Medical-Surgical Nursing
Chapter Exam Questions
Course Introduction
Medical-Surgical Nursing is a foundational course that equips students with the knowledge and skills necessary to provide comprehensive care to adult patients experiencing a wide range of acute and chronic health conditions. Emphasizing clinical reasoning, evidence-based practice, and holistic patient care, this course covers disease processes, therapeutic interventions, perioperative care, medication management, and the use of technology in the clinical setting. Through theoretical instruction and practical application, students develop competencies in assessment, planning, implementation, and evaluation to effectively support patient recovery, promote health, and collaborate with interdisciplinary healthcare teams.
Recommended Textbook
Basic Pharmacology for Nurses 15th Edition by
Bruce D. Clayton
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Chapter 1: Definitions, Names, Standards, and Information
Sources
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Sample Questions
Q1) The nurse is administering Lomotil, a Schedule V drug. Which statement is true about this drug's classification?
A) Abuse potential for this drug is low.
B) Psychological dependency is likely.
C) There is a high potential for abuse.
D) This drug is not a controlled substance.
Answer: A
Q2) Which statement is true about over-the-counter (OTC) drugs?
A) They are not listed in the USP-NF.
B) A prescription from a health care provider is needed.
C) They are sold without a prescription.
D) They are known only by their brand names.
Answer: C
Q3) Which is the most useful drug reference source for patients?
A) American Drug Index
B) American Hospital Formulary
C) Health on the Net Foundation
D) Physicians' Desk Reference
Answer: C
3
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Chapter 2: Principles of Drug Action and Drug Interactions
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Sample Questions
Q1) Which routes enable drug absorption more rapidly than the subcutaneous route? (Select all that apply.)
A) Intravenous route
B) Intramuscular route
C) Inhalation/sublingual
D) Intradermal route
E) Enteral route
Answer: A, B, C
Q2) What is the process by which a drug is transported by circulating body fluids to receptor sites?
A) Osmosis
B) Distribution
C) Absorption
D) Biotransformation
Answer: B
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4
Chapter 3: Drug Action Across the Life Span
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Sample Questions
Q1) Which drugs cause birth defects?
A) Teratogens
B) Carcinogens
C) Metabolites
D) Placebos
Answer: A
Q2) Which patients require special considerations for medication administration? (Select all that apply.)
A) 29-year-old pregnant woman
B) 2-month-old baby
C) 18-year-old college student
D) 45-year-old farmer
E) 82-year-old retired nurse
Answer: A, B, E
Q3) When is the ideal time for a nursing mother to take her own medications?
A) Before the infant latches on to begin to breast-feed
B) As soon as the mother wakes up in the morning
C) Right before the mother goes to sleep at night
D) As soon as the infant finishes breast-feeding
Answer: D
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Chapter 4: The Nursing Process and Pharmacology
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Q1) What is the nurse's primary source of information when obtaining a patient history?
A) The physician
B) The patient record
C) The family
D) The patient
Q2) Which is the priority nursing diagnosis for an older adult with diabetes hospitalized for pneumonia?
A) Deficient Knowledge related to lack of information about diabetic medication
B) Risk for Falls related to weakness
C) Impaired Gas Exchange related to decreased pulmonary ventilation
D) Imbalanced Nutrition: More than Body Requirements related to obesity
Q3) Which outcome statement identified by the nurse is written correctly?
A) After surgery, patient will express acceptance of loss of breast.
B) Patient will die with dignity.
C) At the end of the shift the nurse will determine whether the patient is more comfortable.
D) Within the next 8 hours, urine output will be greater than 30 mL/hr.
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6
Chapter 5: Patient Education and Health Promotion
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Q1) Which are reliable ways to determine a patient's mastery of a psychomotor skill? (Select all that apply.)
A) Describe the process verbally.
B) Write a description of the process.
C) Give a reciprocal demonstration of the process.
D) Ask questions about the process.
E) Demonstrate the process to another person while the nurse supervises.
F) State whether the patient feels the process has been mastered.
Q2) Which should the nurse include during discharge in addition to verbal instructions? (Select all that apply.)
A) Written instructions for the patient's reference
B) A phone number of the provider or hospital unit for follow-up questions
C) Written instructions for monitoring of parameters used to evaluate therapy
D) Documentation in the nurse's discharge notes of the nursing and collaborative problems that require continued monitoring and intervention
E) Identification of the patient's unreasonable expectations of therapy
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Chapter 6: A Review of Arithmetic
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Sample Questions
Q1) 1/200 ÷ 1/150 = _____
Q2) Which mathematical system is most accurate?
A) Apothecary
B) Household
C) Metric
D) Arabic
Q3) Health care provider's order: Versapen 2.5 mg/kg qid (patient weighs 20.2 kg).
Available: Versapen 112.5 mg/5 mL
How many mL will you give? _____
Q4) xi = _____
Q5) Convert 1 tablespoon to milliliters (mL): _____
Q6) Convert 0.2 mg to mcg: _____
Q7) 0.125/0.25 = _____
Q8) 1 3/4 = _____
Q9) 17 = _____
Q10) Convert 2 tsp to milliliters (mL): _____
Q11) Convert 25 g to mg: _____
Available: Heparin 5000 units/mL Page 8
Q12) The physician has ordered 3500 units of heparin subcutaneously q12h
What volume of heparin will you administer? _____
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Chapter 7: Principles of Medication Administration and Medication Safety
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Sample Questions
Q1) Which example best demonstrates safe drug administration by the nurse?
