A patient who experiences motion sickness when flying asks the nurse the best time to take the medication prescribed to prevent motion sickness for a 0900 flight. The nurse will instruct the patient to take the medication at which time?a. As needed, at the first sign of nauseab. At 0700, before leaving for the airportc. At 0830, just prior to boarding the plane d. When seated, just prior to takeoff
ANS: C
The nurse is performing a medication history on a patient who has glaucoma. The patient cannot remember the name of the drug prescribed but tells the nurse that the drug causes light sensitivity. The nurse knows that the drug is among which class of medications?a. Alpha-adrenergic agonistsb. Beta-adrenergic blockersc. Cholinergic agonists d. Cholinesterase inhibitors
ANS: A
The nurse administers proparacaine HCl (Ophthaine) drops to a patient prior to an eye examination. What sign will the nurse look for to determine when the examination can begin?a. Absence of the blink reflexb. Blurred visionc. Drying of the corneal epithelium d. Photophobia
ANS: A
The nurse is administering timolol (Timoptic) eye drops to a patient who has glaucoma. To prevent bradycardia, the nurse will perform which action?a. Apply pressure to the lacrimal ducts.b. Have the patient sit up after instilling the drops.c. Prepare to administer an alpha-adrenergic agonist. d. Wait 5 minutes between drops.
ANS: A
A patient has an infection of the eyelash follicles and in the gland on the eyelid margin. The nurse recognizes these symptoms as being consistent with which condition?a. Blepharitisb. Chalazionc. Endophthalmitis d. Hordeolum
ANS: D
The nurse is preparing to administer atropine sulfate drops as a mydriatic agent. Which assessment would cause the nurse to withhold the drug and notify the provider?a. Blood pressure of 140/90 mm Hgb. Heart rate of 60 beats per minutec. Respiratory rate of 12 breaths per minute d. Temperature of 37.9° C
ANS: A
The nurse is preparing to administer olopatadine (Patanol) eyedrops to a patient who has allergic conjunctivitis. The patient tells the nurse that the drops have caused burning and stinging. What action will the nurse take?a. Administer the drops and reassure the patient that this is a normal side effect.b. Offer an over-the-counter eye lubricant to minimize this adverse effect.c. Request an order for antibiotic eyedrops. d. Withhold the medication and notify the provider.
ANS: A
The nurse is providing teaching for a patient who will begin using tobramycin ointment (Nebcin) 0.5 inches 3 times daily. The patient currently uses pilocarpine HCl (Isopto Carpine) drops to treat glaucoma. Which statement by the patient indicates a need for further teaching?a. “I should apply the third dose of tobramycin at bedtime each day.”b. “I should instill the drops in the conjunctival sac of the lower eyelid.”c. “I should not stop the medications without consulting my provider.” d. “I should put the ointment on first and then instill the eyedrops.”
ANS: D
The nurse is counseling an adolescent patient who has recurrent otitis externa and who works as a lifeguard in the summer about preventing this condition. The nurse will teach this patient toa. avoid using ear plugs while swimming.b. request a prescription for prophylactic antibiotic eardrops.c. use a hair dryer to dry the ears after swimming. d. wear a medical alert bracelet.
ANS: C
The parent of a toddler asks the nurse what can be done to prevent otitis media. What will the nurse recommend?a. Administer diphenhydramine when the child has a runny nose.b. Give phenylephrine (Neo-Synephrine Ophthalmic) to prevent congestion.c. Keep the child’s immunizations up to date. d. Remove cerumen with carbamide peroxide (Auro Ear Drops).
ANS: C
A patient who experiences motion sickness when flying asks the nurse the best time to take the medication prescribed to prevent motion sickness for a 0900 flight. The nurse will instruct the patient to take the medication at which time?a. As needed, at the first sign of nauseab. At 0700, before leaving for the airportc. At 0830, just prior to boarding the plane d. When seated, just prior to takeoff
ANS: C
The nurse is caring for a patient who has unexplained, recurrent vomiting and who is unable to keep anything down. Until the cause of the vomiting is determined, the nurse will anticipate administering which medications?a. Antibiotics and antiemeticsb. Intravenous fluids and electrolytesc. Nonprescription antiemetics d. Prescription antiemetics
ANS: B
The parent of an 18-month-old toddler calls the clinic to report that the child has vomited 5 times that day. The nurse determines that the child has had three wet diapers in the past 6 hours. What will the nurse recommend for this child?a. Administering an OTC antiemetic medication such as diphenhydramineb. Giving frequent, small amounts of Pedialytec. Keeping the child NPO until vomiting subsides d. Taking the child to the emergency department for IV fluids
ANS: B
The nurse is teaching a patient who is about to take a long car trip about using dimenhydrinate (Dramamine) to prevent motion sickness. What information is important to include when teaching this patient?a. “Do not drive while taking this medication.”b. “Dry mouth is a sign of toxicity with this medication.”c. “Take the medication 1 to 2 hours prior to beginning the trip.” d. “Take 100 mg up to 6 times daily for best effect.”
ANS: A
The nurse is caring for a patient who has postoperative nausea and vomiting. The surgeon has ordered promethazine HCl (Phenergan). Which aspect of this patient’s health history would be of concern?a. Asthmab. Diabetesc. GERD d. Glaucoma
ANS: D
The nurse is teaching a group of nursing students about the use of antipsychotic drugs for antiemetic purposes. The nurse will explain that, when given as antiemetics, these drugs are givena. in smaller doses.b. less frequently.c. with anticholinergics. d. with antihistamines.
ANS: A
A patient who is receiving chemotherapy will be given dronabinol (Marinol) to prevent nausea and vomiting. The nurse will tell the patient that this drug will be given at which time?a. Before and after the chemotherapyb. During chemotherapyc. Immediately prior to chemotherapy d. 24 hours prior to chemotherapy
ANS: A
A woman who is 2 months pregnant reports having morning sickness every day and asks if she can take any medications to treat this problem. The nurse will recommend that the patient take which action first?a. Contact the provider to discuss a possible need for intravenous fluids.b. Contact the provider to discuss a prescription antiemetic.c. Use nonpharmacologic measures such as saltines. d. Take over-the-counter antiemetics such as diphenhydramine.
ANS: C
The parent of a child who is receiving chemotherapy asks the nurse why metoclopramide (Reglan) is not being used to suppress vomiting. The nurse will explain that, in children, this drug is more likely to cause which effect?a. Excess sedationb. Extrapyramidal symptomsc. Paralytic ileus d. Vertigo
ANS: B
The child who is a candidate for treatment with an emetic after ingestion of a toxic substance or overdose is the child who has ingested which substance?a. Acetaminophen elixirb. Chlorine bleachc. Kerosene d. Toilet cleanser
ANS: A
The nurse is teaching a group of parents about the use of syrup of ipecac. Which instruction will the nurse provide?a. “Do not administer ipecac without consulting a poison control center.”b. “Expect the onset of emesis to be immediate.”c. “Give ipecac with a glass of milk to increase its emetic effect.” d. “Use ipecac fluid extract and not ipecac syrup.”
