Pharmacology Final
Which statement about food and drug interactions is true? a. Medications are best absorbed on an empty stomach. b. Some foods, such as grapefruit, can inhibit CYP isoenzymes and alter drug metabolism c. Patient discomfort is the food and drug interaction of most concern. d. Foods alter drug absorption and metabolism but not drug action.
B
The healthcare provider is assessing the glucose level of a patient with a diagnosis of diabetes. Which of these is most helpful in evaluating this patient's long-term glucose management? a. Urine glucose b. Urine specific gravity c. Fasting blood glucose level d. Hemoglobin A1c (Hgb A1C)
D
The nurse is caring for a patient who is receiving vancomycin [Vancocin]. The nurse notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The patient's heart rate is 120 beats/min, and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with: a. rhabdomyolysis. b. Stevens-Johnson syndrome. c. allergic reaction. d. red man syndrome
D
A patient is taking ibuprofen 800 mg three times a day by mouth as treatment for OA. While taking a health history, the nurse finds out that the patient has a few beers on weekends. What concern would there be with the interaction of the alcohol and ibuprofen? a. Increased risk for falls b. Increased chance for GI bleeding c. Increased nephrotoxic effects d. Reduced anti-inflammatory effects of the NSAID
B
A nurse cares for a patient who has diabetes mellitus. The nurse administers 6 units of regular insulin and 10 units of NPH insulin at 07:00. At which time would the nurse assess the patient for potential problems related to the NPH insulin? a. 16:00 b. 08:00 c. 23:00 d. 20:00
A
A patient with chronic pain has been receiving morphine sulfate but now has decreased pain. The prescriber changes the medication to ketolorac [Toradol]. The nurse will monitor the patient for: a. nausea and sweating. b. respiratory depression. c. hypotension. d. euphoria.
A
A patient with gout has been treated with allopurinol (Zyloprim) for 2 months. The nurse will monitor laboratory results for which a. Decreased uric acid levels b. Increased hemoglobin and hematocrit levels c. Decreased white blood cell count d. Decreased prothrombin time
A
A patient with post-operative pain who has been receiving an opioid analgesic reports having pain at a new location even though the previous pain is well controlled. The nurse will contact the provider to discuss: a. complication such as infection or deep vein thrombus. b. breakthrough pain. c. drug-seeking behavior. d. tolerance to drug therapy.
A
A physician prescribes a Proton-Pump Inhibitor to a patient with a gastric ulcer. Which medication is considered a PPI? a. Pantoprazole b. Famotidine c. Famotidine d. Metronidazole
A
The nurse is caring for a child who has ingested a toxic amount of aspirin. The provider orders an intravenous drug that will increase pH in the blood and urine. The nurse understands that this effect is necessary to: a. increase the urinary excretion of aspirin. b. decrease the lipid solubility of aspirin. c. decrease the gastric absorption of aspirin. d. increase the serum protein binding of aspirin.
A
A client with diarrhea for 3 days and inability to eat or drink well is brought to the emergency department (ED) by her family. She states she has been taking her diuretics for congestive heart failure (CHF). What nursing actions are indicated at this time? (Select all that apply.) a. Initiate cardiac monitoring b. Evaluate the electrolyte levels. c. Administer the ordered diuretic. d. Assess for orthostatic hypotension. e. Place the client on bed rest.
A, B, D, E
The nurse is caring for a client with a diagnosis of gout. Which laboratory value would the nurse expect to note in the client? a. Potassium level of 4.1 mEq/L b. Uric acid level of 9.0 mg/dL c. Calcium level of 9.0 mg/dL d. Phosphorus level of 3.1 mg/dL
B
When a patient is taking an adrenergic drug, the nurse expects to observe which effect? a. bronchial constriction b. increased heart rate c. increased intestinal peristalsis d. constricted pupils
B
A child with an ear infection is not responding to treatment with amoxicillin [Amoxil]. The nurse will expect the provider to order: a. amoxicillin-clavulanic acid [Augmentin]. b. penicillin G c. ampicillin d. nafcillin
A
A child with otitis media has had three ear infections in the past year. The child has just completed a 10-day course of amoxicillin [Amoxil] with no improvement. The parent asks the nurse why this drug is not working, because it has worked in the past. What will the nurse tell the patient? a. "The bacteria have synthesized penicillinase." b. "Amoxicillin is too narrow in spectrum." c. "The bacteria have developed penicillin-binding proteins (PBPs) that have a low affinity for penicillins." d. "The bacteria have developed a three-layer cell envelope."
A
A client has received a dose of dimenhydrinate (Dramamine), The nurse should observe relief of what sign or symptom to evaluate that the medication has been effective? a. Nausea and vomiting b. Buzzing sound in the ears c. Headache d. Chills
A
A client on anticoagulant therapy is being discharged. Which statement by the client indicates an understanding of the anticoagulants drug action? a. "It should prevent my blood from clotting." b. "It might cause me to get injured more often." c. "It is used to dissolve blood clots." d. "It will thin my blood".
A
A factory worker has been admitted to the emergency department after an industrial accident involving organophosphate insecticides. The nurse knows insecticides belong to which class of potentially toxic drugs? a. acetylcholinesterase inhibitors b. cholinergic agonists c. adrenergic antagonists d. adrenergic agonists
A
A nurse and a nursing student are reviewing the care of a 30-kg patient who will receive intravenous theophylline, a methylxanthine. Which statement by the student indicates an understanding of the administration of this medication? a. "Dosing is titrated based on the serum theophylline levels." b. "After the loading dose has been given, the patient will receive 6 mg/kg/hr." c. "If the patient's serum theophylline level is less than 15 mcg/mL, the rate should be reduced." d. "The patient will receive a loading dose of 180 mg over 5 minutes."
A
A nurse is caring for an intubated patient who is receiving pancuronium (Pavulon) for neuromuscular blockade. The patient's eyes are closed, and the patient is not moving any extremities. The patient's heart rate is 76 beats per minute, and the blood pressure is 110/70 mm Hg. The nurse caring for this patient will do what? a. Talk to the patient while giving care and explain all procedures. b. Review the patient's chart for a history of myasthenia gravis (MG). c. Request and order for an antihistamine to prevent a further drop in blood pressure. d. Request an order for serum electrolytes to evaluate for hyperkalemia.
A
A nurse is preparing to administer medications. Which patient would the nurse consider to have the greatest predisposition to an adverse reaction? a. A 30-year-old man with kidney disease b. A 75-year-old woman with cystitis c. A 9-year-old boy with an ear infection d. A 50-year-old man with an upper respiratory tract infection
A
A nurse is teaching a nursing student what is meant by "generations" of cephalosporins. Which statement by the student indicates understanding of the teaching? a. "Cephalosporins have increased activity against gram-negative bacteria with each generation." b. "First-generation cephalosporins have better penetration of the cerebrospinal fluid." c. "Later generations of cephalosporins have lower resistance to destruction by beta-lactamases d. "Cephalosporins are assigned to generations based on their relative costs to administer."
