Exam 2

Question 1

The nurse is administering an analgesic medication to a client who has an infected surgical incision. Which response at the infection site would the nurse expect?

a. reduction in swelling
b. less surrounding redness
c. reduction in skin tempature
d. less pain

Answer 1

d. less pain

Question 2

What is one of the benefits of the use of nonpharmacologic intervention in pain management?

a. nonpharmacologic interventions allows for pain medications to be given on an as needed basic only.
b. nonpharmacologic interventions provide adequate pain relief without the use of medication.
c. nonpharmacologic intervention do not require addtional training of the health care team.
d. nonpharmacologic intervention allow for lower doses and few drug-related adverse effects of pain medication.

Answer 2

d. nonpharmacologic intervention allow for lower doses and few drug-related adverse effects of pain medication.

Question 3

Salicylated primarily inhibit the synthesis of which substance?

a. pyrogens
b. superoxide radicals
c. histamines
d. prostaglandins

Answer 3

d. prostaglandins

Question 4

a nurse is taking a history for a client who reports that he is taking aspirin about four times a day for a sprained wrist. which of he prescribed medications taken by the client is contraindicated with aspirin?

a. Digoxin (Lanoxin)
b. Metformin (Glucophage)
c. Warfarin (coumadin)
d. Nitroglycerin (Mitro-Dur)

Answer 4

c.Warfarin (coumadin)

Question 5

The nurse supervisor has directed all nurses giving medication to be alert for the “aspirin traid”. What will the nurse be alert for in their clients?

a. Chronic rhinitis, acute bronchospasm, and CHF
b. ibuprofen allergy, nasal congestion, and asthma
c. history of head trauma, CHF, and asthma
d. aspirin allergy, nasal polyps, and asthma

Answer 5

d. aspirin allergy, nasal polyps, and asthma

Question 6

The nurse supervisor notices that the nurse administering medications in a long-term care facility rountinely crushes enteric-coated medications so that they can be administered through feeding tubes. How should the nurse supervisor respond to this situation?

a. tell the nurse that it is okay to crush these medications as long as they can be easily dissolved in water prior to administering.
b. tell the nurse that enteric-coated or sustained- released medications should never be crushed or altered in any manner.
c. tell the nurse to continue crushing enteric-coated medications so they can be administered via feeding tube.
d. tell the nurse that there is no real reason or the enteric-coated to be on many medications.

Answer 6

b. tell the nurse that enteric-coated or sustained- released medications should never be crushed or altered in any manner.

Question 7

An anti-inflammatory agent is ordered to be given intravenously to a client for pain. Which anti inflammatory agent is administered parenterally?

a. Ketorolac (toradol, acular)
b. katorofen (oruvail)
c. ibuprofen ( motrin,advil)
d. celecoxiib (celebrex)

Answer 7

a. Ketorolac (toradol, acular)

Question 8

Salicylates are very popular anti-inflammatory drugs because they:

a. are given primarily by the IM or IV route.
b. have no adverse effect on blood clotting
c. have minimal to no side efects
d. reduces pain

Answer 8

d. reduces pain

Question 9

The client is experiencing mild pain secondary to a minor ankle sprain. what is the drug class of chorice for the clients pain?

a. nonopiod analgesics
b. opioid analgesics
c. adjuvant analgesics
d. patient-controlled analgesics.

Answer 9

a. nonopiod analgesics

Question 10

The home hospice nurse is completeing the initial assessment of a client who is has terminal congestive heart failure. The client frequently has pain with breathing. the nurse need not ask which question?

a. “How much pain are you willing to tolerate?”
b. “ what do you like to do throughout the day?”
c. “ have you ever been addicted to a pain medication?”
d. “ are there any pain medication you would like to avoid?”

Answer 10

c.” have you ever been addicted to a pain medication?”

Question 11

When administering opioid drugs, the nurse should have an opioid antagonist readily avaliable in case the client experiences which effects?

a. nausea and vomiting
b. hyperventilation
c. hypoventilation
d. hypovolemia

Answer 11

c. hypoventilation

Question 12

The nurse is teaching an older adult client about morphine sulfate drug therapy. important safety teaching for this client should include which instruction?

a. do not take the drug with food or milk.
b. take the drug only when absoluetly necessary.
c. always have someone stand by while using the toilet.
d. change positions slowly to avoid dizziness and fainting.

Answer 12

d. change positions slowly to avoid dizziness and fainting.

Question 13

The client has been started on morphine sulfate (MS Contin) for chronic back pain resulting from inoperable disk degeneration. What nursing action is not indicated?

a. use the prn order of docusate (dulcolac) routinely every night.
b. ask the dietary department to add bran cereal to the clients breakfast
c. ask the health care provider to write an order for an indwelling catheter
d. review the trending of the client’s hemoglobin and hermatocrit levels.

Answer 13

c. ask the health care provider to write an order for an indwelling catheter

Question 14

The nurse monitoring a client receiving morphne therapy would be watchful for which common adverse side effects?

a. hypertension, diarrhea, and sedation
b. hypertension, respiratory depression, and constipation
c. hypotension, diarrhea, and insomnia
d. hypotension, respiratory depression, and constipation

Answer 14

d. hypotension, respiratory depression, and constipation

Question 15

A client arrives unconscious in the ER in respiratory depression from an unknown drug overdose. To help diagnose the overdose, the client is given small doses of naloxone (Narcan). What is the purpose of this action?

a. To help wake up the client to obtain the name of the drug
b. to help diagnose if the overdose was an opioid drug
c. to prevent vomiting while the client is unconscious
d. to reduce the psychoactive effects of the drug overdose

Answer 15

b. to help diagnose if the overdose was an opioid drug

Question 16

a nurse is caring for a hospitalized client who is receiving intradermal fentanyl (duragesic) for severe pain. which of the followingg medications should the nurse expect to cause an adverse effect when administered concurrently with fentanyl?

a. ampicillin (Principen)
b. Diazepam (Valium)
c. Furosemide (lasix)
d. Prednisone(deltasone)

Answer 16

b. Diazepam (Valium)

Question 17

A nurse is preparing to adminiser pamidronate (aredia) to a client who has bone pain caused by cancer. Which of the following precautions should the nurse take when administering pamidronate?
a. inspect skin for redness and irritation when changing the client;s intradermal patch.
b. asses IV site for thrombophlebitis frequently during administration
c. instruct the client to sit upright or stand for 30 mins following oral administration.
d watch for manifestations of anaphylaxis for 20 mins after IM administration.

Answer 17

b. asses IV site for thrombophlebitis frequently during administration

Question 18

The nurse is teaching a client who is starting sumatriptan therapy for treatment of migraine headaches. The nurse instructs the client to take the drug at which time?

a. at the first sign of aure or headache
b. first thing in the morning if expecting a headache
c. when the client can lie down for one hour after taking the drug
d. about 30 mins after the start of the headache.

Answer 18

a. at the first sign of aure or headache

Question 19

A client who has migraine headaches self-administered sumatriptan (imitrex) for the first time yesterday. Today the client informs the nurse that after taking the medication the client began experiencing chest pain. the client further states that the drug was effective in relieving the headache. The nurse should:

a. encouage the client to continue using the drug because it is effective.
b. advise the client to tell the health care provider to report the chest pain at the next visit.
c. caution the client to contact the health care provider to report the chest pain today and to not use the sumatriptan until talkin to the health care provider.
d. encourage the client to lie down in a quiet room and use cold packs during the next migraine.

Answer 19

c. caution the client to contact the health care provider to report the chest pain today and to not use the sumatriptan until talkin to the health care provider.

Question 20

During the administeration of nitrous oxide, the client develops anxiety, excitement, and combativeness. the nurse would anticpate what change in the client’s anesthesia is needed?

a. the nitrous oxide will be increased
b. propofol (diprivan) will be given along with the nitrous oxide
c. succinylcholine (anectine) will be given to the client
d. the nitrous oxide will be decreased.

Answer 20

d. the nitrous oxide will be decreased.

Question 21

a nurse is caring for a client who receives a local anesthetic of lidocaine during a repair of a skin laceration. for which of the following adverse reactions should the nurse monitor the client?

a. seizures
b. tachycardia
c. hypertension
d. fever.

Answer 21

a. seizures

Question 22

Which statements by the nurse would be part off a “best plan” to teach a client about anesthesia?

a. an inhaled agent is used to induce sleep, followed by an intravenous agent to promote relaxation.
b. an inhaled agent needs to be followed by an intravenous agent if the inhaled agent is not adequate.
c. an intravenous agent will be used first to induce sleep , then an inhaled agent will be used
d. an intravenous agent to induce sleep is usually all that is required.

Answer 22

c. an intravenous agent will be used first to induce sleep , then an inhaled agent will be used

Question 23

The surgical nuse is preparing a novice nurse for the first day in the operating suite. which comment by the surgical nurse best explains what can be expected when the client is given succinylcholine (anectine)?

a. “ we dont have to worry too much about the client’s cardiovascular status on this drug.”
b. “ the client will rapidy lose consciousness with drug administeration “
c. “ the client will need assistance with breathing,, as it paralyzes the muscles of respiration. “
d. “ we’ll see that the effects of succinylcholine administeration are much like those of atropine”

Answer 23

c.” the client will need assistance with breathing,, as it paralyzes the muscles of respiration. “

Question 24

Which assessment would indicate that surgical anesthesia has not been achieved for the client undergoing surgery with a general anesthetic?

a. muscle rigidity
b. a reduction in heart rate
c. slow eye movements
d. loss of consciousness

Answer 24

a. muscle rigidity

Question 25

The anesthesiologist elects to use an opioid as adjunct to anesthesia for pain relief. Because of the use of this drug, the nurse is more alert to monitor the client for which occurence?

a. risk for addiction
b. risk for profound hypertension
c. risk for respiratory depression
d. risk for diaphramagmatic paralysis

Answer 25

c. risk for respiratory depression

Question 26

the nurse is instructing a client on the characteristics of central nervous system medications. which characteristics should be included in this teaching?

a. ability of the medications to cross the blood- brain barrier
b. neurotransmitters
c. function of the neuron
d. location of synapses

Answer 26

a. ability of the medications to cross the blood- brain barrier

Question 27

a client with depression has been prescribed a central nervous system medication. the nurse will expect to assess which effects of this medication in the client?

a. improved mood
b. activation of the fight or flight response
c. onset of seizures
d. happiness

Answer 27

a. improved mood

Question 28

a client with depression is to begin treatment with an antidepressant medication. in performing the initial asssessment, what is the most important question for the nurse to ask?

a. “are you allergic to any medications?”
b. “ how long have you been depressed ?”
c. “ have you had any thoughts about killing yourself ?”
d. “ how much alcohol do you consume during the week ?”

Answer 28

c.” have you had any thoughts about killing yourself ?”

Question 29

the nurse determines that the client understands an important principle in self- administeration of fluoxetine (prozac) when the client makes which statement?

a. “ i should not decrease my sodium or water intake.”
b. “this drug can be taken concurrently wth a monoamine oxidase inhibitor .”
c. “ it may take up to [one] month to reach full therapuetic effect.”
d. “there are no problems associated with concurrent use of other central nervous system depressants.”

Answer 29

c.” it may take up to [one] month to reach full therapuetic effect.”

Question 30

the number one drawback of amitrptylne (elavil) is:

a. it taste funny
b. it takes several weeks to work
c. it can be used to suicide
d. it is inexpensive.

Answer 30

c. it can be used to suicide

Question 31

a client, prescribed sertraline (zoloft) for anxiety and depression, reports experiencing delaying ejaculation since being on this medication . what is the best response by the nurse ?

a. “I am concerned that you will become suicidal if you stop medication.”
b. “keep taking the medicine, as this usually goes away after a few months,”
c. “ I will let your doctor know.”
d. “ this does happen, but treatng your depression is a bigger priority.”

Answer 31

c. “ I will let your doctor know.”

Question 32

a nurse caring for client who has been taking sertraline (zoloft) for the past 2 days. which of the following assessment findings should alert the nurse to the possibilty that the client is developing serotonin syndrome?

a. bruising.
b. fever.
c. abdominal pain.
d. rash

Answer 32

b. fever.

Question 33

which statement made by the client who is taking lithium carbonate (eskalith) indicates that further teaching if necessary?

a. “I will be sure to remain on a low sodium diet.”
b. “I will have blood levels down every 2 to 3 months , even when i have no symptoms.”
c. “Lithium has a narrow margin of safety, so toxicity is a very real concern.”
d. “I will not be able to breast-feed my baby.”

Answer 33

a. “I will be sure to remain on a low sodium diet.”

Question 34

a nurse in a primary care clinic is assessing a client who takes lithium carbonate (lithotabs) for the treatment of bipolar disorder. The nurse should recognize which of the following findings as a possible indication of toxicity to this medication?

a. severe hypertension
b. coarse tremors
c. constipation
d. urinary retention

Answer 34

b. coarse tremors

Question 35

a client with bipolar disorder in the manic phase is started on lithium (eskalith). the client’s current lithium level is 0.4 mEq/L. What will the nurse expect to assess in the client?

a. a return to baseline behavior: calm and rational
b. signs and symptoms of depression
c. hyperactivity and pressured speech
d. a decrease in manic behavior

Answer 35

c. hyperactivity and pressured speech

Question 36

Which medication, when administered with lithium, increases the risk of toxicity?

a. lomefloxacin
b. sodium bicarbonate
c. calcium iodine
d. furesemide

Answer 36

d. furesemide

Question 37

the client states that he has not taken his antipsychotic drug for the past two weeks because it is causing sexual dysfunction. the nurse is aware that the name antipsychotic indicates that continuing the medication as prescribed is important because:

a. hypertensive crisis may occur with abrupt withdrawal.
b. muscle twitching may occur with abrupt withdrawal.
c. parkinson-like symptoms will occur with withdrawal.
d. symptoms of psychosis are likely to return if the medication is withdrawn.

Answer 37

d. symptoms of psychosis are likely to return if the medication is withdrawn.

Question 38

a client taking fluphenzaine (prolixin) is experiencing muscle spasms of the neck. the neck client is grimacing and having difficultly speaking. which action shuld the nurse take?

a. call the health care provider and prepare to give chlorpromazine (thorazine).
b. distract the client to confirm the client is not fakng a muscle spasm.
c. call the health care provider and prepare to give diphenhydramine (benadryl).
d. engage the client in open-ended conversation to find out why the client is having difficulty.

Answer 38

c. call the health care provider and prepare to give diphenhydramine (benadryl).

Question 39

a client taking clozapine (clozaril) for treatment of schizophrenia is complaining of drowsiness after the first 2 weeks of therapy. the nurse’s best response would be :

a. “ take the medication exactly as prescribed, and do not discontinue it without the health care providers approval. “
b. “ tell the health care provider that you cannot tolerate the drowsiness caused by the medication”
c. “ it may take 6-8 weeks for the drowsiness to subside.
d. “ try taking the medication at bedtime.”

Answer 39

d. “ try taking the medication at bedtime.”

Question 40

a client with acute symptoms of schizophrena is given ziprasidone (Geogon) IM. the nurse connecs the client to a heart monitor to assess the rhythm strip for:

a. normal sinus rhythm
b. sinus irregularity
c. increase in QT interval
d. premature atrial contractions

Answer 40

c. increase in QT interval

Question 41

a nurse is providing discharge teaching for a client who has new prescription for clozapine (clozarik). which of the following statements is appropriate for the nurse to include in the teaching?

a. “you should have a high- carbohydrate snack between meals and at bedtime.”
b. “ you are likely to develop hand tremors if you take this medication for a long period of time.”
c. “you may experience temporary numbness of your mouth after each dose.”
d. “ you shoud have your white blood cell count monitored every week.”

