Question 1

A 38-year-old woman asks the nurse,"Can I just use Tums (calcium carbonate)to help prevent osteoporosis?" Which of the following responses by the nurse is best?
A)"Tums are really an antacid,so there isn't any research to support their use that way."
B)"You can use them that way,but they aren't very effective."
C)"Did your doctor tell you to start taking a calcium supplement?"
D)"It is safe to use them as a calcium supplement,but make sure you're getting enough vitamin D as well."

Accepted Answer

See Patient/Family Teaching for Calcium Salts.Calcium carbonate is indicated for calcium supplementation,but patients should be instructed to get sufficient amounts of vitamin D in their diet.

Question 2

The nurse is preparing to pass morning medications,including newly prescribed Coreg (carvedilol),for a patient admitted with an acute myocardial infarction and congestive heart failure.Which of the following actions should the nurse take first?
A)Check to make sure the medication has been delivered from pharmacy.
B)Take the patient's blood pressure.
C)Monitor the patient's respiratory rate and rhythm.
D)Determine the patient's level of pain.

Accepted Answer

See Nursing Implications for carvedilol.Coreg is an antihypertensive.The nurse must monitor patient pulse and blood pressure frequently during dose adjustments.

Question 3

The nurse recognizes that which of the following medications ordered for a patient may help reduce skeletal muscle spasms?
A)Tagamet (cimetidine)
B)Reglan (metoclopromide)
C)Soma (carisoprodol)
D)Tegretol (carbamazepine)

Accepted Answer

See Indications for carisoprodol.Adjunct to rest and physical therapy in the treatment of muscle spasm associated with acute painful musculoskeletal conditions.

Question 4

The nurse is providing care to a patient with congestive heart failure who is taking Digoxin (lanoxin)and bumetanide.Which of the following statements indicates teaching has been effective?
A)"I need to restrict my intake of salt and potassium while I'm on these medications."
B)"The bumetanide can increase my risk of digoxin overdose,so I should call the doctor if I have any nausea,vomiting,confusion,or muscle cramps."
C)"I need to hold both medications if the top number of my blood pressure is less than 140."
D)"These medications help my heart beat faster so I won't feel so tired all the time."

Accepted Answer

See Nursing Implications for bumetanide.Assess patients receiving digoxin for anorexia,nausea,vomiting,muscle cramps,paresthesia,and confusion ↑ risk of digoxin toxicity due to the potassium-depleting effect of diuretic.Potassium supplements or potassium-sparing diuretics may be used concurrently to prevent hypokalemia.Patients taking lanoxin need to monitor pulse rate.The medications are given to improve cardiac output and reduce fluid overload;they are not intended to make the heart beat faster.

Question 5

The nurse caring for a patient taking Zyrtec (cetirizine)recognizes the treatment plan is effective by which of the following statements?
A)"I don't feel nearly as tired as I used to feel."
B)"I am able to sleep at least 6 or 7 hr every night now."
C)"My eyes itch less and I'm not sneezing as often."
D)"My heartburn has essentially gone away."

Accepted Answer

See Evaluation for cetirizine.Patients taking Zyrtec expect to receive relief from seasonal allergy symptoms.

Question 6

The nurse is providing care to a 9-year-old boy admitted with a broken tibia.The child takes Adderall XR 20 mg/day.The physician has prescribed Meperidine 25 mg IM every 4 hr as needed for pain.Which of the following actions by the nurse is best?
A)Give the Meperidine if the child complains of pain.
B)Hold the Meperidine and contact the physician.
C)Notify the charge nurse.
D)Hold the Adderall.

Accepted Answer

See Interactions for amphetamine mixtures.The Meperidine must be held since use of Adderall XR with MAO inhibitors or Meperidine can result in hypertensive crisis.

Question 7

The nurse is caring for a patient with rheumatoid arthritis who takes Celebrex (celecoxib).The patient is on a pureed diet,and the nurse from the previous shift reported some difficulty with oral pills.Which of the following actions by the nurse is best?
A)Hold the medication.
B)Call the pharmacy to obtain a substitute medication that comes in liquid form.
C)Call the physician to request a different pain medication.
D)Open the capsule and sprinkle granules on applesauce.

