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NURS 6521N _MIDTERM_EXAM (2 versions) | 100% guaranteed PASS | Download To Score An A.

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Selected Answer: nitrate tolerance. Selected Answer: potential adverse effects of the drugs that Mr. Nguyen will be taking. Selected Answer: Bismuth, Metro... nidazole, Omeprazole, and Tetracycline Selected Answer: hypertension. Selected Answer: adrenal insufficiency. The APRN is treating a 56 year old male with diagnosed atrial fibrillation. He is complaining of being light headed. His vital signs are BP 100/68 HR 144 RR 22. The best choice of medication to treat this patient is: Selected Answer: Beta blocker such as Metoprolol Selected Answer: Electrolyte levels Selected Answer: Gastrointestinal distress Selected Answer: It can be combined with an inhaled corticosteroid to improve asthma control A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient's medication regimen. Which of the patient's medications should prompt the nurse to teach her to avoid drinking grapefruit juice? Selected Answer: Atorvastatin (Lipitor) A Nurse Practitioner is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions? Selected Answer: Wear appropriate clothing and sunscreen whenever he is in direct sunlight A 66-year-old woman has a complex medical history that includes poorly- controlled type 1 diabetes, renal failure as a result of diabetic nephropathy and chronic heart failure (CHF). Her care provider has recently added spironolactone (Aldactone) to the woman's medication regimen. The nurse should consequently assess for signs and symptoms of Selected Answer: hyperkalemia. A Nurse Practitioner is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the Nurse Practitioner assess before beginning drug therapy? Selected Answer: Serum potassium levels During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse's assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives Selected Answer: may cause nutrient deficiencies. The Nurse Practitioner is conducting a medication reconciliation of a new resident of a long-term care facility. The Nurse Practitioner notes that the resident takes allopurinol on a daily basis for the treatment of gout. What is the primary purpose of this drug? Selected Answer: To balance urate concentration and prevent gout attacks A woman has a long history of seasonal allergies that are typically accompanied by rhinorrhea, red eyes, and frequent sneezing. Sneezes are a result of Selected Answer: a CNS reflex that is initiated by receptors in the nasal cavities. Answer: Selected Answer: Coffe e A patient has been prescribed lovastatin for a high cholesterol level. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it Selected Answer: inhibits cholesterol syntheses. Selected Answer: Take it on an empty stomach, 1 hour before or 2 hours after meals Selected ototoxicit y. Answer: Selected Answer: a diuretic. A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient's characteristics likely to influence possible treatment with phenytoin? Selected Answer: The patient's protein deficit will likely increase the levels of the free drug in his blood. Selected Answer: understand the signs and symptoms of hypoglycemia. Selected Answer: A 79-year-old male with cardiomegaly Selected Answer: Enlarged prostate gland Selected Answer: 2. Beta blocker A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs? Selected Answer: Digoxin immune fab A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous nitroglycerin 5 mcg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infusion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments? Selected Answer: Blood pressure An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption? Selected Answer: An oral antidepressant that the patient has been taking daily for several years Selected Cilia sweep foreign material and mucus upward toward the Answer: trachea and larynx where they can then be swallowed. Selected Answer: decrease the amount of circulating blood sent through the kidneys. A 76-year-old woman has a complex medical history that includes emphysema, osteoporosis, malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of weakness and suffered a fracture to her femoral head. The woman's subsequent hip-replacement surgery has been scheduled and the care team recognizes that the use of isoflurane will be most significantly influenced by Selected Answer: her history of emphysema. Selected Answer: The therapeutic effects and possible adverse effects The APRN is treating a patient with type 2 diabetes. The patient is on the maximum dose of metformin and glucotrol. Current weight 212 pounds. Labs from this morning indicate a fasting blood sugar of 312 and HbA1C of 9. The APRN wants to start the patient on Lantus 0.2 unit/kg. What dose and instructions should the APRN provide? Selected Answer: Give 19 units of Lantus subcutaneously prior to bedtime. A Native American man who lives a traditional lifestyle is scheduled to have heart surgery. The tribal chief has requested that the tribe's medicine man perform a ritual before the patient goes to surgery. The nurse's response to this