A
A nursing professor is teaching a class about a medication that alters the parasympathetic nervous system functions. To evaluate understanding, the nurse asks the students to describe which functions the parasympathetic nervous system regulates. Which of the following statements represent functions that are primarily regulated by the parasympathetic nervous system: a. "The digestive functions of the body" b. "The cardiovascular system" c. "Body temperature" d. "The fight-or-flight response"
A
A patient has an infection caused by Pseudomonas aeruginosa.The prescriber has ordered piperacillin and amikacin, both to be given intravenously. What will the nurse do? a. Make sure to administer the drugs at different times using different IV tubing. b. Suggest giving larger doses of piperacillin and discontinuing the amikacin. c. Suggest that a fixed-dose combination of piperacillin and tazobactam [Zosyn] be used d. Watch the patient closely for allergic reactions, because this risk is increased with this combination
A
A patient is admitted to the unit for treatment for an infection. The patient receives IV amikacin [Amikin] twice a day. When planning for obtaining a peak aminoglycoside level, when should the nurse see that the blood is drawn? a. 30 minutes after the IV infusion is complete b. 1 hour before administration of the IV infusion c. A peak level is not indicated with twice-daily dosing. d. 1 hour after the IV infusion is complete
A
A patient is receiving instructions regarding the use of caffeine for migraine headaches. The nurse shares that caffeine should be used with caution if which of these conditions is present? a. A history of peptic ulcers b. A history of kidney stones c. Asthma d. Tension headache
A
A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels. The dosing is correct, and this medication has been tolerated by this patient in the past. Which could be a probable cause of the test result? a. The patient is taking another medication that binds to serum albumin. b. The drug was not completely dissolved in the IV solution. c. The medication is being given at a frequency that is longer than its half-life. d. A loading dose was not given.
A
A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what? a. Monitor plasma drug levels. b. Administer this medication intravenously. c. Administer the drug at intervals longer than the drug half-life. d. Teach the patient that maximum drug effects will occur within a short period.
A
A patient recently began receiving clindamycin [Cleocin] to treat an infection. After 8 days of treatment, the patient reports having 10 to 15 watery stools per day. What will the nurse tell this patient? a. The patient should stop taking the clindamycin now and contact the provider immediately. b. The patient should try taking Lomotil or a bulk laxative to minimize the diarrheal symptoms c. The provider may increase the clindamycin dose to treat this infection. d. This is a known side effect of clindamycin, and the patient should consume extra fluids
A
A patient who has been taking gentamicin for 5 days reports a headache and dizziness. What will the nurse do? a. Suspect ototoxicity and notify the prescriber. b. Request an order for a gentamicin peak level. c. Tell the patient to ask for help with ambulation. d. Tell the patient to report any tinnitus.
A
A patient who has developed opioid tolerance will experience which effect? a. decreased analgesic effect b. decreased constipation c. increased respiratory depression d. increased euphoria
A
A patient who has gastroesophageal reflux disease (GERD) receives a prescription for a proton pump inhibitor (PPI) medication. What will the nurse include when teaching the patient about this drug? a. "You should report any fever and cough to your provider." b. "This drug will be given on a short-term basis only." c. "You may experience hypermagnesemia when taking this drug." d. "The FDA has determined that there is a gastric cancer risk with this drug."
A
A patient who takes nonsteroidal anti-inflammatory drugs (NSAIDs) for arthritis asks a nurse what can be done to prevent ulcers. The nurse will recommend asking the provider about using which medication? a. Proton pump inhibitors b. Mucosal protectants c. Histamine-2 receptor antagonists d. Antibiotics
A
A patient with COPD is prescribed tiotropium [Spiriva]. After the initial dose, the patient reports only mild relief within 30 minutes. What will the nurse tell the patient? a. "You should see improved effects within the next week." b. "You may need to take two inhalations instead of one." c. "You should have peak effects in about 6 hours." d. "You may have another dose in 4 hours."
A
A postoperative patient who is worried about pain control will be discharged several days after surgery. The nurse providing discharge teaching tells the patient that the prescribed Lortab is not as strong as the morphine the patient was given in the immediate postoperative period. Which response is the patient likely to experience? a. A negative placebo effect when taking the medication b. Optimistic, realistic expectations about the drug c. A decreased likelihood of filling the prescription for the drug d. An increased compliance with the drug regimen
A
An older adult patient who has cancer and Alzheimer's disease is crying but shakes his or her head "no" when asked about pain. The prescriber has ordered morphine sulfate 2 to 4 mg IV every 2 hours PRN pain. It has been 4 hours since a dose has been given. What will the nurse do? a. Administer 4 mg of morphine and monitor this patient's verbal and nonverbal responses. b. Withhold any analgesic at this time and reassess the patient in 30 to 60 minutes. c. Request an order for a nonopioid analgesic or an antidepressant adjuvant analgesic. d. Give 2 mg of morphine for pain to avoid increasing this patient's level of confusion.
A
An unresponsive patient who has diabetes is brought to the emergency department with slow, deep respirations. Additional findings include: blood glucose 450 mg/dL (24.9 mmol/L), arterial pH 7.2 (acidosis), and urinalysis showing presence of ketones and glucose. Which of the following best describes the underlying cause of this patient's presentation? a. Diabetic Ketoacidosis (DKA) b. Hyperosmolar Hyperglycemic Syndrome (HHS) c. Hypoglycemia d. Respiratory acidosis
A
Benign prostatic hypertrophy (BPH) symptoms may be treated with an adrenergic antagonist such as tamsulosin (Flomax) because: a. these agents block alpha1 receptors to reduce contraction of smooth muscle in the bladder neck and prostatic capsule. b. these agents can increase bladder capacity and thus decrease the sensation of needing to void. c. these agents can cause permanent shrinkage of the prostate gland. d. affected patients generally have hypertension also.
A
Dopamine is administered to a patient who has been experiencing hypotensive episodes. Other than an increase in blood pressure, which indicator would the nurse use to evaluate a successful response to the dopamine? a. Increase in urine output b. Weight gain c. Improved gastric motility d. Decrease in pulse.
A
Jane is a 67 year-old woman with a history of mild hypertension and classic angina pectoris. She is seeking treatment for migraine headaches of moderate intensity. Her headaches are preceeded by bilateral light flashes and dizziness that last about 10 minutes prior to the onset of pain. Her headaches are also frequently accompanied by photophobia, severe nausea and occasional vomiting. What medication would be contraindicated for acute treatment of Jane's headaches? a. Sumatriptan b. Aspirin c. Caffeine d. Propranolol e. Acetaminophen
A
The mechanism of action for carbidopa (Lodosyn), used in the treatment of Parkinson's disease is: a. increasing availability of levodopa available to the CNS by reducing its breakdown b. decreasing cholinergic receptor activation in the CNS c. activating dopamine receptors in the CNS
A
The nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Upon assessing the patient, the nurse notices the individual has developed oral thrush. What describes the etiology of the thrush? a. superinfection b. community-aquired infection c. nosocomial infection d. Antibiotic resistance
A
The nurse instructs a patient on how to correctly use an inhaler with a spacer. In which order would these steps occur? 1. "Press down firmly on the canister to release one dose of medication." 2. "Breathe in slowly and deeply." 3. "Shake the whole unit vigorously three or four times." 4. "Insert the mouthpiece of the inhaler into the nonmouthpiece end of the spacer." 5. "Place the mouthpiece into your mouth, over the tongue, and seal your lips tightly around the mouthpiece." 6. "Remove the mouthpiece from your mouth, keep your lips closed, and hold your breath for at least 10 seconds." a. 4, 3, 5, 1, 2, 6 b. 3, 4, 5, 1, 6, 2 c. 2, 3, 4, 5, 6, 1 d. 5, 3, 6, 1, 2, 4
A
The nurse is overseeing a nursing student who is administering medications to a group of clients receiving treatment for pulmonary embolism. The nurse recognizes the student understands safety and administration of anticoagulant therapy when the student makes which of these statements? a. "Therapy with warfarin (Coumadin) is effective when the INR is between 2 and 3." b. "If bleeding develops, we will give platelets to reverse the anticoagulant." c. "The client will receive a dose of enoxaparin (Lovenox) intramuscularly for 3 days." d. "Once the health care provider orders warfarin (Coumadin), the intravenous heparin can be discontinued."
