pharm exam review.docx

1\) You are beginning of your day shift, and learn that one of your patients has a Central Venous Access Device (CVAD)infusing his maintenance solution. Which of the following is a priority assessment related to the CVAD: a. Neurological assessment b. Peripheral pulses c. Chest assessment d....

1\) You are beginning of your day shift, and learn that one of your patients has a Central Venous Access Device (CVAD)infusing his maintenance solution. Which of the following is a priority assessment related to the CVAD: a. Neurological assessment b. Peripheral pulses c. Chest assessment d. Gastrointestinal assessment 2\) Which of the following patients would be a candidate for insertion of a central line: a. A patient with abnormal coagulation studies b. A patient with septicemia c. A patient with immunocompromise related to chemotherapy treatment d. A patient with an existing thrombus in the innominate or subclavian vein 3\) Your patient is receiving multiple medications, including one drug specifically used to stimulate gastric peristalsis. What influence could this drug have on additional oral medications: a. Reduced excretion b. Enhanced distribution c. Increased absorption d. Decreased absorption 4\) A nurse is caring for a client with hepatitis and resulting hepatic impairment. The nurse would expect the duration of action of most of the clients\' medication to a. Be unaffected b. Increase c. Decrease d. Improve 5\) Each of the following statements describes a phase of pharmacokinetics. Place the statements in order: a. A drug binds to plasma protein albumin and circulates through the body- phase 2 b. Enzymes in the liver transform the drug into an inactive metabolite- phase 3 c. Drug metabolites are secreted through passive glomerular filtration into renal tubules- phase 4 d. A drug moves from the intestinal lumen into the mesenteric blood system- phase 1 6\) A drug that delivers 500mg has a half-life of 4 hours. How many milligrams of drug will remain in the body after 1 half-life? a. 250 mg b. 500 mg c. 125 mg d. 75 mg 7\) when considering pharmacodynamic principles for a client\'s drug therapy. The nurse is aware that affinity for receptors is most closely associated with drugs: a. First-pass effect b. Potency c. Half-life d. Metabolism 8\) What evidence does the nurse collect to determine whether the average dose of medication is effective for a client: Select all that apply: a. Route of administration b. Laboratory values c. Dosage d. Physical examination e. Vital signs 9\) The nurse knows that a drug with a high therapeutic index is a. Probably safe b. Often dangerous c. Less likely to be effective d. More likely to cause toxicity 10\) A nurse is monitoring their client for early lithium (Carbolith) toxicity. Which symptoms would indicate that your client is developing toxicity? Select all that apply: a. Confusion b. Ataxia c. Convulsions d. Persistent gastrointestinal upset e. Polyuria 11\) You are the nurse caring for a patient experiencing alcohol withdrawal. Which classification of medication would you expect to be prescribed to your patient? a. Opioid Antagonist b. Thiazides c. Benzodiazepines d. Antidepressants 12\) A patient with a feeding tube has been ordered risperidone 8mg in two divided doses via a feeding tube. The medication is available in a 1 mg solution. How many milliliters will the nurse administer per dose? 13\) You are the nurse caring for a patient who has been newly prescribed fluoxetine (Prozac) 20mg QAM. At the 4-week follow-up appointment, which of the following would be your priority assessment: a. Nutritional intake b. Difficulty with urination c. Platelet count d. Suicidal ideation 14\) A nurse expects that a client experiencing extrapyramidal symptoms during therapy with phenothiazines will be prescribed: a. Haloperidol (Haldol) b. Diazepam (Valium) c. Benztropine (Cogentin) d. Lorazepam (Ativan) 15\) You are a nurse working on an inpatient mental health unit. Your patient has been non-responsive to antipsychotic treatment and has started on Clozapine. Which laboratory test will be performed regularly while the patient is on this medication? a. EEG b. Complete blood count c. Serum drug levels d. WBC count 16\) The nurse is monitoring a client for adverse effects associated with morphine. Which of the following signs/symptoms would the nurse be monitoring for? Select all that apply: a. Hypertension b. Urinary retention c. Respiratory depression d. Constipation e. Nausea 17\) You are caring for the patient who is 3 days