NUR 211 pharm open book3 Questions and Answers
• Question 1
A client calls from home to report that his lispro (Humalog) insulin has granules
... [Show More] in it. What would be the nurse’s best response?
Selected Answer:
1 out of 1 points
Answers:
“Discard the vial. The solution should be clear.”
“Discard the vial. The solution should be clear.”
“Tell the client to draw it up using a filter needle”
“Lispro is always cloudy. Proceed with the injection."
“Agitate the solution, and the granules should disperse.”
Response Feedback:
~ Correct. Granules would indicate contamination. Log insulin should be clear. The vial should be discarded. (Comprehension-Teaching-Pharmacotherapies-Insulin)
@ Incorrect. Granules would indicate contamination. Log insulin should be clear. The vial should be discarded. (Comprehension-Teaching-Pharmacotherapies-Insulin)
• Question 2
1 out of 1 points
A client in ketoacidosis needs intravenous insulin. What should the nurse understand before giving IV insulin?
Selected Answer:
Answers:
Only regular insulin can be administered IV. It is given in
smaller increments.
Only regular insulin can be administered IV. It is given in smaller increments.
The same dose that would be given subcutaneously per sliding scale should be used.
Insulin should never be given IV, so this order should be questioned.
Response Feedback:
The nurse should ask whether Levimir or Glargine should be given.
~ Correct. Only regular insulin should be given intravenously, and it should be given in smaller amounts. (Comprehension-Implementation-Pharmacotherapies- Insulin)
@ Incorrect. Only regular insulin should be given intravenously, and it should be given in smaller amounts. (Comprehension-Implementation-Pharmacotherapies- Insulin)
• Question 3
1 out of 1 points
A client with type I diabetes reports taking propranolol for hypertension. Why would this cause the nurse to be concerned?
Selected Answer:
The beta blocker can mask the symptoms of hypoglycemia.
Answers: The beta blocker can cause insulin resistance and hyperglycemia.
Response Feedback:
The beta blocker can mask the symptoms of hypoglycemia.
Using the two agents together increases the risk of ketoacidosis.
Propranolol increases insulin requirements because of receptor blocking.
~ Correct. Beta blockers mask the adrenergic symptoms of hypoglycemia, a recurring risk of type 1 diabetes due to inability to produce glucagon internally when needed. (Analysis-Evaluation-Pharmacotherapies-Beta blockers)
@ Incorrect. Beta blockers mask the adrenergic symptoms of hypoglycemia, a recurring risk of type 1 diabetes due to inability to produce glucagon internally when needed.
(Analysis-Evaluation-Pharmacotherapies-Beta blockers)
• Question 4
A patient asks you what they can do to decrease the risk of diarrhea while on an antibiotic. Which of the following is a true statement?
1 out of 1 points
Selected Answer:
Answers:
You can eat yogurt to decrease your risk of diarrhea, but eat it at a separate time than your antibiotic.
You can eat yogurt to decrease your risk of diarrhea, but eat it at a separate time than your antibiotic.
Yogurt, and birth control, along with antibiotics, can cause malaria.
Yogurt and probiotics, if taken with antibiotics, will initiate a disulfuram reaction.
Take your antibiotic with the yogurt, at the same time.
Response Feedback:
Correct: Yogurt will increase the good microflora in the GI tract to help reduce diarrhea, and enhance normall fecal formation. The calcium in the yogurt will interfere with the absorption of the antibiotic, so the yogurt should be taken at a different time.
• Question 5
A steroid dependent client has a blood glucose level of 249 mg/dL. Her blood pressure is 178/99 and she is complaining of muscle aches and
1 out of 1 points
weakness. Her face appears very round and puffy.” What would the nurse suspect? What type of advocacy does the client need?
Selected Answer:
Diuretics and glucose control may be needed. Cushing’s
syndrome presents this way.
Answers: Advocacy for a TSH level is needed because these symptoms indicate Grave’s disease.
Diabetic ketoacidosis is causing the clients sodium pump to shut down. An IV insulin drip is needed.
Diuretics and glucose control may be needed. Cushing’s syndrome presents this way.
Respons e Feedback
:
Advocacy for fludrocortisone is needed because these symptoms are consistent with Addison’s disease.
~ Correct. Hypertension, fluid retention and hyperglycemia are classic signs of prolonged steroid use (Cushing’s syndrome). The primary concern is that these symptoms indicate impending adrenal atrophy and consequent steroid dependence. The probability that these symptoms will persist to perpetuate the development of plaque and gastric erosion is the consequence of adrenal atrophy and steroid dependence. (Analysis-Evaluation- Pharmacotherapies-Steroids)
@ Incorrect. Hypertension, fluid retention and hyperglycemia are classic signs of prolonged steroid use (Cushing’s syndrome). The primary concern is that these symptoms indicate impending adrenal atrophy and consequent steroid dependence. The probability that these symptoms will persist to perpetuate the development of plaque and gastric erosion is the consequence of adrenal atrophy and steroid dependence. (Analysis-Evaluation- Pharmacotherapies-Steroids)
• Question 6
1 out of 1 points
In which of these situations would the nurse question the administration of steroid eye drops?
Selected Answer:
Answers:
for an eye infection
for an eye infection
after a chemical eye splash
after a corneal abrasion
after cataract surgery
Response ~ Correct. Ocular infections are apt to escalate when
Feedback: immune suppressor drops are given. (Analysis-Planning- Pharmacotherapies-Steroids)
@ Incorrect. Ocular infections are apt to escalate when immune suppressor drops are given. (Analysis-Planning- Pharmacotherapies-Steroids)
• Question 7
Lantus Insulin (glargine) is prescribed for a hospitalized patient who is diabetic. When is Lantus insulin usually administered?
Selected Answer:
1 out of 1 points
Answers:
Once daily at bedtime
Once daily at bedtime
After meals and at bedtime
After meals and at bedtime
In the morning and at Noon
• Question 8
1 out of 1 points
The nurse is giving an injection to a client with suspected hepatitis B. After the injection the nurse suffers a dirty needle stick. What is the most important thing the nurse should do for protection?
Selected Answer:
Start hepatitis immune globulin injections and the hepatitis B vaccine series (if needed).
Answers: Go on sick leave until all screening tests are negative.
Start hepatitis immune globulin injections and the hepatitis B vaccine series (if needed).
Have repeated titers to determine exposure to Hepatitis B
Response Feedback:
Start antibiotic therapy immediately
~ Correct. Hepatitis immune globulins offer immediate and targeted protection against hepatitis B infection. (Application-Planning-Risk reduction-Hepatitis)
@ Incorrect. Hepatitis immune globulins offer immediate and targeted protection against hepatitis B infection. (Application-Planning-Risk reduction-Hepatitis)
• Question 9
1 out of 1 points
The nurse is providing client education after laboratory findings reveal am elevated thyroid-stimulating hormone (TSH). How would the nurse best explain the implications of the laboratory finding to the client?
Selected Answer:
A high TSH implies the need for thyroid medication.
Answers: Hypothyroidism causes a decrease in TSH.
TSH is not a good screening test for thyroid disease.
The test probably is erroneous, because you don’t have a goiter.
A high TSH implies the need for thyroid medication.
• Question 10
The nurse manages care for a client with diabetes who takes metformin
1 out of 1 points
(Glucophage). Which laboratory result would cause the nurse to question the prescription?
Selected Answer:
Answers:
Elevated creatinine
Elevated creatinine
Decreased hemoglobin
Decreased platelets
Response Feedback
:
Increased iron
~ Correct. Metformin is nephrotoxic and type 2 diabetics are at risk for renal failure anyway. Creatinine elevation is a primary indicator of progressing renal failure. The risks of toxic harms exceed the benefits of the medication when creatinine rises. (Analysis-Assessment-Pharmacotherapies- Metformin)
@ Incorrect. Metformin is nephrotoxic and type 2 diabetics are at risk for renal failure anyway. Creatinine elevation is a primary indicator of progressing renal failure. The risks of toxic harms exceed the benefits of the medication when creatinine rises. (Analysis-Assessment-Pharmacotherapies- Metformin)
• Question 1
0.25 out of 0.25 points
A client has been prescribed Librax (chlordiazepoxide and clidinium), an anticholinergic benzodiazepine, for irritable bowel syndrome. Which of these conditions would constitute a contraindication for Librax?
Selected Answer:
History of substance abuse
Answers:
History of substance abuse
Glaucoma
Attention deficit disorder
History of migraines
History of anemia
• Question 2
0.25 out of 0.25 points
A client who is taking Haldol, Aricept, Colace, TUMs and Ampicillin is having loose stools. Which of these may be contributing to the diarrhea?
Selected Answer:
Omnipen (ampicillin)
Answers:
Omnipen (ampicillin) Haldol (haloperidol) Aricept (donepezil) Colace (docusate)
TUMs (calcium carbonate)
• Question 3
0.25 out of 0.25 points
A hospitalized patient receives codeine as an antitussive. What type of client could be harmed by cough suppression?
Selected Answer:
A client who aspirates due to reflux and dysphagia
Answers: A client with asthma
A client who aspirates due to reflux and dysphagia
A client with loose stools
A client who is allergic to bee stings
• Question 4
0.25 out of 0.25 points
A mother brings her 17-year-old daughter to the emergency department and states that the daughter took 40 extended-release acetaminophen tablets.
What medication should the nurse procure so it is available when the provider's orders that it should be given.
Selected Answer:
acetylcysteine (Mucomyst)
Answers: flumazenil (Romazicon)
methylprednisolone (Solumedrol)
acetylcysteine (Mucomyst)
protamine sulfate
• Question 5
A patient with a pneumonia-related cough has been advised to add
0.25 out of 0.25 points
guaifenesin to the regimen of antibiotics. What teaching should the nurse offer regarding the use of guaifenesin?
Selected Answer:
"Guaifenesin will loosen the secretions in your airways.”
Answers: "Guaifenesin will potentiate the antibiotics that are fighting your infection.”
"Guaifenesin will relieve any pain associated with your cough.”
"Guaifenesin will help dry up the mucous in your airways.”
"Guaifenesin will loosen the secretions in your airways.”
• Question 6
0.25 out of 0.25 points
A spouse is requesting that an alternative for lactulose be given to a constipated client with elevated liver enzymes. How should the nurse respond?
Selected Answer:
Say that Lactulose binds ammonia in the gut when a liver can't convert it to urea.
Answers: Explain that Lactulose is the only laxative the Veterans Administration will fund.
Validate the concern, given the patients liver issues.
Say that Lactulose binds ammonia in the gut when a liver can't convert it to urea.
Explain that Lactulose is the final stop. It creates ultimate Laxative dependency.
• Question 7
0.25 out of 0.25 points
A spouse of a hospice client wants to know why the sublingual dose of morphine is so much lower than the MS Contin dose that was given orally, and the IM injection dose that was given in the hospital. How should the nurse respond? (Select all that apply)
Selected Answer:
MS Contin acts slowly. Sublingual morphine acts quickly with more intensity.
Answers:
MS Contin acts slowly. Sublingual morphine acts quickly with more intensity.
He is losing consciousness, so his need for pain control is less
The MS Contin was partly metabolized in the liver before it started working
Sublingual medications enter the bloodstream more quickly than IM doses
This must be a mistake. He should need more pain control, not less.
• Question 8
0.25 out of 0.25 points An asthmatic client comes into the emergency room with rapid pulse, rapid respirations, minimal breath sounds in the bases. Which of these therapies
should the nurse anticipate, and have available, pending providers order?
Selected Answer:
Duoneb (albuterol and ipratropium) via nebulizer
Answers:
Duoneb (albuterol and ipratropium) via nebulizer
IV methylprednisolone (Solumedrol) Oxygen
Oral diphenhydramine (Benadryl)
Codeine syrup to suppress cough
• Question 9
0.25 out of 0.25 points
In preparing to administer albuterol (Proventil) and fluticasone (Flovent) inhalers to an asthmatic client, what is most important for the nurse to remember?
Selected Answer:
Administer the albuterol first, wait 5 minutes, and then administer the beclomethasone.
Answers: Change the schedule, because these medications should not be administered concurrently.
Administer the albuterol first, wait 5 minutes, and then administer the beclomethasone.
Call the prescriber, because these medications are the same.
Administer the beclomethasone before breakfast and the albuterol after breakfast.
• Question 10
0.25 out of 0.25 points
The nurse is preparing to give medications to a client taking sucralfate (Carafate) and ciprofloxacin (Cipro). The drugs are ordered for 0900. In what manner should the nurse proceed to administer the drugs?
Selected Answer:
The nurse should ask the prescriber to stagger the medication times.
Answers: The nurse should administer the drugs with a full glass of water.
The nurse should ask the prescriber to stagger the medication times.
The nurse should administer the two drugs at same time with food.
The nurse should administer the ciprofloxacin 15 minutes before the sucralfate.
• Question 11
0.25 out of 0.25 points
The nurse is providing education to a client who has been prescribed both an antacid and ranitidine (Zantac). Which instruction should the nurse give the client about taking the medications?
Selected Answer:
“Take the ranitidine before meals. Take the antacid after meals if needed.”
Answers:
“Take the ranitidine before meals. Take the antacid after meals if needed.”
“The antacid and ranitidine should be taken at the same time for better effect.”
“The antacid should be taken 15 minutes before the ranitidine.”
“Both medications should be taken on a full stomach.”
• Question 12
0.25 out of 0.25 points
The nurse is providing patient education to an elderly being treated for duodenal ulcers with Carafate (Sucralfate). The client asks the nurse how sucralfate helps heal ulcers. How should the nurse respond?
Selected Answer:
“It creates a protective barrier against pepsin and acid.”
Answers:
“It creates a protective barrier against pepsin and acid.”
“It suppresses gastric acidity, irreversibly.”
“It inhibits the enzyme that generates gastric acid.”
“It inhibits the enzyme that generates gastric acid.”
• Question 13
0.25 out of 0.25 points
The nurse who is caring for a post-operative client administers Phenergan, a phenothiazine (Thorazine-like) medication. What side effects should the nurse watch for, given this classification?
Selected Answer:
Extrapyramidal symptoms
Answers:
Extrapyramidal symptoms
Hyper-vigilance Hiccups
Reflux
• Question 14
0.25 out of 0.25 points
The ventrogluteal site is recommended when intramuscular opiates are ordered to treat post-operative abdominal pain. What are the Landmarks for the ventrogluteal site?
Selected Answer:
Palm over trochanter, fingertips over anterior & superior ileac crests
Answers:
Palm over trochanter, fingertips over anterior & superior ileac crests
Two finger breadths below the acromium process Two inches above or below the umbillicus
The right lower quadrant of the buttocks
• Question 15
0.25 out of 0.25 points
When caring for a pregnant woman, the nurse would question giving which of these medications for hyperacidity?
Selected Answer:
misoprostol (Cytotec)
Answers:
misoprostol (Cytotec) metoclopramide (Reglan) calcium carbonate (TUMS)
magnesium calcium combinations (Rolaids)
• Question 16
0.25 out of 0.25 points
When should clients, who don’t require PPIs or H2 inhibitors, take their antacids?
Selected Answer:
Whenever heartburn occurs (prn) Q.I.D.
Answers: Routinely before meals
Routinely after meals
Whenever heartburn occurs (prn) Q.I.D.
At bedtime only
• Question 17
0.25 out of 0.25 points
When teaching a client with renal insufficiency how to manage constipation, what teaching point should the nurse convey about laxatives?
Selected Answer:
Laxatives containing magnesium are dangerous in renal disease.
Answers:
Laxatives containing magnesium are dangerous in renal disease.
Laxatives should only be given after suppositories or enemas have failed.
Laxatives are an unavoidable fact of life for people with renal disease.
Laxatives should be taken daily to prevent nitrate toxicity.
• Question 18
Which antiepileptic medication is considered safer than others in pregnancy?
0.25 out of 0.25 points
Selected Answer:
Lamictal (lamotrigine)
Answers:
Lamictal (lamotrigine)
Dilantin (phenytoin)
Depakote (valproic acid)
Neurontin (gabapentin)
• Question 19
Which of these immune modifiers would the nurse most question in pregnancy?
0.25 out of 0.25 points
Selected Answer:
Methotrexate (Trexall)
Answers:
Methotrexate (Trexall)
Etanercept (Enbrel)
Infliximab (Remicade)
Anakinra (Kineret)
• Question 20
0.25 out of 0.25 points
Which of these teaching points about gastro-esophageal reflux would be helpful to a client with reflux?
Selected Answer:
Reflux is triggered by carbonated beverages.
Answers: Proton pump inhibitors like Protonix should be taken with every meal.
Reflux is triggered by carbonated beverages.
People who have reflux at night should eat cheese and crackers before bed.
Alcohol is a good remedy for reflux because it neutralizes acid. [Show Less]