Download NUR 2407 PHARMACOLOGY FINAL EXAM NEWEST 2024 ALL 100 QUESTIONS AND CORRECT ANSWERS (VERIF and more Exams Nursing in PDF only on Docsity!
NUR 2407 PHARMACOLOGY FINAL EXAM NEWEST 2024 ALL
100 QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+
1. The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were **_just admitted. Which patient should the nurse assess first?
- a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin
- A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and_** are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation ofinsulin should the nurse prepare to administer? - d. Lispro (Humalog) 3. A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing schedule for her. What is the recommended monitoring schedule? - c. Six or seven times a day 4. An adolescent patient recently attended a health fair and had a serum glucose test. The patient telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?" What is the nurse's most accurate response? - a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes." 5. Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the nurse administer this drug? - c. Once daily at bedtime 6. A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned? - d. The beta blocker can mask the symptoms of hypoglycemia.
7. Which statement is correct about the contrast between acarbose and miglitol?- a. Miglitol hasnot been associated with hepatic dysfunction. 8. A nurse counsels a patient with diabetes who is starting therapy with an alpha glucosidase inhibitor. The patient should be educated about the potential for which adverse reactions?(Select all that apply.) b. Flatulence e. Diarrhea 9. The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells the nurse she does not want to take medications while she is pregnant. What will the nurse explain to this patient? - b. Neuropsychologic deficits in the fetus can occur if the condition is not treated. 10. A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine (Synthroid). Which statement by the patient indicates a need for further teaching?- d. "If I take calcium supplements, I may need to decrease my dose of Synthroid." 11. A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse assesses the patient at the beginning of the shift and notes a heart rate of 62 beats per minuteand a temperature of 97.2° F. The patient is lethargic and difficult to arouse. The nurse will contact the provider to request an order for which drug?- c. Intravenous levothyroxine 12. A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The nurse learns that the patient also takes warfarin (Coumadin). The nurse will notify the provider to discuss the dose. b. reducing; warfarin 13. An older adult patient is diagnosed with hypothyroidism. The initial free T4 level is 0. mg/dL, and the TSH level is 8 microunits/mL. The prescriber orders levothyroxine (Levothroid) 100 mcg/day PO. What will the nurse do?- d. Suggest that the provider lower the dose. 14. A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine (Synthroid). The child comes to the clinic for a well-child check up. The nurse will expect the provider to:- a. change the dose of levothyroxine to 6 mcg/kg/day. 15. A patient who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of pain and irritation at the infusion site. The nurse observes signs of redness at the IV insertion site and along the vein. What is the nurse's priority action?- c. Select an alternate intravenous site and administer the infusion more slowly.
25. A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding thatpenicillins:- b. disrupt bacterial cell wall synthesis. 26. A patient is about to receive penicillin G for an infection that is highly sensitive to this drug. While obtaining the patient's medication history, the nurse learns that the patient experienceda rash when given amoxicillin (Amoxil) as a child 20 years earlier. What will the nurse do? - c. Request an order for a skin test to assess the current risk. 27. A patient with no known drug allergies is receiving amoxicillin (Amoxil) PO twice daily. Twenty minutes after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is 100/58 mm Hg. What will the nurse do? - a. Contact the provider and prepare to administer epinephrine. 28. 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 thatthe patient's blood urea nitrogen and serum creatinine levels are elevated. The nurse will contact the provider to discuss:- c. reducing the dose of piperacillin. 29. A patient recently began receiving clindamycin (Cleocin) to treat an infection. After 8 days of treatment, the patient reports having 10 to 15 watery stools per day. What will the nurse tell this patient?
