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NURS 6521 Final Exam – Question and Answers

1. 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:
2. A 20-year-old woman will soon begin taking oral contraceptives for the first What advice should the nurse provide to this patient?
3. A Nurse Practitioner is providing patient education to a 50-year-old woman who is taking methotrexate (MTX) for breast The nurse will instruct the patient to avoid which of the following drugs?
4. A 3-year-old boy has developed otitis media and requires In order to increase the chance that the boy will take his prescribed medication, the nurse should:
5. A patient has endocarditis and is taking The Nurse Practitioner will be sure to monitor which of the following?
6. Phenytoin decreases folic acid absorption by:
7. Which of the following would a Nurse Practitioner assess for in a patient who is taking polymyxin B systemically?
8. Donald is a nurse practitioner He recognizes Which option below could be a secondary use for an anxiolytic medication?
9. A 30-year-old African-American woman tested positive for TB and is prescribed The nurse will plan the patient’s care to include close monitoring of the drug therapy because:
10. 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?
11. 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?
12. A 29-year-old pregnant patient is extremely upset about having to take medication for a pre-existing medical 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?
13. 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 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 This is scheduled drug:
14. Sulconazole has been prescribed for a patient with tinea The nurse will instruct the patient to use the topical agent:
15. A Nurse Practitioner is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for After obtaining vital signs, height, and weight, the nurse will prepare the patient for an:
16. GABA is an amino acid that functions as the primary inhibitory neurotransmitter in the The primary excitatory neurotransmitter is
17. Testosterone is rarely given PO because of it’s
18. Shackleford Has been placed on Ambien to help for her insomnia. The NP must educate the patient regarding the rapid onset of Ambien. Which statement below is correct?
19. A 20-year-old female patient is receiving topical clindamycin for acne She develops a rash and urticaria along with severe itching where the medication is applied. The nurse will formulate which of the following nursing diagnoses for the patient?
20. 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?
21. A 73-year-old woman has osteoporosis and is prescribed She takes calcium and vitamin D supplements, drinks lots of water, and has just quit smoking. The nurse should advise the patient to also
22. Which of the following drugs is most likely to cause sexual dysfunction and males?
23. A Nurse Practitioner is instructing a 19-year-old female patient on the use of fluconazole for candida A teaching priority will be to
24. A Nurse Practitioner is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her 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?
25. Which of the following would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a patient taking estrogen?
26. A patient is prescribed ganciclovir to treat a CMV infection. An oral dosage is To help increase bioavailability of the drug, the nurse will encourage the patient to take the medication
27. A patient with non-Hodgkin’s lymphoma (NHL) will be starting a course of doxorubicin When planning this patient’s care, what nursing diagnosis should the nurse prioritize?
28. LW is on hydroxychloroquine (Plaquenil) for rheumatoid arthritis. Certain tests are recommended before a patient starts this medication. Which of the following is NOT recommended before starting Hydroxychoroquine (Plaquenil)?
29. Gold compounds are contra indicated in in patients with all of the following conditions except:
30. Finasteride(Proscar) is prescribed for a 50-year-old man who is experiencing problem with urination secondary to an enlarged prostate. The practitioner would teach the patient that while he is taking this medication, it is important to:
31. Jessica, the NP is seeing an asthmatic child in the clinic today to evaluate the child’s response to their prescribed therapy. The child uses an ICS (Inhaled Corticosteroid) twice a day and an albuterol mdi as The child’s symptoms are well controlled, However the Nurse Practitioner notes some slowing of the child’s linear growth on a standardized growth chart. The NP should change this medication regimen to:
32. Tetracyclines are contraindicated in children younger than eight years old because of?
33. 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 Which of the following facts provides the best rationale for the use of narrow- spectrum antibiotics whenever possible?
34. Which of the following medications will not increase the likelihood of photosensitivity?
35. A Nurse Practitioner is performing patient education for a woman who has just been prescribed a Which of the following diagnostic and history findings would have prompted the woman’s care provider to prescribe a bisphosphonate?
36. A child is admitted to the burn unit with second and third-degree burns on both arms and part of his or her When administering topical medications to the burned areas, the nurse should:
37. Asberry is taking Levofloxacin for his sinusitis. He calls your clinic and reports some pain just above the heel of his left foot. The NP should:
38. Diazepam, lorazepam, and alprazolam are what controlled substance schedule?
39. A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at The nurse will instruct the parents to administer the drug:
40. What schedule class of drug is Hydrocodone?
41. A female patient is taking filgrastim (Neupogen) to decrease the incidence of The nurse notices a small increase in the neutrophil count 2 days after starting therapy. The nurse’s evaluation of the increase is that:
42. Which of the following medications is most likely to cause weight gain?
43. A male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at each clinic visit?
44. Jacob was eating cheese and drinking Thirty minutes Later, he developed severe hypertension, diaphoresis, Flushing, and muscle rigidity. He may have been taking which drug?
45. A 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe which of the following adverse effects of the drug?
46. 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)?
47. A patient with chronic heart failure has begun treatment with epoetin alfa, which she will receive in her own home-from-home health The nurse should teach the patient to supplement this treatment with a diet that is high in
48. A 68-year-old man is being treated for benign prostatic hypertrophy (BPH) and began treatment with finasteride (Proscar) 3 months When planning the care of this patient, what desired outcome should the nurse prioritize?
49. A patient reports to a clinic with complaints of breast tenderness, a right lumpy breast, and no breast The breast tenderness occurs primarily during her menstrual cycle. The nurse practitioner probably suspects
50. A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for recurring The nurse should recommend:
51. A patient who is at risk for DVT tells the NP she has just learned she is The NP should expect that this patient will use which of the following anticoagulant medications?
