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past test questions

3. Student nurse gave wrong (double) dosage of antihypertensive. BP of pt before hand was 146/98. Student should...

notify clinical instructor

4. 2006 institute of med study said that how many med errors resulted in harm of patient

1.5 million

8. An elderly man is having trouble remembering how to use inhaler, the nurse should ?

should provide ¬- sm. amts of info at a time frequently to help him remember the steps

3. Patient wants to switch form antilipemic to garlic, a nurse response would be

- "lets explore the evidence for the use of garlic to lower cholesterol"

5. OTC drugs account for what percentage of drugs used in the US

60%

7. Decongestants interfere with

hypertension meds

8. Liver disease contraindication for?

8. acetaminophen

9. Anticoagulants are not compatible with

aspirin or NSAIDS

11. Smoking cravings may persist for

months or years after d/c use of ciggarettes

12. Drug interactions: garlic →

insulin

drug interaction problems with cranberry

excrete fluids but retain meds

4. Safest site for admin of an IM on an adult -

ventrogluteal

5. Safest site for admin of an IM on a child

- vastus lateralis

9. Increasing the size of the gauge

a decrease in the diameter of the needle

1. Nurse is assigned to a pt who is newly dx with type one diabetes mellitus, which statement best illustrates an outcome criteria for the pt -

the pt will demonstrate safe insulin self administration technique

2. When monitoring pt on insulin, nurse finds the pt to be lethargic and difficult to awaken, this is an example of an adverse drug reaction r/t -

pharmacologic AE (BS dropped too low)

3. Duration of action -

drug concentration to be sufficient to cause a therapeutic response

19. It's not uncommon for elderly to have reduction in stomach's ability to produce hydrochloric acid - ?

May result in altered absorption of weakly acidic drugs such as aspirin

The nurse is administering drugs to neonates and should consider which factor that may contribute to drug toxicity?

liver is not fully developed

6. Healthy volunteers

- Phase one studies

7. The nurse is developing a care plan, which is a measurable goal

- proper tech to measure insulin

8. Cognitive -

just learned how to add more K+ to diet

9. Opioid withdrawal -

diazepam (Valium)

11. Administered 4 mL of liquid elixir to a child through a ?

calibrated syringe

17. Patient receiving 2 different drugs at current dosage forms. Both drugs absorbed into circulation in identical amounts. Because they have same absorption rates they are:

Bioequivalent

18. When administering drugs, the nurse remembers that the duration of action of a drug is defined as the time it takes?

: For a drugs concentration to be sufficient to cause a therapeutic response

26. Patient in rehab center beginning to experience opioid withdrawal symptoms. Nurse should give what drug?

Methadone

29. Nurse is giving medication though a percutaneous endoscopic gastrostomy tube. Which technique is correct?

Using barrel of syringe, allowing fluid to flow by gravity

30. Nurse about to give a rectal suppository to a patient. Which technique would facilitate the administration of rectal suppository? -

Encourage patient to lie on left side for 15-20 minutes after insertion (would use a water base for insertion)

31. 2 year old gets ear drops. What is the proper technique for administration? - Pull pinna down and back

Pull pinna down and back

1. Antibiotics should only be given if culture and sensitivity test are done first -

false; empiric therapy

2. A patient has a reaction to sulfa drugs, what should the nurse ask next -

ask the pt for more information about the reaction

4. Amoxicillin and clavulanic acid are given through a PEG tube -

inhibits the action of enzymes produced by beta-lactamase producing bacteria

5. Antiseptic

- used to sterilize skin before invasive procedure/surgery

6. When taking Taking tetracycline you should?

avoid sunlight and tanning beds

13. during tetracycline antibiotic treatment, patient complains of nausea and anorexia. Nurse's advice: ?

drink a full glass of water with each dose

10. With aminoglyocside antibiotics therapy renal clearance is ensured with?

trough levels with once daily dosing.

14. nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an infection. Which lab value indicates therapeutic effectiveness?-

decreased WBC count

16. aminoglycoside therapy, monitor for what indicator of potential toxicity?-

tinnitus and hearing loss

17. appropriate nursing diagnosis for a patient starting aminoglycoside therapy-

risk for injury (hearing loss)

18. patient hospitalized for 2 weeks has developed a pressure ulcer that contains MRSA. Which drug should be chosen for his therapy?-

vancomycin (vancocin)

19. patient receiving aminoglycoside therapy will be receiving a beta-lactam antibiotic as well. Patient asks why 2 antibiotics have been ordered. Nurse's best response: "the combined effect of both antibiotics is greater than each of them alone"

"the combined effect of both antibiotics is greater than each of them alone

20. 79 year old patient receiving quinolone as a treatment for a complicated incision infection. Nurse monitors for which adverse effect associated with these drugs?-

tendinitis and tendon rupture

1. A patient diagnosed with shingles is taking a topical acyclovir and the nurse is providing instructions about adverse effects. Which are adverse effects of topical acyclovir that should be discussed with the patient? -

Transient burning when applied

2. A patient with AIDS has been taking Retrovir therapy for almost a year. At this time, the physician decides to switch her medication to didanosine. The patient is very concerned about this change. What will the nurse explain to her? -

The Retrovir therapy may have caused severe bone marrow suppression.

3. The nurse is administering IV acyclovir to a patient with a viral infection. Which administration technique is correct? -

IV infusions should be administered slowly, over at least an hour.

4. A patient is taking a combination of antiviral drugs as treatment for early stages of HIV infection. While discussing the drug therapy, he asks the nurse if the drugs will kill the virus. When answering him, the nurse keeps in mind the fact that antiviral drugs -

may also kill healthy cells while killing viruses

5. The nurse is discussing adverse effects of Antitubercular drugs. Which potential adverse effect should the patient report to his or her prescriber? -

Numbness and tingling of extremities

6. When assessing patients who are to receive Antitubercular therapy, the nurse should assess for which potential contraindication? -

Hepatic Impairment

7. When monitoring patients on Antitubercular drug therapy, the nurse knows that which drug may cause a decrease in visual acuity? -

ethambutol

8. A patient has been taking Antitubercular therapy for 3 months. The nurse notes a therapeutic response to these drugs with which assessment findings? -

There is a decrease in symptoms of tuberculosis along with improved chest xrays and sputum cultures.

9. The nurse is counseling a woman who will be starting rifampin. The patient is on oral contraceptives. Which statement is true regarding rifampin therapy for this patient? -

Oral contraceptives are less effective while the patient is taking this drug

The nurse is reviewing the medication record of a patient who is taking isoniazid. Which drug or drug class has a significant drug interaction which isoniazid?

- Antacids

1. During and IV of amphotericin B, a patient develops tingling and numbness in his toes and fingers. What will the nurse do?

- Discontinue infusion immediately

2. The nurse is preparing an infusion of amphotericin B for a patien who has a severe fungal infection...Before beginning the infusion, the nurse will?

administer an antipyretic and an antiemetic drug

4. During therapy with amphotericin B, the nurse would monitor for known adverse effects that would be reflected by which lab result? -

Serum potassium level of 2.9 mEq/L

5. A patient has received a prescription for a 2-week course of antifungal suppositories for a vaginal yeast infection. She asks the nurse if there is an alternative. The nurse knows a possible alternative prescription would be...

A single dose of fluconazole (Difulcan) oral tablet

7. A patient has an infestation with flukes. The nurse anticipates the use of which drug to treat the infestation? -

Praziquantel (Biltricide)

8. A patient is being evaluated for a possible helminthic infection. The nurse knows that which of the following statements about anthelminthic therapy is true:

Anthelminthics are very specific in their actions

9. A patient is experiencing the exoerythrocyctic phase of malaria. The nurse expects which drug to be used for the patient? - Priaquine

Primaquine

10. A patient is receiving hydroxychloroquine therapy but tells the nurse that she has never traveled out of her state. The nurse knows that a possible reason for this drug therapy is which condition?

- Rheumatoid arthritis

1. The nurse is reviewing therapeutic effects of NSAIDs. Which is a characteristic? -

Antipyretic

2. A patient with gout has been treated with allopurinol for 2 months. The nurse will monitor lab results for which therapeutic effects?

- Uric acid levels

3. The nurse is teaching a patient about the use colchicine for the treatment of gout. Which should be instructed?

- Call doctor if patient has an increase in pain or blood in urine

4. A patient has used buffered aspirin or several years as treatment for osteoarthritis. However, the symptoms are worse and he now needs something stronger. The provider prescribes an NSAID and misoprostol (Cytotec). Why is this?

Cytotec may help prevent gastric ulcers that can occur in patients taking NSAIDs

6. During assessment of a patient with osteoarthritis pain, the nurse knows that which condition is a contraindication to the use of NSAIDs? -

Renal disease

7. A nurse notes in a patient's medication history that the patient is taking allopurinol (Zyloprim). Based on the findings, the nurse interprets the patient has which disorder? -

Gout

8. A patient must be treated immediately for acute organ transplant rejection. The nurse anticipates that the physician will order muromonab-CD3. In preparation for the physician's examination, which factors should the nurse consider before beginning treatment with the drug? -

Fluid volume status

9. A patient has started azathioprine (Imuran) therapy as part of renal transplant surgery. The nurse will monitor for which expected adverse effect of therapy? -

Leukopenia (also thrombocytopenia)

10. Cyclosporine is prescribed for a patient who had an organ transplant. The nurse will monitor the patient for what adverse effects?

- Hypertension

month old received an MMR II vaccine, mother calls clinic that afternoon to ask about helping her fussy infant feel better. What should the nurse suggest? -

Apply warm compress to injection site

2. A housekeeper has experienced a needle stick by a contaminated needle that was placed in a trash can. The nurse expects that which drug will be used to provide passive immunity to hepatitis B infection for this housekeeper? -

Hepatitis B immunoglobulin

3. A nurse is working in an immunization clinic. A new colleague asks, "When is the first dose of DTaP given?" Nurse knows this series is started at what age? -

6 weeks

5. A patient who has been on methotrexate therapy has developed a fever. Her husband calls to see if he can give ibuprofen for the fever. Nurse's response is based on the fact that ibuprofen

...Can lead to methotrexate toxicity

7. Nurse is administering a combination of antineoplastic drugs to a patient who has metastatic breast cancer. Which statement best describes the rationale for combination therapy? -

Increased cancer-killing will occur

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

Delayed-onset cholinergic diarrhea

10. During treatment of a patient who has breast cancer, the nurse hears the physician mention that the patient has reached the "nadir." The nurse knows that this term means:

Lowest level of neutrophils reached during therapy

1. Cisplatin, dose limiting factor =

kidney damage

3. Female taking androgen, this causes which adverse effects?

hirsutism (abnormal body hair) and acne

4. When monitoring a patients response to interferon the nurse notes the major dose limiting factor is?

fatigue (improve symptom by giving medication at night)

5. During a patients therapy with interleukins the nurse monitors the patient for cap leak syndrome. What assessment finding would indicate this problem? -

severe peripheral edema

6. End stage renal disease, severe anemia, refusing blood transfusions. To stimulate RBC production the nurse expects to administer?

give epoetin alpha

7. Chemotherapy, decreased WBC, when would you give colony-stimulating factor?

24hrs later

8. Epoetin, stop therapy when ?

=hemoglobin level of 13

9. Darbepoetin, adverse effects

=bone pain

10. Humira, contraindicated with

=UTI

1. Pt we severe fungal inf concerned with assessment finding of -

history of cardiac dysrhythmias

2. Pt calls clinic, he is currently taking glucosamine - chondroitin supplements for arthritis. Nurse reviews med history and notes concern for interactions with?

Type 2 diabetes (interaction will increase dose)

4. Before injection of monoclonal antibodies are given, give?

give methylprednisolone sodium succinate (steroid to decrease AE)

5. Nurse notes muromonab-CD3 is the only drug indicated for?

active organ rejection

6. Nurse reviews principles of immunity occur when body has to create response to a foreign antigen -

artificial active immunity

8. Why would Cyclosporine and allopurinol be used congruently?

allopurinol enhances the effects of cyclosporine

12. Cancer treatment with mononucleosis antibodies is good because?

bypass normal cells and kill cancer cells

11. Just before the second course of chemo the lab calls to report that a pt's absolute neutrophil count is 600 cells

stop

1. Father calls b/c son has head lice -

make sure he is using the nit comb to remove nits from the hair shaft

2. During treatment with minoxidil for hair thinning -

AE effects systemic labs may cause tachycardia, fluid retention, weight gain

3. Impetigo (gram positive, cocci) -

bacitracin

1. Fungal infection -

sometimes require prolonged therapy

1. Isotretinion

- need two contraceptive methods

5. Patient taking oral aloe supplement and ask about the potential problem - AE constipation/diarrhea

- AE constipation/diarrhea

6. Patient taking corticosteroids dexamethasone with gentamicin ointment - tion

immunosuppression may make it more difficult to eliminate eye infec

Where do you apply eye drops?

conjunctival sac

The nurse will be giving opthalmic drugs to a patient with glycoma, which drug or drug class is used to reduce intraocular pressure?

Mannitol (osmitrol)

Indications for direct and indirect acting miotics include which condition?

open angle glaucoma

In prep for ocular surgery the nurse anticipates using which drug for anesthesia?

Tetracaine

A patient with eye injury has forign body which drug will be used for exam?

fluorescein sodium

7. Need to administer ocular cyclosporine (Restasis) and artificial tear product what order would you give these in?

cyclosporion (Restasis) taken first and then wait 15 minutes before administering the artificial tears

8. Perforated ear canal -

no drop may be administered

9. Carbamide peroxide eardrops

- loosen cerumen for easier removal

How long should you wait before administering ear drops that have been in the refrigerator?

1 hour

If an extravasation of an antineoplastic drug occur what should the nurse do?

Stop the infusion immediatly but leave IV in place

Colony stimulating factors allow for?

Higher doses of chemo because CSF's slow down neutapenia caused by the chemo

epoetin alpha is not effective in patients who have?

anemia

A patient taking penicillin is also taking coumadin, the nurse knows that?

penicillin will enhance the effects of the coumodin

There is a drug interaction between antibiotics and?

oral contraceptives

Which type of cephlosporin is the most appropriate for gram pos infections?

first generation

How do disinfectants and antiseptics differ?

disinfectants are used to kill microorganisms on non-living objects, antiseptics inhibit but don't necessarily kill

Linezoid (zyvox) therapy interacts with?

SSRI's

Dose of vancomyocin discovers patients trough level is 24 mcg/mL what should the nuse do?

hold drug and notify the provider

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