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Quizzes Created: 3 | Total Attempts: 1,676
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1. A patient has been admitted for an exacerbation of chronic obstructive pulmonary disease and will be receiving methylprednisolone (Solu-Medrol) 30 mg, intravenously every 4 hours. The medication is available in 40-mg/mL vials. How many mL will the nurse draw up for this dose?

Explanation

40 mg : 1 mL :: 30 mg : x mL
Solve for x:
(40 X x) = (1 X 30); 40x = 30; x = 0.75, therefore x = 0.75 mL

Submit
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About This Quiz
Take This Science Quiz And Learn About IT - Quiz

Taking up a nursing course puts you in a good place to care for the sick people you come across and help them through their rough patch. Having undertaken the course for the last few months, the quiz is designed to test what you understood. Give it a try and... see morefind out! see less

2. The patient is to receive medroxyprogesterone (Depo-Provera) 500 mg, weekly, intramuscularly, on Mondays for 4 weeks as part of palliative therapy for cancer. The medication is available in vials of 400 mg/mL. How many milliliters will the nurse draw up and administer with each injection? Round to the nearest tenth.

Explanation

400 mg : 1 mL :: 500 mg : x mL
Solve for x: (400 X x) = (1 X 500); 400x = 500; x = 1.25, rounded to 1.3 mL

Submit
3. The insulin order reads, "Check blood glucose levels before meals and at bedtime. For every 5 mg/dL over 150, give one unit of Regular Humulin insulin, subcutaneously." The patient's blood glucose level at 11:30, before lunch, was 203 mg/dL. In units, how much insulin will the nurse will give?

Explanation

203 mg/dL is 53 mg/dL more than 150 mg/dL (203 – 150)
53 / 5 units = 10.6
One cannot administer “0.6” of a unit, so the answer is 10 units.

Submit
4. The nurse is administering lispro insulin and should keep in mind that this insulin will start to have an effect within which time frame?

Explanation

The onset of action for lispro insulin is 15 minutes. The peak plasma concentration is 1 to 2 hours; the elimination half-life is 80 minutes; and the duration is 3 to 5 hours.

Submit
5. The nurse is administering rapid-acting insulin. Which statement is true regarding its administration?

Explanation

Rapid-acting insulins, such as insulin lispro and insulin aspart, are able to mimic closely the body’s natural rapid insulin output after eating a meal; for this reason, both insulins are usually administered within 15 minutes of the patient beginning a meal. The other options are incorrect.

Submit
6. When administering morning medications for a newly admitted patient, the nurse notes that the patient has an allergy to sulfa drugs. There is an order for the sulfonylurea glipizide (Glucotrol). What is the nurse's best action?

Explanation

There is a potential for cross allergy in patients who are allergic to sulfonamide antibiotics. Although such an allergy is listed as a contraindication by the manufacturer, most clinicians do prescribe sulfonylureas for such patients. The order should be clarified.

Submit
7. A 75-year-old woman with type 2 diabetes has recently been placed on glyburide, 10 mg daily. She asks the nurse when the best time would be to take this medication. What is the nurse's best response?

Explanation

The medication should be taken in the morning, 30 minutes before breakfast. When taken at that time it has a longer duration of action, causing it to release a constant amount of insulin. This may be beneficial in controlling blood glucose levels throughout the day.

Submit
8. After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office for a follow-up examination. Which laboratory test will best reflect the patient's adherence to the antidiabetic therapy over the past few months?

Explanation

The hemoglobin A1C level reflects the patient’s adherence to the therapy regimen for several months previously, thus evaluating how well the patient has been doing with diet and drug therapy. The other options are not correct.

Submit
9. When monitoring a patient's response to oral antidiabetic drugs, the nurse knows that the laboratory results that would indicate a therapeutic response would be a(n)

Explanation

A fasting blood glucose level between 70 and 100 mg/dL indicates a therapeutic response to glucose-elevating drugs. The other options are incorrect.

Submit
10. A patient is concerned about the body changes that have resulted from long-term prednisone therapy for the treatment of lupus erythematosus. Which effect of this drug therapy would be present to support the nursing diagnosis of disturbed body image?

Explanation

Facial erythema, weight gain, hirsutism, and “moon face” (characteristic of Cushing’s syndrome) are possible body changes that may occur with long-term prednisone therapy.

Submit
11. A patient who has been on long-term corticosteroid therapy has had surgery to correct an abdominal hernia. The nurse keeps in mind that which potential effect of this medication may have the most impact on the patient's recovery?

Explanation

Muscle weakness and osteoporosis may also result from long-term therapy, but delayed wound healing would have the most impact on the patient’s recovery from abdominal surgery at this time. Hypertension, not hypotension, may result from long-term corticosteroid therapy.

Submit
12. During a follow-up visit, a patient who has been on estrogen therapy admits that she has continued to smoke cigarettes. The nurse will remind the patient that smoking while on estrogen may lead to increased

Explanation

Smoking should be avoided during estrogen therapy because it adds to the risk for thrombosis formation. The other options are not correct.

Submit
13. The nurse should instruct a patient who will be taking bisphosphonate alendronate (Fosamax) to take this medication at which time?

Explanation

Bisphosphonates must be taken in the morning, with 6 to 8 ounces of plain water, to prevent esophageal erosion. In addition, the patient must sit upright for 30 minutes after taking them.

Submit
14. When teaching about hypoglycemia, the nurse should make sure that the patient is aware of the early signs of hypoglycemia, including

Explanation

Early symptoms of hypoglycemia include the central nervous system (CNS) manifestations of confusion, irritability, tremor, and sweating. The other options are incorrect.

Submit
15. A patient with a history of chronic obstructive pulmonary disease and type 2 diabetes has been treated for pneumonia for the past week. He has been receiving intravenous corticosteroids as well as antibiotics as part of his therapy. At this time, his pneumonia has resolved, but when monitoring his blood glucose levels, the nurse notices that his blood glucose level is still elevated, and he has required small amounts of sliding-scale insulin coverage. What is the best explanation for this elevation?

Explanation

Corticosteroids can antagonize the hypoglycemic effects of insulin, resulting in elevated blood glucose levels. The other options are not correct.

Submit
16. The nurse is preparing to administer the contraceptive form of medroxyprogesterone (Depo-Provera). What route should be planned?

Explanation

Depo-Provera is a progestin-only injectable contraceptive that is given by the intramuscular route.

Submit
17. A woman visits a health center requesting oral contraception. Which lab test is most important for the nurse to assess before the patient begins oral contraception therapy?

Explanation

Pregnancy should be ruled out before beginning oral contraceptive therapy because the medications can be harmful to the fetus—pregnancy category X.

Submit
18. When starting a patient's drug therapy with corticosteroids, the nurse is aware that some drug classes can have adverse interactions with corticosteroids, such as

Explanation

Corticosteroids are known to increase the risk of gastrointestinal bleeding and ulcers. Nonsteroidal anti-inflammatory drugs (NSAIDs) also have the same side effects, therefore, combining corticosteroids with NSAIDs can further increase the risk of gastrointestinal complications. This is why the nurse should be aware of this adverse interaction and monitor the patient closely for any signs of bleeding or ulcers when starting corticosteroids. Antibiotics, opioid analgesics, and antidepressants do not have the same adverse interaction with corticosteroids.

Submit
19. The nurse is teaching a group of patients about self-administration of insulin. What teaching is important to include?

Explanation

If mixing insulins in one syringe, the clear (Regular) insulin should always be drawn up in to the syringe first. Patients should always rotate injection sites and should notify their physician if they become ill. Patients should never adjust their own insulin doses!

Submit
20. A patient in the emergency department was showing signs of hypoglycemia and had a fingerstick glucose level of 34 mg/dL. He has just become unconscious. What is the nurse's first action?

Explanation

Intravenous glucose raises blood glucose levels when the patient is unconscious and unable to take oral forms of glucose.

Submit
21. A patient is to receive testosterone therapy via a transdermal patch. He asks the nurse, "Why am I getting a patch? Can't I just take a pill?" What is the nurse's best response?

Explanation

The transdermal form allows for better absorption of testosterone because of its high first-pass effect. Oral forms are poorly absorbed, and the transdermal form is preferable to an injection and is preferred for hormonal replacement therapy. The patch is changed daily.

Submit
22. The nurse is reviewing instructions for a patient with type 2 diabetes who also gives herself insulin injections as part of the therapy. The nurse asks the patient, "What should you do if your fasting blood glucose is 47 mg/dL?" Which response by the patient is correct?

Explanation

Hypoglycemia can be reversed if the patient eats glucose tablets or gel, corn syrup, or honey; or drinks fruit juice or a nondiet soft drink or other quick sources of glucose, which should always be kept at hand. She should not wait for instructions from her physician nor delay taking the glucose by resting. The Regular insulin would only lower her blood glucose levels more.

Submit
23. When couples are treated for infertility with ovulation-inducing drugs, the nurse will include instruction about the increased likelihood of

Explanation

Multiple births are a possible consequence of treatment for infertility with ovulation-inducing drugs.

Submit
24. During the administration of finasteride (Proscar), the nurse must remember which important precaution?

Explanation

Finasteride should not be handled by pregnant women because of its teratogenic effects. It is taken orally and without regard to meals.

Submit
25. The nurse is preparing to administer insulin intravenously. Which statement about intravenous insulin is true?

Explanation

Regular insulin is the usual insulin product to be dosed via intravenous bolus, intravenous infusion, or even intramuscularly. These routes, especially the intravenous infusion route, are often used in cases of diabetic ketoacidosis, or coma associated with uncontrolled type 1 diabetes.

Submit
26. When reviewing the risk factors for osteoporosis, the nurse recognizes that which of the following is considered a risk factor?

Explanation

Risk factors for postmenopausal osteoporosis include white or Asian descent, slender body build, early estrogen deficiency, smoking, alcohol consumption, low-calcium diet, sedentary lifestyle, and family history of osteoporosis.

Submit
27. The nurse is teaching patients about self-injection of insulin. Which statement is true regarding injection sites?

Explanation

Patients taking insulin injections should be instructed to rotate sites, but to do so within the same location for about 1 week (so that all injections would be rotated in one area—for example, the right arm—before rotating to a new location, such as the left arm). Also, each injection should be at least to 1 inch away from the previous site.

Submit
28. The nurse is providing teaching for a patient who is to receive estrogen replacement therapy. Which statement is correct to include in the teaching session? The patient should

Explanation

Patients taking oral estrogen therapy should report weight gain of more than 5 pounds per week to a physician. The other statements are not true for estrogen replacement therapy.

Submit
29. A female patient who lives in New York City is preparing to take a plane trip to Australia. She has been taking the SERM raloxifene (Evista). The nurse will provide which instructions to this patient?

Explanation

A patient taking a SERM should be informed that the drug must be discontinued 72 hours before and during prolonged immobility so as to prevent the development of a thrombosis.

Submit
30. A 73-year-old man is asking for a prescription for sildenafil (Viagra). He has listed on his health history that he is taking a nitrate for angina. The nurse is aware that which problem may occur if sildenafil is taken with a nitrate?

Explanation

In patients with preexisting cardiovascular disease, especially those on nitrates, erectile dysfunction drugs such as sildenafil lowers blood pressure substantially. The other options are not correct.

Submit
31. A patient who is taking the bisphosphonate alendronate (Fosamax) has been instructed to lie flat in bed for 2 days after having plastic surgery. Which intervention is appropriate at this time?

Explanation

The nurse must emphasize that the patient should remain upright in either a standing or sitting position for approximately 30 minutes after taking a bisphosphonate so as to help prevent esophageal erosion or irritation.

Submit
32. The nurse recognizes that use of estrogen drugs is contraindicated in which of the following patients?

Explanation

Estrogenic drugs are contraindicated in people who have active thromboembolic disorders and in those with histories of thromboembolic disease. Atrophic vaginitis and inoperable prostate cancer are potential indications for estrogen therapy. Estrogen is not used to prevent lactation.

Submit
33. A patient who has type 2 diabetes is scheduled for a colonoscopy and has been NPO (nothing by mouth) since midnight. She is concerned because her medications are being held. What is the best action regarding the administration of her oral antidiabetic drugs?

Explanation

When the diabetic patient is NPO, the prescriber should be contacted for further orders regarding the administration of the oral antidiabetic drugs. The other options are not correct.

Submit
34. The nurse knows to administer acarbose (Precose), an alpha-glucosidase inhibitor, at which time?

Explanation

When an alpha-glucosidase inhibitor is taken with the first bite of a meal, excessive postprandial blood glucose elevation (a glucose spike) can be reduced or prevented.

Submit
35. The nurse notes in the patient's medication orders that the patient is taking the tocolytic drugs terbutaline (Brethine). Based on this finding, the nurse interprets that the drug has been ordered for which problem?

Explanation

Tocolytics relax uterine smooth muscles and stop the uterus from contracting.

Submit
36. When a male patient is receiving androgen therapy, the nurse should monitor for signs of excessive androgens such as

Explanation

Fluid retention is an undesirable effect of androgens. The other options are incorrect.

Submit
37. The nurse is administering adrenal drugs to a patient. Which of the following actions is appropriate for this patient?

Explanation

After the patient has used the steroid inhalers, cleaning the oral cavity helps to prevent possible oral fungal infections from developing. Adrenal drugs should be taken with meals to minimize gastrointestinal upset and in the mornings to minimize adrenal suppression, and they should be discontinued by weaning, not abruptly.

Submit
38. A patient is receiving aminoglutethimide (Cytadren) therapy. The nurse knows that this medication is used for which condition?

Explanation

Aminoglutethimide (Cytadren) is an adrenal steroid inhibitor that is used in the treatment of Cushing’s syndrome.

Submit
39. When monitoring a patient who is taking a systemically administered glucocorticoid, the nurse should monitor for signs of which condition?

Explanation

Systemic glucocorticoid drugs may cause potassium depletion, hyperglycemia, and hypernatremia.

Submit
40. A patient is taking fludrocortisone for Addison's disease, and his wife is concerned about all the problems that may occur with this therapy. When teaching them about therapy with this drug, the nurse should include which information?

Explanation

Patients receiving fludrocortisone should take it with food or milk to minimize gastrointestinal upset; weight gain of more than 5 pounds a week should be reported to the physician; abrupt withdrawal is not recommended because it may precipitate an adrenal crisis.

Submit
41. A 48-year-old is diagnosed with metabolic syndrome and is started on metformin (Glucophage). The purpose of the metformin, in this situation, is to

Explanation

Metformin decreases glucose production by the liver; decreases intestinal absorption of glucose; and improves insulin receptor sensitivity in the liver, skeletal muscle, and adipose tissue, resulting in decreased insulin resistance.

Submit
42. A 51-year-old woman will be taking selective estrogen receptor modulators (SERMs) as part of the treatment for postmenopausal osteoporosis. The nurse reviews potential adverse effects with this patient, including the possible occurrence of

Explanation

SERMs such as raloxifene increase the risk for venous thromboembolism. Postmenopausal women taking raloxifene were no more likely to develop breast, uterine, or ovarian cancer than were women taking a placebo. The other options are not correct.

Submit
43. When considering the various types of contraceptive drugs, the nurse is aware that which type most closely duplicates the normal hormonal levels of the female menstrual cycle?

Explanation

The triphasic products most closely duplicate the normal hormonal levels of the female menstrual cycle.

Submit
44. While discussing options for osteoporosis prevention, a patient asks if she will be using estrogen patches. What is the nurse's best response?

Explanation

Studies performed as part of the Women’s Health Initiative have indicated that because of a high incidence of cardiovascular problems, estrogen therapy is not considered the first choice for osteoporosis prevention.

Submit
45. The nurse is reviewing a patient's medication list and notes that sitagliptin (Januvia) is ordered. The nurse should question an additional order for which drug or drug class?

Explanation

Sitagliptin is indicated for management of type 2 diabetes either as monotherapy or in combination with metformin, a sulfonylurea, or a glitazone, but not with insulin.

Submit
46. The nurse expects that a patient is experiencing undersecretion of adrenocortical hormones when which condition is found upon assessment?

Explanation

Dehydration and weight loss are the result of undersecretion of adrenocortical hormones, or Addison’s disease. The other responses are possible effects of glucocorticoid excess.

Submit
47. A patient is receiving oxytocin (Pitocin) to induce labor. During administration of this medication, the nurse will also implement which action?

Explanation

Oxytocin is infused via an infusion pump, not via an intravenous bolus. Magnesium sulfate is not administered with oxytocin (but should be kept at the bedside for emergency use in case of severe hypertension). And fetal heart rate and maternal vital signs should be monitored continuously.

Submit
48. A patient is receiving finasteride (Proscar) for treatment of benign prostatic hyperplasia. The nurse should tell him that a possible effect of this medication is

Explanation

Finasteride is given to reduce prostate size in men with benign prostatic hyperplasia. It has been noted that men taking this medication experience increased hair growth.

Submit
49. A patient is being treated for primary amenorrhea. The nurse expects which drug to be used to treat this problem?

Explanation

Medroxyprogesterone, a progestin, is one of the drugs most commonly used for primary amenorrhea. Primary amenorrhea is not an indication for the other drugs listed.

Submit
50. A patient wants to try an oral soy product to relieve perimenopausal symptoms. The nurse will assess the patient's medication history for potential drug interactions, including

Explanation

Orally administered soy may interfere with thyroid hormone absorption, so concurrent use should be avoided.

Submit
51. The nurse is instructing a male patient about application of transdermal testosterone (Testoderm) patches. What body location is preferred for this specific patch?

Explanation

Testoderm patches are applied to the scrotal skin. Other forms (e.g., Androderm) may be applied to the back, abdomen, upper arms, or thighs.

Submit
52. The nurse is reviewing the medication list of a patient who will be starting androgen therapy. Which drug classes, if taken with androgens, may have an interaction with them?

Explanation

Androgens, when used with oral anticoagulants, can significantly increase or decrease anticoagulant activity. They can also enhance the hypoglycemic effects of oral hypoglycemic (antidiabetic) drugs. The other options are incorrect.

Submit
53. A 21-year-old male athlete admits to using androgenic steroids. The nurse tells him that a possible adverse effect of these drugs is

Explanation

Peliosis of the liver, the formation of blood-filled cavities, is a potential effect of androgenic anabolic steroid therapy and may be life threatening.

Submit
54. A 63-year-old male patient is scheduled for a physical examination, and he tells the nurse that he wants to start taking a vitamin formula that includes saw palmetto for prostate health. Which is the nurse's best response?

Explanation

A prostatic-specific antigen test and digital rectal examination should be performed before initiation of treatment with saw palmetto for benign prostatic hyperplasia. Adverse effects may include gastrointestinal upset, headache, back pain, and dysuria.

Submit
55. The nurse is teaching a patient about the adverse effects of fertility drugs such as clomiphene (Clomid). Which is a potential adverse effect of this drug?

Explanation

Dizziness is one of the possible adverse effects of the fertility drugs. They may also cause restlessness and anorexia.

Submit
56. The nurse notes in a female patient's history that she has an order for the androgen methyltestosterone. Based on this finding, the nurse interprets that the patient has which disorder?

Explanation

Methyltestosterone can be used in cases of inoperable breast cancer in women. The other options are not correct.

Submit
57. Which conditions are indications for glucocorticoid drugs? Select all that apply.

Explanation

Glaucoma, varicella, and septicemia are all contraindications to glucocorticoid therapy. The others are indications for glucocorticoid therapy.

Submit
58. A patient taking an oral contraceptive should be aware of potential drug interactions with which medications? Select all that apply.

Explanation

Patients must be educated about the need to use alternative birth control methods for at least 1 month during and after taking any of the following drugs: antibiotics (especially penicillins and cephalosporins); barbiturates; isoniazid; and rifampin. The effectiveness of other drugs, such as anticonvulsants, beta-blockers, hypnotics, antidiabetic drugs, warfarin, theophylline, tricyclic antidepressants, and vitamins, may be reduced when they are taken with oral contraceptives.

Submit
59. The nurse notes in a patient's medication history that the patient is taking the synthetic androgen danazol (Danocrine). Indications for danazol include which conditions? Select all that apply.

Explanation

Danazol is used to treat hereditary angioedema and to treat women who have endometriosis or fibrocystic breast disease.

Submit
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A patient has been admitted for an exacerbation of chronic obstructive...
The patient is to receive medroxyprogesterone (Depo-Provera) 500 mg,...
The insulin order reads, "Check blood glucose levels before meals and...
The nurse is administering lispro insulin and should keep in mind that...
The nurse is administering rapid-acting insulin. Which statement is...
When administering morning medications for a newly admitted patient,...
A 75-year-old woman with type 2 diabetes has recently been placed on...
After starting treatment for type 2 diabetes mellitus 6 months...
When monitoring a patient's response to oral antidiabetic drugs, the...
A patient is concerned about the body changes that have resulted from...
A patient who has been on long-term corticosteroid therapy has had...
During a follow-up visit, a patient who has been on estrogen therapy...
The nurse should instruct a patient who will be taking bisphosphonate...
When teaching about hypoglycemia, the nurse should make sure that the...
A patient with a history of chronic obstructive pulmonary disease and...
The nurse is preparing to administer the contraceptive form of...
A woman visits a health center requesting oral contraception. Which...
When starting a patient's drug therapy with corticosteroids, the nurse...
The nurse is teaching a group of patients about self-administration of...
A patient in the emergency department was showing signs of...
A patient is to receive testosterone therapy via a transdermal patch....
The nurse is reviewing instructions for a patient with type 2 diabetes...
When couples are treated for infertility with ovulation-inducing...
During the administration of finasteride (Proscar), the nurse must...
The nurse is preparing to administer insulin intravenously. Which...
When reviewing the risk factors for osteoporosis, the nurse recognizes...
The nurse is teaching patients about self-injection of insulin. Which...
The nurse is providing teaching for a patient who is to receive...
A female patient who lives in New York City is preparing to take a...
A 73-year-old man is asking for a prescription for sildenafil...
A patient who is taking the bisphosphonate alendronate (Fosamax) has...
The nurse recognizes that use of estrogen drugs is contraindicated in...
A patient who has type 2 diabetes is scheduled for a colonoscopy and...
The nurse knows to administer acarbose (Precose), an alpha-glucosidase...
The nurse notes in the patient's medication orders that the patient is...
When a male patient is receiving androgen therapy, the nurse should...
The nurse is administering adrenal drugs to a patient. Which of the...
A patient is receiving aminoglutethimide (Cytadren) therapy. The nurse...
When monitoring a patient who is taking a systemically administered...
A patient is taking fludrocortisone for Addison's disease, and his...
A 48-year-old is diagnosed with metabolic syndrome and is started on...
A 51-year-old woman will be taking selective estrogen receptor...
When considering the various types of contraceptive drugs, the nurse...
While discussing options for osteoporosis prevention, a patient asks...
The nurse is reviewing a patient's medication list and notes that...
The nurse expects that a patient is experiencing undersecretion of...
A patient is receiving oxytocin (Pitocin) to induce labor. During...
A patient is receiving finasteride (Proscar) for treatment of benign...
A patient is being treated for primary amenorrhea. The nurse expects...
A patient wants to try an oral soy product to relieve perimenopausal...
The nurse is instructing a male patient about application of...
The nurse is reviewing the medication list of a patient who will be...
A 21-year-old male athlete admits to using androgenic steroids. The...
A 63-year-old male patient is scheduled for a physical examination,...
The nurse is teaching a patient about the adverse effects of fertility...
The nurse notes in a female patient's history that she has an order...
Which conditions are indications for glucocorticoid drugs? Select all...
A patient taking an oral contraceptive should be aware of potential...
The nurse notes in a patient's medication history that the patient is...
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