What To Do In These Situations? Nursing Quiz

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1. When applying transdermal nitroglycerin patches, which instruction by the nurse is correct?

Explanation

The correct answer is "Rotate application sites with each dose." This instruction is correct because rotating the application sites helps to prevent skin irritation and tolerance to the medication. By changing the location of the patch with each dose, the skin has time to recover and reduces the risk of developing a rash or other adverse reactions. Additionally, rotating the application sites ensures that the medication is absorbed evenly and effectively throughout the body.

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About This Quiz
What To Do In These Situations? Nursing Quiz - Quiz

The What To Do In These Situations? Nursing Quiz is designed to evaluate your ability to respond effectively to various nursing scenarios. Nurses play a vital role in providing holistic care that addresses not only physical needs but also the psychosocial, developmental, cultural, and spiritual aspects of patients. This quiz... see moretests your knowledge of nursing responsibilities, critical thinking, and appropriate interventions in real-life situations.

It challenges you to prioritize care, manage emergencies, and support patients’ well-being across diverse contexts. Whether dealing with illness prevention, treatment, or patient advocacy, this assessment ensures you are prepared to deliver compassionate, comprehensive care. Use this quiz to sharpen your clinical judgment and enhance your readiness to handle the complex demands of nursing practice confidently and competently.
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2. When teaching a patient who is beginning antilipemic therapy about possible drug-food interactions, the nurse will discuss which food?

Explanation

Grapefruit juice is known to interact with certain antilipemic drugs, specifically statins, which can lead to increased drug levels in the body. This can result in potential side effects or adverse reactions. Therefore, it is important for the nurse to discuss the potential drug-food interaction between grapefruit juice and antilipemic therapy with the patient.

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3. A patient is being discharged on anticoagulant therapy. The nurse will include in the patient-education conversion that it is important to avoid herbal products that contain which substance?   

Explanation

Ginkgo is an herb that has been shown to have anticoagulant effects, meaning it can thin the blood and increase the risk of bleeding. Therefore, it is important for a patient on anticoagulant therapy to avoid herbal products that contain ginkgo to prevent any potential interactions or adverse effects.

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4. The nurse is reviewing principles of immunization. What type of immunization occurs when antibodies pass from mother to infant during breastfeeding or through the placenta during pregnancy?

Explanation

During breastfeeding or through the placenta during pregnancy, antibodies are transferred from the mother to the infant. This is known as natural passive immunization. In this process, the infant receives pre-formed antibodies from the mother, providing temporary protection against certain diseases until their own immune system develops. This type of immunization is considered passive because the immune response is not actively generated by the infant's own immune system. It is a natural process that helps to protect the newborn during the early stages of life.

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5. A woman who is planning to become pregnant should ensure that she receives adequate levels of which supplements to reduce the risk for fetal neural tube defects?

Explanation

Folic acid is essential for the development of a healthy neural tube in the fetus, which forms the baby's brain and spinal cord. Adequate levels of folic acid can significantly reduce the risk of neural tube defects such as spina bifida and anencephaly. Therefore, it is important for a woman planning to become pregnant to ensure she receives adequate levels of folic acid through supplements or a balanced diet. Vitamin B12, Vitamin D, and iron are also important for a healthy pregnancy, but they do not specifically reduce the risk of neural tube defects.

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6. A patient who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the patient may have taken too much warfarin. The nurse provides the patient with which appropriate antidote?

Explanation

The correct antidote for a patient who has taken too much warfarin is Vitamin K. Warfarin is an anticoagulant that works by inhibiting the synthesis of Vitamin K-dependent clotting factors in the liver. By giving the patient Vitamin K, it helps to reverse the effects of warfarin and restore normal clotting function.

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7. Which action is often recommended to help reduce tolerance to transdermal nitroglycerin therapy?

Explanation

Removing the patch at bedtime and applying a new one in the morning is often recommended to help reduce tolerance to transdermal nitroglycerin therapy. This practice allows for a nitrate-free interval during sleep, which helps prevent the development of tolerance. By removing the patch at night and applying a new one in the morning, the body is given a break from continuous exposure to nitroglycerin, which can help maintain the effectiveness of the therapy.

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8. When teaching a patient who has a new prescription for transdermal nitroglycerin patches, the nurse tells the patient that these patches are most appropriately used for which situation?  

Explanation

Transdermal nitroglycerin patches are most appropriately used to prevent the occurrence of angina. Angina is a symptom of coronary artery disease that causes chest pain or discomfort due to reduced blood flow to the heart muscle. Nitroglycerin patches work by relaxing and widening the blood vessels, improving blood flow to the heart and reducing the frequency and severity of angina episodes. Therefore, using these patches can help prevent the occurrence of angina and provide relief to the patient.

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9. The nurse notes in the patient's medication orders that the patient will be starting anticoagulant therapy. What is the primary goal of anticoagulant therapy?      

Explanation

The primary goal of anticoagulant therapy is to prevent thrombus formation. Anticoagulants work by inhibiting the clotting factors in the blood, thereby reducing the risk of blood clot formation. This is important because blood clots can lead to serious complications such as deep vein thrombosis, pulmonary embolism, and stroke. By preventing thrombus formation, anticoagulant therapy helps to maintain normal blood flow and reduce the risk of these potentially life-threatening conditions.

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10. When an adrenergic drug stimulates beta1-adrenergic receptors, the result is an increased force of contraction, which is known as what type of effect?

Explanation

When an adrenergic drug stimulates beta1-adrenergic receptors, it leads to an increased force of contraction in the heart. This effect is known as a positive inotropic effect.

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11. A patient about to receive a morning dose of digoxin has an apical pulse of 53 beats/minute. What will the nurse do next?

Explanation

The correct answer is to withhold the dose and notify the prescriber. A normal apical pulse for an adult is between 60-100 beats per minute. A pulse rate of 53 beats per minute is considered bradycardia, which can be a potential side effect of digoxin. Administering the dose in this situation could further decrease the heart rate and lead to adverse effects. Therefore, it is important for the nurse to withhold the dose and notify the prescriber for further evaluation and instructions.

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12. A patient who has been newly diagnosed with vertigo will be taking an antihistamine antemetic drug. The nurse will include which information when teaching the patient about this drug?

Explanation

The correct answer is b. The patient will need to avoid driving because of possible drowsiness. This information is important to include when teaching the patient about the antihistamine antemetic drug because drowsiness is a common side effect of this medication. Driving while drowsy can be dangerous and increase the risk of accidents. Therefore, it is essential for the patient to be aware of this potential side effect and take necessary precautions, such as avoiding driving or operating heavy machinery, to ensure their safety and the safety of others.

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13. A 49-year-old patient is in the clinic for a follow-up visit 6 months after starting a beta-blocker for treatment of hypertension. During this visit, his blood pressure is 169/98 mm Hg, and he eventually confesses that he stopped taking this medicine 2 months ago because of an "embarrassing problem." What problem did the most likely experience with this medication that caused him to stop taking it?

Explanation

Impotence is the most likely problem that the patient experienced with the beta-blocker medication, which caused him to stop taking it. Impotence, also known as erectile dysfunction, refers to the inability to achieve or maintain an erection sufficient for sexual intercourse. Beta-blockers can cause sexual side effects, including impotence, by interfering with the normal physiological responses involved in achieving an erection. This side effect can be embarrassing and distressing for patients, leading them to discontinue the medication.

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14. While recovering from surgery, a 74 year old woman started taking a stimulant laxative, senna (Senokot), to relieve constipation caused by the pain medications. Two weeks  later, at her follow-up appointment, she tells the nurse that she like how "regular" her bowel movements are now that she is taking the laxative. Which teaching principle is appropriate for this patient?

Explanation

Long-term use of laxatives often results in decreased bowel tone and may lead to dependency. This explanation is appropriate because it addresses the potential consequences of long-term laxative use, which is relevant to the patient's situation. It highlights the importance of not relying on laxatives for regular bowel movements and encourages the patient to explore other methods for relieving constipation.

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15. A patient has been taking donepezil (Aricept) for 2 weeks as part of the treatment for early stages of Alzheimer's disease. Her daughter calls the prescriber's office and is upset because "Mother has not improved one bit!" Which response by the nurse is appropriate?

Explanation

The appropriate response by the nurse is "It may take up to 6 weeks to see an improvement." This response acknowledges the daughter's concern and provides accurate information about the expected timeframe for improvement with donepezil. It is important for the nurse to educate the daughter about the realistic expectations of the medication and reassure her that improvement may take time.

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16. A patient has been taking a beta blocker for 4 weeks as part of his antianginal therapy. He also has type II diabetes and hyperthyroidism. When discussing possible adverse effects, the nurse will include which information? 

Explanation

Beta blockers can affect blood glucose levels in patients with diabetes. They can mask symptoms of hypoglycemia, making it difficult for the patient to recognize low blood sugar levels. At the same time, they can also impair the body's ability to raise blood sugar levels, leading to hyperglycemia. Therefore, it is important for the patient to monitor their blood glucose levels regularly to ensure they are within a safe range.

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17.  The nurse is administering a stat dose of epinephrine. Epinephrine is appropriate for which situation?

Explanation

Epinephrine is appropriate for cardiac arrest because it is a potent vasoconstrictor and stimulates the heart, leading to increased blood flow and oxygenation. It helps to restore normal heart rhythm and blood pressure during a cardiac arrest situation.

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18.  A hospitalized patient is experiencing a severe anaphylactic reaction to a dose of intravenous penicillin. Which drug will the nurse use to treat this condition? 

Explanation

Epinephrine is the drug of choice for treating severe anaphylactic reactions. It is a potent vasoconstrictor and bronchodilator that helps to reverse the symptoms of anaphylaxis, such as bronchoconstriction, hypotension, and edema. It acts quickly to increase blood pressure, open up the airways, and reduce swelling. Phenylephrine and pseudoephedrine are both decongestants that do not have the same rapid and potent effects as epinephrine. Ephedra is an herbal supplement that is not typically used in the treatment of anaphylaxis.

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19. The nurse is creating a plan of care for a patient with a new diagnosis of hypertension. Which is a potential nursing diagnosis for the patient taking antihypertensive medications?

Explanation

When a patient is taking antihypertensive medications, sexual dysfunction can be a potential nursing diagnosis. Antihypertensive medications can cause side effects such as decreased libido, erectile dysfunction, and difficulties with sexual arousal and orgasm. These side effects can significantly impact a patient's quality of life and may require nursing interventions such as education on managing sexual dysfunction, providing emotional support, and collaborating with the healthcare team to adjust medication regimen if necessary.

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20. A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion. The patient asks the nurse why he has to be on two medications. The nurse's response is based on which rationale?

Explanation

The nurse explains that heparin is used initially to start the anticoagulation process and allow time for the blood levels of warfarin to reach therapeutic levels. Warfarin takes longer to reach its full effect, so heparin is used as a bridge therapy. Once the blood levels of warfarin are adequate, heparin can be discontinued. This approach ensures effective anticoagulation and minimizes the risk of adverse effects.

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21.  A 14-year-old has been treated for asthma for almost 4 months. Two weeks ago, she was given salmeterol as part of her medication regimen. However, her mother has called the clinic to report that it does not seem to work when her daughter is having an asthma attack. Which response by the nurse is appropriate?

Explanation

The correct answer is "This medication is indicated for prevention of bronchospasms, not for relief of acute symptoms.” This response by the nurse is appropriate because salmeterol is a long-acting beta-agonist that is used for the prevention of asthma symptoms, not for immediate relief during an asthma attack. It is important for the nurse to educate the mother about the purpose of the medication and discuss the appropriate use of rescue medications for acute symptoms.

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22. The teaching for a patient who is taking tamsulosin (Flomax) to reduce urinary obstruction due to benign prostatic hyperplasia will include which of these? 

Explanation

Tamsulosin (Flomax) is an alpha-adrenergic blocker commonly used to treat urinary obstruction due to benign prostatic hyperplasia. One of the common side effects of this medication is orthostatic hypotension, which can cause dizziness or lightheadedness when standing up. Therefore, patients should be advised to get up slowly from a sitting or lying position to minimize the risk of falls or injuries. The other options are not relevant to the teaching for a patient taking tamsulosin.

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23. A patient has been taking  digoxin at home but took an accidental overdose and has developed toxicity.The patient has been admitted to the telemetry unit, where the physician has ordered digoxin immune Fab (Digibind). The patient asks the nurse why the medication is ordered. What is the nurse's nest response?

Explanation

Digoxin immune Fab (Digibind) is an antidote used to treat digoxin toxicity. It works by binding to the excess digoxin in the bloodstream and removing it from the body, thereby lowering the blood levels of digoxin. This helps to reverse the toxic effects of the medication. Therefore, the nurse's response that Digibind is an antidote to digoxin and will help to lower the blood levels is the correct explanation.

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24. 2. What is the nurses priority action if extravasation of an antineoplastic drug  occurs during intravenous (IV) administration?

Explanation

The nurse's priority action if extravasation of an antineoplastic drug occurs during IV administration is to stop the infusion immediately, but leave the IV catheter in place. This is important because it allows for the continued administration of an antidote or specific treatment through the same IV catheter, if available. Removing the catheter could lead to further complications or delay in treatment.

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25.  When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse will discuss which potential problem?   

Explanation

When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse will discuss the potential problem of impotence. Antihypertensive drugs can cause sexual dysfunction, including difficulty achieving or maintaining an erection, which can lead to impotence. This is an important potential side effect to discuss with male patients to ensure they are aware of the potential impact on their sexual health and to address any concerns or questions they may have.

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26. A patient with risk factors for coronary artery disease asks the nurse about the "good cholesterol" laboratory values. The nurse knows that "good cholesterol" refers to which lipids?    

Explanation

High-density lipoproteins (HDLs) are often referred to as "good cholesterol" because they help remove excess cholesterol from the bloodstream and transport it back to the liver for processing and elimination. High levels of HDLs are associated with a lower risk of coronary artery disease. Triglycerides, low-density lipoproteins (LDLs), and very-low-density lipoproteins (VLDLs) are not considered "good cholesterol" as they can contribute to the buildup of plaque in the arteries, increasing the risk of coronary artery disease.

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27. The nurse is reviewing the mechanism of action of antidiarrheal drugs. Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?

Explanation

Anticholinergics such as belladonna alkaloids work by decreasing the intestinal muscle tone and peristalsis of the intestines. This means that they reduce the contractions of the intestinal muscles, slowing down the movement of stool through the intestines. This can help to alleviate diarrhea by allowing more time for water absorption and reducing the frequency of bowel movements. Adsorbents, probiotics, and lubricants do not directly affect intestinal muscle tone or peristalsis.

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28. The nurse will teach the patient who is receiving oral iron supplements to watch for which expected adverse effects?

Explanation

The nurse will teach the patient who is receiving oral iron supplements to watch for black, tarry stools as an expected adverse effect. Iron supplements can cause gastrointestinal side effects, including dark or black stools, due to the presence of unabsorbed iron in the stool. This is a common and harmless side effect of iron supplementation and does not require immediate medical attention.

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29. A patient has had an overdose of an intravenous cholinergic drug. The nurse expects to administer which drug as an antidote?

Explanation

Atropine sulfate is the correct antidote for an overdose of an intravenous cholinergic drug. Cholinergic drugs stimulate the parasympathetic nervous system, while atropine sulfate is an anticholinergic drug that blocks the effects of acetylcholine. By administering atropine sulfate, the nurse can counteract the excessive cholinergic stimulation caused by the overdose and help restore normal physiological function. Atenolol, bethanechol, and dobutamine are not appropriate antidotes for cholinergic drug overdose.

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30. The nurse is providing teaching regarding drug therapy to the husband of a woman with Alzheimer's disease. She was diagnosed 3 months ago, has mild memory loss, and will be receiving donepezil (Aricept). What is the drug's expected action?

Explanation

Donepezil (Aricept) is a medication commonly used to treat Alzheimer's disease. It works by increasing the levels of a chemical messenger in the brain called acetylcholine, which is involved in memory and other cognitive functions. By increasing acetylcholine levels, donepezil may help to improve the symptoms of Alzheimer's disease, such as memory loss and cognitive decline. However, it does not prevent memory loss in later stages, reverse the course of the disease, or provide sedation to prevent agitation and restlessness.

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31. The nurse is reviewing the use of anticholinergic drugs with a patient and explains that anticholinergic drugs block the effects of which nervous system?   

Explanation

Anticholinergic drugs block the effects of the parasympathetic nervous system. The parasympathetic nervous system is responsible for rest and digest functions, such as slowing heart rate, constricting pupils, and increasing digestion. By blocking the effects of the parasympathetic nervous system, anticholinergic drugs can have various effects, such as increasing heart rate, dilating pupils, and decreasing digestion.

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32. A patient who has been taking antihypertensive drugs for a few months complains of having a persistent dry cough. The nurse explains that this cough is an adverse effect of which class of antihypertensive drugs?     

Explanation

Angiotensin-converting enzyme (ACE) inhibitors can cause a persistent dry cough as an adverse effect. This is because ACE inhibitors can increase the levels of bradykinin, a substance that can irritate the airways and cause coughing. Beta blockers, angiotensin II receptor blockers (ARBs), and calcium channel blockers do not typically cause this side effect.

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33. A patient has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin tablets. When teaching the patient how to use sublingual nitroglycerin, the nurse will include which instruction?   

Explanation

This instruction is included because if the chest pain is not relieved after taking one tablet of sublingual nitroglycerin, it may indicate a more serious condition such as a heart attack. Calling 911 immediately is important to ensure prompt medical attention and intervention.

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34. When administering heparin subcutaneously, the nurse will follow which procedure?

Explanation

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35. A patient who is taking warfarin (Coumadin) therapy has a headache and calls the prescriber's office to ask about taking a pain reliever. The nurse expects to receive instructions for which type of medication?

Explanation

When a patient is taking warfarin therapy, it is important to avoid medications that can increase the risk of bleeding. Aspirin and ibuprofen are both nonsteroidal anti-inflammatory drugs (NSAIDs) that can interfere with the blood-thinning effects of warfarin and increase the risk of bleeding. Opioids are not typically used for headaches and may have additional side effects. Acetaminophen is a pain reliever that does not have the same blood-thinning effects as NSAIDs, making it a safer choice for patients on warfarin therapy.

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36. A patient tells the nurse that he likes to eat large amounts of garlic "to help lower his cholesterol levels naturally." The nurse reviews his medication history and notes that which drug has a potential interaction with the garlic?    

Explanation

Garlic has been shown to have anticoagulant properties, meaning it can thin the blood and increase the risk of bleeding. Warfarin (Coumadin) is also an anticoagulant medication, so taking garlic along with it can further increase the risk of bleeding. Therefore, there is a potential interaction between garlic and Warfarin (Coumadin).

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37. The nurse recognizes that adrenergic drugs cause relaxation of the bronchi and bronchodilation by stimulating which type of receptors?

Explanation

Adrenergic drugs cause relaxation of the bronchi and bronchodilation by stimulating beta2-adrenergic receptors. These receptors are found in the smooth muscle of the bronchi and when stimulated, they cause the muscles to relax, leading to bronchodilation. This helps to open up the airways and improve airflow, making it easier for the patient to breathe. Dopaminergic receptors are not involved in bronchodilation, while alpha1-adrenergic and beta1-adrenergic receptors have different effects on other parts of the body and are not specifically involved in bronchial relaxation.

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38. A patient has been instructed to take one enteric-coated low-dose aspirin a day as part of therapy to prevent strokes. The nurse will provide which instruction when providing patient teaching about this medication?

Explanation

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39. 6. A patient who has had a liver transplant is taking mycophenolate (cellcept) for the prevention of organ rejection. She tells the nurse that she wants children. The nurse explains that the medication she is currently prescribed

Explanation

The correct answer is C because mycophenolate (cellcept) is known to cause congenital malformation or spontaneous abortions during pregnancy. It is a teratogenic medication that can harm the developing fetus. Therefore, it is not safe for a patient who wants to have children to continue taking this medication.

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40. The nurse is developing a plan care for a patient who is experiencing gastrointestinal adverse effects, including anorexia and nausea, after the first course of antineoplastic therapy. What is an appropriate goal for this patient when dealing with this problem? The patient will

Explanation

The goal of maintaining a diet of small, frequent feedings with nutrition supplements is appropriate for a patient experiencing gastrointestinal adverse effects. This approach helps to manage anorexia and nausea by providing the patient with smaller, more manageable meals that are easier to tolerate. Additionally, the use of nutrition supplements ensures that the patient is receiving adequate nutrients despite their decreased appetite. This goal focuses on maintaining the patient's nutrition and managing their symptoms while they undergo antineoplastic therapy.

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41. A patient has been taking iron supplements for anemia for 2 months. During a follow-up assessment, the nurse will observe for which therapeutic response?

Explanation

During a follow-up assessment, the nurse will observe for increased activity tolerance in a patient who has been taking iron supplements for anemia for 2 months. Iron is essential for the production of red blood cells, which carry oxygen to the body's tissues. Anemia leads to fatigue and decreased activity tolerance due to a lack of oxygen. By taking iron supplements, the patient's iron levels are likely to increase, leading to improved oxygen delivery and increased energy levels, resulting in an increased ability to tolerate physical activity. Therefore, increased activity tolerance is a therapeutic response that the nurse would expect to observe.

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42.  A patient is taking an alpha blocker as treatment for benign prostatic hyperplasia. The nurse will monitor for which potential drug effect?   

Explanation

The nurse will monitor for orthostatic hypotension as a potential drug effect of the alpha blocker medication. Alpha blockers work by relaxing the muscles in the prostate and bladder neck, which can cause a decrease in blood pressure. Orthostatic hypotension refers to a sudden drop in blood pressure when changing positions, such as standing up from a seated or lying position. This can lead to symptoms such as dizziness, lightheadedness, and even fainting. Therefore, it is important for the nurse to monitor the patient's blood pressure regularly and educate them about the potential side effect of orthostatic hypotension.

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43. A patient who has had abdominal surgery has been discharged on a cholinergic drug to assist in increasing gastrointestinal peristalsis. The nurse will teach this patient to look for which therapeutic effect?

Explanation

The nurse will teach the patient to look for the therapeutic effect of passage of flatus because cholinergic drugs stimulate the parasympathetic nervous system, which increases gastrointestinal peristalsis. This can help relieve symptoms of abdominal distension and discomfort by promoting the movement of gas through the intestines, leading to the passage of flatus. Decreased pulse rate, abdominal cramping, and decreased urge to void are not expected therapeutic effects of cholinergic drugs in this context.

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44. The nurse working in a preoperative admitting unit administers an anticholinergic medication to a patient before surgery. What is the purpose of this drug in the preoperative setting?

Explanation

The purpose of administering an anticholinergic medication before surgery is to reduce oral and gastrointestinal secretions. Anticholinergic drugs work by blocking the action of acetylcholine, a neurotransmitter that stimulates secretions in the body. By reducing secretions, the risk of aspiration during surgery is minimized, as well as the potential for complications related to excessive secretions in the respiratory and gastrointestinal tracts.

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45. When the nurse is administering topical nitroglycering ointment, which technique is correct?

Explanation

It is important to remove the old ointment before applying a new one to prevent buildup and ensure the effectiveness of the medication. This allows for proper absorption of the nitroglycerin into the skin.

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46. 3. Just before the second course of chemotherapy, the laboratory calls to report that the patients neutrophil count is 400 cells/mm3. The nurse expects that the oncologist will follow which course of treatment?

Explanation

The neutrophil count of 400 cells/mm3 indicates a low level of neutrophils, which are an important type of white blood cells that help fight infections. Chemotherapy can further decrease the neutrophil count, making the patient more susceptible to infections. Therefore, it is expected that the oncologist will withhold chemotherapy until the neutrophil count returns towards normal levels to minimize the risk of infection.

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47. A 30 year old woman in the clinic for her yearly gynecologic exam and asks the nurse about the '' new vaccine that prevents HPV'' She wants to receive the papillomavirus vaccine (gardisil). Which response by the nurse is most appropriate?

Explanation

The correct answer is A because the nurse is providing the appropriate information about the recommended age range for receiving the HPV vaccine. This answer addresses the patient's question about the vaccine and provides her with the necessary information to make an informed decision about receiving the vaccine.

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48.  The nurse is aware that adrenergic drugs produce effects similar to which of these nervous systems?

Explanation

Adrenergic drugs produce effects similar to the Sympathetic Nervous System. The Sympathetic Nervous System is responsible for the body's "fight or flight" response, which includes increased heart rate, elevated blood pressure, dilation of the pupils, and increased sweating. Adrenergic drugs mimic the effects of the sympathetic nervous system by activating adrenergic receptors in various organs and tissues, leading to similar physiological responses.

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49. During initial rounds, the nurse notes that a dobutamine infusion has extravasated into the forearm of a patient. After stopping the infusion, the nurse follows standing orders and immediately injects phentolamine (Regitine) subcutaneously in a circular fashion around the extravasation site. What is the mechanism of action of the phentolamine in this situation?

Explanation

Phentolamine is an alpha-adrenergic antagonist that works by blocking the alpha receptors on the smooth muscle of blood vessels. By doing so, it causes vasodilation, which increases blood flow to the ischemic site. This increased blood flow helps to prevent tissue damage caused by the extravasated dobutamine.

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50.  A cholinergic drug is prescribed for a patient with a new diagnosis of myasthenia gravis, and the nurse provides instructions to the patient about the medication. What is important include in the teaching?

Explanation

The correct answer is to take the medication 30 minutes before eating to improve swallowing and chewing. This is important because cholinergic drugs increase muscle strength and tone, which can help improve swallowing and chewing difficulties in patients with myasthenia gravis. Taking the medication before meals allows it to take effect before the patient starts eating, maximizing its therapeutic effect. Taking the medication with meals or only if difficulty swallowing occurs during a meal may not provide the same benefit.

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51. The nurse will monitor for which adverse effect when administering an anticholinergic drug?  

Explanation

When administering an anticholinergic drug, the nurse will monitor for the adverse effect of dry mouth. Anticholinergic drugs block the action of acetylcholine, a neurotransmitter responsible for various bodily functions, including saliva production. By blocking acetylcholine, these drugs can lead to a decrease in saliva production, resulting in dry mouth. Monitoring for this adverse effect is important as it can cause discomfort and may lead to other complications such as difficulty in swallowing or speaking.

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52. The nurse is teaching a community education program on hypertension. He informs his students that ______ are parameters that determine the regulation of arterial blood pressure.

Explanation

The nurse is teaching the students about the parameters that determine the regulation of arterial blood pressure. Cardiac output refers to the amount of blood pumped by the heart per minute, while systemic vascular resistance refers to the resistance to blood flow in the blood vessels. Both of these parameters play a crucial role in regulating arterial blood pressure. When cardiac output increases or systemic vascular resistance increases, arterial blood pressure tends to increase as well. Therefore, it is important for the students to understand the relationship between cardiac output and systemic vascular resistance in order to comprehend the regulation of arterial blood pressure.

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53. A patient is taking digoxin (Lanoxin) and a loop diuretic daily . When the nurse enters the room with the morning medications, the patient states, " I am seeing a funny yellow  color around the lights." What is the nurse's next action?

Explanation

The patient's complaint of seeing a funny yellow color around the lights could be indicative of digoxin toxicity, as visual disturbances are a common symptom. Therefore, the nurse's next action should be to assess the patient for other symptoms of digoxin toxicity, such as nausea, vomiting, dizziness, or changes in heart rate. This will help determine if the patient is experiencing an adverse reaction to the medication and if any further intervention or adjustment in dosage is necessary.

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54. While assessing a patient who is receiving intravenous digitalis, the nurse recognizes that the drug has a negative chronotropic  effect. How would this drug effect be evident in the patient?

Explanation

The drug's negative chronotropic effect would be evident in the patient through a decreased heart rate.

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55. When administering chemotherapy for treatment of cancer, the nurse implements which intervention that treats or even prevents chemotherapy –induced nausea and vomiting?

Explanation

Giving an antiemetic 30 to 60 minutes before the chemotherapy is started is the correct intervention to treat or prevent chemotherapy-induced nausea and vomiting. Antiemetics are medications that help to control nausea and vomiting. By administering the antiemetic before the chemotherapy is started, it allows the medication to be in the patient's system and working to prevent or reduce the nausea and vomiting that can be caused by the chemotherapy. This intervention helps to improve the patient's comfort and overall well-being during their cancer treatment.

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56. A patient is taking omeprazole (Prilosec) for the treatment of gastroesophageal reflux disease (GERD). The nurse will include which statement in the teaching plan about this medication?

Explanation

The correct answer is D. The entire capsule must be taken whole, not crushed, chewed, or opened. This is because omeprazole is a delayed-release medication that is designed to release the medication slowly over time. Crushing, chewing, or opening the capsule can interfere with the delayed-release mechanism and may result in a decrease in effectiveness of the medication. It is important for the patient to take the capsule whole to ensure proper absorption and effectiveness of the medication.

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57. During interleukin drug therapy, a patient is showing signs of severe fluid retention, with increasing dyspnea and severe peripheral edema. The next dose of the interleukin is due now. Which action will the nurse take next?

Explanation

The patient is experiencing severe fluid retention, dyspnea, and peripheral edema, which are signs of a potentially serious adverse reaction to the interleukin drug therapy. Holding the drug and notifying the prescriber is the appropriate action to ensure patient safety and to allow the prescriber to assess the situation and determine the best course of action. Giving the drug or monitoring the patient without consulting the prescriber could potentially worsen the patient's condition.

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58. When a patient is taking an adrenergic drug, the nurse expects to observe which effect?    

Explanation

When a patient is taking an adrenergic drug, the nurse expects to observe an increased heart rate. Adrenergic drugs stimulate the sympathetic nervous system, which is responsible for the "fight or flight" response. This response includes an increase in heart rate as the body prepares for physical exertion or stress. Therefore, it is expected that the patient's heart rate will be elevated while taking adrenergic drugs.

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59. The nurse is reviewing the JNC 7 guidelines for treatment of hypertension. Which blood pressure would be classified as "prehypertension" according to the JNC 7 guidelines?  

Explanation

According to the JNC 7 guidelines, blood pressure of 130/88 mm Hg would be classified as "prehypertension". This means that the individual's blood pressure is higher than normal, but not yet in the range of hypertension. Prehypertension is a warning sign that the individual is at risk for developing hypertension in the future, and lifestyle modifications such as diet and exercise may be recommended to prevent progression to hypertension.

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60. A patient is in the urgent care center after experiencing a black widow spider bite. The nurse prepares to give which product to treat this injury?

Explanation

Antivenins or antisera are the appropriate products to treat a black widow spider bite. Antivenins are made from antibodies that neutralize the venom of the spider, while antisera are blood products containing antibodies that can help counteract the effects of the venom. These products are specifically designed to treat venomous bites and stings and can be life-saving in severe cases. Live vaccines, tetanus immune globulin, and tularemia are not relevant to the treatment of a black widow spider bite.

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61. A patient is asking advice about which over-the-counter antacid is considered the most safe to use for heartburn. The nurse explains that calcium antacids are not used as frequently as other antacids because

Explanation

Calcium antacids are not used as frequently as other antacids because their use may result in kidney stones. This means that taking calcium antacids can increase the risk of developing kidney stones, which are hard deposits that form in the kidneys. This potential side effect makes calcium antacids less safe to use compared to other antacids for treating heartburn.

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62. While assessing a patient who is taking a beta blocker for angina, the nurse knows to monitor for which adverse effect?

Explanation

When a patient is taking a beta blocker for angina, the nurse should monitor for bradycardia as an adverse effect. Beta blockers work by blocking the beta receptors in the heart, which leads to a decrease in heart rate and cardiac output. Bradycardia is characterized by a heart rate that is slower than normal, and it can cause symptoms such as fatigue, dizziness, and fainting. Monitoring for bradycardia is important because it can indicate that the medication is having the desired effect, but it can also be a sign of a potentially serious complication.

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63. A patient has a digoxin level of 1.4 ng/mL. The nurse interprets that this level is

Explanation

A digoxin level of 1.4 ng/mL is considered to be within the therapeutic range. This means that the level of digoxin in the patient's blood is at a concentration that is effective for treating their condition. If the level was below the therapeutic range, it would not be sufficient to have a therapeutic effect. If the level was above the therapeutic range, it could potentially be toxic and cause adverse effects. Therefore, the nurse interprets that the digoxin level of 1.4 ng/mL is within the therapeutic range.

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64. The nurse is administering the phosphodiesterase inhibitor milrinone (Primacor) recognizes that this drug will have a positive inotropic effect. Which results reflects this effect?

Explanation

Milrinone is a phosphodiesterase inhibitor that works by increasing the levels of cyclic adenosine monophosphate (cAMP) in cardiac muscle cells. This leads to increased calcium influx into the cells, which in turn increases the force of cardiac contraction. Therefore, the correct answer is "Increased force of cardiac contraction." This drug does not directly affect heart rate, blood vessel dilation, or conduction of electrical impulses across the heart.

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65. 1.       A patient is receiving her third course of 5-fluorouracil therapy and knows that stomatitis is a potential adverse effect of antineoplastic therapy. What will the nurse teach her about managing this problem?

Explanation

The nurse will teach the patient to examine her mouth daily for bleeding, painful areas, and ulcerations as a way to manage stomatitis. Stomatitis is a potential adverse effect of antineoplastic therapy, and it refers to inflammation of the mouth. By regularly checking her mouth, the patient can identify any signs of bleeding, pain, or ulcers and report them to her healthcare provider for further evaluation and treatment. This proactive approach allows for early detection and management of stomatitis, reducing the risk of complications and promoting the patient's overall well-being.

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66. A patient asks about his cancer treatment with monoclonal antibodies. The nurse tells him that which is the major advantage of treating certain cancers with monoclonal antibodies?

Explanation

Monoclonal antibodies have the major advantage of targeting certain tumor cells and bypassing normal cells. This is beneficial because it allows for a more targeted and specific treatment approach, minimizing damage to healthy cells and reducing side effects. By selectively targeting tumor cells, monoclonal antibodies can effectively attack cancer cells while sparing healthy tissues. This targeted approach can lead to improved treatment outcomes and potentially fewer complications for the patient.

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67. The nurse is giving intravenous nitroglycerin to a patient who has just been admitted because of an acute myocardial infarction. Which statement is true regarding the administration of the intravenous form of this medication?

Explanation

The correct answer is that non-polyvinylchloride (non-PVC) plastic intravenous bags and tubing must be used. This is because nitroglycerin is known to interact with PVC, causing the release of phthalates, which can be harmful to the patient. Therefore, using non-PVC materials ensures the safety of the patient during the administration of intravenous nitroglycerin.

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68.  The nurse is preparing to administer adenosine (Adenocard) to a patient who is experiencing an acute episode of paroxysmal supraventricular tachycardia. When giving thismedication, which is important  to remember?

Explanation

Adenosine is a medication used to treat paroxysmal supraventricular tachycardia (PSVT). It works by slowing down the electrical conduction in the heart. One of the potential side effects of adenosine is a brief period of asystole, which is the absence of electrical activity in the heart. This can occur for a few seconds after administration. It is important for the nurse to be aware of this potential side effect and be prepared to monitor the patient closely during and after administration.

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69. The nurse is conducting a class on potential bioterroism aagents, and participants ask, ''which one has three routes of exposure to humans?'' which response by the nurse is correct?

Explanation

Anthrax is the correct answer because it can be transmitted to humans through three routes of exposure: inhalation, ingestion, and through cuts or abrasions on the skin. This makes it a potential bioterrorism agent that can easily infect a large number of people through different means of contact. Smallpox, botulism, and tularemia may have other routes of exposure, but they do not have three routes of exposure like anthrax does.

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70. A patient has a new prescription for tamsulosin (Flomax) as treatment for benign prostatic hyperplasia. The nurse is checking his current medication list and will contact the prescriber regarding a potential interaction if the patient is also taking which drug?

Explanation

Tamsulosin and sildenafil (Viagra) both work by relaxing the smooth muscles in the prostate and bladder neck, which can cause a significant drop in blood pressure. Therefore, if a patient is taking both medications, it can lead to a dangerous drop in blood pressure and potentially cause dizziness, lightheadedness, or fainting. Hence, the nurse should contact the prescriber to discuss the potential interaction and explore alternative treatment options.

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71. While a patient is receiving antilipemic therapy, the nurse knows to monitor the patient closely for the development of which problem?

Explanation

While a patient is receiving antilipemic therapy, the nurse needs to closely monitor the patient for the development of liver dysfunction. Antilipemic therapy is used to lower lipid levels in the blood, and some medications used for this purpose can have adverse effects on the liver. Monitoring liver function is important to detect any signs of liver damage or dysfunction, such as elevated liver enzymes or jaundice. Prompt identification of liver dysfunction allows for early intervention and prevention of further complications.

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72. A patient is receiving lactulose (chronulac) three times a day. The nurse knows that the patient is not constipated and is receiving this drug for which reason?

Explanation

The patient is receiving lactulose three times a day because they have high ammonia levels due to liver failure. Lactulose is commonly used to treat hepatic encephalopathy, a condition that occurs when the liver is unable to remove toxins like ammonia from the blood. Lactulose works by drawing water into the colon, which helps to soften the stool and increase the frequency of bowel movements, leading to the elimination of ammonia from the body. Therefore, options B, C, and D are incorrect as they do not pertain to the specific reason for administering lactulose in this case.

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73. The nurse is monitoring a patient who has severe bone marrow suppression following antineoplastic drug therapy. Which is considered the principal early sign of infection?

Explanation

Fever is considered the principal early sign of infection because it is a common response of the body to an infection. When the body detects the presence of pathogens, it raises its temperature in an attempt to kill off the invaders. Monitoring for fever in a patient with severe bone marrow suppression is crucial because their immune system may be compromised, making them more susceptible to infections. Detecting and treating infections early can help prevent further complications and promote the patient's recovery.

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74. The nurse is teaching a class about the various chemotherapy drugs and explains that alkylating drugs are also called ''cell cycle-nonspecific drugs'' because they are

Explanation

Alkylating drugs are called "cell cycle-nonspecific drugs" because they are cytotoxic in any phase of the cell cycle. This means that they can effectively kill cancer cells regardless of whether they are actively dividing or not. Unlike cell cycle-specific drugs that target specific phases of the cell cycle, alkylating drugs have a broader mechanism of action and can target cancer cells at any stage of their growth. This makes them effective against a wide range of neoplasms and a valuable tool in chemotherapy treatment.

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75. A patient with type 2 diabetes mellitus has been found to have trace proteinuria. The prescriber writes an order for an angiotensin-converting enzyme (ACE) inhibitor. What is the main reason for prescribing this class of drug for this patient?  

Explanation

The main reason for prescribing an ACE inhibitor for a patient with type 2 diabetes mellitus and trace proteinuria is because it has renal protective effects. ACE inhibitors have been shown to slow the progression of kidney disease in patients with diabetes by reducing the amount of protein that is leaked into the urine. This can help preserve kidney function and prevent further damage to the kidneys. Additionally, ACE inhibitors also have cardioprotective effects and can help reduce blood pressure, but the primary reason for prescribing them in this case is their renal protective effects.

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76.  A calcium channel blocker (CCB) is prescribed for a patient, and the nurse provides instructions to the patient about the medication. Which instruction is correct? 

Explanation

A high-fiber diet with plenty of fluids will help prevent the constipation that may occur when taking a calcium channel blocker (CCB). CCBs are known to cause constipation as a side effect, and increasing fiber intake and staying hydrated can help alleviate this symptom.

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77. The nurse is reviewing infection-prevention measures with a patient who is receiving antineoplastic drug therapy. Which statement by the patient indicates the need for further teaching?

Explanation

The correct answer indicates a need for further teaching because it suggests that the patient believes that only fresh fruits and vegetables are safe to consume while receiving antineoplastic drug therapy. This statement shows a lack of understanding about the importance of food safety measures, such as washing fruits and vegetables thoroughly, to prevent infections.

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78. A patient is receiving doxorubicin (Adriamycin) as a part of treatment for ovarian cancer. Which nursing diagnosis is related to this antineoplastic drug?

Explanation

Doxorubicin (Adriamycin) is known to cause cardiotoxicity, which can lead to a decrease in cardiac output. This can result in decreased blood flow to the organs and tissues, leading to potential complications. Therefore, the nursing diagnosis related to this antineoplastic drug would be "Decreased cardiac output related to the adverse effect of cardiotoxicity." This diagnosis reflects the potential impact of the medication on the patient's cardiovascular system and the need for monitoring and intervention to prevent or manage any cardiac complications.

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79. A patient will be taking bismuth subsalicylate (pepto-bismol) to control diarrhea. When reviewing the patients other ordered medications, the nurse recognizes that which medication will interact significantly with the pepto bismol?

Explanation

Bismuth subsalicylate (pepto-bismol) can interact with warfarin (Coumadin), an anticoagulant, and increase the risk of bleeding. This is because both medications have anticoagulant effects and can further thin the blood, leading to excessive bleeding. It is important for the nurse to recognize this potential interaction and inform the healthcare provider to adjust the dosage or consider alternative medications to avoid complications. Acetaminophen (Tylenol), levothyroxine (synthroid), and fluoxetine (Prozac) do not have significant interactions with bismuth subsalicylate.

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80.  An adrenergic agonist is ordered for a patient in shock. The nurse will not that this drug has had its primary intended effect if which expected outcome occurs?

Explanation

If the adrenergic agonist is effective, it will increase blood pressure. Adrenergic agonists stimulate the adrenergic receptors in the sympathetic nervous system, causing vasoconstriction and increased heart rate, which ultimately leads to an increase in blood pressure. This is the primary intended effect of the drug in a patient who is in shock, as low blood pressure is a characteristic feature of shock. Therefore, if the patient's blood pressure increases after administration of the adrenergic agonist, it indicates that the drug is working as intended.

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81.  A patient with elevated lipid levels has a new prescription for nicotinic acid (Niacin). The nurse informs the patient that which adverse effects may occur with this medication?

Explanation

Nicotinic acid, also known as niacin, is commonly used to treat elevated lipid levels. One of the most common adverse effects of niacin is cutaneous flushing, which refers to the sudden reddening and warmth of the skin. This occurs due to the dilation of blood vessels. Pruritus, or itching, is also a common side effect of niacin. These adverse effects are usually temporary and can be minimized by taking niacin with food or using a sustained-release formulation. Tinnitus, urine with a burnt odor, myalgia, fatigue, blurred vision, and headaches are not commonly associated with niacin use.

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82. 8. The nurse is providing teaching to a patient who will be taking the laxative bisacodyl (Dulcolax). Which statement by the nurse is appropriate during this teaching session?

Explanation

Taking the tablets with water, not milk or juice, is appropriate because bisacodyl should be taken with water to ensure proper absorption and effectiveness. Milk or juice may interfere with the absorption of the medication.

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83. During an admission assessment, the patient tells the nurse that he has been self-treating his heartburn for 1 year with over-the-counter Prilosec (OTC) (omeprazole, a proton pump inhibitor). The nurse is aware that this self-treatment may have which result?

Explanation

Long-term use of proton pump inhibitors, such as omeprazole, may contribute to osteoporosis. These medications can decrease the absorption of calcium in the body, which can lead to weakened bones over time. It is important for patients who are using these medications long-term to monitor their bone health and consider calcium and vitamin D supplementation.

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84. A patient with severe liver disease is receiving the angiotensin converting enzyme (ACE) inhibitor, captopril (Capoten). The nurse is aware that the advantage of this drug for this patient is which characteristic?   

Explanation

Captopril is not a prodrug and does not need to be metabolized by the liver before becoming active. This is advantageous for a patient with severe liver disease because their liver may not be able to efficiently metabolize drugs. Since captopril is already active and does not require liver metabolism, it can be safely used in patients with liver disease.

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85. The nurse is reviewing drug therapy for hypertension. According to the JNC 7 guidelines, antihypertensive drug therapy for a newly diagnosed stage 1 hypertensive African-American patient would most likely include which drug or drug classes.   

Explanation

According to the JNC 7 guidelines, antihypertensive drug therapy for a newly diagnosed stage 1 hypertensive African-American patient would most likely include calcium channel blockers with thiazide diuretics. This combination is recommended because African-Americans tend to have a higher prevalence of salt sensitivity, and thiazide diuretics help to reduce sodium and fluid retention. Calcium channel blockers work by relaxing the blood vessels, reducing peripheral resistance, and lowering blood pressure. Therefore, this combination is considered an effective treatment option for African-American patients with hypertension.

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86. A patient is to receive iron dextran injections. Which technique is appropriate when the nurse is administering this medication?

Explanation

The correct answer is c. Intramuscular injection using the z track method. The z track method is appropriate for administering iron dextran injections because it helps to prevent leakage of the medication into the subcutaneous tissue. This method involves pulling the skin and underlying tissues to the side before injecting the medication, and then releasing them after the injection is complete. This creates a zigzag or "z" pattern, which helps to seal the injection site and prevent medication leakage.

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87. A patient has been receiving epoetin (epogen) for severe iron-deficiency anemia. Today, the provoder changed the order to darbepoetin (aranesp). The patient questions the nurse, '' what is the difference in these drugs?'' which response by the nurse is correct?

Explanation

Aranesp is a longer-acting form of the drug, so the patient will need to receive fewer injections compared to epogen. This means that the patient will have a longer duration of action with Aranesp, which can help in managing their anemia more effectively.

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88. A sanitation worker has experienced a needle stick by a contaminated needle that was placed in a trash can. The employee health nurse expects that which drug will be used to provide passive immunity to hepatitis B infection?

Explanation

The correct answer is C. Hepatitis B immunoglobulin (BayHep B). When a sanitation worker experiences a needle stick injury with a contaminated needle, there is a risk of contracting hepatitis B infection. Hepatitis B immunoglobulin is used as a form of passive immunity to provide immediate protection against the virus. It contains antibodies that can neutralize the hepatitis B virus and prevent infection. This is different from the hepatitis B vaccine, which is a form of active immunity that stimulates the body to produce its own antibodies against the virus.

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89. A patient is receiving a dose of edrophonium (Tensilon). The nurse recognizes that this drug is given to determine the diagnosis of which disease?

Explanation

Edrophonium (Tensilon) is a medication used to diagnose Myasthenia Gravis. Myasthenia Gravis is an autoimmune disorder characterized by muscle weakness and fatigue. Edrophonium works by inhibiting the enzyme acetylcholinesterase, which increases the availability of acetylcholine at the neuromuscular junction, temporarily improving muscle strength in patients with Myasthenia Gravis. Therefore, the administration of edrophonium helps determine the diagnosis of Myasthenia Gravis.

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90. A patient who has recently started therapy on a statin drug asks the nurse how long it will take until he sees an effect on his serum cholesterol. Which statement would be the nurse's best response?

Explanation

The nurse's best response would be "It takes 6 to 8 weeks to see a change in cholesterol levels." This is because statin drugs take some time to start lowering cholesterol levels in the blood. It is important for the patient to understand that it may take a few weeks before they see any significant effect on their serum cholesterol.

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91. The nurse is discussing the use of adsorbents such as bismuth subsalicylate (pepto-bismol) with a patient who has diarrhea. The nurse will warn the patient about which possible adverse effect?

Explanation

The nurse will warn the patient about the possible adverse effect of dark stool and blue gums when using adsorbents such as bismuth subsalicylate (pepto-bismol) for diarrhea. This is because bismuth subsalicylate can cause the stool to turn black, which is a harmless but temporary side effect. Additionally, it can also cause the gums to temporarily turn a blue-black color. It is important for the nurse to inform the patient about these potential side effects to prevent unnecessary concern or alarm.

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92. A patient calls the clinic to speak to the nurse about taking an herbal product that contains ginkgo (Ginkgo biloba) to "help my memory." He states the he has read much information about the herbal product. Which statement by the patient indicates a need for further education?

Explanation

The patient's statement about taking aspirin or ibuprofen for a headache indicates a need for further education because ginkgo may cause increased bleeding, and taking these medications along with ginkgo could further increase the risk of bleeding. The patient should be advised to avoid taking aspirin or ibuprofen while using the herbal product to minimize the potential for adverse effects.

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93. When starting a patient on antidysrhythmic therapy, the nurse will remember that which problem is a potential adverse effect of any antidysrhythmic drug?

Explanation

When starting a patient on antidysrhythmic therapy, the nurse must be aware that dysrhythmias can be a potential adverse effect of any antidysrhythmic drug. This means that the medication intended to treat dysrhythmias can actually cause or worsen abnormal heart rhythms. It is important for the nurse to closely monitor the patient's heart rhythm and report any new or worsening dysrhythmias promptly to the healthcare provider.

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94. A patient calls the clinic office saying that the cholestyramine (Questran) powder he started yesterday clumps and sticks to the glass when he tries to mix it. The nurse will suggest what method for mixing the medication for administration?

Explanation

The correct answer is to mix the powder with food or fruit, or at least 4 to 6 ounces of fluid. This method is suggested because cholestyramine powder tends to clump and stick to the glass when mixed with liquid alone. Mixing it with food or fruit, or a sufficient amount of fluid, helps to ensure that the powder is properly dissolved and easier to consume.

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95. The nurse is administering an interferon and will implement which intervention?

Explanation

When administering interferon subcutaneously, it is important to rotate the injection sites to prevent tissue damage and ensure proper absorption of the medication. By rotating the sites, the nurse can avoid injecting into the same area repeatedly, reducing the risk of pain, inflammation, and infection. This intervention also helps to maintain the effectiveness of the medication and promote patient comfort and safety.

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96. A patient has an order for the monoclonal antibody adalimumab (humira). The nurse notes that the patient does not have a history of breast cancer. What is another possible reason for administering this drug?

Explanation

The correct answer is B. Rheumatoid arthritis. Adalimumab is a monoclonal antibody that is commonly used to treat autoimmune conditions such as rheumatoid arthritis. It works by targeting and blocking a specific protein in the body that is involved in the inflammatory response. While adalimumab can be used for other conditions, such as Crohn's disease or psoriasis, rheumatoid arthritis is a common indication for this medication. Severe anemia, thrombocytopenia, and osteoporosis are not typically treated with adalimumab.

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97.  When monitoring a patient who is taking a cholinergic drug, the nurse will watch for which cardiovascular effect?

Explanation

When a patient is taking a cholinergic drug, it increases the activity of the parasympathetic nervous system, which can lead to a decrease in heart rate. This is known as bradycardia. The nurse will monitor the patient for this cardiovascular effect, as it can be a potential side effect of the medication.

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98. 7. A 45 year old man has received a series of immunizing drugs in preparation for a trip to a developing country. Within hours, his wife brings him to the emergency department because he has developed edema to the face, tongue, and throat and is having trouble breathing. The nurse suspects that based on the patients history and symptoms, he is experiencing which condition?

Explanation

The patient's symptoms of edema to the face, tongue, and throat, along with difficulty breathing, are consistent with an allergic reaction. Serum sickness is an immune complex-mediated hypersensitivity reaction that can occur in response to certain medications, including immunizing drugs. This reaction typically occurs within hours to days after exposure to the medication. Symptoms may include rash, fever, joint pain, and swelling of the face, tongue, and throat. Therefore, based on the patient's history and symptoms, serum sickness is the most likely explanation for his condition.

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99. A patient will be taking a 2 week course of combination therapy with omeprazole (Prilosec) and another drug for a peptic ulcer caused by H. pylori. The nurse expects a drug from which class to be ordered with the omeprazole?

Explanation

The nurse expects an antibiotic to be ordered with omeprazole because H. pylori is a bacteria that causes peptic ulcers. Antibiotics are used to treat bacterial infections, so it would be the appropriate class of drug to use in combination therapy with omeprazole to target and eliminate the H. pylori bacteria.

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100. Two patients arrive at the clinic; one is a young boy with sickle cell anemia, and another is a 57 year old woman with early stages of Hodgkin's disease. The nurse notices that both patients need the same vaccine. What vaccine would that be?

Explanation

The Haemophilus influenza type b (Hib) vaccine would be needed for both the young boy with sickle cell anemia and the 57-year-old woman with early stages of Hodgkin's disease. This vaccine helps protect against a bacterial infection that can cause serious illnesses such as meningitis, pneumonia, and sepsis. Both patients, regardless of their specific conditions, would benefit from receiving this vaccine to prevent these potential complications.

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101. A  patient is receiving a tube feeding through a gastrostomy. The nurse expects that which type of drug will be used to promote gastric empyting for this patient?

Explanation

Prokinetic drugs, such as metoclopramide (Reglan), are used to promote gastric emptying. These drugs increase the motility of the gastrointestinal tract, helping to move food through the stomach and into the intestines. This can be particularly beneficial for patients receiving tube feedings through a gastrostomy, as it helps to prevent food from sitting in the stomach for an extended period of time and reduces the risk of complications such as aspiration or delayed gastric emptying.

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102. A nurse is giving instructions to a patient who will be receiving oral iron supplements. Which instructions will be included in the teaching plan?

Explanation

The correct answer is C because taking iron tablets with meals can help alleviate gastrointestinal distress that may occur as a side effect of the medication. Taking the tablets with milk or antacids (option A) can decrease the absorption of iron. Crushing the pills (option B) may alter the medication's effectiveness. Taking the tablets through a straw (option D) does not have any relevance to the administration of oral iron supplements.

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103. 1.       At 9:00, the nurse is about to give morning medications, and the patient has asked for a dose of antacid for severe heartburn. Which schedule for the antacid and medications is correct?

Explanation

The correct answer is c. Give the medications at 9:00, and then the antacid at 10:00. This schedule is correct because antacids can interfere with the absorption of certain medications. By giving the medications first and waiting for an hour before giving the antacid, the effectiveness of the medications will not be compromised. This allows the patient to receive the full benefit of both the medications and the antacid.

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104. A patient has received an accidental overdose of intravenous atropine. The nurse prepares and administers which drug?  

Explanation

Physostigmine (Antilirium) is the correct answer because it is an antidote for atropine overdose. Atropine is a medication that blocks the effects of acetylcholine, causing an increase in heart rate and drying of secretions. Physostigmine works by inhibiting the breakdown of acetylcholine, thereby counteracting the effects of atropine. Atenolol is a beta-blocker used for hypertension and does not reverse the effects of atropine. Bethanechol is a cholinergic agonist used for urinary retention and would exacerbate the symptoms of atropine overdose. Dicyclomine is an anticholinergic used for irritable bowel syndrome and would also worsen the symptoms of atropine overdose.

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105. During therapy with the hematopoietic drugs epoetin alfa (epogen), the nurse instructs the patient about adverse effect that may occur, such as

Explanation

During therapy with epoetin alfa, the nurse instructs the patient about the adverse effect of hypertension. Epoetin alfa is a hematopoietic drug that stimulates the production of red blood cells. One of the potential side effects of this drug is an increase in blood pressure, leading to hypertension. It is important for the nurse to educate the patient about this potential adverse effect so that they can monitor their blood pressure regularly and seek medical attention if necessary.

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106. A patient who has been on methotrexate therapy is experiencing mild pain. Her husband calls to see if he can give her aspirin for the pain. The nurse response is based on the fact that aspirin

Explanation

Aspirin can lead to methotrexate toxicity. Methotrexate is a medication commonly used to treat certain types of cancer, rheumatoid arthritis, and psoriasis. It works by slowing down the growth of cells, including cancer cells and cells of the immune system. Aspirin, on the other hand, can interfere with the elimination of methotrexate from the body, leading to increased levels of the drug in the blood. This can result in methotrexate toxicity, which can cause serious side effects such as liver damage, kidney damage, and bone marrow suppression. Therefore, it is important for patients on methotrexate therapy to avoid taking aspirin without consulting their healthcare provider.

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107. A patient is going home with a new prescription for the beta-blocker atenolol (Tenormin). The nurse will include which content when teaching the patient about this drug?

Explanation

The correct answer is "Never stop taking this medication abruptly." This is an important instruction for patients taking beta-blockers like atenolol because abruptly stopping the medication can lead to rebound hypertension, increased heart rate, and other withdrawal symptoms. It is important for patients to gradually taper off the medication under the guidance of their healthcare provider to avoid any adverse effects.

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108.  A 58-year-old man has had a myocardial infarction (MI), has begun rehabilitation, and is ready for discharge. He is given a prescription for metoprolol (Lopressor), and he becomes upset after reading the patient education pamphlet. "I don't have high blood pressure—why did my doctor give me this medicine?" The nurse explains to him that

Explanation

Metoprolol (Lopressor) is a beta-blocker medication commonly prescribed after a heart attack. Studies have shown that this medication has greatly increased survival rates in patients who have had a heart attack. It helps to prevent further damage to the heart and reduces the risk of future heart attacks. Although the patient may not have high blood pressure, metoprolol is prescribed for its cardiac benefits rather than solely for blood pressure control. The nurse explains this to the patient, reassuring him that the medication is important for his overall heart health and recovery.

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109. 5. A patient who has received chemotherapy has a steadily decreasing white blood cell count. The chemotherapy will end on Tuesday afternoon. The oncologist has mentioned that a colony stimulating factor will be started soon. The nurse knows that the appropriate time to start this medication is when?

Explanation

The appropriate time to start the colony stimulating factor medication is on Wednesday afternoon, 24 hours after the chemotherapy ends. This is because the medication is used to stimulate the production of white blood cells, which are typically suppressed by chemotherapy. Starting the medication too early while the patient is still receiving chemotherapy may not be effective, as the chemotherapy is still actively suppressing the white blood cell count. Waiting until 24 hours after the chemotherapy ends allows for the medication to have the best chance of stimulating the production of white blood cells.

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110. A patient who has been diagnosed with Sjögren's syndrome will be given cevimeline (Evoxac) for the treatment of xerostomia. The nurse will monitor for what therapeutic effect?

Explanation

Cevimeline (Evoxac) is a medication that is commonly prescribed for the treatment of xerostomia, which is a symptom of Sjögren's syndrome. Xerostomia refers to dry mouth, which can significantly impact a patient's quality of life. The therapeutic effect of cevimeline is to stimulate salivation, which helps to alleviate the symptoms of dry mouth. By increasing the production of saliva, cevimeline helps to moisten the mouth, improve oral health, and facilitate the process of chewing and swallowing. Therefore, the nurse will monitor for the therapeutic effect of stimulation of salivation in a patient who is receiving cevimeline for the treatment of xerostomia.

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111. The nurse is preparing to administer adenosine (Adenocard) to a patient who is experiencing an acute episode of paroxysmal supraventricular tachycardia. When giving thismedication, which is important  to remember?

Explanation

Adenosine is a medication used to treat paroxysmal supraventricular tachycardia (PSVT). It works by slowing down the electrical conduction in the heart. One of the important things to remember when giving adenosine is that asystole, which is the absence of electrical activity in the heart, may occur for a few seconds after administration. This is a normal and expected effect of the medication. It is important for the nurse to be prepared to monitor the patient closely during this time and be ready to provide any necessary interventions if needed.

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112. A laxative has been ordered for a patient. The nurse checks the patients medical history and would be concerned if which condition is present?

Explanation

The nurse would be concerned if the patient has abdominal pain of unknown origin because it could indicate a more serious underlying condition that needs to be addressed before administering a laxative. The nurse needs to determine the cause of the abdominal pain before proceeding with any treatment. High ammonia levels due to liver failure may be a contraindication for certain medications, but it is not directly related to the use of a laxative. Diverticulosis and chronic constipation are conditions that may actually warrant the use of a laxative.

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113. A female patient is receiving palliative therapy with androgen hormones as part of treatment for inoperable breast cancer. The nurse will discuss with the patient which potential body image changes that may occur as adverse effects?

Explanation

The correct answer is A. Hirsutism and acne. Androgen hormones can cause an increase in hair growth (hirsutism) and acne in women. These changes can have a negative impact on body image, as they may be seen as undesirable or unfeminine. By discussing these potential adverse effects with the patient, the nurse can help prepare her for these changes and provide support and education on managing them. Weight gain, flushing and hot flashes, and alopecia and body odor are not typically associated with androgen hormone therapy for breast cancer.

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114. The nurse is reviewing the health history of a patient who will be receiving antacids, the nurse recalls that antacids containing magnesium need to be used cautiously in patients with which condition?

Explanation

Antacids containing magnesium need to be used cautiously in patients with renal failure because magnesium is primarily excreted by the kidneys. In patients with renal failure, their kidneys are not functioning properly, which can lead to an accumulation of magnesium in the body. This can result in hypermagnesemia, a condition characterized by high levels of magnesium in the blood. Hypermagnesemia can cause symptoms such as nausea, vomiting, weakness, and in severe cases, can lead to cardiac arrhythmias and respiratory depression. Therefore, it is important to monitor magnesium levels and use alternative antacids in patients with renal failure.

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115. During a teaching session about self-monitoring while taking a beta-blocker at home, the nurse has taught the patient to take his apical pulse daily for 1 minute. If the pulse rate decreases to less than 60 beats per minute, the nurse will instruct the patient to:

Explanation

If the patient's pulse rate decreases to less than 60 beats per minute while taking a beta-blocker, it is important to notify the prescriber. This is because a pulse rate below 60 beats per minute may indicate bradycardia, which can be a potential side effect of beta-blockers. The prescriber needs to be informed so that they can evaluate the patient's condition and determine if any changes in medication dosage or treatment plan are necessary.

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116. A nurse is working in an immunization clinic. A new collegue asks, "when is first dose of the diphtheria, tetanus, and acellular pertussis (Dtap)given? The nurse knows that this series is started at what age?

Explanation

The correct answer is B. 6 weeks. The nurse knows that the first dose of the diphtheria, tetanus, and acellular pertussis (Dtap) vaccine is given at 6 weeks of age. This is the recommended age to start the series of vaccinations for Dtap. Starting the series at this age helps to provide early protection against these diseases.

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117. A patient with motion sickness is planning a cross-country car trip and has a new prescription for a scopolamine transdermal patch. The nurse provides teaching for the use of this patch medication. The patient shows a correct understanding of the teaching with which statement?

Explanation

The correct understanding of the teaching is to change the scopolamine transdermal patch every 3 days. This is because the patch releases medication slowly over a period of time, typically 3 days, to help prevent motion sickness. Changing the patch too frequently or infrequently may result in inadequate or excessive medication delivery, respectively.

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118. A patient's blood pressure elevates to 270/150 mm Hg, and a hypertensive emergency is obvious. He is transferred to the intensive care unit and started on a sodium nitroprusside (Nipride) drip to be titrated per his response. With the medication, the nurse knows that the maximum dose of this drug should be infused for how long?

Explanation

The correct answer is 10 minutes because sodium nitroprusside is a potent vasodilator that is used in hypertensive emergencies to rapidly lower blood pressure. It has a very short half-life of only a few minutes, so it needs to be infused continuously at a high dose to maintain its effects. Infusing the maximum dose for 10 minutes allows for a rapid reduction in blood pressure while minimizing the risk of excessive hypotension.

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119. 4. During therapy with the cytotoxic antibiotic bleomycin, the nurse will assess for a potentially serious adverse effect by monitoring which assessment finding?

Explanation

During therapy with the cytotoxic antibiotic bleomycin, the nurse will assess for a potentially serious adverse effect by monitoring respiratory function. Bleomycin can cause pulmonary toxicity, which can manifest as cough, dyspnea, and pulmonary infiltrates on imaging. Monitoring respiratory function is important to detect any signs of pulmonary toxicity early and intervene promptly to prevent further complications. Assessing blood urea nitrogen and creatinine levels, cardiac ejection fraction, and peripheral nerve sensation are not specifically related to the potential adverse effect of bleomycin therapy.

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120. When administering a bulk-forming laxative, the nurse instructs the patient to drink the medication mixed in a full 8-oz glass of water. Which statement best explains the rationale for this instruction?

Explanation

Bulk-forming laxatives work by absorbing water in the intestines, which helps to soften the stool and promote bowel movements. If these laxatives are taken without enough water, they can swell and cause a blockage in the esophagus, leading to esophageal obstruction. Therefore, it is important for the patient to drink a full 8-oz glass of water when taking a bulk-forming laxative to ensure that there is enough fluid in the intestines to prevent this potential complication.

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121. The nurse is reviewing the mechanism of action of cholinergic drugs. The undesired effects of cholinergic drugs come from the stimulation of which receptors?

Explanation

Cholinergic drugs stimulate cholinergic receptors in the body. Nicotinic receptors are found in both the autonomic ganglia and the neuromuscular junctions of skeletal muscles. Stimulation of nicotinic receptors can lead to undesired effects such as skeletal muscle contractions, increased heart rate, and increased blood pressure. Therefore, the undesired effects of cholinergic drugs come from the stimulation of nicotinic receptors.

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122. A patient is receiving an aluminum-containing antacid. The nurse will inform the patient to watch for which possible adverse effect?

Explanation

When a patient is taking an aluminum-containing antacid, the nurse should inform the patient to watch for constipation as a possible adverse effect. Aluminum-containing antacids can cause constipation due to their ability to slow down the movement of the gastrointestinal tract. This can lead to difficulty in passing stool and can cause discomfort for the patient. Therefore, it is important for the nurse to educate the patient about this potential side effect and advise them to seek medical assistance if constipation becomes severe or persists for an extended period of time.

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123. The nurse is administering liquid oral iron supplements. Which intervention is appropriate when administering this medication?

Explanation

When administering liquid oral iron supplements, instructing the patient to take the medication through a plastic straw is appropriate. This intervention helps to prevent the medication from staining the teeth, as iron supplements can cause tooth discoloration. Using a straw allows the liquid to bypass direct contact with the teeth, reducing the risk of staining.

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124. A patient is receiving high doses of methotrexate and is experiencing severe bone marrow suppression. The nurse explains that which intervention is to be ordered with this drug to reduce this problem?

Explanation

Leucovorin rescue is the correct intervention to reduce severe bone marrow suppression caused by high doses of methotrexate. Methotrexate is an antimetabolite that inhibits the synthesis of DNA, RNA, and proteins, leading to bone marrow suppression. Leucovorin is a folate analog that helps to rescue normal cells from the toxic effects of methotrexate by providing a source of reduced folate, which is necessary for DNA synthesis. By administering leucovorin, the nurse can help protect the patient's bone marrow and reduce the severity of the suppression.

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125. The nurse is reviewing new postoperative orders and notes that the order reads, "Give hydroxyzine (Visatril) 50 mg  IV prn nausea or vomiting." The patient is complaining of slight nausea . Which action by the nurse is correct at this time?

Explanation

The nurse should call the prescriber to question the route that is ordered because hydroxyzine can be given orally, intramuscularly, or intravenously, but the oral route is preferred for treating nausea. The nurse should clarify with the prescriber if the medication can be given orally instead of intravenously. Holding the dose until the patient complains of severe nausea (option a) is not appropriate as the patient is already experiencing slight nausea. Giving the dose orally instead of IV (option b) may be a possible action, but it is important to confirm with the prescriber first. Giving the patient the IV dose of hydroxyzine as ordered (option c) may not be the best choice as the oral route is preferred in this situation.

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126. When administrating mineral oil, the nurse recognizes that it can be interference with the absorption of which substance?

Explanation

Mineral oil is known to interfere with the absorption of fat-soluble vitamins. Fat-soluble vitamins, such as vitamins A, D, E, and K, require fat for proper absorption in the body. Mineral oil can form a barrier in the intestines, preventing the absorption of these vitamins. This can lead to deficiencies in these vitamins if mineral oil is administered regularly or in large amounts. Water-soluble vitamins, minerals, and electrolytes are not affected by mineral oil interference.

