NUR256 Weeks 8-14

Question 1

A bacteriostatic substance is one that:

a) Directly kills any bacteria it comes in contact with
b) Directly kills any bacteria that are sensitive to the substance
c) Prevents the growth of bacteria
d) Prevents the growth of specific bacteria that are sensitive to the substance

Answer 1

d) Prevents the growth of specific bacteria that are sensitive to the substance

Question 2

The goal of antibiotic therapy is:

a) to eradicate all bacteria from the system
b) To suppress resistant strains of bacteria
c) To reduce the number of invading bacteria so that the immune system can deal with the infection
d) To stop the drug as soon as the person feels better

Answer 2

c) To reduce the number of invading bacteria so that the immune system can deal with the infection

Question 3

The penicillins

a) Are bacteriostatic
b) Are bactericidal, interfering with bacteria cell walls
c) Are effective only if given intravenously
d) Do not produce cross-sensitivity within their class

Answer 3

b) Are bactericidal, interfering with bacteria cell walls

Question 4

In general all people receiving antibiotics should receive teaching that includes which of the following points?

a) The need to complete the full course of drug therapy
b) The possibility of oral contraceptive failure
c) When to take the drug related to food and other drugs
d) The need for assessment of blood tests
e) Advisability of saving any leftover medication for future use
f) How to detect super infections and what to do if they occur

Answer 4

a) The need to complete the full course of drug therapy
b) The possibility of oral contraceptive failure
c) When to take the drug related to food and other drugs

Question 5

While teaching the client about taking oral tetracycline, which of the following does the nurse advise the client to do?

a) Consume calcium rich products to decrease the duration of the antibacterial effect
b) Use a soft toothbrush and floss teeth gently to remove staining on teeth
c) Report any ringing in the ears or dizziness
d) Avoid direct exposure to sunlight and apply sun block when outdoors.

Answer 5

d) Avoid direct exposure to sunlight and apply sun block when outdoors.

Question 6

The client is prescribed ciprofloxacin and is instructed to take each dose of medication as evenly spaced apart during the day as possible. The nurse recognizes that this instruction is essential because:

a) The medication can cause sleep pattern disturbances
b) Pathogenic bacteria have extremely rapid growth and reproduction rates
c) Super infections may develop if a dose of the medication is missed
d) Allergic reactions are more likely to occur if a dose is missed

Answer 6

b) Pathogenic bacteria have extremely rapid growth and reproduction rates

Question 7

Proper administration of an ordered narcotic:

a) Can lead to addiction
b) Should be done promptly to prevent increased pain and the need for larger doses
c) Would include holding the drug as long as possible until the person really needs it
d) Should rely on the person’s request for medication

Answer 7

b) Should be done promptly to prevent increased pain and the need for larger doses

Question 8

The nurse is caring for several clients who are receiving opioids for pain relief. Which client is at the highest risk of developing hypotension, respiratory depression, and mental confusion?

a) A 23 year old female, postoperative ruptured appendix
b) A 16 year old male, post-motorcycle injury with lacerations
c) A 54 year old female, post-myocardial infarction
d) An 86 year old male, postoperative femur fracture

Answer 8

d) An 86 year old male, postoperative femur fracture

Question 9

The client asks you if paracetamol will help his arthritis like ‘ my aspirin does’. You base your response on the knowledge that the pharmacotherapeutic actions of paracetamol are:

a) Analgesic and antipyretic
b) Analgesic and anti-inflammatory
c) Anti-inflammatory and antiplatelet
d) Antipyretic and anti-inflammatory

Answer 9

a) Analgesic and antipyretic

Question 10

Naloxone hydrochloride is classified as an:

a) Opioid analgesic
b) Opioid agonist
c) Opioid partial agonist
d) Opioid antagonist

Answer 10

d) Opioid antagonist

Question 11

The parenteral opioid analgesic that carries the greatest risk for respiratory depression with its use is:

a) Fentanyl citrate
b) Morphine sulfate
c) Hydromorphone
d) pethidine

Answer 11

c) Hydromorphone

Question 12

While a person is receiving a general anaesthetic, he or she must be continually monitored because:

a) The person has no pain sensation
b) Generalised CNS depression affects all body function
c) The person cannot move
d) The person cannot communicate

Answer 12

b) Generalised CNS depression affects all body function

Question 13

Local anaesthetics are used to block feeling in specific body areas. If given in increasing concentrations, local anaesthetics can cause loss, in order, of the following:

a) Temperature sensation, touch sensation, proprioception and skeletal muscle tone
b) Touch sensation, skeletal muscle tone, temperature sensation and proprioception
c) Proprioception, skeletal muscle tone, touch sensation and temperature sensation
d) Skeletal muscle tone, touch sensation, temperature sensation and proprioception

Answer 13

a) Temperature sensation, touch sensation, proprioception and skeletal muscle tone

Question 14

Proper administration of an ordered narcotic:

a) Can lead to addiction
b) Should be done promptly to prevent increased pain and the need for larger doses
c) Would include holding the drug as long as possible until the person really needs it
d) Should rely on the person’s request for medication

Answer 14

b) Should be done promptly to prevent increased pain and the need for larger doses

Question 15

The benzodiazepines are the most frequently used anxiolytic drugs because:

a) They are anxiolytic at doses much lower than those needed for sedation or hypnosis
b) They can be stimulating
c) They are more likely to cause physical dependence than older anxiolytic drugs
d) They do not affect the neurotransmitters

Answer 15

a) They are anxiolytic at doses much lower than those needed for sedation or hypnosis

Question 16

The nurse or midwife would expect administration of a NMJ blocker as the drug of choice to accomplish which of the following

a) Facilitate endotracheal intubation
b) Facilitate mechanical ventilation
c) Prevent injury during electroconvulsive therapy
d) Relieve pain during labour and birth
e) Treat myasthenia gravis
f) Treat a person with a history of malignant hyperthermia

Answer 16

a) Facilitate endotracheal intubation
b) Facilitate mechanical ventilation
c) Prevent injury during electroconvulsive therapy

Question 17

Suxamethonium has a more rapid onset of action and a shorter duration of activity than the non-depolarising NMJ blockers because it:

a) Does not bind well to receptor sites
b) Rapidly crosses the blood-brain barrier and is lost
c) Is broken down by acetylcholinesterase that is found in the plasma
d) Is very unstable

Answer 17

c) Is broken down by acetylcholinesterase that is found in the plasma

Question 18

Warfarin an oral anticoagulant, acts:

a) To directly prevent the conversion of prothrombin to thrombin
b) To decrease the production of vitamin K clotting factors in the liver
c) As a catalyst in the conversion of plasminogen to plasmin
d) Immediately, so it is the drug of choice in emergency situations

Answer 18

b) To decrease the production of vitamin K clotting factors in the liver

Question 19

The low-molecular-weight heparin of choice for preventing deep venous thrombosis after hip replacement therapy is:

a) tinzaparin
b) dalteparin
c) heparin
d) enoxaparin

Answer 19

d) enoxaparin

Question 20

A thrombolytic agent could be safely used in:

a) CVA within the last 2 months
b) Acute MI within the last 3 hours
c) Recent, serious GI bleeding
d) Caesarian birth.

Answer 20

b) Acute MI within the last 3 hours

Question 21

Evaluating a person who is taking an anticoagulant for blood loss would usually include assessing for which of the following?

a) The presence of petechiae
b) Bleeding gums while brushing the teeth
c) Dark-coloured urine
d) Yellow colour sclera or skin
e) The presence of ecchymotic areas
f) Loss of hair

Answer 21

a) The presence of petechiae
b) Bleeding gums while brushing the teeth
c) Dark-coloured urine
e) The presence of ecchymotic areas

Question 22

The client with deep vein thrombosis is being treated with a heparin infusion. The nurse would monitor for therapeutic effectiveness by noting which of the following?

a) Activated partial thromboplastin time (aPTT)
b) Prothrombin time (PT)
c) Platelet counts
d) International normalised ratio (INR)

Answer 22

a) Activated partial thromboplastin time (aPTT)

Question 23

• A patient who is taking clopidogrel to prevent another stroke asks the nurse how the medication works. The nurse’s response should be based on an understanding that clopidogrel:

a) Inhibits platelet aggregation to prevent clot formation
b) Activates antithrombin III and subsequently inhibits thrombin
c) Inhibits enzymes involved in the formation of vitamin K
d) Converts plasminogen to plasmin to dissolve fibrin clots

Answer 23

a) Inhibits platelet aggregation to prevent clot formation

Question 24

 A nurse or midwife is about to administer digoxin to a person whose apical pulse is 48 beats/min. She should

a) Give the drug and notify the prescriber that the heart rate is low
b) Retake the pulse in 15 minutes and give the drug if the pulse has not changed
c) Retake the pulse in 1 hour and withhold the drug is the pulse is still less than 60 beats/min.
d) Withhold the drug and notify the prescriber that the heart rate is below 60 beats/min

Answer 24

c) Retake the pulse in 1 hour and withhold the drug is the pulse is still less than 60 beats/min.

