NURS6521N Midterm Exam Questions and Answers. Guaranteed Success. Download To Score A., Exams of Nursing

Download NURS6521N Midterm Exam Questions and Answers. Guaranteed Success. Download To Score A. and more Exams Nursing in PDF only on Docsity! NURS6521N Midterm Exam Questions and Answers. Guaranteed Success. Download To Score A. 1. 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 2. A patient is in the clinic after 6 weeks of taking riluzole (Rilutek) for a recent diagnosis of amyotrophic lateral sclerosis. The nurse will prioritize assessment for which of the following? A) Weight gain B) Constipation C) Increased energy D) Dizziness 3. 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 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 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 commonly 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 12. 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? A) Furosemide B) Digoxin immune fab C) Captopril D) Dopamine 13. 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 professional 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. 14. A patient has been prescribed lithium therapy. Which of the following signs and symptoms will the nurse tell the patient to report immediately? A) Increased urination B) Muscle twitching C) Hair loss D) Increased thirst 15. 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." 16. 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 17. A nurse notes new drug orders for a patient who is already getting several medications. Which of the following is the most important consideration 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 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 diagnosis of cholinergic poisoning is made. Which of the following drugs would be administered? A) Acetylcholine B) Atropine C) Cevimeline D) Nicotine 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. 20. A nurse is developing a care plan for a patient who has multiple sclerosis. 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. 28. A nurse is working in a women's hospital where she is caring for a new mother who is experiencing postpartum urinary retention. Bethanechol (Urecholine) has been ordered. The nurse will observe for which of the following? A) Bradycardia B) Hypertension C) Hypotension D) Decreased salivation 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. 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. D) facial flushing. 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 patient'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. NB: From here to the end Answers are embedded after multiple choices 32. A nurse is aware of the high incidence and prevalence of major depression 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 hospital 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 D) A woman who has recently begun treatment for idiopathic seizure activity B 33. The nurse has been assigned a 49-year-old patient who has acute colitis, and the nurse just completed gathering data concerning core drug knowledge and core patient variables. To implement nursing management of drug therapy for this patient, the nurse will then A) evaluate the outcome of the drug therapy. B) devise strategies to maximize the therapeutic effects of the drug. C) implement planned nursing actions. D) assess for data that will indicate interactions between core drug knowledge and core patient variables. B 34. A nurse has been caring for a 49-year-old man who was hospitalized with recurrent ventricular fibrillation and received IV amiodarone. The man is now scheduled to be discharged on oral amiodarone, and the nurse has just completed discharge instructions. Which of the following statements made by the patient indicates that further instruction is necessary? A) "I will notify my physician if I develop a cough and have difficulty breathing." B) "I am going on a cruise next week and plan to just lie in the sun all day and relax." C) "I plan to see my ophthalmologist in 2 weeks." D) "It is important for me to have my thyroid gland checked regularly." B 35. A 73-year-old man was diagnosed with Parkinson disease earlier this year and has begun taking carbidopa-levodopa four times daily in an effort to control the signs and symptoms of the disease. The nurse should recognize that this therapeutic effect is achieved by influencing the A) uptake of acetylcholine. B) dopamine receptors in the brain. C) synthesis of epinephrine. D) sensitivity of beta-2 receptors. B 36. A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous nitroglycerin 5 mcg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infusion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments? A) Blood pressure B) Urinary output C) Heart rate D) Blood urea nitrogen (BUN) A 37. A patient has been prescribed several drugs and fluids to be given intravenously. Before the nurse starts the intravenous administration, a priority 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. D 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 decreased but the anti- inflammatory effects continue." D 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 regimen? 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 C 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? 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 D 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. D 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 monitor for any sudden increase in A) involuntary movements. B) perspiration. C) appetite or thirst. D) mobility. A 42. A nurse has an order to apply nitroglycerin topically, twice a day. The nurse's initial action will be to A) wipe off the previous dose from the patient's body. B) don a pair of gloves. C) place the ointment on an area free of excessive hair and of unbroken skin. D) wipe off any medication that is on the outside of the medication container. B 43. A woman with an inflammatory skin disorder has begun taking prednisone in an effort to control the signs and symptoms of her disease. The nurse who is providing care for this patient should prioritize which of the following potential nursing diagnoses in the organization of the patient's care? A) Fluid Volume Excess B) Constipation C) Acute Confusion D) Impaired Gas Exchange A 44. A 38-year-old patient is obese and has abscesses around his inner thigh muscles. He is receiving IV antibiotics, but no improvement has been seen. The patient questions the nurse about the most likely cause for the drug therapy failure. The nurse explains to the patient that the A) surface area of the abscesses is not large enough for the drug to have the desired therapeutic effect. B) route of administering the medication should not have been IV. C) distribution of the drug to the area of the abscesses is impaired. D) distribution of the drug to the thigh muscles is generally impaired, even in healthy individuals. C 45. A patient is prescribed regular doses of epinephrine. Which of the following nursing diagnoses is related to comfort and would be most appropriate for this patient? A) Imbalanced Nutrition: Less Than Body Requirements B) Disturbed Sleep Pattern, Insomnia Related to CNS Excitation C) Disturbed Sensory Perception D) Ineffective Tissue Perfusion B 46. A 68-year-old female patient who was diagnosed with hypertension 2 weeks ago and was prescribed a new hypertension medication has returned to the clinic for a follow-up visit. The nurse notes that the patient's blood pressure is unchanged from her last clinic visit. When the patient was asked if she was taking the new medication on a regular basis, 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 B) ask the patient to place a nitroglycerin tablet under his tongue immediately. C) have the patient take his pulse for 1 minute. D) have the patient go into his house and sit or lie down. D 54. Constipation is a major problem in patients with amyotrophic lateral sclerosis (ALS). The nurse will educate the patient and family to A) choose a laxative at the local drug store. B) use prune juice only. C) consult their physician before purchasing a laxative. D) walk at least 500 yards a day. C 55. A nurse has been assigned to care for a 52-year-old attorney who has hypertension and peptic ulcer disease. Before administering his medications, the nurse must complete an initial assessment. Core patient variables 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 A, B, C, D 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 nicotinic N receptors C 57. A woman in her twenties has been accompanied to her primary care provider by her mother, who states that her daughter has been experiencing increasingly severe episodes of irritable grandiose behavior. The care 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 A 58. A patient is treated with an antibiotic for an infection in his leg. After 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. C 59. A 70-year-old man with diabetes mellitus is taking metoprolol (Lopressor) 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. C) avoid smoke-filled rooms. D) understand the signs and symptoms of hypoglycemia. D 60. A 45-year-old man enters the emergency department complaining of chest pain. The nurse has an order to administer amyl nitrite. The nurse will A) administer the medication by intramuscular injection. B) crush the capsule and ask the patient to inhale the vapors. C) place the tablet under the patient's tongue. D) ask the patient to chew the tablet before swallowing. B 61. Mrs. Houston is a 78-year-old woman who resides in an assisted living facility. Her doctor prescribed digoxin at her last visit to the clinic and she has approached the nurse who makes regular visits to the assisted-living facility about this new drug. What teaching point should the nurse emphasize to Mrs. Houston? A) The importance of having required laboratory work performed on time B) The need to take the medication at the same time each day regardless of her heart rate C) The correct technique for using a home blood pressure cuff D) Timing household activities to coincide with the administration times of her digoxin A 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 administered in small doses. A 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 understanding of his new medication? B) drowsiness. C) diarrhea. D) urinary incontinence. B 78. A nurse is providing patient education to a female patient who is taking fludrocortisone. The nurse will instruct the patient to monitor which of the following at home? A) Weight gain B) Thyroid hormone levels C) Heart rate D) Core body temperature A 79. A female patient has been prescribed aminoglutethimide to treat Cushing syndrome. Before therapy begins a priority nursing action would be to review the patient's A) current lab results, especially complete blood count. B) current body weight and height. C) bilirubin level. D) last menstrual period. A 80. A nurse is caring for a patient in the critical care unit. Phentolamine (Regitine, OraVerse) has been ordered for the management of tissue necrosis caused by extravasation of parenterally administered drugs. Before administering this drug, the nurse will check the patient's chart for indications of A) peptic ulcer disease. B) history of acute myocardial infarction. C) diabetes mellitus. D) obesity. B 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?" B 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 B 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 B) Protein-rich foods C) One glass of red wine per day D) OTC cold remedies D 84. A female patient is taking 0.125 mg of digoxin daily for heart failure. 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 concerned that the additional weight will necessitate an increase in the medication. 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." B 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 cardiovascular effects of phenelzine B) Risk for Constipation related to decreased gastrointestinal peristalsis C) Risk for Infection related to immunosuppressive effects of phenelzine D) Risk for Injury related to drug-drug interactions or drug-nutrient interactions D 86. A woman in her thirties has been experiencing increasing weakness and the results of an edrophonium (Tensilon) test have resulted in a diagnosis of myasthenia gravis. The patient's nurse should anticipate that the patient will benefit from treatment with A) carbidopa-levodopa. B) a monoclonal antibody. C) a dopamine agonist. D) a cholinesterase inhibitor. D 87. A nurse is caring for a patient admitted to the intensive care unit because of heart failure. The patient is prescribed digoxin. Which of the following nursing diagnoses would be appropriate for this patient? D) diabetes mellitus. B 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 fibrillation 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 C 96. In which of the following patients would a nurse expect to experience alterations in drug metabolism? A) A 35-year-old woman with cervical cancer B) A 41-year-old man with kidney stones C) A 50-year-old man with cirrhosis of the liver D) A 62-year-old woman in acute renal failure C 97. A patient with class-IV CHF has a medication regimen consisting of metoprolol (Lopressor), enalapril (Vasotec), and furosemide (Lasix). In addition to regularly assessing the patient s heart rate, the nurse should prioritize assessment of the patient's A) intake and output. B) blood pressure. C) cognition. D) exercise tolerance. B Question 1 1 out of 1 points A nurse works in a private hospital and needs to administer some narcotic drugs to one of her patients. Which of the following should the nurse consider when administering narcotics to patients in a hospital setting? Selected Answer: Narcotics to be used in the hospital are dispensed only with a written prescription. Question 2 1 out of 1 points A patient has been receiving regular doses of an agonist for 2 weeks. Which of the following should the nurse anticipate? Selected Answer: The drug will decrease in effectiveness Question 3 1 out of 1 points A nurse is creating a plan of care for a 68-year-old woman with a recent diagnosis of unstable angina and new prescription for nitroglycerin. Which of the following nursing diagnoses should the nurse prioritize in the planning of this patient's care? Selected Answer: Acute Pain, Headache, related to adverse effects of drug therapy Question 4 1 out of 1 points A nurse is caring for a patient who abuses marijuana. The treatment for marijuana abuse consists mainly of Selected Answer: nonpharmacologic interventions combined with an exercise program. Question 5 1 out of 1 points A nurse is caring for a patient who is in severe pain and is receiving an opioid analgesic. Which of the following would be the nurse's priority assessments? Selected Answer: Pain intensity, respiratory rate, and level of consciousness Question 14 A patient who has ongoing pain issues has been prescribed meperidine (Demerol) IM. How should the nurse best administer this medication? Selected Answer: Into the Hip or Thigh Question 15 A nurse is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The nurse should anticipate that the drug will be administered Selected Answer: Twice daily? Question 16 1 out of 1 points A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to Selected Answer: swallow the tablet with milk or food. Question 17 1 out of 1 points A nurse notes new drug orders for a patient who is already getting several medications. Which of the following is the most important consideration when preparing to administer the new drugs? Selected Answer: Possible drug–drug interactions that might occur Question 18 1 out of 1 points A nurse is discussing with a patient the efficacy of a drug that his physician has suggested he begin taking. Efficacy of a drug means which of the following? Selected Answer: How well a drug produces its desired effect Question 19 1 out of 1 points The nurse's assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this? Selected Answer: "I broke out in hives and got terribly itchy when I started a new prescription last year." Question 20 1 out of 1 points An 80-year-old patient has been taking lorazepam since his wife died a year ago. He has been staying with his son, but will now move to an assisted living facility. Before admission to the assisted living facility, the patient's physician has determined that the drug is no longer needed. The nurse at the facility will plan to Selected Answer: withdraw the drug gradually over a 2 to 3 week period. Question 21 1 out of 1 points A patient has been prescribed lithium therapy. Which of the following signs and symptoms will the nurse tell the patient to report immediately? Selected Answer: Muscle twitching Question 22 1 out of 1 points The lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system? Selected Answer: Cilia sweep foreign material and mucus upward toward the trachea and larynx where they can then be swallowed. Question 23 1 out of 1 points A female patient, age 36, is prescribed inhaled corticosteroid (ICS) for daily use. Which of the following adverse effects should the nurse closely monitor for in this patient? Selected Answer: Oropharyngeal Candida albicans infection Question 24 1 out of 1 points A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply. Selected Answers: Is there a need for the drug in treating the presenting problem? Is this the best drug for the presenting problem? Can the patient take the prescribed drug? Question 25 A patient who is experiencing withdrawal from heavy alcohol use have developed psychosis and been treated with haloperidol. Which of the following assessment findings should prompt the care team to assess the patient for neuroleptic malignant syndrome? Selected Answer: The patient develops muscle rigidity and a sudden, high fever. Question 33 1 out of 1 points A patient who has been admitted to the hospital for a mastectomy has stated that she has experienced adverse drug effects at various times during her life. Which of the following strategies should the nurse prioritize in order to minimize the potential of adverse drug effects during the patient's stay in the hospital? Selected Answer: Monitor the patient vigilantly for signs and symptoms of potentially adverse drug effects Question 34 1 out of 1 points 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? Selected Answer: Late afternoon Question 35 1 out of 1 points A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse will instruct the patient to avoid which of the following foods? Selected Answer: Shrimp Question 36 1 out of 1 points A nurse is caring for a 46-year-old patient of Chinese origin who has bipolar disorder. The physician has prescribed lithium carbonate (Eskalith) to treat the disorder. The nurse is aware that the lithium dose will likely be given in a Selected Answer: lower-than-normal dose. Question 37 1 out of 1 points 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 Selected Answer: an elixir. Question 38 1 out of 1 points A 25-year-old woman comes to the clinic because of a chronic, nonproductive cough. Assessment reveals that she has a history of asthma and dextromethorphan, (Robitussin) is prescribed for her. The nurse will question this order because Selected Answer: secretions may be retained. Question 39 1 out of 1 points A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to Selected Answer: rebound bronchoconstriction. Question 40 1 out of 1 points These drugs have a potential for abuse, but the potential is lower than for drugs on Schedule 2. These drugs contain a combination of controlled and noncontrolled substances. Use of these drugs can cause a moderate to low physiologic dependence and a higher psychological dependence. A verbal order can be given to the pharmacy and the prescription can be refilled up to five times within 6 months. Examples include certain narcotics (codeine) and nonbarbiturate sedatives. This is scheduled drug Selected Answer: Schedule 3 Question 41 1 out of 1 points A nurse who is responsible for administering medications should understand that the goals of the MedWatch program are to (Select all that apply.) Selected Answers: provide regular feedback about product safety issues. facilitate the reporting of adverse reactions of drugs. increase awareness of serious reactions caused by drugs or medical devices. Question 42 1 out of 1 points A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing Talwin given in combination with Vistaril diminishes the adverse effects of nausea caused by the Talwin. This drug interaction affecting the pharmacodynamics of the Talwin is Selected Answer: an antagonistic effect. Question 50 1 out of 1 points In order to promote therapeutic drug effects, the nurse should always encourage patients to Selected Answer: take their medication at the prescribed times. Question 51 1 out of 1 points A 57-year-old male patient who has been prescribed doxorubicin for small-cell lung cancer is advised by the nurse to avoid taking aspirin or drugs that contain aspirin because it may Selected Answer: promote bleeding. Question 52 1 out of 1 points A 70-year-old woman is starting on an acidic drug. The nurse is aware that food and nutrient intake can affect drug excretion by changing the urinary pH. About which of the following will the nurse question the patient concerning her diet? Selected Answer: The amount of meat and vegetables Question 53 1 out of 1 points A patient who has been taking buspirone (BuSpar) for 1 week calls the clinic and reports to the nurse that the drug is not working. The patient informs the nurse that she is still having symptoms of anxiety. The nurse will tell the patient that Selected Answer: optimum relief of anxiety usually occurs after 3 to 4 weeks of treatment. Question 54 1 out of 1 points A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider? Selected Answer: Dietary habits Question 55 1 out of 1 points A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is Selected Answer: headache. Question 56 1 out of 1 points A nurse is overseeing the care of a young man whose ulcerative colitis 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? Selected Answer: Carefully assess the patient for infections Question 57 1 out of 1 points A patient has been admitted to the ICU because of multiple traumas due to a motor vehicle accident. The physician has ordered propofol (Diprivan) to be used for maintenance of sedation. Before administration of propofol, a priority assessment by the nurse would be to check for a history of Selected Answer: seizure disorders. Question 58 1 out of 1 points A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The nurse will be sure to Selected Answer: avoid the small veins in the dorsum of the hand or the wrist. Question 59 1 out of 1 points A 75-year-old woman is prescribed magnesium hydroxide for constipation. The nurse's assessment reveals that the patient is being treated for rheumatoid arthritis and hypertension. The patient lives in assisted living and is on a low-sodium diet. Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the patient's Selected Answer: medication history. Question 60 1 out of 1 points Selected Answer: a decrease in the amount of creatinine to be filtered. Question 67 1 out of 1 points 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 adverse effects of the drug? Selected Answer: 1.7 mEq/L Question 68 1 out of 1 points 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? Selected Answer: Digoxin immune fab Question 69 1 out of 1 points A nurse works in a sleep disorder clinic and is responsible for administering medications to the patients. Which of the following patients would be most likely to receive zaleplon (Sonata)? Selected Answer: A 35-year-old man who is having difficulty falling asleep, but once asleep can stay asleep Question 70 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? Selected Answer: Question 71 1 out of 1 points A nurse is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed. Before the drug therapy is started, the nurse will assess for which of the following? Selected Answer: History of taking anticoagulant drugs Question 72 1 out of 1 points An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the patient that Selected Answer: there is risk of an extremely high dose available all at once if the tablet is crushed. Question 73 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 Selected Answer: Med will reduce excretion of Na = Na and K levels Maintain adequate potassium intake to avoid depletion Question 74 1 out of 1 points A patient will begin three new medications as part of her treatment plan. The nurse practitioner understands that proper disposal of medications is key when the nurse practitioner states Selected Answer: Many medications can be potentially harmful if taken by someone other than the person the medication was prescribed. Question 75 1 out of 1 points A diabetic patient being treated for obesity tells the nurse 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's immediate attention? Selected Answer: Increased blood glucose Question 76 1 out of 1 points A 70-year-old patient has just started taking lorazepam 10 days ago for anxiety issues related the death of her husband. She is staying with her daughter for a couple of weeks. The patient's daughter has noticed that her mother is having difficulty walking and seems to be confused at times and calls the clinic to report this to the nurse. The nurse will inform the daughter that Selected Answer: a dose adjustment should be made if these symptoms persist. Question 77 1 out of 1 points 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 very low body mass index. How are this patient's characteristics likely to influence possible treatment with phenytoin? Selected Answer: The patient's protein deficit will likely increase the levels of the free drug in his blood. Question 85 1 out of 1 points A nurse who provides care for older adults is aware of the high incidence of drug interactions in this population. When educating a group of seniors about the prevention of drug interactions, the nurse should encourage them to Selected Answer: consult their care provider before taking new over-the-counter medications. Question 86 1 out of 1 points A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings? Selected Answer: The man may be experiencing nephrotoxic effects of aspirin Question 87 1 out of 1 points A nurse 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? Selected Answer: Electrolyte levels Question 88 1 out of 1 points A patient comes to primary clinic for strep throat. A throat swab culture is sent to lab. What information is required for the nurse practitioner to disclose on lab transmittal? Selected Answer: National Provider Identification (NPI) Question 89 1 out of 1 points Mr. Tan is a 69-year-old man who prides himself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. However, Mr. Tan states that he has experienced occasional constipation in recent months. What remedy should be the nurse's first suggestion? Selected Answer: A bulk-forming (fiber) laxative Question 90 1 out of 1 points A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient's drug therapy? Selected Answer: Increased abdominal pain and vomiting Question 91 1 out of 1 points An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for Selected Answer: falls. Question 92 0 out of 1 points A 57-year-old man is to begin 5-FU therapy for colon cancer. It will be most important for the nurse to monitor which of the following during the first 72 hours of the initial treatment cycle? Selected Answer: White blood cell nadir Question 93 1 out of 1 points A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation? Selected Answer: Monitor glucose levels closely Question 94 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 Selected Answer: four times a day.