ANS: A
A patient asks the nurse about using loperamide (Imodium) to treat infectious diarrhea. Which response will the nurse give?a. “Loperamide results in many central nervous system (CNS) side effects.”b. “Loperamide has no effect on infectious diarrhea.”c. “Loperamide is taken once daily.” d. “Loperamide may prolong the symptoms.”
ANS: D
A child is brought to the emergency department after ingestion of a toxic substance. The child is alert and conscious and is reported to have ingested kerosene 20 minutes prior. The nurse will anticipate administeringa. activated charcoal.b. an anticholinergic antiemetic.c. gastric lavage. d. syrup of ipecac.
ANS: A
A patient who is taking diphenoxylate with atropine (Lomotil) to treat diarrhea asks the nurse why it contains atropine. The nurse will explain that atropine is added toa. decrease abdominal cramping.b. increase intestinal motility.c. minimize nausea and vomiting. d. provide analgesia.
ANS: A
The nurse is caring for an older adult who is receiving diphenoxylate with atropine (Lomotil) to treat severe diarrhea. The nurse will monitor this patient closely for which effect?a. Bradycardiab. Fluid retentionc. Nervousness and tremors d. Respiratory depression
ANS: D
A patient asks the nurse the best way to prevent traveler’s diarrhea. The nurse will provide which recommendation to the patient?a. “Ask your provider for prophylactic antibiotics.”b. “Drink bottled water and eat only well-cooked meats.”c. “Eat fresh, raw fruits and vegetables.” d. “Take loperamide (Imodium) every day.”
ANS: B
An appropriate goal when teaching a patient who has diarrhea is that the patienta. will have less frequent, more formed stools.b. will not have a stool for 1 to 2 days.c. will receive adequate intravenous fluids. d. will receive appropriate antibiotic therapy.
ANS: A
A patient reports having three to four stools, which are sometimes hard, per week. The nurse will perform which action?a. Recommend increased fluids and dietary fiber.b. Request an order for a laxative as needed.c. Request an order for a stool softener. d. Suggest discussing chronic constipation with the provider.
ANS: A
The nurse is instructing a patient who will take psyllium (Metamucil) to treat constipation. What information will the nurse include when teaching this patient?a. The importance of consuming adequate amounts of waterb. The need to monitor for systemic side effectsc. The onset of action of 30 to 60 minutes after administration d. The need to use the dry form of Metamucil to prevent cramping
ANS: A
A 50-year-old male patient reports having decreased libido and testicular atrophy. The nurse will anticipate that the provider may order which medication to treat these symptoms?a. Testosterone (Androderm)b. Finasteride (Proscar)c. Gonadotropin-releasing hormone (Gn-RH) d. Sildenafil (Viagra)
ANS: A
The nurse is teaching the parents of a boy who has inadequate pituitary function and delayed puberty about testosterone enanthate injections. Which statement by the parents indicates a need for further teaching?a. “He will need x-rays of his hands every 6 months.”b. “Injections will be given deep into his gluteal muscles.”c. “Sexual development will occur in 1–2 years.” d. “We should report urinary tract problems immediately.”
ANS: C
The nurse is instructing a patient about the buccal muco-adhesive testosterone system (Striant) to treat low testosterone. What information will the nurse include when teaching this patient about this drug?a. “If the product slides out of position more than 4 h before the next dose, replace it with a new system.”b. “Place the flattened surface against the gum and hold it firmly in place for 30 seconds.”c. “The product may be swallowed after it has been in place for at least 4 h.” d. “To remove the product, slide it upwards away from the tooth until it releases.”
ANS: A
The nurse provides teaching to a man who will begin using an Androderm testosterone patch. Which statement by the patient indicates understanding of the teaching?a. “I may stop using Androderm when my serum testosterone is normal.”b. “I should apply this to any skin other than the scrotum or bony areas.”c. “I will apply two skin patches every morning after a shower.” d. “My serum testosterone will continue to rise with each day of use.”
ANS: B
A man who has been using androgen therapy tells the nurse that he and his wife wish to conceive a pregnancy. The nurse will tell this patient thata. androgen therapy will not harm the fetus.b. he will need to increase his dose of testosterone to increase his sperm count.c. it may take 3 months after cessation of androgen therapy to conceive. d. there should be no problems conceiving while using androgen therapy.
ANS: C
The nurse is teaching an adult male patient about the use of testosterone gel. Which statement by the patient indicates understanding of the teaching?a. “A decreased urinary stream is an expected side effect.”b. “I should apply the gel to my forearms every day.”c. “I will have hand and wrist x-rays every 6 months.” d. “I will need regular evaluation of serum lipid levels.”
ANS: D
The oral antiandrogen drug flutamide (Eulexin) is used to treat which condition?a. Benign prostatic hypertrophy (BPH)b. Breast cancerc. Male-pattern baldness d. Metastatic prostate cancer
ANS: D
A patient will begin taking finasteride (Propecia) to treat benign prostatic hypertrophy (BPH) and asks the nurse how long the medication will be necessary. The nurse will tell the patient that he will need to take this medication for how long?a. 6 monthsb. 12 monthsc. Indefinitely d. Until symptoms resolve
ANS: C
A 14-year-old male is being evaluated for delayed puberty. Which finding indicates delayed puberty in this child?a. Androgen deficiencyb. Growth hormone deficiencyc. Height of 2.5 standard deviations below the mean d. Lack of epiphyseal closure
ANS: A
A male patient wants to begin taking tadalafil (Cialis) to treat erectile dysfunction. Which aspect of this patient’s history would be of concern?a. Angina pectorisb. Asthmac. Benign prostatic hypertrophy d. Color blindness
ANS: A
A patient will begin using sildenafil citrate (Viagra) to treat erectile dysfunction. The nurse will instruct the patient to take the medicationa. daily in the morning.b. just prior to sexual activity.c. 30 min-4 h before sexual activity. d. twice daily.
ANS: C
A woman is taking a combination oral contraceptive and asks the nurse why progestin is necessary. The nurse will explain that progestin helps prevent pregnancy by which method?a. Altering the quantity and viscosity of cervical mucusb. Inhibiting proliferative and secretory changes in the endometriumc. Increasing motility of muscles and cilia in the fallopian tubes d. Stimulating a surge in luteinizing hormone (LH)
ANS: A
A woman will begin taking a combination oral contraceptive (COC) that has a higher estrogenic activity than her previous COC. When teaching this woman about the new product, the nurse will explain that she may experience which effect(s)?a. Cyclic breast changes and chloasmab. Decreased dysmenorrhea and menorrhagiac. Decreased libido d. Weight gain and fatigue
ANS: A
A woman who has recently begun taking a combination oral contraceptive calls the clinic to report breakthrough bleeding. The nurse willa. advise her to use a back-up method of contraception.b. counsel her to continue taking the contraceptive as prescribed.c. recommend discussing an alternative contraceptive with her provider. d. suggest that she perform a home pregnancy test to rule out pregnancy.
ANS: B
A young woman who is taking Ortho-Tri-Cyclen for contraception tells the nurse that her provider has told her it will help to treat her acne. The nurse explains that this is because this product isa. high in progestin.b. low in androgenic activity.c. low in estrogen. d. triphasic.
