6521 Midterm Exam with Complete Solutions

In order to promote therapeutic drug effects, the Nurse Practitioner should always encourage patients to - ANSWER-take their medication at the prescribed times. A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing increasing neuropathic pain in recent months, a symptom that has not responded appreciably to conventional analgesics. The patient's care provider has begun treatment with gabapentin (Neurontin). How is the addition of this drug likely to influence the management of the patient's existing drug regimen? - ANSWER-It is unlikely to influence the patient's other medications because gabapentin does not interact with other drugs. of the following assessment findings should an assisted living facility has begun taking daily oral Following an assessment by her primary care provider, a 70-year-old resident of doses of levothyroxine. Which prompt the nurse to withhold a scheduled dose of levothyroxine? - ANSWER-The resident's apical heart rate is 112 beats/minute with a regular rhythm processes protects the lower respiratory system? - ANSWER-Cilia sweep foreign material and mucus upward toward the trachea and larynx where they can then be swallowed. A 62-year-old man has been prescribed lovastatin. The Nurse Practitioner will instruct the patient to take the medication - ANSWER-at bedtime. A Nurse Practitioner who provides care for older adults is aware of the high incidence of drug interactions in this population. When educating a group of seniors about the prevention of drug interactions, the Nurse Practitioner should encourage them to - ANSWER-consult their care provider before taking new over-the-counter medications. A Nurse Practitioner is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term? - ANSWER-Taking several drugs simultaneously A diabetic patient being treated for obesity tells the Nurse Practitioner that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the Nurse Practitioner's immediate attention? - ANSWER-Increased blood glucose A 22 year old patient is transitioning from oral agents to insulin. He will be taking 20 units of lantus at bedtime and regular insulin before meals. What instructions should the NP provide about the timing and dose of regular insulin? - ANSWER-Take 1 unit of regular insulin for each 10 grams of carbohydrate to be consumed 15 minutes before each meal decongestants should not be used chronically (5 days) because they can cause - ANSWER-rebound rhinitis/congestion The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parent's about the appropriate use of a "rescue drug" for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations? - ANSWER-Albuterol A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by - ANSWER-blocking adrenergic receptors and producing antisympathetic effects. A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction? - ANSWER-Late afternoon A child with sinusitis has been on antibiotics for seven days and his symptoms are not improving., All of the following are options to prescribe for the patient now EXCEPT: - ANSWER-Amoxicillin/clavulanic acid The Nurse Practitioner's assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this? - ANSWER-"I broke out in hives and got terribly itchy when I started a new prescription last year." A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient's characteristics likely to influence possible treatment with phenytoin? - ANSWER-The patient's protein deficit will likely increase the levels of the free drug in his blood. A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAS more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract? - ANSWER-The parietal cells of the stomach have H2 receptors but not H1 receptors. A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient's first dose? - ANSWER-The amount of alcohol consumption