NURS 6521 Midterm Exam 2021 Best Rated A+, Exams of Nursing

Download NURS 6521 Midterm Exam 2021 Best Rated A+ and more Exams Nursing in PDF only on Docsity! NURS 6521 Midterm Exam 2021 Best Rated A+ NURS 6521 Midterm Exam (Complete Solution) Latest: (Detail Solutions Resources for the exam) Question1. A nurse is caring for a postsurgical patient who has small tortuous veins and had a difficult IV insertion. The patient is now receiving IV medications on a regular basis. What is the best nursing intervention to minimize the adverse effects of this drug therapy? A) Monitor the patient's bleeding time B) Check the patient's blood glucose levels C) Record baseline vital signs D) Monitor the IV site for redness, swelling, or pain Question2. A patient is in the clinic after 6 weeks of taking riluzole (Rilutek) for a recent diagnosis of amyotrophic lateral sclerosis. The nurse will priori- tize assessment for which of the following? A) Weight gain B) Constipation C) Increased energy D) Dizziness NURS 6521 Midterm Exam 2021 Best Rated A+ Question3. Which of the following patients demonstrates the clearest indication for treatment with prednisone? A) A 66-year-old woman whose history of smoking has culminated in a diagnosis of emphysema B) A 70-year-old man whose rheumatoid arthritis has not responded to OTC pain relievers C) A 12-year-old boy whose long-standing fatigue and malaise have been attributed to leukemia D) A 50-year-old woman who is being treated for hypertension with a diuretic and an ACE inhibitor Question 4. A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is consid- erably higher than the parenteral dose and understands that this due to A) passive diffusion. B) active transport. C) glomerular filtration. D) first-pass effect. Question5. A cardiac care nurse is monitoring a patient who is receiving NURS 6521 Midterm Exam 2021 Best Rated A+ Question 8. NURS 6521 Midterm Exam 2021 Best Rated A+ A nurse is caring for a patient who has just been diagnosed with Parkinson disease. The patient does not understand how the medication ordered, carbidopa-levodopa, is going to help her condition. Which of the following is the correct response by the nurse? A) "Carbidopa-levodopa will delay the loss of muscle strength and limb function for several months." B) "This drug will change the immune processes in your body to help decrease the tissue damage." C) "Carbidopa-levodopa increases the activity of dopamine in your body, which will decrease your symptoms." D) "Your drug therapy will reduce excessive reflex activity causing your muscle spasms and will allow for muscle relaxation." Question9. 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? A) Chronic diarrhea B) Dental hygiene practices C) Headaches D) Diet Question 10. NURS 6521 Midterm Exam 2021 Best Rated A+ A nurse notes new drug orders for a patient who is already getting several medications. Which of the following is the most important con- sideration when preparing to administer the new drugs? A) How the patient will feel about new medications added to her drug therapy B) Possible drug-drug interactions that might occur C) Any special nursing considerations that the nurse must be aware of D) If generic preparations of the drugs can be used Question 11. A nurse is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following? A) The amount of the drug that must be given to produce a particular re- sponse B) How well a drug produces its desired effect C) A drug's strength of attraction for a receptor site D) A drug's ability to stimulate its receptor Question 12. A nurse is conducting a medication resolution of a new resident of a care facility and notes that the woman has been taking neostigmine. The nurse should recognize that the woman may have a history of what health problem? A) Alzheimer disease NURS 6521 Midterm Exam 2021 Best Rated A+ A nurse who provides care on a busy medical unit of a large hospital is constantly faced with new drugs on patients' medication administra- tion records. What strategy should the nurse employ to foster up-to-date information about the nursing management of new or uncommon drugs? A) Focus on learning about a prototype drug that is characteristic of a larger drug class B) Identify similarities between new drugs and older drugs that are com- monly used on the unit C) Commit time and energy during each shift to learning about new drugs D) Liaise with pharmacists and pharmacy technicians who work at the hospital Question 16. A 58-year-old man is admitted to the emergency department. A diag- nosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs? A) Furosemide B) Digoxin immune fab C) Captopril D) Dopamine Question 17. NURS 6521 Midterm Exam 2021 Best Rated A+ A hospital patient's physician has prescribed quetiapine (Seroquel) to be administered at bedtime. Being unfamiliar with the medication, the nurse has looked it up in a nursing drug manual and noted that the drug is an antipsychotic that is indicated for the treatment of schizophrenia and bipolar disorder. The patient has no psychiatric history, and upon questioning, the physician states that it is being prescribed to help the patient fall asleep at night. How should the nurse best understand this practice? A) This off-label use of the drug is prohibited by federal laws and pro- fessional practice standards. B) This is an appropriate use of the drug, provided it is supported by the literature. C) This is acceptable if the patient has failed to respond adequately to conventional sleep aids. D) This is a practice that may negate the physician's and nurse's liability insurance. Question 18. A 4-year-old child is brought to the emergency department by her mother. The mother reports that the child has been vomiting, and the nurse notes that the child's face is flushed and she is diaphoretic. The mother thinks that the child may have swallowed carbachol drops. A di- agnosis of cholinergic poisoning is made. Which of the following drugs would be administered? A) Acetylcholine B) Atropine C) Cevimeline NURS 6521 Midterm Exam 2021 Best Rated A+ D) Nicotine Question 19. A nurse is providing discharge instructions to a patient who will be taking fludrocortisone at home. The nurse will encourage the patient to eat a diet that is A) low in sodium and potassium. B) low in sodium, high in potassium. C) high in iron. D) low in proteins. Question 20. A nurse is developing a care plan for a patient who has multiple scle- rosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in A) chest pain. B) fatigue. C) breathing difficulties. D) heart palpitations. Question 21. An elderly postsurgical patient has developed postoperative pneumo- nia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption? NURS 6521 Midterm Exam 2021 Best Rated A+ C) The patient will identify satisfying and acceptable sexual practices and some alternative ways of dealing with sexual expression. D) The patient will adopt strategies to maintain proper fluid balance. Question 26. A nurse is caring for a patient who is taking sodium polystyrene sul- fonate (Kayexalate) therapy. The nurse will monitor for which of the fol- lowing? A) Cardiac arrhythmias B) Ventricular arrhythmias C) Hypokalemia D) Cardiotoxicity Question 27. A nurse is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a patient who has just been admitted. What is the most likely goal of this intervention? A) To treat sinus bradycardia accompanied by hypotension B) To resolve the patient's uncompensated heart failure C) To treat the patient's ventricular tachycardia D) To convert the patient's atrial fibrillation to normal sinus rhythm Question 28. NURS 6521 Midterm Exam 2021 Best Rated A+ A nurse is working in a women's hospital where she is caring for a new mother who is experiencing postpartum urinary retention. Bethane- chol (Urecholine) has been ordered. The nurse will observe for which of the following? A) Bradycardia B) Hypertension C) Hypotension D) Decreased salivation Question 29. A 12-year-old child who has been taking sertraline for the past 2 weeks has returned to the clinic to be seen. It will be critical for the nurse to assess for A) onset of suicidal ideation. B) weight loss. C) feelings of grandiosity. D) decreased sleep. Question 30. A 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully monitored for A) dizziness. B) diarrhea. C) increased secretions. NURS 6521 Midterm Exam 2021 Best Rated A+ D) facial flushing. Question 31. A patient has been admitted to the intensive care unit following a myocardial infarction. His nurse is preparing to administer his ordered medications when she notices that one drug ordered is used for treating seizure disorders. The nurse does not find a history of seizures in the pa- tient's record. The most appropriate action for the nurse is to A) ask the charge nurse if she knows why the drug has been ordered. B) look up the drug to see if there are other conditions that the drug could be prescribed for. C) question the physician about the prescribed medication. D) call the pharmacist and inquire about therapeutic uses of the drug. Question 32. A nurse is aware of the high incidence and prevalence of major de- pression in the population. Which of the following individuals possesses the clearest risk factors for depression? A) A man who has a history of intravenous drug use and multiple hospi- tal admissions for subsequent infections B) A woman whose father had a long history of depression before he committed suicide C) A man who is experiencing significant lifestyle changes after losing his job NURS 6521 Midterm Exam 2021 Best Rated A+ B) Urinary output C) Heart rate D) Blood urea nitrogen (BUN) Question 37. A patient has been prescribed several drugs and fluids to be given in- travenously. Before the nurse starts the intravenous administration, a pri- ority assessment of the patient will be to note the A) heart rate. B) body weight and height. C) blood pressure. D) skin surrounding the potential IV site. Question 38. Which of the following patients would a nurse determine to be at the greatest risk for quinidine toxicity? A) A 30-year-old pregnant woman B) A 44-year-old man diagnosed with cardiac insufficiency C) A 50-year-old woman with myasthenia gravis D) A 55-year-old man diagnosed with complete heart block Question 39. A nurse is assigned to a patient who is taking lithium. Which of the following drug serum levels would indicate that the patient is at risk for NURS 6521 Midterm Exam 2021 Best Rated A+ adverse effects of the drug? NURS 6521 Midterm Exam 2021 Best Rated A+ A) 0.3 mEq/L B) 0.6 mEq/L C) 1.7 mEq/L D) 1.2 mEq/L Question 40. A patient experiencing a serious allergic reaction to a bee sting is brought to the emergency department. The patient's right hand is swollen, red, and painful. She is extremely upset, short of breath, and the nurse detects wheezing and stridor. The nurse is ordered to administer epinephrine to relieve the patient's A) pain and swelling around the sting site. B) discoloration in her hand. C) acute anxiety. D) acute bronchospasm. Question 41. A nurse is educating a patient who has Parkinson disease and her husband about the possible adverse effects of carbidopa-levodopa. The nurse should emphasize the need for the patient and her husband to mon- itor for any sudden increase in A) involuntary movements. B) perspiration. NURS 6521 Midterm Exam 2021 Best Rated A+ patient was asked if she was taking the new medication on a regular ba- sis, she stated, "I thought that I was supposed to take the new drug when I had a pounding headache or was in a stressful situation, not all the time." An appropriate nursing diagnosis for this patient would be which of the following? A) Knowledge, deficient due to the lack of understanding of treatment regimen B) Coping, ineffective due to forgetfulness C) Confusion, acute concerning drug administration D) Anxiety due to diagnosis of hypertension Question 47. A nurse is overseeing the care of a young man whose ulcerative coli- tis is being treated with oral prednisone. Which of the following actions should the nurse take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment? A) Avoid OTC antacids for the duration of treatment B) Advocate for intravenous, rather than oral, administration C) Teach the patient strategies for dealing with headaches D) Carefully assess the patient for infections Question 48. A nurse is performing an admission assessment of an elderly patient who is being admitted to a medical ward from the emergency depart- ment. Which of the following is an open-ended assessment question? A) "Have you ever had a bad response to a drug that you've taken?" NURS 6521 Midterm Exam 2021 Best Rated A+ B) "Does anyone in your immediate family have a history of drug aller- gies?" C) "Are you comfortable with receiving needles?" D) "What kind of reactions have you had to medications?" Question 49. In order to promote therapeutic drug effects, the nurse should always encourage patients to A) take their medication with meals. B) take their medication at the prescribed times. C) increase medication dosages if necessary. D) use alternative therapy to increase the effects of their medications. Question 50. Frequent episodes of exercise-related chest pain have caused a 79- year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient's age will have what effect on her use of ni- troglycerin? A) The woman may experience paradoxical vasoconstriction when tak- ing nitroglycerin. B) Decreased saliva production will inhibit the absorption of the drug in her mucosa. C) The woman will need to allow more time between doses in order to facilitate absorption. D) The woman will be more susceptible to hypotension than a NURS 6521 Midterm Exam 2021 Best Rated A+ younger patient. NURS 6521 Midterm Exam 2021 Best Rated A+ Question 55. A nurse has been assigned to care for a 52-year-old attorney who has hypertension and peptic ulcer disease. Before administering his medica- tions, the nurse must complete an initial assessment. Core patient vari- ables will be obtained from which of the following? (Select all that apply.) A) The patient's interview B) The patient's medical history C) The patient's medical record D) The patient's physical examination E) The patient's health insurer Question 56. A 59-year-old woman has long-standing diagnoses of type 1 diabetes and hypertension and has recently been diagnosed with glaucoma. Her