1. Question: Administration of antiemetics with chemotherapy treatment. A patient is on a chemotherapy regimen in an outpatient clinic and is receiving a chemotherapy drug that is known to be highly emetogenic. The nurse will implement which interventions regarding the pharmacologic management of nausea and vomiting? (Select all that apply.)
2. Question: Administration of mannitol. Mannitol (Osmitrol) has been ordered for a patient with acute renal failure. The nurse will administer this drug using which procedure?
3. Question: Adverse effects and interactions with lithium. When reviewing the medication profile of a pt. With a new order for desmopressin (DDAVP) the nurse notes that a drug interaction will occur if which drug is taken with desmopressin?
4. Question: Adverse effects of ACE inhibitors. A patient who has been taking antihypertensive drugs for a few months complains of having a persistent dry cough. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs?
5. Question: Adverse effects of albuterol. Hypotension, Vascular headache, Tremor, palpitations will feel racing heart, jittery, do not use with MAOI, wheezing
6. Question: Adverse effects of antithyroid medications. When reviewing the laboratory values of a patient who is taking antithyroid drugs, the nurse will monitor for which adverse effect?
7. Question: Adverse effects of antivirals. A pt. Is taking a combination of an antiviral drugs as treatments for early stages of a viral infection. While discussing the drug therapy, the pt. Asks the nurse if they drugs will kill the virus. When answering the nurse keeps in mind which face about antiviral drugs?
8. Question: A patient who is diagnosed with shingles is taking topical acyclovir, and the nurse is providing instructions about adverse effects. The nurse will discuss which adverse effects of topical acyclovir therapy?
9. Question: Adverse effects of doxazosin. A patient has a new order for the adrenergic drug doxazosin (Cardura). When providing education about this drug, the nurse will include which instructions?
10. Question: Adverse effects of orlistat. A patient who started taking orlistat (Xenical) 1 month ago calls the clinic to report some embarrassing adverse effects. She tells the nurse that she has had episodes of “not being able to control my bowel movements” Which statement is true about this situation?
11. Question: Adverse effects with thyroid medications (Chapter 31)

A patient, newly diagnosed with hypothyroidism, receives a prescription for a thyroid hormone replacement drug. The nurse assesses for which potential contraindication to this drug?

12. Question: Antibiotic for treatment for CRE: (Chapter 39)

A patient has been diagnosed with carbapenemase-resistant Enterobacteriaceae (CRE). The nurse expects to see orders for which drug?

13. Question: Black box warnings are used for what? The U.S. Food and Drug Administration has issued a warning for users of antiepileptic drugs. Based on this report, the nurse will monitor for which potential problems with this class of drugs?
14. Question: Bone marrow suppression and early s/s of infection. The nurse is monitoring a patient who has severe bone marrow suppression following antineoplastic drug therapy. Which is considered a principal early sign of infection?
15. Question: Calculations of pediatric dosages of opioids. When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations?
16. Question: Chemoreceptor trigger zone, vomiting center, and antiemetics. Chemoreceptor (CTZ) -the area of the brain that is involved in the sensation of nausea and the action of vomiting. Vomiting center - the area of the brain that is involved in stimulating the physiologic events that lead to nausea and vomiting. Antiemetics – drugs given to relieve nausea and vomiting. Example ondansetron (Zofran) Hydroxyzine (Vistaril) antihistamine for nausea, Dronabinol (Marinol) stimulates appetite for AIDS pt
17. Question: Classes of drugs that are CNS stimulants (Ch 13). (Chemical structural similarities, amphetamines, serotonin agonists, sympathomimetics, xanthines)

The nurse is reviewing the use of central nervous system stimulants. Which of these are indications for this class of drugs? (Select all that apply.)

18. Question: Considerations with moderate sedation. A patient is being prepared for an oral endoscopy, and the nurse anesthetist reminds him that he will be awake during the procedure but probably will not remember it. What type of anesthetic technique is used in this situation?
19. Question: Contraindications for males taking nitrates (Chapter 35 Males health Drugs). A 73-year-old male patient is in the clinic for a yearly physical and is asking for a prescription for sildenafil (Viagra). He has listed on his health history that he is taking a nitrate for angina. The nurse is aware that which problem may occur if sildenafil is taken with a nitrate?
20. Question: Contraindications for enoxaparin. The nurse is reviewing new medication orders for a patient who has an epidural catheter for pain relief. One of the orders is for enoxaparin (Lovenox), a low–molecular-weight heparin (LMWH). What is the nurse’s priority action?
21. Question: Decongestants and rebound congestion. A gardener needs a decongestant because of seasonal allergy problems and asks the nurse whether he should take an oral form or a nasal spray. Which of these is a benefit of orally administered decongestants?
22. Question: Desmopressin is used for what. The nurse notes in a patient’s medication history that the patient has been taking desmopressin (DDAVP). Based on this finding, the nurse interprets that the patient has which disorder?
23. Question: Diabetes drug and the Gila monster. Exenatide was approved by the FDA in 2005 as the first incretin mimetic drug. Exenatide (byetta, bydureon) is a long-acting analogue of GLP-1.

All mimemtics are subcutaneous injections only for type 2 DM

24. Question: Differences between general and local anesthetics (ch 11). General anesthesia involves complete loss of consciousness and loss of body reflexes, including respiratory muscles. It requires mechanical or manual ventilation support to avoid brain damage and suffocation (death from respiratory arrest).

Local anesthesia does not involve paralysis of respiratory function bit only elimination of pain sensation in the tissues innervated by anesthetized nerves,

25. Question: Digoxin contraindications and signs of toxicity (chapter 24). When a patient is experiencing digoxin toxicity, which clinical situation would necessitate the use of digoxin immune fab (Digifab)?
26. Question: Dose limiting effects of cisplatin/ When giving cisplatin (Platini-AQ), the nurse is aware that the major dose-limiting effect of this drug is which condition?
27. Question: Doxorubicin and daunorubicin review (Ch. 46 Chemo Drugs/Antineoplastic).A patient is receiving doxorubicin (Adriamycin) as part of treatment for ovarian cancer. Which nursing diagnosis is related to this antineoplastic drug?
28. Question: Drug interactions with sulfonamide treatment. The nurse is reviewing the medication history of a patient who will be taking a sulfonamide antibiotic. During sulfonamide therapy, a significant drug interaction may occur with which of these drugs or drug classes? (Select all that apply.)
29. Question: Educating patients about new medications and scheduling doses (CH 6). Watch for adverse effects, take them at the same time every day, don’t skip a dose or double dose. Inform health care provider of other medications you are currently taking for contraindications and drug-drug interactions. Be informed about the therapeutic effects of the medications and when to contact a health care professional in case of a severe reaction.
30. Question: Educating patients on taking iron supplements. A nurse is giving instructions to a patient who will be receiving oral iron supplements. Which instructions will be included in the teaching plan?
31. Question: Example of subjective data in patient assessment. The nurse is performing an assessment of a newly admitted patient. Which is an example of subjective data?
32. Question: Flunitrazepam and substance abuse. The nurse is presenting a substance-abuse lecture for teenage girls and is asked about “roofies.” The nurse recognizes that this is the slang term for which substance?
33. Question: How digoxin immune fab (Digifab) is dosed for digoxin overdose chapter 24. A patient has been taking digoxin at home but took an accidental overdose and has developed toxicity. The patient has been admitted to the telemetry unit, where the physician has ordered digoxin immune Fab (Digifab). The patient asks the nurse why the medication is ordered. What is the nurse’s best response?
34. Question: Interactions with Phenobarbital. The barbiturate phenobarbital is prescribed for a patient with epilepsy. While assessing the patient’s current medications, the nurse recognizes that interactions may occur with which drugs? (Select all that apply.)
35. Question: Limitation time frame for nasal decongestants. The nurse will instruct patients about a possible systemic effect that may occur if excessive amounts of topically applied adrenergic nasal decongestants are used. Which systemic effect may occur?
36. Question: Lithium levels that are therapeutic. A 22-year-old patient has been taking lithium for 1 year, and the most recent lithium level is0.9 mEq/L. Which statement about the laboratory result is correct?
37. Question: Long term management of insomnia with eszopiclone. A patient has experienced insomnia for months, and the physician has prescribed a medication to help with this problem. The nurse expects which drug to be used for long-term treatment of insomnia?
38. Question: Malignant hyperthermia--signs and symptoms. During the immediate postoperative period, the Post Anesthesia Care Unit nurse is assessing a patient who had hip surgery. The patient is experiencing tachycardia, tachypnea, and muscle rigidity, and his temperature is 103° F (39.4° C). The nurse will prepare for what immediate treatment?
39. Question: Management of diabetes for pregnant women. The nurse is teaching a review class to nurses about diabetes mellitus. Which statement by the nurse is correct?
40. Question: Management when patients need thyroid replacement hormones. A patient, newly diagnosed with hypothyroidism, has received a prescription for thyroid replacement therapy. The nurse will instruct the patient to take this medication at which time of day?
41. Question: Meaning of half life. The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which sentence defines a drug’s half-life?
42. Question: Medication management of peripheral neuropathy. A patient is receiving gabapentin (Neurontin), an anticonvulsant, but has no history of seizures. The nurse expects that the patient is receiving this drug for which condition?
43. Question: Minoxidil (Rogaine) uses and population that uses it. A patient asks about using minoxidil (Rogaine) for hair thinning. Which statement about minoxidil is accurate?
44. Question: MOA of dopamine modulators. Only one drug is currently known to function as a dopamine modulator: Amantadine (Symmetrel). First known use was for treating influenza type A and is now used for Parkinson’s Disease.
45. Question: Most commonly and initially prescribed drug for Diabetes Mellitus Type II. A patient has been diagnosed with metabolic syndrome and is started on the biguanide metformin (Glucophage). The nurse knows that the purpose of the metformin, in this situation, is which of these?
