NU 115 Final Past Paper PDF

Position the patient on the left side for rectal suppository insertion. The suppository is then lubricated with a small amount of water-soluble lubricant, not petroleum-based substances. The patient is told to take a deep breath and exhale through the mouth during insertion. Then, the patient needs...

Position the patient on the left side for rectal suppository insertion. The suppository is then lubricated with a small amount of water-soluble lubricant, not petroleum-based substances. The patient is told to take a deep breath and exhale through the mouth during insertion. Then, the patient needs to remain lying on the left side for 15 to 20 minutes to allow absorption of the drug. DIF: Cognitive Level: Applying (Application) If you need any other Test Banks or eTextbooks contact us: [email protected] 16. 17. TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies A patient is receiving eyedrops that contain a beta-blocker medication. The nurse will use what method to reduce systemic effects after administering the eyedrops? a. b. c. Wiping off excess liquid immediately after instilling the drops Having the patient close the eye tightly after the drops are instilled Having the patient try to keep the eye open for 30 seconds after the drops are instilled d. Applying gentle pressure to the patient‘s nasolacrimal duct for 30 to 60 seconds after instilling the drops ANS: D When administering ophthalmic drugs that may cause systemic effects, one‘s finger should be protected by a clean tissue or glove and gentle pressure applied to the patient‘s nasolacrimal duct for 30 to 60 seconds. The other actions are not appropriate. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies A 2-year-old child is to receive eardrops. The nurse is teaching the parent about giving the eardrops. Which statement reflects the proper technique for administering eardrops to this child? a. b. c. d. Administer the drops without pulling on the ear lobe. Straighten the ear canal by pulling the lobe upward and back. Straighten the ear canal by pulling the pinna down and back. Straighten the ear canal by pulling the pinna upward and outward. ANS: C If you need any other Test Banks or eTextbooks contact us: [email protected] 18. 19. In an infant or a child younger than 3 years of age, the ear canal is straightened by pulling the pinna down and back. In adults, the pinna is pulled up and outward. Pulling the lobe and administering eardrops without pulling on the ear lobe are not appropriate actions. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies A patient with asthma is to begin medication therapy using a metered-dose inhaler. What is an important reminder to include during teaching sessions with the patient? a. b. c. d. Repeat subsequent puffs, if ordered, after 5 minutes. Inhale slowly while pressing down to release the medication. Inhale quickly while pressing down to release the medication. Administer the inhaler while holding it 3 to 4 inches away from the mouth. ANS: B Position the inhaler to an open mouth, with the inhaler 1 to 2 inches away from the mouth, or attach a spacer to the mouthpiece of the inhaler, or place the mouthpiece in the mouth. To administer, press down on the inhaler to release the medication while inhaling slowly. Wait 1 to 2 minutes between puffs if a second puff of the same medication has been ordered. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies When giving parenteral medications, the nurse will use Standard Precautions, which include what action? a. b. c. d. Bending the needle to prevent reuse Recapping needles to prevent needle sticks Discarding all syringes and needles in the trash can Discarding all syringes and needles in a puncture-resistant container If you need any other Test Banks or eTextbooks contact us: [email protected] 20. 21. ANS: D Standard Precautions include wearing clean gloves when there is potential exposure to a patient‘s blood or other body fluids; never recapping needles; never bending needles or syringes; and discarding all disposable syringes and needles in the appropriate puncture-resistant container. DIF: Cognitive Level: Remembering (Knowledge) TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control A patient says he prefers to chew rather than swallow his pills. One of the pills has the abbreviation SR behind the name of the medication. The nurse needs to remember which correct instruction regarding how to give this medication? a. Break the tablet into halves or quarters. b. Dissolve the tablet in a small amount of water before giving it. c. Do not crush or break the tablet before administration. d. Crush the tablet as needed to ease administration. ANS: C Sustained-release (SR) and enteric-coated tablets or capsules are forms of medications that must not be crushed before administration so as to protect the gastrointestinal lining or the medication itself. Do not break, dissolve, or crush these tablets before administering. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control When administering nasal spray, which instruction by the nurse is appropriate? a. b. c. ―You will need to blow your nose before I give this medication.‖ ―You will need to blow your nose after I give this medication.‖ ―When I give this medication, you will need to hold your breath.‖ If you need any other Test Banks or eTextbooks contact us: [email protected] d. ―You need to sit up for 5 minutes after you receive the nasal spray.‖ ANS: A Clear the nasal passages before receiving nasal spray. Blowing one‘s nose after receiving the medication will remove the medication from the nasal passages. The patient will receive the spray while inhaling through the open nostril and needs to remain in a supine position for 5 minutes afterward. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies MULTIPLE RESPONSE 1. The nurse is preparing to give an aqueous intramuscular (IM) injection to an average-sized adult. Which actions are appropriate? (Select all that apply.) a. b. c. d. e. f. Choose a 26- or 27-gauge, 1/4- to 1/2-inch needle. Choose a 20- to 25-gauge, 1- to 1 1/2-inch needle. Choose the dorsogluteal site, the preferred site for IM injections for adults. Insert the needle at a 45-degree angle. Insert the needle at a 90-degree angle. Before injecting the medication, withdraw the plunger to check for blood return. ANS: B, E, F In general, aqueous medications can be given with a 20- to 25-gauge needle, and average needle lengths for adults range from 1 to 1 1/2 inches. Insert the needle at a 90-degree angle. Checking for blood return is also part of the technique for IM injections to prevent inadvertent administration into the bloodstream. The ventrogluteal site is the preferred site for IM injections in adults. The dorsogluteal site is to be avoided because of proximity to nerves and blood vessels. If you need any other Test Banks or eTextbooks contact us: [email protected] DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies COMPLETION 1. A patient is to receive hydromorphone 1.5 mg IV push now. The medication comes in a prefilled syringe, 2 mg/mL. Identify how many milliliters the nurse will administer for this dose. ANS: 0.75 mL 2 mg:1 mL::1.5 mg:x mL (2 x) = (1 1.5); 2x = 1.5; x = 0.75; administer 0.75 mL. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies Chapter 07: Over-the-Counter Drugs and Herbal and Dietary Supplements Lilley: Pharmacology and the Nursing Process, 10th Edition MULTIPLE CHOICE 1. A 25-year-old woman is visiting the prenatal clinic and shares with the nurse her desire to go ―natural‖ with her pregnancy. She shows the nurse a list of herbal remedies that she wants to buy so that she can ―avoid taking any drugs.‖ Which statement by the nurse is correct? a. ―Most herbal remedies are not harmful and are safe for use during pregnancy.‖ b. c. d. ―Please read each label carefully before use to check for cautionary warnings.‖ ―Keep in mind that products from different manufacturers are required to contain consistent amounts of the herbal products.‖ ―It‘s important to remember that herbal remedies do not have proven safety ratings for pregnant women.‖ ANS: D The fact that a drug is an herbal or a dietary supplement does not mean that it can be safely administered to children, infants, or pregnant or lactating women. Many herbal products have not been tested for safety during pregnancy. Simply reading the labels may not provide enough information for use during pregnancy. Last, manufacturers of herbal products are not required to guarantee the reliability of the contents. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 2. The nurse is giving a lecture about current U.S. laws and regulations of herbal products. According to the United States Dietary Supplement and Health Education Act of 1994, which statement is true? If you need any other Test Banks or eTextbooks contact us: [email protected] a. b. c. d. Medicinal herbs are viewed as dietary supplements. Herbal remedies are held to the same standards as drugs. Producers of herbal products must prove therapeutic efficacy. Herbal remedies are protected by patent laws. ANS: A Current U.S. laws view herbal products as dietary supplements and do not hold them to the same efficacy standards as drugs. The other options do not correctly reflect current U.S. laws regarding herbal supplements. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 3. The patient wants to take the herbal product kava to help him rest at night. The nurse would be concerned about potential interactions if he is taking a medication from which class of drugs? a. Digitalis b. Anticoagulants c. Sedatives d. Immunosuppressants ANS: C Kava may cause increased central nervous system depression if used with sedatives. Digitalis, anticoagulants, and immunosuppressants do not have interactions with kava. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential If you need any other Test Banks or eTextbooks contact us: [email protected] 4. 5. The patient has been taking an over-the-counter (OTC) acid-reducing drug because he has had ―stomach problems‖ for several months. He tells the nurse that the medicine helps as long as he takes it, but once he stops it, the symptoms return. Which statement by the nurse is the best advice for this patient? a. b. ―The over-the-counter drug has helped you, so you should continue to take it.‖ ―The over-the-counter dosage may not be strong enough. You should be taking prescription-strength for best effects.‖ c. ―For best results, you need to watch what you eat in addition to taking this drug.‖ d. ―Using this drug may relieve your symptoms, but it does not address the cause. Please make an appointment with your health care provider.‖ ANS: D The use of OTC drugs may postpone effective management of chronic disease states and may delay treatment of serious or life-threatening disorders because these drugs may relieve symptoms without necessarily addressing the cause of the disorder. The other options do not address the need to investigate the cause of the symptoms and are incorrect. DIF: Cognitive Level: Applying (Application) Planning MSC: NCLEX: Safe and Effective Care Environment: Management of Care TOP: Nursing Process: During an assessment, the patient tells the nurse that he takes a garlic supplement for its cardiovascular benefits. Which drug or drug class, if taken, would have a potential interaction with the garlic? a. Acetaminophen (Tylenol) b. Insulin c. Antilipemic drugs d. Sedatives ANS: B If you need any other Test Banks or eTextbooks contact us: [email protected] 6. 7. The use of garlic may interfere with hypoglycemic drugs. The other options are incorrect because acetaminophen, antilipemic drugs, and sedatives do not have interactions with garlic. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential A patient calls the clinic to ask about taking cranberry dietary supplement capsules because a friend recommended them. The nurse will discuss which possible concern when a patient is taking cranberry supplements? a. b. It may increase the risk for bleeding if the patient is taking anticoagulants. It may increase the risk of toxicity of some psychotherapeutic drugs. c. d. It may reduce elimination of drugs that are excreted by the kidneys. Cranberry may increase the intensity and duration of effects of caffeine. ANS: C The use of cranberry decreases the elimination of many drugs that are renally excreted. The other concerns do not occur with cranberry supplements. DIF: Cognitive Level: Applying (Application) Planning MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential TOP: Nursing Process: A patient wants to take the herb gingko to help his memory. The nurse reviews his current medication list and would be concerned about potential interactions if he is taking a medication from which class of drugs? a. Digitalis b. Antiplatelet drugs c. Sedatives d. Immunosuppressants ANS: B If you need any other Test Banks or eTextbooks contact us: [email protected] The use of gingko increases the risk of bleeding with antiplatelet drugs (aspirin, clopidogrel) and anticoagulants (warfarin, heparin). The other concerns do not occur with gingko supplements. DIF: Cognitive Level: Applying (Application) Planning MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential TOP: Nursing Process: MULTIPLE RESPONSE 1. The nurse is conducting a class for senior citizens about the use of over-the-counter (OTC) drugs. Which statements are true regarding the use of OTC drugs? (Select all that apply.) a. b. c. d. e. Use of OTC drugs may delay treatment of serious ailments. Drug interactions with OTC medications are rare. OTC drugs may relieve symptoms without addressing the cause of the problem. OTC drugs are indicated for long-term treatment of conditions. Patients may misunderstand product labels and use the drugs improperly. ANS: A, C, E It is true that use of OTC drugs may delay treatment of serious ailments; OTC drugs may relieve symptoms without addressing the cause of the problem, and patients may misunderstand product labels and use the drugs improperly. These statements should be included when teaching patients about their use. In contrast, drug interactions with OTC medications are not rare and may indeed occur with prescription medications and other OTC drugs. Normally, OTC drugs are intended for short-term treatment of minor ailments. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 2. The nurse is reviewing the criteria for over-the-counter drugs. Which criteria for over-the-counter status in the United States are accurate? (Select all that apply.) If you need any other Test Banks or eTextbooks contact us: [email protected] a. b. c. d. e. The drug must be easy to use. The drug must have a low therapeutic index. The consumer must be able to monitor the drug‘s effectiveness. The drug must have a low potential for abuse. The drug must not have any interactions with other drugs. ANS: A, C, D In the United States, criteria for over-the-counter status include the drug being easy to use, the drug having a low potential for abuse, and the consumer must be able to monitor the drug‘s effectiveness for the condition. The drug must have a high therapeutic index (not a low one), and the drug must have limited interactions with other drugs. DIF: Cognitive Level: Applying (Application) General TOP: Nursing Process: MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies COMPLETION 1. A patient with a PEG tube is to receive ferrous sulfate, 75 mg per the tube, daily. The medication is available as an elixir, 220 mg/5 mL. How many milliliters will the patient receive per dose? Record your answer using one decimal place. ANS: 1.7 mL 220 mg:5 mL::75 mg:x mL (220 mL/dose. x) = (5 75); 220x = 375; x = 1.704 which rounds to 1.7 Chapter 03: Lifespan Considerations Lilley: Pharmacology and the Nursing Process, 10th Edition MULTIPLE CHOICE 1. 2. 3. Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason? a. Decreased fetal surface area b. Increased placental surface area c. Enhanced blood flow to the fetus d. Increased amount of protein-bound drug in maternal circulation ANS: C Drug transfer to the fetus is more likely during the last trimester of pregnancy as a result of enhanced blood flow to the fetus. The other options are incorrect. Increased fetal surface area, not decreased, is a factor that affects drug transfer to the fetus. The placenta‘s surface area does not increase during this time. Drug transfer is increased because of an increased amount of free drug, not protein-bound drug, in the mother‘s circulation. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: General MSC: NCLEX: Health Promotion and Maintenance The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk, but the potential benefits may warrant the use of the medications in her situation. The nurse recognizes that these medications are in which U.S. Food and Drug Administration pregnancy safety category? a. Category A b. Category B c. Category C d. Category D ANS: D Pregnancy category D fits the description given. Category A indicates no risk to the human fetus; Category B indicates no risk to animal fetus; information for humans is not available. Category C indicates adverse effects reported in animal fetus; information for humans is not available. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations? a. West nomogram b. Clark rule c. Height-to-weight ratio d. Milligram per kilogram of body weight formula ANS: D The milligram per kilogram formula, based on body weight, is the most common method of If you need any other Test Banks or eTextbooks contact us: [email protected] 4. 5. 6. calculating doses for pediatric patients. Height-to-weight ratio is not used. The other options are available methods but are not the most commonly used. DIF: Cognitive Level: Remembering (Knowledge) TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy? a. b. c. d. The patient is experiencing multiple illnesses. The patient uses one medication for an illness several times per day. The patient uses over-the-counter drugs for an illness. The patient uses multiple medications simultaneously. ANS: D Polypharmacy usually occurs when a patient has several illnesses and takes medications for each of them, possibly prescribed by different specialists who may be unaware of other treatments the patient is undergoing. The other options are incorrect. Polypharmacy addresses the medications taken, not just the illnesses. Polypharmacy means the patient is taking several different medications, not just one, and can include prescription drugs, over-the-counter medications, and herbal products. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies The nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses in an elderly patient who is taking which type of drug? a. Laxatives b. Anticoagulants c. Sedatives d. Antidepressants ANS: C Sedatives and hypnotics often cause confusion, daytime sedation, ataxia, lethargy, forgetfulness, and increased risk for falls in the elderly. Laxatives, anticoagulants, and antidepressants may cause adverse effects in the elderly, but not the ones specified in the question. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control For accurate medication administration to pediatric patients, the nurse must consider which of these factors? a. Organ maturity b. Renal output c. Body temperature d. Height ANS: A To administer medications to pediatric patients accurately, one must take into account organ maturity, body surface area, age, and weight. The other options are incorrect; renal output and body temperature are not considerations, and height alone is not sufficient. If you need any other Test Banks or eTextbooks contact us: [email protected] 7. 8. 9. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance The nurse recognizes that an elderly patient may experience a reduction in the stomach‘s ability to produce hydrochloric acid. This change may result in which effect? a. Delayed gastric emptying b. Increased gastric acidity c. Decreased gastrointestinal motility d. Altered absorption of some drugs ANS: D Reduction in the stomach‘s ability to produce hydrochloric acid is an aging-related change that results in a decrease in gastric acidity and may alter the absorption of some drugs. The other options are not results of reduced hydrochloric acid production. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity? a. The lungs are immature. b. The kidneys are small. c. The liver is not fully developed. d. Excretion of the drug occurs quickly. ANS: C A neonate‘s liver is not fully developed and cannot detoxify many drugs. The other options are incorrect. The lungs and kidneys do not play major roles in drug metabolism. Renal excretion is slow, not fast, because of organ immaturity, but this is not the factor that contributes the most to drug toxicity. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Planning dosage has been double-checked and updated MSC: NCLEX: Health Promotion and Maintenance An 83-year-old woman has been given a thiazide diuretic to treat heart failure. She and her caregiver should be told to watch for which problems? a. Constipation and anorexia b. Fatigue, leg cramps, and dehydration c. Daytime sedation and lethargy d. Edema, nausea, and blurred vision ANS: B Electrolyte imbalance, leg cramps, fatigue, and dehydration are common complications when thiazide diuretics are given to elderly patients. The other options do not describe complications that occur when these drugs are given to the elderly. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies If you need any other Test Banks or eTextbooks contact us: [email protected] 10. 11. 12. An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy? a. Drug therapy will be based on the patient‘s weight. b. Drug therapy will be based on the patient‘s age. c. The patient will receive the maximum dose that is expected to reduce the blood pressure. d. The patient will receive the lowest possible dose at first, and then the dose will be increased as needed. ANS: D As a general rule, dosing for elderly patients should follow the admonition, ―Start low, and go slow,‖ which means to start with the lowest possible dose (often less than an average adult dose) and increase the dose slowly, if needed, based on patient response. The other responses are incorrect. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies The nurse is trying to give a liquid medication to a 2 1/2-year-old child and notes that the medication has a strong taste. Which technique is the best way for the nurse to give the medication to this child? a. b. c. d. Give the medication with a spoonful of ice cream. Add the medication to the child‘s bottle. Tell the child you have candy for him. Add the medication to a cup of milk. ANS: A Ice cream or another nonessential food disguises the taste of the medication. The other options are incorrect. If the child does not drink the entire contents of the bottle, medication is wasted and the full dose is not administered. Using the word candy with drugs may lead to the child thinking that drugs are actually candy. If the medication is mixed with a cup of milk, the child may not drink the entire cup of milk, and the distasteful drug may cause the child to refuse