Post Test Answers:

1. Which of the following medications may predispose the client to hearing loss? a. Aspirin--ototoxic b. Ampicillin c. Demerol d. Tylenol The typical acute asthmatic attack is usually due to a combination of bronchial spasm, bronchial edema, and the presence of mucoid secretions in the bronchial lumen. The client with asthma was given mucomyst for which of the following reasons? a. To decrease the viscosity of secretions. b. To encourage the movement of the secretions in the bronchi. c. To stimulate the cough reflex. d. To dilate the bronchi.

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3. Most asthmatic attacks respond to Epinephrine (Adrenalin) and it may be used as a therapeutic agent in the treatment of some allergic conditions because it: a. Improves cardiac output due to its positive inotropic effect. b. Acts as a hypertensive agent elevating BP. c. Dilates the bronchi. d. Antagonizes histamine. 4. A 78-year-old-client is taking a combination of 3 drugs: Lasix, Digoxin, and Isordil. Which of the following will be a desired, accumulative effect of the drugs? a. Constipation b. Weight loss = lasix (diuretic), digoxin (improves cardiac output), isordil (vasodilator) c. Postural hypotension d. Dizziness Propanolol (Inderal) is used in the treatment of clients with a. heart block. b. asthma. c. hyperthyroid.beta-blocker d. pulmonary edema. Which of the following types of insulin is administered IV and during emergency? a. NPH b. Regular insulin c. PZI d. Combination of Regular and NPH A manic-depressive client was placed on MAO inhibitor therapy. Which of the following foods will not be appropriate for the client? a. Fatty foods b. Coffee and tea c. Salty foods d. Vegetables A client who is suffering from Osteoarthritis is given Naprosyn (Naproxen) and asked the nurse, How does this drug help me? The PNs appropriate response would be: a. It relieves your spasm. b. It prevents demineralization of your bones. c. It strengthens bone structures. d. It relieves discomfort.

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A client is receiving Kayexalate (Sodium Polystyrene). Which of the following statements indicates that the client understands the teaching given? a. My stool will be hard. b. It will lessen the bacteria in my stomach. c. d. It will decrease the serum K level in my blood. It will decrease the Ca level in my blood.

10. All of these infants attended an infant care class with their mothers. Who among these babies can be given an oral polio vaccine? a. Annie, 5 months old, who finished her 120 ml formula an hour ago. b. Ronnie, 3 months old, who upon arriving to the clinic vomited 2X. c. Jocelyn, 6 months with oral thrush. d. Larry, 6 months, teething and drooling. 11. While the client is receiving Heparin therapy, which of these should be readily available? a. Vitamin K b. Protamine Sulfate c. Calcium Gluconate d. Magnesium Sulfate 12. Why Prednisone dosage is decreased gradually and not abruptly? a. Triggers the adrenal cortex to release ACTH to function normally. b. Costicosteroid suppression. c. Adrenal insufficiency. d. GI irritation. 13. Butch is started on Disulfiram (Antabuse) as a part of his treatment for alcoholism. He will continue this medication at home. Which of the following is contraindicated while Butch is taking Disulfiram? a. Elixir of Terpin Hydrate b. Coated Aspirin c. Bicarbonate of Soda d. Antihistamine 14. The nurse will anticipate which of the following effects when administering Epinephrine to the client who is experiencing anaphylactic shock? a. Brochoconstriction and positive inotropic effect. b. Bronchoconstriction and negative inotropic effect. c. Bronchodilation and positive inotropic effect. d. Bronchodilation and negative inotropic effect. 15. Which of the following is a potential side effect of Elavil? a. Dizziness upon getting up. b. Diuresis c. Potential addiction to the drug. d. Mental confusion 16. The nurse on the day shift receives a report which says, IV solution to be absorbed is 500 ml. The IV is infusing at 75 ml/hr. At the end of the shift at 3:30 PM, which of the following amount should be reported to the incoming shift as IV to be absorbed? a. 100 ml b. 300 ml c. 600 ml d. 900 ml

