Question 1

The nurse recognizes that Apriso (mesalamine) would most likely be included in the plan of care for which of the following patients?

Accepted Answer

Apriso (mesalamine) is typically used to treat inflammatory bowel disease, such as ulcerative colitis. It works by reducing inflammation in the colon. It would not be appropriate for a patient with COPD, cholelithiasis, or ruptured ectopic pregnancy.

Question 2

The nurse is caring for a patient in the intensive care unit. The patient is receiving Osmitrol (mannitol) 0.5 g/kg infused over 60 min. Which of the following would indicate an effective response to the treatment?

Accepted Answer

Mannitol is a diuretic that works by increasing urine output, therefore an increase in urine output would indicate an effective response to the medication. Option B shows a normal white blood cell count, option C indicates low oxygen saturation and option D shows an elevated systolic blood pressure and a low diastolic blood pressure which could indicate hypovolemia or dehydration, and is not a desired response to mannitol therapy.

Question 3

The nurse is caring for a pediatric patient who needs to have an IV line started. The nurse plans to provide EMLA cream (lidocaine/prilocaine) to the patient's arm. Which of the following actions should the nurse take?

Accepted Answer

The best choice is to place a thick layer of cream under an occlusive dressing on a 2-inch site 1 hour prior to the procedure. EMLA cream takes about 1 hour to provide adequate anesthesia to the area where it is applied. A thick layer of cream under an occlusive dressing will enhance the absorption and efficacy of the cream. Applying the cream to a smaller surface area will also decrease the risk of systemic absorption, which is especially important in pediatric patients.

Question 4

The nurse is caring for a patient admitted from an extended care facility who has developed a moist, productive cough. A chest x ray was ordered and new orders for Zyvox (linezolid) 600 mg IV every 12 hr has been received. Which of the following orders should the nurse also complete prior to providing the first dose of medication?

Accepted Answer

A sputum culture and sensitivity should be obtained prior to initiating antibiotic therapy to identify the specific organism causing the infection and to ensure the most appropriate antibiotic is used. Daily weight, CBC, and chemistry profile may be ordered for other purposes but are not directly related to the initiation of antibiotic therapy for a respiratory infection.

Question 5

The nurse is caring for a patient who has been receiving chemotherapy for the past 4 months. The patient takes Reglan (metoclopramide) 10 mg every 4 hr as needed for nausea and vomiting. The nurse should be most concerned with which of the following patient statements?

Accepted Answer

The patient's symptoms of losing balance and shakiness may be signs of tardive dyskinesia, a potential side effect of long-term metoclopramide use. The nurse should notify the provider immediately and assess the patient further. Option B may be a possible side effect of chemotherapy or related to the patient's nausea and vomiting, but it is not as concerning as option A. Options C and D are more about the patient's emotional and social well-being rather than physical health.

Question 6

The nurse is working with a client who is undergoing a bowel prep prior to a scheduled colonoscopy. Which of the following medications should the nurse expect to provide?

Accepted Answer

Magnesium citrate is commonly used for bowel prep prior to a colonoscopy because it is a strong laxative that helps clear the bowels. Magnesium chloride sustained-release tablets, magnesium hydroxide chewable tablets, and magnesium sulfate intravenously are not typically used for bowel prep.

Question 7

The nurse is caring for a patient who reports long-term use of nonsteroidal anti-inflammatory agents for the treatment of osteoarthritis. Which of the following medications would the nurse also expect as part of the patient's treatment plan?

Accepted Answer

Long-term use of nonsteroidal anti-inflammatory agents can lead to gastrointestinal complications such as ulcers and bleeding. Cytotec (misoprostol) is often prescribed to protect the stomach lining from damage.

Question 8

The nurse is caring for a patient who has been on multiple antibiotics for the treatment of pneumonia. The patient reports having a sore throat. The nurse notes a white coating on the patient's tongue as well as redness to the lips and gums. The nurse would most likely contact the physician to request which of the following?

Accepted Answer

The white coating on the patient's tongue and redness to the lips and gums may indicate a fungal infection known as oral thrush, which can occur as a result of prolonged antibiotic use. Nilstat (nystatin) is an antifungal medication that can be used to treat oral thrush and is therefore the most appropriate choice. Pamelor (nortriptyline) is an antidepressant medication, Nimodipine is a calcium channel blocker used to prevent brain damage following a subarachnoid hemorrhage, and Zyprexa (olanzapine) is an antipsychotic medication. None of these medications are appropriate for the treatment of oral thrush.

Question 9

The nurse is caring for a patient who is to receive 1 mg of Ativan (lorazepam) intravenously as conscious sedation prior to a bedside procedure. Which of the following actions should the nurse take?

Accepted Answer

Ativan should be administered over at least 1 minute to prevent adverse effects such as hypotension or respiratory depression. A) Using an insulin syringe is not appropriate for administering IV medication. B) There is no need to dilute Ativan with Lactated Ringer's solution prior to administration. D) Monitoring for hypertension is not a priority for Ativan administration, but monitoring for respiratory depression and sedation is important.

Question 10

A nurse working in the chemotherapy outpatient department is providing antiemetic therapy using Zofran (ondansetron). The ordered dose is 32 mg. Which of the following actions should the nurse take to optimize the efficacy of the medication?

Accepted Answer

Providing the dose diluted in 50 mL of D5W infused intravenously over 15 min at least 30 min prior to starting chemotherapy is the best option to optimize the efficacy of Zofran. This allows time for the medication to be fully absorbed and distributed in the body, and also decreases the risk of adverse reactions such as flushing and headache that could occur with rapid IV administration. Intramuscular injection (option A) is not recommended for Zofran as it has poor bioavailability through this route. Option B involves undiluted IV administration, which can increase the risk of adverse reactions. Option D involves a different diluent (0.9 NaCl) than what is recommended (D5W) and infusing the medication too far in advance (60 min) may decrease its effectiveness.

Question 11

The nurse is caring for a patient admitted with chronic pain who has been receiving meperidine 100 mg orally every 3-4 hr as needed for pain for the past 4 days. Which of the following actions is the highest priority in the patient's care?

Accepted Answer

Meperidine has the potential to accumulate and cause toxic effects, including seizures. The nurse should monitor for signs of meperidine toxicity, including irritability and seizure activity, which is the highest priority in this patient's care. Checking bowel movements and asking about insomnia are important aspects of pain management but do not take priority over monitoring for potential adverse effects of meperidine. Checking triglyceride levels is not relevant to this patient's care.

Question 12

While reviewing a patient's medications for the day, the nurse notes the patient is prescribed Creon (pancrelipase) three times daily. Which of the following actions by the nurse is best?

Accepted Answer

Creon is a pancreatic enzyme replacement therapy used to help digest fats, proteins, and carbohydrates in patients with pancreatic enzyme deficiencies. It should be given with meals or snacks to ensure adequate absorption and effectiveness. Therefore, the best action for the nurse is to provide the medication immediately before or with the patient's meals.

Question 13

The student nurse is caring for a patient who currently takes Ditropan XL (oxybutynin). The student should include which of the following statements in the patient's teaching?

Accepted Answer

Ditropan XL (oxybutynin) is a medication used to help control the symptoms of an overactive bladder. It does not reduce pain or cause ringing in the ears or night sweats. Therefore, option A, B, and D are incorrect. The correct statement to include in patient teaching is option C, as it explains the purpose of the medication.

Question 14

The nurse is counseling the parent of a 14-year-old patient with asthma who is to initiate maintenance therapy with Singulair (montelukast). Which of the following should the nurse include in the teaching?

Accepted Answer

Montelukast (Singulair) has been associated with mood changes and suicidal thoughts in some patients, so it's important for parents to monitor their child for any changes in behavior or new symptoms of depression or suicidal ideation.

Question 15

The nurse is caring for a patient experiencing dysphagia and weight loss due to oral mucositis. Which of the following should be the nurse's highest priority?

Accepted Answer

Providing Xylocaine (viscous lidocaine) topically prior to meals can help relieve pain and discomfort associated with oral mucositis, allowing the patient to eat and maintain their nutritional status. The other options do not directly address the patient's dysphagia and weight loss. Using hydrogen-peroxide-based mouthwash can further irritate the oral mucosa and is not recommended. Normal saline rinses can be helpful for oral hygiene but may not provide significant relief for dysphagia. Ordering a puree diet may be necessary but should not be the first priority as it does not address the underlying issue of oral mucositis.

Question 16

The nurse receives a call from a client who recently started taking Paxil (paroxetine). The parent reports the child has lost 6 pounds in the past 10 days. Which of the following statements by the nurse is best?

Accepted Answer

Weight loss in a child taking Paxil (paroxetine), especially a significant amount in a short period, could indicate a serious side effect or an adverse reaction to the medication. It is important for the healthcare provider to assess the child in person to determine the cause of the weight loss and to ensure the child's safety and well-being.

Question 17

The nurse is caring for a patient who needs emergency surgery. The patient's history includes daily use of Coumadin (warfarin). Which of the following medications should the nurse anticipate being ordered?

