D116 pre-assessment
Study online at https://quizlet.com/_cga42c
1. How will these drug interactions affect this patient? Propranolol can decrease
An elderly patient with a history of asthma and hyper- albuterol's therapeutic ef-
tension presents to the emergency department com- fect.
plaining of chest pain and shortness of breath. The
advanced practice registered nurse (APRN) reviews the
patient's current medications and notes that the pa-
tient is taking propranolol and inhaled albuterol.
2. A 35-year-old mother who is currently breastfeeding Lipid-soluble
her four-month-old baby comes to a clinic for an eval-
uation of a sinus infection. The advanced practice reg-
istered nurse needs to prescribe medication that does
not pass across the membrane into the breast milk.
3. A 42-year-old patient suffering from pain due to cancer The drug depresses peri-
comes to a clinic and visits with the advanced practice stalsis, prolonging drug
registered nurse (APRN). The APRN previously had pre- transit time.
scribed morphine to treat the pain. The patient is con-
cerned because her bowel movements have become
irregular and asks the APRN why she is experiencing
constipation.
How should the APRN respond?
4. An advanced practice registered nurse is prescribing Increases heart rate
dobutamine for a patient in cardiogenic shock.
Which outcome is expected when this drug is used?
5. An advanced practice registered nurse (APRN) volun- Enroll the patient in the
teers one day per month at a local free clinic in the local Mission prescription
community and is seeing a 43-year-old Caucasian pa- assistance program
tient with hypertension. The patient's blood pressure is
196/100, and the patient states being prescribed three
, D116 pre-assessment
Study online at https://quizlet.com/_cga42c
blood pressure medications: metoprolol 100 mg bid,
losartan 50 mg daily, and clonidine 0.1 mg tid.
The patient states that there is no way to check blood
pressure, and upon reviewing all the patient's medica-
tions, the APRN notes that the losartan has not been
filled for three months and only 10 pills remain. The
patient admits taking half the prescribed dose so the
pills last longer.
Which action should be taken by the APRN?
6. A 78-year-old woman is diagnosed with chronic Timolol
open-angle glaucoma. She has a past history of
first-degree atrioventricular block and bradycardia.
Which medication should be avoided by this patient?
7. An advanced practice registered nurse (APRN) is evalu- Change the cimetidine
ating a patient at a six-month follow-up appointment. to ranitidine because the
The patient is taking cimetidine 1 g at bedtime, meto- original drug may de-
prolol 100 mg daily, aspirin 81 mg daily, and metformin crease the effectiveness of
1 g daily. The patient's vitals are BP 160/90, pulse 110, the metoprolol
respirations 12, and temperature 97.8°F.
The patient is concerned that her blood pressure and
pulse are still elevated. The patient tells the APRN she
does not want to take another pill because she feels
she is taking too many.
Which action should the APRN take next?
8. A 47-year-old male is brought to an emergency depart- Assess for acute lidocaine
ment with lacerations to the forearm. After applying toxicity
lidocaine as local anesthetic, the patient states he feels
like he may pass out and is sweating profusely.
, D116 pre-assessment
Study online at https://quizlet.com/_cga42c
Which action by the patient's advanced practice regis-
tered nurse should be taken first?
9. A 34-year-old patient comes to a clinic complaining of Naproxen
pain in the left shoulder. The advanced practice regis-
tered nurse (APRN) assesses the patient and notices
that the patient has a limited range of motion in the
shoulder due to swelling. The APRN determines that
the patient should be prescribed a medication that
treats peripheral nervous system disorders.
Which medication has the APRN prescribed?
10. A 68-year-old patient has chronic pain due to a work- An agonist-antagonist opi-
place back injury. At times, the patient suffers from oid
uncontrollable pain. The patient also has a history of
chronic bowel obstructions. The patient uses a com-
bination of nonpharmacological treatments to control
pain, but from time to time, the pain becomes un-
controllable. The advanced practice registered nurse
(APRN) decides to prescribe a medication that will help
with the pain without increasing the risk of constipa-
tion.
What should the APRN prescribe?
11. A patient with a new diagnosis of Alzheimer disease re- Blocks neuronal receptors
quires extensive education about the disease process for N-methyl-D-aspartate
and medication management. An advanced practice (NMDA)
registered nurse (APRN) provides information to the
patient and family about various support groups and
facts about the progression of the disease. The APRN
also begins treatment with memantine.
Study online at https://quizlet.com/_cga42c
1. How will these drug interactions affect this patient? Propranolol can decrease
An elderly patient with a history of asthma and hyper- albuterol's therapeutic ef-
tension presents to the emergency department com- fect.
plaining of chest pain and shortness of breath. The
advanced practice registered nurse (APRN) reviews the
patient's current medications and notes that the pa-
tient is taking propranolol and inhaled albuterol.
2. A 35-year-old mother who is currently breastfeeding Lipid-soluble
her four-month-old baby comes to a clinic for an eval-
uation of a sinus infection. The advanced practice reg-
istered nurse needs to prescribe medication that does
not pass across the membrane into the breast milk.
3. A 42-year-old patient suffering from pain due to cancer The drug depresses peri-
comes to a clinic and visits with the advanced practice stalsis, prolonging drug
registered nurse (APRN). The APRN previously had pre- transit time.
scribed morphine to treat the pain. The patient is con-
cerned because her bowel movements have become
irregular and asks the APRN why she is experiencing
constipation.
How should the APRN respond?
4. An advanced practice registered nurse is prescribing Increases heart rate
dobutamine for a patient in cardiogenic shock.
Which outcome is expected when this drug is used?
5. An advanced practice registered nurse (APRN) volun- Enroll the patient in the
teers one day per month at a local free clinic in the local Mission prescription
community and is seeing a 43-year-old Caucasian pa- assistance program
tient with hypertension. The patient's blood pressure is
196/100, and the patient states being prescribed three
, D116 pre-assessment
Study online at https://quizlet.com/_cga42c
blood pressure medications: metoprolol 100 mg bid,
losartan 50 mg daily, and clonidine 0.1 mg tid.
The patient states that there is no way to check blood
pressure, and upon reviewing all the patient's medica-
tions, the APRN notes that the losartan has not been
filled for three months and only 10 pills remain. The
patient admits taking half the prescribed dose so the
pills last longer.
Which action should be taken by the APRN?
6. A 78-year-old woman is diagnosed with chronic Timolol
open-angle glaucoma. She has a past history of
first-degree atrioventricular block and bradycardia.
Which medication should be avoided by this patient?
7. An advanced practice registered nurse (APRN) is evalu- Change the cimetidine
ating a patient at a six-month follow-up appointment. to ranitidine because the
The patient is taking cimetidine 1 g at bedtime, meto- original drug may de-
prolol 100 mg daily, aspirin 81 mg daily, and metformin crease the effectiveness of
1 g daily. The patient's vitals are BP 160/90, pulse 110, the metoprolol
respirations 12, and temperature 97.8°F.
The patient is concerned that her blood pressure and
pulse are still elevated. The patient tells the APRN she
does not want to take another pill because she feels
she is taking too many.
Which action should the APRN take next?
8. A 47-year-old male is brought to an emergency depart- Assess for acute lidocaine
ment with lacerations to the forearm. After applying toxicity
lidocaine as local anesthetic, the patient states he feels
like he may pass out and is sweating profusely.
, D116 pre-assessment
Study online at https://quizlet.com/_cga42c
Which action by the patient's advanced practice regis-
tered nurse should be taken first?
9. A 34-year-old patient comes to a clinic complaining of Naproxen
pain in the left shoulder. The advanced practice regis-
tered nurse (APRN) assesses the patient and notices
that the patient has a limited range of motion in the
shoulder due to swelling. The APRN determines that
the patient should be prescribed a medication that
treats peripheral nervous system disorders.
Which medication has the APRN prescribed?
10. A 68-year-old patient has chronic pain due to a work- An agonist-antagonist opi-
place back injury. At times, the patient suffers from oid
uncontrollable pain. The patient also has a history of
chronic bowel obstructions. The patient uses a com-
bination of nonpharmacological treatments to control
pain, but from time to time, the pain becomes un-
controllable. The advanced practice registered nurse
(APRN) decides to prescribe a medication that will help
with the pain without increasing the risk of constipa-
tion.
What should the APRN prescribe?
11. A patient with a new diagnosis of Alzheimer disease re- Blocks neuronal receptors
quires extensive education about the disease process for N-methyl-D-aspartate
and medication management. An advanced practice (NMDA)
registered nurse (APRN) provides information to the
patient and family about various support groups and
facts about the progression of the disease. The APRN
also begins treatment with memantine.
