REX-PN REVIEW END OF COURSE QUESTIONS
AND ANSWERS SURE A+
✔✔A nurse was assigned to care for elderly clients in a nursing home. Which of the
following is the best consideration when preparing the dosage of medications
administered to geriatric clients?
A. Never put older adults on medications with side effects that affect the nervous
system
B. Administer medications at a high dose right away to ensure effectiveness of the drug
therapy
C. Begin by administering medications at a low dose and gradually increasing the dose
over time
D. Change the dose of the medications each week, depending on how the client
responds - ✔✔Answer: C. Begin by administering medications at a low dose and
gradually increasing the dose over time
Aging alters the way the body processes, metabolizes and absorbs medications. For
example, in older clients, the body may be less efficient in breaking down drugs or
excreting them, making them stay in the body longer. Thus, the dosing of medications
administered to older adults usually differs from the dose for younger or middle-aged
persons.
,Considering the physiological changes in older adults, it would be best to give
medications at the lowest effective dose at first and slowly increase it to the target
amount through time.
✔✔A client spoke to the nurse about her and her husband's plans to have their first
child soon. Which of the following indicates that the client understands the nurse's
communication about the association between alcohol consumption and the
development of fetal alcohol syndrome?
A. "I can drink a few cans of beer since it is not hard alcohol."
B. "I should drink alcohol only after meals to reduce the effects of alcohol on the baby."
C. "I should drink a glass of wine after meals since it is good for the baby's heart and
mine."
D. "Drinking alcohol shortly before and during the pregnancy may harm the baby." -
✔✔Answer: D. "Drinking alcohol shortly before and during the pregnancy may harm the
baby."
Alcohol can lead to fetal alcohol syndrome, which is characterized by physical defects
such as small eyes, joint deformities, and small brain size and nervous system issues
such as poor balance and intellectual disability.
According to the CDC, women trying to or are currently pregnant must not drink any
alcoholic beverages. No amount of alcohol at any stage of pregnancy has ever been
proven to be safe for the fetus.
✔✔Which of the following must be completed to accurately identify a specific client?
Select all that apply.
A. Request the client to state their complete name
B. Look at the client's face and compare it with the labelled photograph on their chart
C. Ask the client's 's relative or guardian
D. Check the client's identification bracelet
E. Request the client to state his birthdate - ✔✔Answer: A. Request the client to state
their complete name, B. Look at the client's face and compare it with the labeled
photograph on their chart, D. Check the client's 's identification bracelet, E. Request the
client to state their birthdate
Usage of wristbands has been proven to ensure that clients are correctly identified. It is
also helpful to make a client state essential identifiers such as their name and birthdate
during admission, prior to administration of medications or starting any medical
procedure. Utilizing photographs incorporated in clients charts also help in preventing
misidentification of clients.
✔✔An elderly client was given alendronate (Fosamax) to treat her osteoporosis. Which
of the following must the nurse inform the client regarding the appropriate way to take
the medication?
,A. It must be taken after meals
B. It must be taken with milk, three hours after each meal
C. It must be taken with carbohydrate-rich foods
D. It must be taken on an empty stomach - ✔✔Answer: D. It must be taken on an empty
stomach
Alendronate is used to prevent or treat osteoporosis in men and post-menopausal
women. This drug works only when taken on an empty stomach since substances such
as drinks and food can reduce its absorption in the body.
✔✔A pediatric client has a vaso-occlusive (sickle cell) crisis of the elbow. Which of the
following interventions must be implemented for this client first?
A. Force the client to drink more fluids hourly
B. Regularly monitor the patient-controlled analgesia (PCA)
C. Put hot compress on the client's elbow
D. Urge the client to practice deep breathing exercises - ✔✔Answer: B. Regularly
monitor the patient-controlled analgesia
A vaso-occlusive crisis is also known as a sickle cell crisis. This occurs when the
movement of blood in the small blood vessels is blocked due to the presence of sickle-
shaped erythrocytes, leading to ischemic injury to the organ supplied by those vessels
and pain.
Patient-controlled analgesia has been used to treat clients suffering from vaso-occlusive
crisis due to sickle cell disease. Administration of analgesics through PCA pumps allow
clients to receive a dose of the medication exactly when they want to. While this system
is client-controlled, the nurse must monitor the client regularly to check if the client
develops any side effects.
✔✔The nurse of an elderly client is currently reviewing the list of medications that must
be administered to the client through their gastrostomy tube (G-tube). Which of the
following drugs should the nurse consult the client's doctor about?
A. Digoxin (liquid form)
B. Acetaminophen (liquid form)
C. Diltiazem SR (tablet form)
D. Calcium gluconate (tablet form) - ✔✔Answer: C. Diltiazem SR (tablet form)
According to the list of medications, the client must take diltiazem in its sustained-
release tablet form. Since the nurse must thoroughly crush medications prior to
administration through the client's G-tube, she must talk to the client's doctor first prior
to giving the client diltiazem since sustained-release tablets must never be crushed.
This is because doing so may increase the absorption of the drug at a short span of
time, when in fact, it must be slowly released within several hours. This can have
harmful effects on the client.
By contacting the client's physician, they may talk about alternative routes of
administration of the drug for the client.
, ✔✔The physician ordered a urine culture to be sent to the lab prior to starting a client on
intravenous antibiotics. Which of the following interventions should the nurse take
regarding the specimen collection and antibiotic administration?
A. Give the antibiotics prior to obtaining a sample from the client's urinary collection bag
B. Start the client on antibiotics as soon as the pharmacy releases the medications
C. Ask the client's doctor for the correct order for urine collection and drug
administration
D. Obtain a urine sample from the client's indwelling urinary catheter before giving
antibiotics - ✔✔Answer: D. Obtain a urine sample from the client's indwelling urinary
catheter before giving antibiotics
For most cases of urinary tract infections, it is recommended that the healthcare team
wait for the results of the urine culture prior to administration of antibiotics.
If a client takes antibiotics before the results are released, erroneous results may be
obtained from the tests. Furthermore, the antibiotics given may turn out to be
inappropriate for the bacteria detected through the culture.
✔✔The nurse on the morning shift is newly employed. Shortly after administering the
client's medication, the nurse realized that the client received two doses of the
prescribed drug. Which of the following is the first action the nurse must do after the
incident?
A. The nurse must inform the prescriber immediately
B. The nurse must write an incident report
C. The nurse must tell the nursing supervisor immediately about the mistake
D. The nurse must monitor the client in case the client exhibits signs of an adverse
reaction. - ✔✔Answer: D. The nurse must monitor the client in case they exhibit signs of
an adverse reaction.
While the three incorrect answers must also be completed following the incident, they
should not be completed first. Drug overdose can have adverse effects on a client,
particularly older adults; thus, the first thing that the nurse must do is monitor the client.
✔✔A terminally ill client appears to be very dehydrated. Which of the following
interventions will best assist the terminally ill client?
A. Give the client fluids through a nasogastric tube
B. Ask the client's doctor to prescribe an order for fluids for hypodermoclysis
C. Prepare to give the client fluids intravenously
D. Gently apply a lubricant on the patient's lips and oral mucous membranes -
✔✔Answer: D. Gently apply a lubricant on the client's lips and oral mucous membranes
Terminally ill clients often exhibit changes in their eating and drinking habits. In most
cases, they may refuse to eat or drink anything. This is common in clients at the end of
life, resulting in dehydration.
AND ANSWERS SURE A+
✔✔A nurse was assigned to care for elderly clients in a nursing home. Which of the
following is the best consideration when preparing the dosage of medications
administered to geriatric clients?
A. Never put older adults on medications with side effects that affect the nervous
system
B. Administer medications at a high dose right away to ensure effectiveness of the drug
therapy
C. Begin by administering medications at a low dose and gradually increasing the dose
over time
D. Change the dose of the medications each week, depending on how the client
responds - ✔✔Answer: C. Begin by administering medications at a low dose and
gradually increasing the dose over time
Aging alters the way the body processes, metabolizes and absorbs medications. For
example, in older clients, the body may be less efficient in breaking down drugs or
excreting them, making them stay in the body longer. Thus, the dosing of medications
administered to older adults usually differs from the dose for younger or middle-aged
persons.
,Considering the physiological changes in older adults, it would be best to give
medications at the lowest effective dose at first and slowly increase it to the target
amount through time.
✔✔A client spoke to the nurse about her and her husband's plans to have their first
child soon. Which of the following indicates that the client understands the nurse's
communication about the association between alcohol consumption and the
development of fetal alcohol syndrome?
A. "I can drink a few cans of beer since it is not hard alcohol."
B. "I should drink alcohol only after meals to reduce the effects of alcohol on the baby."
C. "I should drink a glass of wine after meals since it is good for the baby's heart and
mine."
D. "Drinking alcohol shortly before and during the pregnancy may harm the baby." -
✔✔Answer: D. "Drinking alcohol shortly before and during the pregnancy may harm the
baby."
Alcohol can lead to fetal alcohol syndrome, which is characterized by physical defects
such as small eyes, joint deformities, and small brain size and nervous system issues
such as poor balance and intellectual disability.
According to the CDC, women trying to or are currently pregnant must not drink any
alcoholic beverages. No amount of alcohol at any stage of pregnancy has ever been
proven to be safe for the fetus.
✔✔Which of the following must be completed to accurately identify a specific client?
Select all that apply.
A. Request the client to state their complete name
B. Look at the client's face and compare it with the labelled photograph on their chart
C. Ask the client's 's relative or guardian
D. Check the client's identification bracelet
E. Request the client to state his birthdate - ✔✔Answer: A. Request the client to state
their complete name, B. Look at the client's face and compare it with the labeled
photograph on their chart, D. Check the client's 's identification bracelet, E. Request the
client to state their birthdate
Usage of wristbands has been proven to ensure that clients are correctly identified. It is
also helpful to make a client state essential identifiers such as their name and birthdate
during admission, prior to administration of medications or starting any medical
procedure. Utilizing photographs incorporated in clients charts also help in preventing
misidentification of clients.
✔✔An elderly client was given alendronate (Fosamax) to treat her osteoporosis. Which
of the following must the nurse inform the client regarding the appropriate way to take
the medication?
,A. It must be taken after meals
B. It must be taken with milk, three hours after each meal
C. It must be taken with carbohydrate-rich foods
D. It must be taken on an empty stomach - ✔✔Answer: D. It must be taken on an empty
stomach
Alendronate is used to prevent or treat osteoporosis in men and post-menopausal
women. This drug works only when taken on an empty stomach since substances such
as drinks and food can reduce its absorption in the body.
✔✔A pediatric client has a vaso-occlusive (sickle cell) crisis of the elbow. Which of the
following interventions must be implemented for this client first?
A. Force the client to drink more fluids hourly
B. Regularly monitor the patient-controlled analgesia (PCA)
C. Put hot compress on the client's elbow
D. Urge the client to practice deep breathing exercises - ✔✔Answer: B. Regularly
monitor the patient-controlled analgesia
A vaso-occlusive crisis is also known as a sickle cell crisis. This occurs when the
movement of blood in the small blood vessels is blocked due to the presence of sickle-
shaped erythrocytes, leading to ischemic injury to the organ supplied by those vessels
and pain.
Patient-controlled analgesia has been used to treat clients suffering from vaso-occlusive
crisis due to sickle cell disease. Administration of analgesics through PCA pumps allow
clients to receive a dose of the medication exactly when they want to. While this system
is client-controlled, the nurse must monitor the client regularly to check if the client
develops any side effects.
✔✔The nurse of an elderly client is currently reviewing the list of medications that must
be administered to the client through their gastrostomy tube (G-tube). Which of the
following drugs should the nurse consult the client's doctor about?
A. Digoxin (liquid form)
B. Acetaminophen (liquid form)
C. Diltiazem SR (tablet form)
D. Calcium gluconate (tablet form) - ✔✔Answer: C. Diltiazem SR (tablet form)
According to the list of medications, the client must take diltiazem in its sustained-
release tablet form. Since the nurse must thoroughly crush medications prior to
administration through the client's G-tube, she must talk to the client's doctor first prior
to giving the client diltiazem since sustained-release tablets must never be crushed.
This is because doing so may increase the absorption of the drug at a short span of
time, when in fact, it must be slowly released within several hours. This can have
harmful effects on the client.
By contacting the client's physician, they may talk about alternative routes of
administration of the drug for the client.
, ✔✔The physician ordered a urine culture to be sent to the lab prior to starting a client on
intravenous antibiotics. Which of the following interventions should the nurse take
regarding the specimen collection and antibiotic administration?
A. Give the antibiotics prior to obtaining a sample from the client's urinary collection bag
B. Start the client on antibiotics as soon as the pharmacy releases the medications
C. Ask the client's doctor for the correct order for urine collection and drug
administration
D. Obtain a urine sample from the client's indwelling urinary catheter before giving
antibiotics - ✔✔Answer: D. Obtain a urine sample from the client's indwelling urinary
catheter before giving antibiotics
For most cases of urinary tract infections, it is recommended that the healthcare team
wait for the results of the urine culture prior to administration of antibiotics.
If a client takes antibiotics before the results are released, erroneous results may be
obtained from the tests. Furthermore, the antibiotics given may turn out to be
inappropriate for the bacteria detected through the culture.
✔✔The nurse on the morning shift is newly employed. Shortly after administering the
client's medication, the nurse realized that the client received two doses of the
prescribed drug. Which of the following is the first action the nurse must do after the
incident?
A. The nurse must inform the prescriber immediately
B. The nurse must write an incident report
C. The nurse must tell the nursing supervisor immediately about the mistake
D. The nurse must monitor the client in case the client exhibits signs of an adverse
reaction. - ✔✔Answer: D. The nurse must monitor the client in case they exhibit signs of
an adverse reaction.
While the three incorrect answers must also be completed following the incident, they
should not be completed first. Drug overdose can have adverse effects on a client,
particularly older adults; thus, the first thing that the nurse must do is monitor the client.
✔✔A terminally ill client appears to be very dehydrated. Which of the following
interventions will best assist the terminally ill client?
A. Give the client fluids through a nasogastric tube
B. Ask the client's doctor to prescribe an order for fluids for hypodermoclysis
C. Prepare to give the client fluids intravenously
D. Gently apply a lubricant on the patient's lips and oral mucous membranes -
✔✔Answer: D. Gently apply a lubricant on the client's lips and oral mucous membranes
Terminally ill clients often exhibit changes in their eating and drinking habits. In most
cases, they may refuse to eat or drink anything. This is common in clients at the end of
life, resulting in dehydration.