A
The nurse is preparing to administer prescribed medications to a client with hepatic encephalopathy. The nurse anticipates that the health care provider's prescriptions will include which medication? a. Lactulose (an osmotic laxative) b. Psyllium hydrophilic mucilloid (a bulk laxative) c. Magnesium hydroxide (saline laxative) d. Bisacodyl suppository (a stimulant laxative)
A
When titrating an analgesic to manage pain, what is the priority goal? a. Administer smallest dose that provides relief with the fewest side effects. b. Titrate downwards to prevent toxicity. c. Titrate upward until the client is pain free. d. Ensure that the drug is adequate to meet the client's subjective needs.
A
Which client is most likely to receive opioids for extended periods of time? a. A client with progressive pancreatic cancer b. A client with phantom limb pain c. A client with fibromyalgia d. A client with trigeminal neuralgia
A
Which medication should be used for asthma patients as part of step 1 management? a. Short-acting beta2 agonists b. Combination inhaled glucocorticoids/long-acting beta2 agonists c. Inhaled low-dose glucocorticoids d. Long-acting beta2 agonists
A
Which side effect of clindamycin [Cleocin] causes the most concern and may warrant discontinuation of the drug? a. Diarrhea b. Headache c. Nausea d. None of the above
A
Which statement is INCORRECT about Histamine-receptor blockers? a. H2 blockers decrease gastric pH b. "Antacids and H2 blockers should not be given together." c. H2 Blockers absorption is slowed if taken with meals d. "Ranitidine and Famotidine are two types of histamine-receptor blocker medications."
A
Which statement(s) about the neuro transmitter acetylcholine is true? a. "Acetylcholine activates three cholinergic receptor subtypes." b. "Acetylcholine effects are restricted to the parasympathetic nervous system." c. "Acetylcholine is a catecholamine." d. "Cholinesterase inhibitors will decrease levels of acetylcholine."
A
You are working near a war zone and are taking care of a soldier who has been given an irreversible cholinesterase inhibitor during warfare. What action would be the BEST thing to do first in this situation? a. Give the atropine dose that has been ordered b. Give him acetylcholine c. Assess his urine output d. Notify his family that he has been hospitalized
A
Your patient is taking donepezil (Aricept) for Alzheimer's disease. You might expect her to have: a. cholinergic side effects from this drug b. long lasting improvement in symptoms occurs in most patients from this drug c. Signs of renal failure developing from this drug d. dramatic improvement in her symptoms, and potential curative effects from this drug
A
The nurse is administering morning medications. The nurse gives a patient multiple medications, two of which compete for plasma albumin receptor sites. As a result of this concurrent administration, the nurse can anticipate that what might occur? (Select all that apply.) a. Binding of one or both agents will be reduced. b. The increase in free drug will intensify effects. c. Plasma levels of free drug will rise. d. The increase in bound drug will intensify effects. e. Plasma levels of free drug will fall.
A, B, C
A client with peptic ulcer disease asks the nurse what medications they might be prescribed for this problem. The nurse tells the client that which medications will be prescribed? Select all that apply. a. Antibiotics b. Histamine H2-receptor blockers c. Antacids d. Proton Pump Inhibitors e. Nonsteroidal antiinflammatory drugs (NSAIDs)
A, B, C, D
The nurse is caring for a client who is receiving a loop diuretic for treatment of heart failure. Which of these actions will be included in the plan of care? (Select all that apply.) a. Monitor serum potassium. b. Assess daily weights. c. Weigh the client weekly. d. Encourage consumption of citrus fruits and greens.
A, B, D
The nurse is teaching a client who is taking a potassium-sparing diuretic about precautions while taking this medication. Which of these does the nurse teach the client to avoid or use cautiously? (Select all that apply.) a. Bananas b. ACE inhibitors c. Loop diuretics d. Salt substitute
A, B, D
Before administering a medication, what does the nurse need to know to evaluate how individual patient variability might affect the patient's physiologic response to the medication? (Select all that apply.) a. Family medical history b. Ease of administration c. Patient's age d. Patient's diagnosis e. Chemical stability of the medication
A, C, D
What are the results of using glucocorticoid drugs to treat asthma? (Select all that apply.) a. Reduced edema of the airway b. Reduced number of bronchial beta2 receptors c. Increased responsiveness to beta2-adrenergic agonists d. Reduced bronchial hyperreactivity e. Increased synthesis of inflammatory mediators
A, C, D
Which drugs are used to treat COPD? (Select all that apply.) a. Long-acting beta2 agonists b. Leukotriene modifiers c. Glucocorticoids d. Anticholinergic medications e. Monoclonal antibodies
A, C, D
In monitoring a client's response to disease-modifying antirheumatic drugs (DMARDs), which assessment findings would the nurse consider acceptable responses? (Select all that apply) a. Normal white blood cell, platelet, and neutrophil counts b. Inflammation and irritation at the injection site 3 days after the injection is given c. An increased range of motion in the affected joints 3 months into therapy d. Radiological findings that show no progression of joint degeneration e. Control of symptoms during periods of emotional stress f. A low-grade temperature on rising in the morning that remains throughout the day
A, C, D, E
The nurse determines the client needs further instruction on cimetidine (Tagamet) if which statements were made? Select all that apply. a. "I'll know the medication is working if my diarrhea stops." b. "Some of my blood levels will need to be monitored closely since I also take warfarin for atrial fibrillation." c. "I will take the cimetidine with my meals." d. "I will notify my health care provider if I become depressed or anxious." e. "My episodes of heartburn will decrease if the medication is effective." f. "Taking the cimetidine with an antacid will increase its effectiveness."
A, C, F
A drug that is used for nerve pain (neuropathy) that is also a drug used as an anti-epileptic agent is / are: (Select all that apply) a. Gabapentin (Neurontin) b. Phenytoin (Dilantin) c. Diazepam (Valium) d. Carbamazepine (Tegretol)
A, D
Two nurses are discussing theories of drug-receptor interaction. Which statements are true regarding the affinity of a drug and its receptor? (Select all that apply.) a. Affinity refers to the strength of the attraction between a drug and its receptor. b. Drugs with low affinity are strongly attracted to their receptors. c. Affinity and intrinsic activity are dependent properties. d. The affinity of a drug for its receptors is reflected in its potency. e. Drugs with high affinity are strongly attracted to their receptors.
A, D, E
Which of the following terms describe the sympathetic nervous system? a. cholinergic, sympatholytic, parasympathomimetic, antiandrenergic b. adrenergic, anticholinergic, sympathomimetic, parasympatholytic c. sympatholytic, parasympathomimetic, adrenergic blockers, sympathomimetic d. adrenergic, parasympatholytic, nicotinic, muscarinic
B
A patient is beginning therapy with oral methotrexate [Rheumatrex] for rheumatoid arthritis. The nurse will teach this patient about the importance of: a. limiting folic acid consumption. b. reporting alopecia and rash. c. taking the medication on a daily basis. d. having routine renal and hepatic function tests.
D
A 23 year old woman with a history of depression comes to your clinic seeking relief for a severe migraine headache that began 20 minutes ago. She is currently taking the SSRI (selective serotonin repute inhibitor) Citalopram for her depression and an estrogen/progesterone combined oral contraceptive. What medication would you avoid using for her acute treatment? a. Ergotamine (Ergomar) b. Sumatriptan (Imitrex) c. Topiramate (Topamax) d. Morphine
B
A client is taking methimazole (Tapazole) for hyperthyroidism and would like to know how soon this medication will begin working. What is the nurse's best response? a. "You will see effects of this medication immediately." b. "You will see some effects of this medication within 2 weeks." c. "You will see effects of this medication within 1 week." d. "You will see full effects from this medication within 1 to 2 days."
B
A client reports frequent use of sodium bicarbonate to relieve heartburn after meals. The nurse should monitor the client for which condition that the client is at risk for with long-term frequent use of this medication? a. Chronic bronchitis b. Metabolic alkalosis c. Respiratory acidosis d. Urinary calculi
B
A client with a clot in the right atrium is receiving a heparin sodium infusion at 1000 units/hour and warfarin sodium 7.5 mg at 5:00 p.m. daily. The morning laboratory results are as follows: activated partial thromboplastin time (aPTT), 32 seconds; international normalized ratio (INR), 1.3. The nurse should take which action based on the client's laboratory results? a. Collaborate with the HCP to continue the heparin infusion at the same rate and to discuss use of dabigatran (Pradaxa) in place of warfarin sodium. b. Collaborate with the HCP to obtain a prescription to increase the heparin infusion and administer the warfarin sodium as prescribed. c. Collaborate with the health care provider (HCP) to discontinue the heparin infusion and administer the warfarin sodium as prescribed. d. Collaborate with the HCP to withhold the warfarin sodium since the client is receiving a heparin infusion and the aPTT is within the therapeutic range.
B
A client with hypertension is started on verapamil (Calan), a calcium channel blocker. What teaching does the nurse provide for this client? a. "Monitor for irregular pulse." b. "Avoid grapefruit juice." c. "Consume foods high in potassium." d. "Monitor for muscle cramping."
B
A client with thyroid cancer has just received Iodine-131 ablative therapy. Which statement by the client indicates a need for further teaching? a. "I need to wash my clothes separately from everyone else's clothes." b. "I'm ready to hold my newborn grandson now." c. "I cannot share my toothpaste with anyone." d. "I must flush the toilet three times after I use it."
B
A client with type 2 diabetes controlled with Metformin is recovering from surgery. The primary health care provider has placed the client on insulin in addition to the metformin. What is the nurse's best response about why the client needs to take insulin? a. "Your diabetes is getting worse, so you will need to take insulin." b. "Stress, such as surgery, increases blood glucose levels. You'll need insulin to control your blood glucose temporarily." c. "You must take insulin from now on because the surgery will affect your diabetes." d. "You can't take your metformin while in the hospital."
B
A client with typically well controlled diabetes has a glycosylated hemoglobin (HbA1C) level of 9.4%. Which response by the nurse is most appropriate? a. "Keep up the good work." b. "Have you been doing something differently? c. "This is not good at all." d. "You need an increase in your insulin dose."
B
A diabetic patient has the following presentation: unresponsive to voice or touch, tachycardia, diaphoresis, and pallor. Which of the following actions by the healthcare provider is the priority? a. Administer the prescribed insulin b. Administer 50% dextrose IV per hypoglycemia protocol c. Send blood to the laboratory for analysis d. Administer oxygen per nasal cannula
B
A nurse administers medications to a patient who has asthma. Which medication classification is paired correctly with its physiologic response to the medication? a. Cromolyn—disrupts the production of pathways of inflammatory mediators b. Cholinergic antagonist—causes bronchodilation by inhibiting the parasympathetic nervous system c. Corticosteroid (Glucocorticoid)—relaxes bronchiolar smooth muscles by binding to and activating pulmonary beta2 receptors d. Bronchodilator—stabilizes the membranes of mast cells and prevents the release of inflammatory mediators
B
A nurse assesses a patient who is prescribed a medication that stimulates beta1 receptors. Which assessment finding would alert the nurse to urgently contact the healthcare provider? a. Respiratory rate of 18 breaths/min b. Heart rate of 50 beats/min c. Oxygenation saturation of 92% d. Blood pressure of 144/69 mm Hg
B
A nurse assesses a patient who is prescribed levothyroxine (Synthroid) for hypothyroidism. Which assessment finding alerts the nurse that the medication therapy is effective? a. Weight has been the same for 3 weeks. b. Heart rate is 70 beats/min and regular. c. Total white blood cell count is 6000 cells/mm3 (6 × 109/L). d. Thirst is recognized and fluid intake is appropriate.
B
A nurse assesses a patient with diabetes mellitus who self-administers subcutaneous insulin. The nurse notes a spongy, swelling area at the site the patient uses most frequently for insulin injection. What action would the nurse take? a. Consult the provider for a new administration route. b. Instruct the patient to rotate sites for insulin injection. c. Assess the patient for other signs of cellulitis. d. Apply ice to the site to reduce inflammation.
B
A nurse cares for a patient who has elevated levels of antidiuretic hormone (ADH). Which disorder should the nurse identify as a trigger for the release of this hormone? a. Pneumonia b. Dehydration c. Edema d. Renal failure
B
A nurse cares for a patient with diabetes mellitus who is prescribed metformin (Glucophage) and is scheduled for a contrast-enhanced CT. What action should the nurse take first? a. Administer intravenous fluids to dilute and increase the excretion of dye. b. Contact the provider and recommend discontinuing the metformin. c. Keep the patient NPO for at least 6 hours prior to the examination. d. Check the patient's bedside blood glucose and administer prescribed insulin.
B
A nurse is teaching a group of nursing students about the different formulations of beta2-adrenergic agonist medications. Which statement by a student indicates understanding of the teaching? a. "Short-acting beta2 agonists are usually given by nebulizer." b. "Oral beta2 agonists are not useful for short-term treatment." c. "Beta2-adrenergic agonists provide quick relief via any formulation." d. "Long-acting beta2 agonists may be used alone to prevent attacks."
B
A nurse teaches a patient with diabetes mellitus about sick-day management. Which statement would the nurse include in this patient's teaching? a. "If vomiting, do not use insulin or take your oral antidiabetic agent." b. "Monitor your blood glucose levels at least every 4 hours while sick." c. "Try to continue your prescribed exercise regimen even if you are sick." d. "When ill, avoid eating or drinking to reduce vomiting and diarrhea."
B
A nursing student asks the nurse why the provider has ordered a combination product containing an opioid analgesic and an NSAID for a patient who has cancer. Which response by the nurse is correct? a. "There are decreased effects of NSAIDs on the GI tract when a combination product is used." b. "There is increased pain relief with the combination than when either product is used alone." c. "There are fewer adverse effects from both drugs when used in a combination product." d. "There is a decreased likelihood of opioid dependence when it is given in combination with an NSAID."
B
A parent asks a nurse if the provider will prescribe an antibiotic for a child who attends school with several children who have strep throat. The child is complaining of a sore throat and has a fever. What will be the nurse's response? a. "Your child probably has strep throat, so your provider will order an antibiotic." b. "Your child should come to the clinic to have a throat culture done today." c. "Because strep throat is likely, your child should be treated empirically." d. "With good hand washing, your child should not get strep throat."
B
A patient admitted to the hospital has a history of peptic ulcer disease. The patient takes ranitidine [Zantac] and sucralfate [Carafate]. The patient tells the nurse that discomfort is usually controlled but that symptoms occasionally flare up. What will the nurse do? a. Contact the provider to discuss switching to a proton pump inhibitor. b. Counsel the patient on non-drug intervention such as avoiding beverages containing alcohol c. Ask the provider about ordering an endoscopic examination. d. Contact the provider to discuss serologic testing and an antibiotic.