Accepted Answer

See Implementation for celecoxib.Capsules may be opened and sprinkled on applesauce.

Question 8

The nurse is providing care for a patient who received Busulfex (busulfan)2 weeks ago for chronic myelogenous leukemia (CML).Which of the following lab results would be most concerning to the nurse?
A)Ca++ = 5.1 mg/dL
B)Glucose = 98
C)LDH = 120 IU/L
D)Platelets = 84,000/mm³

Accepted Answer

See Nursing Implications for busulfan.High Alert: Monitor for bone marrow depression.Assess for bleeding (bleeding gums,bruising,petechiae,guaiac stools,urine,or emesis).Institute thrombocytopenia precautions if platelet count is less than 150,000/mm³.The nonhematological values are within normal limits.

Question 9

A neighbor reports giving her 3-year-old daughter Pepto Bismol (bismuth subsalicylate)for diarrhea stools for the past 2 days.Which of the following statements by the nurse is the highest priority?
A)"Has your child had a fever during this illness?"
B)"Is the diarrhea better now?"
C)"Has she had diarrhea before?"
D)"What does she think of the taste of that stuff?"

Accepted Answer

See Patient/Family Teaching for bismuth subsalicylates.It is important to determine if the child has a febrile illness since this product contains aspirin and it has been associated with Reye syndrome.Individuals with diarrhea need to notify a health-care professional if diarrhea lasts more than 2 days or is accompanied by a fever.It will be important to determine if the child is improving,but that is not the highest priority.Determining if the child has had diarrhea in the past will not clarify the current concern,nor is the child's preference for the medication important.

Question 10

The nurse is counseling a patient who is to start taking Norvasc (amlodipine)for hypertension.The nurse recognizes that further teaching is required by which of the following statements?
A)"I need to call the doctor if my pulse is less than 50 beats in a minute."
B)"I'll get up slowly since I may be a little dizzy if I get up too fast."
C)"It is important that I take this medication on an empty stomach."
D)"I need to check with the doctor before taking any new over-the-counter cold medicines."

Accepted Answer

See Implementation and Patient/Family Teaching for amlodipine.Norvasc may be administered without regard to meals.Caution patient to change positions slowly to minimize orthostatic hypotension.Instruct patient to contact health-care professional if heart rate is less than 50 bpm.Instruct patient to avoid concurrent use of alcohol or OTC medications,especially cold preparations,without consulting a health-care professional.

Question 11

A client calls the nurse at 2 p.m.stating,"I forgot to take my Tenormin (atenolol)at 8 a.m.like I usually do.Should I take it now?" Which of the following responses by the nurse is best?
A)"It would be best to simply take two pills tomorrow."
B)"No,too much time has gone by so just skip that dose."
C)"Yes,it is important to take the medication each day."
D)"Why did you forget to take it today?"

Accepted Answer

See Patient/Family Teaching for atenolol.Atenolol should be taken as directed at the same time each day,even if feeling well;do not skip or double up on missed doses.Take missed doses as soon as possible up to 8 hr before next dose.Abrupt withdrawal may cause life-threatening arrhythmias,hypertension,or myocardial ischemia.Atenolol is typically given in daily doses.It is not important to determine why the patient forgot the missed dose.

Question 12

The nurse is caring for a patient with bronchitis and prepares to provide Tessalon pearls (benzonatate)as ordered.The patient states,"I don't think I've had this before.What is it for?" Which of the following responses by the nurse is best?
A)"This helps thin the mucus so it is easier for you to cough it up."
B)"It is a cough suppressant and will help reduce your coughing."
C)"This helps dilate the small airways in your lungs to help you breathe."
D)"It is a muscle relaxer so you can rest more comfortably."

Accepted Answer

See Action for benzonatate: Tessalon anesthetizes cough or stretch receptors in vagal nerve afferent fibers found in lungs,pleura,and respiratory passages.It may also decrease transmission of the cough reflex centrally.Therapeutic Effects: Decrease in cough.

