Final Exam Review 318 (1).pdf

Final Exam Review 318 Which potential side effect would the nurse educate the patient about if the patient becomes pregnant after taking clomiphene citrate to increase ovulation? Diarrhea Multiple Gestation Gestational Diabetes Subsequent infertility The health care provider prescribes famotidine to...

Final Exam Review 318 Which potential side effect would the nurse educate the patient about if the patient becomes pregnant after taking clomiphene citrate to increase ovulation? Diarrhea Multiple Gestation Gestational Diabetes Subsequent infertility The health care provider prescribes famotidine to a patient for heartburn and indigestion. Which explanation will the nurse give to the patient about taking this medication? Coughing may occur and does not need to be reported. Drug-induced erectile disfunction is reversible. You can drive a car while on this drug. Avoid eating dairy products like cheese and yogurt. Which adverse effect may result from the use of diphenoxylate with atropine? Select all that apply. One, some, or all responses may be correct. ∙ ∙ ∙ ∙ ∙ Tetany Angioedema Paralytic ileus Agranulocytosis Respiratory Depression Which laboratory test is used to monitor warfarin therapy? ∙ ∙ ∙ ∙ Activated partial thromboplastin time (aPTT) International normalized ratio (INR) Fibrinogen Complete blood count (CBC) Which clinical manifestation, if observed in a patient, prompts the nurse to report adverse effects of promethazine hydrochloride? Select all that apply. One, some, or all responses may be correct. ∙ ∙ ∙ ∙ ∙ Urinary Retention Hypertension Constipation Restlessness Blurred Vision Which nursing instruction(s) is (are) beneficial for a patient who has been prescribed furosemide? Select all that apply. One, some, or all responses may be correct. 01 02 03 04 05 Avoid taking this drug with food Take ginseng along with this drug Take this drug along with breakfast Rise slowly from lying or sitting when taking this drug Avoid foods with a lot of potassium Which statement by the student nurse indicates effective learning if the nurse teaches the student nurse about various drug interactions with thyroid drugs? Thyroid Drugs may increase serum digitalis levels Thyroid drug absorption is increased by cholestyramine Thyroid drugs may decrease the activity of oral anticoagulants Thyroid drugs may decrease the activity of hypoglycemic drugs Nausea Which condition is a side effect associated with estrogen therapy? Dry Skin Weight Loss Higher-pitched voice Which type of insulin did the nurse administer if the nurse administers insulin to the patient at 8:30 a.m. and observes for symptoms of hypoglycemia at about 11:00 a.m.? ∙ ∙ ∙ ∙ Aspart Lispro Regular Gluisine The nurse is providing discharge education to a patient recently prescribed an oral antidiabetic medication. Which statement will the nurse include in the teaching? Select all that apply. One, some, or all responses may be correct. ∙ You will need to keep sugar-containing drinks or hard candy near you at all times. ∙ You may require insulin during times of stress, such as surgery or major infections. ∙ It is ok to drink alcohol while on these medications as long as you do it in moderation. ∙ Because you are on these medications you will not have to check your blood sugar at home. ∙ Seek medical attention if you experience symptoms such as increased thirst or a fruity odor to your breath. Which side effect would the nurse anticipate occurring after administration of tiotropium to a patient with chronic obstructive pulmonary disease? Select all that apply. One, some, or all responses may be correct. ∙ ∙ ∙ ∙ ∙ Tremors Oral Ulcers Palpitations Nervousness Myalgia Which medication is used to treat severe adverse effects of an opioid analgesic? ∙ ∙ ∙ ∙ Naloxone Flumazenil Acetylcysteine Methylprednisolone Which patient would receive nystatin therapy? A patient with aspergillosis A patient with cryptococcosis A patient with histoplasmosis A patient with oral candidiasis Which electrolyte imbalance would the nurse monitor for in a patient receiving solifenacin succinate? ∙ ∙ ∙ ∙ Hyperkalemia Hypocalcemia Hypernatremia Hypomagnesemia For which reason are proton pump inhibitors used in the treatment of patients with bleeding due to erosive esophagitis? ∙ ∙ ∙ ∙ They affect the absorption of food. They do not alter the levels of acid They act directly on the proton pump They inhibit the proton pump in all the cells of the digestive system Which assessment finding would indicate that a patient receiving intravenous epinephrine is experiencing the expected therapeutic effect? ∙ ∙ ∙ ∙ Increased heart rate Bronchial constriction Increased bowel sounds Decreased blood pressure Be sure to avoid eating chocolates Which patient teaching would the nurse include regarding the safe use of tiotropium in a patient with bronchospasm associated with chronic obstructive pulmonary disorder? You should increase your fluid intake This medication should be taken in the evening Wash the HandiHaler with warm water and dry before use Which statement about dietary changes made by a patient receiving warfarin indicates a need for further teaching? Select all that apply. One, some, or all responses may be correct. Avoid I will avoid consuming soybean oil Limit I will limit my intake of leafy green vegetables Avoid I will avoid the intake of food rich in vitamin C Include I will include ginseng in my diet regularly Include I will include large amounts of green tea and coffee in my diet Which action will the nurse perform when administering a medication subcutaneously? ∙ ∙ Makes sure to use a 1-1.5 inch, 25-gauge needle ∙ ∙ Aspirates with heparin and insulin injections Inserts the needle at a 45 or 90 degree angle, depending on patient size, to penetrate subcutaneous tissue Uses the landmark between the greater trochanter and superior iliac crest for the vastus lateralis site Warfarin decreases the metabolism of phenytoin Which explanation is provided for a decrease in warfarin dosage in a patient receiving a new prescription of phenytoin? Renal excretion of phenytoin is lowered when taken with warfarin Decreasing the dosage of warfarin lowers the risk for drug toxicity Taking high doses of both drugs increases the risk for digitalis-induced arrhythmias Which action would the nurse take when caring for a patient who is on levothyroxine and warfarin? TAKE DAILY WEIGHTS ASSESS PERIPHERAL PULSES MONITOR FOR CARDIAC DYSRHYTHMIAS MONITOR FOR INCREASED RISK OF BLEEDING Offer Which action would the nurse take first if a diabetic patient who is on beta blockers exhibits tremors, irritability, diaphoresis, a blood pressure reading of 130/75 mm Hg, a pulse rate of 80 beats per minute, and a respiration rate of 18 breaths per minute? Offer a cup of orange juice Obtain Obtain a blood glucose level Check Check apical pulse for 1 minute blood pressures sitting and lying Assess Assess down Which instruction would a nurse give to a patient who has been prescribed bisacodyl? Select all that apply. One, some, or all responses may be correct. Take Take the drug with milk Take Take the drug at bedtime Eat Eat high-fiber foods consistently Drink Drink 8oz of fluids when taking the drug Chew Chew the tablets thoroughly before swallowing Which response by the nurse is correct if a patient newly diagnosed with diabetes asks, “How does insulin normally work in my body?” ∙ ∙ ∙ ∙ It stimulates the pancreas to reabsorb glucose It promotes synthesis of amino acids into glucose It stimulates the liver to convert glycogen to glucose It promotes the uptake of glucose, amino acids, and fatty acids Increase oral fluid intake A patient has just been prescribed allopurinol 100 mg PO daily for gout. Which information will the nurse include when providing teaching about the medication to the patient? Select all that apply. One, some, or all responses may be correct. Regular lab draws for liver function Regular lab draws for kidney function Yearly eye exams are needed Take vitamin C daily Which adverse reaction would the nurse monitor for in a patient taking an aluminumcontaining antacid? Diarrhea Constipation Gastrointestinal upset Fluid retention Which finding related to diphenoxylate with atropine would the nurse report immediately? ∙ ∙ ∙ ∙ Swelling of the lips Skin peeling from hands Confusion and euphoria Restlessness and abdominal pain Which instruction will the nurse provide to a patient taking both phenytoin and an oral contraceptive? 