Question 1

The nurse is providing Tarceva (erlotinib) intravenously for a client who has small cell lung cancer. The client begins to appear slightly short of breath, respiratory rate has gone from 14 breaths per min to 20 breaths per min and he has been coughing mildly for the past 10 min. Which of the following actions should the nurse take first?

Accepted Answer

Stopping the infusion is the first and most critical action to take because erlotinib (Tarceva) can cause interstitial lung disease, a potentially fatal condition. The symptoms described could indicate the onset of this serious side effect.

Question 2

While investigating the medications taken by a client in the hospital, the student nurse understands that Plendil (felodipine) works to lower blood pressure by causing which of the following physiologic changes?

Accepted Answer

Felodipine is a calcium channel blocker, which lowers blood pressure by blocking the transport of calcium into the smooth muscle cells of the heart and blood vessels, leading to vasodilation.

Question 3

The nurse is caring for a 68-year-old male who is taking Cardura (doxazosin). He denies any history of hypertension. The nurse recognizes this medication can also be used to treat which of the following conditions?

Accepted Answer

Cardura (doxazosin) is primarily used to treat benign prostatic hypertrophy (BPH) by relaxing smooth muscles in the prostate and urinary tract. It may also be prescribed to treat high blood pressure. It is not indicated for the treatment of psoriasis, gout, or lymphoma.

Question 4

A student nurse is preparing to participate in a mission-trip to South Africa and is prescribed Plaquenil (hydroxychloroquine). Which of the following side effects may be experienced by the student? Select all that apply.

Accepted Answer

The answer of A student nurse is preparing to participate...

Question 5

While observing in the operating room, the student nurse notes a client was given Robinul (glycopyrrolate) pre-operatively as part of the anesthesia regimen. The student recognizes this medication will cause which of the following?

Accepted Answer

Robinul (glycopyrrolate) is an anticholinergic medication that reduces oral and respiratory secretions. It does not affect pain perception, neuromuscular function, or consciousness.

Question 6

The nurse responds to a call light for a client with chronic obstructive pulmonary disease and finds the client slightly dyspneic with a respiratory rate of 20 and wheezing noted in the anterior and posterior upper lung fields. The nurse knows the client has orders for Arcapta (indacaterol) inhaler once daily, which is due in 1 hr. Which of the following actions by the nurse is best?

Accepted Answer

The best action for the nurse to take is to determine if the client has other orders for respiratory inhalers or treatments. While the client is exhibiting symptoms of dyspnea and wheezing, it is important to assess the client's overall respiratory plan before administering a medication. Additionally, checking the client's temperature or chest x-ray results would not be the priority in this situation.

Question 7

The nurse is providing care for a client who has new orders to start Victoza (liraglutide) 0.6 mg subcutaneously each day. Which of the following orders should the nurse anticipate? Select all that apply.

Accepted Answer

- Blood sugar monitoring is necessary to assess the effectiveness of Victoza and to prevent hypoglycemia.- Self-injection techniques must be taught to the client to ensure proper administration of the medication.- The client should be instructed to notify the physician of acute abdominal pain, nausea, or vomiting, as these may be signs of pancreatitis, a rare but serious side effect of Victoza.

Question 8

While working in the psychiatric hospital, the nurse provides Fanapt (iloperidone) 2 mg twice daily. Which of the following assessments indicates the medication is effective?

Accepted Answer

Fanapt (iloperidone) is an antipsychotic medication used to treat schizophrenia. One of the symptoms of schizophrenia is hearing voices. Therefore, if the client denies hearing voices after starting Fanapt, it indicates that the medication is effective in treating their symptoms. Stabilizing mood or sleep patterns and weight are not necessarily indicators of effectiveness for this particular medication.

Question 9

The nurse is talking to a neighbor who spent 3 days in the hospital on intravenous antibiotics including erythromycin the week before. The individual states, "I've had such bad diarrhea all night and it really isn't any better today." Which of the following statements by the nurse is best?

Accepted Answer

Antibiotic use, especially broad-spectrum antibiotics like erythromycin, can disrupt the normal gut flora and potentially lead to Clostridium difficile infection, which can cause severe diarrhea, often with blood or pus in the stool. This is a more serious condition that requires medical attention, making it the best question to ask first.

Question 10

The nurse is reviewing the home medication list for a client with identified hypercholesterolemia. The client reports taking Zetia (ezetimibe) daily. The nurse understands this medication is designed to reduce the client's risk for which of the following?

Accepted Answer

Zetia (ezetimibe) is a medication used to treat hypercholesterolemia by inhibiting the absorption of cholesterol from the small intestine, thereby reducing the risk of atherosclerosis, or the buildup of plaque in the arteries. It is not indicated for reducing the risk of angina, deep vein thrombosis, or gastric ulceration.

Question 11

As part of a new treatment regimen for hypothyroidism, a 48-year-old woman is prescribed Levoxyl (levothyroxine). The nurse should include which of the following statements in the client teaching? Select all that apply.

Accepted Answer

The answer of As part of a new treatment regimen...

Question 12

The nurse is providing care for a client with end stage renal disease who is receiving Fosrenol (lanthanum carbonate). The nurse recognizes this medication is effective by which of the following laboratory values?

Accepted Answer

Fosrenol (lanthanum carbonate) is a phosphate binder used to control hyperphosphatemia in patients with ESRD. Therefore, the medication should be effective if the serum phosphate level decreases within the normal range (2.5-4.5 mg/dL). Option D (serum phosphate = 5.4 mg/dL) is the only laboratory value that is abnormal and indicates the need for phosphate-lowering therapy.

Question 13

The student nurse reviews a list of medications a client takes at home. Xopenex (levalbuterol) is on the list. The student expects this medication is provided in which of the following ways?

Accepted Answer

Xopenex (levalbuterol) is a bronchodilator medication that is typically provided through a metered dose inhaler for the treatment of asthma or bronchospasm. It is not administered orally, topically, or rectally.

Question 14

A nurse caring for a client with chronic obstructive pulmonary disease notes the recent addition of a new inhaler, formoterol. The nurse knows this medication is designed to prevent which of the following symptoms?

Accepted Answer

Formoterol is a long-acting bronchodilator that is designed to prevent bronchospasm, a common symptom in patients with chronic obstructive pulmonary disease (COPD). It relaxes the smooth muscles in the airways, allowing for easier breathing. It does not affect mucous production, salivation, or bleb formation.

Question 15

The nurse is caring for a client newly admitted with pelvic inflammatory disease. An order for Primaxin (imipenem/cilastatin) 500 mg IV every 6 hr is noted. The nurse would be most concerned by which of the following findings in the client's history?

Accepted Answer

Imipenem/cilastatin is known to lower the seizure threshold, so a history of seizures would be a concern when administering this medication. The other options are not contraindications for the use of this medication.

Question 16

The nurse is providing Epogen (epoetin) subcutaneously to a client with chronic kidney disease. Which of the following would indicate that the therapy is effective? Select all that apply.

Accepted Answer

A) The rise in hematocrit indicates an increase in red blood cells, which is the therapeutic effect of Epogen, as it stimulates erythropoiesis to treat anemia in clients with chronic kidney disease.
C) Decreased fatigue and dyspnea suggest improved oxygenation, which can be attributed to the rise in hematocrit and improved treatment of anemia.

B, D, E, and F do not directly indicate the effectiveness of Epogen therapy. A fall in serum creatinine may indicate improved kidney function, increased urine output may indicate improved renal perfusion, normal WBC count and absence of fever may indicate absence of infection or inflammation, but these changes are not specific to the therapeutic effect of Epogen.

Question 17

A nurse caring for a client who is to initiate therapy with Merrem (meropenem) 500 mg intravenously every 12 hr would include which of the following statements in the client teaching? Select all that apply.

Accepted Answer

A) This statement is important to include in client teaching to provide information about the purpose of the medication.
B) This statement is important to include in client teaching to ensure that the correct dose is administered considering the client's renal impairment.
C) This statement is important to include in client teaching to monitor for the potential side effect of diarrhea.
D) This statement is incorrect and should not be included in client teaching as there is a small risk of cross-reactivity between penicillin and Merrem.
E) This statement is important to include in client teaching to monitor for the potential side effect of dizziness and provide advice on how to prevent falls.

Question 18

A nurse from the medical unit is floated to the surgical unit. While preparing to provide morning medications, the nurse realizes many clients are taking Demerol (meperidine) and knows the drug must be given cautiously or in reduced doses to which of the following clients? Select all that apply.

Accepted Answer

The answer of A nurse from the medical unit is...

Question 19

While observing in the oncology clinic, a student nurse is reviewing chemotherapy orders for a client with advanced colorectal cancer. The nurse providing care explains the client is to receive "high dose methotrexate with leucovorin rescue." The student understands the leucovorin calcium is given for which of the following reasons?

Accepted Answer

Leucovorin calcium is given as a rescue therapy to reduce the toxic effects of methotrexate on the normal cells of the body. Methotrexate is a folate antagonist and it inhibits the folate-dependent enzymes responsible for the synthesis of DNA and RNA needed for the growth and division of cells. Leucovorin is a reduced form of folic acid that rescues normal cells from the toxic effects of methotrexate by acting as a replacement for the lost folate. This allows cells to continue to grow and divide normally, while still allowing methotrexate to target the cancer cells.

Question 20

A client with Alzheimer is started on Razadyne (galantamine) 4 mg twice daily. The family has been told to return to the physician's office in 4 wk. Which of the following statements by the nurse is best?

Accepted Answer

This medication can cause dizziness so be extra careful to avoid falls.

Davis's Drug Guide for Nurses Test 3