ANS: B
The nurse is caring for a woman who will begin taking ibuprofen to treat arthritis. The woman tells the nurse that she takes Yasmin for contraception. The nurse will perform which action?a. Counsel the patient to use a back-up method of contraception while taking ibuprofen.b. Notify the provider to discuss an alternate combination oral contraceptive.c. Suggest a COX-2 inhibitor instead of ibuprofen for arthritis pain. d. Tell the patient to use a lower dose of ibuprofen to prevent adverse effects.
ANS: B
A woman who is taking a combined oral contraceptive (COC) that contains 21 days of active pills and 7 days of inert pills reports having headaches accompanying withdrawal bleeding every month. The nurse willa. counsel her to take ibuprofen to counter these side effects.b. notify her provider to discuss these adverse effects.c. recommend a Loestrin Fe product. d. suggest she ask her provider about Mircette.
ANS: D
A woman who is using a NuvaRing transvaginal contraceptive product calls to report that the ring has slipped out while sleeping. The nurse will instruct the patient to rinse the ring with lukewarm water, reinsert the ring, anda. abstain from sexual intercourse for 24 h.b. replace it with a new ring as soon as possible.c. take an oral contraceptive product for 2 weeks. d. use a back-up method of contraception for 7 days.
ANS: D
A 35-year-old woman asks the nurse about oral contraceptives. The nurse learns that the patient smokes and has a family history of venous thromboembolism (VTE). The nurse will suggest that the patienta. discuss a progestin-only oral contraceptive with her provider.b. may want to consider having a tubal ligation.c. use a transdermal contraceptive product. d. will not be a candidate for oral contraceptive products.
ANS: A
A woman comes to the clinic for a Depo-Provera injection. The nurse reviews her medical record and notes that it has been 100 days since her last injection. What action will the nurse perform?a. Administer Depo-Provera 150 mg IMb. Give Depo-Provera 300 mg IMc. Perform a pregnancy test d. Suggest she wait until she has had a period.
ANS: C
A 45-year-old woman reports cessation of menses for the past 6 months and asks the nurse if she needs to continue using contraception. The nurse will tell hera. that she may discontinue using contraception.b. that she most likely has premature ovarian failure.c. to begin hormone therapy to prevent menopausal symptoms. d. to continue using contraception for at least 6 more months.
ANS: D
A 45-year-old woman who has not had a period for 15 months reports severe hot flashes and poor sleep. The nurse reviews information about hormone replacement therapy and tells this woman that hormone therapya. is very safe and may be used freely to treat menopausal symptoms.b. may be used indefinitely to treat menopausal symptoms.c. should be used at the lowest dose possible for less than 5 years. d. will be necessary to prevent osteoporosis caused by estrogen depletion.
ANS: C
The parent of a 16-year-old female tells the nurse that the child has not had a menstrual period in spite of having breast and pubic hair development. The nurse recognizes this as characteristic of which condition?a. Dysmenorrheab. Hypothyroidismc. Primary amenorrhea d. Secondary amenorrhea
ANS: C
A young woman reports not having a period for 7 months. Which test will the provider likely order first to evaluate the cause of amenorrhea in this patient?a. Pelvic ultrasoundb. Pregnancy testc. Progestational challenge test d. Serum insulin levels
ANS: B
A woman is diagnosed with polycystic ovarian disease (PCOS) after being unable to conceive. Her provider has ordered metformin (Glucophage) and clomiphene citrate (Clomid). The nurse will explain that metformin is given for which purpose?a. To increase androgen levelsb. To induce ovulationc. To promote a dominant follicle d. To regulate menstrual periods
ANS: D
A 30-year-old woman describes having periods every 30 days, lasting 8 days, with heavy bleeding. The nurse understands that these are signs of which condition?a. Menometrorrhagiab. Menorrhagiac. Menorrhea d. Metrorrhagia
ANS: B
A woman who has menorrhagia is prescribed ibuprofen, and she asks the nurse how a pain medication can decrease uterine bleeding. The nurse will explain that this is most likely explained by ibuprofen’s effects ona. estrogen levels.b. platelet aggregation.c. prostaglandin production. d. uterine endometrium.
ANS: C
A woman who is infertile has taken 50 mg of clomiphene citrate (Clomid) from days 5 through 9 of a cycle and has not ovulated. The nurse will anticipate that the provider will perform which action?a. Begin recombinant follicle-stimulating hormone therapy.b. Increase the dose to 100 mg on days 5 through 9 of her next cycle.c. Order clomiphene citrate to be given throughout her next cycle. d. Repeat the 50 mg of clomiphene citrate for 2 more cycles.
ANS: B
The nurse performs a history on a woman who will begin taking clomiphene citrate (Clomid) to induce ovulation. Which aspect of this patient’s history is of concern?a. Anovulationb. Dysmenorrheac. Sexually transmitted infection d. Uterine fibroids
ANS: D
The nurse is caring for a woman who is in early labor. The woman wants to avoid pain medications as long as possible. What will the nurse tell her?a. “I can give you a sedative-hypnotic now to help you relax.”b. “I can teach you some simple breathing exercises to help lessen discomfort.”c. “If you take fentanyl (Sublimaze) now, it will be more effective than if you wait.” d. “You may take ibuprofen, which won’t cause drowsiness.”
ANS: B
The nurse administers meperidine (Demerol) to a woman who is in early labor. Immediately after the drug is given, the woman’s labor progresses quickly, and she delivers her infant. The nurse will monitor the infant closely for which condition?a. Opioid withdrawal syndromeb. Orthostatic hypotensionc. Respiratory depression d. Tachycardia and poor perfusion
ANS: C
The nurse is caring for an infant who is 2 days postpartum and notes that the infant has a poor sucking response. The nurse reviews the delivery record and will likely note that which drug was given to the mother during labor?a. Butorphanol tartrate (Stadol)b. Fentanyl (Sublimaze)c. Nalbuphine (Nubain) d. Secobarbital (Seconal)
ANS: D
The nurse is caring for a woman who is in active labor and wants to receive a drug for severe pain immediately. Her intravenous line has just infiltrated. The nurse will perform which action?a. Administer fentanyl intramuscularly.b. Contact the provider for an order for IM meperidine (Demerol).c. Give the woman promethazine (Phenergan) d. Request an order for hydroxyzine (Vistaril).
ANS: B
The nurse is caring for a woman who is in labor. The woman is anxious and reports increasing nausea after receiving an opioid analgesic medication. The nurse will contact the provider and request an order for which intravenous medication?a. Hydroxyzine HCl (Vistaril)b. Pentobarbital sodium (Nembutal)c. Promethazine (Phenergan) d. Secobarbital sodium (Seconal)
ANS: C
The nurse is preparing a woman who is in labor for a lumbar epidural and explains that she will receive a continuous infusion of epidural anesthesia. She asks what will happen if that isn’t effective. What response by the nurse is correct?a. “Increasing the amount of anesthesia will increase the risk of postdural headache.”b. “You should tell the provider, and you may receive rescue doses of anesthesia if needed.”c. “You will receive opioid analgesics if the epidural anesthesia is ineffective.” d. “The consistent level provided by the continuous anesthesia will be sufficient.”
