Pharmacology exam 2 test bank with correct marking scheme, Exams of Nursing

Download Pharmacology exam 2 test bank with correct marking scheme and more Exams Nursing in PDF only on Docsity! Pharmacology exam 2 test bank with correct marking scheme When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics? A. Tetracyclines B. Sulfonamides C. Cephalosporins D. Quinolones - Correct Answer c The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which statement by the nurse is correct? A. "Avoid direct sunlight and tanning beds while on this medication." B. "Milk and cheese products result in increased levels of tetracycline." C. "Antacids taken with the medication help to reduce gastrointestinal distress." D. "Take the medication until you are feeling better." - Correct Answer A When reviewing the medication orders for a patient who is taking penicillin, the nurse notes that the patient is also taking the oral anticoagulant warfarin (Coumadin). What possible effect may occur as the result of an interaction between these drugs? A. The penicillin will cause an enhanced anticoagulant effect of the warfarin. B. The penicillin will cause the anticoagulant effect of the warfarin to decrease. C. The warfarin will reduce the anti-infective action of the penicillin. D. The warfarin will increase the effectiveness of the penicillin. - Correct Answer A A patient is receiving his third intravenous dose of a penicillin drug. He calls the nurse to report that he is feeling "anxious" and is having trouble breathing. What will the nurse do first? A. Notify the prescriber. B. Take the patient's vital signs. C. Stop the antibiotic infusion. D. Check for allergies. - Correct Answer C A patient is admitted with a fever of 102.8° F (39.3° C), origin unknown. Assessment reveals cloudy, foul-smelling urine that is dark amber in color. Orders have just been written to obtain stat urine and blood cultures and to administer an antibiotic intravenously. The nurse will complete these orders in which sequence? A. Blood culture, antibiotic dose, urine culture B. Urine culture, antibiotic dose, blood culture C. Antibiotic dose, blood and urine cultures D. Blood and urine cultures, antibiotic dose - Correct Answer D During drug therapy with a tetracycline antibiotic, a patient complains of some nausea and decreased appetite. Which statement is the nurse's best advice to the patient? A. "Take it with cheese and crackers or yogurt." B. "Take each dose with a glass of milk." C. "Take an antacid with each dose as needed." D. "Drink a full glass of water with each dose." - Correct Answer D The nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today the patient tells the nurse that he has had watery diarrhea since the day before and is having abdominal cramps. His oral temperature is 101° F (38.3° C). Based on these findings, which conclusion will the nurse draw? A. The patient's original infection has not responded to the antibiotic therapy. B. The patient is showing typical adverse effects of antibiotic therapy. C. The patient needs to be tested for Clostridium difficile infection. D. Swelling of the tongue E. Itching F. Black, hairy tongue - Correct Answer A, C, D, E The nurse is reviewing the medication history of a patient who will be taking a sulfonamide antibiotic. During sulfonamide therapy, a significant drug interaction may occur with which of these drugs or drug classes? (Select all that apply.) A. Opioids B. Oral contraceptives C. Sulfonylureas D. Antihistamines E. Phenytoin (Dilantin) F. Warfarin (Coumadin) - Correct Answer B, C, E, F When a patient is on aminoglycoside therapy, the nurse will monitor the patient for which indicators of potential toxicity? A. Fever B. White blood cell count of 8000 cells/mm3 C. Tinnitus and dizziness D. Decreased blood urea nitrogen (BUN) levels - Correct Answer C The nurse is administering a vancomycin (Vancian) infusion. Which measure is appropriate for the nurse to implement in order to reduce complications that may occur with this drug's administration? A. Monitoring blood pressure for hypertension during the infusion B. Discontinuing the drug immediately if red man syndrome occurs C. Restricting fluids during vancomycin therapy D. Infusing the drug over at least 1 hour - Correct Answer D Which nursing diagnosis is appropriate for a patient who has started aminoglycoside therapy? A. Constipation B. Risk for injury (renal damage) C. Disturbed body image related to gynecomastia D. Imbalanced nutrition, less than body requirements, related to nausea - Correct Answer B A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for therapy? A. Metronidazole (Flagel) B. Ciprofloxacin (Cipro) C. Vancomycin (Vancian) D. Tobramycin (Niacin) - Correct Answer C A patient is receiving aminoglycoside therapy and will be receiving a beta-lactam antibiotic as well. The patient asks why two antibiotics have been ordered. What is the nurse's best response? A. "The combined effect of both antibiotics is greater than each of them alone." B. "One antibiotic is not strong enough to fight the