Phoop Exam 4
14. A nurse is providing medication teaching to a 12-year-old male patient with hypogonadism. Which statement, made by the patient, indicates an understanding of the prescribed medication, testosterone enanthate? "I will grow significantly taller while taking this medication." "Sexual changes in my body will occur within 4 to 6 months." "I will come to the clinic every 2 weeks for shots of testosterone." "If the medication causes stomach upset, I can take it with food."
"I will come to the clinic every 2 weeks for shots of testosterone."
13. The nurse instructs a patient in the use of combination oral contraceptives for birth control. The nurse determines that teaching is successful if the patient makes which statement? "I'll avoid herbal products such as St. John's wort." "Birth control pills don't have serious side effects." "I can continue taking birth control before elective surgeries." "I should take the pill with food to prevent an upset stomach."
"I'll avoid herbal products such as St. John's wort."
The nurse instructs a patient about taking levothyroxine [Synthroid]. Which statement by the patient indicates the teaching has been effective? "To prevent an upset stomach, I will take the drug with food." "If I have chest pain or insomnia, I should call my doctor." "This medication can be taken with an antacid." "The drug should be taken before I go to bed at night."
"If I have chest pain or insomnia, I should call my doctor."
A patient contacts a clinic nurse to determine the proper action after she forgot to take her oral contraceptive [Ortho Tri-Cyclen] for the past 2 days during the first week of a 28-day regimen. Which response by the nurse is most appropriate? "Take the omitted two doses together with the next dose." "Take two doses per day on the following 2 days." "Stop taking the oral contraceptive until menstruation occurs." "Take a dose now and continue with the scheduled doses."
"Take a dose now and continue with the scheduled doses."
12. The nurse teaches a patient about a Progesterone only pill, Camila. Which statement by the patient requires an intervention by the nurse? "I might have irregular bleeding while taking this pill." "These pills do not usually cause blood clots." "I should take this pill at the same time every day." "This pill works primarily by preventing ovulation."
"This pill works primarily by preventing ovulation."
Michael starts taking a glucocorticoid medication with a metered-dose inhaler (MDI). The nurse should give him which instruction about correct use of the inhaler? a. "After you inhale the medication once, repeat until you obtain symptomatic relief." b. "Wait no longer than 30 seconds after the first puff before taking the second one." c. "Breathe in through the nose and hold for 2 seconds just before activating the inhaler." d. "Use a spacer with the inhaler and rinse your mouth after each dose administration."
"Use a spacer with the inhaler and rinse your mouth after each dose administration."
10. Which patient would be at greatest risk of developing a venous thromboembolism (VTE) if a combination oral contraceptive were prescribed? A 25-year-old patient who drinks 3 to 4 alcoholic drinks a day A 45-year-old patient who has a family history of stroke A 22-year-old patient who smokes 2 packs of cigarettes a day A 29-year-old patient who has used birth control pills for 9 years
A 22-year-old patient who smokes 2 packs of cigarettes a day
9. The nurse identifies which female patient has the least risk for developing complications when hormone therapy is prescribed? A 45-year-old patient who takes estrogen after a hysterectomy A 55-year-old patient who takes estrogen combined with progestin A 58-year-old patient with osteopenia who takes hormone therapy A 60-year-old patient with a family history of breast cancer
A 45-year-old patient who takes estrogen after a hysterectomy
After two weeks of using his inhaled glucocorticoid Michael calls his PCP's office and reports hoarseness. What will the nurse do?
Ask whether the patient is rinsing the mouth after each dose.
16. A patient has been prescribed sildenafil [Viagra] for erectile dysfunction. Which instruction should the nurse include in the teaching plan? Take the medication on an empty stomach. Drink plenty of fluids to prevent priapism. Avoid taking nitroglycerin with this drug. D. Constipation is a common adverse effect
Avoid taking nitroglycerin with this drug.
Constipation is a common adverse effect.A patient is taking finasteride [Proscar] for benign prostatic hyperplasia (BPH). The nurse should explain that this medication has what effect? Decreases the size of the prostate gland. Relaxes smooth muscle of the prostate gland. Reduces the risk of prostate cancer. Improves sexual performance during intercourse.
Decreases the size of the prostate gland.
A patient with hyperthyroidism is taking propylthiouracil (PTU). It is most important for the nurse to assess the patient for which adverse effects? Gingival hyperplasia and dysphagia Dyspnea and a dry cough Blurred vision and nystagmus Fever and sore throat
Fever and sore throat
23. A patient asks what medication would be most effective in the treatment of seasonal hay fever. The nurse will teach the patient about the use of which drug? Azelastine [Astelin] Chlorpheniramine [Chlor-Trimeton] Fluticasone [Flonase] Pseudoephedrine [Sudafed]
Fluticasone [Flonase]
7. The nurse teaches a group of postmenopausal women about hormone therapy (HT). Which information should the nurse include in the teaching plan? The most frequent adverse effect of HT is headache. HT increases the risk of stroke and venous thromboembolism. Blood levels of estrogen are more consistent with oral HT. HT may cause a harmless yellow discoloration of the skin.
HT increases the risk of stroke and venous thromboembolism.
3. Michael successfully takes the Albuterol inhaler and noticies a hand tremor that goes away. The nurse educates Michael that this is an expected side effect. What else should a nurse monitor for following Albuterol administration (select all that apply) Heart rate Respiratory rate Capillary Refill Oxygen saturation
Heart rate Respiratory rate Oxygen saturation
Which of the following is NOT a serious adverse effect of long-term oral glucocorticoid therapy? Adrenal suppression Osteoporosis Hypoglycemia Peptic ulcer disease
Hypoglycemia
15. A male patient is prescribed a topical testosterone gel [AndroGel]. It is most appropriate for the nurse to teach the patient to do what? Apply the gel to the genital area every morning. Leave the patch in contact with the skin for 24 hours. Avoid showering or swimming after gel application. Keep the treated area covered with clothing.
Keep the treated area covered with clothing.
A patient is prescribed metformin. Which statement about metformin does the nurse identify as true? Metformin increases absorption of vitamin B12. Metformin can delay the development of type 2 diabetes in high-risk individuals. Metformin causes patients to gain weight. Metformin use predisposes patients to alkalosis.
Metformin can delay the development of type 2 diabetes in high-risk individuals.
19. Which statement regarding antihistamine administration to older adults does the nurse identify as true? Antihistamines cause CNS excitation in older adults. Larger doses of antihistamines are needed for older adults. Antihistamines can be used to reduce intraocular pressure. Older men with benign prostatic hypertrophy can experience worse symptoms when taking antihistamines.
Older men with benign prostatic hypertrophy can experience worse symptoms when taking antihistamines.
A patient is prescribed insulin glargine [Lantus]. Which statement should the nurse include in the discharge instructions? The insulin will have a cloudy appearance in the vial. Once daily at bedtime. The patient should mix Lantus with the intermediate-acting insulin. The patient will have less risk of hypoglycemic reactions with this insulin.
Once daily at bedtime.
A patient is prescribed codeine as an antitussive. Which symptom will the nurse observe for as an adverse effect of this medication? Respiratory depression Increased heart rate Productive cough Restlessness
Respiratory depression
The nurse auscultates Michael's lungs and hears bilateral wheezes. His O2 is 90% and respirations are 30. "I just can't catch my breath", Michael says. The nurse will prepare to administer: SABA LABA Glucocorticoid Antihistamine
SABA
8. A patient is taking estrogen daily. Which instruction by the nurse should be included to reduce the risk of a cardiovascular event, such as stroke or myocardial infarction? Reduce aerobic activities. Increase dietary intake of trans fat. Stop smoking. Take the medication with food.
Stop smoking.
A patient who takes over-the counter diphenhydramine [Benadryl] for seasonal allergy symptoms complains of drowsiness. What should the nurse do? Instruct the patient to drink caffeinated beverages. Recommend taking the medication with meals. Ask the patient's healthcare provider to prescribe hydroxyzine [Vistaril]. Tell the patient to take cetirizine [Zyrtec] instead of diphenhydramine.
Tell the patient to take cetirizine [Zyrtec] instead of diphenhydramine.
2. A patient is prescribed NPH insulin. Which statement should the nurse include in the discharge instructions? The insulin will have a cloudy appearance in the vial. The onset of action is rapid. The patient should not mix Lantus with short-acting insulin. The patient will have no risk of allergic reactions with this insulin.
The insulin will have a cloudy appearance in the vial.
6. A patient takes levothyroxine [Synthroid] 0.75 mcg every day. It is most appropriate for the nurse to monitor which laboratory test to determine whether a dose adjustment is needed? Thyrotropin-releasing hormone (TRH) Thyroid-stimulating hormone (TSH) Serum free T4 test Serum iodine level
Thyrotropin-releasing hormone (TRH) Thyroid-stimulating hormone (TSH) Serum free T4 test Serum iodine level
Which information should the nurse include when teaching a patient about inhaled glucocorticoids? Inhaled glucocorticoids have many significant adverse effects. The principal side effects of inhaled glucocorticoids include hypertension and weight gain. Use of a spacer can minimize side effects. Patients should rinse the mouth and gargle before administering inhaled glucocorticoids.
Use of a spacer can minimize side effects.
A patient with asthma is prescribed albuterol [Proventil], 2 puffs every 4 hours as needed. The nurse should teach the patient to do what? Rinse the mouth after taking the prescribed dose. Take an extra dose if breathing is compromised. Wait 1 minute between puffs from the inhaler. Take adequate amounts of calcium and vitamin D.
Wait 1 minute between puffs from the inhaler.
The physician now orders Michael an inhaled glucocorticoid with the inhaled long acting beta2 agonist. Which statement by Michael indicates understanding of his medication regimen? a. "The glucocorticoid is used as prophylaxis to prevent exacerbations." b. "The beta2-adrenergic agonist suppresses the synthesis of inflammatory mediators." c. "I should use the glucocorticoid as needed when symptoms flare." d. "I will need to use the beta2-adrenergic agonist drug daily."
a. "The glucocorticoid is used as prophylaxis to prevent exacerbations."
2. The physician orders Michael a metered-dose Inhaler of Albuterol two puffs daily as needed for Asthma. It is important for the nurse to teach Michael that: a. He should wait 1 minute between puffs. b. He should activate the device and then inhale. c. He should store the MDI in the refrigerator between doses. d. He should inhale suddenly to receive the maximum dose.
a. He should wait 1 minute between puffs.
The physician also orders Michael a long acting beta 2 agonist medication. What will the nurse tell Michael? a. LABAs reduce the risk of asthma-related deaths. b. LABAs should be combined with an inhaled glucocorticoid. c. LABAs can be used on an as-needed basis to treat symptoms. d. LABAs are safer than short-acting beta2 agonists.
a. LABAs reduce the risk of asthma-related deaths.