Pharmacological and or Parenteral Therapies (NUR 302_ Chamberlain College of Nursing) Complete Practice Questions and Answers for Test Prep

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Pharmacological and or Parenteral Therapies (NUR 302_ Chamberlain College of Nursing) Complete Practice Questions and Answers for Test Prep 1. A nurse cares for a client during an autologous blood ... transfusion. Thirty minutes after the transfusion was started, the client reports chills. The client’s blood pressure has decreased from 122/84 to 108/62. Which action will the nurse take FIRST? 1. Administer oral diphenyhydramine 25 mg. 2. Administer 0.45% sodium chloride 100 mL/hour intravenously. 3. Stop the transfusion and remove the blood infusion tubing immediately. 4. Check the client’s oral temperature and oxygen saturation level. 2. The nurse cares for a client diagnosed with a compound fracture of the left femur. The client’s vital signs are BP 80/60, pulse 120, respirations 26, temperature 99.0°F (37.2°C). Which IV fluid order should the nurse question? 1. Lactated Ringer’ s. 2. 0.45% sodium chloride. 3. 0.9% sodium chloride. 4. Hetastarch. 3. The health care provider orders an IV with 5% dextrose in water (D5W) started for an 86-year-old client. Which action by the nurse is BEST? 1. Instruct the client to breathe slowly and deeply during auscultation of the posterior chest. 2. Apply the tourniquet 1 to 2 inches above the IV insertion site. 3. Apply a blood pressure cuff above the IV site insertion and inflate the cuff to the same level as the systolic blood pressure. 4. Start the IV using the dorsal veins of the client’ s forearm on the nondominant side. 4. The nurse cares for a client receiving parenteral nutrition (PN) through a central venous access device (CVAD). What is the MOST important action for the nurse to take? 1. Remove the old dressing over the insertion site, moving against the direction the catheter is inserted. 2. Clean the insertion site with an alcohol swab, moving from the outside to the inside in a circular pattern. 3. Flush the unused catheter lumens with a 10 mL syringe. 4. Use clean gloves to reapply an occlusive dressing to the insertion site. 5. The nurse cares for a client receiving hetastarch intravenously. What is a priority action for the nurse to take? 1. Assess for bilateral pretibial edema. 2. Measure the hourly urine output. 3. Obtain daily weights. 4. Auscultate lung sounds. 6. The nurse teaches a client about lorazepam. Which statement by the client requires an intervention by the nurse? 1. “If the dose of lorazepam is increased, I may feel more sleepy than usual.” 2. “I should follow my regular diet when taking this medication.” 3. “I may feel dizzy when I take this medication.” 4. “If I have problems with this medication, I should stop it immediately.” 7. A client diagnosed with a bacterial infection reports hives and difficulty breathing after amoxicillin was prescribed 10 years ago. The client reports a history of allergy to sulfonamides. Which order should the nurse question? 1. Tetracycline hydrochloride. 2. Cefaclor. 3. Azithromycin. 4. Ciprofloxacin. 8. The nurse instructs a client about doxycycline calcium. The nurse should intervene if the client makes which statement? 1. “I should wear a hat and use sunscreen when I am outside.” 2. “I should take this medication 1 hour before meals.” 3. “I should drink more fluids when taking this medication.” 4. “I should take this medication at bedtime.” 9. The health care provider orders amoxicillin trihydrate 20 mg/kg PO every 8 hours for a 12-year-old client. The client weighs 105.6 pounds. How many milligrams should the nurse administer for each dose? Calculate and record the dose in milligrams. 10. The nurse cares for the client receiving propranolol. What is the MOST important question for the nurse to ask? 1. “Have you experienced a dry cough early in the morning?” 2. “How would you describe your breathing?” 3. “Have you noticed an increase in your urine output?” 4. “Describe your sleep pattern to me.” 11.The nurse cares for clients on an acute-care neuroscience unit. Which medication should the nurse administer FIRST? 