A) Administering an oral medication with the patient sitting upright
B) Asking children to say their name before administering the medication
C) Leaving the medications on the bedside stand after verifying patient identification
D) Returning unused portion of a medication to a stock supply bottle
Q2) Which statements are true regarding the types of medication orders? (Select all that apply.)
A) Stat orders are the same as single-dose orders.
B) Standing orders indicate the number of specified doses a medication is to be given.
C) Renewal orders facilitate physician review before continuance of high-risk medications.
D) PRN medications will designate a mandatory number of times the medication is to be administered.
E) Verbal orders should be used as much as possible.
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10
Chapter 8: Percutaneous Administration
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Sample Questions
Q1) Where does the nurse correctly administer ophthalmic medication?
A) At the inner canthus of the eye
B) In the lower conjunctival sac
C) Directly onto the eyeball
D) To the outer corner of the eyelid
Q2) The nurse is teaching a patient about nitroglycerin ointment. Which is an advantage of this form of the medication?
A) It does not give the patient a bad taste in the mouth.
B) The amount of ointment does not matter in obtaining a therapeutic response.
C) It does not cause headaches as an adverse effect.
D) It provides relief of anginal pain for several hours longer than sublingual medication.
Q3) Which actions will the nurse perform when preparing to administer a topical medication? (Select all that apply.)
A) Wash hands before and after administration.
B) Maintain a dry environment to encourage wound healing.
C) Wear gloves during the application process.
D) Use sterile dressings for all wounds.
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Chapter 9: Enteral Administration
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Sample Questions
Q1) Which are common receptacles used in the hospital with pediatric oral medications? (Select all that apply.)
A) Oral syringe
B) Baby bottle full of formula
C) Infant feeding nipple
D) Teaspoon
E) Medicine dropper
Q2) Which route of administration would be ordered by the health care provider if a patient is vomiting?
A) Gastrostomy tube
B) Intradermal
C) Ophthalmic
D) Rectal
Q3) Which action by the nurse is appropriate when administering enteric-coated tablets?
A) Administer with an antacid.
B) Crush the tablet and mix with applesauce.
C) Encourage the patient to drink a full glass of water.
D) Instruct the patient to place the medication between the cheek and teeth.
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Page 12
Chapter 10: Parenteral Administration: Safe Preparation of Parenteral
Medications
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Sample Questions
Q1) Which are risk factors when administering medications by injection? (Select all that apply.)
A) Trauma at the site of the needle puncture
B) Possibility of infection
C) Irretrievability of the medication once administered
D) Delayed absorption
E) Delayed onset of action
F) Chance of allergic reaction
Q2) Which syringe will the nurse use to administer insulin subcutaneously to a patient?
A) A syringe calibrated in minims
B) A syringe calibrated in units
C) A syringe calibrated in tenths of mL
D) A syringe calibrated in mL
Q3) Which information provided by the nurse is most important to include when teaching a patient about the use of an EpiPen?
A) "Hold the syringe at a 45-degree angle against the skin."
B) "Monitor the expiration date of this medication."
C) "After using the EpiPen, lie down for 1 hour."
D) "Place the syringe in a cartridge prior to using."
Page 13
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Chapter 11: Parenteral Administration: Intradermal,
Subcutaneous, and Intramuscular Routes
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Q1) When is it acceptable to use the deltoid muscle as an injection site for infants?
A) Medication is irritating.
B) Dose is a long-acting medication.
C) Child is combative.
D) Volume is quite small.
Q2) Which action by the nurse is most accurate when administering an intradermal injection?
A) Insert the needle at a 45-degree angle.
B) Inject 0.1 mL.
C) Use a 22-gauge needle.
D) Wipe the site with alcohol after injection.
Q3) Which statements are true about when administering medications parenterally?
(Select all that apply.)
A) Subcutaneous absorption is slower than intradermal absorption.
B) Two milliliters or less should be administered in a subcutaneous site.
C) The gluteal area is recommended for children.
D) Needles 1 to 1 1/2 inches in length are common for IM injections.
E) The scapular areas of the back may be used for intradermal injections
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Chapter 12: Parenteral Administration: Intravenous Route
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Q1) Which condition would the nurse expect to be treated with an isotonic solution?
A) Fluid overload
B) Hemorrhagic shock
C) Cellular dehydration
D) Cerebral edema
Q2) A diabetic patient requires the administration of insulin continuously at home. Which system would most likely be used in this instance?
A) Central line catheter
B) Microdrip set
C) Piggyback system
D) Syringe pump
Q3) Following the insertion of a central venous access device, the nurse notes a weak, thready pulse and decreased blood pressure. The patient complains of shortness of breath and palpitations. Which action will the nurse take first?
A) Place the patient on the left side.
B) Reassess vital signs.
C) Stop the infusion.
D) Verify placement of the device.
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Chapter 13: Drugs Affecting the Autonomic Nervous System
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Q1) Which instructions given by the nurse will assist a patient to cope with the common adverse effects of anticholinergic medications? (Select all that apply.)
