Quizam 4

The 56-year-old man is taking levodopa-carbidopa for Parkinson's disease. During the therapy, he becomes light-headed and dizzy. Which of the following is a potentially serious adverse effect of the drug treatment? A. orthostatic hypotension B. diminished fluid volume C. hematuria D. jaundice

A. Orthostatic hypotension is an adverse effect of levodopa/carbidopa. When a client reports light-headedness and dizziness, the nurse should assess the blood pressure when the client is lying down, sitting, and standing up.

The most clear-cut therapeutic indication for use of male sex hormones is which of the following? A. to treat androgen deficiency states in boys and men B. for bodybuilding purposes C. to treat metastatic breast cancer D. to treat anemia associated with renal failure

A. With male sex hormones, the most clear-cut indication for use is to treat androgen deficiency states (e.g., hypogonadism, cryptorchidism, impotence, oligospermia) in boys and men.

Which of the following factors prevents the use of estradiol for the treatment of menstrual migraines for a 14-year-old? A. breakthrough bleeding B. leg pain C. incomplete long bone growth D. anxiety

C. A 14-year-old girl has not finished growing. Incomplete growth of the long bone contraindicates the administration of estradiol.

A woman experiencing preterm labor receives terbutaline sulfate. Which of the following adverse effects should the nurse tell her to expect? A. headache B. edema C. hand tremors D. shortness of breath

C. The nurse should tell the woman that hand tremors are common adverse effects.

A nurse is providing safety education to a client who is scheduled to begin treatment with tamsulosin for benign prostatic hyertrophy (BPH). Which of the following instructions should the nurse include in the teaching? Change positions slowly Crush the medication Take the medication on an empty stomach report increased urinary output immediately

Change positions slowly

Immunomodulators

P: Interferon beta 1a TU: multiple sclerosis

Amphetamines

P: amphetamine / dextroamphetamine TU: ADHD, narcolepsy

Centrally Acting Muscle Relaxant

P: baclofen TU: muscle spasm

Beta 2 adrenergic agonists

terbutaline preterm labor inhibition

A nurse is teaching a client who has a new prescription for transdermal testosterone gel to treat delayed puberty. Which of the following instructions should the nurse include? (S.A.T.A) Apply the gel to the scrotum Cover the area of application with clothing" "Wash your hands after applying the gel" "Do not shower for several hours after applying the gel Apply the gel to the gums above an upper incisor

"Cover the area of application with clothing" "Wash you hands after applying the gel" "Do not shower for several hours after applying the gel

A nurse is caring for a client who is taking combination oral contraceptive ethinyl estradiol and drospirenone and is about to begin taking rifampin to treat tuberculosis. Which of the following instructions should the nurse give the client due to a possible drug interaction? Increase the rifampin dose Increase the oral contraceptive dose Wait 2 hrs between taking each drug Use additional birth control methods

"Use additional birth control methods"

Which characteristics would the nurse recognize as primary symptoms of narcolepsy? (Select all that apply.) A. excessive daytime drowsiness B. fatigue C. cataplexy D. hypnagogic hallucinations E. sleep paralysis

A, B, C, D, and E. Excessive daytime drowsiness, fatigue, cataplexy, hypnagogic hallucinations, and sleep paralysis are all signs and symptoms of narcolepsy.

Which of the following statements by a male patient taking transdermal androgens indicates that teaching has been adequate? (Select all that apply.) A. "I need to weigh myself once or twice weekly and record the amount" B. "I should wash my face and body thoroughly to decrease the risk of acne" C. "The patch systems should be applied nightly to skin on my back, abdomen, upper arm, or thigh" D. "I should apply the patch systems in the morning to the same site each and every day"

A, B, and C. Weighing on a regular basis identifies fluid and electrolyte imbalance. The drugs may cause or aggravate acne. Scrupulous skin care and other antiacne treatment may be needed, especially in adolescent boys. With transdermal systems, apply the patch systems nightly to clean, dry skin on the back, abdomen, upper arm, or thigh. Do not apply to the scrotum. Rotate sites, within 7 days, between applications to a site. Press firmly into place for adherence.

Which of the following are expected adverse effects of amphetamine sulfate? (Select all that apply.) A. weight loss B. anorexia C. dry mouth D. bradycardia E. constipation

A, B, and C. Weight loss with anorexia and dry mouth are all adverse effects of amphetamine sulfate.

Which of the following effects occurs when the naproxen is administered in combination with lithium? A. increased risk of lithium toxicity B. increase in creatinine clearance C. hepatotoxicity D. potential gastrointestinal effects

A. A client who is administered lithium and naproxen sodium is at risk for lithium toxicity.

A mother who calls the clinic to report that her son has recently started medication to treat attention deficit hyperactivity disorder (ADHD) fears her son is experiencing side effects of the medication. Which of the following side effects are typically related to medications used for ADHD? A. poor appetite B. frequency of urination C. weight gain D. sedation

A. Anorexia is an adverse effect of treatment of attention deficit hyperactivity disorder.

A 16-year-old girl develops migraine headaches. Which of the following medications is safe and effective for the treatment of migraine headaches? A. antiepileptic agents B. triptans C. ergot alkaloids D. opioids

A. Antiepileptic agents such as valproic acid are the safest medications to administer to a 16-year-old child. However, the safety and efficacy of these agents have not been established in clients younger than 18 years of age.

Which of the following medications are administered for preventive therapy in the treatment of migraine? A. beta-adrenergic blockers B. nonsteroidal anti-inflammatory agents C. ergot alkaloids D. analgesics

A. Beta-blockers are administered as preventive antimigraine medications.

The nurse who is working in the genitourinary surgical division of the health center has an order to administer bethanechol to a patient. Which of the following statements by the patient would require the nurse to hold the medication and notify the prescriber? A. "I was diagnosed with hyperthyroidism this year." B. "I have not eaten any breakfast." C. "I have not urinated for 6 hours." D. "My mother was allergic to bethanechol."

A. Bethanechol is contraindicated in clients who have been diagnosed with hyperthyroidism.

Finasteride is most effective A. if started early in the development of prostatic hypertrophy B. for improvement of erectile dysfunction C. when prostatic hypertrophy is advanced D. to decrease the risk of prostate cancer

A. Finasteride is most effective when taken early in the course of benign prostatic hypertrophy.

The nurse is educating an older adult client with a history of hypertension diagnosed with benign prostatic hypertrophy (BPH) about the prescribed finasteride. Which statement made by the client establishes the need for further clarification? A. "The drug may take 5 to 7 days to reach its maximum effectiveness in relieving my BPH symptoms." B. "The drug may cause me to feel cold, and it may cause my blood pressure (BP) to be low, so I will monitor my BP." C. "The drug may cause sexual dysfunction such as impotence or decreased sex drive, but it is usually temporary." D. "I will not have my pregnant daughter crush the tabs for me, because it can cause harm to a male fetus."

A. Rationale: The nurse needs to clarify the statement that the client made regarding the drug reaching its maximum effectiveness in 5 to 7 days. The half-life of the drug is 5 to 7 days. It may take the drug 3 to 12 months to reach its maximum effectiveness for relieving symptoms of BPH. The other statements are correct. The drug's actions can lead to hypotension and hypothermia. The client should monitor blood pressure and report if it becomes low so the prescriber may make adjustments with the antihypertensive the client takes for the history of hypertension. The drug can cause sexual dysfunction, which usually is limited in nature. The FDA issued a black box warning stating that pregnant women should not handle broken or crushed tablets, because it can be absorbed and cause harm to a male fetus..

