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Question 1

The nurse is assessing an adolescent after the administration of epinephrine. Which side effect is most important for the nurse to identify?

A. Tachycardia
B. Hypoglycemia
C. Constricted pupils
D. Decreased blood pressure

Answer 1

A. Tachycardia

Question 2

Which side effect would the nurse assess for after epinephrine is administered to an infant with severe bronchospasms?

A. Tachycardia
B. Hypotension
C. Respiratory arrest
D. Central nervous system depression

Answer 2

A. Tachycardia

Question 3

A 12-year-old child has just received a dose of epinephrine. Which assessment is the priority after this medication is administered?

A. Heart rate
B. Glucose level
C. Neurological status
D. Blood pressure

Answer 3

A. Heart rate

Question 4

A client is experiencing anaphylaxis from an insect sting. Which medication should the nurse administer?
A. Dopamine.
B. Ephedrine.
C. Epinephrine.
D. Diphenhydramine.

Answer 4

C. Epinephrine.

Question 5

A nurse is monitoring a client who received epinephrine for angioedema (facial swelling) after a first dose of losartan. Which of the following data indicates a therapeutic response to the epinephrine?

A. Respirations are unlabored.

B. Client reports decreased groin pain of 3 on a 1 to 10 scale.

C. The client’s blood pressure when arising from resting position is at premedication levels.

D. The client tolerates a second dose of medication with no greater than 1+ peripheral edema.

Answer 5

A. Respirations are unlabored.

Question 6

A nurse is caring for a client who received an injection of penicillin G procaine. The client begins to experience dyspnea and tongue swelling. Which of the following actions should the nurse perform first?

A. Obtain intravenous fluids for administration.

B. Record the observed data in medical record.

C. Deliver a dose of aminophylline by inhalation.

D. Administer epinephrine subcutaneously, intramuscular or IV

Answer 6

D. Administer epinephrine subcutaneously, intramuscular or IV

Question 7

A client with a history of methamphetamine use is admitted to the medical unit. Which clinical manifestation would the nurse expect when assessing the client who is under the influence on admission?

A. Constricted pupils
B. Intractable diarrhea
C. Increased heart rate
D. Decreased respirations

Answer 7

C. Increased heart rate

Question 8

Which body system is affected by excessive use of amphetamine / dextroamphetamine?

A. Renal
B. Cardiac
C. Musculoskeletal
D. Gastrointestinal

Answer 8

B. Cardiac

Question 9

A client is admitted to the acute medical unit for severe amphetamine intoxication. Which medications are indicated to counteract the effects of stimulant intoxication?

A. Diazepam (anti-seizure/relaxation) & Propranol (anti-hypertensive/slows heart rate)
B. Digoxin (for Congestive Heart Failure/strengthens heart beat) & sertraline (anti-depressant)
C. Atropine (Anti-Cholinergic/speeds up heart, dries things out) & nitroglycerine (anti-hypertensive/vasodilation)
D. alendronate (Builds strong bones) & pancuronium (muscle paralytic)
Rationale

Answer 9

A. Diazepam (anti-seizure/relaxation) & Propranol (anti-hypertensive/slows heart rate)

Question 10

Which drug category applies to cocaine?

A. Opioids
B. Stimulants
C. Barbiturates
D. Hallucinogens

Answer 10

B. Stimulants

Question 11

Which medication is the first choice of medication for the treatment of attention-deficit/hyperactivity disorder (ADHD)?

A. Clonidine
B. Guanfacine
C. Atomoxetine
D. Methylphenidate

Answer 11

D. Methylphenidate

Question 12

The nurse is teaching the parents of a child with attention-deficit/hyperactivity disorder. Which medication would the nurse include as the frequently prescribed medication for this disorder?

A. Lorazepam
B. Haloperidol
C. Methylphenidate
D. Methocarbamol

Answer 12

C. Methylphenidate

Question 13

Which medications would NOT be indicated for management of attention-deficit/hyperactivity disorder (ADHD)?

A. Amphetamines
B. Benztropine
C. Methylphenidate
D. Dextroamphetamine

Answer 13

B. Benztropine

Question 14

Methylphenidate is prescribed to treat a child’s attention-deficit/hyperactivity disorder (ADHD). Which effect of methylphenidate is used in the treatment of ADHD in children?

A. Diuretic
B. Synergistic
C. Paradoxical/Opposite
D. Hypotensive

Answer 14

C. Paradoxical/Opposite

Question 15

A child with attention-deficit/hyperactivity disorder (ADHD) is prescribed methylphenidate. The mother asks about its action and side effects. Which response by the nurse is most appropriate?

A. ‘This medicine increases the appetite.’
B. ‘This medicine must be continued until adulthood.’
C. ‘It is a short-acting medicine that must be given with each meal.’
D. ‘It is a stimulant that has a calming effect on children with ADHD.’

Answer 15

D. ‘It is a stimulant that has a calming effect on children with ADHD.’

Question 16

A nurse is teaching the parents of a child who has ADHD about methylphenidate. Which of the following statements should the nurse include in the teaching?

A. “Administer the medication at bedtime.”

B. “Your child might gain weight while taking this medication.”

C. “This medication might increase the amount of saliva your child produces.”

D. “Restrict your child’s intake of caffeine while she is taking this medication.”

Answer 16

D. “Restrict your child’s intake of caffeine while she is taking this medication.”

Question 17

The clinic nurse is collecting data from a client who is taking prescribed methylphenidate for the treatment of attention deficit hyperactivity disorder (ADHD) and is requesting an increase in the dose. Which statement by the client would require immediate follow-up by the nurse?

A. “I think I have lost weight since I started taking the medication.”
B. “This medication is not calming me down even with green tea.”
C. “I take more naps during the day on this medication.”
D. “I am performing better at work but need to be more engaged.”

Answer 17

B. “This medication is not calming me down even with green tea.”

Question 18

A health care provider prescribes methylphenidate for a child with attention-deficit/hyperactivity disorder (ADHD). Which instruction would the nurse provide when teaching the parents about this medication?

A. Monitor the effect of the medication on their child’s behavior.
B. Increase or decrease the dosage, depending on the child’s behavior.
C. Avoid imposing too many rules, because this will frustrate the child.
D. Reinforce to the child that behavior can be controlled.

Answer 18

A. Monitor the effect of the medication on their child’s behavior.

Question 19

Methylphenidate has been prescribed with meals for a child with attention-deficit/hyperactivity disorder (ADHD). Which rationale would the nurse provide for the parents about the timing of the medication administration?

A. Ritalin depresses the appetite.
B. This will ensure proper absorption.
C. It is an oral mucous membrane irritant.
D. Children tend to forget to take it before meals.

Answer 19

A. Ritalin depresses the appetite.

Question 20

The nurse is teaching the parents of a child with attention-deficit/hyperactivity disorder (ADHD) about the prescribed medication methylphenidate. Which time identifies when the daily dose will be administered?

A. Before breakfast
B. Just after breakfast
C. Immediately before lunch
D. As soon as the child awakens

Answer 20

B. Just after breakfast

Question 21

Which test would the nurse identify as specific for the diagnosis of myasthenia gravis?

A. Electromyography
B. Pyridostigmine test
C. Edrophonium chloride test
D. History of physical deterioration

Answer 21

C. Edrophonium chloride test

Question 22

A client is undergoing diagnostic testing for myasthenia gravis. Which test would the nurse identify as the most specific for this diagnosis?

A. Electromyography
B. Pyridostigmine test
C. Edrophonium chloride test
D. History of physical deterioration

Answer 22

C. Edrophonium chloride test

Question 23

A client suspected of having myasthenia gravis is scheduled for an edrophonium chloride test. To treat a common complication associated with the test, the nurse will have which medication available?

A. Atropine
B. Phenytoin
C. Neostigmine
D. Diphenhydramine

Answer 23

A. Atropine

Question 24

A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The nurse prepares for intravenous administration of edrophonium chloride (Tensilon). What is the expected outcome for this client following administration of this pharmacologic agent?

