 Question 1

1 out of 1 points
A nurse is performing patient education for a woman who has just been prescribed a
bisphosphonate. Which of the following diagnostic and history findings would have
prompted the woman's care provider to prescribe a bisphosphonate?
Response Bisphosphonate drugs are recommended for long-term management of
Feedback: hypercalcemia to increase bone resorption of calcium, in treating and
preventing osteoporosis in postmenopausal women, and in managing
Paget disease. Low bone density and a family history of osteoporosis
would consequently indicate a potential benefit. Impaired growth, cold
intolerance, and cognitive deficits are not indications for the use of
bisphosphonates.
 Question 2
1 out of 1 points
A woman who is in the second trimester of her first pregnancy has been experiencing
frequent headaches and has sought advice from her nurse practitioner about safe
treatment options. What analgesic can the nurse most safely recommend?
Response Feedback: Acetaminophen is the analgesic of choice during pregnancy.
 Question 3
1 out of 1 points
A nurse is discussing with a 58-year-old male patient the causes of erectile
dysfunction in men over 50 years of age. Which of the following will the nurse inform
the patient is the primary physical cause of erectile dysfunction of men in this age
group?
Response Vascular disease is the most common physical cause of erectile
Feedback: dysfunction. Atherosclerosis of the penile artery is the primary cause of
erectile dysfunction in more than half of men over age 50. Men with
diabetes are more prone to erectile dysfunction because of a
combination of vascular disease and neuropathy. A decrease in
testosterone levels is not a common cause of erectile dysfunction.
Emotional stress is not a physical factor.
 Question 4
1 out of 1 points
The nurse practitioner has recommended that a breast-feeding woman take her
prescribed medications just before her infant takes his longest nap of the day. The
woman does not understand and asks the nurse to explain. The nurse will tell the
woman that the recommendation was made to
Response One of the methods used to reduce neonatal drug exposure is to
Feedback: schedule drug therapy just after breast-feeding or before the infant goes
to sleep for several hours. A drug's half-life helps to determine when
breast-feeding can begin again. Assessing the blood concentration of
the drug and the drug's potential adverse effects helps to determine the
safest drug possible.
  Question 5
1 out of 1 points
After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her
husband have sought a referral to a fertility specialist in order to explore their options.
A nurse at the clinic should recognize that the woman may benefit from
Response Clomiphene is used in treating ovulatory failure in patients who want to
Feedback: become pregnant and have a fertile partner. Estrogen and progesterone
are contraindicated in women who may become pregnant and neither
drug increases the chance of conception. Mifepristone is used to end an
early pregnancy.
 Question 6
1 out of 1 points
A patient has acquired primary hypogonadism and has been prescribed testosterone
transdermal (Androderm) patches. When educating the patient on how to administer
the drug, the nurse will instruct him to
Response The patient should place the patch on the back, abdomen, upper arms,
Feedback: or thighs. He should not place it on the scrotum or on bony areas such
as the shoulder or the hip. The skin area should not be oily, damaged,
or irritated. The patch should stay in place for 7 days before
replacement.
 Question 7
1 out of 1 points
A 36-year-old woman with a history of dysmenorrhea has begun treatment with
progesterone, which she will be receiving by the intramuscular route. The nurse
participating in the woman's care should prioritize which of the following potential
nursing diagnoses?
Response Progesterone therapy carries risks of thrombotic events and vision
Feedback: loss. It is not associated with fluid loss, incontinence, or cognitive
changes.
 Question 8
1 out of 1 points
A 51-year-old female patient has been receiving doxorubicin (Adriamycin) for
metastatic breast cancer. Her medical record indicates she has cardiomyopathy and a
cumulative dose of 300 mg/m 2 of doxorubicin. Which of the following measures would
help limit the severity of the cardiomyopathy in this patient?
Response Dexrazoxane, a cardioprotectant, is recommended to reduce the
Feedback: severity and incidence of cardiomyopathy associated with doxorubicin
for women with metastatic breast cancer who received a cumulative
dose of 300 mg/m 2. Meticulous monitoring or multiplying daily doses
would not reduce the severity and incidence of cardiomyopathy as
effectively as using dexrazoxane, and reducing the dosage is not
advisable.
  Question 9
1 out of 1 points
A 36-year-old patient comes to the clinic and tells the nurse that she suspects that
she is pregnant. During the initial assessment, the nurse learns that the patient is
currently taking medications for diabetes, hypertension, and a seizure disorder. The
nurse would be most concerned about which of the following medications?
Response Most anticonvulsant drugs can have a teratogenic effect on the
Feedback: fetus. Dilantin can cause fetal hydantoin syndrome, which is
characterized by craniofacial abnormalities, limb defects, growth
deficiency, and mental deficiency. Insulin is not harmful in the pregnant
woman, since it cannot pass through to the placenta. Lasix is classified
as a category C drug, which indicates that animal studies have shown
an adverse effect on the fetus but there are no adequate studies in
humans. Advil is classified as a category B drug, which indicates that
animal studies have not demonstrated a risk to the fetus, but there are
no adequate studies in pregnant women during the first and second
trimesters of pregnancy. Advil is, however, considered a category D
drug during the third semester (there is evidence of human fetal risk).
 Question 10
1 out of 1 points
A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive
bladder. On a follow-up visit to the clinic, the nurse will question the patient about
which of the following?
Response Because a prominent anticholinergic effect is dry mouth, good oral
Feedback: hygiene is very important to prevent dental caries and gum disorders.
Dryness may be relieved with hard candies, chewing gum, or lip gloss.
Chronic diarrhea, headaches, and a special diet are not issues with this
drug.
 Question 11
1 out of 1 points
A patient is pregnant and is at 7 weeks' gestation. She has type 1 diabetes and has
been taking insulin since she was 13 years old. She asks the nurse if the insulin will
be harmful to her baby. The best response to the patient by the nurse would be
Response The best response would be to tell the patient that insulin is the drug of
Feedback: choice because it does not cross the placenta and reach the fetus.
Hyperglycemia is not associated with low birth weight. Telling the
patient's physician is also appropriate; however, the nurse can offer
information that can immediately allay the patient's concern.
 Question 12
1 out of 1 points
A 29-year-old pregnant patient is extremely upset about having to take medication for
a pre-existing medical condition. She is consumed with fear that her baby will be born
with a physical deformity or a congenital anomaly but knows that she has to take the
medication. She talks constantly about this and is unable to sleep most nights. Which
of the following is the most appropriate nursing diagnosis for this patient is?
Response The nurse has assessed that the patient is anxious and fearful that her
Feedback: baby will suffer because of her drug therapy. The nurse should work
with the mother to design a plan of care to help decrease the mother's
anxiety. Even though the other nursing diagnoses are plausible, the
most appropriate nursing diagnosis is anxiety related to perceived
danger of drug therapy to fetus or infant.
 Question 13
1 out of 1 points
A man has a demonstrated history of androgen deficiency and the consequences of
this health problem include an inability to maintain an erection. Which of the following
medications would best address this patient's erectile dysfunction (ED)?
Response Testosterone is used in treating erectile dysfunction and male
Feedback: climacteric symptoms when these conditions are secondary to
androgen deficiency. PDE5 inhibitors do not address ED secondary to
androgen deficiency. Tamsulosin is used to treat BPH.
 Question 14
1 out of 1 points
A 20-year-old woman will soon begin taking oral contraceptives for the first time. What
advice should the nurse provide to this patient?
Response An important nursing intervention is teaching about signs and symptoms
Feedback: of potential complications of estrogen and progestin contraceptives.
These may include headaches, vision changes or pain in the calves,
abdomen or chest and should be reported promptly. The use of oral
contraceptives does not preclude future pregnancy. There is not a 10 to
12 week time span between the initiation of oral contraceptives use and
the prevention of pregnancy.
 Question 15
1 out of 1 points
The nurse recognizes that the potential for teratogenic drug effects is not static
throughout the prenatal and postnatal periods. The potential for teratogenic effects is
highest during
Response The critical period of organogenesis, during which the major fetal
Feedback: organs form, is from implantation up to approximately day 58 to 60 after
conception. If drugs that cause teratogenic effects are administered
during this period, major malformations of fetal organ systems may
result.
 Question 16
1 out of 1 points
A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is
perspiring and her blood pressure is 88/50. The serum magnesium level is 10 mg/dL.
The nurse will interpret these manifestations as
Response Maternal adverse effects from magnesium sulfate toxicity are sweating,
Feedback: hypotension, flaccid paralysis, hypothermia, and cardiac depression. A
serum level of 10 to 12 mg/dL is associated with toxicity (normal levels
without infusion of magnesium sulfate are 1.8–3 mg/dL). Common
adverse effects include headache, hyporeflexia, weakness, thirst,
flushing, and burning at the infusion site. These manifestations do not
indicate hypersensitivity or idiosyncratic reactions.
 Question 17
1 out of 1 points
Alprostadil (Caverject), a drug used to treat erectile dysfunction, has been prescribed
to a 42-year-old patient. When providing education to the patient and his wife, the
nurse should inform the wife about which of the following adverse effects?
Response Vaginal burning, itching, or both can occur in the female partner of a
Feedback: man using intraurethral alprostadil. The nurse will advise the wife to be
aware that this is a possibility. The pharmacodynamics of alprostadil
may lead to hemodynamic changes such as low blood pressure and
increased heart rate in the man. However, these changes are not
clinically important and would not affect the female partner. The drug is
not known to decrease sexual desire in either men or women.
 Question 18
1 out of 1 points
A nurse is explaining to a pregnant 21-year-old college student why she cannot
continue to take ibuprofen (Advil) for her headaches. The nurse draws a picture
depicting drug molecules crossing the placental membrane and entering into the fetal
circulation. The nurse tells the patient that the main reason this happens is because
Response Drugs may compete with the hormones of pregnancy for albumin-
Feedback: binding sites, which may result in a larger amount of unbound (or free)
drug in circulation, leaving the drug available to cross the placental
membrane and enter the fetal circulation. A drug does not enter the fetal
circulation as a direct result of increases in blood volume and heart rate
or the occurrence of hemodilution.
 Question 19
1 out of 1 points
A male patient is experiencing climacteric symptoms secondary to androgen
deficiency. His physician has prescribed testosterone. The nursing assessment
reveals that the patient has had a myocardial infarction. The combination of
testosterone therapy and a history of myocardial infarction would place that patient at
a significantly higher risk of
Response A patient who has had a myocardial infarction and is prescribed
Feedback: testosterone is at a significantly higher risk for hypercholesterolemia.
Patients taking testosterone are also at increased risk for prostate
cancer and acute urethral obstruction; however, these risks are less
significant. Gynecomastia is simply a side effect of the drug.
  Question 20
1 out of 1 points
A nurse is providing patient education to a 23-year-old woman who is starting the
norelgestromin/ethinyl estradiol transdermal system (Ortho Evra). Because this is the
patient's first time to use the birth control patch, the nurse will instruct her to apply the
patch
Response The first time a woman uses the norelgestromin/ethinyl estradiol
Feedback: transdermal system, she should start it after her menstrual period
begins. She can choose to apply the first patch either the day her period
starts or the following Sunday. If she chooses the Sunday after the start
of her period, she needs to use backup contraception for the first week
of her first cycle.
 Question 21
1 out of 1 points
A nurse is working with a 16-year-old pregnant teen and assessing for behavior that
may put the baby at risk. The most important assessment the nurse can make is
Response Adolescents are prone to experimentation with various substances,
Feedback: both legal and nonlegal; assessments related to this phenomenon are
important during pregnancy. Insurance coverage, exercise, and dietary
habits are considered less important.
 Question 22
1 out of 1 points
A 20-year-old woman has been prescribed estrogen. As with all women taking
estrogen, the nurse will carefully monitor the patient for which of the following?
Response Women taking estrogen are at an increased risk of cardiovascular
Feedback: complications, along with ovarian and breast cancer. Early epiphyseal
closure is a condition the nurse would watch for in a prepubescent girl
who takes estrogen. Diminished libido and lack of secondary sexual
characteristics are not identified adverse effects of estrogen.
 Question 23
1 out of 1 points
A female patient has been prescribed estrogen therapy. Which of the following will the
nurse advise the patient is a common adverse effect of estrogen therapy?
Response The nurse will advise the patient that common adverse effects include
Feedback: breakthrough bleeding, changes in menstrual flow, dysmenorrhea,
premenstrual-like syndrome, headache, nausea and vomiting, bloating,
abdominal cramps, chloasma, and photosensitivity. Migraine
headaches, dizziness, and changes in libido are less common adverse
effects.
 Question 24
1 out of 1 points
A patient is being discharged from the hospital and will be taking oxybutynin
(Ditropan) for overactive bladder. The nurse will instruct the patient that she will be
taking a medication
Response Oxybutynin is available as a transdermal patch and causes dry mouth
Feedback: approximately 60% of patients. The drug is not noted to cause
palpitations or lightheadedness and it is not administered as an IM
injection.
 Question 25
1 out of 1 points
A woman is receiving prolonged drug therapy during her complicated pregnancy, and
it may pose a risk to both the mother and the fetus. The primary care physician has
made dosage adjustments to minimize adverse effects and prevent toxicity. The
nurse should make sure
Response If prolonged drug use is necessary and poses a risk to the woman or the
Feedback: fetus, the pregnant woman and the fetus need to be monitored for both
therapeutic and adverse effects of drug therapy. Serum levels of the
drug should be monitored to detect elevations that may lead to adverse
effects and the need for dosage adjustments. The FDA would not need
to be informed that the woman is receiving drug therapy. At this point,
with the patient already taking the drug, it is not necessary to check the
FDA category of the drug. The use of nonpharmacologic alternatives is
a good idea but would not be as critical as monitoring drug levels.
 Question 26
1 out of 1 points
A male patient with a medical background tells the nurse that he is not satisfied with
the oral synthetic testosterone that has been prescribed for him and he would like to
try a natural form of oral testosterone. Which of the following would be an appropriate
response by the nurse?
Response Natural testosterone undergoes a high first-pass effect and is therefore
Feedback: not used orally. The form of testosterone that is used orally is a
synthetic androgen that is less extensively metabolized and has a
longer half-life than natural testosterones. Natural testosterone does not
pose a higher risk of gynecomastia.
 Question 27
1 out of 1 points
A 54-year-old woman with a history of osteoporosis has been prescribed ciprofloxacin
for recurrent cystitis. Because of the patient's history, the nurse would be sure to
discuss with the woman the use of
Response Patients who take ciprofloxacin should avoid taking the drug with food
Feedback: that contains iron, calcium, magnesium, and other cations because the
presence of these elements may reduce the bioavailability of
ciprofloxacin. Because the woman has a history of osteoporosis, she is
very likely taking a calcium supplement. Alcohol and nicotine should be
avoided while on any drug therapy. Grapefruit juice is not known to
 interact with ciprofloxacin.
 Question 28
1 out of 1 points
A patient is taking etoposide for a testicular tumor refractory to treatment. The nursing
assessment reveals that he is also taking warfarin. The nurse must carefully monitor
for which of the following?
Response In a patient receiving warfarin concomitantly with etoposide,
Feedback: prothrombin time can become elevated and place the patient at an
increased risk of bleeding. The heart rate, drug serum levels, and liver
enzymes are not affected by concomitant use of warfarin.
 Question 29
1 out of 1 points
A female patient is taking oral cyclophosphamide therapy for breast cancer. Because
of possible adverse effects of the drug, the nurse will instruct the patient to do which
of the following?
Response An adverse effect of this drug is the incidence of hemorrhagic cystitis.
Feedback: The nurse should encourage the patient to drink at least 2 liters of fluid
a day and, in high-dose therapy, administer the uroprotectant agent
mesna. Therapy should include prehydrating the patient orally and
intravenously with at least 2 liters of normal saline solution. Potassium
and magnesium additives may be indicated. The nurse will monitor
urine output vigilantly to ensure an output of at least half of the intake.
Taking the medication at bedtime and increasing protein in her diet are
not associated with limiting the possible adverse effects of the drug.
 Question 30
1 out of 1 points
A nurse is caring for a patient who is at 28 weeks' gestation and is receiving
terbutaline (Brethine) to control preterm labor. Which of the following assessment
parameters should the nurse prioritize?
Response When a patient is taking terbutaline, the nurse should closely monitor
Feedback: the maternal heart rate, the FHR, and the maternal blood pressure and
fluid status. The fetal position may be determined to assess the chances
of successful delivery and the need to induce labor, but is not related to
taking terbutaline.
 Question 31
1 out of 1 points
Alendronate (Fosamax) is prescribed for a 67-year-old postmenopausal woman. In
order to help prevent gastrointestinal distress, the nurse will advise the patient to
Response To decrease gastrointestinal distress, the patient should stand or sit
Feedback: upright for at least 30 minutes after taking the drug. Drinking at least 6 to
8 oz of water with the drug helps maximize the therapeutic effect of the
drug. The patient should also take calcium and vitamin D supplements
 along with lifting weights to improve the success of therapy, but these
interventions would not directly serve to decrease gastrointestinal
distress.
 Question 32
1 out of 1 points
A nurse is instructing a 19-year-old female patient on the use of fluconazole for
candida vaginitis. A teaching priority will be to
Response A teaching priority would be to tell the patient to use another form of
Feedback: birth control if she was taking an oral contraceptive. Fluconazole may
decrease the effectiveness of oral contraceptives. Taking an antiemetic
or antidiarrheal for adverse GI effects would be an appropriate
instruction for this drug. The nurse should also instruct the patient to
take aspirin instead of acetaminophen for relief of minor discomforts
because acetaminophen has the potential to damage the liver and
kidneys. Taking the drug with food is recommended if the patient
experiences GI distress. All of these instructions are important, but not
as important as making sure that the patient does not inadvertently
become pregnant while on the medication.
 Question 33
1 out of 1 points
A male patient is trying to decide if he should use finasteride (Proscar) to treat benign
prostatic hypertrophy (BPH). When providing information about the drug, the nurse
will include which of the following as a risk associated with finasteride therapy?
Response Adverse effects are usually uncommon with finasteride therapy.
Feedback: However, there is a risk of sexual dysfunction related to the use of the
drug. Excess fluid volume related to potential effects of drug therapy
and hypercalcemia related to drug therapy, immobility, and breast
cancer are risks associated with testosterone therapy. Finasteride does
not present a risk of neoplasms.
 Question 34
1 out of 1 points
A nurse is working with a patient in the clinic who has erectile dysfunction. The patient
has been prescribed sildenafil (Viagra). The patient wants to do everything he can to
promote effectiveness of the drug. The nurse will instruct him to
Response Maximum plasma concentrations of sildenafil are reached within 30 to
Feedback: 120 minutes of oral dosing when taken on an empty stomach. The most
frequent peak time is 60 minutes. However, when the drug is taken with
a high-fat meal, absorption is slow and 60 extra minutes are needed to
reach peak plasma levels. A high-fat meal reduces peak serum
concentrations by 29%. Therefore, the patient should be advised to
avoid high-fat meals when ingesting the drug. Avoiding a high-protein
meal or drinking fluids will not help achieve quick effects from the drug.
It is not advisable to increase the dosage of the drug without consulting
 the prescriber.
 Question 35
1 out of 1 points
A nurse is providing patient education to a 50-year-old woman who is taking
methotrexate (MTX) for breast cancer. The nurse will instruct the patient to avoid
which of the following drugs?
Response Because MTX is secreted by the renal tubules, certain drugs that follow
Feedback: the same pathway, such as salicylates, sulfonamides, phenytoin, and
penicillin, may compete with MTX excretion, resulting in accumulation
and increased toxicity. Therefore, if these drugs cannot be avoided, they
should be discontinued 2 days before and restarted 2 days after MTX
therapy. Acetaminophen, furosemide, and digoxin do not cause drug–
drug interactions with MTX.
 Question 36
1 out of 1 points
A pregnant patient who has diabetes has been admitted to the hospital to begin labor.
Since the patient has diabetes, the physician has decided to use oxytocin (Pitocin) to
initiate labor contractions. When talking to the patient about the adverse effects of the
drug, the nurse should understand that the most common adverse effects of the drug
include
Response Adverse effects of oxytocin are dose related and take two forms—
Feedback: maternal and fetal. The most common maternal adverse effects are
nausea, vomiting, uterine tachysystole, and cardiac arrhythmias. Less
common but potentially fatal are severe water intoxication and
hyponatremia.
 Question 37
1 out of 1 points
A nurse is working in a women's hospital where she is caring for a new mother who is
experiencing postpartum urinary retention. Bethanechol (Urecholine) has been
ordered. The nurse will observe for which of the following?
Response The nurse will monitor the patient's blood pressure for possible
Feedback: hypertension. Adverse effects of bethanechol are the same as with
pilocarpine, which are hypertension, tachycardia, bronchiolar spasm,
pulmonary edema, salivation, sweating, and nausea and vomiting.
Bradycardia and decreased salivation are not identified adverse effects.
If the drug is taken with a ganglionic blocking agent, a decrease in blood
pressure could result.
 Question 38
1 out of 1 points
A 73-year-old woman has osteoporosis and is prescribed alendronate. She takes
calcium and vitamin D supplements, drinks lots of water, and has just quit smoking.
The nurse should advise the patient to also
Response The patient should be encouraged to exercise and lift light weights as
Feedback: often as she can to increase bone density. It is also important to have
adequate amounts of vitamin C in her diet, but it would not be directly
related to this therapy. Drinking at least 6 to 8 oz of milk daily is a good
idea, but she is already taking a calcium and vitamin D supplement.
There is no identified adverse relationship between artificial sweeteners
and alendronate therapy.
 Question 39
1 out of 1 points
A 68-year-old man is being treated for benign prostatic hypertrophy (BPH) and began
treatment with finasteride (Proscar) 3 months ago. When planning the care of this
patient, what desired outcome should the nurse prioritize?
Response The primary goal of treatment with finasteride is to facilitate complete
Feedback: bladder emptying, resulting in less urgency and decreased frequency of
voiding. Urethral pain, sexual side effects, and hematuria are possible
but less commonly associated with BPH. Consequently, outcomes
relating to bladder emptying would be prioritized.
 Question 40
1 out of 1 points
A nurse practitioner is reviewing the prepregnancy medication regimen of a patient
who has just had a positive pregnancy test. The nurse should be aware of which of
the following changes in pharmacokinetics that accompanies pregnancy?
Response The hemodynamic changes during pregnancy, such as increased blood
Feedback: volume and heart rate, increase the distribution of drugs. GFR and tidal
volume both typically increase during pregnancy, resulting in increased
excretion rates and increased absorption of inhaled drugs, respectively.
Drug metabolism is not affected by pregnancy.
 Question 41
0 out of 0 points
When completing this quiz, did you comply with Walden University’s Code of Conduct
including the expectations for academic integrity?

Tuesday, July 30, 2019 8:43:47 PM EDT

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