A nurse is providing teaching to a client who is taking bethanechol for urinary retention. Which of the following instructions should the nurse include? (S.A.T.A) Avoid driving and activities that require alertness. Increase fluid intake. Take the drug with food Stay close to a bathroom after taking the drug. Increase weight bearing activities

Avoid driving and activities that require alertness Increase fluid intake Stay close to a bathroom after taking the drug.

A client is taking hormonal contraceptives to prevent pregnancy. The client visits the gynecology clinic and is noted with a blood pressure of 176/102 mm Hg. The client is started on enalapril mesylate 10 mg. In collaboration with the health care provider, what other client teaching should be provided based on the current medical regimen? A. Instruct on a no-salt diet. B. Instruct to discontinue the contraceptives. C. Instruct on the use of relaxation to decrease stress. D. Instruct on the rationale for increasing contraceptive dose.

B

An elderly man begins taking levodopa-carbidopa-entacapone. Which of the following symptoms warrants a change in the dosage? (Select all that apply.) A. dilated pupils B. increased tremors C. static gait D. edema E. nausea

B and C. Increased tremors and static gait are symptoms indicative of Parkinson's disease that warrant a dosage change of levodopa/carbidopa/entacapone.

An anesthesia practitioner administers succinylcholine. What is the expected effect of this drug? Select all that apply. A. decrease in anxiety B. fasciculations C. muscle relaxation D. apnea E. analgesia

B and C. Succinylcholine produces muscle relaxations and fasciculation, relaxes the vocal cords, and terminates laryngospasm.

Reduced dosages of zolpidem are expected in older adults and patients with renal impairment because these conditions result in an increase in which pharmacokinetic states? (Select all that apply.) A. first-pass effect B. bioavailability C. half-life D. peak plasma concentration E. receptor site activation

B, C, and D. Bioavailability, half-life, and peak plasma concentration are increased in older adults and in patients with renal failure taking zolpidem due to decreases in metabolic rate and resultant increase in drug availability. Reduced first-pass effect and reduced receptor site activation, not increases, would be expected in this population.

Which of the following statements indicate the patient is in need of further patient teaching regarding medication for attention deficit hyperactivity disorder? A. I should not crush my tablets. B. I can skip doses when I am feeling good. C. I should not change my dosage without consulting my health care provider. D. I should consult with my health care provider before taking any new medications.

B. Because medication adherence is important, it is necessary to conduct client teaching for knowledge deficit regarding the medication regimen.

Which of the following groups are most commonly used for drug management of the patient with narcolepsy? A. central nervous system (CNS) depressants B. CNS stimulants C. anticonvulsants D. major tranquilizers

B. Central nervous system stimulants are the treatment of choice for narcolepsy.

A client has been diagnosed with impotence and is started on a regimen of androgens. Which statement by the client indicates that the client has understood the teaching? A. "I should expect to see increasing baldness." B. "If my skin appears yellow or my urine turns dark, I will contact my health care provider." C. "My blood count will drop, but if I have bruising, I will contact my health care provider." D. "I know headaches are common, so I won't get alarmed if it is severe."

B. Clients taking anabolic steroids can experience jaundice. It is important for the client to notify the health care provider of this condition. The normal effect of the medication is an increase in hair growth, not baldness. The clotting factor will increase as a result of anabolic steroids. This places the client at increased risk for cerebrovascular accident (CVA). Since severe headache is a potential sign of CVA, the client should be instructed to report it

A 48-year-old man with severe akinesia develops severe symptoms of parkinsonism following the administration of his antiparkinson medications. This condition occurs only one to two times per month. Which of the following medications is the man's prescriber most likely to order? A. bromocriptine mesylate B. apomorphine hydrochloride C. cabergoline D. pramipexole dihydrochloride

B. Clients who develop symptoms one to two times per month after receiving anti-parkinson medications have "off time" symptoms. To combat these symptoms, they take apomorphine hydrochloride.

A 63-year-old man begins to take dutasteride for benign prostatic hypertrophy. He asks the nurse how long he will need to take the medication. The man needs to take drug for how long? A. for 2 years B. indefinitely C. for 2 weeks D. until his prostate is normal

B. Dutasteride needs to be taken indefinitely. Once a man stops taking the drug, the prostate grows, and there are signs of impaired urinary function.

In which of the following men would the use of sildenafil be contraindicated? A. 52-year-old with type 1 diabetes B. 58-year-old with unstable angina C. 69-year-old with asthma D. 74-year-old with cirrhosis

B. Phosphodiesterase type 5 inhibitors such as sildenafil should not be prescribed for men who also take organic nitrates, commonly used to treat angina, because the drug combination can cause severe hypotension resulting in dizziness, syncope, heart attack, or stroke.

A 52-year-old client has made an appointment with the health care provider and has reluctantly admitted that the primary health concern is erectile dysfunction (ED). The client describes the problem as increasing in severity and consequent distress. Which of the nurse's assessment questions is the most likely to address a common cause of ED? A. "How would you describe your overall level of health?" B. "Are you taking any medications for high blood pressure?" C. "How has this problem been affecting your relationship with your spouse?" D. "Have you suffered any injuries of any kind in the last several months?"

B. Rationale: Causes of ED may include drugs such as antidepressants, antihypertensive agents, and histamine receptor antagonists. Injuries are a rare cause. Addressing the impact of the problem and the client's perceptions of health are important, but neither question addresses causation.

A patient admitted to the emergency department complains of a severe headache with nausea and vomiting received a diagnosis of an acute migraine headache. Which medication assists in decreasing the nausea and vomiting related to the acute migraine episode? A. intravenous ketorolac B. subcutaneous sumatriptan C. inhaled albuterol D. oral diclofenac

B. Subcutaneous sumatriptan is administered to decrease nausea and vomiting in clients diagnosed with acute migraine, nausea, and vomiting.

An adolescent female is suffering from migraine headaches and her health care provider orders a combination of acetaminophen, aspirin, and caffeine. Prior to the administration of the medication, it is necessary to assess for which of the following? A. anxiety and depression B. history of smoking C. family history of migraines D. antacid use

B. The administration of aspirin, acetaminophen, and caffeine in a client who smokes decreases the effects of caffeine to treat the migraine pain.

A nurse practitioner prescribes estrogen replacement therapy to relieve severe menopausal symptoms of hot flashes or flushes, which are the result of A. insufficient gonadotropin secretion B. vasomotor instability C. high levels of estrogen D. decreased progesterone

B. Vasomotor instability occurs as a result of estrogen deficiency. Blood vessels dilate, resulting in a sudden, intense warmth sensation that spreads over the body.

When the nurse is caring for a child receiving a central nervous system stimulant for attention deficit hyperactivity disorder, which assessment is most important to monitor? A. liver function B. weight loss C. fever D. seizure activity

B. Weight loss and anorexia are the most common adverse effects of central nervous system stimulants.

A nurse is caring for a male client who has hyperthyroidism an is not responding to treatment. The nurse should identify that hyperthyroidism is a contraindication for which of the following drugs? Sildenafil Bethanechol Tamsulosin Finasteride

Bethanechol

A nurse should question the use of conjugated equine estrogen by a client who has a history of which of the following? Osteoporosis Peptic ulcer disease Rheumatoid arthritis Blood clots

Blood clots

A woman experiencing amenorrhea should be provided with medication information concerning which drug? A. Testosterone B. Follicle-stimulating hormone C. Estrogen D. Lactate

C

A 74-year-old man has Alzheimer's disease. She has been prescribed rivastigmine. Which of the following instructions is most appropriate? A. Change patch every 48 hours. B. Apply the rivastigmine transdermal patch to the same site. C. Apply the rivastigmine transdermal patch to a clean, dry area. D. Administer oral rivastigmine with transdermal patch until a blood level is attained.

C. A rivastigmine patch should be applied to clean, dry skin.

A 40-year-old patient is taking bethanechol for urinary retention. The physician increases the dosage from 30 to 40 mg. For which of the following adverse effects should the nurse assess? A. pulmonary edema B. bronchospasm C. orthostatic hypotension D. pulse deficit

C. As the dose of bethanechol is increased, the client is at risk for orthostatic hypotension.

The nurse should be prepared to administer which of the following drugs as an antidote to cholinergic drug overdose? A. epinephrine B. diphenhydramine C. atropine D. propranolol

C. Atropine is an antidote for cholinergic drugs.

A nurse is teaching family members how to administer donepezil for Alzheimer's disease. The instructions should include which of the following? A. Take the medication with food. B. Take the medication on an empty stomach. C. Take the medication at bedtime. D. Take the medication at the start of each day.

C. Donepezil should be taken at bedtime.

A 50-year-old woman has a subarachnoid bleed. She has received treatment for migraine headaches in the past. Which of the following patient teaching guidelines is a priority on her discharge from the rehabilitation facility? A. Take estrogen to prevent a menstrual migraine. B. Take gabapentin for neuropathic pain. C. Do not take sumatriptan for migraine headache. D. Take zolmitriptan because it has a more rapid onset of action.

C. Due to the risk of vasospasm and thromboembolism, the triptans should not be administered following a subarachnoid bleed.

A woman diagnosed with Alzheimer's disease has used donepezil for 4 years. Her daughter notices her memory is worsening. Which of the following medications might be more successful for enhancing her memory? A. tacrine B. rivastigmine C. memantine D. galantamine

C. Memantine hydrochloride is administered for moderate to severe Alzheimer's disease and is most commonly administered if donepezil decreases in effectiveness.

The daughter of a 75-year-old woman states to the parish nurse that she has noticed her mother rolling her fingers together on her right hand. The nurse observes the patient and determines she is "pill rolling," which is a characteristic of Parkinson's disease. Which of the following factors contributes to the development of central nervous system symptom of "pill rolling?" A. decrease firing of the sinoatrial node B. conversion of angiotensin I to angiotensin II C. increase in excitatory acetylcholine D. influx of potassium through the cell membrane

C. Parkinson's disease is characterized by an imbalance in the neurotransmitters, resulting in a decrease in inhibitory brain dopamine and a relative increase in excitatory acetylcholine. The loss of dopamine leads to more excitatory neurotransmitters. The "pill-rolling" tremor is the cardinal sign of Parkinson's disease.

The nurse is closely following a client who began treatment with testosterone several months earlier. When assessing the client for potential adverse effects of treatment, the nurse should prioritize which assessment? A. Skin inspection for growing lesions B. Lung function testing C. Assessment of serum calcium levels D. Assessment of arterial blood gases

C. Rationale: In the client taking testosterone, the nurse should monitor serum calcium levels and observe for signs of hypercalcemia (e.g., kidney stones, polyuria, abdominal pain, nausea, vomiting, and depression). ABGs, respiratory function, and skin integrity are not typically affected by testosterone.

A 65-year-old woman has been taking levodopa for several weeks for symptoms of Parkinson's disease. Which of the following symptoms indicates that she is not receiving an adequate dose for the treatment of her symptoms? A. edema of the feet and ankles B. widened QRS complex C. static gait D. increased intraocular pressure

C. Static gait is indicative of muscle tension and rigidity. The woman needs an increase in levodopa/carbidopa.

For the patient with migraine headaches who receives a prescription for an ergot alkaloid as abortive therapy, which of the following is a priority nursing intervention for patient education? A. Notify the prescriber if an aura precedes the migraine headache. B. Administer the medication with food. C. Seek emergency help if cardiac changes occur. D. Administer the medication with caffeinated beverages.

C. The administration of ergotamine or ergot alkaloids can cause life-threatening cardiac changes. It is essential to instruct the client to notify the prescriber if changes in the cardiac status occur. Emergency assistance may be necessary.

The nurse has administered bethanechol to a patient who has not voided in 8 hours. What is the priority assessment following the administration of bethanechol? A. Assess the patient's blood pressure in 2 hours. B. Assess the cardiac status every 15 minutes. C. Assess the patient's urinary output in 1 hour. D. Assess the patient's fluid intake for 24 hours.

C. The nurse should assess the client's ability to void in 1 hour after the administration of bethanechol.

A 76-year-old woman is taking levodopa-carbidopa-entacapone. Which of the following is the priority nursing intervention? A. administering with a high-protein meal B. administering with meals only C. assessing for diarrhea D. assessing for constipation

C. The priority intervention when administering levodopa/carbidopa/entacapone is to assess for diarrhea. The client is at risk for drug-induced colitis.

An elderly woman is taking tolcapone. She has noticed that her skin is yellow. The nurse assesses which of the following? A. intake of carrots B. temperature related to infection C. sclera D. amount of urine output E. constipation

C. When a client is taking tolcapone, it is necessary to assess for jaundice of the skin and sclera because the medication is highly toxic to the liver.

A nurse administers a peripherally acting muscle relaxant to a patient with a spinal cord injury. Which of the following drugs does the nurse administer? A. dantrolene B. baclofen C. methocarbamol D. diazepam

CHECK

A client is being administered magnesium sulfate for preterm labor. The client's serum magnesium level is 11 mg/dL. What signs and symptoms will the client present? A. Tachypnea B. Muscle rigidity C. Tachycardia D. Depressed deep tendon reflexes

D

A client is being treated at home for preterm labor. Which beta-adrenergic medication is administered orally to decrease uterine contractions? A. Magnesium sulfate B. Oxytocin C. Nifedipine D. Terbutaline

D

A client of childbearing age is diagnosed with breast cancer. The client is currently taking hormonal contraceptives. What information should the client be given regarding the hormonal contraceptives and the cancer diagnosis? A. The hormonal contraceptives do not affect the course of the disease. B. The hormonal contraceptives will stimulate uterine bleeding. C. The hormonal contraceptives will impair uterine bleeding. D. The hormonal contraceptives will stimulate tumor growth.

D

A woman in preterm labor has been administered terbutaline sulfate. For what potential adverse effects should the nurse assess? A. Pruritus (itching) and copious diaphoresis B. Joint pain and numbness in the extremities C. Headache and visual disturbances D. Palpitations and shortness of breath

D

In assessing the 32-year-old woman who has been taking ergotamine tartrate as abortive therapy for migraine headache for many years, the nurse should assess for which of the following adverse effects? A. hypotension B. muscle weakness C. hypoventilation D. valvular fibrosis

D. A client who is receiving long-term therapy to treat migraine headaches with ergotamine tartrate is at risk for cardiac valvular fibrosis.

A patient has taken sumatriptan-naproxen sodium for an acute migraine. She has also taken over-the-counter ibuprofen for menstrual cramps. Which of the following adverse effects is she at risk for developing? A. bronchospasm B. urinary retention C. edema D. gastrointestinal bleeding

D. A client who takes sumatriptan/naproxen along with ibuprofen is at risk for developing a gastrointestinal bleed. It is important to instruct the client not to take any nonsteroidal anti-inflammatory drug with sumatriptan and naproxen.

A 19-year-old female athlete presents for her first prenatal visit and tells the nurse she has been on androgen therapy to improve her distance running. She asks the nurse if she can continue taking the androgens to maintain her "competitive edge." The nurse should instruct her that she A. can continue taking androgens, because the drugs pose no risk to the fetus B. can continue taking androgens, but a higher dose will be required due to increased drug metabolism during pregnancy C. can continue taking androgens until the third trimester, when they must be discontinued because androgens cause an increased risk of premature rupture of membranes D. must stop taking androgens immediately, because they pose a risk to the fetus; she should discuss this with her health care provider at today's visit

D. Androgens pose risk to the fetus and may produce possible masculinizing effects on a female fetus.

An 8-year-old child is being administered testosterone injections for treatment of hypogonadism. What should be measured every 6 months? A. Electrocardiogram B. Electroencephalogram C. Visual acuity D. Hand and wrist epiphyseal growth plates

D. Because androgens can cause epiphyseal closure, hands and wrists should undergo radiographic examination every 6 months to detect bone maturation and prevent the loss of adult height. No evidence exists that suggests that the electrocardiogram, electroencephalogram, or visual acuity need to be assessed.

A 52-year-old man is taking selegiline for the treatment of Parkinson's disease. He consumes port-wine cheese and crackers at a party. Which of the following symptoms does he develop? A. ataxic gait B. melena C. cardiac dysrhythmia D. hypertension

D. Foods such as port wine cheese are high in tyramine. The combination of selegiline and foods containing tyramine will result in hypertension or hypertensive crisis.

Four patients in an endocrine clinic are ordered to begin androgen therapy. The nurse reviews each patient's current medications and identifies which patient as able to begin androgen therapy without the risk of a known drug interaction? A. patient 1, taking cyclosporine B. patient 2, taking warfarin C. patient 3, taking sulfonylureas D. patient 4, taking heparin

D. No known drug interactions have been reported with concurrent androgen and heparin administration. Androgens may increase effects of cyclosporine and warfarin, apparently by slowing their metabolism and increasing their concentrations in the blood. Androgens also increase effects of sulfonylurea antidiabetic drugs.

A child with attention deficit hyperactivity disorder would most likely exhibit which of the following symptoms? A. anxiety B. positive peer relationships C. hostility D. restlessness

D. Restlessness and inability to sit still are hallmark symptoms of attention deficit hyperactivity disorder.

A 35-year-old woman has begun to take tolcapone in addition to levodopa-carbidopa for Parkinson's disease. Which of the following is the priority nursing intervention? A. Arrange to assess the patient for hypertension early in the morning. B. Evaluate the patient's ability care for herself. C. Have the patient take levodopa-carbidopa 2 hours after tolcapone. D. Instruct the patient to report tea-colored urine to the prescriber.

D. The nurse instructs clients who are taking tolcapone to report tea-colored urine to the prescriber because it is indicative of hepatotoxicity and possible fatal liver failure.

A nurse is assessing a client who has a new prescription of oxybutynin to treat neurogenic bladder. Which of the following assessment findings should the nurse identify as an adverse effect of the drug? (S.A.T.A) Diaphoresis Dilated pupils Dizziness Distended bladder Fever

Dilated pupils Dizziness Distended bladder Fever

A nurse is providing teaching to a client about sildenafil to treat erectile dysfunction. Which of the following instructions should the nurse include? Take the drug with a glass of grapefruit juice Do not take the drug with high-fat foods Increase intake of foods rich in vitamin K Avoid aged cheeses and red wind

Do not take the drug with high-fat foods

A provider has prescribed a dinoprostone vaginal insert to promote cervical ripening in a client who is at 40 weeks of gestation. When administering dinoprostone, which of the following actions should the nurse take? (S.A.T.A) Encourage the client to urinate prior to insertion. Remove the pouch when active labor begins. Monitor for uterine hyperstimulation. Encourage the client to walk after insertion Monitor the client's temperature.

Encourage the client to urinate prior to insertion. Remove the pouch when active labor begins. Monitor for uterine hyperstimulation. Monitor the client's temperature.

A nurse is caring for a client who has a benign prostatic hypertrophy and is taking tamsulosin. The nurse should question the use of the drug if the client also has which of the following? A seizure disorder for which he takes carbamazepine Erectile dysfunction for which he takes sildenafil Diabetes mellitus for which he takes glyburide Angle-closure glaucoma for which he takes pilocarpine

Erectile dysfunction for which he takes sildenafil

A nurse is teaching a client about conjugated estrogen and medroxyprogesterone. Which of the following instructions should the nurse include? Monitor for rectal bleeding Avoid drinking alcoholic beverages Have blood pressure checked regularly. Sit up for 30 min after taking the drug

Have blood pressure checked regularly.

After administering terbutaline to a client to inhibit preterm labor, the nurse should assess which of the following? Peripheral pulses temperature vision heart rate

Heartrate

A nurse should question the use of ethinyl estradiol and drospirenone by a client who has a renal disease due to the increased risk of which of the following? Hyperkalemia Hyponatremia Hypoglycemia Respiratory alkalosis

Hyperkalemia

A nurse is teaching a client who has a new prescription for a testosterone transdermal patch. Which of the following statements made by the client indicates an understanding of the teaching? I should have pancreatic function tests obtained while taking this drug I should have my WBC count checked annually I should take off the patch to shower I should apply the medication to a different site each time

I should apply the medication to a different site each time

A nurse is caring for a client who is about to begin clomiphene therapy to treat infertility. The nurse should monitor the client for which of the following adverse effects? Breast cancer DVT Ovarian hyperstimulation syndrome Restless leg syndrome

Ovarian hyperstimulation syndrome

Cholinergic

P: bethanechol TU: urinary retention

Traditional AED - Carbamazepine

P: carbamazepine TU: seizures

Peripherally Acting Muscle Relaxant

P: dantrolene TU: muscle spasm, malignant hyperthermia

Cholinesterase Inhibitors

P: donezepil TU: Alzheimer's disease

General Anesthesia - Opioids

P: fentanyl TU: supplement to surgery

5-alpha reductase inhibitors

P: finasteride TU: benign prostatic hypertrophy + male patterned baldness

Newer AED

P: gabapentin TU: partial seizures

Dopaminergic Agents

P: levodopa / carbidopa TU: Parkinson's disease

Local Anesthesia

P: lidocaine TU: relieve pain

NMDA Receptor Antagonist

P: memantine TU: Alzheimer's disease

General Anesthesia - Barbiturates

P: methohexital TU: surgery

General Anesthesia - Benzodiazepines

P: midazolam TU: surgery

Non-amphetamines

P: modafinil TU: ADHD, narcolepsy

Anticholinergics

P: oxybutynin TU: neurogenic bladder

Traditional AED - Hydantoin

P: phenytoin TU: seizures

Direct-Acting Dopamine Receptor Agonists

P: pramipexole TU: Parkinson's disease

MAO-B Inhibitors

P: selegiline TU: Parkinson's disease

PDE-5 inhibitor

P: sildenafil (viagra) TU: erectile dysfunction

Serotonin Agonists

P: sumatriptan TU: migraine

alpha-adrenergic receptors antagonist

P: tamsulosin TU: benign prostatic hypertrophy

Testosterone

P: testosterone TU: hypogonadism

Valproates

P: valproate (or valproic acid) TU: seizures

A nurse is providing teaching to a client about using leuprolide to treat endometriosis. Which of the following instructions should the nurse include? Perform weight-bearing activities Wear sunscreen or protective clothing Take the drug with food to increase absorption Avoid drinking grapefruit juice