A) "Take the medication with meals."
B) "Increase fluids daily."
C) "Decrease fiber in the diet."
D) "Suck on candy or ice chips."
E) "Monitor blood sugars."
Q2) A patient with Parkinson's disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate?
A) "These drugs help you urinate."
B) "These drugs will decrease your eye pressure."
C) "These drugs inhibit the action of acetylcholine."
D) "These drugs will assist in lowering your heart rate."
Q3) What is the primary response to alpha-1 receptor stimulation?
A) Bronchodilation
B) Tachycardia
C) Vasoconstriction
D) Uterine relaxation
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Chapter 14: Sedative-Hypnotics
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Q1) Which are common adverse effects of barbiturates? (Select all that apply.)
A) Residual daytime sedation
B) Headache
C) Hyperactivity
D) Blurred vision
E) Impaired coordination
Q2) Why are benzodiazepines often preferred over barbiturates? (Select all that apply.)
A) They have selective action at specific receptor sites.
B) There is a wide range of safety between therapeutic and lethal levels.
C) REM sleep is decreased to a lesser extent.
D) Accidental overdoses are well tolerated.
E) There are no hypotensive episodes when rising to a sitting position.
Q3) Which two phases make up normal sleep?
A) Hypnogogic and hypnopompic
B) REM and non-REM
C) Alpha and beta
D) Delta and theta
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17
Chapter 15: Drugs Used for Parkinsons Disease
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Q1) What is the pharmacologic action of entacapone, a potent catechol-O-methyl transferase (COMT) inhibitor?
A) Slows the deterioration of dopaminergic nerve cells
B) Inhibits the relative excess of dopaminergic activity
C) Reduces the destruction of dopamine in peripheral tissues
D) Enhances the cholinergic symptoms of Parkinson's disease
Q2) The nurse is teaching a patient with Parkinson's disease about levodopa. Which statement by the nurse is accurate regarding drug administration?
A) "Take this medication in between meals."
B) "Take this medication at bedtime to prevent dizziness."
C) "Take this medication when your tremors get worse."
D) "Take this medication with food or antacids to reduce GI upset."
Q3) The nurse is providing education to a patient recently placed on selegiline disintegrating tablets. Which statement by the patient indicates a need for further teaching?
A) "This medication will help slow the development of symptoms."
B) "I will place the tablet on my tongue before breakfast."
C) "I may need to use a stool softer for constipation."
D) "I should not push the tablet through the foil."
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Page 18
Chapter 16: Drugs Used for Anxiety Disorders
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Q1) Which is true regarding psychological drug dependence?
A) It is easier to treat than physiological dependence.
B) It is not considered a true addiction.
C) It is easily controlled by influencing the patient's perceptions.
D) It requires medical intervention to treat.
Q2) The nurse is preparing to educate a patient and significant other about antianxiety medications before the patient's discharge. Which is pertinent information to be included in the teaching plan?
A) Discuss, review, and validate the behavior monitoring system and intervention flow sheet the patient and significant other will continue to use following discharge.
B) Discuss the possible dependence associated with the medication at length to make sure the patient does not overuse the drug.
C) Instruct the patient to educate family members about the medication therapy based on recollection of discussions with the nurse.
D) Provide all instructions verbally, with repetition as needed when requested by the patient.
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Chapter 17: Drugs Used for Mood Disorders
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Q1) Which statements are true regarding the pharmacologic actions of certain antidepressant drugs? (Select all that apply.)
A) MAOIs block the effects of dopamine in the central nervous system.
B) SSRIs inhibit the destruction and reuptake of serotonin at the synaptic cleft.
C) Tricyclic antidepressants block the action of norepinephrine and epinephrine in the SNS.
D) Monocyclic antidepressants such as bupropion (Wellbutrin) have an unknown mechanism of action.
E) SNRIs prolong the action of neurotransmitters by decreasing the destruction of serotonin and norepinephrine.
Q2) Which nursing action is most important when providing care to a patient diagnosed with a mood disorder?
A) Assess the patient for thoughts of suicide.
B) Provide supplemental feedings as needed.
C) Assist with activities of daily living.
D) Offer opportunities for interaction with other patients.
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Chapter 18: Drugs Used for Psychoses
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Q1) Which adverse effects may occur as a result of antipsychotic drug therapy? (Select all that apply.)
A) Acute dystonia
B) Akathisia
C) Weight loss
D) Neuroleptic malignant syndrome
E) Hypoglycemia
F) Tardive dyskinesia
Q2) Which is an appropriate nursing intervention for a patient who has recently been prescribed clozapine (Clozaril)?
A) Assess for signs and symptoms of hypoglycemia.
B) Encourage a low-fiber diet.
C) Measure the patient's waist circumference.
D) Monitor for insomnia.
Q3) The nurse is assessing a patient who is complaining of hearing voices. What is this patient experiencing?
A) Delusions
B) Flight of ideas
C) Disorganized thinking
D) Hallucinations
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Chapter 19: Drugs Used for Seizure Disorders
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Q1) Patients taking phenytoin (Dilantin) for control of seizures must be aware of the risk for which of the following adverse effects? (Select all that apply.)
