Exam (elaborations) NURS 6521 Advanced Pharmacology Final Exam.

Exam (elaborations) NURS 6521 Advanced Pharmacology Final Exam. A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for recurring headaches. The nurse should recommend Selected Answer: tyleno l.  Question 2 1 out of 1 points A Nurse Practitioner working in a cancer center is preparing to administer medication to a 5-year-old child. The nurse will calculate the drug dosage by using Selected Answer: body surface area.  Question 3 1 out of 1 points A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The APRN will be sure to Selected Answer: avoid the small veins in the dorsum of the hand or the wrist.  Question 4 1 out of 1 points A Nurse Practitioner has questioned why a patient's physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of a patient's infection. Which of the following facts provides the best rationale for the use of narrow-spectrum antibiotics whenever possible? Selected Answer: The use of broad-spectrum antibiotics can create a risk for a superinfection.  Question 5 1 out of 1 points A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider? Selected Answer: Dietary habits  Question 6 1 out of 1 points A postmenopausal patient is prescribed bisphosphonates to treat osteoporosis. The nurse will instruct the patient to take the drug NURS 6521 Advanced Pharmacology Final Exam. Selected Answer: first thing in the morning.  Question 7 1 out of 1 points A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is perspiring and her blood pressure is 88/50. The serum magnesium level is 10 mg/dL. The nurse will interpret these manifestations as Selected Answer: magnesium sulfate toxicity.  Question 8 1 out of 1 points A male patient is trying to decide if he should use finasteride (Proscar) to treat benign prostatic hypertrophy (BPH). When providing information about the drug, the nurse will include which of the following as a risk associated with finasteride therapy? Selected Answer: Prostatic neoplasia  Question 9 1 out of 1 points A patient with AIDS has developed a number of secondary infections in recent weeks, including Kaposi's sarcoma. As a result of this most recent diagnosis, his care team has opted to begin treatment with interferon alfa-2a. The nurse is aware that this drug will address the etiology of Kaposi sarcoma by Selected Answer: inhibiting tumor growth by enhancing inflammation.  Question 10 1 out of 1 points A Nurse Practitioner is working with a 16-year-old pregnant teen and assessing for behavior that may put the baby at risk. The most important assessment the nurse can make is Selected Answer: whether the pregnant woman uses illegal substances.  Question 11 1 out of 1 points A patient with a recent diagnosis of chronic myelogenous leukemia (CML) is discussing treatment options with his care team. What aspect of the patient's condition would contraindicate the use of cyclophosphamide for the treatment of leukemia? Selected Answer: The patient's bone marrow function is significantly depressed.  Question 12 1 out of 1 points A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the Selected Answer: ventrogluteal muscle.  Question 13 0 out of 1 points A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The APRN will advise her to take which of the following vitamin supplements while taking the drug? Selected Answer: Vitamin D  Question 14 1 out of 1 points An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with Selected Answer: vancomycin.  Question 15 1 out of 1 points A child is taking permethrin for head lice. The Nurse Practitioner will instruct her mother to Selected Answer: stop using creams, ointments, and oils on the child's skin and scalp.  Question 16 1 out of 1 points A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic can the nurse most safely recommend? Selected Answer: Acetaminophen  Question 17 1 out of 1 points A 54-year-old woman with a history of osteoporosis has been prescribed ciprofloxacin for recurrent cystitis. Because of the patient's history, the nurse would be sure to discuss with the woman the use of Selected Answer: food containing iron or calcium.  Question 18 1 out of 1 points A Nurse Practitioner is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for which of the following? Selected Answer: Neurotoxici ty  Question 19 1 out of 1 points An immunocompromised 7-year-old child was recently discharged home with a peripherally-inserted central line (PIC line) for home antibiotic therapy. He has now been brought to the emergency department by his mother and father with signs and symptoms of line sepsis. Upon questioning, the mother states that she has been removing the PIC dressing daily and washing the site with warm water and a cloth. What nursing diagnosis is most appropriate in this situation? Selected Answer: Ineffective Family Therapeutic Regimen Management  Question 20 1 out of 1 points A female patient is taking filgrastim (Neupogen) to decrease the incidence of infection. The nurse notices a small increase in the neutrophil count 2 days after starting therapy. The nurse's evaluation of the increase is that Selected Answer: the increase in the neutrophil count is only transient.  Question 21 1 out of 1 points A Nurse Practitioner is reviewing the prepregnancy medication regimen of a patient who has just had a positive pregnancy test. The nurse should be aware of which of the following changes in pharmacokinetics that accompanies pregnancy? Selected Answer: Increased drug distribution resulting from hemodynamic changes  Question 22 1 out of 1 points A Nurse Practitioner is assigned to a patient who is at 32 weeks' gestation and is receiving terbutaline (Brethine) IV for 24 hours to control preterm labor. Which of the following nursing actions will the nurse take to decrease the risk of hypotension and promote circulation to the fetus? Selected Answer: Instruct the patient to lie on her left side during the infusion.  Question 23 1 out of 1 points A Nurse Practitioner is to use a single-dose 1 mL vial to administer 0.5 mL of epoetin alfa to a 39-year-old woman who is being treated for chemotherapyinduced anemia. Which of the following will the nurse do with the unused portion of the drug? Selected Answer: Discard the unused portion of the drug.  Question 24 0 out of 1 points The Nurse Practitioner notices a cold sore on a patient's upper lip and requests medication; docosanol (Abreva) is ordered. Before applying the medication, the nurse would first Selected Answer: put gloves on to protect herself.  Question 25 1 out of 1 points Drugs have a valid medical use but a high potential for abuse, both psychological and physiologic. In an emergency, a Schedule 2 drug may be prescribed by telephone if a written prescription cannot be provided at the time. However, a written prescription must be provided within 72 hours with the words authorization for emergency dispensing written on the prescription. These prescriptions cannot be refilled. A new prescription must be written each time. Examples include certain amphetamines and barbiturates. This is scheduled drug Selected Answer: Schedule 2  Question 26 1 out of 1 points A 29-year-old pregnant patient is extremely upset about having to take medication for a pre-existing medical condition. She is consumed with fear that her baby will be born with a physical deformity or a congenital anomaly but knows that she has to take the medication. She talks constantly about this and is unable to sleep most nights. Which of the following is the most appropriate nursing diagnosis for this patient is? Selected Answer: Anxiety related to perceived danger of drug therapy to fetus or infant  Question 27 1 out of 1 points A Nurse Practitioner is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to Selected Answer: stay well hydrated by drinking at least eight 8-oz glasses of water daily.  Question 28 1 out of 1 points A Nurse Practitioner is caring for a 10-year-old boy who complains of chronic headaches. His mother reports that she gives him Tylenol at least three times a day. Which of the following will the nurse work with the physician to evaluate? Selected Answer: Hepatic function  Question 29 1 out of 1 points A 59-year-old man with a recent history of erectile dysfunction has been assessed and prescribed sildenafil (Viagra). When providing patient education to this man, the nurse should tell him which of the following? Selected Answer: "You might find that your face becomes flushed or you get a headache after you take Viagra."  Question 30 1 out of 1 points A man has a demonstrated history of androgen deficiency and the consequences of this health problem include an inability to maintain an erection. Which of the following medications would best address this patient's erectile dysfunction (ED)? Selected Answer: Exogenous testosterone  Question 31 1 out of 1 points A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug Selected Answer: with a glass of water 1 hour before or 2 hours after a meal.  Question 32 1 out of 1 points A 39-year-old woman is receiving doxorubicin for the treatment of cancer. After each treatment, the patient has acute nausea and vomiting accompanied by a slightly increased heart rate. The nurse will advise her to Selected Answer: perform relaxation techniques after the treatments.  Question 33 1 out of 1 points A child is admitted to the burn unit with second and third degree burns on both arms and part of his or her face. When administering topical medications to the burned areas, the nurse should Selected Answer: use sterile technique when applying the medication.  Question 34 1 out of 1 points A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment? Selected Answer: The importance of vigilant hygiene for the boy and the other members of the family  Question 35 1 out of 1 points A 36-year-old woman with a history of dysmenorrhea has begun treatment with progesterone, which she will be receiving by the intramuscular route. The nurse participating in the woman's care should prioritize which of the following potential nursing diagnoses? Selected Answer: Risk for Injury related to loss of vision or thrombotic events  Question 36 1 out of 1 points A 13-year-old patient has juvenile arthritis. He has recently had oral surgery and was told by the surgeon to take aspirin for the pain. The APRN will monitor for which of the following? Selected Answer: Hepatotoxicity  Question 37 1 out of 1 points A Nurse Practitioner is assessing a patient who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the patient for which of the following? Selected Answer: Leukopen ia  Question 38 1 out of 1 points Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent Selected Answer: once a day.  Question 39 1 out of 1 points A patient with non-Hodgkin's lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient's care, what nursing diagnosis should the nurse prioritize? Selected Answer: Risk for Infection related to suppressed bone marrow function  Question 40 1 out of 1 points A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize? Selected Answer: The peak and trough blood levels  Question 41 1 out of 1 points A Nurse Practitioner is explaining to a pregnant 21-year-old college student why she cannot continue to take ibuprofen (Advil) for her headaches. The nurse draws a picture depicting drug molecules crossing the placental membrane and entering into the fetal circulation. The nurse tells the patient that the main reason this happens is because Selected Answer: drugs compete with the hormones of pregnancy for albuminbinding sites.  Question 42 1 out of 1 points A patient with chronic heart failure has begun treatment with epoetin alfa, which she will receive in her own home from a home health nurse. The nurse should teach the patient to supplement this treatment with a diet that is high in Selected Answer: iron-rich foods such as beans and leafy green vegetables.  Question 43 1 out of 1 points An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions? Selected Answer: Prime the IV tubing with an approved IV solution rather than with the drug itself.  Question 44 1 out of 1 points A Nurse Practitioner educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session? Selected Answer: Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected.  Question 45 1 out of 1 points A Nurse Practitioner works at a weight management clinic. To which of the following overweight patients could the nurse safely administer dextroamphetamine? Selected Answer: A 48-year-old Caucasian man who has adultonset diabetes  Question 46 1 out of 1 points A patient is taking etoposide for a testicular tumor refractory to treatment. The nursing assessment reveals that he is also taking warfarin. The nurse must carefully monitor for which of the following? Selected Answer: Elevated prothrombin time  Question 47 1 out of 1 points A Nurse Practitioner will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months? Selected Answer: Liver function tests  Question 48 1 out of 1 points A pregnant patient who has diabetes has been admitted to the hospital to begin labor. Since the patient has diabetes, the physician has decided to use oxytocin (Pitocin) to initiate labor contractions. When talking to the patient about the adverse effects of the drug, the nurse should understand that the most common adverse effects of the drug include Selected Answer: uterine tachysystole.  Question 49 1 out of 1 points A Nurse Practitioner will instruct a patient taking allopurinol to take each dose Selected Answer: after a meal.  Question 50 1 out of 1 points A Nurse Practitioner is discussing with a 58-year-old male patient the causes of erectile dysfunction in men over 50 years of age. Which of the following will the nurse inform the patient is the primary physical cause of erectile dysfunction of men in this age group? Selected Answer: Atherosclerosis of the penile artery  Question 51 1 out of 1 points A patient is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the patient develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is Selected Answer: an allergic response.  Question 52 0 out of 1 points Alprostadil (Caverject), a drug used to treat erectile dysfunction, has been prescribed to a 42-year-old patient. When providing education to the patient and his wife, the nurse should inform the wife about which of the following adverse effects? Selected Answer: Increased heart rate  Question 53 1 out of 1 points During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient's platelet count to be 92,000 cells/mm3. The nurse should do which of the following? Selected Answer: Consult the prescriber for discontinuation of the drug  Question 54 1 out of 1 points A 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe for which of the following adverse effects of the drug? Selected Answer: Lid margin crusting and pruritus  Question 55 1 out of 1 points A 20-year-old female patient is receiving topical clindamycin for acne vulgaris. She develops a rash and urticaria along with severe itching where the medication is applied. The nurse will formulate which of the following nursing diagnoses for the patient? Selected Answer: Risk for Injury related to allergic reactions  Question 56 1 out of 1 points Which of the following would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a patient taking estrogen? Selected Answer: Headaches and chest pain  Question 57 1 out of 1 points A Nurse Practitioner is performing patient education for a woman who has just been prescribed a bisphosphonate. Which of the following diagnostic and history findings would have prompted the woman's care provider to prescribe a bisphosphonate? Selected Answer: Low bone density and a family history of osteoporosis  Question 58 1 out of 1 points A Nurse Practitioner is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered? Selected Answer: Protamine sulfate  Question 59 1 out of 1 points A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient to Selected Answer: complete the entire course of drug therapy.  Question 60 1 out of 1 points A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that Selected Answer: body fluids such as urine, saliva, tears, and sputum may become discolored.  Question 61 1 out of 1 points A 15-year-old patient has meningitis caused by Haemophilus influenzae. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitor Selected Answer: plasma concentrations regularly.  Question 62 1 out of 1 points A patient is receiving long-term clindamycin therapy for a life-threatening infection. The nurse will begin by monitoring this drug therapy by obtaining Selected Answer: a baseline complete blood count.  Question 63 1 out of 1 points A Nurse Practitioner is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation? Selected Answer: A child has a greater body surface area, creating greater permeability resulting in an increase in absorption of topical agents, which may result in more adverse effects.  Question 64 1 out of 1 points A 30-year-old African-American woman tested positive for TB and is prescribed isoniazid. The nurse will plan the patient's care to include close monitoring of the drug therapy because Selected Answer: the patient is at greater risk for high serum levels of the drug.  Question 65 0 out of 1 points When planning care for a patient who is receiving filgrastim (Neupogen) for a nonmyeloid malignancy, the nurse should formulate which of the following patient outcomes? (Select all that apply.) Selected Answers: The patient will not develop an infection. The patient will not experience bone pain. The patient will not develop febrile neutropenia.  Question 66 1 out of 1 points A Nurse Practitioner who provides care on a pediatric medicine unit has conducted a medication reconciliation of a recently-admitted patient. In light of the fact that the child takes methylphenidate (Ritalin), the nurse is justified in considering a history of what health problem? Selected Answer: ADH D  Question 67 1 out of 1 points A patient is prescribed ganciclovir to treat a CMV infection. An oral dosage is prescribed. To help increase bioavailability of the drug, the nurse will encourage the patient to take the medication Selected Answer: with high-fat meals.  Question 68 1 out of 1 points A Nurse Practitioner is caring for a patient who is at 28 weeks' gestation and is receiving terbutaline (Brethine) to control preterm labor. Which of the following assessment parameters should the nurse prioritize? Selected Answer: Fetal heart rate (FHR)  Question 69 1 out of 1 points A Nurse Practitioner who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to Selected Answer: immature liver and kidney function in infants and children.  Question 70 1 out of 1 points A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather's antidepressant to improve his mood. After immediately phoning the boy's stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem? Selected Answer: Hypertensive crisis  Question 71 1 out of 1 points A patient reports to a clinic with complaints of breast tenderness, a right lumpy breast, and no breast discharge. The breast tenderness occurs primarily during her menstrual cycle. The nurse practitioner probably suspects Selected Answer: PMS.  Question 72 1 out of 1 points Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In order to help prevent gastrointestinal distress, the nurse will advise the patient to Selected Answer: stand or sit upright for at least 30 minutes after taking alendronate..  Question 73 1 out of 1 points On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which of the following responses by the nurse is most appropriate? Selected Answer: "It's important to balance the possible benefits of HRT with the fact that it might increase your risk of heart disease and stroke"  Question 74 1 out of 1 points A 68-year-old man is being treated for benign prostatic hypertrophy (BPH) and began treatment with finasteride (Proscar) 3 months ago. When planning the care of this patient, what desired outcome should the nurse prioritize? Selected Answer: The patient will experience complete bladder emptying  Question 75 1 out of 1 points Which of the following patients will be at the greatest risk for anemia and