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NURS 6521N Final Exam (99 out of 100 Points)

1. 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?
2. 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?
3. 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
4. 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?
5. 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?
6. 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
7. 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?
8. 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? nurs 6521n final exam
9. A Nurse Practitioner who provides care on a pediatric medicine unit has conducted a medication reconciliation of a recently-admitted patient. In light of the fact that the child takes methylphenidate (Ritalin), the nurse is justified in considering a history of what health problem?
10. 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
11. 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
12. 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?
13. 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?
14. A 38-year-old pregnant patient admits to the Nurse Practitioner that she is an alcoholic and has been consuming alcohol during her pregnancy. The nurse knows that using alcohol during pregnancy may result in a child who presents with
15. A patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are considered
16. 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?
17. A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor which of the following?
18. A patient with a recent diagnosis of chronic myelogenous leukemia (CML) is discussing treatment options with his care team. What aspect of the patient’s condition would contraindicate the use of cyclophosphamide for the treatment of leukemia?
19. A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize?
20. 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
21. 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?
22. Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent nurs 6521n final exam
23. 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?
24. 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
25. 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
26. 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
27. 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
28. 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?
29. 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?
30. A 13-year-old patient has juvenile arthritis. He has recently had oral surgery and was told by the surgeon to take aspirin for the pain. The APRN will monitor for which of the following?
31. 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?
32. 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
33. 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? nurs 6521n final exam
34. 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?
35. 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
36. A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?
37. 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?
38. A school nurse has been teaching high school students about the risks associated with marijuana use. However, the nurse has been met with considerable skepticism on the part of students, most of whom believe that marijuana is a benign drug. Which of the following teaching points should the nurse provide?
39. A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following?
40. 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?
41. 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?
42. A Nurse Practitioner is instructing a 19-year-old female patient on the use of fluconazole for candida vaginitis. A teaching priority will be to
43. 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 nurs 6521n final exam
44. 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?
45. A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that
46. 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?
47. 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
48. A 20-year-old woman will soon begin taking oral contraceptives for the first time. What advice should the nurse provide to this patient?
49. 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
50. 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
51. A Nurse Practitioner is obtaining baseline physical data from a 7-year-old patient who is to be …..on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an
52. 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
53. 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
54. 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 nurs 6521n final exam
55. 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
56. 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
57. 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?
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 orders 150 mg of oral fluconazole for a patient with vulvovaginal candidiasis. The patient should expect to take medication
60. 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
61. 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 prescribe filgrastim (Neupogen). Which of the nurse’s following assessment questions most directly addresses a common adverse effect of filgrastim?
62. 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
63. 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
64. A male patient has been ….to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The APRN will be sure to
65. A postmenopausal patient is prescribe bisphosphonates to treat osteoporosis. The nurse will instruct the patient to take the drug
66. Which of the following patients will be at the greatest risk for anemia and would be the most likely candidate for epoetin alfa therapy?
67. A Nurse Practitioner will monitor which of the following when assigne to a patient taking allopurinol for chronic gout who visits the clinic every 2 months?
68. A 54-year-old woman with a history of osteoporosis has been ……ciprofloxacin for recurrent cystitis. Because of the patient’s history, the nurse would be sure to discuss with the woman the use of
69. A woman is receiving ….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
70. 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?
71. 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?
72. A Nurse Practitioner is having difficulty administering a bitter drug to a 5-year-old child. The nurse should
73. A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for recurring headaches. The nurse should recommend
74. A 67-year-old man who is being treated for prostate cancer is taking epoetin alfa. The nurse will instruct the patient to nurs 6521n final exam
75. 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?
76. Which of the following would a Nurse Practitioner assess for in a patient who is taking polymyxin B systemically?
77. 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?
78. 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?
79. 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?
80. 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)?
81. A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the nurs 6521n final exam
82. 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?
83. 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
84. An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or failure of a patient’s chemotherapy. Which of the following cancerous cells is most susceptible to the effects of chemotherapeutic drugs?
85. 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?
86. A patient has endocarditis and is taking gentamicin. The Nurse Practitioner will be sure to monitor which of the following? nurs 6521n final exam
87. 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?
88. 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
89. 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?
90. A 39-year-old woman is receiving doxorubicin for the treatment of cancer. After each treatment, the patient has acute nausea and vomiting accompanied by a slightly increased heart rate. The nurse will advise her to
91. 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?
92. 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
93. A 59-year-old man with a recent history of erectile dysfunction has been assessed and prescribed sildenafil (Viagra). When providing patient education to this man, the nurse should tell him which of the following?
94. 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
95. A patient is receiving long-term clindamycin therapy for a life-threatening infection. The nurse will begin by monitoring this drug therapy by obtaining nurs 6521n final exam
96. A 56-year-old woman will soon begin treatment of her overactive bladder with tolterodine (Detrol). What patient teaching should the nurse provide to this woman?
97. A Nurse Practitioner is providing patient education to a 13-year-old girl who was just …..with type 1 diabetes mellitus. Which of the following statements by the patient will alert the nurse that special instructions regarding insulin are necessary?
98. A 30-year-old African-American woman tested positive for TB and is prescribe …… The nurse will plan the patient’s care to include close monitoring of the drug therapy because
99. 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?
100. A Nurse Practitioner educator who coordinates the staff education on an oncology unit is conducting an in-service on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session?