Patient Care in Nursing Final Exam
Course Introduction
Patient Care in Nursing focuses on the foundational concepts and practical skills necessary for delivering high-quality, compassionate care to patients across diverse healthcare settings. The course covers essential topics including patient assessment, communication, safety protocols, hygiene, nutrition, mobility assistance, and basic clinical procedures. Emphasis is placed on building therapeutic relationships, understanding patients physical and emotional needs, ethical considerations, and promoting patient dignity and autonomy. Through theoretical instruction and hands-on practice, students develop the ability to deliver holistic, evidence-based care that supports patient well-being and recovery.
Recommended Textbook
Basic Pharmacology for Nurses 15th Edition by
Bruce D. Clayton
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50 Chapters
879 Verified Questions
879 Flashcards
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Chapter 1: Definitions, Names, Standards, and Information
Sources
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Sample Questions
Q1) What is the most comprehensive reference available to research a drug interaction?
A) Drug Facts and Comparisons
B) Drug Interaction Facts
C) Handbook on Injectable Drugs
D) Martindale-The Complete Drug Reference
Answer: B
Q2) The physician has written an order for a drug with which the nurse is unfamiliar. Which section of the Physicians' Desk Reference (PDR) is most helpful to get information about this drug?
A) Manufacturer's section
B) Brand and Generic Name section
C) Product Category section
D) Product Information section
Answer: B
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Chapter 2: Principles of Drug Action and Drug Interactions
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Sample Questions
Q1) The nurse assesses which blood level to determine the amount of circulating medication in a patient?
A) Peak
B) Trough
C) Drug
D) Therapeutic
Answer: C
Q2) Which statements about liberation of drugs are true? (Select all that apply.)
A) A drug must be dissolved in body fluids before it can be absorbed into body tissues.
B) A solid drug taken orally must disintegrate and dissolve in GI fluids to allow for absorption into the bloodstream for transport to the site of action.
C) The process of converting the drug into a soluble form can be controlled to a certain degree by the dosage form.
D) Converting the drug to a soluble form can be influenced by administering the drug with or without food in the patient's stomach.
E) Elixirs take longer to be liberated from the dosage form.
Answer: A, B, C, D
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4
Chapter 3: Drug Action Across the Life Span
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Sample Questions
Q1) Why are elderly patients at increased risk for drug interactions and toxicity? (Select all that apply.)
A) They have a higher incidence of malnourishment.
B) Their renal function is enhanced.
C) They have increased use of multiple medications.
D) Hepatic function is reduced.
E) There are often issues with swallowing.
Answer: A, C, D
Q2) What will the nurse expect the health care provider's order to be when starting an older adult patient on thyroid hormone replacement therapy?
A) Administer a loading dose of the drug
B) Directions on how to taper the drug
C) A dosage that is one third to one half of the regular dosage
D) A dosage that is double the regular dosage
Answer: C
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5
Chapter 4: The Nursing Process and Pharmacology
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Sample Questions
Q1) Prior to the administration of a nephrotoxic drug, the nurse determines that the kidney lab data are within normal range. Which step of the nursing process is being utilized?
A) Assessment
B) Nursing diagnosis
C) Planning
D) Evaluation
Q2) The nurse has determined that the pain medication given to a patient an hour ago has been effective. The nurse is using which step of the nursing process?
A) Evaluation
B) Intervention
C) Nursing diagnosis
D) Planning
Q3) Which task is included in the assessment step of the nursing process?
A) Establishing patient goals/outcomes
B) Implementation of the nursing care plan
C) Measuring goal/outcome achievement
D) Collecting and communicating data
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Chapter 5: Patient Education and Health Promotion
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Sample Questions
Q1) The nurse is preparing to instruct a patient and his wife on technique and importance of assessing pulse prior to taking heart medication. Which are appropriate principles of learning in this situation? (Select all that apply.)
A) The learning environment
B) The patient's and wife's learning styles
C) The objectives/goal statements listed on the patient's care plan
D) The patient's financial ability to purchase the medication
E) The patient's understanding of the seriousness of his illness
Q2) The nurse is educating a 13-year-old boy newly diagnosed with diabetes and his parents about diet and glucose monitoring. Which domain of learning is represented when the patient expresses concern about feeling different from his peers?
A) Cognitive
B) Psychomotor
C) Affective
D) Learning style
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Chapter 6: A Review of Arithmetic
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Q1) 300/125 \(\times\) 5/1 = _____
Q2) 17 = _____
Q3) 1 L = _____ mL
Q4) 11/15 - 1/4 = _____
Q5) 5/18 - 2/9 = _____
Q6) 1 c = _____ oz
Q7) 0.62 = _____, _____, _____
Q8) 1 kg = _____ pounds
Q9) 144 = _____
Q10) 1000 mL of solution containing 50 g glucose in water: _____
Q11) 5/12 \(\times\) 3/4 = _____
Q12) 19.83 - 4.51 = _____
Q13) 0.00007 = _____
Q14) 1.5 \(\times\) 8.04 = _____
Q15) 4.302 + 1.88 + 0.009 = _____
Q16) 0.5 \(\div\) 4 = _____ Page 8
Q17) 0.100 \(\div\) 1000 = _____
Q18) 15 kg = _____ lb
Q19) Convert 25 g to mg: _____
Q20) 1 tbs = _____ tsp
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Chapter 7: Principles of Medication Administration and Medication Safety
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Sample Questions
Q1) What is the most reliable method to calculate a pediatric patient's medication dosage?
A) Age
B) Height
C) Body surface area (BSA)
D) Placement on a growth scale
Q2) Which statements are true regarding the types of medication orders? (Select all that apply.)
A) Stat orders are the same as single-dose orders.
B) Standing orders indicate the number of specified doses a medication is to be given.
C) Renewal orders facilitate physician review before continuance of high-risk medications.
D) PRN medications will designate a mandatory number of times the medication is to be administered.
E) Verbal orders should be used as much as possible.
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Chapter 8: Percutaneous Administration
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Sample Questions
Q1) Which effect would be important for the nurse to address when teaching a patient about the overuse of nose drops?
A) Rebound
B) Ceiling
C) Idiosyncratic
D) Measured
Q2) The nurse is teaching a patient about nitroglycerin ointment. Which is an advantage of this form of the medication?
A) It does not give the patient a bad taste in the mouth.
B) The amount of ointment does not matter in obtaining a therapeutic response.
C) It does not cause headaches as an adverse effect.
D) It provides relief of anginal pain for several hours longer than sublingual medication.
Q3) The nurse is instructing a patient to use a corticosteroid inhaler. Which statement by the patient indicates the need for further teaching?
A) "I will shake the inhaler before I use it."
B) "I need to rinse my mouth after I use the inhaler."
C) "I will use this when I'm lying in bed in the morning."
D) "After I inhale, I will hold my breath and then breathe out slowly."
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11
Chapter 9: Enteral Administration
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Sample Questions
Q1) After entering the patient's room to administer oral medications, which action will the nurse take first?
A) Assist the patient to sit upright.
B) Check the patient's identification.
C) Inform the patient about the medications.
D) Offer the patient something to drink.
Q2) Which is a characteristic of medication administration via the rectal route?
A) Irritation of the mouth
B) Nausea and vomiting
C) Bypassing of the digestive enzymes
D) Use of the first-pass metabolism
Q3) Which medications are provided in dried, powdered form compressed into small disks?
A) Pills
B) Capsules
C) Tablets
D) Lozenges
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12
Chapter 10: Parenteral Administration: Safe Preparation of Parenteral
Medications
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Sample Questions
Q1) Which are risk factors when administering medications by injection? (Select all that apply.)
A) Trauma at the site of the needle puncture
B) Possibility of infection
C) Irretrievability of the medication once administered
D) Delayed absorption
E) Delayed onset of action
F) Chance of allergic reaction
Q2) Which information provided by the nurse is most important to include when teaching a patient about the use of an EpiPen?
A) "Hold the syringe at a 45-degree angle against the skin."
B) "Monitor the expiration date of this medication."
C) "After using the EpiPen, lie down for 1 hour."
D) "Place the syringe in a cartridge prior to using."
Q3) What is an advantage of administering a drug parenterally?
A) The duration of action is longer.
B) Medications given by this route are inexpensive.
C) The onset of action is more rapid.
D) The dose is usually larger than an oral dose.
Page 13
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Chapter 11: Parenteral Administration: Intradermal,
Subcutaneous, and Intramuscular Routes
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Sample Questions
Q1) Which angle is appropriate when administering an IM medication in the dorsogluteal site to a 46-year-old obese man?
A) 45 degrees
B) 60 degrees
C) 75 degrees
D) 90 degrees
Q2) The nurse is preparing to administer kindergarten immunizations at the local health clinic. Which anatomic site would be best for the injection of the immunizations containing 0.5 mL?
A) Rectus femoris
B) Dorsogluteal
C) Deltoid
D) Ventrogluteal
Q3) A 65-year-old man who weighs 180 lb (81.8 kg) is to receive 1.5 mL of a viscous antibiotic by intramuscular injection. Which needle and syringe will be used?
A) 5/8-inch, 25-gauge needle with 5-mL syringe
B) 1-inch, 28-gauge needle with 4-mL syringe
C) 1 1/2-inch, 21-gauge needle with 3-mL syringe
D) 3-inch, 16-gauge needle with 1.5-mL syringe
Page 14
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Chapter 12: Parenteral Administration: Intravenous Route
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Sample Questions
Q1) A patient is diagnosed with cancer and requires 6 months of chemotherapy infusions. Which type of intravenous access device will likely be used?
A) Peripheral venous access device
B) Midline catheter
C) Winged-needle venous access device
D) Implantable venous infusion port
Q2) Which needle is used to access implanted infusion devices?
A) Jamshedi
B) Huber
C) Gigli
D) Crutchfield
Q3) Which technique by the nurse accurately maintains asepsis of a peripheral intravenous (IV) access device?
A) Wear gloves when hanging all IV solutions.
B) Apply a topical antibiotic ointment to the insertion site.
C) Change fluid administration sets according to institutional policy.
D) Flush with heparin before use.
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15
Chapter 13: Drugs Affecting the Autonomic Nervous System
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Sample Questions
Q1) Which are examples of neurotransmitters? (Select all that apply.)
A) Gamma amino-butyric acid
B) Acetylcholine
C) Serotonin
D) Glucose
E) Histamine
F) Epinephrine
Q2) The autonomic nervous system can be subdivided into which types of adrenergic receptors?
A) Nicotinic and muscarinic
B) Afferent and efferent
C) Alpha and beta
D) Agonists and antagonists
Q3) An older adult patient is to receive atenolol, a beta-adrenergic blocking agent. Prior to administration of the drug, the nurse assesses an apical pulse rate of 58 and notes ankle edema. Which action will the nurse take first?
A) Determine the therapeutic blood level.
B) Encourage the patient to decrease water intake.
C) Elevate the patient's legs.
D) Withhold the medication.
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Chapter 14: Sedative-Hypnotics
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Sample Questions
Q1) In addition to facilitating sleep, what is another benefit of sedatives?
A) Increased pain control postoperatively
B) Reduced bronchial secretions
C) Decreased patient anxiety
D) Increased patient alertness
Q2) Which are common adverse effects of barbiturates? (Select all that apply.)
A) Residual daytime sedation
B) Headache
C) Hyperactivity
D) Blurred vision
E) Impaired coordination
Q3) The nurse is explaining the use of medications to a patient with insomnia. Which statement about sedatives is true?
A) A sedative will produce sleep.
B) Sedatives increase the total time in REM sleep.
C) Increased relaxation occurs with sedatives.
D) Sedatives are more potent than hypnotics.
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Chapter 15: Drugs Used for Parkinsons Disease
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Sample Questions
Q1) Which reaction occurs as a result of prescribing carbidopa-levodopa?
A) Idiosyncratic
B) Additive
C) Hypersensitivity
D) Tolerance
Q2) Which vitamin will reduce the therapeutic effects of levodopa?
A) A
B) B<sub>6</sub>
C) C
D) D
Q3) The nurse is teaching a patient with Parkinson's disease about levodopa. Which statement by the nurse is accurate regarding drug administration?
A) "Take this medication in between meals."
B) "Take this medication at bedtime to prevent dizziness."
C) "Take this medication when your tremors get worse."
D) "Take this medication with food or antacids to reduce GI upset."
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Chapter 16: Drugs Used for Anxiety Disorders
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Sample Questions
Q1) Which patient is most likely to respond quickly to antianxiety therapy with benzodiazepines?
A) Patient with a history of long-term anxiety
B) Patient with recent anxiety reactions
C) Patient with severe depression in addition to being anxious
D) Patient with incidents of auditory hallucinations
Q2) What instruction is most important for the nurse to teach the patient who has recently been prescribed alprazolam (Xanax)?
A) "The medication needs to be taken on an empty stomach."
B) "You may feel dizzy or unsteady when rising to a standing position."
C) "Smoking will require a reduction in dosage of the medication."
D) "Over-the-counter medications are safe to take while on this medication."
Q3) The outcome statement for a patient suffering from anxiety disorder reads, "After 1 week on alprazolam (Xanax) therapy, patient will exhibit a manageable level of anxiety." Which assessment finding validates that this outcome is met?
A) Patient is unable to participate in group therapy conversations.
B) Patient reports persistent fear about dying of a rare illness.
C) Patient verifies family reunions trigger anxiety and excessive drinking.
D) Patient reports sleeping better and increased interest in activities.
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Page 19
Chapter 17: Drugs Used for Mood Disorders
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Sample Questions
Q1) The nurse is providing education to a patient who has been prescribed bupropion (Wellbutrin) for smoking cessation. Which statement by the patient would indicate the need for further teaching?
A) "My dose will increase after 3 days."
B) "I should swallow this medication whole."
C) "If I have the urge to smoke, I will take more medication."
D) "I do not need to taper my dose when the drug is discontinued."
Q2) Which postoperative narcotic analgesic will most likely be prescribed to a patient whose current medications include a monoamine oxidase inhibitor (MAOI), a thyroid hormone, and a multivitamin?
A) Meperidine (Demerol)
B) Morphine
C) Ibuprofen (Advil)
D) Acetaminophen (Tylenol)
Q3) Lithium (Eskalith) is the drug of choice for which of the following disorders?
A) Psychotic episodes
B) Obsessive-compulsive disorders (OCDs)
C) Bipolar disorders
D) Depressive disorders
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Page 20
Chapter 18: Drugs Used for Psychoses
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Sample Questions
Q1) To what does potency of an antipsychotic medication refer?
A) Severity of adverse effects associated with the drug
B) Length of time that it takes to reach a therapeutic blood level of the drug
C) Milligram doses used for the medication
D) Effectiveness of the drug in alleviating psychotic behavior
Q2) The nurse is teaching a patient who is taking clozapine (Clozaril) to have weekly blood tests for the first 6 months of treatment to monitor for which potential complication?
A) Agranulocytosis
B) Vitamin deficiencies
C) Clotting abnormalities
D) Polycythemia
Q3) Which adverse effects may occur as a result of antipsychotic drug therapy? (Select all that apply.)
A) Acute dystonia
B) Akathisia
C) Weight loss
D) Neuroleptic malignant syndrome
E) Hypoglycemia
F) Tardive dyskinesia
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Chapter 19: Drugs Used for Seizure Disorders
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Sample Questions
Q1) Which response by the nurse is accurate when a patient who has been on lamotrigine (Lamictal) for seizure control reports a skin rash and urticaria?
A) Reassure the patient that this is a common adverse effect of the medication and not to worry.
B) Instruct the patient to discontinue use of the drug immediately.
C) Instruct the patient to decrease the dosage of the medication until the rash disappears.
D) Advise the patient that this adverse effect usually resolves but should be reported to the health care provider.
Q2) The nurse is providing discharge teaching to a patient prescribed phenytoin (Dilantin) for management of a seizure disorder. Which patient statement indicates a need for further teaching?
A) "I need to avoid or limit caffeine intake."
B) "I will check with the pharmacist before taking over-the-counter medication."
C) "If I develop enlarged gums, I will stop taking the medication."
D) "It is important for me to take my medicine at the same time daily."
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22
Chapter 20: Drugs Used for Pain Management
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Sample Questions
Q1) An 86-year-old patient who was admitted with gastrointestinal bleeding secondary to salicylate therapy is being discharged. As the nurse reviews the discharge medication list, the patient states that she doesn't understand why Tylenol doesn't work as well as the aspirin she had been taking. What would be the nurse's best response?
A) "Tylenol and aspirin are chemically the same drug."
B) "Tylenol is appropriate for only minor pain."
C) "Tylenol does not help with inflammatory discomfort."
D) "A therapeutic blood level must be established with Tylenol."
Q2) Which medication is contraindicated when a patient is taking warfarin (Coumadin)?
A) Aspirin
B) Acetaminophen (Tylenol)
C) Propoxyphene (Darvon)
D) Morphine (Roxanol)
Q3) What term is used to define an awareness of pain?
A) Tolerance
B) Threshold
C) Perception
D) Sensation
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23
Chapter 21: Introduction to Cardiovascular Disease and Metabolic Syndrome
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Q1) In addition to type 2 diabetes and heart disease, which conditions are associated with metabolic syndrome? (Select all that apply.)
A) Dementia
B) Insomnia
C) Renal disease
D) Obstructive sleep apnea
E) Orthostatic hypotension
F) Polycystic ovary syndrome
Q2) Which cardiovascular conditions are related to coronary artery diseases? (Select all that apply.)
A) Angina pectoris
B) Pulmonary stenosis
C) Acute myocardial infarction
D) Pericarditis
E) Venous stasis ulcers
Q3) What is the incidence of metabolic syndrome in the United States?
A) 1 in 4000
B) 1 in 400
C) 1 in 40
D) 1 in 4
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Chapter 22: Drugs Used to Treat Dyslipidemias
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Q1) The nurse is educating a patient about niacin prescribed to treat his hyperlipidemia. Which are the important teaching points to include in the educational plan? (Select all that apply.)
A) Effectiveness of niacin in lowering total cholesterol
B) Information on high-cholesterol foods and food preparation using unsaturated fats
C) Importance of smoking cessation and daily exercise
D) Alternate funding resource information because of the high cost of niacin
E) Adverse effects to report (e.g., fatigue, anorexia, nausea, malaise, jaundice, muscle aches)
Q2) The nurse is assessing a patient who is being evaluated for hyperlipidemia. Which assessment will most increase the risk of coronary artery disease (CAD)?
A) Blood pressure, 168/90 mm Hg
B) Hemoglobin A<sub>1c</sub>, 6%
C) Walks 3 miles briskly, usually 4 days a week
D) Eats five servings of fruits and vegetables daily
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25
Chapter 23: Drugs Used to Treat Hypertension
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Q1) What is mean arterial pressure (MAP)?
A) The difference between the systolic and diastolic pressures
B) An indicator of the tone of the arterial blood vessel walls
C) The average pressure throughout each cycle of the heartbeat
D) The product of the cardiac output and the peripheral vascular resistance
Q2) The nurse has provided information to a patient with diabetes who has been prescribed a beta-adrenergic blocker. Which statement by the patient indicates a need for further teaching?
A) "If I get dizzy, I will stop taking the medication."
B) "I may not have my usual symptoms of low blood sugars."
C) "My dosage may need adjustment if I start taking any NSAIDs."
D) "I will need to be evaluated in a few weeks to see if my dosage is effective."
Q3) A patient asks the nurse how amlodipine (Norvasc) works to reduce the blood pressure. Which response will the nurse provide?
A) "It causes blood vessel dilation."
B) "It helps you get rid of fluid."
C) "It helps your heart beat stronger."
D) "It slows your heart rate."
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Chapter 24: Drugs Used to Treat Dysrhythmias
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Q1) The nurse is preparing to administer adenosine to a patient with supraventricular tachycardia. Which considerations should the nurse take into account before administration? (Select all that apply.)
A) Constant ECG monitoring is necessary.
B) Initial recommended dosage is 12-mg IV bolus.
C) Rapid IV bolus administration is recommended.
D) Saline flush following bolus is necessary.
E) Long half-life of adenosine may prolong adverse medication effects.
Q2) The nurse is preparing to mix a lidocaine infusion for a patient. Which considerations should the nurse take into account before administration? (Select all that apply.)
A) Lidocaine with preservatives should be used.
B) Dextrose 5% is the solution to mix with lidocaine.
C) Therapeutic blood levels should be 1 to 5 mg/L.
D) The rate of administration is 1 to 4 mg/min.
E) Monitor for changes in neurological status.
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Chapter 25: Drugs Used to Treat Angina Pectoris
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Q1) Which instruction will the nurse include when teaching a patient about the administration of translingual nitroglycerin spray?
A) Shake the container to disperse the medication evenly.
B) Inhale the medication slowly over 1 to 2 minutes.
C) Administer the medication under the tongue.
D) Close the mouth and "swallow" the spray.
Q2) What will the nurse advise the patient to do to avoid the development of tolerance to nitroglycerin?
A) Use the sublingual form only.
B) Administer subsequent doses parenterally.
C) Allow for a daily 8- to 12-hour nitrate-free period.
D) Store the drug in a dark container, free from light and moisture.
Q3) Which lifestyle modifications will the nurse include when educating the patient with angina pectoris? (Select all that apply.)
A) Weight reduction therapy
B) Low-potassium diet
C) Smoking cessation
D) Stress management
E) Independent exercise
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Page 28
Chapter 26: Drugs Used to Treat Peripheral Vascular Disease
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Q1) Which patient statement indicates to the nurse that the patient has a good understanding of peripheral vascular disease?
A) "Symptoms are warning signs of the increased potential to develop diseases."
B) "Pharmacologic treatments can reverse the disease process."
C) "Surgical interventions will cure the disease."
D) "Controlling contributing factors may affect the progression of the disease."
Q2) The nurse is assessing the patient's leg for peripheral vascular disease (PVD) and is unable to palpate the pedal pulse in either foot. Which action will the nurse take first?
A) Contact the health care provider for further orders.
B) Request x-ray studies of the lower extremities.
C) Request that the patient lie flat.
D) Obtain a Doppler ultrasound device for auscultation.
Q3) The nurse is assessing a patient on papaverine therapy and notes tachycardia, which is a compensatory effect of which condition?
A) Hypoventilation
B) Hypotension
C) Excessive sympathetic stimulation
D) Adrenergic suppression
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Chapter 27: Drugs Used to Treat Thromboembolic Disorders
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Q1) The nurse is preparing discharge education for a patient who will be receiving warfarin (Coumadin) at home. Which important points will the nurse include? (Select all that apply.)
A) "Do not make any major changes to your diet without discussing it with your health care provider."
B) "Keep outpatient laboratory appointments for monitoring of therapy."
C) "Take the medication after meals."
D) "Report signs of bleeding to your health care provider, including observing skin for bruising, petechiae, blood in emesis, urine, or stools, bleeding gums, cold, clammy skin, faintness, or altered sensorium."
E) "Avoid aspirin products."
Q2) Which action will the nurse implement to decrease the risk of clot formation in an older patient on bed rest?
A) Assess peripheral pulses.
B) Encourage passive leg exercises.
C) Limit fluid intake.
D) Position pillows behind the knees.
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Chapter 28: Drugs Used to Treat Heart Failure
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Sample Questions
Q1) Which instruction by the nurse will be included when teaching an adult patient about digoxin (Lanoxin) for management of heart failure?
A) "Report nausea and vomiting to your health care provider."
B) "Decrease the amount of high-potassium foods you eat."
C) "Omit your dose of digoxin if your pulse is 60."
D) "Visual disturbances are common adverse effects."
Q2) Which agents stimulate the heart to increase the force of contractions, thereby increasing cardiac output?
A) Inotropic
B) Chronotropic
C) Isotonic
D) Isopropyl
Q3) Which are true statements about vasodilators? (Select all that apply.)
A) They reduce systemic vascular resistance.
B) They increase afterload.
C) They reduce preload.
D) They decrease pulmonary congestion.
E) They increase tissue perfusion to muscles and organs.
F) They increase the volume of blood returning to the heart.
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Page 31
Chapter 29: Drugs Used for Diuresis
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Q1) Which nursing interventions are performed for a patient who is on diuretic therapy? (Select all that apply.)
A) Auscultation of lung sounds
B) Assessment of skin turgor
C) Initiation of electrolyte supplements
D) Positioning techniques
E) Monitoring of intake and output
Q2) The nurse would expect to assess which serum potassium level in a patient who has severe vomiting and diarrhea?
A) Less than 3.5 mEq/L
B) Between 3.5 mEq/L and 4.5 mEq/L
C) Between 4.6 mEq/L and 5 mEq/L
D) Higher than 5.5 mEq/L
Q3) Which medical conditions may contribute to fluid volume excess? (Select all that apply.)
A) Hypertension
B) Liver disease
C) Pregnancy
D) Use of corticosteroids
E) Skin disorders
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Chapter 30: Drugs Used to Treat Upper Respiratory Disease
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Sample Questions
Q1) What can result if a patient overuses topical decongestants?
A) Hypertensive crisis
B) Allergic reaction
C) Secondary congestion
D) Permanent olfactory damage
Q2) When does allergic rhinitis occur? (Select all that apply.)
A) Nasal mucosa become inflamed.
B) Exposure secondary to an allergen produces inflammation.
C) Histamine is released following allergen exposure.
D) The weather is cold during the winter.
E) A person has an initial exposure to an antigen.
Q3) Which medication may be given to patients with allergic seasonal rhinitis who do not respond to antihistamines and sympathomimetics?
A) Leukotrienes
B) Mineralocorticoids
C) Corticosteroids
D) Cortisol
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33
Chapter 31: Drugs Used to Treat Lower Respiratory Disease
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Sample Questions
Q1) The nurse is completing the admission of an older adult patient with a history of COPD whose diagnosis is pneumonia. Which assessments would be most important to include in obtaining the history? (Select all that apply.)
A) Smoking history and exposure to secondhand smoke
B) Current medications
C) Chief complaint and onset of symptoms
D) Support system
E) Home oxygen use
F) Liver function
Q2) Which is true about arterial blood gases (ABGs)? (Select all that apply.)
A) They are measured from an arterial sample.
B) They measure partial pressures of carbon dioxide.
C) They measure blood pH.
D) They measure partial pressures of sodium
E) They measure partial pressures of oxygen.
Q3) What is albuterol (Proventil) used to treat?
A) Acute bronchospasm
B) Acute allergies
C) Nasal congestion
D) Dyspnea on exertion
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Chapter 32: Drugs Used to Treat Oral Disorders
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Sample Questions
Q1) Which information will the nurse include when teaching a patient about cold sores?
A) Use of drying agents prevents the spread of secretions.
B) Erupted lesions are not contagious.
C) Eruptions are related to breaks in personal hygiene.
D) Pus-filled lesions indicate a secondary bacterial infection.
Q2) Which will the nurse include when educating a 12-year-old patient about care of a cold sore? (Select all that apply.)
A) "Keep the cold sore clean with mild soap."
B) "Use of an astringent will assist in drying the cold sore and promote rapid healing."
C) "Keep the cold sore moist to prevent cracking."
D) "Note signs of infection, including the presence of pus. Contact the health care provider if this occurs."
E) "Oral analgesics may help alleviate pain."
Q3) Which condition is treated by saliva substitutes?
A) Caries
B) Mucositis
C) Xerostomia
D) Halitosis
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Chapter 33: Drugs Used to Treat Gastroesophageal Reflux and Peptic Ulcer
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Sample Questions
Q1) Which explanation by the nurse is accurate to include when teaching a patient who is beginning therapy for gastroesophageal reflux disease (GERD) with metoclopramide?
A) "This medication decreases esophageal muscle tone to reduce reflux."
B) "Peristalsis is increased, so food is digested more quickly."
C) "Gastric emptying is delayed, so you may feel full for longer intervals."
D) "This medication is an antikinetic agent, so you may have difficulty with motor skills."
Q2) The nurse is instructing a patient recently diagnosed with GERD. Which statement by the patient indicates a need for further teaching?
A) "I will avoid foods high in fat."
B) "I will eat small frequent meals and have a snack at bedtime."
C) "Orange juice may aggravate my symptoms."
D) "I will wait 2 hours after eating lunch before lying down for a nap."
Q3) Cimetidine (Tagamet) is an example of which class of drug?
A) Protokinetic agent
B) Proton pump inhibitor
C) Histamine (H2) receptor antagonist
D) Coating agent
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Page 36
Chapter 34: Drugs Used to Treat Nausea and Vomiting
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Q1) A patient going on vacation asks the nurse what she can give to her 3-year-old child who becomes car sick. Which responses are accurate? (Select all that apply.)
A) "Positioning techniques such as placing the child facing forward and blocking out scenery through the side windows can be helpful."
B) "There is no such thing as car sickness."
C) "If your child does vomit, there is some over-the-counter Benadryl you can administer."
D) "I would check with the pharmacist regarding over-the-counter products available for young children."
Q2) What is an advantage of using benzodiazepines as an adjunctive treatment for nausea and vomiting associated with chemotherapy?
A) The long half-life will prolong the effectiveness of other drugs.
B) They increase a sense of euphoria.
C) The patient will not develop tolerance to the medications as quickly.
D) The antianxiety effect helps, in addition to reducing the frequency of nausea and vomiting.
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Chapter 35: Drugs Used to Treat Constipation and Diarrhea
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Sample Questions
Q1) An older adult is admitted through the emergency department with complaints of nausea, abdominal tenderness, and continual stooling. On assessment, the nurse notes abdominal distention, smearing of stool on undergarments, and hypoactive bowel sounds LUQ and LLQ. The patient is unable to determine when the last bowel movement was. What is the nurse's priority assessment?
A) Signs and symptoms of an infection
B) An impaction
C) A pattern of laxative abuse
D) History of gastrointestinal disease
Q2) Which effect will the nurse expect when a patient is taking psyllium while on digoxin?
A) Decreased effectiveness of the laxative
B) Increased laxative effect
C) Increased absorption of the digoxin
D) Decreased absorption of the digoxin
Q3) Which symptom is the patient with a lactase deficiency most likely to exhibit?
A) Constipation
B) Excessive salivation
C) Diarrhea
D) Vomiting
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Chapter 36: Drugs Used to Treat Diabetes Mellitus
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Sample Questions
Q1) The patient asks the nurse how sulfonylureas normalize glucose levels. Which response by the nurse is correct?
A) By stimulating pancreatic secretion of insulin
B) By inhibiting secretion of insulin by the pancreas
C) By increasing glucose production in the liver
D) By increasing insulin metabolism in the liver
Q2) Which statements are true about gestational diabetes? (Select all that apply.)
A) It is diagnosed in about 2% of all pregnancies in the United States.
B) It includes diabetic women who become pregnant.
C) Fetal development may be complicated as a result of gestational diabetes.
D) The risk of developing diabetes after pregnancy is increased.
E) Most women with gestational diabetes have normal glucose tolerance post partum.
F) Women need to be reevaluated postpartum to determine their classification with respect to glucose tolerance.
Q3) What test determines glycemic control over the previous 8 to 10 weeks?
A) 24-hour glucose clearance test
B) Fructosamine test
C) Fasting blood sugar
D) A<sub>1c</sub> test
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Page 39
Chapter 37: Drugs Used to Treat Thyroid Disease
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Sample Questions
Q1) Which patient would be a candidate for radioactive iodine therapy?
A) 17-year-old woman with Graves' disease
B) 64-year-old woman with hypothyroidism
C) 46-year-old man with heart disease and thyroid cancer
D) 82-year-old man with myxedema crisis
Q2) Which nursing diagnosis may be identified for a patient with hyperthyroidism?
A) Imbalanced Nutrition: More Than Body Requirements
B) Constipation
C) Disturbed Sleep Pattern
D) Ineffective Airway Clearance
Q3) A patient with a history of heart failure has been diagnosed with hypothyroidism. The drug interaction with glycosides and thyroid replacement therapy will most likely require which change in therapy?
A) Decrease in the daily digoxin dosage
B) Gradual increase in the daily glycoside dosage
C) Not able to begin thyroid replacement therapy because of the underlying heart condition
D) Increased thyroid replacement dosage
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Chapter 38: Corticosteroids
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Sample Questions
Q1) A patient with type 1 diabetes was prescribed a glucocorticoid for COPD. Which will the nurse expect in the treatment plan?
A) A decrease in the amount of insulin needed
B) No change in the amount of insulin needed
C) An increase in the need for carbohydrates
D) An increase in the insulin needed
Q2) Which fluid replacement method will the nurse identify for a patient on a fluid restriction?
A) Freely throughout the day and evening shift
B) One third of the allowed volume on each shift
C) Half the volume with meals and the remainder divided among shifts
D) As the patient desires
Q3) Which are appropriate measures for monitoring hydration and fluid balance in the patient on steroid therapy? (Select all that apply.)
A) Daily weights
B) Abdominal girth measurements
C) Reports of thirst
D) Neurologic assessment
E) Assessment for alteration in skin integrity
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Chapter 39: Gonadal Hormones
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Sample Questions
Q1) Which is most important for the nurse to remember when instructing the patient about treatment with gonadal hormones?
A) Dosage, schedule, and adverse effects
B) Cost, storage, and route of administration
C) Drug interactions and food interactions
D) Scheduling follow-up appointments and lab studies
Q2) The health of a patient receiving androgen therapy for breast cancer declines and she becomes bed bound. Which condition will this patient be at risk of developing?
A) Electrolyte imbalances
B) Hypercalcemia
C) Hyperglycemia
D) Fluid overload
Q3) Which information will the nurse include when teaching a patient with seizures about estrogen therapy?
A) Phenytoin reduces the effectiveness of estrogen.
B) Estrogen reduces the effectiveness of phenytoin.
C) Phenytoin may inhibit the metabolism of estrogen.
D) Estrogen may inhibit the metabolism of phenytoin.
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Chapter 40: Drugs Used in Obstetrics
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Sample Questions
Q1) Which assessments will the nurse complete during routine pregnancy visits? (Select all that apply.)
A) Blood pressure
B) Hemoglobin
C) Weight
D) Fetal heart sounds
E) Glucose tolerance test (GTT)
Q2) Which drug will the nurse administer to prevent neonatal conjunctivitis in the newborn?
A) Silver nitrate
B) Dexamethasone
C) Erythromycin
D) Vitamin K
Q3) Which emergency drug must be available when caring for a patient receiving magnesium sulfate?
A) Naloxone
B) Calcium gluconate
C) Dextrose
D) Dopamine
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Page 43
Chapter 41: Drugs Used in Mens and Womens Health
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Sample Questions
Q1) What is the mechanism whereby estrogen functions as a contraceptive?
A) Inhibiting LH, blocking release of ovum from a follicle
B) Thinning cervical mucus, which inhibits sperm migration
C) Trapping the ovum in the endometrial wall, preventing its growth
D) Blocking FSH, thereby preventing release of ovum
Q2) A nurse working at the community health clinic receives a call from a teen client who reports that she has missed one of her birth control pills. Which response by the nurse is accurate? (Select all that apply.)
A) Take the missed pill now.
B) Take the next pill at the regularly scheduled time.
C) Come into the clinic for a pregnancy test.
D) Start with the next month's pill packet at day 1.
E) Take the missed pill and the next pill together at the next regularly scheduled time.
Q3) Which is more likely to be experienced by women taking the minipill as an oral contraceptive?
A) Ovulation, dysmenorrhea, and break-through bleeding
B) Excessive weight gain and breast tenderness
C) Increased estrogen-related adverse effects
D) Difficulty breast-feeding after pregnancy
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Page 44
Chapter 42: Drugs Used to Treat Disorders of the Urinary System
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Sample Questions
Q1) The nurse is assisting with postpartum care for a mother who has given birth to her fourth child. She reports a moderate amount of urinary incontinence since the birth of the third child and is concerned that this problem will worsen. Which instructions may facilitate management of incontinence? (Select all that apply.)
A) Instruction of proper wiping techniques to prevent bacterial infection
B) Education on bladder training and Kegel exercises
C) Information on personal hygiene measures to prevent perianal breakdown
D) Information of incontinence products and appliances
E) Importance of establishing a regular toileting schedule
F) Importance of increasing fluid intake
Q2) Which interventions help stimulate urination when a patient is experiencing postoperative urinary retention? (Select all that apply.)
A) Reinforcing Kegel exercises
B) Administration of bethanechol chloride (Urecholine)
C) Pouring warm water over the perineum
D) Increasing IV fluids
E) Urinary catheterization
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Chapter 43: Drugs Used to Treat Glaucoma and Other Eye Disorders
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Sample Questions
Q1) Which type of medication would be used to dilate the pupils before an eye examination?
A)Osmotics
B)Adrenergic agent
C)Beta-adrenergic agent
D)Corticosteroid
Q2) Which information will the nurse include when teaching the patient and family about postoperative care for a trabeculectomy? (Select all that apply.)
A) Use aseptic technique for all dressing changes and medication administration.
B) Place the patient on the operated side.
C) Avoid heavy lifting.
D) Redness in the eye, pain, and swelling are common occurrences after surgery.
E) Avoid straining on defecation.
Q3) What is the action of timolol maleate (Timoptic), a beta-adrenergic blocking agent?
A)Draws aqueous humor from the eye into the circulatory network
B)Increases the production of aqueous humor
C)Increases the outflow of aqueous humor
D)Decreases the production of aqueous humor
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Chapter 44: Drugs Used for Cancer Treatment
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Sample Questions
Q1) Why is a patient with prostate cancer prescribed an estrogen?
A) To achieve hormonal balance
B) To decrease the rate of production for malignant cells
C) To soften prostatic tissue
D) To suppress prostate gland function
Q2) Why are bone marrow stimulants used in the treatment of cancer?
A) To increase uptake of the chemotherapy from the interior of the bones
B) To strengthen bones weakened by pathologic processes
C) To enhance the patient's immune system during treatment
D) To protect the bone marrow from destructive actions from the cancer treatment
Q3) What is the importance of correlating the dosage schedule with cell cycle-specific drug therapy?
A) Ongoing proliferation of neoplastic tissue
B) The known cellular kinetics of the neoplasm
C) The hormonal requirements of the patient
D) The body's response in strengthening the immune system
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Chapter 45: Drugs Used to Treat the Muscular System
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Q1) Which drug interaction may occur when an aminoglycoside or tetracycline is given in conjunction with neuromuscular blocking agents?
A) Deep sedation
B) Decreased effectiveness of antibiotics
C) Increased neuromuscular blocking activity
D) Sensitivity to antibiotics and possible allergic reaction
Q2) Which medication will be prescribed for a patient complaining of muscle spasms secondary to a back injury?
A) Acetaminophen (Tylenol)
B) Morphine sulfate
C) Bethanechol (Urecholine)
D) Cyclobenzaprine (Flexeril)
Q3) Which assessment is most important for the nurse to obtain when a patient is being treated with a neuromuscular blocking agent?
A) Skin assessment for rash and urticaria
B) Blood pressure assessment for orthostatic hypotension
C) Respiratory assessment for patent airway
D) Assessment for fluid volume overload
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Chapter 46: Antimicrobial Agents
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Q1) The nurse will monitor patients on cephalosporins and loop diuretics for which adverse effect?
A) Hepatic toxicity
B) Ototoxicity
C) Nephrotoxicity
D) Splenotoxicity
Q2) The health care provider has prescribed penicillin and probenecid for a patient with a sexually transmitted disease. What is the purpose of combining these medications?
A) To accelerate the excretion of the penicillin
B) To inhibit the absorption of penicillin to allow the drug to remain in the transport phase
C) To inhibit the excretion of the penicillin
D) To reduce toxic effects associated with penicillin
Q3) What adverse effect may manifest as dizziness, tinnitus, and progressive hearing loss?
A) Ear infection
B) Drug allergy
C) Ototoxicity
D) Idiosyncratic reaction
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Page 49
Chapter 47: Nutrition
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Q1) Which is a macronutrient that is a separate factor necessary for complete nutrition and wellness?
A) A phytochemical
B) A trace mineral
C) Fiber
D) A vitamin
Q2) A patient is being discharged on psyllium (Metamucil). Which explanations by the nurse are accurate regarding fiber intake? (Select all that apply.)
A) It adds bulk to fecal content.
B) It enhances gastric emptying.
C) It decreases blood cholesterol concentration.
D) It decreases postprandial blood glucose concentration.
E) It stimulates the appetite.
Q3) Which food is a good source of vitamin A?
A) Sweet potatoes
B) Apples
C) Bananas
D) Whole-grain bread
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Chapter 48: Herbal and Dietary Supplement Therapy
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Q1) Which herb is used to stimulate the innate immune system?
A) Aloe
B) Echinacea
C) Chamomile
D) Ginger
Q2) Which herbal medicine may improve a patient's short-term memory loss and cognitive function?
A) Ginger
B) Green tea
C) Feverfew
D) Ginkgo biloba extract
Q3) Which dietary supplement is used to treat benign prostatic hyperplasia?
A) Ginkgo
B) Ephedra
C) Garlic
D) Saw palmetto
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Chapter 49: Substance Abuse
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Q1) Which theory views addiction as a maladaptive habit that can be examined and changed the same way as other habits?
A) Psychoanalytic theory
B) Behavior theory
C) Cognitive theory
D) Family system theory
Q2) What must be administered before glucose infusions for a patient in alcohol withdrawal to prevent Wernicke's encephalopathy?
A) Chlordiazepoxide (Librium)
B) Thiamine
C) Diazepam (Valium)
D) Bromocriptine (Parlodel)
Q3) A 16-year-old male has been referred to the community mental health center following legal charges of driving under the influence. Which screening tests would be appropriate to use on this patient?
A) Drug Abuse Screening Test (DAST)
B) Adolescent Alcohol Involvement Scale (AAIS)
C) Adolescent Drug Abuse Diagnosis (ADAD)
D) Minnesota Multiphasic Personality Inventory (MMPI-2)
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Page 52
Chapter 50: Miscellaneous Agents
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Q1) The nurse receives an order to administer colchicine 0.6 mg every 1 to 2 hours until the patient exhibits adverse effects. The nurse will monitor for which adverse effect?
A) Diminished fever
B) Diarrhea or nausea
C) Increased urination
D) Decrease in erythema
Q2) A patient with early Alzheimer's disease is started on tacrine (Cognex), an acetylcholinesterase inhibitor. How will the nurse evaluate that the drug has been effective?
A) Decrease in the patient's agitation
B) Improvement in the patient's cognitive skills
C) Slowing of disease progression by using a standardized tool
D) Less frequent repetitive behaviors
Q3) What is the rationale for administering acamprosate (Campral)?
A) Withdrawal from alcohol addiction
B) Maintenance of sobriety
C) Improvement of renal function
D) Correction of electrolyte imbalances
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