NURS 6521 Final Exam- Complete Solution Package

NURS 6521 Final Exam Question 1 1 out of 1 points Correct A 77-year-old man's chronic heart failure is being treated with a regimen of quinapril (Accupril) and furosemide (Lasix). Which of the following assessment findings would suggest that the loop diuretic is contributing to a therapeutic effect? Selected Answer: The man's chest sounds are clear and his ankle edema is lessened. Question 2 1 out of 1 points Correct A Nurse Practitioner is caring for a patient who is taking digoxin and a loop diuretic. Which of the following would be most important for the Nurse Practitioner to monitor? Selected Answer: Potassium levels Question 3 1 out of 1 points Correct An expected outcome for a patient who has just taken sublingual nitroglycerin should be Selected Answer: increased heart rate and decreased blood pressure. Question 4 1 out of 1 points Correct A patient taking Metformin (Glucophage) is scheduled for a cardiac cath. The patient asks why he can't take his metformin the day of the test. What is the most appropriate reply? Selected Answer: You can develop lactic acidosis if you take metformin and are given dye. You should have a serum creatinine drawn before restarting the medication. Question 5 1 out of 1 points Correct The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parent's about the appropriate use of a "rescue drug" for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations? Selected Answer: Albuterol Question 6 1 out of 1 points Correct A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of Selected Answer: an adrenergic antagonist. Question 7 1 out of 1 points Correct A female patient, age 36, is prescribed inhaled corticosteroid (ICS) for daily use. Which of the following adverse effects should the nurse closely monitor for in this patient? Selected Answer: Oropharyngeal Candida albicans infection Question 8 1 out of 1 points Correct A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain? Selected Answer: Administer a tablet under his tongue and repeat the action in 5 and 10 minutes if the pain has not subsided Question 9 0 out of 1 points Incorrect Mr. Lacuna is an 83-year-old resident of a long-term care facility who has a diagnosis of moderate Alzheimer disease. Mr. Lacuna's physician recently prescribed oral rivastigmine, but he was unable to tolerate the drug due to its gastrointestinal effects. As a result, he has been ordered the transdermal patch form of the medication. When administering this form of rivastigmine, the nurse should Selected Answer: teach Mr. Lacuna about the importance of rotating sites when he applies the patch. Question 10 1 out of 1 points Correct It is determined that a patient, who is in a hepatic coma, needs a laxative. Lactulose is prescribed. Which of the following should the nurse monitor to assess the efficacy of the lactulose therapy? Selected Answer: Blood ammonia levels Question 11 1 out of 1 points Correct A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to Selected Answer: rebound bronchoconstriction. Question 12 1 out of 1 points Correct Which statement is FALSE regarding the treatment of hyperthyroidism? Selected Answer: Methimazole (Tapazole) is the drug of choice for pregnant or lactating females. Question 13 1 out of 1 points Correct A Nurse Practitioner who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients? Selected Answer: An obese male client who is a heavy alcohol user and who has cirrhosis of the liver Question 14 1 out of 1 points Correct A patient with a recent diagnosis of acute renal failure has a long-standing seizure disorder which has been successfully controlled for several years with antiseizure medications. The nurse should recognize that the patient's compromised renal function will likely Selected Answer: increase the half-life of medications that are metabolized by the kidneys. Question 15 1 out of 1 points Correct A Nurse Practitioner is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed. Before the drug therapy is started, the nurse will assess for which of the following? Selected Answer: History of taking anticoagulant drugs Question 16 1 out of 1 points Correct Mr. Nguyen, age 71, will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During patient education about his drug regimen, Mr. Nguyen's nurse should prioritize teach about Selected Answer: potential adverse effects of the drugs that Mr. Nguyen will be taking. Question 17 1 out of 1 points Correct A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient's Selected Answer: use of alcohol. Question 18 1 out of 1 points Correct A 39-year-old African-American male is 25 pounds overweight and has been diagnosed with hypertension after three consecutive above-normal blood pressure readings. The most likely initial drug therapy for this patient will be Selected Answer: a diuretic. Question 19 0 out of 1 points Incorrect The Nurse Practitioner is treating a patient that takes frequent doses of antacids for his heartburn and is also taking an enteric coded aspirin. What instructions should be provided to the patient? Selected Answer: The aspirin is less effective when taken with an antacid so you need to increase the dose. Question 20 1 out of 1 points Correct A patient has been prescribed lovastatin for a high cholesterol level. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it Selected Answer: inhibits cholesterol syntheses. Question 21 1 out of 1 points Correct A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive Selected Answer: a higher-than-normal dose of drugs that bind to acid glycoproteins. Question 22 1 out of 1 points Correct The APRN is caring for a patient taking a calcium channel blockers for hypertension. The APRN should monitor the patient for what common side effects of this medication? Selected Answer: peripheral edema, constipation, dizziness Question 23 1 out of 1 points Correct A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse's advice? Selected Answer: Integrating the new drug into the patient's existing schedule promotes adherence. Question 24 1 out of 1 points Correct An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for Selected Answer: falls. Question 25 1 out of 1 points Correct A patient with a long history of alcohol abuse has been admitted to an acute medical unit with signs and symptoms of hepatic encephalopathy. His current medication orders include QID doses of oral lactulose. What desired outcomes should the nurse associate with this drug order? Selected Answer: Patient will have three to four loose bowel movements each day. Question 26 1 out of 1 points Correct An elderly postsurgical patient has developed postoperative pneumonia in the days following abdominal surgery and is being treated with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption? Selected Answer: An oral antidepressant that the patient has been taking daily for several years Question 27 1 out of 1 points Correct The APRN's ability to prescribe controlled substances is regulated by: Selected Answers: DEA State Law Question 28 1 out of 1 points Correct A patient is bothered with nighttime episodes of bronchoconstriction related to asthma. Which of the following medications can be administered to decrease the nighttime episodes and prevent asthma attacks? Selected Answer: Leukotriene modifiers Question 29 1 out of 1 points Correct A Nurse Practitioner is providing care for a 71-year-old woman who was sponsored to emigrate from Mexico to the United States 6 months ago. Earlier this week, the woman slipped while getting off a bus and fractured her hip. How should the woman's nurse best exemplify cultural competence in the care of this patient? Selected Answer: Consider dimensions of the woman's cultural background when planning care. Question 30 1 out of 1 points Correct A Nurse Practitioner is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the Nurse Practitioner take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment? Selected Answer: Carefully assess the patient for infections Question 31 1 out of 1 points Correct A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction? Selected Answer: Late afternoon Question 32 1 out of 1 points Correct A Nurse Practitioner who provides care in a long-term care facility is documenting a new resident's medication regimen on the resident's intake admission. The Nurse Practitioner is documenting the generic, rather than proprietary, names of the resident's current drugs because Selected Answer: there is a potential for confusion and miscommunication if proprietary names are used. Question 33 1 out of 1 points Correct Mr. Penny, age 67, was diagnosed with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient's angina? Selected Answer: Mr. Penny requires concurrent treatment with a beta blocker, nitrate, or a calcium channel blocker. Question 34 1 out of 1 points Correct The APRN is seeing Mrs. Smith, age 77, who is here for follow up of hypertension, dyslipidemia, and depression. What should you consider during her follow-up? Selected Answer: Age-related changes in renal function are the main cause of adverse drug reactions Question 35 1 out of 1 points Correct A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely administer a lower-than-normal maintenance dose of digoxin? Selected Answer: A 79-year-old male with cardiomegaly Question 36 1 out of 1 points Correct A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be Selected Answer: suppository. Question 37 1 out of 1 points Correct A 70-year-old woman has experienced peripheral edema and decreasing stamina in recent months and has sought care from her primary care provider. The patient's subsequent diagnostic workup has resulted in a diagnosis of chronic heart failure. The woman has been prescribed digoxin and the nurse has begun patient education. What should the nurse teach the patient about her new medication? Selected Answer: "This drug won't cure your disease, but it will help you be able to exercise more and be more comfortable." Question 38 1 out of 1 points Correct A 79-year-old woman with a medical history that includes osteoporosis has recently moved to a longterm care facility. Medication reconciliation indicates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is Selected Answer: intranasal. Question 39 1 out of 1 points Correct A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient's blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control? Selected Answer: Doses of basal insulin twice daily with regular insulin before each meal Question 40 1 out of 1 points Correct A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient? Selected Answer: "Quitting smoking will significantly increase the chance that this drug will heal your ulcer." Question 41 1 out of 1 points Correct A woman has a long history of seasonal allergies that are typically accompanied by rhinorrhea, red eyes, and frequent sneezing. Sneezes are a result of Selected Answer: a CNS reflex that is initiated by receptors in the nasal cavities. Question 42 1 out of 1 points Correct Which of the following is TRUE about long acting beta agonist use in asthma patients? Selected Answer: It can be combined with an inhaled corticosteroid to improve asthma control Question 43 1 out of 1 points Correct A Nurse Practitioner is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for which of the following? Selected Answer: Increase in plasma concentration of lovastatin Question 44 1 out of 1 points Correct To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should Selected Answer: administer carbohydrates. Question 45 1 out of 1 points Correct A 56-year-old female patient has been admitted to the hospital with chronic muscle spasms and has been prescribed a new medication to treat the spasms. She has a poorly documented allergy to eggs, synthetic clothes, and perfumes. What is the priority action of the nurse to ensure that prescribed medication does not experience an allergic reaction? Selected Answer: Post an allergies notice on the front of the chart and document the allergies in the appropriate