request should be Selected Answer: "As long as the ritual does not interfere with the patient's preoperative care, it will be okay." Selected Answer: Digoxin Selected Answer: a higher-than-normal dose of drugs that bind to acid glycoproteins. Selected Answer: "Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine." Selected Answer: Potassium levels A 60-year-old man has scheduled a follow-up appointment with his primary care provider stating that the omeprazole (Prilosec) which he was recently prescribed is ineffective. The patient states, "I take it as soon as I feel heartburn coming on, but it doesn't seem to help at all." How should the nurse best respond to this patient's statement? Selected "Prilosec will help your heartburn but it's not designed to Answer: provide immediate relief of specific episodes of heartburn." Selected Answer: Route Selected Answer: use of alcohol. A Nurse Practitioner is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the Nurse Practitioner take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment? Selected Answer: Carefully assess the patient for infections Mr. Tan is a 69-year-old man who prides himself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. However, Mr. Tan states that he has experienced occasional constipation in recent months. What remedy should be the nurse's first suggestion? Selected Answer: A bulk-forming (fiber) laxative Selected Answer: The woman will be more susceptible to hypotension than a younger patient. Selected Answer: The amount of alcohol consumption A Nurse Practitioner who provides care in a long-term care facility is documenting a new resident's medication regimen on the resident's intake admission. The Nurse Practitioner is documenting the generic, rather than proprietary, names of the resident's current drugs because Selected Answer: there is a potential for confusion and miscommunication if proprietary names are used. Selected Answer: Oropharyngeal Candida albicans infection Selected Answer: Administering the drug intravenously rather than orally Mr. Penny, age 67, was diagnosed with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient's angina? Selected Answer: Mr. Penny requires concurrent treatment with a beta blocker, nitrate, or a calcium channel blocker. A Nurse Practitioner is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed. Before the drug therapy is started, the nurse will assess for which of the following? Selected Answer: History of taking anticoagulant drugs A 72-year-old man is taking Adderall XR for the treatment of narcolepsy. He is currently having problems with not being able to swallow large tablets or capsules. The man also wears dentures, which makes it even more difficult for him to swallow medication. He is in the clinic to talk to the nurse about his problem. The nurse will instruct him to Selected Answer: open the capsule and sprinkle the beads in applesauce. Selected Answer: hypoglyce mia Selected Answer: transdermal ly. Selected Answer: Hair loss Which statement is FALSE regarding the treatment of hyperthyroidism? Selected Answer: Selected Answer: Methimazole (Tapazole) is the drug of choice for pregnant or lactating females. possible drug toxicity. A 79-year-old woman with a medical history that includes osteoporosis has recently moved to a long-term care facility. Medication reconciliation indicates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is Selected Answer: intranasal. A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy's diagnosis? Selected Answer: Mesalamin e Selected Answer: Measures to alleviate any discomfort associated with adverse effects Selected Answer: avoid prolonged exposure to sunlight. Selected Answer: Short-acting and long acting inhaled beta2 agonists Selected Answer: Bleeding Selected Answer: consulting a drug guide for compatibility. Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine? Selected Answer: The resident's apical heart rate is 112 beats/minute with a regular rhythm Selected Answer: four times a day. The Nurse Practitioner is performing patient education for a woman who will soon begin treatment of hyperlipidemia with simvastatin (Zocor). The patient has asked the Nurse Practitioner if there are any "bad side effects" that she should be aware of. Which of the following statements should underlie the nurse's response? Selected Answer: Most patients tolerate statins well, with minor muscle aches being among the most common adverse effects. Mr. Lacuna is an 83-year-old resident of a long-term care facility who has a diagnosis of moderate Alzheimer disease. Mr. Lacuna's physician recently prescribed oral rivastigmine, but he was unable to tolerate the drug due to its gastrointestinal effects. As a result, he has been ordered the transdermal patch form of the medication. When administering this form of rivastigmine, the nurse should Selected Answer: apply the patch to Mr. Lacuna's back to reduce the chance that he will remove it. Selected Answer: administer carbohydrates. A 47-year-old woman has been diagnosed with open-angle glaucoma. Pilocarpine drops are prescribed. The nurse's assessment reveals that the patient has worn soft contact lenses