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NURS 6521N Final Exam (Score: 100 out of 100)

1. A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for recurring headaches. The nurse should recommend
2. 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
3. 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
4. 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?
5. 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?
6. A postmenopausal patient is prescribed bisphosphonates to treat osteoporosis. The nurse will instruct the patient to take the drug
7. 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
8. 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?
9. 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
10. 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
11. 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?
12. A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the
13. A patient who is a steroid-dependent asthmatic is started on a beclomethasone inhaler. Which should be part of patient education?
14. 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
15. A child is taking permethrin for head lice. The Nurse Practitioner will instruct her mother to
16. 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?
17. A 54-year-old woman with a history of osteoporosis has been prescribed ciprofloxacin for recurrent cystitis. Because of the patient’s history, the nurse would be sure to discuss with the woman the use of
18. 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?
19. 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?
20. 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
21. 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?
22. 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?
23. 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?
24. A patient has been started on a treatment regimen that includes levothyroxine. Select the dosage regimen that is most appropriate for a mean replacement dosage. The patient has been started on a treatment regimen that includes levothyroxine. Select the dosage regimen that is most appropriate for a mean replacement dosage.
25. 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
26. 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?
27. 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
28. 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?
29. 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?
30. 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)?
31. 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
32. 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
33. 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 nurs 6521n final exam
34. 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?
35. 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?
36. 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?
37. 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?
38. Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent
39. 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?
40. A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize? nurs 6521n final exam
41. 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
42. 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
43. 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?
44. 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?
45. A Nurse Practitioner works at a weight management clinic. To which of the following overweight patients could the nurse safely administer dextroamphetamine?
46. A patient is taking etoposide for a testicular tumor refractory to treatment. The nursing assessment reveals that he is also taking warfarin. The nurse must carefully monitor for which of the following?
47. 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? nurs 6521n final exam
48. 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
49. A Nurse Practitioner will instruct a patient taking allopurinol to take each dose
50. 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?
51. 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
52. When prescribing an antihypertensive medication for a type 2 diabetic patient, the drug classifications that would tend to reduce insulin sensitivity are: nurs 6521n final exam
53. During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient’s platelet count to be 92,000 cells/mm3. The nurse should do which of the following?
54. 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?
55. A 20-year-old female patient is receiving topical clindamycin for acne vulgaris. 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?
56. 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? nurs 6521n final exam
57. 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?
58. 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?
59. A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient to
60. A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that
61. 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
62. A patient is receiving long-term clindamycin therapy for a life-threatening infection. The nurse will begin by monitoring this drug therapy by obtaining
63. 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?
64. 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 nurs 6521n final exam
65. A Nurse Practitioner is conducting an assessment of a patient who has recently had several changes made to her drug regimen. What assessment question most directly addresses the safety implications of the patient’s drug regimen?
66. 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?
67. 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
68. 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?
69. 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
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 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
72. 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
73. 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?
74. 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?
75. Which of the following patients will be at the greatest risk for anemia and would be the most likely candidate for epoetin alfa therapy?
76. A nurse practitioner orders 150 mg of oral fluconazole for a patient with vulvovaginal candidiasis. The patient should expect to take medication nurs 6521n final exam
77. 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
78. 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?
79. 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
80. 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?
81. 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
82. Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse’s response to Mr. Lepp? nurs 6521n final exam
83. 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
84. 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
85. 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?
86. A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause
87. 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?
88. 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 nurs 6521n final exam
89. 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?
90. 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?
91. 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
92. A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The patient has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect?
93. 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?
94. A 20-year-old woman will soon begin taking oral contraceptives for the first time. What advice should the nurse provide to this patient? nurs 6521n final exam
95. 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?
96. 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
97. 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
98. 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?
99. 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
100. 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?