01 02 03 04 Follow up with your provider frequently, because a dosage of phenytoin will likely need to be increased. Have your serum drug levels routinely checked, because the dosage of phenytoin will likely need to be decreased. Use an additional form of contraception, because your oral contraceptive may not be as effective while on phenytoin. Monitor your legs for warm, red, and swollen areas and for shortness of breath, which may be signs of a potential blood clot while receiving phenytoin with an oral contraceptive. The health care provider has ordered doxycycline 100 mg PO daily for a patient. After reviewing the patient's current home medications, the nurse will provide counseling for which drug? Select all that apply. One, some, or all responses may be correct. ∙ ∙ ∙ ∙ ∙ Metformin 500mg PO twice a day Warfarin 2.5 mg PO daily Simvastatin 40 mg PO daily Digoxin 0.125 mg PO daily Ethinyl estradiol 20mcg/levonorgestrel 100mcg PO daily Which action will the nurse take for a patient on antacid and sucralfate therapy for a peptic ulcer? REPORT IF THE PATIENT’S URINARY OUTPUT IS BELOW 40ML/HR KEEP A 10-MINUTE GAP BETWEEN SUCRALFATE AND ANTACID ADMINISTRATION GIVE ANY OTHER PRESCRIBED DRUG (EXCEPT ANTACID) AFTER 2 HOURS OF SUCRALFATE ADMINISTRATION ADMINISTER THE DRUG AFTER A MEAL OR WITH A GLASS OF MILK Which type of insulin peaks at 6 to 8 hours after administration? ∙ ∙ ∙ ∙ Lispro Regular Glargine Detemir Which type of insulin can be administered intravenously? ∙ ∙ ∙ ∙ Lispro Glargine Regular Isophane Weight gain Hypoglycemia Which adverse effect is associated with the long-term use of prednisone therapy? Select all that apply. One, some, or all responses may be correct. Increased Sleep Personality changes Loss of muscle bulk Peptic ulcer disease A patient has been taking a prescription of solifenacin succinate 5 mg orally daily. The nurse reviews the patient’s information. Which reaction to the medication is this patient most likely experiencing? Patient Information Dehydration Anticholinergic response Hypersensitivity to medication Gastrointestinal obstruction Vital Signs Temperature 37.3°C (99.1 F) Apical pulse 86 beats per minute Respirations 28 breaths per minute Blood pressure 122/72 mm Hg Patient Comments “I am constipated.” “My mouth is dry.” “I urinate less often during the day.” Physical Assessment Bowel sounds hypoactive Which clinical indicator of hypoglycemia would the nurse include when teaching a patient with type 1 diabetes? Select all that apply. One, some, or all responses may be correct. ∙ ∙ ∙ ∙ ∙ ∙ Headaches Sweating Polyphagia Weight loss Dehydration Tachycardia Which medication regimen would the nurse educate a patient about if the patient is a perimenopausal woman who is experiencing vaginal dryness and hot flashes, especially at night, and asks her health care provider for help with treating these symptoms? ∙ ∙ ∙ ∙ Clonidine Ethinyl estradiol Progestin-only therapy Conjugated equine estrogens with synthetic progestin Which statement by the patient indicates a need for further instruction if the nurse teaches a patient with type 2 diabetes about the administration of glipizide? I CAN STILL HAVE ONE GLASS OF WINE WITH MY EVENING MEAL I SHOULD EAT IMMEDIATELY AFTER TAKING THIS MEDICATION DAILY I WILL NEED TO CHECK MY BLOOD GLUCOSE LEVEL AT LEAST ONCE A DAY I WILL AVOID GREEN TEA AND GREEN TEACONTAINING PRODUCTS Which adverse effect(s) is (are) associated with nonsteroidal antiinflammatory drugs (NSAIDs)? Select all that apply. One, some, or all responses may be correct. ∙ ∙ ∙ ∙ ∙ Tinnitus Anorexia Delusions Dyspepsia Constipation Increases tone of the detrusor urinal muscle Which mode of action is associated with solifenacin succinate? Select all that apply. One, some, or all responses may be correct. Blocks pain receptors in the lining of the urinary tract Exerts a selective muscarinic receptor antagonist effect Depresses voluntary and involuntary bladder contractions Produces a bactericidal effect when the urine pH is less than 5.5 Which information would the nurse include when teaching a patient about prednisone therapy? Discontinue Discontinue the medication if there are adverse effects Take Take the medication with food to dimmish the risk of gastric irritation Take Take the medication only every other day to decrease the risk for adrenal hyperplasia Take Take the medication in the early evening to