Question 1

While counseling a client taking Kepivance (palifermin), the nurse recognizes that further teaching is necessary based on which of the following client statements?
A) "I'll be sure to let my doctor know if I develop a rash or any tongue discolorations."
B) "As long as I'm taking this, I won't get any side effects from my chemotherapy."
C) "This medication helps prevent the mouth sores that were so bad with my last chemotherapy treatment."
D) "I have to get this medication in an IV 3 days before and 3 days after my chemotherapy."

Accepted Answer

The statement "As long as I'm taking this, I won't get any side effects from my chemotherapy" is incorrect and requires further teaching. Kepivance (palifermin) helps to prevent mouth sores but does not prevent other potential side effects of chemotherapy.

Question 2

The nurse is providing instructions to a client who has started therapy withnicardipine. The nurse instructs the client to avoid which of the following foods?
A) Kiwi
B) Grapefruit juice
C) Garlic
D) Ginger

Accepted Answer

Nicardipine is a calcium channel blocker medication that should not be taken with grapefruit juice as it can increase the risk of side effects and decrease the effectiveness of the medication. Kiwi, garlic, and ginger do not interact with nicardipine.

Question 3

The nurse is providing care for an elderly woman with a urinary tract infection. The nurse understands the patient is receiving Pyridium (phenazopyridine) for which of the following reasons?
A) To reduce the frequency and severity of bladder spasms.
B) To provide local anesthetic effects to the bladder mucosa.
C) To kill
D) To promote diuresis and subsequently prevent stone formation.
E) coli bacteria commonly associated with urinary tract infection.

Accepted Answer

Pyridium (phenazopyridine) is a urinary tract analgesic used to provide local anesthetic effects to the bladder mucosa, relieving pain, burning, urgency, and frequency caused by urinary tract infections. It does not kill bacteria or promote diuresis. It also does not reduce the frequency and severity of bladder spasms.

Question 4

A nurse is receiving a shift-to-shift report for a client with multiple medical problems. The client is receiving nabumetone. The nurse recognizes this medication is ordered to address which of the following health-care problems for the client?
A) Benign prostatic hypertrophy
B) Rheumatoid arthritis
C) Venous-thrombosis embolic prophylaxis
D) Urinary tract infection

Accepted Answer

Nabumetone is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used to treat pain and inflammation associated with conditions such as osteoarthritis and rheumatoid arthritis. It is not used to treat any of the other conditions listed.

Question 5

The nurse is providing milrinone to a 71-year-old woman with heart failure. Which of the following nursing assessments during the infusion is of the highest priority?
A) Monitor client's blood sugar every 4 hr.
B) Monitor client's sedation level hourly.
C) Monitor client's telemetry continuously.
D) Monitor client's urine output every 4 hr.

Accepted Answer

Milrinone is a cardiac inotrope medication and can cause arrhythmias, especially in older patients with heart failure. Therefore, continuous telemetry monitoring is the highest priority to monitor for any changes in cardiac electrical activity. Monitoring blood sugar, sedation level, and urine output are important but not the highest priority during milrinone infusion.

Question 6

While caring for a client who is taking Dipentum (olsalazine) for ulcerative colitis, the nurse is aware that it is most important to determine if the patient has an allergy to which of the following?
A) Penicillins or cephalosporins
B) NSAIDs or opioids
C) Beta blockers or nitrosoureas
D) Sulfonamides or salicylates

Accepted Answer

Dipentum (olsalazine) is a sulfasalazine derivative, so it is important to determine if the patient has an allergy to sulfonamides or salicylates. Allergies to penicillins or cephalosporins, NSAIDs or opioids, beta blockers, or nitrosoureas are not directly relevant to the use of Dipentum.

