Davis's Drug Guide for Nurses Test 4

Question 1

While counseling a client taking Kepivance (palifermin), the nurse recognizes that further teaching is necessary based on which of the following client statements?

A) "I'll be sure to let my doctor know if I develop a rash or any tongue discolorations."
B) "As long as I'm taking this, I won't get any side effects from my chemotherapy."
C) "This medication helps prevent the mouth sores that were so bad with my last chemotherapy treatment."
D) "I have to get this medication in an IV 3 days before and 3 days after my chemotherapy."

Answer 1

B

Question 2

The nurse is providing instructions to a client who has started therapy withnicardipine. The nurse instructs the client to avoid which of the following foods?

A) Kiwi
B) Grapefruit juice
C) Garlic
D) Ginger

Answer 2

B

Question 3

The nurse is providing care for an elderly woman with a urinary tract infection. The nurse understands the patient is receiving Pyridium (phenazopyridine) for which of the following reasons?

A) To reduce the frequency and severity of bladder spasms.
B) To provide local anesthetic effects to the bladder mucosa.
C) To kill
D) To promote diuresis and subsequently prevent stone formation.
E) coli bacteria commonly associated with urinary tract infection.

Answer 3

B

Question 4

A nurse is receiving a shift-to-shift report for a client with multiple medical problems. The client is receiving nabumetone. The nurse recognizes this medication is ordered to address which of the following health-care problems for the client?

A) Benign prostatic hypertrophy
B) Rheumatoid arthritis
C) Venous-thrombosis embolic prophylaxis
D) Urinary tract infection

Question 5

The nurse is providing milrinone to a 71-year-old woman with heart failure. Which of the following nursing assessments during the infusion is of the highest priority?

A) Monitor client's blood sugar every 4 hr.
B) Monitor client's sedation level hourly.
C) Monitor client's telemetry continuously.
D) Monitor client's urine output every 4 hr.

Question 6

While caring for a client who is taking Dipentum (olsalazine) for ulcerative colitis, the nurse is aware that it is most important to determine if the patient has an allergy to which of the following?

A) Penicillins or cephalosporins
B) NSAIDs or opioids
C) Beta blockers or nitrosoureas
D) Sulfonamides or salicylates

Question 7

The nurse is caring for a 58-year-old male who has been prescribed Neulasta (pegfilgrastim). The nurse recognizes provision of this medication is based on which of the following lab results?

A) Hgb= 11.7 g/dL
B) CPK = 25 mcg/L
C) Platelets = 114,000 cells/mm³
D) WBC = 2.3 cells/mm³

Question 8

While caring for a client with hypertension who has recently started taking Bystolic (nebivolol), the client reports, "This medication seems to give me a headache." Which of the following statements by the nurse is best?

A) "Headaches are common with your new medications. You should continue to take the medication to help control your blood pressure."
B) "That's too bad. You could try taking half a pill twice a day."
C) "You should call your doctor and let them know about that-it could be a serious side effect of the new medication."
D) "Have you noticed any muscle twitching or facial numbness?"

Question 9

While caring for a client who is receiving Serax (oxazepam), the nurse notes the client is drowsy and slightly confused upon waking. Which of the following conclusions should the nurse draw?

A) The client may be experiencing symptoms of a stroke and the physician should be contacted immediately.
B) The client may be experiencing hypersensitivity and the drug should be held.
C) This is an expected and normal finding with the medication and the patient should be monitored for safety concerns.
D) The client may have underlying psychiatric disorders and should be assessed for the presence of hallucinations.

Question 10

A client admitted with neutropenia would most likely be started on which of the following medications to promote neutrophil differentiation?

A) Epogen (epoetin)
B) Neulasta (pegfilgrastim)
C) Neurontin (gabapentin)
D) Procardia (nifedipine)

Question 11

The nurse is preparing to give an initial dose of Aloxi (palonosetron) as ordered prior to starting chemotherapy for breast cancer. Which of the following nursing actions is of the highest priority?

A) Infuse the medication undiluted 30 min prior to planned chemotherapy.
B) Monitor symptoms of nausea or vomiting.
C) Provide the client with written materials on the chemotherapy agents being used.
D) Determine the client's typical food intake.

Question 12

The nurse caring for clients in the psychiatric unit provides Invega (paliperidone) to one of the clients. The nurse recognizes this medication is effective by which of the following observations?

A) The client's weight is stable for 3 days.
B) The client reports the voices in his head have stopped talking to him.
C) The client stops pacing the halls and ringing his hands.
D) The client is able to focus on completing a puzzle in the day room.

Question 13

While providing care for a client in the intensive care unit, the nurse is preparing to initiate therapy with Nitropress (nitroprusside). Orders are to start the infusion at 0.3 mcg/kg/min. The client weighs 154 pounds. The IV fluid has been sent with 50 mg in 250 mL D5W. Calculate the rate of medication in mL/hr. ______________ mL/hr

Question 14

While providing care for a client who is to receive Amerge (naratriptan), the nurse recognizes that the client understands this medication by which of the following statements?

A) "If my migraine headache doesn't go away, I can repeat the dose within 30 minutes."
B) "This medication will typically make me very sleepy after I take it."
C) "I need to let the doctor know right away if I have any chest pain or tightness after taking this medication."
D) "I need to be sure and take a laxative when I take this medication."

Question 15

The nurse is providing care for a 31-year-old patient with a history of seizures. Which of the following medications would the nurse anticipate is part of the patient's home medication regimen?

A) Trileptal (oxcarbazepine)
B) Pentoxil (pentoxifylline)
C) Zyloprim (allopurinol)
D) Dexedrine (dextroamphetamine)

Question 16

While preparing to give morning medications, Remeron (mirtazapine) was newly ordered for the patient to begin this morning. The nurse would immediately call the physician to question this order if which of the following medications was included in the patient's list of home medications?

A) Enteric coated aspirin
B) Lasix (furosemide)
C) Digoxin (lanoxin)
D) Nardil (phenelzine)

Question 17

In reviewing new orders, the nurse notes Starlix (nateglinide) 120 mg three times daily before meals has been ordered. Before initiating therapy, the nurse should assess for which of the following?

A) Blood sugar
B) Respiratory rate
C) Level of consciousness
D) Creatinine clearance

Question 18

The nurse works in a pediatric psychiatry unit. Ritalin (methylphenidate) 5 mg three times daily is commonly prescribed for many of the clients. The nurse recognizes this drug needs to be used cautiously in which of the following children?

A) An 8-year-old patient with a history of cardiovascular disease
B) A 12-year-old patient with a history of scoliosis
C) A 6-year-old patient who takes Singulair (montelukast) daily
D) A 7-year-old patient with a history of sickle cell anemia

Question 19

The nurse is providing care for a 64-year-old client being prepped for a colonoscopy who is given midazolam. The nurse would expect to see which of the following responses?

A) Decrease in oral secretions
B) Increased heart rate
C) Decrease in abdominal cramping
D) Increased drowsiness

Question 20

A 71-year-old client was newly prescribed Zaroxolyn (metolazone). The nurse recognizes the drug has been effective by which of the following assessments?

A) White blood cell count = 5,500 cells/mm³
B) Client reports sleeping 8 hr per night
C) BP = 132/74
D) Client denies hallucinations

Question 21

While working in the oncology clinic, the nurse provides Matulane (procarbazine) for a patient with Hodgkin disease. Which of the following medications could potentially cause deep coma and/or death if given concurrently?

A) Advil (ibuprofen)
B) Lanoxin (digoxin)
C) Demerol (meperidine)
D) Carafate (sulcrafate)

Question 22

The nurse is providing care for a client receiving Pentam 300 (pentamidine). The nurse should monitor for which of the following complications associated with this medication? Select all that apply.

A) Steven-Johnson syndrome
B) Severe hypotension
C) Respiratory arrest
D) Cardiac arrhythmia
E) Hypoglycemia
F) Hemolytic anemia

Question 23

While working on the medical unit, the nurse is notified that one of the patients has requested a sleeping pill. A new order has been received for Rozerem (ramelteon) 8 mg orally 30 min prior to sleep. The nurse will monitor most closely for which of the following potential adverse reactions?

A) Dizziness
B) Angioedema
C) Nausea
D) Hallucinations

Question 24

A new order for K-Phos (potassium phosphate) 250 mg four times daily has been noted. When preparing to administer the medication, which of the following actions will the nurse take?

A) Provide the tablets orally at least 2 hr before meals.
B) Provide the tablets orally directly after meals.
C) Dissolve the tablets in a full glass of water and let stand for 2-5 min to ensure it is fully dissolved.
D) Provide medication simultaneously with antacid to reduce stomach irritation.

Question 25

A student nurse is preparing to provide Lyrica (pregabalin). Which of the following side effects should be monitored by the students? Select all that apply.

A) Rash
B) Suicidal thoughts
C) Decreased serum potassium
D) Weight gain
E) Dry mouth
F) Hypertension

Question 26

A client with Parkinson disease is started on Mirapex (pramipexole) 0.125 mg three times daily. The family has been told to return to the physician's office in 4 wk. Which of the following statements by the nurse is best?

A) "This medication may cause insomnia, so you may want to take melatonin to help you sleep."
B) "You can break the extended release tablet up to make it easier to swallow."
C) "If you forget to take the extended release tablet in the morning, just take it at bedtime."
D) "Be sure to let the physician know if you notice any confusion or hallucinations."

Question 27

The physician has ordered Glycolax (polyethylene glycol/electrolyte) for an 82-year-old patient. Which of the following actions will be included in the nurse's plan of care? Select all that apply.

A) Add powdered fruit punch to the prep before serving.
B) Instruct the patient to restrict their food intake to clear liquids during the prep.
C) Encourage the client to drink the fluid over a 2-3 hr period of time.
D) Shake vigorously after reconstituting with tap water.
E) Assess client hydration status prior to and throughout the prep.
F) Initiate the prep 1 hr prior to the procedure.

Question 28

The nurse is reviewing the home medication list for a client with a history of head and neck cancer who has been receiving radiation therapy. The client reports taking PO Salagen (pilocarpine) three times daily. The nurse understands this medication is designed to help treat which of the following?

A) Xerostomia
B) Nausea
C) Metastatic disease
D) Taste changes

Question 29

While investigating the medications taken by a client in the hospital, the student nurse understands that Zosyn (piperacillin/tazobactam) has an extended spectrum compared to other penicillins for which of the following reasons?

A) Neither drug is able to cross the placenta well.
B) Tazobactam inhibits an enzyme that destroys penicillins.
C) The half-life of the combined drugs is over 6 hr.
D) Pipercillin is highly metabolized with less than 10% excreted in an unchanged form.

Question 30

The nurse is providing care for a client who is receiving Aciphex (rabeprazole). The nurse recognizes this medication is effective by which of the following assessment findings?

A) Patient voids 250 mL urine and reports feeling reduced bladder spasms.
B) Patient denies abdominal pain or heartburn.
C) Patient reports improvement in itching.
D) Patient's white blood cell count is less than 10,000/mm³.

Question 31

While preparing to pass medications on a medical unit, the student nurse notes a client is scheduled to receive Minipress (prazosin). The student recognizes this medication will cause which of the following?

A) Decreased gastric acid production
B) Reduced oral and respiratory secretions
C) Dilatation of arteries and veins
D) Increased cardiac preload and afterload

Question 32

While preparing to provide morning medications, a new nurse realizes many clients are taking Viagra (sildenafil) and knows the drug must be given cautiously or in reduced doses to which of the following clients?

A) A 52-year-old patient with a history of coronary artery disease
B) A 68-year-old patient with a history of benign prostatic hypertrophy
C) A 64-year-old patient admitted with cellulitis
D) A 56-year-old patient admitted for knee replacement surgery

Question 33

As part of a new treatment regimen for Alzheimer, a 78-year-old woman is prescribed Exelon (rivastigmine). The nurse should include which of the following statements in the client teaching? Select all that apply.

A) "This medication can be given in transdermal patch form that is changed every 24 hours."
B) "Revastigmine can cause dizziness so it is important to use caution until your body adjusts to it."
C) "Let the doctor know if you have nausea, vomiting, anorexia, or weight loss."
D) "You should notice an improvement in your memory and thinking within a few days."
E) "The oral form of this medication should be taken on an empty stomach."
F) "Some clients experience headaches, weakness, and diarrhea with this medication."

Question 34

Which of the following would allow the nurse to determine that a client taking Flomax (tamsulosin) was achieving clinical benefit from the medication?

A) Client's white blood cell count = 10,500/mm^3.
B) Client blood pressure = 142/88 mmHg.
C) Client reports decreased nocturia.
D) Family reports noting improved cooperation and cohesive thought patterns.

Question 35

The nurse is providing medications for a male patient who has been taking Tebrazid (pyrazinamide) 30 mg/kg daily. The nurse notes the patient's AST = 45 units/L. Which of the following actions by the nurse is best?

A) Provide the pyrazinamide at this time.
B) Check the client's total protein level.
C) Hold the medication and call the physician regarding dosage.
D) Contact the pharmacy and ask them to split the dose.

Question 36

A diabetic patient treated with a sulfonylurea has been ordered a beta blocker for hypertension. The nurse is aware that beta blockers taken with sulfonylureas may mask the signs and symptoms of hypoglycemia. The nurse recognizes which of the following medications is included in the class of sulfonylureas? Select all that apply.

A) Januvia (sitagliptin)
B) Amaryl (glimepiride)
C) Diabeta (glyburide)
D) Glucophage (metformin)
E) Glucotrol (glipizide)

Question 37

A nurse caring for a client who is to initiate therapy with Amaryl (glimepiride) 1 mg once daily would include which of the following statements in the client teaching?

A) "This medication is used to treat infections."
B) "You should take this in the evening on an empty stomach for optimal effectiveness."
C) "You can continue to eat or drink whatever you like, including alcohol, while taking this medication."
D) "Please notify me if you have any feelings of low blood sugar such as sweating, dizziness, or tremors."

Question 38

The student nurse reviews a list of medications a client takes at home. Prandin (repaglinide) is on the list. The student expects this medication is provided in which of the following ways?

A) Topically
B) Rectally
C) Orally
D) Subcutaneously

Question 39

The nurse is caring for a 44-year-old patient with fibromyalgia. Savella (milnacipran) has been prescribed. Which of the following statements would be included in the client teaching? Select all that apply.

A) "This medication can cause dizziness so move slowly and call for assistance if you feel dizzy."
B) "One side effect of this medication is headaches; let me know if you experience that."
C) "This can be constipating, so I suggest increasing your fluid and fiber intake."
D) "We will be monitoring your blood pressure and heart rate more frequently since this medication can cause an increase in blood pressure."
E) "There are minimal risks for fetal harm with this medication so you don't need to worry."

Question 40

The nurse is caring for a client who was newly prescribed Crinone (progesterone). The nurse would provide additional education in response to which of the following client statements?

A) "I should stop taking this medication if I suspect I may be pregnant."
B) "If I have spotting or a change in my bleeding pattern, I should call the physician."
C) "I should use sunscreen and protective clothing to reduce the chance of irritation."
D) "This medication is designed to halt ovulation."

Question 41

While reviewing a client's medication list, the nurse notes the client takes Oleptro (trazodone) 50 mg three times daily. The nurse recognizes this medication has multiple indications and is used both on and off label for various reasons including which of the following? Select all that apply.

A) Insomnia
B) Chronic pain syndromes
C) Appetite stimulation
D) Major depression
E) Migraine headaches
F) Diabetic neuropathy

Question 42

While providing care for a 35-year-old client who has been started on (Topiramate) Topamax 25 mg twice daily, the nurse would include which of the following in the plan of care? Select all that apply.

A) Ensure patient drinks 2,000-3,000 mL of fluid to prevent kidney stone formation.
B) Monitor for signs and symptoms of hyper- or hypokalemia.
C) Initiate seizure precautions.
D) Monitor for suicidal thoughts or depression.
E) Place patient in contact isolation.
F) Place patient on telemetry monitoring.

Question 43

The nurse is overseeing medication provision by a student nurse for a client taking Vitamin B-1 (thiamine). The nurse knows the student has a solid understanding of this medication by which of the following statements? Select all that apply.

A) "The patient may have some diarrhea while taking this medication."
B) "Many people who take this medication have a history of alcohol use."
C) "This medication helps prevent Wernicke's encephalopathy."
D) "Sometimes thiamine is given in IV form."
E) "This medication helps prevent bone loss."
F) "We typically get thiamine from foods such as whole grains, pork, and fresh vegetables."

Question 44

The nurse is providing care for a client who has new orders to start Renagel (sevelamer) 800 mg with each meal. Which of the following orders should the nurse anticipate? Select all that apply.

A) Serum calcium and phosphorous in the morning.
B) Teach client self-injection techniques.
C) Administer with meals.
D) Do not give other medications less than 1 hr before or 3 hr after sevelamer.
E) Low protein, renal diet.

Question 45

While caring for a client receiving Ultram (tramadol) for moderate pain control, the nurse recognizes increased CNS depression can occur if this medication is given concurrently with which of the following? Select all that apply.

A) Antineoplastic agents
B) Antihistamines
C) Opioid analgesics
D) Anticoagulants
E) Sedative/hypnotics
F) Bisphosphonates