product will the nurse instruct the patient to avoid when taking montelukast (Singulair)? a. Acetaminophen (Tylenol) b. Echinacea c. Diphenhydramine (Benadryl) d. St. John's wort
d
Which expectorant is frequently an ingredient in cold remedies? a. Dextromethorphan b. Ephedrine c. Guaifenesin d. Promethazine
d
Which of the following should a health care provider include when advising a patient about the use of montelukast (Singulair)? a. use a spacer to improve inhalation b. take the drug at the onset of bronchospasm c. rinse the mouth to print an oral fungal infection d. take the drug once a day in the evening
d
A health care professional is monitoring plasma drug levels in a patient who is taking theophylline (Theo-24). Which of the following adverse effects should the HCP expect to see if the patient's level indicates toxicity? a. seizures b. constipation c. vomiting d. restlessness
a
A health care professional is talking to a patient who is prescribed albuterol (Proventil) via inhaler and fluticasone (Advair) via inhaler for asthma management. The HCP should tell the patient to use the albuterol inhaler before using the fluticasone inhaler for which of the following reasons? a. albuterol will increase the absorption of fluticasone b. albuterol will decrease inflammation c. albuterol will reduce nasal secretions d. fluticasone will reduce the adverse effects of albuterol
a
A health-care professional cautions a patient who is taking guaifenesin (Mucinex) about using combination over-the-counter cold products because a. they can also contain guaifenesin b. serious interactions are possible c. rebound congestion is likely d. drug tolerance is likely
a
A nurse is assessing a 10-year-old child who has asthma. Which of the following findings indicates to the nurse that the child needs a PRN dose of inhaled albuterol? a. inspiratory and expiratory wheezes bilaterally in lung bases b. peak flow rate 85% c. respirations 24/min d. bronchovesicular breath sounds heard over the manubrium
a
A nurse is providing teaching to the parent of the child who is prescribed both an inhaled bronchodilator and an inhaled corticosteroid. Which of the following information should the nurse include in the teaching? a. administer the bronchodilator first b. give the corticosteroid alone during an acute asthma attack c. wait 20 min or longer between each dose of the medications d. rinse the mouth with water before administering the corticosteroid
a
A nurse is teaching a client who has a new prescription for beclomethasone. Which of the following instructions should the nurse include? a. "Rinse your mouth after each use of this medication." b. "Limit fluid intake while taking this medication." c. "Increase your intake of vitamin B12 while taking this medication." d. "You can take this medication as needed."
a
A patient is brought to the emergency department and reports having taken "a lot" of acetaminophen extra-strength tablets 16 hours prior. The nurse will expect the provider to order a. acetylcysteine (Mucomyst) b. dornase alfa (Pulmozyme) c. gastric lavage d. renal enzyme tests
a
A patient is prescribed an antitussive medication. What is the most important instruction for the nurse to include in the patient teaching? a. "This medication may cause drowsiness and dizziness." b. "Watch for diarrhea and abdominal cramping." c. "This medication may cause tremors and anxiety." d. "Headache and hypertension are common side effects."
