What To Do In These Situations? Nursing Quiz

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1/133 Questions

When applying transdermal nitroglycerin patches, which instruction by the nurse is correct?
- “Rotate application sites with each dose.”
- “Use only the chest area for application sites."
- "Temporarily remove the patch if you go swimming.”
- “Apply the patch to the same site each time.”

About This Quiz

A nurse is a caregiver for patients and helps to manage physical needs, prevent illness, and treat health conditions. They are responsible for the holistic care of patients, which encompasses the psychosocial, developmental, cultural, and spiritual needs of the individual.

What To Do In These Situations? Nursing Quiz - Quiz

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2.

When teaching a patient who is beginning antilipemic therapy about possible drug-food interactions, the nurse will discuss which food?
- Oatmeal
- Grapefruit juice
- Licorice
- Dairy products
Correct Answer

A. Grapefruit juice

Explanation

Grapefruit juice is known to interact with certain antilipemic drugs, specifically statins, which can lead to increased drug levels in the body. This can result in potential side effects or adverse reactions. Therefore, it is important for the nurse to discuss the potential drug-food interaction between grapefruit juice and antilipemic therapy with the patient.

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3.

A patient is being discharged on anticoagulant therapy. The nurse will include in the patient-education conversion that it is important to avoid herbal products that contain which substance?
- Valerian
- Ginkgo
- Soy
- Saw palmetto
Correct Answer

A. Ginkgo

Explanation

Ginkgo is an herb that has been shown to have anticoagulant effects, meaning it can thin the blood and increase the risk of bleeding. Therefore, it is important for a patient on anticoagulant therapy to avoid herbal products that contain ginkgo to prevent any potential interactions or adverse effects.

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4.

The nurse is reviewing principles of immunization. What type of immunization occurs when antibodies pass from mother to infant during breastfeeding or through the placenta during pregnancy?
- A. Artificial active immunization
- B. Attenuating immunization
- C. Natural passive immunization
- D. Artificial passive immunization
Correct Answer

A. C. Natural passive immunization

Explanation

During breastfeeding or through the placenta during pregnancy, antibodies are transferred from the mother to the infant. This is known as natural passive immunization. In this process, the infant receives pre-formed antibodies from the mother, providing temporary protection against certain diseases until their own immune system develops. This type of immunization is considered passive because the immune response is not actively generated by the infant's own immune system. It is a natural process that helps to protect the newborn during the early stages of life.

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5.

A woman who is planning to become pregnant should ensure that she receives adequate levels of which supplements to reduce the risk for fetal neural tube defects?
- A. Vitamin B12
- B. Vitamin D
- C. Iron
- D. Folic Acid
Correct Answer

A. D. Folic Acid

Explanation

Folic acid is essential for the development of a healthy neural tube in the fetus, which forms the baby's brain and spinal cord. Adequate levels of folic acid can significantly reduce the risk of neural tube defects such as spina bifida and anencephaly. Therefore, it is important for a woman planning to become pregnant to ensure she receives adequate levels of folic acid through supplements or a balanced diet. Vitamin B12, Vitamin D, and iron are also important for a healthy pregnancy, but they do not specifically reduce the risk of neural tube defects.

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6.

A patient who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the patient may have taken too much warfarin. The nurse provides the patient with which appropriate antidote?
- Vitamin E
- Vitamin K
- Protamine Sulfate
- Potassium Chloride
Correct Answer

A. Vitamin K

Explanation

The correct antidote for a patient who has taken too much warfarin is Vitamin K. Warfarin is an anticoagulant that works by inhibiting the synthesis of Vitamin K-dependent clotting factors in the liver. By giving the patient Vitamin K, it helps to reverse the effects of warfarin and restore normal clotting function.

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7.

Which action is often recommended to help reduce tolerance to transdermal nitroglycerin therapy?
- Omit a dose once a week.
- Leave the patch on for 2 days at a time.
- Cut the patch in half for 1 week until the tolerance subsides
- Remove the patch at bedtime, and then apply a new one in the morning.
Correct Answer

A. Remove the patch at bedtime, and then apply a new one in the morning.

Explanation

Removing the patch at bedtime and applying a new one in the morning is often recommended to help reduce tolerance to transdermal nitroglycerin therapy. This practice allows for a nitrate-free interval during sleep, which helps prevent the development of tolerance. By removing the patch at night and applying a new one in the morning, the body is given a break from continuous exposure to nitroglycerin, which can help maintain the effectiveness of the therapy.

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8.

When teaching a patient who has a new prescription for transdermal nitroglycerin patches, the nurse tells the patient that these patches are most appropriately used for which situation?
- To prevent palpitations
- To prevent the occurrence of angina
- To relieve shortness of breath
Correct Answer

A. To prevent the occurrence of angina

Explanation

Transdermal nitroglycerin patches are most appropriately used to prevent the occurrence of angina. Angina is a symptom of coronary artery disease that causes chest pain or discomfort due to reduced blood flow to the heart muscle. Nitroglycerin patches work by relaxing and widening the blood vessels, improving blood flow to the heart and reducing the frequency and severity of angina episodes. Therefore, using these patches can help prevent the occurrence of angina and provide relief to the patient.

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9.

The nurse notes in the patient’s medication orders that the patient will be starting anticoagulant therapy. What is the primary goal of anticoagulant therapy?
- Stabilizing an existing thrombus
- Dissolving an existing thrombus
- Preventing thrombus formation
Correct Answer

A. Preventing thrombus formation

Explanation

The primary goal of anticoagulant therapy is to prevent thrombus formation. Anticoagulants work by inhibiting the clotting factors in the blood, thereby reducing the risk of blood clot formation. This is important because blood clots can lead to serious complications such as deep vein thrombosis, pulmonary embolism, and stroke. By preventing thrombus formation, anticoagulant therapy helps to maintain normal blood flow and reduce the risk of these potentially life-threatening conditions.

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10.

When an adrenergic drug stimulates beta1-adrenergic receptors, the result is an increased force of contraction, which is known as what type of effect?
- Anti-adrenergic
- Negative Dromotropic
- Positive Inotropic
- Positive Chronotropic
Correct Answer

A. Positive Inotropic

Explanation

When an adrenergic drug stimulates beta1-adrenergic receptors, it leads to an increased force of contraction in the heart. This effect is known as a positive inotropic effect.

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11.

A 49-year-old patient is in the clinic for a follow-up visit 6 months after starting a beta-blocker for treatment of hypertension. During this visit, his blood pressure is 169/98 mm Hg, and he eventually confesses that he stopped taking this medicine 2 months ago because of an “embarrassing problem.” What problem did the most likely experience with this medication that caused him to stop taking it?
- Urge incontinence
- Dizziness when standing up
- Excessive flatus
- Impotence
Correct Answer

A. Impotence

Explanation

Impotence is the most likely problem that the patient experienced with the beta-blocker medication, which caused him to stop taking it. Impotence, also known as erectile dysfunction, refers to the inability to achieve or maintain an erection sufficient for sexual intercourse. Beta-blockers can cause sexual side effects, including impotence, by interfering with the normal physiological responses involved in achieving an erection. This side effect can be embarrassing and distressing for patients, leading them to discontinue the medication.

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12.

A patient about to receive a morning dose of digoxin has an apical pulse of 53 beats/minute. What will the nurse do next?
- Administer the dose
- Administer the dose, and notify the prescriber.
- Check the radical pulse for 1 full minute.
- Withhold the dose, and notify the prescriber.
Correct Answer

A. Withhold the dose, and notify the prescriber.

Explanation

The correct answer is to withhold the dose and notify the prescriber. A normal apical pulse for an adult is between 60-100 beats per minute. A pulse rate of 53 beats per minute is considered bradycardia, which can be a potential side effect of digoxin. Administering the dose in this situation could further decrease the heart rate and lead to adverse effects. Therefore, it is important for the nurse to withhold the dose and notify the prescriber for further evaluation and instructions.

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13.

A patient who has been newly diagnosed with vertigo will be taking an antihistamine antemetic drug. The nurse will include which information when teaching the patient about this drug?
- A. The patient may skip doses if the patient is feeling well.
- B. The patient will need to avoid driving because of possible drowsiness
- C. The patient may experience occasional problems with taste
- D. It is safe to take the medication with a glass of wine in the evening to help settle the stomach.
Correct Answer

A. B. The patient will need to avoid driving because of possible drowsiness

Explanation

The correct answer is b. The patient will need to avoid driving because of possible drowsiness. This information is important to include when teaching the patient about the antihistamine antemetic drug because drowsiness is a common side effect of this medication. Driving while drowsy can be dangerous and increase the risk of accidents. Therefore, it is essential for the patient to be aware of this potential side effect and take necessary precautions, such as avoiding driving or operating heavy machinery, to ensure their safety and the safety of others.

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14.

A patient has been taking donepezil (Aricept) for 2 weeks as part of the treatment for early stages of Alzheimer’s disease. Her daughter calls the prescriber’s office and is upset because “Mother has not improved one bit!” Which response by the nurse is appropriate?
- “Increase the dosage to twice daily.”
- “It takes time for the cure to take effect.”
- “It may take up to 6 weeks to see an improvement.”
- “Take the medication on an empty stomach for improved absorption.”
Correct Answer

A. “It may take up to 6 weeks to see an improvement.”

Explanation

The appropriate response by the nurse is "It may take up to 6 weeks to see an improvement." This response acknowledges the daughter's concern and provides accurate information about the expected timeframe for improvement with donepezil. It is important for the nurse to educate the daughter about the realistic expectations of the medication and reassure her that improvement may take time.

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15.

While recovering from surgery, a 74 year old woman started taking a stimulant laxative, senna (Senokot), to relieve constipation caused by the pain medications. Two weeks later, at her follow-up appointment, she tells the nurse that she like how “regular” her bowel movements are now that she is taking the laxative. Which teaching principle is appropriate for this patient?
- A. She needs to be sure to take this medication with plenty of fluids
- B. It is important to have a daily bowel movement to promote bowel health
- C. Long-term use of laxatives often results in decreased bowel tone and may lead to dependency
- D. She needs to switch to glycerin suppositories to continue having daily bowel movements.
Correct Answer

A. C. Long-term use of laxatives often results in decreased bowel tone and may lead to dependency

Explanation

Long-term use of laxatives often results in decreased bowel tone and may lead to dependency. This explanation is appropriate because it addresses the potential consequences of long-term laxative use, which is relevant to the patient's situation. It highlights the importance of not relying on laxatives for regular bowel movements and encourages the patient to explore other methods for relieving constipation.

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16.

The nurse is administering a stat dose of epinephrine. Epinephrine is appropriate for which situation?
- Cardiac Arrest
- Tachycardia
- Angina
- Severe hypertension
Correct Answer

A. Cardiac Arrest

Explanation

Epinephrine is appropriate for cardiac arrest because it is a potent vasoconstrictor and stimulates the heart, leading to increased blood flow and oxygenation. It helps to restore normal heart rhythm and blood pressure during a cardiac arrest situation.

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17.

A hospitalized patient is experiencing a severe anaphylactic reaction to a dose of intravenous penicillin. Which drug will the nurse use to treat this condition?
- Phenylephrine
- Pseudoephedrine
- Epinephrine
- Ephedra
Correct Answer

A. Epinephrine

Explanation

Epinephrine is the drug of choice for treating severe anaphylactic reactions. It is a potent vasoconstrictor and bronchodilator that helps to reverse the symptoms of anaphylaxis, such as bronchoconstriction, hypotension, and edema. It acts quickly to increase blood pressure, open up the airways, and reduce swelling. Phenylephrine and pseudoephedrine are both decongestants that do not have the same rapid and potent effects as epinephrine. Ephedra is an herbal supplement that is not typically used in the treatment of anaphylaxis.

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18.

The nurse is creating a plan of care for a patient with a new diagnosis of hypertension. Which is a potential nursing diagnosis for the patient taking antihypertensive medications?
- Diarrhea
- Sexual dysfunction
- Urge urinary incontinence
- Impaired memory
Correct Answer

A. Sexual dysfunction

Explanation

When a patient is taking antihypertensive medications, sexual dysfunction can be a potential nursing diagnosis. Antihypertensive medications can cause side effects such as decreased libido, erectile dysfunction, and difficulties with sexual arousal and orgasm. These side effects can significantly impact a patient's quality of life and may require nursing interventions such as education on managing sexual dysfunction, providing emotional support, and collaborating with the healthcare team to adjust medication regimen if necessary.

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19.

A patient has been taking a beta blocker for 4 weeks as part of his antianginal therapy. He also has type II diabetes and hyperthyroidism. When discussing possible adverse effects, the nurse will include which information?
- “Watch for unusual weight loss.”
- “Monitor your pulse for increased heart rate.”
- Use the hot tub and sauna at the gym as long as time is limited to 15 minutes.”
- “Monitor your blood glucose levels for possible hypoglycemia or hyperglycemia.”
Correct Answer

A. “Monitor your blood glucose levels for possible hypoglycemia or hyperglycemia.”

Explanation

Beta blockers can affect blood glucose levels in patients with diabetes. They can mask symptoms of hypoglycemia, making it difficult for the patient to recognize low blood sugar levels. At the same time, they can also impair the body's ability to raise blood sugar levels, leading to hyperglycemia. Therefore, it is important for the patient to monitor their blood glucose levels regularly to ensure they are within a safe range.

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20.

A 14-year-old has been treated for asthma for almost 4 months. Two weeks ago, she was given salmeterol as part of her medication regimen. However, her mother has called the clinic to report that it does not seem to work when her daughter is having an asthma attack. Which response by the nurse is appropriate?
- “She should take up to two puffs every 4 hours to ensure adequate blood levels.”
- "This medication is indicated for prevention of bronchospasms, not for relief of acute symptoms.”
- “She is too young for this particular medication; it should be changed.”
- “It takes time for a therapeutic response to develop.”
Correct Answer

A. "This medication is indicated for prevention of bronchospasms, not for relief of acute symptoms.”

Explanation

The correct answer is "This medication is indicated for prevention of bronchospasms, not for relief of acute symptoms.” This response by the nurse is appropriate because salmeterol is a long-acting beta-agonist that is used for the prevention of asthma symptoms, not for immediate relief during an asthma attack. It is important for the nurse to educate the mother about the purpose of the medication and discuss the appropriate use of rescue medications for acute symptoms.

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21.

The teaching for a patient who is taking tamsulosin (Flomax) to reduce urinary obstruction due to benign prostatic hyperplasia will include which of these?
- Fluids need to be restricted while on this medication.
- Take the medication with breakfast to promote the maximum effects of the drug.
- Get up slowly from a sitting or lying position.
- Blood pressure must be monitored because the medication may cause hypertension.
Correct Answer

A. Get up slowly from a sitting or lying position.

Explanation

Tamsulosin (Flomax) is an alpha-adrenergic blocker commonly used to treat urinary obstruction due to benign prostatic hyperplasia. One of the common side effects of this medication is orthostatic hypotension, which can cause dizziness or lightheadedness when standing up. Therefore, patients should be advised to get up slowly from a sitting or lying position to minimize the risk of falls or injuries. The other options are not relevant to the teaching for a patient taking tamsulosin.

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22.

A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion. The patient asks the nurse why he has to be on two medications. The nurse’s response is based on which rationale?
- The oral and injection forms work synergistically.
- The combination of heparin and an oral anticoagulation results in fewer adverse effects than heparin used alone.
- Oral anticoagulants are used to reach an adequate level of anticoagulation when heparin alone is unable to do so.
- Heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach adequate levels.
Correct Answer

A. Heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach adequate levels.

Explanation

The nurse explains that heparin is used initially to start the anticoagulation process and allow time for the blood levels of warfarin to reach therapeutic levels. Warfarin takes longer to reach its full effect, so heparin is used as a bridge therapy. Once the blood levels of warfarin are adequate, heparin can be discontinued. This approach ensures effective anticoagulation and minimizes the risk of adverse effects.

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23.

When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse will discuss which potential problem?
- Impotence
- Bradycardia
- Increased libido
- Weight gain
Correct Answer

A. Impotence

Explanation

When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse will discuss the potential problem of impotence. Antihypertensive drugs can cause sexual dysfunction, including difficulty achieving or maintaining an erection, which can lead to impotence. This is an important potential side effect to discuss with male patients to ensure they are aware of the potential impact on their sexual health and to address any concerns or questions they may have.

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24.

A patient has been taking digoxin at home but took an accidental overdose and has developed toxicity.The patient has been admitted to the telemetry unit, where the physician has ordered digoxin immune Fab (Digibind). The patient asks the nurse why the medication is ordered. What is the nurse’s nest response?
- “It will increase your heart."
- “This drug helps to lower your potassium levels.”
- “It helps to convert the irregular heart rhythm to a more normal rhythm.”
- “This drug is an antidote to digoxin and will help to lower the blood levels.”
Correct Answer

A. “This drug is an antidote to digoxin and will help to lower the blood levels.”

Explanation

Digoxin immune Fab (Digibind) is an antidote used to treat digoxin toxicity. It works by binding to the excess digoxin in the bloodstream and removing it from the body, thereby lowering the blood levels of digoxin. This helps to reverse the toxic effects of the medication. Therefore, the nurse's response that Digibind is an antidote to digoxin and will help to lower the blood levels is the correct explanation.

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25.

2. What is the nurses priority action if extravasation of an antineoplastic drug occurs during intravenous (IV) administration?
- A. Reduce the infusion rate
- B. Discontinue the IV, and apply warm compresses
- C. Stop the infusion immediately, but leave the IV catheter in place
- D. Change the infusion to normal saline, and inject the area with hydrocortisone
Correct Answer

A. C. Stop the infusion immediately, but leave the IV catheter in place

Explanation

The nurse's priority action if extravasation of an antineoplastic drug occurs during IV administration is to stop the infusion immediately, but leave the IV catheter in place. This is important because it allows for the continued administration of an antidote or specific treatment through the same IV catheter, if available. Removing the catheter could lead to further complications or delay in treatment.

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26.

A patient has had an overdose of an intravenous cholinergic drug. The nurse expects to administer which drug as an antidote?
- Atenolol (Tenormin)
- Bethanechol (Urecholine)
- Dobutamine
- atropine sulfate
Correct Answer

A. atropine sulfate

Explanation

Atropine sulfate is the correct antidote for an overdose of an intravenous cholinergic drug. Cholinergic drugs stimulate the parasympathetic nervous system, while atropine sulfate is an anticholinergic drug that blocks the effects of acetylcholine. By administering atropine sulfate, the nurse can counteract the excessive cholinergic stimulation caused by the overdose and help restore normal physiological function. Atenolol, bethanechol, and dobutamine are not appropriate antidotes for cholinergic drug overdose.

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27.

The nurse is providing teaching regarding drug therapy to the husband of a woman with Alzheimer’s disease. She was diagnosed 3 months ago, has mild memory loss, and will be receiving donepezil (Aricept). What is the drug’s expected action?
- May help to improve the symptoms of Alzheimer’s disease
- Prevent memory loss in later stages
- Reverses the course of Alzheimer’s disease
- Provides sedation to prevent agitation and restlessness
Correct Answer

A. May help to improve the symptoms of Alzheimer’s disease

Explanation

Donepezil (Aricept) is a medication commonly used to treat Alzheimer's disease. It works by increasing the levels of a chemical messenger in the brain called acetylcholine, which is involved in memory and other cognitive functions. By increasing acetylcholine levels, donepezil may help to improve the symptoms of Alzheimer's disease, such as memory loss and cognitive decline. However, it does not prevent memory loss in later stages, reverse the course of the disease, or provide sedation to prevent agitation and restlessness.

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28.

The nurse is reviewing the use of anticholinergic drugs with a patient and explains that anticholinergic drugs block the effects of which nervous system?
- Central nervous system
- Somatic nervous system
- Sympathetic nervous system
- Parasympathetic nervous system
Correct Answer

A. Parasympathetic nervous system

Explanation

Anticholinergic drugs block the effects of the parasympathetic nervous system. The parasympathetic nervous system is responsible for rest and digest functions, such as slowing heart rate, constricting pupils, and increasing digestion. By blocking the effects of the parasympathetic nervous system, anticholinergic drugs can have various effects, such as increasing heart rate, dilating pupils, and decreasing digestion.

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29.

A patient who has been taking antihypertensive drugs for a few months complains of having a persistent dry cough. The nurse explains that this cough is an adverse effect of which class of antihypertensive drugs?
- Beta blockers
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin II receptor blockers (ARBs)
- Calcium channel blockers
Correct Answer

A. Angiotensin-converting enzyme (ACE) inhibitors

Explanation

Angiotensin-converting enzyme (ACE) inhibitors can cause a persistent dry cough as an adverse effect. This is because ACE inhibitors can increase the levels of bradykinin, a substance that can irritate the airways and cause coughing. Beta blockers, angiotensin II receptor blockers (ARBs), and calcium channel blockers do not typically cause this side effect.

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30.

A patient has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin tablets. When teaching the patient how to use sublingual nitroglycerin, the nurse will include which instruction?
- Take up to five doses at 15-minute intervals for an angina attack.
- If the tablet does not dissolve quickly, chew the tablet for maximal effect.
- If the chest pain is not relieved after one tablet, call 911 immediately.
- Wait 1 minute between doses of sublingual tablets, up to three doses.
Correct Answer

A. If the chest pain is not relieved after one tablet, call 911 immediately.

Explanation

This instruction is included because if the chest pain is not relieved after taking one tablet of sublingual nitroglycerin, it may indicate a more serious condition such as a heart attack. Calling 911 immediately is important to ensure prompt medical attention and intervention.

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31.

A patient with risk factors for coronary artery disease asks the nurse about the “good cholesterol” laboratory values. The nurse knows that “good cholesterol” refers to which lipids?
- Triglycerides
- Low-density lipoproteins (LDLs)
- Very-low-density lipoproteins (VLDLs)
- High-density lipoproteins (HDLs)
Correct Answer

A. High-density lipoproteins (HDLs)

Explanation

High-density lipoproteins (HDLs) are often referred to as "good cholesterol" because they help remove excess cholesterol from the bloodstream and transport it back to the liver for processing and elimination. High levels of HDLs are associated with a lower risk of coronary artery disease. Triglycerides, low-density lipoproteins (LDLs), and very-low-density lipoproteins (VLDLs) are not considered "good cholesterol" as they can contribute to the buildup of plaque in the arteries, increasing the risk of coronary artery disease.

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32.

The nurse is reviewing the mechanism of action of antidiarrheal drugs. Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?
- A. Adsorbents such as pepto-bismol
- B. Anticholinergics such as belladonna alkaloids
- C. Probiotics such as lactinex
- D. Lubricants such as mineral oil
Correct Answer

A. B. Anticholinergics such as belladonna alkaloids

Explanation

Anticholinergics such as belladonna alkaloids work by decreasing the intestinal muscle tone and peristalsis of the intestines. This means that they reduce the contractions of the intestinal muscles, slowing down the movement of stool through the intestines. This can help to alleviate diarrhea by allowing more time for water absorption and reducing the frequency of bowel movements. Adsorbents, probiotics, and lubricants do not directly affect intestinal muscle tone or peristalsis.

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33.

The nurse will teach the patient who is receiving oral iron supplements to watch for which expected adverse effects?
- A. Palpitations
- B. Drowsiness and dizziness
- C. Black, tarry stools
- D. Orange-red discoloration of the urine
Correct Answer

A. C. Black, tarry stools

Explanation

The nurse will teach the patient who is receiving oral iron supplements to watch for black, tarry stools as an expected adverse effect. Iron supplements can cause gastrointestinal side effects, including dark or black stools, due to the presence of unabsorbed iron in the stool. This is a common and harmless side effect of iron supplementation and does not require immediate medical attention.

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34.

The nurse recognizes that adrenergic drugs cause relaxation of the bronchi and bronchodilation by stimulating which type of receptors?
- Beta2-adrenergic
- Dopaminergic
- Alpha1-adrenergic
- Beta1-adrenergic
Correct Answer

A. Beta2-adrenergic

Explanation

Adrenergic drugs cause relaxation of the bronchi and bronchodilation by stimulating beta2-adrenergic receptors. These receptors are found in the smooth muscle of the bronchi and when stimulated, they cause the muscles to relax, leading to bronchodilation. This helps to open up the airways and improve airflow, making it easier for the patient to breathe. Dopaminergic receptors are not involved in bronchodilation, while alpha1-adrenergic and beta1-adrenergic receptors have different effects on other parts of the body and are not specifically involved in bronchial relaxation.

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35.

When administering heparin subcutaneously, the nurse will follow which procedure?
- Aspirating the syringe before injecting the medication
- Massaging the site after injection
- Applying heat to the injection site
- Using a ½ to 5/8- inch 25 to 28 gauge needle.
Correct Answer

A. Using a ½ to 5/8- inch 25 to 28 gauge needle.
36.

A patient who is taking warfarin (Coumadin) therapy has a headache and calls the prescriber’s office to ask about taking a pain reliever. The nurse expects to receive instructions for which type of medication?
- Aspirin tablets
- Ibuprofen (Advil)
- Acetaminophen (Tylenol)
- An opioid
Correct Answer

A. Acetaminophen (Tylenol)

Explanation

When a patient is taking warfarin therapy, it is important to avoid medications that can increase the risk of bleeding. Aspirin and ibuprofen are both nonsteroidal anti-inflammatory drugs (NSAIDs) that can interfere with the blood-thinning effects of warfarin and increase the risk of bleeding. Opioids are not typically used for headaches and may have additional side effects. Acetaminophen is a pain reliever that does not have the same blood-thinning effects as NSAIDs, making it a safer choice for patients on warfarin therapy.

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37.

A patient tells the nurse that he likes to eat large amounts of garlic “to help lower his cholesterol levels naturally.” The nurse reviews his medication history and notes that which drug has a potential interaction with the garlic?
- Acetaminophen (Tylenol)
- Warfarin (Coumadin)
- Digoxin (Lanoxin)
- Phenytoin (Dilantin)
Correct Answer

A. Warfarin (Coumadin)

Explanation

Garlic has been shown to have anticoagulant properties, meaning it can thin the blood and increase the risk of bleeding. Warfarin (Coumadin) is also an anticoagulant medication, so taking garlic along with it can further increase the risk of bleeding. Therefore, there is a potential interaction between garlic and Warfarin (Coumadin).

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38.

A patient is taking an alpha blocker as treatment for benign prostatic hyperplasia. The nurse will monitor for which potential drug effect?
- Orthostatic Hypotension
- Increased blood pressure
- Decreased urine flow
- Discolored urine
Correct Answer

A. Orthostatic Hypotension

Explanation

The nurse will monitor for orthostatic hypotension as a potential drug effect of the alpha blocker medication. Alpha blockers work by relaxing the muscles in the prostate and bladder neck, which can cause a decrease in blood pressure. Orthostatic hypotension refers to a sudden drop in blood pressure when changing positions, such as standing up from a seated or lying position. This can lead to symptoms such as dizziness, lightheadedness, and even fainting. Therefore, it is important for the nurse to monitor the patient's blood pressure regularly and educate them about the potential side effect of orthostatic hypotension.

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39.

A patient who has had abdominal surgery has been discharged on a cholinergic drug to assist in increasing gastrointestinal peristalsis. The nurse will teach this patient to look for which therapeutic effect?
- Decreased pulse rate
- Abdominal cramping
- Passage of flatus
- Decreased urge to void
Correct Answer

A. Passage of flatus

Explanation

The nurse will teach the patient to look for the therapeutic effect of passage of flatus because cholinergic drugs stimulate the parasympathetic nervous system, which increases gastrointestinal peristalsis. This can help relieve symptoms of abdominal distension and discomfort by promoting the movement of gas through the intestines, leading to the passage of flatus. Decreased pulse rate, abdominal cramping, and decreased urge to void are not expected therapeutic effects of cholinergic drugs in this context.

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40.

The nurse working in a preoperative admitting unit administers an anticholinergic medication to a patient before surgery. What is the purpose of this drug in the preoperative setting?
- Reduce oral and gastrointestinal secretions
- Reduce urinary frequency
- Relax the patient
- Control the heart rate
Correct Answer

A. Reduce oral and gastrointestinal secretions

Explanation

The purpose of administering an anticholinergic medication before surgery is to reduce oral and gastrointestinal secretions. Anticholinergic drugs work by blocking the action of acetylcholine, a neurotransmitter that stimulates secretions in the body. By reducing secretions, the risk of aspiration during surgery is minimized, as well as the potential for complications related to excessive secretions in the respiratory and gastrointestinal tracts.

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41.

When the nurse is administering topical nitroglycering ointment, which technique is correct?
- Apply the ointment on the skin on the forearm.
- Apply the ointment only in the case of a mild angina episode.
- Remove the old ointment before new ointment is applied.
- Massage the ointment gently into the skin, and then cover the area with plastic wrap.
Correct Answer

A. Remove the old ointment before new ointment is applied.

Explanation

It is important to remove the old ointment before applying a new one to prevent buildup and ensure the effectiveness of the medication. This allows for proper absorption of the nitroglycerin into the skin.

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42.

A patient has been instructed to take one enteric-coated low-dose aspirin a day as part of therapy to prevent strokes. The nurse will provide which instruction when providing patient teaching about this medication?
- Aspirin needs to be taken on an empty stomach to ensure maximal absorption.
- Low-dose aspirin therapy rarely causes problems with bleeding.
- Take the medication with 6 to 8 ounces of water and food.
- Coated tablets may be crushed if necessary for easier swallowing.
Correct Answer

A. Take the medication with 6 to 8 ounces of water and food.
43.

6. A patient who has had a liver transplant is taking mycophenolate (cellcept) for the prevention of organ rejection. She tells the nurse that she wants children. The nurse explains that the medication she is currently prescribed
- A. Can be taken safely with grapefruit juice stirred in a Styrofoam container
- B. Can cause multiple births
- C. Can cause congenital malformation or spontaneous abortions during pregnancy.
- D. Can be taken during the first trimester
Correct Answer

A. C. Can cause congenital malformation or spontaneous abortions during pregnancy.

Explanation

The correct answer is C because mycophenolate (cellcept) is known to cause congenital malformation or spontaneous abortions during pregnancy. It is a teratogenic medication that can harm the developing fetus. Therefore, it is not safe for a patient who wants to have children to continue taking this medication.

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44.

The nurse is developing a plan care for a patient who is experiencing gastrointestinal adverse effects, including anorexia and nausea, after the first course of antineoplastic therapy. What is an appropriate goal for this patient when dealing with this problem? The patient will
- A. Eat three balanced meals a day within 2 days
- B. Return to normal eating pattern within 4 weeks
- C. Maintain normal weight by consuming healthy snacks as tolerated
- D. Maintain a diet of small, frequent feedings with nutrition supplements
Correct Answer

A. D. Maintain a diet of small, frequent feedings with nutrition supplements

Explanation

The goal of maintaining a diet of small, frequent feedings with nutrition supplements is appropriate for a patient experiencing gastrointestinal adverse effects. This approach helps to manage anorexia and nausea by providing the patient with smaller, more manageable meals that are easier to tolerate. Additionally, the use of nutrition supplements ensures that the patient is receiving adequate nutrients despite their decreased appetite. This goal focuses on maintaining the patient's nutrition and managing their symptoms while they undergo antineoplastic therapy.

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45.

A patient has been taking iron supplements for anemia for 2 months. During a follow-up assessment, the nurse will observe for which therapeutic response?
- A. Decreased weight
- B. Increased activity tolerance
- C. Decreased papiltations
- D. Increased appetite
Correct Answer

A. B. Increased activity tolerance

Explanation

During a follow-up assessment, the nurse will observe for increased activity tolerance in a patient who has been taking iron supplements for anemia for 2 months. Iron is essential for the production of red blood cells, which carry oxygen to the body's tissues. Anemia leads to fatigue and decreased activity tolerance due to a lack of oxygen. By taking iron supplements, the patient's iron levels are likely to increase, leading to improved oxygen delivery and increased energy levels, resulting in an increased ability to tolerate physical activity. Therefore, increased activity tolerance is a therapeutic response that the nurse would expect to observe.

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46.

The nurse is aware that adrenergic drugs produce effects similar to which of these nervous systems?
- Somatic Nervous System
- Central Nervous System
- Parasympathetic Nervous System
- Sympathetic Nervous System
Correct Answer

A. Sympathetic Nervous System

Explanation

Adrenergic drugs produce effects similar to the Sympathetic Nervous System. The Sympathetic Nervous System is responsible for the body's "fight or flight" response, which includes increased heart rate, elevated blood pressure, dilation of the pupils, and increased sweating. Adrenergic drugs mimic the effects of the sympathetic nervous system by activating adrenergic receptors in various organs and tissues, leading to similar physiological responses.

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47.

During initial rounds, the nurse notes that a dobutamine infusion has extravasated into the forearm of a patient. After stopping the infusion, the nurse follows standing orders and immediately injects phentolamine (Regitine) subcutaneously in a circular fashion around the extravasation site. What is the mechanism of action of the phentolamine in this situation?
- It increases peripheral vascular resistance and reduces arterial pressure at the site.
- It causes arterial vasoconstriction and reduced pain and swelling at the site.
- It increases blood flow to the ischemic site by vasodilation to prevent tissue damage.
- It neutralizes the extravasated dobutamine immediately.
Correct Answer

A. It increases blood flow to the ischemic site by vasodilation to prevent tissue damage.

Explanation

Phentolamine is an alpha-adrenergic antagonist that works by blocking the alpha receptors on the smooth muscle of blood vessels. By doing so, it causes vasodilation, which increases blood flow to the ischemic site. This increased blood flow helps to prevent tissue damage caused by the extravasated dobutamine.

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48.

A cholinergic drug is prescribed for a patient with a new diagnosis of myasthenia gravis, and the nurse provides instructions to the patient about the medication. What is important include in the teaching?
- Take the medication with meals to avoid gastrointestinal distress
- Give daytime doses close together for maximal therapeutic effect.
- Take the medication 30 minutes before eating to improve swallowing and chewing.
- Take the medication only if difficulty swallowing occurs during a meal.
Correct Answer

A. Take the medication 30 minutes before eating to improve swallowing and chewing.

Explanation

The correct answer is to take the medication 30 minutes before eating to improve swallowing and chewing. This is important because cholinergic drugs increase muscle strength and tone, which can help improve swallowing and chewing difficulties in patients with myasthenia gravis. Taking the medication before meals allows it to take effect before the patient starts eating, maximizing its therapeutic effect. Taking the medication with meals or only if difficulty swallowing occurs during a meal may not provide the same benefit.

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49.

The nurse will monitor for which adverse effect when administering an anticholinergic drug?
- Excessive urination
- Diaphoresis
- Dry mouth
- Pupillary constrictio
Correct Answer

A. Dry mouth

Explanation

When administering an anticholinergic drug, the nurse will monitor for the adverse effect of dry mouth. Anticholinergic drugs block the action of acetylcholine, a neurotransmitter responsible for various bodily functions, including saliva production. By blocking acetylcholine, these drugs can lead to a decrease in saliva production, resulting in dry mouth. Monitoring for this adverse effect is important as it can cause discomfort and may lead to other complications such as difficulty in swallowing or speaking.

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What To Do In These Situations? Nursing Quiz

When applying transdermal nitroglycerin patches, which instruction by the nurse is correct?

Quiz Preview

When teaching a patient who is beginning antilipemic therapy about possible drug-food interactions, the nurse will discuss which food?

A patient is being discharged on anticoagulant therapy. The nurse will include in the patient-education conversion that it is important to avoid herbal products that contain which substance?

The nurse is reviewing principles of immunization. What type of immunization occurs when antibodies pass from mother to infant during breastfeeding or through the placenta during pregnancy?

A woman who is planning to become pregnant should ensure that she receives adequate levels of which supplements to reduce the risk for fetal neural tube defects?

A patient who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the patient may have taken too much warfarin. The nurse provides the patient with which appropriate antidote?

Which action is often recommended to help reduce tolerance to transdermal nitroglycerin therapy?

When teaching a patient who has a new prescription for transdermal nitroglycerin patches, the nurse tells the patient that these patches are most appropriately used for which situation?

The nurse notes in the patient’s medication orders that the patient will be starting anticoagulant therapy. What is the primary goal of anticoagulant therapy?

When an adrenergic drug stimulates beta1-adrenergic receptors, the result is an increased force of contraction, which is known as what type of effect?

A patient about to receive a morning dose of digoxin has an apical pulse of 53 beats/minute. What will the nurse do next?

A patient who has been newly diagnosed with vertigo will be taking an antihistamine antemetic drug. The nurse will include which information when teaching the patient about this drug?

A patient has been taking donepezil (Aricept) for 2 weeks as part of the treatment for early stages of Alzheimer’s disease. Her daughter calls the prescriber’s office and is upset because “Mother has not improved one bit!” Which response by the nurse is appropriate?

The nurse is administering a stat dose of epinephrine. Epinephrine is appropriate for which situation?

A hospitalized patient is experiencing a severe anaphylactic reaction to a dose of intravenous penicillin. Which drug will the nurse use to treat this condition?

The nurse is creating a plan of care for a patient with a new diagnosis of hypertension. Which is a potential nursing diagnosis for the patient taking antihypertensive medications?

A patient has been taking a beta blocker for 4 weeks as part of his antianginal therapy. He also has type II diabetes and hyperthyroidism. When discussing possible adverse effects, the nurse will include which information?

The teaching for a patient who is taking tamsulosin (Flomax) to reduce urinary obstruction due to benign prostatic hyperplasia will include which of these?

A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion. The patient asks the nurse why he has to be on two medications. The nurse’s response is based on which rationale?

When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse will discuss which potential problem?

2. What is the nurses priority action if extravasation of an antineoplastic drug occurs during intravenous (IV) administration?

A patient has had an overdose of an intravenous cholinergic drug. The nurse expects to administer which drug as an antidote?

The nurse is providing teaching regarding drug therapy to the husband of a woman with Alzheimer’s disease. She was diagnosed 3 months ago, has mild memory loss, and will be receiving donepezil (Aricept). What is the drug’s expected action?

The nurse is reviewing the use of anticholinergic drugs with a patient and explains that anticholinergic drugs block the effects of which nervous system?

A patient who has been taking antihypertensive drugs for a few months complains of having a persistent dry cough. The nurse explains that this cough is an adverse effect of which class of antihypertensive drugs?

A patient has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin tablets. When teaching the patient how to use sublingual nitroglycerin, the nurse will include which instruction?

A patient with risk factors for coronary artery disease asks the nurse about the “good cholesterol” laboratory values. The nurse knows that “good cholesterol” refers to which lipids?

The nurse is reviewing the mechanism of action of antidiarrheal drugs. Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?

The nurse will teach the patient who is receiving oral iron supplements to watch for which expected adverse effects?

The nurse recognizes that adrenergic drugs cause relaxation of the bronchi and bronchodilation by stimulating which type of receptors?

When administering heparin subcutaneously, the nurse will follow which procedure?

A patient who is taking warfarin (Coumadin) therapy has a headache and calls the prescriber’s office to ask about taking a pain reliever. The nurse expects to receive instructions for which type of medication?

A patient tells the nurse that he likes to eat large amounts of garlic “to help lower his cholesterol levels naturally.” The nurse reviews his medication history and notes that which drug has a potential interaction with the garlic?

A patient is taking an alpha blocker as treatment for benign prostatic hyperplasia. The nurse will monitor for which potential drug effect?

A patient who has had abdominal surgery has been discharged on a cholinergic drug to assist in increasing gastrointestinal peristalsis. The nurse will teach this patient to look for which therapeutic effect?

The nurse working in a preoperative admitting unit administers an anticholinergic medication to a patient before surgery. What is the purpose of this drug in the preoperative setting?

When the nurse is administering topical nitroglycering ointment, which technique is correct?

A patient has been instructed to take one enteric-coated low-dose aspirin a day as part of therapy to prevent strokes. The nurse will provide which instruction when providing patient teaching about this medication?

6. A patient who has had a liver transplant is taking mycophenolate (cellcept) for the prevention of organ rejection. She tells the nurse that she wants children. The nurse explains that the medication she is currently prescribed

The nurse is developing a plan care for a patient who is experiencing gastrointestinal adverse effects, including anorexia and nausea, after the first course of antineoplastic therapy. What is an appropriate goal for this patient when dealing with this problem? The patient will

A patient has been taking iron supplements for anemia for 2 months. During a follow-up assessment, the nurse will observe for which therapeutic response?

The nurse is aware that adrenergic drugs produce effects similar to which of these nervous systems?

A cholinergic drug is prescribed for a patient with a new diagnosis of myasthenia gravis, and the nurse provides instructions to the patient about the medication. What is important include in the teaching?

The nurse will monitor for which adverse effect when administering an anticholinergic drug?