infection." C. "We have not yet isolated the bacteria, so the two antibiotics are given to cover a wide range of microorganisms." D. "We can give a reduced amount of each one if we give them together." - Correct Answer A The nurse is reviewing the medication orders for a patient who will be receiving gentamicin therapy. Which other medication or medication class, if ordered, would be a potential interaction concern? A. Calcium channel blockers B. Phenytoin C. Proton pump inhibitors D. Loop diuretics - Correct Answer D The nurse checks the patient's laboratory work prior to administering a dose of vancomycin (Vancian) and finds that the trough vancomycin level is 24 mcg/milk what will the nurse do next? A. Administer the vancomycin as ordered. B. Hold the drug, and administer 4 hours later. C. Hold the drug, and notify the prescriber. D. Repeat the test to verify results. - Correct Answer C A patient has been diagnosed with carbapenemase-resistant Enterobacteriaceae (CRE). The nurse expects to see orders for which drug? A. Dispone (Cubic in), a miscellaneous antibiotic B. Ciprofloxacin (Cipro), a quinolone C. Linezolid (Zibo), an oxazolidinone d. Colistimethate sodium (Coly-Mien), a polypeptide antibiotic - Correct Answer D A 79-year-old patient is receiving a quinolone as treatment for a complicated incision infection. The nurse will monitor for which adverse effect that is associated with these drugs? A. Neuralgia B. Double vision C. Hypotension D. Tendonitis and tendon rupture - Correct Answer D He nurse is administering intravenous vancomycin (Vancian) to a patient who has had gastrointestinal surgery. Which nursing measures are appropriate? (Select all that apply.) A. Monitoring serum creatinine levels B. Restricting fluids while the patient is on this medication Concurrent drug therapy with probenecid reduces the nephrotoxicity of the cidofovir. d. The probenecid reduces the adverse gastrointestinal effects of the cidofovir. - Correct Answer C A patient is taking a combination of antiviral drugs as treatment for early stages of a viral infection. While discussing the drug therapy, the patient asks the nurse if the drugs will kill the virus. When answering, the nurse keeps in mind which fact about antiviral drugs? a. They are given for palliative reasons only. b. They will be effective as long as the patient is not exposed to the virus again. c. They can be given in large enough doses to eradicate the virus without harming the body's healthy cells. d. They may also kill healthy cells while killing viruses. - Correct Answer D A young adult calls the clinic to ask for a prescription for "that new flu drug." He says he has had the flu for almost 4 days and just heard about a drug that can reduce the symptoms. What is the nurse's best response to his request? A. "Now that you've had the flu, you will need a booster vaccination, not the antiviral drug." B. "We will need to do a blood test to verify that you actually have the flu." C. "Drug therapy should be started within 2 days of symptom onset, not 4 days." D. "We'll get you a prescription. As long as you start treatment within the next 24 hours, the drug should be effective." - Correct Answer C The nurse is providing counseling to a woman who is HIV positive and has just discovered that she is pregnant. Which anti-HIV drug is given to HIV-infected pregnant women to prevent transmission of the virus to the infant? A. Acyclovir (Overtax) B. Zidovudine (Retroviral) C. Ribavirin (Mirasole) D. Foscarnet (Focsani) - Correct Answer B A patient who is diagnosed with genital herpes is taking topical acyclovir. The nurse will provide which teaching for this patient? (Select all that apply.) A. "Be sure to wash your hands thoroughly before and after applying this medicine." B. "Apply this ointment until the lesion stops hurting." C. "Use a clean glove when applying this ointment." D. "If your partner develops these lesions, then he can also use the medication." E. "You will need to avoid touching the area around your eyes." F. "You will have to practice abstinence when these lesions are active." - Correct Answer A, C, E, F A patient is in the HIV clinic for a follow-up appointment. He has been on antiretroviral therapy for HIV for more than 3 years. The nurse will assess for which potential adverse effects of long-term antiretroviral therapy? (Select all that apply.) A. Lipodystrophy B. Liver damage C. Kaposi's sarcoma D. Osteoporosis E. Type 2 diabetes - Correct Answer A, B, D, E The nurse is discussing adverse effects of ant tubercular drugs with a patient who has active tuberculosis. Which potential adverse effect of ant tubercular drug therapy should the patient report to the prescriber? A. Gastrointestinal upset B. Headache and nervousness C. Reddish-orange urine and stool D. Numbness and tingling of extremities - Correct Answer D A patient who has been taking isoniazid (INH) has a new prescription for pyridoxine. She is wondering why she needs this medication. The nurse explains that pyridoxine is often given concurrently with the isoniazid to prevent which condition? A. Hair loss B. Renal failure C. Peripheral neuropathy D. Heart failure - Correct Answer C The nurse will assess the patient for which potential contraindication to ant tubercular therapy? A. Glaucoma B. Anemia C. Heart failure D. Hepatic impairment - Correct Answer D When monitoring patients on ant tubercular drug therapy, the nurse knows that which drug may cause a decrease in visual acuity? A. Rifampin (Reading) B. Isoniazid (INH) C. Ethambutol (Myambutol) D. Streptomycin - Correct Answer C A patient has been taking ant tubercular therapy for 3 months. The nurse will assess for what findings that indicate a therapeutic response to the drug therapy? A. The chronic cough is gone. B. There are two consecutive negative purified protein derivative (PPD) results over 2 months. C. There is increased tolerance to the medication therapy, and there are fewer reports of adverse effects. D. There is a decrease in symptoms of tuberculosis along with improved chest x-rays and sputum cultures. - Correct Answer D The nurse is counseling a woman who will be starting rifampin (Reading) as part of ant tubercular therapy. The patient is currently taking oral contraceptives. Which statement is true regarding rifampin therapy for this patient? A. Nothing; these are expected side effects of this medication. - Correct Answer A If a patient is taking fluconazole (Dipluran) with an oral anticoagulant, the nurse will monitor for which possible interaction? A. Reduced action of oral anticoagulants B. Increased effects of oral anticoagulants C. Hypokalemia D. Decreased effectiveness of the antifungal drug - Correct Answer B The nurse is preparing an infusion of amphotericin B for a patient who has a severe fungal infection. Which intervention is appropriate regarding the potential adverse effects of amphotericin B? A. Discontinuing the infusion immediately if fever, chills, or nausea occur B. Gradually increasing the infusion rate until the expected adverse effects occur C. If fever, chills, or nausea occur during the infusion, administering medications to treat the symptoms D. Before beginning the infusion, administering an antipyretic and an antiemetic drug - Correct Answer D The nurse is administering one of the lipid formulations of amphotericin B. When giving this drug, which concept is important to remember? A. The lipid formulations may be given in oral form. B. The doses are much lower than the doses of the older drugs. C. The lipid formulations are associated with fewer adverse effects than the older drugs. D. There is no difference in cost between the newer and older forms. - Correct Answer C The nurse is reviewing instructions for vaginal antifungal drugs with a patient. Which statement by the nurse is an appropriate instruction regarding these drugs? A. "The medication can be stopped when your symptoms are relieved." B. "Discontinue this medication if menstruation begins." C. "Daily douching is part of the treatment for vaginal fungal infections." D. "Abstain from sexual intercourse until the treatment has been completed and the infection has resolved." - Correct Answer D A patient is infected by invasive aspergillosis, and the medical history reveals that the patient has not been able to tolerate several antifungal drugs. The nurse anticipates an order for which medication to treat this infection? A. Fluconazole (Dipluran) B. Micafungin (My amine) C. Caspofungin (Candida’s) D. Nystatin (Mycostatin) - Correct Answer C A patient with a severe fungal infection has orders for voriconazole (Vfend). The nurse is reviewing the patient's medical record and would be concerned if which assessment finding is noted? a. Decreased breath sounds in the lower lobes b. History of cardiac dysrhythmias C. History of type 2 diabetes D. Potassium level of 4.0 me/L - Correct Answer B During therapy with amphotericin B, the nurse will monitor the patient for known adverse effects that would be reflected by which laboratory result? A. Serum potassium level of 2.7 me/L B. Serum potassium level of 5.8 me/L C. White blood cell count of 7000 cells/mm3 D. Platelet count of 300,000/ microliter - Correct Answer A A patient has received a prescription for a 2-week course of antifungal suppositories for a vaginal yeast infection. She asks the nurse if there is an alternative to this medication, saying, "I don't want to do this for 2 weeks!" Which is a possibility in this situation? A. A single dose of a vaginal antifungal cream. B. A one-time infusion of amphotericin B. C. A single dose of a fluconazole (Dipluran) oral tablet. D. There is no better alternative to the suppositories. - Correct Answer C A patient is taking nystatin (Mycostatin) oral lozenges to treat an oral candidiasis infection resulting from inhaled corticosteroid therapy for asthma. Which instruction by the nurse is appropriate? A. "Chew the lozenges until they are completely dissolved." B. "Let the lozenge dissolve slowly and completely in your mouth without chewing it." C. "Rinse your mouth with water before taking the inhaler." D. "Rinse your mouth with mouthwash after taking the inhaler." - Correct Answer B The nurse is administering an amphotericin B infusion. Which actions by the nurse are appropriate? (Select all that apply.) A. Administering the medication by rapid IV infusion B. Discontinuing the drug immediately if the patient develops tingling and numbness in the extremities C. If adverse effects occur, reducing the IV rate gradually until they subside D. Using an infusion pump for IV therapy E. Monitoring the IV site for signs of phlebitis and infiltration F. Administering premedication for fever and nausea G. Knowing that the intravenous solution for amphotericin B will be cloudy H. Knowing that muscle twitching may indicate hypokalemia - Correct Answer B, D, E, F A patient who has a helminthic infection has a prescription for pirate (Antimyth). Which is one of the common adverse effects that the patient may experience while on this therapy? A. Vertigo B. Seizures C. Diarrhea a. Quinine b. Chloroquine (Aralen) c. Mefloquine (Lariam) d. Primaquine - Correct Answer D A patient is receiving hydroxychloroquine therapy but tells the nurse that she has never traveled out of her city. The nurse knows that a possible reason for this drug therapy is which condition? a. Lyme disease b. Toxoplasmosis c. Systemic lupus erythematosus d. Intestinal tapeworms - Correct Answer C Hydroxychloroquine (Plaquenil) is prescribed as part of malaria prophylaxis for a patient who will be traveling. The nurse will discuss which potential adverse effects with the patient? (Select all that apply.) a. Diarrhea b. Constipation C. Insomnia D. Dizziness E. Rash F. Headache - Correct Answer A, D, E, F The nurse is reviewing the therapeutic effects of nonsteroidal anti-inflammatory drugs (NSAIDs), which include which effect? A. Anxiolytic B. Sedative C. Antipyretic D. Antimicrobial - Correct Answer C A patient is taking the nonsteroidal anti-inflammatory drug indomethacin (Indocin) as treatment for pericarditis. The nurse will teach the patient to watch for which adverse effect? A. Tachycardia B. Nervousness C. Nausea and vomiting D. Dizziness - Correct Answer C A patient with gout has been treated with allopurinol (Zyloric) for 2 months. The nurse will monitor laboratory results for which therapeutic effect? A. Decreased uric acid levels B. Decreased prothrombin time C. Decreased white blood cell count D. Increased hemoglobin and hematocrit levels - Correct Answer A The nurse is teaching a patient who is taking colchicine for the treatment of gout. Which instruction will the nurse include during the teaching session? A. "Fluids should be restricted while on colchicine therapy." B. "Take colchicine with meals." C. "The drug will be discontinued when symptoms are reduced." D. "Call your doctor if you have increased pain or blood in the urine." - Correct Answer D A mother brings her toddler into the emergency department and tells the nurse that she thinks the toddler has eaten an entire bottle of chewable aspirin tablets. The nurse will assess for which most common signs of salicylate intoxication in children? A. Photosensitivity and nervousness B. Tinnitus and hearing loss C. Acute gastrointestinal bleeding D. Hyperventilation and drowsiness - Correct Answer D A 6-year-old child who has chickenpox also has a fever of 102.9° F (39.4° C). The child's mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse? A. "It's best to wait to see if the fever gets worse." B. "You can use the aspirin, but watch for worsening symptoms." C. "Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin." D. "You can use aspirin, but be sure to follow the instructions on the bottle." - Correct Answer C A patient has used enteric aspirin for several years as treatment for osteoarthritis. However, the symptoms are now worse and she is given a prescription for a nonsteroidal anti-inflammatory drug and misoprostol (Cytec). The patient asks the nurse, "Why am I now taking two pills for arthritis?" What is the nurse's best response? A. "Cytec will also reduce the symptoms of your arthritis." B. "Cytec helps the action of the NSAID so that it will work better." C. "Cytec reduces the mucous secretions in the stomach, which reduces gastric irritation." D. "Cytec may help to prevent gastric ulcers that may occur in patients taking NSAIDs." - Correct Answer D A patient who has a history of coronary artery disease has been instructed to take one 81-mg aspirin tablet a day. The patient asks about the purpose of this aspirin. Which response by the nurse is correct? A. "Aspirin is given reduce anxiety." B. "It helps to reduce inflammation." C. "Aspirin is given to relieve pain." D. "It will help to prevent clot formation." - Correct Answer D During assessment of a patient with osteoarthritis pain, the nurse knows that which condition is a contraindication to the use of nonsteroidal anti-inflammatory drugs (NSAIDs)? A. Renal disease Bruising on the skin D. A sudden, 15-pound weight gain - Correct Answer D A patient who has received chemotherapy has a critically low platelet