a
A patient who has been taking theophylline at home reports having palpitations and jitteriness. What action will the nurse take? a. ask the patient if herbal medications are used b. notify the provider to report theophylline toxicity c. recommend that the patient increase fluid intake d. request an order for renal function studies
a
A patient who has narrow-angle glaucoma asks the nurse to recommend a medication to alleviate cold symptoms such as nasal congestion and runny nose. The nurse will suggest the patient talk to the provider about which medication? a. azelastine (Astelin) b. cetirizine (Zyrtec) c. chlorpheniramine maleate (Chlor-Trimeton) d. diphenhydramine (Benadryl)
a
A patient who is using inhaled cromolyn sodium (Intal) daily calls the clinic to report experiencing cough and a bad taste. The nurse will instruct the patient to perform which action? a. drink water before and after using the inhaler b. schedule an appointment to discuss these effects with the provider c. stop taking the medication immediately d. use the inhaler only as needed for acute bronchospasms
a
A patient will begin using an albuterol metered-dose inhaler to treat asthma symptoms. The patient asks the nurse about the difference between using an oral form of albuterol and the inhaled form. The nurse will explain that the inhaled form of albuterol a. has a more immediate onset than the oral form b. may cause more side effects than the oral preparation c. requires an increased dose in order to have therapeutic effects d. will not lead to tolerance with increased doses
a
A patient will begin using ipratropium bromide (Atrovent), albuterol (Proventil), and an inhaled glucocorticoid medication (steroid) to treat chronic bronchitis. When teaching this patient about disease and medication management, the nurse will instruct the patient to administer these medications in which order? a. albuterol, ipratropium bromide, steroid b. albuterol, steroid, ipratropium bromide c. ipratropium bromide, albuterol, steroid d. steroid, ipratropium bromide, albuterol
a
A patient with chronic obstructive pulmonary disease (COPD) who has a persistent nonproductive cough asks about a medication that will not cause sedation. The nurse will encourage the patient to discuss which medication with the provider? a. Benzonatate HCl (Tessalon Perles) b. Dextromethorphan hydrobromide (Benylin DM) c. Guaifenesin and codeine d. Promethazine with dextromethorphan
a
Compared to first-generation antihistamines, second-generation antihistamines have a lower incidence of which side effect? a. Drowsiness b. Headache c. Tinnitus d. Vomiting
a
Diphenhydramine blocks histamine receptors. Which histamine receptors does it block? a. H1 b. H2 c. B1 d. B2
a
The nurse is caring for a patient recently diagnosed with mild emphysema and provides teaching about the disease and medications for treatment. Which statement by the patient indicates understanding of the medication regimen? a. "I should use albuterol when my symptoms worsen." b. "I will need to take oral prednisone on a daily basis." c. "My provider will prescribe prophylactic antibiotics." d. "My symptoms are reversible with proper medications."
a
The nurse is caring for a patient who is taking a first-generation antihistamine. What is the most important information for the nurse to teach the patient? a. "Do not drive after taking this medication." b. "Make sure you drink a lot of liquids while on this medication." c. "Take this medication on an empty stomach." d. "Do not take this medication for more than 2 days."
a
The patient has environmental allergies and asks the student health nurse about the appropriate dose of diphenhydramine. What is the recommended dosage of diphenhydramine? a. 25-50 mg of q6-8h b. 25-50 mg daily c. 50-100 mg q4-6h d. 100 mg daily
a
The patient is taking a nonselective adrenergic agonist bronchodilator and has a history of coronary artery disease. What is a priority nursing intervention? a. Monitoring patient for potential chest pain b. Monitoring blood pressure continuously c. Assessing daily for hyperkalemia d. Assessing 12-lead ECG each shift
a
The patient is taking an inhaled beta agonist and a steroid for his asthma. He states "I don't have time to wait between taking drugs. I'm very busy. Why do I have to do this?" What is the nurse's best response to the patient? a. "The inhaled drug will allow the bronchioles to dilate so the steroid works better." b. "This is done so you remember which one comes first." c. "The inhaled medication will make your heart circulate the steroid faster." d. "The steroid may make your nose stuff, so you take the inhaled drug first."
a
When advising a patient about taking prednisone for chronic asthma, a health care professional should include which of the following information? a. avoid taking NSAIDs b. rinse your mouth after taking the drug to prevent a yeast infection c. stop taking the drug if you become nauseated d. change position slowly when standing up
a
Which of the following reasons should a patient attach a spacer to a metered-dose inhaler? a. to increase the amount of drug delivered to the lungs b. to increase the amount of drug delivered to the oropharynx c. to increase the amount of drug delivered on exhalation d. to increase the speed of drug delivery
a
A nurse is teaching a client who has a new prescription for diphenhydramine for allergic rhinitis. The nurse should instruct the client to monitor for which of the following adverse reactions of this medication? a. dry mouth b. nonproductive cough c. skin rash d. drowsiness e. urinary hesitation
a, d, e
A health care professional who is advising a patient about the use of an expectorant to treat cough should explain that this type of drug is effective because it performs which of the following actions? a. suppresses the cough stimulus b. reduces surface tension c. redues inflammation d. dries mucous membranes
b
A nurse is caring for a client who states she has been taking phenylephrine nasal drops for the past 10 days for sinusitis. The nurse should assess the client for which of the following adverse effects? a. sedation b. nasal congestion c. productive cough d. constipation
b
A nurse is providing instructions to a client who has a new prescription for albuterol and beclomethasone inhalers for the control or asthma. Which of the following instructions should the nurse include in the teaching? a. take the albuterol at the same time each day b. administer the albuterol inhaler prior to using the beclomethasone inhaler c. use beclomethasone if experiencing an acute episode d. avoid shaking the beclomethasone before use
b
A nurse is providing instructions to the parent of an adolescent client who has a new prescription for albuterol, PO. Which of the following instructions should the nurse include? a. "You can take this medication to abort an acute asthma attack." b. "Tremors are an adverse effect of this medication." c. "Prolonged use of this medication can cause hyperglycemia." d. "This medication can slow skeletal growth rate."
b
A nurse is teaching a client about the use of fluticasone to treat perennial rhinitis. Which of the following statements by the client indicates an understanding of the teaching? a. "I should use the spray every 4 hours while I am awake." b. "It can take as long as 3 weeks before the medication takes a maximum effect." c. "This medication can also be used to treat motion sickness." d. "I can use this medication when my nasal passages are blocked."
b
A patient complains of worsening nasal congestion despite the use of oxymetazoline (Afrin) nasal spray every 2 hours. What is the nurse's most appropriate response? a. "Oxymetazoline is not an effective nasal decongestant." b. "Overuse of nasal decongestants results in rebound congestion." c. "Oxymetazoline should be administered every hour for severe congestion." d. "You are probably displaying an unexpected reaction to oxymetazoline."
b
A patient is prescribed ipratropium (Atrovent) and cromolyn sodium (Intal). What will the nurse teach the patient? a. "Do not take these medications within 4 hours of each other." b. "Take the ipratropium (Atrovent) at least 5 minutes before the cromolyn (Intal)." c. "Administer both medications together in a metered-dose inhaler." d. "Take the ipratropium (Atrovent) only in the mornings."
b
A patient who has a nonproductive cough will begin taking guaifenesin to help with secretions. When teaching this patient about the medication, the nurse will provide which instruction? a. "Avoid driving or using heavy machinery." b. "Drink extra water while taking the medication." c. "Monitor urine output closely." d. "Take with an oral antihistamine for better effects."
b
Antihistamines are another group of drugs used for the relief of cold symptoms. What properties of these drugs result in decreased secretions? a. Analgesic b. Anticholinergic c. Antitussive d. Cholinergic
b
Before prescribing dextromethorphan (Robitussin) to a patient, the primary car provider should know that, when given with an opioid, the drug can result in which of the following? a. reduced antitussive effect of dextromethorphan b. potentiation of the analgesic effect of the opioid c. increased renal reabsorption of the dextromethorphan d. delayed analgesic effect of the opioid
b
The health care provider orders ipratropium bromide (Atrovent), albuterol (Proventil), and beclomethasone (Vanceril) inhalers for a patient. What is the nurse's best action? a. Question the order; three inhalers should not be given at one time. b. Administer the albuterol, wait 5 minutes, administer ipratropium bromide, then beclomethasone several minutes later. c. Administer each inhaler at 30-minute intervals. d. Administer beclomethasone, wait 2 minutes, administer ipratropium bromide, then albuterol several minutes later.
