Question 1

The client with an infected leg wound that is draining purulent material has a prescription for sodium hypochlorite (Dakin solution) to be used in the care of the wound. The nurse would do which of the following while using this solution?

Accepted Answer

Sodium hypochlorite (Dakin solution) can be irritating to healthy tissue, so it should be rinsed off immediately following irrigation to prevent damage to surrounding skin.

Question 2

An adolescent client with severe cystic acne has been prescribed isotretinoin (Accutane). Which statement by the client would suggest the need for further teaching?

Accepted Answer

Isotretinoin (Accutane) is a derivative of vitamin A, and taking additional vitamin A supplements can increase the risk of vitamin A toxicity. Patients are advised not to take vitamin A supplements while on isotretinoin.

Question 3

An ambulatory care client with allergic dermatitis has been given a prescription for a tube of diphenhydramine (Benadryl) 1% to use as a topical agent. The nurse determines that the medication was effective if which of the following was assessed?

Accepted Answer

Diphenhydramine (Benadryl) is an antihistamine used to relieve symptoms of allergy, hay fever, and the common cold. When used topically, as in this case, it is effective in reducing symptoms such as itching and urticaria (hives), which are common in allergic dermatitis. Nighttime sedation is more associated with oral or systemic use, not topical. Absence of ecchymoses (bruises) and healing of burned tissue are not directly related to the use of topical diphenhydramine.

Question 4

The client with cancer has received a course of chemotherapy and received fluorouracil (Adrucil). The nurse should plan to tell the client to report which of the following immediately?

Accepted Answer

Stomatitis and diarrhea are common side effects of fluorouracil (Adrucil) that can indicate severe adverse reactions. These symptoms can lead to significant complications, such as dehydration and infection, and therefore should be reported immediately to healthcare providers for appropriate management.

Question 5

The nurse reviewing a medical record notes that high concentrations of methotrexate followed by leucovorin (citrovorum factor, folic acid) are being given to the client with cancer. The nurse correctly interprets that the reason for therapy with leucovorin is to:

Accepted Answer

Leucovorin is given after high doses of methotrexate to "rescue" normal cells by providing them with a necessary folate, thereby reducing the toxic effects of methotrexate on these cells without diminishing its effect on cancer cells.

Question 6

The nurse understands that an indication for the use of asparaginase (Elspar) is:

Accepted Answer

Asparaginase (Elspar) is specifically used in the treatment of acute lymphocytic leukemia (ALL) because it targets the leukemia cells' metabolism, depriving them of the essential amino acid asparagine, which these cells cannot synthesize on their own.

Question 7

The nurse is caring for a client on the oncology unit who has developed stomatitis during chemotherapy. The nurse would plan which of the following measures to treat this complication?

Accepted Answer

Rinsing the mouth with diluted baking soda or saline is a recommended measure to treat stomatitis, as it can help clean the mouth gently without causing further irritation to the sores. Lemon and glycerin swabs can actually worsen the condition by drying and irritating the oral mucosa. Placing the client on NPO status does not directly address the care of the oral lesions and could impact nutritional status. Regular oral hygiene is important, but brushing teeth and using nonwaxed dental floss might be too harsh for someone with stomatitis, so softer oral care measures are recommended.

Question 8

The client who has been diagnosed with cancer is to receive chemotherapy with both cisplatin (Platinol-AQ) and vincristine (Oncovin). The client asks the nurse why both medications must be given together. The nurse's response is based on the understanding that the purpose of using both medications is to:

Accepted Answer

The combination of different chemotherapy drugs, such as cisplatin and vincristine, is used to increase the destruction of tumor cells. Each drug targets the cancer cells in a different way, making the treatment more effective against the tumor.

Question 9

The nurse tells the client with leukemia who is receiving chemotherapy that allopurinol (Zyloprim) has been added to the medication list. When the client asks the purpose of the new medication, the nurse responds that the allopurinol is intended to preven:

Accepted Answer

Allopurinol is used to prevent hyperuricemia, which can occur during chemotherapy for leukemia due to the rapid breakdown of cancer cells releasing uric acid.

Question 10

The client with breast cancer has been given a prescription for cyclophosphamide (Cytoxan). The nurse determines that the client understands the proper use of the medication if the client states that he or she will:

Accepted Answer

Cyclophosphamide (Cytoxan) can cause hemorrhagic cystitis, a condition where the bladder lining is inflamed and can lead to bleeding. Increasing fluid intake to 2 to 3 liters per day helps flush the bladder and reduce the risk of this side effect.

Question 11

The nurse should be prepared to institute bleeding precautions in the client receiving antineoplastic medication if which of the following results were reported from the lab?

Accepted Answer

The answer of The nurse should be prepared to institute...

Question 12

The client with cancer is about to be started on mitomycin (Mutamycin). The nurse should suggest contacting the physician after noting that the client is also taking which of the following medications?

Accepted Answer

Warfarin (Coumadin) can interact with mitomycin, increasing the risk of bleeding. Mitomycin can have hematologic effects, and when combined with an anticoagulant like warfarin, it may enhance the anticoagulant effect, leading to an increased risk of bleeding. This potential interaction necessitates close monitoring or adjustment of therapy.

Question 13

A client with diabetes mellitus taking daily NPH insulin has been started on therapy with dexamethasone (Decadron). The nurse anticipates that which of the following adjustments in medication dosage will be made?

Accepted Answer

Dexamethasone, like other corticosteroids, can increase blood glucose levels. Therefore, a patient with diabetes may require an increased dose of insulin to maintain glycemic control.

Question 14

The nurse monitors the blood glucose level of the client who received NPH insulin at 7 AM with an understanding that the client may experience a hypoglycemic reaction between:

Accepted Answer

NPH insulin is an intermediate-acting insulin with an onset of 1 to 2 hours, a peak of 4 to 12 hours, and a duration of 18 to 24 hours. Therefore, a hypoglycemic reaction is most likely to occur during its peak time, which would be between 1 to 7 PM if administered at 7 AM.

Question 15

The nurse evaluates that the family of a client newly diagnosed with diabetes mellitus correctly understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat:

Accepted Answer

Glucagon is used to treat severe hypoglycemia (low blood sugar) that can occur in individuals with diabetes, particularly those on insulin therapy. It works by stimulating the liver to release stored glucose into the bloodstream, thereby raising blood sugar levels. It is not used to treat diabetic ketoacidosis or hyperglycemia, which require different management approaches.

Question 16

The nurse is teaching a client with hyperthyroidism regarding the prescribed medication propylthiouracil (PTU). The nurse determines that teaching has been successful if the client states that he will report which of the following symptoms to the physician?

Accepted Answer

Fever can indicate agranulocytosis, a potentially life-threatening side effect of propylthiouracil (PTU), which requires immediate medical attention.

Question 17

The nurse teaches the client with hypocalcemia to take calcium carbonate (Os-Cal) at which time?

Accepted Answer

Calcium carbonate is best absorbed when taken with food, but taking it one hour after a meal can help maximize absorption and reduce the risk of gastrointestinal side effects.

Question 18

The nurse teaches the client being discharged to home with a prescription for a daily dose of prednisone to take the medication:

Accepted Answer

Prednisone mimics the natural hormone cortisol, which is highest in the early morning. Taking prednisone in the early morning helps align with the body's natural cortisol cycle, potentially reducing side effects and improving effectiveness.

Question 19

The nurse monitors the client taking octreotide acetate (Sandostatin) for acromegaly for which most frequent side effect of this medication?

Accepted Answer

Diarrhea is the most frequent side effect of octreotide acetate (Sandostatin), which is used in the treatment of acromegaly.

Question 20

A client with a history of coronary artery disease has developed diabetes insipidus as a result of cranial surgery. The client's medication therapy will include vasopressin (Pitressin). The nurse monitors this client most carefully for which of the following sign/ symptom that indicates an adverse effect of this medication?

Accepted Answer

Vasopressin (Pitressin) can cause vasoconstriction, which might lead to chest pain, especially in clients with a history of coronary artery disease. This is because the increased vasoconstriction can exacerbate underlying coronary artery conditions by reducing blood flow to the heart muscle, potentially leading to angina or other cardiac complications.

Quiz 7: Pharmacology

The client with an infected leg wound that is draining purulent material has a prescription for sodium hypochlorite (Dakin solution) to be used in the care of the wound. The nurse would do which of the following while using this solution?

An adolescent client with severe cystic acne has been prescribed isotretinoin (Accutane) . Which statement by the client would suggest the need for further teaching?

An ambulatory care client with allergic dermatitis has been given a prescription for a tube of diphenhydramine (Benadryl) 1% to use as a topical agent. The nurse determines that the medication was effective if which of the following was assessed?

The client with cancer has received a course of chemotherapy and received fluorouracil (Adrucil) . The nurse should plan to tell the client to report which of the following immediately?