Question 1

The nurse is caring for a patient experiencing dysphagia and weight loss due to oral mucositis.Which of the following should be the nurse's highest priority?

Accepted Answer

A) Instruct the patient to use hydrogen-peroxide-based mouthwash three times daily. 
B) Provide Xylocaine (viscous lidocaine)topically prior to meals. 
C) Encourage normal saline rinses each morning. 
D) Order a puree diet.

Question 2

The nurse receives a call from the parent of an 8-year-old boy who is home sick from school with a headache,sinus congestion,and a cough.The parent asks,"Can I give him some Benadryl to help him breathe easier?" Which of the following statements by the nurse is best?

Accepted Answer

A) "How long has your child been ill?" 
B) "It should be fine if he weighs more than 50 pounds." 
C) "What other over-the-counter medications have you given him?" 
D) "That might make him sleepy,so it is best to give it at night."

Question 3

A nurse working in hospice is providing care for a patient reporting increased instances of pain.Which of the following factors would indicate the patient is a good candidate for Fentanyl /transmucosal (ACTIQ)therapy?

Accepted Answer

A) The patient reports breakthrough pain 8 out of 10. 
B) The patient currently takes greater than 60 mg of oral morphine scheduled around the clock per day. 
C) The patient has pancreatic cancer. 
D) The patient has an allergy to hydromorphone.

Question 4

A 37-year-old male was brought to the emergency room in thyroid crisis.Which medication will likely be ordered?

Accepted Answer

A) Potassium chloride 
B) Potassium gluconate 
C) Potassium iodide 
D) Potassium

Question 5

The nurse is caring for a patient who has been on multiple antibiotics for the treatment of pneumonia.The patient reports having a sore throat.The nurse notes a white coating on the patient's tongue as well as redness to the lips and gums.The nurse would most likely contact the physician to request which of the following?

Accepted Answer

A) Pamelor (nortriptyline)25 mg capsules three times daily 
B) Nimodipine 30 mg capsules every 4 hr 
C) Zyprexa (olanzapine)5 mg tablet daily 
D) Nilstat (nystatin)400,000 unit lozenge four times daily

Question 6

The nurse receives orders to begin Cardura (doxazosin)1 mg daily with the first dose to start today.Which of the following assessments is the highest priority within the first 2 to 4 hr after provision?

Accepted Answer

A) Urinary output 
B) Respiratory rate 
C) Pain relief 
D) Orthostatic hypotension

Question 7

The nurse is caring for a patient with otitis media who reports an allergy to penicillin.Orders are received for ampicillin 500 mg every 8 hr.Which of the following actions by the nurse is best?

Accepted Answer

A) Provide the medication as ordered. 
B) Call the pharmacist to request a substitution. 
C) Ask the patient if he or she has taken ampicillin in the past. 
D) Hold the medication.

Question 8

The nurse is caring for a pediatric patient who needs to have an IV line started.The nurse plans to provide EMLA cream (lidocaine/prilocaine)to the patient's arm.Which of the following actions should the nurse take?

Accepted Answer

A) Rub the cream onto a 2-inch surface of the arm 15 min prior to the procedure. 
B) Rub the cream onto a 6-inch surface of the arm 30-45 min prior to the procedure. 
C) Place a thick layer of cream under an occlusive dressing on a 2-inch site 1 hr prior to the procedure. 
D) Place a thin layer of cream under an occlusive dressing on a 6-inch site 20 min prior to the procedure.

Question 9

Which laboratory values should be monitored for a person receiving Heparin? Select all that apply.

Accepted Answer

A) CBC 
B) WBC 
C) PT 
D) aPTT 
E) Platelet count
F)D-Dimer

Question 10

When taking Catapres (clonidine),which of the following exercise activities should be avoided?

Accepted Answer

A) Weight lifting 
B) Squat thrusts 
C) Bicycling 
D) Jogging

Question 11

The nurse providing therapy with Simponi (golimumab)recognizes the patient must be meticulously screened for which of the following?

Accepted Answer

A) A history of active or latent tuberculosis 
B) The presence of orthostatic hypotension 
C) Risk factors associated with acute respiratory distress syndrome 
D) A history of poorly controlled diabetes mellitus

Question 12

The nurse is providing care for a patient taking Plavix (clopidogrel).Which of the following laboratory results would be most important for the nurse to evaluate?

Accepted Answer

A) Urine-specific gravity 
B) Albumin 
C) Bleeding time 
D) Potassium

Question 13

The nurse is counseling a 55-year-old woman who is to begin taking Fosamax (alendronate)to prevent osteoporosis.Which of the following instructions by the nurse is best?

Accepted Answer

A) Instruct the patient to take each dose with breakfast. 
B) Instruct the patient to take each dose on an empty stomach. 
C) Instruct the patient to take each dose with orange juice. 
D) Instruct the patient to take each dose just prior to bedtime.

Question 14

Which of the following would cause the nurse to suspect that a patient taking Lexapro (escitalopram)may be developing serotonin syndrome? Select all that apply.

Accepted Answer

A) Pulse = 122 bpm 
B) Patient reports seeing blue spiders on the wall. 
C) Patient's blood glucose = 93 g/dL. 
D) Patient complains of nausea and diarrhea. 
E) White blood cell count = 5,500 cell/mm³.
F)Urinary output = 600 mL in 8 hr.

Question 15

The nurse is preparing to provide routine morning medications,which include Synthroid (levothyroxine).Which of the following assessments should be done prior to administration?

Accepted Answer

A) Apical pulse rate 
B) Serum sodium level 
C) Deep tendon reflexes 
D) Pupils' response to light

Question 16

The nurse is caring for a patient with colorectal cancer who has been receiving continuous infusion chemotherapy at home.The patient complains of mouth sores and difficulty swallowing.Upon exam,the homecare nurse notes a whitish coating on the tongue and mucosal breakdown on the inner cheeks and lips.The nurse informs the patient,"The sores in your mouth are caused by the chemotherapy,but it looks like you may also have a secondary yeast infection in your mouth and throat.I will call the doctor so you can be seen right away." The nurse recognizes which of the following medications will most likely be ordered to treat the esophageal candidiasis once the patient is seen by a physician?

Accepted Answer

A) Ditropan XL (oxybutynin) 
B) Fosamax (alendronate) 
C) Fluoroplex (fluorouracil) 
D) Diflucan (fluconazole)

Question 17

The nurse recognizes that Apriso (mesalamine)would most likely be included in the plan of care for which of the following patients?

Accepted Answer

A) A 52-year-old patient with chronic obstructive pulmonary disease (COP
D) . 
B) A 49-year-old patient with acute cholelithiasis. 
C) A 37-year-old patient with ruptured ectopic pregnancy. 
D) A 27-year-old patient with ulcerative colitis.

Question 18

Mrs.Lawson,a 2nd-grade teacher,tells the school nurse that she has started taking echinacea so that she will not get sick this school year.What is the nurse's best response?

Accepted Answer

A) "That is terrific.I think you will notice a big difference in how you feel." 
B) "Echinacea should only be taken when you feel symptoms of a cold starting." 
C) "It is best to get a therapeutic level of echinacea before being exposed to sick children." 
D) "Are you taking vitamin C as well,because echinacea needs to be taken in conjunction with vitamin C?"

Question 19

The nurse is caring for a patient recently started on Seroquel (quetiapine).Which assessment finding would indicate that treatment was effective?

Accepted Answer

A) BP = 178/82 
B) Patient denies hearing voices in his head. 
C) Urine output was 350 mL in 8 hr. 
D) Patient reported pain was a 2 on a 1-10 scale.

Question 20

Prior to the administration of Humira (adalimumab)the nurse should assess which of the following laboratory values?

Accepted Answer

A) Blood glucose 
B) White blood cell count 
C) Red blood cell count 
D) Hemoglobin and hematocrit

Exam 1: Medication Errors: Improving Practices and Patient Safety

The nurse is caring for a patient experiencing dysphagia and weight loss due to oral mucositis.Which of the following should be the nurse's highest priority?

The nurse receives a call from the parent of an 8-year-old boy who is home sick from school with a headache,sinus congestion,and a cough.The parent asks,"Can I give him some Benadryl to help him breathe easier?" Which of the following statements by the nurse is best?

A nurse working in hospice is providing care for a patient reporting increased instances of pain.Which of the following factors would indicate the patient is a good candidate for Fentanyl /transmucosal (ACTIQ) therapy?

A 37-year-old male was brought to the emergency room in thyroid crisis.Which medication will likely be ordered?

The nurse receives orders to begin Cardura (doxazosin) 1 mg daily with the first dose to start today.Which of the following assessments is the highest priority within the first 2 to 4 hr after provision?

The nurse is caring for a patient with otitis media who reports an allergy to penicillin.Orders are received for ampicillin 500 mg every 8 hr.Which of the following actions by the nurse is best?

The nurse is caring for a pediatric patient who needs to have an IV line started.The nurse plans to provide EMLA cream (lidocaine/prilocaine) to the patient's arm.Which of the following actions should the nurse take?

Which laboratory values should be monitored for a person receiving Heparin? Select all that apply.

When taking Catapres (clonidine) ,which of the following exercise activities should be avoided?

The nurse providing therapy with Simponi (golimumab) recognizes the patient must be meticulously screened for which of the following?

The nurse is providing care for a patient taking Plavix (clopidogrel) .Which of the following laboratory results would be most important for the nurse to evaluate?

The nurse is counseling a 55-year-old woman who is to begin taking Fosamax (alendronate) to prevent osteoporosis.Which of the following instructions by the nurse is best?

Which of the following would cause the nurse to suspect that a patient taking Lexapro (escitalopram) may be developing serotonin syndrome? Select all that apply.

The nurse is preparing to provide routine morning medications,which include Synthroid (levothyroxine) .Which of the following assessments should be done prior to administration?

The nurse recognizes that Apriso (mesalamine) would most likely be included in the plan of care for which of the following patients?

Mrs.Lawson,a 2nd-grade teacher,tells the school nurse that she has started taking echinacea so that she will not get sick this school year.What is the nurse's best response?

The nurse is caring for a patient recently started on Seroquel (quetiapine) .Which assessment finding would indicate that treatment was effective?

Prior to the administration of Humira (adalimumab) the nurse should assess which of the following laboratory values?