Question 7

The nurse is caring for a 58-year-old male who has been prescribed Neulasta (pegfilgrastim). The nurse recognizes provision of this medication is based on which of the following lab results? A) Hgb= 11.7 g/dL B) CPK = 25 mcg/L C) Platelets = 114,000 cells/mm³ D) WBC = 2.3 cells/mm³

Accepted Answer

Neulasta (pegfilgrastim) is a medication used to stimulate the production of white blood cells (WBCs) in patients who have undergone chemotherapy or bone marrow transplantation. Therefore, provision of this medication is based on the patient's WBC count. A WBC count of 2.3 cells/mm³ is considered low, indicating the patient could benefit from Neulasta to boost his WBC count. The other lab results, including hemoglobin (Hgb), creatine phosphokinase (CPK), and platelets, are not directly related to the indication for Neulasta.

Question 8

While caring for a client with hypertension who has recently started taking Bystolic (nebivolol), the client reports, "This medication seems to give me a headache." Which of the following statements by the nurse is best?
A) "Headaches are common with your new medications. You should continue to take the medication to help control your blood pressure."
B) "That's too bad. You could try taking half a pill twice a day."
C) "You should call your doctor and let them know about that-it could be a serious side effect of the new medication."
D) "Have you noticed any muscle twitching or facial numbness?"

Accepted Answer

Headaches can be a common side effect when starting Bystolic (nebivolol). The nurse should reassure the client to continue the medication while monitoring the side effect, as it may resolve over time.

Question 9

While caring for a client who is receiving Serax (oxazepam), the nurse notes the client is drowsy and slightly confused upon waking. Which of the following conclusions should the nurse draw?
A) The client may be experiencing symptoms of a stroke and the physician should be contacted immediately.
B) The client may be experiencing hypersensitivity and the drug should be held.
C) This is an expected and normal finding with the medication and the patient should be monitored for safety concerns.
D) The client may have underlying psychiatric disorders and should be assessed for the presence of hallucinations.

Accepted Answer

Drowsiness and confusion upon waking is a common adverse effect of Serax (oxazepam). The nurse should monitor the client for safety concerns but does not need to hold the drug or contact the physician unless the symptoms worsen or persist. The other options are not relevant or appropriate for this situation.

Question 10

A client admitted with neutropenia would most likely be started on which of the following medications to promote neutrophil differentiation?
A) Epogen (epoetin)
B) Neulasta (pegfilgrastim)
C) Neurontin (gabapentin)
D) Procardia (nifedipine)

Accepted Answer

Neulasta (pegfilgrastim) is a medication that stimulates the production and differentiation of neutrophils, which can help increase the patient's neutrophil count and prevent infections. Epogen (epoetin) is used to stimulate red blood cell production and would not be effective in treating neutropenia. Neurontin (gabapentin) is a medication used for nerve pain and seizures, and Procardia (nifedipine) is used for blood pressure control and angina, neither of which are effective for treating neutropenia.

Question 11

The nurse is preparing to give an initial dose of Aloxi (palonosetron) as ordered prior to starting chemotherapy for breast cancer. Which of the following nursing actions is of the highest priority?
A) Infuse the medication undiluted 30 min prior to planned chemotherapy.
B) Monitor symptoms of nausea or vomiting.
C) Provide the client with written materials on the chemotherapy agents being used.
D) Determine the client's typical food intake.

Accepted Answer

Aloxi (palonosetron) is given to prevent nausea and vomiting associated with chemotherapy, and it should be administered 30 minutes before starting chemotherapy to ensure its effectiveness.

Question 12

The nurse caring for clients in the psychiatric unit provides Invega (paliperidone) to one of the clients. The nurse recognizes this medication is effective by which of the following observations?
A) The client's weight is stable for 3 days.
B) The client reports the voices in his head have stopped talking to him.
C) The client stops pacing the halls and ringing his hands.
D) The client is able to focus on completing a puzzle in the day room.

Accepted Answer

Invega (paliperidone) is an antipsychotic medication used to treat symptoms of schizophrenia, such as hallucinations. The cessation of auditory hallucinations, like the voices in the client's head stopping, indicates the medication's effectiveness.

