Posted: May 1st, 2024

NURS 6521 Final Exam / NURS6521 Final Exam (Latest): Advanced Pharmacology

NURS 6521 Final Exam / NURS6521 Final Exam (Latest): Advanced Pharmacology

Question 1: The 31-year-old woman and her husband, who have been trying to conceive for 6 months without success, may benefit from a referral to a fertility specialist. The nurse should recognize that the woman may benefit from further evaluation to explore potential causes of infertility, such as hormonal imbalances, ovulatory dysfunction, or tubal factors.
Question 2: When teaching a patient about the signs and symptoms of thrombophlebitis and thromboembolism while taking estrogen, the nurse should include information about the potential symptoms, such as pain, swelling, redness, and warmth in the affected area. Additionally, the patient should be educated about the signs of pulmonary embolism, such as sudden shortness of breath, chest pain, and coughing up blood.
Question 3: Dextroamphetamine, a central nervous system stimulant, may be safely administered to overweight patients who have been diagnosed with attention deficit hyperactivity disorder (ADHD) and have not experienced significant cardiovascular issues. The nurse should assess the patient’s medical history and cardiovascular health before administering dextroamphetamine.
Question 4: A 71-year-old man prescribed finasteride (Proscar) may have complained of symptoms related to benign prostatic hyperplasia (BPH), such as difficulty urinating, frequent urination, or a weak urine stream. Finasteride is commonly used to manage symptoms of BPH.
Question 5: Using alcohol during pregnancy may result in a child who presents with fetal alcohol spectrum disorders (FASDs), which can lead to a range of physical, behavioral, and cognitive challenges for the child. These may include growth deficiencies, facial abnormalities, and central nervous system problems.
Question 6: A nurse practitioner orders 150 mg of oral fluconazole for a patient with vulvovaginal candidiasis. The patient should expect to take the medication as a single dose, as fluconazole is often prescribed as a one-time treatment for this condition.
Question 7: Cancerous cells that are rapidly dividing, such as those found in leukemia, lymphoma, and small cell lung cancer, are most susceptible to the effects of chemotherapeutic drugs. These cells are often targeted during chemotherapy due to their high rate of proliferation.

Question 8: A middle-aged patient diagnosed with a GI stromal tumor and recommended imatinib as part of the treatment regimen should receive education about the medication. The nurse should provide information about the purpose of imatinib, its potential side effects, the importance of adherence to the prescribed regimen, and the need for regular follow-up appointments to monitor treatment response and manage any adverse effects.
Question 9: When discharging a 12-year-old boy who will be taking two medications at home for an extended period after major surgery, the nurse should provide medication teaching specifically to the patient and the caregivers. This education should include information about the names, dosages, frequencies, and potential side effects of the medications. Additionally, the nurse should emphasize the importance of adherence to the prescribed regimen and the need for close monitoring of the patient’s response to the medications.
Question 10: When a patient has been admitted to the critical care unit with a diagnosis of peritonitis requiring treatment with gentamicin, the care team should be cautious when concurrently administering other medications that may cause nephrotoxicity. Gentamicin is known to have potential nephrotoxic effects, so the use of other nephrotoxic medications should be carefully evaluated to minimize the risk of kidney damage.
Question 11: A 39-year-old woman receiving doxorubicin for cancer treatment and experiencing acute nausea, vomiting, and a slightly increased heart rate after each treatment should be advised to report these symptoms to her healthcare provider. The nurse should also provide supportive care measures to manage the nausea and vomiting, such as antiemetic medications and dietary modifications.
Question 12: A nurse caring for a patient with cancer prescribed dronabinol (Marinol) to reduce nausea and vomiting from chemotherapy should inform the patient that they are taking an oral form of synthetic tetrahydrocannabinol (THC), which is a cannabinoid. The nurse should provide education about the medication’s purpose, potential side effects, and administration instructions.
Question 13: When a 46-year-old man is receiving a quinupristin-dalfopristin IV infusion for a life-threatening infection, the nurse should monitor for potential adverse effects, particularly related to the patient’s liver function. Quinupristin-dalfopristin has been associated with hepatotoxicity, so close monitoring of liver enzymes and signs of liver dysfunction is essential.
Question 14: A woman receiving prolonged drug therapy during her complicated pregnancy, with dosage adjustments made to minimize adverse effects and prevent toxicity, should be closely monitored by the nurse. The nurse should ensure that the patient understands the importance of medication adherence, the need for regular follow-up appointments, and the signs and symptoms of potential adverse effects that should be reported to the healthcare provider.

NURS 6521 FINAL EXAM (3 VERSIONS) & NURS 6521 MIDTERM EXAM (3 VERSIONS) (100 CORRECT Q & A IN EACH VERSION, TOTAL: 600 Q & A)

NURS 6521 Final Exam / NURS6521 Final Exam (Latest): Advanced Pharmacology: Walden University

Walden NURS 6521 Final Exam / Walden NURS6521 Final Exam (Latest): Advanced Pharmacology

· Question 1

After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic should recognize that the woman may benefit from

· Question 2

Which of the following would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a patient taking estrogen?

· Question 3

A nurse works at a weight management clinic. To which of the following overweight patients could the nurse safely administer dextroamphetamine?

· Question 4

A 71-year-old man has just been prescribed finasteride (Proscar). Which of the following complaints by this patient most likely indicated a need for this drug?

· Question 5

A 38-year-old pregnant patient admits to the nurse that she is an alcoholic and has been consuming alcohol during her pregnancy. The nurse knows that using alcohol during pregnancy may result in a child who presents with

· Question 6

A nurse practitioner orders 150 mg of oral fluconazole for a patient with vulvovaginal candidiasis. The patient should expect to take medication

· Question 7

An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or failure of a patient’s chemotherapy. Which of the following cancerous cells is most susceptible to the effects of chemotherapeutic drugs?

· Question 8

A middle-aged patient has received a diagnosis of GI stromal tumor following an extensive diagnostic workup. Imatinib has been recommended as a component of the patient’s drug regimen. What patient education should the nurse provide to this patient?

· Question 9

A 12-year-old boy is being discharged from the hospital after major surgery. The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to

· Question 10

A patient has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that may cause

· Question 11

A 39-year-old woman is receiving doxorubicin for the treatment of cancer. After each treatment, the patient has acute nausea and vomiting accompanied by a slightly increased heart rate. The nurse will advise her to

· Question 12

A nurse is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that he or she is taking an oral form of

· Question 13

A 46-year-old man is receiving a quinupristindalfopristin IV infusion for a life-threatening infection. Which of the following would be most important for the nurse to monitor?

· Question 14

A woman is receiving prolonged drug therapy during her complicated pregnancy, and it may pose a risk to both the mother and the fetus. The primary care physician has made dosage adjustments to minimize adverse effects and prevent toxicity. The nurse should make sure

· Question 15

Alprostadil (Caverject), a drug used to treat erectile dysfunction, has been prescribed to a 42-year-old patient. When providing education to the patient and his wife, the nurse should inform the wife about which of the following adverse effects?

· Question 16

A 36-year-old patient comes to the clinic and tells the nurse that she suspects that she is pregnant. During the initial assessment, the nurse learns that the patient is currently taking medications for diabetes, hypertension, and a seizure disorder. The nurse would be most concerned about which of the following medications?

· Question 17

A male patient with a medical background tells the nurse that he is not satisfied with the oral synthetic testosterone that has been prescribed for him and he would like to try a natural form of oral testosterone. Which of the following would be an appropriate response by the nurse?

· Question 18

A male patient is trying to decide if he should use finasteride (Proscar) to treat benign prostatic hypertrophy (BPH). When providing information about the drug, the nurse will include which of the following as a risk associated with finasteride therapy?

· Question 19

A 2-year-old child is diagnosed with a minor ailment and is to be administered medications at home for 2 weeks. The child lives with his mother, grandmother, and four other children between the ages of 14 months and 7 years. The home health nurse is asked to assess the home environment to determine if it is appropriate for the child to take his medication at home. Which of the following will have the greatest impact on the nurse’s assessment?

· Question 20

A 22-year-old woman has given birth to an infant who exhibits the signs and symptoms of maternal cocaine use during pregnancy. These signs and symptoms are a result of what pathophysiological effect of opioid use during pregnancy?

· Question 21

A 62-year-old patient taking tamoxifen exhibits increased bone and tumor pain along with a local disease flare. The nurse interprets this as an indication of which of the following?

· Question 22

A female patient is prescribed oprelvekin therapy to treat thrombocytopenia. Which of the following should the nurse continuously monitor to determine the efficacy and duration of the oprelvekin therapy?

· Question 23

The clinical nurse educator who oversees the emergency department in a children’s hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children?

· Question 24

A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective?

· Question 25

A patient has been scheduled to begin treatment with rituximab for non-Hodgkin’s lymphoma. The nurse who will administer this drug should understand that it targets

· Question 26

A 15-year-old boy has been diagnosed with bone cancer after several months of fatigue and pain. What question should the nurse include in an assessment when trying to minimize the potential for adverse drug reactions?

· Question 27

A 30-year-old man with a BMI of 59 has recently been diagnosed with type 2 diabetes mellitus. In light of the man’s lack of success with weight loss programs in the past, his care provider has prescribed sibutramine (Meridia). What instructions should the nurse consequently provide to this patient?

· Question 28

A 49-year-old farmer who normally enjoys good health has become seriously ill in recent days and the results of an extensive diagnostic work up have resulted in a diagnosis of histoplasmosis. The patient has been admitted to the hospital and has begun treatment with amphotericin B. The nurse who is providing care for the patient should prioritize which of the following diagnostic results during his course of treatment?

· Question 29

A patient has just received her first dose of imatinib and the nurse on the oncology unit is amending the patient’s care plan accordingly. What nursing diagnosis is most appropriate in light of this addition to the patient’s drug regimen?

· Question 30

A 20-year-old female patient is receiving topical clindamycin for acne vulgaris. She develops a rash and urticaria along with severe itching where the medication is applied. The nurse will formulate which of the following nursing diagnoses for the patient?

· Question 31

Which of the following nursing actions is most important in achieving successful antimicrobial therapy with vancomycin?

· Question 32

A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic can the nurse most safely recommend?

· Question 33

A patient receiving high-dose cisplatin therapy exhibits symptoms of hypomagnesemia. Which of the following should the nurse suggest to help offset the magnesium losses from the cisplatin therapy?

· Question 34

A child is admitted to the burn unit with second and third degree burns on both arms and part of his or her face. When administering topical medications to the burned areas, the nurse should

· Question 35

An immunocompromised 7-year-old child was recently discharged home with a peripherally-inserted central line (PIC line) for home antibiotic therapy. He has now been brought to the emergency department by his mother and father with signs and symptoms of line sepsis. Upon questioning, the mother states that she has been removing the PIC dressing daily and washing the site with warm water and a cloth. What nursing diagnosis is most appropriate in this situation?

· Question 36

A 21-year-old female has a history of irregular menses. She recently became sexually active, and would like to begin taking oral contraceptives (OCs). The nurse practitioner recognizes that most likely this patient would benefit from taking which category of OCs.

· Question 37

A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the chance that the boy will take his prescribed medication, the nurse should

· Question 38

A nurse is providing patient education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which of the following statements by the patient will alert the nurse that special instructions regarding insulin are necessary?

· Question 39

A 28-year-old woman has completed rituximab therapy for an autoimmune disease. She tells the nurse that she and her husband would like to start a family. The nurse will advise her to

· Question 40

A 73-year-old woman has osteoporosis and is prescribed alendronate. She takes calcium and vitamin D supplements, drinks lots of water, and has just quit smoking. The nurse should advise the patient to also

· Question 41

A nurse is performing patient education for a woman who has just been prescribed a bisphosphonate. Which of the following diagnostic and history findings would have prompted the woman’s care provider to prescribe a bisphosphonate?

· Question 42

A 20-year-old woman will soon begin taking oral contraceptives for the first time. What advice should the nurse provide to this patient?

· Question 43

A nurse is providing patient education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the patient to avoid which of the following drugs?

· Question 44

A nurse is instructing a 19-year-old female patient on the use of fluconazole for candida vaginitis. A teaching priority will be to

· Question 45

A nurse is assessing a patient who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the patient for which of the following?

· Question 46

Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse’s following assessment questions most directly addresses a common adverse effect of filgrastim?

· Question 47

A preterm neonate received caffeine for the treatment of apnea. The nurse should monitor the neonate for which of the following?

· Question 48

A patient has been prescribed daptomycin for a complicated skin infection. Which of the following will the nurse advise the patient to report immediately?

· Question 49

A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause

· Question 50

Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent

· Question 51

A nurse has questioned why a patient’s physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of a patient’s infection. Which of the following facts provides the best rationale for the use of narrow-spectrum antibiotics whenever possible?

· Question 52

A female patient has been prescribed estrogen therapy. Which of the following will the nurse advise the patient is a common adverse effect of estrogen therapy?

· Question 53

A nurse is discussing oprelvekin therapy with a male patient. Which of the following will the nurse tell the patient is the most common adverse effect of the drug?

· Question 54

A man has a demonstrated history of androgen deficiency and the consequences of this health problem include an inability to maintain an erection. Which of the following medications would best address this patient’s erectile dysfunction (ED)?

· Question 55

A female patient has follicular non-Hodgkin’s lymphoma and is receiving thalidomide (Thalomid). It will be most important for the nurse to monitor this patient for which of the following?

· Question 56

A nurse has administered filgrastim to a diverse group of patients in recent months. Which of the following patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug?

· Question 57

A nurse is aware that the concept of selective toxicity is foundational to antimicrobial therapy. Which of the following statements most accurately describes selective toxicity?

· Question 58

A 59-year-old man with a recent history of erectile dysfunction has been assessed and prescribed sildenafil (Viagra). When providing patient education to this man, the nurse should tell him which of the following?

· Question 59

A nurse has completed a medication reconciliation of a patient who has been admitted following a motor vehicle accident. Among the many drugs that the patient has received in the previous year is rituximab. The nurse would be justified in suspecting the patient may have received treatment for which of the following diseases?

· Question 60

A patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are considered

· Question 61

A nurse is providing patient education to a 23-year-old woman who is starting the norelgestrominethinyl estradiol transdermal system (Ortho Evra). Because this is the patient’s first time to use the birth control patch, the nurse will instruct her to apply the patch

· Question 62

A nurse is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to

· Question 63

Which of the following patients will be at the greatest risk for anemia and would be the most likely candidate for epoetin alfa therapy?

· Question 64

A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia). After baseline physical data are obtained, the nurse will assess the patient’s childbearing potential. The nurse will inform the patient that during sibutramine therapy she should

· Question 65

The nurse recognizes that the potential for teratogenic drug effects is not static throughout the prenatal and postnatal periods. The potential for teratogenic effects is highest during

· Question 66

On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which of the following responses by the nurse is most appropriate?

· Question 67

A 16-year-old boy is prescribed cromolyn sodium nasal spray to treat a nasal allergy. To maximize the therapeutic effects of the drug, which of the following will the nurse include in instructions to the patient?

· Question 68

A nurse who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to

· Question 69

A nurse who provides care on a pediatric medicine unit has conducted a medication reconciliation of a recently-admitted patient. In light of the fact that the child takes methylphenidate (Ritalin), the nurse is justified in considering a history of what health problem?

· Question 70

A nurse is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient’s laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered?

· Question 71

A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse’s priority assessment would be

· Question 72

A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment?

· Question 73

A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?

· Question 74

During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient’s platelet count to be 92,000 cellsmm3. The nurse should do which of the following?

· Question 75

A nurse is discussing with a 58-year-old male patient the causes of erectile dysfunction in men over 50 years of age. Which of the following will the nurse inform the patient is the primary physical cause of erectile dysfunction of men in this age group?

· Question 76

A patient has been admitted to the critical care unit of the hospital with bacterial septicemia that has failed to respond to initial antibiotic treatment. The patient’s most recent blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the patient’s blood. The nurse will anticipate that this patient will likely require intravenous administration of what antibiotic?

· Question 77

A nurse is instructing a colleague on how an antimicrobial produces a therapeutic effect. Which of the following should be included in the nurse’s teaching?

· Question 78

A 20-year-old woman has been prescribed estrogen. As with all women taking estrogen, the nurse will carefully monitor the patient for which of the following?

· Question 79

A nurse has been assigned to a 55-year-old woman who has a malignant brain tumor. The patient is receiving her first dose of carmustine. It will be critical for the nurse to observe for which of the following?

· Question 80

A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient to

· Question 81

A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this patient would most likely contraindicate the use of tadalafil for his ED?

· Question 82

A nurse is caring for a patient who is at 28 weeks’ gestation and is receiving terbutaline (Brethine) to control preterm labor. Which of the following assessment parameters should the nurse prioritize?

· Question 83

A patient with non-Hodgkin’s lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient’s care, what nursing diagnosis should the nurse prioritize?

· Question 84

A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that

· Question 85

A nurse is administering rituximab to a patient via the IV route. The nurse will set the IV pump at 50 mghour for the first half hour of the initial infusion. If there are not apparent reactions after 30 minutes of the infusion, the nurse will increase the dosage every 30 minutes by 50 mghour until the maximum infusion rate reaches which of the following?

· Question 86

A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The patient has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect?

· Question 87

A patient will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the patient’s drug regimen and the patient has asked about the potential side effects of treatment. How should the nurse best respond?

· Question 88

A patient is taking etoposide for a testicular tumor refractory to treatment. The nursing assessment reveals that he is also taking warfarin. The nurse must carefully monitor for which of the following?

· Question 89

A patient is receiving long-term clindamycin therapy for a life-threatening infection. The nurse will begin by monitoring this drug therapy by obtaining

· Question 90

A patient is prescribed ganciclovir to treat a CMV infection. An oral dosage is prescribed. To help increase bioavailability of the drug, the nurse will encourage the patient to take the medication

· Question 91

A 29-year-old woman who is morbidly obese has recently begun a comprehensive, medically-supervised program of weight reduction. Prior to adding dextroamphetamine (Dexedrine) to her regimen, the patient should be questioned about her intake of

· Question 92

A patient is pregnant and is at 7 weeks’ gestation. She has type 1 diabetes and has been taking insulin since she was 13 years old. She asks the nurse if the insulin will be harmful to her baby. The best response to the patient by the nurse would be

· Question 93

A nurse is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation?

· Question 94

Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse’s response to Mr. Lepp?

· Question 95

A patient with a diagnosis of chronic myeloid leukemia has met with her oncologist, who has recommended treatment with the kinase inhibitor imatinib. What route of administration should the nurse explain to the patient?

· Question 96

A nurse is going to administer medication to an infant using a medicine dropper. The best method is to open the child’s mouth by gently squeezing the cheeks and placing the drops

· Question 97

A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose?

· Question 98

A patient is being treated for Mycoplasma pneumoniae pneumonia. She is allergic to penicillin and is being given azithromycin (Zithromax) in capsule form. The nurse will inform the patient that she will need to take the capsule

· Question 99

A nurse is explaining to a pregnant 21-year-old college student why she cannot continue to take ibuprofen (Advil) for her headaches. The nurse draws a picture depicting drug molecules crossing the placental membrane and entering into the fetal circulation. The nurse tells the patient that the main reason this happens is because

· Question 100

A patient has been prescribed oral tetracycline. The nurse will instruct the patient to take the drug

NURS 6521 Midterm Exam / NURS6521 Midterm Exam (Latest): Advanced Pharmacology: Walden University

Walden NURS 6521 Midterm Exam / Walden NURS6521 Midterm Exam (Latest): Advanced Pharmacology

1. Which of the following patients demonstrates the clearest indication for treatment with prednisone?

A) A 66-year-old woman whose history of smoking has culminated in a diagnosis of emphysema

B) A 70-year-old man whose rheumatoid arthritis has not responded to OTC pain relievers

C) A 12-year-old boy whose long-standing fatigue and malaise have been attributed to leukemia

D) A 50-year-old woman who is being treated for hypertension with a diuretic and an ACE inhibitor

2. A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is consid- erably higher than the parenteral dose and understands that this due to

A) passive diffusion.

B) active transport.

C) glomerular filtration.

D) first-pass effect.

3. A nurse is caring for a postsurgical patient who has small tortuous veins and had a difficult IV insertion. The patient is now receiving IV medications on a regular basis. What is the best nursing intervention to minimize the adverse effects of this drug therapy?

A) Monitor the patient’s bleeding time

B) Check the patient’s blood glucose levels

C) Record baseline vital signs

D) Monitor the IV site for redness, swelling, or pain

4. A patient is in the clinic after 6 weeks of taking riluzole (Rilutek) for a recent diagnosis of amyotrophic lateral sclerosis. The nurse will priori- tize assessment for which of the following?

A) Weight gain

B) Constipation

C) Increased energy

D) Dizziness

5. A cardiac care nurse is monitoring a patient who is receiving lidocaine (Xylocaine) per IV infusion pump for an acute ventricular arrhythmia associated with an acute MI. Which of the following patient manifesta- tions would cause the nurse to notify the physician immediately?

A) Confusion

B) Headache

C) Nausea

D) Leg cramps A

6. A nurse is caring for a patient who is admitted into the cardiac care unit with acute, decompensated heart failure. Nesiritide (Natrecor) has been ordered. When preparing for administration of the drug, the nurse will

A) add the reconstituted vial of medication to a 1,000 mL IV bag.

B) shake the vial vigorously to mix the medication for reconstitution.

C) administer the initial IV bolus over approximately 60 seconds.

D) use the reconstituted solution within a 36-hour period. C

7. A patient has been prescribed lithium therapy. Which of the following signs and symptoms will the nurse tell the patient to report immediately?

A) Increased urination

B) Muscle twitching

C) Hair loss

D) Increased thirst B

8. A nurse is caring for a patient who has just been diagnosed with Parkinson disease. The patient does not understand how the medication ordered, carbidopa-levodopa, is going to help her condition. Which of the following is the correct response by the nurse?

A) “Carbidopa-levodopa will delay the loss of muscle strength and limb function for several months.”

B) “This drug will change the immune processes in your body to help

decrease the tissue damage.”

C) “Carbidopa-levodopa increases the activity of dopamine in your body, which will decrease your symptoms.”

D) “Your drug therapy will reduce excessive reflex activity causing your muscle spasms and will allow for muscle relaxation.”

C

9. A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following?

A) Chronic diarrhea

B) Dental hygiene practices

C) Headaches

D) Diet B

10. A nurse notes new drug orders for a patient who is already getting several medications. Which of the following is the most important con- sideration when preparing to administer the new drugs?

A) How the patient will feel about new medications added to her drug therapy

B) Possible drug-drug interactions that might occur

C) Any special nursing considerations that the nurse must be aware of

D) If generic preparations of the drugs can be used B

11. A nurse is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?

A) The amount of the drug that must be given to produce a particular re- sponse

B) How well a drug produces its desired effect

C) A drug’s strength of attraction for a receptor site

D) A drug’s ability to stimulate its receptor B

12. A nurse is conducting a medication resolution of a new resident of a care facility and notes that the woman has been taking neostigmine. The nurse should recognize that the woman may have a history of what

health problem?

A) Alzheimer disease

B) Parkinson disease

C) Myasthenia gravis

D) Multiple sclerosis C

13. A 77-year-old man’s chronic heart failure is being treated with a regi- men of quinapril (Accupril) and furosemide (Lasix). Which of the fol- lowing assessment findings would suggest that the loop diuretic is con- tributing to a therapeutic effect?

A) The man’s glomerular filtration rate and creatinine levels are within reference ranges.

B) The man’s heart rate is between 60 and 70 beats per minute with a regular rhythm.

C) The man’s potassium and sodium levels remain with reference ranges.

D) The man’s chest sounds are clear and his ankle edema is lessened. D

14. A nurse explains to a patient that nitroglycerin patches should be ap- plied in the morning and removed in the evening. This medication schedule reduces the potential for

A) adverse effects.

B) nitrate dependence.

C) nitrate tolerance.

D) toxic effects. C

15. A nurse who provides care on a busy medical unit of a large hospital is constantly faced with new drugs on patients’ medication administra- tion records. What strategy should the nurse employ to foster up-to-date information about the nursing management of new or uncommon drugs?

A) Focus on learning about a prototype drug that is characteristic of a larger drug class

B) Identify similarities between new drugs and older drugs that are com- monly used on the unit

C) Commit time and energy during each shift to learning about new drugs

D) Liaise with pharmacists and pharmacy technicians who work at the hospital

A

16. A 58-year-old man is admitted to the emergency department. A diag- nosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs?

A) Furosemide

B) Digoxin immune fab

C) Captopril

D) Dopamine B

17. A hospital patient’s physician has prescribed quetiapine (Seroquel) to be administered at bedtime. Being unfamiliar with the medication, the nurse has looked it up in a nursing drug manual and noted that the drug is an antipsychotic that is indicated for the treatment of schizophrenia and bipolar disorder. The patient has no psychiatric history, and upon questioning, the physician states that it is being prescribed to help the patient fall asleep at night. How should the nurse best understand this practice?

A) This off-label use of the drug is prohibited by federal laws and pro- fessional practice standards.

B) This is an appropriate use of the drug, provided it is supported by the literature.

C) This is acceptable if the patient has failed to respond adequately to conventional sleep aids.

D) This is a practice that may negate the physician’s and nurse’s liability insurance.

B

18. A 4-year-old child is brought to the emergency department by her mother. The mother reports that the child has been vomiting, and the nurse notes that the child’s face is flushed and she is diaphoretic. The mother thinks that the child may have swallowed carbachol drops. A di- agnosis of cholinergic poisoning is made. Which of the following drugs would be administered?

A) Acetylcholine

B) Atropine

C) Cevimeline

D) Nicotine B

19. A nurse is providing discharge instructions to a patient who will be taking fludrocortisone at home. The nurse will encourage the patient to eat a diet that is

A) low in sodium and potassium.

B) low in sodium, high in potassium.

C) high in iron.

D) low in proteins. B

20. A nurse is developing a care plan for a patient who has multiple scle- rosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in

A) chest pain.

B) fatigue.

C) breathing difficulties.

D) heart palpitations. B

21. An elderly postsurgical patient has developed postoperative pneumo- nia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption?

A) A sublingual benzodiazepine that has been prescribed to help the pa- tient sleep

B) An intravenous (IV) antibiotic that is being administered by IV pig- gyback at 150 mL/hour

C) An oral antidepressant that the patient has been taking daily for sev- eral years

D) An intramuscular (IM) injection of an opioid analgesic C

22. A female patient diagnosed with chronic atrial flutter has been pre- scribed verapamil in conjunction with digoxin to control ventricular rate.

To enhance the therapeutic effect of the drug, the nurse will instruct the patient to

A) take the medication with meals.

B) avoid grapefruit and grapefruit juice.

C) take an aspirin every day.

D) avoid fresh fruit. B

23. A 28-year-old patient asks his nurse how phenelzine therapy would help him. An appropriate response by the nurse would be

A) “This therapy will help reduce the severity of your bipolar episodes.”

B) “The drug will enable you to gain the appropriate weight.”

C) “The drug will help increase your attention level.”

D) “This therapy will improve your overall mood and increase your so- cial activity.”

D

24. A nurse is creating a plan of care for a 68-year-old woman with a re- cent diagnosis of unstable angina and new prescription for nitroglycerin. Which of the following nursing diagnoses should the nurse prioritize in the planning of this patient’s care?

A) Incontinence, Functional, related to adverse effects of drug therapy

B) Risk for Fluid Volume Deficit related to adverse effects of drug ther- apy

C) Confusion, Acute, related to adverse effects of drug therapy

D) Acute Pain, Headache, related to adverse effects of drug therapy D

25. A nurse is caring for a 38-year-old female patient who just started taking lithium for bipolar disorder. Which of the following outcomes would be most appropriate for this patient?

A) The patient will reestablish and maintain a normal pattern of bowel functioning.

B) The patient will identify appropriate interventions to promote sleep.

C) The patient will identify satisfying and acceptable sexual practices and some alternative ways of dealing with sexual expression.

D) The patient will adopt strategies to maintain proper fluid balance. D

26. A nurse is caring for a patient who is taking sodium polystyrene sul- fonate (Kayexalate) therapy. The nurse will monitor for which of the fol- lowing?

A) Cardiac arrhythmias

B) Ventricular arrhythmias

C) Hypokalemia

D) Cardiotoxicity C

27. A nurse is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a patient who has just been admitted. What is the most likely goal of this intervention?

A) To treat sinus bradycardia accompanied by hypotension

B) To resolve the patient’s uncompensated heart failure

C) To treat the patient’s ventricular tachycardia

D) To convert the patient’s atrial fibrillation to normal sinus rhythm D

28. A nurse is working in a women’s hospital where she is caring for a new mother who is experiencing postpartum urinary retention. Bethane- chol (Urecholine) has been ordered. The nurse will observe for which of the following?

A) Bradycardia

B) Hypertension

C) Hypotension

D) Decreased salivation B

29. A 12-year-old child who has been taking sertraline for the past 2 weeks has returned to the clinic to be seen. It will be critical for the nurse to assess for

A) onset of suicidal ideation.

B) weight loss.

C) feelings of grandiosity.

D) decreased sleep. A

30. A 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully

monitored for

A) dizziness.

B) diarrhea.

C) increased secretions.

D) facial flushing.

A

31. A patient has been admitted to the intensive care unit following a myocardial infarction. His nurse is preparing to administer his ordered medications when she notices that one drug ordered is used for treating seizure disorders. The nurse does not find a history of seizures in the pa- tient’s record. The most appropriate action for the nurse is to

A) ask the charge nurse if she knows why the drug has been ordered.

B) look up the drug to see if there are other conditions that the drug could be prescribed for.

C) question the physician about the prescribed medication.

D) call the pharmacist and inquire about therapeutic uses of the drug. C

32. A nurse is aware of the high incidence and prevalence of major de- pression in the population. Which of the following individuals possesses the clearest risk factors for depression?

A) A man who has a history of intravenous drug use and multiple hospi- tal admissions for subsequent infections

B) A woman whose father had a long history of depression before he committed suicide

C) A man who is experiencing significant lifestyle changes after losing his job

D) A woman who has recently begun treatment for idiopathic seizure ac- tivity

B

33. The nurse has been assigned a 49-year-old patient who has acute col- itis, and the nurse just completed gathering data concerning core drug knowledge and core patient variables. To implement nursing manage- ment of drug therapy for this patient, the nurse will then

A) evaluate the outcome of the drug therapy.

B) devise strategies to maximize the therapeutic effects of the drug.

C) implement planned nursing actions.

D) assess for data that will indicate interactions between core drug knowledge and core patient variables.

B

34. A nurse has been caring for a 49-year-old man who was hospitalized with recurrent ventricular fibrillation and received IV amiodarone. The man is now scheduled to be discharged on oral amiodarone, and the nurse has just completed discharge instructions. Which of the following statements made by the patient indicates that further instruction is neces- sary?

A) “I will notify my physician if I develop a cough and have difficulty breathing.”

B) “I am going on a cruise next week and plan to just lie in the sun all day and relax.”

C) “I plan to see my ophthalmologist in 2 weeks.”

D) “It is important for me to have my thyroid gland checked regularly.” B

35. A 73-year-old man was diagnosed with Parkinson disease earlier this year and has begun taking carbidopa-levodopa four times daily in an ef- fort to control the signs and symptoms of the disease. The nurse should recognize that this therapeutic effect is achieved by influencing the

A) uptake of acetylcholine.

B) dopamine receptors in the brain.

C) synthesis of epinephrine.

D) sensitivity of beta-2 receptors. B

36. A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous nitroglyc- erin 5 mcg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infu- sion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments?

A) Blood pressure

B) Urinary output

C) Heart rate

D) Blood urea nitrogen (BUN)

A

37. A patient has been prescribed several drugs and fluids to be given in- travenously. Before the nurse starts the intravenous administration, a pri- ority assessment of the patient will be to note the

A) heart rate.

B) body weight and height.

C) blood pressure.

D) skin surrounding the potential IV site. D

38. Which of the following patients would a nurse determine to be at the greatest risk for quinidine toxicity?

A) A 30-year-old pregnant woman

B) A 44-year-old man diagnosed with cardiac insufficiency

C) A 50-year-old woman with myasthenia gravis

D) A 55-year-old man diagnosed with complete heart block B

39. A nurse is assigned to a patient who is taking lithium. Which of the following drug serum levels would indicate that the patient is at risk for adverse effects of the drug?

A) 0.3 mEq/L

B) 0.6 mEq/L

C) 1.7 mEq/L

D) 1.2 mEq/L C

40. A patient experiencing a serious allergic reaction to a bee sting is brought to the emergency department. The patient’s right hand is swollen, red, and painful. She is extremely upset, short of breath, and the nurse detects wheezing and stridor. The nurse is ordered to administer epinephrine to relieve the patient’s

A) pain and swelling around the sting site.

B) discoloration in her hand.

C) acute anxiety.

D) acute bronchospasm. D

41. A nurse is educating a patient who has Parkinson disease and her husband about the possible adverse effects of carbidopa-levodopa. The nurse should emphasize the need for the patient and her husband to mon- itor for any sudden increase in

A) involuntary movements.

B) perspiration.

C) appetite or thirst.

D) mobility.

A

42. A nurse has an order to apply nitroglycerin topically, twice a day. The nurse’s initial action will be to

A) wipe off the previous dose from the patient’s body.

B) don a pair of gloves.

C) place the ointment on an area free of excessive hair and of unbroken skin.

D) wipe off any medication that is on the outside of the medication con- tainer.

B

43. A woman with an inflammatory skin disorder has begun taking pred- nisone in an effort to control the signs and symptoms of her disease. The nurse who is providing care for this patient should prioritize which of the following potential nursing diagnoses in the organization of the pa- tient’s care?

A) Fluid Volume Excess

B) Constipation

C) Acute Confusion

D) Impaired Gas Exchange A

44. A 38-year-old patient is obese and has abscesses around his inner thigh muscles. He is receiving IV antibiotics, but no improvement has been seen. The patient questions the nurse about the most likely cause for the drug therapy failure. The nurse explains to the patient that the

A) surface area of the abscesses is not large enough for the drug to have the desired therapeutic effect.

B) route of administering the medication should not have been IV.

C) distribution of the drug to the area of the abscesses is impaired.

D) distribution of the drug to the thigh muscles is generally impaired, even in healthy individuals.

C

45. A patient is prescribed regular doses of epinephrine. Which of the following nursing diagnoses is related to comfort and would be most ap- propriate for this patient?

A) Imbalanced Nutrition: Less Than Body Requirements

B) Disturbed Sleep Pattern, Insomnia Related to CNS Excitation

C) Disturbed Sensory Perception

D) Ineffective Tissue Perfusion B

46. A 68-year-old female patient who was diagnosed with hypertension 2 weeks ago and was prescribed a new hypertension medication has re- turned to the clinic for a follow-up visit. The nurse notes that the pa- tient’s blood pressure is unchanged from her last clinic visit. When the patient was asked if she was taking the new medication on a regular ba- sis, she stated, “I thought that I was supposed to take the new drug when I had a pounding headache or was in a stressful situation, not all the time.” An appropriate nursing diagnosis for this patient would be which of the following?

A) Knowledge, deficient due to the lack of understanding of treatment regimen

B) Coping, ineffective due to forgetfulness

C) Confusion, acute concerning drug administration

D) Anxiety due to diagnosis of hypertension A

47. A nurse is overseeing the care of a young man whose ulcerative coli- tis is being treated with oral prednisone. Which of the following actions should the nurse take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment?

A) Avoid OTC antacids for the duration of treatment

B) Advocate for intravenous, rather than oral, administration

C) Teach the patient strategies for dealing with headaches

D) Carefully assess the patient for infections

D

48. A nurse is performing an admission assessment of an elderly patient who is being admitted to a medical ward from the emergency depart- ment. Which of the following is an open-ended assessment question?

A) “Have you ever had a bad response to a drug that you’ve taken?”

B) “Does anyone in your immediate family have a history of drug aller- gies?”

C) “Are you comfortable with receiving needles?”

D) “What kind of reactions have you had to medications?” D

49. In order to promote therapeutic drug effects, the nurse should always encourage patients to

A) take their medication with meals.

B) take their medication at the prescribed times.

C) increase medication dosages if necessary.

D) use alternative therapy to increase the effects of their medications. B

50. Frequent episodes of exercise-related chest pain have caused a 79- year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient’s age will have what effect on her use of ni- troglycerin?

A) The woman may experience paradoxical vasoconstriction when tak- ing nitroglycerin.

B) Decreased saliva production will inhibit the absorption of the drug in her mucosa.

C) The woman will need to allow more time between doses in order to facilitate absorption.

D) The woman will be more susceptible to hypotension than a younger patient.

D

51. A 47-year-old woman has been diagnosed with open-angle glau- coma. Pilocarpine drops are prescribed. The nurse’s assessment reveals that the patient has worn soft contact lenses for 15 years. The nurse will instruct the patient to

A) apply the contact lenses and wait 5 minutes before applying the

drops.

B) remove the contact lenses before applying the drops.

C) apply the drops directly on the contact lenses.

D) stop wearing the contact lenses during the pilocarpine therapy. B

52. A nurse who provides care on an acute medicine unit has frequently recommended the use of nicotine replacement gum for patients who ex- press a willingness to quit smoking during their admission or following their discharge. For which of the following patients would nicotine gum be contraindicated?

A) A patient who received treatment for kidney failure due to an over- dose of acetaminophen

B) A patient whose pulmonary embolism was treated with a heparin in- fusion

C) A patient with a history of angina who experienced a non-ST wave myocardial infarction

D) A patient whose stage III pressure ulcer required intravenous antibi- otics and a vacuum dressing

C

53. A patient calls the clinic and reports that he is having chest pain. The patient states that “I’m scared that I am going to die and I’ve been pacing up and down my driveway.” After calming the patient, the initial instruc- tion by the nurse would be to

A) ask the patient to call 911 and wait outside for the ambulance to ar- rive.

B) ask the patient to place a nitroglycerin tablet under his tongue imme- diately.

C) have the patient take his pulse for 1 minute.

D) have the patient go into his house and sit or lie down. D

54. Constipation is a major problem in patients with amyotrophic lateral sclerosis (ALS). The nurse will educate the patient and family to

A) choose a laxative at the local drug store.

B) use prune juice only.

C) consult their physician before purchasing a laxative.

D) walk at least 500 yards a day. C

55. A nurse has been assigned to care for a 52-year-old attorney who has hypertension and peptic ulcer disease. Before administering his medica- tions, the nurse must complete an initial assessment. Core patient vari- ables will be obtained from which of the following? (Select all that ap- ply.)

A) The patient’s interview

B) The patient’s medical history

C) The patient’s medical record

D) The patient’s physical examination

E) The patient’s health insurer A, B, C, D

56. A 59-year-old woman has long-standing diagnoses of type 1 diabetes and hypertension and has recently been diagnosed with glaucoma. Her ophthalmologist has prescribed pilocarpine (Akarpine), which will achieve its intended therapeutic effect by which of the following means?

A) By blocking receptors of acetylcholine

B) By increasing synthesis of acetylcholine

C) By directly stimulating cholinergic receptors

D) By stimulating nicotinicN receptors C

57. A woman in her twenties has been accompanied to her primary care provider by her mother, who states that her daughter has been experienc- ing increasingly severe episodes of irritable grandiose behavior. The care provider has consequently begun a treatment regimen that includes pharmacological therapies. This patient is most likely experiencing which of the following mood disorders?

A) Bipolar disorder

B) Dysthymic disorder

C) Major depression

D) Personality disorder A

58. A patient is treated with an antibiotic for an infection in his leg. Af- ter 2 days of taking the antibiotic, the patient calls the clinic and reports that he has a rash all over his body. The nurse is aware that a rash can be an adverse effect of an antibiotic and can be either a biologic, chemical, or physiologic action of the drug, which is an example of

A) pharmacotherapeutics.

B) pharmacokinetics.

C) pharmacodynamics.

D) pharmacogenetics. C

59. A 70-year-old man with diabetes mellitus is taking metoprolol (Lo- pressor) to manage his hypertension. The nurse would be sure to instruct the patient to

A) take his pulse at least four times a day.

B) weigh himself once a week at the same time of the day.

C) avoid smoke-filled rooms.

D) understand the signs and symptoms of hypoglycemia. D

60. A 45-year-old man enters the emergency department complaining of chest pain. The nurse has an order to administer amyl nitrite. The nurse will

A) administer the medication by intramuscular injection.

B) crush the capsule and ask the patient to inhale the vapors.

C) place the tablet under the patient’s tongue.

D) ask the patient to chew the tablet before swallowing. B

61. Mrs. Houston is a 78-year-old woman who resides in an assisted liv- ing facility. Her doctor prescribed digoxin at her last visit to the clinic and she has approached the nurse who makes regular visits to the as- sisted-living facility about this new drug. What teaching point should the nurse emphasize to Mrs. Houston?

A) The importance of having required laboratory work performed on time

B) The need to take the medication at the same time each day regardless of her heart rate

C) The correct technique for using a home blood pressure cuff

D) Timing household activities to coincide with the administration times of her digoxin

A

62. A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain?

A) Call the physician

B) Ask the patient to lie back and try to relax

C) Have the patient swallow a tablet every 5 minutes for 15 minutes

D) Administer a tablet under his tongue and repeat the action in 5 and 10 minutes if the pain has not subsided

D

63. A nurse on an acute medical unit has rectally administered a dose of sodium polystyrene sulfonate to a patient. What assessment should the nurse prioritize in the 48 hours following the administration of this drug?

A) Monitoring of serum potassium levels

B) Stool testing for occult blood

C) Fluid balance

D) Hemoglobin, hematocrit, and red blood cells A

64. An expected outcome for a patient who has just taken sublingual ni- troglycerin should be

A) increased heart rate and decreased blood pressure.

B) decreased heart rate and decreased blood pressure.

C) increased heart rate and increased blood pressure.

D) decreased heart rate and increased blood pressure. A

65. Which of the following patients should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?

A) A 47-year-old female with hypertension

B) A 52-year-old male with adult-onset diabetes

C) A 17-year-old female with symptoms of an upper respiratory infec-

tion

D) A 62-year-old male with gout A

66. Which of the following would be an expected outcome in a patient who has been given atropine during a medical emergency?

A) Reduction of severe hypertension

B) Increased level of consciousness

C) Restoration of normal sinus rhythm

D) Resolution of respiratory acidosis C

67. A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse?

A) “This schedule will be more convenient for you.”

B) “This schedule will enable you to lose weight.”

C) “This schedule will decrease the cost of your medication.”

D) “This schedule allows rest periods so that adverse effects are de- creased but the anti-inflammatory effects continue.”

D

68. A middle-aged male patient has received a diagnosis of amyotrophic lateral sclerosis (ALS) and has begun treatment with riluzole (Rilutek). The patient’s nurse should recognize what goal of this treatment regi- men?

A) Restoration of normal motor nerve function

B) Maintenance of normal mobility and activities of daily living

C) Delaying of tracheostomy or mechanical ventilation

D) Relief of neuropathic pain C

69. A patient has been prescribed an oral drug that is known to have a high first-pass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells?

A) Giving the drug with food in order to delay absorption

B) Administering the drug in small, frequent doses

C) Limiting the patient’s protein intake and encouraging fluids

D) Administering the drug intravenously rather than orally D

70. A patient has been receiving regular doses of an agonist for 2 weeks. Which of the following should the nurse anticipate?

A) The drug will decrease in effectiveness

B) The drug will increase in effectiveness

C) There will be a steady state with no anticipated changes

D) The drug will cause excessive therapeutic effects even when adminis- tered in small doses.

A

71. After seeking care for tremors that have become increasingly severe in recent months, a 71-year-old man has been diagnosed with Parkinson disease and will soon begin treatment with carbidopa-levodopa. Which of the following statements indicates that the patient has an accurate un- derstanding of his new medication?

A) “I’ll have to learn how to modify each dose of carbidopa-levodopa based on how bad my symptoms are that day.”

B) “I’ve read that carbidopa-levodopa is quite short-acting so I’ll have to take it several times a day.”

C) “I’ll make sure to stop taking my other medications so that my car- bidopa-levodopa doesn’t interact with them.”

D) “I’ve heard that it can take up to a year for carbidopa-levodopa to cure someone of Parkinson disease.”

B

72. A nurse is caring for a patient who is taking metoprolol (Lopressor). Which of the following statements would indicate that teaching by the nurse concerning the beta-adrenergic antagonist has been effective?

A) “I may have a very dry mouth while taking this drug.”

B) “I should never stop taking this drug abruptly.”

C) “I can stop walking a mile a day.”

D) “Since I am taking this drug, I no longer need to worry about my diet.”

B

73. A female patient has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of pred- nisone to avoid

A) hypokalemia.

B) gastrointestinal problems.

C) adrenal insufficiency.

D) menstrual irregularities. C

74. A 21-year-old man experienced massive trauma and blood loss dur- ing a motorcycle accident and has been started on a dopamine infusion upon his arrival at the hospital. In light of this drug treatment, what as- sessment should the care team prioritize?

A) Respiratory assessment

B) Arterial blood gases

C) Monitoring of intracranial pressure

D) Cardiac monitoring D

75. A 58-year-old woman was diagnosed with myasthenia gravis many years ago and has been on a regimen of neostigmine (Prostigmin), a re- versible cholinesterase inhibitor. In light of the patient’s drug regimen, a nurse can conclude that the pathophysiology of myasthenia gravis in- volves

A) excessive synthesis and release of acetylcholine at neuromuscular junctions.

B) a lack of functional cholinergic receptors at neuromuscular junctions.

C) an inherent susceptibility to cholinergic crisis.

D) deficient reuptake of acetylcholine. B

76. A nurse has been assigned to a 52-year-old woman who has been hospitalized and has a diagnosis of Parkinson disease. The patient has been taking carbidopa-levodopa for about 1 year. The patient states that she has been having “more side effects from her drugs lately” and the nurse observes that the client appears to be lethargic and have a de- creased attention span. Which of the following would be an appropriate nursing diagnosis based on the statement of the patient and the observa-

tions of the nurse?

A) Disturbed Thought Processes

B) Disturbed Sleep Pattern

C) Impaired Physical Mobility

D) Risk for Injury B

77. A patient who is going on a cruise is concerned about motion sick- ness and sees his physician, who prescribes scopolamine. The nurse in- forms the patient that using scopolamine may cause him to experience

A) pupil constriction.

B) drowsiness.

C) diarrhea.

D) urinary incontinence. B

78. A nurse is providing patient education to a female patient who is tak- ing fludrocortisone. The nurse will instruct the patient to monitor which of the following at home?

A) Weight gain

B) Thyroid hormone levels

C) Heart rate

D) Core body temperature A

79. A female patient has been prescribed aminoglutethimide to treat Cushing syndrome. Before therapy begins a priority nursing action would be to review the patient’s

A) current lab results, especially complete blood count.

B) current body weight and height.

C) bilirubin level.

D) last menstrual period. A

80. A nurse is caring for a patient in the critical care unit. Phentolamine (Regitine, OraVerse) has been ordered for the management of tissue necrosis caused by extravasation of parenterally administered drugs. Be- fore administering this drug, the nurse will check the patient’s chart for indications of

A) peptic ulcer disease.

B) history of acute myocardial infarction.

C) diabetes mellitus.

D) obesity.

B

81. A 28-year-old man has been taking sertraline for a few months. On a follow-up visit to the clinic, he reports a change in sexual functioning, dizziness, and insomnia. The most appropriate response by the nurse would be

A) “How much of the drug are you taking at one time?”

B) “Have you stopped taking the drug?”

C) “Do you eat a lot of fat in your diet?”

D) “How much alcohol do you consume?” B

82. A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments?

A) Oxygen saturation and respiratory rate

B) Heart rate and blood pressure

C) Level of consciousness and pain level

D) Temperature and respiratory rate B

83. A 59-year-old female patient has been prescribed digoxin. The nurse assigned to the patient will instruct her to avoid which of the following?

A) Grapefruit juice

B) Protein-rich foods

C) One glass of red wine per day

D) OTC cold remedies D

84. A female patient is taking 0.125 mg of digoxin daily for heart fail- ure. At a recent clinic visit she reports that since she has been on the drug, she can breathe better and her heart rate has been around 74 beats per minute. The nurse weighs the patient and notices that she has gained 10 pounds since the digoxin therapy was started. The patient is con- cerned that the additional weight will necessitate an increase in the med-

ication. Which of the following is an appropriate response by the nurse?

A) “Yes, the drug dosage will probably have to be increased.”

B) “No, the drug dosage will likely stay the same.”

C) “No, the drug dosage will have to be decreased.”

D) “I don’t know; I will have to ask your physician.” B

85. A middle-aged patient was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, his psychiatrist has prescribed phenelzine. When planning this patient’s subsequent care, what nursing diagnosis should the nurse prioritize?

A) Risk for Ineffective Peripheral Tissue Perfusion related to cardiovas- cular effects of phenelzine

B) Risk for Constipation related to decreased gastrointestinal peristalsis

C) Risk for Infection related to immunosuppressive effects of phenelzine

D) Risk for Injury related to drug-drug interactions or drug-nutrient in- teractions

D

86. A woman in her thirties has been experiencing increasing weakness and the results of an edrophonium (Tensilon) test have resulted in a di- agnosis of myasthenia gravis. The patient’s nurse should anticipate that the patient will benefit from treatment with

A) carbidopa-levodopa.

B) a monoclonal antibody.

C) a dopamine agonist.

D) a cholinesterase inhibitor. D

87. A nurse is caring for a patient admitted to the intensive care unit be- cause of heart failure. The patient is prescribed digoxin. Which of the following nursing diagnoses would be appropriate for this patient?

A) Risk for Hyperthyroidism related to adverse effects of drug therapy

B) Decreased Cardiac Output related to altered cardiac function

C) Acute Pain and Headache related to adverse effects of the drug ther- apy

D) Risk of Constipation related to adverse effects of the drug therapy

B

88. Which of the following activities would the nurse expect to complete during the evaluation phase of the nursing process in drug therapy?

A) Compare the outcome expected with the actual patient outcome

B) Reconsider core drug knowledge and core patient variables

C) Ask questions to prepare an effective patient education program

D) Establish a baseline for the patient’s treatment and care A

89. A patient is taking tocainide for a life-threatening ventricular ar- rhythmia. The most serious potential adverse effects involve

A) blood dyscrasias.

B) vertigo.

C) paresthesia.

D) visual impairment. A

90. A nurse in the intensive care unit is caring for a patient in shock and has started IV administration of dopamine (Intropin). For a patient in shock, dopamine helps to

A) decrease heart rate.

B) decrease blood pressure.

C) increase blood pressure.

D) increase body temperature. C

91. A 42-year-old African-American man with congestive heart failure has been prescribed hydralazine-isosorbide. The nurse will closely moni- tor for which of the following?

A) Hypertension

B) Hypotension

C) Decrease in body temperature

D) Increased heart rate B

92. After successful treatment for a myocardial infarction, a 69-year-old man has developed a ventricular arrhythmia. His care team has opted for treatment with a Class II antiarrhythmic. The nurse would understand that this patient is likely to be prescribed

A) acebutolol.

B) lidocaine.

C) amiodarone.

D) verapamil. A

93. A patient has been prescribed aminoglutethimide 250 mg PO q6h to increase to 2g daily over the next several weeks. The nurse should rec- ognize that this patient most likely has a diagnosis of

A) Cushing syndrome.

B) Addison disease.

C) diabetes insipidus.

D) an autoimmune condition such as asthma. A

94. A patient has a diagnosis of Parkinson disease, and the physician will prescribe carbidopa-levodopa. Before drug therapy, the patient should be carefully assessed for the presence of

A) macular degeneration.

B) closed-angle glaucoma.

C) peptic ulcer disease.

D) diabetes mellitus. B

95. A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely administer a lower-than-normal maintenance dose of digoxin?

A) A 25-year-old male with congestive heart failure and atrial fibrilla- tion

B) A 32-year-old female with cardiomegaly

C) A 79-year-old male with cardiomegaly

D) A 42-year-old female with a third heart sound C

96. In which of the following patients would a nurse expect to experi- ence alterations in drug metabolism?

A) A 35-year-old woman with cervical cancer

B) A 41-year-old man with kidney stones

C) A 50-year-old man with cirrhosis of the liver

D) A 62-year-old woman in acute renal failure C

97. A patient with class-IV CHF has a medication regimen consisting of metoprolol (Lopressor), enalapril (Vasotec), and furosemide (Lasix). In addition to regularly assessing the patient s heart rate, the nurse should prioritize assessment of the patient’s

A) intake and output.

B) blood pressure.

C) cognition.

D) exercise tolerance. B

98. A nurse is caring for a patient who is taking metoprolol (Lopressor). Which of the following statements would indicate that teaching by the nurse concerning the beta-adrenergic antagonist has been effective?

a. “I may have a very dry mouth while taking this drug.”

b. “I should never stop taking this drug abruptly.”

c. “I can stop walking a mile a day.”

d. “Since I am taking this drug, I no longer need to worry about my diet.”

99. A nurse is developing a care plan for a patient who has multiple scle- rosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in

a. chest pain.

b. fatigue.

c. breathing difficulties.

d. Heart palpitations.

100. An elderly postsurgical patient has developed postoperative pneumo- nia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption?

A. A sublingual benzodiazepine that has been prescribed to help the pa- tient sleep

B. An intravenous (IV) antibiotic that is being administered by IV pig- gyback at 150 mL/hour

C. An oral antidepressant that the patient has been taking daily for sev- eral years

D. An intramuscular

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