Question 25

 Antiarrhythmic drugs alter the action potential of the cardiac cells. Because they alter the action potential, antiarrhythmic drugs often:

a) Cause heart failure
b) Alter blood flow to the kidney
c) Cause new arrhythmias
d) Cause electrolyte disturbances

Answer 25

c) Cause new arrhythmias

Question 26

 A person who is receiving an antiarrhythmic drug needs:

a) Constant cardiac monitoring until stabilised
b) Frequent blood tests, including drug levels
c) An antidepressant to deal with the psychological depression
d) Dietary changes to prevent irritation of the heart muscle

Answer 26

a) Constant cardiac monitoring until stabilised

Question 27

 Medications that increase the force of myocardial contractions have what type of effect?

a) Positive inotropic
b) Negative inotropic
c) Positive chronotropic
d) Negative chronotropic

Answer 27

a) Positive inotropic

Question 28

 Digoxin is classified as a:

a) Hypokalaemic
b) Cardiac glycoside
c) Coronary artery vasodilator
d) Positive chronotropic

Answer 28

b) Cardiac glycoside

Question 29

 Atropine and hyoscine work by blocking

a) Nicotinic receptors only
b) Muscarinic and nicotinic receptors
c) Muscarinic receptors only
d) Adrenergic receptors to allow cholinergic receptors to dominate

Answer 29

c) Muscarinic receptors only

Question 30

 A nurse or midwife would expect atropine to be used for which of the following?

a) To depress salivation
b) To dry up bronchial secretions
c) To increase the heart rate
d) To promote uterine contractions
e) To treat myasthenia gravis
f) To treat alzheimer’s disease

Answer 30

a) To depress salivation
b) To dry up bronchial secretions
c) To increase the heart rate

Question 31

 A health care provider prescribes adrenaline to a patient who was stung by several wasps 30 minutes ago. The nurse knows that the primary purpose of this medication for this client is to:

a) Stop the systemic release of histamine produced by the mast cells
b) Counteract the formation of antibodies in response to an invading organism
c) Increase the number of white blood cells produced to fight the primary invader
d) Increase a declining blood pressure and dilate constricting bronchi associated with anaphylaxis

Answer 31

a) Stop the systemic release of histamine produced by the mast cells

Question 32

 A smoker who is being treated for hypertension with a beta-blocker is most likely receiving:

a) A non-specific ß-blocker
b) An α1-specific ß-blocker
c) ß- and α-blockers
d) A ß1-specific blocker

Answer 32

d) A ß1-specific blocker

Question 33

 You would caution a person who is taking an adrenergic blocker

a) To avoid exposure to infection
b) To stop the drug if he or she experiences flu-like symptoms
c) Never to stop the drug abruptly
d) To avoid exposure to the sun

Answer 33

c) Never to stop the drug abruptly

Question 34

O The nurse or midwife would anticipate an order for a loop diuretic as the drug of choice for a person with:

a) Hypertension
b) Shock
c) Pulmonary oedema
d) Fluid retention of pregnancy

Answer 34

c) Pulmonary oedema

Question 35

O The nurse is teaching a group of clients with cardiac conditions who are taking diuretic therapy. The nurse explains that individuals prescribed frusemide should:

a) Avoid consuming large amounts of cabbage, cauliflower, and kale.
b) Rise slowly from sitting or lying position
c) Count their pulse for 1 full minute before taking the medication
d) Restrict fluid intake to no more than 1000mL in a 24 hour period.

Answer 35

b) Rise slowly from sitting or lying position

Question 36

O A person with severe glaucoma who is about to undergo eye surgery would benefit from a decrease in intraocular fluid. This is often best accomplished by giving the person

a) A loop diuretic
b) A thiazide diuretic
c) A carbonic anhydrase inhibitor
d) An osmotic diuretic

Answer 36

d) An osmotic diuretic

Question 37

O Clients prescribed spironolactone are often at risk for electrolyte imbalance. The nurse assesses for this adverse effect because this drug may cause the body to:

a) Retain potassium
b) Release magnesium
c) Excrete potassium
d) Bind calcium

Answer 37

a) Retain potassium

Question 38

O Routine Care of a person receiving a diuretic would include which of the following?

a) Daily weighing
b) Tight fluid restrictions
c) Periodic electrolyte evaluations
d) Monitoring of urinary output
e) Regular intraocular pressure testing
f) Teaching the person to report muscle cramping

Answer 38

a) Daily weighing
b) Tight fluid restrictions
c) Periodic electrolyte evaluations
d) Monitoring of urinary output
f) Teaching the person to report muscle cramping

Question 39

O Combination oestrogens and progestins are commonly used as oral contraceptives. It is thought that this combination has its effect by:

a) Acting to block the release of FSH and LH, preventing follicle development
b) Directly suppressing the ovaries and preventing ovulation
c) Keeping the endometrium constantly lush and blood filled
d) Preventing menstruation, which prevents pregnancy

Answer 39

a) Acting to block the release of FSH and LH, preventing follicle development

Question 40

O Oxytocin, a synthetic form of the hypothalamic hormone, is used to:

a) Induce labour by stimulating uterine contraction
b) Stimulate milk production in the lactating woman
c) Increase fertility and the chance of conception
d) Relax the gravid uterus to prevent preterm labour

Answer 40

a) Induce labour by stimulating uterine contraction

Question 41

O Testosterone is approved for use in:

a) Treatment of breast cancers
b) Increasing muscle strength in athletes
c) Oral contraceptives
d) Increasing hair distribution in male pattern baldness

Answer 41

a) Treatment of breast cancers