46. Question: Nitroglycerin patch education. When applying transdermal nitroglycerin patches, which instruction by the nurse is correct?
47. Question: Nurse management of patients on diuretics. A 79-year-old patient is taking a diuretic for treatment of hypertension. This patient is very independent and wants to continue to live at home. The nurse will know that which teaching point is important for this patient?
48. Question: Nursing diagnosis for plan of care; newly diagnosed patient with diabetes. The nurse is writing a nursing diagnosis for a plan of care for a patient who has been newly diagnosed with type 2 diabetes. Which statement reflects the correct format for a nursing diagnosis?
49. Question: Nursing management of patients taking somatropin. A 16-year-old boy who is taking somatropin comes into the office because he had an asthma attack during a race at school. Because of this new development, the nurse expects which intervention to occur next?
50. Question: Opioid risks and adverse effects (slide 33) Chapter 10. CNS Depression leads to respiratory depression. (most serious adverse effect) respirations less than 10. Nausea and vomiting, urinary retention, diaphoresis, flushing. Pupil constriction (miosis) Constipation, itching Contraindications (patient to take into extreme caution): Respiratory insufficiency, elevated cranial pressure. Morbid obesity or sleep apnea, paralytic ileus, pregnancy.
51. Question: Oral contraceptives interactions. The nurse is counseling a woman who will be starting rifampin (Rifadin) as part of antitubercular therapy. The patient is currently taking oral contraceptives. Which statement is true regarding rifampin therapy for this patient?
52. Question: Oral contraceptives most closely duplicate the female menstrual cycle. When considering the various types of contraceptives drugs the nurse is aware that which type most closely duplicates the normal hormonal levels of the female menstrual cycle?
53. Question: Pediatric medication calculation process Calculate based on weight of child. Mg/Kg/day
54. Question: Pharmacologic management of patients receiving chemotherapy. A patient is on a chemotherapy regimen in an outpatient clinic and is receiving a chemotherapy drug that is known to be highly emetogenic. The nurse will implement which interventions regarding the pharmacologic management of nausea and vomiting? (Select all that apply)
55. Question: Phases of clinical trials & what occurs with each one (CH 4 pg 53). During discharge patient teaching, the nurse reviews prescriptions with a patient. Which statement is correct about refills for an analgesic that is classified as Schedule C-III?
56. Question: Prevention of medication errors. The nurse is reviewing medication errors. Which situation is an example of a medication error?
57. Question: Prophylactic antibiotics. A patient will be having oral surgery and has received an antibiotic to take for 1 week before the surgery. The nurse knows that this is an example of which type of therapy?
58. Question: Review chemotherapy precautions with cyclophosphamide. May lead to hemorrhagic cystitis; therefore document baseline urinary patterns and any abnormal symptoms. Note hydration before administering (hydration maintained to minimize this effect). Sudden onset of hematuria with bladder pain and discomfort. Can affect both good and bad cells in the body, may cause leukemia or myelodysplasia, make sure to inform your doctor about any over the counter medications, vitamins, DO not take aspirin, DO not get vaccinations, hazardous to fetus and do not breastfeed.
59. Question: Review QSEN of Lab Values related to coagulation modifiers. PT, aPTT used to monitor heparin therapy levels and TT assess blood clotting functions and times in pt. Normal lab values are
60. Question: Rifampin interactions (CH 41 Antitubercular drugs)
61. Question: Risk for development of C. diff. The nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today the patient tells the nurse that the nurse that he has watery diarrhea since the day before and is having abdominal cramps. His oral temperature is 101^o F (38.3^oC). Based on these findings, which conclusion will the nurse draw?
62. Question: Risk for infection with ANC of 500, 1000, & 1500. - Occurs between 10-28 days after treatment/depending upon drug(s)
63. Question: Risks and adverse effects for older adults prescribed opioids. Constipation, respiratory distress, opioid addiction, breakthrough pain may occur an opioid tolerance Last resort
64. Question: Safe management of patients taking long-acting insulin. Ensure they adhere to new insulin treatment regimen. Avoid garlic supplements or large amount of garlic Lantus and Levemir are long-acting. When the nurse teaches a skill such as self-injection of insulin to the pt. The best way to teach them is?
65. Question: Side effect of entacapone. A patient taking entacapone (Comtan) for the first time calls the clinic to report a dark discoloration of his urine. After listening to the patient, the nurse realizes that what is happening in this situation?
66. Question: Steroid topical ointment used for which kind of dermatological issues Pilocarpine is used topically to reduce intraocular pressure in pts. With glaucoma. Topically applied adrenergic nasal decongestants can cause palpitations. Topical acyclovir used for genital herpes; watch for adverse effect of burning when applied Minoxidil (Rogaine) used for thinning hair

Mupirocin (bactroban) used for impetigo skin infections and staphylococcal (MRSA) Fluorouraxil (efudex) cream used for treatment of basal cell carcinoma

67. Question: Teaching for patients taking digoxin. Digoxin can cause seeing colors around lights if levels are toxic. Be aware of visual problems and bradycardia, headache, dizziness, confusion. AVOID Bran muffins. A patient is taking digoxin (Lanoxin) and a loop diuretic daily. When the nurse enters theroom with the morning medications, the patient states, “I am seeing a funny yellow color around the lights.” What is the nurse’s next action?
68. Question: Teaching for patients taking oral bisphosphonate alendronate. The nurse is providing patient teaching about the oral bisphosphonate alendronate (Fosamax). Which statement by the patient indicates a good understanding of when this drug should be taken?
69. Question: Teaching principles for educating patients on newly prescribed medications. Which nursing diagnosis is appropriate for the patient who has just received a prescription fora new medication?
70. Question: Therapeutic response to oral antidiabetic drugs. When monitoring a patient’s response to oral antidiabetic drugs, the nurse knows that which laboratory result would indicate a therapeutic response?
71. Question: Treatment for acute asthma attack Chapter (37). A patient is in an urgent care center with an acute asthma attack. The nurse expects that which medication will be used for initial treatment?
72. Question: Treatment for impetigo skin infection. A child has been diagnosed with impetigo, a skin infection. The nurse anticipates that which drug will be used to treat this condition?
73. Question: Treatment for opioid withdrawal. A patient in a rehabilitation center is beginning to experience opioid withdrawal symptoms. The nurse expects to administer which drug as part of the treatment?
74. Question: Treatment options for ear infections. The nurse is administering eardrops that contain a combination of an antibiotic and a corticosteroid. What is the rationale for combining these two drugs in eardrops?
75. Question: Uses for cyclopentolate solution (Cyclogyl) pg.895. Cyclopentolate solution (Cyclogyl) is used primarily as a diagnostic mydriatic and cycloplegic drug. Unlike atropine, it is not used to treat uveitis.
76. Question: What are the risks for patients receiving opioids via a PCA?
77. Question: What happens when phenytoin (Dilantin) is given via a dextrose solution? The nurse is giving an intravenous dose of phenytoin (Dilantin). Which action is correct when administering this drug?
78. Question: What would you do if you gave a patient an overdose of an antihypertensive oral medication?
79. Question: When a thrombolytic or an antifibrinolytic is used. A patient will be receiving a thrombolytic drug as part of the treatment for acute myocardial infarction. The nurse explains to the patient that this drug is used for which purpose?
80. Question: When is it appropriate for anorexiants to be prescribed?
81. Question: Ziprasidone (Geodon) is used for treatment of which disorders? See Drug Book
82. Question: Adverse effects for antifungal: Amphotericin B and Voriconazole. During therapy with amphotericin B, the nurse will monitor the patient for known adverse effects that would be reflected by which laboratory result? During an intravenous (IV) infusion of amphotericin B, a patient develops tingling and numbness in his toes and fingers. What will the nurse do first?
83. Question: What type of translator can we use? During an admission assessment, the nurse discovers that the patient does not speak English. Which is considered the ideal resource for translation?