ANS: B
The nurse is assisting with placement of epidural anesthesia for a woman who is in labor. To help prevent maternal hypotension, which is the nurse’s initial action?a. Administer 40–80 mcg of intravenous phenylephrine.b. Infuse a bolus of 500–1000 mL of IV crystalloid solution.c. Monitor the patient’s blood pressure closely during epidural placement. d. Turn the patient onto her left side and give a rapid bolus of crystalloid solution.
ANS: B
The nurse examines a primipara woman who has received an epidural block. The woman’s cervix has been dilated at 5 cm for an hour after having shown steady progression earlier. The nurse will notify the provider and anticipate a need fora. caesarean section.b. forceps delivery.c. intravenous oxytocin. d. vacuum extraction.
ANS: C
The nurse is caring for a patient after the third stage of labor, and the provider orders 20 units of oxytocin to be given intramuscularly. The nurse will explain to the patient that this drug for which purpose?a. To allow the cervix to closeb. To enhance milk letdownc. To prevent uterine atony d. To suppress lactation
ANS: C
The nurse is caring for a postpartum woman who has chosen not to breastfeed her infant. She asks why she cannot use drugs to suppress lactation. Which response by the nurse is correct?a. “Hormonal drugs are not as effective as complementary therapies.”b. “Hormonal drugs cause increased constipation.”c. “Hormonal drugs increase the risk of blood clots.” d. “Hormonal drugs promote uterine atony.”
ANS: C
The nurse provides teaching for a postpartal woman who will take bisacodyl tablets to help with constipation. What information will the nurse include when teaching this patient about this medication?a. “Crush the tablet if it is difficult to swallow.”b. “Store this medication in a cool, dry place.”c. “Take the tablet with a carbonated beverage.” d. “Take with milk if gastrointestinal upset occurs.”
ANS: B
When teaching a postpartal patient about the use of mineral oil as a laxative, the nurse will explain that mineral oila. does not have serious side effects.b. is safe to take with other laxatives.c. may be taken with food. d. should be mixed with juice or soda.
ANS: D
The nurse is caring for a postpartal patient who has just delivered her first baby by caesarean section. The mother’s blood type is Rh-negative, and the infant’s blood type is Rh-positive. The provider has ordered human D immune globulin (RhoGAM). The nurse understands that this patient will needa. less than the usual RhoGAM dose.b. more than the usual RhoGAM dose.c. no RhoGAM. d. the usual RhoGAM dose.
ANS: B
The nurse has just administered Rho(D) immune globulin (RhoGAM) to a postpartal woman. What information will the nurse include when teaching this patient?a. “Avoid live vaccines for 3 months.”b. “There are no adverse reactions to this injection.”c. “The immune globulin does not cross into breast milk.” d. “You will not need to have the injection with future deliveries.”
ANS: A
The nurse is caring for a postpartal woman and reviews the following lab results in her medical record: HBsAg-negative, rubella titer less than 1:8/1:10, Rh-negative with Rh-positive infant. Which injections will the nurse expect to be ordered?a. Hepatitis B immune globulin and MMR todayb. MMR and Rho(D) immune globulin (RhoGAM) todayc. Rho(D) immune globulin (RhoGAM) and hepatitis B immune globulin today d. Rho(D) immune globulin (RhoGAM) today and MMR in 3 months
ANS: D
A woman who is 2 months pregnant tells the nurse that she has never received the MMR vaccine and has not had these diseases. She has 3-year-old and 5-year-old children who have not been immunized. The nurse will counsel the patient to perform which action?a. Delay obtaining the vaccines for her children and herself until after her baby is born.b. Have her children vaccinated now and obtain the vaccine for herself after the baby is born.c. Obtain the MMR vaccine for her children and herself when she is in her third trimester of pregnancy. d. Obtain the MMR vaccine for her children and herself within the next few weeks.
ANS: B
A pregnant woman asks the nurse about whether a medication is safe to take during pregnancy. The nurse notes that the drug has a low-molecular weight. Based on this drug characteristic, the nurse understands that this druga. can cause greater gastrointestinal distress and hyperemesis.b. has reduced renal elimination resulting in toxicity.c. is more sensitive to metabolism by circulating maternal hormones. d. will be more likely to cross the placenta and affect the fetus.
ANS: D
A woman who is 4 weeks pregnant is worried that a medication she took until 3 weeks ago may cause birth defects. The nurse will tell her thata. drugs taken in the first week of pregnancy can cause CNS defects.b. medications have increased teratogenicity during the first week of pregnancy.c. she should have an ultrasound immediately. d. teratogenic effects are rare in the first 2 weeks of pregnancy.
ANS: D
Which statement by the nurse is accurate regarding iron supplementation during pregnancy?a. “All women should take iron supplements throughout their pregnancy.”b. “Iron supplements are given to supply the fetus.”c. “Iron supplements usually are not necessary until the second trimester.” d. “The greatest iron demand is in the first trimester of pregnancy.”
ANS: C
A patient who has just delivered her baby asks the nurse if she needs to continue taking her iron supplement. What instruction will the nurse provide to the patient?a. “Continue taking iron for 6 more weeks.”b. “Stop taking the iron supplement now.”c. “Take the iron supplement while nursing.” d. “Take the iron only if your hemoglobin is low.”
ANS: A
The nurse is teaching a woman who is pregnant about iron supplementation. Which statement by the woman indicates understanding of the teaching?a. “I may take the iron with an antacid to reduce gastrointestinal upset.”b. “I should drink a glass of milk with iron to increase absorption.”c. “I should take the iron supplement with a glass of orange juice.” d. “I will stop taking the iron if my stools turn black and tarry.”
ANS: C
A young woman who is contemplating pregnancy asks the nurse what she can do to get healthy in preparation for pregnancy. The nurse will recommend which dietary supplement?a. 60 mg of elemental iron per dayb. 400 mcg of folic acid per dayc. 400 IU of vitamin D per day d. 1200 mg of calcium per day
ANS: B
A pregnant woman who has morning sickness asks the nurse what she can do to decrease her symptoms. The nurse will counsel her to take which action?a. Avoid fatty foods.b. Drink fluids with meals.c. Eat a large lunch and dinner. d. Take an iron supplement in the morning.
ANS: A
A pregnant woman asks the nurse if she must give up caffeinated coffee while pregnant. How will the nurse advise the patient?a. “Two cups of coffee can increase your risk of spontaneous abortion.”b. “Drinking fewer than 6 cups of coffee per day is not harmful.”c. “You may consume coffee freely during your third trimester.” d. “There is evidence that caffeine is teratogenic.”
ANS: A
The nurse is caring for a patient who is 6–7 weeks pregnant and has moderate to severe vomiting. The provider has ordered doxylamine (Unisom) and intravenous fluids. The patient reports a history of asthma and type 2 diabetes mellitus. The nurse will hold the drug and contact the provider because doxylamine should not be given to patients whoa. are pregnant.b. are in their first trimester.c. have asthma. d. have diabetes.
ANS: C
A woman who is pregnant tells the nurse she has frequent heartburn in spite of eating small meals slowly; avoiding greasy, gas-forming foods; and remaining upright for 30 min after eating. The nurse will recommend which over-the-counter product?a. Alka-Seltzerb. Magaldratec. Pepcid d. TUMS
ANS: B
A pregnant woman reports having constipation and has tried dietary changes without success. What will the nurse recommend?a. Bisacodyl (Dulcolax)b. Mineral oilc. Psyllium (Metamucil) d. Senna (Senokot)
ANS: C
A woman who is in her third trimester of pregnancy asks the nurse why she cannot take ibuprofen instead of acetaminophen for headaches. The nurse will explain that NSAIDsa. will affect her fetus.b. have renal toxicity.c. induce premature labor. d. prolong labor.
ANS: A
A woman who is experiencing premature labor is being given betamethasone (Celestone). She asks the nurse why this drug is being given. The nurse will explain that betamethasone is given for which reason?a. It lowers her blood pressure and prevents seizures.b. It prevents closure of the ductus arteriosus.c. It prevents respiratory distress in her infant. d. It stops her contractions.
ANS: C
The nurse is caring for a woman who is experiencing premature labor. The provider has ordered intravenous terbutaline (Brethine) to be given. The nurse will explain that this medication will have which action?a. It will decrease uterine contractions.b. It will enhance fetal lung development.c. It will increase fetal blood supply. d. It will lower her blood pressure.
ANS: A
The nurse is caring for a woman who is in labor and has a blood pressure of 180/98 mm Hg with proteinuria of 400 mg/24 h. The woman is receiving magnesium sulfate. The woman becomes lethargic with slurring of her speech and decreased muscle tone. Her serum magnesium sulfate level is 11 mEq/L. The nurse recognizes which condition in this patient?a. Abruptio placentab. Hypertensive crisisc. Impending eclampsia d. Magnesium toxicity
ANS: D
The nurse is caring for a woman who is in her third trimester of pregnancy. The patient has a blood pressure of 165/95 mm Hg with proteinuria of 350 mg/24 h and has been diagnosed with preeclampsia. The nurse recognizes which conditions as risk factors for this condition?a. African American, multigravida, and 40 years of ageb. Caucasian, multifetal gestation, and preexisting hypertensionc. Maternal infection, age 19, and preexisting renal disease d. History of preeclampsia, obesity, and surrogacy
ANS: C
A woman who is experiencing preeclampsia asks what changes she has to make to her routine to minimize the risk of worsening her condition. The nurse will explain that she shoulda. lie on her right side when sleeping.b. be hospitalized for the remainder of the pregnancy.c. restrict her fluids to 1000 mL/day. d. maintain a low stimulating environment.
ANS: D
Which are physiologic changes during pregnancy that affect drug absorption, metabolism, distribution, and excretion? (Select all that apply.)a. Circulating steroid hormonesb. Decreased gastrointestinal motilityc. Decreased renal perfusiond. Increased maternal circulatory blood volumee. Poor sleep and fatigue f. Rapid respiratory rate
ANS: A, B, D
The nurse is teaching a group of nursing students about diabetes. The nurse explains that which type of diabetes is the most common?a. Type 1 diabetes mellitusb. Type 2 diabetes mellitusc. Diabetes insipidus d. Secondary diabetes
ANS: B
A patient develops type 2 diabetes mellitus. The nurse will explain that this type of diabetesa. is generally triggered by medications.b. is not as common as type 1 diabetes.c. is often related to heredity and obesity. d. will not require insulin therapy.
ANS: C
A patient who is overweight is being evaluated for diabetes. The patient has a blood glucose level of 160 mg/dL and a hemoglobin A1c of 5.8%. The nurse understands that this patient has which condition?a. Diabetes mellitusb. Hypoglycemiac. Normal blood levels d. Prediabetes
ANS: D
The nurse is teaching a patient who is newly diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient indicates a need for further teaching?a. “I may use a chosen site daily for up to a week.”b. “I should give each injection a knuckle length away from a previous injection.”c. “I will not be concerned about a raised knot under my skin from injecting insulin.” d. “Insulin is absorbed better from subcutaneous sites on my abdomen.
ANS: C
The nurse is teaching a patient how to administer insulin. The patient is thin with very little body fat. The nurse will suggest injecting insulina. by pinching up the skin and injecting straight down.b. in the abdomen only with the needle at a 90-degree angle.c. subcutaneously with the needle at a 45- to 60-degree angle. d. using the thigh and buttocks areas exclusively.
ANS: C
The nurse receives the following order for insulin: IV NPH (Humulin NPH) 10 units. The nurse will perform which action?a. Administer the dose as ordered.b. Clarify the insulin type and route.c. Give the drug subcutaneously. d. Question the insulin dose.
ANS: B
The nurse will administer parenteral insulin to a patient who will receive a mixture of NPH (Humulin NPH) and regular (Humulin R). The nurse will give this medication via which route?a. Intradermalb. Intramuscularc. Intravenous d. Subcutaneous
ANS: D
The nurse is teaching a patient about home administration of insulin. The patient will receive regular (Humulin R) and NPH (Humulin NPH) insulin at 0700 every day. What is important to teach this patient?a. “Draw up the medications in separate syringes.”b. “Draw up the NPH insulin first.”c. “Draw up the regular insulin first.” d. “Draw up the medications after mixing them in a vial.”
ANS: C
A patient is ordered to receive insulin lispro at mealtimes. The nurse will instruct this patient to administer the medication at which time?a. 5 min before eatingb. 15 min after eatingc. 30 min before eating d. 10 min after eating
ANS: A
The parent of a junior high school child who has type 1 diabetes asks the nurse if the child can participate in sports. The nurse will tell the parenta. that strenuous exercise is not recommended for children with diabetes.b. that the child must be monitored for hyperglycemia while exercising.c. to administer an extra dose of regular insulin prior to exercise. d. to send a snack with the child to eat just prior to exercise.
ANS: D
A patient has administered regular insulin 30 min prior but has not received a breakfast tray. The patient is experiencing nervousness and tremors. What is the nurse’s first action?a. Administer glucagon.b. Give the patient orange juice.c. Notify the kitchen to deliver the tray. d. Perform bedside glucose testing.
ANS: B
A patient who has type 1 diabetes mellitus asks the nurse about using a combination insulin product such as Humalog 70/20. The nurse will tell the patient that use of this producta. depends on individual insulin needs.b. is useful for patient with insulin resistance.c. means less rotation of injection sites. d. requires refrigeration at all times.
ANS: A
The patient asks the nurse about storing insulin. Which response by the nurse is correct?a. “All insulin vials must be refrigerated.”b. “Insulin will last longer if kept in the freezer.”c. “Opened vials of insulin must be discarded.” d. “Some combination pens do not require refrigeration.”
ANS: D
A patient who has insulin-dependent diabetes mellitus must take a glucocorticoid medication for osteoarthritis. When teaching this patient, the nurse will explain that there may be a need toa. decrease the glucocorticoid dose.b. decrease the insulin dose.c. increase the glucocorticoid dose. d. increase the insulin dose.
