final prep Flashcards
1
Q
- The nurse is setting up a teaching session with an 85-year-old patient who will be going home on anticoagulant therapy. Which educational strategy would reflect consideration of the age-related changes that may exist with this patient?
a. Show a video about anticoagulation therapy.
b. Present all the information in one session just before discharge.
c. Give the patient pamphlets about the medications to read at home.
d. Develop large-print handouts that reflect the verbal information presented.
A
Develop large-print handouts that reflect the verbal information presented.
2
Q
- During an admission assessment, the nurse discovers that the patient does not speak English. Which is considered the ideal resource for translation?
a. A family member of the patient
b. A close family friend of the patient
c. A translator who does not know the patient
d. Prewritten note cards with both English and the patient’s language
A
c. A translator who does not know the patient
3
Q
A patient with a new prescription for a diuretic has just reviewed with the nurse how to include more potassium in her diet. This reflects learning in which domain?
A
cognitive
4
Q
- The nurse is reviewing the teaching plan for a clinic patient who was seen for a sinus infection.
a. The patient will take the prescribed antibiotic for the full 14 days of the
prescription.
A
affective domain of learning
5
Q
- When the nurse teaches a skill such as self-injection of insulin to the patient, what is the best way to set up the teaching/learning session?
a. Provide written pamphlets for instruction.
b. Show a video, and allow the patient to practice as needed on his own.
c. Verbally explain the procedure, and provide written handouts for reinforcement.
d. After demonstrating the procedure, allow the patient to do several return demonstrations.
A
d. After demonstrating the procedure, allow the patient to do several return demonstrations.
6
Q
- During a nursing assessment, which question by the nurse allows for greater clarification and additional discussion with the patient?
a. “Are you allergic to penicillin?”
b. “What medications do you take?”
c. “Have you had a reaction to this drug?”
d. “Are you taking this medication with meals?”
A
b. “What medications do you take?”
7
Q
- The nurse is developing a care plan for a patient who will be self-administering a metered-dose inhaler. Which statement reflects a measurable outcome?
a. The patient will know about self-administration of a metered-dose inhaler.
b. The patient will understand the principles of self-administration of a metered-dose inhaler.
c. The patient will demonstrate the proper technique of self-administering a metered-dose inhaler.
d. The patient will comprehend the proper technique of self-administering a metered-dose inhaler.
A
c. The patient will demonstrate the proper technique of self-administering a metered-dose inhaler.
8
Q
- A 2-year-old child is to receive eardrops. The nurse is teaching the parent about giving the eardrops. Which statement reflects the proper technique for administering eardrops to this child?
a. Administer the drops without pulling on the ear lobe.
b. Straighten the ear canal by pulling the lobe upward and back.
c. Straighten the ear canal by pulling the pinna down and back.
d. Straighten the ear canal by pulling the pinna upward and outward.
A
c. Straighten the ear canal by pulling the pinna down and back.
9
Q
- A patient says he prefers to chew rather than swallow his pills. One of the pills has the abbreviation SR behind the name of the medication. The nurse needs to remember which correct instruction regarding how to give this medication?
a. Break the tablet into halves or quarters.
b. Dissolve the tablet in a small amount of water before giving it.
c. Do not crush or break the tablet before administration.
d. Crush the tablet as needed to ease administration.
A
c. Do not crush or break the tablet before administration.
10
Q
- The nurse is reviewing the dosage schedule for several different antiepileptic drugs (AEDs). Which antiepileptic drug allows for once-a-day dosing?
a. Levetiracetam (Keppra)
b. Phenobarbital
c. Valproic acid (Depakote)
d. Gabapentin (Neurontin)
A
b. Phenobarbital
11
Q
- A patient is experiencing status epilepticus. The nurse prepares to give which drug of choice for the treatment of this condition?
A
Diazepam (Valium)
12
Q
- Carbidopa-levodopa (Sinemet) is prescribed for a patient with Parkinson’s disease. The nurse informs the patient that which common adverse effects can occur with this medication?
A. Drowsiness, headache, weight loss
B. Dizziness, insomnia, nausea
C. Peripheral edema, fatigue, syncope
D. Heart palpitations, hypotension, urinary retention
A
D. Heart palpitations, hypotension, urinary retention
13
Q
- The nurse is developing a care plan for a patient who is taking an anticholinergic drug. Which human needs statement would be appropriate for this patient?
A. Altered gastrointestinal elimination (diarrhea)
B. Altered urinary elimination
C. Altered safety needs, risk for infection
D. Altered sleep needs
A
B. Altered urinary elimination
14
Q
- A patient taking entacapone (Comtan) for the first time calls the clinic to report a dark discoloration of his urine. After listening to the patient, the nurse realizes that what is happening in this situation?
A. This is a harmless effect of the drug.
B. The patient has taken this drug along with red wine or cheese.
C. The patient is having an allergic reaction to the drug.
D. The ordered dose is too high for this patient.
A
A. This is a harmless effect of the drug.
15
Q
- While a patient is receiving drug therapy for Parkinson’s disease, the nurse monitors for dyskinesia, which is manifested by which finding?
