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1. The nurse understands the differences between COX-1 and COX-2 inhibitors, in that ibuprofen is more likely than celecoxib to cause which adverse effect?
a. Fever
b. Constipation
c. Peptic ulcers
d. Metallic taste |
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2. A nurse is administering gold, a disease-modifying antirheumatic drug, to a client. Which should the nurse monitor carefully?
a. Hypertension
b. Blood in urine
c. Peripheral edema
d. Respiratory depression |
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3. When teaching the client who is receiving allopurinol, what should the nurse encourage the client to do?
a. Eat more meat.
b. Increase vitamin C intake.
c. Have annual eye examinations.
d. Take medication 2 hours before meals. |
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4. A client is admitted to the hospital with an acute gout attack. The nurse expects that which medication will be ordered to treat acute gout?
a. colchicine
b. allopurinol
c. probenecid
d. sulfinpyrazone |
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5. A client is taking aspirin for arthritis. Which adverse reaction should the nurse teach the client to report to the health care provider?
a. Tinnitus
b. Seizures
c. Sinusitis
d. Palpitations |
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6. The nurse is teaching a client about taking aspirin. Which are important points for the nurse to include? (Select all that apply.)
a. Advising client to avoid alcohol while taking aspirin
b. Instructing client to take aspirin before meals on an empty stomach
c. Instructing client to inform dentist of aspirin dosage before any dental work
d. Instructing client to inform surgeon of aspirin dosage before any surgery
e. Suggesting that aspirin may be given to children for flu symptoms |
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7. A client is taking infliximab (Remicade) and asks the nurse what side effects/adverse reactions to expect from this drug. The nurse lists which side effects? (Select all that apply.)
a. Fatigue
b. Headache
c. Chest pain
d. Renal damage
e. Severe infections |
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1. A client is receiving amoxicillin (Amoxil). The nurse knows that the action of this drug is by which process?
a. Inhibition of protein synthesis
b. Alteration of membrane permeability
c. Inhibition of bacterial cell-wall synthesis
d. Alteration of synthesis of bacterial ribonucleic acid |
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2. Amoxicillin (Amoxil) is prescribed for a client who has a respiratory infection. The nurse is teaching the client about this medication and realizes that more teaching is needed when the client makes which statement?
a. “I should not take my medication with food.”
b. “I will take my entire prescription of medication.”
c. “I should report to the physician any genital itching.”
d. “I should report to the health care provider any excess bleeding.” |
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3. A client is prescribed dicloxacillin (Dynapen). The nurse plans to monitor the client for which side effect/adverse reaction?
a. Seizures
b. Renal failure
c. Hypertension
d. Hemolytic anemia |
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4. A client is taking cefoperazone (Cefobid). The nurse anticipates which appropriate nursing intervention(s) for this medication? (Select all that apply.)
a. Monitoring renal function studies
b. Monitoring liver function studies
c. Infusing IV medication over 30 minutes
d. Monitoring client for mouth ulcers
e. Advising client to take medication with food |
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5. A client has been prescribed cefaclor (Ceclor). The nurse knows what fact about this medication?
a. It has a normal adult dose of 2 grams q6h.
b. It has a common side effect of hypotension.
c. It has an intramuscular administration route.
d. It is used to treat respiratory infections. |
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6. Penicillin G (Pentids) has been prescribed for a client. Which nursing intervention(s) should the nurse include for this client? (Select all that apply.)
a. Collect C & S prior to first dose.
b. Monitor client for mouth ulcers.
c. Instruct client to limit fluid intake to 1000 mL/day.
d. Have epinephrine on hand for a potential severe allergic reaction. |
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7. A client is prescribed cephradine (Velosef). The nurse should follow which nursing implication(s)? (Select all that apply.)
a. Report seizures to the health care provider.
b. Advise client to eat yogurt to prevent a superinfection.
c. Monitor client for an allergic reaction especially after first and second dose.
d. Advise client to take medication on an empty stomach even if GI distress occurs.
e. Culture infected area prior to first dose of medication. |
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1. A client is taking azithromycin (Zithromax). The nurse should apply which interventions? (Select all that apply.)
a. Monitor periodic liver function tests.
b. Dilute with 50 mL for IV administration.
c. Tell the client to report any hearing loss.
d. Instruct the client to report evidence of superinfection.
e. Teach the client to take oral drug 1 hour a.c. or 2 hours p.c.
f. Avoid antacids from 2 hours prior to 2 hours after azithromycin administration. |
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2. The nurse closely monitors the client taking lincosamides for which serious adverse effect?
a. Seizures
b. Ototoxicity
c. Hepatotoxicity
d. Pseudomembranous colitis |
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3. The nurse enters a client's room to find that his heart rate is 120, his BP is 70/50, and he is flushed. Vancomycin (Vancocin) is running IVPB. The nurse interprets this as a severe adverse effect of “red man syndrome.” What should the nurse do?
a. Stop the infusion and call the laboratory.
b. Reduce the infusion to 10 mg/min.
c. Encourage the client to drink more oral fluids up to 2 L/day.
d. Report to health care provider the onset of Stevens-Johnson syndrome. |
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4. The nurse is administering tetracycline (Vibramycin) to a client. Which would be appropriate teaching?
a. Take sunscreen precautions when at the beach.
b. Take an antacid or milk with the drug to prevent severe GI distress.
c. Obtain frequent hearing tests for early detection of hearing loss.
d. Obtain frequent eye checkups for early detection of retinal damage. |
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5. A client is taking levofloxacin (Levaquin). The nurse knows that which is true regarding this drug?
a. Administered IV only
b. May cause hypertension
c. Classified as an aminoglycoside
d. Adverse reaction includes dysrhythmias |
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6. What should the nurse include when teaching a client about gentamicin (Garamycin)? (Select all that apply.)
a. Client should report any hearing loss.
b. Client must use sunscreen.
c. IV gentamicin will be given over 20 minutes.
d. Client will be monitored for mouth ulcers and vaginitis.
e. Peak levels will be drawn 30 minutes prior to IV dose.
f. Client should increase fluid intake. |
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7. The nurse acknowledges which nursing intervention(s) for the client taking ciprofloxacin (Cipro)? (Select all that apply.)
a. Obtain culture prior to drug administration.
b. Tell the client to avoid taking Cipro with antacids.
c. Monitor the client for hearing loss.
d. Encourage fluids to prevent crystalluria.
e. Infuse IV Cipro over 60 minutes.
f. Monitor blood glucose, as Cipro can decrease effects of oral hypoglycemic. |
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1. Sulfasalazine (Azulfidine) has been ordered for a client. The nurse knows that this drug is most effective against which organisms?
a. Escherichia coli and Clostridium
b. Neisseria gonorrhoeae and H. Influenzae
c. Pseudomonas aeruginosa and Helicobacter pylori
d. Enterococcus faecium and Staphylococcus aureus |
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2. A client is taking sulfasalazine (Azulfidine). What should the nurse teach the client to do?
a. Drink at least 10 glasses of fluid per day.
b. Monitor blood glucose carefully to avoid hyperglycemia.
c. Avoid operating a motor vehicle as this drug may cause drowsiness.
d. Take this drug with an antacid to decrease the risk of gastrointestinal distress. |
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3. The nurse is teaching a client about sulfadiazine (Microsulfon). Which directive should the nurse include in the teaching?
a. Avoid caffeine during sulfonamide treatment.
b. Administer in 50 mL of fluid over 30 minutes.
c. Avoid sulfonamides during the third trimester of pregnancy. |
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4. A client is ordered to take trimethoprim-sulfamethoxazole (Bactrim). The nurse knows to expect which common adverse reaction?
a. Bronchospasm
b. Dysrhythmias
c. Pseudomembranous colitis
d. Stevens-Johnson syndrome |
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5. A client is taking a sulfonamide for an acute urinary tract infection. Which medication does the nurse realize is a short-acting sulfonamide?
a. sulfasalazine (Azulfidine)
b. sulfadiazine (Microsulfon)
c. sulfamethoxazole (Gantanol)
d. co-trimoxazole/TMP-SMZ (Bactrim) |
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6. The nurse is teaching the client about trimethoprim-sulfamethoxazole (Bactrim). Which directives should be included in the teaching? (Select all that apply.)
a. Report any bruising or bleeding immediately.
b. Report any diarrhea or bloody stools promptly.
c. Report any fever, rash, or sore throat promptly.
d. Avoid unprotected exposure to sunlight.
e. Report thirst and polyuria immediately. |
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1. A client is beginning isoniazid and rifampin treatment for tuberculosis. The nurse gives the client which instruction?
a. Do not skip doses.
b. Take the drugs t.i.d. with food.
c. Take an antacid with the drugs to decrease GI distress.
d. Take rifampin initially, and then begin isoniazid after 2 months. |
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2. A client taking isoniazid is worried about the side effects/adverse reactions. The nurse realizes that which is a common adverse reaction of isoniazid?
a. Ototoxicity
b. Hepatotoxicity
c. Nephrotoxicity
d. Optic nerve toxicity |
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3. The nurse teaches the client taking amphotericin B to report which signs and symptoms to the health care provider?
a. Blindness
b. Loss of hearing
c. Nephrotoxicity
d. Stevens-Johnson syndrome |
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4. A client with a diagnosis of intestinal amebiasis develops severe nausea, vomiting, fever, facial flushing, slurred speech, tachycardia, hypotension, and palpitations. A beginning assessment reveals that the client has just had several alcoholic beverages. The nurse should obtain a drug history for which drug?
a. bacitracin (Baci-IM)
b. fluconazole (Diflucan)
c. metronidazole (Flagyl)
d. ethambutol (Myambutol) |
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5. A client has developed vaginal candidiasis. The nurse knows that which medication is appropriate treatment for this condition?
a. terconazole (Terazol-3)
b. haloprogin (Halotex)
c. terbinafine (Lamisil)
d. tolnaftate (Aftate) |
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6. A client has been diagnosed with tuberculosis and is to begin the antitubercular medications isoniazid, rifampin, and ethambutol. What should the nurse do? (Select all that apply.)
a. Encourage periodic eye examinations.
b. Instruct client to take medications with meals.
c. Suggest that client take antacids with medications to prevent GI distress.
d. Advise client to report numbness and tingling of hands or feet.
e. Alert client that body fluids may develop a red-orange color.
f. Teach client to avoid direct sunlight and to use sunblock. |
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1. A client is diagnosed with HSV-3. The nurse understands that this illness is better known by which name?
a. Chicken pox
b. Hepatitis B
c. Shingles in an adult
d. Cytomegalovirus |
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2. Zanamivir (Relenza) is ordered for a client. The nurse knows that this drug is intended for which purpose?
a. Treatment of HSV-2
b. Oral administration for treatment of HSV-1
c. Treatment of varicella-zoster viruses
d. Administration within 48 hours of onset of symptoms to be effective |
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3. A client who is taking acyclovir asks the nurse about the drug. Which instruction should the nurse include in client teaching?
a. Restrict fluids to prevent complications.
b. Monitor blood pressure for hypertension.
c. Stevens-Johnson syndrome is an adverse effect.
d. Importance of frequent CBC, BUN, and creatinine tests. |
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4. A client with a history of malaria, presently being treated with chloroquine, is admitted to the hospital. What should the nurse advise the client to do?
a. Get frequent hearing checks.
b. Take antimalarials before meals.
c. Get frequent testing of stool specimens.
d. Check heart rate before taking drug to ensure 60 or above. |
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5. A client is taking thiabendazole. What does the nurse realize about this drug?
a. The drug is given for 7 days.
b. The drug should be avoided if the client has renal disease.
c. Family members should be checked for the same disease.
d. Proper hygiene must be taught to avoid the spread of disease. |
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6. Acyclovir (Zovirax) has been ordered for a client with genital herpes. Which nursing interventions are appropriate for this client? (Select all that apply.)
a. Monitor BUN and creatinine.
b. Monitor client's BP for hypertension.
c. Administer IV acyclovir over 30 minutes.
d. Advise client to maintain adequate fluid intake.
e. Teach client to perform oral hygiene several times a day.
f. Monitor client's CBC, especially WBC, platelets, hemoglobin, and hematocrit. |
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1. For the client who is crushing nitrofurantoin (Macrodantin) tablets, what should the nurse teach the client to do?
a. Expect the urine to turn blue.
b. Keep the urine acidic by drinking milk.
c. Rinse the mouth after oral nitrofurantoin to avoid teeth staining.
d. Take an antacid with oral nitrofurantoin to avoid gastrointestinal distress. |
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2. The client complains about a burning sensation and pain when urinating. The nurse knows that which is an appropriate urinary analgesic?
a. tolterodine (Detrol)
b. oxybutynin (Ditropan)
c. bethanechol (Urecholine)
d. phenazopyridine (Pyridium) |
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3. A client is taking the urinary antiseptic methenamine mandelate (Mandelamine) for a UTI. The nurse realizes that this drug should not be given concurrently with which other drug to avoid potential crystalluria?
a. ertapenem (Invanz)
b. ciprofloxacin (Cipro)
c. nalidixic acid (NegGram)
d. trimethoprim-sulfamethoxazole (Bactrim) |
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4. A client is receiving solifenacin succinate (VESIcare). The nurse knows that this drug is used to treat which condition?
a. Chronic cystitis
c. Urinary tract spasms
d. Urinary tract infection
b. Overactive bladder |
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5. The client is taking tolterodine tartrate (Detrol). The nurse should teach the client to report which condition?
a. Alkaline urine
b. Urinary retention
c. Excessive tearing
d. Reddish orange urine |
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6. The nurse is caring for a client taking nitrofurantoin (Macrodantin). Which are appropriate nursing interventions for this client? (Select all that apply.)
a. Monitor urinary output and urine specific gravity.
b. Monitor the client for peripheral neuropathy.
c. Advise the client to wear protective clothing to prevent photosensitivity.
d. Warn the client to avoid excess exposure to sunlight.
e. Inform the client that urine may turn a harmless brown color. |
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1. A client has been prescribed HAART therapy following a laboratory test that indicated an increasing viral load. The client reports that he's glad to have a choice of medications from which to choose so he will have an easier time with daily medications. What should the nurse's response include?
a. Education about the importance of using multiple medications concurrently
b. Written information about the scheduling of his medications with meals
c. Support and encouragement for the client's readiness for treatment
d. Guidelines for follow-up laboratory monitoring and clinic appointments |
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2. A client who has been taking antiretroviral treatment for 6 months indicates increasing difficulty managing the daily dosing and remembering to take the medications at frequent but inconvenient times throughout the day. In discussing the plan of treatment with the health care team, what should the nurse recommend?
a. Consulting with the dietician to manage food and medication management for greatest efficacy
b. Monitoring the client's laboratory values more frequently
c. Asking the client to bring a significant other to the next appointment to help monitor medication management
d. Using a single daily dose of coformulated medication |
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3. During routine prenatal testing, a client was newly diagnosed with HIV infection. To help prevent perinatal transmission of HIV to the fetus, what should the nurse do?
a. Provide the parents with contact information for the local AIDS support group.
b. Educate the client about the risks of HIV disease to her unborn child.
c. Notify the CDC of the client's diagnosis.
d. Provide written and oral education about the use of antiretroviral therapy during pregnancy. |
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4. During a routine visit, a client asks how she is supposed to follow all the blood values in her laboratory results. She wonders if she will ever understand how to tell that her condition is improving as a result of her prescribed antiretroviral medications. The nurse explains that which is the best lab value to track to see results of antiretroviral treatment?
a. Serum creatinine level
b. CD4 T-cell level
c. Lipids
d. Hemoglobin |
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5. When a client does not appear for her routine clinic visit, the nurse calls to ask about the missed visit. The client says, “I really don't need to come any longer. I'm so thankful I no longer have HIV.” The nurse finds that the laboratory results indicated an “undetectable” HIV viral load and that the client stopped her medication several weeks earlier. What is the nurse's best response?
a. Inform the client that she must be seen immediately because the undetectable viral load indicates that her medication stopped working.
b. Have the client reschedule the clinic visit.
c. Congratulate the client on her treatment success.
d. Educate the client about the continued need for her medications and ongoing laboratory monitoring. |
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1. The father of a 4-month-old infant calls in to the clinic reporting that his child is having a reaction to immunizations. What is the most important piece of information the nurse should elicit?
a. A list of the immunizations received
b. Whether the father has given the infant any acetaminophen
c. The signs/symptoms the infant is experiencing
d. The sites used to administer the immunizations |
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2. The nurse is preparing to administer varicella vaccine to a young woman. Which factor has the greatest implication for this young woman's care?
a. The client tells the nurse she is “deathly afraid of needles.”
b. The medical record indicates that the client is allergic to eggs.
c. The medical history indicates the client had leukemia as a young child.
d. The client appears to be pregnant. |
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3. A 38-year-old migrant farm worker presents to the clinic with a cut to his arm sustained when he reached into an “old metal drum.” The client has sutures placed, and the attending provider orders “Tdap” for him. What is the nurse's most important action in carrying out this order?
a. The nurse provides the client with a Vaccine Information Statement about Tdap in the client's primary language.
b. The nurse determines the exact date of the client's last tetanus booster.
c. The nurse documents that the client did not experience any side effects immediately following immunization.
d. The nurse provides the client with a record of the immunization administered at the visit. |
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4. The nurse is preparing to administer routine, recommended immunizations to a medically fragile 6-month-old child. What is the most important information to know about this infant?
a. The infant receives all feedings via a gastrostomy tube.
b. The infant receives inhaled steroids daily.
c. The infant received his previous round of immunizations on time.
d. The infant is not yet able to roll over. |
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5. A 61-year-old man is to receive zoster vaccine. What is essential for the nurse to discuss with this client?
a. Verify that the vaccine is being stored in a freezer maintained at ≤5° F.
b. Review the client's medication list and allergies.
c. Choose an appropriate needle length in order to administer the vaccine subcutaneously.
d. Confirm that the client has a history of chickenpox. |
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6. The school nurse is reviewing all new student immunization records and making a list of needed immunizations. It is important for the nurse to know that which of the following are live attenuated vaccines? (Select all that apply.)
a. Intranasal influenza
b. DTaP
c. MMR
d. Rotavirus
e. IPV
f. Hepatitis A |
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