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Question 1
A nurse who works at an outpatient mental health clinic follows numerous clients who have schizophrenia, many of whom are being treated with olanzapine (Zyprexa). Which of the following clients likely has the highest susceptibility to the adverse effects of olanzapine? A. A client who is morbidly obese and who has a sedentary lifestyle B. A client who was recently treated with intravenous antibiotics because of cellulitis in his lower leg C. A client who has a body mass index of 16.5 (underweight) and who smokes one pack of cigarettes daily D. A client who has type 1 diabetes and who practices poor glycemic control 1 points Question 2 A nurse will be prepared to administer naloxone (Narcan) to a patient who has had an overdose of morphine. Repeated doses of Narcan will be necessary because Narcan A. has a shorter half-life than morphine. B. causes the respiratory rate to decrease. C. combined with morphine, increases the physiologic action of the morphine. D. has less strength in each dose than do individual doses of morphine. 1 points Question 3 A nurse is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the nurse should be aware that A. intravenous lidocaine may be preferable to topical application. B.
pain relief is unlikely to be achieved due to the destruction of nerve endings in the burn site. C. there is a risk of systemic absorption of the lidocaine through the patient's traumatized skin. D. lidocaine must be potentiated with another anesthetic in order to achieve pain control. 1 points Question 4 A patient has been hospitalized for treatment of substance abuse after being arrested and jailed for the past 24 hours. The patient is experiencing severe muscle and abdominal cramps, seizures, and acute psychosis due to abrupt withdrawal. Which of the following drug classes is the most likely cause of these severe and potentially fatal withdrawal symptoms? A. Amphetamines B. Opioids C. Benzodiazepines D. Sedative–hypnotic drugs 1 points Question 5 A nurse is caring for a patient who abuses marijuana. The treatment for marijuana abuse consists mainly of A. no nursing action unless the patient experiences a “bad trip.” B. drug therapy with bromocriptine (Parlodel). C. nonpharmacologic interventions combined with an exercise program. D. aggressive respiratory assistance 1 points Question 6 A nurse is caring for a patient who is in severe pain and is receiving an opioid analgesic. Which of the following would be the nurse's priority assessments? A.
nurse will inform him that excessive intake of acetaminophen may result in A. acute renal failure. B. cognitive deficits. C. liver damage. D. gastrointestinal distress. 1 points Question 10 A postsurgical patient has been provided with a morphine patient-controlled analgesic (PCA) but has expressed her reluctance to use it for fear of becoming addicted. How can the nurse best respond to this patient's concerns? A. “If you do become addicted, we'll make sure to provide you with the support and resources necessary to help you with your recovery.” B. “It is not uncommon to develop a dependence on pain medications, but this usually takes place over a long period and is not the same as addiction.” C. “It's important that you accept that your current need to control your pain is more important than fears of becoming addicted.” D. “You don't need to worry. It's actually not true that you can get addicted to the medications we use in a hospital setting.” 1 points Question 11 A 4-year-old child is brought to the emergency department by her mother. The mother reports that the child has been vomiting, and the nurse notes that the child's face is flushed and she is diaphoretic. The mother thinks that the child may have swallowed carbachol drops. A diagnosis of cholinergic poisoning is made. Which of the following drugs would be administered? A. Cevimeline B. Acetylcholine C.