Perform weight bearing activities

A nurse is caring for a client who is about to begin taking cabergoline to treat infertility. The nurse should explain to the client the need to monitor which of the following laboratory values? Potassium Glucose BUN and creatinine Prolactin level

Prolactin level

A nurse is caring for a client who is about to begin taking finasteride to treat benign prostatic hypertrophy. The nurse should explain to the client the need to monitor which of the following laboratory values? Prostate-specific antigen (PSA) BUN Creatine phosphokinase (CPK) ALT

Prostate specific antigen (PSA)

A nurse is caring for a client who has a new prescription for transdermal conjugated estrogen and medroxyprogesterone to treat postmenopausal symptoms. The nurse should explain to the client that this drug combination includes which of the following therapeutic effects? (S.A.T.A) Reduces the risk of ovarian cancer Relieves hot flashes Prevents osteoporosis Reduces the risk of breast cancer Reduces the risk of thromboembolism

Reduces the risk of ovarian cancer Relieves hot flashes Prevents osteoporosis

A nurse is assessing a client who has a new prescription for the combination oral contraceptive ethinyl estradiol and drospirenone. Which of the following findings should the nurse identify as a contraindication to use of this medication? Drinks a glass of wine each night Smokes half a pack of cigarettes a day Runs marathons regularly Drive a school bus

Smokes half a pack of cigarettes a day

A nurse is caring for a client who missed a dose of oral contraceptive. Which of the following instructions should the nurse give the client? Take a pregnancy test Double up on pills for remainder of the pack Take the missed dose as soon as possible. Stop the oral contraceptive and use a different one

Take the missed dose as soon as possible.

A nurse is preparing to administer finasteride to a client who has BPH. Which of the following precautions should the nurse plan to take when administering this drug? Administer medication while client is sitting or reclining Withhold the medication of the client doesn't eat Wear gloves when handling the tablet Monitor heart rate prior to administration

Wear gloves when handling the tablet

LH + FSH stimulant

clomiphene infertility

Estrogen HRT

conjugated equine estrogen postmenopausal symptoms

Estrogen + Progesterone HRT

conjugated estrogen + medroxyprogesterone postmenopausal symptoms

synthetic prostaglandins

dinoprostone promotes cervical ripening

Oral contraceptives

ethinyl estradiol and drospirenone (Yasmin) oral contraceptive, PMS

A nurse is caring for a client who received human menopausal gonadotropin (hMG). Which of the following findings should the nurse expect? Prolactin secretion estrogen release follicular maturation oxytocin secretion

follicular maturation

Ovulation Stimulant

human chorionic gonadotropin (hCG) infertility

GnRH agonist

leuprolide infertility

Anticonvulsant

magnesium sulfate seizures

Progesterone

medroxyprogesterone endometriosis, dysfunctional uterine bleeding, endometrial carcinoma

Ergot Alkaloids

methylergonovine postpartum hemorrhage

Oxytocin

oxytocin labor induction, post-partum hemorrhage

A nurse is caring for a client who has a new prescription for conjugated equine estrogen. The nurse should instruct the client to report which of the following indications of a serious adverse reaction? Hot flashes UTI vaginal bleeding bone pain

vaginal bleeding

A nurse is teaching a client about receiving leuprolide to treat endometriosis. The nurse should instruct the client to expect which of the following side effects? Vaginal dryness Hypertension Blurred vision Orthostatic hypotension

vaginal dryness

A pregnant woman states that she has been constipated since becoming pregnant. Which medication is most appropriate for preventing constipation related to pregnancy? A. Psyllium B. Mineral oil C. Saline cathartic D. Stimulant cathartic

A

A woman was administered misoprostol in an effort to induce labor, but the health care team is unsatisfied with the results. Consequently, oxytocin will be used. Prior to administering oxytocin, what must occur? A. Four hours must elapse after the last dose of misoprostol. B. The woman must have a type and cross-match performed. C. The woman must receive a bolus of 500-mL normal saline. D. The woman must have her electrolytes measured.

A

An 18-week-gestation pregnant woman has been diagnosed with fetal demise. What medication can be administered to initiate the birthing process? A. Misoprostol B. Calcium gluconate C. Magnesium sulfate D. Folic acid

A

A woman is to receive indomethacin for treatment of preterm labor. The nurse understands the teaching was successful when the woman states which of the following as adverse fetal effects? (Select all that apply.) A. ductus arteriosus constriction B. polyhydramnios C. oligohydramnios D. ductus venosus constriction

A and C. Administration of indomethacin, especially before 32 weeks of gestation, can lead to premature closure of the ductus arteriosus and oligohydramnios by reducing fetal urine output. This contributes to lower volumes of amniotic fluid. Indomethacin does not affect the ductus venosus or contribute to polyhydramnios. because narcotics are often prescribed and may lead to constipation. Laxatives are usually part of the preparation for a colonoscopy. Laxatives are often needed in clients with decreased activity such as those with Parkinson's disease to stimulate bowel function.

The nurse is circulating in the operating room when the anesthesia practitioner declares a malignant hyperthermia emergency. Which of the following symptoms are indicative of malignant hyperthermia? Select all that apply. A. muscle rigidity B. bradycardia C. rash D. hypercapnia E. increased serum creatinine F. hyperkalemia

A and D,E,F. Increased serum creatinine, hypercapnia, hyperkalemia, muscle rigidity, and hyperthermia are symptoms indicative of malignant hyperthermia, which may occur after the use of isoflurane or any volatile inhalation anesthetic.

A couple have been trying unsuccessfully for nearly a year to become pregnant and have now sought fertility counseling. The nurse should be aware of what potential etiological factors related to infertility? Select all that apply. A. Absence of sperm B. Endometriosis C. Vaginitis D. Blocked fallopian tubes E. Fibromyalgia

A,B,D

A patient is taking phenobarbital for a seizure disorder. Which of the following statements indicates that the patient should be seen by a health care provider immediately? A. "I have a rash that started on my trunk, and now it is on my arms and legs." B. "I rest if I feel tired." C. "I take my medication routinely and do not skip doses." D. "I have my blood levels checked if my breathing decreases."

A. A client taking phenobarbital who develops a rash may be developing Stevens-Johnson syndrome and should be seen by the primary health care provider immediately.

A pregnant woman is discussing immunizations recommended during pregnancy with her provider. Which of the following vaccines is recommended during each pregnancy? A. tetanus-diphtheria-pertussis B. tetanus-diphtheria C. live attenuated influenza vaccine D. measles, mumps, and rubella

A. A single dose of the tetanus-diphtheria-pertussis vaccine is recommended for all pregnant women during each pregnancy. The tetanus-diphtheria-pertussis is preferred over the tetanus-diphtheria toxoid due the rise in pertussis rates. Live vaccines such as the live attenuated influenza vaccine and the measles, mumps, and rubella vaccine are not recommended during pregnancy.

A woman with a seizure disorder has been taking phenytoin since she was 6 years old. She has recently married and wants to start a family. She understands the risk related to the use of phenytoin during pregnancy. What should the nurse advise the woman about pregnancy? A. She should discuss her concerns with her gynecologist and neurologist. B. She should stop the phenytoin and take folic acid. C. She should begin to take prenatal vitamins. D. She should consult a genetic counselor about her seizure disorder.