ANS: D
Which statement by a patient who will begin using an external insulin pump indicates understanding of this device?a. “I will have an increased risk for hypoglycemia.”b. “I will leave this on when bathing or swimming.”c. “I will not need to count carbohydrates anymore.” d. “I will still need to monitor serum glucose.”
ANS: D
A patient who is unconscious and has a pulse is brought to the emergency department. The patient is wearing a Medic-Alert bracelet indicating type 1 diabetes mellitus. The nurse will anticipate an order to administera. cardiopulmonary resuscitation (CPR).b. glucagon.c. insulin. d. orange juice.
ANS: B
A patient who has type 2 diabetes mellitus asks the nurse why the provider has changed the oral antidiabetic agent from tolbutamide (Orinase) to glipizide (Glucotrol). The nurse will explain that glipizidea. has a longer duration of action.b. has fewer gastrointestinal side effects.c. may be taken on an as-needed basis. d. results in less hypoglycemic potential.
ANS: A
A patient who has been taking a sulfonylurea antidiabetic medication will begin taking metformin (Glucophage). The nurse understands that this patient is at increased risk for which condition?a. Hypoglycemiab. Hyperglycemiac. Renal failure d. Respiratory distress
ANS: C
A 45-year-old patient who is overweight has had a diagnosis of type 2 diabetes for 2 years. The patient uses 20 units of insulin per day. The patient’s fasting blood glucose (FBG) is 190 mg/dL. The patient asks the nurse about using an oral antidiabetic agent. The nurse understands that oral antidiabetic agentsa. cannot be used if the patient is overweight.b. cannot be used once a patient requires insulin.c. may be used since this patient meets criteria. d. may not be used since this patient’s fasting blood glucose is too high.
ANS: C
The nurse is providing teaching for an adolescent who has acne vulgaris. In addition to teaching about correct administration of the prescribed medications, the nurse will instruct this patient toa. apply topical vitamin D3.b. cleanse the skin gently several times a day.c. cleanse the affected skin vigorously twice daily. d. take supplemental vitamin A.
ANS: B
A patient reports using benzoyl peroxide 2.5% for acne but doesn’t feel that it is working. The nurse notes papules and nodules on the patient’s face, neck, and back, consistent with moderate acne vulgaris. The nurse will counsel this patient to ask the provider abouta. adding isotretinoin (Amnesteem) to the treatment regimen.b. increasing the benzoyl peroxide to a 5% solution.c. taking systemic antibiotics until symptoms improve. d. using benzoyl peroxide 10% and a topical antibiotic.
ANS: D
The nurse is teaching a female patient who will begin taking isotretinoin (Amnesteem) to treat severe cystic acne. Which statement by the patient indicates understanding of the teaching?a. “I may get a 3-month supply of the medication with each refill.”b. “I must abstain from intercourse while taking this drug.”c. “I should avoid strenuous exercise when I am taking this medication.” d. “I should take a vitamin A supplement while I am taking the medication.”
ANS: C
A patient who has psoriasis is taking methoxsalen (Oxsoralen) to treat the condition along with receiving therapeutic ultraviolet A. The nurse notes burning and blistering of the patient’s skin. Which action will the nurse take?a. Ask the patient about any recent exposure to sunlight.b. Explain to the patient that these signs mean the treatment is working.c. Report spread of the psoriasis to the patient’s provider. d. Tell the patient to take the methoxsalen after the ultraviolet A treatment.
ANS: A
A patient who has psoriasis will begin taking etanercept (Enbrel). The nurse will ensure that which laboratory test is performed prior to initiating treatment with this drug?a. Complete blood count (CBC) with differentialb. CD4 and T-cell countc. Serum pregnancy test d. Tuberculin test
ANS: D
The nurse assists the provider to treat a patient who has warts with cantharidin (Cantharone). After the cantharidin is applied to the warts, the nurse willa. apply gauze dressings to the warts and secure them with tape.b. cover the warts with nonporous tape when the solution dries.c. prepare to assist the provider with cryotherapy to complete the procedure. d. treat the warts with Burrow’s soaks and apply a wet-to-dry dressing.
ANS: B
A patient reports localized itching after contact with a new brand of laundry detergent. The nurse will suggest that the patient contact the provider to discuss treatment with which product?a. Calamine lotionb. Systemic glucocorticoidc. Topical diphenhydramine d. Topical glucocorticoid
ANS: D
A patient who works outdoors has frequent contact dermatitis flares secondary to exposure to plant irritants. The patient asks the nurse how to minimize these episodes. The nurse will counsel this patient to perform which action?a. Apply topical glucocorticoid medication prior to exposure.b. Cleanse the skin immediately after any contact with plants.c. Take systemic diphenhydramine (Benadryl) after being outdoors. d. Use calamine lotion prior to working outdoors.
ANS: B
A female patient has begun using 2% minoxidil (Rogaine) to treat thinning of her hair. After several weeks of treatment, she reports minimal effectiveness but has noticed some improvement. The nurse will counsel her to perform which action?a. Continue to use the 2% minoxidil.b. Change to finasteride (Propecia).c. Discontinue the minoxidil. d. Increase to 5% minoxidil.
ANS: A
The nurse is teaching a group of adolescents about sun protection. What information will the nurse include when teaching this group?a. Effective sunscreens guard against melanoma and basal cell carcinoma.b. SPF numbers indicate UVB protection, and UVA protection is assumed for all products.c. SPF ratings are proportional to the amount of UVB radiation that they block. d. Sunscreen products of all SPF ratings will protect for 2 hours if not exposed to moisture.
ANS: D
An adolescent patient is preparing to take a summer job as a landscaper and asks the nurse about insect repellents and sunscreens. Which statement by the nurse is correct?a. Apply sunscreen prior to applying insect repellents containing DEET.b. Apply sunscreen containing PABA 30 minutes prior to sun exposure.c. Most sunscreens block both UVB and UVA radiation. d. Reapply sunscreen every 2 hours if sweating occurs.
ANS: D
A patient who has extensive second- and third-degree burns will use mafenide acetate (Sulfamylon) to treat the burns. What is an important aspect of care for this patient?a. Assess for fluid overload.b. Explain that this medication will decrease pain.c. Monitor the patient’s electrolytes. d. Teach the patient how to use sterile technique at home.
ANS: C
A patient has second- and third-degree burns, and the nurse is applying silver sulfadiazine (Silvadene) to the burns with each dressing change. The patient reports a burning sensation. The nurse understands that this isa. a hypersensitivity reaction to the medication.b. an expected adverse reaction to the medication.c. a sign of localized tissue infection. d. a sign of skin necrosis.
ANS: B
The parents of an 11-year-old boy ask about growth hormone therapy for their child, who is shorter than his 10-year-old sister. The nurse will tell the parents that growth hormonea. does not affect other hormones when given.b. is available as an oral tablet to be taken once daily.c. is given after tests prove that it is necessary. d. may be given until the child’s desired height is reached.
