Exam 4 Flashcards
The nurse is assessing a child with otitis media. Which statement about otitis media is correct?
Common symptoms include pain, fever, malaise, and a sensation of fullness in the ears
The nurse is reviewing the use of ophthalmic preparations. Indications for the direct- and indirect-acting miotics include which condition?
Open-angle glaucoma
A 55-year-old obese patient was diagnosed with candidiasis in the skin folds under her breasts. When the nurse sees her at a follow-up visit 2 months later, she complains that is has returned. She said she applied the medicine for 1 week and stopped because the itching stopped and the cream was messy. Which statement is true regarding fungal infections of the skin?
Fungal infections often require prolonged therapy
The nurse is reviewing instructions for a patient with type 2 diabetes who also gives herself insulin injections as part of the therapy. The nurse asks the patient, “What should you do if your fasting blood glucose is 47 mg/dL?” Which response by the patient reflects a correct understanding of insulin therapy?
I will take an oral form of glucose
The nurse is administering oxytocin (Pitocin). Which situation is an indication for the use of oxytocin?
Stimulation of contractions in dysfunctional labor
The nurse is teaching a patient’s wife about administering eardrops to her husband. The nurse will use which technique when demonstrating the skill?
Pull the pinna of the ear up and back.
A patient with a history of chronic obstructive pulmonary disease (COPD) and type 2 diabetes has been treated for pneumonia for the past week. He has been receiving intravenous corticosteroids as well as antibiotics as part of his therapy. At this time, his pneumonia has resolved, but when monitoring his blood glucose levels, the nurse notices that his blood glucose level is still elevated, and he has required small amounts of sliding-scale insulin coverage. What is the best explanation for this elevation?
The corticosteroids may cause an increase in glucose levels.
The nurse is reviewing the medical record of a patient who is to receive wound care with topical silver sulfadiazine (Silvadene). Which finding, if noted, would be a potential contraindication?
The patient is allergic to sulfonamide drugs.
A patient is receiving ocular cyclosporine (Restasis) and also has an order for an artificial tears product. The nurse includes which instructions in the teaching plan for these medications?
The Restasis should be taken first, then wait 15 minutes before taking the artificial tears.
A glucocorticoid is prescribed for a patient. The nurse checks the patient’s medical history knowing that glucocorticoid therapy is contraindicated in which disorder?
Peptic ulcer disease
A 21-year-old male athlete admits to using androgenic steroid. The nurse tells him that a possible adverse effect of these drugs is
Peliosis of the liver
A patient, newly diagnosed with hypothyroidism, has received a prescription for thyroid replacement therapy. The nurse will instruct the patient to take this medication at which time of day?
In the morning
An 8-year-old girl has been diagnosed with true pituitary dwarfism. She is being treated with somatropin. In follow-up visits, the nurse will monitor for which expected outcome?
Increased growth
A 75-year-old woman with type 2 diabetes has recently been placed on glipizide (Glucotrol), 10 mg daily. She asks the nurse when the best time would be to take this medication. What is the nurse’s best response?
“Take this medication in the morning, 30 minutes before breakfast.”
When monitoring a patient who is taking a systemically administered glucocorticoid, the nurse should monitor for signs of which condition?
Hypokalemia
A 63-year-old male patient is scheduled for a physical examination, and he tells the nurse that he wants to start taking a vitamin formula that includes saw palmetto for prostate health. Which is the nurse’s best response?
“The doctor will need to draw some blood and do a digital rectal exam first.”
When monitoring a patient’s response to oral antidiabetic drugs, the nurse knows that the laboratory results that would indicate a therapeutic response would be a(n)
Fasting blood glucose level between 92 and 120 mg/Dl
The nurse is providing patient teaching about the oral bisphosphonate alendronate (Fosamax). Which statement by the patient indicates a good understanding of when this drug should be taken?
“I will take it in the morning with an 8-ounce glass of water.”
A 16-year-old boy who is taking somatropin comes into the office because he has had an asthma attack during a race at school. Because of this new development, the nurse expects which intervention to occur next?
The somatropin dosage may be adjusted
Which is the most appropriate regarding the nurse’s administration of a rapid-acting insulin to a hospitalized patient?
It should be given 15 minutes before the patient begins a meal.
The nurse is preparing to administer the contraceptive form of medroxyprogesterone (Depo-Provera). What route is appropriate?
Intramuscular
The nurse is teaching a patient about the adverse effects of fertility drugs such as clomiphene (Clomid). Which is a potential adverse effect of this drug?
Headache
The nurse is teaching a group of patients about management of diabetes. Which statement about basal dosing is correct?
