NUR 2474 Pharmacology Final Exam ( 175 questions and answers)complete

NUR 2474 Pharmacology Final Exam The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were just admitted. Which patient should the nurse assess first? a.The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin b.The patient with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin) c.The patient with a blood pressure of 136/92 mm Hg who complains of having a headache d.The patient with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin) - a.The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer? a.No insulin should be administered. b.NPH c.70/30 mix d.Lispro (Humalog) - d.Lispro (Humalog) A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing schedule for her. What is the recommended monitoring schedule? a.Before each meal and before bed b.In the morning for a fasting level and at 4 PM for the peak level c.Six or seven times a day d.Three times a day, along with urine glucose testing - c.Six or seven times a dayAn adolescent patient recently attended a health fair and had a serum glucose test. The patient telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?" What is the nurse's most accurate response? a."Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes." b."At this level, you probably have diabetes. You will need an oral glucose tolerance test this week." c."This level is conclusive evidence that you have diabetes." d."This level is conclusive evidence that you do not have diabetes." - a."Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes." Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the nurse administer this drug? a.Approximately 15 to 30 minutes before each meal b.In the morning and at 4 PM c.Once daily at bedtime d.After meals and at bedtime - c.Once daily at bedtime A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned? a.The beta blocker can cause insulin resistance. b.Using the two agents together increases the risk of ketoacidosis. c.Propranolol increases insulin requirements because of receptor blocking. d.The beta blocker can mask the symptoms of hypoglycemia. - d.The beta blocker can mask the symptoms of hypoglycemia. Which statement is correct about the contrast between acarbose and miglitol? a.Miglitol has not been associated with hepatic dysfunction. b.With miglitol, sucrose can be used to treat hypoglycemia. c.Miglitol is less effective in African Americans.d.Miglitol has no gastrointestinal side effects. - a.Miglitol has not been associated with hepatic dysfunction. A nurse counsels a patient with diabetes who is starting therapy with an alpha-glucosidase inhibitor. The patient should be educated about the potential for which adverse reactions? (Select all that apply.) a.Hypoglycemia b.Flatulence c.Elevated iron levels in the blood d.Fluid retention e.Diarrhea - b.Flatulence e.Diarrhea The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells the nurse she does not want to take medications while she is pregnant. What will the nurse explain to this patient? a.Hypothyroidism is a normal effect of pregnancy and usually is of no consequence. b.Neuropsychologic deficits in the fetus can occur if the condition is not treated. c.No danger to the fetus exists until the third trimester. d.Treatment is required only if the patient is experiencing symptoms. - b.Neuropsychologic deficits in the fetus can occur if the condition is not treated. A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine (Synthroid). Which statement by the patient indicates a need for further teaching? a."I should not take heartburn medication without consulting my provider." b."I should report insomnia, tremors, and an increased heart rate to my provider." c."If I take a multivitamin with iron, I should take it 4 hours after the Synthroid." d."If I take calcium supplements, I may need to decrease my dose of Synthroid." - d."If I take calcium supplements, I may need to decrease my dose of Synthroid."A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse assesses the patient at the beginning of the shift and notes a heart rate of 62 beats per minute and a temperature of 97.2° F. The patient is lethargic and difficult to arouse. The nurse will contact the provider to request an order for which drug? a.Beta blocker b.Increased dose of PO levothyroxine c.Intravenous levothyroxine d.Methimazole (Tapazole) - c.Intravenous levothyroxine A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The nurse learns that the patient also takes warfarin (Coumadin). The nurse will notify the provider to discuss _____ the _____ dose. ing levothyroxine ing warfarin asing levothyroxine asing warfarin - ing; warfarin An older adult patient is diagnosed with hypothyroidism. The initial free T4 level is 0.5 mg/dL, and the TSH level is 8 microunits/mL. The prescriber orders levothyroxine (Levothroid) 100 mcg/day PO. What will the nurse do? a.Administer the medication as ordered. b.Contact the provider to discuss giving the levothyroxine IV. c.Request an order to give desiccated thyroid (Armour Thyroid). d.Suggest that the provider lower the dose. - d.Suggest that the provider lower the dose. A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine (Synthroid). The child comes to the clinic for a well-child check up. The nurse will expect the provider to:e the dose of levothyroxine to 6 mcg/kg/day. ntinue the drug if the child's physical and mental development is normal. ase the dose to accommodate the child's increased growth. the drug for 4 weeks and check the child's TSH level. - e the dose of levothyroxine to 6 mcg/kg/day. A patient who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of pain and irritation at the infusion site. The nurse observes signs of redness at the IV insertion site and along the vein. What is the nurse's priority action? a.Apply warm packs to the arm, and infuse the medication at a slower rate. b.Continue the infusion while elevating the arm. c.Select an alternate intravenous site and administer the infusion more slowly. d.Request central venous access. - c.Select an alternate intravenous site and administer the infusion more slowly. A nurse is teaching a nursing student what is meant by "generations" of cephalosporins. Which statement by the student indicates understanding of the teaching? a."Cephalosporins are assigned to generations based on their relative costs to administer." b."Cephalosporins have increased activity against gram-negative bacteria with each generation." c."First-generation cephalosporins have better penetration of the cerebrospinal fluid." d."Later generations of cephalosporins have lower resistance to destruction by beta-lactamases." - b."Cephalosporins have increased activity against gram-negative bacteria with each generation." A provider has ordered ceftriaxone 4 gm once daily for a patient with renal impairment. What will the nurse do? a.Administer the medication as prescribed. b.Contact the provider to ask about giving the drug in divided doses.c.Discuss increasing the interval between doses with the provider. d.Discuss reducing the dose with the provider. - a.Administer the medication as prescribed. A patient will be discharged home to complete treatment with intravenous cefotetan with the assistance of a home nurse. The home care nurse will include which instruction when teaching the patient about this drug treatment? a.Abstain from alcohol consumption during therapy. b.Avoid dairy products while taking this drug. c.Take an antihistamine if a rash occurs. d.Use nonsteroidal anti-inflammatory drugs (NSAIDs), not acetaminophen, for pain. - a.Abstain from alcohol consumption during therapy. The nurse is caring for a patient who is receiving vancomycin (Vancocin). The nurse notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The patient's heart rate is 120 beats per minute, and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with: gic reaction. man syndrome. omyolysis. d.Stevens-Johnson syndrome. - man syndrome. A patient is to undergo orthopedic surgery, and the prescriber will order a cephalosporin to be given preoperatively as prophylaxis against infection. The nurse expects the provider to order which cephalosporin? a.First-generation cephalosporin b.Second-generation cephalosporin c.Third-generation cephalosporin d.Fourth-generation cephalosporin - a.First-generation cephalosporinA patient receiving a cephalosporin develops a secondary intestinal infection caused by Clostridium difficile. What is an appropriate treatment for this patient? a.Adding an antibiotic, such as vancomycin (Vancocin), to the patient's regimen b.Discontinuing the cephalosporin and beginning metronidazole (Flagyl) c.Discontinuing all antibiotics and providing fluid replacement d.Increasing the dose of the cephalosporin and providing isolation measures - b.Discontinuing the cephalosporin and beginning metronidazole (Flagyl) Besides the cost of administering a given drug, which are considerations when a provider selects a cephalosporin to treat an infection? (Select all that apply.) a.Adverse effects b.Antimicrobial spectrum c.Brand name d.Manufacturer e.Pharmacokinetics - a.Adverse effects b.Antimicrobial spectrum e.Pharmacokinetics A patient has an infection caused by Pseudomonas aeruginosa. The prescriber has ordered piperacillin and amikacin, both to be given intravenously. What will the nurse do? a.Make sure to administer the drugs at different times using different IV tubing. b.Suggest giving larger doses of piperacillin and discontinuing the amikacin. c.Suggest that a fixed-dose combination of piperacillin and tazobactam (Zosyn) be used. d.Watch the patient closely for allergic reactions, because this risk is increased with this combination. - a.Make sure to administer the drugs at different times using different IV tubing.A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding that penicillins: hibit transpeptidases. pt bacterial cell wall synthesis. it autolysins. it host cell wall function. - pt bacterial cell wall synthesis. A patient is about to receive penicillin G for an infection that is highly sensitive to this drug. While obtaining the patient's medication history, the nurse learns that the patient experienced a rash when given amoxicillin (Amoxil) as a child 20 years earlier. What will the nurse do? a.Ask the provider to order a cephalosporin. b.Reassure the patient that allergic responses diminish over time. c.Request an order for a skin test to assess the current risk. d.Suggest using a desensitization schedule to administer the drug. - c.Request an order for a skin test to assess the current risk. A patient with no known drug allergies is receiving amoxicillin (Amoxil) PO twice daily. Twenty minutes after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is 100/58 mm Hg. What will the nurse do? a.Contact the provider and prepare to administer epinephrine. b.Notify the provider if the patient develops a rash. c.Request an order for a skin test to evaluate possible PCN allergy. d.Withhold the next dose until symptoms subside. - a.Contact the provider and prepare to administer epinephrine. A patient with an infection caused by Pseudomonas aeruginosa is being treated with piperacillin. The nurse providing care reviews the patient's laboratory reports and notes that the patient's blood urea nitrogen and serum creatinine levels are elevated. The nurse will contact the provider to discuss:g an aminoglycoside. ing to penicillin G. ing the dose of piperacillin. ing nafcillin. - ing the dose of piperacillin. A patient recently began receiving clindamycin (Cleocin) to treat an infection. After 8 days of treatment, the patient reports having 10 to 15 watery stools per day. What will the nurse tell this patient? a.The provider may increase the clindamycin dose to treat this infection. b.This is a known side effect of clindamycin, and the patient should consume extra fluids. c.The patient should stop taking the clindamycin now and contact the provider immediately. d.The patient should try taking Lomotil or a bulk laxative to minimize the diarrheal symptoms. - c.The patient should stop taking the clindamycin now and contact the provider immediately. Which side effect of clindamycin (Cleocin) causes the most concern and may warrant discontinuation of the drug? a.Diarrhea b.Headache c.Nausea d.Vomiting - a.Diarrhea A patient develops CDAD. Which antibiotic is recommended for treating this infection? a.Chloramphenicol b.Clindamycin (Cleocin) c.Linezolid (Zyvox) d.Vancomycin - d.VancomycinA pregnant patient is treated with trimethoprim/sulfamethoxazole (TMP/SMZ) (Bactrim) for a urinary tract infection at 34 weeks' gestation. A week later, the woman delivers her infant prematurely. The nurse will expect to monitor the infant for: defects. lycemia. . al jaundice. - al jaundice. A patient who is taking immunosuppressants develops a urinary tract infection. The causative organism is sensitive to sulfonamides and to another, more expensive antibiotic. The prescriber orders the more expensive antibiotic. The nursing student assigned to this patient asks the nurse why the more expensive antibiotic is being used. Which response by the nurse is correct? a."Immunosuppressed patients are folate deficient." b."Patients who are immunosuppressed are more likely to develop resistance." c."Sulfonamides are bacteriostatic and depend on host immunity to work." d."Sulfonamides intensify the effects of immunosuppression." - c."Sulfonamides are bacteriostatic and depend on host immunity to work." A nurse teaches a patient about sulfonamides. Which statement by the patient indicates a need for further teaching? a."I need to drink extra fluids while taking this medication." b."I need to use sunscreen when taking this drug." c."I should call my provider if I develop a rash while taking this drug." d."I should stop taking this drug when my symptoms are gone." - d."I should stop taking this drug when my symptoms are gone." A patient with type 2 diabetes mellitus takes glipizide. The patient develops a urinary tract infection, and the prescriber orders TMP/SMZ. What will the nurse tell the patient?a.Patients with diabetes have an increased risk of an allergic reaction. b.Patients taking TMP/SMZ may need increased doses of glipizide. c.The patient should check the blood glucose level more often while taking TMP/SMZ. d.The patient should stop taking the glipizide while taking the TMP/SMZ. - c.The patient should check the blood glucose level more often while taking TMP/SMZ. A nurse is obtaining a drug history from a patient about to receive sulfadiazine. The nurse learns that the patient takes warfarin, glipizide, and a thiazide diuretic. Based on this assessment, the nurse will expect the provider to: e the antibiotic to TMP/SMZ. ase the dose of the glipizide. or the patient's electrolytes closely. or the patient's coagulation levels. - or the patient's coagulation levels. A patient will be discharged from the hospital with a prescription for TMP/SMZ (Bactrim). When providing teaching for this patient, the nurse will tell the patient that it will be important to: 8 to 10 glasses of water each day. foods that are high in potassium. the medication with food. folic acid supplements. - 8 to 10 glasses of water each day. A nurse is discussing microbial resistance among sulfonamides and trimethoprim with a nursing student. Which statement by the student indicates a need for further teaching? a."Bacterial resistance to trimethoprim is relatively uncommon." b."Resistance among gonococci, streptococci, and meningococci to sulfonamides is high." c."Resistance to both agents can occur by spontaneous mutation of organisms." d."Resistance to sulfonamides is less than resistance to trimethoprim." - d."Resistance to sulfonamides is less than resistance to trimethoprim."A patient with bronchitis is taking TMP/SMZ, 106/80 mg orally, twice daily. Before administering the third dose, the nurse notes that the patient has a widespread rash, a temperature of 103° F, and a heart rate of 100 beats per minute. The patient looks ill and reports not feeling well. What will the nurse do? a.Administer the dose and request an order for an antipyretic medication. b.Withhold the dose and request an order for an antihistamine to treat the rash. c.Withhold the dose and notify the provider of the symptoms. d.Request an order for intravenous TMP/SMZ, because the patient is getting worse. - c.Withhold the dose and notify the provider of the symptoms. A patient with histoplasmosis is being treated with itraconazole (Sporanox). The nurse will teach this patient to report which symptoms? a.Gynecomastia and decreased libido b.Headache and rash c.Nausea, vomiting, and anorexia d.Visual disturbances - c.Nausea, vomiting, and anorexia A patient who is pregnant has a history of recurrent genital herpesvirus (HSV). The patient asks the nurse what will be done to suppress an outbreak when she is near term. The nurse will tell the patient that: iral medications are not safe during pregnancy. venous antiviral agents will be used if an outbreak occurs. acyclovir (Zovirax) may be used during pregnancy. al acyclovir (Zovirax) must be used to control outbreaks - acyclovir (Zovirax) may be used during pregnancy. The nurse is caring for a patient receiving intravenous acyclovir (Zovirax). To prevent nephrotoxicity associated with intravenous acyclovir, the nurse will:te the patient during the infusion and for 2 hours after the infusion. ase the patient's intake of foods rich in vitamin C. or urinary output every 30 minutes. de a low-protein diet for 1 day before and 2 days after the acyclovir infusion. - te the patient during the infusion and for 2 hours after the infusion. A nurse is performing a preoperative drug history on a patient who is admitted to the hospital for surgery. To evaluate the risk of hemorrhage, the nurse will ask the patient about antiplatelet and anticoagulant medications as well as which dietary supplement? a.Coenzyme Q-10 b.Ginkgo biloba c.Ma Huang (ephedra) d.St. John's wort - b.Ginkgo biloba A patient will begin taking immunosuppressant drugs for rheumatoid arthritis. The nurse will caution this patient to avoid which dietary supplement? a.Black cohosh b.Echinacea c.Feverfew d.Glucosamine - b.Echinacea An infant has allergies and often develops a pruritic rash when exposed to allergens. The infant's parents ask the nurse about using a topical antihistamine. What does the nurse tell them? a.Antihistamines given by this route are not absorbed as well in children. b.Applying this medication to the skin can cause toxicity in this age group. c.The child will also need oral medication to achieve effective results. d.Topical medications have fewer side effects than those given by other routes. -b.Applying this medication to the skin can cause toxicity in this age group.The parents of a child with asthma ask the nurse why their child cannot use oral corticosteroids more often, because they are so effective. The nurse will offer which information that is true for children? a.Chronic steroid use can inhibit growth. b.Frequent use of this drug may lead to a decreased response. c.A hypersensitivity reaction to this drug may occur. d.Systemic steroids can be toxic. - a.Chronic steroid use can inhibit growth. Parents ask the nurse why an over-the-counter cough suppressant with sedative side effects is not recommended for infants. Which response by the nurse is correct? a."Babies have a more rapid gastric emptying time and don't absorb drugs well." b."Cough medicine tastes bad, and infants usually won't take it." c."Infants are more susceptible to central nervous system effects than are adults." d."Infants metabolize drugs too rapidly, so drugs aren't as effective." - c."Infants are more susceptible to central nervous system effects than are adults." A nurse is caring for an infant after a surgical procedure. After ensuring that the ordered dose is appropriate for the infant's age and weight, the nurse administers a narcotic analgesic intravenously. When assessing the infant 15 minutes later, the nurse notes respirations of 22 breaths per minute and a heart rate of 110 beats per minute. The infant is asleep in the parent's arms and does not awaken when vital signs are assessed. The nurse understands that these findings are the result of: allergic reaction to the medication. urity of the blood-brain barrier in the infant. effects of the narcotic, requiring naloxone (Narcan) as an antidote. ected side effects of medications in infants. - urity of the blood-brain barrier in the infant. An infant is receiving a medication that has a narrow therapeutic range. The nurse reviews the medication information and learns that the drug is excreted by the kidneys. When giving the medication, the nurse will assess the infant for:ased effectiveness of the drug. er period of the drug's effects. of drug toxicity. al CNS effects. - of drug toxicity. A prescriber has ordered medication for a newborn. The medication is eliminated primarily by hepatic metabolism. The nurse expects the prescriber to: a dose that is lower than an adult dose. a dose that is higher than an adult dose. ase the frequency of medication dosing. ntinue the drug after one or two doses. - a dose that is lower than an adult dose. A nurse caring for a 5-year-old child notes that the child has discoloration of several teeth. When taking a medication history, the nurse will ask about which group of medications? a.Glucocorticoids b.Salicylates c.Sulfonamides d.Tetracyclines - d.Tetracyclines A nurse is caring for a patient and her newborn immediately after delivery. The patient's medication history includes prenatal vitamins throughout pregnancy, one or two glasses of wine before knowing she was pregnant, occasional use of an albuterol inhaler in her last trimester, and intravenous morphine during labor. What will the nurse expect to do? a.Administer opioids to the infant to prevent withdrawal syndrome. b.Monitor the infant's respirations closely and prepare to administer oxygen. c.Note a high-pitched cry and irritability in the infant.d.Prepare the patient for motor delays in the infant caused by the alcohol use. - b.Monitor the infant's respirations closely and prepare to administer oxygen. A patient who has just learned she is pregnant has stopped using a prescription medication that she takes for asthma because she doesn't want to harm her baby. What will the nurse tell her? a.That asthma medications will not affect the fetus b.That her baby's health is dependent on hers c.To avoid taking medications during her pregnancy d.To resume the medication in her second trimester - b.That her baby's health is dependent on hers A pregnant patient asks the nurse about the safe use of medications during the third trimester. What will the nurse tell her about drugs taken at this stage? a.They may need to be given in higher doses if they undergo renal clearance. b.They require lower doses if they are metabolized by the liver. c.They are less likely to cross the placenta and affect the fetus. d.They are more likely to cause anatomical defects if they are teratogenic. - a.They may need to be given in higher doses if they undergo renal clearance. A breast-feeding patient