post-op from bowel surgery. They are eating soft foods, ambulating regularly, and using oxycodone acetaminophen (Percocet) for pain. What would you include in the nursing care plan? a. Increasing dietary fiber and fluids, assess need for stool softener. b. Weaning pain medication to prevent addiction c. Inserting a urinary catheter for urinary retention d. Monitoring vital signs for respiratory depression 18\) your patient with diabetes reports increasing pain and numbness in his legs. It feels like pins, and needles all the time, especially at night. Which drug would the nurse expect to be prescribed for this client? a. Gabapentin (Neurontin) b. Ibuprofen (Motrin) c. Methadone (Metadol) d. Acetaminophen (Tylenol) 19\) You are caring for several patients who have orders for acetaminophen PRN for pain. As you are reviewing your patient\'s medical histories and assessments you discover that one of your patients has a contraindication to acetaminophen therapy. Which of the following patients should receive an alternate medication? a. A patient with severe hepatitis b. A patient with a fever of 39.8C c. A patient who had abdominal surgery 1 week ago d. A patient admitted with a deep vein thrombosis 20\) You are the nurse caring for several patients receiving opioid analgesics for pain relief. Which of the following patients would be at the highest risk for developing hypotension, respiratory depression, and mental confusion? a. An 86-year-old male had a post-operative femur fracture. b. A 16-year-old male, type 1 diabetes, was involved in a near-fatal motor vehicle accident c. A 54-year-old female, recovering from an acute MI d. A 23-year-old female smoker, recovering from abdominal 21\) A client who is having a scalp laceration sutured will be receiving local anesthesia with lidocaine (Xylocaine) that contains epinephrine. This nurse knows that the purpose of this drug combination is to: a. Increase vasodilation at the site of laceration b. Increase the duration of the anesthetic action c. Decrease blood pressure in individuals who are hypertensive d. Ensure infection at the wound site will not occur. 22\) During a patient\'s recovery from a lengthy surgery, the nurse monitors for sign of malignant hypothermia. In addition to a rapid rise in body temperature, which assessment findings would indicate the possible presence of this condition? Select all that apply: a. Muscle rigidity b. Tachypnea c. Respiratory depression d. Tachycardia e. Decreased levels of CO2 in blood 23\) What is the mechanism of action of non-steroidal anti-inflammatory drugs (NSAIDs) a. Inhibiting prostaglandin production b. Enhancing pain perception c. Increasing the supply of natural endorphins d. Increasing blood flow to painful areas 24\) An order for a child reads, "Give ibuprofen suspension 30mg/kg/day divided into 4 doses, for pain." The child weighs 15 kg. How many mg child receive per dose? 25\) You are providing health teaching to your patient who has started on NSAID therapy. Which of the following adverse effects will you tell your patient to immediately report to their prescriber? a. Diarrhea b. Non-productive cough c. Black, tarry stool d. Mild ingestion 26\) Which statement made by your client would alert the nurse that anti-Parkinson's medication is still effective? a. My skin does not itch anymore b. I am able to shower by myself c. My appetite has improved d. I am sleeping a lot more now, especially during the day 27\) Which considerations are important for the nurse to remember when administering benzodiazepine as a sedative-hypnotic drug? Select all that apply: a. The drug is used as a first choice for the treatment of sleeplessness. b. The drugs can be administered safely with other benzodiazepines for insomnia. c. The patient needs to be evaluated for drowsiness that may occur the next morning d. These drugs are intended for the long-term management of insomnia. e. The dose needs to be given about 1 hour before the patient\'s bedtime. 28\) While teaching a patient about taking a newly prescribed antiepileptic drug (AED), what information should the nurse emphasize? a. If seizures recur, the patient should take a double dose of medication b. Antacids can be taken with the AED to reduce gastrointestinal treatment c. Regular consistent dosing is important for successful treatment d. Driving will be allowed after 2 weeks of therapy. 