A. Progressive difficulty with swallowing.
B. Decreased respiratory effort.
C. Improvement in generalized fatigue.
D. Decreased muscle weakness.

Answer 24

D. Decreased muscle weakness.

Question 25

Which conclusion would the nurse make about the development of loose stools and increased salivation two days after a client with myasthenia gravis begins taking pyridostigmine? A. The client is experiencing a myasthenic crisis. B. The medication is causing cholinergic side effects. C. The medication is triggering a paradoxical reaction. D. The client is exhibiting toxic effects of the medication.

Answer 25

B. The medication is causing cholinergic side effects.

Question 26

The anticholinesterase medication pyridostigmine is prescribed for the client with myasthenia gravis. When providing medication teaching, the nurse explains that the client should expect a decrease in which function? A. Bowel function B. Heart rate C. Skeletal muscle contraction D. Urinary frequency

Answer 26

B. Heart rate

Question 27

A client presents to the clinic for a follow-up appointment after starting pyridostigmine for management of myasthenia gravis. Which new client problem are NOT an adverse effects of pyridostigmine? A. Increased urinary frequency B. Diplopia (double vision) C. Muscle twitching D. Diarrhea

Answer 27

B. Diplopia (double vision)

Question 28

A client with myasthenia gravis begins taking pyridostigmine. Two days later, the client develops loose stools and increased salivation. Which conclusion would the nurse make about these new developments? A. The client is experiencing a myasthenic crisis. B. The medication is causing cholinergic side effects. C. The medication is triggering a paradoxical reaction. D. The client is exhibiting toxic effects of the medication.

Answer 28

B. The medication is causing cholinergic side effects.

Question 29

The health care provider prescribes neostigmine for a client with myasthenia gravis. Which client statement indicates understanding regarding medication management plans? A. 'I must keep the medication in a container in the refrigerator.' B. 'I should take the medication at the exact time that is listed on the prescription.' C. 'I will plan to take the medication between meals.' D. 'I expect that the onset of the medication’s action will occur several hours after I take it.'

Answer 29

B. 'I should take the medication at the exact time that is listed on the prescription.'

Question 30

Pyridostigmine bromide is prescribed for a client with myasthenia gravis. The nurse evaluates that the medication regimen is understood when the client makes which statement? A. 'I will take the medication on an empty stomach.' B. 'I need to set an alarm so I take the medication on time.' C. 'It will be important to check my heart rate before taking the medication.' D. 'I should monitor for an increase in blood pressure after taking the medication.'

Answer 30

B. 'I need to set an alarm so I take the medication on time.'

Question 31

A client with myasthenia gravis is receiving pyridostigmine bromide to control symptoms. Recently, the client has begun experiencing increased difficulty in swallowing. Which nursing action is effective in preventing aspiration of food? A. Place a tracheostomy set in the client’s room. B. Assess respiratory status after meals. C. Request for the diet to be changed from soft to clear liquids. D. Coordinate mealtimes with the peak effect of the medication

Answer 31

D. Coordinate mealtimes with the peak effect of the medication

Question 32

Pyridostigmine is prescribed for a client with myasthenia gravis. Why would the nurse instruct the client to take pyridostigmine about 1 hour before meals? A. This timing limits first pass metabolism. B. Taking it on an empty stomach increases absorption. C. Taking it before meals decreases gastric irritation. D. Taking it before meals improves the ability to chew.

Answer 32

D. Taking it before meals improves the ability to chew.

Question 33

A client begins treatment with pyridostigmine bromide therapy for myasthenia gravis. Which action would the nurse perform in administration of the medication? A. Administer the medication after meals. B. Administer the medication on an empty stomach. C. Evaluate the client’s psychological responses between medication doses. D. Evaluate the client’s muscle strength every hour after the medication is given.

Answer 33

D. Evaluate the client’s muscle strength every hour after the medication is given.

Question 34

Which action would the nurse perform when beginning pyridostigmine bromide therapy for a client with myasthenia gravis? A. Administer the medication after meals. B. Administer the medication on an empty stomach. C. Evaluate the client’s psychological responses between medication doses. D. Evaluate the client’s muscle strength every hour after the medication is given.

Answer 34

D. Evaluate the client’s muscle strength every hour after the medication is given.

Question 35

A client with myasthenia gravis has been receiving neostigmine and asks about its action. Which information would the nurse consider when formulating a response? A. Stimulates the cerebral cortex B. Blocks the action of cholinesterase C. Replaces deficient neurotransmitters D. Accelerates transmission along neural sheaths

Answer 35

B. Blocks the action of cholinesterase

Question 36

The health care provider prescribes a cholinergic medication to treat a client’s urinary problem. Which effect would the nurse anticipate? A. Urinary frequency decreases. B. Urinary retention is prevented. C. Pain is controlled. D. Urinary urgency decreases.

Answer 36

B. Urinary retention is prevented.

Question 37

Cholinergic agonists are prescribed for which type of urinary condition? A. Kidney stones B. Urine retention C. Spastic bladder D. Urinary tract infections

Answer 37

B. Urine retention

Question 38

The nurse has administered fentanyl, atropine, cefazolin and benzocaine to a client for an endoscopic procedure. The nurse is monitoring the client and notes that the heart rate has increased from the pre-procedure baseline. The nurse knows that which of the following medications is most likely responsible for the client's increased heart rate? A. Fentanyl B. Atropine C. Cefazolin D. Benzocaine

Answer 38

B. Atropine

Question 39

During a procedure, the client’s heart rate drops to 38 beats/min. Which medication is indicated to treat bradycardia? A. Digoxin B. Lidocaine C. Amiodarone D. Atropine sulfate

Answer 39

D. Atropine sulfate

Question 40

A nurse is caring for a client who has a cardiopulmonary arrest. The nurse anticipates the emergency response team will administer which of the following medications if the client’s restored rhythm is symptomatic bradycardia? A. Epinephrine B. Magnesium C. Atropine D. Sodium bicarbonate

Answer 40

C. Atropine

Question 41

When a client exhibits severe bradycardia, which type of medication will the nurse be prepared to administer? A. Nitrate B. Anticholinergic C. Antihypertensive D. Cardiac glycoside

Answer 41

B. Anticholinergic

Question 42

The nurse is caring for a client who has been prescribed atropine preoperatively. The nurse understands the intended purpose for administering this preoperatively is to induce which effect? A. Reduce heart rate B. Elevate blood pressure C. Enhance sedation D. Decrease secretions

Answer 42

D. Decrease secretions

Question 43

Which action is likely to reduce the pancreatic and gastric secretions of a client with pancreatitis? A. Encourage clear liquids. B. Obtain a prescription for morphine. C. Assist the client into a semi-Fowler position. D. Administer prescribed anticholinergic medication such as atropine.

Answer 43

D. Administer prescribed anticholinergic medication such as atropine.

Question 44

manage the symptoms of chronic obstructive pulmonary disease. What information should the nurse include in the discharge teaching? A. It may be a few days before you feel the full effects of tiotropium. B. This medication cannot be used to relieve sudden breathing problems. C. Be sure to swallow the capsules with a full glass of water. D. A common side effect is nausea and loose stools.

Answer 44

B. This medication cannot be used to relieve sudden breathing problems.

Question 45

The nurse in a urology office is developing a plan of care for a client newly diagnosed with urge urinary incontinence due to an overactive bladder. Which interventions should the nurse include? A. Administer ant-seizure medications B. Administration of cholinergic drugs C. Administration of anticholinergic drugs D. Administration of loop diuretics

Answer 45

C. Administration of anticholinergic drugs

Question 46

The nurse is caring for a client who was recently prescribed atropine as a treatment for symptomatic bradycardia. Which condition should the nurse question as a contraindication when taking this medication? A. Urinary incontinence B. Right-sided heart failure C. Glaucoma D. Increased intracranial pressure

Answer 46

C. Glaucoma

Question 47

Which ophthalmic solution is contraindicated for clients with glaucoma? A. Timolol B. Atropine C. Pilocarpine D. Epinephrine

Answer 47

B. Atropine