Question 13

While providing care for a client in the intensive care unit, the nurse is preparing to initiate therapy with Nitropress (nitroprusside). Orders are to start the infusion at 0.3 mcg/kg/min. The client weighs 154 pounds. The IV fluid has been sent with 50 mg in 250 mL D5W. Calculate the rate of medication in mL/hr. ______________ mL/hr

Accepted Answer

The answer of While providing care for a client in...

Question 14

While providing care for a client who is to receive Amerge (naratriptan), the nurse recognizes that the client understands this medication by which of the following statements?
A) "If my migraine headache doesn't go away, I can repeat the dose within 30 minutes."
B) "This medication will typically make me very sleepy after I take it."
C) "I need to let the doctor know right away if I have any chest pain or tightness after taking this medication."
D) "I need to be sure and take a laxative when I take this medication."

Accepted Answer

Amerge belongs to a class of drugs known as triptans, which are used to treat migraines. Triptans can cause chest pain or tightness, which could be a sign of a serious side effect. It is important for the client to contact their healthcare provider immediately if they experience such symptoms. The other options are incorrect statements about Amerge.

Question 15

The nurse is providing care for a 31-year-old patient with a history of seizures. Which of the following medications would the nurse anticipate is part of the patient's home medication regimen?
A) Trileptal (oxcarbazepine)
B) Pentoxil (pentoxifylline)
C) Zyloprim (allopurinol)
D) Dexedrine (dextroamphetamine)

Accepted Answer

Trileptal is an anticonvulsant medication commonly used to treat seizures. Pentoxil is a medication used to improve blood flow and treat peripheral artery disease, Zyloprim is used to treat gout, and Dexedrine is a central nervous system stimulant used to treat ADHD and narcolepsy. None of these medications are commonly used to treat seizures.

Question 16

While preparing to give morning medications, Remeron (mirtazapine) was newly ordered for the patient to begin this morning. The nurse would immediately call the physician to question this order if which of the following medications was included in the patient's list of home medications?
A) Enteric coated aspirin
B) Lasix (furosemide)
C) Digoxin (lanoxin)
D) Nardil (phenelzine)

Accepted Answer

Nardil is a monoamine oxidase inhibitor (MAOI), which interacts with other serotonergic agents, such as mirtazapine, to cause serotonin syndrome, a potentially life-threatening condition. Therefore, the nurse would immediately call the physician to question this order if the patient was currently taking Nardil.

Question 17

In reviewing new orders, the nurse notes Starlix (nateglinide) 120 mg three times daily before meals has been ordered. Before initiating therapy, the nurse should assess for which of the following?
A) Blood sugar
B) Respiratory rate
C) Level of consciousness
D) Creatinine clearance

Accepted Answer

Before initiating therapy with Starlix (nateglinide), the nurse should assess the patient's blood sugar levels to ensure that the medication is being appropriately dosed and effective in controlling blood sugar levels. Respiratory rate, level of consciousness, and creatinine clearance are not directly related to the use of this medication.

Question 18

The nurse works in a pediatric psychiatry unit. Ritalin (methylphenidate) 5 mg three times daily is commonly prescribed for many of the clients. The nurse recognizes this drug needs to be used cautiously in which of the following children?
A) An 8-year-old patient with a history of cardiovascular disease
B) A 12-year-old patient with a history of scoliosis
C) A 6-year-old patient who takes Singulair (montelukast) daily
D) A 7-year-old patient with a history of sickle cell anemia

Accepted Answer

Ritalin is a central nervous system stimulant that can cause an increase in heart rate and blood pressure. Therefore, it should be used cautiously in children with a history of cardiovascular disease, making choice A the best option. Scoliosis, Singulair use, and sickle cell anemia do not increase the risk of adverse reactions with Ritalin.

Question 19

The nurse is providing care for a 64-year-old client being prepped for a colonoscopy who is given midazolam. The nurse would expect to see which of the following responses?
A) Decrease in oral secretions
B) Increased heart rate
C) Decrease in abdominal cramping
D) Increased drowsiness

Accepted Answer

Midazolam is a benzodiazepine sedative that causes drowsiness, relaxation, and may impair memory formation. It does not typically have an effect on oral secretions, heart rate, or abdominal cramping.

Question 20

A 71-year-old client was newly prescribed Zaroxolyn (metolazone). The nurse recognizes the drug has been effective by which of the following assessments? A) White blood cell count = 5,500 cells/mm³ B) Client reports sleeping 8 hr per night C) BP = 132/74 D) Client denies hallucinations

Accepted Answer

Zaroxolyn is a diuretic used to reduce fluid retention and lower blood pressure. A reduction in blood pressure would indicate that the medication is working as intended. A and D are unrelated to the action of the drug, and B does not provide any indication of effectiveness.

Davis's Drug Guide for Nurses Test 4

While counseling a client taking Kepivance (palifermin) , the nurse recognizes that further teaching is necessary based on which of the following client statements?

The nurse is providing instructions to a client who has started therapy withnicardipine. The nurse instructs the client to avoid which of the following foods?

The nurse is providing care for an elderly woman with a urinary tract infection. The nurse understands the patient is receiving Pyridium (phenazopyridine) for which of the following reasons?

A nurse is receiving a shift-to-shift report for a client with multiple medical problems. The client is receiving nabumetone. The nurse recognizes this medication is ordered to address which of the following health-care problems for the client?

The nurse is providing milrinone to a 71-year-old woman with heart failure. Which of the following nursing assessments during the infusion is of the highest priority?

While caring for a client who is taking Dipentum (olsalazine) for ulcerative colitis, the nurse is aware that it is most important to determine if the patient has an allergy to which of the following?

The nurse is caring for a 58-year-old male who has been prescribed Neulasta (pegfilgrastim) . The nurse recognizes provision of this medication is based on which of the following lab results?

While caring for a client with hypertension who has recently started taking Bystolic (nebivolol) , the client reports, "This medication seems to give me a headache." Which of the following statements by the nurse is best?

While caring for a client who is receiving Serax (oxazepam) , the nurse notes the client is drowsy and slightly confused upon waking. Which of the following conclusions should the nurse draw?

A client admitted with neutropenia would most likely be started on which of the following medications to promote neutrophil differentiation?

The nurse is preparing to give an initial dose of Aloxi (palonosetron) as ordered prior to starting chemotherapy for breast cancer. Which of the following nursing actions is of the highest priority?

The nurse caring for clients in the psychiatric unit provides Invega (paliperidone) to one of the clients. The nurse recognizes this medication is effective by which of the following observations?

While providing care for a client who is to receive Amerge (naratriptan) , the nurse recognizes that the client understands this medication by which of the following statements?

The nurse is providing care for a 31-year-old patient with a history of seizures. Which of the following medications would the nurse anticipate is part of the patient's home medication regimen?

While preparing to give morning medications, Remeron (mirtazapine) was newly ordered for the patient to begin this morning. The nurse would immediately call the physician to question this order if which of the following medications was included in the patient's list of home medications?

In reviewing new orders, the nurse notes Starlix (nateglinide) 120 mg three times daily before meals has been ordered. Before initiating therapy, the nurse should assess for which of the following?

The nurse works in a pediatric psychiatry unit. Ritalin (methylphenidate) 5 mg three times daily is commonly prescribed for many of the clients. The nurse recognizes this drug needs to be used cautiously in which of the following children?

The nurse is providing care for a 64-year-old client being prepped for a colonoscopy who is given midazolam. The nurse would expect to see which of the following responses?

A 71-year-old client was newly prescribed Zaroxolyn (metolazone) . The nurse recognizes the drug has been effective by which of the following assessments?