coincide with the natural secretion patter of the adrenal cortex Which antiemetic may cause a false pregnancy test? ∙ ∙ ∙ ∙ Droperidol Promethazine Metoclopramide hydrochloride Granisetron Which nursing action would be most important before administering an intravenous dose of penicillin? LOCATING THE IV SITE RECORDING THE DAILY URINE OUTPUT OBTAINING SERUM CREATININE LEVELS ASSESSING THE PATIENT FOR ANY ALLERGIES Which patient parameter would cause the nurse to question a new prescription for glipizide? Select all that apply. One, some, or all responses may be correct. ∙ ∙ ∙ ∙ ∙ Platelet count of 25,000 History of prostate cancer Hemoglobin A1c of 10.2% Serum creatinine of 3.7mg/dL Currently taking metoprolol daily Which medication carries a high risk for adverse reactions? Select all that apply. One, some, or all responses may be correct. ∙ ∙ ∙ ∙ ∙ Gentamicin Tramadol Insulin Clopidogrel Warfarin Which drug is most appropriate for a patient experiencing an acute asthma attack? ∙ ∙ ∙ ∙ Albuterol Epinephrine Tiotropium Theophylline Which assessment finding indicates that a patient has overdosed on morphine sulfate? ∙ ∙ ∙ ∙ Blood in urine Pinpoint pupils Increased peristalsis Increased urinary output Which number of tablets would the nurse administer if a patient has been prescribed 0.075 mg of levothyroxine daily and the drug is available as 0.05-mg scored tablets? ∙ ∙ ∙ ∙ 0.5 1 1.5 2 Which statement made by the nurse about acetaminophen indicates a need for additional education? ∙ Alcohol use disorder is a contraindication of acetaminophen ∙ Severe hepatic disease is a contraindication of acetaminophen ∙ Do not administer acetaminophen if the ALT ALP and GTT lab values are low ∙ Do not administer acetaminophen if the therapeutic serum level is greater than 20 mcg/ml Which intervention would the nurse implement when preparing to administer insulin lispro to a patient diagnosed with type 1 diabetes? Ensure that the patient is wearing a medical alert bracelet Administer the dose according to the regular insulin sliding scale Shake the vial prior to administration Make sure the patient eats the food on the bedside meal tray within the next 10 to 15 minutes Which side effect(s) may occur in a patient receiving isoniazid for tuberculosis? Select all that apply. One, some, or all responses may be correct. ∙ ∙ ∙ ∙ ∙ ∙ Tremors Drowsiness Photosensitivity Changes in vision Changes in hearing Passing of red-orange urine Which statement by the nurse explains the differences between cholinergic agonists and cholinergic antagonists? The nurse must be alert for which cue related to central nervous system side or adverse effects in a patient taking lorazepam? Select all that apply. One, some, or all responses may be correct. ∙ ∙ ∙ ∙ ∙ Seizures Suicidal ideation Confusion Paralysis Amnesia Which instruction will the nurse provide a patient prescribed diphenhydramine? TAKE THIS MEDICINE IN THE AFTERNOON DO NOT DRIVE WHILE ON DRUG THERAPY TAKE THE DRUG WITHOUT FOOD USE A SUGAR CANDY FOR DRY MOUTH The adverse effects can be managed well Which would be the best information for the nurse to include in medication education to promote adherence to the therapeutic regimen if a patient who has taken fluoxetine for 2 weeks to treat an anxiety disorder reports dissatisfaction with the therapy? This medication usually requires titration Relaxation exercise can offer some relief A therapeutic effect can be expected in another 2 to 4 weeks Which patient does the nurse anticipate will receive alteplase therapy? The patient with peptic ulcer disease The patient with gastrointestinal bleeding The patient with an acute myocardial infarction The patient with a local thrombosis from a peripheral IV Which instruction will a nurse provide a patient receiving dextromethorphan for cough to ensure safe administration? USE A HUMIDIFIER WHILE SLEEPING ELEVATE YOUR BED WHILE SLEEPING INCREASE YOUR FLUID INTAKE TO 3000ML PER DAY RESTRICT ACTIVITIES THAT REQUIRE MENTAL ALERTNESS Which side effect(s) would a nurse monitor for after administering lisinopril to a patient? Select all that apply. One, some, or all responses may be correct. ∙ ∙ ∙ ∙ ∙ Anemia Dry cough Hematuria Anuria Hyperkalemia Which symptom of hypoglycemia would the nurse instruct the patient’s family to treat with a fast-acting carbohydrate source? Select all that apply. One, some, or all responses may be correct. ∙ ∙ ∙ ∙ ∙ Chills Tremors Sweating Confusion Nervousness Which mode of action is associated with the drug tiotropium? Select all that apply. One, some, or all responses may be correct. ∙ ∙ ∙ ∙ ∙ Dilate the bronchi Antagonizes acetylcholine action Relaxes the smooth muscles of the bronchi Blocks muscarinic cholinergic receptors Stimulates the central nervous system Insomnia Which side effect is associated with the use of testosterone? Select all that apply. One, some, or all responses may be correct. Depression Gynecomastia Aggressive behavior Postural hypotension Which adverse effect is associated with furosemide? ∙ ∙ ∙ ∙ Hypokalemia Hypoglycemia Hypercalcemia Hypervolemia Which property of aspirin differentiates it from other nonsteroidal antiinflammatory drugs (NSAIDs)? ∙ ∙ ∙ ∙ Analgesic Antipyretic Antiplatelet Antiinflammatory Which statement by the patient indicates that the nurse’s teaching on aluminum hydroxide administration was effective? 01 02 03 04 I will take aluminum hydroxide at mealtime I will take a laxative if I develop constipation I will drink 2oz of water after taking aluminum hydroxide I will take aluminum hydroxide within 30 minutes of my other medications Which statement describes the mechanism of action of clomiphene citrate? ∙ ∙ ∙ ∙ Stimulates ovulation Decreases serum thyroxine Prevents prolactin secretion Binds to dopamine receptors Reports nausea and diarrhea Which patient parameter requires immediate action by the nurse for a patient taking metformin? Select all that apply. One, some, or all responses may be correct. Serum creatinine of 3.2mg/dL Reports drinking a six-pack of beer every day Reports taking metformin with black iced tea Scheduled for a CT scan with contrast the next morning Which medication will the nurse anticipate administering to a patient with a blood glucose level of 48 mg/dL? ∙ ∙ ∙ ∙ Glipizide Glucagon Glimepiride Glyburide-metformin Which instruction will the nurse give to a patient prescribed levothyroxine? Increase Increase your intake of broccoli and soy products while taking this medication Take If you miss a dose, take the medicine immediately Have Tell Have the medicine with food to avoid side effects Tell your healthcare provider if you have profuse sweating and palpitations while taking this medicine Which statement by the patient indicates that the nurse’s teaching on the administration of antacids was effective? Select all that apply. One, some, or all responses may be correct. ∙ ∙ ∙ ∙ ∙ Antacids form a protective barrier in the stomach Antacids neutralize the acid present in the stomach Calcium-containing antacids may cause constipation Antacids decrease the secretion of acid in the stomach Aluminum-containing antacids may cause constipation Increase sodium levels Which laboratory finding would a nurse expect to see in a patient who uses bisacodyl for constipation? Increased calcium levels Decreased potassium levels Increased magnesium levels It is excreted in the feces Which statement about the administration of metformin is correct? Green tea can lead to hyperglycemia It is recommended for patients with renal impairment Gastrointestinal side effects are common Which laboratory finding may occur in a patient receiving diphenoxylate with atropine? ∙ ∙ ∙ ∙ Decreased ammonia levels Increased serum magnesium levels Decreased serum glucose levels Increased serum liver enzyme levels Which statement describes the reason why a nurse would instruct a patient to take sucralfate on an empty stomach and avoid using additional forms of antacids? Sucralfate promotes the healing of ulcers Sucralfate is active in acidic environments Sucralfate reduces the absorption of other drugs Sucralfate forms a protective barrier between ulcer and gastric acids. The nurse is providing teaching to a patient with a new diagnosis of type 1 diabetes mellitus. Which patient statement indicates an understanding of diabetic ketoacidosis (DKA)? DKA happens when I take too much insulin Confusion and a headache are often the first signs of DKA When I am really thirsty all of a sudden, I need to check my blood sugar If I start feeling nervous or having tremors, I should drink orange juice right away