A. Rigid, tense muscles
B. Difficulty in performing voluntary movements
C. Limp extremities with weak muscle tone
D. Confusion and altered mental status
A
B. Difficulty in performing voluntary movements
16
Q
- A patient has been admitted to the emergency department with a suspected overdose of a tricyclic antidepressant. The nurse will prepare for what immediate concern?
A
Cardiac dysrhythmias
17
Q
. Clozapine (Clozaril), an atypical antipsychotic, is prescribed for a patient. The nurse will monitor for which adverse effect during this drug therapy?
a. Edema
b. Photosensitivity
c. Hypotension
d. Severe neutropenia
A
d. Severe neutropenia
18
Q
- A patient has been taking the monoamine oxidase inhibitor (MAOI) phenelzine (Nardil) for 6 months. The patient wants to go to a party and asks the nurse, “Will just one beer be a problem?” Which advice from the nurse is correct?
A. “You can drink beer as long as you have a designated driver.”
B. “Now that you’ve been on the drug for 6 months, there will be no further dietary restrictions.”
C. “If you begin to experience a throbbing headache, rapid pulse, or nausea, you’ll need to stop drinking.”
D. “You need to avoid all foods that contain tyramine, including beer, while taking this medication.”
A
D. “You need to avoid all foods that contain tyramine, including beer, while taking this medication.”
19
Q
The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor (MAOI). Which food choice would indicate the need for additional teaching?
A. Grapefruit juice
B. Fried eggs over-easy
C. Pepperoni pizza
D. Pancakes and maple syrup
A
C. Pepperoni pizza
20
Q
During a teaching session for a patient on antithyroid drugs, the nurse will discuss which dietary instructions?
A. Using iodized salt when cooking
B. Avoiding foods containing iodine
C. Restricting fluid intake to 2500 mL/day
D. Increasing intake of sodium- and potassium-containing foods
A
B. Avoiding foods containing iodine
21
Q
A patient who is taking propylthiouracil (PTU) for hyperthyroidism wants to know how this medicine works. Which explanation by the nurse is accurate?
A. It promotes the formation of thyroid hormone.
B. It slows down the formation of thyroid hormone.
C. It destroys overactive cells in the thyroid gland.
D. It inactivates already existing thyroid hormone in the bloodstream.
A
B. It slows down the formation of thyroid hormone.
22
Q
A patient, newly diagnosed with hypothyroidism, receives a prescription for a thyroid hormone replacement drug. The nurse assesses for which potential contraindication to this drug?
A. Infection
B. Diabetes mellitus
C. Liver disease
D. Recent myocardial infarction
A
D. Recent myocardial infarction
23
Q
A patient with hypothyroidism is given a prescription for levothyroxine (Synthroid). When the nurse explains that this is a synthetic form of the thyroid hormone, he states that he prefers to receive more “natural” forms of drugs. What will the nurse explain to him about the advantages of levothyroxine?
A. It has a stronger effect than the natural forms.
B. Levothyroxine is less expensive than the natural forms.
C. The synthetic form has fewer adverse effects on the gastrointestinal tract.
D. The half-life of levothyroxine is long enough to permit once-daily dosing.
A
D. The half-life of levothyroxine is long enough to permit once-daily dosing.
24
Q
When reviewing the laboratory values of a patient who is taking antithyroid drugs, the nurse will monitor for which adverse effect?
A. Decreased glucose levels
B. Decreased white blood cell count
C. Increased red blood cell count
D. Increased platelet count
A
B. Decreased white blood cell count
25
A patient is concerned about the body changes that have resulted from long-term prednisone therapy for the treatment of asthma. Which expected effect of this drug therapy would cause a change in the patient’s appearance?
A. Weight loss
B. Weight gain
C. Pale skin color
D. Hair loss
B. Weight gain
26
A patient is taking fludrocortisone (Florinef) for Addison’s disease, and his wife is concerned about all of the problems that may occur with this therapy. When teaching them about therapy with this drug, the nurse will include which information?
A. It may cause severe postural hypotension.
B. It needs to be taken with food or milk to minimize gastrointestinal upset.
C. The medication needs to be stopped immediately if nausea or vomiting occurs.
D. Weight gain of 5 pounds or more in 1 week is an expected adverse effect.
B. It needs to be taken with food or milk to minimize gastrointestinal upset.
27
When monitoring a patient who is taking a systemically administered glucocorticoid, the nurse will monitor for signs of which condition?
A. Dehydration
B. Hypokalemia
C. Hyponatremia
D. Hypoglycemia
B. Hypokalemia
28
A glucocorticoid is prescribed for a patient. The nurse checks the patient’s medical history knowing that glucocorticoid therapy is contraindicated in which disorder?
A. Cerebral edema
B. Peptic ulcer disease
C. Tuberculous meningitis
D. Chronic obstructive pulmonary disease
B. Peptic ulcer disease
29
A patient who has been on long-term corticosteroid therapy has had surgery to correct an abdominal hernia. The nurse keeps in mind that which potential effect of this medication may have the most impact on the patient’s recovery?
