According to the gate control theory, what interventions by the nurse could help block pain impulses? A. Administration of opioid medicationsB. Administration of narcotic agonist-antagonistsC. Back massageD. Acupuncture
C. Back massage
Before administering an opiate medication, what will the nurse assess?A. The patient's weightB. The patient's heart rateC. The patient's respiratory rateD. The patient's drug tolerance
C. Respiratory rate
The home care nurse administers oral morphine to the patient with cancer pain. When will the nurse expect this medication to reach peak activity?A. 10 minutesB. 30 minutesC. 45 minutesD. 60 minutes
D. 60 minutes
The nurse administers a narcotic analgesic to the post operative patient with cancer pain. When will the nurse expect this medication to reach peak activity? A. Observe the patient without her awareness.B. Use a pain assessment tool before and 30 minutes after administration.C. Assess vital signs.D. Measure oxygen saturation.
B. Use a pain assessment tool before and 30 minutes after administration.
The nurse is administering morphine to a trauma patient for acute pain. Before administering the morphine, what common adverse effect should the nurse inform the patient about? A. Paresthesia in lower extremitiesB. Occipital headacheC. Increased intracranial pressureD. Drowsiness
D. Drowsiness
What drug might the nurse administer for both analgesic and antitussive effects? A. CodeineB. AspirinC. IbuprofenD. Acetaminophen
A. Codeine
The nurse is caring for a patient who is receiving an opioid analgesic. What are the nurse's priority assessments?A. Pain intensity and blood glucose level B. Level of consciousness and respiratory rateC. Respiratory rate and electrolytes D. Urine output and pain intensity
B. Level of consciousness and respiratory rate
The pediatric patient has a fever and the nurse is preparing to administer an antipyretic. What drug would be the best choice for this patient?A. Balsalazide (Colazal) B. Naproxen (Naprosyn)C. Indomethacin (Indocin)D. Aspirin
B. Naproxen (Naprosyn)
The patient has been diagnosed with RA. She also reports pain in various muscle groups secondary to a diagnosis of fibromyalgia and dysmenorrhea with painful cramping during menses. What drug would be most effective in treating all 3 of this patient's problems? A. Naproxen (Naprosyn)B. Acetaminophen (Tylenol)C. Etanercept (Enbrel)D. Sodium hyaluronate (Hyalgan)
A. Naproxen (Naprosyn)
The nurse teaches a patient with rheumatic disease who is being prescribed salicylate therapy o monitor himself or herself for what?A. TinnitusB. Visual changesC. StomatitisD. Hirsutism
A. Tinnitus
A mother has brought her 6 year old child to the clinic. The child has a fever of 102.8F and is diagnosed with the flu. What medication will he nurse suggest for this child? A. Etanercept (Enbrel)B. Penicillamine (Depen)C. Acetaminophen (Tylenol)D. Aspirin (Bayer)
C. Acetaminophen (Tylenol)
A nurse is assessing a patient who has been taking non-steroidal anti-inflammatory drugs (NSAID). What statement by the patient indicated to the nurse that the patient has a good understanding of the use of this therapy?A. "I drink a glass of wine just about every night."B. "I asked my doctor to check for blood in my stool regularly."C. "I do not like to swallow tablets so I crush them."D. "I drink as little water as possible when I take my medication.
B. "I asked my doctor to check for blood in my stool regularly.
The nurse evaluates teaching as effective when a patient taking a benzodiazepine statesA. "I should always take the medication with meals."B. "I should not stop taking this drug without talking to my health care provider first."C. "I cannot take aspirin with this medication."D. "I will have to take this medication for the rest of my life.
B. "I should not stop taking this drug without talking to my health care provider first.
A patient presents at the emergency department with respiratory depression and excessive sedation. The family tells the nurse that the patient has been taking medication throughout the evening and gives the nurse an almost empty bottle of benzodiazepines. What other adverse effects would the nurse assess this patient for?A. SeizuresB. TachycardiaC. HeadacheD. Coma
D. Coma
What would the nurse assess for when benzodiazepines are abruptly stopped?A. Urinary retention and change in sexual functioningB. Dry mouth, constipation, nausea, and vomitingC. Nausea, headache, vertigo, malaise, and nightmaresD. In most cases nothing significant
C. Nausea, headache, vertigo, malaise, and nightmares?
Why would the nurse expect the patient with liver disease to receive a smaller dose of benzodiazepines?A. Excretion of the drug relies on liver function.B. The drugs are metabolized extensively in the liver.C. They are lipid soluble and well distributed throughout the body.D. The drugs are well absorbed from the gastrointestinal tract.
B. The drugs are metabolized extensively in the liver
The nurse is caring for a resident in a long-term care facility who is African American with a history of an anxiety disorder. The patient is receiving oral lorazepam (Ativan) 2 mg t.i.d. When developing this patient's plan of care, what priority assessment will the nurse include?A. DepressionB. Extreme sedationC. PhlebitisD. Nightmares
B. Extreme sedation
A patient arrives at the emergency room after attempting suicide by taking an entire bottle of diazepam. What antidote will the nurse most likely administer?A. Phenobarbital (Luminal)B. Dexmedetomidine (Precedex)C. Flumazenil (Romazicon)D. Ramelteon (Rozerem)
C. Flumazenil (Romazicon)
A nurse is discussing the use of alprazolam (Xanax) with a 68-year-old patient. What statement indicates that the patient has an understanding of the drug?A. "When I stop having panic attacks, I can stop taking the drug."B. "This drug will calm me down in about 30 minutes after I take it."C. "One dose will keep me calm for about 24 hours."D. "I am taking an increased dose because of my age.
B. "This drug will calm me down in about 30 minutes after I take it.
When patients do not understand the information provided with their medication, whose responsibility is it to help them sort through and comprehend the meaning?A. Care giverB. NurseC. PatientD. Physician
B. Nurse
The nurse is preparing to administer cefadroxil 1 g PO. The medication is supplied in 500-mg tablets. How many tablets will the nurse administer?A. 0.5 tabletB. 1 tabletC. 2 tabletsD. 3 tablets
C. 2 tablets
A student nurse asks her study group how to define a drug allergy. What would be the peer group's best response?A. A second effect of the body to a specific drugB. The formation of antibodies to a drug protein causing an immune response when the person is next exposed to that drug.C. A serum sickness caused by a reaction to a drugD. Immediate systemic reaction to the drug when exposed to the drug the first time.
B. The formation of antibodies to a drug protein causing an immune response when the person is next exposed to that drug.
The patient is taking low dose aspirin daily for his heart. The nurse knows only a portion of the medication taken actually reaches the tissue due to what process?A. DistributionB. First-pass effectC. Reduced absorptionD. Gastrointestinal circulation
B. First-pass effect
The nursing students are learning about the half-life of drugs. A student asks the instructor to explain half-life. What is the instructor's best response?A. Half-life of a drug is the time it takes for the amount of drug in the body to decrease to half of the peak level it previously achieved.B. Half-life is the amount of time it takes for the drug to be metabolized by the body.C. Half-life is the amount of time it takes for half of the drug to reach peak level in the body.D. Half-life of a drug is the time it takes for the drug to reach half its potential peak level in the body.
A. Half-life of a drug is the time it takes for the amount of drug in the body to decrease to half of the peak level it previously achieved.
What factor influences drug absorption?A. Kidney functionB. Route of administrationC. Liver functionD. Cardiovascular function
C. Liver function
A nurse is caring for a patient who is supposed to receive two drugs at the same time. What is the nurse's priority action?A. Wash her hands before handling the medications.B. Consult a drug guide for compatibility.C. Question the patient concerning drug allergies.D. Identify the patient by checking the armband and asking the patient to state his name.
B. Consult a drug guide for compatibility.
A patient presents to the emergency department with a drug level of 50 units/mL. The half-life of this drug is 1 hour. With this drug, concentrations above 25 units/mL are considered toxic and no more drug is given. How long will it take for the blood level to reach the non-toxic range?A. 30 minutesB. 1 hourC. 2 hoursD. 3 hours
B. 1 hour
The nurse receives an order to administer an unfamiliar medication and obtains a nurse's drug guide published four years earlier. What is the nurse's most prudent action?A. Find a more recent reference source.B. Use the guide if the drug is listed.C. Ask another nurse for drug information.D. Verify the information in the guide with the pharmacist.
A. Find a more recent reference source.
The nurse, providing patient teaching about home medication use to an older adult, explains that even when drugs are taken properly they can produce negative or unexpected effects. What are these negative or unexpected effects called?A. Teratogenic effectsB. Toxic effectsC. Adverse effectsD. Therapeutic effects
C. Adverse effects
The nurse is preparing to administer a medication from a multidose bottle. The label is torn and soiled but the name of the medication is still readable. What is the nurse's priority action?A. Discard the entire bottle and contents and obtain a new bottle.B. Find the drug information and create a new label for the bottle.C. Ask another nurse to verify the contents of the bottle.D. Administer the medication if the name of the drug can be clearly read.
A. Discard the entire bottle and contents and obtain a new bottle.
A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a Pregnancy Category B drug. What would the nurse inform the patient?A. "Adequate studies in pregnant women have demonstrated there is no risk to the fetus."B. "Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant women."C. "Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in pregnant women."D. "There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks.
B. "Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant women.
You are evaluating the discharge teaching you have done with your client concerning medication therapy. What statement from the client best indicates that teaching has been effective?A. "I have to take three pills each day and I can take them at the time that fits my schedule."B. "I should take the white pill in the morning because the doctor wants me to take it."C. "I will add the names and dosages of these new medications to my medication list in my wallet."D. "I have prescriptions at different pharmacies. I shop around for the best price for each drug.
C. "I will add the names and dosages of these new medications to my medication list in my wallet.
.Why does the nurse need to be alert for any indication of an allergic reaction in clients?A. To obtain early warning of noncompliance in medication therapyB. To increase the effectiveness of a specific medicationC. To maintain the client's safety during medication therapyD. To reduce the risk of adverse effects during medication therapy
C. To maintain the client's safety during medication therapy
While studying for the test, the nursing student encounters the following drug label: naproxen (Aleve). What does the nursing student identify the name "Aleve" as?A. The generic nameB. The chemical nameC. The brand nameD. The nickname
C. The brand name
When taking a medication history on a client why should the nurse ask about the use of complementary or alternative therapies?A. Clients starting on new medications are usually not compliant with medical regimens.B. Many medication-alternative therapy interactions can cause serious problems.C. Natural products may be more effective and the prescribed medications may not be needed.D. The cost of the medication and the alternative therapy may be too expensive for the patient to handle.
B. Many medication-alternative therapy interactions can cause serious problems.
What would be the most important reason the nurse would educate clients on the importance of providing a complete list of the prescription, over-the-counter and homeopathic medications to their primary care provider?A. For the patient to avoid spending large amounts of money on medications.B. Just for data collection, but no other purpose.C. To avoid drug-drug medication interactions.D. To persuade patients to give up all medications.
C. To avoid drug-drug medication interactions.
What would be the best source of medication information for a nurse?A. WikipediaB. A nurse's drug guideC. A drug package insertD. The Physicians' Drug Reference (PDR)
B. A nurse's drug guide
What is the responsibility of the nurse related to the client's medication therapy in the hospital? (Select all that apply.)A. Teaching the patient how to cope with medication side effects to ensure the best outcome.B. Administer medications timely and safely.C. Evaluating the effectiveness of medication therapy.D. Promote patient safety.E. Recommending appropriate over-the-counter medications to treat adverse effects of prescription drug therapy
A. Teaching the patient how to cope with medication side effects to ensure the best outcome.B. Administer medications timely and safely.C. Evaluating the effectiveness of medication therapy.D. Promote patient safety.E. Recommending appropriate over-the-counter medications to treat adverse effects of prescription drug therapyAll of the above
The patient presents to the emergency department with a headache in the back of the head, palpitations, neck stiffness, nausea, vomiting, sweating, dilated pupils, tachycardia, and chest pain. Blood pressure measures 180/124 and heart rate is 168 beats per minute. The spouse says the only medication he takes is something for depression but she does not know the name of the drug and the patient is also unable to supply the name. What classification of antidepressant does the nurse suspect this patient is taking?A. Monoamine oxidase inhibitors (MAOIs)B. Selective serotonin reuptake inhibitors (SSRIs)C. Tricyclic antidepressants (TCAs)D. Antianxiety antidepressants
A. Monoamine oxidase inhibitors (MAOIs)
The nurse needs to consider teratogenic effects of medications when caring for what population of clients?A. Older adultsB. Clients with a history of cancerC. ChildrenD. Young adult women
D. Young adult women
The nurse is teaching a patient taking a monoamine oxidase inhibitor (MAOI) about dietary changes required to minimize adverse effects of the drug. The nurse determines the patient understands a low tyramine diet when what meal is chosen?A. A chop salad with blue cheese, sardines, and pepperoniB. Sandwich with turkey, avocado, and Swiss cheeseC. Corned beef hash, eggs, and hash brownsD. A hamburger, French fries, and a strawberry milkshake
D. A hamburger, French fries, and a strawberry milkshake (correct answer)
The nurse is reviewing the client's medication orders and finds an order stating "amoxicillin 250 mg every 8 hours." What would the nurse question regarding this order?A. DoseB. RouteC. Frequency of administrationD. Allowance for generic substitution
B. Route
The nurse is caring for a patient who is taking amitriptyline for depression. What teaching will the nurse include in the teaching plan to help the patient monitor for adverse effects?A. "If chest pain occurs an over-the-counter pain reliever will help."B. "Nasal congestion indicates a respiratory virus is beginning."C. "Measure and record your blood pressure daily." D. "Adverse effects will subside as you adjust to the medication.
C. "Measure and record your blood pressure daily.
The client asks the nurse, "Is it safe to take over-the-counter (OTC) medications with prescription medications?" All of these would be correct responses, EXCEPT:A. "OTC medications can interact with prescription medications."B. "It is important to tell your doctor all medications you take, including OTC."C. "OTC medications could mask or hide signs and symptoms of a disease."D. "Taking OTC medications never interferes with prescription medications.
D. "Taking OTC medications never interferes with prescription medications.
Someone asks a nurse about a new drug that is in preclinical testing and wants to know why it cannot be used to treat a friend's illness. Which statement by the nurse is correct?A. "A drug at this stage of development can be used only in patients with serious disease."B. "At this stage of drug development, the safety and usefulness of the medication is unknown."C. "Clinical trials must be completed to make sure the drug is safe to use in humans."D. "Until post-marketing surveillance data are available, the drug cannot be used.
B. "At this stage of drug development, the safety and usefulness of the medication is unknown.
Drugs do not metabolize the same way in all people. Of the clients listed, which client would a nurse expect to assess for a greater alteration in drug metabolism?A. A 35-year-old woman with a urinary tract infectionB. A 41-year-old man with kidney stonesC. A 50-year-old man with cirrhosis of the liverD. A 62-year-old woman with cervical cancer
C. A 50-year-old man with cirrhosis of the liver
Discharge planning for clients leaving the hospital should include instructions on the use of over-the-counter (OTC) drugs. Which comment by the client would demonstrate an understanding of OTC drugs?A. "OTC drugs are safe and do not cause adverse effects if taken properly."B. "OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA)."C. "OTC drugs are different from any drugs available by prescription and cost less."D. "OTC drugs could cause serious harm if not taken according to directions.
D. "OTC drugs could cause serious harm if not taken according to directions.
Antidepressants carry a "black box" warning about the increased risk of suicide in what age group?A. Infants and childrenB. Children and adolescentsC. Adolescents and adultsD. Adults and older adults
B. Children and adolescents
After administering a medication, for what should the nurse assess the client for?A. Drug effectsB. AllergiesC. PregnancyD. Pre-existing conditions
A. Drug effects
. A patient whose spouse has died recently reports feeling down most of each day for the past 2 months. On further questioning, the nurse learns that the patient has quit participating in church and social activities, has difficulty falling asleep, and has lost 5 pounds. The patient reports feeling tired and confused all the time but does not have suicidal thoughts. What does the nurse suspect?A. Grief and sadnessB. HypomaniaC. Major depression D. Situational depression
C. Major depression
A patient taking fluoxetine (Prozac) complains of decreased sexual interest. A prescriber orders a "drug holiday." What teaching by the nurse would best describe a drug holiday?A. "Cut the tablet in half anytime to reduce the dosage."B. "Discontinue the drug for 1 week."C. "Don't take the medication on Friday and Saturday."D. "Take the drug every other day.
C. "Don't take the medication on Friday and Saturday.
A patient taking an MAOI is seen in the clinic with a blood pressure of 170/96 mm Hg. What will the nurse ask this patient?A. Whether any antihypertensive medications are usedB. Whether the patient drinks grapefruit juiceC. To list all foods eaten that dayD. Whether SSRIs are taken in addition to the MAOI
C. To list all foods eaten that day
A patient is brought to the emergency department after taking a handful of TCA pills. What is the initial action the nurse will expect to provide when caring for this patient?A. Cardiac monitoringB. Cholinesterase inhibitorsC. Gastric lavage and activated charcoalD. Sedative medicationsE. Procainamide
C. Gastric lavage and activated charcoal
A nurse is working with a 29-year-old who exhibits signs and symptoms of obsessive-compulsive disorder (OCD). What drug will the nurse anticipate may be prescribed for the client?A. Phenelzine (Nardil)B. Amitriptyline (Elavil)C. Fluvoxamine (Prozac)D. Isocarboxazid (Marplan)
C. Fluvoxamine (Prozac)
A nurse is teaching a patient about a prescription for a monoamine oxidase (MAO) inhibitor for depression. What will the nurse teach the patient to avoid while taking this drug?A. EggsB. Aged cheesesC. Brussels sprouts and cabbageD. Grapefruit juice
D. Grapefruit juice
A nurse is teaching a group of nursing students about tricyclic antidepressants (TCAs). Which statement by a student indicates a need for further teaching?A. "TCAs block receptors for histamine, acetylcholine, and norepinephrine."B. "TCAs block the uptake of norepinephrine and 5-HT."C."TCAs have many side effects, but none of them are serious."D. "TCAs have other uses than for depression.
C."TCAs have many side effects, but none of them are serious.
A nurse is reviewing a medication administration record before administering medications. Which order should the nurse implement?A.Furosemide (Lasix) 20 mg QD POB. Furosemide (Lasix) 20 mg qd POC. Furosemide (Lasix) 20 mg dailyD. Furosemide (Lasix) 20 mg PO daily
D. Furosemide (Lasix) 20 mg PO daily
A nurse is reviewing a client's medical record before administering a medication. Which factor(s) can alter the client's physiologic response to the drug? (Select all that apply.)A. Ability to swallow pillsB. AgeC. Genetic factorsD. Gender E. Height
D. Gender (correct answer)E. Height (correct answer)
A nurse is planning client teaching about a newly prescribed medication. What is a priority teaching point included by the nurse to improve compliance and safety?A. The nurse doesn't have any responsibility to teach about this new medication. It was the physician's job to do that first.B. Measures to alleviate any discomfort associated with adverse effects.C. The cost of the brand name drug compared to the cost of the generic brand of the drug.D. Statistics related to Phase III testing for the prescribed drug.
B. Measures to alleviate any discomfort associated with adverse effects.
A nurse is caring for a client who is scheduled to receive naproxen and furosemide tablets. What is the nurse's priority action to ensure the highest degree of safety for the client when administering medications at the bedside?A. Wash hands before handling the medications.B. Consult a drug guide for compatibility.C. Ask the client about their level of pain.D. Client identification and allergy verification.
D. Client identification and allergy verification.
A nurse is assessing the client's home medication use. This client has a variety of medications that have drug-to-drug interactions. Which of these would be a priority question?A. "Where do you buy your medications?"B. "Do drink 8 glasses of water a day?"C. "Are you storing these medications in your kitchen?"D. "Do you take any over-the-counter medications?
D. "Do you take any over-the-counter medications?
A client receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what?A. Administer the drug at intervals longer than the drug half-life.B. Administer this medication intravenously.C. Monitor plasma drug levels.D. Teach the patient that maximum drug effects will occur within a short period.
C. Monitor plasma drug levels.
A client is being discharged home today. The discharge order reads: Take 10 mL of acetaminophen PO q4h. This over-the-counter medication comes in bottles with plastic measuring caps. How much should the nurse teach the patient to take at home?A. 1/2 tspB. 1 tspC. 1tbspD.2 tsp
D.2 tsp
A client has an order for linezolid 400mg IV . However, the nurse administers 600mg IV. What is the nurse's priority action?A. Reassure the client that this is a harmless error.B. Do nothing and see if any adverse effects occur.C. Notify the healthcare provider and report the error according to the facility policy.D. Administer half of the next dose to adjust for the error
C. Notify the healthcare provider and report the error according to the facility policy.
A client asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient's:A. drug receptor sites.B. hypersensitivity potential.C. metabolism of drugs.D. psychosocial response.
C. metabolism of drugs.
A 75-year-old male patient is brought to the emergency department by his family because he is "talking to people who aren't there." During the initial admission assessment, his daughter mentions that her mother died 4 months ago and "Dad just hasn't been the same. The doctor has even put him on antidepressant medication. I go by the house every day to make sure he takes his medication." What would the nurse suspect is happening to this patient?A. The patient is having hallucinations as an adverse effect of his antidepressant medication.B. The mental status change is due to the patient's age.C. The patient probably has a urinary tract infection.D. The patient is having delusions because of his depression over the loss of his wife.
A. The patient is having hallucinations as an adverse effect of his antidepressant medication.
A 17-year-old patient is hospitalized with severe depression. The patient has been taking a selective serotonin reuptake inhibitor (SSRI). What is the priority nursing action for the patient?A. Monitor food intake for levels of tyramine.B. Assess for weight loss and difficulty sleeping.C. Monitor the patient for severe headaches.D. Implement suicide precautions
D. Implement suicide precautions