Question 1 Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient's physician has prescribed quinine along with
... [Show More] an adjunctive drug. The nurse should question the physician's order if the patient has a history of osteoporosis or low bone density. chronic obstructive pulmonary disease (COPD). diabetes mellitus. cardiac arrhythmias. Question 2 A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for recurring headaches. The nurse should recommend aspiri n. advil. tyleno l. motri n. A Nurse Practitioner is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an electrocardiogram (ECG). electromyelogram (EMG). electroencephalogram (EEG). electrophysiologic study (EPS). A Nurse Practitioner is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered? Coumadin Contact: [email protected] Alteplase Ticlopidine Protamine sulfate Question 5 A patient reports to a clinic with complaints of breast tenderness, a right lumpy breast, and no breast discharge. The breast tenderness occurs primarily during her menstrual cycle. The nurse practitioner probably suspects breast cancer. cancerous breast tenderness. pain in the heart. PMS. Question 6 A postmenopausal patient is prescribed bisphosphonates to treat osteoporosis. The nurse will instruct the patient to take the drug at bedtime. after meals. at any time of the day with tea or coffee. first thing in the morning. Question 7 Which test should the NP order for monitoring effectiveness of the patient receiving heparin? Arterial blood gas levels PTT Complete blood count Hemoglobin level Question 8 Finasteride (Proscar) is prescribed for a 50-year-old man who is experiencing a problem with urination secondary to an enlarged prostate. The practitioner would teach the patient that while he is taking this medication, it is important to: Increase his fluid intake. Restrain from sexual activity Take special precautions around women of childbearing age Begin folic acid Question 9 A 15-year-old patient has meningitis caused by Haemophilus influenzae. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitor blood sugar levels daily. liver enzymes monthly. plasma concentrations regularly. urine output daily. Question 10 A patient has been taking doxazosin (Cardura) 2 mg PO daily for 3 weeks for treatment of BPH. He returns to the clinic and is complaining of feeling dizzy when he stands up. Which action would the family nurse practitioner take? Order urinalysis (UA) to determine hematuria and presence of bacteria. Determine blood pressure (BP) with patient lying down, standing, and sitting. Review with patient his symptoms over the past 3 weeks. Perform digital rectal exam to determine if prostate is smaller than previously noted. Question 11 A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the deltoid muscle. rectus femoris muscle. ventrogluteal muscle. dorsogluteal muscle. Question 12 A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor which of the following? Visual function Blood counts Pap test results Liver function Question 13 A 21-year-old has been placed on risperidone. Monitoring for risperidone includes Bradykinesia, akathisia and agitation Excessive weight gain Hypertension Potentially fatal agranulocytosis Question 14 A patient who is at risk for DVT tells the NP she has just learned she is pregnant. The NP should expect that this patient will use which of the following anticoagulant medications? Aspirin Heparin Dabigatr an Warfarin Question 15 When a NP chooses a benzodiazepine to treat anxiety the prescriber needs to be aware of the possibility of dependence. The Benzodiazepine associated with the greatest likelihood of causing rapid dependence is: Chlordiazepoxide (Libri um) Clonazepam (Klonopin) Alprazolam (Xanax) Oxazepam (serax) Question 17 A male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at each clinic visit? Serum cholesterol levels Bone growth Hemoglobin levels Urinary elimination patterns Question 18 What schedule class of drug is Hydrocodone? I II III IV Question 19 Which of the following would a Nurse Practitioner assess for in a patient who is taking polymyxin B systemically? Peripheral neuropathy Nephrotoxicity and hepatotoxicity Hyperkalemia and hyponatremia Endocarditis and hypertension Question 20 A school nurse has been teaching high school students about the risks associated with marijuana use. However, the nurse has been met with considerable skepticism on the part of students, most of whom believe that marijuana is a benign drug. Which of the following teaching points should the nurse provide? "Most people don't know that marijuana can be just as addictive as heroin or cocaine over time." "Marijuana can easily interact with other drugs and cause potentially fatal reactions." "Every year, thousands of Americans end up in emergency departments with marijuana overdoses." "Smoking marijuana is just as bad, or worse, for your lungs as smoking cigarettes." Question 21 A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to take the vitamins at least 2 hours before or after taking ciprofloxacin. alternate the dosage of ciprofloxacin and vitamin supplements. reduce the dosage of vitamin supplements. reduce the dosage of vitamin supplements and double the dosage of ciprofloxacin. Question 22 Cindy has been on Citalopram (Lexapro) For a year and is willing to try tapering off of the selective serotonin reuptake inhibitor. What is the initial dosage adjustment when tapering off antidepressants Reduce dose by 50% for 3 to 4 days Reduce dose by 50% every other day Change Dose to every other day dosing for a week Lexapro can be stopped abruptly due to its long half life Question 23 Ms. LW is on hyrdroxychloroquine (Plaquenil) for rheumatoid arthritis. Certain tests are recommended before a patient starts this medication. Which of the following is NOT recommended before starting Hydroxychoroquine (Plaquenil)? Comprehensive Eye Exam CBC (Complete Blood Count) Liver Function profile 24 hour urine Question 24 Terazosin (Hytrin) is classified under which of the following drug class: beta blockers tricyclic blockers alpha blockers calcium channel blockers Question 25 Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain and burning during the infusion by slowing the infusion. decreasing the volume used for dilution. decreasing the total volume of the primary IV infusion. administering a dose of 2 units of bleomycin before carmustine. Question 26 Drugs have a valid medical use but a high potential for abuse, both psychological and physiologic. In an emergency, a Schedule 2 drug may be prescribed by telephone if a written prescription cannot be provided at the time. However, a written prescription must be provided within 72 hours with the words authorization for emergency dispensing written on the prescription. These prescriptions cannot be refilled. A new prescription must be written each time. Examples include certain amphetamines and barbiturates. This is scheduled drug Schedule 1 Schedule 2 Schedule 3 Schedule 4 Question 27 The NP is reviewing Mrs. Oglethorpe's medication list and recognizes that which drug listed below has been associated with increased risk for MI in women? Aspirin Beta blockers Lipid lowering agents Estrogen replacement Question 28 Which of the following agents would not be expected to cause nausea, vomiting, Flushing, dizziness, headache, and abdominal discomfort after consumption of alcohol? Cefotetan Chlorpropami de Metronidazol e Fomepizole Question 29 Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The nurse will advise the patient to avoid dairy products. fatty foods. alcohol. vitamin C. Question 30 Jennifer, the Nurse Practitioner, is seeing Mr. Johns, a 65 year old male in the clinic today with c/o Arthritis pain. What is a serious side effect of ibuprofen use in the older adult patient? Rebound headaches Neuropathy Pancreatic failure Impairment of renal function Question 31 A 29-year-old woman who is morbidly obese has recently begun a comprehensive, medically-supervised program of weight reduction. Prior to adding dextroamphetamine (Dexedrine) to her regimen, the patient should be questioned about her intake of alcohol. trans fat. caffeine. grapefruit juice. Question 32 A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The patient has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect? By promoting the rapid excretion of vitamin K by the gastrointestinal mucosa By inhibiting the action of vitamin K at its sites of action By inhibiting platelet aggregation on vessel walls and promoting fibrinolysis By inactivating clotting factors and thus stopping the coagulation cascade Question 33 A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment? The importance of vigilant hygiene for the boy and the other members of the family The need for the boy to provide serial stool samples for 6 months following treatment The need to supplement the anthelminthic drug with prophylactic antibiotics The need to use prescription skin cleansers during treatment and for 6 weeks after Question 34 A 38-year-old pregnant patient admits to the Nurse Practitioner that she is an alcoholic and has been consuming alcohol during her pregnancy. The nurse knows that using alcohol during pregnancy may result in a child who presents with a high-pitched cry. microcephaly. an electrolyte imbalance. thrombocytopenia. Question 35 An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with ciprofloxacin. clindamycin. vancomycin. an antistaphylococcic penicillin. Question 36 A patient has endocarditis and is taking gentamicin. The Nurse Practitioner will be sure to monitor which of the following? Potassium level Creatinine clearance Serum albumin level Prothrombin time Question 37 A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug? That the infant's skin has greater permeability than that of an adult That there is less body surface area to be concerned about That there is decreased absorption rates of topical drugs in infants That there is a lower concentration of water in an infant's body compared with an adult Question 38 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? Excess fluid volume related to potential effects of drug therapy Hypercalcemia related to drug therapy, immobility, and breast cancer Sexual dysfunction related to erectile dysfunction Prostatic neoplasia Question 39 Baby Jasmine is a 5 mth old breastfed infant with a fever. Treatment for her fever may include: Acetaminophen suppository "baby" aspirin Ibuprofen suppository Alternating acetaminophen and ibuprofen Question 40 A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the APRN is responsible for facilitating this new aspect of the patient's drug regimen. This will involve the administration of weekly subcutaneous injections. daily, oral administration . weekly administration of an enteric coated tablet. daily, outpatient intravenous therapy. Question 41 Phenytoin decreases folic acid absorption by Altaring in the pH of the stomach Increasing gastric emptying time Inhibiting intestinal enzymes require for folic acid absorption Chelation of the folic acid into inactive ingredients Question 42 Ms. Lewis Is in 74-year-old female who presents to your clinic for routine visit today. You review her medical record and notice she is prescribed aspirin therapy. You provide patient education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is: Tremors Vomiting Tinnitus Black, tarry stools Question 43 A 34-year-old male has been diagnosed with TB and will be started on INH therapy. The medication history reveals that he currently takes antacids on a regular basis. The nurse will instruct the patient to take antacids during the day and INH only at night. antacids before meals and INH 1 or 2 hours after meals. INH before meals and antacids 1 or 2 hours after meals. antacids not less than 1 hour before or 2 hours after taking INH. Question 44 The NP has just placed Mr. Johnson on a selective serotonin reuptake inhibitor. What symptoms should be reviewed with the patient who is newly prescribed this class of medication? They will no longer have dreams they could feel a bit of nausea, but this will resolve in about a week or so They Will have excessive flatus They may have insomnia but only for about a week Question 45 The nurse practitioner, Jill, is deciding what medication to put her patient on. She recognizes that the mechanism of action of triptans is as: a Selective serotonin receptor agonist A dopamine antagonist A vasoconstrictor An inhibitor of leukotriene synthesis Question 46 When planning care for a patient who is receiving filgrastim (Neupogen) for a nonmyeloid malignancy, the nurse should formulate which of the following patient outcomes? (Select all that apply.) The patient will not develop an infection. The patient will not experience bone pain. The patient will be able to self-administer filgrastim at home. The patient will not develop febrile neutropenia. The patient will not retain fluid. Question 47 What is the best initial treatment plan for a sleep disorder in the older adult patient? Medicate with amitriptyline (Elavil). Medicate with trazodone (Desyrel). Decrease noise and light in the environment Discuss the importance of naps daily. Question 48 A child is admitted to the burn unit with second and third degree burns on both arms and part of his or her face. When administering topical medications to the burned areas, the nurse should cool the medication prior to administration. use sterile technique when applying the medication. allow the child to apply the medication if possible. use clean technique only when applying the medication. Question 49 A 46-year-old man is receiving a quinupristin/dalfopristin IV infusion for a life-threatening infection. Which of the following would be most important for the nurse to monitor? Increased heart rate Breathlessness Infiltration, edema, or phlebitis at the infusion site Nausea and vomiting Question 50 A Nurse Practitioner will instruct a patient taking allopurinol to take each dose at night. first thing in the morning. after a meal. before a meal. Question 51 A Nurse Practitioner is assessing a patient who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the patient for which of the following? Diabetes mellitus Hypertension Leukopenia Hypoglycemia Question 52 An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman's pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient's pain? [Show Less]