Test Bank For Pharmacology Clear and Simple A Guide to Drug 2nd Edition Watkins

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Pharmacology Clear and Simple A Guide to Drug 2nd Edition Watkins Test Bank

 

Chapter 1. History of Pharmacology

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   While caring for a client who is taking furosemide (Lasix), the nurse recognizes dietary teaching has been effective if the patient includes which of the following foods in his daily menus?

A. Broccoli and kiwi
B. Oranges and sweet potatoes
C. Kale and cucumbers
D. Bananas and melon

 

 

____    2.   A client newly diagnosed with diabetes tells the nurse, “I can’t take any insulin made from pigs or cows.” Which of the following responses by the nurse is best?

A. “Most insulin comes from animal sources, but I’m sure alternative options are available.”
B. “Medications that are derived from animals are typically less expensive than synthetic medications, but synthetic insulin is commonly available.”
C. “Most insulin is synthetic now to help reduce the risk of disease transmission.”
D. “The animals aren’t hurt in the production of medications, so you don’t need to worry.”

 

 

____    3.   While providing medications to clients on the cardiac unit, the nurse anticipates that hydralazine hydrochloride and isosorbide dinitrate (BiDil) would most likely be prescribed for which of the following clients?

A. A 48-year-old Caucasian male diagnosed with atrial fibrillation
B. A 55-year-old African American female diagnosed with hypertension
C. A 63-year-old Caucasian female diagnosed with sick sinus syndrome
D. A 64-year-old African American male diagnosed with heart failure

 

 

____    4.   While caring for a patient scheduled for knee replacement surgery, the nurse provides cefazolin (Ancef) as ordered 30 minutes pre-operatively. The nurse knows that teaching has been effective by which of the following client statements?

A. “The antibiotic is given as a prophylactic to help reduce the risk of infection after surgery.”
B. “This is a palliative medication to help ease the pain from surgery.”
C. “This medication will replace vitamins and minerals that may be lost due to bleeding during surgery.”
D. “This medication will help the surgeon identify areas of bone destruction due to arthritis.”

 

 

____    5.   While caring for a patient with a history of hypothyroidism, the nurse expects which of the following medications to be included in the patient’s medication list?

A. Levothyroxine sodium (Synthroid)
B. Estrogen (Estradiol)
C. Iodine 131
D. Carbimazole (Methimazole)

 

 

____    6.   The nurse is receiving a shift-to-shift report on a medical unit and is informed that a 55-year-old patient with a history of vomiting is scheduled for a diagnostic radiograph of the upper gastrointestinal tract. Which of the following statements would the nurse include in the client’s teaching?

A. “You will need to drink a large amount of prep to clear out your system before the test.”
B. “It is important that you be given a prophylactic medication to prevent aspiration during the test.”
C. “You will be asked to drink a barium contrast about 30 minutes before the test to help highlight any digestive problems.”
D. “You will be given a sedative to help make you sleepy during the testing procedure.”

 

 

____    7.   A student nurse is providing care for a 29-year-old patient with advanced cervical cancer who was recently admitted with metastatic disease. While reviewing the patient’s medication list, the student would categorize which of the following medications as palliative in nature?

A. Cisplatin (Platinol) 50 mg IV weekly to start day 8
B. Sorafenib (Nexavar) 200 mg orally twice daily for 7 days
C. Ondansetron (Zofran) 4 mg IV prior to chemotherapy
D. Morphine sulfate (Roxanol) 5 mg po every 4 hours as needed for pain

 

 

____    8.   A woman experiencing menopausal symptoms asks the nurse about conjugated estrogen (Premarin). Which of the following statements by the individual indicates an understanding of the medication’s origin?

A. “I’m against animal cruelty, so I don’t want to take anything made from animal flesh.”
B. “I was told the medication is actually derived from the urine of pregnant horses.”
C. “Because I’m Jewish, I can’t take the medication since it comes from pigs.”
D. “I think harvesting medicines from cows seems rather odd.”

 

 

____    9.   The nurse working in a diagnostic center is responsible for verifying client allergies prior to testing. A 47-year-old woman reports being allergic to iodine, and thus is unable to have which test?

A. Computerized axial tomography (CAT) scan
B. Magnetic resonance imaging (MRI)
C. Colonoscopy
D. Thyroid scan

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____    1.   While working with patients in home care, a nurse becomes interested in additional ways to support patient healing and comfort. Which of the following is recognized as an alternative therapy? (Select all that apply.)

 

 

 

 

Chapter 3. Patient Safety in Medication Administration

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   The student nurse is preparing to provide medications to a client scheduled to receive lisinopril (Zestril) 10 mg PO daily and ofloxacin (Floxin) 2 drops o.s. three times daily. Which of the following actions by the student is best?

A. Provide the lisinopril by mouth and the ofloxacin into the right ear.
B. Provide the lisinopril into the right ear and the ofloxacin into the right eye.
C. Provide the lisinopril into the left ear and the ofloxacin orally.
D. Provide the lisinopril orally and the ofloxacin into the left eye.

 

 

____    2.   When providing medications from floor stock to a client on the Alzheimer’s unit of a long-term-care facility, the nurse demonstrates the principle of right drug by which of the following?

A. Checks the label before taking the medication out of the cabinet, checks the label before pouring the medication, checks the label before placing the bottle back in the cabinet
B. Checks the label before taking the medication out of the cabinet, checks the label before  pouring the medication, checks the label before leaving the medication room
C. Checks the label after removing the bottle from the cabinet, checks the label after pouring the dose of medication, checks the label before closing the cabinet door
D. Checks the label while removing the bottle from the cabinet, checks the label after pouring the dose of medication, checks the label while replacing the bottle in the cabinet

 

 

____    3.   The nurse is preparing to discharge a client originally admitted for community-acquired pneumonia who has a discharge prescription for cefditoren (Spectracef). Which of the following instructions would the nurse include in the discharge teaching?

A. “Be sure to take the medication until your cough is gone.”
B. “It is important that you take the medication with meals.”
C. “Taking the medication at set time intervals will help blood levels stay constant.”
D. “Keeping the medication on the counter top will help you remember to take it.”

 

 

____    4.   While working in an urgent care center, the nurse assists in the care of a client with allergic rhinitis who has been given a prescription for beclomethasone nasal spray (Beconase), 2 sprays in each nostril 2 to 4 times daily. The nurse would provide further instruction to which of the following client statements?

A. “This will help my nose to not run so constantly.”
B. “I should spray this in each nostril whenever my nose starts to drip.”
C. “I can use this before I go to work, midday, and again at bedtime.”
D. “This medication is a mild steroid and will reduce swelling and irritation of my nasal    passages.”

 

 

____    5.   The nurse is conducting a home visit for a 43-year-old client. The client, who has three children under the age of 12, is 3 days post-mastectomy. The nurse would be most concerned by which of the following?

A. The client has a calendar for appointments and a list with physician contact information by the phone.
B. The client keeps her medications in a daily pill box that sits on the kitchen windowsill.
C. The client reports that it was too uncomfortable to wear the temporary prosthesis she had been given.
D. The children are participating in a support group for family members of people with cancer.

 

 

____    6.   The nurse is providing medications to a client with a gastrostomy tube. Diclofenac (Cambia) has been ordered. Prior to administration, the nurse should take which of the following actions?

A. Ensure that the medication comes as a liquid preparation.
B. Obtain a 3-mL syringe and needle with a safety device.
C. Document the medication provision.
D. Ask the client to state her name and room number.

 

 

____    7.   A nurse on the pediatric unit is preparing to pass medications for a 10-year-old client with exacerbation of asthma. Amphetamine (Adderall) and fluticasone (Advair) are scheduled. The nurse must be aware of which of the following?

A. Adderall and Advair should not be given at the same time.
B. Adderall is used to reduce bronchospasms.
C. Advair must be given with food.
D. Adderall and Advair each have look-alike/sound-alike medications.

 

 

____    8.   A nurse working in the GI clinic is performing pre-op phone calls. The nurse calls a client who is scheduled for a colonoscopy to inform the client of the following orders, “Begin clear liquid diet 24 hours prior to the exam; take magnesium citrate (Citroma) 1 bottle PO 12 hours prior to the exam and another 8 hours prior to the exam; remain NPO for 6 hours prior to the study.” The test is scheduled the next day at 2 p.m. The nurse would instruct the patient to:

A. “Only have liquids to drink at this point until the test. Use the enema prep at 2 a.m. and then again at 6 a.m. You can’t have anything to eat or drink after waking in the morning.”
B. “Start a clear liquid diet today at 2 p.m. Drink a bottle of prep at 2 a.m. and another at 6 a.m., and then don’t eat or drink anything after 8 a.m.”
C. “Don’t eat anything solid starting with lunch today. Give yourself an enema with the prep at 6 a.m. and again at noon, and don’t have anything to eat or drink after 8 a.m.”
D. “Start a clear liquid diet with dinner today. Drink the prep 12 hours and 8 hours before your test at 2 p.m. tomorrow, and be sure not to eat anything solid after you get up in the morning.”

 

 

____    9.   While working in a surgical clinic, the nurse notes orders that read, “.25 mg digoxin (Lanoxin) IV now.” Which action by the nurse is best?

A. Give .25 mg of digoxin intravenously.
B. Give 25 mg of digoxin as an injection into the skin.
C. Contact the physician for clarification of the order.
D. Give .25 mL of digoxin as an intramuscular injection.

 

 

____  10.   A client being seen in the outpatient clinic has been given a new prescription for tetracycline (Doxycycline) orally each day. The client reported current medications include a multivitamin with calcium, St. John’s Wort, and omeprazole (Prilosec). The nurse would provide additional teaching for which client statement?

A. “I should try to take the medication at roughly the same time each day.”
B. “I can take this medication with my other morning meds.”
C. “I should take this medication at least an hour before or 2 hours after I eat.”
D. “Drinking extra water is important when taking this medication.”

 

 

____  11.   The nurse receives a phone call from an elderly woman who states that her husband has recently started taking atorvastatin (Lipitor) and is complaining of having sore muscles. Which response by the nurse is best?

A. “Does your husband smoke cigarettes?”
B. “What type of exercise is your husband doing?”
C. “Does your husband have a history of heart disease?”
D. “Your husband should be seen in the clinic today for some tests.”

 

 

____  12.   A nurse from the adult medical unit is pulled to the geriatric unit. The nurse notes many of the common medications provided are in lower doses than typically prescribed. What action by the nurse is the highest priority?

A. Notify the charge nurse that clients may have received inappropriate medication dosages.
B. Call the nursing supervisor to investigate the nurse’s concerns.
C. Don’t worry about the discrepancy since this is not the nurse’s unit.
D. Evaluate the lab values of each client to determine liver and kidney function.

 

 

____  13.   While working on a geriatric unit, the nurse would be most concerned by which of these findings?

A. An 81-year-old client is scheduled to take 12 pills at 9 a.m.
B. A 72-year-old client given a sleeping pill the night before seems confused.
C. A 69-year-old client with a deep vein thrombosis has an order for an anticoagulant.
D. A 74-year-old client with diabetes has a fasting glucose result of 88 g/dL.

 

 

____  14.   The nurse notes that an elderly client admitted with metastatic cancer has a low serum protein level. Which action by the nurse is best?