A. Hypotension
B. Delayed wound healing
C. Muscle weakness
D. Osteoporosis
B. Delayed wound healing
30
A gardener needs a decongestant because of seasonal allergy problems and asks the nurse whether he should take an oral form or a nasal spray. Which of these is a benefit of orally administered decongestants?
A. Immediate onset
B. A more potent effect
C. Lack of rebound congestion
D. Shorter duration
C. Lack of rebound congestion
31
7. A patient has been advised to add a nasal spray (an adrenergic decongestant) to treat a cold. The nurse will include which instruction?
A. “You won’t see effects for at least 1 week.”
B. “Limit use of this spray to 3 to 5 days.”
C. “Continue the spray until nasal stuffiness has resolved.”
D. “Avoid use of this spray if a fever develops.”
B. “Limit use of this spray to 3 to 5 days.”
32
A patient asks the nurse about the uses of echinacea. Which use will the nurse include in the response?
A. Memory enhancement
B. Boosting the immune system
C. Improving mood
D. Promoting relaxation
B. Boosting the immune system
33
A patient with a tracheostomy has difficulty removing excessive, thick mucus from the respiratory tract. The nurse expects that which drug will be ordered to aid in the removal of mucus?
A. Guaifenesin (Mucinex)
B. Benzonatate (Tessalon Perles)
C. Diphenhydramine (Benadryl)
D. Dextromethorphan (Robitussin DM)
A. Guaifenesin (Mucinex)
34
When giving dextromethorphan, the nurse understands that this drug suppresses the cough reflex by which mechanism of action?
A. Causing depression of the central nervous system
B. Anesthetizing the stretch receptors
C. Having direct action on the cough center
D. Decreasing the viscosity of the bronchial secretions
C. Having direct action on the cough center
35
A patient is taking a xanthine derivative as part of treatment for chronic obstructive pulmonary disease. The nurse will monitor for which adverse effects associated with the use of xanthine derivatives?
a. Diarrhea
b. Palpitations
c. Bradycardia
d. Drowsiness
b. Palpitations
36
A patient is in an urgent care center with an acute asthma attack. The nurse expects that which medication will be used for initial treatment?
A. An anticholinergic such as ipratropium
B. A short-acting beta2 agonist such as albuterol
C. A long-acting beta2 agonist such as salmeterol
D. A corticosteroid such as fluticasone
B. A short-acting beta2 agonist such as albuterol
37
After receiving a nebulizer treatment with a beta agonist, the patient states she is feeling slightly nervous and wonders if her asthma is getting worse. What is the nurse’s best response?
A. “This is an expected adverse effect. Let me take your pulse.”
B. “The next scheduled nebulizer treatment will be skipped.”
C. “I will notify the physician about this adverse effect.”
D. “We will hold the treatment for 24 hours.”
A. “This is an expected adverse effect. Let me take your pulse.”
38
A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers will the nurse give to the patient?
A. “Take the corticosteroid inhaler first.”
B. “Take the bronchodilator inhaler first.”
C. “Take these two drugs at least 2 hours apart.”
D. “It does not matter which inhaler you use first.”
B. “Take the bronchodilator inhaler first.”
39
When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects?
A. Fatigue and depression
B. Anxiety and palpitations
C. Headache and rapid heart rate
D. Oral candidiasis and dry mouth
D. Oral candidiasis and dry mouth
40
The nurse is monitoring drug levels for a patient who is receiving theophylline. The most recent theophylline level was 22 mcg/mL, and the nurse evaluates this level to be:
A. below the therapeutic level.
B. at a therapeutic level.
C. above the therapeutic level.
D. at a toxic level.
C. above the therapeutic level.
41
When evaluating a patient’s use of a metered-dose inhaler (MDI), the nurse notes that the patient is unable to coordinate the activation of the inhaler with her breathing. What intervention is most appropriate at this time?
A. Notify the prescriber that the patient is unable to use the MDI.
B. Obtain an order for a peak flow meter.
C. Obtain an order for a spacer device.
D. Ask the prescriber if the medication can be given orally.
C. Obtain an order for a spacer device.
42
The nurse is providing instructions about the Advair inhaler (fluticasone propionate and salmeterol). Which statement about this inhaler is accurate?
A. It is indicated for the treatment of acute bronchospasms.
B. It needs to be used with a spacer for best results.
C. Patients need to avoid drinking water for 1 hour after taking this drug.
D. It is used for the prevention of bronchospasms.
D. It is used for the prevention of bronchospasms.
43
When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics?
A. Tetracyclines
B. Sulfonamides
C. Cephalosporins
D. Quinolones
C. Cephalosporins
44
The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which statement by the nurse is correct?
A. “Avoid direct sunlight and tanning beds while on this medication.”
B. “Milk and cheese products result in increased levels of tetracycline.”
C. “Antacids taken with the medication help to reduce gastrointestinal distress.”
D. “Take the medication until you are feeling better.”
A. “Avoid direct sunlight and tanning beds while on this medication.”
45
A patient is receiving his third intravenous dose of a penicillin drug. He calls the nurse to report that he is feeling “anxious” and is having trouble breathing. What will the nurse do first?