B
A patient diagnosed with type 2 diabetes mellitus is admitted to the medical unit with pneumonia. The patient's oral antidiabetic medication has been discontinued and the patient is now receiving insulin for glucose control. Which of the following statements best explains the rationale for this change in medication? a. Infection has compromised beta cell function so the patient will need insulin from now on b. Stress-related states such as infections increase risk of hyperglycemia c. Insulin administration will help prevent hypoglycemia during the illness d. Acute illnesses like pneumonia will cause increased insulin resistance
B
A patient has just received a prescription for fluticasone/salmeterol [Advair Diskus]. What will the nurse include as part of the teaching for this patient about the use of this device? a. "You will need to use a spacer to help control the medication." b. "You do not need good hand-lung coordination to use this device." c. "You will begin to inhale before activating the device." d. "You will take 2 inhalations twice daily."
B
A patient is admitted for diabetic ketoacidosis (DKA), and an IV drip titrated to maintain blood glucose levels between 120 and 200 is ordered (intravenous infusion). The only insulin that would be administered IV is: a. NPH insulin b. Regular insulin c. None of the above, insulin cannot be administered IV d. Lantus (Glargine) insulin
B
A patient is brought to the emergency department by friends, who report finding the patient difficult to awaken. The friends report removing three fentanyl transdermal patches from the patient's arm. On admission to the emergency department, the patient is slow to respond, has pinpoint pupils and a respiratory rate of 6 breaths per minute. The nurse recognizes the priority intervention as: a. Obtain an order for a head CT. b. Administer Naloxone (Narcan) per standing order. c. Administration of IV fluids containing glucose. d. Obtain an order for a different opioid analgesic to manage the patient's pain.
B
A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels. The dosing is correct, and this medication has been tolerated by this patient in the past. Which could be a probable cause of the test result? a. The medication is being given at a frequency that is longer than its half-life. b. The patient is taking another medication that binds to serum albumin. c. The drug was not completely dissolved in the IV solution. d. A loading dose was not given.
B
A patient is receiving tobramycin 3 times daily. The provider has ordered a trough level with the 8:00 AM dose. The nurse will ensure that the level is drawn at what time? a. 7:00AM b. 7:45AM c. 4:00AM d. 8:45AM
B
A patient newly diagnosed with PUD reports taking low-dose aspirin (ASA) for prevention of cardiovascular disease. The nurse learns that the patient drinks 2 to 3 cups of coffee each day and has a glass of wine with dinner 3 or 4 nights per week. The patient eats three meals a day. The nurse will counsel this patient to: a. discontinue taking aspirin, because it can irritate the stomach. b. change the meal pattern to five or six smaller meals per day c. switch to a decaffeinated coffee and reduce the number of servings.
B
A patient who has been newly diagnosed with asthma is referred to an asthma clinic. The patient reports daily symptoms requiring short-acting beta2-agonist treatments for relief. The patient has used oral glucocorticoids three times in the past 3 months and reports awakening at night with symptoms about once a week. The nurse will expect this patient to be started on which regimen? a. No daily medications; just a SABA as needed b. Daily low-dose inhaled glucocorticoid/LABA with a SABA as needed c. Continue current medication regimen as is
B
A patient who has pancreatitis reports a pain level of 8 on a 1 to 10 pain scale with 10 being the most severe pain. The patient has an order for acetaminophen (Tylenol) as needed for pain, and has been taking it as ordered around the clock. Which action by the nurse is correct? a. Explain to the patient the importance not exceeding 4000mg of acetaminophen daily b. Contact the prescriber and request the addition of an opioid c. Administer an additional dose of the acetaminophen (Tylenol) as ordered. d. Contact the provider to discuss nonpharmacologic pain measures
B
A patient who takes oral theophylline [Theochron] twice daily for chronic stable asthma develops an infection and will take ciprofloxacin. The nurse will contact the provider to discuss: a. changing to a different antibiotic. b. reducing the theophylline dose. c. switching from theophylline to a LABA. d. giving theophylline once daily.
B
A patient with a history of heart failure and hypertension is in the clinic for a follow-up visit. The patient is on lisinopril (Prinivil) and warfarin (Coumadin). The patient reports new-onset cough. What action by the nurse is most appropriate initial intervention? a. obtain a set of vital signs and document them. b. assess the patient's lung sounds and oxygenation. c. remind the patient that cough is a side effect of Prinivil. d. instruct the patient on another antihypertensive.
B
A patient with asthma is admitted to an emergency department with a respiratory rate of 22 breaths per minute, a prolonged expiratory phase, tight wheezes, and an oxygen saturation of 90% on room air. The patient reports using fluticasone [Flovent HFA] 110 mcg twice daily and has used 2 puffs of albuterol [Proventil HFA], 90 mcg/puff, every 4 hours for 2 days. The nurse will expect to administer which drug? a. Intramuscular glucocorticoids and salmeterol by metered-dose inhaler b. Intravenous glucocorticoids, nebulized albuterol and ipratropium, and oxygen c. Four puffs of albuterol, oxygen, and intravenous theophylline d. Intravenous theophylline, oxygen, and fluticasone (Flovent HFA) 220 mcg
B
A patient with cancer is admitted to the hospital. The nurse obtains an admission history and learns that the patient has been taking oxycodone and a nonsteroidal anti-inflammatory drug (NSAID) for a year. The patient reports a recent increase in the intensity of pain, along with a new pain described as "burning" and "shooting." The nurse anticipates that the prescriber will order: a. An increase in the oxycodone and NSAID doses. b. A fentanyl transdermal patch, acetaminophen, and an adjunctive analgesic for nerve pain. c. Intramuscular morphine sulfate and acetaminophen. d. A combination opioid/NSAID and an adjunctive analgesic.
B
A patient with gout who has increasingly frequent acute gouty attacks will begin receiving allopurinol [Zyloprim] and colchicine. The nurse will include which statement when teaching the patient about this drug regimen? a. "The colchicine is given to enhance the effects of the allopurinol." b. "You will take both drugs initially and then stop taking the colchicine." c. "Allopurinol helps reduce the gastrointestinal side effects of colchicine." d. "Allopurinol reduces the likelihood of gouty episodes that usually occur with initial colchicine therapy."
B
A patient with rheumatoid arthritis is experiencing sudden vision changes. Which medication found in the patient's medication list can cause retinal damage? a. Methylprednisolone (Medrol) b. Hydroxychloroquine (Plaquenil) c. Sulfasalazine (Azulfidine) d. Lefluomide (Arava)
B
A patient with stable COPD is prescribed a bronchodilator medication. Which type of bronchodilator is preferred for this patient? a. An oral beta2 agonist b. A long-acting inhaled beta2 agonist c. An intravenous methylxanthine d. A short-acting beta2 agonist
B
Intravenous heparin therapy is prescribed for a client. While implementing this prescription, the nurse ensures that which medication is available on the nursing unit? a. Potassium chloride b. Protamine sulfate c. Aminocaproic acid d. Vitamin K
B
Loop diuretics have all of the following potential adverse effects except: a. Hypotension b. Urinary Retention c. Hyponatremia d. Hypokalemia
B
Place the examples of drugs in the order of usage according to the World Health Organization (WHO) analgesic ladder. a. Morphine, hydromorphone, acetaminophen and lorazepam b. NSAIDs and corticosteroids c. Codeine, oxycodone and diphenhydramine a. A, B, C b. B, C, A c. B, A, C d. C, A, B
B
The nurse is preparing to administer penicillin G intramuscularly to a child. The child's parents ask why the drug cannot be given in an oral liquid form. What is the nurse's reply? a. "This drug has a narrow therapeutic range, and the dose must be tightly controlled." b. "This drug would be inactivated by enzymes in the stomach." c. "This drug is absorbed much too quickly in an oral form." d. "This drug causes severe gastric upset if given orally."