A) Blood dyscrasias
B) Hyperglycemia
C) Urinary retention
D) Gingival hyperplasia
E) Insomnia
F) Sedation
Q2) For which condition may carbamazepine (Tegretol) be used?
A) Tardive dyskinesia
B) Psychotic episodes
C) Trigeminal neuralgia pain
D) Sedation
Q3) Which medication is used to control seizures or prevent migraine headaches?
A) Topiramate (Topamax)
B) Zonisamide (Zonegran)
C) Valproic acid (Depakene)
D) Tiagabine (Gabitril)
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Chapter 20: Drugs Used for Pain Management
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Q1) What term is used to define an awareness of pain?
A) Tolerance
B) Threshold
C) Perception
D) Sensation
Q2) Which sign or symptom displayed by a patient would be indicative of opiate withdrawal?
A) Bradycardia
B) Diarrhea
C) Lethargy
D) Hypothermia
Q3) In which case would the nurse be correct in withholding an opiate agonist?
A) Evidence of postural hypotension
B) Presence of constipation
C) Pain rating of 7 on a 0 to 10 scale
D) Respiratory rate of 10 breaths/min
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23
Chapter 21: Introduction to Cardiovascular Disease and Metabolic Syndrome
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Q1) Which instruction by the nurse is accurate to include in a patient's care to manage metabolic syndrome?
A) Encourage the client to exercise 20 minutes every day.
B) Eliminate alcohol intake.
C) Increase simple carbohydrates in the diet.
D) Reduce stress.
Q2) What is the most critical approach to the treatment of metabolic syndrome?
A) Psychotherapy
B) Pharmacotherapy
C) Lifestyle management
D) Patient education
Q3) Drug therapy for initial treatment of metabolic syndrome is targeted at controlling which conditions? (Select all that apply.)
A) Obstructive sleep apnea
B) Diabetes mellitus
C) Hypertension
D) Obesity
E) Dyslipidemia
F) Insulin resistance
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Chapter 22: Drugs Used to Treat Dyslipidemias
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Q1) Which antilipemic agent is most potent?
A) Niacin
B) HMG-CoA reductase inhibitor
C) Bile acid-binding resin
D) Fibric acid
Q2) The nurse is teaching a patient about statin therapy. Which statement by the patient indicates a need for further teaching?
A) "I will take this medication at night."
B) "This medication will reduce blood clot formation."
C) "I will avoid drinking grapefruit juice."
D) "If I get a headache, I will notify my health care provider."
Q3) The nurse is preparing medications for a patient. When is the best time for the nurse to administer lovastatin (Mevacor)?
A) 2 hours after breakfast
B) During the patient's dinner
C) 1 hour before breakfast
D) 30 minutes<sup> </sup>before lunch
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Chapter 23: Drugs Used to Treat Hypertension
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Q1) A patient recently prescribed felodipine (Plendil) for treatment of hypertension is experiencing dizziness when rising to a standing position. Which action will the nurse take?
A) Encourage the patient to sit down if feeling faint.
B) Advise the patient to increase dietary sodium.
C) Inform the patient to discontinue the medication.
D) Instruct the patient to monitor weight daily.
Q2) The nurse is finished conducting nutritional education with a patient about the DASH (dietary approaches to stop hypertension) diet. The patient would like to complete the breakfast menu for tomorrow. Which foods offered for breakfast would be most appropriate for the patient to choose? (Select all that apply.)
A) Grapefruit
B) Bacon
C) Whole milk
D) Orange juice
E) Eggs
F) Oatmeal
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Chapter 24: Drugs Used to Treat Dysrhythmias
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Q1) A patient is diagnosed with atrial fibrillation. The nurse anticipates that which drug will be used in the treatment of this dysrhythmia?
A) Disopyramide (Norpace)
B) Flecainide (Tambocor)
C) Lidocaine (Xylocaine)
D) Mexiletine (Mexitil)
Q2) The nurse is preparing to administer adenosine to a patient with supraventricular tachycardia. Which considerations should the nurse take into account before administration? (Select all that apply.)
A) Constant ECG monitoring is necessary.
B) Initial recommended dosage is 12-mg IV bolus.
C) Rapid IV bolus administration is recommended.
D) Saline flush following bolus is necessary.
E) Long half-life of adenosine may prolong adverse medication effects.
Q3) Amiodarone is contraindicated for patients with which condition?
A) Pulmonary edema
B) Severe sinus node dysfunction causing bradycardia
C) Atrial fibrillation
D) Premature ventricular contractions (PVCs)
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Page 27
Chapter 25: Drugs Used to Treat Angina Pectoris
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Q1) How frequently are nitroglycerin tablets discarded and prescriptions refilled?
A) Monthly
B) Every 3 months
C) Every 6 months
D) Yearly
Q2) The nurse is teaching a patient about nitroglycerin prior to discharge to home. Which instruction will the nurse provide the patient?
A) "Report any headaches following self-administration to your health care provider."
B) "Carry the medication in a pocket directly next to the body."
C) "Carry the medication with you at all times."
D) "Store nitroglycerin in a clear glass container with a tight lid."
Q3) Which action by the nurse is most accurate when administering nitroglycerin ointment to a patient?
A) Spread the ointment on the patient's legs in a thin, uniform layer.
B) Cover the patch with a clear plastic wrap.
C) Rub the ointment into the skin in a circular motion.
D) Shave the skin prior to application.
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28
Chapter 26: Drugs Used to Treat Peripheral Vascular Disease
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Q1) The nurse is preparing a teaching plan for a patient with Raynaud's disease who is soon to be discharged. Which information will be included to improve circulation and prevent complications of this disease? (Select all that apply.)
A) Begin a daily exercise program.
B) Keep hands and feet warm.
C) Surgery is often the most effective treatment.
D) Elevate the lower extremities when reclining.
E) Smoking cessation will improve outcomes.
Q2) Which are included in the baseline assessment of PVD? (Select all that apply.)
A) History of heart disease
B) Smoking and dietary habits
C) Current medications
D) Weight
E) Limb pain
F) Mental status
Q3) Which assessment verifies increased blood perfusion to the lower extremities?
A) Toes cool to the touch
B) Decreased sensation below the knees
C) Increased amplitude of pedal pulses
D) Paleness of the foot
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Chapter 27: Drugs Used to Treat Thromboembolic Disorders
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Q1) A trauma patient arrives in the emergency department via EMS. He is bleeding profusely. A medical alert bracelet indicates that he is on heparin therapy. The nurse will most likely administer which medication that counteracts the action of heparin?
A) Warfarin sodium (Coumadin)
B) Enoxaparin (Lovenox)
C) Protamine sulfate
D) Vitamin K
Q2) Which action will the nurse implement to decrease the risk of clot formation in an older patient on bed rest?
A) Assess peripheral pulses.
B) Encourage passive leg exercises.
C) Limit fluid intake.
D) Position pillows behind the knees.
Q3) Anticoagulant therapy may be used for which situations? (Select all that apply.)
A) To prevent stroke in patients at high risk
B) Following a myocardial infarction
C) Following total hip or knee joint replacement surgery
D) With deep vein thrombosis
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Chapter 28: Drugs Used to Treat Heart Failure
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Q1) Which nursing assessment is most important to determine fluid status for a patient with heart failure?
A) Auscultation of lungs
B) Daily weights
C) Intake and output
D) Measurement of abdominal girth
Q2) Which instruction by the nurse will be included when teaching an adult patient about digoxin (Lanoxin) for management of heart failure?
A) "Report nausea and vomiting to your health care provider."
B) "Decrease the amount of high-potassium foods you eat."
C) "Omit your dose of digoxin if your pulse is 60."
D) "Visual disturbances are common adverse effects."
Q3) Which agents stimulate the heart to increase the force of contractions, thereby increasing cardiac output?
A) Inotropic
B) Chronotropic
C) Isotonic
D) Isopropyl
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Chapter 29: Drugs Used for Diuresis
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Sample Questions
Q1) A patient who has heart failure and difficulty breathing is being admitted. Which physical assessments indicate fluid volume excess? (Select all that apply.)
A) Rapid, bounding, irregular pulse rate
B) Clear lung sounds
C) 3+ pitting ankle edema
D) Neck vein engorgement
E) Shortness of breath
Q2) Which patient assessment would alert the nurse to withhold a loop diuretic?
A) Crackles in the lung bases
B) +2 pitting peripheral edema
C) Serum potassium of 2.6 mEq/L
D) Weight gain of 2 pounds in 2 days
Q3) Which are common signs and symptoms of dehydration? (Select all that apply.)
A) Furrowed tongue
B) Decreased intake and output levels
C) Bounding pulse rate
D) Mental confusion
E) Elastic skin turgor
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Chapter 30: Drugs Used to Treat Upper Respiratory Disease
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Sample Questions
Q1) When does allergic rhinitis occur? (Select all that apply.)
A) Nasal mucosa become inflamed.
B) Exposure secondary to an allergen produces inflammation.
C) Histamine is released following allergen exposure.
D) The weather is cold during the winter.
E) A person has an initial exposure to an antigen.
Q2) Which patients would be able to take an alpha-adrenergic decongestant safely? (Select all that apply.)
A) 24-year-old woman with allergic rhinitis
B) 18-year-old man with cold symptoms
C) 64-year-old woman with a history of heart disease
D) 70-year-old woman with glaucoma
E) 56-year-old man with prostatic hypertrophy
Q3) Which instruction will the nurse include when teaching a patient with seasonal rhinitis and blocked nasal passages about intranasal corticosteroid therapy?
A) "Clear your nasal passage after administration."
B) "Anticipate a therapeutic benefit within 24 hours."
C) "Use a decongestant prior to administration."
D) "Report nasal burning to your health care provider."
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Page 33
Chapter 31: Drugs Used to Treat Lower Respiratory Disease
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Sample Questions
Q1) Which principles are included when teaching a patient to use a steroid inhaler? (Select all that apply.)
A) Frequent oral hygiene is necessary.
B) The inhaler should be used on a PRN basis only.
C) Rinse and spit after inhalation of the medication.
D) When taking a steroid drug as well as a bronchodilator, the bronchodilator should be administered first.
E) Hold the breath for 10 seconds during inhalation of the medication.
Q2) Which is a common expectorant in over-the-counter medications?
