Sale!

Pharmacology for Nurses A Pathophysiologic Approach 4th Edition, Adams Test Bank

$25.99 $12.99

Test Bank For Pharmacology for Nurses A Pathophysiologic Approach 4th Edition, Adams. Note: This is not a text book. Description: ISBN-13: 978-0133026184, ISBN-10: 0133026183.

Category: Tag:

Description

Test Bank Pharmacology Nurses Pathophysiologic Approach 4th Edition, Adams

CHAPTER 1

Question 1

Type: MCMA

The nurse is teaching a pharmacology class to student nurses. What does the nurse include as key events in the history of pharmacology?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Initial drugs included morphine, cocaine, and penicillin.
  2. Early researchers used themselves as test subjects.
  3. The initial intention of pharmacology was to relieve human suffering.
  4. Modern pharmacology began in the early 1600s.
  5. Pharmacologists synthesized drugs in the laboratory in the twentieth century.

Question 2

Type: MCSA

The student nurse asks the nursing instructor why he needs to take anatomy and physiology, as well as microbiology, when he only wants to learn about pharmacology. What is the best response by the instructor?

  1. “Because pharmacology is an outgrowth of those subjects.”
  2. “You must learn all, since those subjects, as well as pharmacology, are part of the curriculum.”
  3. “Knowledge of all those subjects will prepare you to provide the best patient care, including the administration of medications.”
  4. “Because an understanding of those subjects is essential to understanding pharmacology.”

Question 3

Type: MCMA

The nursing instructor is teaching a pharmacology class to student nurses. The current focus is pharmacology and therapeutics. The nursing instructor determines that learning has occurred when the students make which comments?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “Pharmacology is the use of drugs to relieve suffering.”
  2. “Pharmacology is the study of medicines.”
  3. “Therapeutics is the study of the therapeutic use of drugs.”
  4. “Therapeutics is the study of drug interactions.”
  5. “Pharmacology is the study of drugs to prevent disease.”

Question 4

Type: MCSA

The nurse administers a vaccine to a child. What is the best understanding of the nurse as it relates to the manufacture of this vaccine?

  1. The vaccine is produced by natural plant extracts in the laboratory.
  2. The vaccine is naturally produced in animal cells or microorganisms.
  3. The vaccine is produced by a combination of animal and plant products.
  4. The vaccine is most commonly synthesized in a laboratory.

Question 5

Type: MCSA

The elderly client has gastrointestinal bleeding. The client says to the nurse “I don’t understand this. All I did was take ibuprofen (Advil) for my arthritis.” Which plan would be best as it relates to the nurse’s education of this client?

  1. A plan to teach the client to use drugs that bypass the gastrointestinal system, like topical drugs
  2. A plan to teach the client to substitute safer drugs like acetaminophen (Tylenol)
  3. A plan to teach the client to obtain physician approval prior to the use of over-the-counter (OTC) medications
  4. A plan to teach the advantages and disadvantages of ibuprofen (Advil)

Question 6

Type: MCSA

The elderly client has gastrointestinal bleeding. The client says to the nurse “I don’t understand this. All I did was take ibuprofen (Advil) for my arthritis.” Which plan would be best as it relates to the nurse’s education of this client?

  1. A plan to teach the client to use drugs that bypass the gastrointestinal system, like topical drugs.
  2. A plan to teach the client to substitute safer drugs like acetaminophen (Tylenol).
  3. A plan to teach the client to obtain physician approval prior to the use of over-the-counter (OTC) medications.
  4. A plan to teach the advantages and disadvantages of ibuprofen (Advil).

Question 7

Type: MCSA

The pharmaceutical representative comes to the physician’s office and says his company’s pharmaceutical laboratory is marketing a drug that does not need approval by the Food and Drug Administration (FDA). What is the best response by the nurse?

  1. “Any pharmaceutical laboratory in America must have approval from the Food and Drug Administration (FDA) before marketing a drug.”
  2. “Is this an over-the-counter (OTC) drug? They do not need approval by the Food and Drug Administration (FDA).”
  3. “Is your pharmaceutical laboratory private? Only public pharmaceutical laboratories need approval from the Food and Drug Administration (FDA).”
  4. “Your pharmaceutical laboratory must be involved in academic research because they are exempt from approval by the Food and Drug Administration (FDA).”

Question 8

Type: MCSA

The nurse is employed by the Food and Drug Administration (FDA), and is involved in clinical investigation. What is the primary role of the nurse in this phase of the review and approval process by the FDA?

  1. To perform tests on the population-at-large
  2. To perform tests on various species of animals
  3. To perform tests on human cells cultured in the laboratory
  4. To perform tests on human clients

Question 9

Type: MCSA

The student nurse is taking a pharmacology course and studying about the Food and Drug Administration (FDA). What has the student learned about how the FDA has decreased the amount of time involved in bringing a new drug to the market?

  1. The Food and Drug Administration (FDA) is not as strict as it once was with regard to drug approval.
  2. Since consumers have demanded more drugs, the Food and Drug Administration (FDA) has streamlined the review/approval process.
  3. Drug manufacturers are required to pay yearly user fees, which allow the Food and Drug Administration (FDA) to hire more employees to increase its efficiency.
  4. Drug manufacturers are required by the Food and Drug Administration (FDA) to test more drugs on an annual basis.

Question 10

Type: MCSA

The student nurse has completed an initial pharmacology course and tells the nursing instructor that it was difficult and she is glad it is over. What is the best response by the nursing instructor?

  1. “It may be over, but now you must apply what you have learned to patient care.”
  2. “Learning is gradual and continuous; we never completely master all areas of pharmacology.”
  3. “Learning is always painful, but we must continue anyway.”
  4. “It really isn’t over; you should take a graduate course next.”

CHAPTER 2

Question 1

Type: MCSA

The nursing instructor teaches the student nurses about the pharmacological classification of drugs. The instructor evaluates that learning has occurred when the students make which response?

  1. “An anti-anginal treats angina.”
  2. “A calcium channel blocker blocks heart calcium channels.”
  3. “An antihypertensive lowers blood pressure.”
  4. “An anticoagulant influences blood clotting.”

Question 2

Type: MCSA

The nurse is providing medication education to a client with hypertension. The nurse teaches the client that the physician ordered a diuretic to decrease the amount of fluid in his body. Which statement best describes the nurse’s instruction?

  1. The nurse provided appropriate medication education.
  2. The nurse explained the drug’s mechanism of action.
  3. The nurse taught the client about a prototype drug.
  4. The nurse explained the consequences of not using the drug.

Question 3

Type: MCSA

During pharmacology class, the student nurse asks the nursing instructor how students will ever learn about the individual antibiotic drugs since there are so many. What is the best response by the nursing instructor?

  1. “You will learn a little trick called mnemonics.”
  2. “You will learn how to do a flow chart to enhance memory.”
  3. “You will learn how to categorize the individual drugs.”
  4. “You will learn a representative drug from each class.”

Question 4

Type: MCSA

The physician ordered a brand name drug for the client, paroxetine (Paxil). After taking this medication for a year, the client tells the nurse that it is no longer working. What is the best assessment of the nurse at this time?

  1. “This sounds like your medication needs changing.”
  2. “Let’s look for interactions with other medications you are taking.”
  3. “Are you taking Paxil or paroxetine?”
  4. “It is time for us to do the Beck Depression assessment again.”

Question 5

Type: MCSA

The physician has prescribed a brand name drug for the client. The client tells the nurse that the medication is too expensive. What is the best plan by the nurse?

  1. Help the client receive free medicine through a “patient assistance” program.
  2. Ask the physician if a cheaper brand name drug may be substituted.
  3. Ask the physician if a generic drug may be substituted.
  4. Maintain the client on samples of the brand name drug from the physician’s office.

Question 6

Type: MCMA

The nurse is teaching a medication class for parents of children with attention-deficit hyperactivity disorder who are receiving stimulant medications. The nurse has reviewed reasons why the medications are restricted. The nurse determines that learning has occurred when the parents make which response(s)?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “The use of these medications is restricted so that the pharmacies can track the rate of drug abuse in our city.”
  2. “The use of these medications is restricted because the physician needs to evaluate our child more often.”
  3. “The use of these medications is restricted because they have the potential for abuse.”
  4. “The use of these medications is restricted so that the drug companies can make a bigger profit.”
  5. “The use of these medications is restricted because this is the current law.”

Question 7

Type: MCSA

The client says to the nurse, “My doctor said my drug is a controlled substance; am I considered an addict?” What is the best response by the nurse?

  1. “Are you concerned about becoming an addict? We can discuss this in more detail it you would like to.”
  2. “You are not an addict; the Drug Enforcement Administration (DEA) restricts the use of drugs with a high potential for abuse.”
  3. “Why do you ask about becoming an addict? Not many of our clients have asked this question.”
  4. “You are not an addict, but the Drug Enforcement Administration (DEA) will monitor you for this.”

Question 8

Type: MCSA

The client is receiving methadone (Dolophine), a Schedule II drug. The client says to the nurse, “A pharmacist told me his pharmacy must register with the Drug Enforcement Administration (DEA) to give me this drug; will DEA agents be snooping around my house?” What is the best response by the nurse?

  1. “It is probably unlikely that Drug Enforcement Administration (DEA) agents will be bothering you.”
  2. “No, the Drug Enforcement Administration (DEA) restricts drugs that have a high potential for abuse.”
  3. “No. I think our system should be more like Europe; they have fewer controlled drugs.”
  4. “That’s an interesting question. Are you worried about the Drug Enforcement Administration (DEA)?”

Question 9

Type: MCSA

During the admission assessment, the client tells the nurse “Sure I smoke a little weed (marijuana) to manage my stress. Doesn’t everyone?” What is the best assessment question for the nurse to ask?

  1. “What other ways do you think you might use to help you to manage your stress?”
  2. “That is a Schedule I drug; aren’t you afraid of going to jail for a long time?”
  3. “Do you really believe that everyone smokes marijuana to manage stress?”
  4. “How often do you smoke marijuana, and how much each time?”

Question 10

Type: MCSA

The mother of an adolescent receiving methylphenidate (Concerta) for attention-deficit hyperactivity disorder tells the nurse that her son is better and asks why she can’t just get refills on the prescription. What is the best response by the nurse?

  1. “Just drop by and I will get a prescription for you without seeing your son.”
  2. “We can’t do that; maybe you can find another doctor’s office that will do it.”
  3. “The law does not allow us to give you refills on this medication.”
  4. “The medication can be addictive so your son needs a monthly medical evaluation.”

CHAPTER 3

Question 1

Type: MCMA

The physician has ordered several medications for the patient. What does the nurse recognize as responsibilities regarding administration of medications?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Knowing whether or not the medication is on the hospital formulary
  2. Knowing the reason the medication was prescribed for this patient
  3. Knowing how the medication is to be administered.
  4. Knowing how the medication is supplied by the pharmacy
  5. Knowing the name of the medication

Question 2

Type: MCMA

The nurse is preparing medications prior to administration. To promote patient safety, the nurse uses “rights” of drug administration. What do these “rights” include?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. The right medication
  2. The right time of delivery
  3. The right dose
  4. The right route of administration
  5. The right patient

Question 3

Type: MCSA

The nurse suspects that the patient has not been taking his prescribed antihypertensive medication because the patient’s blood pressure remains elevated. What is the best therapeutic question the nurse can ask that will assess noncompliance?

