Final Flashcards
(103 cards)
1
Q
When administering medication to a hospitalized client who is awake and carrying on a
conversation with visitors, what would be the most accurate way for the nurse to check
this client’s identity?
A
- Ask the client- can you tell me your name and date of birth?
2
Q
The medication administration record shows that a client is to receive Lisinopril (Zestril)
10mg. PO at 9:00AM. On hand are tablets labeled fosinopril (Monopril) 20 mg. What
action should the nurse take next?
A
Read original physician order to verify the drug order
3
Q
The nurse received an order to give morphine 5 mg IV every 2 hours PRN pain. Which
action is not part of the six rights of drug administration?
A
- Assessing the patient’s pain level 15 to 30 minutes after giving the medication.
4
Q
A patient receives a drug that has a narrow therapeutic range. The nurse administering
this medication will expect to do what?
A
- Monitor plasma drug levels to decrease the risk of toxicity.
5
Q
During an initial nursing assessment that patient reports that he is allergic to a particular
medicine. The nurse should:
A
- Ask what symptoms occurred with the allergic reaction?
6
Q
A patient is receiving morphine sulfate 4 mg intravenously every 3 hours for pain. The
nurse understands that the half-life for morphine sulfate is approximately 3 hours. Which
statement made by the nurse best demonstrates understanding of the concept of “drug
half-life?”
A
- The half-life of a medication refers to the time required for the amount of drug in
the body to decrease by 50
7
Q
For best results when treating severe pain associated with pathologic spinal fractures
related to metastatic bone cancer, the nurse should remember that the best type of
dosage schedule is to administer the pain medication:
A
- Around the clock
8
Q
A nurse is conducting patient education about the physical dependence induced by
opioid analgesics. Which comment made by the patient indicates that the person
understands the meaning or physical dependence on a drug? Physical dependence is a
state in which:
A
- An abstinence syndrome will occur if the drug is abruptly discontinued.
9
Q
A postoperative patient has received an epidural infusion of morphine sulfate. The
patient’s respiratory rate decreases to 4 breaths per minute and he has a decreased
level of epossidusiness and mfusis. Which medication would the nurse anticipate
administering?
A
- Naloxone (Narcan)
10
Q
Which of the following patients is an appropriate candidate for aspirin therapy?
A
- ** A patient with osteoarthritis
- A 5 year old with a fever and flu like symptoms
- A patient who is having surgery tomorrow morning
- A patient with a recent history of gastrointestinal bleeding
11
Q
A patient is receiving a high dose of an NSAID for pain relief. Which of the following
would be most important for the nurse to include in the teaching plan?
A
- Signs and symptoms of GI bleeding
12
Q
An adolescent is brought to the emergency department by a parent who reports that the
patient took a whole bottle of extended release acetaminophen tablets somewhere
between 8 to 10 hours ago. The nurse will anticipate administering which of the
following?
A
- Acetylcysteine (Mucomyst)
13
Q
A patient presents to the clinic at 9 with an unsteady gait and slurred speech. During the
health history, the patient admits to consuming a case of beer every day for 7 years but
denies being an alcoholic. Which of the following medications that the patient is taking
would concern the nurse the most?
A
- Acetaminophen daily
14
Q
A patient with a history of emphysema is prescribed propanolol (Inderal) to treat
hypertension. In this situation, the nurse should assess for the presence of:
A
- Bronchoconstriction
15
Q
Your diabetic client requires a beta blocker to treat a tachydysthythmia. Due to the
beta-blocker therapy, you should teach this patient not to rely on which of the following
signs of developing hypoglycemia?
A
Tachycardia
16
Q
What assessment finding would warrant withholding a beta-blocker and consulting the
prescriber?
A
Pulse rate of 46 beats/ minute
17
Q
A patient who is taking digoxin is admitted to the hospital for treatment of congestive
heart failure. The prescriber has ordered furosemide [Lasix]. The nurse notes an
irregular heart rate of 86 beats per minute, a respiratory rate of 22 breaths per minute,
and a blood pressure of 130/82 mm Hg. The nurse auscultates crackles in both lungs.
Which laboratory value causes the nurse the most concern?
A
Potassium level of 3.3
18
Q
What assessment finding in a patient with heart failure receiving furosemide (Lasix)
would indicate an improvement in her fluid volume status
A
Absence of crackles on auscultation of lungs
19
Q
A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time.
What is the priority nursing action at this time?
A
- Instruct the patient not to get up without assistance
20
Q
A patient who is prescribed an ACE inhibitor complains of tongue swelling and is
experiencing obvious dyspnea. What is the priority action by the nurse?
A
-Administer epinephrine
21
Q
The patient is being treated with an angiotensin-converting enzyme (ACE) inhibitor. The
nurse should advise the patient that ACE inhibitors should not be taken concurrently with
which of the following drugs?
A
-Potassium-sparing diuretics
22
Q
- A patient begins taking amlodipine (Norvasc) a calcium channel blocker along with a
beta blocker, to treat hypertension. The nurse understands that the beta blocker is used
to:
A
- Prevent reflex tachycardia
23
Q
A patient taking vasodilator complains of dizziness when getting out of bed to go to the
bathroom. Which intervention is a priority for this patient?
A
Moving slowly from one position to another
24
Q
A patient is receiving diltiazem (Cardizem) via IV infusion for atrial fibrillation. Which of
the following adverse effects will the nurse monitor for related to this drug?
A
Bradycardia
25
A nurse is caring for a patient recently admitted to the ICU with heart disease. Which
symptom is a life threatening adverse effect of digoxin toxicity?
-Dysrhythmia
26
client taking spironolactone (Aldactone) for hypertension reports to the laboratory clinic
with bilateral edema in the lower legs. After receiving the laboratory test results, the
nurse decides to withhold the additional dose that was just ordered because of which
value?
Potassium 6.0
27
After the nurse administers albuterol (Proventil) to a 24 year old client with symptoms of
an acute asthma attack, which of the following outcomes is best?
Relief of wheezing
28
A patient has been taking digoxin (Lanoxin) 0.25mg. And furosemide (Lasix) 40 mg daily.
Upon routine assessment by the nurse, the patient states, “I see yellow halos around the
lights” The nurse should perform which of the following actions based off this
assessment?
Check the patient for other signs of digoxin toxicity
29
A nurse is caring for a patient receiving digoxin (Lanoxin). Which pre administration
assessment would require the nurse to hold administration for this medication?
Heart rate 48 beats/min
30
A nurse provides discharge instructions to a client about the use of amiodarone
(Cordarone). Which statement indications that the client has the knowledge to safely
self-administer the drug?
The side effects of this medication may not begin to show up for several weeks
or even months after I start taking it.
31
A patient comments, “ I don’t understand why I have chest pain at times when I
am exercising. How will metoprolol (Toprol XL) help? Which of the following
comments made by the nurse is correct?
decrease heart rate
32
The nurse is scheduled to administer a dose of digoxin (Lanoxin) to an adult
client with atrial fibrillation. The client has a potassium level of 4.3 mEq/L. The
nurse should perform which of the following activities next?
Administer the dose as ordered
33
A hospitalized patient complains of acute chest pain. The nurse administers a 0.4 mg sublingual nitroglycerin tablet, but the patient continues to complain of
pain. The vital signs remain stable. What is the nurse’s next step?
Give a second dose of nitroglycerin after 5 min
34
A patient presents to the clinic with complaints of muscle aches and weakness.
Upon review of the individual’s medications, the nurse notes that the patient is concurrently taking gemfibrozil (Lopid) and simvastin (Zocor) for his high
cholesterol. The nurse suspects
Myopathy
35
A patient started on albuterol (Proventil). The nurse will instruct the patient to
watch for which of the following side effects?
Tachycardia
36
A patient is instructed to take diphenhydramine after an allergic reaction. Which
of the following statements by the patient indicates successful teaching
concerning the Benadryl)
-I should not drive my car after taking this medication
37
A patient is instructed on the administration of inhaled corticosteroid agents to
treat asthma. How do inhaled corticosteroid agents assists in the treatment of
asthma?
- Inhaled corticosteroid agents will reduce airway inflammation
38
The nurse concludes that a client with an upper respiratory infection understands
principles of self-administration of a prescribed oral antibiotic after the client
makes which statement?
-I will continue to take the antibiotic as it is ordered, even though I no longer have
a cough with yellow sputum
39
When administering vancomycin, the nurse knows that which of the following is
the most important thing to assess before giving a dose?
-Renal function
40
During therapy with the intravenous aminoglycoside, the patient calls the nurse
and says, “I am hearing some odd sounds, like ringing, in my ears” Which is the next action of the nurse at this time?
