NURSING MSN 571 FINAL EXAM QUESTIONS
AND ANSWERS
A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill.
Which action should the prescriber take initially? - ANSWER: Arrange to schedule an
appointment with the patient.
A metered-dose albuterol inhaler is prescribed for asthma management. The patient
reports feeling jittery sometimes when taking the medication, and does not feel that the
medication is always effective. Which action will the provider take to best minimize
patient risks and maximize medication effectiveness? - ANSWER: Auscultate the
patient's lung sounds and obtain other relevant vital signs.
A patient is prescribed metronidazole for bacterial vaginosis. Which patient history
finding would be most concerning to the provider? - ANSWER: The patient drinks two
glasses of wine every night.
The provider prepares a patient with newly diagnosed type 1 diabetes for hospital
discharge. Which action by the provider will best support the patient's ability to
effectively manage medication therapy? - ANSWER: Asking the patient to
demonstrate how to measure and administer insulin
A patient reports that a medication prescribed for recurrent migraine headaches is not
working. Which action is the prescriber's priority when addressing the patient's concern?
- ANSWER: Ask the patient about the number and frequency of tablets taken.
The drug manual states that older adult patients are at increased risk for hepatotoxicity.
Which action is most important when prescribing this medication to an 80-year-old
patient? - ANSWER: Obtaining baseline liver function studies
A patient with bipolar disorder is prescribed daily lithium. Which action is most important
for the provider to take in order to determine if the therapeutic level is maintained? -
ANSWER: Order periodic laboratory testing.
Which factor best supports an increase for full prescriptive authority for both advanced
practice registered nurses (APRNs) and physician assistants (PAs)? - ANSWER:
More patients will have access to health care.
#$%^&&^
A pediatric patient prescribed ampicillin for streptococcal pharyngitis reports new onset %$#$%^&
of a pruritic, dull red, maculopapular rash on the chest and neck. Which action is most
&^%$%^&
important for the provider to take to minimize this patient's risk for injury? - ANSWER:
Discontinue the ampicillin. *(*&^%$%
^&*()(*&^
Which prescriber action will have the greatest impact on the patient's commitment to %^&*(*&^
adherence to any type of medication therapy? - ANSWER: Providing medication %$%*(*&^
education that the patient can easily understand %$%^*(*&
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,NURSING MSN 571 FINAL EXAM QUESTIONS
AND ANSWERS
Which patient statement suggests to the provider that the patient's nonadherence with
their medication plan is related to dissatisfaction with the therapy? - ANSWER: "I've
been taking this medication for well over a week and I lost only a half a pound."
How can the prescriber's regular collaboration with a pharmacist improve positive
outcomes for patients? - ANSWER: Pharmacists have additional information on drug
interactions. The pharmacist can suggest adequate medication dosing. Pharmacists
have firsthand knowledge of the facility formulary.
Which statements made by the prescriber demonstrate an understanding of effective
medication education? - ANSWER: "This medication needs to be stored in the
refrigerator. "Take 3 tablets daily: 1 with breakfast, 1 with lunch, and one with dinner."
"You need to take the medication as we discussed until all the tablets are gone." "Call
the office immediately if you begin experiencing any itching, headache, or difficulty
breathing."
The patient who has been prescribed lithium for a diagnosis of bipolar disorder asks
why blood tests are required on a regular basis. Which provider responses demonstrate
an understanding of why the patient requires a variety of laboratory tests? -
ANSWER: "We need to monitor how your thyroid is functioning." "We need to monitor
kidney function while you are on this drug. This medication can cause you to lose
sodium, so we need to measure sodium levels."
When prescribing lovastatin, what will a provider advise to decrease the risk of
developing muscle toxicity? - ANSWER: Substitute grapefruit juice with orange juice
When prescribing drugs with a narrow therapeutic index, what intervention does the
provider take to decrease risk to the patient? - ANSWER: Monitor the patient's
plasma drug levels at regular intervals.
A patient reports that a medication no longer effectively alleviates symptoms. What
process informs the provider's response to the patient's concerns? - ANSWER:
Desensitization of receptor sites results from continual exposure to the drug.
#$%^&&^
A patient reports that Brand X tablets work faster than Brand Y tablets of the same
%$#$%^&
amount of the same drug. Which statement informs the prescriber's response when
&^%$%^&
explaining this phenomenon to the patient? - ANSWER: Inactive ingredients used in
composition can result in differing rates of dissolution, which can alter the drug's onset *(*&^%$%
of action. ^&*()(*&^
%^&*(*&^
A patient receiving intravenous gentamicin has a toxic serum drug level. The prescriber
%$%*(*&^
confirms that the dosing is correct. Which possible cause of this situation will the
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, NURSING MSN 571 FINAL EXAM QUESTIONS
AND ANSWERS
provider explore? - ANSWER: Whether patient is taking a medication that binds to
serum albumin.
A patient takes a drug that is metabolized by CYP3A4 isoenzymes. If a CYP3A4
inducing drug is prescribed, what drug adjustment may be necessary to maintain a
therapeutic level of CYP3A4 substrate? - ANSWER: Increase dosage of the CYP3A4
substrate
The provider prescribes hydrocodone with acetaminophen for a patient's postsurgical
pain. What instruction will the prescriber include regarding alcohol intake? -
ANSWER: "You should avoid drinking alcohol while you are taking the pain
medication I've ordered."
Which order for furosemide is written appropriately by the prescriber? - ANSWER:
Furosemide [Lasix] 20 mg PO daily
A drug can cause symptoms that resemble those of Parkinson disease. What action
should the prescriber take to minimize the potential patient risk? - ANSWER:
Thoroughly educate the patient about recognizing such symptoms and the need to
notify the office immediately.
A patient who has been taking sertraline for depression was prescribed azithromycin to
treat an infection by a provider at an after-hours clinic. What action will the primary care
provider take to address the risk this combination of medication has posed for the
patient? - ANSWER: Discontinue the azithromycin and write an order for an
alternative antibiotic.
A patient reports mild nausea within an hour after taking the first two doses of a newly
approved medication. Nausea is not listed among the known side effects of this drug.
What instructions will the provider give the patient? - ANSWER: "Take the next dose
with food and call the office if the nausea reoccurs or if other symptoms develop."
A patient develops shortness of breath shortly after taking the initial dose of a newly
prescribed medication. The patient's heart rate is 86 beats/minute, the respiratory rate is
24 breaths/minute, and the blood pressure is 120/70 mm Hg. The prescriber will #$%^&&^
discontinue the drug based on the assumption the patient experienced what medication
%$#$%^&
induced effect? - ANSWER: A side effect
&^%$%^&
A provider recommends genetic testing of a patient before prescribing a medication. *(*&^%$%
What response should the provider give when asked by the patient about the purpose of ^&*()(*&^
genetic testing? - ANSWER: "Such testing will tell us how quickly your body is likely %^&*(*&^
to metabolize, or process, the drug." %$%*(*&^
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AND ANSWERS
A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill.
Which action should the prescriber take initially? - ANSWER: Arrange to schedule an
appointment with the patient.
A metered-dose albuterol inhaler is prescribed for asthma management. The patient
reports feeling jittery sometimes when taking the medication, and does not feel that the
medication is always effective. Which action will the provider take to best minimize
patient risks and maximize medication effectiveness? - ANSWER: Auscultate the
patient's lung sounds and obtain other relevant vital signs.
A patient is prescribed metronidazole for bacterial vaginosis. Which patient history
finding would be most concerning to the provider? - ANSWER: The patient drinks two
glasses of wine every night.
The provider prepares a patient with newly diagnosed type 1 diabetes for hospital
discharge. Which action by the provider will best support the patient's ability to
effectively manage medication therapy? - ANSWER: Asking the patient to
demonstrate how to measure and administer insulin
A patient reports that a medication prescribed for recurrent migraine headaches is not
working. Which action is the prescriber's priority when addressing the patient's concern?
- ANSWER: Ask the patient about the number and frequency of tablets taken.
The drug manual states that older adult patients are at increased risk for hepatotoxicity.
Which action is most important when prescribing this medication to an 80-year-old
patient? - ANSWER: Obtaining baseline liver function studies
A patient with bipolar disorder is prescribed daily lithium. Which action is most important
for the provider to take in order to determine if the therapeutic level is maintained? -
ANSWER: Order periodic laboratory testing.
Which factor best supports an increase for full prescriptive authority for both advanced
practice registered nurses (APRNs) and physician assistants (PAs)? - ANSWER:
More patients will have access to health care.
#$%^&&^
A pediatric patient prescribed ampicillin for streptococcal pharyngitis reports new onset %$#$%^&
of a pruritic, dull red, maculopapular rash on the chest and neck. Which action is most
&^%$%^&
important for the provider to take to minimize this patient's risk for injury? - ANSWER:
Discontinue the ampicillin. *(*&^%$%
^&*()(*&^
Which prescriber action will have the greatest impact on the patient's commitment to %^&*(*&^
adherence to any type of medication therapy? - ANSWER: Providing medication %$%*(*&^
education that the patient can easily understand %$%^*(*&
^%$&*(*&
^%%^&*(*
&^%%^&*
*&^%%^&
*()(*&^%
,NURSING MSN 571 FINAL EXAM QUESTIONS
AND ANSWERS
Which patient statement suggests to the provider that the patient's nonadherence with
their medication plan is related to dissatisfaction with the therapy? - ANSWER: "I've
been taking this medication for well over a week and I lost only a half a pound."
How can the prescriber's regular collaboration with a pharmacist improve positive
outcomes for patients? - ANSWER: Pharmacists have additional information on drug
interactions. The pharmacist can suggest adequate medication dosing. Pharmacists
have firsthand knowledge of the facility formulary.
Which statements made by the prescriber demonstrate an understanding of effective
medication education? - ANSWER: "This medication needs to be stored in the
refrigerator. "Take 3 tablets daily: 1 with breakfast, 1 with lunch, and one with dinner."
"You need to take the medication as we discussed until all the tablets are gone." "Call
the office immediately if you begin experiencing any itching, headache, or difficulty
breathing."
The patient who has been prescribed lithium for a diagnosis of bipolar disorder asks
why blood tests are required on a regular basis. Which provider responses demonstrate
an understanding of why the patient requires a variety of laboratory tests? -
ANSWER: "We need to monitor how your thyroid is functioning." "We need to monitor
kidney function while you are on this drug. This medication can cause you to lose
sodium, so we need to measure sodium levels."
When prescribing lovastatin, what will a provider advise to decrease the risk of
developing muscle toxicity? - ANSWER: Substitute grapefruit juice with orange juice
When prescribing drugs with a narrow therapeutic index, what intervention does the
provider take to decrease risk to the patient? - ANSWER: Monitor the patient's
plasma drug levels at regular intervals.
A patient reports that a medication no longer effectively alleviates symptoms. What
process informs the provider's response to the patient's concerns? - ANSWER:
Desensitization of receptor sites results from continual exposure to the drug.
#$%^&&^
A patient reports that Brand X tablets work faster than Brand Y tablets of the same
%$#$%^&
amount of the same drug. Which statement informs the prescriber's response when
&^%$%^&
explaining this phenomenon to the patient? - ANSWER: Inactive ingredients used in
composition can result in differing rates of dissolution, which can alter the drug's onset *(*&^%$%
of action. ^&*()(*&^
%^&*(*&^
A patient receiving intravenous gentamicin has a toxic serum drug level. The prescriber
%$%*(*&^
confirms that the dosing is correct. Which possible cause of this situation will the
%$%^*(*&
^%$&*(*&
^%%^&*(*
&^%%^&*
*&^%%^&
*()(*&^%
, NURSING MSN 571 FINAL EXAM QUESTIONS
AND ANSWERS
provider explore? - ANSWER: Whether patient is taking a medication that binds to
serum albumin.
A patient takes a drug that is metabolized by CYP3A4 isoenzymes. If a CYP3A4
inducing drug is prescribed, what drug adjustment may be necessary to maintain a
therapeutic level of CYP3A4 substrate? - ANSWER: Increase dosage of the CYP3A4
substrate
The provider prescribes hydrocodone with acetaminophen for a patient's postsurgical
pain. What instruction will the prescriber include regarding alcohol intake? -
ANSWER: "You should avoid drinking alcohol while you are taking the pain
medication I've ordered."
Which order for furosemide is written appropriately by the prescriber? - ANSWER:
Furosemide [Lasix] 20 mg PO daily
A drug can cause symptoms that resemble those of Parkinson disease. What action
should the prescriber take to minimize the potential patient risk? - ANSWER:
Thoroughly educate the patient about recognizing such symptoms and the need to
notify the office immediately.
A patient who has been taking sertraline for depression was prescribed azithromycin to
treat an infection by a provider at an after-hours clinic. What action will the primary care
provider take to address the risk this combination of medication has posed for the
patient? - ANSWER: Discontinue the azithromycin and write an order for an
alternative antibiotic.
A patient reports mild nausea within an hour after taking the first two doses of a newly
approved medication. Nausea is not listed among the known side effects of this drug.
What instructions will the provider give the patient? - ANSWER: "Take the next dose
with food and call the office if the nausea reoccurs or if other symptoms develop."
A patient develops shortness of breath shortly after taking the initial dose of a newly
prescribed medication. The patient's heart rate is 86 beats/minute, the respiratory rate is
24 breaths/minute, and the blood pressure is 120/70 mm Hg. The prescriber will #$%^&&^
discontinue the drug based on the assumption the patient experienced what medication
%$#$%^&
induced effect? - ANSWER: A side effect
&^%$%^&
A provider recommends genetic testing of a patient before prescribing a medication. *(*&^%$%
What response should the provider give when asked by the patient about the purpose of ^&*()(*&^
genetic testing? - ANSWER: "Such testing will tell us how quickly your body is likely %^&*(*&^
to metabolize, or process, the drug." %$%*(*&^
%$%^*(*&
^%$&*(*&
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