Accepted Answer

Coumadin (warfarin) is an anticoagulant medication that works by blocking the production of clotting factors in the liver. In the case of emergency surgery, it is necessary to reverse the anticoagulant effect of Coumadin to avoid excessive bleeding during surgery. Vitamin K (phytonadione) is commonly used to reverse the effects of Coumadin by promoting the production of clotting factors. Therefore, the nurse should anticipate that vitamin K will be ordered for this patient. Dilantin (phenytoin) is an antiepileptic medication and has no role in reversing the effects of Coumadin. Luminal (phenobarbital) is a barbiturate medication that can be used to treat seizure disorders, anxiety, and insomnia. Protamine sulfate is a medication used to reverse the effects of heparin, another type of anticoagulant medication, and is not effective in reversing the effects of Coumadin.

Question 18

A nurse in an outpatient clinic receives a call from a patient who reports having had symptoms of the flu for the past 4 days. The patient is seeking an appointment with the physician and wants, "the medication that treats the flu [Tamiflu (oseltamivir)]." Which of the following responses by the nurse is best?

Accepted Answer

Tamiflu (oseltamivir) is most effective when started within the first 48 hours of symptom onset. After 4 days of symptoms, it is less likely to be beneficial.

Question 19

The student nurse is participating in discharge teaching for the parents of a 2-year-old patient diagnosed with impetigo who have been given a prescription for Bactroban (mupirocin). The student understands that this medication is provided in which of the following forms?

Accepted Answer

Bactroban (mupirocin) is a topical ointment used for bacterial skin infections such as impetigo. It is not available in oral, rectal, or liquid suspension form.

Question 20

The nurse is caring for a patient who has been started on Corgard (nadolol). Which of the following assessment findings would be most concerning to the nurse?

Accepted Answer

Noted jugular vein distension can indicate heart failure, which is a potential side effect of Corgard. The other assessment findings are within normal limits and do not indicate any immediate concerns.

Davis's Drug Guide for Nurses Test 1

The nurse recognizes that Apriso (mesalamine) would most likely be included in the plan of care for which of the following patients?

The nurse is caring for a patient in the intensive care unit. The patient is receiving Osmitrol (mannitol) 0.5 g/kg infused over 60 min. Which of the following would indicate an effective response to the treatment?

The nurse is caring for a pediatric patient who needs to have an IV line started. The nurse plans to provide EMLA cream (lidocaine/prilocaine) to the patient's arm. Which of the following actions should the nurse take?

The nurse is caring for a patient who has been receiving chemotherapy for the past 4 months. The patient takes Reglan (metoclopramide) 10 mg every 4 hr as needed for nausea and vomiting. The nurse should be most concerned with which of the following patient statements?

The nurse is working with a client who is undergoing a bowel prep prior to a scheduled colonoscopy. Which of the following medications should the nurse expect to provide?

The nurse is caring for a patient who reports long-term use of nonsteroidal anti-inflammatory agents for the treatment of osteoarthritis. Which of the following medications would the nurse also expect as part of the patient's treatment plan?

The nurse is caring for a patient who is to receive 1 mg of Ativan (lorazepam) intravenously as conscious sedation prior to a bedside procedure. Which of the following actions should the nurse take?

A nurse working in the chemotherapy outpatient department is providing antiemetic therapy using Zofran (ondansetron) . The ordered dose is 32 mg. Which of the following actions should the nurse take to optimize the efficacy of the medication?

The nurse is caring for a patient admitted with chronic pain who has been receiving meperidine 100 mg orally every 3-4 hr as needed for pain for the past 4 days. Which of the following actions is the highest priority in the patient's care?

While reviewing a patient's medications for the day, the nurse notes the patient is prescribed Creon (pancrelipase) three times daily. Which of the following actions by the nurse is best?

The student nurse is caring for a patient who currently takes Ditropan XL (oxybutynin) . The student should include which of the following statements in the patient's teaching?

The nurse is counseling the parent of a 14-year-old patient with asthma who is to initiate maintenance therapy with Singulair (montelukast) . Which of the following should the nurse include in the teaching?

The nurse is caring for a patient experiencing dysphagia and weight loss due to oral mucositis. Which of the following should be the nurse's highest priority?

The nurse receives a call from a client who recently started taking Paxil (paroxetine) . The parent reports the child has lost 6 pounds in the past 10 days. Which of the following statements by the nurse is best?

The nurse is caring for a patient who needs emergency surgery. The patient's history includes daily use of Coumadin (warfarin) . Which of the following medications should the nurse anticipate being ordered?

The student nurse is participating in discharge teaching for the parents of a 2-year-old patient diagnosed with impetigo who have been given a prescription for Bactroban (mupirocin) . The student understands that this medication is provided in which of the following forms?

The nurse is caring for a patient who has been started on Corgard (nadolol) . Which of the following assessment findings would be most concerning to the nurse?