-Stop the infusion immediately and notify the prescriber
41
```
When assessing a patient for adverse reactions to the combination of Isoniazid
and rifampin (Rifadin) the nurse should monitor which lab results?
```
-Liver function test
42
A client receives a new prescription for ciprofloxacin (Cipro). When teaching
about this drug, which information in his history requires attention by the nurse:
-He works 20 hours a week as a lifeguard at the local pool
43
While teaching the client about taking a new prescription of oral metronidazole
(Flagyl) which information would be most important for the nurse to include?
-Avoid intake of alcoholic beverages
44
A nurse is administering morphine sulfate to a postoperative patient. Which of
the following are appropriate nursing actions related to this drug? (Select all that
apply)
XXX?
45
The nurse is caring for a patient who is being started on zidovudine for treatment
of HIV/AIDS. Which of the following statements, made by the patient, indicates
that he has understood the patient teaching?
Zidovudine slows the progression of the disease but does not cure it
46
When evaluating the patient’s use of a metered dose inhaler, the nurse notes that
the patient is unstable to coordinate the activation of the inhaler with her
breathing. What intervention would be most appropriate at this time?
-Obtain and order for a spacer device
47
Cholesterol lowering drug therapy is prescribed for a patient and the nurse
provides instructions to the patient regarding the therapy. Which of the following
instructions will the nurse include (select all that apply)
-Eat extra servings of fruits and veggies everyday,
-report yellow discoloration of
the skin to the provider,
-report unusual muscle pain
48
An elderly patient has been discharged following treatment for an exacerbation
of his heart failure. He will be taking Furosemide (Lasix) 40mg PO daily. Which
instructions from the nurse are appropriate? (Select all that apply)
XXX?
49
A nurse is preparing to teach the client newly diagnosed with angina pectoris
how to self-administer nitroglycerin tablets. What client teaching should the
nurse emphasize (Select all)
-stop all activities immediately and sit down if chest pain occurs,
-if the pain is
unrelieved after taking once NTG tablet continue to rest take another tablet in 5
min and call for help
50
The nurse is preparing to administer a dose of insulin. What does the nurse need
to assess prior to giving this medication?
Blood glucose level
51
After ingesting amoxicillin (Amoxil) for 10 days. The client has developed
diarrhea, with approximately 8-10 watery stools a day. The nurse should
anticipate the need for which priority interventions. (Select all that apply)
-Prepare for administration of replacement fluids,
-Administer Flagyl,
- monitor for
clinical manifestations of dehydration,
-collect a stool specimen for C.diff
52
```
Insulin glargine (Lantus) is prescribed for a hospitalized patient who is diabetic.
When will the nurse administer this drug?
```
Once daily
53
A teaching plan for a patient who is taking lispro (Humalog) should include which
instruction by the nurse?
-Inject this insulin with your first bite of food because it is very fast acting
54
A patient is taking an Alpha Blocker as treatment for benign prostatic
hypertrophy. The nurse monitors for which potential drug effects (Select all that
apply)
- Orthostatic hypotension,
- syncope,
- --?
55
A patient who took NPH insulin at 8 reports feeling weak and shaky with a fast
heartbeat and diaphoresis at 1700. What is the priority nursing action?
-Check the patient’s blood sugar
56
The college health nurse is caring for a student with Type II diabetes mellitus
who was brought to the health clinic after getting drunk. Takes metformin
(Glucophage) 850mg once a day. The nurse assesses the student. What
assessment would be of the most concern to the nurse?
Respirations 32 breaths per minute and deep
57
A patient who has type 2 diabetes will begin taking the sulfonylurea glyburide
(DiaBeta). Which statement by the patient is concerning to the nurse?
-I may continue to have a few glasses of wine with dinner every day
58
A patient taking glucocorticoids should be instructed to do what?
XXX?
59
Patients taking oral or IV glucocorticoids have an increased risk for which of the
following?
-infection
60
Which of the following is not an adverse effect of glucocorticoid therapy?
-decreased blood glucose levels
61
A male patient is taking cimetidine “Tagamet”. Which adverse effects is more
likely to occur with cimetidine than any other H2 antagonist?
-Gynecomastia
62
A patient with renal disease is scheduled for a colonoscopy. Before the
procedure, the nurse will anticipate administering:
-polyethylene glycol and electrolytes
63
A nurse is teaching a patient about measures to prevent and treat constipation,
which is a common adverse effect of a newly prescribed drug. Which statement
made by the patient indicates a need for additional instruction?
- Drinking 6-8 glasses of water each day will keep my bowels regular
64
A nurse is caring for an older adult patient after a right open reduction internal
fixation. The patient is taking an opioid every 6 hours as needed for pain. The
nurse discusses obtaining an order from the prescriber for which medication?
-Docusate Sodium
65
A pregnant patient who is taking ondansetron (Zofran) for morning sickness tells
the nurse she is experiencing headache and dizziness. What will the nurse tell
her?
-These are the common side effects
66
A patient is given promethazine (Phenergan) for nausea and vomiting. Which of
the following is an adverse effect of promethazine?
severe drowsiness, weak or shallow breathing;
a light-headed feeling, like you might pass out;
confusion, agitation, hallucinations, nightmares;
67
A nurse is teaching a patient about the use of Viagra for erectile dysfunction,
Which statement by the patient indicates understanding of the teaching?
-If my erection lasts longer than 4 hours, I should seek medical help
68
A patient in the ED reports taking Viagra, and nitrogylcerin 1 hour before sexual
activity. Which of the following would the nurse report immediately to the
physician?
-BP 70/30
69
A patient is taking finasteride (Proscar) for benign prostatic hyperplasia (BPH).
The nurse should explain that this medication does what?
-Decreases the size of the prostate gland
70
The nurse is caring for a 56 year old patient who is post-total knee replacement.
The patient has been taking hormonal replacement therapy with estrogen to
relieve menopausal symptoms and increase bone mineral density. Which new
assessment finding would be the most concern to the nurse?
XXX?
71
A patient with Rheumatoid athritis is being treated with oral steroid for a flare of
RA. Which statement by the patient would suggest to the nurse that this patient
needs more teaching?
-Taking this drug with food will prevent me from having any bad effects
72
A patient has received instructions regarding administration of levothyroxine
(Synthyroid) Which of these statements made by the patient would indicate that
the patient understood the directions?
-Taking the drug on an empty stomach 30-60 min before breakfast increases
drug absorption
73
A client is taking levothyroxine (Synthyroid). For which of the following adverse
effects would the nurse monitor the client?
-Tachycardia
74
74. A client with GERD is taking metoclopramide as prescribed. Which client
statement tells the nurse that the medication teaching session was effective?
-The purpose of the drug is to increase GI motility
75
The nurse concludes that docusate sodium (Colace) is appropriate for use in
which of the following clients (select all that apply)
- A patient with painful and bleeding hemorhoids, a post operative patient, a
client who experienced myocardial infarction
76
A hypertensive patient newly diagnosed with diabetes expresses concern about
losing her vision.. Which interventions should be included in the plan of care to reduce this risk (select all that apply)
-Ways to reduce hyperglycemic episodes, smoking cessation, emphasis on the
importance of taking antihypertensive drugs constantly
77
A patient tells the nurse that he was told by the prescriber that the analgesic he is
taking is very effective. Which statement by the patient demonstrates an
understanding of the drug’s effectiveness?
-It might make me sleepy, and it lessens pain for several hours at a time
78
A patient newly diagnosed with type 1 diabetes is to be discharged from the
hospital. The nurse teaching this patient about home management understands
that which of the following is priority for the patient to learn prior to discharge?
- teaching patient how to measure and admin insulin
79
A patient is given a prescription for an antibiotic and asks the nurse why the dose
on the first day is twice the amount of the dose on the next 4 days. Which reply
by the nurse is correct?
-A large initial dose helps to get the drug to optimal levels in the body faster
80
An adult male patient is 1 day post op from a total hip replacements. The patient
is rocking back and forth with a facial grimace. On a scale of 0-10, with 10 being
the greatest pain, which medication admin route would have the fastest action to
relieve the patient’s pain?
-IV
81
Dopamine is administered to a patient who has been experiencing hypotensive
episodes. Other than an increase in blood pressure, which indicator would the
nurse use to evaluate a successful response?
-Increase in urine output
82
The nurse who is teaching a pharmacology refresher course to a group of nurses
is discussing antibiotic selective toxicity, which refers to the ability to
-kill or injure a target organism without injuring the host
83
During a health history a nurse is questioning a patient about her diet. Which drug
food interaction would the nurse be most concerned about due to its many
interactions?
-grapefruit juice
84
A nurse is preparing to administer a drug to a patient. The nurse understands
that the route by which absorption is the most substantial barrier is
-oral
85
A nurse is trying to determine whether a patient has experienced an adverse drug
reaction. Which question would most likely assist the nurse in this
determination?
-DId the patient’s symptoms appear shortly after the drug was first used?
86
A nurse is providing patient education regarding the development of drug
tolerance. Which statement made by the nurse is correct with regard to the
development of drug tolerance?
-The patient will require a greater dosage of drug for the same effect to be
achieved if tolerance has developed
87
A patient’s chart includes an order that reads as follows: Lanoxin 250 mg once
daily at 900. Which action by the nurse is correct?
-The nurse should contact the prescriber to clarify the route of medication
88
While caring for a patient with cirrhosis or hepatitis, the nurse knows that
abnormalities in which phase of pharmacokinetics may occur?
-Metabolism
89
A patient has just received a prescription for an enteric coated stool softener.
When teaching the patient, the nurse should include which statement?
-Be sure to swallow the tablet whole without chewing or breaking it
90
When taking a patient’s drug history, the nurse asks about the use of over the
counter drugs, the patient responds by saying “Oh i frequently, take aspirin for my
headaches, but I did not mention it because aspirin is nonprescription. What is
the best response from the nurse?
-Although aspirin is an OTC it is still important to know why you take it, how much
you take, and how often
91
When assessing a client for toxicites associated with aminoglycoside therapy,
the nurse should include evaluation of which of the following (select all that
apply)
Hearing and balance
Creatinine levels
Urine output
92
A nurse is preparing to administer medications, Which patient would the nurse
consider to have the greatest predisposition to an adverse reaction
-a 30 year old man with kidney disease
93
The nurse is administering morning medications. A patient questions the nurse.
How does the drug know where to go? The nurse’s best response to the patient is
based on the understanding that the drug
-Selective
94
In a discussion of drug-drug interactions, which would be the best example of a
beneficial inhibitory interaction?
-Naloxone blocking morphine sulfate’s actions ins a pT experiencing respiratory
depression
95
Patient ask the nurse why an over-the counter cough suppressant with sedative
side effect is not recommended for infants. Which response by the nurse is correct
-Infants are more susceptible to CNS effects than are adults
96
96. A patient has an order for digoxin (Lanoxin) 375 mcg. The digoxin tablets are 0.125
mg each. How many tablets will you give?
3
97
97. A patient is to receive 1000 mg of vancomycin, 1000mg IV to infuse over 90 minutes.
The pharmacy sends vancomycin 1000mg in 300mL. At what rate will you set the pump?
(Round to the nearest tenth).
3.4
98
The physician orders a heparin infusion to run at a rate of 14 units/kg/hr. The
pharmacy sends heparin 25,000units/500mL. The patient weighs 198 pounds. At what rate will
you set the pump? (Round to the nearest tenth if necessary).
75.6
99
patient has an order for morphine 7mg IV push. You have morphine 10mg/mL.
How many mL will you draw up to administer? (Round to the nearest hundredth if necessary).
0.7
100
100. A patient has an order for ampicillin 0.75g IM every 6 hours. The vial reads
ampicillin 500mg which when mixed with 1 mL of sterile water, will yield 2 mL net drug solution.
How many mL of the drug will you administer? (Round to the nearest tenth)
3.0
101
The nurse is caring for a patient with a history of hypertension who is being treated
with metoprolol hydococblocothorale and caotopril. The client has a blood pressure of
140/80mm HG and a pulse rate of 54 beats per min. Which of the following is the best action of
the nurse
XXX?
102
The nurse plans to administer oral medication for hypertension to a client. To safely
administer the medications, in which order should the nurse complete the following
interventions?
A. Review client's medication history and drug allergies.
B. Record drug administration in medication administration record.
C. Identify the client and explain the intended action of the medications.
D. Administer medication after verifying proper drug, route, time, and dose.
E. Obtain medication and compare the drug label against the healthcare
provider's order.
103
103. When you begin your shift, the client’s PCA has 40 mL dilaudid in the pump. The concentration of Dilaudid is 0.5mg/mL. At the end of your shift, the pump has 28mL. How many
mg of Dilaudid did the client receive?
6