1. Prednisone 60 mg orally for a client diagnosed with multiple sclerosis reporting increased muscle weakness and fatigue. 2. Pyridostigmine 75 mg orally for a client diagnosed with myasthenia gravis reporting increased difficulty chewing. 3. Benztropine 1 mg orally for a client diagnosed with Parkinson’s disease who is drooling. 4. Heparin 5,000 units subcutaneously for a client diagnosed with a thrombotic stroke 48 hours ago. 12.The nurse instructs an elderly client about the use of clonidine hydrochloride transdermal patches. Which statement by the client indicates further teaching is required? 1. “When I get out of bed in the morning, I move slowly so I don’t get dizzy.” 2. “One time I put the adhesive patch on my right arm, and the next time I put it on my left arm.” 3. “I remove the adhesive patch before I take my shower each morning and put on a new one in the evening.” 4. “Sometimes the medicine makes me feel sleepy in the middle of the day, so I take a short nap.” 13.After 2 weeks of receiving lithium therapy, a client diagnosed with mania becomes depressed. It is MOST important for the nurse to take which action? 1. Monitor the client for suicidal behavior. 2. Continue the current treatment plan. 3. Explore with the client the reasons the client appears depressed. 4. Contact the health care provider to discuss the addition of an antidepressant. 15.The nurse cares for a client several hours after insertion of a central venous access device (CVAD) in the subclavian vein. An IV of 0.9% sodium chloride is infusing through the line at 75 mL/hr. The client becomes restless and reports shortness of breath. The nurse should take which action FIRST? 1. Elevate the head of the bed to 90°. 2. Check the IV flow rate and insertion site. 3. Obtain equipment for insertion of a chest tube. 4. Reassure the client that things will improve. 16.The nurse receives a phone call from a client taking ciprofloxacin 250 mg PO bid for the past 3 days. The client tells the nurse while bathing this morning he noticed small, red spots on his chest. Which response by the nurse is BEST? 1. “Did you use a new bath soap?” 2. “Call me back if the rash gets worse.” 3. “When do you take the medication?” 4. “Stop taking the medication.” 17.The nurse cares for a client diagnosed with breast cancer and type 1 diabetes mellitus. Which medication requires frequent blood glucose monitoring? 1. Prednisone. 2. Captopril. 3. Nifedipine. 4. Spironolactone. 18.The nurse instructs a client taking clopidogrel 75 mg daily. Which statement by the client indicates understanding about the instructions? 1. “I can continue to take ibuprofen pills for my arthritis pain while taking clopidogrel.” 2. “It will be necessary for me to have blood test monitoring done while I am taking clopidogrel.” 3. “I should not continue to take ginkgo for my memory problems while taking clopidogrel.” 4. “I will need to take a daily multivitamin pill every day while taking clopidogrel. 19.The nurse cares for a client receiving cisplatin. It is MOST important for the nurse to follow up on which statement? 1. “I drink 8–10 glasses of water every day.” 2. “I now use a soft toothbrush.” 3. “I take lorazepam the day after my cisplatin treatment.” 4. “My family thinks I ignore them when they are talking to me.” 20.The nurse receives an order for 0.5 mg benztropine for a client diagnosed with glaucoma and type 2 diabetes mellitus. Which action should the nurse take FIRST? 1. Withhold the benztropine and contact the health care provider. 2. Obtain the client’s blood sugar prior to the first dose of the medication. 3. Tell the client that the beneficial effects of the medication will decrease over time. 4. Inform the client that benztropine may cause urinary retention. 21.The nurse receives a phone call from a mother of an 8- year-old taking methylphenidate. The mother reports that her child has lost 4 pounds in the last 2 weeks. It is MOST important for the nurse to make which statement? 1. “What has your child been eating during the last 2 weeks?” 2. “Give your child one-half the prescribed dose every other day during the next week.” 3. “You need to contact your health care provider today.” 4. “It will be necessary to give your child high-calorie nutritious foods while taking the methylphenidate.” 22.The nurse instructs a client about the administration of albuterol and beclomethasone by metered dose inhaler (MDI). Which statement requires an intervention by the nurse? 1. “I will use the beclomethasone inhaler first.” 2. “I should look for white spots or areas of redness in my mouth every day.” 3. “It doesn’t matter if I sit or stand up when I use the inhaler.” 4. “If I haven’t used the inhaler for several days, I should push one spray into the air.” 23.The home care nurse visits an elderly client diagnosed with heart failure. The client’s blood pressure is 130/80, apical pulse 65 per minute, and respirations 16 per minute. The client denies shortness of breath but reports nausea for the past 3 days. The client takes digoxin 0.25 mg daily and spironolactone 50 mg daily. Which action by the nurse is BEST? 1. Instruct the client to increase intake of potassium-rich foods. 2. Encourage the client to increase fluid intake. 3. Plan a return visit in 3 days. 4. Contact the health care provider. 24.The nurse administers furosemide 40 mg IV bid. What is a PRIORITY assessment for the nurse to make prior to administration of the furosemide? 1. Muscle weakness. 2. Metabolic acidosis. 3. Increased apical heart rate. 4. Hypertension 25.The nurse cares for a client diagnosed with pre-eclampsia. The health care provider orders include IV administration of magnesium sulfate in 5% dextrose and water. Which finding MOST concerns the nurse? 1. The client has bilateral 3 + deep tendon reflexes. 2. The client’s urine output is 100 mL in 8 hours. 3. The client’s respiratory rate is 10 breaths per minute. 4. Negative Homans’ sign. 26.The nurse instructs a client about alendronate. Which statement by the client indicates understanding of the instructions? 1. “I need to increase my intake of calcium for this medication to work properly.” 2. “Taking alendronate on a regular basis will restore the bone loss that I have experienced.” 3. “If I take the medication at night, I will experience fewer side effects.” 4. “If I have any discomfort in my chest or stomach after I take this medication, I should contact my health care provider.” 27.The nurse performs discharge teaching for a client diagnosed with small cell lung cancer (SCLC) with metastases to the thoracic vertebrae. Which statement by the client indicates that further teaching is needed? 1. “I will swallow my controlled-release oxycodone tablet whole without chewing it.” 2. “I should call my health care provider if I notice swelling of my feet, legs or hands.” 3. “The chemotherapy treatments I am to receive over the next few months will not affect the tumors in my spine.” 4. “I should take the morphine liquid at 07:00, 11:00, and 17:00 before meals.” 28.The nurse provides discharge instructions for a client taking hydrocodone 7.5 mg and acetaminophen 750 mg for the treatment of low back pain. Which statement by the client requires an intervention by the nurse? 1. “I should drink a glass of prune juice every day.” 2. “I will have to urinate more often while I am taking hydrocodone 7.5 mg/acetaminophen 750 mg.” 3. “I may experience some facial flushing after I take the medication.” 4. “My cough may not be as strong while I am taking the hydrocodone 7.5 mg/acetaminophen 750 mg.” 29.An older client tells the nurse “I have pressure in my chest.” The client’s blood pressure is 150/90, pulse 88, respirations 20. The nurse administers nitroglycerin 0.4 mg sublingually as ordered. What will the nurse expect to observe? 1. Blood pressure 160/100, pulse 120, respirations 16. 2. Blood pressure 150/90, pulse 60, respirations 28. 3. Blood pressure 100/60, pulse 96, respirations 20. 4. Blood pressure 90/60, pulse 60, respirations 24. 30.The nurse prepares to administer ketorolac 15 mg IV to an 82-year-old client after hip replacement surgery. Which assessment is a PRIORITY to make prior to administration of ketorolac? 