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Pharm exam 4 prep u

question

The nurse caring for a 24-year-old woman admitted with pneumonia explains how antibiotics work to help cure her pneumonia. Which statement would be correct about how antibiotic therapy works?
answer

Antibiotics work by inhibiting cell wall synthesis.
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A client is receiving aminoglycoside therapy. The nurse would be alert for
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kidney dysfunction
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What is critical to helping prevent development of resistant strains of microbes?
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Maintain the optimum duration of the antimicrobial agent.
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What are classified as anti-infectives? (Select all that apply.)
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• antihelmintics • antifungals • antiprotozoals
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To ensure that the most appropriate drug is being used to treat a pathogen, which would need to be done first?
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Obtaining sensitivity testing
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Clients receiving aminoglycosides should be monitored closely for which toxicities?
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Renal
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A client is diagnosed with strep throat. Which of the factor has contributed to the development of the illness?
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Leukopenia
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Bacitracin (Baciguent) interferes with the cell wall synthesis of which type of bacteria?
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Staphylococcal
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The client is taking an antibiotic for a urinary tract infection. The client asks how the antibiotic interferes with the growth of bacteria. The nurse explains that the antibiotic has the ability to suppress or kill an infecting microbe without injury to the host. This is referred to as:
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selective toxicity.
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A nurse is aware that the concept of selective toxicity is foundational to antimicrobial therapy. Which statement mostaccurately describes selective toxicity?
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A drug harms microbes without harming human cells
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A client is to be started on an antibiotic. Which is most important to take into consideration before beginning the antibiotic regimen?
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Culture and susceptibility
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What would be categorized as an anti-infective agent?
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Anthelmintics
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Successful treatment with bacteriostatic antibiotics depends upon:
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the ability of the host’s immune system to eliminate the inhibited bacteria and an adequate duration of drug therapy.
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When describing an anti-infective agent with a narrow spectrum of activity, what would the nurse include?
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The drug is selective in its action on organisms
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A client with acne has been receiving an anti-infective agent for a prolonged period. Initially, the drug was effective, but over time its effectiveness as decreased. What is the nurse’s best action?
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Refer the client to the health care provider because the client may be experiencing resistance.
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An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with
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vancomycin.
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A client is receiving aminoglycosides for a severe infection. The client reports an increasing ringing in the ears. The nurse realizes this is indicative of:
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ototoxicity.
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A client is diagnosed with a drug-resistant infection. The client is at greatest risk for:
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death.
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A client is admitted to the hospital with elevated temperature, chills, cough, and fatigue. The physician orders a chest x-ray, which indicates pneumonia. The blood cultures also come back positive for a Gram-negative bacillus. The physician orders two antibiotics to be given to the client, one for Gram-negative organisms and one for Gram-positive organisms. Why does the physician not prescribe just one antibiotic for both types of bacteria?
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Broad-spectrum antibiotics can cause antibiotic resistance.
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A client comes to the clinic reporting mouth sores that appear consistent with an oral yeast infection. The nurse should question the client about recent use of:
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antibiotics.
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Aminogylcoside antibiotics tend to collect in the eighth cranial nerve. The nurse would anticipate that which clinical manifestation may occur from the cranial nerve involvement?
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Vertigo
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The nurse is preparing to administer a drug that is bactericidal. The nurse should explain what characteristic of this drug?
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It will directly cause the death of pathogenic cells.
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A group of students are reviewing information about anti-infective agents. The students demonstrate a need for additional review when they identify what as an anti-infective agent?
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anticoagulant
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The nurse understands that an infection caused by a secondary pathogen, which can occur during prolonged antibiotic therapy, is known as which of the following?
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Superinfection
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A nurse is instructing a client on the antibiotic regimen for the treatment of pneumonia. Which intervention is mostimportant to teach the client?
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Complete the entire prescription of medication.
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The client has been taking her antibiotic for five days. She tells the nurse that she is now experiencing vaginal itching and discharge. The nurse suspects what has occurred?
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The client has developed a superinfection
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Although the numbers and virulence of microorganisms help determine whether a person acquires an infection, another major factor is:
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the host’s ability to defend itself against the would-be invaders.
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A burn client develops a wound infection. What type of microorganism contributes to the development of the wound infection?
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Opportunistic
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What occurs when the normal flora is destroyed by the use of anti-infectives?
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superinfection
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An elderly client is treated for pneumonia with clindamycin (Cleocin). One week after the completion of the medication, the client develops diarrhea. What is the most probable cause of the diarrhea?
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Change in normal flora
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A nurse has questioned why a client’s physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of an infection. Which facts provide the best rationale for the use of narrow-spectrum antibiotics whenever possible?
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The use of broad-spectrum antibiotics can create a risk for a superinfection.
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The client has been started on a fluoroquinolone and is now experiencing fever, abdominal cramping, and diarrhea. The nurse suspects the client may be experiencing:
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superinfection.
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What is critical to helping prevent development of resistant strains of microbes?
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Maintain the optimum duration of the antimicrobial agent.
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What would contribute to drug resistance?
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Antibiotic prescription for viral illness
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Which would be the most significant factor in the selection of an antibiotic drug for treatment of a client’s infection?
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culture and susceptibility test results
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A client who is receiving anti-infective therapy is experiencing gastrointestinal toxicity. What would the nurse expect to assess?
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diarrhea
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A client is to undergo extensive dental surgery. The dentist prescribes a course of antibiotics before beginning the procedure and continuing for 5 days after the procedure. This is an example of:
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prophylaxis
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Inappropriate use of antibiotics does all of the following except increase:
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the number of available effective drugs for serious or antibiotic-resistant infections.
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Which type of testing should be completed prior to an anti-infective being prescribed?
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Culture
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A nurse is teaching a colleague about the factors that are known to contribute to antibiotic resistance. When phenomenon should the nurse describe?
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Use of antibiotics for viral illnesses
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Assessment of a newly-admitted patient reveals the characteristic signs and symptoms of cellulitis to the back of her hand. A swab of the patient’s wound was ordered upon admission, but the results of culture and sensitivity (C&S) testing are not yet available. What strategy will most likely be adopted to treat this patient’s infection?
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Empiric antimicrobial therapy will be implemented until laboratory results are available.
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Bacitracin (Baciguent) interferes with the cell wall synthesis of which type of bacteria?
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Staphylococcal
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A nurse is instructing a colleague on how an antimicrobial produces a therapeutic effect. What should be included in the nurse’s teaching?
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Penicillin interferes with synthesis of the bacteria cell wall.
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A premenopausal woman has been bothered with recurrent urinary tract infections. What antibiotic after sexual intercourse would assist in preventing the recurrence of infection?
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Trimethoprim-sulfamethoxazole (Bactrim)
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A client is receiving aminoglycoside therapy. The nurse would be alert for:
answer

kidney dysfunction.
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To ensure that the most appropriate drug is being used to treat a pathogen, which would need to be done first?
answer

Obtaining sensitivity testing
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An 82-year-old woman with influenza and pneumonia has been admitted to the hospital for IV antibiotic therapy. Which type of antibiotic would rely the least on the client’s defense mechanisms?
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Penicillin
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A client with an upper respiratory tract infection was prescribed roxithromycin, an antibiotic. To what should the nurse tell the client that irregular administration of this medication could lead?
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Development of drug resistance
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A nurse teaching the patient with tuberculosis (TB) should include the following information about ethambutol
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It can cause optic neuritis.
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Tuberculosis typically affects the lungs but can also involve other parts of the body. Which of the following can be affected by the disease?
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All the above
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A client has been on an antibiotic for two weeks for treatment of an infection. The client asks the nurse why a superinfection has been caused by this medication. What is the nurse’s best response?
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Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur.”
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The nurse is caring for a client whose prescribed course of cefaclor will soon be completed. What health education should the nurse provide to the client?
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“Make sure to avoid drinking any alcohol for the next three days.”
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The nurse is caring for a client who is receiving IV vancomycin. The nurse infuses the medication at the prescribed rate to prevent what from occurring?
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Red man syndrome
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A nurse is demonstrating the correct technique for instilling antibiotic ear drops into a child’s ear canal. The nurse should teach the child’s caregivers to do which of the following?
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Place a cotton ball in the ear canal after instilling the ear drops.
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A 66-year-old woman with a history of recurrent urinary tract infections has been admitted to the hospital with a diagnosis of pyelonephritis. The patient began treatment 36 hours ago with intravenous gentamicin and is being monitored closely. The nurse is aware that the therapeutic effect of the patient’s drug regimen is primarily a result of
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interference with bacterial reproduction.
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A client is prescribed ciprofloxacin for a urinary tract infection. The nurse is preparing to teach the client about the medication. What must the nurse include in the education plan?
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Take precautions to prevent photosensitivity
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Tetracyclines should not be used in children younger than 8 years of age because of their effects on:
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teeth and bones
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A homeless client presented at a street clinic with reports of hemoptysis and subsequently tested positive for TB. Which characteristics of the client’s present circumstances would preclude treatment with INH?
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an alcoholic who has hepatitis C (HCV)
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The nurse is caring for a 6 year-old child who has pyelonephritis. The use of what group of antibiotics would be contraindicated due to the client’s age?
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Tetracyclines
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Tuberculosis (TB) affects only the lungs. True or false?
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False
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A patient has been treated several times for a recurring ear infection with ofloxacin. The nurse instructs the patient to look for side effects from the prolonged use of the antibiotic and informs the patient that this is known as which of the following?
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superinfection
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A nurse is caring for a 52-year-old man with pyelonephritis. The physician has prescribed gentamicin. Which pair of symptoms would alert the nurse to a serious adverse reaction?
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tinnitus and decreased urinary output
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A nurse is caring for a patient with HIV who is suspected to also have tuberculosis (TB). Which of the following is true about patients with HIV and TB?
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The skin test may not show a reaction even though the disease is present.
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Beta-lactam antibiotics, such as penicillins and cephalosporins, fight infection by inhibiting development of the causative bacteria. What specific component of bacterial development do these drugs affect?
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Cell wall synthesis
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A client asks the purpose for using three medications in combination to treat his tuberculosis. The nurse informs the client that multiple medications are given for which of the following reasons?
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To prevent resistance
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After teaching a group of students about carbapenems, the instructor determines the need for additional teaching when the students identify what as an example?
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Cefuroxime
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A group of students are reviewing material for a test on antibiotics. They demonstrate an understanding of the material when they identify what as the first antibiotic introduced for clinical use?
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Penicillin
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The nurse has administered a client’s first scheduled dose of amoxicillin after the client was diagnosed with acute otitis media. What subsequent assessment finding should prompt the nurse to discontinue the use of this drug?
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The client reports shortness of breath
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A patient seen in the clinic has symptoms of persistent cough, fever, and night sweats. He recently entered the United States from the Philippines. From what condition is the patient suffering?
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Active tuberculosis
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The nurse is giving discharge instructions to a woman who will be taking amoxicillin for treatment of acute otitis media. The nurse teaches the client that which symptom indicates the development of a superinfection and should be reported to the physician?
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Vaginal itching and discharge
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The nursing student read about a disease called Hansen’s disease, which is caused by the bacterium Mycobacterium leprae and is treated with many of the same drugs as are used for TB. The student learned that another name for Hansen’s disease is what?
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Leprosy
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A patient receiving isoniazid (INH) and rifampin (Rifadin) has a decreased urinary output and peripheral neuropathy. Which laboratory values should be assessed?
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ALT/AST and creatinine
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A pregnant woman calls the clinic and asks if it is suitable to use ofloxacin otic drops that she used prior to pregnancy for a current ear infection. What would be an appropriate response from the nurse?
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“Some medications are contraindicated in pregnancy, and ofloxacin is one of these medications.”
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The nurse would question the use of sulfonamide therapy in which client? (Select all that apply.)
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• 18-month-old female client • breastfeeding client 32 years of age
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the nurse is administering erythromycin to a patient. For what common side effects should the nurse monitor the patient?
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Nausea, vomiting, and diarrhea
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Michael, 25 years old, has had mitral valve regurgitation since age four, after having rheumatic fever. Michael is planning to go to his dentist to have his teeth cleaned. Because of Michael’s history he will need to take antibiotics in conjunction with this procedure to prevent bacteremia. Which class of antibiotics will Michael most likely receive if he has no allergies?
answer

Penicillin
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An elderly patient comes to the clinic and informs the nurse that he feels as if his ear is clogged. He states that he frequently has to have his ears irrigated to get out the wax. He asks the nurse what causes this wax build-up. What is the nurse’s best response?
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Modified sweat glands in the ear canal
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A patient is being treated for a urinary tract infection with trimethoprim-sulfamethoxazole (Bactrim). What assessment should the nurse make prior to the administration of the medication?
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Renal insufficiency
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A patient is hospitalized with active tuberculosis. The patient is receiving antitubercular drug therapy and is not responding to the medications. What do you suspect the patient is suffering from?
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Drug-resistant tuberculosis
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For which patient would the nurse contact the physician to question an order for gentamicin?
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A 52-year-old male with an infection of his AV fistula graft
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A 75-year-old patient with a history of renal impairment is admitted to the primary health care center with a UTI and has been prescribed a cephalosporin. Which of the following interventions is most important for the nurse to perform when caring for this patient?
answer

Monitoring blood creatinine levels.
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Sulfonamides are commonly used to treat which of the following types of infections? Select all that apply.
answer

• Ulcerative colitis • Urinary tract infection • Acute otitis media
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A nurse is caring for a patient undergoing the second phase of standard TB treatment. The nurse knows that which of the following combinations of drugs need to be administered to the client?
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Rifampin and isoniazid
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Which of the following is true in regards to the oral administration of tetracyclines? (Choose one)
answer

Tetracyclines should be administered with a full glass of water.
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A child has just returned home from a family vacation on a tropical island and is now reporting worsening tenderness in the right ear. The client is subsequently diagnosed with otitis externa. What causative factor of this infection should the nurse suspect?
answer

frequent swimming and water sports while the child was on vacation
question

Your client is being treated for streptococcal pharyngitis and is NPO. Her health care provider has ordered Penicillin G to be given IM. She wants to know why she cannot take her medications via an oral route. Your best response is:
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Penicillin G is inactivated by gastric acid, therefore it is only given IM or IV.
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When instilling ear drops, the nurse informs the patient that to facilitate penetration of the drug into the ear canal, the patient should lie on the untreated side for how many minutes after receiving the drops?
answer

5 minutes
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A male client is admitted to the unit with Pseudomonas aeruginosa sepsis. The physician orders aminoglycoside to be given concomitantly with penicillin intravenously. How would the nurse administer these drugs?
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By administering the drug in separate IV bags
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A client has been prescribed INH for the treatment of tuberculosis. The nurse teaches the client about dietary restrictions while taking this medication. What is the most important instruction to give the client about dietary restrictions?
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“Do not drink beer or red wine while taking this medication because a serious adverse reaction can occur.”
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The client has been taking her antibiotic for five days. She tells the nurse that she is now experiencing vaginal itching and discharge. The nurse suspects what has occurred?
answer

The client has developed a superinfection.
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An HIV-positive patient is in a continuing phase of TB. The patient has completed the initial phase of the treatment program. In the continuing phase, the patient has shown no positive sputum results for six months. The nurse knows that under what circumstances does the treatment in the second phase last for four months or more?
answer

Positive sputum culture after the completion of initial treatment
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A client who takes zinc daily is diagnosed with a severe infection and is ordered levofloxacin (Levaquin). The nurse is aware that taking these two drugs may have what affect on the antibiotic?
answer

Decreased absorption
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An 80-year-old client is diagnosed with latent tuberculosis infection. What is a risk for the elderly population when being treated with INH?
answer

Hepatotoxicity
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When administering aminoglycosides, the nurse must be aware of which of the following adverse reactions?
answer

Ototoxicity and nephrotoxicity
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The pharmacology instructor is discussing ways to decrease the incidence and severity of adverse effects among people taking aminoglycosides. What do the guidelines on this matter include?
answer

Keeping the patient well hydrated
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A client’s risk for ototoxicity, nephrotoxicity, and neurotoxicity increases dramatically if he or she receives an aminoglycoside in conjunction with a potent diuretic.
answer

True
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A nurse is speaking to a 62-year-old female client who has been started on sulfisoxazole, a sulfonamide antibiotic. The nurse should teach this client to contact the physician if the client experiences what adverse effect associated with the drug?
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skin rash or itching
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The nurse should advise the client which of the following in regards to the administration of fluoroquinolones? (Choose one)
answer

Do not take antacids while taking fluoroquinolones
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A patient has been treated several times for a recurring ear infection with ofloxacin. The nurse instructs the patient to look for side effects from the prolonged use of the antibiotic and informs the patient that this is known as which of the following?
answer

superinfection
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In the rare instance in which penicillin is considered essential, hypersensitivity can be assessed by administering:
answer

a skin test.
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A client has a diagnosis of otitis media and has just begun antibiotic treatment. The client reports otalgia and has asked for medication. The nurse should anticipate the administration of:
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acetaminophen (Tylenol).
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Which of the following represents the mechanism of action of fluoroquinolones? (Choose one)
answer

Interference with the synthesis of bacterial DNA.
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If a nurse needs to administer otic preparations in both of the patient’s ears, how long should the nurse wait to place drops in the second ear? (Choose one)
answer

At least 5 minutes
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A client is receiving ciprofloxacin for a urinary tract infection. This drug is administered IV. During an infusion, the nurse notes fluid leaking into the tissue around the IV site. What is the best response of the nurse?
answer

Discontinue the IV.
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A patient is admitted to hospice with the diagnosis of XDR-TB. Knowing some of the contributing factors to this disease, the nurse understands this disease is a major indication of:
answer

The failure to adequately diagnose, prevent, and treat MDR-TB.
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The nurse knows that pseudomembranous colitis is a superinfection of fluoroquinolones, especially when they are administered in high doses, because these medications have what effect in the body?
answer

They disrupt the microbial flora of the body.
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After teaching a group of students about aminoglycosides, the instructor determines that the teaching was successful when the group identifies which drug as the prototype for this class?
answer

Gentamicin
question

A 72-year-old patient with TB is undergoing standard treatment in a health care facility. Which of the following nursing interventions should the nurse perform during ongoing assessment of the treatment?
answer

Monitor for appearance of adverse reactions.
question

A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient’s pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?
answer

The use of ciprofloxacin is contraindicated in pregnancy.
question

A nurse is demonstrating the correct technique for instilling antibiotic ear drops into a child’s ear canal. The nurse should teach the child’s caregivers to do which of the following?
answer

Place a cotton ball in the ear canal after instilling the ear drops.
question

A patient is allergic to penicillin and has been diagnosed with a genitourinary infection caused by Chlamydia trachomatis. Which of the following medications will be administered?
answer

Erythromycin (Ery-Tab)
question

A nurse teaching the patient with tuberculosis (TB) should include the following information about ethambutol:
answer

It can cause optic neuritis.
question

A nurse is caring for a patient who has an acute bacterial exacerbation of chronic bronchitis and who has been prescribed telithromycin (Ketek). Before therapy begins, the nurse will assess the patient for a history of which of the following?
answer

Arrhythmias
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A 25-year-old woman is being treated with penicillin G as prophylaxis to prevent bacterial endocarditis prior to a dental procedure. The nurse should question the patient concerning her the use of
answer

oral contraceptives.
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A nurse is caring for a patient who is being administered penicillin. What are the common adverse reactions to penicillin a nurse should assess for?
answer

Inflammation of the tongue and mouth
question

A patient with TB is admitted to a health care facility. The nurse is required to administer an antitubercular drug through the parenteral route to this patient. Which of the following precautions should the nurse take when administering frequent parenteral injections?
answer

Rotate injection sites for frequent parenteral injections.
question

A female client is admitted to the critical care unit with sepsis related to a contaminated central line. The physician orders intravenous beta-lactam antimicrobials. The client’s current laboratory report reflects renal impairment. What would the nurse expect the physician to do?
answer

Decrease the drug dose.
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The client is diagnosed with osteoarthritis and reports joint pain and stiffness. Which medication would be most appropriate for the client to take?
answer

Celecoxib
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After teaching a local community group about the use of OTC anti-inflammatory agents, the nurse determines that the group needs additional teaching when they state:
answer

“These drugs are relatively safe since they don’t have adverse effects.”
question

A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to:
answer

swallow the tablet with milk or food.
question

A child has symptoms of the flu with fever. Which medication should not be administered to the child because of the risk of Reye syndrome?
answer

Acetylsalicylic acid (aspirin)
question

African Americans are at lower risk for developing GI adverse effects with NSAIDs.
answer

False
question

A patient taking penicillamine calls the clinic and tells the nurse that he is seeing double and his eyes are “drooping closed.” What is the best response by the nurse?
answer

“Do not take any more of the medication and come into the clinic immediately to see the physician.”
question

The most common side effects caused by NSAIDs involve the:
answer

stomach.
question

An 11-year-old client is going to have a cavity filled in the left mandibular first molar. The physician has prescribed aspirin for pain relief after the procedure. The nurse finds out that the child is suffering from a flulike illness. The nurse contacts the physician about the prescribed medication for pain. What is the risk if aspirin is administered to Diane?
answer

Reye syndrome
question

Which statement by the client identifies that the use of celecoxib is effective?
answer

“My hip pain has decreased.”
question

A 21-year-old female is admitted after taking 25 aspirin tablets in an attempt to take her life. She is admitted with tinnitus, nausea, and vomiting. The physician diagnoses Kelly with salicylate poisoning. What can be used as a treatment for salicylate poisoning due to an overdose of aspirin? (Select all that apply.)
answer

• Gastric emptying • Administration of activated charcoal • Life support, if indicated
question

The nurse understands that the primary adverse reaction of salicylates is:
answer

gastric distress
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A black client is receiving a high dose of NSAID for pain relief. Which would be most important for the nurse to include in the teaching plan?
answer

Signs and symptoms of gastrointestinal bleeding
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The nurse explains to the client that NSAIDs act by which actions?
answer

Inhibiting the synthesis of prostaglandins
question

What is classified as a nonsalicylate analgesic?
answer

Tylenol
question

A patient is receiving auranofin as treatment for rheumatoid arthritis. The nurse would expect this drug to be given by which route?
answer

Oral
question

the nurse recognizes that which NSAID may be used in the treatment of rheumatoid arthritis?
answer

Etodolac
question

A 65-year-old man who just had a heart attack is placed on aspirin, 81 mg daily. The nurse is explaining the purpose of this medication to the client. What would be the best explanation?
answer

The aspirin is being prescribed because it reduces your risk of a second heart attack.
question

A salicylate is contraindicated in clients who have had surgery within the past week for which reason?
answer

Increased risk for bleeding
question

A nurse is assigned to care for a patient with arthritis in a health care facility. The patient has been prescribed celecoxib. Celecoxib is contraindicated in clients with:
answer

allergy to sulfonamides
question

An 80-year-old male client presents to the physician’s office with reports of fatigue and a change in the color of stools. He self-administers ibuprofen 400 mg each night for general discomfort. The physician orders a stool test for guaiac, which yields positive results. The physician discontinues the ibuprofen. The nurse is responsible for a client education plan. The client should be educated regarding what as a risk with chronic use of NSAIDs?
answer

GI bleed
question

Temperature regulation occurs in the hypothalamus. Normally, when the body temperature increases the body will respond by causing vasodilation in the periphery. What physiologic change is occurring with fever that allows the body’s temperature to increase?
answer

Fever occurs as a result of increased synthesis of prostaglandin in the hypothalamus.
question

A nurse is caring for a 10-year-old boy who reports chronic headaches. His mother reports that she gives him Tylenol at least three times a day. What will the nurse work with the physician to evaluate?
answer

Hepatic function
question

While providing client teaching relative to inflammatory disorders, the nurse would explain the presence of inflammation as:
answer

an attempt by the body to remove the damaging agent and repair the damaged tissue
question

The nurse is administering chrysotherapy to a patient with rheumatoid arthritis. What drug will the nurse be administering?
answer

Gold salts
question

A patient with mild low back pain has been advised to take acetaminophen. The nurse will inform him that excessive intake of acetaminophen may result in:
answer

liver damage.
question

the nurse correctly identifies medications used to treat pain as:
answer

analgesics.
question

A male 16 years of age presents to the physician’s office with nausea, vomiting and pain in the right upper quadrant. He states he has had flu-like symptoms for four to five days. What is the most appropriate action of the nurse?
answer

Ask for a medication history.
question

A 15-year-old client is brought to the emergency department by his friends. He reports visual changes, drowsiness, and tinnitus. He is confused and hyperventilating. These symptoms may be attributable to which condition?
answer

Salicylate intoxication
question

Which client is at highest risk for developing hepatotoxicity related to the use of acetaminophen?
answer

A male 30 years of age who drinks four beers per day
question

A patient with muscle ache would like to use an over-the-counter NSAID. The patient informs a nurse that he is taking antihypertensive drugs for blood pressure control. Why should the nurse caution the patient against the use of an NSAID while on antihypertensive drug therapy?
answer

it causes decreased effectiveness of the antihypertensive drug.
question

A patient with acute joint inflammation asks the nurse why she shouldn’t use acetaminophen for her condition. What would be the nurse’s best response to this patient?
answer

The drug has no effect on inflammation.
question

A client is being discharged following an allergic reaction after ingesting aspirin. Included in patient education about the allergy, the nurse would inform the client that:
answer

the client should not take aspirin or non-aspirin NSAIDs.
question

A student nurse asks the nurse why acetaminophen and NSAIDs help to reduce cancer pain. What is the nurse’s best explanation?
answer

Cancer often produces chronic pain from tumor invasion of tissues or complications of treatment. These drugs prevent sensitization of peripheral pain receptors by inhibiting prostaglandin formation.
question

The client has been prescribed one aspirin a day. The nurse understands that is prescribed for which of the following?
answer

To inhibit platelet aggregation
question

A nurse is caring for a patient who has been administered ibuprofen for fever reduction. Which should the nurse monitor the patient for?
answer

Dyspepsia
question

Which of the following NSAIDs is associated with an increased risk of cardiovascular thrombosis, myocardial infarction, and stroke?
answer

Celecoxib (Celebrex)
question

A nurse suspects that a client is experiencing salicylism. What would the nurse assess?
answer

Ringing in the ears
question

Prostaglandins are:
answer

Chemical mediators found in most body tissues; they participate in the inflammatory response.
question

A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic can the nurse most safely recommend?
answer

Acetaminophen
question

What effects are exerted by aspirin? (Select all that apply.)
answer

Analgesic • Antipyretic • Anti-inflammatory
question

Which of the following is a serious risk involved in the use of NSAIDs?
answer

Cardiovascular thrombosis
question

A client is ordered to receive an NSAID for pain. The client states that NSAIDs are taken to decrease inflammation. The nurse identifies that these medications are also used to:
answer

decrease body temperature.
question

An older adult woman has been experiencing significant joint pain and has informed her primary care provider that she has begun taking aspirin two to three times each day. What aspect of this patient’s medical history may contraindicate the use of aspirin?
answer

The patient has a history of peptic ulcer disease.
question

A patient with mild low back pain has been advised to take acetaminophen. The nurse will inform him that excessive intake of acetaminophen may result in:
answer

liver damage.
question

After teaching a local community group about the use of OTC anti-inflammatory agents, the nurse determines that the group needs additional teaching when they state:
answer

“These drugs are relatively safe since they don’t have adverse effects.”
question

The most common side effects caused by NSAIDs involve the:
answer

stomach.
question

A patient with arthritis is on NSAID therapy. What should be evaluated by the nurse to determine the effectiveness of NSAID therapy?
answer

Better mobility
question

Which statement by the client identifies that the use of celecoxib is effective?
answer

“My hip pain has decreased.”
question

Which instruction would be most important to include when teaching parents about OTC anti-inflammatory agents?
answer

Be sure to read the label for the ingredients and dosage
question

It is important for the nurse to recognize medications from a class of medications. Which are classified as NSAIDs? (Select all that apply.)
answer

Meloxicam (Mobic) • Ibuprofen (Motrin)
question

A client is receiving anakinra as treatment for arthritis. The nurse understands that this drug acts in which manner?
answer

Blocks interleukin-1
question

A client is being discharged following an allergic reaction after ingesting aspirin. Included in patient education about the allergy, the nurse would inform the client that
answer

the client should not take aspirin or non-aspirin NSAIDs.
question

A nurse is administering an anti-inflammatory medication to a patient who has severe rheumatoid arthritis. Which would the nurse question if ordered by the physician?
answer

Oral anticoagulant
question

A patient takes ibuprofen at approximately 10 AM. The patient would most likely feel peak effects of the drug at which time?
answer

12 PM
question

A patient enters the emergency room with reports of visual changes, drowsiness, and tinnitus. The patient is confused and hyperventilating. These symptoms may be attributable to:
answer

salicylate intoxication.
question

The nurse identifies that mefenamic is indicated for:
answer

acute pain.
question

The pharmacology instructor is discussing disease-modifying antirheumatic drugs (DMARDs). According to the instructor, these drugs are prescribed in the treatment of rheumatoid arthritis (RA) because of their:
answer

immunosuppressive properties.
question

Antivenins are used for passive, transient protection from which bites? (Select all that apply.)
answer

Rattlesnake • Black widow • Copperhead
question

A client is 50 years old. The client asks what, if any, vaccines the client should get. The nurse’s best response is
answer

Tetanus-diphtheria-pertussis; hepatitis B vaccine once; influenza vaccine annually.
question

A male, 65 years of age, is deer hunting when he is suddenly attacked by a rabid dog. The man is seen in the emergency department for exposure to rabies. The client has become highly agitated and wants immediate treatment for the dog bite. The nurse checks the electronic health record and discovers the client has had no history of allergic reactions to immunization agents. The client’s history guides the nurse to take which action?
answer

Teach the client that the agent of choice is rabies immune globulin, used if the client has not been previously immunized.
question

An elderly client has been given a tetanus-diphtheria (Td) booster after stepping on a rusty nail. Which statements indicate an understanding of vaccine schedules?
answer

I know that this booster is good for 10 years.
question

A 60-year-old patient is seen in the family practice clinic. Which vaccine should be administered to prevent herpes zoster
answer

Zoster vaccine
question

A nurse is working at a free vaccination clinic today and expects to give vaccinations to more than one hundred children. Which item is most important to have available
answer

Epinephrine pen
question

A nurse is receiving post-exposure prophylaxis for hepatitis B. What would the nurse most likely receive
answer

Immune globulin
question

The nurse is teaching a course to students about immunologic agents. In order for the students to understand active immunity, the nurse explains that there are agents that provide active immunity. Which is an active immunity agent?
answer

Vaccines
question

A nurse should warn a client about which adverse reactions that can occur after the administration of influenza vaccine (Fluzone)? (Select all that apply.)
answer

• Chills • Fever • Lethargy • Muscle aches
question

To prevent chickenpox, a patient would receive a viral vaccine
answer

True
question

A group of students are role-playing scenarios involving biological weapon exposure. Which medication would the students identify as using for a client with cutaneous anthrax?
answer

Ciprofloxacin
question

What would the nurse identify as a vaccine that is a toxoid
answer

Tetanus
question

The administration of immune globulins or antivenins to a patient is a form of what type of immunity?
answer

Passive immunity
question

A patient with a history of chronic cough is suspected of having pulmonary tuberculosis. Which vaccination is used to prevent the condition?
answer

BCG vaccine
question

s a participant in an educational event at a local senior center, the nurse is explaining the administration of vaccines. What group would the nurse identify as being ineligible for live-virus vaccines?
answer

People undergoing systemic, long-term corticosteroid therapy
question

When providing patient teaching to parents regarding measles, mumps, and rubella vaccine administration, which is most important regarding the schedule for administration?
answer

It is administered at 12-15 months.
question

The nurse is working at a community agency administering the polyvalent pneumococcal vaccine. The nurse understands that administration of this vaccine should be avoided in which patients?
answer

1 ½ -year-old
question

Which agent would the nurse expect to administer to a pregnant woman to prevent Rh factor sensitization?
answer

RHO immune globulin
question

Which statements best indicates the client understands recommended vaccines following the 65th birthday?
answer

A tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age
question

Which is an example of artificially acquired active immunity? (Select all that apply.)
answer

• Administration of the influenza vaccine to an individual who has no immunity to the disease. • Administration of the rubella vaccine to an individual who has no immunity to the disease. • Administration of the varicella vaccine to an individual who has no immunity to the disease
question

A patient develops fever and arthralgia 4 days after the administration of tetanus toxoid. What reaction to the vaccine is this?
answer

Serum sickness
question

A nursing instructor is discussing the intended populations for various vaccines. Which groups might the instructor mention when discussing the hepatitis B vaccine?
answer

Paramedics and emergency medical technicians
question

A client was bitten by a poisonous snake. Which treatment would be most appropriate to administer?
answer

Antivenin
question

A nurse prepares to administer antithymocyte immune globulin. The nurse understands that this is used to:
answer

treat acute renal transplant rejection.
question

What is the best source of information for current recommendations regarding immunizations and immunization schedules?
answer

centers for Disease Control and Prevention
question

An infant is being administered an immunization. What provides an accurate description of an immunization
answer

it is the administration of an antigen for an antibody response.
question

After teaching a group of students about the standard childhood immunizations given today, the instructor determines that the students need additional teaching when they identify which as a common disease for which immunizations are given?
answer

Tuberculosis
question

Cell-mediated immunity depends on which of the following? (Choose one)
answer

The action of T lymphocytes
question

A patient who was bitten by a pit viper is to receive antivenin. The nurse would expect to administer this agent by which route?
answer

Intravenous
question

What is a contraindication to an MMR booster for an adolescent female?
answer

Pregnancy
question

To prevent meningococcal infections, the nurse would administer:
answer

Vaccine
question

What would the nurse identify as a vaccine that is a toxoid?
answer

Tetanus
question

Administration of the tetanus toxoid in adults involves two initial injections given four weeks apart, a booster injection given six months to a year later, and periodic injections thereafter. What is the recommended interval for the periodic injections?
answer

Every 10 years
question

A nurse should screen clients of child-bearing age for pregnancy as the administration of which vaccines is contraindicated during pregnancy? (Select all that apply.)
answer

Rubella • Mumps • Varicella • Measles
question

A nurse is administering a mumps vaccine to an adolescent. Which medications should be available when administering an immunization?
answer

Epinephrine
question

When describing the use of vaccines to a local community group, what would the nurse include
answer

Vaccines are used to provide active immunity.
question

Which is an example of naturally acquired active immunity? (Select all that apply.
answer

An individual who is exposed to chickenpox for the first time and has no immunity to the disease. • An individual who is exposed to pertussis for the first time and has no immunity to the disease
question

For what group of adults is pre-exposure immunization against hepatitis B recommended?
answer

People who are at risk for exposure to the disease
question

As a participant in an educational event at a local senior center, the nurse is explaining the administration of vaccines. What group would the nurse identify as being ineligible for live-virus vaccines?
answer

People undergoing systemic, long-term corticosteroid therapy
question

When instructing the parents of a child who has received immunization in the vastus lateralis, which reaction is most common in the days after the administration?
answer

Tenderness and redness at the site
question

The nurse should not administer sedatives or hypnotic drugs to which client?
answer

Comatose client
question

An elderly patient is administered a sedative for the treatment of insomnia. Which sign should the nurse look for in the patient when monitoring the effects of the administered drug?
answer

Confusion
question

Respiratory distress is a contraindication for the use of barbiturates.
answer

true
question

A group of nursing students answers correctly if they identify which medication as the prototype benzodiazepine?
answer

Diazepam (Valium)
question

After reviewing the various drugs that are classified as barbiturates, a student demonstrates understanding when identifying which as the prototype?
answer

Phenobarbital
question

A patient receiving halcion 0.25 mg PO at bedtime appears very drowsy and is difficult to rouse when the nurse enters the room. Based on these findings, what would be the best nursing diagnosis for this patient?
answer

Risk for injury
question

A truck driver has been diagnosed with a generalized anxiety disorder (GAD) and lorazepam has been prescribed. The patient asked the nurse how this medication will affect his job. The nurse advised him to:
answer

avoid driving until he is aware of the adverse effects.
question

Medication reconciliation of an 82-year-old man who has recently moved to a long-term care facility reveals that the man takes 1 to 2 mg of lorazepam bid prn. The nurse should recognize what consequence of this aspect of the resident’s drug regimen?
answer

Increased risk for falls
question

A nurse is caring for a patient whose physician has ordered a benzodiazepine sedative-hypnotic. The nurse knows that most of these drugs are used with caution in patients with which disorders?
answer

Liver disease
question

A client is prescribed an anxiolytic agent. What would be most important for the nurse to include in the teaching?
answer

Be sure not to stop the drug abruptly.”
question

A patient undergoing treatment with barbiturates is showing symptoms of barbiturate toxicity. Which intervention should the nurse perform?
answer

Provide respiratory assistance
question

A patient with a known seizure disorder is admitted to the intensive care unit with a diagnosis of septic shock. The patient is being sedated with midazolam (Versed). Following discontinuation of the medication, the patient remains sedated for several days. Based on the patient’s history, what is the rationale for not treating with flumazenil (Romazicon)?
answer

increased risk of seizures
question

A 28-year-old patient is to receive a dose of lorazepam intravenously for sedation during a procedure. The nursing priority would be to assess for:
answer

respiratory disturbances and partial airway obstruction.
question

What are the most important physical assessments for a nurse to perform when admitting a client diagnosed with elevated blood pressure due to anxiety? (Select all that apply.)
answer

• Skin temperature and color • Respiratory rate • Blood pressure
question

A patient received a parenteral benzodiazepine at 9 AM. The nurse would maintain the patient on bedrest until which time?
answer

12 PM
question

Patients taking benzodiazepines, especially elderly patients, are at high risk for:
answer

falls.
question

Which action would be least appropriate for the nurse to do after administering an anxiolytic to a patient?
answer

Having the patient walk to the bathroom
question

After teaching a patient about his prescribed anxiolytic agent, which patient statement indicates that the patient has understood the teaching?
answer

“I will make sure not to stop the drug abruptly
question

A patient who suffers from GERD and diverticulosis has just been admitted to a medical floor. The admitting physician orders cimetadine and a sedative to calm the patient. About what should the nurse be concerned?
answer

Increased sedative effect
question

Which are examples of benzodiazepine antianxiety drugs? (Select all that apply.)
answer

• Alprazolam (Xanax) • Chlordiazepoxide (Librium) • Lorazepam (Ativan)
question

A male client is admitted to the emergency department via ambulance. He is attempting to pull out his IV line, exhibiting symptoms of agitation, and thrashing about. The physician orders a benzodiazepine-type sedative. What information is needed prior to administration of the drug?
answer

Whether the client is experiencing drug intoxication or withdrawal
question

The nurse would be most alert for what issue in a patient who is receiving an intravenous barbiturate?
answer

Hypotension
question

å nurse is caring for a patient who is prescribed flurazepam. Which is an effect of flurazepam?
answer

Induces sleep
question

The daughter of an older adult client asks the nurse if her father should be aware of any special precautions while taking lorazepam (Ativan). What is the nurse’s best response?
answer

Monitor for increased signs of confusion or forgetfulness.
question

A 70-year-old patient has just started taking lorazepam 10 days ago for anxiety issues related the death of her husband. She is staying with her daughter for a couple of weeks. The patient’s daughter has noticed that her mother is having difficulty walking and seems to be confused at times and calls the clinic to report this to the nurse. The nurse will inform the daughter that:
answer

a dose adjustment should be made if these symptoms persist.
question

A client has received a benzodiazepine for sedation before a diagnostic procedure. Which agent would the nurse expect the client to receive to reverse the sedative effects?
answer

Flumazenil
question

The nurse is describing an anxiolytic that has no sedative, anticonvulsant, or muscle relaxant properties, but is effective in reducing the signs and symptoms of anxiety. Which agent would the nurse most likely be describing?
answer

Buspirone
question

A 70-year-old male client asks why he is receiving a lower dose of zaleplon than his son. As part of the nurse’s teaching plan, which explanation will the nurse give this client?
answer

“Older adults metabolize the drug more slowly, and half-lives are longer than in younger adults.”
question

A male client’s anxiety is interfering with his ability to perform basic activities of daily living and return to work. The nurse expects that which diagnosis will probably be made by his physician?
answer

Anxiety disorder
question

The patient has been taking a sleep medication for the last 6 months and informs the primary care provider that she sleeps great now and wants to discontinue the drug. The provider tells the patient that this is not a good idea. What is the best rationale for this advice?
answer

The provider believes that stopping the drug abruptly may cause serious consequences for the patient.
question

A patient who experiences panic attacks in social situations has been prescribed an antianxiety medication. What should the nurse check before administering the drug?
answer

Blood pressure
question

Which drug used to treat anxiety would be appropriate for a patient who is a school teacher and is concerned about feeling sedated at work?
answer

Buspirone (BuSpar)
question

A patient who suffers from GERD and diverticulosis has just been admitted to a medical floor. The admitting physician orders cimetadine and a sedative to calm the patient. About what should the nurse be concerned?
answer

Increased sedative effect
question

What might occur if a client inadvertently receives a benzodiazepine intra-arterially?
answer

Arteriospasm
question

A client is receiving a barbiturate intravenously. The nurse would monitor the client for:
answer

bradycardia.
question

A 28-year-old patient is to receive a dose of lorazepam intravenously for sedation during a procedure. The nursing priority would be to assess for:
answer

respiratory disturbances and partial airway obstruction.
question

A nurse is caring for an elderly patient undergoing antianxiety treatment. The patient is to be administered antianxiety drugs parenterally. What precautions should be taken by the nurse?
answer

Have resuscitative equipment ready.
question

A new mother asks her nurse about the safety of taking St. John’s wort for postpartum depression. What would be the nurse’s best response?
answer

“There is insufficient evidence to support the use of St. John’s wort, and drug interactions may be extensive.”
question

A 40-year-old man has been prescribed fluoxetine (Prozac). The patient states he has not continued the prescribed therapy even though his depression improved. What assessment is most important for the nurse to make?
answer

Assess for sexual dysfunction
question

A 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully monitored for
answer

dizziness.
question

A 12-year-old child who has been taking sertraline for the past 2 weeks has returned to the clinic to be seen. It will be critical for the nurse to assess for
answer

onset of suicidal ideation.
question

A client taking phenelzine (Nardil) is at a dinner party and has several glasses of red wine. The client begins to feel nauseated and develops a terrible headache. The client is taken to the nearest emergency department. This client might be experiencing a hypertensive crisis. As the nurse in the ED, what other symptoms might the client experience if they are having a hypertensive crisis? (Select all that apply.)
answer

Chest pain • Tachycardia • Stiff neck
question

A client has been taking fluoxetine (Prozac) for the last ten days and calls the clinic reporting not feeling any better. What is the nurse’s best response to this client?
answer

“It may take another two to three weeks before the medication is completely effective
question

A patient suffers from depression and states feelings of gloom and inability to perform the activities of daily living. What neurotransmission is decreased?
answer

Serotonin
question

After reviewing information about the various antidepressants, a group of students demonstrate their understanding of the information when they identify what as an SSRI?
answer

Sertraline
question

A nurse is reviewing a client’s serum lithium level. Which finding would indicate that the client is experiencing lithium toxicity?
answer

1.8 mEq/L
question

When taking MAO inhibitors, clients should avoid which foods?
answer

Aged cheeses and meats, concentrated yeast extracts, sauerkraut, and fava beans
question

how long does a patient need to wait after stopping a phenelzine (Nardil) before starting paroxetine (Paxil)?
answer

14 days
question

A physician has prescribed an antidepressant medication for a 15-year-old female patient. Which statement would be appropriate for inclusion in patient teaching?
answer

There may be an increased risk of suicide while taking this drug.”
question

After teaching a group of students about tricyclic antidepressants, the instructor determines that the teaching has been successful when the students identify that this group of drugs is administered by which route?
answer

Oral
question

Which class of antidepressants exerts its effects by inhibiting reuptake serotonin?
answer

Selective serotonin reuptake inhibitors
question

A nurse is working with a Chinese immigrant who is taking an MAOI. The most important instruction to the patient by the nurse will be to
answer

avoid use of soy sauce in the diet.
question

A female client has been diagnosed with depression. She also has a history of alcoholism. She has been sober now for 4 months, but at her last physical examination, the physician noted right-upper-quadrant tenderness and elevated liver enzyme levels. The physician has prescribed sertraline to treat Ms. Tooka’s depression. Which factor would need to be considered prior to administering this medication to her?
answer

The medication should be started at a lower dose due to liver dysfunction, and the patient should be monitored for side effects.
question

A client is receiving an SSRI. The nurse would inform the client that the full benefits of the drug may not occur for which time period?
answer

4 weeks
question

Why are selective serotonin reuptake inhibitors considered the first line of drug therapy for patients with depression?
answer

The medications have fewer anticholinergic effects than alternatives.
question

A patient has been prescribed phenelzine sulfate (Nardil), which is an MAO inhibitor. Which food should the patient avoid eating?
answer

Cheddar cheese and bratwurst
question

the adverse effects of selective serotonin reuptake inhibitors are less than other antidepressants.
answer

True
question

Tricyclic antidepressants reduce the reuptake of serotonin and norepinephrine.
answer

True
question

The nurse would assess for what in a client with type 2 diabetes using an oral antidiabetic agent and receiving an MAOI
answer

Hypoglycemia
question

A patient who ingests foods high in tyramine while taking a selective serotonin reuptake inhibitor is at risk for developing severe hypertensive crisis.
answer

False
question

A nurse is caring for a patient with depression. Which symptom should the nurse closely monitor for in the patient?
answer

Extreme sadness
question

In patients requiring sertraline therapy, which patient would require the closest monitoring by the nurse?
answer

A 45-year-old man with liver impairment
question

A deficiency of a biogenic amine in key brain areas is believed to result in depression.
answer

True
question

A client is receiving fluoxetine. The nurse would monitor the client for:
answer

cough
question

When monitoring a patient receiving escitalopram for therapeutic effectiveness, the nurse would keep in mind that full effect may take up to how long?
answer

4 weeks
question

A client is receiving an antidepressant that also aids in smoking cessation. Which drug would this most likely be?
answer

Bupropion
question

After teaching a patient who is taking trazodone about the adverse effects, the nurse determines that the teaching was successful when the patient states that he should notify the physician immediately if he develops:
answer

painful sustained erection.
question

A male client has a history of hepatic dysfunction secondary to alcoholism. Based on the client’s diagnostic history, what would the nurse expect his physician to order?
answer

A lower dose of the antidepressant
question

Which antidepressant would the nurse identify as being one associated with the least amount of common adverse effects
answer

Nortriptyline
question

A nurse is caring for a patient with depression. The patient has been prescribed amitriptyline, a tricyclic antidepressant. What should the nurse identify as the effect of this antidepressant on the patient’s body?
answer

Decreased reuptake of norepinephrine
question

The nurse is caring for a group of clients in a long-term care facility. The nurse is aware that SSRIs are associated with what side effect that is especially undesirable in older adults?
answer

Weight loss
question

When a patient is started on an antidepressant, it is important for the nurse to explain to the patient that it may take time to see a change in mood, but that adverse reaction may occur soon after initiation of therapy. How long can it take for the patient to see the beneficial effects of an antidepressant?
answer

