Davis's Drug Guide for Nurses Test 3

Question 1

While providing care for an 84-year-old patient with Parkinson disease who is taking Sinemet (carbidopa/levodopa), the nurse notes abnormalities in the client's lab values. Which of the following could be attributed to the medication?

A) Platelet count-440,000 c/mm³
B) Hemoglobin-10.4 g/dL
C) Albumin-3.2 g/dL
D) B-type natriuretic peptide (BNP)-449 pg/mL

Answer 1

B

Question 2

While caring for a client with Parkinson disease who has recently started taking Cogentin (benztropine), the client reports, "My mouth seems so dry all the time." Which of the following statements by the nurse is best?

A) "Dry mouth is common with your new medications. You should rinse frequently and consider using hard sugarless candies or gum to help with the symptom."
B) "I wonder if your dose is too high; try taking half the pill twice a day instead of all at once and see if that helps."
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 fever or night sweats lately?"

Answer 2

A

Question 3

The nurse is providing Ethyol (amifostine) to a 51-year-old woman with ovarian cancer who is also receiving Cisplatin. Which of the following nursing assessments during the infusion is of the highest priority?

A) Monitor client blood sugar every hr.
B) Monitor client's respiratory rate every 30 min.
C) Monitor client's blood pressure every 5 min.
D) Monitor client's urine output every 4 hr.

Answer 3

C

Question 4

The nurse is providing instructions to a client who has started therapy with Buprenex (buprenorphine) to assist with opioid withdrawal. The nurse instructs the client to avoid which of the following natural substances/herbs? Select all that apply.

A) Kava-kava
B) Valerian
C) Garlic
D) Ginger
E) Chamomile
F) Hops

Question 5

While caring for a client taking Clozaril (clozapine), the nurse determines the medication is effective by which of the following findings?

A) Decreased swelling noted at the site of cellulitis in the left hand.
B) Apical heart rate is regular at 72 bpm.
C) Client is cooperative; oriented to person, place, and time; and has no hallucinations or delusions.
D) Breath sounds are clear throughout anterior, lateral, and posterior aspects.

Question 6

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

A) "This medication may cause me to have a dry mouth or lower my saliva production."
B) "This medication will reduce my nicotine cravings and help me quit smoking."
C) "I need to let the doctor know right away if I have any thoughts of suicide or worsening depression."
D) "I need to be sure and drink at least 4 quarts of water each day while I'm taking this medication."

Question 7

The nurse is providing care for a 64-year-old client on the telemetry unit whose heart rate suddenly jumps to 144 bpm. Telemetry shows supraventricular tachycardia and the client reports feeling a bit lightheaded and dizzy. The nurse attempts vagal stimulation without success and prepares to administer Adenocard (adenosine) 6 mg IV push. The nurse would expect which of the following to occur?

A) A gradual slowing of the heart rate over the next 30 min with an end result of normal sinus rhythm and improved symptoms.
B) Slowing of the tachycardia with an end rate between 100-120 bpm and improved dizziness within 5 min.
C) Loss of consciousness for the client in preparation for electric shock/cardioversion.
D) A short period of heart block or asystole immediately after injection followed by conversion to normal sinus rhythm.

Question 8

While counseling a client taking Pristiq (desvenlafaxine), 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 have any thoughts of suicide."
B) "If I need something for pain, I should take aspirin, ibuprofen, or another non-steroidal anti-inflammatory instead of Tylenol while I'm taking this medication."
C) "I shouldn't drive a car for a few weeks since this medication can cause dizziness."
D) "I should avoid drinking alcohol while I'm taking this medication."

Question 9

The nurse is caring for a 6-month-old patient receiving oral Moxatag (amoxicillin) 25 mg/kg/day divided into two doses and distributed as 50 mg/mL oral suspension. The child weighs 33 pounds. How much medication (in mL) will this nurse pour/provide each dose?

Question 10

While preparing to give Fungizone (amphotericin B) to a client who is also receiving Dexasone (dexamethasone), the nurse recognizes the client is at increased risk for which of the following?

A) Hypoglycemia
B) Hyponatremia
C) Hypocalcemia
D) Hypokalemia

Question 11

The nurse is providing care for an 82-year-old client with glaucoma. Diamox (acetazolamide) 250 mg orally twice daily has been ordered as a new medication. The nurse would be most concerned by which of the following?

A) The client has a listed allergy to sulfonamides.
B) The client has a history of rheumatoid arthritis.
C) The client takes Cogentin (benztropine) daily.
D) The client's potassium is 3.6 mEq/dL.

Question 12

In reviewing new orders, the nurse notes Azactam (aztreonam) 1 gram IV every 8 hr has been ordered. Before initiating therapy, the nurse should assess for an allergy history to which of the following? Select all that apply.

A) Penicillins
B) MAO inhibitors
C) Antifungals
D) Cephalosporins
E) Non-steroidal anti-inflammatory agents

Question 13

A client admitted with atrial fibrillation would most likely be started on which of the following medications to reduce the risk of embolization?

A) Pradaxa (dabigatran)
B) DDAVP (desmopressin)
C) Effexor (venlafaxine)
D) Flomax (tamsulosin)

Question 14

The nurse is caring for a 34-year-old patient with a large hilar mass due to lymphoma. Chemotherapy is being provided and the client also has orders for Zyloprim (allopurinol) 300 mg orally twice daily. When providing this medication, the nurse would include which of the following statements in the client teaching?

A) "This medication will help prevent gout, which occurs when clients are given radiation therapy."
B) "Allopurinol binds to the uric acid being released by the destroyed cancer cells and prevents it from damaging your kidneys."
C) "Chemotherapy agents can reduce the number of white blood cells, red blood cells, and platelets in your body; this medication helps protect those cells."
D) "This is part of the chemotherapy regimen since some chemo agents are given in your IV and others are given by mouth."

Question 15

A client with breast cancer is taking Arimidex (anastrozole). The nurse recognizes that teaching has been effective by which of the following client statements?

A) "If I miss a dose, I should take a double dose the next day."
B) "I must take this medication on an empty stomach before going to bed each night."
C) "Oral chemotherapy generally has fewer side effects and is much safer."
D) "There is a risk of allergic reaction for this medication so I need to notify the doctor right away if I have any swelling in my face, difficulty swallowing, or rashes."

Question 16

While caring for a client who is taking Sandimmune (cyclosporine) after a cardiac transplant, the nurse is aware that it is most important to monitor for which of the following?

A) Hypokalemia
B) Hypotension
C) Anorexia
D) Nephrotoxicity

Question 17

While caring for a client who is receiving Desferal (deferoxamine), the nurse notes the client's urine is reddish colored. Which of the following conclusions should the nurse draw?

A) There is a risk of hemolytic cystitis with this medication and the next dose should be held.
B) The client may be experiencing liver toxicity; the physician should be contacted to request laboratory analysis be done.
C) This is an expected and normal finding with the medication due to the excretion of iron.
D) The client may have a secondary urinary tract infection and a urinalysis should be sent.

Question 18

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

A) Ventilator-associated pneumonia
B) Deep vein thrombosis
C) Hypotension
D) Urosepsis

Question 19

A 21-year-old client is brought to the emergency room with suspected overdose with Tylenol (acetaminophen). Which of the following medications would the nurse expect to be ordered?

A) Protamine sulfate
B) Primaxin (imipenem)
C) Acetadote (acetylcysteine)
D) Diabeta (glyburide)

Question 20

The nurse is providing care for a 41-year-old patient with a severe head injury following a motor vehicle accident. The nurse notes the client's urinary output for the past four hr is 900 mL. Which of the following medications would the nurse anticipate being ordered?

A) DDAVP (desmopressin)
B) Lasix (furosemide)
C) Lopurin (allopurinol)
D) Dexedrine (dextroamphetamine)

Question 21

The nurse is providing Tarceva (erlotinib) intravenously for a client who has small cell lung cancer. The client begins to appear slightly short of breath, respiratory rate has gone from 14 breaths per min to 20 breaths per min and he has been coughing mildly for the past 10 min. Which of the following actions should the nurse take first?

A) Listen to breath sounds to determine if the client is experiencing fluid volume overload.
B) Stop the infusion since there is a risk of interstitial lung disease with this medication.
C) Check the client's temperature to determine if he is developing pneumonia.
D) Reassure the client that a cough is normal as cancer cells are destroyed and continue to monitor closely.

Question 22

While investigating the medications taken by a client in the hospital, the student nurse understands that Plendil (felodipine) works to lower blood pressure by causing which of the following physiologic changes?

A) Dilatation of the vascular wall
B) Blocking the transport of calcium
C) Inhibiting the beta receptors on cell membranes
D) Reducing the formation of ectopic beats

Question 23

The nurse is caring for a 68-year-old male who is taking Cardura (doxazosin). He denies any history of hypertension. The nurse recognizes this medication can also be used to treat which of the following conditions?

A) Psoriasis
B) Gout
C) Lymphoma
D) Benign prostatic hypertrophy

Question 24

A student nurse is preparing to participate in a mission-trip to South Africa and is prescribed Plaquenil (hydroxychloroquine). Which of the following side effects may be experienced by the student? Select all that apply.

A) Rash
B) Headache
C) Ringing in the ears
D) Anorexia
E) Diarrhea
F) Hypertension

Question 25

While observing in the operating room, the student nurse notes a client was given Robinul (glycopyrrolate) pre-operatively as part of the anesthesia regimen. The student recognizes this medication will cause which of the following?

A) Decreased pain perception during the procedure
B) Reduced oral and respiratory secretions
C) Neuromuscular blockage and paralysis
D) Reduced consciousness and sedation

Question 26

The nurse responds to a call light for a client with chronic obstructive pulmonary disease and finds the client slightly dyspneic with a respiratory rate of 20 and wheezing noted in the anterior and posterior upper lung fields. The nurse knows the client has orders for Arcapta (indacaterol) inhaler once daily, which is due in 1 hr. Which of the following actions by the nurse is best?

A) Provide the Arcapta (indacaterol) inhaler at this time.
B) Check the client's temperature.
C) Determine if the client has an order for other respiratory inhalers/treatment.
D) Identify the most recent chest x-ray results.

Question 27

The nurse is providing care for a client who has new orders to start Victoza (liraglutide) 0.6 mg subcutaneously each day. Which of the following orders should the nurse anticipate? Select all that apply.

A) Check blood sugar before meals and at bedtime.
B) Teach client self-injection techniques.
C) Conduct liver function tests every morning for the next 3 days.
D) Discontinue low molecular weight heparin.
E) Notify physician of acute abdominal pain, nausea, or vomiting.
F) Hold all aspirin products.

Question 28

While working in the psychiatric hospital, the nurse provides Fanapt (iloperidone) 2 mg twice daily. Which of the following assessments indicates the medication is effective?

A) The client's mood is stabilized.
B) The client is able to sleep for 8 hr at night.
C) The client denies hearing voices.
D) The client's weight is stabilized.

Question 29

The nurse is talking to a neighbor who spent 3 days in the hospital on intravenous antibiotics including erythromycin the week before. The individual states, "I've had such bad diarrhea all night and it really isn't any better today." Which of the following statements by the nurse is best?

A) "Are you taking any oral antibiotics now?"
B) "Antibiotics commonly cause diarrhea; be sure to drink plenty of fluids."
C) "Have you noticed any blood or pus in the stool?"
D) "Is anyone else in the family experiencing the same symptoms?"

Question 30

The nurse is reviewing the home medication list for a client with identified hypercholesterolemia. The client reports taking Zetia (ezetimibe) daily. The nurse understands this medication is designed to reduce the client's risk for which of the following?

A) Atherosclerosis
B) Angina
C) Deep vein thrombosis
D) Gastric ulceration

Question 31

As part of a new treatment regimen for hypothyroidism, a 48-year-old woman is prescribed Levoxyl (levothyroxine). The nurse should include which of the following statements in the client teaching? Select all that apply.

A) "You should take this medication at roughly the same time each day."
B) "Once you've been taking this medication for a few weeks, you should be cured and the doctor will stop it."
C) "Let the doctor know if you lose more than 2 pounds per week while taking this medication."
D) "Do not take this medication at the same time as any other medications."
E) "Avoid eating beef or pork while taking this medication."
F) "Some clients experience headaches, nervousness, sweating, and palpitations while taking this medication."

Question 32

The nurse is providing care for a client with end stage renal disease who is receiving Fosrenol (lanthanum carbonate). The nurse recognizes this medication is effective by which of the following laboratory values?

A) Serum potassium = 3.7 mEq/L
B) Hemoglobin = 10.2 g/dL
C) Uric acid = 3.7 mg/dL
D) Serum phosphate = 5.4 mg/dL

Question 33

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

A) Orally
B) Topically
C) Rectally
D) Metered dose inhaler

Question 34

A nurse caring for a client with chronic obstructive pulmonary disease notes the recent addition of a new inhaler, formoterol. The nurse knows this medication is designed to prevent which of the following symptoms?

A) Mucous production
B) Salivation
C) Bleb formation
D) Bronchospasm

Question 35

The nurse is caring for a client newly admitted with pelvic inflammatory disease. An order for Primaxin (imipenem/cilastatin) 500 mg IV every 6 hr is noted. The nurse would be most concerned by which of the following findings in the client's history?

A) Use of an intrauterine device for birth control
B) Family history of hypertension
C) Order for morphine sulfate 2 mg IV every 4 hr as needed for pain
D) History of seizures

Question 36

The nurse is providing Epogen (epoetin) subcutaneously to a client with chronic kidney disease. Which of the following would indicate that the therapy is effective? Select all that apply.

A) The client's hematocrit rises from 27.4 to 32.9%.
B) The client's serum creatinine falls from 5.6 mg/dL to 4.9 mg/dL.
C) The client reports decreased fatigue and dyspnea.
D) The client reports 500 mL of urine output in a 24-hr period.
E) The client's WBC = 7.4 u/L.
F) The client has remained afebrile for 2 wk.

Question 37

A nurse caring for a client who is to initiate therapy with Merrem (meropenem) 500 mg intravenously every 12 hr would include which of the following statements in the client teaching? Select all that apply.

A) "This medication is used to treat various infections."
B) "The dose is reduced since you have a history of renal impairment."
C) "Be sure to let us know if you develop any diarrhea."
D) "Since you have an allergy to penicillin, there is no risk of allergy to this medication."
E) "The medication can cause dizziness for some people so be sure to call for help when you need to get up out of bed."

Question 38

A nurse from the medical unit is floated to the surgical unit. While preparing to provide morning medications, the nurse realizes many clients are taking Demerol (meperidine) and knows the drug must be given cautiously or in reduced doses to which of the following clients? Select all that apply.

A) A 42-year-old patient taking Nitro-Bid (nitroglycerine)
B) A 68-year-old patient taking Prozac (fluoxetine)
C) A 74-year-old patient taking Matulane (procarbazine)
D) A 66-year-old patient taking Dilantin (phenytoin)
E) A 51-year-old patient taking Zovirax (acyclovir)
F) A 76-year-old patient taking Synthroid (levothyroxine)

Question 39

While observing in the oncology clinic, a student nurse is reviewing chemotherapy orders for a client with advanced colorectal cancer. The nurse providing care explains the client is to receive "high dose methotrexate with leucovorin rescue." The student understands the leucovorin calcium is given for which of the following reasons?

A) As a catalyst to increase the number of cancer cells destroyed by the methotrexate.
B) As an antidote to the methotrexate to reduce the destruction of blood cells.
C) As a second chemotherapeutic agent that will destroy cancer cells using a different mechanism.
D) As a carrying agent to ensure delivery of the methotrexate into the cells.

Question 40

A client with Alzheimer is started on Razadyne (galantamine) 4 mg twice 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) "Sometimes a higher dose of this medication is needed to see improvement."
B) "You should notice improvement within a day or two."
C) "If you forget a dose one day, just have her take two the next day."
D) "This medication can cause dizziness so be extra careful to avoid falls."

Question 41

While reviewing a client's medication list, the nurse notes the client takes Remeron (mirtazapine) 15 mg 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) Major depressive disorder
B) Schizophrenia
C) Anorexia nervosa
D) Panic disorder
E) Generalized anxiety disorder
F) Post-traumatic stress disorder

Question 42

The nurse is caring for a client taking Skelaxin (metaxalone). The nurse knows teaching has been effective by which of the following statements? Select all that apply.

A) "I might be constipated while I'm on this medication."
B) "Most people who take this medication have fewer muscle spasms and less pain."
C) "This can cause dizziness, blurred vision, and sleepiness so I shouldn't drive while I'm on it."
D) "I need to move slowly so I don't faint."
E) "I can drink up to 2 beers per day safely while I'm on this medication."
F) "If I forget this medication, I can take it within one hour or skip that dose and remain on the schedule."

Question 43

While caring for a client receiving methyldopa for hypertension, the nurse recognizes elevations in which of the following labs may be caused by the medication? Select all that apply.

A) Serum creatinine
B) White blood cells
C) Amylase
D) Albumin
E) Potassium
F) Sodium

Question 44

A new order for Foscavir (foscarnet) 60 mg/kg IV every 8 hr has been noted. The patient weighs 50 kg. With a dilution required concentration of 12 mg/mL, what size IV bag will the nurse need to infuse this medication ___________________?

Question 45

The nurse is preparing to start therapy with IV Dobutrex (dobutamine). The pre-mixed solution has 250 mg in 250 mL. The orders read 5 mcg/kg/min and the client weighs 165 pounds. At what rate, expressed in mL/hr, should the infusion be started? (Round to the nearest tenths place.) ___________ mL/hr

Question 46

While providing care for a 45-year-old woman client who has been started on Tapazole (methimazole) 15 mg every 4 hr, the nurse would include which of the following in the plan of care? Select all that apply.

A) Teach client self-injection techniques.
B) Monitor for signs and symptoms of hyper- or hypothyroidism.
C) Place client in protective isolation.
D) Assess white blood cell and differential counts.
E) Strain all urine.
F) Monitor for signs or symptoms of bleeding.

Question 47

The nurse receives orders to begin Robaxin (methocarbamol) 4.5 grams per day in 3 equally divided doses. The medication is available in 500 mg tablets. How many pills will the nurse provide with each dose? __________ pills

Question 48

Which of the following would cause the nurse to suspect that a client taking Glucophage (metformin) may be developing lactic acidosis? Select all that apply.

A) Client reports chills and muscle aches.
B) Blood pressure = 98/54 mmHg.
C) Client reports profound headache and ringing in the ears.
D) Client complains of dizziness and diarrhea.
E) White blood cell count = 7,500 cell/mm3.
F) Pupils are dilated and unresponsive to light.