Question 1

The nurse receives a call from a patient who recently began taking Zyrtec (cetirizine) 5 mg daily. The patient reports that her mouth frequently feels dry. Which of the following responses by the nurse is best?

Accepted Answer

Dry mouth is a known side effect of Zyrtec, and the nurse's response provides practical suggestions for managing the side effect. The suggestion to rinse the mouth frequently and use sugarless chewing gum or candy is evidence-based and non-pharmacological, making it an appropriate interventions to recommend. Option B is not correct as the patient is taking the correct dose, so halving the pill is not necessary. Option C is not the best choice as the patient's symptom is not indicative of an allergic reaction. Option D is not the best choice as although it is important to take the medication with a full meal and drink sufficient water, it is unlikely to alleviate the dry mouth side effect.

Question 2

The nurse is tracking patient symptoms related to acute alcohol intoxication and withdrawal. Which of the following medications would the nurse expect to provide in the management of these symptoms?

Accepted Answer

Tranxene (clorazepate) is a benzodiazepine that can be used to manage symptoms related to acute alcohol intoxication and withdrawal, including anxiety, agitation, and seizures. Plavix (clopidogrel) is an antiplatelet medication used to prevent and treat blood clots in patients with a history of heart attack or stroke. Zyban (bupropion) is an antidepressant medication used to treat depression and also for smoking cessation. Prilosec (omeprazole) is a proton pump inhibitor used to treat gastroesophageal reflux disease (GERD) and other acid-related conditions.

Question 3

While providing care for patients on a neuroscience unit, which of the following medications should the nurse provide first?

Accepted Answer

Dantrium (dantrolene) is a medication used to treat malignant hyperthermia, a life-threatening condition that can occur during anesthesia. It is important to administer this medication first to prevent complications and potentially save the patient's life. Norpramin (desipramine) is a tricyclic antidepressant and is not a priority medication for a patient admitted with syncope. Enablex (darifenacin) is used to treat overactive bladder and would not be a priority medication for a patient with cerebrovascular accident. Cymbalta (duloxetine) is an antidepressant and is not a priority medication for a patient with diabetes.

Question 4

The nurse is preparing to provide medications for a patient newly admitted with a cerebral vascular accident who reportedly had difficulty swallowing pills during the previous shift. The nurse plans to crush the patient's medications and provide them in applesauce. Which of the following medications will require an alternative form of administration?

Accepted Answer

Enablex (darifenacin-XR) is an extended-release medication and should not be crushed as it may alter the medication's release and absorption properties. It should be administered whole. The other medications listed can be crushed and given in applesauce.

Question 5

The nurse is caring for a patient with a history of Parkinson disease who recently started taking Comtan (entacapone). The nurse notes the patient's urine has a brownish-orange discoloration. Which of the following actions should the nurse take next?

Accepted Answer

Brownish-orange discoloration of the urine is a known and harmless side effect of entacapone (Comtan), a medication used in the treatment of Parkinson's disease. It does not indicate harm or require a change in treatment, so the nurse should document the finding in the patient's chart.

Question 6

The nurse is counseling a patient started on Zithromax (azithromycin) for the treatment of an upper respiratory infection. The nurse recognizes that teaching has been effective by which of the following patient statements?

Accepted Answer

CA) Zithromax (azithromycin) is often prescribed as a 5-day course, with the patient taking one pill per day, which aligns with the patient's understanding in this statement.C) Azithromycin can start working within a few days, but symptoms might not clear immediately. The patient's understanding that symptoms may not clear for 3 days indicates an understanding of how the medication works.

Question 7

The nurse is transcribing new orders for a patient with multiple sclerosis. Amrix (cyclobenzaprine) 10 mg orally three times daily has been ordered. Which of the following would require an immediate intervention by the nurse?

Accepted Answer

Nardil is a monoamine oxidase inhibitor (MAOI), and cyclobenzaprine should not be given to patients taking MAOIs due to the risk of serotonin syndrome. The nurse should immediately notify the provider and hold the medication until further clarification is obtained. Allergies to acetaminophen, family history of breast cancer, and diabetes are not contraindications for cyclobenzaprine.

Question 8

The nurse is providing care for a patient who returned from surgery 4 hr earlier. The patient reports adequate pain control with the use of patient-controlled analgesia but states she is having significant nausea. Which of the following medications should the nurse provide?

Accepted Answer

Inapsine (droperidol) is an antiemetic medication commonly used for post-operative nausea and vomiting. Benadryl (diphenhydramine) is an antihistamine and is not commonly used for nausea control. Morphine (morphine sulfate) is a pain medication and would not address the patient's nausea. Colace (docusate sodium) is a stool softener and would not address the patient's nausea.

Question 9

The nurse is instructing the parent of a 6-year-old patient recently started on a ProAir HFA (albuterol) inhaler for exercise-induced asthma. The nurse recognizes that further teaching is necessary by which of the following client statements?

Accepted Answer

The statement "He can use the inhaler as many times during football practice as he needs it" indicates a lack of understanding about the appropriate use of albuterol. The medication should not be overused and should only be taken as directed by a healthcare provider. The other statements demonstrate understanding of potential side effects and proper dosing.

Question 10

The nurse is counseling a patient with diabetes, hypertension, and chronic obstructive pulmonary disease on his medications. To verify patient understanding of his medications, the nurse states, "You are taking Cymbalta (duloxetine) 60 mg once a day; do you know why you take that medication?" The nurse determines the patient has a good understanding of his medications if which of the following responses is given?

Accepted Answer

Cymbalta (duloxetine) is often prescribed for diabetic neuropathy, which can cause pain in the feet among patients with diabetes. This response indicates the patient understands the purpose of this medication in the context of his condition.

Question 11

A young woman reports to the emergency department with frank vaginal bleeding and a stated history of being 10 wk pregnant. Ultrasound confirms an incomplete miscarriage, and the woman is scheduled for a dilatation and curettage. Which of the following medications should the nurse anticipate being provided after the surgical procedure?

Accepted Answer

Methergine (methylergonovine) is a medication that helps to promote uterine contractions and prevent excessive bleeding in the postoperative period after a dilatation and curettage for an incomplete miscarriage. Rheumatrex (methotrexate) is a medication used to terminate ectopic pregnancies, but it is not appropriate in this case as the miscarriage has already occurred. Magnesium sulfate is used to prevent seizures in cases of preeclampsia or eclampsia, which is not relevant to this scenario. Terbutaline is a medication used to prevent or stop preterm labor, which is also not relevant to this scenario.

Question 12

The nurse prepares to provide Colcrys (colchicine) to a patient. The nurse should assess which of the following prior to administration of the medication?

Accepted Answer

Prior to administration of Colcrys, the nurse should assess the patient's complete blood count (CBC) to monitor for potential side effects such as bone marrow suppression. Blood pressure, triglyceride level, and oxygen saturation are not directly related to the administration of Colcrys.

Question 13

While caring for a patient in hospice who is actively dying, the nurse notes moderate respiratory distress, copious oral secretion, and a frequent moist cough. Which of the following prn medications would most promote comfort for the patient?

Accepted Answer

Atropine can help reduce oral secretions and alleviate respiratory distress, promoting comfort for the patient.

Question 14

The home-care nurse is preparing to see a patient being treated for diabetic foot ulcerations with Regranex (becaplermin). Which of the following instructions will the nurse include in the patient teaching?

Accepted Answer

Regranex (becaplermin) should be stored in the refrigerator to maintain its effectiveness.

Question 15

The nurse is caring for a patient with otitis media who reports an allergy to penicillin. Orders are received for ampicillin 500 mg every 8 hr. Which of the following actions by the nurse is best?

Accepted Answer

Ampicillin is a type of penicillin, so giving it to a patient with a penicillin allergy could cause an allergic reaction. The best action is to hold the medication and consult with the healthcare provider for an alternative.

Question 16

The nurse is providing care for a patient scheduled to take Precose (acarbose) 25 mg three times daily with meals. The patient reports feeling sweaty, weak, and tremulous. Which of the following actions by the nurse is best?

Accepted Answer

The patient's symptoms (sweating, weakness, tremulousness) suggest hypoglycemia (low blood sugar). Precose is a medication used to treat diabetes by slowing down the digestion of carbohydrates, which can lead to hypoglycemia if not taken correctly. Checking the patient's blood glucose level is the priority action and will provide important information about whether the symptoms are related to the medication. Reassurance may be appropriate if the symptoms are mild and expected side effects, but should not be the first response. Reporting an adverse drug reaction to the pharmacy may be necessary, but is not the priority at this time. Anemia is not related to the symptoms described, so determining the patient's history of anemia is not the priority action.

Question 17

The nurse receives orders to begin Cardura (doxazosin) 1 mg daily with the first dose to start today. Which of the following assessments is the highest priority within the first 2 to 4 hr after provision?

Accepted Answer

The highest priority assessment within 2 to 4 hours after provision of Cardura is orthostatic hypotension. Cardura is an alpha-1 blocker used to treat hypertension and benign prostatic hyperplasia, and it can cause sudden drops in blood pressure, especially when standing up from a seated or lying position. Therefore, monitoring for orthostatic hypotension is crucial in the first few hours after administration. Urinary output, respiratory rate, and pain relief are important assessments, but they are not as high a priority as monitoring for a potential adverse reaction to the medication.

Question 18

While responding to a rapid response called on the cardiac step-down unit, the nurse from intensive care observes the unit nurse massaging a patient's neck and instructing the patient to bear down. Which of the following medications will most likely be used if the patient's pulse does not return to normal?

Accepted Answer

The nurse is performing a carotid sinus massage and instructing the patient to perform the Valsalva maneuver, both of which are non-pharmacological interventions to terminate supraventricular tachycardia (SVT). If these maneuvers do not return the pulse to normal, Adenocard (adenosine) is the medication of choice for pharmacologically converting SVT to a normal sinus rhythm.

Question 19

The nurse is caring for a patient who takes Dexedrine (dextroamphetamine). The nurse should be most concerned by which of the following patient statements?

Accepted Answer

St. John's wort is an herbal supplement that has been shown to interact with many medications, including Dexedrine. Taking these two together can increase the risk of serotonin syndrome, which can lead to serious complications such as seizures and organ failure. The patient should be advised to speak with their healthcare provider before taking any new medications or supplements while on Dexedrine. Choices A and B are common side effects of Dexedrine and can usually be managed with proper dosing and timing. Choice D is a minor deviation from the patient's normal medication schedule and is unlikely to cause harm.

Question 20

While providing care for an adolescent patient newly prescribed Elavil (amitriptyline), the nurse should be most concerned by which of the following patient statements?

Accepted Answer

This statement suggests that the patient may be experiencing increased depression or suicidal ideation, which is a serious concern and requires immediate follow-up by the healthcare provider. The other statements are common side effects of Elavil, such as dry mouth and drowsiness, or a normal behavior like drinking coffee.

Davis's Drug Guide for Nurses Test 1