must take a prescription medication for 2 weeks. The medication is safe, but the patient wants to make sure her baby receives as little of the drug as possible. What will the nurse tell the patient? a.To give the baby formula as long as the mother is taking the medication b.To take the medication immediately after breast-feeding c.To pump breast milk and feed the baby by bottle d.To take the medication 1 hour before breast-feeding - b.To take the medication immediately after breast-feedingWhich type of drug taken by a pregnant patient is more likely to have effects on a fetus? a.Drug that is highly polar b.Ionized drug c.Lipid-soluble drug d.Protein-bound drug - c.Lipid-soluble drug A nurse is concerned about renal function in an 84-year-old patient who is taking several medications. What should the nurse assess? a.Creatinine clearance b.Sodium levels c.Potassium levels d.Serum creatinine - a.Creatinine clearance Based on changes in hepatic function in older adult patients, which adjustment should the nurse expect for oral medications that undergo extensive first pass metabolism? a.A higher dose should be used with the same time schedule. b.The interval between doses should be increased. c.No change is necessary - metabolism will not be affected. d.The interval between doses should be reduced. ; b.The interval between doses should be increased. A nurse is preparing to give medications to four geriatric patients who are all taking multiple medications. Which patient is most likely to have an adverse drug reaction related to increased drug effects? a.Obese patientb.Patient with decreased serum creatinine c.Patient with chronic diarrhea d.Thin patient with a chronically low appetite - d.Thin patient with a chronically low appetite A nurse is teaching a group of nursing students about administering medications to older adult patients. Which statement by a student indicates a need for further teaching? a."Alteration in hepatic function requires more frequent drug dosing." b."Changes in GI function in older adult patients lead to lower serum drug levels." c."Most adverse drug reactions in older adult patients are related to altered renal function." d."Most nonadherence among older adult patients is intentional." - a."Alteration in hepatic function requires more frequent drug dosing." A thin older adult woman is admitted to the hospital after several days of vomiting, diarrhea, and poor intake of foods and fluids. She has not voided since admission. In preparing to care for this patient, the nurse will look for what laboratory values to help guide medication administration? (Select all that apply.) a.Creatinine clearance b.Gastric pH c.Plasma drug levels d.Serum albumin e.Serum creatinine - a.Creatinine clearance c.Plasma drug levels d.Serum albumin A patient with a seizure disorder is admitted to the hospital and has a partial convulsive episode shortly after arriving on the unit. The patient has been taking phenytoin (Dilantin) 100 mg three times daily and oxcarbazepine (Trileptal) 300 mg twice daily for several years. The patient's phenytoin level is 8.6 mcg/mL, and the oxcarbazepine level is 22 mcg/mL. The nurse contacts the provider to report these levels and the seizure. What will the nurse expect the provider to order? a.A decreased dose of oxcarbazepineb.Extended-release phenytoin c.An increased dose of phenytoin d.Once-daily dosing of oxcarbazepine - c.An increased dose of phenytoin A nurse counsels a patient who is to begin taking phenytoin (Dilantin) for epilepsy. Which statement by the patient indicates understanding of the teaching? a."I should brush and floss my teeth regularly." b."Once therapeutic blood levels are reached, they are easy to maintain." c."I can consume alcohol in moderation while taking this drug." d."Rashes are a common side effect but are not serious." - a."I should brush and floss my teeth regularly." A patient is to begin taking phenytoin (Dilantin) for seizures. The patient tells the nurse that she is taking oral contraceptives. What will the nurse tell the patient? a.She may need to increase her dose of phenytoin while taking oral contraceptives. b.She should consider a different form of birth control while taking phenytoin. c.She should remain on oral contraceptives, because phenytoin causes birth defects. d.She should stop taking oral contraceptives, because they reduce the effectiveness of phenytoin. - b.She should consider a different form of birth control while taking phenytoin. A nurse is completing a discharge plan for a 24-year-old patient who will begin taking phenytoin. Which information is important to teach this patient? a.She may stop taking the drug when she is seizure free for a year. b.Taking the medication will ensure that she no longer has seizures. c.She may need to discontinue the drug if serious side effects occur. d.She should be sure to use an effective contraceptive method. - d.She should be sure to use an effective contraceptive method.A patient who has had abdominal surgery has been receiving morphine sulfate via a patient-controlled analgesia (PCA) pump. The nurse assesses the patient and notes that the patient's pupils are dilated and that the patient is drowsy and lethargic. The patient's heart rate is 84 beats per minute, the respiratory rate is 10 breaths per minute, and the blood pressure is 90/50 mm Hg. What will the nurse do? a.Discuss possible opiate dependence with the patient's provider. b.Encourage the patient to turn over and cough and take deep breaths. c.Note the effectiveness of the analgesia in the patient's chart. d.Prepare to administer naloxone and possibly ventilatory support. - d.Prepare to administer naloxone and possibly ventilatory support A patient with cancer has been taking an opioid analgesic four times daily for several months and reports needing increased doses for pain. What will the nurse tell the patient? a.PRN dosing of the drug may be more effective. b.The risk of respiratory depression increases over time. c.The patient should discuss increasing the dose with the provider. d.The patient should request the addition of a benzodiazepine to augment pain relief. - c.The patient should discuss increasing the dose with the provider. A woman in labor receives meperidine (Demerol) for pain. The nurse caring for the infant will observe the infant closely for: nital anomalies. sive crying and sneezing. ratory depression. rs and hyperreflexia. - ratory depression. A postoperative patient has received an epidural infusion of morphine sulfate. The patient's respiratory rate decreases to 8 breaths per minute, and he has a decreased level of consciousness and miosis. Which medication would the nurse anticipate administering?a.Naloxone (Narcan) b.Acetylcysteine (Mucomyst) c.Methylprednisolone (Medrol) d.Physostigmine (Antilirium) - a.Naloxone (Narcan) A patient is brought to the emergency department by friends, who report finding the patient difficult to awaken. The friends report removing two fentanyl transdermal patches from the patient's arm. On admission to the emergency department, the patient has pinpoint pupils and a respiratory rate of 6 breaths per minute. A few minutes after administration of naloxone, the respiratory rate is 8 breaths per minute and the patient's pupils are dilated. The nurse recognizes these symptoms as signs of: a.a mild opioid overdose. ased opioid drug levels. ved ventilation. ning hypoxia. - ning hypoxia. A nurse is administering morphine sulfate to a postoperative patient. Which are appropriate routine nursing actions when giving this drug? (Select all that apply.) a.Counting respirations before and after giving the medication b.Encouraging physical activity and offering increased fluids c.Monitoring the patient's