Nurs 6521 advanced pharmacology final exam quizlet
Nurs 6521 advanced pharmacology final exam questions and answers
Nurs 6521 advanced pharmacology final exam questions
Nurs 6521 advanced pharmacology final exam pdf
Nurs 6521 advanced pharmacology final exam answers
nurs 6521 final exam quizlet
nurs 6521 final exam course hero
nurs 6521 advanced pharmacology midterm exam
NURS 6521 – Advanced Pharmacology
Final Exam
A patient has just received her first dose of imatinib and the nurse on the oncology unit is
amending the patient’s care plan accordingly. What nursing diagnosis is most appropriate in
light of this addition to the patient’s drug regimen?
– Risk for Infection related to bone marrow suppression
A 20-year-old female patient is receiving topical clindamycin for acne vulgaris. She develops a
rash and urticaria along with severe itching where the medication is applied. The nurse will
formulate which of the following nursing diagnoses for the patient?
– Risk for Injury related to allergic reactions
A 21-year-old female has a history of irregular menses. She recently became sexually active,
and would like to begin taking oral contraceptives (OCs). The nurse practitioner recognizes that
most likely this patient would benefit from taking which category of OCs.
– Monophasic
A woman who is in the second trimester of her first pregnancy has been experiencing
frequent headaches and has sought advice from her nurse practitioner about safe treatment
options. What analgesic can the nurse most safely recommend?
– Acetaminophen
A patient receiving high-dose cisplatin therapy exhibits symptoms of hypomagnesemia.
Which of the following should the nurse suggest to help offset the magnesium losses from the
cisplatin therapy?
– Consuming chocolates
A child is admitted to the burn unit with second and third degree burns on both arms and part
of his or her face. When administering topical medications to the burned areas, the nurse
should
– use sterile technique when applying the medication.
A 30-year-old man with a BMI of 59 has recently been diagnosed with type 2 diabetes mellitus.
In light of the man’s lack of success with weight loss programs in the past, his care provider has
prescribed sibutramine (Meridia). What instructions should the nurse consequently provide to
this patient?
– “Take this drug once each day on an empty stomach.”
A 21-year-old female has a history of irregular menses. She recently became sexually active,
and would like to begin taking oral contraceptives (OCs). The nurse practitioner recognizes
that most likely this patient would benefit from taking which category of OCs.
– Monophasic
A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the
chance that the boy will take his prescribed medication, the nurse should
– offer a choice between liquid and chewable medications, if possible.
A 28-year-old woman has completed rituximab therapy for an autoimmune disease. She tells
the nurse that she and her husband would like to start a family. The nurse will advise her to
– continue using birth control for at least 12 months.
A 73-year-old woman has osteoporosis and is prescribed alendronate. She takes calcium and
vitamin D supplements, drinks lots of water, and has just quit smoking. The nurse should
advise the patient to also
– perform light-weight exercises and go for walks
A nurse is performing patient education for a woman who has just been prescribed a
– Low bone density and a family history of osteoporosis
A 20-year-old woman will soon begin taking oral contraceptives for the first time. What
advice should the nurse provide to this patient?
– “Make sure to seek care quickly if you experience bad headaches, calf pain, or
changes in vision.”
A nurse is providing patient education to a 50-year-old woman who is taking methotrexate
(MTX) for breast cancer. The nurse will instruct the patient to avoid which of the following
drugs?
– Salicylates
A nurse is instructing a 19-year-old female patient on the use of fluconazole for candida
vaginitis. A teaching priority will be to
– use an alternative form of birth control, if taking an oral contraceptive.
A nurse 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?
– Leukopenia
Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung
cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been
prescribed filgrastim (Neupogen). Which of the nurse’s following assessment questions most
directly addresses a common adverse effect of filgrastim?
– “Do you feel like you’re having any pain in your bones?”
A preterm neonate received caffeine for the treatment of apnea. The nurse should monitor the
neonate for which of the following?
– Bloody stools
A patient has been prescribed daptomycin for a complicated skin infection. Which of the
following will the nurse advise the patient to report immediately?
– Muscle pain or tingling
A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be
sure to inform the parents that this drug could cause
– staining of permanent teeth
Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the
patient to use the topical agent
– Once a day
A nurse has questioned why a patient’s physician has prescribed a narrow-spectrum antibiotic
rather than a broad-spectrum drug in the treatment of a patient’s infection. Which of the
following facts provides the best rationale for the use of narrow-spectrum antibiotics whenever
possible?
– The use of broad-spectrum antibiotics can create a risk for a superinfection
A female patient has been prescribed estrogen therapy. Which of the following will the nurse
advise the patient is a common adverse effect of estrogen therapy?
– Breakthrough bleeding
A nurse is discussing oprelvekin therapy with a male patient. Which of the following will the
nurse tell the patient is the most common adverse effect of the drug?
– Fluid retention weight gain
A man has a demonstrated history of androgen deficiency and the consequences of this health
problem include an inability to maintain an erection. Which of the following medications
would best address this patient’s erectile dysfunction (ED)?
– Exogenous testosterone
A female patient has follicular non-Hodgkin’s lymphoma and is receiving thalidomide
(Thalomid). It will be most important for the nurse to monitor this patient for which of the
following?
– Bleeding
A nurse has administered filgrastim to a diverse group of patients in recent months. Which of
the following patients should the nurse observe for extremely elevated white blood cell
counts following administration of the drug?
– A 19-year-old male receiving radiotherapy
A nurse is aware that the concept of selective toxicity is foundational to antimicrobial
therapy. Which of the following statements most accurately describes selective toxicity?
– A drug harms microbe without harming human cells.
A 59-year-old man with a recent history of erectile dysfunction has been assessed and
prescribed sildenafil (Viagra). When providing patient education to this man, the nurse should
tell him which of the following?
– “You might find that your face becomes flushed or you get a headache after you
take Viagra.”
A nurse has completed a medication reconciliation of a patient who has been admitted
following a motor vehicle accident. Among the many drugs that the patient has received in
the previous year is rituximab. The nurse would be justified in suspecting the patient may
have received treatment for which of the following diseases?
– Non-Hodgkin’s lymphoma
A patient asks the nurse practitioner about food sources such as soybeans and soy products.
The nurse practitioner understands that these foods are considered
– phytoestrogens
A nurse is providing patient education to a 23-year-old woman who is starting the
norelgestrominethinyl estradiol transdermal system (Ortho Evra). Because this is the patient’s
first time to use the birth control patch, the nurse will instruct her to apply the patch
– on the day her menstrual period begins
A nurse is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is
discussed as a major adverse effect in older patients. To minimize the risk of the patient
developing this adverse effect, the nurse will advise him to
– stay well hydrated by drinking at least eight 8-oz glasses of water daily
Which of the following patients will be at the greatest risk for anemia and would be the most
likely candidate for epoetin alfa therapy?
– A 62-year-old male with cancer
A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia).
After baseline physical data are obtained, the nurse will assess the patient’s childbearing
potential. The nurse will inform the patient that during sibutramine therapy she should
– Use adequate contraception
The nurse recognizes that the potential for teratogenic drug effects is not static throughout the
prenatal and postnatal periods. The potential for teratogenic effects is highest during
– The first 2 months of pregnancy
On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss
the potential benefits of hormone replacement therapy in controlling the symptoms of
menopause. Which of the following responses by the nurse is most appropriate? “It’s important
to balance the possible benefits of HRT with the fact that it might
– Increase your risk of heart disease and stroke
A 16-year-old boy is prescribed cromolyn sodium nasal spray to treat a nasal allergy. To
maximize the therapeutic effects of the drug, which of the following will the nurse include in
instructions to the patient?
– Take the drug for one full week before coming in contact with allergens
A nurse who provides care on a pediatric unit of a hospital is aware that the potential for harm
as a result of drug errors is higher among infants and children than adults. This fact is
primarily due to
– Immature liver and kidney function in infants and children
A nurse who provides care on a pediatric medicine unit has conducted a medication
reconciliation of a recently-admitted patient. In light of the fact that the child takes
methylphenidate (Ritalin), the nurse is justified in considering a history of what health
problem?
– ADHD
A nurse 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?
– Protamine sulfate
A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic
visit, the nurse’s priority assessment would be
– height and weight
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? provided patient and family
education, the nurse should teach the mother with which of the following measures to avoid
reinfection following treatment?
– The importance of vigilant hygiene for the boy and the other members of the family
A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug
therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor
which combination of laboratory test results?
– Serum alanine transaminase, aspartate transaminase, and bilirubin
During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient’s
platelet count to be 92,000 cellsmm3. The nurse should do which of the following?
– Consult the prescriber for discontinuation of the drug
A nurse is discussing with a 58-year-old male patient the causes of erectile dysfunction in
men over 50 years of age. Which of the following will the nurse inform the patient is the
primary physical cause of erectile dysfunction of men in this age group?
– Atherosclerosis of the penile artery
A patient has been admitted to the critical care unit of the hospital with bacterial septicemia
that has failed to respond to initial antibiotic treatment. The patient’s most recent blood
cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the
patient’s blood. The nurse will anticipate that this patient will likely require intravenous
administration of what antibiotic?
– Vancomycin
A nurse is instructing a colleague on how an antimicrobial produces a therapeutic effect.
Which of the following should be included in the nurse’s teaching?
– Penicillin interferes with synthesis of the bacteria cell wall.
A 20-year-old woman has been prescribed estrogen. As with all women taking estrogen, the
nurse will carefully monitor the patient for which of the following?
– Cardiovascular complications
A nurse has been assigned to a 55-year-old woman who has a malignant brain tumor. The
patient is receiving her first dose of carmustine. It will be critical for the nurse to observe for
which of the following?
– Respiratory difficulty
A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will
instruct the patient to
– complete the entire course of drug therapy
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?
– The patient has unstable angina and uses a nitroglycerin patch
A nurse 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?
– Fetal heart rate (FHR)
A patient with non-Hodgkin’s lymphoma (NHL) will be starting a course of doxorubicin
shortly. When planning this patient’s care, what nursing diagnosis should the nurse prioritize?
– Risk for Infection related to suppressed bone marrow function
A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the
patient, the nurse should stress that
– body fluids such as urine, saliva, tears, and sputum may become discolored
A nurse is administering rituximab to a patient via the IV route. The nurse will set the IV pump
at 50 mg/hour for the first half hour of the initial infusion. If there are not apparent reactions
after 30 minutes of the infusion, the nurse will increase the dosage every 30 minutes by 50
mg/hour until the maximum infusion rate reaches which of the following?
– 400 mg/hour
A nurse working in a cancer center is preparing to administer medication to a 5-year-old child.
The nurse will calculate the drug dosage by using
– Body surface area
A patient will soon begin targeted therapy as a component of her treatment plan for chronic
leukemia. The nurse is conducting health education about this new aspect of the patient’s drug
regimen and the patient has asked about the potential side effects of treatment. How should
the nurse best respond?
– “Both classes of drugs have adverse effects, but targeted therapies tend to have
less of an effect on healthy body cells.”
A patient is taking etoposide for a testicular tumor refractory to treatment. The nursing
assessment reveals that he is also taking warfarin. The nurse must carefully monitor for which
of the following?
– Elevated prothrombin time
A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has
been experiencing a depressed mood and a sense of hopelessness. He confides in the school
nurse that he has begun taking his stepfather’s antidepressant to improve his mood. After
immediately phoning the boy’s stepfather, the nurse learns that the drug in question is
phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that
this combination of drugs creates a serious risk of what health problem?
– Hypertensive crisis
A patient is receiving long-term clindamycin therapy for a life-threatening infection. The
nurse will begin by monitoring this drug therapy by obtaining
– A baseline complete blood count
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
– Caffeine
A patient is pregnant and is at 7 weeks’ gestation. She has type 1 diabetes and has been taking
insulin since she was 13 years old. She asks the nurse if the insulin will be harmful to her
baby. The best response to the patient by the nurse would be
– “Insulin is usually the drug of choice for controlling blood glucose levels during
pregnancy because it does not cross into the placenta.”
A nurse 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?
– A child has a greater body surface area, creating greater permeability resulting in an
increase in absorption of topical agents, which may result in more adverse effects.
A patient with a diagnosis of chronic myeloid leukemia has met with her oncologist, who has
recommended treatment with the kinase inhibitor imatinib. What route of administration
should the nurse explain to the patient?
– Oral administration of imatinib in a home setting
A nurse is going to administer medication to an infant using a medicine dropper. The best
method is to open the child’s mouth by gently squeezing the cheeks and placing the drops
– In the buccal pouch
A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams
will the patient receive in one dose?
– 2000 mg
A patient is being treated for Mycoplasma pneumoniae pneumonia. She is allergic to penicillin
and is being given azithromycin (Zithromax) in capsule form. The nurse will inform the patient
that she will need to take the capsule
– On an empty stomach
A nurse is explaining to a pregnant 21-year-old college student why she cannot continue to
take ibuprofen (Advil) for her headaches. The nurse draws a picture depicting drug molecules
crossing the placental membrane and entering into the fetal circulation. The nurse tells the
patient that the main reason this happens is because
– Drugs compete with the hormones of pregnancy for albumin-binding sites.
A patient has been prescribed oral tetracycline. The nurse will instruct the patient to take the
drug
– On an empty stomach 1 hour before or 2 hours after taking any meals or other drugs.
A nurse works at a weight management clinic. To which of the following overweight patients
could the nurse safely administer dextroamphetamine?
– A 48-year-old Caucasian man who has adult-onset diabetes
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?
– “Lately, I have to get up three or four times a night to go to the bathroom.”
After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband
have sought a referral to a fertility specialist in order to explore their options. A nurse at the
clinic should recognize that the woman may benefit from
– clomiphene.
Which of the following would the nurse include in a teaching plan about the signs and
symptoms of thrombophlebitis and thromboembolism that should be reported by a patient
taking estrogen?
– Headaches and chest pain
A 38-year-old pregnant patient admits to the nurse 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
– microcephaly
A nurse practitioner orders 150 mg of oral fluconazole for a patient with vulvovaginal
candidiasis. The patient should expect to take medication
– Once a day
An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague
the factors that contribute to the success or failure of a patient’s chemotherapy. Which of the
following cancerous cells is most susceptible to the effects of chemotherapeutic drugs?
– Cells that have a rapid mitotic rate
A middle-aged patient has received a diagnosis of GI stromal tumor following an extensive
diagnostic workup. Imatinib has been recommended as a component of the patient’s drug
regimen. What patient education should the nurse provide to this patient? “It’s important that
you let us know if you develop any significant swelling or
– Puffiness
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
– both the boy and his mother regarding all medication issued.
A patient has been admitted to the critical care unit with a diagnosis of peritonitis that has
necessitated treatment with gentamicin. As a result, the care team should be cautious when
concurrently administering other medications that may cause
– ototoxicity or nephrotoxicity
A 39-year-old woman is receiving doxorubicin for the treatment of cancer. After each
treatment, the patient has acute nausea and vomiting accompanied by a slightly increased
heart rate. The nurse will advise her to
– perform relaxation techniques after the treatments.
A nurse 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
– marijuana
A 46-year-old man is receiving a quinupristindalfopristin IV infusion for a life-threatening
infection. Which of the following would be most important for the nurse to monitor?
– Infiltration, edema, or phlebitis at the infusion site
A woman is receiving prolonged drug therapy during her complicated pregnancy, and it may
pose a risk to both the mother and the fetus. The primary care physician has made dosage
adjustments to minimize adverse effects and prevent toxicity.
– The nurse should make sure that serum levels of the drug are being monitored
Alprostadil (Caverject), a drug used to treat erectile dysfunction, has been prescribed to a 42-
year-old patient. When providing education to the patient and his wife, the nurse should
inform the wife about which of the following adverse effects?
– Vaginal burning
A 36-year-old patient comes to the clinic and tells the nurse that she suspects that she is
pregnant. During the initial assessment, the nurse learns that the patient is currently taking
medications for diabetes, hypertension, and a seizure disorder. The nurse would be most
concerned about which of the following medications?
– Phenytoin (Dilantin)
A male patient with a medical background tells the nurse that he is not satisfied with the oral
synthetic testosterone that has been prescribed for him and he would like to try a natural form
of oral testosterone. Which of the following would be an appropriate response by the nurse?
– “Natural testosterone undergoes a high first-pass effect and is not used orally.”
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?
– Prostatic neoplasia
A 2-year-old child is diagnosed with a minor ailment and is to be administered medications at
home for 2 weeks. The child lives with his mother, grandmother, and four other children
between the ages of 14 months and 7 years. The home health nurse is asked to assess the
home environment to determine if it is appropriate for the child to take his medication at
home. Which of the following will have the greatest impact on the nurse’s assessment?
– Where the medications will be stored
A 22-year-old woman has given birth to an infant who exhibits the signs and symptoms of
maternal cocaine use during pregnancy. These signs and symptoms are a result of what
pathophysiological effect of opioid use during pregnancy?
– Vasoconstriction leading to reduced placental blood flow
A 62-year-old patient taking tamoxifen exhibits increased bone and tumor pain along with a
local disease flare. The nurse interprets this as an indication of which of the following?
– The tumor responding to treatment
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?
– That the infant’s skin has greater permeability than that of an adult
The clinical nurse educator who oversees the emergency department in a children’s hospital
has launched an awareness program aimed at reducing drug errors. What measure addresses
the most common cause of incorrect doses in the care of infants and children? Having nurses
check their math calculations with a colleague before
– administering a drug.
A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following
assessment findings would most strongly indicate that treatment has been effective?
– The patient’s hemoglobin level is 11 gdL
A patient has been scheduled to begin treatment with rituximab for non-Hodgkin’s
lymphoma. The nurse who will administer this drug should understand that it targets
– specific antigens on the surface of malignant B cells.
A 15-year-old boy has been diagnosed with bone cancer after several months of fatigue and
pain. What question should the nurse include in an assessment when trying to minimize the
potential for adverse drug reactions?
– “Do you ever use alcohol or drugs?”
A 30-year-old man with a BMI of 59 has recently been diagnosed with type 2 diabetes
mellitus. In light of the man’s lack of success with weight loss programs in the past, his care
provider has prescribed sibutramine (Meridia). What instructions should the nurse
consequently provide to this patient?
– “Take this drug once each day on an empty stomach.”
A 49-year-old farmer who normally enjoys good health has become seriously ill in recent days
and the results of an extensive diagnostic work up have resulted in a diagnosis of
histoplasmosis. The patient has been admitted to the hospital and has begun treatment with
amphotericin B. The nurse who is providing care for the patient should prioritize which of the
following diagnostic results during his course of treatment?
– Electrolytes, blood urea nitrogen, and creatinine
NURS 6521 Final Exam Advanced Pharmacology: WaldenUniversity (Verified Answers)•Question 11 out of 1 pointsThe nurse practitioner orders Amoxicillin 500 mg tid? What is the total amount ofmedication patient will take per day?Selected Answer: 1500 mg•Question 21 out of 1 pointsA 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe for which of the following adverse effects of the drug?Selected Answer: Lid margin crusting and pruritus•Question 31 out of 1 pointsA patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize?Selected Answer: The peak and trough blood levels•Question 41 out of 1 points A Nurse Practitioner is caring for a 64-year-old female patient who is receiving IV heparinPage 1 of 37
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 ofthe following drugs may be ordered?Selected Answer:Protamine sulfate•Question 51 out of 1 pointsA patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are consideredSelected Answer: phytoestrogens.•Question 61 out of 1 pointsAn immunocompromised cancer patient has developed cryptococcal meningitis and been admitted to the intensive care unit for treatment with amphotericin B. How should the nurse most safely administer this drug?Selected Answer:Infuse the drug over 2 to 4 hours into a central line using an infusion pump•Question 71 out of 1 pointsThe clinical nurse educator who oversees the emergency department in a children’s hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children?Selected Answer:Having nurses check their math calculations with a colleague before administering a drug.Page 2 of 37
•Question 81 out of 1 pointsPage 3 of 37
A female patient is taking filgrastim (Neupogen) to decrease the incidence ofinfection. The nurse notices a small increase in the neutrophil count 2 days afterstarting therapy. The nurse’s evaluation of the increase is thatSelected Answer: the increase in the neutrophil count is only transient.•Question 91 out of 1 points A nurse practitioner has administered filgrastim to a diverse group of patients in recent months. Which of the following patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug?Selected Answer:A 19-year-old male receiving radiotherapy•Question 101 out of 1 pointsA man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient toSelected Answer: complete the entire course of drug therapy.•Question 110 out of 1 pointsA 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 asSelected Answer: common adverse effects of magnesium sulfate.•Question 120 out of 1 pointsA patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse willSelected Answer: monitor the site of injection.Page 4 of 37
•Question 131 out of 1 points Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The nurse will advise the patient to avoidSelected Answer:alcohol.•Question 141 out of 1 points A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for recurring headaches. The nurse should recommendSelected Answer:tylenol.•Question 151 out of 1 points A Nurse Practitioner will instruct a patient taking allopurinol to take each doseSelected Answer:before a meal.•Question 162 out of 1 pointsPage 5 of 37
After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic should recognize that the woman may benefit fromPage 6 of 37
Document continues below
Discover more from:
Medical Surgical Nursing 1 (NUR 2210C)(NUR 2210C)
17 documents
Go to course
16
ATI Nutrition NP1 Med Surg
ATI Nutrition NP1 Med Surg
Medical Surgical Nursing 1
100% (1)
16
2022 NRP Practice EXAM Questions AND Answers ALL Solved Solution
2022 NRP Practice EXAM Questions AND Answers ALL Solved Solution
Medical Surgical Nursing 1
67% (3)
66
6521N Midterm
6521N Midterm
Medical Surgical Nursing 1
None
124
AGNP Board EXAM Questions Neurology Assessment
AGNP Board EXAM Questions Neurology Assessment
Medical Surgical Nursing 1
None
29
ANAT final
ANAT final
Medical Surgical Nursing 1
None
18
6650 Final Study Aid
6650 Final Study Aid
Medical Surgical Nursing 1
None
Selected Answer: clomiphene.•Question 171 out of 1 pointsA 5-year-old boy needs an IM injection. The least painful and most effective injection site would be theSelected Answer: ventrogluteal muscle.•Question 181 out of 1 pointsA woman is receiving prolonged drug therapy during her complicated pregnancy, and it may pose a risk to both the mother and the fetus. The primary care physician has made dosage adjustments to minimize adverse effects and prevent toxicity. The nurse should make sureSelected Answer: that serum levels of the drug are being monitored.•Question 191 out of 1 pointsA 34-year-old male has been diagnosed with TB and will be started on INH therapy.The medication history reveals that he currently takes antacids on a regular basis. The nurse will instruct the patient to takeSelected Answer: antacids not less than 1 hour before or 2 hours after taking INH.•Question 201 out of 1 pointsThe recommended treatment for trichomoniasis is Selected Answer: Flagyl.•Question 211 out of 1 points A Nurse Practitioner is explaining to a pregnant 21-year-old college student why she cannotPage 7 of 37
continue to take ibuprofen (Advil) for her headaches. The nurse draws a picture depicting drug molecules crossing the placental membrane and entering into the fetal circulation. The nurse tells the patient that the main reason this happens is becauseSelectedAnswer: drugs compete with the hormones of pregnancy for albumin-binding sites.•Question 221 out of 1 pointsA patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective?Selected Answer: The patient’s hemoglobin level is 11 g/dL•Question 231 out of 1 pointsA patient will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the patient’s drug regimen and the patient has asked about the potential side effects of treatment. How should the nurse best respond?Selected Answer:”The adverse effects to targeted therapies are most often a result ofthe patient’s cancer, not the drugs themselves.”•Question 242 out of 1 pointsA 29-year-old pregnant patient is extremely upset about having to take medicationfor a pre-existing medical condition. She is consumed with fear that her baby will be born with a physical deformity or a congenital anomaly but knows that she hasto take the medication. She talks constantly about this and is unable to sleep most nights. Which of the following is the most appropriate nursing diagnosis for this patient is?Page 8 of 37
Selected Answer: Anxiety related to perceived danger of drug therapy to fetus or infant•Question 251 out of 1 pointsPage 9 of 37
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?Selected Answer: Prostatic neoplasia•Question 261 out of 1 pointsA male patient is receiving heparin by continuous intravenous infusion. The nurse will instruct the patient and family members to report which of the following should it occur?Selected Answer: Presence of blood in urine or stools•Question 271 out of 1 pointsA 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?Selected Answer:”Lately, I have to get up three or four times a night to go to the bathroom.”•Question 281 out of 1 pointsA 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?Selected Answer: That the infant’s skin has greater permeability than that of an adult•Question 291 out of 1 pointsPage 10 of 37
A Nurse Practitioner is caring for a 46-year-old female patient who is taking paclitaxel forovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for which of the following?Selected Answer:NeurotoxicityPage 11 of 37
•Question 301 out of 1 points 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?Selected Answer:Hypoglycemia•Question 312 out of 1 points A Nurse Practitioner will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months?Selected Answer:Liver function tests•Question 321 out of 1 pointsA patient has acquired primary hypogonadism and has been prescribed testosterone transdermal (Androderm) patches. When educating the patient on how to administer the drug, the nurse will instruct him toSelected Answer: place the patch on the back, abdomen, upper arms, or thighs.•Question 331 out of 1 pointsPage 12 of 37
A Nurse Practitioner is performing patient education for a woman who has just been prescribed a bisphosphonate. Which of the following diagnostic and history findings would have prompted the woman’s care provider to prescribe a bisphosphonate?Selected Answer:Low bone density and a family history of osteoporosis•Question 341 out of 1 pointsA male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at each clinic visit?Selected Answer: Serum cholesterol levels•Question 352 out of 1 points A Nurse Practitioner is caring for a 10-year-old boy who complains of chronic headaches. His mother reports that she gives him Tylenol at least three times a day. Which of the following will the nurse work with the physician to evaluate?Selected Answer:Hepatic function•Question 361 out of 1 pointsA 15-year-old patient has meningitis caused by Haemophilus influenzae. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitorSelected Answer: plasma concentrations regularly.•Question 371 out of 1 pointsPage 13 of 37
Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient toSelected Answer: stand or sit upright for at least 30 minutes after taking alendronate..•Question 381 out of 1 pointsLaboratory 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 ofSelected Answer: cardiac arrhythmias.•Question 391 out of 1 pointsA 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could causeSelected Answer: staining of permanent teeth.•Question 401 out of 1 points 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?Selected Answer:Fetal heart rate (FHR)•Question 411 out of 1 pointsThe nurse recognizes that the potential for teratogenic drug effects is not static throughout the prenatal and postnatal periods. The potential for teratogenic effectsis highest duringSelected Answer: the first 2 months of pregnancy.Page 14 of 37
•Question 421 out of 1 points A patient with AIDS has developed a number of secondary infections in recent weeks, including Kaposi’s sarcoma. As a result of this most recent diagnosis, his care team has opted to begin treatment with interferon alfa-2a. The nurse is aware that this drug will address the etiology of Kaposi sarcoma bySelected Answer:inhibiting tumor growth by enhancing inflammation.•Question 431 out of 1 points Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agentSelected Answer:once a day.•Question 441 out of 1 points 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 ofSelected Answer:weekly subcutaneous injections.Page 15 of 37
•Question 45Page 16 of 37
1 out of 1 pointsA 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?Selected Answer: Headaches•Question 462 out of 1 pointsMr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment oflung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse’s following assessment questions most directly addresses a common adverse effect of filgrastim?Selected Answer: “Do you feel like you’re having any pain in your bones?”•Question 471 out of 1 pointsWhich of the following would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reportedby a patient taking estrogen?Selected Answer: Headaches and chest pain•Question 481 out of 1 pointsA 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the chance that the boy will take his prescribed medication, the nurse shouldSelected Answer: offer a choice between liquid and chewable medications, if possible.•Question 491 out of 1 pointsA 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He Page 17 of 37
confides in the school nurse that he has begun taking his stepfather’s antidepressant to improve his mood. After immediately phoning the boy’s stepfather, the nurse learns that the drug inPage 18 of 37
question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). Thenurse should recognize that this combination of drugs creates a serious risk ofwhat health problem?Selected Answer: Hypertensive crisis•Question 501 out of 1 points A Nurse Practitioner is going to administer medication to an infant using a medicinedropper. The best method is to open the child’s mouth by gently squeezing thecheeks and placing the dropsSelected Answer:in the buccal pouch.•Question 511 out of 1 pointsA 35-year-old woman is on a weight-loss program and is to begin taking sibutramine(Meridia). After baseline physical data are obtained, the nurse will assess the patient’s childbearing potential. The nurse will inform the patient that during sibutramine therapy she shouldSelected Answer: use adequate contraception.•Question 521 out of 1 pointsA pregnant patient who has diabetes has been admitted to the hospital to begin labor. Since the patient has diabetes, the physician has decided to use oxytocin (Pitocin) to initiate labor contractions. When talking to the patient about the adverse effects of the drug, the nurse should understand that the most common adverse effects of the drug includeSelected Answer: uterine tachysystole.•Question 531 out of 1 pointsPage 19 of 37
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 toSelected Answer: both the boy and his mother regarding all medication issued.•Question 541 out of 1 pointsA 30-year-old African-American woman tested positive for TB and is prescribed isoniazid. The nurse will plan the patient’s care to include close monitoring of the drug therapy becauseSelected Answer: the patient is at greater risk for high serum levels of the drug.•Question 551 out of 1 pointsA 62-year-old patient taking tamoxifen exhibits increased bone and tumor pain along with a local disease flare. The nurse interprets this as an indication of which of the following?Selected Answer: The tumor responding to treatment•Question 561 out of 1 pointsA 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?Selected Answer: The use of ciprofloxacin is contraindicated in pregnancy.•Question 571 out of 1 points A Nurse Practitioner is having difficulty administering a bitter drug to a 5-year-old child. The nurse shouldPage 20 of 37
SelectedAnswer: offer the child a flavored ice chip or ice pop prior to administering the drug.•Question 581 out of 1 pointsA woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitionerabout safe treatment options. What analgesic can the nurse most safely recommend?Selected Answer: Acetaminophen•Question 591 out of 1 points A Nurse Practitioner is reviewing the prepregnancy medication regimen of a patientwho has just had a positive pregnancy test. The nurse should be aware of which ofthe following changes in pharmacokinetics that accompanies pregnancy?Selected Answer:Increased drug distribution resulting from hemodynamic changes•Question 601 out of 1 pointsA 54-year-old woman with a history of osteoporosis has been prescribed ciprofloxacin for recurrent cystitis. Because of the patient’s history, the nurse would be sure to discuss with the woman the use ofSelected Answer: grapefruit juice.•Question 612 out of 1 pointsPage 21 of 37
On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which of the following responses by the nurse is mostappropriate?Selected Answer:”It’s important to balance the possible benefits of HRT with the factthat it might increase your risk of heart disease and stroke”•Question 621 out of 1 pointsDrugs have a valid medical use but a high potential for abuse, both psychological and physiologic. In an emergency, a Schedule 2 drug may be prescribed by telephone if a written prescription cannot be provided at the time. However, a written prescription must be provided within 72 hours with the words authorizationfor emergency dispensing written on the prescription. These prescriptions cannot be refilled. A new prescription must be written each time. Examples include certain amphetamines and barbiturates.This is scheduled drug Selected Answer: Schedule 2•Question 631 out of 1 pointsA 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?Selected Answer: Blood counts•Question 642 out of 1 points A child is taking permethrin for head lice. The Nurse Practitioner will instruct her mother toPage 22 of 37
Selected Answer:stop using creams, ointments, and oils on the child’s skin and scalp.•Question 651 out of 1 pointsPage 23 of 37
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 withSelected Answer: vancomycin.•Question 661 out of 1 pointsAn immunocompromised patient with a diagnosis of candidiasis has failed to respond to conservative therapy and has consequently begun treatment with amphotericin B. The nurse is aware that this drug achieves a therapeutic effect by way of its influence onSelected Answer: the permeability of fungal cell walls.•Question 671 out of 1 pointsA 36-year-old woman with a history of dysmenorrhea has begun treatment with progesterone, which she will be receiving by the intramuscular route. The nurse participating in the woman’s care should prioritize which of the following potential nursing diagnoses?Selected Answer: Risk for Injury related to loss of vision or thrombotic events•Question 681 out of 1 points A Nurse Practitioner is explaining the use of acyclovir therapy to a 72-year-old man.Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him toSelectedAnswer: stay well hydrated by drinking at least eight 8-oz glasses of water daily.•Question 691 out of 1 pointsPage 24 of 37
A 36-year-old patient comes to the clinic and tells the nurse practitioner that she suspects that she is pregnant. During the initial assessment, the nurse practitioner learns that the patient is currently taking medications for diabetes, hypertension, and a seizure disorder. The nurse would be most concerned about which of the following medications?Selected Answer:Phenytoin (Dilantin)•Question 701 out of 1 points The Nurse Practitioner has established peripheral IV access and begun an infusion of magnesium sulfate on a 29-year-old antepartum patient who is 35 weeks pregnant. Which of the following assessment findings most likely prompted the patient’s physician to order magnesium sulfate for this patient?Selected Answer:Systolic blood pressure readings in excess of 190 mmHg•Question 711 out of 1 points A Nurse Practitioner educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session?SelectedAnswer: Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected.•Question 721 out of 1 pointsPage 25 of 37
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 toSelected Answer: take the vitamins at least 2 hours before or after taking ciprofloxacin.•Question 731 out of 1 pointsA postmenopausal patient is prescribed bisphosphonates to treat osteoporosis. The nurse will instruct the patient to take the drugSelected Answer: after meals.•Question 742 out of 1 points A patient is prescribed ganciclovir to treat a CMV infection. An oral dosage is prescribed. To help increase bioavailability of the drug, the nurse will encourage the patient to take the medicationSelected Answer:with high-fat meals.•Question 751 out of 1 pointsA patient with chronic heart failure has begun treatment with epoetin alfa, whichshe will receive in her own home from a home health nurse. The nurse should teachthe patient to supplement this treatment with a diet that is high inSelected Answer: iron-rich foods such as beans and leafy green vegetables.•Question 761 out of 1 pointsPage 26 of 37
A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administeredPage 27 of 37
intravenously. The APRN will be sure toSelected Answer:avoid the small veins in the dorsum of the hand or the wrist.•Question 771 out of 1 pointsA 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?Selected Answer:By inhibiting platelet aggregation on vessel walls and promoting fibrinolysis•Question 782 out of 1 points A nurse practitioner has been assigned to a 55-year-old woman who has a malignant brain tumor. The patient is receiving her first dose of carmustine. It will be critical for the nurse to observe for which of the following?Selected Answer:Respiratory difficulty•Question 791 out of 1 pointsA patient reports to a clinic with complaints of breast tenderness, a right lumpy breast, and no breast discharge. The breast tenderness occurs primarily during her menstrual cycle. The nurse practitioner probably suspectsSelected Answer: PMS.•Question 80Page 28 of 37
1 out of 1 pointsPage 29 of 37
A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose?Selected Answer: 2000 mg•Question 811 out of 1 points A Nurse Practitioner has completed a medication reconciliation of a patient who has been admitted following a motor vehicle accident. Among the many drugs that the patient has received in the previous year is rituximab. The nurse would be justified in suspecting the patient may have received treatment for which of the following diseases?Selected Answer:Non-Hodgkin’s lymphoma•Question 821 out of 1 pointsA male patient is experiencing climacteric symptoms secondary to androgen deficiency. His physician has prescribed testosterone. The nursing assessment reveals that the patient has had a myocardial infarction. The combination of testosterone therapy and a history of myocardial infarction would place that patient at a significantly higher risk ofSelected Answer: hypercholesterolemia.•Question 831 out of 1 pointsAn immunocompromised 7-year-old child was recently discharged home with a peripherally-inserted central line (PIC line) for home antibiotic therapy. He has now been brought to the emergency department by his mother and father with signs and symptoms of line sepsis. Upon questioning, the mother states that she has been removing the PIC dressing daily and washing the site with warm water and a cloth. What nursing diagnosis is most appropriate in this situation?Selected Answer: Ineffective Family Therapeutic Regimen Management•Question 84Page 30 of 37
1 out of 1 pointsPage 31 of 37
A child is admitted to the burn unit with second and third degree burns on both arms and part of his or her face. When administering topical medications to the burned areas, the nurse shouldSelected Answer: use sterile technique when applying the medication.•Question 851 out of 1 pointsA 2-year-old child is diagnosed with a minor ailment and is to be administered medications at home for 2 weeks. The child lives with his mother, grandmother, andfour other children between the ages of 14 months and 7 years. The home health nurse is asked to assess the home environment to determine if it is appropriate for the child to take his medication at home. Which of the following will have the greatest impact on the nurse’s assessment?Selected Answer: Where the medications will be stored•Question 861 out of 1 pointsA 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?Selected Answer:The importance of vigilant hygiene for the boy and the other members of the family•Question 871 out of 1 points A Nurse Practitioner is obtaining baseline physical data from a 7-year-old patient who isto be started on dextroamphetamine for ADHD. After obtaining vital signs, height,and weight, the nurse will prepare the patient for anSelected Answer:electrocardiogram (ECG).Page 32 of 37
•Question 88Page 33 of 37
1 out of 1 pointsMr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his current wound care regimen involves the daily application of silver sulfadiazine to his wounds. The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering this medication?Selected Answer: Cleanse the wound of debris prior to applying the silver sulfadiazine•Question 891 out of 1 pointsA patient has been admitted to the critical care unit of the hospital with bacterial septicemia that has failed to respond to initial antibiotic treatment. The patient’s most recent blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the patient’s blood. The nurse will anticipate that this patient will likely require intravenous administration of what antibiotic?Selected Answer: Vancomycin•Question 901 out of 1 pointsA patient with non-Hodgkin’s lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient’s care, what nursing diagnosis should the nurse prioritize?Selected Answer: Risk for Infection related to suppressed bone marrow function•Question 911 out of 1 points A Nurse Practitioner is working with a 57-year-old man who is a former intravenous drugabuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient?Selected Answer:Avoid high-fat foodsPage 34 of 37
•Question 922 out of 1 pointsMr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeksago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse’s response to Mr. Lepp?Selected Answer:The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients.•Question 931 out of 1 pointsA 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?Selected Answer: The patient has unstable angina and uses a nitroglycerin patch•Question 941 out of 1 pointsA man has a demonstrated history of androgen deficiency and the consequences of this health problem include an inability to maintain an erection. Which of the following medications would best address this patient’s erectile dysfunction (ED)?Selected Answer: Exogenous testosterone•Question 951 out of 1 points 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 isSelected Answer:whether the pregnant woman uses illegal substances.Page 35 of 37
•Question 961 out of 1 points A Nurse Practitioner is aware that the concept of selective toxicity is foundational to antimicrobial therapy. Which of the following statements most accurately describes selective toxicity?Selected Answer:A drug harms microbes without harming human cells.•Question 971 out of 1 pointsA 20-year-old woman has been prescribed estrogen. As with all women taking estrogen, the nurse will carefully monitor the patient for which of the following?Selected Answer: Cardiovascular complications•Question 981 out of 1 pointsA 13-year-old female took a weight loss drug that activated the sympathetic nervous system. Which of the following assessment findings would the nurse expect?Selected Answer: Increased cardiac conduction•Question 991 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 habitsPage 36 of 37
•Question 1001 out of 1 pointsWhich of the following patients will be at the greatest risk for anemia and would be the most likely candidate for epoetin alfa therapy?Selected Answer: A 62-year-old male with cancerPage 37 of 37
A nurse is caring for an infant after a surgical procedure. After ensuring that the ordered dose is appropriate for the infant’s age and weight, the nurse administers a narcotic analgesic intravenously. When assessing the infant 15 minutes later, the nurse notes respirations of 22 breaths/minute and a heart rate of 110 beats/minute. The infant is asleep in the parent’s arms and does not awaken when vital signs are assessed. The nurse understands that these findings are the result of:
immaturity of the blood-brain barrier in the infant.
500 mg/5 mL to 375 mg PO twice daily
“Infants are more susceptible to central nervous system effects than are adults.”
Applying an antihistamine to the skin can cause toxicity in this age group.
order a dose that is lower than an adult dose.
Chronic steroid use can inhibit growth.
“You will need to take an oral antipsychotic drug for 3 weeks.”
“If the ANC is less than 3000, the drug will be discontinued permanently.”
Teach the patient about drug side effects and how to manage them.
“Dry mouth and constipation are uncommon with this medication.”
try a second-generation antipsychotic (SGA).
What are negative symptoms of schizophrenia? Select all that apply.
Poor judgment
Poor self-care
Poverty of speech
“Because this may be an exacerbation of psychosis, the provider may increase the dose of the FGA.”
Giving an anticholinergic medication
A patient with schizophrenia has been taking an oral FGA for 1 week. The patient has been taking the drug daily in two divided doses. The individual complains of daytime drowsiness. The patient’s family reports a decrease in the person’s hostility and anxiety but states that the patient remains antisocial with disordered thinking. What will the nurse tell the patient and the family?
Some symptoms take months to improve.
A patient with schizophrenia has been taking an antipsychotic drug for several days. The nurse enters the patient’s room to administer a dose of haloperidol [Haldol] and finds the patient having facial spasms. The patient’s head is thrust back, and the patient is unable to speak. What will the nurse do?
Request an order to give diphenhydramine.
Agranulocytosis
Anticholinergic effects
Metabolism by CYP3A4
Dantrolene
Intravenous fluids
Withdrawal of haloperidol
A patient who has diabetes mellitus is diagnosed with schizophrenia and the provider orders thioridazine. The patient asks the nurse why the provider has not ordered olanzapine [Zyprexa], which the patient has seen advertised on television. Which response by the nurse is the most important reason that this patient is not receiving olanzapine?
“Olanzapine causes more metabolic side effects than thioridazine.”
stop taking the MAOI 2 weeks before starting the SSRI.
A young adult patient has been taking an antidepressant medication for several weeks and reports having increased thoughts of suicide. The nurse questions further and learns that the patient has attempted suicide more than once in the past. The patient identifies a concrete plan for committing suicide. The nurse will contact the provider to discuss:
hospitalizing the patient for closer monitoring.
divide the daily dose into two equal doses 12 hours apart.
Discuss these symptoms with a dentist.
irritability, tremor, and respiratory distress.
Cardiac monitoring
Cholinesterase inhibitors
Gastric lavage and activated charcoal
using nondrug therapies to augment the medication.
Which patients are candidates for MAOIs? Select all that apply.
A patient whose spouse has died recently reports feeling down most of every day for the past 2 months. On further questioning, the nurse learns that the patient has quit participating in church and social activities, has difficulty falling asleep, and has lost 5 pounds. The patient reports feeling tired and confused all the time but does not have suicidal thoughts. What does the nurse suspect?
To list all foods eaten that day
“Don’t take the medication on Friday and Saturday.”
Psychotherapy
Regular sleep and exercise
Using a chart to monitor mood changes
A patient with bipolar disorder who is taking divalproex sodium [Valproate] has just been admitted to the hospital. During the admission assessment, the patient tells the nurse about recent suicidal ideation. The nurse observes several areas of bruising over soft tissue areas and notes a weight gain of 10 pounds since the last admission 1 year ago. What will the nurse do?
Contact the provider to report these findings.
“I’ve broken out in a rash on my chest and back.”
Reassure the patient that these effects occur early in treatment and will resolve over time.
Administration of levothyroxine
Administer the dose and tell the patient that the side effects are temporary.
A patient recently was diagnosed with bipolar disorder. The patient, who has a history of seasonal allergies, is an athlete who participates in track. The nurse is teaching the patient about lithium [Lithobid], which the prescriber has just ordered. Which statement by the patient indicates the need for further teaching?
“I can continue to use ibuprofen as needed for muscle pain.”
A patient with bipolar disorder is admitted to the hospital. The patient has been taking lithium [Lithobid] for several years and has not been evaluated by a provider for over a year. Besides obtaining a lithium level, the nurse caring for this patient will anticipate orders for which laboratory tests? Select all that apply.
Calcium level
Renal function tests
Thyroid function tests
“During manic episodes, many patients don’t see the benefit of prophylactic medications.”
A patient with bipolar disorder has frequent manic episodes alternating with depressive episodes. The prescriber orders risperidone [Risperdal] in addition to the lithium [Lithobid] that the patient is already taking. The patient asks the nurse why another drug is needed. The nurse will tell the patient that the risperidone is used to:
help control symptoms during manic episodes.
“Phenobarbital doses for seizures are nonsedating.”
A patient who travels frequently for business reports occasional instances of being unable to fall asleep. The patient tells the nurse that job demands require staying up late and then getting up early for meetings. The nurse expects that the provider will prescribe which medication for this patient?
the patient has a cross-dependence to the benzodiazepine.
A patient who has been using secobarbital for several months to treat insomnia tells the nurse that the prescriber has said the prescription will be changed to temazepam [Restoril] because it is safer. The patient asks why this agent is safer. The nurse is correct in telling the patient that temazepam:
potentiates endogenous gamma-aminobutyric acid (GABA) producing a finite CNS depression.
“When this drug is metabolized, the resulting compound has longer-lasting effects.”
Ask the patient about any alcohol consumption in conjunction with the benzodiazepine.
“Benzodiazepines affect the hippocampus and the cerebral cortex to cause anterograde amnesia.”
Ask the patient if the medication was stopped abruptly.
“I should stop taking the Ativan when I start taking the Buspar.”
Selective serotonin reuptake inhibitors
Generalized anxiety disorder (GAD)
Obsessive-compulsive disorder
Panic disorder
Social anxiety disorder
It helps the patient reduce anxiety about causing a fire.
A patient describes feelings of anxiety and fear when speaking in front of an audience and is having difficulty at work because of an inability to present information at meetings three or four times each year. The patient is reluctant to take long-term medications. The nurse will expect the provider to order which treatment?
Benzodiazepines have a rapid onset of action.
A child has been taking SD methylphenidate [Ritalin], 10 mg at 0800 and 1200 and 5 mg at 1600, for 2 months. The parents tell the nurse that the child sometimes misses the noon dose while at school. The child’s appetite is normal. The teacher has reported a slight improvement in hyperactivity and impulsivity. What will the nurse do?
Ask the prescriber whether this child could be given methylphenidate [Concerta].
Therapeutic effects may not be felt for 1 to 3 weeks after beginning therapy.
“This drug will make him less impulsive while he’s at school.”
A university student who is agitated and restless and has tremors is brought to the emergency department. The patient’s heart rate is 110 beats/minute, the respiratory rate is 18 breaths/minute, and the blood pressure is 160/95 mm Hg. The patient reports using concentrated energy drinks to stay awake during finals. This patient is at risk of having:
234. A nurse is providing education to a group of patients regarding amphetamines. To evaluate the group’s understanding, the nurse asks a participant what effects amphetamines would have on her. The participant shows that she understands the effects of these drugs if she gives which answers? Select all that apply.
“It will not interfere with my normal sleep.”
“The tablet needs to be swallowed whole, not crushed or chewed.”
“Avoid consuming alcohol while taking this medication.”
Hyperactivity
Inattention
Impulsivity
A patient has been receiving heparin while in the hospital to treat deep vein thromboses and will be discharged home with a prescription for enoxaparin [Lovenox]. The nurse provides teaching for the nursing student who asks about the advantages of enoxaparin over heparin. Which statement by the student indicates a need for further teaching?
“Enoxaparin is more cost-effective than heparin.”
A patient is receiving heparin postoperatively to prevent deep vein thrombosis. The nurse notes that the patient has a blood pressure of 90/50 mm Hg and a heart rate of 98 beats/minute. The patient’s most recent aPTT is greater than 90 seconds. The patient reports lumbar pain. The nurse will request an order for:
“The onset of warfarin is delayed.”
phytonadione (vitamin K1) 1 mg IV over 1 hour.
give alteplase [Activase] within 2 hours.
A patient who takes warfarin for atrial fibrillation undergoes hip replacement surgery. On the second postoperative day, the nurse assesses the patient and notes an oxygen saturation of 83%, pleuritic chest pain, shortness of breath, and hemoptysis. The nurse will contact the provider to report possible and request an order for
administer the dose as ordered.
notify the provider to discuss changing the patient’s antibiotic.
continue taking the clopidogrel until talking to the provider.
“I will stop taking the warfarin and will start taking the dabigatran when my INR is less than 2.”
There is most likely no protective benefit for patients her age.
A patient who takes warfarin [Coumadin] is brought to the emergency department after accidentally taking too much warfarin. The patient’s heart rate is 78 beats/minute and the blood pressure is 120/80 mm Hg. A dipstick urinalysis is normal. The patient does not have any obvious hematoma or petechiae and does not complain of pain. The nurse will anticipate an order for:
discontinue the heparin and notify the provider.
It is important not to crush, chew, or open capsules of dabigatran.
Aspirin, heparin, abciximab [ReoPro]
increase the dose of warfarin.
mask the signs of vitamin B12 deficiency.
A nurse is caring for a patient after hip replacement surgery. The patient has been receiving iron
replacement therapy for 2 days. The nurse notes that the patient’s stools appear black. The patient is pale and complains of feeling tired. The patient’s heart rate is 98 beats/minute, respirations are 20 breaths/minute, and the blood pressure is 100/50 mm Hg. The nurse will contact the provider to:
request a hemoglobin and hematocrit (H&H).
Administer the drug intravenously with erythropoietin.
400 to 800 mg of folic acid per day
determining the cause of the anemia.
Blood loss of 750 mL/week
Celiac disease with anemia
Intestinal disease impairing absorption
Whether the prescription needs to be refilled
The patient with which of the following is most at risk for folic acid deficiency?
IM cyanocobalamin and folic acid
oral deferasirox [Exjade]Giving parenteral deferoxamine [Desferal]
A postmenopausal patient who has had a hysterectomy and who has a family history of coronary heart disease reports experiencing vaginal dryness and pain with intercourse but tells the nurse that she does not want to take hormones because she is afraid of adverse effects. The nurse will suggest that the woman ask her provider about:
transdermal preparations have fewer side effects.
A patient who will begin combination estrogen/progestin therapy (EPT) for menopause asks the nurse why she cannot take an estrogen-only preparation. The patient has not had a hysterectomy, has a slightly increased risk of cardiovascular disease, and has mild osteopenia. The nurse will tell her that the progestin is necessary to:
decrease her risk of endometrial cancer
“I should take the lowest effective dose for the shortest time needed.”
“When hormone therapy is discontinued, bone mass is quickly lost.”
“Principal benefits of ET are suppression of menopausal symptoms and prevention of bone loss.”
Vasomotor symptoms are a common side effect of this drug.
The patient should discuss an alternative method of birth control prior to surgery.
clean the ring with warm water, reinsert it, and use condoms for 7 days.
DMPA (Depo-Provera) and condoms
An 18-year-old woman with multiple sexual partners.
“I will need to use backup contraception if I miss a pill.”
within 7 weeks of conception.”
reassure the patient that this is normal with this form of contraception.
Change products at the beginning of her next cycle.
increased transmission of the human immunodeficiency virus (HIV).
The patient should request an OC containing less estrogen
take a pill now, continue the pack, skip the placebo pills, and start a new pack on week 4.
She should discard the inert pills and start a new pack during the honeymoon.
Schedule an appointment for her to receive the injection in 3 weeks.
Discuss an oral contraceptive with increased estrogen.
the day the last pill is taken and use backup contraception for 7 days
“Use another form of contraception for the next month.”
“I should not let my child touch the gel to prevent behavioral problems.”
Injections are given every 2 to 4 weeks for 3 to 4 years.
When testicular enlargement occurs
A 14-year-old male patient has not begun puberty. His parents tell the nurse that their son does not want to go to school, because he gets teased. The nurse learns that the boy’s father did not begin puberty until age 16 years. Laboratory tests on this child do not reveal true hypogonadism. What will the nurse tell these parents when they ask what can be done for their son?
“A limited course of androgen therapy may be prescribed, but it is not necessary.”
“I should apply the medication to my genitals for best results.”
“Testosterone treats anemia by stimulating the synthesis of a renal hormone.”
“My libido may improve while I am taking this medication.”
A 14-year-old male patient who plays football is admitted to the hospital. The nurse notes that the patient has short stature for his age according to a standard growth chart. The patient is muscular, has a deep voice, and needs to shave. The nurse notifies the provider of these findings. Which test will the nurse expect the provider to order?
Liver function tests and serum cholesterol
Transurethral administration has fewer side effects.
Snoring now wakens the patient’s wife
Nitro-tab 0.4 mg sublingual PRN
Which finding would indicate that terazosin has been effective for a patient with BPH?
“I will take the pill 30 minutes before sex.”
“Even normal flora can develop resistance and transfer this to pathogens.”
order empiric antibiotics while waiting for sputum culture results.
Obtaining all cultures before the antibiotic is administered
Increased adherence to prescribed antibiotics
Spontaneous mutation leads to resistance to only one antimicrobial agent.
“Your child should come to the clinic to have a throat culture done today.”
“Some agents cause phagocytosis of bacterial cells.”
Request an order for a skin test to assess the current risk.
Make sure to administer the drugs at different times using different IV tubing.
amoxicillin-clavulanic acid [Augmentin].
Request an order for serum electrolytes and cardiac monitoring.
Give the penicillin at 0800, 1600, and 2400; give the gentamicin [Garamycin] at 1800 and 0600.
disrupt bacterial cell wall synthesis.
Question the need for a penicillinase-resistant penicillin.
Ampicillin is not as acid stable as amoxicillin.
“The bacteria have synthesized penicillinase.”
Contact the provider and prepare to administer epinephrine.
A patient with an infection caused by Pseudomonas aeruginosa is being treated with
piperacillin. The nurse providing care reviews the patient’s laboratory reports and notes that the patient’s blood urea nitrogen and serum creatinine levels are elevated. The nurse will contact the provider to discuss:
reducing the dose of piperacillin.
Contact the provider to discuss changing the drug to benzathine penicillin G.
“MRSA bacteria have developed PBPs with a low affinity for penicillins.”
A patient with second-degree burns is treated with silver sulfadiazine [Silvadene]. A nursing student asks the nurse about the differences between silver sulfadiazine and mafenide [Sulfamylon], because the two are similar products, and both contain sulfonamides. What does the nurse tell the student about silver sulfadiazine?
It has antibacterial effects related to release of free silver.
“I should stop taking this drug when my symptoms are gone.”
drink 8 to 10 glasses of water every day.
monitor the patient’s coagulation levels.
A patient with bronchitis is taking TMP/SMZ, 160/800 mg orally, twice daily. Before administering the third dose, the nurse notes that the patient has a widespread rash, a temperature of 103° F, and a heart rate of 100 beats/minute. The patient looks ill and reports not feeling well. What will the nurse do?
Withhold the dose and notify the provider of the symptoms.
The patient should check the blood glucose level more often while taking TMP/SMZ.
A patient who is taking immunosuppressant medications develops a urinary tract infection. The causative organism is sensitive to sulfonamides and to another, more expensive antibiotic. The prescriber orders the more expensive antibiotic. The nursing student assigned to this patient asks the nurse why the more expensive antibiotic is being used. Which response by the nurse is correct?
“Sulfonamides are bacteriostatic and depend on host immunity to work.”
“Resistance to sulfonamides is less common than resistance totrimethoprim”
Contact the provider to request a different antibiotic for this patient.
begin antibiotic therapy after urine culture and sensitivity results are available.
“You will need to take a low dose of medication for 6 months to prevent infections.”
begin a 2-week course of antibiotics.
A young, nonpregnant female patient with a history of a previous urinary tract infection is experiencing dysuria, urinary urgency and frequency, and suprapubic pain of 3 days’ duration. She is afebrile. A urine culture is positive for more than 100,000/mL of urine. The nurse caring for this patient knows that which treatment is most effective?
A 3-day course of trimethoprim/sulfamethoxazole [Bactrim]
Elevated blood urea nitrogen and creatinine
The parent of a 5-year-old child who has had four urinary tract infections in the past year asks the nurse why the provider doesn’t just order an antibiotic for the child’s current symptoms of low-grade fever, flank pain, and dysuria since these are similar symptoms as before. Which is the most important reason given by the nurse?
“Your child may need tests to assess for urinary tract abnormalities.”
An older adult man with a low-grade fever, flank pain, and an indwelling catheter
Uncomplicated lower urinary tract infection treatable with short-course therapy
A patient presents to the emergency department with complaints of chills, severe flank pain, dysuria, and urinary frequency. The patient has a temperature of 102.9° F, a pulse of 92 beats/minute, respirations of 24 breaths/minute, and a blood pressure of 119/58 mm Hg. The nurse would be correct to suspect that the patient shows signs and symptoms of:
“This agent is not effective against infections of the upper urinary tract.”
take the calcium either 6 hours before or 2 hours after taking the ciprofloxacin
A 65-year-old patient who receives glucocorticoids for arthritis is admitted to the hospital for treatment of a urinary tract infection. The prescriber has ordered intravenous ciprofloxacin [Cipro]. Before administering the third dose of this drug, the nurse reviews the bacterial culture report and notes that the causative organism is Escherichia coli. The bacterial sensitivity report is pending. The patient complains of right ankle pain. What will the nurse do?
Withhold the dose of ciprofloxacin and notify the provider of the patient’ssymptoms.
recent serum electrolyte levels.
“I should take this medication with food or milk to improve absorption.”
Suggest that the provider order a different antibiotic for this patient.
A patient is being treated for a systemic fungal infection with amphotericin B [Abelcet] and will be discharged home from the hospital to complete every-other-day infusions of the medication for 6 to 8 weeks. The nurse provides discharge teaching before dismissal. Which statement by the patient indicates a need for further teaching?
“I may experience headaches and pain in my lower back, legs, and abdomen.”
“Your child will need to take this oral medication for 6 to 8 weeks.”
Acetaminophen [Tylenol], diphenhydramine [Benadryl], and meperidine [Demerol]
Request an order for a different antifungal medication.
lowers the dose of amphotericin B and reduces toxicity.
Using a different antifungal agent
“Infusions of amphotericin B should be administered over 1 to 2 hours.”
“Use the medication for at least 1 week after the symptoms have cleared”
This is caused by a reversible effect on estradiol synthesis.
Reassure the patient that these effects will subside in about 30 minutes.
Discuss a 400-mg twice-daily drug regimen with the provider.
Administer the omeprazole at least 2 hours after the ketoconazole.
A nurse is caring for a patient who is receiving amphotericin B [Abelcet] for a systemic fungal infection. In spite of receiving diphenhydramine and acetaminophen before initiation of treatment, the patient has fever and chills with rigors. The nurse will contact the provider to discuss the addition of which drug?
Administer the drug as ordered.
Nausea, vomiting, and anorexia
Which superficial mycosis is generally treated with oral antifungalagents?
A nursing student asks a nurse about flucytosine [Ancobon]. Which statement by the nurse is correct?
“Resistance is common with this medication”
“Azoles have lower toxicity than amphotericin B.”
A patient with HIV and mucocutaneous HSV is being treated with foscarnet after failing treatment with acyclovir. After 2 weeks, the patient’s dose is increased to 90 mg/kg over 2 hours from 40 mg/kg over 1 hour. The patient reports numbness in the extremities and perioral tingling. What will the nurse do?
Notify the provider and request an order for a serum calcium level
“I should receive the vaccine every year in October or November.”
no medication therapy at this time.
give intravenous foscarnet every 8 hours for 2 to 3weeks.
is administered less frequently than interferon.
may not be effective because of the delay in starting treatment
oral acyclovir [Zovirax] may be used during pregnancy.
“The implant will remain in place permanently.”
“Entecavir can reverse fibrosis and cirrhosis of the liver when taken long term.”
hydrate the patient during the infusion and for 2 hours after the infusion.
The drug may cause serious adverse effects in immunocompromised patients.
Boceprevir is contraindicated in males whose partners are pregnant.
she will need a monthly pregnancy test during her treatment.
an indefinite, prolonged period of time.
Male partners should always be treated, even if they are asymptomatic
“Your baby will need to be treated with oral erythromycin.”
“Women with asymptomatic C. trachomatis infections can become sterile.”
Doxycycline [Vibramycin], 100 mg IV twice daily, and cefoxitin, 2 g IV every 6 hours in the hospital
Ceftriaxone [Rocephin], 250 mg IM once, and azithromycin [Zithromax], 1 g PO once