Milestone exam 1 Questions and
Answers Latest 2023
Two hours after taking the first dose of penicillin, a client arrives at the emergency
department complaining of feeling ill, exhibiting hives, having difficulty breathing, and
experiencing hypotension. The nurse will develop an immediate plan of care based
on which finding?
A.Severe acute anaphylactic response
B.Side reaction that should resolve
C.Idiosyncratic reaction
D.Cumulative drug response
A-
✔️Rationale: Anaphylaxis related to penicillin can cause a life-threatening allergic
response characterized by bronchospasm, laryngeal edema, and a precipitous drop
in blood pressure. This client's ingestion of penicillin and presenting clinical picture
indicate the client is having an acute reaction with respiratory difficulty. Options B, C,
and D are other physiologic responses to medications, but immediate action is
required for a potential loss of airway, breathing, and circulation.
Which response best supports the observations that the nurse identifies in a client
who is experiencing a placebo effect?
A.Beneficial response or cure for disease
B.Behavioral or psychotropic responses
C.Malingering or drug-seeking behaviors
D.Psychological response to inert medication
D-
✔️Rationale:The placebo effect is a response in the client that is caused by the
psychological impact of taking an inert drug that has no biochemical properties. A
placebo effect can be therapeutic, negative, or ineffective but provides no cure or
benefit to the client's progress. The placebo effect may evoke behavioral changes
but does not affect neurochemical psychotropic changes. Malingering and drug
seeking are behaviors that a client exhibits to obtain treatment for nonexistent
disorders or obtain prescription medications.
A mother brings her 18-month-old child to the community health center because the
child has had "bad diarrhea" for the last 3 days. She states, "I bought some of this
liquid at the pharmacy and gave my child a half-ounce." The nurse sees that the
bottle contains loperamide. What is the next nursing action?
A.Tell the mother never to give this drug to her toddler.
B.Ask if any other siblings have experienced diarrhea.
C.Take the child's oral and tympanic temperatures.
D.Ask the mother when the child last voided.
D-
✔️Rationale: Determining when the child last voided is most important because
urine output is decreased with dehydration and an 18-month-old with a 3-day history
of diarrhea could be severely dehydrated. Although the manufacturer states that
, loperamide should not be given to a child younger than 2 years except under the
direction of a health care provider, option A is not the best answer for this question.
In addition, loperamide causes an anticholinergic effect of urinary retention. Data
obtained in options B and C are not as high a priority as option D in this situation.
A client receives an antihypertensive agent daily. Which action is most important for
the nurse to implement prior to administering the medication?
A.Verify the expiration date.
B.Obtain the client's blood pressure.
C.Determine the client's history of adverse reactions.
D.Review the client's medical record for a change in drug route.
B-
✔️Rationale:To determine the most accurate response to antihypertensive therapy,
baseline blood pressures should be obtained before an antihypertensive drug is
administered and should be compared with orthostatic vital signs to determine
whether any side effects are occurring. Although options A, C, and D are required
nursing actions prior to giving any drug, the therapeutic response should be
determined before another dose is administered.
A client with trichomoniasis (Trichomonas vaginalis) receives a prescription for
metronidazole. Which instruction is most important for the nurse to include in this
client's teaching plan?
A.Avoid alcohol consumption.
B.Complete the medication regimen.
C.Use a barrier contraceptive method.
D.Treat partner(s) concurrently.
A-
✔️Rationale:Clients should be instructed to avoid alcohol and products containing
alcohol while taking metronidazole because of the possibility of a disulfiram-like
reaction. Option B helps prevent the development of metronidazole-resistant T.
vaginalis. To prevent reinfection, clients should abstain from sexual contact or use a
barrier contraceptive while taking metronidazole, and their partner(s) should be
treated concurrently. The most important instruction for client well-being is option A.
A client with HIV who was recently diagnosed with tuberculosis (TB) asks the nurse,
"Why do I need to take all of these medications for TB?" What information should the
nurse provide?
A.Antiretroviral medications decrease the efficacy of the TB drugs.
B.Multiple drugs prevent the development of resistant organisms.
C.Duration of the medication regimen is shortened.
D.Potential adverse drug reactions are minimized.
B-
✔️A multidrug regimen is prescribed for a client with HIV and TB to prevent the
development of resistance of the tubercle bacilli. Although antitubercular medications
can inhibit some antiretrovirals, a multidrug regimen is needed to inhibit the
proliferation of the virulent tubercle bacilli. The duration of antitubercular therapy is
typically 6 to 9 months and is not shortened by the use of multiple medications. A
client who is receiving HIV and TB therapy is at an increased risk of adverse
reactions because of the complex medication regimens and complications secondary
to immunosuppression.
Answers Latest 2023
Two hours after taking the first dose of penicillin, a client arrives at the emergency
department complaining of feeling ill, exhibiting hives, having difficulty breathing, and
experiencing hypotension. The nurse will develop an immediate plan of care based
on which finding?
A.Severe acute anaphylactic response
B.Side reaction that should resolve
C.Idiosyncratic reaction
D.Cumulative drug response
A-
✔️Rationale: Anaphylaxis related to penicillin can cause a life-threatening allergic
response characterized by bronchospasm, laryngeal edema, and a precipitous drop
in blood pressure. This client's ingestion of penicillin and presenting clinical picture
indicate the client is having an acute reaction with respiratory difficulty. Options B, C,
and D are other physiologic responses to medications, but immediate action is
required for a potential loss of airway, breathing, and circulation.
Which response best supports the observations that the nurse identifies in a client
who is experiencing a placebo effect?
A.Beneficial response or cure for disease
B.Behavioral or psychotropic responses
C.Malingering or drug-seeking behaviors
D.Psychological response to inert medication
D-
✔️Rationale:The placebo effect is a response in the client that is caused by the
psychological impact of taking an inert drug that has no biochemical properties. A
placebo effect can be therapeutic, negative, or ineffective but provides no cure or
benefit to the client's progress. The placebo effect may evoke behavioral changes
but does not affect neurochemical psychotropic changes. Malingering and drug
seeking are behaviors that a client exhibits to obtain treatment for nonexistent
disorders or obtain prescription medications.
A mother brings her 18-month-old child to the community health center because the
child has had "bad diarrhea" for the last 3 days. She states, "I bought some of this
liquid at the pharmacy and gave my child a half-ounce." The nurse sees that the
bottle contains loperamide. What is the next nursing action?
A.Tell the mother never to give this drug to her toddler.
B.Ask if any other siblings have experienced diarrhea.
C.Take the child's oral and tympanic temperatures.
D.Ask the mother when the child last voided.
D-
✔️Rationale: Determining when the child last voided is most important because
urine output is decreased with dehydration and an 18-month-old with a 3-day history
of diarrhea could be severely dehydrated. Although the manufacturer states that
, loperamide should not be given to a child younger than 2 years except under the
direction of a health care provider, option A is not the best answer for this question.
In addition, loperamide causes an anticholinergic effect of urinary retention. Data
obtained in options B and C are not as high a priority as option D in this situation.
A client receives an antihypertensive agent daily. Which action is most important for
the nurse to implement prior to administering the medication?
A.Verify the expiration date.
B.Obtain the client's blood pressure.
C.Determine the client's history of adverse reactions.
D.Review the client's medical record for a change in drug route.
B-
✔️Rationale:To determine the most accurate response to antihypertensive therapy,
baseline blood pressures should be obtained before an antihypertensive drug is
administered and should be compared with orthostatic vital signs to determine
whether any side effects are occurring. Although options A, C, and D are required
nursing actions prior to giving any drug, the therapeutic response should be
determined before another dose is administered.
A client with trichomoniasis (Trichomonas vaginalis) receives a prescription for
metronidazole. Which instruction is most important for the nurse to include in this
client's teaching plan?
A.Avoid alcohol consumption.
B.Complete the medication regimen.
C.Use a barrier contraceptive method.
D.Treat partner(s) concurrently.
A-
✔️Rationale:Clients should be instructed to avoid alcohol and products containing
alcohol while taking metronidazole because of the possibility of a disulfiram-like
reaction. Option B helps prevent the development of metronidazole-resistant T.
vaginalis. To prevent reinfection, clients should abstain from sexual contact or use a
barrier contraceptive while taking metronidazole, and their partner(s) should be
treated concurrently. The most important instruction for client well-being is option A.
A client with HIV who was recently diagnosed with tuberculosis (TB) asks the nurse,
"Why do I need to take all of these medications for TB?" What information should the
nurse provide?
A.Antiretroviral medications decrease the efficacy of the TB drugs.
B.Multiple drugs prevent the development of resistant organisms.
C.Duration of the medication regimen is shortened.
D.Potential adverse drug reactions are minimized.
B-
✔️A multidrug regimen is prescribed for a client with HIV and TB to prevent the
development of resistance of the tubercle bacilli. Although antitubercular medications
can inhibit some antiretrovirals, a multidrug regimen is needed to inhibit the
proliferation of the virulent tubercle bacilli. The duration of antitubercular therapy is
typically 6 to 9 months and is not shortened by the use of multiple medications. A
client who is receiving HIV and TB therapy is at an increased risk of adverse
reactions because of the complex medication regimens and complications secondary
to immunosuppression.