A. No action is required because the patient is terminal.
B. Increase the frequency of vital sign monitoring.
C. Determine the most recent complete blood count (CBC) results.
D. Increase awareness and assessment of potential medication side effects.

 

 

____  15.   Shortly after providing a new sleeping pill to a client on the medical unit, the nurse answers the client’s call light. Which of the following findings would indicate to the nurse that the client is experiencing an anaphylactic reaction to the medication?

A. The client’s respiratory rate is 28 and slightly labored.
B. The client complains of continued wakefulness and agitation.
C. The client states that she feels nauseated and has a headache.
D. The client reports feeling hot and has a rash across her chest.

 

 

____  16.   A nurse working at the poison control center receives a call from a young woman babysitting for a 4-year-old child who reportedly swallowed some of the parent’s medication. Which statement by the nurse is best?

A. “I’m calling emergency personnel for you now.”
B. “What do the pills look like?”
C. “Have the child drink a glass of milk.”
D. “What is the name of the pills?”

 

 

____  17.   The nurse is preparing to provide medications to a client in a double room. The client’s roommate has multiple visitors present. Which of the following actions would the nurse take first?

A. Identify the action and side effect of each medication as it is provided.
B. Pull the client’s bedside curtain and talk in subdued tones.
C. Ask the client to state his name and birth date to verify identity.
D. Determine what questions the client has about his medications.

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____    1.   While providing medications in the clinical lab, a student would perform actions related to safe administration that include which of the following? (Select all that apply.)

A. Right medication
B. Right dose
C. Right time
D. Right room
E. Right patient
F. Right route

 

 

____    2.   While supervising a student nurse providing morning medications to clients in the long-term-care facility, the nurse would intervene if the student was observed performing which of the following actions? (Select all that apply.)

A. The student checks the patient’s arm band to verify identity.
B. The student verifies the medication order.
C. The student scans the medication with the computer scanner.
D. The student checks the medication’s expiration date.
E. The student prepares a medication scheduled for 1800.
F. The student asks the client to state his first name prior to giving the medication.

 

 

____    3.   A female nursing student is 18 weeks pregnant while attending her pharmacology class. Which of the following facts related to fetal effects of medications will the student recognize as true? (Select all that apply.)

A. Category A drugs are known to have minimal risk to the fetus.
B. Category C drugs are known to cause severe risk to the fetus in human trials.
C. Drugs that are classified as teratogenic are not able to cross the placental barrier.
D. Category X drugs have not been studied in pregnant women.
E. Category B drugs have slight risk to the fetus; both animal and human studies have been done.

 

 

____    4.   A nurse is working with a group of male veterans participating in a smoking-cessation program. The nurse recognizes that which of the following statements related to medications in these clients is true? (Select all that apply.)

A. An increased number of medications will have teratogenic effects in this population.
B. Medications are likely to be absorbed and distributed more rapidly.
C. This population has a decreased lipase secretion.
D. These clients may need larger doses of liver-metabolized drugs.
E. Drugs will be metabolized more slowly by this population.

 

 

____    5.   A nurse working in the emergency room is preparing for the admission of a 34-year-old client with a drug overdose. Which of the following equipment and/or orders will the nurse anticipate?

A. Telemetry monitoring
B. Blood transfusion
C. Activated charcoal
D. Dialysis machine
E. Nasogastric tube and 60-mL syringe for lavage
F. Contrast for magnetic resonance imaging (MRI) testing

 

 

____    6.   A nurse working on the orthopedic unit is providing discharge instructions for a client with a fractured femur. When explaining the client’s narcotic pain medication, the nurse would include which statement? (Select all that apply.)

A. “This medication may make you sleepy, so you can’t drive while taking it.”
B. “Narcotics can cause constipation, so be sure to drink extra fluid and eat a high-fiber diet.”
C. “Many patients who take this feel dizzy or light-headed, so you must be careful of falls, especially at night.”
D. “Only take the number of pills prescribed per day. Taking more can be dangerous.”
E. “You can take this medication as many times as needed for pain control.”

 

 

____    7.   An RN is working to support clinical trials in clients with cancer. Which of the following would be an anticipated part of this role? (Select all that apply.)

A. Educating the clients about the treatment, side effects, and alternative therapies
B. Ensuring that informed consent to participate is obtained
C. Documenting client and family understanding related to the trial
D. Providing payment to the client for participation in the trial
E. Ordering medications from the pharmacy based on clients’ height and weight

 

 

Matching

 

Place the following steps of medication administration for an ordered medication in the correct order.

A. Ask the client to state his/her name and birth date.
B. Open the medication packaging.
C. Verify the medication and dose.
D. Scan the medication with the computer scanner.

 

 

____    1.   First

 

____    2.   Second

 

____    3.   Third

 

____    4.         Fourth

Chapter 5. Prescriptions and Labels

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   The nurse notes orders for lorazepam (Ativan) 1 mg PO qhs prn. Which action by the nurse is best?

A. Give the client 1 mg at noon each day.
B. Ask the client at bedtime if he/she would like to take an Ativan.
C. Schedule the Ativan daily with breakfast.
D. Instruct the client to ask for Ativan any time it is needed.

 

 

____    2.   The following order is written for a 28-year-old client with asthma, “Budesonide nasal (Pulmicort) 2 sprays each nostril bid.” The nurse will instruct the client to take this medication:

A. Once daily with two sprays in each nostril
B. Once each evening with one spray in each nostril
C. One spray in each nostril twice daily
D. Two sprays in each nostril two times each day

 

 

____    3.   A client with Alzheimer’s disease is started on donepezil (Aricept) 10 mg PO qhs. The nurse will administer this medication at:

A. 6 p.m.
B. 6 a.m.
C. 9 p.m.
D. 9 a.m.

 

 

____    4.   A client with diabetes mellitus is ordered sliding scale insulin glulisine (Apidra) 2 to 10 units ac and hs based on blood glucose results. The nurse will need to check the client’s blood sugar:

A. Before each meal and at bedtime
B. Fasting in the morning and again at bedtime
C. Just before breakfast and again at dinner
D. After each meal

 

 

____    5.   A neighbor calls the nurse saying, “This bottle of infant acetaminophen (Tylenol) doesn’t have a dropper; it has a little cup. How do I know how much to give to my 3-month-old daughter?” Which response by the nurse is best?