17. A client with schizophrenia, paranoid type, was placed on Haldol therapy due to her agitation. Which of the following is a manifestation of the side effect of major tranquilizer like Haldol? a. Unstable gait b. Extrapyrimidal side effects c. Constipation d. Nausea 18. The client who is taking Haldol is placed on drug therapy to counteract the side effects of Haldol, which drug is appropriate? a. Cogentin b. Antacid c. Vit. K d. Benadryl 19. To prevent the side effect of Decadron it must be taken with a. fluids. b. crackers. GI irritation c. empty stomach. d. high fiber diet. 20. Which of the following indicates that Cogentin is effective? a. The client has improved ability to concentrate. b. The client has decreased tremors. c. The clients BP is decreased. d. The client appears more relax and less agitated. 21. Which of the following is a side effect of Lasix? a. Increased urine output. b. Lightheadedness. c. d. K level 5.0 mEq/L. Urine specific gravity, 1.030.

22. The client is placed on Lithium Carbonate for his manic psychosis. When giving discharge teaching, the PN should include which of the following? a. Limit fluid intake to 1 L/day. b. Inform MD if client develops fatigue and drowsiness. c. Avoid foods such as aged cheese and wine. d. Avoid foods that are salty. 23. Which of the following complaints of the client would the PN suspect a side effect of Streptomycin? a. The client turns up the volume of the television. Streptomycin is ototoxic b. The client complains of burning sensation on urination. c. The client complains of nausea. d. The client complains of rashes on both hands. 24. A student nurse is assigned to an 8-month-old infant who is receiving Lanoxin that is being supplied by pharmacy in suspension form. Which of the following actions by the student nurse reflects the most accurate way of administering liquid (suspension) medication? a. Administer the medication using a teaspoon. b. Administer the medication using a dropper. c. Administer the medication using a medication cup. d. Administer the medication using a 3 ml syringe.

25. Yolanda is a 26-year-old client who is scheduled for breast biopsy. Her preop. Medications are Demerol 40 mg and Atropine 0.4 mg to be given in one syringe. The Demerol vial is labeled 100 mg/ml, the Atropine vial is labeled 1 mg/ml. The total volume of this injection should be: a. 0.5 ml b. 0.8 ml c. 1.1 ml d. 1.4 ml 26. Josh is to receive an antibiotic in 25 ml of IV fluids during a 40-inute period. The IV apparatus delivers 60 drops per ml. Josh should receive how many drops per minute? a. 17 to 18 25 ml X 60 gtt/ml/ 40 minutes = 37.5 b. 27 to 28 c. 37 to 38 d. 47 to 48 27. Adelle is to receive Phenergan 35 mg IM. The drug is available in ampules containing 50 mg in 1 ml of solution. Adelle should receive which of this amount of solution? a. 0.3 ml b. 0.7 ml c. 1.0 ml d. 1.4 ml 28. The doctor ordered Gravol IM 25 mg every 4 hours PRN for vomiting. The available dose is 100mg/2 ml. How much should the PN give to the client? a. 0.25 ml b. 0.50 ml c. 0.125 ml d. 5.0 ml 29. Cynthia came in with a diagnosis of mild dehydration. The physician orders IV 1 liter to be infused in 8 hours. The IV set delivers 10 drops/ml. The PN sets the IV pump at which of the following rate? a. 21 drops/min b. 30 drops/min c. 17 drops/min d. 25 drops/min 30. Which of the following medications will be most likely being ordered on the client with Atrial Fibrillation? a. Morphine Sulfate b. Digoxin c. Inderal d. Oxygen 31. A 67-year-old male client was admitted into a surgical unit because of syncope and cardiac arrhythmias. On physical assessment, the nurse noted petechiae on his trunk and bruising on his limbs. His gums are moist, spongy and bleeding easily. The PN suspects a deficiency in: a. Vitamin A b. Iodine c. Vitamin C makes iron available for formation of heme d. Iron 32. The drug of choice to treat the clients thyroid storm would be: a. Propanolol (Inderal) b. Nipedipine (Procardia) c. Verapamil (Calan) d. Quinidine (Quinidex)

33. A 70-year-old male is 5 feet, 9 tall. He was admitted with an inferior MI. His condition is stable. He reports that he drinks a six-pack of beer every night. This mans history suggests that he is predisposed to a deficiency in a. Thiamine b. Vitamin B12 c. Zinc d. Vitamin C 34. Your client is receiving Decadron (Dexamethasone). Based on your knowledge of this drug, you would question the physician if a craniotomy client is not receiving which of the following medication? a. Sodium Bicarbonate b. Morphine Sulfate c. Zantac (Ranitidine) decadron is a GI irritant d. Inderal 35. Which of the following is a side effect of Vasotec? a. Dizziness b. Headache c. Confusion d. Muscle weakness 36. The physician orders Silver Sulfadiazine (Silvadene) as a topical antibiotic treatment for a client with burn wounds. An advantage of this treatment is which of the following? a. Hardens eschar, allowing a faster recovery period. b. Is absorbed more rapidly than other topical agents. c. Acts against both gram negative and gram positive microorganisms. d. Increase granulocyte formation for efficient wound healing. 37. The international normalized ratio (INR) is used to measure the effectiveness of which of the following? a. Heparin b. Thrombolytics c. Warfarin d. Antiplatelets 38. Foods high in which vitamins can decrease the effectiveness of Warfarin (Coumadin)? a. C b. E c. K d. A 39. Who is at the greatest risk for complications while receiving anticoagulant therapy? a. A 45-year-old female with Acute MI. b. A 24-year-old patient who had prosthetic valve operation. c. An 80-year-old female with angina. d. A 70-year-old male with liver cirrhosis.Liver produces clotting factors (prothrombin) 40. Morphine Sulfate is the medication of choice in treating a client with chest pain because the drugs desired effects would be a. Morphines vasodilating properties will perfuse the heart muscles. b. Morphines vasodilating effect will promote diuresis. c. Morphine decreases cardiac contractility. d. Morphine decreases cardiac output.

41. Which of the following is a legal aspect of administration of narcotics? a. Get another nurse to witness your narcotic waste. b. The drug must be signed out in the medication record after it was administered to the client. a. Return the left-over narcotic to the locked cabinet. b. Ask a trusted colleague to administer the drug for you. 42. The PCA (patient controlled analgesia) pump on Mr. Lou was discontinued today. The nurse who discards the remaining Morphine in the PCA pump will appropriately do which of the following? a. Discontinue the IV access and discard the remaining medication. b. Discontinue the IV access; ask another nurse to witness as you discard the remaining medication. c. Keep the PCA pump running until someone is ready as you discard the remaining medication. d. Return the remaining medication to the pharmacy. 43. Enteric Coated Aspirin is an important drug during and following MI attack. The PN would question which of the following order with Aspirin? a. Coumadin.potentiates aspirin b. NTG SL. c. Digoxin. d. Lasix. 44. Twenty-four hours following burn accident, Johnny was given Morphine Sulfate to control his pain. Which of the following parameters should the PN utilize to accurately measure the clients response to drug therapy? a. How the client feels. b. Use the pain scale systemScale of 1 of 10. c. Pay attention to non-verbal cues. d. Monitor the clients vital signs. 45. Mrs. Reno was admitted in the medical until for evaluation of her elevated blood pressure. The client has been on Aldomet therapy for the last 6 months. With Aldomet therapy her blood pressure is noted to have gone up from 180/100. An informed PN is aware that the clients response to the drug therapy is known as a. synergistic reaction. b. hypersusceptibility. c. potentiating effect. d. paradoxical reaction. 46. John is a 65-year-old male client with history of Rheumatic Heart Disease and was admitted to the hospital with a diagnosis of Aortic Regurgitation. He has been fairly well until 2 weeks ago when he started to experience shortness of breath on exertion, fatigue, and inability to walk ten (10) steps on a ground level. He reports that he has to sleep with three (3) pillows to ease his breathing. Today, while waiting for the physician to evaluate him, he complained of severe excruciating chest pain. The PN who is assigned to him gave him NTG SL X3. Which of the following statement is correct about NTG administration? a. NTG SL must be taken in a sitting position. b. NTG must be taken when chest pain is experienced. c. The nurse should call the physician if the client is still in pain. d. NTG SL must be taken with sips of water. 47. A 72-year-old is admitted with cerebral arteriosclerosis, complicated by polycythemia vera, and heparin Q6H is prescribed. If the anticoagulant therapy is effective, the PN would expect: a. A PTT twice the normal value. b. An absence of ecchymotic areas. c. A decreased viscosity of the blood. d. A reduction of confusion and weakness.

48. To assess the effectiveness of a vasodilator administered to lower hypertension, the PN should take the clients pulse and blood pressure: a. Prior to administering the drug. b. Thirty minutes after giving the drug. c. Immediately after the patient gets out of bed. d. After the patient has been lying flat for 5 minutes. 49. Mr. Lou, 65 years old, with liver cirrhosis was ordered neomycin enema for which of the following goals? a. To lower the clients high BP. b. To improve the clients level of consciousness. c. To promote diarrhea. d. To correct constipation. 50. A male, Hispanic client with history of excessive alcohol-drinking, was admitted with a diagnosis of recurrent pancreatitis. On admission, the client was complaining of unbearable pain. The PN knows that the appropriate narcotic analgesic for this client would be a. Demerol. b. Morphine. c. Tylenol #3. d. Ativan. 51. The clients heart rate drops to 48 while the physician was inserting the pacemaker. The PN who is assisting the physician will anticipate a drug order of which of the following: a. Digoxin b. Lidocaine c. Atropineincreases HR d. Pronestyl 52. Following Lasix therapy on a client with heart failure, the PN would assess which of the following reflecting the desired effect of the drug: a. Electrolyte imbalance. b. Vital signs. c. Diuresis. d. Hypotension. 53. A 35-year-old female client is receiving dosed of chemotherapy. The nurse who is assigned to the client knows that one of the following is an important nursing intervention: a. Chemotherapy is given IV push. b. The client is usually NPO for 12 hours post chemotherapy to prevent vomiting. c. Use sterile gloves when administering the chemotherapy drugs. d. Administer antiemetic 30 minutes prior to the administration of the drug. 54. Following Nitroglycerin patch application, an expected outcome experienced by the client would be one of the following: a. Elevated blood pressure b. Tachycardia c. Tingling sensation d. Increased urine outputNTG is a vasodilator 55. A client is receiving furosemide (Lasix) to relieve edema. The PN should monitor the client for evidence of a. negative nitrogen balance. b. excessive retention of sodium ions. c. excessive loss of potassium ions. d. elevation of the urine-specific gravity. dehydration

56. When teaching a client about antacid therapy, the PN should include the fact that antacid tablets: a. Are taken 1 hour before meals. b. Are as effective as the liquid forms. c. Should be taken only at 4-hour intervals. d. Interfere with the absorption of other drugs. 57. A client with tuberculosis has been receiving INH as part of the chemotherapeutic therapy protocol. During a subsequent clinic visit the PN should recognize that prompt intervention is required when the client develops a. yellow sclera. INH is hepatotoxic b. orange stools. c. a temperature of 98.6F. d. a weight gain of 5 lb. 58. A client is receiving hydrochlorthiazide (HydroDUIRIL). The best method the PN can use to determine the effectiveness of this therapy is to observe the clients a. blood pressure - this is the desired effect of the drug b. absence of edema. c. serum sodium level. d. urine specific gravity. 59. In a med-surg floor you have a doctors order of Aldactone 25 mg q12h and potassium chloride 25 mg q12h. Which of the following will the PN perform? a. Give Aldactone in AM and K @ HS. b. Give both medications together. c. Question the order and recheck with doctor. aldactone is potassium-sparing d. Give Aldactone @ HS and K in AM. 60. A nurse picks up an order for an asthmatic child. The order reads: Propranolol (Inderal) 80 mg. PO QD. The PN reads this order as a. Appropriate dose. b. Contraindicated. c. Inappropriate dose. d. Indicated. 61. Your patient has pulmonary edema, which of the following would not be included in the drug management? a. Epinephrine b. Lasix c. Isosorbide dinitrate d. Morphine Sulphate 62. A manic client is being treated with lithium carbonate. The PN would correctly suggest which of the following activities for this client. a. Playing solitaire b. Basketball c. Distribution towels to other patients rooms d. Monopoly 63. Which of the following signs should the PN be aware of on a patient who is taking Prednisone? a. Melena b. Hypoglycemia c. Hyperkalemia d. Low platelet counts

64. Which of the following clients would the PN question if a narcotic analgesic medication was ordered? a. A 70-year-old client with gout b. A 24-year-old MVA client with head injury c. A 52-year-old client two days post gallbladder surgery d. A 16-year-old with rheumatoid arthritis 65. Ms. Cox is an adult patient who was prescribed depo-provera. The drug was prescribed for which of the following? a. It is a contraceptive drug given by IM injection every 3 months. b. It is a type of hormonal replacement therapy given every 3 months by IM injection. c. It is a drug that prevents osteoporosis. d. It is the drug of choice for those who are planning to get pregnant. 66. Mary Jane is 7-year-old girl who was admitted with asthma exacerbation. Admission vital signs include a HR of 120 bpm, RR 34, breathing was wheezy on auscultation, Temp 99.5F. Based on the admission assessment, the PN will expect which drug will be ordered on the patient ASAP? a. Intal b. Ventolin c. Mucolytics d. Solumedrol IV 67. Mrs. Byron rushes into the ER carrying 2-year-old Amanda in her arms. She thrusts a half-empty bottle of aspirin at the nurse and states that he saw Amanda eating them just 30 minutes earlier. After confirming that Amanda had eaten at least six tablets of aspirin, the PN should a. give her 15 milliliters of ipecac syrup and a large glass of water. b. prepare her for gastric lavage. c. catheterize her for a fresh urine sample. d. start an intravenous infusion for administration of an antidote. 68. James Brandon, 30 years old, was admitted with swelling of the right neck. He has difficulty swallowing and the doctor ordered Pen G Sodium 1 million unit every 6 hours and Solucortef 50 mg IV every 6 hours and both drugs are due at 2400 hours. A well-informed PN administers the two medications as follows a. administer Pen G at 2300 hour, Solucortef at 2400 hour. b. administer Solucortef at 2400 hour, Pen G at 0100 hour. c. administer both medications at the same time. d. administer Pen G at 2330 hour, Solucortef at 0100 hour. 69. Danielle Knetchel, 32 years old, experiences diarrhea after eating in the restaurant. She went to the clinic and the physician prescribed anti-diarrheal drug, a narcotic that causes dryness of the mouth. Which of the following drugs was given to Danielle? a. Gravol b. Immodium c. Chew lemon d. Lomotil 70. The physician ordered Lomotil 5 mg p.o. QID on Mr. Spikes for his diarrhea. Expected side effect of the drug would include: a. Urinary retention b. Decreased peristalsis c. Tinnitus d. More diarrhea 71. Diane is admitted with IDDM. She received 10 U of Regular Insulin at 0730 and had her breakfast at 0800. The PN should watch for hypoglycemic reaction at a. Between 0830 and 0930.

b. c. d.

Between 1030 and 1200. Between 1330 and 1630. Between 1930 and 2130.

72. The nurse administers prescribed pancreatin replacement therapy to Bonnie. To effectively evaluate the effect of this treatment, should expect that this medication will result to a. bulky, foul, smelly stools. b. close to normal stools. c. loose, frequent stools. d. constipation. 73. Mr. Marin, 84 years old, was admitted for surgical correction of a fractured left wrist sustained from a fall. The client has a significant past medical history of hypertension, high cholesterol, diabetes mellitus, and rheumatoid arthritis. He has been taking several medications. As the client verbalizes concerns about might not remember to take all his medications on time, the PN will include important discharge teaching which a. provides intense teaching that ensures clients compliance. b. refers the client to the visiting nurse for a follow-up visit to check on his medication. c. suggests the use of medication boxes and review the medication with the client and provide a written instruction. d. provides a list of all his prescribed medications as well as the OTC medications along with the written instructions. 74. The doctor ordered an important drug for your client, which should be administered on time. You will take one of the following actions because you have not received the drug on time: a. Try to explain to the client that you have not received the drug from the pharmacy. b. Call the pharmacy and ask them to deliver the drug ASAP and inform the physician. c. Inform the physician about the delay of the drug and ask him to re-order the drug. d. Inform your nursing supervisor. Bthe pharmacy is responsible for dispensing the medication. The physician must be informed if the ordered medication was not given on time. 75. Heparin 300 units QD was ordered to flush the PICC line. The agency PN, who is aware if she can perform the procedure, appropriately performs which of the following? a. Informs the nurse in charge. a. Asks another nurse in the unit to teach her. b. Reads the policy on PICC line care. c. Rearrange the patients assignment. A the nurse should communicate her competency to the charge nurse. The RN is legally responsible for her actions. 76. The PN documents and performs which of the following when the patient refuses his medication? a. Kardex; physician. b. Medication record; physician. c. Medication record, progress notes; informs the physician. d. Incident report form; physician. 77. After the patient has refused the medication, the next step taken by the PN will be: a. Document the patients refusal. b. Explore why the patient refuses. c. Inform the nurse-in-charge about the refusal. d. Notify the physician immediately. 78. The PN who has explored the patient reason for refusing the medication will a. Document the patients refusal. b. Inform the nurse-in-charge about the refusal.

c. Notify the physician. d. Inform the patients family. 79. Mr. Lacey is a 52-year-old male admitted due to his 2-day fever, chest pain, and productive cough. His admitting diagnosis is pneumonia and COPD stemming from emphysema. In view of his pneumonia, which of the following is the most important for the PN to ask Mr. Lacey during the admission interview? a. The type of work he does. b. Family history of respiratory problems. c. His usual sleeping habits. d. History of any allergies. D- Pneumonia is treated with antibiotics. Some patients are allergic to certain antibiotics. 80. Aminophylline IV is ordered on a client with asthma. Common side effect (s) of the drug that the PN should observe for is (are): a. Tachycardia and increase urine output. b. Bradycardia and hypotension. c. Diaphoresis. d. Constricted pupils. Atachycardia & diuresis are the two most common side effects of the drug. 81. Additional client teaching about Coumadin will include which of the following: a. The client states that he should increase his intake of fruits and vegetables while on Coumadin. b. The client states that he should stop the Coumadin when he feels dizzy. c. The client states that he should not take any medication except for his ASA while on Coumadin. d. The client states that Coumadin must be taken at the same time each day to maintain a steady blood level. CASA has an antiplatelet effect while coumadin is anticoagulant. Combination of this drugs will result to bleeding. 82. Mr. Dick Tracey improves. Hes now receiving Digoxin, 0.25 mg po daily and oxygen by nasal cannula, 2 L/min. Which of the following signs indicates the Digoxin is working? a. Increased urine output. b. Increased pulse rate. c. Decreased respiratory rate. d. Decreased blood pressure. Adigoxin increases the contraction of the heart muscles increasing cardiac output manifested by increased urine output (kidneys are perfused). 83. If your patient is receiving antiplatelet, anticoagulant, or fibrinolytic therapy, you should: a. Monitor vital signs every 4 hours. b. Perform stool tests for occult blood. c. Administer sublingual NTG as ordered. d. Obtain a daily CXR. Bbleeding is the side effects of these drugs. 84. On admission to the medical unit, the clients ECG shows a varying AV block. His serum Digoxin level is 3.2 ng/dl. The PN should expect which of the following orders? a. Withhold Digoxin dosage. b. Administer oxygen. c. Administer Atropine Sulfate. d. Assess the HR prior to administering the drug. A The patients digoxin level is abnormally elevated. 85. The physician orders regular insulin, 8U added to IV fluid on Eva with renal failure. The PN understands that this therapy is indicated for which of the following reasons?

a.

The client has diabetes.

b. Insulin will decrease the high K level of the client. c. To lower the clients high blood sugar. d. To prevent metabolic acidosis. Binsulin transports glucose, hydrogen ions, and potassium back to the cells. 86. Mr. S was involved in a skiing accident. Upon his arrival to the emergency room he was showing signs of increasing ICP. The physician ordered Mannitol IV to decrease the pressure. Which of the following nursing observations would most likely indicate that the drug is having its desired effect? a. BP decreases to 120/85. b. Urine output increases. c. Weight decreases. d. The client is more alert and symptoms of increased ICP disappeared. BMannitol has an osmotic diuretic effect.