area of the patient's record Question 46 1 out of 1 points Correct Federal legislation dictates a lengthy and rigorous process of testing for new drugs. What is the primary purpose of this testing process? Selected Answer: To ensure the safety of the public Question 47 1 out of 1 points Correct A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing increasing neuropathic pain in recent months, a symptom that has not responded appreciably to conventional analgesics. The patient's care provider has begun treatment with gabapentin (Neurontin). How is the addition of this drug likely to influence the management of the patient's existing drug regimen? Selected Answer: It is unlikely to influence the patient's other medications because gabapentin does not interact with other drugs. Question 48 1 out of 1 points Correct Mr. Tan is a 69-year-old man who prides himself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. However, Mr. Tan states that he has experienced occasional constipation in recent months. What remedy should be the nurse's first suggestion? Selected Answer: A bulk-forming (fiber) laxative Question 49 1 out of 1 points Correct A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following? Selected Answer: How well a drug produces its desired effect Question 50 1 out of 1 points Correct A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient's first dose? Selected Answer: The amount of alcohol consumption Question 51 1 out of 1 points Correct A child with sinusitis has been on antibiotics for seven days and his symptoms are not improving. All of the following are options to prescribe for the patient now EXCEPT: Selected Answer: Azithromycin (Zithromycin) Question 52 1 out of 1 points Correct A clinic Nurse Practitioner has been assigned a 49-year-old female patient who has a history of diabetes. A recent diagnosis of hypertension has been made, and the patient has been prescribed a thiazide diuretic and labetalol. The patient will be scheduled to return to the clinic once a month for the next 6 months. A priority action by the Nurse Practitioner will be to Selected Answer: monitor the patient's blood pressure. Question 53 1 out of 1 points Correct A Nurse Practitioner receives an order to administer a critically ill patient two drugs immediately (stat). The Nurse Practitioner begins the process by Selected Answer: consulting a drug guide for compatibility. Question 54 1 out of 1 points Correct Decongestants are recommended to use in which of the following patients? Selected Answer: patients with otitis media Question 55 1 out of 1 points Correct Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from Helicobacter pylori infection. Which of the following medications will likely be used in an attempt to eradicate the patient's H. pylori infection? (Select all that apply.) Selected Answers: Antibiotics A PPI Question 56 1 out of 1 points Correct In order to promote therapeutic drug effects, the Nurse Practitioner should always encourage patients to Selected Answer: take their medication at the prescribed times. Question 57 The APRN is prescribing a medication that is known to induce hepatic enzymes. What effect should you anticipate? Selected Answer: Induction increases the rate of metabolism, thereby decreasing serum levels of drug Question 58 1 out of 1 points Correct Which of the following would be an expected outcome in a patient who has been given atropine during a medical emergency? Selected Answer: Restoration of normal sinus rhythm Question 59 0 out of 1 points Incorrect A 62 year old male who had a myocardial infarction one year ago is being seen for hypertension. Which medication has the best evidence in mortality reduction? Selected Answer: Beta blocker Question 60 Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine? Selected Answer: The resident's apical heart rate is 112 beats/minute with a regular rhythm Question 61 1 out of 1 points Correct A patient is being treated for respiratory infection. He is a recovering alcoholic and has impaired liver function. The nurse will instruct the patient to be especially cautious when taking Selected Answer: an elixir. Question 62 1 out of 1 points Correct Advanced practice nurse prescribing of scheduled medications is affected most by: Selected Answer: Individual states laws regarding scheduled medications that can be prescribed and for how long Question 63 A Nurse Practitioner is caring for a female patient who has developed atelectasis because of thick mucus secretions. The Nurse Practitioner is monitoring IV administration of acetylcysteine (Mucomyst) and notices that the patient's face is flushed. The appropriate nursing action would be to Selected Answer: slow the administration of acetylcysteine and administer diphenhydramine if ordered. Question 64 1 out of 1 points Correct A 60-year-old man has scheduled a follow-up appointment with his primary care provider stating that the omeprazole (Prilosec) which he was recently prescribed is ineffective. The patient states, "I take it as soon as I feel heartburn coming on, but it doesn't seem to help at all." How should the nurse best respond to this patient's statement? Selected Answer: "Prilosec will help your heartburn but it's not designed to provide immediate relief of specific episodes of heartburn." Question 65 1 out of 1 points Correct A Nurse Practitioner explains to a patient that nitroglycerin patches should be applied in the morning and removed in the evening. This medication schedule reduces the potential for Selected Answer: nitrate tolerance. Question 66 1 out of 1 points Correct A 48-year-old woman who works as an office manager is prescribed metoclopramide (Reglan) for diabetic gastroparesis. The nurse will be sure to assess the patient for Selected Answer: depression. Question 67 1 out of 1 points Correct A clinic Nurse Practitioner is planning care for a 68-year-old man who has been on omeprazole (Prilosec) therapy for heartburn for some time. Regarding the patient's safety, which of the following would be a priority nursing action? Selected Answer: Coordinate bone density testing for the patient. Question 68 1 out of 1 points Correct The Nurse Practitioner is conducting a medication reconciliation of a new resident of a long-term care facility. The Nurse Practitioner notes that the resident takes allopurinol on a daily basis for the treatment of gout. What is the primary purpose of this drug? Selected Answer: To balance urate concentration and prevent gout attacks Question 69 1 out of 1 points Correct An unconscious patient has been brought to the hospital, and the Nurse Practitioner has prescribed a life-saving drug to be administered parenterally. Which of the following methods would be the most appropriate for the nurse to use when administering the medication? Selected Answer: Intravenous infusion. Question 70 1 out of 1 points Correct A Native American man who lives a traditional lifestyle is scheduled to have heart surgery. The tribal chief has requested that the tribe's medicine man perform a ritual before the patient goes to surgery. The nurse's response to this request should be Selected Answer: "As long as the ritual does not interfere with the patient's preoperative care, it will be okay." Question 71 1 out of 1 points Correct A Nurse Practitioner is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The Nurse Practitioner should anticipate that the drug will be administered Selected Answer: transdermally. Question 72 1 out of 1 points Correct A diabetic patient being treated for obesity tells the Nurse Practitioner that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the Nurse Practitioner's immediate attention? Selected Answer: Increased blood glucose Question 73 1 out of 1 points Correct The lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system? Selected Answer: Cilia sweep foreign material and mucus upward toward the trachea and larynx where they can then be swallowed. Question 74 1 out of 1 points Correct A 22-year-old male college senior has lived with a diagnosis of Crohn's disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn's disease? Selected Answer: Infliximab (Remicade) Question 75 1 out of 1 points Correct A Nurse Practitioner has been following a male patient who is taking hydralazine, clonidine, and a diuretic for hypertension. After 2 weeks of medication therapy, the patient begins to complain of numbness and tingling in his hands and feet. The Nurse Practitioner suspects that these signs or symptoms are Selected Answer: signs of peripheral neuritis. Question 76 1 out of 1 points Correct A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for? Selected Answer: Bleeding Question 77 1 out of 1 points Correct Topical inhaled alpha adrenergic blocking agents or nasal vasoconstricting decongestants should not be used chronically (5 days) because they can cause Selected Answer: rebound rhinitis/congestion Question 78 1 out of 1 points Correct A Nurse Practitioner is caring for a 70-year-old patient who is taking desmopressin (DDAVP). The patient has a history of cardiovascular disease. The nurse will prioritize the assessment of which of the following? Selected Answer: Electrolyte levels Question 79 1 out of 1 points Correct A male patient is to begin treatment for pneumonia with an albuterol (Ventolin) inhaler. The nurse will advise the patient that he will most likely experience which of the following common adverse effects of the drug? Selected Answer: Throat irritation Question 80 1 out of 1 points Correct A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by Selected Answer: decreasing the influx of sodium into neurons. Question 81 1 out of 1 points Correct Mesalamine (Asacol) is prescribed for a 22-year-old woman with Crohn disease. The nurse will discuss with the patient the possibility for which of the following adverse effects related to the new drug therapy? Selected Answer: Hair loss Question 82 1 out of 1 points Correct A patient who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess which of the following? Selected Answer: Serum phosphate level Question 83 1 out of 1 points Correct A Nurse Practitioner is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called Selected Answer: pharmacogenomics. Question 84 1 out of 1 points Correct The APRN should educate a diabetic patient that beta blockers may mask the signs and symptoms of Selected Answer: hypoglycemia Question 85 1 out of 1 points Correct A patient has been prescribed a drug that can be self-administered at home. Which of the following would be the most important information for the nurse to relate to the patient concerning selfadministration of a drug? Selected Answer: The therapeutic effects and possible adverse effects Question 86 1 out of 1 points Correct A patient has been admitted to the ICU because of multiple traumas due to a motor vehicle accident. The physician has ordered propofol (Diprivan) to be used for maintenance of sedation. Before administration of propofol, a priority assessment by the nurse would be to check for a history of Selected Answer: seizure disorders. Question 87 1 out of 1 points Correct A patient with unstable angina pectoris who is NOT controlled with a nitrate would likely benefit most from the addition of: Selected Answer: 2. Beta blocker Question 88 1 out of 1 points Correct A Nurse Practitioner who provides care for older adults is aware of the high incidence of drug interactions in this population. When educating a group of seniors about the prevention of drug interactions, the Nurse Practitioner should encourage them to Selected Answer: consult their care provider before taking new over-the-counter medications. Question 89 1 out of 1 points Correct The Nurse Practitioner's assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this? Selected Answer: "I broke out in hives and got terribly itchy when I started a new prescription last year." Question 90 1 out of 1 points Correct In which of the following patients would a Nurse Practitioner expect to experience alterations in drug metabolism? Selected Answer: A 50-year-old man with cirrhosis of the liver Question 91 1 out of 1 points Correct A 22 year old patient is transitioning from oral agents to insulin. He will be taking 20 units of lantus at bedtime and regular insulin before meals. What instructions should the NP provide about the timing and dose of regular insulin? Selected Answer: Take 1 unit of regular insulin for each 10 grams of carbohydrate to be consumed 15 minutes before each meal Question 92 1 out of 1 points Correct A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAs more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract? Selected Answer: The parietal cells of the stomach have H2 receptors but not H1 receptors. Question 93 1 out of 1 points Correct A Nurse Practitioner is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions? Selected Answer: Wear appropriate clothing and sunscreen whenever he is in direct sunlight Question 94 1 out of 1 points Correct A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation? Selected Answer: Monitor glucose levels closely Question 95 1 out of 1 points Correct A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.) Selected Answers: Heart rate Blood pressure Question 96 1 out of 1 points Correct A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia. Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.) Selected Answers: The drug does not cause sleepiness in the morning. One of the most common adverse effects of the drug is headache. It is available in both quick-onset and continuous-release oral forms. Question 97 1 out of 1 points Correct A Nurse Practitioner is caring for a 78-year-old patient with renal insufficiency and chronic heart failure who is receiving rapid infusions of high-dose furosemide. It will be a priority for the Nurse Practitioner to monitor for Selected Answer: ototoxicity. Question 98 1 out of 1 points Correct A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments? Selected Answer: Heart rate and blood pressure Question 99 1 out of 1 points Correct During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse's assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives Selected Answer: may cause nutrient deficiencies. Question 100 1 out of 1 points Correct A 70-year-old man with diabetes mellitus is taking metoprolol (Lopressor) to manage his hypertension. The nurse would be sure to instruct the patient to Selected Answer: understand the signs and symptoms of hypoglycemia. Question 101 0 out of 0 points Correct When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Selected Answer: Yes Monday, December 30, 2019 9:56:14 AM EST A patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest? Selected Answer: Take it on an empty stomach, 1 hour before or 2 hours after meals A Nurse Practitioner is providing care for a 71-year-old woman who was sponsored to emigrate from Mexico to the United States 6 months ago. Earlier this week, the woman slipped while getting off a bus and fractured her hip. How should the woman's nurse best exemplify cultural competence in the care of this patient? Selected Answer: Consider dimensions of the woman's cultural background when planning care. A diabetic patient being treated for obesity tells the Nurse Practitioner that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the Nurse Practitioner's immediate attention? Selected Answer: Increased blood glucose A Nurse Practitioner is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called Selected Answer: pharmacogenom ics. An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for Selected Answer: falls. A 39-year-old African-American male is 25 pounds overweight and has been diagnosed with hypertension after three consecutive above-normal blood pressure readings. The most likely initial drug therapy for this patient will be Selected Answer: a diuretic. A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain? Selected Answer: Administer a tablet under his tongue and repeat the action in 5 and 10 minutes if the pain has not subsided A Nurse Practitioner working for a drug company is involved in phase III drug evaluation studies. Which of the following might the Nurse Practitioner be responsible for during this stage of drug development? Selected Answer: Administering investigational drugs to patients After a recent history of shortness of breath that has become increasingly severe, a woman has been prescribed ipratropium by MDI while she undergoes a diagnostic workup. What patient teaching should the nurse provide to this patient? Selected Answer: "Make sure that you take this at the scheduled times, regardless of whether you feel short of breath." Which of the following patients is most likely to benefit from the administration of an adrenergic agonist? Selected Answer: A man who is in cardiogenic shock following a myocardial infarction A 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this patient's statements? Selected Answer: "Taking too many laxatives can make your bowels dependent on them, making you more susceptible to constipation." A Nurse Practitioner who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients? Selected Answer: An obese male client who is a heavy alcohol user and who has cirrhosis of the liver During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse's assessment reveals that the patient has been taking over-the- counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives Selected Answer: may cause nutrient deficiencies. A 29-year-old female patient has been prescribed orlistat (Xenical) for morbid obesity. The nurse is providing patient education concerning the drug. An important instruction to the patient would be to Selected Answer: omit the dose if the meal does not contain fat. A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings? Selected Answer: The man may be experiencing nephrotoxic effects of aspirin The Nurse Practitioner is prescribing Salmeterol (Serevent) inhaler for a patient with asthma. What instructions would be correct to provide the patient? Selected Answer: "This is a long acting medication for your asthma and should be used once every 12 hours" You are seeing a 55 year old patient recently diagnosed with a bleeding ulcer. What should be the initial treatment choice for this patient? Selected Answer: A Proton Pump Inhibitor A patient has been prescribed a drug that can be self-administered at home. Which of the following would be the most important information for the nurse to relate to the patient concerning self-administration of a drug? Selected Answer: The therapeutic effects and possible adverse effects A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family doctor. What effect will the patient's smoking status have on the therapeutic use of theophylline? Selected Answer: The patient may require higher doses of theophylline than a nonsmoker The Nurse Practitioner is treating a patient that takes frequent doses of antacids for his heartburn and is also taking an enteric coded aspirin. What instructions should be provided to the patient? Selected Answer: The medications should be taken at least 2 hours apart. A 22 year old patient is transitioning from oral agents to insulin. He will be taking 20 units of lantus at bedtime and regular insulin before meals. What instructions should the NP provide about the timing and dose of regular insulin? Selected Answer: Take 1 unit of regular insulin for each 10 grams of carbohydrate to be consumed 15 minutes before each meal A patient is being treated for respiratory infection. He is a recovering alcoholic and has impaired liver function. The nurse will instruct the patient to be especially cautious when taking Selected Answer: an elixir. A 68-year-old man complains of a chronic, nonproductive cough. He states that he has to have relief, that he has been coughing every 2 to 3 minutes, and he is worn out. Dextromethorphan is prescribed for him. Before he leaves the clinic he asks how long it will take for the medicine to work. The nurse will advise him that he should experience therapeutic effects in Selected Answer: 15 to 30 minutes. A 47-year-old woman has been diagnosed with open-angle glaucoma. Pilocarpine drops are prescribed. The nurse's assessment reveals that the patient has worn soft contact lenses for 15 years. The nurse will instruct the patient to Selected Answer: remove the contact lenses before applying the drops. A patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which of the following is an appropriate response by the nurse? Selected Answer: "Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine." A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by Selected Answer: decreasing the influx of sodium into neurons. A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAs more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract? Selected Answer: The parietal cells of the stomach have H2 receptors but not H1 receptors. A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy's diagnosis? Selected Answer: Mesalamin e A 79-year-old patient in a long-term care facility is to receive an intravenous fat emulsion. Which of the following lab values would be a priority for the nurse to assess before administration? Selected Answer: Triglyceride levels A Nurse Practitioner is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The Nurse Practitioner will question the patient about her intake of which of the following? Selected Answer: Coffe e An unconscious patient has been brought to the hospital, and the Nurse Practitioner has prescribed a life-saving drug to be administered parenterally. Which of the following methods would be the most appropriate for the nurse to use when administering the medication? Selected Answer: Intravenous infusion. A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply. Selected Answers: Is there a need for the drug in treating the presenting problem? Is this the best drug for the presenting problem? Can the patient take the prescribed drug? A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by Selected Answer: inhibiting the movement of calcium ions across the cardiac muscle cell membrane. A Nurse Practitioner has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The Nurse Practitioner notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to Selected Answer: first-pass effect. Drugs have a high potential for abuse. There is no routine therapeutic use for these drugs and they are not available for regular use. They may be obtained for "investigational use only" by applying to the U.S. Drug Enforcement Agency. Examples include heroin and LSD. Which scheduled drug is this? Selected Answer: Schedule 1 A 22-year-old male college senior has lived with a diagnosis of Crohn's disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn's disease? Selected Answer: Infliximab (Remicade) The APRN is caring for a patient taking a calcium channel blockers for hypertension. The APRN should monitor the patient for what common side effects of this medication? Selected Answer: peripheral edema, constipation, dizziness The APRN is seeing Mrs. Smith, age 77, who is here for follow up of hypertension, dyslipidemia, and depression. What should you consider during her follow-up? Selected Answer: Age-related changes in renal function are the main cause of adverse drug reactions A 55-year-old man's hypertension has not responded adequately to his current medication regimen consisting or an ACE inhibitor, a beta-blocker and a thiazide diuretic. As a result, he will soon begin taking hydralazine (Apresoline) in addition to his existing antihypertensives. The addition of this medication to his regimen means that the nurse must prioritize which of the following nursing actions? Selected Answer: Frequent assessment of the patient's cardiac status A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following? Selected Answer: How well a drug produces its desired effect A Nurse Practitioner is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the Nurse Practitioner should be aware that Selected Answer: there is a risk of systemic absorption of the lidocaine through the patient's traumatized skin. A Nurse Practitioner is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term? Selected Answer: Taking several drugs simultaneously A Nurse Practitioner is caring for a female patient who has developed atelectasis because of thick mucus secretions. The Nurse Practitioner is monitoring IV administration of acetylcysteine (Mucomyst) and notices that the patient's face is flushed. The appropriate nursing action would be to Selected Answer: slow the administration of acetylcysteine and administer diphenhydramine if ordered. Which statement is FALSE regarding the treatment of hyperthyroidism? Selected Answer: Methimazole (Tapazole) is the drug of choice for pregnant or lactating females. Topical inhaled alpha adrenergic blocking agents or nasal vasoconstricting decongestants should not be used chronically (5 days) because they can cause Selected Answer: rebound rhinitis/congestion A 58-year-old man is prescribed dicyclomine (Bentyl) for irritable bowel syndrome. In which of the following conditions is dicyclomine therapy contraindicated? Selected Answer: Glaucoma A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs? Selected Answer: Digoxin immune fab A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.) Selected Answers: Heart rate Blood pressure A 67-year-old man is admitted to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. Further assessment by the nurse reveals that the patient has a history of mild hypertension. He explains that he owns a business and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondness for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectiveness of the patient's drug therapy? Selected Answer: Vascular impairment An elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client's lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient's pulmonary edema? Selected Answer: Furosemide A female patient has been taking zafirlukast for a week and is experiencing diarrhea. The nurse should instruct her to do which of the following? Selected Answer: Drink plenty of fluids A 62-year-old woman has been prescribed a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately Selected Answer: 24 hours. A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAs more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract? Selected Answer: The parietal cells of the stomach have H2 receptors but not H1 receptors. Which of the following patients should be advised by the Nurse Practitioner to avoid over-the-counter cold and allergy preparations that contain phenylephrine? Selected Answer: A 47-year-old female with hypertension A Nurse Practitioner has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The Nurse Practitioner notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to Selected Answer: first-pass effect. A male patient is to begin treatment for pneumonia with an albuterol (Ventolin) inhaler. The nurse will advise the patient that he will most likely experience which of the following common adverse effects of the drug? Selected Answer: Throat irritation A Nurse Practitioner is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions? Selected Answer: Wear appropriate clothing and sunscreen whenever he is in direct sunlight A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy's diagnosis? Selected Answer: Mesalamine A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments? Selected Answer: Heart rate and blood pressure A Nurse Practitioner is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term? Selected Answer: Taking several drugs simultaneously A patient is bothered with nighttime episodes of bronchoconstriction related to asthma. Which of the following medications can be administered to decrease the nighttime episodes and prevent asthma attacks? Selected Answer: Leukotriene modifiers A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that Selected Answer: she must be prepared to show identification when buying a drug that contains pseudoephedrine. Mr. Lacuna is an 83-year-old resident of a long-term care facility who has a diagnosis of moderate Alzheimer disease. Mr. Lacuna's physician recently prescribed oral rivastigmine, but he was unable to tolerate the drug due to its gastrointestinal effects. As a result, he has been ordered the transdermal patch form of the medication. When administering this form of rivastigmine, the nurse should Selected Answer: apply the patch to Mr. Lacuna's back to reduce the chance that he will remove it. A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction? Selected Late Answer: afternoon A patient is being treated for respiratory infection. He is a recovering alcoholic and has impaired liver function. The nurse will instruct the patient to be especially cautious when taking Selected Answer: an elixir. A Nurse Practitioner is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The Nurse Practitioner should anticipate that the drug will be administered Selected Answer: transdermal ly. A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient's drug therapy? Selected Answer: Increased abdominal pain and vomiting A Nurse Practitioner is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning. The Nurse Practitioner administers colchicine intravenously in order to Selected Answer: avoid aggravating the gastrointestinal tract. A patient has been prescribed an oral drug that is known to have a high first- pass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells? Selected Answer: Administering the drug intravenously rather than orally An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for Selected Answer: falls. To maximize the therapeutic effect of diphenoxylate HCl with atropine sulfate, the nurse will instruct the patient to take the medication Selected Answer: four times a day. • Question 72 1 1 out of 1 points Decongestants are recommended to use in which of the following patients? Selected Answer: patients with otitis media A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient's medication regimen. Which of the patient's medications should prompt the nurse to teach her to avoid drinking grapefruit juice? Selected Answer: Atorvastatin (Lipitor) • 1 out of 1 points The Nurse Practitioner is following up on a patient who is experiencing acute asthma problems. Albuterol (Proventil) by metered-dose inhaler (MDI) has been ordered as treatment. Which patient response would indicate to the family nurse practitioner that the patient understands how to take the medication? Selected Answer: “I will take 1 puff of the medication and then wait a minute before taking the second puff.” A Nurse Practitioner is providing care for a 71-year-old woman who was sponsored to emigrate from Mexico to the United States 6 months ago. Earlier this week, the woman slipped while getting off a bus and fractured her hip. How should the woman's nurse best exemplify cultural competence in the care of this patient? Selected Answer: Consider dimensions of the woman's cultural background when planning care. A Nurse Practitioner is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the Nurse Practitioner take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment? Selected Answer: Carefully assess the patient for infections A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse? Selected Answer: "This schedule allows rest periods so that adverse effects are decreased but the anti-inflammatory effects continue." A diabetic patient being treated for obesity tells the Nurse Practitioner that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the Nurse Practitioner's immediate attention? Selected Answer: Increased blood glucose Which of the following patients should be advised by the Nurse Practitioner to avoid over-the-counter cold and allergy preparations that contain phenylephrine? Selected Answer: A 47-year-old female with hypertension A 22 year old patient is transitioning from oral agents to insulin. He will be taking 20 units of lantus at bedtime and regular insulin before meals. What instructions should the NP provide about the timing and dose of regular insulin? Selected Answer: Take 1 unit of regular insulin for each 10 grams of carbohydrate to be consumed 15 minutes before each meal What critical piece of information is missing from the following medication order: Amoxicillin 250 mg every 8 hours? Selected Answer: Route A Nurse Practitioner is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a patient who has just been admitted. What is the most likely goal of this intervention? Selected Answer: To convert the patient's atrial fibrillation to normal sinus rhythm A Nurse Practitioner is teaching a patient about his newly prescribed drug, colchicine, for gout. The Nurse Practitioner will instruct the patient to avoid which of the following foods? Selected Answer: Shrim p Which of the following is TRUE about long acting beta agonist use in asthma patients? Selected Answer: It can be combined with an inhaled corticosteroid to improve asthma control A Nurse Practitioner is caring for a patient who is taking digoxin and a loop diuretic. Which of the following would be most important for the Nurse Practitioner to monitor? Selected Answer: Potassium levels A 70-year-old man with diabetes mellitus is taking metoprolol (Lopressor) to manage his hypertension. The nurse would be sure to instruct the patient to Selected Answer: understand the signs and symptoms of hypoglycemia. Topical inhaled alpha adrenergic blocking agents or nasal vasoconstricting decongestants should not be used chronically (5 days) because they can cause Selected Answer: rebound rhinitis/congestion A patient with mild low back pain has been advised to take acetaminophen. The nurse will inform him that excessive intake of acetaminophen may result in Selected Answer: liver damage. A 77-year-old man's chronic heart failure is being treated with a regimen of quinapril (Accupril) and furosemide (Lasix). Which of the following assessment findings would suggest that the loop diuretic is contributing to a therapeutic effect? Selected Answer: The man's chest sounds are clear and his ankle edema is lessened. Shirley, age 58, has been diabetic for 7 years. Her blood pressure for the last three office visits have been 154/100, 144/94, and 144/90. What would you prescribe today during her routine office visit? Selected Answer: An ACE Inhibitor A Nurse Practitioner is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for which of the following? Selected Answer: Increase in plasma concentration of lovastatin A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation? Selected Answer: Monitor glucose levels closely A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments? Selected Answer: Heart rate and blood pressure A patient has been prescribed lovastatin for a high cholesterol level. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it Selected Answer: inhibits cholesterol syntheses. A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following? Selected Answer: Nausea A 72-year-old female patient is prescribed ipratropium aerosol for pulmonary emphysema. The nurse will instruct her to "test spray" the new metered-dose inhaler (MDI) three times before using it to prevent which of the following? Selected Answer: Paradoxic acute bronchospasm A 22-year-old male college senior has lived with a diagnosis of Crohn's disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn's disease? Selected Answer: Infliximab (Remicade) A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by Selected Answer: inhibiting the movement of calcium ions across the cardiac muscle cell membrane. A Nurse Practitioner is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports "dizzy spells and weakness" and feels that the drug is no longer effective. The Nurse Practitioner suspects that the change in the effectiveness of the drug is related to Selected Answer: the impact of the warmer climate on the patient's physical state. A child with sinusitis has been on antibiotics for seven days and his symptoms are not improving. All of the following are opt