,1) A nurse is caring for a client with hyperparathyroidism and notes that the client's
serum calcium level is 13 mg/dL. Which medication should the nurse prepare to
administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - CORRECT ANSWERS -3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
hypercalcemia. Calcium gluconate and calcium chloride are medications used for the
treatment of tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia,
large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases
the plasma calcium level by inhibiting bone resorption and lowering the serum calcium
concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency
anemia. The nurse instructs the mother to administer the iron with which best food
item?
1. Milk
2. Water
3. Apple juice
4. Orange juice - CORRECT ANSWERS -4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed
to administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk
may affect absorption of the iron. Water will not assist in absorption. Orange juice
contains a greater amount of vitamin C than apple juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse
monitors the client, knowing that which of the following would indicate the presence of
systemic toxicity from this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations - CORRECT ANSWERS -1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can
result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological
disturbances. Constipation and diarrhea are not associated with salicylism.
4.) The camp nurse asks the children preparing to swim in the lake if they have applied
sunscreen. The nurse reminds the children that chemical sunscreens are most effective
when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
, 4. At least 30 minutes before exposure to the sun - CORRECT ANSWERS -4. At least
30 minutes before exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to the
sun so that they can penetrate the skin. All sunscreens should be reapplied after
swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When
applying the medication, the client complains of local discomfort and burning. Which of
the following is the most appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site - CORRECT ANSWERS -3.
Informing the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and
is used to treat burns to reduce bacteria present in avascular tissues. The client should
be informed that the medication will cause local discomfort and burning and that this is a
normal reaction; therefore options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to
the site of injury. The nurse monitors the client, knowing that which of the following
indicates that a systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site - CORRECT ANSWERS -1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of
acid, thereby causing acidosis. Clients receiving this treatment should be monitored for
signs of an acid-base imbalance (hyperventilation). If this occurs, the medication should
be discontinued for 1 to 2 days. Options 3 and 4 describe local rather than systemic
effects. An elevated blood pressure may be expected from the pain that occurs with a
burn injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of
this medication, the nurse anticipates that which laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count - CORRECT ANSWERS -2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured
before treatment and periodically thereafter until the effect on the triglycerides has been
, evaluated. Options 1, 3, and 4 do not need to be monitored specifically during this
treatment.
8.) A client with severe acne is seen in the clinic and the health care provider (HCP)
prescribes isotretinoin. The nurse reviews the client's medication record and would
contact the (HCP) if the client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) - CORRECT ANSWERS -1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of
isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A
supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4 are
not contraindicated with the use of isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse
would monitor for the potential for increased systemic absorption of the medication if the
medication were being applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - CORRECT ANSWERS -2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is
higher from regions where the skin is especially permeable (scalp, axilla, face, eyelids,
neck, perineum, genitalia), and lower from regions in which permeability is poor (back,
palms, soles).
10.) The clinic nurse is performing an admission assessment on a client. The nurse
notes that the client is taking azelaic acid (Azelex). Because of the medication
prescription, the nurse would suspect that the client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex - CORRECT ANSWERS -1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid
appears to work by suppressing the growth of Propionibacterium acnes and decreasing
the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client
with a partial-thickness burn, which has cultured positive for gram-negative bacteria.
The nurse is reinforcing information to the client about the medication. Which statement
made by the client indicates a lack of understanding about the treatments?
1. "The medication is an antibacterial."
serum calcium level is 13 mg/dL. Which medication should the nurse prepare to
administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - CORRECT ANSWERS -3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
hypercalcemia. Calcium gluconate and calcium chloride are medications used for the
treatment of tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia,
large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases
the plasma calcium level by inhibiting bone resorption and lowering the serum calcium
concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency
anemia. The nurse instructs the mother to administer the iron with which best food
item?
1. Milk
2. Water
3. Apple juice
4. Orange juice - CORRECT ANSWERS -4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed
to administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk
may affect absorption of the iron. Water will not assist in absorption. Orange juice
contains a greater amount of vitamin C than apple juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse
monitors the client, knowing that which of the following would indicate the presence of
systemic toxicity from this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations - CORRECT ANSWERS -1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can
result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological
disturbances. Constipation and diarrhea are not associated with salicylism.
4.) The camp nurse asks the children preparing to swim in the lake if they have applied
sunscreen. The nurse reminds the children that chemical sunscreens are most effective
when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
, 4. At least 30 minutes before exposure to the sun - CORRECT ANSWERS -4. At least
30 minutes before exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to the
sun so that they can penetrate the skin. All sunscreens should be reapplied after
swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When
applying the medication, the client complains of local discomfort and burning. Which of
the following is the most appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site - CORRECT ANSWERS -3.
Informing the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and
is used to treat burns to reduce bacteria present in avascular tissues. The client should
be informed that the medication will cause local discomfort and burning and that this is a
normal reaction; therefore options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to
the site of injury. The nurse monitors the client, knowing that which of the following
indicates that a systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site - CORRECT ANSWERS -1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of
acid, thereby causing acidosis. Clients receiving this treatment should be monitored for
signs of an acid-base imbalance (hyperventilation). If this occurs, the medication should
be discontinued for 1 to 2 days. Options 3 and 4 describe local rather than systemic
effects. An elevated blood pressure may be expected from the pain that occurs with a
burn injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of
this medication, the nurse anticipates that which laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count - CORRECT ANSWERS -2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured
before treatment and periodically thereafter until the effect on the triglycerides has been
, evaluated. Options 1, 3, and 4 do not need to be monitored specifically during this
treatment.
8.) A client with severe acne is seen in the clinic and the health care provider (HCP)
prescribes isotretinoin. The nurse reviews the client's medication record and would
contact the (HCP) if the client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) - CORRECT ANSWERS -1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of
isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A
supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4 are
not contraindicated with the use of isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse
would monitor for the potential for increased systemic absorption of the medication if the
medication were being applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - CORRECT ANSWERS -2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is
higher from regions where the skin is especially permeable (scalp, axilla, face, eyelids,
neck, perineum, genitalia), and lower from regions in which permeability is poor (back,
palms, soles).
10.) The clinic nurse is performing an admission assessment on a client. The nurse
notes that the client is taking azelaic acid (Azelex). Because of the medication
prescription, the nurse would suspect that the client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex - CORRECT ANSWERS -1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid
appears to work by suppressing the growth of Propionibacterium acnes and decreasing
the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client
with a partial-thickness burn, which has cultured positive for gram-negative bacteria.
The nurse is reinforcing information to the client about the medication. Which statement
made by the client indicates a lack of understanding about the treatments?
1. "The medication is an antibacterial."