for 15 years. The nurse will instruct the patient to Selected Answer: remove the contact lenses before applying the drops. Several months of treatment with a statin accompanied by lifestyle modifications have failed to appreciably improve a patient's cholesterol levels. Consequently, the patient has been prescribed cholestyramine. The nurse should recognize that this drugs achieves its therapeutic effect by Selected oxidizing cholesterol to bile acids. Answer: Selected Answer: Throat irritation A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.) Selected Answers: Heart rate Blood pressure A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing increasing neuropathic pain in recent months, a symptom that has not responded appreciably to conventional analgesics. The patient's care provider has begun treatment with gabapentin (Neurontin). How is the addition of this drug likely to influence the management of the patient's existing drug regimen? Selected Answer: It is unlikely to influence the patient's other medications because gabapentin does not interact with other drugs. A Nurse Practitioner who provides care on an acute medicine unit has frequently recommended the use of nicotine replacement gum for patients who express a willingness to quit smoking during their admission or following their discharge. For which of the following patients would nicotine gum be contraindicated? Selected Answer: A patient with a history of angina who experienced a non-ST wave myocardial infarction A clinic Nurse Practitioner is planning care for a 68-year-old man who has been on omeprazole (Prilosec) therapy for heartburn for some time. Regarding the patient's safety, which of the following would be a priority nursing action? Selected Answer: Coordinate bone density testing for the patient. Mrs. Houston is a 78-year-old woman who resides in an assisted living facility. Her doctor prescribed digoxin at her last visit to the clinic and she has approached the nurse who makes regular visits to the assisted-living facility about this new drug. What teaching point should the nurse emphasize to Mrs. Houston? Selected Answer: The importance of having required laboratory work performed on time In light of her recent high blood pressure readings, a patient has been started on a thiazide diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most likely rationale for using two medications to address the patient's hypertension? Selected Answer: Using the two drugs to treat a health problem may create a synergistic effect. A 70-year-old woman has a complex medical and a current drug regimen that includes calcium and vitamin D supplements for osteoporosis, metformin (Glucophage) for type 2 diabetes, phenelzine (Nardil) for depression, and metoprolol (Lopressor) and furosemide (Lasix) for hypertension. The woman is requesting dextromethorphan for the treatment of a recurrent cough. What component of her drug regimen contraindicates the use of dextromethorphan? Selected Answer: Phenelzine (Nardil) A 68-year-old man complains of a chronic, nonproductive cough. He states that he has to have relief, that he has been coughing every 2 to 3 minutes, and he is worn out. Dextromethorphan is prescribed for him. Before he leaves the clinic he asks how long it will take for the medicine to work. The nurse will advise him that he should experience therapeutic effects in Selected Answer: 15 to 30 minutes. Selected Answer: A chemical must have a proven therapeutic value or efficacy without severe toxicity or damaging properties to become a drug. Selected Answer: Blood ammonia levels The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parent's about the appropriate use of a "rescue drug" for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations? Selected Answer: Albuterol Selected Answer: increased heart rate and decreased blood pressure. Selected Answer: "Determine if the drug is going to make you drowsy before you drive." Selected Answer: Serum phosphate level A 77-year-old man's chronic heart failure is being treated with a regimen of quinapril (Accupril) and furosemide (Lasix). Which of the following assessment findings would suggest that the loop diuretic is contributing to a therapeutic effect? Selected Answer: The man's chest sounds are clear and his ankle edema is lessened. Selected Answer: How well a drug produces its desired effect Selected Answer: omit the dose if the meal does not contain fat. Selected Answer: Individual states laws regarding scheduled medications that can be prescribed and for how long A Nurse Practitioner who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients? Selected Answer: An obese male client who is a heavy alcohol user and who has cirrhosis of the liver A Nurse Practitioner is caring for a 73-year-old man who is receiving drug therapy. He is beginning to exhibit signs of decline in his renal system, yet his current serum creatinine level is normal. The Nurse Practitioner will base the patient's plan of care on the understanding that there is Selected Answer: a decrease in the amount of creatinine to be filtered. Selected Answer: Take 1 unit of regular insulin for each 10 grams of carbohydrate to be consumed 15 minutes before each meal Selected Answer: A Proton Pump Inhibitor Selected Answer: Triglyceride levels A patient is bothered with nighttime episodes of bronchoconstriction related to asthma. Which of the following medications can be administered to decrease the nighttime episodes and prevent asthma attacks? Selected Answer: Leukotriene modifiers Selected Answer: swallow the tablet with milk or food. Selected Answer: Beta blocker Selected Answer: inhibiting the movement of calcium ions across the cardiac muscle cell membrane. · Question 101 1 out of 1 points In order to promote therapeutic drug effects, the Nurse Practitioner should always encourage patients to Selected Answer: take their medication at the prescribed times. Question 102 1 out of 1 points A 62-year-old man has been prescribed lovastatin. The Nurse Practitioner will instruct the patient to take the medication. Selected Answer: at bedtime. Question 103 1 out of 1 points A Nurse Practitioner who provides care for older adults is aware of the high incidence of drug interactions in this population. When educating a group of seniors about the prevention of drug interactions, the Nurse Practitioner should encourage them to Selected Answer: consult their care provider before taking new over-the-counter medications. Question 104 1 out of 1 points A Nurse Practitioner is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term? Selected Answer: Taking several drugs simultaneously · Question 105 1 out of 1 points A diabetic patient being treated for obesity tells the Nurse Practitioner that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the Nurse Practitioner's immediate attention? Selected Answer: Increased blood glucose Question 106 1 out of 1 points Topical inhaled alpha adrenergic blocking agents or nasal vasoconstricting decongestants should not be used chronically (>5 days) because they can cause Selected Answer: rebound rhinitis/congestion Question 107 1 out of 1 points A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction? Selected Answer: Late afternoon · Question 108 1 out of 1 points The Nurse Practitioner's assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this? Selected Answer: "I broke out in hives and got terribly itchy when I started a new prescription last year." Question 109 1 out of 1 points A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAs more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract? Selected Answer: The parietal cells of the stomach have H2 receptors but not H1 receptors. · Question 110 1 out of 1 points A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient? Selected Answer: "Quitting smoking will significantly increase the chance that this drug will heal your ulcer." · Question 111 1 out of 1 points A 75-year-old woman is prescribed magnesium hydroxide for constipation. The nurse's assessment reveals that the patient is being treated for rheumatoid arthritis and hypertension. The patient lives in assisted living and is on a low-sodium diet. Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the patient's Selected Answer: medication history. · Question 112 1 out of 1 points A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit she reports that since she has been on the drug, she can breathe better and her heart rate has been around 74 beats per minute. The nurse weighs the patient and notices that she has gained 10 pounds since the digoxin therapy was started. The patient is concerned that the additional weight will necessitate an increase in the medication. Which of the following is an appropriate response by the nurse? Selected Answer: "No, the drug dosage will likely stay the same." Question 113 1 out of 1 points A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by Selected Answer: decreasing the influx of sodium into neurons. Question 114 1 out of 1 points A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family doctor. What effect will the patient's smoking status have on the therapeutic use of theophylline? Selected Answer: The patient may require higher doses of theophylline than a nonsmoker · Question 115 1 out of 1 points A 56-year-old female patient has been admitted to the hospital with chronic muscle spasms and has been prescribed a new medication to treat the spasms. She has a poorly documented allergy to eggs, synthetic clothes, and perfumes. What is the priority action of the nurse to ensure that prescribed medication does not experience an allergic reaction? Selected Answer: Post an allergies notice on the front of the chart and document the allergies in the appropriate area of the patient's record Question 116 1 out of 1 points A 34-year-old male patient is prescribed methimazole (MMI). The Nurse Practitioner will advise him to report which of the following immediately? Selected Answer: Intolerance to cold Question 117 1 out of 1 points A patient with a long history of alcohol abuse has been admitted to an acute medical unit with signs and symptoms of hepatic encephalopathy. His current medication orders include QID doses of oral lactulose. What desired outcomes should the nurse associate with this drug order? Selected Answer: Patient will have three to four loose bowel movements each day. Question 118 1 out of 1 points The Nurse Practitioner is treating a patient that takes frequent doses of antacids for his heartburn and is also taking an enteric coded aspirin. What instructions should be provided to the patient? Selected Answer: The medications should be taken at least 2 hours apart. · Question 119 1 out of 1 points A Nurse Practitioner is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the Nurse Practitioner should be aware that Selected Answer: there is a risk of systemic absorption of the lidocaine through the patient's traumatized skin. Question 120 1 out of 1 points A patient has been admitted to the ICU because of multiple traumas due to a motor vehicle accident. The physician has ordered propofol (Diprivan) to be used for maintenance of sedation. Before administration of propofol, a priority assessment by the nurse would be to check for a history of Selected Answer: seizure disorders. Question 121 1 out of 1 points A Nurse Practitioner is providing a patient with a list of drugs as a part of the patient's plan of care. Which of the following drug nomenclatures should the Nurse Practitioner use to list the drugs? Selected Answer: The drugs' generic names Question 122 1 out of 1 points A clinic Nurse Practitioner has been assigned a 49-year-old female patient who has a history of diabetes. A recent diagnosis of hypertension has been made, and the patient has been prescribed a thiazide diuretic and labetalol. The patient will be scheduled to return to the clinic once a month for the next 6 months. A priority action by the Nurse Practitioner will be to Selected Answer: monitor the patient's blood pressure. · Question 123 1 out of 1 points Which of the following would be an expected outcome in a patient who has been given atropine during a medical emergency? Selected Answer: Restoration of normal sinus rhythm Question 124 1 out of 1 points A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply. Selected Answers: Is there a need for the drug in treating the presenting problem? Is this the best drug for the presenting problem? Can the patient take the prescribed drug? Question 125 1 out of 1 points The APRN is prescribing a medication that is known to induce hepatic enzymes. What effect should you anticipate? Selected Answer: induction increases the rate of metabolism, thereby decreasing serum levels of drug. Question 126 1 out of 1 points Drugs have a high potential for abuse. There is no routine therapeutic use for these drugs and they are not available for regular use. They may be obtained for "investigational use only" by applying to the U.S. Drug Enforcement Agency. Examples include heroin and LSD. Which scheduled drug is this? Selected Answer: Schedule 1 Question 127 1 out of 1 points The Nurse Practitioner is prescribing Salmeterol (Serevent) inhaler for a patient with asthma. What instructions would be correct to provide the patient? Selected Answer: "This is a long-acting medication for your asthma and should be used once every 12 hours". Question 128 1 out of 1 points A patient with a recent diagnosis of acute renal failure has a long-standing seizure disorder which has been successfully controlled for several years with antiseizure medications. The nurse should recognize that the patient's compromised renal function will likely Selected Answer: increase the half-life of medications that are metabolized by the kidneys. Question 129 1 out of 1 points A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be Selected Answer: suppository. Question 130 1 out of 1 points A 20-year-old woman calls the clinic at 5 PM and reports to the Nurse Practitioner that she forgot to take her morning dose of fexofenadine (Allegra). She usually takes her evening dose at 8 PM. She wants to know what she should do. The Nurse Practitioner will instruct her to Selected Answer: forget about the morning dose and take the evening dose. Question 131 1 out of 1 points A Nurse Practitioner is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a patient who has just been admitted. What is the most likely goal of this intervention? Selected Answer: To convert the patient's atrial fibrillation to normal sinus rhythm Question 132 1 out of 1 points A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient's drug therapy? Selected Answer: Increased abdominal pain and vomiting. Question 133 1 out of 1 points A 58-year-old man is prescribed dicyclomine (Bentyl) for irritable bowel syndrome. In which of the following conditions is dicyclomine therapy contraindicated? Selected Answer: Glaucoma. Question 134 1 out of 1 points A patient is taking cholestyramine. The Nurse Practitioner will assess for which of the following common adverse effects of the drug? Selected Answer: Constipation Question 135 1 out of 1 points A Nurse Practitioner is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports "dizzy spells and weakness" and feels that the drug is no longer effective. The Nurse Practitioner suspects that the change in the effectiveness of the drug is related to Selected Answer: the impact of the warmer climate on the patient's physical state. Question 136 1 out of 