b
The nurse is caring for a patient who is hospitalized for an asthma exacerbation. The patient reports taking diphenhydramine at home at night to help with symptoms of allergic rhinitis and cough. The nurse will contact the patient's provider to request an order for which medication? a. benzonatate (Tessalon Perles) b. cetirizine (Zyrtec) c. dextromethorphan hydrobromide (Benylin DM) d. diphenhydramine (Benadryl)
b
The nurse is caring for a patient who is receiving diphenhydramine. The nurse notes that the patient has not voided for 12 hours. What action will the nurse take? a. encourage the patient to drink more fluids b. evaluate the bladder to check for distension c. request an order for an intravenous fluid bolus d. request an order for urinary catheterization
b
The nurse is caring for a patient who is receiving intravenous theophylline. The patient complains of headache and nausea. The nurse will contact the provider to a. change the medication to an oral theophylline b. obtain an order for a serum theophylline level c. request an order for an analgesic medication d. suggest an alternative methylxanthine medication
b
The nurse is caring for a patient who will begin taking theophylline at home. During the assessment, the nurse learns that the patient smokes. The nurse reports this to the provider and will expect the provider to a. decrease the dose of theophylline b. increase the dose of theophylline c. keep the theophylline dose as ordered d. discontinue the theophylline
b
The nurse is providing teaching for a patient who will use intranasal dexamethasone (Decadron) after discharge home from the hospital. What information is important to include when teaching this patient about this drug? a. "Dexamethasone may be used for year-round symptoms." b. "Dexamethasone should be discontinued after 30 days." c. "Dexamethasone should not be taken with antihistamines." d. "Dexamethasone should not cause systemic steroid side effects."
b
The nurse is teaching the patient on the use of beclomethasone diproprionate (Beconase). Which statement by the patient indicates an understanding of the teaching? a. "I will need to taper off the medication to prevent acute adrenal crisis." b. "This medication will help prevent the inflammatory response of my allergies." c. "I will need to monitor my blood sugar more closely because it may increase." d. "I need to take this medication only when my symptoms get bad."
b
The parents of a 3-year-old child tell the nurse that they are planning to give their child diphenhydramine (Benadryl) on a flight to visit the child's grandparents to help the child sleep during the flight. What will the nurse tell the parents about giving this drug? a. administer 25 mg of diphenhydramine when using to induce sleep b. diphenhydramine may have the opposite effect and could cause agitation c. give the diphenhydramine about 5 minutes prior to takeoff d. loratadine should be used instead of diphenhydramine to minimize side
b
The patient has asthma and takes cromolyn. Which statement by the patient indicates the need for more education? a. "I must take this drug everyday" b. "It will stop an asthma attack when taken immediately" c. "I can rinse my mouth out with water to get rid of the taste" d. "It is important for me to take this exactly as directed"
b
The patient has been prescribed both ipratropium and cromolyn. How many minutes should the patient wait between using the two drugs? a. 1 b. 5 c. 10 d. It does not matter
b
The patient tells the nurse that she has a cold, is coughing, and feels like she has fluid in her lungs. What action will the nurse anticipate performing next? a. Administer dextromethorphan. b. Administer guaifenesin. c. Encourage the patient to drink fluids hourly. d. Administer fluticasone (Flonase).
b
What is the most important thing for the nurse to teach a patient who is switching allergy medications from diphenhydramine (Benadryl) to loratadine (Claritin)? a. Loratadine can potentially cause dysrhythmias b. Loratadine has fewer sedative effects. c. Loratadine has increased bronchodilating effects. d. Loratadine causes less gastrointestinal upset.
b
When explaining how a patient should use ipratropium (Atrovent), a health care professional should include which of the following instructions? a. do not drink anything for 30 min after using the drug b. wait 5 min between using the drug and another inhaled drug c. this drug is used to thin respiratory secretions d. check pulse rate after inhaling the drug
b
Which of the following anticholinergic drugs has few systemic effects and is administered by aerosol? a. Albuterol b. Ipratropium c. Isoproterenol d. Tiotropium
b
The parent of an 18-month-old toddler calls the clinic to report that the child has vomited 5 times that day. The nurse determines that the child has had three wet diapers in the past 6 hours. What will the nurse recommend for this child? a. Administering an OTC antiemetic medication such as diphenhydramine b. Giving frequent, small amounts of Pedialyte c. Keeping the child NPO until vomiting subsides d. Taking the child to the emergency department for IV fluids
B
A patient who experiences motion sickness when flying asks the nurse the best time to take the medication prescribed to prevent motion sickness for a 0900 flight. The nurse will instruct the patient to take the medication at which time? a. As needed, at the first sign of nausea b. At 0700, before leaving for the airport c. At 0830, just prior to boarding the plane d. When seated, just prior to takeoff
C