Question 13

While reviewing medications for a patient with multiple sclerosis,the student nurse recognizes that Lioresal (baclofen)is given for which the following symptoms?
A)Depression
B)Anxiety
C)Muscle spasticity
D)Headache

Accepted Answer

See Indications for baclofen.Baclofen is used in the treatment of reversible spasticity due to multiple sclerosis or spinal cord lesions.

Question 14

The nurse is caring for a patient diagnosed with hypocalcaemia related to cancer.Which of the following medications would the nurse anticipate being ordered?
A)Rolaids (calcium carbonate)
B)Miacalcin (calcitonin)
C)Capsin (capsaicin)
D)Norvasc (nifedipine)

Accepted Answer

See Implications for calcitonin.Miacalcin is used as adjunct therapy in the treatment of hypocalcemia.

Question 15

The nurse is assisting in the care of a 28-year-old woman who has been seen by a psychologist for depression.The woman is interested in starting treatment with Wellbutrin XR (bupropion).Which of the following factors would indicate this plan should be questioned?
A)The patient smokes a pack of cigarettes each day.
B)The patient is currently taking birth control pills.
C)The patient has a history of hypertension
D)The patient has a history of seizures.

Accepted Answer

See Contraindications/Precautions for bupropion.Extreme caution should be exercised in patients with a history of seizures.Wellbutrin XR can be used for smoking cessation,so there are no precautions necessary due to smoking.No contraindication for birth control pills or antihypertensives is listed.

Question 16

While counseling a patient who takes Dulcolax (bisacodyl)for constipation,the nurse recognizes that further teaching is required by which of the following statements?
A)"I try not to take it very often,but when I need it,it sure helps."
B)"If I take it at night,I can usually have a bowel movement in the morning."
C)"They told me it was important not to strain when I move my bowels."
D)"I usually drink about three cups of water or coffee every day;I don't like milk or juice."

Accepted Answer

See Patient/Family Teaching for bisacodyl.It is important for clients to consume 1,500-2,000 mL of fluid each day.One cup is 240 mL,so this patient is not drinking sufficient quantities of fluid.The use of laxatives should be limited.Colace may be administered at bedtime for morning results.Instruct patients with cardiac disease to avoid straining during bowel movements.

Question 17

The nurse is caring for a patient with ulcerative colitis.New orders are received for Anaflex (salsalate)orally TID.The nurse recognizes the patient cannot received this drug due to an allergy to which of the following?
A)Meperidine
B)Sulfa
C)Penicillin
D)Aspirin

Accepted Answer

See Contraindications/Precautions for salicylates.Anaflex is a salicylate that is contraindicated in patients with hypersensitivity to aspirin,tartrazine (FDC yellow dye #5),or other salicylates.Patients should be assessed for allergy to salicylates.

Question 18

The nurse is counseling a patient who will begin taking buspirone).Which of the following statements indicates further teaching is required?
A)"I might feel dizzy or sleepy with this medication."
B)"I shouldn't drive until I know how I'm going to respond to this medication."
C)"It's all right to take most over-the-counter medications and things with this medication."
D)"I should avoid alcohol or other medications that depress my nervous system."

Accepted Answer

See Patient/Family Teaching for buspirone.Advise patient to consult a health-care professional before taking OTC medications or herbal products with this drug.It may cause dizziness or drowsiness.Caution patient to avoid driving or other activities requiring alertness until response to the medication is known.Advise patient to avoid concurrent use of alcohol or other CNS depressants.

Question 19

While providing peri-care for a patient receiving multiple intravenous antibiotics,the nurse notes that the patient's groin folds and peri-area are red,inflamed,and excoriated and that whitish discharge is noted from the vagina.When contacting the physician to report the patient's condition,which of the following medications would the nurse anticipate being ordered?
A)Neomycin ointment
B)Monistat cream
C)Calamine lotion
D)Hydrocortisone cream

Accepted Answer

See Indications for Antifungals vaginal: Monistat (miconazole)is given for the treatment of vulvovaginal candidiasis,and the patient is both at risk for and has signs of a yeast infection.