Basal dosing delivers a constant dose of insulin
The nurse is administering insulin lispro (Humalog) and should keep in mind that this insulin will start to have an effect within which time frame?
15 minutes
A patient who is taking the bisphosphonate alendronate (Fosamax) has been instructed to lie flat in bed for 2 days after having plastic surgery. Which intervention is appropriate at this time?
She should not take the alendronate until she can sit up for 30 minutes.
A patient is being treated for secondary amenorrhea. The nurse expects which drug to be used to treat this problem?
Medroxyprogesterone (Provera)
The nurse recognizes that the risk of osteoporosis is higher in an individual with which risk factor?
White or Asian race
The nurse is teaching a review class to nurses about diabetes mellitus. Which statement by the nurse is correct?
Insulin therapy is possible during pregnancy if managed carefully
A patient who is taking propylthiouracil (PTU) for hyperthyroidism wants to know how this medicine works. Which explanation by the nurse is accurate?
Slows down formation of thyroid hormone
A patient is concerned about the body changes that have resulted from long-term prednisone therapy for the treatment of asthma. Which effect of this drug therapy would be present to support the nursing diagnosis of disturbed body image?
Weight gain
The order reads, “Give levothyroxine (Synthroid), 200 mg, PO once every morning.” Which action by the nurse is correct?
Question order because it’s higher than 200mcg
During a teaching session for a patient on antithyroid drugs, the nurse should discuss which dietary instructions?
Avoiding foods containing iodine
A patient who has been on long-term corticosteroid therapy has had surgery to correct an abdominal hernia. The nurse keeps in mind that which potential effect of this medication may have the most impact on the patient’s recovery?
Delayed wound healing
After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office for a follow-up examination. Which laboratory test will best reflect the patient’s adherence to the antidiabetic therapy over the past few months?
Hemoglobin A1C level
A patient has been diagnosed with metabolic syndrome and is started on the biguanide metformin (Glucophage). The nurse knows that the purpose of the metformin, in this situation, is which of these?
To decrease insulin resistance.
During the administration of finasteride (Proscar), the nurse must remember which important precaution?
Finasteride should not be handled by pregnant women
The nurse is reviewing the medication list of a patient who will be starting androgen therapy. Which drug classes, if taken with androgens, may have an interaction with them?
Oral anticoagulants
The nurse is administering antibiotic eyedrops to a patient for the first time. After the first drop is given, the patient states, “That eyedrop is making my eye sting! Is that normal?” Which is the best response by the nurse?
“Sometimes these eyedrops may cause burning and stinging, but it should go away soon.”
A patient is receiving finasteride (Proscar) for treatment of benign prostatic hyperplasia. The nurse will tell him that a possible effect of this medication is:
Increased hair growth.
A patient wants to try an oral soy product to relieve perimenopausal symptoms. The nurse will assess the patient’s medication history for potential drug interactions, including
Thyroid replacement therapy.
The nurse is preparing to administer insulin intravenously. Which statement about the administration of intravenous insulin is true?
Only regular insulin can be administered intravenously.
The nurse is administering eardrops that contain a combination of an antibiotic and a corticosteroid. What is the rationale for combining these two drugs in eardrops?
The corticosteroid reduces the inflammation and itching associated with ear infections.
A female patient has been taking isotretinoin (Amnesteem) for 3 months. During a follow-up appointment, which statement by the patient would be of highest concern to the nurse?
“I have been feeling rather down and lonely lately.”
A patient is to receive testosterone therapy via a transdermal patch. He asks the nurse, “Why am I getting a patch? Can’t I just take a pill?” Which response by the nurse is correct?
“The patch allows for better absorption of the medication.”
A patient has been taking levothyroxine (Synthroid) for more than 1 decade for primary hypothyroidism. Today she calls because she has a cousin who can get her the same medication in a generic form from a pharmaceutical supply company. Which is the nurse’s best advice?
It’s better not to switch brands until we check with your doctor
A patient asks about using minoxidil (Rogaine) for hair thinning. Which statement about minoxidil is accurate?
Systemic absorption may cause tachycardia, fluid retention, and weight gain.
A patient with hypothyroidism is given a prescription for levothyroxine. When the nurse explains that this is a synthetic form of the thyroid hormone, he states that he prefers to receive more “natural” forms of drugs. What will the nurse explain to him about the advantages of levothyroxine?
The half-life of levothyroxine is long enough to permit once-daily dosing.
The nurse is providing teaching for a patient who is to receive estrogen replacement therapy. Which statement is correct to include in the teaching session?
The patient should be sure to report any weight gain of 5 pounds or more per week
When considering the various types of contraceptive the nurse is aware that which type most closely duplicates the normal hormonal levels of the female menstrual cycle?
Triphasic