ANS: C
The nurse is caring for a patient who is receiving growth hormone. Which assessment will the nurse monitor daily?a. Complete blood countb. Height and weightc. Renal function d. Serum glucose
ANS: D
The parents of a 16-year-old boy who plays football want their child to receive growth hormone to improve muscle strength. What will the nurse tell the parents?a. “Growth hormone may be used to improve strength in young athletes.”b. “If the epiphyses are not fused, growth hormone may be an option.”c. “Small doses of growth hormone may be used indefinitely for this purpose.” d. “Using growth hormone to build muscle mass is not recommended.”
ANS: D
Which would be a contraindication for hormone therapy with somatropin (Genotropin) in a school-age child?a. Asthmab. Dwarfismc. Enuresis d. Prader-Willi syndrome
ANS: D
A child exhibits acromegaly caused by a tumor that cannot be destroyed with radiation. Which medication will most likely be used to treat this child?a. Bromocriptine mesylate (Parlodel)b. Octreotide acetate (Sandostatin)c. Somatrem (Protropin) d. Somatropin (Genotropin)
ANS: A
The nurse is caring for a patient who has hypothyroidism. To assist in differentiating between primary and secondary hypothyroidism, the nurse will expect the provider to order which drug?a. Liothyronine sodium (Cytomel)b. Liotrix (Thyrolar)c. Methimazole (Tapazole) d. Thyrotropin (Thytropar)
ANS: D
The nurse administers intravenous corticotropin (Acthar) to a patient. A serum cortisol level drawn 60 min later shows no change in serum cortisol levels from prior to the dose. What is the nurse’s first action?a. Notify the provider to discuss a possible non-functioning adrenal gland.b. Recognize the need for an increased dose to treat pituitary insufficiency.c. Request an order for a second dose of corticotropin to treat cortisone deficiency. d. Request an order to repeat the serum cortisol level in 1–2 h.
ANS: A
The nurse provides teaching for a patient who is receiving corticotropin. The nurse will instruct the patient to contact the provider if which condition occurs?a. Bruisingb. Constipationc. Myalgia d. Nausea
ANS: A
The nurse is caring for a patient who has experienced head trauma in a motor vehicle accident. The patient is having excessive output of dilute urine. The nurse will notify the provider and will anticipate administering which medication?a. Calcifediol (Calderol)b. Corticotropin (Acthar)c. Prednisolone (AK-Pred) d. Vasopressin (Pitressin)
ANS: D
The nurse is preparing to administer piperacillin to a patient to treat an infection caused by pseudomonas. The nurse learns that the patient receives corticotropin to treat multiple sclerosis. The nurse will request an order fora. a different antibiotic.b. blood glucose monitoring.c. cardiac monitoring. d. serum electrolytes.
ANS: D
The nurse is caring for a patient who is receiving desmopressin acetate (DDAVP). Which assessments are important while caring for this patient?a. Blood pressure and serum potassiumb. Heart rate and serum calciumc. Lung sounds and serum magnesium d. Urine output and serum sodium
ANS: D
A 35-year-old woman reports lethargy, difficulty remembering things, facial edema, dry skin, and cessation of menses. The nurse notes a heart rate of 60 beats per minute and a weight increase of 5 pounds from a previous visit. The nurse will notify the provider of which possible condition?a. Cretinismb. Early menopausec. Hyperthyroidism d. Myxedema
ANS: D
A patient is admitted to the hospital to treat hypothyroidism. For rapid improvement in symptoms, the nurse will expect to administer which medication?a. Levothyroxine sodium (Synthroid)b. Liothyronine (Cytomel)c. Liotrix (Thyrolar) d. Thyroid desiccated (Armour Thyroid)
ANS: B
A patient who takes warfarin (Coumadin) and digoxin (Lanoxin) develops hypothyroidism and will begin taking levothyroxine (Synthroid). The nurse anticipates which potential adjustments in dosing for this patient?a. Decreased digoxin and decreased warfarinb. Decreased digoxin and increased warfarinc. Increased digoxin and decreased warfarin d. Increased digoxin and increased warfarin
ANS: C
A patient who takes the oral antidiabetic agent metformin (Glucophage) will begin taking levothyroxine (Synthroid). The nurse will teach this patient to monitor fora. hyperglycemia.b. hypoglycemia.c. hyperkalemia. d. hypokalemia.
ANS: A
A patient who has hyperthyroidism will begin treatment with an antithyroid medication. The patient asks the nurse about dietary requirements. The nurse will counsel the patient to avoid which food(s)?a. Fava beansb. Foods high in purinec. Grapefruit d. Shellfish
ANS: D
The nurse is caring for a patient who is being treated for hypothyroidism. The patient reports insomnia, nervousness, and flushing of the skin. Before notifying the provider, the nurse will perform which action?a. Assess serum glucose to evaluate possible hypoglycemia.b. Check the patient’s heart rate to assess for tachycardia.c. Perform an assessment of hydration status. d. Take the patient’s temperature to evaluate for infection.
ANS: B
A patient with Graves disease exhibits tachycardia, heat intolerance, and exophthalmos. Prior to surgery, which drug is used to alter thyroid hormone levels?a. Liotrix (Thyrolar)b. Propranolol (Inderal)c. Propylthiouracil (PTU) d. Thyroid (Thyro-Tab)
ANS: C
A patient has hypocalcemia caused by parathyroid hormone deficiency. Which medication will the nurse anticipate giving to this patient?a. Calcitoninb. Calcitriolc. Calcium d. Vitamin D
ANS: B
A patient is receiving a glucocorticoid medication to treat an inflammatory condition, and the provider has ordered a slow taper in order to discontinue this medication. The nurse explains to the patient that this is done to prevent which condition?a. Acromegalyb. Adrenocortical insufficiencyc. Hypertensive crisis d. Thyroid storm
ANS: B
A patient is taking prednisolone and fludrocortisone (Florinef). When teaching this patient about dietary intake, the nurse will instruct the patient to consume a dieta. high in carbohydrates.b. high in fat.c. high in protein. d. low in potassium.
ANS: C
A patient who takes high-dose aspirin to treat arthritis will need to take prednisone to treat an acute flare of symptoms. What action will the nurse perform?a. Observe the patient for hypoglycemia.b. Monitor closely for increased urine output.c. Observe the patient for hypotension. d. Request an order for enteric-coated aspirin.
ANS: D
A patient who has been instructed to use a liquid antacid medication to treat gastrointestinal upset asks the nurse about how to take this medication. What information will the nurse include when teaching this patient?a. Take a laxative if constipation occurs.b. Take 60 minutes after meals and at bedtime.c. Take with at least 8 ounces of water to improve absorption. d. Take with milk to improve effectiveness.
ANS: B
A patient who has symptoms of peptic ulcer disease will undergo a test that requires drinking a liquid containing 13C urea and breathing into a container. The nurse will explain to the patient that this test is performed toa. assess the level of hydrochloric acid.b. detect H. pylori antibodies.c. measure the pH of gastric secretions. d. test for the presence of 13CO2.
ANS: D
A patient is taking esomeprazole (Nexium) 15 mg per day to treat a duodenal ulcer. After 10 days of treatment, the patient reports that the pain has subsided. The nurse will counsel the patient toa. continue the medication for 4 more weeks.b. reduce the medication dose by half.c. stop taking the medication. d. take the medication every other day.
ANS: A
A patient with a peptic ulcer has been diagnosed with H. pylori. The provider has ordered lansoprazole (Prevacid), clarithromycin (Biaxin), and metronidazole (Flagyl). The patient asks the nurse why two antibiotics are needed. The nurse will explain that two antibioticsa. allow for less toxic dosing. c. have synergistic effects. b. combat bacterial resistance. d. improve acid suppression.
ANS: B
A patient who takes propantheline bromine (Pro-Banthine) and omeprazole (Prilosec) for an ulcer will begin taking an antacid. The nurse will give which instruction to the patient regarding how to take the antacid?a. Take the antacid 2 hours after taking the propantheline.b. Take the antacid along with a meal.c. Take the antacid with milk. d. Take the antacid with the propantheline bromine.
ANS: A
Which antacid is likely to cause acid rebound?a. Aluminum hydroxideb. Calcium carbonatec. Magnesium hydroxide d. Magnesium trisilicate
ANS: B
An elderly patient reports using Maalox frequently to treat acid reflux. The nurse should notify the patient’s provider to request an order for which laboratory tests?a. Liver enzymes and serum calciumb. Liver enzymes and serum magnesiumc. Renal function tests and serum calcium d. Renal function tests and serum magnesium
ANS: D
The nurse is caring for a patient who has Zollinger-Ellison syndrome. Which medication order would the nurse question for this patient?a. Cimetidine (Tagamet)b. Pantoprazole (Protonix)c. Rabeprazole (Aciphex) d. Ranitidine (Zantac)
ANS: A
A patient who is diagnosed with peptic ulcer disease has been started on a regimen that includes ranitidine (Zantac) 300 mg daily at bedtime. The patient calls the clinic 1 week later to report no relief from discomfort. What action will the nurse take?a. Contact the provider to discuss changing to cimetidine (Tagamet).b. Notify the provider to discuss increasing the dose.c. Reassure the patient that the drug may take 1 to 2 weeks to be effective. d. Suggest that the patient split the medication into twice daily dosing.
ANS: C
A male patient who has been taking a histamine2 blocker for several months reports decreased libido and breast swelling. What will the nurse do?a. Contact the provider to report possible drug toxicity.b. Reassure the patient that these symptoms will stop when the drug is discontinued.c. Request an order for serum hormone levels. d. Suggest that the patient see an endocrinologist.
ANS: B
A patient who has been taking ranitidine (Zantac) continues to have pain associated with peptic ulcer. A noninvasive breath test is negative. Which treatment does the nurse expect the provider to order for this patient?a. Adding an over-the-counter antacid to the patient’s drug regimenb. A dual drug therapy regimenc. Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec) d. Lansoprazole (Prevacid) instead of ranitidine
ANS: D
A patient has been taking famotidine (Pepcid) 20 mg bid to treat an ulcer but continues to have pain. The provider has ordered lansoprazole (Prevacid) 15 mg per day. The patient asks why the new drug is necessary, since it is more expensive. The nurse will explain that lansoprazolea. can be used for long-term therapy.b. does not interact with other drugs.c. has fewer medication side effects. d. is more potent than famotidine.
ANS: D
The nurse is caring for a patient who will begin taking omeprazole (Prevacid) 20 mg per day for 4 to 8 weeks to treat gastroesophageal reflux disease esophagitis. The nurse learns that the patient takes digoxin. The nurse will contact the provider for orders toa. decrease the dose of omeprazole.b. increase the dose of digoxin.c. increase the omeprazole to 60 mg per day. d. monitor for digoxin toxicity.
ANS: D
A patient reports experiencing flatulence and abdominal distension to the nurse. Which over-the-counter medication will the nurse recommend?a. Alka-Seltzerb. Maaloxc. Mylicon d. Tums
ANS: C
A patient who recently began having mild symptoms of gastroesophageal reflux disease (GERD) is reluctant to take medication. What measures will the nurse recommend to minimize this patient’s symptoms? (Select all that apply.)a. Avoiding hot, spicy foodsb. Avoiding tobacco productsc. Drinking a glass of red wine with dinnerd. Eating a snack before bedtimee. Taking ibuprofen with foodf. Using a small pillow for sleeping g. Wearing well-fitted clothing
ANS: A, B, E
A woman is diagnosed with bacterial vaginosis and will begin taking metronidazole (Flagyl). What will the nurse teach the patient about this medication?a. “Abstain from sexual intercourse while taking this medication.”b. “Do not consume alcohol while taking this drug and for 48 hours after finishing the prescription.”c. “Take this medication on an empty stomach to increase absorption.” d. “Topical preparations are ineffective for treating bacterial vaginosis.”
ANS: B
The nurse is teaching the parent of an 11-year-old girl about the Gardasil vaccine. What will the nurse include in teaching?a. “Gardasil is given to females and not to males.”b. “Gardasil protects against cervical dysplasia.”c. “Gardasil reduces the need for routine Pap smears.” d. “Gardasil will be given as a single injection.”
ANS: B
A patient is taking azithromycin to treat a chancroid infection. What nonpharmacologic measures will the nurse recommend as adjunct therapy to treat this infection?a. Apply a bacteriostatic ointment to the lesions twice daily.b. Avoid washing the lesions to prevent spread of the infection.c. Cover the lesions with gauze at all times to minimize discomfort. d. Use compresses to remove necrotic material and clean the lesions three times daily.
ANS: D
A woman is diagnosed with gonorrhea and asks the nurse about treatment. Which statement will the nurse include in teaching?a. “Ceftriaxone IM is prescribed.”b. “Erythromycin ointment is prescribed.”c. “IM ceftriaxone and oral azithromycin are prescribed.” d. “Oral doxycycline is prescribed.”
ANS: C
A woman is diagnosed with gonorrhea and receives ceftriaxone intramuscularly in clinic and a prescription for doxycycline to be taken twice daily for 7 days. She asks the nurse why she needs to take medicine since she has had a shot. How will the nurse respond?a. “Both medications are required to fully treat the gonorrheal infection.”b. “Doxycycline helps prevent spread of gonorrhea to your sexual partners.”c. “Patients with gonorrhea are always treated for chlamydia as well.” d. “The second medication decreases your chances of disease recurrence.”
ANS: C
A woman is diagnosed with herpes simplex virus (genital herpes). Which statement by the patient indicates understanding of the medication regime?a. “Antiviral drugs, it taken long enough, can cure the virus.”b. “I can take a drug that reduces the frequency of outbreaks.”c. “If I am taking antiviral medication, I cannot pass the virus on to my partner.” d. “I can use the medications once a month to treat symptoms.”
ANS: C
A woman with complaints of abnormal vaginal discharge, vaginal soreness, pruritus, and dysuria is diagnosed with vulvovaginal candidiasis (VVC). Which statement will the nurse include in teaching?a. “Treatment with prescription medication is lifelong.”b. “Alcohol should be avoided during treatment.”c. “Candida albicans can be readily passed between sex partners.” d. “Over the counter cream is used to treat the condition.”
ANS: D |