Medical-Surgical Nursing Exam Practice Tests - 1446 Verified Questions

Medical-Surgical Nursing Exam Practice Tests

Course Introduction

Medical-Surgical Nursing provides a comprehensive overview of the principles and practices involved in caring for adult patients with a wide range of medical and surgical conditions. The course covers pathophysiology, assessment, and management of common diseases and disorders, integrating clinical reasoning, evidence-based interventions, and patient-centered care. Students learn to collaborate within healthcare teams, implement prioritized nursing interventions, and utilize critical thinking skills to address the complex needs of diverse patient populations in various healthcare settings. Emphasis is placed on patient safety, ethical considerations, holistic care, and the use of current technology and nursing research to promote optimal health outcomes.

Recommended Textbook

Lehnes Pharmacology for Nursing Care 9th Edition by Burchum

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110 Chapters

1446 Verified Questions

1446 Flashcards

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Chapter 1: Orientation to Pharmacology

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5 Verified Questions

5 Flashcards

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Sample Questions

Q1) The nurse is teaching a patient how a medication works to treat an illness. To do this,the nurse will rely on knowledge of which topic?

A) Clinical pharmacology

B) Drug efficacy

C) Pharmacokinetics

D) Pharmacotherapeutics

Answer: D

Q2) Before administering a medication,what does the nurse need to know to evaluate how individual patient variability might affect the patient's response to the medication?

(Select all that apply.)

A) Chemical stability of the medication

B) Ease of administration

C) Family medical history

D) Patient's age

E) Patient's diagnosis

Answer: C,D,E

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Chapter 2: Application of Pharmacology in Nursing Practice

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13 Verified Questions

13 Flashcards

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Sample Questions

Q1) The nurse is preparing to care for a patient who will be taking an antihypertensive medication. Which action by the nurse is part of the assessment step of the nursing process?

A) Asking the prescriber for an order to monitor serum drug levels

B) Monitoring the patient for drug interactions after giving the medication

C) Questioning the patient about over-the-counter medications

D) Taking the patient's blood pressure throughout the course of treatment

Answer: C

Q2) A nurse is preparing to administer medications. Which patient would the nurse consider to have the greatest predisposition to an adverse reaction?

A) A 30-year-old man with kidney disease

B) A 75-year-old woman with cystitis

C) A 50-year-old man with an upper respiratory tract infection

D) A 9-year-old boy with an ear infection

Answer: A

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4

Chapter 3: Drug Regulation, Development, Names, and Information

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6 Verified Questions

6 Flashcards

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Sample Questions

Q1) A nurse is teaching nursing students about the use of nonproprietary names for drugs. The nurse tells them which fact about nonproprietary names?

A) They are approved by the FDA and are easy to remember.

B) They are assigned by the U.S. Adopted Names Council.

C) They clearly identify the drug's pharmacologic classification.

D) They imply the efficacy of the drug and are less complex.

Answer: B

Q2) A nurse educator is conducting a continuing education class on pharmacology. To evaluate the learning of the nurses in the class,the nurse educator asks,"Which drug name gives information about the drug's pharmacologic classification?" Which is the correct response?

A) Amoxicillin

B) Tylenol

C) Cipro

D) Motrin

Answer: A

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5

Chapter 4: Pharmacokinetics

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13 Verified Questions

13 Flashcards

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Sample Questions

Q1) The nurse is preparing to administer penicillin G intramuscularly to a child. The child's parents ask why the drug cannot be given in an oral liquid form. What is the nurse's reply?

A) "This drug causes severe gastric upset if given orally."

B) "This drug has a narrow therapeutic range, and the dose must be tightly controlled."

C) "This drug is absorbed much too quickly in an oral form."

D) "This drug would be inactivated by enzymes in the stomach."

Q2) A provider has written an order for a medication: drug ´ 100 mg PO every 6 hours. The half-life for the drug is approximately 6 hours. The nurse is preparing to administer the first dose at 8:00 AM on Tuesday. On Wednesday,when will the serum drug level reach plateau?

A) 2:00 AM

B) 8:00 AM

C) 2:00 PM

D) 8:00 PM

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Chapter 5: Pharmacodynamics

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8 Flashcards

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Sample Questions

Q1) Two nurses are discussing theories of drug-receptor interaction. Which statements are true regarding the affinity of a drug and its receptor? (Select all that apply.)

A) Affinity and intrinsic activity are dependent properties.

B) Affinity refers to the strength of the attraction between a drug and its receptor.

C) Drugs with high affinity are strongly attracted to their receptors.

D) Drugs with low affinity are strongly attracted to their receptors.

E) The affinity of a drug for its receptors is reflected in its potency.

Q2) What occurs when a drug binds to a receptor in the body?

A) It alters the receptor to become nonresponsive to its usual endogenous molecules.

B) It increases or decreases the activity of that receptor.

C) It gives the receptor a new function.

D) It prevents the action of the receptor by altering its response to chemical mediators.

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Chapter 6: Drug Interactions

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Sample Questions

Q1) Which statement about food and drug interactions is true?

A) Foods alter drug absorption and metabolism but not drug action.

B) Medications are best absorbed on an empty stomach.

C) Patient discomfort is the food and drug interaction of most concern.

D) Some foods can inhibit CYP isoenzymes and alter drug metabolism.

Q2) A nurse is caring for a patient who is taking multiple medications. To help ensure that adverse drug reactions are prevented or minimized,the nurse will do which of the following? (Select all that apply.)

A) Ask the patient about over-the-counter medications used.

B) Contact the prescriber to request cytochrome P450 levels.

C) Limit the patient's calcium intake.

D) Obtain a thorough diet history.

E) Request orders for PRN medications to treat any anticipated symptoms of drug interactions.

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8

Chapter 7: Adverse Drug Reactions and Medication Errors

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13 Verified Questions

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Sample Questions

Q1) Which patients are at increased risk for adverse drug events? (Select all that apply.)

A) A 2-month-old infant taking a medication for gastroesophageal reflux disease

B) A 23-year-old female taking an antibiotic for the first time

C) A 40-year-old male who is intubated in the intensive care unit and taking antibiotics and cardiac medications

D) A 7-year-old female receiving insulin for diabetes

E) An 80-year-old male taking medications for COPD

Q2) A patient is given a new medication and reports nausea within an hour after taking the drug. The nurse consults the drug information manual and learns that nausea is not an expected adverse effect of this drug. When the next dose is due,what will the nurse do?

A) Administer the drug and tell the patient to report further nausea.

B) Hold the drug and notify the provider of the patient's symptoms.

C) Report the symptoms of nausea to the MEDWATCH program.

D) Request an order for an antiemetic to counter this drug's effects.

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Chapter 8: Individual Variation in Drug Responses

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10 Verified Questions

10 Flashcards

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Sample Questions

Q1) Which groups of people are especially sensitive to medication effects? (Select all that apply.)

A) Older adults

B) Caucasians

C) Infants

D) Minorities

E) Women

Q2) A nurse is teaching a group of women about medications. The women want to know why so many drugs have unpredictable effects in women. The nurse will tell them that:

A) drugs usually have more toxic effects in women.

B) most known drug effects are based on drug trials in men.

C) women have varying responses to drugs during menstrual cycles.

D) women metabolize drugs more slowly.

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Chapter 9: Drug Therapy During Pregnancy and Breast-Feeding

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10 Verified Questions

10 Flashcards

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Sample Questions

Q1) A nursing student asks the nurse why more is not known about the teratogenic effects of maternal medication ingestion during pregnancy. Which response by the nurse is correct?

A) "Clinical trials to assess this risk would put the fetus at risk."

B) "It is safer to recommend that pregnant women avoid medications while pregnant."

C) "Most women are reluctant to admit taking medications while they are pregnant."

D) "The relatively new MEPREP study will allow testing of medications during pregnancy in the future."

Q2) A nurse is teaching a class to a group of pregnant patients. The nurse correctly teaches that the highest risk of teratogen-induced gross malformations exists during which time?

A) Immediately before conception

B) During the first trimester

C) During the second trimester

D) During the third trimester

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11

Chapter 10: Drug Therapy in Pediatric Patients

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11 Verified Questions

11 Flashcards

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Sample Questions

Q1) A nurse is teaching nursing students about pediatric medication administration. What will the nurse include when discussing pediatric drug research?

A) Early studies revealed that less than 10% of drugs known to be effective in adults were effective in children.

B) Research findings show that drug doses may be safely calculated by extrapolating adult dosing.

C) Studies showed a significant percentage of unanticipated and potentially lethal side effects in children.

D) There is no need to continue with pediatric-specific drug research, since early studies were reassuring.

Q2) A nurse caring for a 5-year-old child notes that the child has discoloration of several teeth. When taking a medication history,the nurse will ask about which group of medications?

A) Glucocorticoids

B) Salicylates

C) Sulfonamides

D) Tetracyclines

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12

Chapter 11: Drug Therapy in Geriatric Patients

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12 Verified Questions

12 Flashcards

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Sample Questions

Q1) A nurse is reviewing an older adult patient's chart before giving medications. Which patient information is of most concern?

A) Chronic constipation

B) Increased body fat

C) Low serum albumin

D) Low serum creatinine

Q2) A nurse is making a home visit to an older adult woman who was recently discharged home from the hospital with a new prescription. The nurse notes that a serum drug level drawn the day before was subtherapeutic. What will the nurse do next?

A) Ask the patient if she has difficulty swallowing pills.

B) Count the pills in the prescription bottle.

C) Notify the provider to request more frequent dosing.

D) Request an order for renal function tests.

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13

Chapter 12: Basic Principles of Neuropharmacology

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8 Flashcards

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Sample Questions

Q1) A nurse is preparing to administer a medication and learns that it is a nonselective agonist drug. What does the nurse understand about this drug?

A) It directly activates receptors to affect many physiologic processes.

B) It directly activates receptors to affect a specific physiologic process.

C) It prevents receptor activation to affect many physiologic processes.

D) It prevents receptor activation to affect a specific physiologic processes.

Q2) A nurse learns about a drug that interferes with transmitter storage in the PNS. The transmitter affected by this drug causes an increased heart rate. What response will the nurse expect to see when this drug is administered?

A) Bradycardia

B) Positive inotropic effects

C) Prolonged receptor activation

D) Tachycardia

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14

Chapter 13: Physiology of the Peripheral Nervous System

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9 Verified Questions

9 Flashcards

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Sample Questions

Q1) A nurse is administering an agonist drug that acts on postganglionic neurons of the sympathetic nervous system. Which response will the nurse expect to see?

A) Decreased sweating

B) Bronchodilation

C) Increased cardiac output

D) Pinpoint pupils

Q2) What is the target organ when a beta₁agonist is administered?

A) heart

B) kidney

C) respiratory

D) liver

Q3) A pregnant patient is in premature labor. Which class of drug will she be given?

A) Alpha₁ agonist

B) Anticholinergic

C) Beta₂ agonist

D) Beta₂ antagonist

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Chapter 14: Muscarinic Agonists and Antagonists

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9 Verified Questions

9 Flashcards

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Sample Questions

Q1) A prescriber has ordered pilocarpine [Pilocar]. A nurse understands that the drug stimulates muscarinic receptors and would expect the drug to have which action?

A) Reduction of excessive secretions in a postoperative patient

B) Lowering of intraocular pressure in patients with glaucoma

C) Inhibition of muscular activity in the bladder

D) Prevention of hypertensive crisis

Q2) A patient will begin using a transdermal preparation of a muscarinic antagonist for overactive bladder (OAB). The nurse teaches the patient what to do if side effects occur. Which statement by the patient indicates the need for further teaching?

A) "I can use sugar-free gum for dry mouth."

B) "I may need laxatives for constipation."

C) "I should keep the site covered to prevent other people from getting the medicine."

D) "I will take Benadryl for any itching caused by a local reaction to the patch."

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16

Chapter 15: Cholinesterase Inhibitors and Their Use in Myasthenia Gravis

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9 Verified Questions

9 Flashcards

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Sample Questions

Q1) A patient who has myasthenia gravis will be taking neostigmine [Prostigmin]. What will the nurse emphasize when teaching this patient about the medication?

A) "Stop taking the drug if you have diarrhea."

B) "Take a supplementary dose before exercise."

C) "Use atropine if you have excessive salivation."

D) "Withhold the dose if ptosis occurs."

Q2) A nurse is caring for a patient who has myasthenia gravis. The prescriber has ordered neostigmine [Prostigmin]. An important initial nursing action before administration of the medication includes assessing:

A) the ability to raise the eyelids.

B) level of fatigue.

C) skeletal muscle strength.