ophthalmologist has prescribed pilocarpine (Akarpine), which will achieve its intended therapeutic effect by which of the following means? A) By blocking receptors of acetylcholine B) By increasing synthesis of acetylcholine C) By directly stimulating cholinergic receptors D) By stimulating nicotinicN receptors Question 57. A woman in her twenties has been accompanied to her primary care provider by her mother, who states that her daughter has been experienc- NURS 6521 Midterm Exam 2021 Best Rated A+ ing increasingly severe episodes of irritable grandiose behavior. The care NURS 6521 Midterm Exam 2021 Best Rated A+ provider has consequently begun a treatment regimen that includes pharmacological therapies. This patient is most likely experiencing which of the following mood disorders? A) Bipolar disorder B) Dysthymic disorder C) Major depression D) Personality disorder Question 58. A patient is treated with an antibiotic for an infection in his leg. Af- ter 2 days of taking the antibiotic, the patient calls the clinic and reports that he has a rash all over his body. The nurse is aware that a rash can be an adverse effect of an antibiotic and can be either a biologic, chemical, or physiologic action of the drug, which is an example of A) pharmacotherapeutics. B) pharmacokinetics. C) pharmacodynamics. D) pharmacogenetics. Question 59. A 70-year-old man with diabetes mellitus is taking metoprolol (Lo- pressor) to manage his hypertension. The nurse would be sure to instruct the patient to A) take his pulse at least four times a day. B) weigh himself once a week at the same time of the day. NURS 6521 Midterm Exam 2021 Best Rated A+ A) increased heart rate and decreased blood pressure. B) decreased heart rate and decreased blood pressure. C) increased heart rate and increased blood pressure. D) decreased heart rate and increased blood pressure. Question 65. Which of the following patients should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine? A) A 47-year-old female with hypertension B) A 52-year-old male with adult-onset diabetes C) A 17-year-old female with symptoms of an upper respiratory infection D) A 62-year-old male with gout Question 66. Which of the following would be an expected outcome in a patient who has been given atropine during a medical emergency? A) Reduction of severe hypertension B) Increased level of consciousness C) Restoration of normal sinus rhythm D) Resolution of respiratory acidosis Question 67. NURS 6521 Midterm Exam 2021 Best Rated A+ A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse? A) "This schedule will be more convenient for you." B) "This schedule will enable you to lose weight." C) "This schedule will decrease the cost of your medication." D) "This schedule allows rest periods so that adverse effects are de- creased but the anti-inflammatory effects continue." Question 68. A middle-aged male patient has received a diagnosis of amyotrophic lateral sclerosis (ALS) and has begun treatment with riluzole (Rilutek). The patient's nurse should recognize what goal of this treatment regi- men? A) Restoration of normal motor nerve function B) Maintenance of normal mobility and activities of daily living C) Delaying of tracheostomy or mechanical ventilation D) Relief of neuropathic pain Question 69. A patient has been prescribed an oral drug that is known to have a high first-pass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells? NURS 6521 Midterm Exam 2021 Best Rated A+ A) Giving the drug with food in order to delay absorption B) Administering the drug in small, frequent doses C) Limiting the patient's protein intake and encouraging fluids D) Administering the drug intravenously rather than orally Question 70. A patient has been receiving regular doses of an agonist for 2 weeks. Which of the following should the nurse anticipate? A) The drug will decrease in effectiveness B) The drug will increase in effectiveness C) There will be a steady state with no anticipated changes D) The drug will cause excessive therapeutic effects even when adminis- tered in small doses. Question 71. After seeking care for tremors that have become increasingly severe in recent months, a 71-year-old man has been diagnosed with Parkinson disease and will soon begin treatment with carbidopa-levodopa. Which of the following statements indicates that the patient has an accurate un- derstanding of his new medication? A) "I'll have to learn how to modify each dose of carbidopa-levodopa based on how bad my symptoms are that day." B) "I've read that carbidopa-levodopa is quite short-acting so I'll have to take it several times a day." NURS 6521 Midterm Exam 2021 Best Rated A+ she has been having "more side effects from her drugs lately" and the NURS 6521 Midterm Exam 2021 Best Rated A+ nurse observes that the client