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1. A client who has been taking phenazopyri- C) Have you had any relief from urinary pain,
dine (Pyridium) for symptoms of urethritis burning, or urgency?
and cystitis comes to the clinic because Feedback:
her urine is reddish-orange. Which ques- Phenazopyridine, an over-the-counter urinary
tion should the practical nurse ask to de- analgesic, acts on the mucosa of the urinary
termine if the medication has been effec- tract to relieve urinary pain, burning, itching,
tive? or urgency (C) associated with urethritis and
A) How much water have you been drink- cystitis. Although determining if the client is
ing each day? forcing fluids (A), experiencing staining from
B) Does the urine color stain your toilet Pyridium's side effect (B), or having signs of
bowl or undergarments? a urinary infection (D) are worthwhile assess-
C) Have you had any relief from urinary ments, the therapeutic response of Pyridium
pain, burning, or urgency? is related to urinary discomforts only.
D) Did your urine appear cloudy or have a
foul odor on voiding?
2. A male client who has been receiving an D) Shave with an electric razor.
antineoplastic drug has developed throm- Feedback:
bocytopenia. What instructions should Thrombocytopenia is a common side effect of
the practical nurse (PN) reinforce? bone marrow depression caused by several
A) Use suppository form of drugs. antineoplastic agents. The client is experienc-
B) Avoid large public gatherings. ing a low platelet count and should use an
C) Rise slowly when standing up. electric razor (D) to reduce his risk of bleed-
D) Shave with an electric razor. ing. (A, B, and C) are not indicated for a client
who needs to implement thrombocytopenia
precautions.
3. The practical nurse (PN) is caring for a B) Weight gain.
client who has been taking prednisone Feedback:
(Deltasone) daily for a year. Which adverse Long term use of prednisone causes fluid
effect should the PN document in the retention and redistribution of fat deposi-
client's record? tion. Weight gain (B) and moon face reflect
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A) Photosensitvity. adverse effects of long-term prednisone use
B) Weight gain. and should be documented. (A, C, and D) do
C) Loss of hair. not occur with treatment using prednisone.
D) Pale skin color.
4. A female client with recurring headaches B) Hepatic enzymes.
tells the practical nurse (PN) that she has Feedback:
been taking at least 4 grams of aceta- Liver toxicity can occur when doses of aceta-
minophen a day. Which laboratory studies minophen exceed 4 grams a day, resulting in
should the PN review for this client? an elevation in hepatic enzyme values (B). (A,
A) Creatinine clearance. C, and D) do not reveal findings related to
B) Hepatic enzymes. acetaminophen toxicity.
C) Coagulation values.
D) Arterial blood gases.
5. A client receives a prescription for an oral A) Constipation.
opioid analgesic for post-operative pain. Feedback:
Which adverse effect should the practical Opioid analgesics slow peristalsis, which
nurse (PN) monitor for with the client? leads to constipation (A), a common side ef-
A) Constipation. fect of opiates. (B, C, and D) are not associ-
B) Photosensitivity. ated with opioid analgesics.
C) Decreased heart rate.
D) Frequent urination.
6. Which action should the practical nurse D) Place the medication between the upper
implement when administering a buccal molar teeth and cheek.
medication? Feedback:
A) Encourage the client to swallow. Buccal medications are placed between the
B) Administer water with medication. upper molar teeth and the cheek (D) for ab-
C) Ensure the medication is positioned un- sorption by the capillaries of the oral mucosa.
der the tongue. The client should be cautioned against swal-
lowing, not (A). Buccal medications are not
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D) Place the medication between the up- administered with water (B). (C) describes
per molar teeth and cheek. sublingual administration.
7. What assessment is most important for C) Understanding of diet modification.
the practical nurse (PN) to obtain pri- Feedback:
or to initiating medication therapy with To prevent a potentially lethal hyperten-
phenelzine (Nardil) for a client with de- sive crisis, a tyramine-free diet should be
pression? maintained during antidepressant therapy
A) Activity level. with Nardil, a monoamine oxidase inhibitor
B) Mood and affect. (MAOI). It is most important to determine if
C) Understanding of diet modification. the client understands diet modification (C)
D) The client's support system. before Nardil is initiated to prevent consump-
tion of foods that interact with Nardil. Al-
though a client's activity level (A) and mood
and affect (B) should be monitored during
antidepressant therapy, it is most important
that the client understand diet modifications.
The client's support system (D) and network
of family and friends is important, but the
client should understand the responsibility of
dietary compliance with the medication regi-
men.
8. The practical nurse (PN) is unable to A) Naloxone (Narcan).
arouse a client who is receiving meperi- Feedback:
dine (Demerol) for postoperative pain. Narcan (A) is an opioid antagonist and should
The client is stuporous, has constrict- be administered to reverse the effects of a
ed pupils, and a respiratory rate of 8 Demerol, an opioid, overdose. (B, C, and D)
breaths/minute. Which PRN prescription are common postoperative PRN prescriptions
should the PN give the client? but are not indicated for narcotic overdose.
A) Naloxone (Narcan).
B) Promethazine (Phenergan).