1) A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level
is 13 mg/dL. Which medication should the
... [Show More] nurse prepare to administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D Correct Answer- 3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium
gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a
result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin,
a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the
serum calcium concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse
instructs the mother to administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice Correct Answer- 4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer
the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the
iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple
juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client,
knowing that which of the following would indicate the presence of systemic toxicity from this
medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations Correct Answer- 1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms
include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not
associated with salicylism.
4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The
nurse reminds the children that chemical sunscreens are most effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun Correct Answer- 4. At least 30 minutes before
exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they
can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the
medication, the client complains of local discomfort and burning. Which of the following is the most
appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site Correct Answer- 3. Informing the client that
this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to treat
burns to reduce bacteria present in avascular tissues. The client should be informed that the medication
will cause local discomfort and burning and that this is a normal reaction; therefore options 1, 2, and 4
are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury.
The nurse monitors the client, knowing that which of the following indicates that a systemic effect has
occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site Correct Answer- 1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby
causing acidosis. Clients receiving this treatment should be monitored for signs of an acid-base
imbalance (hyperventilation). If this occurs, the medication should be discontinued for 1 to 2 days.
Options 3 and 4 describe local rather than systemic effects. An elevated blood pressure may be
expected from the pain that occurs with a burn injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication,
the nurse anticipates that which laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count Correct Answer- 2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before
treatment and periodically thereafter until the effect on the triglycerides has been evaluated. Options 1,
3, and 4 do not need to be monitored specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes
isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is
taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) Correct Answer- 1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin
toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued
before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for
the potential for increased systemic absorption of the medication if the medication were being applied
to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands Correct Answer- 2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions
where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower
from regions in which permeability is poor (back, palms, soles).
10.) The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is
taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the
client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex Correct Answer- 1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to work by
suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes.
Options 2, 3, and 4 are incorrect.
11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partialthickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing
information to the client about the medication. Which statement made by the client indicates a lack of
understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the wound." Correct Answer- 3. "The medication will
permanently stain my skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against gramnegative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to assist in
healing. It does not stain the skin.
12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic
medication. During the infusion, the client complains of pain at the insertion site. During an inspection
of the site, the nurse notes redness and swelling and that the rate of infusion of the medication has
slowed. The nurse should take which appropriate action?
1. Notify the registered nurse.
2. Administer pain medication to reduce the discomfort.
3. Apply ice and maintain the infusion rate, as prescribed.
4. Elevate the extremity of the IV site, and slow the infusion. Correct Answer- 1. Notify the registered
nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via IV, great care must be
taken to prevent the medication from escaping into the tissues surrounding the injection site, because
pain, tissue damage, and necrosis can result. The nurse monitors for signs of extravasation, such as
redness or swelling at the insertion site and a decreased infusion rate. If extravasation occurs, the
registered nurse needs to be notified; he or she will then contact the health care provider.
13.) The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The
nurse caring for the client anticipates that which diagnostic study will be prescribed?
1. Echocardiography
2. Electrocardiography
3. Cervical radiography
4. Pulmonary function studies Correct Answer- 4. Pulmonary function studies
Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can cause interstitial
pneumonitis, which can progress to pulmonary fibrosis. Pulmonary function studies along with
hematological, hepatic, and renal function tests need to be monitored. The nurse needs to monitor lung
sounds for dyspnea and crackles, which indicate pulmonary toxicity. The medication needs to be
discontinued immediately if pulmonary toxicity occurs. Options 1, 2, and 3 are unrelated to the specific
use of this medication.
14.) The client with acute myelocytic leukemia is being treated with busulfan (Myleran). Which
laboratory value would the nurse specifically monitor during treatment with this medication?
1. Clotting time
2. Uric acid level
3. Potassium level
4. Blood glucose level Correct Answer- 2. Uric acid level
Rationale:
Busulfan (Myleran) can cause an increase in the uric acid level. Hyperuricemia can produce uric acid
nephropathy, renal stones, and acute renal failure. Options 1, 3, and 4 are not specifically related to this
medication.
15.) The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse who is
assisting in caring for the client during its administration understands that which side effect is
specifically associated with this medication?
1. Alopecia
2. Chest pain
3. Pulmonary fibrosis
4. Orthostatic hypotension Correct Answer- 4. Orthostatic hypotension
Rationale:
A side effect specific to etoposide is orthostatic hypotension. The client's blood pressure is monitored
during the infusion. Hair loss occurs with nearly all the antineoplastic medications. Chest pain and
pulmonary fibrosis are unrelated to this medication.
16.) The clinic nurse is reviewing a teaching plan for the client receiving an antineoplastic medication.
When implementing the plan, the nurse tells the client:
1. To take aspirin (acetylsalicylic acid) as needed for headache
2. Drink beverages containing alcohol in moderate amounts each evening
3. Consult with health care providers (HCPs) before receiving immunizations
4. That it is not necessary to consult HCPs before receiving a flu vaccine at the local health fair Correct
Answer- 3. Consult with health care providers (HCPs) before receiving immunizations
Rationale:
Because antineoplastic medications lower the resistance of the body, clients must be informed not to
receive immunizations without a HCP's approval. Clients also need to avoid contact with individuals who
have recently received a live virus vaccine. Clients need to avoid aspirin and aspirin-containing products
to minimize the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity and side
effects.
17.) The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the
client, knowing that which of the following indicates a side effect specific to this medication?
1. Diarrhea
2. Hair loss
3. Chest pain
4. Numbness and tingling in the fingers and toes Correct Answer- 4. Numbness and tingling in the
fingers and toes [Show Less]