  1. “Taking medication is difficult for many people. What are some of your concerns about the medication?”
  2. “Your blood pressure is really high; do you realize the serious consequences of not taking your medication?”
  3. “I really doubt that you are taking your medication. What would you think about talking to the doctor?”
  4. “You are one of my favorite patients and I want you to be safe. Are you really taking your medication?”

Question 4

Type: MCSA

The patient is having chest pain. The physician orders sublingual nitroglycerine STAT. The nurse obtains the medication from the pharmacy and administers it to the patient 30 minutes later. Which statement best describes the nurse’s action?

  1. The medication should have been administered immediately.
  2. The physician should have specified the time frame for the medication.
  3. The medication should have been administered within a 5-minute time frame.
  4. The nursing action was correct because the medication was not on the unit.

Question 5

Type: MCSA

The nurse uses the nursing process prior to administering any medications. Which step will assure the best patient safety?

  1. Assess the patient’s developmental level.
  2. Assess the patient’s medical history.
  3. Assess the patient’s disease process.
  4. Assess the patient’s learning needs.

Question 6

Type: MCSA

The physician prescribes an oral medication for the patient. What is the primary nursing assessment of the patient prior to receiving this medication?

  1. The patient’s understanding of the medication
  2. The patient’s ability to swallow
  3. The patient’s allergies
  4. The patient’s eyesight

Question 7

Type: MCSA

The physician ordered an oral medication. The nurse incorrectly administered the medication intravenously. What does the best analysis of the nurse’s action reveal?

  1. An antidote cannot be given.
  2. The nurse will be terminated from her job.
  3. The medication cannot be retrieved.
  4. A lawsuit by the patient will be impending.

Question 8

Type: MCSA

What is the best plan as the nurse prepares to administer a topical medication?

  1. Check the medication for interactions with other medications.
  2. Take the patient’s vital signs.
  3. Educate the patient to not disturb the patch.
  4. Assess the patient’s skin where the medication will be applied.

Question 9

Type: MCSA

The physician ordered an intravenous medication for a patient with nausea. The patient asks the nurse how it will help his nausea. What is the best response by the nurse?

  1. “We have more intravenous drugs for nausea than we do oral drugs.”
  2. “If you take an oral medication, you will just vomit it up.”
  3. “This will work much faster for your nausea.”
  4. “You can’t have anything by mouth, so will receive the medication intravenously.”

Question 10

Type: MCSA

The physician orders enteric-coated aspirin, 300 mg every day, for the patient with a nasogastric tube. What is the priority action by the nurse?

  1. Crush the tablet, dissolve it in 30 mL of water, and administer through the tube.
  2. Put the tablet in the tube, “milk” it down the tube, and then flush the tube with 60 mL of water.
  3. Withhold the medication and contact the physician.
  4. Substitute plain aspirin, dissolve it in 30 mL of water, and administer through the tube.

CHAPTER 4

Question 1

Type: MCSA

The nurse is conducting medication education for patients with hypertension. The focus of the education is on enhancing the absorption of their medications. The nurse determines that learning has occurred when the patients make which statement?

  1. “We can safely take the drug for at least 6 months beyond the expiration date.”
  2. “We don’t need to worry about storage of the drug, it won’t lose potency.”
  3. “We should not take our medications with milk or dairy products.”
  4. “We need to be careful about taking the medication with certain foods.”

Question 2

Type: MCSA

The physician ordered a loading dose of medication for the patient; it is to be followed by a lower dose. When the patient receives the lower dose, she says to the nurse, “I think my doctor made a mistake; my medication dose is too low.” What is the best response by the nurse?

  1. “The initial dose shortened the half-life, so the medication would work more quickly.”
  2. “We always give medications this way; the doctor did not make a mistake.”
  3. “You had a larger dose initially so that the medication would work more quickly.”
  4. “Giving a larger dose initially will reduce the chance of side effects.”

Question 3

Type: MCSA

The patient has meningitis. The physician initially prescribed a water-soluble drug. Another physician changed the order to a lipid-soluble drug. The patient is confused about this. Which plan best resolves the patient’s concern?

  1. Teach the patient that lipid-soluble drugs are better because of protein binding.
  2. Teach the patient that lipid-soluble drugs are more effective in treating his illness.
  3. Teach the patient that lipid-soluble drugs are better because they have fewer side effects.
  4. Teach the patient that lipid-soluble drugs are more effective because they are excreted at a slower rate.

Question 4

Type: MCSA

The patient is malnourished and has a low serum albumin. The physician has ordered aspirin, a highly protein-bound drug, for the patient. Which evaluation by the nurse best describes the effect this will have on the patient?

  1. The patient will be at risk to experience a decreased effectiveness of the drug.
  2. The patient will be at risk to experience toxic effects of the drug.
  3. The patient’s kidneys will excrete the drug at a faster rate.
  4. The patient’s serum globulin is more important than serum albumin.

Question 5

Type: MCSA

The patient is admitted to the hospital in chronic renal failure, and is on several medications. What best describes the nurse’s assessment of this patient?

  1. The patient’s liver may compensate for renal failure; the drugs may be effective.
  2. The patient may have drug toxicity from all the drugs.
  3. The patient may have drug toxicity only if the drugs are excreted by the kidneys.
  4. The patient may have decreased effectiveness of the drugs.

Question 6

Type: MCSA

The patient comes to the emergency department following an overdose of aspirin, an acidic drug. What will the best plan of the nurse include?

  1. Administration of intravenous fluids to flush the kidneys
  2. Administration of ammonium chloride to the patient
  3. Administration of sodium bicarbonate to the patient
  4. Administration of intravenous proteins to bind the aspirin

Question 7

Type: MCSA

The patient is complaining of a severe headache. The physician orders aspirin. Which action by the nurse will result in the fastest relief of the patient’s headache?

  1. Administer the aspirin with an alkaline food, like cottage cheese.
  2. Administer the aspirin in an enteric-coated formulation.
  3. Administer the aspirin with a high-fat food, like peanut butter.
  4. Administer the aspirin on an empty stomach.

Question 8

Type: MCSA

The patient is receiving lithium (Eskalith) and asks the nurse why he has to have blood drawn so often. What is the best response by the nurse?

  1. “To detect side effects before they become a problem.”
  2. “To be sure the medication is working properly.”
  3. “To determine if your body is responding as it should.”
  4. “To be sure you have the correct amount of medication in your system.”

Question 9

Type: MCSA

The nursing mother asks the nurse if it is all right to take St. John’s wort for mild depression. What is the best response by the nurse?

  1. “No, it will probably cause your baby to have more allergies.”
  2. “No, because it might decrease the amount of milk you produce.”
  3. “No, it could be excreted in your milk and affect the baby.”
  4. “No, it will affect the taste of your milk, and your baby might reject nursing.”

Question 10

Type: MCMA

The nursing instructor is teaching pharmacology to student nurses. What will the nursing instructor include as the four major components of pharmacokinetics?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. How drugs move from the site of administration to circulating fluids
  2. How drugs are converted to a form that is easily removed from the body
  3. How drugs change body illnesses and pathogens
  4. How drugs are transported throughout the body
  5. How drugs are removed from the body

CHAPTER 5

Question 1

Type: MCSA

A patient looks up the drug he is taking in a drug guide. The patient asks the nurse why the physician prescribed a medication that has a lethal dose measure. What is the best response by the nurse?

  1. “It just refers to what is done in research; it is not used by doctors prescribing drugs.”
  2. “It is a value determined during research, which helps to determine the safe dose to give.”
  3. “All that means is that the drug could be lethal, but I will watch you for side effects.”
  4. “Don’t worry about that, I’ll have your doctor explain it to you.”

Question 2

Type: MCSA

Prior to administering medications, the student nurse reviews the therapeutic index. Which statement best describes the student’s understanding of therapeutic index?

  1. The student is able to determine if the physician prescribed the best drug for the patient.
  2. The student is able to determine if the patients are receiving safe doses of the medications.
  3. The student is able to identify interactions among the drugs each patient is receiving.
  4. The student is able to identify the patients who will need to have serum blood levels monitored.

Question 3

Type: MCSA

The nursing instructor prepares to teach student nurses about how mean effective doses of medications are related to clinical practice. As a result of the instruction, what is the best understanding of the student nurses?

  1. About 50% of patients will experience severe side effects from the drug.
  2. Some patients will respond differently depending on their ethnic background.
  3. About 50% of patients will not experience any effect from the drug.
  4. Some patients will require more or less than the average dose of the drug.

Question 4

Type: MCSA

The patient receives antibiotics for a serious infection. The patient asks the nurse, “Why don’t you just give me more of that drug to cure this infection faster?” What is the best response by the nurse?

  1. “I will check with the doctor to see if it is time to increase the medication.”
  2. “You are at a maximum dose; taking more will cause interactions with other medications.”
  3. “You must stay on this drug for 2 more weeks before it can be increased.”
  4. “You are at a maximum dose; taking more will not help.”

Question 5

Type: MCSA

The nurse administers narcotics to surgical patients. Which statement represents the nurse’s best understanding as it relates to the potency of different narcotics?

  1. Codeine is less potent than morphine; it will not produce an allergic reaction.
  2. Morphine is more potent than codeine; a lesser dose will be required.
  3. Morphine is more potent than codeine; it will produce more adverse effects.
  4. Codeine is less potent than morphine; it will not relieve pain as well.

Question 6

Type: MCSA

The nurse is conducting medication education about the difference between potency and efficacy to a group of patients. The nurse correctly determines that learning has occurred when the patients makes which response?

  1. “The best drug for us is the one with the highest potency.”
  2. “The best drug for us is the one with the greatest efficacy.”
  3. “Drugs with the greatest efficacy will produce the least side effects.”
  4. “Low potency drugs have efficacy and do not produce side effects.”

Question 7

Type: MCMA

The patient has had hypertension for many years. The physician orders an antihypertensive drug that has just come on the market. The nurse teaches the patient that this drug works more effectively than his prior drug, and has fewer side effects. The patient asks how this can be. What is the best response by the nurse?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “Newer drugs are altered to affect your cells’ receptors in a different way.”
  2. “Receptors tend to ‘burn-out,’ so newer drugs are required.”
  3. “Research into receptors helps ‘fine-tune’ drugs to be more effective.”
  4. “Changing the response of the drug to protein receptor-complexes produces fewer side effects.”
  5. “It is a process of trial and error with receptors until the new drug proves effective.”

Question 8

Type: MCSA

The nurse plans to teach a group of patients about how their medications work in their bodies. If education has been successful, what will be the best understanding of the patients?

  1. Medications change the function of the cells in the body.
  2. Medications help the body produce new enzymes.
  3. Medications change how body tissues function.
  4. Medications work by enhancing or blocking normal body functioning.

Question 9

Type: MCSA

The patient and his wife receive the same medication for hypertension. The patient’s wife asks the nurse why she is receiving a higher amount of the medication. What is the best response by the nurse?

  1. “Females have a higher metabolism, so you need more medication.”
  2. “Everyone is unique and responds differently to medications.”
  3. “Your hormones are different from your husband’s, so you need more medication.”
  4. “You have a greater percentage of body fat, so more medication is needed.”

Question 10

Type: MCSA

The student nurse has been reading about the Human Genome Project and asks the nursing instructor how this will impact future pharmacological therapies. What is the best response by the instructor?

  1. “We will be able to alter genes so we will not need drugs.”
  2. “We will be able to standardize drug doses to make prescribing easier.”
  3. “It will help prevent disease through gene manipulation, but will not impact drugs.”
  4. “It will help to individualize drug therapy for people in a more effective way.”

CHAPTER 6

Question 1

Type: MCSA

The nurse follows the nursing process when conducting medication education about insulin. The step of evaluation is best demonstrated by which question?

  1. “Is your abdomen the best place to inject insulin?”
  2. “What questions do you have about insulin?”
  3. “Can you recognize when you are experiencing hypoglycemia?”
  4. “Can you tell me four points you remember about how to take your insulin?”

Question 2

Type: MCMA

The nurse assesses the patient with diabetes mellitus prior to administering medications. Which questions are important to ask the patient?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “Are you allergic to any medications?”
  2. “Are you taking any herbal or over-the-counter medications?”
  3. “How difficult is it for you to maintain your ideal body weight?”
  4. “Will you please tell me about the kind of diet you follow?”
  5. “What other medications are you currently taking?”

Question 3

Type: MCSA

The physician has prescribed a nitroglycerine (Nitrodur) patch for the patient. What is the best outcome for this patient as it relates to use of the medication?

  1. Patient will be able to identify the expiration date of the medication prior to discharge.
  2. Patient will verbalize three side effects of the medication prior to discharge.
  3. Patient will state the reason for receiving the medication prior to discharge.
  4. Patient will demonstrate correct application of the patch prior to discharge.

Question 4

Type: MCSA

The patient is receiving albuterol (Proventil) for treatment of bronchospasm related to asthma. What is the initial nursing intervention as it relates to this medication?

  1. Monitor the patient for relief of bronchospasms.
  2. Monitor the patient for nausea and headache.
  3. Monitor the patient’s serum drug levels.
  4. Provide the patient with age-appropriate education about albuterol (Proventil).

Question 5

Type: MCSA

The patient is receiving an oral antibiotic as treatment for cellulitis of the lower extremity. The patient’s outcome is “Patient will state a key point about antibiotic treatment for cellulitis.” Which statement by the patient provides the best evaluation by the nurse at this time?

  1. “If the pain gets too bad, I can take my prescribed pain medication.”
  2. “If the swelling continues, I can apply an ice pack.”
  3. “I need to take all the pills even if my leg looks better.”
  4. “I must keep my leg elevated until the swelling goes down.”

Question 6

Type: MCMA

The physician has prescribed quetiapine (Seroquel) for the patient with chronic auditory hallucinations. The patient has stopped taking the medication. The nurse incorrectly uses the diagnosis of “noncompliance.” What is essential for the nurse to assess prior to using this nursing diagnosis?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Do cultural or religious issues have an impact on taking the medication?
  2. Has the patient made an informed decision not to take the medication?
  3. Is the noncompliance related to a lack of finances?
  4. Did the patient understand why the medication had been prescribed?
  5. Are side effects causing the patient to refuse the medication?

Question 7

Type: MCSA

The nurse is preparing for medication administration to a group of patients. What is the best overall outcome for the patients?

  1. Patients will take the medications after receiving medication instruction.
  2. Patients will receive the best therapeutic outcome from the medications.
  3. Patients will state the reason they are receiving the medications.
  4. Patients will experience minimal side effects after taking the medications.

Question 8

Type: MCSA

The nurse is managing care for several patients at a diabetic treatment center. What is the primary intervention for the nurse?

  1. To administer the correct medicine to the correct patient at the correct dose and the correct time via the correct route
  2. To return the patient to an optimum level of wellness while limiting adverse effects related to the patient’s medical diagnosis
  3. To include any cultural or ethnic preferences in the administration of the medication
  4. To answer any questions the patient may have about the medicine, or any possible side effect of the medication

 

Question 9

Type: MCSA

What is the most significant role for nurses as defined by state nurse practice acts and by regulating bodies such as The Joint Commission (TJC)?

  1. Planning care
  2. Teaching
  3. Assessment
  4. Evaluating care

Question 10

Type: MCSA

The Joint Commission (TJC) documented that patient education was deficient on several medical-surgical units of a local hospital. A nursing committee was formed to address this problem and focused on what likely nursing intervention?

  1. Providing educational pamphlets about medications to the patients.
  2. Asking the physicians to provide medication education to the patients.
  3. Discussing medications each time they are administered to patients.
  4. Requesting more frequent pharmacy consults for the patients.

CHAPTER 7

Question 1

Type: MCMA

The nursing instructor teaches the student nurses about how medication errors can occur. What information will the nursing instructor include in the presentation?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. The nurse miscalculates the medication dose.
  2. The nurse does not check the patient’s identification band.
  3. The nurse does not validate an order with the physician.
  4. The nurse misinterprets a physician’s order.
  5. The nurse administers the incorrect drug.

Question 2

Type: MCSA

The nurse recognizes that agency system checks are in place to decrease medication errors. Who commonly collaborates with the nurse on checking the accuracy of the medication prior to administration?

  1. The nursing supervisor
  2. The nursing unit manager
  3. The pharmacist
  4. The physician

Question 3

Type: MCSA

The nurse makes a medication error and a patient dies. In court, the attorney for the family of the deceased patient asks the nurse if she followed standards of care in administering the medication. How would the attorney phrase this question?

  1. “Did you follow agency guidelines as in previous circumstances?”
  2. “Did you follow the physician’s orders and double-check them before administration?”
  3. “Did you do the three checks and follow the five rights as taught in school?”
  4. “Did you do what another nurse would have done under similar circumstances?”

Question 4

Type: MCSA

The nurse manager plans to teach the graduate nurse the reason why the nursing unit has policies and procedures. What best describes the reason for policies and procedures?

  1. The policies and procedures establish standards of care for the institution.
  2. The policies and procedures indicate how nursing personnel are to perform skills.
  3. The policies and procedures establish how the health care facility is to be run.
  4. The policies and procedures indicate the steps that must be taken when a medication error occurs.

Question 5

Type: MCSA

The nurse in the emergency department administers an adult dose of an antibiotic to a 3-month-old baby. As a result, the baby suffers permanent brain damage. What best describes the effect of this error on the health care facility?

  1. The professional license of the nurse will be lost.
  2. The morale of the staff involved will be depleted.
  3. The reputation of the health care facility will suffer.
  4. The health care facility will pay a very large settlement.

Question 6

Type: MCSA

The nurse administers an evening medication to the patient in the morning. The medication did go to the correct patient. What is the nurse’s best course of action at this time?

  1. Change the medication administration time to the morning.
  2. Notify the physician about the error and complete an incident report.
  3. Tell the evening nurse to hold the evening dose just for tonight.
  4. Notify the physician and ask if any further action needs to be taken.

Question 7

Type: MCSA

The nurse is preparing medications for a group of patients. Another nurse begins telling the nurse about her recent engagement. What is the best action by the first nurse?

  1. Ask the second nurse to help with administering medications so they can have more time to talk.
  2. Continue to prepare the medications for administration and pretend to listen to the first nurse.
  3. Stop preparing medications until the first nurse has finished talking about her engagement.
  4. Tell the second nurse that the conversation is distracting and must cease while medications are being prepared.

Question 8

Type: MCSA

The nurse was very busy and unfamiliar with a new medication, but administered it anyway. Later the nurse looked up the medication. How does the nurse manager evaluate this behavior?

  1. This was acceptable as long as the nurse looked up the action and side effects of the drug later.
  2. An error could have occurred because the nurse was unfamiliar with the medication.
  3. The nurse manager was partially at fault because the nursing unit was understaffed and the nurse was too busy.
  4. An error did occur because the nurse could have administered the medication via the incorrect route.

Question 9

Type: MCSA

The nurse commits a medication error. The nurse documents the error in the patient’s record and completes the incident report. What does the nurse recognize as the primary reason for doing this?

  1. To verify that the patient’s safety was protected
  2. To protect the patient from further harm
  3. To protect the health care facility from litigation
  4. To protect the nurse from liability

Question 10

Type: MCMA

The nurse is working very hard to prevent medication errors. What plan(s) will assist the nurse in preventing most errors?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Plan to always check the patient’s identification band prior to administration of medications.
  2. Plan to open all of the medications immediately prior to administration.
  3. Plan to tell physicians that verbal orders will not be accepted.
  4. Plan to record the medication on the medication administration record (MAR) immediately prior to administration.
  5. Plan to validate all orders with another nurse prior to administration of medications.

CHAPTER 8

Question 1

Type: MCSA

The nurse teaches a class about medication used during pregnancy to pregnant women. The nurse determines that additional instruction is required when a patient makes which response?

  1. “The baby can only be harmed by medications during the first trimester.”
  2. “It is important to not take over-the-counter (OTC) drugs during my pregnancy.”
  3. “Exposure to teratogens can result in my baby’s death or in malformations.”
  4. “If I breastfeed my baby, drugs can come through my breast milk.”

Question 2

Type: MCSA

The pregnant patient plans to breastfeed her baby. She asks the nurse about the use of herbal products during breastfeeding. What is the best response by the nurse?

  1. “Be sure to check the label to see if the herbal product could be used during breastfeeding.”
  2. “Most drugs can be transferred to the infant during breastfeeding, so this is not recommended.”
  3. “Herbal products are considered natural, so it should be fine to use them during breastfeeding .”
  4. “This should be fine, as long as there is at least 12 hours between the time you use the product and when you breastfeed.”

Question 3

Type: MCMA

The nurse plans to teach a safety class to parents of toddlers about household exposure to medications. What will the best plan of the nurse include?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Keep the toddler awake and observe for side effects of the medication.
  2. Keep all medications locked up and stored out of reach of the toddler.
  3. Use syrup of ipecac immediately if the toddler has ingested medication.
  4. Call the Poison Control Center for guidance with any medication ingested.
  5. Teach the toddler that medications are for adult use only.

Question 4

Type: MCMA

The nursing instructor teaches student nurses about the Food and Drug Administration (FDA) Pregnancy Categories. What is the best information to include?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Food and Drug Administration (FDA) Pregnancy Category C is safe to use during pregnancy.
  2. Food and Drug Administration (FDA) Pregnancy categories provide a framework for safe use of drugs in pregnant women.
  3. Food and Drug Administration (FDA) Pregnancy categories for individual drugs seldom change once they are established.
  4. Food and Drug Administration (FDA) Pregnancy categories are based on studies using clinical human research trials.
  5. Food and Drug Administration (FDA) Pregnancy Category X has been associated with teratogenic effects.

Question 5

Type: MCSA

The nurse plans to administer medication to the preschool child. Which approach indicates the nurse has an understanding of growth and development?

  1. The child is often more cooperative if the parent is not in the room.
  2. The child does better with verbal instruction than with play instruction.
  3. There should be no need to restrain a child of this age.
  4. Use a brief rationale, followed by quick administration of the medication.

Question 6

Type: MCSA

The nurse will administer medication to a school-age child. What is the preferred action by the nurse?

  1. Teach the child the action and expected side effects of the medication.
  2. Tell the child he will not be allowed to go to recess if the medication is not taken.
  3. Offer the child a choice of beverage with which to take the medication.
  4. Offer to play with the child prior to medication administration.

Question 7

Type: MCSA

An adolescent patient comes to the school nurse with complaints of vague abdominal pain. What assessment data would help to confirm the nurse’s suspicion that the adolescent has body image concerns?

  1. The adolescent says, “Everyone makes a big deal about what I eat, so don’t ask.”
  2. The adolescent tells the nurse, “I have been sexually active with my boyfriend.”
  3. The adolescent reports, “My periods are irregular. Should I see a doctor?”
  4. The adolescent tells the nurse, “I just can’t seem to get along with my parents.”

Question 8

Type: MCSA

The nurse provides care for elders in an assisted living facility. What does the nurse assess as a primary contributing factor for medication complications in the elderly?

  1. The elderly often abuse alcohol.
  2. The elderly are frequently dehydrated.
  3. The elderly are frequently constipated.
  4. The elderly have decreased stomach acid.

Question 9

Type: MCSA

The pregnant patient tells the nurse that her prescribed medication is not as effective as it was before her pregnancy. What is the best response by the nurse?

  1. “This is because your blood volume has increased.”
  2. “Tell me how you have been taking your medication.”
  3. “This is because your baby is receiving part of the medication.”
  4. “Maybe the medication has expired; check the label.”

Question 10

Type: MCSA

The toddler refuses to take his oral medication. What is the best suggestion to the mother from the nurse for ensuring the toddler receives his medication?

  1. “Tell him you will buy him a toy if he takes the medication.”
  2. “Crush the tablet and mix it with a small amount of jam.”
  3. “Crush the tablet and mix it with milk.”
  4. “Tell him he will be punished if he does not take the medicine.”

CHAPTER 9

Question 1

Type: MCMA

The nurse is doing a holistic assessment on a patient prior to the initiation of antihypertensive medication. What will the best assessment include?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Blood pressure
  2. The cause of the hypertension
  3. Mood
  4. Level of education
  5. Belief in a higher power

Question 2

Type: MCSA

The adolescent Hispanic male has been diagnosed with attention-deficit hyperactivity disorder (ADHD), and is taking methylphenidate (Ritalin). Even though the drug helps with focus and grades, the adolescent will not go to the school office at noon for his medication. Which statement best describes the result of the nurse’s evaluation?

  1. The adolescent has developed alternative coping mechanisms to increase his focus during classes.
  2. The adolescent is fearful that this drug may be a “gateway drug” and he will abuse other substances.
  3. The adolescent really does not need an additional dose of methylphenidate (Ritalin) at school.
  4. The adolescent is embarrassed about having to take medicine at school; it is a social stigma.

Question 3

Type: MCSA

The patient is from an Arab culture and is in labor and delivery. Her husband insists he must stay with her, and will not allow her to receive any analgesia during the experience. What is the best action by the nurse?

  1. Inform the husband that it is his wife’s choice whether or not to receive analgesia.
  2. Inform the husband that he must sign a release of responsibility to avoid future litigation against the hospital.
  3. Allow the request, but inform the husband that the physician will make the final decision about analgesia.
  4. Allow this request, and be available in the event the request changes.

Question 4

Type: MCSA

A patient is diagnosed with cancer. The physician has recommended chemotherapy, which would likely save the patient’s life. The patient tells the nurse, “This is punishment from God for sins I have committed; some women at my church say so.” What will the best plan of the nurse include?

  1. With the patient’s permission, plan to involve a hospital minister to discuss the patient’s perspective about cancer.
  2. With the patient’s permission, plan to bring the case before the hospital’s board of ethics.
  3. With the patient’s permission, plan to contact the patient’s minister to discuss the patient’s perspective about cancer.
  4. With the patient’s permission, plan to meet with family members to discuss the patient’s perspective about cancer.

Question 5

Type: MCSA

The African American patient has panic attacks, is suicidal, and is on an inpatient psychiatric unit. The psychiatrist orders sertraline (Zoloft) and clonazepam (Klonopin). The patient refuses the drugs; he requests to have herbs and African objects in his room to “remove the curse.” What is the priority action by the nurse?

  1. Allow the request without seeking further information from the patient.
  2. Allow the request as long as the herbs and objects do not pose a safety risk for the patient or other patients.
  3. Allow the request after the patient signs a release of responsibility to avoid litigation.
  4. Allow the request after all members of the treatment team agree to it.

Question 6

Type: MCSA

The public health nurse notices that several patients in the hypertension clinic have poorly controlled hypertension, even though they have been prescribed appropriate antihypertensive drugs. Which question will best enable the nurse to assess these patients?

  1. “Does your religion allow the use of high blood pressure medication?”
  2. “Do you think your high blood pressure is a problem?”
  3. “Can you afford the high blood pressure medication?”
  4. “Does your culture use herbs to treat high blood pressure?”

Question 7

Type: MCSA

The nurse is providing group education about warfarin (Coumadin) to minority patients who have experienced strokes (brain attacks). The nurse determines that learning has occurred when the patients make which statement?

  1. “We may need to have more frequent blood tests.”
  2. “We may need to have less frequent blood tests.”
  3. “We may need more medication than other ethnic groups.”
  4. “We may need less medication than other ethnic groups.”

Question 8

Type: MCMA

The nurse is conducting a holistic assessment of a patient with alcoholism. What are the important questions to ask?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “How is drinking alcohol viewed by your culture?”
  2. “Have you ever attended Alcoholic Anonymous meetings?”
  3. “Did you see your parents drinking alcohol when you were growing up?”
  4. “Have you been in alcohol rehabilitation before now?”
  5. “What blood relatives of yours are addicted to alcohol?”

Question 9

Type: MCSA

The patient is an American Indian admitted to the hospital for chemotherapy. At any given time, five family members are in the patient’s room, which is private. The nurse tells the patient that according to hospital policy; only two visitors at a time are allowed. What does the best analysis by the nurse manager reveal about the nurse’s action?

  1. The nurse should have assessed the patient’s preferences about how many family members she wanted to be present.
  2. The nurse should have called the physician and obtained an order for additional family members to be present.
  3. This was the correct action; the nurse was following protocol by informing the patient about hospital policy.
  4. The nurse should have allowed the patient to have as many family members as she wanted to be present.

Question 10

Type: MCSA

The physician has prescribed a chemotherapeutic drug for the patient with cancer. This drug commonly causes loss of hair. The patient asks the nurse, “Will all of my hair fall out?” What is the most therapeutic response by the nurse?

  1. “We are not really sure; applying an ice bag to your head may help.”
  2. “Don’t worry, we can recommend an excellent wig company if need be.”
  3. “Yes, that is one of the expected side effects of this medication.”
  4. “It might. Have you discussed this with your physician?”

CHAPTER 10

Question 1

Type: MCSA

The patient confides in the nurse that she is drawn to complementary and alternative medicine because it promotes the “whole person.” The patient would like spirituality and prayer included in her plan of care. What is the best response by the nurse?

  1. “We will include spirituality in your plan. Would you like to say a prayer?”
  2. “I think your spiritual concerns are best left up to you and your minister.”
  3. “What exactly do you mean by spirituality and prayer?”
  4. “We usually do not pray with patients; is there something you are worried about?”

Question 2

Type: MCSA

The nurse plans to teach patients about the difference between herbal preparations and prescription medications. Which statement describes the best plan by the nurse?

  1. “Herbs, like prescription drugs, usually only contain one active ingredient.”
  2. “The active ingredients in an herb, unlike prescription drugs, may be present in just one part or many parts.”
  3. “Most herbs, like prescription drugs, are standardized and regulated by the Food and Drug Administration (FDA).”
  4. “Herbs are considered to be safer than prescription medications as they are natural.”

Question 3

Type: MCMA

The patient tells the nurse that she plans to take St. John’s wort to treat her depression. What is the best response by the nurse?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “That should be fine as long as you are not suicidal.”
  2. “St. John’s wort is successfully used in Europe for minor depression.”
  3. “It would be a good idea to try this before paying for a prescription medication.”
  4. “It would be better to have a psychiatric assessment first.”
  5. “Herbal preparations can interact with many other medications.”

Question 4

Type: MCSA

The patient tells the nurse that he has been taking herbal preparations to boost his immune system functioning. He does not know the names of the preparations. What is the best assessment question for the nurse to ask?

  1. “Would you please tell your doctor about the herbs during the next visit?”
  2. “Would you please ask your wife to discuss this with me during her next visit?”
  3. “Would you please have your wife bring the bottles to the hospital?”
  4. “Would you please ask your wife to call the hospital pharmacist with the names?”

Question 5

Type: MCSA

The nurse is teaching a class on dietary supplements. The nurse determines that learning has occurred when the patients make which statement?

  1. “Products can make claims based on body structure and function like ‘promotes healthy urinary tract.’”
  2. “Dietary supplements must go through rigorous testing prior to being marketed by the manufacturer.”
  3. “The Food and Drug Administration (FDA) is not involved with the approval of the dietary supplement and cannot remove it from the market.”
  4. “The manufacturer of the dietary supplement has the burden of proof for the safety of the supplement.”

Question 6

Type: MCSA

The patient uses Ginkgo biloba to enhance memory functioning, but has not told the nurse about this herb. The physician orders warfarin (Coumadin) for the patient. What will the best assessment of the nurse include?

  1. Headache, dizziness, sweating, and agitation
  2. A blood glucose of 56
  3. An international normalized ratio (INR) of 3.0
  4. Petechiae and bleeding from the gums

Question 7

Type: MCMA

Which patient would be most likely to seek complementary and alternative therapies as a treatment modality?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. A 48-year-old male who wants to boost his immune system
  2. A 22-year-old male athlete who is preparing for the Olympics
  3. A 50-year-old female going through menopause
  4. A 58-year-old male with prostate problems
  5. A 28-year-old female who is healthy

Question 8

Type: MCSA

Patients at a senior citizen center have asked the nurse to do a presentation on herbal preparations. Which statement would be included in the best plan by the nurse?

  1. “Herbal preparations are safe as long as you carefully read the label.”
  2. “As long as the herbal preparation has been tested in the clinical setting, it is safe.”
  3. “Herbal preparations actually are drugs; you must be careful with them.”
  4. “Herbal preparations can be dangerous if you are allergic to them.”

Question 9

Type: MCSA

The older adult asks the nurse how dietary supplements will help support health. What is the best response by the nurse?

  1. “Fish oil will help to enhance your brain function.”
  2. “Chromium will help you achieve and maintain optimum weight.”
  3. “Dietary supplements will help support and maintain hydration.”
  4. “Soy isoflavone will help prevent Alzheimer disease.”

Question 10

Type: MCSA

The patient takes St. John’s wort for depression, but does not tell anyone about this. The psychiatrist prescribes an MAO inhibitor. What will the best assessment of the nurse reveal?

  1. Blood pressure of 210/100 mmHg
  2. Serum glucose level of 340
  3. Blood pressure of 78/40 mmHg
  4. Serum potassium of 6.0

CHAPTER 11

Question 1

Type: MCMA

The nurse is managing care for a group of substance abusers. The patients have completed group education about the disease of addiction. The nurse determines that learning has occurred when the patients make which statements?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “A heroin addict can die from heroin withdrawal.”
  2. “Substance abuse depends on complex variables.”
  3. “Most addicts became addicted from pain medication in a hospital.”
  4. “Addiction includes a compulsion to use a mood-altering substance.”
  5. “There is most likely a genetic component to addiction.”

Question 2

Type: MCSA

The adolescent patient is in a drug rehabilitation program. The mother of this patient says to the nurse, “The doctor said my son has a physical addiction to alcohol. What does this mean?” What is the best response by the nurse?

  1. “His brain remembers the euphoria he had with alcohol, and he has a craving to return to it.”
  2. “He will have an intense craving for alcohol; this is best managed in group therapy.”
  3. “His body is used to alcohol; he will have specific withdrawal symptoms when it is stopped.”
  4. “He will have feelings of depression when stopping alcohol; we need to monitor him for suicide.”

Question 3

Type: MCSA

The patient has an extensive history of alcoholism. He is having coronary bypass surgery. While administering anesthesia, the certified nurse anesthetist notes that the patient requires higher-than-usual amounts of the drug. The nurse correctly evaluates this response as what phenomenon?

  1. The nurse anesthetist most likely did not calculate the correct amount of anesthesia for this patient.
  2. The patient has developed a paradoxical reaction to the anesthesia, and will require a different drug.
  3. The patient has developed a resistance to the anesthesia, so it will not work very well.
  4. The patient had developed cross-tolerance to the anesthesia, and will require higher amounts.

Question 4

Type: MCSA

The patient comes to the emergency department and tells the nurse, “I have been off my drugs for 3 days.” The nurse assesses the patient for withdrawal symptoms associated with the category of drug used. Withdrawal from which drug, if taken by the patient, should cause the nurse the most concern?

  1. Heroin
  2. Alprazolam (Xanax)
  3. Cocaine
  4. Marijuana

Question 5

Type: MCSA

The mother of an adolescent patient says to the nurse, “I think my son is staying up too late studying, and I see him using Visine eye drops all the time for his red eyes. Should I have his vision checked?” What is the best response by the nurse?

  1. “He might be depressed; insomnia is common with depression.”
  2. “Sounds like he is smoking marijuana, and I would talk to him.”
  3. “Sounds like he is using cocaine; I have seen this before.”
  4. “Yes, that is a great idea, he may need some glasses.”

Question 6

Type: MCSA

The patient has been abusing alcohol for several years and tells the nurse, “I used to drink a pint of whiskey every day. Now I get sick and pass out after just two drinks.” What does the nurse correctly recognize about this patient?

  1. The patient’s symptoms are related to hyperglycemia; he may have pancreatic damage.
  2. The patient may have liver damage, resulting in an inability to metabolize large amounts of alcohol.
  3. The patient is in denial and is most likely minimizing the amount of alcohol he consumes.
  4. The patient has brain damage from the alcohol and cannot remember how much he consumes.

Question 7

Type: MCMA

The patient is withdrawing from opioids. Which symptom best describe(s) the results of the nurse’s assessment?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Abdominal cramping and pain
  2. Hypotension
  3. Pinpoint pupils
  4. Dilated pupils
  5. Diaphoresis

Question 8

Type: MCSA

What is a priority outcome for the patient who has chronic alcoholism with liver damage?

  1. The patient will switch to a safer drug, like a benzodiazepine.
  2. The patient will become involved in Alcoholics Anonymous (AA).
  3. The patient will keep all appointments with the doctor treating his liver damage.
  4. The patient will learn to drink more responsibly.

Question 9

Type: MCSA

The patient is admitted to the in-patient substance abuse unit. She tells the nurse she has been buying “yellow jackets” (pentobarbital, [Nembutal]) on the street, but hasn’t had any for a few days. What is the best plan by the nurse at this time?

  1. Prepare to manage the depression and suicidal thoughts the patient will have.
  2. Prepare to do frequent room searches, as the patient’s friends will most likely bring drugs in for her.
  3. Prepare to manage a withdrawal that could be life threatening.
  4. Prepare to manage a withdrawal that will likely be minimal.

Question 10

Type: MCSA

The patient had been abusing cocaine for several years. Recently, the patient snorted cocaine that was much purer than was thought, resulting in an overdose. The patient died in the emergency department. What does the nurse recognize as the most likely cause of death?

  1. Cardiac arrest
  2. Rhabdomyolysis
  3. Impurities in the cocaine
  4. Bowel ischemia

CHAPTER 12

Question 1

Type: MCMA

The nurse is teaching the importance of drugs for emergency preparedness to local firemen. The nurse determines that learning has occurred when the firemen make which statement(s)?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “The vendor-managed inventory (VMI) package can reach any community within 24 to 36 hours.”
  2. “Our local hospital is supposed to be stockpiling antibiotics.”
  3. “The push package can reach any community within 12 hours of an attack.”
  4. “The Strategic National Stockpile is located at the Centers for Disease Control and Prevention (CDC) in Atlanta.”
  5. “Our country’s drug stockpile is managed by the Centers for Disease Control and Prevention (CDC).”

Question 2

Type: MCMA

The nurse works for the Centers for Disease Control and Prevention (CDC). In planning for a bioterrorist attack, what will the best plan of the nurse include?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Learn the signs and symptoms of chemical and biological agents.
  2. Obtain a listing of health and law enforcement contacts.
  3. Assist in the stockpiling of medications.
  4. Obtain current knowledge of emergency management.
  5. Assist in triage at local hospitals.

Question 3

Type: MCSA

The patient comes to the emergency department with an anxiety attack. He tells the nurse he heard that there was another anthrax attack in the capitol and is concerned about running out of medications. What is the best response by the nurse?

  1. “You don’t need to worry about another attack at all; I think our government can take care of us.”
  2. “Your health is in danger due to the anxiety; we really need to focus on reducing your anxiety now.”
  3. “The Centers for Disease Control and Prevention (CDC) maintains a large stockpile of medications for us in case that occurs.”
  4. “I’m sure the Centers for Disease Control and Prevention (CDC) has contingency plans in the event of an anthrax attack.”

Question 4

Type: MCSA

The nurse is teaching a class on anthrax to a group of emergency response workers. What is the best instruction to include?

  1. Anthrax is a deadly bacterium; the most common and deadly form is gastrointestinal anthrax.
  2. Cutaneous anthrax is the most common form, but inhaled anthrax is the most lethal form.
  3. Anthrax most commonly affects wild rodents such as mice, rats, squirrels, and chipmunks.
  4. Cutaneous anthrax is serious because it quickly spreads by person-to-person contact.

Question 5

Type: MCSA

The patient has been exposed to anthrax. What treatment will the nurse plan to administer?

  1. Penicillin (Bicillin LA) and vancomycin (Vancocin).
  2. Tetracycline (Sumycin) and erythromycin (Erythrocin).
  3. Ampicillin (Principen) and cefepime (Maxipime).
  4. Ciprofloxacin (Cipro) and doxycycline (Vibramycin).

Question 6

Type: MCSA

The patient was exposed to cutaneous anthrax 2 weeks ago. What will the nurse see when assessing the patient’s skin?

  1. Large pustules, and later, reddish scabs
  2. Small, fluid-filled vesicles, and later, small skin erosions
  3. Ulcerated areas, and later, keloids
  4. Small skin lesions, and later, black scabs

Question 7

Type: MCSA

The nursing instructor is teaching student nurses about the use of viruses in a bioterrorism attack. The nurse determines that learning has occurred when the students make which statement?

  1. “The Centers for Disease Control and Prevention (CDC) has a plan to vaccinate Americans against most viruses.”
  2. “Actually, a bigger concern is a nuclear weapon exploding in a city.”
  3. “Most Americans have already been vaccinated against the lethal viruses.”
  4. “A bioterrorist attack with viruses is a real threat to Americans.”

Question 8

Type: MCSA

The patient tells the nurse that she is concerned about terrorist activity and questions if everyone should be immunized against smallpox. What is the best response by the nurse?

  1. “The vaccine has side effects, which are serious and could kill many people.”
  2. “I really do not think our country has enough vaccine to do this.”
  3. “Don’t be so concerned; if an attack comes, we will immunize people then.”
  4. “The vaccine has some serious side effects, but this is probably a good idea.”

Question 9

Type: MCSA

The nursing instructor is teaching student nurses about dangerous infectious diseases. The nurse determines that learning has occurred when the students make which statement?

  1. “The influenza virus is the most dangerous virus today.”
  2. “The human immunodeficiency virus is the most deadly virus we have.”
  3. “The dengue fever virus will kill more people than any other virus.”
  4. “The Ebola virus has the potential to kill more people than any other virus.”

Question 10

Type: MCSA

The patient has been exposed to a nerve agent. For which symptoms will the nurse most likely assess?

  1. Salivation, involuntary urination, and convulsions
  2. Dilated pupils and increased blood pressure and heart rate
  3. Pinpoint pupils, decreased blood pressure, and increased heart rate
  4. Rapid breathing and cold, clammy skin

CHAPTER 13

Question 1

Type: MCSA

The patient receives methyldopa (Aldomet), an adrenergic drug. The nurse determines that the patient is having side effects when the patient makes which statement?

  1. “Will you check my pupils? I can’t see very well at all.”
  2. “I am so thirsty; will you please bring me another pitcher of water?”
  3. “I am so anxious; I really need to walk around the room.”
  4. “I feel so sleepy that I don’t think I can eat my dinner.”

Question 2

Type: MCSA

The patient receives metaproterenol (Alupent), an adrenergic drug. A consulting physician orders carteolol (Cartrol), a beta blocker. What best describes the nurse’s assessment?

  1. The patient is at risk for a hypertensive crisis.
  2. The effects of metaproterenol (Alupent) will be decreased.
  3. The drugs are compatible; there will not be any adverse effects.
  4. The effects of metaproterenol (Alupent) will be increased.

Question 3

Type: MCSA

The nurse has been doing medication education for the patient receiving atenolol (Tenormin), a beta blocker. The nurse determines that learning has occurred when the patient makes which statement?

  1. “I need to take my pulse every day.”
  2. “If I have any side effects, I will stop the medication.”
  3. “I cannot take this drug if I develop glaucoma.”
  4. “I cannot continue to have my morning cup of coffee.”

Question 4

Type: MCSA

The physician ordered prazosin (Minipress), an alpha-adrenergic blocker, for the patient. The nurse plans to do medication education. What will the best plan of the nurse include?

  1. Instruct the patient to not take any OTC herbal preparations.
  2. Instruct the patient to not take hot tub baths or hot showers.
  3. Instruct the patient to decrease his intake of sodium.
  4. Instruct the patient to wear sunglasses when outdoors.

Question 5

Type: MCSA

The nurse has completed medication education about pyridostigmine (Mestinon), an indirect cholinergic drug, for the patient with myasthenia gravis. The nurse determines that learning has occurred when the patient makes which statement?

  1. “I must monitor my blood pressure while on this drug.”
  2. “I will need to increase my fluid intake with this medication.”
  3. “I must take this medication with meals for proper absorption.”
  4. “It is really important to take my medication on time.”

Question 6

Type: MCSA

The physician has ordered bethanechol (Urecholine), a cholinergic drug, for the patient with urinary retention. The patient also has an enlarged prostate gland. What is the priority action by the nurse?

  1. Hold the drug and prepare to catheterize the patient.
  2. Administer the drug and measure urinary output.
  3. Administer the drug and push fluids.
  4. Hold the drug and contact the physician.

Question 7

Type: MCSA

The preop patient will be receiving glycopyrrolate (Robinul), an anticholinergic drug, and asks the nurse, “Why do I need to have that shot?” What is the best response by the nurse?

  1. “It will decrease your respiratory secretions during surgery.”
  2. “It will increase your urinary output during surgery.”
  3. “It will help you breathe better during surgery.”
  4. “It will help maintain your blood pressure during surgery.”

Question 8

Type: MCSA

The nurse is preparing to administer medications to a group of patients. One of the medications is benztropine (Cogentin), an anticholinergic drug. This drug is contraindicated in which patient?

  1. The patient with a fractured femur
  2. The patient with tachycardia
  3. The patient with an irritable colon
  4. The patient with diarrhea

Question 9

Type: MCSA

The nurse is preparing to administer medications to a group of patients. One of the medications is atropine, an anticholinergic drug. This drug is contraindicated in which patient?

  1. The patient with glaucoma
  2. The patient with hyperthyroidism
  3. The patient with a hiatal hernia
  4. The patient with lung cancer

Question 10

Type: MCSA

The physician orders dicyclomine (Bentyl), an anticholinergic drug, for a patient. What is the nurse’s priority assessment prior to administering this drug?

  1. Does the patient have light sensitivity?
  2. Is the patient able to urinate?
  3. Does the patient have a history of alcoholism?
  4. Is the patient dizzy upon standing?

CHAPTER 14

Question 1

Type: MCSA

The patient tells the nurse he worries about everything all day, feels confused, restless, and just can’t stop worrying. What is the best response by the nurse?

  1. “You have generalized anxiety; I will teach you some relaxation techniques.”
  2. “This sounds like social anxiety. You need to calm down and you’ll be fine.”
  3. “You have posttraumatic stress disorder (PTSD), and it is time for your therapy session.”
  4. “This is called panic disorder; I’ll get your medication for you.”

Question 2

Type: MCMA

The nurse has completed group education for patients with anxiety disorders. The education is evaluated as successful when the patients make which statements?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “Relaxation techniques will often decrease anxiety.”
  2. “Antianxiety medicine should be used until our anxiety is gone.”
  3. “Antianxiety medicine should not be used indefinitely.”
  4. “We need therapy to learn where this anxiety comes from.”
  5. “We need different medicines for anxiety, and for difficulty in sleeping.”

Question 3

Type: MCSA

The patient tells the nurse that she is interested in the human brain, and questions which parts of the brain control anxiety and insomnia. What is the best reply by the nurse?

  1. “The limbic system and reticular activating system control anxiety and insomnia.”
  2. “The frontal lobes and limbic system control anxiety and insomnia.”
  3. “The thalamus and reticular activating system control anxiety and insomnia.”
  4. “The limbic system and hypothalamus control anxiety and insomnia.”

Question 4

Type: MCMA

The patient tells the nurse, “I am really confused after talking to my doctor. He said I would be taking different kinds of medications for my anxiety and insomnia. Will you please explain it?” What is the best response by the nurse?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “You will be taking medications known as sedative-hypnotics.”
  2. “You will be taking medications known as antidepressants.”
  3. “You will be taking a medication known as paraldehyde.”
  4. “You will be taking medications known as barbiturates.”
  5. “You will be taking medications known as benzodiazepines.”

Question 5

Type: MCSA

The patient has generalized anxiety disorder. He asks the nurse, “Will I need medication for this? My neighbor is very nervous and he takes medication.” What is the best response by the nurse?

  1. “Medications are a way of life for patients with anxiety disorders.”
  2. “Medication is necessary initially; later we will try therapy.”
  3. “Probably not, but you shouldn’t compare yourself to your neighbor.”
  4. “Medication is necessary when anxiety interferes with your quality of life.”

Question 6

Type: MCSA

The patient has been treated by the same physician for 2 years and has had insomnia the entire time. Many different medications have been tried with limited success. What should be the nurse’s primary assessment at this time?

  1. Assess for a primary sleep disorder such as sleep apnea.
  2. Assess if the patient has been selling his medications to addicts.
  3. Assess if the patient has an addictive personality disorder.
  4. Assess the patient for a primary personality disorder.

Question 7

Type: MCSA

The patient is scheduled to have an EEG to confirm the presence of a sleep disorder. The patient asks the nurse to describe Stage IV NREM sleep. What is the best response by the nurse?

  1. “This is the lightest stage of sleep, and is profoundly affected by anxiety.”
  2. “Dreaming occurs here; without dreams you will be irritable and paranoid.”
  3. “This is the deepest stage of sleep; without it you will be tired and depressed.”
  4. “This stage comprises the greatest amount of sleep time, and is important.”

Question 8

Type: MCSA

The patient has been taking lorazepam (Ativan) for 2 years. The patient stopped this medication after a neighbor said the drug manufacturer’s plant was contaminated with rat droppings. What best describes the nurse’s assessment of the patient when seen 3 days after stopping his medication?

  1. Increased heart rate, fever, and muscle cramps
  2. Nothing different; it is safe to abruptly stop lorazepam (Ativan)
  3. Pinpoint pupils, constipation, and urinary retention
  4. A sense of calmness and lack of anxiety

Question 9

Type: MCSA

The patient comes to the emergency department after an overdose of lorazepam (Ativan). The nurse will plan to administer which medication?

  1. Pralidoxime (Protopam)
  2. Naloxone (Narcan)
  3. Flumazenil (Romazicon)
  4. Nalmefene (Revex)

Question 10

Type: MCSA

The nurse works with a physician who frequently prescribes benzodiazepines. The use of benzodiazepines in which patient would cause the nurse the most concern?

  1. An 87-year-old patient who uses a cane for ambulation
  2. A 9-year-old child with panic attacks
  3. A 42-year-old businessman who travels internationally
  4. A 32-year-old mother of two preschool children

CHAPTER 15

Question 1

Type: MCSA

The patient says to the nurse, “My doctor said I have epilepsy and need to take medicine for those seizures I had. Do I really need medicine?” What is the best response by the nurse?

  1. “Having epilepsy is the same as having a mental illness; the medications are very similar.”
  2. “You will need medicine for a little while to cure the seizures.”
  3. “You might not need medicine; you may be controlled by a ketogenic diet.”
  4. “Yes, you need to take medication on a continual basis to control the seizures.”

Question 2

Type: MCMA

The nurse is teaching a class for patients who have been recently diagnosed with epilepsy. The nurse determines that learning has occurred when the patients make which statements?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “Excessive stress levels cause disruptions in how the brain receives oxygen, leading to epilepsy.”
  2. “Epilepsy may be caused by a head injury.”
  3. “Eating disorders, like anorexia nervosa, increase the risk for developing epilepsy.”
  4. “A stroke, or brain attack, could increase the risk for developing epilepsy.”
  5. “With some cases of epilepsy, the cause is never determined.”

Question 3

Type: MCSA

A parent says to the nurse, “The doctor prescribed ethosuximide (Zarontin) for my child, who has absence seizures. What does this mean?” What is the best response by the nurse?

  1. “Absence seizures are basically the same kind of seizures as grand mal, but they are less frequent.”
  2. “Your daughter’s seizures manifest as a staring into space for a few seconds. Ethosuximide (Zarontin) is a good medication for this type of seizure.”
  3. “Explaining the types of seizure activity is complicated. Have you spoken to your doctor about it?”
  4. “Are you sure your doctor prescribed ethosuximide (Zarontin)? Phenobarbital (Luminal) is used much more frequently with children.”

Question 4

Type: MCSA

The patient has epilepsy and receives phenytoin (Dilantin). The patient has been seizure-free, and asks the nurse why he still needs blood tests when he is not having seizures. What is the best response by the nurse?

  1. “Because phenytoin (Dilantin) has a very narrow range between a therapeutic dose and a toxic dose.”
  2. “Because phenytoin (Dilantin) can cause blood-thinning in some patients.”
  3. “Because phenytoin (Dilantin) can cause Stevens-Johnson syndrome, which will show up in the blood tests.”
  4. “Because phenytoin (Dilantin) can deplete your system of potassium.”

Question 5

Type: MCSA

The nurse has been conducting medication education for a patient with epilepsy. What is the best outcome for this patient?

  1. The patient will recognize that the antiseizure medication must be continued indefinitely.
  2. The patient will recognize the need to be on a tyramine-free diet while on antiseizure medications.
  3. The patient will recognize the need to be on a ketogenic diet in combination with antiseizure medications.
  4. The patient will recognize the need to be on antiseizure medication for one year after the last seizure.

Question 6

Type: MCSA

The physician has ordered intravenous (IV) diazepam (Valium) for the patient in status epilepticus. During administration, which assessment by the nurse is most important?

  1. Assessing respirations every 5 to 15 minutes
  2. Assessing level of consciousness
  3. Assessing pulse for bradycardia
  4. Assessing blood pressure for hypertension

Question 7

Type: MCSA

The physician has ordered intravenous (IV) phenytoin (Dilantin). The nurse does not read the drug label and administers the medication intramuscularly (IM). What is the most likely response in the patient?

  1. Local tissue damage following extravasation will most likely occur.
  2. A phenomenon known as purple gluteus syndrome will most likely occur.
  3. A marked decrease in serum glucose levels will most likely occur.
  4. Nothing adverse, the medication may be administered intravenously (IV) or intramuscularly (IM).

Question 8

Type: MCMA

The physician has ordered intravenous phenytoin (Dilantin). The patient is also receiving 5% dextrose in water (D5W) intravenously (IV). What will the nurse plan to do before administering this medication?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Use a large vein for the infusion.
  2. Use an intravenous (IV) line with a filter.
  3. Flush the intravenous (IV) line with saline.
  4. Monitor the patient for hypertension.
  5. Monitor the patient for Stevens-Johnson Syndrome.

Question 9

Type: MCSA

The patient is receiving valproic acid (Depakene) for treatment of seizures. The patient has also been taking a daily 81 mg aspirin tablet prophylactically for a cardiac condition. What would the nurse be most likely to observe?

  1. An increase in seizure activity
  2. Stevens-Johnson syndrome
  3. Migraine headaches and generalized irritability
  4. Bleeding from the gums and bruising of the skin

Question 10

Type: MCSA

The patient is receiving Phenobarbital (Luminal) for control of seizures. The patient tells the nurse she plans to become pregnant. What is the best response of the nurse?

  1. “Your medication dose will need to be decreased during your pregnancy.”
  2. “Please talk to your doctor; this drug is contraindicated in pregnancy.”
  3. “Your medication dose will need to be increased during your pregnancy.”
  4. “Please talk to your doctor; you will need a safer drug like valproic acid (Depakene).”

CHAPTER 16

Question 1

Type: MCSA

The patient tells the nurse, “I thought I was just depressed, but my doctor says I have bipolar disorder. What is that?” What is the best response by the nurse?

  1. “Bipolar disorder is just another type of depression, except your depression occurs in cycles.”
  2. “Bipolar disorder is a type of depression that includes attention deficit disorder symptoms.”
  3. “Bipolar disorder just means that your mood alternates with the seasons, and it becomes worse in the winter.”
  4. “Bipolar disorder means you have cycles of depression as well as hyperactivity, or mania.”

Question 2

Type: MCSA

The mother of a 7-year-old child says to the nurse, “My child is distractible in school, cannot complete assignments on time, and interrupts other children while they are speaking. What do you think?” What is the best response by the nurse?

  1. “This sounds like your child is depressed; depression looks different in children and is very serious.”
  2. “This sounds like bipolar disorder; you might want to have your child tested by a child psychiatrist.”
  3. “This could be attention-deficit hyperactivity disorder (ADHD); you might want to have your child tested.”
  4. “This sounds like typical 7-year-old behaviors to me; if they do not resolve, have your child tested.”

Question 3

Type: MCMA

The nurse is conducting a group education session for patients who have been diagnosed with depression. The nurse evaluates the education as effective when a patient makes which comment(s) about the cause of depression?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “Depression has many causes; they could include environmental as well as brain-based disorders.”
  2. “Depression includes impaired relationships, and is also an inherited illness.”
  3. “We really don’t know what causes depression; it has not been studied very much.”
  4. “Depression results from unresolved conflicts in your childhood.”
  5. “Depression results from parents who are cold and distant and don’t really care about their children.”

Question 4

Type: MCSA

The patient receives imipramine (Tofranil) as treatment for depression. He is admitted to the emergency department following an intentional overdose of this medication. What will the best assessment by the nurse include?

  1. The patient’s cardiac status
  2. The patient’s liver function
  3. The patient’s renal status
  4. The patient’s neurological function

Question 5

Type: MCSA

The patient has been receiving amitriptyline (Elavil) for 2 weeks. He tells the nurse he doesn’t think this medicine is working, as he is still depressed. What is the best response by the nurse?

  1. “It is working, but it can take several weeks to have an effect.”
  2. “You might still feel depressed, but you are looking much better.”
  3. “This may not be the best medicine for you; I’ll call your doctor.”
  4. “It is working, but it can take several months to have an effect.”

Question 6

Type: MCSA

The physician has prescribed sertraline (Zoloft) for the patient who is anxious and depressed. The patient calls the nurse to report that he has experienced delayed ejaculation since being on this medication. What is the best response by the nurse?

  1. “I will let your doctor know, and he will most likely change your medication.”
  2. “This does happen, but treating your depression is a bigger priority.”
  3. “I am concerned that you will become suicidal if you stop the medication.”
  4. “Keep taking the medicine, as this usually goes away after a few months.”

Question 7

Type: MCSA

The patient has been depressed and the physician plans to begin treatment with an antidepressant medication. In performing the initial assessment, what is the most important question for the nurse to ask?

  1. “How much alcohol do you consume during the week?”
  2. “Are you allergic to any medications?”
  3. “How long have you been depressed?”
  4. “Have you had any thoughts about killing yourself?”

Question 8

Type: MCMA

The nurse has completed medication education for a patient prior to the patient receiving phenelzine (Nardil). The nurse evaluates the education as effective when the patient makes which statement(s)?

Note: Credit will be given only if all correct choices and no incorrect choices are selected

.Standard Text: Select all that apply.

  1. “I am really going to miss my morning coffee and sweet roll.”
  2. “I’ll have to give up my beer at the football games.”
  3. “I can’t eat fried chicken and gravy.”
  4. “I am not supposed to have processed meats or cheese.”
  5. “I really shouldn’t eat at a restaurant; too many foods are on my restricted list.”

Question 9

Type: MCSA

The patient has bipolar disorder and is in a manic phase. The physician prescribes lithium (Eskalith). The patient’s current lithium level is 0.4. What will the nurse expect to assess in this patient?

  1. A return to baseline behavior, calm and rational
  2. Hyperactivity and pressured speech
  3. Signs and symptoms of depression
  4. A decrease in manic behavior

Question 10

Type: MCSA

The nurse has completed medication education with the patient who is receiving lithium (Eskalith). What is the best patient outcome?

  1. The patient will be able to work a normal work schedule and will receive adequate sleep.
  2. The patient will identify signs of lithium (Eskalith) toxicity and verbalize measures to avoid it.
  3. The patient will engage in activities of daily living and report enjoyment with them.
  4. The patient will report stabilization of mood, including absence of mania or depression.

CHAPTER 17

Question 1

Type: MCMA

The patient has been admitted to the hospital for the treatment of schizophrenia. The patient’s mother says to the nurse, “This is all so confusing. How did he get this? Did I do something?” What is (are) the best response(s) of the nurse?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “Schizophrenia is a biological brain disorder.”
  2. “Schizophrenia is linked to drinking alcohol during pregnancy.”
  3. “Research indicates that a very stressful environment causes schizophrenia.”
  4. “Research indicates that schizophrenia is a genetic disorder.”
  5. “Schizophrenia is due to too much dopamine in certain parts of the brain.”

Question 2

Type: MCSA

The patient with schizophrenia is sitting quietly in a chair. The patient does not respond much to what is happening, and has a lack of interest in the environment. What best describes the result of the nurse’s assessment?

  1. The patient is most likely very depressed.
  2. The patient is most likely hearing voices.
  3. The patient is experiencing positive symptoms.
  4. The patient is experiencing negative symptoms.

Question 3

Type: MCSA

The physician has prescribed haloperidol (Haldol) for the patient with schizophrenia. What is the priority patient outcome?

  1. The patient will consume adequate fluids and a high-fiber diet.
  2. The patient will be compliant with taking the medication as prescribed.
  3. The patient will report a decrease in auditory hallucinations.
  4. The patient will report symptoms of restlessness.

Question 4

Type: MCSA

The nurse is managing the care of a group of patients with schizophrenia. The patients are receiving conventional antipsychotic medications. When assessing for anticholinergic side effects, which would the nurse immediately report to the physician?

  1. Acute dystonia
  2. Complaint of a severe headache
  3. Hypertension
  4. Urinary retention

Question 5

Type: MCSA

The patient has been receiving chlorpromazine (Thorazine) for the treatment of schizophrenia. The nurse assesses that the patient has tardive dyskinesia. What describes the result of the nurse’s assessment?

  1. Tremor, muscle rigidity, and a shuffling gait
  2. Severe muscle spasms of the back, neck, and tongue
  3. An inability to rest or relax, and restlessness
  4. Unusual facial movements and lip smacking

Question 6

Type: MCSA

The patient is receiving risperidone (Risperdal). During morning assessment, the nurse notes that the patient has a temperature of 102 degrees F. What is the priority nursing intervention?

  1. Contact the physician, as this could be a symptom of neuroleptic malignant syndrome.
  2. Contact the physician, as this could be a symptom of an acute urinary infection.
  3. Contact the physician, as this could be a symptom of a bacterial pneumonia.
  4. Contact the physician, as this could be a symptom of extrapyramidal side effects.

Question 7

Type: MCSA

The patient is receiving clozaril (Clozapine) for the treatment of schizophrenia. The nurse evaluates the effectiveness of this medication when the patient makes which statement?

  1. “I will start going to group therapy.”
  2. “I think I am ready for discharge, as I feel better.”
  3. “I am not hearing the voices anymore.”
  4. “I promise not to skip breakfast anymore.”

Question 8

Type: MCSA

The nurse has completed medication education with the patient who is receiving clozapine (Clozaril). The nurse evaluates that the education has been effective when the patient makes which statement?

  1. “I must call my doctor if I start to have a lot of nightmares.”
  2. “I must have my blood work done while taking this medication.”
  3. “I must call my doctor if I start to lose a lot of weight.”
  4. “I must call my doctor if I notice any unusual bruising.”

Question 9

Type: MCSA

The patient is receiving clozapine (Clozaril). What is a priority outcome for this patient?

  1. The patient reports any narrowing of the field of vision.
  2. The patient reports any joint pain or swelling.
  3. The patient reports any signs of a sore throat or an infection.
  4. The patient reports any yellowish halos around lights.

Question 10

Type: MCSA

For any patient receiving clozapine (Clozaril), which laboratory result should be reported to the physician?

  1. Red blood cell (RBC) of 3.8 million cells/mL
  2. Red blood cell (RBC) of 5.0 million cells/mL
  3. White blood cell (WBC) of 3,800 cells/mcl
  4. White blood cell (WBC) of 12,000 cells/mcl

CHAPTER 18

Question 1

Type: MCMA

The nurse teaches patients about nonpharmacological techniques for pain management. The nurse determines learning has occurred when the patients make which statement(s)?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “Nonpharmacological techniques are a good adjunct to pharmacotherapy.”
  2. “Nonpharmacological techniques have not reached mainstream yet.”
  3. “Nonpharmacological techniques may be used in place of drugs.”
  4. “Nonpharmacological techniques include an aerobic exercise.”
  5. “Nonpharmacological techniques are not usually valued by nurses.”

Question 2

Type: MCSA

The nursing instructor teaches the nursing students about neural mechanisms of pain. What does the nursing instructor teach about substance P?

  1. Substance P modifies sensory information in the spinal cord.
  2. Substance P is also known as an endogenous opioid.
  3. Substance P stimulates pain receptors in the spinal cord.
  4. Substance P controls which pain signals reach the brain.

Question 3

Type: MCSA

The patient, addicted to heroin, is being treated for opioid dependence. He has been prescribed methadone (Dolophine). The patient asks how this will help because methadone (Dolophine) is another opioid. What is the best response by the nurse?

  1. “Methadone (Dolophine) will make you really sick if you use heroin.”
  2. “Methadone (Dolophine) does not cause euphoria like heroin does.”
  3. “Methadone (Dolophine) cures your addiction to heroin.”
  4. “Methadone (Dolophine) causes you to have an allergy to heroin.”

Question 4

Type: MCSA

The patient has intractable pain, and the physician has proposed a nerve block. The nurse plans to teach the patient about nerve blocks. Which statement would be included in the best plan of the nurse?

  1. A nerve block depresses the activity of the sympathetic nervous system.
  2. A nerve block enhances the effect of most of the endogenous opioids.
  3. A nerve block modifies sensory information being sent to the spinal cord.
  4. A nerve block stops pain transmission along the nerve to stop the pain.

Question 5

Type: MCSA

The patient receives morphine for pain. He asks the nurse how it works to relieve pain. What is the best response by the nurse?

  1. “It inhibits the primary pain neurotransmitters in your brain.”
  2. “It stimulates the receptors that secrete endorphins in your brain.”
  3. “It stimulates a receptor in your brain that induces pleasure.”
  4. “It promotes the primary pleasure neurotransmitters in your brain.”

Question 6

Type: MCSA

The patient has a patient-controlled analgesia (PCA) pump following surgery. The nurse keeps naloxone (Narcan) in the patient’s room as per protocol. What does the nurse recognize as the rationale for this protocol?

  1. Naloxone (Narcan) enhances the effect of the opioid in the patient-controlled analgesia (PCA) pump and increases analgesia.
  2. Naloxone (Narcan) is the antidote if an anaphylactic reaction to the opioid in the patient-controlled analgesia (PCA) pump occurs.
  3. Naloxone (Narcan) is available to treat any systemic side effects, like constipation, of the opioid in the patient-controlled analgesia (PCA) pump.
  4. Naloxone (Narcan) will reverse the effects of the narcotic in the patient-controlled analgesia (PCA) pump if an overdose occurs.

Question 7

Type: MCSA

What is a priority assessment question to ask a postsurgical patient prior to administration of an opioid analgesic?

  1. “Have you ever been addicted to prescription pain medications?”
  2. “Why do you want to receive this pain medication?”
  3. “Would you like me to help you change your position for comfort?”
  4. “Would you please rate your pain on a scale of 1-to-10?”

Question 8

Type: MCSA

The postsurgical patient has an order for morphine 2 mg IV push every 2 hours and propoxyphene 100 (Darvon 100) every 3 hours. He received the morphine 2 hours ago, and is complaining of pain again. What will the best plan of the nurse include?

  1. Plan to administer the morphine again.
  2. Plan to administer the propoxyphene 100 (Darvon 100).
  3. Plan to have the patient do some distraction techniques.
  4. Plan to assess the patient’s level of pain.

Question 9

Type: MCSA

The patient comes to the emergency department with a head injury, broken ribs, and internal bleeding. Opioid analgesics are contraindicated. What does the nurse recognize as the primary rationale for this?

  1. The use of opioid analgesics will depress the patient’s blood pressure.
  2. The patient may not be able to communicate his level of pain.
  3. Opioids will not effectively relieve pain in the patient’s periphery.
  4. Opioids can mask changes in the patient’s level of consciousness.

Question 10

Type: MCSA

The patient receives morphine for pain. Which comment by the patient does the nurse assess to be a side effect of morphine?

  1. “My ears are constantly ringing.”
  2. “My heart feels like it is skipping beats.”
  3. “I feel like I am going to throw up.”
  4. “I feel cold shivers all over.”

CHAPTER 19

Question 1

Type: MCMA

The nursing instructor teaches the nursing students about the advantages of the newer local anesthetics, such as lidocaine (Xylocaine). What will the best plan of the nursing instructor include?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Amides have fewer side effects than esters.
  2. Amides block potassium entry into the cell.
  3. Amides are similar in structure to cocaine.
  4. Amides tend to last longer than esters.
  5. Amides block calcium entry into the cell.

Question 2

Type: MCSA

The patient has entered Stage 3 of general anesthesia, known as surgical anesthesia. What will the best assessment of the nurse reveal?

  1. Heart rate and breathing become irregular.
  2. Eye movements are slow, and general sensation is lost.
  3. The medulla region of the brain is paralyzed.
  4. Relaxation, stable respiration, and slow eye movements

Question 3

Type: MCMA

The nurse teaches the patient about the correct use of a topical anesthetic for a skin condition. The nurse determines that learning has occurred when the patient makes which statement(s)?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “This lotion should only be used on small areas of skin.”
  2. “I must wear gloves when I apply the lotion.”
  3. “This lotion works well on cuts too.”
  4. “I must wash my hands before touching my eyes.”
  5. “It’s all right to use a lotion after the expiration date.”

Question 4

Type: MCSA

What does the nurse recognize as the most dangerous adverse effect of inhalation anesthesia?

  1. Hypertension
  2. Ventricular tachycardia
  3. Malignant hyperthermia
  4. Increased intracranial pressure

Question 5

Type: MCSA

The patient receives succinylcholine (Anectine). What will be a priority assessment by the nurse?

  1. Spontaneous bleeding
  2. Respiratory paralysis
  3. Anaphylactic shock
  4. Delirium

Question 6

Type: MCSA

The student nurse does an operating room rotation and notes that many patients receive succinylcholine (Anectine). The student nurse asks the nursing instructor how the drug works. What is the best response by the nursing instructor?

  1. “The patient will rapidly lose consciousness when this drug is administered.”
  2. “The patient’s cardiac muscle will be impacted as well as the respiratory muscles.”
  3. “The patient will need to be monitored with an electrocardiogram (ECG).”
  4. “The patient will need assistance with breathing; it paralyzes respiratory muscles.”

Question 7

Type: MCSA

The patient has a serious laceration to the arm. The patient receives a local anesthetic mixed with epinephrine prior to suturing. What does the nurse recognize as the rationale for the epinephrine?

  1. Constricted blood vessels will extend the duration of action of the drug.
  2. Constricted blood vessels will decrease the amount of pain experienced.
  3. Constricted blood vessels will promote relaxation of the patient.
  4. Constricted blood vessels will result in decreased bleeding.

Question 8

Type: MCSA

Which patient is most likely to experience an adverse reaction to inhalation anesthesia?

  1. A 15-year-old with diabetes mellitus
  2. A 6-year-old with no chronic health problems
  3. A 79-year-old with arteriosclerosis
  4. A 55-year-old with a serious neck injury

Question 9

Type: MCSA

The patient is in Stage 2 of general anesthesia. What are the priority nursing interventions at this time?

  1. Assist the anesthesiologist in repositioning the patient.
  2. Complete the surgical scrub.
  3. Keep the environment quiet and calm.
  4. Insert the Foley catheter.

Question 10

Type: MCSA

A pregnant woman has a malignant melanoma on her leg, and will need surgery. She is concerned about anesthesia. What is the best response by the nurse?

  1. “You will probably have an epidural, and this won’t harm your baby.”
  2. “There are newer general anesthetics available that are safe for your baby.”
  3. “You will most likely have local anesthesia; this will not affect your baby.”
  4. “Inhalation anesthetics are safe because they remain in your lungs.”

CHAPTER 20

Question 1

Type: MCMA

Several senior citizens have asked the nurse to do a presentation on degenerative diseases. What does the nurse plan to teach as the most common degenerative diseases?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Amyotrophic lateral sclerosis
  2. Multiple sclerosis
  3. Alzheimer’s disease
  4. Huntington’s chorea
  5. Parkinson’s disease

Question 2

Type: MCSA

The patient is diagnosed with Parkinson’s disease. The patient’s wife asks the nurse how taking medicine will help her husband. What is the best response by the nurse?

  1. “The medications will help prevent muscle wasting in your husband.”
  2. “The medications will boost your husband’s appetite and energy.”
  3. “The medications will balance serotonin and acetylcholine in your husband’s brain.”
  4. “The medications will help your husband to eat and walk.”

Question 3

Type: MCMA

The nurse plans to teach a class about Alzheimer’s disease to a caregiver’s support group. What will the best plan by the nurse include?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Depression and aggressive behavior are common with the disease.
  2. Alzheimer’s disease accounts for about 50% of all dementias.
  3. Glutamergic inhibitors are the most common class of drugs for treating Alzheimer’s disease.
  4. Chronic inflammation of the brain may be a cause of the disease.
  5. Memory difficulties are an early symptom of the disease.

Question 4

Type: MCSA

The nurse plans care for a patient with Parkinson’s disease. What will the best plan by the nurse include?

  1. Monitor the patient for the ability to chew and swallow.
  2. Check peripheral circulation for thrombophlebitis.
  3. Monitor the patient for psychotic symptoms.
  4. Limit exercise to decrease the possibility of fractures.

Question 5

Type: MCSA

The patient receives levodopa (Larodopa). The nurse has completed medication education and determines that learning has occurred when the patient makes which statement?

  1. “I need to increase my daily intake of protein.”
  2. “I must increase the fiber in my diet.”
  3. “I need to check my pulse before taking the medication.”
  4. “I must avoid yellow vegetables in my diet.”

Question 6

Type: MCSA

The nurse prepares to administer benztropine (Cogentin) to the patient. The nurse holds the dose and notifies the physician based on which assessment finding?

  1. A respiratory rate of 14
  2. A pulse of 102
  3. Blood pressure of 88/60 mmHg
  4. A temperature of 100.2°F

Question 7

Type: MCSA

The patient receives aspirin, a multivitamin, and an antihistamine every day. What is the best instruction by the nurse prior to administering levodopa (Larodopa)?

  1. “You should not take the aspirin with your levodopa (Larodopa).”
  2. “You should not take the antihistamine with your levodopa (Larodopa).”
  3. “You should not take the multivitamin with your levodopa (Larodopa).”
  4. “These medications are safe to take with levodopa (Larodopa).”

Question 8

Type: MCSA

The elderly patient receives levodopa (Larodopa). The nurse is primarily concerned about which problem with this patient?

  1. Hypertension
  2. Diarrhea
  3. Muscle twitching
  4. Dark urine

Question 9

Type: MCSA

The patient receives levodopa and carbidopa (Sinemet). What will the best teaching by the nurse include as relates to this medication?

  1. Avoid drinking caffeinated beverages.
  2. Take the medication with meals.
  3. Take the medication on an empty stomach.
  4. Take the medication with a protein food.

Question 10

Type: MCSA

The patient has been diagnosed with Alzheimer’s disease. What is the best medication education the nurse gives to the patient’s husband?

  1. “The medication may help her symptoms for a little while.”
  2. “The medication has serious side effects if used for a long time.”
  3. “Her symptoms will improve as long as she takes the medication.”
  4. “Her symptoms should begin improving in a few days.”

 

AND MUCH MORE