A. A woman with a seizure disorder who is taking antiepileptic agents such as phenytoin should consult her gynecologist and neurologist prior to becoming pregnant.

After patient teaching of the warning signs associated with combination hormonal contraception, what statement would result in the nurse providing additional education? A. "Breakthrough bleeding is a sign of a uterine abnormality." B. "I should immediately go to the emergency department if I get a sudden, severe headache that is not relieved with rest or analgesic." C. "Severe leg pain and swelling should immediately be reported." D. "Cardiovascular problems are the most severe adverse effect associated with oral contraceptives."

A. Breakthrough bleeding with the administration of combination hormonal contraception is a common side effect associated with this method. Breakthrough bleeding does not indicate a sign of uterine abnormality. The client will need more client education regarding the adverse effects of combination hormonal contraception.

A woman is admitted to labor and delivery for labor induction due to postterm pregnancy. Labor has not begun on its own, and the cervix is unfavorable. Which of the following medications promotes cervical ripening? A. dinoprostone B. nifedipine C. naproxen sodium D. oxytocin

A. Dinoprostone is administered to promote cervical ripening.

A boy comes to the school nurse's office and states, "I did not take my Ritalin today." Which of the following is the most appropriate nursing intervention? A. Call the child's parent or guardian to try to find out if the boy has taken his medicine. B. Give the child his morning dose because it is in the office. C. Send him back to class and tell him it is not necessary to take the medication. D. Call the child's physician to obtain a one-time dose of methylphenidate

A. Even if the nurse has the right dose and right medication in the office, he or she should check with the child's mother, father, or guardian to verify that the medication had not been given that morning.

A woman has been diagnosed with gestational diabetes. What effect does maternal hyperglycemia have on the fetus? A. It results in fetal hyperinsulinemia. B. It produces seizures in the newborn. C. It increases the mother's risk of preterm labor. D. It decreases the birth weight.

A. Gestational diabetes places the fetus at risk for hyperinsulinemia.

The rationale for withholding food or fluids following the application of a local anesthetic to the mouth or throat is to A. prevent aspiration B. prevent infection C. minimize a hypersensitivity reaction D. enhance pain control

A. It is necessary to withhold food and fluid in clients who have had a local anesthetic in the mouth or throat to prevent aspiration until full sensation returns.

What is the rationale for the administration of ketamine? A. It provides sedation and analgesia. B. It can be administered without risk. C. It slowly crosses the blood-brain barrier. D. It reduces blood pressure.

A. Ketamine produces sedation and analgesia. It places the patient in a trance-like state.

Local anesthetics reduce the excitability neuronal cell membranes by decreasing permeability to which ion? A. sodium B. potassium C. chloride D. magnesium

A. Local anesthetics decrease the permeability of the nerve cell membrane to ions, especially sodium. This action reduces the excitability of cell membranes.

A woman is admitted to the labor and delivery unit with a blood pressure of 200/90 mm Hg. The admitting diagnosis is preeclampsia. The intravenous magnesium sulfate ordered for this patient prevents? A. seizures B. myocardial damage C. tetany D. hypothermia

A. Magnesium sulfate is administered parenterally to prevent seizures.

Progesterone is a progestin concerned almost entirely with reproduction. In nonpregnant women, progesterone is secreted by which of the following? A. corpus luteum B. hypothalamus C. anterior pituitary D. adrenal cortex

A. Progesterone is secreted by the corpus luteum in the first few weeks of pregnancy. It plays an important role in the stabilization of the endometrium to support the pregnancy.

A patient stops taking clonazepam. What adverse effect will occur? A. status epilepticus B. bone marrow depression C. cerebral edema D. lethargy

A. The abrupt withdrawal of clonazepam results in the development of status epilepticus.

A client is diagnosed with dysmenorrhea. Which oral medication will be prescribed? A. Estrogen B. Progestins C. Naproxen D. Ibuprofen

B

A client is receiving oxytocin. Which is a maternal-focused adverse effect of the medication? A. Acute confusion B. Hypertension C. Edema D. Inverted T wave

B

A client taking hormonal contraceptives will soon turn 35 years of age. The client is moderately obese and has smoked for 15 years. Which action should the nurse encourage the client to take to best minimize risk for complications associated with contraception use? A. Beginning an exercise regime B. Beginning smoking cessation C. Beginning daily aspirin therapy D. Beginning taking a loop diuretic to aid weight loss

B

When administering magnesium sulfate, the nurse should assess the client for what sign? A. Dry, pale skin B. Respiratory depression C. Agitation D. Tachycardia

B

A man is admitted to the postanesthesia care unit following surgery, where he received vecuronium. He is unable to raise his head and develops shortness of breath. What are the priority nursing interventions? Select all that apply. A. Draw an arterial blood gas. B. Notify the anesthesia practitioner. C. Administer furosemide. D. Apply high-flow oxygen. E. Intubate the patient.

B and D. For a client who develops respiratory insufficiency and the inability to lift his or her head, it is necessary to first administer high-flow oxygen. Then, it is necessary to notify the anesthesia provider.

A patient has been administered lidocaine via an epidural. Which of the following symptoms indicate the patient is having an adverse reaction to the anesthesia? (Select all that apply.) A. blood pressure of 130/86 mm Hg B. metallic taste in mouth C. pulse rate of 76 beats/min D. crackles in the right lower lobe of the lung E. circumoral numbness F. anxiety

B and F. A client who develops anxiety after lidocaine is administered epidurally is at risk for local anesthetic systemic toxicity (LAST). In addition, altered taste or metallic taste is an adverse effect.

A seriously ill pediatric patient has been admitted to the ICU. The patient is intubated, and propofol is used for long-term sedation so the patient does not "fight" the ventilator. Which of the following laboratory values should be monitored? Select all that apply. A. complete blood count B. triglycerides C. alkaline phosphatase D. lactate E. creatine kinase F. luteinizing hormone

B, C, D, and E. The use of propofol places the patient at risk for the development of metabolic acidosis. Triglycerides, alkaline phosphatase, lactate, and creatinine kinase should be monitored.

Patient teaching for a woman who will be using the transdermal patch Ortho Evra should include which of the following? (Select all that apply.) A. Apply to skin daily. B. Apply to clean and dry skin. C. Apply the patch on the same day of the week each week for 3 weeks. D. Apply the patch the first day of the menstrual cycle initially. E. Use a backup method for birth control the first 2 weeks of using the patch. F. Use a backup method for birth control the first 3 weeks of using the patch.

B, C, and D. The application of a transdermal patch to clean, dry skin is essential for the proper adherence and absorption. The patch should be applied the first day of menses or the Sunday following the start of menses. The woman should use a back-up method for the first week of use. Lotions and occlusive dressings should not be used at the application site. The patch should always be changed on the same day of the week. When a new patch cycle is delayed beyond the scheduled start date, the woman should be instructed to apply a patch as soon as she remembers and use back-up contraception for at least 1 week.

A patient is taking carisoprodol for back spasms related to an occupational injury. Which of the following is most important to teach the patient? A. to take the medication at 8:00 am, 2:00 pm, and 8:00 pm B. to know the signs and symptoms of an idiosyncratic reaction C. to take the medication between meals D. to stop the medication with the first sign of abdominal cramping

B. A patient who takes carisoprodol should receive instruction about the signs and symptoms of an idiosyncratic reaction.

