Question 1

To monitor the peak efficacy after providing oral Dilaudid (hydromorphone)Immediate Release for a patient reporting pain ranked 6 out of 10 on a numeric pain scale.The patient should report some relief in pain at the peak action of the drug.Which of the following reflects the peak action of Dilaudid Immediate Release?

Accepted Answer

A) 15-30min 
B) 30-90 min 
C) 1-2 hr 
D) Over 2 hr

Question 2

The nurse is caring for an individual receiving intravenous Vancocin (vancomycin).Which of the following assessments is most important to prevent permanent complication?

Accepted Answer

A) Serum vancomycin levels 
B) Visual acuity 
C) Gag reflex 
D) Deep tendon reflexes

Question 3

The nurse receives a call from an 82-year-old patient with advanced prostate cancer who is being treated with Eligard (leuprolide)therapy.Which of the following statements requires immediate notification of the physician?

Accepted Answer

A) "I've been having hot flashes lately,what should I do?" 
B) "The pain in my bones seems worse since I started this medication." 
C) "I forgot to get my shot 3 hours ago like I usually do,so I was going to take it now;is that okay?" 
D) "My legs feel numb and weak;is that normal with this medication?"

Question 4

The nurse recognizes that which of the following individuals will need to receive supplemental vitamin B₁₂ injections?

Accepted Answer

A) A 37-year-old patient with acute renal calculi. 
B) A 59-year-old patient with gastric resection for stomach cancer. 
C) A 24-year-old patient with sickle cell anemia. 
D) A 58-year-old patient with congestive heart failure.

Question 5

While preparing to discharge a patient who has started taking Lopressor (metoprolol)during their hospitalization,the nurse recognizes further teaching is necessary by which of the following statements:

Accepted Answer

A) "I should take my pulse every day before taking this medication." 
B) "I need to stay on a low-salt diet to help control my blood pressure." 
C) "I'll have to have my blood drawn frequently to monitor for toxic levels of this medication." 
D) "I should contact the physician immediately if I notice any wheezing,difficulty breathing,or dizziness."

Question 6

The nurse is caring for a patient who is NPO after midnight for a cardiac catheterization scheduled for 1 p.m.The patient normally receives Glucophage (metformin)1,000 mg po BID,and the morning dose is due at 8:30 a.m.The patient's blood glucose result was 115.Which of the following actions should the nurse take?

Accepted Answer

A) Hold the medication. 
B) Give the medication with a glass of juice. 
C) Give the medication with a sip of water. 
D) Call the physician for direction.

Question 7

An individual with a history of angina takes sublingual nitroglycerine to relieve chest pain ranked 6/10.Five min later,the chest pain is 4/10.What action should the nurse take next?

Accepted Answer

A) Have a family member call 911. 
B) Tell the individual to take a warm shower. 
C) Instruct the individual to take another sublingual nitroglycerine tablet. 
D) Monitor the individual for an additional 10 min before taking any action.

Question 8

A nurse caring for a patient who's prescribed Inderal LA (propranolol)is being tapered off over a 2-wk period.The nurse would include which of the following statements in the patient teaching?

Accepted Answer

A) "I bet you're glad to be getting off this medication since it is so expensive." 
B) "Stopping this medication suddenly can be very dangerous,so it is important that you follow the taper schedule carefully." 
C) "Patients usually only take this drug for a 1-2 wk cycle before switching to another medication." 
D) "By slowly weaning you from this drug,the risk of rebound headaches is reduced."

Question 9

A student nurse caring for a patient who is taking Creon (pancrelipase)would include which of the following statements when reviewing medications with the instructor?

Accepted Answer

A) "This reduces inflammation of the pancreas seen with pancreatitis." 
B) "This increases absorption of fats since the pancreas is not excreting normal enzymes." 
C) "This is used to bind with proteins and reduce protein excretion in the urine." 
D) "This helps relieve abdominal pain caused by liver damage in patients with a history of alcohol abuse."

Question 10

A neighbor says to the nurse,"My arthritis is getting worse in this cold weather;what can I take?" The nurse would base the response on the knowledge that which of the following medications would provide both pain relief and help decrease inflammation associated with arthritis.Select all that apply.

Accepted Answer

A) Ecotrin (aspirin) 
B) Choline and magnesium salicylates 
C) Tylenol (acetaminophen) 
D) Advil (ibuprofen) 
E) Excedrin
F)Acephen (acetaminophen)

Question 11

The nurse is caring for a patient who recently started taking Compro (prochlorperazine)10 mg po QID.Which of the following symptoms would cause the nurse to contact the physician immediately?

Accepted Answer

A) Temp = 104.5°F and new onset urinary incontinence. 
B) Pulse = 70 bpm and patient complains of constipation. 
C) Blood pressure = 126/64 mmHg and complaints of hiccups. 
D) Respirations = 18 per min and patient reports mild nausea.

Question 12

At a follow-up appointment at the urologist's office,the nurse is gathering data on a patient who takes VESIcare (solifenacin)for an overactive bladder.Which of the following statements would be most concerning to the nurse?

Accepted Answer

A) I started taking an aerobics class twice a week. 
B) I drink three cups of coffee each day. 
C) I smoke a half pack of cigarettes a day. 
D) A friend recommended St.John's wort and I've been taking that for a few weeks now.

Question 13

The nurse is caring for a patient receiving Aredia (pamidronate)for the treatment of Paget's disease.Which of the following symptoms would be most concerning to the nurse?

Accepted Answer

A) Anorexia 
B) Bone pain 
C) Constipation 
D) Muscle twitching

Question 14

A nurse working in the health department recognizes that the shingles vaccine (Zostavax)is contraindicated for which of the following individuals? Select all that apply.

Accepted Answer

A) A 55-year-old patient with a history of atrial fibrillation 
B) A 49-year-old patient with HIV 
C) A 61-year-old patient with an upper respiratory infection;T = 101.4°F 
D) A 33-year-old patient who is 6 wk pregnant 
E) A 42-year-old patient with an allergy to eggs
F)A 51-year-old patient with a history of chronic obstructive pulmonary disease

Question 15

An infant being treated for colic was prescribed Mylicon (simethicone)drops and has returned to the clinic for follow-up evaluation.Which of the following nursing action has the highest priority?

Accepted Answer

A) Assessment of the infant's startle reflex. 
B) Gentle palpation of the anterior fontanel. 
C) Inspection and auscultation of the abdomen. 
D) Measurement of the infant's head circumference.

Question 16

The nurse is caring for a woman in labor who is given Talwin (pentazocine).Which of the following actions should the nurse take next?

Accepted Answer

A) Elevate the side rails and instruct the patient to call before attempting to ambulate. 
B) Prepare for the placement of an internal monitoring device. 
C) Encourage the client to lie on her right side. 
D) Monitor the patient's blood pressure every 15 min.

Question 17

A nurse working at an adult care center for individuals with mental illness provides an individual with their dose of Risperdal (risperidone).The nurse should intervene if the client mixes the liquid medication with which of the following?

Accepted Answer

A) Milk 
B) Cola 
C) Orange juice 
D) Water

Question 18

A student nurse caring for a client with a history of anxiety disorder would expect which of the following medications to be included in the patient's treatment plan?

Accepted Answer

A) Atarax (hydroxyzine) 
B) Bonine (meclizine) 
C) Ativan (lorazepam) 
D) Adalat CC (nifedipine)

Question 19

A nurse caring for an individual taking Avandia (rosiglitazone)monitors which of the following lab results to help evaluate treatment effectiveness?

Accepted Answer

A) Glycosylated hemoglobin 
B) Serum calcium 
C) Serum iron 
D) Cardiac troponin

Question 20

The nurse prepares to provide Zofran (ondansetron)in orally disintegrating tablet.Which of the following instructions should the nurse provide?

Accepted Answer

A) "Simply suck on the pill like a lozenge,and it will dissolve over a few minutes." 
B) "Place the tablet on your tongue;it will melt in seconds and then you can swallow." 
C) "Take this with a full swallow of water." 
D) "I will dissolve this in some water,and you can drink it in one sip."

Exam 2: Detecting and Managing Adverse Drug Reactions

The nurse is caring for an individual receiving intravenous Vancocin (vancomycin) .Which of the following assessments is most important to prevent permanent complication?

The nurse receives a call from an 82-year-old patient with advanced prostate cancer who is being treated with Eligard (leuprolide) therapy.Which of the following statements requires immediate notification of the physician?

The nurse recognizes that which of the following individuals will need to receive supplemental vitamin B₁₂ injections?

While preparing to discharge a patient who has started taking Lopressor (metoprolol) during their hospitalization,the nurse recognizes further teaching is necessary by which of the following statements:

An individual with a history of angina takes sublingual nitroglycerine to relieve chest pain ranked 6/10.Five min later,the chest pain is 4/10.What action should the nurse take next?

A nurse caring for a patient who's prescribed Inderal LA (propranolol) is being tapered off over a 2-wk period.The nurse would include which of the following statements in the patient teaching?

A student nurse caring for a patient who is taking Creon (pancrelipase) would include which of the following statements when reviewing medications with the instructor?

A neighbor says to the nurse,"My arthritis is getting worse in this cold weather;what can I take?" The nurse would base the response on the knowledge that which of the following medications would provide both pain relief and help decrease inflammation associated with arthritis.Select all that apply.

The nurse is caring for a patient who recently started taking Compro (prochlorperazine) 10 mg po QID.Which of the following symptoms would cause the nurse to contact the physician immediately?

At a follow-up appointment at the urologist's office,the nurse is gathering data on a patient who takes VESIcare (solifenacin) for an overactive bladder.Which of the following statements would be most concerning to the nurse?

The nurse is caring for a patient receiving Aredia (pamidronate) for the treatment of Paget's disease.Which of the following symptoms would be most concerning to the nurse?

A nurse working in the health department recognizes that the shingles vaccine (Zostavax) is contraindicated for which of the following individuals? Select all that apply.

An infant being treated for colic was prescribed Mylicon (simethicone) drops and has returned to the clinic for follow-up evaluation.Which of the following nursing action has the highest priority?

The nurse is caring for a woman in labor who is given Talwin (pentazocine) .Which of the following actions should the nurse take next?

A nurse working at an adult care center for individuals with mental illness provides an individual with their dose of Risperdal (risperidone) .The nurse should intervene if the client mixes the liquid medication with which of the following?

A student nurse caring for a client with a history of anxiety disorder would expect which of the following medications to be included in the patient's treatment plan?

A nurse caring for an individual taking Avandia (rosiglitazone) monitors which of the following lab results to help evaluate treatment effectiveness?

The nurse prepares to provide Zofran (ondansetron) in orally disintegrating tablet.Which of the following instructions should the nurse provide?