A. “How much did you give your three-year-old son when he was a baby?”
B. “Read the label on the back of the box to find the strength and recommended dosage.”
C. “Why do you need to give the baby Tylenol?”
D. “Tylenol is no longer given to infants or children.”

 

 

____    6.   While caring for a client being sent home with a prescription for oxycodone and acetaminophen (Percocet), the nurse must caution the client to avoid which of the following?

A. Eye drops or medications causing pupil constriction
B. Alcoholic beverages and grapefruit juice
C. Cold remedies and other products containing Tylenol
D. Fiber laxatives and other stool softeners

 

 

____    7.   An 18-year-old patient calls a physician’s office to request a refill for birth control pills. Which response by the nurse is best?

A. “The physician must see you at least every 6 months to provide prescription refills.”
B. “If you’ve been seen by the doctor in the last year, a prescription refill can be called to your pharmacy.”
C. “All birth control medications require a hand-written prescription, so you will need to pick this up at the desk at your convenience.”
D. “Are you sexually active?”

 

 

____    8.   The nurse is providing care for a client who is taking dulasteride (Avodart) for benign prostatic hypertrophy (BPH). The client’s prescription reads, “Take daily by mouth.” Thirty pills have been dispensed and the prescription allows for five refills. The nurse anticipates seeing the client again in:

A. 1 month
B. 3 months
C. 6 months
D. 1 year

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____    1.   The nurse notes a prescription for eletriptan (Relpax) to be taken prn for migraine headaches. What additional information would the nurse expect to see on the prescription bottle? (Select all that apply.)

A. Picture of the medication
B. Drug dosage
C. Physician DEA number
D. Subscription information
E. Client’s name and address
F. Pharmacy contact information

 

 

____    2.   A 34-year-old patient recovering from a motor vehicle accident is receiving physical therapy. The client has been prescribed metaxalone (Skelaxin) 800 mg tablet qid. Which of following directions or warning labels would the nurse expect to see on the prescription label? (Select all that apply.)

A. Avoid alcoholic beverages when taking this medication
B. Take four times each day
C. Take three times a day with meals
D. May cause drowsiness or dizziness
E. Shake well

Chapter 7. Measurement Systems

 

Completion

Complete each statement.

 

  1. The nurse is providing care for a newborn that weighs 8 lb 8 oz. The physician has ordered medications based on a kg weight. How much does the infant weigh in kg? Round to the nearest whole number.

 

  1. While working in the pediatric clinic, the nurse weighs a 5-year-old child as 20.5 kg. The mother asks, “How much is that in pounds?” Provide the child’s weight to the nearest whole pound.

 

  1. While removing the dinner tray from a client’s room, the nurse notes the client drank 1 cup of water, 6 oz of beef broth, 4 oz of gelatin, 120 mL of juice and 1 2-oz popsicle. What would the nurse record for intake in mL?

 

  1. While attempting to track the intake of an elderly client, the nurse asks the client to identify what the client drank that day. The client reports, “I had a small cup of tea, a juice glass full of juice, and 2 cups of milk.” The nurse would record how many oz for this client’s intake?

 

  1. While preparing to dispense a dose of liquid medication for a client with a gastrostomy tube, the nurse notes the ordered dose is 15 mL. How many cc will the nurse draw into the cath-tipped syringe when dispensing the medication?

 

  1. The physician has ordered a child’s antibiotic dose as 5 mg/kg. The child weighs 14 kg. The antibiotic is provided in a vial with 10 mg/mL. How many mL of antibiotic will be dispensed? Round to the nearest whole number.

 

  1. The nurse is mixing diluent with a powdered medication. The package directions instruct the nurse to mix 3 mL of sterile water to achieve a concentration of 4 mg/mL. The client’s dose is 6 mg. How many mL will the nurse withdraw to provide to the client? Round to the nearest tenth.

 

  1. A client is ordered 25 mg of diphenhydramine (Benadryl) by intramuscular injection. The medication is supplied in a 1-mL vial with 50 mg dosage. How much will the nurse inject?

Chapter 11. Integumentary System Medications

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   While working in a dermatologist’s office, the nurse welcomes a new client who is 15 years old. The client has notable facial acne and a quick examination reveals scattered areas of keratinization and multiple pustules and comedos across the client’s shoulders and back. The nurse anticipates which of the following medications will be recommended?

A. Lindane (Rid-X)
B. Salicylic acid (Stri-Dex)
C. Anthralin (Psoriatec)
D. Etanercept (Enbrel)

 

 

____    2.   A nurse’s teenage daughter tearfully states, “I keep getting pimples on my face even though I wash it every day and I’m not eating any chips or cookies. What can I do?” While looking at over-the-counter treatment options, what common ingredient will the nurse most likely find in topical creams and lotions?

A. Hydrocortisone
B. Lidocaine
C. Clotrimazole
D. Benzoyl peroxide

 

 

____    3.   The nurse is admitting a 22-year-old client to the hospital with suspected fractures of the right arm after a bicycle accident. The client reports taking Vitamin A daily. Which of the following would the nurse expect to see during the physical examination?

A. Flushed nose and cheeks
B. Oral fever blisters
C. Dry patchy reddened areas on the hands and elbows
D. Genital warts

 

 

____    4.   While playing at the park with her children, the nurse notes a toddler who has honey-colored crusts and open areas on the lips and nose. Which of the following actions should the nurse take first?

A. No action is required as the child is exhibiting symptoms of a common cold and medications will not alter the child’s symptoms.
B. Ask the child’s parent if the child has food allergies and suggest the use of an antihistamine.
C. Inform the child’s parent the child may have a common bacterial infection and should be seen by a physician for topical or systemic antibiotics.
D. Suggest the child’s parent seek treatment for suspected thrush with an oral antifungal agent.

 

 

____    5.   A nurse working for a family practice physician sees a 48-year-old client who reports severe itching of his hands and under arms. Examination reveals redness and irritation in the webbing of both hands and axillae. The physician orders permethrin (Elimite) cream, a scabicide. The nurse recognizes treatment has been effective by which of the following statements?

A. “I can’t believe I have lice. I wonder if I got it from my niece.”
B. “So applying this cream between my fingers and arm pits will kill the mites and eggs.”
C. “I will need to use a fine-tooth comb to go through my hair daily for the next full week.”
D. “Scabies only live on top of the skin, so the itch should disappear within a day.”

 

 

____    6.   A nursing instructor informs a nursing student that the assigned client has been prescribed a pediculicide medication. The student recognizes the client has been diagnosed with which of the following?

A. Lice
B. Psoriasis
C. Impetigo
D. Malignant melanoma

 

 

____    7.   The nurse is providing instructions for a client newly that will begin taking docosanol 10% (Abreva) for HSV-1 infection. Which of the following instructions indicates further teaching is necessary?

A. “Side effects of this medication could be headache or nasal congestion.”
B. “I should apply this medication once daily.”
C. “I don’t need a prescription for this medication.”
D. “The medication helps shorten how long I’ll have symptoms because it blocks the spread of the virus.”

 

 

____    8.   A nurse working in the gynecology office is asked to assist in the treatment of a client with condylomas. Which of the following actions should the nurse take?

A. Prepare the client for full-body phototherapy.
B. Ask the client if there are any known allergies to iodine.
C. Make a list of the client’s sexual partners for the past 3 weeks.
D. Assist the client to remove their clothing below the waist.

 

 

____    9.   While performing a skin assessment for a newly admitted 82-year-old patient, the nurse notes the client has reddened, peeling areas between his toes and around the soles of his feet. Which of the following medications would the nurse request?

A. Nystatin
B. Lidocaine
C. Clotrimazole
D. Calcipotriene

 

 

____  10.   Ultraviolet therapy will be most helpful for which of the following clients?

A. A 41-year-old with psoriasis
B. A 55-year-old with squamous cell carcinoma
C. A 15-year-old with atopic dermatitis
D. A 28-year-old with basal cell carcinoma

 

 

____  11.   Family members at a reunion on the beach return from a long walk with sunburn on their shoulders and feet. Which of the following recommendations will the nurse make?

A. “Apply hydrocortisone cream to the area to reduce swelling.”
B. “Soak your feet in cool water and apply cold cloths to your shoulders for 20 minutes, then apply aloe vera ointment.”
C. “Take oral antihistamines to help reduce the chance of blistering.”
D. “Apply butter to the area to stop the burn.”

 

 

____  12.   The nurse is caring for a client with extensive third-degree burns scattered across the left leg and hip. Orders for chemical debridement using collagenase (Santyl) are noted. The nurse will take which of the following actions?

A. Apply the collagenase to the pink, open-areas within the burned area.
B. Apply the collagenase to the blackened, dead tissue within the burned area.
C. Work the collagenase into sterile 4 ´ 4 dressings and apply these uniformly across the burned area.
D. Mix the collagenase with sterile normal saline and apply soaked dressing to entire wound bed.

 

 

____  13.   While working with a client who has extensive third-degree burns, the nurse applies becaplermin (Regranex) gel to the client’s wound bed. The client asks, “What will that do?” Which of the following responses is best?

A. “This will kill topical bacteria and help reduce the risk of infection.”
B. “The gel helps slow tissue growth to prevent scarring that may cause contractures.”
C. “By stimulating phagocytosis, the gel reduces the amount of fluid loss within your burns.”
D. “The gel helps new tissue grow within the wound bed and increase healing.”

 

 

____  14.   The nurse is educating a client who is to start a prescription for tacrolimus (Protopic) for the treatment of atopic dermatitis. The nurse knows further teaching is necessary when the client states which of the following?

A. “This medication will help reduce the swelling and redness on my skin.”
B. “I should notice a big improvement in the constant itch I’ve been having.”
C. “I will have to take this medication by mouth at least three times a day.”
D. “This medication alters the local immune response on my skin but won’t increase my risk for other infections.”

 

 

____  15.   Which of the following clients would be instructed to avoid/discontinue using the noted treatment?

A. A 16-year-old male with acne prescribed tretinoin (Retin-A) who reports has a history of asthma
B. A 21-year-old female with eczema using hydrocortisone (Cortaid) who reports she is pregnant
C. A 34-year-old male with tinea infection that reports localized itching while using clotrimazole (Lotrimin)
D. A 26-year-old female with psoriasis using fluorouracil (Efudex) who reports photosensitivity since starting the medication

 

 

____  16.   While performing skin assessments during a local mall screening event, the nurse would be most concerned by which of the following findings?

A. A 55-year-old client with multiple nevi across his back and shoulders
B. A 47-year-old client with a small tan, flat, scaly patch noted on his cheek
C. A 39-year-old client with a purplish-black irregular shaped area on the shoulder blade
D. A 64-year-old client with reddish, firm, dry, and peeling patches noted on his knuckles and elbows

 

 

____  17.   A nurse working at a dermatologist’s office is working with a client with suspected basal cell carcinoma. The nurse would most likely prepare for which of the following?