B
The nurse is teaching a client about thyroid replacement therapy. Which statement by the client indicates a need for further teaching? a. "I will have more energy with this medication." b. "If I continue to lose weight, I may need an increased dose." c. "I will take the medication every morning." d. "If I gain weight and feel tired, I may need an increased dose."
B
The nurse is teaching a patient about home administration of insulin to treat diabetes mellitus. As part of the teaching, the patient and nurse identify goals to maintain specific blood glucose ranges. This represents which aspect of the nursing process? a. Evaluation b. Planning c. Implementation d. Assessment
B
The nurse is teaching a patient how to self-administer triptan injections for migraine headaches. Which statement by the patient indicates that he needs further teaching? a. "I will take this medication when I feel a migraine headache starting." b. "I will take this medication regularly to prevent a migraine headache from occurring." c. "I will keep a journal to record the headaches I have and how the injections are working." d. "This medication does not reduce the number of migraines I will have."
B
The nurse notes in a patient's medication history that the patient is taking allopurinol (Zyloprim). Based on this finding, the nurse interprets that the patient has which disorder? a. rheumatoid arthritis b. Gout c. Systemic lupus erythematosus d. osteoarthritis
B
The nurse receives an order to give morphine 5 mg IV every 2 hours PRN pain. Which action is not part of the six rights of drug administration? a. Documenting the reason the medication was given in the patient's electronic medical record b. Assessing the patient's pain level 15 to 30 minutes after giving the medication c. Consulting a drug manual to determine whether the amount the prescriber ordered is appropriate d. Checking the medication administration record to see when the last dose was administered
B
The nurse recognizes that adrenergic drugs cause relaxation of the bronchi and bronchodilation by stimulating which type of receptors? a. dopaminergic b. Beta2 adrenergic c. Beta1 adrenergic d. Alpha1 adrenergic
B
A client with gout has begun to take allopurinol. The nurse informs the client that which medication may also be necessary during the beginning phase of medication therapy with allopurinol? (Select all that apply) a. Oxycodone b. Indomethacin c. Naproxen d. Hydromorphone e. Colchicine
B, C, E
You are providing discharge teaching to a patient taking Sucralfate (Carafate). Which statement by the patient demonstrates they understand how to take this medication? (Select all that apply) a. "I will take this medication once a week." b. "I will continue to take this medication as a preventative therapy" c. "It is best to take this medication with antacids." d. "I will always take this medication on an empty stomach."
B, D
A 17 year-old high school athlete with a history of asthma comes to your clinic seeking a preventative medication for migraine headaches. Which of the following would be contraindicated? a. Amitriptyline (Axert) b. Topiramate (Topamax) c. Propranolol (Inderal) d. Valproate (valproic acid)
C
A 7-year-old child with asthma uses a daily inhaled glucocorticoid and an albuterol MDI as needed. The provider has added montelukast [Singulair] to the child's regimen. Which statement by the child's parent indicates understanding of this medication? a. "I will give my child one 4-mg chewable tablet daily." b. "I should give this medication twice daily." c. "I may notice mood changes in my child." d. "This drug can alleviate symptoms during an acute attack."
C
A child is receiving a combination albuterol/ipratropium [DuoNeb] inhalation treatment. The patient complains of a dry mouth and sore throat. What will the nurse do? a. Notify the provider of a possible allergic reaction. b. Contact the provider to report systemic anticholinergic side effects. c. Reassure the patient that these are expected side effects. d. Discontinue the aerosol treatment immediately.
C
A client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition? a. Diverticulitis with perforation b. Intestinal obstruction c. Vomiting following cancer chemotherapy d. Peptic ulcer with melena (bloody stool)
C
A client with diabetic neuropathy reports a burning, electrical-type in the lower extremities that is not responding to NSAIDs. You anticipate that the physician will order which adjuvant medication for this type of pain? a. Methylphenidate (Ritalin) b. Corticosteroids c. Amitriptyline (Elavil) d. Lorazepam (Ativan)
C
A first day postoperative client on a PCA pump reports that the pain control is inadequate. What is the first action you should take? a. Try non-pharmacological comfort measures. b. Deliver the bolus dose per standing order. c. Assess the pain for location, quality, and intensity. d. Contact the physician to increase the dose
C
A patient with persistent, frequent asthma exacerbations asks a nurse about a long-acting beta2-agonist medication. What will the nurse tell this patient? a. LABAs are safer than short-acting beta2 agonists. b. LABAs can be used on an as-needed basis to treat symptoms. c. LABAs should be combined with an inhaled glucocorticoid. d. LABAs reduce the risk of asthma-related deaths.
C
A nurse assesses a patient after administering a prescribed beta-blocker. Which assessment would the nurse expect to find? a. Respiratory rate decreased from 25 to 14 breaths/min b. Oxygen saturation increased from 88% to 96% c. Pulse decreased from 100 to 80 beats/min d. Blood pressure increased from 98/42 to 132/60 mm Hg
C
A nurse is administering Hydrochlorothiazide to a client who has gouty arthritis. The nurse should monitor the client for which findings that could indicate an adverse effect from this drug? a. Hypoglycemia b. Hypernatremia c. Hyperuricemia d. Hyperkalemia
C
A nurse is teaching a patient about a drug that induces P-glycoprotein. The nurse will explain that this drug may cause which effect on other drugs? a. Increased brain exposure b. Increased fetal absorption c. Decreased absorption in the intestines d. decreased elimination through the kidneys
C
A nursing student is preparing to give a medication that has a "High Alert" or "Black Boxed Warning". The student asks the nurse what this means. What will the nurse explain about boxed warnings? a. They provide detailed information about the adverse effects of the drug. b. They indicate that a drug should not be given except in life-threatening circumstances. c. They alert prescribers to measures to mitigate potential harm from side effects. d. They provide information about antidotes in the event that toxicity occurs.
C
A patient asks the nurse what can be given to alleviate severe, chronic cancer pain of several months' duration. The patient has been taking oxycodone [OxyContin] and states that it is no longer effective. The nurse will suggest discussing which medication with the provider? a. Hydrocodone [Vicodin] PO b. Pentazocine [Talwin] PO c. Fentanyl [Duragesic] transdermal patch d. Naloxone (Narcan)
C
A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet of Brand Y of the same drug. Both brands contain the same amount of the active ingredient. What does the nurse know to be most likely? a. Advertising by pharmaceutical companies can enhance patient expectations of one brand over another, leading to a placebo effect. b. The bioavailability of a drug is determined by the amount of the drug in each dose. c. Brands or generic forms of tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug's effects in the body. d. Because the drug preparations are chemically equivalent, the effects of the two brands must be identical.
C
A patient has had three gouty flare-ups in the past year. Which drug class will the nurse expect the provider to order for this patient? a. Colchicine b. Glucocorticoids c. Urate-lowering drugs d. Nonsteroidal anti-inflammatory drugs
C
A patient is receiving Interferon Beta for treatment of multiple sclerosis. As the nurse you will stress the importance of? a. Physical exercise to improve fatigue b. Reporting feelings of severe depression of suicidal thoughts c. Hand hygiene to avoid infection d. Low fat diet
C
A patient who has been taking gentamicin for 5 days reports a headache and dizziness. What will the nurse do? a. Tell the patient to report any tinnitus b. Tell the patient to ask for help with ambulation. c. Suspect ototoxicity and notify the prescriber d. Request an order for a gentamicin peak level
C
A patient who uses an inhaled glucocorticoid for chronic asthma calls the nurse to report hoarseness. What will the nurse do next? a. Request an order for an antifungal medication. b. Tell the patient to discontinue use of the glucocorticoid. c. Ask whether the patient is rinsing the mouth after each dose. d. Suggest that the patient be tested for a bronchial infection.
