NURS 6521 Final Exam Questions and Answers- Walden University

Question 1 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: ADHD Question 2 Selected Answer: A Nurse Practitioner is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient? Drink plenty of water every day Question 3 Selected Answer: A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the ventrogluteal muscle. Question 4 Selected Answer: A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to take the vitamins at least 2 hours before or after taking ciprofloxacin. Question 5 Selected Answer: The recommended treatment for trichomoniasis is Flagyl. Question 6 Selected Answer: Autonomic Drugs are often using topical form for what purpose? To shrink mucous membranes Question 7 A 62-year-old patient taking tamoxifen exhibits increased bone and tumor pain along with a local Selected Answer: disease flare. The nurse interprets this as an indication of which of the following? The tumor responding to treatment Question 8 Selected Answer: A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this patient would most likely contraindicate the use of tadalafil for his ED? The patient has unstable angina and uses a nitroglycerin patch Question 9 Selected Answer: 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 whether the pregnant woman uses illegal substances. Question 10 Selected Answer: A patient is experiencing side effects of drowsiness, confusion, and dry mouth. Which medication is the most likely culprit? fluoxetine Question 11 Selected Answer: Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse's following assessment questions most directly addresses a common adverse effect of filgrastim? "Do you feel like you're having any pain in your bones?" Question 12 Selected Answer: A 73-year-old woman has osteoporosis and is prescribed alendronate. She takes calcium and vitamin D supplements, drinks lots of water, and has just quit smoking. The nurse should advise the patient to also perform light-weight exercises and go for walks. Question 13 Selected Answer: A male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at each clinic visit? Urinary elimination patterns Question 14 Selected Answer: Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient's physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician's order if the patient has a history of cardiac arrhythmias. Question 15 Selected Answer: The clinical nurse educator who oversees the emergency department in a children's hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children? Having nurses check their math calculations with a colleague before administering a drug. Question 16 Selected Answer: A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results? Serum alanine transaminase, aspartate transaminase, and bilirubin Question 17 Selected Answer: Monitoring of male patients are using phosphodiesterase type 5 (PDE-5) inhibitors includes which of the following? blood pressure Question 18 A patient has been taking doxazosin (Cardura) 2 mg PO daily for 3 weeks for treatment of BPH. He Selected Answer: returns to the clinic and is complaining of feeling dizzy when he stands up. Which action would the family nurse practitioner take? Determine blood pressure (BP) with patient lying down, standing, and sitting. Question 19 Selected Answer: A patient will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the patient's drug regimen and the patient has asked about the potential side effects of treatment. How should the nurse best respond? "Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells." Question 20 Selected Answer: A Nurse Practitioner is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an electrocardiogram (ECG). Question 21 Selected Answer: 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? Protamine sulfate Question 22 Selected Answer: 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 with a glass of water 1 hour before or 2 hours after a meal. Question 23 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 Selected Answer: this adverse effect, the nurse will advise him to stay well hydrated by drinking at least eight 8-oz glasses of water daily. Question 24 Selected Answer: A female patient is taking oral cyclophosphamide therapy for breast cancer. Because of possible adverse effects of the drug, the nurse will instruct the patient to do which of the following? Drink a lot of water Question 25 Selected Answer: How is hydrocodone eliminated from the body? Kidney Question 26 Selected Answer: All of the following systemic drugs interfere with metabolism of oral contraceptives except Corticosteroids Question 27 Selected Answer: Which step in the clotting cascade allows prothrombin to be converted to thrombin? Activation of factor X to factor Xa Question 28 Selected Answer: A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia). After baseline physical data are obtained, the nurse will assess the patient's childbearing potential. The nurse will inform the patient that during sibutramine therapy she should use adequate contraception. Question 29 A 67-year-old man who is being treated for prostate cancer is taking epoetin alfa. The nurse will instruct the patient to Selected Answer: schedule an appointment to measure hemoglobin twice a week for at least 2 to 6 weeks. Question 30 Selected Answer: An immunocompromised patient with a diagnosis of candidiasis has failed to respond to conservative therapy and has consequently begun treatment with amphotericin B. The nurse is aware that this drug achieves a therapeutic effect by way of its influence on the permeability of fungal cell walls. Question 31 Selected Answer: Black cohosh is an herb that is commonly used for Menopausal symptoms Question 32 Selected Answer: Which of the following is a true statement about aspirin and its action on platelets It is used for prophylaxis against strokes and acute myocardial infarction Question 33 Selected Answer: What is the first line treatment for hypertension and a male with benign prosthetic hypertrophy? Alpha blockers