blood pressure closely for hypertension d.Palpating the patient's lower abdomen every 4 to 6 hours e.Requesting an order for methylnaltrexone (Relistor) to prevent constipation -a.Counting respirations before and after giving the medication b.Encouraging physical activity and offering increased fluids d.Palpating the patient's lower abdomen every 4 to 6 hours Which side effects of opioid analgesics can have therapeutic benefits? (Select all that apply.) a.Biliary colicb.Cough suppression c.Suppression of bowel motility d.Urinary retention e.Vasodilation - b.Cough suppression c.Suppression of bowel motility e.Vasodilation A nurse is preparing to administer medications to a hospitalized patient who has been taking lithium (Lithobid) for 3 days. The patient is complaining of mild nausea and abdominal bloating. The patient's lithium level is 0.8 mEq/L. What will the nurse do? a.Administer the dose and tell the patient that the side effects are temporary. b.Contact the prescriber to request an order for serum electrolytes. c.Hold the dose and notify the prescriber of the patient's lithium level. d.Request an order for amiloride (Midamor). - a.Administer the dose and tell the patient that the side effects are temporary. A patient recently was diagnosed with bipolar disorder. The patient, who has a history of seasonal allergies, is an athlete who participates in track. The nurse is teaching the patient about lithium (Lithobid), which the prescriber has just ordered. Which statement by the patient indicates the need for further teaching? a."I can continue to use ibuprofen as needed for muscle pain." b."I should drink extra fluids before and during exercise." c."I should not use antihistamines while taking lithium." d."I should report muscle weakness and tremors to my provider." - a."I can continue to use ibuprofen as needed for muscle pain." A patient with bipolar disorder is admitted to the hospital. The patient has been taking lithium (Lithobid) for several years and has not been evaluated by a provider for over a year. Besides obtaining a lithium level, the nurse caring for this patient will anticipate orders for which laboratory tests? (Select all that apply.)a.Calcium level b.Complete blood count with differential c.Liver function tests d.Renal function tests e.Serum potassium f.Thyroid function tests - b.Complete blood count with differential d.Renal function tests f.Thyroid function tests A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this patient will expect to administer which drug? a.Furosemide (Lasix) b.Hydrochlorothiazide (HydroDIURIL) c.Mannitol (Osmitrol) d.Spironolactone (Aldactone) - a.Furosemide (Lasix) A patient who is taking digoxin is admitted to the hospital for treatment of congestive heart failure. The prescriber has ordered furosemide (Lasix). The nurse notes an irregular heart rate of 86 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82 mm Hg. The nurse auscultates crackles in both lungs. Which laboratory value causes the nurse the most concern? a.Blood glucose level of 120 mg/dL b.Oxygen saturation of 90% c.Potassium level of 3.5 mEq/L d.Sodium level of 140 mEq/L - c.Potassium level of 3.5 mEq/L A patient with hypertension is taking furosemide (Lasix) for congestive heart failure. The prescriber orders digoxin to help increase cardiac output. What other medication will the nurse expect to be ordered for this patient?a.Bumetanide (Bumex) b.Chlorothiazide (Diuril) c.Hydrochlorothiazide (HydroDIURIL) d.Spironolactone (Aldactone) - d.Spironolactone (Aldactone) A nurse preparing to administer morning medications notes that a patient with a history of hypertension has been prescribed the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten) concurrently with spironolactone (Aldactone). Morning laboratory results reveal a serum sodium level of 144 mg/dL, a serum potassium level of 5.1 mEq/L, and a blood glucose level of 128 mg/dL. Which intervention is appropriate? a.Administer the medications as ordered. b.Ask the patient about the use of salt substitutes. c.Contact the provider to report the laboratory values. d.Request an order for furosemide (Lasix). - c.Contact the provider to report the laboratory values. A patient is taking gentamicin (Garamycin) and furosemide (Lasix). The nurse should counsel this patient to report which symptom? a.Frequent nocturia b.Headaches c.Ringing in the ears d.Urinary retention - c.Ringing in the ears An older adult patient with congestive heart failure develops crackles in both lungs and pitting edema of all extremities. The physician orders hydrochlorothiazide (HydroDIURIL). Before administering this medication, the nurse reviews the patient's chart. Which laboratory value causes the nurse the most concern? a.Elevated creatinine clearanceb.Elevated serum potassium level c.Normal blood glucose level d.Low levels of low-density lipoprotein (LDL) cholesterol - a.Elevated creatinine clearance A patient with chronic congestive heart failure has repeated hospitalizations in spite of ongoing treatment with hydrochlorothiazide (HydroDIURIL) and digoxin. The prescriber has ordered spironolactone (Aldactone) to be added to this patient's drug regimen, and the nurse provides education about this medication. Which statement by the patient indicates understanding of the teaching? a."I can expect improvement within a few hours after taking this drug." b."I need to stop taking potassium supplements." c."I should use salt substitutes to prevent toxic side effects." d."I should watch closely for dehydration." - b."I need to stop taking potassium supplements." A patient begins taking an ACE inhibitor and complains of a dry cough. What does the nurse correctly tell the patient about this symptom? a.It indicates that a serious side effect has occurred. b.It is a common side effect that occurs in almost all patients taking the drug. c.It may be uncomfortable enough that the drug will need to be discontinued. d.It occurs frequently in patients taking the drug but will subside over time. - c.It may be uncomfortable enough that the drug will need to be discontinued. A patient with hypertension who has been taking captopril (Capoten) for several months is admitted to the hospital. The patient reports that food "tastes funny." What will the nurse do? a.Compare the patient's admission weight to a previous weight. b.Notify the provider to request a different antihypertensive medication. c.Reassure the patient that this is a temporary side effect of the drug. d.Request an order for a white blood cell count (WBC) with differential. - a.Compare the patient's admission weight to a previous weight.A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE inhibitors will not occur with an ARB medication? a.Angioedema b.Cancer c.Cough d.Renal failure - c.Cough A patient begins taking nifedipine (Procardia), along with a beta blocker, to treat hypertension. The nurse understands that the beta blocker is used to: e flushing. ize gingival hyperplasia. nt constipation. nt reflex tachycardia. - nt reflex tachycardia. A nurse is teaching a patient who will begin taking verapamil (Calan) for hypertension about the drug's side effects. Which statement by the patient indicates understanding of the teaching? a."I may become constipated, so I should increase fluids and fiber." b."I may experience a rapid heart rate as a result of taking this drug." c."I may have swelling of my hands and feet, but this will subside." d."I may need to increase my digoxin dose while taking this drug." - a."I may become constipated, so I should increase fluids and fiber." A nurse is preparing to assist a nursing student in administering intravenous verapamil to a patient who also receives a beta blocker. The nurse asks the nursing student to discuss the plan of care for this patient. Which statement by the student indicates a need for further teaching?a."I will check to see when the last dose of the beta blocker was given." b."I will monitor vital signs closely to assess for hypotension." c."I will monitor the heart rate frequently to assess for reflex tachycardia." d."I will prepare to administer intravenous norepinephrine if necessary." - c."I will monitor the heart rate frequently to assess for reflex tachycardia." A patient who has been taking verapamil (Calan) for hypertension complains of constipation. The patient will begin taking amlodipine (Norvasc) to prevent this side effect. The nurse provides teaching about the difference between the two drugs. Which statement by the patient indicates that further teaching is needed? a."I can expect dizziness and facial flushing with nifedipine." b."I should notify the provider if I have swelling of my hands and feet." c."I will need to take a beta blocker to prevent reflex tachycardia." d."I will need to take this drug once a day." - c."I will need to take a beta blocker to prevent reflex tachycardia." A nurse prepares to administer a scheduled dose of digoxin. The nurse finds a new laboratory report showing a plasma digoxin level of 0.7 ng/mL. What action should the nurse take? a.Withhold the drug for an hour and reassess the level. b.Withhold the drug and notify the prescriber immediately. c.Administer Digibind to counteract the toxicity. d.Check the patient's apical pulse, and if it is within a safe range, administer the digoxin. - d.Check the patient's apical pulse, and if it is within a safe range, administer the digoxin. A man asks a nurse why he cannot use digoxin (Lanoxin) for his heart failure, because both of his parents used it for HF. The nurse will explain that digoxin is not first-line therapy for which reason? a.It causes tachycardia and increases the cardiac workload. b.It does not correct the underlying pathology of heart failure.c.It has a wide therapeutic range that makes dosing difficult. d.It may actually shorten the patient's life expectancy. - b.It does not correct the underlying pathology of heart failure. A nurse is preparing to administer digoxin (Lanoxin) to a patient. The patient's heart rate is 62 beats per minute, and the blood pressure is 120/60 mm Hg. The last serum electrolyte value showed a potassium level of 5.2 mEq/L. What will the nurse do? a.Contact the provider to request an increased dose of digoxin. b.Give the dose of digoxin and notify the provider of the potassium level. c.Request an order for a diuretic. d.Withhold the dose and notify the provider of the heart rate. - b.Give the dose of digoxin and notify the provider of the potassium level. A patient with heart failure who has been given digoxin (Lanoxin) daily for a week complains of nausea. Before giving the next dose, the nurse will: s the heart rate (HR) and give the dose if the HR is greater than 60 beats per minute. ct the provider to report digoxin toxicity. st an order for a decreased dose of digoxin. w the serum electrolyte values and withhold the dose if the potassium level is greater than 3.5 mEq/L. - s the heart rate (HR) and give the dose if the HR is greater than 60 beats per minute. A patient is taking a thiazide diuretic for hypertension and quinidine to treat a dysrhythmia. The prescriber orders digoxin 0.125 mg to improve this patient's cardiac output. The nurse should contact the provider to request: g spironolactone (Aldactone). ing the dose of digoxin. ntinuing the quinidine. g potassium supplements. - ntinuing the quinidine.A patient with heart failure who takes a thiazide diuretic and digoxin (Lanoxin) is admitted for shortness of breath. The patient's heart rate is 66 beats per minute, and the blood pressure is 130/88 mm Hg. The serum potassium level is 3.8 mEq/L, and the digoxin level is 0.8 ng/mL. The nurse admitting this patient understands that the patient: digoxin toxicity. showing signs of renal failure. experiencing worsening of the disease. a potassium-sparing diuretic. - experiencing worsening of the disease. A patient has been taking digoxin (Lanoxin) 0.25 mg, and furosemide (Lasix) 40 mg, daily. Upon routine assessment by the nurse, the patient states, "I see yellow halos around the lights." The nurse should perform which action based on this assessment? a.Check the patient for other symptoms of digitalis toxicity. b.Withhold the next dose of furosemide. c.Continue to monitor the patient for heart failure. d.Document the findings and reassess in 1 hour. - a.Check the patient for other symptoms of digitalis toxicity. A nurse is providing teaching for a patient with stable angina who will begin taking nitroglycerin. Which statement by the patient indicates understanding of the teaching? a."I should not participate in aerobic exercise while taking this drug." b."I should take aspirin daily to reduce my need for nitroglycerin." c."If I take nitroglycerin before exertion, I can reduce the chance of an anginal attack." d."I take nitroglycerin to increase the amount of oxygen to my heart." - c."If I take nitroglycerin before exertion, I can reduce the chance of an anginal attack." A patient asks a nurse how nitroglycerin works to relieve anginal pain. The nurse correctly states, "Nitroglycerin:es coronary arteries to increase blood flow to the heart." ases the oxygen supply to the cardiac muscle." ases ventricular filling to improve cardiac output." tes vasodilation, which reduces preload and oxygen demand." - tes vasodilation, which reduces preload and oxygen demand." A hospitalized patient complains of acute chest pain. The nurse administers a 0.3 mg sublingual nitroglycerin tablet, but the patient continues to complain of pain. Vital signs remain stable. What is the nurse's next step? a.Apply a nitroglycerin transdermal patch. b.Continue dosing at 10-minute intervals. c.Give a second dose of nitroglycerin in 5 minutes. d.Request an order for intravenous nitroglycerin. - c.Give a second dose of nitroglycerin in 5 minutes. A patient who has begun using transdermal nitroglycerin for angina reports occasional periods of tachycardia. The nurse will expect the prescriber to order: in (Lanoxin) to slow the heart rate. iate discontinuation of the nitroglycerin. ds of rest when the heart rate increases. amil as an adjunct to nitroglycerin therapy. - amil as an adjunct to nitroglycerin therapy. A patient with angina who uses sublingual nitroglycerin tells the nurse that the episodes are increasing in frequency and usually occur when the patient walks the dog. The patient reports needing almost daily doses of the nitroglycerin and states that one tablet usually provides complete relief. What will the nurse do? a.Contact the provider to suggest ordering a transdermal patch for this patient.b.Question the patient about consumption of grapefruit juice. c.Suggest that the patient limit walking the dog to shorter distances less frequently. d.Suggest that the patient take two tablets of nitroglycerin each time, because the symptoms are increasing in frequency. - a.Contact the provider to suggest ordering a transdermal patch for this patient. A patient is taking a calcium channel blocker (CCB) for stable angina. The patient's spouse asks how calcium channel blockers relieve pain. The nurse will explain that CCBs: relax peripheral arterioles to reduce afterload. ve coronary artery perfusion. ase the heart rate to improve myocardial contractility. ase the QT interval. - relax peripheral arterioles to reduce afterload. A patient with stable exertional angina has been receiving a beta blocker. Before giving the drug, the nurse notes a resting heart rate of 55 beats per minute. Which is an