NR293 Final Exam Review & Practice
Questions With Complete Solutions
A 10-year-old patient will be started on
methylphenidate hydrochloride (Ritalin) therapy.
The nurse will perform which essential baseline
assessment before this drug is started?
a. Eye examination
b. Height and weight
c. Liver function studies
d. Hearing test Correct Answers ANS: B
Assessment of baseline height and weight is
important before beginning Ritalin therapy because
it may cause a temporary slowing of growth in
prepubertal children. The other studies are not as
essential at this time.
A 19-year-old student was diagnosed with
hypothyroidism and has started thyroid
replacement therapy with levothyroxine
(Synthroid). After 1 week, she called the clinic to
report that she does not feel better. Which
response from the nurse is correct?
a. "It will probably require surgery for a cure to
happen."
b. "The full therapeutic effects may not occur for 3
to 4 weeks."
,c. "Is it possible that you did not take your
medication as instructed?"
d. "Let's review your diet; it may be causing
absorption problems." Correct Answers ANS: B
Patients need to understand that it may take up to
3 to 4 weeks to see the full therapeutic effects of
thyroid drugs.
A 19-year-old woman has been diagnosed with
hypothyroidism and has started thyroid
replacement therapy with levothyroxine
(Synthroid). After 6 months, she calls the nurse to
say that she feels better and wants to stop the
medication. Which response by the nurse is
correct?
a. "You can stop the medication if your symptoms
have improved."
b. "You need to stay on the medication for at least
1 year before a decision about stopping it can be
made."
c. "You need to stay on this medication until you
become pregnant."
d. "Medication therapy for hypothyroidism is
usually lifelong, and you should not stop taking the
medication." Correct Answers ANS: D
These medications must never be abruptly
discontinued, and lifelong therapy is usually the
norm.
,A 22-year-old patient has been taking lithium for 1
year, and the most recent lithium level is 0.9
mEq/L. Which statement about the laboratory
result is correct?
a. The lithium level is therapeutic.
b. The lithium level is too low.
c. The lithium level is too high.
d. Lithium is not usually monitored with blood
levels. Correct Answers ANS: A
Desirable long-term maintenance lithium levels
range between 0.6 and 1.2 mEq/L.
A 38-year-old man has come into the urgent care
center with severe hip pain after falling from a
ladder at work. He says he has taken several pain
pills over the past few hours but cannot remember
how many he has taken. He hands the nurse an
empty bottle of acetaminophen (Tylenol). The
nurse is aware that the most serious toxic effect of
acute acetaminophen overdose is which condition?
a. Tachycardia
b. Central nervous system depression
c. Hepatic necrosis
d. Nephropathy Correct Answers ANS: C
Hepatic necrosis is the most serious acute toxic
effect of an acute overdose of acetaminophen. The
other options are incorrect.
, A 49-year-old patient is in the clinic for a follow-up
visit 6 months after starting a beta blocker for
treatment of hypertension. During this visit, his
blood pressure is 169/98 mm Hg, and he
eventually confesses that he stopped taking this
medicine 2 months ago because of an
"embarrassing problem." What problem did the
patient most likely experience with this medication
that caused him to stop taking it?
a. Urge incontinence
b. Dizziness when standing up
c. Excessive flatus
d. Impotence Correct Answers ANS: D
Impotence is a potential adverse effect of beta
blockers and may cause patients to stop taking the
medication. The other options are not adverse
effects of beta blockers.
A 51-year-old woman will be taking selective
estrogen receptor modulators (SERMs) as part of
treatment for postmenopausal osteoporosis. The
nurse reviews potential contraindications, including
which condition?
a. Hypocalcemia
b. Breast cancer
c. Stress fractures
d. Venous thromboembolism Correct Answers
ANS: D
Questions With Complete Solutions
A 10-year-old patient will be started on
methylphenidate hydrochloride (Ritalin) therapy.
The nurse will perform which essential baseline
assessment before this drug is started?
a. Eye examination
b. Height and weight
c. Liver function studies
d. Hearing test Correct Answers ANS: B
Assessment of baseline height and weight is
important before beginning Ritalin therapy because
it may cause a temporary slowing of growth in
prepubertal children. The other studies are not as
essential at this time.
A 19-year-old student was diagnosed with
hypothyroidism and has started thyroid
replacement therapy with levothyroxine
(Synthroid). After 1 week, she called the clinic to
report that she does not feel better. Which
response from the nurse is correct?
a. "It will probably require surgery for a cure to
happen."
b. "The full therapeutic effects may not occur for 3
to 4 weeks."
,c. "Is it possible that you did not take your
medication as instructed?"
d. "Let's review your diet; it may be causing
absorption problems." Correct Answers ANS: B
Patients need to understand that it may take up to
3 to 4 weeks to see the full therapeutic effects of
thyroid drugs.
A 19-year-old woman has been diagnosed with
hypothyroidism and has started thyroid
replacement therapy with levothyroxine
(Synthroid). After 6 months, she calls the nurse to
say that she feels better and wants to stop the
medication. Which response by the nurse is
correct?
a. "You can stop the medication if your symptoms
have improved."
b. "You need to stay on the medication for at least
1 year before a decision about stopping it can be
made."
c. "You need to stay on this medication until you
become pregnant."
d. "Medication therapy for hypothyroidism is
usually lifelong, and you should not stop taking the
medication." Correct Answers ANS: D
These medications must never be abruptly
discontinued, and lifelong therapy is usually the
norm.
,A 22-year-old patient has been taking lithium for 1
year, and the most recent lithium level is 0.9
mEq/L. Which statement about the laboratory
result is correct?
a. The lithium level is therapeutic.
b. The lithium level is too low.
c. The lithium level is too high.
d. Lithium is not usually monitored with blood
levels. Correct Answers ANS: A
Desirable long-term maintenance lithium levels
range between 0.6 and 1.2 mEq/L.
A 38-year-old man has come into the urgent care
center with severe hip pain after falling from a
ladder at work. He says he has taken several pain
pills over the past few hours but cannot remember
how many he has taken. He hands the nurse an
empty bottle of acetaminophen (Tylenol). The
nurse is aware that the most serious toxic effect of
acute acetaminophen overdose is which condition?
a. Tachycardia
b. Central nervous system depression
c. Hepatic necrosis
d. Nephropathy Correct Answers ANS: C
Hepatic necrosis is the most serious acute toxic
effect of an acute overdose of acetaminophen. The
other options are incorrect.
, A 49-year-old patient is in the clinic for a follow-up
visit 6 months after starting a beta blocker for
treatment of hypertension. During this visit, his
blood pressure is 169/98 mm Hg, and he
eventually confesses that he stopped taking this
medicine 2 months ago because of an
"embarrassing problem." What problem did the
patient most likely experience with this medication
that caused him to stop taking it?
a. Urge incontinence
b. Dizziness when standing up
c. Excessive flatus
d. Impotence Correct Answers ANS: D
Impotence is a potential adverse effect of beta
blockers and may cause patients to stop taking the
medication. The other options are not adverse
effects of beta blockers.
A 51-year-old woman will be taking selective
estrogen receptor modulators (SERMs) as part of
treatment for postmenopausal osteoporosis. The
nurse reviews potential contraindications, including
which condition?
a. Hypocalcemia
b. Breast cancer
c. Stress fractures
d. Venous thromboembolism Correct Answers
ANS: D