A) Dextromethorphan
B) Diphenhydramine
C) Guaifenesin
D) Codeine
Q3) The nurse is providing nutrition information to a patient diagnosed with a lower respiratory tract disease. What is the rationale for limiting caffeine?
A) Caffeine increases the respiratory rate.
B) Caffeine can result in thicker lung secretions.
C) Caffeine will increase the anxiety response associated with dyspnea.
D) Caffeine can cause bronchospasm.
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Page 34
Chapter 32: Drugs Used to Treat Oral Disorders
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Sample Questions
Q1) In addition to discomfort, which are adverse effects of xerostomia? (Select all that apply.)
A) Reduced taste and appetite
B) Excessive salivation
C) Difficulty chewing and swallowing food
D) Increase in dental caries
E) Difficulty with speech
F) Improved taste and enjoyment of food
Q2) Which condition is treated by saliva substitutes?
A) Caries
B) Mucositis
C) Xerostomia
D) Halitosis
Q3) Which local anesthetic is used for inflammation of oral mucous membranes?
A) Chlorhexidine (Peridex)
B) 2% viscous lidocaine
C) Nystatin (Mycostatin)
D) Hydrogen peroxide
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35
Chapter 33: Drugs Used to Treat Gastroesophageal Reflux and Peptic Ulcer
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Sample Questions
Q1) Which factors contribute to the development of PUD? (Select all that apply.)
A) Cigarette smoking
B) Stress
C) Genetics
D) Excessive ingestion of milk products
E) Helicobacter pylori
Q2) Which is considered an acceptable time frame for a patient with gastric distress to self-medicate with over-the-counter antacids?
A) Hours
B) Days
C) Weeks
D) Months
Q3) Which factors prevent breakdown of the body's normal defense barriers that protect against ulcer formation? (Select all that apply.)
A) Stomach pH
B) Prostaglandins
C) Intrinsic factor
D) Mucous cells
E) Hydrochloric acid
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Chapter 34: Drugs Used to Treat Nausea and Vomiting
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Sample Questions
Q1) Why does the nurse monitor daily weights prior to the administration of antiemetic medications to chemotherapy patients?
A) Antiemetics are calculated according to body surface area.
B) Antiemetics are toxic, and the minimal dosage should be administered.
C) Weight loss is a common adverse effect associated with chemotherapy, and dosages may need to be readjusted.
D) Fluid overload is common, and antiemetic dosages are increased as treatment progresses.
Q2) A patient going on vacation asks the nurse what she can give to her 3-year-old child who becomes car sick. Which responses are accurate? (Select all that apply.)
A) "Positioning techniques such as placing the child facing forward and blocking out scenery through the side windows can be helpful."
B) "There is no such thing as car sickness."
C) "If your child does vomit, there is some over-the-counter Benadryl you can administer."
D) "I would check with the pharmacist regarding over-the-counter products available for young children."
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Chapter 35: Drugs Used to Treat Constipation and Diarrhea
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Sample Questions
Q1) When the nurse assesses bowel habits in a patient, which is the best example of normal bowel elimination?
A) Daily bowel movements
B) Multiple soft stools daily
C) Daily liquid stools
D) Regular bowel elimination pattern of soft stool
Q2) Which effect will the nurse expect when a patient is taking psyllium while on digoxin?
A) Decreased effectiveness of the laxative
B) Increased laxative effect
C) Increased absorption of the digoxin
D) Decreased absorption of the digoxin
Q3) Which signs and symptoms are consistent with dehydration? (Select all that apply.)
A) Increased hemoglobin and hematocrit
B) Decreased urine specific gravity
C) Mental confusion and excessive thirst
D) Periorbital edema and increased blood pressure
E) Nonelastic skin turgor and delayed capillary filling
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Chapter 36: Drugs Used to Treat Diabetes Mellitus
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Sample Questions
Q1) A third subclass of diabetes mellitus includes additional types of diabetes that are part of other diseases having features not generally associated with the diabetic state. Which disorders may have an associated diabetic component? (Select all that apply.)
A) Patients receiving high-dose corticosteroid therapy for disease maintenance
B) Cushing's syndrome
C) Alzheimer's disease
D) Acromegaly
E) Malnutrition
Q2) Which statements are correct regarding type 2 diabetes mellitus? (Select all that apply.)
A) Type 2 diabetes is more prevalent in overweight people older than 45 years.
B) A genetic predisposition exists for the development of type 2 diabetes mellitus.
C) Type 2 diabetes requires lifelong insulin replacement.
D) Type 2 diabetes is often diagnosed after complications have resulted.
E) Women have a higher incidence of type 2 diabetes.
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Chapter 37: Drugs Used to Treat Thyroid Disease
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Sample Questions
Q1) Which clinical symptoms would the nurse observe in a patient with thyrotoxicosis? (Select all that apply.)
A) Decreased metabolic rate
B) Decreased heart rate
C) Decreased body temperature
D) Muscle tremors
E) Restlessness
F) Anxiety
G) Sweating
Q2) Which is characteristic of antithyroid drugs that act on the thyroid gland? (Select all that apply.)
A) They are a physiologic hormone replacement.
B) They block synthesis of T<sub>3</sub> and T<sub>4</sub> in the thyroid gland.
