Question 1

An infant being treated for colic was prescribed Mylicon (simethicone)drops and has returned to the clinic for follow-up evaluation.Which of the following nursing action has the highest priority?

Accepted Answer

See Assessment for simethicone.Assess patient for abdominal pain,distention,and bowel sounds prior to and periodically throughout course of therapy.

Question 2

A nurse caring for a patient who's prescribed Inderal LA (propranolol)is being tapered off over a 2-wk period.The nurse would include which of the following statements in the patient teaching?

Accepted Answer

See Assessment for propranolol.Abrupt withdrawal of propranolol may precipitate life-threatening arrhythmias,hypertension,or myocardial ischemia.Drug should be tapered off over a 2-wk period before discontinuation.Assess patient carefully during tapering and after medication is discontinued.Consider that patients taking propranolol for noncardiac indications may have undiagnosed cardiac disease.Abrupt discontinuation or withdrawal over too short a period of time (less than 9 days)should be avoided.While the cost of medications is important,it is not the highest priority.

Question 3

While preparing to discharge a patient who has started taking Lopressor (metoprolol)during their hospitalization,the nurse recognizes further teaching is necessary by which of the following statements:

Accepted Answer

See Patient/Family Teaching for metoprolol.Blood levels are not followed for this medication.Teach patient and family how to check pulse daily and blood pressure biweekly and to report significant changes to a health-care professional.Reinforce the need to continue additional therapies for hypertension (weight loss,sodium restriction,stress reduction,regular exercise,moderation of alcohol consumption,and smoking cessation).Advise patient to notify health-care professional if slow pulse,difficulty breathing,wheezing,cold hands and feet,dizziness,light-headedness,confusion,depression,rash,fever,sore throat,unusual bleeding,or bruising occurs.

Question 4

The nurse is caring for an infant with oral thrush whose medications include Mycostatin (nystatin)suspension 5 mL QID.Which of the following actions should the nurse take?

Accepted Answer

See Implementation for nystatin.For neonates and infants,paint suspension into recesses of the mouth.

Question 5

The nurse is caring for a patient with tuberculosis who is on a diet with honey-thick liquids.Which action should the nurse take to administer the dose of Rifadin (rifampin)?

Accepted Answer

See Implementation for rifampin.Capsules may be opened and contents mixed with applesauce or jelly for patients with difficulty swallowing.While the pharmacist can compound a syrup for patients unable to swallow solids,this patient has difficulty swallowing liquids.If honey-thick liquids are ordered,nonthickened water should be avoided.Parenteral therapy is not required.

Question 6

A nurse working on the postpartum floor is checking orders and notes the following,"Methergine (methylergonovine)200 mcg po q 6 hr for 48 hr." Which of the following nursing interventions should be added to the patient's plan of care?

Accepted Answer

See Assessment for methylergonovine.Methergine is used in the treatment of postpartum hemorrhage.Monitor blood pressure,heart rate,and uterine response frequently during medication administration.

Question 7

Which of the following would indicate to the nurse that treatment was effective in a patient being treated with propylthiouracil?

Accepted Answer

See Evaluation for propylthiouracil.PTU decreases the severity of symptoms of hyperthyroidism (lowered pulse rate and weight gain).Symptoms of hyperthyroidism include tachycardia,palpitations,nervousness,insomnia,fever,diaphoresis,heat intolerance,tremors,weight loss,and diarrhea.Symptoms of hypothyroidism include intolerance to cold,constipation,dry skin,headache,listlessness,tiredness,or weakness.

Question 8

To monitor the peak efficacy after providing oral Dilaudid (hydromorphone)Immediate Release for a patient reporting pain ranked 6 out of 10 on a numeric pain scale.The patient should report some relief in pain at the peak action of the drug.Which of the following reflects the peak action of Dilaudid Immediate Release?

Accepted Answer

See Pharmacokinetics for hydromorphone.The peak action for this medication is 30-90 min.

Question 9

While caring for a patient with myasthenia gravis and a history of dysphasia who is taking Mestinon (pyridostigmine),the nurse recognizes the need for further teaching by which of the following statements?

Accepted Answer

See Patient/Family Teaching for pyridostigmine.Patients with a history of dysphagia should have a nonelectric or battery-operated back-up alarm clock to remind them of exact dose time.Patients with dysphagia may not be able to swallow medication if the dose is not taken exactly on time.Taking dose late may result in myasthenic crisis.Taking dose early may result in cholinergic crisis.Patients with myasthenia gravis must continue this regimen as a life-long therapy.Advise patient to carry identification describing their disease and medication regimen at all times.

Question 10

The nurse observing a patient who uses a prescribed Serevent Diskus (salmeterol)recognizes that teaching has been effective if which of the following is observed?

Accepted Answer

See Patient/Family Teaching for salmeterol.Instruct patient using powder for inhalation never to exhale into diskus device and always to hold device in a level horizontal position.Mouthpiece should be kept dry and should never be washed.

Question 11

The nurse is caring for a patient who recently started taking Compro (prochlorperazine)10 mg po QID.Which of the following symptoms would cause the nurse to contact the physician immediately?

Accepted Answer

See Assessment for prochlorperazine.Monitor for development of neuroleptic malignant syndrome (fever,respiratory distress,tachycardia,seizures,diaphoresis,hypertension or hypotension,pallor,tiredness,severe muscle stiffness,and loss of bladder control).Notify physician or other health-care professional immediately if these symptoms occur.Constipation is a known side effect with this medication,and the pulse is normal.Blood pressure is within normal limits and hiccups are not immediately concerning.Respirations are within normal parameters,and Compro is taken for nausea,so mild nausea may be expected.

Question 12

A nurse working at an adult care center for individuals with mental illness provides an individual with their dose of Risperdal (risperidone).The nurse should intervene if the client mixes the liquid medication with which of the following?

Accepted Answer

See Implementation for risperidone.Oral solution can be mixed with water,coffee,orange juice,or low-fat milk;do not mix with cola or tea.

Question 13

A nurse caring for an individual taking Avandia (rosiglitazone)monitors which of the following lab results to help evaluate treatment effectiveness?

Accepted Answer

See Assessment/Lab test considerations for rosiglitazone.Monitor serum glucose and glycosylated hemoglobin periodically during therapy to evaluate effectiveness.

Question 14

While in the recovery room,the nurse cares for a post-anesthesia patient who reports severe nausea.The nurse would most likely request an order for which of the following medications?

Accepted Answer

See Indications for scopolamine.Scopolamine is used in the management of nausea and vomiting associated with opioid analgesia or general anesthesia/recovery from anesthesia.Eldepryl is used in the management of Parkinson disease.Januvia is used in the management of diabetes.Cialis is used for erectile dysfunction.

Question 15

A nurse caring for a patient with non-Hodgkin lymphoma prepares to provide Leukine (sargramostim).Which of the following will indicate successful response to the medication?

Accepted Answer

See Action for sargramostim.Indications include accelerated recovery of bone marrow after autologous bone marrow transplantation,resulting in decreased risk of infection and other complications.

Question 16

A hospice nurse is caring for a patient with end-stage stomach cancer who has a new order to be kept NPO.The patient complains of nausea and has a standard order for promethazine for this complaint.Which of the following actions should the nurse take?

Accepted Answer

See Routes/dosages for promethazine.Because the patient has orders to be kept NPO,any oral preparation is contraindicated without an overriding order.Rectal dosing is available and can be used effectively,although it may be less reliable.This noninvasive route should be chosen over starting an IV.

Question 17

At a follow-up appointment at the urologist's office,the nurse is gathering data on a patient who takes VESIcare (solifenacin)for an overactive bladder.Which of the following statements would be most concerning to the nurse?

Accepted Answer

See Patient/Family Teaching for solifenacin.Advise patient to consult a health-care professional prior to taking Rx,OTC,or herbal products with solifenacin.Drug-Drug: Drugs that induce or inhibit the CYP3A4 enzyme system may significantly alter blood levels of solifenacin;ketoconazole ↑ blood levels and risk of toxicity (do not exceed 5 mg/day).

Question 18

A client taking vitamin B₆ (pyridoxine)calls the nurse at 3 p.m.to report she is at work and didn't take the pill at breakfast.Which of the following statements by the nurse is best?

Accepted Answer

See Patient/Family Teaching for pyridoxine.Instruct patient to take medication as directed.If a dose is missed,it may be omitted because an extended period of time is required to become deficient in vitamin B₆.

Question 19

A patient is admitted with suspected overdose of Bloxiverz (neostigmine).Which of the following will be used as an antidote?

Accepted Answer

See Assessment/Toxicity and Overdose for neostigmine.If an overdose occurs,atropine is the antidote.

Question 20

The nurse is providing care for a patient in hospice who has been converted to a continuous infusion of morphine for pain control via the use of a patient-controlled analgesia pump.The nurse recognizes that break-through pain should be handled in which of the following ways?

Accepted Answer

See Assessment for Morphine.Patients on a continuous infusion should have additional bolus doses provided every 15-30 min,as needed,for break-through pain.

Quiz 2: Detecting and Managing Adverse Drug Reactions

An infant being treated for colic was prescribed Mylicon (simethicone) drops and has returned to the clinic for follow-up evaluation.Which of the following nursing action has the highest priority?

A nurse caring for a patient who's prescribed Inderal LA (propranolol) is being tapered off over a 2-wk period.The nurse would include which of the following statements in the patient teaching?

While preparing to discharge a patient who has started taking Lopressor (metoprolol) during their hospitalization,the nurse recognizes further teaching is necessary by which of the following statements:

The nurse is caring for an infant with oral thrush whose medications include Mycostatin (nystatin) suspension 5 mL QID.Which of the following actions should the nurse take?

The nurse is caring for a patient with tuberculosis who is on a diet with honey-thick liquids.Which action should the nurse take to administer the dose of Rifadin (rifampin) ?

A nurse working on the postpartum floor is checking orders and notes the following,"Methergine (methylergonovine) 200 mcg po q 6 hr for 48 hr." Which of the following nursing interventions should be added to the patient's plan of care?

Which of the following would indicate to the nurse that treatment was effective in a patient being treated with propylthiouracil?

While caring for a patient with myasthenia gravis and a history of dysphasia who is taking Mestinon (pyridostigmine) ,the nurse recognizes the need for further teaching by which of the following statements?

The nurse observing a patient who uses a prescribed Serevent Diskus (salmeterol) recognizes that teaching has been effective if which of the following is observed?

The nurse is caring for a patient who recently started taking Compro (prochlorperazine) 10 mg po QID.Which of the following symptoms would cause the nurse to contact the physician immediately?

A nurse working at an adult care center for individuals with mental illness provides an individual with their dose of Risperdal (risperidone) .The nurse should intervene if the client mixes the liquid medication with which of the following?

A nurse caring for an individual taking Avandia (rosiglitazone) monitors which of the following lab results to help evaluate treatment effectiveness?

While in the recovery room,the nurse cares for a post-anesthesia patient who reports severe nausea.The nurse would most likely request an order for which of the following medications?

A nurse caring for a patient with non-Hodgkin lymphoma prepares to provide Leukine (sargramostim) .Which of the following will indicate successful response to the medication?

A hospice nurse is caring for a patient with end-stage stomach cancer who has a new order to be kept NPO.The patient complains of nausea and has a standard order for promethazine for this complaint.Which of the following actions should the nurse take?

At a follow-up appointment at the urologist's office,the nurse is gathering data on a patient who takes VESIcare (solifenacin) for an overactive bladder.Which of the following statements would be most concerning to the nurse?

A client taking vitamin B₆ (pyridoxine) calls the nurse at 3 p.m.to report she is at work and didn't take the pill at breakfast.Which of the following statements by the nurse is best?

A patient is admitted with suspected overdose of Bloxiverz (neostigmine) .Which of the following will be used as an antidote?

The nurse is providing care for a patient in hospice who has been converted to a continuous infusion of morphine for pain control via the use of a patient-controlled analgesia pump.The nurse recognizes that break-through pain should be handled in which of the following ways?