A. Notify the prescriber.
B. Take the patient’s vital signs.
C. Stop the antibiotic infusion.
D. Check for allergies.
C. Stop the antibiotic infusion.
46
A patient is admitted with a fever of 102.8 F (39.3 C), origin unknown. Assessment reveals cloudy, foul-smelling urine that is dark amber in color. Orders have just been written to obtain stat urine and blood cultures and to administer an antibiotic intravenously. The nurse will complete these orders in which sequence?
A. Blood culture, antibiotic dose, urine culture
B. Urine culture, antibiotic dose, blood culture
C. Antibiotic dose, blood and urine cultures
D. Blood and urine cultures, antibiotic dose
D. Blood and urine cultures, antibiotic dose
47
. A patient will be having oral surgery and has received an antibiotic to take for 1 week before the surgery. The nurse knows that this is an example of which type of therapy?
a. Empiric
b. Prophylactic
c. Definitive
d. Resistance
b. Prophylactic
48
A patient has a urinary tract infection. The nurse knows that which class of drugs is especially useful for such infections?
a. Macrolides
b. Carbapenems
c. Sulfonamides
d. Tetracyclines
c. Sulfonamides
49
The nurse is preparing to use an antiseptic. Which statement is correct regarding how antiseptics differ from disinfectants?
A. Antiseptics are used to sterilize surgical equipment.
B. Disinfectants are used as preoperative skin preparation.
C. Antiseptics are used only on living tissue to kill microorganisms.
D. Disinfectants are used only on nonliving objects to destroy organisms.
D. Disinfectants are used only on nonliving objects to destroy organisms.
50
A patient with a long-term intravenous catheter is going home. The nurse knows that if the patient is allergic to seafood, which antiseptic agent is contraindicated?
A. Chlorhexidine gluconate (Hibiclens)
B. Hydrogen peroxide
C. Povidone-iodine (Betadine)
D. Isopropyl alcohol
C. Povidone-iodine (Betadine)
51
During antibiotic therapy, the nurse will monitor closely for signs and symptoms of a hypersensitivity reaction. Which of these assessment findings may be an indication of a hypersensitivity reaction? (Select all that apply.)
```
A. Wheezing
B. Diarrhea
C. Shortness of breath
D. Swelling of the tongue
E. Itching
F. Black, hairy tongue
```
A. Wheezing
C. Shortness of breath
D. Swelling of the tongue
E. Itching
52
The nurse is administering a vancomycin (Vancocin) infusion. Which measure is appropriate for the nurse to implement in order to reduce complications that may occur with this drug’s administration?
A. Monitoring blood pressure for hypertension during the infusion
B. Discontinuing the drug immediately if red man syndrome occurs
C. Restricting fluids during vancomycin therapy
D. Infusing the drug over at least 1 hour
D. Infusing the drug over at least 1 hour
53
When a patient is on aminoglycoside therapy, the nurse will monitor the patient for which indicators of potential toxicity?
A. Fever
B. White blood cell count of 8000 cells/mm3
C. Tinnitus and dizziness
D. Decreased blood urea nitrogen (BUN) levels
C. Tinnitus and dizziness
54
```
Which problem may occur in a patient who has started aminoglycoside therapy?
A. Constipation
B. Renal damage
C. Gynecomastia
D. Leukocytosis
```
B. Renal damage
55
A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for therapy?
A. Metronidazole (Flagyl)
B. Ciprofloxacin (Cipro)
C. Vancomycin (Vancocin)
D. Tobramycin (Nebcin)
C. Vancomycin (Vancocin)
56
The nurse checks the patient’s laboratory work prior to administering a dose of vancomycin (Vancocin) and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next?
A. Administer the vancomycin as ordered.
B. Hold the drug, and administer 4 hours later.
C. Hold the drug, and notify the prescriber.
D. Repeat the test to verify results.
C. Hold the drug, and notify the prescriber.
57
An infant has been hospitalized with a severe lung infection caused by the respiratory syncytial virus (RSV) and will be receiving medication via the inhalation route. The nurse expects which drug to be used?
Ribavirin (Virazole)
58
A patient who is diagnosed with genital herpes is taking topical acyclovir, and the nurse is providing instructions about adverse effects. The nurse will discuss which adverse effects of topical acyclovir therapy?
A. Insomnia and nervousness
B. Temporary swelling and rash
C. Burning when applied
D. This medication has no adverse effects.
C. Burning when applied
59
A patient who is HIV-positive has been receiving medication therapy that includes zidovudine (Retrovir). However, the prescriber has decided to stop the zidovudine because of its dose-limiting adverse effect. Which of these conditions is the dose-limiting adverse effect of zidovudine therapy?
A. Retinitis
B. Renal toxicity
C. Hepatotoxicity
D. Bone marrow suppression
D. Bone marrow suppression
60
The nurse is administering intravenous acyclovir (Zovirax) to a patient with a viral infection. Which administration technique is correct?
A. Infuse intravenous acyclovir slowly, over at least 1 hour.
B. Infuse intravenous acyclovir by rapid bolus.
C. Refrigerate intravenous acyclovir.
D. Restrict oral fluids during intravenous acyclovir therapy.
A. Infuse intravenous acyclovir slowly, over at least 1 hour.
61
A patient is taking a combination of antiviral drugs as treatment for early stages of a viral infection. While discussing the drug therapy, the patient asks the nurse if the drugs will kill the virus. When answering, the nurse keeps in mind which fact about antiviral drugs?
A. They are given for palliative reasons only.
B. They will be effective as long as the patient is not exposed to the virus again.
C. They can be given in large enough doses to eradicate the virus without harming the
body’s healthy cells.
D. They may also kill healthy cells while killing viruses.
D. They may also kill healthy cells while killing viruses.
62
The nurse is providing counseling to a woman who is HIV positive and has just discovered that she is pregnant. Which anti-HIV drug is given to HIV-infected pregnant women to prevent transmission of the virus to the infant?
Zidovudine (Retrovir)
63
The nurse is providing patient teaching for a patient who is starting antitubercular drug therapy. Which of these statements should be included? (Select all that apply.)
A. “Take the medications until the symptoms disappear.”
B. “Take the medications at the same time every day.”
C. “You will be considered contagious during most of the illness and must take precautions to avoid spreading the disease.”
D. “Stop taking the medications if you have severe adverse effects.”
E. “Avoid alcoholic beverages while on this therapy.”
F. “If you notice reddish-brown or reddish-orange urine, stop taking the drug and
contact your doctor right away.”
G. “If you experience a burning or tingling in your fingers or toes, report it to your
prescriber immediately.”
H. “Oral contraceptives may not work while you are taking these drugs, so you will
have to use another form of birth control.”
B. “Take the medications at the same time every day.”
E. “Avoid alcoholic beverages while on this therapy.”
G. “If you experience a burning or tingling in your fingers or toes, report it to your
prescriber immediately.”
H. “Oral contraceptives may not work while you are taking these drugs, so you will
have to use another form of birth control.”
64
The nurse is discussing adverse effects of antitubercular drugs with a patient who has active tuberculosis. Which potential adverse effect of antitubercular drug therapy should the patient report to the prescriber?
A. Gastrointestinal upset
B. Headache and nervousness
C. Reddish-orange urine and stool
D. Numbness and tingling of extremities
D. Numbness and tingling of extremities
65
```
The nurse will assess the patient for which potential contraindication to antitubercular therapy?
A. Glaucoma
B. Anemia
C. Heart failure
D. Hepatic impairment
```
D. Hepatic impairment
66
The nurse is counseling a woman who will be starting rifampin (Rifadin) as part of antitubercular therapy. The patient is currently taking oral contraceptives. Which statement is true regarding rifampin therapy for this patient?
A. Women have a high risk for thrombophlebitis while on this drug.
B. A higher dose of rifampin will be necessary because of the contraceptive.
C. Oral contraceptives are less effective while the patient is taking rifampin.
D. The incidence of adverse effects is greater if the two drugs are taken together.
C. Oral contraceptives are less effective while the patient is taking rifampin.
67
A patient newly diagnosed with tuberculosis (TB) has been taking antitubercular drugs for 1 week calls the clinic and is very upset. He says, “My urine is dark orange! What’s wrong with me?” Which response by the nurse is correct?
A. “You will need to stop the medication, and it will go away.”
B. “It’s possible that the TB is worse. Please come in to the clinic to be checked.”
C. “This is not what we usually see with these drugs. Please come in to the clinic to
be checked.”
D. “This is an expected side effect of the medicine. Let’s review what to expect.”
D. “This is an expected side effect of the medicine. Let’s review what to expect.”
68
The nurse notes in a patient’s medication history that the patient is taking allopurinol (Zyloprim). Based on this finding, the nurse interprets that the patient has which disorder?
A. Rheumatoid arthritis
B. Gout
C. Osteoarthritis
D. Systemic lupus erythematosus
B. Gout
69
A mother brings her toddler into the emergency department and tells the nurse that she thinks the toddler has eaten an entire bottle of chewable aspirin tablets. The nurse will assess for which most common signs of salicylate intoxication in children?
A. Photosensitivity and nervousness
B. Tinnitus and hearing loss
C. Acute gastrointestinal bleeding
D. Hyperventilation and drowsiness
D. Hyperventilation and drowsiness
70
A 6-year-old child who has chickenpox also has a fever of 102.9 F (39.4 C). The child’s mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse?
A. “It’s best to wait to see if the fever gets worse.”
B.“You can use the aspirin, but watch for worsening symptoms.”
C. “Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin.”
D. “You can use aspirin, but be sure to follow the instructions on the bottle.”
C. “Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin.”
71
During an admission assessment, the patient tells the nurse that he has been self-treating his heartburn for 1 year with over-the-counter Prilosec OTC (omeprazole, a proton pump inhibitor). The nurse is aware that this self-treatment may have which result?
A. No serious consequences
B. Prevention of more serious problems, such as an ulcer
C. Chronic constipation
D. Masked symptoms of serious underlying diseases
D. Masked symptoms of serious underlying diseases
72
A patient is taking omeprazole (Prilosec) for the treatment of gastroesophageal reflux disease (GERD). The nurse will include which statement in the teaching plan about this medication?
A. “Take this medication once a day after breakfast.”
B. “You will be on this medication for only 2 weeks for treatment of the reflux disease.”
C. “The medication may be dissolved in a liquid for better absorption.”
D. “The entire capsule must be taken whole, not crushed, chewed, or opened.”
D. “The entire capsule must be taken whole, not crushed, chewed, or opened.”
73
A patient has excessive and painful gas. The nurse checks the patient’s medication orders and prepares to administer which drug for this problem?
A. Famotidine (Pepcid)
B. Aluminum hydroxide and magnesium hydroxide (Maalox or Mylanta)
C. Calcium carbonate (Tums)
D. Simethicone (Mylicon)
D. Simethicone (Mylicon)
Simethicone alters the elasticity of mucus-coated bubbles, causing them to break, and is an over-the-counter antiflatulent. The other options are incorrect.
74
The nurse is teaching a patient who will be taking a proton pump inhibitor as long-term therapy about potential adverse effects. Which statement is correct?
A. Proton pump inhibitors can cause diarrhea.
B. These drugs can cause nausea and anorexia.
C. Proton pump inhibitors cause drowsiness.
D. Long-term use of these drugs may contribute to osteoporosis.
D. Long-term use of these drugs may contribute to osteoporosis.
75
A patient in the intensive care unit has a nasogastric tube and is also receiving a proton pump inhibitor (PPI). The nurse recognizes that the purpose of the PPI is which effect?
A. Prevent stress ulcers
B. Reduce bacteria levels in the stomach
C. Reduce gastric gas formation (flatulence)
D. Promote gastric motility
A. Prevent stress ulcers
76
When administering a bulk-forming laxative, the nurse instructs the patient to drink the medication mixed in a full 8-ounce glass of water. Which statement best explains the rationale for this instruction?
A. The water acts to stimulate bowel movements.
B. The water will help to reduce the bulk of the intestinal contents.
C. These laxatives may cause esophageal obstruction if taken with insufficient water.
D. The water acts as a lubricant to produce bowel movements.
C. These laxatives may cause esophageal obstruction if taken with insufficient water.
77
```
A patient is about to undergo a diagnostic bowel procedure. The nurse expects which drug to be used to induce total cleansing of the bowel?
A. Docusate sodium (Colace)
B. Lactulose (Enulose)
C. Mineral oil
D. Polyethylene glycol 3350 (GoLYTELY)
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D. Polyethylene glycol 3350 (GoLYTELY)
78
A patient asks the nurse about the difference between diphenoxylate with atropine (Lomotil) and the over-the-counter drug loperamide (Imodium). Which response by the nurse is correct?
A. “Lomotil acts faster than Imodium.”
B. “Imodium does not cause physical dependence.”
C. “Lomotil is available in suppository form.”
D. “Imodium is a natural antidiarrheal drug.”
B. “Imodium does not cause physical dependence.”
79
The nurse is discussing the use of adsorbents such as bismuth subsalicylate (Pepto-Bismol) with a patient who has diarrhea. The nurse will warn the patient about which possible adverse effects?
A. Dark stools and blue gums
B. Urinary hesitancy
C. Drowsiness and dizziness
D. Blurred vision and headache
A. Dark stools and blue gums
80
11. A patient who has been on antibiotic therapy for 2 weeks has developed persistent diarrhea. The nurse expects which medication class to be ordered to treat this diarrhea?
a. Lubricants
b. Adsorbents
c. Anticholinergics
d. Probiotics
d. Probiotics
81
A patient is receiving lactulose (Enulose) three times a day. The nurse knows that the patient is not constipated and is receiving this drug for which reason?
A. High ammonia levels due to liver failure
B. Prevention of constipation
C. Chronic renal failure
D. Chronic diarrhea
A. High ammonia levels due to liver failure
82
The nurse is reviewing the uses of oral laxatives. Which conditions are general contraindications to or cautions about the use of oral laxatives? (Select all that apply.)
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A. Irritable bowel syndrome
B. Undiagnosed abdominal pain
C. Nausea and vomiting
D. Fecal impaction
E. Ingestion of toxic substances
F. Acute surgical abdomen
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B. Undiagnosed abdominal pain
C. Nausea and vomiting
D. Fecal impaction
F. Acute surgical abdomen
83
A patient who has AIDS has lost weight and is easily fatigued because of his malnourished state. The nurse anticipates an order for which antinausea drug to stimulate his appetite?
A. Metoclopramide (Reglan), a prokinetic drug
B. Dronabinol (Marinol), a tetrahydrocannabinoid
C. Ondansetron (Zofran), a serotonin blocker
D. Aprepitant (Emend), a substance P/NK1 receptor antagonist
B. Dronabinol (Marinol), a tetrahydrocannabinoid
84
A patient who has severe nausea and vomiting following a case of food poisoning comes to the urgent care center. When reviewing his medication history, the nurse notes that he has an allergy to procaine. The nurse would question an order for which antiemetic drug if ordered for this patient?
A. Metoclopramide (Reglan)
B. Promethazine (Phenergan)
C. Phosphorated carbohydrate solution (Emetrol)
D. Palonosetron (Aloxi)
A. Metoclopramide (Reglan)
85
A mother calls the pediatrician’s office to report that her 18-month-old child has eaten half of a bottle of baby aspirin. She says, “I have a bottle of syrup of ipecac. Should I give it to him? He seems fine right now. What do I do?” What is the nurse’s best response?
A. “Go ahead and give him the ipecac, and then call 911.”
B. “Don’t give him the ipecac. Call the Poison Control number immediately for instructions.”
C. “Please come to the office right away so that we can check him.”
D. “Go ahead and take him to the emergency room right now.”
B. “Don’t give him the ipecac. Call the Poison Control number immediately for instructions.”
86
A patient who has been newly diagnosed with vertigo will be taking an antihistamine antiemetic drug. The nurse will include which information when teaching the patient about this drug?
A. The patient may skip doses if the patient is feeling well.
B. The patient will need to avoid driving because of possible drowsiness.
C. The patient may experience occasional problems with taste.
D. It is safe to take the medication with a glass of wine in the evening to help settle
the stomach.
B. The patient will need to avoid driving because of possible drowsiness.
87
The nurse is teaching a patient with iron-deficiency anemia about foods to increase iron intake. Which food may enhance the absorption of oral iron forms?
A. Milk
B. Yogurt
C. Antacids
D. Orange juice
D. Orange juice
88
A nurse is giving instructions to a patient who will be receiving oral iron supplements. Which instructions will be included in the teaching plan?
A. Take the iron tablets with milk or antacids.
B. Crush the pills as needed to help with swallowing.
C. Take the iron tablets with meals if gastrointestinal distress occurs.
D. If black tarry stools occur, report it to the doctor immediately.
C. Take the iron tablets with meals if gastrointestinal distress occurs.
89
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The nurse will teach a patient who is receiving oral iron supplements to watch for which expected adverse effects?
A. Palpitations
B. Drowsiness and dizziness
C. Black, tarry stools
D. Orange-red discoloration of the urine
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C. Black, tarry stools
90
The nurse is administering liquid oral iron supplements. Which intervention is appropriate when administering this medication?
A. Have the patient take the liquid iron with milk.
B. Instruct the patient to take the medication through a plastic straw.
C. Have the patient sip the medication slowly.
D. Have the patient drink the medication, undiluted, from the unit-dose cup.
B. Instruct the patient to take the medication through a plastic straw.
91
A patient with end-stage renal failure has been admitted to the hospital for severe anemia. The patient is refusing blood transfusions. The nurse anticipates drug therapy with which drug to stimulate the production of red blood cells?
A. Folic acid
B. Cyanocobalamin (vitamin B12)
C. Epoetin alfa (Epogen)
D. Filgrastim (Neupogen)
C. Epoetin alfa (Epogen)
92
A cancer patient is receiving drug therapy with epoetin alfa (Epogen). The nurse knows that the medication must be stopped if which laboratory result is noted?
A. White blood cell count of 550 cells/mm3
B. Hemoglobin level of 12 g/dL
C. Potassium level of 4.2 mEq/L
D. Glucose level of 78 mg/dL
B. Hemoglobin level of 12 g/dL
93
A patient has been receiving epoetin alfa (Epogen) for severe iron-deficiency anemia. Today, the provider changed the order to darbepoetin (Aranesp). The patient questions the nurse, “What is the difference in these drugs?” Which response by the nurse is correct?
A. “There is no difference in these two drugs.”
B. “Aranesp works faster than Epogen to raise your red blood cell count.”
C. “Aranesp is given by mouth, so you will not need to have injections.”
D. “Aranesp is a longer-acting form, so you will receive fewer injections.”
D. “Aranesp is a longer-acting form, so you will receive fewer injections.”
94
A woman who is planning to become pregnant should ensure that she receives adequate levels of which supplement to reduce the risk for fetal neural tube defects?
A. Vitamin B12
B. Vitamin D
C. Iron
D. Folic acid
D. Folic acid
95
The nurse will teach a patient who is receiving oral iron supplements to watch for which expected adverse effects?
A. Palpitations
B. Drowsiness and dizziness
C. Black, tarry stools
D. Orange-red discoloration of the urine
C. Black, tarry stools
96
During therapy with the hematopoietic drug epoetin alfa (Epogen), the nurse instructs the patient about adverse effects that may occur, such as:
a. anxiety.
b. drowsiness.
c. hypertension.
d. constipation.
c. hypertension.
97
A woman suffered a second-degree burn of the skin on her arm and hand while cooking breakfast. After examination in the urgent care center, silver sulfadiazine cream (Silvadene) is ordered for the burned area. The nurse will apply the medication using which procedure?
A. Gently patting a moderate amount over the burned area
B. Massaging the cream completely into the wound
C. Applying a thick layer over the burned area, and then leaving the area open
D. Applying a thin layer with a sterile, gloved hand to clean and débrided areas
D. Applying a thin layer with a sterile, gloved hand to clean and débrided areas
98
A child has been diagnosed with impetigo, a skin infection. The nurse anticipates that which drug will be used to treat this condition?
A. Spinosad (Natroba)
B. Nystatin (Mycostatin)
C. Acyclovir (Zovirax)
D. Mupirocin (Bactroban)
D. Mupirocin (Bactroban)
99
A patient is admitted to the hospital for possible septicemia. He has a large pressure ulcer on his heel that is open and includes necrotic tissue. However, his prothrombin time/international normalized ratio (PT/INR) values are too high to permit surgical débridement at this time. The nurse expects that which wound-care product will be used to treat the wound?
A. Cadexomer iodine (Iodosorb)
B. Biafine topical emulsion
C. Povidone-iodine (Betadine)
D. Collagenase (Santyl)
D. Collagenase (Santyl)
100
The nurse is reviewing the medical record of a patient who is to receive wound care with topical silver sulfadiazine (Silvadene). Which finding, if noted, would be a potential contraindication?
A. The patient has an open wound from a burn on her arm.
B. The patient is allergic to sulfonamide drugs.
C. The patient is allergic to shellfish.
D. The patient’s burn wound has been débrided.
B. The patient is allergic to sulfonamide drugs.
101
A child is being treated for head lice with spinosad (Natroba). Which of these statements about treatment with spinosad is true? (Select all that apply.)
A. “You will need a prescription for a second product, malathion.”
B. “You will also need to decontaminate clothes and personal items.”
C. “Be sure to use a nit comb to remove nits from the hair shafts.”
D. “Try combing through the hair with mineral oil to loosen the lice from the hair
shafts.”
E. “It is not necessary to comb the nits when using spinosad.”
B. “You will also need to decontaminate clothes and personal items.”
E. “It is not necessary to comb the nits when using spinosad.”
102
The nurse is reviewing the use of ophthalmic preparations. Indications for the direct- and indirect-acting miotics include which condition?
A. Cataracts
B. Removal of foreign bodies
C. Open-angle glaucoma
D. Ocular infections
C. Open-angle glaucoma
103
A patient has been taking the corticosteroid dexamethasone (Decadron) but has developed bacterial conjunctivitis and has a prescription for gentamicin (Garamycin) ointment. The nurse notes that which interaction is possible if the two drugs are used together?
A. The infection may become systemic.
B. The gentamicin effects may become more potent.
C. The corticosteroid may cause overgrowth of nonsusceptible organisms.
D. Immunosuppression may make it more difficult to eliminate the eye infection.
D. Immunosuppression may make it more difficult to eliminate the eye infection.
104
The nurse is administering antibiotic eyedrops to a patient for the first time. After the first drop is given, the patient states, “That eyedrop is making my eye sting! Is that normal?” Which is the best response by the nurse?
A. “That’s unusual. Let me rinse the medication from your eye.”
B. “Sometimes these eyedrops may cause burning and stinging, but it should go away soon.”
C. “These may be serious side effects, so I will notify your doctor before the next dose is due.”
D. “Let’s wait and see if these effects happen the next time you receive these drops.”
B. “Sometimes these eyedrops may cause burning and stinging, but it should go away soon.”
105
The nurse is administering ophthalmic drops. Choose the action that should be performed first.
A. Close the eye gently.
B. Apply gentle pressure to the inner canthus/lacrimal sac for 1 minute.
C. Place drops into the conjunctival sac.
D. Clean debris from the eye as needed.
E. Have the patient tilt the head back and look up at the ceiling.
F. Remove excess medication gently from around the eyes.
D. Clean debris from the eye as needed.
106
The nurse is preparing to administer a new order for eardrops. Which is a potential contraindication to the use of many otic preparations?
A. Ear canal itching
B. Perforated eardrum
C. Staphylococcus aureus otitis externa infection
D. Escherichia coli ear infection
B. Perforated eardrum
107
The nurse is teaching a patient about proper administration of eardrops. Which statements are correct? (Select all that apply.)
A. Remove cerumen with a cotton-tipped swab before instilling the drops.
B. Instill the drops while still cool from refrigeration.
C. Warm the eardrops to room temperature before instillation.
D. The adult patient should pull the pinna of the ear up and back.
E. Insert a dry cotton ball gently into the ear canal after instillation.
F. Massage the earlobe after instillation.
C. Warm the eardrops to room temperature before instillation.
D. The adult patient should pull the pinna of the ear up and back.
E. Insert a dry cotton ball gently into the ear canal after instillation.