1 points A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation? Selected Answer: Monitor glucose levels closely Question 137 1 out of 1 points A Nurse Practitioner who is responsible for administering medications should understand that the goals of the MedWatch program are to (Select all that apply.) Selected Answers: provide regular feedback about product safety issues. facilitate the reporting of adverse reactions of drugs. increase awareness of serious reactions caused by drugs or medical devices. Question 138 1 out of 1 points A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain? Selected Answer: Administer a tablet under his tongue and repeat the action in 5 and 10 minutes if the pain has not subsided. Question 139 1 out of 1 points A 22-year-old male college senior has lived with a diagnosis of Crohn's disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn's disease? Selected Answer: Infliximab (Remicade) Question 140 1 out of 1 points Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from Helicobacter pylori infection. Which of the following medications will likely be used in an attempt to eradicate the patient's H. pylori infection? (Select all that apply.) Selected Answers: Antibiotics A PPI Question 141 1 out of 1 points Federal legislation dictates a lengthy and rigorous process of testing for new drugs. What is the primary purpose of this testing process? Selected Answer: To ensure the safety of the public Question 142 1 out of 1 points A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings? Selected Answer: The man may be experiencing nephrotoxic effects of aspirin Question 143 1 out of 1 points An unconscious patient has been brought to the hospital, and the Nurse Practitioner has prescribed a life-saving drug to be administered parenterally. Which of the following methods would be the most appropriate for the nurse to use when administering the medication? Selected Answer: Intravenous infusion. Question 144 1 out of 1 points A Nurse Practitioner has been following a male patient who is taking hydralazine, clonidine, and a diuretic for hypertension. After 2 weeks of medication therapy, the patient begins to complain of numbness and tingling in his hands and feet. The Nurse Practitioner suspects that these signs or symptoms are Selected Answer: signs of peripheral neuritis. Question 145 1 out of 1 points The APRN is caring for a patient taking a calcium channel blockers for hypertension. The APRN should monitor the patient for what common side effects of this medication? Selected Answer: peripheral edema, constipation, dizziness Question 146 1 out of 1 points A 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this patient's statements? Selected Answer: "Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation." Question 147 1 out of 1 points A 72-year-old female patient is prescribed ipratropium aerosol for pulmonary emphysema. The nurse will instruct her to "test spray" the new metered-dose inhaler (MDI) three times before using it to prevent which of the following? Selected Answer: Paradoxic acute bronchospasm Question 148 1 out of 1 points A female patient has been taking zafirlukast for a week and is experiencing diarrhea. The nurse should instruct her to do which of the following? Selected Answer: Drink plenty of fluids Question 149 1 out of 1 points A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia. Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.) Selected Answers: The drug does not cause sleepiness in the morning. One of the most common adverse effects of the drug is headache. It is available in both quick-onset and continuous-release oral forms. Question 150 1 out of 1 points A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse's advice? Selected Answer: Integrating the new drug into the patient's existing schedule promotes adherence. Question 151 1 out of 1 points Decongestants are recommended to use in which of the following patients? Selected Answer: patients with otitis media Question 152 1 out of 1 points After a recent history of shortness of breath that has become increasingly severe, a woman has been prescribed ipratropium by MDI while she undergoes a diagnostic workup. What patient teaching should the nurse provide to this patient? Selected Answer: "Make sure that you take this at the scheduled times, regardless of whether you feel short of breath." Question 153 1 out of 1 points A 62-year-old woman has been prescribed a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately Selected Answer: 24 hours. Question 154 1 out of 1 points A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of Selected Answer: an adrenergic antagonist. Question 155 1 out of 1 points The APRN is seeing Mrs. Smith, age 77, who is here for follow up of hypertension, dyslipidemia, and depression. What should you consider during her follow-up? Selected Answer: Age-related changes in renal function are the main cause of adverse drug reactions Question 156 1 out of 1 points In which of the following patients would a Nurse Practitioner expect to experience alterations in drug metabolism? Selected Answer: A 50-year-old man with cirrhosis of the liver Question 157 1 