Question 1

While checking orders for a patient newly admitted with abdominal pain and suspected pancreatitis, the nurse notes the following order, "meperidine 50-100 mg IM q 3-4 hr prn for pain." Which of the following medications currently taken by the patient would cause the nurse to contact the physician?

Accepted Answer

Meperidine should not be used in patients taking MAO inhibitors like phenelzine (Nardil) due to the risk of serious interactions, including hypertensive crisis.

Question 2

While providing initial chemotherapy teaching for a patient who is scheduled to receive cisplatin for metastatic ovarian cancer, the nurse recognizes that teaching has been effective by which of the following client statements? Select all that apply.

Accepted Answer

A) Incorrect. Cisplatin is not usually taken as a pill.
B) Correct. Checking lab values before each treatment is important to ensure safe administration of cisplatin, which can cause nephrotoxicity and myelosuppression.
C) Correct. Antiemetic medications, such as ondansetron, are usually given before and after cisplatin to prevent or minimize nausea and vomiting.
D) Incorrect. Cisplatin is associated with numerous side effects, including diarrhea, constipation, hair loss, hearing loss, and peripheral neuropathy, among others.
E) Correct. Nausea and loss of appetite are common side effects of cisplatin that may persist for up to a week after treatment.
F) Correct. Cisplatin is usually administered intravenously in an infusion center or hospital setting.

Question 3

The nurse is asked by the parent of a 13-year-old girl, "How does the new cervical cancer vaccine work?" Which of the following statements by the nurse is best?

Accepted Answer

Option A provides a clear and accurate explanation of how the cervical cancer vaccine works, including the fact that it is a series of three vaccinations over six months and what virus it is targeting (HPV). Option B is incorrect as it mentions the herpes virus, which is not targeted by the vaccine. Option C is also incorrect as it suggests that the vaccine helps prevent ovarian cancer, which it does not. Option D is not helpful and does not provide any useful information for the parent.

Question 4

As part of a new treatment regimen for migraine headaches, an 18-year-old girl is prescribed Axert (almotriptan). The nurse should include which of the following statements in the patient teaching? Select all that apply.

Accepted Answer

A) This statement is incorrect as Axert is not meant to be taken daily for migraine prevention; it is used to treat migraine headaches as they occur.
B) This statement is correct because alcohol can increase the risk of side effects such as dizziness or drowsiness.
C) This statement is incorrect as the maximum recommended dose for Axert is one dose every 24 hours, and the total number of doses in 24 hours should not exceed 2.
D) This statement is correct as Axert works best when taken as soon as possible after the onset of a migraine headache.
E) This statement is correct as certain over-the-counter medications can interact with Axert or worsen its side effects.
F) This statement is correct as chest pain or tightness can be a sign of a serious side effect and should be reported to the physician immediately.

Question 5

The nurse is caring for a patient taking Nexium (esomeprazole). The nurse knows teaching has been effective by which of the following statements? Select all that apply.

Accepted Answer

B) Nexium (esomeprazole) is a proton pump inhibitor that reduces stomach acid production, which can help with conditions like gastroesophageal reflux disease (GERD).C) The medication's pellets should not be chewed or crushed to ensure proper absorption and effectiveness.E) Eliminating alcohol can help reduce stomach acid production and reflux symptoms, making this a beneficial lifestyle change for someone taking esomeprazole.

Question 6

The nurse is providing care for a patient who has new orders to start Pacerone (amiodarone) po 400 mg BID. Which of the following orders should the nurse anticipate? Select all that apply.

Accepted Answer

The answer of The nurse is providing care for a...

Question 7

Which of the following would cause the nurse to suspect that a patient taking Lexapro (escitalopram) may be developing serotonin syndrome? Select all that apply.

Accepted Answer

Symptoms of serotonin syndrome include tachycardia (pulse > 100 bpm), hallucinations, and gastrointestinal symptoms such as nausea and diarrhea. Seeing visual hallucinations like blue spiders on the wall is a potential symptom of serotonin syndrome. Blood glucose, white blood cell count, and urinary output are not typically affected in serotonin syndrome.

Question 8

While providing care to a 68-year-old man taking Lopid (gemfibrozil), the nurse recognizes that which of the following assessments indicates the medication and treatment plan are effective?

Accepted Answer

Lopid (gemfibrozil) is a medication used to lower cholesterol and triglycerides levels in the blood. Therefore, the most effective assessment indicating the medication and treatment plan are working is a decrease in cholesterol levels, as seen in choice C. The other options, weight loss (choice A) and a decrease in HDL levels (choice B), are not necessarily indicative of the effectiveness of the medication or treatment plan. The LDL level, as given in choice D, is just a baseline value and does not show the effectiveness of the medication or treatment plan.

Question 9

The nurse contacts a patient whose physician has ordered Feosol (carbonyl iron) 60 mg BID after routine lab work revealed mild iron-deficiency anemia. Which of the following statements would be included in the patient teaching?

Accepted Answer

The statement about dark green or black stool is correct and important to include in patient teaching. Option A is incorrect because diet should not be restricted while taking iron supplement and option C is incorrect because doses should be spaced out. Option D is incorrect because too much iron during menstruation is harmful.

Question 10

A nurse from the medical unit is floated to the cardiology floor. While preparing to provide morning medications, the nurse realizes many patients are taking bisoprolol and knows the drug must be given cautiously or in reduced doses to which of the following patients? Select all that apply.