Nicotine D. Atropine 1 points Question 12 A 59-year-old woman has presented to a clinic requesting a prescription for lorazepam (Ativan) in order to treat her recurrent anxiety. Her care provider, however, believes that a selective serotonin reuptake inhibitor (SSRI) would be more appropriate. What advantage do SSRIs have over benzodiazepines in the treatment of anxiety? A. SSRIs have a more rapid therapeutic effect. B. SSRIs do not require serial blood tests during therapy. C. SSRIs generally have fewer adverse effects. D. SSRIs require administration once per week, versus daily or twice daily with benzodiazepines. 1 points Question 13 A 62-year-old woman has been prescribed a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately A. 32 hours. B. 12 hou rs. C. 6 hours. D. 24 hours. 1 points Question 14 Which of the following drugs used to treat anxiety would be appropriate for a patient
Question 17 A patient is suffering from acute inhalant intoxication. The priority nursing intervention will be to A. provide an emesis basin. B. administer epinephrine. C. administer oxygen therapy. D. assess the patient's psychosocial status. 1 points Question 18 An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman's pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient's pain? A. Twice-daily doses of long-acting morphine, with short-acting morphine available for breakthrough pain B. A large long-acting dose of morphine at 8 a.m. with smaller doses at 12 p.m., 5 p.m., and 10 p.m. C. Scheduled doses of short-acting morphine q1h around the clock D. Alternating doses of long-acting morphine with short-acting morphine 1 points Question 19 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 avoid A. dairy products. B. fatty foods. C. vitamin C. D.
alcohol. 1 points Question 20 A patient who has been taking buspirone (BuSpar) for 1 week calls the clinic and reports to the nurse that the drug is not working. The patient informs the nurse that she is still having symptoms of anxiety. The nurse will tell the patient that A. she will report this to the physician immediately. B. optimum relief of anxiety usually occurs after 3 to 4 weeks of treatment. C. it may take up to 6 months for the drug to relieve her anxiety. D. the drug is not going to work for her and the medication needs to be changed. 1 points Question 21 A 26-year-old professional began using cocaine recreationally several months ago and has begun using the drug on a daily basis over the past few weeks. He has noticed that he now needs to take larger doses of cocaine in order to enjoy the same high that he used to experience when he first used the drug. A nurse should recognize that this pattern exemplifies A. withdrawal. B. drug tolerance. C. addiction. D. dependence. 1 points Question 22 A patient who is experiencing withdrawal from heavy alcohol use have developed psychosis and been treated with haloperidol. Which of the following assessment findings should prompt the care team to assess the patient for neuroleptic malignant syndrome? A. The patient develops muscle rigidity and a sudden, high fever. B. The patient demonstrates a significant increase in agitation after being given haloperidol.
C.
diabetic hyperlipidemia. D. seizure disorders. 1 points Question 26 A nurse is assigned to a patient who is taking lithium. Which of the following drug serum levels would indicate that the patient is at risk for adverse effects of the drug? A. 1.7 mEq/L B. 0.6 mEq/L C. 0.3 mEq/L D. 1.2 mEq/L 1 points Question 27 A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia. Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.) A. The drug should not be used for longer than 1 month. B. It is available in both quick-onset and continuous-release oral forms. C. One of the most common adverse effects of the drug is headache. D. The drug does not cause sleepiness in the morning. E. It should be taken 1 hour to 90 minutes before going to bed. 1 points Question 28 A patient has been prescribed lithium therapy. Which of the following signs and symptoms will the nurse tell the patient to report immediately? A. Increased urination
B.
Hair loss C. Increased thirst D. Muscle twitching 1 points Question 29 The wife of a patient who is taking haloperidol calls the clinic and reports that her husband has taken the first dose of the drug and it is not having a therapeutic effect. An appropriate response by the nurse would be A. “I'll ask the nurse practitioner if the haloperidol can be discontinued and another drug started.” B. “I'll report this to the nurse practitioner and see if he will add another drug to enhance the effects of the haloperidol.” C. “Continue the prescribed dose. It may take several days to work.” D. “I'll ask the nurse practitioner if the dosage can be increased.” 1 points Question 30 A middle-aged patient was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, his psychiatrist has prescribed phenelzine. When planning this patient's subsequent care, what nursing diagnosis should the nurse prioritize? A. Risk for Constipation related to decreased gastrointestinal peristalsis B. Risk for Injury related to drug–drug interactions or drug–nutrient interactions C. Risk for Ineffective Peripheral Tissue Perfusion related to cardiovascular effects of phenelzine D. Risk for Infection related to immunosuppressive effects of phenelzine Test Week 5 - Quiz Started 6/29/17 8:38 AM
The duration of the morphine may be longer than the duration of naloxone. Therefore, naloxone has a shorter half-life than morphine. Repeated doses may be necessary to maintain reversal of the opiate's effects. Naloxone does not increase the action of morphine, and it causes the respiratory rate to increase, not decrease. Dosage strength is not associated with drug duration. Question 3 1 out of 1 points A nurse is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the nurse should be aware that Response Feedback: Applying lidocaine preparations to severely traumatized mucosa (large skin abrasions, eczema, and burns) can increase its absorption, which in turn increases the risk of systemic toxicity. Intravenous lidocaine is not normally used for analgesia. The destruction of nerve endings in a burn site does not mitigate the need for topical pain control and lidocaine does not need to be potentiated with another anesthetic. Question 4 1 out of 1 points A patient has been hospitalized for treatment of substance abuse after being arrested and jailed for the past 24 hours. The patient is experiencing severe muscle and abdominal cramps, seizures, and acute psychosis due to abrupt withdrawal. Which of the following drug classes is the most likely cause of these severe and potentially fatal withdrawal symptoms? Response Feedback: Abrupt withdrawal from long-term use of sedative–hypnotic drugs should never be attempted because withdrawal symptoms are serious and potentially fatal. Withdrawal symptoms include agitation, dysphoria, insomnia, vomiting, diarrhea, ataxia, hallucinations, acute psychosis, muscle and abdominal cramps, anorexia, and seizures. These symptoms may occur 12 to 72 hours after the last use of the drug and may last up to 14 days. The abrupt withdrawal of benzodiazepines, opioids, and amphetamines does not cause such severe and potentially fatal withdrawal symptoms. Question 5 1 out of 1 points
A nurse is caring for a patient who abuses marijuana. The treatment for marijuana abuse consists mainly of Response Feedback: Treatment for marijuana abuse consists mainly of nonpharmacologic interventions combined with an exercise program to help deal with withdrawal symptoms and cravings for the drug. Treatment of LSD and PCP use is necessary only when the user experiences a “bad trip.” Parlodel is given for cocaine addiction. Patients with acute inhalant intoxication may need respirator assistance. Question 6 1 out of 1 points A nurse is caring for a patient who is in severe pain and is receiving an opioid analgesic. Which of the following would be the nurse's priority assessments? Response Feedback: The nurse must assess the patient's pain intensity before and after administering an opioid analgesic. The respiratory rate and level of consciousness need to be assessed because respiratory depression and sedation are two adverse effects of opioid analgesics. Seizure activity, electrolytes, liver function, blood glucose level, and mental status may need to be assessed during opioid analgesic therapy related to adverse effects, but they would not be the priority assessments. Question 7 1 out of 1 points A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by Response Feedback: Phenytoin reversibly binds to sodium channels while they are in the inactive state. This binding delays the return of the channel to an active state. Because sodium can enter the cell to initiate an action potential only when the channels are active, the time
