NURS 6521N MIDTERM EXAM WITH ANSWERS (100/100 POINTS

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 Selected Answer: consult their care provider before taking new over-the-counter medications. • Question 2 1 out of 1 points A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive Selected Answer: a lower-than-normal dose of drugs that bind to acid glycoproteins. • Question 3 2 out of 1 points A patient with a recent diagnosis of acute renal failure has a long-standing seizure disorder which has been successfully controlled for several years with antiseizure medications. The nurse should recognize that the patient's compromised renal function will likely Selected Answer: increase the half-life of medications that are metabolized by the kidneys. • Question 4 0 out of 1 points A Nurse Practitioner is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The Nurse Practitioner should anticipate that the drug will be administered Selected Answer: orally . • Question 5 1 out of 1 points 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? Selected Answer: lOMoARcPSD| H2 As have a longer duration of action and fewer adverse R effects than H1RAs. • Question 6 2 out of 1 points A Nurse Practitioner is caring for a female patient who has developed atelectasis because of thick mucus secretions. The Nurse Practitioner is monitoring IV administration of acetylcysteine (Mucomyst) and notices that the patient's face is flushed. The appropriate nursing action would be to Selected Answer: slow the administration of acetylcysteine and administer diphenhydramine if ordered. • Question 7 1 out of 1 points A Nurse Practitioner is teaching a patient about his newly prescribed drug, colchicine, for gout. The Nurse Practitioner will instruct the patient to avoid which of the following foods? Selected Answer: Shrim p • Question 8 1 out of 1 points A 75-year-old woman is prescribed magnesium hydroxide for constipation. The nurse's assessment reveals that the patient is being treated for rheumatoid arthritis and hypertension. The patient lives in assisted living and is on a low- sodium diet. Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the patient's Selected Answer: medication history. • Question 9 1 out of 1 points 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? Selected Answer: The amount of alcohol consumption • Question 10 1 out of 1 points 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 Selected Answer: inhibiting the movement of calcium ions across the cardiac muscle cell membrane. • Question 11 lOMoARcPSD| 0 out of 1 points A patient has been prescribed an oral drug that is known to have a high firstpass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells? Selected Answer: Giving the drug with food in order to delay absorption • Question 12 1 out of 1 points To maximize the therapeutic effect of diphenoxylate HCl with atropine sulfate, the nurse will instruct the patient to take the medication Selected Answer: once a day. • Question 13 2 out of 1 points A Nurse Practitioner who provides care in a long-term care facility is documenting a new resident's medication regimen on the resident's intake admission. The Nurse Practitioner is documenting the generic, rather than proprietary, names of the resident's current drugs because Selected Answer: there is a potential for confusion and miscommunication if proprietary names are used. • Question 14 1 out of 1 points Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from Helicobacter pylori infection. Which of the following medications will likely be used in an attempt to eradicate the patient's H. pylori infection? (Select all that apply.) Selected Answers: Antibiotics A PPI • Question 15 1 out of 1 points A 56-year-old female patient has been admitted to the hospital with chronic muscle spasms and has been prescribed a new medication to treat the spasms. She has a poorly documented allergy to eggs, synthetic clothes, and perfumes. What is the priority action of the nurse to ensure that prescribed medication does not experience an allergic reaction? Selected Answer: Post an allergies notice on the front of the chart and document the allergies in the appropriate area of the patient's record • Question 16 1 out of 1 points lOMoARcPSD| A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following? Selected Answer: Bradycardia • Question 17 2 out of 1 points Mr. Tan is a 69-year-old man who prides himself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. However, Mr. Tan states that he has experienced occasional constipation in recent months. What remedy should be the nurse's first suggestion? Selected Answer: A bulk-forming (fiber) laxative • Question 18 1 out of 1 points A Nurse Practitioner is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called Selected Answer: pharmacogenom ics. • Question 19 1 out of 1 points A Nurse Practitioner is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning. The Nurse Practitioner administers colchicine intravenously in order to Selected Answer: avoid aggravating the gastrointestinal tract. • Question 20 1 out of 1 points A 45-year-old man who is a construction worker has been diagnosed with hyperlipidemia and has been prescribed lovastatin. The nurse will advise the patient to Selected Answer: avoid prolonged exposure to sunlight. • Question 21 1 out of 1 points A home health Nurse Practitioner is performing a home visit to an elderly client who has early-stage dementia. The Nurse Practitioner observes that some of the client's pill bottles are empty, even though the client is not due for refills for 2 weeks. What nursing diagnosis should the Nurse Practitioner prioritize when planning this client's care? lOMoARcPSD| Selected Answer: Ineffective Therapeutic Regimen Management • Question 22 1 out of 1 points lOMoARcPSD| A Nurse Practitioner is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for which of the following? Selected Answer: Increase in plasma concentration of lovastatin • Question 23 1 out of 1 points A 60-year-old African-American man lives with a number of chronic health problems. Genetic factors are likely to influence his etiology and/or treatment of Selected Answer: hypertension . • Question 24 1 out of 1 points A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to Selected Answer: rebound bronchoconstriction. • Question 25 1 out of 1 points A Nurse Practitioner receives an order to administer a critically ill patient two drugs immediately (stat). The Nurse Practitioner begins the process by Selected Answer: washing his or her hands before handling the medications. • Question 26 2 out of 1 points The Nurse Practitioner is prescribing Salmeterol (Serevent) inhaler for a patient with asthma. What instructions would be correct to provide the patient? Selected Answer: "This is a long acting medication for your asthma and should be used once every 12 hours" • Question 27 1 out of 1 points A patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which of the following is an appropriate response by the nurse? Selected "Yes, but be sure to wait at least 2 hours to take the antacid lOMoARcPSD| Answer: after you take the ranitidine." • Question 28 1 out of 1 points A patient is being treated for respiratory infection. He is a recovering alcoholic and has impaired liver function. The nurse will instruct the patient to be especially cautious when taking Selected Answer: an elixir. • Question 29 1 out of 1 points A Nurse Practitioner who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients? Selected Answer: An obese male client who is a heavy alcohol user and who has cirrhosis of the liver • Question 30 0 out of 1 points The Nurse Practitioner is treating a patient that takes frequent doses of antacids for his heartburn and is also taking an enteric coded aspirin. What instructions should be provided to the patient? Selected Answer: The aspirin is less effective when taken with an antacid so you need to increase the dose. • Question 31 0 out of 1 points A Nurse Practitioner is instructing a patient in the administration of regular insulin by the subcutaneous route. Which of the following strategies would the Nurse Practitioner suggest if the goal is to promote absorption of the regular insulin? Selected Answer: Rotate injection sites by using the arm one day, the stomach the next day, and the thigh the day after and then repeating the cycle. • Question 32 1 out of 1 points A patient is bothered with nighttime episodes of bronchoconstriction related to asthma. Which of the following medications can be administered to decrease the nighttime episodes and prevent asthma attacks? Selected Answer: Beta2-adrenergic agonists • Question 33 2 out of 1 points lOMoARcPSD| A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this lOMoARcPSD| drug, one common adverse effect that can be severe is Selected Answer: headache. • Question 34 1 out of 1 points Topical inhaled alpha adrenergic blocking agents or nasal vasoconstricting decongestants should not be used chronically (>5 days) because they can cause Selected Answer: rebound coughing • Question 35 2 out of 1 points The nurse practitioner orders Amoxicillin 500 mg tid? What is the total amount of medication patient will take per day? Selected Answer: 1500 mg • Question 36 1 out of 1 points A female patient has been taking zafirlukast for a week and is experiencing diarrhea. The nurse should instruct her to do which of the following? Selected Answer: Drink plenty of fluids • Question 37 0 out of 1 points The APRN is treating a patient with type 2 diabetes. The patient is on the maximum dose of metformin and glucotrol. Current weight 212 pounds. Labs from this morning indicate a fasting blood sugar of 312 and HbA1C of 9. The APRN wants to start the patient on Lantus 0.2 unit/kg. What dose and instructions should the APRN provide? Selected Answer: Give 24 units of Lantus subcutaneously prior to dinner • Question 38 1 out of 1 points A patient comes to primary clinic for strep throat. A throat swab culture is sent to lab. What information is required for the nurse practitioner to disclose on lab transmittal? Selected Answer: None of the above • Question 39 2 out of 1 points lOMoARcPSD| An elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client's lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient's pulmonary edema? Selected Answer: Furosemide • Question 40 1 out of 1 points A woman has a long history of seasonal allergies that are typically accompanied by rhinorrhea, red eyes, and frequent sneezing. Sneezes are a result of Selected Answer: a CNS reflex that is initiated by receptors in the nasal cavities. • Question 41 1 out of 1 points Which of the following serves to protect the public by ensuring the purity of a drug and its contents? Selected Answer: United States Adopted Names Council • Question 42 2 out of 1 points A Nurse Practitioner who is responsible for administering medications should understand that the goals of the MedWatch program are to (Select all that apply.) Selected Answers: provide regular feedback about product safety issues. facilitate the reporting of adverse reactions of drugs. increase awareness of serious reactions caused by drugs or medical devices. • Question 43 1 out of 1 points A female patient has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of prednisone to avoid Selected Answer: adrenal insufficiency. • Question 44 1 out of 1 points A Nurse Practitioner is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports "dizzy spells and weakness" and feels that the drug is no lOMoARcPSD| longer effective. The Nurse Practitioner suspects that the change in the effectiveness of the drug is related to Selected Answer: the impact of the warmer climate on the patient's physical state. • Question 45 1 out of 1 points A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient's drug therapy? Selected Answer: Increased abdominal pain and vomiting • Question 46 1 out of 1 points The Nurse Practitioner is conducting a medication reconciliation of a new resident of a long-term care facility. The Nurse Practitioner notes that the resident takes allopurinol on a daily basis for the treatment of gout. What is the primary purpose of this drug? Selected Answer: To balance urate concentration and prevent gout attacks • Question 47 1 out of 1 points The APRN should educate a diabetic patient that beta blockers may mask the signs and symptoms of Selected Answer: hypoglyce mia • Question 48 1 out of 1 points A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that Selected Answer: she must be prepared to show identification when buying a drug that contains pseudoephedrine. • Question 49 1 out of 1 points Which of the following affects drug distribution throughout the body? Selected Answer: Protein binding • Question 50 lOMoARcPSD| 0 out of 1 points lOMoARcPSD| Mesalamine (Asacol) is prescribed for a 22-year-old woman with Crohn disease. The nurse will discuss with the patient the possibility for which of the following adverse effects related to the new drug therapy? Selected Answer: Fatigue • Question 51 1 out of 1 points A 62-year-old woman has been prescribed a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately Selected Answer: 24 hours. • Question 52 1 out of 1 points You are seeing a 55 year old patient recently diagnosed with a bleeding ulcer. What should be the initial treatment choice for this patient? Selected Answer: A Proton Pump Inhibitor • Question 53 1 out of 1 points A 70-year-old woman has experienced peripheral edema and decreasing stamina in recent months and has sought care from her primary care provider. The patient's subsequent diagnostic workup has resulted in a diagnosis of chronic heart failure. The woman has been prescribed digoxin and the nurse has begun patient education. What should the nurse teach the patient about her new medication? Selected Answer: "This will lessen the workload of your heart by reducing your blood pressure." • Question 54 2 out of 1 points A patient has been prescribed lovastatin for a high cholesterol level. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it Selected Answer: inhibits cholesterol syntheses.