Question 20

The nurse is providing care for a woman who is in labor and is requesting something for pain.The order reads,"Stadol (butorphanol)2 mg every 4 hr as needed." Which of the following assessments should the nurse complete prior to providing the medication?
A)Cervical dilation
B)Respiratory rate
C)Contraction rate
D)Capillary refill

Accepted Answer

See Nursing Implications for butorphanol.Assess blood pressure,pulse,and respirations before and periodically during administration.If respiratory rate is less than 10 breaths/min,assess level of sedation.

Quiz 1: Medication Errors: Improving Practices and Patient Safety

A 38-year-old woman asks the nurse,"Can I just use Tums (calcium carbonate) to help prevent osteoporosis?" Which of the following responses by the nurse is best?

The nurse is preparing to pass morning medications,including newly prescribed Coreg (carvedilol) ,for a patient admitted with an acute myocardial infarction and congestive heart failure.Which of the following actions should the nurse take first?

The nurse recognizes that which of the following medications ordered for a patient may help reduce skeletal muscle spasms?

The nurse is providing care to a patient with congestive heart failure who is taking Digoxin (lanoxin) and bumetanide.Which of the following statements indicates teaching has been effective?

The nurse caring for a patient taking Zyrtec (cetirizine) recognizes the treatment plan is effective by which of the following statements?

The nurse is providing care to a 9-year-old boy admitted with a broken tibia.The child takes Adderall XR 20 mg/day.The physician has prescribed Meperidine 25 mg IM every 4 hr as needed for pain.Which of the following actions by the nurse is best?

The nurse is caring for a patient with rheumatoid arthritis who takes Celebrex (celecoxib) .The patient is on a pureed diet,and the nurse from the previous shift reported some difficulty with oral pills.Which of the following actions by the nurse is best?

The nurse is providing care for a patient who received Busulfex (busulfan) 2 weeks ago for chronic myelogenous leukemia (CML) .Which of the following lab results would be most concerning to the nurse?

A neighbor reports giving her 3-year-old daughter Pepto Bismol (bismuth subsalicylate) for diarrhea stools for the past 2 days.Which of the following statements by the nurse is the highest priority?

The nurse is counseling a patient who is to start taking Norvasc (amlodipine) for hypertension.The nurse recognizes that further teaching is required by which of the following statements?

A client calls the nurse at 2 p.m.stating,"I forgot to take my Tenormin (atenolol) at 8 a.m.like I usually do.Should I take it now?" Which of the following responses by the nurse is best?

The nurse is caring for a patient with bronchitis and prepares to provide Tessalon pearls (benzonatate) as ordered.The patient states,"I don't think I've had this before.What is it for?" Which of the following responses by the nurse is best?

While reviewing medications for a patient with multiple sclerosis,the student nurse recognizes that Lioresal (baclofen) is given for which the following symptoms?

The nurse is caring for a patient diagnosed with hypocalcaemia related to cancer.Which of the following medications would the nurse anticipate being ordered?

The nurse is assisting in the care of a 28-year-old woman who has been seen by a psychologist for depression.The woman is interested in starting treatment with Wellbutrin XR (bupropion) .Which of the following factors would indicate this plan should be questioned?

While counseling a patient who takes Dulcolax (bisacodyl) for constipation,the nurse recognizes that further teaching is required by which of the following statements?

The nurse is caring for a patient with ulcerative colitis.New orders are received for Anaflex (salsalate) orally TID.The nurse recognizes the patient cannot received this drug due to an allergy to which of the following?

The nurse is counseling a patient who will begin taking buspirone) .Which of the following statements indicates further teaching is required?

The nurse is providing care for a woman who is in labor and is requesting something for pain.The order reads,"Stadol (butorphanol) 2 mg every 4 hr as needed." Which of the following assessments should the nurse complete prior to providing the medication?