epoetin alfa (Epogen)

which of the following are correct statements to include in patient teaching about antihistamine use?  (more than 1)

a. antihistamines are best tolerated when taken with meals

b. the pt. can suck on hard candy or chew gum if he/she experiences dry mouth

c. the main adverse effect of antihistamines is drowsiness

d. OTC meds are generally safe to use with antihistamines 

a. antihistamines are best tolerated when taken with meals

b. the pt. can suck on hard candy or chew gum if he/she experiences dry mouth

c. the main adverse effect of antihistamines is drowsiness

a pt asks the nurse for advice about one of the newer antihistamines that does not cause drowsiness. 
Which of these drugs is appropriate?

a. loratadine (Claritin)

b. diphenhydramine (Benadryl)

c. dimenhydrinate (Drammamine)

d. meclizine (Antivert) 

which drugs are considered first-line drugs for the treatment of nasal congestion?

a. antihistamines such as diphenhydramine

b. decongestants such as naphazoline

c. antitussives such as dextromethorphan

d. expectorants such as guaifenesin 

when giving an antitussive, the nurse remembers that they are used primarily to

a. relieve nasal congestion

b. thin secretions to ease removal of excessive secretions

c. stop th ecough reflex when the cough is nonproductive

d. suppress productive and nonproductive coughs 

which teaching is appropriate for the pt receiving an expectorant

a. avoid fluids for 30-35 min after the dose

b. force fluids, unless contraindicated, to aid in expectoration of sputum

c. avoid driving or operating heavy machinery while taking this medication

d. expect secretions to become thicker 

a pt has been self-medicating with diphenhydramine to help her sleep.  She calls the clinic nurse to ask, "why do I feel so tired during th day after I take this pill? I get a good night's sleep!"  which statement by the nurse is correct?

a. "you are probably getting too much sleep" 

b. "you are taking too much of the drug"

c. "this drug is not really meant to help people sleep"

d. "this drug often causes a 'hangover effect' during the day after taking it" 

frequent use of bronchodilators may cause which adverse effects?  (more than 1)

a. blurred vision

b. increased heart rate

c. decreased heart rate

d. nausea

e. nervousness

f. tremors 

b. increased heart rate

d. nausea

e. nervousness

f. tremors

for pt taking leukotriene antagonist, the nurse should include which of the following in pt teaching?

a. if a dose is missed, the pt may take a double dose to maintain blood levels

b. the pt should gargle or rinse the mouth after using the inhaler

c. the medication should be taken at the first sign of bronchospasm

d. improvement should be seen within a week of use 

which drug acts by blocking leukotrienes and thus reducing inflammation in the lungs?

a. albuterol (Proventil)

b. cromolyn (Intal)

c. theophylline (Theo-Dur)

d. montelukast (Singulair)

a pt in status asthmaticus has not yet responded to epinephrine.  the nurse will expect which of the following drugs to be used next?

a. albuterol (Proventil)

b. aminophylline

c. cromolyn (Intal)

d. montelukast (Singulair) 

when a pt is taking perenteral xanthine derivatives, such as aminophylline, the nurse should monitor for which adverse effect?

a. decreased respirations

b. hypotension

c. tachycardia

d. hypoglycemia 

a pt who is taking a ß-adrenergic agonist for bronchodilation may also take which type of inhaled drug for its antiinflammatory effects?

a. corticosteroid

b. anticholinergic

c. xanthine derivative

d. antileukotriene 

when teaching a pt about the common adverse effects of therapy with NSAIDs, the nurse should mention which of the following?

a.  dizziness

b.  heartburn

c. palpitations

d. diarrhea 

a 13 y.o. teen has the flu, and her mother is concerned about her fever of 103°F.  which med should the nurse suggest the mother use to tx the teen's fever?

a. aspirin

b. acetaminophen

c. indomethacin

d. naproxen 

a pt is receiving tx with allopurinol for an acute flare-up of gout.  which statements should be included in the pt teaching? (more than 1)

a. be sure to avoid alcohol and caffeine

b. take the med with meals to prevent stomach problems

c. you need ot take this med on an empty stomach to improve absorption

d. you need to increase fluid intake to up to 3 L a day 

a. be sure to avoid alcohol and caffeine

b. take the med with meals to prevent stomach problems

d. you need to increase fluid intake to up to 3 L a day

when reviewing the HH of a pt who is to receive NSAID tx, the nurse keeps in mind that contraindications for the use of these drugs include which of the following?

a. pericarditis

b. osteoarthritis

c. bleeding disorders

d. juvenile rheumatoid arthritis 

a pt receiving gold injections as tx for arthritis should be told which of the following?

a. injections will be given via the IV route

b. the med is more effective if fluids are restricted

c. relief from symptoms can be expected in a few days

d. relief from symptoms may take 3-4 months 

a young man is in the urgent care center after experiencing a severe ankle sprain during a basketball game.  the nurse expects that which pain reliever wil be ordered for this pt?

a. ketorolac (toradol)

b. aspirin

c. indomethacin (indocin)

d. meloxicam (mobic) 

when monitoring  pts on immunosuppressant tx, the nurse must keep in mind that the major risk factor for pt taking these drugs is which of the following?

a. severe hypotension with potential renal failure

b. increased susceptibility to opportunistic infections

c. decreased platelet aggregation

d. increased bleeding tendencies 

a pt is experiencing rejection of a transplanted organ.  the nurse expects which drug to be given to manage this?

a. azathioprine

b. cyclosporine

c. muromonab-CD3

d. tacrolimus 

a pt who is taking cyclosporine calls the office to sya that he has heard that some food can increase the effectiveness of this drug.  the nurse recognizes that he is talking about which of the following?

a. dairy

b. orange juice

c. grapefruit juice

d. red wines 

when teaching pt who are taking oral doses of immunosuppressants, the nurse should instruct the pt to take them:

a. with food to min. GI upset

b. on an empty stomach to increase absorption rate

c. only when adverse effects are tolerable

d. with antacids 

pt teaching for those taking immunosuppressants should include which of the following?  select all that apply

a. the mouth and tongue should be inspected carefully for white patches

b. allergic reactions to theses drugs are rare

c. pt should avoid crowds to min. the risk of infection

d. pt should report any fever, sor throat, chills, or joint pain 

a. the mouth and tongue should be inspected carefully for white patches

c. pt should avoid crowds to min. the risk of infection

d. pt should report any fever, sor throat, chills, or joint pain

which of the following is the only immunosuppressant currently indicated for the tx of MS?

a. glariramer acetate (copaxone)

b. azathioprine (imuran)

c. basiliximab (simulect)

d. daclizumab (zenapax) 

the immunity that is passed from a mother to her nursing infant through antibodies in breast milk is known as which type of immunity?

a. artificially acquired passive immunity

b. naturally acquired passive immunity

c. active immunity

d. genetic immunity 

which of the following contain substances that trigger the formation of antibodies against specific pathogens?

a. antivenins

b. serums

c. toxoids

d. vaccines 

when reviewing various immunizing drugs, the nurse recalls that some products provide longlasting immunity against a particular pathogen.  an example would be

a. poliovirus vaccine, live oral

b. tetanus immune globulin

c. Rh₀(D) immune globulin

d. black widow spider antivenin 

the nurse is preparing to give a second dose of DTaP vaccine to a 6 month old infant.   the infant's mother tells the nurse that the last time he received this vaccination, the injection site on his leg became warm, slightly swollen, and red.  the nurse's best response would be:

a. to explain that these effects can be expected and give the med

b. to give half the prescribed dose this week and the other half next week if tolerated well

c. to skip the dose and notify the physician

d. wait 6 months and then administer the dose 

a nurse has been stuck by a used needle while starting an IV line.  which preparation is used as a prophylaxis against disease after exposure to blood and body fluids?

a. Hib vaccine

b. Rh₀(D) immune globulin

c. Hepatitis B immune globulin

d. hepatitis  antitoxin

active/passive and purpose

varicella virus vacine (Varivax) 

active/passive; purpose

Haemophilus influenzae type b conjugate vaccine (Hib) 

active/passive; purpose

Recombivax, HB 

active/passive; purpose

RhoGAM, MICRhoGAM 

passive; postpartum antibody suppression

Rh- exposed to Rh+ 

active/passive; purpose

BCG vaccine 

active/passive; purpose

DTaP 

active/passive; purpose

Tetanus immune globulin 

active/passive; purpose

Td 

when administering antineoplastic drugs, the nurse needs to keep in mind that the general adverse effects of these drugs include which of the following?

a. bone marrow suppression

b.  infertility

c. diarrhea

d. urinary retention

e. nausea and vomiting

f. stomatitis 

a. bone marrow suppression

b.  infertility

c. diarrhea

e. nausea and vomiting

a pt will be receiving chemotherapy with paclitaxel.  what should the nurse expect to do along with administering this drug?

a. administer platelet infusions

b. provide acetaminophen as needed

c. keep the pt on npo status  b/c of expected n/v

d. premedicate with a steroid and antihistamine 

as the nurse is preparing to give the pt chemotherapy, the pt asks the nurse why more than one drug is used.  the nurse should explain that combos of chemo drugs arfe used to:

a. prevent drug resistance

b. reduce the incidence  of adverse effects

c. decrease the cost of tx

d. reduce tx time 

if extravasation of a neoplstic drug occurs, what should the nurse do first?

a. remove the IV cath immediately

b. stop the drug infusion without removing the IV cath

c. aspirate residual drug or blood from the tube if possible

d. administer the appropriate antidote 

during chemo, the nurse should monitor the pt for symptoms of stomatitis, such as which of the following?

a. indigestion and heartburn

b. severe vomiting and anorexia

c. ulcerations of the mouth

d. diarrhea dn perianal irritation 

while hanging a new infusion bag of a chemo drug, the nurse accidentally spills a small amt of soln on the floor.  the nurse's best action would be which of the following?

a. let it dry then mop the floor

b. wipe the area with a paper towel

c. use a spill kit to clean the area

d. ask the housekeeping dept to wipe the floor 

a pt is receiving leucovorin as part of his chemo regimen.  the nurse expects that the pt is receiving which antineoplastic drug?

a. bleomycin

b. cisplatin

c. dactinomycin

d. methotrexate 

a pt receiving chemo for a testicular tumor complains of hearing a "loud ringing sound" in his ears.  the nurse expects that which of the following will happen next?

a. the tx will continue as ordered

b. the tx will be stopped until the pt's hearing is evaluated

c. the tx will be withheld for a day, then resumed

d. the tx will be stopped until renal studies are performed. 

when teaching a pt who is receiving outpt chemo about potential problems, the nurse needs to mention signs and symptoms of an oncologic emergency, which include which of the following?

a. swollen tongue

b. blood in the urine

c. temp of 100º  or higher

d. chills

e. alopecia

f. nausea and vomiting 

a. swollen tongue

b. blood in the urine

c. temp of 100º  or higher

d. chills

the nurse monitors very closely for signs of liver toxicity when which antineoplastic drug is given?

a. doxorubicin

b. cisplatin

c. bevacizumab

d. hydroxyurea 

a pt who has cancer is to receive a course of chemo with doxorubicin.  which coexisting condition will require very close monitoring while the pt is taking this drug?

a. hypertension

b. DM

c. gout

d. cardiomyopathy 

during a marathon, a runner had to drop out after 16 mi. b/c of severe muscle spasms.  this type of pain is classified as which of the following?

a. chronic pain

b. somatic pain

c. visceral pain

d. superficial pain 

a young man has been taken to the ED b/c of a suspected OD of morphine tabs.  which drug may be used to tx this OD?

a. meperidine (demerol)

b. naproxen (naprosyn)

c. aspirin

d. naloxone HCl (narcan) 

an anticonvulsant drug has been ordered as part of a pt's pain management program.  the purpose of the anticonvulsant in this case is to

a. produce sleep

b. prevent seizures

c. relieve neuropathic pain

d. reduce anxiety 

moderate to severe pain is best treated with which of the following?

a. acetaminophen (tylenol)

b. opioid antagonists

c. benzos

d. opioid analgesics 

which of the following should be included in an assessment before giving an opioid analgesic?

(more than 1)

a. blood clotting times

b. the level of pain rated on a scale

c. prior analgesic use (time, amt, effectiveness)

d. dietary hx

e. allergies 

b. the level of pain rated on a scale

c. prior analgesic use (time, amt, effectiveness)

e. allergies

examples of adjunctive drugs used w/ anesth. include which of the following? (1+)

a. sedatives-hypnotics

b. anticonvulsants

c. anticholinergics

d. inhaled  gas

e. opioid analgesics 

a. sedatives-hypnotics

c. anticholinergics

e. opioid analgesics

lidocaine is frequently used for which of the following?

a. spinal anesth

b. local anesth

c. IV anesth

d. general anesth 

the nurse monitoring a pt after sx keeps in mind that the primary concern w/ use of an NMBA is which of the following?

a. respiratory arrest

b. HA

c. bradycardia

d. HTN 

to decrease the possibility of a HA after spinal anesth, the nurse should instruct the pt to do which of the following?

a. sit in high fowler's position

b. lie flat in bed

c. limit fluids

d. engage in activity 

local anesth. is indicated for which of the following? (all)

a. cardioversions

b. suturing a skin laceration

c. diagnostic procedures

d. long-duration sx

e. dental procedures 

b. suturing a skin laceration

c. diagnostic procedures

e. dental procedures

a sudden elevation in body temp. in a pt. who has just returned from sx may indicate which of the following?

a. a normal temp. change after sx 

b. malignant HTN

c. malignant hyperthermia

d. fever 

1. small, rapidly moving muscles, such as those of the fingers and eyes

2. limbs, neck, trunk muscles

3. intercostal muscles and diaphragm 

during a class on nosocomial infections, several facts are shared.  which of the following statements about nosocomial infections are true?  (1+)

a. they are contracted in the home or community

b. they are contracted in a hospital or institution

c. ther are more difficult to tx

d. the organisms that cause these infections are more virulent 

b. they are contracted in a hospital or institution

c. ther are more difficult to tx

d. the organisms that cause these infections are more virulent

which statement accurately describes the action of antiseptics?

a. they are used to kill organisms on nonliving objects

b. they are used to kill organisms on living tiss

c. they are used to sterilize equiptment

d. they are used to inhibit the growth of organisms on living tiss 

when preparing an area of skin before a procedure, the nurse knows that whcih strenght of isopropanol (isopropyl alcohol) is most effective agst microorganisms?

a. 25%

b. 50%

c. 70%

d. 95% 

before using povidone-iodine (betadine) soln. to prepare skin for sx, the nurse should ask the pt about allergies to which of the following?

a. seafood

b. pen

c. mercury

d. milk 

if a pt is allergic to povidone-iodine, the nurse may use which agent as a surgical scrub?

a. acetic acid

b. hibiclens

c. gentian violet

d. phenol 

which agent is used to disinfect surgical instruments?

a. 5% acetic acid

b. hydrogen peroxide

c. glutaraldehyde (Cidex)

d. gentian violet 

ms p is worried about her husband, who has postsurgical nausea.  she sees that his roomate is receiving a TPN and asks "can't you do that for my husband, just while he's so nauseated?"  TPN, you explain, is to be used only when enteral support is impossible or when the

GI tract's _____ or functional capacity is insufficient 

the max concentration of dextrose in peripheral TPN infusions should be which of the following?

a. 10%

b. 20

c. 50

d. 100 

a pt has a need for a nutritional supp. that contains complex nutrients derived from proteins, carbs, and fat.  however, this pt is intolerant to milk.  which product would be most suitable for this pt?

a. casec

b. polycose

c. ensure

d. vivonex 

when monitoring a pt who is receiving TPN through a central line, the nurse should observe for complications, including which of the following?

a. pneumothorax

b. aspiration

c. hyperglycemia

d. infection

e. air embolus 

a. pneumothorax

c. hyperglycemia

d. infection

a pt who is just starting to take enteral nutrition supp. should be taught that the most common adverse effect he may experience is which of the following?

a. anorexia

b. constipation

c. diarrhea

d. flatulence 

when reviewing a pt's need for nutritional supp., the nurse remembers that peripheral TPN is most appropriate for which of the following?

a. pt who will receive short-tern TPN (<2wks)

b. pt who will receive long-term TPN (>2wks)

c. pt w/ severe nutritional problems

d. pt who wish to reduce their wt. 

NI for pt receiving enteral feedings include which of the following?

a. checking gastric residual vol. 1 x day

b. starting the infusions at eht max rate ordered

c. keeping the head of the bed flat

d. giving tube feeding formulas that are at room temp. 

3 days after beginning tx w/ oral iron tabs, a pt calls the office.  "I'm very worried b/c my bowel movements are black!"  what should the nurse do?

a. tell the pt to stop the tabs

b. tell teh pt to take the tabs every other day

c. ask the pt to come into the office for an exam

d. explain to the pt that this is an expected effect of the med. 

pt who take iron preps should be warned of the poss. adverse effects, which may include which of hte following?

a. dizziness, orthostatic hypotension

b. n, v, stomach cramps

c. drowsiness, lethargy, fatigue

d. neuropathy, tingling in the extremities 

what happens if folic acid is given to treat anemia w/out determining the underlying cause of the anemia?

a. erythropoiesis is inhibited

b. excessive levels of folic acid may accumulate, causing toxicity

c. the symptoms of pernicious anemia may be masked, delaying tx

d. intestinal intrinsic factor is destroyed 

a pt is about to receive folic acid supp. the nurse knows that indications for folic acid supp. include which of the following?  1+

a. megaloblastic anemia

b. tropical sprue

c. prevention of fetal neural tube defects

d. pernicious anemia 

a. megaloblastic anemia

b. tropical sprue

c. prevention of fetal neural tube defects

when teaching the pt about oral iron preps, the nurse will include which of the following instructions?  (all)

a. mix the liquid iron preps w/ antacids to reduce GI distress

b. take the iron w/ meals if GI distress occurs

c. liquid forms should be taken through a straw to avoid discoloration of tooth enamel

d. oral forms should be taken w/ juice, not milk 

b. take the iron w/ meals if GI distress occurs

c. liquid forms should be taken through a straw to avoid discoloration of tooth enamel

d. oral forms should be taken w/ juice, not milk

a pt asks the nurse, "what foods are good sources of iron? i know meat contains iron, but what other choices are there?"  the nurse should suggest which of the following?

a. apples

b. citrus fruits

c. wheat crackers

d. raisins 

which of the following statements accurately describes antifungal tx for topical infections?

a. the length of tx required to eradicate the organism may be from several wks to as long as a yr

b. antifung. tx works best when the affected area  is exposed to sunlight

c. oral drugs are teh preferred drugs for tx topical fungal infections

d. antifung. tx is palliative only; fungi are rarely eradicated from topical areas 

when instucting a pt on how to use suppositories for vaginal yeast infections, the nurse shoud keep in mind that

a. supposit. should be inserted every other day h.s. x 1 wk

b. supp. should be inserted 1 x day h.s. x 3 days

c. 1 x dose is admin. in a.m.

d. supp. should be inserted h.s. until symptms stop 

a pt has a painful sunburn that covers a lrg. area of the  body.  to enhanc eth pt's comfort, the nurse can suggest that which of the follwoing formulations be used for this pt's topical med?

a. aerosol spray

b. gel

c. oil

d. cream 

a pt needs a med that has excellent emollient properties.  b/c she works as a swimming coach, the med prescribed should not wash off when it comes in contact w/ water.  if ea. has the samw healing properties, which of the following formulations would be preferred for this pt?

a. aerosol spray

b. oil

c. gel

d. cream 

which of the following statements about topical antiviral drugs are true?

a. common adverse effects including stinging, itching , and rash

b. topically applied acyclovir does not cure viral skin infections but dies seem to decrease the healing time and pain

c. topically applied acyclovir can cure viral skin infections if applied as soon as symptoms appear

d. antiviral drugs are applied topically for the tx of both initial and recurrent herpes simplex infections 

a. common adverse effects including stinging, itching , and rash

b. topically applied acyclovir does not cure viral skin infections but dies seem to decrease the healing time and pain

d. antiviral drugs are applied topically for the tx of both initial and recurrent herpes simplex infections

a 22 y.o. woman is taking isotretinoin (accutane) as part of the tx for severe cystic acne.  which of the following is part of the pt teaching she will require?

a. this drug reduces acne by causeing skin peeling

b. its use is contraindicated if she is allergic to erythromycin

c. she will need to apply it twice a day to her face, after washing her face thoroughly

d. she will need to use two forms of b.c.p. while take this med.