Answer 41

d.” you shoud have your white blood cell count monitored every week.”

Question 42

which statement made by the client who is taking risperdone (risperdal) indicates that further teaching is necessary?

a. “ill monitor my weight every month.”
b. “i can increase my intake of fluids and fiber if i have any gastrointestinal problems.”
c. “ill have my blood presure monitored regularly.”
d. “ there is no problem if i want to drink alcohol on the weekends.”

Answer 42

d.” there is no problem if i want to drink alcohol on the weekends.”

Question 43

the nurse expects that the client experiencing extrapyramidal symptoms during therapy with phenothiazines will be prescribed:

a. benztrpine (congentin)
b. diazepam (valium)
c. haloperidol (haldol)
d. lorazepam (ativan)

Answer 43

a. benztrpine (congentin)

Question 44

a client diagnosed with anxiety, is prescibed paroxetine (paxil). when the client asks the nurse why an antidepressant has been prescribed, the nurse’s response is:

a. “paxil is a sedative-hypnotic that will enhance sleep.”
b. “ many antidepressants are effective for treating anxiety.”
c. “ antidepressants medications are safer than other medications to induce sleep.”
d. “ antidepressants act immediately, allowing for faster relief from insomnia.”

Answer 44

b.” many antidepressants are effective for treating anxiety.”

Question 45

a nurse working in an ER is caring for a client who as benzodiazepine toxicity due to an overdose. which of the following is the priority nursing action?

a. administer flumazenil (romazicon)
b. identify the clients level of orientation
c. infuse iv fluids
d. . prepare the client gastric levage

Answer 45

b. identify the clients level of orientation

Question 46

the nurse is caring fo a client receiving a sedative-hynotic. which adverse effect associated with this drug therapy is the highest priority for the nurse?

a. urinary incontnence
b. activity intolerance
c. risk for falls.
d. poor nutritional intake.

Answer 46

c. risk for falls.

Question 47

the nurse is concerned that a client taking an antipsychotic medication is experiencing extrapyramidal side effects. for which effecct should the nurse notify the health care provider?

a. complaints of slight drowsiness
b. urinary hesitancy
c. muscular spasms in the head and neck
d. dry mouth

Answer 47

c. muscular spasms in the head and neck

Question 48

the development of which symptom(s) in a client taking an antipsychotic must be reported immediately?

a. fever, tachycardia, stupor, and incontinence
b. suddenly occurin muscle spasms, especially in the neck and back.
c. sexual dysfunction
d. leg pains, pacing, an inability to sit still.

Answer 48

a. fever, tachycardia, stupor, and incontinence

Question 49

the client is postop, day after an abdominal hysterectomy, and is requesting morphine sulfate IV, which is prescibed. the client rates her pain as 8 out of 10, with 10 being the most intense. the nurse caring for this client says to another nurse, “ she really doesnt look like she is in pain. maybe she is an addict”. what is the best response from the other nurse?

a. “ maybe you could tell her to do some distractions techniques first.”
b. “ you could call the doctor and et an order for an oral medication.”
c. “ i would give the morphine; pain is subjective and we dont know about her history.”
d. “ I would hold the medication until she looks lke she is in pain. “

Answer 49

c. “ i would give the morphine; pain is subjective and we dont know about her history.”

Question 50

a nurse is providing instructions to a female client who has a new prescription for zolpidem( ambien). which of the following instructions should the nurse include?

a. notify the provider if you plan to become pregnant.
b. take the medication one hour before you plan to go to sleep.
c. allow at least 6 hours for sleep when taking zolpidem.
d. to increase the effectiveness of zolpidem, take it with a bedtime snack

Answer 50

a. notify the provider if you plan to become pregnant.