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NURS 6521 Final Exam (100 out of 100 Points)

1. A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose?
2. A 19-year-old patient reports to a clinic with vaginal discharge with a foul odor. A microscopic exam reveals trichomonas vaginalis. The nurse practitioner is aware that
3. A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is perspiring and her blood pressure is 88/50. The serum magnesium level is 10 mg/dL. The nurse will interpret these manifestations as
4. 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?
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. 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?
7. A Nurse Practitioner is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that he or she is taking an oral form of
8. A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug
9. 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?
10. 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
11. A Nurse Practitioner is assessing a patient who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the patient for which of the following?
12. The Nurse Practitioner notices a cold sore on a patient’s upper lip and requests medication; docosanol (Abreva) is ordered. Before applying the medication, the nurse would first
13. A Nurse Practitioner is to use a single-dose 1 mL vial to administer 0.5 mL of epoetin alfa to a 39-year-old woman who is being treated for chemotherapy-induced anemia. Which of the following will the nurse do with the unused portion of the drug?
14. A Nurse Practitioner is assigned to a patient who is at 32 weeks’ gestation and is receiving terbutaline (Brethine) IV for 24 hours to control preterm labor. Which of the following nursing actions will the nurse take to decrease the risk of hypotension and promote circulation to the fetus?
15. A Nurse Practitioner works at a weight management clinic. To which of the following overweight patients could the nurse safely administer dextroamphetamine?
16. 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
17. 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?
18. 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?
19. 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?
20. A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for recurring headaches. The nurse should recommend
21. 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?
22. A patient has endocarditis and is taking gentamicin. The Nurse Practitioner will be sure to monitor which of the following?
23. 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?
24. 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
25. A 46-year-old man is receiving a quinupristin/dalfopristin IV infusion for a life-threatening infection. Which of the following would be most important for the nurse to monitor?
26. A Nurse Practitioner is providing patient education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the patient to avoid which of the following drugs?
27. 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?
28. 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?
29. A patient has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that may cause
30. A Nurse Practitioner is caring for a patient who is on amphotericin B. On morning rounds the patient reports weakness, numbness, and a tingling sensation in his feet. What would be a priority action by the nurse?
31. A Nurse Practitioner has questioned why a patient’s physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of a patient’s infection. Which of the following facts provides the best rationale for the use of narrow-spectrum antibiotics whenever possible?
32. 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?
33. 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?
34. A Nurse Practitioner is providing patient education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which of the following statements by the patient will alert the nurse that special instructions regarding insulin are necessary?
35. 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
36. 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?
37. 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
38. An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identified potential benefits of imatinib. Which of the following characteristics of this patient’s current health status may preclude the use of imatinib?
39. 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
40. 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?
41. A female patient is taking oral cyclophosphamide therapy for breast cancer. Because of possible adverse effects of the drug, the nurse will instruct the patient to do which of the following?
42. 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
43. A 43-year-old man has been diagnosed with active TB. He is prescribed multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?
44. 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
45. 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
46. 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?
47. 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
48. A 68-year-old man is being treated for benign prostatic hypertrophy (BPH) and began treatment with finasteride (Proscar) 3 months ago. When planning the care of this patient, what desired outcome should the nurse prioritize?
49. 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?
50. Which of the following would a Nurse Practitioner assess for in a patient who is taking polymyxin B systemically?
51. 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?
52. 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?
53. 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
54. 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?
55. 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?
56. 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?
57. 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
58. A 45-year-old woman with acute leukemia is going to begin chemotherapy with vincristine. The nurse is aware that vincristine must always be administered
59. A Nurse Practitioner who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to
60. A 29-year-old woman who is morbidly obese has recently begun a comprehensive, medically-supervised program of weight reduction. Prior to adding dextroamphetamine (Dexedrine) to her regimen, the patient should be questioned about her intake of
61. 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?
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. A Nurse Practitioner working in a cancer center is preparing to administer medication to a 5-year-old child. The nurse will calculate the drug dosage by using
64. A patient is to begin taking tobramycin (Nebcin) for nosocomial infection. Which of the following assessments should the nurse prioritize?
65. A patient is receiving long-term clindamycin therapy for a life-threatening infection. The nurse will begin by monitoring this drug therapy by obtaining
66. 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?
67. 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
68. An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman’s pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient’s pain?
69. A Nurse Practitioner is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation?
70. A 15-year-old patient has meningitis caused by Haemophilus influenza. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitor
71. The recommended treatment for trichomoniasis is
72. When planning care for a patient who is receiving filgrastim (Neupogen) for a non-myeloid malignancy, the nurse should formulate which of the following patient outcomes? (Select all that apply.)
73. 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?
74. A 51-year-old female patient has been receiving doxorubicin (Adriamycin) for metastatic breast cancer. Her medical record indicates she has cardiomyopathy and a cumulative dose of 300 mg/m2 of doxorubicin. Which of the following measures would help limit the severity of the cardiomyopathy in this patient?
75. A Nurse Practitioner is discussing with a 58-year-old male patient the causes of erectile dysfunction in men over 50 years of age. Which of the following will the nurse inform the patient is the primary physical cause of erectile dysfunction of men in this age group?
76. 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
77. A 16-year-old boy is prescribed cromolyn sodium nasal spray to treat a nasal allergy. To maximize the therapeutic effects of the drug, which of the following will the nurse include in instructions to the patient?
78. 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?
79. 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?
80. 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
81. 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
82. 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?
83. 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?
84. A patient is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the patient develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is
85. 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
86. An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions?
87. A Nurse Practitioner will instruct a patient taking allopurinol to take each dose
88. A Nurse Practitioner is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient?
89. A patient will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the patient’s drug regimen and the patient has asked about the potential side effects of treatment. How should the nurse best respond?
90. 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
91. A 20-year-old woman will soon begin taking oral contraceptives for the first time. What advice should the nurse provide to this patient?
92. 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
93. Which of the following patients will be at the greatest risk for anemia and would be the most likely candidate for epoetin alfa therapy?
94. A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The APRN will advise her to take which of the following vitamin supplements while taking the drug?
95. 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
96. 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
97. Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent
98. A 67-year-old man who is being treated for prostate cancer is taking epoetin alfa. The nurse will instruct the patient to
99. A male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at each clinic visit?
100. 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