A. Liquid nitrogen cryotherapy
B. Radiation therapy
C. Surgical excision with wide margins
D. Topical treatment with corticosteroids

 

 

____  18.   Which of the following individuals will need a referral to determine the potential need for systemic chemotherapy?

A. A 66-year-old patient with squamous cell carcinoma who is receiving radiation after surgical excision of the primary lesion
B. A 54-year-old patient with basal cell carcinoma on the nose who is being treated with a topical immunomodulators
C. A 61-year-old patient with malignant melanoma who had a wide surgical excision with clear margins
D. A 48-year-old patient with basal cell carcinoma who is being treated with topical fluorouracil

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____    1.   An 18-year-old male seen routinely in the dermatology clinic, has recently been given a prescription for tretinoin (Retin-A). Which of the following statements will the nurse include in the client teaching? (Select all that apply.)

A. “This medication may increase the risk of sun burn, so be sure to wear a hat and sunscreen.”
B. “It will be particularly important for you to immediately report any thoughts of suicide while you are taking this medication.”
C. “Be sure you drink at least 10 glasses of water each day as this medication can damage your kidneys.”
D. “I’m so glad the doctor started this medication for you, it will make your psoriasis clear right up.”
E. “This medication acts by reducing oil production by the glands in your skin.”
F. “It is important for you to apply this medication with the first symptoms of burning or tingling that indicates a cold sore is forming.”

 

 

____    2.   A school nurse is preparing a letter to parents to notify them of a recent case of head lice in a second grade student. Which of the following statements should be included in the letter? (Select all that apply.)

A. “Any child found to have lice during the school day will immediately be given oral antibiotic therapy.”
B. “Lice rarely spread from child to child, so no special precautions need to be taken.”
C. “Children’s hair should be examined at home daily using a fine-toothed comb for small, round, white eggs or nits.”
D. “Over-the-counter shampoo products are available for the treatment of lice.”
E. “If your child is found to have lice, your health care provider should be seen to obtain a prescription for antifungal therapy.”

 

 

____    3.   A nurse working with adolescents recognizes that which of the following could be used to help treat acne? (Select all that apply.)

A. Topical immunomodulators
B. Oral contraceptives
C. Systemic antibiotics
D. Salicylic acid
E. Sulfur
F. Benzoyl peroxide

 

 

____    4.   Antiviral medications can be used to treat which of the following conditions? (Select all that apply.)

A. Thrush
B. Scabies
C. HPV
D. Herpes zoster
E. HSV-2
F. Eczema

 

 

____    5.   While performing an admission history with a client who has extensive eczema, the nurse may anticipate the client will report a history of which other conditions? (Select all that apply.)

A. Asthma
B. Recurrent urinary tract infections
C. Frequent/severe sunburn in the past
D. Allergic rhinitis
E. Cardiomyopathy
F. Sickle cell disease

 

 

____    6.   A nurse caring for a client with psoriasis recognizes the client is very knowledgeable about his disease by which of the following statements? (Select all that apply.)

A. “My skin peels because the cells underneath are damaged and don’t replace themselves fast enough to maintain a protective barrier.”
B. “I traveled to Argentina and soaked in a hot spring—it was wonderful and did help my skin.”
C. “I’ve used topical steroids and antihistamine creams, but they haven’t helped much lately.”
D. “The doctor said if the anthralin (Psoriatec) cream doesn’t help I may need to take methotrexate.”
E. “I keep hoping the doctor will find the medication that cures this so it will go away for good.”

 

 

Matching

 

While working in the hospital with patients who have been burned, the nurse prepares to apply the initial dressings to a client with second and third degree burns. Place the following steps in order for this procedure.

A. Apply silver sufadiazine (Silvadene) to the burn area.
B. Cover the burn with sterile dressing.
C. Set up a sterile field and don sterile gloves.
D. Assess and measure the wounds.

 

 

____    1.   First

 

____    2.   Second

 

____    3.   Third

 

____    4.         Fourth

  1. The nurse is preparing to provide sliding scale insulin coverage to a client with diabetes. The client’s blood sugar is 240 g/dL. The sliding scale indicates the client should receive 8 units of insulin. The insulin is provided in a multi-dose vial with a concentration of 100 units/10 mL. How many mL of insulin will the nurse provide?

 

  1. The nurse is caring for a client who is to receive cefoperazone (Cefodbid) 1.5 g in 100 mL normal saline intravenously over 30 minutes. The nurse begins the infusion and a little while later the client calls to report itching so the nurse stops the infusion. The pump reading has recorded 44 mL infused. Approximately how much medication (in mg) did the client receive?

Chapter 13. Nervous System Medications

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   The nurse is providing care for a client with a history of manic-depression. Which of the following classifications of medications would the nurse expect to find prescribed for the client?

A. Narcotics
B. Benzodiazepines
C. Cholinergics
D. Psychotropics

 

 

____    2.   A nursing student asks another student, “What does the blood brain barrier have to do with medications?” Which of the following responses by the student is best?

A. “The barrier helps reduce the risk of infection, so not as many antibiotics are needed.”
B. “It prevents some medications from affecting the central nervous system.”
C. “There are only a few medications that don’t cross the barrier, so we have to know those.”
D. “It has to do with how medications affect brain growth in a developing fetus.”

 

 

____    3.   While studying for the medication exam, the nursing student determines that norepinephrine (Levophed), if given to a patient, would be contraindicated for which of the following individuals?

A. A 52-year-old patient with a blood pressure of 186/94
B. A 49-year-old patient with a pulse of 65
C. A 61-year-old patient with a respiratory rate of 18
D. A 75-year-old patient with a history of seizures

 

 

____    4.   The LPN is collecting history information for a client planning outpatient surgery. Which of the following statements by the client would cause the nurse to contact the anesthesiologist?

A. “I forgot to sign the consent form while I was in the office last time.”
B. “I usually take alprazolam (Xanax) to help me sleep a couple times a week.”
C. “I used my pilocarpine (Pilopine) eye drops this morning but didn’t take any of my pills.”
D. “I brushed my teeth this morning with just a sip of water.”

 

 

____    5.   While counseling the mother of an 18-month-old child diagnosed with a viral infection, the nurse should include which of the following statements in the client’s teaching?

A. “The doctor will probably prescribe an antibiotic to help with the ear pain.”
B. “Be sure not to give the baby anything with aspirin in it.”
C. “You can crush a regular acetaminophen (Tylenol) and put it in the baby’s bottle.”
D. “The doctor might order a narcotic to help the baby sleep.”

 

 

____    6.   The LPN is providing care for a client who reports an allergy to acetaminophen (Tylenol) and penicillin. The client has orders for morphine 1 mg IM every 2 hours prn for severe pain, and Percocet, two tablets every 4 hours prn for moderate pain. The client reports pain of 4 on a 10-point scale. Which of the following actions should the nurse take first?

A. Ask the client what kind of reaction was seen when penicillin was taken.
B. Ask the client which medication the client would like to use for pain management.
C. Provide the client with 2 tablets of Percocet.
D. Contact the RN so orders can be clarified.

 

 

____    7.   The LPN is assisting with a newly admitted client who reports taking 800 mg ibuprofen (Advil) four times daily for chronic back pain. Which action by the nurse is most appropriate?

A. Ask the client if the ibuprofen is effective for the pain.
B. Notify the RN of the prescribed dose.
C. Ask the client if he’s experienced any abdominal pain.
D. Inform the client that aspirin may be a more effective pain reliever.

 

 

____    8.   The LPN is caring for a client one day after a total hip replacement. The client has orders for a Dilaudid PCA machine and currently reports his pain is well controlled. The nurse would be most concerned by which of the following findings?

A. The client’s wife reports his last bowel movement was the day before surgery.
B. The client’s blood pressure is 126/62 and pulse rate is 60.
C. The nurse notes the client has not voided since the Foley was removed 3 hours ago.
D. The client is difficult to arouse with a respiratory rate of 10.

 

 

____    9.   The LPN is working with an elderly client who reports difficulty sleeping. When reviewing the client’s record, the nurse notes numerous prn medications. Which of the following would the nurse suggest at this time?

A. Alprazolam (Xanax)
B. Oxycodone with ibuprofen (Combunox)
C. Clonazepam (Klonopin)
D. Eszopiclone (Lunesta)

 

 

____  10.   While assisting with the care of a client with a history of alcohol abuse, the LPN determines the client’s withdrawal symptoms are worsening. Which of the following actions should the nurse take next?

A. Provide the client with warm blankets and turn out the lights and reduce noise levels.
B. Call the family to see if someone can come with the client.
C. Determine if the client has an order for prn diazepam (Valium).
D. Inform the RN that the client is in need of restraints.

 

 

____  11.   An LPN working in a physician’s office receives a call from the parent of a child who recently started taking dexmethylphenidate hydrochloride (Focalin). The parent reports, “My son says he hasn’t slept well for the past three days.” Which of the following statements by the nurse is best?

A. “Does your son watch TV or play video games in his room at night?”
B. “Insomnia is a common side effect with this type of medication and it may take a while for your son to adjust.”
C. “I suggest you just give him half a pill in the morning today and see what happens.”
D. “When does he usually take the medication?”

 

 

____  12.   While working with a client who is taking selegiline (Eldepryl), the LPN recognizes the client understands the required dietary restrictions, if the client selects which of the following lunches?

A. Bologna sandwich on wheat bread with chips and a diet soda
B. Hamburger with an onion bun, coleslaw, and a glass of milk
C. Pepperoni pizza with a side salad and ranch dressing with iced tea
D. Stir fried rice and vegetables with soy sauce and a cup of coffee

 

 

____  13.   While studying for the pharmacology examination, the student nurse identifies that sertraline (Zoloft), paroxetine (Paxil), and fluoxetine (Prozac) are all examples of which classification of medications?

A. Monoamine oxidase inhibitor agents
B. Selective serotonin reuptake inhibitors
C. Tricyclic antidepressants
D. Mood stabilizers

 

 

____  14.   The LPN is working with a client whose medication list includes lithium. The LPN would be most concerned by which of the following?

A. The client reports blurry vision and sensitivity to light.
B. The client’s urinary output was 1,600 mL the previous day.
C. The client reports following a low-salt diet.
D. The lab report indicates the client’s lithium level is therapeutic.

 

 

____  15.   An LPN is approached by a friend whose mother was recently diagnosed with Alzheimer’s disease. The friend states, “The doctor wants to put her on donepezil (Aricept) right away, but right now she’s just occasionally forgetful. We had no idea she had Alzheimer’s and I worry about side effects.” Which of the following is the best response by the nurse?

A. “It is hard to know the best way to go with this diagnosis. Have you gotten a second opinion?”
B. “Early diagnosis and treatment seems to be giving the best results for long-term function.”
C. “I’ve given that medication many times and most people don’t have any side effects.”
D. “I’m so sorry to hear about this. What do your siblings think you should do?”

 

 

____  16.   While discussing the care plan of a client living in a long-term care facility who has Parkinson’s disease, the LPN emphasizes that the client has been more forgetful, has been wandering at night, and seems more withdrawn in his behavior. Which of the following suggestions for the plan of care is best?

A. Encourage the client to take advantage of more social outings and activities.
B. Discuss an increased exercise program with the physical therapist.
C. Suggest the physician evaluate the client for use of a rivastigmine (Exelon) patch.
D. Determine if the client would like to have a bird in her room to keep him company.

 

 

____  17.   While caring for a client in the pediatric clinic, the nurse notes the physician has prescribed otic benzocaine (Americaine Otic) for a child. The LPN’s instructions to the child’s parents will be based on an understanding that this medication:

A. Is used in the topical treatment of conjunctivitis
B. Is provided in a cream formulation to be placed along the inner eyelid
C. Will help numb the inner ear and relieve pain
D. Will kill yeast associated with thrush

 

 

____  18.   As students are studying, one student asks, “What is the difference between anesthetics that are esters and those that are amides?” Which of the following responses is best?

A. “Amides don’t last as long so they are very helpful with conscious sedation.”
B. “Novocaine is an ester, so just keep that in your mind as an example.”
C. “The esters are used as inhaled anesthetics and the amides are not.”
D. “Both are local anesthetics but esters are used topically since the risk of anaphylaxis is high.”

 

 

____  19.   While assisting in the care of a client receiving a bright yellow IV solution containing thiamine and other vitamin B supplements, the LPN concludes the client is most likely being treated for which of the following?

A. Osteoporosis
B. Alcohol withdrawal
C. Seizure disorder
D. Parkinson’s disease

 

 

____  20.   The LPN is preparing to provide a dose of cough syrup and notes it contains alcohol as a listed ingredient. The LPN would notify the aide to be aware that the client is at increased risk for which of the following?

A. Falls
B. Incontinence
C. Bronchospasms
D. Anorexia

 

 

____  21.   While assisting in the care of a client diagnosed with petit mal seizures, the LPN overhears the treatment team discussing the addition of ethosuximide (Zarontin) to the client’s medication regimen. The nurse is aware that this medication works by:

A. Altering the transfer of sodium ions across a synaptic membrane
B. Delaying the movement of calcium over the neuron
C. Increasing the neurologic sensitivity to electric stimuli and lowering the seizure threshold
D. Blocking GABA transmitters in the brain

 

 

____  22.   The nurse is assisting in the care of a 35-year-old man who is diagnosed with depression. The client is interested in starting treatment with selegline (Eldepryl). Which of the following factors would be of most concern to the health care team?

A. The patient smokes a pack of cigarettes each day.
B. The patient lives alone.
C. The patient has a history of heart disease.
D. The patient has a history of seizures.

 

 

____  23.   The nurse is counseling a patient who will begin taking diazepam (Valium). Which of the following statements indicates further teaching is required?

A. “I might feel sleepy with this medication.”
B. “I shouldn’t drive until I know how you’re going to respond to this medication.”
C. “This medication can be addictive, so I should only take it if I really need it.”
D. “I can drink alcohol as long as I don’t get drunk.”

 

 

____  24.   Which of the following lab values would the nurse be most concerned with for a client who was taking phenytoin (Dilantin)?

A. Uric acid level
B. Hemoglobin
C. Creatinine
D. Liver enzymes

 

 

____  25.   The student nurse recognizes that citalopram (Celexa) would most likely be taken by which of the following clients?

A. A 26-year-old patient with a history of schizophrenia
B. A 16-year-old patient diagnosed with alcoholism
C. A 27-year-old patient with a history of seizures
D. A 42-year-old patient with a history of depression

 

 

____  26.   A nurse working in an outpatient psychiatric clinic and assists with the care of a 24-year-old patient with schizophrenia who started taking chlorpromazine (Thorazine) three days ago. Which of the following should be reported to the physician immediately?

A. The patient reports no bowel movement since he started the medication.
B. The client is blinking rapidly and making odd facial movements involuntarily.
C. Patient says, “I heard the angels talking again last night.”
D. Patient reports he is staying at a homeless shelter four blocks away.

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____    1.   While passing medications in a long-term care facility, the nurse recognizes that a medication affecting the autonomic nervous system may cause which of the following symptoms? (Select all that apply.)

A. Changes in pupil size
B. Spastic twitching in the legs
C. Fine tremors in the hands
D. Altered heart rate
E. Flushing of the skin
F. Dryness of oral mucous membranes

 

 

____    2.   The student nurse has been assigned to assist in the care of a client with a history of seizures. The student anticipates which of the following medications may be included in the client’s profile? (Select all that apply.)

A. Atropine (Atropen)
B. Phenytoin (Dilantin)
C. Ethosuximide (Zarontin)
D. Topiramate (Topamax)
E. Methylphenidate (Ritalin)
F. Amitriptyline (Elavil)

 

 

____    3.   An LPN from the dementia unit has been pulled to work on the long-term psych unit of an extended care facility. When the charge nurse mentions, “Many of our clients have hallucinations and take neuroleptic medications,” the LPN is aware that may include which of the following? (Select all that apply.)

A. Chlorpromazine (Thorazine)
B. Clozapine (Clopine)
C. Thioridazine (Mellaril)
D. Citalopram (Celexa)
E. Pemoline (Cylert)
F. Phentermine (Zantryl)

 

 

____    4.   The LPN is reinforcing discharge instructions for a client who received a new prescription for tamsulosin (Flomax). The nurse determines teaching has been effective by which of the following client statements? (Select all that apply.)

A. “This medication can interact with alcohol so I must avoid drinking.”
B. “I might get sleepy when I take this, so I shouldn’t drive.”
C. “Tamsulosin is an adrenergic blocker so it might lower my blood pressure and heart rate.”
D. “This medication will help with urine flow since I have an enlarged prostate.”
E. “I might get addicted to this medication, so I can only use it for a few weeks.”

 

A. Acupuncture
B. Aromatherapy
C. Therapeutic touch
D. Stem cell treatment
E. Vegetarianism
F. Acupressure

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