4 weeks
question

A patient has been diagnosed with depression. The physician has ordered sertraline. The patient asks, “How soon will it be until I feel better?” What would be the best response?
answer

The medication will start to work in as soon as 10 days, but it may take up to 4 weeks to be fully effective
question

A nurse is caring for a patient who is taking a monoamine oxidase (MAO) inhibitor for treatment of a depressive disorder. What is a potentially serious side effect of MAO inhibitors?
answer

Hypertension
question

A patient visits the medical unit. The patient has fallen asleep on the line of the factory where the patient works and has a history of muscle weakness. This instance is not the first time the patient has fallen asleep on the line. From what disease process does the occupational health nurse suspect the patient is suffering?
answer

Narcolepsy
question

The community health nurse is conducting a class for parents of preschoolers. One of the parents asks if a child with ADHD will always have problems with hyperactivity. What is the nurse’s best response?
answer

“ADHD usually starts in childhood and may persist through adulthood.”
question

A patient who was diagnosed with schizophrenia in 1962 was prescribed chlorpromazine (Thorazine). The patient has been taking the medication for more than 40 years. What adverse effect will the patient most likely experience?
answer

Tardive dyskinesia
question

A patient has been prescribed an amphetamine as part of obesity treatment. Which of the following interventions should the nurse perform before the dosage regimen starts?
answer

Record the patient’s weight.
question

Mania is characterized by extreme overactivity and excitement.
answer

True
question

Kate, age 34, comes to your office for preconception counseling. She is currently drinking 10 to 12 cans of diet cola each day. She verbalizes her concern about her excessive caffeine intake and the adverse effects that caffeine will have on the baby. She asks what she can do to limit her caffeine intake. What is the best recommendation for you to make?
answer

Gradually decrease her daily intake of caffeine.
question

A patient is prescribed olanzapine (Zyprexa) for the treatment of acute bipolar disorder. The patient tells the nurse he is voiding three times at night and is always thirsty. Based on the adverse effects of this medication, what should the nurse suspect the patient has developed?
answer

Diabetes mellitus
question

What would lead the nurse to suspect that a patient receiving antipsychotic therapy is developing tardive dyskinesia?
answer

Lip smacking
question

A nurse is caring for a patient who is taking haloperidol. The patient has orders for a new drug, and the nurse notes that it is highly protein bound. The nurse will plan care based on a(n):
answer

increased risk for toxic effects of haloperidol therapy.
question

A client with dementia has been very agitated lately. What type of medication might the provider prescribe to help with the agitation?
answer

Antipsychotic
question

An African American male client routinely takes haloperidol to manage his psychosis. Recently, he presented to the physician’s office with signs of tardive dyskinesia, and his physician modified the drug regimen over time. The client will now take the drug olanzapine and discontinue the haloperidol. What will the nurse tell the client to help decrease his anxiety about the new drug regimen?
answer

“When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in African Americans.”
question

The nursing student learned in anatomy and physiology class that the nervous system has how many divisions?
answer

2
question

John is a 45-year-old man who is obese. He is coming to see the physician today about diet and medications to help him lose weight. He wants to be prescribed dextroamphetamine. Based on John’s history, what would contraindicate the use of this medication?
answer

Myocardial infarction 2 months previously
question

The wife of a patient who is taking haloperidol calls the clinic and reports that her husband has taken the first dose of the drug and it is not having a therapeutic effect. An appropriate response by the nurse would be:
answer

“Continue the prescribed dose. It may take several days to work.”
question

Dexmethylphenidate has been prescribed to Scott, a 7-year-old boy who was diagnosed with ADHD. The mother asks how this medication will help her son. Which would be the most accurate description of the purpose of this medication?
answer

Dexmethylphenidate will improve Scott’s attention span so that he will be able to complete a task.
question

A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse’s priority assessment would be
answer

height and weight.
question

A patient diagnosed with schizophrenia is being seen by the home care nurse. What is the most important aspect of patient teaching with this patient?
answer

Maintain medication regime
question

A patient is taking an amphetamine for ADHD. He has developed constipation since beginning therapy. Which of the following should the patient be taught?
answer

Increase fiber
question

A patient has been prescribed Focalin 10 mg daily in two divided doses for ADHD. The drug availability is 2.5-mg capsules. How many capsules will a nurse administer to the patient each time?
answer

2 capsules
question

Which of the following clients are at increased risk for the development of lithium toxicity? Select all that apply:
answer

• Clients receiving furosemide (Lasix) • Clients experiencing diarrhea • Clients with renal insufficiency • Clients experiencing vomiting
question

A male client comes into the emergency department and is agitated, swiping his arms at “the bugs” and screaming that Harry Potter sent the bugs to take him away. After two security officers help to restrain the client, the doctor orders 5 mg of Haldol STAT. How would the nurse administer this drug?
answer

5 mg IM in the client’s gluteus maximus
question

A client, who has been diagnosed with schizophrenia and is taking an antipsychotic medication, reports constant thirst, frequent urination, and feeling nauseous. The nurse knows that the client may:
answer

have undiagnosed diabetes.
question

After teaching the parents of a child diagnosed with ADHD about the disorder and its treatment, the nurse determines that the teaching has been effective when the parents state:
answer

“We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention.”
question

A female client relates that she is taking Valium for a muscle relaxant and Provigil for treatment of narcolepsy. Additionally, she informs you that she takes a contraceptive. As part of client education, the nurse would include:
answer

Provigil may decrease the effects of her contraceptive, and she may need to use other protection.
question

A nurse is caring for a patient who is taking haloperidol. The patient has orders for a new drug, and the nurse notes that it is highly protein bound. The nurse will plan care based on a(n):
answer

increased risk for toxic effects of haloperidol therapy.
question

Which of the following effects can be noticed in a patient who has been administered amphetamines?
answer

Decreased appetite
question

A patient with obesity who recently became unemployed has been taking desoxyn for more than 9 months. The nurse thinks that the patient should stop this drug for which of the following reasons?
answer

Long-term use can cause tolerance.
question

A male client refuses to take his oral antipsychotic medication. What should the nurse do?
answer

Attempt to reason with the client. If he still refuses, contact the provider for further instructions.
question

A dose of 60 mg Doxapram HCL has been prescribed for a patient to be administered intravenously. The drug is available in 20-mL vials containing 400 mg of the drug. How many mL of the available solution should be administered to the patient?
answer

3
question

A patient has been treated with amphetamines for ADHD. At the age of 16 years, she is diagnosed with hyperthyroidism. What intervention should be implemented with this patient?
answer

Discontinue the amphetamines
question

A patient has been prescribed an amphetamine as part of obesity treatment. Which of the following interventions should the nurse perform before the dosage regimen starts?
answer

Record the patient’s weight
question

For clients taking clozapine (Clozaril), it is necessary to monitor what lab test for the first 6 months?
answer

White blood cells
question

A client asks the nurse dopamine is. What is a correct response by the nurse?
answer

“Dopamine is a neurotransmitter that deals with pleasure and reward in the brain.”
question

Which of the following reactions can occur in a patient who has been administered caffeine?
answer

Skeletal muscle stimulation
question

Which of the following is usually administered before, during, and after CNS stimulant administration to a patient with respiratory depression? (Choose one)
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Oxygen
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The nurse is caring for a patient who is receiving drug therapy for a psychotic disorder. Which goals should the nurse include in a care plan for the patient following discharge from the hospital?
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The patient will take medications as prescribed.
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After reviewing the indications for antipsychotic agents, a group of students demonstrate understanding when they identify which agent as appropriate for treating mania and schizophrenia?
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Aripiprazole
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A patient is seen in the ambulatory care clinic with a report of insomnia. What should the nurse assess in regard to the insomnia?
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Daily intake of caffeine-containing products
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A nurse caring for a client with attention deficit hyperactivity disorder (ADHD) may administer which of the following CNS stimulants? (Select all that apply.)
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• Dextroamphetamine (Dexedrine) • Methylphenidate (Concerta)
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When providing education to a patient who is taking dextroamphetamine, what would be a priority teaching point?
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Dextroamphetamine should not be taken with other over-the-counter medications
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A nurse is charting a client who has repetitive tongue thrusting, jaw movements, and a facial tick. What term could the nurse use in charting to describe these findings?
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Tardive dyskinesia
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Which statement should be included in the teaching plan for a patient receiving methylphenidate (Ritalin)?
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Adverse effects include hypertension and nervousness.
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A 75-year-old male client is given an order for a CNS stimulant secondary to a new diagnosis of narcolepsy. He begins to experience signs and symptoms of excessive CNS stimulation. The nurse knows that the client is likely to also experience an exacerbation of which preexisting condition?
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Cardiac dysrhythmias
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Which test should be scheduled every week for a patient taking clozapine?
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WBC count
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The nurse is administering morphine sulfate to a client who had a myocardial infarction. What vital sign would the nurse monitor that directly relates to the use of this narcotic?
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Respiratory rate
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The nurse is caring for a postoperative client receiving an opioid medication for pain management. The nurse finds the client lethargic with a respiratory rate of 6 breaths per minute. Which of the following actions should be performed first?
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Attempt to arouse the client and coach his or her breathing pattern.
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Opioid antagonists may produce withdrawal symptoms in patients physically dependent on which of the following?
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Opioids
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A trauma patient has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the patient’s
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bowel patterns.
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Which of the following conditions would occur due to the administration of an opioid antagonist in a patient who is physically dependent on opioids?
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Withdrawal symptoms
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A patient is prescribed zolmitriptan for migraine headaches. The nurse would instruct the patient to administer this drug most likely by which route?
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Oral
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The physician has ordered 0.2 mg naloxone (Narcan) to be administered intramuscularly stat. The pharmacy has available naloxone 0.4 mg/mL. How much naloxone will the nurse administer to the client?
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0.5
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An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the patient that
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there is risk of an extremely high dose available all at once if the tablet is crushed.
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A nurse is caring for a 49-year-old woman in the intensive care unit. The patient was in a motor vehicle accident and is in severe pain. She is being given morphine. After 2 days in the unit, the nurse suspects that the patient is developing a cold. The nurse will monitor for which of the following?
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Pneumonia
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Naloxone (Narcan) will reverse the effects of which of the following drugs?
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Fentanyl (Duragesic)
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The nurse enters the client’s room and the client is sitting up in bed laughing and visiting with family. The client states that the pain is a “10” on a pain scale of 0 to 10. The client is requesting pain medication. What is the best response by the nurse?
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Administer the pain medication as ordered.
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The client is to take almotriptan 6.25 mg orally for her migraine. Almotriptan is sent to the unit in 12.5 mg tablets. The nurse will administer how many tablet(s)?
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0.5
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Which agent would a nurse expect to be prescribed for a patient with migraine headaches?
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Sumatriptan
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A 50-year-old woman has been prescribed sumatriptan for the treatment of migraines. What instructions should then the nurse provide to the patient about the safe and effective use of this drug?
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“Take this drug as soon as you feel the first signs of a migraine.”
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A client is to receive a narcotic cough syrup. The nurse would expect this preparation to contain which of the following?
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Codeine
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Naloxone (Narcan) 2 mg IM has been ordered. The pharmacy has available naloxone 1 mg/mL. How much naloxone will the client receive?
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2
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Your client has difficulty swallowing and requests you to crush all her medications. You note that she has been prescribed an extended release opioid. You would contact the health care provider because:
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Chewing or crushing destroys the long-acting feature and constitutes an overdose.
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What is the best information the nurse can give the client concerning the use of pain medication after surgery?
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Ask for pain medication before the pain gets severe.
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Which of the following conditions should the nurse monitor for in the patient receiving an opioid antagonist?
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Sweating
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A nurse is assessing a client’s pain level. Which of the following would be the most appropriate method?
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Have the client rate it on a scale of 1 to 10.
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A patient has been administered an opioid. For which of the following effects should the patient be assessed?
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Hypotension
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Which agent would be used as part of a treatment plan for narcotic detoxification?
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Methadone
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Your client returns from the post anesthesia recovery unit. You note a respiratory rate of 6. Which of the following drugs would you anticipate being given immediately?
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Narcan
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Opioids exert widespread pharmacologic effects, especially in the CNS and the gastrointestinal (GI) system. What are two major adverse effects of opioids that are potentially life threatening?
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Sedation and respiratory depression
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A 40-year-old male client with arthritis of the knee joint has been prescribed an analgesic to relieve the pain. Which of the following is a narcotic analgesic?
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Morphine
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A trauma patient has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the patient’s
answer

bowel patterns
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Opioid receptors are highly concentrated in some regions of the central nervous system, including the ascending and descending pain pathways and portions of the brain essential to the endogenous analgesia system. True or false?
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true
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In reviewing the medical history of a patient who is to receive ergotamine, which of the following would alert the nurse to the need for close monitoring?
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Pruritus
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Prior to administering morphine, the nurse checks the client’s medication history. The nurse will contact the physician and hold the morphine if the nurse notes the client is currently taking which medication?
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Monoamine oxidase (MAO) inhibitor
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Which of the following should be included when assessing pain? Select all that apply.
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• Location of the pain • Intensity of pain • What factors cause the pain to improve or worsen • What medications client usually takes to relieve the pain
question

The nurse is caring for a postoperative client receiving an opioid medication for pain management. The nurse finds the client lethargic with a respiratory rate of 6 breaths per minute. Which of the following actions should be performed first?
answer

Attempt to arouse the client and coach his or her breathing pattern.
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The A-delta fibers are myelinated and found in the skin and muscle to transmit sharp, well-localized pain signals. True or false?
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True
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Opioid antagonists are second-line drugs for the treatment of moderate to severe pain. They include the following brand name drugs:
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Stadol and Nubain.
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A nurse is caring for a patient with chronic pain who has been prescribed epidural analgesia. The nurse should monitor the patient for which of the following conditions after insertion of the epidural catheter and throughout the therapy?
answer

Respiratory depression
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How quickly does naloxone (Narcan) work to reverse opioid induced respiratory depression?
answer

1 to 2 minutes
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A client’s family asks why the nurse has placed suction equipment in the room immediately after administering a dose of naloxone (Narcan). Which of the following explanations by the nurse is correct?
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Abrupt reversal of opioid-induced respiratory depression may cause vomiting.
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A-delta fibers are small myelinated fibers that respond quickly to acute pain.
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True
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The male client states that he does not have a back injury; it is his leg that hurts. He feels the physician is not listening to him. What is the best response of the nurse?
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“Sometimes when there is nerve damage, it shows up as pain in a different part of the body.”
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A client is to receive a narcotic that will be applied transdermally. The nurse identifies this as which agent?
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Fentanyl
question

Naloxone (Narcan) will reverse the effects of which of the following drugs?
answer

Fentanyl (Duragesic)
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The nurse is caring for a postoperative client with a history of opioid abuse who has been ordered to receive a dose of an opioid antagonist medication. Which of the following issues should the nurse be prepared to address?
answer

The client may begin to demonstrate symptoms of withdrawal.
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Morphine, an opioid agonist, is administered for both acute and chronic pain. Along with the administered dosage, which of the following determines the patient’s response to morphine?
answer

The route of administration
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When administering an opioid antagonist drug to a client, the primary goal of the therapy is to provide which of the following?
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A return to normal respiratory rate, rhythm, and depth
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A patient has been given MS Contin. You enter the room and the patient is unresponsive. His respirations are 8 per minute. What medication will be ordered for the patient?
answer

Naloxone (Narcan)
question

When administering narcotics to clients, the nurse must monitor for which of the following side effects?
answer

Constipation
question

The nurse knows that, of the following clients, who is least likely to be prescribed transdermal fentanyl?
answer

A woman 85 years of age
question

Which of the following medications requires that naloxone (Narcan) be administered to counter the effects? Select all that apply.
answer

morphine sulfate (MS Contin) • acetaminophen and oxycodone (Percocet) • hydromorphone (Dilaudid)