NURS 6521N Final Exam Week 11

NURS 6521N Final Exam Week 11 (Feb 2020) NURS-6521N-56 Final Exam Week 11 - Advanced Pharmacology Winter 2019 100 out of 100 points 1. The nurse practitioner orders Amoxicillin 500 mg tid? What is the total amo ...

NURS 6521N Final Exam Week 11 (Feb 2020) NURS-6521N-56 Final Exam Week 11 - Advanced Pharmacology Winter 2019 100 out of 100 points 1. The nurse practitioner orders Amoxicillin 500 mg tid? What is the total amount of medication patient will take per day? 2. A 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe for which of the following adverse effects of the drug? 3. A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize? 4. A Nurse Practitioner is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered? 5. A patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are considered 6. An immunocompromised cancer patient has developed cryptococcal meningitis and been admitted to the intensive care unit for treatment with amphotericin B. How should the nurse most safely administer this drug? 7. The clinical nurse educator who oversees the emergency department in a children's hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children? 8. A female patient is taking filgrastim (Neupogen) to decrease the incidence of infection. The nurse notices a small increase in the neutrophil count 2 days after starting therapy. The nurse's evaluation of the increase is that 9. A nurse practitioner has administered filgrastim to a diverse group of patients in recent months. Which of the following patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug? 10. A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient to 11. How does cholestyramine lowers blood cholesterol? 12. A 66-year-old woman has a complex medical history that includes poorly-controlled type 1 diabetes, renal failure as a result of diabetic nephropathy and chronic heart failure (CHF). Her care provider has recently added spironolactone (Aldactone) to the woman's medication regimen. The nurse should consequently assess for signs and symptoms of 13. Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The nurse will advise the patient to avoid 14. A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for recurring headaches. The nurse should recommend 15. Which antihypertensive agent is associated with hair growth? 16. After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic should recognize that the woman may benefit from 17. A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the 18. A woman is receiving prolonged drug therapy during her complicated pregnancy, and it may pose a risk to both the mother and the fetus. The primary care physician has made dosage adjustments to minimize adverse effects and prevent toxicity. The nurse should make sure 19. A 34-year-old male has been diagnosed with TB and will be started on INH therapy. The medication history reveals that he currently takes antacids on a regular basis. The nurse will instruct the patient to take 20. The recommended treatment for trichomoniasis is 21. A Nurse Practitioner is explaining to a pregnant 21-year-old college student why she cannot continue to take ibuprofen (Advil) for her headaches. The nurse draws a picture depicting drug molecules crossing the placental membrane and entering into the fetal circulation. The nurse tells the patient that the main reason this happens is because 22. A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective? 23. A Nurse Practitioner is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following? 24. A 29-year-old pregnant patient is extremely upset about having to take medication for a pre-existing medical condition. She is consumed with fear that her baby will be born with a physical deformity or a congenital anomaly but knows that she has to take the medication. She talks constantly about this and is unable to sleep most nights. Which of the following is the most appropriate nursing diagnosis for this patient is? 25. A male patient is trying to decide if he should use finasteride (Proscar) to treat benign prostatic hypertrophy (BPH). When providing information about the drug, the nurse will include which of the following as a risk associated with finasteride therapy? 26. A male patient is receiving heparin by continuous intravenous infusion. The nurse will instruct the patient and family members to report which of the following should it occur? 27. A 71-year-old man has just been prescribed finasteride (Proscar). Which of the following complaints by this patient most likely indicated a need for this drug? 28. A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug? 29. A Nurse Practitioner is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for which of the following? 30. A 65-year-old male presents with a history of worsening urinary urgency, frequency, and hesitancy. He also tells you that he has to "push really hard" to urinate and that his urine dribbles a little after he is done urinating. What medication should be avoided 31. A Nurse Practitioner will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months? 32. A patient has acquired primary hypogonadism and has been prescribed testosterone transdermal (Androderm) patches. When educating the patient on how to administer the drug, the nurse will instruct him to 33. A Nurse Practitioner is performing patient education for a woman who has just been prescribed a bisphosphonate. Which of the following diagnostic and history findings would have prompted the woman's care provider to prescribe a bisphosphonate? 34. The side effects of antihistamines are mostly due to their: 35. A Nurse Practitioner is caring for a 10-year-old boy who complains of chronic headaches. His mother reports that she gives him Tylenol at least three times a day. Which of the following will the nurse work with the physician to evaluate? 36. A 15-year-old patient has meningitis caused by Haemophilus influenzae. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitor 37. Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to 38. Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient's physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician's order if the patient has a history of 39. A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause 40. A Nurse Practitioner is caring for a patient who is at 28 weeks' gestation and is receiving terbutaline (Brethine) to control preterm labor. Which of the following assessment parameters should the nurse prioritize? 41. The nurse recognizes that the potential for teratogenic drug effects is not static throughout the prenatal and postnatal periods. The potential for teratogenic effects is highest during 42. A patient with AIDS has developed a number of secondary infections in recent weeks, including Kaposi's sarcoma. As a result of this most recent diagnosis, his care team has opted to begin treatment with interferon alfa-2a. The nurse is aware that this drug will address the etiology of Kaposi sarcoma by 43. Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent 44. A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the APRN is responsible for facilitating this new aspect of the patient's drug regimen. This will involve the administration of 45. A patient is recovering from an acute episode of thrombophlebitis and is being treated with warfarin (Coumadin) 5 mg PO daily. In reviewing medication information, the Nurse Practitioner would include what information in their teaching? 46. Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse's following assessment questions most directly addresses a common adverse effect of filgrastim? 47. Which of the following would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a patient taking estrogen? 48. A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the chance that the boy will take his prescribed medication, the nurse should 49. A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather's antidepressant to improve his mood. After immediately phoning the boy's stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem? 50. A Nurse Practitioner is going to administer medication to an infant using a medicine dropper. The best method is to open the child's mouth by gently squeezing the cheeks and placing the drops 51. A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia). After baseline physical data are obtained, the nurse will assess the patient's childbearing potential. The nurse will inform the patient that during sibutramine therapy she should 52. A pregnant patient who has diabetes has been admitted to the hospital to begin labor. Since the patient has diabetes, the physician has decided to use oxytocin (Pitocin) to initiate labor contractions. When talking to the patient about the adverse effects of the drug, the nurse should understand that the most common adverse effects of the drug include 53. A 12-year-old boy is being discharged from the hospital after major surgery. The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to 54. A 30-year-old African-American woman tested positive for TB and is prescribed isoniazid. The nurse will plan the patient's care to include close monitoring of the drug therapy because 55. A 62-year-old patient taking tamoxifen exhibits increased bone and tumor pain along with a local disease flare. The nurse interprets this as an indication of which of the following? 56. A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis? 57. A Nurse Practitioner is having difficulty administering a bitter drug to a 5-year-old child. The nurse should 58. A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic can the nurse most safely recommend? 59. A Nurse Practitioner is reviewing the prepregnancy medication regimen of a patient who has just had a positive pregnancy test. The nurse should be aware of which of the following changes in pharmacokinetics that accompanies pregnancy? 60. A 39 y/o female is diagnosed with Graves disease. She also has a small goiter =. Her symptoms are not deemed to be severe and propylthiouracil is prescribed. Whare is the most serious potential adverse effect of this medication? 61. On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which of the following responses by the nurse is most appropriate? 62. Drugs have a valid medical use but a high potential for abuse, both psychological and physiologic. In an emergency, a Schedule 2 drug may be prescribed by telephone if a written prescription cannot be provided at the time. However, a written prescription must be provided within 72 hours with the words authorization for emergency dispensing written on the prescription. These prescriptions cannot be refilled. A new prescription must be written each time. Examples include certain amphetamines and barbiturates. This is scheduled drug 63. Which of the following can block the action of heparin? 64. A child is taking permethrin for head lice. The Nurse Practitioner will instruct her mother to 65. An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with 66. An immunocompromised patient with a diagnosis of candidiasis has failed to respond to conservative therapy and has consequently begun treatment with amphotericin B. The nurse is aware that this drug achieves a therapeutic effect by way of its influence on 67. A 36-year-old woman with a history of dysmenorrhea has begun treatment with progesterone, which she will be receiving by the intramuscular route. The nurse participating in the woman's care should prioritize which of the following potential nursing diagnoses? 68. A Nurse Practitioner is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to 69. A 36-year-old patient comes to the clinic and tells the nurse practitioner that she suspects that she is pregnant. During the initial assessment, the nurse practitioner learns that the patient is currently taking medications for diabetes, hypertension, and a seizure disorder. The nurse would be most concerned about which of the following medications? 70. The Nurse Practitioner has established peripheral IV access and begun an infusion of magnesium sulfate on a 29-year-old antepartum patient who is 35 weeks pregnant. Which of the following assessment findings most likely prompted the patient's physician to order magnesium sulfate for this patient? 71. A Nurse Practitioner educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session? 72. A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to 73. A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be 74. A patient is prescribed ganciclovir to treat a CMV infection. An oral dosage is prescribed. To help increase bioavailability of the drug, the nurse will encourage the patient to take the medication 75. A patient with chronic heart failure has begun treatment with epoetin alfa, which she will receive in her own home from a home health nurse. The nurse should teach the patient to supplement this treatment with a diet that is high in 76. A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The APRN will be sure to 77. Ginger, a 25 year old female presents at the clinic with known history of depression. She reports taking an SSRI with only partial relief. Which of the following drugs can be used safely at any dose in conjunction with an SSRI? 78. A nurse practitioner has been assigned to a 55-year-old woman who has a malignant brain tumor. The patient is receiving her first dose of carmustine. It will be critical for the nurse to observe for which of the following? 79. A patient reports to a clinic with complaints of breast tenderness, a right lumpy breast, and no breast discharge. The breast tenderness occurs primarily during her menstrual cycle. The nurse practitioner probably suspects 80. A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose? 81. A Nurse Practitioner has completed a medication reconciliation of a patient who has been admitted following a motor vehicle accident. Among the many drugs that the patient has received in the previous year is rituximab. The nurse would be justified in suspecting the patient may have received treatment for which of the following diseases? 82. A male patient is experiencing climacteric symptoms secondary to androgen deficiency. His physician has prescribed testosterone. The nursing assessment reveals that the patient has had a myocardial infarction. The combination of testosterone therapy and a history of myocardial infarction would place that patient at a significantly higher risk of 83. An immunocompromised 7-year-old child was recently discharged home with a peripherally-inserted central line (PIC line) for home antibiotic therapy. He has now been brought to the emergency department by his mother and father with signs and symptoms of line sepsis. Upon questioning, the mother states that she has been removing the PIC dressing daily and washing the site with warm water and a cloth. What nursing diagnosis is most appropriate in this situation? 84. A child is admitted to the burn unit with second and third degree burns on both arms and part of his or her face. When administering topical medications to the burned areas, the nurse should 85. A 2-year-old child is diagnosed with a minor ailment and is to be administered medications at home for 2 weeks. The child lives with his mother, grandmother, and four other children between the ages of 14 months and 7 years. The home health nurse is asked to assess the home environment to determine if it is appropriate for the child to take his medication at home. Which of the following will have the greatest impact on the nurse's assessment? 86. A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment? 87. A Nurse Practitioner is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an 88. Mr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his current wound care regimen involves the daily application of silver sulfadiazine to his wounds. The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering this medication? 89. A patient has been admitted to the critical care unit of the hospital with bacterial septicemia that has failed to respond to initial antibiotic treatment. The patient's most recent blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the patient's blood. The nurse will anticipate that this patient will likely require intravenous administration of what antibiotic? 90. A patient with non-Hodgkin's lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient's care, what nursing diagnosis should the nurse prioritize? 91. Drugs that use CYP 3A4 isoenzymes for metabolism may: 92. Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse's response to Mr. Lepp? 93. A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this patient would most likely contraindicate the use of tadalafil for his ED? 94. A man has a demonstrated history of androgen deficiency and the consequences of this health problem include an inability to maintain an erection. Which of the following medications would best address this patient's erectile dysfunction (ED)? 95. A Nurse Practitioner is working with a 16-year-old pregnant teen and assessing for behavior that may put the baby at risk. The most important assessment the nurse can make is 96. A Nurse Practitioner is aware that the concept of selective toxicity is foundational to antimicrobial therapy. Which of the following statements most accurately describes selective toxicity? 97. A 20-year-old woman has been prescribed estrogen. As with all women taking estrogen, the nurse will carefully monitor the patient for which of the following? 98. A 13-year-old female took a weight loss drug that activated the sympathetic nervous system. Which of the following assessment findings would the nurse expect? 99. A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider? 100. Which of the following patients will be at the greatest risk for anemia and would be the most likely candidate for epoetin alfa therapy?