C) They destroy T<sub>3</sub> and T<sub>4</sub>.
D) Immediate improvement is observed.
E) They may be used before subtotal thyroidectomy.
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Chapter 38: Corticosteroids
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Sample Questions
Q1) A patient with type 2 diabetes is being discharged on glucocorticoid (prednisone) therapy for rheumatoid arthritis. Which information will the nurse include in discharge teaching? (Select all that apply.)
A) "Daily, single-dose therapy should be taken in the morning."
B) "The metabolic needs of your body will be increased."
C) "Steroids should never be abruptly discontinued."
D) "Signs and symptoms of infections may not be evident."
E) "Blood glucose levels will be elevated on corticosteroid therapy."
Q2) A patient who has been taking glucocorticoids over the past 3 months for Crohn's disease comes in for a follow-up visit. On assessment, the nurse notes facial edema, thinning extremities, and a fatty deposition (buffalo hump) on the scapular area. The patient reports the symptoms of the Crohn's disease are "somewhat better." What will the nurse expect the treatment to be?
A) Decrease the steroid dosage by one half.
B) Increase the steroid dosage.
C) Maintain the steroid dosage.
D) Immediately stop the steroid dosage.
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Chapter 39: Gonadal Hormones
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Sample Questions
Q1) Which is the most potent of the natural estrogenic hormones produced in the ovaries?
A) Estradiol
B) Estrone
C) Estriol
D) Estrogen
Q2) What is progestin therapy used for? (Select all that apply.)
A) Contraception
B) Endometriosis
C) Amenorrhea
D) Abnormal uterine bleeding
E) Cancer
Q3) A female patient with a history of endometriosis presents with bilateral lower quadrant pain reportedly at midcycle. Which gonadal drug is indicated for treating symptoms of endometriosis?
A) Estrogen
B) Progesterone
C) Androgens
D) Gonadotropins
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Page 42
Chapter 40: Drugs Used in Obstetrics
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Sample Questions
Q1) Which medication is used to treat a patient with atonic uterus?
A) Estradiol
B) Ergonovine
C) Ergotamine
D) Egophony
Q2) Which test would the nurse anticipate to be done to determine if preterm labor is present in a patient whose symptoms are questionable?
A) Sonogram
B) Fetal fibronectin test
C) Amniocentesis
D) Doppler study
Q3) Which drug is administered after delivery to reduce the risk of postpartum hemorrhage after the placenta has been delivered?
A) Oxytocin (Pitocin)
B) Magnesium sulfate
C) Vitamin K
D) Dopamine
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43
Chapter 41: Drugs Used in Mens and Womens Health
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Sample Questions
Q1) What is the mechanism whereby estrogen functions as a contraceptive?
A) Inhibiting LH, blocking release of ovum from a follicle
B) Thinning cervical mucus, which inhibits sperm migration
C) Trapping the ovum in the endometrial wall, preventing its growth
D) Blocking FSH, thereby preventing release of ovum
Q2) A nurse working at the community health clinic receives a call from a teen client who reports that she has missed one of her birth control pills. Which response by the nurse is accurate? (Select all that apply.)
A) Take the missed pill now.
B) Take the next pill at the regularly scheduled time.
C) Come into the clinic for a pregnancy test.
D) Start with the next month's pill packet at day 1.
E) Take the missed pill and the next pill together at the next regularly scheduled time.
Q3) Why must caution be used when taking a phosphodiesterase inhibitor to enhance male sexual function?
A) It can become habit-forming.
B) Life-threatening consequences can occur with cardiovascular disorders.
C) It is an ineffective treatment.
D) It is expensive and available only by special prescription.
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Page 44
Chapter 42: Drugs Used to Treat Disorders of the Urinary System
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Sample Questions
Q1) How often is fosfomycin (Monurol) usually administered when used in the treatment of urinary tract infections?
A) In a one-time dose
B) Once per day
C) Once per week
D) Monthly
Q2) Fluoxetine, erythromycin, clarithromycin, ketoconazole, itraconazole, miconazole, vinblastine, retonavir, and nefazodone may inhibit the metabolism of which drugs? (Select all that apply.)
A) Warfarin
B) Tolterodine
C) Phenytoin
D) Darifenacin
E) Heparin
F) Solifenacin
Q3) Which organism causes most urinary tract infections?
A) Proteus mirabilis
B) Klebsiella pneumoniae
C) Escherichia coli
D) Pseudomonas aeruginosa
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Chapter 43: Drugs Used to Treat Glaucoma and Other Eye Disorders
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Sample Questions
Q1) Which type of medication would be used to dilate the pupils before an eye examination?
A)Osmotics
B)Adrenergic agent
C)Beta-adrenergic agent
D)Corticosteroid
Q2) Which information will the nurse include when teaching the patient and family about postoperative care for a trabeculectomy? (Select all that apply.)
A) Use aseptic technique for all dressing changes and medication administration.
B) Place the patient on the operated side.
C) Avoid heavy lifting.
D) Redness in the eye, pain, and swelling are common occurrences after surgery.
E) Avoid straining on defecation.
Q3) Which is a potential serious adverse effect associated with mannitol (Osmitrol)?
