Week 8-14 Multiple Choice

Question 1

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 1

b

Question 2

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, post-op ruptured appendix
b) A 16 year old male, post-motorcycle injury with lacerations
c) A 54 year old female, post-MI
d) An 86 year old male, post-op femur fracture

Answer 2

d

Question 3

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 3

a

Question 4

Naloxone hydrochloride is classified as an:

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

Answer 4

d

Question 5

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

a) Fentanyl citrate
b) Morphine sulphate
c) Hydromorphone
d) Pethidine

Answer 5

c

Question 6

Carcinomas are tumours that originate in:

a) Mesenchyme
b) Bone marrow
c) Striated muscle
d) Epithelial cells

Answer 6

d

Question 7

Antineoplastic drugs destroy human cells. They are most likely to cause cell death among healthy cells that:

a) Have poor cell membrane
b) Are rapidly turning over
c) Are in dormant tissues
d) Cross the blood-brain barrier

Answer 7

b

Question 8

Cancer treatment usually occurs in several different treatment phases. In assessing the appropriateness of another round of chemotherapy for a particular person, which of the following would be evaluated as the most important?

a) Hair loss
b) Bone marrow function
c) Anorexia
d) Heart rate

Answer 8

b

Question 9

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 9

d

Question 10

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 10

c

Question 11

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 11

b

Question 12

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 12

d

Question 13

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 recognises that the 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 13

b

Question 14

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 14

b

Question 15

Local anaesthetics are used to block feelings in specified 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 15

a

Question 16

The benzodiazepines are the most frequently used anxiolytic drugs because:

a) they are anxiolytic at doses much lower that 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 16

a

Question 17

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 ECT
d) Relieve pain during labour and birth
e) Treat myasthenia gravis
f) Treat a person with a history of malignant hyperthermia

Answer 17

a, b, c

Question 18

Suxemethonium has a more rapid onset of action and a shorter duration of activity that 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 18

c

Question 19

Warfarin, an oral anticoagulant, acts:

a) to directly prevent the conversion of prothrombin to thrombin.
b) to decrease the production of vit 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 19

b

Question 20

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

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

Answer 20

d

Question 21

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 21

b

Question 22

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 22

a, b, c and possibly e

Question 23

The client with DVT 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 23

a

Question 24

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 forrmation of vit K
d) converts plasminogen to plasmin to dissolve fibrin clots

Answer 24

a

Question 25

An example of a drug allergy is:

a) dry mouth occurring with use of an antihistamine
b) increased urination occurring with use of a thiazide diuretic
c) breathing difficulty after an injection of penicillin
d) skin rash associated with procainamide use

Answer 25

c

Question 26

A person is experiencing a reaction to the penicillin injection that was administered approx 30 mins ago. The healthcare provider is concerned that it might be an anaphylactic reaction. What signs and symptoms would validate her suspicion?

a) Rapid heart rate
b) Diaphoresis
c) Constricted pupils
d) Hypotension
e) Rash
f) The person reporting a panic feeling

Answer 26

a, b, e, f

Question 27

A woman has repeated bouts of bronchitis throughout the autumn and has been taking antibiotic. She calls the clinic with complaints of vaginal pain and itching. When she is seen, it is discovered that she has developed a yeast infection. You would explain to her that:

a) her bronchitis has moved to the vaginal area
b) she has developed a super infection because the antibiotics kill bacteria that normally provide protection
c) she probably has developed a sexually transmitted disease related to her lifestyle
d) she will need to take even more antibiotics to treat this new infection

Answer 27

b

Question 28

A drug reaction that does not occur unless the client has been previously exposed to the agent is a:

a) idiosyncratic reaction
b) teratogenic reaction
c) allergic reaction
d) liberation reaction

Answer 28

c

Question 29

When the pharmacological effects of one medication are potentiated or diminished by another medication, this is termed a:

a) Adverse drug reaction
b) Medication incompatibility
c) Medication interaction
d) Placebo effect

Answer 29

c

Question 30

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 30

c

Question 31

Anti-arrhythmic drugs alter the action potential of the cardiac cells. Because they alter the action potential, anti-arrhythmic drugs often:

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

Answer 31

c

Question 32

A person who is receiving an anti-arrhythmic 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 32

a

Question 33

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 33

a

Question 34

Digoxin is classified as a:

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

Answer 34

b

Question 35

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 35

c

Question 36

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 disease

Answer 36

a, b, c

Question 37

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 37

d

Question 38

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 38

d

Question 39

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 39

c

Question 40

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 40

c

Question 41

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 41

b

Question 42

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 42

d

Question 43

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 43

a

Question 44

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 44

a, b, c, d, f

Question 45

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 45

a

Question 46

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 46

a, b

Question 47

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 47

a