C
A patient with asthma will be using a metered-dose inhaler (MDI) for delivery of an inhaled medication. The provider has ordered 2 puffs to be given twice daily. It is important for the nurse to teach this patient that: a. the patient should activate the device and then inhale. b. the patient should store the MDI in the refrigerator between doses. c. the patient should wait 1 minute between puffs. d. the patient should inhale suddenly to receive the maximum dose
C
A young adult woman will begin using an inhaled glucocorticoid to treat asthma. The nurse will teach this patient about the importance of which action? a. Taking oral glucocorticoids during times of acute stress b. Using two reliable forms of birth control to prevent pregnancy c. Participating in weight-bearing exercises on a regular basis d. Lowering her calcium intake and increasing her vitamin D intake
C
An adrenergic agonist is ordered for a patient in cardiogenic shock. The nurse will note that this drug has had its primary intended effect if which expected outcome occurs? a. reduced anxiety b. volume restoration c. increased cardiac output d. decreased urine output
C
An older adult patient with chronic obstructive pulmonary disease (COPD) develops bronchitis. The patient has a temperature of 39.5°C. The nurse will expect the provider to: a. treat symptomatically, because antibiotics are usually ineffective against bronchitis b. treat the patient with more than one antibiotic without obtaining cultures. c. order empiric antibiotics while waiting for sputum culture results d. obtain a sputum culture and wait for the results before prescribing an antibiotic.
C
The U.S. Food and Drug Administration (FDA) recommends genetic testing of patients receiving certain medications. Genetic testing helps prescribers: a. better establish a drug's therapeutic index. b. identify racial characteristics that affect psychosocial variation in drug response. c. determine whether a patient is a rapid or slow metabolizer of the drug. d. produce a drug that is tailored to an individual patient's genetic makeup.
C
The clinic nurse is providing instructions to a client with hypertension who will be taking captopril. Which statement by the client indicates a need for further instruction? a. "I need to sit down and rest if dizziness or lightheadedness occurs." b. "I need to avoid taking hot baths or showers." c. "I need to drink at least 4 quarts (4 liters) of water daily." d. "I need to change positions slowly."
C
The nurse has administered a dose of docusate. The nurse evaluates that the medication has been effective if the client experiences which finding? a. Decreased heartburn b. Decrease in fatty stools c. Bowel movement with soft, formed stool d. Relief of sharp abdominal pain
C
The nurse is aware that adrenergic drugs produce effects similar to which of these nervous systems? a. central nervous system b. somatic nervous system c. sympathetic nervous system d. parasympathetic nervous system
C
The nurse is caring for a patient on a medical-surgical unit who has a fever of unknown origin. The prescriber has ordered a broad-spectrum antibiotic. Which intervention is the priority? a. Administering antipyretics as soon as possible b. Delaying administration of the antibiotic until the culture results are available c. Obtaining all cultures before the antibiotic is administered (not the results of the cultures) d. Administering the antibiotic immediately
C
The nurse is caring for a patient with atrial fibrillation (AF). In addition to an antidysrhythmic, what medication does the nurse plan to administer? a. Dobutamine b. Magnesium sulfate c. Heparin d. Atropine
C
The nurse is providing education to a patient who has been prescribed both an antacid and a cimetidine [Tagamet]. Which instruction should the nurse give the patient about taking the medications? a. "Take the antacid 15 minutes before the ranitidine." b. "Take the antacid 30 minutes after the ranitidine." c. "Take the antacid 1 hour after the ranitidine." d. "The antacid and ranitidine should be taken at the same time for better effect."
C
The prescriber's order says to administered the diuretic Lasix 40 mg IV twice a day. The patient has bilateral lower extremity edema and complains of leg pain. The patient has the following morning labs: Na+ 148 K+ 2.9 BUN 10 Which of the following is a nursing priority? a. Administer Lasix as ordered b. Assess the patient's lung sounds c. Hold the Lasix dose and notify the prescriber of the potassium level d. Notify the prescriber of the Na+ level
C
What occurs when a drug binds to a receptor in the body? a. It gives the receptor a new function. b. It prevents the action of the receptor by altering its response to chemical mediators. c. It increases or decreases the activity of that receptor d. It alters the receptor to become nonresponsive to its usual endogenous molecules.
C
When metronidazole [Flagyl] is a component of the H.pylori treatment regimen, the patient must be instructed to do what? a. Take the drug with food. b. Take the drug on an empty stomach. c. Avoid any alcoholic beverages d. Avoid foods containing tyramine
C
When monitoring a patient who is taking a low-dose cholinergic drug, the nurse will watch for which cardiovascular effect? a. vasoconstriction b. tachycardia c. bradycardia d. palpitations
C
Which of the following insulins have no peak but a duration of 24 hours? a. Aspart insulin b. Humulin R (Regular insulin) c. Lantus (insulin glargine) d. NPH insulin
C
Which of the following is NOT a common adverse effect of opioid analgesics? a. Respiratory Depression b. Nausea c. Diarrhea d. Sedation
C
Which route of administration is preferred if immediate analgesia and rapid titration are necessary? a. Patient-controlled analgesia (PCA) b. Sublingual c. Intravenous (IV) d. Intraspinal
C
A patient has been prescribed pharmacologic doses of glucocorticoids. It is most important for the nurse to teach the patient to do what? a. Have an eye examination every year. b. Increase intake of dietary sodium. c. Take antibiotics to prevent infection. d. Never abruptly withdraw therapy.
D
Which statement below is true regarding a catecholamine? (Select All that Apply) a. Catecholamines are commonly given by the enteral route b. Catecholamines are cholinergic in their effect c. Catecholamines cannot cross the blood brain barrier d. Catecholamines must be given by parenteral route e. Catecholamines are metabolized slowly
C, D
A child ingests a parent's aspirin tablets, and the prescriber orders sodium bicarbonate to block the toxic effects of the aspirin. The nurse caring for this patient knows that sodium bicarbonate is effective against the aspirin because it: a. induces CYP isoenzymes to increase drug metabolism. b. accelerates its passage through the intestine. c. alters urinary pH to enhance renal excretion. d. raises the pH of the interstitial fluid to facilitate passage out of the cells.
D
A client has just been prescribed with Methotrexate (Trexall) for the treatment of rheumatoid arthritis who did not respond to any other treatment. An important reminder for the client is to? a. Get a daily source of sunlight during the day. b. Clay-colored stool is a normal response of the treatment c. Pregnancy is not contraindicated with the use of the medication. d. Strict hand washing.
D
A client is being tapered off opioids and the nurse is watchful for signs of withdrawal. What is one of the first signs of withdrawal? a. Abdominal cramps b. Nausea c. Fever d. Diaphoresis
D
A client is taking large doses of acetylsalicylic acid (ASA) for rheumatoid arthritis. Which assessment findings indicate that the client is experiencing ototoxicity as a result of the medication? a. Dizziness, sore throat, and purpura b. Gastrointestinal upset and dizziness c. Gastrointestinal bleeding, ecchymosis, and dizziness d. Tinnitus, hearing loss, dizziness, and ataxia
D
A client receives a dose of scopolamine for nausea from motion sickness. The nurse determines that which sign or symptom later displayed by the client is a result of medication side and adverse effects? a. Pupillary constriction b. Excessive urination c. Diaphoresis d. Dry mouth
D
A client with gastrointestinal hypermotility has a prescription to receive atropine sulfate. The nurse should withhold the medication and question the prescription if the client has a history of which disease process? a. Sinus bradycardia b. Peptic ulcer disease c. Biliary colic d. Narrow-angle glaucoma
D
A client with rheumatoid arthritis is receiving Hydroxychloroquine (Plaquenil) in the recent months. The nurse tells the client to visit which of the following while on the treatment? a. Pulmonologist b. Endocrinologist c. Dentist d. Ophthalmologist
D
A client with type 1 diabetes mellitus received regular insulin at 7:00 a.m. The client will need to be monitored for hypoglycemia at which time? a. 7:30pm b. 7:30 am c. 2:00pm d. 11:00am
D
A nurse is administering morphine sulfate to a postoperative patient. Which is NOT an appropriate routine nursing actions when giving this drug? a. Monitoring respirations before giving the medication and throughout the course of therapy b. Encouraging physical activity and offering increased fluids c. Palpating the patients abdomen twice per shift and monitoring for constipation d. Monitoring the patient's blood pressure closely for hypertension
D
A nurse is caring for a patient who takes an ACE inhibitor and an ARB medication who will begin taking TMP/SMZ to treat a urinary tract infection. Which serum electrolyte will the nurse expect to monitor closely? a. Sodium b. Calcium c. Magnesium d. Potassium
D
A patient has a long history of hypertension. Which category of medications would the nurse expect to be ordered to avoid chronic kidney disease (CKD)? a. Histamine blocker b. Antibiotic c. Bronchodilator d. Angiotensin-converting enzyme (ACE) inhibitor
D
A patient has a prescription to take a powdered form of psyllium after discharge. The nurse should plan to include which information when teaching the client about this medication? a. Mix the medication with applesauce. b. Decrease the amount of fiber in the diet when taking this medication. c. Decrease fluid intake following administration of the medication. d. Mix the medication with a full glass of water or juice.
D
A patient who is receiving intravenous ciprofloxacin for pneumonia develops diarrhea. A stool culture is positive for Clostridium difficile. The nurse will expect the provider to: a. switch to gemifloxacin. b. restrict dairy products. c. increase the dose of ciprofloxacin. d. add metronidazole [Flagyl].
D
A patient will begin taking hydroxychloroquine [Plaquenil] for rheumatoid arthritis. The patient is currently taking high-dose NSAIDs and methotrexate. What will the nurse teach the patient? a. To obtain tests of renal and hepatic function while taking this drug b. That the dose of NSAIDs may be decreased when beginning hydroxychloroquine c. To stop taking methotrexate when starting hydroxychloroquine d. That an eye exam is necessary at the beginning of therapy with this drug
D
A patient with chronic congestive heart failure has repeated hospitalizations in spite of ongoing treatment with hydrochlorothiazide [HydroDIURIL] (diuretic). The prescriber has ordered spironolactone [Aldactone] (diuretic) to be added to this patient's drug regimen, and the nurse provides education about this medication. Which statement by the patient is correct? a. "I should watch closely for dehydration." b. "I should use salt substitutes to prevent toxic side effects." c. "I can expect improvement within a few hours after taking this drug." d. "I need to stop taking potassium supplements."
D
A patient with no known drug allergies is receiving amoxicillin [Amoxil] PO twice daily. Twenty minutes after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is 100/58 mm Hg. What will the nurse do? a. Notify the provider if the patient develops a rash. b. Request an order for a skin test to evaluate possible PCN allergy. c. Withhold the next dose until symptoms subside. d. Contact the provider and prepare to administer epinephrine.
D
A patient with stable COPD receives prescriptions for an inhaled glucocorticoid and an inhaled beta2-adrenergic agonist. Which statement by the patient indicates understanding of this medication regimen? a. "The beta2-adrenergic agonist suppresses the synthesis of inflammatory mediators." b. "I will need to use the beta2-adrenergic agonist drug daily." c. "I should use the glucocorticoid as needed when symptoms flare." d. "The glucocorticoid is used as prophylaxis to prevent exacerbations."
D
A pregnant patient asks the nurse whether she should continue to take her prescription for tetracycline [Sumycin] to clear up her acne. Which response by the nurse is correct? a. "Tetracycline will prevent asymptomatic urinary tract infections." b. "Tetracycline may cause allergic reactions in pregnant women." c. "Tetracycline is safe to take during pregnancy." d. "Tetracycline can be harmful to the baby's teeth and should be avoided."
D
An older adult patient with severe gastroesophageal reflux disease (GERD) has had only minimal relief using a histamine2-receptor antagonist (H2RA). The patient is to begin taking omeprazole [Prilosec]. What will the nurse teach this patient? a. A complete cure is expected with this medication. b. Lifestyle changes can be as effective as medication therapy. c. The medication will be used until surgery can be performed. d. Long-term therapy may be needed.
D
During therapy with a beta blocker, the patient notices that she has swollen feet, has gained 3 pounds within 2 days, feels short of breath even when walking around the house, and has been dizzy. The nurse suspects that which of these is occurring? a. The patient is experiencing expected adverse effects of the drug. b. The patient is experiencing an allergic reaction. c. More time is needed for the patient to see a therapeutic response to the drug. d. The patient may be developing heart failure
D
In caring for a young child with pain, which assessment tool is the most useful? a. 0-10 numeric pain scale b. McGill-Melzack pain questionnaire c. Simple description pain intensity scale d. Faces pain-rating scale
D
Prior to administering a client's daily dose of digoxin, the nurse reviews the client's laboratory data and notes the following results: serum calcium 9.8 mg/dL serum magnesium 1.0 mEq/L serum potassium 4.1 mEq/L serum creatinine 0.9 mg/dL Which result should alert the nurse that the client is at risk for digoxin toxicity? a. Serum calcium level b. Serum potassium level c. Serum creatinine level d. Serum magnesium level
D
The nurse is teaching a patient who is taking colchicine for the treatment of gout. Which instruction will the nurse include during the teaching session? a. "Fluids should be restricted while on colchicine therapy." b. "Take colchicine with meals." c. "Call your doctor if you have increased pain or blood in the urine." d. "The drug will be discontinued when symptoms are reduced."
D
What is a desired outcome when a drug is described as easy to administer? a. It is usually relatively inexpensive to produce. b. It does not interact significantly with other medications. c. It can be stored indefinitely without need for refrigeration. d. It enhances patient adherence to the drug regimen.
D
What is the best way to schedule medication for a client with constant pain? a. IV bolus after pain assessment b. PRN at the client's request c. Prior to painful procedures d. Around-the-clock
D
When an adrenergic drug stimulates beta1-adrenergic receptors, the result is an increased force of contraction, which is known as what type of effect? a. anti-adrenergic b. positive chronotropic c. negative dromotropic d. positive inotropic
D
When considering replacement therapy options for a patient who has Adrenocortical insufficiency, the nurse should recognize that the provider will choose which of the following drugs? a. Desmopressin b. Glucagon c. Somatotropin d. Hydrocortisone
D
Your patient is taking levodopa (Dopar), and you have been conducting an analysis of the patient's diet. You find that she eats three times the recommended amount of protein at each meal. Your best response to this is to tell her: a. that her protein intake is good, as protein increases the effect of levodopa. b. that she is likely to damage her kidneys if she maintains this diet plan. c. that protein in her diet will benefit the transport of levodopa throughout her body. d. that too much dietary protein could make the levodopa less effective.
D
Which groups of people are especially sensitive to medication effects? (Select all that apply.) a. Caucasians b. Minorities c. Women d. Older Adults e. Infants
D, E