count. The nurse expects which drug or drug class to be used to stimulate platelet cell production? A. Filgrastim (Neupogen) b. Interferons c. Oprelvekin (Neumega) d. Epoetin alfa (Epogen) - Correct Answer C A patient who has received chemotherapy has a steadily decreasing white blood cell count. The chemotherapy will end on Tuesday afternoon. The oncologist has mentioned that a colony-stimulating factor will be started soon. The nurse knows that the appropriate time to start this medication is when? a. While the patient is still receiving chemotherapy b. Two hours after the chemotherapy ends c. Wednesday afternoon, 24 hours after the chemotherapy ends d. In 2 to 4 days, after the white blood cells have reached their nadir - Correct Answer C A patient has an order for the monoclonal antibody adalimumab (Humira). The nurse notes that the patient does not have a history of cancer. What is another possible reason for administering this drug? a. Severe anemia b. Rheumatoid arthritis c. Thrombocytopenia d. Osteoporosis - Correct Answer B During interleukin drug therapy, a patient is showing signs of severe fluid retention, with increasing dyspnea and severe peripheral edema. The next dose of the interleukin is due now. Which action will the nurse take next? a. Hold the drug, and notify the prescriber. b. Give the drug, and notify the prescriber. c. Give the drug along with acetaminophen and diphenhydramine (Benadryl). d. Monitor the patient for 2 hours, and then give the drug if the patient's condition improves. - Correct Answer A The nurse is administering an interferon and will implement which intervention? a. Giving the medication with meals b. Monitoring daily weights c. Limiting fluids while the patient is taking this medication d. Rotating sites if administered subcutaneously - Correct Answer D Abatacept (Orencia) is prescribed for a patient with severe rheumatoid arthritis. The nurse checks the patient's medical history, knowing that this medication would need to be used cautiously if which condition is present? a. Coronary artery disease b. Chronic obstructive pulmonary disease c. Diabetes mellitus d. Hypertension - Correct Answer B Aldesleukin [IL-2] (Proleukin) is prescribed for a patient. The nurse reviews the patient's medication list and would note a potential drug interaction if which drug class is also ordered? a. Anticoagulants b. Antiepileptic drugs c. Oral hypoglycemic drugs d. Antihypertensive drugs - Correct Answer D During therapy with hematopoietic drugs, the nurse will monitor the patient for which adverse effects? (Select all that apply.) a. Hypotension b. Edema c. Diarrhea d. Black, tarry stools e. Nausea and vomiting f. Headache - Correct Answer B,C,E,F A patient must be treated immediately for acute organ transplant rejection. The nurse anticipates that muromonab-CD3 (Orthoclone OKT3) will be ordered. What is the priority assessment before beginning drug therapy with muromonab-CD3? a. Serum potassium level b. Fluid volume status c. Electrocardiogram d. Blood glucose level - Correct Answer B A patient is about to undergo a kidney transplant. She will be given an immunosuppressant drug before, during, and after surgery to minimize organ rejection. During the preoperative teaching session, which information will the nurse include about the medication therapy? a. Several days before the surgery, the medication will be administered orally. b. The oral doses need to be taken 1 hour before meals to maximize absorption. c. Mix the oral liquid with juice in a disposable Styrofoam cup just before administration. d. Intramuscular injections of the medication will be needed for several days preceding surgery. - Correct Answer A A patient has an order for cyclosporine (Sandimmune). The nurse finds that cyclosporine-modified (Neoral) is available in the automated medication cabinet. Which action by the nurse is correct? a. Hold the dose until the prescriber makes rounds. b. Give the cyclosporine-modified drug. c. Double-check the order, and then give the cyclosporine-modified drug. d. Diarrhea d. Thrombocytopenia e. Hepatotoxicity f. Fluid retention - Correct Answer B,D,E Two patients arrive at the clinic; one is a young boy with sickle cell anemia, and another is a 57-year-old woman with early stages of Hodgkin's disease. The nurse notices that both patients need the same vaccine. What vaccine would that be? a. Varicella virus vaccine (Varivax) b. Herpes zoster vaccine (Zostavax) c. Hepatitis B virus vaccine, inactivated (Recombivax HB) d. Haemophilus influenzae type b (Hib) vaccine - Correct Answer D The nurse is reviewing principles of immunization. What type of immunization occurs when antibodies pass from mother to infant during breastfeeding or through the placenta during pregnancy? a. Artificial active immunization b. Attenuating immunization c. Natural passive immunization d. Artificial passive immunization - Correct Answer C A 45-year-old man has received a series of immunizing drugs in preparation for a trip to a developing country. Within hours, his wife brings him to the emergency department because he has developed edema of the face, tongue, and throat and is having trouble breathing. The nurse suspects that, based on the patient's history and symptoms, he is experiencing which condition? a. Serum sickness b. Cross-sensitivity c. Thrombocytopenic purpura d. Adenopathy - Correct Answer A A 12-month-old infant has received an MMR II (measles, mumps, and rubella virus vaccine), and her mother calls the clinic that afternoon to ask about helping her fussy infant to "feel better." What will the nurse suggest? a. Apply an ice pack to the injection site. b. Apply warm compresses to the injection site. c. Observe the site for further swelling and redness. d. Bring the infant in to the emergency department for an immediate examination. - Correct Answer B A sanitation worker has experienced a needle stick by a contaminated needle that was placed in a trash can. The employee health nurse expects that which drug will be used to provide passive immunity to hepatitis B infection? a. Haemophilus influenzae type b (Hib) b. Varicella virus vaccine (Varivax) c. Hepatitis B immunoglobulin (BayHep B) d. Hepatitis B virus vaccine (inactivated) (Recombivax HB) - Correct Answer C A nurse is working in an immunization clinic. A new colleague asks, "When is the first dose of the diphtheria, tetanus, and acellular pertussis (DtaP, Daptacel) given?" The nurse knows that this series is started at what age? a. At birth b. 6 weeks c. 3 months d. 1 year - Correct Answer B A patient is in the urgent care center after experiencing a black widow spider bite. The nurse prepares to give which product to treat this injury? a. Live vaccine b. Antivenins or antisera c. Tetanus immune globulin d. Active immunizing drug - Correct Answer B A 30-year-old woman is in the clinic for her yearly gynecologic exam and asks the nurse about the "new vaccine that prevents HPV." She wants to receive the papillomavirus vaccine (Gardasil). Which response by the nurse is most appropriate? a. "For women, the recommended age for this vaccine is 13 to 26 years of age." b. "We will need to make sure you are not pregnant first." c. "There will be a total of three injections." d. "I will check with your health care provider and then get the first dose of the vaccine ready." - Correct Answer A The nurse is reviewing the health history of a new patient who may need immunizations. Active immunizations are usually contraindicated in which patients? (Select all that apply.) a. Patients with a febrile illness b. Children younger than 1 year of age c. Elderly patients d. Patients who are immunosuppressed e. Those receiving cancer chemotherapy - Correct Answer A,D,E The nurse is reviewing the information about the herpes zoster vaccine (Zostavax) before administering the dose. Which statements about the vaccine are true? (Select all that apply.) a. It is a one-time vaccine. b. The vaccine is recommended for patients 50 years of age and older. c. The vaccine is given to children to prevent chickenpox. d. It is used to prevent postherpetic neuralgia. e. It is contraindicated in patients who have already had shingles. f. The vaccine is used to prevent reactivation of the zoster virus that causes shingles. - Correct Answer A,B,F experiencing breakthrough pain. The nurse expects this type of pain to be managed by which of these interventions? a. Administering NSAIDs b. Administering an immediate-release opioid c. Changing the opioid route to the rectal route d. Making no changes to the current therapy - Correct Answer B The nurse is reviewing herbal therapies. Which is a common use of the herb feverfew? a. Muscle aches b. Migraine headaches c. Leg cramps d. Incision pain after surgery - Correct Answer B A patient is to receive acetylcysteine (Mucomyst) as part of the treatment for an acetaminophen (Tylenol) overdose. Which action by the nurse is appropriate when giving this medication? a. Giving the medication undiluted for full effect b. Avoiding the use of a straw when giving this medication c. Disguising the flavor with soda or flavored water d. Preparing to give this medication via a nebulizer - Correct Answer C A patient is receiving gabapentin (Neurontin), an anticonvulsant, but has no history of seizures. The nurse expects that the patient is receiving this drug for which condition? a. Inflammation pain b. Pain associated with peripheral neuropathy c. Depression associated with chronic pain d. Prevention of seizures - Correct Answer B The nurse is assessing a patient who has been admitted to the emergency department for a possible opioid overdose. Which assessment finding is characteristic of an opioid drug overdose? a. Dilated pupils b. Restlessness c. Respiration rate of 6 breaths/min d. Heart rate of 55 beats/min - Correct Answer C The drug nalbuphine (Nubain) is an agonist-antagonist (partial agonist). The nurse understands that which is a characteristic of partial agonists? a. They have anti-inflammatory effects. b. They are given to reverse the effects of opiates. c. They have a higher potency than agonists. d. They have a lower dependency potential than agonists. - Correct Answer D The nurse is assessing a patient for contraindications to drug therapy with acetaminophen (Tylenol). Which patient should not receive acetaminophen? a. A patient with a fever of 101° F (38.3° C) b. A patient who is complaining of a mild headache c. A patient with a history of liver disease d. A patient with a history of peptic ulcer disease - Correct Answer C A patient arrives at the urgent care center complaining of leg pain after a fall when rock climbing. The x-rays show no broken bones, but he has a large bruise on his thigh. The patient says he drives a truck and does not want to take anything strong because he needs to stay awake. Which statement by the nurse is most appropriate? a. "It would be best for you not to take anything if you are planning to drive your truck." b. "We will discuss with your doctor about taking an opioid because that would work best for your pain." c. "You can take acetaminophen, also known as Tylenol, for pain, but no more than 1000 mg per day." d. "You can take acetaminophen, also known as Tylenol, for pain, but no more than 3000 mg per day." - Correct Answer D A patient is suffering from tendonitis of the knee. The nurse is reviewing the patient's medication administration record and recognizes that which adjuvant medication is most appropriate for this type of pain? a. Antidepressant b. Anticonvulsant c. Corticosteroid d. Local anesthesia - Correct Answer C Vicodin (acetaminophen/hydrocodone) is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication? (Select all that apply.) a. Diarrhea b. Constipation c. Lightheadedness d. Nervousness e. Urinary retention f. Itching - Correct Answer B,C,E,F During a fishing trip, a patient pierced his finger with a large fishhook. He is now in the emergency department to have it removed. The nurse anticipates that which type of anesthesia will be used for this procedure? a. No anesthesia b. Topical benzocaine spray on the area c. Topical prilocaine (EMLA) cream around the site d. Infiltration of the puncture wound with lidocaine - Correct Answer D Sympathetic nervous system d. Parasympathetic nervous system - Correct Answer C When an adrenergic drug stimulates beta1-adrenergic receptors, the result is an increased force of contraction, which is known as what type of effect? a. Positive inotropic b. Anti-adrenergic c. Negative dromotropic d. Positive chronotropic - Correct Answer A When a patient is taking an adrenergic drug, the nurse expects to observe which effect? a. Increased heart rate b. Bronchial constriction c. Constricted pupils d. Increased intestinal peristalsis - Correct Answer A An adrenergic agonist is ordered for a patient in shock. The nurse will note that this drug has had its primary intended effect if which expected outcome occurs? a. Volume restoration b. Increased cardiac output c. Decreased urine output d. Reduced anxiety - Correct Answer B The nurse is administering a stat dose of epinephrine. Epinephrine is appropriate for which situation? a. Severe hypertension b. Angina c. Cardiac arrest d. Tachycardia - Correct Answer C A patient is on a low-dose dobutamine drip for heart failure. She had been feeling better but now has a sense of tightness in her chest, palpitations, and a bit of anxiety. Her heart rate is up to 110 per minute, and her blood pressure is 150/98 mm Hg (increased from previous readings of 86 per minute and 120/80 mm Hg). What is the nurse's immediate concern for this patient? a. She is experiencing normal adverse effects of dobutamine therapy. b. She may be experiencing an allergic reaction to the dobutamine. c. The medication may be causing a worsening of a pre-existing cardiac disorder. d. The dosage of the dobutamine needs to be increased to control the symptoms better. - Correct Answer C A 14-year-old patient has been treated for asthma for almost 4 months. Two weeks ago, she was given salmeterol as part of her medication regimen. However, her mother has called the clinic to report that it does not seem to work when her daughter is having an asthma attack. Which response by the nurse is appropriate? a. "It takes time for a therapeutic response to develop." b. "She is too young for this particular medication; it will be changed." c. "She needs to take up to two puffs every 4 hours to ensure adequate blood levels." d. "This medication is indicated for prevention of bronchospasms, not for relief of acute symptoms." - Correct Answer D A hospitalized patient is experiencing a severe anaphylactic reaction to a dose of intravenous penicillin. Which drug will the nurse expect to use to treat this condition? a. Ephedra b. Epinephrine c. Phenylephrine d. Pseudoephedrine - Correct Answer B The nurse recognizes that adrenergic drugs cause relaxation of the bronchi and bronchodilation by stimulating which type of receptors? a. Dopaminergic b. Beta1 adrenergic c. Beta2 adrenergic d. Alpha1 adrenergic - Correct Answer C The nurse is preparing to administer dopamine. Which is the correct technique for administering dopamine? a. Orally b. Intravenous (IV) push injection c. Intermittent IV infusions (IV piggyback) d. Continuous IV infusion with an infusion pump - Correct Answer D The nurse is presenting information to a class of students about adrenergic drugs. Which are the effects of drugs that stimulate the sympathetic nervous system? (Select all that apply.) a. Dilation of bronchioles b. Constriction of bronchioles c. Decreased heart rate d. Increased heart rate e. Dilated pupils f. Constricted pupils g. Glycogenolysis - Correct Answer A,D,E,G When giving dextromethorphan, the nurse understands that this drug suppresses the cough reflex by which mechanism of action? a. Causing depression of the central nervous system b. Anesthetizing the stretch receptors c. Having direct action on the cough center d. Decreasing the viscosity of the bronchial secretions - Correct Answer C "Antihistamines may cause restlessness and disturbed sleep." f. "Avoid activities that require alertness until you know how adverse effects are tolerated." - Correct Answer C,D,F A patient tells the nurse that she wants to start taking the herbal product goldenseal to improve her health. The nurse will assess for which potential cautions or contraindications to goldenseal? (Select all that apply.) a. Taking a proton-pump inhibitor b. Nasal congestion c. Hypothyroidism d. Hypertension e. Sinus infections f. Pregnancy - Correct Answer A,D,F A patient is taking intravenous aminophylline for a severe exacerbation of chronic obstructive pulmonary disease. The nurse will assess for which therapeutic response? a. Increased sputum production b. Increased heart rate c. Increased respiratory rate d. Increased ease of breathing - Correct Answer D A patient is taking a xanthine derivative as part of treatment for chronic obstructive pulmonary disease. The nurse will monitor for which adverse effects associated with the use of xanthine derivatives? a. Diarrhea b. Palpitations c. Bradycardia d. Drowsiness - Correct Answer B A patient is in an urgent care center with an acute asthma attack. The nurse expects that which medication will be used for initial treatment? a. An anticholinergic such as ipratropium (Atrovent) b. A short-acting beta2 agonist such as albuterol (Proventil) c. A long-acting beta2 agonist such as salmeterol (Serevent) d. A corticosteroid such as fluticasone (Flovent) - Correct Answer B The prescriber has changed the patient's medication regimen to include the leukotriene receptor antagonist (LTRA) montelukast (Singulair) to treat asthma. The nurse will emphasize which point about this medication? a. The proper technique for inhalation must be followed. b. The patient needs to keep it close by at all times to treat acute asthma attacks. c. It needs to be taken every day on a continuous schedule, even if symptoms improve. d. When the asthma symptoms improve, the dosage schedule can be tapered and eventually discontinued. - Correct Answer C After receiving a nebulizer treatment with a beta agonist, the patient complains of feeling slightly nervous and wonders if her asthma is getting worse. What is the nurse's best response? a. "This is an expected adverse effect. Let me take your pulse." b. "The next scheduled nebulizer treatment will be skipped." c. "I will notify the physician about this adverse effect." d. "We will hold the treatment for 24 hours." - Correct Answer A A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers will the nurse give to the patient? a. "Take the corticosteroid inhaler first." b. "Take the bronchodilator inhaler first." c. "Take these two drugs at least 2 hours apart." d. "It does not matter which inhaler you use first." - Correct Answer B When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects? a. Fatigue and depression b. Anxiety and palpitations c. Headache and rapid heart rate d. Oral candidiasis and dry mouth - Correct Answer D The nurse is monitoring drug levels for a patient who is receiving theophylline. The most recent theophylline level was 22 mcg/mL, and the nurse evaluates this level to be: a. below the therapeutic level. b. at a therapeutic level. c. above the therapeutic level. d. at a toxic level. - Correct Answer C When evaluating a patient's use of a metered-dose inhaler (MDI), the nurse notes that the patient is unable to coordinate the activation of the inhaler with her breathing. What intervention is most appropriate at this time? a. Notify the doctor that the patient is unable to use the MDI. b. Obtain an order for a peak flow meter. c. Obtain an order for a spacer device. d. Ask the prescriber if the medication can be given orally. - Correct Answer C The nurse is providing instructions about the Advair inhaler (fluticasone propionate and salmeterol). Which statement about this inhaler is accurate? a. It is indicated for the treatment of acute bronchospasms. b. It needs to be used with a spacer for best results. c. Patients need to avoid drinking water for 1 hour after taking this drug. d. It is used for the prevention of bronchospasms. - Correct Answer D