- c. The patient should stop taking the clindamycin now and contact the provider immediately. 30. Which side effect of clindamycin (Cleocin) causes the most concern and may warrant discontinuation of the drug? - a. Diarrhea 31. A patient develops CDAD. Which antibiotic is recommended for treating this infection? - d. Vancomycin 32. A pregnant patient is treated with trimethoprim/sulfamethoxazole (TMP/SMZ) (Bactrim) for a urinary tract infection at 34 weeks' gestation. A week later, the woman delivers her infant prematurely. The nurse will expect to monitor the infant for: - d. scleral jaundice. 33. A patient who is taking immunosuppressants 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? - c. "Sulfonamides are bacteriostatic and depend on host immunity to work."
34. A nurse teaches a patient about sulfonamides. Which statement by the patient indicates a need for further teaching? - d. "I should stop taking this drug when my symptoms are gone." 35. A patient with type 2 diabetes mellitus takes glipizide. The patient develops a urinary tract infection, and the prescriber orders TMP/SMZ. What will the nurse tell the patient? - c. The patient should check the blood glucose level more often while taking TMP/SMZ. 36. A nurse is obtaining a drug history from a patient about to receive sulfadiazine. The nurse learns that the patient takes warfarin, glipizide, and a thiazide diuretic. Based on this assessment, the nurse will expect the provider to: - d. monitor the patient's coagulation levels. 37. A patient will be discharged from the hospital with a prescription for TMP/SMZ (Bactrim). When providing teaching for this patient, the nurse will tell the patient that it will be important to: - a. drink 8 to 10 glasses of water each day. 38. A nurse is discussing microbial resistance among sulfonamides and trimethoprim with a nursing student. Which statement by the student indicates a need for further teaching? - d. "Resistance to sulfonamides is less than resistance to trimethoprim." 39. A patient with bronchitis is taking TMP/SMZ, 106/80 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 per minute. The patient looks ill andreports not feeling well. What will the nurse do? - c. Withhold the dose and notify the provider of the symptoms. 40. A patient with histoplasmosis is being treated with itraconazole (Sporanox). The nurse will teach this patient to report which symptoms? - c. Nausea, vomiting, and anorexia 41. A patient who is pregnant has a history of recurrent genital herpesvirus (HSV). The patient asks the nurse what will be done to suppress an outbreak when she is near term. The nurse will tell the patient that: - c. oral acyclovir (Zovirax) may be used during pregnancy. 42. The nurse is caring for a patient receiving intravenous acyclovir (Zovirax). To prevent nephrotoxicity associated with intravenous acyclovir, the nurse will: - a. hydrate the patientduring the infusion and for 2 hours after the infusion. 43. A nurse is performing a preoperative drug history on a patient who is admitted to the hospitalfor surgery. To evaluate the risk of hemorrhage, the nurse will ask the patient about antiplatelet and anticoagulant medications as well as which dietary supplement?
54. A pregnant patient asks the nurse about the safe use of medications during the third trimester. What will the nurse tell her about drugs taken at this stage? - a. They may need to be given inhigher doses if they undergo renal clearance. 55. A breast-feeding patient must take a prescription medication for 2 weeks. The medication is safe, but the patient wants to make sure her baby receives as little of the drug as possible. What will the nurse tell the patient?- b. To take the medication immediately after breast- feeding 56. Which type of drug taken by a pregnant patient is more likely to have effects on a fetus? - c. Lipid-soluble drug 57. A nurse is concerned about renal function in an 84-year-old patient who is taking severalmedications. What should the nurse assess? - a. Creatinine clearance 58. Based on changes in hepatic function in older adult patients, which adjustment should the nurse expect for oral medications that undergo extensive first pass metabolism? b. The interval between doses should be increased. 59. A nurse is preparing to give medications to four geriatric patients who are all taking multiplemedications. Which patient is most likely to have an adverse drug reaction related to increased drug effects? - d. Thin patient with a chronically low appetite 60. A nurse is teaching a group of nursing students about administering medications to olderadult patients. Which statement by a student indicates a need for further teaching? - a. "Alteration in hepatic function requires more frequent drug dosing." 61. A thin older adult woman is admitted to the hospital after several days of vomiting, diarrhea,and poor intake of foods and fluids. She has not voided since admission. In preparing to carefor this patient, the nurse will look for what laboratory values to help guide medication administration? (Select all that apply.) - a. Creatinine clearance c. Plasma drug levels d. Serum albumin 62. A patient with a seizure disorder is admitted to the hospital and has a partial convulsive episode shortly after arriving on the unit. The patient has been taking phenytoin (Dilantin) 100 mg three times daily and oxcarbazepine (Trileptal) 300 mg twice daily for several years. The patient's phenytoin level is 8.6 mcg/mL, and the oxcarbazepine level is 22 mcg/mL. The nurse contacts the provider to report these levels and the seizure. What will the nurse expect the provider to order?
