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NURS 676 FINAL EXAM APRN WCU
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Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient's physician has prescribed quinine along with an adjunctive drug. The nurse should the physician's order if the patient has a history of osteoporosis or low bone density. chronic obstructive pulmonary disease (COPD). diabetes mellitus. cardiac arrhythmias.
A pregnant patient asks the Nurse Practitioner what over-the-counter medication she can take for recurring headaches. The nurse should recommend aspiri n. advil. tyleno l. motri n. A Nurse Practitioner 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 electrocardiogram (ECG). electromyelogram (EMG). electroencephalogram (EEG). electrophysiologic study (EPS). A Nurse Practitioner is caring for a 64 - year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient's laboratory test results and
finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered? Coumadin Alteplase Ticlopidine Protamine sulfate
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 breast cancer. cancerous breast tenderness. pain in the heart. PMS.
A postmenopausal patient is prescribed bisphosphonates to treat osteoporosis. The nurse will instruct the patient to take the drug at bedtime. after meals. at any time of the day with tea or coffee. first thing in the morning.
Which test should the NP order for monitoring effectiveness of the patient receiving heparin? Arterial blood gas levels PTT Complete blood count Hemoglobin level
A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor which of the following? Visual function Blood counts Pap test results Liver function
A 21 - year-old has been placed on risperidone. Monitoring for risperidone includes Bradykinesia, akathisia and agitation Excessive weight gain Hypertension Potentially fatal agranulocytosis
A patient who is at risk for DVT tells the NP she has just learned she is pregnant. The NP should expect that this patient will use which of the following anticoagulant medications? Aspirin Heparin Dabigatr an Warfarin
When a NP chooses a benzodiazepine to treat anxiety the prescriber needs to be aware of the possibility of dependence. The Benzodiazepine associated with the greatest likelihood of causing rapid dependence is: Chlordiazepoxide (Libri um) Clonazepam (Klonopin)
Alprazolam (Xanax) Oxazepam (serax)
A male patient is taking finasteride for BPH. Which of the following will the nurse evaluate at each clinic visit? Serum cholesterol levels Bone growth Hemoglobin levels Urinary elimination patterns
What schedule class of drug is Hydrocodone? I II III IV
Which of the following would a Nurse Practitioner assess for in a patient who is taking polymyxin B systemically? Peripheral neuropathy Nephrotoxicity and hepatotoxicity Hyperkalemia and hyponatremia Endocarditis and hypertension
A school nurse has been teaching high school students about the risks associated with marijuana use. However, the nurse has been met with considerable skepticism on the
Count) Liver Function profile 24 hour urine
Terazosin (Hytrin) is classified under which of the following drug class: beta blockers tricyclic blockers alpha blockers calcium channel blockers
Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain and burning during the infusion by slowing the infusion. decreasing the volume used for dilution. decreasing the total volume of the primary IV infusion. administering a dose of 2 units of bleomycin before carmustine.
Drugs have a valid medical use but a high potential for abuse, both psychological and physiologic. In an emergency, a Schedule 2 drug may be prescribed by telephone if a written prescription cannot be provided at the time. However, a written prescription must be provided within 72 hours with the words authorization for emergency dispensing written on the prescription. These prescriptions cannot be refilled. A new prescription must be written each time. Examples include certain amphetamines and barbiturates. This is scheduled drug Schedule 1 Schedule 2 Schedule 3 Schedule 4
The NP is reviewing Mrs. Oglethorpe's medication list and recognizes that which drug listed below has been associated with increased risk for MI in women? Aspirin Beta blockers Lipid lowering agents Estrogen replacement
@QUIZ 28
Which of the following agents would not be expected to cause nausea, vomiting, Flushing, dizziness, headache, and abdominal discomfort after consumption of alcohol? Cefotetan Chlorpropami de Metronidazol e Fomepizole
Morphine has been prescribed for a 28 - year-old man with severe pain due to a back injury. The nurse will advise the patient to avoid dairy products. fatty foods. alcohol. vitamin C.
Jennifer, the Nurse Practitioner, is seeing Mr. Johns, a 65 year old male in the clinic today with c/o Arthritis pain. What is a serious side effect of ibuprofen use in the older adult patient?
A 38 - year-old pregnant patient admits to the Nurse Practitioner that she is an alcoholic and has been consuming alcohol during her pregnancy. The nurse knows that using alcohol during pregnancy may result in a child who presents with a high-pitched cry. microcephaly. an electrolyte imbalance. thrombocytopenia.
An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with ciprofloxacin. clindamycin. vancomycin. an antistaphylococcic penicillin.
@QUIZ 36
A patient has endocarditis and is taking gentamicin. The Nurse Practitioner will be sure to monitor which of the following? Potassium level Creatinine clearance Serum albumin level Prothrombin time
A 6 - month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug? That the infant's skin has greater permeability than that of an adult That there is less body surface area to be concerned about That there is decreased absorption rates of topical drugs in infants
That there is a lower concentration of water in an infant's body compared with an adult
A male patient is trying to decide if he should use finasteride (Proscar) to treat benign prostatic hypertrophy (BPH). When providing information about the drug, the nurse will include which of the following as a risk associated with finasteride therapy? Excess fluid volume related to potential effects of drug therapy Hypercalcemia related to drug therapy, immobility, and breast cancer Sexual dysfunction related to erectile dysfunction Prostatic neoplasia
Baby Jasmine is a 5 mth old breastfed infant with a fever. Treatment for her fever may include: Acetaminophen suppository "baby" aspirin Ibuprofen suppository Alternating acetaminophen and ibuprofen
A 66 - year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the APRN is responsible for facilitating this new aspect of the patient's drug regimen. This will involve the administration of weekly subcutaneous injections. daily, oral administration. weekly administration of an enteric coated tablet. daily, outpatient intravenous therapy.
Phenytoin decreases folic acid absorption by Altaring in the pH of the stomach
The nurse practitioner, Jill, is deciding what medication to put her patient on. She recognizes that the mechanism of action of triptans is as: a Selective serotonin receptor agonist A dopamine antagonist A vasoconstrictor An inhibitor of leukotriene synthesis
When planning care for a patient who is receiving filgrastim (Neupogen) for a nonmyeloid malignancy, the nurse should formulate which of the following patient outcomes? (Select all that apply.) The patient will not develop an infection. The patient will not experience bone pain. The patient will be able to self-administer filgrastim at home. The patient will not develop febrile neutropenia. The patient will not retain fluid.
What is the best initial treatment plan for a sleep disorder in the older adult patient? Medicate with amitriptyline (Elavil). Medicate with trazodone (Desyrel). Decrease noise and light in the environment Discuss the importance of naps daily.
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 cool the medication prior to administration. use sterile technique when applying the medication.
allow the child to apply the medication if possible. use clean technique only when applying the medication.
A 46 - year-old man is receiving a quinupristin/dalfopristin IV infusion for a life-threatening infection. Which of the following would be most important for the nurse to monitor? Increased heart rate Breathlessness Infiltration, edema, or phlebitis at the infusion site Nausea and vomiting
A Nurse Practitioner will instruct a patient taking allopurinol to take each dose at night. first thing in the morning. after a meal. before a meal.
A Nurse Practitioner is assessing a patient who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the patient for which of the following? Diabetes mellitus Hypertension Leukopenia Hypoglycemia
An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman's pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient's pain?
I did not make drugs have a little effect when administered: Orally Intramuscula rly Intravenously By inhalation
Ms. Shackleford Has been placed on Ambien to help for her insomnia. The NP must educate the patient regarding the rapid onset of Ambien. Which statement below is correct? Zolpidem should be taken just before going to bed Zolpidem may cause dry mouth and constipation They may need to double the dose for effectiveness They should stop drinking alcohol at least 30 minutes before taking zolpidem
A 71 - year-old man has just been prescribed finasteride (Proscar). Which of the following complaints by this patient most likely indicated a need for this drug? "My urine is extremely concentrated lately and it smells strong." "To be honest, I find that I can't get an erection for the past few months." "My urine's been cloudy for the last little while and it burns when I go to the bathroom." "Lately, I have to get up three or four times a night to go to the bathroom."
A 30 - year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4 - day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis? Ciprofloxacin is safe to use in pregnancy and the patient may use to same dose and route as a nonpregnant patient. The use of ciprofloxacin is contraindicated in pregnancy.
It is safe for the patient to use topical ciprofloxacin but the oral route is potential teratogenic. The patient will require a lower dose and longer course of ciprofloxacin than a nonpregnant, adult patient.
Mr. Lepp is a 63 - year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse's response to Mr. Lepp? Epoetin alfa is normally contraindicated in patients who are receiving radiotherapy or chemotherapy. Treatment with epoetin alfa will likely begin 4 to 6 days before Mr. Lepp's first round of chemotherapy and continue indefinitely. The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients. Mr. Lepp's oncologist should have begun treatment with epoetin alfa immediately after he was diagnosed.
A child is taking permethrin for head lice. The Nurse Practitioner will instruct her mother to wash her hair daily with a good shampoo. increase her daily intake of milk. maximize the child's fluid intake. stop using creams, ointments, and oils on the child's skin and scalp.
Some drugs are given to patients using other routes such as sublingual or topical to avoid movement through the liver and possible side effects. Which of the following effects is the Nurse Practitioner attempting to avoid by administering certain medications via alternative routes? Prodrug effect Plasma concentration-time curve effect First-Pass effect Drug-receptor interaction effect
Drink plenty of water every day Take the tablets before bedtime Avoid red meat
The recommended treatment for trichomoniasis is Flagyl. Diflucan. Amoxicillan. Meclizine.
A 67 - year-old man who is being treated for prostate cancer is taking epoetin alfa. The nurse will instruct the patient to stop taking the drug after a 2 - week period. schedule an appointment to measure hemoglobin twice a week for at least 2 to 6 weeks. schedule an appointment to check if the patient has a high WBC count. begin taking a calcium channel blocker to treat hypertension, which usually develops as an adverse effect of epoetin alfa therapy.
Which antibiotic is most frequently associated with "Red man Syndrome" Rifampin Vancomycin Amphotericin B Ciprofloxacin
Which of the following oral agents has the most rapid analgesic onset?
Naproxen (Naprosyn) Liquid ibuprofen (Motrin, Advil) Diclofenac (Voltaren) Enteric coated naproxen (Naproxen EC)
A child with chronic allergic symptoms uses an intranasal steroid for control of symptoms. At this child's annual well-child checkup, the NP should carefully review what? blood pressure weight and height liver function tests urinalysis
A 66 - year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this patient would most likely contraindicate the use of tadalafil for his ED? The patient takes allopurinol for the treatment of gout The patient has a family history of osteoporosis and has undergone bone density testing The patient has unstable angina and uses a nitroglycerin patch The patient often takes ginseng when he gets a common cold
A Nurse Practitioner is working with a 16 - year-old pregnant teen and assessing for behavior that may put the baby at risk. The most important assessment the nurse can make is whether the pregnant woman uses illegal substances. whether the pregnant woman has health insurance. the pregnant woman's exercise habits.