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127. The nurse is administering intravenous iron dextran for the first time to a patient with anemia. After giving a test dse, how long will the nurse wait before administering the remaining portion of the dose?

Explanation

After giving a test dose of intravenous iron dextran to a patient with anemia, the nurse should wait for 1 hour before administering the remaining portion of the dose. This is because a test dose is given to monitor the patient for any adverse reactions or allergies. Waiting for 1 hour allows the nurse to observe the patient for any signs of an allergic reaction or adverse effects before administering the full dose. This is a standard practice to ensure patient safety and minimize the risk of any complications.

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128. A patient is complaining of excessive and painful gas. The nurse checks the patients medication orders and prepares to administer which drug for this problem?

Explanation

Simethicone (mylicon) is the correct answer because it is a medication used to relieve symptoms of excessive gas in the digestive tract. It works by breaking down gas bubbles, making it easier for them to be passed out of the body. Famotidine (Pepcid) is an antacid used to reduce stomach acid and treat conditions like heartburn and ulcers. Aluminum hydroxide and magnesium hydroxide (maalox or Mylanta) and calcium carbonate (tums) are also antacids used to relieve symptoms of heartburn and indigestion, but they do not specifically target excessive gas.

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129. A patient who has AIDS has lost weight and is easily fatigued because of his malnourished state. The nurse anticipates an order for which antinausea drug to stimulate his appetite?

Explanation

The correct answer is b. Dronabinol (Marinol), a tetrahydrocannabinoid. Dronabinol is a synthetic form of THC, the active component of marijuana. It is used to stimulate appetite in patients with AIDS-related weight loss and anorexia. THC has been shown to increase appetite and food intake in patients with HIV/AIDS by acting on the cannabinoid receptors in the brain. This can help the patient regain weight and improve their overall nutritional status.

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130.  A patient is receiving a moderate-level dose of dobutamine for shock and is complaining of feeling more "skipping beats" than yesterday. What is the nurse's next action?

Explanation

The patient's complaint of feeling more "skipping beats" could indicate a serious cardiac arrhythmia. Discontinuing the dobutamine immediately is necessary to prevent further harm to the patient. Monitoring for other signs of a therapeutic response, adjusting the dose, or assessing vital signs and cardiac rhythm may not be sufficient actions in this situation.

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131. A patient has been started on therapy of a continuous infusion of lidocaine after receiving a loading dose of the drug. The nurse will monitor the patient for which adverse effect?

Explanation

The nurse will monitor the patient for convulsions as an adverse effect of the continuous infusion of lidocaine. Lidocaine is a local anesthetic that can also be used to treat certain cardiac arrhythmias. However, it can cause neurological side effects such as convulsions, which may indicate toxicity. Monitoring for convulsions is important to ensure the patient's safety and adjust the dosage if necessary.

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132. A patient is receiving irinotecan (Camptosar), along with other antineoplastic drugs, as treatment for ovarian cancer. The nurse will monitor for potentially life-threatening adverse effect that is associated with this drug?

Explanation

Irinotecan is known to cause delayed-onset cholinergic diarrhea, which typically occurs 24-72 hours after administration. This adverse effect can be potentially life-threatening and requires close monitoring and intervention by the nurse. Severe stomatitis, bone marrow suppression, and immediate and severe nausea and vomiting are all potential adverse effects of antineoplastic drugs, but they are not specifically associated with irinotecan.

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133. A patient with multiple sclerosis will be starting therapy with an immunosuppressant drug. The nurse expects that which drug will be used?

Explanation

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When applying transdermal nitroglycerin patches, which instruction by...
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Which action is often recommended to help reduce tolerance to...
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The nurse notes in the patient's medication orders that the patient...
When an adrenergic drug stimulates beta1-adrenergic receptors, the...
A patient about to receive a morning dose of digoxin has an apical...
A patient who has been newly diagnosed with vertigo will be taking an...
A 49-year-old patient is in the clinic for a follow-up visit 6 months...
While recovering from surgery, a 74 year old woman started taking a...
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 The nurse is administering a stat dose of epinephrine....
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The nurse is creating a plan of care for a patient with a new...
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The teaching for a patient who is taking tamsulosin (Flomax) to reduce...
A patient has been taking  digoxin at home but took an accidental...
2. What is the nurses priority action if extravasation of an...
 When counseling a male patient about the possible adverse...
A patient with risk factors for coronary artery disease asks the nurse...
The nurse is reviewing the mechanism of action of antidiarrheal drugs....
The nurse will teach the patient who is receiving oral iron...
A patient has had an overdose of an intravenous cholinergic drug. The...
The nurse is providing teaching regarding drug therapy to the husband...
The nurse is reviewing the use of anticholinergic drugs with a patient...
A patient who has been taking antihypertensive drugs for a few months...
A patient has been diagnosed with angina and will be given a...
When administering heparin subcutaneously, the nurse will follow which...
A patient who is taking warfarin (Coumadin) therapy has a headache and...
A patient tells the nurse that he likes to eat large amounts of garlic...
The nurse recognizes that adrenergic drugs cause relaxation of the...
A patient has been instructed to take one enteric-coated low-dose...
6. A patient who has had a liver transplant is taking mycophenolate...
The nurse is developing a plan care for a patient who is experiencing...
A patient has been taking iron supplements for anemia for 2 months....
 A patient is taking an alpha blocker as treatment for benign...
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The nurse working in a preoperative admitting unit administers an...
When the nurse is administering topical nitroglycering ointment, which...
3. Just before the second course of chemotherapy, the laboratory calls...
A 30 year old woman in the clinic for her yearly gynecologic exam and...
 The nurse is aware that adrenergic drugs produce effects similar...
During initial rounds, the nurse notes that a dobutamine infusion has...
 A cholinergic drug is prescribed for a patient with a new...
The nurse will monitor for which adverse effect when administering an...
The nurse is teaching a community education program on hypertension....
A patient is taking digoxin (Lanoxin) and a loop diuretic daily . When...
While assessing a patient who is receiving intravenous digitalis, the...
When administering chemotherapy for treatment of cancer, the nurse...
A patient is taking omeprazole (Prilosec) for the treatment of...
During interleukin drug therapy, a patient is showing signs of severe...
When a patient is taking an adrenergic drug, the nurse expects to...
The nurse is reviewing the JNC 7 guidelines for treatment of...
A patient is in the urgent care center after experiencing a black...
A patient is asking advice about which over-the-counter antacid is...
While assessing a patient who is taking a beta blocker for angina, the...
A patient has a digoxin level of 1.4 ng/mL. The nurse interprets that...
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A patient asks about his cancer treatment with monoclonal antibodies....
The nurse is giving intravenous nitroglycerin to a patient who has...
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The nurse is conducting a class on potential bioterroism aagents, and...
A patient has a new prescription for tamsulosin (Flomax) as treatment...
While a patient is receiving antilipemic therapy, the nurse knows to...
A patient is receiving lactulose (chronulac) three times a day. The...
The nurse is monitoring a patient who has severe bone marrow...
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A patient with type 2 diabetes mellitus has been found to have trace...
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The nurse is reviewing infection-prevention measures with a patient...
A patient is receiving doxorubicin (Adriamycin) as a part of treatment...
A patient will be taking bismuth subsalicylate (pepto-bismol) to...
 An adrenergic agonist is ordered for a patient in shock. The...
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8. The nurse is providing teaching to a patient who will be...
During an admission assessment, the patient tells the nurse that he...
A patient with severe liver disease is receiving the angiotensin...
The nurse is reviewing drug therapy for hypertension. According to the...
A patient is to receive iron dextran injections. Which technique is...
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When starting a patient on antidysrhythmic therapy, the nurse will...
A patient calls the clinic office saying that the cholestyramine...
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7. A 45 year old man has received a series of immunizing drugs in...
A patient will be taking a 2 week course of combination therapy with...
Two patients arrive at the clinic; one is a young boy with sickle cell...
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A nurse is giving instructions to a patient who will be receiving oral...
1.       At 9:00, the nurse is about to...
A patient has received an accidental overdose of intravenous atropine....
During therapy with the hematopoietic drugs epoetin alfa (epogen), the...
A patient who has been on methotrexate therapy is experiencing mild...
A patient is going home with a new prescription for the beta-blocker...
 A 58-year-old man has had a myocardial infarction (MI), has...
5. A patient who has received chemotherapy has a steadily...
A patient who has been diagnosed with Sjögren's syndrome will be...
The nurse is preparing to administer adenosine (Adenocard) to a...
A laxative has been ordered for a patient. The nurse checks the...
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During a teaching session about self-monitoring while taking a...
A nurse is working in an immunization clinic. A new collegue asks,...
A patient with motion sickness is planning a cross-country car trip...
A patient's blood pressure elevates to 270/150 mm Hg, and a...
4. During therapy with the cytotoxic antibiotic bleomycin, the nurse...
When administering a bulk-forming laxative, the nurse instructs the...
The nurse is reviewing the mechanism of action of cholinergic drugs....
A patient is receiving an aluminum-containing antacid. The nurse will...
The nurse is administering liquid oral iron supplements. Which...
A patient is receiving high doses of methotrexate and is experiencing...
The nurse is reviewing new postoperative orders and notes that the...
When administrating mineral oil, the nurse recognizes that it can be...
The nurse is administering intravenous iron dextran for the first time...
A patient is complaining of excessive and painful gas. The nurse...
A patient who has AIDS has lost weight and is easily fatigued because...
 A patient is receiving a moderate-level dose of dobutamine for...
A patient has been started on therapy of a continuous infusion of...
A patient is receiving irinotecan (Camptosar), along with other...
A patient with multiple sclerosis will be starting therapy with an...
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