1
A healthcare provider prescribes cephalexin monohydrate
(Keflex) for a client with a postoperative infection. It is
most important for the nurse to assess for what additional
drug allergy before administering this prescription?
A) Penicillins.
B) Aminoglycosides.
C) Erythromycins.
D) Sulfonamides.
A) Penicillins.
Cross-allergies exist between penicillins (A) and
cephalosporins, such as cephalexin monohydrate (Keflex),
so checking for penicillin allergy is a wise precaution before
administering this drug.
Which nursing intervention is most important when caring
for a client receiving the antimetabolite cytosine
arabinoside (Arc-C) for chemotherapy?
A) Hydrate the client with IV fluids before and after
infusion.
B) Assess the client for numbness and tingling of
extremities.
C) Inspect the client's oral mucosa for ulcerations.
D) Monitor the client's urine pH for increased acidity.
C) Inspect the client's oral mucosa for ulcerations.
Cytosine arabinoside (Arc-C) affects the rapidly growing
cells of the body, therefore stomatitis and mucosal
ulcerations are key signs of antimetabolite toxicity (C). (A,
B, and D) are not typical interventions associated with the
administration of antimetabolites.
When assessing an adolescent who recently overdosed on
acetaminophen (Tylenol), it is most important for the
nurse to assess for pain in which area of the body?
A) Flank.
B) Abdomen.
C) Chest.
D) Head.
B) Abdomen.
Acetaminophen toxicity can result in liver damage;
therefore, it is especially important for the nurse to assess
for pain in the right upper quadrant of the abdomen (B),
which might indicate liver damage. (A, C, and D) are not
areas where pain would be anticipated.
,2
An adult client is given a prescription for a scopolamine
patch (Transderm Scop) to prevent motion sickness while
on a cruise. Which information should the nurse provide to
the client?
A) Apply the patch at least 4 hours prior to departure.
B) Change the patch every other day while on the cruise.
C) Place the patch on a hairless area at the base of the
skull.
D) Drink no more than 2 alcoholic drinks during the cruise.
A) Apply the patch at least 4 hours prior to departure.
Scopolamine, an anticholinergic agent, is used to prevent
motion sickness and has a peak onset in 6 hours, so the
client should be instructed to apply the patch at least 4
hours before departure (A) on the cruise ship. The duration
of the transdermal patch is 72 hours, so (B) is not needed.
Scolopamine blocks muscarinic receptors in the inner ear
and to the vomiting center, so the best application site of
the patch is behind the ear, not at the base of the skull (C).
Anticholinergic medications are CNS depressants, so the
client should be instructed to avoid alcohol (D) while using
the patch.
The nurse is reviewing the use of the patient-controlled
analgesia (PCA) pump with a client in the immediate
postoperative period. The client will receive morphine 1
mg IV per hour basal rate with 1 mg IV every 15 minutes
per PCA to total 5 mg IV maximally per hour. What
assessment has the highest priority before initiating the
PCA pump?
A) The expiration date on the morphine syringe in the
pump.
B) The rate and depth of the client's respirations.
C) The type of anesthesia used during the surgical
procedure.
D) The client's subjective and objective signs of pain.
B) The rate and depth of the client's respirations.
A life-threatening side effect of intravenous administration
of morphine sulfate, an opiate narcotic, is respiratory
depression (B). The PCA pump should be stopped and the
healthcare provider notified if the client's respiratory rate
falls below 12 breaths per minute, and the nurse should
anticipate adjustments in the client's dosage before the
PCA pump is restarted. (A, C, and D) provide helpful
information, but are not as high a priority as the
assessment described in (B).
, 3
A medication that is classified as a beta-1 agonist is most
commonly prescribed for a client with which condition?
A) Glaucoma.
B) Hypertension.
C) Heart failure.
D) Asthma.
C) Heart failure.
Beta-1 agonists improve cardiac output by increasing the
heart rate and blood pressure and are indicated in heart
failure (C), shock, atrioventricular block dysrhythmias, and
cardiac arrest. Glaucoma (A) is managed using adrenergic
agents and beta-adrenergic blocking agents. Beta-1
blocking agents are used in the management of
hypertension (B). Medications that stimulate beta-2
receptors in the bronchi are effective for
bronchoconstriction in respiratory disorders, such as
asthma (D).
A female client with rheumatoid arthritis take ibuprofen
(Motrin) 600 mg PO 4 times a day. To prevent
gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg
PO is prescribed. Which information is most important for
the nurse to include in client teaching?
A) Use contraception during intercourse.
B) Ensure the Cytotec is taken on an empty stomach.
C) Encourage oral fluid intake to prevent constipation.
D) Take Cytotec 30 minutes prior to Motrin.
A) Use contraception during intercourse.
Cytotec, a synthetic form of a prostaglandin, is classified as
pregnancy Category X and can act as an abortifacient, so
the client should be instructed to use contraception during
intercourse (A) to prevent loss of an early pregnancy. (B) is
not necessary. A common side effect of Cytotec is diarrhea,
so constipation prevention strategies are usually not
needed (C). Cytotec and Motrin should be taken together
(D) to provide protective properties against gastrointestinal
bleeding.
A client with heart failure is prescribed spironolactone
(Aldactone). Which information is most important for the
nurse to provide to the client about diet modifications?
A) Do not add salt to foods during preparation.
B) Refrain for eating foods high in potassium.