29\) A nurse is counseling the caregiver of a client with Alzheimer's disease. Which statement by the caregiver would indicate that the session has been effective? a. I should give this medication as symptoms of AD become noticeable b. I will take the client\'s vital signs before every dose of medication c. The medication may improve symptoms, but it will not cure the disease d. If constipation occurs, I will notify the healthcare provider immediately. 30\) A 23-year-old has been taking gabapentin (Neurontin) for control of partial seizures. He is admitted to the emergency department with slurred speech, dyspnea, reports of double vision, and sedation. The admitting nurse suspects the client has: a. taken an overdose of the drug, either accidentally or deliberately b. Taken the drug with grapefruit or grapefruit juice c. not taken his medication for several days and experiencing withdrawal d. Continued to smoke despite prior client education that smoking interacts with the drug 31\) A nurse is teaching a client about the use of an adrenergic, agonist nasal spray at home. What client teaching is needed to be related to this medication? Select all that apply: a. Infants and children should not use this medication b. Symptoms of excessive use of this drug are lethargy and fatigue c. Do not share this medication with another person d. Only use this drug for 3-5 days unless directed by your health provider e. The drug can be safely used by individuals with diarrhea 32\) When an adrenergic drug stimulates b1-adrenergic receptors, the result is an increased force of contraction, which is known as what type of positive effect? a. Dromotropic b. Adrenergic c. Inotropic d. Chronotropic 33\) The healthcare provider prescribes epinephrine (adrenaline) which was stung by several wasps 30 minutes ago. The nurse knows that the primary purpose of this medication for the client is to: a. Increase declining blood pressure and dilate the constricted bronchi associated with anaphylaxis. b. Counteract the formation of antibodies in response to an invading antigen c. Increase the number of WBCs produced to fight the primary invader d. Stop the systemic release of histamine produced by mast cells. 34\) A patient has been on a dopamine drip, and the nurse notices that the infusion has extravasated into the tissue of the forearm. After stopping the infusion, the nurse immediately injects phentolamine into the interstitial catheter. What is the effect of this action? a. It increases the blood flow to the ischemic site by vasodilation and prevents permanent tissue damage b. It causes arterial vasoconstriction and reduced pain and swelling at the site c. It causes vasoconstriction and rapid uptake of extravasated dopamine d. It increases peripheral vascular resistance and reduces arterial pressure at the site 35\) A client takes a dose of salbutamol (Ventolin) prior to bedtime. Which effect would the nurse consider normal to this drug? a. Insomnia b. Sleepiness c. Urticaria d. Tinnitus 36\) The nurse discussing the adverse effects associated with muscarinic agonists knows that reflex tachycardia may occur with this drug because: a. Baroreceptors acknowledge transient hypotension and signal the medulla to increase the heart rate. b. The drug stimulates the sinoatrial node in the right atrium c. Aortic receptors identify episodes of systolic hypertension and stimulate heart rhythms d. This drug stimulates bronchial smooth muscle contraction and a narrowing of the airway 37\) A nurse is discussing the therapeutic effects of bethanechol (Duvoid) with a patient who is receiving this drug for urinary retention. The nurse understands that the bethanechol: a. Changes in the diameter of the urethral opening b. Increase the amount of urine made in the kidney c. Improves blood flow to the kidney d. Increases the contractions of the bladder and structures that promote urination 38\) which of the following is an anticholinergic drug that decreases mucus secretions in the respiratory tract and dries mucous membranes of the mouth, nose, pharynx, and bronchi? a. Acetylcholinesterase (AchE) inhibitors b. Bethanechol c. Atropine d. Ipratropium 39\) A patient who has an accidental overdose of tricyclic antidepressants is to receive physostigmine 1.5mg STAT. the medication is available in a 2ml vial, with a concentration of 1mg/ml. how much medication will the nurse draw up into the syringe for this dose? 40\) The nurse is teaching a patient about the possible adverse effects of donepezil (Aricept) for Alzheimer\'s disease. Which of these are possible adverse effects? Select all that apply. a. Dizziness b. Constipation c. Blurred vision d. Drowsiness e. GI upset 41\) the nurse is providing education to an older adult regarding their newly prescribed cholinergic-blocking drug. Which would be an important point to emphasize for this patient? a. Avoid exposure to high-temperature b. Stop the medication if dry mouth occurs c. Begin an exercise program to avoid adverse effects d. Limit liquid intake to avoid fluid overload 42\) A client is receiving hydralazine (Apresoline) for elevated blood pressure levels. The nurse\'s care plan will include monitoring the client for which adverse effect? a. Atelectasis b. Observing skin pressure points for turgor and integrity c. Orthostatic hypotension d. Photosensitivity 43\) A 65-year-old male client has been newly diagnosed with hypertension with an average blood pressure reading of 164/92 mm Hg. Which of the following drug groups will potentially be ordered initially? Select all that apply. a. Beta-blockers b. Calcium channel blockers c. Thiazide diuretics d. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) e. Direct-acting vasodilators 44\) A patient has a new prescription for ACE inhibitors. During the review of a patient\'s list of current medications, which would cause concern about a possible interaction with tis new prescription. Select all that apply. a. A nonsteroidal anti-inflammatory drug is taken as needed for headaches. b. A benzodiazepine taken as needed for allergies c. An opioid used for occasional severe pain d. A potassium supplement taken daily e. An oral anticoagulant taken daily. 45\) Your patient asks how atenolol (Tenormin) helps angina. The nurse\'s response is based on which concept? The medication: a. Block sodium channels and elevate depolarization b. Decreases blood pressure and block the alpha 2 receptors c. Increases the heart rate and diminishes contractility d. Slows the heart rate and reduces contractility 46\) A client with chest pain is receiving sublingual nitroglycerin. The nurse's care plan will include monitoring the client for what adverse effects? a. Elevated blood pressure b. Decreased blood pressure c. Vomiting and diarrhea d. Photosensitivity 47\) Your patient has been admitted for angina. You understand that angina occurs when: a. The supply of oxygen and nutrients in the blood is insufficient to meet the demands of the heart b. Beta 2 Adrenergic receptors are activated in the lungs and bronchodilation occurs c. There is a deviation from the normal rhythm of the heart. d. The RAAS is decreasing blood volume. 48\) A client newly diagnosed with heart failure and an acute MI has a prescription for enalapril (Vasotec). This drug class is frequently used in early heart failure because of which clinical improvement? a. It has diuretic effects, decreasing peripheral edema and pulmonary congestion b. It strengthens the force of myocardial contraction to improve cardiac output c. It decreases peripheral vascular resistance, increasing cardiac output d. It slows the heart rate, improving filling time and increasing cardiac output 49\) In providing a client with heart failure information prior to discharge, the nurse will discuss digoxin (Lanoxin) therapy. Which point would the nurse include in teaching the client a. Eat a diet high in bran fiber and calcium b. Take the drug in the morning before rising c. Hold your dose if the pulse rate is 70bpm d. Monitor your pulse daily prior to taking the drug. 50\) A patient is taking a beta blocker as a part of the treatment plan for heart failure. The nurse knows that the purpose of beta-blocker for this patient is to do which of the following: a. Prevent stimulation of the heart from circulating catecholamines b. Cause peripheral vasodilation c. Increase the contractility of the heart muscle d. Slows down heart rate and decreases blood pressure 51\) A client with arterial dysrhythmias is being treated with verapamil (Isoptin). The nurse will monitor for therapeutic effectiveness by noting which of the following in the client? a. Increase in the serum potassium level b. Increase in blood pressure c. Reduction in urine output d. Changes in cardiac rhythm 52\) Your client is prescribed propranolol (Inderal) for the treatment of atrial dysrhythmias associated with heart failure. The nurse knows that this drug is used cautiously in clients with heart failure because of which effect? a. It may lead to bronchoconstriction b. It causes sodium retention, worsening congestion c. It is a negative inotropic drug and will decrease myocardial contractility and cardiac output. d. Its adverse effects include hypertension and worsening heart failure 53\) You are providing health teaching to your patient regarding an antidysrhythmic drug. Which of the following health teaching points should the nurse ensure to communicate to their patient? Select all that apply. a. Report weight gain of 2.3 kg or more in one week immediately to the provider b. Stop taking the medication if you are experiencing severe adverse effects c. Take the medication with an antacid if stomach upset occurs d. Do not chew sustained-release capsules e. You may take the medication with food if stomach upset occurs. 54\) You are caring for a patient who has reported a previous allergic reaction to penicillin. You know that this patient may also have sensitivity to which other classifications of antibiotics? a. Cephalosporin b. Sulfonamides c. Tetracyclines d. Macrolides 55\) A client with deep vein thrombosis is being treated with heparin infusion. The nurse will monitor for therapeutic effectiveness by notifying which of the following? a. International normalized ratio (INR) b. Platelet counts c. Prothrombin time (PT) d. Activated partial thromboplastin time (aPTT) 56\) A client taking clopidogrel (Plavix) to prevent another stroke, asks the nurse how the medication works. The nurse\'s response should be based on the knowledge that Plavix: a. Convert plasminogen to plasmin to dissolve fibrin clots b. Inhibits platelet aggregation to prevent clot formation c. Activates antithrombin III and subsequently inhibits thrombin d. Inhibits enzyme involved in the formation of vitamin K 57\) A client who is taking Warfarin (Coumadin) states that I wake up every morning with arthritis pain and I always take aspirin or ibuprofen. The nurse\'s response would be based on which physiological concepts: a. The combination of aspirin products with anticoagulants always worsens arthritis pain b. Aspirin and ibuprofen will counteract the effects of many anticoagulants c. Anticoagulants will reduce the half-life of drugs such as aspirin and ibuprofen d. Many substances such as aspirin and ibuprofen increase the risk of bleeding 58\) Which assessment finding discovered by the nurse would be an expected effect associated with niacin therapy? Select all that apply. a. Fever and chill b. Hypoglycemia c. Dry mucous membranes d. Intense flushing and hot flashes e. Tingling of the fingers and toes 59\) the nurse is caring for a client receiving gemfibrozil (lopid) for hyperlipidemia. The nurse would question the order of the prescriber if the client reported a history of what. Select all that apply a. Diabetes b. Hypertension c. Renal disease d. Gall bladder disease e. Angina 60\) Lipids and lipoproteins participate in the formation of atherosclerotic plaque, which subsequently leads to the development of 61\) The nurse is teaching a group of clients with cardiac conditions who are taking diuretic therapy. The nurse explained the individual prescribed furosemide (Lasix) should: a. Avoid consuming large amounts of cabbage, cauliflower, and kale b. Restrict fluid intake of more than 1000 ml in 24 hours. c. Count their pulse for one full minute before taking the medication d. Rise slowly from sitting and lying positions 62\) While preparing for a client for discharge, which of the following statements should the nurse include the instruction regarding the client's new prescription of hydrochlorothiazide: a. Report muscle cramps or weakness to healthcare providers b. Antihypertensive drugs that concurrently may produce sleepiness c. Ingest vitamin K rich food d. There is no limitation on your salt and fluid intake 63\) the order reads: give mannitol 0.05g/kg, IV now, over 2 hours. The patient weighs 165 lbs., and you have 100ml vial of 20% mannitol (20g/100ml) How many grams will the patient receive? How many ml you will prepare for the infusion? a. 3.5g/19 ml b. 27.5g/100ml c. 3.6g/20ml d. 3.75g/18.8ml 64\) A client with Type 1 diabetes will use a combination of insulin that includes NPH and regular insulin. The nurse explains the importance of knowing the peak times for both insulins. Why is it important information for the client to know: a. Additional insulin may be required during the peak periods to avoid hyperglycemia b. The risk of hypoglycemia is greatest around the peak time of insulins c. You can skip taking the meal if it is not within these peak periods of insulin action d. The client will be able to estimate the next dose of insulin based on peak times. 65\) before administering morning lispro insulin (Humalog) injection, which activity should the nurse perform? Select all that apply. a. Ensure the breakfast trays are present on the unit and the client can eat b. Check the client\'s blood glucose levels using a glucometer c. Obtain a morning urine sample of glucose and ketones d. Obtain VS e. Assess for the symptoms of hypoglycemia 66\) A daughter calls a virtual walk-in clinic and reports her mother had an insulin overdose and was found unconscious. The daughter gave a glucagon injection 20 minutes ago. Her mother has since woken up but remains groggy with incoherent speech. What should the nurse tell the daughter? a. Place some hard candies in her mouth b. Give her more time to wake up on her own, remove loose clotting, and place her in a recovery position. c. Just let her sleep for now. People can be tired after a hypoglycemic event d. Give her another injection and call 911 for immediate medical assistance 67\) A client on replacement therapy with Levothyroxine (Synthroid) reports feeling nervous and is having occasional palpitations and tremors. The nurse recognizes that these symptoms may indicate which effect is occurring. a. The client now has normal thyroid function and levothyroxine is no longer needed. b. The client is experiencing symptoms of hypothyroidism and drug dosage may need to be decreased. c. The client has developed diabetes and needs further evaluation d. The client is still experiencing hypothyroidism and the dose may need to increase 68\) which of the following assessment findings would the nurse expect to observe in an adult client experiencing therapeutic effects from levothyroxine? Select all that apply. a. Constipation and weight gain b. Decreased blood cholesterol levels c. Decreased lacrimation and salivation d. The pulse rate is between 60 to 100 bpm e. Decreased reports of fatigue 69\) A client with adrenocortical insufficiency has started therapy with fludrocortisone. Which important invention related to this drug therapy should nurse teach to clients? a. Report any abdominal pain or changes in stool color b. Return monthly for lab work to check blood lipid levels c. Weigh yourself daily, ideally same time each day d. Report any unusual changes in your mood 70\) A client with asthma asks which of the following prescribed medications should be used in the event of acute bronchospasm. The nurse will instruct the client to use: a. Zafirlukast b. Beclomethasone c. Ipratropium d. Salbutamol 71\) A client is prescribed beclomethasone, a glucocorticoid inhaler. Health teaching from the nurse should include which of the following: a. You may feel shaky and nervous after using this drug b. Limit your coffee intake while you are on this drug c. Check your heart rate, as this may cause tachycardia d. Rinse your mouth well after each use 72\) A nurse should inform the client who is prescribed a nebulizer treatment with salbutamol (Ventolin) that the common adverse effects is: a. Temporary dyspnea b. A predisposition to infection c. An increased heart rate with palpitation d. Sedations 73\) You are providing a demonstration to your 11-year-old patient regarding the proper use of an inhaler. The client is unable to demonstrate proper technique in using the training inhaler and is becoming frustrated. What is the best action for a nurse to take? a. Switch to oral form for Beta agonist b. Provide a spacer for use with the inhaler c. Notify the healthcare provider that they are incompetent in using an inhaler d. Encourage the patient to keep practicing until they get the technique right 74\) you are receiving medication orders for PRN medications that can be given to the patient who has bronchitis and a productive cough. Which drug would you choose to administer? a. An antitussive b. An antihistamine c. A decongestant d. An expectorant 75\) A therapeutic response to antihistamine-type drugs that treat the upper respiratory tract may include a reduction of the following: Select all that apply. a. Bronchospasm b. Congestion c. Coughing d. Motion sickness e. Allergic symptoms 76\) A healthcare provider orders magnesium hydroxide (Milk of magnesia) for a client with constipation, secondary to post-operative opioid use. Before administering the drug, the nurse will assess a. Ability to ambulate to the commode b. Bowel sounds c. Respiration rate d. Blood pressure 77\) A client asks the nurse about using an OTC drug bismuth subsalicylate (Pepto-Bismol) to treat their daughter\'s diarrhea. On which of the following factors will the nurse base her recommendation? Select all that apply. a. Normal activity level b. Cause of the diarrhea c. School schedule d. Dietary restrictions e. Age of the daughter 78\) Ondansetron (Zofran) has been ordered prior to chemotherapy for your patient receiving treatment for breast cancer. Prior to administering this drug, the nurse will review the clients past medical history for which condition? a. Allergy to egg or soy products b. History of chronic constipation c. Glaucoma d. Cardiac dysrhythmia 79\) The nurse is scheduling her client\'s daily medication, when would be the most appropriate time for the client to receive proton pump inhibitors? a. Half an hour before meal b. Once daily at 0800 c. At bedtime d. 2 hours before or after a meal 80\) A nurse caring for gastroesophageal reflux disease should question the order for which drug to treat this condition a. Antibiotics b. Antacids c. H2 receptor antagonists d. Proton pump inhibitors 81\) Which instruction should the nurse give a 21-year-old female patient being treated with ampicillin? a. An antibiotic taken concurrently with oral contraceptives causes toxicity b. Use oral contraceptives as prescribed because antibiotics do not react with birth control pills c. Stop taking oral contraceptives because serious drug interactions can occur d. The antibiotic may decrease the effectiveness of oral contraceptives 82\) the client reports abnormal vaginal discharge after completing a prescription of cefotaxime (Claforan). For which condition is the client most likely exhibiting symptoms a. Superinfection b. Clostridium defficile c. Hypersensitivity reaction d. Antibiotic toxicity 83\) A patient is admitted with a fever of 39 degrees Celsius of unknown origin. The assessment reveals bilateral crackles and a productive cough. The prescriber has ordered sputum and blood cultures and administration of 500mg IV STAT and Q6H. What is the correct sequence for the nurse to follow to complete these orders: a. Blood and sputum cultures, ampicillin dose b. Blood culture. Ampicillin dose, Sputum culture c. Sputum culture, ampicillin dose, and blood culture d. Ampicillin dose, blood, and sputum culture 84\) A nurse caring for a patient with gastroesophageal reflux disease should question the order for which drug to treat this condition. a. Antibiotics b. Antacids c. H2 receptor antagonists d. Proton pump inhibitors 85\) your patient is receiving gentamicin 1mg/kg IV Q8H for the treatment of pneumonia. Which of the following assessment results may indicate a possible toxicity of this drug? a. Decreased blood urea nitrogen and creatinine levels b. Skin rash and fever c. Tinnitus and hearing loss d. A peak serum drug level of 7mcg/mL 86\) You are caring for a patient who is receiving treatment for a viral infection. Which of the following would you expect to see as a therapeutic response? a. Elimination of the virus b. Positive resistance to future viral infections c. Delayed progression of HIV infection d. Eradication of superinfection 87\) Your patient has been prescribed the antifungal medication ketoconazole to treat an infection. What monitoring should the nurse ensure is included prior to beginning drug therapy? a. Neurological vital signs b. Snellen eye exam c. International Normalized Ratio d. Hepatic function studies 88\) Harrison is 4 months 4-month-old infant who is brought to the clinic for their first check-up. The mother states that the child has never been ill and is meeting milestones appropriate for their age. Which factor would the nurse consider most significant in assessing the baby\'s likelihood of receiving immunizations? a. Maternal and paternal allergy reactions related to vaccine administration b. Nurses\' knowledge of the recommended pediatric immunizing schedule c. Mothers' preconceptions and reservations relating to vaccine d. Allergy to previously prescribed medications 89\) The nurse determines that the client understands the teaching given for required care following a tetanus toxoid injection when the client states a. I will limit my fluid intake for the next 24 hours b. I will take acetaminophen (Tylenol) if my arms get sore c. I will avoid crowds and people for the next 7 days as I will be temporarily immunocompromised from the immunization d. I will keep my arm still for 24 hours for maximum absorption 90\) Which of the following are included in the roles and responsibilities of RPN in medication administration? a. Monitoring adverse effects b. Monitoring laboratory studies if applicable c. Providing health teaching regarding drug use d. Monitoring for therapeutic responses to drug treatment e. Completing the eight rights and three checks