NURS 6521N ADVANCED PHARMACOLOGY WINTER QTR EXAM - WEEK 11

WALDEN UNIVERSITY | NURS 6521N-14 WINTER QTR TEST EXAM WEEK 11 ADVANCED PHARMACOLOGY WINTER QTR EXAM - WEEK 11 Exam Elaborations Questions & Answers Selected Answer: ventrogluteal muscle. Selected Answer: staining of permanent teeth. A 51-year-old female patient has been receiving doxorubicin (Adriamycin) for metastatic breast cancer. Her medical record indicates she has cardiomyopathyand a cumulative dose of 300 mg/m2 of doxorubicin. Which of the following measures would help limit the severity of the cardiomyopathy in this patient? Selected Answer: The use of dexrazoxane in conjunction with doxorubicin A patient with non-Hodgkin's lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient's care, what nursing diagnosisshould the nurse prioritize? Selected Answer: Risk for Infection related to suppressed bone marrow function A Nurse Practitioner is performing patient education for a woman who has just been prescribed a bisphosphonate. Which of the following diagnostic and history findingswould have prompted the woman's care provider to prescribe a bisphosphonate? Selected Answer: Low bone density and a family history of osteoporosis Selected Answer: Agranulocytosis The recommended treatment for trichomoniasis is Selected Answer: Flagyl. A Nurse Practitioner educator who coordinates the staff education on an oncology unitis conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session? Selected Answer: Targeted therapies have the potential to damage cancerous cellswhile leaving normal body cells less affected. 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 followingactions? Selected Dispose of intravenous lines used for chemotherapy administration in a covered trash can in the patient's room. Answer: Selected Answer: on an empty stomach 1 hour before or 2 hours after taking anymeals or other drugs. 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 followingwill the nurse include in instructions to the patient? Selected Answer: Take the drug for one full week before coming in contact with allergens An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside herhome. 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? Selected Answer: Twice-daily doses of long-acting morphine, with short-acting morphine available for breakthrough pain 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 Selected Answer: electrocardiogram (ECG). An immunocompromised 7-year-old child was recently discharged home with a peripherally-inserted central line (PIC line) 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, the mother states that she has been removing the PIC dressing daily and washing the site with warmwater and a cloth. What nursing diagnosis is most appropriate in this situation? Selected Answer: Ineffective Family Therapeutic Regimen Management A 65-year-old woman has an advanced form of rheumatoid arthritis. Hertreatment includes a regular dosage of methotrexate. The APRN will advise her to take which of the following vitamin supplements while taking the drug? Selected Answer: Vitamin B A nurse practitioner has been assigned to a 55-year-old woman who has a malignant brain tumor. The patient is receiving her first dose of carmustine. It will be critical for the nurse to observe for which of the following? Selected Answer: Respiratorydifficulty A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitaminsupplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to Selected Answer: take the vitamins at least 2 hours before or after taking ciprofloxacin. Selected Answer: alcohol. A Nurse Practitioner is assessing a patient who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes hydroxyurea (Hydrea). Thenurse will assess the patient for which of the following? Selected Answer: Leukope nia A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug Selected Answer: with a glass of water 1 hour before or 2 hours after a meal. A patient is taking etoposide for a testicular tumor refractory to treatment. Thenursing assessment reveals that he is also taking warfarin. The nurse must carefully monitor for which of the following? Selected Answer: Elevated prothrombin time A Nurse Practitioner is providing patient education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which of the following statements by the patient will alert the nurse that special instructions regarding insulin are necessary? Selected Answer: "I am on the middle school track team." A patient has acquired primary hypogonadism and has been prescribed testosterone transdermal (Androderm) patches. When educating the patient onhow to administer the drug, the nurse will instruct him to Selected Answer: place the patch on the back, abdomen, upper arms, orthighs. A child is admitted to the burn unit with second and third degree burns on botharms and part of his or her face. When administering topical medications to theburned areas, the nurse should Selected Answer: use sterile technique when applying the medication. Selected Answer: wash her hair daily with a good shampoo. 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 heparininfusion. How does this drug achieve therapeutic effect? Selected Answer: By inhibiting platelet aggregation on vessel walls and promoting fibrinolysis Selected Answer: put gloves on to protect herself. 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, thenurse should teach the mother with which of the following measures to avoid reinfection following treatment? Selected Answer: The importance of vigilant hygiene for the boy and the other members of the family 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'smost recent blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the patient's blood. The nurse will anticipatethat this patient will likely require intravenous administration of what antibiotic? Selected Answer: Vancomycin An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identified potential benefits of imatinib. Which of the following characteristics of this patient's current health status may precludethe use of imatinib? Selected Answer: The patient has chronic heart failure resulting in significant peripheral edema. A patient is taking rifampin (Rifadin) for active TB. When discussing this drugwith the patient, the nurse should stress that Selected Answer: body fluids such as urine, saliva, tears, and sputum may become discolored. Selected Answer: Peripheral neuropathy 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 finasteridetherapy? Selected Answer: Sexual dysfunction related to erectile dysfunction Alprostadil (Caverject), a drug used to treat erectile dysfunction, has been prescribed to a 42-year-old patient. When providing education to the patient andhis wife, the nurse should inform the wife about which of the following adverse effects? Selected Answer: Vaginal burning A Nurse Practitioner is to use a single-dose 1 mL vial to administer 0.5 mL of epoetin alfa to a 39-year-old woman who is being treated for chemotherapy-induced anemia.Which of the following will the nurse do with the unused portion of the drug? Selected Answer: Discard the unused portion ofthe drug. A 12-year-old boy is being discharged from the hospital after major surgery. Theboy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to Selected Answer: both the boy and his mother regarding all medication issued. Selected Answer: A 48-year-old Caucasian man who has adult-onset diabetes A Nurse Practitioner is caring for a patient who is at 28 weeks' gestation and is receiving terbutaline (Brethine) to control preterm labor. Which of the followingassessment parameters should the nurse prioritize? Selected Answer: Fetal heart rate (FHR) 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 thenurse provide? Selected Answer: "Smoking marijuana is just as bad, or worse, for your lungs as smoking cigarettes." Selected Answer: Typical daily fluid intake Selected Answer: twice a day. A Nurse Practitioner is going to administer medication to an infant using a medicinedropper. The best method is to open the child's mouth by gently squeezing the cheeks and placing the drops Selected Answer: in the buccal pouch. A Nurse Practitioner is explaining to the parents of a 6-year-old child suffering from angina why nitroglycerin patches for chest pain would not be appropriate. Which ofthe following will the nurse include in an explanation? Selected Answer: 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. A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is perspiring and her blood pressure is 88/50. The serum magnesium level is 10 mg/dL. The nurse will interpret these manifestations as Selected Answer: magnesium sulfate toxicity. A Nurse Practitioner 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 placental membrane and entering intothe fetal circulation. The nurse tells the patient that the main reason this happens is because Selected Answer: there is a 40% increase in blood volume during pregnancy. A 73-year-old woman has osteoporosis and is prescribed alendronate. She takes calcium and vitamin D supplements, drinks lots of water, and has just quitsmoking. The nurse should advise the patient to also Selected Answer: stop using artificial sweeteners while taking alendronate. Selected avoid the small veins in the dorsum of the hand Answer: or the wrist. A patient with AIDS has developed a number of secondary infections in recent weeks, including Kaposi's sarcoma. As a result of this most recent diagnosis, his care team has opted to begin treatment with interferon alfa-2a. The nurse is aware that this drug will address theetiology of Kaposi sarcoma by Selected Answer: increasing the production of B cells and T cells. Selected Answer: schedule an appointment to measure hemoglobin twice a weekfor at least 2 to 6 weeks. A 15-year-old patient has meningitis caused by Haemophilus influenzae. She isbeing treated with chloramphenicol. The most important nursing action for this patient would be to monitor Selected Answer: plasma concentrations regularly. 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? Selected Answer: Cells that have a rapid mitotic rate Selected Answer: slowing the infusion. A Nurse Practitioner is instructing a 19-year-old female patient on the use offluconazole for candida vaginitis. A teaching priority will be to Selected Answer: use an alternative form of birth control, if taking an oralcontraceptive. 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 afterstarting therapy. The nurse's evaluation of the increase is that Selected Answer: the increase in the neutrophil count is only transient. Which of the following would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should bereported by a patient taking estrogen? Selected Answer: Headaches and chest pain A Nurse Practitioner is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimizethe risk of the patient developing this adverse effect, the nurse will advise him to Selected Answer: stay well hydrated by drinking at least eight 8-oz glassesof water daily. 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 patientwill require treatment with Selected Answer: vancomycin. A patient is receiving radiotherapy for an overactive thyroid gland and asks whether her milk is safe for her baby. If her treatment cannot be discontinued,what should the nurse recommend? Selected Answer: Advise her to discard her breast milk in a biohazard container,as it is unsafe for the baby. Selected Answer: whether the pregnant woman uses illegalsubstances. Selected Answer: 1500 mg A Nurse Practitioner 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 childrenthan adults. This fact is primarily due to Selected Answer: immature liver and kidney function in infantsand children. Selected Answer: complete the entire course of drug therapy. Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatmentof lung cancer that has metastasized to his liver. In an effort to prevent infection,Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse's following assessment questions most directly addresses a common adverse effect of filgrastim? Selected Answer: "Have you noticed any bleeding in your gums or cheeks?" 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 current wound care regimen involves the daily application of silver sulfadiazine to his wounds. The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering thismedication? Selected Answer: Cleanse the wound of debris prior to applying the silver sulfadiazine The Nurse Practitioner has established peripheral IV access and begun an infusion of magnesium sulfate on a 29-year-old antepartum patient who is 35 weeks pregnant.Which of the following assessment findings most likely prompted the patient's physician to order magnesium sulfate for this patient? Selected Answer: Systolic blood pressure readings in excess of190 mmHg 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 willinvolve the administration of Selected Answer: weekly subcutaneous injections. Selected Answer: Liver function tests Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist.Which of the following facts should underlie the nurse's response to Mr. Lepp? Selected Answer: The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients. 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? Selected Answer: Infiltration, edema, or phlebitis at the infusionsite Selected Answer: phytoestrogens. A Nurse Practitioner is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. Thenurse will inform the patient that he or she is taking an oral form of Selected Answer: marijua na. A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by thenurse will be to monitor which combination of laboratory test results? Selected Answer: Red blood count, white blood count, and differential A patient has been admitted to the critical care unit with a diagnosis of peritonitisthat has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that maycause Selected Answer: ototoxicity or nephrotoxicity. A 30-year-old African-American woman tested positive for TB and is prescribed isoniazid. The nurse will plan the patient's care to include close monitoring of the drug therapy because Selected Answer: the process of drug metabolism may be faster in this patient. A 35-year-old woman is on a weight-loss program and is to begin taking sibutramine (Meridia). After baseline physical data are obtained, the nurse will assess the patient's childbearing potential. The nurse will inform the patient thatduring sibutramine therapy she should Selected Answer: use adequate contraception. Selected Answer: Urinary elimination patterns A 15-year-old boy who has been taking dextroamphetamine for the treatment ofADHD 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? Selected Answer: Hypertensive crisis Selected Answer: Increased cardiac conduction 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 homehealth 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 followingwill have the greatest impact on the nurse's assessment? Selected Answer: Where the medications will be stored A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic can the nurse mostsafely recommend? Selected Answer: Acetaminophen Selected Answer: tylenol. Selected Answer: stand or sit upright for at least 30 minutes after taking alendronate.. Selected Answer: 2000 mg A 20-year-old female patient is receiving topical clindamycin for acne vulgaris.She develops a rash and urticaria along with severe itching where the medication is applied. The nurse will formulate which of the following nursing diagnoses for the patient? Selected Answer: Risk for Injury related to allergic reactions Selected Answer: The patient's hemoglobin level is 11 g/dL An immunocompromised patient with a diagnosis of candidiasis has failed to respond to conservative therapy and has consequently begun treatment with amphotericin B. The nurse is aware that this drug achieves a therapeutic effectby way of its influence on Selected Answer: the permeability of fungal cell walls. A 59-year-old man with a recent history of erectile dysfunction has been assessed and prescribed sildenafil (Viagra). When providing patient educationto this man, the nurse should tell him which of the following? Selected Answer: "You might find that your face becomes flushed or you get a headache after you take Viagra." A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription fortadalafil (Cialis) based on television commercials he has seen. What characteristic of this patient would most likely contraindicate the use of tadalafil for his ED? Selected Answer: The patient has unstable angina and uses a nitroglycerinpatch 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 wordsauthorization 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 scheduleddrug Selected Answer: Schedule 2 A patient with chronic heart failure has begun treatment with epoetin alfa, whichshe will receive in her own home from a home health nurse. The nurse should teach the patient to supplement this treatment with a diet that is high in Selected Answer: iron-rich foods such as beans and leafy green vegetables. Selected Answer: first thing in the morning. A Nurse Practitioner is providing patient education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the patient toavoid which of the following drugs? Selected Answer: Salicylat es Selected Answer: "You might find that you get a dry mouth or a headache from thisdrug, but this does not mean it has to be discontinued." Selected Answer: A 62-year-old male with cancer The clinical nurse educator who oversees the emergency department in a children's hospital has launched an awareness program aimed at reducing drugerrors. What measure addresses the most common cause of incorrect doses inthe care of infants and children? Selected Answer: Having nurses check their math calculations with a colleaguebefore administering a drug. Selected Answer: once a day. A 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe for which of thefollowing adverse effects of the drug? Selected Answer: Lid margin crusting and pruritus A patient with a recent diagnosis of chronic myelogenous leukemia (CML) is discussing treatment options with his care team. What aspect of the patient's condition would contraindicate the use of cyclophosphamide for the treatment ofleukemia? Selected Answer: The patient has decreased renal function. A Nurse Practitioner is assigned to a patient who is at 32 weeks' gestation and is receiving terbutaline (Brethine) IV for 24 hours to control preterm labor. Which of thefollowing nursing actions will the nurse take to decrease the risk of hypotension and promote circulation to the fetus? Selected Answer: Instruct the patient to lie on her left side duringthe infusion. A Nurse Practitioner is caring for a 46-year-old female patient who is taking paclitaxelfor ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for which of the following? Selected Answer: Neurotoxic ity Selected Ye Answer: s Friday, February 7, 2020 11:44:59 AM EST