52. A Nurse Practitioner is explaining to a pregnant 21-year-old college student why she cannot continue to take ibuprofen (Advil) for her 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 that:
53. A Nurse Practitioner is explaining the use of acyclovir therapy to a 72-year-old 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
54. A 29-year-old woman who is morbidly obese has recently begun a comprehensive, medically-supervised program of weight Prior to adding dextroamphetamine (Dexedrine) to her regimen, the patient should be questioned about her intake of:
55. A Nurse Practitioner is to use a single-dose 1 mL vial to administer 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?
56. 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?
57. 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 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?
58. 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?
59. A 62-year-old patient taking tamoxifen exhibits increased bone and tumor pain along with a local disease The nurse interprets this as an indication of which of the following?
60. A patient with bipolar disorder is on rival pro ex sodium (Depakote)for mania. What est(s) would the family nurse practitioner monitor?
61. A Nurse Practitioner is assessing a patient who has chronic lymphoblastic myelogenous The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the patient for which of the following?
62. A patient is receiving radiotherapy for an overactive thyroid gland and asks whether her milk is safe for her baby. If her treatment cannot be discontinued, what should the nurse recommend?
63. Which test should the NP order for monitoring the effectiveness of the patient receiving heparin?
64. Which of the following medications has anticholinergic and antianxiety effects?
65. A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient to:
66. The nurse practitioner orders Amoxicillin 500 mg tid? What is the total amount of medication the patient will take per day?
67. Which of the following combination medications does not contain progestin combined with estrogen?
68. A school nurse has been teaching high school students about the risks associated with marijuana 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?
69. The recommended treatment for trichomoniasis is:
70. Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient’s physician has prescribed quinine along with an adjunctive The nurse should question the physician’s order if the patient has a history of:
71. Which of the following medication classes should be avoided and men with BPH
72. Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal In order to help prevent gastrointestinal distress, the nurse will advise the patient to:
73. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse’s response to Mr. Lepp?
74. 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?
75. The nurse practitioner has prescribed elemental iron 6mg/kg/day in divided doses for a toddler diagnosed with iron deficiency anemia. What instructions would the family nurse practitioner include for the parents?
76. A nurse practitioner has been assigned to a 55-year-old woman who has a malignant brain The patient is receiving her first dose of carmustine. It will be critical for the nurse to observe for which of the following?
77. A female patient is taking oral cyclophosphamide therapy for their breast Because of possible adverse effects of the drug, the nurse will instruct the patient to do which of the following?
78. A Nurse Practitioner has completed a medication reconciliation of a patient who has been admitted following a motor vehicle 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?
79. TW is a 47-year-old female with known rheumatoid arthritis (RA). She was placed on prednisone 5mg POqd. In teaching the patient about her medication, it would be important for the nurse practitioner to include what information?
80. A woman has a Chlamydia infection. Before initiating treatment with a tetracycline antibiotic, the NP should :
81. Women who are prescribed progestin-only contraception need education regarding which common adverse drug effect?
82. When prescribing Phosphodiesterase type 5 (PDE-5) inhibitors such as sildenafil, the patient should be screened for use of?
83. Cindy has been on Citalopram (Lexapro) For a year and is willing to try tapering off of the selective serotonin reuptake inhibitor. What is the initial dosage adjustment when tapering off antidepressants:
84. 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 Which of the following assessment findings most likely prompted the patient’s physician to order magnesium sulfate for this patient?
85. A patient is receiving long-term clindamycin therapy for a life-threatening The nurse will begin by monitoring this drug therapy by obtaining:
86. A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse will:
87. A Nurse Practitioner is caring for a 10-year-old boy who complains of chronic 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?
88. Which of the following brand-generic combinations is incorrectly matched?
89. A child with chronic allergic symptoms uses an intranasal steroid for control of At this child’s annual well-child checkup, the NP should carefully review what?
90. A 39-year-old woman is receiving doxorubicin for the treatment of After each treatment, the patient has acute nausea and vomiting accompanied by a slightly increased heart rate. The nurse will advise her to:
91. A nurse practitioner orders 150 mg of oral fluconazole for a patient with vulvovaginal The patient should expect to take the medication:
92. A 54-year-old woman with a history of osteoporosis has been prescribed ciprofloxacin for recurrent Because of the patient’s history, the nurse would be sure to discuss with the woman the use of:
93. The NP is considering a medication to treat Ms. Robert’s Urinary Tract Infection. The NP knows that Trimethoprim-sulfamethoxazole (Bactrim) Is contra-indicated in which of the following conditions:
94. 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:
95. The NP has just placed Johnson on a selective serotonin reuptake inhibitor. What symptoms should be reviewed with the patient who has been newly prescribed this class of medication?
96. A Nurse Practitioner is discussing with a 58-year-old male patient the causes of erectile dysfunction in men over 50 years of Which of the following will the nurse inform the patient is the primary physical cause of erectile dysfunction of men in this age group?
97. A 19-year-old patient reports to a clinic with the vaginal discharge with a foul odor. A microscopic exam reveals trichomonas The nurse practitioner is aware that:
98. Some drugs are given to patients using other routes such as sublingual or topical to avoid moving through the liver and possible side Which of the following effects is the Nurse Practitioner attempting to avoid by administering certain medications via alternative routes?
99. A 38-year-old pregnant patient admits to the Nurse Practitioner that she is an alcoholic and has been consuming alcohol during her The nurse knows that using alcohol during pregnancy may result in a child who presents with:
100. 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: