Core Concepts in Pharmacology 3rd Edition By Holland Adams –
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
|1) The term pharmacology is defined as:||1)|
- The study of medicine.
- The use of medicine to treat disease.
- The branch of medicine concerned with the treatment of disease and suffering.
- The use of herbs, natural extracts, vitamins, minerals, or dietary supplements to treat diseases.
|2)||In addition to physicians, which of the following health care providers are able to prescribe||2)|
|medications? Select all that apply.|
|A) Physicianʹs assistants||B) Medical assistants|
|C) Advanced nurse practitioners||D) Dentists|
|3)||The branch of medicine concerned with the treatment of disease and suffering is known as:||3)|
|A) Therapeutics.||B) Pathophysiology.|
|C) Pharmacology.||D) Pharmacotherapeutics.|
|4)||Which of the following best describes the term pharmaceutics?||4)|
- Herbs, natural extracts, vitamins, minerals, and dietary supplements
- The science of preparing and dispensing drugs, and a very important part of pharmacotherapy
- Agents naturally produced in animal cells, in microorganisms, or by the body itself
- The use of medicine to treat disease
|5)||Which of the following are considered medically therapeutic? Select all that apply.||5)|
|A) Natural alternative therapies||B) Biologics|
|C) Traditional drugs||D) Sunscreens and antiperspirants|
|6)||Therapeutic drugs are sometimes classified on the basis of how they are produced. Insulin would||6)|
|fall into which category?|
|A) Traditional therapeutic drug||B) Biologics|
|C) Natural therapy||D) Alternative therapies|
|7)||Which of the following statements best describes how a traditional drug is different from a biologic||7)|
- Biologics include herbs, natural extracts, vitamins, minerals, and dietary supplements.
- Biologics and traditional drugs are identical chemically
- Traditional drugs are naturally produced by the body or in animal cells, where biologic agents are chemically produced in a laboratory.
- Traditional drugs are chemically produced in a laboratory, where biologic agents are naturally produced by the body or in animal cells.
|8)||Drugs that demonstrate wide margins of safety and are used over long periods of time are often||8)|
|A) Traditional drug therapy classification to biologics classification|
|B) Prescription-only to over-the-counter (OTC) drug.|
|C) One classification to a lower, less restrictive one.|
|D) Therapeutic to effective.|
|9)||Which of the following statements describe advantages of prescription drugs versus||9)|
|over-the-counter (OTC) drugs? Select all that apply.|
- The practitioner can maximize therapy by ordering the proper medication for the clientʹs condition.
- There are fewer side effects of prescription drugs than of OTC drugs.
- The cost of the drug is always less than the cost of an OTC drug.
- The practitioner is able to control the dose and frequency of dosing of the drug.
|10) Reasons why a client might prefer to take an OTC drug are numerous. Which of the following||10)|
|statements is a potential advantage of OTC drugs versus prescription drugs?|
- OTC drugs can react with foods, herbal products, and prescriptions, or with other OTC drugs.
- Choosing the proper medication for a specific problem can be challenging.
- A client can obtain OTC drugs more easily than prescription drugs.
- Self-treatment is sometimes ineffective.
|11)||The science of preparing and dispensing drugs is known as:||11)|
|A) Pharmacology.||B) Therapeutics.|
|C) Traditional drug therapy.||D) Pharmaceutics.|
|12)||A client expresses concerns about his newly prescribed medication. The nurse explains that the||12)|
|safety and effectiveness of the medication have been proven, according to the statutes of which|
|A) FDA Modernization Act||B) Pure Food and Drug Act|
|C) Public Health Service Act||D) Food, Drug, and Cosmetic Act|
|13)||A client asks the nurse whether the claims made regarding a new medication are true or false. The||13)|
|nurse tells the client the following act or amendment was passed in 1912 to prevent the sale of|
|drugs with false therapeutic claims that were intended to cheat the consumer:|
|A) Food, Drug, and Cosmetic Act.||B) FDA Modernization Act.|
|C) The Sherley Amendment.||D) Pure Food and Drug Act.|
|14)||If the FDA discovers a serious problem with a medication that has been approved, the FDA will:||14)|
- Issue a warning to practitioners to watch for side effects in clients taking the drug
- Require that the drug be withdrawn from the market and its use discontinued.
- Continue to monitor the medication in post-marketing studies.
- Require the medication to have additional clinical trials conducted.
|15) A certain drug, prescribed for treatment of a particular condition, is found to be beneficial in||15)|
|treating a different problem. Which legislation allows drug companies to share this type of|
|information with health care practitioners?|
|A) Health Products and Food Branch||B) Therapeutic Products Programme|
|C) Prescription Drug User Fee Act||D) Food and Drugs Act|
|16) A client asks the nurse if all herbal supplements undergo the same testing that prescription drugs||16)|
|undergo. Which of the following statements would be the best response by the nurse?|
- ʺHerbal and dietary supplements may not be marketed without prior approval from the FDA.ʺ
- ʺAll medications and herbal supplements undergo the same testing before being made available for purchase.ʺ
- ʺHerbal products and dietary supplements are regulated by the Dietary Supplement Health and Education Act of 1994. This act does not require the same research for herbal or dietary supplements.ʺ
- ʺThe Center for Food Safety and Applied Nutrition (CFSAN) regulates use of herbal supplements, which means the medication must be safe.ʺ
|17)||Which government agency has control over which prescription or OTC drugs may be used for||17)|
|A) The Center for Food Safety and Applied Nutrition (CFSAN)|
|B) The Center for Biologics Evaluation and Research (CBER)|
|C) The Center for Drug Evaluation and Research (CDER)|
|D) The National Institutes of Health (NIH)|
|18)||Which branch of the FDA is responsible for the use of biologics, including serums, vaccines, and||18)|
|products found in the bloodstream?|
|A) The Center for Biologics Evaluation and Research (CBER)|
|B) The FDA does not have a branch responsible for the use of biologics.|
|C) The Center for Food Safety and Applied Nutrition (CFSAN)|
|D) The Center for Drug Evaluation and Research (CDER)|
|19)||A client has been selected as a participant in the approval process of a particular drug. The clientʹs||19)|
|dose and any effects from the medication are being monitored. The phase of drug approval in|
|which this client is participating is the:|
|A) Post-marketing study.||B) Post-clinical investigation|
|C) Clinical phase trial.||D) Preclinical investigation.|
|20)||Which phase of clinical research involves basic science research?||20)|
|A) Preclinical investigation||B) Submission of NDA|
|C) Post-marketing study||D) Clinical phase trials|
|21)||Which of the following lists the stages of approval for therapeutic and biologic drugs in the correc||21)|
- NDA submission with review, preclinical investigation, clinical investigation, and post-marketing studies
- Preclinical investigation, NDA submission with review, clinical investigation, and post-marketing studies
- Preclinical investigation, clinical investigation, NDA submission with review, and post-marketing studies
- NDA submission with review, clinical investigation, preclinical investigation, and post-marketing studies
|22) The nurse is aware of the increased potential for adverse drug—drug and drug—herbal||22)|
|interactions, and explains this to the client in the following statement:|
|A) ʺPeople are using more herbs, so the risk for interaction is greater.ʺ|
|B) ʺManaged care has made a greater number of drugs available to consumers.ʺ|
|C) ʺDrugs are being developed at a faster rate than their risk can be assessed.ʺ|
|D) ʺThe restrictions placed by the FDA are stricter.ʺ|
|23) Which division of Health Canada is responsible for ensuring that health products and foods||23)|
|approved for sale to Canadians are safe and of high quality?|
|A) Therapeutic Products Directorate (TPD)|
|B) Health Products and Food Branch (HPFB)|
|C) Biologics and Genetic Therapies Directorate (BGTD)|
|D) Natural Health Products Directorate (NHPD)|
|24) A client asks the nurse about the safety of medications from Canadian pharmacies. The nurse||24)|
|responds that drugs sold in Canada:|
|A) Are not safe.|
|B) Are not governed by Canada.|
|C) Are not the same as those sold in the United States.|
|D) Must be marketed with an NOC and DIN.|
|25) A public health nurse is seeking information on bioterrorist agents to present education regarding||25)|
|security and defense in case of attack. Which of the following would be an appropriate resource?|
|A) U.S. Armed Forces||B) U.S. National Guard|
|C) U.S. Department of Homeland Security||D) FEMA|
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1) A student nurse asks what the difference between a therapeutic class and a pharmacologic class is. 1)
The best response would be:
- Therapeutic classification is how the medication produces an effect in the body, where pharmacologic classification is how a medication works clinically.
- Pharmacologic classification is how the medication produces an effect in the body, where therapeutic classification is how a medication works clinically.
- Therapeutic classification is how addictive a medication is, where pharmacologic classification is how the medication produces an effect in the body.
- There are no differences between therapeutic and pharmacologic classes.
|2)||A drug is labeled ʺused for minor skin irritations.ʺ This is an example of which classification?||2)|
|A) Function||B) Usefulness||C) Pharmacologic||D) Therapeutic|
|3)||A nursing instructor is teaching fundamental pharmacological content. In helping the students||3)|
|become comfortable with this material, the instructor suggests that they focus initially on|
|familiarizing themselves with the:|
|A) Trade names.||B) Adverse effects.|
|C) Prototype.||D) Generic names.|
|4)||The original, well-understood drug model from which other medications in a pharmacologic class||4)|
|have been developed is known as:|
|A) The prototype drug.||B) A generic drug.|
|C) A proprietary drug.||D) A combination drug.|
|5)||Which of the following statements is true regarding prototype drugs?||5)|
- A nurse can apply understanding of the effects of a prototype drug to other drugs in the same class.
- The mechanism of action is different for the prototype drug than for other drugs in the same class.
- The most commonly used drug in a specific class is always the most widely prescribed drug.
- Understanding the effects of the prototype drug does not help the nurse to understand the effects of other drugs in the same class.
|6)||A generic drug takes 60 minutes to produce a therapeutic effect; the brand name drug takes the||6)|
|same amount of time to produce the same effect. This is a measure of the drugʹs:|
|A) Efficacy.||B) Therapeutic effect.|
|C) Adverse effect.||D) Bioavailability.|
|7)||The physiologic ability of the drug to reach its target cells and produce its effect is known as||7)|
|A) Therapeutic effect.||B) Efficacy.|
|C) Bioavailability.||D) Adverse effect.|
|8)||Which of the following is a trade name?||8)|
|A) Anticoagulant||B) Loop diuretic|
|C) Benadryl||D) Calcium channel blocker|
9) When a new drug is developed, it cannot be made by other pharmaceutical companies for 17 years 9)
after the new drug application (NDA) because:
- It takes 17 years for all pharmaceutical companies to develop a generic version of the drug.
- This allows the pharmaceutical company to earn back the money spent to develop the drug.
- Animal testing must continue for 10 years, then 7 years of human clinical trials, for a drug to be approved.
- It will take 17 years of clinical trials to approve the drug
|10) A client asks the nurse why the physician often refers to medications by the generic name instead||10)|
|of by the brand name. The best response by the nurse would be:|
- There is only one generic name for each medication, but there are often many brand names.
- The physician prefers to use a more technical-sounding name for medications.
- The client needs to ask the physician to explain why medications have so many different names.
- The pharmacy will only accept a prescription written with the generic name.
|11) Which of the following is not a reason why generic names are preferred over chemical or trade||11)|
- A) Chemical names are often complicated and difficult to remember.
- B) There might be multiple trade names for a drug.
- C) The generic name can consistently be matched to the active ingredients.
- D) The generic name is always a shortened version of the chemical name.
12) Sometimes medications are placed on a negative formulary list, which means the pharmacist must: 12)
- Dispense either the generic or trade name medication.
- Verify the order with the physician a second time before dispensing the trade name medication.
- Dispense only the generic medication.
- Dispense only the trade name medication.
|13) A controlled substance is a drug that:||13)|
- Is always called to the pharmacy by the practitioner.
- Requires both a written prescription and a telephone call from the prescribing practitioner.
- Is regulated under the Controlled Substances Act, and may have many restrictions placed on ordering or refilling this medication.
- Does not require a prescription to purchase.
|14)||Some drugs are frequently abused, and cause overwhelming feeling that drives someone to use a||14)|
|drug repeatedly, which is known as:|
|A) Psychological dependence.||B) Dependence.|
|C) Addiction.||D) Physical dependence.|
|15)||A drug that requires a written prescription for refill would belong to which category?||15)|
|A) II||B) I||C) III||D) IV|
|16)||Which of the following would be categorized as Schedule II drugs? Select all that apply.||16)|
|A) Tylenol with codeine||B) Morphine|
|C) Methadone||D) Valium|
|17)||A drug with limited or no therapeutic use would belong to which schedule?||17)|
|A) I||B) X||C) III||D) V|
|18)||Scheduled drugs are classified by their potential for abuse. Which of the following classifications||18)|
|has the highest potential for abuse?|
|A) V||B) III||C) I||D) II|
|19)||Scheduled drugs are classified by their potential for abuse. Which of the following classifications||19)|
|has the lowest potential for abuse?|
|A) II||B) I||C) V||D) III|
|20)||Drugs that have the potential for abuse are regulated by which act in Canada?||20)|
- There are no such restrictions in the Narcotic Control Act.
- The Controlled Drugs and Substance Act
- Part III, Schedule G, of the Canadian Food and Drugs Act
- Part IV, Schedule H of the Canadian Food and Drugs Act
|21)||In Canada, medications are classified under a three-schedule system. Which of the following does||21)|
|not fall under Schedule I?|
|A) Narcotic drugs||B) All prescription drugs|
|C) All nonprescription drugs||D) Controlled drugs|
|22)||A pregnant woman with a life-threatening condition must take medication that can cause harm to||22)|
|her fetus. What is the safety category that this medication most likely represents?|
|A) A||B) B||C) C||D) D|
|23)||Which of the following medications would have the greatest risk to a fetus if given to a pregnant||23)|
- Potassium chloride (K-Lor)
- Ranitidine (Zantac)
- Estrogen with progesterone (Ortho Novum)
- Warfarin (Coumadin)
|24)||Which of the following medications would have the least risk to a fetus if given to a pregnant||24)|
|A) Estrogen with progesterone (Ortho Novum)|
|B) Warfarin (Coumadin)|
|C) Potassium chloride (K-Lor)|
|D) Ranitidine (Zantac)|
|25)||A medication that is a teratogen is:||25)|
- A non-narcotic pain reliever.
- A controlled substance.
- One that will harm a developing fetus or embryo.
- A medication used to treat bacterial infections.
|MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.|
|1)||Prior to administering a medication to a client the nurse needs to understand which of the||1)|
|following? Select all that apply.|
|A) The manufacturer of the medication|
|B) Name (generic and trade) and drug classification|
|C) What drug is ordered|
|D) Contraindications for this medication|
|2)||After administering a medication, the nurse notes that the client has itching and a runny nose. The||2)|
|nurseʹs next action is to:|
|A) Notify the charge nurse.||B) Monitor the client closely.|
|C) Assess vital signs.||D) Document the findings.|
|3)||Following administration of a drug to a client the person who is most responsible for monitoring||3)|
|the client for adverse reactions is:|
|A) The family of the client.||B) The physical therapist.|
|C) The nurse.||D) The nursing assistant.|
|4)||The six rights of drug administration are:||4)|
- Right client, right medication, right dose, right route of administration, right time o preparation, and right documentation.
- Right client, right medication, right dose, right type of medication, right time of preparation and right documentation.
- Right client, right medication, right dose, right route of administration, right time of delivery and right documentation.
- Right client, right dose, right route of administration, right time of delivery and righ documentation.
|5) Which of the following is not one of the three checks of drug administration?||5)|
- Checking the drug with the medication administration record (MAR) or medication information system when removing it from the medication drawer, refrigerator, or controlled substance locker.
- Checking the drug when preparing it, pouring it, taking it out of the unit dose container, o connecting the IV tubing to the bag
- Checking the drug after administering it to the patient
- Checking the drug before administering it to the patient
|6) The nurse is speaking with a client regarding current medications. The client states she does not||6)|
always take the medications as prescribed. Which of the following are potential reasons for noncompliance? Select all that apply.
- Adverse effects such as headache, dizziness, nausea, diarrhea, or impotence often cause noncompliance.
- The client always takes medications as prescribed.
- Patients sometimes forget doses of medications.
- The drug may be too expensive or may not be approved by the patientʹs health insurance plan.
|7) A medication order that should be given immediately and only once is known as:||7)|
|A) A single order.||B) An ASAP order.|
|C) A prn order.||D) A STAT order.|
|8) A medication has been ordered to be given PO. The nurse understands the route of administration||8)|
|A) Intramuscular.||B) Vaginal.||C) Oral.||D) Rectal.|
|9) The physician ordered amlodipine (Norvasc) 5mg tab PO bid. The nurse understands the||9)|
|amlodipine (Norvasc) should be administered to the client:|
|A) One tablet orally once per day.||B) One tablet orally three times per day.|
|C) One tablet orally twice per day.||D) One tablet orally four times per day.|
|10) The physician writes an order for a medication to be given SL tid. The nurse understands this||10)|
|means the medication should be given:|
|A) Subcutaneous four times per day.||B) Sublingual four times per day.|
|C) Sublingual three times per day.||D) Subcutaneous three times per day.|
|11) Which of the following drug administration abbreviations are matched correctly with their||11)|
|definition? Select all that apply.|
|A) hs- hour of sleep/bedtime||B) qid- three times per day|
|C) prn- when needed/necessary||D) ac- after meals; after eating|
|12) Which of the following drug administration abbreviations are matched correctly with their||12)|
|definition? Select all that apply.|
|A) PO- pills only||B) gtt- drop||C) no- number||D) qh- every hour|
|13) A standing order is:||13)|
- Usually carried out within 2 hours of the time the order is written by the physician, but the exact timing is defined by each facility.
- Is administered as required by the patientʹs condition.
- To be given only once and at a specific time.
- Written in advance of a situation, and should be carried out under specific circumstances.
|14)||The medication is ordered as follows: Give 5 ml by mouth four times per day. The nurse instructs||14)|
|the client that this dose is equivalent to:|
|A) Three teaspoons.||B) One teaspoon.|
|C) One tablespoon.||D) Five teaspoons.|
|15)||The nurse is recording intake for a client. The nurse knows that one cup equals:||15)|
|A) 8 fluid drams or 30 ml.||B) 4 fluid drams or 15 ml.|
|C) 500 ml or 1 pint.||D) 240 ml or 8 ounces.|
|16)||One kilogram equals:||16)|
|A) 2.2 pounds.||B) 3.2 pounds.||C) 1.2 pounds.||D) 0.45 pounds.|
17) A client has been prescribed a liquid medication to be taken 15 ml tid. The nurse instructs the client 17)
- Carefully measure the medication using any teaspoon and take one teaspoon three times per day.
- Carefully measure using a medical dosing device and take 15 ml which equals one tablespoon three times per day.
- Carefully measure using a medical dosing device and take 15 ml which equals one teaspoon three times per day.
- Carefully measure the medication using any tablespoon available and take one tablespoon 3 times per day.
|18)||A client is being discharged with an order to drink 2400 ml of fluid per day. The client asks the||18)|
|nurse how many cups this equals. The nurse replies:|
|A) You should drink five 8 ounce glasses of fluid per day.|
|B) You should drink 1 pint of fluid per day.|
|C) You should drink ten 8 ounce glasses of fluid per day.|
|D) You should drink 2 pints of fluid per day|
|19)||Enteral medication administration includes which of the following routes? Select all that apply.||19)|
|A) Medications given orally||B) Medications given subcutaneously|
|C) Medications given via nasogastric tube||D) Medications given via gastrostomy tubes|
|20)||Which type of medication should not be given via nasogastric (NG) tube?||20)|
- Sustained-release medications
- Liquid medications
- All medications can be given via NG tube
|21)||The physician orders a medication to be given via the buccal route. The nurse gives which of the||21)|
|following instructions to the client prior to taking this medication?|
|A) The tablet is placed under the tongue and allowed to dissolve slowly.|
|B) This drug should be applied directly to the skin|
|C) The tablet is placed in the oral cavity between the gum and the cheek.|
|D) The tablet should be crushed and given in either pudding or applesauce.|
|22)||Parenteral medication administration includes which of the following routes? Select all that apply.||22)|
|A) Vaginal||B) Oral|
|C) Intramuscular injection||D) Intravenous infusion|
|23)||IM injections cannot be administered in which site?||23)|
|A) Vastus lateralis site||B) Deltoid site|
|C) Subscapular areas of the upper back||D) Ventrogluteal site|
|24)||The nurse is preparing a syringe for an intramuscular injection. The nurse is to administer the||24)|
|injection in the deltoid muscle and knows the maximum amount of medication for this site is:|
|A) 3 ml.||B) 2 ml.||C) 1 ml.||D) 4 ml.|
|25)||Which of the following is a disadvantage of administering medication via the subcutaneous or||25)|
|A) This route allows medications to avoid digestive enzymes.|
|B) This route allows medications to avoid the first-pass effect in the liver.|
|C) This route allows only small volumes can be administered.|
|D) This route can be used in clients who are unable to take medications orally.|
|26)||Topical drugs given to deliver local effects produce the desired reaction of:||26)|
|A) Absorption of the medication into the circulation.|
|B) Fewer side effects.|
- C) A specified rate of delivery.
- D) Systemic absorption through the skin.
- Pharmacokinetics is a term that describes:
- What a drug does to the body.
- How drugs activate specific receptors.
- What the body does to a drug.
- The efficacy of a drug.
|2)||Pharmacokinetics includes four different processes. Which of the following lists the processes in||2)|
|the order they take place?|
|A) Distribution, absorption, metabolism, and excretion|
|B) Absorption, metabolism, distribution, and excretion|
|C) Absorption, distribution, metabolism, and excretion|
|D) Metabolism, absorption, distribution, and excretion|
|3)||Which of the following is the first step in drug transport?||3)|
|A) Absorption||B) Distribution||C) Metabolism||D) Excretion|
|4)||The process by which drugs are transported after they have been absorbed or administered||4)|
|directly into the bloodstream is known as:|
|A) Administration.||B) Metabolism.|
|C) Excretion.||D) Distribution.|
|5)||The main organ of excretion is the:||5)|
|A) Liver.||B) Kidney.||C) Lung.||D) Colon.|
|6)||Which of the following will slow the absorption of a drug?||6)|
- Taking medication with water
- Taking medication as prescribed
- Taking medication earlier than prescribed
- Taking medication with food
|7)||When a medication binds to a plasma protein, the drug:||7)|
|A) Has reached its target cells.|
|B) Is working at its full potential|
|C) Is unable to reach its target cells.|
|D) Is in the process of being excreted by the body.|
|8)||A client takes two medications at the same time. The nurse knows the action of one drug could be||8)|
- A client must never take two medications at the same time.
- Both drugs compete for the plasma protein receptors, and one drug will displace the other.
- Neither drug will bind to any plasma protein receptors, and the effect of the more potent drug will be intensified.
- The drugs bind together, and the effect of the more potent drug is intensified.
|9) Which of the following organs contains anatomical barriers that limit some drugs from gaining||9)|
|A) Heart||B) Liver||C) Kidney||D) Brain|
|10)||Which of the following is not a barrier to distribution of medications?||10)|
|A) Blood—testicular barrier||B) Blood—brain barrier|
|C) Blood—placental barrier||D) Blood—lung barrier|
|11)||First-pass effect can result in a large fraction of administered drugʹs being metabolically||11)|
|deactivated. Which of the following client factors will decrease the magnitude of the first-pass|
|effect? Select all that apply.|
|A) Elderly client||B) Hepatic disease|
|C) Renal disease||D) Gall bladder disease|
|12)||Metabolism can be affected by which of the following factors? Select all that apply.||12)|
|A) Liver disease||B) Age||C) Kidney disease||D) Genetics|
|13)||A biotransformation reaction:||13)|
- Converts drugs from one form to another that can result in increased or decreased activity.
- Is the final step in excretion of a drug from the body.
- Is the process of absorption.
- Does not change the effect of a drug.
|14) A prodrug:||14)|
- Is a name brand drug.
- Is not absorbed by the body.
- Requires metabolism to make it active.
- Is the first drug developed in a drug class.
|15)||Drugs can be excreted into which of the following? Select all that apply.||15)|
|A) Feces||B) Gastric juice||C) Urine||D) Breast milk|
|16)||Kidney damage: (Select all that apply.)||16)|
|A) Does not cause adverse reactions.||B) Is a common cause of adverse reactions.|
|C) Can significantly prolong drug action||D) Can significantly shorten drug action.|
|17)||Which method of excretion excretes most drugs in their original, unmetabolized form?||17)|
|A) Sweating||B) Urination||C) Defecation||D) Exhalation|
|A) Results in prolonged drug action||B) Results in a decreased drug action.|
|C) Involves the kidneys.||D) Does not affect drug action.|
|19)||Which of the following is an indicator of how long a drug will produce its effect in the body?||19)|
|A) Bioavailability||B) Potency||C) Efficacy||D) Half-life (t1/2)|
|20)||The length of time for a drug concentration to decrease by half is its:||20)|
|A) Half-life.||B) Metabolism.||C) Distribution.||D) Half-time.|
|21)||Pharmacodynamics is a term that describes:||21)|
|A) How a drug exerts its effects.||B) The potency of a drug.|
|C) The efficacy of a drug.||D) What the body does to a drug.|
|22) A receptor is:||22)|
- Analogous to the ʺkeyʺ in the lock-and-key model of drug—receptor interaction.
- Required to drug action.
- A cell component to which a drug binds in a dose-dependent manner.
- Present only in the drugʹs target tissue.
- A drug that acts as an antagonist:
- Blocks the actions of an agonist.
- Facilitates cell action.
- Does not bind with receptors.
- Has no therapeutic benefit.
|24)||Drug A produces a certain therapeutic effect at a dose of 5 mg/kg. Drug B produces the same||24)|
|magnitude of effect at a dose of 0.1 mg/kg. Drug A is ________ than drug B.|
|A) Less efficacious||B) More potent|
|C) More efficacious||D) Less potent|
|25)||Codeine has a greater maximal ability to suppress cough when compared with dextromethorphan.||25)|
|Codeine is ________ than dextromethorphan.|
|A) Less potent||B) More efficacious|
|C) More potent||D) Less efficacious|
|1)||The ________ phase of the nursing process is the systematic collection, organization, validation||1)|
|and documentation of patient data.|
|A) Implementation||B) Assessment|
|C) Planning||D) Evaluation|
|2)||Select all of the reasons a nurse needs to collect baseline data for each client:||2)|
- To evaluate therapeutic drug effects
- To be able to evaluate current laboratory data
- To eliminate the need to monitor vital signs
- To evaluate adverse drug effects
|3)||Assessment related to pharmacology must include which of the following? Select all that apply.||3)|
|A) Heart and lung assessment|
|B) Allergies to medications|
|C) All current medications, including OTC medications|
|D) Herbal products and dietary supplements|
|4)||The client complains of pain and nausea. The client has an elevated serum potassium level, and||4)|
|has vomited twice on day shift. Which of these signs and symptoms are examples of subjective|
|data? Select all that apply.|
|A) Nausea||B) Elevated serum potassium level|
|C) Pain||D) Vomiting|
|5)||Which of the following would not be objective data?||5)|
|A) Nausea||B) Chest x-ray|
|C) Current vital signs||D) Palpable pulses in all extremities|
|6)||The nurse is caring for a client who verbalized severe pain in the right arm. The nurse understands||6)|
|this to be:|
|A) Critical data.||B) Subjective data.|
|C) Irrelevant data.||D) Objective data.|
|7)||Sources of data collection include which of the following? Select all that apply||7)|
- The client
- The client is the only source for data collection.
- Other health care providers
- The medical record
|8) The role of the LPN/LVN is to:||8)|
- Develop a plan of care.
- Identify appropriate nursing diagnoses.
- Incorporate medical diagnoses into the care plan.
- Collect data.
|9) When obtaining a medication history, the nurse should: (Select all that apply.)||9)|
|A) Assess the client for potential IV sites.|
|B) Assess tobacco and alcohol use.|
|C) Assess pregnancy status in female clients.|
|D) Assess for medication allergies.|
|10) A nursing diagnosis is identified and developed by the RN. Which of the following statements is||10)|
|an accurate example of a nursing diagnosis?|
|A) Left leg fracture related to fall|
|B) Activity intolerance related to acute knee pain.|
|C) Activity intolerance|
|D) Non-radiating left knee pain|
|11) The diagnosis phase of the nursing process addresses which three areas of concern? Select all that||11)|
|A) Minimizing drug effects and toxicity|
|B) Promoting therapeutic drug effects|
|C) Ensuring that the client takes all prescribed medications|
|D) Maximizing the ability of the client for self-care|
|12) The RN has developed nursing diagnoses for a client. Which of the following nursing diagnoses||12)|
|are related to pharmacology? Select all that apply.|
- Altered nutrition: less than body requirements related to drug-induced nausea
- Activity intolerance related to acute knee pain
- Risk for injury related to drug effects
- Non-compliance with drug therapy related to lack of knowledge
|13)||Following the establishment of a nursing diagnosis, which phase of the nursing process begins?||13)|
|A) Implementation||B) Planning|
|C) Assessment||D) Evaluation|
|14)||The ________ phase of the nursing process includes prioritizing diagnoses, formulating goals, and||14)|
|selecting nursing interventions.|
|A) Assessment||B) Evaluation|
|C) Planning||D) Implementation|
|15)||Which of the following should not be considered when planning interventions?||15)|
|A) Acceptability to the client||B) The personal beliefs of the nurse|
|C) Available resources||D) Current practice guidelines|
|16)||When administering PO medications, the nurse must plan how and when to administer the drug.||16)|
|Which of the following is not a factor when planning to administer a PO medication?|
- Should the medication be given on an empty stomach?
- How long should the infusion last?
- Can the medication be split?
- Can the medication be crushed?
|17)||A client has been prescribed a medication that will be given only while the client is in the hospital.||17)|
|The nurse does not need to include which of the following in client teaching?|
|A) Potential side effects||B) Name of the drug|
|C) Reason for administration||D) Drug classification|
|18)||The first step of the planning phase is identifying a goal with specific evaluation criteria. The||18)|
|second step is:|
- Assessment of current vital signs.
- There is only one step in the planning phase.
- Formulation of a list of health conditions.
- Formulation of a list of nursing interventions.
|19)||The ________ phase is when the nurse applies knowledge, skills, and principles of nursing care to||19)|
|move the client towards the desired goal.|
|A) Planning||B) Assessment|
|C) Implementation||D) Evaluation|
|20)||A hospitalized client has several medications scheduled for 0900. The nurse prepares to administer||20)|
|the medications to the client. Which of the following is true regarding the administration of|
- A hospitalized client cannot refuse medications.
- The nurse needs to assess vital signs, laboratory tests, and physical findings to determine whether administration of medication is appropriate at this time.
- The nurse must always give all scheduled medications.
- Physical assessment does not need to be done prior to medication administration.
|21)||When applied to pharmacology, the implementation phase involves which of the following? Select||21)|
|all that apply.|
|A) Evaluation of goals||B) Provide client teaching.|
|C) Documentation||D) Administration of the drug|
|22)||The ________ phase compares the clientʹs current health status with desired outcomes to||22)|
|determine whether the plan of care is appropriate or needs revision.|
|A) Evaluation||B) Planning|
|C) Assessment||D) Implementation|
|23)||Following the evaluation phase of the nursing process, a lack of medication response could be||23)|
- All medications produce appropriate response.
- Lack of change in clientʹs health condition.
- Adherence to drug regimen.
- Non-adherence to drug regimen.
|24) Many clients take OTC supplements on a daily basis. Which of the following is not true of OTC||24)|
- A) OTC supplements can cancel the effects of a medication.
- B) OTC supplements have no effect on prescription medications.
- C) OTC supplements can never be taken with prescription medications.
- D) OTC supplements can increase the effects of a medication.
|25) The best way to prevent adverse drug effects is:||25)|
- Through assessment.
- Through thorough assessment and medication history.
- To check vital signs prior to administering medication
- Through medication history.
|1)||The client asks if ʺnaturalʺ products are superior to prescription medication. The best response by||1)|
|the nurse is:|
|A) ʺInteractions are rare when mixing natural and prescribed medications.ʺ|
|B) ʺNatural products are not as potent as approved medications.ʺ|
|C) ʺYes, since the product is based in nature.ʺ|
|D) ʺNatural does not always mean better or safe.ʺ|
|2)||The nurse understands that CAM therapies have common characteristics, such as which of the||2)|
|following? Select all that apply.|
|A) Focusing on treatment of the person as an individual|
|B) Recognizing the role of spirituality in health and healing|
|C) Promotion of disease prevention, self-care, and self-healing|
|D) Consideration of the specific system involved|
|3)||The nurse advises the menopausal client that which of the following herbal products might help||3)|
|alleviate her symptoms?|
|A) Black cohosh||B) Valerian|
|C) Ginger||D) Cranberry tablets|
|4)||Which of the following is not a characteristic of complementary and alternative medicine (CAM)?||4)|
|A) Promote disease prevention, self-care, and self-healing.|
|B) Consider the health of the whole person.|
|C) Focus on treating each individual person.|
|D) Replace all traditional medication.|
|5)||CAM includes biological therapies and alternate health care systems. Which of the following is an||5)|
|example of an alternate health care system?|
|A) Special diets||B) Naturopathy|
|C) Nutritional supplements||D) Herbal therapies|
|6)||A client ask the nurse about the benefits of yoga and meditation. The nurse understands yoga and||6)|
|meditation both to be the ________ type of CAM.|
|A) Manual healing||B) Alternate health care systems|
|C) Biological therapies||D) Mind—body intervention|
|7)||A client tells the nurse she takes garlic on a daily basis. The nurse knows the effect of garlic on the||7)|
|body is to:|
- A) Work as an antitoxin.
- B) Decrease cholesterol and blood pressure.
- C) Decrease stomach upset and motion sickness.
- D) Enhance sexual function.
|8) Although used for many years by various cultures, the effectiveness (or non-effectiveness) of||8)|
complementary and alternative medicine (CAM) therapies has only recently been of interest. The nurse educates her client that this has been mainly due to the fact that:
- The popularity of these therapies has only been recent.
- The Food and Drug Administration has not been supportive of this type of therapy.
- Practitioners have not been suggesting them as treatments to their clients.
- Few have been subjected to rigorous clinical and scientific study.
|9) The nurse explains to her client, when questioned about use of herbal therapies, that use has||9)|
|increased over time because:|
|A) Natural herb products can be standardized and produced more cheaply.|
|B) Medical schools are including this information as part of the curriculum|
|C) Of renewed interest in preventive medicine.|
|D) Of controls by regulatory agencies.|
|10) The nurse understands the increase in popularity of herbal products has occurred recently. Which||10)|
|of the following is not a reason for this increase?|
|A) Herbal products are readily available.|
|B) Renewed interest in preventative medicine|
|C) Aggressive marketing by the herbal industry|
|D) Lack of side effects from herbal products|
|11) The nurse explains that the liquid form of an herbal product might not be the same as a solid form,||11)|
|A) Liquid forms are concentrated in solvents at various strengths.|
|B) Liquid products may be administered as salves and ointments.|
|C) Solid products include parts of the plant.|
|D) Liquid forms do not contain active chemicals from the plant.|
|12) A client asks the nurse what a botanical or herb is. The nurse replies:||12)|
|A) ʺAny plant product with useful application.ʺ|
|B) ʺAny plant that is used to supplement diet only.ʺ|
|C) ʺAny plant product that does not cause a skin reaction.ʺ|
|D) ʺAny plant that can be made into a tea.ʺ|
|13) Liquid and herbal products are made by extracting the active chemicals using a solvent. Which of||13)|
|the following is not used for this purpose?|
|A) Glycerol||B) Alcohol||C) Sucrose||D) Water|
|14) The nurse understands that solid herbal products include which of the following? Select all that||14)|
|A) Tablets||C) Tea||D) Salves|
|15) When asked if there are any regulatory controls on herbal or dietary supplements, the nurse||15)|
|responds to the client by informing him that dietary supplements are regulated by the:|
- Joint Commission on the Accreditation of Healthcare Organizations (JCAHO).
- Dietary Supplement Health and Education Act (DSHEA).
- Food, Drug, and Cosmetic Act.
- Department of Health and Human Services (HHS).
|16)||The nurse explains that in regard to regulation by the Dietary Supplement Health and Education||16)|
|Act, dietary supplements:|
|A) Do not have to demonstrate effectiveness.|
|B) Are tested prior to marketing.|
|C) Are determined to be safe before being placed on the market.|
|D) Are checked for label accuracy.|
|17)||Which of the following is not a weakness of the Dietary Supplement Health and Education Act||17)|
|A) The accuracy of the label is not regulated.|
|B) Dietary supplements do not need to be tested prior to marketing.|
|C) The manufacturer does not need to prove the safety of the supplement.|
|D) The FDA can remove products from the market if they pose a significant risk.|
|18)||A client asks the nurse to explain what a dietary supplement is, and how these supplements are||18)|
|regulated. Which of the following should the nurse tell the client? Select all that apply.|
- ʺDietary supplements are products to enhance the diet that are not approved as drugs.ʺ
- ʺDietary supplements are exempted from The Food, Drug, and Cosmetic Act.ʺ
- ʺDietary supplements are only vitamins and minerals.ʺ
- ʺThe FDA can remove products from the market if they pose an unreasonable risk to the public.ʺ
|19)||When beginning herbal products, the nurse understands that the best way to identify allergic or||19)|
|other adverse reactions is to have the client:|
|A) Check with a reputable pharmacist.|
|B) Never take them with prescription medications.|
|C) Use only one herbal product at a time.|
|D) Take less than the recommended dose initially.|
|20)||Which of the following statements is incorrect regarding herbal therapy?||20)|
|A) Natural does not always mean better or safe.|
|B) Herbs can interact with prescription medication.|
|C) Herbs cause no significant side effects.|
|D) Not all natural substances are therapeutic.|
|21)||The nurse is explaining to a client why it is important to discuss all herbal medications with the||21)|
|physician. The nurse knows the potential for drug interaction increases in which of the following|
|client populations? Select all that apply.|
|A) Elderly||B) Pregnant women|
|C) Clients with hepatic impairment||D) Clients with renal impairment|
|22)||One reason it is difficult for a client to be sure the herbal product purchased at the store is made in||22)|
|the same strength if the client purchases a different brand is because:|
- All herbs are collected under the same conditions.
- Only one active ingredient is in each herb.
- Multiple active ingredients are present in herbs.
- All herbal products contain the same amount of active ingredients.
|23)||The nurse responds to the clientʹs questions about CAM therapies, and explains that some have||23)|
|been popular for centuries in treating conditions of the body and mind, including which of the|
|following? Select all that apply.|
|A) Ointments with steroid base||B) Massage|
|C) OTC medications||D) Meditation|
|24)||The client asks the nurse which supplement can be used to treat arthritis and joint pain. The nurse||24)|
|knows the supplement is:|
|A) Coenzyme Q10.||B) Selenium.|
|C) Fish oil.||D) Glucosamine and chondroitin.|
|25)||________ supplements are non -herbal products that are widely used to promote wellness.||25)|
|A) Tea||B) Herbal extract|
|C) Traditional drug||D) Specialty|
|1) The nurse knows one way to decrease the chance of addiction to a prescription drug is to take the:||1)|
- A) Highest dose possible for the shortest time necessary.
- B) Highest dose possible for the longest time necessary.
- C) Lowest effective dose for the longest time necessary.
- D) Lowest effective dose for the shortest time necessary.
|2) Addiction can be caused by:||2)|
- Only prescription drugs
- Only illegal drugs.
- Any medication to treat pain.
- A need for prescription pain medications.
|3)||The progressive and chronic abuse of a substance caused by an overwhelming feeling that drives||3)|
|someone to use a drug repeatedly despite serious consequences is known as:|
|A) Psychological dependence.||B) Addiction.|
|C) Withdrawal.||D) Physical dependence.|
|4)||________ dependence causes no apparent signs of physical discomfort after the agent is stopped,||4)|
|whereas ________ dependence causes uncomfortable symptoms when the drug is stopped.|
|A) Psychological; physical||B) Substance; physical|
|C) Physical; psychological||D) Psychological; substance|
|5)||A client plans to enter a treatment facility for alcohol abuse. The client asks the nurse if there are||5)|
|medications that can decrease the severity of withdrawal symptoms. The nurse knows which of|
|the following drugs is used for this purpose?|
|A) Bupropion (Wellbutrin)||B) Methadone (Dolphine)|
|C) Marijuana||D) Diazepam (Valium)|
|6)||A client asks the nurse why withdrawal syndrome occurs when some drugs are stopped. The best||6)|
|response by the nurse would be:|
- ʺOver time, the bodyʹs cells are tricked into believing it is normal for that substance to always be present, and when it is no longer present, the body experiences withdrawal syndrome.ʺ
- ʺA substance must be abused for at least a year to cause withdrawal syndrome.ʺ
- ʺOnly illegal substances cause withdrawal syndrome.ʺ
- ʺThis is a misconception. All abused substances cause withdrawal syndrome.ʺ
|7) ________ is a biological condition that occurs when the body adapts to a substance after it is||7)|
|repeatedly administered, and a higher dose is needed to achieve the initial response.|
|A) Tolerance||B) Addiction|
|C) Cross-tolerance||D) Dependence|
|8) A designer drug is:||8)|
- Made from a naturally occurring substance.
- Created in an illegal laboratory solely for illegal drug trafficking
- Less addictive than prescription medications.
|9) A client asks the nurse what the two most commonly abused drugs are. The nurse replies:||9)|
|A) ʺLSD and marijuana.ʺ||B) ʺAlcohol and marijuana.ʺ|
|C) ʺMarijuana and nicotine.ʺ||D) ʺAlcohol and nicotine.ʺ|
|10)||Drugs that were once used therapeutically and are now illegal because of a high potential for||10)|
|abuse include which of the following? Select all that apply.|
|A) Barbiturates||B) LSD||C) Opioids||D) Cocaine|
|11)||A client is admitted for alcohol intoxication. The nurse knows the symptoms of alcohol withdrawal||11)|
- Tremors, fatigue, anxiety, abdominal cramping, hallucinations, confusion, seizures, and delirium.
- Rarely observed.
- Mental depression, anxiety, extreme fatigue, and hunger.
- Excessive sweating, restlessness, dilated pupils, agitation, goose bumps, tremor, decreased heart rate and blood pressure, nausea and vomiting, and abdominal cramps.
|12)||A client states that the physician prescribed a tranquilizer for a sleep disorder. The nurse knows||12)|
|that another name for tranquilizers is:|
|A) Hallucinogens.||B) Cannabinoids.||C) Sedatives.||D) Alcohol.|
|13)||Barbiturates cause which of the following when used for long periods of time at high doses? Select||13)|
|all that apply.|
|A) Tolerance||B) Tremors|
|C) Physical dependence||D) Psychological dependence|
|14)||A client arrives in the Emergency Department with a barbiturate overdose. The nurse knows that||14)|
|which of the following are possible? Select all that apply.|
|A) Coma||B) Increased respirations|
|C) Death||D) Decreased respirations|
|15)||A client arrives in the Emergency Department with an overdose from benzodiazepines. The nurse||15)|
|knows death is very likely if the client:|
- Combined benzodiazepines with a CNS stimulant.
- Has never taken a benzodiazepine before.
- Has taken a benzodiazepine with a CNS depressant.
- Took a high dose of benzodiazepines.
|16) A client is receiving treatment for opioid addiction. The nurse expects which medication to be||16)|
|prescribed to help treat this addiction?|
|A) Methadone (Dolphine)||B) Fentanyl (Druagesic)|
|C) Hydromorphone (Dilaudid)||D) Propoxyphene (Darvon)|
|17) Effects of alcohol overdose include:||17)|
- Nausea, severe hypotension, and increased respirations.
- Vomiting, severe hypotension, respiratory failure, coma, and death.
- Severe hypertension, stroke, coma, and death.
- Vomiting, severe hypertension, respiratory failure, coma, and death.
|18)||Which of the following statements made by a client who smokes marijuana is not true?||18)|
|A) ʺMarijuana makes me hungry.ʺ|
|B) ʺMarijuana makes me thirsty.ʺ|
|C) ʺMarijuana does not increase the risk for lung cancer.ʺ|
|D) ʺMarijuana makes me paranoid.ʺ|
|19)||A client presents in the Emergency Department with hallucinations, anxiety, and confusion. The||19)|
|client denies taking any illegal drugs in the past 48 hours. The nurse knows these symptoms can|
|occur as flashbacks from which type of drug?|
|A) Cannabinoids||B) Hallucinogens||C) Barbiturates||D) Opioids|
|20)||A client reports restlessness, nervousness, irritability, and insomnia. The client denies caffeine||20)|
|intake, but has been taking an OTC pain reliever for a headache. The nurse explains that:|
- These symptoms are normal side effects of OTC pain relievers.
- Caffeine is added to some OTC pain relievers.
- These symptoms indicate that the client is allergic to the OTC pain reliever.
- These symptoms are normal side effects of a headache.
|21)||The nurse explains to the client why she should not smoke while taking oral contraceptives. Which||21)|
|of the following statements by the client shows understanding?|
|A) ʺI should stop smoking if I get pregnant.ʺ|
|B) ʺSmoking increases the risk of cardiovascular problems.ʺ|
|C) ʺI can only smoke half a pack per day.ʺ|
|D) ʺThere is no problem with smoking.ʺ|
|22)||The client exhibits symptoms of dilated pupils, sweating, and tremors. Nursing assessment will||22)|
|most likely indicate that the client has ingested what category of drug?|
|A) CNS depressant||B) Opioid|
|C) Alcohol||D) CNS stimulant|
|23)||The client has chronic alcoholism. Which lab test is most important for the nurse to evaluate?||23)|
|A) Stool for occult blood||B) Liver function test|
|C) Complete blood count||D) White blood count|
|24)||The client receives disulfiram (Antabuse) and asks the nurse what will happen if alcohol is||24)|
|consumed while taking this drug. What is the best response by the nurse?|
- ʺThere is a good chance you will become very euphoric.ʺ
- ʺHeadache and nausea or vomiting are the most common effects.ʺ
- ʺMost people experience severe depression and suicidal thoughts.ʺ
- ʺIt really depends on how much alcohol you drink.ʺ
|25) The client will be receiving disulfiram (Antabuse) for 3 months. What is priority teaching at the||25)|
time of discharge?
- A) ʺIt is very important to take this drug with food.ʺ
- B) ʺDo not drink any alcohol for 2 weeks after you stop this drug.ʺ
- C) ʺIt is very important to take this drug on an empty stomach.ʺ
- D) ʺDo not operate heavy machinery while taking this drug.ʺ
|1)||The nervous system consists of which two divisions? Select all that apply.||1)|
|A) Central nervous system||B) Peripheral nervous system|
|C) Sympathetic nervous system||D) Autonomic nervous system|
|2)||The autonomic nervous system consists of which two subsystems? Select all that apply.||2)|
|A) Sympathetic nervous system||B) Peripheral nervous system|
|C) Somatic nervous system||D) Parasympathetic nervous system|
|3)||The somatic nervous system consists of nerves that:||3)|
- Provide involuntary control of glands.
- Provide involuntary control over cardiac muscles.
- Provide voluntary control of skeletal muscles.
- Provide involuntary control over smooth muscles.
|4)||Flight-or-flight is part of the ________ nervous system.||4)|
|A) Somatic||B) Sympathetic|
|C) Peripheral||D) Parasympathetic|
|5)||Chemicals called ________ allow nerve impulses to cross the synaptic cleft.||5)|
|A) Neurons||B) Neurotransmitters|
|C) Autonomic drugs||D) Presynaptic neurons|
|6)||Two subtypes of norepinephrine receptors are which of the following? Select all that apply.||6)|
|A) Alpha||B) Beta||C) Epsilon||D) Delta|
|7)||A client has been diagnosed with myasthenia gravis, and is experiencing severe muscle weakness.||7)|
|The nurse recognizes that myasthenia gravis is an autoimmune disorder characterized by the|
- Norepinephrine (adrenergic) receptors found in smooth muscle.
- Muscarinic (cholinergic) receptors found in smooth muscle.
- Norepinephrine (adrenergic) receptors found in skeletal muscle.
- Nicotinic (cholinergic) receptors found in skeletal muscles
|8)||A client with asthma is using ipratropium (Atrovent). The nurse advises the client to:||8)|
|A) Decrease fluid intake.||B) Limit outside activity.|
|C) Increase outside activity.||D) Monitor serum glucose.|
|9)||When teaching a client about beta blockers, the nurse informs the client that abrupt||9)|
|discontinuation can result in:|
|A) Dizziness and coma.||B) Chest pain and rebound hypertension|
|C) Dry mouth and painful urination.||D) Cramping and constipation.|
|10)||A client with benign prostatic hypertrophy (BPH) is started on the alpha blocker, alfuzosin||10)|
|(Uroxatral). The nurse knows it is important to inform the client of which possible side effect?|
|A) Constipation||B) Dental caries||C) Impotence||D) Diaphoresis|
|11)||During discharge education, a nurse tells her client prescribed an adrenergic blocker to notify a||11)|
|health care provider before taking over-the-counter cold, cough, or sinus medication. Which of the|
|following conditions would you suspect this client to have?|
|A) Gastritis||B) Hypertension||C) Seizures||D) Severe cold|
|12)||The nurse knows some sympathomimetic drugs stimulate which type of receptors that makes||12)|
|these drugs useful in treating asthma?|
|A) Beta 2||B) Alpha 2||C) Beta 1||D) Alpha 1|
|13)||The client asks the nurse which of the following medications is a beta-adrenergic blocker?||13)|
|A) Atenolol (Tenormin)||B) Terazosin (Hytrin)|
|C) Prazosin (Minipress)||D) Doxazosin (Cardura)|
|14)||A client has been prescribed a beta blocker. The nurse knows this medication is most often used to||14)|
|A) Hypertension.||B) Increased intraocular pressure.|
|C) Urinary retention.||D) Hypotension.|
|15)||The nurse is caring for a client with chronic nasal congestion. The client is being treated with||15)|
|phenylephrine (Neo-Synephrine). What are some possible nursing diagnoses for this client? Select|
|all that apply.|
- Knowledge deficit, related to drug therapy
- Ineffective breathing pattern
- Urinary retention
|16)||Stimulation of the sympathetic nervous system is caused by which type(s) of drug? Select all that||16)|
|A) Adrenergic agents||B) Sympathomimetics|
|C) Cholinergic agents||D) Parasympathomimetics|
|17)||A client with chronic sinusitis complains of heart palpitations and nervousness following the use o||17)|
|Afrin (pseudoephedrine) nasal spray. The nurse recognizes that this is a common side effect of:|
|A) Adrenergic blockers.||B) Sympathomimetics.|
|C) Histamines.||D) Parasympathomimetics.|
|18)||Stimulation of the parasympathetic nervous system is caused by which type(s) of drug? Select all||18)|
|A) Cholinergic agents||B) Parasympathomimetics|
|C) Adrenergic agents||D) Sympathomimetics|
|19)||While providing comfort to a client on anticholinergics, the nurse knows to avoid||19)|
|A) Oral rinses.||B) Frequent oral hygiene.|
|C) Hard candy.||D) Alcohol-containing mouthwash.|
|20)||Inhibition of the sympathetic nervous system is caused by which type(s) of drug? Select all that||20)|
|apply||B) Cholinergic agents|
|A) Adrenergic blockers|
|C) Sympathomimetics||D) Parasympathomimetics|
|21)||Inhibition of the parasympathetic nervous system is caused by which type(s) of drug? Select all||21)|
|A) Cholinergic blockers||B) Sympathomimetics|
|C) Parasympathomimetics||D) Anticholinergics|
|22)||Bethanechol (Urecholine) has been prescribed for a client, who asks the nurse what the side effects||22)|
|of this drug are. Select all side effects related to this drug.|
|A) Abdominal cramping||B) Hypertension|
|C) Increased salivation||D) Hypotension|
|23)||The physician states that an anticholinergic drug has been prescribed for a client. The nurse||23)|
|anticipates which of the following to be ordered?|
|A) Ipratropium (Atrovent)||B) Pyridostigmine (Mestinon)|
|C) Bethanechol (Urecholine)||D) Neostigmine (Prostigmin)|
|24)||Side effects that limit the usefulness of anticholinergics include which of the following? Select al||24)|
|A) Hypotension||B) Urinary retention|
|C) Tachycardia||D) Increased salivation|
|25)||Following a chemical explosion, a client presents to the Emergency Department with muscle||25)|
|twitching, loss of bowel and bladder control, and confusion. The nurse recognizes that the client|
|has been in contact with a nerve agent, and knows to give:|
|A) Pridostigmine (Mestinon).||B) Ethosuximide (Zarontin).|
|C) Atropine (Atropine).||D) Ritodrine (Yutopar).|
|1)||A client complains of restlessness, fatigue, nervousness, and sleep disturbances. The nurse knows||1)|
|these are symptoms of:|
|A) Panic disorder.||B) Generalized anxiety disorder.|
|C) Obsessive compulsive disorder.||D) Post-traumatic stress disorder.|
|2)||A client has returned from combat, and is re-experiencing combat in dreams. She feels helpless||2)|
|and anxious. The nurse knows ________ causes these symptoms.|
|A) Generalized anxiety disorder.||B) Post-traumatic stress disorder.|
|C) Obsessive compulsive disorder.||D) Panic disorder.|
|3)||The most productive way to treat anxiety disorders is to:||3)|
- Allow the client to self-medicate with OTC medications.
- Immediately start multiple-drug therapy.
- Uncover and address the cause of anxiety.
- Provide the client with a powerful medication.
|4)||Which of the following instructions should the nurse provide to the client prescribed a||4)|
|benzodiazepine? Select all that apply.|
|A) Report significant mood changes.|
|B) Avoid alcoholic beverages.|
|C) If a dose is missed, the client should take a double dose as soon as possible.|
|D) Avoid OTC medications used to induce sleep.|
|5)||The risk for physical and psychological dependence is high from which of the following classes of||5)|
|medications, which are rarely used to treat insomnia or anxiety?|
|A) Benzodiazepines||B) Barbiturates|
|C) MAOIs||D) SSRIs|
|6)||A benzodiazepine has been prescribed for a client with short-term insomnia. Which of the||6)|
|following benzodiazepines is appropriate to treat insomnia?|
|A) Chlordiazepoxide (Librium)||B) Temazepam (Restoril)|
|C) Diazepam (Valium)||D) Clonazepam (Klonopin)|
|7)||A client is being treated for an anxiety disorder. Which of the following type(s) of medications are||7)|
|used to treat anxiety disorders? Select all that apply.|
|A) Benzodiazepines||B) Barbiturates|
|C) Alpha blockers||D) Beta blockers|
|8)||The client asks the nurse why a tricyclic antidepressant has not been prescribed for depression.||8)|
|The best response by the nurse would be:|
- ʺTricyclic antidepressants cause weight gain.ʺ
- ʺTricyclic antidepressants are not recommended for a client with a history of heart attack.ʺ
- ʺTricyclic antidepressants cause sexual dysfunction.ʺ
- ʺTricyclic antidepressants have many side effects, including orthostatic hypotension, headache, and diarrhea.ʺ
|9) The physician ordered a MAOI for a client with depression. The nurse expects which of the||9)|
|following to be ordered?|
|A) Tranylcypromine (Parnate)||B) Fluoxetine (Prozac)|
|C) Citalopram (Celexa)||D) Amitriptyline (Elavil)|
|10)||A client taking a MAOI should be instructed to avoid:||10)|
|A) Large amounts of water.|
|B) Foods that contain tyramine and caffeine.|
|C) A diet that is high in fat.|
|D) A diet that is high in salt.|
|11)||A female client has been prescribed a tricyclic antidepressant, and should be instructed that most||11)|
|are pregnancy categories:|
|A) A and B.||B) C and D.||C) B and C.||D) A and D.|
|12)||A client has been taking a SNRI, and complains of confusion, anxiety, tremors, and sweating. The||12)|
|nurse understands that these symptoms:|
- Indicate too high a dose has been given.
- Will diminish with continued use of the medication.
- Indicate too low a dose has been given.
- Are normal with SNRIs.
|13)||A teenage client is taking duloxetine (Cymbalta) for a generalized anxiety disorder. The dose has||13)|
|been changed by the physician. The nurse advises the client and the family to watch for:|
|A) Fatigue.||B) Irritability.|
|C) Weight gain.||D) Warning signs of suicide.|
|14)||A nurse is caring for a client who reports frequent insomnia. Possible causes of insomnia include:||14)|
|(Select all that apply.)|
|A) Stress.||B) Quite sleeping area.|
|C) Darkened room.||D) Caffeine.|
|15)||A client has abruptly stopped taking a CNS depressant, and is experiencing withdrawal||15)|
|symptoms. Which of the following symptoms should the nurse expect to see?|
- Hypothermia, psychosis, seizures, decreased heart rate, increased blood pressure, and panic anxiety
- Fever, euphoria, headache, increased heart rate, and fatigue
- Fever, psychosis, seizures, increased heart rate, decreased blood pressure, panic, and anxiety
- Euphoria, fever, tremor, relaxation, and coma
|16)||It is important for the nurse to teach a client to avoid ________ when taking barbiturates.||16)|
|A) Alcohol||B) Bananas||C) Caffeine||D) Nicotine|
|17)||An elderly client receives temazepam (Restoril) for sleep. Which assessment data is indicative of a||17)|
|potentially serious complication?|
- The client sleeps for 1 hour longer than usual.
- The client becomes agitated.
- The client reports a decrease in appetite
- The client reports a dry mouth.
|18)||The client will be receiving amitriptyline (Elavil), a tricyclic antidepressant, for chronic anxiety||18)|
|Which nursing assessment is a priority for this client?|
|A) History of diabetes mellitus||B) History of ulcers|
|C) History of heart disease||D) History of alcoholism|
|19)||The nurse instructs the client that buspirone (BuSpar) has which of the following common side||19)|
|A) Decreased heart rate and blood pressure||B) Nausea and vomiting|
|C) Cognitive impairment||D) Dizziness, headache, and drowsiness|
|20)||The client receives buspirone (BuSpar) for chronic anxiety. At time of discharge, what is a priority||20)|
|for the nurse to teach this client about the medication?|
- ʺThis drug must be taken on an empty stomach.ʺ
- ʺYou can only take this for a few weeks, as dependence is very high with this drug.ʺ
- ʺTherapeutic blood levels are required with this drug.ʺ
- ʺIt will take a few weeks before you feel a reduction in anxiety.ʺ
|21) The client has been taking clonazepam (Klonopin) for chronic anxiety for three years. The client||21)|
tells the nurse he wants to stop the medication. What is the best response by the nurse?
- A) ʺI donʹt think it is a good idea to stop your medication.ʺ
- B) ʺThere are not any serious complications to stopping this drug.ʺ
- C) ʺMedications for anxiety must be taken for the rest of your life.ʺ
- D) ʺYou will need to gradually decrease your dose before stopping.ʺ
22) The client receives temazepam (Restoril) at bedtime for sleep. The client tells the nurse that he also 22) has a glass of wine before bed to help him sleep. What is the nurseʹs best response?
- ʺCombining wine with your medication will decrease the effectiveness of your medication.ʺ
- ʺOne glass of wine is okay, but be sure not to have more than that.ʺ
- ʺCombining wine with your medication can sedate you and cause breathing problems.ʺ
- ʺThis is okay as long as you have a high-fat meal with your wine.ʺ
|23)||The client receives zaleplon (Sonata) for sleep. What is the priority teaching by the nurse at time of||23)|
|A) ʺAvoid taking OTC sleep-inducing antihistamines.ʺ|
|B) ʺDrinking a cup of tea with this drug will promote relaxation.ʺ|
|C) ʺIt will take about a week for this drug to be effective.ʺ|
|D) ʺThis drug can be taken indefinitely.ʺ|
|24)||The client receives lorazepam (Ativan) for chronic anxiety. The nurse determines that medication||24)|
|education has been most effective when the client makes which statement?|
|A) ʺI will probably always need this medication for my anxiety.ʺ|
|B) ʺThis medication will help me relax so I can focus on problem solving.ʺ|
|C) ʺMy anxiety will be eliminated when I take this medication.ʺ|
|D) ʺThis medication is not addictive.ʺ|
|25)||The nurse explains that zolpidem (Ambien) begins to work:||25)|
|A) Rapidly, and should be taken just before bedtime.|
- B) Four hours after dosing.
- C) Sixty minutes after dosing.
- D) Two hours after dosing.
|26) A client has been prescribed a medication to help him fall asleep but wake early. Which of the||26)|
|following drugs would the nurse expect to find ordered for this client?|
|A) Eszopiclone (Lunesta)||B) Zaleplon (Sonata)|
|C) Remelton (Rozerum)||D) Diphenhydramine (Nytol)|
|1)||The nurse is caring for a client with depression. The nurse recognizes which of the following to be||1)|
|symptoms of depression? Select all that apply.|
|A) Lack of energy||B) Increased energy|
|C) Feelings of despair||D) Sleep disturbances|
|2)||The nurse is caring for a client diagnosed with bipolar disorder exhibiting the following symptoms||2)|
|insomnia, exaggerated confidence, attention seeking, and is easily agitated. The nurse knows these|
|symptoms are signs of:|
|A) Mania.||B) Depression.|
|C) Overdose of barbiturates.||D) Side effects of lithium (Eskalith).|
|3)||The clients asks the nurse what causes depression. The best answer by the nurse is:||3)|
- ʺMost people are not really depressed. They are just looking for attention.ʺ
- ʺMost people who are depressed suffer from seasonal affective disorder.ʺ
- ʺThere are many causes, including genetics, hormone changes, grief, substance abuse, and prescription drugs.ʺ
- ʺThe main cause of depression is substance abuse.ʺ
|4)||A client is being treated for reoccurring severe depressive illness. The nurse expects the client to||4)|
|receive which type of treatment?||B) Grief counseling|
|A) Medication only|
|C) Medication and psychotherapy||D) Psychotherapy only|
|5)||The physician has ordered a tricyclic antidepressant for a client with biological depression. The||5)|
|nurse expects to find which of the following medications to be ordered for the client?|
|A) Fluoxetine (Prozac)||B) Duloxetine (Cymbalta)|
|C) Amitriptyline (Elavil)||D) Citalopram (Celexa)|
|6)||The nurse is performing an assessment on a client who has been taking a tricyclic antidepressant||6)|
|for several weeks. The nurse knows the most common adverse effect of tricyclic antidepressants is:|
|A) Orthostatic hypotension.||B) Bradycardia.|
|C) Sedation.||D) Dry mouth.|
|7)||The nurse explains to a client that ________ have become the drugs of choice in treating||7)|
|A) SNRIs||B) MAOIs||C) TCAs||D) SSRIs|
|8)||The nurse should instruct the client taking SSRIs:||8)|
- That depression should improve immediately.
- That there are few side effects of SSRIs.
- To take the medication at bedtime.
- That full therapeutic effect takes one month.
|9) The nurse instructs the client prescribed a SSRI to: (Select all that apply.)||9)|
|A) Drink adequate amounts of fluid.||B) Restrict fluid intake.|
|C) Avoid laxatives and stool softeners.||D) Add dietary fiber.|
|10) A child diagnosed with ADHD would most likely exhibit which of the following symptoms? Select||10)|
|all that apply.|
- Excessive talking
- Easily distracted
- Able to focus on a task for an extended period of time
|11)||The client receives amitriptyline (Elavil). What is a priority for the nurse to teach this client at||11)|
|A) Begin a low-carbohydrate diet.|
|B) Do not rapidly stand up or change positions.|
|C) Do not take aspirin with this drug.|
|D) Avoid green, leafy vegetables.|
|12)||The client receives paroxetine (Paxil), and tells the nurse that sexual dysfunction has become a||12)|
|problem. What is the best response by the nurse?|
|A) ʺYour depression is of primary concern right now.ʺ|
|B) ʺYou should stop the medication right away.ʺ|
|C) ʺThis side effect usually subsides in a few months.ʺ|
|D) ʺThis is common. Please discuss it with your physician.ʺ|
|13)||The client receives sertraline (Zoloft) and lithium. Which assessment data are most indicative of a||13)|
|potentially serious complication?|
|A) Fever and lack of muscular coordination||B) Nausea and headache|
|C) Anxiety and insomnia||D) Dry mouth and constipation|
|14)||The client receives phenelzine (Parnate). Which dietary components would indicate the best||14)|
|planning by the nurse and client? Select all that apply.|
|A) Tomato soup||B) Grilled chicken breast|
|C) Bologna sandwich||D) Avocado salad|
|15)||The nurse evaluates a client taking a high daily dose of duloxetine (Cymbalta) for which of the||15)|
|following signs and symptoms? Select all that apply.|
|A) Increased libido||B) Suicidal ideation|
|C) Liver failure||D) Seizures|
|16)||A client has just begun therapy with lithium (Eskalith). The nurse notices the serum level of lithium||16)|
|for this client is 1.3 m/Eq/L. The nurse knows the normal range is:|
|A) 1.5—3.0 m/Eq/L.||B) 0.6—1.5 m/Eq/L.|
|C) 3.0—4.5 m/Eq/L.||D) 0.1—0.6 m/Eq/L.|
|17)||A client receiving lithium (Eskalith) for bipolar disorder would be at risk for increased lithium||17)|
|toxicity if it were prescribed with:|
|A) Potassium citrate.|
|C) There are no drug interactions with lithium (Eskalith).|
|D) Sodium bicarbonate.|
|18)||A client is taking Saint Johnʹs wort and an SSRI. The nurse observes the client for which of the||18)|
|following symptoms? Select all that apply.|
|A) Confusion||B) Hypotension||C) Mania||D) Renal failure|
|19)||The nurse is caring for a client who has not responded to several antidepressant drugs. The nurse||19)|
|expects the physician to order which of the following classifications of medication for this client?|
|A) MAOI||B) TCA||C) SNRI||D) SSRI|
|20)||The nurse instructs the client receiving MAOIs to avoid:||20)|
|A) All dairy products.||B) Foods containing tyramine.|
|C) All physical activity.||D) Calcium channel blockers.|
|21)||A child has been ordered the most commonly prescribed medication for ADHD. The nurse expects||21)|
|________ to be prescribed for this client.|
|A) Pemoline (Cylert)||B) Methamphetamide (Desoxyn)|
|C) Methylphenidate (Ritalin)||D) Clonidine (Catapres)|
|22)||The client is in a manic phase of bipolar disorder, and is receiving lithium. What will the nurse||22)|
|expect to assess when the clientʹs lithium level is 0.3 m/Eq/L?|
|A) Vomiting and diarrhea||B) Hyperactivity|
|C) Calm behavior||D) Sedation|
|23)||The mother of an 8-year-old client who is receiving methylphenidate (Ritalin) tells the nurse that||23)|
|her child has not slept well since being started on this drug. Which assessment data question is a|
|priority for this client?|
- ʺIs you child having problems at school?ʺ
- ʺDoes your child have sleep apnea?ʺ
- ʺDo you give the medication with food?ʺ
- ʺWhat time do you give your child the medication?ʺ
|24) Which statement is priority teaching at the time of discharge for the client who receives||24)|
- ʺYou can stop the medication when you are no longer feeling depressed.ʺ
- ʺPlease notify your health care provider of any changes in urine quantity or quality.ʺ
- ʺYou must maintain a normal intake of salt while on this medication.ʺ
- ʺYou will need to maintain a low-fat diet while on this medication.ʺ
|25) The client is receiving phenelzine (Parnate). She comes to the clinic and tells the nurse that she||25)|
consumed two glasses of Chianti wine at lunchtime. What is the nurseʹs priority action?
- A) Discuss how wine can increase the symptoms of depression.
- B) Arrange for admittance to the psychiatric unit.
- C) Discuss the effects of wine on the action of antidepressants.
- D) Assess the clientʹs blood pressure.
|26) The nurse has been doing medication education for the client receiving lithium (Eskalith). Which||26)|
statement by the client indicates that teaching has been effective?
- A) ʺI can stop taking my lithium when my moods are stable.ʺ
- B) ʺI need to call my physician if I get sick with vomiting and diarrhea.ʺ C) ʺI need to restrict my intake of salt while I am taking lithium.ʺ
- D) ʺI donʹt need to have by blood checked anymore after I leave the hospital.ʺ
|1)||The nurse is caring for a client with delusions, hallucinations, paranoia, disorganized behavior, and||1)|
|difficulty relating to others. The nurse understands these are symptoms of:|
|A) Depression.||B) Psychosis.|
|C) Bipolar disorder.||D) ADHD.|
|2)||The nurse is caring for a client with psychotic-like symptoms. The nurse explains to the family:||2)|
- Psychosis-like symptoms can be caused by a brain tumor, infection, cocaine use, and schizophrenia.
- The only causes for psychosis are schizophrenia and schizoaffective disorder.
- Psychotic symptoms are only seen in clients with schizoaffective disorder.
- Psychotic symptoms are only seen in clients with schizophrenia.
|3)||A schizophrenic client is being assessed by the nurse. The client is demonstrating positive||3)|
|symptoms. Which of the following would be considered positive symptoms? Select all that apply.|
|A) Hallucinations||B) Lack of responsiveness.|
|C) Disorganized thoughts or speech||D) Lack of interest|
|4)||A schizophrenic client is being assessed by the nurse. The client is demonstrating negative||4)|
|symptoms. Which of the following would be considered negative symptoms? Select all that apply.|
|A) Lack of responsiveness||B) Disorganized thoughts or speech|
|C) Hallucinations||D) Lack of interest|
|5)||Positive symptoms of schizophrenia are most effectively controlled by which of the following||5)|
|medications? Select all that apply.|
|A) Citlopram (Celexa)||B) Chlorpromazine (Thorazine)|
|C) Perphenazine (Phenazine)||D) Clonidine (Catapres)|
|6)||A client with schizophrenia exhibits positive and negative symptoms. The nurse anticipates which||6)|
|drug to be prescribed for this client?|
|A) Haloperidol (Haldol)||B) Chlorpromazine (Thorazine)|
|C) Clonidine (Catapres)||D) Clozapine (Clozaril)|
|7)||Which of the following statements is true regarding schizophrenia?||7)|
- Schizophrenia is caused by a brain tumor.
- There is not a genetic component to schizophrenia.
- It is caused by underactive dopaminergic pathways found in the basal nuclei.
- There appears to be a genetic component to schizophrenia.
|8) The primary goals of pharmacotherapy for schizophrenic patients is to: (Select all that apply.)||8)|
- Reduce psychotic symptoms to a level that allows the patient to maintain normal social relationships.
- Increase delusional symptoms.
- Cure schizophrenia.
- Reduce psychotic symptoms to a level that allows the patient to perform self-
|9) ________ has less EPS and anticholinergic symptoms than does haloperidol (Haldol).||9)|
|A) Aripiprazole (Abilify)||B) Molindone HCl (Moban)|
|C) Thiothixene (Navane)||D) Chloroprothixene (Tarcan)|
|10)||The nurse receives in report a client exhibiting extrapyramidal adverse effects. The nurse expects||10)|
|to see which of the following symptoms? Select all that apply.|
|A) Akathisia||B) Parkinsonism|
|C) Dry mouth||D) Tardive dyskinesia|
|11)||A female client has been prescribed risperidone (Risperdal). The physician monitors the client for||11)|
|increased prolactin levels. The nurse anticipates which of the following symptoms to be present in|
|a female client with increased prolactin levels? Select all that apply.|
|A) Decreased libido||B) Menstrual disorders|
|C) Osteoporosis||D) Sense of euphoria|
|12)||Haloperidol (Haldol) has been prescribed for an elderly client. The nurse expects the initial dose to||12)|
|A) Withheld due to client age.||B) The same as an adult dose.|
|C) Two times the adult dose.||D) One-half the adult dose.|
|13)||The client receives ziprasidone (Geodon). What is priority teaching at time of discharge?||13)|
|A) To exercise at least 60 minutes per day||B) To stop smoking|
|C) To avoid drinking alcohol||D) To be on a low-fat diet|
|14)||The client receives clozapine (Clozaril). Which clinical finding is most important for the nurse to||14)|
|A) Increased appetite||B) Drowsiness|
|C) Sore throat||D) Constipation|
|15)||The client receives clozapine (Clozaril). Before this drug is administered, the nurse should check||15)|
|which lab data?||B) White blood count|
|A) Serum protein|
|C) Liver function||D) Renal function|
|16)||A client receives risperidone (Risperdal). The nurse observes that the client is experiencing severe||16)|
|muscle spasms of his back and neck. Which nursing action is a priority for this client?|
- Encourage the client to take a warm shower to relax the muscles.
- Withhold risperidone (Risperdal) until the symptoms subside.
- Administer benztropine (Cogentin) IM.
- Administer an additional dose of risperidone (Risperdal).
17) The client has a medical diagnosis of schizophrenia, and receives aripiprazole (Abilify). What is the 17) primary expected client outcome related to dopamine reduction?
- Client will have improved sleep patterns.
- Client will improve social relationships
- Client will decrease anxiety.
- Client will have reduced psychotic behavior.
|18)||A client has been prescribed chlorpromazine (Thorazine). The nurse expects most symptoms to||18)|
|A) In 6 months.||B) In 7—8 weeks.|
|C) Within a few days.||D) Immediately.|
|19)||A client is being discharged home with a prescription for chlorpromazine (Thorazine). The nurse||19)|
|instructs the client to avoid:|
|A) Chewing gum.||B) Increased fiber intake.|
|C) Increased fluids.||D) Caffeine.|
|20)||The nurse administers an IM dose of risperidone (Risperdal) to a client. The nurse knows this dose||20)|
|will last approximately:|
|A) 1—2 weeks.||B) 4—6 weeks.||C) 1 day.||D) 3 weeks.|
|21)||Which of the following statements are true regarding chlorpromazine (Thorazine)? Select all that||21)|
- Chlorpromazine (Thorazine) has a wide safety margin between a therapeutic and a lethal dose.
- This drug does not cause physical or psychological dependence.
- Anticholinergic effects such as dry mouth, postural hypotension, and urinary retention are common.
- Many clients overdose on this medication.
|22)||Which of the following statements are true regarding antipsychotic drugs? Select all that apply.||22)|
|A) Antipsychotic drugs do not cure mental illness.|
|B) Many symptoms of psychosis can be controlled with medication.|
|C) Almost all clients are compliant with medications.|
|D) Antipsychotic drugs cure mental illness.|
|23)||The nurse instructs the client receiving a dopamine system stabilizer that which of the following||23)|
|side effects are possible? Select all that apply.||B) Constipation|
|C) Nausea and vomiting||D) Diarrhea|
|24)||Which of the following drug classes can cause bone marrow suppression?||24)|
|A) Beta blockers||B) Nonphenothiazine drugs|
|C) Phenothiazine drugs||D) Atypical antipsychotic drugs|
|25)||Which of the following drug classes can cause diabetes mellitus type II?||25)|
|A) Atypical antipsychotic drugs||B) Phenothiazine drugs|
|C) Beta blockers||D) Nonphenothiazine drugs|
|1)||Three common debilitating and progressive neurologic disorders are: (Select all that apply.)||1)|
|A) Multiple sclerosis||B) Parkinsonʹs disease.|
|C) Alzheimerʹs disease.||D) Psychosis.|
|2)||The progressive loss of brain function characterized by memory loss, confusion, and dementia is||2)|
|A) Alzheimerʹs disease.||B) Psychosis.|
|C) Parkinsonʹs disease.||D) Multiple sclerosis|
|3)||The nurse is assessing a client with progressive weakness and wasting of muscles caused by||3)|
|destruction of motor neurons. The nurse knows these are symptoms of:|
|A) Parkinsonʹs disease.||B) Multiple sclerosis|
|C) Amyotrophic lateral sclerosis (ALS).||D) Alzheimerʹs disease.|
|4)||A client has been diagnosed with Parkinsonʹs disease. The nurse knows there is a lack of ________||4)|
|in the brain.|
|A) Potassium||B) Sodium|
|C) Dopamine||D) Norepinephrine|
|5)||A client taking medications for dementia should be instructed to:||5)|
- Take any OTC medication needed.
- Never take with high-fat foods.
- Report any changes in urine color immediately.
- Be extremely careful about getting up quickly from a seated position.
|6)||Alzheimerʹs disease is treated with:||B) Cholinergic blockers.||6)|
|A) Beta blockers.|
|C) Dopaminergic agents.||D) Acetylcholinesterase inhibitors.|
|7)||A client diagnosed Parkinsonʹs disease has been prescribed carbidopa/levodopa (Sinemet). Which||7)|
|data indicates the medication has been effective?|
- The client has tremors.
- The client is able to walk upright without stumbling
- The client has muscle rigidity.
- The client has bradykinesia.
|8)||Which medication used to treat muscular sclerosis causes flu-like symptoms?||8)|
|A) Modafinil (Provigil)||B) Interferon beta 1b (Betaseron)|
|C) M||<||itoxantrone (Novantrone)||D) Glatiramer acetate (Copaxone)|
|9)||The client receives levodopa (Larodopa). Which foods does the nurse plan to teach the client may||9)|
|be included in the diet? Select all that apply.|
|A) Chocolate||B) Banana|
|C) Citrus fruit||D) Green, leafy vegetables|
|10)||An adult client, diagnosed with Parkinsonʹs disease, has been prescribed levodopa (L-dopa). What||10)|
|nursing observations would indicate that the medication is working?|
|A) Blood pressure changes from 180/90 to 140/80mm Hg.|
|B) Increased strength on affected side|
|C) Urine output increases to 60 ml per hour.|
|D) Decrease in tremors in upper extremities|
|11)||Which assessment data is most indicative of a potential complication in a patient who receives||11)|
|A) Depression||B) Psychosis|
|C) Jaundice||D) Flu-like symptoms|
|12)||The client has been diagnosed with Parkinsonʹs disease, and wants to know the goal of||12)|
|pharmacotherapy. Which is the nurseʹs best response?|
- ʺTo alleviate the depression associated with your illness.ʺ
- ʺTo hopefully cure your illness.ʺ
- ʺTo prevent progressive memory loss and confusion.ʺ
- ʺTo increase your ability to perform normal daily activities.ʺ
|13)||A client is placed on tacrine (Cognex) for Alzheimerʹs disease. The nurse monitors which lab test||13)|
|for this client?|
|A) Liver function test (LFT)||B) Complete blood count (CBC)|
|C) White blood cell count (WBC)||D) Platelets|
|14)||The client takes ginkgo biloba at home for memory impairment. Which statement by the client||14)|
|indicates that teaching by the nurse has been effective?|
- ʺI canʹt take any other medication with ginkgo biloba.ʺ
- ʺI need to be on a low-fat diet while I am taking ginkgo biloba.ʺ
- ʺI can have increased bleeding if I have to take an anticoagulant drug.ʺ
- ʺGinkgo biloba will keep me from developing Alzheimerʹs disease.ʺ
|15) The client has a medical diagnosis of multiple sclerosis, and receives modafinil (Provigil). Which||15)|
|evaluation by the nurse would most likely indicate a therapeutic response to this drug?|
|A) Decreased myelin swelling and inflammation|
|B) Improved appetite and ability to eat|
|C) Reduction of pain and anxiety|
|D) Increased alertness and energy|
|16) A client is receiving tizanidine (Zanaflex) for treatment of muscle spasms. The nurse educates the||16)|
|A) To take the medication on a scheduled basis.|
|B) That Zanaflex is used for diseases of the central nervous system.|
|C) That this is a seizure medication.|
|D) To exercise caution when operating machinery.|
|17) Which of the following are antispasmodic drugs? Select all that apply.||17)|
|A) Methylprednisolone (Solu-Medrol)||B) Baclofen (Lioresal)|
|C) Tizanidine (Zanaflex)||D) M||<||itoxantrone (Novantrone)|
|18)||A client with a spinal cord injury is left with spasticity and dystonia. The nurse understands the||18)|
|most effective treatment for this condition is:|
|A) Physical therapy and medications.||B) Hydrotherapy and massage.|
|C) Surgery and medications.||D) Physical therapy and surgery.|
|19)||Nonpharmacological interventions that the nurse may utilize in helping a client with muscle||19)|
|spasms include which of the following? Select all that apply.|
|A) Massage||B) Application of heat or cold|
|C) Hydrotherapy||D) Manipulation|
|20)||Nondepolarizing blocking agents such as ________ are used to relax the muscles of patients being||20)|
|prepared for longer surgical procedures. Select all that apply.|
- Succinylcholine chloride (Anectine, Quelicin)
- Vecocuronium (Norcuron)
- Atracurium (Tracrium)
- Doxacurium (Nuromax)
|21)||Botulinum toxin type A (Botox, Dysport) and botulinum toxin type B (Myobloc) are ________||21)|
|A) Centrally acting antispasmodic||B) Direct-acting antispasmodic|
|C) Indirect-acting antispasmodic||D) Peripherally acting antispasmodic|
|22)||A client taking a muscle relaxant is experiencing side effects from the medication. Which of the||22)|
|following are side effects of muscle relaxants? Select all that apply.|
|A) Ataxia||B) Drowsiness||C) Epistaxis||D) Dry mouth|
|23)||Common adverse effects of baclofen (Lioresal) are:||23)|
- Insomnia, decreased energy, and increased appetite.
- Dizziness, weakness, and increased appetite.
- Drowsiness, increased appetite, and renal failure.
- Drowsiness, dizziness, weakness, and fatigue.
|24) Which of the following statements is true about botulinum toxin type A (Botox)?||24)|
- At lower doses, it is a safe and effective muscle relaxant for patients with dystonia.
- There are no side effects of Botox.
- It can only be injected into large muscle groups.
- Botox can be also taken orally.
|25) Medications to treat muscle spasms include which of the following? Select all that apply.||25)|
|A) Anti-inflammatory agents||B) Immune system—modulating drugs|
|C) Analgesics||D) Centrally acting skeletal muscle relaxants|
|1)||________ specifically refer(s) to involuntary, violent spasms of the large skeletal muscles of the||1)|
|face, neck, arms, and legs.|
|A) Convulsions||B) Seizures||C) Anticonvulsant||D) Epilepsy|
|2)||A disturbance of electrical activity in the brain that can affect consciousness, motor activity, and||2)|
|sensation is known as:|
|A) Dystonia.||B) Seizure.||C) Convulsion.||D) Epilepsy.|
|3)||Which of the following is not a known cause of seizures?||3)|
|A) Ingestion of poison||B) Meningitis|
|C) Hypoglycemia||D) Hypertension|
|4)||The nurse is admitting a client to the labor and delivery unit. While obtaining the assessment data,||4)|
|the client informs the nurse she has had high blood pressure since week 32 of this pregnancy.|
|Upon assessment, the nurse finds 2+ edema. The client relates that she has an occasional headache.|
|Before the nurse leaves the room, the client begins to have a seizure. What pregnancy disorder is|
|this client experiencing?|
|A) Posteclampsia||B) HELLP||C) Eclampsia||D) Pre-eclampsia|
|5)||The nurse is caring for a client who has been diagnosed with complex partial seizures. Which of||5)|
|the following symptoms would the client be likely to experience with a complex partial seizure?|
|Select all that apply.|
- The client stumbles and falls for no apparent reason.
- The client experiences alternating contraction and relaxation of muscles.
- Seizure is preceded by an aura.
- A period of brief confusion and somnolence following the seizure
|6)||A 5-month-old infant has been brought to the Emergency Department, and the parent states the||6)|
|child had a high fever and rapid jerking motions that lasted for a minute. The nurse understands|
|these symptoms are characteristic of which type of seizure?|
|A) Atonic seizures||B) Myoclonic seizures|
|C) Febrile seizures||D) Generalized seizures|
|7)||The nurse is caring for a client with epilepsy. The client informs the nurse that she is pregnant.||7)|
|About which condition does the nurse warn the client?|
|A) Anemia||B) Folate deficiency|
|C) Vitamin C deficiency||D) Decreased oxygen|
|8)||The nurse knows that the client with history of epilepsy might have a diagnosis of:||8)|
|A) Chronic pain.||B) Risk for injury.|
|C) Impaired gas exchange.||D) Risk for infection.|
|9) A client on the unit is experiencing tonic-clonic seizures. What drug does the nurse know is||9)|
|considered the drug of choice for this type of seizure?|
|A) Zonisamide (Zonegran)||B) Carbamezepine (Tegretol)|
|C) Valproic acid (Depakote)||D) Phenytoin (Dilantin)|
|10) In order to monitor the effectiveness of drug therapy in a client with seizures, the nurse teaches the||10)|
|client to do which of the following? Select all that apply.|
|A) Skip missed doses.||B) Keep a diary of seizure activity.|
|C) Take medications as ordered.||D) Take double doses.|
|11) The nurse is teaching a client about medications for seizures. Which of the following which should||11)|
|be included in this teaching? Select all that apply.|
- Once a medication is selected, the patient is placed on a low initial dose.
- Seizure medication will be stopped when the seizures have been gone for a month.
- If seizure activity continues, a different medication is added in small-dose increments while the dose of the first drug is slowly reduced.
- The amount is gradually increased until seizure control is achieved, or until drug adverse effects prevent additional increases in dose.
|12)||The choice of drug for epilepsy pharmacology is determined upon assessment of the client. Once a||12)|
|medication is selected, the client is placed on a:|
|A) Maximum dose.||B) Bolus dose.|
|C) Life dose.||D) Low initial dose.|
|13)||A client taking phenytoin (Dilantin) chronically for seizures should be encouraged to maintain||13)|
|good oral hygiene and visit the dentist every 6 months. Phenytoin (Dilantin) causes which of the|
|following?||B) Gingival hyperplasia|
|C) Builds up tartar on the teeth.||D) Mouth cancers|
|14)||A female client taking phenytoin (Dilantin) has notified the nurse that she is pregnant. The nurse||14)|
|knows that phenytoin (Dilantin) is a pregnancy category ________ drug.|
|A) A||B) B||C) C||D) D|
|15)||An accident victim who presented to the Emergency Department 8 hours earlier begins having||15)|
|seizures. Toxicology reports indicate an abnormally high blood alcohol level. Based on this|
|information, what drug does the nurse expect to administer?|
|A) Phenytoin (Dilantin)||B) Gabapentin (Neurontin)|
|C) Lorazepam (Ativan)||D) Valproic acid (Depakote)|
|16)||A client with history of seizures is taking phenytoin (Dilantin). The nurse knows this client is at an||16)|
|increased risk for:|
|A) Headaches.||B) Constipation.||C) Weight gain.||D) Back pain.|
|17)||The three general mechanisms by which antiseizure drugs work are: (Select all that apply.)||17)|
- Delaying an influx of sodium ions.
- Increasing the neuronal firing in the brain.
- Delaying an influx of calcium ions.
- Stimulating an influx of chloride ions, an effect associated with the neurotransmitter gamma-aminobutyric acid (GABA).
|18) The client prescribed clonazepam (Klonopin) asks the nurse why the medication dose needs to be||18)|
|adjusted. The best response by the nurse would be:|
- ʺTolerance can begin to develop after only a few months of therapy, and seizures can recur unless doses are periodically adjusted.ʺ
- ʺYour body stores this drug, and you will need a lower dose of the medication now.ʺ
- ʺYour dose will be decreased every month until you begin to have seizures again.ʺ
- ʺThe physician will not need to adjust your medication dose.ʺ
|19)||A client is admitted to the Emergency Department with seizures after ingestion of rat poison. The||19)|
|nurse knows that the drug of choice to administer is:|
|A) Diazepam (Valium).||B) Secobarbital (Seconal).|
|C) Ethosuximide (Zarontin).||D) Clonazepam (Klonopin).|
|20)||A client complains of gingival hypertrophy and weight loss. The nurse knows that this patient has||20)|
|a history of petit mal seizures. What drug is most likely responsible for the clientʹs|
|A) Phenytoin (Dilantin)||B) Amobarbital (Amytal)|
|C) Gabapentin (Neurontin)||D) Ethosuximide (Zarontin)|
|21)||A client is taking carbamazepine (Tegretol). The nurse knows that this client probably has a history||21)|
|A) Grand mal seizures.||B) Petit mal seizures.|
|C) Tonic-clonic seizures.||D) Partial seizures.|
|22)||The nurse is caring for a client with absence seizures. Which of the following medications would be||22)|
|appropriate to treat absence seizures?|
|A) Carbamazepine (Tegretol)||B) Gabapentin (Neurontin)|
|C) Pregabalin (Lyrica)||D) Valproic acid (Depakene)|
|23)||The client is experiencing status epilepticus. The nurse anticipates the physician to order||23)|
|A) Gabapentin (Neurontin).||B) Clonazepam (Klonopin).|
|C) Diazepam (Valium).||D) Pregabalin (Lyrica).|
|24)||A client has been prescribed phenobarbital (Luminal). Which of the following that are side effects||24)|
|of phenobarbital (Luminal)? Select all that apply.|
|A) Tachycardia||B) Vitamin deficiencies|
|C) Hypertension||D) Drowsiness|
|25)||The client taking phenytoin (Dilantin) asks the nurse what the side effects of the drug are. The||25)|
|nurse should include which of the following? Select all that apply.|
|A) Hypoglycemia||B) Bradycardia|
|C) Hyperglycemia||D) Stevens-Johnson syndrome|
|1)||The nurse is admitting a client to the floor with a diagnosis of migraine headache. The client relates||1)|
|she has had this type of headache for 12 years. On admission, the client states the headaches are|
|coming more frequently, which has forced her to quit her job. What type of pain is this client|
|A) Neuropathic pain||B) Chronic pain|
|C) Acute pain||D) Surgical pain|
|2)||A client presents with chronic pain that has recently increased in severity. The nurse knows pain||2)|
|can be increased by which of the following? Select all that apply.|
|A) Anxiety||B) Overuse of OTC pain relievers|
|C) Fatigue||D) Depression|
|3)||The nurse is caring for two clients with the same diagnosis. One client complains of pain rated 6/10||3)|
|and the other client complains of pain 1/10. The nurse understands the difference in pain scale|
|rating by the two clients is because:|
- One client has progressed further in the disease.
- The clientʹs reaction to pain should be the same.
- The client with the pain rated 1/10 does not want to complain.
- The clientʹs reaction to pain is a subjective experience.
|4)||A client complains of pain that is a generalized dull, throbbing, or aching pain. The nurse||4)|
|understands this type of pain is:|
|A) Acute pain.||B) Visceral pain.|
|C) Somatic pain.||D) Neuropathic pain.|
|5)||Which of the following statements are true regarding pain medications? Select all that apply.||5)|
|A) Opioids act within the CNS.||B) Opioids act at the peripheral level.|
|C) NSAIDs act within the CNS.||D) NSAIDs act at the peripheral level.|
|6)||The nurse instructs to use nonpharmacologic therapies for pain management. Which of the||6)|
|following should be included into this teaching? Select all that apply.|
|A) Reiki||B) Massage|
|C) Anti-inflammatory drugs||D) Heat or cold packs|
|7)||Which of the following statements are true regarding opioid receptors? Select all that apply.||7)|
- Opioid blockers such as naloxone (Narcan) stimulate both the mu and kappa receptors.
- Opioids interact with at least six types of receptors: mu (types one and two), kappa, sigma, delta, and epsilon.
- Opioid blockers such as naloxone (Narcan) inhibit both the mu and kappa receptors.
- Some opioids stimulate a particular receptor; others block a receptor.
|8) The client asks which type of medications will be given for severe pain. The nurse replies that||8)|
|________ is/are the drug of choice for moderate -to-severe pain.|
|A) Acetaminophen (Tylenol)||B) Opioids|
|C) NSAIDs||D) Beta blockers|
|9) The nurse is caring for a client who has a morphine (Astramorph) PCA. Which of the following||9)|
|medications should the nurse ensure is readily available?|
|A) Butorphanol tartrate (Stadol)||B) Naltrexone hydrochloride (Trexan)|
|C) Naloxone hydrochloride (Narcan)||D) Meperidine (Demerol)|
|10) A client receiving maintenance methadone (Dolophine) must:||10)|
- Take methadone (Dolophine) only when the client is tempted to use illegal drugs.
- Continue treatment for many months or years, until the patient decides to enter a total withdrawal treatment program.
- Administer methadone (Dolophine) IV.
- Only take methadone (Dolophine) for 1 month.
|11)||The nurse is caring for a client who has been diagnosed with migraine headaches that occur every||11)|
|2—3 days and placed on preventive therapy with the beta blocker propranolol (Inderal). Which|
|data indicates the medication is effective?|
|A) The client has developed orthostatic hypotension.|
|B) The client had only one headache in the past week.|
|C) The apical pulse is 78 beats per minute for this client.|
|D) The client supplemented Inderal with sumatriptan (Imitrex) four times.|
|12)||A client has taken OTC acetaminophen (Tylenol) and ibuprofen (Motrin) for migraine headaches||12)|
|without relief. Which of the following classes of medications would the nurse anticipate being|
|A) Triptans||B) Beta-adrenergic blockers|
|C) Tricyclic antidepressants||D) Calcium channel blockers|
|13)||The client has been prescribed propranolol (Inderal) for migraine headache prophylaxis. The nurse||13)|
|prepares to give the client discharge instructions, and knows this medication is a:|
|A) Calcium channel blocker.||B) Triptan.|
|C) Beta blocker.||D) Ergot alkaloid.|
|14)||The client reports severe headaches that are preceded by flashing lights and strange smells. The||14)|
|nurse understands that these symptoms are signs of:|
- Combining food with NSAIDs.
- An adverse reaction to acetaminophen (Tylenol).
- A tension headache.
- An aura of a migraine.
|15)||A client is being discharged with a prescription for oxycodone HCl (Oxycontin). The nurse||15)|
|instructs the client to do which of the following? Select all that apply.|
|A) Use OTC sleep-inducing antihistamines when needed.|
|B) Increase the dose of oxycodone if the pain returns.|
|C) Maintain adequate fluid intake.|
|D) Withhold the medication if respirations are fewer than 12 breaths per minute.|
|16)||The client has been prescribed Percocet for pain. The nurse should advise the client to avoid:||16)|
|A) Increased fluids.||B) Green, leafy vegetables.|
|C) Vitamin supplements.||D) Acetaminophen (Tylenol).|
|17)||The client with a headache rates the pain at a 3 on a 1—10 scale. Which medication would the||17)|
|A) Butorphanol (Stadol) IM|
|B) Dihydroergotamine (D.H.E.45) intranasally|
|C) Sumatriptan (Imitrex), subcutaneous|
|D) Ibuprofen (Motrin) p.o.|
|18)||When caring for a client who is taking acetaminophen (Tylenol), the nurse should pay particular||18)|
|A) Severe upper or lower abdominal pain.||B) Blood pressure.|
|C) Respiratory rate.||D) Pulse rate.|
|19)||The nurse is caring for a client who is 24 hours postoperative cholecystectomy. The client has a||19)|
|meperidine (Demerol) PCA pump. Which of the following symptoms should be reported to the|
|A) Urine output of 15 ml per hour||B) Urine output of 35 ml per hour|
|C) Constipation||D) Respiratory rate of 18 breaths per minute|
|20)||The nurse is caring for a client receiving morphine sulfate 2—4 mg IV every 4 hours as needed for||20)|
|pain. The clientʹs family calls the nursesʹ station to request pain medication for the client. When the|
|nurse arrives in the room, the client is lying in the bed. The nurse obtains the following vital signs:|
|BP 120/80, P 80, and R 8. What is the nurseʹs first action?|
- Withhold the medication.
- Call the physician after giving the pain medication.
- Call the physician.
- Find out when the client had the last dose of medication.
|21) The nurse is providing discharge teaching to a client who is to take aspirin 325 mg per day. Which||21)|
of the following statements by the client indicates an understanding of the teaching? A) ʺNow that I take aspirin, I can no longer take my acetaminophen (Tylenol).ʺ B) ʺI will check with my physician before taking any OTC medications.ʺ
- C) ʺNow that I take an aspirin a day, my gastric ulcer will be healed.ʺ
- D) ʺI can still take my ibuprofen every day, as I did before taking the aspirin.ʺ
22) The nurse is performing the AM assessment on a client who is postoperative cholecystectomy. The 22) client states he needs his pain medication. The client has meperidine (Demerol) 50 mg. IM ordered
for pain. Which of the following must be assessed before administering a narcotic?
- The last time the client had a bowel movement
- The quality, intensity, location, and duration of pain
- The quality of the pain only
- The intensity of the pain only
23) The nurse is instructing a client on the proper procedure for taking an extended-release tablet. The 23)
nurse knows the teaching has been effective when the client states:
- ʺBecause these are extended -release tablets, it is okay to break them in half.ʺ
- ʺBecause these are extended -release tablets, I must swallow them whole.ʺ
- ʺBecause these are extended -release tablets, it is okay to crush them.ʺ
- ʺBecause these are extended -release tablets, it is okay to chew them.ʺ
24) Which of the following should be included in the discharge instructions for a client diagnosed with 24) cancer who is taking hydrocodone with acetaminophen (Vicodin) PRN?
- Notify the physician if the medication relieves the pain.
- Take the medication only when the pain is greater than an 8 on a scale of 1—10.
- Use Tylenol for any pain unrelieved by the Vicodin.
- Increase the intake of fluids and roughage in the diet, because this medication can cause constipation.
|25) What is the mechanism of action of sumatriptan (Imitrex) and other triptans?||25)|
- A) They cause vasoconstriction of cranial arteries.
- B) They affect mu receptors.
- C) They block COX-
- D) They block prostaglandin synthesis.
26) A client who was admitted with gastrointestinal bleeding secondary to aspirin use therapy is being 26) discharged. The client asks why acetaminophen (Tylenol) doesnʹt work as well as the aspirin the
client had been taking. What would be the nurseʹs best response?
- ʺTylenol is only appropriate for severe pain.ʺ
- ʺTylenol and aspirin are the same drug.ʺ
- ʺTylenol does not reduce inflammation.ʺ
- ʺYou should take double the prescribed dose of Tylenol.ʺ
|1)||A client has to have major surgery. The OR nurse knows that three of the five major routes for||1)|
|applying local anesthetics include: (Select all that apply.)|
|A) Tendon block.||B) Spinal.||C) Epidural.||D) Topical.|
|2)||The nurse knows that local anesthetics work by:||2)|
|A) Blocking sodium channels.||B) Increasing sensation.|
|C) Numbing the skin.||D) Blocking calcium channels.|
|3)||________ occurs when sensation is lost to a limited part of the body without loss of consciousness.||3)|
|A) General anesthesia||B) Local anesthesia|
|C) Surgical anesthesia||D) Total anesthesia|
|4)||A client comes into the dentist office for a root canal. The nurse knows that from the mid-1900s to||4)|
|the 1960s, the ester of choice for dental procedures was:|
|A) Benzocaine (Solarcaine).||B) Cocaine.|
|C) Lidocaine (Xylocaine).||D) Procaine (Novocain).|
|5)||Which of the following medications is not an ester?||5)|
|A) Tetracaine (Pontocaine)||B) Benzocaine (Americaine)|
|C) Chloroprocaine (Nesacaine)||D) Bupivicaine (Marcaine)|
|6)||A client is receiving a local anesthetic. The nurse instructs the client to||6)|
- Never take at home.
- Report any unusual heart palpitations, lightheadedness, drowsiness, or confusion.
- Allow family members to use as needed.
- Take only when drowsiness is present.
|7)||When explaining the surgical procedure to a client, the nurse tells the client that a small amount of||7)|
|which drug is sometimes added to the anesthetic solution to lengthen the duration of action of the|
|A) Diazepam (Valium)||B) Diphenhydramine (Benadryl)|
|C) Epinephrine (Adrenaline)||D) Lidocaine (Xylocaine)|
|8)||A client is having major surgery tomorrow. The nurse knows the client understands preop||8)|
|teaching by what statement?|
- ʺI will probably feel pain during the procedure.ʺ
- ʺI will lose consciousness, movement, and memory.ʺ
- ʺI wonʹt feel a thing because I will be asleep.ʺ
- ʺI will retain all memory of my procedure.ʺ
|9) A client having an abdominal resection also has a history of myasthenia gravis. The OR nurse||9)|
|knows that using nitrous oxide with this client causes a greater risk for:|
|A) Respiratory depression and prolonged hypnotic effects.|
|B) Increased cranial pressure and vomiting.|
|C) Nausea and vomiting during surgery.|
|D) Increased intracranial pressure and respiratory depression.|
|10)||A client with a history of depression is having a thyroidectomy. The nurse knows this client has a||10)|
|history of using herbal remedies. What drug would the nurse anesthetist need to know about prior|
|A) Saint Johnʹs Wort||B) Echinacea|
|C) Senna||D) Comfrey|
|11)||________ is the only gas used for anesthesia.||11)|
|A) Dyclonine (Dyclone)||B) Dibucaine (Nupercaine)|
|C) Nitrous oxide||D) Pramoxine (Tronothane)|
|12)||A client in a state of consciousness yet insensitive to pain and unaware of the surroundings, caused||12)|
|by combining the opioid fentanyl (Sublimaze) with the antipsychotic agent droperidol (Inapsine),|
|is said to be in a state of:|
|A) Regional analgesia.||B) Surface analgesia.|
|C) Neurolept analgesia.||D) Dissociative analgesia.|
|13)||There are ________ stages of general anesthesia.||13)|
|A) 2||B) 3||C) 1||D) 4|
|14)||________ is/are used to rapidly cause unconsciousness and muscle relaxation, and to maintain||14)|
|deep anesthesia.||B) Multiple medications|
|A) Single medication|
|C) Always five medications||D) Always two medications|
|15)||Stage three anesthesia is called:||15)|
|A) Balanced anesthesia.||B) Surgical anesthesia.|
|C) Topical anesthesia.||D) Local anesthesia.|
|16)||The nurse knows that the only depolarizing blocker is succinylcholine (Anectine), which works by||16)|
|binding to acetylcholine receptors at neuromuscular junctions, causing:|
|A) Loss of consciousness.||B) Total skeletal muscle relaxation.|
|C) Light sedation.||D) Prevention of muscle contractions.|
|17)||A client comes into the clinic complaining of jaw pain, and admits to teeth gritting at night. The||17)|
|client wants natural remedies, no prescriptive drugs. The nurse knows to inform the client of what|
|A) Cooking sherry||B) Eugenia|
|C) Acetaminophen (Tylenol)||D) Pimpinella|
|18)||Nitrous oxide is:||18)|
|A) Often used for local anesthesia.||B) Often used for general anesthesia.|
|C) Often used for dental procedures.||D) Rarely used in any setting.|
|19)||Which of the following is not an inhaled anesthetic?||19)|
|A) Halothane (Fluothane)||B) Methoxyflurane (Penthrane)|
|C) Isoflurane (Forane)||D) Propofol (Diprivan)|
|20)||Thiopental (Pentothal) is a/n ________ anesthetic.||C) Topical||20)|
|A) Intravenous||B) Oral||D) Inhaled|
|1) Which of the following statements made by the client demonstrates understanding of the link||1)|
|between cardiovascular disease and high cholesterol?|
- ʺThere is no link between cardiovascular disease and cholesterol levels.ʺ
- ʺMy diet does not need to be changed to help control my cardiovascular risk.ʺ
- ʺThe only people at risk for high cholesterol are those with a family history.ʺ
- ʺThe greater the amount of cholesterol circulating in the blood, the greater the risk of cardiovascular disease.ʺ
|2)||The nurse is educating a group of clients on how high cholesterol leads to heart disease. The best||2)|
|explanation for this is that high cholesterol:|
|A) Interferes with the conduction system of the heart.|
|B) Binds to vessel walls, decreasing the amount of blood getting to the heart.|
|C) Thickens the blood, causing clots.|
|D) Damages the heart muscle.|
|3)||The nurse instructs that client that which of the following foods contain high amounts of Omega-3||3)|
|fatty acids? Select all that apply.|
|A) Green beans||B) Bananas||C) Tofu||D) Salmon|
|4)||The client asks which components of the lipid profile should be low. The nurseʹs best response is||4)|
- VLDL should be high.
- LDL should be low.
- Total cholesterol levels do not give sufficient information
- HDL should be low.
|5)||________ are the major storage form of fat in the body and the only type of lipid that serves as an||5)|
|important energy source.|
|A) HDL||B) Cholesterol||C) LDL||D) Triglycerides|
|6)||The client asks how the body gets rid of cholesterol. The nurseʹs correct response is that cholesterol||6)|
|A) As HDL.||B) Through the kidneys.|
|C) In bile.||D) In feces.|
|7)||The client asks which type of cholesterol is the good cholesterol?||7)|
|A) VLDL||B) LDL||C) Triglycerides||D) HDL|
|8)||LDL (low-density lipoprotein) is called the ʺbad cholesterolʺ because it:||8)|
|A) Consists of 50 percent cholesterol.||B) Synthesizes other steroids.|
|C) Is stored in the tissues.||D) Increases the risk of heart disease.|
|9)||The client has an HDL cholesterol value of 38 mg/dl. The nurse interprets this value as:||9)|
|A) Normal.||B) Borderline.||C) Low.||D) High.|
|10)||Lifestyle changes that can lower blood lipid levels include which of the following? Select all tha||10)|
|A) Increased exercise|
|B) Restriction of dietary saturated fat and cholesterol|
|C) Smoking cessation|
|D) Taking medication|
|11)||The client has been diagnosed with hyperlipidemia and is being educated on types of food to||11)|
|include in his diet. The most appropriate nursing diagnosis for this client is:|
|A) Impaired health maintenance, related to effects of drug therapy.|
|B) Deficient knowledge, related to need for altered lifestyle.|
|C) Noncompliance, related to dietary regime.|
|D) Self-care deficit, related to disease process.|
|12)||The nurse instructs the client to do which of the following to decrease cholesterol? Select all that||12)|
|A) Stop smoking||B) Increase physical activity|
|C) Increase dietary fiber||D) Increase LDL intake|
|13)||Therapeutic lifestyle changes that can control high blood cholesterol levels include what||13)|
|percentage of total caloric intake as saturated fat?|
|A) 10 percent||B) 6 percent||C) 7 percent||D) 2 percent|
|14)||The client has been taking nicotinic acid (Nicobid). Which of the following adverse effects are||14)|
|common with nicotinic acid? Select all that apply.|
|A) Chills||B) Hot flashes||C) Goosebumps||D) Flushing|
|15)||________ are the drug of choice to decrease triglyceride levels.||15)|
|A) Statin||B) Fibric acid agents|
|C) Bile acid agents||D) HMG CoA reductase inhibitors|
|16)||The client is going to be started on cholestyramine (Questran), 6 mg, three times daily. The nurse||16)|
|instructs the client to:|
|A) Take with large amounts of fluid.||B) Take in the morning.|
|C) Take with food.||D) Take without food.|
|17)||The physician tells the nurse a HMG-CoA reducatase inhibitor has been ordered. The nurse||17)|
|knows this type of drug is also known as:|
|A) Fibric acid.||B) Omega-3 fatty acid.|
|C) Statin.||D) Bile acid resin.|
|18)||________ is a medical condition in which the muscle tissue becomes extremely inflamed resulting||18)|
|in breakdown of muscle that can be caused by statins.||B) Spasticity|
|C) Multiple sclerosis||D) Dystonia|
|19) The nurse instructs a client taking colesevelam (WelChol) to:||19)|
- Take other medications 1 hour before or 4 hours after colesvelam.
- Take other medications 4 hours before or 1 hour after taking colesvelam.
- Avoid all other medications for 6 hours before and after taking colesvelam.
- Take all medications at the same time as colesevelam.
|20)||The client asks the nurse how Lipitor will help lower cholesterol. The nurse responds, Lipito||20)|
|belongs to a class of drugs that:|
|A) The action of which is not understood.|
|B) Make the body excrete cholesterol quicker.|
|C) Bind to cholesterol and inhibit its production|
|D) Interfere with how cholesterol is made.|
|21)||A client taking simvastatin (Zocor) should be instructed to avoid:||21)|
|A) All fruit juices.||B) Co Q10 supplements.|
|C) Grapefruit juice.||D) Grape juice.|
|22)||Bile acid resins cause which of the following adverse events? Select all that apply.||22)|
|A) Bloating||B) Constipation|
|C) Headache||D) Increased urination|
|23)||The nurse explains ezetimibe (Zetia):||23)|
- Works in the small intestine to block absorption of dietary cholesterol
- Causes rhabdomyolysis.
- Increases LDL levels.
- Increases triglyceride levels.
|24) Combination drugs may improve compliance because:||24)|
- There are no side effects to combination drugs.
- The physician can prescribe a combination drug to prevent rhabdomyolysis.
- The client can obtain with a prescription.
- Taking one tablet is easier to remember.
|25) Which statement made by the client indicates a need for further teaching?||25)|
- I can eat any food I want as long as I take my medications.
- I need to call the physician if I experience severe muscle weakness.
- I should take my medications every day.
- A low fat diet needs to be followed even with medications to treat high cholesterol.
|26) The nurse instructs the client to decrease irritation of the mouth and constipation when taking bile||26)|
acid agents to:
- A) Take with coffee to increase the effect of the drug.
- B) Dissolve in water and increase fluid intake.
- C) Decrease fluid intake.
- D) Chew tablets.
|1)||________ is defined as the consistent elevation of arterial blood pressure.||1)|
|A) Tachycardia||B) Bradycardia||C) Hypertension||D) Hypotension|
|2)||The nurse is teaching the client about the long-term consequences of untreated hypertension.||2)|
|Which of the following should the nurse include in the teaching? Select all that apply.|
|A) Diabetes||B) Stroke|
|C) Heart failure||D) Myocardial infarction|
|3)||The client asks the nurse what the first number given in a blood pressure stands for. The nurse||3)|
- ʺThe first number is the systolic pressure.ʺ
- ʺThe first number is the pulse pressure.ʺ
- ʺThe first number is the diastolic pressure.ʺ
- ʺThe first number is the heart rate.ʺ
|4) Cardiac output is:||4)|
- Equal to the mean arterial pressure.
- The diastolic pressure.
- The volume of blood pumped per minute.
- The systolic pressure.
|5)||Blood pressure is regulated on a minute-to-minute basis by:||5)|
|A) The vasomotor center.||B) The lungs.|
|C) The liver.||D) The kidney.|
|6)||The client asks the nurse how to control hypertension without taking medications. Which of the||6)|
|following would be appropriate for the nurse to reply? Select all that apply.|
|A) Stop smoking.||B) Increase exercise.|
|C) Decrease sodium intake.||D) Increase weight if overweight.|
|7)||Which two lifestyle changes can be the most beneficial to a client to delay the progression from||7)|
|prehypertension to hypertension?|
|A) Stopping smoking||B) Limiting alcohol intake|
|C) Maintaining optimum body weight||D) Eating a healthy low-fat, low-salt diet|
|8)||Which of the following statements indicates understanding of hypertensive therapy by the client?||8)|
- ʺWhen I feel good, I donʹt need to take my medications.ʺ
- ʺI should take all medications as prescribed to control my high blood pressure.ʺ
- ʺIf I think my blood pressure is increased, I should take a double dose of my medications.ʺ
- ʺI should take hypertension medications only when I do not feel well.ʺ
9) A client is prescribed multiple medications for hypertension. The client asks the nurse which of the 9) medications prescribed is a beta blocker. Select all that apply.
- A) Ramipril (Altace) B) Furosemide (Lasix)
- C) Amlodipine (Norvasc) D) Metoprolol (Lopressor)
|10)||A client is prescribed multiple medications for hypertension. The client asks the nurse which of the||10)|
|medications prescribed is a ACE inhibitor. Select all that apply.|
|A) Metoprolol (Lopressor)||B) Ramipril (Altace)|
|C) Amlodipine (Norvasc)||D) Furosemide (Lasix)|
|11)||A client is prescribed multiple medications for hypertension. The client asks the nurse which of the||11)|
|medications prescribed is a loop diuretic. Select all that apply.|
|A) Amlodipine (Norvasc)||B) Metoprolol (Lopressor)|
|C) Ramipril (Altace)||D) Furosemide (Lasix)|
|12)||A client is prescribed multiple medications for hypertension. The client asks the nurse which of the||12)|
|medications prescribed is a calcium channel blocker. Select all that apply.|
|A) Metoprolol (Lopressor)||B) Ramipril (Altace)|
|C) Amlodipine (Norvasc)||D) Furosemide (Lasix)|
|13)||The nurse instructs the client the most common side effect of ACE inhibitor therapy is:||13)|
|A) Cough.||B) Hypokalemia.||C) Headache.||D) Angioedema.|
|14)||Which of the following medications is not a calcium channel blocker?||14)|
|A) Propranolol (Inderal)||B) Diltiazem (Cardizem)|
|C) Verapamil (Calan)||D) Amlodipine (Norvasc)|
|15)||The nurse is caring for a client prescribed enalapril (Vasotec). The nurse knows a potentially||15)|
|life-threatening side effect of enalapril (Vasotec) is:|
|A) Supraventricular tachycardia.||B) Hypokalemia.|
|C) Ventricular fibrillation.||D) Angioedema.|
|16)||The physician ordered a beta blocker for a client. The nurse checks vital signs for this client. Which||16)|
|vital sign would cause the nurse to question administering the medication?|
|A) Pulse 48 beats per minute||B) Temperature 99.4°F|
|C) Respirations 18 breaths per minute||D) Blood pressure 148/62|
|17)||The nurse is teaching the client about side effects of medications for hypertension. For which of the||17)|
|following should the client contact the physician? Select all that apply.|
|A) Blood pressure 120/70||B) Signs and symptoms of hypotension|
|C) Signs and symptoms of hypertension||D) Pulse 80 beats per minute|
|18)||The physician has prescribed an alpha blocker for the client. The nurse anticipates which of the||18)|
|following to be prescribed?||B) Lisinopril (Zestril)|
|A) Diltiazem (Cardizem)|
|C) Doxazosin (Cardura)||D) Atenolol (Tenormin)|
|19)||________ are often the first choice for treating hypertension.||19)|
|A) Beta blockers||B) Diuretics||C) ACE inhibitors||D) Alpha blockers|
|20)||The client has been prescribed furosemide (Lasix). The nurse understands that furosemide (Lasix):||20)|
|A) Causes hyperkalemia.||B) Increases respirations.|
|C) Causes hypokalemia.||D) Increases blood pressure.|
|21)||The nurse teaches the client prescribed a thiazide diuretic to:||21)|
|A) Take before bed.||B) Take the medication in the morning.|
|C) Take with two full glasses of water.||D) Avoid foods containing potassium.|
|22)||An African-American client has been ordered BiDil for hypertension. The nurse explains that||22)|
|BiDil contains which of the following medications?||B) Metoprolol and isosorbide DN|
|A) Hydralazine and furosemide|
|C) Isosorbide DN and hydralazine||D) Furosemide and ramipril|
|23)||A client has been prescribed a loop diuretic and instructed to eat foods rich in potassium. Which of||23)|
|the following foods are rich in potassium? Select all that apply.|
|A) Milk||B) Bananas||C) Bread||D) Salmon|
|24)||A client has been prescribed candesartan (Atacand) daily. This medication is a/n:||24)|
|A) Calcium channel blocker.||B) Beta blocker.|
|C) ACE inhibitor.||D) Angiotensin-receptor blocker.|
|25)||Which of the following should be used with caution in clients with asthma and heart failure?||25)|
|A) Beta1 blockers||B) Non-selective beta blockers|
|C) ACE inhibitors||D) Alpha blockers|
|26)||________ is the drug of choice for hypertensive emergency.||26)|
|A) Enalapril (Vasotec)||B) Diltiazem (Cardizem)|
|C) Nitroprusside (Nitropress)||D) Lisinopril (Zestril)|
|1)||Which of the following disorders are associated with an increased risk for heart failure? Select all||1)|
|A) Diabetes||B) Coronary artery disease|
|C) Myocardial infarction||D) Chronic hypertension|
|2)||The client asks the nurse to explain heart failure. Which of the following statements should be||2)|
|included in the teaching by the nurse?|
- Heart failure is very uncommon in people over age 70.
- Medications can cure heart failure.
- Heart failure is the inability of the ventricles to pump enough blood to meet the bodyʹs metabolic demands.
- There are no known risk factors for developing heart failure.
|3)||A client who has a history of angina and hypertension now complains of fatigue, shortness of||3)|
|breath, and cough. The nurse suspects that the client might be developing:|
|A) Hypokalemia.||B) Left-sided heart failure.|
|C) Peripheral edema.||D) Right-sided heart failure.|
|4)||A client has been diagnosed with right-sided heart failure. The nurse expects to observe which of||4)|
|the following when assessing the client?|
|A) Increased body temperature||B) Peripheral edema|
|C) Decreased body temperature||D) Fatigue, shortness of breath, and cough|
|5)||Which of the following are first-choice pharmacotherapy of heart failure? Select all that apply.||5)|
|A) Beta-adrenergic blockers||B) Diuretics|
|C) Phosphodiesterase inhibitors||D) ACE inhibitors|
|6)||Which of the following are second-choice pharmacotherapy of heart failure? Select all that apply.||6)|
|A) Beta-adrenergic blockers||B) ACE inhibitors|
|C) Phosphodiesterase inhibitors||D) Diuretics|
|7)||A client has been prescribed furosemide (Lasix) for heart failure. The nurse knows this drug is a||7)|
|________ -choice pharmacotherapy for heart failure.|
|A) First||B) Second||C) Third||D) Fourth|
|8)||The nurse is preparing a client to be discharged home. Which of the following should the nurse||8)|
|instruct the client to do to help control heart failure? Select all that apply.|
|A) Stop using tobacco.||B) Reduce weight to an optimum level.|
|C) Increase salt intake.||D) Increase caffeine intake.|
|9) A client has been prescribed lisinopril (Prinivil), and asks the nurse to explain the common side||9)|
|effects of this drug. The best response by the nurse would be:|
- ʺThe most common adverse effects are cough, headache, angioedema, and rash.ʺ
- ʺThe most common adverse effects are cough, headache, dizziness, orthostatic hypotension, and rash.ʺ
- ʺThere are no common adverse effects of this medication.ʺ
- ʺThe most common adverse effects of this medication are cough, hypertension, hypokalemia, and rash.ʺ
|10)||A client has been prescribed an ACE inhibitor to treat heart failure. Which of the following||10)|
|medications is an ACE inhibitor?||B) Quinapril (Accupril)|
|A) Furosemide (Lasix)|
|C) Hydrochlorothiazide (Microzide)||D) Candesartan (Atacand)|
|11)||The physician tells the nurse that a thiazide diuretic has been prescribed for the client. The nurse||11)|
|expects which of the following to be prescribed?|
|A) Furosemide (Lasix)||B) Spironolactone (Aldactone)|
|C) Eplenerone (Inspra)||D) Hydrochlorothiazide (Microzide)|
|12)||The primary action of digoxin (Lanoxin) is:||12)|
|A) A decrease in the force of contraction.||B) Increased diuresis.|
|C) Decreased blood pressure.||D) An increase in the force of contraction.|
|13)||The nurse checks the serum digoxin level for a client, and the result is 2.0 mg/ml. The nurse||13)|
|anticipates which of the following medications to be ordered because of this level?|
|A) Digoxin immune fab (Ovine)||B) The same dose of digoxin (Lanoxin)|
|C) Furosemide (Lasix)||D) An increased dose of digoxin (Lanoxin)|
|14)||The client with digoxin (Lanoxin) toxicity might exhibit which of the following symptoms? Select||14)|
|all that apply.||B) Confusion|
|A) Loss of appetite|
|C) Blurred vision||D) Tachycardia|
|15)||A client has been prescribed carvedilol (Coreg) to treat heart failure. Which of the following||15)|
|statements are true regarding carvedilol (Coreg) and treatment for heart failure? Select all that|
- Carvedilol (Coreg) is always used in combination with other agents, usually ACE inhibitors
- Carvedilol (Coreg) is a first-line drug for treating heart failure.
- Carvedilol (Coreg) should not be used to treat heart failure.
- Carvedilol (Coreg) has the potential to worsen heart failure.
|16) The client has been prescribed a vasodilator for the treatment of heart failure. The nurse knows||16)|
|there are two vasodilators used to treat heart failure. Which of the following are vasodilators?|
|Select all that apply.|
|A) Isosorbide dinitrate (Isordil)||B) Hydralazine (Apresoline)|
|C) Carvedilol (Coreg)||D) Lisinopril (Prinivil)|
|17)||The client is receiving milrinone (Primacor). Which of the following a potentially life-threatening||17)|
|side effect of this drug?|
|A) Ventricular dysrhythmia||B) Angioedema|
|C) Hyperkalemia||D) Hypokalemia|
|18)||The nurse is caring for a client receiving ACE inhibitor therapy for heart failure. The nurse knows||18)|
|that which of the following statements are true regarding ACE inhibitors treatment of heart|
|failure? Select all that apply.|
- ACE inhibitors lower blood pressure and reduce blood volume by enhancing the excretion of sodium and water.
- ACE inhibitors increase the workload of the heart.
- ACE inhibitors decrease cardiac output.
- ACE inhibitors increase cardiac output.
|19)||Which of the following mediations are reserved for clients unable to tolerate the adverse effects of||19)|
|ACE inhibitors? Select all that apply.|
|A) Candesartan (Atacand)||B) Valsartan (Diovan)|
|C) Lisinopril (Prinivil)||D) Enalapril (Vasotec)|
|20)||The nurse is caring for a client receiving furosemide (Lasix) for heart failure. The nurse knows to||20)|
|monitor the laboratory results for:|
|A) Increased WBCs.||B) Hyperkalemia.|
|C) Hypokalemia.||D) Anemia.|
|21)||The ability to increase the strength of contraction is called a:||21)|
|A) Positive inotropic effect.||B) Negative inotropic effect.|
|C) Preload.||D) Afterload.|
|22)||Which of the following drug classes prescribed for the treatment of heart failure have a negative||22)|
|A) Angiotensin-receptor blockers||B) Beta-adrenergic blockers|
|C) ACE inhibitors||D) Cardiac glycosides|
|23)||Vasodilators have limited use due to which of the following side effects? Select all that apply.||23)|
|A) Reflex tachycardia||B) Orthostatic hypotension|
|C) Hypertension||D) Blurry vision|
|24)||The nurse is caring for a client who has not responded well to other treatments for heart failure.||24)|
|Which drug class is used for 2—3 days when other drugs have failed?|
|A) Phosphodiesterase inhibitors||B) Cardiac glycosides|
|C) Angiotensin-receptor blockers||D) Beta-adrenergic blockers|
|25)||The client is ordered to receive a cardiac glycoside. Which of the following vital signs would make||25)|
|the nurse question administering this medication?|
|A) Apical pulse 55 beats per minute||B) Blood pressure 118/66|
|C) Respirations 12 breaths per minute||D) Temperature 99.4°F|
|1)||Dysrhythmias that originate in the atria are sometimes referred to as:||1)|
|A) Tachycardia.||B) Supraventricular.|
|C) Heart block.||D) Fibrillation.|
|2)||The nurse teaches the client that which of the following diseases are associated with||2)|
|dysrhythmias? Select all that apply.||B) Arthritis|
|A) Myocardial infarction|
|C) Hypertension||D) Hyperkalemia|
|3)||A client asks the nurse to explain how a normal heart works. Which of the following statements by||3)|
|the nurse should be included in client teaching?|
- A normal resting heart rate is 50 beats per minute.
- The electrical impulse causes the ventricles to contract, and then the atria contract.
- For the heart to function properly, the atria must contract simultaneously, sending their blood into the ventricles.
- The heart generates electrical impulses that start in the atrioventricular node.
|4)||An extra beat often originating from a source other than the SA node can be which of the||4)|
|following? Select all that apply.|
|A) Premature atrial contraction||B) Premature ventricular contraction|
|C) Ventricular fibrillation||D) Atrial fibrillation|
|5)||The client asks the nurse what the medical term for a slow heart rate is. The nurse replies:||5)|
|A) ʺAtrial fibrillation.ʺ||B) ʺBradycardia.ʺ|
|C) ʺTachycardia.ʺ||D) ʺPremature ventricular contraction.ʺ|
|6)||A client has a heart rate of 130 beats per minute. The nurse knows this heart rate would be||6)|
|classified as:||B) Atrial fibrillation.|
|C) Tachycardia.||D) Premature ventricular contraction.|
|7)||Most medications used to treat dysrhythmias block ion channels. Which of the following is not an||7)|
|ion channel blocked to treat dysrhythmias?|
|A) Potassium||B) Calcium||C) Magnesium||D) Sodium|
|8)||The physician has ordered a nonpharmacologic therapy for a client diagnosed with bradycardia.||8)|
|The nurse anticipates which of the following to be ordered for this client?|
|A) Cardioversion||B) Defibrillation|
|C) Increased exercise||D) Cardiac pacemakers|
|9) The client asks the nurse how most medications for dysrhythmias work. The best answer would||9)|
- ʺThese medications will lower your blood pressure, which will change the rhythm of your heart.ʺ
- ʺThe mechanism of these drugs is unknown.ʺ
- ʺBlocking potassium, sodium, or calcium ion channels is the primary way to prevent or terminate dysrhythmias.ʺ
- ʺMost medications for dysrhythmias shorten the refractory period.ʺ
|10)||A client has been prescribed propranolol (Inderal) for a dysrhythmia. Which of the following side||10)|
|effects might be related to propranolol (Inderal)? Select all that apply.|
|A) Hypertension||B) Bradycardia||C) Hypotension||D) Tachycardia|
|11)||The nurse caring for a client with a dysrhythmia understands the effects of which drug can last 4||11)|
|—8 weeks after the drug is discontinued because it has an extended half-life that can exceed 100|
|A) Digoxin (Lanoxin)||B) Propranolol (Inderal)|
|C) Amiodarone (Cardarone)||D) Verapamil (Calan)|
|12)||The client has just been started on procainamide (Procan SR). The nurse will assess for which||12)|
|common side effects?|
|A) Anxiety and tremors||B) GI upset and diarrhea|
|C) Drowsiness and lethargy||D) Headache and dizziness|
|13)||The client has been started on propranolol (Inderal). The nurse expects which finding?||13)|
|A) Increased respiratory rate||B) Increased blood pressure|
|C) Stabilized oxygen saturation||D) Lowered heart rate|
|14)||The client is receiving digoxin for a dysrhythmia. The nurse understands that medication levels in||14)|
|the blood will be monitored closely since:|
- Subtherapeutic levels are fatal.
- Interactions with other medications are common.
- Digoxin is used for ventricular dysrhythmias.
- Excessive levels can produce serious dysrhythmias.
|15)||The nurse is preparing to administer adenosine (Adenocard) to a client. The nurse knows the||15)|
|half-life of this medication is:|
|A) 10 hours.||B) 10 minutes.||C) 10 seconds.||D) 10 days.|
|16)||A client has been prescribed diltiazem (Cardizem). The nurse instructs the client to notify the||16)|
|physician if: (Select all that apply.)|
- Dizziness occurs when standing up quickly.
- Heart rate is less than 60 beats per minute.
- Blood glucose increases.
- Systolic blood pressure is less than 90 mm Hg.
|17) The nurse is caring for a client with a dysrhythmia. The nurse understands that which of the||17)|
|following classes of medications are used to treat dysrhythmias? Select all that apply.|
|A) Potassium channel blockers||B) Magnesium channel blockers|
|C) Angiotensin channel blockers||D) Sodium channel blockers|
|18)||A client has been prescribed a beta blocker for a dysrhythmia. Which of the following side effect||18)|
|could be related to the beta blocker therapy? Select all that apply.|
|A) Hypertension||B) Tachycardia||C) Bradycardia||D) Hypotension|
|19)||The physician orders a potassium channel blocker for a client. Which of the following medications||19)|
|would the nurse anticipate the physician to order?|
|A) Lidocaine (Xylocaine)||B) Mexiletine (Mexitil)|
|C) Amiodarone (Cordarone)||D) Disopyramide (Norpace)|
|20)||A client presents in the Emergency Department with a cardiac dysrhythmia. The nurse||20)|
|investigates possible causes of the dysrhythmia. Which of the following are possible causes? Select|
|all that apply.|
|A) Hypoxia||B) Anxiety|
|C) Tobacco use||D) Caffeine ingestion|
|21)||A client asks the nurse why an antidysrhythmic drug is not prescribed for prophylaxis. Which of||21)|
|the following statements should the nurse include in the response? Select all that apply.|
- ʺResearch studies have found that the use of antidysrhythmic medications for prophylaxis can actually increase patient mortality.ʺ
- ʺYou should speak with your physician about receiving a prescription for prophylaxis.
- ʺThese drugs are only prescribed for prophylaxis if you have a family history of dysrhythmias.ʺ
- ʺAntidysrhythmics have the ability not only to correct dysrhythmias but also to worsen or even create new dysrhythmias.ʺ
|22)||A client with cardiac rhythm disturbance is hospitalized during the initial stage of antidysrhythmic||22)|
|therapy. The nurse explains that this is because:|
|A) Continual ECG monitoring will be necessary.|
|B) High dosages of medication will have to be administered.|
|C) The safety margin of dosing is very narrow.|
|D) The client will be able to recover sooner.|
|23)||The nurse learns that the client has been started on sotalol (Betapace). What is the most likely||23)|
|rationale for this?|
|A) Chronic atrial fibrillation||B) Atrial dysrhythmia|
|C) Serious ventricular dysrhythmia||D) Hypertension|
|24)||The client has a dysrhythmia, and is started on a calcium channel blocker. The nurse understands||24)|
|that the rationale for this is that the client:|
|A) Will respond quicker.||B) Has a supraventricular dysrhythmia.|
|C) Will have fewer side effects.||D) Is not a candidate for an ICD.|
|25)||The client with asthma has just been placed on a beta blocker for a dysrhythmia. The nurse||25)|
|A) Dizziness and fainting.||B) Bradycardia.|
|C) Increased asthma attacks.||D) Elevated blood pressure.|
|1)||________ is the stopping of blood flow, an essential mechanism protecting the body from both||1)|
|external and internal injury.|
|A) Coagulation||B) Hemostasis||C) Hemostatics||D) Thrombolytic|
|2)||________ is a complex series of steps that begins when the injured cells release a chemical called||2)|
|prothrombin activator, or prothrombinase.|
|A) Hemostatics||B) Hemostasis|
|C) Thrombolytic||D) The coagulation cascade|
|3)||A client asks the nurse to describe conditions that require coagulation-modifying medications. The||3)|
|nurse should include which of the following disorders? Select all that apply.|
|A) Deep vein thrombosis (DVT)||B) Angina|
|C) Headache||D) Myocardial infarction|
|4)||A client has been prescribed an anticoagulant, and asks the nurse to explain why this medication||4)|
|has been prescribed. The nurse replies:|
- ʺThese medications are used to dissolve such life-threatening clots.ʺ
- ʺThese medications are used to prevent the formation of clots.ʺ
- ʺThese medications are used to prevent clot formation in arteries.ʺ
- ʺThese medications inhibit the normal removal of fibrin, thus keeping the clot in place for a longer period of time.ʺ
5) A client has been prescribed a thrombolytic, and asks the nurse to explain why this medication has 5)
been prescribed. The nurse replies:
- ʺThese medications are used to prevent the formation of clots.ʺ
- ʺThese medications are used to dissolve such life-threatening clots.ʺ
- ʺThese medications are used to prevent clot formation in arteries.ʺ
- ʺThese medications inhibit the normal removal of fibrin, thus keeping the clot in place for a longer period of time.ʺ
|6) A client has been prescribed an antiplatelet drug, and asks the nurse to explain why this||6)|
|medication has been prescribed. The nurse replies:|
- ʺThese medications are used to prevent clot formation in arteries.ʺ
- ʺThese medications inhibit the normal removal of fibrin, thus keeping the clot in place for a longer period of time.ʺ
- ʺThese medications are used to prevent the formation of clots.ʺ
- ʺThese medications are used to dissolve such life-threatening clots.ʺ
|7) The physician prescribes a newer antithrombin medication that is given subcutaneously 15||7)|
|minutes prior to hip replacement surgery for prophylaxis of DVT. The nurse knows this|
|A) Desirudin (Iprivask).||B) Argatroban (Acova).|
|C) Lepirudin (Refludan).||D) Bivalirudin (Angiomax).|
|8) The client is receiving heparin (Heplock). The nurse knows to monitor which of the following||8)|
|laboratory results to evaluate therapeutic response?|
|A) BNP||B) PT||C) PT and INR||D) aPTT|
|9) The client is receiving warfarin (Coumadin). The nurse knows to monitor which of the following||9)|
|laboratory results to evaluate therapeutic response?|
|A) PT and INR||B) BNP||C) aPTT||D) PT|
|10) A client is receiving heparin (Heplock) therapy, and serious hemorrhage occurs. Which medication||10)|
|should the nurse administer to reverse the effects of heparin (Heplock)?|
|A) Desirudin (Iprivask)||B) Protamine sulfate|
|C) Potassium||D) Vitamin K|
|11) A client receiving warfarin (Coumadin) therapy has a INR of 5.6. Which medication would the||11)|
|nurse expect the physician to order to reverse the warfarin (Coumadin)?|
|A) Desirudin (Iprivask)||B) Vitamin K|
|C) Potassium||D) Protamine sulfate|
|12) The nurse caring for a client receiving heparin (Heplock) monitors the patient for which serious||12)|
|complication that occurs in up to 30% of patients taking the drug?|
- Heparin-induced thrombocytopenia (HIT)
|13)||A client taking warfarin (Coumadin) should be instructed to avoid herbal supplements such as||13)|
|green tea, ginkgo, feverfew, garlic, cranberry, chamomile, and ginger because these could:|
|A) Decrease the effect of the warfarin (Coumadin).|
|B) Cause severe headache.|
|C) Increase the risk of bleeding.|
|D) Cause severe hypotension.|
|14)||A client is taking aspirin (ASA), and asks the nurse how long the anticoagulant effect of a single||14)|
|dose of aspirin can last. The nurse replies:|
- ʺThe anticoagulant effect of a single dose of aspirin can last for as long as a week.ʺ
- ʺThe anticoagulant effect of a single dose of aspirin can last for as long as a day.ʺ
- ʺThe anticoagulant effect of a single dose of aspirin can last for as long as 12 hours.ʺ
- ʺThe anticoagulant effect of a single dose of aspirin can last for as long as a month.ʺ
|15)||A client has been prescribed clopidogrel (Plavix). The nurse instructs the client that which of the||15)|
|following types of drugs can increase the risk for bleeding? Select all that apply.|
|A) NSAIDs||B) Some antibiotics|
|C) Anticoagulants||D) Thrombolytic agents|
|16)||Alteplase (Activase) must be given within ________ hours of the onset of symptoms of MI and||16)|
|within ________ hours of thrombotic stroke to be effective.|
|A) 24; 12||B) 3; 6||C) 12; 24||D) 6; 3|
|17)||________ are used to prevent and treat excessive bleeding following surgical procedures.||17)|
|A) Anticoagulants||B) Antiplatelets||C) Hemostatics||D) Thrombolytics|
|18) A client has been ordered a thrombolytic medication. The nurse knows to obtain a comprehensive||18)|
|medical history because:|
- Thrombolytics cannot be given to a patient with a history of asthma.
- Thrombolytics will stop bleeding.
- Thrombolytics are contraindicated in patients with active bleeding or with a history of recent trauma.
- Many patients are allergic to this medication.
|19)||Which of the following is not a reason why a client would be prescribed a thrombolytic drug?||19)|
|A) Postoperative bleeding||B) Pulmonary embolism|
|C) Cerebrovascular accident (CVA)||D) Acute MI|
|20)||The three primary subclasses of antiplatelet agents are: (Select all that apply.)||20)|
- Aspirin (ASA).
- Adenosine diphosphate (ADP) receptor blockers.
- Glycoprotein IIb/IIIa receptor blockers.
|21)||The nurse is caring for a client receiving an ADP receptor blocker. The nurse knows which of the||21)|
|following are ADP receptor blockers? Select all that apply.|
|A) Heparin (Heplock)||B) Clopidogrel (Plavix)|
|C) Warfarin (Coumadin)||D) Ticlopidine (Ticlid)|
|22)||A client states that the physician is going to prescribe an antiplatelet agent. The nurse knows that||22)|
|which of the following medications are antiplatelet agents? Select all that apply.|
|A) Warfarin (Coumadin)||B) Cilostazol (Pletal)|
|C) Pentoxifylline (Trental)||D) Heparin (Heplock)|
|23)||A client has been prescribed a subcutaneous anticoagulant. The nurse knows that which of the||23)|
|following are given subcutaneously? Select all that apply.|
|A) Dalteparin (Fragmin)||B) Enoxaparin (Lovenox)|
|C) Lepirudin (Refludan)||D) Warfarin (Coumadin)|
|24)||A client asks the nurse what the most common side effect of anticoagulant therapy is. The nurse||24)|
|A) ʺBleeding.ʺ||B) ʺHypotension.ʺ||C) ʺHeadache.ʺ||D) ʺAtaxia.ʺ|
|1)||________ is the term used to describe impaired blood flow in the coronary arteries.||1)|
|A) Coronary heart disease||B) Angina pectoris|
|C) Myocardial infarction||D) Cerebrovascular accident|
|2)||Angina is characterized by:||2)|
- Sudden weakness with severe headache.
- Chest pain on physical exertion or emotional stress.
- Crushing chest pain that radiates to the jaw and left arm.
- Slow heart rate and difficulty standing.
|3) A client asks the nurse to explain the difference between stable and unstable angina. The best||3)|
|response by the nurse would be:|
- ʺUnstable angina is caused by spasms of the coronary arteries. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest.ʺ
- ʺStable angina is predictable in its frequency, intensity, and duration. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest.ʺ
- ʺUnstable angina is predictable in its frequency, intensity, and duration. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest.ʺ
- ʺStable angina is caused by spasms of the coronary arteries. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest.ʺ
|4)||A client presents in the Emergency Department with chest pain. The nurse knows that which of||4)|
|the following conditions can cause chest pain? Select all that apply.|
|A) Arthritis||B) Peptic ulcer disease|
|C) Myocardial infarction||D) Gastric reflux|
|5)||The nurse recognizes the need for further teaching when the client makes which of the following||5)|
- ʺI am going to a smoking cessation class.ʺ
- ʺAs long as I exercise, stress at my job will not bother me.ʺ
- ʺIʹll make sure to take my high—blood pressure pills.ʺ
- ʺI will check my weight gain/loss regularly.ʺ
|6) The client with angina is being discharged to home. The nurse is instructing the client on dietary||6)|
changes. Which of the following should be included in this teaching?
- A) Limit alcohol and fat intake and increase sodium intake.
- B) Decrease salt and fat intake and limit alcohol intake.
- C) Increase salt and fat intake and limit alcohol intake.
- D) There are no dietary restrictions for a person diagnosed with angina.
|7) A client arrives in the Emergency Department with severe chest pain. The nurse explains to the||7)|
|client that the difference between angina and a myocardial infarction is:|
- ʺBoth are caused by a clot blocking the coronary arteries. Angina occurs if a small vessel is blocked, and a myocardial infarction occurs if a large vessel is blocked.ʺ
- ʺAngina does not cause severe chest pain, but a myocardial infarction always causes severe chest pain.ʺ
- ʺThere is no way to tell the difference between the two. You will be treated for a myocardial infarction.ʺ
- ʺAngina usually goes away with rest, and is rarely fatal, but a myocardial infarction requires immediate treatment, and can be life-ʺ
|8)||A client has ordered a thrombolytic for treatment of CVA. The nurse knows that which of the||8)|
|following types of stroke should not be treated with a thrombolytic?|
|A) Hemorrhagic stroke|
|B) Thrombolytic stroke|
|C) Both types can be treated with a thrombolytic.|
|D) Neither type can be treated with a thrombolytic.|
|9)||A client taking nitroglycerin (Nitrostat) complains of a headache. The nurse knows that:||9)|
- The client will not have a headache if the nitroglycerin is taken with a high-fat meal.
- Nitroglycerin does not cause headache.
- The most common side effect of nitroglycerin is headache.
- A headache indicates a serious allergic reaction to nitroglycerin.
|10)||A client taking nitroglycerin (Nitrostat) for angina asks the nurse to explain possible side effects||10)|
|Which of the following should be included in client teaching? Select all that apply.|
|A) Dizziness||B) Hypertension|
|C) Hyperkalemia||D) Reflex tachycardia|
|11)||A client has been prescribed diltiazem (Cardizem), and asks the nurse what type of drug this is.||11)|
|The nurse replies:|
|A) ʺA beta blocker.ʺ||B) ʺAn alpha blocker.ʺ|
|C) ʺA sodium channel blocker.ʺ||D) ʺA calcium channel blocker.ʺ|
|12)||A client has been prescribed several medications. Which of the following is a beta blocker?||12)|
|A) Verapamil (Calan)||B) Clopidogrel (Plavix)|
|C) Captopril (Capoten)||D) Nadolol (Corgard)|
|13)||The client is being discharged with nitroglycerin (Nitrostat). Client education would include||13)|
- ʺBe sure to call 911 before you take any tablets.ʺ
- ʺIf your chest pain doesnʹt go away after three tablets, call 911; you might be having a heart attack.ʺ
- ʺIf your chest pain doesnʹt go away with one tablet, you can repeat the dose as many times as you need to.ʺ
- ʺYour chest pain should go away with one tablet.ʺ
|14) ________ is only approved for chronic angina that has not responded to other agents.||14)|
|A) Atenolol (Tenormin)||B) Ranolazine (Ranexa)|
|C) Sildenafil (Viagra)||D) Nitroglycerin (Nitrostat)|
|15)||The nurse is preparing to administer atenolol (Tenormin) to a client with angina. Which of the||15)|
|following vital signs would cause the nurse to question administering this drug?|
|A) Pulse 52 beats per minute||B) Oxygen saturation 95%|
|C) Blood pressure 134/72||D) Respirations 12 breaths per minute|
|16)||Reteplase (Retavase) has been ordered for a client diagnosed with a MI. The nurse understands||16)|
|that this drug needs to be administered within which time frame following the onset of symptoms?|
|A) 30 minutes to 12 hours||B) 60 minutes to 24 hours|
|C) 45 minutes to 18 hours||D) 90 minutes to 36 hours|
|17)||Following a stroke, a client has been started on clopidogrel (Plavix). The nurse understands this||17)|
|medication is given:|
- To increase blood pressure.
- To decrease blood pressure.
- To provide antiplatelet activity in patients who cannot tolerate aspirin
- To prevent stroke in high-risk patients, such as those with prosthetic heart valves.
|18)||A client presents in the Emergency Department with a suspected MI. Which of the following||18)|
|medications should be given as soon as possible?|
|A) Metoprolol (Lopressor)||B) Morphine|
|C) Aspirin (ASA)||D) Clopidogrel (Plavix)|
|19)||The client asks the nurse why an ACE inhibitor has been prescribed following a MI. The best||19)|
|response by the nurse would be:|
- ʺACE inhibitors are always prescribed with a beta blocker and calcium channel blocker following a MI.ʺ
- ʺThis medication will treat your hypotension.ʺ
- ʺACE inhibitors have been found to reduce mortality following MI.ʺ
- ʺThis medication will lower your potassium level.ʺ
|20)||Which of the following drug classes has been found to decrease mortality if given within 8 hours of||20)|
|a MI due to a decrease in cardiac workload?|
|A) Calcium channel blockers||B) Beta-adrenergic blockers|
|C) ACE inhibitors||D) Antiplatelet|
|21)||A client has been prescribed a calcium channel blocker for angina. The nurse knows this||21)|
|medication should be used with caution in combination with which of the following drug classes?|
|Select all that apply.|
|A) Cardiac glycosides||B) Beta blockers|
|C) NSAIDs||D) Diuretics|
|22)||The client asks the nurse what common side effects of calcium channel blockers are. Which of the||22)|
|following should the nurse include in client teaching? Select all that apply.|
|A) Edema of lower extremities||B) Headache|
|C) Epistaxis||D) Constipation|
|23) The client asks the nurse why the nitrate patch needs to be off for 8 hours per day. The best||23)|
|response by the nurse would be:|
- ʺThere is no reason to take the patch off each day.ʺ
- ʺLeaving the patch off for 8 hours per day helps to delay the development of tolerance.ʺ
- ʺYou should only leave the patch off for 15 minutes.ʺ
- ʺYou should wear the patch for 1 day and then leave off for 1 day.ʺ
|24)||A client has been prescribed a drug to prevent angina pain. The nurse knows that the first type of||24)|
|medication prescribed to prevent angina is:|
|A) Organic nitrates.||B) Beta blockers.|
|C) Calcium channel blockers.||D) Alpha blockers.|
|25)||The nurse is caring for a client who has been diagnosed with angina. Which three of the following||25)|
|drug classes are used to treat angina? Select all that apply.|
|A) Alpha blockers||B) Calcium channel blockers|
|C) Beta blockers||D) Organic nitrates|
|1)||The nurse realizes that the risk for cardiogenic shock following MI is high, with a mortality rate of||1)|
|A) 70—80 percent.||B) 50—60 percent.|
|C) 20—30 percent.||D) 40—50 percent.|
|2)||If the client is entering hypovolemic shock, the nurse understands that which of the following||2)|
|becomes a priority?|
- Maintenance of the clientʹs airway
- Administration of norepinephrine (Levophed)
- Maintenance of volume
- Administration of sodium bicarbonate
|3)||Initial, usual responses of the body to an antigen include which of the following? Select all that||3)|
|A) Release of histamine and mast cells||B) Itching with development of hives|
|C) Inflammation and antibody production||D) Swelling of the larynx|
|4)||A client presents with shock in the hospital, and has a history of a recent infection. The nurse||4)|
|suspects the client is suffering from:|
|A) Cardiogenic shock.||B) Septic shock.|
|C) Neurogenic shock.||D) Hypovolemic shock.|
|5)||The earliest sign of shock that the nurse can assess would be:||5)|
|A) Restlessness.||B) Complaints of nausea.|
|C) Pale skin.||D) Complaints of thirst.|
|6)||Metabolic findings that the nurse assesses as symptomatology of shock include:||6)|
|A) Low temperature and thirst.||B) Restlessness, anxiety, and confusion.|
|C) Rapid, shallow respiratory effort.||D) Tachycardia and hypotension.|
- The first step to treating shock is to provide
- Blood and/or blood products.
- Basic life support.
- Medications to counteract the sequelae.
- Fluid replacement.
|8)||The nurse knows that the client entering anaphylaxis will have difficulty breathing because of:||8)|
|A) Reflex tachycardia.|
|B) Bronchoconstriction in response to the allergen.|
|C) Compensation for a rapid fall in blood pressure.|
|D) The bodyʹs response to histamine.|
|9)||Fluid replacement agents used to treat shock include which of the following? Select all that apply||9)|
|A) Oral fluids||B) Crystalloids||C) Blood products||D) Colloids|
|10)||The nurse is preparing to administer a crystalloid IV to a client. Which of the following IV fluids is||10)|
|A) Fresh frozen plasma||B) Hetastarch (Hespan)|
|C) Lactated Ringerʹs||D) Dextran|
|11)||The nurse is administering IV fluid to a client. The nurse knows it is important to monitor||11)|
|electrolytes when administering:|
|A) Blood products.||B) Crystalloids.|
|C) Antibiotics.||D) Colloids.|
|12)||A client who has not responded to IV fluids to raise blood pressure will be treated with which type||12)|
|of medication to raise blood pressure?|
|A) Whole blood||B) Vasodilators|
|C) Additional crystalloids||D) Vasopressors.|
|13)||The nurse gets ready to administer norepinephrine (Levophed) to a client in shock. The rationale||13)|
|for this action is to:|
- Produce vasoconstriction.
- Cause bradycardia and reserve heart function.
- Increase cardiac output.
- Cause the heartʹs conduction system to work more effectively.
|14)||Dopamine (Dopastat) produces which of the following effects when used for cardiogenic and||14)|
|hypovolemic shock? Select all that apply.|
|A) Increases renal blood flow.||B) Increases cardiac output.|
|C) Depends on the dose.||D) Hypotension|
|15)||Which of the following vasoconstrictors is usually associated with the treatment of anaphylaxis?||15)|
|A) Dopamine (Dopastat)||B) Dobutamine (Dobutrex)|
|C) Norepinephrine (Levophed)||D) Epinephrine|
|16)||Drugs that the nurse may administer to treat the symptoms of life -threatening shock can include:||16)|
|A) Epinephrine.||B) Antihistamines.|
|C) Oxygen.||D) Corticosteroids.|
|17)||A client is receiving norepinephrine (Levophed). The nurse knows vital signs must be continually||17)|
|monitored to watch for which of the following effects?|
|A) Oliguria||B) Hypertension||C) Bradypnea||D) Tachycardia|
|18)||A client has been given an IM dose of an antibiotic at an outpatient clinic. The client should be||18)|
|A) 20—60 minutes.||B) 5 minutes.|
|C) 30—120 minutes.||D) 15—20 minutes.|
|19)||A client presents with anaphylaxis. Which of the following are likely to be given to this client to||19)|
|treat anaphylaxis? Select all that apply.|
|A) Oxygen||B) Aspirin (ASA)|
|C) Albuterol (Ventolin)||D) Diphenhydramine (Benadryl)|
|20)||________ have the potential to reverse the cardiac symptoms of shock by increasing the force of||20)|
|A) Colloids||B) Vasopressors||C) Crystalloids||D) Inotropic drugs|
|21)||At low doses, which of the following medications selectively increases blood flow to the kidneys?||21)|
|A) Digoxin (Lanoxin)||B) Dopamine (Dopastat)|
|C) Norepinephrine (Levophed)||D) Dobutamine (Dobutrex)|
|22)||A client is receiving a blood product. The nurse should monitor for which of the following? Selec||22)|
|all that apply.||C) Pruritus|
|A) Hematuria||B) Proteinuria||D) Dyspnea|
|23)||A client receiving albumin (Albuminar) should be monitored for an excess of:||23)|
|A) Calcium.||B) Potassium.||C) Protein.||D) Sodium.|
|24)||Which of the following IV fluids is not a colloid?||24)|
|A) Plasma protein fraction (Plasmanate)||B) Dextran 40 (Gentran 40)|
|C) Albumin (Albuminar)||D) Plasmalyte|
- Which of the following IV fluids is not a crystalloid?
- Hypertonic saline (3% sodium chloride)
- Plasma protein fraction (Plasmanate)
- Normal saline (0.9% sodium chloride)
|1) A client is in chronic renal failure. The nurse understands that this client might require:||1)|
- A kidney transplant.
- Higher dosages of medications than would a client with normally functioning kidneys.
- A significant dosage reduction in most medications.
- The same medication dosage as would a client with normally functioning kidneys.
|2)||Which of the following are functions of the kidneys? Select all that apply.||2)|
|A) Secrete the enzyme renin.||B) Stimulate red blood cell production.|
|C) Regulate fluid balance.||D) Aid in digestion.|
|3)||The nurse is instructing the client about different types of diuretics. Which of the following should||3)|
|be included in teaching?|
- Thiazide and loop diuretics cause potassium to be lost in the urine
- All diuretics cause hyperkalemia.
- All diuretics cause potassium to be lost in the urine
- Diuretics do not cause potassium to be lost in the urine
|4)||An important teaching item to include when a client is placed on potassium supplements is:||4)|
|A) Take with food.|
|B) Take on an empty stomach.|
|C) Tablets may be crushed or broken for easier swallowing.|
|D) Do not use with antacids.|
|5)||The client has a pH of 7.6. Which of the following statements are correct? Select all that apply.||5)|
- The client should be monitored for symptoms of CNS depression, which could result in coma.
- The client is acidotic.
- The client should be monitored for symptoms of CNS stimulation that include nervousness and convulsions.
- The client is alkalotic.
|6)||A client has been admitted with a mild case of alkalosis. Which of the following would the nurse||6)|
|expect to be ordered?||B) Oral potassium supplements|
|A) 09. NS with 20 mEq potassium|
|C) Lactated Ringer’s solution||D) 0.9 NS|
|7)||Which of the following medications is used to increase red blood cell production in patients with||7)|
|A) Epoetin alfa (Epogen)||B) Mannitol (Osmitrol)|
|C) Chlorthalidone (Hygroton)||D) Methazolamide (Neptazane)|
|8)||The client is taking furosemide (Lasix) 80mg b.i.d. The patient should be monitored for:||8)|
|A) Hyperkalemia.||B) Hypocalcemia.|
|C) Hypercalcemia.||D) Hypokalemia.|
|9) The client asks the nurse: ʺWhich of the following medications is a loop diuretic?ʺ||9)|
|A) Amiloride (Midamor)||B) Spironolactone (Aldactone)|
|C) Triamterene (Dyrenium)||D) Furosemide (Lasix)|
|10)||A potassium-sparing diuretic has been prescribed for a client. The nurse expects which of the||10)|
|following medications to be ordered?|
|A) Hydrochlorothiazide (HCTZ)||B) Diltiazem (Cardizem)|
|C) Spironolactone (Aldactone)||D) Furosemide (Lasix)|
|11)||The client has been prescribed a thiazide diuretic. Which of the following are potential adverse||11)|
|effects of thiazide diuretics? Select all that apply.||C) Epistaxis|
|A) Hyperkalemia||B) Hypotension||D) Dizziness|
|12)||A client is receiving IV furosemide (Lasix). The nurse will monitor for which adverse effect?||12)|
|A) Hypotension||B) Nausea||C) Vomiting||D) Bradycardia|
|13)||A client who has been placed on spironolactone (Aldactone) should be closely monitored for||13)|
|hyperkalemia, especially if also on:|
|A) Furosemide (Lasix).||B) Hydrochlorothiazide (HydroDIURIL).|
|C) Prinivil (Zestril).||D) Digoxin (Lanoxin).|
|14)||A diuretic that is also used for treatment in certain types of glaucoma is:||14)|
|A) Mannitol (Osmitrol).||B) Indapamide (Lozol).|
|C) Triamterene (Dyrenium).||D) Amiloride hydrochloride (Midamor).|
|15)||A client has been diagnosed with hyperkalemia. Which of the following medications would the||15)|
|nurse expect to give?|
|A) Furosemide (Lasix)||B) Potassium chloride|
|C) Sodium polystyrene sulfate (Kayexalate)||D) Calcium carbonate (TUMS)|
|16)||Thiazides might be preferred over loop diuretics because:||16)|
- The frequency of adverse effects is much lower.
- They can be taken on an as -needed basis.
- Possible dehydration is not a factor.
- They do not cause electrolyte imbalance.
|17)||A client has been taking spironolactone (Aldactone), and continues to have peripheral edema. The||17)|
|nurse should ask the client if he is also taking:|
|A) Digoxin (Lanoxin).||B) Corticosteroids.|
|C) Aspirin (ASA).||D) Potassium supplements.|
|18)||The client is receiving dextran 40 as a fluid replacement agent. The nurse knows this solution||18)|
|works by its ability to:|
|A) Leave the blood and enter cells.||B) Increase osmotic pressure.|
|C) Replace electrolytes.||D) Promote urine output.|
|19)||A client who is receiving sodium bicarbonate for an acid—base imbalance should also have blood||19)|
|levels monitored for which drug?|
|A) Digoxin (Lanoxin)||B) Lithium (Eskalith)|
|C) Spironolactone (Aldactone)||D) Potassium supplement|
|20)||Foods high in potassium include which of the following? Select all that apply||20)|
|A) Bananas||B) Broccoli||C) Peanut butter||D) Dried fruits|
|21)||The client has been prescribed a potassium supplement and spironolactone (Aldactone). The nurse||21)|
- The two medications will be ineffective if taken together.
- The client is at risk for hyperkalemia when taking both the supplement and spironolactone (Aldactone).
- These two medications will decrease potassium levels.
- Spironolactone (Aldactone) will lower potassium levels, so a supplement is necessary.
|22)||The client has been prescribed furosemide (Lasix). Which of the following are potential side effects||22)|
|of treatment? Select all that apply.|
|A) Dizziness||B) Hypotension||C) Dehydration||D) Dysrhythmias|
|23)||Diuretics are used to treat which of the following? Select all that apply.||23)|
|A) Heart failure||B) Hypotension|
|C) Hypertension||D) Pulmonary edema|
|24)||The client complains of frequent urination at night since starting diuretic therapy. The nurse||24)|
|advises the client to:|
|A) Increase sodium intake.||B) Take the medication earlier in the day.|
|C) Decrease fluid intake.||D) Not worry; this is an expected effect.|
|25)||A client was admitted with acidosis. During treatment, the client develops confusion, irritability||25)|
|slow respiration rate, and vomiting. The nurse understands these symptoms to:|
|A) Indicate worsening of acidosis.||B) Be expected response to treatment.|
|C) Indicate overtreatment of acidosis.||D) Indicate increased blood pressure.|
|1)||Common signs of inflammation include which of the following? Select all that apply.||1)|
|A) Swelling||B) Itching||C) Pain||D) Redness|
|2)||A defense mechanism that occurs in response to many different stimuli, including physical injury,||2)|
|exposure to toxic chemicals, extreme heat, invading microorganisms, or death of cells, is known as:|
|A) Allergy.||B) Inflammation.|
|C) Histamine response.||D) Pain.|
|3)||Rapid release of histamine on a large scale throughout the body is responsible for:||3)|
|A) Redness.||B) Anaphylaxis.||C) Pain.||D) Swelling.|
|4)||Which of the following are used to treat mild inflammation? Select all that apply.||4)|
|A) Ice packs||B) Glucocorticoids||C) NSAIDs||D) Rest|
|5)||The goal of pharmacotherapy with anti-inflammatory drugs is to:||5)|
- Decrease the intensity of the inflammatory response.
- Keep the client taking a constant dose of anti-inflammatory medications indefinitely.
- Increase range of motion.
- Treat all inflammation with glucocorticoids.
|6)||________ immunity is initiated when an antigen encounters a type of lymphocyte known as a B||6)|
|A) Vaccine||B) Cytokines||C) Humoral||D) Cell-mediated|
|7)||A client has been taking high-dose aspirin (ASA) for pain. Which of the following side effects||7)|
|would the nurse expect the client to experience? Select all that apply.|
|A) Heartburn||B) Bleeding||C) Inflammation||D) Ataxia|
|8)||Which of the following statements made by the client taking naproxen sodium (Aleve) indicates||8)|
|the need for further instruction?|
- ʺI should not take herbal supplements without checking with my doctor first.ʺ
- ʺI should take this medication on an empty stomach.ʺ
- ʺI should take this medication with food.ʺ
- ʺI will notify my dentist of my medication use before my next cleaning.ʺ
|9) The client asks the nurse which of the OTC pain medications is used to treat inflammation. Select||9)|
|all that apply.|
|A) Ibuprofen (Advil)||B) Aspirin (ASA)|
|C) Acetaminophen (Tylenol)||D) Naproxen sodium (Aleve)|
|10) A client is taking glucocorticoids for an extended period of time. The nurse would anticipate the||10)|
|client to display which of the following physical signs? Select all that apply.|
|A) Moon face||B) Fat deposits on the shoulders|
|C) Constipation||D) Increased urination|
|11)||Prednisone has been prescribed for a client with inflammation. The nurse knows prednisone is||11)|
|usually prescribed for:|
|A) 4—10 days.||B) 2—20 days.||C) 7—18 days.||D) 1—3 days.|
|12)||Which of the following are examples of live attenuated vaccines? Select all that apply.||12)|
|A) Hepatitis A vaccine||B) Influenza|
|C) Tetanus toxoid||D) Measles, mumps and rubella vaccine|
|13)||An adult client is receiving hepatitis B (Engerix-B) injections. The nurse knows the client should||13)|
|have the shots on which of the following schedules?|
- First dose followed by a booster 6—12 months later
- Single annual dose
- Three doses, with the second dose 30 days after the first and the final dose 6 months after the first
- The first dose at age 11 or 12 years, the second dose 2 months after the first dose, and the third dose 6 months after the first dose
|14)||Interferons are used for which of the following? Select all that apply.||14)|
|A) Treat anti-inflammatory actions.||B) Decrease blood pressure.|
|C) Slow the spread of viral infections.||D) Decrease heart rate.|
|15)||After assessing a client who underwent a kidney transplant, the nurse expects to administer:||15)|
|A) Phenytoin (Dilantin).||B) Nabumetone (Relafen).|
|C) Cyclosporine (Sandimmune).||D) Cortisone (Cortone).|
|16)||An inpatient client with COPD has been diagnosed with allergic rhinitis, and is given an||16)|
|antihistamine. The nurse knows to:|
- Premedicate with acetaminophen (Tylenol).
- Consult physician before administering.
- Give before client starts wheezing.
- Keep resuscitative equipment accessible.
|17)||A client has been prescribed an immunosuppressant. The client asks the nurse: ʺWhich of the||17)|
|following medications is an immunosuppressant?ʺ|
|A) Prednisone||B) Cyclosporine (Neoral)|
|C) Ibuprofen (Motrin)||D) Cortisone (Cortone)|
|18)||A client complains of mild inflammation. Which of the following medications would not be an||18)|
|appropriate choice to treat mild inflammation?|
|A) Ibuprofen (Advil)||B) Cyclosporine (Neoral)|
|C) Naproxen sodium (Aleve)||D) Aspirin (ASA)|
|19)||A client with Hodgkinʹs disease has been on long-term prednisone therapy. The nurse knows this||19)|
|client is at risk for developing:|
- Cushingʹs syndrome.
- Systemic inflammatory response syndrome (SIRS).
|20)||After assessing a client with allergic rhinitis, the most appropriate medication that the nurse wil||20)|
|A) Oxymetazoline (Afrin).||B) Echinacea (Echinacea purpurea).|
|C) Diphenhydramine (Benadryl).||D) Naproxen (Naprosyn).|
|21)||A nurse is teaching her client cyclosporine therapy following a recent liver transplant. What||21)|
|statement by the client indicates further teaching is needed?|
- ʺI can take acetaminophen (Tylenol) for a headache, but I have to be very careful.ʺ
- ʺI might experience a decrease in urinary flow.ʺ
- ʺI will need to come into the clinic for periodic blood counts.ʺ
- ʺI can take this drug with any fluid as long as it is at the same time every day.ʺ
|22)||A client received the hepatitis B vaccine per job policy. The nurse teaches the client that the vaccine||22)|
|provides prophylaxis against exposure to the hepatitis B virus, which is transmitted through:|
|A) Blood.||B) Water.||C) Food.||D) Germs.|
|23)||Teaching parents the importance of maintaining up-to-date vaccinations is a dynamic||23)|
|responsibility for the nurse. The nurse must stress the importance of:|
|A) The school nurse.||B) Preventing illness.|
|C) Treating illness.||D) Health departments.|
|24)||A client is diagnosed with leukemia. The nurse knows that vaccinations for this client are:||24)|
- Too late.
- Contraindicated because of a weak immune system.
- The cause of the leukemia.
- Critical for survival.
|25) The anthrax vaccination has been licensed by the FDA for more than 30 years. The nurse knows||25)|
that the Centers for Disease Control and Prevention recommends this vaccination for which of the following? Select all that apply.
- A) Laboratory personnel
- B) Military personnel
- C) All health care personnel
- D) Those who deal with imported animal products
|1)||A highly virulent organism is one that can produce disease when:||1)|
|A) Present in small numbers.||B) The immune system is suppressed.|
|C) Present in large numbers.||D) Another disease is present.|
|2)||Bacteria are described and classified by which of the following methods? Select all that apply.||2)|
|A) Shape||B) Ability to use O2|
|C) Color||D) Staining|
|3)||Which of the following is used to describe the stain of a bacteria?||3)|
|A) Bacillus||B) Cocci||C) Gram-positive||D) Aerobic|
|4)||The nurse understands that the difference between bacteriostatic and bacteriocidal medications is:||4)|
- Bacteriostatic medications must be given first.
- That bacteriocidal medications kill bacteria, and bacteriostatic medications slow the growth of bacteria.
- Both terms have the same meaning.
- That bacteriocidal medications slow the growth of bacteria, and bacteriostatic medications kill bacteria.
|5) The client asks the nurse how a bacteria becomes resistant to antibiotics. The nurse should include||5)|
|which of the following in the response? Select all that apply.|
- Prematurely stopping antibiotic therapy allows some pathogens to survive and become resistant to antibiotics.
- Bacteria reproduce quickly, and can have a variation in the genetic code that allows them to become resistant.
- Frequent handwashing by health care providers encourages the spread of bacteria to many clients receiving antibiotics in the hospital.
- The longer an antibiotic is used in the population and the more often it is prescribed, the higher will be the percentage of resistant strains.
|6)||The nurse is admitting a client with a diagnosis of urinary tract infection. The physician has||6)|
|ordered an IV antibiotic. Before administering this medication, it is most important to obtain:|
|A) PTT.||B) PT.|
|C) Urine for culture and sensitivity.||D) Platelets.|
|7)||A sputum culture has been collected and sent for culture and sensitivity. The physician orders a||7)|
|broad-spectrum antibiotic. The nurse understands that the reason for this is:|
- Most people are allergic to narrow-spectrum antibiotics.
- Treatment for severe infections is started on broad-spectrum antibiotics while the culture is pending and then changed to a narrow-spectrum antibiotic.
- The broad-spectrum antibiotic will cure the infection before the culture results are ready.
- The culture and sensitivity will take 2 weeks for the results to be available.
|8) A superinfection is:||8)|
- A secondary infection that occur when microorganisms normally present in the body are killed by the drug.
- A drug-resistant infection.
- An infection that is difficult to treat.
- A secondary infection that is caused by a weakened immune system.
|9) Signs and symptoms of a superinfection include which of the following? Select all that apply.||9)|
|A) Diarrhea||B) Epistaxis||C) Headache||D) Bladder pain|
|10)||A client has been prescribed penicillin (Penicillin G). The nurse knows that the most serious||10)|
|adverse effect is:|
|A) Anaphylaxis.||B) Tachycardia.||C) Bradycardia.||D) Hemorrhage.|
|11)||The client has been prescribed cefotaxime (Claforan). The nurse knows this medication is used to||11)|
|treat infections in which of the following? Select all that apply.|
|A) Skin||B) Central nervous system|
|C) Lower respiratory tract||D) Joints|
|12)||Which of the following statements is not correct regarding cephalosporins?||12)|
- GI-related adverse effects such as diarrhea, vomiting, and nausea can occur.
- Many must be given IM or IV.
- Clients who are allergic to penicillin might be allergic to cephalosporins
- All cephalosporins are absorbed well from the GI tract.
|13)||The nurse is instructing a client who has been prescribed tetracycline (Sumycin). The nurse advises||13)|
|the client to avoid:|
|A) Exercise.||B) Foods that contain wheat.|
|C) Taking with food.||D) Sunlight.|
|14)||The nurse is admitting a client to the floor with a protozoan infection. Which of the following||14)|
|medications would the nurse expect the physician to order?|
|A) Ciprofloxacin (Cipro)||B) Metronidazole (Flagyl)|
|C) Quinupristin-dalfopristin (Synercid)||D) Penicillin|
|15)||The nurse is caring for a client receiving gentamicin IV. Which of the following adverse effects||15)|
|would the nurse report to the physician immediately?|
|A) Ototoxicity||B) Nausea|
|C) Increased urinary output||D) Diarrhea|
|16)||The nurse is admitting a client to the acute care floor with methicillin-resistant S. aureus . The nurse||16)|
|would expect the physician to order which of the following medications for this client?|
|A) Vancomycin (Vancocin)||B) Penicillin|
|C) Streptomycin||D) Kanamycin (Kantrex)|
|17)||The nurse is discharging a client to home with a prescription for clarithromycin (Biaxin). The nurse||17)|
|knows that the teaching has been effective when the client states:|
|A) ʺI cannot clean house while taking this medication.ʺ|
|B) ʺI can quit taking this medication when I feel better.ʺ|
|C) ʺI cannot drive while taking this medication.ʺ|
|D) ʺI need to take the medication until it is gone.ʺ|
|18)||The nurse is admitting a client to the acute care floor. While obtaining the history, the client tells||18)|
|the nurse she is allergic to penicillin. Which of the following medications, if ordered by the|
|physician, would be safe for this client?|
|A) Cefdinier (Omnicef)||B) Erythromycin (E-Mycin)|
|C) Cefaclor (Ceclor)||D) Cephalexin (Keflex)|
|19)||The nurse is preparing discharge instructions for a client who will be taking penicillin G. The clien||19)|
|tells the nurse she is also taking birth control pills. What is the nurseʹs best response?|
- ʺYou may continue taking the birth control pills as your only means of contraception.ʺ
- ʺYou do not need to take your birth control pills while taking this medication.
- ʺYou will need to use another form of contraception while taking the antibiotic and for at least one month after you finish treatment.ʺ
- ʺIf you feel you do not need to take the antibiotic, that is fine.ʺ
|20)||A client enters the Emergency Department with suspected exposure to anthrax. The physician||20)|
|confirms this suspicion and orders the client an antibiotic. Which of the following medications|
|would the nurse expect the physician to order?|
|A) Doxycycline (Vibramycin)||B) Oxytetracycline (Terramycin)|
|C) Ciprofloxacin (Cipro)||D) Penicillin|
|21)||The nurse is caring for a client who is being discharged with a prescription for a tetracycline||21)|
|Which of the following statements, if made by the client, would demonstrate an understanding of|
|the discharge instructions?|
- ʺI am so glad to be leaving today because I have an appointment at the tanning salon.ʺ
- ʺIt is fine for me to become pregnant while taking this medication.ʺ
- ʺI will stop taking this medication as soon as I feel better.ʺ
- ʺI will need to postpone my vacation at the beach until I finish this medication.ʺ
|22)||The nurse is providing discharge instructions to a client being discharged on ciprofloxacin (Cipro)||22)|
|Which of the following should be included in the teaching? Select all that apply.|
|A) ʺDrink as much coffee as you would like.ʺ|
|B) ʺDo not take with antacids.ʺ|
|C) ʺYou might have some dizziness.ʺ|
|D) ʺDo not take with mineral supplements.ʺ|
|23)||A client has been diagnosed with tuberculosis. The nurse would anticipate treatment to continue||23)|
|A) 10—14 days.||B) 6—12 months.||C) 2—4 weeks.||D) 3—6 months.|
|24)||The client with tuberculosis will be treated with||24)|
- Different combinations of two or more antibiotics.
- Alternate day dosing of three antibiotics.
- Only one antibiotic for 12 months.
- Always two antibiotics.
|25) A client has been prescribed isoniazid (INH). Select all of the foods the client should avoid while||25)|
|taking this medication.|
|A) Aged cheese||B) Bananas||C) Chocolate||D) Beer|
|1)||The nurse is admitting a client to the Acute Care Unit with Trichomonas vaginalis. Which of the||1)|
|following is the drug of choice for this infection?|
|A) Pyrimethamine (Daraprim)||B) Curamin (Germanin)|
|C) Metronidazole (Flagyl)||D) Praziquantel (Biltricide)|
|2)||A client is admitted with a systemic fungal infection. The nurse understands that this type of||2)|
|A) Affects the skin.||B) Affects the scalp.|
|C) Affects the oral mucosa.||D) Affects internal organs.|
|3)||Which of the following clients is at greatest risk for a serious fungal infection?||3)|
- 35-year-old healthy woman
- 76-year-old client with hypertension
- 12-year-old client with a renal transplant
- 18-year-old client with asthma
|4)||Viruses are called:||4)|
|A) Symbiotic.||B) Intracellular parasites.|
|C) Capsid.||D) Fungi.|
|5)||The nurse is preparing to teach a client how to prevent influenza. What is the best approach for||5)|
|individuals to take to prevent influenza?|
|A) Weekly lab testing||B) Take vitamin C daily.|
|C) Annual physical examination||D) Annual vaccination|
|6)||The nurse is preparing to discharge a client on an antiretroviral agent. The clientʹs spouse asks the||6)|
|nurse how she can best practice infection-control techniques. What techniques should the nurse|
|discuss with the clientʹs spouse? Select all that apply.|
|A) Take the clientʹs temperature daily.||B) Take your temperature daily.|
|C) Avoid the affected area.||D) Practice good handwashing.|
|7)||The nurse is caring for a client with herpes simplex virus. Which of the following medications||7)|
|would the nurse expect the physician to order for this client?|
|A) Metronidazole (Flagyl)||B) Nystatin (Fungizone)|
|C) Zidovudine (Retrovir)||D) Acyclovir (Zovirax)|
|8)||The nurse is planning care for a client receiving an antiretroviral agent. Which of the following||8)|
|nursing diagnoses should be the priority?||B) Risk for infection|
|C) Deficient knowledge||D) Self-care deficit|
|9) During the latent phase of HIV infection, antiviral medications are prescribed to:||9)|
|A) Prevent the spread of HIV.|
|B) Cure HIV.|
|C) Relieve symptoms that occur during the latent phase.|
|D) Delay onset of acute symptoms and the development of AIDS.|
|10) The therapeutic goals for the pharmacotherapy of HIV/AIDS include which of the following?||10)|
|Select all that apply.|
- Improve the quality of life.
- Prevent the transmission from mother to child in HIV-infected pregnant patients.
- Increase HIV-related morbidity, and prolong survival.
- Maximum suppression of viral load
|11)||A client with HIV has been prescribed HAART. The nurse understands that the goal of HAART is||11)|
|A) Cure HIV.|
|B) Reduce the amount of HIV in the plasma to its lowest possible level.|
|C) Increase the amount of HIV in the plasma.|
|D) Decrease adverse effects from HAART therapy.|
|12)||The Centers for Disease Control and Prevention (CDC) recommends that travelers to||12)|
|malaria-infested areas receive prophylactic antimalarial drugs prior to and during their visit, and|
|for 1 week after leaving. The client asks the nurse which medication will be prescribed for this. The|
|A) ʺPraziquantel (Biltricide).ʺ||B) ʺChloroquine (Aralen).ʺ|
|C) ʺAlbendazole (Albenza).ʺ||D) ʺMebendazole (Vermox).ʺ|
|13)||Which of the following are helminths? Select all that apply.||13)|
|A) Flukes||B) Hookworm||C) Protozoans||D) Tapeworm|
|14)||Zidovudine (Retrovir) has been prescribed to a client with HIV. The client asks why it is given in||14)|
|combination with other medications to treat HIV. The nurse should include which of the following|
|in client teaching? Select all that apply.|
- The combination allows HIV to be attacked by several different mechanisms.
- The combination will cure HIV.
- Strains of HIV resistant to zidovudine are common.
- The combination slows the development of resistance.
15) Zidovudine (Retrovir) has been prescribed to a client with HIV. The client asks why blood needs to 15)
be drawn on a regular basis. The nurse replies:
- ʺReduced numbers of red and white blood cells are common, and need to be monitored.ʺ
- ʺThis medication can cause an increase in red and white blood cells, and needs to be monitored.ʺ
- ʺThis medication will cause dehydration, so your blood needs to be monitored for this.ʺ
- ʺSerum creatinine must be monitored for clients taking zidovudine.ʺ
|16) A client with herpes lesions on the face asks the nurse which medication has been prescribed. The||16)|
|nurse knows a topical cream has been ordered, and knows that which of the following is a topical|
|A) Acyclovir (Zovirax)||B) Docosanol (Abreva)|
|C) Cidofovir (Vistide)||D) Famciclovir (Famvir)|
|17)||The client asks the nurse what are possible treatments for influenza. Which of the following should||17)|
|the nurse include in client teaching? Select all that apply.|
|A) Amantadine (Symmetrel)||B) Zanamivir (Relenza)|
|C) Valacyclovir (Valtrex)||D) Oseltamivir (Tamiflu)|
|18)||A client has been prescribed metronidazole (Flagyl). The nurse understands that this medication||18)|
|has many uses, and is used to treat which of the following? Select all that apply.|
|A) CNS infections||B) Trichomoniasis||C) Amebiasis||D) Rosacea|
|19)||A client has been prescribed amphotericin B (AmBisome). The nurse knows to monitor the client||19)|
|for which of the following side effects? Select all that apply.|
|A) Hepatotoxicity||B) Fever and chill||C) Phlebitis||D) Nephrotoxicity|
|20)||The nurse is preparing to discharge a client who will be taking an antiretroviral agent. Upon which||20)|
|of the following symptoms should the client discontinue the medication and inform the health care|
|provider? Select all that apply.|
|A) Sore throat||B) Rash|
|C) Wheezing||D) Shortness of breath|
|21)||The nurse is preparing to discharge a client with a prescription for zidovudine (Retrovir). Which of||21)|
|the following drugs should the client avoid while taking this medication? Select all that apply.|
|A) Acetaminophen (Tylenol)||B) Aspirin (ASA)|
|C) Penicillin (PCN)||D) Herbal supplements|
|22)||The nurse is preparing to administer the antifungal medication nystatin to an adult client. The||22)|
|nurse also has a PO medication to give this client. How should the nurse administer these|
- Give the PO medicine to the client, and allow the client to swallow the medication with the nystatin.
- Give the nystatin first.
- It does not matter which medication is given first.
- Give the PO medication first.
|23)||The nurse is preparing to administer ketoconazole (Nizoral) to a client. With which of the||23)|
|following liquids should the client take this medication?|
|A) Pepsi||B) Milkshake||C) Milk||D) Apple juice|
|24)||The nurse is caring for a client who is taking an antiviral medication. Which of the following||24)|
|assessments might alert the nurse to possible bone marrow suppression? Select all that apply.|
|A) Decreased appetite||B) Bruising|
|C) Hematuria||D) Temperature of 102°F|
|25)||Nystatin (Mycostatin) has been prescribed for a client topically. The nurse understands that the||25)|
|most common side effect is:|
|A) Nausea.||B) Skin irritation.||C) Vomiting.||D) Diarrhea.|
|1) Which of the following statements is true regarding cancer cells? Select all that apply.||1)|
- Cancer cells lose their normal functions, divide rapidly, and invade surrounding cells
- The abnormal cells often travel to distant sites where they populate new tumors, a process called metastasis.
- Cancer is thought to result from damage to genes controlling cell growth
- Cancer cells divide slowly.
|2) An 8-year-old client is diagnosed with cancer. The nurse knows that:||2)|
- Because of the clientʹs age, the prognosis is positive.
- Because of the clientʹs age, there is no medicine available.
- This is the leading cause of death in children younger than 15 years old.
- Because of the clientʹs age, there will be no pain involved.
|3)||The nurse knows to tell her clients that certain foods provide protective effects against cancer.||3)|
|Those foods include:|
|A) Chicken.||B) Grits.||C) Cod.||D) Beef jerky.|
|4)||Antioxidants are thought to offer a protective effect against cancer. A nurse teaches her clients that||4)|
|which beverage also increases longevity and mental alertness, and provides a mild diuretic effect?|
|A) Orange pekoe||B) Green tea||C) Black tea||D) Echinacea|
|5)||The client asks the nurse to explain ways to decrease the risk of cancer. The nurse includes which||5)|
|of the following in client teaching? Select all that apply.|
- Maintain a healthy diet low in fat and high in fresh vegetables and fruit.
- Limit or eliminate alcoholic beverage use.
- Eliminate tobacco use and exposure to secondhand tobacco smoke.
- Exercise regularly and keep body weight within optimum guidelines.
|6) A client asks if a benign tumor is cancerous. The nurse replies:||6)|
- Yes, these grow rapidly and can become resistant to treatment.
- No, but if surgically removed, it will grow back
- Yes, this word is often used interchangeably with tumor.
- No, these rarely require drug treatment.
|7)||Two examples of benign tumors are: (Select all that apply.)||7)|
|A) Adenoma.||B) Carcinoma.||C) Lipoma.||D) Sarcoma.|
|8)||The nurse knows another term for tumor is:||8)|
|A) Carcinoma.||B) Neoplasm.||C) Adenoma.||D) Sarcoma.|
|9)||The client asks the nurse what the possible treatments for cancer are. The nurse should include||9)|
|which of the following in the answer? Select all that apply.|
|A) Chemotherapy||B) Diet and exercise|
|C) Radiation||D) Surgery|
|10)||Chemotherapy has three general goals, which are: (Select all that apply.)||10)|
|A) Cure.||B) Control.||C) Palliation.||D) Prevention.|
|11)||The client asks the nurse why cancer is difficult to cure. The nurse states:||11)|
- ʺMost people will not take the medications.ʺ
- ʺSurgery is the only way to cure cancer.ʺ
- ʺThe only way to cure cancer is to use medication, surgery, and radiation in all clients.ʺ
- ʺEvery cancer cell must be removed or destroyed to cure cancer.ʺ
12) The nurse explains to the client why combination therapy and special dosing schedules are used to 12) treat cancer. Which of the following statements indicates the need for further teaching?
- ʺThe medications need to be given in higher doses when used in combination.ʺ
- ʺThis is more effective than using one medication.ʺ
- ʺLower doses of the medications can be given.ʺ
- ʺThis reduces the resistance to medication.ʺ
|13)||A client recently diagnosed with ovarian cancer is concerned about alopecia while taking||13)|
|cyclophosphamide (Cytoxan). The nurse knows that effective teaching has taken place when the|
|A) ʺI will never have hair again!ʺ|
|B) ʺMy hair will probably grow back.ʺ|
|C) ʺWigs only exacerbate the alopecia.ʺ|
|D) ʺI donʹt need to worry about losing my hair.ʺ|
|14)||The nurse educates the client on possible side effects of chemotherapy. Which of the following||14)|
|should not be included in the teaching?|
|A) Hair loss||B) Decreased white blood cells|
|C) Nausea||D) Increased red blood cells|
|15)||The client experiences nausea and vomiting with each treatment of chemotherapy. Which of the||15)|
|following should the nurse advise the client to do to decrease nausea and vomiting?|
- Increase food intake.
- Take antiemetic medications prior to treatment.
- Do not eat for 12 hours before treatment.
- Decrease water intake.
16) Cyclophosphamide (Cytoxan) has been prescribed orally for a client. The nurse understands this is 16)
- There are few side effects when given orally.
- The client has a new diagnosis of cancer.
- It is only available as a pill.
- It is one of only a few anticancer drugs that are well absorbed when given orally.
|17) Methotrexate (Rheumatrex) is prescribed alone or in combination to treat which of the following||17)|
|types of tumor or cancers? Select all that apply.|
|A) Head and neck cancers||B) Bone cancers|
|C) Lung carcinoma||D) Benign|
|18)||The nurse understands that the most serious adverse effect of doxorubicin (Adriamycin) is:||18)|
|A) Decreased white blood cells.||B) Leaking from injection site.|
|C) Delayed cardiac toxicity.||D) Vomiting.|
|19)||A client is diagnosed with bone cancer, and is placed on methotrexate (Mexate). The nurse knows||19)|
|that methotrexate (Mexate) inhibits folic acid metabolism and is classified as:|
|A) An alkaloid.||B) An antitumor antibody.|
|C) An antimetabolite.||D) An alkylating agent.|
|20)||The nurse knows that the adverse effects of anticancer drugs include, but are not limited to, which||20)|
|of the following? Select all that apply.|
|A) Anemia||B) Fatigue||C) Anorexia||D) Alopecia|
|21)||A client with breast cancer is started on chemotherapy. Her daughter is started on the same drug||21)|
|prophylactically. Because the daughter is at high risk to develop breast cancer, the nurse suspects|
|the hormone blocker prescribed is:|
|A) Goserelin (Zoladex).||B) Medroxyprogesterone (Provera).|
|C) Anastrozole (Arimidex).||D) Tamoxifen (Nolvadex).|
|22)||A client with hairy cell leukemia complains of flu-like symptoms including fever, chill, dizziness,||22)|
|and fatigue during the first few weeks of chemotherapy. The nurse suspects the drug responsible|
|for the clientʹs symptoms is:|
|A) Interferon alfa-2 (Roferon A).||B) Letrozole (Femara).|
|C) Daunorubicin (Cerubidine).||D) Paclitaxel (Taxol).|
|23)||The nurse knows that a client with Kaposiʹs sarcoma will most likely be prescribed:||23)|
|A) Interferon alfa-2 (Roferon A).||B) Paclitaxel (Taxol).|
|C) Doxorubicin (Adriamycin).||D) Letrozole (Femara).|
|24)||A client is undergoing antineoplastic therapy. The nurse, in an effort to minimize the toxic effects||24)|
|of therapy, administers growth factors such as:|
|A) Teniposide (Vumon).||B) Megestrol acetate (Megace).|
|C) Carmustine (Gliadel).||D) Filgrastim (Neupogen).|
|25)||Which of the following medications are alkylating agents? Select all that apply.||25)|
|A) Cisplatin (Platinol)||B) Cyclophosphamide (Cytoxan)|
|C) Estramustine (Emcyt)||D) Chlorambucil (Leukeran)|
|1)||The nurse is caring for a client with asthma. The client asks the nurse what structures make up the||1)|
|upper respiratory tract. The nurse explains the upper respiratory tract consists of:|
|A) The nose and nasal cavity only.|
|B) The lungs and associated structures.|
|C) The nose, nasal cavity, pharynx, paranasal sinuses, and the lungs.|
|D) The nose, nasal cavity, pharynx, and paranasal sinuses.|
|2)||Blood flow through the lung is called||2)|
|A) Expiration.||B) Respiration.||C) Inspiration.||D) Perfusion.|
|3)||A client asks the nurse what ventilation is. The nurse replies:||3)|
|A) ʺVentilation is the process of moving air into and out of the lungs.ʺ|
|B) ʺVentilation is taking a breath in.ʺ|
|C) ʺVentilation is the blood flow through the lung.ʺ|
|D) ʺVentilation is the process by which gases are exchanged.ʺ|
|4)||The nurse explains to the client why inhalation medications work rapidly. Which of the following||4)|
|should the nurse include in teaching? Select all that apply.|
|A) The inside surface of the lungs is small, and the dose is concentrated in that area.|
|B) There is a rich blood supply to the lungs|
|C) There is a large surface area inside the lungs.|
|D) Inhaled medications are given at very high doses.|
|5)||The nurse explains to the client the different ways to administer inhalation mediations. Which of||5)|
|the following is not a way to administer inhalation medications?|
|A) Hypodermic syringe||B) Metered dose inhaler|
|C) Nebulizer||D) Dry powder inhaler|
|6)||A client has been diagnosed with allergic rhinitis. Which of the following symptoms would the||6)|
|nurse expect to observe? Select all that apply.||B) Nasal congestion|
|C) Wheezing||D) Watery eyes|
|7)||The client asks the nurse to identify possible causes of allergic rhinitis. The nurse should includ||7)|
|which of the following in client education? Select all that apply.|
|A) Pollen||B) Mold||C) Asthma||D) Dust mites|
|8)||The nurse explains to the client that common triggers for asthma attacks include which of the||8)|
|following? Select all that apply.|
- Exercise in dry, warm climates.
- Household dust
- Tobacco smoke
- Drugs such as aspirin (ASA) or ibuprofen (Advil)
|9) During an asthma attack, the bronchioles become swollen, contracted with excessive mucous||9)|
|secretion. This results in the clientʹs:|
|A) Going into respiratory arrest.||B) Requiring oxygen.|
|C) Being able to inhale but not exhale.||D) Having fits of coughing.|
|10) Classmates of a hospitalized child want to bring a gift for their friend. The nurse makes which||10)|
|suggestion based on knowledge of asthma causes?|
|A) A plant||B) Flowers|
|C) A stuffed animal||D) A book|
|11) A client asks the nurse what the goal of treatment for allergic rhinitis is. The nurse responds,||11)|
|ʺThere are two goals, which are:|
- ʺSuppression of cough and immune system.ʺ
- ʺRelief of symptoms and suppression of immune system.ʺ
- ʺPrevention of occurrence and relief of symptoms.ʺ
- ʺPrevention of occurrence and increase of symptoms.ʺ
|12)||The client wants to know why the physician prescribed an inhaled form of a beta-adrenergic||12)|
|stimulator instead of an oral form. The nurse replies that the inhaled form:|
|A) Causes bronchodilation.||B) Produces little systemic toxicity.|
|C) Produces fewer side effects.||D) Works quickly to decrease inflammation.|
|13)||Decongestants should be used with caution in patients with all of the following diagnoses: (Select||13)|
|all that apply.)|
|A) Hyperthyroidism||B) Hypertension|
|C) Diabetes||D) Heart disease|
|14)||A healthy client asks the nurse what types of medications can be taken for the common cold.||14)|
|Which of the following drug classes should the nurse include in client education? Select all that|
|apply.||B) Antitussives||C) Mucolytics|
|A) Antihistamines||D) Decongestants|
|15)||A client asks the nurse what the most commonly used OTC antitussive is. The nurse replies:||15)|
|A) ʺGuaifenesin (Mucinex)ʺ||B) ʺDextromethorphanʺ|
|C) ʺBenzonatate (Tessalon)ʺ||D) ʺAcetylcysteine (Mucomyst)ʺ|
|16)||The client asks the nurse which antihistamines are available as intranasal sprays. Which of the||16)|
|following are intranasal antihistamines? Select all that apply.|
|A) Olopatadine (Patanase)||B) Loratadine (Claritin)|
|C) Azelastine (Astelin)||D) Diphenhydramine (Benadryl)|
|17)||A client has been prescribed fexofenadine (Allegra) for allergic rhinitis. Which of the following||17)|
|statements made by the client indicates the need for further teaching?|
- ʺI will take this medication every day to prevent symptoms of allergies.ʺ
- ʺI will take this medication only when I have seasonal allergy symptoms.ʺ
- ʺThis medication is available only in pill form.ʺ
- ʺThis medication does not cause drowsiness.ʺ
|18) The client complains of numbness of the throat and tongue after taking benzonate (Tessalon). The||18)|
|nurse should instruct the client to:|
- Stop taking benzonate immediately, because this is a life-threatening emergency.
- Swallow the medication whole.
- Take one-half the prescribed dose.
- Take benzonate with an antihistamine.
|19)||A client has prescriptions for proventil (Albuterol) and serevent (Salumetrol). The nurse instructs||19)|
|A) To take Salumetrol first.|
|B) That the order of administration doesnʹt matter.|
|C) That they should not be taken together.|
|D) To take Albuterol first.|
|20)||After taking the medication guaifenesin (Mucinex), the client complains of coughing up phlegm.||20)|
|The nurse explains that this response:|
|A) Requires further investigation.|
|B) Is indicative of an allergic reaction.|
|C) Means there is probably more pathology present.|
|D) Is normal.|
|21)||Xanthines are not as popular as they were 20 years ago, mainly due to the fact that they:||21)|
|A) Are related to caffeine.|
|B) Interact with a large number of other drugs.|
|C) Produce less effective bronchodilation.|
|D) Have a slower onset.|
|22)||The nurse teaches the client prescribed a first-generation antihistamine to avoid alcohol and other||22)|
|CNS depressants because:|
- The antihistamine will not work if combined with alcohol or a CNS depressant.
- The sedating effects will be increased.
- Anaphylaxis is more likely when antihistamines are taken with alcohol.
- This combination will cause insomnia.
|23) Antihistamines should be used with caution in clients with asthma or COPD because:||23)|
- Anticholinergic effects of antihistamines can trigger angioedema.
- Anticholinergic effects of antihistamines can trigger bronchospasm.
- Most people with asthma are allergic to antihistamines.
- Antihistamines cause severe headache when given to clients with COPD or asthma.
|24)||A client with asthma asks the nurse which type of medication will decrease inflammation||24)|
|associated with asthma. The nurse replies:||B) ʺCorticosteroids.ʺ|
|C) ʺAntitussives.ʺ||D) ʺBronchodilators.ʺ|
|25)||A client with asthma asks the nurse which type of medication will decrease bronchoconstriction||25)|
|associated with asthma. The nurse replies:|
|A) ʺBronchodilators.ʺ||B) ʺExpectorants.ʺ|
|C) ʺAntitussives.ʺ||D) ʺCorticosteroids.ʺ|
|1)||The GI tract contains which of the following? Select all that apply.||1)|
|A) Large intestine||B) Liver||C) Pancreas||D) Stomach|
|2)||Risk factors associated with peptic ulcer disease include which of the following? Select all tha||2)|
|A) Family history||B) Drinking caffeine|
|C) Blood type A||D) Smoking tobacco|
|3)||A duodenal ulcer can be differentiated from a gastric ulcer by the presence of:||3)|
|A) Nighttime pain.||B) Nausea and vomiting.|
|C) Anorexia.||D) Postprandial pain.|
|4)||A client has just been diagnosed with peptic ulcer disease. The nurse knows that the first-choice||4)|
|drug will most likely be:|
|A) Omeprazole (Prilosec).||B) Magaldrate (Riopan).|
|C) Famotidine (Pepcid).||D) Sodium bicarbonate (Alka-Seltzer).|
|5)||An ulcer caused by H. pylori can be successfully treated with which classification of drugs?||5)|
|A) Antacids||B) H2-receptor blockers|
|C) Proton pump inhibitors||D) Antibiotics|
|6)||A client was placed on ranitidine (Zantac) 2 days ago, and continues to complain of ulcer pain. The||6)|
|nurseʹs best response is:|
- ʺYou should be taking the medication with food.ʺ
- ʺWeʹll switch you to a different medication.ʺ
- ʺYou might not notice relief for several days.ʺ
- ʺYou probably have something else besides an ulcer.ʺ
|7) A client asks the nurse why two antibiotics have been prescribed to treat H. pylori. The nurse||7)|
- ʺThe acid in your stomach will make one antibiotic ineffective, so you must take two.ʺ
- ʺYou should only be prescribed one antibiotic to treat H. pylori.ʺ
- ʺTwo or more antibiotics are given concurrently to increase the effectiveness of therapy and to lower the potential for bacterial resistance.ʺ
- ʺOne antibiotic is to treat H. pylori and the other is for a secondary infection.ʺ
|8) A client has been taking an opioid for pain relief following abdominal surgery. The client||8)|
complains of constipation. Which of the following statements indicate understanding by the client? Select all that apply.
- A) ʺI should only take a laxative when necessary.ʺ
- B) ʺI should strain when I try to have a bowel movement.ʺ
- C) ʺI should increase fiber intake.ʺ
- D) ʺI should increase fluid intake.ʺ
|9) Which type of laxative causes peristalsis by irritating the bowel?||9)|
|A) Stool softener||B) Bulk-forming laxative|
|C) Saline/osmotic laxative||D) Stimulant laxative|
|10) An example of a laxative that is often taken prophylactically to prevent constipation is:||10)|
- Magnesium hydroxide (milk of magnesia).
- Psyllium muciloid (Metamucil).
- Bisacodyl (Dulcolax).
- Castor oil (Emulsoil).
|11)||Which drug produces a bowel movement in 1—6 hours, and should not be used on a regular basis||11)|
|because of the possibility of fluid and electrolyte depletion?|
|A) Bulk-forming laxative||B) Stimulant laxative|
|C) Stool softener||D) Saline/osmotic laxative|
|12)||Patients should be advised not to overuse laxatives, because the smooth muscle in the colon can||12)|
|lose its tone. This leads to:|
|A) Frequent vomiting.||B) Chronic nausea.|
|C) Chronic diarrhea.||D) Chronic constipation.|
|13)||Which client is most at risk for developing an acid—base imbalance or electrolyte disorder?||13)|
- 27-year-old with a 24-hour history of nausea and vomiting
- A client who has a gastrostomy tube
- 70-year-old with constipation
- 18-month-old who has had watery stools for 3 days
|14)||Antiemetic drugs belong to a number of different classes, including which of the following? Select||14)|
|all that apply.||B) Antipsychotics|
|C) Benzodiazepines||D) Glucocorticoids|
|15)||Sibutramine (Meridia) should be used with caution for a client with which of the following?||15)|
|A) Asthma||B) Stable atrial fibrillation|
|C) Diabetes mellitus||D) Hypotension|
|16)||The nurse explains to the client prescribed orlistat (Xenical) that the drug works in what way?||16)|
- ʺIt suppresses appetite, probably by affecting the hunger center in the brain.ʺ
- ʺOrlistat blocks the enzyme lipase in the GI tract, which blocks the absorption of fats.ʺ
- ʺIt causes nausea so you will eat less.ʺ
- ʺIt speeds up your metabolism.ʺ
|17) A client has been diagnosed with pancreatic insufficiency. The nurse knows that the treatment for||17)|
this condition is:
- A) Replacement therapy with pancreatic enzymes.
- B) Treatment with PPIs to decrease stomach acid.
- C) Increase food intake.
- D) Decrease food intake.
|18)||Which drugs are the most effective for treating severe diarrhea? Select all that apply.||18)|
|A) Furazolidone (Furoxone)||B) Bismuth salt (Pepto-Bismol)|
|C) Loperamide (Imodium)||D) Diphenoxylate (Lomotil)|
|19)||A client was seen in the Emergency Department for severe vomiting, and was discharged with a||19)|
|prescription for prochlorperazine (Compazine) 10 mg, three times daily. The most effective route|
|to give this medication would be:|
|A) IV.||B) PO.||C) RS.||D) IM.|
|20)||A client complains of nausea and vomiting. Which of the following medication would not be||20)|
|prescribed for nausea and vomiting?|
|A) Ondansetron (Zofran)||B) Prochlorperazine (Compazine)|
|C) Promethazine (Phenergan)||D) Diphenoxylate with atropine (Lomotil)|
|21)||The nurse instructs the client prescribed pancrelipase (Cotazym) to:||21)|
- Take the medication with meals.
- Increase dosing with a large meal.
- Take the medication at least 2 hours prior to meals.
- Decrease fluid intake.
|22)||The client being treated for peptic ulcer should be instructed to avoid which of the following||22)|
|A) NSAIDs||B) Antacids|
|C) H2-receptor blockers||D) PPIs|
|23)||The client taking a bulk-forming laxative should be instructed to:||23)|
- Take with at least two full glasses of water.
- Decrease water intake.
- Increase food intake.
- Decrease food intake.
|24)||Which of the following side effects would the nurse expect a client taking a PPI to report? Select all||24)|
|A) Ataxia||B) Epistaxis||C) Headache||D) Diarrhea|
|25)||The goals of pharmacotherapy for a client with an ulcer are to: (Select all that apply.)||25)|
- Prevent recurrence of the disease.
- Promote healing of the ulcer.
- Reduce frequency of constipation.
- Provide immediate relief from symptoms.
|1)||A significant difference between fat-soluble and water-soluble vitamins is that:||1)|
|A) Water-soluble vitamins can be toxic if stored in excess.|
|B) Water-soluble vitamins are A and D.|
|C) Fat-soluble vitamins cannot be stored for later use.|
|D) Excess water-soluble vitamins are excreted in the urine.|
|2)||Teaching for the client who has initiated an herbal supplement includes:||2)|
|A) Beginning with the lowest recommended dose.|
|B) Eliminating the supplement from the diet so as not to cause toxicity.|
|C) Discontinuation of other medications.|
|D) Providing a variety of places to purchase their supplements.|
|3)||Which of the following statements is not true regarding vitamins?||3)|
- Human cells are able to synthesize most vitamins.
- If the vitamin is not present in adequate amounts, the bodyʹs metabolism will be disrupted, and disease will result.
- Vitamins or their precursors must be supplied in the diet.
- The symptoms of the deficiency can be reversed by the administration of the missing vitamin.
|4)||Important characteristics of vitamins include which of the following? Select all that apply.||4)|
|A) Provitamins are supplied in the diet.|
|B) The body synthesizes necessary vitamins.|
|C) Vitamins are similar in the nutritional roles they play.|
|D) Disease results when vitamins are not present in adequate amounts.|
|5)||A client who is experiences heavy menstrual periods could be deficient in:||5)|
|A) Potassium.||B) Iron.||C) Calcium.||D) Vitamin K.|
|6)||Vitamin K is given to reverse the effects of which medication?||6)|
|A) Aspirin (ASA)||B) Warfarin (Coumadin)|
|C) Enoxaparin (Lovenox)||D) Acetaminophen (Tylenol)|
|7)||A client has been ordered to receive iron via IM administration. Which of the following is given||7)|
|either IM or IV?|
|A) Ferrous fumarate (Feostat)||B) Iron dextran (Dexferrum)|
|C) Ferrous gluconate (Fergon)||D) Ferrous sulfate (Feosol)|
|8)||A client has been prescribed potassium chloride (K-Dur) twice daily. Which of the following||8)|
|should the nurse teach the client? Select all that apply.|
- This medication is used to prevent high blood phosphate levels in patients who are on dialysis.
- Electrolyte levels should be frequently assessed.
- This medication is used for the treatment of metabolic acidosis.
- Potassium chloride (K-Dur) discontinued immediately if hyperkalemia is suspected.
|9) Which of the following should the nurse instruct a client taking a calcium supplement to avoid||9)|
|eating at the same time as taking the supplement? Select all that apply.|
|A) Cheese||B) Nuts||C) Soy||D) Spinach|
|10)||Which of the following are indications for vitamin therapy?||10)|
|A) Pregnancy||B) Alcoholism|
|C) Heart disease||D) Chronic kidney disease|
|11)||When answering the clientʹs questions regarding nutritional supplement, the nurse explains that:||11)|
- Organic foods are higher in vitamins and minerals.
- Dietary supplements are essential to maintain health.
- Most people obtain the necessary nutrients through their normal diet.
- Vitamins and minerals are necessary to increase energy levels.
|12)||The RDA values represent the ________ amount of vitamin or mineral needed to prevent a||12)|
|deficiency in a healthy adult.|
|A) Therapeutic||B) Toxic||C) Minimum||D) Maximum|
|13)||Which statement made by the client indicates the need for further teaching?||13)|
- ʺToo much vitamin A or D is not good for me.ʺ
- ʺVitamin supplements can be a substitute for a balanced diet.ʺ
- ʺIt is not harmful for most patients to consume 2—3 times the recommended levels of most vitamins.ʺ
- ʺAlthough the label on a vitamin supplement might indicate that it contains 100% of the RDA for a particular vitamin, the body might only absorb a little of the vitamin.ʺ
|14)||The client is receiving cyanocobalamin (Cyanabin) every other week. Teaching includes:||14)|
|A) Treatment might be necessary throughout the life span.|
|B) Alcohol increases the absorption.|
|C) Headache is a common side effect.|
|D) Foods high in potassium should be avoided.|
|15)||________ or toxic levels of vitamins has been reported for vitamins A, C, D, E, B 6, niacin, and folic||15)|
|A) Vitamin overload||B) Pernicious anemia|
|C) Hypervitaminosis||D) Vitamin deficiency|
|16)||Causes of vitamin deficiencies include which of the following? Select all that apply.||16)|
|A) Poverty||B) Prolonged parenteral feeding|
|C) Chronic alcoholism||D) Adequate diet|
|17)||A client has been prescribed ferrous sulfate (Feosol) for iron-deficiency anemia. Which of the||17)|
|following statements by the client indicates a need for further teaching?|
- ʺIron should be taken with meals.ʺ
- ʺAntacids and food decrease the absorption of iron.ʺ
- ʺCalcium (including dairy products) and bran block ferrous sulfateʹs absorption.ʺ
- ʺVitamin C increases the absorption of iron.ʺ
18) Major minerals include which of the following? Select all that apply. 18)
- A) Calcium B) Fluoride C) Iron D) Chloride
|19)||Minor minerals include which of the following? Select all that apply.||19)|
|A) Zinc||B) Sodium||C) Fluoride||D) Copper|
|20)||Major and minor minerals are classified based on:||20)|
|A) The amount available in dairy products.||B) The amount of the mineral in the world.|
|C) The amount needed in the diet.||D) The molecular weight of the mineral.|
|21)||Administration of food or supplements via the GI tract, either orally or through a feeding tube, is||21)|
|A) Standard nutrition.||B) Enteral nutrition.|
|C) Parenteral nutrition.||D) Supplemental nutrition.|
|22)||Enteral therapy has been initiated on a client who is now exhibiting nausea and vomiting. The||22)|
|nurse knows this is most likely caused from:|
- A viral agent common to clients with feeding tubes.
- The type or amount of feeding.
- An allergic reaction to the feeding.
- Irritation of the gastric tube along the stomach serosa.
|23)||When a client is diagnosed with undernutrition, the nurse understands that the goals of therapy||23)|
|A) Using short-term therapy and counseling.|
|B) Treating the cause aggressively and allowing the client to gain weight.|
|C) Using nutritional supplements and medication.|
|D) Identification of the deficiency and supplying the missing nutrients.|
|24)||The nurse might assess which of the following in a client who has undernutrition?||24)|
|A) Loss of subcutaneous fat||B) History of HIV/AIDS|
|C) Chronic inflammatory bowel disease||D) Eating disorders|
|25)||A client with severe malabsorption disease would be best treated with which of the following?||25)|
- Herbal preparations
- Supplements including macro and trace elements
- Enteral therapy
|1)||Which of the following are included in the endocrine system? Select all that apply.||1)|
|A) Pancreas||B) Parathyroid glands|
|C) Heart||D) Thyroid glands|
|2)||The pancreas excretes which of the following? Select all that apply.||2)|
|A) Growth hormone||B) Insulin|
|C) Antidiuretic hormone||D) Glucagon|
|3)||The client asks the nurse which type of diabetes is caused by a lack of insulin secretion by the||3)|
|pancreas. The nurse replies:|
- ʺBoth type I and II.ʺ
- ʺNeither–they both result from the inability of the body to use insulin.ʺ
- ʺType I.ʺ
- ʺType II.ʺ
|4)||The client asks the nurse which of the following are signs and symptoms of type I diabetes. Select||4)|
|all that apply.||B) Polydipsia|
|A) Polyuria||C) Pancreatitis||D) Polyphagia|
|5)||Which of the following clients is at greatest risk for developing type II diabetes?||5)|
|A) 55-year-old female||B) 25-year-old male|
|C) 8-year-old female||D) 12-year-old male|
|6)||The nurse needs to monitor the clientʹs blood sugar after administration of Humulin R. Peak action||6)|
|will occur in:|
|A) 1—2 hours.||B) 4—6 hours.|
|C) 2—4 hours.||D) 15—30 minutes.|
|7)||The type of insulin that is given at bedtime, with or without other types, is||7)|
- NPH 70/30 (Humulin 70/30).
- Insulin glargine (Lantus).
- Regular insulin.
- Isophane insulin suspension (Humulin N).
|8)||The nurse administered insulin lispro (Humalog) to the client at 0800. The nurse should reassess||8)|
|the client for hypoglycemia between:|
|A) 1200 and 1600.||B) 0900 and 1100.||C) 1400 and 1800.||D) 1000 and 1400.|
|9)||The client received lispro (Humalog) insulin with breakfast. Two hours later, the client experiences||9)|
|tachycardia, confusion, sweating, and drowsiness. The nurse understands that these symptoms are|
|A) Hyperglycemia.||B) Allergic reaction to lispro (Humalog)|
|C) Hypoglycemia.||D) Myocardial infarction.|
|10)||The nurse is caring for a diabetic client who has breath with a fruity odor. The nurse understands||10)|
|that this is caused by:|
|A) Allergic reaction to medication for diabetes.|
|C) Frequent intake of candy.|
|11)||The nurse is being educated on treatment of clients following a nuclear accident. Objectives have||11)|
|been met when the nurse makes which statement?|
- ʺPotassium iodide will provide protection if taken within days of a nuclear accident.ʺ
- ʺClients will be given potassium iodide tablets.ʺ
- ʺRadiation exposure can be treated with medications.ʺ
- ʺIodine-131 will protect the clientʹs vital organs.ʺ
|12)||The client is being educated on monitoring effects of thyroid medication. One measurement the||12)|
|client can take to determine effectiveness of thyroid medications is:|
|A) Respiratory rate.||B) Pulse rate.|
|C) Temperature.||D) Blood pressure.|
|13)||A client complains of slowed body metabolism, slurred speech, bradycardia, weight gain, low||13)|
|body temperature, and intolerance to cold environments. The nurse knows that these are|
|A) Type I diabetes.||B) Type II diabetes.|
|C) Hyperthyroidism.||D) Hypothyroidism.|
|14)||A client complains of increased body metabolism, tachycardia, weight loss, high body||14)|
|temperature, and anxiety. The nurse knows these are symptoms of:|
|A) Hypothyroidism.||B) Type II diabetes.|
|C) Type I diabetes.||D) Hyperthyroidism.|
|15)||Mineralocorticoids, glucocorticoids, and androgens are released by:||15)|
|A) The thyroid gland.||B) The pituitary gland.|
|C) The adrenal glands.||D) The pancreas.|
|16)||A client complains of hypoglycemia, fatigue, hypotension, and GI disturbances such as anorexia,||16)|
|vomiting, and diarrhea. The nurse knows these are symptoms of:|
|A) Addisonʹs disease.||B) Hypothyroidism.|
|C) Hypoglycemic reaction.||D) Cushingʹs syndrome.|
|17)||Hydrocortisone (Cortef) has been prescribed for a client. The nurse knows that this medication is||17)|
|prescribed for which of the following conditions? Select all that apply.|
|A) Adrenocortical insufficiency||B) Intra-articular injections|
|C) Allergic disorders||D) Inflammation|
|18)||The physician has ordered medication to treat hyperthyroidism. The nurse anticipates which of the||18)|
|following medications to be prescribed?|
|A) Levothyroxine (Levothyroid)||B) Thyroid (S-P-T)|
|C) Liotrix (Euthroid)||D) Propylthiouracil (PTU)|
19) The nurse is instructing the client prescribed glipizide (Glucotrol) about possible side effects. Which 19) of the following should be included in client teaching? Select all that apply.
- Increased appetite
- Avoid prolonged exposure to the sun because glipizide causes photosensitivity
|20)||Hormone pharmacotherapy use includes which of the following? Select all that apply.||20)|
|A) Exaggerated response||B) Antineoplastics|
|C) Replacement therapy||D) Therapeutic advantage|
|21)||The client is receiving glipizide (Glucotrol) once a day. The best time to administer the dose is:||21)|
|A) Midday, between meals.||B) Before the primary meal of the day.|
|C) In the evening.||D) In the morning.|
|22)||A client taking levothyroxine (Synthroid) and cholestyramine (Questran) should be alert to||22)|
|A) Hypothyroid.||B) Hyperthyroid.|
|C) Hypolipidemia.||D) Hyperlipidemia.|
|23)||A preparation of antidiuretic hormone (ADH) that is occasionally used by the intranasal route to||23)|
|treat enuresis (bedwetting) is:|
|A) Betamethasone (Celestone).||B) Desmopressin (Stimate).|
|C) Lypressin (Diapid).||D) Vasopressin (Pitressin).|
|24)||Aside from having potent anti-inflammatory effects, glucocorticoids also promote homeostasis of||24)|
|A) Cardiovascular||B) Gastric|
|C) Reproductive||D) Hematopoietic|
|25)||Long-term therapy with corticosteroids can produce a variety of adverse effects, including which||25)|
|of the following? Select all that apply.|
|A) Diarrhea||B) Sodium retention|
|C) Increased risk for infections||D) Delayed wound healing|
|1)||________ is responsible for the maturation of the reproductive organs and for the appearance of||1)|
|the secondary sex characteristics in women.|
|A) Testosterone||B) Progesterone||C) Androgen||D) Estrogen|
|2)||________ is responsible for maturation of the male sex organs and the secondary sex characteristics||2)|
|A) Testosterone.||B) Progesterone.|
|C) Follicle-stimulating hormone (FSH).||D) Estrogen.|
|3)||Birth control pills work in which of the following ways? Select all that apply||3)|
- Do not allow the egg to mature.
- Prevent ovulation.
- Make the lining of the uterus less favorable to receiving an embryo.
- Decrease blood flow to the ovaries.
|4)||Hormone replacement therapy (HRT) is used to treat symptoms of menopause. Data suggest that||4)|
|women who utilize HRT have increased risk for which of the following? Select all that apply.|
|A) Venous thromboembolism||B) Breast cancer|
|C) Endometrial cancer||D) Stroke|
|5)||The nurse is taking a health history from postmenopausal client. The nurse recognizes that||5)|
|potential consequences of estrogen loss include:|
|A) Stress incontinence.||B) Insomnia.|
|C) Vaginal atrophy.||D) Colon cancer.|
|6)||An appropriate nursing diagnosis addressing adverse effects for the client receiving hormone||6)|
|replacement therapy might be:|
- Noncompliance, related to medication regimen.
- Nausea, related to side effects of drug.
- Knowledge deficient, related to drug therapy.
- Excess fluid volume, related to side effects of drug.
|7)||More side effects are observed when estrogens are used to treat certain cancers. The nurse realizes||7)|
|this is true because:|
|A) Symptoms of cancer mimic estrogen use.|
|B) Higher doses are used, so more side effects are observed.|
|C) Side effect risk increases due to chronic disease present.|
|D) In this case, estrogens are used for short term.|
|8)||A client with dysfunctional uterine bleeding is prescribed progestin. The nurse instructs the clien||8)|
|to take the progestin:|
- A) Starting the day of the onset of menses and continuing for 28 days.
- B) Every other day for 3 months.
- C) Starting the last day of the menstrual period and continuing for 14 days.
- D) Starting 5 days after the onset of menses and continuing for the next 20 days.
|9) A client has been started on oxytocin (Pitocin) while in labor. The nurse knows this medication is||9)|
|A) Prevent uterine rupture.|
|B) Cause the uterus to contract.|
|C) Increase the volume of milk production.|
|D) Cause milk to be ejected from the mammary glands.|
|10)||A client is in preterm labor. Which of the following medications would be used to slow uterine||10)|
|A) Nifedipine (Procardia)||B) Oxytocin (Pitocin)|
|C) Dinoprostone (Cervidil)||D) Misoprostol (Cytotec)|
|11)||Which of the following medications is used to expel a fetus that has died?||11)|
|A) Misoprostol (Cytotec)||B) Dinoprostone (Cervidil)|
|C) Nifedipine (Procardia)||D) Oxytocin (Pitocin)|
|12)||Deficiency of testosterone in prepubertal men can result in a lack of maturation of the sex organs, a||12)|
|A) Pituitary disease.||B) Hypogonadism.|
|C) BPH.||D) Erectile dysfunction.|
|13)||Precautions should be used by the client who uses sildenafil (Viagra) for erectile dysfunction and||13)|
|A) Progesterone (Prometrium).||B) Diltiazem (Verapamil).|
|C) Atenolol (Tenormin).||D) Organic nitrates (Nitro-Dur).|
|14)||A client is taking finasteride (Proscar). The nurse realizes this is probably prescribed for||14)|
|male-pattern baldness and not benign prostatic hypertrophy (BPH) because the client is:|
|A) Using it on an as-needed basis.||B) Taking a larger dose.|
|C) Using a topical preparation of the drug.||D) Taking a smaller dose.|
|15)||A client with erectile dysfunction asks the nurse which medications treat ED. Which of the||15)|
|following should the nurse include in client teaching? Select all that apply.|
|A) Testosterone enanthate (Andro)||B) Vardenafil (Levitra)|
|C) Tadalafil (Cialis)||D) Sildenafil (Viagra)|
|16)||The nurse is teaching the client prescribed tamsulosin (Flomax) for BPH. Which of the following||16)|
|should the nurse include in client teaching? Select all that apply.|
- ʺThis medication will shrink the prostate.ʺ
- ʺThis medication has no effect on blood pressure.ʺ
- ʺThis medication will lower your blood pressure.ʺ
- ʺDrug therapy alleviates the symptoms but does not cure the disease.ʺ
|17) A client is prescribed hormone replacement therapy. The nurse should instruct the client to do||17)|
|which of the following?|
|A) Use an additional form of contraception.||B) Perform breast self-examinations.|
|C) Avoid heavy lifting.||D) Decrease intake of high-fiber foods.|
|18) Which of the following statements made by the client indicate a need for further instruction||18)|
|regarding oral contraceptives?|
- ʺI do not need to perform monthly breast exams while taking an oral contraceptive.ʺ
- ʺI should stop smoking.ʺ
- ʺIf I miss two consecutive periods, I should contact my doctor.ʺ
- ʺIf I miss a dose, I should take it as soon as I remember, or two the next day.ʺ
|19) A female client has been prescribed norethindrone (Micronor) as an oral contraceptive. The nurse||19)|
|understands this medication works to prevent pregnancy by:|
- Increasing ovulation.
- Terminating pregnancy.
- Preventing ovulation.
- Producing a thick, viscous mucus at the entrance to the uterus that prevents penetration by sperm.
|20)||A client asks the nurse which of the following contraceptives are long-term formulations. Select all||20)|
|A) Ethinyl estradiol and levonorgestrel (Alesse)|
|B) Ethinyl estradiol and norelgestromin (Ortho-Evra)|
|C) Estrogen and progestin (NuvaRing)|
|D) Medroxyprogesterone acetate (Depo-Provera)|
|21)||Behavior changes that may occur with long-term use of anabolic steroids include:||21)|
|A) Depression and fatigue.|
|B) Stress and anxiety.|
|C) Aggression and dependence.|
|D) Liver damage and menstrual irregularities.|
|22)||Biphasic oral contraceptives contain:||22)|
- Progestin only.
- Constant estrogen with an increase in progestin at the end of the cycle.
- Constant amounts of estrogen and progestin.
- Both estrogen and progestin, varying in three distinct phases.
|23)||A client taking an oral contraceptive should be advised to:||23)|
|A) Avoid foods that are high in folic acid.||B) Exercise if leg pain is present.|
|C) Avoid foods that are high in B6.||D) Stop smoking.|
|24)||Oral contraceptives have more benefits than just contraception, some of which include:||24)|
- Prevention of stroke.
- Treatment for pelvic inflammatory disease.
- Treatment for blood clots.
- Decrease in the number of hospitalizations for ectopic pregnancy.
|1)||When working with clients who have disorders associated with movement, the nurse realizes||1)|
|treatment could be difficult because:|
|A) Underlying causes can be related to four distinct body systems.|
|B) Arthritis is a chronic condition without a cure|
|C) Disorders of movement can require extensive rehabilitation.|
|D) Most medications used for pain can cause dependence.|
|2)||A client with a spinal cord injury is left with spasticity and dystonia. The nurse understands that||2)|
|the most effective treatment for this condition is:|
|A) Physical therapy and medications.||B) Hydrotherapy and massage.|
|C) Surgery and medications.||D) Physical therapy and surgery.|
|3)||Nonpharmacological interventions that the nurse may utilize in helping a client with muscle||3)|
|spasms include which of the following? Select all that apply.|
|A) Application of heat or cold||B) Ultrasound|
|C) Massage||D) Manipulation|
|4)||A client is admitted with hypercalcemia. Which of the following are possible causes of||4)|
|hypocalcemia? Select all that apply.|
|A) Parathyroidectomy||B) Hypertension|
|C) Heart failure||D) Vitamin D deficiency|
|5)||Assessment findings in a client with hypocalcemia include:||5)|
|A) Bleeding problems or bruising.||B) Muscle twitching or tremor.|
|C) Muscle weakness and bone pain.||D) Hypertension and tachycardia.|
|6)||Modifiable risk factors for osteoporosis include which of the following? Select all that apply||6)|
|A) High alcohol or caffeine consumption||B) Lack of vitamin D or calcium in the diet|
|C) Postmenopausal age||D) Physical inactivity|
|7)||If Pagetʹs disease is diagnosed late in the diseaseʹs progression, other disorders also can appear,||7)|
- Arthritis, kidney stones, and heart disease.
- Glaucoma, diabetes mellitus, and arthritis.
- Arthritis, endometrial cancer, and hypertension.
- Rheumatoid arthritis, epilepsy, and heart disease.
|8) Teaching for clients following sodium hyaluronate (Hyalgan) injections include:||8)|
- A) Avoid strenuous exercise for 48 hours after injection.
- B) Continue with all activities following injection, so as not to cause stiffness
- C) Increase ROM to joint for better dispersal of the medication.
- D) No weight bearing on the joint following injection.
|9) A client is taking colchicine for gouty arthritis and furosemide (Lasix) for treatment of congestive||9)|
|heart failure. Teaching regarding drug interactions includes which of the following?|
- Skin rashes are common.
- The client should be monitored for signs of bleeding.
- GI upset is common, and could be intensified.
- The client should call the physician if there is no improvement in gout symptoms.
|10)||A safe and inexpensive natural alternative to anti-inflammatory drugs for arthritis is:||10)|
|A) Glucosamine sulfate.||B) Black cohosh.|
|C) Echinacea.||D) Chondroitin.|
|11)||A client has been prescribed an IM vitamin D supplement. Which of the following is administered||11)|
|via this route?|
|A) Calcitriol (Calcijex)||B) Calcifediol (Calderol)|
|C) Ergocalciferol (Deltalin)||D) Calcium gluconate (Kalcinate)|
|12)||A client asks the nurse to explain why a prescription for calcitriol (Calcijex) has been given when||12)|
|vitamin D is available without a prescription. The nurse states:|
- ʺYou donʹt need to fill the prescription. You can buy the over-the-counter vitamin D.ʺ
- ʺThis will allow you to buy vitamin D and pay your co-ʺ
- ʺCalcitriol (Calcijex) is the active form of vitamin D, and the over-the-counter calcium is not the same.ʺ
- ʺThere is no difference between the two.ʺ
|13)||The nurse explains to the female client the risk factors for osteoporosis. Which of the following||13)|
|should be included in teaching? Select all that apply.|
|A) Lack of adequate vitamin D or calcium in the diet|
|B) Excessive vitamin D or calcium in the diet|
|C) Tobacco use|
|D) High alcohol or caffeine consumption|
|14)||Women with osteoporosis are likely to have a fracture in which locations? Select all that apply.||14)|
|A) Wrists||B) Fingers||C) Hips||D) Skull|
|15)||A client has been prescribed raloxifene hydrochloride (Evista). Which should be included in client||15)|
|teaching regarding side effects? Select all that apply.|
|A) Hot flashes||B) Breast pain|
|C) Sinus headache||D) Vaginal bleeding|
|16)||A client has been prescribed alendronate (Fosamax). The nurse understands this medication is not||16)|
|used to treat which of the following?|
- Symptomatic Pagetʹs disease in both women and men
- Glucocorticoid-induced osteoporosis in both women and men
- Prevention of osteoporosis in postmenopausal women
|17) A client diagnosed with osteoarthritis asks the nurse what different types of treatment are||17)|
|available. Which of the following the nurse should include in the response? Select all that apply.|
|A) NSAIDs||B) Immunosuppressants|
|C) Intra-articular glucocorticoids||D) Topical medications|
|18)||A client has been diagnosed with rheumatoid arthritis. Which of the following medications would||18)|
|be appropriate to treat this client?|
|A) Allopurinol (Lopurin)||B) Sulfinapyrazone (Anturane)|
|C) Probenecid (Benemid)||D) Hydroxychloroquine (Plaquenil)|
|19)||A client is receiving tizanidine ( Zanaflex) for treatment of muscle spasms. The nurse educates the||19)|
- To exercise caution when operating machinery.
- That Zanaflex is used for diseases of the central nervous system.
- That this is a seizure medication.
- To take the medication on a scheduled basis.
|20)||A client asks the nurse how to prevent gout. Which of the following that the nurse should include?||20)|
|Select all that apply.|
|A) Dietary management||B) Treatment with antigout medications|
|C) Decreased fluid intake||D) Avoidance of drugs that worsen gout|
|21)||A client taking calcium supplements needs to be advised to avoid which of the following foods||21)|
|because of a decreased absorption of calcium? Select all that apply.|
|A) Tofu||B) Seeds||C) Nuts||D) Ice cream|
|22)||A client taking antigout medication needs to be instructed to:||22)|
|A) Restrict activities.||B) Drink plenty of fluids.|
|C) Decrease fluid intake.||D) Increase intake of high-purine foods.|
|23)||Which of the following medications that are used to treat rheumatoid arthritis? Select all that||23)|
|A) Rituxamab (Rituxan)||B) Sulfasalazine (Azulfidine)|
|C) Tizanidine ( Zanaflex)||D) Leflunomide (Arava)|
|24)||________ is/are drugs of choice for the pharmacotherapy of Pagetʹs disease.||24)|
- Hormone therapy (HT)
- Selective estrogen-receptor modulators (SERMs)
|25) Which of the following therapies for calcium disorders may be prescribed? Select all that apply.||25)|
|A) NSAIDs||B) Bisphosphonates|
|C) Calcium supplements||D) Vitamin D supplements|
|1)||The three layers of the skin are the: (Select all that apply.)||1)|
|A) Dermis.||B) Epidermis.|
|C) Stratum corneum.||D) Hypodermis.|
|2)||Age-related changes in the skin include which of the following? Select all that apply.||2)|
|A) Fragile epidermis||B) Loss of elasticity|
|C) Increase in skin tumors||D) Loss of hair follicles|
|3)||Symptoms associated with stress or injury to the skin include which of the following? Select all that||3)|
|A) Sores and lesions||B) Crusty and cracked areas|
|C) Blisters and calluses||D) Infections and infestations|
|4)||The nurse is educating the mother of an infant with dermatitis regarding long-term effects of the||4)|
|condition. A correct statement for the nurse to pass on to the mother is:|
- ʺApproximately 60 percent of infants with dermatitis have symptoms into adulthood.ʺ
- ʺBecause your child has dermatitis now, your child will outgrow the symptoms.ʺ
- ʺOnce the dermatitis is clear, your child will have no further problems.ʺ
- ʺIf you use the treatment as prescribed, the dermatitis will be cured.ʺ
|5)||A mother of a school-aged child asks the nurse why her child continues to have itching with no||5)|
|sign of mites. The nurse gives which of the following responses?|
|A) ʺYou will have to switch to something else besides Lindane (Kwell).ʺ|
|B) ʺItching is common, even after the mites have been killed.ʺ|
|C) ʺ Lindane (Kwell) usually works, but your child must need something stronger.ʺ|
|D) ʺThe mites are too small to see, and treatment should be continued.ʺ|
|6)||The most effective treatment for sunburn is:||6)|
- Prevention with use of sunscreens, sunglasses, and sufficient clothing.
- Lotions to prevent further irritation to the skin
- Tetanus toxoid to prevent infection.
- Anesthetics for pain reduction.
|7)||A client with rosacea asks how to limit exacerbation of symptoms. The nurse recommends:||7)|
|A) Using drugs to inhibit bacterial growth|
|B) Use of burdock root as a skin detoxifier.|
|C) Keeping the skin moist.|
|D) Eliminating alcohol and spicy foods from the diet.|
|8)||The client has scabies. The nurse assesses which anatomic areas common for this skin disorder?||8)|
|A) Waist and armpit areas||B) Any skin area|
|C) Head and groin||D) Across the shoulders and neck area|
|9)||________ are pharmacological agents that kill mites.||9)|
|A) Psoralens||B) Antibiotics||C) Pediculicides||D) Scabicides|
|10) The nurse instructs the mother of a school-age child with lice to prevent reinfestation by doing||10)|
|which of the following? Select all that apply.|
- All material coming in close contact with the patient should be washed or treated with the medication.
- Inspect hair shafts daily for at least 1 week after treatment.
- Cut the hair of the child to 1 inch.
- Comb the infested area after the hair has been dried.
|11)||Benzocaine (Americaine) is used to treat which of the following? Select all that apply.||11)|
|A) Second-degree burns||B) Pruritus|
|C) Sunburn||D) Insect bites|
|12)||A client with acne asks the nurse which OTC medication is used to treat acne. The nurse replies:||12)|
|A) ʺBenzoyl peroxide (Benzaclin).ʺ||B) ʺAdapalene (Differin).ʺ|
|C) ʺDoxycycline (Doryx).ʺ||D) ʺTretinoin (Retin-A).ʺ|
|13)||A client has been prescribed tretinoin (Retin-A). The nurse advises the client to do which of the||13)|
|following? Select all that apply.|
|A) ʺDo not use this medication if pregnant.ʺ||B) ʺAvoid exposure to the sun.ʺ|
|C) ʺIncrease intake of vitamin A.ʺ||D) ʺAvoid using vitamin C supplements.ʺ|
|14)||A client is being treated with corticosteroids for contact dermatitis. The client asks how to avoid||14)|
|contact dermatitis. The nurse explains contact dermatitis can be caused by which of the following?|
|Select all that apply.|
|A) Jewelry||B) Peanuts||C) Latex||D) Perfume|
|15)||Which of the following are systemic medications used to treat psoriasis? Select all that apply.||15)|
|A) Betamethasone (Diprolene)||B) Etretinate (Tegison)|
|C) Acitreten (Soriatane)||D) Dexamethasone (Decaspray)|
|16)||Which of the following is not a treatment for psoriasis?||16)|
|A) Topical glucocorticoids||B) Immunosuppressant medications|
|C) Antibiotics||D) Emollients|
|17)||A client with scabies has been prescribed a medication that should be rinsed from the body within||17)|
|10 minutes after being applied. The nurse knows the medication prescribed is:|
|A) Crotamiton (Eurax).||B) Pyrethrin (Rid).|
|C) Permethrin (Nix).||D) Malathion (Ovide).|
|18)||A client taking tretinoin (Retin-A) should have blood drawn to monitor which of the following?||18)|
|Select all that apply.|
|A) Serum creatinine||B) Serum glucose|
|C) Liver function||D) Serum triglyceride|
|19)||Periodic monitoring of which of the following is indicated for the client taking||19)|
|isotretinoin/13-cis-retinoic acid (Accutane)?|
|A) Blood levels of vitamin A||B) Heart rate|
|C) Triglycerides||D) Blood pressure|
|20) The client using amcinonide (Cyclocort ) should be instructed to:||20)|
- Monitor for irritation and redness, which are common effects with initial application.
- Keep a thin layer of medication on the area at all times.
- Cover the affected area with an adhesive bandage after application with medicine.
- Apply the medication to affected areas.
|21)||Which is a medication used to treat sickle-cell anemia and also psoriatic symptoms?||21)|
|A) Adapalene (Differin)||B) Calcipotriene (Dovonex)|
|C) Tarzarotene (Tazorac)||D) Hydroxyurea (Hydrea)|
|22)||A client taking carbamazepine (Tegretol) for seizures has also been started on||22)|
|isotretinoin/13-cis-retinoic acid (Accutane). The nurse recognizes that the client:|
- Might have increased seizure activity.
- Will need to monitor blood glucose levels
- Will have elevated triglycerides.
- Will have increased risk for cardiovascular disease.
|23)||Which of the following is a topical therapy for psoriasis that may be used without other||23)|
|medications for psoriasis?|
|A) Methotrexate (Amethopterin)||B) Tar treatment (coal tar)|
|C) Cyclosporine (Sandimmune)||D) Hydroxyurea (Hydrea)|
|24)||UVB (ultraviolet B) and UVA (ultraviolet A) phototherapy are techniques used in cases of severe||24)|
|psoriasis. Which type is less hazardous?|
|A) Both are the same.||B) Neither is hazardous.|
|C) UVA (ultraviolet A)||D) UVB (ultraviolet B)|
|25)||Psoralens are oral or topical agents that, when exposed to UV light:||25)|
- Increase the size of plaques.
- Produce a photosensitive reaction.
- Inhibit DNA synthesis and arrest abnormal cell growth.
- Increase cell growth.
|1)||In the anterior chamber of the eye, a watery fluid called ________ is found.||1)|
|A) Trabecular meshwork||B) Canal of Schlemm|
|C) Aqueous humor||D) Ciliary body|
|2)||The client has been diagnosed with acute glaucoma. The nurse understands that common causes||2)|
|include which of the following?|
|A) Trauma or hemorrhage||B) Increased intraocular pressure|
|C) Increased intracranial pressure||D) Diabetes mellitus or renal disease|
|3)||Glaucoma leads to blindness because:||3)|
- Pressure around the optic nerve builds over time.
- The optic nerve atrophies.
- The fluid in the eye blocks the optic nerve.
- The optic nerve cannot transmit signals with glaucoma.
|4)||Characteristics of closed-angle glaucoma include which of the following? Select all that apply.||4)|
|A) Caused by stress||B) Most common type of glaucoma|
|C) Pressure develops slowly, over time.||D) Caused by impact injury|
|5)||Characteristics of open-angle glaucoma include which of the following? Select all that apply.||5)|
- Is caused by impact injury.
- Intraocular pressure develops slowly.
- It is the most common type of glaucoma.
- The iris does not cover trabecular meshwork.
|6)||Drugs increasing the outflow of aqueous humor include which of the following? Select all that||6)|
|A) Sympathomimetics||B) Prostaglandins|
|C) Miotics||D) Beta blockers|
|7)||Drugs that decrease the formation of aqueous humor include which of the following? Select all that||7)|
|A) Alpha2||–||adrenergic agents||B) Carbonic-anhydride inhibitors|
|C) Prostaglandins||D) Osmotic diuretics|
|8)||A client has been prescribed latanoprost (Xalatan). The nurse informs the client regarding potential||8)|
|side effects. Which is not a side effect of latanoprost (Xalatan)?|
|A) Decreased pigmentation||B) Photophobia|
|C) Dryness||D) Heightened pigmentation|
|9)||The client has been prescribed acetylcholine chloride (Miochol). Which of the following is a||9)|
|temporary adverse effect?|
|A) Blurred vision||B) Dryness|
|C) Heightened pigmentation||D) Photophobia|
|10) The client has been prescribed travoprost (Travatan). The maximum effect of this medication||10)|
- 4 hours after administration.
- 6 hours after administration.
- 12 hours after administration.
- 2 hours after administration.
|11)||A client has been prescribed timolol (Timoptic). The maximum therapeutic effect:||11)|
|A) Takes 1—2 weeks.||B) Takes 2—4 weeks.|
|C) Begins immediately.||D) Takes 6—8 weeks.|
|12)||The client complains of blurry vision after using pilocarpine hydrochloride (Isopto Carptine). The||12)|
|nurse gives which of the following explanations?|
- ʺUse only half the dose, and monitor the results.ʺ
- ʺThis is a common reaction, but should be temporary.ʺ
- ʺYou have an allergy, and should stop using the drops.ʺ
- ʺI will have the physician prescribe something different for you.ʺ
|13)||Dipivefrin hydrochloride (Propine) effectively decreases intraocular pressure by:||13)|
|A) Decreasing the formation of aqueous humor.|
|B) Converting to epinephrine and increasing outflow of aqueous humor.|
|C) Reducing plasma volume very quickly.|
|D) The exact mechanism is not fully understood.|
|14)||To prevent systemic absorption of timolol (Timoptic), the client should be instructed to||14)|
|A) Apply pressure over the lacrimal sac for 1 minute.|
|B) Wait 5 minutes before administering other ophthalmic solutions.|
|C) Remove contact lenses prior to administering eyedrops.|
|D) Administer the eyedrop in the conjunctival sac.|
|15)||Drugs for minor irritation and injury include which of the following? Select all that apply||15)|
|A) Antimicrobials||B) Local anesthetics|
|C) Diphenhydramine HCl (Benadryl)||D) NSAIDs|
|16)||A client asks about using aloe vera for eye irritation. For the client to obtain therapeutic effect, the||16)|
- Treating the areas around the eyes.
- Placing aloe in the eye.
- Asking for a prescription for an anti-inflammatory medication instead.
- That the client refrain from using this natural alternative.
|17)||Drugs specifically designed for ophthalmic examinations include:||17)|
|A) Corticosteroids and antibiotics.||B) Antimicrobials and local anesthetics.|
|C) Local anesthetics and NSAIDs.||D) Cycloplegics and mydriatics.|
|18)||Following an extensive eye examination where a mydriatic agent was utilized, which nursing||18)|
|diagnosis is most appropriate for the client?|
- Deficient knowledge, related to disease process
- Pain, related to chemical agents
- Self-care deficit, related to impaired vision
- Risk for injury, related to visual acuity deficits
|19)||The client asks the nurse which OTC medication will lubricate the eye and cause vasoconstriction.||19)|
|The nurse replies:|
|A) ʺOxymetazoline hydrochloride (OcuClear).ʺ|
|B) ʺMethylcellulose (Methulose).ʺ|
|C) ʺPolyvinyl alcohol (Liquifilm).ʺ|
|D) ʺLanolin alcohol (Lacri-lube).ʺ|
|20)||Which of the following medications is a mydriatic?||20)|
- Atropine sulfate (Isopto Atropine)
- Hydroxyamphetamine (Paredrine)
- Scopolamine hydrobromide (Isopto Hyoscine)
- Cyclopentolate (Cyclogyl)
|21)||Which of the following medications is/are used to remove buildup of earwax?||21)|
|A) Triethanolamine polypeptide oleate 10% condensate (Cerumenex)|
|B) Acetic acid and hydrocortisone (Vosol HC)|
|C) Ciprofloxacin hydrochloride and hydrocortisone (Cipro)|
|D) Polymixin B, neomycin, and hydrocortisone (Cortisporin)|
|22)||Client teaching to prevent ʺswimmerʹs earʺ includes:||22)|
- Use of earwax-dissolving agents to help prevent irritation
- Application of 2 percent acetic acid to the ear canal after swimming.
- Use of glucocorticoid drops to prevent inflammation.
- Gently cleaning the ear canal with a swab to water or debris.
|23)||Inflammation that involves the middle ear is referred to as:||23)|
|A) Otitis media.||B) Mastoiditis.|
|C) Swimmerʹs ear.||D) Otitis externa.|
|24)||Neomycin and hydrocortisone (Cortisporin) may be used in combination to treat ear infections.||24)|
|Combined effects include:|
- Antibiotic and prophylactic therapy.
- Antipyretic and antifungal.
- Antibiotic therapy with an analgesic.
- Anti-inflammatory and antibiotic therapy.
|25) The client should be instructed to clean the ear canal by:||25)|
- Using a bulb syringe approved for removing debris and cold water.
- Using a bulb syringe approved for removing debris and warm water.
- Using a cotton swab.
- Never attempt to clean the ear canal at home.