appropriate nursing action? a.Administer the drug as ordered, because this is a desired effect. b.Withhold the dose and notify the provider of the heart rate. c.Request an order for a lower dose of the medication. d.Request an order to change to another antianginal medication. - a.Administer the drug as ordered, because this is a desired effect. A nurse provides teaching to a patient with angina who also has type 2 diabetes mellitus, asthma, and hypertension. Which statement by the patient indicates a need for further teaching? a."An ACE inhibitor, in addition to nitroglycerin, will lower my risk of cardiovascular death." b."Beta blockers can help control hypertension." c."I should begin regular aerobic exercise." d."Long-acting, slow-release calcium channel blockers can help with anginal pain." - b."Beta blockers can help control hypertension."A patient with atrial fibrillation is receiving warfarin (Coumadin). The nurse notes that the patient's INR is 2.7. Before to giving the next dose of warfarin, the nurse will notify the provider and: ister the dose as ordered. st an order to decrease the dose. st an order to give vitamin K (phytonadione). st an order to increase the dose. - ister the dose as ordered. A patient who takes warfarin for atrial fibrillation undergoes hip replacement surgery. On the second postoperative day, the nurse assesses the patient and notes an oxygen saturation of 83%, pleuritic chest pain, shortness of breath, and hemoptysis. The nurse will contact the provider to report possible _____ and request an order for _____. stive heart failure furosemide (Lasix) rhage vitamin K (phytonadione) rdial infarction tissue plasminogen activator (tPA) nary embolism heparin - nary embolism heparin A patient who takes warfarin (Coumadin) is brought to the emergency department after accidentally taking too much warfarin. The patient's heart rate is 78 beats per minute and the blood pressure is 120/80 mm Hg. A dipstick urinalysis is normal. The patient does not have any obvious hematoma or petechiae and does not complain of pain. The nurse will anticipate an order for: in K (phytonadione). mine sulfate. c.a PTT. d.a PT and an INR. - d.a PT and an INR. A patient who has taken warfarin (Coumadin) for a year begins taking carbamazepine. The nurse will anticipate an order to: ase the dose of ase the dose of warfarin. rm more frequent aPTT monitoring. de extra dietary vitamin K. - ase the dose of warfarin. A patient who is taking warfarin (Coumadin) has just vomited blood. The nurse notifies the provider, who orders lab work revealing a PT of 42 seconds and an INR of 3.5. The nurse will expect to administer: nadione (vitamin K1) 1 mg IV over 1 hour. nadione (vitamin K1) 2.5 mg PO. mine sulfate 20 mg PO. mine sulfate 20 mg slow IV push. - nadione (vitamin K1) 1 mg IV over 1 hour. A patient who has chronic adrenal insufficiency is admitted to the hospital for an open cholecystectomy. The nurse obtaining the admission history learns that the patient takes hydrocortisone 25 mg PO daily in the morning. The patient's surgery is scheduled for the next morning. The nurse will expect an order to: ister the usual morning dose of hydrocortisone 25 mg PO. ister hydrocortisone 75 mg PO in the morning. ister hydrocortisone 75 mg IV before surgery. old the morning dose of hydrocortisone and give it after surgery. - ister hydrocortisone 75 mg IV before surgery. A patient who has been newly diagnosed with adrenal hormone deficiency will begin taking hydrocortisone. The nurse provides teaching for this patient. Which statement by the patient indicates understanding of the teaching? a."I may take all of my daily dose in the morning or divide it in half and take it twice daily." b."I will need to take this medication until my symptoms completely clear, and then I may stop." c."Side effects are common with hydrocortisone, even with therapeutic doses." d."When I am sick, I should take three times the normal dose for 3 days in a row." - d."When I am sick, I should take three times the normal dose for 3 days in a row."The nurse is providing patient education about glucocorticoid therapy to a patient preparing to be discharged home. Which statement made by the patient best demonstrates understanding of glucocorticoid therapy? a."I will take the entire dose early with breakfast." b."I may take two-thirds of the dose in the morning and one-third in the evening." c."I will divide the dose in half and take half in the morning and half in the afternoon." d."I will take a dose with each meal." - b."I may take two-thirds of the dose in the morning and one-third in the evening." A 50-year-old postmenopausal patient who has had a hysterectomy has moderate to severe vasomotor symptoms and is discussing estrogen therapy (ET) with the nurse. The patient is concerned about adverse effects of ET. The nurse will tell her that: estrogen-progesterone product will reduce side effects. intravaginal preparation may be best for her. effects of ET are uncommon among women her age. dermal preparations have fewer side effects. -dermal preparations have fewer side effects. A patient who is at risk for osteoporosis will begin taking the selective estrogen receptor modulator raloxifene (Evista). Which statement will the nurse include when teaching this patient about the medication? a.Raloxifene reduces the risk of thromboembolism. b.The drug is associated with an increased risk of breast cancer. c.Use of this drug increases the risk of endometrial carcinoma. d.Vasomotor symptoms are a common side effect of this drug. - d.Vasomotor symptoms are a common side effect of this drug. A nurse provides teaching to a patient who has had a hysterectomy and is about to begin hormone therapy to manage menopausal symptoms. Which statement by the patient indicates understanding of the teaching? a."Because I am not at risk for uterine cancer, I can take hormones indefinitely."b."I can take estrogen to reduce my risk of cardiovascular disease." c."I should take the lowest effective dose for the shortest time needed." d."I will need a progestin/estrogen combination since I have had a hysterectomy." - c."I should take the lowest effective dose for the shortest time needed." A nurse provides teaching to a group of nursing students about the risks and benefits of hormone therapy (HT), including estrogen therapy (ET) and combination estrogen/progestin therapy (EPT). Which statement by a student indicates understanding of the teaching? a."ET can provide protection against coronary heart disease and reverse osteoporosis." b."EPT is generally safer than ET, especially in women who have undergone hysterectomies." c."In women with established coronary heart disease, EPT can protect against myocardial infarction." d."Principle benefits of ET are suppression of menopausal symptoms and prevention of osteoporosis." - d."Principle benefits of ET are suppression of menopausal symptoms and prevention of osteoporosis." A patient who will begin combination estrogen/progestin therapy (EPT) for menopause asks the nurse why she can't take an estrogen-only preparation. The patient has not had a hysterectomy, has a slightly increased risk of cardiovascular disease, and has mild osteopenia. The nurse will tell her that the progestin is necessary to: ase her risk of endometrial cancer. ase bone resorption to prevent fractures. her risk of myocardial infarction (MI). nt deep vein thrombosis (DVT). - ase her risk of endometrial cancer. The nurse is providing patient education for a postmenopausal patient who is considering estrogen/progestin replacement therapy (EPT). Which risks associated with EPT should the nurse discuss with the patient? (Select all that apply.) a.Decreased colon cancer b.Strokec.Deep vein thrombosis d.Ovarian cancer e.Decreased bone density - b.Stroke c.Deep vein thrombosis d.Ovarian cancer A nurse provides teaching for a female patient with anemia who has had cancer chemotherapy and who will begin treatment with testosterone. Which statement by the patient indicates understanding of the teaching? a."Facial hair may develop with this drug but will go away over time." b."I may experience an increase in breast size while taking this drug." c."Testosterone may increase my high-density lipoprotein (HDL) cholesterol and reduce my low-density lipoprotein (LDL) cholesterol." d."Testosterone treats anemia by stimulating the synthesis of a renal hormone." - d."Testosterone treats anemia by stimulating the synthesis of a renal hormone." A clinic nurse is assessing an adolescent male patient who has been receiving androgen therapy for hypogonadism via a transdermal patch. The patient's last clinic visit was 4 weeks earlier. Which part of the interval history is of most concern to the nurse? a.Five pound weight gain b.Rash at the site of the patch c.Breast enlargement d.Presence of acne - a.Five pound weight gain A nurse is providing education to a patient who is beginning therapy with testosterone gel. What statement made by the patient demonstrates a need for further teaching? a."I should not shower or swim for at least 5 to 6 hours after application." b."I should avoid direct skin-to-skin contact with my spouse where the medication was applied." c."I should have my blood drawn for laboratory tests in 14 days."d."I should apply the entire contents of the packet to my genitals." - d."I should apply the entire contents of the packet to my genitals." A nurse is obtaining a history and reviewing the chart of an adult male patient who has been taking oral androgens. Which assessment would warrant notifying the provider? a.Acne and increased facial hair b.Breast enlargement c.Increased libido d.Nausea, anorexia, and fatigue - d.Nausea, anorexia, and fatigue A nurse is teaching a male adult patient about the use of testosterone gel. Which statement by the patient indicates an understanding of the teaching? a."I should apply this to my forearms and neck after showering." b."I should keep treated areas exposed to the air so that they can dry." c."I should not let my child touch the gel to prevent behavioral problems." d."I should not swim or bathe for 3 to 4 hours after applying the gel." - c."I should not let my child touch the gel to prevent behavioral problems." A 14-year-old male patient who plays football is admitted to the hospital. The nurse notes that the patient has short stature for his age according to a standard growth chart. The patient is muscular, has a deep voice, and needs to shave. The nurse notifies the provider of these findings. Which test will the nurse expect the provider to order? a.Coagulation studies b.Complete blood count (CBC) with differential c.Liver function tests and serum cholesterol d.Serum glucose and hemoglobin A1c - c.Liver function tests and serum cholesterolA nurse is teaching a group of parents about the role of testosterone in puberty for boys. To evaluate the group's understanding, the nurse asks, "What physiologic effects related to testosterone can you expect to see in your sons?" Which responses indicate an understanding of the role of testosterone in male puberty? (Select all that apply.) a."It promotes skeletal muscle growth." b."It increases height and weight." c."It delays epiphyseal closure." d."It causes a high-pitched voice." e."It causes acne." - a."It promotes skeletal muscle growth." b."It increases height and weight." e."It causes acne." A male patient is being treated for benign prostatic hyperplasia (BPH) by another provider but cannot remember which drug he is taking. He comes to the clinic seeking treatment for erectile dysfunction and receives a prescription for sildenafil (Viagra). What will the nurse teach this patient? a."Sildenafil is not safe to take in conjunction with finasteride (Proscar)." b."Sildenafil is safe with any medication for benign prostatic hyperplasia." c."To be safe, you should have a transurethral resection before starting sildenafil." d."You should not take sildenafil if you are taking silodosin (Rapaflo)." - d."You should not take sildenafil if you are taking silodosin (Rapaflo)." A nurse is teaching a patient about the use of sildenafil (Viagra) for erectile dysfunction. Which statement by the patient indicates understanding of the teaching? a."If my erection lasts longer than 4 hours, I should contact my provider." b."I should not use nitroglycerin within 12 hours of using sildenafil." c."I should take this drug about 15 minutes before sexual activity." d."This drug may cause me to have an erection when I don't want one." - a."If my erection lasts longer than 4 hours, I should contact my provider."A male patient tells the nurse he awakens once or twice each night to void and has difficulty starting his stream of urine. He describes these symptoms as "annoying." The patient's provider examines him and notes that the prostate is moderately enlarged. The patient is sexually active and tells the nurse that he does not want to take any medication that will interfere with sexual function. The nurse anticipates the provider will order: osin (Cardura). teride (Proscar). osin (Rapaflo). d.a transurethral prostatectomy. - osin (Cardura). A patient who has erectile dysfunction asks a nurse whether sildenafil (Viagra) would be a good medication for him to take. Which aspect of this patient's history would be of most concern? a.Benign prostatic hypertrophy b.Mild hypertension c.Occasional use of nitroglycerin d.Taking finasteride - c.Occasional use of nitroglycerin Which are contraindications for taking sildenafil (Viagra)? (Select all that apply.) a.Patients who are taking nitroglycerin for angina pectoris b.Patients with nonarteritic ischemic optic neuropathy (NAION) in one eye c.Patients with BPH who are taking alpha1-adrenergic antagonists d.Patients with a blood pressure of 100/60 mm Hg e.Patients with a history of myocardial infarction (MI) in the past 6 months - a.Patients who are taking nitroglycerin for angina pectoris b.Patients with nonarteritic ischemic optic neuropathy (NAION) in one eye c.Patients with BPH who are taking alpha1-adrenergic antagonistsA pregnant patient asks the nurse if she can take antihistamines for seasonal allergies during her pregnancy. What will the nurse tell the patient? a.Antihistamines are contraindicated during the third trimester of pregnancy. b.Second-generation antihistamines are safer than first-generation antihistamines. c.Antihistamines should not be taken during pregnancy, but may be taken when breast-feeding. d.The margin of safety for antihistamines is clearly understood for pregnant patients. - a.Antihistamines are contraindicated during the third trimester of pregnancy. A nurse is teaching a group of nursing students about antihistamines. Which statement by a student indicates an understanding of the mechanism of action of the antihistamines? a."Antihistamines block H1 receptors to prevent actions of histamine at these sites." b."Antihistamines block release of histamine from mast cells and basophils." c."H1 antagonists can bind to H1 receptors, H2 receptors, and muscarinic receptors." d."First-generation antihistamines are more selective than second-generation antihistamines." - a."Antihistamines block H1 receptors to prevent actions of histamine at these sites." A patient will begin taking fexofenadine (Allegra) for hay fever. The nurse teaching this patient will tell the patient that: enadine should be taken with food to prevent gastrointestinal (GI) symptoms. medication may be taken once or twice dail