D) swallowing ability.

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Chapter 16: Drugs That Block Nicotinic Cholinergic

Transmission: Neuromuscular Blocking Agents

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10 Verified Questions 10 Flashcards

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Sample Questions

Q1) A patient who will undergo electroconvulsive therapy to treat severe depression will be given succinylcholine just prior to the procedure. When teaching the patient about the procedure the nurse will explain that the succinylcholine is given for what purpose?

A) To minimize the amount of electroshock treatment required

B) To prevent harm caused by electroshock-induced convulsions

C) To prolong the therapeutic electroshock-induced convulsions

D) To stop the electroshock-induced convulsions once therapeutic effects have occurred

Q2) A nurse is teaching a group of nursing students about neuromuscular blocking agents. For what may these agents be used? (Select all that apply.)

A) Analgesia

B) Electroshock therapy

C) Malignant hyperthermia

D) Mechanical ventilation

E) Surgery

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18

Chapter 17: Adrenergic Agonists

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12 Flashcards

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Sample Questions

Q1) A patient is admitted to the intensive care unit for treatment of shock. The prescriber orders isoproterenol [Isuprel]. The nurse expects this drug to increase tissue perfusion in this patient by activating:

A) alpha₁ receptors to cause vasoconstriction.

B) alpha₁ receptors to increase blood pressure.

C) beta₁ receptors to cause a positive inotropic effect.

D) beta₂receptors to cause bronchodilation.

Q2) A nurse is teaching a nursing student about the two classes of adrenergic agonist drugs. Which statement by the nursing student indicates understanding of the teaching?

A) "Catecholamines may be given orally."

B) "Catecholamines often require continuous infusion to be effective."

C) "Noncatecholamines do not cross the blood-brain barrier."

D) "Noncatecholamines undergo rapid degradation by monoamine oxidase."

Q3) Because they cause vasoconstriction,alpha₁-adrenergic agonists are especially useful for:

A) causing hemostasis in skin and mucous membranes.

B) producing mydriasis to facilitate ophthalmic examinations.

C) slowing the heart rate in tachycardic patients.

D) treating hypotension.

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Page 19

Chapter 18: Adrenergic Antagonists

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15 Verified Questions

15 Flashcards

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Sample Questions

Q1) A nurse prepares to administer propranolol [Inderal] to a patient recovering from acute myocardial infarction. The patient's heart rate is 52 beats per minute,and the rhythm is regular. What action should the nurse take next?

A) Administer the drug as prescribed.

B) Request an order for atropine.

C) Withhold the dose and document the pulse rate.

D) Withhold the dose and notify the prescriber.

Q2) A patient with pheochromocytoma is admitted for surgery. The surgeon has ordered an alpha-blocking agent to be given preoperatively. What does the nurse understand about this agent?

A) It is ordered to prevent perioperative hypertensive crisis.

B) It prevents secretion of catecholamines by the adrenal tumor.

C) It reduces contraction of smooth muscles in the adrenal medulla.

D) It is given chronically after the surgery to prevent hypertension.

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Chapter 19: Indirect-Acting Antiadrenergic Agents

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Sample Questions

Q1) A prescriber has ordered methyldopa for a patient with hypertension. The nurse teaches the patient about drug actions,adverse effects,and the ongoing blood tests necessary with this drug. The nurse is correct to tell the patient what?

A) "If you have a positive Coombs' test result, you will need to discontinue the medication, because this means you have hemolytic anemia."

B) "Methyldopa can be used for its analgesic effects and for its hypertensive effects."

C) "Xerostomia and orthostatic hypotension are serious side effects and indications for withdrawing the medication."

D) "You will need to contact the provider and stop taking the medication if your eyes look yellow."

Q2) A nurse is teaching a patient about a new prescription for reserpine [Serpasil] for hypertension. Which statement by the patient indicates the need for further teaching?

A) "Depressive side effects are common and will improve over time."

B) "I should report gastrointestinal side effects to the provider."

C) "I should stand up slowly when getting up and lie down if I feel dizzy."

D) "Therapeutic effects may not be optimal for a couple of weeks."

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Chapter 20: Introduction to Central Nervous System

Pharmacology

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Sample Questions

Q1) A nurse is teaching a group of nursing students how the CNS adapts to psychotherapeutic medications. Which statement by a nursing student indicates a need for further teaching?

A) "Adaptation can lead to tolerance of these drugs with prolonged use."

B) "Adaptation helps explain how physical dependence occurs."

C) "Adaptation often must occur before therapeutic effects develop."

D) "Adaptation results in an increased sensitivity to side effects over time."

Q2) A patient asks a nurse to explain what drug tolerance means. The nurse responds by telling the patient that when tolerance occurs,it means the patient:

A) has developed a psychologic dependence on the drug.

B) may need increased amounts of the drug over time.

C) will cause an abstinence syndrome if the drug is discontinued abruptly.

D) will have increased sensitivity to drug side effects.

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22

Chapter 21: Drugs for Parkinsons Disease

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16 Verified Questions

16 Flashcards

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Sample Questions

Q1) The nurse provides teaching for a patient who will begin taking rotigotine [Neupro] to treat Parkinson's disease. What will the nurse include in teaching?

A) "If you develop nausea and vomiting, you should stop taking the medication."

B) "If you need to stop this drug, your provider will order a gradual withdrawal."

C) "You will start this drug regimen with a higher than usual loading dose."

D) "You will take this medication by mouth with food."

Q2) A patient with Parkinson's disease is taking levodopa/carbidopa [Sinemet] along with amantadine [Symmetrel] 400 mg/day to treat dyskinesias. The patient reports having increased dyskinesias several months after beginning the amantadine. The nurse will contact the provider to discuss which action?

A) Increasing the dose of amantadine [Symmetrel]

B) Interrupting treatment with amantadine for several weeks

C) Ordering renal function tests

D) Ordering another anticholinergic medication

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Chapter 22: Drugs for Alzheimers Disease

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10 Verified Questions

10 Flashcards

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Sample Questions

Q1) A nurse is caring for an older adult patient who has Alzheimer's disease. The patient is taking a cholinesterase inhibitor drug. Which side effects would concern the nurse?

A) Confusion and memory impairment

B) Dizziness and headache

C) Nausea, vomiting, and diarrhea

D) Slowed heart rate and lightheadedness

Q2) A nurse is teaching a group of nursing students about the use of memantine [Namenda] for Alzheimer's disease. Which statement by a student indicates understanding of the teaching?

A) "Memantine is indicated for patients with mild to moderate Alzheimer's disease."

B) "Memantine modulates the effects of glutamate to alter calcium influx into neurons."

C) "Memantine prevents calcium from leaving neurons, which improves their function."

D) "Memantine and donepezil combined may stop progression of Alzheimer's disease."

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Chapter 23: Drugs for Multiple Sclerosis

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Sample Questions

Q1) A patient with multiple sclerosis is to begin treatment with interferon beta. The patient comes to the clinic to have pretreatment laboratory tests. Which statement by the patient indicates a need for further teaching about these tests?

A) "After the first year of treatment, I will need once yearly blood work."

B) "I will need to have lab tests done every 3 months for the first year."

C) "If my liver function tests are abnormal, I will need to stop using this drug."

D) "These lab tests will measure liver and bone marrow function."

Q2) A patient has received an initial dose of glatiramer acetate [Copaxone] for relapsing-remitting multiple sclerosis. The nurse notes that the patient appears flushed and anxious and has urticaria. The patient reports palpitations,chest pain,and a feeling of laryngeal constriction. What will the nurse do?

A) Obtain an order for epinephrine to treat a hypersensitivity reaction.

B) Prepare to provide cardiorespiratory support.

C) Report a possible cardiotoxic episode to the provider.

D) Stay with the patient until this self-limiting episode passes.

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25

Chapter 24: Drugs for Epilepsy

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17 Verified Questions

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Sample Questions

Q1) A patient is to begin taking phenytoin [Dilantin] for seizures. The patient tells the nurse that she is taking oral contraceptives. What will the nurse tell the patient?

A) She may need to increase her dose of phenytoin while taking oral contraceptives.

B) She should consider a different form of birth control while taking phenytoin.

C) She should remain on oral contraceptives, because phenytoin causes birth defects.

D) She should stop taking oral contraceptives, because they reduce the effectiveness of phenytoin.

Q2) A nurse is providing teaching to a patient newly diagnosed with partial seizures who will begin taking oxcarbazepine [Trileptal]. The patient also takes furosemide [Lasix] and digoxin [Lanoxin]. Which statement by the patient indicates understanding of the teaching?

A) "I may need to increase my dose of Trileptal while taking these medications."

B) "I may develop a rash and itching, but these are not considered serious."

C) "I should report any nausea, drowsiness, and headache to my provider."

D) "I should use salt substitutes instead of real salt while taking these drugs."

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26

Chapter 25: Drugs for Muscle Spasm and Spasticity

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Sample Questions

Q1) A nurse is teaching the parent of a child with spastic quadriplegia about intrathecal baclofen [Lioresal]. Which statement by the parent indicates a need for further teaching?

A) "I can expect my child to be more drowsy when receiving this medication."

B) "I should not notice any change in my child's muscle strength."

C) "I will contact the provider if my child is constipated or cannot urinate."

D) "If my child has a seizure, I should stop giving the medication immediately."

Q2) A patient has localized muscle spasms after an injury. The prescriber has ordered tizanidine [Zanaflex] to alleviate the spasms. When obtaining the patient's health history,the nurse should be concerned about which possible reason for considering another drug?

A) Concomitant use of aspirin

B) A history of hepatitis

C) A history of malignant hyperthermia

D) Occasional use of alcohol

Q3) Which patient should receive dantrolene [Dantrium] with caution?

A) A 20-year-old woman with a spinal cord injury

B) A 45-year-old man with a history of malignant hyperthermia

C) A 55-year-old woman with multiple sclerosis

D) An 8-year-old child with cerebral palsy

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Chapter 26: Local Anesthetics

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11 Verified Questions

11 Flashcards

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Sample Questions

Q1) A nurse is assisting a physician who is performing a circumcision on a newborn. The physician asks the nurse to prepare lidocaine and epinephrine for injection to provide anesthesia. What will the nurse do?

A) Ask the provider why an injectable anesthetic is being used for this procedure.

B) Draw up the medication as ordered and prepare the infant for the procedure.

C) Make sure that seizure precautions are in place.

D) Question the use of the epinephrine for this procedure.

Q2) A nurse is assisting the physician during a procedure in which a local anesthetic is administered. Within a few minutes of administration of the anesthetic,the patient has a pulse of 54 beats per minute,respirations of 18 breaths per minute,and a blood pressure of 90/42 mm Hg. The nurse should monitor the patient for further signs of:

A) heart block.

B) anaphylaxis.

C) central nervous system excitation.

D) respiratory depression.

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28

Chapter 27: General Anesthetics

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Sample Questions

Q1) A patient receives a neuromuscular blocking agent as an adjunct to inhalation anesthesia. When caring for this patient,it is important for the nurse to remember that neuromuscular blocking agents:

A) cause vagal slowing of the heart.

B) increase the required dose of inhalation anesthetics.

C) increase the depth of unconsciousness.

D) prevent contraction of the diaphragm.

Q2) An anesthesiologist completes preoperative teaching for a patient the night before surgery. The patient asks the nurse to clarify the reason methohexital [Brevital] will be given as an adjunct to the anesthetic. Which statement by the patient indicates understanding?

A) "Brevital allows a larger amount of inhaled anesthetic to be used without increased side effects."

B) "Brevital is given to enhance the analgesic and muscle relaxation effects of the inhaled anesthetic."

C) "Brevital is used to produce rapid unconsciousness before administration of the inhaled anesthetic."

D) "Brevital is used to reduce cardiovascular and respiratory depression caused by the inhaled anesthetic."

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Chapter 28:

Analgesics, Opioid Antagonists, and Nonopioid Centrally Acting Analgesics

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Sample Questions

Q1) A patient with moderate to severe chronic pain has been taking oxycodone [OxyContin] 60 mg every 6 hours PRN for several months and tells the nurse that the medication is not as effective as before. The patient asks if something stronger can be taken. The nurse will contact the provider to discuss:

A) administering a combination opioid analgesic/acetaminophen preparation.

B) changing the medication to a continued-release preparation.

C) confronting the patient about drug-seeking behaviors.

D) withdrawing the medication, because physical dependence has occurred.

Q2) A patient asks the nurse what can be given to alleviate severe,chronic pain of several months' duration. The patient has been taking oxycodone [OxyContin] and states that it is no longer effective. The nurse will suggest discussing which medication with the provider?

A) Fentanyl [Duragesic] transdermal patch

B) Hydrocodone [Vicodin] PO

C) Meperidine [Demerol] PO

D) Pentazocine [Talwin] PO

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Chapter 29: Pain Management in Patients with Cancer

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17 Flashcards

Source URL: https://quizplus.com/quiz/8422

Sample Questions

Q1) A patient is taking hydrocodone and ibuprofen for cancer pain and is admitted to the hospital for chemotherapy. The nurse anticipates that the prescriber will ____ ibuprofen.

A) reduce the dose of B) discontinue the C) increase the dose of D) order aspirin (ASA) instead of

Q2) A patient newly diagnosed with cancer is admitted to the hospital,and the provider orders oxycodone [OxyContin] every 4 to 6 hours PRN pain. The patient requests pain medication whenever he reports pain as a 7 or 8 on a scale of 1 to 10 (10 being the worst pain),but he tells the nurse the medication is not working well. The nurse will contact the provider to discuss:

A) a fixed dosing schedule for the oxycodone.

B) intramuscular meperidine [Demerol].

C) intravenous morphine sulfate.

D) transdermal fentanyl.

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Chapter 30: Drugs for Headache

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13 Flashcards

Source URL: https://quizplus.com/quiz/8423

Sample Questions

Q1) A patient who has recurrent migraine headaches is prescribed sumatriptan [Imitrex]. Which aspect of this patient's history is of concern when taking this drug?

A) Asthma

B) Coronary artery disease

C) Diabetes

D) Renal disease

Q2) A young woman with migraine headaches who has recently begun taking sumatriptan [Imitrex] calls the nurse to report a sensation of chest and arm heaviness. The nurse questions the patient and determines that she feels pressure and not pain. What will the nurse do?

A) Ask the patient about any history of hypertension or coronary artery disease.

B) Determine whether the patient might be pregnant.

C) Reassure the patient that this is a transient, reversible side effect of sumatriptan.

D) Tell the patient to stop taking the medication immediately.

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Chapter 31: Antipsychotic Agents and Their Use in Schizophrenia

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Sample Questions

Q1) A patient who is taking a first-generation antipsychotic (FGA)drug for schizophrenia comes to the clinic for evaluation. The nurse observes that the patient has a shuffling gait and mild tremors. The nurse will ask the patient's provider about which course of action?

A) Administering a direct dopamine antagonist

B) Giving an anticholinergic medication

C) Increasing the dose of the antipsychotic drug

D) Switching to a second-generation antipsychotic drug

Q2) A parent reports being afraid that a child may have schizophrenia because of disorganized speech and asocial behaviors. The nurse will tell this parent that which of the following must also be present to make a diagnosis? (Select all that apply.)

A) A decrease in self-care, job, or school function

B) A history of substance abuse

C) A 1-month duration of active phase symptoms

D) Continuous signs of disturbance for longer than 6 months

E) The presence of manic episodes

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33

Chapter 32: Antidepressants

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Sample Questions

Q1) Which patients are candidates for MAOIs? (Select all that apply.)

A) Patients who have not responded to SSRIs and TCAs

B) Patients with atypical depression

C) Patients with bulimia nervosa

D) Patients with hypotension

E) Patients with postpartum depression

Q2) A provider has indicated that a serotonin/norepinephrine reuptake inhibitor (SNRI)will be prescribed for a patient who is experiencing major depression. When conducting a pretreatment health history,the nurse learns that the patient has a recent history of alcohol abuse. Which SNRI would be contraindicated for this patient?

A) Desvenlafaxine [Pristiq]

B) Duloxetine [Cymbalta]

C) Escitalopram [Lexapro]

D) Venlafaxine [Effexor SR]

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34

Chapter 33: Drugs for Bipolar Disorder

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Sample Questions

Q1) A patient with bipolar disorder is admitted to the hospital. The patient has been taking lithium [Lithobid] for several years and has not been evaluated by a provider for over a year. Besides obtaining a lithium level,the nurse caring for this patient will anticipate orders for which laboratory tests? (Select all that apply.)

A) Calcium level

B) Complete blood count with differential

C) Liver function tests

D) Renal function tests

E) Serum potassium

F) Thyroid function tests

Q2) A patient with bipolar disorder has been taking lithium [Lithobid] for several years. The patient has developed a goiter,and serum tests reveal hypothyroidism. What will the nurse expect the provider to order for this patient?

A) Administration of levothyroxine

B) Increasing the lithium dose

C) Iodine supplements

D) Referral to an endocrinologist

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Chapter 34: Sedative-Hypnotic Drugs

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Sample Questions

Q1) A patient has been taking high doses of clorazepate [Tranxene] for several months for an anxiety disorder. The nurse assessing the patient observes that the patient is agitated,euphoric,and anxious. What will the nurse do?

A) Double-check the chart to make sure the last dose was given.

B) Request an order for a longer-acting benzodiazepine.

C) Suspect a possible paradoxical reaction to the clorazepate.

D) Withhold the next dose until a drug level can be drawn.

Q2) A nurse recognizes that the actions of benzodiazepines include which findings? (Select all that apply.)

A) Sleep deprivation

B) Relief of general anxiety

C) Suppression of seizures and/or seizure activity

D) Development of tardive dyskinesia

E) Increase in muscle spasms

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Chapter 35: Management of Anxiety Disorders

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Sample Questions

Q1) A patient who has been taking alprazolam [Xanax] to treat generalized anxiety disorder (GAD)reports recently stopping the medication after symptoms have improved but reports having feelings of panic and paranoia. Which initial action by the nurse is correct?

A) Ask the patient if the medication was stopped abruptly.

B) Instruct the patient to resume taking the alprazolam.

C) Notify the provider that the patient is experiencing a relapse.

D) Suggest that the patient discuss taking buspirone [Buspar] with the provider.

Q2) A nurse is performing an admission assessment on a patient. The patient reports taking alprazolam [Xanax] for "nerves." The nurse knows that this patient is most likely being treated for which condition?

A) Generalized anxiety disorder

B) Obsessive-compulsive disorder (OCD)

C) Panic disorder

D) Post-traumatic stress disorder (PTSD)

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Chapter 36: Central Nervous System Stimulants and

Attention-Deficit/Hyperactivity Disorder

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Sample Questions

Q1) A parent thinks a school-aged child has ADHD. The nurse asks the parent to describe the child's behaviors. Which behaviors are characteristic of ADHD? (Select all that apply.)

A) Anxiety

B) Compulsivity

C) Hyperactivity

D) Inattention

E) Impulsivity

Q2) A patient who is morbidly obese is admitted for treatment. The prescriber orders lisdexamfetamine [Vyvanse]. The nurse will be concerned if this patient shows signs of:

A) anorexia.

B) dyspnea.

C) insomnia.

D) loquaciousness.

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38

Chapter 37: Drug Abuse I: Basic Considerations

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Sample Questions

Q1) A nurse is teaching a class on addiction. Which statement by one of the class participants indicates a need for further teaching?

A) "Addictive drugs lead to dopamine release in amounts similar to those released by normal reward circuits."

B) "Neural remodeling leads to decreased dopamine release, leaving users with feelings of lifelessness and depression."

C) "Over time, the brain will develop reduced responses to many addictive drugs."

D) "With the use of a drug over time, the brain undergoes synaptic remodeling."

Q2) A psychiatric nurse is caring for a drug-addicted patient. The nurse knows that the ideal goal of drug rehabilitation for this patient is:

A) abstinence from the drug.

B) decreasing episodes of relapse.

C) minimizing drug cravings.

D) reduction of drug use.

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Chapter 38: Drug Abuse II: Alcohol

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Sample Questions

Q1) An alcoholic patient's spouse asks a nurse about recovery from chronic alcoholism. The patient is confused and has abnormal eye movements and nystagmus. Which statement by the nurse is correct?

A) "The symptoms your spouse shows are partly reversible in most people."

B) "These symptoms can be reversed with vitamin therapy and good nutrition."

C) "Your spouse has symptoms of an irreversible encephalopathy."

D) "Your spouse will probably recover completely after detoxification."

Q2) A nurse is screening a patient being admitted to the hospital. The patient reports being fired for drinking at work. On further questioning,the patient reveals a history of daily alcohol consumption of more than a six-pack of beer each day,regular morning drinking,and several unsuccessful attempts to stop drinking. The nurse detects alcohol on the patient's breath. The nurse will inform the provider of these findings and request an order for which medication?

A) Chlordiazepoxide [Librium]

B) Clonidine

C) Disulfiram [Antabuse]

D) Naltrexone [ReVia]

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Page 40

Chapter 39: Drug Abuse III: Nicotine and Smoking

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Sample Questions

Q1) A 4-year-old child is brought to the emergency department with symptoms of nausea and vomiting and a weak,thready pulse of 120 beats per minute after ingesting several cigarettes at home. The nurse caring for this child will expect to provide which treatment?

A) Gastric lavage

B) Hemodialysis

C) Respiratory support

D) Vasoconstrictors

Q2) A nurse is conducting a smoking cessation class in the community and is discussing the physiologic effects of nicotine. The nurse is correct to teach that these effects include which of the following? (Select all that apply.)

A) Increased blood pressure

B) Decreased gastric acid

C) Vomiting

D) Suppression of nausea

E) Increased alertness

F) Suppression of appetite

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Chapter 40: Drug Abuse IV: Major Drugs of Abuse Other

Than Alcohol and Nicotine

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Sample Questions

Q1) Which factors make meperidine an opioid of choice among nurses and physicians who abuse opioids? (Select all that apply.)

A) Easy access to syringes for administration of the drug

B) Highly effective oral dosing

C) Increased effects on smooth muscle function

D) Less pupillary constriction than other opioids

E) Shorter half-life than other opioids

Q2) In discussing the rationale for using methadone to ease opioid withdrawal,the nurse would explain that it has which pharmacologic properties or characteristics?

A) Methadone can prevent abstinence syndrome.

B) Methadone has a shorter duration of action than other opioids.

C) Methadone is a nonopioid agent.

D) Methadone lacks cross-tolerance with other opioids.

Q3) What is the primary reason for opioid abuse?

A) Ease of access

B) Initial "rush" similar to orgasm

C) Peer pressure

D) Prolonged sense of euphoria

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Chapter 41: Diuretics

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Sample Questions

Q1) A patient has 2+ pitting edema of the lower extremities bilaterally. Auscultation of the lungs reveals crackles bilaterally,and the serum potassium level is 6 mEq/L. Which diuretic agent ordered by the prescriber should the nurse question?

A) Bumetanide [Bumex]

B) Furosemide [Lasix]

C) Spironolactone [Aldactone]

D) Hydrochlorothiazide [HydroDIURIL]

Q2) Besides having diuretic effects for patients with congestive heart failure,thiazides are also used to treat what? (Select all that apply.)

A) Diabetes insipidus

B) Hepatic failure

C) Increased intracranial pressure

D) Intraocular pressure

E) Postmenopausal osteoporosis

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Chapter 42: Agents Affecting the Volume and Ion Content of Body Fluids

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Sample Questions

Q1) Which order for potassium (KCl)would the nurse question? (Select all that apply.)

A) \( D_{5} 1 / 2 \) NS with 20 mEq KCl to start after patient voids

B) \( D_{5} 1 / 2 \) NS with 60 mEq KCl for a patient with a serum potassium of 3.2 mEq/L

C) K-Dur, 1 tablet daily for a patient in diabetic ketoacidosis

D) K-Dur, 1 tablet with a full glass of water

E) Potassium chloride, 10 mEq rapid IV push

Q2) A patient with congestive heart failure is admitted to the hospital. During the admission assessment,the nurse learns that the patient is taking a thiazide diuretic. The nurse notes that the admission electrolyte levels include a sodium level of 142 mEq/L,a chloride level of 95 mEq/L,and a potassium level of 3 mEq/L. The prescriber has ordered digoxin to be given immediately. What will the nurse do initially?

A) Give the digoxin and maintain close cardiac monitoring.

B) Hold the digoxin and report the laboratory values to the provider.

C) Hold the thiazide diuretic and give the digoxin.

D) Request an order for an electrocardiogram (ECG).

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Chapter 43: Review of Hemodynamics

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Sample Questions

Q1) A nurse is assessing a patient who has heart failure. The patient complains of shortness of breath,and the nurse auscultates crackles in both lungs. The nurse understands that these symptoms are the result of:

A) decreased force of ventricular contraction.

B) increased force of ventricular contraction.

C) decreased ventricular filling.

D) increased ventricular filling.

Q2) A patient with a history of hypertension is admitted for a procedure. If the patient's arterial pressure decreases,which clinical manifestation would the nurse expect to see?

A) Decreased heart rate

B) Increased heart rate

C) Decreased blood pressure

D) Syncope

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Chapter 44: Drugs Acting on the

Renin-Angiotensin-Aldosterone System

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Sample Questions

Q1) A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB)medication. Which side effect of ACE inhibitors will not occur with an ARB medication?

A) Angioedema

B) Cough

C) Hyperkalemia

D) Renal failure

Q2) A provider has ordered captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct?

A) Administer the captopril and monitor for adverse effects.

B) Hold the dose and notify the provider.

C) Request an order to administer fosinopril instead of captopril.

D) Reassure the patient that this is not a serious side effect.

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Chapter 45: Calcium Channel Blockers

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Sample Questions

Q1) A nurse is preparing to assist a nursing student to administer intravenous verapamil to a patient who also receives a beta blocker. The nurse asks the nursing student to discuss the plan of care for this patient. Which statement by the student indicates a need for further teaching?

A) "I will check to see when the last dose of the beta blocker was given."

B) "I will monitor vital signs closely to assess for hypotension."

C) "I will monitor the heart rate frequently to assess for reflex tachycardia."

D) "I will prepare to administer intravenous norepinephrine if necessary."

Q2) Which are therapeutic uses for verapamil? (Select all that apply.)

A) Angina of effort

B) Cardiac dysrhythmias

C) Essential hypertension

D) Sick sinus syndrome

E) Suppression of preterm labor

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Chapter 46: Vasodilators

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Sample Questions

Q1) Which medications are most likely to cause postural hypotension? (Select all that apply.)

A) Minoxidil

B) Diltiazem [Cardizem]

C) Prazosin [Minipress]

D) Captopril [Capoten]

E) Losartan [Cozaar]

Q2) A nursing student asks a nurse why a patient in hypertensive crisis is receiving both intravenous sodium nitroprusside [Nitropress] and oral hydralazine. The nurse will explain that this is done to prevent:

A) cyanide poisoning.

B) fluid retention.

C) rebound hypertension.

D) reflex tachycardia.

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Chapter 47: Drugs for Hypertension

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Sample Questions

Q1) The nurse is caring for a pregnant patient who is in labor. The woman reports having had mild preeclampsia with a previous pregnancy. The nurse notes that the woman has a blood pressure of 168/102 mm Hg. The nurse will contact the provider to request an order for which drug?

A) Angiotensin-converting enzyme (ACE) inhibitor

B) Hydralazine (Apresoline)

C) Magnesium sulfate

D) Sodium nitroprusside

Q2) A nurse has provided education for a patient newly diagnosed with hypertension who is just beginning therapy with antihypertensive medications. Which statement by the patient indicates a need for further teaching?

A) "I may experience serious long-term problems even if I am not having symptoms."

B) "I should report side effects to the provider since other drugs may be substituted."

C) "I will need to take medications on a long-term basis."

D) "When my symptoms subside, I may discontinue the medications."

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Chapter 48: Drugs for Heart Failure

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Sample Questions

Q1) A patient has heart failure and is taking an ACE inhibitor. The patient has developed fibrotic changes in the heart and vessels. The nurse expects the provider to order which medication to counter this development?

A) Aldosterone antagonist

B) Angiotensin II receptor blocker (ARB)

C) Beta blocker

D) Direct renin inhibitor (DRI)

Q2) A nurse prepares to administer a scheduled dose of digoxin. The nurse finds a new laboratory report showing a plasma digoxin level of 0.7 ng/mL. What action should the nurse take?

A) Withhold the drug for an hour and reassess the level.

B) Withhold the drug and notify the prescriber immediately.

C) Administer Digibind to counteract the toxicity.

D) Check the patient's apical pulse, and if it is within a safe range, administer the digoxin.

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Chapter 49: Antidysrhythmic Drugs

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Sample Questions

Q1) A patient will be taking amiodarone [Cordarone]. Which baseline tests are necessary before this medication is started? (Select all that apply.)

A) Chest radiograph and pulmonary function tests

B) Complete blood count with differential

C) Ophthalmologic examination

D) Renal function tests

E) Thyroid function tests

Q2) A prescriber is considering prescribing the amiodarone derivative dronedarone [Multaq] for a patient with atrial flutter. The nurse should be concerned about which of the following?

A) History of asthma

B) History of hypothyroidism

C) PR interval of 260 msec

D) QT interval of 520 msec

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Chapter 50: Prophylaxis of Atherosclerotic Cardiovascular

Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels

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Sample Questions

Q1) A patient who is taking simvastatin [Zocor] develops an infection and the provider orders azithromycin [Zithromax] to treat the infection. The nurse should be concerned if the patient complains of:

A) nausea.

B) tiredness.

C) muscle pain.

D) headache.

Q2) A nurse is reviewing a patient's medications and realizes that gemfibrozil [Lopid] and warfarin [Coumadin] are to be administered concomitantly. Which effect will the nurse anticipate in this patient?

A) Increased levels of gemfibrozil

B) Decreased levels of gemfibrozil

C) Increased anticoagulant effects

D) Reduced anticoagulant effects

Q3) Which is a possible benefit of taking fish-oil supplements?

A) A decrease in low-density lipoprotein and triglyceride levels

B) Decreased risk of thrombotic stroke

C) Prevention of heart disease in high-risk patients

D) Reduced risk of dysrhythmia in patients after myocardial infarction

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Chapter 51: Drugs for Angina Pectoris

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Sample Questions

Q1) A nurse is discussing the difference between stable and variant angina with a group of nursing students. Which statement by a student indicates the need for further teaching?

A) "Beta blockers are effective in stable angina but not in variant angina."

B) "In both types of angina, prophylactic treatment is possible."

C) "Variant angina is primarily treated with vasodilators to increase oxygen supply."

D) "Variant angina is the result of increased oxygen demand by the heart."

Q2) A patient is taking a calcium channel blocker (CCB)for stable angina. The patient's spouse asks how calcium channel blockers relieve pain. The nurse will explain that CCBs:

A) help relax peripheral arterioles to reduce afterload.

B) improve coronary artery perfusion.

C) increase the heart rate to improve myocardial contractility.

D) increase the QT interval.

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Sample Questions

Q1) A patient has been receiving heparin while in the hospital to treat deep vein thromboses and will be discharged home with a prescription for enoxaparin [Lovenox]. The nurse provides teaching for the nursing student who asks about the advantages of enoxaparin over heparin. Which statement by the student indicates a need for further teaching?

A) "Enoxaparin does not require coagulation monitoring."

B) "Enoxaparin has greater bioavailability than heparin."

C) "Enoxaparin is more cost-effective than heparin."

D) "Enoxaparin may be given using a fixed dosage."

Q2) A nurse caring for a patient receiving heparin therapy notes that the patient has a heart rate of 98 beats per minute and a blood pressure of 110/72 mm Hg. The patient's fingertips are purplish in color. A stat CBC shows a platelet count of less than 100,000 mm³. The nurse will:

A) administer oxygen and notify the provider.

B) discontinue the heparin and notify the provider.

C) request an order for protamine sulfate.

D) request an order for vitamin K (phytonadione).

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Page 54

Chapter 53: Management of ST-Elevation Myocardial Infarction

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Sample Questions

Q1) A patient who is receiving reperfusion therapy has a history of heparin-induced thrombosis (HIT). The patient has a creatinine clearance of 28 mL/min. In addition to the fibrinolytic agent,which medication will the nurse expect to administer to this patient?

A) Aspirin

B) Bivalirudin [Angiomax]

C) Clopidogrel [Plavix]

D) Fondaparinux [Arixtra]

Q2) A patient who is recovering from a STEMI 3 months prior is in the clinic for a follow-up evaluation. The patient is taking 81 mg of aspirin,a beta blocker,and an ACE inhibitor daily and uses nitroglycerine as needed for angina. The patient's BMI is 24.5 kg/m²,and serum LDL is 150 mg/dL. The patient has a blood pressure of 135/80 mm Hg. What will the nurse expect the provider to order for this patient?

A) An antihypertensive medication

B) Counseling about a weight loss diet

C) Discontinuing the ACE inhibitor

D) High-dose statin therapy

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55

Chapter 54: Drugs for Hemophilia

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Sample Questions

Q1) A patient with hemophilia B is admitted to the hospital for surgery. The patient's history reveals long-term use of factor replacement as prophylaxis for bleeding episodes. The nurse anticipates that the provider will order which medication to prevent excessive perioperative bleeding?

A) Desmopressin

B) Factor VIII

C) Ibuprofen

D) Tranexamic acid

Q2) A nurse is caring for an African American patient with severe hemophilia A who has been admitted for bleeding into the knee joint. The prescriber has ordered intravenous factor VIIa [NovoSeven RT]. A nursing student wants to know why this patient is not receiving factor VIII. Which statement by the nurse is correct?

A) "Factor VIIa is stronger than factor VIII and will work faster."

B) "Factor VIII is used for prophylaxis, and factor VIIa is used for acute episodes."

C) "Factor VIIa is used when patients develop antibodies against factor VIII."

D) "Factor VIIa provides immune tolerance therapy so that factor VIII will be more effective."

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Page 56

Chapter 55: Drugs for Deficiency Anemias

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Sample Questions

Q1) A patient with vitamin B₁₂deficiency is admitted with symptoms of hypoxia,anemia,numbness of hands and feet,and oral stomatitis. The nurse expects the prescriber to order which of the following therapies?

A) IM cyanocobalamin and folic acid

B) IM cyanocobalamin and antibiotics

C) PO cyanocobalamin and folic acid

D) PO cyanocobalamin and blood transfusions

Q2) A patient was given a 30-day supply of Feosol and has been taking the drug for 4 weeks for iron deficiency anemia. The patient's initial hemoglobin was 8.9 gm/dL. The nurse notes that the hemoglobin has risen to 9.7 gm/dL. What will the nurse ask the patient about?

A) Dietary iron intake

B) Gastrointestinal (GI) upset

C) Whether stools have been tarry or black

D) Whether the prescription needs to be refilled

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Chapter 56: Hematopoietic Agents

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Sample Questions

Q1) Which patients are eligible to receive erythropoiesis stimulating agents? (Select all that apply.)

A) All patients with nonmyeloid malignancies who require transfusions

B) All patients with nonmyeloid malignancies whose chemotherapy is palliative

C) All patients whose goal of therapy is curative

D) All patients with nonmyeloid malignancies and chemotherapy-induced anemia

E) All patients with leukemias or myeloid malignancies

Q2) A nurse is teaching a patient who has chronic renal failure who will begin receiving epoetin alfa [Epogen] about this drug therapy. Which statement by the patient indicates understanding of the teaching?

A) "If I have to start dialysis, I will have to stop taking this drug."

B) "Taking this drug will not eliminate my need for blood transfusions."

C) "Taking this medication will prevent the need for dialysis in the future."

D) "When I take this, my serum ferritin levels will increase."

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Chapter 57: Drugs for Diabetes Mellitus

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Sample Questions

Q1) A nurse counsels a patient with diabetes who is starting therapy with an alpha-glucosidase inhibitor. The patient should be educated about the potential for which adverse reactions? (Select all that apply.)

A) Hypoglycemia

B) Flatulence

C) Elevated iron levels in the blood

D) Fluid retention

E) Diarrhea

Q2) A patient who has type 2 diabetes will begin taking glipizide [Glucotrol]. Which statement by the patient is concerning to the nurse?

A) "I will begin by taking this once daily with breakfast."

B) "It is safe to drink grapefruit juice while taking this drug."

C) "I may continue to have a glass of wine with dinner."

D) "I will need to check my blood sugar once daily or more."

Q3) Which statement is correct about the contrast between acarbose and miglitol?

A) Miglitol has not been associated with hepatic dysfunction.

B) With miglitol, sucrose can be used to treat hypoglycemia.

C) Miglitol is less effective in African Americans.

D) Miglitol has no gastrointestinal side effects.

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Page 59

Chapter 58: Drugs for Thyroid Disorders

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Sample Questions

Q1) A nurse caring for a patient notes that the patient has a temperature of 104°F and a heart rate of 110 beats per minute. The patient's skin is warm and moist,and the patient complains that the room is too warm. The patient appears nervous and has protuberant eyes. The nurse will contact the provider to discuss:

A) cretinism.

B) Graves' disease.

C) myxedema.

D) Plummer's disease.

Q2) A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine [Synthroid]. Which statement by the patient indicates a need for further teaching?

A) "I should not take heartburn medication without consulting my provider."

B) "I should report insomnia, tremors, and an increased heart rate to my provider."

C) "If I take a multivitamin with iron, I should take it 4 hours after the Synthroid."

D) "If I take calcium supplements, I may need to decrease my dose of Synthroid."

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Chapter 59: Drugs Related to Hypothalamic and Pituitary Function

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Sample Questions

Q1) A male patient reports decreased libido and the nurse notes galactorrhea during a physical assessment. The nurse will report these findings to the provider and will anticipate an order for which medication?

A) Cabergoline

B) Conivaptan

C) Dopamine

D) Prolactin

Q2) A nurse is preparing to administer a dose of growth hormone and reconstitutes the medication. After adding the diluent,the nurse notices that the preparation is cloudy. What will the nurse do?

A) Administer the drug as ordered.

B) Discard the drug and prepare another dose.

C) Notify the prescriber.

D) Shake the drug to dissipate the particles.

Q3) What are the effects of prolactin secretion in males? (Select all that apply.)

A) Breast development

B) Decreased libido

C) Delayed puberty

D) Galactorrhea

E) Infertility

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Chapter 60: Drugs for Disorders of the Adrenal Cortex

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Sample Questions

Q1) A nurse is explaining congenital adrenal hyperplasia (CAH)to a group of nursing students. Which statement by a student indicates understanding of the teaching?

A) "CAH is caused by a deficiency of ACTH production."

B) "CAH is the result of an inability to synthesize glucocorticoids."

C) "Newborn screening provides a definitive diagnosis for CAH"

D) "The enzyme 21-alpha-hydroxylase increases the production of androgens."

Q2) The nurse is providing patient education to a patient who will begin taking fludrocortisone [Florinef] as adjunctive therapy to hydrocortisone. Which statement by the patient indicates understanding of the teaching?

A) "I should move from sitting to standing slowly."

B) "I should report any swelling of my hands and feet."

C) "I should report weight loss to my provider."

D) "I should report excessive urine output."

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Chapter 61: Estrogens and Progestins: Basic Pharmacology and

Noncontraceptive Applications

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Sample Questions

Q1) The nurse is providing patient education about the application of transdermal estrogen spray. Which statement made by the patient best demonstrates understanding of the application of this medication? "I should apply this medication to my:

A) waistline and shoulders."

B) abdomen and arms."

C) breasts and abdomen."

D) thighs and calves."

Q2) According to studies of estrogen/progestin therapy (EPT),what are its known benefits? (Select all that apply.)

A) Cardiovascular protection in older patients

B) Decreased osteoporosis risk

C) Glycemic control

D) Improved wound healing

E) Prevention of colorectal cancer

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63

Chapter 62: Birth Control

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Sample Questions

Q1) A patient is taking a combination oral contraceptive (OC)and reports breast tenderness,edema,and occasional nausea. What will the nurse recommend?

A) The patient should ask her provider about an OC with less progestin.

B) The patient should discuss an alternate method of birth control.

C) The patient should request an OC containing less estrogen.

D) The patient should take the OC at bedtime to reduce side effects.

Q2) A patient who is taking a combination oral contraceptive begins taking carbamazepine. After several weeks,the patient tells the nurse she has begun experiencing spotting during her cycle. What will the nurse tell her to do?

A) Change to condoms instead of oral contraceptives.

B) Discuss an oral contraceptive with increased estrogen.

C) Request a decreased dose of carbamazepine.

D) Stop taking the oral contraceptive immediately.

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Chapter 63: Drug Therapy of Infertility

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Sample Questions

Q1) The nurse counseling a couple who cannot conceive learns that female infertility problems have been ruled out. What will the nurse expect to tell this couple?

A) "If medication is necessary for male infertility, treatment will last a few months."

B) "Male infertility is usually treatable with a combination of medications."

C) "Most male infertility is not linked to known endocrine disorders."

D) "Treatment with sildenafil [Viagra] will be necessary to improve fertility."

Q2) A patient with endometriosis is being treated with the gonadotropin-releasing hormone (GnRH)agonist leuprolide [Lupron Depot]. A nurse is teaching the patient about the drug. Which statement by the patient indicates understanding of the teaching?

A) "I can continue to take the medication if I get pregnant."

B) "I can expect the medication to cure my symptoms."

C) "I may have menopausal-like symptoms when taking this medication."

D) "I will need to take the medication for several years."

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65

Chapter 64: Drugs That Affect Uterine Function

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Sample Questions

Q1) A pregnant patient is 1 week post-term and will receive intravenous oxytocin. Which will the nurse evaluate before starting the infusion? (Select all that apply.)

A) Cervical ripening

B) Fetal monitoring

C) Renal function

D) Respiratory function

E) Uterine activity

Q2) Which are indications for early induction of labor? (Select all that apply.)

A) Abruptio placentae

B) Active genital herpes infection

C) Gestational hypertension

D) Premature rupture of the membranes

E) Umbilical cord prolapse

Q3) Which drugs are useful for preventing preterm labor? (Select all that apply.)

A) Antibiotics

B) Hydroxyprogesterone

C) Indomethacin

D) Magnesium sulfate

E) Terbutaline

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Chapter 65: Androgens

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Sample Questions

Q1) A nurse is obtaining a history and reviewing the chart of an adult male patient who has been taking oral androgens. Which assessment would warrant notifying the provider?

A) Acne and increased facial hair

B) Breast enlargement

C) Increased libido

D) Nausea, anorexia, and fatigue

Q2) A clinic nurse is assessing an adolescent male patient who has been receiving androgen therapy for hypogonadism via a transdermal patch. The patient's last clinic visit was 4 weeks earlier. Which part of the interval history is of most concern to the nurse?

A) Five-pound weight gain

B) Increased growth of pubic hair

C) Rash at the site of the patch

D) Presence of acne

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Chapter 66: Drugs for Erectile Dysfunction and Benign

Prostatic Hyperplasia

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Sample Questions

Q1) A male patient tells the nurse he awakens once or twice each night to void and has difficulty starting his stream of urine. He describes these symptoms as "annoying." The patient's provider examines him and notes that the prostate is moderately enlarged. The patient is sexually active and tells the nurse that he does not want to take any medication that will interfere with sexual function. The nurse anticipates the provider will order:

A) doxazosin [Cardura].

B) finasteride [Proscar].

C) silodosin [Rapaflo].

D) a transurethral prostatectomy.

Q2) A healthy male patient who does not have erectile dysfunction asks about medications to improve sexual stamina. What will the nurse tell this patient?

A) "Medications for ED can improve the duration of erection in healthy men."

B) "Medications for ED can improve the quality of erection in healthy men."

C) "Medications for ED have no effect on erections in healthy men."

D) "Medications for ED will cause priapism in healthy men."

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Chapter 67: Review of the Immune System

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Sample Questions

Q1) A nurse is teaching a group of nursing students about immunoglobulins. Which statement by a student indicates a need for further teaching?

A) "IgD provides a first line of defense against microbes entering the body through the lungs."

B) "IgE plays a role in hypersensitivity reactions and responses to parasites."

C) "IgG and IgM participate in the complement response to promote target cell lysis."

D) "Neonatal immunity is the result of IgG crossing the placenta."

Q2) A nurse is teaching a group of nursing students about antibodies. The nurse correctly explains that which type of response is triggered when antigens bind to antibodies on mast cells or basophils?

A) Acquired immune response

B) Autoimmune response

C) Hypersensitivity reaction

D) Transplant rejection

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Chapter 68: Childhood Immunization

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Sample Questions

Q1) A 1-year-old child receives the MMR vaccine. The next day the child's parent calls the nurse to report that the child has a temperature of 103°F. What will the nurse do?

A) File an adverse event report with the Vaccine Adverse Event Reporting System (VAERS).

B) Notify the child's provider that thrombocytopenia is likely to occur.

C) Reassure the parent that fever can occur with the MMR vaccine.

D) Tell the parent to take the child to the emergency department.

Q2) The public health nurse is teaching a group of parents about immunizations. The nurse tells the parents that after receiving the varicella virus vaccine,children should temporarily avoid close contact with whom? (Select all that apply.)

A) Neonates

B) Siblings

C) Relatives older than 65 years

D) Pregnant women

E) Individuals infected with HIV

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Chapter 69: Immunosuppressants

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Sample Questions

Q1) A nurse provides teaching to a patient who has undergone kidney transplantation and will begin taking cyclosporine [Sandimmune],a glucocorticoid,and sirolimus [Rapamune]. Which statement by the patient indicates understanding of the teaching?

A) "I should take sirolimus at the same time as the cyclosporine."

B) "I will need to have my blood sugar checked regularly."

C) "I will need to take an antibiotic to prevent lung infections."

D) "Taking this combination of drugs lowers my risk of kidney damage."

Q2) The nurse is caring for a 15-year-old patient who has undergone a liver transplant. Which provider order will the nurse question?

A) Cyclosporine [Sandimmune] and ketoconazole [Nizoral]

B) Everolimus [Zortress] 1 mg twice daily

C) Prednisone 60 mg daily

D) Tacrolimus [Prograf] 50 mcg/kg twice daily the day after surgery

Q3) The nurse knows that which immunosuppressants are among the most effective?

A) Azathioprine [Imuran] and everolimus [Zortress]

B) Cyclosporine [Sandimmune] and tacrolimus [Prograf]

C) Methotrexate [Rheumatrex] and muromonab-CD3 [Orthoclone OKT3]

D) Sirolimus [Rapamune] and methylprednisolone

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Chapter 70: Antihistamines

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Sample Questions

Q1) A patient tells a nurse that antihistamines help relieve cold symptoms and wants to know why they are not recommended or prescribed for this purpose. The nurse tells the patient that antihistamines provide only mild relief from some cold symptoms by:

A) anticholinergic properties that decrease rhinorrhea.

B) blocking H₁ receptors in nasal passages.

C) reducing secretions at H₂ receptor sites.

D) having sedative effects, which help patients rest and sleep.

Q2) A family is preparing for travel and the parents report that their 5-year-old child has frequent motion sickness. The nurse will tell the parents to ask the provider about which antihistamine to help prevent symptoms?

A) Desloratadine [Clarinex]

B) Dimenhydrinate [Dramamine]

C) Hydroxyzine [Vistaril]

D) Promethazine [Phenergan]

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Chapter 71: Cyclooxygenase Inhibitors: Nonsteroidal

Anti-inflammatory Drugs and Acetaminophen

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Sample Questions

Q1) A patient tells the nurse that she takes aspirin for menstrual cramps,but she does not feel that it works well. What will the nurse suggest?

A) The patient should avoid any type of COX inhibitor because of the risk of Reye's syndrome.

B) The patient should increase the dose to a level that suppresses inflammation.

C) The patient should use a first-generation nonsteroidal anti-inflammatory medication instead.

D) The patient should use acetaminophen because of its selective effects on uterine smooth muscle.

Q2) A nurse is teaching a group of nursing students about cyclooxygenase (COX)inhibitors. A student asks the nurse about characteristics of COX-1 inhibitors. Which statement by the nurse is true?

A) "COX-1 inhibitors protect against colorectal cancer."

B) "COX-1 inhibitors protect against myocardial infarction and stroke."

C) "COX-1 inhibitors reduce fever."

D) "COX-1 inhibitors suppress inflammation."

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Chapter 72: Glucocorticoids in Nonendocrine Disorders

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Sample Questions

Q1) Which disorders may be treated with glucocorticoids? (Select all that apply.)

A) Allergic rhinitis

B) Anaphylaxis

C) Bronchiolitis

D) Gout

E) Ulcerative colitis

Q2) A patient is about to receive prednisone for tendonitis. The nurse reviewing the chart would be concerned about which of the following in the patient's medical history?

A) Asthma and allergic rhinitis

B) Gouty arthritis

C) Seborrheic dermatitis

D) Systemic fungal infection

Q3) A patient taking high doses of a glucocorticoid develops weakness in the muscles of the upper arms and in the legs. What will the nurse do?

A) Contact the provider to ask about reducing the dose.

B) Encourage the patient to restrict sodium intake.

C) Reassure the patient that this is an expected side effect.

D) Tell the patient to stop taking the drug.

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Chapter 73: Drug Therapy of Rheumatoid Arthritis

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Sample Questions

Q1) A patient about to begin therapy with etanercept has a positive tuberculin skin test. A chest radiograph is negative. The nurse will expect this patient to:

A) begin taking antituberculosis drugs at the beginning of treatment with etanercept.

B) have periodic chest radiographs during treatment with etanercept.

C) have regular monitoring of symptoms to detect active tuberculosis.

D) undergo tuberculosis treatment prior to beginning etanercept treatment.

Q2) A child who has juvenile idiopathic arthritis and who has been taking methotrexate [Rheumatrex] will begin a course of abatacept [Orencia]. What will the nurse include when teaching the child's family about this drug?

A) That abatacept and methotrexate must both be taken to be effective

B) To continue getting vaccinations during therapy with abatacept

C) That signs of infection may warrant immediate discontinuation of abatacept

D) That a tumor necrosis factor (TNF) antagonist may be added if this therapy is not effective

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Chapter 74: Drug Therapy of Gout

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Sample Questions

Q1) A patient is admitted for treatment of gout that has been refractory to treatment with allopurinol and probenecid. The patient is taking colchicine,and the prescriber orders pegloticase [Krystexxa]. Before administering this drug,the nurse will expect to:

A) administer an antihistamine and a glucocorticoid.

B) discontinue the colchicine.

C) increase the dose of colchicine.

D) prepare to administer a bronchodilator if needed.

Q2) A patient is being treated with warfarin [Coumadin] to prevent thrombus. The patient develops hyperuricemia,and the provider orders allopurinol [Zyloprim]. The nurse will contact the provider to discuss ____ the ____ dose.

A) increasing; allopurinol

B) increasing; warfarin

C) reducing; allopurinol

D) reducing; warfarin

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Chapter 75: Drugs Affecting Calcium Levels and Bone

Mineralization

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Sample Questions

Q1) A patient taking risedronate IR [Actonel] for osteoporosis reports experiencing diarrhea and headaches. What will the nurse tell this patient?

A) These are common side effects of this drug.

B) These symptoms indicate serious toxicity.

C) The patient should discuss taking risedronate DR [Atelvia] with the provider.

D) The medication should be taken after a meal to reduce symptoms.

Q2) A patient reports experiencing weakness, fatigue, nausea, vomiting, constipation, and nocturia. Total serum calcium is 10.5 mg/dL. A dipstick urinalysis shows a positive result for protein. When questioned, the patient reports taking vitamin D and calcium supplements. The nurse will counsel the patient to:

A) reduce the amount of vitamin D and stop taking the calcium.

B) discuss taking calcitonin-salmon [Fortical] with the provider.

C) stop both supplements and discuss the use of a diuretic with the provider.

D) stop taking vitamin D, reduce the amount of calcium, and increase the fluid intake.

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Chapter 76: Drugs for Asthma and Chronic Obstructive Pulmonary Disease

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Sample Questions

Q1) Which medication should be used for asthma patients as part of step 1 management?

A) Combination inhaled glucocorticoids/long-acting beta₂agonists

B) Inhaled low-dose glucocorticoids

C) Long-acting beta₂ agonists

D) Short-acting beta₂agonists

Q2) A patient with stable COPD receives prescriptions for an inhaled glucocorticoid and an inhaled beta₂-adrenergic agonist. Which statement by the patient indicates understanding of this medication regimen?

A) "I should use the glucocorticoid as needed when symptoms flare."

B) "I will need to use the beta₂-adrenergic agonist drug daily."

C) "The beta₂-adrenergic agonist suppresses the synthesis of inflammatory mediators."

D) "The glucocorticoid is used as prophylaxis to prevent exacerbations."

Q3) Which drugs are used to treat COPD? (Select all that apply.)

A) Anticholinergic medications

B) Glucocorticoids

C) Leukotriene modifiers

D) Long-acting beta₂ agonists

E) Monoclonal antibodies

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Chapter 77: Drugs for Allergic Rhinitis, Cough, and Colds

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Sample Questions

Q1) A patient who has a viral upper respiratory infection reports having a runny nose and a cough that prevents sleep and asks the nurse to recommend an over-the-counter medication. Which medication will the nurse recommend?

A) Diphenhydramine [Benadryl]

B) Fexofenadine/pseudoephedrine [Allegra-D]

C) Guaifenesin [Mucinex]

D) Phenylephrine drops

Q2) A patient who has seasonal allergies in the spring and fall asks the nurse about oral antihistamines. Which response by the nurse is correct?

A) "Anticholinergic effects are more common with second-generation antihistamines."

B) "First-generation antihistamines, such as diphenhydramine [Benadryl], are more effective."

C) "Make sure you take antihistamines only when you have symptoms to minimize side effects."

D) "You should take oral antihistamines daily during each allergy season to get maximum effects."

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Chapter 78: Drugs for Peptic Ulcer Disease

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Sample Questions

Q1) A patient who has gastroesophageal reflux disease (GERD)receives a prescription for a proton pump inhibitor (PPI)medication. What will the nurse include when teaching the patient about this drug?

A) "The FDA has determined that there is a gastric cancer risk with this drug."

B) "This drug will be given on a short-term basis only."

C) "You may experience hypermagnesemia when taking this drug."

D) "You should report any fever and cough to your provider."

Q2) When metronidazole [Flagyl] is a component of the H. pylori treatment regimen,the patient must be instructed to do what?

A) Avoid any alcoholic beverages

B) Avoid foods containing tyramine

C) Take the drug on an empty stomach

D) Take the drug with food

Q3) A patient is diagnosed with Zollinger-Ellison syndrome. Which medication does the nurse expect the provider to order for this patient?

A) Cimetidine [Tagamet]

B) Esomeprazole [Nexium]

C) Ranitidine [Zantac]

D) Sucralfate [Carafate]

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Page 80

Chapter 79: Laxatives

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Sample Questions

Q1) A patient reports taking an oral bisacodyl laxative [Dulcolax] for several years. The provider has suggested discontinuing the laxative,but the patient is unsure how to do this. The nurse will tell the patient to:

A) stop taking the oral laxative and use a suppository until normal motility resumes.

B) stop taking the laxative immediately and expect no stool for several days.

C) switch to a bulk-forming laxative, such as methylcellulose [Metamucil].

D) withdraw from the laxative slowly to avoid a rebound constipation effect.

Q2) A 6-year-old child has frequent constipation. The nurse provides teaching after the parent asks the nurse why the provider recommended using laxatives only when needed. Which statement by the parent indicates a need for further teaching?

A) "Children who take laxatives regularly can become dehydrated."

B) "Chronic laxative use can cause electrolyte imbalances."

C) "Frequent use of laxatives can cause diverticulitis."

D) "The normal reflex to defecate can be inhibited with overuse of laxatives."

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Chapter 80: Other Gastrointestinal Drugs

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Sample Questions

Q1) A patient with Crohn's disease will begin receiving an initial infusion of infliximab [Remicade]. The nurse explains how this drug works to treat this disease. Which statement by the patient indicates a need for further teaching?

A) "I may have an increased risk of infections, such as tuberculosis, when taking infliximab."

B) "I should report chills, fever, itching, and shortness of breath while receiving the infusion."

C) "This drug sometimes provides a complete cure of inflammatory bowel disease."

D) "I will take the second dose in 2 weeks, the third dose in 6 weeks, and then a dose every 8 weeks thereafter."

Q2) A nurse is caring for a patient with cancer who has been undergoing chemotherapy. The patient has oral mucositis as a result of the chemotherapy,and the provider has ordered palifermin [Kepivance]. Which is an appropriate nursing action when giving this drug?

A) Administering the drug as a slow IV infusion

B) Flushing the IV line with heparin before infusing the drug

C) Giving the drug within 6 hours of the chemotherapy

D) Warning the patient about the potential for distortion of taste

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82

Chapter 81: Vitamins

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Sample Questions

Q1) A patient with hyperlipidemia has been told by the provider to take extra niacin. The nurse will tell the patient to:

A) increase servings of poultry, fish, and cereals.

B) take nicotinamide supplements.

C) take nicotinic acid supplements.

D) take tryptophan supplements.

Q2) A nursing student asks a nurse working in the newborn nursery how vitamin K deficiency is treated in newborns. Which response by the nurse is correct?

A) "A newborn infant's intestinal flora will produce vitamin K."

B) "If coagulation studies show a bleeding disorder, oral menadione is given."

C) "Menadione is given intravenously shortly after delivery."

D) "Phytonadione is given intramuscularly immediately after delivery."

Q3) A child is diagnosed with rickets. The nurse knows that this child is most likely deficient in which vitamin?

A) Niacin (nicotinic acid)

B) Thiamin (vitamin B₁)

C) Vitamin C (ascorbic acid)

D) Vitamin D

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83

Chapter 82: Drugs for Weight Loss

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Sample Questions

Q1) A nurse performing an admission history on a patient learns that the patient is taking orlistat [Xenical],warfarin [Coumadin],and levothyroxine [Synthroid]. What will the nurse do?

A) Contact the provider to discuss increasing the warfarin dose.

B) Give the levothyroxine at least 4 hours before giving the orlistat.

C) Suggest that the patient avoid fatty foods while taking these medications.

D) Tell the patient to take the orlistat on an empty stomach.

Q2) A 50-year-old patient with a body mass index (BMI)of 26 and a waist circumference (WC)of 37 who smokes asks a nurse about drugs for weight loss. She tells the nurse,"I keep trying to eat less,but it doesn't work." What will the nurse do?

A) Ask her to begin keeping a log of her food intake and activities.

B) Counsel her to quit smoking to reduce her health risk.

C) Suggest she begin walking every day to increase the number of calories burned.

D) Tell her she is a candidate for drug therapy and suggest she contact her provider.

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84

Chapter 83: Basic Principles of Antimicrobial Therapy

Available Study Resources on Quizplus for this Chatper

13 Verified Questions

13 Flashcards

Source URL: https://quizplus.com/quiz/8476

Sample Questions

Q1) The nurse is teaching a pharmacology refresher course to a group of nurses. A student asks what host factors affect the choice of agents in antimicrobial therapy. The nurse will tell the students that such host factors include what? (Select all that apply.)

A) Age

B) Gender

C) Immune system status

D) Infection site

E) Weight

Q2) A nursing student asks a nurse to clarify the differences between the mechanisms of spontaneous mutation and conjugation in acquired resistance of microbes. What will the nurse say?

A) Conjugation results in a gradual increase in resistance.

B) Conjugation results in random changes in the microbe's DNA.

C) Spontaneous mutation leads to resistance to only one antimicrobial agent.

D) Spontaneous mutation can transfer DNA from one organism to another.

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Chapter 84: Drugs That Weaken the Bacterial Cell Wall I:

Penicillins

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15 Verified Questions

15 Flashcards

Source URL: https://quizplus.com/quiz/8477

Sample Questions

Q1) A nurse is discussing methicillin-resistant Staphylococcus aureus (MRSA)with a group of nursing students. Which statement by a student correctly identifies the basis for MRSA resistance?

A) "MRSA bacteria have developed PBPs with a low affinity for penicillins."

B) "MRSA bacteria produce penicillinases that render penicillin ineffective."

C) "MRSA occurs because of host resistance to penicillins."

D) "MRSA strains replicate faster than other Staphylococcus aureus strains."

Q2) A child with an ear infection is not responding to treatment with amoxicillin [Amoxil]. The nurse will expect the provider to order:

A) amoxicillin-clavulanic acid [Augmentin].

B) ampicillin.

C) nafcillin.

D) penicillin G [Benzylpenicillin].

Q3) A patient has an infection caused by Streptococcus pyogenes. The prescriber has ordered dicloxacillin PO. What will the nurse do?

A) Administer the medication as ordered.

B) Contact the provider to suggest giving the drug IV.

C) Question the need for a penicillinase-resistant penicillin.

D) Suggest ordering vancomycin to treat this infection.

Page 86

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Chapter 85: Drugs That Weaken the Bacterial Cell Wall II:

Cephalosporins, Carbapenems, Vancomycin, Telavancin, Aztreonam, and Fosfomycin

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13 Verified Questions

13 Flashcards

Source URL: https://quizplus.com/quiz/8478

Sample Questions

Q1) Which cephalosporin may be used to treat meningitis?

A) Cefaclor

B) Cefazolin

C) Cefoxitin

D) Cefotaxime

Q2) A provider has ordered ceftriaxone 4 gm once daily for a patient with renal impairment. What will the nurse do?

A) Administer the medication as prescribed.

B) Contact the provider to ask about giving the drug in divided doses.

C) Discuss increasing the interval between doses with the provider.

D) Discuss reducing the dose with the provider.

Q3) A patient receiving a cephalosporin develops a secondary intestinal infection caused by Clostridium difficile. What is an appropriate treatment for this patient?

A) Adding an antibiotic, such as vancomycin [Vancocin], to the patient's regimen

B) Discontinuing the cephalosporin and beginning metronidazole [Flagyl]

C) Discontinuing all antibiotics and providing fluid replacement

D) Increasing the dose of the cephalosporin and providing isolation measures

Page 87

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Chapter 86: Bacteriostatic Inhibitors of Protein Synthesis:

Tetracyclines, Macrolides, and Others

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21 Verified Questions

21 Flashcards

Source URL: https://quizplus.com/quiz/8479

Sample Questions

Q1) A pregnant adolescent patient asks the nurse whether she should continue to take her prescription for tetracycline [Sumycin] to clear up her acne. Which response by the nurse is correct?

A) "Tetracycline can be harmful to the baby's teeth and should be avoided."

B) "Tetracycline is safe to take during pregnancy."

C) "Tetracycline may cause allergic reactions in pregnant women."

D) "Tetracycline will prevent asymptomatic urinary tract infections."

Q2) A 6-week-old infant who has not yet received immunizations develops a severe cough. While awaiting nasopharyngeal culture results,the nurse will expect to administer which antibiotic?

A) Clindamycin [Cleocin]

B) Doxycycline [Vibramycin]

C) Erythromycin ethylsuccinate

D) Penicillin G

Q3) To prevent yellow or brown discoloration of teeth in children,tetracyclines should not be given:

A) to children once the permanent teeth have developed.

B) to patients taking calcium supplements.

C) to pregnant patients after the fourth month of gestation.

D) with dairy products or antacids.

Page 88

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Chapter 87: Aminoglycosides: Bactericidal Inhibitors of Protein Synthesis

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18 Verified Questions

18 Flashcards

Source URL: https://quizplus.com/quiz/8480

Sample Questions

Q1) A nurse preparing to administer intravenous gentamicin to a patient notes that the dose is half the usual dose for an adult. The nurse suspects that this is because this patient has a history of:

A) antibiotic resistance.

B) interpatient variation.

C) liver disease.

D) renal disease.

Q2) A patient shows signs and symptoms of conjunctivitis. Which aminoglycoside would the nurse expect to be ordered?

A) Amikacin [Amikin]

B) Kanamycin [Kantrex]

C) Neomycin [Neomycin]

D) Paromomycin [Humatin]

Q3) A patient who has been receiving intravenous gentamicin for several days reports having had a headache for 2 days. The nurse will request an order to:

A) discontinue the gentamicin.

B) obtain a gentamicin trough before the next dose is given

C) give an analgesic to control headache discomfort.

D) obtain renal function tests to evaluate for potential nephrotoxicity.

Page 89

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Chapter 88: Sulfonamides and Trimethoprim

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12 Verified Questions

12 Flashcards

Source URL: https://quizplus.com/quiz/8481

Sample Questions

Q1) A patient who is taking immunosuppressant medications develops a urinary tract infection. The causative organism is sensitive to sulfonamides and to another,more expensive antibiotic. The prescriber orders the more expensive antibiotic. The nursing student assigned to this patient asks the nurse why the more expensive antibiotic is being used. Which response by the nurse is correct?

A) "Immunosuppressed patients are folate deficient."

B) "Patients who are immunosuppressed are more likely to develop resistance."

C) "Sulfonamides are bacteriostatic and depend on host immunity to work."

D) "Sulfonamides intensify the effects of immunosuppression."

Q2) A patient with a urinary tract infection is given a prescription for TMP/SMZ. When reviewing the drug with the patient,the nurse learns that the patient has type 1 diabetes mellitus and consumes alcohol heavily. What will the nurse do?

A) Contact the provider to request a different antibiotic for this patient.

B) Obtain frequent blood glucose determinations while giving TMP/SMZ.

C) Suggest that the patient take a potassium supplement while taking TMP/SMZ.

D) Tell the patient to avoid excessive fluid intake while taking TMP/SMZ.

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90

Chapter 89: Drug Therapy of Urinary Tract Infections

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15 Verified Questions

15 Flashcards

Source URL: https://quizplus.com/quiz/8482

Sample Questions

Q1) The nurse is discussing upper and lower UTIs. Which of these conditions can be treated at home? (Select all that apply.)

A) Acute cystitis

B) Acute urethritis

C) Recurrent UTI

D) Severe pyelonephritis

E) Acute bacterial prostatitis

Q2) An older male patient comes to the clinic with complaints of chills,malaise,myalgia,localized pain,dysuria,nocturia,and urinary retention. The nurse would most likely suspect that the patient has:

A) acute cystitis.

B) urinary tract infection.

C) pyelonephritis.

D) prostatitis.

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Chapter 90: Antimycobacterial Agents: Drugs for

Tuberculosis, Leprosy, and Mycobacterium avium Complex

Infection

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21 Verified Questions

21 Flashcards

Source URL: https://quizplus.com/quiz/8483

Sample Questions

Q1) A patient with HIV who takes protease inhibitors develops tuberculosis and will begin treatment. Which drug regimen will be used for this patient?

A) Isoniazid, pyrazinamide, ethambutol + rifabutin

B) Isoniazid, pyrazinamide, ethambutol

C) Isoniazid, rifampin, pyrazinamide, ethambutol

D) Isoniazid + rifabutin

Q2) A patient has been taking isoniazid [Nydrazid] for 4 months for latent tuberculosis. The patient reports bilateral tingling and numbness of the hands and feet,as well as feeling clumsy. The nurse expects the provider to:

A) discontinue the isoniazid.

B) lower the isoniazid dose and add rifampin.

C) order pyridoxine 100 mg per day.

D) recheck the tuberculin skin test to see whether it worsens.

Q3) Which patient(s)should be tested for latent TB? (Select all that apply.)

A) A day care employee

B) A worker in a mycobacteriology laboratory

C) A patient with cardiovascular disease

D) A patient with diabetes mellitus

E) An immigrant from a country where TB is prevalent

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Chapter 91: Miscellaneous Antibacterial Drugs:

Fluoroquinolones, Metronidazole, Daptomycin, Rifampin, Rifaximin, Bacitracin, and Polymyxins

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11 Verified Questions

11 Flashcards

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Sample Questions

Q1) A patient who is receiving intravenous ciprofloxacin for pneumonia develops diarrhea. A stool culture is positive for Clostridium difficile. The nurse will expect the provider to:

A) add metronidazole [Flagyl].

B) increase the dose of ciprofloxacin.

C) restrict dairy products.

D) switch to gemifloxacin.

Q2) Which fluoroquinolone antibiotics may be administered to children? (Select all that apply.)

A) Ciprofloxacin [Cipro]

B) Levofloxacin [Levaquin]

C) Moxifloxacin [Avelox]

D) Norfloxacin [Noroxin]

E) Ofloxacin

Q3) Which antibiotics may be administered topically? (Select all that apply.)

A) Bacitracin

B) Daptomycin

C) Ofloxacin

D) Polymyxin B

E) Rifampin

Page 93

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Chapter 92: Antifungal Agents

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23 Verified Questions

23 Flashcards

Source URL: https://quizplus.com/quiz/8485

Sample Questions

Q1) A patient will begin taking an immunosuppressant medication. The nurse learns that the patient has a history of frequent candidal infections. The nurse will expect the provider to order which drug as prophylaxis?

A) Fluconazole [Diflucan]

B) Ketoconazole

C) Posaconazole [Noxafil]

D) Voriconazole [Vfend]

Q2) A patient is receiving intravenous voriconazole [Vfend]. Shortly after the infusion starts,the patient tells the nurse,"Colors look different,and the light hurts my eyes." What will the nurse do?

A) Observe the patient closely for the development of hallucinations.

B) Reassure the patient that these effects will subside in about 30 minutes.

C) Stop the infusion and notify the provider of CNS toxicity.

D) Tell the patient that this is an irreversible effect of the drug.

Q3) Which superficial mycosis is generally treated with oral antifungal agents?

A) Tinea capitis

B) Tinea corporis

C) Tinea cruris

D) Tinea pedis

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Page 95

Chapter 93: Antiviral Agents I: Drugs for Non-HIV Viral

Infections

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15 Verified Questions

15 Flashcards

Source URL: https://quizplus.com/quiz/8486

Sample Questions

Q1) A patient comes to the clinic and receives valacyclovir [Valtrex] for a herpes-zoster virus. The nurse instructs the patient to take the medication:

A) without regard to meals.

B) without any dairy products.

C) each morning.

D) on an empty stomach.

Q2) A patient with hepatitis B begins treatment with adefovir [Hepsera] and asks the nurse how long the drug therapy will last. The nurse will tell the patient that the medication will need to be taken for:

A) a lifetime.

B) an indefinite, prolonged period of time.

C) 48 weeks.

D) until nephrotoxicity occurs.

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96

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14 Verified Questions

14 Flashcards

Source URL: https://quizplus.com/quiz/8487

Sample Questions

Q1) The nurse is caring for a patient who is HIV positive and has a previous history of drug and alcohol abuse. The patient is being treated with combination therapies,including didanosine [Videx]. Which laboratory findings would most concern the nurse?

A) Increased serum amylase and triglycerides and decreased serum calcium

B) Decreased serum amylase and serum triglycerides and increased serum calcium

C) Decreased hemoglobin and hematocrit

D) Increased serum amylase, decreased triglycerides, and increased platelets

Q2) The nurse is caring for a patient who is taking a protease inhibitor (PI). Upon review of the laboratory test results,the nurse notes that the patient has newly elevated plasma triglycerides and cholesterol. The nurse expects that the prescriber will manage these levels with:

A) lovastatin [Mevacor].

B) simvastatin [Zocor].

C) modified diet and exercise.

D) Pancrease.

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Chapter 95: Drug Therapy of Sexually Transmitted Diseases

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11 Verified Questions

11 Flashcards

Source URL: https://quizplus.com/quiz/8488

Sample Questions

Q1) A newborn infant has been given erythromycin ophthalmic ointment as a routine postpartum medication. The infant's mother learns that she has a C. trachomatis infection and asks the nurse if her baby will need to be treated. Which response by the nurse is correct?

A) "The erythromycin ointment will prevent your baby from developing conjunctivitis."

B) "Without additional treatment, your baby could develop blindness."

C) "Your baby will need to be treated with oral erythromycin."

D) "Your baby will need to take doxycycline [Vibramycin] for 10 days."

Q2) A female patient has come to the STD clinic and has been diagnosed with a Trichomonas vaginalis infection. What education should be provided to this patient?

A) Male partners should always be treated, even if they are asymptomatic.

B) The applicator for the vaginal gel should be washed after each application.

C) The infection is not completely eliminated with the medication.

D) The medication should be taken twice daily for 2 weeks.

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98

Chapter 96: Antiseptics and Disinfectants

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10 Verified Questions

10 Flashcards

Source URL: https://quizplus.com/quiz/8489

Sample Questions

Q1) A patient arrives in the emergency department after a bicycle-automobile accident with multiple dirty abrasions. Which product might be used initially to cleanse this patient's wounds?

A) Hydrogen peroxide

B) Isopropanol (isopropyl alcohol)

C) Povidone iodine [Betadine]

D) Soap and water

Q2) A nursing student asks a nurse why systemic antibiotics and not topical antiseptic agents are used to treat localized skin infections. Which statement by the student indicates a need for further teaching?

A) "Systemic agents are not affected by wound exudates."

B) "Systemic agents penetrate to the site of infection."

C) "Topical agents can damage inflamed or abraded tissues."

D) "Topical agents work only against established local infections."

Q3) For which patient would a topical antiseptic be most appropriate?

A) A patient with a systemic infection

B) A patient with a medium-sized abscess

C) A patient who has a wound with moderate exudate

D) A patient who needs to have wounds cleansed for prophylaxis

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Page 99

Chapter 97: Anthelmintics

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9 Flashcards

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Sample Questions

Q1) A patient is being treated with albendazole [Albenza] for neurocysticercosis caused by larval forms of the pork tapeworm. Which statement by the patient indicates a need for further teaching about the drug regimen?

A) "I may need to take this medication for a month before the infestation is cleared."

B) "I should take this drug with a fatty meal to improve absorption."

C) "I will need to have liver function tests before and during treatment."

D) "I will take the drug in 3 consecutive cycles of 28 days, followed by 14 drug-free days."

Q2) A patient is being treated for trichinosis. The patient asks the nurse why the provider has ordered prednisone in addition to the anthelmintic medication. The nurse will tell this patient that this is ordered to:

A) prevent swelling of the legs caused by larval infestation of lymphatics.

B) reduce the inflammation that occurs during larval migration.

C) suppress the patient's allergic response to the anthelmintic agent.

D) suppress dermatologic symptoms that occur with heavy infestation.

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Chapter 98: Antiprotozoal Drugs I: Antimalarial Agents

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11 Verified Questions

11 Flashcards

Source URL: https://quizplus.com/quiz/8491

Sample Questions

Q1) A nurse is teaching a group of nursing students about the two most common forms of malaria,Plasmodium vivax malaria and Plasmodium falciparum malaria. Which statement by a student indicates a need for further teaching?

A) "Once erythrocyte forms of P. falciparum are eliminated, relapse will not occur."

B) "Patients with P. vivax malaria experience relapse with increased frequency over time."

C) "Patients with P. falciparum malaria experience symptoms at irregular intervals."

D) "Patients with P. vivax malaria rarely encounter drug resistance."

Q2) A patient who has contracted falciparum malaria has received a prescription for artemether/lumefantrine [Coartem] and tells the nurse she thinks she may be pregnant.

What will the nurse tell this patient?

A) "Ask your provider about taking only the artemether component."

B) "The medication should be taken with food to prevent nausea."

C) "This drug is safe during the first trimester of pregnancy."

D) "You should talk to your provider about a different medication."

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Chapter 99: Antiprotozoal Drugs II: Miscellaneous Agents

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9 Verified Questions

9 Flashcards

Source URL: https://quizplus.com/quiz/8492

Sample Questions

Q1) A patient taking metronidazole [Flagyl] for asymptomatic intestinal amebiasis complains of tingling and numbness of the hands and feet. What action by the nurse is most appropriate?

A) Encourage the patient to exercise to improve circulation.

B) Inform the patient that numbness is a common and reversible side effect.

C) Stress the need to avoid constrictive clothing and crossing the legs.

D) Withhold the drug and notify the prescriber.

Q2) A 20-kg pediatric patient is being treated for toxoplasmosis,and the provider orders pyrimethamine [Daraprim] 10 mg twice daily. The nurse caring for this patient will anticipate which additional order from the provider?

A) Administer 10 to 15 mg of folinic acid with each dose of pyrimethamine.

B) Give the medication intravenously over 30 to 45 minutes.

C) Increase the dose to 20 mg twice daily after 2 to 4 days.

D) Teach the family to monitor for muscle pain and joint stiffness.

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Chapter 100: Ectoparasiticides

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13 Verified Questions

13 Flashcards

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Sample Questions

Q1) Which patient should not use lindane? (Select all that apply.)

A) A child with a history of seizures

B) A patient who has used lindane in the past 2 months

C) A person who weighs 115 pounds

D) A person with an autoimmune disorder

E) A person with atopic dermatitis

Q2) A patient is treated for Phthirus pubis with permethrin 1% lotion. Two days after using the lotion as directed,the patient calls to report increased itching,erythema,and edema of the pubic skin. What will the nurse tell the patient?

A) This is an expected effect of the treatment and will subside.

B) This represents an allergic reaction to the lotion.

C) The patient should ask the provider about using malathion 0.5% lotion.

D) The patient should repeat the permethrin now and contact the provider if no improvement is seen.

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Chapter 101: Basic Principles of Cancer Chemotherapy

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16 Verified Questions

16 Flashcards

Source URL: https://quizplus.com/quiz/8494

Sample Questions

Q1) A nursing student asks a nurse why chemotherapeutic agents are given intermittently instead of continuously. The nurse will tell the student that intermittent dosing:

A) allows normal cells to recover and repopulate.

B) catches malignant cells in latent phases.

C) increases cancer cell kill and speeds up treatment.

D) suppresses drug resistance in tumor cells.

Q2) Which are guidelines for selecting chemotherapeutic agents to use in combination therapy? (Select all that apply.)

A) Drugs used should have different mechanisms.

B) Each drug should be delivered by different routes.

C) Each drug should be effective.

D) Each drug should have different dosing schedules.

E) Toxicities should be minimally overlapping.

Q3) A patient asks a nurse about ways to minimize side effects of chemotherapy. Which response is correct?

A) "Avoid contact with people who are ill."

B) "Take antiemetics immediately after receiving chemotherapy."

C) "Treat fevers immediately with ibuprofen."

D) "Use a firm-bristled toothbrush to stimulate gums."

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Chapter 102: Anticancer Drugs I: Cytotoxic Agents

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18 Verified Questions

18 Flashcards

Source URL: https://quizplus.com/quiz/8495

Sample Questions

Q1) A nurse is discussing vesicant chemotherapeutic agents with a nursing student. Which statement by the student indicates a need for further teaching about this type of drug?

A) "Extravasation of this type of drug may result in the need for skin grafts."

B) "If an IV line used for a vesicant drug infiltrates, it must be discontinued immediately."

C) "These drugs may be administered orally as well as intravenously."

D) "This type of drug may not be infused at a site of previous irradiation."

Q2) A patient will begin chemotherapy with cisplatin. Which medications will the nurse expect to administer to offset this agent's side effects?

A) Amifostine [Ethyol], diuretics, and antiemetics

B) Antiemetics, vitamin B₁₂, and glucocorticoids

C) Dexamethasone, antiemetics, and vistonuridine

D) Folic acid, gabapentin, and vitamin B₁₂

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Chapter 103: Anticancer Drugs II: Hormonal Agents,

Targeted Drugs, and Other Noncytotoxic Anticancer Drugs

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13 Verified Questions

13 Flashcards

Source URL: https://quizplus.com/quiz/8496

Sample Questions

Q1) A patient with advanced cancer of the prostate begins treatment with leuprolide [Lupron Depot] injections and will receive 7.5 mg IM once per month. After the first injection,the patient experiences an increase in cancer symptoms. What will the nurse tell the patient?

A) Desensitization to the drug over time will result in a decrease in these symptoms.

B) The dose of leuprolide may have to be increased to 22.5 mg per month.

C) These symptoms indicate a need for surgical castration to treat the cancer.

D) This is a sign that the patient's cancer is getting worse.

Q2) A patient with advanced prostate cancer will begin treatment with leuprolide [Lupron]. The provider has ordered flutamide to be given as adjunct therapy. The patient asks the nurse why both drugs are necessary. The nurse will tell the patient that:

A) flutamide reduces the side effects, such as hot flushes, caused by leuprolide.

B) flutamide suppresses initial tumor flare caused by leuprolide.

C) leuprolide helps to reduce the toxicity of flutamide.

D) the combination of both drugs increases cancer survival.

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Chapter 104: Drugs for the Eye

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14 Verified Questions

14 Flashcards

Source URL: https://quizplus.com/quiz/8497

Sample Questions

Q1) The nurse is reviewing personal knowledge of the medications used in the treatment of open-angle glaucoma. The nurse would be correct to identify which medication(s)as treatment? (Select all that apply.)

A) Alpha₂ agonists

B) Prostaglandin analogs

C) Anticholinergics

D) Carbonic anhydrase inhibitors

E) Beta blockers

Q2) A nursing student asks the nurse to discuss the differences between POAG and angle-closure glaucoma. Which statement by the nurse is correct?

A) "Angle-closure glaucoma may be asymptomatic until irreversible damage has occurred."

B) "Both types are more common in African American patients."

C) "Drug therapy is the definitive treatment for angle-closure glaucoma."

D) "Early treatment with prostaglandin analogs can stop the progression of POAG."

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Chapter 105: Drugs for the Skin

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21 Verified Questions

21 Flashcards

Source URL: https://quizplus.com/quiz/8498

Sample Questions

Q1) A patient is using a high-concentration keratolytic agent containing 20% salicylic acid to remove warts. What will the nurse teach this patient?

A) Peeling and drying are desired effects of this drug.

B) Systemic effects may occur with this medication.

C) Tinnitus is a common side effect of little concern.

D) Tissue injury is unlikely at this dose.

Q2) A female patient with baldness asks a nurse about the safety and efficacy of minoxidil [Rogaine]. What will the nurse tell the patient?

A) Hair regrowth is most effective when baldness has developed recently.

B) Minoxidil cannot be used by female patients.

C) Once hair has been restored, minoxidil may be discontinued, because hair loss will stop.

D) Systemic side effects, such as headaches and flushing, are common.

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Chapter 106: Drugs for the Ear

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Source URL: https://quizplus.com/quiz/8499

Sample Questions

Q1) A child has been diagnosed with otitis media with effusion (OME),and the child's parent asks the nurse what this means. The nurse will explain that OME is:

A) a condition with a heightened risk of acute otitis media.

B) an acute ear infection with fluid in the middle ear.

C) an infection of the skin and tissues of the outer ear.

D) fluid in the middle ear without localized or systemic infection.

Q2) A 12-month-old child attends day care and is seen in a clinic for a second middle ear infection since age 8 months. The parent calls the nurse to report that after the third day of giving amoxicillin [Amoxil],the child continues to have a temperature of 39.5°C and is unable to sleep well because of pain. What will the nurse do?

A) Encourage the parent to discuss amoxicillin/clavulanate [Augmentin] with the child's provider.

B) Recommend that the parent consider removing the child from day care to reduce exposure to infection.

C) Schedule a clinic appointment for the child to clinic to receive ceftriaxone [Rocephin] IM.

D) Tell the parent the child will probably need surgery for tympanostomy tubes to reduce infections.

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Chapter 107: Additional Noteworthy Drugs

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Source URL: https://quizplus.com/quiz/8500

Sample Questions

Q1) An adult patient with sickle cell anemia is being treated for a severe acute crisis with an opioid analgesic,a glucocorticoid,and hydroxyurea. The patient's complete blood count reveals neutrophils 2000/mm³,platelets 85,000/mm³,reticulocytes 85,000/mm³,and a hemoglobin of 4.2 gm/dL. What will the nurse anticipate doing?

A) Decreasing the glucocorticoid dose

B) Increasing the glucocorticoid dose

C) Increasing the hydroxyurea dose

D) Stopping the hydroxyurea

Q2) A pregnant patient begins active labor at 30 weeks' gestation. The provider orders dexamethasone 6 mg intramuscularly to be given twice daily for 4 doses. The patient asks the nurse what effect this drug will have on the fetus. The nurse will tell her that the dexamethasone is given to:

A) improve cognitive function in the fetus.

B) improve fetal neuromotor development.

C) increase fetal weight and length.

D) increase lung development in the fetus.

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Chapter 108: Dietary Supplements

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10 Verified Questions

10 Flashcards

Source URL: https://quizplus.com/quiz/8501

Sample Questions

Q1) A nursing student asks a nurse what the NMBER system that rates dietary supplements means. The nurse responds that the NMBER system:

A) describes the chemistry, toxicology, pharmacology, and uses of supplements.

B) helps consumers evaluate the safety and efficacy of products.

C) provides free information about clinical trials and epidemiologic studies of products.

D) provides funding for research on complementary and alternative medicine.

Q2) The nurse is obtaining a history from a patient who discloses daily use of St. John's wort in addition to prescription drugs. Which effect of this dietary supplement would most concern the nurse?

A) It accelerates the metabolism of some drugs.

B) It enhances the effects of digoxin.

C) It counteracts the effects of CNS depressants.

D) It increases the risk of bleeding.

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Chapter 109: Management of Poisoning

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11 Verified Questions

11 Flashcards

Source URL: https://quizplus.com/quiz/8502

Sample Questions

Q1) A parent brings a child to the emergency department,because the child drank a solution containing ferrous sulfate. The nurse will prepare for:

A) administration of activated charcoal.

B) gastric lavage.

C) peritoneal dialysis.

D) whole-bowel irrigation.

Q2) An alert child is brought to the emergency department after ingesting gasoline. The nurse will prepare to administer which treatment to minimize poison absorption in this child?

A) Activated charcoal

B) Chelation therapy

C) Gastric lavage with aspiration

D) Whole bowel irrigation

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112

Chapter 110: Potential Weapons of Biologic, Radiologic, and Chemical Terrorism

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11 Verified Questions

11 Flashcards

Source URL: https://quizplus.com/quiz/8503

Sample Questions

Q1) A patient asks a nurse about who is eligible to receive anthrax vaccine [BioThrax]. The nurse will respond by saying that which groups of people would be candidates for this vaccine? (Select all that apply.)

A) Hospital personnel

B) Laboratory workers

C) Military personnel

D) Nursing home residents

E) Veterinarians

Q2) A patient reported to have been exposed to mustard gas is brought to the emergency department. The patient's skin is red and swollen with small blisters,and the patient's eyes are red and tearing. The patient has a runny nose and a dry,barking cough. What should the nurse's initial action be?

A) Prepare for renal dialysis.

B) Provide oxygen and prepare for mechanical ventilation.

C) Remove the patient's clothing and clean the skin with soap and water.

D) Rush the patient to the intensive care unit for cardiorespiratory monitoring.

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