 Question 1

1 out of 1 points
A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a
regular dosage of methotrexate. The nurse will advise her to take which of the following
vitamin supplements while taking the drug?
Response Taking vitamin B every day will help decrease the potential for adverse effects of
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methotrexate. This drug is given cautiously to very young and elderly patients,
because these patients' livers and kidneys cannot adequately clear the drug.
Vitamin C is contraindicated with most antiarthritic and antigout drugs because it
decreases the renal excretion of drugs. Supplements of vitamin A or D would not
be necessary.
 Question 2
1 out of 1 points
Following an assessment by her primary care provider, a 70-year-old resident of an assisted
living facility has begun taking daily oral doses of levothyroxine. Which of the following
assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?
Response If the pulse rate is greater than 100 bpm, it is necessary to withhold a
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levothyroxine dose in an older adult. Anorexia, recent vaccination, and recent
falls do not necessary indicate a need to withhold this medication.
 Question 3
1 out of 1 points
A nurse is developing a care plan for a patient who has multiple sclerosis. An expected
outcome for the patient who is receiving glatiramer would be a decrease in
Response Glatiramer should reduce the frequency of multiple sclerosis–related attacks and
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therefore decrease fatigue. Fatigue, weakness, spasticity, balance problems,
bladder and bowel problems, numbness, vision loss, tremor, and vertigo are the
most common symptoms of multiple sclerosis. Chest pain, breathing difficulties,
and heart palpitations are all identified side effects of glatiramer and are not
common manifestations of MS.
 Question 4
1 out of 1 points
A nurse is instructing a patient in the administration of regular insulin by the subcutaneous
route. Which of the following strategies would the nurse suggest if the goal is to promote
absorption of the regular insulin?
Response To promote the absorption of regular insulin, one anatomic area should be selected
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for subcutaneous injections. Serial locations within that anatomic area are then
chosen to rotate the exact injection site. Injection sites should not be rotated by
using different anatomic areas each day, because this would substantially change
the absorption of the insulin and the patient's blood glucose levels. Using one
injection site regularly may lead to lipodystrophy. Regular insulin is administered
about 30 to 60 minutes before eating a meal, not after.
 Question 5
 1 out of 1 points
To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic
patient, as the patient regains consciousness, the nurse should
Response While it is important to monitor a patient for nausea and vomiting and help him or
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her into a more comfortable position, it is most important to administer
supplemental carbohydrates as soon as the patient becomes conscious.
Administering supplemental carbohydrates serves to restore liver glycogen and
prevent secondary hypoglycemia. Calcium supplements are not necessary in this
situation.
 Question 6
1 out of 1 points
During long-term desmopressin therapy in a 48-year-old woman, it will be most important for
the nurse to assess which of the following?
Response During long-term desmopressin therapy, the nurse should periodically assess the
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patient's nasal passages because inappropriate administration of the drug may lead
to nasal ulceration. Consequently, subsequent doses may be inadequate. General
skin assessment, diet, and environment are also factors that need to be assessed,
but these are not as important as assessing the patient's nasal passages.
 Question 7
1 out of 1 points
A 49-year-old woman has been diagnosed with myalgia. The physician has recommended
aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will
encourage the patient to
Response Taking aspirin with milk or food minimizes the stomach upset because it buffers
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the stomach wall from direct contact with the medication, decreasing gastric
distress. Chewable tablets can be chewed before swallowing or crushed and then
advised to be taken with food or mixed in a drink. Swallowed whole, extended-
release tablets are enteric coated to delay release of the aspirin, which again
buffers the stomach wall from the medication, decreasing gastric distress.
Nonchewable tablets should be swallowed whole and should never be advised to
be crushed or chewed.
 Question 8
1 out of 1 points
A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident.
He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor which of the
following?
Response The nurse will monitor alanine aminotransferase and total bilirubin levels, because
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a serious adverse effect of dantrolene is drug-induced hepatitis. The nurse will
also educate the patient and family concerning signs and symptoms of hepatitis.
Prothrombin time and partial thromboplastin time would be monitored for
someone taking an anticoagulant, not for someone taking dantrolene. Urine
specific gravity is part of a urinalysis and would be used to assess urinary
 function, which is not affected by dantrolene use. Follicle-stimulating hormone
level is important to the female reproductive system and would not be assessed in
a male.
 Question 9
1 out of 1 points
A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine.
When developing a care plan for this patient, which factor will be most important for the nurse
to consider?
Response The nurse must consider the patient's dietary habits because foods high in purines
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increase uric acid concentrations in the blood, making a gouty attack more likely.
Assessing the patient's work environment, fluid intake, and ethnicity are not as
important as assessing his dietary habits.
 Question 10
1 out of 1 points
A 13-year-old patient has juvenile arthritis. He has recently had oral surgery and was told by
the surgeon to take aspirin for the pain. The nurse will monitor for which of the following?
Response Aspirin has been associated with hepatotoxicity in patients with juvenile arthritis,
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active systemic lupus erythematosus, rheumatic fever, or preexisting hepatic
impairment. The hepatotoxicity is thought to be a direct toxicity to the liver and is
associated with high-dose therapy. Bronchoconstriction is one of the
hypersensitivity responses to aspirin, while patients with hemophilia are at risk for
agranulocytosis and aplastic anemia.
 Question 11
1 out of 1 points
A nurse is working with a 57-year-old man who is a former intravenous drug abuser. He has
been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the
following will the nurse include in her teaching plan for this patient?
Response Use of illicit drugs as well as an age-related decrease in renal function may have
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predisposed the patient to nephrotoxicity. Therefore, it is most important for the
nurse to advise the patient to drink enough water to decrease the risk for
nephrotoxicity when taking methotrexate. Avoiding red meat or taking the tablets
before bedtime does not help reduce the risk of nephrotoxicity.
 Question 12
1 out of 1 points
A nurse is assessing a patient who has come to the emergency department complaining of back
spasms. The patient states that he has a history of opioid addiction and does not want to take
any drug that “puts me at risk of becoming physically dependent.” Which of the following
medications would the nurse question, if ordered?
Response The nurse would be concerned if the physician ordered cyclobenzaprine because
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long-term use of this drug may result in physical dependence. The other drugs
listed are not associated with physical dependence.
 Question 13
1 out of 1 points
A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy
begins, a priority action by the nurse will be to assess the patient's
Response The nurse should assess the patient's alcohol consumption before therapy is
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initiated. Concomitant alcohol use increases the rate of glyburide metabolism and
may cause a disulfiram-like reaction. Even though the patient's blood pressure
should be assessed, it is not as important as making sure that the patient is aware
of the serious reaction that alcohol can cause while on glyburide. The amount of
salt used in the patient's diet is important as well as the patient's potassium level,
but not specifically in relation to the use of glyburide.
 Question 14
1 out of 1 points
A 32-year-old female patient is taking tizanidine (Zanaflex) for spasticity related to her
multiple sclerosis. The nurse will inform the patient and her husband that the adverse effect
that poses the greatest safety risk to the patient is
Response Tizanidine (Zanaflex) has been associated with hypotension, which could be a
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safety risk, especially if the patient is also taking an antihypertensive drug.
Constipation, dry mouth, and fatigue are common adverse effects that do not pose
a safety risk.
 Question 15
1 out of 1 points
A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a
recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been
prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what
teaching point should the woman's nurse provide?
Response Dantrolene causes weakness because of its generalized reduction of muscle
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contraction. It is not associated with drug dependence, hyperglycemia,
hypoglycemia, or hallucinations.
 Question 16
1 out of 1 points
A 34-year-old male patient is prescribed methimazole (MMI). The nurse will advise him to
report which of the following immediately?
Response The nurse should ask the patient to report immediately if he notices decreased
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cardiac rate, intolerance to cold, or weight gain. These are indications of
hypothyroidism resulting from antithyroid therapy, and if the medication is
continued unchanged, insidious goitrogenic hypothyroidism may occur. Vertigo,
drowsiness, loss of appetite, and epigastric distress are possible adverse effects of
the therapy but would not present an immediate risk to the patient's health.
 Question 17
1 out of 1 points
A nurse has been invited to speak to a support group for persons with movement disorders and
 their families. Which of the following statements by the nurse addresses the chronic nature of
these diseases and the relevant drug therapies?
Response It is most important that patients and their families know that movement disorders
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are chronic, that there is no cure, and that drug therapy only serves to help
decrease the severity of the symptoms. Symptoms are not normally eliminated
completely. Culture must be considered because of catecholamine-O-
methyltransferase (COMT), which affects the absorption of levodopa in the body.
Some of the drugs used to treat movement disorders can pose a risk of causing
renal or hepatic dysfunction, but not all.
 Question 18
1 out of 1 points
A 66-year-old woman has experienced a significant decline in her quality of life as a result of
worsening rheumatoid arthritis. Her physician has prescribed etanercept and the nurse is
responsible for facilitating this new aspect of the patient's drug regimen. This will involve the
administration of
Response Feedback: Etanercept is a weekly subcutaneous injection.
 Question 19
1 out of 1 points
A patient is taking gabapentin (Neurontin) for spasticity associated with multiple sclerosis.
Which of the following should be the priority for monitoring?
Response Gabapentin is not metabolized and is excreted unchanged in the urine. Therefore,
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it is important to monitor renal function. Hepatic, cardiac, and respiratory
functions are not compromised with this drug.
 Question 20
1 out of 1 points
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?
Response After an early morning dose of NPH insulin, the patient should be alert for a
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possible hypoglycemic reaction during mid- to late-afternoon. The lengthy peak
action time produces additional risks for hypoglycemic reactions.
 Question 21
1 out of 1 points
A male patient with a diagnosis of relapsing-remitting multiple sclerosis is in the clinic to
discuss with the nurse the possibility of self-administration of glatiramer. During the patient
education session for self-administration, the nurse will emphasize
Response Since administration of glatiramer is by subcutaneous injection only, the nurse
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will teach the patient to rotate injection sites. Appropriate sites for the patient
would include the thigh, stomach, and upper arm.
 Question 22
1 out of 1 points
A nurse 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 administers colchicine intravenously in order to
Response The patient is given colchicine intravenously to avoid aggravating his
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gastrointestinal tract. Giving the drug intravenously may ensure quick distribution
of the drug, but considering the patient's food poisoning, the main objective would
be to avoid aggravating the gastrointestinal tract and symptoms that the patient
already has. Giving the drug intravenously does not prevent infection, bleeding, or
depressed bone marrow function.
 Question 23
1 out of 1 points
A clinic nurse is following a 9-year-old boy who is taking somatropin. Which of the following
will the nurse monitor periodically?
Response Somatropin is used for the long-term treatment of pediatric patients who have
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growth failure due to an inadequate secretion of endogenous growth hormone;
therefore, the nurse should check the patient's height. If the patient's growth rate
does not exceed the pretreatment rate by at least 2 cm per year, nonadherence to
therapy, antibody formation, malnutrition, or hypothyroidism may be considered
as possible causes. Somatropin would not significantly affect antidiuretic hormone
(ADH) levels, or cause dehydration or water retention.
 Question 24
1 out of 1 points
A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for
gout. Which of the following will the nurse monitor the patient most closely for?
Response Since sulfinpyrazone inhibits antiplatelet action, it is important for the nurse to
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monitor the patient for signs of bleeding. It is also important to avoid
administration of sulfinpyrazone with other drugs such as salicylates and
anticoagulants (warfarin) that affect platelet aggregation. The drug does not pose a
risk of hypothermia, hypotension, or renal dysfunction.
 Question 25
1 out of 1 points
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?
Response Gabapentin is unusual in that it does not interact with other drugs and does not
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alter the serum concentrations of other anticonvulsants. Consequently, it is
unnecessary to modify the patient's existing drug regimen. Regular assessment of
renal function is necessary in patients with diabetes, but this is not a consequence
of the use of gabapentin.
 Question 26
1 out of 1 points
A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse
 will instruct the patient to avoid which of the following foods?
Response High consumption of meat products and seafood increases the risk of
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hyperuricemia, which is the root cause of gout. Purine-rich vegetables do not
increase the risk of hyperuricemia, and a high dairy intake is actually protective.
 Question 27
1 out of 1 points
A nurse will instruct a patient taking allopurinol to take each dose
Response The nurse should teach the patient to take each dose after a meal to decrease the
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potential for nausea and vomiting. Taking this medicine at night, in the morning,
or before a meal would not help decrease the GI symptoms associated with this
drug.
 Question 28
1 out of 1 points
Which of the following would be the most important safety-related instruction for a nurse to
give to a patient taking baclofen (Lioresal)?
Response In a patient experiencing spasticity, the nurse should advise the patient to stop
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drinking alcohol. Alcohol consumption may increase the adverse effect of
sedation, causing sleepiness, dizziness, and blurred vision. The patient should not
drive or walk after taking the drug; he should learn to self-administer the drug;
and constipation is a concern. However, the most important safety concern is to
avoid alcohol.
 Question 29
1 out of 1 points
A nurse will monitor which of the following when assigned to a patient taking allopurinol for
chronic gout who visits the clinic every 2 months?
Response The most common adverse effects of allopurinol include pruritus, maculopapular
Feedback:
rash, nausea and vomiting, elevated liver function tests, and acute gout symptoms.
Blood sugar levels, blood pressure, and body temperature are not associated with
adverse effects of allopurinol.
 Question 30
1 out of 1 points
A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an
expectorant). What special instructions should the nurse include in the patient teaching for this
situation?
Response Special instructions need to be given to patients with diabetes when they are
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prescribed syrups. A diabetic patient needs to monitor glucose levels closely
because syrups contain high levels of sugars, which can cause elevated glucose
levels. Increased gastrointestinal tract infections are not directly related to diabetic
patients taking cough syrups. Noting the time that a medication is taken and good
hand-washing are always important, but are not specific considerations for a
diabetic patient taking cough syrup.
Thursday, July 7, 2016 9:26:01 AM EDT