NURS 6521: Advanced Pharmacology final exam Question 1 A nurse educator who coordinates the staff education on an oncology unit is conducting an inservice
... [Show More] on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session? Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected. Question 2 Alprostadil (Caverject), a drug used to treat erectile dysfunction, has been prescribed to a 42-year-old patient. When providing education to the patient and his wife, the nurse should inform the wife about which of the following adverse effects? Low blood pressure Vaginal burning Question 3 A 12-year-old boy is being discharged from the hospital after … The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to both the boy and his mother regarding all medication issued. Question 4 A 30-year-old African-American woman tested positive for …and is prescribed … The nurse will plan the patient’s care to include close monitoring of the drug therapy because the patient is at greater risk for high serum levels of the drug. Question 6 A 16-year-old boy is prescribed cromolyn sodium nasal spray to treat a nasal allergy. To maximize the therapeutic effects of the drug, which of the following will the nurse include in instructions to the patient? Take the drug for 1 full week before coming in contact with allergens. Question 7 Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient’s physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician’s order if the patient has a history of cardiac arrhythmias. Question 8 A nurse is explaining to a pregnant 21-year-old college student why she cannot continue to take ibuprofen (Advil) for her headaches. The nurse draws a picture depicting drug molecules crossing the drugs compete with the hormones of pregnancy for albumin-binding sites. Question 9 66-year-old man has made an appointment with his primary care provider to discuss his recent …and has requested a prescription for …based on television commercials he has seen. What characteristic of this patient would most likely contraindicate the use of The patient has unstable angina and uses a nitroglycerin patch Question 10 A man has a demonstrated history of androgen deficiency and the consequences of this health problem include an inability to maintain an erection. Which of the following medications would best address this patient’s erectile dysfunction (ED)? Exogenous testosterone Question 11 A 39-year-old woman is receiving doxorubicin for the treatment of cancer. After each treatment, the patient has acute nausea and vomiting accompanied by a slightly increased heart rate. The nurse will advise her to perform relaxation techniques after the treatments. Question 12 A nurse has administered filgrastim to a diverse group of patients in recent months. Which of the following patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug? A 19-year-old Male receiving radiation therapy Question 13 A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following? Dental hygiene practices Question 17 A female patient is taking filgrastim (Neupogen) to decrease the incidence of infection. The nurse notices a small increase in the neutrophil count 2 days after starting therapy. The nurse’s evaluation of the increase is that the increase in the neutrophil count is only transient. Question 18 A 2-year-old child is diagnosed with a minor ailment and is to be administered medications at home for 2 weeks. The child lives with his mother, grandmother, and four other children between the ages of 14 months and 7 years. The home health nurse is asked to assess the home environment to determine if it is appropriate for the child to take his medication at home. Which of the following will have the greatest impact on the nurse’s assessment? Where the medication will be stored Question 19 A nurse who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to Immature liver and kidney function in infants and children. Question 20 A nurse is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for which of the following? Neurotoxicity Question 21 A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather’s antidepressant to improve his mood. After immediately phoning the boy’s stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem? Hypertensive crisis Question 22 A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause orange-tinged urine. staining of permanent teeth. sleep deprivation. deep muscle pain. Question 23 Mr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his .. Apply a layer of silver sulfadiazine that is sufficiently thick to make the wound bed invisible. Cleanse the wound of debris prior to applying the silver sulfadiazine Question 24 A patient has been prescribed daptomycin for a complicated skin infection. Which of the following will the nurse advise the patient to report immediately? Muscle pain or tingling Question 25 An immunocompromised 7-year-old child was recently discharged home with a … for home antibiotic therapy. He has now been brought to the emergency department by his mother and father with signs and symptoms of line sepsis. Upon questioning, … Caregiver Ineffective Family Therapeutic Regimen Management Question 26 A patient’s current course of cancer treatment involves the administration of a conjugated monoclonal antibody. What characteristic of the ? The targeted therapy is combination of a monoclonal antibody, a kinase inhibitor, and an inorganic cytotoxin. The drug is able to adapt its pharmacokinetics to the etiology of the patient’s cancer. Question 27 A female patient has been prescribed estrogen therapy. Which of the following will the nurse advise the patient is a common? Breakthrough bleeding Question 28 A nurse works at a weight management clinic. To which of the following overweight patients could the nurse safely administer dextroamphetamine? A 48 year old Caucasian man who has adult-onset diabetes Question 29 A patient with a diagnosis of chronic myeloid leukemia has met with her oncologist, who has recommended treatment with the kinase inhibitor imatinib. What route of administration should the nurse explain to the patient? Oral administration of imatinib in a home setting Question 37 A nurse is instructing a 19-year-old female patient on the use of fluconazole for candida vaginitis. A …will be to use an alternative form of birth control, if taking an oral contraceptive. Question 38 A nurse is assigned to a patient who is at 32 weeks’ gestation and is receiving …for 24 hours to control preterm labor. Which of the following nursing actions will the nurse take to decrease the risk of hypotension and promote circulation to the fetus? Instruct the patient to lie on her left side during the infusion. Question 39 A nurse is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that oral form of marijuana Question 40 A 36-year-old woman with a history of dysmenorrhea has begun treatment with progesterone, which she will be receiving by the intramuscular route. The nurse participating in the Risk for Injury related to loss of vision or thrombotic events Question 41 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 … 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 Question 42 A patient has been admitted to the critical care unit of the hospital with bacterial septicemia that has failed to respond to initial antibiotic treatment. The patient’s most recent blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the patient’s blood. The nurse vancomycin Question 43 A nurse is working in a women’s hospital where she is caring for a new mother who is experiencing postpartum urinary retention. Bethanechol (Urecholine) has been ordered. The nurse will observe for which of the following? Hypertension Question 44 A patient is pregnant and is at 7 weeks’ gestation. She has type 1 diabetes and has been taking insulin since she was 13 years old. She asks the nurse if the insulin will be harmful to her baby. The best response to the patient by the nurse would be “Insulin is usually the drug of choice for controlling blood glucose levels during pregnancy because it does not cross into the placenta.” Question 58 A female patient is prescribed oprelvekin therapy to treat thrombocytopenia. Which of the following should the nurse continuously monitor to determine the efficacy and duration of the ? Fluid retention/weight gain Question 59 Which of the following is critical to helping prevent development of resistant strains of microbes? Maintain the optimum duration of the antimicrobial agent Question 60 A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is … The clinician suspects a bacterial, rather than viral, etiology. How will the patient’s pregnancy affect the potential use …? The use of ciprofloxacin is contraindicated in pregnancy Question 68 A 56-year-old woman will soon begin treatment of her …. What patient teaching should the nurse provide to this woman? you might find that you get a dry mouth or a headache but this does not mean it has to be discontinued Question 69 A nurse is instructing a colleague on how an antimicrobial produces a therapeutic effect. Which of the following should be included in the nurse'steaching? Penicillin interferes with synthesis of the bacteria cell wall. Question 70 A nurse is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin patch for chest pain would not be appropriate. Which of the following will the nurse include in an explanation? A child has a greater body surface area, creating greater permeability resulting in an increase in absorption of topical agents, which may result in more adverse effects. Question 71 A patient is being discharged from the hospital and will be taking oxybutynin (Ditropan) for overactive bladder. The nurse will instruct the patient that she will be taking a medication that may be prescribed as a patch and which may cause dry mouth. Question 72 A nurse is aware that the concept of selective toxicity is foundational to antimicrobial therapy.Which of the following statements most accurately describes selective toxicity? A drug harms microbes without harming human cells. Question 98 A nurse is caring for a patient who is at 28 weeks' gestation and is receiving terbutaline (Brethine) to control preterm labor. Which of the following assessment parameters should the nurse prioritize? Fetal heart rate (FHR) Question 99 An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions? Prime the IV tubing with an approved IV solution rather than with the drug itself. Question 100 A nurse is discussing with a 58-year-old male patient the causes of erectile dysfunction in men over 50 years of age. Which of the following will the nurse inform the patient is the primary physical cause of erectile dysfunction of men in this age group? Atherosclerosis of the penile artery A 57-year-old man is to begin 5-FU therapy for colon cancer. It will be most important for the nurse to monitor which of the following during the first 72 hours of the initial treatment cycle? Cardiac events 2 A patient on 5-FU calls the clinic and reports that he has between five and seven loose bowel movements daily. The nurse will instruct the patient to notify the clinic if the stools are black or if there is evidence of blood. 3 A nurse is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for which of the following? Neurotoxicity 4 A patient is taking etoposide for a testicular tumor refractory to treatment. The nursing assessment reveals that he is also taking warfarin. The nurse must carefully monitor for which of the following? Elevated prothrombin time 5 During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient's platelet count to be 92,000 cells/mm3. The nurse should do which of the following? Consult the prescriber for discontinuation of the drug 6 A 45-year-old woman with acute leukemia is going to begin chemotherapy with vincristine. The nurse is aware that vincristine must always be administered through a central line. 7 A nurse is providing patient education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the patient to avoid which of the following drugs? Salicylates 8 A 54-year-old male patient with small-cell lung cancer is receiving etoposide. The nurse will carefully monitor for which of the following? Hypotension 9 A 63-year-old male patient has just begun treatment with IV paclitaxel. About 10 minutes into the infusion, the nurse becomes concerned about a possible anaphylactic reaction to the drug because the patient is experiencing dyspnea. 10 A nurse 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? Leukopenia 11 A patient with a diagnosis of nonsmall cell lung cancer is currently undergoing chemotherapy. At the encouragement of a family member, the patient has announced to the nurse his intention to complement this treatment with a regimen of herbal remedies. How should the nurse respond to this patient's statement? “It's important to discuss what herbs you'll be taking with your doctor or the pharmacist to make sure there aren't any interactions.” 12 A 56-year-old man with a diagnosis of colorectal cancer has been told by his oncologist that chemotherapy will have the benefit of shrinking the man's tumor prior to bowel resection surgery. This patient's physician is describing neoadjuvant therapy. 13 An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or failure of a patient's chemotherapy. Which of the following cancerous cells is most susceptible to the effects of chemotherapeutic drugs? Cells that have a rapid mitotic rate 14 Prior to administering a dose of 5-FU to a patient with pancreatic cancer, the nurse is conducting the necessary drug research. The nurse is aware that 5-FU is a cell cycle–specific chemotherapeutic agent. Which of the following statements best describes cell cycle–specific drugs? They affect cancerous cells during a particular phase of cellular reproduction. 15 An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions? Prime the IV tubing with an approved IV solution rather than with the drug itself. A nurse is instructing a colleague on how an antimicrobial produces a therapeutic effect. Which of the following should be included in the nurse's teaching? Penicillin interferes with synthesis of the bacteria cell wall. 2 Which of the following statements by a patient indicates to the nurse that additional teaching concerning the use of antimicrobials is needed? “I will stop the antibiotic as soon as I feel better.” 3 A patient is to undergo extensive dental surgery. The dentist prescribes a course of antibiotics before beginning the procedure and continuing for 5 days after the procedure. This is an example of which of the following? Prophylaxis 4 Which of the following is critical to helping prevent development of resistant strains of microbes in patients? Maintain the optimum duration of the antimicrobial agent 5 A nurse is caring for a patient in the intensive care unit. The patient was admitted 2 hours ago with a severe infection and was started on empiric therapy. Which of the following tests will be done to identify drug susceptibility? Culture and sensitivity 6 The following patients each have a bacterial infection requiring antibacterial drug therapy. Which patient will likely require the most long-term follow-up care by the nurse? An elderly woman with a recent pacemaker insertion 7 When caring for infants and the elderly who are in need of an antimicrobial agent, the nurse is aware that when compared with doses for young and middle-aged adults, these patients may require a lower dose. 8 A nurse is caring for an African-American man who has an infection. Which of the following drug therapies would the nurse question if ordered for this patient? A sulfonamide 9 Which of the following nursing actions is most important in achieving successful antimicrobial therapy with vancomycin? Promote adequate intake of fluids and nutrients 10 Which of the following is the most important nursing action to help prevent antimicrobial resistance in health care settings? Good hand-washing between each patient contact 11 A nurse is aware that the concept of selective toxicity is foundational to antimicrobial therapy. Which of the following statements most accurately describes selective toxicity? A drug harms microbes without harming human cells. 12 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 vancomycin. 13 Assessment of a newly-admitted patient reveals the characteristic signs and symptoms of cellulitis to the back of her hand. A swab of the patient's wound was ordered upon admission, but the results of culture and sensitivity (C&S) testing are not yet available. What strategy will most likely be adopted to treat this patient's infection? Empiric antimicrobial therapy will be implemented until laboratory results are available. 14 A nurse has questioned why a patient's physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of a patient's infection. Which of the following facts provides the best rationale for the use of narrow-spectrum antibiotics whenever possible? The use of broad-spectrum antibiotics can create a risk for a superinfection. 15 A 70-year-old woman has been prescribed an antimicrobial drug for the treatment of a urinary tract infection (UTI). What teaching point should the nurse prioritize when providing patient education? “Make sure that you take all the pills that you're prescribed, even if your infection gets better.” [Show Less]