A healthcare provider prescribes cephalexin monohydrate
(Keflex) for a client with a postoperative infection. It is
most important for the nurse to assess for what additional
drug allergy before administering this prescription?
A) Penicillins.
B) Aminoglycosides.
C) Erythromycins.
D) Sulfonamides.
A) Penicillins.
Cross-allergies exist between penicillins (A) and
cephalosporins, such as cephalexin monohydrate (Keflex),
so checking for penicillin allergy is a wise precaution before
administering this drug.
Which nursing intervention is most important when caring
for a client receiving the antimetabolite cytosine
arabinoside (Arc-C) for chemotherapy?
A) Hydrate the client with IV fluids before and after
infusion.
B) Assess the client for numbness and tingling of
extremities.
C) Inspect the client's oral mucosa for ulcerations.
D) Monitor the client's urine pH for increased acidity.
C) Inspect the client's oral mucosa for ulcerations.
Cytosine arabinoside (Arc-C) affects the rapidly growing
cells of the body, therefore stomatitis and mucosal
ulcerations are key signs of antimetabolite toxicity (C). (A,
B, and D) are not typical interventions associated with the
administration of antimetabolites.
When assessing an adolescent who recently overdosed on
acetaminophen (Tylenol), it is most important for the
nurse to assess for pain in which area of the body?
A) Flank.
B) Abdomen.
C) Chest.
D) Head.
B) Abdomen.
Acetaminophen toxicity can result in liver damage;
therefore, it is especially important for the nurse to assess
for pain in the right upper quadrant of the abdomen (B),
which might indicate liver damage. (A, C, and D) are not
areas where pain would be anticipated.
,2
An adult client is given a prescription for a scopolamine
patch (Transderm Scop) to prevent motion sickness while
on a cruise. Which information should the nurse provide to
the client?
A) Apply the patch at least 4 hours prior to departure.
B) Change the patch every other day while on the cruise.
C) Place the patch on a hairless area at the base of the
skull.
D) Drink no more than 2 alcoholic drinks during the cruise.
A) Apply the patch at least 4 hours prior to departure.
Scopolamine, an anticholinergic agent, is used to prevent
motion sickness and has a peak onset in 6 hours, so the
client should be instructed to apply the patch at least 4
hours before departure (A) on the cruise ship. The duration
of the transdermal patch is 72 hours, so (B) is not needed.
Scolopamine blocks muscarinic receptors in the inner ear
and to the vomiting center, so the best application site of
the patch is behind the ear, not at the base of the skull (C).
Anticholinergic medications are CNS depressants, so the
client should be instructed to avoid alcohol (D) while using
the patch.
The nurse is reviewing the use of the patient-controlled
analgesia (PCA) pump with a client in the immediate
postoperative period. The client will receive morphine 1
mg IV per hour basal rate with 1 mg IV every 15 minutes
per PCA to total 5 mg IV maximally per hour. What
assessment has the highest priority before initiating the
PCA pump?
A) The expiration date on the morphine syringe in the
pump.
B) The rate and depth of the client's respirations.
C) The type of anesthesia used during the surgical
procedure.
D) The client's subjective and objective signs of pain.
B) The rate and depth of the client's respirations.
A life-threatening side effect of intravenous administration
of morphine sulfate, an opiate narcotic, is respiratory
depression (B). The PCA pump should be stopped and the
healthcare provider notified if the client's respiratory rate
falls below 12 breaths per minute, and the nurse should
anticipate adjustments in the client's dosage before the
PCA pump is restarted. (A, C, and D) provide helpful
information, but are not as high a priority as the
assessment described in (B).
, 3
A medication that is classified as a beta-1 agonist is most
commonly prescribed for a client with which condition?
A) Glaucoma.
B) Hypertension.
C) Heart failure.
D) Asthma.
C) Heart failure.
Beta-1 agonists improve cardiac output by increasing the
heart rate and blood pressure and are indicated in heart
failure (C), shock, atrioventricular block dysrhythmias, and
cardiac arrest. Glaucoma (A) is managed using adrenergic
agents and beta-adrenergic blocking agents. Beta-1
blocking agents are used in the management of
hypertension (B). Medications that stimulate beta-2
receptors in the bronchi are effective for
bronchoconstriction in respiratory disorders, such as
asthma (D).
A female client with rheumatoid arthritis take ibuprofen
(Motrin) 600 mg PO 4 times a day. To prevent
gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg
PO is prescribed. Which information is most important for
the nurse to include in client teaching?
A) Use contraception during intercourse.
B) Ensure the Cytotec is taken on an empty stomach.
C) Encourage oral fluid intake to prevent constipation.
D) Take Cytotec 30 minutes prior to Motrin.
A) Use contraception during intercourse.
Cytotec, a synthetic form of a prostaglandin, is classified as
pregnancy Category X and can act as an abortifacient, so
the client should be instructed to use contraception during
intercourse (A) to prevent loss of an early pregnancy. (B) is
not necessary. A common side effect of Cytotec is diarrhea,
so constipation prevention strategies are usually not
needed (C). Cytotec and Motrin should be taken together
(D) to provide protective properties against gastrointestinal
bleeding.
A client with heart failure is prescribed spironolactone
(Aldactone). Which information is most important for the
nurse to provide to the client about diet modifications?
A) Do not add salt to foods during preparation.
B) Refrain for eating foods high in potassium.
