NURS 6521N Midterm Exam (100 out of 100) Latest Exam Update 2023, Exams of Nursing

Download NURS 6521N Midterm Exam (100 out of 100) Latest Exam Update 2023 and more Exams Nursing in PDF only on Docsity! 1 NURS 6521N Midterm Exam (100 out of 100) Latest Exam Update 2023 A patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest? Selec ted Answ er: Take it on an empty stomach, 1 hour before or 2 hours after meals Selec ted Answ er: Amoxicillin, Metronidazole, and Bismuth Page 1 of 58 • Question 2 0 out of 1 points 2 • Question 3 1 out of 1 points • Question 4 1 out of 1 points A diabetic patient being treated for obesity tells the Nurse Practitioner that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the Nurse Practitioner's immediate attention? Selec ted Answ er: Increased blood glucose A Nurse Practitioner is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called Selec ted Answ er: pharmaco genom ics. Page 2 of 58 • Question 9 1 out of 1 points 5 Selec ted Answ er: Administering investigational drugs to patients After a recent history of shortness of breath that has become increasingly severe, a woman has been prescribed ipratropium by MDI while she undergoes a diagnostic workup. What patient teaching should the nurse provide to this patient? Selec ted Answ er: "Make sure that you take this at the scheduled times, regardless of whether you feel short of breath." Selected Answer: Page 5 of 58 • Question 10 1 out of 1 points Which of the following patients is most likely to benefit from the administration of an adrenergic agonist? • Question 11 1 out of 1 points 6 A man who is in cardiogenic shock following a myocardial infarction A 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this patient's statements? Selec ted Answ er: "Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation." Page 6 of 58 • Question 13 1 out of 1 points 7 A Nurse Practitioner who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients? Selec ted Answ er: An obese male client who is a heavy alcohol user and who has cirrhosis of the liver During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse's assessment reveals that the patient has been taking over-the- counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives Selected Answer: Page 7 of 58 • Question 18 1 out of 1 points 10 Selec ted Answ er: A Proton Pump Inhibitor A patient has been prescribed a drug that can be self-administered at home. Which of the following would be the most important information for the nurse to relate to the patient concerning self- administration of a drug? Selec ted Answ er: The therapeutic effects and possible adverse effects Page 10 of 58 • Question 17 1 out of 1 points You are seeing a 55 year old patient recently diagnosed with a bleeding ulcer. What should be the initial treatment choice for this patient? • Question 19 1 out of 1 points • Question 20 0 out of 1 points 11 A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family doctor. What effect will the patient's smoking status have on the therapeutic use of theophylline? Selec ted Answ er: The patient may require higher doses of theophylline than a nonsmoker A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient's first dose? Selec ted Answ er: The number of cigarettes smoked per day Page 11 of 58 • Question 21 1 out of 1 points 12 A 22 year old patient is transitioning from oral agents to insulin. He will be taking 20 units of lantus at bedtime and regular insulin before meals. What instructions should the NP provide about the timing and dose of regular insulin? Selec ted Answ er: Take 1 unit of regular insulin for each 10 grams of carbohydrate to be consumed 15 minutes before each meal Page 12 of 58 • Question 22 0 out of 1 points • Question 26 1 out of 1 points 15 None of the above A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by Selec ted Answ er: decreasing the influx of sodium into neurons. Page 15 of 58 • Question 27 0 out of 1 points • Question 28 1 out of 1 points 16 Advanced practice nurse prescribing of scheduled medications is affected most by: Selec ted Answ er: Combined state medical / pharmacy / nursing prescribing board regulations A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy's diagnosis? Selec ted Answ er: Mesala min e Page 16 of 58 • Question 29 1 out of 1 points • Question 30 1 out of 1 points 17 A 79-year-old patient in a long-term care facility is to receive an intravenous fat emulsion. Which of the following lab values would be a priority for the nurse to assess before administration? Selec ted Answ er: Triglyceride levels A Nurse Practitioner is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following? Selec ted Answ er: Co ffe e Page 17 of 58 • Question 35 1 out of 1 points 20 Nurse Practitioner notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to Selec ted Answ er: first- pass effec t. Drugs have a high potential for abuse. There is no routine therapeutic use for these drugs and they are not available for regular use. They may be obtained for "investigational use only" by applying to the U.S. Drug Enforcement Agency. Examples include heroin and LSD. Which scheduled drug is this? Selec ted Answ er: Schedule 1 Page 20 of 58 • Question 36 1 out of 1 points • Question 37 1 out of 1 points 21 A 22-year-old male college senior has lived with a diagnosis of Crohn's disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn's disease? Selec ted Answ er: Infliximab (Remicade) The APRN is caring for a patient taking a calcium channel blockers for hypertension. The APRN should monitor the patient for what common side effects of this medication? Page 21 of 58 • Question 38 1 out of 1 points • Question 39 0 out of 1 points 22 Selec ted Answ er: peripheral edema, constipation, dizziness The APRN is seeing Mrs. Smith, age 77, who is here for follow up of hypertension, dyslipidemia, and depression. What should you consider during her follow- up? Selec ted Answ er: Age-related changes in renal function are the main cause of adverse drug reactions A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit she reports Page 22 of 58 • Question 43 1 out of 1 points • Question 44 1 out of 1 points 25 Selec ted Answ er: Taking several drugs simultaneo usly A Nurse Practitioner is caring for a female patient who has developed atelectasis because of thick mucus secretions. The Nurse Practitioner is monitoring IV administration of acetylcysteine (Mucomyst) and notices that the patient's face is flushed. The appropriate nursing action would be to Selec ted Answ er: slow the administration of acetylcysteine and administer diphenhydramine if ordered. Which statement is FALSE regarding the treatment of hyperthyroidism? Page 25 of 58 • Question 46 1 out of 1 points 26 Selec ted Answ er: Methimazole (Tapazole) is the drug of choice for pregnant or lactating females. Selec ted Answ er: rebound rhinitis/con gestion A 58-year-old man is prescribed dicyclomine (Bentyl) for irritable bowel syndrome. In which of the following conditions is dicyclomine therapy contraindicated? Selec ted Answ er: Glaucoma Page 26 of 58 • Question 45 1 out of 1 points Topical inhaled alpha adrenergic blocking agents or nasal vasoconstricting decongestants should not be used chronically (>5 days) because they can cause • Question 47 1 out of 1 points 27 A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs? Selec ted Answ er: Digoxin immune fab Page 27 of 58 • Question 48 1 out of 1 points A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before • Question 52 1 out of 1 points 30 A 62-year-old woman has been prescribed a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately Selec ted Answ er: 24 hours. Page 30 of 58 • Question 54 0 out of 1 points 31 A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAs more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract? Selec ted Answ er: The parietal cells of the stomach have H2 receptors but not H1 receptors. A Nurse Practitioner is instructing a patient in the administration of regular insulin by the subcutaneous route. Which of the following strategies would the Nurse Practitioner suggest if the goal is to promote absorption of the regular insulin? Selec ted Answ er: Rotate injection sites by using the arm one day, the stomach the next day, and the thigh the day after and then repeating the cycle. Page 31 of 58 • Question 55 0 out of 1 points • Question 56 1 out of 1 points 32 A Nurse Practitioner who is responsible for administering medications should understand that the goals of the MedWatch program are to (Select all that apply.) Select ed Answ ers: increase awareness of serious reactions caused by drugs or medical devices. A male patient is to begin treatment for pneumonia with an albuterol (Ventolin) inhaler. The nurse will advise the patient that he will most likely experience which of the following common adverse effects of the drug? Selec ted Answ er: Thro at irrita tion Page 32 of 58 • Question 60 0 out of 1 points • Question 61 1 out of 1 points 35 A Nurse Practitioner is caring for a 70-year-old patient who is taking desmopressin (DDAVP). The patient has a history of cardiovascular disease. The nurse will prioritize the assessment of which of the following? Selec ted Answ er: W ei g ht A patient is bothered with nighttime episodes of bronchoconstriction related to asthma. Which of the following medications can be administered to decrease the nighttime episodes and prevent asthma attacks? Selec ted Answ er: Leukotri ene modifier s Page 35 of 58 • Question 62 1 out of 1 points • Question 63 0 out of 1 points 36 A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that Selec ted Answ er: she must be prepared to show identification when buying a drug that contains pseudoephedrine. The Nurse Practitioner is performing patient education for a woman who will soon begin treatment of hyperlipidemia with simvastatin (Zocor). The patient has asked the Nurse Practitioner if there are any "bad side effects" that she should be aware of. Which of the following statements should underlie the nurse's response? Page 36 of 58 • Question 64 1 out of 1 points • Question 65 1 out of 1 points 37 Selec ted Answ er: Many patients experience gastrointestinal upset with statins, which can be partially alleviated by taking the drug with food. A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction? Selec ted Answ er: Late afternoon A patient is being treated for respiratory infection. He is a recovering alcoholic and has impaired liver function. The nurse will instruct the patient to be especially cautious when taking Page 37 of 58 • Question 70 0 out of 1 points 40 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? Selec ted Answ er: Administering the drug intravenously rather than orally Mr. Penny, age 67, was diagnosed with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient's angina? Selec ted Answ er: Amlodipine will now be contraindicated in the treatment of Mr. Penny's angina. Page 40 of 58 • Question 73 1 out of 1 points 41 Selec ted Answ er: four times a day. Selec ted Answ er: patients with otitis media A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient's medication regimen. Which of the patient's medications should prompt the nurse to teach her to avoid drinking grapefruit juice? Page 41 of 58 • Question 71 1 out of 1 points To maximize the therapeutic effect of diphenoxylate HCl with atropine sulfate, the nurse will instruct the patient to take the medication • Question 72 1 out of 1 points Decongestants are recommended to use in which of the following patients? • Question 74 0 out of 1 points 42 Selec ted Answ er: Atorvastatin (Lipitor) A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a Page 42 of 58 • Question 78 0 out of 1 points 45 Selec ted Answ er: "This schedule allows rest periods so that adverse effects are decreased but the anti-inflammatory effects continue." A Nurse Practitioner has administered a medication to a patient with hypertension. The prescribed drug is supposed to decrease cardiac output. A decrease in cardiac output would most likely Selec ted Answ er: increase the synergistic effect of the drug. Page 45 of 58 • Question 79 1 out of 1 points 46 Which of the following patients should be advised by the Nurse Practitioner to avoid over-the-counter cold and allergy preparations that contain phenylephrine? Selec ted Answ er: A 47-year-old female with hypertension Selec ted Answ er: Bet a bloc ker Selec ted Answ er: Route Page 46 of 58 • Question 80 0 out of 1 points A 62 year old male who had a myocardial infarction one year ago is being seen for hypertension. Which medication has the best evidence in mortality reduction? • Question 81 1 out of 1 points What critical piece of information is missing from the following medication order: Amoxicillin 250 mg every 8 hours? • Question 83 1 out of 1 points 47 Select ed Answ ers: All of the abov e A Nurse Practitioner is teaching a patient about his newly prescribed drug, colchicine, for gout. The Nurse Practitioner will instruct the patient to avoid which of the following foods? Selec ted Answ er: Sh ri m p Page 47 of 58 • Question 82 0 out of 1 points The APRN's ability to prescribe controlled substances is regulated by: • Question 89 1 out of 1 points 50 indicates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is Selec ted Answ er: subcutaneous. Selec ted Answ er: liver damage. A 77-year-old man's chronic heart failure is being treated with a regimen of quinapril (Accupril) and furosemide (Lasix). Which of the following assessment findings would suggest that the loop diuretic is contributing to a therapeutic effect? Page 50 of 58 • Question 88 1 out of 1 points A patient with mild low back pain has been advised to take acetaminophen. The nurse will inform him that excessive intake of acetaminophen may result in • Question 90 1 out of 1 points 51 Selec ted Answ er: The man's chest sounds are clear and his ankle edema is lessened. Shirley, age 58, has been diabetic for 7 years. Her blood pressure for the last three office visits have been 154/100, 144/94, and 144/90. What would you prescribe today during her routine office visit? Page 51 of 58 • Question 91 1 out of 1 points • Question 92 1 out of 1 points 52 Selec ted Answ er: An ACE Inhibitor A Nurse Practitioner is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for which of the following? Selec ted Answ er: Increase in plasma concentration of lovastatin A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an Page 52 of 58 • Question 97 0 out of 1 points 55 A 72-year-old female patient is prescribed ipratropium aerosol for pulmonary emphysema. The nurse will instruct her to "test spray" the new metered-dose inhaler (MDI) three times before using it to prevent which of the following? Selec ted Answ er: Paradoxic acute bronchosp asm A female patient calls the clinic and reports that since she has been taking dextromethorphan (Robitussin), she has been extremely drowsy and dizzy. The nurse will question the patient about which of the following? Selec ted Answ er: The amount of water she drinks every day Page 55 of 58 • Question 99 1 out of 1 points 56 Selec ted Answ er: Epigastr ic distress A Nurse Practitioner is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports "dizzy spells and weakness" and feels that the drug is no longer effective. The Nurse Practitioner suspects that the change in the effectiveness of the drug is related to Selec ted Answ er: the impact of the warmer climate on the patient's physical state. Page 56 of 58 • Question 98 0 out of 1 points A 34-year-old male patient is prescribed methimazole (MMI). The Nurse Practitioner will advise him to report which of the following immediately? • Question 96 1 out of 1 points • Question 100 1 out of 1 points 57 A child with sinusitis has been on antibiotics for seven days and his symptoms are not improving. All of the following are options to prescribe for the patient now EXCEPT: Selec ted Answ er: Azithromycin (Zithromycin) Page 57 of 58 • Question 101 0 out of 0 points