NURS-6521N-Advanced Pharmacology.2020 Summer

A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the 1 out of 1 points Response Feedback: The ventrogluteal site is the best choice because it is free of major nerves and blood vessels and is characterized by deep muscle mass. The drug is injected into the gluteus medius muscle, which is in the ventrogluteal site. Injection in the gluteus medius is less painful than injection in the vastus lateralis. The dorsogluteal site should be used only as a last resort because of potential damage to the sciatic nerve if the site is not chosen with precision. The scalp veins are never used for injections; they are used only as intravenous sites in infants. • Question 2 A 21-year-old female has a history of irregular menses. She recently 1 out of 1 points became sexually active, and would like to begin taking oral contraceptives (OCs). The nurse practitioner recognizes that most likely this patient would benefit from taking which category of OCs. • Question 3 A 35-year-old woman is on a weight-loss program and is to begin taking 1 out of 1 points sibutramine (Meridia). After baseline physical data are obtained, the nurse will assess the patient's childbearing potential. The nurse will inform the patient that during sibutramine therapy she should Response Feedback: Before sibutramine therapy is started, the nurse should assess the female patient for pregnancy or the intention to become pregnant. This drug is classified as pregnancy category C. Patients should be told to use adequate contraception and to advise their physician if they become or intend to become pregnant during sibutramine therapy. It would not be appropriate to tell the patient to abstain from sex, and a pregnancy test would not be necessary once a month. However, it would be advisable to have a pregnancy test before therapy begins if the patient is unsure if she is pregnant or if the patient has irregular menstrual periods. A pap smear is not necessarily related to the use of sibutramine but should be done on a regular basis as a normal disease-prevention measure for women. • Question 4 A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the chance that the boy will take his prescribed medication, the nurse should 1 out of 1 points Response Feedback: Preschoolers are often uncooperative during drug administration. Strategies for enlisting cooperation include offering choices (e.g., between liquid medicines or chewable tablets) when feasible. This is preferable to forcibly administering a medication. Teaching is unlikely to influence a 3-year-old child's reluctance. A central IV line would not be a preferred strategy if oral medications are available. • Question 5 1 out of 1 points A child is admitted to the burn unit with second and third degree burns on both arms and part of his or her face. When administering topical medications to the burned areas, the nurse should Response Feedback: In second- and third-degree burns, the skin is often broken, and the nurse needs to use sterile technique when applying a topical drug to prevent introducing bacteria and other organisms into the body. Do not cool medications unless instructed to do so. Children should not be instructed to apply medications to burned areas of their body. Using clean technique will not be as effective as sterile technique in decreasing the risk of infection when applying the medication. • Question 6 1 out of 1 points A patient asks the nurse practitioner about food sources such as soybeans and soy products. The nurse practitioner understands that these foods are considered • Question 7 A 16-year-old boy is prescribed cromolyn sodium nasal spray to treat a 1 out of 1 points nasal allergy. To maximize the therapeutic effects of the drug, which of the following will the nurse include in instructions to the patient? Response Feedback: To maximize the therapeutic effects of the drug, the patient should take cromolyn sodium for one full week before coming in contact with allergens. Taking the drug on a full stomach is inappropriate, since the drug is in the form of a nasal spray. Neither avoiding high noise levels nor drinking plenty of fluids would help maximize the therapeutic effects of the drug. • Question 8 A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse's priority assessment would be 0 out of 1 points Response Feedback: The nurse should assess blood pressure, body temperature, and vision at each clinic visit as routine nursing measures in caring for a pediatric patient. However, the priority assessment would be of height and weight. Monitoring the growth and development of children taking amphetamines is extremely important because these drugs have been associated with growth suppression. • Question 9 A nurse is explaining to the parents of a 6-year-old child suffering from 1 out of 1 points angina why nitroglycerin patches for chest pain would not be appropriate. Which of the following will the nurse include in an explanation? Response Feedback: Increased absorption of topical drugs is common in pediatric patients because children have a greater body surface area and a child's skin exhibits greater permeability. Increased absorption of topical drugs can result in adverse effects that do not occur in adult patients. Erratic blood flow would affect an intramuscular or subcutaneous route of drug administration. Gastric pH would not affect topical absorption. • Question 10 1 out of 1 points A patient reports to a clinic with complaints of breast tenderness, a right lumpy breast, and no breast discharge. The breast tenderness occurs primarily during her menstrual cycle. The nurse practitioner probably suspects • Question 11 1 out of 1 points 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 home health 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 following will have the greatest impact on the nurse's assessment? Response Feedback: An important question that should be asked during the assessment is whether there is a safe place to keep drugs out of the reach of the patient and the other children. Many drugs have serious adverse and toxic effects in children if taken without adult supervision. Although factors like health status of other family members, the cleanliness of the house, and the parent's understanding about the medications are important considerations, the most important consideration is the safety of the child who is taking the medication and the other children. • Question 12 1 out of 1 points A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose? • Question 13 A nurse 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? 1 out of 1 points Response Feedback: Because the patient is on the track team, she will have increased exercise at various times that will require increased insulin and special instructions related to hypoglycemia that may come hours after she has ceased exercising. Walking two blocks every day and walking up stairs would not be considered increased physical exercise and would not be a factor. Wanting to have her mother administer the insulin is not uncommon for this age patient, and the nurse would normally instruct both the mother and the daughter in the administration of the drug. • Question 14 1 out of 1 points A 19-year-old patient reports to a clinic with vaginal discharge with a foul odor. A microscopic exam reveals trichomonas vaginalis. The nurse practitioner is aware that • Question 15 1 out of 1 points A nurse 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 Response Feedback: In addition to baseline physical data including height, weight, and vital signs, the nurse should prepare the patient for an ECG. This would be important for ruling out any cardiovascular abnormalities that CNS stimulants might exacerbate, especially in this patient who is 7 years old. An EMG measures the electrical activity of muscle and is used to differentiate between neuropathy and myopathy. This test is not indicated in this patient. An EEG is a recording of the electrical activity of the brain and is used to help identify a focus of disturbance in the brain. An EEG may be performed to evaluate narcolepsy, sleeping patterns, and sleep apnea. However, it would not be indicated in this patient with ADHD. EPS is similar to a cardiac catheterization and can monitor the entire conduction system with mapping of normal and abnormal pathways of the heart. This test would not be needed unless the patient had a serious cardiac condition.