nurse best respond to this patient's concerns? Response Feedback: Addiction to opioids is a rare occurrence among hospital patients who do not have a history of drug abuse. It would be inappropriate to downplay the patient's concerns, however. A more appropriate response would be to explain the phenomenon of dependence and to differentiate it from addiction. Question 11 1 out of 1 points A 4-year-old child is brought to the emergency department by her mother. The mother reports that the child has been vomiting, and the nurse notes that the child's face is flushed and she is diaphoretic. The mother thinks that the child may have swallowed carbachol drops. A diagnosis of cholinergic poisoning is made. Which of the following drugs would be administered? Response Feedback: Acetylcholine and cevimeline are both cholinergic agonists, and, like carbachol, would be contraindicated in this patient. Administration of either of these drugs could be fatal. Nicotine is a direct-acting nicotinic agonist and is not indicated in cholinergic poisoning. Atropine is considered the antidote for cholinergic poisoning. The actions of atropine are a reduction in salivary, bronchial, and sweat gland secretions; mydriasis; cycloplegia; changes in heart rate; contraction of the bladder detrusor muscle and of the gastrointestinal smooth muscle; decreased gastric secretion; and decreased gastrointestinal motility. Question 12 1 out of 1 points A 59-year-old woman has presented to a clinic requesting a prescription for lorazepam (Ativan) in order to treat her recurrent anxiety. Her care provider, however, believes that a selective serotonin reuptake inhibitor (SSRI) would be more appropriate. What advantage do SSRIs have over benzodiazepines in the treatment of anxiety? Response Feedback: SSRIs are generally well tolerated with few adverse effects. Unlike the benzodiazepines, they do not cause diminished alertness or ataxia. However, they take longer to have a
therapeutic effect. Neither class of drug necessitates serial blood testing. SSRIs are normally taken daily. Question 13 1 out of 1 points A 62-year-old woman has been prescribed a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately Response Feedback: The nurse will instruct the patient that it will take approximately 24 hours for the full pain-relieving effect of a fentanyl transdermal patch to occur. Question 14 1 out of 1 points Which of the following drugs used to treat anxiety would be appropriate for a patient who is a school teacher and is concerned about feeling sedated at work? Response Feedback: Buspirone does not cause as much sedation and functional impairment as lorazepam, alprazolam, and diazepam. However, it can cause dizziness, nausea, headache, nervousness, lightheadedness, or excitement. Question 15 1 out of 1 points A 20-year-old man has begun treatment of the psychotic symptoms of schizophrenia using olanzapine (Zyprexa). Which of the following symptoms would be categorized as a negative symptom of schizophrenia? Response Feedback: The negative symptoms of schizophrenia include flat or blunted emotions, lack of pleasure or interest in things (anhedonia), and limited speech. The positive symptoms
An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman's pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient's pain? Response Feedback: The use of long-acting analgesia combined with short-acting opioids for breakthrough pain is a proactive pain management technique that maximizes therapeutic benefit while minimizing the risks of adverse effects. Question 19 1 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 avoid Response Feedback: The nurse should advise the patient to avoid alcohol and any other CNS depressants while taking morphine. These combinations can cause serious respiratory depression and sedation. Vitamin C, fatty foods, and dairy products are not known to interact with morphine. Question 20 1 out of 1 points A patient who has been taking buspirone (BuSpar) for 1 week calls the clinic and reports to the nurse that the drug is not working. The patient informs the nurse that she is still having symptoms of anxiety. The nurse will tell the patient that Response Feedback: The nurse will inform the patient that it will likely take 3 to 4 weeks of treatment before she notices consistent relief of her anxiety. However, some improvement is often seen within 7 to 10 days of starting therapy. Since the patient had only been taking the drug 1 week, there is no need to inform the physician. The nurse would not make the assumption that the medication is not going to work for the patient nor would she tell her that it would take up to 6 months to see therapeutic results.
Question 21 1 out of 1 points A 26-year-old professional began using cocaine recreationally several months ago and has begun using the drug on a daily basis over the past few weeks. He has noticed that he now needs to take larger doses of cocaine in order to enjoy the same high that he used to experience when he first used the drug. A nurse should recognize that this pattern exemplifies Response Feedback: With drug use over time, tolerance develops. Tolerance occurs when the body develops a natural resistance to the drug's physical or euphoric effects, making it necessary to take increasing doses more frequently to achieve the desired effect. Question 22 1 out of 1 points A patient who is experiencing withdrawal from heavy alcohol use have developed psychosis and been treated with haloperidol. Which of the following assessment findings should prompt the care team to assess the patient for neuroleptic malignant syndrome? Response Feedback: Neuroleptic malignant syndrome is characterized by fever, sweating, tachycardia, muscle rigidity, tremor, incontinence, stupor, leukocytosis, elevated creatinine phosphokinase levels, and renal failure. Agitation, pruritis, thirst, and increased urine output are not indicative of neuroleptic malignant syndrome. Question 23 1 out of 1 points A 64-year-old-patient has been prescribed lorazepam (Ativan) because of increasing periods of anxiety. The nurse should be careful to assess for Response Feedback:
