Case Study: Managing a 64-year-old Female on Heparin and Alteplase, Exams of Nursing

Download Case Study: Managing a 64-year-old Female on Heparin and Alteplase and more Exams Nursing in PDF only on Docsity! NUR 6521 final EXAM NUR 6521 final EXAM Question 1 osteoporosis or low bone density. chronic obstructive pulmonary disease (COPD). diabetes mellitus. cardiac arrhythmias. Question 2 aspiri n. advil. tyleno l. motri n. A Nurse Practitioner is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an A Nurse Practitioner is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered? Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient's physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician's order if the patient has a history of A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for recurring headaches. The nurse should recommend NUR 6521 final EXAM c Coumadin NUR 6521 final EXAM Question 12 Visual function Blood counts Pap test results Liver function Question 13 Bradykinesia, akathisia and agitation Excessive weight gain Hypertension Potentially fatal agranulocytosis Question 14 Aspirin Heparin Dabigatr an Warfarin Question 15 Chlordiazepoxide (Libri um) Clonazepam (Klonopin) A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor which of the following? A 21-year-old has been placed on risperidone. Monitoring for risperidone includes A patient who is at risk for DVT tells the NP she has just learned she is pregnant. The NP should expect that this patient will use which of the following anticoagulant medications? When a NP chooses a benzodiazepine to treat anxiety the prescriber needs to be aware of the possibility of dependence. The Benzodiazepine associated with the greatest likelihood of causing rapid dependence is: NUR 6521 final EXAM Alprazolam (Xanax) Oxazepam (serax) Question 17 Serum cholesterol levels Bone growth Hemoglobin levels Urinary elimination patterns Question 18 I II III IV Question 19 Peripheral neuropathy Nephrotoxicity and hepatotoxicity Hyperkalemia and hyponatremia Endocarditis and hypertension Question 20 A male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at each clinic visit? What schedule class of drug is Hydrocodone? A school nurse has been teaching high school students about the risks associated with marijuana use. However, the nurse has been met with considerable skepticism on the Which of the following would a Nurse Practitioner assess for in a patient who is taking polymyxin B systemically? NUR 6521 final EXAM "Most people don't know that marijuana can be just as addictive as heroin or cocaine over time." "Marijuana can easily interact with other drugs and cause potentially fatal reactions." "Every year, thousands of Americans end up in emergency departments with marijuana overdoses." "Smoking marijuana is just as bad, or worse, for your lungs as smoking cigarettes." Question 21 take the vitamins at least 2 hours before or after taking ciprofloxacin. alternate the dosage of ciprofloxacin and vitamin supplements. reduce the dosage of vitamin supplements. reduce the dosage of vitamin supplements and double the dosage of ciprofloxacin. Question 22 Reduce dose by 50% for 3 to 4 days Reduce dose by 50% every other day Change Dose to every other day dosing for a week Lexapro can be stopped abruptly due to its long half life Question 23 Comprehensive Eye Exam CBC (Complete Blood part of students, most of whom believe that marijuana is a benign drug. Which of the following teaching points should the nurse provide? A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to Cindy has been on Citalopram (Lexapro) For a year and is willing to try tapering off of the selective serotonin reuptake inhibitor. What is the initial dosage adjustment when tapering off antidepressants Ms. LW is on hyrdroxychloroquine (Plaquenil) for rheumatoid arthritis. Certain tests are recommended before a patient starts this medication. Which of the following is NOT recommended before starting Hydroxychoroquine (Plaquenil)? NUR 6521 final EXAM Rebound headaches Neuropathy Pancreatic failure Impairment of renal function Question 31 alcohol. trans fat. caffeine. grapefruit juice. Question 32 By promoting the rapid excretion of vitamin K by the gastrointestinal mucosa By inhibiting the action of vitamin K at its sites of action By inhibiting platelet aggregation on vessel walls and promoting fibrinolysis By inactivating clotting factors and thus stopping the coagulation cascade Question 33 The importance of vigilant hygiene for the boy and the other members of the family The need for the boy to provide serial stool samples for 6 months following treatment The need to supplement the anthelminthic drug with prophylactic antibiotics The need to use prescription skin cleansers during treatment and for 6 weeks after A 29-year-old woman who is morbidly obese has recently begun a comprehensive, medically-supervised program of weight reduction. Prior to adding dextroamphetamine (Dexedrine) to her regimen, the patient should be questioned about her intake of A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The patient has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect? A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment? NUR 6521 final EXAM Question 34 a high-pitched cry. microcephaly. an electrolyte imbalance. thrombocytopenia. Question 35 ciprofloxacin. clindamycin. vancomycin. an antistaphylococcic penicillin. Question 36 Potassium level Creatinine clearance Serum albumin level Prothrombin time Question 37 That the infant's skin has greater permeability than that of an adult That there is less body surface area to be concerned about That there is decreased absorption rates of topical drugs in infants A 38-year-old pregnant patient admits to the Nurse Practitioner that she is an alcoholic and has been consuming alcohol during her pregnancy. The nurse knows that using alcohol during pregnancy may result in a child who presents with An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug? A patient has endocarditis and is taking gentamicin. The Nurse Practitioner will be sure to monitor which of the following? NUR 6521 final EXAM That there is a lower concentration of water in an infant's body compared with an adult Question 38 Excess fluid volume related to potential effects of drug therapy Hypercalcemia related to drug therapy, immobility, and breast cancer Sexual dysfunction related to erectile dysfunction Prostatic neoplasia Question 39 Acetaminophen suppository "baby" aspirin Ibuprofen suppository Alternating acetaminophen and ibuprofen Question 40 weekly subcutaneous injections. daily, oral administration . weekly administration of an enteric coated tablet. daily, outpatient intravenous therapy. Question 41 Altaring in the pH of the stomach A male patient is trying to decide if he should use finasteride (Proscar) to treat benign prostatic hypertrophy (BPH). When providing information about the drug, the nurse will include which of the following as a risk associated with finasteride therapy? Baby Jasmine is a 5 mth old breastfed infant with a fever. Treatment for her fever may include: A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the APRN is responsible for facilitating this new aspect of the patient's drug regimen. This will involve the administration of Phenytoin decreases folic acid absorption by NUR 6521 final EXAM allow the child to apply the medication if possible. use clean technique only when applying the medication. Question 49 Increased heart rate Breathlessness Infiltration, edema, or phlebitis at the infusion site Nausea and vomiting Question 50 at night. first thing in the morning. after a meal. before a meal. Question 51 Diabetes mellitus Hypertension Leukopenia Hypoglycemia Question 52 A 46-year-old man is receiving a quinupristin/dalfopristin IV infusion for a life-threatening infection. Which of the following would be most important for the nurse to monitor? A Nurse Practitioner will instruct a patient taking allopurinol to take each dose A Nurse Practitioner is assessing a patient who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the patient for which of the following? An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman's pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient's pain? NUR 6521 final EXAM Alternating doses of long-acting morphine with short-acting morphine A large long-acting dose of morphine at 8 a.m. with smaller doses at 12 p.m., 5 p.m., and 10 p.m. Twice-daily doses of long-acting morphine, with short-acting morphine available for breakthrough pain Scheduled doses of short-acting morphine q1h around the clock Question 53 methamphetam ine. cocaine. marijuana. nicotine. Question 54 Chronic diarrhea Dental hygiene practices Headaches Diet Question 55 Steady state is: The point on the drug concentration current absorption exceeds excretion With the amount of drug in the body stays below the minimum toxic concentration (MTC) When the amount of drug in the body remains constant All of the above A Nurse Practitioner is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that he or she is taking an oral form of A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following? NUR 6521 final EXAM Question 56 Orally Intramuscula rly Intravenously By inhalation Question 57 Zolpidem should be taken just before going to bed Zolpidem may cause dry mouth and constipation They may need to double the dose for effectiveness They should stop drinking alcohol at least 30 minutes before taking zolpidem Question 58 "My urine is extremely concentrated lately and it smells strong." "To be honest, I find that I can't get an erection for the past few months." "My urine's been cloudy for the last little while and it burns when I go to the bathroom." "Lately, I have to get up three or four times a night to go to the bathroom." Question 59 Ciprofloxacin is safe to use in pregnancy and the patient may use to same dose and route as a nonpregnant patient. The use of ciprofloxacin is contraindicated in pregnancy. I did not make drugs have a little effect when administered: Ms. Shackleford Has been placed on Ambien to help for her insomnia. The NP must educate the patient regarding the rapid onset of Ambien. Which statement below is correct? A 71-year-old man has just been prescribed finasteride (Proscar). Which of the following complaints by this patient most likely indicated a need for this drug? A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis? NUR 6521 final EXAM Drink plenty of water every day Take the tablets before bedtime Avoid red meat Question 67 Flagyl. Diflucan. Amoxicillan. Meclizine. Question 68 stop taking the drug after a 2-week period. schedule an appointment to measure hemoglobin twice a week for at least 2 to 6 weeks. schedule an appointment to check if the patient has a high WBC count. begin taking a calcium channel blocker to treat hypertension, which usually develops as an adverse effect of epoetin alfa therapy. Question 69 Rifampin Vancomycin Amphotericin B Ciprofloxacin Question 70 The recommended treatment for trichomoniasis is A 67-year-old man who is being treated for prostate cancer is taking epoetin alfa. The nurse will instruct the patient to Which antibiotic is most frequently associated with "Red man Syndrome" Which of the following oral agents has the most rapid analgesic onset? NUR 6521 final EXAM Naproxen (Naprosyn) Liquid ibuprofen (Motrin, Advil) Diclofenac (Voltaren) Enteric coated naproxen (Naproxen EC) Question 71 blood pressure weight and height liver function tests urinalysis Question 72 The patient takes allopurinol for the treatment of gout The patient has a family history of osteoporosis and has undergone bone density testing The patient has unstable angina and uses a nitroglycerin patch The patient often takes ginseng when he gets a common cold Question 73 whether the pregnant woman uses illegal substances. whether the pregnant woman has health insurance. the pregnant woman's exercise habits. A child with chronic allergic symptoms uses an intranasal steroid for control of symptoms. At this child's annual well-child checkup, the NP should carefully review what? A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this patient would most likely contraindicate the use of tadalafil for his ED? A Nurse Practitioner is working with a 16-year-old pregnant teen and assessing for behavior that may put the baby at risk. The most important assessment the nurse can make is NUR 6521 final EXAM the pregnant woman's dietary habits. Question 74 The patient has type 2 diabetes mellitus that is controlled using diet and oral antihyperglycemics. The patient has chronic heart failure resulting in significant peripheral edema. The patient experienced a mild ischemic stroke several years ago and had transient ischemic attacks last year. The patient had a total knee arthroplasty several months earlier. Question 75 Which of the following drugs is most likely to cause sexual dysfunction and males? Selective serotonin reuptake inhibitors Angiotensin converting enzyme inhibitors Atypical antidepressants Amphetamines Question 76 the mother regarding why the boy needs to take the medications. both the boy and his mother regarding all medication issued. the boy by telling him not to worry about the medications and to take them as directed. the mother and be sure to reinforce the need to force the medications, if her son does not want to take them. Question 77 An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identified potential benefits of imatinib. Which of the following characteristics of this patient's current health status may preclude the use of imatinib? A 12-year-old boy is being discharged from the hospital after major surgery. The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to NUR 6521 final EXAM grapefruit juice. food containing iron or calcium. nicotine. Question 85 110 mg daily 110 mg tid 330 mg once a day 330 mg tid Question 86 All insects have an FDA black box warning regarding Potential for causing life-threatening G.I. bleed Increase risk of developing systemic arthritis with prolonged use Risk of life-threatening rashes to include Stevens Johnson syndrome Risk for changes in serum glucose Question 87 Maternal body temperature Fetal heart rate (FHR) Correct fetal position Fetal blood pressure An NP is seeing a child who weights 25 pounds, 2 oz and needs a medication. The NP learns that the recommended dosing for this drug is 30-35 mg per kg per day in three divided doses. The NP should order A Nurse Practitioner is caring for a patient who is at 28 weeks' gestation and is receiving terbutaline (Brethine) to control preterm labor. Which of the following assessment parameters should the nurse prioritize? NUR 6521 final EXAM Question 88 Dispose of intravenous lines used for chemotherapy administration in a covered trash can in the patient's room. Use an IV system for administration that includes needles to reduce the risk of accidental spills. Prime the IV tubing with an approved IV solution rather than with the drug itself. Encourage patients who have been receiving chemotherapy to use a bedside commode rather than a toilet. Question 89 Skin Liver Gastrointestinal tract Kidney Question 90 A reduced dose A single large dose instead of multiple doses The use of dexrazoxane in conjunction with doxorubicin Meticulous monitoring during drug administration Question 91 The patient will remain free of sexual side effects related to drug therapy The patient will experience complete bladder emptying An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions? How is hydrocodone eliminated from the body? A 51-year-old female patient has been receiving doxorubicin (Adriamycin) for metastatic breast cancer. Her medical record indicates she has cardiomyopathy and a cumulative dose of 300 mg/m2 of doxorubicin. Which of the following measures would help limit the severity of the cardiomyopathy in this patient? A 68-year-old man is being treated for benign prostatic hypertrophy (BPH) and began treatment with finasteride (Proscar) 3 months ago. When planning the care of this patient, what desired outcome should the nurse prioritize? NUR 6521 final EXAM The patient will remain free of urethral pain The patient will not experience hematuria Question 92 Consult the prescriber for an increase in dosage Consult the prescriber for a decrease in dosage Consult the prescriber for discontinuation of the drug Continue the therapy as prescribed Question 93 every day until the infection is gone. once a day. for 30 days. for 20 days. Question 94 common adverse effects of magnesium sulfate. magnesium sulfate toxicity. a hypersensitivity reaction to magnesium sulfate. an idiosyncratic reaction from the magnesium sulfate. Question 95 A child has an erratic blood flow from an immature peripheral circulation, which increases drug absorption, causing an increase in adverse effects. A child's gastric pH is decreased, causing less of the drug to be absorbed from the During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient's platelet count to be 92,000 cells/mm3. The nurse should do which of the following? A nurse practitioner orders 150 mg of oral fluconazole for a patient with vulvovaginal candidiasis. The patient should expect to take medication A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is perspiring and her blood pressure is 88/50. The serum magnesium level is 10 mg/dL. The nurse will interpret these manifestations as A Nurse Practitioner is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation?