NUR 221 Final exam questions &
answers
Which assessment finding suggests hypersensitivity of receptors when a patient
suddenly stops taking atenolol (Tenormin), a Beta 2 receptor antagonist that slows the
heart rate? - ANSWER Pulse 118 beats/min
A terminal cancer patient has been receiving narcotic analgesics for severe pain for
more than 6 months. The prescriber has increased the dose of the long-acting opiate
and added an "as-needed" opiate for breakthrough pain. What should the nurse do? -
ANSWER Recognize that the higher dose is needed because the patient has developed
pharmacodynamic tolerance
A patient has been taking phenytoin, a drug with a narrow therapeutic index, to control
seizures. If fluoxetine, a drug that inhibits the liver enzyme that metabolizes phenytoin,
is prescribed to treat obsessive compulsive disorder, drug interaction puts the patient at
risk for which effect? - ANSWER Toxicity from phenytoin
Based on pharmacokinetics, drugs are most likely to pass into fetal circulation if they
are - ANSWER lipid-soluble
Premature infants are at risk for what kind of response to drugs? - ANSWER Intense
and prolonged response
An older adult is receiving several drugs that are normally highly protein bound. The
patient's serum albumin is 2.8 mg/dL (normal 3.5 to 5 mg/dL). Drug effects in this
patient may be - ANSWER increased
An older adult patient frequently forgets to take an oral medication that has been
prescribed to be taken 3 times a day. Which action by the nurse is best? - ANSWER
Call the prescriber for a sustained-release form of the drug
An older adult patient is taking a new prescription medication. After reviewing the
patient's medical record, the nurse is most concerned about an adverse drug reaction if
what is documented? - ANSWER The patient's urinary creatinine clearance is 70
mL/min/1.73 m2 (reference range: 105 to 110 mL/min/1.73 m2)
A patient is taking a Category A drug during pregnancy. Which statement by the nurse
is accurate? - ANSWER "The risk of harm to the fetus is remote."
A patient who is breast-feeding her newborn infant is prescribed a category A antibiotic
to take after discharge. Which statement should the nurse include when providing
discharge instructions? - ANSWER "Take the antibiotic immediately after breast-
feeding."
, Which question would provide the most useful information when taking the history of a
child diagnosed with rickets? - ANSWER "How many hours a day does your child watch
television?"
A 24-year-old patient has been prescribed cetirizine (Zyrtec) for seasonal allergic
rhinitis. What should the nurse include in this patient's education? - ANSWER This
medication can cause dry eyes, and you can use over the counter artificial tears if you
experience this side effect. If you have any changes in your vision, contact the
prescriber right away, This medication can cause drowsiness, so do not operate heavy
machinery, including drive a vehicle, until you know how this medication will affect you,
This medication can cause constipation, so be sure to drink plenty of fluids and eat
plenty of fiber
You are assessing your patient who was admitted for a COPD exacerbation, and you
notice a marked change from your last assessment 4 hours ago. What symptoms
indicate this patient has hypoxemia and hypercapnia? - ANSWER lethargy, confusion,
tachycardia
Why does the lung collapse if air enters the pleural space? - ANSWER The pressure
surrounding the lung becomes the same as the pressure in the atmosphere, so the lung
cannot expand
Which of the following are possible causes of pulmonary edema? - ANSWER left-sided
congestive heart failure, inflammation due to a severe lower respiratory infection,
pulmonary hypertension, low plasma protein levels
Which of the following is the most common cause of pulmonary embolisms? - ANSWER
Deep Vein Thrombosis (of the legs)
Which lung structure contains the highest percentage of smooth muscle? - ANSWER
Bronchioles
Which of the following conditions places a patient at greater risk for contracting
bronchopneumonia? - ANSWER Immobility/hyperactivity, breathing shallowly and
avoiding coughing because they are in pain, poor nutritional intake, immune
suppression
A student nurse asks you why a patient with COPD only has oxygen on at 2 L/min if his
O2 saturation is only 93% percent. What would be the most appropriate response that
you could provide? - ANSWER Patients with COPD have chronically elevated CO2
levels, so their respiratory center in their brain stimulates breathing based on how much
oxygen is in their blood. If we increase his oxygen flow rate to increase his saturation to
100%, his respiratory drive will not be stimulated and cause respiratory arrest. We will
continue to titrate his oxygen flow rate to maintain a saturation between 90% and 93%.