A 50-year-old patient is 1-day postoperative following abdominal surgery for resection of colon cancer. Which of the following pain control devices is most effective in treating his pain? A. lidocaine using IV regional anesthesia B. bupivacaine by the epidural route C. benzocaine by the transdermal route D. fentanyl citrate by patient-controlled analgesia

B. Bupivacaine hydrochloride by the epidural route is the most effective method of pain relief for a client in this situation.

Which of the following groups are most commonly used for drug management of the hyperactive child? A. central nervous system (CNS) depressants B. CNS stimulants C. anticonvulsants D. major tranquilizers

B. Central nervous system stimulants are the treatment of choice for attention deficit hyperactivity disorder.

Which of the following medications is administered for status epilepticus? A. phenytoin B. diazepam C. levetiracetam D. clobazam

B. Diazepam is administered for status epilepticus.

Which of the following medications prolongs the effect of local anesthetics? A. propofol B. epinephrine C. calcium D. labetalol

B. Epinephrine combined with a local anesthetic prolongs the effectiveness of the local anesthetic.

A nurse is providing prenatal teaching in the obstetric clinic. Which of the following herbal supplements helps in the prevention of nausea and vomiting? A. St. John's wort B. ginger C. black cohosh D. garlic

B. Ginger helps prevent nausea and vomiting during pregnancy.

Which behavior would a nurse expect in the child who takes methylphenidate every morning? A. sitting and playing with toys for 90 minutes B. getting along well with peers C. expressing anger in an appropriate manner D. not throwing toys across the room

B. Having better relationships with his peers is an intended or therapeutic effect of the medication.

Hormone therapy is indicated for A. treatment of osteoporosis B. relief of vasomotor symptoms C. cardiovascular disease prevention D. endometrial cancer treatment

B. Hormone therapy is indicated for the relief of vasomotor symptoms related to estrogen deficiency. It is not indicated for the treatment of osteoporosis, cardiovascular disease prevention, or treatment of endometrial cancer.

Which of the following places the patient at risk for toxicity following the administration of phenytoin? A. The patient skips a dose of phenytoin. B. The patient takes a different brand of phenytoin. C. The patient switches to a different antiepileptic agent. D. The patient receives phenytoin in an enteral feeding.

B. If a client switches brands of phenytoin, the client is at risk for the development of toxicity.

What is the expected outcome for a central nervous system stimulant in a child? A. increased behavioral problems B. improved performance in schoolwork C. decreased ability to complete a task D. increased hyperactivity

B. Improved performance is an intended or therapeutic effect of the medication.

A 30-year-old woman suffering from postpartum depression is scheduled to receive electroconvulsive therapy. Which of the following anesthetic agents will most likely be administered? A. methotrexate sodium B. methohexital sodium C. methocarbamol D. methimazole

B. Methohexital sodium is administered for sedation in clients receiving electroconvulsive therapy (ECT) because it is the drug of choice prior to ECT. Methohexital does not raise the seizure threshold.

Once an ovum is fertilized, what hormone works to maintain pregnancy? A. estrogen B. progesterone C. follicle-stimulating hormone D. luteinizing hormone

B. Progesterone is known as the "hormone of pregnancy" because of the endometrial support that the hormone provides. It is produced by the corpus luteum during the first few weeks of pregnancy and then by the placenta. This hormone maintains the optimal endometrial environment for fetal development.

A woman is admitted to the labor and delivery unit in preterm labor. The woman was diagnosed with hyperthyroidism 3 years ago. Which tocolytic is contraindicated? A. magnesium sulfate B. terbutaline sulfate C. nifedipine D. indomethacin

B. Terbutaline is contraindicated in clients with hyperthyroidism.

A woman has been unable to conceive for many months and will soon begin treatment with clomiphene. What health education should the nurse provide to this client? A. Avoid drinking alcohol while taking clomiphene. B. Perform daily OTC pregnancy tests beginning the day after taking clomiphene. C. Take basal temperature between 5 and 10 days after taking clomiphene. D. Report any numbness or tingling in the hands or lips to the health care provider.

C

A woman is being administered IV magnesium sulfate for treatment of toxemia. What is the most important outcome related to the administration of magnesium sulfate? A. Decreased contractions B. Respiratory rate below 16 C. Absence of seizure activity D. Diminished reflexes

C

A woman who began labor several hours ago is now prescribed oxytocin. What is the goal of oxytocin therapy? A. Prevent postpartum bleeding. B. Decrease fetal hyperactivity. C. Augment weak or irregular contractions. D. Diminish periods of uterine relaxation.

C

An insulin-dependent diabetic client has begun taking an oral contraceptive. What effect will this medication regime have on the client physiologically? A. Increase blood pressure B. Increase heart rate C. Increase blood glucose D. Metabolic alkalosis

C

The certified nurse midwife administers misoprostol in the woman's vagina to increase cervical ripening. The cervix ripens, but the contractions are not significant for the fetus to pass through the birth canal, and oxytocin is ordered. Which of the following is most important with regard to the administration of oxytocin? A. Begin the oxytocin immediately. B. Begin the oxytocin in 2 hours. C. Begin the oxytocin in 4 hours. D. Begin the oxytocin in 8 hours.

C

. A patient is admitted to the diagnostic procedure center for a routine colonoscopy. Propofol is the drug of choice for sedation. Which of the following would contraindicate the use of propofol? A. a history of postoperative nausea and vomiting B. a diagnosis of hypertension C. an allergy to eggs D. the need for rapid emergence

C. A client who is allergic to eggs should not receive propofol. The nurse should communicate this finding to the anesthesia provider.

The nurse is providing immunization education to a pregnant woman. She should receive which of the following vaccines during cooler seasonal temperatures? A. rubella B. mumps C. influenza D. tetanus

C. A pregnant woman should receive the influenza vaccine in the autumn to prevent influenza. The administration of the vaccine at that time allows the woman to develop significant resistance to influenza during the winter months.

A nurse administers baclofen to a young man for a back injury. Which of the following interventions is most important related to the administration of baclofen? A. Assess heart rate. B. Assess for edema. C. Assess blood sugar. D. Assess for increased spasticity.

C. Baclofen has an adverse effect of hyperglycemia. It is most important to assess the client's blood sugar.

A surgical patient with which of the following conditions may experience recurarization following the administration of vecuronium? A. hypertension B. hyperthyroidism C. cirrhosis D. Parkinson's disease

C. Because of the extensive hepatic metabolism and biliary excretion of vecuronium, patients with significant hepatic impairment such as cirrhosis or cholestasis can experience slow elimination and prolonged muscle paralysis.

A patient is admitted to the emergency department with repeated tonic-clonic seizures. Tonic-clonic seizures may be attributed to which of following drugs? A. ciprofloxacin hydrochloride B. cimetidine C. cocaine D. morphine sulfate

C. Cocaine administration can result in seizure development.

A 32-year-old woman is admitted to the hospital for an appendectomy. She has a history of reactive airway disease. Which of the following inhalation anesthetic agents, if any, is contraindicated? A. isoflurane B. sevoflurane C. desflurane D. nitrous oxide

C. Desflurane is contraindicated in clients who have restricted airway disease due to the development of bronchoconstriction.

Which of the following interventions assists the patient in decreasing the anticholinergic effects of cyclobenzaprine? A. Have the patient void before the administration of cyclobenzaprine. B. Give the patient lemon juice mixed with warm water to prevent constipation. C. Give the patient hard candy to suck on. D. Assess the patient's pulse and blood pressure.

C. Hard candy assists in relieving thirst related to anticholinergic effects of cyclobenzaprine.

A woman diagnosed with anovulation receives a prescription for menotropin to be administered subcutaneously. When providing education about medication administration, the nurse should teach the woman to: A. massage the area prior to administering the drug B. administer the drug at a 90-degree angle C. alternate the sides of the abdomen for the injection sites D. take human chorionic gonadotropin before the menotropin

C. It is necessary to alternate the sides of the abdomen when injecting subcutaneous menotropin.

Which of the following is most important to teach a patient who is being administered lamotrigine? A. to report the development of edema B. to report anxiety C. to report the development of a skin rash D. to report anorexia

C. It is necessary to instruct the client to report the development of skin rash when administered lamotrigine. The U.S. Food and Drug Administration has issued a black box warning concerning potential development of serious dermatologic reactions.

When oral contraceptives are contraindicated in women with liver disease, what other birth control option would be safe? A. Ortho Evra (contraceptive patch) B. Depo-Provera (injectable progestin) C. barrier method (condoms) D. Nexplanon (subdermal implant)

C. Ortho Evra, DepoProvera, and Implanon are all hormonal methods of birth control in which the metabolism of these hormones occurs in the liver. Impaired liver function is a contraindication to hormonal contraceptive use. Thus, a barrier method would be most appropriate.

The certified nurse midwife administers misoprostol in the woman's vagina to increase cervical ripening. The cervix ripens, but the contractions are not significant for the fetus to pass through the birth canal, and oxytocin is ordered. Which of the following is most important with regard to the administration of oxytocin? A. Begin the oxytocin immediately. B. Begin the oxytocin in 2 hours. C. Begin the oxytocin in 4 hours. D. Begin the oxytocin in 8 hours.

C. Oxytocin should not be administered until 4 hours after the last dose of misoprostol.

A nurse knows that teaching was successful when expectant parents give which of the following rationales for administering folic acid supplements? A. prevent hydrocele B. increase absorption C. prevent neural tube deformity D. decrease blood glucose

C. The supplement folic acid helps prevent neural tube deformity.

Postmenopausal women with an intact uterus taking estrogen for hormone replacement therapy require progestin because A. progestins enhance the effects of estrogen B. combination therapy provides osteoporosis prevention C. progestin opposes the effects of estrogen on the endometrium D. uterine cancer is increased

C. The use of unopposed estrogen on an intact uterus increases the risk of endometrial cancer greatly. Therefore, progestin is necessary to block the estrogenic effects on the endometrium.

A 12-year-old boy comes to the school nurse's office after falling during gym class. The nurse assesses the child and notes that he has bruising and petechiae over most of his legs, arms, and torso. The child has a history of absence seizures that are treated with valproate. Based on the child's history, what would the nurse suspect? A. abuse B. leukemia C. adverse effect D. anemia

C. Valproic acid has an adverse effect of bleeding. The first sign of bleeding in this client is bruising and petechiae.

A woman in preterm labor has developed depressed deep tendon reflexes. Which medication will be administered? A. Potassium chloride B. Epinephrine C. Carboprost D. Calcium gluconate

D

A woman is at 42 weeks of gestation. Which medication will be administered to promote cervical ripening? A. Calcium gluconate B. Magnesium sulfate C. Terbutaline D. Dinoprostone

D

During client teaching, a young client asks the nurse, "If I get pregnant on the 'pill' should I continue to take it?" What is the nurse's best response? A. "The pill has no effect on pregnancy." B. "The pill will cause miscarriage." C. "The pill is not harmful to the male fetus." D. "The pill can be harmful to the female fetus."

D

A patient is having a seizure that lasts longer than 30 minutes. What type of generalized seizure is the patient experiencing? A. tonic-clonic B. absence seizure C. atonic seizure D. status epilepticus

D. A client having a seizure lasting longer than 30 minutes is experiencing status epilepticus.

Which finding is indicative of an adverse effect of dextroamphetamine? A. increased appetite B. respiratory depression C. sedation D. cardiac dysrhythmias

D. Cardiac adverse effects are common with dextroamphetamine.

A couple has been trying to conceive for the past 8 months without success. Which of the following medications is the first drug of choice? A. leuprolide B. human chorionic gonadotropin C. follitropin beta D. clomiphene citrate

D. Clomiphene citrate is the drug of choice for a couple with infertility.

An 18-year-old man is having an open reduction external fixation of a hip following a football injury. During surgery, he develops a fever of 105°F. Which of the following medications is administered? A. cyclobenzaprine hydrochloride B. dexamethasone sodium phosphate C. phenytoin D. dantrolene sodium

D. Dantrolene is the skeletal muscle of choice for the treatment of malignant hyperthermia.

A woman is receiving intravenous (IV) magnesium sulfate to control symptoms of preeclampsia. Which of the following signs or symptoms indicates a need for the administration of IV calcium gluconate? A. urine ketosis B. respiratory rate of 36 breaths/min C. anuria D. loss of deep tendon reflexes

D. Diminished deep tendon reflexes are indicative of hypermagnesemia and indicate the need for calcium gluconate IV.

Patient teaching for children taking methylphenidate for attention deficit hyperactivity disorder should include which of the following? A. Give the child the drug at bedtime. B. Drowsiness may be a side effect. C. If necessary, the child may take over-the-counter cold products without problems. D. Provide for periodic drug-free holidays.

D. Drug-free periods are initiated by the health care provider to allow for periods of growth and weight gain.

The effects of endogenous estrogen are multifaceted. Which of the following statements is associated with the effects of endogenous estrogen? A. It decreases protein anabolism, bone growth, and epiphyseal closure in young girls. B. It increases low-density lipoproteins. C. It decreases vascularity in the skin. D. It promotes bone formation and decreases bone loss.

D. Estrogen increases protein anabolism, bone growth, and epiphyseal closure in young adults; decreases low-density lipoproteins; and increases vascularity in the skin.

A child returns to school after a dental procedure requiring anesthesia. He visits the school nurse's office to take his pain medication. The most important assessment the nurse should make prior to the administration of the pain medication is to assess the A. prescription for an expiration date B. child's blood pressure and pulse C. child's mouth for bleeding D. child's mouth for numbness

D. Following dental procedures in which a client has been administered a local anesthetic, the nurse should assess the child's mouth for numbness before administering pain medication.

The nurse is preparing a presentation of the risk factors of oral contraceptives. What factor is an absolute contraindication? A. bulimia B. cigarette smoking at age 33 C. body mass index (BMI) of 23 D. history of thromboembolism

D. History of thromboembolism is an absolute contraindication of oral contraceptives because stroke and heart attack are greatly increased with previous thromboembolism.

A male infant is admitted to the emergency department. His parents report that he had a seizure. The infant's aural temperature is 104.3°F. What is the most likely cause of the seizure? A. head injury B. developmental delay C. sepsis D. fever

D. The cause of the infant's seizure is his fever. This is a febrile seizure.

When a 7-year-old child, already of short stature, is prescribed amphetamine sulfate, which intervention will promote growth? A. administering growth hormone B. encouraging daily exercise C. maintaining a 2200-calorie diet D. drug holidays when on school breaks

D. The nurse should instruct the parents about using drug holidays when the child is not in school. These assist in promoting growth.

Glucocorticoids

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Hyperprolactinemia Inhibitor

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