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A nurse is teaching safety precautions to a patient with parkinsons disease who is prescribed benztropine. The nurse understands that benztropine is an anticholinergic. Therefore safety precautions include which of the following? Stay indoors in the air conditioned setting during hot weather For which adverse effect does the nurse monitor in a patient with parkinsons disease after administering pramipexole? Narcolepsy or sleep attacks Which strategy BEST supports safe medication administration for patients with alzheimers disease? Include the patients care provider when teaching about the patients drugs Which statement by the patient with alzheimers disease indicates to the nurse the need for additional teaching? When I have been taking donepezil for 6 weeks I should regain my memories Which food or beverage does the nurse teach a patient who is prescribed quietiapine to avoid? Grapefruit and grapefruit juice Four hours after receiving risperidone to treat psychosis a patient on the psychiatric unit has an elevation of 4 degrees the nurse knows this may be a sign of neuroleptic malignant syndrome. What is the nurse best action Hold the next dose and notify prescriber immediately The family of a patient who was prescribed chlorpromazine to treat psychosis reports the patient continually rolls his tongue and smacks his lips. What is the best action? Instruct the family to hold the next dose of the drug and seen by pcp immediately may be experiencing tardive dyskinesia How do the major antipsychotic drugs exert their effects to reduce psychotic episodes? They block dopamine receptors and reduce neuronal impulse transmission which then decreases symptoms of hallucinations illusions and delusions A female patient who has been prescribed diazepam for anxiety tells the nurse that she and her husband are planning to have a child. What is the nurse best response Consult with your pcp because taking diazepam while pregnant has been associated with birth defects A patient who has been prescribed diazepam reports taking as needed PRN drugs more often to keep anxiety symptoms under control and does not want pcp to stop prescribing it. What is the nurse best interpretation of this information? The patient may be developing signs of drug dependence
On admission to the acute care unit a patient tells the nurse that she stopped taking her prescribed clonazepam 2 days ago. What is the nurse best first action? Notify the pcp and watch for seizures What is the advantage of treating a patient with anxiety with benzodiazepine drug rather than a SSRI? Benzo act to treat anxiety within 20 min and can be given on an as needed basis A patient who has been prescribed clonazepam for the last 3 months tells the nurse that he wants to stop this drug because he constantly feels like he is in a fog. What is the nurse best response? I will contact the pcp but it will be necessary to take this drug at a lower dosage for a while Which statement by the patient with chronic depression who is prescribed fluoxetine indicates to the nurse the need for additional teaching? When I am feeling better and no longer depressed I will stop taking the Prozac A patient who was prescribed citalopram 1 week ago for depression reports feeling no different now from 1 week ago and wants to stop taking the drug. What is the nurses best response? Most drugs for depression take atleast 2 weeks to start making you feel better A patient who is prescribed gabapentin for seizures is also taking aluminum hydroxide for indigestion. What does the nurse caution the patient about taking these two drugs? Schedule atleast 2 hours between taking gab and alumin hydroxide Which assessment question is most important for the nurse to ask a patient who is prescribed clonazepam for panic disorder before administering the first dose? Do you smoke cigarettes? Why does a nurse instruct a patient taking lithium carbonate to avoid taking NSAIDS? Toxicity What does the nurse plan to teach a patient who is prescribed ethosuimide about going outdoors? Wear dark glasses when the sun is bright A patient who has been prescribed ethosuximide 2xdaily for absence seizures reports the morning dose was missed 10 hours ago. What is the nurse best advice? Take the regularly scheduled second dose now and forget about the morning dose A female patient with a seizure disorder who is taking birth control pills is prescribed valproic acid. What must the nurse be sure to include in his patients teaching plan? Plan to use another form of contraceptive A patient who has been prescribed phenytoin reports gum swelling around the teeth. What is the nurse best action?
Tardive dyskinesia The nurse in a clinic has a patient that stopped taking alprazolam suddenly the nurse knows to look for Withdrawal symptoms A patient started fluoxetine for depression is admitted to the ER with agitation, dialated pupils and confusion. The nurse suspects Serotonin syndrome The nurse has a young patient starting fluoxetine to treat depression. The family should monitor Suicidal thoughts Patient instructions for buspirone should include Allow 2-4 weeks before feeling better A patient who is taking bupropion hydrochloride to treat depression and has a history of a head injury is at increased risk for Seizure activity Adverse effects of echothiophate to treat glaucoma include Cataracts A patient has been prescribed rasagiline as MAO B inhibitor to treat parkinsons disease. Which foods should the patient avoid? Soy, aged cheese, sour cream Side effects of valproic acid to treat seizures include Rash, drowsiness Patient teaching for instilling pilocarpine to treat open angle glaucoma should include Apply gentle pressure, do not touch dropper tip, remove contact lens A patient is prescribed temazepam, a benzodiazepine, to treat insomnia. Pt teaching? Avoid alcohol, take 30 in before bedtime A patient has been prescribed amitriptyline to treat depression. What pt teaching Check pulse daily, avoid driving, include fiber, smoking cigarettes decrease effect
After gently rotating a vial of glargine (Lantus), the nurse notes that the drug has a cloudy appearance. What step does the nurse take before administering it to a patient? Discarding the current vial and opening a new one. A nurse is caring for a patient with chronic adrenocortical insufficiency. Which medication would the nurse prepare to teach the patient about? hydrocortisone A nurse is preparing to administer a client’s daily dose of NPH insulin at 0730. The nurse should expect this type of insulin to peak within which of the following timeframes after administration? 4 to 12 hr A nurse is reinforcing teaching about immunizations with a woman in her first trimester of pregnancy whose diagnostic testing indicates she does not have an immunity to rubella. The nurse should recommend that the client receive a measles, mumps, rubella (MMR) vaccine at which of the following times? Prior to discharge from the hospital after giving birth A nurse performing patient teaching about radioactive iodine 131, an anti-thyroid drug, for Graves disease, should include which information? Expect full effects in 2-3 months A patient arrives to receive a second round of combination chemotherapy. What is the most important patient assessment finding to report to the prescriber? Weight A patient asks how insulin works in the body to help with hyperglycemia. What would the nurse's best response be? It promotes movement of glucose from blood into the cells. A patient asks why he must rotate sites when self -injecting regular insulin. The nurses best response
How are vaccination and immunization related? The outcome of successful vaccination is immunization. How do thyroid replacement drugs affect diabetes? Thyroid replacement drugs reduce the effectiveness of all antidiabetic drugs. If a patient taking repaglinide for type 2 diabetes skips a meal, what should the nurse teach the patient to do? Skip the dose Knowing that one adverse effect may be that it mimics the effect of disulfiram; the nurse teaches a patient starting glipizide for type 2 diabetes to do which of the following? Avoid drinking alcohol pioglitazone, a thiazolidinedione, for type 2 diabetes can cause the adverse effect of heart failure. Due to this, which side effect must the nurse monitor for? Weight gain The nurse alerts a radiographer about a patient who needs an angiography using iodine-containing contrast dye, and is taking metformin. An interaction may occur causing which adverse effect? Acute Renal Failure The nurse at a community center is teaching adults which immunizations they should receive each year unless there are contraindications. Which one from the following list is included? Influenza The nurse expects the physician to order a lower dose of propylthiouracil (PTU), anti- thyroid medication, to a patient who calls to report weight gain, drowsiness, and depression. The nurse suspects which of the following adverse reactions? Hypothyroidism The nurse knows a patient taking levothyroxine for hypothyroidism understands how to take the drug when he makes which of the following statements? I should expect to take this for the rest of my life The nurse knows that the unit treating patients taking insulin must have which medication available? glucagon The nurse of a patient starting levothyroxine for hypothyroidism, notifies the physician upon noticing a recent patient history of which condition? A recent myocardial infarction
The school nurse has a high school student come into the office who takes glipizide. The student report shakiness, feeling hungry and fatigued. The nurse should instruct the student to first do what? Perform a finger stick blood glucose level What adverse effect would the nurse suspect for a patient taking metformin that reports muscle pain? Lactic acidosis What is the duration time for glargine (Lantus) insulin? 24 hours What is the most important action for the nurse to perform before administering a sliding scale short- acting insulin to a patient with type 1 diabetes? Checking whether the patients meal or snack is already on the unit. What is the most important precaution for the nurse to teach a patient who is on insulin therapy? Do not skip meals when taking insulin. What makes insulin a “high-alert” drug? Serious harm can occur if the wrong dose is given. Which blood laboratory test result indicates to the nurse that the patient is maintaining good longer term control of his or her diabetes? Hemoglobin A1C is 5.2%. Which condition would be a contraindication for giving RhoGam to an Rh-negative mother? Giving birth to an Rh-negative infant Which mineral is critical for the thyroid to use in making thyroid hormones? Iodine Which type of chemotherapy drug causes tissue damage on direct contact? Vesicants Which type of insulin has the shortest duration of action? Rapid-acting insulin Which vaccination is routinely administered to infants at ages 2 months, 4 months, and 6 months? DTaP What is the most important action for the nurse to perform before administering a sliding scale short- acting insulin to a patient with type 1 Diabetes?
A patient taking tetracycline orally for chlamydia reports blood tinged diarrhea. What does the nurse suspect? Pseudomembranous colitis A patient receiving IV vancomycin has developed redness on the face, neck, chest, back, and arms. The family asks the nurse if the drug should be stopped because of this response. What is nurse's best response? The Vancomycin may be being administered too rapid. I will contact the physician. What drug would the nurse expect to be ordered for a patient with streptococcal pharyngitis, who is allergic to penicillins and cephalosporins? erythromycin A nurse is caring for a patient about to start taking celecoxib to treat rheumatoid arthritis. The patient should be taught to report which adverse reaction? Chest pain A patient who is taking oral contraceptives and is about to start taking rifampin to treat tuberculosis. What should the nurse teach the patient? Use additional contraception The nurse has a patient who is using nystatin to treat oral candida albicans from using tetracycline. Which of the following instruction would the nurse give to the patient? Swish in mouth before swallowing How are bactericidal drugs different from bacteriostatic drugs? Bactericidal drug actions result in killing the bacteria, whereas bacteriostatic drugs only slow bacterial growth. The nurse working in a physicians office is speaking with an elderly patient about to start taking aspirin to treat an ankle sprain. The nurse should advise the patient to report which of the following adverse reactions? Weight gain A patient experiences facial angioedema after receiving a dose of a new antibacterial drug. Which assessment does the nurse perform first? Airway patency Why should tetracycline drugs be avoided during pregnancy and lactation?
The drug interferes with tooth enamel development causing permanently stained teeth. A patient is prescribed topical hydrocortisone 0.1% for skin inflammation. What does the nurse teach the patient for applying this drug? Apply a thin coat only over the affected area. A nurse caring for patient who has osteoarthritis and about to start taking aspirin would teach the patient to report s/s of salicylism including which adverse effect? Tinnitus Due to the possible adverse effect of nephrotoxicity; a patient taking gentamicin to treat an infection would have which of the following monitored? Urine output A nurse is caring for a patient taking warfarin who is about to start taking trimethoprim/sulfamethoxazole for a UTI. The nurse questions this new order since taking these drugs concurrently can cause what problem? Bleeding The nurse is caring for a patient about to start taking acyclovir (Zorvirax) for herpes. Which lab values should be monitored? BUN and creatinine A patient taking imipenem reports that she cant eat due to mouth pain. What does the nurse suspect this is? Suprainfection The nurse is caring for an older adult who is taking prednisone for long term treatment of rheumatoid arthritis. What adverse effect would the nurse discuss with the patient? Bone loss A patient with arthritis of the left knee reports pain extending from the knee half-way down the lower leg. What type of pain is this patient perceiving? Radiating An older adult patient is prescribed gentamycin. Which assessment technique is most important for the nurse to perform daily?
A patient received a tuberculosis skin test injection of purified protein derivative (PPD) 72 hours ago. Which assessment finding of the test site does the nurse interpret as a positive reaction? The skin is red and very hard for 12 mm around the injection site. How do morphine and other opioid pain medications relieve a patient’s pain? They bind to opioid receptors in the brain and central nervous system which alters the perception of pain. The nurse understands that naloxone can reverse effects of excessive dosage of which drug? Morphine Which statement by a patient indicates the need for more teaching about pain and pain control? There is no reason for me to take drugs for pain; after all, you can't cure old age. A child is having trouble using an albuterol inhaler. The nurse helps by teaching the child to do which of the following? Use a spacer A common side effect that the nurse would expect in a patient taking diphenhydramine would be which of the following? sedation A patient asks how proton pump inhibitors will help to treat peptic ulcer disease and GERD. What is the nurse's best response? It will block the action of pumps located in acid-secreting cells, which will totally block stomach acid secretion. A patient asks if the nurse could leave a prescribed ipratropium inhaler by the bedside to be used after the patient is finished eating. What would be the nurse's best response? I will come back with the inhaler later after you have finished eating. A patient has been receiving bisacodyl tablets for a week and the stool record was not updated. Which lab value should the nurse evaluate? Potassium A patient is prescribed an inhaled bronchodilator and an inhaled corticosteroid. What instructions for using these drugs does the nurse stress to the patient? Use the bronchodilator first, wait at least 5 minutes, then use the corticosteroid.
A patient is taking omeprazole, a proton pump inhibitor, to treat a duodenal ulcer. The nurse would include which instruction? Swallow capsule whole A patient prescribed metoclopramide is noted to have uncontrolled movement of his legs. What is the nurse's best action? Hold the drug and notify the prescriber. A patient recuperating from an MI asks the nurse why he is taking docusate sodium. The nurses best response is that the medication will do which of the following? Prevent straining A patient reports taking an over-the-counter laxative for constipation daily for the past 3 weeks. What is the nurse's best action? Instruct the patient that these drugs should not be used for more than a week without consulting the prescriber. A patient reports taking psyllium, a bulk forming laxative, every morning to prevent constipation. What is the nurses best action? Document this information as the only action. A patient taking theophylline, a methylxanthine, needs to have blood level monitored to assure the level does not become toxic which may cause which of the following symptoms? cardiac dysrhythmias and seizures A patient that suffers from heartburn and indigestion asks the nurse how an antacid will relieve his discomfort. What is the nurse's best response? It will neutralize stomach acids. A patient who has been prescribed an inhaled corticosteroid develops a thick white coating on the tongue and patches on the inside cheeks. What is the nurses best action? Document the finding and notify the prescriber. A patient with asthma asks why he must take regularly scheduled systemic drugs when he can stop several asthma attacks each day within a few minutes of their onset by using a short-acting beta agonist inhaler. What is the nurses best response? Frequent asthma attacks, even if they are halted relatively quickly, damage the bronchial tissues over
The nurse would expect to see which of the following sign/symptom of constipation? patient straining to have a bowel movement The spouse of an older adult with Alzheimer's disease tells the nurse that he has been giving the patient aluminum hydroxide for heartburn. What is the nurses best action? Teach the spouse that taking drugs containing aluminum can worsen the patient's confusion. What does PERF stand for? Peak expiratory rate flow. Which action of metoclopramide helps prevent nausea and vomiting? Helping food move more rapidly through the GI system. Which assessment is most important for the nurse to perform before administering a bronchodilator by inhalation? Listening with a stethoscope to the patients lung sounds Which medication is the antidote for acetaminophen overdose? acetylcystein (Mucomist) Which protective mechanism by the stomach protects it from stomach acids and the formation of gastric ulcers? The stomach secretes a thick gel-like mucus to coat itself. The nurse would explain to a patient taking metoclopramide (Reglan) that the medication works by treating H pylori infection. False Which of the following drugs are common antiemetics? Promethazine[Phenergan] The nurse administering ipratropium an inhaled anticholinergic, would recognize which of the following is not a possible side effect of this medication Ataxia Which precaution is most important to teach a patient who is prescribed an antacid? Take this drug at least 2 hours before or after taking any other drug
Question 1 0 / 1 pts The nurse prepares to administer a lanoxin for heart failure to a patient. Which assessment finding does the nurse report to the prescriber before administering the drug? Urine output of 2100 mL in 24 hours You Answered Systolic blood pressure increase from 136 to 142 Weight gain of 1 pound in 3 days Correct Answer Heart rate of 52 beats per minute Question 2 1 / 1 pts A patient has an IV piggyback of ceftriaxone sodium 500 mg in 50 mL D5W to run over 20 minutes. The tubing has a drip factor of 10. How many drops per minute should be administered? 32 21 Correct! 25 4 Question 3 0 / 1 pts A patient taking metoprolol for hypertension reports all of the following side effects. For which side effect will you notify the prescriber? Increased urination during the daytime
Question 6 1 / 1 pts A patient who is prescribed ezetimibe has developed swelling around the eyes, nose, and lips. What is the nurse’s priority action at this time? Check the patient's blood pressure. Notify the prescriber. Elevate the head of the bed. Correct! Assess the patient's airway. Question 7 1 / 1 pts What is the most important action for the nurse to perform before administering a patients daily dose of digoxin? Correct! Check the patients apical heart rate for a full 60 seconds. Verify that the time of administration today is within one-half hour of the time the drug was administered yesterday. Assess the patient's dependent body areas for edema formation. Ask whether the patient has experienced any heart palpitations during the last 24 hours. Question 8 1 / 1 pts What does the term “rhabdomyolysis” mean? High blood lipid levels Coronary artery disease from atherosclerosis
Correct! Skeletal muscle breakdown Skin yellowing (jaundice) from liver complications Question 9 1 / 1 pts A patient asks the nurse how diltiazem ; a calcium channel blocker works to lower his blood pressure? The nurse's best reply is that this drug increases water and sodium loss prevents angiotensin from binding to its receptors blocks the effect of epinephrine on muscle cells Correct! relaxes smooth muscle cells of arteries thereby dilating the vessels and lowering resistance. Question 10 1 / 1 pts A patient who has been taking lisinopril develops swollen lips and reports that the tongue feels thick. What is the nurse’s best action? Document the report and reassure the patient that this is a common drug side effect. Check the patients pulse for rhythm and take the patient's blood pressure. Ask the patient whether this has ever happened before. Correct! Hold the lisinopril dose and notify the prescriber immediately. Question 11 1 / 1 pts