Question 34 Selected Answer: Ms. Carter, a 48 year old female was placed on an aminoglycoside. The NP knows that an adverse reaction to aminoglycosides is? Ototoxicity Question 35 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 Selected Answer: following as a risk associated with finasteride therapy? Sexual dysfunction related to erectile dysfunction Question 36 Selected Answer: A 20-year-old woman has been prescribed estrogen. As with all women taking estrogen, the nurse will carefully monitor the patient for which of the following? Cardiovascular complications Question 37 Selected Answer: A Nurse Practitioner is providing patient education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the patient to avoid which of the following drugs? Salicylates Question 38 Selected Answer: A male patient is receiving heparin by continuous intravenous infusion. The nurse will instruct the patient and family members to report which of the following should it occur? Presence of blood in urine or stools Question 39 Selected Answer: Which antibiotic is most frequently associated with "Red man Syndrome" Vancomycin Question 40 Selected Answer: 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 stand or sit upright for at least 30 minutes after taking alendronate.. Question 41 Selected Answer: 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? The patient will experience complete bladder emptying Question 42 Selected Answer: 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? Dietary habits Question 43 Selected Answer: 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 put gloves on to protect herself. Question 44 Selected Answer: A 2-year-old child is diagnosed with a minor ailment and is to be administered medications at home for 2 weeks. The child lives with his mother, grandmother, and four other children between the ages of 14 months and 7 years. The home health nurse is asked to assess the home environment to determine if it is appropriate for the child to take his medication at home. Which of the following will have the greatest impact on the nurse's assessment? Where the medications will be stored Question 45 Selected Answer: Which medication does not have any dietary precautions? ciprofloxacin Question 46 A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the Selected Answer: drug? That the infant's skin has greater permeability than that of an adult Question 47 Selected Answer: The Nurse practitioner is considering ordering a medication for a patient. He/she knows that an advantage of prescribing a sublingual medication is that the medication it is: Absorbed rapidly Question 48 Selected Answer: Jennifer, the Nurse Practitioner, is seeing Mr. Johns, a 65 year old male in the clinic today with c/o Arthritis pain. What is a serious side effect of ibuprofen use in the older adult patient? Impairment of renal function Question 49 Selected Answer: A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse will monitor the patient for bleeding gums. Question 50 Selected Answer: Medications that potentiate the actions of GABA in the brain will likely have which of the following effects? provide sedation Question 51 Selected Answer: 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? Fetal heart rate (FHR) Question 52 Selected Answer: A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The patient has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect? By inactivating clotting factors and thus stopping the coagulation cascade Question 53 Selected Answer: 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? The use of broad-spectrum antibiotics can create a risk for a superinfection. Question 54 Selected Answer: A patient is receiving radiotherapy for an overactive thyroid gland and asks whether her milk is safe for her baby. If her treatment cannot be discontinued, what should the nurse recommend? Advise her to discard her breast milk in a biohazard container, as it is unsafe for the baby. Question 55 Selected Answer: 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 chemotherapy-induced anemia. Which of the following will the nurse do with the unused portion of the drug? Discard the unused portion of the drug. Question 56 Selected Answer: Steady state is: When the amount of drug in the body remains constant Question 57 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 Selected Answer: will the nurse take to decrease the risk of hypotension and promote circulation to the fetus? Instruct the patient to notify the nurse if she experiences palpitations. Question 58 Selected Answer: Which of the following is an FDA approved antidepressant to treat hot flashes? paroxetine Question 59 Selected Answer: Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse's response to Mr. Lepp? The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients. Question 60 Selected Answer: John, the Nurse Practitioner is prescribing Fosamax for his patient. Bisphosphonate administration education includes Sitting erect for at least 30 minutes afterwards Question 61 Selected Answer: The maximum amount of acetaminophen that can be taken per day is 4 grams Question 62 Selected Answer: 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? Ineffective Family Therapeutic Regimen Management Question 63 Selected Answer: A 51-year-old female patient has been receiving doxorubicin (Adriamycin) for metastatic breast cancer. Her medical record indicates she has cardiomyopathy and a cumulative dose of 300 mg/m2 of doxorubicin. Which of the following measures would help limit the severity of the cardiomyopathy in this patient? The use of dexrazoxane in conjunction with doxorubicin Question 64 Selected Answer: 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? Acetaminophen Question 65 Selected Answer: Off-label prescribing is common and necessary Question 66 Selected Answer: Off label prescribing is: Legal if there is scientific evidence for the use Question 67 Selected Answer: Which of the following statements is false regarding metronidazole? Patient may take standard-release without regard to food. Extended-release should be taken one hour before or 2 hours after meals. Question 68 Mr. Samuels has been prescribed olanzapine (Zyprexa). The NP know that he should be monitored for: Selected Answer: Weight gain Question 69 Selected Answer: A 16-year-old boy is prescribed cromolyn sodium nasal spray to treat a nasal allergy. To maximize the therapeutic effects of the drug, which of the following will the nurse include in instructions to the patient? Take the drug for one full week before coming in contact with allergens Question 70 Selected Answer: What is the minimum inhibitory concentration (MIC) The lowest concentration of a chemical drug need it to inhibit the growth of bacteria Question 71 Selected Answer: Which of the following drugs is most likely to cause sexual dysfunction and males? Selective serotonin reuptake inhibitors Question 72 Selected Answer: Ms. Lewis Is in 74-year-old female who presents to your clinic for routine visit today. You review her medical record and notice she is prescribed aspirin therapy. You provide patient education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is: Tinnitus Question 73 Selected Answer: Some drugs are given to patients using other routes such as sublingual or topical to avoid movement through the liver and possible side effects. Which of the following effects is the Nurse Practitioner attempting to avoid by administering certain medications via alternative routes? First-Pass effect Question 74 Selected Answer: Which of the following brand-generic combinations is incorrectly matched? Valium-alprazolam Question 75 Selected Answer: A nurse practitioner has administered filgrastim to a diverse group of patients in recent months. Which of the following patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug? A 19-year-old male receiving radiotherapy Question 76 Selected Answer: A patient who is at risk for DVT tells the NP she has just learned she is pregnant. The NP should expect that this patient will use which of the following anticoagulant medications? Heparin Question 77 Selected Answers: The NP recognizes that these medications are useful when taken during early symptoms of a migraine. (Select all that apply) Acetaminophen Question 78 Selected Answer: Pernicious anemia is treated with Vitamin B12 Question 79 Selected Answer: A 12-year-old boy is being discharged from the hospital after major surgery. The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to both the boy and his mother regarding all medication issued. Question 80 Selected Answer: 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 iron-rich foods such as beans and leafy green vegetables. Question 81 Selected Answer: 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? The patient's bone marrow function is significantly depressed. Question 82 Selected Answer: All of the following can cause photosensitivity except testosterone Question 83 Selected Answer: What schedule class of drug is Hydrocodone? II Question 84 Selected Answer: An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or failure of a patient's chemotherapy. Which of the following cancerous cells is most susceptible to the effects of chemotherapeutic drugs? Cells that have a rapid mitotic rate Question 85 Selected An immunocompromised cancer patient has developed cryptococcal meningitis and been admitted to the intensive care unit for treatment with amphotericin B. How should the nurse most safely administer this drug? Answer: Infuse the drug over 2 to 4 hours into a central line using an infusion pump Question 86 Selected Answer: Which of the following medications is most likely to cause weight gain? bupropion Question 87 Selected Answer: 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 use sterile technique when applying the medication. Question 88 Selected Answer: A patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are considered phytoestrogens. Question 89 Selected Answer: An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman's pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient's pain? Twice-daily doses of long-acting morphine, with short-acting morphine available for breakthrough pain Question 90 Selected Answer: A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize? The peak and trough blood levels Question 91 Selected Answer: When a NP chooses a benzodiazepine to treat anxiety the prescriber needs to be aware of the possibility of dependence. The Benzodiazepine associated with the greatest likelihood of causing rapid dependence is: Alprazolam (Xanax) Question 92 Selected Answer: 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? Low bone density and a family history of osteoporosis Question 93 Selected Answer: A Nurse Practitioner is having difficulty administering a bitter drug to a 5-year-old child. The nurse should offer the child a flavored ice chip or ice pop prior to administering the drug. Question 94 Selected Answer: JC is a 13 year old female to be seen in your clinic today. You review JC's medication and realize that which medication is a potential risk of growth suppression in prepubescent children? corticosteroids Question 95 Selected Answer: A Nurse Practitioner will instruct a patient taking allopurinol to take each dose after a meal. Question 96 After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic should recognize that the woman may benefit from Friday, May 13, 2022 1:20:00 AM EDT Selected Answer: clomiphene. Question 97 Selected Answer: The anticoagulant drug that acts as a vitamin K antagonist is: coumadin Question 98 Selected Answer: 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 vancomycin. Question 99 Selected Answer: Donald is a nurse practitioner student. He recognizes Which option below could be a secondary use for an anxiolytic medication? ethanol withdrawal Question 100 Selected Answer: A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose? 2000 mg Question 101 Selected Answer: When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity