NR 293 Questions and Answers A+.
Psychological response to inert medication
1. Methylphenidate HCl (Concerta) is prescribed for daily administration to a 10-year-old
childwithattentiondeficit-hyperactivitydisorder(ADHD).Inpreparingateachingplan for
the parents of this child newly diagnosed withADHD, which instruction is most
important for the nurse to provide to the parents?
✓ Administerthemedicationinthemorningbeforethechildgoesto school.
2. Whichphysiologicmechanismexplainsadrug'sincreasedmetabolismthatistriggered by a
disease process?
✓ Pharmacokinetics
3. The health care provider prescribes ipratropium (Atrovent) for a client.An allergic
reactiontowhichothermedicationwouldcausethenursetoquestiontheprescriptionfor
Atrovent?
✓ Atropinesulfate(Atropine)
4. A42-year-oldclientisadmittedtotheemergencydepartmentaftertakinganoverdoseof
amitriptyline (Elavil) in a suicide attempt. Which drug should the nurse plan to
administer to reverse the cardiac & central nervous system effects of amitriptyline
(Elavil)?
✓ Sodium bicarbonate
5. Aclient who is hypertensive receives a prescription for hydrochlorothiazide (HCTZ) –
thiazidediureticcausepotassiumwastingintheurine.Whenteachingabouttheside effects
of this drug, which symptoms are most important for the nurse to instruct the client to
report?
✓ Fatigue&muscle weakness
6. Thenurseispreparingtoapplyasurfaceanestheticagentforaclient.Whichaction should
the nurse implement to reduce the risk of systemic absorption?
✓ Avoidabradedskinareaswhenapplyingtheanesthetic.–applytothesmallest
surfaceofintactskin
,7. Thehealthcareproviderprescribescisplatin(Platinol)tobeadministeredin5%dextrose &
0.45% normal saline with mannitol (Osmitrol) added. Which assessment parameters
would be most helpful to the nurse in evaluating the effectiveness of the Osmitrol
therapy?
✓ Urine output
8. A19-year-old male client who has sustained a severe head injury is intubated & placed
on assisted mechanical ventilation. To facilitate optimal ventilation & prevent the client
from"fighting"theventilator,thehealthcareprovideradministerspancuroniumbromide
(Pavulon) IV, with adjunctive opioid analgesia. What medication should the nurse
maintain at the client's bedside?
✓ Neostigminebromide(Prostigmin)
9. The nurse is reviewing a client's laboratory results before a procedure in which a
neuromuscularblockingagentisast&ingorder.Whichfindingshouldthenursereportto the
health care provider?
✓ Hypokalemia-Lowpotassiumlevelsenhancetheeffectsofneuromuscular
blockingagents
10. Afemaleclientwithmyastheniagravisistakingacholinesteraseinhibitor&asksthe nurse
what can be done to remedy her fatigue & difficulty swallowing. What action should
the nurse implement?
✓ Developateachingplanfortheclienttoself-adjustthedoseofmedication in
responsetosymptoms.-Clientsshouldbetaughttorecognizesignsof
overmedication&undermedicationsothattheycanmodifythedosagethemselvesbas
edonaprescribedslidingscale.
11. Aclientreceivespancuronium(Pavulon),along-acting,nondepolarizingneuromuscular
blocker, during surgical anesthesia. Which client situation should alert the nurse to
evaluate the client for a prolonged muscle relaxation response to this medication?
✓ Renal insufficiency
12. Aclientisordered22mgofgentamicinbyIMinjection.Thedrugisavailablein20mg/2 mL. How
many mL should be administered?
✓ 2.2mL- (22mg/20mg)×2mL=2.2mL
13. Aclientisreceivingoralgriseofulvin(Grisactin)forapersistenttineacorporisinfection. Which
response by the client indicates an accurate underst&ing of the drug teaching conducted
by the nurse?
✓ "I'llwearsunscreenwheneverImowthelawn."-Photosensitivityisasideeffectof
griseofulvin(Grisactin),soclientsshouldbecautionedtowearprotective
sunscreenduringsunexposure.
, 14. Thenursehascompleteddiabeticteachingforaclientwhohasbeennewlydiagnosed
withdiabetesmellitus.Whichstatementbythisclientwouldindicatetothenursethat further
teaching is needed?
✓ "WhenIexercise,Ishouldplantoincreasemyinsulindosage."-Exercisehelps
facilitatetheentryofglucoseintothecell,soincreasinginsulindoseswithexercis
ewouldplacetheclientathighriskforahypoglycemicreaction.
15. The nurse is evaluating a client's underst&ing of the prescribed antilipemic drug
lovastatin(Mevacor).Whichclientstatementindicatesthatfurtherteachingis needed?
✓ "Iwilltakethemedicationeverydaybeforebreakfast."- Theenzymethathelps
metabolizecholesterolisactivatedatnight,sothismedicationshouldbetaken
withtheeveningmeal.
16. Aclient with acute lymphocytic leukemia is to begin chemotherapy today. The health
careprovider'sprescriptionspecifiesthatondansetron(Zofran)istobeadministeredIV 30
minutes prior to the infusion of cisplatin (Platinol). What is the rationale for
administering Zofran prior to the chemotherapy induction?
✓ Reductionoreliminationofnausea&vomiting
17. Aclientwhoarrivesinthepostanesthesiacareunit(PACU)aftersurgeryisnotawake from
general anesthesia. Which action should the nurse implement first?
✓ Reviewthemedicationadministrationrecord(MAR).-Mostgeneralanesthetics
producecardiovascular&respiratorydepression,soareviewoftheclient'sMARiden
tifiesallthemedicationsreceivedduringsurgery&helpsthenurseanticipatetheclient
'sresponse&emergencefromanesthesia.
18. Which class of antineoplastic chemotherapy agents resembles the essential elements
requiredforDNA&RNAsynthesis&inhibitsenzymesnecessaryforcellularfunction&replicat
ion?
✓ Antimetabolites
19. Aclient who is HIV-positive is receiving combination therapy with the antiviral
medicationzidovudine(Retrovir).Whichinstructionshouldthenurseincludeinthis
client's teaching plan?
✓ Returntotheclinicevery2weeksforbloodcounts.-Bonemarrowdepressionwith
granulocytopeniaisaseverebutcommonadverseeffectofzidovudine(Retrovir).Car
efulmonitoringofCBCsisindicated.
Psychological response to inert medication
1. Methylphenidate HCl (Concerta) is prescribed for daily administration to a 10-year-old
childwithattentiondeficit-hyperactivitydisorder(ADHD).Inpreparingateachingplan for
the parents of this child newly diagnosed withADHD, which instruction is most
important for the nurse to provide to the parents?
✓ Administerthemedicationinthemorningbeforethechildgoesto school.
2. Whichphysiologicmechanismexplainsadrug'sincreasedmetabolismthatistriggered by a
disease process?
✓ Pharmacokinetics
3. The health care provider prescribes ipratropium (Atrovent) for a client.An allergic
reactiontowhichothermedicationwouldcausethenursetoquestiontheprescriptionfor
Atrovent?
✓ Atropinesulfate(Atropine)
4. A42-year-oldclientisadmittedtotheemergencydepartmentaftertakinganoverdoseof
amitriptyline (Elavil) in a suicide attempt. Which drug should the nurse plan to
administer to reverse the cardiac & central nervous system effects of amitriptyline
(Elavil)?
✓ Sodium bicarbonate
5. Aclient who is hypertensive receives a prescription for hydrochlorothiazide (HCTZ) –
thiazidediureticcausepotassiumwastingintheurine.Whenteachingabouttheside effects
of this drug, which symptoms are most important for the nurse to instruct the client to
report?
✓ Fatigue&muscle weakness
6. Thenurseispreparingtoapplyasurfaceanestheticagentforaclient.Whichaction should
the nurse implement to reduce the risk of systemic absorption?
✓ Avoidabradedskinareaswhenapplyingtheanesthetic.–applytothesmallest
surfaceofintactskin
,7. Thehealthcareproviderprescribescisplatin(Platinol)tobeadministeredin5%dextrose &
0.45% normal saline with mannitol (Osmitrol) added. Which assessment parameters
would be most helpful to the nurse in evaluating the effectiveness of the Osmitrol
therapy?
✓ Urine output
8. A19-year-old male client who has sustained a severe head injury is intubated & placed
on assisted mechanical ventilation. To facilitate optimal ventilation & prevent the client
from"fighting"theventilator,thehealthcareprovideradministerspancuroniumbromide
(Pavulon) IV, with adjunctive opioid analgesia. What medication should the nurse
maintain at the client's bedside?
✓ Neostigminebromide(Prostigmin)
9. The nurse is reviewing a client's laboratory results before a procedure in which a
neuromuscularblockingagentisast&ingorder.Whichfindingshouldthenursereportto the
health care provider?
✓ Hypokalemia-Lowpotassiumlevelsenhancetheeffectsofneuromuscular
blockingagents
10. Afemaleclientwithmyastheniagravisistakingacholinesteraseinhibitor&asksthe nurse
what can be done to remedy her fatigue & difficulty swallowing. What action should
the nurse implement?
✓ Developateachingplanfortheclienttoself-adjustthedoseofmedication in
responsetosymptoms.-Clientsshouldbetaughttorecognizesignsof
overmedication&undermedicationsothattheycanmodifythedosagethemselvesbas
edonaprescribedslidingscale.
11. Aclientreceivespancuronium(Pavulon),along-acting,nondepolarizingneuromuscular
blocker, during surgical anesthesia. Which client situation should alert the nurse to
evaluate the client for a prolonged muscle relaxation response to this medication?
✓ Renal insufficiency
12. Aclientisordered22mgofgentamicinbyIMinjection.Thedrugisavailablein20mg/2 mL. How
many mL should be administered?
✓ 2.2mL- (22mg/20mg)×2mL=2.2mL
13. Aclientisreceivingoralgriseofulvin(Grisactin)forapersistenttineacorporisinfection. Which
response by the client indicates an accurate underst&ing of the drug teaching conducted
by the nurse?
✓ "I'llwearsunscreenwheneverImowthelawn."-Photosensitivityisasideeffectof
griseofulvin(Grisactin),soclientsshouldbecautionedtowearprotective
sunscreenduringsunexposure.
, 14. Thenursehascompleteddiabeticteachingforaclientwhohasbeennewlydiagnosed
withdiabetesmellitus.Whichstatementbythisclientwouldindicatetothenursethat further
teaching is needed?
✓ "WhenIexercise,Ishouldplantoincreasemyinsulindosage."-Exercisehelps
facilitatetheentryofglucoseintothecell,soincreasinginsulindoseswithexercis
ewouldplacetheclientathighriskforahypoglycemicreaction.
15. The nurse is evaluating a client's underst&ing of the prescribed antilipemic drug
lovastatin(Mevacor).Whichclientstatementindicatesthatfurtherteachingis needed?
✓ "Iwilltakethemedicationeverydaybeforebreakfast."- Theenzymethathelps
metabolizecholesterolisactivatedatnight,sothismedicationshouldbetaken
withtheeveningmeal.
16. Aclient with acute lymphocytic leukemia is to begin chemotherapy today. The health
careprovider'sprescriptionspecifiesthatondansetron(Zofran)istobeadministeredIV 30
minutes prior to the infusion of cisplatin (Platinol). What is the rationale for
administering Zofran prior to the chemotherapy induction?
✓ Reductionoreliminationofnausea&vomiting
17. Aclientwhoarrivesinthepostanesthesiacareunit(PACU)aftersurgeryisnotawake from
general anesthesia. Which action should the nurse implement first?
✓ Reviewthemedicationadministrationrecord(MAR).-Mostgeneralanesthetics
producecardiovascular&respiratorydepression,soareviewoftheclient'sMARiden
tifiesallthemedicationsreceivedduringsurgery&helpsthenurseanticipatetheclient
'sresponse&emergencefromanesthesia.
18. Which class of antineoplastic chemotherapy agents resembles the essential elements
requiredforDNA&RNAsynthesis&inhibitsenzymesnecessaryforcellularfunction&replicat
ion?
✓ Antimetabolites
19. Aclient who is HIV-positive is receiving combination therapy with the antiviral
medicationzidovudine(Retrovir).Whichinstructionshouldthenurseincludeinthis
client's teaching plan?
✓ Returntotheclinicevery2weeksforbloodcounts.-Bonemarrowdepressionwith
granulocytopeniaisaseverebutcommonadverseeffectofzidovudine(Retrovir).Car
efulmonitoringofCBCsisindicated.