- c. An increased dose of phenytoin
63. A nurse counsels a patient who is to begin taking phenytoin (Dilantin) for epilepsy. Which statement by the patient indicates understanding of the teaching? - a. "I should brush and floss my teeth regularly." 64. A patient is to begin taking phenytoin (Dilantin) for seizures. The patient tells the nurse that she is taking oral contraceptives. What will the nurse tell the patient? - b. She should considera different form of birth control while taking phenytoin. 65. A nurse is completing a discharge plan for a 24-year-old patient who will begin taking phenytoin. Which information is important to teach this patient? - d. She should be sure to use an effective contraceptive method. 66. A patient who has had abdominal surgery has been receiving morphine sulfate via a patient- controlled analgesia (PCA) pump. The nurse assesses the patient and notes that the patient's pupils are dilated and that the patient is drowsy and lethargic. The patient's heart rate is 84 beats per minute, the respiratory rate is 10 breaths per minute, and the blood pressure is 90/50mm Hg. What will the nurse do? - d. Prepare to administer naloxone and possibly ventilatorysupport 67. A patient with cancer has been taking an opioid analgesic four times daily for several monthsand reports needing increased doses for pain. What will the nurse tell the patient? - c. The patient should discuss increasing the dose with the provider. 68. A woman in labor receives meperidine (Demerol) for pain. The nurse caring for the infantwill observe the infant closely for: - c. respiratory depression. 69. A postoperative patient has received an epidural infusion of morphine sulfate. The patient'srespiratory rate decreases to 8 breaths per minute, and he has a decreased level of consciousness and miosis. Which medication would the nurse anticipate administering?- a.Naloxone (Narcan) 70. A patient is brought to the emergency department by friends, who report finding the patient difficult to awaken. The friends report removing two fentanyl transdermal patches from the patient's arm. On admission to the emergency department, the patient has pinpoint pupils anda respiratory rate of 6 breaths per minute. A few minutes after administration of naloxone, therespiratory rate is 8 breaths per minute and the patient's pupils are dilated. The nurse recognizes these symptoms as signs of: - d. worsening hypoxia. 71. A nurse is administering morphine sulfate to a postoperative patient. Which are appropriateroutine nursing actions when giving this drug? (Select all that apply.) - a. Counting respirations before and after giving the medication b. Encouraging physical activity and offering increased fluids d. Palpating the patient's lower abdomen every 4 to 6 hours
81. An older adult patient with congestive heart failure develops crackles in both lungs and pitting edema of all extremities. The physician orders hydrochlorothiazide (HydroDIURIL). Before administering this medication, the nurse reviews the patient's chart. Which laboratory value causes the nurse the most concern? – a. Elevated creatinine clearance 82. A patient with chronic congestive heart failure has repeated hospitalizations in spite of ongoing treatment with hydrochlorothiazide (HydroDIURIL) and digoxin. The prescriber has ordered spironolactone (Aldactone) to be added to this patient's drug regimen, and the nurse provides education about this medication. Which statement by the patient indicates understanding of the teaching? - b. "I need to stop taking potassium supplements." 83. A patient begins taking an ACE inhibitor and complains of a dry cough. What does the nurse correctly tell the patient about this symptom? - c. It may be uncomfortable enough that the drug will need to be discontinued. 84. A patient with hypertension who has been taking captopril (Capoten) for several months is admitted to the hospital. The patient reports that food "tastes funny." What will the nurse do? - a. Compare the patient's admission weight to a previous weight. 85. A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB) medication. Which side effect of - c. Cough 86. A patient begins taking nifedipine (Procardia), along with a beta blocker, to treat hypertension. The nurse understands that the beta blocker is used to:- d. prevent reflextachycardia. 87. A nurse is teaching a patient who will begin taking verapamil (Calan) for hypertension aboutthe drug's side effects. Which statement by the patient indicates understanding of the teaching? - a. "I may become constipated, so I should increase fluids and fiber." 88. A nurse is preparing to assist a nursing student in administering intravenous verapamil to apatient who also receives a beta blocker. The nurse asks the nursing student to discuss the plan of care for this patient. Which statement by the student indicates a need for further teaching? - c. "I will monitor the heart rate frequently to assess for reflex tachycardia." 89. A patient who has been taking verapamil (Calan) for hypertension complains of constipation. The patient will begin taking amlodipine (Norvasc) to prevent this side effect. The nurse provides teaching about the difference between the two drugs. Which statement by the patient indicates that further teaching is needed? - c. "I will need to take a beta blocker to prevent reflex tachycardia."
90. A nurse prepares to administer a scheduled dose of digoxin. The nurse finds a new laboratoryreport showing a plasma digoxin level of 0.7 ng/mL. What action should the nurse take?- d. Check the patient's apical pulse, and if it is within a safe range, administer the digoxin. 91. A man asks a nurse why he cannot use digoxin (Lanoxin) for his heart failure, because both of his parents used it for HF. The nurse will explain that digoxin is not first-line therapy for which reason?- b. It does not correct the underlying pathology of heart failure. 92. A nurse is preparing to administer digoxin (Lanoxin) to a patient. The patient's heart rate is 62 beats per minute, and the blood pressure is 120/60 mm Hg. The last serum electrolyte value showed a potassium level of 5.2 mEq/L. What will the nurse do?- b. Give the dose of digoxinand notify the provider of the potassium level. 93. A patient with heart failure who has been given digoxin (Lanoxin) daily for a week complains of nausea. Before giving the next dose, the nurse will:
- a.assess the heart rate (HR) and give the dose if the HR is greater than 60 beats per minute. 94. A patient is taking a thiazide diuretic for hypertension and quinidine to treat a dysrhythmia.The prescriber orders digoxin 0.125 mg to improve this patient's cardiac output. The nurse should contact the provider to request: - c. discontinuing the quinidine. 95. A patient with heart failure who takes a thiazide diuretic and digoxin (Lanoxin) is admitted for shortness of breath. The patient's heart rate is 66 beats per minute, and the blood pressureis 130/88 mm Hg. The serum potassium level is 3.8 mEq/L, and the digoxin level is 0.8 ng/mL. The nurse admitting this patient understands that the patient: - c. is experiencing worsening of the disease. 96. A patient has been taking digoxin (Lanoxin) 0.25 mg, and furosemide (Lasix) 40 mg, daily. Upon routine assessment by the nurse, the patient states, "I see yellow halos around the lights." The nurse should perform which action based on this assessment?- a. Check the patient for other symptoms of digitalis toxicity. 97. A nurse is providing teaching for a patient with stable angina who will begin taking nitroglycerin. Which statement by the patient indicates understanding of the teaching?- c. "If I take nitroglycerin before exertion, I can reduce the chance of an anginal attack." 98. A patient asks a nurse how nitroglycerin works to relieve anginal pain. The nurse correctlystates, "Nitroglycerin:- d. promotes vasodilation, which reduces preload and oxygen demand." 99. A hospitalized patient complains of acute chest pain. The nurse administers a 0.3 mg sublingual nitroglycerin tablet, but the patient continues to complain of pain. Vital signs
109. A patient who is taking warfarin (Coumadin) has just vomited blood. The nurse notifies the provider, who orders lab work revealing a PT of 42 seconds and an INR of 3.5. The nurse will expect to administer:- a. phytonadione (vitamin K1) 1 mg IV over 1 hour. 110. A patient who has chronic adrenal insufficiency is admitted to the hospital for an open cholecystectomy. The nurse obtaining the admission history learns that the patient takes hydrocortisone 25 mg PO daily in the morning. The patient's surgery is scheduled for the next morning. The nurse will expect an order to:- c. administer hydrocortisone 75 mg IV before surgery. 111. A patient who has been newly diagnosed with adrenal hormone deficiency will begin taking hydrocortisone. The nurse provides teaching for this patient. Which statement by the patient indicates understanding of the teaching? - d. "When I am sick, I should take three times the normal dose for 3 days in a row." 112. The nurse is providing patient education about glucocorticoid therapy to a patient preparingto be discharged home. Which statement made by the patient best demonstrates understanding of glucocorticoid therapy? - b. "I may take two-thirds of the dose in the morning and one-third in the evening." 113. A 50-year-old postmenopausal patient who has had a hysterectomy has moderate to severe vasomotor symptoms and is discussing estrogen therapy (ET) with the nurse. The patient is concerned about adverse effects of ET. The nurse will tell her that: - d. transdermal preparations have fewer side effects. 114. A patient who is at risk for osteoporosis will begin taking the selective estrogen receptor modulator raloxifene (Evista). Which statement will the nurse include when teaching this patient about the medication?- d. Vasomotor symptoms are a common side effect of this drug. 115. A nurse provides teaching to a patient who has had a hysterectomy and is about to begin hormone therapy to manage menopausal symptoms. Which statement by the patient indicates understanding of the teaching? - c. "I should take the lowest effective dose for the shortest time needed." 116. A nurse provides teaching to a group of nursing students about the risks and benefits of hormone therapy (HT), including estrogen therapy (ET) and combination estrogen/progestintherapy (EPT). Which statement by a student indicates understanding of the teaching?
- d."Principle benefits of ET are suppression of menopausal symptoms and prevention of osteoporosis." 117. A patient who will begin combination estrogen/progestin therapy (EPT) for menopause asks the nurse why she can't 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:- a. decrease her risk of endometrial cancer.
118. The nurse is providing patient education for a postmenopausal patient who is considering estrogen/progestin replacement therapy (EPT). Which risks associated with EPT should the nurse discuss with the patient? (Select all that apply.)- b. Stroke c. Deep vein thrombosis d.Ovarian cancer 119. A nurse provides teaching for a female patient with anemia who has had cancer chemotherapy and who will begin treatment with testosterone. Which statement by the patient indicates understanding of the teaching? - d. "Testosterone treats anemia by stimulating the synthesis of a renal hormone." 120. A clinic nurse is assessing an adolescent male patient who has been receiving androgen therapy for hypogonadism via a transdermal patch. The patient's last clinic visit was 4 weeks earlier. Which part of the interval history is of most concern to the nurse?- a. Five pound weight gain 121. A nurse is providing education to a patient who is beginning therapy with testosterone gel. What statement made by the patient demonstrates a need for further teaching?- d. "I shouldapply the entire contents of the packet to my genitals." 122. A nurse is obtaining a history and reviewing the chart of an adult male patient who has been taking oral androgens. Which assessment would warrant notifying the provider?- d. Nausea,anorexia, and fatigue 123. A nurse is teaching a male adult patient about the use of testosterone gel. Which statement by the patient indicates an understanding of the teaching? - c. "I should not let my child touch the gel to prevent behavioral problems." 124. 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? - c. Liver function tests and serum cholesterol 125. A nurse is teaching a group of parents about the role of testosterone in puberty for boys. To evaluate the group's understanding, the nurse asks, "What physiologic effects related to testosterone can you expect to see in your sons?" Which responses indicate an understandingof the role of testosterone in male puberty? (Select all that apply.)- a. "It promotes skeletal muscle growth." b. "It increases height and weight." e. "It causes acne." 126. A male patient is being treated for benign prostatic hyperplasia (BPH) by another provider but cannot remember which drug he is taking. He comes to the clinic seeking treatment for erectile dysfunction and receives a prescription for sildenafil (Viagra). What will the nurse teach this patient? - d. "You should not take sildenafil if you are taking silodosin (Rapaflo)."
136. A patient is brought to the emergency department after ingesting a handful of diphenhydramine (Benadryl) tablets. The patient has dilated pupils, a flushed face, and tremors. The patient is agitated and has a heart rate of 110 beats per minute. The nurse mayanticipate administering which agents? (Select all that apply.)- a. Activated charcoal b. Cathartics d. Phenytoin 137. A patient who takes daily doses of aspirin is scheduled for surgery next week. The nurse should advise the patient to:- c. stop using aspirin immediately. 138. A patient who is taking acetaminophen for pain wants to know why it does not cause gastrointestinal upset, as do other over-the-counter pain medications. The nurse will explainthat this is most likely because of which property of acetaminophen?- b. It has minimal effects at peripheral sites. 139. A patient tells the nurse that she takes aspirin for menstrual cramps, but she does not feel thatit works well. What will the nurse suggest?
- c. The patient should use a first-generation nonsteroidal anti-inflammatory medicationinstead. 140. A patient who takes aspirin for rheumatoid arthritis is admitted to the hospital complaining ofheadache and ringing in the ears. The plasma salicylate level is 300 mcg/mL, and the urine pH is 6.0. What will the nurse do?- d. Withhold the aspirin until the patient's symptoms have subsided. 141. An adolescent is brought to the emergency department by a parent who reports that the patient took a whole bottle of extended-release acetaminophen tablets somewhere between 8 and 10 hours ago. The nurse will anticipate administering which of the following?- a. Acetylcysteine (Mucomyst) 142. An older male patient with an increased risk of MI is taking furosemide (Lasix) and low-dose aspirin. The patient is admitted to the hospital, and the nurse notes an initial blood pressure of140/80 mm Hg. The patient has had a 10-pound weight gain since a previous admission 3 months earlier. The patient has voided only a small amount of concentrated urine. The serum creatinine and blood urea nitrogen (BUN) levels are elevated. The nurse will contact the provider to discuss: - d. withdrawing the aspirin. 143. A pregnant patient in her third trimester asks the nurse whether she can take aspirin for headaches. Which response by the nurse is correct?- b. "Aspirin may cause premature closureof the ductus arteriosus in your baby."
144. A nurse is caring for a patient who has been taking low-dose aspirin for several days. The nurse notes that the patient has copious amounts of watery nasal secretions and an urticarialrash. The nurse will contact the provider to discuss: - a. administering epinephrine. 145. A nurse is teaching a nursing student who wants to know how aspirin and nonaspirin first-generation NSAIDs differ. Which statement by the student indicates a need for further teaching? c."Unlike aspirin, first-generation NSAIDs do not carry a risk of hypersensitivity reactions." 146. A nurse is providing teaching for an adult patient with arthritis who has been instructed to take ibuprofen (Motrin) for discomfort. Which statement by the patient indicates a need for further teaching?- a. "I may experience tinnitus with higher doses of this medication." 147. A patient who reports regular consumption of two or three alcoholic beverages per day asks about taking acetaminophen when needed for occasional, recurrent pain. What will the nursetell the patient? - a. "Do not take more than 2 gm of acetaminophen a day." 148. A nurse tells a nursing student that the glucocorticoids given for rheumatoid arthritis are nearly identical to substances produced naturally by the body. The student remarks that thedrug must be very safe. Which response by the nurse is correct?- c. "Side effects can occurand are dependent on the dose and duration of treatment." 149. A clinic patient who has been taking a glucocorticoid for arthritis for several months remarks to the nurse, "It's a good thing my symptoms are better, because my mother has been quite ill, and I have to take care of her." The patient's blood pressure is 100/60 mm Hg. The nurse willreport this to the provider and ask about: - c. increasing the patient's dose. 150. A patient who is a long-distance runner has been diagnosed with rheumatoid arthritis in both knees and will begin glucocorticoid therapy. When teaching the patient about the medication, the nurse will include what information? - b. "Glucocorticoids are used as adjunctive therapyduring acute flare-ups." 151. A patient is about to receive prednisone for tendonitis. The nurse reviewing the chart would be concerned about which of the following in the patient's medical history? - d. Systemic fungal infection 152. A patient taking high doses of a glucocorticoid develops weakness in the muscles of the upper arms and in the legs. What will the nurse do? - a. Contact the provider to ask aboutreducing the dose. 153. A patient taking a glucocorticoid for arthritis reports feeling bloated. The nurse notes edema of the patient's hands and feet. Which action by the nurse is correct?- a. Ask the patient about sodium intake.
163. A parent asks a nurse about growth suppression resulting from the use of an inhaled glucocorticoid in children. What will the nurse tell the parent? - a. Growth may be slowed, but eventual adult height will not be reduced. 164. A 7-year-old child with asthma uses a daily inhaled glucocorticoid and an albuterol MDI as needed. The provider has added montelukast (Singulair) to the child's regimen. Which statement by the child's parent indicates understanding of this medication? - a. "I may noticemood changes in my child." 165. A nurse is teaching a group of nursing students about the different formulations of beta2- adrenergic agonist medications. Which statement by a student indicates understanding of the teaching? - d. "Oral beta2 agonists are not useful for short-term treatment." 166. A patient who takes theophylline (Theochron) twice daily for chronic stable asthma develops an infection and will take ciprofloxacin. The nurse will contact the provider to discuss:- b. reducing the theophylline dose. 167. A child is receiving a combination albuterol/ipratropium (DuoNeb) inhalation treatment. Thepatient complains of a dry mouth and sore throat. What will the nurse do?- d. Reassure the patient that these are expected side effects. 168. A patient with persistent, frequent asthma exacerbations asks a nurse about a long- actingbeta2-agonist medication. What will the nurse tell this patient?- d. LABAs should be combined with an inhaled glucocorticoid. 169. What are the results of using glucocorticoid drugs to treat asthma? (Select all that apply.)- a.Reduced bronchial hyperreactivity b. Reduced edema of the airway d. Increased responsiveness to beta2-adrenergic agonists 170. A patient admitted to the hospital has a history of peptic ulcer disease. The patient takes ranitidine (Zantac) and sucralfate (Carafate). The patient tells the nurse that discomfort isusually controlled but that symptoms occasionally flare up. What will the nurse do? - b. Contact the provider to discuss serologic testing and an antibiotic. 171. When metronidazole (Flagyl) is a component of the H. pylori treatment regimen, the patient must be instructed to do what?- a. Avoid any alcoholic beverages 172. An older adult patient with severe gastroesophageal reflux disease (GERD) has had only minimal relief using a histamine2-receptor antagonist (H2RA). The patient is to begin taking
omeprazole (Prilosec). What will the nurse teach this patient?- c. Long-term therapy may be needed.
173. Patient stops taking a proton pump inhibitor (PPI) after 6 weeks of therapy for treatment of peptic ulcer disease. The patient reports symptoms of dyspepsia to the nurse. The nurse willtell this patient to: - d. try an antacid to see whether it relieves these symptoms. 174. A nursing student is caring for a patient who is taking sucralfate (Carafate) and ciprofloxacin (Cipro) to treat peptic ulcer disease. The student asks the nurse about the pharmacokinetics ofsucralfate. Which statement by the student indicates a need for further teaching? - d. "Sucralfate has a moderate acid-neutralizing capacity." 175. A prescriber has written an order for a medication: drug X 100 mg PO every 6 hours. The half-life for the drug is approximately 6 hours. The nurse is preparing to administer the first dose at 8:00 AM on Tuesday. On Wednesday, when will the serum drug level reach plateau?- b. 8:00 AM
