EXAM 150 QUESTIONS AND CORRECT
ANSWERS AGRADE
A client is taking hydromorphone (Dilaudid) PO q4h at home. Following surgery,
Dilaudid IV q4h PRN and butorphanol tartrate (Stadol) IV q4h PRN are prescribed for
pain. The client received a dose of the Dilaudid IV four hours ago, and is again
requesting pain medication. What intervention should the nurse implement?
A) Alternate the two medications q4h PRN for pain.
B) Alternate the two medications q2h PRN for pain.
C) Administer only the Dilaudid q4h PRN for pain.
D) Administer only the Stadol q4h PRN for pain. - ANSWER>> C) Administer only the
Dilaudid q4h PRN for pain.
Dilaudid is an opioid agonist. Stadol is an opioid agonist-antagonist. Use of an
agonistantagonist for the client who has been receiving opioid agonists may result in
abrupt withdrawal symptoms, and should be avoided (C). (A, B, and D) do not reflect
good nursing practice.
A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new
prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor
prescription, the nurse assesses the client.
Which finding requires the most immediate intervention? A)
Heartburn.
,B) Headache.
C) Constipation.
D) Vomiting. - ANSWER>> D) Vomiting.
Vomiting, anorexia and abdominal pain are early indications of digitalis toxicity. Since
Lipitor increases the risk for digitalis toxicity, this finding requires the most immediate
intervention by
A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information
should the nurse include in the client's instruction?
A) Notify the clinic of any changes in the color of urine.
B) Avoid overexposure to the sun.
C) Stop the medication after the diarrhea resolves.
D) Take the medication with food. - ANSWER>> D) Take the medication with food.
Flagyl, an amoebicide and antibacterial agent, may cause gastric distress, so the client
should be instructed to take the medication on a full stomach (D). Urine may be red-
brown or dark from Flagyl, but this side effect is not necessary to report (A).
Photosensitivity (B) is not a side effect associated with
Flagyl. Despite the resolution of clinical symptoms, antiinfective medications should be
taken for their entire course because stopping the medication (C) can increase the risk
of resistant organisms.
A client asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should
the nurse provide?
A) "Yes, it is an oral insulin and has the same actions and properties as
intermediate insulin."
,B) "Yes, it is an oral insulin and is distributed, metabolized, and excreted in the
same manner as insulin."
C) "No, it is not an oral insulin and can be used only when some beta cell function is
present."
D) "No, it is not an oral insulin, but it is effective for those who are resistant to
injectable insulins." - ANSWER>> C) "No, it is not an oral insulin and can be used only
when some beta cell function is present."
An effective oral form of insulin has not yet been developed (C) because when insulin is
taken orally, it is destroyed by digestive enzymes. Glipizide (Glucotrol) is an oral
hypoglycemic agent that enhances pancreatic production of insulin. (A, B, and D) do not
provide accurate information
A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis.
The nurse prepares for intravenous administration of edrophonium chloride (Tensilon).
What is the expected outcome for this client following administration of this
pharmacologic agent? A) Progressive difficulty with swallowing.
B) Decreased respiratory effort.
C) Improvement in generalized fatigue.
D) Decreased muscle weakness. - ANSWER>> D) Decreased muscle weakness.
Administration of edrophonium chloride (Tensilon), a cholinergic agent, will temporarily
reduce muscle weakness (D), the most common complaint of newly-diagnosed clients
with myasthenia gravis. This medication is used to diagnose myasthenia gravis due to
its short duration of action. This drug would temporarily reverse (A and B), not increase
these symptoms. (C) is not a typical complaint of clients with myasthenia gravis, but
weakness of specific muscles, especially after prolonged use, is a common symptom.
, A category X drug is prescribed for a young adult female client. Which instruction is
most important for the nurse to teach this client? A) Use a reliable form of birth
control.
B) Avoid exposure to ultra violet light.
C) Refuse this medication if planning pregnancy.
D) Abstain from intercourse while on this drug. - ANSWER>> A) Use a reliable form of
birth control.
Drugs classified in the category X place a client who is in the first trimester of pregnancy
at risk for teratogenesis, so women in the childbearing years should be counseled to
use a reliable form of birth control (A) during drug therapy. (B) is not a specific
precaution with Category X drugs. The client should be encouraged to discuss plans for
pregnancy with the healthcare provider, so a safer alternative prescription (C) can be
provided if pregnancy occurs. Although the risk of birth defects during pregnancy
explains the restriction of these drugs during pregnancy, (D) is not indicated.
A client is taking hydromorphone (Dilaudid) PO q4h at home. Following surgery,
Dilaudid IV q4h PRN and butorphanol tartrate (Stadol) IV q4h PRN are prescribed for
pain. The client received a dose of the Dilaudid IV four hours ago, and is again
requesting pain medication. What intervention should the nurse implement? A)
Alternate the two medications q4h PRN for pain.
B) Alternate the two medications q2h PRN for pain.
C) Administer only the Dilaudid q4h PRN for pain.
D) Administer only the Stadol q4h PRN for pain. - ANSWER>> C) Administer only the
Dilaudid q4h PRN for pain.