Accepted Answer

Bisoprolol is a beta-blocker that can exacerbate respiratory conditions in patients with pulmonary disease, necessitating caution or reduced doses. Patients with chronic renal failure may require dose adjustments due to impaired drug clearance. Similarly, elevated liver enzymes indicate liver dysfunction, which can affect drug metabolism, also necessitating cautious use or dose adjustments.

Question 11

The nurse is assisting in the care of a patient complaining of severe pruritis. Which of the following medications does the nurse anticipate being available on an as-needed basis for the patient?

Accepted Answer

Hydroxyzine (Atarax) is an antihistamine and sedative that can be used to relieve itching. Toradol (ketorolac) is a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief, Dilaudid (hydromorphone) is a strong opioid used for severe pain, and Hyzodro ER (hydrocodone) is a narcotic pain reliever. None of these medications are typically used specifically for pruritis.

Question 12

The nurse is caring for an 82-year-old woman with superior vena cava syndrome due to a clot formed around the patient's implanted port. The patient is on a heparin drip at 12 units/hr. Which of the following laboratory values will be used to titrate the infusion rate?

Accepted Answer

The partial thromboplastin time (aPTT) is used to monitor the effectiveness of heparin therapy. It measures the time it takes for blood to clot and is used to adjust the heparin dose to achieve the desired level of anticoagulation. Hemoglobin and platelet count may be affected by the patient's condition or treatment but are not used to titrate heparin infusion rate. Clotting time is not a standard lab test and its interpretation is not well-established.

Question 13

The nurse is providing care for a patient with hepatic encephalopathy who is receiving lactulose via a nasogastric tube QID. Which of the following indicates the patient is responding appropriately to the medication?

Accepted Answer

Lactulose is used to treat hepatic encephalopathy by reducing the amount of ammonia produced in the gut and thereby reducing serum ammonia levels. Therefore, the best indicator of an appropriate response to lactulose would be a return of serum ammonia level to normal limits. Choices B, C, and D are incorrect because they are not directly related to the treatment of hepatic encephalopathy with lactulose.

Question 14

The nurse is providing care for a 12-year-old child whose order reads, "Ciprofloxin 15 mg/kg po q 12 hr." The child weighs 88 pounds (40 kg). What dose of Ciprofloxin should be provided?

Accepted Answer

The correct dose is calculated as 15 mg/kg * 40 kg = 600 mg every 12 hours. Therefore, a 500 mg tablet and a 100 mg tablet every 12 hours (option B) is the correct dosage.

Question 15

A nurse working in an outpatient psychiatric clinic is assessing a 39-year-old patient with a history of schizophrenia who started taking Haldol (haloperidol) 3 mg po TID last week. Which of the following should be reported to the physician immediately?

Accepted Answer

The patient displaying symptoms of smacking his lips and chewing is indicative of tardive dyskinesia, a serious and potentially irreversible side effect of antipsychotic medications like Haldol (haloperidol). This should be reported to the physician immediately for assessment and potential adjustment of medication.

Question 16

A nurse caring for a patient who is to initiate therapy with Zostrix (capsaicin) would include which of the following statements in the patient teaching? Select all that apply.

Accepted Answer

Capsaicin (Zostrix) is a topical medication used for pain relief in conditions such as arthritis. It should be applied 3-4 times daily, avoiding contact with eyes or open skin, and rubbed into the affected area thoroughly. It is not used for treating local skin infections or taken orally.

Question 17

The nurse is providing care for a 54-year-old woman with insulin-dependent diabetes. The woman is pale, diaphoretic, groggy, and difficulty to arouse. Her blood glucose result is 49. Which of the following actions should the nurse take next?

Accepted Answer

The patient is experiencing hypoglycemia, and the blood glucose level is dangerously low. Glucagon can help increase blood glucose levels quickly, and administering it intravenously is the fastest method of delivery. The physician should also be notified, but immediate action is necessary to prevent further complications. Encouraging the patient to drink orange juice with added sugar is not the best option as it may take longer for the body to absorb the sugar and may not be fast enough to prevent worsening symptoms. Requesting a stat lab blood draw may also take too long to get results, and immediate action needs to be taken.

Question 18

The nurse is talking to a friend who recently revealed that she is 6 weeks pregnant. The woman says, "The doctor told me to take prenatal vitamins that have folic acid in them; what is that for?" Which of the following is the best response by the nurse?

Accepted Answer

Folic acid is important for fetal development, specifically in the development of the neural tube. It can help prevent birth defects such as spina bifida.

Question 19

A nurse caring for a patient with a history of diabetes mellitus notes that his prebreakfast blood glucose is 268. The nurse understands the patient most likely has sliding scale insulin using which of the following?

Accepted Answer

Sliding scale insulin typically involves the use of a short-acting insulin such as Humulin R, which can be adjusted based on blood glucose levels before meals. Novolog Mix 70/30 and Humulin N are intermediate-acting insulin and Lantus is a long-acting insulin, which would not be appropriate for sliding scale insulin therapy.

Question 20

The nurse is caring for a patient being treated for tuberculosis who is taking INH (isoniazid). Which of the following statements indicates the need for further teaching?

Accepted Answer

Limiting alcohol intake is recommended, but the limit is actually one drink a day, not three.

Davis's Drug Guide for Nurses Test 1