out of 1 points A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following? Selected Answer: Nausea Question 158 1 out of 1 points A patient is being treated for respiratory infection. He is a recovering alcoholic and has impaired liver function. The nurse will instruct the patient to be especially cautious when taking Selected Answer: an elixir. Question 159 1 out of 1 points A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a Selected Answer: C-II drug. Question 160 1 out of 1 points A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse? Selected Answer: "This schedule allows rest periods so that adverse effects are decreased but the anti-inflammatory effects continue." Question 161 1 out of 1 points A home health Nurse Practitioner is performing a home visit to an elderly client who has early- stage dementia. The Nurse Practitioner observes that some of the client's pill bottles are empty, even though the client is not due for refills for 2 weeks. What nursing diagnosis should the Nurse Practitioner prioritize when planning this client's care? Selected Answer: Ineffective Therapeutic Regimen Management Question 162 1 out of 1 points A Nurse Practitioner is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called Selected Answer: Pharmacogenomics Question 163 1 out of 1 points A female patient calls the clinic and reports that since she has been taking dextromethorphan (Robitussin), she has been extremely drowsy and dizzy. The nurse will question the patient about which of the following? The nurse should assess the amount of grapefruit or orange juice ingestion, because these juices can substantially increase the concentration of dextromethorphan and cause an increase in the frequency and severity of the adverse effects of the drug. Tea, soft drinks, coffee, or water would not increase the drowsiness or dizziness that is often associated with the use of this drug. Question 164 1 out of 1 points A Nurse Practitioner is instructing a patient in the administration of regular insulin by the subcutaneous route. Which of the following strategies would the Nurse Practitioner suggest if the goal is to promote absorption of the regular insulin? Selected Answer: Select one anatomic area for regular insulin injections and ten us serial locations within that area Question 165 1 out of 1 points After a recent history of shortness of breath that has become increasingly severe, a woman has been prescribed ipratropium by MDI while she undergoes a diagnostic workup. What patient teaching should the nurse provide to this patient? Selected Answer: "Make sure that you take this at the scheduled times, regardless of whether you feel short of breath." Question 166 1 out of 1 points A child is prescribed an inhaled corticosteroid agent to decrease respiratory inflammation related to exposure to an animal. The patient’s parent administers a higher than prescribe dose of the medication for 5 days. What should the APRN monitor the child for? Selected Answer: Adrenal insufficiency Question 167 1 out of 1 points Which of the following patients is most likely to benefit from the administration of an adrenergic agonist? Selected Answer: A man who is in cardiogenic shock following a myocardial infarction Question 168 1 out of 1 points A 48-year-old woman who works as an office manager is prescribed metoclopramide (Reglan) for diabetic gastroparesis. The nurse will be sure to assess the patient for Selected Answer: depression. Question 169 1 out of 1 points A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to Selected Answer: rebound bronchoconstriction. Question 170 1 out of 1 points A 70-year-old woman has experienced peripheral edema and decreasing stamina in recent months and has sought care from her primary care provider. The patient's subsequent diagnostic workup has resulted in a diagnosis of chronic heart failure. The woman has been prescribed digoxin and the nurse has begun patient education. What should the nurse teach the patient about her new medication? Selected Answer: "This drug won't cure your disease, but it will help you be able to exercise more and be more comfortable." Question 171 1 out of 1 points Which of the following patients should be advised by the Nurse Practitioner to avoid over-the- counter cold and allergy preparations that contain phenylephrine? Selected Answer: A 47-year-old female with hypertension 1. Q_: The recommended range for maintaining serum theophylline levels is: 10 to 20 μg/mL. 2. Q_: A Nurse Practitioner is conducting an assessment of a patient who has recently had several changes made to her drug regimen. What assessment question most directly addresses the safety implications of the patient's drug regimen? "Do you take any herbal supplements or alternative medications?" 3. Q_: Which antihypertensive agent is ... with hair growth? Minoxidil- Vasodialator 4. Q_: The Nurse Practitioner is preparing to Prescribe a medication regimen for her patient. He or she recognizes that criteria for choosing an effective drug for any disorder include: consulting nationally recognized guidelines for disease management 5. Q_: A common side effect of metformin (Glucophage) therapy is: GI disturbances such as anorexia, nausea and vomiting, weight loss, abdominal discomfort 6. Q_: Which effect does the Nurse Practitioner expect may occur when using cholinergic agonists? increased bladder tone 7. Q_: Simpson has a known history of asthma. She is on Theophylline daily. The NP contemplates giving her an antibiotic for her respiratory infection. The NP knows that which choice below could elevate theophylline levels? Ciprofloxacin 8. Q_: Some first-generation antihistamines are used : to prevent motion sickness 9. Q_: When prescribing an antihypertensive medication for a type 2 diabetic patient, the drug classifications that would tend to reduce insulin sensitivity are: Diuretics and beta blockers 10. Glargine (Lantus) is an insulin analog that essentially has no peak and is usually administered: Once a day. 11. The side effects of antihistamines are mostly due to their: Anticholinergic effects 12. Autonomic drugs have little effect when administered: Orally 13. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the: onset of action 14. Glucocorticoids affect the metabolism of carbohydrates, protein, and fats. True 15. A patient with a known history of benign prostatic hyperplasia (BPH) presents to the clinic 4 days after developing a cold. He tells you he began experiencing a sore throat and nasal congestion and began to take an over the counter decongestant. Today, he complains of not urinating over the last 12 hours. He also has suprapubic fullness on exam. Which of the following medications are most likely responsible for this patient's urinary retention? Phenylephriine 16. What drug class will decrease the facial flushing that occurs with niacin? Administer aspirin 30 minutes before each dose 17. The Elderly are at high risk of Adverse Drug Reactions due to: age related decrease in renal function 18. Biguanides control hyperglycemia in type 2 diabetes primarily by acting at which organ? Liver 19. A 39 y/o female is diagnosed with Graves disease. She also has a small goiter =. Her symptoms are not deemed to be severe and propylthiouracil is prescribed. What is the most serious potential adverse effect of this medication? Agranulocytosis 20. Which medication class is recognized for the treatment of moderate to severe dementia? N-methyl-d-aspartame (NMDA) Receptor Antagonist Memantine (Namenda) 21. The nurse practitioner has prescribed elemental iron 6 mg/kg/day in three divided doses for a toddler diagnosed with iron-deficiency anemia. What instructions would the family nurse practitioner include for the parents? Give the medication through a straw to decrease the staining of the teeth. 22. A patient who is a steroid-dependent asthmatic is started on a beclomethasone inhaler. Which should be part of patient education? Rinse the mouth well after each use 23. A 65-year-old male presents with a history of worsening urinary urgency, frequency, and hesitancy. He also tells you that he has to "push really hard" to urinate and that his urine dribbles a little after he is done urinating. What medication should be avoided: Ipratropium inhaler 24. Which can elevate theophylline levels? Concomitant treatment with cimetidine (Tagamet). 25. Your patient is on Atorvastatin 40 mg daily, and presents for their routine follow up appointment. They complain of extreme fatigue, muscle aches, and dark colored urine. What is your best course of action given presentation? Discontinue Pravastatin and order a liver function profile test 26. A patient has been started on a treatment regimen that includes levothyroxine. Select the dosage regimen that is most appropriate for a mean replacement dosage. The patient has been started on a treatment regimen that includes levothyroxine. Select the dosage regimen that is most appropriate for a mean replacement dosage. 1.7 mcg/kg of body weight per day 27. You decide to start your pt, Ms. Rodrigues, on spironolactone (Aldactone) 50 mg PO daily. As the NP, you will instruct the patient to call the clinic if which symptoms are experienced? Muscle twitching, numbness, tingling, burning sensations of the limbs, and diarrhea 28. What is a serious side effect of ibuprofen in the older adult patient? Impairment of renal function 29. Drugs that use CYP 3A4 isoenzymes for metabolism may: Induce the metabolism of another drug, and Inhibit the metabolism of another drug 30. Jillian is a Nurse Practitioner. She recognizes that Nurse Practitioner prescriptive authority Is regulated by: The state board of nursing for each state 31. A male patient who is hypertensive takes Hydrochlorothiazide for his blood pressure . He presents with red, painful swelling of the great toe. In addition to treating gout, you recognize that you may need to: Change his thiazide antihypertensive medication 32. Mr. Lastinger was prescribed warfarin sodium (Coumadin). You advise him to avoid eating large amounts of leafy green vegetables because: The high vitamin K levels will decrease the INR 33. Acetazolamide is categorized as which of the following? Carbonic anhydrase inhibitor 34. The anticoagulant drug that acts as a vitamin K antagonist is: coumadin [Show More]

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