appears to be lethargic and have a de- creased attention span. Which of the following would be an appropriate nursing diagnosis based on the statement of the patient and the observa- tions of the nurse? A) Disturbed Thought Processes B) Disturbed Sleep Pattern C) Impaired Physical Mobility D) Risk for Injury Question 77. A patient who is going on a cruise is concerned about motion sick- ness and sees his physician, who prescribes scopolamine. The nurse in- forms the patient that using scopolamine may cause him to experience A) pupil constriction. B) drowsiness. C) diarrhea. D) urinary incontinence. Question 78. A nurse is providing patient education to a female patient who is tak- ing fludrocortisone. The nurse will instruct the patient to monitor which of the following at home? NURS 6521 Midterm Exam 2021 Best Rated A+ A) Weight gain NURS 6521 Midterm Exam 2021 Best Rated A+ Question 81. A 28-year-old man has been taking sertraline for a few months. On a follow-up visit to the clinic, he reports a change in sexual functioning, dizziness, and insomnia. The most appropriate response by the nurse would be A) "How much of the drug are you taking at one time?" B) "Have you stopped taking the drug?" C) "Do you eat a lot of fat in your diet?" D) "How much alcohol do you consume?" Question 82. A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments? A) Oxygen saturation and respiratory rate B) Heart rate and blood pressure C) Level of consciousness and pain level D) Temperature and respiratory rate Question 83. A 59-year-old female patient has been prescribed digoxin. The nurse assigned to the patient will instruct her to avoid which of the following? A) Grapefruit juice NURS 6521 Midterm Exam 2021 Best Rated A+ B) Protein-rich foods NURS 6521 Midterm Exam 2021 Best Rated A+ C) One glass of red wine per day D) OTC cold remedies Question 84. A female patient is taking 0.125 mg of digoxin daily for heart fail- ure. At a recent clinic visit she reports that since she has been on the drug, she can breathe better and her heart rate has been around 74 beats per minute. The nurse weighs the patient and notices that she has gained 10 pounds since the digoxin therapy was started. The patient is con- cerned that the additional weight will necessitate an increase in the med-ication. Which of the following is an appropriate response by the nurse? A) "Yes, the drug dosage will probably have to be increased." B) "No, the drug dosage will likely stay the same." C) "No, the drug dosage will have to be decreased." D) "I don't know; I will have to ask your physician." Question 85. A middle-aged patient was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, his psychiatrist has prescribed phenelzine. When planning this patient's subsequent care, what nursing diagnosis should the nurse prioritize? A) Risk for Ineffective Peripheral Tissue Perfusion related to cardiovas- cular effects of phenelzine B) Risk for Constipation related to decreased gastrointestinal peristalsis NURS 6521 Midterm Exam 2021 Best Rated A+ D) increase body temperature. Question 91. A 42-year-old African-American man with congestive heart failure has been prescribed hydralazine-isosorbide. The nurse will closely moni- tor for which of the following? A) Hypertension B) Hypotension C) Decrease in body temperature D) Increased heart rate Question 92. After successful treatment for a myocardial infarction, a 69-year-old man has developed a ventricular arrhythmia. His care team has opted for treatment with a Class II antiarrhythmic. The nurse would understand that this patient is likely to be prescribed A) acebutolol. B) lidocaine. C) amiodarone. D) verapamil. Question 93. A patient has been prescribed aminoglutethimide 250 mg PO q6h to increase to 2g daily over the next several weeks. The nurse should rec- ognize that this patient most likely has a diagnosis of A) Cushing syndrome. NURS 6521 Midterm Exam 2021 Best Rated A+ B) Addison disease. C) diabetes insipidus. D) an autoimmune condition such as asthma. Question 94. A patient has a diagnosis of Parkinson disease, and the physician will prescribe carbidopa-levodopa. Before drug therapy, the patient should be carefully assessed for the presence of A) macular degeneration. B) closed-angle glaucoma. C) peptic ulcer disease. D) diabetes mellitus. Question 95. A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely administer a lower- than-normal maintenance dose of digoxin? A) A 25-year-old male with congestive heart failure and atrial fibrilla- tion B) A 32-year-old female with cardiomegaly C) A 79-year-old male with cardiomegaly D) A 42-year-old female with a third heart sound Question 96. In which of the following patients would a nurse expect to experi- ence NURS 6521 Midterm Exam 2021 Best Rated A+ alterations in drug metabolism?