answers
Which assessment finding suggests hypersensitivity of receptors when a patient
suddenly stops taking atenolol (Tenormin), a Beta 2 receptor antagonist that slows the
heart rate? - ANSWER Pulse 118 beats/min
A terminal cancer patient has been receiving narcotic analgesics for severe pain for
more than 6 months. The prescriber has increased the dose of the long-acting opiate
and added an "as-needed" opiate for breakthrough pain. What should the nurse do? -
ANSWER Recognize that the higher dose is needed because the patient has developed
pharmacodynamic tolerance
A patient has been taking phenytoin, a drug with a narrow therapeutic index, to control
seizures. If fluoxetine, a drug that inhibits the liver enzyme that metabolizes phenytoin,
is prescribed to treat obsessive compulsive disorder, drug interaction puts the patient at
risk for which effect? - ANSWER Toxicity from phenytoin
Based on pharmacokinetics, drugs are most likely to pass into fetal circulation if they
are - ANSWER lipid-soluble
Premature infants are at risk for what kind of response to drugs? - ANSWER Intense
and prolonged response
An older adult is receiving several drugs that are normally highly protein bound. The
patient's serum albumin is 2.8 mg/dL (normal 3.5 to 5 mg/dL). Drug effects in this
patient may be - ANSWER increased
An older adult patient frequently forgets to take an oral medication that has been
prescribed to be taken 3 times a day. Which action by the nurse is best? - ANSWER
Call the prescriber for a sustained-release form of the drug
An older adult patient is taking a new prescription medication. After reviewing the
patient's medical record, the nurse is most concerned about an adverse drug reaction if
what is documented? - ANSWER The patient's urinary creatinine clearance is 70
mL/min/1.73 m2 (reference range: 105 to 110 mL/min/1.73 m2)
A patient is taking a Category A drug during pregnancy. Which statement by the nurse
is accurate? - ANSWER "The risk of harm to the fetus is remote."
A patient who is breast-feeding her newborn infant is prescribed a category A antibiotic
to take after discharge. Which statement should the nurse include when providing
discharge instructions? - ANSWER "Take the antibiotic immediately after breast-
feeding."
, Which question would provide the most useful information when taking the history of a
child diagnosed with rickets? - ANSWER "How many hours a day does your child watch
television?"
A 24-year-old patient has been prescribed cetirizine (Zyrtec) for seasonal allergic
rhinitis. What should the nurse include in this patient's education? - ANSWER This
medication can cause dry eyes, and you can use over the counter artificial tears if you
experience this side effect. If you have any changes in your vision, contact the
prescriber right away, This medication can cause drowsiness, so do not operate heavy
machinery, including drive a vehicle, until you know how this medication will affect you,
This medication can cause constipation, so be sure to drink plenty of fluids and eat
plenty of fiber
You are assessing your patient who was admitted for a COPD exacerbation, and you
notice a marked change from your last assessment 4 hours ago. What symptoms
indicate this patient has hypoxemia and hypercapnia? - ANSWER lethargy, confusion,
tachycardia
Why does the lung collapse if air enters the pleural space? - ANSWER The pressure
surrounding the lung becomes the same as the pressure in the atmosphere, so the lung
cannot expand
Which of the following are possible causes of pulmonary edema? - ANSWER left-sided
congestive heart failure, inflammation due to a severe lower respiratory infection,
pulmonary hypertension, low plasma protein levels
Which of the following is the most common cause of pulmonary embolisms? - ANSWER
Deep Vein Thrombosis (of the legs)
Which lung structure contains the highest percentage of smooth muscle? - ANSWER
Bronchioles
Which of the following conditions places a patient at greater risk for contracting
bronchopneumonia? - ANSWER Immobility/hyperactivity, breathing shallowly and
avoiding coughing because they are in pain, poor nutritional intake, immune
suppression
A student nurse asks you why a patient with COPD only has oxygen on at 2 L/min if his
O2 saturation is only 93% percent. What would be the most appropriate response that
you could provide? - ANSWER Patients with COPD have chronically elevated CO2
levels, so their respiratory center in their brain stimulates breathing based on how much
oxygen is in their blood. If we increase his oxygen flow rate to increase his saturation to
100%, his respiratory drive will not be stimulated and cause respiratory arrest. We will
continue to titrate his oxygen flow rate to maintain a saturation between 90% and 93%.