1. Hemoglobin. 2. Serum sodium. 3. Aspartate aminotransferase (AST). 4. Serum creatinine. 31.The nurse receives an order for 0.4 mg tamsulosin and prepares to administer the first dose. What is the MOST important action for the nurse to take? 1. Ask the client about the frequency and amount of urination. 2. Instruct the client to attempt to void every 2 hours during the day. 3. Obtain a urine sample for culture and sensitivity. 4. Administer the medication at bedtime with a snack. 32.The nurse cares for a client in the emergency center. The client is diagnosed with an abdominal injury from a motor vehicle accident. Which information is MOST important for the nurse to obtain from the client’ s family? 1. The client takes glipizide 5 mg daily. 2. The client takes levothyroxine 100 mcg daily. 3. The client takes clopidrogel 75 mg daily. 4. The client takes zolpidem. 33.The home care nurse receives 4 phone messages. Which of the message should the nurse return FIRST? 1. A client diagnosed with multiple sclerosis takes prednisone daily and reports constant hunger. 2. A client diagnosed with hypothyroidism takes levothyroxine every morning and reports heart palpitations. 3. A client diagnosed with tuberculosis takes rifampin and reports orange urine. 4. A client diagnosed with atrial fibrillation takes metoprolol tartrate daily and reports coughing and wheezing. 34.The nurse prepares to administer the initial dose of losartan 25 mg to a client. What is the PRIORITY action for the nurse to take? 1. Give the medication with a high protein snack. 2. Determine if the client is following a weight reduction diet. 3. Instruct the client to sit on the edge of the bed before ambulating. 4. Tell the client to inform health care providers if a dry cough develops. 35.The nurse cares for a client receiving atorvastatin. Which value indicates to the nurse that treatment with atorvastatin is effective? 1. Serum triglyceride level 210 mg/dL (2.4 mmol/L). 2. Low-density lipoprotein (LDL) cholesterol 100 mg/dL (2.6 mmol/L). 3. Serum cholesterol 220 mg/dL (5.7 mmol/L). 4. High-density lipoprotein (HDL) level 25 mg/dL (0.7 mmol/L). 36.The nurse cares for clients on an acute care inpatient unit. Which medication should the nurse administer FIRST? 1. Digoxin 0.25 mg orally to a client diagnosed with heart failure. Fine crackles are present in the bases of the lungs. 2. Nimodipine 60 mg orally to a client diagnosed with a subarachnoid hemorrhage 48 hours ago. The client reports a dull, throbbing headache. 3. Warfarin sodium 3.5 mg orally to a client diagnosed with atrial fibrillation. The client’s apical heart rate is 96 beats per minute. 4. Metformin 500 mg orally to a client diagnosed with type 2 diabetes mellitus. The blood glucose level is 168 mg/dL. 37.The nurse teaches a client diagnosed with a duodenal ulcer. The health care provider prescribes famotidine 20 mg once daily. It is MOST important for the nurse to follow up on which client statement? 1. “I can continue to take one aspirin tablet a day.” 2. “I take magnesium and aluminum hydroxide at the same time I take my other medications.” 3. “I am supposed to take the famotidine at bedtime.” 4. “I realize that I must avoid exposure to second-hand smoke at all times.” 38.The nurse reviews charts of clients in the medical clinic. The nurse identifies which clients may be taking medication that interacts with grapefruit juice? Select all that apply 1. ❏ Digoxin. 2. ❏ Levothyroxine. 3. ❏ Buspirone. 4. ❏ Verapamil. 5. ❏ Carbamazepine. 6. ❏ Simvastatin. 39.The nurse assesses a client receiving cyclophosphamide. It is MOST important for the nurse to ask which question? 1. “Have you noticed any hair loss?” 2. “Have you lost any weight?” 3. “Have you had any nausea and vomiting?” 4. “Has constipation been a problem for you?” 40.The nurse prepares to administer carbamazepine 200 mg to a client. What is the PRIORITY assessment for the nurse to make prior to administration? 1. Serum platelet levels and hemoglobin. 2. Blood urea nitrogen and creatinine. 3. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT). 4. C-reactive protein and creatinine kinase (CK). 41.The RN receives report from the LPN/LVN about care provided to clients on the surgical unit. It is MOST important for the nurse to follow up on which statement? 1. “The client 3 hours after a tonsillectomy is alert, oriented, and swallowing frequently.” 2. “The client 12 hours after an ileostomy has loose, dark green liquid drainage coming from the stoma.” 3. “The client 18 hours after a prostatectomy states he has the urge to void 1 hour after receiving darifenacin.” 4. “The client 24 hours after a total hip replacement reports increased pain.” 42.The nurse instructs a client taking brimonidine tartrate 0.5% ophthalmic solution 1 drop 3x a day and latanoprost 0.005% solution 1 drop daily in the evening. Which statement indicates that further teaching is needed? 1. “I should instill both the eye drops before putting in my soft contact lenses.” 2. “I should apply gentle pressure on the inside corner of my eye after instilling each eye drop.” 3. “I should squeeze my eyes shut after I put eye drops into each of my eyes.” 4. “My vision may be temporarily blurred immediately after I instill the eye drops.” 43. The nurse reviews the records of clients in the medical clinic who are at risk for developing type 2 diabetes. Arrange the following clients in order from greatest risk to least risk for developing type 2 diabetes. Use all answer choices. 1 A 26-year-old African American with a history of gestational diabetes and following a weight reduction diet. 2 A 36-year-old Caucasian with a serum triglyceride level of 310 mg/dL (1.24 mmol/L) and whose mother-in-law has type 1 diabetes. 3 A 42-year-old Hispanic American with a history of hypertension and a serum high density lipoprotein (HDL) level of 30 mg/dL (0.78 mmol/L). 4 A 56-year-old Native American who is 5’8” tall, weighs 200 lb, and has two siblings with type 2 diabetes. 4 A 56-year-old Native American who is 5’8” tall, weighs 200 lb, and has two siblings with type 2 diabetes. 3 A 42-year-old Hispanic American with a history of hypertension and a serum high density lipoprotein (HDL) level of 30 mg/dL (0.78 mmol/L). 1 A 26-year-old African American with a history of gestational diabetes and following a weight reduction diet. 2 A 36-year-old Caucasian with a serum triglyceride level of 310 mg/dL (1.24 mmol/L) and whose mother-in-law has type 1 diabetes. 44. The nurse teaches a client after a Billroth II surgical procedure about dumping syndrome. Which statement indicates that further teaching is necessary? Select all that apply 1. ❏ I can continue to eat whole wheat toast with jam for breakfast every day. 2. ❏ It is important to eat 3 meals a day and increase my calorie intake during each meal. 3. ❏ I shall include foods that contain fats and protein at every meal. 4. ❏ I should lie down or sit in my recliner for 30 to 60 minutes after eating. 5. ❏ I should wait for 1 hour after I eat before drinking fluids. 45.The nurse cares for an infant in the newborn nursery. The nurse notes that the infant is drooling and has excessive amounts of frothy sputum in the mouth. Which action by the nurse is BEST? 1. Place the newborn flat and turned to the right side. 2. Listen for the intensity and frequency of bowel sounds. 3. Check the pH of the oral secretions. 4. Contact the health care provider. 46.The nurse teaches a client how to care for an ileostomy at home. Which statement BEST indicates understanding of the discharge teaching? 1. “I will sit on the edge of the bed each morning before walking to the bathroom.” 2. “I will observe the amount of fluid in the pouch 2 times a day before breakfast and at bedtime.” 3. “I will eat cashew nuts and popcorn during my afternoon snack time.” 4. “I should decrease my fluid intake to a quart a day and restrict my consumption of carbonated beverages.” 47.A nurse cares for a client recently diagnosed with psoriasis. The client receives adalimumab as part of the treatment. What is the BEST action for the nurse to take while caring for the client? 1. The nurse wears gloves while taking the client’ s vital signs. 2. The nurse instructs the client to avoid exposure to sunlight. 3. The nurse teaches the client to avoid exposure to people with colds or the flu. 4. The nurse reassures the client that with continued therapy, the client will be cured. 48. A mother brings her toddler to the clinic. The nurse notes that the child has fluid- filled vesicles, honey colored crusts, and reddened areas around the mouth and axillae. The nurse should include which statements when teaching the mother? Select all that apply 1. ❏ “Your child has developed an irritation because of the pacifier.” 2. ❏ “Your child has an infection that can be treated with an antibiotic cream or oral antibiotic.” 3. ❏ “Wash your hands before and after applying a topical antibiotic.” 4. ❏ “Have you given your child a new food in the last 2 weeks?” 5. ❏ “Your child has been exposed to a sick child and should be isolated for 4 days.” 6. ❏ “Your child can be in contact with other children 24 hours after starting the antibiotic.” 49.The nurse plans preoperative care for a 5-year-old scheduled for a tonsillectomy. What is the MOST important action for the nurse to take? 1. Gather a blood pressure cuff, stethoscope, pulse oximetry monitor, and ice pack for a play session with the child. 2. Show the child a short video about a tonsillectomy, which gives simple directions using cartoon characters. 3. Discourage the parents from allowing the child to tour the perioperative areas. 4. Ask the child’s parents to read a story about a child preparing for surgery. 50.The spouse of an elderly client diagnosed with type 1 diabetes calls the clinic nurse to report that the client experiences trembling and headaches every morning around 09:00. Which statement by the spouse MOST concerns the nurse? 1. “My spouse awakens at 07:00, walks the dog at 09:00, and naps for half an hour at 13:00.” 2. “I give my spouse human lispro insulin at 07:30. Breakfast is at 09:00. and dinner is at 18:00.” 3. “My spouse eats a scrambled egg, toast, and coffee for breakfast, and has a glass of wine before dinner.” 4. “I give my spouse glargine insulin at 21:00. and we go to bed at 22:00. 51. The nurse prepares a client for discharge following a scleral buckle repair of a detached retina. Which statement by the client indicates that the discharge teaching is effective? Select all that apply 1. ❏ “I should avoid jarring movements of my head.” 2. ❏ “My eye may water and itch for several weeks after the surgery.” 3. ❏ “I can resume my usual activities immediately.” 4. ❏ “I will increase my intake of fluids and roughage.” 5. ❏ “I will have to get 40-watt bulbs for my lamps.” 6. ❏ “I am going to wash my hair as soon as I get home.” 52.A 2-year-old is seen in the clinic for treatment of acute otitis media. The nurse teaches the child’s parent how to care for the child at home. What instructions should be included? 1. Apply ice packs to the affected ear 3 times daily. 2. Observe for headache, stiff neck, and increasing temperature. 3. Give the ordered antibiotics until the complaints of ear pain subside. 4. Administer a decongestant medication and aspirin twice daily. 53.The nurse cares for a 4-week-old infant diagnosed with pyloric stenosis. What is the MOST important action the nurse should take immediately after feeding the infant? 1. Position the infant on the right side with the head elevated 45°. 2. Position the infant in the supine position with the head elevated 20°. 3. Position the infant on the abdomen with the head turned to the right side. 4. Position the infant on the left side with the head in the flat position. 54.The nurse instructs a client diagnosed with alcoholic cirrhosis and ascites. Which statement by the client indicates that the teaching is effective? 1. “I need to remember to cough and deep breathe frequently.” 2. “I am going to use freezer meals for lunch and dinner. They are easier for me to prepare.” 3. “It will be necessary for me to restrict my sugar intake from now on.” 4. “I will take no more than 8 ibuprofen tablets a day for my stomach pain.” [Show More]

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