A) Bradycardia
B) Fluid overload
C) Anaphylaxis
D) Fever
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Chapter 44: Drugs Used for Cancer Treatment
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Sample Questions
Q1) Which are treatments that may be used alone or in combination for the treatment of cancer? (Select all that apply.)
A) Surgery
B) Radiation
C) Chemotherapy
D) Immunotherapy
E) Phlebotomy
Q2) Which nursing considerations are taken into account prior to the administration of cisplatin IV? (Select all that apply.)
A) Review of laboratory data for presence of myelosuppression and hepatic and renal parameters
B) Administration of IV hydration as prescribed
C) Administration of epoetin alpha (Epogen)
D) Administration of prechemotherapy mesna (Mesnex)
E) Assessment for dermatologic conditions
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Chapter 45: Drugs Used to Treat the Muscular System
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Sample Questions
Q1) Patients with which conditions must be carefully assessed to determine whether they would tolerate treatment with a neuromuscular blocking agent? (Select all that apply.)
A) Pregnancy
B) Hepatic disease
C) Pulmonary disease
D) Renal disease
E) Neurologic disorders
F) Psychiatric disorders
Q2) What are the reasons that neuromuscular blocking agents are used? (Select all that apply.)
A) Alleviation of pain
B) Reducing the use and adverse effects of general anesthetics
C) Easing endotracheal intubation and prevent laryngospasm
D) Producing amnesia during painful procedures
E) Decreasing muscular activity in electroshock therapy
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48
Chapter 46: Antimicrobial Agents
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Sample Questions
Q1) Which conditions may occur with the administration of broad-spectrum antibiotics over an extended period of time?
A) Cross-sensitivity
B) Immunosuppression
C) Secondary infection
D) Immunity
Q2) A patient indicates during the nursing assessment that he is currently taking zidovudine (Retrovir). For which condition is the patient being treated?
A) Influenza A
B) HIV infection
C) Tuberculosis
D) Herpes simplex
Q3) What adverse effect may manifest as dizziness, tinnitus, and progressive hearing loss?
A) Ear infection
B) Drug allergy
C) Ototoxicity
D) Idiosyncratic reaction
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Chapter 47: Nutrition
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Sample Questions
Q1) Which meal contains the best sources of dietary fiber?
A) Eggs, bacon, orange juice
B) Salad, whole-wheat toast, sliced peach
C) Roast beef, mashed potatoes with gravy, corn, milk
D) Grilled hamburger on a bun, fresh carrot sticks, potato chips
Q2) How are essential fatty acids used in the body? (Select all that apply.)
A) Building cell membranes
B) Energy production
C) Prostaglandin production
D) Catalyzing metabolic reactions
E) Eicosanoid production
F) Stimulation of growth hormone
Q3) Which can be directly absorbed from the GI tract into the bloodstream? (Select all that apply.)
A) Glucose
B) Sucrose
C) Fructose
D) Galactose
E) Lactose
F) Maltose
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Chapter 48: Herbal and Dietary Supplement Therapy
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Q1) The use of which medication would alert the nurse to educate the patient about using Ginkgo biloba cautiously?
A) Antiemetics
B) Anti-inflammatories
C) Anticoagulants
D) Antibiotics
Q2) What is St. John's wort used to treat?
A) Rheumatoid arthritis
B) Asthma
C) Depression
D) Viral infections
Q3) For what is black cohosh used?
A) Preventing miscarriage during the first trimester
B) Reducing symptoms of premenstrual syndrome
C) Providing antispasmodic activity of the GI system
D) Controlling migraine headaches
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Chapter 49: Substance Abuse
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Sample Questions
Q1) What does the biologic model theory of substance abuse hypothesize? (Select all that apply.)
A) A predisposition to substance abuse based on a hereditary condition
B) Alcoholic individuals as fixated at the oral stage of development, needing satisfaction through oral behaviors such as drinking
C) Genetic aberrations that block feelings of well-being, resulting in anxiety, anger, low self-esteem, and other negative feelings, leaving a craving for a substance that will suppress the bad feelings
D) That genes may play a role in alteration of metabolic enzyme systems in the body that enhance or detract from pleasurable responses to chemical substances
E) That it is a person's choice of whether to use drugs, which drugs to use, how much to use, and to seek treatment for substance abuse
Q2) What does a urinalysis that is positive for the drug tested indicate?
A) It indicates illegal drug use.
B) It verifies drug dependency.
C) It is a violation of the individual's constitutional rights.
D) It verifies whether the drug is present in the specimen.
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Page 52
Chapter 50: Miscellaneous Agents
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Q1) Which common adverse effect will the nurse expect to assess in a patient recently prescribed tacrine (Cognex)?
A) Dyspepsia
B) Bradycardia
C) Jaundice
D) Rash
Q2) What important points of patient education should be included about disulfiram (Antabuse) therapy? (Select all that apply.)
A) The patient should return for liver function tests in 10 to 14 days following initiation of therapy.
B) Headache, fatigue, and a metallic taste are common adverse effects that usually resolve.
C) Avoid alcohol ingestion to prevent a reaction.
D) Carefully read all labels for possible alcohol content, including perfumes, and over-the-counter medications such as cough syrups.
E) Report to the health care provider any allergic symptoms, such as hives or pruritus.
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